Dr. Talya Miron-Shatz on Medical Decisions & Being an Informed Patient



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Katie: Hello, and welcome to the ďWellness Mama Podcast.Ē Iím Katie from wellnessmama.com and wellnesse.com, thatís wellnesse with an E on the end. And in this episode, I am here with Dr. Talya Miron-Shatz, thatís T-A-L-Y-A. And sheís the author of a book called, ďYour Life Depends on It: What You Can Do to Make Better Choices About Your Health.Ē And I wanted to have her on today to talk about some of the specifics of navigating the relationship with your doctors and healthcare providers because I hear from a lot of people who are frustrated by these relationships, who feel pushed by their doctors into different things they donít want to do or feel like theyíre not heard by their doctors. And I wanted to get her perspective on this, and how we can frame that as a better relationship.

So we talk about how to build an actual relationship and partnership with your doctor, the questions to ask to understand if the doctor is going to be a good fit, and to make better choices in your health. She walks through three questions you always ask to make sure that youíre making informed consent, how to find good practitioners for your children as well, what to do when youíre confronted with health news you maybe donít want to hear, and even how to navigate the gender differences that still occur in medicine. So we go definitely deep on this topic today. If you have ever felt frustrated or not heard in a relationship with a doctor or medical provider, I feel like this interview will have some tangible steps that can help you along the way. So, letís jump in. Dr. Talya, welcome, and thanks for being here.

Dr. Talya: Itís my absolute pleasure. Thank you for having me.

Katie: Well, Iím excited to chat with you because weíre gonna be talking about something that applies to all of us, and that I get quite a few questions about and have had some negative experiences with in the past myself. But before we jump into that, I have notes in my show notes that you speak Italian and French, which is amazing. I would love to hear a little bit more about that, because becoming bilingual is quite the feat, and trilingual even more so.

Dr. Talya: I also speak Hebrew, fluently. Itís, like, my first language. Yeah. I guess once youíre exposed to more than one language, it becomes kind of easier. So, French is my momís first language, so I heard it around as a kid. Arabic was my fatherís first language. He was a Jew from Syria. So, once youíre exposed to languages, it just becomes easier. And then, Italian is a bit of a cop-out because itís a lot like French. And itís fun.

Katie: It is fun. I speak very little Italian, but itís a lot of fun. And Italyís one of my favorite places to visit. Have you learned these through travels? Or, I would love just to hear a couple places in the world that you would consider most worth visiting?

Dr. Talya: Well, French, I studied in university. Italian, I studied in a summer course. I went to Calabria. Itís in the south of Italy. I spent three weeks there in a summer course, and it was like being 16 again. I was not 16. I already had two kids. But I just spent three weeks there, immersed, and it was really absolutely beautiful and fun. And then, the fun continued.

Katie: I love that. Well, okay. So, on to our actual topic of today, even though I could talk about travel all day long. I think this is a really important and not often talked about topic, and you have just written a book about this, which is why I was so excited to have you on, about making better choices when it comes to your health, not just in the every day, which we hopefully are all doing, and I talk a lot about on here, on making good daily choices in what we eat, what we put in and on our bodies, our sleep habits, but interaction with the medical world is also a big piece of that. And, you know, we hear a lot about how there are shortcomings in the medical system, but also, this is the medical system that we have to interact with today. And Iíve said many times, I think the best outcomes happen when you have a well-informed patient who is willing to be proactive in their own health, working with a practitioner who they view as a partner. And you speak a lot to this topic. So, to start really broad, I would love for you to just kind of touch on kind of the idea of becoming a more informed patient, and what that even means in todayís medical system.

Dr. Talya: Right. So, I think, you know, you should have written the book instead of me, because you basically framed it really well. Thereís a number of things we need to take into account. So, never before have we had access to so much health information, never before have we been given so much choice in our healthcare, and never before has it been so confusing. So, why is it confusing? Thereís a number of reasons, and some of them are very big and global, and some of them are very personal. On a global level, thereís just so much information, some of which we donít understand. Thatís fine. You know, youíre an expert at what you do. Youíre not an expert in medicine. Thatís absolutely okay. But when the information you get is incredibly confusing or incredibly high-level, you could actually get confused. Me too. And by the way, you know who else? Doctors. Because when doctors are patients, they get confused as well. They are anxious. Theyíre in pain. And these things debilitate us a little bit. And this is something I want to tell everyone.

