History of medical decision making:

1900-1980 (post Flexner era): physician driven 

1980 to 2020 (employer based insurance growth/managed care boom):

Insurance/Institution driven decisions

2020 - present (post-COVID/GLP-1):

Patient-driven clinical decisions

Physician always trying to learn, passionate about healthspan and precision medicine.

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What are some examples where you're seeing patient-driven clinical decisions?

Feels like its still very emergent and its hard for patient-driven decisions to happen within the entrenched insurance/institutional paradigm

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This is also where the 2 tier health system is coming into full view.

Definitely more common to see with cash based things. Much much harder with insurance.

Peptides are probably the biggest one. Patients essentially hearing X peptide on Huberman then reach out, if one Dr can’t do it, they look for another one, and keep shopping until find someone that is willing to.