Marty Makary, M.D.: The US healthcare system—why it's broken, steps to fix it, and how to protect yourself

**Peter Attia** (0:04)
Hey everyone, welcome to The Peter Attia Drive. I'm your host, Peter Attia.
The drive is a result of my hunger for optimizing performance, health, longevity, critical thinking, along with a few other obsessions along the way. I've spent the last several years working with some of the most successful top performing individuals in the world. And this podcast is my attempt to synthesize what I've learned along the way to help you live a higher quality, more fulfilling life. If you enjoy this podcast, you can find more information on today's episode and other topics at peterattiamd.com.
Hey everybody, welcome to this week's episode of The Drive. I'd like to take a couple of minutes to talk about why we don't run ads on this podcast, and why instead, we've chosen to rely entirely on listener support. If you're listening to this, you probably already know, but the two things I care most about professionally are how to live longer and how to live better.
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My guest this week is Dr. Marty Makary. Marty, who's a close personal friend from residency, we overlapped when he was a fellow at Hopkins and I was a resident, is currently a professor of surgical oncology and the chief of the Islet Transplant Center at Johns Hopkins. And while so much of his work and professional accolades come from his surgical career and the work that he does in pancreatic surgery, especially in minimally invasive pancreatic surgery, Marty is one of the pioneering surgeons in doing one of the most complicated operations that's ever done, which is removing the head of the pancreas, minimally invasively, meaning laparoscopically, something I can't even fathom because at the time of my training, that wasn't even something that was considered. We actually don't touch on that one bit because there's so many other things that we really wanted to talk about. The other thing that Marty's really known for is being one of the co-creators of the surgical checklist. And this is something that has made its way up to the WHO, Safe Surgery, Save Lives Committee. Today, many of you, if you're ever in the hospital, if you're ever having a surgical procedure, will encounter this checklist because it's the thing that makes sure that people don't get operated on the wrong side, which is actually something that happened to me when I was in medical school, and it actually is something Marty wrote about in his first book, which was a New York Times bestseller called Unaccountable. And it's actually that book that became the basis for a very, very popular television show called The Resident, which is based on Marty's work. We touched on that briefly, but most of what we talk about is the material and the content that's featured in his upcoming book, The Price We Pay, which will be available shortly. And this book really takes on Marty's next challenge, because if figuring out a way to do the most complicated pancreatic surgery from a minimally invasive standpoint wasn't enough, and then going after medical errors and trying to figure out a way to fix the system that makes it too easy to commit medical errors, well, if that wasn't enough, you know, Marty's decided the next thing that he's interested in trying to address is the broken healthcare system, which I think anybody listening to this knows in the United States is pretty clear. What I like about Marty is he isn't one of these guys who's trying to put the single silver bullet and blame it all on one thing. Oh, it's all drug prices or it's all this or it's all that. What follows is a pretty nuanced discussion that it sometimes makes me really upset. There were times during this interview when I just couldn't believe the stories he was telling. And I think many of you will be equally upset by these things and find it totally unacceptable. But at the same time, when it was all said and done, and as is often the case when these podcasts finish and the mic is off, we keep talking. And I think to myself, oh, I wish we recorded that because that was probably the most interesting part of the discussion we had. But I actually came away before Marty left my apartment, I came away realizing there's actually hope here. And I've actually never felt that there was hope for this problem. I truly thought that the US healthcare system is something that will drive itself off a cliff until it bankrupts us and that is the end of it. And I came away from this discussion thinking, no, there are actual steps that could be taken to fix the structural errors that have allowed people with in some cases, very good intentions, in some cases, reasonable intentions, and in rare cases, horrible intentions to basically create the most financially irresponsible system that I think has ever existed in the free market. If you're listening to this and wondering why does this concern you, I believe it concerns almost anybody because anybody who's ever received an explanation of benefits that made no sense, anybody who's ever received a medical bill that seemed ridiculous, anybody who's ever known anyone who's been chased down by a collections agency, which sadly the numbers of Americans who experience this is staggering. You'll want to listen to this because I thought I understood this system well enough that I could coexist with it. I learned so much from Marty about what people can do to protect themselves from this sort of predatory pricing that is, I mean, literally gouging the pocketbooks of people. I think if nothing else, you will come away from this episode with a greater sense of empowerment and how you can protect yourself in such situations and protect the people that you care about. I'll share with you just one statistic that breaks my heart. I believe it's one in four, maybe one in five women who undergo treatment for breast cancer about a year after their treatment is currently being pursued by a collections agency for some sort of ridiculous predatory pricing scheme that resulted from the treatment. To know that a patient now, based on some of the work that Marty has done, have steps that they can take to put an end to that kind of stuff and fight for their rights is just one of the many things in this episode that kind of gave me some comfort. So, without further delay, please enjoy my conversation with my good friend, Dr. Marty Makary.