Latest / Wellness, Actually with Emily Oster & Perry Wilson, MD / Race, Values-based Care, and Advocating for Yourself With Erica Chidi

Transcript

Race, Values-based Care, and Advocating for Yourself With Erica Chidi · Wellness, Actually with Emily Oster & Perry Wilson, MD

• 0:00
  Speaker 1: So welcome to parent Data. This week in the newsletter,
• 0:03
  Speaker 1: we've been honoring a Black Maternal Health Week and the
• 0:07
  Speaker 1: issues that face black women in particular in maturity care.
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  Speaker 1: And today, I am extremely excited to have Ericatchiti here
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  Speaker 1: to talk about these issues and also talk about possible solutions.
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  Speaker 1: So Erica, welcome, Thank you for coming, Thank you for
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  Speaker 1: having me.
• 0:24
  Speaker 2: It's so fun to be here.
• 0:26
  Speaker 1: So Erica has a million hats.
• 0:28
  Speaker 2: Let me list a few hats.
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  Speaker 1: So you are the founder of LOOM. You're the author
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  Speaker 1: of the book Nurture, a Modern Guide to Pregnancy, birth,
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  Speaker 1: early motherhood, and trusting yourself and your body. You're a doula,
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  Speaker 1: You're a creator. You do all kinds of amazing stuff.
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  Speaker 1: I would love you to introduce yourself a little bit,
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  Speaker 1: so tell us who you are and why you do
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  Speaker 1: what you do well.
• 0:51
  Speaker 3: I would say definitely a multi hyphen it. I think
• 0:56
  Speaker 3: what takes up ninety eight percent of my time these
• 1:00
  Speaker 3: days is Loom, And as you kind of explained somewhat
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  Speaker 3: given my background, it is a health education app that
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  Speaker 3: is focused on helping women feel better in their body
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  Speaker 3: through learning about their bodies and really kind of the
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  Speaker 3: key reason for developing this platform is because health literacy
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  Speaker 3: is really poor for a.
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  Speaker 2: Lot of folks out there.
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  Speaker 3: A lot of people, regardless of their gender, have a
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  Speaker 3: very basic understanding of how their bodies function and how
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  Speaker 3: to basically take care of themselves in and out of
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  Speaker 3: health crises. And in terms of my background and kind
• 1:43
  Speaker 3: of what got me here, Loom actually was a physical
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  Speaker 3: space in Los Angeles from twenty seventeen to twenty nineteen
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  Speaker 3: where we, along with well myself, along with our team,
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  Speaker 3: taught classes across the female specific licene, so across women's health,
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  Speaker 3: essentially everything from period classes to fertility classes, pregnancy classes.
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  Speaker 3: There were miscarriage and abortion support groups, there were queer
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  Speaker 3: centered family planning support groups, and so really what happened
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  Speaker 3: in the physical space essentially was a microcosm of what
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  Speaker 3: we eventually wanted to.
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  Speaker 2: Execute on in a tech stack.
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  Speaker 3: As they say, so essentially that's really what the app
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  Speaker 3: is focusing on. And in terms of my background, I
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  Speaker 3: was a doula and health educator for about ten years
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  Speaker 3: before deciding to raise venture capital and pivot into tech.
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  Speaker 3: And you know, I think I spent a good amount
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  Speaker 3: of that decade really getting up close to what the
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  Speaker 3: pain points were for women and their partners moving through
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  Speaker 3: these really important life events like pregnancy, like trying to
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  Speaker 3: get pregnant, or starting to move through perimenopause. And I
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  Speaker 3: think what I realized, as I just said, in terms
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  Speaker 3: of what the app is solving for, is that, regardless
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  Speaker 3: of your background, the kind of ultimate unifier or the
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  Speaker 3: great equalizer is the fact that.
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  Speaker 2: Most people have the same questions when it comes to
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  Speaker 2: these experiences.
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  Speaker 3: And I think there hasn't been a way to solve
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  Speaker 3: for this type of health literacy in a way that
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  Speaker 3: feels engaging and fun and isn't so focused on pathology
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  Speaker 3: or something being wrong. I think really the focus is
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  Speaker 3: trying to support people around preventative health. And I got
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  Speaker 3: my start as a doula working in the San Francisco
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  Speaker 3: County jail providing childbirth education to folks that were currently incarcerated,
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  Speaker 3: and at the same time, I was also servicing definitely
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  Speaker 3: the top one to five percent of people living in
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  Speaker 3: a really fancy San Francisco neighborhood who also needed Doodles support.
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  Speaker 3: And what I noticed across both of those groups of
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  Speaker 3: people is they had basically the same questions about pregnancy
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  Speaker 3: and their bodies and the next stage of their lives.
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  Speaker 3: And so that lack of help literacy, that lack of
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  Speaker 3: understanding is what unifies us. And it's also what's been
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  Speaker 3: my key motivator in all iterations of my career being
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  Speaker 3: to try and close that knowledge gap.
