Jack

So, there may be an opportunity in the vacuum that is created.

Bill G

Well, in fairness, I was actually at a meeting earlier this week that involved both the AFP and the AFMRD lobbyists. They’re in the process of discerning what questions they’re going to plant during the confirmation hearings. And actually, this issue of health, nutrition, and highly processed food did come up. It’s in the mix. They’ll only get a chance to plant a certain number of questions to both Oz and RFK. And they are trying to discern how to prioritize the questions they really want to ask and to press RFK and Oz on providing answers to these questions and get their answers on the public record. Whether that then becomes a basis for advocacy for confirmation or a basis to lobby against confirmation remains an open question. I think that’s a very dynamic process right now. But at least I heard at the AFP lobbying level that this issue of nutrition, the broader issue of the impact of highly processed foods, and the subsidies on human health were definitely on the table for discussion.

Now, whether it goes anywhere, that’s different. However, it is a time when all of us who are somewhat active in those circles—particularly people like Jack, Jeremy, Michael and myself—can at least throw some arguments in the ring. We can hope that the public dialogue will be informed during these confirmation hearings.

Bill B

So, to bring it out to 50,000 feet, I want to go back to Thomas Kuhn and his notion about the structure of scientific revolution. What’s powerful is that he says the shattering of paradigms tends to occur out in the margins, among the wackos, among people who are not in power—such as family physicians and others in healthcare who are discounted or considered to be outside the mainstream. The system keeps trying to patch things together, but it’s not working, so it begins to fall apart. The outsiders step in and offer new perspectives and practices that do work. For instance, a very important concept called systems theory was developed up in Edmonton, Alberta. That’s where it all came from. Not Harvard University or Yale. It came from Edmonton, which at the time was really backwater. Research and theorizing done at the university in Edmonton was discounted. Then this new perspective on the operations of systems was introduced and revolutionized the way we think about how things operate in both the world of biology and human behavior. So, the hope might be that the new models in healthcare come from unusual, strange places—places that have usually been discounted. Those working in these discounted places usually don’t have a lot of power—such as people working in family medicine. There’s hope based on a history of revolution in the sciences. It’ll be interesting to see what occurs over the next year in this major societal experiment that we’re talking about today.

Jeremy

I think this could have some direct relevance. We’ve talked about lifestyle medicine. There’s a book, Jack, called Good Energy that was written by Casey Means. She was in her last year of chief residency at OHSU. She dropped out to become what appears to be a functional med doctor. In so doing she has written a very mitochondrial energy focused nutrition-based book that’s been a bestseller. Her brother, Calley Means, is an advisor to RFK. I thought her brother was going to end up being the FDA director. It was being tossed around. Casey has been pushing for nutrition changes along with Bob Lustig from Stanford and UCSF. Lustig is the author of Metabolical –which is sort of the Bible now concerning nutritional impacts on biological processes in human beings. I think these are experts who could be linked to the AAFP advocacy people.