It used to be the Olympics was all about amateur athletic competition between nations. Those days are long gone. Today, we have professional athletes competing against other professional athletes. Gone are the days of amateurs in the Olympics. I don’t mind the shift to professionals as much as I mind the increasing political agenda of many nations. The Paris Olympics took politics and liberal political correctness to a whole new level – as one would expect from a liberal nation like France. The bizarre opening ceremony with its sacra religious depiction of The Last Supper even drew a rebuke from the liberal Pope Francis.

But today I’m writing about the controversy that received less attention – the French attempt to force the athletes to eat politically correct food! It’s no secret that Europe in general and the French in particular are climate change alarmists. But it was unexpected they would try to force athletes from all over the world to conform to their ideas about a “climate friendly diet.”

Dr. Charles Cornish-Dale, writing for The Epoch Times, tells us the French made a commitment that 30% of the food offered to the athletes should be vegetarian “to reduce the Games carbon footprint.” Naturally, the athletes revolted. Dissatisfied with the choices in the canteen, teams such as the Australians started flying in their own food instead. Teams complained, and to stave off a potentially damaging revolt, reports suggest that the organizers brought in 700 kilograms (about 1,543 pounds) of eggs and at least a metric ton of meat to replace “fake meat meals and non-dairy options.”

Dr. Cornish-Dale says, “Having to bring in extra meat and eggs was an embarrassment for the organizers, of course, but it was just as disappointing for advocates of plant-based diets more generally, who were hoping for a stunning vindication of their own dietary choices. The first plant-based Olympics: See, you really can break world records without eating meat, eggs, or dairy! Paris was intended to be the definitive test of a claim that’s made regularly now on behalf of plant-based diets, including in the 2018 documentary “The Game Changers,” which surprisingly was co-produced by a famous bodybuilder, a man who built his legendary physique with precisely the kind of foods we’re now being told we must abandon: superhuman quantities of steak, chicken, eggs, raw milk, and cream.”

Medical school taught me that a purely vegetarian diet cannot provide all the nutrients required for a healthy metabolism. Olympic athletes, perhaps the most health-conscious beings on earth, understood this and they revolted. They were only interested in peak performance at the games, not “saving the planet.”

Dr. Cornish-Dale goes on to say, “The Olympic athletes, by voting with their plates, reminded us of what we already know—or should know: A vegetarian, and especially a vegan diet, is maladaptive. Plant foods are not the foods we should be reaching for when we want to perform at the highest level. In fact, a diet built solely on plant foods will not make us healthy even in our day-to-day lives. Far from it.”

This misguided belief that the planet can be saved by altering our food sources has gotten out of hand. Some are calling for the abandonment of animal proteins in favor of laboratory-grown meat. In response, Florida Governor Ron DeSantis banned lab-grown meat in the state and producing or selling lab-grown meat is now punishable with a fine and up to 60 days in prison. DeSantis said his aim was to protect Florida’s “vibrant agricultural industry against acts of man, against an ideological agenda that wants to finger agriculture as the problem, that views things like raising cattle as destroying our climate.”

The French may have had good intentions, but foisting their ideas about climate change on a population of world-class athletes only reinforced the beliefs of many that climate change activists are unconnected to reality. However, this virtue signaling by the French may have one beneficial outcome – perhaps it will promote honest debate about what’s really going to impact climate change and what a really healthy diet is all about.

In Parts I and II, we have discussed a managerial revolution taking place in medicine. This revolution is changing the way medicine is practiced because most doctors (70%) are no longer in private practice but work for a hospital system, corporation, or the government.

In Part II we learned that there are four tenets of the managerial ideology that drives this new method of healthcare delivery. The first was technocratic scientism, which is the belief that everything, including society and human nature, can and should be fully understood and controlled through materialist scientific and technical means, and that those with superior scientific and technical knowledge are therefore best placed to govern society.

In Part III we will discuss the other tenets of managerial ideology.

Aaron Kheriaty, writing in The Epoch Times, tells us the second tenet of our managerial ideology is utopian progressivism, or the belief that a perfect society is possible through perfect application of scientific and technical knowledge and that the Arc of History bends toward utopia as more expert knowledge is acquired. He tells of a conversation with a nurse ethicist from Johns Hopkins a few years ago who was giving a guest lecture at the medical school where he taught. “She remarked that Johns Hopkins Hospital used the marketing tagline “The Place Where Miracles Happen.” Medicine is clearly not immune from utopian progressivism, even if it’s only cynically tapping into this ideology for public relations purposes.

The third feature of the managerialist ideology is liberationism, the belief that individuals and societies are held back from progress by the rules, restraints, relationships, historical institutions, communities, and traditions of the past—all of which are necessarily inferior to the new, and which we must therefore be liberated from in order to move forward. Contrary to this ideology, there are some things in medicine that will never change.

Dr Kheriaty says, “At its foundation, medicine is constituted by a particular kind of relationship, one based upon trust between a patient made vulnerable by illness and a doctor who professes to use his knowledge and skills always and only for the purposes of health and healing. No technological advance, no societal development, will ever alter this. The ends, or purposes, of medicine are baked into the kind of profession that it is, grounded in the realities of health, illness, and the human body.”

This liberationism has led to all kinds of perverse thinking. “Why limit ourselves to healing when we can turn men into women, women into men, and humans into bigger, faster, stronger, smarter post-humans or super-humans? Liberationist projects will free man not just from the ravages of illness, but from the constraints of human nature itself,” says Kheriaty.