So, I basically have almost two conflicting messages. One is, you should take better care of your health choices. And the other is that this is hard. So, I donít want people to bash themselves for finding it difficult. It is really difficult. But hereís what you can do about it. And thereís really a number of things that you can do to make better health choices. Now, the first one is the word you use, itís partner, is to find a doctor that you feel is your partner. That is crucial, because if you donít trust your physician, why would you follow up on anything they say? Youíre just not going to. And it makes sense, right? But itís not great for your health. So letís view our healthcare providers, and a lot of them just hate the word ďprovider.Ē Itís like, itís so impersonal. Itís like, ďI wanna be a doctor. Thatís what I wanna be. I donít wanna be a Ďproviderí,Ē like, I donít know, electricity provider. So letís find doctors that we care about, and hopefully, that also care about us, and take it from there.

So, even though I do a lot of work as a consultant with digital health, and there are amazing things that digital health now does, from adherence to medication, to delivering information, to new payment models, like, seriously, anything, and itís amazing, and COVID has made it boom, fantastic. But still, whatever you do, make sure to find a service, a person that you trust and that you like. Thatís important. Itís not really an add-on. Itís the basis of our relationship. And our relationship with our doctors is just that. Itís a relationship. If you donít like and trust the person youíre in a relationship with, youíre in trouble.

Katie: I think thatís such a great point, to view it as a relationship, and enter it with this kind of discernment that you would look at when youíre making a really important decision about your life. What is the person, that partner on the other side, gonna be like? Are you gonna be able to work with them? Like, you want this to be aÖ And I can understand both sides of that pretty well, havingÖ I used to have Hashimotoís, and it took me many years to get answers on that, through a lot of different doctors. And I remember being in the thick of that and just wanting answers so badly, and just wishing I could just outsource that to a doctor, and they could just tell me what was wrong. And I had to learn, even the best doctors in the world, and there are some amazing ones, they will never have as much vested interest in your health as you do. And so, that key piece is you have to be also a very active partner in that and being willing to be informed.

And I think, for doctors, Iím sure thereís frustration as well, because many people do, especially in that frustration of being in an illness, you just want answers, and you want doctors to just be able to fix everything for you. And so, I can understand, probably, that frustration on the doctor end as well, but realizing, you know, theyíre not infallible, they donít have access to how your body feels. Youíre the one who gets that data every day. And so, finding a doctor who you can partner with, who can understand you and have that conversationÖ Iíve always said, I know people get frustrated with the medical system, but I really truly believe, every doctor Iíve met, theyíre amazing people with huge hearts, that really do wanna help. And I think doctors probably, you can speak to this, have as much frustration with a lot of the system, and with patients not wanting to take ownership of their own health, as we do as patients sometimes.

Dr. Talya: Wow. You have no idea. Absolutely. Really. So, one thing that really relates more to doctors is the fact that itís a relationship, right? And a relationship is a two-way street. So, much as we love to trust our doctors and like them and be liked by them, doctors feel the same way. They donít wanna feel like, ďHey, give me care. I donít care what your name is.Ē Just like we donít wanna feel like ďpatient number whatever.Ē And what I found, and I was writing aÖI thought I was writing a book for patients. Then I realized I was also writing a book for doctors. So, my book, ďYour Life Depends on It: What You Can Do to Make Better Choices About Your Health,Ē is where I realized that when doctors feel that they have a relationship with the patients, and they feel valued by their patients and by their system, they have less burnout, they make fewer errors, major errors. So really, everyone wins.

So to think that relationship is just redundant would be very, very wrong. And thatís one source of frustration and pain, and I would add, worry, for all of us. And thereís something else Iím wanna say, that you mentioned, and thatís incredibly important. You know, ideally, we would never see our doctors. Ideally, we would live a very healthy life and we would not get sick. I mean, of course, this doesnít happen because you could get sick just through sheer lack of luck and things happen. But one of the things we need to understand is whatís going to happen if we go on with our health behaviors. And some of us choose not to exercise, or choose not to eat healthy. And some of us donít really live a very healthy lifestyle. And for the most part, people know that. Theyíre aware of that. People arenít stupid. Nobody says, ďHey, oh my god. Yeah, I would love to just not be able to move well and to have my body hurt.Ē No, nobody wakes up in the morning and say, ďThatís my goal for the day.Ē

But sometimes we do things that donít serve us well. And the thing is, we donít get immediate feedback. I mean, you put your finger in a cup of tea, ďWoah, that is very unpleasant.Ē Thatís the last time youíre gonna do it. You have one glass of alcohol too many, or you donít work out. Itís like, ďOkay. Nothing happened.Ē But eventually, these things accumulate. Likewise, if you donít adhere to your medications, like, ďYeah, sure. Well, I donít need this,Ē until you realize that you really do. So thatís a major source of frustration for doctors, and thatís a place where we and Iíve seen it, I havenít seen it often, to have digital health and to have patient information in a way that you donít have to get to that bad place and say, ďHey, doc, I feel really bad.Ē And your doctorís like, ďWell, you know, itís nice that you went on a diet, but you used to be obese, and that takes a toll on your body, even when itís over.Ē So, to be able to have, like, this trajectory of where weíre heading, and where thatís gonna take us, before we get there.

