Why The Right Doctor Matters

Speaker 1: The more that you can open up or share something that's important to you, the more you will have the opportunity to create connection. Cause I think that is probably the key. Can we connect at some level so that you can hear me and I can hear you.

Speaker 2: Welcome back to Until It's Fixed, where we explore new ideas and work underway to make healthcare simpler and more effective for everyone. I'm your host, Callie Chamberlain.

Speaker 3: [00:00:30] And I'm Dr. Kenny Poole. Welcome back everyone. In today's episode, we're talking about finding the right doctor for you and why that matters. Having a doctor who you trust, who listens to you, who you communicate well with this not just a bonus feature of care, can really make a difference in terms of your health. And in some cases it can literally change your life.

Speaker 2: Yeah, absolutely. A recent Mayo Clinic study found that people reported more satisfaction with their care, a better quality [00:01:00] of life and fewer health issues. When they had a good relationship with their provider, they were also more likely to stick to a care plan if they trusted that person, which makes sense.

Speaker 3: Yeah. And for that study that you referenced, Callie, on the flip side, they found that the less comfortable you are with the doctor, the less likely you are to follow their advice or treatment plan.

Speaker 2: And I mean, that makes sense because what we're assuming is that there's trust there, which is why you're likely more able and willing to listen, to follow directions, to ask questions, and really just to feel [00:01:30] comfortable.

Speaker 3: Kylie, I'm curious, just given a lot of the reflections that you have had in many of the other episodes, you do seem really in tune to your own health and your own experience as a patient. And so I'm curious, do you have a specific physician or provider who you really had a connection with or who's had a lasting imprint on you?

Speaker 2: Yeah, I have had a couple doctors that I've really liked. And what I liked about those [00:02:00] doctors is that they really felt like they were taking their time. I didn't feel rushed. They responded to the questions that I had. They kind of shared with me the thinking behind why we were gonna do certain tests or what they thought something might be. There's also like a level of reassurance that was coming through. But I think the biggest thing is they just talked to me like a person and they cared for me like a person. They didn't talk down to me, they didn't dismiss my questions. They really made me feel respected and [00:02:30] clear about what was happening and why.

Speaker 3: I reflect on my own experiences as a primary care physician for several years. I go back to the person who applied to med school, like I wanted to help people. I care about people, I wanna see people do better. I wanna see people win and I want to help them doing that. Right. And so my approach, my philosophy, if you will, has really been the same. It's about making sure that [00:03:00] people, number one, feel comfortable enough to communicate everything. As a physician, I need you to give me all of the information. Like I need all the facts, I need all the information, even things that you may not think are significant. As a patient, I may need those things in order to make the correct diagnosis or the correct treatment plan, or to suggest the right test to figure something out, making sure that I'm the best provider that I could be. The second thing [00:03:30] though is I've always made it a point, and I think I may have referenced this in one of the other shows that we had, is to make sure that everybody leaves having the main issue that they came in with addressed.

Speaker 2: Yeah, no, that makes sense. Two of the big things that I check for are sort of like, do I feel like I'm being heard with the questions that I'm bringing or the concerns that I have? And then separately, sometimes I feel rushed. Mm-hmm. <affirmative>. And in a retail health clinic setting, that's a little bit of a different expectation [00:04:00] than if I'm going to see a provider or a specialist. I think there's also a balance between, at least for me, like recognizing that doctors are humans too. And you don't always have all the answers. You might be having a bad day, you might be getting behind on scheduling. Ultimately they're just people. But I think some of the big things that we're talking about in this episode and that you've already shared are just making sure that you can be comfortable with somebody, right. And that if you don't feel comfortable, you're able to make changes so that you do get what you need from your provider relationship. Couldn't

Speaker 3: [00:04:30] Be said better. So to help us learn more about the doctor patient relationships and just how important they are and can be. We spoke with Dr. Sue Re, who's vice president of Medical Science Quality Solutions at Health Grades. Let's listen in here. Dr. Reid, I'm really excited to talk to you. We'll start from the beginning. Can you tell us a little bit about what inspired you to be a physician?

