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SMNTY Interviews: Dr. Sharon Malone · Stuff Mom Never Told You

• 0:05
  Speaker 1: Hey, this is Annie and Samantha. I'm welcome to Stuff
• 0:07
  Speaker 1: I Never Told You, production of iHeartRadio, and today we
• 0:19
  Speaker 1: are so excited to welcome health expert, reproductive rights advocate,
• 0:23
  Speaker 1: author of best selling book Grown Women Talk, and the
• 0:27
  Speaker 1: host of the podcast The Second Opinion, doctor Sharon Malone. Hello,
• 0:32
  Speaker 1: Thank you so much for being here.
• 0:33
  Speaker 2: Well, thank you so much for having me.
• 0:35
  Speaker 1: We're so excited to talk to you. We have so
• 0:37
  Speaker 1: many questions. Can you introduce yourself to our audience please?
• 0:44
  Speaker 2: Yes. I am doctor Sharon Malone. I'm a Board certified obgyn.
• 0:49
  Speaker 2: I am also a certified menopause practitioner. I'm the chief
• 0:54
  Speaker 2: medical Advisor at Alloy Women's Health after a thirty year
• 0:59
  Speaker 2: career in private practice, and you recently a podcaster. You know,
• 1:04
  Speaker 2: I've done a lot of things since I left my
• 1:06
  Speaker 2: practice five years ago, and I don't think anyone can
• 1:09
  Speaker 2: accuse me of being in retirement. I hate that word,
• 1:12
  Speaker 2: by the way, I hate retirement. I've just pivoted new careers.
• 1:17
  Speaker 1: I love that you have done so much and this
• 1:20
  Speaker 1: is a This is kind of an interesting pivot into
• 1:23
  Speaker 1: the podcasting world with the new show. Can you tell
• 1:26
  Speaker 1: us about the podcast and how you got into podcasting.
• 1:31
  Speaker 2: Yeah, you know, it's a really unexpected turn, to be
• 1:34
  Speaker 2: honest with you. You know, I was one of those
• 1:37
  Speaker 2: people who during the great COVID time, I got three
• 1:42
  Speaker 2: months off from work because you know, I was considered
• 1:45
  Speaker 2: it's really harsh to be considered non essential. But you know,
• 1:49
  Speaker 2: I guess pap smears and talking about menopause weren't emergency care.
• 1:53
  Speaker 2: So I had those three months off and I had
• 1:56
  Speaker 2: a little bit of time, a lot of time actually,
• 1:59
  Speaker 2: to re I'm like, you know, is this really what
• 2:02
  Speaker 2: I want to continue doing. I loved what I did,
• 2:05
  Speaker 2: and I you know, and I have no complaints about that,
• 2:09
  Speaker 2: but it just seemed like the right time to exit
• 2:11
  Speaker 2: stage left. And after those three months off, decided to
• 2:16
  Speaker 2: leave my private practice with no plans in mind. And
• 2:19
  Speaker 2: then funny things happen when you have a little time
• 2:23
  Speaker 2: on your hands. And my dear friend Michelle Obama had
• 2:26
  Speaker 2: just launched her first podcast, the Michelle Obama Podcast, five
• 2:31
  Speaker 2: years ago, and she said, you know what, why don't
• 2:34
  Speaker 2: we talk about menopause? Because we've had countless conversations around
• 2:40
  Speaker 2: the table, you know this and talking to my friends
• 2:43
  Speaker 2: and giving my obgin menopause advice, and she said, you
• 2:48
  Speaker 2: know what, I want to talk about it. So she
• 2:50
  Speaker 2: was really one of the first people that openly, I
• 2:54
  Speaker 2: say first famous people who sort of claimed it and said, hey,
• 2:58
  Speaker 2: no shame in this game. I'm menopausal and this is
• 3:02
  Speaker 2: what I do. So that we had that conversation five
• 3:05
  Speaker 2: over five years ago, and once I did that podcast,
• 3:11
  Speaker 2: it sort of opened up a world because you know,
• 3:13
  Speaker 2: I'm known here in Washington, but just to my patients,
• 3:16
  Speaker 2: and that sort of opened up a new world. That's
• 3:18
  Speaker 2: how the founders at Alloy, which was just a really
• 3:23
  Speaker 2: a startup startup at that point, found me because they
• 3:26
  Speaker 2: heard me on the Michelle Obama podcast. So fast forward,
• 3:29
  Speaker 2: Michelle and I did a couple of podcasts and she said,
• 3:33
  Speaker 2: you know, and I will give her all the credit
• 3:35
  Speaker 2: in the world because this was her initiative to say,
• 3:39
  Speaker 2: I really want to talk about you know, women's health
• 3:42
  Speaker 2: and to have a space for that. Would you do it?
• 3:45
  Speaker 2: And so this has been a long time coming. We
• 3:47
  Speaker 2: really started talking about it five years ago and it
• 3:50
  Speaker 2: just came to Fruition this week and we decided to
• 3:55
  Speaker 2: do the second opinion. Her show is in my opinion,
• 3:58
  Speaker 2: So my show is the opinion makes total sense. It does.
• 4:03
  Speaker 3: I mean listening to that podcast specifically was phenomenal. Like
• 4:08
  Speaker 3: there's so many conversations that aren't had enough. You are
• 4:12
  Speaker 3: really just on the beat when we need more information,
• 4:16
  Speaker 3: like with all this disinformation, misinformation and just complete erasure,
• 4:21
  Speaker 3: especially when it comes to women's healthcare. Yes, this is
• 4:24
  Speaker 3: such an important topic that's not being talked about enough,
• 4:28
  Speaker 3: and so you coming with this podcast is phenomenal. But
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  Speaker 3: I also love the fact that you're talking about menopause
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  Speaker 3: because as a person who is entering into possibly perimenopause,
• 4:41
  Speaker 3: which I'm still trying to figure out and not even understanding,
• 4:44
  Speaker 3: this is something that needs to be talked about even
• 4:47
  Speaker 3: more in a time where people don't want to understand.
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  Speaker 3: I guess what what do you think when we talk
• 4:53
  Speaker 3: about like perimenopause and menopause and as it's coming into
• 4:56
  Speaker 3: more in conversation, Well, you know, I think.
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  Speaker 2: That as well women generally, we have been taught to
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  Speaker 2: be ashamed of so many things that our bodies do.
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  Speaker 2: You know, from our periods to nursing. Everything is shameful
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  Speaker 2: and it's been over sexualized or desexualized. I should say
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  Speaker 2: about our bodily functions, and you know it's time to say, yeah,
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  Speaker 2: we're going to talk about this. Why would you walk
• 5:23
  Speaker 2: into perimenopause and menopause with as little information as women do.
• 5:29
  Speaker 2: I mean, you know, a generation ago women walked into
• 5:32
  Speaker 2: puberty that way. You know, they didn't have any information
• 5:35
  Speaker 2: about their periods, and then all of a sudden, all
• 5:37
  Speaker 2: these changes started happening in your body, and then you
• 5:40
  Speaker 2: start bleeding on top of that, and it was horrifying. Well,
• 5:44
  Speaker 2: the same thing happens entering, you know, perimenopause, and we
• 5:49
  Speaker 2: don't prepare women for it. And so when all of
• 5:52
  Speaker 2: these things start happening and they're you know, the list
• 5:55
  Speaker 2: of perimenopausal and menopausal symptoms is growing every day. I
• 5:59
  Speaker 2: think we're up to like thirty four plus symptoms. But
• 6:03
  Speaker 2: when they happen and in no particular order, you're shocked
• 6:07
  Speaker 2: by them, or you think that there's something wrong, And unfortunately,
• 6:12
  Speaker 2: because you don't realize that it's all part of a
• 6:14
  Speaker 2: constellation of symptoms, it is a transition. Women sort of
• 6:18
  Speaker 2: parcel out their symptoms to different doctors. Oh I'm depressed
• 6:23
  Speaker 2: or anxious, Maybe I should be on an antidepressant. Oh
• 6:25
  Speaker 2: i'm gaining weight, maybe I should see an endocrinologist, and
• 6:29
  Speaker 2: you see how we treat the individual symptoms without realizing
• 6:32
  Speaker 2: that it's all part of a bigger picture. And you know,
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  Speaker 2: the unfortunate thing is not only women who are caught unawares,
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  Speaker 2: but there is a generation of doctors who have not
• 6:44
  Speaker 2: been trained and know how to adequately treat and counsel
• 6:48
  Speaker 2: women in perimenopause and menopause as well. And that's the
• 6:51
  Speaker 2: unfortunate part. When you need the help the most and
• 6:53
  Speaker 2: the most trusted source would be your doctor, and your
• 6:56
  Speaker 2: doctor doesn't know what to do, then you're just really
• 6:59
  Speaker 2: left out there on your well.
• 7:02
  Speaker 1: Yes, and we're going to talk about that more in
• 7:05
  Speaker 1: a bit because Samantha and I both have recently had
• 7:08
  Speaker 1: some health issues and we want to be the show
• 7:12
  Speaker 1: very open about it on the show, so we'll talk
• 7:15
  Speaker 1: about that in a second. But I did want to
• 7:17
  Speaker 1: One of the reasons we knew this would be a
• 7:20
  Speaker 1: really good fit to have this conversation with you is
• 7:23
  Speaker 1: one thing we do discuss on the show is how
• 7:27
  Speaker 1: often women aren't believed when it comes to the medical field,
• 7:32
  Speaker 1: or in some cases present different symptoms than men do.
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  Speaker 1: And that's what's been kind of long studied or haven't
• 7:39
  Speaker 1: been studied at all, and when it comes to certain
• 7:42
  Speaker 1: condition and how that gets worse when you add other
• 7:47
  Speaker 1: intersections like race or sexual orientation and you dig into
• 7:51
  Speaker 1: a lot of these issues around these disparities. On your
• 7:55
  Speaker 1: podcast with interviews from topics around birth to depression, you
• 8:00
  Speaker 1: dismiss the symptoms, right, Can you break down some of
• 8:04
  Speaker 1: this for us as someone who has been working in
• 8:07
  Speaker 1: this field for decades.
• 8:09
  Speaker 2: Well, you know, the one thing that I want your
• 8:11
  Speaker 2: listeners to understand is this is that the medical profession
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  Speaker 2: generally has been dismissive of women, you know, and it
• 8:19
  Speaker 2: wasn't until even eighteen fifties that it was even deemed
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  Speaker 2: that the study of women's reproductive issues was even a
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  Speaker 2: thing that was worthy of studying. And unfortunately, it had
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  Speaker 2: very fraud roots. And that was with Jay Mary and Simms,
• 8:35
  Speaker 2: who experimented a lot on enslaved women. And unfortunately, you know,
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  Speaker 2: he gets touted as being this father of gynecology and
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  Speaker 2: the inventor of the field, but there was no knowledge
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  Speaker 2: and no really acknowledgment of the women that he experimented
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  Speaker 2: on on Narka, Betsy and Lucy who are the only
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  Speaker 2: names that we know that helped him create the field.
