Is Anybody Watching

(0:01) Hi, this is Dr. Daniels and welcome to Healing with Dr. Daniels. It is Sunday, October 27th, and today's topic is, "Is Anybody Watching?" Today, I'm going to examine a watchdog group in the healthcare industry, its findings, and why watchdog groups are ineffective in assuring the quality of your medical care. And as always, think happens.

(0:33) Now, as always, I have to look at, like, why this topic? Well, it came up in conversation with my mother. She was enraged that she received more or less $50,000 worth of surgery, which was not only unnecessary—she later found out—and, of course, extremely harmful, almost leading to her needing an amputation. And she realized that the financial incentives were such that the hospital was actually incentivized to create these events, and she was very, very upset about this.

(1:12) And then, of course, she confided in me that my brother just got out of the hospital from an overdose. He's diabetic, on his insulin medications. He's still not able to answer his cell phone—I know because I called. And we think his brain might be fried, this time for good, from having too little blood sugar for too long. So my mother says, there needs to be oversight. The government needs to create oversight.

(1:40) And so, of course, we can forgive grandma because she's 89 years old. However, I must say, in her defense, that I thought the same thing at the tender age of 25. And that was right before I graduated from medical school. I said, man, there's got to be some oversight here. This is out of control. So we're going to look into this concept of oversight.

(2:07) But first, we're going to take our turpentine and our shilajit.

(2:16) And we have our usual—we have some turpentine. Yay! Now, I live alone, so it's okay for me to not label my bottle. But you guys need to label your bottle. Your turpentine bottle should be clearly labeled because someone in your house might accidentally drink it, thinking it's something else, and have a negative experience. So this turns out to be about half a teaspoon in this pipette dropper. It's a pipette dropper, and they're available on Amazon, of course, in bulk for a very reasonable price.

(2:49) And we're just going to squeeze this on top, like so. Now, you will notice that not all of the sugar is saturated. Yeah, see that? Okay. Now, we have some water handy. I like to put the water in my mouth first, because then I can get it off the spoon quickly and down my throat.

(3:25) All right. That's the turpentine. Now, any turpentine left in my lips, I wipe off because I don't like the flavor of it. But it is so good and helps you feel just wonderful. And then we have our little—let's call it a research spatula. Get these at Amazon as well for not very much. And this is Shilajit. Now, I use this because it's metal and this stuff is very tough and gooey.

(4:01) So actually, it's been very hot these days, so this is melting very easily. Here we have it. There we go. Now, we're going to put that in our water, and we're going to let it dissolve, and we're going to drink that a little later on. Yep.

(4:18) All right. Let's get back to this matter of oversight.

(4:25) Now, what is it that my mother at the age of 89 just figured out? Well, why don't we ask the folks at Purdue University what mom figured out? And so here it is. It says, "Your health care may kill you." Medical errors. Of course, I disagree with that. These are not errors. These are doctors doing what they were taught and trained to do. And so it's referred to as errors. The word is "errors" because it was not the intent of the doctor to kill the patient, and that was the error.

(5:00) Whereas a doctor's procedure, that is not what the error was because in many cases, in most cases, these doctors did indeed follow the standard of care. So just so you understand what a medical error is. It's called a medical error when the outcome, patient death, is something that wasn't planned in advance.

(5:17) So the big thing about the people at Purdue and what they figured out is that recent studies of medical errors estimated errors may account for as many as 251,000 deaths in the United States. Now there are estimates out there in the medical community itself, but not me, them, as high as 444,000 deaths a year. Might count 880,000, but hey, let's use the low, this is like a very low number, 251,000. We're going to go with that number and that's enough for us to do our calculations. We don't need to make anything any bigger than what the medical industrial complex confesses to.

(6:08) Now the folks at Purdue took a pretty big look at this, and this is in 2017, and they said, "Hey, medical errors in the United States is a third leading cause of death." This is something that's established. There are medical articles saying it's not true, but that's exactly the article say it's not true. They don't offer any quantitative recount. They don't say, look, this number of 40,000 to hospital-acquired infections, that's wrong. Those deaths were really due to blah, blah, blah, blah. So there's no itemized refuting of this number of 251,000. The only refutation is, "No, no, can't be true."

(6:54) Yeah. Shocking, but this is something that's been checked and double-checked and this 251,000 is a rock-bottom number, and it's actually much higher as they will say.

(7:03) Medical errors are the third leading cause of death. Error rates are substantially higher in the United States than in other developed countries, such as Canada, Australia, New Zealand, Germany, and the United Kingdom. Even though this is much higher, only 10% of errors—medical errors, we'll just call this events when people die. Let's be really just clear about this—are reported.

