How the Flexner Report Changed Medicine | STUFF YOU SHOULD KNOW

[music]. Welcome to Stuff You Should Know, a. production of iHeart Radio. [music]. Hey, [music] and welcome to the podcast. I'm Josh and there's Chuck and Jerry Jar. Binks is here, too. And this is stuff. you should know about the Flexner. Report. >> That's right. Uh, this was a suggestion. by my [music] wife. >> Oh, that's a good one. >> Yeah, Emily. uh of course everyone knows. if they listen to the show as a organic.

gardener and an herbalist. >> Mhm. >> And she said has long asked me to do one. on the Flexner report which is a report. uh written in 1910. uh that did a lot of things basically. kind of revamped how medicine worked in. the United States moving forward in. medical school in particular. >> Right. Uh but Emily was interested. because uh another thing it did, a. byproduct was it um basically completely. squashed what we would now call. alternative medicine uh homeopathy. Uh.

basically saying it has zero value and. we're not doing that anymore. >> It sure did. Biff. >> Yeah. And it was also racist and sexist. and. >> it was definitely of its time. This is a. document produced in 1910 for sure and. it definitely stinks of eugenics and all. that. >> Yeah. So, it's it's one of those weird. things where like. >> um you can see it from all sides because. it did a lot of good and it also maybe. didn't do some good in certain areas.

>> Yeah, for sure. And there's there's not. many people who are like, "No, the. Flexner report sucks. It was all bad.". because it if you enjoy being treated. successfully for cancer, you can pretty. much thank the Flexner report for that. Um, but at the same time, yeah, if you. believe that there are alternative. therapies that are as good or better. than medications, then yeah, you. probably don't like that part of the. Flexner report. But I think on the whole.

it was a it was a good thing. there. seems to be now among you know thinking. people who don't just um wade and wallow. in dogma. saying like we need a a new flexner. report for the 21st century because it's. basically run its course and now again. it's become dogma and we need to do. something about that. >> right I think that's a great setup and. maybe we should paint a little bit of a. picture about what uh medicine and. medical school looked like in the United. States uh pre flexner report um.

>> it was bad. >> it was bad. I guess quickly we should. say that Europe was doing it right. before we were. >> Yeah. >> Um in France especially, they had some. pretty top-notch medical schools where. they embraced uh real science and were. practicing medicine on people like as. practice in colleges and stuff like. that. >> Mhm. >> Uh but in the United States that was. around 1850. In the US in 1850 they had. 52 medical schools. This is what 50 60. years before the Flexner report.

>> Mhm. And medicine was not, you know, to. be a doctor was not some prestigious. thing. Medicine was a trade. Uh, if you. were associated with a university at all. as a medical school, it was a two-year. program. The the curricula was very, very broad. They were super underfunded. Even at places like Harvard, they had to. pay for their own teaching supplies. And. those were the good ones that are were. attached to universities. >> Yeah. I mean, there were plenty of. diploma mills. There were um a lot of. proprietary.

um medical schools where it was just. some people got together and created a. for-profit school where they would teach. you how to become a doctor, but they. were not doing a very good job of it and. your admission requirement was the. ability to pay the tuition fees. essentially. >> Yeah, for sure. Um you might have like. redundant classes that literally went. over the same things. You might not have. your hands on a scalpel. >> ever. You might not have an exam ever. >> Um, you may not see uh patients. You.

might not have any contact with another. human being at that medical school. >> It'd be kind of like if you went to go. skydive and in the class before you go. skydive, they just talk about how um. hard the ground can be if you hit it and. then they take you up in a plane and. push you out. It's similar to something. like that. >> That's good. >> Thanks. >> I like it. But then everybody the Civil. War came around in the 1860s and there.

was wartime doctrine happening and after. the Civil War uh people came out of that. saying we're in trouble everybody like. the doctrine wasn't so great in this in. this war and we need to fix this. >> Well, what I interpreted is that they. went out and got real world experience. and realized like the stuff they learned. at school was not preparing them for. actual medicine. >> Oh yeah. I mean, I think it was a little. bit of both. I think the person who. >> had their leg chopped off unnecessarily. complained.

