Critical Care Physician, Inova Fairfax Hospital
Member, Physicians Committee for Responsible Medicine National Advisory Board
Member of the Board of Directors, Plant-based Prevention Of Disease, Inc.
Milton Mills, MD practices urgent care medicine in the Washington DC area, and has served previously as Associate Director of Preventive Medicine, and currently as a member of the National Advisory Board, for Physicians Committee for Responsible Medicine (PCRM). He has been a major contributor to position papers presented by PCRM to the United States Department of Agriculture regarding Dietary Guidelines for Americans, and is the lead plaintiff in PCRM’s class action lawsuit that asks for warning labels on milk. Dr. Mills earned his medical degree at Stanford University School of Medicine, and completed an Internal Medicine residency at Georgetown University Hospital. He has published several research journal articles dealing with racial bias in federal nutrition policy. He frequently donates his time via practicing at free medical clinics, and travels widely, speaking at hospitals, churches and community centers throughout the country. A major focus of his patient advisement as well as his lecturing, is the use of nutritional measures to reduce the risk of major chronic diseases. Dr. Mills notes that the scientific research literature shows plant-based diets as supporting better overall immune system function, and during work with HIV-positive and AIDS patients at clinics, he’s observed that those who go vegetarian seem to improve, with increased energy and higher T-cell counts. He therefore hopes throughout the future to examine further the relationships between diet and immune functionality, particularly the effects of plant-based eating choices upon outcomes for HIV-positive patients.
Caryn Hartglass: Hey everybody. Hi there. I am Caryn Hartglass and you are listening to It’s All About Food. I’m anticipating a very exciting program and I recommend all of us take a nice, deep breath before we get started.
My anxiety is up, how about yours? Everyday, we learn about something new that is going on in the United States with our government that doesn’t feel very good. We are going to be talking about a lot of different things today, connecting dots between one thing or another, and bringing it all back to my favorite subject: food. And I am really excited because I finally talk to one of my favorite doctors and colleagues, to take some time to talk to me.
Dr. Milton Mills is on the program today. He is, he practices urgent care medicine in Washington D.C. area and has served previously as Associate Director of Preventative Medicine and currently is a member of the National Advisory Board for the Physician’s Committee for Responsible Medicine. He has been a major contributor to physician papers presented by PCRM and to the United States Department of Agriculture regarding dietary guidelines for Americans and is the lead plaintiff in PCRM’s class action lawsuit that asks for warning labels on milk.
Dr. Mills earned his medical degree at Stanford University of Medicine and completed an internal medicine residency at Georgetown University Hospital. He has published several research journal articles regarding racial bias in federal nutrition policy. He frequently donates his time via practicing in free medical clinics then travels widely, speaking at hospitals and community centers throughout the country. And I just have to add that he is a super human being.
Welcome, Milton. How are you?
Dr. Mills: I’m good, Caryn. Thank you so much. It’s great to be here.
Caryn Hartglass: I’m giving you a big, virtual hug.
Dr. Mills: I’m hugging you right back. It’s so good to talk on this-
Caryn Hartglass: I like to say on this program that we tune in love- we tune in live and we tune in love.
Dr. Mills: Absolutely.
Caryn Hartglass: Okay, so the last time you were on this program was five years ago.
Dr. Mills: Wow. It’s been that long?
Caryn Hartglass: Yeah!
Dr. Mills: It doesn’t seem that long.
Caryn Hartglass: We had a great conversation. I was reviewing the transcript from before. A lot of people still access that program in the archives because I think they’re looking for you. And I’m glad I have something to offer.
Dr. Mills: Awesome.
Caryn Hartglass: I feel like we’ve been connected because I’ve been reading a lot of your posts on Facebook for the last- oh, a little more than a hundred days, I think.
Dr. Mills: (Laughs) Yeah, and I still haven’t been picked up by the NSA, so.
Caryn Hartglass: (Laughs) That’s very good. So, I want to start first talking about you and your work, and then maybe we’ll talk a little more about some of these big issues that seem to be changing on a daily basis.
Dr. Mills: Sure.
Caryn Hartglass: Now, you’re working in critical care? The ICU?
