July 31, 2025 • 27 mins
Listen & Watch:🎧 Listen on Apple Podcasts  ▶️ Watch on YouTube
Dr. Erin Nance—orthopedic surgeon, author of Little Miss Diagnosed, and viral TikTok creator—joins Lindsey to pull back the curtain on the medical system’s blind spots. From patient dismissal and gender bias to the complexities of insurance and burnout, Dr. Nance shares her raw, firsthand experience navigating the healthcare world as a young female surgeon.
We discuss why medical misinformation is rampant, how social media has become her second stethoscope, and what needs to change so that medicine can better serve patients and providers alike. This is a powerful conversation about courage, clarity, and reclaiming the human side of healthcare.
Key Takeaways from Dr. Erin Nance’s Interview
Resources & Next Steps:
Become a supporter of this podcast: https://www.spreaker.com/podcast/the-lindsey-elmore-show--5952903/support.
Dr. Erin Nance—orthopedic surgeon, author of Little Miss Diagnosed, and viral TikTok creator—joins Lindsey to pull back the curtain on the medical system’s blind spots. From patient dismissal and gender bias to the complexities of insurance and burnout, Dr. Nance shares her raw, firsthand experience navigating the healthcare world as a young female surgeon.
We discuss why medical misinformation is rampant, how social media has become her second stethoscope, and what needs to change so that medicine can better serve patients and providers alike. This is a powerful conversation about courage, clarity, and reclaiming the human side of healthcare.
Key Takeaways from Dr. Erin Nance’s Interview
- Listening is powerful medicine.
- Being a female surgeon still comes with resistance.
- Mental health is essential for healthcare providers.
- Social media has helped her reconnect with purpose.
- Success isn’t always what it seems.
- You can be both a surgeon and a storyteller.
- Redefining ambition can be revolutionary.
Resources & Next Steps:
- Grab the Book: Little Miss Diagnosed
- Follow Dr. Nance on TikTok: @littlemissdiagnosed
- Visit Her Website: https://nancemd.com
Become a supporter of this podcast: https://www.spreaker.com/podcast/the-lindsey-elmore-show--5952903/support.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:01):
It seems to be a lot of pitting doctors against
patients and patients against doctors, right, And it's because both
sides are equally frustrated with the system in which we're
both operating inside of. Right, the patients are saying, hey,
my doctor only talked to me for two minutes, and
the doctors are saying, I've got fifty patients on my schedule.
(00:24):
How am I supposed to talk to these patients for
more than two.
Speaker 2 (00:26):
Minutes, Doctor Aaron Nance, Welcome to the Lindsay Olmore Show.
Thanks Lindsay so much for having me. I'm so excited
to talk to you.
Speaker 1 (00:38):
We're going to be.
Speaker 2 (00:38):
Talking about how you lend from an orthopedic surgeon to
looking behind the scenes in the highs, the lows, and
the ethical ray zones that are modern medicine.
Speaker 1 (00:55):
You're known for your TikTok.
Speaker 2 (00:56):
Account, and I would love to know more about Little Misdiagnosed,
and so let's dive in and just get to some
some talking points and just really learning more about who
you are, what brought you here, why you decided that
this was so important for patients, and so people have
(01:19):
called you the real life Meredith Gray. How do you
feel about the comparison, and in what ways do you
think that it is accurate and in what ways do
you think that it is romanticized.
Speaker 1 (01:33):
It's a great question. Uh huh. You know, online I'm
known as the medical storyteller, and I really got my
start by sharing stories about what my life was like
as a young woman in orthopedic surgery in New York City.
And the very first story I ever told was the
story of my first stay of work. And I had
(01:55):
wanted to be an orthopedic surgeon my whole life. Okay,
I had been preparing for this moment, and I'm starting
on night shift. It's July, fourth weekend, and the very
first call I get is not about a patient. It's
from my mom. They're like, Mom, what are you doing.
I'm at work right my first day. Like, I got it,
I'm good. I don't need to drink more water. Yeah,
(02:18):
But it was actually my mom calling to tell me
that my brother had been in a diving accident and
he had broken his neck and become a quadriplegic. So
what was unexpected was that my first patient was actually
my family member. And the book really goes into how
that family tragedy shaped me as a doctor, and I
(02:41):
think it gets to your point about how or why
people may refer to me as you know, Meredith Gray,
I think I have just a tremendous amount of empathy
for patients because I was on that other side so
early on in my career, right, I know how important
it is the communication aspect. Right. And don't get me wrong,
(03:05):
I'm an orthopedic surgeon. Right, I'm doing rounds at five
am when everyone is asleep, But I know those and
the patient family they are waiting with baited breadth for
that one minute when they catch the doctor right in
between rounds and earths. So for me, I always bring
it back to how would I like to be treated
as a patient, as part of a patient's family unit?
(03:28):
And that's you know, I think the what grounds me
as a doctor. How do you want to be treated
as a patient. As a patient, you want to be
treated like someone who's been seen, right, someone who's been heard.