>> and I think the doctor who did the. chopping might have complained as well, >> right? They didn't teach me that. patients complain in medical school. >> Yeah. Um, so yes, regardless, by the by the. 1860s, like it was quite clear that. American medicine was lacking. tremendously and that the main reason. for that was that the doctors who were. practicing medicine had virtually no. actual training in medicine. They were. lectures, textbooks, that's basically. it. So there were there was a part of.

the progressive era. um this actually. this push to to create a movement to um. make medicine in America better and by. by focusing on the medical school. education that that came around in about. the 1870s. It was led by Harvard. >> Yeah. >> But really John's Hopkins University was. the one that really hopped on it. >> Yeah, for sure. like Harvard got the. ball rolling for a couple of decades and. by the time John's Hopkins opened in.

1893. >> they became kind of the standard for the. American model moving forward which as. we see was based on the German model. >> right. >> uh you had to have a first of all you. had to have a college degree just to get. in and that was previously not. necessarily the case. >> no. >> uh secondly they had full-time faculty. uh they were medical scientists so they. weren't doctors on the side as Well, uh, they were just fully employed to teach. Uh, and they had a 4-year, like a full.

four-year course of study where it was. hands-on and a lot of laboratory work. >> Yeah. And Yes. where they were actually. working with patients or assisting other. actual doctors in working with patients. Like it wasn't just like sit there and. listen to this lecture. >> Yeah. that was that and that essentially. that John's Hopkins model is what became. the model for American medical school. and there's a lot of um there's a lot of.

talk at parties if you stop and listen. about whether this would have happened. on its own or not. Yeah. >> And for the most part it seems that yes, this progressive era movement would have. gotten there eventually just because it. was a good idea. Yeah, >> the Flexner report helped it happen on a. dime because not only did it show to. everybody else, this is the way to do. it. It also said this is very expensive. and here's how we need to get the money. for it and did get the money for it. Like that's how it was implemented.

>> Yeah, for sure. Um the American Medical. Association was founded in 1847. Uh, and one of the reasons, and you. know, again, this is, uh, this is stuff. that I learned from sort of Emily's. urgings. >> Mhm. >> Uh, one of the reasons the American. Medical Association was founded to begin. with was like on a mission to squash, uh, homeopathy. Um, it says so in its. charter. And when the AMA was founded, they they discouraged any association or.

communication with those kinds of. doctors and had a code of ethics. There. was a clause in there known as a. consultation clause. >> that said if you even talk to a quote. unquote non-regular practitioner. >> then you're going to lose your license. to practice medicine. >> They carved out exemptions for. Massachusetts and New York because it. was homeopathy was really really really. popular at the time among the elite. wealthy Americans like the major. politicians, the uh corporate leaders.

Uh I think it was Rockefeller. I think. it was Rockefeller that was under the. care of a homeopathic doctor for like 50. years. >> Wow. >> So they carved out exceptions for those. two states for a while until they were. able, you know, all those people died. off basically and they were able to. completely squash it, >> right? Rockefeller died. So I guess the. homeopathy didn't work. >> Uh well, he he lived another like 48. years after being told he didn't have. long to live, I think. >> Oh wow. The homeopathy works. Case.

closed. So yes, I think that you've really put. your finger on it. The AMA became the. arbiter of what qualifies as medicine in. the United States. >> thanks to this Flexner report. It it. basically strengthened all of its. position and um and yes, they were the. driving force behind this initially. They went to the Carnegie um the. Carnegie Foundation and said, "Hey, you. got a lot of money. Why don't you help. us figure out how to change American.

medical education in the exact way we. want it and uh we'll help you figure out. who to who to do that with. We like the. John's Hopkins model. We basically want. a report that says the John's Hopkins. model is great. Let's get an outsider in. here. And that is how Abraham Flexner. enters the story. >> Yeah. And you know, this is not to say. that he was like cooking the books or. anything like that and no, this was all. a sham, but that was just sort of the. AMA was definitely after that. >> Well, one of the reasons he was selected. is he was already a a person, an.

educator who espoused exactly this kind. of stuff, just not necessarily as it. applied to medical education. He just. wasn't exposed to medical education at. the time, but he was an educational. philosopher and theorist. And he was. fully on board with that kind of. thinking. >> Yeah. I mean, he wrote a book, I guess. we should say. He um he he did go to. John's Hopkins, but not for medicine. Uh. I think he studied uh classic. civilizations. >> Sure. >> And he was a teacher in his hometown in. Louisville, Kentucky.

