June 10, 2026 • 48 mins
Dr. Priyanka and Hari take a hard look at the state of American healthcare and what it means to advocate for yourself in a system that often feels impossible to navigate. Joined by OBGYN physician assistant and We Deserve More author Nikki Sapiro Vinkier, they discuss medical gaslighting, reproductive justice, trauma-informed care, and why patients deserve more than the bare minimum.
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Speaker 1 (00:00):
This podcast is for information purposes only and should not
be considered professional medical advice.
Speaker 2 (00:08):
This is not about patient care anymore. This is about profit.
Speaker 1 (00:11):
I was blown away by how awesome it was as
a resource for people.
Speaker 3 (00:18):
Previously, women just didn't even know that they could ask
for that level of care.
Speaker 2 (00:26):
I'm Hurricandbolu.
Speaker 1 (00:27):
I'm doctor prenkle Wally, and.
Speaker 2 (00:29):
This is health stuff. Hey, Prianca, Hey, Hey, how are
you three hays?
Speaker 1 (00:39):
I'm feeling I'm feeling extra hey today apparently, so what
I mean here? We are healthcare twenty twenty six, Yeah,
the United States. Yeah, and I want to hear about
kind of your experience, Like when you go in and
(01:02):
you have an appointment, do you prepare for the visit
or do you have pre organized questions in your mind?
I mean, like how do you sort of navigate yeah,
your visits?
Speaker 2 (01:16):
Yeah, I mean, if I'm seeing my GP, there's a
list of things. I'm like, let's focus on the ailments
that I feel are most important, Like, you know, do
I need do I need to see urologists? Do I
need to see I don't know why urologists was the
first thing that came out of my mouth, Maybe because
I'm like forty three and that was the first, Like,
(01:38):
or you know, do I need to see some of
my arm hurts, my legs hurt? Like who do I
see for those? So I try to make a list
because I feel like setting up another appointment waiting another
couple of weeks because you know, my GPS so busy
to get a proper appointment. Like, you know, if I'm sick,
I'll just go to an urgent care most likely, because
(02:00):
trying to get in a point with my doctor when
I'm sick is like, it's just not it doesn't line
up right, So.
Speaker 1 (02:06):
I mean the irony of that, right right?
Speaker 2 (02:08):
Oh, I can never see my doctor when I'm sick.
Of it always has to be preventative. If it's preventative,
I can make it too, you know, for getting blood
work or something. I can do that two weeks in advance.
But now I'm in this weird spot of like my
GP is leaving the practice and sorry, it's awful. Now
I got to find a new GP. And that's become
a whole process of who does insurance cover? I don't
(02:31):
want to go into Manhattan from Brooklyn. There's there's something
that's nearby and it's it's such a confusing system and
it's not clear where you know, and sometimes there's there'll
be like these three people take your insurance and I
call to double check two of them don't right, So
it's it's such a it's I don't know if we
(02:51):
have any international listeners, but you should know the American
system is not very good. And yes, and it's very
because because it's a capitalist system and services aren't always
up to par, because you know, it's about saving dollars
at the end of the day.
Speaker 1 (03:08):
To put it simply, yeah, very simply. I'll tell you
when I go see the doctor. As a doctor, I
usually type up all of the pertinent history related to
the situation at hand, details and I'll write like at
the top preon Kowali pertinent medical history and literally like
(03:29):
write their note for them and then hand it to
the medical assistant and say like this is for the
doctor to review before they come in.
Speaker 2 (03:37):
So that they have that on file already.
Speaker 1 (03:39):
So you would think, you would think, but like how
a doctor documents their notes is provider dependent. You don't
know how much time they have to chart, and we
know there's very little time when you see a doctor
and like the traditional insurance based system. So I am
just trying to make their life easier so that the
(04:02):
moment they walk in, they know exactly what the issue
is and what we're going to talk about, and then
it goes by much more efficiently. But that is an
extra kind of piece of work that I do, like
before each visit for very specific issues. If it's like
a general issue, like I'm here for a general wellness
(04:24):
check or whatever, I'll still make a list of Okay,
these are the points we need to talk about. And
even like going to the pediatrician for my son. Let's
say my husband's going to go take him to the pediatrician,
I will give my husband the list of like these
are the updates since the last visit, and these are
the questions for the pediatrician. So you're like, I mean,
(04:48):
I feel like you have to be unless you're not
going to be able to cover everything that you want
to r This is why I'm so excited to talk
to our guests today. Nicky Sapiro Vink here, who is
an obgay and physician assistant, because she developed this really
great resource called TakeBack Trust that really helps patients with
(05:10):
their provider visits and navigating this maze of a healthcare system,
like capitalism is clearly the problem.
Speaker 3 (05:18):
Oh yes, you know, like this.
Speaker 1 (05:20):
Is really I don't know at what point a soulless
individual was like, yeah, yeah, we're gonna make money off
of people's health and ailments.
Speaker 3 (05:29):
Yeah, you know, Like I.
Speaker 1 (05:31):
Don't understand how we as a society can keep doing this.
Speaker 2 (05:37):
Well, I mean think about they want to privatize education too, Like,
this is all the things that are supposed to be givens,
you know, Like, what what is the purpose of being
in a so called developed society that doesn't offer the
basics to live?
Speaker 3 (05:53):
Right?
Speaker 2 (05:53):
Then?
Speaker 1 (05:53):
What exactly are we getting?
Speaker 2 (05:56):
What's the point?
Speaker 1 (05:56):
What's the point?
Speaker 2 (05:57):
I thought that was part of the membership benefits of
being in a country, right, I.
Speaker 1 (06:01):
Mean this is like a Chase Sapphire reserve gone wrong,
right right? They have raised the prices way too much.
It is time to cancel, you know what I'm saying. Yes,
I think this can't be sustainable. And for me, I'm
(06:22):
very curious and also curious to ask our guests how
is this going to end? Because it's already showing the
signs of a system in distress and people are getting
hurt and harmed and it's not working. And so the
question is how much further can this go before we
all need to just look at each other and be like, Okay,
(06:45):
enough is enough, Like seriously.
Speaker 2 (06:48):
I mean, patient cares is so not prioritized at this point.
It's so like my mom worked at a hospital and
got bought by a larger hospital, and that's part the
reasons she wanted to retire. She was just like, this
is not about patient care anymore. This is it's about profit.
And it's so clear with how they make us document
(07:09):
everything and how they suggest we handle patients. It's like,
this is not about patient care anymore. So why am
I in this industry?
Speaker 3 (07:17):
I mean?
Speaker 1 (07:17):
And I think probably the system has lost a lot
of really good providers for that reason, like your mother.
So I hope the goal here for today's talk is
to get more information around Nikki's perspective. But also the
question I have is is there hope for us or
do we need to burden down the whole barn and
(07:39):
start over. It's hard, you know, you want, like in
this show to not be like doom and gloom. You
want it to be uplifting and hopeful, but I do
think on some level we really have to look at
these systemic failures and acknowledge that they exist and stop
pretending like everything is okay, yes.
Speaker 2 (07:58):
Because I mean our job is still to be realistic,
like this is what we're up against. What we try
to do on this podcast is to try to look
for answers. So I think it's completely reasonable to diagnose
the system as broken and then try to look for
answers and see what can we actually do because so
many of the issues we've talked about, a lot of
them have involved like inefficient systems, right, right, and that
(08:20):
has to do with money. It's a necessary kind of
reevaluation of the system.
Speaker 1 (08:25):
Yeah, shadow work, We're looking at the shadow work of
the collective.
Speaker 3 (08:29):
Yes.
Speaker 2 (08:33):
Today's guest is Nicky sapayro Vinkier, an OBGYN, physician, assistant,
reproductive health educator, and the founder of take Back Trust,
a platform helping people navigate reproductive healthcare. She's also the
author of the book We Deserve More, which explores the
systemic failures and reproductive healthcare and give us patients tools
(08:54):
to better advocate for themselves in the exam room and beyond.
Welcome to the show, NICKI.
Speaker 3 (09:00):
Thank you so much. I'm glad to be here.
Speaker 1 (09:02):
Oh, we're so thrilled to have you. Let's start by
talking about take Back Trust, because when I saw the website,
I was blown away by how awesome it was as
a resource for people. Can you talk a little bit
about the story behind why you started.
Speaker 3 (09:21):
It, Yeah, I'd love to.
Speaker 1 (09:24):
So.
Speaker 3 (09:25):
As a clinician, you know, I spent the last ten
years or so working with patients answering questions, and I
felt like there were a lot of the same questions
that were coming up over and over, and so some
of those questions and answering those questions was part of
why I was like, Oh, why don't people know this?
Like why isn't this more common knowledge? And really feeling
(09:45):
like there was a void. And then I really wanted
to be able to address the fact that this landscape
is changing so drastically all the time, and oftentimes people
feel really stuck between this idea of like, I know
this is what I mean, and maybe this is what's
happening in the country or in the world, and how
do I relate the two of those As I'm going
(10:07):
in to get kynecological care and so the goal is
really to help explain to people what does that healthcare
system actually look like, and how do you advocate for
yourself better within this system that we find ourselves in,
and kind of painting a very real picture from a
landscape of Oh, do you have embryo in Alabama? Do
(10:28):
we want to move those out of state? Are you
concerned about some of these things? Right? Are you interested
in an IUD, here's the timing of that, and here's
how we ask for better paid management, which we know
is such a hot topic. Right, So really addressing some
of those questions and concerns that I was seeing surface
online and having them in a home that you know,
(10:50):
people could go to and access it whenever they needed.
