Latest / Radically Genuine / 152. Two Family Physicians Issue Warning About American Healthcare

Transcript

152. Two Family Physicians Issue Warning About American Healthcare · Radically Genuine

• Roger K. McFillin, Psy.D, ABPP (00:01.589) Welcome to the Radically Genuine Podcast. I am Dr. Roger McFillin. The business of healthcare in America is complex, misunderstood, and in crisis. Despite spending nearly twice as much on healthcare as other high -income nations, the United States ranks last in health outcomes amongst developed countries. Life expectancy in America has declined for two consecutive years, a trend not seen since World War I. Meanwhile, chronic diseases are skyrocketing with over 60 % of adults now living with at least one chronic condition. But it's not just our health that's failing. Our trust in the medical establishment is eroding at an alarming rate. A recent Gallup poll showed that only 34 % of Americans have a great deal of confidence in the medical system. That's down from 80 % in 1975. Even more concerning, trust in public health officials has plummeted during the COVID -19 pandemic. Less than half of Americans say they even trust the CDC. Today, we're going to peel back the layers on this complex system to expose the truth about American healthcare. We're going to be examining several critical issues that affect the health and wallets of every single American. We'll get into the Affordable Care Act. It was promised as a solution to our healthcare woes, but has it delivered? We'll explore how this landmark legislation has reshaped the medical landscape, its impact on family medicine and private practice in particular. The results may surprise you. The industrialization of healthcare, we've transitioned from personalized care to what many are just calling assembly line medicine. There's huge corporate influence in medicine. Who is really making the decisions about your health will follow the money from insurance companies, hospital administrators. the role of major medical organizations, of course, pharmaceuticals, really revealing how financial interests are increasingly shaping patient care. I mean, is there an illusion of an independent medical doctor at this point? The decline of independent medical practice, this is on the backbone of a lot of the legislative changes that have occurred in the country. I mean, is it now nearly impossible for a Roger K. McFillin, Psy.D, ABPP (02:24.065) physician to act independently, you know, have a separate business outside of corporate interest and having to meet the high standards, rigid standards set by the US government. So this isn't just going to be another independent medical. This isn't going to be just another healthcare discussion. I mean, we're here to challenge prevailing narratives. We have to question some of the established norms shine light on aspects of the system. that many would prefer just to keep in the shadows. I mean, if you follow corporate media, you're never really going to get an understanding of what American healthcare really is in practice. Our goal is not here to sensationalize, we're here to stimulate critical thinking and hopefully by the end of this episode, you and I will have a clearer understanding of the forces shaping healthcare, empowering all of us to make informed decisions about our health in this increasingly complex system. To have this conversation today, I'm proud to welcome doctors Tim and May Hindmarsh, who's host of a great podcast, the BS Free MD podcast. They're both experienced family practice physicians with over 30 years in small town practice covering a wide range of medical roles. With their background in family practice, hospital medicine, urgent care, they're gonna bring a wealth of information in this conversation. May, Tim, welcome to the Radically Genuine Podcast. Drs Hindmarsh BSfreeMD (03:51.33) Thanks for having us, super excited. And I was gonna add to that wonderful bio you read and Tim's wealth of, we joke, knowledge of being on every, I think, committee available in the systems that we were part of. So he's got a lot of insight, which your listeners and you will find fascinating on how our views have changed over the years with gathering that information. Absolutely. Roger K. McFillin, Psy.D, ABPP (04:18.945) Yeah, I can't wait to pick your brain. There's so many questions I personally have that I don't even understand that they don't make necessarily logical sense to me, but they've become the norm in healthcare practice. But let's just introduce the both of you to my audience. If you can give us a little bit about your, your background and how you kind of broke free from the system and why you did. Drs Hindmarsh BSfreeMD (04:20.421) Ha ha ha ha. Drs Hindmarsh BSfreeMD (04:38.616) That could take a whole episode. So, well, here's some fun facts. Maybe you don't know this yourself. So Tim and I actually were born and raised in Canada. We grew up in the Canadian healthcare system that so many people we meet nowadays worship and cherish and want the American system to be. And that has, I think a lot more faults than benefits at this point. And that really has shaped our thinking and is part of the reason how we ended up in the US. Roger K. McFillin, Psy.D, ABPP (04:40.352) You Drs Hindmarsh BSfreeMD (05:07.922) And we love to talk about that as well. having family still in that system, family members practicing medicine as my sister is still a nurse up in that system visiting my dad and my mom passed. It's horrible what's happening up there. When we were residents and in our final year of family practice residency in Edmonton, the government in Canada put out a as a way to control where doctors practice basically. And since they're the only insurance company, they basically said, we need more physicians in rural areas, and we need to control where physicians are. So what we're gonna do is not pay anybody, you need a billing number to bill the government for services. You won't get a billing number unless you stay in whatever province you did your training. And that was indefinitely, no one knew how long that would last. So all of us new grads coming out of the system at that time, in 94, as well as many others who were fed up with the system thought, this is restrictive. can I as a professional be told by a governing body where I have to actually live in the country? What other profession does that? So what happened was at the same time as more managed care was coming out in the US in the 90s and everyone needed to stop hopping from specialist to specialist and insurance companies were wanting the... family practice, internal medicine, primary care, docs to be the quarterback of the team and kind of control things. Recruitment got heavy and people fled Canada like crazy for the US. And so we were one of the two thirds of our, I think, our graduating class that left Canada, came to the US. Some went back, but many of us stayed. And so what happened was then Tim and I found the perfect little community that was very similar to how we were trained in Canada as far as the the system, the practice in rural Oregon. And we lived in a town of 8 ,000, practiced actually in two different communities and did rural family practice. And Tim did full obstetrics care as well as a family practice. I did not do obstetrics. We did hospital medicine, which included taking care of our patients in the ICU. We did rounds on our in -hospital patients. We didn't do ER down here. Drs Hindmarsh BSfreeMD (07:29.73) but it was small town, family medicine. were coroners, death investigators. We did death investigations. I mean, had one day where I actually drove to a funeral home, did a death investigation on two kids high on meth that drove into a tree after they were chased by three different police jurisdictions and then went to the hospital, delivered one of my best friend's wife's baby and then held the hand of a dying guy in the ICU that... And like that was it. We did everything. And then I got involved in leadership, was on the parent board of a seven hospital system, tons of committees. I started to see how everything worked on the insurance side, because we actually, our hospital system had two insurance lines. And then I started seeing how the government was involved in all of this stuff and how they really made the rules and steered the ship using carrots and sticks, financial carrots and sticks. And I was like, well, this is complete nonsense. because you have a bunch of people in Washington, DC, essentially patient care decisions using money. And so this void, I mean, what's the ultimate therapeutic relationship? It's where you have a connection with your physician, your therapist, whoever it is, and there's this mutual beneficial trade for getting better and connecting as human beings. Well, since