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Episode 10: Lessons & Themes - What We've Learned So Far · The Antisocial Doctors Podcast

• 1:27
  Sonia Singh MD: You are listening to the Antisocial Doctors Podcast, hosted by me, Sonia Singh, a board certified internal medicine physician with a Master's in nutrition and a special interest in health anxiety
• 1:38
  Rebecca Berens MD: and me, Rebecca Barons, a board certified family medicine physician with a special interest in disordered eating.
• 1:43
  Sonia Singh MD: We're also a millennial women anxious moms and curious humans navigating social media.
• 1:48
  Sonia Singh MD: We've seen firsthand how these platforms can be powerful tools for education and connection, but can also make us unwell.
• 1:56
  Rebecca Berens MD: This podcast is meant to be the antidote to your doom.
• 1:58
  Rebecca Berens MD: Scrolling, a solve for the anxiety, stress, guilt, shame, and confusion that comes from social media's messaging around health.
• 2:05
  Rebecca Berens MD: In each episode, we discuss a health related talk trending on social media with curiosity, nuance, evidence, humility, and compassion.
• 2:12
  Sonia Singh MD: This is not your average debunking podcast.
• 2:14
  Sonia Singh MD: We wanna explore not just what is trending on social media, but why?
• 2:18
  Sonia Singh MD: Why are so many people drawn to this?
• 2:20
  Sonia Singh MD: What is the nugget of truth here?
• 2:21
  Sonia Singh MD: What are the facts?
• 2:23
  Sonia Singh MD: What can we learn from this as patients and doctors?
• 2:25
  Sonia Singh MD: No shame.
• 2:26
  Sonia Singh MD: No blame, no snark.
• 2:27
  Rebecca Berens MD: We're so glad you're here.
• 2:40
  Sonia Singh MD: Let's start.
• 2:40
  Sonia Singh MD: Guess what?
• 2:41
  Sonia Singh MD: I wanna tell you some funny things.
• 2:42
  Sonia Singh MD: First of all, okay.
• 2:43
  Sonia Singh MD: When I I, so I was using chat GBT to help me come up with more catchy titles for some of the episodes and to come up with the summaries and stuff.
• 2:52
  Sonia Singh MD: And you know what it, we did an episode on who are we, like introducing ourselves?
• 2:56
  Sonia Singh MD: Yeah.
• 2:56
  Sonia Singh MD: Do you know what it suggested as the title for that episode?
• 2:59
  Rebecca Berens MD: What?
• 2:59
  Sonia Singh MD: Doctors who Doom Scroll, which I was like, maybe that should have been the title of the whole podcast.
• 3:05
  Sonia Singh MD: We slept on a great name.
• 3:07
  Rebecca Berens MD: That's amazing.
• 3:08
  Sonia Singh MD: But yeah.
• 3:08
  Sonia Singh MD: But
• 3:08
  Rebecca Berens MD: we don't doom scroll anymore.
• 3:10
  Rebecca Berens MD: So
• 3:10
  Sonia Singh MD: we don't doom scroll anymore, which we'll talk about.
• 3:13
  Sonia Singh MD: Yes.
• 3:13
  Sonia Singh MD: But anyway.
• 3:14
  Sonia Singh MD: Hi Rebecca.
• 3:15
  Sonia Singh MD: I missed the official opener.
• 3:18
  Rebecca Berens MD: Hi Sonia.
• 3:18
  Sonia Singh MD: Okay, so We're concluding our first batch of episodes that we've made for this project, and so we wanted to do an episode on.
• 3:27
  Sonia Singh MD: Kind of what we've learned from this experience and over researching these topics and touch on some general themes that seem to be recurring over and over.
• 3:35
  Sonia Singh MD: 'cause I think there's several that have come up again and again.
• 3:38
  Sonia Singh MD: And I think just touching on those and even applying them to, other things that come up in social media might be enlightening and helpful for people.
• 3:45
  Sonia Singh MD: But yeah, I wanted to mention the doctors who Dreams girl thing, because I just wanted to remind everyone that we too are consumers of social, we are living this with you.
• 3:55
  Sonia Singh MD: It's not like we are talking from above and we're like, here's what we think about all this crazy stuff going on.
• 4:01
  Sonia Singh MD: Social media, we too get anxiety from our social media feeds and we too are trying to navigate our own relationships with social media.
• 4:10
  Sonia Singh MD: So anyway, maybe at the end of this episode we can discuss our own.
• 4:15
  Sonia Singh MD: Evolution with social media over the past six months as we've been working on this project.
• 4:19
  Sonia Singh MD: But I just was thinking about how grateful I am that I had, a foundation of medical knowledge and experience before Instagram became a thing.
• 4:31
  Sonia Singh MD: Because if I hadn't I think I would've fallen down so many rabbit holes I.
• 4:38
  Sonia Singh MD: Have a note on my phone that I've had since first year of medical school, of all the diseases that I thought I have had since I started medical training.
• 4:46
  Sonia Singh MD: And the list is long.
• 4:49
  Sonia Singh MD: And I think I've basically had exposure therapy over all these years of seeing these things up close and being like, okay, no, you don't have it.
• 4:57
  Sonia Singh MD: And yeah, I just I wanna acknowledge that I, I don't think consumers of social media are gullible or that I'm just like, how could people believe this?
• 5:07
  Sonia Singh MD: I don't think that at all.
• 5:08
  Sonia Singh MD: I would a hundred percent be falling for a lot of these trends if I did not have, the background that I have.
• 5:14
  Sonia Singh MD: I don't know.
• 5:15
  Sonia Singh MD: What do you think?
• 5:16
  Rebecca Berens MD: Yeah, no, absolutely.
• 5:17
  Rebecca Berens MD: I think I still fall for them a little bit because I'll look at it and I'll be like, maybe, and then I'll go but let's, like you said, now at least we have the ability to like.
• 5:26
  Rebecca Berens MD: Know where to look and how to interpret the information.
• 5:29
  Rebecca Berens MD: We've been trained on how to do that.
• 5:30
  Rebecca Berens MD: Yeah.
• 5:31
  Rebecca Berens MD: So then you can't, but in the gut moment that you see it, you're like, oh, that's what it is.
• 5:36
  Rebecca Berens MD: Yes,
• 5:37
  Sonia Singh MD: Yes.
• 5:37
  Rebecca Berens MD: Why was I, why did I never learn that?
• 5:39
  Rebecca Berens MD: And then you're like, wait a minute, I step back here.
• 5:41
  Rebecca Berens MD: Yeah.
• 5:41
  Rebecca Berens MD: I think so.
• 5:42
  Rebecca Berens MD: Absolutely.
• 5:43
  Rebecca Berens MD: It's, and even like doctors that, that are whole doctors that do some of this stuff that we're talking about.
• 5:49
  Rebecca Berens MD: Yeah.
• 5:49
  Rebecca Berens MD: Yeah.
• 5:49
  Rebecca Berens MD: And I think it's it taps into our human, which we're gonna talk about, just our human desire to manage uncertainty.
• 6:00
  Sonia Singh MD: Yeah.
• 6:01
  Rebecca Berens MD: And yeah, I think it it's very human and very normal and happens to all of us.
• 6:06
  Sonia Singh MD: Yeah.
• 6:07
  Sonia Singh MD: So let's go through some of the themes.
• 6:09
  Sonia Singh MD: I came up with some of them and then I also made chat.
