Taking to the Streets of Portland to Ask People About Their Experience with Doctors and Healthcare

Apr 12, 2022 | Podcast

In the season 1 finale of Third Opinion MD podcast, I’m taking to the streets of Portland, Oregon with my friend and colleague, Alisha Harrington, to speak to real people about their experiences with the healthcare system. You see, I strongly believe that true healing comes from real listening, and I wanted to hear the unfiltered stories of people in everyday settings. Alisha and I visited food carts and a local park and interviewed people about their experiences with doctors and healthcare. I know that many of their stories will sound familiar to you, and you may have experienced something similar in interacting with the healthcare system. 

In this episode, I’m also sharing 8 “dos and don’ts” for you to use on your own healthcare journey, so you can get the best results possible. You can find these listed below, as well.

True Healing Comes from Real Listening 

Taking to the streets for community conversations offered Alisha and I the chance to really listen to people. Like myself, Alisha has a background in both Eastern and Western medicine. She is an acupuncturist, and is now training to be a Doctor of Osteopathic Medicine. She and I have known each other for many years, and I thought it would be interesting to have her join me to hear stories from people outside of a medical setting.

As I share in this episode, doctors very rarely have more than about 7 minutes to spend with a patient. The ability to spend time with people and listen to their stories, as well as understand the root of their health concerns, feels like an amazing gift to me.

It’s likely not shocking to anyone reading or listening that no one had anything really positive to say about their experiences with doctors or with the healthcare system. And while some may assume that older people were most dissatisfied, it turned out that what we heard was that the youngest generations were the ones that were most disgruntled about healthcare.

And, while hearing all of this is a “hard pill to swallow,” I feel that having these conversations, and educating both patients and doctors on how we collectively can embrace a more integrated and nuanced way of approaching care, can change the system. And that is what I am here to do.

The Impacts On Your Third Opinion

I found my conversation with Nali to be especially insightful. Nali is 23 years old. If I had met Nali when I worked in a hospital, I would have only had about five minutes to speak with her, and that would not have been enough time to really find out what was going on with her. Nali’s most recent health concern had been about stomach pain, which she thought may be an ulcer. She had no diagnosis after visiting her own doctor four times, and became so ill on vacation that she had to go to an ER, where she was diagnosed with an ulcer. She is understandably frustrated by the Western medical system, and wishes she could find a better way to address her health concerns. I imagine many readers or listeners can relate to her story.

Nali also had a history of eczema, and she and her mother had been to an acupuncturist for care earlier in her life. Nali reflected that acupuncture was a very helpful way for her to address eczema in the past. She knew that when she followed what her acupuncturist recommended, her eczema was under control and she felt she was in good health even though she did not fully understand how it actually worked.

We talked a bit about how her experiences with Eastern and Western medicine were very different from each other. And then Nali said to me, “Chinese medicine treats the root. My parents always told me that.”

As a patient or a doctor in Western society, it’s important to recognize that both Western and Eastern medicine have good aspects to them. Western medicine is very good at treating symptoms and at dealing with the immediate needs of a patient. Eastern medicine is very good at treating the root issues that are causing the symptoms and with prevention. When you begin to embrace that you are at the center of your own care, and that your intuition often gives you important information about that care, then you become a powerful advocate for your own health.

Some of my pearls of wisdom around how to best interact with your healthcare system:

  • Write down the specific department, and the direct phone number for the doctor you are working with, or have been referred to. It’s easy to get lost in a phone tree or get bounced around in referrals.
  • Request and keep a copy of your health records, preferably every year or six months. Read through them. Ask questions or ask for revisions if something is incorrect or no longer accurate about your current health status. Maintain your records because you will likely change doctors. In being your own best advocate, it’s important that you also keep the records and understand your own health history.
  • Remain calm and in control of your emotions when you are working with people in healthcare. It’s reasonable to be frustrated and feel overwhelmed. For the best care, keep to the golden rule of “treat others as you’d like to be treated.” It goes a long way with doctors who are limited by time to engage with you..
  • Don’t let insurance coverage dictate what you should do for your health. Self care is the key to supplementing what insurance won’t.
  • Use the Patient Elevator Speech to use your time at your doctor’s appointment wisely and efficiently. You’ll want to include:
    • When your symptoms started, and where they are located (pain, nausea, anxiety, etc).
    • The quality and intensity of a symptom, especially regarding pain.
    • What you were doing when the symptoms started.
    • If there is anything that makes the symptoms better or worse.
    • If you’ve had the symptoms before (a prior episode).
    • Any prior diagnosis you’ve had that may be related to the symptoms.
    • Past treatments and if they worked or not.