Speaker 2 (10:53):
We often talk about access to reproductive healthcare in terms
of law and geography, but you seem focused on emotional
access and informational access. Can you talk about why those
are just as critical and also define what they mean?
Speaker 3 (11:07):
Yeah. I think a big part of the issue is
that we don't actually know how to engage in the system,
Like we were never actually taught how to be patients
in a way. So you have a patient who comes
in and has seventeen questions in a laundry list of
issues to ask during their annual exam, and that's not
the right time to get those addressed. So then they
leave that visit feeling frustrated or like they weren't heard
(11:31):
they didn't have time to ask their questions, when in actuality,
they just needed to make a different appointment. But nobody
ever tells them these things. So how do we actually
teach people not just Okay, here's the issues you're having,
but here's how you make the right appointment for those things.
So it's not just where you live, what the laws
are in the book, but do actually even know what
appointment you're going in for to begin with, and really
(11:53):
setting that up from the get go and asking for
what you need when you're making that appointment too. And
so I think there's so many things that can hinder
access to care, and I think one of them is
as simple as just setting the right appointment to start.
Speaker 1 (12:09):
Yeah, And so, you know, it's very interesting you're hitting
on something I want to kind of double click on
a little bit because you've spent more than a decade
as an obgy and physician assistant, and so you've seen
sort of the transformation of the way care has been delivered.
You know, you mentioned earlier around how you come in
with seventeen issues, but that doesn't make sense to address
(12:30):
that like your preventative sort of visit. And in terms
of the timeline, I mean, at what point do you
think healthcare started to change like this? Because I don't
it wasn't always like this, But in your experience, at
what point did you start to realize that patients just
(12:51):
they are not entering these appointments with the tools that
they need.
Speaker 3 (12:56):
I think it's multifactorial. I think there's a lot of
things that add to it. I think right now within gynecology,
women are more empowered than ever to ask for what
they need. So I think previously there were things and
thoughts in the back of women's mind that maybe they
didn't actually feel comfortable bringing up or addressing. So I
don't necessarily I want to push back a little bit
that I don't think that it's just now, But I
(13:18):
do think we're seeing a seismic cultural shift that people
are now feeling empowered and able to ask questions that
perhaps they had been thinking for decades prior, right, And
so I think that that's a really big culture shift
that we're seeing in this moment, and I think a
lot of that is from normalization of these topics within
(13:39):
you know, friendships, within social media, within the Internet. We
have access to so many things now that can help
kind of like illuminate these thoughts that are in the
back of our head to say, oh, we do need
to be asking these things. So yes, I think it's
you know, obviously medicine has so many issues. But I
(13:59):
really don't know if it's just that, like we have
seventeen issues now or if we always had seventeen issues
and previously women just didn't even know that they could
ask for that level of care, that they could even
share those concerns, you know, that they could even say,
this is what I'm really feeling and really meeting. And
I think that's the piece that I really noticed is
(14:21):
changing the most, is that we're actually demanding the care
that we should have been getting all along.
Speaker 2 (14:30):
More after this break. I love that you included a
take back trust for men's section on your website, because
healthcare conversations so often are just framed as women's issues.
Do you think better reproductive education for men could improve
relationships and communication in addition to health outcomes.
Speaker 3 (14:52):
Yeah, I mean I can't nod my head. I know
this is an audio podcast, but if you could see
me visually, I am enthusiastic nodding my head. And I think,
you know, we've really done a disservice to people saying
no uterus, no opinion, And I think we've really punted
men out of the conversation and have said if this
(15:13):
isn't your issue, we don't even want you in this conversation.
And then we've been seeing that we're having a hard
time even winning over all women to take this on
as their own, you know, issue to vote for and
root for and care about. And I think we're really realizing, actually,
we do need to galvanize the support of men, and
(15:36):
we need to prove to them and show them that
this isn't just a women's issue, that this is a
family issue, that this looks at your ability also to
go to college, your economic security and safety, your ability
to have kids when and if you want. Right when
we look at the framework of reproductive justice in general,
it talks not just about abortion care, but the ability
(15:59):
to raise and grow and thrive with your family, and
that impacts all parents of any gender, and so I
think we've really done a disservice for so long saying like,
don't bother chiming in, we don't want you. And I
think that now we're kind of realizing actually, like, please
(16:19):
come on board. I don't need you to talk over
me about my reproductive health care, but I need you
to stand shoulder to shoulder with me and really back me.
And I think aside from that, like what we're seeing
with some of these women who are dying as a
result of abortion bands is if they had a support
person who could more loudly advocate for them, more clearly
(16:41):
say this person is hemorrhaging and bleeding and needs treatment. Right. Unfortunately,
we live in a world where men's concerns are taken
more seriously than women, and so I think we need
to be really active in opening up the conversation and
bringing men on board entirely. And so with back trust
and having take back trust for men, my goal was
(17:03):
to give men a space where men could educate themselves
on it. Right. I think one of the biggest issues
is that as women were burdened with so many things
and then having to take on another burden of teaching
reproductive healthcare is like even more annoying. And so my
goal was to kind of take that burden off of
women so men could do the work of learning about
(17:26):
reproductive health care. And we partnered with Men for Choice
on it, and there's a whole blog section that's for
men by Men that has a lot of different blog
posts on men thinking about talking about reproductive health care
into journal entries. There's a whole glossary of terms, and yeah,
the goal is to make it so that men feel
(17:48):
like it is their fight.
Speaker 1 (17:50):
Also, Yeah, I mean that's such a critical point. Everybody
has to be involved in this for it to be successful.
And the thought in which you've put into this website
take back trust dot com, I really want to share
it not just with our listeners, but patients in my
own practice or people in my life. I think it's
an incredibly helpful tool and so timely as well. So
(18:14):
I mean, you created this, what is your vision of success, Like,
what would be the change that you would want to
see the most, let's say in ten years.
Speaker 3 (18:24):
Yeah. You know, I had a patient one time who
came to me and said, you know, we had a
normal visit and we were done, and she was like, well,
what questions do I need to be asking you? And
I was like, Oh, that's cute, and I'll sit with you.
I'll sit here with you and I'll talk to you forever.
But not all clinicians will. And it turns out as
(18:45):
a patient, we need to do our homework before we
go into the office. Right. We need to know what
are our symptoms that we're feeling, how long has it
been going on, really be able to address, how is
it presenting for me? How does it impact my quality
of life? My goal is that take Back Trust can
be the site that people go to to kind of
(19:05):
do that homework before they go in for a visit. Right,
And we've got that provider visit planner where you can
map out questions that you're going to ask your clinician
coming up, kind of regarding whatever topic of concern as
bringing you in. And I really wanted it to be
kind of this you know, treasure trove of information where
you don't feel alone, where you're going through it and
(19:28):
you feel seen and you feel validated, and there's a
very strong trauma informed lens throughout. And you know, I
think that's a big issue too in healthcare, is that
we're not addressing how common it is to have sexual
health issues and sexual trauma and or medical trauma, and
how does that relate when you're circling back into medical care, Right,
(19:52):
And so that was the goal and ten years what
my vision would be is that people are using a
tool like this instead of chateing or web mding their symptoms.
You know that you're using an evidence based, clinical rooted
guide to kind of walk you through what that homework
model can look like. So you're still engaging in our
(20:12):
healthcare system with clinicians who have best interests in mind,
but you're able to also do your homework too. Yeah.
Speaker 2 (20:20):
Since Roe was overturned in twenty twenty two, have you
noticed a shift in the kinds of fears or questions
patients are bringing into OBGA and appointments.
Speaker 3 (20:30):
Yeah, I mean I'll go back even further. Right. I
started practicing in twenty fifteen, and in twenty sixteen was
the first Trump election, and that was the first time
that I started having patients asking about long acting reversible contraceptives.
The spike in people asking for marina IDs that at
the time were indicated for five years and now they're
(20:50):
food for eight years. It was tremendous because people wanted
them put in in that lame duck window before Trump
took office, and they wanted it to carry them through
his entire present. And see, so yeah, I think before
Roe versus Wade was overturned, that was definitely a shift
that I was seeing happen within healthcare visits. After Roe fell,
(21:11):
I saw a significant increase in people asking for permanent sterilization,
google removals, and vasectomies of like, you know, we've been
on the fence, we've decided, and we want that, you know,
definitive answer. And it was really interesting. In twenty twenty two,
you know, we were surfacing still from COVID a little bit,
and so there were still a lot of delays on
(21:33):
elective surgeries and procedures, and so my own partner went
to get a vasectomy and it took like five months
for him to get in for an appointment. And I
think because it was a combination of the demand being
higher still a backlog from COVID, like all of the things.
So yeah, I definitely think that that was real.
Speaker 1 (21:53):
So I guess the question I have given the landscape
right now, I really want to hear what you think
about the future of reproductive healthcare here in the United States?
Is there any hope? What worries you right now?
Speaker 3 (22:11):
There's a lot that worries me. There's a lot that
worries me in the ways that we were saying, you know,
we think row is going to fall, and we were
considered hysterical at that point. I think the ways that
I'm watching the narrative change online about birth control feels horrifying,
the way that they're kind of like seeding so many
questions in the back of people's mind that birth control
(22:34):
is harmful, birth control is damaging, that birth control is
a pipeline to infertility. I mean, they are actively seeding
miss and distrust in the healthcare system in medications. It's
the same thing that we've seen them do with vaccinations
they're doing right now in terms of birth control. And
so I think that feels really scary because birth control
(22:57):
has been liberating for women, for death kids. It has
been a huge tool that has enabled women to go
advance their education, to get better jobs, to have a
family when they want to have a family, or if
they want to have a family, And I think that
they're actively, you know, kind of poisoning the idea of
(23:21):
birth control all the while gutting abortion access in the country.