Katie: Yeah. That makes sense. And to your point, I think, there have been, of course, many frustrating results of the last couple of years of the pandemic. But I think one of the great ones has been, like you said, weíre seeing much better patient-doctor access to each other through digital means, and Iím excited for that to continue to happen. I think that lets us have more access to our doctors, and hopefully, lightens their load with not having every visit have to be in the office as much. But it makes me wonder how can we, as patients, learn to ask better questions of our doctors, and also to help reframe that relationship. Because I think doctors arenít, like I said in the beginning, used to necessarily patients being informed as much, whereas many of the listeners of this podcast are deeply researched and very informed in their own health. And thatís the thing Iíve struggled to navigate with doctors in the past.

And the best I have figured out is to go into it, like, with a ton of kindness, but also confidence, and even tell them at the beginning, like, I know that you may have had frustration in the past with patients thinking they already know whatís wrong, or trying to tell you how to do your job, and Iím not trying to do that, however, I have been on this road for a long time and I have done hundreds of hours of research about my own health, and I track things very carefully. Hereís my last two yearsí worth of labs. I want to be a very involved patient. I want to be very proactive and take action, and I need your help in these areas, in running these tests and these medications. But is there a better way, or how can we approach that conversation with our doctors in a way that builds that relationship?

Dr. Talya: So, I think what you just described is a very, very, very informed patient. I could add a couple more verys right there, because thatís really, I think, the height of being an informed patient, on many levels. One thing to remember is that our doctors will overprescribe if we ask them to. So, we want them to be open to us, and to listen to us, and to respect the information that we bring about our bodies and about our internet research, and Iím gonna tell you a story about that in a minute. But we also need to be mindful of what they say. And if they say, you know, ďI think you wanna order this test, but actually, I see that youíve done that a year ago and results donít change over yearsÖĒ and Iím totally making this up as I go along. Or, ďItís not necessary for you to take this medication because youíre already on that medication, and it actually covers the sameÖit does very similar things in a very similar way, and we donít want to add this on,Ē we should be able to listen.

And thatís, like, the fine line that weíre seeing now, is healthcare consumers. And, you know, weíre consumers in so many ways. Iím gonna get a coffee soon, and Iím gonna have a ton of choices. I mean, I could spend a good 15 minutes saying, ďOoh, thisÖoh, no, that one. Well, let me see,Ē you know, and I can choose, and whatever I choose is fine. With health, itís not the same way. You know, with coffee, I get something, I hate it, I just toss it. You know, Iíve lost $5, if I was splurging. Thatís it. With health, I donít get immediate feedback, I donít have knowledge. And the consequences could be much more dire. So we really need to tread this fine line between being a super-informed patient, if we can, and you just described yourself as a person who really put in the work and the research and dedication to get there. And some us can do that, and some of us canít do that, and some of us canít do that all the time. And thatís fine, too. So, that means the onus isnít necessarily on us, for anyone whoís listening to Katie now and thinking, ďWow, oh my gosh, sheís so amazing. I could never be the kind of patient she is. Iím just a bad patient.Ē So, no, youíre wrong. Youíre just a patient, and thatís fine.

And if you need more guidance, itís absolutely fine to ask for it. Itís entirely, entirely legitimate. And thatís something that we just have to accept. You know, like, when we have kids, theyíre not all the same. And theyíre not all the same, and you canít say, ďWell, why canít you be like your brother?Ē Thatís probably the dumbest thing to say, right? So, why canít you be like Katie? Because youíre not Katie. You are who you are. If you feel very well-researched, amazing. If youíre saying, ďYou know, Iím in pain, Iím scared. This is above my pay grade. I canít do this.Ē Thatís also absolutely fine. But, but, but. I wanna caveat that. I wanna give some very, very simple tools that anyone can use, and really, listen up, and Iím gonna repeat this, because itís important. So, whenever youíre offered treatment or medication or anything to be done to you, ask three questions. What are the risks? What are the benefits? What are the alternatives? So, again, risks, benefits, alternatives.

Why do I start with the risks? Because the benefits are very tempting. And we, yeah, itís great. Itís gonna help you. Itís gonna solve your problem. Oh, fantastic. But letís start with the risks. What are the risks? It may not work, and then you will be disqualified for a number of treatments. ďOh. Oh, wait. I donít like these risks at all. So let me weigh this.Ē And the third question, I love the most, which is what are the alternatives? Now, why do I love that? Because we like our own ideas, and our doctors like their own ideas. And when a doctor offers something, they are like, ďOh, thatís the best thing. I mean, nothing to talk about.Ē They may not raise the alternatives. But if you ask, theyíre not gonna lie to you. Thereís a difference between not bringing something up, withholding information, and flat-out lying. Are there alternatives? If the doctor says no and there are alternatives, thatís not good. And they know that.