Dr. Mills: That’s right. I, in fact, I worked last night and we had the usual kinds of cases that we see in the ICU. Patients with poorly controlled diabetes who are in a serious metabolic state called diabetic ketoacidosis, which means that they have such severe metabolic derangement that if they aren’t admitted into the intensive care unit and then put on IV medications, they are in danger of literally dying from their disease. And I saw people with blood infections, pneumonia, heart disease, you know the usual kinds of acute manifestations of chronic diseases that we often see in Western countries that, again, in most cases are related to the way we eat and live.
Caryn Hartglass: I mean, I can’t imagine. You’ve been doing this for such a long time, how profoundly frustrated you must be knowing that most of these cases shouldn’t be there, are not necessary. Diabetes is preventable, reversible.
Dr. Mills: Right, right. Absolutely. Heart disease, and even the patients who, for instance- I had a very unfortunate case last night of a gentleman who was in his mid fifties who died from a cancer that again was strongly linked to dietary and lifestyle factors and therefore, potentially preventable. I, once again, was speaking to his young son who was in his twenties and looking into this young man’s eyes, and having to deliver the news that your dad, your father is probably not going to make it through this. Seeing the hurt, seeing the pain, it’s just heartbreaking.
Caryn Hartglass: It is, well, there is no pun intended there either. It is heartbreaking. His heart was broken by his lifestyle, unfortunately.
Dr. Mills: Absolutely.
Caryn Hartglass: Okay, so five years ago, we talked about rethinking food and how people should look at their food differently-
Dr. Mills: Sure.
Caryn Hartglass: -Not necessarily that it tastes good, but are they being nourished from it? And I really enjoyed that conversation. Have you seen any changes in the last five years?
Dr. Mills: I have seen some changes, but certainly not nearly enough. Again, sadly, as I was leaving the hospital this morning, I stopped by the cafeteria-
Caryn Hartglass: (Laughs)
Dr. Mills: -and just grabbed some things, and again there were people in line buying the usual markers of the American standard diet: bacon, sausage, eggs, and so forth. And it was so ironic and just personally painful to be standing in a hospital, watching people eating food that essentially is destroying their bodies.
So, there has been some change. Clearly, the knowledge and attention that is being paid to plant-based lifestyle and eating and the importance of this diet is more widely known. There are more people who are changing their diets everyday. It used to be, you know, veganism, the word vegan was a strange word to people, whereas now you say vegan and people immediately know what you are talking about and they don’t think you are from another country, let alone outer space.
So, yes, there have been positive changes, but again, not nearly enough. I think a big part of that is because the traditional American and Western approach to food, as we spoke about last time, tends to look at food as a hedonistic experience, meaning that here is an opportunity to indulge yourself and immerse yourself in some kind of gustatory pleasure, when, you know, there is no question that we want the act of eating to be pleasant, but the primary purpose of eating, again as we discussed last time, is really to serve a means of delivering important and necessary nutrients to our bodies.
But, that fact is often completely lost, or certainly overshadowed by the idea that people just want to have a pleasurable experience and really not pay attention to whether or not they are actually getting the appropriate kinds of nutrients and enough of those nutrients.
Caryn Hartglass: All right, let’s delve into some other topics. The Affordable Care Act came into play a few years ago.
Dr. Mills: Oh my gosh, yes.
Caryn Hartglass: And now, our government is wanting to rewrite that into the Affordable Healthcare Act of-
Dr. Mills: Which is a complete misnomer.
Caryn Hartglass: We learned so many things, like people didn’t realize Obamacare was the Affordable Care Act. All kinds of crazy things. I personally feel that there was a large group of people who just didn’t want a black man to have a legacy and they’re doing whatever they can to turn that around.
Dr. Mills: There is no question that that is absolutely a part of, a large part of, why the Republicans are so determined to try and erase President Obama’s legacy as manifested by the Affordable Care Act. But, you know, here in America, it’s one simple axiom that you always, always have to pay attention and follow the money. And the biggest reason that the Republicans want to get rid of the Affordable Care Act, also known as Obamacare, is the fact that in order to finance this, the Affordable Care Act, that provided healthcare to millions of Americans who had been traditionally underinsured, uninsured, or uninsurable, was that there was a tax placed on the top 10% of income earned.