(7:28) So now they concluded this and they did an evaluation of the implementation of the MedMarx medication error reporting system. And so we can just say that what they're saying is after implementing this medical error reporting system, that errors being reported over a 12-month period increased significantly. At the same time, the proportion of corrective actions taken by the hospitals remained relatively constant. In other words, the hospital was aware of more adverse events, but did not take corrective action commensurate with the increased awareness.

(8:37) So again, this is the folks at Purdue and it's published in PubMed, the National Library of Medicine. But the important thing here to understand is 251,000 deaths per year due to medical care and only 10% are reported. Well, let's get the math on this. If 251,000 is only 10% of the damage, could it be 2.1 million Americans every year die as a result of having received medical care?

(9:04) Let's not stop there. Let's take a look at something else. We have, thank God, Hispanics in the United States. Why do we thank God for Hispanics? Because Hispanics have a cultural difference from other Americans and they live seven years longer than the average American. This is even longer than so-called wealthy Americans because they've tried to create class divisions, rich against poor, black against white.

(9:38) So you're saying that, well, rich people live longer. They don't live longer than poor Hispanics though. So living longer is not a matter of money. So we can just discard that concept. It's nothing to do with money. That might be the opposite. So one thing that sets these Hispanics apart, aside from their knowledge of Spanish, is that they do not have access to healthcare and they live seven years longer.

(10:09) So you can deduce that if access to healthcare shortens the life of Americans by an average of seven years, then a large number of Americans must be dying from their healthcare, which brings us to the next question. So if we take a 251,000, and that's only 10%, then the true damage must be, excuse me, 2.5 million. Well, how many Americans die every year? Well, for this, we need to go to CDC. That would be the Center for Disease Control. They count these things and they say, well, 2.8 million Americans die every year.

(10:45) Well, let's do a little itty-bitty bit of math. And if we say that 2.5 million Americans a year in the year 2017, we don't have stats from our recent years, die from their medical care. Only 2.8 million people died that year.

(10:58) Then 89% of people die because they had access to healthcare. Shocking, isn't it? Absolutely shocking. So this is just one way of indirectly measuring the magnitude of the problem.

(11:18) So you probably say, oh, Dr. Daniels, surely you're exaggerating. I really wish I was. But we only need to go to Wikipedia. I like to really rely on these mainstream information sources to let people know that the information is out there. It's just like sitting there right in front of your eyes and for anyone who wants to look. So, you know, you might draw different conclusions than I draw, but the facts are there.

(12:00) So if you ask Wikipedia, you say, hey, wiki, who's looking? Are there any organizations that are looking at the quality of healthcare in the United States? Wow. Holy cow.

(12:11) There are no fewer than 40 organizations. Let me just read you a few. So now the presumption is that healthcare is so dangerous that it can only be provided by people who are trained, tested, and certified. So all of these accreditation organizations that test nurses and test doctors are actually part of the quality assurance program. All right. So the Medicare and Medicaid has said, if you're not accredited by these organizations, they won’t pay you.

(12:56) So there's American Association of Accreditation for Ambulatory Surgery, Accreditation for Association of Ambulatory Healthcare. You would think it would be redundant, but maybe not. Accreditation Commission for Healthcare, American Board of Certification in Orthotics and Prosthetics, Pedo-Orthotics, Board of Certification in International Certification, Center for Improvement in Healthcare Quality, Commission on Accreditation of Rehabilitation Facilities.

(13:19) You get the idea. The point is, there's at least 40 organizations here. Now, there's one organization in particular, the Joint Commission, TJC. This used to be JCAH.

(13:31) This is the most well-known. It credits hospitals and health systems, and they have to maintain their accreditation regarding their clinical care processes, ability, and performance on specific quality measures and standards of care. This organization has been involved in performance measurements since the mid-1980s, which is when I came into contact with them. I'll tell you more later about that. And they launched its initiative in the late 1990s as the first national program for measurement of hospital quality.

(14:00) TJC has established standardized core performance measure sets for hospital operations and contributes to the national strategy for improving healthcare quality transparency. So just the fact that there are organizations like this and that there are more than 50 of them should set the bells off, right? I mean, do you have 50 organizations accrediting your ability to wipe your butt? No. Why? It's a pretty safe endeavor, right? It’s also private.

(14:34) But the point is, the number of organizations overseeing the safety should immediately let you understand that healthcare is very dangerous. And my estimation that 89% of people die from chronic healthcare might not be excessive. So let's take a look and see.

(15:15) There’s a few more major organizations. So seven quality measure healthcare organizations are actually explained. And TJC is one. It was JCAH back in my day. That was 1985-86-7.

(15:28) The Centers for Medicare and Medicaid Services, this mandates reporting of quality measures by hospitals, doctors, and providers of other healthcare products and services. It measures the management system, provides a standardized process for ensuring that the Centers for Medicare will have a rational and conspicuous system to measure the quality of care delivered to recipients. The system was developed in coordination with the other organizations mentioned in this post.

