0:00:17.815,0:00:18.915
You wake up.

0:00:19.479,0:00:21.909
Before you even grab your cell phone,

0:00:22.269,0:00:24.109
you say, "Today is the day.

0:00:24.544,0:00:27.904
Today is the day[br]that I'm going to be proactive.

0:00:28.453,0:00:30.843
I'm going to take control of my life.

0:00:31.236,0:00:33.156
I'm going to go see the doctor.

0:00:34.493,0:00:36.063
I'm going to get healthy."

0:00:36.934,0:00:40.084
So you sacrifice a day off work,

0:00:40.084,0:00:43.564
you sit in one-hour standstill traffic,

0:00:43.564,0:00:46.784
you even wait 30 minutes[br]in the office to see the doctor.

0:00:47.613,0:00:49.643
Finally the doctor walks in,

0:00:50.010,0:00:53.790
and all of that built-up[br]anxiety begins to fade.

0:00:54.528,0:00:56.848
In the midst of your conversation,

0:00:57.228,0:00:59.498
you ask the doctor a few questions,

0:00:59.870,0:01:02.760
"Doctor, what's the healthiest diet?"

0:01:03.600,0:01:06.640
You get back, "I don't know."

0:01:07.783,0:01:11.523
You say: "Okay, doctor.[br]You say I have a respiratory virus.

0:01:11.523,0:01:12.923
Which virus is it?"

0:01:13.458,0:01:15.608
Again, you get, "I don't know."

0:01:16.648,0:01:18.728
Your mind begins to wonder

0:01:19.388,0:01:22.208
whether or not this doctor[br]was properly educated.

0:01:23.551,0:01:24.551
Finally, you ask,

0:01:24.551,0:01:29.281
"Doctor, what is the reason[br]that the rate of autism is increasing?"

0:01:30.611,0:01:34.295
You hear, "I don't know,"[br]and your frustration hits a peak.

0:01:36.068,0:01:38.118
Let's stop this hypothetical for a second.

0:01:39.007,0:01:43.477
I'm going to explain to you right now[br]why you need not be frustrated,

0:01:43.818,0:01:48.748
and instead celebrate those who are not[br]afraid to say, "I don't know."

0:01:49.655,0:01:53.315
The theme of this conference[br]is "License To Know."

0:01:53.895,0:01:55.735
But hopefully after this talk,

0:01:56.075,0:02:00.025
you'll be proud to say that you have[br]a license to say, "I don't know."

0:02:02.362,0:02:04.502
My name is Doctor Mikhail Varshavski.

0:02:05.014,0:02:07.824
Like it was mentioned earlier,[br]most know me as Doctor Mike.

0:02:08.634,0:02:11.784
I'm an actively practicing[br]family medicine physician

0:02:11.784,0:02:14.584
out of Overlook Medical Center[br]in the United States.

0:02:15.374,0:02:19.094
I also happen to be the most[br]followed doctor on social media,[br]

0:02:19.094,0:02:21.234
with 3.5 millions subscribers.

0:02:22.916,0:02:25.556
This gives me unique vantage point

0:02:25.906,0:02:29.566
to witness an epidemic[br]within the healthcare space

0:02:29.566,0:02:31.956
that receives so little attention,

0:02:32.596,0:02:36.386
and that's the epidemic of IKA,

0:02:37.625,0:02:41.795
the epidemic of the "I Know All" expert.

0:02:43.917,0:02:46.547
There are too many[br]of these experts out there,

0:02:46.547,0:02:48.847
claiming to have all of the answers

0:02:48.847,0:02:52.227
when the rest of the scientific[br]community has questions.

0:02:52.953,0:02:54.843
Now, this may surprise you.

0:02:55.203,0:03:00.933
But you and I are both[br]partially, if not more so,

0:03:00.933,0:03:02.733
to blame for this epidemic.

0:03:03.001,0:03:05.121
When someone says to us[br]they don't know,

0:03:05.121,0:03:08.176
we're quick to judge,[br]we're quick to dismiss.

0:03:08.616,0:03:13.066
And in even a less cognizant way,[br]we support them with our clicks.

