Prescription for Survival: Be the CEO of Your Health!

Subscribe to the video podcast: https://www.youtube.com/@SomaMandalsays/videos   In this episode of Soma Says, Dr. Soma welcomes Dana E. Sherwin, founder of The Thinking Patient, to discuss the importance of patient advocacy, communication, and preparation in healthcare. Dana shares insights from her 35-year career in healthcare administration and personal experiences with a chronic illness. The conversation highlights strategies for improving patient-doctor interactions, the significance of asking the right questions, and the critical role of patients in their own healthcare. Dana also emphasizes the need for better integration of resources and support systems from healthcare providers and employers to enhance patient care.     00:00 Introduction and Disclaimer 00:43 Meet Dana E. Sherwin 01:36 Dana's Background and Career 08:46 Personal Health Journey 15:21 The Thinking Patient Framework 20:37 Challenges in Healthcare 27:26 The Importance of Medication Reconciliation 28:54 Effective Question Asking in Medical Appointments 29:40 Research Insights on Patient Preparedness 30:35 Three Key Questions for Better Health Outcomes 32:36 Patient Advocacy and Communication Strategies 34:58 Navigating Doctor-Patient Relationships 42:41 The Role of Employers in Healthcare 43:47 Future of Healthcare: Technology and Integration 51:34 Concluding Thoughts and Resources   How to learn more about Dana E. Sherwin: https://www.linkedin.com/in/desherwin/ Learn more about Dana's consulting firm: https://www.thethinkingpatient.com/  

Episode Transcript

(00:01):
Hi, this is Dr.
Soma.
Just a disclaimer, this podcast is for informational purposes only and isn't intended as medical advice.
Always consult with your doctor before making any changes to your diet, exercise, or health regimen.
Let's go to the show.

(00:43):
Welcome back to Soma Says.
today I have a special guest, Dana E.
Sherwin.
.999Dana is the founder of The Thinking Patient, a professional services firm providing consulting, speaking, and training resources to support and enhance patient physician communication.
She has served in healthcare, executive, and consultant positions throughout her 35 year career.

(01:06):
.999In prior roles, Dana has worked in hospitals, managed care plans, and three of the largest public accounting management consulting firms in the U.
S. 13 00:01:15,694.999 --> 00:01:17,94.9 She holds a Master's of Health Education. 14 00:01:17,95.1 --> 00:01:25,215 She has a Bachelor of Health Services Administration degree from the University of Michigan School of Public Health, and a Bachelor of Science degree from Cornell University. 15 00:01:25,524.999 --> 00:01:28,655 She is a fellow in the American College of Healthcare Executives.

(01:28):
Let's welcome her to the show. 17 00:01:36,547.687 --> 00:01:44,447.688 I called my sort of small consulting company, the thinking patient, because being sick or thinking about being sick. 18 00:01:44,447.688 --> 00:01:53,417.688 Whether it's something that happens once in a while, or you're subject to a chronic disease, is a very emotional, anxiety provoking condition. 19 00:01:56,775.761 --> 00:02:08,385.7595 I thought if I could create tools for people and help people develop their skills, then the anxiety could be lessened because they could have a stronger pathway. 20 00:02:12,283.8335 --> 00:02:16,883.8335 if you don't ask doctor questions, then the doctor will assume that, you don't have any questions. 21 00:02:16,883.8335 --> 00:02:46,719.6945 You understand everything, your health care will only be better if you are prepared and participate in this and share who you are with the doctor, right? So you have your role to play I wanted to welcome you to my podcast, Soma Says We shared a little fun fact offline that We both went to East Meadow High School and you grew up in East Meadow, Long Island? Yes, I did. 22 00:02:46,769.6945 --> 00:02:52,79.6935 And I grew up on the part of East Meadow that was right behind a jail. 23 00:02:52,269.6945 --> 00:02:52,809.6945 Yes. 24 00:02:52,809.7945 --> 00:02:54,159.7935 And a hospital. 25 00:02:55,219.7945 --> 00:03:17,304.794 So I was going to go into Hospital administration or prison administration? It's funny because I did my residency at Bellevue hospital and I feel like it was the same thing there in Bellevue There was a jail there was a school also, And it had his own little community within the hospital itself. 26 00:03:17,304.794 --> 00:03:20,594.7945 And it reminded me a lot of, of the area. 27 00:03:20,989.7945 --> 00:03:22,689.7945 Around the high school. 28 00:03:23,479.7945 --> 00:03:24,679.7945 So it was interesting. 29 00:03:24,679.7945 --> 00:03:33,659.7935 I was wondering why did they put a high school so close to a prison, right? Across the street close. 30 00:03:33,659.7935 --> 00:03:36,69.7935 It was across the street and there were there it was. 31 00:03:36,69.7935 --> 00:03:40,629.7935 Yes You are very welcome. 32 00:03:40,779.7935 --> 00:04:02,94.7925 On my podcast right now because There's a lot happening in healthcare, right? And I feel that patients really, are suffering, Because unless they have a family member to advocate for themselves, it's very difficult at this time to navigate what's going on. 33 00:04:02,494.7925 --> 00:04:15,314.7935 And I can share with you without giving away too much HIPAA in terms of my family member, like last year, I was, even though I'm a doctor, I served as a patient advocate for my mom. 34 00:04:16,184.7935 --> 00:04:20,294.7935 And had I not been there, I don't know what would have happened. 35 00:04:20,764.7935 --> 00:04:22,284.7935 I really don't know. 36 00:04:22,624.7935 --> 00:04:27,704.7925 And this was involving the hospital system where she was admitted twice last year. 37 00:04:28,94.7925 --> 00:04:38,594.7935 And, it got me to thinking okay, she has me thankfully, but there are God knows how many people who don't and what happens to them. 38 00:04:39,79.7935 --> 00:04:42,269.7935 I know what happens to them because I've been in the system. 39 00:04:42,769.7935 --> 00:04:52,359.7935 And so I wanted to learn from you a little bit about your background, have my listeners learn about you and what inspired you to start being a healthcare advocate. 40 00:04:54,209.7935 --> 00:04:54,709.7925 Thank you. 41 00:04:54,709.7935 --> 00:04:56,539.7925 And I appreciate this opportunity. 42 00:04:56,559.7935 --> 00:05:01,129.7935 And I would say that in my sort of speaking rounds this is the. 43 00:05:02,669.7935 --> 00:05:05,889.7935 First time that I've gotten to speak to a doctor directly. 44 00:05:05,909.7935 --> 00:05:19,609.7925 So I'm really looking forward to this conversation because you have so much input into the conversation about how we can help people prepare better to be engaged in their healthcare. 45 00:05:19,859.7935 --> 00:05:22,339.7935 And it is a really complicated. 46 00:05:24,674.7935 --> 00:05:25,464.7935 Absolutely. 47 00:05:25,654.7935 --> 00:05:28,864.7935 And I, so I was fortunate in many ways. 48 00:05:28,864.7935 --> 00:05:32,4.7935 I had I had a father who loved his job. 49 00:05:32,34.7935 --> 00:05:33,734.7925 He worked for a health insurance company. 50 00:05:33,974.7935 --> 00:05:35,824.7925 He worked there for 36 years. 51 00:05:35,854.7925 --> 00:05:39,4.7935 And when I was a teenager, he brought me home three brochures. 52 00:05:39,344.7935 --> 00:05:42,404.7935 One brochure was healthcare administrator. 53 00:05:42,534.7935 --> 00:05:58,394.7945 One brochure was Was a nutritionist and another brochure was a human resources administrator and based on what I was already doing in high school in terms of leading clubs and being involved in more organizational management kinds of issues. 54 00:05:58,644.7945 --> 00:06:02,414.7945 I felt like a kinship that's where my skills were. 55 00:06:04,249.7955 --> 00:06:11,989.7955 So I went to the best college that I could go to, but I was focused on going to graduate school for healthcare administration. 56 00:06:11,989.7955 --> 00:06:19,59.7945 In fact, I had applied to a few schools, and they said, you're applying to the graduate school because remember back then in the 70s, there was no internet. 57 00:06:19,289.7935 --> 00:06:29,404.7945 So I was just using library resources and I applied to schools, because I thought, And why they said, no, you have to go to college first and then you can apply here. 58 00:06:29,634.7945 --> 00:06:33,364.7945 I went to the university of Michigan, which had a great program, great professors. 59 00:06:33,364.7945 --> 00:06:35,314.7945 I'm still in touch with a lot of people. 60 00:06:35,674.7935 --> 00:06:39,564.7935 People made from Michigan have made great contributions to the healthcare system. 