(15:50) And it collaborates with private nonprofit organizations as a whole other list, such as the Joint Commission and the American Medical Association to create quality measures necessary for regulatory compliance, including the hospital outpatient quality data reporting system.

(16:06) Okay. And we have the National Committee for Quality Assurance with the National Quality Forum. We have the American Medical Association with the Agency for Healthcare Research and Quality, AHRQ.

(16:24) Write that down. Look them up. They document killings after killings after killings after killings in the medical system. I have done at least five radio shows just with the data AHRQ has unearthed and is published on the internet. Now, have any deaths been, anyone been punished? Of course not. But that’s not what we’re about today. We don’t want to punish anybody. We’re not interested in that.

(16:51) Utilization Review Accreditation Commission. And this one checks into healthcare utilization reviews, patient-centered healthcare homes, pharmacy benefits management, healthcare website maintenance, claims management, and disease management to list a few. And so this one is far-reaching. And that you can even tweet them.

(17:19) So if we take a micro look, let’s just take a micro dive into one such organization. And so when mom told me there's got to be oversight, there is oversight. And even with this oversight, she received $50,000 of devastating surgery, which her insurance company did pay for. And her son recently was overdosed on his medications. And so now we have literally a 89-year-old woman ministering to the health of her 63-year-old son, both of whom have been devastated by the healthcare system.

(18:10) Medscape to the rescue. So as I was looking into this, I said, well, let me do some research. Let me look and see about mom's little oversight concerns. And here it is. Headlines, October 22nd, hot off the press, 2019. Medscape Family Medicine says, "Watchdog Group Finds There Are Safety Quality Gaps in Outpatient Surgery Centers." So we have a watchdog group, they are watching, and man, have they got findings.

(18:59) So yes, mother, there is oversight. Now let's take a look at this oversight and how they are oversighting and what they have found. And you would hope, and many of us presume, that oversight means you look, you find a problem and you correct it. And there’s a lot of implicit assumptions just in that one sentence. And many of those assumptions may not be true. So let’s take a look.

(19:27) And so outpatient same-day surgery centers across the United States differ in training of providers and staff, communication with patients, and several key quality and safety measures, according to a report released today by the nonprofit watchdog organization, the Leapfrog Group. Researchers collected information from two surveys on the measures of hospital outpatient departments and ambulatory surgery centers. The results are aggregated in this year's nationally, but after next year's survey, they will be available by facility, according to Leapfrog's president.

(20:03) So they threw all the numbers together in the aggregate. So you couldn’t tell if one center had better stats or compliance than another center. But next year they’re going to separate it out so you can say, oh, that clinic did better than this clinic. Okay. So what does it mean to do better? So by August 31st hospitals, 1,141 hospitals and 321 ambulatory surgery centers had responded to the surveys and others have until November 30th to submit information to the website. So some information is missing, but let’s go with what we have.

(20:43) So one gap is found in the percentage of providers who are board certified. 71% of people who perform anesthesia are board certified compared with 83 in hospital departments. So if you have your anesthesia outside of the hospital, it’s being done by someone who’s board certified in 71% of cases. If you have your surgery done in the hospital, the person’s board certified doing your anesthesia in 83% of the cases. That’s about a 12% difference. So it’s a 12% chance if you’re at an ambulatory center, increased chance that whoever’s doing your anesthesia is not board certified.

(21:28) So when asked whether all providers performing procedures in the facility were board certified, only 64% of ambulatory centers said yes and 64.9% of hospital departments answered yes. So if indeed board certification is important, there appears to be not a difference between the hospital departments or the ambulatory care departments. And that’s an if. So let’s just put that as an if.

(21:56) Now I will tell you when I was training in medical school, I did a rotation called anesthesia. So from one month—actually it was my residency—I was putting people to bed, to sleep, and waking them up, putting them to sleep and waking them up. I was assisting the major anesthesiologist. And in most cases back then, the anesthesiologist was not board certified, but his outcomes were outstanding actually.

(22:28) And so what they’re saying here is board certification is a designation that demonstrates expertise in a specialty area. And it’s one of the things that can signal consumers in particular that their physicians have the right experience. Now, this is like Saturday Night Live would say, not necessarily news, not necessarily true.

(22:45) So the board certification process for many specialists involves them sitting at a computer and clicking buttons until they get the right answers. So it’s not—that particular board certification process is not necessarily, or I shouldn’t say not—it doesn’t. It doesn’t reflect the doctor’s ability to do anything except click buttons.

(23:12) Okay. She added another surprise in the findings was that outpatient surgery facilities, some of them, are not using safe surgery checklists. And so we think it’s a patient expectation that when they go in for a procedure in any of these settings, the surgical team is doing everything they can to make sure that they’re going to be kept safe.

