Peter Attia's Problem
Distasteful does not equal illegal, but what about his judgement?
So Peter Attia has had a rough time.
If you haven’t been paying attention, he’s mentioned about 1700 times in the Jeffrey Epstein email release. I’m not going to attempt to link to all the interesting emails, I’m sure you all can find them easily enough, there are only a few.
Apparently, he was in contact with Epstein from 2014 to 2019, and had a number of meetings and visits with him. Most of the emails, apparently, are about arranging meetings.
It’s important to note: at this point nothing in the emails so far disclosed suggests any illegal activity.
While my initial reaction was that this really wasn’t that big of an issue if he had a medical relationship with Epstein, Attia has released a statement saying that he was not Epstein’s doctor.
Physicians traditionally have an obligation to treat anyone who comes to them for help, or at least to try to get them help (an eye doctor won’t be much help for your cancer diagnosis, for instance, but he might help you find a specialist).
If he had been trying to help Epstein with some health problem, this would have been a fair explanation of his relationship with him.
In my opinion, that fact that this was not a medical relationship makes it worse for Attia.
So someone offered to introduce Attia to Epstein. Peter says that he was aware of Epstein’s conviction, but proceeded anyway.
Don’t Fraternize with Felons
I am reminded of a job interview I did once. We were looking for a consultant to work on our accounting system. The fellow we interviewed came highly recommended from a consulting firm we had used for years. He was very intelligent, and while he didn’t have specific knowledge of our system, his general knowledge of accounting was peerless. He had been a foreign exchange trader at a bank.
But it was rather odd that a fellow like this would want a short-term, gig like this, which seemed pretty far below his pay grade.
So of course I Googled the guy. It took about a half an hour, and would have been shorter if I hadn’t read a bunch of the documents that turned up.
It turned out that he had been convicted of bank robbery, and was awaiting sentencing (!).
He had done this by manipulating the bank’s accounting system to get paid bonuses for profits he had never made.
Hence his deep knowledge of accounting systems and principles.
The idiot who recommended him didn’t initially understand why we were so upset that he had sent this guy to us. The relationship never recovered.
Now let’s imagine that we had hired the felon. Can you imagine what the response of our investors and the regulatory authorities would have been?
Do Your Homework
Obviously asking the bank robber wouldn’t have been a good idea. “So, do you plan on using your access to our system to rob us?” That wouldn’t have cut it.
That’s from Attia’s mea culpa. As due diligence, it’s a joke. By 2014 there were lots of accounts online discussing what exactly he’d been convicted of.
Instead, Attia waited until a 2018 article came out: “In 2018 I came to learn this was grossly minimized…”
Attia could have saved himself a lot of trouble with the query above.
No Evidence of Criminal Behavior.
Attia points out in his mea culpa that he didn’t do anything criminally wrong with Epstein. There’s no evidence that he did, in the DOJ document release, or anywhere else.
That’s a low bar for a physician.
Does Poor Judgement Matter In A Physician?
It’s well understood that we have an epidemic of opioid overuse and overdose in the U.S.
What’s not so well understood is that the critical failure that led to this epidemic was not Purdue Pharmaceutical’s fraudulent claims about the alleged non-addictive nature of their OxyContin. It was that physicians as a class largely failed us—one can also note the Sackler brothers who owned Purdue were all physicians. Physicians have a monopoly on prescribing these drugs, and they are supposedly trained to evaluate the claims and evidence that pharmaceutical companies use to justify prescribing a new drug to the physicians’ patients. Instead they accepted weak or nonexistent marketing evidence from Purdue, along with “branded promotional items such as OxyContin fishing hats, stuffed plush toys, and music compact discs (‘Get in the Swing With OxyContin’)” (Van Zee, 2009). They exercised poor judgement, believed some absurd claims, and kicked off an opioid-abuse epidemic that at last accounting, had resulted in 600,000 deaths, and still continues.
So yes, judgement matters in a physician.
