I was already impressed by Dr. Doug McGuff, but now I’m even more so.

Dr. McGuff’s book Body by Science (co-written with trainer John Little) is one of the best I’ve read on exercise and fitness.  It’s a how-to guide for high-intensity resistance training, but also a nice primer on the science of how your muscles work, adapt and grow.

When you read this book, you’ll learn about the different types of muscle fibers and how they’re recruited during exertion.  You’ll learn why there’s really no such thing as “cardiovascular fitness.”  (All fitness comes down to muscular fitness.  Your vascular system doesn’t become “fit.”)  You’ll understand why you will never – no matter how hard you work – develop eye-popping muscles like a body-builder or professional athlete unless you’ve been blessed with an unusual ratio of fast-twitch vs. slow-twitch muscle fibers.  That’s the bad news.  The good news is that you’ll also learn how to become as fit and as strong as you can be by lifting weights correctly during brief but intense workouts.

I’ve also seen Dr. McGuff give a couple of speeches on diet, exercise and health that I thought were excellent.  The man knows his stuff on those topics.  I expected that.

I didn’t expect him to be equally impressive speaking about economics, but he is.  (Any doctor who can talk intelligently about Milton Friedman’s spending quadrant is cool in my book.)  After last week’s debate in the comments about insurance and ObamaCare, a reader sent me a link to this speech Dr. McGuff gave in 2012 titled Fitness, Health and Liberty.   It’s more than an hour long, but worth the watch if you want to understand the economics of how and why our medical system got so screwed up in the first place.  (Hint:  products and services rarely become prohibitively expensive as a result of too much freedom.)

As an emergency-room physician, Dr. McGuff has seen what happens when people wind up in the medical system,  which he calls “the belly of the beast.”  I’d suggest paying close attention to the end of the speech, when he offers advice on how to avoid winding up in an emergency room in the first place.

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29 Responses to “A Little Tribute to Dr. Doug McGuff”
  1. Cindy Austin says:

    This is a great post, the ER can be a needful thing, but I HATE even just the thought of going there and I try to avoid it at all cost! Now I have kids and fear for them in this situation as well, I got a hold of a great resource in Keeping Your Kids Out of the Emergency Room by Dr. Chris Johnson, chrisjohnsonmd.com. He’s got it loaded with info and tips and I swear I have been saved by things he wrote already! I highly recommend it, at least for the pediatric aspect!

    I definitely want to keep my kids out of the emergency room, for all kinds of reasons.

  2. Kathy in Texas says:

    Thanks for that – very informative and easy to understand. Now to figure out how to get my friends/family to watch it.

  3. Geoff says:

    My favorite quote from one of his lectures regarding paleo was, “if you can’t pick it, hook it, or beat it to death with a stick, you shouldn’t eat it.”

  4. Howard says:

    The ER is perhaps the only part of the VA medical system that I would consider competent. My H1-b primary care doc knows nothing about health care (she thinks cholesterol is a disease to be treated with a toxic pill), and less than nothing about nutrition (she is a vegetarian, and thinks I should be, too).

    If I should have an accident, or become a victim of a crime in which I am seriously injured, I suspect that the ER is probably my best bet.

    In fact, the *only* reason I visit my VA quack is so that I stay on the active roll at the VA, so that if I do ever need the ER, I can go there. Plus, it keeps me out of BH0care, sort of. My personal care quack has already labeled me as “noncompliant.”

    Dr. McGuff mentions several times that there are great doctors in the E.R. It’s “the beast” you want to avoid … the system that employs those great doctors.

  5. Lori says:

    This reminds me of the Soviet Union, where the sickest patients were turned out of hospitals so the hospitals could meet survival quotas.

    I suppose someday we can look forward to the totally out-of-pocket surgery at a four-star center for the rich and back-door care from vets and renegade doctors for everyone else.

    The way things are going, the smart move is to start saving up for your private-surgery fund just in case.

  6. Bill RN says:

    This is a great video. In some circles, this might get Dr. McGuff in trouble, but I’m sure he doesn’t care. Heck, I don’t care… this is the truth. I even wish more nurses had attitudes like this, then something might get done. (Nursing is the largest, most-trusted healthcare workforce in the US. It being a female-dominated field doesn’t bode well… nurses don’t get along, (mostly females) and can’t seem to agree on much. Don’t believe me? Ask an experienced nurse.)

    The Emergency Department is a great place for trauma and such, but that’s about it. I’m happy to take care of your laceration, broken bone, or kidney stone. Its not a great place for your long-term illnesses; heart failure, diabetes, etc. I could educate you about your illness, treatment and medications until I’m blue in the face. But if you don’t care, it doesn’t matter one iota. And now, the hospital won’t get paid if you decide to come back in to the hospital within 48 hours of being discharged.