we've had third pair, payment in the United States, which is essentially since the end of World War II, that void has gotten further and further and further apart. And really, the consumer of health care is the one that pays for it. And we have what, 65 % or 70 % of payments going through federal and state governments. So really, as a physician, if I take insurance, the customers that I'm taking care of are the insurance companies and the governments, not the patient. I remember, man, even back, it wasn't quite when we started, but not long after patients, older patients telling me in the old days, I used to get a bill. I would come in to see you, you'd do a visit, labs, whatever. I would get a bill and I would know how much it cost. And then of course I would submit it to my insurance company, much like we do with other things in our life, vehicles or home, owners think policies, but I would at least see what things were costing. Drs Hindmarsh BSfreeMD (09:56.054) And then, you know, I would pay my portion and send it in to insurance to get reimbursed. And now, as things have changed, they've cut out the patient completely. They have no idea. We as physicians have no idea. mean, cut to recent years when someone came into urgent care and they were like, I'm cash pay, how much does it cost for you to sew my finger up? And I'm like, I have no idea. Ask the receptionist or the billing clerk, I have no idea. You know, and then it would take two weeks to try to get ahold of someone higher up in the corporate world. And they're like, well, why do they want to know that? Well, what size is the last orationals? What stitch is like? Well, how long did and we don't have an exact idea. OK, I mean, can you imagine that's where you imagine going to a mechanic and not getting an itemized statement? I mean, I went to this I was serving on the on the parent board of this corporation. I went to the CFO and I gave him my bill and I said, tell me what I'm being charged for. It just says. you know, labs, and then there's a big number, and then it said, you know, surgery, and there's a number, and then hospital fee to the, you know, the mothership, and there's a number. I said, tell me, itemize this. I mean, if I got this bill from my mechanic that just said, mechanic stuff, oil, I would lose my mind. Roger K. McFillin, Psy.D, ABPP (11:09.235) Okay, now we need to explain this to the audience and to me personally too, because a lot of us have seen these itemized bills, these inflated costs that are being charged from like a hospital based system, which the hospital doesn't get reimbursed that money from the insurance company, but the costs itself are inflated. What is the reason for that? Drs Hindmarsh BSfreeMD (11:31.502) Because when you negotiate contracts with insurance companies, you negotiate a percentage of reasonable and customary charges or whatever the vernacular is now. So you're building in a discount. So for instance, if I have a, I mean, most hospital systems are gonna contract with 100 different insurance companies. So this is another thing people don't understand. you're billed, if you have insurance A, the hospital is getting paid a different amount of money for the exact same service if another patient has insurance B. So there's all these different, so the way they kind of funge these numbers is they, let's just say a normal vaginal delivery is $15 ,000. So they charge 15 ,000, knowing that they're only gonna collect from the insurance company like 11 ,000. And so then, you the cash pay patient gets a 10 % discount. Yeah, but you're getting a 10 % discount off of what? Off of what the insurance company would get paid or off of what the actual bill is, in which case you're actually getting screwed by 10%, you know, depending on how you look at this stuff. And so these charges get inflated and inflated, which I think is just a logical consequence of the fact that when you don't have transparency in what something costs, of course it's going to become more expensive. You can hide the costs in there. The hospital comes back and the way they rationalize this is they say, we give away hundreds of millions of dollars of care a year to the indigent, to the uninsured, people in an ER that have no care, blah, blah, blah. So we have to make the money where we can make the money, which is, know, bypasses, total joint, like that's big money stuff. Roger K. McFillin, Psy.D, ABPP (13:23.521) Okay. So you were working in a small rural town in Oregon. So you almost get to know the families pretty intimately, right? It's a small town. It's really individualized healthcare. And there's a commitment to your community. Things have really changed throughout the United States. It seems like all the independent family practices have been bought out by large hospital networks. and is the death of the independent physician. Can you explain to us the process of that? Like how and why that has occurred? Drs Hindmarsh BSfreeMD (14:01.28) Okay, so the why I'll start with, the how is really simple. The why is I think more important. The reason it's happened is if you look back, even when we started, you just had a paper chart, you saw a patient, you prescribed a medication or whatever. and you dictated into a dictaphone and somebody transcribed that and that was your note and then you sent a bill to the insurance company if the insurance company needed to make sure you actually saw the patient and wanted to make sure that your treatment was reasonable then they would request that and somebody would literally have to pull the piece of paper out photocopy it, send it to the insurance company. Okay, that's how, and that was back in the mid 90s. Well, then everything started to get more electronic. Well, then what ended up happening is you had this government regulation creep where, okay, well, you're not gonna get paid the same amount unless you can do all these extra metrics. Okay, so what are the metrics? The metrics are things like you go to the, you haven't been to your doctor in six months. and you're going in for something simple like a hangnail and they ask you, you feel safe at home? They give you a depression inventory. They ask you how many beers you drink and you know, blah, blah, blah. You know, do you have monkeypox? Like all this ridiculous stuff that you don't necessarily care about. And ultimately, in the kind of intimate practice we had where we knew everybody for decades, it's insulting. I mean, it's insulting to, you you don't need much healthcare. You go in for a simple visit and you get asked all the same idiotic questions. So they're trying to data mine, you know, and all of this started back really, really, really intensely in 2008 with the stimulus package where the federal government through Centers of Disease or CMS, Centers for Medicare Systems, Drs Hindmarsh BSfreeMD (16:03.104) implemented value -based care. So what happened with the stimulus package was the beginning of these metrics. You ask these questions, you collect this data, you send the data. If you're meeting these box ticking metrics, then you're going to get paid more. If you don't do it, you're not going to get paid more. And if you don't start doing it by a certain date, we're going to start carving money away. Roger K. McFillin, Psy.D, ABPP (16:27.945) Okay, so the doctors are incentivized to administer these range of screening measures. Drs Hindmarsh BSfreeMD (16:36.588) incentivized and punished if they don't do it because of lack of payment. And some are not just screening measures. was looking through some of the newer, mean, this Hydra continues to pop out tentacles as time goes on as any government program does. And so some of the metrics are actually reasonable. Counseling a child about obesity or something. I that's not a bad thing. It's hard to do any harm that way. But then there's other ones. If your patient has been diagnosed with heart failure, do you have them on an ACE inhibitor? Like mandating that they're on a certain medication. Roger K. McFillin, Psy.D, ABPP (17:13.441) Yeah, let me ask the question there. So it almost feels and like I get this feedback from people all the time. It's you're going into your primary care center. It's like you're being sold things. You're being sold this additional test, this additional drug, this additional vaccination. And it seems like this is like it would increase the cost of health care, not decrease the cost of health care. And a lot of people don't understand why this would be the case if If the government's role or insurance company wants to decrease the cost of healthcare, why are we pushing so many medical interventions on everybody? Drs Hindmarsh BSfreeMD (17:51.138) No, man, I it speaks to me like I've made an appointment just online because you have to check in online. Like everybody's system is