Indian vs American Medical Systems: Which One is BETTER? | With ROHIN FRANCIS From MEDLIFE CRISIS

Abhijit: Hey everyone. Welcome back to Rationable Conversations. Today we have a very special guest who I've been a fan of for a very long time.

It's Rohin Francis from medlife Crisis on YouTube. Rohin, welcome to the Rationable Conversations.

Rohin Francis: Thanks so much, Abhijit. Thanks for the invite. Lovely to be here.

Abhijit: Oh, it's my pleasure.

when did you realize in your life that you wanted to be a doctor? Is it a family thing? Has it been handed down for generations or

Rohin Francis: No? I'm, one of the very few Indian family is where my mom didn't want me to go to medical school I, I actually just I think it was a natural fit.

I really loved science in school. I think I probably would've done physics had I been better at maths, but I found biology fascinating. It was a kind of applied form of biology with some other people skills, which I thought were interesting. So for me it was more the attraction to the scientific aspect as opposed to any desire to help people.

I'm not, I'm still not sure I've got a intrinsic desire to help people. I just find the subject matter quite interesting. But yeah I, I find that the actual, physiology and pathology really fascinating.

Abhijit: Yeah, you know what? I've always been fascinated with the human body, and I honestly, I would've loved to have become a doctor, but I am so bad at maths that I couldn't even get into the commerce subjects.

Like in, in Indian schools, you have humanities, which is at the bottom. Then you have commerce without maths. Then you have commerce with maths and then you have science on top of that for the really smart kids. And I couldn't even, I could barely get into commerce without maths. So you can imagine me doing my accounting without knowing maths.

Bit of a disaster. But I'm so glad you're doing it. And honestly, you do want to help people because you've got a YouTube channel, which is helping people. So you sorry about that.

Rohin Francis: Even that probably is just a selfish motivation. I think I look at it more as a creative outlet and fun thing to do, and if people find it interesting, that's great.

Abhijit: And of course you've got the big bucks coming in from big pharma.

Rohin Francis: Of course. Yeah. I get my regular checks every week I don't really have to work,

Abhijit: as do I. I live in this lush home. I don't do a damn thing for a living. It's just big pharma all the way. I love it anyway. Yeah. But you said that you had been talking about as, now the thing is of course you are of Indian origin.

When did and are you, your connection with India is still pretty strong 'cause I've seen several videos of you being in India and in Calcutta in particular. Do you come back here often, every now and then?

Rohin Francis: Yeah, we come back pretty much every year. My wife and kids maybe even more than once a year.

Typically to Bangalore, although probably more. Now it'll be more Calcutta in forthcoming years. So yeah, with, still, I was born in India, but I came to the UK when I was pretty young. Ah yeah, we, I like to cover, I think I've always got in mind I'm trying to appeal to a wide audience.

With a uniting concept of an interest in science. And I think my videos are not, but they're, they're not, they don't have mass appeal. Yeah. I think they attract nerds, but I think nerds from different stripes. So I like to talk about, say, Indian issues occasionally. Aiming for a more general audience and trying to convey some of the things that, that you know to say an a, a briss or an American that might be watching.

But yeah, I mean I'm absolutely keen to, to stay involved and I, met people like you and some other friends from the Indian creator ecosystem, which is pretty different, I would say actually to that western English speaking YouTube world for example, and really enjoy making those connections.

Abhijit: Absolutely, and I really was very curious. Now, I lived in the UK for a couple of years, and honestly I was in the care of the NHS for a short bit of time and broken an ankle in the Lake District and they'd come out on Christmas Day, the mountain rescue, and they carted me off to a hospital. And everybody was absolutely lovely. I could not believe my ears when they said that. I was like, do you want me to show you my paperwork, my passport? I'm a student here. And they were like, don't worry about a thing darling, you're fine.

And I was just blown away and I was like, this is amazing. And then I come back here. And the landscape is, of course, is very different. But have you dug deep into the Indian side of how India practices medicine versus versus the UK and versus the US as I imagine you are quite well versed with that as well.

How does it all compare?