(23:39) There’s certainly a lot of evidence that safe surgery checklists can do that. But you know that only 4% said they didn’t always use a checklist. That’s from a voluntary sample who were willing to actually say they didn’t think it was important or didn’t do it routinely.

(24:00) Now again, data is data and we’re going to accept their data as complete. So really, is a deficiency present in 4% of centers going to account for death or say hastened death in 89% of cases? I think not.

(24:28) So we have two things here. The board certification of doctors being measured and there’s not any clear indication that that is a measure of quality. And even if it is, the percent that are board certified between hospital departments and outpatient departments is not substantially different.

(24:55) The next thing is checklists. Well, if this is a deficiency, let’s just say it is, only 4% of centers say that this is something that they’re lacking.

(25:03) Now, here’s my pet peeve. The surveys asked facilities if they always had a clinician certified in advanced cardiac life support and/or pediatric advanced life support present when patients are having procedures or are recovering from them.

(25:30) I took advanced training and became certified not only in advanced cardiac life support, but advanced surgical life support because I was a medical director in a remote area in Wisconsin where I just didn’t have backup because there just weren’t other doctors. So the decision was made that I should be certified in advanced surgical life support. In other words, putting in chest tubes, arterial lines, subclavian lines, intubation, whatever would need to be done surgically on an emergency basis for a sick person.

(26:15) I was enthusiastic. I was thrilled. So I flew to the center because of course I was in a very remote place. It was pretty much a plane ride to get anywhere from where I lived in northern Wisconsin. So I fly to this place, it’s snowing, it’s winter, and I get up early, leave my hotel room and get to the hospital. They have all these dogs that have been anesthetized and we’re going to practice on these dogs. We have seven procedures, as I recall. This is back in 1985-ish. So I do these procedures.

(26:52) Oh, they tell us. We’re doing all these life-saving procedures on these dogs, which are similar enough to humans, they have the same organs. If your dog is alive at the end of this, you’re exceptional. I said, okay, my dog is going to live. And I did all of these procedures. Everyone else had all the procedures. This dog died, that dog died, the other dog died. So my dog, I did all the procedures and my dog lived.

(27:18) And so I said to the teacher, hey, my dog’s still alive. What are we going to do? Ready for my prize, right? Ready to take all the tubes out, maybe give the dog some rehabilitation, turn him into a service dog, whatever. That’s what I thought. Wrong.

(27:37) The teacher said, everyone will continue to do procedures on your dog until your dog is also dead. Aside from the animal cruelty angle, which we won’t even get into, the procedures that your doctor is being taught to do in an emergency surgical situation would actually kill a healthy living organism. So to say that certification in this particular area is desirable or a measure of increased patient safety.

(28:18) All right. So we’ve got two measures, which if implemented, we know would not improve any patient outcomes. And then what about advanced cardiac life support? Again, I used to do that when I was practicing and I was trained in that in medical school.

(28:42) But let’s look at pediatric life support. So we’re saying then parents should make sure that a pediatric advanced life support certified person is present when their children are having procedures.

(29:00) And so almost all of them had adult life support certification, but this was not the case. So for patients and for kids, 88% in one case, in the outpatient, and 96% of the hospital departments had this certification. So the question is, what if the ambulatory centers increased their compliance to the 96% of the hospital departments?

(29:36) So I took the liberty of looking up pediatric advanced life support. And if a child received pediatric advanced life support, what was their chance of survival? Answer, 7%. And those 7% who survived generally had long-term damage. But let’s not go into that. A life is a life, let them live.

(29:59) But 7%, so for 100 kids who received advanced life support, 97 died and 7% lived. All right. Let’s not sneeze at that. But wait, we’re talking about an 8%—I’m sorry, about 7% improvement in something that is only going to apply to 7% of people. So if we do the math on that, and we round it up to the nearest percent, the number of lives that would be saved if the ambulatory centers increased their pediatric advanced life support certification is zero. Zero.

(30:48) Few monitored hygiene mechanically. So Leapfrog, named the organization leaders, called the findings on hand hygiene disappointing. So no ambulatory centers, only 6% of hospital departments, reported using mechanical monitoring. Almost all in both categories reported they rely on direct observation. Only 75% of ambulatory centers and 66% of hospital departments had a system in place to regularly train clinicians on and validate handwashing procedures. Accountability was also lacking. Only 53% of ambulatory centers report their leadership is held accountable in this area and 69% of hospital outpatient departments stand for said.

(31:55) So again, the difference in compliance between ambulatory centers and outpatient departments is not substantial enough to make a difference. And again, you have to ask yourself, not that doctors should not wash their hands, but are the systems that they are talking about going to be effective and have consequences in terms of positive impact on patient outcome?

