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Home » Cardiologist Dr Aseem Malhotra’s Interview on The Diary Of A CEO (Transcript)

Cardiologist Dr Aseem Malhotra’s Interview on The Diary Of A CEO (Transcript)

Read the full transcript of consultant cardiologist Dr Aseem Malhotra’s interview on The Diary Of A CEO Podcast with Steven Bartlett episode titled “We’ve Been Lied To About Medication!”, July 25, 2024.

The Documentary “First Do No Pharm”

STEVEN BARTLETT: Dr. Aseem, you’re working on a documentary called “First Do No Pharm,” which will be out shortly. Why did you choose the name for your documentary “First Do No Pharm”?

DR ASEEM MALHOTRA: Well, first and foremost, the credit to that name actually goes to my co-producer, Donal O’Neill, who’s made a number of health documentaries and he’s a former international athlete. He used to work in marketing and PR, so he’s very good with slogans and sound bites.

But it totally resonated with my work and what I’ve been doing probably for well over a decade, which is to try and shift our approach to health from a predominantly pharmacological-based, drug-based model within healthcare to one which is more based upon lifestyle. That’s because that’s where the best evidence is in terms of improving our health, but also in terms of managing the healthcare system where there is so much waste, where drugs are over-prescribed.

Obviously “First Do No Pharm” means in the consultation room, the ideal scenario should be with every patient that if there is a non-drug-based way, non-pharmacological way of managing their illness, chronic disease, which is the big problem in society right now on healthcare systems, that should be the primary approach. As well as highlighting through the title that there is so much harm that comes from drug prescriptions.

This is something that even brings gasps from audiences when I give talks and lectures all around the world. One credible estimate suggests the third most common cause of death globally after heart disease and cancer is prescribed medications – what your doctor prescribes for you. So-called appropriately, mainly because the information which doctors use to make decisions for patients when prescribing drugs invariably is based upon a gross exaggeration on the safety and the benefits of those drugs.

STEVEN BARTLETT: And the phrase “first do no harm,” which is the original phrase that you spanned for the title, where does that phrase originate from?

DR ASEEM MALHOTRA: Well, actually, it’s one of the basic principles of medical ethics. As doctors, that’s something that’s almost we’re indoctrinated or ingrained with whenever we practice medicine, treat patients. That should be at the forefront of our minds.

Professional Background

STEVEN BARTLETT: What professionally, what is your professional title?

DR ASEEM MALHOTRA: I’m a consultant cardiologist.

STEVEN BARTLETT: What does that mean?

DR ASEEM MALHOTRA: So I qualified as a doctor, medical doctor, in 2001 and then after becoming a – I decided after two years of doing my initial postgraduate basic training in medicine, to subspecialize in cardiology, which is basically everything to do with the heart.

Then within that subspecialization of cardiology or specialization of cardiology, I trained in interventional cardiology. In layman’s terms, Steve, that means keyhole heart surgery. So that’s what I trained to do. I did that up until probably 2014, 2015, and then I shifted more towards a more holistic approach to managing heart disease, especially looking at the science and practicing the evidence base behind how lifestyle changes can manage heart disease and even potentially reverse it.

STEVEN BARTLETT: You must have seen a lot of hearts in your time.

DR ASEEM MALHOTRA: Yes, I think in terms of – I was thinking about this because up until 2019, I was an NHS doctor. We’ll come back to later why, what happened in 2019, but that’s my passion.

Within the NHS, which I think trains doctors brilliantly, it’s a very high intense workload. Just to give you perspective on that, we have the highest capita population per doctors in Europe, so least number of doctors per population in the country and the most number of doctors on night shifts. So it’s quite intense.

Because of that, I was thinking back in terms of the patients I would see on the wards and the throughput and the people that I would see in what we call cardiac catheter lab, where we did the diagnostic angiograms to visualize the heart arteries and we put stents in. Over my career, I’ve probably managed tens of thousands of patients.

Why Specialize in Cardiology?

STEVEN BARTLETT: Why did you choose to specialize in the heart versus other parts of the medical ecosystem that you could have pursued? Was there something?

DR ASEEM MALHOTRA: I don’t know if there’s one answer to that. I think one trigger very early on in my life is, I grew up in a medical family. Both my parents were GPs and I had an older brother who had Down syndrome and which also meant he had a small hole in his heart as well.

When I was 11 and he was 13, shortly after his birthday, he got a tummy bug, standard tummy bug. We didn’t think anything of it. Within six days, Steve, he became breathless and rapidly deteriorated, got admitted to hospital and had a cardiac arrest and died.

Later on, it emerged the post mortem showed his heart was massively enlarged and essentially had something called viral myocarditis. It can happen actually to anybody. You get a cold and in 1 in 10,000 people, up to 1 in 100,000 people, the body then has what we call an autoimmune reaction. Instead of dealing with a cold on its own, it then attacks the heart. In a third of those patients who get that, they will deteriorate and they will die.

So I think for me, that had such a profound impact on my life. With both parents being doctors, of course there was a bit of – there was no pressure from my parents. They wanted me to – my dad wanted to be a cricketer. But I think that was implanted in my mind that if I was to go into medicine, I wanted to get involved in managing and helping people, or prevent heart disease. So I think that’s where it started from.

The Global Heart Disease Crisis

STEVEN BARTLETT: It’s interesting because when we think about our health, a lot of people think about the amount of weight they have on them.