Resources Sign up for my newsletter to receive the 11 Dos and Don’ts to Get the Best Results from Your Healthcare System Download the full Patient Elevator Speech Learn more about Alisha Harrington in the upcoming Episode 7, coming out in May 2022

Transcript

Barbara:  Welcome to Third Opinion MD Podcast. I’m your host Barbara de la Torre. I’m an artist and physician out to change the healthcare system and change the way you interact with it. This episode is the very first time that I’m sharing with you my experience with what we call field recording. That’s going out there, braving the elements of all of the sounds that can interfere with good quality sound on a podcast. I’m going outside and I’m interviewing people in Portland. I want to find out what people think about healthcare and what do people think makes a doctor. This is going to be for this episode and the next one.

I’m also bringing in a dear friend of mine, her name is Alisha Harrington and she is a fourth year medical student at an osteopathic school in Oregon, and she also is a teaching fellow. What we share in common is that we love both types of medicine, we love Eastern Asian medicine or Chinese medicine, as we call it, and Western medicine or traditional medicine. I went to medical school, so I have an MD, and Alisha went to osteopathic school, and she’s still there right now finishing her last year, and she will be a DO. Both of us, when we finish our MD and DO, we both can apply for the same residencies, so it gives you an idea that we are equal but with slightly different training. We’re going to go over that in season two.

I invited Alisha, and she was very gracious. I said let’s interview outside, let’s go and meet some people outside, and I started to ask questions.

[Begin interview with Alisha]

Barbara: Welcome, Alisha. You and I had walked the other day and tried the field recording bit. I’m going to just tell you guys, I’ve never field recorded before, so it was my first time, and of course there was some major equipment failure, but I think I’ll be able to salvage some of that.

When we were walking around and talking to people, what was your take on how people were dealing with healthcare and their experience?

Alisha:  Most people had felt like there was definitely a struggle. It didn’t seem like their first response was a positive one when we asked them about healthcare. It kind of depended on the person what their specific struggle was, but nobody revealed positive feelings right away. We had to kind of pry it out of them that they had a few good experiences with some kind doctors. For the most part, healthcare was a difficult system to navigate.

Barbara:  That was across the board. I think you and I were interviewing six people on the day that we walked out to the community, and then yesterday, I interviewed another four people. No one had anything really positive to say about it. It didn’t matter how old they were. In fact, the youngest generations were the ones that were most disgruntled about healthcare.

Alisha:  That’s true. Whether it was because they didn’t have access or had to pay cash for expensive tests that didn’t reveal anything.

[End Interview with Alisha]

Barbara:  I love to interview people who are passionate about integrating different systems together so that we can look at health in a different way. Again, remember, my expertise is in Western medicine and Chinese medicine.

There are other types of medical models out there, but primarily the premise is that if we have an integrated healthcare system – and I mean truly integrative, not going to a wellness center or a clinic that claims to have different providers with different skills sets, you’re still going to different silos. In other words, you’re going to one person who then charges you money, then you go to another person who then charges you money. They are not meeting in the same room to talk about you. You’re seeing these people separately.

What we really need is a system that incorporates these different tools in our toolbox to be healthier. But the most important tool is you. That’s where you need to come in and learn about how to take care of yourself.

Chinese medicine offers what I call those gap fillers for Western medicine. Where we are lacking in preventive medicine, in chronic disease management, in really humane and compassionate ways of treating mental illness, Chinese medicine can step in beautifully for that. Western medicine still maintains their strengths in rescuing and in understanding things on a very microscopic level, and in taking things apart and looking at the parts. But to look at the whole, you need the Chinese medicine model to do that. What if we put these two things together? What if? That’s the intention.

This episode is dedicated to the community because it’s my intention to really be in touch with you. I wanted to start with my own community in Portland, Oregon, so I decided to go walk out there and talk to people. What I was surprised by is that everybody said yes to interviews. I was really taken aback by that because I thought people wouldn’t want to talk to me. We’re just getting out of the pandemic. Who is this person asking these questions, asking about what has been your experience with healthcare, what do you think it takes to make a doctor?

While I talk to these community members, I’m going to also give you what I call the dos and don’ts to get the best out of the healthcare system. I have a full list for you. You can access this on my website. All you have to do is go to Third Opinion MD, scroll down to the bottom, and join the email list, and you will get that list of dos and don’ts to get the best out of the healthcare system. I call it the pearls of accessing the system to get the best out of it, and then avoiding certain pitfalls that can actually cause you more harm than good.

You have to know, because the system, as I’ve been talking about and as other guests have talked about, isn’t perfect. In order to get that revolutionary change in healthcare, we have to evolve individually to do that. In order to do that, we have to meet the system where it’s at and then adapt ourselves to a new way of living healthier so that we don’t need the system as much. The system in turn will adapt to us. If we try to go head on and say, “You guys need to change,” we’re not really speaking that language, so it’s really about a translation that is important here.

I want to help translate how healthcare operates and in turn help you to speak with them. But we’re going to go over a few points here as I interview different people on the street in the community. I will comment on a couple of the points, but the rest of them will be on the website.

[Begin interview with Deanna]

Barbara: What’s your understanding of what makes a doctor?