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  Speaker 2: Yeah.
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  Speaker 1: I think this knowledge gap is so crucial and so
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  Speaker 1: problematic and almost in some ways so confusing. I mean,
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  Speaker 1: I remember when I got pregnant and like, I am,
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  Speaker 1: you know, ultimately a person like you who wrote a
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  Speaker 1: book about this. And I remember the experience of thinking
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  Speaker 1: about trying to get pregnant and somebody told me, you know,
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  Speaker 1: read this book Taking Charge of your Fertility, and I
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  Speaker 1: was like, oh, okay, I'll read that, and there were
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  Speaker 1: all of these things in there I did not know.
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  Speaker 2: You know, I didn't know.
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  Speaker 1: I basically didn't know like when you ovulated and how
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  Speaker 1: I just didn't understand how these things worked. And I
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  Speaker 1: just wonder, like, do you what is the deep underlying
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  Speaker 1: reason why we are not educating anyone about this?
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  Speaker 2: Well? Well, I think there's a couple layers to it.
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  Speaker 3: I think firstly, there is the kind of religious halo
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  Speaker 3: that encircles our culture, and the fact that talking about
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  Speaker 3: these things really leans into this idea of what is
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  Speaker 3: respectable and what is okay to talk about. There's this
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  Speaker 3: idea that, you know, we don't want to talk about sex,
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  Speaker 3: or we don't want to talk about fertility or the
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  Speaker 3: possibility of getting pregnant because it feels shameful, or at
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  Speaker 3: least that's what we've been conditioned to think. And it
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  Speaker 3: also has a lot to do with control, right. I think,
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  Speaker 3: for you know, women or non binary people that have
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  Speaker 3: that anatomy, the more that we know know about it,
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  Speaker 3: the more control we have over our ability to approcreate,
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  Speaker 3: whether we want to or not. And I think our
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  Speaker 3: culture definitely one of misogyny, one of patriarchy, the desire
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  Speaker 3: to relinquish any control to women has been severely undermotivated.
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  Speaker 2: And so I.
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  Speaker 3: Think the idea here is it's really about control, and
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  Speaker 3: it's about religion and I think what's really interesting, and
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  Speaker 3: economics too.
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  Speaker 2: Obviously, I think.
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  Speaker 3: There's a big piece there, maybe less so now in
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  Speaker 3: certain ways, but I think those three pieces are the
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  Speaker 3: why you know, I think the economics piece matters more
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  Speaker 3: sometimes than people think when we think about something like
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  Speaker 3: not not as much the education, but like why don't.
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  Speaker 1: We know the answers to some of these questions. You know,
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  Speaker 1: why are there so many unanswered questions in women's health
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  Speaker 1: about about breastfeeding, about perimenopause, about all this kind of
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  Speaker 1: like why is this so poorly understood? And I think
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  Speaker 1: sometimes the answer to that is like, well, you know,
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  Speaker 1: there isn't a lot of money in learning about this,
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  Speaker 1: and I think that's a piece of it that that
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  Speaker 1: I think probably is there too, Yeah, to at least
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  Speaker 1: some extent.
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  Speaker 3: Yeah, absolutely, I mean I think there's a lot of
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  Speaker 3: discussion now. A dear friend of mine, susaying, doctor Susanne
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  Speaker 3: Gilbert Lenz, talks a lot about this, the fact that
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  Speaker 3: you know, physicians are not incentivized financially to practice quote unquote,
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  Speaker 3: for lack of a better term, slower medicine or slow
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  Speaker 3: medicine where there is more space for education or is
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  Speaker 3: more space for non pharmological interventions. You're really thinking about
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  Speaker 3: the whole patient insurance has really not caught the wave
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  Speaker 3: of that being something to build against a in a
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  Speaker 3: higher way. I think there is starting to be, you know,
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  Speaker 3: a tide shift. Tide shift is maybe somewhat layered, and
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  Speaker 3: that values based care is really starting to become more
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  Speaker 3: and more of the focal point for larger care organizations
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  Speaker 3: and really thinking about paying providers for their outcomes, not
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  Speaker 3: just paying them for service, which is you know, the
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  Speaker 3: really big kind of like paradigm shift that's happening, because
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  Speaker 3: if we're incentivizing providers to have really strong outcomes, it
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  Speaker 3: means that the way that they practice medicine would have
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  Speaker 3: to fundamentally change. And I think that there's some deep
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  Speaker 3: alignment there in that change with you know, younger providers,
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  Speaker 3: you know, graduating and coming out wanting to practice slightly
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  Speaker 3: differently or having just a different ecology for themselves around
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  Speaker 3: how they want to you know, be with their patients
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  Speaker 3: and be with the work.
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  Speaker 2: You know.