And I think there's a lot of back and forth
right now, especially online on my you know what I
(03:50):
see on TikTok is it seems to be a lot
of pitting doctors against patients and patients against doctors, right,
And it's because both sides are fully frustrated with the
system in which we're both operating inside of Right, the
patients are saying, hey, my doctor only talked to me
for two minutes, And the doctors are saying, I've got
(04:11):
fifty patients on my schedule. How am I supposed to
talk to these patients for more than two minutes?
Speaker 2 (04:17):
Right? I had I think three minutes maths to be
able to build and to get them in and out
the door and onto the next one.
Speaker 1 (04:24):
Correct. So I think it's about bringing these two sides together,
And what I really think that my account is doing
is that it is bridging that gap between the doctor
and the patient outside of the office setting.
Speaker 2 (04:39):
Tell us about tell us about your your your organization
and why you decided to start it, what are your
missions and visions and what do you bring to patients.
Speaker 1 (04:54):
I think what I was noticing online was that there
were a lot of great doctors on the platform giving
incredible educational you know, content disease awareness. But the platforms
themselves are untrustworthy, right, I mean, medical misinformation is probably
the most dangerous part of healthcare. And I will tell
(05:16):
you I'm in a society for New York State surgeons.
Medical misinformation online is their number one concern and complaint. Okay,
bigger problem than insurance getting you know, reimbursement from insurance
or you know, malpractice. It's medical misinformation. And what I
did was built a platform. It's it's not even publicly
(05:39):
launched yet, but the whole plan is to be a
safe and trusted place for patients to understand that the
content on this platform called Feel Better v e t
R is from credible, verified sources, because nowadays it's almost
impossible to understand who is who, what's real, what's AI right,
(06:03):
what are the motives behind the people giving these recommendations
making these you know, product recommendations. So I really lean
into the medical education and community support. I mean, I
think that.
Speaker 2 (06:19):
The education as well as the purchasing through affiliate links
of different devices and supplements and things like that.
Speaker 1 (06:28):
It used to be something very very common and everybody
did it. Now there are a lot of people who.
Speaker 2 (06:39):
Don't, who just say I'm not going to go out
there and get this, that or the other, but they
go to the grocery store and the products are absolutely terrible.
And so there is this push and pull between Do
I go an affiliate where I got to get everything online?
(07:02):
Do I go to my local grocery store. Do I
go to a local pharmacy which is even going to
have a different a different brand, you know, I mean
orthopedic surgery is not necessarily where we think about going
and saying I'm gonna come up with this big not
just supplement but also like medical gadget routine that's going
(07:27):
to help keep my joints healthy. But if patients are
going out there to do that and we've got so
many misdiagnoses all over the place, how do you encourage
people to kind of untangle those things to where they
(07:48):
can get the supplements, the education, the surgical care that
they need while also not getting ten, you know, that
thousand dollars worth of supplements that are just not going
to be helpful for that, you know.
Speaker 1 (08:08):
I think, as I said before, you have to consider
the source of the content. And I am a true
believer that patient experience is just as valuable as the
medical expertise. If you're a woman with endometriosis, there's no
one you trust more than another woman with endemytriosis. Okay,
(08:28):
so I think we have to have this balance. You
want the doctor to be the one to say, yes,
this is a safe product. Right, this is something that
I recommend for my patients in my office. But at
the same time, I'm not the one who has carpal tunnel.
I don't have a migraine. So I think it's really
(08:51):
it puts a lot of onus on the individual to
do kind of their homework, to do their research. And
where I think really the danger is part comes into
play is especially for things like supplements, right, there are
tangible harms okay that can be can happen, side effects
(09:12):
can happen. These medications or supplements are taken without the
supervision of someone, and so this is this is even
speaks to the larger called direct to consumer movement of pharmaceuticals.
Right now, how many commercials did you see online about
ozembic and wagob where you're not even going to a
(09:33):
doctor to talk about these things, right, And this has
been happening for years now, with biagra, with hair loss medications.
You know, the this movement, there has been a blurring
of the lines between medicine and wellness, and you have
the wellness population creeping into the medical field. And then
(09:56):
you have the medical field also creeping into what was
traditiontionally wellness, right your mark Hymen's and you know all
those types of doctors. Casey means who's now going to
be our Secretary General or general secretary, whoever's that the
high Surgeon general and Surgeon Gennerful there we go, So listen,
(10:17):
I don't necessarily think that one side is right or wrong, right,
but I do encourage people to research the source question,
the source question, the motive behind the information, and make
an informed decision for yourself. Yeah. Yeah, making informed decisions
can be can be really.
Speaker 2 (10:37):
Hard if you're facing any kind of financial insecurity when
it comes to when it comes to healthcare, and and
I also find that when it comes to misdiagnoses, and
as we're looking at you know, different ways that patients
are are treated within our system, you know, homelessness, addiction,
(11:04):
having to use kind of snap benefits or governmental assistance
to access medications.
Speaker 1 (11:12):
You know, this really changes how how we heal.
Speaker 2 (11:16):
And it changes things medically, it changes things emotionally.
Speaker 1 (11:21):
What are your thoughts on.
