JOEL BERVELL: My guest on this episode of The Dose is Dr. Mike Varshavski, better known to millions simply as Doctor Mike. And if you spend any time at the intersection of medicine and the internet, you’ve probably seen him. With more than 30 million followers across platforms, Doctor Mike has become one of the most recognizable physician voices online, and he does it all. He reacts to medical scenes in shows like The Pitt, calls out viral misinformation, hosts his own podcast, and still practices medicine, running a primary care clinic in New Jersey.
But for me, what makes his influence interesting isn’t just how visible he is. It’s how intentional he’s been about building a platform that matters is fact-based. Doctor Mike initially jumped onto social media about 10 years ago because he saw waves of medical misinformation flowing through various channels on the internet, and it sincerely worried him that the real people that were taking this not so great advice were having less-than-optimal health outcomes.
So he stepped in with relatable, digestible content, and people, including myself, love it. And his influence just seems to keep growing. That matters because more than ever, people are looking online for answers to health questions, even if they’re concerned that the information may be questionable. That’s exactly what I’m looking forward to talking about in this conversation.
Doctor Mike, thank you so much for joining me.
MIKE VARSHAVSKI: I’m so excited to join. I appreciate the invitation and such a warm welcome on that introduction.
JOEL BERVELL: Absolutely. Well, let’s start with social media and health care. I think both of us spend a lot of time on TikTok and Instagram, and I think our intentions are pretty aligned to trying to get people accurate, useful information about their health. In your experience, what actually works?
MIKE VARSHAVSKI: I think what works is meeting people where they are. There’s obviously room for many different strategies on social media within health care. And I think that’s what makes it a great opportunity for physicians from different specialties, different backgrounds, demographics, even those who have different passions and hobbies that they want to highlight to the world. Because ultimately, what resonates best online is not being a physician first, being a human first.
And when you can lead with that human-first approach, you can have a lot of success in getting people excited to learn about health, to teach them about how to handle difficult problems within this broken health care system that we all have to function in. And I think there are a lot of great people on social media within the health care space that are doing a phenomenal job, all in unique and different ways. And I think that’s exactly how it needs to be.
JOEL BERVELL: So how do we measure impact? Is it the views, the comments, messages that you get from patients, changes in behavior? What can actually tell you that a piece of content actually mattered and is moving people?
MIKE VARSHAVSKI: That’s a very difficult question to answer because one thing that is missing from the conversation surrounding health care and social media is research, quality research, measuring that impact. Sure, I have plenty of anecdotes of people sending emails, leaving comments, writing letters about the impact that the work has had on their lives. And that’s very reassuring. It gets me excited, motivated to continue making content. And because I think last month we had a quarter-billion views on our content. That’s in one month, four weeks.
So to think about that potential impact when you’re presenting accurate, evidence-based information, we do need good data here to back up the impact of that information, but also understand that there are ways to measure impact that are perhaps algorithmically driven and algorithmically successful factors to decide whether or not your content is working.
For example, on a site like YouTube or on an app like YouTube, you’ll see certain measures within your YouTube studio, YouTube analytics that show you how often people are clicking onto your content. And more importantly, it shows you the audience retention on your content. And why I like looking at this audience retention, not the number, but the actual graph minute by minute, second by second of how long people are watching is because it shows you your ability to keep an audience engaged.
So when I look at these retention graphs, I see that we’re doing a good job keeping people’s attention. I know that the evidence that we’re discussing is accurate. It’s coming from the best level of evidence that we have for whatever given subject that we’re discussing. So to me, that engagement is a sign that the information is working and landing well. So I’m curious if you had those experiences.
JOEL BERVELL: Yeah, I absolutely second that. But the piece that you’re talking about, this research piece is kind of that credible information piece that’s missing a lot of the times from what we’re trying to do in social media, actually getting numbers out there. And I’m curious, what kind of research could we be doing in order to strengthen that to show people that this actually works and it matters and that there are metrics that could be measured or at least that you would find useful?