Deanna:  A degree [laughter].

Barbara:  Okay. How do you think it’s working out, what’s your experience?

Deanna:  Well, I’ve been to doctor appointments and had them be wrong before, so it’s not like a fool-proof degree that makes you the doctor.

[Transition to monologue]

Barbara:  That’s Deanna. She lives in Portland, Oregon, and we met at a typical place you would want to meet, food carts. Alisha and I were hungry and everybody there was willing to talk to us, so it was a great place to start.

Deanna:  I appreciate medicine and if you’re in pain, drugs are good, but I’ve also been thrown through hoops and drawn in circles, and paid a lot of money for it, for false diagnosis.

Barbara:  Was that through a big system or through a private clinic?

Deanna:  A big system.

Barbara:  Big systems are hard to be noticed in, and you almost feel like you’re invisible, it seems like.

Deanna:  Yeah.

Barbara:  I used to work in a big system.

Deanna:  Nice. I mean, maybe not, actually [laughter].

Barbara:  No, it was all good learning. Nothing is bad, right? In the end, if you can learn from it, it’s good. What would you want to do if you could change anything, like you had a magic wand and you could change medical education, what would you want to add to it or change it?

Deanna:  I would just want doctors to be a little bit more understanding that I know my body probably better than they do. Just in my 33 years of existence, I’ve seen probably 17 doctors, and they just look at a chart to identify me versus me knowing certain traits about myself or areas that maybe need more attention than others.

[End interview with Deanna]

Barbara:  You want to keep a detailed log of all of your communication with healthcare representatives. Anybody you deal with in the healthcare system, you need to keep a record of it. You can do this in a notebook, on your phone, anywhere really. You just need to find some way, even index cards. You can go totally analog on this, it doesn’t matter.

You just have to maintain that so that every time you interact with the healthcare system, you’re totally aware, because they’re going to make mistakes. There’s too many people involved in your care. That can sound like a really good thing, but when there’s a lot of people involved, then you have that game of lost in translation, or some miscommunication will happen, so you need to be prepared for that.

Here’s one thing. You might want to include a phone number that might be more direct to talk to the people that you need to speak with, or writing down a department you need to really be speaking with instead of another. You’d be surprised how people get tossed from department to department. It’s like the old phone prompts, please hold, and then they transfer to somebody else, and that happens like five times on a phone call.

You have to be that ace detective for your own care. At the same time, you want to be careful not to be your own worst conspiracy theorist when it comes to that, because it can be very taxing to be your own healthcare CEO, which is really what I’m asking you to do. If you take all of these small steps and these tips that I’m giving you here, and you can have the full list on the website, if you do that, you lower that stress level and it becomes less of a crisis and more of just maintenance. Just little bits at a time, rather than swallowing large bits of information at once. That’s too overwhelming, and then you miss a lot.

[Begin interview with Lucas]

Lucas:  I’m actually just now dealing with a situation through my work where I was injured on the job. I sprained my knee. I’ve never had such an aggressive experience with a doctor.

Barbara:  What was that like, what happened?

Lucas:  Like I said, I felt like I was constantly being interrogated, as if I was seeking attention or seeking pain killers. I didn’t know my knee was sprained until three months after it happened, just because the rolling diagnosis was that I had torn my meniscus in my leg, so I was like I’m going to have to get surgery, no one is giving me any answers.

[Transition to monologue]

Barbara:  This is Lucas. He’s 23 years old, and he’s talking about his experience with the healthcare system when he experienced an on-the-job injury. Before then, he never really had to use the system very much.

Lucas:  I just keep getting these screenings scheduled where they’re like, “This is probably what it is,” and then seeing this doctor and they say, “I think you’re good to go back to work.” I’m like no, I’m in a lot of pain. Don’t I have to get surgery? He’s like, “Why would you need that?” Well, isn’t this what’s happening? He said, “No, you just have a sprained knee. It’s fine.”

Barbara:  Did they do any imaging at that time?

Lucas:  Yes. They did an ultrasound and I was going to get an x-ray.

[Transition to monologue]

Barbara:  You’ve got to keep a copy of your health records and actually read them. I’m not talking about that little visit summary that sometimes they’ll give you after an appointment that shows maybe your vitals. Most likely, it shows your name and date of birth and who you saw that day, but it doesn’t give you any information on what is going on with you or what you have. Now it’s within your right legally to be able to look at your medical records and to see what doctors are writing about you, what nurses are writing about you. They are also paying attention as well.

Here’s the caveat. What people write in your medical records can sometimes look strange and odd because the language of medicine is different from the everyday language that we use. For example, if somebody is a “poor historian,” that sounds terrible, but it just means that you didn’t share your information in a way that conveyed an understanding of what’s going on with you. You need to be your own medical detective here so that your healthcare records work for you instead of against you.