    We’re is the patients’ responsibility? Their health is THEIR responsibility. My health is MY responsibility.

    And now with ObamaCare, if push comes to shove, I’ll just not have insurance and just save my own money as my catastrophic plan.

    Kid has a fever? Don’t bring them in to the ED… wait it out. Most every injury or illness will heal with TIME. Its important to remember that the body wants to heal itself. People just have to provide their body with what it needs.

    Ok, rant off.

    Thank you for sharing.

    Bill RN, Emergency Nurse

    It’s a fine rant.

    • Firebird7478 says:

      Wow, I know a Bill who is an ER nurse. I know of his dietary habits and suspect your are not him (He single handedly keeps Sonic in business).

      My mom is a retired LPN and the discussions I have with her are head banging to say the least. She disagrees with just about everything I say right down to my sister’s total body pain issues that have her quitting her job working with special needs kids. I don’t blame it on her diet but I am sure it contributes to it. My guess is she eats 800 calories a day of low fat foods and low protein intake. Her body would heal if it had the tools to do so. She’s a paltry 116 and doctors and nurses have told her she should be at 125-130. But she wants to be thin and have abs at 45. Mom enables that.

      Here’s a video that compliments McGuff’s. The two go hand in hand.

      http://www.youtube.com/watch?v=r9q1Id41wGo&list=FLXMDhrVdIuQx52letcpH1IQ&index=1

    • Kathy in Texas says:

      Yes it is!

  7. Michele says:

    http://news.yahoo.com/blogs/oddnews/mom-fined–10-by-daycare-for-packing-%E2%80%98unhealthy%E2%80%99-lunch-224131736.html

    A bit off topic- but interesting article I saw on Yahoo today. A Canadian mom was fined by her daycare for not providing a healthy lunch for her kids. They are required BY LAW to include grains, so the daycare gave her kids Ritz crackers! The mom had sent them with roast beef, carrots, potatoes, and orange and milk!

    Hmmm … should I be happy officials in Canada are as stupid as those in the U.S.?

  8. Lori says:

    Hey, a dog in Colorado has successfully enrolled in Obamacare!
    http://www.foxnews.com/politics/2013/11/21/colorado-man-informed-his-dog-has-successfully-signed-up-for-obamacare/

    Excellent. That will almost double the enrollment numbers.

  9. Raz says:

    thanks for the link pilgrim

  10. Dave, RN says:

    Bill, RN, I feel your pain.

    I’ve been telling people for a while now “get healthy and stay out of the system”. In my mind of course that means spending more on high quality food, paleo style, and expanding your horizons on food and learning how to cook. In fact I just made my first batch of chicken feet broth. Man, talk about a gelled stock! Making the soup tonight.

    I’ve found that the only ones that actually listened are my (now adult) kids!

    Nobody else really seems to care.

  11. Nancy P. says:

    Many years ago I read an article in Money Magazine (I think) about retiring comfortably and their #1 suggestion was to be/get healthy. After listening to this talk, it drives the point home even more. Great talk, I’ll be listening to more by Dr. McGuff. Thanks for sharing this.

    Good advice. It’s not just a case of being sick driving up your medical bills. Being sick robs you of the energy to work hard and succeed.

  12. Elenor says:

    Geez Tom, you scared the hell out of me!! I saw your headline and thought: OMG! Did Doug die?!?!?! (Whew!)

    Doug’s fantastic book and excellent weightlifting program make me happy (and stronger!)

    Sorry for the scare. He’s a live and well … probably exceptionally well.

  13. Angel says:

    Wow, great video. I rarely watch video clips online because there’s almost always more annoying filler/white noise than I can tolerate. This video was all substance! And I loved his recommendations for staying out of the ER (at about the 50 minute mark). Thanks for posting.

  14. Chris says:

    “Body By Science” is an important book. I’ve been doing Super Slow weightlifting for 9 years. At age 63, I’m stronger than I was as a 22-year old decent college high jumper. The key to most of this diet and exercise “stuff” is being able to unlearn all the things you know to be true. The key piece for me in Doug’s book is that rest builds muscle. Having adequate recovery time is critical. At City Wide Super Slow in Chicago, you are only allowed to exercise twice a week. The gym’s owner is my age and says exercising once every 7 to 10 days is plenty.

    Key thing you have to unlearn in eating better is fat doesn’t make you fat. Carbohydrates do.

    Sadly, too many people can’t accept new information that proves they’re wrong so they cling to their beliefs and get fatter, weaker and sicker.

    I’ve already watched the video a couple of times. Great content. Rules for staying out of the emergency room are priceless.