61 00:06:39,854.7925 --> 00:06:48,614.7925 Came back to New York where I grew up, family, friends, and started a very You know, diverse career. 62 00:06:48,824.7925 --> 00:06:51,814.7925 I, my goal was to be a hospital administrator. 63 00:06:52,84.7925 --> 00:06:57,64.7925 I worked in a hospital for four years, but I got an opportunity to work in consulting for a while. 64 00:06:57,274.7915 --> 00:07:01,34.7915 And I learned about reimbursement systems and financial systems. 65 00:07:01,284.7925 --> 00:07:07,834.7925 And then I got recruited to work at a hospital association, a metropolitan hospital association. 66 00:07:08,174.7925 --> 00:07:13,804.7925 And the president at the time was new to New York, but he was recruiting people, but he was from Michigan. 67 00:07:13,814.7925 --> 00:07:18,199.7925 And that's how I got that job as in a hospital association. 68 00:07:18,789.7925 --> 00:07:25,239.7915 And he said do you want to help one hospital? Or do you want to help a lot of hospitals? Cause that's what the hospital association. 69 00:07:27,29.7925 --> 00:07:37,549.7915 So I was there for 19 years doing many different things, learning about policy and organization and regulation and really what leadership really was. 70 00:07:37,724.7925 --> 00:07:38,734.7925 In a hospital. 71 00:07:38,984.7925 --> 00:07:41,754.7925 And then after that, I did multiple things. 72 00:07:41,754.7925 --> 00:07:43,864.7925 I went back to consulting. 73 00:07:43,944.7925 --> 00:07:50,414.7915 I was an interim director of a foster care agency because they were in a leadership crisis. 74 00:07:50,414.7925 --> 00:07:51,424.7925 So I helped them out. 75 00:07:51,814.7915 --> 00:08:00,74.7925 And then I did more consulting and then I had the opportunity to help start a managed care plan, Medicaid managed care. 76 00:08:00,524.7925 --> 00:08:06,429.6925 And I helped start that plan in terms of applying and meeting all the regulations and launching the plan. 77 00:08:08,149.7925 --> 00:08:28,179.7915 And I eventually became the executive director of a Medicaid and Medicare managed care plan, and I always looked at it, it was an extension of everything that I had done in terms of how to expand access to health care services for people for the members of this health care plan, who are also patients, some of them. 78 00:08:29,599.7925 --> 00:08:41,979.7925 And we're both low income and elderly and all of my previous experience really came into play in terms of creating, this managed care services to bring to people to make their lives better. 79 00:08:42,699.7925 --> 00:08:45,709.7925 So it was a very, had a very long career. 80 00:08:46,49.7925 --> 00:08:58,939.7925 About 20 years ago, I was diagnosed with a a chronic blood disorder called polycythemia it's part in the disease category of myeloproliferative neoplasms. 81 00:08:59,519.7925 --> 00:09:03,439.7925 And I was able, I was just being monitored for it. 82 00:09:03,559.7925 --> 00:09:12,809.7915 There was no cure but I was being monitored, but I was able to live a very sort of normal productive life. 83 00:09:12,809.7915 --> 00:09:16,399.7915 I was able to have children and work full time. 84 00:09:16,709.7915 --> 00:09:31,269.7915 Until my health crashed, because my disease converted to what's called myelofibrosis, where you don't have enough blood in your system, and your bone marrow dries up, and the only cure is a stem cell transplant. 85 00:09:31,699.7915 --> 00:09:41,289.7895 And early on in the progression of my disease, my doctors really tried to push me, have the stem cell transplant sooner than later, because you're younger, it'll be better. 86 00:09:41,289.7905 --> 00:09:44,549.7905 But my kids were still in high school, needed to apply to college. 87 00:09:44,599.7905 --> 00:09:52,234.7905 And the internet was saying that the chances of Survival were only 30%. 88 00:09:52,554.7905 --> 00:09:58,344.7905 And so I waited and unknowingly waited till the last minute until my health crashed. 89 00:09:58,394.7905 --> 00:09:59,514.7895 I needed to leave work. 90 00:09:59,914.7905 --> 00:10:07,654.7895 I was on some bridge therapy for a while until they could find a donor for me because I didn't have a family donor available. 91 00:10:08,594.7905 --> 00:10:15,904.7905 And and five years, five and a half years ago, I had the stem cell transplant and, happy to say that my recovery is going fairly well. 92 00:10:16,414.7905 --> 00:10:21,154.7895 But after about two years into my recovery, I started feeling better. 93 00:10:21,164.7895 --> 00:10:23,394.7895 My mentally started waking up. 94 00:10:23,854.7885 --> 00:10:27,114.7885 And my doctor said to me, so this was the hematologist. 95 00:10:27,114.7885 --> 00:10:29,994.7885 oncologist who was really shepherding my care. 96 00:10:30,44.7885 --> 00:10:33,844.7885 And she went to introduce me to somebody and said, Oh, I want you to meet Dana. 97 00:10:33,874.7885 --> 00:10:35,594.7885 She's one of my best patients. 98 00:10:35,594.7885 --> 00:10:37,904.7875 And I said, Oh, means my health. 99 00:10:37,904.7885 --> 00:10:38,884.7885 I'm doing really well. 100 00:10:38,934.7885 --> 00:10:41,134.7865 And she said no, I didn't mean that. 101 00:10:41,194.7875 --> 00:10:43,154.7865 I meant you come to every appointment. 102 00:10:43,154.7875 --> 00:10:44,174.7875 So prepared. 103 00:10:44,484.7875 --> 00:10:45,924.7875 You ask good questions. 104 00:10:45,924.7875 --> 00:10:47,844.7875 You have good follow up. 105 00:10:47,844.7875 --> 00:10:51,84.7875 You remind me of things you do such a good job as a patient. 106 00:10:51,144.7875 --> 00:10:56,524.7875 And I said, doesn't everybody do that? And she said, no, not everybody does that. 107 00:10:57,44.7875 --> 00:10:58,344.7875 So it just. 108 00:10:59,44.7875 --> 00:11:09,874.787 inspired me to think about what do I know that other people don't know? What am I doing that other people aren't doing? But as part of that, I a lot of research as well. 109 00:11:10,184.788 --> 00:11:11,904.788 I read everybody's books. 110 00:11:11,924.787 --> 00:11:12,754.788 I bought books. 111 00:11:12,824.788 --> 00:11:13,484.788 I read them. 112 00:11:13,554.787 --> 00:11:18,24.7875 I did my own research, all the scholarly research that's happening all over the country. 113 00:11:18,24.7875 --> 00:11:19,964.788 That's been happening for 50 years. 114 00:11:20,364.788 --> 00:11:26,264.788 Researchers studying physician, patient communication, and how that affects health outcomes. 115 00:11:26,574.788 --> 00:11:28,494.788 And I just was so drawn to it. 116 00:11:28,514.788 --> 00:11:28,854.788 I will. 117 00:11:30,194.788 --> 00:11:41,274.788 It was very like I, I thought, okay, I think I found a path where I could make all my experiences, both my professional experiences and my personal experiences come together. 118 00:11:41,944.788 --> 00:11:50,684.688 And instead of just writing a book, because when you're in a health crisis, your first thought isn't to go to Barnes and Noble to buy a book to help. 119 00:11:50,684.688 --> 00:11:52,144.688 You through the healthcare process. 120 00:11:52,154.688 --> 00:12:02,544.688 So I decided to develop really resources and a framework for people to use that was pretty straightforward that people would remember and they would think about these things. 121 00:12:02,554.687 --> 00:12:10,914.688 So I called my sort of small consulting company, the thinking patient, because being sick or thinking about being sick. 122 00:12:10,914.688 --> 00:12:19,884.688 Whether it's something that happens once in a while, or you're subject to a chronic disease, is a very emotional, anxiety provoking condition. 123 00:12:19,974.688 --> 00:12:21,884.688 Nobody likes to be sick. 124 00:12:22,184.688 --> 00:12:37,124.687 Nobody likes to see a doctor if they don't really have to, but even when they do have to, it's a really nerve wracking, overwhelming, Situation and I certainly found that with my disease and I was plugged into the system, but it's so overwhelming. 125 00:12:37,144.687 --> 00:12:48,754.6855 I thought if I could create tools for people and help people develop their skills, then the anxiety could be lessened because they could have a stronger pathway. 126 00:12:49,404.6865 --> 00:13:09,934.6865 To then have a visit with a doctor to make the most of limited appointment times so that the doctor could then say, Oh, this patient really has prepared for this appointment and the doctor will respond enthusiastically to a patient's need to know, and also a patient's desire to participate. 127 00:13:11,459.6865 --> 00:13:12,439.6865 in their care. 128 00:13:12,999.6865 --> 00:13:17,759.6865 And if you don't ask doctor questions, then the doctor will assume that, you don't have any questions. 