(32:55) We don’t know. Consents often are being taken the same day. So researchers ask, when consents were being solicited for the surgeries and most of the ambulatory centers, 64.8% and nearly half of the hospital departments, 48.7% said the day of the surgery. Only one in seven, 14% of ambulatory and one in five, 20% of hospital departments said they asked one to three days in advance. And the reason for this, of course, is the patient might feel pressure to go through with a procedure that maybe they would have backed out of. You know, here they are, they’ve done the whole prep work, they’ve got their relatives to drive them here, and now they’re presented with a form and they’re like, nah, I’ll sign it.

(33:02) So it could be construed as undue pressure. But does it lead to worse clinical outcomes? Again, we don’t know. And why don’t we know? Because they didn’t measure.

(33:07) So the shortcoming of many of these watchdog groups is they are measuring parameters that may not have relevancy to outcomes. So another stat that I found was that if your doctor is not liked by his colleagues and they decide that they’re going to report him for what, I don’t know, for anything, then doctors who’ve been reported by their colleagues have an increase in adverse outcomes. Right. Yeah. But how much of an adverse outcome?

(34:03) So they actually did a study and they found that these—I’ll call them unpopular doctors—had surgical, these are surgeons, had surgical complication rates of 14%. We will presume the complications they measured were pertinent and relevant complications, okay, so we’re not going to question that. The surgeons who were more popular with their colleagues and had zero complaints had a 10% complication rate.

(34:34) So unpopularity with your peers only accounted for four percentage points. In other words, like 25 to 30% of the patient harm. Well, duh, what about 75% of patient harm that’s being done by the popular doctors? Again, this is why oversight is so ineffective because you’re looking at things that have very small, very little impact. No one takes a look at the big nut. Why are 10% of all surgical patients having a complication? It’s not due to doctor popularity because these are the doctors who have zero complaints lodged against them.

(35:43) And so you got to, again, this is another sample that these doctors who are responsible for the lion’s share of damage and patient harm are doing exactly as they were trained to do, are following the standard of care and are in no way deviating even in their personality and temperament.

(36:43) And so this answers the question, is anyone looking? Oh yeah, they’re looking. There’s a lot of watching being done, a lot of looking, a lot of looking, a lot of looking. Well, it took mom to age 89 to sort this out. A lot of people figured out a lot earlier and they’re like, oh man, we got to get a committee to get a look at this. This is so harmful and damaging.

(37:00) And so the real deal is this, that it is the routine, customary, appropriate, and sanctioned approved practice of medicine that is causing the lion’s share of harm, easily 60% plus. And this is why medicine is so dangerous. So they have you, the patient, looking in all the wrong directions. Is my doctor washing his hands? Not, is the surgery intrinsically dangerous and unnecessary and ineffective? Oh no, don’t ask that question. Is my doctor board certified? Is the facility accredited?

(37:54) And so you’re looking, looking at all these things that just frigging don’t matter and are not, not only not keeping you safe, but in large part responsible for your health and your harm.

(38:28) And another example I’ll give you is when I was the medical director of this community clinic in Hayward, Wisconsin. Well, really Lakota Ray, Wisconsin. So it’s outside of Hayward, but we were so small. The nearest city was Hayward, population 1,500 at the time.

(38:46) So I decided that the community I served was going to get healthcare that was thorough. We had systems in place. Every ordered lab test was done. Every lab test that was done, we got results on. If we didn’t get results, we’d call the lab and follow it up and all the results were received. They were reviewed. They were initialed. Patients were contacted and we had a system where no one fell through the cracks. It was like boom, boom, boom, boom, boom, thorough.

(39:52) And we even followed up with patients to make sure they were compliant and how they were doing. If anyone had any issues, adjustments in therapy were made. And so we had this whole system that was in place and all these things were happening.

(40:05) So the administrator of the clinic wanted the ability to bill for our care. So we were giving out the care free to Indians, but non-Indians hearing about our great outcomes wanted to come to the clinic and we had no way to bill them. And in order to bill them, we had to get accredited by JCAH at the time, which has morphed and got renamed and renamed and renamed. And when you hear my experience with JCAH, you will see why they got renamed at least four times.

(40:46) So I was very excited. I looked forward to any opportunity for feedback and improvement and I wanted to make things better, better, better, the best they could be.

(41:02) And so in came the JCAH criteria. So before they do a site review, they let you know what they’re looking for and what they want to see in place. And I looked at what they wanted us to do and what they wanted us to do and implement would have actually resulted in a lower quality of healthcare.

(41:29) It would have resulted in us spending an incredible amount of time on paperwork and not spending the time on contacting the patients, doing the follow-up, finding those missing lab tests, making sure they were done. And instead, our energy was diverted into activities that would not benefit the patients at all. And I took a look at what they wanted us to do.