• 6:12
  Sonia Singh MD: GBT listen to all of our episodes.
• 6:14
  Sonia Singh MD: Oh, wow.
• 6:14
  Sonia Singh MD: And see some of the things that come up over and over just so I did not have to listen to my own voice again after having edited all of the episodes.
• 6:23
  Sonia Singh MD: And so some of these are, I came up with in some of these chat GBT found which was also just an interesting experiment.
• 6:29
  Sonia Singh MD: But the.
• 6:30
  Sonia Singh MD: One theme that comes up in literally every single episode that I don't even think we needed to do the episodes.
• 6:35
  Sonia Singh MD: I think it's, one of the main reasons we wanted to do this specific podcast is that.
• 6:40
  Sonia Singh MD: We in medicine are part of the problem here, and I think we don't do a good enough job of acknowledging that consistently.
• 6:49
  Sonia Singh MD: There's a lot of great docs out there doing, spreading evidence-based information, doing the debunking.
• 6:55
  Sonia Singh MD: But I think to just start with the acknowledgement that we have left big gaps in terms of information and validation in traditional medicine is the starting point for any kind of meaningful conversation on this.
• 7:07
  Rebecca Berens MD: Yeah, I know.
• 7:08
  Rebecca Berens MD: Absolutely.
• 7:08
  Rebecca Berens MD: And I think especially on social media in particular, doctors have been very notably absent up until very recently.
• 7:16
  Rebecca Berens MD: I remember when, when we were in med school social media was still relatively new.
• 7:21
  Rebecca Berens MD: And It would've been considered extremely unprofessional to be yeah, on social media.
• 7:26
  Rebecca Berens MD: It's, no one was making videos necessarily back then, but if you were like a doctor on YouTube, I think Pete, I think people would've been like, what's wrong with you?
• 7:32
  Rebecca Berens MD: That's so unprofessional.
• 7:33
  Rebecca Berens MD: That's not legitimate.
• 7:34
  Sonia Singh MD: No, it was an immediate eye roll.
• 7:36
  Sonia Singh MD: Like I remember seeing Dr.
• 7:37
  Sonia Singh MD: Mike in People Magazine and I was like, oh, Dr.
• 7:40
  Sonia Singh MD: Mike is really attractive.
• 7:42
  Sonia Singh MD: But I was just like, he's not a real doctor.
• 7:44
  Sonia Singh MD: He's not a real doctor.
• 7:46
  Sonia Singh MD: Turns out Dr.
• 7:47
  Sonia Singh MD: Mike is a real doctor, and I'm a fan.
• 7:49
  Sonia Singh MD: 'cause he is a very good proponent of evidence-based medicine.
• 7:51
  Sonia Singh MD: Yes.
• 7:51
  Sonia Singh MD: He puts out a lot of good information.
• 7:53
  Sonia Singh MD: But yeah, I remember the first time I saw Dr.
• 7:55
  Sonia Singh MD: Mike and I was just like, my eyes rolled in the back of my heart eyes and then eyes rolling in back of my okay, all right.
• 8:02
  Sonia Singh MD: You're
• 8:03
  Rebecca Berens MD: It's just the TV doctor, the TV doctor.
• 8:05
  Rebecca Berens MD: Is not
• 8:06
  Sonia Singh MD: yes.
• 8:06
  Rebecca Berens MD: The doctors.
• 8:07
  Sonia Singh MD: Yeah.
• 8:07
  Rebecca Berens MD: It's not thought of in academic medicine.
• 8:09
  Rebecca Berens MD: Yes.
• 8:09
  Rebecca Berens MD: And so it, that it's like an extension of that.
• 8:11
  Rebecca Berens MD: And so not only are we doing a very poor job communicating in the healthcare system, we're also completely ignoring the large and ever-growing space where people are obtaining more and more information.
• 8:24
  Rebecca Berens MD: So what did we expect to happen?
• 8:27
  Sonia Singh MD: Yes.
• 8:27
  Sonia Singh MD: And then, I think it I said this kind of at the top of the episode, but we just need to acknowledge it's not that people are being gullible or they're falling for crazy stuff.
• 8:35
  Sonia Singh MD: It's like they're acting very rationally in responding to needs that are not being met by their doctors or in a traditional healthcare setting.
• 8:44
  Sonia Singh MD: And so they're going into these other spaces.
• 8:47
  Sonia Singh MD: Now, I also.
• 8:48
  Sonia Singh MD: Don't want to gaslight the doctors because most doctors, over 70% are working for giant healthcare systems in which they have very little control over their schedules, over their appointment times, over how they run their appointments, and it's very rare for the doctor to have enough time and bandwidth to fully explain something to you, even if they want to, and they know the information and they have a lot to say about it.
• 9:14
  Sonia Singh MD: I, you and I have been in that position, for many years and know how that feels, and we've just not created a healthcare system that.
• 9:24
  Sonia Singh MD: Leaves room for that kind of con, deeper conversation and context and nuance and building that personal trust and that relationship.
• 9:31
  Sonia Singh MD: It's just, it's not built for that.
• 9:33
  Sonia Singh MD: It's very problem focused.
• 9:35
  Sonia Singh MD: It's very much in and out, which is what drives, I think a lot of the.
• 9:39
  Sonia Singh MD: Jump to medication before talking about lifestyle is to meaningfully talk about lifestyle with someone.
• 9:44
  Sonia Singh MD: You have to know a little bit about their lifestyle.
• 9:46
  Sonia Singh MD: You have to be able to take the time to give them some, specific guidance that's relevant and, feasible for them.
• 9:53
  Sonia Singh MD: And it's hard to do that in, four minutes, 11 minutes, however long you have.
• 9:58
  Rebecca Berens MD: Yeah, and like my pre-practice, pre private practice life, I was always in very low resource settings.
• 10:03
  Rebecca Berens MD: Yeah.
• 10:04
  Rebecca Berens MD: So not only is there the time crunch, but there's also talking about diet and lifestyle with someone who is being evicted from their home and has, just witnessed severe violence in their neighborhood.
• 10:15
  Rebecca Berens MD: There's so many other things
• 10:17
  Sonia Singh MD: Yeah.
• 10:18
  Rebecca Berens MD: That are huge and the ability of that person to then go and make these like sweeping lifestyle changes that we're talking about, there's, that's just so not the biggest priority for that person's health and safety at that moment.
• 10:29
  Rebecca Berens MD: And I think that's what also gets ignored in these sort of social media discussions of health is these.
• 10:35
  Rebecca Berens MD: Socioeconomic and, structural discrimination factors that are affecting, that are really affecting people's health.
• 10:43
  Rebecca Berens MD: Yeah.
• 10:43
  Rebecca Berens MD: Are not things that we can even address in that vi, in that short visit.
• 10:47
  Rebecca Berens MD: We have to have the social supports and the societal.
• 10:50
  Rebecca Berens MD: Structure in place for people to have their basic needs be met before we can start talking about optimizing diet and lifestyle.
• 10:57
  Sonia Singh MD: Yeah, totally.
• 10:59
  Sonia Singh MD: So that my next subpoint on this was just that health is a bio psychosocial phenomenon.
• 11:05
  Sonia Singh MD: We in medicine.
• 11:06
  Sonia Singh MD: Are very focused on the bio and that is what we are trained to diagnose and treat and deal with.