129 00:13:17,759.6865 --> 00:13:21,119.686 You understand everything, but that's hardly ever the case. 130 00:13:21,119.686 --> 00:13:24,809.6865 And I don't care what level of ability somebody is. 131 00:13:25,229.6865 --> 00:13:29,19.6865 It's just, it's very hard for people to come into that room. 132 00:13:29,29.6855 --> 00:13:30,244.5865 You need to. 133 00:13:30,244.5865 --> 00:13:31,594.5865 Prepare you need to do the work. 134 00:13:31,594.5865 --> 00:13:32,694.5865 You need to have the skills. 135 00:13:32,954.5865 --> 00:13:41,54.5865 And I just wanted to make it easier by laying out some fundamental concepts and also skills and strategies to help people. 136 00:13:41,404.5865 --> 00:13:41,684.5865 Sure. 137 00:13:41,684.5865 --> 00:13:42,744.586 I think that's great. 138 00:13:42,744.586 --> 00:13:54,594.5875 I think, I always appreciate and patients feel like they're bothering me when they sheepishly bring out a sheet of questions or their files or whatever it is. 139 00:13:54,894.5875 --> 00:13:57,754.5875 And I'm always grateful for it because I feel. 140 00:13:58,94.5875 --> 00:14:18,774.5875 That the appointment we get much more done and much more addressed and as we all get older We don't remember everything right and you're in a doctor's office and you feel nervous and you're like, oh my god What was I supposed to ask? I don't remember All sorts of stuff happens to everyone, not just, you, not just me, a lot of people. 141 00:14:19,104.5875 --> 00:14:23,694.5875 So I always say it's better to come prepared. 142 00:14:24,44.5875 --> 00:14:27,834.5875 Even if it's a question that you think is stupid, there is no such question. 143 00:14:27,834.5875 --> 00:14:29,914.5865 That's stupid, right? It's important. 144 00:14:29,914.5875 --> 00:14:32,354.5865 If you have a question, then it should be addressed. 145 00:14:32,764.5865 --> 00:14:36,664.5875 And the other thing I also welcome is family members. 146 00:14:36,944.5875 --> 00:14:46,74.5875 Because not only do I realize that The patient is cared for and supported, but there's an investment there. 147 00:14:46,184.5875 --> 00:14:59,194.5855 The family cares, right? And if they come with questions, I'm always happy to address those questions because then I know that appointment is going to be made, that CAT scan is going to be, scheduled. 148 00:14:59,574.5855 --> 00:15:04,454.5855 Especially when I emphasize the timeline and in, in which I would like things done. 149 00:15:05,74.5855 --> 00:15:14,84.5855 So give us an idea of what you have, your consulting company, how you have supported patients. 150 00:15:14,654.5855 --> 00:15:19,54.5855 Give us some examples of how patients have benefited from that. 151 00:15:21,124.5855 --> 00:15:21,554.5855 Okay. 152 00:15:21,574.5855 --> 00:15:31,34.5845 So I have been doing workshops and presentations on first having people understand what the dynamic is between being a patient and being a doctor. 153 00:15:31,364.5855 --> 00:15:35,645.25883333 And the two really have more in common than patients would normally think. 154 00:15:35,645.25883333 --> 00:15:49,164.5855 So I start by trying to give them A really good idea of what a doc, what the doctor's perspective is when a patient walks through the room and then juxtapose that to what the patient feels and what the patient is feeling. 155 00:15:49,414.5855 --> 00:15:52,794.5855 And there really is such an alignment between the two. 156 00:15:52,954.5855 --> 00:15:59,324.5855 And when you understand that, then a patient or a patient's family member, caregiver. 157 00:15:59,754.5855 --> 00:16:09,164.5845 Can come to this appointment with really a clear set of what their priorities are, what they want to accomplish, what they want to share with the doctor. 158 00:16:09,514.5855 --> 00:16:18,376.5045 And so how I share that my framework is really starting with there are five parts the first part is is preparation. 159 00:16:18,376.5045 --> 00:16:22,87.8845 So that before the appointment. 160 00:16:22,597.8845 --> 00:16:27,917.8845 And for certain specialists, or if you're having an annual visit, it's not just the day of the appointment. 161 00:16:28,147.8845 --> 00:16:29,367.8845 It's keep a notebook. 162 00:16:29,397.8845 --> 00:16:36,967.8845 It doesn't matter how structured or what the notebook looks like, but everything being all together to keep a notebook. 163 00:16:36,967.8845 --> 00:17:03,507.9835 So as you think of things, or you're doing research, or you've met other doctors, taking your you're taking really that inventory of what you want to accomplish when you see the doctor what questions you want to ask, and maybe some research we've done on your subject matter in addition to be able to ask the doctor, I'd like to clarify my diagnosis, or I'd like to go over my test results from an appointment from three months ago. 164 00:17:03,687.9835 --> 00:17:18,867.9835 So you are prepared and most people don't come in as you had mentioned, they don't come in with things written down, but it's been shown that when you write things down, you also remember them better, you write them down. 165 00:17:19,27.9835 --> 00:17:21,542.8835 So when you're engaged in the discussion, you can focus things down. 166 00:17:22,942.9835 --> 00:17:35,12.9835 On the discussion and new information that the doctor brings up so you can ask additional questions so you don't have to worry about whether you forgot something so really honing in on some basic skills. 167 00:17:35,12.9835 --> 00:17:38,372.9835 And the writing things down by hand also improves. 168 00:17:38,382.9835 --> 00:17:50,902.9835 It's been these are other studies proves the connection between the remembering things you write things down, you remember them better, you might not even if you focused. 169 00:17:51,657.9835 --> 00:17:54,287.9835 Whether it's weeks or just days before your appointment. 170 00:17:54,842.9835 --> 00:17:57,892.9835 And you've created this list because you've written it down. 171 00:17:57,892.9835 --> 00:17:58,862.9835 It's been yours. 172 00:17:59,52.9835 --> 00:18:04,192.9845 You probably wouldn't even have to refer to it that much when you're at this discussion with the doctor. 173 00:18:04,442.9845 --> 00:18:13,932.9835 And then it also becomes the record of that appointment, what we covered in this appointment, what the doctor's responses to my questions have been. 174 00:18:14,312.9845 --> 00:18:21,132.9845 And I go to appointments and before I even created my own sort of, I call it the thinking patient planner that includes. 175 00:18:22,22.9845 --> 00:18:28,122.9845 space for 30 appointments and other resources and information to make a handy dandy guide for people to use. 176 00:18:28,292.9845 --> 00:18:41,192.8855 But you don't really even need that as long as you have a dedicated notebook and that you have space for, the doctor you saw, the date, what your priorities, your agenda, your questions, the resources. 177 00:18:41,192.8855 --> 00:18:42,342.8855 search that you've done. 178 00:18:42,672.8855 --> 00:18:44,842.8855 And then you're able to also look back. 179 00:18:44,902.8855 --> 00:18:57,632.8855 I always look, I've had a very complicated disease and I wanted to track, I know my doctor was extremely busy and had so much respect for her and what she did, but I couldn't expect her to remember everything. 180 00:18:57,932.8855 --> 00:19:00,212.8845 And she would say to me like three months. 181 00:19:00,252.8855 --> 00:19:00,692.8855 Okay. 182 00:19:00,692.9855 --> 00:19:01,387.7855 I don't. 183 00:19:02,767.8855 --> 00:19:06,47.8855 We need to do a bone marrow biopsy now, but maybe we'll look at it in three months. 184 00:19:06,287.8855 --> 00:19:13,117.8855 So here I am at my appointment three months later and I have that note because I'm looking back and seeing what did we do with the last appointment. 185 00:19:13,472.8855 --> 00:19:31,272.8855 And what are we going to do with this appointment? And I took note that, oh, last appointment, you said, because really the way that electronic medical records work and doctors note taking during appointments and then after appointments, and perhaps you want to even speak about that, how intense. 186 00:19:31,702.8855 --> 00:19:40,272.8855 The information is that you can expect your doctor will not do a complete record of what happened in terms of the discussion. 187 00:19:40,602.8845 --> 00:19:42,172.8855 It won't be in the medical record. 188 00:19:42,992.8855 --> 00:19:46,932.8855 Most doctors I've met have amazing memories. 189 00:19:46,992.8855 --> 00:19:53,387.8855 I'm just bowled over the things that my Doctor remembers from even five years ago about my life. 190 00:19:53,727.8855 --> 00:19:57,7.885 And I will tell the doctor, she goes, Oh, I remember that's what happened. 191 00:19:57,7.885 --> 00:19:58,677.8855 And that's why I recommended that. 192 00:19:58,697.8855 --> 00:20:00,67.8845 And she will remember. 