>> Uh eventually he was a private school. headmaster that he founded the school. >> And after earning a degree in psychology. from Harvard, he wrote a book called The. American College, which was sort of the. Flexner report of the university system. as a whole. And this guy named Henry. Pritchette, who was the president of the. Carnegie Foundation at the time, was. like, "Yeah, like Josh of Clark of the. Future will say, "This is this is our. guy." Because did you see the way he. came at the regular universities? Like, wait till he finds out what's happening.

in medical schools. >> Exactly. And then one of the other. reasons that he was such a great. candidate because he was an outsider and. a non-f physician is that they were. quite aware that there was going to be a. lot of blowback that there were. [clears throat] going to be a lot of. bruised egos and stepped on toes and. that somebody outside of the profession. would be less likely to suffer say like. a professional injury or being. ostracized for the rest of their career. Um yeah, Flexner was like I don't care. what you think of me doctors.

>> That's right. Uh so he started out by. researching uh the European models, the. American models. Uh like I said, he they. he was really impressed with the German. model. >> Yeah. >> Uh and in fact, a couple of years after. the American uh and Canadian, as we'll. see, Plex in a report, he published a. European version which critiqued um. well, Europe, basically everybody but. Germany. He was. >> he was very uncritical of the German. system. Uh and uh we also need to point. out some of the bad things he said. Uh.

there were several anti-semitic passages. in the European version of the Flexner. report because he was so enamored of how. the Germans did their medicineing. >> Yeah, this was um yeah, that German. model also inspired the guy who founded. John's Hopkins medical school, William. Welch. Um and that was essentially so. essentially the Flexner report said the. John's Hopkins model is what we want. John's Hopkins said the German model is. what we want. And the Germans said yeah. Uh, ya.

>> Yah. Da. >> Yeah. >> No, that's Russian. >> Das boot. That's German. >> Yeah. Nice. What else? >> Um, the Heimlick maneuver. >> Yeah, that's it. >> Brought Cider. >> Okay. [laughter]. >> Yeah. All that stuff. October [snorts]. Fest but with a K. >> Should we take a break? >> Yeah. >> All right. You're going to think think. Did you say yah? >> Yeah. We're going to think of some more. German words or Deutsche words and we're.

going to be back with more on what. Plexer said right after this. [music]. [music]. >> [music]. >> Chuck, I could only come up with one. more and it was Strudel, but it's the.

best one. >> Yeah. >> Oh, wait. Frankenstein. >> Yeah, >> that's it. >> Do you see that new Frankenstein movie? >> Uh, the bride. >> No, no, no. The uh what's his name's new. Frankenstein movie? >> I don't I don't know. The Rock. Who? >> No, the director. Gail Gallmo del Toro's. >> Oh, no. Frankenstein. >> What did you think of it? >> It was pretty good. I got a little. bored, but it was Everyone said it was. really great. I think I was distracted.

>> Maggie Gyllenhaal is redoing The Bride. in like a really strange like out there. kind of fashion that looks interesting. >> Yeah, I saw that. I thought it seemed. super interesting and I love Mags, so. I'm down. >> Uh, okay. Well, that's fine. I'll allow. it. >> Uh, so back to the Flexner report. uh he. started that research in 1908. I think. the thing came out in n 1910 is like we. said. >> but he went around all over the place. He went to 105 155 medical schools. Uh.

148 of which were in the United States, seven were in Canada, spent a couple of. days there with his nose turned up. And. he did this for about 18 months. >> Yeah. And just to be clear here, this. guy was not phoning this in. He. definitely took the assignment and did. it to uh like he did it like all of. those those 155 medical schools in the. US and Canada. That was every medical. school in the US and Canada, including. ones that taught alternative medicine um. and black uh medical schools in the.

United States. So like he he definitely. went through the paces. It wasn't just. like a Yeah, let's look at John's. Hopkins and here's my report. >> Yeah, for sure. And you mentioned the. black medical schools because they they. come up pretty uh front and center here. in a minute. >> Yeah. >> But uh John's Hopkins was the like the. gold standard. So that was his. comparison point for all of them. He. looked at everything. He looked at how. they financed their school. He looked at. how big the classrooms were, how many. teachers they had per student,

>> uh what like admissions, what it took to. get in, what they were actually. teaching, um laboratory stuff, facilities, kind of everything. And what. he came out with was one of three. determinations in the end for each. school. >> Uh the school is good. You can stay you. can keep your doors open. Um your school. is not so great, but you show promise. So maybe if you have some more funding. and you change these things, you you can. be okay. And then I'm sorry, please. close your doors forever.