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  Speaker 2: And this man went on to become the president of
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  Speaker 2: the American Medical Association. He was the founder of the
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  Speaker 2: first women's hospital in New York City. So you know,
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  Speaker 2: that's how we started, you know, so you can imagine
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  Speaker 2: there's a lot of bias. There's a lot of not
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  Speaker 2: really understanding the importance and the really and acknowledging the
• 9:23
  Speaker 2: autonomy of women. You know, women were to be dealt with,
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  Speaker 2: and then if you complained, you were hysterical or you
• 9:32
  Speaker 2: were it was all in your head and you were
• 9:34
  Speaker 2: just behaving badly. You know, women, if you would just
• 9:38
  Speaker 2: stop all this whining, perhaps you'd feel better. And this
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  Speaker 2: is and that goes from Freud to you know, the
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  Speaker 2: medical profession, i'd say writ large even to today. So
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  Speaker 2: that's a lot of infrastructure that's been built in that
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  Speaker 2: all of us as physicians have been trained in this
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  Speaker 2: same tradition of thinking that women make things, or that
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  Speaker 2: all of our health problems are really psychological problems, they're
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  Speaker 2: not really physical problems, and not looking at the whole
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  Speaker 2: woman rather than just our separate parts.
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  Speaker 1: Absolutely, yes, and it's very disheartening in some ways that
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  Speaker 1: we're still having these conversations, and it's also I'm glad
• 10:24
  Speaker 1: that we are. And yeah, one of the things you
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  Speaker 1: talk about in your intros is being your own best advocate, right,
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  Speaker 1: And I did recently have a pretty scary medical experience
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  Speaker 1: where I wished I'd had someone as an advocate, even
• 10:44
  Speaker 1: if it was me, because it so quickly I turned
• 10:47
  Speaker 1: it into oh, I'm exaggerating. I was doing the gaslighting myself,
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  Speaker 1: which I know you talked about in the shows as well,
• 10:53
  Speaker 1: and Samantha and I have been we've talked about that
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  Speaker 1: where we're so ready to not be believed that it
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  Speaker 1: has to be like I'm about to die before I
• 11:02
  Speaker 1: go seek help. Why do you think it's important for
• 11:07
  Speaker 1: women to have this information, understand this information, and the
• 11:11
  Speaker 1: value of having a friend or an advocate.
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  Speaker 2: Well, you know I write about this in my book
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  Speaker 2: and Grown a Woman Talk, because you know, my book
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  Speaker 2: is not just about menopause. It is really about how
• 11:24
  Speaker 2: to navigate and advocate for yourself in a medical system
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  Speaker 2: that oftentimes doesn't see you, doesn't hear you. And so
• 11:32
  Speaker 2: if you understood a little bit more about how the
• 11:34
  Speaker 2: system worked and why it is that way, then it
• 11:38
  Speaker 2: helps you better advocate for yourselves. And I think the
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  Speaker 2: biggest myth that we have, and you know I get it,
• 11:46
  Speaker 2: but you know, there's this notion that the doctor knows everything.
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  Speaker 2: If I feel a certain way and the doctor tells
• 11:51
  Speaker 2: me it's nothing, then it must be nothing because the
• 11:54
  Speaker 2: doctor knows more than I do. That's sort of the
• 11:56
  Speaker 2: nature of the doctor patient relationship. And it's only you know,
• 12:00
  Speaker 2: it's only really exaggerated when it comes to women, but
• 12:03
  Speaker 2: it's that way generally. You know, the doctor knows best,
• 12:06
  Speaker 2: not really, so we sort of take a backseat. And
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  Speaker 2: I want you know, I wrote the book with the
• 12:14
  Speaker 2: intent that you understand enough. Nobody's trying to send you
• 12:18
  Speaker 2: to medical school. That's not the point. I don't want
• 12:20
  Speaker 2: you to argue, you know, differential diagnoses with your doctor,
• 12:24
  Speaker 2: but I want you to be able to clearly, clearly
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  Speaker 2: articulate what your issues are and to not leave that
• 12:32
  Speaker 2: interaction without having a concrete plan or a follow up
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  Speaker 2: about what we're going to do about it. Because for
• 12:40
  Speaker 2: someone to say, oh, you're fine, no, no, no, if
• 12:44
  Speaker 2: you know that you're not, remember no one is a
• 12:47
  Speaker 2: better expert of you than you. So if you get
• 12:52
  Speaker 2: an answer that seems satisfactory to you, and you can
• 12:55
  Speaker 2: follow up with that, that's fine, But don't ever be
• 12:57
  Speaker 2: dismissed and then leave and continue to have that part
• 13:00
  Speaker 2: problem and not get it addressed, because that's how, really
• 13:04
  Speaker 2: how we get into trouble. And I think that that's
• 13:06
  Speaker 2: how women really disengage sometimes from the medical community, and
• 13:12
  Speaker 2: then you go to quackery, you know, because you still
• 13:15
  Speaker 2: you still are having whatever the issue is. And if
• 13:18
  Speaker 2: you don't get an answer there, then trust me, there's
• 13:20
  Speaker 2: going to be somewhere, somewhere out there in the world
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  Speaker 2: who's going to give you, you know, a crystal amulet
• 13:28
  Speaker 2: or you know, a magic herb or something, and you
• 13:31
  Speaker 2: so want that relief. And that's the point that I
• 13:35
  Speaker 2: want to make is that the best your best option
• 13:38
  Speaker 2: really is a medical professional know when to leave. You know,
• 13:42
  Speaker 2: if someone is not serving you, then you say, all right,
• 13:46
  Speaker 2: well that was unsatisfactory. You know, I used the analogy
• 13:51
  Speaker 2: all the time. I said, you know, if you went
• 13:53
  Speaker 2: to a restaurant and you got bad service, would you
• 13:55
  Speaker 2: continue to eat there? You know, move on? There will
• 13:59
  Speaker 2: be someone else, or you know, at the very least
• 14:02
  Speaker 2: give them the the expectation in this interaction that you're
• 14:09
  Speaker 2: an adult. You know that you are capable of making decisions.
• 14:13
  Speaker 2: And let me say this to you that the reason
• 14:15
  Speaker 2: why I say that the whole concept of a second
• 14:19
  Speaker 2: opinion even exists is because a lot of medicine is interpretation.
• 14:25
  Speaker 2: We may be arguing from the same set of facts
• 14:29
  Speaker 2: or data, but how that is interpreted may vary from
• 14:32
  Speaker 2: one person to another. And so to imply that everything
• 14:37
  Speaker 2: or every answer, you know, every problem has one answer,
• 14:42
  Speaker 2: is not true. So you know, if you you know,
• 14:45
  Speaker 2: and I said, I'm very liberal about the fact about
• 14:48
  Speaker 2: second opinions, and when I was practicing, I would tell
• 14:51
  Speaker 2: my patients, you know, I would tell them, I say, look,
• 14:54
  Speaker 2: I'm very clear about what I know and what I
• 14:56
  Speaker 2: think you know. And I do get to have that
• 14:59
  Speaker 2: a pain, and it might be, yes, a little bit
• 15:02
  Speaker 2: more informed than your opinion, but I'll at least tell
• 15:04
  Speaker 2: you why, and then you get to decide which of
• 15:08
  Speaker 2: those opinions makes most sense for you. And that is
• 15:13
  Speaker 2: really the crux of how this relationship has to be
• 15:16
  Speaker 2: moving forward and not just someone telling you what to do.
• 15:21
  Speaker 2: You know, we're adults, we're grown women. I don't need
• 15:23
  Speaker 2: to be lectured to and I don't need to be dismissed,
• 15:26
  Speaker 2: but I do need to be involved in the most
• 15:28
  Speaker 2: important thing of all, which is my health.
• 15:32
  Speaker 1: Oh I wish i'd found you earlier, Saul could have
• 15:35
  Speaker 1: helped me.
• 15:36
  Speaker 2: It's never too late. It's never too late.
• 15:39
  Speaker 4: Yes.
• 15:40
  Speaker 1: Yes. Something that is so great about what you're doing now.
• 15:53
  Speaker 1: What you focus on is accessibility, making healthcare more accessible,
• 15:59
  Speaker 1: because it is a lot of it is very complicated
• 16:03
  Speaker 1: and very intimidating, and so when you're trying to understand
• 16:07
  Speaker 1: it as someone outside the medical field, it can just
• 16:11
  Speaker 1: be so complicated and a lot of the stuff you
• 16:16
  Speaker 1: talk about on the podcast, it's very complicated, but you
• 16:20
  Speaker 1: explain it in a way that is understandable, not condescending
• 16:24
  Speaker 1: at all, very like, Okay, I get this now I
• 16:29
  Speaker 1: have the facts, and maybe I can understand more about
• 16:32
  Speaker 1: what's going on with me or what have you. How
• 16:35
  Speaker 1: did you come by that skill and what are the
• 16:38
  Speaker 1: challenges of it?
• 16:39
  Speaker 2: Well, you know, I'm first off, I was a regular
• 16:42
  Speaker 2: person for a lot longer than I was a doctor,
• 16:45
  Speaker 2: and I have been on the other side of that desk,
• 16:50
  Speaker 2: you know, with family members and with friends. So the
• 16:54
  Speaker 2: one thing that really struck me was that if you
• 16:58
  Speaker 2: listen to two doctors who talk to each other, we
• 17:02
  Speaker 2: really do have a different language, you know, and I
• 17:05
  Speaker 2: understand what someone's saying, but the person who's sitting there
• 17:08
  Speaker 2: next to me, that I may be there with a
• 17:10
  Speaker 2: family member or a friend, I know that they don't
• 17:14
  Speaker 2: understand that. And I think for a lot of doctors,
• 17:17
  Speaker 2: they forget that that you're talking to regular people and
• 17:22
  Speaker 2: that we're using terms and we're saying things and throwing
• 17:25
  Speaker 2: out numbers and facts and figures that don't make sense.
• 17:30
  Speaker 2: And so there's a way to have that conversation, but
• 17:32
  Speaker 2: to have it in regular person speak. And so I've
• 17:37
  Speaker 2: always just sort of approached how I speak to patients,
• 17:40
  Speaker 2: how I would speak to another adult who perhaps does
• 17:45
  Speaker 2: not We don't speak the same language, but I think
• 17:48
  Speaker 2: I can be an interpreter. I can take doctor speak
• 17:53
  Speaker 2: and translate it into regular person speak, and it doesn't
• 17:57
  Speaker 2: mean that that is condescending. You're not speaking, You're just
• 18:00
  Speaker 2: making sure that people understand what you're saying. And you know,
• 18:05
  Speaker 2: for those of you who don't know me, I have
• 18:07
  Speaker 2: a musical reference for everything throughout my book I have,
• 18:10
  Speaker 2: you know, I have a playlist. I have music in there,
• 18:12
  Speaker 2: and there's a line from the great Erica Badou and
• 18:17
  Speaker 2: she says, what good do your words do if they
• 18:20
  Speaker 2: don't understand you? And that's sort of the approach that
• 18:24
  Speaker 2: I take when I'm talking to patients. You know, I've
• 18:26
  Speaker 2: always been of the mind that women are capable women
• 18:31
  Speaker 2: people are capable of making good decisions for themselves if
• 18:36
  Speaker 2: they are presented with facts that they can understand or
• 18:41
  Speaker 2: options that they can understand. But a lot of people,
• 18:45
  Speaker 2: I think, go in and particularly of my generation, and
• 18:48
  Speaker 2: before they expect that the doctor's just supposed to tell
• 18:51
  Speaker 2: you what to do. And now it's a partnership and
• 18:55
  Speaker 2: you and your doctors should be in this together and
• 18:57
  Speaker 2: our goals are the same, and it's to you resolve
• 19:01
  Speaker 2: whatever issues you may have. And you know, and I
• 19:05
  Speaker 2: think for me as a doctor, there should be an
• 19:08
  Speaker 2: element of humility. I know what I know, and I
• 19:11
  Speaker 2: know what I don't know, and when I don't know it,
• 19:14
  Speaker 2: then I'm going to make sure that I get you
• 19:16
  Speaker 2: to someone that does know it. But I would never
• 19:19
  Speaker 2: say because I can't figure it out, that it's unfigure outable.