Speaker 1 (23:26):
And when you just to clarify when you say they,
who specifically are you naming?
Speaker 3 (23:31):
You know, I think that it's a pretty thoughtful methological
process that comes out of the Heritage Foundation is kind
of who seedes it. But there's a lot of like
wellness influencers and the Maha movement, and so I don't
think it can be traced back to like one singular person,
but I would say it does tend to come from
(23:52):
one side.
Speaker 1 (23:54):
So are there any parts that do give you hope?
Speaker 3 (23:58):
Yeah? So let me expand though on the things that
I'm scared of, because I want to also talk about
fertility for a second, because IVF is getting really wrapped
up in the discussions around abortion bands, specifically around embryo
creation and testing, because if those embryo don't test well,
we discard them and that's not approved, right, And so
(24:19):
I think that's an issue. And their recommendation for pulling
away from the way we've leaned on IVF and leaning
into what they call restorative regenerative medicine, of restorative reproductive medicine,
more of this like wellness based infertility management, which we
know isn't actually going to get you the baby in
(24:41):
arms the same way that IVF will. So I think
those are things that I'm really concerned about in terms
of things that give me hope. What I think is
really cool is that people are finding community right now.
And as much as I do want to just on
social media all the time, like I think there are
things that are actually really helpful. Like we have this
(25:02):
thing called Nancy's Nook, which is basically a community on
Facebook of endometriosis patients and surgeons where they can go
on and kind of recommend, you know, specific excision surgeons
and have a support network where people feel seen, heard
and supported. We have Facebook groups of IVF mothers where
(25:24):
they got pregnant and have leftover medication and they create
their own like black market because IVF meds are so
expensive and they want to support one another. And like,
as ridiculous as that is that we have to do that,
I think it's also something really beautiful in the fact
that it used to be so lonely and isolating, and
(25:44):
right now I think there are so many people who
share their stories and kind of come out to talk
about what that experience looks like for them that that
part does give me hope within medicine, within you know,
specifically reproductive healthcare, because we're not doing this in the
shadows anymore. We're talking about the miscarriages we're having, We're
talking about the fact that our periods lay us out
(26:06):
for two to three days at a time. We're talking
about all these things that for decades it's been like, hush, hush,
don't talk about that. Like when I was younger, and
I'm sure you know so many people will relate to this.
If I was on my period, you would take your
tampon and hide it in the sleeve of your sweatshirt.
Do you remember that?
Speaker 1 (26:25):
Oh my gosh, yes, yes, I totally remember people in
school doing that.
Speaker 3 (26:30):
Because God forbid, people knew you were on your menstrual cycle,
which every woman gets once a month. Right, So we
went in the last twenty to thirty years from like
I have to hide the tampon in the sleeve of
my coat to I will be able to talk about this.
So I think that part really does give me hope,
as I think we are normalizing a lot of the
(26:52):
conversations that should not have been stigmatized. To begin with.
Speaker 1 (27:01):
We'll be back with more health stuff after this break.
Speaker 2 (27:07):
I just want to jump back to the birth control
hormonal contraception conversation just for one more moment. How do
you respond when patients come in genuinely terrify that birth
control is poisoning them or causing permanent infertility because of
the crap they've seen online.
Speaker 3 (27:24):
I think you have to be curious. I think that
we cannot dispel anything that they say, think, or come
into the clinic with. And so I think that's the
biggest issue is that there are people who do have
negative side effects to birth control. That is very real.
And if we dismiss that across the board, then we
(27:45):
gaslight women into saying your experiences aren't real. And I
think we have to balance saying, oh, you may have
a side effect on birth control, great, let's try something else,
Or what worked for your best friend may not work
for you. Like I think we have to be meeting
them in the moment where we're saying, if this isn't
working for you, let's find something that is. And we
(28:08):
can also say, oh, if you have no side effects,
if you truly feel fine, this is a winning ticket,
right And so I think that it is a matter
of like really pulling apart. Are you having any symptoms
of side effects? Are you having any issues with it?
Are there any things that you've noticed? And I think
if we lay that out and actually give them the
(28:29):
opportunity to like self triage, self reflect, self diagnose, they
might actually come to the table and be like, no,
I feel good, right. And I think that's that kind
of like you have to get them on board because
it's their healthcare. And if we're just not listening and
saying that's ridiculous, don't listen to that, you're not getting
(28:50):
that buy in from them that we actually need. And
so I think that the name of the game is
really empowering them to make the right choice rather than
kind of like dictating top down what we think is
best and really you know, being curious about how it's
presenting for them and if they are having any negative
experiences and trying to fix those.
Speaker 1 (29:12):
Yeah, I mean you're hitting it so correctly. It also
is so critical that the provider genuinely listens to the patient.
That's so important. I have seen this a lot, but
you know people out there you mentioned earlier just feeling
medically gas lit about their experience, or they are prescribed
(29:33):
something and they have side effects and they're just brushed aside.
This is a good segue to giving our listeners helpful
tips for navigating the system. So what advice do you
have for someone who feels like they are in a
medical situation with their provider where they are experiencing being
medically gaslet or brushed aside? What should they do?
Speaker 3 (29:56):
I think the best thing we can do is bring
in the receipts, right that if you had someone with
a GI issue and you're trying to figure out do
you have an allergy to food and what type of
food is it, and you make them keep an entire
dietary log I think we need to be doing the
same things with our symptoms that we experience. So, for example,
(30:18):
right now, perimenopause is a big topic of conversation, and
there are a lot of different symptoms that women can
have as a result of perimenopause. So just saying I'm
in perimenopause or I feel like I'm in perimenopause is
not actually helpful, because sure, pretty much anyone in their
forties is right. But what is helpful is saying I
(30:42):
have difficulty sleeping at night, but not just difficulty falling asleep.
I wake up at two am and I am up
for two hours, and it happens every night, and it
impacts me this way. Or I have gained weight and
it has only happened over the last year, or you know,
I feel like my anxiety has worsened. It's not cyclical.
(31:03):
It doesn't happen with ovulation or with my mensies. It's
all of the time, right, And if we go in
with these tracked symptoms, almost in a diary format, in
a calendar format, it makes it a lot harder to dismiss.
It makes it a lot harder to say that's not happening. Right,
(31:23):
If you say, here's what I've tried already, I have
really bad cramping. The cramping happens all of the time,
and I've tried ibuprofen, you know whatever dose every six hours.
That doesn't fix it. We're making it a lot harder
for them to tell you go monitor it for two
to three months and come back to me and let
me know how it is, because you've already done that, right,
(31:46):
And so I think that's the biggest piece is like
come in ready to lay it all out and say
it's you know, here's how this presents for me, and
then it makes it a whole lot harder for them
to say no or you know, poo pooh you away.
Speaker 1 (32:01):
Yeah, And just to follow up on that, I mean,
you're essentially advocating for having patients speak in a way
that's more congruent with the language of medicine, for providers
to then recognize that this is a sign or symptom
of some sort of disease process in the sort of
the algorithm of their brain.
Speaker 3 (32:20):
It's literally like a soap note, right, like these things
that we learned in medicine, and we know unfortunately we
as clinicians have few minutes to decipher these things. And
so yeah, I agree. I think it is kind of
almost like saying, Okay, here are the things that could
be and I know what it could be. Also, because
(32:41):
everybody has chat GPT and they're symptoms before they've come
in the door, like and everybody has right, so people
walk in saying this is what I think it is,
So how do I get this to happen? But we
know chat GPT is wrong with over forty five percent
of cases, and we know in women it's only higher
because they're based on studies that actually include men. So
(33:02):
instead of asking chatjipet to diagnose you and going in
to see your doctor, what you can do is saying, hey,
chat gipt, what are the things that I can express
to my clinician. What are the ways that I can
talk about my pain? What are the things that I
should be telling them that it's not or doesn't feel
like right?
Speaker 1 (33:18):
Like?
Speaker 3 (33:18):
What are the lab tests I could even inquire about?
And then you present all that to a real human
clinician and let the clinician better be able to kind
of like sort through all of that information, and you
give them kind of this like silver platter to help
them figure it out.
Speaker 2 (33:36):
There's been a growing public conversation around pain management for
IUD insertion and gynecologic procedures. Why do you think women's
pain has historically been minimized in these settings?
Speaker 3 (33:47):
Oh, let's go back to the very beginning. Yeah, So
the grandfather of gynecology, doctor J. Marion Simms, who's again
is referred to as the grandfather of gynecology, performed his
surgeries on unanesthetized enslaved black women. Yep, So the three
(34:11):
main women that he performed these surgeries on were Anarca, Betsy,
and Lucy, though there were about thirty different enslaved women
that he did, and he did this without consent, without anesthesia,
and then turned around and did these same surgeries on
white women with anesthesia and consent. So when we look
at pain and recognition of pain, it has never been recognized,
(34:32):
and specifically for black and brown women, that is very
important to name outright is that their pain has never
been acknowledged, received supported like it is for white women,
and it's still sh for white women, which means it's
really bad for black and brown women. And so I
think it is absolutely imperative when we talk about pain
management in gynecology that we go all the way back
(34:55):
to the beginning, because without recognizing and reconciling that, I
don't think we get any whereas clinicians or as patients.
Speaker 1 (35:02):
Right.