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  Speaker 3: That said again, I feel like I can really dive
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  Speaker 3: into the numbers here because it's you the demand for
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  Speaker 3: obgins versus the supply will outstrip each other by twenty thirty,
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  Speaker 3: so we'll just be so many people that need those
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  Speaker 3: services and not enough obe's to go around.
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  Speaker 2: So there, I think it's it's we're.
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  Speaker 3: In this time that's very interesting where there's there does
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  Speaker 3: have to be a change, primarily because just the foundations
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  Speaker 3: are shifting so much in terms of what's available from
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  Speaker 3: a care perspective, and.
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  Speaker 1: I think it's it's sort of going to be very
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  Speaker 1: interesting to think about sort of what are we what
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  Speaker 1: are we replacing that with, and how are we continuing
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  Speaker 1: to sort of serve people ideally better in that in
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  Speaker 1: that kind of environment. I mean, and this is where
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  Speaker 1: I think people bring up things like group prenatal care,
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  Speaker 1: like could we do better?
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  Speaker 2: And I think some of that has been shown to.
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  Speaker 1: Be effective, particularly with black women. I think in showing
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  Speaker 1: these like groupings in some ways can be effective as
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  Speaker 1: a way to deliver better information during pregnancy.
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  Speaker 2: Yeah.
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  Speaker 3: Absolutely, I mean, you know, centering longstanding framework in.
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  Speaker 1: Most of the world, specifically the UK.
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  Speaker 3: You know, centering is a great way to provide maternal
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  Speaker 3: care just because there's less isolation. And the thing about pregnancy,
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  Speaker 3: unfortunately in the United States is it's deeply pathologized and
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  Speaker 3: it's very interventionalist in terms of how the medicine is
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  Speaker 3: administered here. But being pregnant is actually not a pathology.
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  Speaker 3: It's a normal process.
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  Speaker 1: So it's not a disease per se, not a disease
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  Speaker 1: per sae.
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  Speaker 3: Depending everybody can have a lot of maladies, things can
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  Speaker 3: happen during pregnancy, but it's not a disease.
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  Speaker 2: So the idea of syncing up.
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  Speaker 3: With ten or fifteen other people that are going through
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  Speaker 3: pregnancy is helpful if you're all around the same time,
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  Speaker 3: because you should all be having a lot of the
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  Speaker 3: same experiences and there can be a lot of support
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  Speaker 3: gain from being able to touch in and talk about
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  Speaker 3: those experiences as well. But going back to what you
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  Speaker 3: were saying about how medicine is practiced overall, given some
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  Speaker 3: of the strains that are coming in from a supply
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  Speaker 3: and demand standpoint, a big part of that is going
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  Speaker 3: to be the improvement around health education and health literacy.
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  Speaker 3: People need to have a better understanding of their bodies,
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  Speaker 3: what's going on, to make better health care decisions, to
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  Speaker 3: advocate for themselves, to help support providers who are burnt
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  Speaker 3: out and overwhelmed. We know that, and I think there
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  Speaker 3: needs to be more equity in the exchange. And I
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  Speaker 3: think especially when it comes to black women, black bodied
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  Speaker 3: people experiencing healthcare due to systemic racism built in from
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  Speaker 3: the very foundation of medicine education and a framework of
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  Speaker 3: discussion and an acknowledgment of racial anxiety, which is what
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  Speaker 3: the New York Times piece that myself and doctor Khill
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  Speaker 3: co authored a couple of years ago is about has
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  Speaker 3: to really be at the forefront, which is why I
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  Speaker 3: think the values based care trajectory is so powerful because
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  Speaker 3: it's about outcomes. So if all of your if people
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  Speaker 3: are dying and people aren't making it through, and you
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  Speaker 3: are now being reimbursed based on how many people you
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  Speaker 3: keep alive or how many people thrive, I think, unfortunately,
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  Speaker 3: economics might be the answer to some of the racial
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  Speaker 3: disparities that we are experiencing, because people.
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  Speaker 2: Are not going to not want to be paid well
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  Speaker 2: because they don't have good outcomes.
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  Speaker 3: And I think that's maybe one piece about values based
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  Speaker 3: care that's I mean, obviously ideologically it aligns with me
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  Speaker 3: and anybody who is a compassionate human, But I think
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  Speaker 3: knowing the economics is what really makes the world go
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  Speaker 3: round might.
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  Speaker 2: End up being, you know, a key motivator there.
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  Speaker 1: It's interesting because sort of that idea, which I'm quite
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  Speaker 1: sympathetic too, I think it assumes, and this is something
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  Speaker 1: I want to sort of turn back to you as
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  Speaker 1: a question. It kind of assumes that there is something
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  Speaker 1: underlying these disparities in outcomes for black women in particular
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  Speaker 1: which are extreme. I mean the you know, we put
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  Speaker 1: some of this data in earlier this week in the newsletter,
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  Speaker 1: but we look at maternal mortality rates in twenty twenty one,
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  Speaker 1: even maternal mortality rates for Black women are two and
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  Speaker 1: a half times higher than any other racial group, and
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  Speaker 1: you know, far higher than any comparably developed country. And
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  Speaker 1: there's many things in those data which are deeply concerning.
