Absolutism In Medicine Is A Poison (w/Dr. Vinay Prasad)

[@bursenurse3501]

I really love when these two get together

[@lauratencelski2305]

It's becoming one if my favorite things

[@okeeyoungsoon]

Same!

[@morpheus7144]

Same with him and Marty Makary...could just listen to a weekly podcast with all these guys

[@Jaji1948]

"I'd rather have questions that cannot be answered than answers that cannot be questioned." Richard Feynman

[@vickidoc4]

As a primary care physician in private practice who teaches medical students and Nurse practitioner students in my office, THIS is the type of information I need to hear! Keep the flow!!!!

[@benjaminchiarolanza3493]

It is so refreshing to hear people have a reasonable conversation about COVID.

[@c5jp904]

The medical profession could learn a lot from professional aviation whether it’s checklists, continuing training, observational check flights, or on the job mentoring. Sitting in the copilot seat and watching good and bad captains can teach you plenty.

[@Tech-49]

I feel like I could listen to 10 hours of this, keep it coming

[@carexpert5945]

@23:30, the 'system' should be exams to ensure proficiency and each person's "abilities". Why not the step and board exams (or any universal exam)? Many NPs have commented on how easy NP training is. Why allow NP grads the ability to practice independently while med school grads cannot without a residency?

[@tn7846]

i agree. What amazes me is that NPs are not held to the same standards as MD equivalent IMGs who are trained in X specialty in their home country. instead we let NPs run freely and harm patients with no standardization. if NPs wanna become physician, im all for it if they take the USMLE step 1, 2 ck + cs, and step 3. do an ACGME residency and pass the board certification for that residency (+ or - fellowship too) if we hold IMGs MDs to that standard, we should also hold NPs to that standard.

[@angelp.5224]

Because of tge urgent need just my opinion RN 4 37yrs

[@jenniferlloyd1986]

Love these two together!!! As a nurse, I wish I could work with more docs like them.

[@rexwitherspoon7176]

Have you read: "Patients at Risk: The Rise of the Nurse Practitioner and Physician Assistant in Healthcare"?

[@maryg.7790]

Hmmm....need to do that!

[@6789uiop]

This dynamic as pissed me off for decades.

[@AJ-iy4mf]

Z needs to address this. I love Z and I think he’s great for medicine but I feel that he doesn’t bring enough attention to the topic because of potential loss of supporters. There’s a problem with independent practice and a problem with diploma mills.

[@carmivanronk275]

I always enjoy when Vinay is on the channel. Great talk.

[@gookygal]

I am a healthcare pro here in the UK, your conversation is upbeat, rational and en-pointe so much better than msm, and some of your music covers very good!

[@hhlagen]

The voices of reason crying in the wilderness. Love you guys!!

[@LilCraftyNook]

I live in CA and it _is_ getting so crazy...🙄 You are so spot on about social media. I love your energy and your intelligence! !🙌🏻🙌🏻 Definitely sharing!!

[@MsMedalf]

Love love love your talks with Dr. Prasad. Please keep doing them!

[@CricketsMa]

Unforgettable conversations! Thanks for sharing with us.😘

[@darkydoom9955]

Enjoying listening to your input on different groups of healthcare workers and admitting to different levels of skills and abilities. Just thinking of how many SHIT healthcare workers I've had as a patient and it just drives me harder to be a better nurse myself, and argh! The anguish I've dealt with being misdiagnosed and ignored and pushed aside for over a freaking decade reeeeeeer! And then the amazing ones I've met just fills me with hope and motivation.

[@monykalynf3604]

I wanna know just how long you guys talked, and can ya'll just livestream it for however long you guys go? Your conversations are absolutely the best therapy to the craziness out IRL. I even tune into Dr Prisad's 3 hour podcasts now LOL

[@thistleskeptic]

This is like Joe Rogan for medicine. I love listening to people talk about what they are passionate about!

[@Asptuber]

Except it should be three times as long!

[@angelp.5224]

Amen! Nurse Angela East TN RN 4 37yrs!

