WEBVTT

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You wake up.

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Before you even grab your cell phone,

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you say, "Today is the day.

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Today is the day
that I'm going to be proactive.

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I'm going to take control of my life.

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I'm going to go see the doctor.

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I'm going to get healthy."

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So you sacrifice a day off work,

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you sit in one-hour standstill traffic,

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you even wait 30 minutes
in the office to see the doctor.

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Finally the doctor walks in,

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and all of that built-up
anxiety begins to fade.

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In the midst of your conversation,

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you ask the doctor a few questions,

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"Doctor, what's the healthiest diet?"

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You get back, "I don't know."

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You say: "Okay, doctor.
You say I have a respiratory virus.

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Which virus is it?"

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Again, you get, "I don't know."

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Your mind begins to wonder

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whether or not this doctor
was properly educated.

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Finally, you ask,

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"Doctor, what is the reason
that the rate of autism is increasing?"

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You hear, "I don't know,"
and your frustration hits a peak.

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Let's stop this hypothetical for a second.

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I'm going to explain to you right now
why you need not be frustrated,

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and instead celebrate those who are not
afraid to say, "I don't know."

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The theme of this conference
is "License To Know."

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But hopefully after this talk,

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you'll be proud to say that you have
a license to say, "I don't know."

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My name is Doctor Mikhail Varshavski.

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Like it was mentioned earlier,
most know me as Doctor Mike.

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I'm an actively practicing
family medicine physician

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out of Overlook Medical Center
in the United States.

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I also happen to be the most
followed doctor on social media,


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with 3.5 millions subscribers.

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This gives me unique vantage point

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to witness an epidemic
within the healthcare space

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that receives so little attention,

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and that's the epidemic of IKA,

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the epidemic of the "I Know All" expert.

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There are too many
of these experts out there,

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claiming to have all of the answers

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when the rest of the scientific
community has questions.

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Now, this may surprise you.

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But you and I are both
partially, if not more so,

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to blame for this epidemic.

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When someone says to us
they don't know,

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we're quick to judge,
we're quick to dismiss.

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And in even a less cognizant way,
we support them with our clicks.

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We click on the catchy headlines,

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we click and purchase
those miracle cure-all products.

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Within medicine,

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there are two specific situations
where these IKA experts flourish.

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The first is the gray zone.

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That is when a question
within the field of medicine

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has not yet had a complete answer
by modern science.

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Take the increased rate of autism.

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You ask an honest, up-to-date doctor,
they'll tell you, "We don't know."

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Now, you ask an IKA expert,
they'll throw you a theory,

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and they'll do it
in a very convincing fashion,

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so much so that they might even further
their career in one way or another.

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That's the problem with these IKA experts.

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The second way that they do this

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is they do it in moments
where good medicine has proved

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that tangible positive effect
is only achieved

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through hard work and dedication.

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Take diet, take exercise, take sleep.

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The way to improve all of these things
is through hard work.

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But the IKA expert
will give you a shortcut.

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And I'm sure many of you here today
have heard of these shortcuts.

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Take, for instance, the shortcut
of the miracle weight-loss diet

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known as the cookie diet.

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Or better yet, the miracle detox plan

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that will detoxify your body
through a juice cleanse,

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will boost your immune system.

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How do these IKA experts

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cause you to ignore legitimate
scientific evidence and advice

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and listen to their theories?

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They do so through stress.

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When your mind is stressed,
your mind is very easily influenced.

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There's a great book called
The Influential Mind.

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And there was a great example
from this book I'd like to share with you.

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Take September 11th, 2001,
in New York City,

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one of the worst
terrorist attacks of all time.

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The day after those terrorist attacks,

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distress in New York City
has an all-time high.

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It takes only one person to run and scream
to get hundreds to do the same.

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Now, if you take that same person
one day prior to the terrorist attacks,

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what will you get?

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You'll get a lot of New Yorkers
looking at this person running and saying,

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"Ah, just another crazy New Yorker."

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Your mind does not respond well to stress.

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As a survival mechanism,

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your mind uses stress as a way
to be influenced by the majority.