• 11:13
  Sonia Singh MD: And, that's most of our job, and when we're talking about, for instance, something like nutrition, when I got interested in nutrition, my initial in.
• 11:20
  Sonia Singh MD: Distinct was I'm gonna go into public health because this is not a problem that we're gonna solve One patient at a time, me talking to somebody in clinic about what they're eating for breakfast, that is really not solving this problem.
• 11:30
  Sonia Singh MD: What's driving this is these much bigger, economic, cultural, social, all these different drivers.
• 11:36
  Sonia Singh MD: The built environment, so many things drive people to eat what they eat and move, how much or how little they move.
• 11:43
  Sonia Singh MD: And I think just acknowledging that.
• 11:46
  Sonia Singh MD: Making you feel well is not gonna a hundred percent happen in your doctor's office and can't even if you have a great doctor.
• 11:54
  Sonia Singh MD: And that health is just determined by so many more factors than just the biology of your physical body.
• 12:01
  Sonia Singh MD: Is something that, we need to remind ourselves.
• 12:03
  Sonia Singh MD: We need to remind our patients and we need to advocate for, or we should, we can advocate for in other ways besides in our medical work.
• 12:12
  Sonia Singh MD: Yeah.
• 12:12
  Sonia Singh MD: Okay.
• 12:13
  Sonia Singh MD: And yeah, and those are also, not only are they not addressed in the exam room, but they're not really addressed on social media either.
• 12:18
  Sonia Singh MD: No, in, in the wellness world or in the wellness space.
• 12:21
  Rebecca Berens MD: Yeah.
• 12:22
  Rebecca Berens MD: Or if they are, it's an excuse.
• 12:25
  Sonia Singh MD: Okay.
• 12:25
  Rebecca Berens MD: It's like I've seen so many of the videos of everyone has the same 24 hours, which is absolutely false.
• 12:32
  Rebecca Berens MD: But I think that is, it's almost.
• 12:35
  Rebecca Berens MD: Counteractive to what is actually going on.
• 12:38
  Rebecca Berens MD: What on social media is like you can be, you can do whatever you wanna do.
• 12:42
  Rebecca Berens MD: You're in control of your situation, which is the opposite of what is true.
• 12:46
  Sonia Singh MD: Okay.
• 12:46
  Sonia Singh MD: This is not the next one I had on the list, but I have another one down that I think is relevant to what you're pointing to, which is that.
• 12:52
  Sonia Singh MD: The value of a certain intervention or lifestyle change or the risks and benefit, the risk benefit ratio of it can be very different from person to person.
• 13:04
  Sonia Singh MD: So the same thing for somebody who has unlimited resources and has a doctor who is already highly qualified and taking care of their health and dah.
• 13:11
  Sonia Singh MD: And they wanna spend$2,000 on a whole body MRI.
• 13:15
  Sonia Singh MD: That is a different calculation than somebody who's on a highly limited income, has no health insurance, has no access to a PCP, and sees that Kim Kardashian got a whole body MRI, and thinks that is good healthcare.
• 13:27
  Sonia Singh MD: And that is something that maybe they should do to make sure they're healthy.
• 13:30
  Sonia Singh MD: Meanwhile, they may have totally uncontrolled hypertension.
• 13:33
  Sonia Singh MD: They may have thyroid disease, they may have, they can have a million problems that are not gonna show up on that MRI, but.
• 13:39
  Sonia Singh MD: That risk benefit, the cost of that versus the benefit of it for those two different people, for a celebrity versus, that person on the, it's just a very different calculation.
• 13:49
  Sonia Singh MD: So I think people have this idea when, we're talking about when people talk about like Medicine 3.0 and all these biohacking and all of these fancy new tests and interventions Could those be reasonable for some people?
• 14:03
  Sonia Singh MD: Maybe, with adequate discussion and good health literacy and a lot of other things surrounding it.
• 14:09
  Sonia Singh MD: Maybe.
• 14:10
  Sonia Singh MD: But I think the problem is when it's on social media, it gets presented as though, that is something bad is gonna happen if you don't do it.
• 14:17
  Sonia Singh MD: And that is something that you need as opposed to something that is an optional luxury if you have a ton of disposable income that you wanna throw around.
• 14:26
  Sonia Singh MD: And so that's a theme that I think we are gonna see more in our next best batch of episodes.
• 14:31
  Sonia Singh MD: 'cause we have a lot of those kind of fancier interventions in that batch.
• 14:34
  Sonia Singh MD: But.
• 14:35
  Sonia Singh MD: I think we saw it a little bit in some of these too.
• 14:37
  Sonia Singh MD: In terms of clean eating, clean beauty, like a lot of times those things, those lifestyles cost more money.
• 14:43
  Sonia Singh MD: And is it reasonable for somebody who can afford to spend$60 on the face cream versus$20, yeah.
• 14:49
  Sonia Singh MD: Yeah, it's fine.
• 14:50
  Sonia Singh MD: If you wanna spend$6 on the face, cream is fine.
• 14:53
  Sonia Singh MD: What is the problem with it when we are presenting that as the ideal, the health ideal or the wellness ideal and, what consequences does that have for people who are working with limited resources and maybe are foregoing something else in order to get that thing.
• 15:07
  Rebecca Berens MD: Yeah.
• 15:07
  Rebecca Berens MD: And then how is it influencing people's views on how we should utilize our healthcare resources?
• 15:13
  Rebecca Berens MD: Because if we,
• 15:14
  Sonia Singh MD: yeah,
• 15:14
  Rebecca Berens MD: we have limited healthcare resources, in Yes.
• 15:16
  Rebecca Berens MD: The world and for the country and for people and the, if that is perceived as that's what we should be doing for everyone now we're, are we shuttling healthcare resources into that, that could be better used for public health in another way.
• 15:28
  Rebecca Berens MD: And that's, it's influencing I think the, the beliefs of the population about that.
• 15:34
  Rebecca Berens MD: When they're seeing that kind of stuff.
• 15:35
  Rebecca Berens MD: 'cause they're like you're not doing this, you're not doing this, you're not doing this.
• 15:37
  Rebecca Berens MD: What are you doing for my health?
• 15:38
  Rebecca Berens MD: And it's yeah, the boring, blood pressure screening and vaccines is that's boring.
• 15:43
  Rebecca Berens MD: Who needs that?
• 15:44
  Rebecca Berens MD: I want the full body MRI.
• 15:45
  Sonia Singh MD: And then in the same vein, the a choice that might not cause much harm to one patient, like deciding that you're going to eat clean and you per, perhaps you consider that just reducing your intake of processed foods and eating more.
• 15:58
  Sonia Singh MD: So patient was to say, I'm gonna eat more Whole Foods.
• 16:01
  Sonia Singh MD: I'm gonna try to eat more vegetables this year.
• 16:02
  Sonia Singh MD: I'm gonna eat healthier.
• 16:03
  Sonia Singh MD: That's fine.
• 16:04
  Sonia Singh MD: All of that.
• 16:04
  Sonia Singh MD: I don't have any, I, I wouldn't.
• 16:06
  Sonia Singh MD: Have any problem with any of that.
• 16:08
  Sonia Singh MD: But perhaps a person with a history of disordered eating who already struggles a lot with guilt and shame around food or just guilt and shame generally.
• 16:16
  Sonia Singh MD: And who now is being served a lot of information about clean eating and has decided to go the risk benefit ratio for that person of doing that and following that content is very different than, my husband following that content.