0:03:13.523,0:03:16.063
We click on the catchy headlines,

0:03:16.063,0:03:19.493
we click and purchase[br]those miracle cure-all products.

0:03:21.006,0:03:22.276
Within medicine,

0:03:22.606,0:03:28.416
there are two specific situations[br]where these IKA experts flourish.

0:03:29.145,0:03:31.385
The first is the gray zone.

0:03:32.199,0:03:35.349
That is when a question[br]within the field of medicine

0:03:35.845,0:03:40.135
has not yet had a complete answer[br]by modern science.

0:03:40.903,0:03:44.513
Take the increased rate of autism.

0:03:45.772,0:03:50.852
You ask an honest, up-to-date doctor,[br]they'll tell you, "We don't know."

0:03:51.345,0:03:55.485
Now, you ask an IKA expert,[br]they'll throw you a theory,

0:03:56.044,0:03:58.954
and they'll do it[br]in a very convincing fashion,

0:03:59.474,0:04:03.654
so much so that they might even further[br]their career in one way or another.

0:04:05.138,0:04:09.138
That's the problem with these IKA experts.

0:04:09.880,0:04:12.220
The second way that they do this

0:04:12.220,0:04:16.020
is they do it in moments[br]where good medicine has proved

0:04:16.339,0:04:20.219
that tangible positive effect[br]is only achieved

0:04:20.219,0:04:22.579
through hard work and dedication.

0:04:22.983,0:04:26.983
Take diet, take exercise, take sleep.

0:04:27.355,0:04:30.735
The way to improve all of these things[br]is through hard work.

0:04:31.239,0:04:34.909
But the IKA expert[br]will give you a shortcut.

0:04:34.909,0:04:38.509
And I'm sure many of you here today[br]have heard of these shortcuts.

0:04:39.134,0:04:43.290
Take, for instance, the shortcut[br]of the miracle weight-loss diet

0:04:43.290,0:04:45.080
known as the cookie diet.

0:04:46.599,0:04:49.869
Or better yet, the miracle detox plan

0:04:49.869,0:04:52.709
that will detoxify your body[br]through a juice cleanse,

0:04:52.709,0:04:54.779
will boost your immune system.

0:04:56.309,0:04:59.119
How do these IKA experts

0:04:59.591,0:05:05.261
cause you to ignore legitimate[br]scientific evidence and advice

0:05:05.261,0:05:07.307
and listen to their theories?

0:05:07.858,0:05:09.718
They do so through stress.

0:05:10.954,0:05:16.944
When your mind is stressed,[br]your mind is very easily influenced.

0:05:17.763,0:05:21.113
There's a great book called[br]The Influential Mind.

0:05:21.113,0:05:24.597
And there was a great example[br]from this book I'd like to share with you.

0:05:25.074,0:05:28.834
Take September 11th, 2001,[br]in New York City,

0:05:28.834,0:05:31.644
one of the worst[br]terrorist attacks of all time.

0:05:32.092,0:05:34.582
The day after those terrorist attacks,

0:05:34.582,0:05:37.743
distress in New York City[br]has an all-time high.

0:05:38.796,0:05:44.186
It takes only one person to run and scream[br]to get hundreds to do the same.

0:05:45.276,0:05:50.706
Now, if you take that same person[br]one day prior to the terrorist attacks,

0:05:51.196,0:05:52.788
what will you get?

0:05:52.788,0:05:57.178
You'll get a lot of New Yorkers[br]looking at this person running and saying,

0:05:57.178,0:05:59.118
"Ah, just another crazy New Yorker."

0:06:00.315,0:06:03.645
Your mind does not respond well to stress.

0:06:03.645,0:06:05.916
As a survival mechanism,

0:06:05.916,0:06:11.626
your mind uses stress as a way[br]to be influenced by the majority.

0:06:12.066,0:06:15.033
So what these IKA experts do

0:06:15.033,0:06:20.244
is they throw around words[br]like "cancer," "disease," "death,"

0:06:20.244,0:06:22.984
even get your family involved at times.