    I first learned about the importance of adequate recovery time from Fred Hahn. And yes, it does make a difference.

    • Firebird7478 says:

      I learned about rest and recovery from Mike Mentzer who also preached 7-10 days rest between training sessions. (I don’t call them workouts. Workouts are what you do with your problems.)

  15. labrat says:

    I have been packing away money in my HSA since its inception and suggest others with the means to do so do the same. I never want to put myself in the position that any insurance or government entity dictates what my options are.

    Since I refuse to pony up an extra $10,000 per year for ObamaCare (with a higher annual deductible than I have with my “substandard” policy), I plan to build up an emergency fund. In three years of not buying ObamaCare, that’s $30,000 … and if I never need another surgery, I can actually spend that money.

  16. Mike says:

    Tom,
    The video was very interesting – I don’t know how anyone could defend all the bureaucracy that Dr. McGuff described.
    But I cannot see how anyone could describe health care as a “free market exchange.”
    Will you treat your kid’s illness with the lowest cost provider?
    Will you instruct others to call several ambulance companies to get the best price to take you to the ER in the event of some catastrophic accident or health event?
    Will you always research you and your family’s health problems to the degree that you Dr. shop to find one that agrees with your assessments?
    Or, shall we have regulations and standards of care that give us some assurance that we are getting the right treatment.
    Dr. McGuff just barely touched on the profit motive – which I believe to be one of the biggest root of evil in our current system. If I sold the chemo therapy that you believe will save your life – don’t I, as a good libertarian, charge all that you have (or perhaps not do business with you because someone else will pay more)?
    I will part with one question: if something were to happen to you, would you prefer your family (your Mom, your Wife and Kids) to live in the conservative / Libertarian / Republican “I got mine – screw everyone else” world, or the progressive / liberal / Democratic “We’ve got your back, and won’t let you starve, freeze, or die from lack of medical care” world?

    You’re describing what you’ve been told free markets and libertarianism are about, not what they are. A free market doesn’t mean I’d always choose the lowest-cost provider. It means I’d balance the cost and quality, just like with any other decision. We have a free market for elective surgeries, and that’s exactly what people do. When I got snipped after deciding we didn’t want more children, it was quite enlightening to call around to different surgeon’s office and notice that the nurse or receptionist always mentioned the cost right up front. They’re competing and they know it.

    The profit motive is evil? Please, do yourself a favor and pick up a copy of Thomas Sowell’s book “Basic Economics.” If you want a product or service to be available and affordable, you’d better hope to hell someone’s making a profit. Lack of a profit motive is why the communist countries couldn’t produce enough shoes, couldn’t keep the grocery stores full, couldn’t build a decent car, etc. Lack of a profit motive means no pressure to innovate, to improve, to find a way to deliver the goods at a lower cost than your competitors. To mention one example, when Gorbachev visited London, he was stunned by the sheer amount of the affordable and quality food available in groceries and restaurants. He asked Margaret Thatcher how the government managed to accomplish this amazing feat. She replied, “That’s the point. We don’t. Profit does.”

    No, I wouldn’t ask someone to call around for ambulance prices while I was bleeding in the street. I would expect my free-market health provider to have already done that research for me.

    And no, a libertarian chemo provider wouldn’t charge you a fortune for chemo, because he’d expect to get his ass kicked by other providers in the market. As I mentioned with elective surgeries, the market competition has led to lower prices, not higher. Getting your eyes fixed has dropped from a few grand per eye to about $1000 for both eyes, with less recovery time. That’s what market forces do.

    I would much, much rather live in the libertarian world than in the big-government world. It’s not about “I’ve got mine, so screw everyone else.” It’s about freedom. It’s about not coercing people. It’s about not passing regulations “to protect the public” that in fact merely serve to stifle competition and drive up prices for the politically connected.

    If you believe liberals are more caring and generous than those evil, stingy conservatives, I suggest you do some research on how much liberals vs. conservatives give to charity. Conservatives aren’t against helping people. They’re against being forced to participate in the government’s version of “help.” Liberals are like doctors who insist on bleeding the patient to release the bad humours, and when someone points out that bleeding will do more harm than good, they scream, “Oh, I see! So you don’t care if he dies, huh?! At least I’m trying to help!” And I’m sure many Democrats do mean well … as they kill you with their incompetence.

    The “we’ve got your back” Democrats will end up giving everyone a “right” to health care that won’t actually be delivered, thanks to them totally hosing the industry. In the meantime, they decided I need to lose the policy that cost me $369 per month and perfectly suited my needs and buy a policy that costs $10,000 more per year but has higher deductibles — which means it’ll cost me quite a bit more if I never need another knee surgery. They’ve also managed to cancel more than 5 million insurance policies so far, in many cases causing people who were in the middle of ongoing cancer therapies to lose access to their doctors.