[@sandrat66]

Only seeing this now, 09/30/2021, and loving it! Needed this today; thank you Docs

[@Wyguyfryguy]

These shows are so great! Thank you so much !!

[@MalikaBourne]

I know I'm going to love this video with you two guys. I am ready to get the video my full attention.

[@learningisnotquiet7371]

I am a doctoral student and my question for Dr. Vinay Prasad with anecdotes in shaping public policy is that qualitative research is generally anecdotes collected in systematic and meaningful ways (obviously separate from social media). Does your belief in using anecdotes extend to qualitative research or is it just on social media platforms?

[@BeyondDentistry]

Love these conversations. Thanks so much Dr. Z

[@allenwarren1269]

3:00 Reputation and gladiation around fearing unpopularity. What happened to the integrity between word and deed, commitment and fulfillment?

[@jaythefit8817]

I know the VA will use NP's and PA's when there are not doctors available. It wasn't upsetting to me. I was in the maintenance stage and if I needed a specialist they would order what they call a consul. The NP was more existentially connected than many doctors. She was personable and discussed things that would be meaningful to me as a husband and a father. The Indian part caused me to smile a bit. My thoughts were why couldn't I be an Indian with all you smart guys? I got screwed being thrown into existence as an Irishman. I'm using humor to say I am impressed with your guests no matter who they are.

[@billhiggins-ha4all795]

I am Irish, English, partially native Indian, with a little scotch thrown in for flavor (typo intentional)...

[@billhiggins-ha4all795]

I fully agree with welcoming the practice of Nurse practitioners and Physician assists. It is difficult to keep providers in the VA health care system. As a patient with bipolar disorder, the best psychological service has been through a psychiatric nurse practitioner with unique qualifications. As a patient, I did not find the normal wall of diplomas. I found the paraphernalia of a woman that had served as a helicopter pilot on active duty. She had "been there and done that" in her own service. In the service, we call it an "I love me wall". That made her far more effective in serving veterans. As a pilot, she had suffered mental health depression, then lost her ability to fly. After leaving the service with a VA disability she chose to develop the skills to serve other veterans. She will do so for about 20 more years, far more effectively than one without her life experience.

I love these dialogues!

[@carexpert5945]

Lots of NPs are against the diploma mills. Why not support an NP flexner report?

[@6789uiop]

1) Ivermectin 2) In-home rapid tests, no Rx required.

[@TheMrssanderson]

Exactly! Ya gotta wonder why we can’t have those at home tests...🤔

[@joanneaming7922]

My dad loved laughing and giving jokes and he lived to be over 90 years. My son love listening to these drs, he fine that they are funny but serious. They also explain things well.

[@annegraheck5713]

Go to Fremont. True that! Washington Township Hospital. Even.before it was a subsidiary of Stanford. I saw the worst care ever there. And some of the best. As an RN I share the worst care with new grad RN so that they understand the difference of what a family always remembers. I will never forget how disrespectfully they treated my mother as she died. I choose to treasure it as the last lessons she gave me, one nurse to another.

[@TheMorningtrain]

I loved listening to Vinray. Great conversation. Just curious What kind of doctor is Vinray?

[@missmeggie6461]

I’d like to know your opinion on the Great Barrington declaration...🤔

[@debraisel2059]

As Black Beauty could tell you, the road to Hell is paved with good intentions. He was a very smart horse. As an NP working in the ED, I take care of the patient with the UTI, doing enough to make sure it isn't pyelonephritis or an ectopic so the people who went to those schools and training take care people in danger of dying. Win-win-win.

[@dmitriybelous7775]

i love these conversations

[@omar-fy7cr]

@Zdogg ❤️❤️❤️

[@Mermaid2261]

watch out when these two get together!!!

[@GlobalFreeLiving]

Great interview... Too funny! You guys are soul brothers from different mothers.

[@Sigma_Prime]

Hey Dr. Z. What are your thoughts on ivermectin for Covid and can you do a video on your thoughts of the safety or long term effects of taking the Covid vaccine. Love your channel!