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  Speaker 1: The idea that that providing people better incentives, providing providers
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  Speaker 1: different kinds of incentives might affect their behavior sort of
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  Speaker 1: presumes that there is something that they are doing that
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  Speaker 1: we could identify that is like changeable, that there's just
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  Speaker 1: sort of some underlying issue which is alterable in the
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  Speaker 1: behavior of the medical system. Maybe that's so not much
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  Speaker 1: you're assuming, but I think that would be one interpretation
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  Speaker 1: of that, And I'm sort of curious if you have
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  Speaker 1: thoughts on kind of is there something we could point to,
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  Speaker 1: as you know, this is the thing that needs to
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  Speaker 1: change underlying unsolved problem and misunderstanding something that we could
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  Speaker 1: point to there.
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  Speaker 3: I would say, in in healthcare, the default is speed
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  Speaker 3: and volume, and if those are the key drivers, they
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  Speaker 3: immediately create an environment that is not very passionate, and
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  Speaker 3: I think that when you are not plugged into compassion, you.
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  Speaker 2: Are very very very.
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  Speaker 3: Far away from being able to plug into racial sensitivity
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  Speaker 3: and cultural awareness and cultural competency, especially for white providers
• 14:21
  Speaker 3: servicing non white or black patients.
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  Speaker 2: So I think, as you were saying, or have been saying,
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  Speaker 2: because the values.
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  Speaker 3: Of healthcare and how it's delivered in this country are
• 14:37
  Speaker 3: already not aligned for.
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  Speaker 2: Good outcomes, kind of.
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  Speaker 3: Writ large, it really makes care consistently susceptible to being racist.
• 14:54
  Speaker 2: There's just not room. There's not room obviously the hippocratic
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  Speaker 2: oath that's do no harm.
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  Speaker 3: But again, like the framework of medicine was developed by
• 15:03
  Speaker 3: white people, so it's do no harm to us because
• 15:07
  Speaker 3: it's really just us that are here administering.
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  Speaker 2: The care right.
• 15:10
  Speaker 3: And so it's a very interesting and very complex problem
• 15:16
  Speaker 3: that probably won't be solved in our lifetime. I think
• 15:19
  Speaker 3: it's only right now, like real conversations are starting to
• 15:23
  Speaker 3: be had in medicine around race and how it impacts care.
• 15:27
  Speaker 3: We're just really starting, and so we have a long
• 15:31
  Speaker 3: way to go. But I think in terms of what
• 15:34
  Speaker 3: you're saying around behavior change and identifying what behaviors are problematic.
• 15:41
  Speaker 3: There are so many there's just so many steps that are.
• 15:46
  Speaker 2: Creating the problem that we have, and a lot of
• 15:48
  Speaker 2: it has to do before someone even starts medical school.
• 15:50
  Speaker 3: It has to do with just how we're socialized and
• 15:54
  Speaker 3: how we are socialized to see each other.
• 15:57
  Speaker 2: And so the outcomes.
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  Speaker 3: Focus is a economic lever that I think will help
• 16:06
  Speaker 3: support this more foundational ideological DEI work that is now
• 16:13
  Speaker 3: in medical school and in the day today for providers.
• 16:16
  Speaker 3: If we can have economic incentives coupled and then political
• 16:20
  Speaker 3: incentives too, I mean, these are the momnibus.
• 16:23
  Speaker 2: These pieces all have to kind of compound.
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  Speaker 3: I would say all of these pieces have to compound
• 16:29
  Speaker 3: for there to be actual systemic change because it's a
• 16:32
  Speaker 3: systemic problem. So we can't just look at providers only.
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  Speaker 3: You've got to look at payer, you got to look
• 16:37
  Speaker 3: at politics.
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  Speaker 2: What you said about the speed.
• 16:41
  Speaker 1: Is really I think is really interesting because you know,
• 16:44
  Speaker 1: we know when we look at like implicit association tests
• 16:47
  Speaker 1: that like most people perform in a way that suggests
• 16:51
  Speaker 1: significant racial bias on implicit association tests, and some of
• 16:53
  Speaker 1: those are just about what happens the first thing you see,
• 16:56
  Speaker 1: what is your first instinct. We also know that you know,
• 17:00
  Speaker 1: with enough moments of time, people can redo their first
• 17:04
  Speaker 1: instincts and they can have a second instinct and that may.
• 17:06
  Speaker 2: Be a better one.