MIKE VARSHAVSKI: I think if we’re looking to get incredibly dense information that we can really dig into and find certain patterns, we can download entire comment sections on videos that have millions of views. For example, my debates that I’ve done with those who are anti-vaccine, those who were MAHA or RFK Jr. supporters, and looking to see how that content landed for that group of people that watched that content. And from there, you can create a list of positive, negative, neutral words and just see where the trends lie and compare different styles of content to see what those outcomes are.
I think you could even simplify that research even further. We look at major medical organizations, the AMA as an example. All we have to do really is look whenever they’re putting out some piece of content, what is the success rate of that content? Meaning, if they’re spending a lot of time making that content, drafting it, making sure it’s appropriate, accurate, understandable, and 10 people on average are liking it, perhaps that effort is better placed elsewhere or help can be brought in to make that messaging more effective.
So something as simple as just looking to see if the message is being welcomed by the public in terms of likes, views, et cetera, could be a good place to start to create, like we have in medical journals, the impact factor, the social media impact factor.
JOEL BERVELL: Oh, I absolutely love that. And I don’t know if you said that before, but I’m coining it here right now. You probably have said it before.
MIKE VARSHAVSKI: That was the first time.
JOEL BERVELL: Oh wait, I love it.
MIKE VARSHAVSKI: That was the first time.
JOEL BERVELL: Oh, awesome. Okay. DB’ing it here, the social media impact factor. But when you think about the tools that we have today, social media, now AI, online communities, what do you think that we as professionals aren’t using well yet in health care?
MIKE VARSHAVSKI: Well, I think we’ve definitely misused the tool of social media because we viewed it as beneath us. We viewed it as something silly where we saw ourselves as all high and mighty. We should only be having conversations at medical institutions or research symposiums or medical journals, when in reality that information needs to be translated for the general public. And it cannot be done only at touch points when they’re coming in to have an interaction with us because then we’re losing a whole subset of people that are not getting that information, especially in the day and age where any reasonable human will honestly say that if they have a symptom, if they get a diagnosis, the first thing they do is take out their phone and Google or social media search those symptoms.
So if people are going to seek health care advice from a location, let’s not even call it social media or the internet, and there are no doctors in this location, but alternative health-focused individuals are staffing this location, do we think good outcomes are going to be had there? No. It’s like a hospital without medical professionals.
JOEL BERVELL: Absolutely.
MIKE VARSHAVSKI: So that’s exactly what’s happening across social media and we need to wake up to the idea that social media can be used appropriately, it can be used valuably. Not every medical professional needs to be on social media. That can cause a whole other subset of problems. But if we’re going to nominate people who have a skill set that fits the social media arena, let’s do that. Let’s get the big medical organizations collaborating with people who know how to do it well, going to areas that are information deserts.
If we think about certain places that I’ve tried to go on and educate people, like Fox News, people would judge me for going on Fox News within the medical sphere because they felt that there was a lot of misinformation being put forward in these news stations or on that channel. And I said, “Well, that’s exactly the reason I have to go on that platform in order to get people to learn.”
And in fact, we’ve had some really cool outcomes in those areas where one of the hosts on the morning show that I did for several years, historically anti-flu vaccine. And after multiple, multiple conversations over the course of those three years, she decided to get the flu shot on my advice. On the episode of the show following, says she got the flu shot, had no side effects, did not get the flu, it did not hurt, and she recommends her audience get the shot as well. There’s no better outcome when we’re talking about public health communication. And again, if we’re not going to be there, if we’re going to let it be a bygone technology, we can only expect negative outcomes.
JOEL BERVELL: Absolutely. And one other thing you mentioned was institutions with power overall. How can we fix this gap between legacy institutions of health care, social media, and why is it important to actually get people to narrow this gap?
