August 21, 2024 • 43 mins
Collaborative Leadership from Boardroom to Patient-Centered Caregiving is essential for fostering effective relationships between CEOs and board members, as well as between healthcare professionals and patients. This approach not only enhances organizational dynamics but also improves patient outcomes by prioritizing communication, trust, and shared goals. By empowering all stakeholders and embracing transparency, collaborative leadership creates an environment where diverse perspectives are valued, and innovative solutions can emerge to address complex challenges in healthcare and beyond.
In this episode of Unlimited, I invited Heather Maurer (she/her) CEO of the National Association of Nurse Practitioners in Women’s Health to join me in a conversation around advancing collaborative leadership from boardroom to patient-centered caregiving.
Some of what we talk about in this episode includes:
- Listening to yourself, saying no, and respecting your own expertise and role
- Empowerment vs control and collaborative decision-making
- Building trust through transparency, time, and accountability
- Separating systems and humans as we advocate
- Ways to support asking for what you need
LINKS FROM THIS EPISODE:
Cultivating Collaboration Over Competition
Navigating Our Relationship with Death
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Valerie Friedlander (00:00):
Hello, my friends and welcome to another
episode of unlimited today weare talking about collaborative
leadership, from boardroom topatient centered caregiving,
collaborative leadership isessential for fostering
effective relationships wherepeople are working toward a
shared goal, whether we'retalking about CEOs and board
(00:24):
members or between healthcareprofessionals and patients or
even parents, not that we'retalking about that right now,
but I do want to recognize thatthis idea of collaboration and
leadership are key in All of ourhuman to human interactions and
relationships. Leadership holdsresponsibility, responsibility
(00:47):
over how they show up, and alsothe power that they hold within
a relationship. And so whenwe're functioning within
systems, it is also being ableto acknowledge and honor that
dynamic that's present, giventhe power and privilege that
(01:09):
someone holds within thatdynamic. So being able to build
trust requires transparency andaccountability coming in with
mutual respect means showingthat there's respect and
creating a space wherecollaboration can occur to
(01:34):
engage this conversation andexplore what this looks like
within These different spaces.
I've invited Heather Maurer.
Heather is the CEO of theNational Association of nurse
practitioners in women's health.
She's also a leadership coachand a healthcare advocate. She
is deeply committed toaddressing the barriers that
hinder access to evidence basedhealthcare. She passionately
(01:58):
advocates for health carepolicies that tackle health
disparities and promoteequitable access to quality
care. At the core of Heather'swork lies a steadfast focus on
the patient, driving herunwavering dedication to
improving health care outcomesfor all some of the things that
we explore in this episode, arelistening to yourself and
(02:23):
respecting your own expertiseand role, saying no empowerment
versus control and collaborativedecision making, building trust
through transparency, time andaccountability, separating
systems and humans as weadvocate and ways to support
(02:43):
asking for what you need withinthe healthcare system and for
your health and well being.
Heather shares lots of valuableinsights about leadership, about
the healthcare system and aboutnavigating it, herself and her
own lived experiences, even withthe amount of privilege that she
(03:04):
comes in with, I know you'regoing to love this conversation.
So now, without further ado,let's get started. Hey there.
I'm Valerie Friedlander,Certified Life business
alignment coach, and this isunlimited. This podcast bridges
the individual and the societal,scientific and spiritual,
positive and negative, nerdy andno, there's just a lot of nerdy.
(03:27):
Come on board, and let's unlocka light that's as badass as you
are.
Welcome, Heather. I'm so excitedto have you on unlimited.
Heather Maurer (03:44):
Thank you so much for inviting me.
Valerie Friedlander (03:46):
So I like to start off with this question,
which is, what is a limit thatyou took for granted, that you
have since unlearned?
Heather Maurer (03:56):
The ability to say no, and that saying no was
okay,
Valerie Friedlander (04:01):
Yeah,
Heather Maurer (04:02):
And I'm in a good place where I'm now able to
say no. However, I'm stillworking through being truly
comfortable with it. I look atprior to saying no, what are the
repercussions if I say no, andwhat are the repercussions if I
say yes? And weigh those, andalso look at, where am I
(04:25):
utilizing this power to say, No,you know, is it an emotional
reaction, or is it truly amechanism to protect myself and
my well being and my mental andphysical and spiritual health?
Valerie Friedlander (04:40):
Yeah, oh, those are really important
questions, and it's such acommon one for high achieving
women, because we get soconditioned around people
pleasing as self protection.
Heather Maurer (04:51):
Yes, absolutely, absolutely. And I was raised in
a great family, but a verystrict family. I was. Also
raised Catholic. Went toCatholic High School, lots and
lots of rules. Pleasing was whatgot you the extra piece of
candy, or the teacher liked youmore, and you were chosen for X,
(05:13):
Y or Z. So it was almost a wayof manipulating, I think, too,
sometimes just not conscious.
Certainly the people pleasing,it's actually gets complex.
People pleasing isn't just aboutpleasing.
Valerie Friedlander (05:28):
Yeah, oh yeah. Well, I mean, it's, it's
the fawn response, basicallythat most women get conditioned
around. That's how we survive,is if we please you, then we'll
get what we need and to at acertain point that really
doesn't work well, you know? Andit's interesting. It makes me
think, when you talk aboutcontrol, that difference between
(05:49):
empowerment and control, likecontrol is that I'm trying to
hold on to things and managethings that are external to me,
to, you know, other people,places and things, versus that
empowerment of What are mychoices, and being able to own
my choices
Heather Maurer (06:03):
Exactly.
Valerie Friedlander (06:04):
And that's huge.
Heather Maurer (06:06):
Huge. And very, very, very different. One is
coming from within, like yousaid. The other one is external.
One makes you feel good. Theother one, there's not too much
uptick, and then there'sauthority that sometimes can be
kind of melded into control. Andthat's also different too.
Valerie Friedlander (06:29):
Yeah, it's interesting, because I think
that that moves us really wellinto what we're talking about,
because you work with in thehealthcare field, and this is
one of those places wherecontrol works, the more power
you have, but it doesn't reallyserve. And you know, one of the
(06:52):
things you talk a lot about isthat collaborative relationship,
and we're looking at like as aleader in a nonprofit space as
well as in healthcare and thepatients healthcare provider
relationship, when we thinkabout empowerment versus
control, feel like that that isa very particular energy. And a
(07:17):
lot of times I feel like we feela lot more control, especially
with recent policies and anddynamics that are happening
around women's health in our inthe US, and that idea of control
versus empowerment is stark. Iwonder if we were to look at
(07:37):
like first, starting with yourrole as a CEO on a board, when
you think of that difference ofcreating an empowered leadership
versus a controlling leadership,how do you see that difference
play out in your work?
Heather Maurer (07:58):
Yeah, it's a great question. I think that
first of all, I recognize andknow that we are better when we
are all in it together, and theability to work collaboratively,
to create a space and process,to hear all viewpoints and to
(08:21):
want to really talk it out, youknow, and I think that we are
living in a very fast pacedworld that takes time
cultivating relationships. What,you know, we always say, walk in
those shoes. I don't think wecan really walk in someone's
shoes, but we can definitelyfollow beside them, and we can
see what they're living and, youknow, we've seen this all the
(08:44):
time in mean quotes about, youknow, someone else that is
fighting a battle that you knownothing about, be kind. And it's
really true. I had somethingtoday that happened, and I
recognized, you know, what, theperson that is writing this is
under a lot of stress. I'm goingto give them a lot of grace. I'm
going to give myself a lot ofgrace, and we'll figure this
(09:06):
out. And then just recognizingthat, that I truly believe, and
I think this is also at thepremise of who I am as a leader,
is that I assume that peoplecome to the table wanting to do
great work to really support theorganization, to support the
mission and vision, our IDEcommitment, which is our
(09:27):
inclusivity, diversity andequity commitment, and be the
best association that we can befor the women's health nurse
practitioner and other advancedpractice nurses who provide
women's and gender relatedhealthcare. So I think coming
from that premise really setsthe foundation. I also believe
(09:48):
that, sure, there are peoplethat have taken advantage of
that, and the great thing is, Ihave really strong intuition,
and when my gut says something'swrong, I'm going to figure out
what that is. Yeah, and Iusually call it as well, saying
I'm feeling something's up.
What? What's going on here? Whyam I feeling this? And again,
sometimes it just needs to beclarification, but sometimes
(10:08):
there are things at the root ofthat.