[@sevenmileshome]

There are a few cohort studies being presented that show decrease in mortality, however they are confounded due to patients also being treated with hydroxychloroquine and anti virals and have a small sample size

[@earthangel2524]

@@sevenmileshome Reading studies alone is too Ivory Tower for me. I am listening to a number of physicians discuss such preprints etc. while they experience AGGRESSIVE EARLY TREATMENTS AT HOME with their vulnerable patients.

[@corie51785]

I read somewhere that CA closed outdoor dining because it's supposed to "teach residents a 'lesson'" from the increase in covid cases. They are making it analogous to drugs where outdoor dining will lead to "harder" socialization....

[@birdy1959]

Refreshing!

[@splashesin8]

Swimming after the UV has become bearable. Like night suddenly makes chlorine or distancing any different than instant skin cancer swim time. Yes, I'm biased toward heme/oncs, I can't help it. It's a very formative part of my life. 😅☺️ I miss the talk. This was very satisfying. 😂

[@kk555ify]

I agree that NPs & other professionals who need certifications should practice at the top of their educational training! I worked at the VA for almost 20 years, & I respected the training & education of everyone. To share a little about my training, I worked oncology, trauma icu at UMC, step down which included many heart patients including tranplantation. Not every nurse, RN is not going to have that training! Working in primary care caring for 1000 VA patients was a different kind of experience. I love your program & the in your face presentation! “Peace”...

[@jzen1455]

Damn, watching the two of you talk about medicine, ethics, decision-making, etc make me wish I had gone into the medical field. I've thought about going to NP school to become a psychiatric nurse, but I'm just not sure I have the grit to make it through. Would you say being an MD is sort of like being a professor with tenure? Of course MDs are held to stricter standards than professors, but it seems being at that level of the medical food chain provides a degree of autonomy that those "below" don't have. But then again, if something goes wrong, the MD is usually the one to take most of the blame right? Dr. Vinay Prasad should definitely give stand up comedy a try! He'd definitely kill it with his blunt honesty, unique perspective on things, and not being afraid to go against the grain. Or maybe a podcast of his own.

[@docbee1830]

As someone who lives in California and who also saw multiple covid patients today I completely agree with these guys. “California, what are you doing?”. I hate this state and only live here because of family. I still went to the playground when the idiots in government closed the nearby playground and if that makes me a terrible doctor I really don’t care what governor hair gel Ross Gellar, I mean Newsom, thinks. The poor small businesses.

[@mweinheim7911]

Your culture values education far more than anyone else. Hence there are brilliant “Indian” professionals!! Nothing wrong with that

[@Sherrn21]

Dr Z. What is your take on Ivermectin for COVID?

[@sevenmileshome]

There are ongoing studies that demonstrate decreased mortality, however those studies have issues and have not been peer reviewed.

[@earthangel2524]

Everything is new with this novel virus. I think it best to view the line-by-line reading and discussion of preprint research papers by some of the brave physicians useng this and/or other things for customized AGGRESSIVE EARLY TREATMENT of vulnerable patients AT HOME. For example, kzbin.info/www/bejne/Z2jChmeIhbSpp6c.

[@Sherrn21]

We intubated and proned three COVID patients in my unit today and we had a patient succumb to COVID. All I kept thinking was, “Could this truly have been prevented if we had treated our patients early on with Ivermectin?”

[@hmann4531]

"Ivermectin - Ivermectin has also been proposed as a potential therapy based on in vitro activity against SARS-CoV-2, but the drug levels used in vitro far exceed those achieved in vivo with safe drug doses [127]; various clinical trials of ivermectin are underway."

[@hmann4531]

@@Sherrn21 no

[@toby9999]

We had these restrictions in Melbourne and more. Curfews, travel limits, time limits, work permits, mandated masks. It worked. Now no community transmission for 40 days. Your problem exists now (in the US). You don't have time for the "science of lock-downs" to be scienced. You can argue over the details but we've actually made the sacrifices and saved the lives. Minimize unnecessary interactions. Keep the schools closed. Kids can always make up for lost time but the dead can't be brought back. The idea that school is vital and necessary for mental well-being is BS. School can be very corrosive. School can cause suicides in children. If you are really "alt-middle" then you should both be a little less biased. For instance closing playgrounds... it should be obvious that if you have children from multiple families all sharing playground equipment then the virus will be spread around and brought back into their homes.