Speaker 2 (11:26):
How we maintain humanity within medicine? Knowing that you know
misdiagnoses are out there everywhere that are costing people money
that they may or.
Speaker 1 (11:40):
May not have.
Speaker 2 (11:42):
You know.
Speaker 1 (11:42):
So, I'm the co host of a podcast called The
Medical Detectives where we have a patient on every week
share their story about their journey about how they've been misdiagnosed.
It's kind of like a date client meet meets Gray's anatomy.
And every time the patient has been through an odyssey
where because of the frankly bias of the physicians who
(12:07):
have been treating them, that that has been a barrier
for them to get the right diagnosis, the right treatment. Okay,
you talk about addiction. We had a patient it was
actually the patient's wife told the story how he had
a history of substance abuse and every time he went
to the er complaining about pain, they just immediately said,
(12:27):
you categorized him as your drug seeker. And in the end,
I don't even remember he might have had cancer or
he had a physical medical problem behind it. And so
a lot of it is on the position side. We
have to understand that whether it's conscious or unconscious, bias
exists all right when we are treating our patients, and
(12:48):
we cannot ignore the fact that there are hardcore data
right if you are a mother or a pregnant woman
and you are black, are thirty percent more likely to
die after giving birth to a child right paired to winner?
Oh yeah, quite absolutely. So this goes back to again
(13:10):
the bias that the system has for certain groups. And
the best thing that I can tell you, know the
individual patients is you have to protect yourself and be
on the lookout for yourself and understand that many times
this is not a conscious decision that doctors are doing.
They're putting you into their box. But I do say,
(13:30):
you do want to speak up, You want to No
one is going to care about your condition more than you.
And the hardest thing to do is to learn to
form a partnership with your physician.
Speaker 2 (13:43):
If if someone listening has never really they've been in healthcare,
but they've never really worked on like, do I really
have bias? And if I do, in what way? Because
you know, I think racial bias, people talk about it,
gender bias, people talk about it, But you think about
(14:09):
medication dispensing bias, where you know, some pharmacists will feel
fully confident to dispuss, to dispense medication a but the
other pharmacist is like, no way, I'm not I'm not
doing it, And that can be very stressful for a patient.
(14:30):
And so I don't want the bias discussion to go
in a you know, sunshine and rainbows and you know,
day dreams about what it is. But how do we
bring it down to earth, get people to look inside
(14:50):
and go Like I was raised in this particular area
where there was this demographic which led me to have
these believes. Here's how that impacts my practice today. How
do we change this and shift our biases to where
(15:11):
we're genuinely taking.
Speaker 1 (15:13):
Care of patients.
Speaker 2 (15:14):
We're not going to get rid of the biases, but
we're genuinely taking care of patients. How do we shift
to that point in a way that, like I said, is.
Speaker 1 (15:25):
Really down to earth and really grounded and not something
that just is kind of like woo woo. Yeah. I mean,
I'll give you a quick example. One of the chapters
of my book, I talk about when I was a
medical student, there was a young woman, she had just
had a baby, and she was admitted to the psych word. Yeah.
(15:45):
This woman wore a j cru cardigan, she had her
hair in a braid. She looked more put together than
I did, right, And I'm like, what is this woman
doing in the psychlord? Okay, she's reading Jane Austen, Okay,
what is going on? And I was like this, there's
nothing wrong with this lady. Okay. Like I'm like, you
guys got it wrong. And it wasn't until months later
(16:06):
I was off the rotation and I go to the
grocery store and I see her picture on the cover
of a tabloid magazine. She had eloped or escaped from
the hospital and she had gone into full blown postpartum
psychosis schizophrenia break and I really had to step back
and be like why did I like really like how
(16:28):
did I get this so wrong? And I had to
acknowledge that I had biased in a different way, right,
like I was giving her too much credit because I thought, well,
she looked like me, she acted like me. I'm not crazy, right,
So I think it's sometimes you have to be confronted
with it, like black and white, like right in front
(16:50):
of your face, with that you know, magazine staring at
your front of the face. Those moments are going to
be few and far between. But listen, we really have
just take a good deep dive into our practices, right,
the patterns that we're doing. Why why are the same
thing going back to you know, black mortality rate in
(17:14):
in maternal you know, post post postpartum period. Black women
are also way more likely to get c sections, yeah
than white women. Well why is that? Why is that right?
This is this is a systemic pattern. It isn't just
one small area of the country. This is across the country.
(17:35):
So sometimes, yes, it's hard to call out the individuals
right and say like, doctor nance, are you be you know,
prescribing equitably or whatnot? And I think we have to
look at it in terms of a large system matter
and then do the the internal look and say, okay,
like let me see, am I really doing this pattern? Also?
(17:58):
So let's let's take.
Speaker 2 (18:00):
The same ideas about prescribing and being sure that we're
really looking at the patient as a person as we
prescribe for them. We also need to look at the
operating room as a place that is staffed with human beings.
It is a male dominant space, and there are a
(18:24):
lot of young fresh out of medical school residents that
are coming in to the operating room.
Speaker 1 (18:36):
How would do you encourage.
Speaker 2 (18:38):
Women to enter these male dominated spaces, and what is
something that you wish that you had.