(41:55) But first of all, we were already exceeding the quality in all of their outcome measures. We were already exceeding their quality. In their process measures, the processes they wanted to put in place were very cumbersome and resulted in less attention, almost no attention really, to the patients and to their situation and helping them.

(42:28) And I was extremely, extremely disappointed. And I realized that implementing what they wanted implemented would result in actually decreased patient outcomes. And of course, this was 1985, 86-ish.

(42:53) And so I was told, they always tell me, "Oh, Dr. Daniels, thank you so much for your input. We are always improving our processes. And right now, this is what we’re going to do, and we’re sure it’s going to get better later."

(43:08) So what ended up happening was there’s a so-called oversight organization, but they were under pressure to develop criteria that every center could pass. And we’re going to find out who pays these people. And here it is, conflict of interest. JCAH inspections must be paid for by the facilities.

(44:02) So they have an interest in having as many facilities as possible accredited so they can have repeat visits, right? So once you get accredited, it’s only for a limited period of time, and JCAH has to come back and accredit you again. So really, are they going to take a look at facilities and start shutting them down? Well, then their market is going to shrink.

(44:43) So that’s another issue with these agencies. And the pressure on these accrediting agencies is to accredit as many facilities or individuals as possible, because that’s where they make the money. They get paid per individual they accredit. And this is why these accrediting agencies and organizations can never and will never result in a reduction in the number of Americans who die prematurely as a result of their healthcare.

(45:44) Now, and I think that’s a better understanding than to say, oh, this person was killed by their healthcare. It’s like my husband was riding his motorcycle and got run over by a truck. OK, getting run over by a truck didn’t kill him on the spot, but he definitely died sooner having that shock to his system.

(46:29) And so it is the case with the medical industrial complex, you know, getting a certain number of injections, getting certain numbers of surgery, numbers of times you go under anesthesia, all these things weaken the body, weaken the body, weaken the body, and cause it to die sooner than had those interventions never happened. And this is something that is simply not recognized at all. Instead, what they want to measure is the proximal cause. The doctor make the cut that caused the death within 30 days.

(46:51) And so because that is the way it’s looked at, the cumulative effect of the weakening and the destruction of the medical system is not even looked at and not even appreciated. And this is what we capture when we look at the Hispanic paradox, which is we have the least doctored population in the United States and they’re living seven years longer than the average American who has access to healthcare.

(47:36) Now, what you want to do about it? Hey, that’s on you. I can tell you what I’ve done about it. I have moved back into the jungle where there is no chance, none, none of me getting any healthcare, right? There’s no ambulance that can get here. There’s no hospital within even an hour. And so I’m feeling pretty safe, feeling pretty safe. Yeah, I should make it to maybe seven years longer than the average American.

(48:03) And even with my mother who’s 89, you know, there have been many times where I’ve had to intervene and save her life by extracting her from the medical industrial complex and stopping her drugs. Of course, I turned my back. Six months later, she’s taking one or two drugs. And I was like, mom. So the next time your insurance company refuses to approve medical care, count yourself lucky.

(48:43) So what else do I do? I don’t have health insurance. So I make it real clear that if someone decides to provide healthcare for me, they will not get paid. It won’t happen. So that’s really important. Now, my husband, many of you know, he died two years ago. He was sick and he decided he wanted to go to the hospital. I said, okay, honey, we will go to the hospital. We lived in a different place that had better roads and the ambulance could get to the house. So the ambulance came and took him to the hospital.

(49:39) And then they decided that he needed surgery. And they said, we can’t do surgery now though, because it’s going to take the anesthesiologist at least four hours to get here. Well, where are anesthesiologists? He’s out on his boat or whatever. So the anesthesiologist came to the hospital. And from the time the anesthesiologist arrived and they wheeled him into the operating room, it took him 35 minutes and $3,000 to kill him. And so I feel like I really got off easy. Had it been the United States, it would have taken him probably a week and $100,000 to kill him.

(49:47) So they told me, of course, that yes, we did kill him. However, we did him and you a favor because he was in a lot of pain. I said, oh, so the cure for pain is killing someone. And actually, if you look at the United States and the opioid epidemic, that is true. The cure for pain is killing the person.

(50:06) But what am I trying to say? What I’m trying to say is healthcare is simply dangerous. And when you embark on engaging the system, it’s not something you can win. As you can see, the Hispanics, the Hispanic paradox, who do not have access to the system are living on average seven years longer than people who are educated, sophisticated, and wealthy. So money, not a protection. Intelligence, not a protection. It is simply engagement. It’s like walking into a meat grinder. It’s just not going to end well.