>> Yeah. There was a lot of them that he. categorized as hopelessly deficient. >> A lot mo most in fact. >> Yeah. And it wasn't just like him being. a snoody buttthead. Like the, as we. said, like the medical schools in the. United States were in a lot of cases. hopelessly deficient. And that's a. problem when you're producing doctors, you know. So, he did make a pretty good. case that that there were a lot that. were hopelessly deficient, but the. deficient ones, they actually had. different rankings. for example, um Iowa.

State University's medical school, he. basically said, >> uh they're they know what they're. wanting to do, but the hospital. associated with it is too small. >> Um and the the your clinical faculty, the people who are supposed to be doing. research and teaching medicine to the. students, they all have their own. private practices because they have to. support themselves. So if if you gave. this this group enough funding, they. could create a top-notch medical school. in the John's Hopkins model. That was.

kind of like that deficient category, um. the varying degrees of how much money. you would need and whether you were. you're headed in the right direction. >> Yeah, for sure. uh the way he wrote uh. in what was called Carnegie Foundation. bulletin number four or medical. education in the United States and. Canada aka Flexner report was that. >> uh very muckreking style. Um it it's not. the kind of report you would people.

wouldn't write it this way today because. he did get a little it seems like he. enjoyed sort of the put downs and coming. up with new ways of saying how bad a. school was. So, people would write it. that way today, unfortunately. >> Well, you're probably right. Uh, one of. them he said, "Apparently, the. inexcusable degree of ignorance begins. just where the ability to pay fees. leaves off.". >> Oh, >> yeah. And so, he was basically taking. them to task over low admission. requirements, if any. >> He didn't say low admission. requirements. He also used the word.

reeks, which you don't usually see in. academic um studies. >> Yeah. He said that the osteopathic. schools in the United States, there are. eight of them, that they of. commercialism, that they attract. students with a mass of hysterical. exaggerations that confidently appeals. to the crude boys or disappointed men. and women whom it successfully exploits. Yeah, >> we should we should say osteopathy is an. accepted um form of medicine in the. United States now, but a lot of people. still view it as a um pseudocientific.

alternative medicine. >> Yeah. I mean, he had a sight set on them. on chiropractors. on on all kinds of things that um a a. lot of people put a lot of great value. in today. So, he was off base on some. stuff for sure. Uh but again, this was. 1910. So, um, of the underfunded medical. schools, and this was a problem, too. This is actually what, um, one of the. things that befell black medical. schools, as we'll see in a minute, if.

you were underfunded, that was it. Sorry. No amount of funding is going to. bring you up. Well, maybe some amount of. funding is going to bring you up to. speed, but we need that money to bring. other medical schools that are closer up. because we can bring more of them up to. snuff or we can bring fewer up to snuff. and basically get the ones that are the. least funded. His whole premise was just. close those poorly funded ones because. they're just not going to be able to do. this. >> Yeah. And you know, he was probably on. to something there because there was a. glut of bad schools. And his quote was,

"The curse of medical education is the. excessive number of schools. The. situation can improve only as weaker and. superfluous schools are extinguished.". >> Right? >> Uh like I said, it was Canada and the. US. Canada fared much better. Uh our. northern friends up there of the seven. Canadian medical schools, he only. recommended one for closure. >> So 17th of them. >> That's right. of the 148 medical schools. in the United States, uh more than half.

of them he recommended closing and I. think it ended up being more than that. even, right? >> Uh yeah, he actually recommended. reducing the full number of schools in. the um US and Canada from 155 down to. 31. >> Yeah, >> that's four fifths. >> So yeah, I mean like he was basically a. hatchet man. They brought him in to. basically get rid of competing, poorly. funded, poorly medical schools. He said, "If you're a proprietary medical school,

it doesn't matter what you're doing, you're closed." He saw um med school as. an a public trust, that it should be. publicly funded, ergo, they should be. associated or attached to public. universities. And that the reason that doctors were. being produced was to help society. along. that you should not have a board. or stockholders to whom you were really. kind of beholden to so they would affect. your decision- making. No, you needed to. be beholden to science, right? And.

ideally to patients, although he didn't. put much emphasis on that part. >> Yeah. And we'll we'll talk about that at. the end. So, every single proprietary. school was immediately on the list. basically from the jump. >> Uh like if you weren't affiliated with. the university, you had no hope for. surviving this. uh all the holistic or. what we call alternative medical systems. were completely shut down. Um five of. the seven black medical schools were. recommended for closure. Uh I think.