• 16:29
  Sonia Singh MD: I think just recognizing who is, who are you, or who is the person who is consuming this content.
• 16:34
  Sonia Singh MD: Maybe it's your child, your friend, your mom, whatever, and thinking about the fact that, that same information could have a very different effect on them versus us.
• 16:43
  Sonia Singh MD: And I think I was, when I was editing the clean eating episode, after that I was like, oh, I should have challenged you more.
• 16:49
  Sonia Singh MD: 'cause I can imagine a lot of people saying you're overcomplicating this, like we're overcomplicating it by saying there's a problem with saying PE people just mean that they're eating more whole foods.
• 16:59
  Sonia Singh MD: We, we say all the time, like having a Whole Foods plant-based diet is a very healthy dietary pattern, so maybe this is just a shortcut way for people to say that thing.
• 17:07
  Sonia Singh MD: And are we just, making it all PC by saying, oh we don't like when people say clean,
• 17:11
  Rebecca Berens MD: yeah.
• 17:12
  Sonia Singh MD: But I think.
• 17:14
  Sonia Singh MD: As healthcare professionals, as doctors the words we use really matter, and as we talked about on both the clean eating and the clean beauty episode, the word clean has moral connotations and invokes, shame and guilt and morality and purity in a way that all those other ways of saying, I'm going to eat healthier, or I'm going to eat this or that.
• 17:38
  Sonia Singh MD: It's different than those things.
• 17:40
  Sonia Singh MD: And I think, it's just, it's, we owe it to our patients to reflect on the words that we're using.
• 17:46
  Sonia Singh MD: And in the same way, we no longer would say this is a demented 80-year-old.
• 17:50
  Sonia Singh MD: We would say, this is an 80-year-old, with dementia.
• 17:54
  Sonia Singh MD: I think to use, throw the word clean around when it's meaningless and when it has those other connotations.
• 18:00
  Sonia Singh MD: Is dangerous and we need to write it,
• 18:03
  Rebecca Berens MD: absolutely.
• 18:04
  Rebecca Berens MD: Absolutely.
• 18:05
  Sonia Singh MD: Okay, so going back to the top here I tried to go in order of things that came up the most.
• 18:11
  Sonia Singh MD: I think Desire for Control is a common theme that we see over and over, which is like.
• 18:18
  Sonia Singh MD: A lot of things in health and medicine, we don't have total control over, or we don't have complete knowledge or deep understanding of yet.
• 18:25
  Sonia Singh MD: And oftentimes people are just looking for that control and that certainty and social media is really good at offering the illusion of control in the form of.
• 18:34
  Sonia Singh MD: Very simple explanations.
• 18:37
  Sonia Singh MD: And then buyable cooked solutions,
• 18:40
  Rebecca Berens MD: click here.
• 18:41
  Sonia Singh MD: Yes,
• 18:41
  Rebecca Berens MD: add to
• 18:42
  Sonia Singh MD: cart or afraid of cancer or just avoid all of these toxic ingredients and eat cleaner and use clean beauty products.
• 18:48
  Sonia Singh MD: When in fact, cancer is much more complex phenomenon than that.
• 18:52
  Sonia Singh MD: And I think in terms of what we can learn from that or take from it, I think just advocating for policies that give patients autonomy and control and, that's the broader sense.
• 19:02
  Sonia Singh MD: But then on a day to day, really making sure that we're doing shared decision making around these things and giving them true informed consent about here are all of the options, including, you, these are all of this is the option I would recommend and these are the alternatives, yeah.
• 19:15
  Sonia Singh MD: And talking through the risks and benefits of all of those, because I do think that helps people feel like they have agency as opposed to when you offer them one thing and they don't feel like they've understood, their options or the risks and benefits and they feel like that's all you're gonna offer.
• 19:29
  Rebecca Berens MD: Yeah.
• 19:30
  Rebecca Berens MD: And that, I think that is such a huge part of this.
• 19:32
  Rebecca Berens MD: I talk a lot about this when I talk about trauma informed care because there's.
• 19:36
  Rebecca Berens MD: There's quite a few physicians I've run into who hear that word and they're like, I don't know.
• 19:40
  Rebecca Berens MD: I can't do that.
• 19:41
  Rebecca Berens MD: That's, and I'm like, anyone can be trauma informed in their care.
• 19:44
  Rebecca Berens MD: That's I think the biggest piece of it is like giving back that agency and control to the patient that has been taken from them by whatever Traumatic situation they experienced.
• 19:54
  Sonia Singh MD: Yeah.
• 19:54
  Rebecca Berens MD: And I do think that a lot of patients who avoid care because of, past experiences or trauma or whatever, they do want to have that control back.
• 20:02
  Rebecca Berens MD: And that it does lead them right into the hands of these less scrupulous people who are offering them that viable solution because it's like you're in control.
• 20:11
  Rebecca Berens MD: You can decide like this is up to you.
• 20:13
  Rebecca Berens MD: And if we just have that conversation in that way with our patients in the office, which doesn't take really any more time and is, allowing them to be able to feel more in control, then they don't get so sucked into the other alternative ways.
• 20:26
  Sonia Singh MD: Yeah.
• 20:27
  Sonia Singh MD: So again, I think the more ways we can try to help our patients feel empowered and like they have agency.
• 20:34
  Sonia Singh MD: Yeah.
• 20:35
  Sonia Singh MD: The less, I think there's this unmet need for control manifesting as, looking to social media.
• 20:41
  Sonia Singh MD: This is similar to that, but.
• 20:43
  Sonia Singh MD: Again, this lure of the one simple solution for something that's complicated.
• 20:49
  Sonia Singh MD: So we saw this with thyroid disease, we saw this with perimenopause where there it's a one stop explanation for all these things that are ailing somebody.
• 20:59
  Sonia Singh MD: And I think you could say this, you could look at that list of symptoms and you could say it's Lyme.
• 21:03
  Sonia Singh MD: You could say it's long COVID.
• 21:04
  Sonia Singh MD: You could say it's parasites.
• 21:06
  Sonia Singh MD: You could say it's mold exposure.
• 21:07
  Sonia Singh MD: A lot of these things have.
• 21:08
  Sonia Singh MD: Overlapping, non-specific symptoms.
• 21:11
  Sonia Singh MD: And when you are having those and it's so confusing and you don't even know which doctor to go to or where to start, and then you start getting fed this content that kind of says, oh, all of that, could be.
• 21:25
  Sonia Singh MD: Perimenopause.
• 21:26
  Sonia Singh MD: That's very compelling.
• 21:28
  Sonia Singh MD: And, on social media, like you said, once they give you that solution, there's, once they give you that answer, then there's immediately a solution.
• 21:36
  Sonia Singh MD: There's like a viable thing or there's a personal choice that you can make to, then.
• 21:42
  Sonia Singh MD: Manage that.
• 21:43
  Sonia Singh MD: And I think the downside of, there's a lot of downsides.
• 21:47
  Sonia Singh MD: Obviously you can go down the wrong path, you can be misdiagnosed, you can be anchored to a diagnosis that then prevents you from finding the right diagnosis.
• 21:54
  Sonia Singh MD: You could delay treatment, you could do the wrong treatment that causes you harm.
• 21:57
  Sonia Singh MD: But I think one of the harms of this that we don't recognize is when we make it seem like it's all just a matter of personal choice it, it shifts the responsibility away from society and from systems and from like.