You have the right to request your medical records, including office visit notes, tests, and medications. You need to make sure that you request them every six to 12 months to look for errors. You need to look for expired health problems, because these health problems live forever on your list, and you need to make sure that’s tidied up and updated. A lot of times, providers don’t have time to update your records in terms of your problem list.

Again, problem list doesn’t mean that you have a problem like there is something wrong with you as a person. Problem list refers to the list of conditions that you have dealt with in the past. Let’s say that you were prediabetic and now you’re no longer prediabetic. You don’t need that on your list anymore. Or if you were misdiagnosed with a mental health issue, which in some cases people are wrongfully diagnosed based on unconscious bias. You need to check on that and make sure that’s accurate. If you are diagnosed with something that you’re not comfortable with, you need to be able to talk to someone about it and why that’s there, and make sure that there’s a mutual agreement about it.

Lucas:  With my insurance, I could only go in for an appointment every two weeks, just because they were waiting for a payout every time. That same thing had happened to me with a non-work-related injury about a year ago.

Barbara:  Did you ever need the system before you got injured?

Lucas:  No.

Barbara:  So you’re kind of relying on things at home, like a scraped knee?

Lucas:  I didn’t even think of seeking attention until it really was I’m in so much pain that I don’t know what else to do, so I’m going to go see a doctor.

Barbara:  How did you injure it, do you remember?

Lucas:  Yes. It was just a weird thing, I was squatting while lifting something too heavy, and just something happened and I was like, “Wow, I’m in a lot of pain. I’m just going to not think about it, take it easy for a while, eventually it will be done, it will get over itself.” I did sports through high school, and that’s just kind of what you do, it will heal itself eventually.

[End interview with Lucas]

Barbara:  Don’t wait until you have a crisis to know how to access the system. You need to be prepared.

If you don’t know how to access your healthcare services, that’s like not knowing how to deal with a natural disaster, which most of us are also not prepared for either. This just goes down to a couple of basic things that we don’t think about until we’re in the crisis. To prepare for a crisis, you would want to fill prescriptions at least three business days before you run out. You want to avoid that Friday afternoon panic call to the doctor’s office. You also want to maybe call ahead to these main phone numbers from your insurance, if you are lucky and fortunate enough to have insurance.

You want to call and check out what it’s like to call to get an urgent care appointment or to go to the emergency room. Call the main numbers and ask questions. Just say, “I don’t need you guys right now, but what if I need you later, what’s the process of me getting an appointment?” You can’t imagine how that’s going to save you a ton of time later.

[Begin interview with Annalise]

Annalise:  My experiences also haven’t been the best. I’ve been on the same medication since I was 11.

[Transition to monologue]

Barbara:  This is Annalise, and she is 21 years old. She talks about the difficulties she had with filling prescriptions that she’s been on for years.

Annalise:  It’s suddenly gotten really hard to get. I don’t physically need it, but I’m definitely very addicted to it. It’s like Adderall.

Barbara:  Is it for ADHD?

Annalise:  Yeah. I’ve been on that since I was 11, and I’ve been on the maximum dose since I was probably 14. The primary care physician that I was with recently had to change. I can’t go back to the other place anymore because they were just treating me for a certain thing.

Suddenly, it’s extremely hard for me to get them. I need to do drug tests where I can’t even smoke completely legal substances that don’t even have any sort of adverse reactions with my meds at all, in order to even be considered. It will take a week before I can reach them, and I have to check in with them every single month.

Barbara:  Do you want to need them anymore? If you could wave a magic wand, would you want to keep taking them?

Annalise:  No. I’ve tried several things, but I don’t have that much hope for the society that we live in to change enough that I don’t need them, because I don’t necessarily think it’s a me problem, it’s a problem that I can’t really I guess be as productive as I’m “supposed” to.

Barbara:  It’s never a problem with just us. Right? It’s our community, it’s everything around us.

Annalise:  Exactly.

[End interview with Annalise]

Barbara:  Back in the day, you would have your doctor that you could talk to, that you could trust. Lo and behold, doctors are not treated very well in the big systems, because administrators outnumber doctors now 10-to-1, as of a recent report in 2022. You do not have the luxury of having a doctor that is going to stay with you over the years, so it’s really important, that’s why I mentioned that you have to keep your own records, maintain control over your health situation, because it won’t be your doctor anymore.

Your doctor is your guide. If you find a good one that you can stay with for a long time, wonderful, I love that, but that’s rare. The more common thing is that your doctors will change, so you need to be on top of what’s going on with your health. Western medicine alone is not enough. It’s just not enough. The system is limited, so it doesn’t allow for you to really get a comprehensive holistic view of your health. This is why I encourage you to learn also Eastern medicine, to really fill those gaps.

This next person I spoke with was just delightful as well. Her name is Nali, she’s 23 years old. If I was in the hospital speaking with her and I had five minutes, I would never truly find out really what was going on with her, what her narrative is that drives her concerns about her health. We had some very interesting discussions, so I want to take a little bit more time with Nali here.