Promoting Dubious Longevity Drugs
I’ve listened to Attia’s podcast since he started producing it. He’s had some terrific guests on, and a number of the episodes have been quite educational. But one theme that has been pretty consistent is Attia’s infatuation with various drugs that have been proposed to be longevity enhancers, particularly metformin and rapamycin. In the episodes that he’s produced with experts on these drugs, they’ve been far more measured in their evaluation of the drugs than Attia has, in fact, a good part of the reason I’m skeptical about these drugs (rapamycin especially) was from listening to these experts! Rapamycin may be proved to be a longevity drug at some point, but the evidence does not exist yet. Attia stopped taking metformin after realizing that it was harmful for adaptation to exercise, and a big part of his longevity protocol is low-grade aerobic exercise. There’s no good evidence for metformin as a longevity drug, and while he’s ceased promoting it, It boggles my mind that he ever did.
I’m not a physician, I don’t have the training he has, and I don’t have access to the research team and experts that he does. So if I’m able to figure out before he does that metformin is a bad idea, why would I want his health information?
“Avoid the obvious mito-toxins, like seed oils, statins, metformin, and feed yourself correctly.”
Promoting Incorrect Health Information
I was shocked to hear Attia say in one of his podcasts that running was bad for your knees. This is misinformation that has been known to be such for decades, and a physician who brags about his research team should know better. This is, unfortunately, a medical myth that ill-informed physicians continue to propagate.
Worse are his views on cardiovascular disease. He said in one podcast that cardiovascular disease is essentially a part of our genetic heritage, which is the logical conclusion of the belief that the lipoprotein ApoB causes heart attacks.
Unfortunately this idea was pretty definitively debunked in the 1960s.
One of the better interviews Attia did was with Dr. Eric Topol. This is what Topol had to say about Attia’s mea culpa.
“…But the man you are today vs 10 years ago has not changed w/r to arrogance. Moreover, these days you are riddled with conflicts as a huckster for David Bars, AG-1 supplement, and so many other things that diminish your credibility. That's a shame.”
I don’t even know what the AG-1 supplement is, and based on Attia’s previous infatuations, I don’t really care. Guilt by association.
However…
So I follow Attia’s podcast for his guests, which have been excellent, if very conventional. But as compared to other physicians, he’s not terrible. His basic advice is to eat well, get exercise, and it’s pretty hard to agree with those views. He’s probably better than the average physician, in fact.
Conclusion
So Attia’s problem is that he’s got poor judgement, basically. Does he have worse judgement than the average physician? As we can see from the OxyContin fiasco, there are lots of physicians with poor judgement, who get suckered by claims that shouldn’t fool a “trained professional”. The list of such claims are long, unfortunately, as most medical interventions are poorly supported by scientific evidence.
“Most medical decisions, however, come with far less certainty. The BMJ clinical evidence team reviewed 3000 treatments used in the UK’s National Health Service and found that about one half were of unknown effectiveness and only 11% were clearly beneficial.” (Mandrola, 2019)
Ultimately, Attia’s problem is that he’s a physician, and he was trained as a surgeon. Arrogance and over-confidence in Medicine is unfortunately typical of such professionals.
While I do know some good, conservative physicians, and I’m sure there are more out there, they are unfortunately the exception.
So ultimately the lesson of the Attia affair is to be wary of any over-confident physician, and always double-check their work.
(I did a little less referencing than usual on this one, to get it out the door. If you have any requests, let me know in the comments.)
References
Mandrola, John, Adam Cifu, Vinay Prasad, and Andrew Foy. 2019. “The Case for Being a Medical Conservative.” The American Journal of Medicine 132 (8): 900–901. https://doi.org/10.1016/j.amjmed.2019.02.005.
Van Zee, Art. 2009. “The Promotion and Marketing of OxyContin: Commercial Triumph, Public Health Tragedy.” American Journal of Public Health 99 (2): 221–27. https://doi.org/10.2105/AJPH.2007.131714.
Attia's main problem is that he is a psychopath who will do, say, and probably believe anything if he thinks it will advance his position.
Despicable.
Well written. Thanks.
It's a Greek tragedy. Delphic Maxim #3, from 548BC: Don't be so sure.