Speaker 1: Yeah, absolutely. [00:05:00] I see myself as an idealist and an optimist and I think I saw the role of a physician as that of a healer. And for me that was so inspiring and I felt that if there's one thing that I can apply myself to and say at the end of my day that was worth it, it would be meeting somebody and connecting at their place of need. And so that's what really inspired me. [00:05:30] And then just nerding out about science and the human body and it's fascinating. And to be able to marry what I was interested in with what I felt like could be rewarding was what really drove me toward that path.

Speaker 3: And then what is your specialty in terms of practice?

Speaker 1: I was practicing as an endocrinologist. Okay. So things like diabetes, thyroid, you know, osteoporosis, that type of thing. I got into that path because my paternal [00:06:00] grandfather had diabetes and had many complications from diabetes. And then subsequently I found out so many of my family members did. And then I have pre-diabetes. I'm uh, Asian-American and it's pretty prevalent in the population. And so that's when I was like, oh, what is this field? And for me it's like a big puzzle and I like putting things together. That's what appealed to me about endocrinology.

Speaker 3: What got you out of medicine into health grades?

Speaker 1: Yes, absolutely. So my own [00:06:30] health journey, I started out as a provider, but I quickly became a patient. I have rheumatoid arthritis and I was diagnosed after my daughter was born. And for myself, it was a journey of trying to be everything to everybody. I was trying to be the best physician I could be, trying to be the best mom I could be. And I think at the end of the day I was burning the candle at both ends. And I got to a point where [00:07:00] I was physically unable to continue my clinical practice. I had to take a pause, I had complications from medication, I needed surgeries. I didn't know would I be able to return to medicine or not really through that journey, I really, you know, was in the other chair. But being a patient made me even a better provider, I think because I could empathize with the people and I wanted to really listen and I wanted to hear because that's where I was at.

Speaker 1: Fortunately, [00:07:30] I did improve my health to the point that I started looking for how could I make an impact with my background, with my work experience, but more at a macro level. And so that's how I started looking for opportunities and eventually that's what led to my role at Health Grades. Interesting. Can you tell us about your experience with doctors growing up and how that experience helped shape your career? Certainly my parents were immigrants. I didn't have that much experience with physicians [00:08:00] growing up. But what really struck me when I say the word growing up is there's almost like this journey of grazing physicians. You know, we go to medical school, you know, you're a student and you learn. But then growing up to be a physician, for me that really the first day of internship, my residency director said, no matter what, the one thing you need to know is a person in front of you. See them like family and treat them like family. He said, they're your mother, your father, your [00:08:30] sister, your brother, your child, you know, your loved one. And to me, that forever has stuck in my mind. And fortunately I was able to be raised as a physician, so to speak, by different providers who showed that type of perspective. And that's the type of intention with which they went to work and with which they trained us. And that's what really stuck with me. That is beautiful.

Speaker 2: Thank you for sharing that.

Speaker 3: When you say, um, family, that implies relationship. [00:09:00] Can you talk a little bit about why a good relationship between a patient and a provider is extremely important?

Speaker 1: Yeah, absolutely. I learned the most, I think about relationship both as a mom and as a wife. But I would say any relationship, and this is the learning I've had character university, I've heard recently a term <laugh> is that safety, trust, acceptance, just to know that I matter, [00:09:30] you know, those are really foundational because that will allow for vulnerability, that will allow for honesty and that will allow for courage because it takes all of those components for me to say this is a good relationship. Those foundational elements between a patient and a physician of, do I feel safe? Do I feel seen? Do I feel heard? Can I speak up? Do this person care? Those are fundamental [00:10:00] for things like sharing my concerns, disclosing things I might be embarrassed about or I don't know if it's a bad question. In fact, there are no bad questions.

Speaker 1: But we start to think these things when we don't feel that it's safe to share or that it matters or that we're dismissed. And so the ability to share then lends itself to a physician being able to have the data points that they need. Because it's not just labs, it's [00:10:30] not just physical findings, it's really what is the story behind the person and what is that person going through? Where are they at? And so the ability for the physician to then take that information and create a full picture and see the patient as a whole person and then even a patient to trust the advice. Because there's many times where it'd be very difficult for a patient to trust the advice and the medical term is adhere to or compliance. But at the end of the day, that [00:11:00] means I'm gonna try out what the doctor told me to and then I'm gonna come back and I'm gonna let them know how it went. Those things are fundamental to wellbeing. So I think when we think about what is a successful or good relationship between a physician and a patient, I would say the way that we can know it's good is if there is the outcome of wellness. Hmm.