The most grotesque example of this kind of thinking is so-called “gender-affirming care.” Kheriaty tells us this is quickly crumbling under the weight of evidence showing that puberty-blocking hormones, cross-sex hormones, and surgeries that destroy healthy reproductive organs have not improved the mental health outcomes of gender-dysphoric youth.

“What has unfolded in the past several years with the explosion of “gender-affirming care” was largely driven not just by the liberationist ideology, but also by financial considerations and the desire to create a cohort of lifelong patients entirely dependent on the health care system, who were once otherwise physically healthy. The result has been a form of institutionalized and medicalized child abuse fueled by social contagion and sustained by the slandering and silencing of critics. Gender medicine will go down as one of the greatest scandals and follies of medical history, and is poised to soon globally collapse under the weight of its own contradictions.”

The fourth feature of the managerial revolution is homogenizing universalism, or the belief that all human beings are fundamentally interchangeable units of a single universal group and that the systemic “best practices” discovered by scientific management are universally applicable in all places and for all peoples. Therefore, any nonsuperficial particularity or diversity of place, culture, custom, nation, or government structure anywhere is evidence of an inefficient failure to converge successfully on the ideal system; progress always naturally entails centralization and homogenization.

What are the outcomes of these tenets of managerial ideology?

Dr. Kheriaty answers, “None of this improves medical outcomes. In fact, they often worsen medical outcomes by mandating a one-size-fits-all approach to clinical care. This compromises physicians’ appropriate clinical judgment and discretionary latitude. Doctors are pushed to hit metrics on measurements like blood pressure, even if this does not actually improve meaningful outcomes like heart attacks or strokes.”

Could there be an incentive for doctors to overprescribe medications?

These guidelines are often pushed by industry groups that have a vested interest in expanding disease categories or widening disease definitions. “Let’s lower the threshold for what counts as hypertension or high cholesterol so that more patients get on antihypertensives and statins,” for example. If doctors don’t comply, we don’t get paid. It does not matter whether putting more patients on statins fails to save lives. This leads, among other issues, to preventative overprescribing. In the United States, 25 percent of people in their 60s are on five or more long-term medications. That number rises to 46 percent for people in their 70s, and 91 percent for nursing home residents.

Dr. Kheriaty calls for the development of parallel medical institutions – entirely new models of clinical care and reimbursement – started by physicians who opt out of this perverse system entirely. For this to happen, we will need an entirely new era of doctors who hold fast to the beliefs of past generations like mine who went into medicine to put the patient ‘s interests first – not the medical institution.

In Part I we talked about a new managerial revolution that is taking place in medicine today.

Aaron Kheriaty, writing in The Epoch Times, tells us the managerialist ideology consists of several core tenets, according to Washington-based writer and analyst N.S. Lyons. The first is technocratic scientism, or the belief that everything, including society and human nature, can and should be fully understood and controlled through materialist scientific and technical means, and that those with superior scientific and technical knowledge are therefore best placed to govern society.

This ideology manifests itself in medicine through the metastatic proliferation of top-down “guidelines,” imposed on physicians to dictate the management of various illnesses. These come not just from professional medical societies but also state and federal regulatory authorities and public health agencies.

“Guidelines” is in fact a euphemism designed to obscure their actual function: They control physicians’ behavior by dictating payments and reimbursement based on hitting certain metrics. In 1990, the number of available guidelines was 70; by 2012, there were more than 7,500. In this metastatic managerial regime, the physician’s clinical discretion goes out the window, sacrificed on the altar of unthinking checklists. As every physician knows from clinical experience, each patient is sui generis, unrepeatably unique.

Dr. Kheriaty says, “Real patients cannot be adequately managed by a diagnostic-based algorithm or treated by an iPad. Checklists are useful only once the problem has been understood. For the practitioner to be able to make sense of problems in the first place requires intuition and imagination—both attributes in which humans still have the edge over the computer. Problem-solving in a complex environment involves cognitive processes analogous to creative endeavors, but medical education as currently configured does not cultivate these capabilities.”

Technocratic scientism has likewise driven the campaign for so-called “evidence-based medicine” (EBM)—the application of rationalized expert knowledge, gleaned typically from controlled clinical trials, to individual clinical cases. At first glance, evidence-based medicine seems hard to argue with—after all, shouldn’t medical interventions be based on the best available evidence? But this model has serious flaws, which have been exploited by Big Pharma. Studies yield statistical averages, which apply to populations but say nothing about individuals. No two human bodies are exactly alike, but technocratic scientism treats bodies as fungible and interchangeable.

By this way of thinking, treating patients might just as easily be done by robots – plug in the symptoms, out comes a diagnosis and treatment. No need for any human intervention. I’m sure there are those who would agree with this approach, but doctors know better. Medicine is both science and art – a unique blend of scientific knowledge and human experience that only can be applied by humans.

EBM proponents claim we should only use the “best available evidence” to make clinical judgments. But this sleight-of-hand is deceptive and wrong: We should use all available evidence, not just that deemed “best” by self-appointed “experts.” The term “evidence-based” functions to smuggle in the claim that double-blinded, randomized, placebo-controlled trials (RCTs) are the best form of evidence and therefore the gold standard for medical knowledge.

Dr. Kheriaty says, “This results in, among other things, the scrapping of the entire discipline of epidemiology. EBM’s criteria constitute Big Pharma propaganda masquerading as the “best” expert scientific and technical knowledge.”

(Note: More on managerial ideology and its impact on medicine next post.)