Speaker 3 (35:02):
So, I think that's a really important thing that we
need to be talking about way more often, because when
we look at medical distrust mistrust, there's no way to
bring people along to trust us again if we're not
talking about the ways that we messed up in the past, right,
So I think that's a critical critical piece, But there's
(35:23):
been a lot of bullsh information that has come out
saying that, like, you know, there's not nerve endings in
the cervix, or that you don't feel pain, or that
doing a cervical block is not going to help with
the cramping you're going to have at the top of
the uterus because it doesn't block it all the way right, Like,
there has not been enough research into women's pain. There
(35:45):
is not enough investment and understanding and support of women's
pain to actually prioritize this. And I think when we
look at the things that do make me happy about
social media, it is the fact that women bravely live
streamed their eye AD insertions for the last probably I
would say, eight to ten years. And I think it
(36:06):
was only a direct result of that that ACoM has
come out and said here are pain management guidelines and
recommendations for IED insertions for endometrial biopsies, et cetera. And
so I think that that was a direct response to
bottom up, grassroots pain management cries for help that AKOG
(36:26):
finally said, Okay, we need to respond to this top
down and give some guidance on this. And so when
I look at things that do bring me hope. That's
a huge motivation of like we demanded better and we're
still not quite there on that, but like, look there
they are listening, Like we have their ear and we
(36:47):
have their attention.
Speaker 1 (36:48):
Yeah, I mean because we had like direct video evidence
of how horrible it was, you know, and so you know,
there's clearly been so much rupture in the trust relationship.
So for people who are maybe survivors of medical trauma
and are now sort of avoiding getting gynecologic care because
(37:11):
of the fear or the trauma they experience, what could
be some steps that they could take to restore their
sense of agency.
Speaker 3 (37:21):
These are such great questions that I'm so happy to
be here because these are like all the things that
I really love talking about and things that I don't
think we've done a good enough job of talking about.
And so I think these are the conversations where we
actually do get to like change what happens, change what
people know, and change what people feel like they get
to ask for. And so I think really acknowledging trauma
(37:43):
is the ground level that I think it is absolutely
imperative to say, hey, I have a history of trauma,
whether it's medical trauma, sexual trauma, and any other form
of trauma that we go into the room with. And
I think that's a piece that really hasn't been addressed.
(38:04):
For example, we know that three out of ten women
statistically will have been sexually abused or assaulted in their life,
and we don't talk about that as clinicians, and we
don't do exams that are reflective of that percentage of
our population. And for all of my patients who would
come and see me after they had had a rape
(38:25):
kit done in a hospital, you know, the sound of
a speculum clicking open is hugely traumatic. And until we
have every clinician across the country who not just like
hypothetically understands that, but really truly understands that, we don't
(38:46):
have hope for trauma informed Karen So, I think that
if anyone has had a history of or past of,
I think that's important to name and say it is
imperative to me that this practice offers and provound's trauma
informed healthcare. Is that something your practice in your office
specializes in. As are making the appointment, like, name it
(39:07):
and talk about it, And then I think it's totally fair.
I wrote in my book like ask for trauma informed care,
and if you don't feel comfortable saying it out loud,
you can write it on a piece of paper and
hand it over as you walk in the door, being
like I have a history of trauma. That's all it
has to say, right, And I think that clinicians steer
(39:30):
away from these conversations because they're delicate and they take
time in the exam room and you're worried about triggering somebody.
But by not acknowledging it, we're missing the whole point entirely,
and I think we need to really actually lean into it,
not away from it.
Speaker 2 (39:48):
What's the one thing you wish every patient knew before
walking into an obgian appointment today?
Speaker 3 (39:55):
Ooh, I wish they knew that they are the boss.
I wish they knew that actually, like it is their
experience and if it's not working for them, then they
can get up and leave. They don't have to white
knuckle through an exam if the provider does not feel
like the right fit for them, that they can go
at their own pace, that they can talk first and say, hey,
(40:15):
I'm going to come back another time if I need
more time, and tell the exam right that they get
to dictate is this working for me or not. If
you feel like you know you're not getting what you
need out of the system, then how do you advocate
for better or different care? And I think, especially with
the shifting of medicine into these larger group models, it
(40:38):
doesn't always mean you have to like completely reinvent the
wheel and go to a whole different practice where your
medical records are out the window. But it might be
finding someone else within the same group and just getting
a little bit of a fresh start of who's the
person who's best suited for me, not necessarily who delivered
my three babies, and I'm you know, I'm stuck with
them for the rest of my life because I owe
(41:00):
them everything. I think it's important that people know that
their experience is theirs and they get to talk about
it and be an individual within a system that I
think often forgets individuality.
Speaker 1 (41:13):
So can you walk through for our listeners what would
be some of the signs that they should look out
for if they should consider finding a different provider.
Speaker 3 (41:25):
I mean, I think these things are more simple than
we think they are. It's just a matter of listening
to them. I think we know in our heart and
in our gut, if this is the right fit for
us or not, if we feel comfortable or not, and
if we don't like, that's all you need, you know.
I think that really feeling listened to and feeling listened
(41:48):
to doesn't have to mean that they sat down with
me for twenty to thirty minutes and went through all
seventeen of my questions, right, But I think the sincerity
of the experience is important, and the plan the I
understand you have a lot of concerns, and so let's
make another appointment to address the next three things you
(42:08):
may have. And I think that's how we as clinicians
can make this better too, is not by just like
walking out of the room and ignoring the rest of
the laundry list, but by saying, hey, I see you
have a pen and pad of all these different concerns.
Tell me your top two to three things that you
want to address today, and let's make an appointment to
(42:31):
follow up on those and go through the next ones
at your next visit. And I think, of course that's
a luxury to be able to do that, because there
are copays to these visits and it is time. But
I think that's Also where we can lean into telehealth
is figure out what do you actually need for an
in person visit and can you do some of these
(42:51):
follow ups via telehealth? How do we make it easier
on us and our patients so we're meeting them where
they are.
Speaker 2 (42:57):
What are signs someone should consider finding a new provider immediately.
Speaker 3 (43:03):
If you feel uncomfortable during a pelvic exam, I think
that's like a Yeah, that's a no brainer. If it's
a painful pelvic exam, If they're not talking to you
about what's happening, if they're not giving you choices for
pain management, for any of the procedures you need, if
they are mandating really any of their recommendations without walking
(43:24):
you through it. If you are perimenopausal and struggling and
they're telling you that hormone replacement therapy is not an
option or it's not safe. That is outdated guidelines and recommendations.
And I'm not saying every woman needs, you know, hormone replacement,
but I'm saying it should at least be an option
that they are informed about and can talk through with you. Yeah.
Speaker 1 (43:46):
Any kind of final sort of advice for our listeners,
anything that you want them to know before we sign off.
Speaker 3 (43:56):
I would want them to know that their voice matter
and that what they think matters, you know, how they
feel matters, and really tuning into themselves. Nobody knows your
body better than you do, and I think that learning
your body and leaning into that expertise and wisdom you
(44:17):
have is really important. And making sure that you're using
you know that you chat GPT appropriately right, that you're
not like catastrophically, it used to be twenty years ago
that we webmd'd things, and we thought WebMD would always
tell us that we had cancer if we were tired, right, Like,
the same thing can happen now that we kind of
(44:39):
circle these rabbit holes. But how do you use it
to empower you? How do you use it to help
you plan for these visits? So we're still working within
the same system rather than constantly butting up against it.
Speaker 2 (44:52):
Yeah, Nikki, thank you so much for joining us today.
This is honestly, it's been a fantastic conversation, a very
important conversation.
Speaker 3 (44:58):
Thank you for having me. Yeah, this was so fun
And I think these conversations are so important, and I
think especially talking about the trauma medical trauma, sexual trauma,
like these are things that we don't talk about often enough,
and they impact far more people than we think, whether
it's you, your best friend, your sister, your cousin, right
(45:20):
like it is everybody or everybody knows somebody, And so
I think starting to normalize these conversations is so critical
and so thank you for leaning into that. I really
appreciate that space too.
Speaker 1 (45:30):
Oh absolutely, and we'll definitely be sharing take back trust
with our listeners and everyone else. Yay man. I mean,
you know, as a physician, like I objectively know all
of these things, like the things that Nikki was talking about,
Like it's not new information. It just it makes me
(45:52):
feel so crummy, I'll be honest, like it just it's
it's just makes me sad, and I just think we
can do better. And it's funny her books called we
deserve More. Yeah, right, it's called we Deserve More. And
I agree, yeah, we deserve better, we deserve more. So
I'm just like sitting with the acknowledgment. I do have hope.
(46:13):
I do genuinely have hope. I do believe there is
a future where we will have reproductive justice. I have
to believe that we can have a better future and
it's going to happen in our lifetimes, in my lifetime.
That's what I hold on too. And I think, you know,
to Nikki's point, we have come a long ways, but
(46:36):
obviously we still have more work to do.
Speaker 2 (46:38):
Yeah. Yeah, Knowing that she's one of the advocates is
really empowering, just to know somebody like that is putting
the work in. I mean, she's so passionate about her
advocacy and she's so well informed and is exactly what
I feel like this movement needs.
Speaker 1 (46:55):
Yeah, I mean, we can't change the things that we
don't see. And I think what's so important about the
work that she's doing is that she's naming it. And
if you read her book, she goes through literally every
grievance with the medical system, the history of medicine, reproductive justice,
she names it, and I think that is an important
(47:16):
first step to changing things. Once we move to a
matriarchal society, I'm sure she'll be pretty high up in
the pegging order.
Speaker 2 (47:26):
I'm on board.
Speaker 1 (47:27):
Yeah, you're ready, I'm ready. Yeah, No, I'm down, Let's
do it. Health Stuff is a production of iHeart Podcasts.