Valerie Friedlander (10:12):
It's such a powerful thing to engage
curiosity. That's one of thethings that I suggest. When
people the pause, slow it down,take a pause to really think
about it, and then, you know,engage curiosity. And so I love
that you kind of outlined thatin practice of that's what it
looks like, and I would imaginethat certain spaces are a little
(10:32):
bit more conducive to assumegood intent, you know, like when
you're dealing with in anorganization that is really
clearly aligned, holding true tothat mission, to that vision. If
everyone is together under thatthen you can build and you
mentioned some things in aprevious conversation around
(10:53):
building trust and havingtransparency in so many spaces.
I think the idea of leadershipwhen it's around control, you
take away the transparency,because the more you can hold
close to the chest, the moreother people don't know that you
know, the more power you have,the more control you can wield
(11:13):
over other people and over thedecisions, versus being able to
build trust and transparency andtrue collaboration. What are
some strategies that you'veimplemented within your
leadership to maintain thattransparency and build trust
within the organization?
Heather Maurer (11:33):
Sure, so I started three weeks after the
pandemic was declared, andactually started a week early.
So I literally went from aFriday, from one job to a Monday
with a new job, this one with nomental break in between and a
declared pandemic. And I didthat for the main reason was, is
that the PPP loans wereavailable for 501, c3,
(11:55):
organizations, and the paperworkto pull that together was going
to take some time, and I didn'twant to miss the deadline,
knowing that our organizationwould need that money. So I
didn't even have time to focuson building trust. I needed to
hit the ground working and atthe same time, build trust. So I
think one of the big things Iwant to just share with the
(12:17):
listeners is it takes time tobuild trust. Sure you can both
come in with very similarpremises, but it still takes
time. And in this case, therewere a lot of challenges. There
wasn't the opportunity to meetin person, which I think meeting
in person. There's a differentenergy exchange. And when I say
energy exchange, it's true. Wecan feel and read things. We
(12:40):
know that communication is, youknow, what is it? 80% body
language and the way our eyestwitch and hands move, and those
things not the words coming outof our mouth, the tone of our
voice, sure. So there was a lotof challenge in building that
trusting relationship with theboard, with the staff, with the
(13:01):
members, because I didn't get tosee them. You know, it's this
two dimensional zoom world foralmost two years. So I
initially, I gave myself grace.
I said, this is going to be muchharder. This is not your typical
start to a new job as a CEO. Andthese are uncharted territory
for everybody. So I think as acollective, created that grace
(13:24):
internally, certainly among thestaff and the board. And I also
believe at the time, the boardfelt that they were left out of
things and that they I thinkthey kind of felt like they
didn't have control, and thatthey were told what to do,
versus it being a collaborativeand so I initially may have over
(13:47):
shared sometimes, you know,there's there's sharing and then
there's sharing, but I wantedfull transparency, so that they
could understand everything, andthat any question that they had
could be asked, and that duringthat also what their role and
responsibilities were as boardmembers, and some of that was
(14:07):
just basic fundamentals. And Ithink that's another thing that
comes into working with boards,is everyone comes in with
different levels ofunderstanding board governance
and best practices and roles andresponsibilities. So in the
middle of trying to do my job inthis pandemic, making sure that
our doors stayed open and wewere supporting our members, I
(14:29):
was also working on sharingfundamentals, getting resources
for them to read about roles andresponsibilities for those that
were new to being a boardmember, developing new processes
so that there was acollaborative process for, let's
say, budget, and if they hadquestions, those questions were
(14:49):
answered with the greatest oftransparency, and not only from
me, but from our accountants,from our auditors, so that there
was. Even greater authority, sothat it supported what I was
saying. And I think that'sanother thing is, is that you
don't have to be an expert ateverything, but bring your
experts to the table, so that itillustrates that you are
(15:11):
comfortable with having someonefrom the outside speak on it,
and especially with CPAs andauditors, they have rules that
they have to follow. They're notgoing to lie for a CEO. And I
think that's also important, isreally bring those experts to
the table to support the workthat you're doing.
Valerie Friedlander (15:33):
Yeah, what I'm connecting as you talk is
that shared trust, like you'recoming in. You want to build
trust with them, so that theytrust you, but also it's
incumbent upon you to trust themthat they're also coming to the
table with the same goals. Sowhile they may be coming at it
from a different direction, asyou mentioned, with like, we
(15:56):
don't know someone's livedexperience, but we can listen to
it. We can hear what they haveto bring to the table, that you
can trust that they're with you,even if they're approaching it
in a different way, and thattrust makes a huge difference in
terms of your openness andability to share. So it's kind
(16:17):
of a mutual interaction, as wellas the transparency to then be
able to have accountability,because without transparency,
there's no accountability
Heather Maurer (16:27):
That's right and accountability for their roles
as board members. You know, theyhave fiduciary responsibilities
to the organization. They haveother obligations that are
legal. So there was that, aswell as my responsibilities and
role as CEO to support theorganization and support the
operations. And I think that'salso really key for any of the
(16:49):
board members out there. They'reresponsible for setting the
strategic priorities andstrategic direction of the
organization in a c3 and yourCEO and staff is there to
operationalize it andcommunicate along the way those
outcomes the process is reallyleft to the internal team and
staff members. And sometimesboard members get too in the
(17:11):
weeds, and sometimes they're toohands off. So there is a happy
balance, and I would say thatthat is something that is a
constant of ebb and flow andrecognizing where, oh, it looks
like, you know, this is gettingtoo operational. That's, that's
my neck of the woods, you know,but that strategic priority, or
(17:32):
what those priorities are goingto be for next year, that's,
that's your area. So we have agreat chart. Well, I have a
great chart. My husband actuallygave it to me. He's also in the
c3 world. And it reallydelineates like, this is a board
responsibility, this is a CEOstaff or outside vendor
responsibility that comes downto an audit or something like
(17:54):
that. And it's really helpful tohave those, because it's then a
neutral and again, it comes tothat table with we're all
working to achieve the samegoals, and sometimes we just
need those general reminders,like, Oops, I'm in that zone.
Let me jump back over in myspot. So I think it can be done
with gentleness. And again, ittakes time to learn these
(18:14):
things.
Valerie Friedlander (18:16):
Yeah, yeah.
Well, to have that sharedresponsibility and be like, Oh,
I'm not on my side, and I needto move back over and trust that
the people who are on that sideare going to handle it, and
maybe there's missinginformation, like, I need this
information because that willgive me that stability, or vice
versa, like, if there's not thetransparency and accountability
(18:38):
and that information sharing,then it's really hard to stay on
your own side of the streetbecause you're like, but I'm
missing information, right? Andthe other piece that I wanted to
engage with you was the Allright, let's step out of the
boardroom and into the doctor'soffice, the nurse practitioner's
office, and that patientcaregiver interaction. Because I
(19:01):
think I imagine very similarthemes in that space as well,
where we recognize what eachperson's responsibilities and
knowledge is, and having thatshared decision making around
the health of the person, thepatient, and so I'm curious if
(19:22):
we applied that, like, what aresome best practices for
encouraging patients to activelyparticipate in healthcare
decisions, and also encouragingproviders to allow patient
participation or be receptive topatient participation, because I
feel like that's one of theplaces where I hear a lot of
(19:43):
complaints around I don't feellistened to, I don't feel heard.
Heather Maurer (19:48):
Yeah, so we have a couple of things. One is, is
that as a country, the way wevalue healthcare is not
equitable. The system wasn'tcreated to be equitable. The
system wasn't created to beinclusive of people of color, of
(20:09):
different gender identities. Andwe also live in a capitalist
society. We live in a culturewhere profitability is above
health. And so we have a premisewhere it's really difficult to
even get the care that you need.
Then we've got a 10 to maybegenerously stating 20 minute
(20:35):
exchange with that provider.
