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

The Wellness Mama Podcast

493: Dr. Talya Miron-Shatz on Medical Decision Making & Being an Informed Patient

00:00 / 00:49:31

In this episode, Dr. Talya Miron-Shatz is my guest. She’s the author of a book called Your Life Depends on It: What You Can Do to Make Better Choices About Your Health. Today, we talk about our relationships with doctors and health care providers—and the specifics of navigating these relationships. I hear from a lot of listeners who are frustrated by their relationships with their doctors because they feel pushed into doing things they don’t want to do or they feel like their doctors don’t listen to them.

Today, we talk about how to build a relationship with your doctor. Dr. Miron-Shatz shares the questions we need to ask our doctors and also how to find good practitioners for your children. We even talk about how to navigate the gender differences that still occur in medicine.

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 to help you along the way. So, let’s jump in!

Episode Highlights With Talya Miron-Shantz

Why healthcare is so confusing
How to partner with doctors and practitioners in your health
Why we should view our interactions with a doctor as a relationship and how to cultivate it
The most crucial piece of any relationship with our doctor
How to be an informed patient
The three questions to ask before any procedure or diagnosis: risks, benefits, and alternatives
Why asking about alternatives is a very important piece of your healthcare
The importance of having a good relationship with your doctor even when you or your kids aren’t sick
How to maximize your time with your doctor during appointments
How to ask better questions and talk to your doctor as an informed patient so they can listen and understand
Working with our doctors to get better care for our kids
What to do when you receive shocking or distressing medical information
How to discern what medical information is valuable
Navigating gender differences in healthcare and medicine

Resources We Mention

Your Life Depends on It: What You Can Do to Make Better Choices About Your Health by Dr. Tayla Miron-Shatz
Dr. Tayla Miron-Shatz’s website
Kenkora – health assessments and coaches
Daddy-Long-Legs by Jean Webster
How Doctors Think by Jerome Groopman

More from Wellness Mama

Did you enjoy this episode? Please drop a comment below or leave a review on iTunes to let us know. We value knowing what you think and this helps other moms find the podcast as well.

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Katie: Hello, and welcome to the “Wellness Mama Podcast.” I’m Katie from wellnessmama.com and wellnesse.com, that’s wellnesse with an E on the end. And in this episode, I am here with Dr. Talya Miron-Shatz, that’s T-A-L-Y-A. And she’s the author of a book called, “Your Life Depends on It: What You Can Do to Make Better Choices About Your Health.” 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 don’t want to do or feel like they’re 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 you’re making informed consent, how to find good practitioners for your children as well, what to do when you’re confronted with health news you maybe don’t 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, let’s jump in. Dr. Talya, welcome, and thanks for being here.

Dr. Talya: It’s my absolute pleasure. Thank you for having me.

Katie: Well, I’m excited to chat with you because we’re 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. It’s, like, my first language. Yeah. I guess once you’re exposed to more than one language, it becomes kind of easier. So, French is my mom’s first language, so I heard it around as a kid. Arabic was my father’s first language. He was a Jew from Syria. So, once you’re exposed to languages, it just becomes easier. And then, Italian is a bit of a cop-out because it’s a lot like French. And it’s fun.

Katie: It is fun. I speak very little Italian, but it’s a lot of fun. And Italy’s 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. It’s 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 I’ve 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 today’s 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. There’s 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? There’s a number of reasons, and some of them are very big and global, and some of them are very personal. On a global level, there’s just so much information, some of which we don’t understand. That’s fine. You know, you’re an expert at what you do. You’re not an expert in medicine. That’s 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. They’re 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 don’t want people to bash themselves for finding it difficult. It is really difficult. But here’s what you can do about it. And there’s really a number of things that you can do to make better health choices. Now, the first one is the word you use, it’s partner, is to find a doctor that you feel is your partner. That is crucial, because if you don’t trust your physician, why would you follow up on anything they say? You’re just not going to. And it makes sense, right? But it’s not great for your health. So let’s view our healthcare providers, and a lot of them just hate the word “provider.” It’s like, it’s so impersonal. It’s like, “I wanna be a doctor. That’s what I wanna be. I don’t wanna be a ‘provider’,” like, I don’t know, electricity provider. So let’s 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 it’s 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. That’s important. It’s not really an add-on. It’s the basis of our relationship. And our relationship with our doctors is just that. It’s a relationship. If you don’t like and trust the person you’re in a relationship with, you’re in trouble.