193 00:20:00,77.8855 --> 00:20:02,97.8855 And I just bowled over. 194 00:20:02,217.8845 --> 00:20:07,957.8855 I've in my best days, I never had that kind of memory. 195 00:20:07,967.8845 --> 00:20:14,907.8845 So for me, writing things down was a great tool to be able to also be in charge of your own information. 196 00:20:15,187.8845 --> 00:20:18,787.8845 And do you know that preparation phase is just so important. 197 00:20:19,47.8845 --> 00:20:35,307.7845 And it's not a hard concept for people to understand, but it keeps getting them closer and closer to having more control and understanding of their own health care information and being able for them to be ready to have the conversation with the doctor. 198 00:20:36,317.8845 --> 00:20:37,97.8845 Absolutely. 199 00:20:37,97.8845 --> 00:20:42,927.8845 I think, there's so much, as you know that is happening in healthcare primary care shortages. 200 00:20:42,967.8845 --> 00:20:49,947.8845 And, it's very difficult to get, appointments with specialists and there's a nursing shortage. 201 00:20:49,947.8845 --> 00:20:59,737.8845 I just did a podcast a couple of weeks ago about empowering, a new generation of nurses and what they're trying to do different because apparently, nurses are quitting. 202 00:21:00,77.8845 --> 00:21:05,557.8845 In the same amount of period it took for them to become nurses, they're quitting in that same, time period. 203 00:21:05,837.8845 --> 00:21:10,897.8855 So all that investment of becoming a nurse, it, it's not fruitful apparently. 204 00:21:10,897.8855 --> 00:21:17,267.8835 And I think, my generation is different, but I'm reading articles about all sorts of things of, how doctors. 205 00:21:17,282.9835 --> 00:21:22,527.296 And a lot of doctors are also leaving medicine, which is really sad and actually very scary. 206 00:21:22,767.296 --> 00:21:25,937.296 And the reason why I'm saying this is because I'm trying to highlight. 207 00:21:26,447.296 --> 00:21:31,807.296 That there is so much in medicine that patients are not aware of. 208 00:21:31,897.296 --> 00:21:39,127.296 And honestly, how can they be right? It's unless you're in the thick of it, right? It's really hard to understand. 209 00:21:40,67.296 --> 00:21:45,337.296 what's going on, but all these things that are happening that are causing shortages. 210 00:21:45,832.296 --> 00:21:49,132.296 That they're putting pressure on doctors and nurses. 211 00:21:49,662.296 --> 00:21:58,382.295 It is also putting a crunch on time, right? Because that is one last person to answer a patient question. 212 00:21:58,782.295 --> 00:22:10,662.295 It's one last, person to see a patient, right? Because again, if you have less doctors and less nurses the wait time for patients are going to be. 213 00:22:12,192.295 --> 00:22:14,322.295 So it's even more important. 214 00:22:14,322.295 --> 00:22:20,52.294 I feel to be organized and to be prepared for when you finally get that appointment. 215 00:22:20,387.295 --> 00:22:22,817.295 So that time doesn't get wasted. 216 00:22:23,757.295 --> 00:22:34,27.194 So you were mentioning, writing things down because then you have this memory that forms, right? You don't even have to really remember what you wrote down. 217 00:22:34,297.195 --> 00:22:51,107.095 What other tools or perhaps apps or websites do you recommend for patients to, to use, to advocate for their health? We really move like to the next part of the framework, which is the second part is language. 218 00:22:51,137.094 --> 00:22:59,27.095 I call it language because it's really about learning the language of your healthcare so you can express yourself. 219 00:22:59,387.094 --> 00:23:05,527.095 And that language, there are just 20 years ago. 220 00:23:05,907.095 --> 00:23:10,177.095 Everyone should really know how to pronounce their diagnosis and what it means. 221 00:23:10,207.095 --> 00:23:16,347.094 And you can ask your doctor and you could write it down, but to really understand it, you should read something about it. 222 00:23:16,637.095 --> 00:23:20,317.095 And also the beautiful part of all this information that's out there. 223 00:23:20,317.095 --> 00:23:26,307.095 And most of the time it's very overwhelming for people, but whatever the diagnosis is, and it could be as. 224 00:23:26,652.095 --> 00:23:30,822.095 Straightforward is pre diabetic because let me just back up for a minute. 225 00:23:30,862.095 --> 00:23:36,462.0945 It's not just about chronic diseases and my whole message is not as, as patients. 226 00:23:36,462.0945 --> 00:23:37,462.095 We're all patients. 227 00:23:37,492.095 --> 00:23:44,352.094 Cause whether we go to a doctor once a year or once a month, we're all patients throughout our entire lives. 228 00:23:44,382.094 --> 00:23:44,692.094 Yes. 229 00:23:44,982.094 --> 00:23:45,292.094 Yes. 230 00:23:45,472.094 --> 00:23:46,422.094 So that's important. 231 00:23:46,752.094 --> 00:23:51,261.995 So now there is really a community, whether it's. 232 00:23:52,12.095 --> 00:24:01,942.095 Research community, a patient community and advocacy community for every single major and minor disease category that exists today. 233 00:24:02,252.095 --> 00:24:13,982.095 And for me, my experience, my community, it started as a research foundation was started by a patient, Only two years before I was diagnosed, but it very quickly ramped up. 234 00:24:14,182.095 --> 00:24:19,652.095 And in fact, this research foundation, the Milo Proliferative Treatment, Researchfoundation. 235 00:24:19,662.095 --> 00:24:30,522.093 org had so much information about the disease, so it distilled everything for people who were in shock of receiving a diagnosis of a blood cancer disorder. 236 00:24:30,862.092 --> 00:24:38,172.093 And so this really website and research community and patient community just offered so much to people. 237 00:24:38,412.093 --> 00:24:41,662.093 We are very fortunate today that there's a lot of information available. 238 00:24:41,682.093 --> 00:24:45,942.093 So that would be the first place that I would go if you're newly diagnosed. 239 00:24:45,942.093 --> 00:24:50,372.092 And I think that, on the flip side, I think doctors should share with the patients. 240 00:24:50,672.092 --> 00:24:55,892.092 So I have really terrific doctors, but I had to find out all of this on my own. 241 00:24:56,272.092 --> 00:25:02,242.092 So I really reinforce with people, this is one thing that you have to have agency to do yourself. 242 00:25:02,512.092 --> 00:25:04,652.092 Go to where trusted. 243 00:25:04,652.092 --> 00:25:32,797.092 sources of information, whether it's, the American Heart Foundation or the cancer, there's like hundreds of cancer foundations, and they both do research, and they do advocacy, and they also have peer communities where if you feel like, I really want to talk to somebody who's gone through this thing that I'm going through, you contact them, and they have people who volunteer, who are patients, or are patients, and volunteer to share that with other people as well. 244 00:25:33,57.092 --> 00:25:38,837.092 The other thing about language that I think is so important, is learning the language of your medications. 245 00:25:38,877.092 --> 00:25:56,787.092 And I just also, I'm so surprised by, my peer Not in my disease category, my peers in my profession even, or just friends, do not know how to pronounce the names of their medication, and whether it's the generic, or it's the brand name, you need to know what drugs you're taking. 246 00:25:56,847.091 --> 00:26:05,707.092 So when the doctor, every single time, and you can speak to this of Why it's so important to keep reviewing a patient's medication as part of the visit. 247 00:26:05,717.092 --> 00:26:24,567.092 Maybe you can talk a little bit about that, but I find that it's so important because the patient needs to know what they're taking, how they're taking it, needs to be refrigerated, needs to be taken with food how to really manage their own medications and how to ask the questions related to drug interactions, and also. 248 00:26:24,972.092 --> 00:26:36,992.091 If they forget to ask the doctor, okay, what are the drug interactions, you can ask your pharmacist or there are websites online now where you could put in the medication, it'll tell you what the drug interactions are. 249 00:26:37,2.092 --> 00:26:38,632.092 You can find this on WebMD. 250 00:26:39,232.092 --> 00:26:54,842.0925 I don't know the names of all of them, but I have done this and then I bring that information to my doctor and it says this, or I had my doctor because it was important for me to have all the right vitamins after my transplant. 251 00:26:55,462.0925 --> 00:27:02,232.092 I, I was getting my vitamins from, National Pharmacy, I won't mention the name, and however, They got it. 252 00:27:02,232.092 --> 00:27:03,472.092 They would just pour it in the bottle. 