now with my gynecologist office and what happens not just at the beginning, but at the end, you can't get out of the app and say your visit's confirmed until you look at all these ads for uprelvy or all these things that don't even apply to me and do you want to sign up? you want a health free? discount card and I just keep hitting no and I'm getting pissed off by the second because I have to watch 10 ads and that's just to check in for a visit. going back to you know what we were talking about as far as upfront problem is what caused me to even leave that this was in 2010 out of family practice was the fact that somebody would come in and you we were we had the ability because we knew people intimately. We are in a smaller community, so you're familiar with everything. And so it's like, yeah, I can get you in for a visit like today, this afternoon for that urgent problem, that quick, I think broken finger or your kid's got an earache. I can fit you in my schedule because that's what you wanna do is take care of your patients. But then we got blocked because now the computer's asking, but you haven't seen this person in six months. So before... you can see them for their earache, you have to check their blood pressure, talk about their cholesterol, do all these things. And now I'm like, I don't have time for that if I wanna get them in for their earache, it's not relevant, I'm trying to take care of the patient. And then we would get notes from upper management, it's like, well, you have to do that before you can get them in for their earache, because this is what insurance and the metrics are wanting. And at that point is when I pulled the plug and said, this is bullshit, this is not good care, I get there's a point to do that and have them come in. for those blood pressure discussions or checks, but not in the realm of what's happening with my patient today. And I said, if this is the way medicine is gonna be, I can't do this. I opt for going another route, which is when I went to urgent care because it hadn't affected it yet. So back in 2010 was when I had had enough of it and it was a very, very early birthing pains stage of the game. But I'm like, I can't have. Drs Hindmarsh BSfreeMD (20:05.624) corporate or insurance telling me how to take care of my patients because now I can't get you in because I know I'm gonna be stuck doing all this stuff, clicking boxes and talking about your cholesterol and your husband just died yesterday and you just wanna come in and discuss that with me and I'm not gonna have time because I'm doing all these other But just think of that insanity of trying to top down, know, Pollard Bureau, Stalinize healthcare. Okay, so somebody from church, their husband dies tragically. And it happened with some frequency in our community. It means a logging community. Bad things happen. And all you wanna do is get him in at the end of the day. But you're gonna get in crap from the CFO, who knows what, compliance manager. If you don't ask them, give them a depression inventory. Do you feel sad? Yeah, I feel sad. My husband got squished by a log and he's dead. They, you know, and this stuff, it's, it's Politburo medicine is really what it is. It's Politburo medicine. They're making it. It would be better if people had better blood pressure. Yes, it would be better, but you don't know how to treat it. You don't even know how many missiles you need in Hungary. Politburo guy. I mean, that's the part. It's so crazy when you divorce the producer and the consumer in any economic relationship, you get a disaster. And usually the disaster is terrible service that's unspeakably expensive. And I'd like to just jump in and share like two really important examples of what was the final straw for Tim. He might forget, but I remember because I remember the poor guy. You know, he was doing nursing home visits still. What year was that? 2013 and came back home, severely ticked off one day because he has this wonderful. little old lady in the nursing home who's 90, say, years old, demented, visits her, but the government is not happy that the fact that, you know, Tim's not prescribing her Lipitor anymore for her hyperlipidemia, even though she's lying there bedridden and on a bunch of medications that he's stopped because what's the point of being on Lipitor after you're 90 and demented and bedridden and, you you might not have much life expectancy and it's, so I remember that. Drs Hindmarsh BSfreeMD (22:28.598) was one thing where he's like, so I'm being punished because I think, you know, Mrs. Smith, this is not really need her lipothor, we're spending money on this, it's probably causing her more harm than good with her liver. The other was, they check up on you, now not only, you know, are they demanding that you do these things, but they have hired mid -level people, nurses, to call up the patients and say, well, you went into the doctor, and yet they were supposed to, you know, check your blood pressure, check your feet, you have diabetes and you're due for your annual foot, you know, or six months foot check, you went in to see Dr. Tim Hindmarsh because you had X problems. I can't remember what it was. Doesn't matter sore throat or some weird abdominal backache thing. And you hadn't been in for six months. He didn't do a foot exam. And so we're concerned about that. And Tim's patient said, lady, I haven't had a foot exam in 10 years because I have no feet. They're amputated. He has no legs. Roger K. McFillin, Psy.D, ABPP (23:24.428) Wow. Drs Hindmarsh BSfreeMD (23:26.718) And strangely, legs are connected to feet, generally speaking. So this is what's happening. Roger K. McFillin, Psy.D, ABPP (23:29.823) Wow. Well, let me ask you a question. Why would the government care about whether or not Lipitor is being prescribed to a patient? Drs Hindmarsh BSfreeMD (23:41.942) Well, I think the obvious answer is because Pfizer is paying the government to care that Lipitor is prescribed to the patient. I don't think that there's any other, I don't think there's any other answer. You know, I think you follow the money and then you get the answer. What did I hear that was just the, is it the stat that 80 % of the CD's, the FDA money 70 % of the FDA money is funded by pharma. mean, there's no, There's like it's it's obvious there's no. I mean. Yeah, I mean, I money money stocks. I think that's I think that that's the key, right? So but but but there's a million. There's a million layers of sediment that make it look plausibly good. OK, so in other words, well, we don't want her to have a stroke and blah, blah, blah, blah, blah. Study shows that there's a blah, blah, blah, blah, blah reduction if you're on a statin. you know, et cetera, et cetera. Okay, well that's fine. And that may be true, but the guy that created that, you know, that randomized controlled trial is the drug company that has a financial interest in it. They can kind of bend outcomes to, you know, what they want. And then, but then it's like, well, you're not practicing evidence -based medicine unless you do this. And I'm like, tell me the study, because a real study would be show me demented 90 year olds laying in a hospital bed. That cohort, would have to be studied specifically. Well, they're not. So it's not, Evan, it's a smoke screen of nonsense. Roger K. McFillin, Psy.D, ABPP (25:15.361) which now takes your freedom as an independent practicing physician. Like you don't really have the freedom because you're going to be punished monetarily, financially, if you don't follow the government's rules. And so when we take a look at statins, know, very questionable efficacy actually, you know, as we know now with statins. But I mean, you're pushing somebody to be on that drug to the last day of their lives, right? Because it's financially incentivized to do so because the drug companies are in bed with the federal government. And at the very least, you know, they're going to be funding politicians' campaigns and their lobbyists are going to be intimately involved in a lot of individual politicians. They fund the FDA. So it goes, same thing with the... antidepressants, for example. So you were mentioning the screener for depression, which is the PHQ -9, which was developed by Pfizer, which a marketer from the Pfizer department. a clinical psychologist who's well versed in test construction, I feel like I'm going to vomit every time I read that questionnaire, because it's not a valid construct. I mean, it doesn't have construct validity, which means it doesn't in any way represent what depression is. I mean, you're going to have such a false identification of people with depression by administering that and that's the point, right? So you get somebody in there who did lose their husband and you force something like that on them and they're gonna have these