0:06:24.014,0:06:25.774
And that's how they get you.

0:06:26.793,0:06:29.093
Now, because of my social media fame,

0:06:29.093,0:06:32.303
I find myself at a very[br]interesting crossroads

0:06:32.303,0:06:35.123
between marketing and medicine.

0:06:35.403,0:06:40.800
A marketer's job is to sell product[br]or to push a brand,

0:06:40.800,0:06:43.729
and they do so by studying[br]your human psyche

0:06:43.729,0:06:46.469
to figure out the best way[br]to accomplish that.

0:06:47.246,0:06:52.796
They often pair celebrities with products[br]in order to get better results,

0:06:52.796,0:06:57.031
because they know that when you hear[br]advice from a familiar face,

0:06:57.379,0:06:59.039
they'll sell more products.

0:06:59.613,0:07:01.613
I'm going to be honest[br]with you here today.

0:07:01.613,0:07:05.803
I've received some of these offers[br]in near seven-figure totals

0:07:05.803,0:07:08.314
to support the IKA products.

0:07:08.617,0:07:09.627
Me!

0:07:09.627,0:07:14.049
Imagine what a true celebrity gets[br]if I'm being offered these deals.

0:07:14.409,0:07:15.347
Forget that.

0:07:15.347,0:07:19.523
Imagine what these companies[br]make from IKA products

0:07:19.523,0:07:22.804
that they're able to pay[br]these huge sums of money.

0:07:23.912,0:07:25.032
Look, I get it.

0:07:25.032,0:07:26.942
We live in a fast-paced world.

0:07:26.942,0:07:30.082
We want quick answers[br]and even faster results.

0:07:30.454,0:07:35.584
But before you go on this desperate search[br]for answers and shortcuts,

0:07:35.584,0:07:38.403
let's talk about what a true expert is.

0:07:38.720,0:07:40.680
A true expert not only looks

0:07:40.680,0:07:44.242
at the current, most up-to-date[br]scientific evidence,

0:07:44.242,0:07:47.812
but also looks at history as a guide.

0:07:48.992,0:07:52.512
How many times have you heard[br]doctors go back and forth

0:07:52.512,0:07:55.792
on the health benefits[br]and risks of coffee,

0:07:55.792,0:07:58.082
something we all drink every day?

0:07:59.182,0:08:03.174
In 1981, the New York Times[br]published a study

0:08:03.174,0:08:08.044
that said two cups of coffee[br]increase the risk of pancreatic cancer.

0:08:08.954,0:08:12.914
In 2017, we claimed[br]that coffee extends your life.

0:08:14.429,0:08:18.569
Doctors used to advocate smoking[br]as a stress reliever.

0:08:20.947,0:08:26.877
We used to believe that bloodletting,[br]a.k.a letting a patient bleed out,

0:08:26.877,0:08:28.868
was a way to cure an infection.

0:08:30.094,0:08:32.694
This doesn't mean[br]that doctors are not smart.

0:08:32.991,0:08:34.666
What this means

0:08:34.666,0:08:40.976
is that expert opinion is and should be[br]considered the lowest form of evidence.

0:08:42.076,0:08:47.886
That is what our job as a true expert is:[br]to explain that to the general population.

0:08:49.039,0:08:52.579
Take any PhD in this room[br]and they'll all tell you the same thing.

0:08:53.074,0:08:56.664
The more years they've spent[br]studying a subject,

0:08:56.664,0:08:58.944
the more they realize they don't know,

0:08:59.755,0:09:02.095
the more questions you have,

0:09:02.095,0:09:04.255
because they more questions you have,

0:09:04.998,0:09:07.328
that's the sign of intelligence.

0:09:07.962,0:09:10.682
Now, look, this isn't just[br]a theoretical discussion,

0:09:10.682,0:09:13.492
where we're going to talk[br]about philosophical change

0:09:13.492,0:09:15.081
and things of that nature.

0:09:15.631,0:09:18.151
I'm going to have some[br]practical tips for you as well.