[Begin interview with Nali]

Nali:  I’ve done a lot of acupuncture. Me and my mom have not had luck with the medical system at all. There’s a few skin problems that my mom has had that only worked through Chinese medicine. They only gave her steroids, which is really bad for you. Steroid cream, which is bad for you to constantly put all over your skin because it makes your skin really weak and thin.

[Transition to monologue]

Barbara:  Don’t accept medication treatment or prescriptions without first knowing all of the options. Here’s an open secret. Pharmaceutical companies are in the business of keeping us dependent. They are in the business of keeping us sick, because if we’re all healthy, they go out of business, they lose a lot of money.

Medications, supplements, over-the-counter treatments all have good uses to help us through health events, sometimes long term, sometimes a lifetime, but for the most part they’re not. They should never replace our own role in maintaining health. Several of these medications and supplements carry potential side effects or what we call drug-drug interactions, and they can deplete nutrients, so there are nutrient depletions that are important to know about with each of your medications, supplements, and herbs.

The buck always stops with you. Your body is a priceless commodity, so you need to explore lifestyle options as well as other non-medication therapies. You want to weigh the risks and the benefits of taking or adding any medication to your list. Remember, your quality and your quantity of life depends on this.

Nali:  Chinese medicine was the only thing that would work, and it was really just soup full of god knows what, but it was organic stuff, like literally natural shit. One time I had this eczema, I get eczema sometimes, and the only thing that would help was these tiny little black balls. I have no clue what they were, and I couldn’t read the package or anything like that.

Barbara:  Would you want to know what those did, would you want to understand what kind of treatments they are?

Nali:  I’d love to. The person who was the pharmacist couldn’t speak English. You’d just give them the slip from your acupuncturist, who could also speak limited English, and then they give you this thing that was written on it and they tell you once a day or whatever.

Barbara:  Did it get better?

Nali:  Yes, it went away until a year when I dyed my hair and then got that whole thing back, like 15 years later.

[Transition to monologue]

Barbara:  In the case of Nali and her mom, she’s talking about a skin condition known as eczema, which is an inflammatory condition or a condition that causes inflammation of the skin, redness, itching, scaling. It’s usually something that is inherited. What’s really interesting is that Western medicine mostly treats it with a topical, sometimes they’ll treat it with pills to stop that inflammation. The problem is those topical medications are a big problem used long term, and they only treat the surface. It’s like treating a leaf falling from the tree rather than treating the root of the problem.

In this case, I’m really proud of what Nali and her mom did, they sought different options. They knew better. They really were trying to look at all of the alternatives and what would actually address the problem. They sought acupuncture and herbs, which is part of Chinese medicine. For them, it worked really well.

Nali:  I’m going to talk about this. Another reason why I hate the fucking medical system – sorry.

Barbara:  You can swear, it’s okay. Speak freely.

Nali:  Okay. I’m not used to talking to people that I don’t have to swear around.

I’ve had an ulcer for two or three years now. I went to the doctor four times with the same symptoms, telling them I’ve not stopped throwing up, I can’t stop throwing up, I have this burning, stabbing pain right here in my stomach, the exact spot. Then I would tell them all the basics, I’m hurting, all this stuff. They’d be like, “You’re fine.” Four times I went for the same thing because I was either throwing up blood, I was just in so much pain I had all this acid stuff, just throwing bile, all this just nasty shit.

The fourth time I went I told them I think it’s an ulcer because I looked it up and I feel this way, I have all the symptoms, literally every symptom. They were like, “It’s probably just extra acid. I’m going to give you this.” They just gave me over-the-counter, not even prescription, just over-the-counter stuff. They didn’t believe me for the fourth time. They did not believe me at all. It was the same doctor, too, over the whole time.

[Transition to monologue]

Barbara:  Don’t yell, don’t lose your cool, as much as possible, if ever, in the healthcare system. I know in America the customer is always right, but in healthcare you are not. You will become the “difficult patient” if you lose your temper or act out. It doesn’t mean that it’s not justified. It happens, we’re all human. But the reason you don’t want to earn this label is not that you’re going to receive the worst care as a result, but you’re going to attract very similar agitated or cold responses from the healthcare staff, which just spreads misery all around.

If you’re getting angry and allowing your cortisol level to rise, that’s terrible for your health, too. You’ve got to be your best self and you will attract a similar reaction from other people. This is again that golden rule. It works, it really does work. Even though you may not get it right away, if you’re consistent, you keep your cool, don’t yell, stay in control, the system will serve you better.

Nali:  A week and a half later, I was on vacation, and I had to go to the ER because I was throwing up so bad, I couldn’t do anything. They told me I have an ulcer, and then they tried to figure out why. They were like, “You don’t seem to eat bad. You don’t seem to do this. Do you have a lot of anxiety or PTSD?” I was like yes, I have a serious amount.

Barbara:  There’s a study called The Adverse Childhood Events study, have you heard about that? It’s called ACE for short.

Nali:  No.