Rohin Francis: I think certainly I've compared and contrasted the three, and I think there's three very interesting approaches to health provision with a lot of problems. And I'm really happy to hear that you had a good experience with the NHS. Sounds like maybe that was a few years ago.

I think sadly the landscape has changed quite significantly now and I feel like the NHS, which is a national Health Service to those unaware, which is the socialized or am as Americans would say, single payer health service in the uk, which was set up in 1947 is a fantastic aspiration.

I think it's an amazing accomplishment. I think it is a wonderful mission. It's where healthcare is free at the point of access. So when somebody goes to the hospital, they don't pay anything at any point in that visit or anything like that, but we pay with tax. So we all pay our taxes and that, that funds the healthcare system.

But the world has changed since 1947. People are living far longer. There are far more medical interventions, treatments available. Very expensive ones. And health needs have changed. We have very complex elderly patients now with multiple different medical problems who are without wanting to use any kind of words, suggesting blame or anything, but that, that, that is a huge.

Expenditure for a health service now, which is different to how it was even just a few years ago. Plus we've had chronic underfunding, so I think the UK has a lot of problems. And answer to your question about the Indian and US systems, I think they're much more similar. In that it's a private healthcare model.

There is a government provision, but I think it is woefully inadequate. And so those people with money can achieve a great level of care in India and in the us I think if you're rich, you can get some of the best care in the world. But the general provision is very poor because, they don't there there's an irony here in the US which.

Is fundamentally opposed to socialized medicine actually has the highest GDP expenditure on healthcare by a mile, by, by huge amounts over the next one country because we can come onto that if you like, but they've just got the worst of both worlds. Indeed. I don't know if I've gone digging deep into the Indian system and I'm sure.

Doctors working in India will understand the day-to-day far better than me. But I think I know the broad strokes. And I think why I say that similar to America is not only that if you have money you can achieve good level of healthcare, but also there is a huge impact of money in how medicine is practiced.

So there are, doctors receiving, money to incentivize doing certain things. And I think anytime you have a fee per payment or something like that, then it leads to a lot of over investigation and overtreatment. And I think that's a problem in the kind of upper levels of healthcare in the, in India as it is in the us.

Abhijit: Absolutely. And you had mentioned that a lot of the system is geared in such a way that it really leads to the proliferation of a lot of alternative medicine. And I've talked about homeopathy to a great extent on my channel. I have touched on Ayurveda with though, in the current political climate, one wants to keep kind of a little levelheaded on that one, but it's I have seen that, especially with a lot of doctors in India being so extremely overburdened because there are so few of them per capita, per thousand people that the hospitals i've literally had to sit for three to four hours to be able to see a doctor in a major hospital, and it takes ages and then they see you, they look at you, they poke you and prod you for five minutes, and then they jot down a prescription, tell you a fuck off, and that kind of leaks leaves you feeling very uncared for. And there are, of course there are a million other aspects. Have you noticed these kinds of things, especially in the Indian system?

Rohin Francis: Oh, absolutely.

I think that is the main driver of, which is why I think a lot of my. Content that I create I'm never trying to blame people for seeking out alternative medicine, whether it's Ayurveda, homeopathy, or any of the kind of different things that exist in America, like chiropractic or whatever.

Because why are people being pushed into this is because they're dissatisfied with the conventional setup as you've pointed out. India, one of the problems is enormous overwork and under doctoring the number of doctors per head catheter per, population is prob, I assume is probably the lowest in the world.

I haven't double checked that statistic, but, India's got such a vast population and needs way more doctors than it has. And so the, as you say you are left feeling. Dissatisfied with the level of service you've received, access to the services is very difficult. That's becoming a big problem in the UK as well for the same kind of reasons.

Overwork and under resource, under staffing. And in the US that is also a problem, but then also it's a monetary barrier as well. So in all of these countries, people are feeling. Unhappy with the conventional system. So I don't, for any number of reasons, there are many o other things to go into.