The show is hosted by me Doctor preancle Wally and
Harrie Konnebolu. Producers are Rebecca Eisenberg, Jenna Cagel, Christina Loranger,
(47:49):
Maya Howard, and Katrina Norvel. Our researcher is Maria Tremarki
and our intern is Katiya Soobel Leayala. To send us
a question, you can email us voice memo at Healthstuff
Podcasts at gmail dot com. Thanks so much for listening
This podcast is for information purposes only and should not
be considered professional medical advice.
Speaker 2 (00:08):
This is not about patient care anymore. This is about profit.
Speaker 1 (00:11):
I was blown away by how awesome it was as
a resource for people.
Speaker 3 (00:18):
Previously, women just didn't even know that they could ask
for that level of care.
Speaker 2 (00:26):
I'm Hurricandbolu.
Speaker 1 (00:27):
I'm doctor prenkle Wally, and.
Speaker 2 (00:29):
This is health stuff. Hey, Prianca, Hey, Hey, how are
you three hays?
Speaker 1 (00:39):
I'm feeling I'm feeling extra hey today apparently, so what
I mean here? We are healthcare twenty twenty six, Yeah,
the United States. Yeah, and I want to hear about
kind of your experience, Like when you go in and
(01:02):
you have an appointment, do you prepare for the visit
or do you have pre organized questions in your mind?
I mean, like how do you sort of navigate yeah,
your visits?
Speaker 2 (01:16):
Yeah, I mean, if I'm seeing my GP, there's a
list of things. I'm like, let's focus on the ailments
that I feel are most important, Like, you know, do
I need do I need to see urologists? Do I
need to see I don't know why urologists was the
first thing that came out of my mouth, Maybe because
I'm like forty three and that was the first, Like,
(01:38):
or you know, do I need to see some of
my arm hurts, my legs hurt? Like who do I
see for those? So I try to make a list
because I feel like setting up another appointment waiting another
couple of weeks because you know, my GPS so busy
to get a proper appointment. Like, you know, if I'm sick,
I'll just go to an urgent care most likely, because
(02:00):
trying to get in a point with my doctor when
I'm sick is like, it's just not it doesn't line
up right, So.
Speaker 1 (02:06):
I mean the irony of that, right right?
Speaker 2 (02:08):
Oh, I can never see my doctor when I'm sick.
Of it always has to be preventative. If it's preventative,
I can make it too, you know, for getting blood
work or something. I can do that two weeks in advance.
But now I'm in this weird spot of like my
GP is leaving the practice and sorry, it's awful. Now
I got to find a new GP. And that's become
a whole process of who does insurance cover? I don't
(02:31):
want to go into Manhattan from Brooklyn. There's there's something
that's nearby and it's it's such a confusing system and
it's not clear where you know, and sometimes there's there'll
be like these three people take your insurance and I
call to double check two of them don't right, So
it's it's such a it's I don't know if we
(02:51):
have any international listeners, but you should know the American
system is not very good. And yes, and it's very
because because it's a capitalist system and services aren't always
up to par, because you know, it's about saving dollars
at the end of the day.
Speaker 1 (03:08):
To put it simply, yeah, very simply. I'll tell you
when I go see the doctor. As a doctor, I
usually type up all of the pertinent history related to
the situation at hand, details and I'll write like at
the top preon Kowali pertinent medical history and literally like
(03:29):
write their note for them and then hand it to
the medical assistant and say like this is for the
doctor to review before they come in.
Speaker 2 (03:37):
So that they have that on file already.
Speaker 1 (03:39):
So you would think, you would think, but like how
a doctor documents their notes is provider dependent. You don't
know how much time they have to chart, and we
know there's very little time when you see a doctor
and like the traditional insurance based system. So I am
just trying to make their life easier so that the
(04:02):
moment they walk in, they know exactly what the issue
is and what we're going to talk about, and then
it goes by much more efficiently. But that is an
extra kind of piece of work that I do, like
before each visit for very specific issues. If it's like
a general issue, like I'm here for a general wellness
(04:24):
check or whatever, I'll still make a list of Okay,
these are the points we need to talk about. And
even like going to the pediatrician for my son. Let's
say my husband's going to go take him to the pediatrician,
I will give my husband the list of like these
are the updates since the last visit, and these are
the questions for the pediatrician. So you're like, I mean,
(04:48):
I feel like you have to be unless you're not
going to be able to cover everything that you want
to r This is why I'm so excited to talk
to our guests today. Nicky Sapiro Vink here, who is
an obgay and physician assistant, because she developed this really
great resource called TakeBack Trust that really helps patients with
(05:10):
their provider visits and navigating this maze of a healthcare system,
like capitalism is clearly the problem.
Speaker 3 (05:18):
Oh yes, you know, like this.
Speaker 1 (05:20):
Is really I don't know at what point a soulless
individual was like, yeah, yeah, we're gonna make money off
of people's health and ailments.
Speaker 3 (05:29):
Yeah, you know, Like I.
Speaker 1 (05:31):
Don't understand how we as a society can keep doing this.
Speaker 2 (05:37):
Well, I mean think about they want to privatize education too, Like,
this is all the things that are supposed to be givens,
you know, Like, what what is the purpose of being
in a so called developed society that doesn't offer the
basics to live?
Speaker 3 (05:53):
Right?
Speaker 2 (05:53):
Then?
Speaker 1 (05:53):
What exactly are we getting?
Speaker 2 (05:56):
What's the point?
Speaker 1 (05:56):
What's the point?
Speaker 2 (05:57):
I thought that was part of the membership benefits of
being in a country, right, I.
Speaker 1 (06:01):
Mean this is like a Chase Sapphire reserve gone wrong,
right right? They have raised the prices way too much.
It is time to cancel, you know what I'm saying. Yes,
I think this can't be sustainable. And for me, I'm
(06:22):
very curious and also curious to ask our guests how
is this going to end? Because it's already showing the
signs of a system in distress and people are getting
hurt and harmed and it's not working. And so the
question is how much further can this go before we
all need to just look at each other and be like, Okay,
(06:45):
enough is enough, Like seriously.
Speaker 2 (06:48):
I mean, patient cares is so not prioritized at this point.
It's so like my mom worked at a hospital and
got bought by a larger hospital, and that's part the
reasons she wanted to retire. She was just like, this
is not about patient care anymore. This is it's about profit.
And it's so clear with how they make us document
(07:09):
everything and how they suggest we handle patients. It's like,
this is not about patient care anymore. So why am
I in this industry?
Speaker 3 (07:17):
I mean?
Speaker 1 (07:17):
And I think probably the system has lost a lot
of really good providers for that reason, like your mother.
So I hope the goal here for today's talk is
to get more information around Nikki's perspective. But also the
question I have is is there hope for us or
do we need to burden down the whole barn and
(07:39):
start over. It's hard, you know, you want, like in
this show to not be like doom and gloom. You
want it to be uplifting and hopeful, but I do
think on some level we really have to look at
these systemic failures and acknowledge that they exist and stop
pretending like everything is okay, yes.
Speaker 2 (07:58):
Because I mean our job is still to be realistic,
like this is what we're up against. What we try
to do on this podcast is to try to look
for answers. So I think it's completely reasonable to diagnose
the system as broken and then try to look for
answers and see what can we actually do because so
many of the issues we've talked about, a lot of
them have involved like inefficient systems, right, right, and that
(08:20):
has to do with money. It's a necessary kind of
reevaluation of the system.
Speaker 1 (08:25):
Yeah, shadow work, We're looking at the shadow work of
the collective.
Speaker 3 (08:29):
Yes.
Speaker 2 (08:33):
Today's guest is Nicky sapayro Vinkier, an OBGYN, physician, assistant,
reproductive health educator, and the founder of take Back Trust,
a platform helping people navigate reproductive healthcare. She's also the
author of the book We Deserve More, which explores the
systemic failures and reproductive healthcare and give us patients tools
(08:54):
to better advocate for themselves in the exam room and beyond.
Welcome to the show, NICKI.
Speaker 3 (09:00):
Thank you so much. I'm glad to be here.
Speaker 1 (09:02):
Oh, we're so thrilled to have you. Let's start by
talking about take Back Trust, because when I saw the website,
I was blown away by how awesome it was as
a resource for people. Can you talk a little bit
about the story behind why you started.
Speaker 3 (09:21):
It, Yeah, I'd love to.
Speaker 1 (09:24):
So.
Speaker 3 (09:25):
As a clinician, you know, I spent the last ten
years or so working with patients answering questions, and I
felt like there were a lot of the same questions
that were coming up over and over, and so some
of those questions and answering those questions was part of
why I was like, Oh, why don't people know this?
Like why isn't this more common knowledge? And really feeling
(09:45):
like there was a void. And then I really wanted
to be able to address the fact that this landscape
is changing so drastically all the time, and oftentimes people
feel really stuck between this idea of like, I know
this is what I mean, and maybe this is what's
happening in the country or in the world, and how
do I relate the two of those As I'm going
(10:07):
in to get kynecological care and so the goal is
really to help explain to people what does that healthcare
system actually look like, and how do you advocate for
yourself better within this system that we find ourselves in,
and kind of painting a very real picture from a
landscape of Oh, do you have embryo in Alabama? Do
(10:28):
we want to move those out of state? Are you
concerned about some of these things? Right? Are you interested
in an IUD, here's the timing of that, and here's
how we ask for better paid management, which we know
is such a hot topic. Right, So really addressing some
of those questions and concerns that I was seeing surface
online and having them in a home that you know,
(10:50):
people could go to and access it whenever they needed.
Speaker 2 (10:53):
We often talk about access to reproductive healthcare in terms
of law and geography, but you seem focused on emotional
access and informational access. Can you talk about why those
are just as critical and also define what they mean?