Barbara:  They interviewed 17,000 people and reviewed their charts. They found that anybody who had trauma has a higher correlation with certain physical illnesses. There are direct links. If you don’t treat the underlying root… This is part of the problem with Western medicine. Again, I love both because both have good things, but Western medicine treats symptoms.

Nali:  The Chinese medicine treats the root. My parents always told me that, yes.

Barbara:  Yes, but you need to treat the root. That’s what I’m hoping, that we can get a system that teaches people self-doctor type of care, because the system can’t do it. You saw what COVID did, right? Hospitals were way overwhelmed. It got worse than it already was. Now we’re going to go back to what we did? We can’t do it.

A lot of people with PTSD, if they’re not present, if you’re not present in your body, the treatment doesn’t work as well. That includes drugs or qi or using acupuncture. Does that make sense? Because you’re checked out.

Nali:  Your body is also if you think about a situation, your body actually thinks you’re there. Like I have anger issues, and a lot of times I’ll get mad, or someone will make me mad, but then I’ll imagine fighting them, but imagine it so hard that my heart rate is higher, I’m breathing hard and shaking because my body actually thinks I’m doing it and there and stuff. It’s the same thing with when I have PTSD attacks and I can’t see anything around me.

[Transition to monologue]

Barbara:  Here’s the elephant in the room. If we don’t mention the word trauma, we’re missing a huge component of healthcare and the disconnect that happens between patients and providers. Almost everybody has been through something. We’ve all been through stress at some point in our life, but some of us have complex trauma. I would say many of us have complex trauma.

What I want to encourage you to do is to learn about seeking help from providers who are trauma-informed. There is a term called trauma-informed care. More and more providers are being trained to look at trauma in a different way. Western neuroscience is talking about the same thing that Chinese medicine has recognized for centuries. That is that trauma, especially complex trauma, gets into the tissues and affects multiple systems.

A lot of times, it’s difficult to recognize if we’re just looking at the symptoms, like in Western medicine. We’ll mistake someone getting upset with being a difficult person. We always have to understand their narrative.

Now, this is beyond the scope of this episode, but in season two we’re going to really delve into that with an interview with Alaine Duncan. I can’t wait for you guys to hear about what she has to say about how we should understand trauma, from not just a Western perspective, but an Eastern perspective as well. We’re going to look at a Chinese medicine and Western neuroscience approach to trauma.

Let’s go back now to the conversation with Nali, Lucas, and Annalise….

[Resume interview with Nali, Lucas, and Annalise]

The thing is that there are things out there, but I encourage you to explore some stuff because, really, there’s exciting stuff out there right now.

Nali:  It’s good.

Barbara:  Anger, like three minutes of anger is good for you, it’s okay. More than three minutes of anger has long term effects, but you can address that.

Nali:  Ah….[squealing, then brief laughter]

Barbara:  I’m serious.

Nali:  I just have issues.

Barbara:  All of these issues can be worked on. That’s the cool part.

Nali:  Uhum.

Barbara: Would you want to see something like that, would you want to have, if you could have access to things like that?

 

Lucas:  Absolutely. I think the promotion of that is important, because if we are able to get people collectively a better relationship with their bodies and taking care of themselves, then there isn’t that much of a demand, there isn’t that much of an overload on the medical system.

Barbara:  Exactly.

[End interview with Nali, Lucas and Annalise]

Barbara: This one is real important, too. Don’t let insurance coverage dictate what you should do for your health. If insurance covers certain things that you say, “Well, because it covers it, I’m going to use that way of getting better.” If that’s not the best way for you to get better individually, don’t fall into that trap. Self-care is the key to supplementing what insurance won’t cover.

Now, is it fair that they won’t cover it? No. But we’re not dealing with what’s fair and what’s not fair. We’re dealing with what’s possible at the moment. In order to supplement that, self-care is necessary because insurance businesses are not in the business of taking care of people individually. They always work in their own best interest, not yours. Remember that.

Imagine if you’re buying a new car and you have this car insurance. Are you just going to rely on your car insurance to take care of all of your maintenance? No. You need to do other things to make sure that your car is in good shape. The insurance is there just in case. You want to make sure that you don’t need the just in case, because then the insurance may go up. You need to provide your own maintenance and improvement plans, no matter what. Especially now with the system the way it is, you have to do it.

[Begin interview with Naida]

What kinds of things have you learned about for self-care and lifestyle medicine? Has that ever been emphasized when you go to a healthcare appointment?

Naida:  Not with a regular medical doctor.

Barbara:  Who do you go see for that kind of stuff?

I met a lovely woman named Naida and her little dog named Zu-Zu. Naida is 69 years old. She found a good primary care doctor who listens to her. One of the things that we talked about was the challenges that she faced in speaking with doctors in general, that she was trying to find ways to speak to them where they would listen to her. Here’s what she had to say.