There’s a graduated tax that all Americans earning more than $200,000 a year had to pay to help support and finance the Affordable Care Act. And again, the more money you make, for instance, if you make what the current occupant of the Whitehouse- 100 million dollars a year, you pay a substantial higher portion of taxes. And the bottom line is that if the Republicans are successful in repealing the Affordable Care Act, that is going to translate into a 600 billion dollar tax cut for the top 10% of income earners in the United States. And that is the probably single biggest reason they are determined to repeal the Affordable Care Act.
And, you know, it’s very interesting to me that while President Obama was in office, all the Republicans had to do was call it Obamacare and say, “hey, look, this is something this black man is trying to do”, and a lot of Americans with racial issues never even stopped to think about what they were considering. They were just against it, just because they don’t want anything to be administered or mandated by an African American man. But now that he’s out of office, now what you are seeing at these town halls is that when these representatives talk to their constituents about repealing these benefits that people have gained in the Affordable Care Act, suddenly they are furious because once they actually stop to consider what is being offered to them and provided to them via the Affordable Care Act, they like it.
They like the fact that they now have insurance that allows them to see doctors on a regular basis without having to mortgage their home. They like the fact that they can keep their children on their insurance until the kids are out of the house. They like the fact that they can no longer be kicked off of insurance for having preexisting conditions, or be prevented from getting insurance in the first place from having preexisting conditions. So, you know, President Obama unfortunately was a very convenient straw man for the Republican Party. Now that he’s no longer in office and people are actually considering what is offered to them through the Affordable Care Act, they really like those benefits and don’t want to part with them.
Caryn Hartglass: It’s a very civilized concept, insurance for everyone.
Dr. Mills: Yes. Yes, and it’s- go ahead. Just let me say this. It’s horrifying, for me, to hear some of these Republican representatives literally say things like, you know, healthcare is not a right, and good people don’t have preexisting conditions, and that if you can’t afford insurance, then you don’t deserve it. I mean, those are just hideous, heinous, inhuman statements, but these are the things that these people truly believe. And I think the only recourse we have is to vote these horrible, horrible people out of office.
Caryn Hartglass: Absolutely. I think it was, was it Miss USA who also said that recently? That healthcare is a privilege.
Dr. Mills: Wow.
Caryn Hartglass: Now there is an authority.
Dr. Milton: (Laughs)
Caryn Hartglass: (Laughs) Anyway, I know that the Affordable Care Act unfortunately is different from state to state, and some states have had some really good results with it, and others haven’t. So, what have you seen with it in your experience with it in the last few years?
Dr. Mills: Sure. Well, I am happy to talk about that because we talked about the kind of medicine I practice, but one thing that we didn’t discuss was where I practice my medicine.
Caryn Hartglass: Yep.
Dr. Mills: And ever since I finished residency, I deliberately have chosen to work in clinics that are free clinics, or well you know, that afford the Affordable Care Act for uninsured patients in public hospitals for low income and underinsured individuals.
And there is no question but that since the Affordable Care Act has been put in place, people who previously were not able to see, to either have a private physician, or see that doctor on a regularly basis simply because they couldn’t afford to pay for their healthcare and were therefore forced to wait until they were so sick that they had no choice but to come into an emergency room- a lot of that has changed.
We have seen where a large percentage of poorer populations were presenting with end stage diseases because of their inability to care for themselves with their pain care and manage their health issues. That process is being reversed. Now people are able, through the Affordable Care Act, to see a doctor on a regular basis, to keep their medical conditions managed, as opposed to allowing them to reach a point where they have no choice but to be carried into an emergency room. And it significantly improved the overall health profile of patients I’ve seen in Washington D.C., Maryland, and Virginia.
There’s also no question that hospitals, which frequently were operating in the red because they were being forced to treat so many people who couldn’t pay them, and were therefore in danger of closing, are now on a much firmer financial footing. So, you have hospitals, which otherwise wouldn’t be able to remain open, being financially solvent and being available to people in areas where they live, as opposed to before where we were seeing these hospitals closing and people being literally, both figuratively and literally, further from care, simply because there was no hospitals in their neighborhood or region, simply because those hospitals had closed due to financial difficulties.
So, it’s made a huge difference, and that’s why the American Medical Association, the American Hospital Association, and physicians across the country have come out decidedly in favor of maintaining the Affordable Care Act and are horrified by this so called American Healthcare Act, which is healthcare in name only.