Katie: I think that’s such a great point, to view it as a relationship, and enter it with this kind of discernment that you would look at when you’re 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 a… And I can understand both sides of that pretty well, having… I used to have Hashimoto’s, 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, I’m sure there’s 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, they’re not infallible, they don’t have access to how your body feels. You’re 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 conversation… I’ve always said, I know people get frustrated with the medical system, but I really truly believe, every doctor I’ve met, they’re 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 it’s 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 don’t wanna feel like, “Hey, give me care. I don’t care what your name is.” Just like we don’t wanna feel like “patient number whatever.” And what I found, and I was writing a…I thought I was writing a book for patients. Then I realized I was also writing a book for doctors. So, my book, “Your Life Depends on It: What You Can Do to Make Better Choices About Your Health,” 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 that’s one source of frustration and pain, and I would add, worry, for all of us. And there’s something else I’m wanna say, that you mentioned, and that’s 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 doesn’t 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 what’s 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 don’t really live a very healthy lifestyle. And for the most part, people know that. They’re aware of that. People aren’t stupid. Nobody says, “Hey, oh my god. Yeah, I would love to just not be able to move well and to have my body hurt.” No, nobody wakes up in the morning and say, “That’s my goal for the day.”

But sometimes we do things that don’t serve us well. And the thing is, we don’t get immediate feedback. I mean, you put your finger in a cup of tea, “Woah, that is very unpleasant.” That’s the last time you’re gonna do it. You have one glass of alcohol too many, or you don’t work out. It’s like, “Okay. Nothing happened.” But eventually, these things accumulate. Likewise, if you don’t adhere to your medications, like, “Yeah, sure. Well, I don’t need this,” until you realize that you really do. So that’s a major source of frustration for doctors, and that’s a place where we and I’ve seen it, I haven’t seen it often, to have digital health and to have patient information in a way that you don’t have to get to that bad place and say, “Hey, doc, I feel really bad.” And your doctor’s like, “Well, you know, it’s nice that you went on a diet, but you used to be obese, and that takes a toll on your body, even when it’s over.” So, to be able to have, like, this trajectory of where we’re heading, and where that’s 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, we’re seeing much better patient-doctor access to each other through digital means, and I’m 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 aren’t, 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 that’s the thing I’ve 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 what’s wrong, or trying to tell you how to do your job, and I’m 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. Here’s my last two years’ 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 that’s 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 I’m 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, “I think you wanna order this test, but actually, I see that you’ve done that a year ago and results don’t change over years…” and I’m totally making this up as I go along. Or, “It’s not necessary for you to take this medication because you’re already on that medication, and it actually covers the same…it does very similar things in a very similar way, and we don’t want to add this on,” we should be able to listen.

And that’s, like, the fine line that we’re seeing now, is healthcare consumers. And, you know, we’re consumers in so many ways. I’m gonna get a coffee soon, and I’m gonna have a ton of choices. I mean, I could spend a good 15 minutes saying, “Ooh, this…oh, no, that one. Well, let me see,” you know, and I can choose, and whatever I choose is fine. With health, it’s not the same way. You know, with coffee, I get something, I hate it, I just toss it. You know, I’ve lost $5, if I was splurging. That’s it. With health, I don’t get immediate feedback, I don’t 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 can’t do that, and some of us can’t do that all the time. And that’s fine, too. So, that means the onus isn’t necessarily on us, for anyone who’s listening to Katie now and thinking, “Wow, oh my gosh, she’s so amazing. I could never be the kind of patient she is. I’m just a bad patient.” So, no, you’re wrong. You’re just a patient, and that’s fine.

And if you need more guidance, it’s absolutely fine to ask for it. It’s entirely, entirely legitimate. And that’s something that we just have to accept. You know, like, when we have kids, they’re not all the same. And they’re not all the same, and you can’t say, “Well, why can’t you be like your brother?” That’s probably the dumbest thing to say, right? So, why can’t you be like Katie? Because you’re not Katie. You are who you are. If you feel very well-researched, amazing. If you’re saying, “You know, I’m in pain, I’m scared. This is above my pay grade. I can’t do this.” That’s 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 I’m gonna repeat this, because it’s important. So, whenever you’re 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, it’s great. It’s gonna help you. It’s gonna solve your problem. Oh, fantastic. But let’s start with the risks. What are the risks? It may not work, and then you will be disqualified for a number of treatments. “Oh. Oh, wait. I don’t like these risks at all. So let me weigh this.” 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, “Oh, that’s the best thing. I mean, nothing to talk about.” They may not raise the alternatives. But if you ask, they’re not gonna lie to you. There’s 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, that’s not good. And they know that.