• 22:10
  Sonia Singh MD: The broader structures that lead people to feel this way.
• 22:15
  Sonia Singh MD: Like we talked a lot in the perimenopause episode about all the reasons that women may feel unwell and a lot of them are big systemic issues.
• 22:24
  Sonia Singh MD: And I think when we hyperfocus on you just gotta get this much protein and this much fiber intake, these supplements and get on the right HRT, it unburdens the rest of society from acknowledging that they don't provide enough support for us in terms of.
• 22:37
  Sonia Singh MD: Access to affordable childcare.
• 22:38
  Sonia Singh MD: They don't pay us enough in the workplace, and they don't provide us enough maternity leave.
• 22:42
  Sonia Singh MD: And, it just, it shifts the focus away from, the powers that be and the situation on a broader scale, which I think
• 22:49
  Rebecca Berens MD: is
• 22:50
  Sonia Singh MD: actually the big change will happen.
• 22:52
  Rebecca Berens MD: Yeah.
• 22:52
  Rebecca Berens MD: And that's, that is like also that control thing, it's Making you.
• 22:55
  Rebecca Berens MD: If there is a simple solution, then that's a simple solution that I have control over.
• 22:58
  Rebecca Berens MD: I can choose, I can do now.
• 23:00
  Rebecca Berens MD: And it again, it is making you feel like you're in control when you're actually not.
• 23:04
  Sonia Singh MD: Take away our agency in all these big ways and be like, but you can still get on the right normal therapy and feel pretty good.
• 23:11
  Rebecca Berens MD: Just add to cart now.
• 23:12
  Sonia Singh MD: Yeah, add to cart.
• 23:13
  Sonia Singh MD: Add to cart, buy now, one click.
• 23:15
  Sonia Singh MD: Okay.
• 23:16
  Sonia Singh MD: And the next theme that I think we've talked about multiple times is the line between informative and empowering and fear mongering and anxiety provoking is very thin.
• 23:29
  Sonia Singh MD: So I think.
• 23:31
  Sonia Singh MD: A lot of times you'll see some content, it'll be like, oh, this ingredient, it's so bad for you.
• 23:36
  Sonia Singh MD: Or this med, it can potentially have this side effect or this test, you might need to get this test and your doctor might not be ordering it.
• 23:42
  Sonia Singh MD: A lot of that information at first glance feels oh my God, I'm so glad I saw this.
• 23:46
  Sonia Singh MD: Now I'm informed and I'm educated on this thing and I can go and advocate for myself and try to get this sorted out, but I think in a lot of those cases, I, when I think about some of that content from a medical perspective, I'm like.
• 23:58
  Sonia Singh MD: How relevant was this really?
• 24:00
  Sonia Singh MD: And is this really even true?
• 24:01
  Sonia Singh MD: And is, is this really informing you in any way that's going to have a significant effect on your overall health and wellbeing?
• 24:08
  Sonia Singh MD: And I think oftentimes, rather than improving your health or having a significant, good health outcome for you, it just creates fear and anxiety and distrust.
• 24:19
  Sonia Singh MD: And that's something that I sense over and over in a lot of our.
• 24:23
  Sonia Singh MD: A lot of our episodes.
• 24:25
  Rebecca Berens MD: Yeah.
• 24:25
  Rebecca Berens MD: And I think obviously there's precedent for like public health communication, right?
• 24:30
  Rebecca Berens MD: We want to inform people, we want'em to be aware of those big important public health sort of things.
• 24:36
  Rebecca Berens MD: And we, that pre-social media was a thing that was happening, there was messaging going out about health.
• 24:42
  Rebecca Berens MD: But because of like we've talked about the the way that the algorithms work and it.
• 24:47
  Rebecca Berens MD: The just boring, go get your mammogram content is not as exciting as the
• 24:53
  Sonia Singh MD: fear-based content.
• 24:53
  Rebecca Berens MD: Fear-based mammograms are actually killing you.
• 24:56
  Sonia Singh MD: Yes.
• 24:56
  Rebecca Berens MD: And that stuff is gonna go straight to the top and it's so hard to counteract that in.
• 25:00
  Rebecca Berens MD: Because of the way that the algorithms prioritize information and how your response to it then affects your behaviors of staying on the app to read more.
• 25:08
  Sonia Singh MD: Yeah.
• 25:09
  Sonia Singh MD: So it's just heavily biased towards fear-based content.
• 25:12
  Sonia Singh MD: And so I would ask yourself as you're scrolling through your feed when you see something health or wellness related.
• 25:18
  Sonia Singh MD: Is this fear-based and disguised as something educational and for informative?
• 25:23
  Sonia Singh MD: And I bet a lot of the time the answer will be yes.
• 25:26
  Rebecca Berens MD: Yeah.
• 25:26
  Sonia Singh MD: Okay.
• 25:27
  Sonia Singh MD: And then going back for a moment to the idea of Cleanliness and clean.
• 25:32
  Sonia Singh MD: I think we're seeing this broader trend of like moralization of health and wellness.
• 25:36
  Sonia Singh MD: So we talked a little bit about, in some of the episodes, how, with less participation in religion, organized religion and religious services, people now act out there.
• 25:45
  Sonia Singh MD: Their purity and their values in the way that they eat.
• 25:48
  Sonia Singh MD: Or the beauty regimen that they choose, or, all these other life choices that we have not historically necessarily thought of as moral choices.
• 25:57
  Sonia Singh MD: And so I think you see that in clean beauty and clean food.
• 25:59
  Sonia Singh MD: Clean living.
• 26:00
  Sonia Singh MD: The clean girl aesthetic.
• 26:02
  Sonia Singh MD: I heard my 16-year-old niece talking about that over the holidays and it's, it all invokes this certain moral dimension.
• 26:11
  Sonia Singh MD: And again, I think I didn't touch on this before, I talked about how, it's important in that words matter and especially as healthcare professionals, we need to think about the words that we're using.
• 26:19
  Sonia Singh MD: We need to think about the words that we're using in front of children and adolescent.
• 26:22
  Sonia Singh MD: Whose brains are still developing and we're figuring out what it all means.
• 26:25
  Sonia Singh MD: But I think it's another example of where, when you use the word clean a lot of people, it immediately resonates with them.
• 26:32
  Sonia Singh MD: 'cause they're like, yeah, I want clean.
• 26:34
  Sonia Singh MD: Like I, I want something that's natural and non-toxic and.
• 26:37
  Sonia Singh MD: People have this immediate positive moral intuition associated with that word.
• 26:42
  Sonia Singh MD: And it allows you to bypass the need to prove things scientifically, to provide scientific evidence.
• 26:47
  Sonia Singh MD: You don't have to have scientific liter literacy.
• 26:50
  Sonia Singh MD: You can just hear the word clean, be like, yeah, I like clean, sounds good to me.
• 26:53
  Sonia Singh MD: And I think.
• 26:54
  Sonia Singh MD: It again, it just, it shifts the attention.
• 26:57
  Sonia Singh MD: It's like it's clean.
• 26:58
  Sonia Singh MD: So don't worry about the fact that it costs three times as much.
• 27:00
  Sonia Singh MD: And don't worry about the fact that we replaced the paraben with something that's just like a paraben, but has a different name.
• 27:05
  Sonia Singh MD: Don't worry about that stuff, don't worry about that.