elevated scores, same things with other vulnerable populations like adolescents, for example. I mean, we're pushing antidepressants on adolescents, a population that even has a much greater risk to that drug and that drug has... poor efficacy and horrible safety data to begin with, and it's much worse with children. But this is what's happening in our healthcare system, and this is why we're no longer trusting healthcare professionals, because those on the front lines, the primary care physicians, are really just working for the federal government and the pharmaceutical companies, and they're just pushing more interventions and more drugs. And it feels like when you talk to the healthcare professional now, it's almost robotic. Roger K. McFillin, Psy.D, ABPP (27:33.119) It's like they're all repeating the same lines like they're a robot. And it's absolutely strange. And it is so odd because now, especially post COVID, like the population, the general public is generally speaking, becoming much more informed on certain things, especially with your access to podcasts, social media, various experts that are outspoken. And I think the COVID vaccine is a great example of this is you walk in there and you refuse the COVID vaccine for obvious reasons. It's a novel mRNA technology. You've already had COVID. You're not in an at risk category. You have children, all these things. It's not studied long -term. There's all these concerns. Experts are talking about the problematic safety data that's coming out, but yet you're primary care physician is telling you to deny all that and you should get it anyway. Drs Hindmarsh BSfreeMD (28:30.266) Yeah, you know, I was thinking as you're bringing up the thing about the PHQ and the depression screening and all this stuff, and this is even way before COVID happened, that these questionnaires were coming out. And you know, I remember taking our kids into the doctor in high school just for some things. these questionnaires, as everybody knows, are not asked by your. PCP, your loving, caring psychiatrist sitting face to face with you. Most of the time these are done when you check in and you're ticking the boxes or you're getting a college kid screening for whatever, or I go in for an elbow problem to the orthopedist and that's the first thing on there. So people are just like, I don't want to fill orthopedic surgeon is gonna give two craps about whether So A, don't want to fill this out and be honest, even if I'm struggling. And B, the other times, I mean when we were working last, and this is years ago, like I said, pre -COVID. you have a medical assistant who comes in to do vitals and then bless their heart, they go through and they're the ones asking that. And I remember our kids and our son looking at me going, why is this lady asking this? Who is this lady? It's not like Dr. X that I really like and trust because he's my vibe. So the physician is now removed from that when you have the report, when you can really explore with the patient the important things like know, grief, the true depression or they're at risk for alcohol or drug abuse. It's just this, you're right, rote automated thing that either the computer is asking or someone in the system, because the metrics have to get done. don't get to... But you have to understand, you have to understand that those metrics would not exist without the federal government and without the insurance companies playing along. So I think that this is a time where you have every single right in the world to lie. Like if somebody asked me, do you drink? Nope, I've never even smelled a bottle cap. Even though we have a show, even though we have a show called Doctails with Cocktails, nope, I never drink. Never, never. Because who's asking the question? It's not your doctor asking the question. Yeah, I feel safe at home. I'm never sad. I'm actually so happy it's nauseating to the people around me. Like honestly, it... Roger K. McFillin, Psy.D, ABPP (30:48.245) Why don't we just have people refuse to take those? mean, to me, you have to resist it. You refuse to take it. You don't let your kids take these things. If there's still a market for it and people are not educated and they just continue just to follow along because there's deference to the medical authority, well, then this system is going to be maintained. I think everyone just has to resist that bullshit. Drs Hindmarsh BSfreeMD (30:50.848) You can. Yes. Drs Hindmarsh BSfreeMD (31:11.489) Exactly. Roger K. McFillin, Psy.D, ABPP (31:12.331) that you do not take these things anymore. You go into the doctor, you have a relationship with your doctor, you tell them what you want, right? This is your life, this is your health. The government doesn't own you. You don't have to do anything you don't want to do. Drs Hindmarsh BSfreeMD (31:21.123) Yep. Drs Hindmarsh BSfreeMD (31:25.056) Absolutely, absolutely. I'd say who's asking this? Who really cares? Is this my doctor or is this just some info? I mean, I wouldn't, I'd No, that's what you have to do. It's still as much as I have whore lying, I think that this is when it's morally justified and it's just kind of more fun to tell. That's funny. Roger K. McFillin, Psy.D, ABPP (31:46.837) All right, let me ask, I want to get a little bit more historically here, because I don't think we really answered the question about the loss of independent doctors. Now, I always assume that this had to do with the Affordable Care Act and all the restrictions that were placed on doctors. mean, it just seemed like it was too expensive to have to meet all these demands from the federal government. Drs Hindmarsh BSfreeMD (32:03.192) Yes. Roger K. McFillin, Psy.D, ABPP (32:15.399) and your overhead became too high. So you had to become part of the larger integrated network. But maybe I'm missing some, you know, pieces of this. Have we seen the death of the independent private practice physician? Drs Hindmarsh BSfreeMD (32:21.986) Mm Drs Hindmarsh BSfreeMD (32:27.929) No. No, think what we're seeing is we're seeing the spawn of the best independent practice and we'll get to that in a second. So when you first asked this question, I talked about 2008 and then comes 2014, which is basically the beginning of the ACA. And so if you really wanna get paid, you have to have these really robust and very well structured systems to mine the metrics, to tick the boxes, to have this. So if you're in a gigantic system that has, know, a great EMR and lots of employees to double check this. They don't literally hire, you know, nurse practitioners to just do welcome to Medicare exams, which isn't even an exam. It's just a welcome to Medicare. Here's your benefits. They do some screening for falls. They fill out a bunch of paperwork. I hate it. It's a terrible metric, but they get paid. so it became to, to actually make a reasonable living and practice medicine the way you want to is impossible if you stay in the insurance system. That's really where it came to. So if you had a large practice and you're in a reasonably large system and one of these companies comes knocking at your door, offering you literally two or three times your annual wage as a buyout. and yeah, you get to keep your job and yeah, you're gonna probably get a raise. But nothing's gonna change. And we went through that experience. We watched it happen in a corporate atmosphere. And interestingly enough, the company that bought that 195 physician network or group practice was not the government and it was not a hospital system. It was an insurance company. Roger K. McFillin, Psy.D, ABPP (34:15.83) Interesting. Drs Hindmarsh BSfreeMD (34:15.95) And they're the ones that have been gobbling, gobbling, gobbling, gobbling stuff up. And you look at Optum, which is the patient care delivery side of UnitedHealthcare. UnitedHealthcare is the single biggest for -profit health entity in the entire world. the beginning of the ACA in 2014, they were trading at about $80. I checked today, it's $598, it's almost $600. They made nothing but money through COVID. How do you come through COVID and double the value of your company when you're a health insurance company and everyone was supposed to be dying? Answer me that question. Roger K. McFillin, Psy.D, ABPP (34:49.43) Wow. Roger K. McFillin, Psy.D, ABPP (35:03.051) Yeah, I mean, isn't that the problem with the entire system right now is the sicker we are, the richer they become, the more dependent we become on their product, the healthcare system, it's going to increase their profit. And so when I look at the pharmaceutical companies approach to their business model, I mean, they're trying to create sickness younger and younger because you're looking for customers for life. And that's like my, my concern and why there's such a distrust for the vaccine schedule and a number of other