So, it’s important for me to say, again, risks, benefits, alternatives, especially alternatives, because we defer to the doctors. And sometimes doctors says something, we say, “Okay. That’s it.” You know, we don’t ask. Let’s raise the question, is there an alternative? Yeah. And, in fact, my son didn’t 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, “You could try reflexology. And here’s a number.” I was like, “Okay, that’s interesting.” Well, I trust my pediatrician. He’s been my pediatrician for a long time. I know he is legit. If he’s 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. What’s the alternative? Surgery. Not keen on that. We’re a family of swimmers. It’s hard to have surgery on your ears, not get them wet. Guess what? It worked.

The alternative worked. I didn’t 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 would’ve 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 someone’s 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 it’s 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 they’re 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, there’s a lot of misinformation. Sadly, there’s a lot of political dispute. Come on, we don’t 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, I’m in New York City and people aren’t masking up, and sometimes I feel safer with a mask. I’m like, what am I losing? Well, cramps my style. I’ll live. What’s the benefit? I feel safer. That’s good.

So, to just think of what’s the best thing for my health, for my child’s health, that’s 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 sandwich… You skipped making sandwiches, that was a health choice too. So, we do that all the time. We brush our teeth. I mean, it’s all over us. I didn’t wanna write a book that people will say, “Oh, that’s for sick people. I’ll read it if I need to. It’s like a bummer.” No, no. It’s like, you’re proactive, you’re 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 that’s a great point that we’re all making these decisions all the time, especially I feel like when it comes to kids, because often, there’s that relationship with the pediatrician that hopefully these…I mean, I know there are certainly kids with health struggles, but hopefully, your child isn’t sick and you’re just having a good relationship with the pediatrician. I’ve also heard from so many parents who feel that they are not listened to, or pushed into things, or kind of bullied. I’ve heard that word from parents referring to their relationship with their medical provider or their child’s medical provider before. What are some questions, maybe, like, good screening questions or ways to know going into a relationship with a doctor if it’s gonna be a good relationship, so that maybe we’re 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 doesn’t have a lot of information to go into it, but it’s immediate and it’s 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 they’re being respected. And that’s important. So that’s 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 don’t trust them, it’s not gonna go well. So that’s really the first point I wanna make. I think when we ask for information, when we hear something from our doctor, it’s incredibly legitimate that we ask for information like about the alternatives and the risks and the benefits. We should ask when we’re told about benefits, how many will benefit from this? Because there’s an element of medicine that we really don’t like. I wish it wasn’t there. And that’s uncertainty.

We don’t know for sure. Our doctors don’t know for sure either. Sometimes there’s 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. It’s a bit of a bummer thing to say, but I’ll say it nonetheless. Doctors go into this profession in order to care for people. That’s not the bummer part. The bummer part comes next. They are thrown into circumstances where they don’t have much time to sit with us. They really don’t. They wish they did, but they do not. So we also need to be mindful of that, and to think, “What’s the most burning thing I have to know?” 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, “Look, I’m concerned. What are the risks of this? Does it help everyone? Is there an alternative? If it doesn’t help everyone, what proportion of people does it help? What sort of side effects are we looking at?” So, just to narrow it down to a small amount of questions that’s more manageable. By the way, it’s 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 let’s just really focus. And when we focus, we can get good information from our doctors, within their constraints.

Katie: Yeah. That’s a great point as well. I say, like, I think, I’ve 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, it’s important to realize, that’s a great point, like, we can’t 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 we’re 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 there’s still unanswered questions. And I’ve also seen this kind of what I consider a false dichotomy that floats around on the internet every once in a while, where I’ve seen doctors say, you know, “Don’t confuse your internet search with my medical degree.” And I’ve seen patients shoot back, “Don’t confuse your medical degree with my informed consent.” 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 don’t like when that false dichotomy comes up, because I think it’s not ever either/or, it’s 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 don’t have. And I’ve 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 don’t understand. And also, my background is in nutrition, which, to my understanding, a lot of doctors don’t 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 you’re a mom as well, so I think also it’s that, you know, mothers have their kids’ 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 what’s best for their kids. So how do we unite all of that knowledge in the best way possible, so that we’re 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: That’s a great question. You know, it’s like, it’s a three-way street now, it’s not just a one-way. It’s 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 I’m really sick, the sicker we are, the more we listen to our doctors, because the more we’re scared, and the more we realize there is so much at stake, and there’s a lot that we don’t know. And that is fine. That’s really fine. It doesn’t make us less good patients, people, or mothers, if there’s a lot we don’t know or understand about our children’s care. We shouldn’t be butting heads about who’s more important, who knows more. It’s just, it’s the wrong place to be. Nobody benefits, least of all our children. But that’s 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 it’s unnecessary, just because they’re afraid of being sued, just because they’re afraid of being complained on. So we should really think, when I’m asking for something, and my doctor says no, and tells me, you know, “I could prescribe you this test for you or for your kid. It just, it’s a shame because there’s a lot of radiation, which I think is unnecessary and can be covered by, say, an ultrasound, or let’s do some watchful waiting and come back in six months.” 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 child’s health? That’s a good question. I would hope it’s about my child’s health.