Howard University in DC and Mahairi. Medical College right here in Georgia he. thought might be salvageable. But there are a couple of chapters in. there, uh, chapter 14 specifically, the. medical education of the negro was the. title of that chapter where he shows a. real disdain for black medical schools. >> Uh, he said they were wasting money, small sums of money annually, uh, that. undisiplined men whose lack of real. training is covered up by imposing M MD. degrees. And he basically ended up.

saying like close most of these and my. suggestion is just to make black medical. schools to train black doctors to treat. black patients only and they should. really just concentrate on hygiene. >> Yeah. They should they should focus on. public health in order to keep black. people from spreading disease to white. people. That was essentially his take on. the purpose and for the existence of. black doctors. um out of 346 pages in. the initial version of the report, two.

chapter 14 was two pages long and that. is shocking in and of itself. But the. Flexner report was essentially the first. like document about medicine and medical. school that even acknowledged the. existence of black medical schools. Up. to this point, they were totally. invisible, completely ignored. So the. fact in a really silver lining to the. cloud way of looking at this, the fact. that Howard University and Mahairi.

Medical College in Georgia made the cut. >> Yeah. >> Um was really substantial. Like that was. a that was sadly a really big positive. for black medical schools unfortunately. >> Yeah, for sure. Uh you know, I mentioned. sexism too. the AMA and the Carnegie. Foundation were also not too hot on the. idea of the three U women's medical. college. >> uh colleges even existing. Uh and. Flexner himself um basically came out.

and said, "I don't think women can. withstand the the mental rigors of being. a doctor.". >> He never met Elizabeth Blackwell. >> Yeah, no kidding. And uh he he literally. said, you know, women make better. patients than doctors. This is the 1910s. >> Yeah, it's not like 1810. >> So, um, yeah. So, this was I mean I. guess on the other way of approaching. this too. So, we've talked about. everything that he was giving the. hatchet to, he had a version of what.

made an idea ideal medical education and. again it was based on the German model. which the John's Hopkins model was based. on. And he essentially said so you need. to have rigorous instruction. Yeah. you. need to have rigorous um admissions. requirements and you have to enforce. them too. >> Um and in doing so, he basically said. you're going to you're going to weed out. candidates who aren't they don't have. they can't make the cut for this new. kind of doctor. So that meant you had to.

have money to even get started because. this new model was so much more. expensive than the old model. three to. like tuition I think needed to increase. three to four times just to start to. meet the funding for this. So you like. you just out of the gate had to have. money to even try to apply to medical. school. And then the the academic. requirements meant that even if you had. money if you didn't have what it took to. like really dedicate yourself to.

learning this stuff you were going to. fail out too. So in that sense it it. took doctors from being just ordinary. trades people and said these people are. responsible for keeping the the. population of the United States healthy. and we're making sure that they are up. to the task in in return um they're rich. now. >> That's right. Uh and you know you know. part of it was medical school was. expensive was because um or ended up. being more expensive is because they.

needed better facilities. they needed. better equipment. Uh I know we already. mentioned that teachers were working uh. part-time as doctors just cuz they had. to make a living, but. >> one of his big key recommendations was. you have to have a full-time faculty. that is just doing biomedical research. Like they're not doctoring on the side. >> And in order to come up with this kind. of money, it was expensive. um the idea. of medical philanthropy really really. took off because you know John's Hopkins. was one thing but if you wanted to have. more than one John's Hopkins like model.

out there right. >> uh you had to lay out this road map of. basically you know starting in 1910 and. over the next like few decades and. continuing today these huge foundations. were created uh and also local groups. just donating money um to to make sure. the Flexner report was enacted like the. Rockefeller Foundation. Um they gave hundreds of millions of. dollars to get these programs going. across the country. >> Yeah. And it worked. But again, it took.

hundreds of millions of dollars in I. think 1910 money, too. >> Should we take a break? >> Let's take a break. >> All right. We'll be right back with uh. the closing act of the Flexner report. [music]. [music]. >> [music].