Usually you'll have a nursethat'll come and take your blood
pressure, your weight, ask you acertain series of questions, and
then that next provider comes inand asks you another series and
if you've got some chronicconditions or symptoms that you
(20:55):
want to discuss, as long asthat's not a well visit, you can
discuss that. If it's a wellvisit, then you got to make
another appointment to discussthat, because your insurance
might not cover it. So they alsohave that challenge, right? And
I am not a provider. So justwant to be really clear, I am a
patient and I am an advocate forpatients. I'm also an advocate
(21:17):
for providers in supportingtheir education, continuing
education in women's and genderrelated healthcare. So that's I
just want to be really clear,but I've had some great patient
experiences, and I've had somehorrible patient experiences. I
chose to give birth with acertified nurse midwife and a
freestanding birth center, and Ichose that model because my
(21:38):
visits were 45 minutes and Ididn't have a nurse weigh me. I
weighed myself. There were somethings where I was was
empowered. I was empowered overmy health care and the shared
decision making model that Iexperienced I have not
experienced with any otherprovider, with the exception of
the women's health nursepractitioner that I work with,
(21:59):
who has a private practice, andbecause she has a private
practice, she's able to havelonger visits and be available
and supportive of my care. Sothe average person doesn't have
that accessibility, thatprivilege. I recognize my
privilege, and I have to say,part of why I do what I do is
(22:20):
because of hearing the storiesor when I've had bad care,
thinking about that woman whohad to take three busses to get
to that appointment and thenleaves and doesn't have her
issue or condition resolved,she's not going to follow up.
She doesn't have the time. Shejust lost three hours of pay
because there's no paid timeoff. You may have had to pay a
(22:43):
babysitter to take care of herkid, who knows what the
situation is, but it is not fairand equitable. So that
infuriates me, and that drivesme every day to figure out ways
to make this better. This is abig challenge. I mean, there's
so many barriers for us as acollective in this country to
get good health care. It'sreally a system that's been
(23:05):
designed for the rich and forthe white, and it's it's being
dismantled slowly, but there aresteps that are being made, and I
think some of it's with theresearch that is coming out. So
the more and more we learn themore and more we're going to be
able to change, but we're upagainst a big, powerful
(23:26):
opposition that does not want tolet go of the control.
Valerie Friedlander (23:30):
Yeah, I think it's so important that you
called all of that out. I'mhearing, you know, we have both
our own advocacy as a patientand we also have our advocacy
collectively, because this isimpacting all of us very
fundamentally, because we'retalking about our health here
(23:51):
and quality of life. So withthat in mind for the people who
are going into medicalestablishments asking for care
and advocating for what we need,recognizing the constraints that
are present because all of thesepeople are stuck in the system,
(24:14):
just in different ways. We stillwant to advocate.
Heather Maurer (24:18):
Right and they're not happy in the system.
That's the other thing. I mean,they may love the work that
they're doing and caring forpatients, that's why they went
into the business that they'rein and the way that they make
their living. But they're alsotrapped in this system and are
fighting a battle that we don'teven know, as patients, what
they're up against. And I thinkwe need to remember they're
(24:40):
humans, and I know there's somenot so great doctors and wh and
PS and nurses and midwives outthere, but for the most part,
they truly want wellness forpeople. So you were asking, you
know, how does that patient comein, and how does that patient
interact with. Provider. Firstof all, there's some great
(25:02):
things that we know that are inplace now. Not everybody has
this, but a lot of us do is wehave these portals. And sure,
you're not going to rememberyour username and password, but
maybe, maybe you can do a littleface ID on your phone and then
it just pops up. Um, that's howI have mine set up, and I will
email or message within thesystem. My provider before my
(25:25):
appointment to say, I want tomake sure we cover this, this
and this. And if I've comeacross, because I'm one of those
geeky nerds, a study that isrelated to something that I'm
going through. And I'll give youan example in a second, I upload
that so that they can see thatand say, and just say, I want to
talk about this because I'mexperiencing this. And here's a
(25:46):
study that I found so that thatpractitioner has potentially
some time to go over that, orlook at that, or the nurse
brings it to their attention,whatever their internal system
is. I'm perimenopausal. I'm 53years old, and I have been very
fortunate to be surrounded by alot of providers and menopause
(26:07):
experts who are certified inmenopause care, who are women's
health nurse practitioners andcertified nurse midwives and
NPS. And I have been hearing alot of scientific evidence based
medicine about the safety andprevention that estrogen and
progesterone, I still have myuterus, so I need to take
(26:30):
progesterone if you're takingestrogen, helps, and so I'm
really big about preventativemedicine. My I lost my brother
at 46 to terminal cancer. He wasan internal medicine doctor, and
I am very curious about what Ican do to prevent rundown immune
system, or if it's a geneticcomponent, to understand that as
(26:51):
well. So I've always beeninterested in this since I was a
little kid. We grew up on afarm. I'm surprised I didn't
study science, has always beenan interest of mine in what I
read and what I listen to. So Iwent in to ask for systemic
estrogen as well as vaginalestrogen. She was a family nurse
(27:13):
practitioner, a lovely woman,wonderful human, and said, No,
we don't prescribe those at thesame time, and I said, Well, I
shared with her what I'velearned. So she said, Well, let
me talk to my OBGYN, and in themeantime, I'm looking and
texting some wh NPS I know, andsaying, Hey, is there a study
that shows that systemic andvaginal estrogen at the same
(27:37):
time are safe and I don't haveanything to prevent me from
being on these hormones, andthere was no study. Nobody could
find a study, because it doesn'texist. It's a practice. And I
think that's something that Ilearned. That sometimes in
medicine, we have practice, wehave evidence, and then we have
(27:59):
journal articles, and sometimesone of those elements is
missing, and that was a reallywild thing to navigate because,
and I shared this with her, Isaid, Well, we've now created
this really weird dynamicbetween us, because I'm going to
go on vaginal estrogen. I knowthe benefits of it, and I want
to prevent what menopause bringsto me, physically. And one of
(28:25):
the big things is it preventschronic urinary tract infections
as well as atrophy, which Ibelieve there's a new word for
atrophy, again, not a provider.
And she said, Well, my OBGYN isnot comfortable doing this
either. And what I realized wasthere was a big gap in knowledge
for both of them, and thescience is also coming out very
fast. Practitioners are workingclinically, and then they're
(28:48):
going home and doing theirfamilies time to study and read
up on the latest literature. Itreally takes a lot of dedication
and time past the office to dothat. Now, there are providers
that do that all the time. Mybrother was one of those
providers. He had journalarticles all over the house, and
he read them from start tofinish, and ironically, my mom
(29:08):
also would send him articlesfrom the Washington Post about
rare diseases that were peoplewere diagnosed, so that he would
just have that in his reservoirof information, and he said he
used three of her articles todiagnose patients with
conditions he'd never heardabout. So you know. And again,
the system's not set up for allof this, and so sure, maybe you
(29:31):
get a conference or two a year,which is great, but especially
for the Women's Health NursePractitioners aren't always paid
for by the practice. So thatmeans that provider has to come
out of pocket for that. It'sexpensive. And these are things
as a CEO of an association,we've been really cognizant of
in how we plan our programming,how we support our providers,
(29:54):
and making it cost effective andeasily accessible.
Valerie Friedlander (30:00):
That's so important to recognize, because
in our hustle culture, we arelike working all the time and
not giving room, and you're notgoing to have somebody showing
up as their best self if they'renot taking room for themselves
and for breaks. And at the sametime, there's so much
information that wasn't studied,that wasn't looked at,
(30:22):
especially when it comes towomen's health, like so much is
coming out now, because there'sso many more people with access
who are doing that work, going,hey, there should be information
about this. Hey, why haven't welooked at this? Where is this
coming from? And one of thethings you mentioned earlier was
this shared decision makingmodel. And I would love for you
(30:44):
to share just a little bit aboutwhat is that, first and
foremost. And then, if you wereto come in and look for somebody
who utilizes that, because itseems like, you know, we do have
to take, unfortunately, way moreresponsibility for our own
health and our own advocacy,then one would want when we, you
know, living in this, thesystems that we live in. So what
(31:07):
is the shared decision makingmodel, and how do we ask for
that as patients or encouragethat?
Heather Maurer (31:15):
Sure, so the model, as I understand it, is
empowering the patient,providing all of the
information, the evidence onwhat the disease is, what the
recommendations are, to treatit, cure it. And so when having
a conversation on comfort level,on lived experience, religious
(31:37):
beliefs, spiritual beliefs,family structure. You have
support, we know that there arecertain procedures they won't do
unless you have support that'sgoing to be able to take care of
you when you come home from,let's say, that surgery or that
chemo treatment. So it is reallygoing through those and from the
(31:59):
provider to understand that thatpatient's needs, that patient's
comfort level, and thenrespecting it. You know, that's
the other thing, and with thatcomes legal obligation for that
provider to say, I need torecord this that you were not
wanting to have that IV whileyou're in labor. This goes
against hospital protocols andpolicy and procedure and
(32:22):
whatever the legality that theyneed to bring into it, because
we are in a litigious societywhere people can sue for
mistakes. And I'm not sayingthat's right or wrong. I'm just
saying that's the environment.