• 17:07
  Speaker 1: And so this idea of kind of you need more
• 17:10
  Speaker 1: time to be able to have these larger cultural conversations
• 17:16
  Speaker 1: and just to recognize the other factors other than the
• 17:18
  Speaker 1: first thing that comes into your head when you start
• 17:20
  Speaker 1: trying to do something and that you know is potentially
• 17:23
  Speaker 1: bought by time exactly.
• 17:26
  Speaker 2: YEA. Interesting.
• 17:27
  Speaker 1: So I was going to ask where you see hope,
• 17:29
  Speaker 1: but I'm I'm ask a more specific version of the
• 17:32
  Speaker 1: question of where you see hope, which is, do you
• 17:34
  Speaker 1: see hope in policy change? Do you think that there
• 17:38
  Speaker 1: are at the political level policy changes that are feasible
• 17:41
  Speaker 1: and would be helpful.
• 17:43
  Speaker 3: I think I do see hope that people that I
• 17:46
  Speaker 3: know that are going up to Washington having the conversations
• 17:51
  Speaker 3: are or seeing some possibility show up more so than
• 17:56
  Speaker 3: ever before.
• 17:59
  Speaker 2: However, I.
• 18:01
  Speaker 3: Don't look to politics being the only answer, just as
• 18:06
  Speaker 3: much as I don't look to do as being.
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  Speaker 2: The only answer for black women either.
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  Speaker 3: I think again, in order for there to be systemic change,
• 18:14
  Speaker 3: all of these things need to work together. And you know,
• 18:18
  Speaker 3: I think even this conversation that we're having right now
• 18:21
  Speaker 3: is also a part of it. It is a collective
• 18:25
  Speaker 3: shift that is going to have to happen over a
• 18:28
  Speaker 3: number of decades. However, I do think change is happening,
• 18:33
  Speaker 3: but it's happening really slowly.
• 18:37
  Speaker 1: So let's talk about You're a part of the solution.
• 18:40
  Speaker 1: You're a change. So let's talk about LOOM. So tell me,
• 18:44
  Speaker 1: Like we sort of alluded to this in the beginning,
• 18:45
  Speaker 1: but like, tell us, what are you building?
• 18:48
  Speaker 3: Well, as I was sharing, it's a health education app.
• 18:52
  Speaker 3: But what makes you the most excited about it is
• 18:55
  Speaker 3: I think what we've figured out over here is how
• 18:59
  Speaker 3: to make learning about your body fun. And one of
• 19:05
  Speaker 3: the real reasons why we wanted to solve for fun
• 19:09
  Speaker 3: and the experience is just because oftentimes when we are
• 19:12
  Speaker 3: focused on the body, it's usually because we need to
• 19:15
  Speaker 3: fix something, something is wrong, you know, or we're trying
• 19:18
  Speaker 3: to like optimize something.
• 19:20
  Speaker 2: And I think, what we're trying to solve.
• 19:22
  Speaker 1: For but the pot is thinking about all the things
• 19:25
  Speaker 1: I do to try to Like, I how much time
• 19:27
  Speaker 1: I spend on optimization.
• 19:28
  Speaker 3: It's a lot, it's a lot. But I think what
• 19:31
  Speaker 3: we're trying to solve for with the app is just
• 19:34
  Speaker 3: this idea of micro learning and compound learning over time
• 19:40
  Speaker 3: about things that you need to know. It's one of
• 19:44
  Speaker 3: the kind of key tenets of Loom and really just
• 19:48
  Speaker 3: of my body of work is this idea of biological empathy,
• 19:51
  Speaker 3: which is, you know, what would happen if you had
• 19:54
  Speaker 3: enough health education to be able to have a sense
• 20:01
  Speaker 3: of empathy for a experience that you haven't gone through yet.
• 20:05
  Speaker 3: So really, what's happening in the app is we're serving
• 20:09
  Speaker 3: you up education about menopause, regardless.
• 20:13
  Speaker 2: Of where you are in your lifespan.
• 20:16
  Speaker 3: Information about IDs, even if you don't use one. Because really,
• 20:22
  Speaker 3: what we notice in a lot of our user research
• 20:24
  Speaker 3: is that women or non binary people want to share
• 20:29
  Speaker 3: health information with people that they love or their community.
• 20:33
  Speaker 3: It's like, if they find out information, they want to
• 20:35
  Speaker 3: share it. I mean, in many ways, I would say
• 20:37
  Speaker 3: it's kind of the genesis of your work. It's like,
• 20:39
  Speaker 3: what's happening, I want more people to.
• 20:41
  Speaker 2: Know about this.