>> So, we're back. Um, one of the results. we talked about was all these schools. shutting down. I think more within 10. years, I'm sorry, within five years. >> of the reports released, more than 50 of. the medical schools in the United States. shut down. And 20 years on, only 76 of. the original 148 in the United States. remained. >> Mhm. >> Um like you said, five of the seven. black medical schools. Um 80% of the. alternative medicine programs were shut.

down and the handful of schools that had. admitted women were um either shut down. or not admitting women anymore for a. while. >> Right. So it like this was a huge impact. on the way that doctors were created in. the United States and again the. profession of doctoring in the first. place. Um and it happened very quickly. as you just mentioned. Uh and there are. a lot of positives to it but there are a. lot of criticisms to the outcomes too.

One of the big ones is the impact that. the Flexner had on producing black. doctors in the United States. Uh I saw. an estimate that had all seven of the. black um medical schools stayed open and. been funded so that they could follow. this model. Mhm. >> Um, another 30,000 doctors, black. doctors, would have been produced in the. United States between 1910 and 2012, I. think, which is a big deal because. apparently right now 2% of American. doctors are black, but the um the.

percentage of the black population in. the American population overall is 13%. So they're grossly under reppresented, which is another problem in and of. itself because studies show that black. patients are likelier to follow the. orders and instructions of black doctors. than they are of doctors of other races. They just it's just a question of. comfort. >> Yeah, for sure. And you could also uh. make an argument that that gave rise to. things like the Tuskegee experiments and.

other like awful experiments carried out. by white doctors on black patients that. led to this cycle of mistrust of the you. know the medical profession as a whole. >> Yeah. There was a whole there like part. of this this emphasis on science uh and. because Flexner was not a physician he. really ignored um the idea of the. physician as a healer. The physician is. somebody who was meant to see their. patients as human. And instead, because. of this focus on rationalism over. humanism, the patient became essentially.

just a walking bag of medical issues. that needed to be diagnosed and treated. They weren't a person. That stuff didn't. matter. The point of the doctor was to. treat their illnesses and make them. better, not to be their friend. And in. doing that like the medical profession. lost a lot of um I guess connection with. the rest of us where you know doctors. are kind of looked at as. uh looking at the rest of us is not. fully human and that doesn't really jive.

and feel good you know when you're a. patient. >> Yeah for sure. I think um I can't find. it. It's not in front of me now, but I. sent you one study from uh a few years. ago where I think the long and short of. it was they were surveying people that. uh how happy they were with like the end. of care um. >> care. >> uh for relatives and I think uh only 40%. of the people were satisfied with like. how their uh the end of the lives of. their relatives went and a lot of that. had to do with pain management and that.

sort of ties back to what you were. saying about um just sort of the. rigorous you know, uh, eyeballs on a. microscope and and not like eyeballs on. a human. Um, you know, it all it's all. sort of tied in together, I think. >> Yeah. And the the other way that that. manifested itself was a huge emphasis on. separating academic physicians from. practicing physi physicians so that the. academics could just focus on research. >> And then they emphasized the research. that the academics were producing. Like.

that's the most important thing. you. clinicians listen to the research. doctors and what they're finding and. then you can go apply it to your. practice. And so they were like, well, you've taken these people away from. patients and they're just using like. this the this scientific mentality and. there's no humanism to it. And they. critics say that was one of the ways. that this whole idea of science losing. its humanity or medicine losing part of. its humanity or soul came about.

>> Yeah, for sure. uh you know I know I've. already mentioned a little bit about. eliminating sort of all kinds of. alternative u medicines and that. homeopathy was homeopathy homeopathy. what do you say. >> I've heard both. >> okay uh. >> saying both at the same time. >> was very popular at the time I mean. there are people that think that uh they. were doing pretty well with uh. homeopathy and and curing disease with. natural remedies um other people will. say no you've got your tinfoil hat on. and that's not the case they just didn't.

know real science at the time. So, there's a lot of raging debate online. about that kind of stuff. But another. point of this all is that uh psychiatric. medicine. >> um lost a lot of um I guess curricular. elements that were very beneficial at. the time for mental health treatment. Like they they were making a lot of. strides at the time with things like. meditation and like how nutrition like. food can can alter like a person's or. lifestyle can alter a person's mental. health. Mhm.