Speaker 1 (18:44):
Known earlier in your career. My field is ninety four
percent mail. Okay, it's been ninety four percent mail for
over fifty years. There has literally been no Neil change.
Although I will say there is a higher percentage of
women training, but they don't stick around. And well why
is that right? Well, there's zero support for what it
(19:07):
also means to be a woman in her twenties and thirties.
In my residency. If I wanted to have a child,
I could only take off two weeks or else I
would have to retreat the entire year of residency, right,
which is a bird? Okay? Is that compatible without starting
a family?
Speaker 2 (19:25):
No?
Speaker 1 (19:26):
All right, you know so things have changed a little
bit in that way. But it took a generation of
my female colleagues to say that's not okay. I don't
want a young woman who's going into medicine. Listen, I
used to work thirty six hours straight. I would not
have a drop of water. People say, oh, I never
went to the bathroom. I go, well, if you're not
(19:47):
drinking any water, you don't have to go to the bathroom. Okay,
I don't want my trainees coming home with their lips
cracked and bleeding because they were too busy they could
not even take a sip of water, which I'm not exaggerated, Okay,
this was my life. Sure. So I I think we
have gotten away from the generation who said, well I
(20:08):
did it this way, so you have to do it
this way. And really we encourage safer practices for residents.
I want there to be better mental health support. One
of the great things about having more I would say
MP's and PA's as part of the care team is
(20:29):
that not all of responsibility is falling onto these junior residents,
these young doctors, and that we do have more support
in other areas. So yeah, I think you know, you
got to you got to be in it to win it.
So you got to put yourself you know there, You
got to get there, You got to do the work.
You have to know why you're there. Uh, and when
(20:50):
you're there, take your shot, right, don't be a wallflower,
speak your mind, answer the questions, ask questions right right,
Asking those.
Speaker 2 (21:02):
Questions to really get into what does it mean to
really work in medicine, in nursing, in pharmacy, and really
what is the integration of all of those points, and
the reason that we do it is because we're there
to take care of patients. We're there to help them
(21:25):
live either their best life and they're going out there
and about to go run a marathon, or we're helping
them to live their best life as they're approaching maybe
the end of life, and that leads to some pretty
heartbreaking stories that we work with within the hospital. What
(21:46):
are some of the stories that have kind of broken
you open, changed the way that you really feel about
healing and the importance of emotions within healing, and really
how do you use those patient stories when the going
(22:06):
gets tough and maybe there's some jerk in the operating
room who is kind of bosson year round saying I'm
the dude, whatever is going on in the day. What
are some of your favorite patient stories, What ethical dilemmas
do they teach us, and how do they keep you
going throughout the day.
Speaker 1 (22:26):
Well, my most recent viral story on TikTok, which was
also another one of the chapters and Little Misdiagnosed, was
about the time I was actually a fellow and a
construction worker had fallen eight stories and he had almost
taken off his hand, almost almost a full amputation hate hating.
(22:49):
He came to the er, but what didn't give his
name and ended up leaving before we ever treated him.
And I said, what is going on? He's got to die, Lily,
gonna die if he doesn't get this taken care of.
So I went to the construction site, which is across
the street from the hospital, and I'm like, what is
what's going on? Why did this guy run away? And
(23:12):
someone came up to me and said, he's terrified he's undocumented. Uh,
and he's terrified that he's going to, you know, be deported,
and which is an absolutely real fear. And what I
ended up doing was finding a way to admit him
under a John Doe name and doing the surgery and
(23:34):
trying my best to decrease those chances of something like
that bad happening. I couldn't guarantee that, you know, something
like that wouldn't happen, but but in my I just
felt this man did not deserve to die because he
was worried about being sent home from this country. And
(23:56):
I told this story really not to.
Speaker 3 (24:00):
Describe how I'm a hero, but just describe how I'm
a human, Right, I think anyone in that situation would
also realize, okay, even I mean there was risk to myself,
risk the attending to do something like that, you know, legally,
But in the end, I just brought it back to
this is a human, This is a person.
Speaker 1 (24:23):
What can we do to help him? Yeah?
Speaker 2 (24:25):
Yeah, absolutely, I mean it is so important for us
to remember these patients are people, you know, the patients
are absolutely people, and when we dehumanize people throughout the system,
it really puts not only the patient at risk, but
(24:50):
our own humanity as as well.
Speaker 1 (24:53):
So well, Aaron, it has been such.
Speaker 2 (24:56):
A joy to get to talk to you about little
Miss andsed all about how you have taken your trail
blazing orthopedic surgeon career and turned it into a viral
TikTok sensation that helps to pull back the curtain on
the high pressure world of modern medicine. And you also
(25:21):
have a debut essay collection called little Miss Diagnosed listeners
that you can find out more about Aaron and the
work that she does at nancemd dot com as well
as on the Instagram and Facebook handle as well as
Twitter handle little Miss Diagnosed dot com. I'll have your
(25:43):
TikTok here in front of me. Is it the same
handle there?
Speaker 1 (25:47):
So the TikTok handle is little Misdiagnosed on Instagram and Facebook.