[@jzen1455]

Thing is, many Americans don't have the constitution to tolerate such draconian lockdowns. America is a very polarized nation politically and progress is very very very slow as legislation gets debated and stuck in gridlock. The second relief bill (which provides less relief than the first) has still yet to take effect sometime in January, which is about 9 months after the first. States have been left to fend for themselves with varying degrees of restrictions. Americans are living in two parallel alternate realities with nearly diametrically opposed political views, which makes a strict lockdown a logistical impossibility. I agree, the US should have done really strict lockdowns with provisions to keep businesses afloat and people able to pay for necessities. Instead, we had a hodge-podge of restrictions with minimal federal assistance.

[@yosamy00]

I'm in PA and we have had this odd indoor masking orders for in bars & restaurants for months now. Literally have to have a mask on to get in the door....sit down, take mask off....stand up (to go to restroom or get a drink at the bar, or walking out the door) put mask on 🤔🙄 Many places put up outside tents with heaters in so they wouldn't be over the 25% indoor capacity that our governor put in place..... We're probably going to be shut down again soon.

[@markstuber4731]

Cool! You're a Zoroastrian? The closest I have ever come to meeting one was a bar buddie of mine who is dating an Iranian Zoroastrian.

[@Jaji1948]

I live in Arizona's white mountains. They closed Los Burros, a camping/picnic area in the middle of a 2.5 million acre national forest. Instead I had a picnic with my grandkids in the tailgate of my car outside the chained off road to Los Burros. Sigh ...

[@adrianguinn3331]

Made it 1:47 in As a comedian, trust me, when tensions are high, comedy is at it's peak. If you are having problems navigating this new time and being called unfunny, its probably because you suck at being funny 🤷 It's like your horrendous parody videos. Not everyone is gonna hit a homerun every time. Just accept that even you can say something bigoted or closeminded - Yes, even if you're not a Caucasian - and we can all collectively move forward.

[@DrProfX]

“Knowing” absolute truth is much easier than seeking it... it is this kind of dogma that leads many religious (and other) groups to do all sorts of bad things... 🤷🏼‍♂️

[@lisahenderson7150]

"How is it possible for Florida to have fewer hospitalizations per million than California right now, when California is restricted every which way and Florida is completely open?" Dr Jay Bhattacharya of Stanford asked this of Dr Fauci. Here in the UK indoor dining is open, mostly to those who live in the same household, granted, however these indoor dining venues would go under without this minimal attendance. How is wearing a mask suddenly, (in relative terms), the be all and end all when prior to covid operating theatre staff only wore them if you were right up close to wounds, because there's 30 years of research to suggest masks being very limited protection for patients. FFP3 masks are fit tested to wear with positive patients who have a cough or AGP.. The Denmark study didn't show significant changes in the community transmission when masks worn. Dozens of states and countries show rises in cases since masks have been made mandatory. Sorry, but your mask narrative isn't based on anything but assumptions and biases. Other than that, I love your videos!

[@margotbw4660]

Personally I am reassured by the honest "we don't know".

[@jodyjones8155]

I do appreciate these 2 getting together ❤ Good show 👏 We've ( my husband and I) have learned to be better friends inside the house . More 1 on 1 and interaction. By the way, we're old!

[@jamesnelson2844]

As a medical teacher I see the irony in controlling one thing like shutting down playgrounds but a grocery store is the same thing instead of children touching the swings and play items adults are touching all the food items and other adults come along and touch the same thing and no ones is wiping down those items and there is no good medical data showing your getting COVID from shopping. The rules to COVID wear a mask, wash your hands and be kind to others.

[@robinstanley6008]

Fantastic discussion, thank you!

[@uog293]

Stories today don't have to be factually true, they need to be EMOTIONALLY true. This is what humanity is devolving into, Trump is a classic story teller in this way, and so is this nurse

[@Rickpa]

Zoroastrianism? This reminds me of our current social duality. In Vedic/Indic religions, the good gods are Devas, and the anti-gods are Asuras. In Persian Zoroastrianism, the good gods are Ahuras, and the anti-gods are Daevas. Was your first car a Mazda?

