Do doctors even care about prevention?

Yes, they do, but not if you listen to Big Wellness

Casey Means recently appeared alongside her brother, Calley, on Tucker Carlson’s podcast. The Stanford-trained physician left medicine during her fifth year of surgical residency because, according to her, the medical system doesn’t treat “the whole person.”

Casey, who now runs a continuous glucose monitoring subscription service marketed to biohackers and optimizers (evidence is scant to non-existent in their utility for non-diabetics), and Calley, who runs a company that lets people use HSA and FSA accounts to buy things like supplements and ice baths under the guise of evidence-based medicine, have vested interests in criticizing modern medicine—which they did, repeatedly, for two hours and 20 minutes on Carlson.

Not that the system isn’t problematic (more on that below). One claim that comes up repeatedly, during this podcast and from many others in wellness and biohacking spaces, is that trained healthcare professionals aren’t versed in preventive medicine and habits. So I put forward the following question on Threads.

I also shared the query on Instagram, where 100+ replies rolled in. Quite a few doctors and healthcare professionals noted the constraints of our for-profit healthcare system, something most of us experience far too often. This is a real problem.

But another problem is people selling wellness products and services under the assumption that doctors aren’t trained in preventive medicine, which is a bogus claim; below are a few of my favorite replies.

Out of curiosity, I looked into Stanford’s physician curriculum, which Casey would have had to gone through in order to receive her degree. This is the preclinical list of topics she would have had to studied—and she did 4+ years of residency, but I’ll limit it to the first two years.

Basic Sciences

• Anatomy

• Histology

• Biochemistry

• Neurobiology

• Biostatistics and Epidemiology

• Genetics

• Immunology

• Molecular Biology

• Physiology

• Hematology

• Medical Microbiology

• Pathology

• Pharmacology

Clinical Foundations

• Physicians and Patients course (medical interviewing)

• Physical examination skills

• Basic Cardiac Life Support training

• Neurology examination

• Psychiatry and behavioral sciences

Additional Components

• Nutrition Principles (web-based self-study course)

• Computer skills competency

Sadly, the idea that medical training doesn’t address the “whole person” plays well when you’re selling a wellness-based subscription service, or promoting a reductive popular science book you co-wrote with your brother about how metabolic issues are the “root” of most diseases.

Biology is complex. Medicine is complex. The “root” of many diseases is often multifactorial. Rarely is an illness genetic alone, for example; environmental factors play an essential role in many diseases. The problem is that public health measures and discussions of the social determinants of health aren’t monetizable.

For those selling untested and unregulated products, policy discussions distract from marketable binaries: Doctors aren’t trained in prevention! My book discusses the underlying factors of disease, which doctors never address!

Evidence-based medicine addresses prevention as well as the “whole person.” The system is the problem, as I’ve again experienced writing this with my second case of Covid.