(50:53) So that is what I would recommend, to simply not engage the system. Many people say, oh my God, Dr. Daniels, that’s great for you because you’re a doctor. Oh, no, no, no, no. Watch your brain. Watch your mind. So I may have gone to medical school, may have become a doctor, even got board certified in family medicine. But my plan for my health does not include any drugs at all, any screening tests, any hospitals, any clinics, none of it.

(51:24) And some people say, oh, well, I just get my annual physical every year. Did you know the medical industrial complex has determined that your annual physical exam is actually bad for your health? And some people say, well, I just get my baseline. Well, I have tests done. Yeah. So again, there’s no evidence that those things are useful or beneficial. And I’m saying this to you as a 62-year-old individual who has lived without health insurance for at least 25 years, at least 25 years.

(51:57) And how do I do it? The answer is while I was practicing medicine, I noticed that what I was doing in terms of what I was taught in medical school to do was absolutely useless. I mean, frigging useless. And so what I did was I started using natural methods and I would compare it heads up to the medical method. So I do the medical method first and it failed 80% of the time. And so the placebo effect is 30%, right? So the medical intervention was actually harmful because its success rate was less than doing nothing.

(52:39) Then I offered people the option of doing nothing or doing natural stuff. And I saw which natural things they did that gave them success when the medical industrial complex failed. And I have a course and you can find this at vitalitycapsules.com forward slash heal at home. Yes, heal at home. And that will share with you the very knowledge that I rely on and have relied on for the past 25 years. And that has saved me over $100,000 in health insurance premiums, co-pays, deductibles. It saved nothing of time out of my life where I haven’t had to get in the car, drive someplace, sit, wait in a waiting room, submit to humiliation, felonious assault and dismemberment.

(53:30) And I sit here before you today with most of my body parts. I did lose my appendix in an unnecessary surgery. And that was, I said, the last straw, never again, no more engagement for me. No, I have many friends who are doctors and socially fine. We get along, but no, no prescriptions, no surgery, no testing. I am done. And as you can see, doing very well for it.

(53:59) And you’d say, oh, Dr. Daniels, you’re just an unusual case. Hispanic paradox. Yep.

(54:03) So that brings us to the questions that you mailed in. Let us take a look and see. I know I got this opened up. You know, if I were more computer savvy. It says search. Sunday podcast questions. Here they are. Yep. All right. Sunday show, October 28th. Yay. Oh, 27th. Sorry. October 27th. Oh, my daughter’s birthday was yesterday. Hi, Emily. Happy birthday.

(55:07) I had Emily at home on the floor without assistance living in Florida. I just put out a little blanket there, sat down, sip some Kool-Aid and waited. Ouchy pop, eight and a half pounds. Not a problem. Just giving y’all some reinforcement there. Okay. So let’s see. Joe says,

(55:24) Hi, Dr. Daniels. On a recent show, you mentioned not using Vicks anymore because they dropped in a key ingredient. What ingredients did they take out? Turpentine. Turpentine. So they took out turpentine. So I’ve since rethought that position. So I would say, go ahead and get Vicks and look on the bottle, see how many grams it is, multiply that by 4% and add that much turpentine. Stir it up. There you go. Ready to go. So you can still have turpentine in the ointment form.

(55:57) Here’s another question. Am I able to continue using turpentine sugar if I’m pregnant? Will it hurt a developing baby at all? That’s a good question. So in answering the question, well, the quick answer is I do not recommend turpentine and sugar for pregnant people because I don’t have enough personal experience to know if it’s safe. That’s my personal position. So I don’t recommend it. I have had people use turpentine and sugar in order to conceive because it really helps with infertility. And as soon as they get a positive pregnancy test, they stop it. And those ladies have done very well and they’ve had just really wonderful babies.

(56:34) However, the state of California has put turpentine on a list of things that possibly or are known to cause birth defects. So I do not recommend that.

(56:51) Next question. How long does it take for salt water to go bad? Almost never. Almost never. So I would say if you’ve mixed up salt water and you’re going to not use it on the spot, then just put it in the refrigerator and it should be fine. And it should last really weeks.

(57:29) How long will bottled salt water last at room temperature? I would say at least a day. And again, you say bottled salt water, I’m not sure what that is, but you want your salt water to be distilled water with salt added. So that water will have the maximum lifespan because what makes water go bad is the living organisms that are in it. There’s a hawk that went by the window with prey in his claws.

(58:09) Okay. What can I do to lower cholesterol and reduce gout? Okay. So I do not recommend that you lower cholesterol. In fact, I recommend that you raise cholesterol. But let’s talk about lowering gout, reducing gout. You can reduce your gout by reducing your protein intake. What does that mean? So you reduce your intake of protein as a percent of your diet. And so over the years, and with observation, I’ve come to see that that’s what causes gout attacks. So if someone is drinking, say, skim milk, gout attack. Switch to whole milk, no gout attack. Why? Skim milk as a percent of calories is very high in protein. Full milk is not because you have the fat and everything else.