[@dj9632543]

what is the end point of this whole covid? Do they (bureaucrats) plan on irradiating sickness and death?

[@saratonnan]

YAY! Dr. Prasad! He's great. 😁

[@SiegfriedEmme]

I like the fingerprint story. Perfect example of why thousands of people will die in the next 4 months. Lack of common sense from bureaucracy. Why don't you use your influence can help save people. Watch this video kzbin.info/www/bejne/eaaromRod8SHrM0 showing Dr Pierre Kory opening remarks at a Senate committee hearing. Best quote of the whole video "always humble, willing to admit what they don't know, and willing to improve upon it "

[@rosemarieloncaric-spataro2861]

Ridiculous restrictions. What is the definition of a pandemic?

[@anotherpovx468]

I really enjoy this kind of discourse, although im definitely much more on the critical side. There is one thing that does not make any sense to me and which is holding me sceptic for so long, because I never got a satisfying answer; myb someone here can help me. Excess mortality in Germany (where I come from) does not make sense in regards to the interventions which are implemented. If you look at the following data (officially deaths reported): www.destatis.de/DE/Themen/Querschnitt/Corona/Gesellschaft/bevoelkerung-sterbefaelle.html you see that excess mortality generated by covid (red line) spikes in week 14 2020 at around 21.000 deaths per week. However the excess mortality generated by seasonal flue 2018 (upper line of the light blue area) spikes in week 10 at about 27.000 deaths per week. As far as I am informed, there is pretty good evidence for no correlation between NPIs and deaths, so NPIs shouldn't had a relevant impact on those death counts. That, said, I really don't get why we went like crazy this year, while doing absolutely nothing in 2018. Or to put a little more into perspective: lets imagine we've never gotten a PCR Test and were able to detect the virus. If you look at this data not knowing that Covid exists, I would assume with high certainty that absolute nobody would have given a crap about anything. But to be fair, someone came up with a second interpretation of this data which is: We heavily underestimated the seasonal flue in the past and should have done something against contagious diseases much earlier. Which I think is a valid point which I share but it does not explain all the heavy interventions and especially the focus onto Covid alone this year. So my question is: Did I miss something? Did I interpreted something wrong? I went with this argument a couple dozen times into the German pro-NPI Twitter Bubble and nobody had an answer. And to be very clear: this this for German only, I recognised heavy discrepancies in-between countries. But since im living in Germany and NPIs should implemented according to the circumstances, this is relevant for me. I tried to explain this to myself and the best I came up with so far, was: its the media. Media in comparison to 2009 (swine flue) has developed massively, I can't dodge corona wherever I go. I think many people are victims of heavy media distortion which is the much bigger problem than corona (again: for Germany).

[@Asptuber]

I think the answer is that deaths are not really the metric to look at. Remember back in spring? The arguments that I found convincing was 1. What can our healthcare systems cope with? 2. What happens when a really big proportion of the population gets sick simultaneously? Now we know that point 2 isn't really that worrisome, because such a large percentage of

[@monykalynf3604]

look at Ivor Cummins videos on some of this - he does address some of these things, and brings up seasonality, excess deaths etc from a purely statistical standpoint

[@anotherpovx468]

