The Epidemic of the “I Know All” Expert: Mikhail Varshavski at TEDxMonteCarlo (Transcript)

Following is the full transcript of celebrity doctor Mikhail Varshavski’s (aka Dr. Mike) TEDx Talk: The Epidemic of the “I Know All” Expert at TEDxMonteCarlo conference. This event occurred on November 11, 2017. To learn more about the speaker, read the bio here.

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.

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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.

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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 the 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 meta-analysis. 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.

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