• 19:23
  Speaker 2: You know, I may not know the answer, so let's
• 19:26
  Speaker 2: go figure out where we can get you to someone
• 19:28
  Speaker 2: that could get you a better resolution than I could.
• 19:32
  Speaker 3: There's so much in that conversation. I'm like you being
• 19:35
  Speaker 3: willing to say I don't know. I feel like that
• 19:37
  Speaker 3: doesn't happen enough in any profession. If someone thinks that
• 19:40
  Speaker 3: they're a professional, they truly believe then they are the
• 19:43
  Speaker 3: end all, and not enough people are willing to say
• 19:46
  Speaker 3: this is wrong. And I think we see that as
• 19:48
  Speaker 3: a whole when it comes to any kind of system.
• 19:51
  Speaker 3: But in the medical field, especially right now, especially as
• 19:54
  Speaker 3: we're trying to navigate insurances that have monopolies, as well
• 19:57
  Speaker 3: as the decreasing in meta care and Medicare, or like
• 20:01
  Speaker 3: what's being covered and what's not. Overall, there's so many things,
• 20:05
  Speaker 3: especially in the US, I guess we need to keep
• 20:07
  Speaker 3: that regional in this speak and in this timeframe of
• 20:11
  Speaker 3: healthcape that we are in that right now, everything seems
• 20:16
  Speaker 3: like it's getting worse for the normal person, a person
• 20:20
  Speaker 3: who's covered by the insurance system, whether it be the
• 20:24
  Speaker 3: affordable healthcare or whether it is Medicare or Medicare. What
• 20:28
  Speaker 3: do you see are some of the biggest failures that
• 20:31
  Speaker 3: are happening and what do you think maybe some of
• 20:33
  Speaker 3: the fixes or are there fixes, Like I don't know
• 20:37
  Speaker 3: when we're talking about with COVID times we have now telehealth,
• 20:42
  Speaker 3: but that's slowly slipping backwards, but things like that, what
• 20:45
  Speaker 3: could be some of those fixes.
• 20:46
  Speaker 2: Well, I tell you we're at this very serious inflection
• 20:49
  Speaker 2: point now just in healthcare, healthcare delivery. Healthcare costs a
• 20:54
  Speaker 2: lot of things, and there's a lot that contributes to that,
• 20:57
  Speaker 2: and that is one. We are facing a current and
• 21:05
  Speaker 2: increasingly worse worsening doctor shortage. Okay, because we have you know,
• 21:13
  Speaker 2: we have now we're in just in my field alone
• 21:16
  Speaker 2: in obg I in we're going to be in relatively
• 21:19
  Speaker 2: short about five thousand obgy in short. But even that
• 21:24
  Speaker 2: five thousand doctor shortage is not evenly distributed. There are
• 21:27
  Speaker 2: over fifty percent of the counties in the United States
• 21:29
  Speaker 2: that do not have a practicing OBGYN. We have a
• 21:33
  Speaker 2: shortage of primary care doctors. The aging population, the over
• 21:38
  Speaker 2: sixty five group is growing, is the fastest growing demographic,
• 21:42
  Speaker 2: and we don't have geriatricians. We don't have doctors you know,
• 21:46
  Speaker 2: solely devoted to aging patients. And so the kind of
• 21:51
  Speaker 2: care that you're going to get is spotty. You know,
• 21:54
  Speaker 2: you where you live is going to determine whether or
• 21:57
  Speaker 2: not you have access to quality healthcare. And even if
• 22:00
  Speaker 2: you're in a place like New York City or Washington,
• 22:03
  Speaker 2: d C. The shortages are here because it's affected by
• 22:09
  Speaker 2: whether or not you have insurance. There's so many doctors
• 22:12
  Speaker 2: that are so frustrated with the system and the insurance
• 22:15
  Speaker 2: market that they are coming out of the insurance marketplace.
• 22:22
  Speaker 2: So you get a really good doctor in there, you know,
• 22:25
  Speaker 2: and they're frustrated and they're saying, you know what, I'm
• 22:27
  Speaker 2: not doing this anymore. I'm going to I'm going to
• 22:30
  Speaker 2: be a concierge doctor, or I'm going to be fee
• 22:32
  Speaker 2: for service. So that bottleneck that already exists because of
• 22:36
  Speaker 2: just the changing demographics, it gets tighter and tighter. Women
• 22:41
  Speaker 2: who are increasingly, you know, a larger percentage of the
• 22:45
  Speaker 2: doctor workforce are leaving in droves. Young women who are
• 22:49
  Speaker 2: in their forties. I at least was sixty two when
• 22:52
  Speaker 2: I left. But women who are in their mid forties
• 22:55
  Speaker 2: are saying, you know what, I'm out of here, I'm done.
• 22:57
  Speaker 2: I'm finding another I'm finding an exit ramp, and I'm
• 23:00
  Speaker 2: going to do something that's maybe medical related but not
• 23:03
  Speaker 2: direct patient care. And that's creating you know, it's creating
• 23:07
  Speaker 2: a chasm between the need and being able to meet
• 23:11
  Speaker 2: that need. So what are we going to do about it? Well,
• 23:14
  Speaker 2: we can't clone doctors, okay, But I think what we
• 23:18
  Speaker 2: can do is realize that this is the time where
• 23:22
  Speaker 2: we have the technology and we have the wherewithal that
• 23:25
  Speaker 2: we're going to have to alter how we deliver care,
• 23:29
  Speaker 2: just like we changed you know, fifty sixty years ago,
• 23:33
  Speaker 2: where a doctor used to make a house call. Guess what,
• 23:36
  Speaker 2: we don't do that anymore, you know, and patients got
• 23:38
  Speaker 2: used to it. Well, now we are. We're sort of
• 23:42
  Speaker 2: understanding that there are a lot of things that need
• 23:45
  Speaker 2: that can be done in a digital health space. You know,
• 23:50
  Speaker 2: not everything requires an in person visit. Yes, there are
• 23:53
  Speaker 2: things that do, but the things that don't we're going
• 23:56
  Speaker 2: to have to offload that. We're going to have to
• 23:58
  Speaker 2: harness technology. We're going to have to use artificial intelligence
• 24:03
  Speaker 2: intelligently such that we can meet the needs of our patients.
• 24:07
  Speaker 2: And it's going to involve sort of broadening the population
• 24:12
  Speaker 2: of healthcare providers. It will be nurse practitioners, it'll be
• 24:15
  Speaker 2: physicians assistants, because the point is that you get what
• 24:19
  Speaker 2: you need. And doctors do a lot of things, and
• 24:21
  Speaker 2: particularly obgi ns. You know, on any given day, we're
• 24:25
  Speaker 2: a social worker, we're you know, a psychologist, we're a
• 24:28
  Speaker 2: marriage counselor oh yeah, and we deliver babies and do
• 24:30
  Speaker 2: surgery and we're supposed to talk to you about menopause,
• 24:34
  Speaker 2: which is which is a thing in and of itself,
• 24:37
  Speaker 2: and to be honest with you, it's just too much.
• 24:40
  Speaker 2: And so we're going to have to figure out, you know,
• 24:42
  Speaker 2: how do we reorganize, you know, how do we get
• 24:46
  Speaker 2: more efficient? You know, that's why, you know, when I
• 24:50
  Speaker 2: left my practice, I wasn't done being a doctor. I
• 24:54
  Speaker 2: was just done working in that particular space. And so
• 25:00
  Speaker 2: when I had the opportunity at Alloy to be in
• 25:03
  Speaker 2: on the ground floor and to say, all right, if
• 25:06
  Speaker 2: we're going to do menopause, how would we reimagine getting
• 25:10
  Speaker 2: that care too, and the accessibility to women who need it,
• 25:16
  Speaker 2: and to do that affordably. Those were the two missions
• 25:21
  Speaker 2: at hand. And I think that we've done that, and
• 25:24
  Speaker 2: that's it's just the you know, this is just the
• 25:27
  Speaker 2: tip of the iceberg. But there's a lot of stuff
• 25:29
  Speaker 2: that we're going to see in the next few years
• 25:31
  Speaker 2: that you know is really going to involve technology. And
• 25:34
  Speaker 2: for your generation, who's really you know, you're already digitally
• 25:38
  Speaker 2: savvy and you know how to do this. It won't
• 25:40
  Speaker 2: be odd to you, just like it was not odd
• 25:43
  Speaker 2: to me. Why would I expect the doctor to come
• 25:46
  Speaker 2: to my house? That would be ridiculous. You know, it'll
• 25:48
  Speaker 2: be the same thing. Why do I have to take
• 25:50
  Speaker 2: a day off from work and go pay money and
• 25:52
  Speaker 2: sit and pay for parking and wait for an hour
• 25:55
  Speaker 2: for a doctor to tell me you're fine? Maybe I am,
• 25:58
  Speaker 2: maybe I'm not, But I did I need to do
• 26:00
  Speaker 2: all that for that?
• 26:01
  Speaker 4: Yeah, you know, oh pay for parking. That annoys me,
• 26:04
  Speaker 4: not to know. I don't know why, but that was
• 26:07
  Speaker 4: just like a ma cherry on top.
• 26:09
  Speaker 2: If I heard one more time a patient asked me,
• 26:11
  Speaker 2: do you validate parking? No, we don't. We don't validate
• 26:15
  Speaker 2: park I.
• 26:15
  Speaker 3: Will say for our healthcare person that are like they
• 26:17
  Speaker 3: told us at the beginning, did you park here?
• 26:19
  Speaker 4: All right? We can validate like they just didn't. Just
• 26:21
  Speaker 4: we're already we didn't.
• 26:22
  Speaker 2: Oh, if we validated parking, we would like we'd go
• 26:25
  Speaker 2: into negative dollars for the visit.
• 26:27
  Speaker 3: You know, it's like, oh, there's so many things I
• 26:29
  Speaker 3: have to ask Let me ask you what your thoughts
• 26:31
  Speaker 3: are on medical tourism.
• 26:34
  Speaker 2: Oh, you know what, it's it's scary to me.
• 26:39
  Speaker 4: Like the way you begin that if it was like, oh, yeah, no, because.
• 26:43
  Speaker 2: I mean, I don't you know, let me say this.
• 26:45
  Speaker 2: Let me tell you this is falls in the category
• 26:47
  Speaker 2: of what I think now, what I know right right, right,
• 26:49
  Speaker 2: all right, So I would be very wary of going
• 26:53
  Speaker 2: to another country. Maybe it's fine, maybe it's not. But again,
• 26:58
  Speaker 2: it tells you the that people will go to to
• 27:03
  Speaker 2: get care for something because it's so out of hand here,
• 27:07
  Speaker 2: you know. And I hate to be the bearer of
• 27:09
  Speaker 2: bad news, you know, but once the price of something
• 27:11
  Speaker 2: goes up, it very rarely goes down, you know. You can.