I believe it's doctor Aaron Nance. I have so many
scam accounts of me that are out there. There's actually
a Facebook account of over one hundred thousand people and
a YouTube account with seventy thousand people. It's not me,
(26:08):
it's my content that I create. I really am only
on TikTok that is where my main you know, content
comes from. But I have started, you know, reposting at
doctor Aaron Nance on on Instagram and Facebook.
Speaker 2 (26:22):
And TikTok is is Aaron Nance.
Speaker 1 (26:26):
TikTok is little Misdiagnosed.
Speaker 2 (26:28):
Okay, all right, listeners, go and check out all of
Aaron's content over on TikTok. It is little missed and diagnosed,
and you can find out all of the ethical dilemmas
that go into the modern practice of medicine and find
out what it means to be a real life Meredith Gray.
(26:51):
Doctor Aaron Nance, thank you so much for coming in
today and being a guest on the Lindsay Elmore Show.
Speaker 1 (26:56):
Thank you, Lindsey. It was a pleasure.
Speaker 2 (27:01):
S
It seems to be a lot of pitting doctors against
patients and patients against doctors, right, And it's because both
sides are equally frustrated with the system in which we're
both operating inside of. Right, the patients are saying, hey,
my doctor only talked to me for two minutes, and
the doctors are saying, I've got fifty patients on my schedule.
(00:24):
How am I supposed to talk to these patients for
more than two.
Speaker 2 (00:26):
Minutes, Doctor Aaron Nance, Welcome to the Lindsay Olmore Show.
Thanks Lindsay so much for having me. I'm so excited
to talk to you.
Speaker 1 (00:38):
We're going to be.
Speaker 2 (00:38):
Talking about how you lend from an orthopedic surgeon to
looking behind the scenes in the highs, the lows, and
the ethical ray zones that are modern medicine.
Speaker 1 (00:55):
You're known for your TikTok.
Speaker 2 (00:56):
Account, and I would love to know more about Little Misdiagnosed,
and so let's dive in and just get to some
some talking points and just really learning more about who
you are, what brought you here, why you decided that
this was so important for patients, and so people have
(01:19):
called you the real life Meredith Gray. How do you
feel about the comparison, and in what ways do you
think that it is accurate and in what ways do
you think that it is romanticized.
Speaker 1 (01:33):
It's a great question. Uh huh. You know, online I'm
known as the medical storyteller, and I really got my
start by sharing stories about what my life was like
as a young woman in orthopedic surgery in New York City.
And the very first story I ever told was the
story of my first stay of work. And I had
(01:55):
wanted to be an orthopedic surgeon my whole life. Okay,
I had been preparing for this moment, and I'm starting
on night shift. It's July, fourth weekend, and the very
first call I get is not about a patient. It's
from my mom. They're like, Mom, what are you doing.
I'm at work right my first day. Like, I got it,
I'm good. I don't need to drink more water. Yeah,
(02:18):
But it was actually my mom calling to tell me
that my brother had been in a diving accident and
he had broken his neck and become a quadriplegic. So
what was unexpected was that my first patient was actually
my family member. And the book really goes into how
that family tragedy shaped me as a doctor, and I
(02:41):
think it gets to your point about how or why
people may refer to me as you know, Meredith Gray,
I think I have just a tremendous amount of empathy
for patients because I was on that other side so
early on in my career, right, I know how important
it is the communication aspect. Right. And don't get me wrong,
(03:05):
I'm an orthopedic surgeon. Right, I'm doing rounds at five
am when everyone is asleep, But I know those and
the patient family they are waiting with baited breadth for
that one minute when they catch the doctor right in
between rounds and earths. So for me, I always bring
it back to how would I like to be treated
as a patient, as part of a patient's family unit?
(03:28):
And that's you know, I think the what grounds me
as a doctor. How do you want to be treated
as a patient. As a patient, you want to be
treated like someone who's been seen, right, someone who's been heard.
And I think there's a lot of back and forth
right now, especially online on my you know what I
(03:50):
see on TikTok is it seems to be a lot
of pitting doctors against patients and patients against doctors, right,
And it's because both sides are fully frustrated with the
system in which we're both operating inside of Right, the
patients are saying, hey, my doctor only talked to me
for two minutes, And the doctors are saying, I've got
(04:11):
fifty patients on my schedule. How am I supposed to
talk to these patients for more than two minutes?
Speaker 2 (04:17):
Right? I had I think three minutes maths to be
able to build and to get them in and out
the door and onto the next one.
Speaker 1 (04:24):
Correct. So I think it's about bringing these two sides together,
And what I really think that my account is doing
is that it is bridging that gap between the doctor
and the patient outside of the office setting.
Speaker 2 (04:39):
Tell us about tell us about your your your organization
and why you decided to start it, what are your
missions and visions and what do you bring to patients.
Speaker 1 (04:54):
I think what I was noticing online was that there
were a lot of great doctors on the platform giving
incredible educational you know, content disease awareness. But the platforms
themselves are untrustworthy, right, I mean, medical misinformation is probably
the most dangerous part of healthcare. And I will tell
(05:16):
you I'm in a society for New York State surgeons.