In fact, it does not provide healthcare for people. It provides the allusion of healthcare, because if you listen to the Republicans talk about this so called American Healthcare Act, what they say is that it provides access to healthcare, meaning that theoretically, people will be able to access insurance, but the kinds of premiums and deductibles they would have to pay means that practically speaking, they won’t have healthcare. It’s sort of like, if I tell someone, who is a homeless person in Bel Air, well you have access to the homes here. Yeah.
Caryn Hartglass: (Laughs)
Dr. Mills: Well, yeah, but they cost a couple million dollars. They can’t afford it. So, you know, it’s a sick and cruel joke to talk about access to healthcare- so called healthcare that is completely unaffordable.
Caryn Hartglass: Well, I always like to look at the big picture and look at history.
Dr. Mills: Mhm.
Caryn Hartglass: And, I think all of us in the United States, especially our leaders and our politicians, really need to look history in the face and see what this country was built on.
Dr. Mills: Right.
Caryn Hartglass: So, just briefly, we started by blasting away people. We just ran over the Native American Indians, and took over. Not a very pretty thing.
Dr. Mills: And actually, in many cases, committed deliberate genocide-
Caryn Hartglass: Yes.
Dr. Mills: -So that we could take over their land. Yeah, I mean, this is not a benign sort of process that occurred by second intention. Our government did things like deliver smallpox infected blankets to Indian tribes with the deliberate goal of wiping them out, so that their lands would become available for European settlers. Yeah, so.
Caryn Hartglass: So, I want to have a certain amount of pride in this country, and I’ve learned that I have a wonderful life and a lot of opportunity. I know that that’s not true of everyone. But, the history is not pretty, and of course then we had slaves in this country and I believe we still do have slaves in this country. Some of them have come in from other countries illegally that are working in pockets that we don’t- aren’t aware about.
Dr. Mills: Sure.
Caryn Hartglass: And then many people are working for such small wages that they are practically slaves.
Dr. Mills: That is so true. And I also think that we have, to some extent, exported our slavery because we have manufacturing being done in countries where people are virtual slaves and are working in such onerous conditions and for such meager sums that they are effectively wage slaves. And while, you know, we may not personally “own” those slaves, we certainly benefit from their abuse and maltreatment by going out and buying their sneakers and handbags manufactured by these people.
Caryn Hartglass: You know, until we realize that when we make life better for everyone with opportunities and a base line of simple rights- food, and health care, a place to live-
Dr. Mills: Sure.
Caryn Hartglass: And access to education. That’s going to elevate everyone’s lives.
Dr. Mills: Absolutely.
Caryn Hartglass: And when we take these rights and opportunities and benefits and hand outs, as some people may call them, we are only asking for more crime, more hate, more violence, and-
Dr. Mills: That is so true, yes.
Caryn Hartglass: Yeah.
Dr. Mills: And the other thing that people, you know, don’t- and this is the part that has never ceased to amaze me- that somehow, we look at the corporate giveaways we give wealthy Americans and wealthy corporations, as somehow their right, but when low income individuals ask for similar consideration, it’s somehow seen to be an inappropriate request, or welfare. But, it’s- we allow corporations to write off taxes and get money from the government in the form of tax breaks for a variety of behaviors.
Farmers can get government subsidies for raising certain crops, or for even not using their land to raise crops, but somehow that’s seen as being appropriate, yet when a mother with two children needs help in the form of food stamps that’s considered to be just wrong or a sign of poor character.
And it’s really twisted, the way we tend to look at things. I often point out to people that if you look at the time period in this nation when our population had the highest general level of standard of living and the greatest social mobility in terms of going to college or paying in higher education, or finding good paying jobs that allowed you to take care of your children and buy a home, it was a period of time when we had a very different corporate and individual tax structure. Everyone paid a somewhat larger percentage of their income in taxes, but the general benefit to society as a whole was much greater.
Since the 1980s, when Reagan and his method of trickle down economics took hold, the general standard of living for most Americans has markedly declined, whereas the top 10% of Americans, their wealth has accumulated to a monstrous degree. But, in general, most Americans are doing much worse. And it’s a simple matter of you get what you pay for; if we don’t pay for anything but allow instead a few individuals to accumulate obscene amounts of wealth, we all suffer as a consequence, except for the very wealthy.