And so I think that just torecognize that that's what the
model is, and that that providerhas an obligation to share with
you as much information as theycan about that condition, and
(32:45):
for you to collectively andcollaboratively come up with a
course of treatment, or even ifit's just the model of how you
want to be treated in thosevisits, if there's a limitation
where you're not comfortablewith a pelvic exam, you have a
right to say, no. There aremethods where pelvic exams do
(33:07):
not need to be done by theprovider. There's a new cervical
test that's just come out for athome testing. There's new STI
tests as well at home. Sothere's a lot of products that
are coming on the market thatwill empower that patient to do
their own care, especially ifthere's been trauma, and then
(33:28):
also trauma. Informed care iswoven throughout every education
I'll speak to the women's healthnurse practitioner that is woven
throughout the education, aswell as shared decision making
models, and what that trulymeans. And it's also in our
mission we really respectsomeone's lived experience,
cultural, spiritual, religiousneeds, and so that is brought
(33:52):
forward in the course oftreatment and the interaction
with that individual.
Valerie Friedlander (34:00):
That's so important and speaks to that,
like, here's what I know, here'smy expertise, that transparency
of information, here's myexpertise. You have expertise
over your own body, and so likerespect your own especially for
those of us who have that peoplepleasing tendency to go in and
remember, we have expertise overour own body. They may have
(34:20):
medical expertise, we canrespect their medical expertise
and recognize that there arelimitations to both. And so if
we can show up to a situationand say, you know, this is my
expertise, respect your ownexpertise. That's right, not
just the medical expertise, butalso your own expertise, and
advocate for that respect to bereciprocal and then recognizing
(34:46):
the limitations that we arefunctioning in. So if we all
show up with that recognizingthe limitations, then we can
have a better patient providerrelationship.
Heather Maurer (34:57):
Absolutely
Valerie Friedlander (34:59):
Huge.
Heather Maurer (34:59):
And I also think if you're not getting what you
need to be brave and to say soand to to share what your needs
are, and especially if you haveneeds that are above and beyond
just the average visit onething. So when my brother was
dying, I went to my provider,and I said, I think I'm
(35:22):
depressed. And she said, Well,okay, what's going on? And so I
said, Here's my situation. Andshe said, Okay. And I, you know,
shared with my brother hasterminal brain cancer,
definitely progressing. I justgave her the whole context, like
the download one is I needed toclearly talk about it, because
it was a very, very significantevent in my life. And she said,
(35:45):
I don't know if you'redepressed. I think it might be
anxiety, and rightfully so. Soshe did a screening, sure
enough, came up as anxiety. Iwent on some anti anxiety
medicines, but again, it waslived context. I had been on
Prozac in my 20s. I told herthat I didn't like how that made
me feel. So again, I gave her mylived experience, and then she
(36:07):
was able to help me with acourse forward. And she said, If
you don't want to go themedication route, you know,
there are some suggestions Ihave, which I think you should
do anyway. Are you givingyourself time to grieve? Because
the grieving process, in thiscase, begins prior to knowing
that the death is eminent. Youknow, are you doing something
(36:29):
nice for yourself? Have youchanged your level of
responsibilities, like, have youtaken things off your plate and
simplified your world? Are youmeditating or praying or
supporting your spiritual sidein this process. And so she
really looked at the wholeperson, and I said, I want to do
all of that, and I want thedrug. I didn't want to collapse.
(36:52):
I didn't want to, like, have amental breakdown because of
this. I knew I was strong, but Ineeded some help. And you know,
again, I share this because Ireally want to destigmatize
mental health, and I share mystory very freely, because we
all are going to experiencesignificant deaths in our life,
and there's great help outthere, and I am still on the
(37:14):
anti anxiety medicine. It hasreally helped me regulate. I'm
so sorry for your loss. Oh,thank you. You know what my
brother was, is my greatestteacher. While I wish he was
here, the experience has beentremendously transformative for
me on all levels, so
Valerie Friedlander (37:32):
And it speaks of the importance, also
of community support, likehaving resources. You know, one
person isn't going to have allthe resources, and if they're in
a collaborative space with otherpractitioners. Actually, one of
the the interviews that I haveon the podcast is with a death
doula who talks about that.
Heather Maurer (37:52):
Oh yeah, that's going to be my retirement work.
I am fascinated with death. Ithink it's an area that we as a
culture don't explore, and it isa remarkable moment when
somebody dies, and to be thereis truly an honor and a
privilege. I'm a birth doula, soI feel that birth doulas and
(38:13):
death doulas have very similarwork, and it's really about
holding space for thatindividual and that family to
either bring forth life or maketheir transition out of the
life.
Valerie Friedlander (38:25):
Well, I will have that on the podcast as
well.
Heather Maurer (38:29):
I'll check that out.
Valerie Friedlander (38:29):
So, having those resources is so important
because, you know, doctor isn'tgoing to have everything, and so
to be able to say, you know,here's the medication, or here's
a person to talk to or here's,you know, here are the resources
for you to know about. So therecan be that shared, sharing of
information and knowledge andworking together in that
(38:49):
collaborative way.
Heather Maurer (38:51):
And I think that's the other thing I want to
also emphasize, be honest withyour providers. They've heard it
all, and the more transparentyou are with them, the more that
they can help you. I was intherapy, so I was going to
therapy weekly. As soon as mybrother was diagnosed, I got a
therapist within about two orthree weeks to start, because I
just knew that with thisimpacting our family, that
(39:15):
family stuff was going to comeup, and I was going to need some
help working through that, ontop of this massive loss. So it
really was very, very helpful,and I was able to really work
through some things that Ihadn't known I needed to work
through. So again, it wasreally, really helpful. So I
think that's that's just anotherthing I want to share is, you
(39:37):
know, if you have access totherapy, take advantage of it
Valerie Friedlander (39:40):
Absolutely.
I so appreciate everything thatyou've shared. Is there anything
any final thoughts that camefrom what we talked about that
you would like to make sure thatlisteners are aware of
Heather Maurer (39:52):
Just remember that your healthcare providers
are humans too, that 99.9% arethere because they really. Want
you to be healthy and well, andthey want to support you in
whatever capacity that they canand whatever their specialty
Can, can support and that thereis opportunity for that shared
decision making that should beat every interaction. You can
(40:16):
bring them articles like I do.
You can share what you'velearned, and you can do it in a
way that's supportive and thatis ongoing. I mean, with
portals, and we've also beenknown to mail articles to prior
providers before these portalswent in place. And you can
advocate for yourself, you know,stand up for yourself. I think
(40:38):
that's a big one. You know, betrue to yourself and trust
yourself as well. Your intuitionabout what's going on in your
body is a very, very powerfultool. Do not let anyone
undermine it, and if they areand you have the opportunity
find a different provider. Yeah,it's okay to say no, it's okay
to make a change if you can.
Valerie Friedlander (41:01):
Yeah, thank you. So now I always like to
wrap up with a question of, whatdoes it mean to you to be
unlimited?
Heather Maurer (41:11):
Very simply, no fear or working through the fear
breaking the fear apart. Fearcan propel, but it also can
stall and paralyze. Gotta breakthrough the fear to make
yourself do the things that arescary. Work with it, recognize
it, say hi to it, and then breakit apart so it's not dictating
(41:32):
your life, in your mind and yourbeing.
Valerie Friedlander (41:37):
And when you want to feel unlimited. What
song do you listen to?
Heather Maurer (41:43):
This is a great question. So one of my go to
songs is Warrior by Aurora. Ilove that album, and it is,
well, the whole album, I justfind empowering, but it's just
real and honest. And I love themusic I love, what she creates.
She's an incredible artist.
Valerie Friedlander (42:04):
Well, I will add that to the unlimited
playlist. Where can people findyou if they would like to
connect further?
Heather Maurer (42:11):
Sure. So I'm on LinkedIn, and it is under my
name, Heather l Mauer, so youcan just look that up. I'm also
on IG Instagram under the samename, so you can connect either
of those places.
Valerie Friedlander (42:26):
Awesome.
Well, I will have all the linksin the show notes, and thank you
so much for joining me. I reallyappreciated this conversation.
Heather Maurer (42:34):
Oh, thank you so much for having me. It's a
pleasure, and I love what you'redoing and how you are bringing
relationship into all thesedifferent aspects. I think it's
a really important conversationand conversations to have and
keep having.