Medical misinformation online is their number one concern and complaint. Okay,
bigger problem than insurance getting you know, reimbursement from insurance
or you know, malpractice. It's medical misinformation. And what I
did was built a platform. It's it's not even publicly
(05:39):
launched yet, but the whole plan is to be a
safe and trusted place for patients to understand that the
content on this platform called Feel Better v e t
R is from credible, verified sources, because nowadays it's almost
impossible to understand who is who, what's real, what's AI right,
(06:03):
what are the motives behind the people giving these recommendations
making these you know, product recommendations. So I really lean
into the medical education and community support. I mean, I
think that.
Speaker 2 (06:19):
The education as well as the purchasing through affiliate links
of different devices and supplements and things like that.
Speaker 1 (06:28):
It used to be something very very common and everybody
did it. Now there are a lot of people who.
Speaker 2 (06:39):
Don't, who just say I'm not going to go out
there and get this, that or the other, but they
go to the grocery store and the products are absolutely terrible.
And so there is this push and pull between Do
I go an affiliate where I got to get everything online?
(07:02):
Do I go to my local grocery store. Do I
go to a local pharmacy which is even going to
have a different a different brand, you know, I mean
orthopedic surgery is not necessarily where we think about going
and saying I'm gonna come up with this big not
just supplement but also like medical gadget routine that's going
(07:27):
to help keep my joints healthy. But if patients are
going out there to do that and we've got so
many misdiagnoses all over the place, how do you encourage
people to kind of untangle those things to where they
(07:48):
can get the supplements, the education, the surgical care that
they need while also not getting ten, you know, that
thousand dollars worth of supplements that are just not going
to be helpful for that, you know.
Speaker 1 (08:08):
I think, as I said before, you have to consider
the source of the content. And I am a true
believer that patient experience is just as valuable as the
medical expertise. If you're a woman with endometriosis, there's no
one you trust more than another woman with endemytriosis. Okay,
(08:28):
so I think we have to have this balance. You
want the doctor to be the one to say, yes,
this is a safe product. Right, this is something that
I recommend for my patients in my office. But at
the same time, I'm not the one who has carpal tunnel.
I don't have a migraine. So I think it's really
(08:51):
it puts a lot of onus on the individual to
do kind of their homework, to do their research. And
where I think really the danger is part comes into
play is especially for things like supplements, right, there are
tangible harms okay that can be can happen, side effects
(09:12):
can happen. These medications or supplements are taken without the
supervision of someone, and so this is this is even
speaks to the larger called direct to consumer movement of pharmaceuticals.
Right now, how many commercials did you see online about
ozembic and wagob where you're not even going to a
(09:33):
doctor to talk about these things, right, And this has
been happening for years now, with biagra, with hair loss medications.
You know, the this movement, there has been a blurring
of the lines between medicine and wellness, and you have
the wellness population creeping into the medical field. And then
(09:56):
you have the medical field also creeping into what was
traditiontionally wellness, right your mark Hymen's and you know all
those types of doctors. Casey means who's now going to
be our Secretary General or general secretary, whoever's that the
high Surgeon general and Surgeon Gennerful there we go, So listen,
(10:17):
I don't necessarily think that one side is right or wrong, right,
but I do encourage people to research the source question,
the source question, the motive behind the information, and make
an informed decision for yourself. Yeah. Yeah, making informed decisions
can be can be really.
Speaker 2 (10:37):
Hard if you're facing any kind of financial insecurity when
it comes to when it comes to healthcare, and and
I also find that when it comes to misdiagnoses, and
as we're looking at you know, different ways that patients
are are treated within our system, you know, homelessness, addiction,
(11:04):
having to use kind of snap benefits or governmental assistance
to access medications.
Speaker 1 (11:12):
You know, this really changes how how we heal.
Speaker 2 (11:16):
And it changes things medically, it changes things emotionally.
Speaker 1 (11:21):
What are your thoughts on.
Speaker 2 (11:26):
How we maintain humanity within medicine? Knowing that you know
misdiagnoses are out there everywhere that are costing people money
that they may or.
Speaker 1 (11:40):
May not have.
Speaker 2 (11:42):
You know.
Speaker 1 (11:42):
So, I'm the co host of a podcast called The
Medical Detectives where we have a patient on every week
share their story about their journey about how they've been misdiagnosed.
It's kind of like a date client meet meets Gray's anatomy.
And every time the patient has been through an odyssey
where because of the frankly bias of the physicians who
(12:07):
have been treating them, that that has been a barrier
for them to get the right diagnosis, the right treatment. Okay,
you talk about addiction. We had a patient it was
actually the patient's wife told the story how he had
a history of substance abuse and every time he went
to the er complaining about pain, they just immediately said,
(12:27):
you categorized him as your drug seeker. And in the end,
I don't even remember he might have had cancer or
he had a physical medical problem behind it. And so
a lot of it is on the position side. We
have to understand that whether it's conscious or unconscious, bias
exists all right when we are treating our patients, and
(12:48):
we cannot ignore the fact that there are hardcore data
right if you are a mother or a pregnant woman
and you are black, are thirty percent more likely to
die after giving birth to a child right paired to winner?