Speaker 3 (11:07):
Yeah. I think a big part of the issue is
that we don't actually know how to engage in the system,
Like we were never actually taught how to be patients
in a way. So you have a patient who comes
in and has seventeen questions in a laundry list of
issues to ask during their annual exam, and that's not
the right time to get those addressed. So then they
leave that visit feeling frustrated or like they weren't heard
(11:31):
they didn't have time to ask their questions, when in actuality,
they just needed to make a different appointment. But nobody
ever tells them these things. So how do we actually
teach people not just Okay, here's the issues you're having,
but here's how you make the right appointment for those things.
So it's not just where you live, what the laws
are in the book, but do actually even know what
appointment you're going in for to begin with, and really
(11:53):
setting that up from the get go and asking for
what you need when you're making that appointment too. And
so I think there's so many things that can hinder
access to care, and I think one of them is
as simple as just setting the right appointment to start.
Speaker 1 (12:09):
Yeah, And so, you know, it's very interesting you're hitting
on something I want to kind of double click on
a little bit because you've spent more than a decade
as an obgy and physician assistant, and so you've seen
sort of the transformation of the way care has been delivered.
You know, you mentioned earlier around how you come in
with seventeen issues, but that doesn't make sense to address
(12:30):
that like your preventative sort of visit. And in terms
of the timeline, I mean, at what point do you
think healthcare started to change like this? Because I don't
it wasn't always like this, But in your experience, at
what point did you start to realize that patients just
(12:51):
they are not entering these appointments with the tools that
they need.
Speaker 3 (12:56):
I think it's multifactorial. I think there's a lot of
things that add to it. I think right now within gynecology,
women are more empowered than ever to ask for what
they need. So I think previously there were things and
thoughts in the back of women's mind that maybe they
didn't actually feel comfortable bringing up or addressing. So I
don't necessarily I want to push back a little bit
that I don't think that it's just now, But I
(13:18):
do think we're seeing a seismic cultural shift that people
are now feeling empowered and able to ask questions that
perhaps they had been thinking for decades prior, right, And
so I think that that's a really big culture shift
that we're seeing in this moment, and I think a
lot of that is from normalization of these topics within
(13:39):
you know, friendships, within social media, within the Internet. We
have access to so many things now that can help
kind of like illuminate these thoughts that are in the
back of our head to say, oh, we do need
to be asking these things. So yes, I think it's
you know, obviously medicine has so many issues. But I
(13:59):
really don't know if it's just that, like we have
seventeen issues now or if we always had seventeen issues
and previously women just didn't even know that they could
ask for that level of care, that they could even
share those concerns, you know, that they could even say,
this is what I'm really feeling and really meeting. And
I think that's the piece that I really noticed is
(14:21):
changing the most, is that we're actually demanding the care
that we should have been getting all along.
Speaker 2 (14:30):
More after this break. I love that you included a
take back trust for men's section on your website, because
healthcare conversations so often are just framed as women's issues.
Do you think better reproductive education for men could improve
relationships and communication in addition to health outcomes.
Speaker 3 (14:52):
Yeah, I mean I can't nod my head. I know
this is an audio podcast, but if you could see
me visually, I am enthusiastic nodding my head. And I think,
you know, we've really done a disservice to people saying
no uterus, no opinion, And I think we've really punted
men out of the conversation and have said if this
(15:13):
isn't your issue, we don't even want you in this conversation.
And then we've been seeing that we're having a hard
time even winning over all women to take this on
as their own, you know, issue to vote for and
root for and care about. And I think we're really realizing, actually,
we do need to galvanize the support of men, and
(15:36):
we need to prove to them and show them that
this isn't just a women's issue, that this is a
family issue, that this looks at your ability also to
go to college, your economic security and safety, your ability
to have kids when and if you want. Right when
we look at the framework of reproductive justice in general,
it talks not just about abortion care, but the ability
(15:59):
to raise and grow and thrive with your family, and
that impacts all parents of any gender, and so I
think we've really done a disservice for so long saying like,
don't bother chiming in, we don't want you. And I
think that now we're kind of realizing actually, like, please
(16:19):
come on board. I don't need you to talk over
me about my reproductive health care, but I need you
to stand shoulder to shoulder with me and really back me.
And I think aside from that, like what we're seeing
with some of these women who are dying as a
result of abortion bands is if they had a support
person who could more loudly advocate for them, more clearly
(16:41):
say this person is hemorrhaging and bleeding and needs treatment. Right. Unfortunately,
we live in a world where men's concerns are taken
more seriously than women, and so I think we need
to be really active in opening up the conversation and
bringing men on board entirely. And so with back trust
and having take back trust for men, my goal was
(17:03):
to give men a space where men could educate themselves
on it. Right. I think one of the biggest issues
is that as women were burdened with so many things
and then having to take on another burden of teaching
reproductive healthcare is like even more annoying. And so my
goal was to kind of take that burden off of
women so men could do the work of learning about
(17:26):
reproductive health care. And we partnered with Men for Choice
on it, and there's a whole blog section that's for
men by Men that has a lot of different blog
posts on men thinking about talking about reproductive health care
into journal entries. There's a whole glossary of terms, and yeah,
the goal is to make it so that men feel
(17:48):
like it is their fight.
Speaker 1 (17:50):
Also, Yeah, I mean that's such a critical point. Everybody
has to be involved in this for it to be successful.
And the thought in which you've put into this website
take back trust dot com, I really want to share
it not just with our listeners, but patients in my
own practice or people in my life. I think it's
an incredibly helpful tool and so timely as well. So
(18:14):
I mean, you created this, what is your vision of success, Like,
what would be the change that you would want to
see the most, let's say in ten years.
Speaker 3 (18:24):
Yeah. You know, I had a patient one time who
came to me and said, you know, we had a
normal visit and we were done, and she was like, well,
what questions do I need to be asking you? And
I was like, Oh, that's cute, and I'll sit with you.
I'll sit here with you and I'll talk to you forever.
But not all clinicians will. And it turns out as
(18:45):
a patient, we need to do our homework before we
go into the office. Right. We need to know what
are our symptoms that we're feeling, how long has it
been going on, really be able to address, how is
it presenting for me? How does it impact my quality
of life? My goal is that take Back Trust can
be the site that people go to to kind of
(19:05):
do that homework before they go in for a visit. Right,
And we've got that provider visit planner where you can
map out questions that you're going to ask your clinician
coming up, kind of regarding whatever topic of concern as
bringing you in. And I really wanted it to be
kind of this you know, treasure trove of information where
you don't feel alone, where you're going through it and
(19:28):
you feel seen and you feel validated, and there's a
very strong trauma informed lens throughout. And you know, I
think that's a big issue too in healthcare, is that
we're not addressing how common it is to have sexual
health issues and sexual trauma and or medical trauma, and
how does that relate when you're circling back into medical care, Right,
(19:52):
And so that was the goal and ten years what
my vision would be is that people are using a
tool like this instead of chateing or web mding their symptoms.
You know that you're using an evidence based, clinical rooted
guide to kind of walk you through what that homework
model can look like. So you're still engaging in our
(20:12):
healthcare system with clinicians who have best interests in mind,
but you're able to also do your homework too. Yeah.
Speaker 2 (20:20):
Since Roe was overturned in twenty twenty two, have you
noticed a shift in the kinds of fears or questions
patients are bringing into OBGA and appointments.
Speaker 3 (20:30):
Yeah, I mean I'll go back even further. Right. I
started practicing in twenty fifteen, and in twenty sixteen was
the first Trump election, and that was the first time
that I started having patients asking about long acting reversible contraceptives.
The spike in people asking for marina IDs that at
the time were indicated for five years and now they're
(20:50):
food for eight years. It was tremendous because people wanted
them put in in that lame duck window before Trump
took office, and they wanted it to carry them through
his entire present. And see, so yeah, I think before
Roe versus Wade was overturned, that was definitely a shift
that I was seeing happen within healthcare visits. After Roe fell,
(21:11):
I saw a significant increase in people asking for permanent sterilization,
google removals, and vasectomies of like, you know, we've been
on the fence, we've decided, and we want that, you know,
definitive answer. And it was really interesting. In twenty twenty two,
you know, we were surfacing still from COVID a little bit,
and so there were still a lot of delays on
(21:33):
elective surgeries and procedures, and so my own partner went
to get a vasectomy and it took like five months
for him to get in for an appointment. And I
think because it was a combination of the demand being
higher still a backlog from COVID, like all of the things.
So yeah, I definitely think that that was real.
Speaker 1 (21:53):
So I guess the question I have given the landscape
right now, I really want to hear what you think
about the future of reproductive healthcare here in the United States?
Is there any hope? What worries you right now?
Speaker 3 (22:11):
There's a lot that worries me. There's a lot that
worries me in the ways that we were saying, you know,
we think row is going to fall, and we were
considered hysterical at that point. I think the ways that
I'm watching the narrative change online about birth control feels horrifying,
the way that they're kind of like seeding so many
questions in the back of people's mind that birth control
(22:34):
is harmful, birth control is damaging, that birth control is
a pipeline to infertility. I mean, they are actively seeding
miss and distrust in the healthcare system in medications. It's
the same thing that we've seen them do with vaccinations
they're doing right now in terms of birth control. And
so I think that feels really scary because birth control
(22:57):
has been liberating for women, for death kids. It has
been a huge tool that has enabled women to go
advance their education, to get better jobs, to have a
family when they want to have a family, or if
they want to have a family, And I think that
they're actively, you know, kind of poisoning the idea of
(23:21):
birth control all the while gutting abortion access in the country.
Speaker 1 (23:26):
And when you just to clarify when you say they,
who specifically are you naming?