Valerie Friedlander (42:47):
Thank you.
Thanks for listening. I soappreciate you being here. If
you got something out of today'sepisode, please share it, leave
me a review, take a screenshotand post it on social with a
shout out to me, send it to afriend or, you know, all of the
above. Want to hang out more,join me on Instagram, or better
yet, get on my mailing list tomake sure you don't miss out on
(43:08):
anything, and remember yourpossibilities are as unlimited
as you are. Allow yourself toshine, my friend, the world
needs your light. See you nexttime you
Hello, my friends and welcome to another
episode of unlimited today weare talking about collaborative
leadership, from boardroom topatient centered caregiving,
collaborative leadership isessential for fostering
effective relationships wherepeople are working toward a
shared goal, whether we'retalking about CEOs and board
(00:24):
members or between healthcareprofessionals and patients or
even parents, not that we'retalking about that right now,
but I do want to recognize thatthis idea of collaboration and
leadership are key in All of ourhuman to human interactions and
relationships. Leadership holdsresponsibility, responsibility
(00:47):
over how they show up, and alsothe power that they hold within
a relationship. And so whenwe're functioning within
systems, it is also being ableto acknowledge and honor that
dynamic that's present, giventhe power and privilege that
(01:09):
someone holds within thatdynamic. So being able to build
trust requires transparency andaccountability coming in with
mutual respect means showingthat there's respect and
creating a space wherecollaboration can occur to
(01:34):
engage this conversation andexplore what this looks like
within These different spaces.
I've invited Heather Maurer.
Heather is the CEO of theNational Association of nurse
practitioners in women's health.
She's also a leadership coachand a healthcare advocate. She
is deeply committed toaddressing the barriers that
hinder access to evidence basedhealthcare. She passionately
(01:58):
advocates for health carepolicies that tackle health
disparities and promoteequitable access to quality
care. At the core of Heather'swork lies a steadfast focus on
the patient, driving herunwavering dedication to
improving health care outcomesfor all some of the things that
we explore in this episode, arelistening to yourself and
(02:23):
respecting your own expertiseand role, saying no empowerment
versus control and collaborativedecision making, building trust
through transparency, time andaccountability, separating
systems and humans as weadvocate and ways to support
(02:43):
asking for what you need withinthe healthcare system and for
your health and well being.
Heather shares lots of valuableinsights about leadership, about
the healthcare system and aboutnavigating it, herself and her
own lived experiences, even withthe amount of privilege that she
(03:04):
comes in with, I know you'regoing to love this conversation.
So now, without further ado,let's get started. Hey there.
I'm Valerie Friedlander,Certified Life business
alignment coach, and this isunlimited. This podcast bridges
the individual and the societal,scientific and spiritual,
positive and negative, nerdy andno, there's just a lot of nerdy.
(03:27):
Come on board, and let's unlocka light that's as badass as you
are.
Welcome, Heather. I'm so excitedto have you on unlimited.
Heather Maurer (03:44):
Thank you so much for inviting me.
Valerie Friedlander (03:46):
So I like to start off with this question,
which is, what is a limit thatyou took for granted, that you
have since unlearned?
Heather Maurer (03:56):
The ability to say no, and that saying no was
okay,
Valerie Friedlander (04:01):
Yeah,
Heather Maurer (04:02):
And I'm in a good place where I'm now able to
say no. However, I'm stillworking through being truly
comfortable with it. I look atprior to saying no, what are the
repercussions if I say no, andwhat are the repercussions if I
say yes? And weigh those, andalso look at, where am I
(04:25):
utilizing this power to say, No,you know, is it an emotional
reaction, or is it truly amechanism to protect myself and
my well being and my mental andphysical and spiritual health?
Valerie Friedlander (04:40):
Yeah, oh, those are really important
questions, and it's such acommon one for high achieving
women, because we get soconditioned around people
pleasing as self protection.
Heather Maurer (04:51):
Yes, absolutely, absolutely. And I was raised in
a great family, but a verystrict family. I was. Also
raised Catholic. Went toCatholic High School, lots and
lots of rules. Pleasing was whatgot you the extra piece of
candy, or the teacher liked youmore, and you were chosen for X,
(05:13):
Y or Z. So it was almost a wayof manipulating, I think, too,
sometimes just not conscious.
Certainly the people pleasing,it's actually gets complex.
People pleasing isn't just aboutpleasing.
Valerie Friedlander (05:28):
Yeah, oh yeah. Well, I mean, it's, it's
the fawn response, basicallythat most women get conditioned
around. That's how we survive,is if we please you, then we'll
get what we need and to at acertain point that really
doesn't work well, you know? Andit's interesting. It makes me
think, when you talk aboutcontrol, that difference between
(05:49):
empowerment and control, likecontrol is that I'm trying to
hold on to things and managethings that are external to me,
to, you know, other people,places and things, versus that
empowerment of What are mychoices, and being able to own
my choices
Heather Maurer (06:03):
Exactly.
Valerie Friedlander (06:04):
And that's huge.
Heather Maurer (06:06):
Huge. And very, very, very different. One is
coming from within, like yousaid. The other one is external.
One makes you feel good. Theother one, there's not too much
uptick, and then there'sauthority that sometimes can be
kind of melded into control. Andthat's also different too.
Valerie Friedlander (06:29):
Yeah, it's interesting, because I think
that that moves us really wellinto what we're talking about,
because you work with in thehealthcare field, and this is
one of those places wherecontrol works, the more power
you have, but it doesn't reallyserve. And you know, one of the
(06:52):
things you talk a lot about isthat collaborative relationship,
and we're looking at like as aleader in a nonprofit space as
well as in healthcare and thepatients healthcare provider
relationship, when we thinkabout empowerment versus
control, feel like that that isa very particular energy. And a
(07:17):
lot of times I feel like we feela lot more control, especially
with recent policies and anddynamics that are happening
around women's health in our inthe US, and that idea of control
versus empowerment is stark. Iwonder if we were to look at
(07:37):
like first, starting with yourrole as a CEO on a board, when
you think of that difference ofcreating an empowered leadership
versus a controlling leadership,how do you see that difference
play out in your work?
Heather Maurer (07:58):
Yeah, it's a great question. I think that
first of all, I recognize andknow that we are better when we
are all in it together, and theability to work collaboratively,
to create a space and process,to hear all viewpoints and to
(08:21):
want to really talk it out, youknow, and I think that we are
living in a very fast pacedworld that takes time
cultivating relationships. What,you know, we always say, walk in
those shoes. I don't think wecan really walk in someone's
shoes, but we can definitelyfollow beside them, and we can
see what they're living and, youknow, we've seen this all the
(08:44):
time in mean quotes about, youknow, someone else that is
fighting a battle that you knownothing about, be kind. And it's
really true. I had somethingtoday that happened, and I
recognized, you know, what, theperson that is writing this is
under a lot of stress. I'm goingto give them a lot of grace. I'm
going to give myself a lot ofgrace, and we'll figure this
(09:06):
out. And then just recognizingthat, that I truly believe, and
I think this is also at thepremise of who I am as a leader,
is that I assume that peoplecome to the table wanting to do
great work to really support theorganization, to support the
mission and vision, our IDEcommitment, which is our
(09:27):
inclusivity, diversity andequity commitment, and be the
best association that we can befor the women's health nurse
practitioner and other advancedpractice nurses who provide
women's and gender relatedhealthcare. So I think coming
from that premise really setsthe foundation. I also believe
(09:48):
that, sure, there are peoplethat have taken advantage of
that, and the great thing is, Ihave really strong intuition,
and when my gut says something'swrong, I'm going to figure out
what that is. Yeah, and Iusually call it as well, saying
I'm feeling something's up.
What? What's going on here? Whyam I feeling this? And again,
sometimes it just needs to beclarification, but sometimes
(10:08):
there are things at the root ofthat.
Valerie Friedlander (10:12):
It's such a powerful thing to engage
curiosity. That's one of thethings that I suggest. When
people the pause, slow it down,take a pause to really think
about it, and then, you know,engage curiosity. And so I love
that you kind of outlined thatin practice of that's what it
looks like, and I would imaginethat certain spaces are a little
(10:32):
bit more conducive to assumegood intent, you know, like when
you're dealing with in anorganization that is really
clearly aligned, holding true tothat mission, to that vision. If
everyone is together under thatthen you can build and you
mentioned some things in aprevious conversation around
(10:53):
building trust and havingtransparency in so many spaces.