    So you want to tell me how they have everyone’s back? More like they’re giving it to everyone in the backside.

    • Wayne Gage says:

      Capitalism is voluntary exchange, the only moral and ethical means of trade. All other systems require force…also, why would you want to rely on a health care system that has no skin in the game?

  17. Big Mike says:

    Tom,

    You might find this video on health care by Bill Whittle (Mr. Virtual President) amusing. It’s only 8-1/2 minutes.

    https://www.billwhittle.com/mr-virtual-president/your-government-health-care

    Cheers!

    That makes so much sense economically, Congress would never, ever allow it to happen.

    We once had a system more along the lines of what Virtual President Whittle is describing. Then the government “fixed” it.

    https://www.youtube.com/watch?v=72kvjDC8Cq8

    • Mike says:

      Here here! It is the tragedy of the commons. The “commons” is everyone who wants to live and needs occasional heath care and has money to pay for it. The “tragedy” is profit mongering insurance companies and lack of, or bad regulations. We have bad regulations due to the fact that we let people get rich enough to corrupt democracy and distort the market.
      Join me in signing the petition at http://www.MoveToAmend.ORG to get democracy back to the people.
      I am all over the “common sense” plans that people should come together and create a common solution with pooled resources to solve problems that everyone faces. It’s called GOVERNMENT!
      Our government provides a very cheap insurance plan that provides great benefits for disabled, widows, and orphans, and even provides a retirement stipend so that our elderly population does not starve or freeze to death – it is call Social Security. It does need to be fixed, and here is my idea, from your side of the aisle – FLAT TAX!

      I suggest you go back and read up on what “the tragedy of the commons” actually means. You either don’t understand it or you’re being sarcastic in using the term.

      I also suggest you check up on 1) the return on investment paid by Social Security vs. simply putting your money in an DJ500 index fund, and 2) the unfunded liabilities we’re facing because of Social Security and Medicare. Then come back and explain why more government is the answer to our problems.

      Funny how when people like you talk about giving power to “the people” it always ends up meaning giving more power to government. Since government is based on coercion under threat of violence, that doesn’t strike me as a good means of making individuals more powerful. I also find it fascinating how people like you point to corporations corrupting government as evidence that we need more government. Apparently you believe the bigger and more powerful the government, the less motivation corporations will have to bribe someone and leverage that power for themselves. I’m fairly certain you’ve got back that backwards. Nobody bribes a powerless government official.

      But given the great competence demonstrated by the government in the ObamaCare rollout, I can see why you’d want them in charge of more aspects of our lives.

  18. Wayne Gage says:

    Great video. With any government control of prices there will be shortages…when the shortage in health care develops it raises the question of will there be a black market health care and what will the government do about this? Canada does not allow black market health care.

    • Actually the Canadian supreme court banned the banning of private health services a few years ago, blatantly saying that it was anti-business and therefore unjust.
      Part of the problem with Canada is few people want to pay extra for private services; we already pay taxes for public health insurance and some people pay supplemental insurance for things not covered i.e. in Ontario: Rx drugs, dentistry, 2-bed or 1-bed hospital room instead of 4-bed… Asking people to pay even more for services they believe they’re already entitled to by paying taxes seems ludicrous to those who don’t understand the benefit… and if people don’t wanna pay, private doctors won’t get paid. I wonder how many supporters of free healthcare have ever seen the inside of a hospital?

  19. Tom have you ever seen this commercial?
    https://www.youtube.com/watch?v=Y09YOkVmGg0
    It’s a little bit before my time but I swear this actually aired on TV.

    That aired on TV?

  20. Possibly. Hard to imagine today but I swear I saw it on TV when I was young.
    They also have this “Scoring Beaver” ad:
    http://www.youtube.com/watch?v=u0LT-RZGXBc
    It doesn’t make sense for them to create 2 ads in the 1990s and not air them.

    Also they’re the same people that brought us these which are in the same comedy style:
    http://www.youtube.com/watch?v=up0i0G_y05A

  21. Dan OBeirne says:

    Nice post!

    I got into Nautilus inventor Arthur Jones high intensity low volume training back in 1980 but continued to overtrain at time. Dr McGuff adds much to this in many ways.

    Now that finally all in: paleosque slow carb eating + intervals 1 – 2X week + wt train only 1 -2 X week everything has improved: More time for life, more energy, more muscle + my younger wife is MUCH happier numerous times each week.

    I presume that means you’re giving her a foot-rub numerous times per week.

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