MIKE VARSHAVSKI: I think it starts with collaboration. So, taking people who are doing it responsibly on an individual level and finding unique ways to educate and partner with these companies. I know many health care influencers that are doing it the right way, that are leading with an evidence-based approach. They’re hungry for the support of major medical institutions.
In fact, many of them have to hide where they work for fear of repercussions for putting out information. When they have a license to take care of individual health, they’re allowed to prescribe medications, cut people open in surgeries, but God forbid they make a video about the topic they’re an expert on on social media. To me, there’s no clearer, ridiculous example of a double standard than saying, “Oh, we trust you to cut people open, to prescribe all these medicines that have potential side effects, but we don’t trust you to make a video on the subject.” I don’t understand it, especially when they already have a track record of proving themselves in doing that repetitively over and over again.
JOEL BERVELL: It’s taking what they’re doing already inside the clinics every single day, bring it just to another medium, but doing the same thing, replicating it in a way that reaches millions. I remember when I first wanted to go into medicine, I was so worried that I would only — this sounds so weird to say now — but only have a one-on-one impact, that every day you’re going and seeing one patient, but then you’re missing out on so many other people, but there are so many other ways to get education out there, to reach millions of people, like you’re saying, through the same things that we do every single day in the hospital system. What would it look like if the hospital or public health systems actually did this well?
MIKE VARSHAVSKI: Well, I think we have to think about it both from a micro and macro perspective. So, the fear that you had is understandable because you wanted to do the most good for the most number of people. And that’s very reasonable for someone who’s excited to enter this space of medicine, but it’s totally important, extremely valuable to not forget about that micro impact.
In fact, some of the biggest value that I get in being a physician is less so from my successes on social media and doing this stuff and much more when I’m spending time in the exam room with my patients in an outpatient setting or perhaps training residents to take care of their patients. So there is both a value in taking care of patients on a micro level, on an individual level, but at the same time, there are potential avenues if you have a unique skill set, being able to communicate, being funny, bringing your passions to the world. These are valuable skill sets that you can leverage to make public health accessible, interesting, transparent because where my success comes from on social media has always been not fearing thinking outside of the box. Not being worried about how something might land for someone when my intentions were pure, when I wanted to do the right thing, when we were making sure that the evidence was at the heart of what we were doing and the reasons why I was recommending those statements were coming from a good medical place, that was of utmost importance.
If medical organizations, professional organizations, if they’re able to strike this balance correctly, meaning between micro and macro impact, we can actually improve health care outcomes simply by educating patients. You’ve probably seen patients on rounds where you thought to yourself, “Man, if they had a little bit more education on their condition, they would’ve been able to prevent this hospitalization, the next hospitalization. Their quality of life would improve.”
So it’s like this downstream impact of the investment into the macro is so untapped, and in the era of our health care spending ballooning to an out of control level, this is also a financially wise investment. There are so many positives to this. It almost feels like everyone should be doing this. It’s a no-brainer. All of our investments should be at least somewhat focused on this, and yet it’s met with a lot of shoulder shrugs in the C-suites.
JOEL BERVELL: I can tell you 10 patients literally just today that I saw that where the amount of just simple education. One patient that had stopped their blood thinner before and now is anticoagulated right now at this moment in the operating room. So just simple things like that of people understanding the whys makes a huge, huge difference.
I want to narrow down into your day-to-day now too. The other practice I really want to talk about is how you do work with your patients. And I’m hoping you can take us to your clinic, the community where your in-real-life patients live. What happens there? What do you encounter most with the populations there? And does it reflect what you often see online?
MIKE VARSHAVSKI: So I think that’s probably the biggest difference between what I see online and what I actually see in my practice in that online, a lot of the experts that are the most successful, you think of the most successful podcast hosts, the talking heads, they oftentimes treat a clientele, and I say clientele, not patient, because they’re usually extremely wealthy individuals that are not functioning in the world that my patients function in where they have multiple jobs, multiple children, are underinsured or fighting with insurance companies or even uninsured completely.