• 20:42
  Speaker 3: It's a very it's a very natural inclination actually, and
• 20:44
  Speaker 3: it's pretty ubiquitous, which is, but not everybody has the
• 20:47
  Speaker 3: means or the time or the access to be able
• 20:50
  Speaker 3: to leverage that information that they have found in a
• 20:52
  Speaker 3: way that feels supportive. And so the app is about
• 20:55
  Speaker 3: you getting to learn, you also getting to share what
• 20:57
  Speaker 3: you've learned, and then alsofying voices of women's health stories
• 21:03
  Speaker 3: from around the world. There is an audio component there
• 21:06
  Speaker 3: we'll be able to listen to source from all people
• 21:09
  Speaker 3: you know, people you don't know, to learn. And we
• 21:12
  Speaker 3: did that because there's a really huge gap in women's
• 21:17
  Speaker 3: health research. Again, the monit's the the economics of researching
• 21:20
  Speaker 3: women is not super lucrative. Apparently maybe that's maybe that's
• 21:24
  Speaker 3: going to change, maybe, but that currently is how it is.
• 21:28
  Speaker 3: And so, you know, what I learned when we had
• 21:30
  Speaker 3: our physical space for LOOM is that women's stories are
• 21:34
  Speaker 3: actually anecdotal evidence that other women can kind of cling
• 21:39
  Speaker 3: on to to make sense.
• 21:40
  Speaker 2: Of their own bodies.
• 21:41
  Speaker 3: Even though there's not, you know, research article in a
• 21:44
  Speaker 3: journal about this thing. If three or four women are
• 21:47
  Speaker 3: experiencing it, more than likely there's probably more and there's
• 21:50
  Speaker 3: something to cling on to there. And so the app
• 21:52
  Speaker 3: really brings together this factual, evidence based information that's easy
• 21:57
  Speaker 3: to consume so that women have more visibility into what
• 22:02
  Speaker 3: is kind of the latest information that could be helpful
• 22:05
  Speaker 3: for them. And then there's actual stories from real women
• 22:08
  Speaker 3: that can also help connect the dots if there isn't
• 22:10
  Speaker 3: something in the research, and so we're bringing those those
• 22:14
  Speaker 3: pieces together and it's exciting. It's just look, it's not
• 22:18
  Speaker 3: a panacea. It's not like rocket science or not. It's
• 22:22
  Speaker 3: not a wearable. It's not something that you can like,
• 22:25
  Speaker 3: you know, da da da da, but it is it's
• 22:29
  Speaker 3: pretty important because what happens is something's going on and
• 22:34
  Speaker 3: you end up on WebMD or you end up down
• 22:37
  Speaker 3: some rabbit hole. And we're really trying to be a
• 22:41
  Speaker 3: home base for women throughout their life to get this
• 22:44
  Speaker 3: information to share it, and we look forward to being
• 22:47
  Speaker 3: able to really iterate and do more with the platform
• 22:50
  Speaker 3: as it grows.
• 22:51
  Speaker 1: I love this story aspect of the platform, but I
• 22:54
  Speaker 1: also sort of love this connection of like there's a space,
• 22:59
  Speaker 1: a sort of evidence space between the kind of one
• 23:02
  Speaker 1: story and you know, the gold standard medical journal, where
• 23:06
  Speaker 1: like shared experiences are actually can be quite informative, and
• 23:10
  Speaker 1: there are you know, often things that come up in
• 23:11
  Speaker 1: the work that I do where people will say, many
• 23:14
  Speaker 1: people will share I have had this experience and it's
• 23:16
  Speaker 1: not really very well covered in any medical literature and
• 23:19
  Speaker 1: occasional mention to a doctor in this way. I don't know,
• 23:22
  Speaker 1: I don't really know anything about that, but yet I
• 23:24
  Speaker 1: can see it is clearly something that many people are experiencing.
• 23:28
  Speaker 1: And I think that just feeling of being able to
• 23:30
  Speaker 1: connect with someone else who's having the same emotional experience,
• 23:34
  Speaker 1: the same physical experience, or whatever it is, is a
• 23:36
  Speaker 1: really I mean, it's very relaxing, can be very relaxing.
• 23:40
  Speaker 3: Yes, yes, And we also did something else of the
• 23:42
  Speaker 3: platform that I feel like you will resonate with this
• 23:46
  Speaker 3: idea of time poverty, not having enough time to do
• 23:50
  Speaker 3: really anything, and women kind of holding the brunt of that.
• 23:54
  Speaker 3: One of the things we really wanted to solve for,
• 23:56
  Speaker 3: as well as knowing everyone is so busy, you know,
• 23:59
  Speaker 3: how do you get a lot of value and not
• 24:01
  Speaker 3: necessarily have to spend a lot of time with us?
• 24:04
  Speaker 2: And so we've really.
• 24:05
  Speaker 3: I really feel like the app does that, like you
• 24:08
  Speaker 3: can get a lot, but you don't have to live there,
• 24:10
  Speaker 3: which is I think sometimes the definitive feature of a
• 24:14
  Speaker 3: lot of social apps, or they want to take as
• 24:17
  Speaker 3: much of your time as.