So if I’m convinced, and I have the research to back it up that this, whatever it is I’m asking, is the best thing, by all means, go for it. If it’s not the case, then maybe let’s 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 don’t always have the knowledge. And I say that as someone who’s educated and I can read “The New England Journal of Medicine” research, and it’s not foreign language to me. Used to be. Not anymore. I’ve trained myself in this area. My Ph.D. is in psychology, but I’ve been doing a lot of medical research for the past 20 years, so some of it has definitely rubbed off on me. And still, I’m not a medical doctor. And that is perfectly all right that I’m not.

Katie: Yeah. That’s a great point and a great way to frame it.

Another thing I think it’s 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 don’t 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 you’re going into a situation where you might hear medical information you don’t 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 it’s not going to happen. A few pointers. The first one is this is not your best time to be processing information, at all. And that’s 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. It’s almost inhuman. And we could be making wrong decisions just because we’re freaked out. And we don’t like to be in a place of uncertainty. We’d like to know what’s going on. And if we decide what’s going on based off of just, “let’s get this over with,” that is not great. So, understanding our limitations is key here, and you can replace the word “limitations” with just being human. That’s pretty much the same thing.

Katie: And another area I feel like this can get confusing for people is there’s so many medical ads. To me, it’s almost humorous for me when any…we don’t watch TV often, but anytime it’s on, I see the medical ads where it’s you almost don’t even know what the specific drug is they’re advertising. And it’s like a kind of dreamy scenario with people walking on a beach or whatever, and “Ask your doctor if you need this thing,” and then, like, “Side effects may include liver failure, and death, and anaphylaxis,” or whatever. But it’s interesting to me that we’re getting so much marketing for all these different treatments and pharmaceuticals. And I think…I would love to hear from you, like, how can we discern what’s valuable information versus what’s not. I guess my default would be I’m 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: That’s a really great question. I love what you describe, that it looks like a dreamy scenario and then it says, “Side effects may include death and liver failure.” 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 won’t say, “This could include liver failure.” They’ll say, “This could include liver failure,” and it sounds so placid and nice. It’s like, “Yeah, whatever. Oh, I’m looking at the beach. That’s beautiful. Oh, liver failure, whatever.” And that’s the goal, that we won’t be able to process that. So, first of all, let’s, again, trust our doctors with our medical conditions, and let’s 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, because… I don’t wanna attack pharma. I think it’s been plenty attacked, and I think it’s 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 wouldn’t want that to happen. So, it’s their job to advertise, and it’s our job to say, “Do I need this? Could I fight whatever it is that I’m 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.” Because the job of advertising is to sell. It’s not to inform you in a balanced way. That would just be giving you a black and white brochure, “Here, read,” and that’s it. There would be no actors and music and beaches. So it’s on us to say, “Someone’s selling me something that sounds great, but is it really?” 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 didn’t happen. So let’s take the same skeptical approach with pharmaceutical advertising.

Katie: And another issue that comes into play, I’ve 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 how…and I’ve known this. Like, much of the research is done on men, because they have fewer hormone variables, and so there isn’t 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 is…it’s pretty well-documented, gender-based discrimination in medicine. I’ve heard from many, many women who have been told, like, their symptoms are just in their head, or, “That’s just normal. That’s just hormones.” I was told, “Oh, it’s probably just postpartum.” Or, “Of course, all those things are normal, because you’re a female and hormones,” 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 aren’t often the goal of the doctor, certainly. And sometimes maybe they’re 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 I’m really glad you brought this up. I’m glad you brought this up and I’m sad that this exists, really. Doctors don’t do this on purpose, but some of them have an implicit bias. And it’s also racial sometimes, and it’s also gender-based. So, when a man complains of pain, especially a white man, then he’s in pain. He should be given something for his pain, because he’s a strong white man, and he’s the silent type, and if he’s complaining, that’s gotta be serious. If a woman, on the other hand, complains, she’s probably hysterical. She’s exaggerating. I mean, she’s a woman, you know, overdramatize stuff. I’m being ironic here, please. Just in case someone didn’t get it. I’m being incredibly sarcastic about this. So, this is something that we encounter, and it’s almost too easy. It’s too easy for the doctor to say, “Well, you know, it’s psychological.” And I’ve had that. I’ve had a doctor say that to my daughter, who was suffering from the Zumba disease. And if you don’t know what the Zumba disease is, you have got to read my book, because it’s one hell of a story.