@@Asptuber Much appreciation for your extended answer. I totally agree on what you're saying and should have been more precise: I don't understand why we are in still in panic mode today when looking at this data ^^? Our chancellor just today gave a really emotional speech, which in my opinion had zero ground; there is absolut nothing to worry about other than positive PCR results. We have a huge company which owns the vast amount of privatised hospitals and they published their data from this year and also from 2018 + 2019. The usage of ICU is pretty much the same (varying between 80-85% per week). The collection of official data on ICU by "divi Intensivregister" just started bc of covid, so we have no comparison; but the usage of ICU is pretty much consistent from May until today. The only worrying thing to me is, that the amount of ICU is now tracked in accordance to available healthcare worker (we had lot of ICU but not enough peoplel), which was foremost a good adjustment. The problem is, that the amount of available ICU is declining. Journalists found out that this is mostly because of healthcare workers are quarantined solely based on a positive PCR result (asymptomatic). And since the Interpretation of PCR test results are highly debatable, this is really worrying me. So death counts are not worrying and the usage of ICU is the same as the past years from what we can look at; the only difference seems to be the existence of PCR testing which is causing panic. So I would still say for Germany: media is the bigger problem than Corona and most interventions are useless. Testing: Officially the RKI (our "CDC") defined a new testing strategy in the beginning of November (only testing symptomatic people) but since the RKI does not overwatch the laboratories, we don't know if they actually adapted. By looking at the test data, I don't think anything really changed. Tests are declining really slowly but not the way I would expect it, if we only would test symptomatic people. If you want to take a look at this data: www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Testzahl.html The first of the three links at the bottom of the page and then the second column in the data set ("Testzahlen"). I would actually prefer the testing strategy proposed by the RKI. I know from Thailand that they are doing exactly that from the beginning of the pandemic (only symptomatic ppl, cT

[@anotherpovx468]

@@monykalynf3604 Thanks for your the advice but I’m already familiar with the statistical analysis from Ivor Cummins. I think he is right tho.

[@Asptuber]

@@anotherpovx468 Thx - do you know why RKI proposed only testing symptomatic people? Is it lab capacity, or something else? [ETA: Took a look at the RKI-numbers, and it seems like lab capacity, since these new guidelines come in just as the sample backlog is getting alarming. So the change isn't to get a truer view, it is to direct capacity to where it is most needed.] I don't think it matters much if there's a smattering of false positives from PCR (however you want to define that), as long as the NPI measures are sensible. On the individual level this would of course be much easier if we had fast re-testing. Don't agree with this at all: "I think this little time frame where we might be infectious but do not have any symptoms, is pretty much irrelevant for transmission of Corona." I followed both Finnish and Swedish information very closely in the spring (a little less os now in autumn), and this was the Swedish way of thinking. Whereas the uncertainty of this featured in the Finnish messaging from the start, and pretty quickly went to "you can be transmitting without knowing it". The difference in outcomes seem pretty conclusive, especially if we look at the autumn, when Sars-Cov-2 was already pretty well seeded all around both countries. For most of the autumn Finland has had less strict recommendations than Sweden, but still our curve was much much slower. The problem with not taking into account pre-(and a-)symptomatic spread is that while it is probably few individuals who are contagious in this way, those individuals might be very contagious (as in general with this). And it is impossible to know in advance who might be in this group. So the general advice must be "avoid breathing directly on other people in an enclosed space". Also, if you don't focus messaging on this it is impossible to make nursing homes etc more safe. Back to what I said about false pcr-positives not mattering that much IF measures are sensible. This means re-testing asymptomatic people during isolation. It might even mean making it possible for key workers to work even if positive (someone here wanted to make a scandal out of this practice wrt ICU-personnel, but that died quickly). I haven't really come to a conclusion about what to make of ICU-data. It seems to be less useful than we thought back in the spring. Whereas "plain hospitalisation" seem to have become much more important in treatment. And the data on this is much less sexy for the media, and therefore less available. But since ICU-data (and in some countries even splitting out number of patients on ventilators) is so much more "interesting", we get figures that are so easy to manipulate (especially if given as % of capacity), that I wonder how meaningful they are, once removed from their immediate local setting. Again I feel the messaging and the press are not asking the right questions. In too many places it seems stuck on ICU and even ventilators. The heroics, needing to keep capacity for saving lives. This is so much more psychologically salient, than looking at the boring stuff. And the boring stuff is intermediate level hospital beds, people being sick but not needing hospital care (for how long? my personal anecdata is between 4 days and 6 months - with a span like that it is impossible to do predictions to base policy on), getting test & trace to a place where it works (which involves much more than just the turnaround time for the lab). I would really not want to be in a position to make policy. We have 5 main indicators (number positive, percent positive, hospitalisations, ICU and deaths), and they are all afflicted by a time-lag of at least a few weeks. And all of them, even deaths, are fraught with possible confounders.

[@CCB249]

This conversation is interesting, but I don't understand why people are on Twitter.