>> And that was all just sort of flushed. down the toilet uh because of this. And. the neurochemical model came out of. mental illness. And the same people that. were arguing for uh homeopathy basically. said, you know, what the Flexner report. really did was among other things was um. led us down the path of people like the. Rockefeller Foundation um creating big. pharma essentially and getting people on. endless amounts of medicine that just. don't heal you and they're just never.

ending and make big pharma bigger. >> Yeah. Psychiatric medicine is a good. example of that. they just took the the. neurochemical model of mental illness. and that that was that. >> I mean I think a lot of that stuff has. come back now it's just not super funded. and you're not going to find any like. huge uh you know medical schools that. that um tout their homeopathy um. departments or anything like that but I. think the there's underground movements. for all that stuff like hey meditation.

can help your mental health and maybe. these herbs can make you feel better or. this honey that you rub on your cut is. better than bactene or whatever. >> It really is. If you see a good um. psychiatrist, especially probably a. younger one these days, one of the first. things they're going to ask you is how. are you sleeping? Are you exercising? What's your diet like? >> Yeah, totally. >> And then they'll start to go into meds, but like they're going to say like you. need to really pay attention to these. three things. And if you still need. meds, it'll still drastically reduce the.

kind or amount of meds you'll probably. need, >> right? If you're taking care of yourself. in the other ways. >> Exactly. So that has definitely come. back in psychiatry. And that's a really. good example of what a lot of people. point to. The Flexner report suppressed. that for a hundred years. It derailed. black doctors. It derailed women. doctors. It derailed alternative. medicines. It even took the stuff that. was part of the medical establishment. and twisted it around. And it it took a.

full century for things to start to even. come back. And that again is a really. big criticism of the whole thing. But. overall, you can point to a lot of. stuff, a lot of lives that were saved, a. lot of lives that were improved, a lot. of lifespans that were extended because. of this John's Hopkins German model that. the Flexner report essentially with the. AMA got the Rockefeller Foundation to. fund. >> and create this new model for America. >> Yeah, this is one of those rare episodes.

where there's truly like two ways to. look at it. Uh, I mean, he definitely. threw the baby out with the bathwater in. a lot of cases. >> Oh, well, well put. >> But you could also argue that like it. was such a mess that like something. drastic had to happen. Um, >> or else it, you know, who knows how many. more decades it would have taken. I. mean, I definitely agree with you that. like it would have happened at some. point. I doubt if we'd still be sitting. here today had the Flexner report not. been written and like I'm sitting here.

with like a leech on my forehead. >> Right. Or I have typhus. >> Yeah, exactly. Uh yeah, I agree with you. Uh Chuck, this is a good one. Thank you, Emily, for it. >> Thanks, Josh. You're welcome. >> That was a great Emily. >> Nice seeing you in San Francisco, buddy. >> Yeah, it was great to see you, too. I. don't know why I'm talking like you, but. I am. [laughter]. Uh if you want to know more about the. Flexion Report, go out and read it. It's. 346 pages of muck raking gold. And since. I just wrapped up this episode as if it.

were from 2010, >> I think it's Chuck Time for listener. mail. >> That's right. Uh, this is from Kyle. Hey. guys, I'm sure you've uh heard this over. the years, maybe receive snarky [music]. emails from people saying, "What do you. mean I should know this?". >> Oh, yeah. I like this email. Thanks for. picking it. >> Uh, in a way, it makes it seem like they. interpret it as stuff you should already. know. But I always took the approach. that a quintessential SYSK episode sheds. light on something that a person should. know in order to give voice to.

situations, regions, historical events, things like that. Uh something we should. know today to help learn and grow. And. Kyle, that's of course always been the. case. >> Yeah, it's stuff that we think you. should know which we want to share with. you. >> It is interesting to learn how the son. of the jackhammer works. I found I see. what you're doing there, K. Uh, I found. that the Helen Keller and Anne Sullivan. episode was exactly what I think of as a. great stuff you should know episode. My. only knowledge of Helen Keller was what. I had learned from the late 90s and as.

media and pop culture. So, thank you for. showing me um how amazing both of them. were as people, activists, advocates, and his friends. Uh, the lives of. [music] Keller and Sullivan is something. everyone should know. Uh, thank you. That is from Kyle. [music]. >> Thank you right back, Kyle. That was a. worldclass email. Don't you think, Chuck? Yes, Kyle, that was wonderful. >> Yeah. So, if you want to knock it out of. the park with an email like Kyle did, wrap it up, spank it on the bottom, and. [music] send it off to stuffodcast@.

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