• 27:16
  Speaker 2: All you can do and hope for in medicine is
• 27:19
  Speaker 2: that we that we put pump the brakes on some
• 27:23
  Speaker 2: of it, you know. And maybe but I'm gonna I'm
• 27:28
  Speaker 2: gonna go back step farther and I'm gonna I'm gonna
• 27:31
  Speaker 2: say something that doctors would probably like not to hear
• 27:36
  Speaker 2: me say. But it's true. Doctors have to make a living, right,
• 27:40
  Speaker 2: I get it right, you know. And unfortunately, this is
• 27:43
  Speaker 2: the the vice gript that doctors are in. You go
• 27:48
  Speaker 2: to school, you've got a mountain of debt when you
• 27:51
  Speaker 2: get out. I mean basically, you get out of med
• 27:53
  Speaker 2: school and you've already bought your first house, and it's
• 27:55
  Speaker 2: called here's my medical debt, my tuition debt from from
• 27:59
  Speaker 2: mets school and college. And you're in this this this
• 28:06
  Speaker 2: constant push and pull with insurance companies. Insurance companies will
• 28:10
  Speaker 2: tell you I don't care what you charge. This is
• 28:13
  Speaker 2: what I'm going to pay, so you know it maybe
• 28:16
  Speaker 2: fifty percent it maybe thirty percent of what your charge is.
• 28:20
  Speaker 2: So there's this this, this this real economic pressure that
• 28:26
  Speaker 2: doctors have. You know, we they're high and let me
• 28:29
  Speaker 2: say highly trained professionals. You know, they deserve their time
• 28:33
  Speaker 2: is worth something. But you have someone else who is
• 28:37
  Speaker 2: telling you what your time is worth, you know, and
• 28:39
  Speaker 2: so many of the medical practice is now. As a
• 28:43
  Speaker 2: you know, as a physician, I was not just a physician.
• 28:46
  Speaker 2: I was a I was a business. I was a
• 28:48
  Speaker 2: small business owner. Our practice was independent. We ran a practice.
• 28:52
  Speaker 2: We could make decisions about what days I was going
• 28:55
  Speaker 2: to work, what days I didn't want to work, how off,
• 28:58
  Speaker 2: you know, And it was all sort of based on
• 29:00
  Speaker 2: what my particular needs were at that time. And now
• 29:03
  Speaker 2: that so many medical practices have been bought by private
• 29:07
  Speaker 2: equity groups or they've been subsumed by large universities and
• 29:11
  Speaker 2: hospital groups, doctors are no longer in control of their time.
• 29:15
  Speaker 2: They're not. So you're being told, now, okay, you're going
• 29:19
  Speaker 2: to see this is how many patients you're going to
• 29:21
  Speaker 2: see a day, this is how this is what your
• 29:24
  Speaker 2: productivity plan is about how you get paid. I mean,
• 29:28
  Speaker 2: that's very disheartening for people who have been medical professionals,
• 29:33
  Speaker 2: thinking that you're going to have some autonomy and you do.
• 29:36
  Speaker 2: Most doctors now that you will see and you can
• 29:40
  Speaker 2: check this out, most of them are employees, you know,
• 29:43
  Speaker 2: or somehow or the other. They're not in control of that.
• 29:46
  Speaker 2: So there's a real economic pressure and people will do
• 29:50
  Speaker 2: sort of a lot of machinations to around the system
• 29:53
  Speaker 2: because the payment the repayment schedule is so complicated that
• 29:59
  Speaker 2: there is a tendency to say, okay, well, you're only
• 30:02
  Speaker 2: going to pay me fifty percent for this and twenty
• 30:05
  Speaker 2: percent for that, so I'll just put as many things
• 30:08
  Speaker 2: in there as I can to charge for in the
• 30:10
  Speaker 2: hopes that in aggregate it'll end up being just a
• 30:14
  Speaker 2: fair price for my time and my work. And those
• 30:18
  Speaker 2: are the games that we play with insurance companies. That's
• 30:21
  Speaker 2: the game that we play with Medicare and medicaid. But
• 30:24
  Speaker 2: at the end of the day, no one has yet
• 30:26
  Speaker 2: said this makes no sense. You know, why don't we
• 30:30
  Speaker 2: decide what's fair, what's accurate, how to do it so
• 30:34
  Speaker 2: people don't have to play these games. But who I'll
• 30:37
  Speaker 2: tell you who gets hurt by that? Okay, you have
• 30:40
  Speaker 2: your insurance, so you go in, you pay, you get
• 30:43
  Speaker 2: your copay, or you have your surgery or whatever. The
• 30:47
  Speaker 2: insurance company, let's just say they pay me fifty cents
• 30:50
  Speaker 2: on a dollar. You, Samantha, come in with the same issue,
• 30:54
  Speaker 2: you have the same procedures done, but you don't have insurance,
• 30:58
  Speaker 2: or you have insurance has a really high deductible. Guess what,
• 31:04
  Speaker 2: you have to pay one hundred percent. You don't get
• 31:08
  Speaker 2: a discount because I say, well, you know what, this
• 31:10
  Speaker 2: insurance company is only going to pay me fifty percent,
• 31:13
  Speaker 2: So you pay fifty percent. No, you pay one hundred percent,
• 31:16
  Speaker 2: so you see what I mean. So you've got this
• 31:18
  Speaker 2: this patchwork system where the people who get hurt the
• 31:22
  Speaker 2: most are the people who can afford it the least,
• 31:27
  Speaker 2: because these are people who can't afford insurance or for
• 31:31
  Speaker 2: whatever reason, you know, are caught in that gap. Maybe
• 31:34
  Speaker 2: you're between jobs, and you know, so it's not an
• 31:38
  Speaker 2: accident that the number one reason for bankruptcy in this
• 31:41
  Speaker 2: country is medical debt because the people that can't pay,
• 31:46
  Speaker 2: you know, what are you going to do? You can't say, well,
• 31:50
  Speaker 2: that's all right, I'll just die. No, that's not a
• 31:52
  Speaker 2: that's not an acceptable answer to that. So you know,
• 31:56
  Speaker 2: our system's broken. That's the bottom line. It's broken. It's
• 32:00
  Speaker 2: unnecessarily complicated. And you know, the best example that I
• 32:05
  Speaker 2: can give you, and you may be too young to
• 32:07
  Speaker 2: remember this, but I'll tell you because I remember the
• 32:12
  Speaker 2: old in the old days, what's about to happen to
• 32:15
  Speaker 2: doctors is what has happened to pharmacies and pharmacists. Okay,
• 32:21
  Speaker 2: there was a time in the not too distant past
• 32:24
  Speaker 2: when pharmacies were independently owned. You know, you had you
• 32:29
  Speaker 2: into your corner pharmacy. The pharmacist there was usually the
• 32:35
  Speaker 2: owner of the pharmacy. They are trained professionals. They were
• 32:40
  Speaker 2: back there. They weren't just you know, taking a pill
• 32:44
  Speaker 2: out of one big bottle and putting in a little bottle.
• 32:47
  Speaker 2: They were doing things they knew. They would counsel patients,
• 32:50
  Speaker 2: they would actually compound things back there. So it was
• 32:53
  Speaker 2: a very different pharmacist that you were looking at now
• 32:57
  Speaker 2: and very well respected in the community. Well what do
• 33:00
  Speaker 2: you think of now when you think of a pharmacist.
• 33:03
  Speaker 2: Do you think of they're just back there? You know,
• 33:06
  Speaker 2: they're they're working at nay any pharmacies, CVS, Walgreens or whatever.
• 33:11
  Speaker 2: They're a technical in your eyes, they're a technician. All
• 33:15
  Speaker 2: they're doing you know, what are you doing? It's like,
• 33:17
  Speaker 2: how hard could that be? Here and there? And so
• 33:21
  Speaker 2: we have sort of devalued the profession, even though those
• 33:26
  Speaker 2: people are just as highly trained as the pharmacists, probably
• 33:32
  Speaker 2: more so because they have more things to think about
• 33:34
  Speaker 2: from fifty years ago. But you don't think of that
• 33:37
  Speaker 2: pharmacist at CVS as someone being you know, yeah, this
• 33:41
  Speaker 2: person's going to give me some advice and go make
• 33:44
  Speaker 2: me something if I can't take it. I used to
• 33:46
  Speaker 2: love the pharmacists here because my children, you know, children
• 33:51
  Speaker 2: don't like to take yucky medicine. And he would actually
• 33:56
  Speaker 2: compound their antibiotics, so it would be bubblegum flavor, or
• 33:59
  Speaker 2: it will be this whatever. He would make it and
• 34:02
  Speaker 2: loved it. Okay, No, they don't do that anymore, And
• 34:06
  Speaker 2: so medicine is becoming where doctors, I think doctors time
• 34:11
  Speaker 2: is devalued. And I don't think doctors. No one went
• 34:15
  Speaker 2: into medicine because they wanted to do a bad job
• 34:17
  Speaker 2: or be dismissive. But if you were under that pressure,
• 34:20
  Speaker 2: Oh my goodness, I've got a patient every fifteen minutes,
• 34:24
  Speaker 2: then you annie needing more time that may or may
• 34:28
  Speaker 2: not happen. Or it's just say come back another day,
• 34:30
  Speaker 2: you know, and now another parking, another half day off
• 34:34
  Speaker 2: from work, just to get your questions answered. There's a
• 34:37
  Speaker 2: better way, and we just got to you know, we
• 34:41
  Speaker 2: have the tools. We've just got to figure out how
• 34:42
  Speaker 2: to put it all together.
• 34:44
  Speaker 1: Yes, I recently had an experience where I was, I'm
• 34:48
  Speaker 1: trying to find a doctor, and I was. I went
• 34:51
  Speaker 1: to a place near me. There was a sign on
• 34:56
  Speaker 1: the window and it was quite long and it was
• 34:58
  Speaker 1: about how how they do insurance M M. And I
• 35:03
  Speaker 1: just remember thinking, yes, there's got to be a better
• 35:06
  Speaker 1: way than this, because clearly the doctor's frustrated. I can't
• 35:11
  Speaker 1: understand any of this.
• 35:13
  Speaker 2: So to this day, to this day, I do not understand.
• 35:18
  Speaker 2: There's so much about insurance that I don't understand. I'm like, wall,
• 35:20
  Speaker 2: what you know you get when you go to a doctor,
• 35:24
  Speaker 2: and you get when you fire your insurance and you
• 35:26
  Speaker 2: get what's called a EOB which is an explanation of benefits,
• 35:30
  Speaker 2: and I call it it's confusion of benefits. I'm like,
• 35:34
  Speaker 2: I don't know, so wait, wait a minute, that didn't
• 35:36
  Speaker 2: get paid for what? And it is? It is a
• 35:38
  Speaker 2: system that is not designed to confuse you. It is
• 35:43
  Speaker 2: designed to not pay the doctors in a timely fashion,
• 35:48
  Speaker 2: but also to get you. The more you deny a patient,
• 35:53
  Speaker 2: then you've got to decide is it worth it for
• 35:55
  Speaker 2: me to be on the phone for half a day
• 35:57
  Speaker 2: trying to get the answer to this, And increasingly for
• 36:01
  Speaker 2: a lot of people, you're like, you know what, it's
• 36:02
  Speaker 2: not worth it. You know, if it's below a certain amount,
• 36:04
  Speaker 2: you're like, whatever, and so who wins? Who wins? I'm
• 36:10
  Speaker 2: not gonna I'll leave it at that.