[@ramneekmathur]

Your audio and video quality is so good, it's annoying.

[@markstuber4731]

Another potential harm of closing down the play grounds: Depriving children of sun that is, Vitamin D production.

[@cherylshort5005]

That mentality is in my mind, similar to waving and saying "have fun storming the castle" almost mob mentality. Grab a pitchfork add fuel to the fire...

[@tammyschilling5362]

All people tend to gravitate toward and have a preference toward their own tribe. It's just human nature. It's what gives rise to Chinatown and Little Italy and other ethnic neighborhoods. So what? It doesn't mean they hate people outside of their tribe. It just means they will tend to know more people like themselves.

[@DomFortress]

This isn't ethnocentrism in sociology, but factionism.

[@jzen1455]

Being Asian myself, I've never had such an inclination. But I've always considered myself more of a rootless lone wolf.

[@tinkerinWstuff]

Love your program! I’m sure you’re tired of mask questions but I haven’t seen this addressed anywhere. If amount of viral load is proven to affect severity, could mask wearing make people MORE sick because they recycle shed viral particles back into their own system? Thanks Doc!

[@jeffwade4761]

My old ER program director loved to quote Sir William Osler: One patient, one disease. My counter is Hickam's dictum: Patients can have as many diseases as they damn well please.

[@VishalRaoOnYouTube]

Will you do a video on Tony Hsieh's tragic passing (and what was happening to him)? I ask because I know he had an impact on your life and was a friend of your family.

[@jzen1455]

Did either one of you used to go to the UCSF library or gym in 2008-2009? I used to work at the Galen library at workout at the Millbery Gym on Parnassus.

[@wchphoto]

After college, I had to do a one-year training in a clinical lab to get my license. The lab director made all males wear a tie with the lab coat. I was the only male on the day shift. One day, a female senior tech/teacher took the other two female trainees and me up to a patient's room for some lesson that I don't recall (it was 1978!). The senior tech asked the patient (female) something and the patient turned her head toward me and said..."Well, what do you think, doctor?" I don't remember my response but I hope I set the record straight. The senior tech gave me grief for my entire training year. She was a sweetheart but I could always expect the grief!

[@tammyschilling5362]

"Dog whistle" is a way for people to put words into the mouths of others. They pick anything they want, interpret it to mean the words they want to put in your mouth, and call it a dog whistle.

[@earthangel2524]

Tammy is astute.

[@jzen1455]

Claiming something is a dog whistle is a dog whistle in itself for a disingenuous character assassination based on flimsy evidence.

[@jackrabbit11]

Ask any deployed service member about deployment mid-point craziness. This feels similar. It's a leadership problem.

[@saramoore6850]

We do have indoor dining available in Miami, but most people eat outside on the patio, in my neighborhood anyway. The indoor dining is pretty empty. Most people behave responsibly without government mandates 🤷🏻‍♀️

[@toby9999]

Where I live, too many people don't behave responsibly, hence the need for government mandates and even with the rules, too many people will flout the rules. I don't know where you live but it's pretty obvious that too many people are not behaving responsibly in the US and UK and other high case rate jurisdictions. Their daily case rates prove the point. By contrast, heavy policing did limit poor behavior to a hard core with the result that we've had no new cases for a month.

[@lucrezaborgia]

You clearly haven't been to NE Wisconsin

[@DiamondLil]

This is the first time I have ever been first!!

[@JoshDTech]

64% of spread occurs in households.

[@jhern083]

The only thing people need to comply with is stop hanging out in their houses/private gathering areas, indoors, without masks for extended periods of time. Good luck with that tho..

[@monykalynf3604]

So the solution in California is to close OUTDOOR spaces where distance/capacity is limited for you. Makes PERFECT sense right? Because the "just say no" campaign of the 1980's worked soooooooooooooooooo well!

[@johnbailey1503]

Thank god I live where we can go out to eat. I live in one state and work in another. The state I work in closed down and both states have about the same amount of cases. But the my state has less deaths. My coworkers are for the most part are for the close down. They don't get it. I guess working with covid patients makes you jaded about the rest of the people not working.