253 00:27:03,472.092 --> 00:27:05,12.092 So I didn't even know it was in their vitamins. 254 00:27:05,12.092 --> 00:27:10,902.092 And when I started to feel better, I said, I need to know what's in these vitamins, what I'm taking this multivitamin because I don't want any food dye in there. 255 00:27:10,902.092 --> 00:27:12,332.092 I want to have the most natural. 256 00:27:12,662.092 --> 00:27:20,872.091 And I realized that there was folic acid in the vitamin composition and my doctor separately prescribed folic acid. 257 00:27:21,102.091 --> 00:27:25,327.092 So I said to her, She says, okay, you could stop taking the folic acid. 258 00:27:26,527.092 --> 00:27:28,897.092 You are getting double dosing of folic acid. 259 00:27:30,377.092 --> 00:27:36,147.091 So what would you say when you say, doctor, every time I come, I visit you once a month and you keep going over my medications. 260 00:27:36,357.091 --> 00:27:37,597.092 Maybe you could speak to that. 261 00:27:37,597.092 --> 00:27:39,907.091 I would love to hear a physician's opinion on this. 262 00:27:40,157.092 --> 00:27:49,357.092 And for whatever reason, there are patients who get annoyed or irritated with my medical assistant, rarely me, whoever is reviewing their medications. 263 00:27:49,737.092 --> 00:28:08,917.091 why do I have to do this? And what I say to them is it's really important for me to, do a reconciliation of your medications because there are other doctors, practitioners who are prescribing things who are not even in the same group as where I'm practicing. 264 00:28:09,177.091 --> 00:28:14,67.092 So I need to know, if this is the case, if you've stopped these meds or not. 265 00:28:14,407.092 --> 00:28:35,967.189 If there's a different dose because not everything is always up to date, and there's always, something that is not included, whether it's a vitamin or supplement, so it's very important To make sure we review the medications each and every visit just like checking someone's blood pressure, checking someone's weight. 266 00:28:36,327.19 --> 00:28:38,567.19 They have issues with the weight as well. 267 00:28:39,57.189 --> 00:28:40,917.1885 So this is what I usually tell them. 268 00:28:40,917.1885 --> 00:28:43,67.189 I don't know if it registers or not. 269 00:28:43,227.189 --> 00:28:46,937.189 Because I guess, for whatever reason they feel like everything is the same. 270 00:28:46,937.189 --> 00:28:52,377.089 But it's checks and balances, but often not, but often that's why it's so important. 271 00:28:52,377.189 --> 00:28:53,237.189 Absolutely. 272 00:28:53,397.189 --> 00:28:53,927.189 Yes. 273 00:28:54,287.189 --> 00:28:58,747.1885 So the other part of the framework is question asking and to be a good questioner. 274 00:28:58,787.1885 --> 00:29:04,957.1885 And although I talked a little bit about it in that preparation phase some sort of tools and strategies. 275 00:29:05,697.1885 --> 00:29:09,617.1885 Or it's called like the technical term is called question prompts. 276 00:29:10,197.1885 --> 00:29:25,697.1885 And so before a doctor's appointment or after a new diagnosis, you want to know so what are the questions I should be asking? What should I ask my doctor about this? I don't what should I know what's important to know? Again, there's so much information on the internet, https: otter. 277 00:29:25,697.2885 --> 00:29:39,792.1885 ai Google it and say, what should I ask my doctor about cardiovascular disease and what my test results show? And you will, inform yourself and also help form the questions. 278 00:29:40,82.1885 --> 00:29:54,722.1885 And I think what was interesting in my research I guess I'm partly an academic at heart, not really, because I really love making things move and change and bring new systems, but I really found it interesting that. 279 00:29:55,272.1885 --> 00:30:11,802.1875 The health researchers did study, if we help patients prepare in advance, what are the questions what we should give them and how would it improve health outcomes? And they started with 22 questions that they gave patients and went through it. 280 00:30:12,272.1885 --> 00:30:15,892.1875 And they said, Oh, this works, but you know what? There's a little bit of overlap. 281 00:30:15,962.1875 --> 00:30:18,82.1875 Let's reduce it to 15 questions. 282 00:30:18,702.1875 --> 00:30:24,302.1865 And then they got to seven questions and then lo and behold, they came up with. 283 00:30:25,807.1875 --> 00:30:34,597.1875 They said, you know what, let's check if we just had, gave patients three questions and wanted quote it directly. 284 00:30:35,157.1875 --> 00:30:47,417.1865 Three questions for patients to ask their doctors that would make a big impact and have the patients be more involved in the decision making related to their care and make them more engaged. 285 00:30:47,917.1865 --> 00:30:50,867.1865 They tested these three questions and it worked. 286 00:30:51,232.1865 --> 00:30:52,722.1865 And it improved health outcomes. 287 00:30:52,722.1865 --> 00:31:29,587.1865 And the questions are, what are my options, including the wait and watch option? What are the possible benefits and the risks of each of these options? And how likely are each of these benefits and risks happen to me based on my health condition? And what will happen to me if I do nothing? And so these three questions, if you get frozen, I can't think of anything to ask because you're bombarded by this overwhelming Oh, how is my life going to change. 288 00:31:30,137.1865 --> 00:31:41,407.1865 What extra things am I going to need to do or will buy my life be shortened because of this, or just something simple if you don't, if you don't take care of your high blood pressure. 289 00:31:41,787.1865 --> 00:31:47,737.1865 What are these things going to happen that it gives you this really a tool, a pathway. 290 00:31:48,437.1865 --> 00:31:57,857.1865 To say, okay, if I can't get into the details right now, please doctor, what are my options? Can we go through my options? Yeah. 291 00:31:57,947.1855 --> 00:32:09,297.186 And you would think these are just such basic questions, but I agree with each and every one of them because a lot of people don't ask these questions. 292 00:32:09,297.286 --> 00:32:22,137.186 And I often have to say, okay, are you interested in learning about this? Your options, what could happen if you decide not to take the medication that I'm suggesting? And so I'm the one who will introduce it. 293 00:32:22,137.187 --> 00:32:31,677.186 Most of my patients are great and they will come prepared, some and you have to wonder why, what's going on, right? That they're not asking these questions. 294 00:32:32,47.186 --> 00:32:36,77.087 I have to be a lot more comprehensive with them. 295 00:32:36,477.087 --> 00:32:39,667.087 So give us one example. 296 00:32:40,47.087 --> 00:32:53,597.087 of patient advocacy that led to a good outcome where if you didn't play that role for them, that things may not have turned the same in terms of benefits. 297 00:32:55,137.087 --> 00:33:01,437.088 I'm going to give you an example of an interaction I had with somebody in the audience where I was presenting. 298 00:33:01,437.088 --> 00:33:23,567.088 The framework and having this discussion about how to communicate better with doctors and the people who usually show up to these sort of more open presentation, community presentations, whether they are libraries or community centers, or people who are really already interested and engaged in their care, because who would really want to come to this if they didn't think, Oh, this is important. 299 00:33:23,597.088 --> 00:33:24,277.088 It's interesting. 300 00:33:24,277.088 --> 00:33:24,817.088 It's important. 301 00:33:24,967.088 --> 00:33:26,57.088 And maybe you could help me. 302 00:33:26,317.088 --> 00:33:32,241.989 And so I'm always very moved by the questions that these people have because they have been engaged in their care. 303 00:33:32,621.989 --> 00:33:54,371.9875 So one is that because of the stressors on doctors about limited appointment times and, the pressures of the productivity related to moving through and giving them, all their attention, but also Anticipating the difficulty that the doctor may think that certain patients are more difficult to communicate than with others. 304 00:33:54,381.9875 --> 00:33:59,51.9875 So this man tells me that he does his research. 305 00:33:59,51.9875 --> 00:34:00,351.9875 He comes prepared. 306 00:34:00,496.9875 --> 00:34:12,856.9865 He's not shoving anything in the doctor's face, like some patients come in with a whole file full of research and doctors generally don't like that and I don't think that's the right approach for patients anyway to do that. 307 00:34:13,66.9865 --> 00:34:16,406.9875 I think patients should be prepared with questions and have a discussion. 