I think the idea of leadershipwhen it's around control, you
take away the transparency,because the more you can hold
close to the chest, the moreother people don't know that you
know, the more power you have,the more control you can wield
(11:13):
over other people and over thedecisions, versus being able to
build trust and transparency andtrue collaboration. What are
some strategies that you'veimplemented within your
leadership to maintain thattransparency and build trust
within the organization?
Heather Maurer (11:33):
Sure, so I started three weeks after the
pandemic was declared, andactually started a week early.
So I literally went from aFriday, from one job to a Monday
with a new job, this one with nomental break in between and a
declared pandemic. And I didthat for the main reason was, is
that the PPP loans wereavailable for 501, c3,
(11:55):
organizations, and the paperworkto pull that together was going
to take some time, and I didn'twant to miss the deadline,
knowing that our organizationwould need that money. So I
didn't even have time to focuson building trust. I needed to
hit the ground working and atthe same time, build trust. So I
think one of the big things Iwant to just share with the
(12:17):
listeners is it takes time tobuild trust. Sure you can both
come in with very similarpremises, but it still takes
time. And in this case, therewere a lot of challenges. There
wasn't the opportunity to meetin person, which I think meeting
in person. There's a differentenergy exchange. And when I say
energy exchange, it's true. Wecan feel and read things. We
(12:40):
know that communication is, youknow, what is it? 80% body
language and the way our eyestwitch and hands move, and those
things not the words coming outof our mouth, the tone of our
voice, sure. So there was a lotof challenge in building that
trusting relationship with theboard, with the staff, with the
(13:01):
members, because I didn't get tosee them. You know, it's this
two dimensional zoom world foralmost two years. So I
initially, I gave myself grace.
I said, this is going to be muchharder. This is not your typical
start to a new job as a CEO. Andthese are uncharted territory
for everybody. So I think as acollective, created that grace
(13:24):
internally, certainly among thestaff and the board. And I also
believe at the time, the boardfelt that they were left out of
things and that they I thinkthey kind of felt like they
didn't have control, and thatthey were told what to do,
versus it being a collaborativeand so I initially may have over
(13:47):
shared sometimes, you know,there's there's sharing and then
there's sharing, but I wantedfull transparency, so that they
could understand everything, andthat any question that they had
could be asked, and that duringthat also what their role and
responsibilities were as boardmembers, and some of that was
(14:07):
just basic fundamentals. And Ithink that's another thing that
comes into working with boards,is everyone comes in with
different levels ofunderstanding board governance
and best practices and roles andresponsibilities. So in the
middle of trying to do my job inthis pandemic, making sure that
our doors stayed open and wewere supporting our members, I
(14:29):
was also working on sharingfundamentals, getting resources
for them to read about roles andresponsibilities for those that
were new to being a boardmember, developing new processes
so that there was acollaborative process for, let's
say, budget, and if they hadquestions, those questions were
(14:49):
answered with the greatest oftransparency, and not only from
me, but from our accountants,from our auditors, so that there
was. Even greater authority, sothat it supported what I was
saying. And I think that'sanother thing is, is that you
don't have to be an expert ateverything, but bring your
experts to the table, so that itillustrates that you are
(15:11):
comfortable with having someonefrom the outside speak on it,
and especially with CPAs andauditors, they have rules that
they have to follow. They're notgoing to lie for a CEO. And I
think that's also important, isreally bring those experts to
the table to support the workthat you're doing.
Valerie Friedlander (15:33):
Yeah, what I'm connecting as you talk is
that shared trust, like you'recoming in. You want to build
trust with them, so that theytrust you, but also it's
incumbent upon you to trust themthat they're also coming to the
table with the same goals. Sowhile they may be coming at it
from a different direction, asyou mentioned, with like, we
(15:56):
don't know someone's livedexperience, but we can listen to
it. We can hear what they haveto bring to the table, that you
can trust that they're with you,even if they're approaching it
in a different way, and thattrust makes a huge difference in
terms of your openness andability to share. So it's kind
(16:17):
of a mutual interaction, as wellas the transparency to then be
able to have accountability,because without transparency,
there's no accountability
Heather Maurer (16:27):
That's right and accountability for their roles
as board members. You know, theyhave fiduciary responsibilities
to the organization. They haveother obligations that are
legal. So there was that, aswell as my responsibilities and
role as CEO to support theorganization and support the
operations. And I think that'salso really key for any of the
(16:49):
board members out there. They'reresponsible for setting the
strategic priorities andstrategic direction of the
organization in a c3 and yourCEO and staff is there to
operationalize it andcommunicate along the way those
outcomes the process is reallyleft to the internal team and
staff members. And sometimesboard members get too in the
(17:11):
weeds, and sometimes they're toohands off. So there is a happy
balance, and I would say thatthat is something that is a
constant of ebb and flow andrecognizing where, oh, it looks
like, you know, this is gettingtoo operational. That's, that's
my neck of the woods, you know,but that strategic priority, or
(17:32):
what those priorities are goingto be for next year, that's,
that's your area. So we have agreat chart. Well, I have a
great chart. My husband actuallygave it to me. He's also in the
c3 world. And it reallydelineates like, this is a board
responsibility, this is a CEOstaff or outside vendor
responsibility that comes downto an audit or something like
(17:54):
that. And it's really helpful tohave those, because it's then a
neutral and again, it comes tothat table with we're all
working to achieve the samegoals, and sometimes we just
need those general reminders,like, Oops, I'm in that zone.
Let me jump back over in myspot. So I think it can be done
with gentleness. And again, ittakes time to learn these
(18:14):
things.
Valerie Friedlander (18:16):
Yeah, yeah.
Well, to have that sharedresponsibility and be like, Oh,
I'm not on my side, and I needto move back over and trust that
the people who are on that sideare going to handle it, and
maybe there's missinginformation, like, I need this
information because that willgive me that stability, or vice
versa, like, if there's not thetransparency and accountability
(18:38):
and that information sharing,then it's really hard to stay on
your own side of the streetbecause you're like, but I'm
missing information, right? Andthe other piece that I wanted to
engage with you was the Allright, let's step out of the
boardroom and into the doctor'soffice, the nurse practitioner's
office, and that patientcaregiver interaction. Because I
(19:01):
think I imagine very similarthemes in that space as well,
where we recognize what eachperson's responsibilities and
knowledge is, and having thatshared decision making around
the health of the person, thepatient, and so I'm curious if
(19:22):
we applied that, like, what aresome best practices for
encouraging patients to activelyparticipate in healthcare
decisions, and also encouragingproviders to allow patient
participation or be receptive topatient participation, because I
feel like that's one of theplaces where I hear a lot of
(19:43):
complaints around I don't feellistened to, I don't feel heard.
Heather Maurer (19:48):
Yeah, so we have a couple of things. One is, is
that as a country, the way wevalue healthcare is not
equitable. The system wasn'tcreated to be equitable. The
system wasn't created to beinclusive of people of color, of
(20:09):
different gender identities. Andwe also live in a capitalist
society. We live in a culturewhere profitability is above
health. And so we have a premisewhere it's really difficult to
even get the care that you need.
Then we've got a 10 to maybegenerously stating 20 minute
(20:35):
exchange with that provider.
Usually you'll have a nursethat'll come and take your blood
pressure, your weight, ask you acertain series of questions, and
then that next provider comes inand asks you another series and
if you've got some chronicconditions or symptoms that you
(20:55):
want to discuss, as long asthat's not a well visit, you can
discuss that. If it's a wellvisit, then you got to make
another appointment to discussthat, because your insurance
might not cover it. So they alsohave that challenge, right? And
I am not a provider. So justwant to be really clear, I am a
patient and I am an advocate forpatients. I'm also an advocate
(21:17):
for providers in supportingtheir education, continuing
education in women's and genderrelated healthcare. So that's I
just want to be really clear,but I've had some great patient
experiences, and I've had somehorrible patient experiences. I
chose to give birth with acertified nurse midwife and a
freestanding birth center, and Ichose that model because my
(21:38):
visits were 45 minutes and Ididn't have a nurse weigh me. I
weighed myself. There were somethings where I was was
empowered. I was empowered overmy health care and the shared
decision making model that Iexperienced I have not
experienced with any otherprovider, with the exception of
the women's health nursepractitioner that I work with,
(21:59):
who has a private practice, andbecause she has a private
practice, she's able to havelonger visits and be available
and supportive of my care. Sothe average person doesn't have
that accessibility, thatprivilege. I recognize my
privilege, and I have to say,part of why I do what I do is
(22:20):
because of hearing the storiesor when I've had bad care,
thinking about that woman whohad to take three busses to get
to that appointment and thenleaves and doesn't have her
issue or condition resolved,she's not going to follow up.