Oh yeah, quite absolutely. So this goes back to again
(13:10):
the bias that the system has for certain groups. And
the best thing that I can tell you, know the
individual patients is you have to protect yourself and be
on the lookout for yourself and understand that many times
this is not a conscious decision that doctors are doing.
They're putting you into their box. But I do say,
(13:30):
you do want to speak up, You want to No
one is going to care about your condition more than you.
And the hardest thing to do is to learn to
form a partnership with your physician.
Speaker 2 (13:43):
If if someone listening has never really they've been in healthcare,
but they've never really worked on like, do I really
have bias? And if I do, in what way? Because
you know, I think racial bias, people talk about it,
gender bias, people talk about it, But you think about
(14:09):
medication dispensing bias, where you know, some pharmacists will feel
fully confident to dispuss, to dispense medication a but the
other pharmacist is like, no way, I'm not I'm not
doing it, And that can be very stressful for a patient.
(14:30):
And so I don't want the bias discussion to go
in a you know, sunshine and rainbows and you know,
day dreams about what it is. But how do we
bring it down to earth, get people to look inside
(14:50):
and go Like I was raised in this particular area
where there was this demographic which led me to have
these believes. Here's how that impacts my practice today. How
do we change this and shift our biases to where
(15:11):
we're genuinely taking.
Speaker 1 (15:13):
Care of patients.
Speaker 2 (15:14):
We're not going to get rid of the biases, but
we're genuinely taking care of patients. How do we shift
to that point in a way that, like I said, is.
Speaker 1 (15:25):
Really down to earth and really grounded and not something
that just is kind of like woo woo. Yeah. I mean,
I'll give you a quick example. One of the chapters
of my book, I talk about when I was a
medical student, there was a young woman, she had just
had a baby, and she was admitted to the psych word. Yeah.
(15:45):
This woman wore a j cru cardigan, she had her
hair in a braid. She looked more put together than
I did, right, And I'm like, what is this woman
doing in the psychlord? Okay, she's reading Jane Austen, Okay,
what is going on? And I was like this, there's
nothing wrong with this lady. Okay. Like I'm like, you
guys got it wrong. And it wasn't until months later
(16:06):
I was off the rotation and I go to the
grocery store and I see her picture on the cover
of a tabloid magazine. She had eloped or escaped from
the hospital and she had gone into full blown postpartum
psychosis schizophrenia break and I really had to step back
and be like why did I like really like how
(16:28):
did I get this so wrong? And I had to
acknowledge that I had biased in a different way, right,
like I was giving her too much credit because I thought, well,
she looked like me, she acted like me. I'm not crazy, right,
So I think it's sometimes you have to be confronted
with it, like black and white, like right in front
(16:50):
of your face, with that you know, magazine staring at
your front of the face. Those moments are going to
be few and far between. But listen, we really have
just take a good deep dive into our practices, right,
the patterns that we're doing. Why why are the same
thing going back to you know, black mortality rate in
(17:14):
in maternal you know, post post postpartum period. Black women
are also way more likely to get c sections, yeah
than white women. Well why is that? Why is that right?
This is this is a systemic pattern. It isn't just
one small area of the country. This is across the country.
(17:35):
So sometimes, yes, it's hard to call out the individuals
right and say like, doctor nance, are you be you know,
prescribing equitably or whatnot? And I think we have to
look at it in terms of a large system matter
and then do the the internal look and say, okay,
like let me see, am I really doing this pattern? Also?
(17:58):
So let's let's take.
Speaker 2 (18:00):
The same ideas about prescribing and being sure that we're
really looking at the patient as a person as we
prescribe for them. We also need to look at the
operating room as a place that is staffed with human beings.
It is a male dominant space, and there are a
(18:24):
lot of young fresh out of medical school residents that
are coming in to the operating room.
Speaker 1 (18:36):
How would do you encourage.
Speaker 2 (18:38):
Women to enter these male dominated spaces, and what is
something that you wish that you had.
Speaker 1 (18:44):
Known earlier in your career. My field is ninety four
percent mail. Okay, it's been ninety four percent mail for
over fifty years. There has literally been no Neil change.
Although I will say there is a higher percentage of
women training, but they don't stick around. And well why
is that right? Well, there's zero support for what it
(19:07):
also means to be a woman in her twenties and thirties.
In my residency. If I wanted to have a child,
I could only take off two weeks or else I
would have to retreat the entire year of residency, right,
which is a bird? Okay? Is that compatible without starting
a family?
Speaker 2 (19:25):
No?
Speaker 1 (19:26):
All right, you know so things have changed a little
bit in that way. But it took a generation of
my female colleagues to say that's not okay. I don't
want a young woman who's going into medicine. Listen, I
used to work thirty six hours straight. I would not
have a drop of water. People say, oh, I never
went to the bathroom. I go, well, if you're not
(19:47):
drinking any water, you don't have to go to the bathroom. Okay,
I don't want my trainees coming home with their lips
cracked and bleeding because they were too busy they could
not even take a sip of water, which I'm not exaggerated, Okay,
this was my life. Sure. So I I think we
have gotten away from the generation who said, well I
(20:08):
did it this way, so you have to do it
this way. And really we encourage safer practices for residents.