The length of a appointment, as you've said, it's very brief. In the UK a general practitioner might see 30, 40 patients a day. And the average time that they can spend is they've got 10 minutes for the whole appointment, which includes. Reading things in advance, speaking to the patient, examining them, making a treatment plan, examining it, documenting everything, prescribing all that has to be done in 10 minutes.

So the actual time you are in contact with the patient is probably about seven minutes. And yeah who can, you get all these sort of influences online saying, oh, the doctor didn't ask about my dietary habits and how much exercise I'm doing and my stress levels, and what my job is.

Who? Who can do that in seven minutes? That's not to suggest those things aren't important. They're vitally important, but this simply isn't a good experience for the patient. So what happens? They look to other providers, other sources they. Look online, they see whether they can do things themselves, whether they can see an, another kind of practitioner.

And I think one of the interesting parallels between India, which does have this parallel health system, and it's, really interesting to hear you talk about political climate and things like that. I feel maybe I'm a little protected being in another country. I'm very aware, it can have significant ramifications on people who speak out.

But now you have Ayurvedic practitioners, prescribing what in India is referred to as allopathic medication.

Abhijit: Yeah,

Rohin Francis: I would caution against using this word because, 'cause it is a word coined by the alternative medicine. In opposition. Yes. To homeopathy. It's exactly.

Samuel Hahnemann,

Abhijit: He cooked this up. Pasta. Yeah. Sorry.

Rohin Francis: So I would just say evidence-based medicine or conventional medicine. And these are practitioners who, and I'm not at all rubbishing the entire field of Ayurvedic medicine, but they are not trained in the same way. And you now have Absolutely news reports of them performing.

Operations, this is really shocking. And I think in India it's tolerated because the government know they cannot provide a good level of service for the general population. So they almost have, for many years allowed homeopathy and Ayurvedic medicine to exist.

Parallel health systems, but now in recent years, are actually promoting them. They are, they're, elevating them to a fully legitimized form of medicine because then they will modify the population who will then feel like they're being cared for and are being duped because these are things that are not actually going to help them, but they will at least feel, oh yes, I'm receiving some level of care.

Yeah. And in America, the equivalent is the kind of Maha movement, which is really risen to the fore in the last year or so with oh boy, RFK Junior becoming the health secretary in the US who has no medical training and is a prominent, the most prominent anti-vaccine voice. And you have these, this now this wellness world, which has again been legitimized in a similar way.

I think that, those are some very striking parallels between the two countries.

Abhijit: Yeah, absolutely. And it's, of course, RFK JR is an absolute nightmare when it comes to having him in charge of an entire nation's medical system. It is the worst possible scenario. But I want to, there's one thing.

See, I also thought that Ayurvedic practitioners, especially in India, are have absolutely no clue when it comes to standards of care. And I was actually corrected on this by a couple of people and I was told that, people who have been to college and studied ave and studied homeopathy, apparently in India.

Getting into an alternative medicine college and course is actually a backdoor into getting into mainstream medicine, especially in some parts of India, including Maharashtra. And you are actually given some basic training in standards of care. So even if you don't turn out to be. And like a mainstream, like a doctor.

By the end of your course, you can become like an assistant nurse of some sort. You can become, you can actually apply as nurse personnel if that's the right, correct term. Sorry about that. But, so I was actually quite pleasantly surprised that actually these guys do actually have some basic sense of what the standards of care should be.

But of course, when your head is so full of completely unscientific ideas, it makes you wonder what are the things that you're actually gonna provide the patient if they're in trouble? And if you are the only person around to provide them with care it is a very scary thought indeed. And.

Rohin Francis: I wouldn't be too reassured to be honest.

Yeah, I, yeah. I think cautiously reassured,

Abhijit: sure

Rohin Francis: there are some basic kind of tenets that would be passed on, but. As you say, ultimately it's a back door. Why create this separate parallel route? Why not just educate more nurses? Why not just educate more MBBS doctors create more medical school places rather than saying, oh, okay, people who graduated from other schools can now perform some of the same tasks Again, there is this kind of interesting historical parallel that.