308 00:34:16,776.9865 --> 00:34:36,346.9865 So this man said to me that the doctor started being rude to him because he said, what is it? You don't trust me? Who went to medical school, me or you? And this poor man, maybe it was in his seventies, and very intelligent man who really wanted to come prepared to every appointment. 309 00:34:36,666.9875 --> 00:34:40,16.987 He said, look, I don't have a lot of options for doctors. 310 00:34:40,16.987 --> 00:34:42,686.9875 There aren't a lot of geriatricians or internists. 311 00:34:42,696.9865 --> 00:34:44,406.9865 It's hard to find a good doctor. 312 00:34:44,406.9875 --> 00:34:45,966.9875 Somebody who has a good reputation. 313 00:34:46,496.9875 --> 00:34:50,776.9875 I don't want to leave this doctor just because he got snippy with me. 314 00:34:52,916.9875 --> 00:34:58,366.9875 What should I say to a doctor if a doctor comes back at me like this. 315 00:34:58,786.9875 --> 00:35:03,596.9875 I say, you have to, as a patient, you take the high road. 316 00:35:04,106.9875 --> 00:35:06,606.9875 You know yourself better than anybody. 317 00:35:07,506.9875 --> 00:35:12,341.9865 The doctor, this is, the doctor's business, to see you and try to, Take care of you. 318 00:35:12,341.9865 --> 00:35:20,531.9865 But it's up to you to really explain to the doctor what you're after and say, look, doctor, I really have a lot of respect for you. 319 00:35:20,701.9865 --> 00:35:22,661.9865 And I'm not saying that this guy should apologize. 320 00:35:22,671.9865 --> 00:35:31,851.9865 It's not about the patient shouldn't apologize to the doctor, but it's about the patient showing, look, I have a lot of respect for your expertise and we've had such a good working relationship. 321 00:35:31,851.9865 --> 00:35:32,571.9865 already. 322 00:35:32,931.9865 --> 00:35:36,911.9865 What I really need to know is this X, Y, Z. 323 00:35:37,271.9865 --> 00:35:50,247.9865 And so you're saying it, calmly and diplomatically, and I know that's a hard thing to do, but it's this strategy, a communication mode that you need to get into as a patient because you are this. 324 00:35:50,247.9865 --> 00:35:51,927.9865 CEO of your own health. 325 00:35:52,437.9865 --> 00:35:56,357.9865 You have to tell doctors who you are and what you need. 326 00:35:56,657.9865 --> 00:35:58,897.9865 And many patients they don't have the language. 327 00:35:58,897.9865 --> 00:36:01,37.9865 That's why I say the language to express themselves. 328 00:36:01,47.9865 --> 00:36:04,877.9845 They don't have, the questions prepared to express themselves. 329 00:36:05,127.9855 --> 00:36:10,47.9855 They're afraid of sharing certain information with a doctor, whether it's. 330 00:36:10,547.9855 --> 00:36:26,977.984 They smoke too much, they drink too much, anything happening in, their sexual lifestyle, or maybe they're not taking their medications and they don't want to tell a doctor because they don't really like taking medications and so they're only taking it sometimes, and they don't like to share this sort of sensitive information with a doctor. 331 00:36:27,337.985 --> 00:36:33,707.985 So people need to know that they have a big role to play in communicating with doctors. 332 00:36:34,17.985 --> 00:36:36,777.985 And if a doctor has a little bit of an off day. 333 00:36:37,277.985 --> 00:36:47,837.985 You have to say, it's just like in a relationship with anybody to take a little bit of step back and take a breath and know that, I want to share who I am with you. 334 00:36:47,837.985 --> 00:36:48,847.985 I have certain questions. 335 00:36:48,847.985 --> 00:36:49,897.985 I have a need to know. 336 00:36:50,177.985 --> 00:37:11,917.984 And I hope, and I want to know that I, you to know that I respect you, But, can we get back to you understanding what I'm trying to share with you? And I think that's been one of my biggest contributions in terms of helping people have a pathway when they're under such stress. 337 00:37:11,977.986 --> 00:37:18,357.985 And certainly, and you probably know because I know you have a lot of older patients in your practice, that people want to live. 338 00:37:18,677.985 --> 00:37:19,937.985 And people want to feel good. 339 00:37:20,147.985 --> 00:37:27,557.985 And as you get older, there's certain things you could take all the care of yourself possible and be in good physical condition. 340 00:37:29,352.985 --> 00:37:36,882.985 But as you age, things happen and it no matter what you do, sometimes it's just genetics or your reaction to medication or whatever. 341 00:37:36,882.985 --> 00:37:38,682.985 So it's hard for people. 342 00:37:39,142.985 --> 00:37:45,542.984 So giving people sort of tools and a pathway to make them be able to like, let's hold on to that. 343 00:37:45,542.984 --> 00:37:50,712.984 And that's why I keep going back to, that's why it's like these mental tools. 344 00:37:50,822.984 --> 00:37:56,402.984 They're like mindset tools to think about how I communicate with doctors so I could get the best. 345 00:37:57,197.985 --> 00:38:11,687.985 Care that I can get and if ultimately you're not satisfied with an interaction with a doctor, because it happens more than once or you feel you're not really getting answers to your questions or whatever it is, or maybe you really feel the doctor doesn't like me. 346 00:38:12,237.985 --> 00:38:20,727.985 You let you find another doctor, you just have to try to find another doctor and I tell people that straight up but you know hearing from people directly. 347 00:38:22,247.985 --> 00:38:37,807.987 People who try so hard to have an intelligent conversation and are honest and share who they are, I tried to give them either confirm that you know look you're doing all that you can keep going, just do that, take care of yourself, and just make sure that. 348 00:38:38,237.987 --> 00:38:44,637.987 All the doctors that you see, you're asking all the questions that you need to ask, and you're keeping track of things. 349 00:38:45,7.987 --> 00:38:53,227.988 As much as you can That just reminded me of there are times when i'll have patients, and everyone likes to google everything Google this doctor. 350 00:38:53,237.987 --> 00:39:02,687.988 They google me they google, you know who i'm sending them to and then sometimes i'll say Oh, but that doctor doesn't have whatever five stars on google or you know Whatever site. 351 00:39:02,777.988 --> 00:39:05,757.988 And I'm like, okay, here's the thing about this doctor. 352 00:39:05,997.988 --> 00:39:18,937.986 They may have not gotten the stars, but in this condition that I'm sending you for whatever cancer, whatever surgery they need, right? He or she happens to be the best in this area. 353 00:39:19,267.987 --> 00:39:22,837.987 And maybe they, they're not going to be touchy feely with you. 354 00:39:22,837.987 --> 00:39:27,997.987 And, but if that's what you want, I can send you to that type of doctor, but you may not also have the best outcomes. 355 00:39:28,387.987 --> 00:39:30,537.987 And this is what you may encounter. 356 00:39:30,657.987 --> 00:39:38,767.987 Yes, they won't be touchy feely with you, but they will, be able to address your issue and also rectify it. 357 00:39:39,27.987 --> 00:39:41,137.986 And I'm obviously here to support you. 358 00:39:41,407.987 --> 00:39:47,837.987 So sometimes it's a little bit of coaching as well, because the internet has Changed everything. 359 00:39:47,837.987 --> 00:39:51,747.987 We were not restaurants here, right? We're people, we're human beings. 360 00:39:51,747.987 --> 00:40:00,907.987 And you were mentioning, right? If the doctor says, who's the doctor? I went to medical school, right? I don't think that doctor probably says that every day, but we have bad days. 361 00:40:01,762.987 --> 00:40:02,692.987 We have bad days. 362 00:40:02,692.987 --> 00:40:21,382.987 We run late, right? We have our own lives and sometimes that affects us when we're working and seeing patients because it is a stressful job where at the end of the day we are dealing with lives and you know taking care of people's health and at least I Take that very seriously. 363 00:40:21,382.987 --> 00:40:24,32.987 I feel like it's an honor that I've been able to do that. 364 00:40:24,342.987 --> 00:40:35,832.9865 And with that I sometimes feel the burden of that responsibility, right? That okay, what if I missed that test that, the patient had, right? So it's my job to review all those things. 