I want there to be better mental health support. One
of the great things about having more I would say
MP's and PA's as part of the care team is
(20:29):
that not all of responsibility is falling onto these junior residents,
these young doctors, and that we do have more support
in other areas. So yeah, I think you know, you
got to you got to be in it to win it.
So you got to put yourself you know there, You
got to get there, You got to do the work.
You have to know why you're there. Uh, and when
(20:50):
you're there, take your shot, right, don't be a wallflower,
speak your mind, answer the questions, ask questions right right,
Asking those.
Speaker 2 (21:02):
Questions to really get into what does it mean to
really work in medicine, in nursing, in pharmacy, and really
what is the integration of all of those points, and
the reason that we do it is because we're there
to take care of patients. We're there to help them
(21:25):
live either their best life and they're going out there
and about to go run a marathon, or we're helping
them to live their best life as they're approaching maybe
the end of life, and that leads to some pretty
heartbreaking stories that we work with within the hospital. What
(21:46):
are some of the stories that have kind of broken
you open, changed the way that you really feel about
healing and the importance of emotions within healing, and really
how do you use those patient stories when the going
(22:06):
gets tough and maybe there's some jerk in the operating
room who is kind of bosson year round saying I'm
the dude, whatever is going on in the day. What
are some of your favorite patient stories, What ethical dilemmas
do they teach us, and how do they keep you
going throughout the day.
Speaker 1 (22:26):
Well, my most recent viral story on TikTok, which was
also another one of the chapters and Little Misdiagnosed, was
about the time I was actually a fellow and a
construction worker had fallen eight stories and he had almost
taken off his hand, almost almost a full amputation hate hating.
(22:49):
He came to the er, but what didn't give his
name and ended up leaving before we ever treated him.
And I said, what is going on? He's got to die, Lily,
gonna die if he doesn't get this taken care of.
So I went to the construction site, which is across
the street from the hospital, and I'm like, what is
what's going on? Why did this guy run away? And
(23:12):
someone came up to me and said, he's terrified he's undocumented. Uh,
and he's terrified that he's going to, you know, be deported,
and which is an absolutely real fear. And what I
ended up doing was finding a way to admit him
under a John Doe name and doing the surgery and
(23:34):
trying my best to decrease those chances of something like
that bad happening. I couldn't guarantee that, you know, something
like that wouldn't happen, but but in my I just
felt this man did not deserve to die because he
was worried about being sent home from this country. And
(23:56):
I told this story really not to.
Speaker 3 (24:00):
Describe how I'm a hero, but just describe how I'm
a human, Right, I think anyone in that situation would
also realize, okay, even I mean there was risk to myself,
risk the attending to do something like that, you know, legally,
But in the end, I just brought it back to
this is a human, This is a person.
Speaker 1 (24:23):
What can we do to help him? Yeah?
Speaker 2 (24:25):
Yeah, absolutely, I mean it is so important for us
to remember these patients are people, you know, the patients
are absolutely people, and when we dehumanize people throughout the system,
it really puts not only the patient at risk, but
(24:50):
our own humanity as as well.
Speaker 1 (24:53):
So well, Aaron, it has been such.
Speaker 2 (24:56):
A joy to get to talk to you about little
Miss andsed all about how you have taken your trail
blazing orthopedic surgeon career and turned it into a viral
TikTok sensation that helps to pull back the curtain on
the high pressure world of modern medicine. And you also
(25:21):
have a debut essay collection called little Miss Diagnosed listeners
that you can find out more about Aaron and the
work that she does at nancemd dot com as well
as on the Instagram and Facebook handle as well as
Twitter handle little Miss Diagnosed dot com. I'll have your
(25:43):
TikTok here in front of me. Is it the same
handle there?
Speaker 1 (25:47):
So the TikTok handle is little Misdiagnosed on Instagram and Facebook.
I believe it's doctor Aaron Nance. I have so many
scam accounts of me that are out there. There's actually
a Facebook account of over one hundred thousand people and
a YouTube account with seventy thousand people. It's not me,
(26:08):
it's my content that I create. I really am only
on TikTok that is where my main you know, content
comes from. But I have started, you know, reposting at
doctor Aaron Nance on on Instagram and Facebook.
Speaker 2 (26:22):
And TikTok is is Aaron Nance.
Speaker 1 (26:26):
TikTok is little Misdiagnosed.
Speaker 2 (26:28):
Okay, all right, listeners, go and check out all of
Aaron's content over on TikTok. It is little missed and diagnosed,
and you can find out all of the ethical dilemmas
that go into the modern practice of medicine and find
out what it means to be a real life Meredith Gray.
(26:51):
Doctor Aaron Nance, thank you so much for coming in
today and being a guest on the Lindsay Elmore Show.
Speaker 1 (26:56):
Thank you, Lindsey. It was a pleasure.
Speaker 2 (27:01):
S
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