• 36:25
  Speaker 1: Well, going back to the technology aspect, because it is
• 36:29
  Speaker 1: true that a lot of us have these expensive We
• 36:34
  Speaker 1: know how expensive going to the doctor will be, and
• 36:37
  Speaker 1: so where do we go. First We go online and
• 36:39
  Speaker 1: we're trying to figure out how serious is this. And
• 36:43
  Speaker 1: one of the interesting things of working on this show
• 36:46
  Speaker 1: is like, for instance, with heart attacks, we know that
• 36:49
  Speaker 1: symptoms for heart attacks look different with women, and so
• 36:53
  Speaker 1: I know that going in, but if I can't find
• 36:56
  Speaker 1: the great information about how different they look, then it's
• 37:01
  Speaker 1: almost just as confusing, if that makes sense, because I
• 37:05
  Speaker 1: now I don't know anything at all, and so I'm
• 37:09
  Speaker 1: just curious because it's interesting that we've reached this point
• 37:11
  Speaker 1: where we know there's a difference, but maybe not quite
• 37:15
  Speaker 1: what the difference is. And then on the other side
• 37:18
  Speaker 1: of that, when I recently went to the hospital, they
• 37:23
  Speaker 1: they told me like, oh, you're too young for this,
• 37:25
  Speaker 1: and you're distressed. And that's something you talk about in
• 37:29
  Speaker 1: your podcast is the kind of the expectation the doctor
• 37:33
  Speaker 1: might have of this, is what a patient of this
• 37:35
  Speaker 1: looks like. So can you talk about all of that?
• 37:40
  Speaker 2: As doctors? This is sort of how we're trained. There's
• 37:43
  Speaker 2: so much to know and honestly learning an individual requires
• 37:50
  Speaker 2: that I have some you know, I have some experience
• 37:53
  Speaker 2: with you. You know, I've seen you once. In my practice,
• 37:56
  Speaker 2: I had seen patients, you know, I've taken care of
• 37:58
  Speaker 2: them since high school through menopause. You know, I know
• 38:02
  Speaker 2: your mother, I know your children, I know your family.
• 38:04
  Speaker 2: So I have context, you know, I don't just have
• 38:07
  Speaker 2: just a random string of facts about what this looks
• 38:10
  Speaker 2: like and what that looks like. I know that you
• 38:12
  Speaker 2: annie complain all the time, Samantha, you never do so
• 38:15
  Speaker 2: how to interpret what comes in from that? But so
• 38:19
  Speaker 2: much of how we make decisions and make diagnoses is
• 38:25
  Speaker 2: really heavily dependent just upon pattern recognition. You know, I
• 38:31
  Speaker 2: have to know that who's at risk for this? You
• 38:34
  Speaker 2: know who's at risk for that? What are the symptoms?
• 38:37
  Speaker 2: How do they all hang together? But it's a pattern,
• 38:40
  Speaker 2: and I have and we have been taught to have
• 38:42
  Speaker 2: a picture in our mind of who presents with what.
• 38:47
  Speaker 2: And that's just built in bias, because that means that
• 38:50
  Speaker 2: just because you don't look like the textbook picture for
• 38:53
  Speaker 2: that thing, that you don't have it. And that's what
• 38:56
  Speaker 2: we lack is really the context and the ability to
• 38:59
  Speaker 2: sort of go beyond this superficial and that's where a
• 39:02
  Speaker 2: lot of racial bias really gets built into the system.
• 39:05
  Speaker 2: That's where a lot of the gender bias gets built
• 39:08
  Speaker 2: into the system because you're thinking, well, for time immemorial,
• 39:12
  Speaker 2: all we had to base these symptoms on really were men,
• 39:16
  Speaker 2: you know, and women weren't even included in clinical trials
• 39:19
  Speaker 2: until nineteen ninety three, which was you know, I mean
• 39:25
  Speaker 2: nineteen ninety three. My first daughter was born in nineteen
• 39:27
  Speaker 2: ninety three, so I'm like, that wasn't that long ago.
• 39:31
  Speaker 2: But women weren't included. So a lot of the things
• 39:35
  Speaker 2: about how symptoms present in women, we're just really sort
• 39:40
  Speaker 2: of understanding that because we never really looked at it
• 39:43
  Speaker 2: or paid into attention. And I didn't coin this phrase,
• 39:46
  Speaker 2: but you know, it's out. I forget who did. But
• 39:49
  Speaker 2: this notion that women are not small men, you know,
• 39:52
  Speaker 2: and how we present is very different. We can have
• 39:56
  Speaker 2: the same condition like heart attacks, and when we talk
• 40:00
  Speaker 2: about and this is how biased the conversation is when
• 40:02
  Speaker 2: we talk about heart attacks and women in heart attacks
• 40:05
  Speaker 2: and men, the language is, well, women have atypical symptoms
• 40:11
  Speaker 2: as we present for heart attacks, and it's like, well,
• 40:14
  Speaker 2: really are they atypical? Are they atypical? For men, you know,
• 40:18
  Speaker 2: because you're using that sort of pattern recognition pattern and
• 40:22
  Speaker 2: putting it on and overlaying it on women, and it's
• 40:25
  Speaker 2: not the same. So we are now just becoming aware
• 40:29
  Speaker 2: of the fact that women present differently that different points
• 40:33
  Speaker 2: of our reproductive lives. I mean, that's why we've had
• 40:36
  Speaker 2: so much of an issue with menopause and not understanding
• 40:41
  Speaker 2: that menopause in and of itself is not just a
• 40:45
  Speaker 2: reproductive issue. It's not just the end of your periods yay.
• 40:49
  Speaker 2: It is a total body experience that has effects from
• 40:55
  Speaker 2: your hair to your toes and everything in between. And
• 40:59
  Speaker 2: we haven't really taken into account how menopause and the
• 41:04
  Speaker 2: change in your hormones affects your body composition, your bones,
• 41:09
  Speaker 2: your brain, your heart, you know, whether or not you're
• 41:12
  Speaker 2: diagnosed with diabetes. All of this stuff is hormone dependent
• 41:16
  Speaker 2: and it's different for women than it is for men.
• 41:19
  Speaker 2: And then we also, you know, have when you're at
• 41:22
  Speaker 2: the intersection of gender and race. Then it's even more
• 41:27
  Speaker 2: ridiculous because we have a picture in our mind of
• 41:31
  Speaker 2: who we think has endometriosis. You know, it's a thin
• 41:35
  Speaker 2: white woman. We have a picture in our mind of
• 41:38
  Speaker 2: you know who has depression and anxiety. We have, you know,
• 41:43
  Speaker 2: so all of these little shorthand notes that we use
• 41:47
  Speaker 2: will will leave out a lot of people. And that's
• 41:50
  Speaker 2: what we're really trying to address is to realize that,
• 41:53
  Speaker 2: you know, look at the person, not the stereotype, and
• 41:57
  Speaker 2: listen to what they're saying. And a lot of time times.
• 42:00
  Speaker 2: You know, again that requires time. But we have an
• 42:04
  Speaker 2: opportunity and I think a huge opportunity here because if
• 42:08
  Speaker 2: we're to address this and how we build these large
• 42:13
  Speaker 2: language models for AI, we can either build that same
• 42:18
  Speaker 2: bias into the AI or we can take it out
• 42:22
  Speaker 2: of that. You know, we can make we can make
• 42:25
  Speaker 2: the intake race neutral. You know, I don't have to
• 42:29
  Speaker 2: look at Samantha and say, oh, well, here's an Asian person,
• 42:32
  Speaker 2: and here's a black person, and here's this person. So
• 42:34
  Speaker 2: these things, because again it really sort of gets us
• 42:38
  Speaker 2: on a path that sometimes is hard to get out of.
• 42:41
  Speaker 2: So I think that you know, again, with technology, it's
• 42:44
  Speaker 2: a huge opportunity if we build them correctly, because you know,
• 42:49
  Speaker 2: as we say, garbage in, garbage out, So if you
• 42:52
  Speaker 2: put the same you know, you put the same thing
• 42:55
  Speaker 2: in that what we've been using and what we've been taught,
• 42:57
  Speaker 2: you're going to come up with the same uh out,
• 43:00
  Speaker 2: which is unfortunate, but we have it's a huge, huge opportunity.
• 43:05
  Speaker 2: So you know, I think that the more informed any
• 43:10
  Speaker 2: person is coming into a doctor's office, the better that
• 43:13
  Speaker 2: interaction is going to be. And you can be informed
• 43:16
  Speaker 2: without being aggressive or confrontational. Ask good questions, you know,
• 43:21
  Speaker 2: make the doctor think about it well, like, oh, well,
• 43:23
  Speaker 2: maybe you didn't know that my mother had whatever, or
• 43:29
  Speaker 2: my family history. I may not look like a person
• 43:32
  Speaker 2: who has osteoporosis, but my mother broke her hip and
• 43:35
  Speaker 2: she's in a nursing home. Those are the kinds of
• 43:38
  Speaker 2: contextual things that sometimes doctors don't have the time to
• 43:44
  Speaker 2: ferret out. But if you put them in a system
• 43:48
  Speaker 2: that takes all that into account, then I think you're
• 43:50
  Speaker 2: going to get a better outcome.
• 43:52
  Speaker 3: Right, another big caveat if if they train appropriately.
• 43:57
  Speaker 2: Yeah, but you know what, and this is where I
• 43:59
  Speaker 2: think it's important doctors get involved. You know, don't let
• 44:03
  Speaker 2: other people who are developing this who are really all right,
• 44:07
  Speaker 2: you know, yeah, you're out there to make money. Doctors
• 44:10
  Speaker 2: are really weird technophobes. Let me say, you know, how
• 44:13
  Speaker 2: long how doctors are still complaining about electronic medical records.
• 44:18
  Speaker 2: But that's a classic example of what happens when you
• 44:22
  Speaker 2: develop a system that doesn't really take into account how
• 44:27
  Speaker 2: doctors actually practice this?
• 44:29
  Speaker 3: Right.
• 44:30
  Speaker 2: It's onerous. It's worse now than I think it was
• 44:33
  Speaker 2: when you had a paper chart, just simply because you know,
• 44:36
  Speaker 2: of all the things that you took into account, you
• 44:39
  Speaker 2: didn't take into account, Well, how does this fit into
• 44:42
  Speaker 2: a doctor's workday? How about you know you may have
• 44:45
  Speaker 2: a very thorough chart that you've asked everything, but you
• 44:50
  Speaker 2: have to ask yourself, is a doctor every time that
• 44:53
  Speaker 2: patient walks into your office and it's a different doctor
• 44:56
  Speaker 2: seeing you, are they going to read the fifty seven
• 44:58
  Speaker 2: pages that were generated from your her last visit? Probably not,
• 45:02
  Speaker 2: you know. So that's why I said opportunity, and I
• 45:06
  Speaker 2: urged all my physician friends who said, I said, don't
• 45:09
  Speaker 2: let these things get developed without you, right, without taking
• 45:13
  Speaker 2: into account the things that we need to fix.
• 45:16
  Speaker 3: Right, And that's why it's important to have a diverse group. Yes,
• 45:20
  Speaker 3: it is when it comes to being in these.
• 45:22
  Speaker 2: Faces exactly exactly.
• 45:25
  Speaker 3: And then you know, you brought up heart attacks And
• 45:27
  Speaker 3: I've told the story before, so I'm adopted.
• 45:28
  Speaker 4: My mother is white.
• 45:30
  Speaker 3: But at the age late forties, early fifties, she started
• 45:35
  Speaker 3: having weird symptoms. I was putting quotes weird in that
• 45:38
  Speaker 3: like no one could figure it out. She went through
• 45:39
  Speaker 3: four to five doctors.
• 45:41
  Speaker 4: She had like jaw.
• 45:42
  Speaker 3: Pain, all these other things, and it wasn't your typical thing.