A lot of people don't realize that. The US is the only country where you can be an MD doctor or you can also be something called a do, which is a doctor of osteopathy. And yeah, end up as a medical doctor and in the US now they are interchangeable. So you can come out of, do school and go into any kind of medical residency, but it wasn't always the case.

And so a lot of the online. Doctors you might, may see because I think do, doctors are overrepresented in the medical influencer world because they do tend to still while they now learn absolutely, legitimate formal medical education and can become doctors like in any field like anything else.

They also still have some pseudoscientific. Parts of their curriculum from the origins of osteopathy, and they've modernized and updated. You still have, some prominent doctors online, like Dr. Mike for example, who's do yeah,

Abhijit: I was very surprised to find that out. I was like, no.

Rohin Francis: And I was totally blown way, I think his content is absolutely fine and, absolutely.

I think he's a very good influence and says very sensible stuff online. But there is this aspect of corrections and manipulation of the spine and things like this that come from osteopathy that remain in their education. And it's a very odd system that I think people outside the US don't realize.

Generally, and I don't want to, speak outta turn here. I'm not from that country, but the perception is, which is based on statistics, that is, it's harder to get into MD medical school. So people who end up with DOS maybe didn't get into MD school, but there's also a cost implication. It's cheaper to go there, don't want to cast any aspersions, but it's weird to have this parallel system in every other country.

To become a doctor, you just go to medical school and I wonder if that's the end destination for Ayurvedic or Ho Homeopathic or Unani or all these other parallel AYUSH affiliated specialties is that we will start funneling them all into a kind of practitioner, medical practitioner and people will come from different backgrounds.

The upshot of that is, I think it's very confusing for patients. We've got a. A version of that in the uk in that there've been creation of roles like nurse consultant or surgical practitioner or, things like that where the job title is a bit confusing to the patient. And often surveys have done on patients where they haven't realized that the person that's been treating them, even doing an operation on them doing an angiogram, all kinds of quite significant procedures and treatments, they had no idea that person wasn't actually a doctor.

Again, it's another way of doing this. One argument is that, look, if you are achieving a certain standard of care, what's the problem? Which, what background somebody comes from. I don't subscribe to that way of thinking. I think we have a pathway to generate surgeons, doctors, and people like that.

Why not just put resources into that? Let's try and test it. Absolutely. And people, ultimately, patients want to be treated by doctors with a proper education. I don't think they want people who have come in via a backdoor.

Abhijit: Yeah. But then but I, that's where I feel that modern medicine has a lot to learn from the alternative practitioners because of this, conveyor belt factory.

Medical I agree. I think because the alternative medicine people have have this, like even I went to when I was to live in Calcutta back in, back in the day when I was a kid, I remember going to an homeopath and he sat me down and we had a long discussion which went on for about half an hour at least, which where he would not only read my poem.

But also check my pulse. He checked my heart rate, my breathing. He'd ask me about what I did in school and how I, what I ate, and he asked me all sorts of what seemed like unrelated questions, but it questions that meant that he was interested in who you are. Unfortunately. That is something that mainline mainstream doctors should be doing with as many patients as possible.

And I've tried my level best and I've taken, that's taken time and money. To be able to find a doctor who is able to take care of me in that way instead of going to somebody who just looks at me for five minutes and throws me a prescription and chucks me out the door. I think more people should be doing that.

I think more doctors should be practicing in that manner. I think more people should be demanding that their doctors practice in that manner, and unfortunately, that also leads to this horrible falsity falsehood that. That alternative medicine always treats the root cause, and modern medicine treats only the symptoms.

How do you react to that statement that I'm sure you've heard thrown around quite a bit?

Rohin Francis: Yeah. That's a very common trope from quacks and wellness influences, in influences that conventional doctors don't look at the root cause. I think that is clearly a absurd statement because.

That's exactly what we study is what causes disease, but the kernel of truth that is often the way with pseudoscience that leads to people believing this, is that the perception of the patient, as you exactly say, is that it's just the doctor throwing some prescription at a, the classic example being, oh, take an antidepressant.