And that’s a more realistic picture of what a human has to go through, both with their condition, their education, the struggles to get access to health care. And when I see someone arguing whether or not a sleep tracker is going to drastically make someone’s life better, I get confused because that is not a realistic problem that’s going to be solved and improve the life of my everyday patients.
What would improve their life is making access to health care insurance easier, cheaper, less problematic with hoops to jump through for the simplest of procedures, imaging tests, lab tests, et cetera. What would make their lives better is quality education, not arguing whether one food versus another ingredient is ultimately going to be the deciding factor in their health, but shifting them away from unhealthy habits towards generally healthier habits.
And that doesn’t happen online because a lot of times that’s not the content that goes viral. However, to me, that is a cop-out. That content absolutely has the potential to go viral. And I want everyone to look at my channel as the example here and do it better than me because you can say the old adage of sleep well, eat well, exercise, focus on your mental health, and still get views. You just have to be creative.
It’s not easy to get views by doing that. It is a lot easier to say you have the next best fad diet to offer someone, but that’s not realistic. That’s not going to create long-term health benefits. Tried and true, accurate representation of what medicine is and isn’t. In fact, I was just on a podcast the other day and I said something that I think is worth repeating, where in health care, some health care is better than none, more health care isn’t better than some, and a good primary care doctor will help you understand what some is right for you.
JOEL BERVELL: Okay. I’m taking that. I’m stealing that. I love that. That’s so poetic too. I think everything that you’re doing . . .
MIKE VARSHAVSKI: It’s a steal from something about choice, the paradox of choice where some choices are better than none because no one wants to be stuck with only one choice. But when you have 50 choices, it sometimes is overwhelming. How do you choose . . .
JOEL BERVELL: Exactly.
MIKE VARSHAVSKI: . . . and it becomes quite difficult.
JOEL BERVELL: Absolutely. So I’d mentioned a patient earlier in this conversation that had come to the hospital and that was exactly what she was doing. She was kind of overtreating her symptoms, reading things online, actually going, flying out to Mexico in order to get these treatments. It ended up hurting her more than it helped her. And so she was coming to us for a fix after that.
And I think there are people out there that can capitalize on people that have poor health or poor health literacy. And it’s so easy to get people to buy into a belief that could be a miracle cure when there may not be one. So you’ve become really famous for also breaking down medical scenes from shows like Scrubs and The Pitt. Those videos are very entertainment-formed, but do you actually see them also as a form of patient education?
MIKE VARSHAVSKI: Yeah, I do. I think when you’re entertaining people, you’re keeping their attention, and that is one of the most important factors to make sure that education is landing. That is part of the struggle of transferring information. When you’re presenting highly technical info, it can be boring, it can be overwhelming, but when you’re presenting it in a nonscary space and a nonintimidating space, that suddenly makes it more appealing.
And the goal of my channel is to make medical information, in general, more appealing, more appetizing to learn, and more absorbable. Plus, there’s a secondary impact of understanding algorithmic success with content. So when I make a video like doctor reacts to medical memes, people go, “Why the heck is a doctor doing comedy about medical memes?” Well, when I get two million views on a medical memes video from people who otherwise wouldn’t click on medical content, I am now part of their watch history so that when I put out my next video about the misinformation coming out of HHS or about the history of smallpox, polio, that video will be served to them. Whereas never before would they have gotten a video on the subject simply because they watched my silly, more entertainment-focused video.
JOEL BERVELL: And millions of people are watching those shows and hundreds of thousands watch your breakdowns. What do you think people are really looking for when they watch those videos?
MIKE VARSHAVSKI: I think when they watch the shows, one of the biggest voices in the back of most people’s minds is, “Is this real? Is this actually how it goes down?” And that’s a natural question we want answered to gauge the veracity of whatever it is that we’re watching. So it’s nice to have a medical expert right there on the side to jump in and say, “Yes, this is exactly what happens. This actually happened to me on this day last year and here’s how my case was different.”