• 27:07
  Sonia Singh MD: We tested on animals don't worry about that stuff.
• 27:09
  Sonia Singh MD: I think just paying attention to who benefits from this and, what is the broader, what is the root of this broader movement of moralizing health and wellness?
• 27:20
  Sonia Singh MD: And is it a good thing?
• 27:22
  Rebecca Berens MD: Yeah.
• 27:22
  Rebecca Berens MD: And I think also to the flip side of the moralization is if you're unhealthy, it's your fault.
• 27:26
  Rebecca Berens MD: It's not the fault of our, many institutions that have created this situation that you're in, that you, that are causing you to have the health issues that you're having.
• 27:34
  Rebecca Berens MD: It, it further.
• 27:37
  Rebecca Berens MD: Pushes the narrative of this is a moral decision that you've made and if you're un unhealthy, it's because of something that you did.
• 27:43
  Rebecca Berens MD: It's
• 27:43
  Sonia Singh MD: a failure.
• 27:44
  Sonia Singh MD: It's a personal failure.
• 27:45
  Rebecca Berens MD: Yes.
• 27:45
  Sonia Singh MD: And contrary to what, probably organized religion and many of our, families of origin may have convinced us Shame and blame is not an effective strategy to improve health outcomes.
• 27:56
  Sonia Singh MD: It does not work to help people make healthier choices or lose weight or, yeah.
• 28:01
  Sonia Singh MD: It just, it's not an effective intervention.
• 28:03
  Sonia Singh MD: I think the moralization put nudges people in that shame, guilt, blame direction.
• 28:07
  Sonia Singh MD: Yes.
• 28:07
  Sonia Singh MD: When they're not able to make the clean choices and, I don't think that's actually beneficial and helpful.
• 28:13
  Rebecca Berens MD: Yeah.
• 28:13
  Rebecca Berens MD: And I, yeah, that I always say to people, you can't hate yourself healthier.
• 28:17
  Sonia Singh MD: No, I love that phrase.
• 28:17
  Sonia Singh MD: I'm gonna start using that.
• 28:19
  Sonia Singh MD: I like that.
• 28:20
  Sonia Singh MD: Okay the next one is context is key.
• 28:23
  Sonia Singh MD: This is, again, I don't know if we, this, we even needed to do the episodes to know this.
• 28:28
  Sonia Singh MD: I think especially in that first episode where you kinda reviewed, what is the evidence about health and wellness information on social media?
• 28:34
  Sonia Singh MD: It rarely gives you the full picture.
• 28:36
  Sonia Singh MD: It's rarely accurate.
• 28:37
  Sonia Singh MD: There's rarely discussion of risks and benefits.
• 28:39
  Sonia Singh MD: It's usually just I did this thing and it was amazing.
• 28:42
  Sonia Singh MD: No one's and I also got constipated and bloated.
• 28:46
  Sonia Singh MD: No one says that stuff.
• 28:47
  Sonia Singh MD: And and even when, another important fact is even when.
• 28:51
  Sonia Singh MD: Content is factually correct, like the post I talked about where somebody was talking about a potential side effect of a certain category of antibiotic for somebody with ER's downloads, that was factually correct, but when it's taken out of context and the nuance is missing, it can be very misleading for people and not actually helpful content.
• 29:11
  Sonia Singh MD: Even when true, because of the format of social media, it's just.
• 29:16
  Sonia Singh MD: There's a tendency for it to still be misleading.
• 29:19
  Rebecca Berens MD: Yeah.
• 29:19
  Sonia Singh MD: Okay.
• 29:20
  Sonia Singh MD: And then algorithms are not optimized for truth.
• 29:23
  Sonia Singh MD: We've touched on that.
• 29:24
  Sonia Singh MD: It's really optimized for your attention, your eyeballs.
• 29:27
  Sonia Singh MD: It's not meant to improve your health.
• 29:29
  Sonia Singh MD: It's not trying to limit bad information in any way.
• 29:32
  Sonia Singh MD: It's just built to keep your full attention.
• 29:34
  Sonia Singh MD: And so I think.
• 29:35
  Sonia Singh MD: What it's most likely to do is reconfirm preexisting beliefs and serve you more and more extreme versions of those same beliefs.
• 29:44
  Sonia Singh MD: It's oh, like you're hesitant about this thing, this medicine.
• 29:47
  Sonia Singh MD: Let me tell you all the things that are really bad about it.
• 29:49
  Sonia Singh MD: Let me tell you some bad things about other medicines, and let me tell you what doctors don't want you to know about.
• 29:54
  Sonia Singh MD: Pharma, it takes you down this hole because it needs to serve up something new and tasty for you when it feels like you've already gotten the message that you previously were entertained by.
• 30:06
  Sonia Singh MD: And so I think, and I see this happening in both directions, that there's this increasing, like polarization and radicalization happening, and I've never.
• 30:16
  Sonia Singh MD: Thought about or used the word radicalization in the context of wellness before, but I absolutely think it's a thing that is happening now.
• 30:26
  Sonia Singh MD: And I think it's happening in all directions.
• 30:28
  Sonia Singh MD: I, I see that, I don't wanna say it's only one side or another that's becoming Yeah, radicalized.
• 30:33
  Sonia Singh MD: We have not touched, vaccine hesitancy or skepticism at all in this podcast.
• 30:37
  Sonia Singh MD: And who knows if we ever will.
• 30:39
  Sonia Singh MD: But I remember someone had posted something that a different doctor had put out about vaccines.
• 30:45
  Sonia Singh MD: And they had posted it in one of our local groups that was physician only.
• 30:49
  Sonia Singh MD: And I did not read the Post as being anti-vaccine.
• 30:52
  Sonia Singh MD: I did not agree with the post, but I was this is like someone's opinion.
• 30:55
  Sonia Singh MD: Like I can, I, it's okay, whatever.
• 30:58
  Sonia Singh MD: But the vitriol over this person posting anything that, you know to towed the line of would leave room for somebody to, think that this vaccine was harmful.
• 31:10
  Sonia Singh MD: I was shocked by, and I just thought oh my God.
• 31:13
  Sonia Singh MD: So if I were to ask, a basic question, one time I remember I was looking for data about absolute risk reduction, like of a vaccine and I couldn't find it anywhere.
• 31:21
  Sonia Singh MD: And I thought about posting in the group and now I'm like, oh my God.
• 31:23
  Sonia Singh MD: If I had posted in the group, I probably would've gotten accused of being anti-vaccine, which I am not.
• 31:27
  Sonia Singh MD: Yes.
• 31:28
  Sonia Singh MD: And so I see that as evidence of polar further polarization where people have this perception that you can't even give an inch because if you do maybe the other side's gonna take a mile or maybe you're not on our side after all, and so I really feel like it's created this divide in a way where I don't even think.
• 31:49
  Sonia Singh MD: There's room for that conversation.
• 31:51
  Sonia Singh MD: I actually felt like that Post was acknowledging that a lot of this person's patients were probably not gonna follow his, the official CDC guidelines and was just giving some data to help them make a decision.
• 32:01
  Sonia Singh MD: And, I don't fully agree with not following the guidelines, but I felt that person was acknowledging a reality and trying to meet some people where they were.
• 32:10
  Sonia Singh MD: And I can understand why they would do that, and yeah I just think that it feels like a us versus them situation and it's social media is absolutely exacerbating it.