Rather than exploring, hang on, why is this patient feeling this way? Should we do some tests? And a lot of the time it's not a simple, straightforward answer that there are many complex lifestyle factors. And, we all look at the modern world today. It's particularly in India, I think, where some of these problems are.

Especially acute, our working lives are very hard. We're all working very long days, sitting in front of a computer, not doing enough exercise, eating unhealthy food. And things out of our control like air quality and things like that are all contributing to these symptoms.

And one approach, which is the kind of. Conventional doctor approaches. Oh, here, yeah, try this pill. 'cause that's all they feel they have the ability to do. And even though that doctor. I guarantee you, I promise you, the majority of normal doctors want to spend some time with the patient. They want to explore those factors, but they just don't have the resources, don't have the time.

And as you ex, I completely agree, you go to a alternative medicine practitioner, you have a half an hour, you have an hour, but of course, you know you are paying. So that's the key difference here. They will spend time with you and they'll do exactly that. You will feel heard, you will feel listened to.

And I think you, you summed it up really nicely by saying that while they do some, mystical stuff, they also do some very conventional, sensible things like taking a proper history and maybe doing some standard blood tests and other medical tests. It's impossible to.

Just think about alternative medicine and say, oh, these guys are taking advantage of people without looking at our own, what our own role in this. And I as doctors, where we have in these three countries where we're focusing on each one has created a healthcare system where the patient is not being well served.

So I, I absolutely agree that. It's not a, it's not a level playing field here. We're comparing completely different experiences and Yeah. I think that, that is a fundamental thing that we, how could someone like RFK Junior rise to the highest level of health in the most powerful country in the world when, just a few years ago, any.

Mainstream person would've called him a complete kook and quack. This guy was, this is not like some guy saying Hey, we should exercise more and eat less processed food. No, this guy is a lunatic. Like he, he's linked ly wifi and 5G to cancer. He's. Talked about vaccines for the last 25 years, constantly changing the goalpost when he's proven wrong.

He ignores all data that doesn't suit what he says and is, anybody, even people like Joe Rogan up just a few years ago would've said, this guy's mad. But now we've achi, we've reached a point where people are trusting him over. Normal doctors because their perception of the medical industry in America is one which is corrupt with money where insurance companies are gouging hospitals and patients.

And look, we had a CEO of a medical insurance company get assassinated. That's where we're at in America. So of course, we've gotta examine our own role in how people have, I'm not. Saying, I'm not excusing any of these charlatan's behavior, but that's how we've got there.

Abhijit: Absolutely. And, but now the thing is that we have, now we've talked about, the extremes of mainstream medicine versus alternative medicine, but there is this new relatively new middle, like a blurred middle line called functional medicine or integrated medicine. Have you encountered it much?

Rohin Francis: Oh, very much yeah. I it's not a, it's not a real field. They're claiming that this lifestyle medicine and functional medicine interchangeably they're just rebranding of. Things that already exist. Alter complimentary medic, alternative medicine was rebranded, complimentary medicine to, to try and move away from, the kind of pseudoscientific interpretation and functional medicine was coined.

I, I forget when. And it's often used interchangeably as lifestyle medicine, and. On the surface, if you go to the, British Society of Lifestyle Medicine the pillars are absolutely reasonable. The importance of lifestyle factors on health all the things we've just been talking about, diet, exercise all these kinds of things that sounds perfectly legitimate.

Why do I have a problem with functional medicine or lifestyle medicine is because that is already just normal medicine, a good doctor. Is already thinking about those things. I fully accept that what we've just been talking about is that is not always practiced in reality for reasons outside the doctor's control.

And a lot of lifestyle medicine and functional medicine is a, is a, what's the word? I don't wanna keep using the phrase backdoor today, but it's a sort of. Gateway into, I wanna be

Abhijit: a BTO man. Sorry.

Rohin Francis: It's a gateway to non-evidence based stuff. So I see a lot now young doctors who are quite idealistic and they really wanna help their patients and that's fantastic.

And I just had dinner I gave a talk at a meeting yesterday with a lot of local general practitioners, family doctors from the area. And I was sitting next to a. Doctor about my age and she's. Really enthused by lifestyle medicine and functional medicine, and she is a totally legitimate gp.