Speaker 3 (23:31):
You know, I think that it's a pretty thoughtful methological
process that comes out of the Heritage Foundation is kind
of who seedes it. But there's a lot of like
wellness influencers and the Maha movement, and so I don't
think it can be traced back to like one singular person,
but I would say it does tend to come from
(23:52):
one side.
Speaker 1 (23:54):
So are there any parts that do give you hope?
Speaker 3 (23:58):
Yeah? So let me expand though on the things that
I'm scared of, because I want to also talk about
fertility for a second, because IVF is getting really wrapped
up in the discussions around abortion bands, specifically around embryo
creation and testing, because if those embryo don't test well,
we discard them and that's not approved, right, And so
(24:19):
I think that's an issue. And their recommendation for pulling
away from the way we've leaned on IVF and leaning
into what they call restorative regenerative medicine, of restorative reproductive medicine,
more of this like wellness based infertility management, which we
know isn't actually going to get you the baby in
(24:41):
arms the same way that IVF will. So I think
those are things that I'm really concerned about in terms
of things that give me hope. What I think is
really cool is that people are finding community right now.
And as much as I do want to just on
social media all the time, like I think there are
things that are actually really helpful. Like we have this
(25:02):
thing called Nancy's Nook, which is basically a community on
Facebook of endometriosis patients and surgeons where they can go
on and kind of recommend, you know, specific excision surgeons
and have a support network where people feel seen, heard
and supported. We have Facebook groups of IVF mothers where
(25:24):
they got pregnant and have leftover medication and they create
their own like black market because IVF meds are so
expensive and they want to support one another. And like,
as ridiculous as that is that we have to do that,
I think it's also something really beautiful in the fact
that it used to be so lonely and isolating, and
(25:44):
right now I think there are so many people who
share their stories and kind of come out to talk
about what that experience looks like for them that that
part does give me hope within medicine, within you know,
specifically reproductive healthcare, because we're not doing this in the
shadows anymore. We're talking about the miscarriages we're having, We're
talking about the fact that our periods lay us out
(26:06):
for two to three days at a time. We're talking
about all these things that for decades it's been like, hush, hush,
don't talk about that. Like when I was younger, and
I'm sure you know so many people will relate to this.
If I was on my period, you would take your
tampon and hide it in the sleeve of your sweatshirt.
Do you remember that?
Speaker 1 (26:25):
Oh my gosh, yes, yes, I totally remember people in
school doing that.
Speaker 3 (26:30):
Because God forbid, people knew you were on your menstrual cycle,
which every woman gets once a month. Right, So we
went in the last twenty to thirty years from like
I have to hide the tampon in the sleeve of
my coat to I will be able to talk about this.
So I think that part really does give me hope,
as I think we are normalizing a lot of the
(26:52):
conversations that should not have been stigmatized. To begin with.
Speaker 1 (27:01):
We'll be back with more health stuff after this break.
Speaker 2 (27:07):
I just want to jump back to the birth control
hormonal contraception conversation just for one more moment. How do
you respond when patients come in genuinely terrify that birth
control is poisoning them or causing permanent infertility because of
the crap they've seen online.
Speaker 3 (27:24):
I think you have to be curious. I think that
we cannot dispel anything that they say, think, or come
into the clinic with. And so I think that's the
biggest issue is that there are people who do have
negative side effects to birth control. That is very real.
And if we dismiss that across the board, then we
(27:45):
gaslight women into saying your experiences aren't real. And I
think we have to balance saying, oh, you may have
a side effect on birth control, great, let's try something else,
Or what worked for your best friend may not work
for you. Like I think we have to be meeting
them in the moment where we're saying, if this isn't
working for you, let's find something that is. And we
(28:08):
can also say, oh, if you have no side effects,
if you truly feel fine, this is a winning ticket,
right And so I think that it is a matter
of like really pulling apart. Are you having any symptoms
of side effects? Are you having any issues with it?
Are there any things that you've noticed? And I think
if we lay that out and actually give them the
(28:29):
opportunity to like self triage, self reflect, self diagnose, they
might actually come to the table and be like, no,
I feel good, right. And I think that's that kind
of like you have to get them on board because
it's their healthcare. And if we're just not listening and
saying that's ridiculous, don't listen to that, you're not getting
(28:50):
that buy in from them that we actually need. And
so I think that the name of the game is
really empowering them to make the right choice rather than
kind of like dictating top down what we think is
best and really you know, being curious about how it's
presenting for them and if they are having any negative
experiences and trying to fix those.
Speaker 1 (29:12):
Yeah, I mean you're hitting it so correctly. It also
is so critical that the provider genuinely listens to the patient.
That's so important. I have seen this a lot, but
you know people out there you mentioned earlier just feeling
medically gas lit about their experience, or they are prescribed
(29:33):
something and they have side effects and they're just brushed aside.
This is a good segue to giving our listeners helpful
tips for navigating the system. So what advice do you
have for someone who feels like they are in a
medical situation with their provider where they are experiencing being
medically gaslet or brushed aside? What should they do?
Speaker 3 (29:56):
I think the best thing we can do is bring
in the receipts, right that if you had someone with
a GI issue and you're trying to figure out do
you have an allergy to food and what type of
food is it, and you make them keep an entire
dietary log I think we need to be doing the
same things with our symptoms that we experience. So, for example,
(30:18):
right now, perimenopause is a big topic of conversation, and
there are a lot of different symptoms that women can
have as a result of perimenopause. So just saying I'm
in perimenopause or I feel like I'm in perimenopause is
not actually helpful, because sure, pretty much anyone in their
forties is right. But what is helpful is saying I
(30:42):
have difficulty sleeping at night, but not just difficulty falling asleep.
I wake up at two am and I am up
for two hours, and it happens every night, and it
impacts me this way. Or I have gained weight and
it has only happened over the last year, or you know,
I feel like my anxiety has worsened. It's not cyclical.
(31:03):
It doesn't happen with ovulation or with my mensies. It's
all of the time, right, And if we go in
with these tracked symptoms, almost in a diary format, in
a calendar format, it makes it a lot harder to dismiss.
It makes it a lot harder to say that's not happening. Right,
(31:23):
If you say, here's what I've tried already, I have
really bad cramping. The cramping happens all of the time,
and I've tried ibuprofen, you know whatever dose every six hours.
That doesn't fix it. We're making it a lot harder
for them to tell you go monitor it for two
to three months and come back to me and let
me know how it is, because you've already done that, right,
(31:46):
And so I think that's the biggest piece is like
come in ready to lay it all out and say
it's you know, here's how this presents for me, and
then it makes it a whole lot harder for them
to say no or you know, poo pooh you away.
Speaker 1 (32:01):
Yeah, And just to follow up on that, I mean,
you're essentially advocating for having patients speak in a way
that's more congruent with the language of medicine, for providers
to then recognize that this is a sign or symptom
of some sort of disease process in the sort of
the algorithm of their brain.
Speaker 3 (32:20):
It's literally like a soap note, right, like these things
that we learned in medicine, and we know unfortunately we
as clinicians have few minutes to decipher these things. And
so yeah, I agree. I think it is kind of
almost like saying, Okay, here are the things that could
be and I know what it could be. Also, because
(32:41):
everybody has chat GPT and they're symptoms before they've come
in the door, like and everybody has right, so people
walk in saying this is what I think it is,
So how do I get this to happen? But we
know chat GPT is wrong with over forty five percent
of cases, and we know in women it's only higher
because they're based on studies that actually include men. So
(33:02):
instead of asking chatjipet to diagnose you and going in
to see your doctor, what you can do is saying, hey,
chat gipt, what are the things that I can express
to my clinician. What are the ways that I can
talk about my pain? What are the things that I
should be telling them that it's not or doesn't feel
like right?
Speaker 1 (33:18):
Like?
Speaker 3 (33:18):
What are the lab tests I could even inquire about?
And then you present all that to a real human
clinician and let the clinician better be able to kind
of like sort through all of that information, and you
give them kind of this like silver platter to help
them figure it out.
Speaker 2 (33:36):
There's been a growing public conversation around pain management for
IUD insertion and gynecologic procedures. Why do you think women's
pain has historically been minimized in these settings?
Speaker 3 (33:47):
Oh, let's go back to the very beginning. Yeah, So
the grandfather of gynecology, doctor J. Marion Simms, who's again
is referred to as the grandfather of gynecology, performed his
surgeries on unanesthetized enslaved black women. Yep, So the three
(34:11):
main women that he performed these surgeries on were Anarca, Betsy,
and Lucy, though there were about thirty different enslaved women
that he did, and he did this without consent, without anesthesia,
and then turned around and did these same surgeries on
white women with anesthesia and consent. So when we look
at pain and recognition of pain, it has never been recognized,
(34:32):
and specifically for black and brown women, that is very
important to name outright is that their pain has never
been acknowledged, received supported like it is for white women,
and it's still sh for white women, which means it's
really bad for black and brown women. And so I
think it is absolutely imperative when we talk about pain
management in gynecology that we go all the way back
(34:55):
to the beginning, because without recognizing and reconciling that, I
don't think we get any whereas clinicians or as patients.
Speaker 1 (35:02):
Right.