things. And when you try to make sense of obesity and youth, the rising rates of chronic illness, neurocognitive conditions, when you see, I think we're like one out of every 34 children is now autistic. You know, and that that's from like, in the 1960s, what are you talking about? Maybe one in 1300 to one in 2700. Like that's an astronomical number. And when an entire industry benefits from your illness, this is why you see the pervasive distrust that exists. And then when we sit and we listen to how healthcare is now currently delivered based on all these various metrics and all these number of boxes that have to be ticked, you understand like the more people that are pushed to drugs, and there's going to be more side effects to those drugs. And then the more side effects to the drugs are more drugs. And then there's worsening health, worsening metabolic health, all the things that drive later problems, whether it's cancer, or whether it's heart disease or diabetes. I mean, you're seeing the implication of this with early treatment, with early treatment creating metabolic illness to later be managed with more drugs. It just seems like You know, it's a big scam. Drs Hindmarsh BSfreeMD (36:59.276) No, it's a totally big scam. Like when you're we were just listening to another podcast talk about even childhood obesity and what's happening with now, know, ozempic and then wanting to be able to prescribe that to kids like down to age six. And there are kids in junior high and high school already loaded up on these anti obesity drugs, metabolic drugs, antidepressants. Let's not even get into the hormone blocking expense, but. look what we as a nation spend on healthcare and this is gonna continue to skyrocket as you prescribe more of these drugs, you get lifelong customers in these kids, you outsource it and OZMPIC is what made in Europe making gazillions of dollars off of us charging whatever they want while our nation gets more unhealthy. if any, if an individual running their own home or their own business had this problem where it's like you're bleeding out money and wouldn't you like, look for the source of the problem instead of just throwing up. Yeah, well, this is what it's like. More drugs at instead of it's like, what is the problem? Why are we unhealthy? How do we stop paying for all these drugs? How do we get people off of them? How do we make them healthier? But no, it's just like, let's just prescribe another thing. But what you have to believe to actually go along with this idea of giving ozempic all the way down to six year olds. This is like, I really want it. We had Labrador retrievers when we lived out in the country and I'd love to get another one. and but you know, it's not that time. But it's like this, I get two lab puppies and I'm lazy and I don't really train them to go outside and I don't take them for walks. And so they just defecate all over my house. Not my And I just hate the smell of dog poo. So the solution to solving the dog poo smell problem is to buy everyone that comes to my house a nose clamp. It's a Febreze. So they can just clamp their nose and breathe through their mouths and enjoy my fetid horrible situation that I've created for myself by my lack of discipline and my ability to somehow buy too many dogs. Like if you literally think that a six year old child needs a pharmacologic agent to not be fat, you're dumber than the guy with 50 dogs that never cleans up after them. Like literally you're Roger K. McFillin, Psy.D, ABPP (39:16.481) But that's legitimate conversation to have about our American public. mean, are we just getting so fat, dumb and lazy that there's such apathy that we would actually consider all these interventions? I mean, that's some of my problem right now. My frustration is I can't believe how many people just buy this idea of a quick fix and feel are just completely disconnected from reality. I mean, so many people in my field are going for the prescription, just the easy, the illusion that there's some easy fix to the legitimate problems that they face in their lives. And I don't understand how the brainwashing has occurred. Drs Hindmarsh BSfreeMD (40:02.2) But that's the phantom. That's the phantom that all that is the false premise of all of Western medicine, all of allopathic medicine is based on this fantastic idea that we're broken and need to be fixed by some external agent. That's it. that's a hopelessness too, because it's like, I used to believe the same thing that most people were. I would say just either uneducated. So they're relying on those of us who are supposedly more wise and educated in this field of medicine to know better. But number two is that, yes, Americans like a quick fix. They don't want to go run around the block for two miles after work or after school. They'd rather just sit down, relax, eat some Cheetos and you deserve a break today. And a pill is easier than having to sit down and talk to a therapist for an hour and I could just maybe take a Prozac and feel better for a while. I still think there's a lot of that, but the people that really want to change, it's hard. mean, even if financially to buy food that's not tainted now with every glyphosate or sprayed with every chemical or injected with hormones. mean, even we make great income and I'm like, gosh, this food's expensive. Do I want to pay for this? Putting in my time at the gym paying for fitness classes or even for free getting the time. Even if you are... financially able to have the means, it's tough. And then who do you trust? I don't trust the mainstream physician when I go in there because she's like, your cholesterol bumped up a little bit. You shouldn't be eating red meat. Time for some cholesterol medicine. Let's check your labs again. I'm like, no thanks. But you know what, But you know what? I'm going to disagree with you. Perfect. This is what makes our show so hopefully great. I'm going to disagree with you. You've kind of bought the commercialized narrative that you need to go to the gym, that you need to have expensive shoes, that you need to have you know, ex kind of special meat. You don't like the thing is you don't like we've talked to carnivores that have done it on virtually nothing. Like they're like, I would eat the crummiest fattest versions of hamburger from Walmart before I would eat anything that comes like out of a cereal box or whatever. So there's ways to do this. But we've also been, we've also been drinking the Kool -Aid up. Well, if you want to be fit, that means you got to go to F 45 and pace, you know, 395 bucks a month. No, you don't. Drs Hindmarsh BSfreeMD (42:24.802) You have to go outside and walk around. It's not that it really isn't that hard. It's that you would rather do something simple like watch TV, which is actually really expensive compared to just walking around outside, which is way cheaper than paying for cable. So there's that. Roger K. McFillin, Psy.D, ABPP (42:35.346) Heh. Roger K. McFillin, Psy.D, ABPP (42:39.903) Yeah. And there's certainly some data out there that, you know, lot of people say that the reason we have some of this obesity and healthcare crisis is because, you know, the poor can't, afford healthy food. And the data doesn't support that. mean, and like, like Tim said, you can, you can buy meat and be on a carnivore based diet. And with the saturated fat and the protein, it's much more, you know, satiating. Drs Hindmarsh BSfreeMD (42:52.577) Mm -hmm. Roger K. McFillin, Psy.D, ABPP (43:09.373) and more nutrient dense, you're not as hungry, you spend less versus going on this addictive food where you're eating all these chemicals and sugar and it's hijacking your brain. You feel like you have to eat three meals and three snacks a day. It adds up. I mean, that's part of the lie that exists out there as well. I want to transition a little bit because I'm trying to put myself in the shoes of a primary care doctor right now because I've been Drs Hindmarsh BSfreeMD (43:28.462) True. Roger K. McFillin, Psy.D, ABPP (43:38.839) you know, really outspoken against the primary care physicians because 80 to 85 % of psychiatric drugs are being prescribed by primary care physicians. And I spoke with a pediatrician not too long ago, who told me his dilemma. He says we have these guidelines that we have to follow. They're pushed by the American Academy of Pediatrics. So he was talking about an SSRI and I have so much knowledge at this point about the history of SSRIs, about the clinical trials, about what the drug does, what it doesn't do, the negative and adverse health effects that exist and are substantial, the long -term problems including permanent sexual dysfunction. And it would be absolutely insane to prescribe a child or an adolescent those drugs. Like there is no... benefit. There is no identifiable value to