So, itís important for me to say, again, risks, benefits, alternatives, especially alternatives, because we defer to the doctors. And sometimes doctors says something, we say, ďOkay. Thatís it.Ē You know, we donít ask. Letís raise the question, is there an alternative? Yeah. And, in fact, my son didnít have ear problems, but both of my daughters did. And she had the ear infections, repeated ear infections. That was not fun. And she was scheduled for an ear surgery. And then my pediatrician said, you know, ďYou could try reflexology. And hereís a number.Ē I was like, ďOkay, thatís interesting.Ē Well, I trust my pediatrician. Heís been my pediatrician for a long time. I know he is legit. If heís offering this, I will try. What are the risks? There really are no risks to reflexology. What are the benefits? I could save surgery. Yes. Whatís the alternative? Surgery. Not keen on that. Weíre a family of swimmers. Itís hard to have surgery on your ears, not get them wet. Guess what? It worked.

The alternative worked. I didnít even think to ask. I was a young mother, with a kid with repeated ear infections and I wanted to do the right thing. We all wanna do the right thing by ourselves and by our children. Had the doctor not raised the alternative, my daughter wouldíve had ear surgery, as would her younger sister afterwards, with exactly the same problem.

Katie: That is such an encouraging story. And it makes me so happy to hear of more and more doctors that seem to have that more holistic understanding. And before we go deeper on this, I think another important point to clarify is, like, this becomes a very important point if someone is sick or someoneís child is sick, but is this information only for people who are sick, or is this important baseline information for all of us to know, even if itís just for proactive, well, medical care?

Dr. Talya: Definitely for all of us. And if you had a doubt, all you had to do for the past two years is read the newspapers, because we are all living in a world where we make health and medical choices all the time. Should I vaccinate for myself and for my children? Should I vaccinate my kids when theyíre eligible? Should I wear masks? Should I encourage my kids to wear masks when they go on the subway? You know, what should I do? And these are very important questions. Sadly, thereís a lot of misinformation. Sadly, thereís a lot of political dispute. Come on, we donít care about that when it comes to our health. We just wanna be healthy. So, I think arming yourself with a good, critical mindset, and thinking about what could I be losing? You know, I think, I mean, Iím in New York City and people arenít masking up, and sometimes I feel safer with a mask. Iím like, what am I losing? Well, cramps my style. Iíll live. Whatís the benefit? I feel safer. Thatís good.

So, to just think of whatís the best thing for my health, for my childís health, thatís incredibly important. And we seriously are making these choices all the time. You made your kids sandwiches this morning. That was a health choice. Whatever you put in the sandwichÖ You skipped making sandwiches, that was a health choice too. So, we do that all the time. We brush our teeth. I mean, itís all over us. I didnít wanna write a book that people will say, ďOh, thatís for sick people. Iíll read it if I need to. Itís like a bummer.Ē No, no. Itís like, youíre proactive, youíre strong. You wanna grab your life and make the most of it, so use this approach, also, when it comes to your medical choices.

Katie: And thatís a great point that weíre all making these decisions all the time, especially I feel like when it comes to kids, because often, thereís that relationship with the pediatrician that hopefully theseÖI mean, I know there are certainly kids with health struggles, but hopefully, your child isnít sick and youíre just having a good relationship with the pediatrician. Iíve also heard from so many parents who feel that they are not listened to, or pushed into things, or kind of bullied. Iíve heard that word from parents referring to their relationship with their medical provider or their childís medical provider before. What are some questions, maybe, like, good screening questions or ways to know going into a relationship with a doctor if itís gonna be a good relationship, so that maybe weíre avoiding some of those more, like, butting head dynamics that can happen with doctors?

Dr. Talya: So, I think the way you feel about your doctor is very immediate. It doesnít have a lot of information to go into it, but itís immediate and itís important to see, is the doctor listening to me? Is the doctor listening to my kid? Because kids are small people, but they are still people, and they need to feel that theyíre being respected. And thatís important. So thatís definitely a crucial element, a crucial part of the deal, and your doctor, your pediatrician, or any doctor will prescribe things for you, for your child, and if you donít trust them, itís not gonna go well. So thatís really the first point I wanna make. I think when we ask for information, when we hear something from our doctor, itís incredibly legitimate that we ask for information like about the alternatives and the risks and the benefits. We should ask when weíre told about benefits, how many will benefit from this? Because thereís an element of medicine that we really donít like. I wish it wasnít there. And thatís uncertainty.