Caryn Hartglass: Well, I like to think that if everybody was eating a plant-based diet, we’d get a lot smarter and we could make better decisions, but I don’t think that that’s the only thing that’s going to do it, unfortunately. (Laughs)
Dr. Mills: No, but it would go a long way towards helping because, for one thing, it would again change the complexion of our general health. As opposed to spending trillions of dollars every year on what are, without question, preventable healthcare issues, we would have a lot more money to spend on helping people to remain healthy, instead of trying to retrieve their health once it is lost.
Caryn Hartglass: I’ve been using an app called Resist Spot lately, I don’t know if you’ve heard about it.
Dr. Mills: No, no. I haven’t.
Caryn Hartglass: But it’s on my phone. Resist Spot. I recommend looking it up. It makes it very easy to send letters to your senators and representatives in Congress. And I’ve been sending one or two a day. I’m going nutty. What they do is type up your thing in a letter and fax it-
Dr. Mills: Oh, that’s fantastic.
Caryn Hartglass: And they can even add your signature, so it looks really like a real letter, because it is. But, it’s so much easier to do. Anyway, I bring it up because in talking about insurance and the cost of healthcare, if we only talked about educating people to eat healthier and if we only changed the balance of food production so that healthy plant foods were the least expensive options and made them more accessible, we could dramatically reduce the cost of healthcare and this insurance debacle wouldn’t be the mess that it is.
Dr. Mills: That is absolutely 100% true. There is no question that that is true.
Caryn Hartglass: So, everybody write your representatives and say we need to be talking about plant-based diets and bring healthcare costs down. Phew.
Dr. Mills: Absolutely. And I would say, at the end of each letter, just make a note, I’m paying attention to how you vote, and please keep in mind that I also vote. And if I don’t like your vote, I’m going to vote against you in the next election.
Caryn Hartglass: Oh, yeah.
Dr. Mills: And that is one thing that these representatives do pay attention to, because of the fact that the only way they can keep their jobs is if they keep getting reelected, and if they know people are actually paying attention to the way that they vote and will punish them if they don’t vote properly, that is the only way we are going to change our government.
Caryn Hartglass: Exactly. And it all comes down to capitalism, unfortunately. My hope for the future is to find a better system than capitalism because capitalism isn’t working.
Dr. Mills: Well, you know, I would agree with you. And one of the fundamental problems is that it’s built on, its fundamental impulse is selfishness-
Caryn Hartglass: It’s built on exploitation, Milton!
Dr. Mills: Right, exactly.
Caryn Hartglass: Exploitation!
Dr. Mills: It’s a zero sum game, in that I can’t advance unless I take something from you, and that’s really sad and unfortunate.
Caryn Hartglass: Yes, okay. One last thing. I want to end on a happy, delicious note. So, have you had anything interesting, yummy in the vegan world in your travels?
Dr. Mills: Oh my goodness. Well, there’s a new vegan chain called Nu Vegan that has two outlets here in the D.C. metro area. One is in College Park in Maryland, near the University of Maryland college, and then there’s another branch in Washington D.C. on Georgia Avenue and the food there is just absolutely amazing. I’ve been taking some samples of their food to work to share with my colleagues who are, I mean, they absolutely love it.
Whereas before they thought vegan food- simply because they hadn’t experienced it- were concerned oh, I’m not going to like it, or this is so extreme. They were like my goodness, this food is delicious, it’s satisfying, and it’s actually good for me, and they realized I can be more plant-based if I choose to, so that’s a very positive thing.
Caryn Hartglass: That’s fantastic. Dr. Milton Mills, thank you so much for this time. I love you and I love talking to you, and I look forward to reading more of your rants on Facebook.
Dr. Mills: (Laughs) Well, there will be more!
Caryn Hartglass: Ah, yes. Unfortunately. Okay, be well! Thank you for joining me on It’s All About Food.
Dr. Mills: My pleasure, Caryn. Talk to you soon.
Caryn Hartglass: Okay. Phew. That was Dr. Milton Mills. Isn’t he awesome? I think so.
Transcribed by Sara Scanlon, 6/6/2017