Podcast: Victor Montori – Mayo Clinic MD calls for patient revolution

Michael Joyce

Dr. Oliver,

Thank you for sharing your concern regarding how the Mayo Clinic (and as you note, ‘and now Cleavland [sic] Clinic’) can be ‘relentless promoters of a brand’. Not infrequently we share similar concerns, or — at the very least — we critique something they do which we find potentially misleading or harmful to consumers. If you search our website with either institution’s name you will find dozens of instances we have been highly critical of both.

But allow me to critique your reaction to Dr. Montori. First, he is not ‘complaining’ about the medical industrial complex. He rigorously studies it and is committed to being part of the solution, not part of the problem. Second, although it is true that Dr. Montori is an employee of the Mayo Clinic, this is a self-published book and not a publication of the Mayo Clinic.

Finally, if you listened to the podcast, thank you. My goal was to reveal the thinking and passion of this remarkable physician. My sense in speaking with him was that he was trying to promote much needed change, not his employer. That comes through in the book as well which — if you get a chance to read it — might change your opinion of him as either complaining or promoting a brand.

Charles L Carter

Dr Montori’s heart is really in the right place. But implicit in his argument is that few doctors share his values of kindness and shared decision making. In med school in the 80’s, I was told the days of patriarchal medicine should be left behind. Shared decision making is a re-branding of this concept, not wrong or bad in itself but not especially new. Each patient and each situation are different and many patients will say, “Just make me better “. Engaging them in their health, especially for chronic illness, can be a challenge though vital.
Dr Montori’s credibility suffers somewhat as well from his specialty. Regimens for diabetics are among the most demanding and are among those promoted with relatively weak evidence.
Doctors certainly warrant encouragement such as Dr Montori’s advises, but the real solution lies in payment models,loan forgiveness, and diminishing regulatory burdens to promote primary care. More PCP’s and more time for them to actually interact with patients in an unstructured way would go very far to advancing his ideas. And specialists acting as consultants rather than long term managers of their slice of a patient.