that drug. There is only harm. And he says, well, what am I supposed to do? A suicidal teen is in my office. Their parents bring that child to me. And I am being told that an antidepressant is a frontline treatment and it's stated there clearly in the American Academy of Pediatrics guidelines for the treatment of adolescent depression. And so if I choose to do watchful waiting, for example, with a referral to a counselor or a psychologist like you, I may or may not be able to get them in somewhere. Most likely not, there's going to be a waiting list. And even if I am concerned that the drug is not effective and it more than doubles the risk of a suicide event, if something does happen to that teenager, I can be held liable because I did not follow the guidelines of my field. That's when I dug into the guidelines of the American Academy of Pediatrics and realized that they cherry picked studies that were 25, 30 years old to misrepresent the efficacy of the drug and to downplay any of the side effects or the adverse effects. the family physicians are getting faulty information. Roger K. McFillin, Psy.D, ABPP (46:03.189) You look into the funding sources of the American Academy of Pediatrics, it's pharmaceutical companies or nonprofits that are propped up by the pharmaceutical companies. They're just it's just another way to push the drugs. So we're putting our family physicians or primary care pediatricians in these impossible positions. And I don't know the answer to it, other than you having to really put your neck out on the line. and understand that research and provide informed consent to the family and to the teen and express the concern. So they can make a choice, they can make a decision, but 99 % of primary care doctors don't have that knowledge base. It's not their level of expertise. So I don't even know what the answer is at this point. Drs Hindmarsh BSfreeMD (46:51.694) Well, there's two answers. One, you have to nut up and you have to say the actual data. mean, there's black, there's a black box warning for SSRIs, especially in teenagers for suicide. So you sit there and you say, look, tell them, the dilemma. The American Academy of Pediatrics is telling me that I'm supposed to give your son who just went through a breakup with his girlfriend and now is saying he's gonna kill himself. I have to give him an SSRI, which is gonna mess him up. We don't know what it does to a developing brain, because that's never been studied. And the American Academy of Pediatrics is saying that's what I need to do to try to defend my license and do good care. Meanwhile, there's a black box warning that this will increase suicidality. So guess what? I'm on your side. I will not give an agent to a kid that increases suicidality. I don't give a good gosh darn what the American Academy of Pediatrics says, because they say that you can cut off the penis of a 17 -year -old and give them cross -sex hormones. So they're idiots by definition. And you have to document that in a way that's reasonable that a court will accept. And you also have to accept the fact that the risk of getting sued in a situation like that is basically zero. It really is. You have to be a jerk to a patient to get sued. You have to have a bad outcome. And most 17 year old boys that break up with their girlfriend all say they want to kill themselves. That's called being a 17 year old boy and getting dumped. So eventually you just got to nut up and accept reality for what it is. The other thing you got to do is you got to get away from insurance companies nine million miles away. There is a model which is called direct primary care, which is subscription based. You pay, you know, a hundred bucks a month and it's open season on your family doctor. And they are not under any of, they have to, you know, abide by the medical practice act of their state, which is really easy, but all the metrics, all the nonsense, all of that BS goes away. So, I mean. Roger K. McFillin, Psy.D, ABPP (48:55.285) Yeah, those are great. Yeah, great solutions. You know, also part of the problem is I, I don't want to assume that all the doctors, you know, have this knowledge about the problems with the drugs most don't. And so, you know, a lot of the conversations that I have about them, they're hearing this information for the first time, they can't believe it. And it goes back to how medical professionals are educated, and what the medical school education looks like and how that is funded in a lot of ways by the pharmaceutical companies, whether they're funding the academics to write the textbooks, their ghost writing papers, there's so many. It's part of the game that that that occurs in this medical misinformation that exists in the way an allopathic medicine medical doctor does. get trained. So the question for the two of you just reflecting back on your on your training, and we all agree that lifestyle is medicine, food is medicine, all these things that are really important. But in your medical training, how much time is spent on nutrition, for example, where you become real experts in this and then also how much time is spent on like understanding clinical trials. and like how to interpret data from the clinical trials and things like that because there seems to be a real issue with statistical significance versus clinical relevance. Drs Hindmarsh BSfreeMD (50:34.05) There was way more, in our training, especially in our residency, there was way more emphasis on actual clinical trials. We were reasonably well -trained, I think, in that compared to most people. Although it's statistics in everyone's Your eyes glaze over and you lose your mind. I hated that class. And then nutrition was almost zero. And the problem with nutrition is... You don't, honestly don't want allopathic medical schools to teach nutrition. Like it's better if they don't teach any of it because what they're going to teach you is the food pyramid. even South park knows that the food pyramid is up. Roger K. McFillin, Psy.D, ABPP (51:11.041) No, no, no. Drs Hindmarsh BSfreeMD (51:12.59) So, they're not going to come in there and have Sean Baker and Annette Bosworth give a lecture on the keto diet and carnivore and how if you eat tons of saturated fat and basically no carbs, you're going to be super healthy. No, I mean, we would send people to the traditionally trained nutritionist with their diabetes and they're just wanting to put them on more carbohydrate exchanges because they need so many carbs. No, 15 years ago. That's what we're trained. Or 15 or 20 years ago. Almost 30 years ago now because that's why I did a thing where I did 10 extreme sports in a day. raise money for diabetic education. And then I would meet with the diabetic educators and I'd freak out on them. I'd say, these patients need no carbs. They're type two diabetics, their metabolism is broken. You have to unbreak their metabolism. And the way you do that is by basically feeding them no carbs. I mean, this is like 2007, I'm saying this. Well, but carbohydrates are their main source of energy. said, that's the problem. And so what they would do, what they would do is they would literally everything centered around how many carbs they got. And then based on how many carbs they got, they got more insulin. So they're, locking them into like insulin is basically fat growth hormone instead of making you buff as growth hormone, it makes you fat. And so you're giving them more calories, more carbs and more insulin. No, you're making the problem 10 times worse. I mean, eventually I just gave up. Yeah, that's the problem with nutrition. As far as nutrition, don't teach it because they'll teach the bullshittiest version of it, which is bad. And I'd say I just remember being past, you know, out of residency in a busy family practice and you know, you're trying to keep up and the drug reps would come by with their study and you're like, I really like this person. They're really nice. They work for pick your drug company choice, Mark, Pfizer, Lilly, whatever there are nowadays. And this is the information. yeah, they're really trustworthy. I trust them. That's what their studies say. This looks good. I'll take a look at And she's also a smoking hot blonde that only bends over with her knees perfectly straight. So most physicians don't, they're so busy going home now charting and getting their stuff done at the end of the day and then want to have time for themselves and their family, let alone to be sitting and reading studies and. Drs Hindmarsh BSfreeMD (53:26.678) and picking through and knowing how to pick through what is real and false information and where it's being funded by and coming from. So no, that's not happening. Roger K. McFillin, Psy.D, ABPP (53:36.439) Okay, final talking point here, because I need some understanding about the insurance