The epidemic of the “I Know All” expert | Mikhail (Doctor Mike) Varshavski | TEDxMonteCarlo


Translator: Thành H. Châu
Reviewer: Leonardo Silva You wake up. Before you even grab your cell phone, you say, “Today is the day. Today is the day
that I’m going to be proactive. I’m going to take control of my life. I’m going to go see the doctor. I’m going to get healthy.” So you sacrifice a day off work, you sit in one-hour standstill traffic, you even wait 30 minutes
in the office to see the doctor. Finally the doctor walks in, and all of that built-up
anxiety begins to fade. In the midst of your conversation, you ask the doctor a few questions, “Doctor, what’s the healthiest diet?” You get back, “I don’t know.” You say: “Okay, doctor.
You say I have a respiratory virus. Which virus is it?” Again, you get, “I don’t know.” Your mind begins to wonder whether or not this doctor
was properly educated. Finally, you ask, “Doctor, what is the reason
that the rate of autism is increasing?” You hear, “I don’t know,”
and your frustration hits a peak. Let’s stop this hypothetical for a second. I’m going to explain to you right now
why you need not be frustrated, and instead celebrate those who are not
afraid to say, “I don’t know.” The theme of this conference
is “License To Know.” But hopefully after this talk, you’ll be proud to say that you have
a license to say, “I don’t know.” My name is Doctor Mikhail Varshavski. Like it was mentioned earlier,
most know me as Doctor Mike. I’m an actively practicing
family medicine physician out of Overlook Medical Center
in the United States. I also happen to be the most
followed doctor on social media, with 3.5 millions subscribers. This gives me unique vantage point to witness an epidemic
within the healthcare space that receives so little attention, and that’s the epidemic of IKA, the epidemic of the “I Know All” expert. There are too many
of these experts out there, claiming to have all of the answers when the rest of the scientific
community has questions. Now, this may surprise you. But you and I are both
partially, if not more so, to blame for this epidemic. When someone says to us
they don’t know, we’re quick to judge,
we’re quick to dismiss. And in even a less cognizant way,
we support them with our clicks. We click on the catchy headlines, we click and purchase
those miracle cure-all products. Within medicine, there are two specific situations
where these IKA experts flourish. The first is the gray zone. That is when a question
within the field of medicine has not yet had a complete answer
by modern science. Take the increased rate of autism. You ask an honest, up-to-date doctor,
they’ll tell you, “We don’t know.” Now, you ask an IKA expert,
they’ll throw you a theory, and they’ll do it
in a very convincing fashion, so much so that they might even further
their career in one way or another. That’s the problem with these IKA experts. The second way that they do this is they do it in moments
where good medicine has proved that tangible positive effect
is only achieved through hard work and dedication. Take diet, take exercise, take sleep. The way to improve all of these things
is through hard work. But the IKA expert
will give you a shortcut. And I’m sure many of you here today
have heard of these shortcuts. Take, for instance, the shortcut
of the miracle weight-loss diet known as the cookie diet. Or better yet, the miracle detox plan that will detoxify your body
through a juice cleanse, will boost your immune system. How do these IKA experts cause you to ignore legitimate
scientific evidence and advice and listen to their theories? They do so through stress. When your mind is stressed,
your mind is very easily influenced. There’s a great book called
The Influential Mind. And there was a great example
from this book I’d like to share with you. Take September 11th, 2001,
in New York City, one of the worst
terrorist attacks of all time. The day after those terrorist attacks, distress in New York City
has an all-time high. It takes only one person to run and scream
to get hundreds to do the same. Now, if you take that same person
one day prior to the terrorist attacks, what will you get? You’ll get a lot of New Yorkers
looking at this person running and saying, “Ah, just another crazy New Yorker.” Your mind does not respond well to stress. As a survival mechanism, your mind uses stress as a way
to be influenced by the majority. So what these IKA experts do is they throw around words
like “cancer,” “disease,” “death,” even get your family involved at times. And that’s how they get you. Now, because of my social media fame, I find myself at a very
interesting crossroads between marketing and medicine. A marketer’s job is to sell product
or to push a brand, and they do so by studying
your human psyche to figure out the best way
to accomplish that. They often pair celebrities with products
in order to get better results, because they know that when you hear
advice from a familiar face, they’ll sell more products. I’m going to be honest
with you here today. I’ve received some of these offers
in near seven-figure totals to support the IKA products. Me! Imagine what a true celebrity gets
if I’m being offered these deals. Forget that. Imagine what these companies
make from IKA products that they’re able to pay
these huge sums of money. Look, I get it. We live in a fast-paced world. We want quick answers
and even faster results. But before you go on this desperate search
for answers and shortcuts, let’s talk about what a true expert is. A true expert not only looks at the current, most up-to-date
scientific evidence, but also looks at history as a guide. How many times have you heard
doctors go back and forth on the health benefits
and risks of coffee, something we all drink every day? In 1981, the New York Times
published a study that said two cups of coffee
increase the risk of pancreatic cancer. In 2017, we claimed
that coffee extends your life. Doctors used to advocate smoking
as a stress reliever. We used to believe that bloodletting,
a.k.a letting a patient bleed out, was a way to cure an infection. This doesn’t mean
that doctors are not smart. What this means is that expert opinion is and should be
considered the lowest form of evidence. That is what our job as a true expert is:
to explain that to the general population. Take any PhD in this room
and they’ll all tell you the same thing. The more years they’ve spent
studying a subject, the more they realize they don’t know, the more questions you have, because they more questions you have, that’s the sign of intelligence. Now, look, this isn’t just
a theoretical discussion, where we’re going to talk
about philosophical change and things of that nature. I’m going to have some
practical tips for you as well. Number 1: ask better questions. A doctor prescribes a treatment
or tells you not to go for a treatment. Ask, “Hey, doc, why do I need
these antibiotics? Do I even need these antibiotics?” When an IKA expert claims there’s
a miracle cure for whatever ails you, ask how is it possible that there are
millions of doctors across the world, whose sole mission,
and it’s the same mission, to eradicate diseases
and restore optimal health, don’t agree with them. Why is it the same five IKA experts
you see appearing in documentaries, talking about doom and gloom
from all the things that ail you. Second: understand basic research. Oftentimes these IKA experts
will tout a single study, and try and convince you
of their theories. Take the recent uproar of autism
and childhood immunizations. This uproar started from a single study, with 12 subjects, which was done by a doctor who’s been discredited
and lost their license. And yet, children are dying. So it’s your job to be
aware of this research. And here I’ll tell you how to do that. Know that the best form of research
is a metaanalysis. It’s a combination
of studies, not just one, which allows for the decreased likelihood
of chance and bias within the results. Note that newer studies are not
necessarily better than older studies. Know that studies
that focus on disease markers are not nearly as good as studies
that focus on outcomes and developments of disease. And no matter what media tells you
is a breakthrough, there is no single study that will influence
the field of medicine enough to change the standard of care. It can guide us, it can put itself into the context
of the entire body of evidence. to allow us to figure out what the true results are
and what they mean. And lastly, third: do not write off health professionals
who say “I don’t know.” Instead, what you should infer
is that this doctor is self-aware, this doctor acknowledges
scientific limitations. And most importantly, this doctor is not interested
in slimming your wallet. Let’s move away from the era
of juice cleanses, and move to an era we judge doctors
not by the answers, but by the quality of their questions. Do not be afraid to say, “I don’t know.” Thank you. (Applause)