Naida:  About 10 years ago, I did find a book that was supposed to teach me how to talk to a doctor so that they’ll hear you. [laughter]

Barbara:  Did it work?

Naida:  I tried some of the things.

Barbara:  Give me one example of what you tried. Do you remember?

Naida:  One of the things was don’t tell them what you think it is. If you’re having an issue someplace, don’t tell them what you think it is because then they’re not going to look at anything else, even though you might know what it is.

Barbara:  The truth is you know what it is. One person told me earlier this week when I interviewed her, she said, “What I would want a doctor to do is for the first time understand that I know my body better than they do.” That’s the way it should be.

We’re taught to be objective and emotionless in medicine because it can “cloud your judgment.” But my belief – as someone who really deeply cares about emotional health, mental health, spiritual health, and physical – is that it’s an exchange.

If you went into the office to see me, would you have more trust if we were talking like this? If I listened when you said you think it’s this, you’d probably trust me a bit more.

Naida:  Yes.

Barbara:  Usually, not everybody is trained that way. Also, they’re under a lot of pressure, so these doctors, honestly, I don’t know how the system is still lasting as long as it is, because they’re leaving the profession. Nurses are angry, and they’re overworked. Doctors are completely powerless. Even though you think they have a lot of power, they don’t. If you become a “difficult patient,” you don’t get listened to.

Naida:  The reason I’ve stayed with this doctor is because she is probably the only one that I can go in there and say, “I think this is what’s happening,” and she will talk to me about it.

Barbara:  She respects that.

[Transition to monologue]

This is the top of the list when it comes to the tips I give you on how to navigate through the healthcare system. When you finally get to see the doctor, you want to spend it wisely and efficiently. The truth is from the moment that doctor enters the room, the clock is ticking.

The average amount of time scheduled for a routine visit is 15 minutes long, maybe even 10 minutes. By the time you get to see the doctor, you’ve got 7 minutes. That’s right, 7 minutes. That’s not a long time. By the time the medical assistant checks you in, by the time they review your medical record, they take your vital signs, you will have about 7 minutes to spill your guts to the doctor or to the healthcare provider that’s seeing you.

It’s tempting to consult with Doctor Google. Doctor Google usually tells you the worst possible cause of your symptoms. You might think it makes sense to tell your doctor what you think you have and what tests you need, in order to save time, but stop. It’s not that you shouldn’t. In fact, Googling is fine. It’s in our society, everybody Googles, doctors Google, it’s just a thing now.

It’s okay to search and form your own opinion, that’s what I encourage, but this is about spending the time wisely and efficiently. I’ve created what’s called a patient elevator speech. You know when you give that elevator speech to somebody, you’re going from one floor to the next and you have about 30 seconds to convince someone that your idea is good. This is about convincing them to look at certain things that you feel are wrong with you because you know yourself best. As Deanna said, she and her 33 years of existence knows her body better than the doctor seeing her.

I one hundred percent agree with that. The key is, how do you communicate that so that they listen? Remember, doctors, nurses, physician assistants, medical assistants go to school, they learn a whole other way of speaking. If you have 7 minutes, and they speak a certain way, if you don’t speak that way, you’re not going to get through to them. This is a time crunch. There are things that you should include in your elevator speech.

Again, you can look at this on my website, ThirdOpinionMD.org, and sign up for the email list and you’ll get the free list. You want to write these things down. I call it the 10-point patient elevator speech. When did your symptoms start? What are they? Where are they? What’s the quality of it? You want to describe what it’s like.

For example, pain is what we talk about with quality. What kind of pain? Not how severe, that’s intensity. Is it sharp, dull, aching, burning, stabbing, pulsating? You get the idea. Intensity is how severe it is on a scale of 1 to 10. Please don’t say 20. You can say it feels like 20, but it’s actually a 9. Ten is the worst pain you’ve ever experienced in your life. It’s hard because a 1 to 10 scale is so small that sometimes it’s hard for people to put it in there. But you need to put it in there. Think of what the absolute worst pain is. If it’s the pain you’re having right now when you’re talking to them, then it’s a 10.

All of these things go into a 10-point patient elevator speech. Everything is included in the healthcare appointment checklist. As long as you have these 10 points, you have an idea, you’re preparing.

By nature, I’m a teacher. This is your homework: Next time you go to an appointment, even if it’s a crisis appointment, you have something to write down, because if you start to speak that language, suddenly you’re not that “difficult” patient. You will get the care that you need, the best care that they can provide. That’s not to say that Western medicine is the only care that you need.

This is also about how you would talk to a Western doctor. For an acupuncturist, you may just make sure that they’re explaining things to you, that you understand Chinese medicine. That’s where I hope to help you with these podcast episodes, is to understand the underlying principles of Chinese medicine so that you can communicate with the acupuncturist and not just be a passive recipient of aggressive care. Across the board, you should never be passive again. Your life depends on it. Your quality of life depends on it.