(58:46) So the quickest way to not have gout attack is stop eating lean meats. No. If you’re going to eat meat, eat the fat, the skin, the whole bottle less. But more precisely, let’s just cut to the chase. If you really want to get rid of your gout, drink more water, have more bowel movements, because what causes gout is the buildup of uric acid. And uric acid happens when your body’s ability to metabolize protein is exceeded by the protein in your diet. So that protein that you eat is converted to uric acid, but the next step doesn’t happen, which is the uric acid going through the kidney and getting peed out. A lot of people say, well, Dr. Jones, what about uric acid stones? Good question.

(59:38) I challenge anyone listening to collect your urine until you have a quart of it. Leave that urine sitting someplace. You can put a top on it if you want to. Check back at one day, two day, and three days. You will see crystals and stones forming. So what forms stones in your kidneys, it’s not uric acid, it’s not oxalic acid, it’s stagnation. And so you need to increase your water to flush that stuff out. Now, of course, yes, it does help to cut out the protein in your diet. So increase your water, increase your vegetables, and increase your bowel movements. When you increase your bowel movements, that uric acid is now dumped through the liver and out into the toilet.

(1:00:51) So let’s just say you’re not going to do what I just said. At least keep your hands and feet warm, because if you keep them warm, the crystals will not form. So the crystals form at a lower temperature, they form at a higher meat in your diet, and they form when you don’t have enough water to drink. Those are the reasons for the formation of these uric acid crystals. They’re like knives that literally stab you and, oh, it hurts so bad. And you get all this swelling. All right, so that’s how you reduce gout. You got a lot of choices there. If you do even one of those things, it will help.

(1:01:06) Billy says, what would Dr. Daniels do exactly to recover from multiple sclerosis? Of course, I wouldn’t get in the first place, but multiple sclerosis, some people do get it. Please be specific from diet all the way to which supplements, the whole nine yards again, please. Your advice for me is gold. All right, so obviously that’s a pretty long question. It’s taking a long time to answer, but these are the kinds of things I address in the Heal at Home program that you can find at vitalitycapsules.com forward slash heal at home.

(1:02:04) All right, so Billy, that’s the answer. The answer is we talk about all these different natural healing regimens in the natural healing course, which is a home healers course, where literally my goal is to train each person to be the healer in their home, so they no longer have a need for health insurance, deductibles, co-pays, doctor visits, pharmacies, even over-the-counter medicines all become unnecessary.

(1:03:11) Peggy says, my other half says he was told a long time ago that we cannot digest lettuce, so he doesn’t eat it. Is this true? All right, so what’s the word "digest" mean? That means to break it in smaller bits and absorb it. So lettuce has a very high fiber content. Different things that you eat have different purposes. So lettuce is eaten as a raw vegetable, but the fiber content literally scrubs your intestines and cleans them and enables them to be in a better condition to absorb nutrients. Now, the lettuce itself, depends on what kind of lettuce you have. If you’re eating iceberg lettuce, which is bitter, it actually helps stimulate the liver and it does have some chlorophyll and some nutrition that you can absorb.

(1:04:45) But in the main, he is correct, lettuce is mostly fiber, but it’s very important fiber. So this person says, hello, what would you say is the best way to avoid age spots besides regular bowel movements? Well, let me put it this way. If you’re not having regular bowel movements, you will not avoid age spots no matter what you do. Look at my face. I have a little mole that I’ve had since I was in my 20s. And look at the absence of age spots. Yes, absence of age spots. So what did I do today that many people probably didn’t do? I put on castor oil. If you apply castor oil to your skin, it loosens up the toxins on your skin so that you don’t form age spots.

(1:05:29) And the age spots you already have, they tend to go away. Now, castor oil does not smell very good. So I add a little lavender oil and ylang-ylang to my castor oil and you’d never know it was castor oil. But at the same time, the result is that I have skin that’s clear and no age spots. I take my skin very seriously. And it’s okay for you to take yours seriously, too.

(1:06:29) Okay, we have come to the end of our show, end of our 60 minutes. And I just want to remind people to please visit VitalityCapsules.com to get your free report on the wonders of turpentine. It’s called the Candida Cleaner, but we’re interested in renaming it, by the way. So if you’d like to submit your suggestion for a name for a report that tells about all the wonders of turpentine to help people get the benefits and save tens of thousands of dollars in healthcare and torture and suffering, then please send your suggestion to jdaaniels@gmail.com. You can also send your questions for next week’s show to jdaaniels@gmail.com. So look forward to getting your questions and your suggestions for a new name for the Candida Cleaner report. Also, please visit VitalityCapsules.com and check out our sponsor, Vitality Capsules. And as always, think happens and we’ll see you next week.