• 45:45
  Speaker 3: She was not necessarily overweight. And when she finally went
• 45:49
  Speaker 3: to a final doctor, they were like, oh, my god,
• 45:51
  Speaker 3: let's do a scan all these things, and they realized
• 45:54
  Speaker 3: like ninety four percent of her widow maker of her
• 45:57
  Speaker 3: heart was clogged as she was on the press, so
• 46:00
  Speaker 3: having a massive heart attack, and it took months months
• 46:05
  Speaker 3: for them to even figure this out. Again, this is
• 46:07
  Speaker 3: like two thousand and five to two thousand and seven,
• 46:10
  Speaker 3: so not that long ago.
• 46:12
  Speaker 4: When I say twenty years ago, it sounds like a
• 46:13
  Speaker 4: long time ago.
• 46:14
  Speaker 3: But when you put it in context of like in
• 46:16
  Speaker 3: the Twin like it was still the two thousands that
• 46:19
  Speaker 3: they did not understand the modern doctors. So we're from Atlanta.
• 46:23
  Speaker 3: She was going through all the specialists in Atlanta did
• 46:26
  Speaker 3: not understand until like months months later that she was
• 46:29
  Speaker 3: about to die.
• 46:30
  Speaker 4: Like they were like, oh.
• 46:32
  Speaker 3: Because she was a woman with quote unquote atypical symptoms.
• 46:37
  Speaker 3: And we know we finally that people are finally starting
• 46:39
  Speaker 3: to talk about that, Like we see campaigns coming out
• 46:42
  Speaker 3: in conversations about like all these different things. And we
• 46:45
  Speaker 3: know a part of that is due to the grants
• 46:48
  Speaker 3: and the divers of programs that have been out there
• 46:51
  Speaker 3: because of DEI.
• 46:53
  Speaker 4: And all these other things.
• 46:55
  Speaker 3: Now we're watching all these programs slowly come back, even
• 46:57
  Speaker 3: striking out any programs that have the word women, God
• 47:00
  Speaker 3: forbid or of that. Should we be concerned about these
• 47:04
  Speaker 3: rollbacks when it comes to finally being able to say,
• 47:07
  Speaker 3: let's study women, let's study people with uteruses.
• 47:12
  Speaker 2: Oh, I could not agree more. I mean, we were
• 47:15
  Speaker 2: at this we're finally at this inflection point where we
• 47:19
  Speaker 2: were going to say, wow, we haven't had a study
• 47:22
  Speaker 2: of a large scale study on women and particularly postmenopausal
• 47:27
  Speaker 2: women since the Women's Health Initiative. And that was almost
• 47:31
  Speaker 2: thirty years ago that that study was initiated, you know,
• 47:34
  Speaker 2: and it was stopped twenty three years ago. Large scale
• 47:38
  Speaker 2: learned a lot from that, misinterpreted a few things, So
• 47:40
  Speaker 2: there's that. But it was really the first time that
• 47:45
  Speaker 2: anyone said, Okay, let's look at women let's look how
• 47:47
  Speaker 2: women and even a lot of the heart data, the
• 47:50
  Speaker 2: cardiac data. The reason why it's so difficult. All right,
• 47:54
  Speaker 2: So nineteen ninety three, you've got to include women in
• 47:57
  Speaker 2: clinical trials. Okay, But before that, the face of a
• 48:00
  Speaker 2: heart attack was you know, an overweight black person with hypertension,
• 48:07
  Speaker 2: or it was a type a white man you know,
• 48:10
  Speaker 2: who was in his fifties and sixties. You know, so
• 48:13
  Speaker 2: a nice, trim, forty seven year old woman. It's like,
• 48:16
  Speaker 2: oh no, it's not it can't be that, because you
• 48:19
  Speaker 2: don't fit that mold of what we're trying to do.
• 48:22
  Speaker 2: But to be able to do that, it really requires
• 48:24
  Speaker 2: that when we look at the data, when we look
• 48:27
  Speaker 2: at heart when we're evaluating any medication, you including women
• 48:33
  Speaker 2: women in trials is one thing, but you can't lump
• 48:36
  Speaker 2: them all together in your results. Because if it works
• 48:40
  Speaker 2: really well for men and not so great for women,
• 48:43
  Speaker 2: but you smash them all together, it seems like it's working,
• 48:47
  Speaker 2: you know. And to say that you can't disaggregate data,
• 48:51
  Speaker 2: and this is sort of where we are now by race,
• 48:54
  Speaker 2: or we can't disaggregate data by gender. We are losing
• 48:59
  Speaker 2: value information because guess what things don't work the same
• 49:03
  Speaker 2: in women as they work in men. We do have
• 49:05
  Speaker 2: a totally separate hormonal milieu that medications have to work in.
• 49:12
  Speaker 2: And that's my fear that even if we have women
• 49:16
  Speaker 2: in trials, if you don't separate them and report out separately,
• 49:20
  Speaker 2: will lose a lot. And then when it comes to race,
• 49:24
  Speaker 2: the you know, the same thing is happening in race.
• 49:28
  Speaker 2: It's like when it says if any studies that say
• 49:31
  Speaker 2: disparities or race or gender or any of the things
• 49:36
  Speaker 2: that these charged words, then if we're not going to
• 49:41
  Speaker 2: study them, then how will we know. I mean, and
• 49:45
  Speaker 2: you know, one of my issues that I work on
• 49:49
  Speaker 2: a lot is that that is the racial disparities in
• 49:51
  Speaker 2: healthcare in this country. And they are bad, and they've
• 49:57
  Speaker 2: been bad. You know, it's not like this is a
• 49:59
  Speaker 2: new situation here. You would think that the disparities and
• 50:04
  Speaker 2: all that means is, you know, what is it for
• 50:06
  Speaker 2: the majority population and what is it in African American
• 50:09
  Speaker 2: name anything, and it's worse. And it's not just maternal mortality.
• 50:13
  Speaker 2: That's that's the least of the issues in terms of
• 50:15
  Speaker 2: the disparity heart attacks, strokes, Alzheimer's, obesity, you know, any
• 50:21
  Speaker 2: chronic disease and you can use that same two to
• 50:25
  Speaker 2: three times multiplier. We've known this since for as long
• 50:31
  Speaker 2: as we have kept healthcare statistics. The only thing that's
• 50:36
  Speaker 2: happened as we've gotten better at treating things, the overall
• 50:41
  Speaker 2: numbers have gotten better for everybody. You know, I mean,
• 50:45
  Speaker 2: breast cancer used to be a death sentence, you know,
• 50:48
  Speaker 2: seventy five years ago. Guess what it's not now ninety
• 50:51
  Speaker 2: percent of women who are diagnosed early will live. Yay,
• 50:56
  Speaker 2: But guess what. The disparity still exists between black and
• 50:59
  Speaker 2: white women. And the better the treatment gets. Here's the
• 51:03
  Speaker 2: little conundrum here. The better the treatment gets, the larger
• 51:07
  Speaker 2: the disparity gets between black and white. And that is
• 51:11
  Speaker 2: because you don't have access. It's not like you got
• 51:15
  Speaker 2: some new genes and all of a sudden, you know
• 51:18
  Speaker 2: you're doing worse. It's the environment that we find ourselves.
• 51:22
  Speaker 2: Is lack of education, is of access to quality care.
• 51:29
  Speaker 2: All of those things are far more important than anybody's
• 51:33
  Speaker 2: racial composition. You could take a poor white person from Appalaysia,
• 51:37
  Speaker 2: put them, you know, and look at those and say, WHOA,
• 51:39
  Speaker 2: those are worse too? Do they have different genes from
• 51:43
  Speaker 2: another Scottish American who is living in New York City. No,
• 51:46
  Speaker 2: they don't, but the environment is different. And I think
• 51:49
  Speaker 2: that unless until we stop blaming individuals or individual racial
• 51:57
  Speaker 2: groups for poor outcomes on or behavior. You know, if
• 52:02
  Speaker 2: you would just stop doing any number of things, you'd
• 52:06
  Speaker 2: be better and just understanding that the problems really exist
• 52:10
  Speaker 2: outside the individual and those are the things that we
• 52:13
  Speaker 2: choose not to address. Is now that we can't there again,
• 52:18
  Speaker 2: they're quite figure outable and we've known them forever. We
• 52:21
  Speaker 2: just do nothing about it. And this is you can
• 52:24
  Speaker 2: go through study after study after study from the I
• 52:28
  Speaker 2: mean when I say the early nineteen hundreds to today
• 52:32
  Speaker 2: and those same disparities and the only thing that's changed is,
• 52:35
  Speaker 2: like I said, the overall numbers down, the disparities still exist.
• 52:39
  Speaker 1: Yeah, and we do. We've talked about this before on
• 52:41
  Speaker 1: the show. There's a lot of moralizing around. Yeah, you
• 52:46
  Speaker 1: should if you just ate correctly, if you exercised correctly,
• 52:50
  Speaker 1: this is all right on you. I remember my dad
• 52:54
  Speaker 1: he was diagnosed with cancer and they told him you
• 52:59
  Speaker 1: should have been coming for a check every year, and
• 53:01
  Speaker 1: he had been coming in for a check every year,
• 53:04
  Speaker 1: like kind of turning it on the patient and Samantha
• 53:08
  Speaker 1: and I've kind of talked to about that a lot
• 53:10
  Speaker 1: of having bad doctor experiences and trying not to get
• 53:15
  Speaker 1: turned off by that. So, as someone who is looking
• 53:20
  Speaker 1: for a doctor right now, what are some things you
• 53:22
  Speaker 1: think people should look for they're trying to find a
• 53:24
  Speaker 1: good doctor.
• 53:25
  Speaker 2: I'm going to tell you, Annie, And it would take
• 53:27
  Speaker 2: too long to do this, but I have a whole
• 53:30
  Speaker 2: that's the whole first chapter of my book is how
• 53:33
  Speaker 2: do you pick a doctor?
• 53:35
  Speaker 3: You know?
• 53:35
  Speaker 2: What do you even look at? Where do you go?
• 53:37
  Speaker 2: How do you evaluate them at? You know? And I
• 53:41
  Speaker 2: put in it's very actionable items, because here's the other
• 53:44
  Speaker 2: thing that you say, Okay, we'll go on the internet
• 53:45
  Speaker 2: and whatever. But there's so much information. How do you
• 53:48
  Speaker 2: know what's good information, what's bad information? How do you
• 53:51
  Speaker 2: know someone someone's telling you to do something and then
• 53:54
  Speaker 2: someone's telling you to do the exact opposite of that.
• 53:57
  Speaker 2: So what I did, in addition to giving really on
• 54:00
  Speaker 2: crete advice, is that I have references in the back
• 54:04
  Speaker 2: of my book and resources, just resources. So I'm like,
• 54:07
  Speaker 2: if you're going to go and you want to know about,
• 54:10
  Speaker 2: you know, how do I evaluate my doctor? How do
• 54:13
  Speaker 2: I check and see, ooh, does this doctor have you know,
• 54:16
  Speaker 2: one hundred and fifty lawsuits out outstanding? You know, do
• 54:19
  Speaker 2: they have a dui or any of those things. You
• 54:22
  Speaker 2: can go to those references and say per chapter and
• 54:26
  Speaker 2: look at them and say, all right, this is how
• 54:27
  Speaker 2: I valuate it. But don't discount. Don't discount your gut, okay,
• 54:33
  Speaker 2: because you can have the most credentialed doctor in the
• 54:36
  Speaker 2: world who is an apple, you know, and if they
• 54:41
  Speaker 2: make you feel like, you know whatever and put you off,
• 54:46
  Speaker 2: then that's not a good fit. So it's not just
• 54:49
  Speaker 2: the credentials. That's a that's a minimum. You know, is
• 54:53
  Speaker 2: my doctor board certified? You know? Do they have other
• 54:56
  Speaker 2: issues that are outstanding? And then you go from that
• 55:00
  Speaker 2: to okay, then what do I feel in this interaction?