She doesn't have the time. Shejust lost three hours of pay
because there's no paid timeoff. You may have had to pay a
(22:43):
babysitter to take care of herkid, who knows what the
situation is, but it is not fairand equitable. So that
infuriates me, and that drivesme every day to figure out ways
to make this better. This is abig challenge. I mean, there's
so many barriers for us as acollective in this country to
get good health care. It'sreally a system that's been
(23:05):
designed for the rich and forthe white, and it's it's being
dismantled slowly, but there aresteps that are being made, and I
think some of it's with theresearch that is coming out. So
the more and more we learn themore and more we're going to be
able to change, but we're upagainst a big, powerful
(23:26):
opposition that does not want tolet go of the control.
Valerie Friedlander (23:30):
Yeah, I think it's so important that you
called all of that out. I'mhearing, you know, we have both
our own advocacy as a patientand we also have our advocacy
collectively, because this isimpacting all of us very
fundamentally, because we'retalking about our health here
(23:51):
and quality of life. So withthat in mind for the people who
are going into medicalestablishments asking for care
and advocating for what we need,recognizing the constraints that
are present because all of thesepeople are stuck in the system,
(24:14):
just in different ways. We stillwant to advocate.
Heather Maurer (24:18):
Right and they're not happy in the system.
That's the other thing. I mean,they may love the work that
they're doing and caring forpatients, that's why they went
into the business that they'rein and the way that they make
their living. But they're alsotrapped in this system and are
fighting a battle that we don'teven know, as patients, what
they're up against. And I thinkwe need to remember they're
(24:40):
humans, and I know there's somenot so great doctors and wh and
PS and nurses and midwives outthere, but for the most part,
they truly want wellness forpeople. So you were asking, you
know, how does that patient comein, and how does that patient
interact with. Provider. Firstof all, there's some great
(25:02):
things that we know that are inplace now. Not everybody has
this, but a lot of us do is wehave these portals. And sure,
you're not going to rememberyour username and password, but
maybe, maybe you can do a littleface ID on your phone and then
it just pops up. Um, that's howI have mine set up, and I will
email or message within thesystem. My provider before my
(25:25):
appointment to say, I want tomake sure we cover this, this
and this. And if I've comeacross, because I'm one of those
geeky nerds, a study that isrelated to something that I'm
going through. And I'll give youan example in a second, I upload
that so that they can see thatand say, and just say, I want to
talk about this because I'mexperiencing this. And here's a
(25:46):
study that I found so that thatpractitioner has potentially
some time to go over that, orlook at that, or the nurse
brings it to their attention,whatever their internal system
is. I'm perimenopausal. I'm 53years old, and I have been very
fortunate to be surrounded by alot of providers and menopause
(26:07):
experts who are certified inmenopause care, who are women's
health nurse practitioners andcertified nurse midwives and
NPS. And I have been hearing alot of scientific evidence based
medicine about the safety andprevention that estrogen and
progesterone, I still have myuterus, so I need to take
(26:30):
progesterone if you're takingestrogen, helps, and so I'm
really big about preventativemedicine. My I lost my brother
at 46 to terminal cancer. He wasan internal medicine doctor, and
I am very curious about what Ican do to prevent rundown immune
system, or if it's a geneticcomponent, to understand that as
(26:51):
well. So I've always beeninterested in this since I was a
little kid. We grew up on afarm. I'm surprised I didn't
study science, has always beenan interest of mine in what I
read and what I listen to. So Iwent in to ask for systemic
estrogen as well as vaginalestrogen. She was a family nurse
(27:13):
practitioner, a lovely woman,wonderful human, and said, No,
we don't prescribe those at thesame time, and I said, Well, I
shared with her what I'velearned. So she said, Well, let
me talk to my OBGYN, and in themeantime, I'm looking and
texting some wh NPS I know, andsaying, Hey, is there a study
that shows that systemic andvaginal estrogen at the same
(27:37):
time are safe and I don't haveanything to prevent me from
being on these hormones, andthere was no study. Nobody could
find a study, because it doesn'texist. It's a practice. And I
think that's something that Ilearned. That sometimes in
medicine, we have practice, wehave evidence, and then we have
(27:59):
journal articles, and sometimesone of those elements is
missing, and that was a reallywild thing to navigate because,
and I shared this with her, Isaid, Well, we've now created
this really weird dynamicbetween us, because I'm going to
go on vaginal estrogen. I knowthe benefits of it, and I want
to prevent what menopause bringsto me, physically. And one of
(28:25):
the big things is it preventschronic urinary tract infections
as well as atrophy, which Ibelieve there's a new word for
atrophy, again, not a provider.
And she said, Well, my OBGYN isnot comfortable doing this
either. And what I realized wasthere was a big gap in knowledge
for both of them, and thescience is also coming out very
fast. Practitioners are workingclinically, and then they're
(28:48):
going home and doing theirfamilies time to study and read
up on the latest literature. Itreally takes a lot of dedication
and time past the office to dothat. Now, there are providers
that do that all the time. Mybrother was one of those
providers. He had journalarticles all over the house, and
he read them from start tofinish, and ironically, my mom
(29:08):
also would send him articlesfrom the Washington Post about
rare diseases that were peoplewere diagnosed, so that he would
just have that in his reservoirof information, and he said he
used three of her articles todiagnose patients with
conditions he'd never heardabout. So you know. And again,
the system's not set up for allof this, and so sure, maybe you
(29:31):
get a conference or two a year,which is great, but especially
for the Women's Health NursePractitioners aren't always paid
for by the practice. So thatmeans that provider has to come
out of pocket for that. It'sexpensive. And these are things
as a CEO of an association,we've been really cognizant of
in how we plan our programming,how we support our providers,
(29:54):
and making it cost effective andeasily accessible.
Valerie Friedlander (30:00):
That's so important to recognize, because
in our hustle culture, we arelike working all the time and
not giving room, and you're notgoing to have somebody showing
up as their best self if they'renot taking room for themselves
and for breaks. And at the sametime, there's so much
information that wasn't studied,that wasn't looked at,
(30:22):
especially when it comes towomen's health, like so much is
coming out now, because there'sso many more people with access
who are doing that work, going,hey, there should be information
about this. Hey, why haven't welooked at this? Where is this
coming from? And one of thethings you mentioned earlier was
this shared decision makingmodel. And I would love for you
(30:44):
to share just a little bit aboutwhat is that, first and
foremost. And then, if you wereto come in and look for somebody
who utilizes that, because itseems like, you know, we do have
to take, unfortunately, way moreresponsibility for our own
health and our own advocacy,then one would want when we, you
know, living in this, thesystems that we live in. So what
(31:07):
is the shared decision makingmodel, and how do we ask for
that as patients or encouragethat?
Heather Maurer (31:15):
Sure, so the model, as I understand it, is
empowering the patient,providing all of the
information, the evidence onwhat the disease is, what the
recommendations are, to treatit, cure it. And so when having
a conversation on comfort level,on lived experience, religious
(31:37):
beliefs, spiritual beliefs,family structure. You have
support, we know that there arecertain procedures they won't do
unless you have support that'sgoing to be able to take care of
you when you come home from,let's say, that surgery or that
chemo treatment. So it is reallygoing through those and from the
(31:59):
provider to understand that thatpatient's needs, that patient's
comfort level, and thenrespecting it. You know, that's
the other thing, and with thatcomes legal obligation for that
provider to say, I need torecord this that you were not
wanting to have that IV whileyou're in labor. This goes
against hospital protocols andpolicy and procedure and
(32:22):
whatever the legality that theyneed to bring into it, because
we are in a litigious societywhere people can sue for
mistakes. And I'm not sayingthat's right or wrong. I'm just
saying that's the environment.