But the doctor didn’t have a solution, and he was dismissing her internet research, and she said, “So what do we do?” He said, “I could send you to an MRI. I think there will be no findings. And yeah, well, you know, it’s just, it’s psychological.” She was deeply offended, because it’s like he’s saying, “Well, you know, you have kind of symptoms I don’t really understand. I don’t know what to do for you. It’s all in your head. It’s psychological.” It’s like, “your mind is messed up.” “Seriously? That’s why you went to med school?” So I don’t think this is an answer that men get, oftentimes. I think what we can do to counter this is to ask, “Could there be another reason? This isn’t solving my problem. Could there be another reason? Can we check in a different direction?” I almost wanna say, “Would you say this to a man?” But I don’t think that would elicit a lot of cooperation from the doctors, even if it’s true, even if I’m dying to not just say, but to scream it, you know. But it’s our job as women to say, “Let’s view this from a different angle. Because ‘this is psychological,’ it just doesn’t seem like a good medical solution to the problem I’m having.” I think that’s a very valid argument to be making, and I think the psychological cop-out is a cop-out. It’s not a solution. It’s unacceptable. For me, it’s 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, it’s 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 don’t, but that I have more of an interest in my health than the doctor ever could, because I’m 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, it’s how we phrase our questions, and not just asking yes-or-no questions, but to your point, instead of just asking, “Is it this or not?” 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 we’ve been talking about the whole time, as a partner in this equation, versus just…and having them understand, “I’m not trying to outsource this to you. I’m also very involved in this, and willing to make the effort myself,” and building that relationship, and viewing it, that’s been the theme of this interview, is building that as a relationship before you need it. Hopefully, before an acute situation where it’s now, like, you’re in pain, or you’re 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 we’re 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 there’s 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. I’m gonna list two books. The first one, I doubt that many Americans have heard of. It’s called the “Daddy-Long-Legs.” It was written in 1902. It’s a very old book. I absolutely love it. It’s about an orphan girl who grows up in an intellectual and emotional wilderness, really. And then she gets sent into college, and that’s 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, I’m not an orphan. I grew up with wonderful parents. But I do feel that when I was young, I didn’t have enough intellectual simulation. And then when I went to high school, I went to an amazing high school, and it was like, “Oh 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.” 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 they’re 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 didn’t send me to this world knowing that I’m 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 I’m doing, I’m blown away. I am. I published a book with Basic Books. It’s a very good publisher. I got to send my ideas out into the world. I got to be able to say, “Listen, I wrote this book that can help you.” That’s amazing. How many people get to say that? So, I’m super appreciative of these opportunities that were thrown my way. I think that’s part of the magic of “Daddy-Long-Legs” too. I’m just constantly appreciating. And more on point with our interview, I was blown away when I first read Jerome Groopman’s book, “How Doctors Think.” Amazing. Amazing, because I’d never read anything like that. It’s non-fiction, about medicine. You start…and you’re gonna love, you’re gonna absolutely love the first story, the introduction. It’s about a woman who comes to see the doctor, and she’s having very bad stomach pains, and she can’t put on weight. And the doctors know, they know, “It’s psychological. She’s anorexic, and she’s just in denial,” and they know, right?

But they don’t really know, and that’s not true, because the fact is that she’s severely gluten intolerant, and they don’t know that. So she tries to load up with carbs, and that, of course, doesn’t go well. It takes about 15 years for a doctor to figure this out. And it’s an ordeal for her. And it’s so humiliating to be called, you know, “Well, you have a psychiatric problem,” which she doesn’t. If she did, it would be great. It would be cured. But she does not. And just an amazing way of looking at someone who’s trying very hard to be proactive about their health and to take good care of themselves, and it’s not working. It’s 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 I’ll check them out too. And any parting advice for the listeners today?

Dr. Talya: Yes. Thank you for listening to this wonderful show. If you’ve listened to it, then I know you care about your family and about your health, and that’s amazing. Please read and get all the tools and skills you can about your medical life, as I’m 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, “Your Life Depends on It: What You Can Do to Make Better Choices About Your Health.” 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. It’s all free and available. It’s 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 “The Wellness Mama Podcast.”

If you’re 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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493: Dr. Talya Miron-Shatz on Medical Decision Making & Being an Informed Patient

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