0:09:18.471,0:09:19.811
Number 1:

0:09:19.811,0:09:21.991
ask better questions.

0:09:22.591,0:09:26.219
A doctor prescribes a treatment[br]or tells you not to go for a treatment.

0:09:26.219,0:09:29.079
Ask, "Hey, doc, why do I need[br]these antibiotics?

0:09:29.079,0:09:31.614
Do I even need these antibiotics?"

0:09:31.614,0:09:37.314
When an IKA expert claims there's[br]a miracle cure for whatever ails you,

0:09:37.314,0:09:42.454
ask how is it possible that there are[br]millions of doctors across the world,

0:09:42.454,0:09:46.014
whose sole mission,[br]and it's the same mission,

0:09:46.014,0:09:48.884
to eradicate diseases[br]and restore optimal health,

0:09:48.884,0:09:50.724
don't agree with them.

0:09:50.724,0:09:56.904
Why is it the same five IKA experts[br]you see appearing in documentaries,

0:09:56.904,0:10:01.242
talking about doom and gloom[br]from all the things that ail you.

0:10:02.162,0:10:03.262
Second:

0:10:03.262,0:10:05.812
understand basic research.

0:10:06.313,0:10:11.823
Oftentimes these IKA experts[br]will tout a single study,

0:10:11.823,0:10:14.333
and try and convince you[br]of their theories.

0:10:15.224,0:10:20.664
Take the recent uproar of autism[br]and childhood immunizations.

0:10:21.024,0:10:24.176
This uproar started from a single study,

0:10:24.862,0:10:27.262
with 12 subjects,

0:10:27.868,0:10:30.478
which was done by a doctor

0:10:30.478,0:10:33.628
who's been discredited[br]and lost their license.

0:10:34.605,0:10:37.995
And yet, children are dying.

0:10:38.541,0:10:41.421
So it's your job to be[br]aware of this research.

0:10:41.421,0:10:44.071
And here I'll tell you how to do that.

0:10:44.071,0:10:47.767
Know that the best form of research[br]is a metaanalysis.

0:10:47.767,0:10:50.797
It's a combination[br]of studies, not just one,

0:10:50.797,0:10:56.137
which allows for the decreased likelihood[br]of chance and bias within the results.

0:10:56.627,0:11:01.607
Note that newer studies are not[br]necessarily better than older studies.

0:11:01.607,0:11:05.077
Know that studies[br]that focus on disease markers

0:11:05.077,0:11:08.572
are not nearly as good as studies[br]that focus on outcomes

0:11:08.572,0:11:10.672
and developments of disease.

0:11:11.285,0:11:14.775
And no matter what media tells you[br]is a breakthrough,

0:11:15.370,0:11:18.063
there is no single study

0:11:18.063,0:11:21.503
that will influence[br]the field of medicine enough

0:11:21.503,0:11:24.123
to change the standard of care.

0:11:24.123,0:11:25.783
It can guide us,

0:11:26.083,0:11:30.213
it can put itself into the context[br]of the entire body of evidence.

0:11:30.656,0:11:32.686
to allow us to figure out

0:11:33.156,0:11:36.795
what the true results are[br]and what they mean.

0:11:37.469,0:11:39.609
And lastly, third:

0:11:40.114,0:11:45.724
do not write off health professionals[br]who say "I don't know."

0:11:46.524,0:11:51.326
Instead, what you should infer[br]is that this doctor is self-aware,

0:11:51.776,0:11:55.460
this doctor acknowledges[br]scientific limitations.

0:11:55.900,0:11:56.926
And most importantly,

0:11:56.926,0:12:00.506
this doctor is not interested[br]in slimming your wallet.

0:12:02.846,0:12:06.536
Let's move away from the era[br]of juice cleanses,

0:12:06.956,0:12:11.056
and move to an era we judge doctors[br]not by the answers,

0:12:11.786,0:12:14.756
but by the quality of their questions.

0:12:15.298,0:12:17.929
Do not be afraid to say, "I don't know."

0:12:18.278,0:12:19.461
Thank you.

0:12:19.461,0:12:21.449
(Applause)