I don't want to ever suggest that people interested in these fields are doing something wrong because she's looking at this that, ah, this is a kind of medicine I want to be practicing because she's become dis disillusioned with her day-to-day work because she's feeling like this con, she's on this conveyor belt that she's just.

Not actually helping anyone. They're coming in with complex problems. She's not able to help them. So she's feeling the allure of this kind of, ah, going to conferences, talking about lifestyle medicine and how we should be, taking dietary histories from patients and everything. It's yeah, we already, we should.

That's good. It's not a separate field it's Exactly. It's not a new thing. It's just that we've lost the ability to do these things and then you see people. Getting pulled into the direction of quackery by embracing these things and turning their back on normal medicine. So yeah, I think much of functional medicine, lifestyle medicine is fine, but I don't think it is a real new thing in itself.

It is just good conventional medicine. And if we are not doing that's on us. But I don't feel we need to reinvent the wheel here.

Abhijit: Yeah, but it's but it's really but do you think that, is it just the standards of care and the amount of care that a mainstream doctor can provide versus the amount of time that a functional medicine doctor can spend with you?

Or is there something truly lacking in medicine itself in the science that's stopping us from actually. Providing the ne level of care that patients need. There are so many idiopathic conditions like fibromyalgia, which is poo-pooed by a lot of doctors. Is that, what's, is that another factor, do you think that's holding it back, that's holding modern medicine back from, reaching people that it wants it should be able to reach?

Rohin Francis: I think that's a great question. I think there are two, two aspects to this. I wouldn't say. I think the main one is probably the banner headline would be uncertainty. And you are absolutely right that in medicine, a lot of times we don't know. We don't, we can't put our finger on and say, look, if somebody comes and says, look, I'm just feeling lousy, they're probably a hundred different contributing factors.

And it's disingenuous or dishonest of me to say. This is the problem because it's really that simple. Medicine is complex and for all the reasons we, we've talked about already, people are often feeling that their health is getting affected, but we can't necessarily put our finger on one cause we a lifestyle functional alternative kind of practitioner.

Will often, their modus operandi is to send off a battery of tests like maybe, a dozen, sorry, bang the microphone. Dozens of tests. And if you do that's what we call a shopping expedition. You will find something abnormal. Then say, aha, ah, your vitamin D is slightly low. This is the problem.

And then they will obviously offer some treatment. And a lot of the time the treatment is not necessarily harmful. A vitamin D supplement is not gonna do much harm in normal quantities, but then the patient may end up feeling better and that could just be a placebo. And yet they, their experience is that the lifestyle medicine person or whoever, whatever we're calling them, had identified a problem and I feel better.

And that if it's a placebo is unlikely to be poone, it's probably gonna be transient. But then of course you're creating the business model that people will keep coming back. And ascribe looking for an easy answer. Looking for certainty, I think is the big promise that can be made where. Doctors like me speak in probabilities.

We speak in vague terms. We speak in the chances are it's unlikely, it's likely. Whereas a alternative medicine practitioner will say, ah, this will definitely help you. They'll speak in certain terms and they, and that's what people want, they want, this is why people believe in conspiracy theories.

They want. Certainty in a un uncertain, confusing world, they want some sort of explanation why they're feeling a certain way somebody can provide it for them. So I, I don't think that's modern medicine been being held back. I think that is just science in general. The human bodies immensely complex.

It's the most complex, system. We, under we know and we don't fully understand it. And to try and provide easy answers I think is just not good science. So that's, but in the other aspect of your question is whether modern medicine poo-poos these things, I think is also true. So that is a failing.

I think we can be the motivation, I think. Motivation. But I think the reason why a lot of doctors don't have an interest in fibromyalgia or chronic fatigue syndrome, long COVID post postural orthostatic tachycardia syndrome, these are very common conditions which affect people particularly in younger age groups where the, what we won't find a clear organic.

We'll do a lot of tests and say, look, everything's come back normal. And the doctor might well convey that in a way that they think nothing's wrong with you. That's what the patient hears is like this is in your head. Yeah. And that is. That I think is because the doc made me feel I'm being too charitable to doctors here.