Or perhaps there’s moments in a show where because they’re making it realistic, like in The Pitt, for example, they’ll say highly technical lingo. And it’s cool to watch. At the same time, it could be overwhelming because you’re not sure exactly what is being said and it’s nice to have someone come in there and explain the thought process of each one of the characters in the given moment. So I think it’s like giving an extra dimension to a show that gets people really excited.
JOEL BERVELL: I was sitting down with my parents the other day and they’d never seen The Pitt. So I of course had to throw it on for them and I just immediately was like, “Oh, this happened yesterday. Oh, that happened last week. When I was on the ICU, we had that honor walk.” And seeing their faces be like, “Oh, wow, this is actually not fiction. This is what it can actually look like in the hospital,” I think was surprising to them. So that totally resonates with me.
MIKE VARSHAVSKI: And I think a show like The Pitt has a higher potential to impact culture, therefore impacting policy better than some of these medical establishments that we hope are going to be doing these things . . .
JOEL BERVELL: Oh, absolutely.
MIKE VARSHAVSKI: . . . because it is so disarming, because it is reaching an audience that perhaps would’ve never heard the message otherwise.
JOEL BERVELL: And just to highlight that, there was an episode that talked about Freedom House, which was the first ambulance system in the United States staffed by Black men, and that episode went really viral and actually reached Congresswoman Summer Lee’s office. She ended up saying, “Hey, why are these people not known more? Let’s actually give them the Congressional Medal of Freedom.”
And I think right now we’re in this trust misinformation ecosystem where a lot of people don’t trust the health care system. A few months ago, you released an episode called, “The Truth About My Anti-Vax Debate,” and it was about your Jubilee episode where you literally sat around and debated anti-vaxxers. I’m curious, why did you feel it was important to make a new video and address the most common things you were hearing from everyone?
MIKE VARSHAVSKI: Much in the same way that when I would watch a medical drama with a friend and they would ask me questions about what they were seeing and me realizing that this is a potentially good avenue to make content, because if they had that question, perhaps many others would.
When I got back from this anti-vaccine conversation, there were three hours of content that we filmed. I think they ended up publishing just under two hours of content, and there was so much I wanted people to take away from it, but at the same time, I realized not everyone is going to sit present for a two-hour piece of content. So I said, “Well, wait. If we make a nice little summary here that’s 10, 15 minutes long, it will reach a lot more people. It would double down on the messaging that I’ve discussed to perhaps reiterate some of my points. Perhaps in the moment I wasn’t as eloquent or selective with my words as I could have been.” But then it also said, “Well, this could serve as a commercial to get people excited to watch the entire two-hour conversation because I thought it was valuable for the world to see.”
JOEL BERVELL: Well, let me just say, I was so impressed watching you hold it down.
MIKE VARSHAVSKI: Thank you.
JOEL BERVELL: I was truly . . . I felt proud. I don’t know another word to say, but you have a gift for being able to take someone that is skeptical about something, meet them where they’re at, but then take them the other way, if that makes sense. And I’m watching that, I was literally taking notes. I was like, okay, how did he do that? How did he get someone that was so distrustful to suddenly say, “Hey, maybe I actually don’t know everything and that’s okay. And maybe the information I’m getting was fed to me the opposite way of what I was thinking.” So really, I think you did a masterful job and you opened the eyes . . .
MIKE VARSHAVSKI: Thank you.
JOEL BERVELL: . . . to so many people that were distrustful, but also physicians and other professionals who saw a way to actually have those conversations, not in a way that’s top-down, but in a way that’s really meeting people where they’re at.
MIKE VARSHAVSKI: Yeah, I think one of the big differences between someone like me versus Secretary Kennedy — and this is probably what I’m most proud of of my work — is I am happy to admit not just when I’m wrong, when the health care system is wrong, when the health care system fails people, where we need to do better and improvements need to be had. That is the sign of someone who’s trying their best to be intellectually honest, at least someone who’s coming in with an open mind.