[Resume interview with Alisha]

What’s interesting is when you and I walked around and talked to everyone, they all did Western medicine. Yesterday, everybody I spoke with tapped into acupuncture and Chinese medicine.

Alisha:  Oh. Cool.

Barbara:  Isn’t that cool? I wish you were there. It was really neat. One person said, “I hate the healthcare system,” but then when I talked to her about acupuncture, she was like, “Oh, yes. Acupuncture gets to the root of the problems.” I was like oh my god, right answer, that was great. She got it. That’s pretty cool.

I’d like to keep going out there and just checking in with people. When you and I were walking out there, I was most surprised by how hopeless the younger respondents were.

Alisha:  Yeah, I would agree.

Barbara:  They were so negative. There’s just no one showing them what’s possible. So, I think there’s so much room for us to do that and to grow.

[End interview with Alisha]

Barbara: What you have to say is really important. What all of you have to say is really important. Thank you to Nali, Lucas, Annalise, Nayda, and Deanna. You guys were great.

That wraps up this episode where I reached out to the community for the first time. I want to know, I really want to engage with the community. If it means starting with Portland, great, but I mean all over. I don’t care where you’re from. Tell me about your healthcare experience. What has it been like?

The other question I have for you, and this comes up for the next episode, is on what makes a doctor. What do we need to be doing with training our future doctors to help make the healthcare system better? I know it’s more complex than that. Obviously, we’ve talked about that.

I’m going to be really honest that going out to the community and asking people about their experience with healthcare is one thing. Asking them what they think makes a doctor is a totally other thing all together. It might be polarizing for doctors to interview people about their experiences with doctors and healthcare, but my advantage now is that I have left the corporate system and I have the freedom to ask anything I want. Not only that, but to really engage in real listening.

True healing comes from real listening. It’s my hope that community conversations will take us closer to that so that we make this healthcare work better for individuals, for communities, and really improve our quality of life, improve the way we interact with one another, broaden how we look at health all together.

I’m really excited about, as I wrap up this season, this is the last episode of season one, going into season two there are some really exciting things that I’m going to share with you. I have some wonderful guests who are coming on the show. I have an acupuncturist who has integrated Western neuroscience with Chinese medical principles called the five elements. She talks about trauma and the stress response, and how we can really treat trauma in a more holistic and integrated way. I can’t wait to introduce you to her.

I have another expert coming on the show who is an expert on what makes orthodox and unorthodox medicine, so we’re exploring the history of what’s called “quack medicine” or quackery. Why do we define some medicine as okay and some as not okay, these labels that we give? It’s going to be so interesting, I can’t wait to introduce you to him.

We’re going to talk about Chinese medical principles in another episode and discovering how the language of Chinese medicine can help you with your own self-care in the modern world. I’ll continue with the scavenger hunt of my family history and go on to the next chapter. Then I will be bringing in a lovely gentleman who has had experience as an acupuncturist working with addiction and psychosis, treating mental illness in an entirely different way than we’re used to in Western medicine.

Season two is going to be quite eclectic, really interesting, with people that are thinking outside the box. Season two will be starting on May 10th and will run for six episodes, every second and fourth Tuesday. I’ll bring on Alisha Harrington, she’s going to come back for episode 7, the first episode of season two. We’re going to move into the conversation of what makes a doctor. The two of us have had integrated training, and Alisha is now finishing her second phase of her integrated training as an osteopathic physician, she will be graduating in 2023. We’re going to have some very engaging discussion about can we do this differently, do we have to continue medical school the way it is? The way people are talking about doctors and their healthcare experience, I think it’s time to think about reframing education.

This is literally my call to action to all of you. I want to talk to you, I want to hear from you. Email me at info@thirdopinionmd.org. Although I’m interviewing people in the community, this is where I can put my feet down on the ground. I want to hear from anyone, anywhere about your healthcare experience. I want to know what you think of the show. I would love to know what you would suggest. This is a movement. This is the call to make big changes. We can’t live with this system anymore. We can’t do things as we did before. We’re coming out of this pandemic, and we know things cannot go back to the way they used to be. I look forward to hearing from you.

Thank you again for listening. Please rate this on your podcast player. Share this with anyone you can. I rely on this very much for making this even possible. In order for me to make this podcast last, I really encourage you to share this with whoever you can. Keep listening, keep talking about it. I wish you well. Thank you.

 

Third Opinion MD Podcast is produced by me, Barbara de la Torre, and is generously funded in part by a grant from the Regional Arts and Culture Council. Music is licensed through AudioJungle.

I’d love to hear from you. Please send me your comments, questions, or suggestions for future topics and guests you’d like to have on the show. You can find the contact form under the podcast tab at the website ThirdOpinionMD.org.

Any comments made by the host or guests on Third Opinion MD reflect opinions about healthcare and self-care. Please consult with your physician for any medical issues that you may be having.

Be sure to follow or subscribe to this podcast and submit a rating on your favorite podcast player.

Thank you for listening.

 

 

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