And so I think that just torecognize that that's what the
model is, and that that providerhas an obligation to share with
you as much information as theycan about that condition, and
(32:45):
for you to collectively andcollaboratively come up with a
course of treatment, or even ifit's just the model of how you
want to be treated in thosevisits, if there's a limitation
where you're not comfortablewith a pelvic exam, you have a
right to say, no. There aremethods where pelvic exams do
(33:07):
not need to be done by theprovider. There's a new cervical
test that's just come out for athome testing. There's new STI
tests as well at home. Sothere's a lot of products that
are coming on the market thatwill empower that patient to do
their own care, especially ifthere's been trauma, and then
(33:28):
also trauma. Informed care iswoven throughout every education
I'll speak to the women's healthnurse practitioner that is woven
throughout the education, aswell as shared decision making
models, and what that trulymeans. And it's also in our
mission we really respectsomeone's lived experience,
cultural, spiritual, religiousneeds, and so that is brought
(33:52):
forward in the course oftreatment and the interaction
with that individual.
Valerie Friedlander (34:00):
That's so important and speaks to that,
like, here's what I know, here'smy expertise, that transparency
of information, here's myexpertise. You have expertise
over your own body, and so likerespect your own especially for
those of us who have that peoplepleasing tendency to go in and
remember, we have expertise overour own body. They may have
(34:20):
medical expertise, we canrespect their medical expertise
and recognize that there arelimitations to both. And so if
we can show up to a situationand say, you know, this is my
expertise, respect your ownexpertise. That's right, not
just the medical expertise, butalso your own expertise, and
advocate for that respect to bereciprocal and then recognizing
(34:46):
the limitations that we arefunctioning in. So if we all
show up with that recognizingthe limitations, then we can
have a better patient providerrelationship.
Heather Maurer (34:57):
Absolutely
Valerie Friedlander (34:59):
Huge.
Heather Maurer (34:59):
And I also think if you're not getting what you
need to be brave and to say soand to to share what your needs
are, and especially if you haveneeds that are above and beyond
just the average visit onething. So when my brother was
dying, I went to my provider,and I said, I think I'm
(35:22):
depressed. And she said, Well,okay, what's going on? And so I
said, Here's my situation. Andshe said, Okay. And I, you know,
shared with my brother hasterminal brain cancer,
definitely progressing. I justgave her the whole context, like
the download one is I needed toclearly talk about it, because
it was a very, very significantevent in my life. And she said,
(35:45):
I don't know if you'redepressed. I think it might be
anxiety, and rightfully so. Soshe did a screening, sure
enough, came up as anxiety. Iwent on some anti anxiety
medicines, but again, it waslived context. I had been on
Prozac in my 20s. I told herthat I didn't like how that made
me feel. So again, I gave her mylived experience, and then she
(36:07):
was able to help me with acourse forward. And she said, If
you don't want to go themedication route, you know,
there are some suggestions Ihave, which I think you should
do anyway. Are you givingyourself time to grieve? Because
the grieving process, in thiscase, begins prior to knowing
that the death is eminent. Youknow, are you doing something
(36:29):
nice for yourself? Have youchanged your level of
responsibilities, like, have youtaken things off your plate and
simplified your world? Are youmeditating or praying or
supporting your spiritual sidein this process. And so she
really looked at the wholeperson, and I said, I want to do
all of that, and I want thedrug. I didn't want to collapse.
(36:52):
I didn't want to, like, have amental breakdown because of
this. I knew I was strong, but Ineeded some help. And you know,
again, I share this because Ireally want to destigmatize
mental health, and I share mystory very freely, because we
all are going to experiencesignificant deaths in our life,
and there's great help outthere, and I am still on the
(37:14):
anti anxiety medicine. It hasreally helped me regulate. I'm
so sorry for your loss. Oh,thank you. You know what my
brother was, is my greatestteacher. While I wish he was
here, the experience has beentremendously transformative for
me on all levels, so
Valerie Friedlander (37:32):
And it speaks of the importance, also
of community support, likehaving resources. You know, one
person isn't going to have allthe resources, and if they're in
a collaborative space with otherpractitioners. Actually, one of
the the interviews that I haveon the podcast is with a death
doula who talks about that.
Heather Maurer (37:52):
Oh yeah, that's going to be my retirement work.
I am fascinated with death. Ithink it's an area that we as a
culture don't explore, and it isa remarkable moment when
somebody dies, and to be thereis truly an honor and a
privilege. I'm a birth doula, soI feel that birth doulas and
(38:13):
death doulas have very similarwork, and it's really about
holding space for thatindividual and that family to
either bring forth life or maketheir transition out of the
life.
Valerie Friedlander (38:25):
Well, I will have that on the podcast as
well.
Heather Maurer (38:29):
I'll check that out.
Valerie Friedlander (38:29):
So, having those resources is so important
because, you know, doctor isn'tgoing to have everything, and so
to be able to say, you know,here's the medication, or here's
a person to talk to or here's,you know, here are the resources
for you to know about. So therecan be that shared, sharing of
information and knowledge andworking together in that
(38:49):
collaborative way.
Heather Maurer (38:51):
And I think that's the other thing I want to
also emphasize, be honest withyour providers. They've heard it
all, and the more transparentyou are with them, the more that
they can help you. I was intherapy, so I was going to
therapy weekly. As soon as mybrother was diagnosed, I got a
therapist within about two orthree weeks to start, because I
just knew that with thisimpacting our family, that
(39:15):
family stuff was going to comeup, and I was going to need some
help working through that, ontop of this massive loss. So it
really was very, very helpful,and I was able to really work
through some things that Ihadn't known I needed to work
through. So again, it wasreally, really helpful. So I
think that's that's just anotherthing I want to share is, you
(39:37):
know, if you have access totherapy, take advantage of it
Valerie Friedlander (39:40):
Absolutely.
I so appreciate everything thatyou've shared. Is there anything
any final thoughts that camefrom what we talked about that
you would like to make sure thatlisteners are aware of
Heather Maurer (39:52):
Just remember that your healthcare providers
are humans too, that 99.9% arethere because they really. Want
you to be healthy and well, andthey want to support you in
whatever capacity that they canand whatever their specialty
Can, can support and that thereis opportunity for that shared
decision making that should beat every interaction. You can
(40:16):
bring them articles like I do.
You can share what you'velearned, and you can do it in a
way that's supportive and thatis ongoing. I mean, with
portals, and we've also beenknown to mail articles to prior
providers before these portalswent in place. And you can
advocate for yourself, you know,stand up for yourself. I think
(40:38):
that's a big one. You know, betrue to yourself and trust
yourself as well. Your intuitionabout what's going on in your
body is a very, very powerfultool. Do not let anyone
undermine it, and if they areand you have the opportunity
find a different provider. Yeah,it's okay to say no, it's okay
to make a change if you can.
Valerie Friedlander (41:01):
Yeah, thank you. So now I always like to
wrap up with a question of, whatdoes it mean to you to be
unlimited?
Heather Maurer (41:11):
Very simply, no fear or working through the fear
breaking the fear apart. Fearcan propel, but it also can
stall and paralyze. Gotta breakthrough the fear to make
yourself do the things that arescary. Work with it, recognize
it, say hi to it, and then breakit apart so it's not dictating
(41:32):
your life, in your mind and yourbeing.
Valerie Friedlander (41:37):
And when you want to feel unlimited. What
song do you listen to?
Heather Maurer (41:43):
This is a great question. So one of my go to
songs is Warrior by Aurora. Ilove that album, and it is,
well, the whole album, I justfind empowering, but it's just
real and honest. And I love themusic I love, what she creates.
She's an incredible artist.
Valerie Friedlander (42:04):
Well, I will add that to the unlimited
playlist. Where can people findyou if they would like to
connect further?
Heather Maurer (42:11):
Sure. So I'm on LinkedIn, and it is under my
name, Heather l Mauer, so youcan just look that up. I'm also
on IG Instagram under the samename, so you can connect either
of those places.
Valerie Friedlander (42:26):
Awesome.
Well, I will have all the linksin the show notes, and thank you
so much for joining me. I reallyappreciated this conversation.
Heather Maurer (42:34):
Oh, thank you so much for having me. It's a
pleasure, and I love what you'redoing and how you are bringing
relationship into all thesedifferent aspects. I think it's
a really important conversationand conversations to have and
keep having.
Valerie Friedlander (42:47):
Thank you.
Thanks for listening. I soappreciate you being here. If
you got something out of today'sepisode, please share it, leave
me a review, take a screenshotand post it on social with a
shout out to me, send it to afriend or, you know, all of the
above. Want to hang out more,join me on Instagram, or better
yet, get on my mailing list tomake sure you don't miss out on
(43:08):
anything, and remember yourpossibilities are as unlimited
as you are. Allow yourself toshine, my friend, the world
needs your light. See you nexttime you
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