And I really hope that someone who’s interested in the truth sees that in someone, appreciates that in someone, because the reality of these Jubilee conversations isn’t to argue or to get them to see my way, it’s to truth-seek together. If one of us has some kernel of truth that is valuable to the other person, we can both learn from it and we can both come to a more uniting conclusion.
And I definitely learned a lot from the participants in these Jubilee debates just to see, as an example, how often our health care system screws people over to the point where they have this belief that doctors are these evil people that are enriching themselves on the backs of hardworking individuals like themselves, and that is just so far from the truth.
In fact, just thinking about the fact that Secretary Kennedy paints pediatricians as these enriching physicians that are taking advantage of people, when it’s the lowest-paying specialty.
JOEL BERVELL: Quite literally the opposite.
MIKE VARSHAVSKI: But my guy, if you’re going to attack anyone, attack the wealthy doctors, not the ones that are struggling to get by because they have to pay staff, they have student loans to hundreds of thousands of dollars, literally you’re attacking the least-paid doctors. Why? I don’t get it. I struggle to understand it and I hope that those who are reasonable and are not of the camp where they say, “Nothing will change my mind,” perhaps they will be open-minded enough to see the truth here.
JOEL BERVELL: Absolutely. I want to shift gears a little bit and talk about something you said before. You’ve said before that you’re actually pro-health meme. What’s a good example of one that works and why do memes sometimes land better than serious messaging?
MIKE VARSHAVSKI: Well, I think they’re not as intimidating and it almost functions as a spinach muffin where people feel like they’re getting a piece of dessert, but in reality, there’s some vital nutrients there as well. And I think that that style of educating has always worked well to get me interested in a subject. So I can only assume if it worked well for me and so many of my classmates, it would, odds on, work well for so many others. And again, thinking about that algorithmic point as well, we want to get people to watch more content on health topics, even if it’s not a hundred percent health, because the next one that will be more health-focused will land in their inbox.
JOEL BERVELL: Absolutely. And I want to close with this final question. So 10 years ago, doctors weren’t really on social media. Ten years from now, what role do you think physicians should be playing online?
MIKE VARSHAVSKI: That’s a good question. I think in 10 years, there’s going to be a lot of shifting as to how people receive, process, and appreciate information because of the advances that we’ll see within AI, and specifically with AI informational gathering. So I’m curious how in the next 10 years, medical students will respond to this call to action where they now need to shift from information-gathering to informational oversight and AI oversight because it’s very easy to undertrain that oversight muscle and allow AI to do the heavy lifting for you, but then we might not be sharing accurate information and we may be becoming victims of misinformation ourselves. So how that whole ecosystem will evolve is going to be really interesting and I’m definitely keeping an eye on it as much as I can.
JOEL BERVELL: A lot of food for thought. Well, Doctor Mike, this has been an amazing conversation. We talked about misinformation, the responsibility that comes with influence, what it means to practice medicine right now in a world where patients are increasingly getting information online and a lot of misinformation. So truly, thank you so much for being you, for doing what you do, for being an inspiration to so many in the next generation coming up, and for just truly caring and wanting to make the world a better place.
MIKE VARSHAVSKI: Cool. Same. Right back at you. Keep up the great work. And I look forward to the day where you say, “Hey, Doctor Mike, you got 250 million views last month. I got 500 million because I’m better at it now.” So that’s on your shoulder, sir.
JOEL BERVELL: This episode of The Dose was produced by Jody Becker, Jesús Alvarado, and Naomi Leibowitz. Special thanks to Barry Scholl for editorial support, Matthew Simonson for recording assistance, Jen Wilson and Rose Wong for art and design, and Paul Frame for web support. Our theme music is “Arizona Moon” by Blue Dot Sessions. If you want to check us out online, visit thedose.show. There, you’ll be able to learn more about today’s episode and explore other resources. That’s it for The Dose. I’m Dr. Joel Bervell, and thank you for listening.