• 55:03
  Speaker 2: And trust it? You know, just like you would trust
• 55:05
  Speaker 2: anything else. And when you're in a doctor's office, you
• 55:08
  Speaker 2: should feel I say, you should feel seen, heard, and
• 55:12
  Speaker 2: respect it. And if that's if those three basic things
• 55:17
  Speaker 2: can't be met, then it doesn't matter where your doctor
• 55:20
  Speaker 2: went to med school. It really doesn't.
• 55:23
  Speaker 3: I haven't thought of that as a process, but now
• 55:26
  Speaker 3: you're making me think of things about self respecting doctors.
• 55:29
  Speaker 2: Okay, I mean that's the minimum. I mean that's the minimum.
• 55:34
  Speaker 2: I mean we as doctors, no matter how we want
• 55:37
  Speaker 2: to see ourselves. We're in a service industry, you know,
• 55:42
  Speaker 2: and my job is to make sure that your needs
• 55:45
  Speaker 2: are met. However that needs to be done. And you know,
• 55:50
  Speaker 2: and occasionally, and I will say this occasionally, occasionally, sometimes
• 55:55
  Speaker 2: I will have something or there'll be something that's so
• 55:57
  Speaker 2: specific that, yeah, sometimes you might need to see that all,
• 56:01
  Speaker 2: you know, if you've got us, if you've got and
• 56:05
  Speaker 2: I'll give you an example, my daughter and I happen
• 56:08
  Speaker 2: to have a lovely neurosurgeon that I sent my daughter to.
• 56:11
  Speaker 2: But but sometimes it's like there are people that what
• 56:18
  Speaker 2: they do is so specific, you know, And yes, you
• 56:22
  Speaker 2: need common things you don't need to see that person for.
• 56:25
  Speaker 2: But if you have that one thing that this person
• 56:28
  Speaker 2: is the world export in and you're going to see them,
• 56:31
  Speaker 2: you know, once or twice and get that resolve, then
• 56:33
  Speaker 2: hold your nose and see them. I get. But I
• 56:36
  Speaker 2: warn patients before I see them. I'm like, I'm just
• 56:38
  Speaker 2: gonna tell you he's a little bit of a jerk,
• 56:42
  Speaker 2: but we need this fixed. And he's he or she
• 56:46
  Speaker 2: is the person to fix it. And I say that
• 56:48
  Speaker 2: sounds very sexist, but it is true. But it is
• 56:50
  Speaker 2: usually a he who's a jerky Yeah, I said it,
• 56:55
  Speaker 2: but you know what I mean. And so that's why
• 56:58
  Speaker 2: I said, know your mission. You know what am I
• 57:01
  Speaker 2: there for? Is this someone I'm going to spend the
• 57:03
  Speaker 2: next twenty years with? And no, you need a better
• 57:05
  Speaker 2: person that you have rapport with. But this is something
• 57:07
  Speaker 2: I'm there for, a specific thing, and this person is
• 57:11
  Speaker 2: the best in the world at that thing. Then do
• 57:13
  Speaker 2: that right, deal with you know, then talk to your
• 57:16
  Speaker 2: other doctor later about it.
• 57:17
  Speaker 4: Look for the results, not necessarily for a pat on
• 57:19
  Speaker 4: the back.
• 57:20
  Speaker 2: I like it.
• 57:31
  Speaker 3: Well, I'm going to tell you this, like having you
• 57:33
  Speaker 3: on the show is a dream, and obviously you are
• 57:35
  Speaker 3: a podcaster's dream, especially when it comes to intersectional feminism
• 57:39
  Speaker 3: and in this conversation, and I know you are now
• 57:42
  Speaker 3: in this podcasting world. You've been in this podcasting world
• 57:45
  Speaker 3: for a minute. I mean again, you're with Michelle Obama
• 57:48
  Speaker 3: talking about so many things. But as you are in
• 57:52
  Speaker 3: this world officially with your podcast being released, what are
• 57:57
  Speaker 3: some of the takeaways you have from doing this podcast
• 58:02
  Speaker 3: and or from the interviews like, have you learned something
• 58:05
  Speaker 3: new or something that was like stood out to you already?
• 58:08
  Speaker 2: Well, you know, I hope to learn a lot of
• 58:10
  Speaker 2: things because, as I said, I don't know everything. I
• 58:12
  Speaker 2: know what I know, but I have a very low
• 58:17
  Speaker 2: bar for things that I don't know. I will do
• 58:22
  Speaker 2: the vetting for you, because see, I will get the
• 58:25
  Speaker 2: experts that I know in trust, and I think that
• 58:28
  Speaker 2: there is an opinion that is worth having that. So
• 58:31
  Speaker 2: that's the whole purpose of the second opinion. I will
• 58:34
  Speaker 2: learn things you know about things that I don't treat,
• 58:38
  Speaker 2: you know. So it's not just a show about menopause.
• 58:41
  Speaker 2: It is about all things women's health. So we will
• 58:44
  Speaker 2: talk about gynecologic things, we'll talk about herd health, we'll
• 58:47
  Speaker 2: talk about I have a whole show that I loved
• 58:49
  Speaker 2: on GLP ones, because that's something even when I at
• 58:53
  Speaker 2: the time I wrote my book, I hadn't really taken
• 58:56
  Speaker 2: care of anyone who was on GOLP one. So I
• 58:58
  Speaker 2: didn't really and I very clear about them. I'm like, I,
• 59:01
  Speaker 2: you know, I don't really know it's it's it's not
• 59:04
  Speaker 2: my thing. But now I understand some things about GLP
• 59:09
  Speaker 2: ones now talking to an expert that I didn't know
• 59:12
  Speaker 2: going into it, So that's it's going to be too pronged.
• 59:16
  Speaker 2: There'll be things that I want you to know some
• 59:19
  Speaker 2: experts and to see what the experts have to say
• 59:21
  Speaker 2: about it. That's my second opinion. And then as a
• 59:23
  Speaker 2: result of that we all get smarter. I'll learn something
• 59:27
  Speaker 2: I didn't know either, so you know, next time someone
• 59:29
  Speaker 2: asked me, I'll know what.
• 59:30
  Speaker 4: You're say.
• 59:33
  Speaker 3: That.
• 59:34
  Speaker 1: Curiosity is so valuable and refreshing too, like going back
• 59:39
  Speaker 1: to admitting what you don't know and what you do
• 59:42
  Speaker 1: know and being very clear about that. And one thing
• 59:45
  Speaker 1: that I got when I was listening to the podcast
• 59:48
  Speaker 1: was I did feel really empowered and validated of like, Okay,
• 59:53
  Speaker 1: so I'm not the only one who thinks this. I'm
• 59:56
  Speaker 1: not the only one who has all these questions about this,
• 59:59
  Speaker 1: and maybe we don't have the answers yet, but at
• 1:00:02
  Speaker 1: least I'm not the only one who's asking these questions.
• 1:00:05
  Speaker 1: And I think that that's something that I know is
• 1:00:08
  Speaker 1: important to you, is empowering women people to make these
• 1:00:13
  Speaker 1: healthcare decisions, to have this knowledge for it to be
• 1:00:16
  Speaker 1: more accessible. So what is it that you're really hoping
• 1:00:21
  Speaker 1: people take away from this podcast.
• 1:00:23
  Speaker 2: You know, I am hoping that at the end of
• 1:00:27
  Speaker 2: every episode that you walk away with something, some knowledge
• 1:00:31
  Speaker 2: you did not have at the beginning, and you'll be
• 1:00:34
  Speaker 2: able to use that knowledge to effectively advocate, maybe not
• 1:00:38
  Speaker 2: for you, but for your friends. So the next person
• 1:00:41
  Speaker 2: who comes up with that and say, you know what,
• 1:00:43
  Speaker 2: perhaps you should take a look at this because it's
• 1:00:47
  Speaker 2: so important. And the message I want to give is
• 1:00:50
  Speaker 2: not to It's not gloom and doom. Oh my god, women,
• 1:00:53
  Speaker 2: we have so much stuff and it's going to be terrible,
• 1:00:55
  Speaker 2: and you know, getting old is horrible. No, it's not.
• 1:00:58
  Speaker 2: I mean, you know, and you know I don't mind
• 1:01:00
  Speaker 2: saying it. You know, I'm sixty six years old, you know,
• 1:01:02
  Speaker 2: and I've pivoted, I'm doing different things in life. I
• 1:01:05
  Speaker 2: feel as good now as I've ever felt. But I
• 1:01:09
  Speaker 2: also want that to be the expectation. If I say,
• 1:01:14
  Speaker 2: where do I want you at forty to start thinking
• 1:01:17
  Speaker 2: about your life as sixty. I want you to think
• 1:01:20
  Speaker 2: of it as something great, not something you know, like,
• 1:01:23
  Speaker 2: oh then what I'm you know. No, don't don't think
• 1:01:27
  Speaker 2: that the inevitable is decline followed by death. You know
• 1:01:33
  Speaker 2: it can be, but just know that you have the
• 1:01:36
  Speaker 2: ability to change that trajectory. Regardless of what your family
• 1:01:41
  Speaker 2: history is and regardless of what your current health situation is,
• 1:01:45
  Speaker 2: you can make it better. You know, there's never too
• 1:01:49
  Speaker 2: late to start. But I like to get people really
• 1:01:51
  Speaker 2: early in this process and get them invested in their
• 1:01:55
  Speaker 2: health and making them understand that you know, oh, Okay,
• 1:01:59
  Speaker 2: your mother had breast cancer. I've had two sisters with
• 1:02:02
  Speaker 2: breast cancer. That doesn't mean I'm going to get it.
• 1:02:04
  Speaker 2: There are I may or I may not, but understand
• 1:02:07
  Speaker 2: the things that I can do along the way that
• 1:02:09
  Speaker 2: minimize my risk. You know, nothing is inevitable. There are
• 1:02:14
  Speaker 2: very few things that are strictly genetic, very few things,
• 1:02:18
  Speaker 2: and even with genes, how those genes interact in the
• 1:02:21
  Speaker 2: environment that you're in matter. So, you know, I think
• 1:02:25
  Speaker 2: that overall, the message that I want to have is
• 1:02:28
  Speaker 2: really a hopeful one, and that I want you to
• 1:02:31
  Speaker 2: feel is that, yeah, I feel empowered because the course
• 1:02:35
  Speaker 2: of my health is going to be determined by what
• 1:02:38
  Speaker 2: I do, not what someone does for me after the fact.
• 1:02:42
  Speaker 2: You know. So there's a there's a huge prevention message
• 1:02:47
  Speaker 2: that I want people to get, and I think once
• 1:02:49
  Speaker 2: you explain to people why it's important you get complying.
• 1:02:55
  Speaker 2: I mean, you know, people will comply. No one wants
• 1:02:58
  Speaker 2: to feel bad. And I I have always found that
• 1:03:01
  Speaker 2: to be a much more potent motivator when I'm talking
• 1:03:05
  Speaker 2: to my patients, to tell them why not just do it?
• 1:03:10
  Speaker 2: And then you know what, most of them do they
• 1:03:13
  Speaker 2: hear it.
• 1:03:14
  Speaker 1: I love that. Yes, And as we said, this is
• 1:03:18
  Speaker 1: such a needed it has been such a needed conversation.
• 1:03:21
  Speaker 1: Very glad it's happening right now. And you you seem
• 1:03:26
  Speaker 1: like someone who has a lot of stuff going on.