We donít know for sure. Our doctors donít know for sure either. Sometimes thereís more certainty than in other times, but even with COVID, you can not vaccinate and be healthy, or you can not vaccinate and catch COVID, and be in a very bad place. There is no certainty. If there was, people would have a clear idea of what to do. So we need to accept that, but we also need to be in a position where we ask questions and we get answers. I wanna say something practical. Itís a bit of a bummer thing to say, but Iíll say it nonetheless. Doctors go into this profession in order to care for people. Thatís not the bummer part. The bummer part comes next. They are thrown into circumstances where they donít have much time to sit with us. They really donít. They wish they did, but they do not. So we also need to be mindful of that, and to think, ďWhatís the most burning thing I have to know?Ē My kid is being prescribed something. What do I need to know, now? If I only have three minutes, which might be all I have with the doctor, let me figure this thing out.

Let me ask, ďLook, Iím concerned. What are the risks of this? Does it help everyone? Is there an alternative? If it doesnít help everyone, what proportion of people does it help? What sort of side effects are we looking at?Ē So, just to narrow it down to a small amount of questions thatís more manageable. By the way, itís also good for us, or the way we think. We love to think of ourselves as super sophisticated. Basically, we base our judgments off of not a lot of information. So letís just really focus. And when we focus, we can get good information from our doctors, within their constraints.

Katie: Yeah. Thatís a great point as well. I say, like, I think, Iíve said before, mothers are some of the busiest people on the planet, and I think doctors are right up there. And so, especially if you have doctors who are also moms, itís important to realize, thatís a great point, like, we canít go in and give them eight hours of our life story. We need to, like, to distill down, for their sake, the most relevant information, in the most concise way possible, and then make sure weíre being clear on what is our most burning question we need to get answered today, and then also be willing to ask for the follow-up appointment, or ask for another appointment if thereís still unanswered questions. And Iíve also seen this kind of what I consider a false dichotomy that floats around on the internet every once in a while, where Iíve seen doctors say, you know, ďDonít confuse your internet search with my medical degree.Ē And Iíve seen patients shoot back, ďDonít confuse your medical degree with my informed consent.Ē And to me, those things should not ever be at odds.

I think the best relationships happen when we have doctors who have the knowledge of a medical degree, and also, to your point, that desire to care for people, and we have patients who are willing to do the research and the work and have informed consent, and also who have an understanding of their own body. And so, like, I donít like when that false dichotomy comes up, because I think itís not ever either/or, itís both/and, and those are both very valid things. How a patient feels, like, understanding of their own body, very, very important. Medical research and medical school, also very important and valid, and something that most of us donít have. And Iíve had that chance to explain that to doctors as well in the past, is, you know, like, I very much appreciate their understanding of physiology and biology in a way that I donít understand. And also, my background is in nutrition, which, to my understanding, a lot of doctors donít get a ton of nutrition knowledge, and so, how do we work together, understanding that we both have these degrees of knowledge in different areas, how do we work together for the best outcomes?

And youíre a mom as well, so I think also itís that, you know, mothers have their kidsí best interest at heart, of course. So do doctors, I believe, in many, many cases. But moms are gonna be the most motivated to do whatís best for their kids. So how do we unite all of that knowledge in the best way possible, so that weíre gonna get the best outcomes? And I think that segues into maybe some guidance on how do we find the best partners in doctors for our children, because that definitely seems to be a pain point for a lot of parents, is finding pediatricians, especially, that will listen and be respectful of parents, and also be great partners in that.

Dr. Talya: Thatís a great question. You know, itís like, itís a three-way street now, itís not just a one-way. Itís not just two-way street, because you need to be in a respectful relationship with your doctor, with you, and with your child. So, I think we need to understand, you know, what you were talking about as a false dichotomy. When I go to my doctor, I definitely expect them to have the medical knowledge. And I expect them to respect me for what I bring, and I bring my information and I bring my experiences, but I have to know that each of us bring something unique to the table. And honestly, if Iím really sick, the sicker we are, the more we listen to our doctors, because the more weíre scared, and the more we realize there is so much at stake, and thereís a lot that we donít know. And that is fine. Thatís really fine. It doesnít make us less good patients, people, or mothers, if thereís a lot we donít know or understand about our childrenís care. We shouldnít be butting heads about whoís more important, who knows more. Itís just, itís the wrong place to be. Nobody benefits, least of all our children. But thatís not a great place to be.