• 24:18
  Speaker 1: Possible, so everyone should just go down download the app
• 24:22
  Speaker 1: because it's great.
• 24:23
  Speaker 2: Yeah.
• 24:25
  Speaker 3: Yeah, it only comes out in July, so your folks
• 24:27
  Speaker 3: are hearing about it first.
• 24:29
  Speaker 1: Yeah, so in July, go download the app. But one
• 24:31
  Speaker 1: of the things that my sense is the app will
• 24:34
  Speaker 1: do in July is these little sort of pings of information,
• 24:38
  Speaker 1: which I think is exactly in this space of like,
• 24:41
  Speaker 1: here's a fact that you might be interested about perimenopause,
• 24:44
  Speaker 1: and like you don't have to spend a lot of
• 24:46
  Speaker 1: time reading it. It's short, it comes, you read it
• 24:48
  Speaker 1: that's interesting, or you don't read it today and that's
• 24:49
  Speaker 1: you read it tomorrow. And I think that it's just interesting.
• 24:53
  Speaker 1: It's interesting, it's interesting. It's like an enjoyable way to learn.
• 24:57
  Speaker 1: I think that's, you know, going back to the sort
• 24:59
  Speaker 1: of underlying idea of like this should be fun and
• 25:02
  Speaker 1: not something that you're doing because you know something is wrong.
• 25:05
  Speaker 2: Yeah exactly, and then you're ready. Okay.
• 25:07
  Speaker 1: So what I want to sort of end by coming
• 25:10
  Speaker 1: back to you mentioned this New York Times piece from
• 25:12
  Speaker 1: several years ago, which I think is really fantastic and
• 25:16
  Speaker 1: important piece, but some of it is really focused on
• 25:19
  Speaker 1: sort of from the perspective of black women, like how
• 25:21
  Speaker 1: can you advocate for yourself in these settings. So do
• 25:23
  Speaker 1: you want to just take like two minutes and talk
• 25:26
  Speaker 1: a little bit about what advice you would give? Is
• 25:28
  Speaker 1: maybe the sort of direct way to ask it to
• 25:30
  Speaker 1: Black women who are going through sort of pregnancy in
• 25:33
  Speaker 1: this space that we know has these you know, sort
• 25:35
  Speaker 1: of underlying issues and want to be in a position
• 25:37
  Speaker 1: to best advocate for themselves.
• 25:40
  Speaker 3: So, you know, one thing I want to say before
• 25:43
  Speaker 3: I dive into it is when the piece came out,
• 25:45
  Speaker 3: the majority of the feedback was overwhelmingly positive. There was
• 25:49
  Speaker 3: some feedback which I really resonate with that shared why
• 25:54
  Speaker 3: does the burden have to be on Black women to
• 25:57
  Speaker 3: do any kind of advocacy for themselves in this environment
• 26:02
  Speaker 3: because we already take on so much. Shouldn't it be
• 26:06
  Speaker 3: you know, the provider's responsibility. So I really just want
• 26:08
  Speaker 3: to acknowledge that and hold that because I do understand
• 26:12
  Speaker 3: that and it does make sense to me. Again, I
• 26:14
  Speaker 3: don't have immediate solve for that, but I just think
• 26:18
  Speaker 3: it's worth acknowledging there is like an inherent power dynamic,
• 26:22
  Speaker 3: there is an inherent challenge in that environment. That said,
• 26:27
  Speaker 3: my recommendation is really reminding the provider that you are
• 26:33
  Speaker 3: black and how that impacts your outcomes and your care
• 26:40
  Speaker 3: based on what you know, because again going back in
• 26:44
  Speaker 3: our conversation about some of the key mandates in healthcare,
• 26:49
  Speaker 3: it's speed and volume. Right, obviously it's care, but it's
• 26:53
  Speaker 3: care speed and volume. The speed is what creates a
• 27:00
  Speaker 3: big part of the problem in the patient provider rapport.
• 27:05
  Speaker 3: And so when I say, remind the provider that you
• 27:09
  Speaker 3: are black and your outcomes and how that impacts you,
• 27:13
  Speaker 3: it's really just slowing the provider down to take you
• 27:16
  Speaker 3: in and take a beat and to be cognizant of
• 27:23
  Speaker 3: that reality.
• 27:24
  Speaker 2: Because it is very much like I got fifty minutes
• 27:26
  Speaker 2: with you, what do you need?
• 27:28
  Speaker 3: You know, they're they're like I said, you know, both
• 27:30
  Speaker 3: my parents are clinicians, and so I've always really come
• 27:33
  Speaker 3: to the space with a very humanistic approach, like they're
• 27:37
  Speaker 3: they're overwhelmed too. We have a lot that they're holding,
• 27:40
  Speaker 3: especially inside of the pandemic.