365 00:40:35,832.9865 --> 00:40:38,532.9865 And that often takes up a lot of my time. 366 00:40:38,912.9875 --> 00:40:41,372.9875 And it often leads to stress as well. 367 00:40:41,772.9875 --> 00:40:46,842.9865 Having these open conversations with patients take, takes time. 368 00:40:47,262.9875 --> 00:41:25,857.9865 So do you think that there is room? In our health care system for more number one advocacy groups and also I'll give an example and I unfortunately, we don't have this in as part of our employer Support system, but there was a time when there was a I don't even know what it was called But it was a group that was employed That helped guide us in terms of not just cost effectiveness, but let's say you had a question about, if you needed to see a specialist, they could recommend someone to you. 369 00:41:26,17.9875 --> 00:41:30,767.9865 I don't necessarily need these types of services, but I thought it was fantastic. 370 00:41:31,217.9865 --> 00:41:33,857.9875 I even ran into some billing issues. 371 00:41:34,442.9875 --> 00:41:39,122.9875 And that I could have addressed myself, but I gave it a test it over to them. 372 00:41:39,122.9875 --> 00:41:44,302.9865 I outsourced it and they handled the matter for me and, found out what the answer was. 373 00:41:44,532.9855 --> 00:41:49,912.9865 Do you think there's more room for things like that to, to help us as patients? Yeah, absolutely. 374 00:41:49,963.0865 --> 00:42:01,473.0865 Obviously the my focus is on having the patients be more prepared and have the knowledge and skills and also courage, which we haven't talked about directly, but those things are really important. 375 00:42:01,493.0865 --> 00:42:08,622.9865 So my focus is on building that up because the doctors need to do what the doctors do. 376 00:42:08,863.0865 --> 00:42:26,673.0865 And but your health care will only be better if you are prepared and participate in this and share who you are with the doctor, right? So you have your role to play to doctors, providers, hospital systems, physician practices can generally do a better job in sharing. 377 00:42:27,563.0865 --> 00:42:41,343.0865 Other resources so not taking up time during the visit, but directing people to resources just like you said coaching people or helping people navigate if it's not your practice, a specialist isn't in your practice helping to navigate. 378 00:42:41,763.0855 --> 00:42:45,933.0865 But the third group that has a really role to play are employers. 379 00:42:45,933.0865 --> 00:43:03,873.087 So the majority of people in the United States get their health insurance through employers, but employers don't only provide health insurance, they provide employee assistance benefits, which includes, mental health services, financial support, stress support, crisis management, they have a whole list of things. 380 00:43:05,668.087 --> 00:43:09,678.087 And then employers also sometimes have their own wellness program. 381 00:43:09,678.087 --> 00:43:18,298.086 So there's like a three prong thing of employers and everything's just seems to be so transactional rather than integrated. 382 00:43:18,548.087 --> 00:43:20,798.0875 And you raise a very important issue. 383 00:43:21,38.0855 --> 00:43:44,23.0855 Is there an important And thread throughout all we've been talking about from patients to providers to insurers, this thread that can tie everything together that makes the information flow very person centered, because the system knows the person and this or the system. 384 00:43:45,508.0855 --> 00:43:47,718.0855 System can assess the person. 385 00:43:47,998.0855 --> 00:44:00,838.0855 And actually I've been thinking a lot about that because I think this is like the new area that needs to evolve with all the changes that are happening in the health care system related to a I assessments of your health. 386 00:44:01,18.0845 --> 00:44:08,405.584 The digital the wearables that people can monitor their own health, which is really like limited right now, but it's something. 387 00:44:08,545.584 --> 00:44:16,675.584 And it seems like the people who are more athletic or in better shape tend to use the wearables or, move, really move into that direction. 388 00:44:17,115.584 --> 00:44:29,630.584 But all the tools that are becoming available, there's a big part of the population that really doesn't Touch it because people are older and they're not that interested in doing new things. 389 00:44:29,910.584 --> 00:44:37,730.584 But for people who are still working and, people can work up through their 70s or even 80 years old these days. 390 00:44:37,740.583 --> 00:44:42,990.484 So you're working and you have access to all these employer, employers make big decisions. 391 00:44:44,360.584 --> 00:44:51,840.584 Investments in the health of their employees, buying insurance, buying AP services, doing wellness programs, because they got to compete for the talent. 392 00:44:52,70.584 --> 00:44:54,190.583 And right now that's what employers do. 393 00:44:54,200.584 --> 00:44:55,650.584 They have all these things. 394 00:44:55,850.584 --> 00:45:06,915.5845 So how to make this, As seamless as possible to integrate so that somebody can really go to one source, whether you call it, health coaches are known as something different. 395 00:45:06,915.5845 --> 00:45:08,825.5845 So I'm not really calling it a health coach. 396 00:45:08,835.5835 --> 00:45:24,875.584 Maybe it's more of a navigator, but it's like a personalized navigator system to help direct so people don't have, it's just, there's so much information on the internet now that you, everybody ends up having to start from scratch every time. 397 00:45:26,310.584 --> 00:45:28,380.584 Time, which is one thing that got me interested in. 398 00:45:28,760.584 --> 00:45:43,720.584 How can I help in aggregating this information and making it easier for people so they don't have to do two years of research like I did to come up with a methodology that can really help people, move through and be in charge of their own care and participate and share decision making. 399 00:45:43,960.584 --> 00:45:53,660.584 But I do think both the provider systems and employer systems need to do a better job of helping people move through this transformation. 400 00:45:53,870.583 --> 00:45:55,280.584 And maybe it starts with. 401 00:45:55,695.584 --> 00:46:02,75.584 Genetic testing and health screening and, all the things and finding out. 402 00:46:02,75.584 --> 00:46:13,665.583 So what's specific to that individual? And it's fascinating for me and I hope I live long enough to see a lot of these things evolve because everything I read about, I know it's going to be a better. 403 00:46:15,90.583 --> 00:46:17,970.583 Better I don't know if it's going to be better access in the future. 404 00:46:17,970.583 --> 00:46:28,960.582 I can't really predict the access part, but certainly there are going to be better technologies to detect disease on an earlier basis than there is now. 405 00:46:29,380.583 --> 00:46:33,320.583 My disease now, they developed blood tests to test my disease. 406 00:46:33,320.583 --> 00:46:34,900.583 Mine went 20 years ago. 407 00:46:35,530.583 --> 00:46:45,120.583 My disease was detected because I had a blood clot in the portal vein of my liver, and if I didn't do anything about it within a certain amount of time, Time, I wouldn't be here to talk about it. 408 00:46:45,160.583 --> 00:46:56,520.582 So it was detected because I had a symptom, but I went symptom less for my whole life because I had a genetic defect in my blood by bone marrow in my blood. 409 00:46:56,760.583 --> 00:47:06,260.583 So I, every time I read about something to help people move through these chronic diseases better or early detection. 410 00:47:06,400.583 --> 00:47:08,610.583 I think that's really where we want to get to. 411 00:47:08,890.583 --> 00:47:11,140.583 And like you identified. 412 00:47:11,515.583 --> 00:47:27,345.582 How are we going to move an entire population to be able to have access to these kinds of services and information and awareness, but it starts with also having great leadership and role models that want the population to have better. 413 00:47:27,345.583 --> 00:47:28,975.5825 It's not just access to services. 414 00:47:28,975.5825 --> 00:47:32,815.583 It's like participation of all the parts to move it forward. 415 00:47:33,315.583 --> 00:47:36,535.583 And, I talk about This patient physician communication. 416 00:47:36,565.583 --> 00:47:47,965.483 It is a a similar way of saying patient engagement, right? The patient engagement is about the healthcare systems and the patient engaging with each other. 417 00:47:48,145.482 --> 00:47:52,935.483 It's not just making, Oh, let's make forms easier to fill out like they don't need me. 418 00:47:52,955.482 --> 00:48:00,675.482 The system doesn't need me to help, create easier forms or an easier whatever I'm trying to just like yeah. 419 00:48:01,10.483 --> 00:48:24,630.483 People do weightlifting to improve muscle tone and how do you lift those weights of your life so you can be as healthy as you can possibly be if that's what you want? And I know for me it was really important because the statistics were not good for people with my disease and certainly for my live fibrosis in general, but I'm here to talk about it. 420 00:48:24,640.483 --> 00:48:34,105.383 And I feel like I have something to share and I'm, I'm still figuring it out, like how best to share it and what's going on in the world and bringing the best to the world. 