• 32:22
  Rebecca Berens MD: And it's like you said,, once it figures out like the first thing you're interested in, it sends you down a funnel and that those funnels are like diverging funnels, right?
• 32:29
  Rebecca Berens MD: And so you end up on these two sides and then when you hear something that's from the other side, you're like, how could you possibly think that?
• 32:34
  Rebecca Berens MD: That's insane.
• 32:35
  Rebecca Berens MD: But it's it's so easy to see how this happens but if we can't even meet in the middle and have a conversation.
• 32:41
  Rebecca Berens MD: This is only going to get worse.
• 32:43
  Rebecca Berens MD: And the lack of your ability to have a conversation and listen to an alternative idea or viewpoint just makes you even less trustworthy to that person.
• 32:54
  Rebecca Berens MD: 'Cause it's like you're so rigid.
• 32:56
  Rebecca Berens MD: You're obviously crazy.
• 32:57
  Rebecca Berens MD: And it's you're so real.
• 32:58
  Rebecca Berens MD: It's just, you can't it just furthers the divide and it's we see it obviously happening and politically and with all sorts of other, issues.
• 33:05
  Rebecca Berens MD: But seeing it, like you said, seeing it with health stuff is like relatively new, I feel like.
• 33:10
  Sonia Singh MD: Yeah.
• 33:10
  Rebecca Berens MD: And yeah, it's it's scary.
• 33:13
  Sonia Singh MD: Yeah, so I've become convinced that wellness content is a pipeline to a lot of scary and bad stuff.
• 33:21
  Sonia Singh MD: I think it leads you to conspiracy theories.
• 33:23
  Sonia Singh MD: I think it leads you to extreme viewpoints.
• 33:26
  Sonia Singh MD: I think it leads you to A lot of woowoo communities that are borderline cultish in their following of a particular wellness guru.
• 33:34
  Sonia Singh MD: It can obviously lead you to disordered eating.
• 33:35
  Sonia Singh MD: It can worsen health anxiety.
• 33:37
  Sonia Singh MD: So anyway, I just, I, I think before we started working on this podcast, I didn't.
• 33:43
  Sonia Singh MD: Quite have a grasp of how easily that can happen.
• 33:47
  Sonia Singh MD: And now I see even with, I think I gave the example in the Clean Beauty episode is like you're just like, okay, let me find a non-toxic sunscreen.
• 33:53
  Sonia Singh MD: And then you're like, wait, but.
• 33:55
  Sonia Singh MD: Now I can't trust my dermatologist recommendation.
• 33:57
  Sonia Singh MD: They recommended something that was, that had all these terrible ingredients and what can I trust her?
• 34:01
  Sonia Singh MD: Can I trust my doctor's recommendation to do this vaccine or this mammogram or this whatever?
• 34:05
  Sonia Singh MD: And it, it just, it's a slippery slope and it happens real quick.
• 34:10
  Sonia Singh MD: And yeah, I've just become more and more convinced that, perhaps the risks and the potential harms like outweigh some of the benefits that I was getting from social media.
• 34:19
  Sonia Singh MD: So I think.
• 34:19
  Sonia Singh MD: You and I both, ironically, we started out as doctors who doom scroll.
• 34:25
  Sonia Singh MD: And I think both of us have essentially extracted ourselves from most social media over the past six months, which is crazy.
• 34:34
  Rebecca Berens MD: Yeah.
• 34:34
  Rebecca Berens MD: Yeah.
• 34:35
  Rebecca Berens MD: And I think, I don't know what your experience has been like doing that.
• 34:38
  Rebecca Berens MD: It's difficult.
• 34:40
  Sonia Singh MD: Yeah.
• 34:40
  Rebecca Berens MD: But it's definitely, I think, been.
• 34:43
  Rebecca Berens MD: Very beneficial for me personally.
• 34:45
  Rebecca Berens MD: But yeah.
• 34:45
  Rebecca Berens MD: How have you felt like that experience has gone
• 34:48
  Sonia Singh MD: well?
• 34:49
  Sonia Singh MD: It's hard.
• 34:50
  Sonia Singh MD: It's really hard.
• 34:50
  Sonia Singh MD: Especially when you're a professional and you're an entrepreneur and you're, I have things to market and to, yes.
• 34:57
  Sonia Singh MD: Tell people about, and it's a lot harder when I can't just hop on Instagram stories and talk about it.
• 35:02
  Sonia Singh MD: I miss the connection that I have with people.
• 35:04
  Sonia Singh MD: I have a lot of people who see me in real life and then they're like, are you okay?
• 35:07
  Sonia Singh MD: And I'm like, yes, I'm fine.
• 35:08
  Sonia Singh MD: I'm just not broadcasting my life on social media.
• 35:10
  Sonia Singh MD: I am fine.
• 35:11
  Sonia Singh MD: I'm doing all the same things.
• 35:13
  Sonia Singh MD: But I notice a lot more vividly now how I feel when I do look at social media.
• 35:19
  Sonia Singh MD: 'cause before I was looking at it.
• 35:20
  Sonia Singh MD: Multiple times a day, every day.
• 35:22
  Sonia Singh MD: And now since I do it, so rarely, I'll notice like just this morning, I went on Instagram for five minutes because I was answering a DM and then I looked at the first thing on my feed and then I looked at the second thing on my feed and I was just five minutes.
• 35:35
  Sonia Singh MD: Rage and terrible.
• 35:36
  Sonia Singh MD: And I had all these rage thoughts and things that I was like, I should say this and I should, and then I was like, oh no.
• 35:41
  Sonia Singh MD: This is why I am taking a break.
• 35:43
  Sonia Singh MD: This is why I'm not doing this.
• 35:44
  Sonia Singh MD: This is a waste of my energy.
• 35:45
  Sonia Singh MD: I'm doing meaningful work to achieve the goals I have in other avenues, and I don't need to be consuming this content.
• 35:52
  Sonia Singh MD: And just having inner rage.
• 35:54
  Rebecca Berens MD: Yeah.
• 35:55
  Sonia Singh MD: For no reason, so I think it's been really positive.
• 35:58
  Sonia Singh MD: I still.
• 35:59
  Sonia Singh MD: I still scroll Pinterest in a mind numbing kind of fashion.
• 36:03
  Sonia Singh MD: So I, I still do mind numbing dopamine type activities, but I feel like doing them away from your typical social media platforms has been a positive change.
• 36:16
  Rebecca Berens MD: Yeah.
• 36:16
  Rebecca Berens MD: And I totally agree.
• 36:17
  Rebecca Berens MD: And, I actually, I got a brick from my phone because Yeah.
• 36:20
  Rebecca Berens MD: I could not stop.
• 36:23
  Rebecca Berens MD: Yeah.
• 36:23
  Rebecca Berens MD: Like it was subconscious.
• 36:25
  Rebecca Berens MD: What was happening.
• 36:26
  Rebecca Berens MD: And so I couldn't even just delete the app'cause I would literally go read down.
• 36:29
  Rebecca Berens MD: It's, it was that bad and it just yeah.
• 36:31
  Rebecca Berens MD: The parallels to addiction are so stark.
• 36:33
  Sonia Singh MD: It is addiction.
• 36:34
  Rebecca Berens MD: Yeah.
• 36:34
  Rebecca Berens MD: It's totally addictive.