• 27:42
  Speaker 2: That that we've been moving through.
• 27:44
  Speaker 3: So it's just again it's like it's bringing them into
• 27:48
  Speaker 3: your story, bringing them into your experience, and really trying
• 27:53
  Speaker 3: to ask them to be collaborative with you about avoiding
• 27:57
  Speaker 3: these possibilities based on what you know. And then I
• 28:02
  Speaker 3: think on the other side of that, my other recommendation
• 28:06
  Speaker 3: is for black women to have a care buddy, have
• 28:10
  Speaker 3: a partner, friend, family, bring somebody with you that can
• 28:15
  Speaker 3: help to be a second set of eyes and ears
• 28:17
  Speaker 3: that can help remind you of what you need inside
• 28:20
  Speaker 3: that appointment, because I mean, even for me, I mean
• 28:23
  Speaker 3: I always I'm coming with all the things, but depending
• 28:25
  Speaker 3: on how long I had to wait for the appointment,
• 28:28
  Speaker 3: depending on like how I'm feeling. You know, it's there's
• 28:31
  Speaker 3: all of these components that can make it very difficult
• 28:34
  Speaker 3: to optimize an appointment.
• 28:36
  Speaker 2: So I think, you know, having a care buddy would
• 28:39
  Speaker 2: be really important. And then thirdly, you know, I like
• 28:42
  Speaker 2: to call them speed bumps for the appointment. To slow
• 28:44
  Speaker 2: it down.
• 28:45
  Speaker 3: Is actually to bring in written questions on a piece
• 28:49
  Speaker 3: of paper printed out or like on your phone, put
• 28:52
  Speaker 3: an alarm to be like in the middle of the appointment,
• 28:55
  Speaker 3: to get your phone to go off, to be like, oh.
• 28:57
  Speaker 2: I have this question. Like those speed bumps I think.
• 29:00
  Speaker 3: Can help just provide a little bit more clarity or
• 29:05
  Speaker 3: just a little bit more space so the information can
• 29:08
  Speaker 3: get metabolized better or more before you're already out the door, right,
• 29:15
  Speaker 3: you know, those are those are important important things as well.
• 29:18
  Speaker 3: And I think the last thing too, you know, depending
• 29:21
  Speaker 3: on what kind of care appointments you're having. I think
• 29:24
  Speaker 3: for pregnancy, consider bringing your own robe to your appointment,
• 29:29
  Speaker 3: if possible, that you use for your appointments, because that's
• 29:33
  Speaker 3: another way to again differentiate yourself and also to keep
• 29:38
  Speaker 3: you feeling less like a patient more like someone who's well.
• 29:43
  Speaker 3: Those are things that we sometimes would recommend, you know,
• 29:45
  Speaker 3: when I was a duel, I like working in the
• 29:47
  Speaker 3: hospital for labor, it'd be like, bring bring your own
• 29:50
  Speaker 3: labor down. That can put all the leads and everything
• 29:53
  Speaker 3: in it. Doesn't you know, interrupt intervention or medical process
• 29:57
  Speaker 3: that's happening, but it will make you feel more comfortable,
• 29:59
  Speaker 3: and that might be you know, another piece again to you.
• 30:03
  Speaker 3: And also just like for a conversation point for provided
• 30:05
  Speaker 3: to be like, oh that's a nice rout.
• 30:06
  Speaker 2: They'll be like this person's different, they're doing something different.
• 30:09
  Speaker 2: You know. It's like it's all these small again.
• 30:12
  Speaker 3: It's like I wish we didn't need to do small
• 30:14
  Speaker 3: tactics like this, but I do feel it's every little
• 30:19
  Speaker 3: bit helps.
• 30:22
  Speaker 2: I love that.
• 30:22
  Speaker 1: Yeah, this sort of just to really go back to
• 30:25
  Speaker 1: this idea of slowing down, which it just feels like
• 30:28
  Speaker 1: very key to a lot of to a lot of
• 30:30
  Speaker 1: what you're saying. All Right, thank you.
• 30:33
  Speaker 2: So much, Erica.
• 30:34
  Speaker 1: This was really fantastic, a fantastic conversation, and I know
• 30:38
  Speaker 1: everybody will be learning a lot more of themselves about
• 30:41
  Speaker 1: themselves come July.
• 30:42
  Speaker 3: But I just I really appreciate you being here. Thank you,
• 30:45
  Speaker 3: Thank you so much for having me. I love love
• 30:48
  Speaker 3: chatting with you always.
• 30:52
  Speaker 1: Thanks for listening. If you like what you heard, subscribe
• 30:56
  Speaker 1: to parent Data in your favorite podcast now and rate
• 30:59
  Speaker 1: and review the show.
• 31:00
  Speaker 2: Apple Podcasts. You can subscribe to the whole.
• 31:02
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• 31:07
  Speaker 2: Talk to you soon,