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So what these IKA experts do

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is they throw around words
like "cancer," "disease," "death,"

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even get your family involved at times.

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And that's how they get you.

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Now, because of my social media fame,

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I find myself at a very
interesting crossroads

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between marketing and medicine.

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A marketer's job is to sell product
or to push a brand,

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and they do so by studying
your human psyche

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to figure out the best way
to accomplish that.

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They often pair celebrities with products
in order to get better results,

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because they know that when you hear
advice from a familiar face,

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they'll sell more products.

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I'm going to be honest
with you here today.

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I've received some of these offers
in near seven-figure totals

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to support the IKA products.

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Me!

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Imagine what a true celebrity gets
if I'm being offered these deals.

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Forget that.

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Imagine what these companies
make from IKA products

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that they're able to pay
these huge sums of money.

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Look, I get it.

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We live in a fast-paced world.

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We want quick answers
and even faster results.

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But before you go on this desperate search
for answers and shortcuts,

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let's talk about what a true expert is.

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A true expert not only looks

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at the current, most up-to-date
scientific evidence,

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but also looks at history as a guide.

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How many times have you heard
doctors go back and forth

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on the health benefits
and risks of coffee,

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something we all drink every day?

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In 1981, the New York Times
published a study

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that said two cups of coffee
increase the risk of pancreatic cancer.

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In 2017, we claimed
that coffee extends your life.

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Doctors used to advocate smoking
as a stress reliever.

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We used to believe that bloodletting,
a.k.a letting a patient bleed out,

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was a way to cure an infection.

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This doesn't mean
that doctors are not smart.

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What this means

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is that expert opinion is and should be
considered the lowest form of evidence.

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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.

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The more years they've spent
studying a subject,

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the more they realize they don't know,

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the more questions you have,

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because they more questions you have,

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that's the sign of intelligence.

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Now, look, this isn't just
a theoretical discussion,

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where we're going to talk
about philosophical change

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and things of that nature.

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I'm going to have some
practical tips for you as well.

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Number 1:

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ask better questions.

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A doctor prescribes a treatment
or tells you not to go for a treatment.

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Ask, "Hey, doc, why do I need
these antibiotics?

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Do I even need these antibiotics?"

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When an IKA expert claims there's
a miracle cure for whatever ails you,

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ask how is it possible that there are
millions of doctors across the world,

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whose sole mission,
and it's the same mission,

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to eradicate diseases
and restore optimal health,

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don't agree with them.

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Why is it the same five IKA experts
you see appearing in documentaries,

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talking about doom and gloom
from all the things that ail you.

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Second:

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understand basic research.

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Oftentimes these IKA experts
will tout a single study,

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and try and convince you
of their theories.

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Take the recent uproar of autism
and childhood immunizations.

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This uproar started from a single study,

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with 12 subjects,

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which was done by a doctor

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who's been discredited
and lost their license.

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And yet, children are dying.

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So it's your job to be
aware of this research.

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And here I'll tell you how to do that.

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Know that the best form of research
is a metaanalysis.

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It's a combination
of studies, not just one,

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which allows for the decreased likelihood
of chance and bias within the results.

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Note that newer studies are not
necessarily better than older studies.

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Know that studies
that focus on disease markers

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are not nearly as good as studies
that focus on outcomes

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and developments of disease.

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And no matter what media tells you
is a breakthrough,

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there is no single study

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that will influence
the field of medicine enough

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to change the standard of care.

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It can guide us,

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it can put itself into the context
of the entire body of evidence.

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to allow us to figure out

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what the true results are
and what they mean.

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And lastly, third:

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do not write off health professionals
who say "I don't know."

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Instead, what you should infer
is that this doctor is self-aware,

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this doctor acknowledges
scientific limitations.

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And most importantly,

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this doctor is not interested
in slimming your wallet.

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Let's move away from the era
of juice cleanses,

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and move to an era we judge doctors
not by the answers,

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but by the quality of their questions.

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Do not be afraid to say, "I don't know."

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Thank you.

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(Applause)