companies and the Affordable Care Act. So the Affordable Care Act attempted to control costs by requiring insurers to 80 to 85 % of premiums on patient care. it basically restricted the amount of profit, right, to like 15 % in my Am I correct on that? Drs Hindmarsh BSfreeMD (54:08.184) As far as my understanding, yes. Roger K. McFillin, Psy.D, ABPP (54:10.153) Okay. Now, the Affordable Care Act was also supposed to reduce healthcare premiums, but that doesn't seem to have occurred. They continue to rise. So the cost of health insurance continues to rise for the American public. And I recently attempted to try to negotiate with the health insurance companies that we are paneled with. to try to create some incentivized model. Like if we keep my patients here out of the hospital, for example, they may actually make improvement, right? So I wanted to see if I could get paid more for strong outcomes and paid less if we were costing them more money, right? I thought this was something that would, they'd really be interested in, like this could revolutionize it, right? I care so much about quality of care, I'm going to bet on myself, right? And I'm going to bet on my center. They weren't interested. Why wouldn't they be interested? Why does it actually seem like they want more people receiving care than people getting better? Drs Hindmarsh BSfreeMD (55:14.637) because Drs Hindmarsh BSfreeMD (55:21.602) Because it's not insurance. That's the key. have to understand it's not insurance. If you're a really terrible driver and have three DUIs, you're going to be uninsurable. OK? I mean, we live in Sarasota, Florida. There's parts of Sarasota where there's multimillion dollar homes. Those guys don't have insurance. There's not a chance. You couldn't get insurance. It floods every, you know, it flooded twice this year already. You can't insure that. And so health insurance, or whatever you want to call it, it's prepaid health care. And so when you look at the ACA and they say that you have to spend 85 % on patient care, but you're guaranteed, it's not that you can only make 15%. In a way, it's almost like you're guaranteed 15%. But there's another part in the ACA. It didn't say that they couldn't increase prices. So that's what they do. So they increase prices, they get more people insured, they keep charging more, and they just guarantee themselves 15%. So of course, as long as they can keep increasing prices, it doesn't matter. They're guaranteed 15%. I mean, if somebody came to you and said, your stock portfolio, we will guarantee you 15 % in perpetuity. Would you take that bet? Yeah. I mean, actually, I would be retired tomorrow if someone gave that to me. So, you know, that, it's, I mean, you also have to understand where this stuff came from, like the ACA, they wrote it. The industries write these things. know, Obamacare landed in its, you know, 15 ,000 pages or whatever it is that landed on the desk of Obama. Like it was what, two days or three days or whatever it was after he was inaugurated. All this stuff is pre -written by think tanks and industries and all of this stuff. It's not like Nancy Pelosi goes to rehab, dries out, and then writes the legislation. It doesn't work that way. It's all pre -written by the powers that be. Otherwise, how could UnitedHealthcare private industry? Drs Hindmarsh BSfreeMD (57:28.302) If they were going to get screwed by the ACA, by the government, how do they go from whatever it was, $65 a share at the beginning of 2014 to $598? It's because they're controlling the legislation. There's no other answer than that. Roger K. McFillin, Psy.D, ABPP (57:46.411) This has been enlightening. let's talk about, you know, solutions to this. You've already provided a couple options of breaking free from the insurance system. But we're also in this fear -based culture, where the American public is constantly bombarded about fear of the next disease and fear of getting this screener, this evaluation, this test to catch it early. Right? Preventative based care. Okay. And so that's like the most difficult aspect that I think I have in trying to communicate with people to pull themselves out of the sick care system and to take control of their own health is the fear. The what if, right? So what are the, if I was going to place the two of you as the leader of the world healthcare, and you were going to be able to make sweeping changes to improve the health and wellbeing of the global population. Now let's just make it the United States, all right? So just the United States, you two are the leaders of this. How do you advise the American public to approach their own health? And what about their relationships with their allopathic medical doctors who work in these large care hospital -based systems? Are you advising them to just end those? relationships and do something different? Like what's the what's the answer? Drs Hindmarsh BSfreeMD (59:16.683) No, you don't just end those relationships. The reason that we're having this conversation and we're so wound up about it isn't because allopathic medicine is bad. It's because it's so good, but it's been corrupted. It's the same reason why murder is so bad, because you're taking someone's life. It's because life is so valuable. If somebody takes someone else's life, that's a heinous crime. And so the fact is, because we really run this risk of just abandoning something very good, throwing the baby out with the bath water. Now, here's the thing. If I was going to advise somebody that lived in the system now, I would say, find, find a functional medicine doctor that you see regularly, pay for it. It's worth it. You'll actually do what they say. If you pay for it, get a high deductible insurance. And if you need a bypass or cancer treatment, or you fall off your motorcycle or God knows what that's what allopathic medicine is for. Even though I don't necessarily agree with all of cancer, but that's another bunny trail. But you know that it's for. emergencies, it's for big procedures, all of that stuff, we do a pretty good job at it. That's what I would advise now. Now, if you wanted to fix the system, what I would do is every hospital based medicine physician, so every surgeon, every anesthesiologist, everything, they would all be salaried, which sounds totally socialistic and it probably is, but I don't care. And the reason is you have to get rid of the incentive if you're a spine surgeon from getting paid more if you do more spine surgeries. Surgeons should not get paid more to do more surgery. They should get paid more to do the right surgeries. So you got to take the highly specialized, super expensive stuff and just basically say, this is the market wage. This is what you get paid. This is your call. just essentially kind of centrally plan that side of the system. Drs Hindmarsh BSfreeMD (01:01:10.944) Then in primary care and quote wellness, you get rid of all insurance. It's cash only. then, and you would see it, but you can still get money put into your medical savings account by yourself, by your employer, by whatever. you're, you're incentivized to use tax free dollars to use your own head to find the provider that's going to give you the best outcome. that's how you would change. You would have the best healthcare system in the world, the cheapest healthcare system, and patients would be happy. Because if they wanted to go see allopathic Al who screens you for every fricking thing that doesn't matter, you can do that. If you want to go and see just, you know, see somebody that, you know, is a natural path and never went to allopathic medical school, God bless you. and let the consumer, the American people are dumb, but they're not that dumb. I'm stunned at the wisdom of the hive mind. Let the market, let the visible hand of the market solve what needs, what can be solved, and the part where the market can't solve it because the market's not gonna solve. whether or not you need a spine surgery because you don't have enough knowledge to know if you need that. Yeah, I, you know, thinking deeply on this often on, agree with everything Tim said and I would add a couple other things that I think make a big difference. But just like we, I believe in it, punish people for driving drunk and you get demerits on your license. I think there should be some negatives, whether it's for your health insurance or a. you get a tax rebate because you're not a smoker. Or other lifestyle modification factors that are in your hands that take money off the system instead of being dependent on oxygen and these long -term inhalers for your COPD. You either, I hate to use the term, those people and it costs more or there's demerits, but the people that are doing it right are incentivized to live better lifestyle. Drs Hindmarsh BSfreeMD (01:03:24.632) health savings accounts instead