Doctors are between rock and a hard place, because we are more in a consumer health environment, because they care about our ratings, because if we ask for something, they might give it to us, even if they think itís unnecessary, just because theyíre afraid of being sued, just because theyíre afraid of being complained on. So we should really think, when Iím asking for something, and my doctor says no, and tells me, you know, ďI could prescribe you this test for you or for your kid. It just, itís a shame because thereís a lot of radiation, which I think is unnecessary and can be covered by, say, an ultrasound, or letís do some watchful waiting and come back in six months.Ē So, I can be very demanding, and I can put my foot down, and I can get that CT or whatever that is. Is this really the best thing? Is this about my ego? Or is this about my childís health? Thatís a good question. I would hope itís about my childís health.

So if Iím convinced, and I have the research to back it up that this, whatever it is Iím asking, is the best thing, by all means, go for it. If itís not the case, then maybe letís just try to be informed about this, and also listen. Because truly, when we get to that consumer place, we are given a lot of power, and we donít always have the knowledge. And I say that as someone whoís educated and I can read ďThe New England Journal of MedicineĒ research, and itís not foreign language to me. Used to be. Not anymore. Iíve trained myself in this area. My Ph.D. is in psychology, but Iíve been doing a lot of medical research for the past 20 years, so some of it has definitely rubbed off on me. And still, Iím not a medical doctor. And that is perfectly all right that Iím not.

Katie: Yeah. Thatís a great point and a great way to frame it.

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Another thing I think itís important to talk about is hopefully a situation that nobody will have to navigate, but statistically, one that about half of us at least will, which is how do you process medical information that you donít wanna hear, especially when it comes as a shock, how to be mentally prepared for that? I would guess those same questions are really important to have top of mind if youíre going into a situation where you might hear medical information you donít wanna hear. But any guidance for patients on that?

Dr. Talya: Absolutely. So, I hope nobody ever hears information, medical information, that comes as a shock or is distressing, but I know that itís not going to happen. A few pointers. The first one is this is not your best time to be processing information, at all. And thatís fine. So, when you hear something that comes as a shock, I would suggest you ask the doctor to write it down, first of all, because you could forget it or you could mess it up or you could just be not sure that you even heard it, to be pointed to a place where you can research this, and to schedule another appointment, and to come to the other appointment with someone who accompanies you, who helps you ask questions, who helps you process the information. Just to think that we can receive incredibly distressing information, process it, and make decisions on it at the same time, is too much. Itís almost inhuman. And we could be making wrong decisions just because weíre freaked out. And we donít like to be in a place of uncertainty. Weíd like to know whatís going on. And if we decide whatís going on based off of just, ďletís get this over with,Ē that is not great. So, understanding our limitations is key here, and you can replace the word ďlimitationsĒ with just being human. Thatís pretty much the same thing.

Katie: And another area I feel like this can get confusing for people is thereís so many medical ads. To me, itís almost humorous for me when anyÖwe donít watch TV often, but anytime itís on, I see the medical ads where itís you almost donít even know what the specific drug is theyíre advertising. And itís like a kind of dreamy scenario with people walking on a beach or whatever, and ďAsk your doctor if you need this thing,Ē and then, like, ďSide effects may include liver failure, and death, and anaphylaxis,Ē or whatever. But itís interesting to me that weíre getting so much marketing for all these different treatments and pharmaceuticals. And I thinkÖI would love to hear from you, like, how can we discern whatís valuable information versus whatís not. I guess my default would be Iím probably not gonna look to TV or ads to get my medical information, but these are in magazines and TV and everywhere. How do you suggest that people navigate that?

Dr. Talya: Thatís a really great question. I love what you describe, that it looks like a dreamy scenario and then it says, ďSide effects may include death and liver failure.Ē And, in fact, you know, I worked, and I still do, I work quite a lot with health advertisers, but I try to be very clear and transparent when we do the work. Some of the things that advertisers do is they give you information, and they give you visuals and music that contradict the information. So, they wonít say, ďThis could include liver failure.Ē Theyíll say, ďThis could include liver failure,Ē and it sounds so placid and nice. Itís like, ďYeah, whatever. Oh, Iím looking at the beach. Thatís beautiful. Oh, liver failure, whatever.Ē And thatís the goal, that we wonít be able to process that. So, first of all, letís, again, trust our doctors with our medical conditions, and letís not be super excited about everything we see on TV as an ad. A better advice, even, is to try and maintain a healthy lifestyle, becauseÖ I donít wanna attack pharma. I think itís been plenty attacked, and I think itís really unfair because when I get really sick and I have an infection, I wanna get an antibiotic. And guess what? A pharmaceutical company manufactures it.