• 1:03:29
  Speaker 1: Do you have any other things on the horizon that
• 1:03:31
  Speaker 1: you're excited about that you want to talk about?
• 1:03:33
  Speaker 2: Oh my god, that's enough. I mean, that's fair. I have,
• 1:03:38
  Speaker 2: you know, I have my I continue I still you know,
• 1:03:41
  Speaker 2: my my my heart is always with the menopausal woman.
• 1:03:46
  Speaker 2: So I love my perimenopause and menopausal work, and I
• 1:03:50
  Speaker 2: will continue to do that with alloy because again, my
• 1:03:54
  Speaker 2: mission is access and affordability. It doesn't do anyone any
• 1:03:59
  Speaker 2: good to edge you about all this great menopausal stuff
• 1:04:02
  Speaker 2: or whatever and then you're like, oh great, and then
• 1:04:04
  Speaker 2: you can't find a new place to go. So access
• 1:04:06
  Speaker 2: is important to me, and you know, and so I
• 1:04:10
  Speaker 2: will always continue to do that. I hope that the
• 1:04:12
  Speaker 2: podcast is helpful, you know, and that that's my goal,
• 1:04:16
  Speaker 2: because I you know, I have no you know, I
• 1:04:19
  Speaker 2: cannot say that I harbored a secret desire to be
• 1:04:22
  Speaker 2: a podcaster. That wasn't that wasn't on my BINGO card.
• 1:04:27
  Speaker 2: But if it can serve a purpose, then I'm all in.
• 1:04:31
  Speaker 2: And I really want listeners to understand same thing I
• 1:04:36
  Speaker 2: want to hear from them. I want to hear what
• 1:04:38
  Speaker 2: do you want to know about? Because remember, you're only
• 1:04:41
  Speaker 2: going to get that fifteen minute visit in your doctor's office,
• 1:04:44
  Speaker 2: and only about five to seven minutes of that has
• 1:04:46
  Speaker 2: spent with the doctor. So what are all the things
• 1:04:49
  Speaker 2: of other than that five to seven minutes that we
• 1:04:52
  Speaker 2: can sort of help expand during this time. And that's
• 1:04:55
  Speaker 2: really my goal for the podcast. And if I can
• 1:04:58
  Speaker 2: do that, then hey, I've done my job.
• 1:05:01
  Speaker 1: Yes, yes, And it's it's such important information because no
• 1:05:06
  Speaker 1: one teaches you that, no one teaches you how to
• 1:05:09
  Speaker 1: go to the doctor and what to say and what
• 1:05:11
  Speaker 1: to do, and.
• 1:05:13
  Speaker 2: You know, and we're going to shed all this shame
• 1:05:15
  Speaker 2: and stigma about women and women's bodies, you know, and
• 1:05:19
  Speaker 2: the one thing that I'm really encouraged by is that
• 1:05:23
  Speaker 2: I just did Oh my godness, I did three events
• 1:05:26
  Speaker 2: in New York this past weekend. And over the years,
• 1:05:30
  Speaker 2: the number, just the appetite for this conversation is growing,
• 1:05:37
  Speaker 2: and women are so grateful to be able to have it.
• 1:05:40
  Speaker 2: And I'm just amazed at the things that people will
• 1:05:45
  Speaker 2: say out loud. Let me just say, twenty years ago,
• 1:05:47
  Speaker 2: no one would have ever said these things. They'll get
• 1:05:49
  Speaker 2: out there open mic. Oh and by the way, you know,
• 1:05:52
  Speaker 2: I was having and I was like, oh, okay, well,
• 1:05:55
  Speaker 2: you know, I'm not embarrassed, and I'm glad you're not,
• 1:05:59
  Speaker 2: because we're just going to put it all out here
• 1:06:01
  Speaker 2: and answer these questions. But the one thing I want
• 1:06:04
  Speaker 2: also people to understand is that women's health is everybody's issue.
• 1:06:12
  Speaker 2: It's not just women's health. Because what we we're the
• 1:06:16
  Speaker 2: center of focus in families. We're either caregiving for elders,
• 1:06:20
  Speaker 2: or we're taking care of children, or we're navigating the
• 1:06:23
  Speaker 2: health care for everybody in our space. So keeping us
• 1:06:27
  Speaker 2: healthy and happy should be everybody's goal. It's not just
• 1:06:32
  Speaker 2: a women's issue. Men should be out here advocating for
• 1:06:35
  Speaker 2: this as well, and men need to be educated about menopause,
• 1:06:39
  Speaker 2: as do family members, so you can have a little
• 1:06:42
  Speaker 2: bit of grace and understand what's going on in this
• 1:06:46
  Speaker 2: space without thinking. You know, again, don't perpetuate those stereotypes
• 1:06:51
  Speaker 2: moms crazy, you know, Oh, I can't believe she's so
• 1:06:53
  Speaker 2: out of control. You know, those kinds of things that
• 1:06:56
  Speaker 2: we have been saying about women imperimenopause for way too long.
• 1:07:00
  Speaker 2: We're going to have We're going to have to shed
• 1:07:02
  Speaker 2: that and I think that the more we know, the
• 1:07:05
  Speaker 2: more we're able to navigate this space, not just individually
• 1:07:09
  Speaker 2: but collectively. There is for your perimenopausal and menopausal women.
• 1:07:14
  Speaker 2: Because the one thing that has been a problem is
• 1:07:17
  Speaker 2: the really the lack of research and the lack of
• 1:07:21
  Speaker 2: federal funds that have gone into conditions that affect women,
• 1:07:25
  Speaker 2: not just menopause. Everything forty five billion dollars in twenty
• 1:07:30
  Speaker 2: twenty two, less than eleven percent of that went to
• 1:07:32
  Speaker 2: conditions that affect women exclusively. We're fifty one percent of
• 1:07:36
  Speaker 2: the population. How do we get eleven percent of the
• 1:07:39
  Speaker 2: budget and that includes you know, polycystic o varying disease, fibroids, migraines,
• 1:07:45
  Speaker 2: autoimmune diseases, all these things that disproportionately affect women that
• 1:07:49
  Speaker 2: we have just said, oh well, you know, women, what
• 1:07:51
  Speaker 2: are you going to do? You know, that's no longer
• 1:07:54
  Speaker 2: an acceptable answer. So we want to make sure that
• 1:07:58
  Speaker 2: people know how to effective life advocate not just for yourself,
• 1:08:02
  Speaker 2: but again collectively, or what I call the big A advocacy.
• 1:08:07
  Speaker 2: You know, right, your legislator, state legislators, right, your governor, right,
• 1:08:12
  Speaker 2: your you know, your congress people, and we have bills now,
• 1:08:15
  Speaker 2: and well we have bills in Congress, so good luck
• 1:08:18
  Speaker 2: with that, right, but they are there waiting to be
• 1:08:23
  Speaker 2: voted on. But just really to elevate the issues of
• 1:08:26
  Speaker 2: women's health. As I said, it's in everyone's best interest.
• 1:08:31
  Speaker 2: And for those who want to have an idea of
• 1:08:34
  Speaker 2: what to do, there is the Citizen's Guide to Menopause
• 1:08:38
  Speaker 2: Advocacy that actually lays it out. You can just you know,
• 1:08:41
  Speaker 2: google it, find it, and it actually lays out you know,
• 1:08:45
  Speaker 2: what do you say? What do you right? What are
• 1:08:47
  Speaker 2: the things that are important? And it makes sure that
• 1:08:49
  Speaker 2: that that's how we are going to move the needle.
• 1:08:52
  Speaker 2: We're going to really have to you know, advocate for
• 1:08:55
  Speaker 2: ourselves collectively. In addition to the advocation see that we
• 1:09:00
  Speaker 2: have to do one on one in doctor's offices every day.
• 1:09:04
  Speaker 1: Absolutely and we have loved having you on today, Doctor Sharon.
• 1:09:08
  Speaker 1: This has been so fantastic. H thank you, thank you,
• 1:09:11
  Speaker 1: thank you for being here and for all of the
• 1:09:14
  Speaker 1: great information. Where can the good listeners find you?
• 1:09:18
  Speaker 2: I'm on instagram S Malone, MD. I have a website,
• 1:09:22
  Speaker 2: So if anybody has questions or things that they would
• 1:09:26
  Speaker 2: like to submit that they'd like to hear about in
• 1:09:28
  Speaker 2: the second Opinion, you can go to my website doctor
• 1:09:32
  Speaker 2: Dr Sharon Malone dot com and go to the second
• 1:09:36
  Speaker 2: Opinion tab and it will also have you know things
• 1:09:39
  Speaker 2: sometimes I will do in person appearances, places and so
• 1:09:44
  Speaker 2: it we'll keep you'll have an idea of what's there,
• 1:09:46
  Speaker 2: and then you also know upcoming episodes in TSO and
• 1:09:49
  Speaker 2: also put in requests because I want to answer questions
• 1:09:53
  Speaker 2: that that people have and so the more I know
• 1:09:56
  Speaker 2: what you're interested in, the more I know about to
• 1:10:00
  Speaker 2: go out and answer those questions for you. If I
• 1:10:02
  Speaker 2: don't know myself, and I want to hear real women's
• 1:10:04
  Speaker 2: stories too, not just the experts. I want to hear
• 1:10:07
  Speaker 2: real women talking about real problems.
• 1:10:10
  Speaker 1: Yes, and your podcasts the second in my second opinion,
• 1:10:14
  Speaker 1: go check.
• 1:10:15
  Speaker 2: Us out with the opinion. Yes, the second opinion. You can.
• 1:10:18
  Speaker 2: You can get it wherever you get your podcasts, Apple, Spotify, YouTube,
• 1:10:24
  Speaker 2: and it's out there and it's in the world. And
• 1:10:27
  Speaker 2: we're going to have we have two episodes out now
• 1:10:29
  Speaker 2: and there will be a new episode every week every Monday,
• 1:10:34
  Speaker 2: new topic.
• 1:10:35
  Speaker 1: Awesome. Well, thank you so much for being here. Hopefully
• 1:10:38
  Speaker 1: we can have you back again. We would love to talk.
• 1:10:40
  Speaker 2: You back again. Of course. See this is easy. I
• 1:10:44
  Speaker 2: didn't have to get dressed or anything. See if I'd
• 1:10:46
  Speaker 2: known that, I was like, yeah, well next time you'll know,
• 1:10:49
  Speaker 2: a couple of times a week, no makeup, no problem, you.
• 1:10:52
  Speaker 4: Want, I love it.
• 1:10:55
  Speaker 1: If you would like to contact us, you can. You
• 1:10:57
  Speaker 1: can email us at Hello stuff I never told you,
• 1:11:00
  Speaker 1: find us a blue sctyp, mosta podcast or Instagram and
• 1:11:02
  Speaker 1: TikTok at stuff one never told you. We're also on YouTube.
• 1:11:05
  Speaker 1: We have new merchandise aid Cotton Bureau, and we have
• 1:11:07
  Speaker 1: a book you can get wherever you get your books.
• 1:11:09
  Speaker 1: Thanks always Tis a super producer, procedaor executive producer. My
• 1:11:11
  Speaker 1: under contributor Joey, thank you, and thanks to you for
• 1:11:14
  Speaker 1: listening stuff I never told you. Petion by heart Radio.
• 1:11:16
  Speaker 1: For more podcasts from my heart Radio, you can check
• 1:11:18
  Speaker 1: out the heart radio app, podcast or where you listen
• 1:11:20
  Speaker 1: to your favorite shows,