of it just being for, you know, spending on more health crap. How about we use it for healthy lifestyle things that improve health and wellness? So you take your HSA money for working out or for... Organic steaks. Exactly. So I think there needs to be some responsibility to put back on people individually that... Because most of healthcare, this chronic disease management doesn't need to exist if they took care of themselves and they wouldn't need the doctor in allopathic medicine except for those true emergencies. The traumas, the surgical things, and the rare things that we I don't understand though, what I don't understand, and this is just a complete mystery to me and I know it's true, is shouldn't being fat, stupid, and sad be enough reason to change your behavior? Like that's what I don't understand, and it's not. I mean, I know these people, I see them as patients. You hit them with a $150 a month difference in their premium and they'll change their lifestyle. The fact that they can't tie their shoes or see their genitals naked, that's not a motivator. But somehow 150 bucks a month is. I do not understand that. I mean, I had trouble getting my kiteboard on efficiently because I need to lose a few pounds. Man, I'm super motivated. Roger K. McFillin, Psy.D, ABPP (01:04:35.809) Yeah. Drs Hindmarsh BSfreeMD (01:04:47.382) Because I mean, I love being active. fitness is important to me. And I'm like, how do you communicate that? Because like shouldn't being sad all the time and not sleeping and having a sleep apnea machine be like kind of a motivator? You're the psychologist. You, Raj, you would know better whether it's punitive action or reward action would be better. But either way, there needs to be some incentives or disincentives back to the people because it's getting too expensive. Roger K. McFillin, Psy.D, ABPP (01:05:13.291) Yeah, the most effective way to change behavior is by reinforcing the behaviors you want to see change, right? So there's this illusion of a free market in the United States. A lot of what you're talking about is some of the core principles of what a free market would be. If you're going to be rewarded for getting healthy, like you're going to keep money in your pocket, and you're going to be able to grow wealth for your family, Drs Hindmarsh BSfreeMD (01:05:18.562) Mm -hmm. Drs Hindmarsh BSfreeMD (01:05:22.285) Right. Roger K. McFillin, Psy.D, ABPP (01:05:38.315) Well, then you're going to be highly incentivized to live in a healthy way. But if it doesn't matter, right, you have to pay these high insurance costs anyway, and you're being pushed the sick care model, you're being told nothing's your fault, right? It's genetics, it's this, it's all part of the lies that are being sold to put you more to get sick and be on drugs than it does. It just loses the incentive. And I think what's very challenging for me is for how many people just buy the lies, they buy the politicians lies. They just accept it. Like there's still people who believe without the Affordable Care Act, they wouldn't have healthcare. Like it's just such nonsense, right? It is absolute nonsense. And we're getting, we are getting sicker. We're getting more miserable. Every data point suggests it. If this isn't the time to be incentivized to make changes and pull yourself out of the system, I don't know. But you know, when it would be. but yeah, I loved your free market solutions. I love your practical strategies. Drs Hindmarsh BSfreeMD (01:06:15.086) Mm Roger K. McFillin, Psy.D, ABPP (01:06:34.135) that exists and I think they're financially sound like decisions for it for my family. I've got I've got three kids between the ages of 18 and 23 all healthy. But two of them have been athletes and so the only time we ever used a health care system is through orthopedics. So it only makes sense for me to get a high deductible plan. Drs Hindmarsh BSfreeMD (01:06:54.756) Right. Right. Right. Roger K. McFillin, Psy.D, ABPP (01:06:58.731) We don't go to the doctors other than that because everyone's healthy. Why would I go to the doctor if I'm not sick? I'm not going to follow your rules. I'm not going to get the next injection. We're not going to get COVID. We're not going to get flu. We're not going to get all these things that you say we have to get because we don't get sick. know, and that's part, you know, I think it is intertwined with fear and fear is a powerful motivator and we do have to shift the incentives. Drs Hindmarsh BSfreeMD (01:07:04.874) Exactly. Drs Hindmarsh BSfreeMD (01:07:17.697) Right. Drs Hindmarsh BSfreeMD (01:07:25.172) I think people need to like for some reason somewhere along the way and I think it started the least I remember for us when we were in family practice it was pushing the whole preventative medicine model and I bought into that I'm like this is good we need to stop that people need to take responsibility for their own bodies their own health they're not the doctor doing your preventative medicine check no I mean it's your body it's your body so your health is your responsibility The dumbest thing we ever came up with was preventative medicine. Like you use a medicine to prevent anything. No, like that's just, that's just silliness. You use a medicine to treat a disease. And we all can disagree how we want to treat our bodies. And there's so many different models out there, whether you're into Eastern medicine, Western medicine, naturopathic medicine. I mean, I've had people will refuse to take any antibiotic for really bad, you know, infections and they want to do the natural. Ultimately. should be your body, your choice, correct? so therefore act like it, like take responsibility. You be the driver instead of just falling into a system that's gonna get you sicker. Roger K. McFillin, Psy.D, ABPP (01:08:39.253) Yeah, good points. I mean, it's part of the brainwashing to outsource your health to an expert. And there's too much, there's been too much expert culture in the United States that people have now lost personal responsibility for their own health and wellbeing. This was a fascinating and illuminating conversation. I truly appreciate it. I know my listeners will too, but I think that you guys are having these conversations quite frequently. Drs Hindmarsh BSfreeMD (01:08:43.565) right. Roger K. McFillin, Psy.D, ABPP (01:09:02.996) on your podcast. Tell us about your podcast and the content and what you're generally focusing on. Drs Hindmarsh BSfreeMD (01:09:11.298) Well, we have two shows a week. One is BS4AMD where we interview cool people like yourself. And we go across the gamut. We have had everything from Olympic athletes to... top fuel, dragster champion to all the COVID experts, know, Peter McCullough, Harvey rich, all of them, all the diet experts, a of years ago. And we've really just gone down all of these rabbit holes and had our, our heads really expanded. You know, if it's done 10 % for the audience, what it's done for us, that would be amazing because it really has opened our minds. so there's that. And then there's, have another show called Doctails with Cocktails where we. basically mock the idiocy that's going on in the world, primarily in the healthcare world. And so that's a fun show. We do a live stream once a week, usually Wednesday nights on that, and then that's repurposed as a podcast on Monday mornings. So. We really like to call BS on. the healthcare system, even what we've been taught, things we've done and, know. Well, we've been part of the problem. mean, we were really a part of the problem. And so now it's kind of like at the end of, you know, the end of our practice careers, we want to try to be part of the solution. And if you ever want have another discussion, we could go down the opioid hole sometime down that rabbit hole, because that one, if you want a really good metaphor for how broken... and brainwash people who are in allopathic medicine, the whole, because we essentially practiced through the entire history of the opiate epidemic. And that is a real fact. Roger K. McFillin, Psy.D, ABPP (01:10:54.475) Well, I'll make sure I include the links in our show summary for everybody to check it out. I mean, it really is a fascinating and interesting podcast. I've listened to number of episodes. I was on BS3MD, one of the episodes talking about psychiatric drugs and the mental health system. So I really do encourage people to check it out. Really, really appreciative, grateful for the two of you coming on. I think it was a fascinating conversation. get a lot of information from the inside, from two physicians, think it's highly credible and really do appreciate everything that you've been able to bring today. So I to thank you, doctors, Tim and May Hindmarsh for a radically genuine conversation. Drs Hindmarsh BSfreeMD (01:11:36.632) Thanks for having us.