421 00:48:34,605.383 --> 00:48:36,455.383 Bringing the best knowledge. 422 00:48:36,885.383 --> 00:48:42,695.383 And in fact, these, the three questions that we just talked about was developed by a group in Australia. 423 00:48:42,785.383 --> 00:48:46,915.383 I was able to make connections with people who are doing similar kinds of. 424 00:48:47,590.383 --> 00:48:54,430.383 Investigations, and also trying to put that out there for consumers, for people. 425 00:48:54,470.383 --> 00:48:59,130.383 We're all patients, so just putting that information out there, making it easier for people. 426 00:48:59,130.383 --> 00:49:04,870.384 Healthcare is big and complicated, both in terms of systems and in terms of what's really going to help people. 427 00:49:05,380.384 --> 00:49:05,850.384 Yes. 428 00:49:05,890.384 --> 00:49:13,460.384 And I think, with recent events, with the, the murder of the CEO of UnitedHealthcare, it really speaks. 429 00:49:13,460.384 --> 00:49:33,340.383 Obviously that is definitely, an outlier and most people don't resort to these kind of, measures, but it's, speaks to the frustration when you go through, some of the comments that are being made, right? And I think some of it is not appropriate, but a lot of people you could see and hear people's frustration. 430 00:49:33,750.384 --> 00:49:35,170.384 With the healthcare system. 431 00:49:35,180.384 --> 00:49:40,780.384 But as I mentioned, there's so much to healthcare right now that people are not aware of. 432 00:49:41,90.384 --> 00:49:46,520.384 So the, at the end of the day, the common denominator is forget I'm a doctor. 433 00:49:46,770.384 --> 00:49:47,580.384 I'm a patient. 434 00:49:47,590.384 --> 00:49:48,430.384 You're a patient. 435 00:49:48,450.384 --> 00:49:49,720.383 We're all patients. 436 00:49:50,10.384 --> 00:49:54,270.384 We all have to, as you said, be the CEO of our own health. 437 00:49:54,850.384 --> 00:50:00,130.384 And so sometimes that means, it may mean filing an appeal with your insurance company. 438 00:50:00,420.384 --> 00:50:03,830.383 It may mean Instead of waiting for the doctor to do it yourself. 439 00:50:03,860.384 --> 00:50:08,70.384 I have done that where I have not waited for my physician to do it. 440 00:50:08,340.385 --> 00:50:09,800.385 I've appealed myself. 441 00:50:09,910.385 --> 00:50:11,190.384 Sometimes I was successful. 442 00:50:11,210.384 --> 00:50:12,230.384 Sometimes I was not. 443 00:50:12,520.385 --> 00:50:19,640.385 And of course, yes, I use my title, and express my frustration with what was, whatever, was decided at that time. 444 00:50:19,690.385 --> 00:50:22,980.385 But we need to be the CEOs of our own health. 445 00:50:23,580.385 --> 00:50:28,770.385 And, I think patients, in general think that the doctor's offices can do it all. 446 00:50:28,770.385 --> 00:50:31,50.385 But the bottom line is we're bombarded really. 447 00:50:32,770.385 --> 00:50:38,580.385 And we have so much to deal with that it's dealing with prior authorizations and appeals and all sorts of stuff. 448 00:50:39,50.385 --> 00:50:41,80.384 It takes a lot of our time up. 449 00:50:41,480.385 --> 00:50:45,760.384 So we really need help from patients to assist with that. 450 00:50:45,880.385 --> 00:50:53,720.485 And it's a continuum of, Asking the right questions, right? Of, being organized of writing things down. 451 00:50:54,100.485 --> 00:51:04,300.485 It's basically being an active participant in your health and not just sitting back and letting the doctor tell you, okay, this is what's going to happen. 452 00:51:05,450.484 --> 00:51:07,880.484 It should be a shared decision making. 453 00:51:07,880.484 --> 00:51:17,980.485 And I think that's, what's, different between now and maybe 30, 40 years ago, right? Where we were seen as, okay, you decide and I'll do whatever you tell me to do. 454 00:51:18,665.485 --> 00:51:20,25.485 Times are very different now. 455 00:51:20,585.485 --> 00:51:30,745.485 And, I think people should realize they are just as in charge that we are making these decisions together, or at least we should be. 456 00:51:31,295.485 --> 00:51:34,535.485 You have, talked about great, positive things. 457 00:51:34,535.485 --> 00:51:57,405.485 I wish I could carry this conversation on for another two hours, but as all good things come to an end, but I feel like you and I have come full circle and I think East Meadow high school would be really proud of what we've accomplished and I would, thoroughly enjoy, for you to come back on my podcast at any time to discuss more. 458 00:51:57,755.485 --> 00:52:05,625.485 So how can my listeners find you in terms of all the great work that you do yes, thank you so much. 459 00:52:05,745.485 --> 00:52:09,555.485 For the past year, I've been doing weekly content on LinkedIn. 460 00:52:09,615.485 --> 00:52:22,945.485 And so I post I do research and I write about things that I feel would be helpful to people or that have really piqued my interest because it's something new that I have learned or share my experience and how that might relate to other people. 461 00:52:23,175.485 --> 00:52:24,140.385 So my LinkedIn community. 462 00:52:25,450.485 --> 00:52:26,290.485 And I'm Dana E. 463 00:52:26,290.485 --> 00:52:29,700.485 Sherwin and just, put that in the search bar and you'll find me. 464 00:52:29,710.485 --> 00:52:31,780.484 So you can contact me through LinkedIn. 465 00:52:31,880.485 --> 00:52:38,420.4845 And happy to talk to anybody about what they think might be useful to their organization. 466 00:52:40,580.4845 --> 00:52:43,390.4845 their company, the healthcare practice. 467 00:52:43,500.4845 --> 00:52:51,260.4845 Because I think the combination between my professional experience and my personal experience gives me a pretty unique viewpoint. 468 00:52:51,540.4845 --> 00:52:58,550.5835 And I don't really only focus on, even though I have, I still consider myself to have a chronic illness, even though my doctor told me. 469 00:53:00,60.5845 --> 00:53:11,880.5845 I'm in remission, so I'm happy to say that, but I think the whole point is how we address our health how we address it and the role that we take to take charge of our own health and actively participate. 470 00:53:12,140.5845 --> 00:53:15,80.5845 And I try to cover most of those issues on LinkedIn. 471 00:53:15,90.5835 --> 00:53:17,930.5845 I do have a website, thethinkingpatient. 472 00:53:17,970.5845 --> 00:53:35,145.5835 com, that's It's available to companies and organizations that might be interested in talking to me about speaking within their communities or to employees or, other areas that might be interested in exploring this and sharing the knowledge with people. 473 00:53:36,145.5845 --> 00:53:36,555.5845 Great. 474 00:53:36,585.5835 --> 00:53:39,885.5835 Thank you so much for coming on the show for. 475 00:53:40,165.5845 --> 00:53:44,985.5845 Speaking so passionately about what you do and what you do to help patients. 476 00:53:45,285.5845 --> 00:53:54,265.5845 I think like myself I don't know about you, but it was well after medical school where I figured out why I became a doctor. 477 00:53:54,650.5845 --> 00:54:01,910.5845 The standard answer back when we were interviewing for, getting into medical school was because I want to help people. 478 00:54:01,910.5845 --> 00:54:13,950.5845 And certainly I still do, right? There's an immense amount of satisfaction that I get, but a lot of it is also to heal ourselves when we take care of other people. 479 00:54:14,340.5845 --> 00:54:17,960.5845 And it sounds like you and I align in that way. 480 00:54:17,960.6845 --> 00:54:18,250.4845 Absolutely. 481 00:54:19,230.5845 --> 00:54:20,110.5845 Absolutely. 482 00:54:21,100.5845 --> 00:54:28,120.5845 In our parting thoughts, I don't know if you remember the team mascot for East Meadow? I, when I graduated, it was go Jets. 483 00:54:28,680.5835 --> 00:54:32,610.5835 Was it safe for you? We were the Jets. 484 00:54:32,680.5825 --> 00:54:34,920.5825 it's been great speaking with you. 485 00:54:34,920.5825 --> 00:54:35,900.4825 Thank you so much. 486 00:54:37,810.5825 --> 00:54:38,440.5825 Thank you. 487 00:54:38,480.5825 --> 00:54:39,150.5825 Appreciate it. 488 00:54:39,150.5825 --> 00:54:43,250.5825 And don't forget to like, share and review my podcast. 489 00:54:43,800.5825 --> 00:54:47,590.5825 Remember, it's always ladies first on Soma Says. 490 00:54:47,890.5825 --> 00:54:51,550.5825 Let's make a difference one conversation at a time.