…this miraculous COVID-19 cure/test/treatment that’s been proven to work with no side effects but there’s a conspiracy by the AMA and Big Pharma to cover it up?”

Sorry if I replied to your email with just this link. I would like to spend time on a personal response, but I just don’t have the resources for that right now.

I probably have heard of the miracle cure. I’m spending all of my leisure time (after seeing patients at Oasis, trying to find data and testing resources on this pandemic, running the Oasis IT infrastructure, contributing IT resources to community agencies, participating in an open-source ventilator project, 3D-printing masks for ER personnel, and being a single dad to my home-from-school teenage sons) reading as much of the papers and literature as I can. So it’s unlikely that you have uncovered something that’s totally new to me. At the same time, I like it when my patients are informed, and I think it’s good to do your own research (as long as you maintain healthy skepticism) and I’m glad when you share what you’ve found. I’m overwhelmed with what seems like important work right now, though, so I’d like to lay down some ground rules.

Ground Rules

Please don’t expect a response. I am trying to help get all of us through this calamity, but that necessarily means spending a lot less time on answering emails. I saw your email. I read it. I probably took at least some action on it, but I’m not going to compose a personal response. Thank you, truly, but right now I have to direct my energy elsewhere.

Not YouTube. No, no, no! There’s great stuff on YouTube, but it’s also a colossal trash heap of dangerous medical misinformation. A few years ago (when I had more time), I watched a lot of videos and tried to figure out what made YouTube medical videos such a Dumpster fire. It basically comes down to this: YouTube is an incredibly easy way for someone to disseminate their brilliant or crackpot ideas to people. Get a $20 webcam and just talk. At the same time, it puts an extreme burden on the consumers of your pearls o’ wisdom. In the time it takes me to “please just watch this 20-minute video” I can do a meaningful face-to-face or telemedicine visit with a patient, or critically review half a dozen articles or publications. A video sucks up all that time, but gives me no opportunity to fact-check or critique — to do that, I have to invest a lot more slow and frustrating time scrubbing through the video, extracting claims, and doing my own research and scholarship. In other words, it’s a perfect vehicle for flim-flam: it’s fast and easy for the creator, but difficult, painful, and time-consuming for every one of the people who might want to look critically at the data being presented. The ‘tuber might even interpret this lack of critical response, caused by the barriers the medium has created, as validation. If someone has something important to say, they need to write it down and make their data available and cite their sources. Often, too, the charisma of the ‘tuber covers up a lot of deficiencies in the presentation. If you send me an email with a video link, you’ll only get a link to this page in response. (Hey, at least I wrote it down and won’t make you stare at my lovely face to see your response.) If you really feel that I need to know about something, send me a link to the information in printed form, preferably that includes real data (not just “I’ve cured 50,000 patients without failures and with no side effects! And I have a courtesy affiliation to this well-known medical institution!”) I’ll review the data, I promise, though likely I won’t have time to do a formal critique in my return email.

No, I won’t facilitate bad medicine or hoarding. Just because someone makes claims on YouTube (or even in a peer-reviewed scientific journal) doesn’t make their ideas good medicine. I won’t prescribe medications to you just because you or someone else thinks it’s a good idea. Even more emphatically, I won’t prescribe potential but unproven treatments just so you can keep them to yourself and potentially deprive actual sick people of benefits should the treatments ultimately prove helpful. Please don’t even ask.

Critically reading scientific literature has been an avocation of mine since long before medical school. I have thousands of hours of training and experience. When this crisis is closer to being over, perhaps I will write a paper (possibly even a book) on “Why That Medical Miracle Probably Isn’t as Amazing as it Sounds.” Until then, just trust me (or at least just trust that I believe) that it is far, far more complicated than most people (even most doctors) appreciate.

Thanks for reading this far and, again, my apologies for not responding personally.