Speaker 3 (35:02):
So, I think that's a really important thing that we
need to be talking about way more often, because when
we look at medical distrust mistrust, there's no way to
bring people along to trust us again if we're not
talking about the ways that we messed up in the past, right,
So I think that's a critical critical piece, But there's
(35:23):
been a lot of bullsh information that has come out
saying that, like, you know, there's not nerve endings in
the cervix, or that you don't feel pain, or that
doing a cervical block is not going to help with
the cramping you're going to have at the top of
the uterus because it doesn't block it all the way right, Like,
there has not been enough research into women's pain. There
(35:45):
is not enough investment and understanding and support of women's
pain to actually prioritize this. And I think when we
look at the things that do make me happy about
social media, it is the fact that women bravely live
streamed their eye AD insertions for the last probably I
would say, eight to ten years. And I think it
(36:06):
was only a direct result of that that ACoM has
come out and said here are pain management guidelines and
recommendations for IED insertions for endometrial biopsies, et cetera. And
so I think that that was a direct response to
bottom up, grassroots pain management cries for help that AKOG
(36:26):
finally said, Okay, we need to respond to this top
down and give some guidance on this. And so when
I look at things that do bring me hope. That's
a huge motivation of like we demanded better and we're
still not quite there on that, but like, look there
they are listening, Like we have their ear and we
(36:47):
have their attention.
Speaker 1 (36:48):
Yeah, I mean because we had like direct video evidence
of how horrible it was, you know, and so you know,
there's clearly been so much rupture in the trust relationship.
So for people who are maybe survivors of medical trauma
and are now sort of avoiding getting gynecologic care because
(37:11):
of the fear or the trauma they experience, what could
be some steps that they could take to restore their
sense of agency.
Speaker 3 (37:21):
These are such great questions that I'm so happy to
be here because these are like all the things that
I really love talking about and things that I don't
think we've done a good enough job of talking about.
And so I think these are the conversations where we
actually do get to like change what happens, change what
people know, and change what people feel like they get
to ask for. And so I think really acknowledging trauma
(37:43):
is the ground level that I think it is absolutely
imperative to say, hey, I have a history of trauma,
whether it's medical trauma, sexual trauma, and any other form
of trauma that we go into the room with. And
I think that's a piece that really hasn't been addressed.
(38:04):
For example, we know that three out of ten women
statistically will have been sexually abused or assaulted in their life,
and we don't talk about that as clinicians, and we
don't do exams that are reflective of that percentage of
our population. And for all of my patients who would
come and see me after they had had a rape
(38:25):
kit done in a hospital, you know, the sound of
a speculum clicking open is hugely traumatic. And until we
have every clinician across the country who not just like
hypothetically understands that, but really truly understands that, we don't
(38:46):
have hope for trauma informed Karen So, I think that
if anyone has had a history of or past of,
I think that's important to name and say it is
imperative to me that this practice offers and provound's trauma
informed healthcare. Is that something your practice in your office
specializes in. As are making the appointment, like, name it
(39:07):
and talk about it, And then I think it's totally fair.
I wrote in my book like ask for trauma informed care,
and if you don't feel comfortable saying it out loud,
you can write it on a piece of paper and
hand it over as you walk in the door, being
like I have a history of trauma. That's all it
has to say, right, And I think that clinicians steer
(39:30):
away from these conversations because they're delicate and they take
time in the exam room and you're worried about triggering somebody.
But by not acknowledging it, we're missing the whole point entirely,
and I think we need to really actually lean into it,
not away from it.
Speaker 2 (39:48):
What's the one thing you wish every patient knew before
walking into an obgian appointment today?
Speaker 3 (39:55):
Ooh, I wish they knew that they are the boss.
I wish they knew that actually, like it is their
experience and if it's not working for them, then they
can get up and leave. They don't have to white
knuckle through an exam if the provider does not feel
like the right fit for them, that they can go
at their own pace, that they can talk first and say, hey,
(40:15):
I'm going to come back another time if I need
more time, and tell the exam right that they get
to dictate is this working for me or not. If
you feel like you know you're not getting what you
need out of the system, then how do you advocate
for better or different care? And I think, especially with
the shifting of medicine into these larger group models, it
(40:38):
doesn't always mean you have to like completely reinvent the
wheel and go to a whole different practice where your
medical records are out the window. But it might be
finding someone else within the same group and just getting
a little bit of a fresh start of who's the
person who's best suited for me, not necessarily who delivered
my three babies, and I'm you know, I'm stuck with
them for the rest of my life because I owe
(41:00):
them everything. I think it's important that people know that
their experience is theirs and they get to talk about
it and be an individual within a system that I
think often forgets individuality.
Speaker 1 (41:13):
So can you walk through for our listeners what would
be some of the signs that they should look out
for if they should consider finding a different provider.
Speaker 3 (41:25):
I mean, I think these things are more simple than
we think they are. It's just a matter of listening
to them. I think we know in our heart and
in our gut, if this is the right fit for
us or not, if we feel comfortable or not, and
if we don't like, that's all you need, you know.
I think that really feeling listened to and feeling listened
(41:48):
to doesn't have to mean that they sat down with
me for twenty to thirty minutes and went through all
seventeen of my questions, right, But I think the sincerity
of the experience is important, and the plan the I
understand you have a lot of concerns, and so let's
make another appointment to address the next three things you
(42:08):
may have. And I think that's how we as clinicians
can make this better too, is not by just like
walking out of the room and ignoring the rest of
the laundry list, but by saying, hey, I see you
have a pen and pad of all these different concerns.
Tell me your top two to three things that you
want to address today, and let's make an appointment to
(42:31):
follow up on those and go through the next ones
at your next visit. And I think, of course that's
a luxury to be able to do that, because there
are copays to these visits and it is time. But
I think that's Also where we can lean into telehealth
is figure out what do you actually need for an
in person visit and can you do some of these
(42:51):
follow ups via telehealth? How do we make it easier
on us and our patients so we're meeting them where
they are.
Speaker 2 (42:57):
What are signs someone should consider finding a new provider immediately.
Speaker 3 (43:03):
If you feel uncomfortable during a pelvic exam, I think
that's like a Yeah, that's a no brainer. If it's
a painful pelvic exam, If they're not talking to you
about what's happening, if they're not giving you choices for
pain management, for any of the procedures you need, if
they are mandating really any of their recommendations without walking
(43:24):
you through it. If you are perimenopausal and struggling and
they're telling you that hormone replacement therapy is not an
option or it's not safe. That is outdated guidelines and recommendations.
And I'm not saying every woman needs, you know, hormone replacement,
but I'm saying it should at least be an option
that they are informed about and can talk through with you. Yeah.
Speaker 1 (43:46):
Any kind of final sort of advice for our listeners,
anything that you want them to know before we sign off.
Speaker 3 (43:56):
I would want them to know that their voice matter
and that what they think matters, you know, how they
feel matters, and really tuning into themselves. Nobody knows your
body better than you do, and I think that learning
your body and leaning into that expertise and wisdom you
(44:17):
have is really important. And making sure that you're using
you know that you chat GPT appropriately right, that you're
not like catastrophically, it used to be twenty years ago
that we webmd'd things, and we thought WebMD would always
tell us that we had cancer if we were tired, right, Like,
the same thing can happen now that we kind of
(44:39):
circle these rabbit holes. But how do you use it
to empower you? How do you use it to help
you plan for these visits? So we're still working within
the same system rather than constantly butting up against it.
Speaker 2 (44:52):
Yeah, Nikki, thank you so much for joining us today.
This is honestly, it's been a fantastic conversation, a very
important conversation.
Speaker 3 (44:58):
Thank you for having me. Yeah, this was so fun
And I think these conversations are so important, and I
think especially talking about the trauma medical trauma, sexual trauma,
like these are things that we don't talk about often enough,
and they impact far more people than we think, whether
it's you, your best friend, your sister, your cousin, right
(45:20):
like it is everybody or everybody knows somebody, And so
I think starting to normalize these conversations is so critical
and so thank you for leaning into that. I really
appreciate that space too.
Speaker 1 (45:30):
Oh absolutely, and we'll definitely be sharing take back trust
with our listeners and everyone else. Yay man. I mean,
you know, as a physician, like I objectively know all
of these things, like the things that Nikki was talking about,
Like it's not new information. It just it makes me
(45:52):
feel so crummy, I'll be honest, like it just it's
it's just makes me sad, and I just think we
can do better. And it's funny her books called we
deserve More. Yeah, right, it's called we Deserve More. And
I agree, yeah, we deserve better, we deserve more. So
I'm just like sitting with the acknowledgment. I do have hope.
(46:13):
I do genuinely have hope. I do believe there is
a future where we will have reproductive justice. I have
to believe that we can have a better future and
it's going to happen in our lifetimes, in my lifetime.
That's what I hold on too. And I think, you know,
to Nikki's point, we have come a long ways, but
(46:36):
obviously we still have more work to do.
Speaker 2 (46:38):
Yeah. Yeah, Knowing that she's one of the advocates is
really empowering, just to know somebody like that is putting
the work in. I mean, she's so passionate about her
advocacy and she's so well informed and is exactly what
I feel like this movement needs.
Speaker 1 (46:55):
Yeah, I mean, we can't change the things that we
don't see. And I think what's so important about the
work that she's doing is that she's naming it. And
if you read her book, she goes through literally every
grievance with the medical system, the history of medicine, reproductive justice,
she names it, and I think that is an important
(47:16):
first step to changing things. Once we move to a
matriarchal society, I'm sure she'll be pretty high up in
the pegging order.
Speaker 2 (47:26):
I'm on board.
Speaker 1 (47:27):
Yeah, you're ready, I'm ready. Yeah, No, I'm down, Let's
do it. Health Stuff is a production of iHeart Podcasts.
The show is hosted by me Doctor preancle Wally and
Harrie Konnebolu. Producers are Rebecca Eisenberg, Jenna Cagel, Christina Loranger,
(47:49):
Maya Howard, and Katrina Norvel. Our researcher is Maria Tremarki
and our intern is Katiya Soobel Leayala. To send us
a question, you can email us voice memo at Healthstuff
Podcasts at gmail dot com. Thanks so much for listening
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