But I think that is because doctors feel frustrated because they have nothing to offer, and that's a bad feeling. Yeah. That's the fundamental reason we do what we do. We wanna make people feel better. And if a doctor can't do that, they feel upset, they feel frustrated, and they may take that out in the wrong way.

They may say, look, there's nothing wrong with you. Don't waste my time. Just go away. And that's really bad. That's not what we want to be doing. But I fully accept that is often happening. And the alternative medicine practitioner will, their first success the reason they will win over is that they will just say, Hey, listen you are, I you are experiencing these symptoms and we're gonna try and figure out what's going on.

Now where of course I would object is that they, and they will offer something which hasn't been proven to work, whether it's their own supplement or some, crack therapy. Yeah, that's not defendable. But acknowledging the problem and not acknowledging the patient's symptoms and experience is something that we don't do well because we, we don't have the answers.

And so say here in the NHS where the government has to justify expenditure. They will look at these conditions and say, look, they're not life threatening. They're not cancer, they're not killing people early. They are generally what is called benign. And comparing to diseases where there's a, there's an organic pathology.

So they will say we are not gonna allocate resources. We're not gonna do research in this field. We're not going to start a clinic for this stuff. And that. That feels like you're just being neglected, like nobody's doing anything to help you. That is a big problem and one positive I thought might come outta the pandemic is that we would allocate more resource to, to researching some of these things with long COVID becoming a big problem.

That's pretty much dried up already. I would say, there are still a few research teams working in the field, but a lot of the kind of long COVID clinics have closed a lot of services. Won't accept referrals for chronic fatigue syndrome or pots or hypermobility and all these kinds of associated conditions.

So the patient feels abandoned

Abhijit: and that's a horrible thing. I think physics girl. If you remember the physics call from YouTube? Yeah. She's been going through fantastic. Yeah, she is, she's gone through a long twist with long COVID, with barely being able to get out of bed. It's been absolutely awful.

I've been trying to keep tabs on how she's been doing, but now she's made a very good recovery and she's continues to recover. But that is very disheartening to hear, but, and I just, I was wondering like. Is there any way that we like as humans, because we have to acknowledge that doctors are also human and if they treat, if they deal with something badly, they're just not being their best selves.

Maybe at that point of time, maybe they're having a bad day, and that's something that we have to understand. But is there something that we can do personally from our own individual standpoints to be able to ask our doctors to be better in certain ways? Or, how can we help the system improve in our own little ways?

Rohin Francis: That's a tough question. I, it I'm reluctant to try and, suggest individuals. Are the ones responsible for combating systemic problems? I think, yeah, the doctor as an individual or the patient, these are problems outside their control, but what can we do as patients?

Yeah. There are no easy, I was gonna say, education is important to, to. Educate yourself, but then the obvious question is how, you go on Instagram and then YouTube, you're more likely to find bad information and that's maybe gonna lead you. Talking about physics girl who is it Just one of the best science YouTubers and I don't know her we've never met or anything, but we, followed each other and.

I've like all of my friends in the kind of science YouTube world have been following what's been happening with her over the last three years, isn't it? Yeah. Completely debilitated by long COVID, one of the most severe cases I've seen and The, yeah. Obviously there's huge goodwill for her to get better and I've. Thought about covering this. I didn't want to, I thought, I don't want to focus on an individual or anything like that, but her husband Kyle, has been posting updates of different things they've been trying and while I want more than anything for her to get better.

Sometimes I get a little uncomfy with the stuff that he's post posted because I feel like they're being taken advantage of. I feel like somebody, they've flown to some clinic or something and are trying some experimental treatment and of course, why wouldn't you in their position you want to try anything you under, if somebody's promising that this may work, you're desperate, but.

When I've looked at it, I'm like, oh, this does not seem like it's gonna, any possible buyer plausibility to it. And I feel, is that me really on your end or my end? I've got a,

Abhijit: I think you're ringing somewhere probably.