And thank you for manufacturing it, pharmaceutical company, or I could die of infection, like the good old days. I wouldnít want that to happen. So, itís their job to advertise, and itís our job to say, ďDo I need this? Could I fight whatever it is that Iím having with healthy lifestyle? If I need the medication, let me listen carefully to the information, and let me discuss it with my doctor in a level-headed manner.Ē Because the job of advertising is to sell. Itís not to inform you in a balanced way. That would just be giving you a black and white brochure, ďHere, read,Ē and thatís it. There would be no actors and music and beaches. So itís on us to say, ďSomeoneís selling me something that sounds great, but is it really?Ē Am I just being sold to, like, you know, if you buy a soft drink, you become gorgeous, athletic, and you have 20 guys in sports cars running after you. I tried, it didnít happen. So letís take the same skeptical approach with pharmaceutical advertising.

Katie: And another issue that comes into play, Iíve talked about this a little bit on this podcast before, is gender differences when it comes to medical care. I had a whole podcast with someone, her name was Sarah, and she talked about howÖand Iíve known this. Like, much of the research is done on men, because they have fewer hormone variables, and so there isnít as much research on the female body as there is on the male body, and most standard of care is figured out on men versus women. We also know there isÖitís pretty well-documented, gender-based discrimination in medicine. Iíve heard from many, many women who have been told, like, their symptoms are just in their head, or, ďThatís just normal. Thatís just hormones.Ē I was told, ďOh, itís probably just postpartum.Ē Or, ďOf course, all those things are normal, because youíre a female and hormones,Ē and I had a very legitimate thyroid condition at that time. So, any advice for navigating the, kind of, maybe gender differences that still exist? I know those arenít often the goal of the doctor, certainly. And sometimes maybe theyíre not even aware of some of these things that are still playing out in medicine, but how do we as informed patients navigate that?

Dr. Talya: So, and I wanna say Iím really glad you brought this up. Iím glad you brought this up and Iím sad that this exists, really. Doctors donít do this on purpose, but some of them have an implicit bias. And itís also racial sometimes, and itís also gender-based. So, when a man complains of pain, especially a white man, then heís in pain. He should be given something for his pain, because heís a strong white man, and heís the silent type, and if heís complaining, thatís gotta be serious. If a woman, on the other hand, complains, sheís probably hysterical. Sheís exaggerating. I mean, sheís a woman, you know, overdramatize stuff. Iím being ironic here, please. Just in case someone didnít get it. Iím being incredibly sarcastic about this. So, this is something that we encounter, and itís almost too easy. Itís too easy for the doctor to say, ďWell, you know, itís psychological.Ē And Iíve had that. Iíve had a doctor say that to my daughter, who was suffering from the Zumba disease. And if you donít know what the Zumba disease is, you have got to read my book, because itís one hell of a story.

But the doctor didnít have a solution, and he was dismissing her internet research, and she said, ďSo what do we do?Ē He said, ďI could send you to an MRI. I think there will be no findings. And yeah, well, you know, itís just, itís psychological.Ē She was deeply offended, because itís like heís saying, ďWell, you know, you have kind of symptoms I donít really understand. I donít know what to do for you. Itís all in your head. Itís psychological.Ē Itís like, ďyour mind is messed up.Ē ďSeriously? Thatís why you went to med school?Ē So I donít think this is an answer that men get, oftentimes. I think what we can do to counter this is to ask, ďCould there be another reason? This isnít solving my problem. Could there be another reason? Can we check in a different direction?Ē I almost wanna say, ďWould you say this to a man?Ē But I donít think that would elicit a lot of cooperation from the doctors, even if itís true, even if Iím dying to not just say, but to scream it, you know. But itís our job as women to say, ďLetís view this from a different angle. Because Ďthis is psychological,í it just doesnít seem like a good medical solution to the problem Iím having.Ē I think thatís a very valid argument to be making, and I think the psychological cop-out is a cop-out. Itís not a solution. Itís unacceptable. For me, itís unacceptable.

Katie: Yeah. And I think that goes back to, I find this in all areas of life, being able to ask better questions and align motivations, like, I think often as a parent, and in business, leadership is about aligning motivations. So, itís approaching these relationships in a way of how can I align our motivations, and understand that the doctor has research and expertise in an area that I donít, but that I have more of an interest in my health than the doctor ever could, because Iím me? And how do we align motivations, and move toward a solution?

