In recent years, there has been an explosion of interest in healthcare related content on the internet. Podcasts by figures such as Peter Attia, Andrew Huberman, Rhonda Patrick, Ken Berry, and Gabrielle Lyon, to name a few, have become extremely popular. Typically these podcasts take a health issue and dissect it for the average person, often with a bit of a different perspective than is found in mainstream medicine. And while I don’t agree with every single thing that each of the above doctors says or touts, I think that overall these folks do a great service to the American (and global) public by empowering people to learn more about how to take charge of their own health.
Perhaps the most successful of the above names is Peter Attia. A Stanford and Johns Hopkins trained surgeon by background, Dr. Attia now runs a longevity clinic based in New York City that charges, last I checked, $150,000 per year for intensive personalized coaching aimed at maximizing one’s odds of living a longer and healthier life.
For those who are not able or willing to spend such a sum, Dr. Attia has a very popular podcast (“The Drive”) in which he regularly interviews world experts on a variety of longevity related topics, including exercise, nutrition, sleep, and the science of various chronic conditions. Or, you could read Dr. Attia’s wildly successful book Outlive, which was published last year and became an instant best seller.
I read Outlive recently (I’ve already been a devotee of Dr. Attia’s podcast and online writings for years) and have generally positive things to say about it. While I can quibble with some of his specific arguments, his main thesis is sound, and comes down to this:
Medicine 1.0 was medicine prior to the late 1800s. It was based on art and very little on science, and as such did only a small number of things well, and often caused harm.
Medicine 2.0 was kicked off by the rise of medicine as a scientific profession. The great breakthroughs of Medicine 2.0 included helping to create a safe supply of food and water for the general population, the invention of antibiotics, and of safe surgical techniques that transformed the biggest killers throughout most of human history (namely infection, trauma, and childbirth) into comparatively rare causes of death, and thus led to an extraordinary rise in longevity and quality of life. Nonetheless, this model of care has failed to tame the major chronic/lifestyle diseases that are now the leading causes of death in modern industrialized nations such as cancer, diabetes, and heart disease.
As such, Dr. Attia argues for the need for Medicine 3.0, which will take a comprehensive and proactive approach toward treating – and more importantly, preventing – these issues.
For example, Dr. Attia notes that in our current model of healthcare (“Medicine 2.0”) we wait until a patient has Type 2 diabetes before placing them on treatment. Medicine 3.0, by contrast, would screen patients for signs they are going to develop diabetes years before they get the disease, and would then lean (mostly) on lifestyle changes to try to prevent them from ever progressing toward that point.
Dr. Attia also spends a great deal of time discussing the “four horsemen” of the current health apocalypse: heart disease, cancer, diabetes, and neurodegenerative disorders such as Alzheimer’s, and how a “Medicine 3.0” approach might approach each of these problems and yield better results than the current “Medicine 2.0” approach.
One of the reasons that I enjoy Peter Attia’s work is because here at Dr. Fischer, MD, I am in fact trying to create exactly the sort of care that he would describe as “Medicine 3.0.”
As I recently quipped to a physician colleague who also follows Dr. Attia’s work, my practice is in many ways an attempt to provide Peter Attia style medical care with the feel and customer service of a small town 1950s medical practice.
At any rate, if you have the time and interest, I would recommend Outlive as an interesting read. While I don’t agree with all of Dr. Attia’s conclusions, I do think his book presents a lot of useful information, and does the much needed job of challenging us all to think about how we might reimagine healthcare in the 21st century.