• 36:35
  Rebecca Berens MD: And and you go I, now I have my, have the brick and you have the withdrawal and then have, and then it's once you get back in, the cravings come back.
• 36:43
  Rebecca Berens MD: It's just, it's so crazy to see how our brains have been changed by this technology.
• 36:48
  Rebecca Berens MD: Yeah.
• 36:48
  Rebecca Berens MD: And the biggest thing for me is like.
• 36:51
  Rebecca Berens MD: Trying to prevent my kids from having the same experience.
• 36:53
  Rebecca Berens MD: 'cause we've talked about this, you and I both grew up at the time where no one knew what was gonna happen with all this internet stuff.
• 36:58
  Sonia Singh MD: Yeah.
• 36:58
  Rebecca Berens MD: We were just the Guinea pigs for every single technological advance since the 1980s.
• 37:04
  Rebecca Berens MD: And and I think, now we've talked a lot on this podcast about How the disproportionate, this impact this has on children and developing brains.
• 37:11
  Rebecca Berens MD: And like for me, the biggest thing is making sure I'm not doing this kind of stuff in front of my kids or setting up that idea as a behavior that is normal or that I want to promote.
• 37:21
  Rebecca Berens MD: Yeah, totally.
• 37:21
  Rebecca Berens MD: And, but it really has made a big difference in me being more present with them and not having my phone like.
• 37:27
  Rebecca Berens MD: Right there all the time.
• 37:28
  Sonia Singh MD: Yeah.
• 37:29
  Sonia Singh MD: Yeah.
• 37:29
  Sonia Singh MD: My husband uses the Clear Space app, which I guess makes him do a breathing exercise before he's allowed to access his social media.
• 37:38
  Sonia Singh MD: So sometimes in the evening when we're in our wind down phase, I'll look over and he's and I'm like, you wanna go on Twitter, don't you, Twitter?
• 37:46
  Sonia Singh MD: Huh.
• 37:46
  Sonia Singh MD: So yeah, I mean it's amazing.
• 37:48
  Sonia Singh MD: The fact that we have to go to these lengths to get ourselves to stop using it is just an indicator of I have so many patients who are I don't wanna be on a medication'cause I don't wanna be dependent on it.
• 37:58
  Sonia Singh MD: And it's think about how we are acting with social media right now.
• 38:01
  Sonia Singh MD: Like it is hard Yeah.
• 38:02
  Rebecca Berens MD: To break that.
• 38:03
  Rebecca Berens MD: Yeah.
• 38:03
  Rebecca Berens MD: You'll never be dependent on a medicine.
• 38:05
  Rebecca Berens MD: Maybe a few, but most medicines you would never be as dependent on as we are with social media.
• 38:10
  Sonia Singh MD: Yeah.
• 38:11
  Sonia Singh MD: So anyway that brings us to the conclusion of this episode, on our reflection as a reflection of the last, nine episodes and what we've learned.
• 38:18
  Sonia Singh MD: I hope you guys have enjoyed being on this journey with us.
• 38:22
  Sonia Singh MD: I'm curious how.
• 38:23
  Sonia Singh MD: Listening to this content will influence other people's decisions and, interactions with social media and how they engage with it.
• 38:30
  Sonia Singh MD: We have a whole new batch of episodes coming.
• 38:32
  Sonia Singh MD: So stay tuned and then, if you have feedback, questions ideas for topics that you want us to cover, please feel free to reach out to us.
• 38:40
  Sonia Singh MD: You can reach us at the antisocial doctors@gmail.com.
• 38:44
  Sonia Singh MD: That is right.
• 38:45
  Rebecca Berens MD: Yes.
• 38:46
  Sonia Singh MD: Yes.
• 38:46
  Sonia Singh MD: Okay.
• 38:47
  Sonia Singh MD: And you can also subscribe to our substack.
• 38:49
  Sonia Singh MD: So if you're not a huge podcast listener, or sometimes you just wanna have the information in writing so that you can forward it to your friends and family who are not podcast listeners feel free to follow us there as well and get everything in written form.
• 39:01
  Rebecca Berens MD: Yeah.
• 39:01
  Sonia Singh MD: Well,
• 39:01
  Rebecca Berens MD: and actually if you're giving us feedback, I would also love to hear the other ways that people are using to modulate their social media usage.
• 39:09
  Rebecca Berens MD: Yes.
• 39:09
  Rebecca Berens MD: I've never heard of that Clear Space app, and I feel like it's useful to know about these other tools that are out there because it's actually useful for patients too.
• 39:16
  Sonia Singh MD: Totally.
• 39:17
  Sonia Singh MD: Yeah.
• 39:17
  Sonia Singh MD: I think this should all be, I think digital hygiene should be something that we learn in medical school that we talk about in our clinic visits.
• 39:25
  Sonia Singh MD: I think I might add it actually to my list of kind of screening questions on my yearly physical.
• 39:29
  Sonia Singh MD: So yeah, I think that's gonna be a huge topic in the new year, and I'm excited to explore that further and learn more about how we can have better digital hygiene in 2026.
• 39:38
  Rebecca Berens MD: Yeah, absolutely.
• 39:39
  Sonia Singh MD: All right,
• 39:39
  Rebecca Berens MD: Rebecca, take care.
• 39:40
  Rebecca Berens MD: Thanks.
• 39:41
  Rebecca Berens MD: Okay, bye.
• 39:42
  Rebecca Berens MD: Bye.
• 39:45
  Sonia Singh MD: Hey guys.
• 39:45
  Sonia Singh MD: Last
• 39:46
  Rebecca Berens MD: but
• 39:46
  Sonia Singh MD: not least, we have a very important disclaimer.
• 39:49
  Sonia Singh MD: This podcast is intended for educational and entertainment purposes only.
• 39:53
  Sonia Singh MD: The content shared on this podcast, including but not limited to opinions, research discussions, case examples, and commentary, is not medical advice and should not be considered a substitute for professional medical evaluation diagnosis.
• 40:07
  Sonia Singh MD: Or treatment.
• 40:08
  Sonia Singh MD: Listening to this podcast does not establish a physician patient relationship between you and the hosts.
• 40:13
  Sonia Singh MD: We are doctors, but not your doctors.
• 40:16
  Sonia Singh MD: Any medical topics discussed are presented for general informational purposes and may not apply to your individual circumstances.
• 40:23
  Sonia Singh MD: Always seek the advice of your own qualified healthcare professional regarding any questions you have about your health, medical conditions, or treatment options.
• 40:30
  Sonia Singh MD: Never disregard or delay medical advice because of something you've heard on this podcast.
• 40:35
  Sonia Singh MD: While the hosts are licensed physicians, the views and opinions expressed are our own and do not represent those of our employers, institutions, organizations, or professional societies with which we are affiliated, although we do our best to stay up to date.
• 40:49
  Sonia Singh MD: Please note that this podcast includes discussion of.
• 40:51
  Sonia Singh MD: Emerging research, evolving medical concepts and differing professional opinions.
• 40:56
  Sonia Singh MD: Medicine is not static and information may change over time.
• 41:00
  Sonia Singh MD: We, the hosts make no guarantees about the accuracy, completeness, or applicability of this content, and we disclaim any liability for actions taken or not taken based on the information provided in this podcast by listening to the Antisocial Doctors Podcast, you have agreed to these terms.
• 41:15
  Sonia Singh MD: Thanks again for joining us.