And I find often, like, even in negotiation in business, and I think this applies in doctor relationships as well, itís how we phrase our questions, and not just asking yes-or-no questions, but to your point, instead of just asking, ďIs it this or not?Ē ask how can we, or what could be another solution, or how can we find a solution together for this? An open-ended problem-solving-based question, versus, like, kind of a black-and-white question, and then getting them on board, like weíve been talking about the whole time, as a partner in this equation, versus justÖand having them understand, ďIím not trying to outsource this to you. Iím also very involved in this, and willing to make the effort myself,Ē and building that relationship, and viewing it, thatís been the theme of this interview, is building that as a relationship before you need it. Hopefully, before an acute situation where itís now, like, youíre in pain, or youíre in an acute health crisis, and then you have to figure out how to navigate that. So, pre-building those relationships and having those doctors in our corner, so that weíre proactive in both directions, and that they already have a good relationship with us as well.

A little bit unrelated of a question that I love to ask toward the end of our time is if thereís a book or a number of books that have had a profound impact on your life, and if so, what they are and why?

Dr. Talya: Okay. Iím gonna list two books. The first one, I doubt that many Americans have heard of. Itís called the ďDaddy-Long-Legs.Ē It was written in 1902. Itís a very old book. I absolutely love it. Itís about an orphan girl who grows up in an intellectual and emotional wilderness, really. And then she gets sent into college, and thatís the most amazing, eye-opening experience of her life. I absolutely loved it. I feel a little bit like her, just a tiny bit. I mean, Iím not an orphan. I grew up with wonderful parents. But I do feel that when I was young, I didnít have enough intellectual simulation. And then when I went to high school, I went to an amazing high school, and it was like, ďOh my god, there are so many people here I can talk to. This is so interesting. My teachers are so great. The world has opened up.Ē And that was phenomenal. And I think it gave me a sense of appreciation to the kind of experiences I had. And I feel very appreciative. Some people come to this world knowing that this is what theyíre gonna do. Their parents are whatever, have major degrees, major accomplishments. My mom is a retired nurse. My dad was a bank teller. They were great, great people, but they didnít send me to this world knowing that Iím gonna be another physician in a long, long line of physicians, or whatever, or even an academic person.

And just to be able to know what Iím doing, Iím blown away. I am. I published a book with Basic Books. Itís a very good publisher. I got to send my ideas out into the world. I got to be able to say, ďListen, I wrote this book that can help you.Ē Thatís amazing. How many people get to say that? So, Iím super appreciative of these opportunities that were thrown my way. I think thatís part of the magic of ďDaddy-Long-LegsĒ too. Iím just constantly appreciating. And more on point with our interview, I was blown away when I first read Jerome Groopmanís book, ďHow Doctors Think.Ē Amazing. Amazing, because Iíd never read anything like that. Itís non-fiction, about medicine. You startÖand youíre gonna love, youíre gonna absolutely love the first story, the introduction. Itís about a woman who comes to see the doctor, and sheís having very bad stomach pains, and she canít put on weight. And the doctors know, they know, ďItís psychological. Sheís anorexic, and sheís just in denial,Ē and they know, right?

But they donít really know, and thatís not true, because the fact is that sheís severely gluten intolerant, and they donít know that. So she tries to load up with carbs, and that, of course, doesnít go well. It takes about 15 years for a doctor to figure this out. And itís an ordeal for her. And itís so humiliating to be called, you know, ďWell, you have a psychiatric problem,Ē which she doesnít. If she did, it would be great. It would be cured. But she does not. And just an amazing way of looking at someone whoís trying very hard to be proactive about their health and to take good care of themselves, and itís not working. Itís just not working. Very, very, very frustrating, heart-wrenching.

Katie: I will link to those in the show notes as well. Those are both new for me as well, so Iíll check them out too. And any parting advice for the listeners today?

Dr. Talya: Yes. Thank you for listening to this wonderful show. If youíve listened to it, then I know you care about your family and about your health, and thatís amazing. Please read and get all the tools and skills you can about your medical life, as Iím sure you do about your nutrition and your exercise, because your medical life is an important part of your experience, and frankly, of your obligation, as parents, and of just being good stewards to your own health. So, I invite you to read my book, ďYour Life Depends on It: What You Can Do to Make Better Choices About Your Health.Ē I invite you to look at my website, where there are many webinars and a lot of materials on medical decision-making that could really help you and you could watch them. Itís all free and available. Itís talyamironshatz.com. And please tell me what you think. You have a contact form there, and I would love to hear from you.

Katie: Awesome. And those links, you guys listening, will be in the show notes, wellnessmama.fm as well. So you can find them if you are driving or exercising while you listen. And as always, thank you guys so much for listening. Thank you so much for being here, for sharing today. It was a pleasure. And I hope that you guys will all join me again on the next episode of ďThe Wellness Mama Podcast.Ē

If youíre enjoying these interviews, would you please take two minutes to leave a rating or review on iTunes for me? Doing this helps more people to find the podcast, which means even more moms and families could benefit from the information. I really appreciate your time, and thanks as always for listening.


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