[@jbailey1898]

Wtaf, CDC! They.are.ridiculous. Also, I’m white but I identify as brown, so keep it up. Being brown is rad. I hope to be brown next time around. 😂

[@cherlgolja5402]

Go ahead profile we love you Doctor Z🧑🏻‍🦲

[@jessicaprzydzial5972]

I keep thinking about the industry that promotes "immune building" pills, but people are afraid of "immune building" vaccines

[@diyeana]

Z, it's because Indian doctors are the best. It is known.

[@lesleybielanski4908]

I live in Michigan. We’re basically padlocked in isolation

[@bullsfan2021]

I think we found Brown Ben Shapiro...

[@jzen1455]

Dr Vinay Prasad seems more open-minded and less dogmatic than Ben Shapiro. Other than being fast talking, smart, and somewhat right leaning, Vinay isn't that similar to Ben Shapiro.

[@martavongrey]

Just saying, the whole state doesn’t look like Seattle. Half the state does get sunshine! LOL😂

[@sophieoshaughnessy9469]

Thank you Dr Prasad! That is exactly right imho. I have known star NPs to whom I would trust my life, MDs who are really lacking... and of course Vice Versa. The real skill is to know what you know and what you don’t. Great thing about being in NP is that I knew when to punt, and it was encouraged. I always felt bad for the MD who was acculturated to hide their lack of experience or ability instead of being supported in overcoming it. This is especially relevant in Primary Care.

[@robinstanley6008]

Have been retired from a large HMO for 14 years. In my last 3 years of work I collaborated with a military-trained NP who was the bomb. Would have trusted him with my life. Also chose an NP as my PCP for gyn services. Ego is missing.

[@jzen1455]

@@robinstanley6008 From my experience, however, it seems a greater percentage of NPs have more gaps in their knowledge than MDs. I must say though, MDs tend to have a stubborn "I know it all" attitude when making a diagnosis while NPs are more open to patient input.

[@robinstanley6008]

@@jzen1455 Possibly true, I just don't have enough evidence one way or another. However, if the issue at hand is outside their scope of practice or knowledge, as Vinay mentioned, they're likely to ask for assistance.

[@TheXtremeDrums]

Unless you have medical training I have serious doubts about how you can know who has greater knowledge or who is lacking on medical training. Is actually disgusting that the general population has accepted this depreciation of care.

[@sophieoshaughnessy9469]

@@TheXtremeDrums you wouldn’t think it were disgusting if you lived in an underserved rural area and some underpaid NP (and often very experienced) was your life line. Try to keep your mind a little open.

[@elizabethlaird4171]

Ima keep laughing! Zoroaster rocked! People need to Lighten up..uh ph that is racist!

[@lauram9290]

👍. I wonder if the new vaccine will bring Comedy back too?! We miss it

[@williamholder2020]

How effective is your nose hairs at filtering viruses?

[@DomFortress]

Less effective than our evolutionary adaptive T-cells immune respond, which provides immunity from all infections on a cellular level(www.cebm.net/covid-19/what-is-the-role-of-t-cells-in-covid-19-infection-why-immunity-is-about-more-than-antibodies/). Which can be further primed and optimized through therapeutic lifestyles like intermittent fasting(www.ncbi.nlm.nih.gov/pmc/articles/PMC7351063/) and high intensity exercise(www.ncbi.nlm.nih.gov/pmc/articles/PMC7351507/). DO YOU EVEN SCIENCE?!

[@jarcrey5015]

The 'tall poppy syndrome' - a perceived tendency to discredit or disparage those who have achieved notable wealth or prominence in public life.

[@bullsfan2021]

wOw tHeSe gUys ArE s0 dOwn tO EaRth

[@johnbelcher7955]

We are all brown! Melanin is just one colour we are all just shades of beauty 😍

[@joanneaming7922]

Laughing is good for the soul.

[@hettiesimpson]

Dr Prasad: tells the story about the fingerprints Me: hit like button

[@saramoore6850]

The fingerprint story is hysterical. Government bureaucracy at its worst. Lol 😂

[@danharris7212]

Good times