Rohin Francis: I dunno where it's ringing. But anyway. Sorry. I feel concerned that people in a vulnerable position like that who are desperate for some progress do get taken advantage of.

Yeah, I can't remember where, what the original question was now. What can people do? Yeah. I think it's extremely tough. But in your interactions with doctors. You can, I think my comments are generally aimed at doctors and I tend often speak to medical audiences.

And I say, look, you've gotta try and meet the patient where they are, rather than saying, look, there's nothing wrong with you. Say what are you feeling? What do you want to get out of this consultation? And that's something we're often taught to ask what is your objective coming here today?

What do you want? And then. Try to explore with them why something that may maybe they've seen online is unlikely to actually help them get to their destination. And maybe we can explore some ways to do it, which are more grounded in evidence, and then be honest and say, look, we've exhausted ev the resources available to us.

I'm really sorry I haven't been able to make you feel better. I've been able to exclude. X, Y, Z, which I think is very important. I don't feel it as any of these conditions, which you may be feeling anxiety about, but I can't tell you exactly what it is, and I wish I could, but I also don't want you to.

Spend lots of money going down this particular path with this therapy that you are, you've seen, because I think that is potentially dangerous or whatever. And just speak to each other like human beings. And I think that's often missing. And some of the stories I hear from India, it really feels like a cattle market.

And Yeah. I think the humanity's gone.

Abhijit: Especially in the government hospitals where they're so overburdened with such a huge influx of people, especially, of course I'm talking about in urban centers where we do have large go government hospitals and the doctors have absolutely no capacity to be able to care for everybody equally.

The hospital itself doesn't have enough beds to care for everybody equally. And then of course, the problem spreads out into the weeds, into the f. Into the further and further into rural India where we have absolutely, no adequate medical interventions at all. And if there are any, a lot of the interventions will be.

Traditional medicine, because that's what the people will know because they wouldn't have had adequate medical training otherwise. But is there, but thank you very much. I know that we are a little short on time today, so I won't keep you much, any, any longer. And thank you so much for joining us.

We will definitely have. I'll definitely be, I hopefully we'll be able to get into a sec a second part of this conversation. But thank you so much for joining us. This has been very enlightening and education and educational. Oh, I'm all over the place today.

Rohin Francis: No, it's been great. I'm sorry if I rambled and ranted.

Some, sometimes I notice that I've been speaking unopposed for several minutes.

Abhijit: No, that's fine. I love that when I'm talking to somebody and we are talking passionately about, about the topics that we are interested in, and I certainly hope that with this conversation and the things that we've talked about, I hope that a few of our listeners have maybe gotten a slightly better idea on how to question their doctors and ask and maybe even demand for better treatment and more time from their doctors, even if it's a little bit.

And it, it might hopefully help someone some way. So thank you very much for joining us, and I definitely hope that this will help somebody else other than the two of us. Of course.

Rohin Francis: I hope so. And I know it is tough. But yeah, I'd love to chat more and I'd love to also, get to know more about what it's like on the ground.

Obviously, from family interactions and things like that, I know that Yeah. How prevalent some of these un unscientific beliefs are. And I'm often sent, WhatsApps from family members should I be drinking apple cider vinegar to lose weight? And all the, these kind, that's the more harmless end.

In COVID there were many aunties, Oh yes, sister. Very bizarre things. And every time, my mother-in-law. Is one of the big believers in all this stuff. So we have circular conversations every time I go and visit her. And but but yeah I, I think I, I really take my hat off to you and people like you who, who are trying to spread sensible, critical thinking in India because it, if here it feels in the uk there's the skeptical community, the whether it's not just in medical things, but just science in general or even if we're getting wider into sort of religion feels pretty well established and it doesn't feel controversial or dangerous to talk about any of these things. Maybe I feel like I'm fighting a losing battle, but I don't feel any.

Yeah. And I think that's not always the case. If I can do anything to help, then I'm happy and hats off to all of you.

Abhijit: You've already helped a fantastic amount by being a part of this conversation. So thanks a ton. Take care of yourself and I will hopefully talk to you very soon.

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