Speaker 2: I love this. And I'm wondering what are some of the ways that people might be able to test for some of these characteristics with the doctor?

Speaker 1: [00:11:30] Yeah, there's so much information and there's so many sources. I do love Health Grade's approach to keeping it simple. The framework is compatibility, experience, and quality. Those three things, if you have that trifecta, it's like having a stool. One of the legs are missing and it falls. And so I think that when it comes to how can I even begin to find that type of [00:12:00] relationship, we want to think about, well it's super important that I can relate to or feel that this is somebody I can be compatible with and then experience, does this person have deep experience in what I'm looking for at this time or what I need at this time? Because my needs will change as I change, as I get older, as I go through things. And then quality, there's a study health Grades has done that showed people will spend, you know, 40% more time looking for an [00:12:30] appliance and a physician. And I think part of that is we don't really know what to look for. Yeah, it's a great point. Quality is one of them because where a physician practices the hospitals that they practice at, they're not all the same. And so it's not just the who, it's also where they work. And so compatibility, experience and quality, those are three things that can help to narrow the search.

Speaker 3: I have a follow up question to that. When we talk about more nuanced searches for a physician or for [00:13:00] a doctor based on gender, people of color, lgbtq plus community, what are some of the challenges that you see in terms of finding a provider?

Speaker 1: Yeah, that's a really great question. There's a word called concordance. Concordance means I wanna work with somebody who looks like me. It's not everything, but I think that it is one factor that's important to many people. [00:13:30] Health grades has profiles for almost every doctor in America. They can choose to have a picture up so you can actually see what they look like. And Health Grades is coming out soon through a partnership with an organization called outcare to be able to identify or allow for self-identification of LGBTQ+ affirming providers. And so that's something really exciting is, you know, can people look for that as a characteristic or an attribute? [00:14:00] There is a limitation there because not that many providers are bipo or black, indigenous people of color. And there are even fewer providers who really understand the lgbtq, lgbtq plus needs. But we can make steps toward that.

Speaker 1: And then also, you know, reviews. <laugh> reviews are not all created equal. Cause inherently there's a lot of bias in reviews. However, we're human. And so if we don't have a huge community to ask, do do you recommend as a provider, [00:14:30] then we can leverage what people share. For example, in health grades, it's not just did you like not like them, but there's categories of they listened and answer questions. Mm-hmm. <affirmative>, the staff was friendly appointment scheduling, it was at a good or a no, right? They explained conditions well, the appointment wasn't rushed. There's even a category for long wait times, <laugh>, you know, or I trusted the provider's decisions. So these are different things that people can say yes or no to. That can be helpful because [00:15:00] if I'm somebody in a marginalized population, to me, even maybe more important than I'm Asian, they're Asian, it might be other people trusted this person's decisions, other people said this provider listened to me and answered my questions. And so breaking that down I think provides a helpful way to organize and internalize those reviews or those shared opinions to say, is this [00:15:30] who I might want to share and be vulnerable with?

Speaker 2: I love that. And you mentioned the designation for providers that support LGBTQ plus populations and I'm wondering if that's gonna expand at any point to be inclusive of other types of identities that people might be looking for.

Speaker 1: Yeah, absolutely. Al care is the pilot. Got it. Al care is the first. One of the limitations is that there's not that many organizations out there that vet to marginalized [00:16:00] populations. These are people of affirming care. But definitely that is the vision to be able to have more and more people identify with this person is affirming of the different aspects of what makes me who I am.

Speaker 2: And when we talk about affirming, does that mean education? Does that mean similar self-identity? Like talk to us a little bit about what that looks like.

Speaker 1: Yeah. In the medical world, we call it culturally competent. Mm-hmm. <affirmative>, there's an element [00:16:30] of openness, willingness, and interest. Got it. As well as education training, a lot of it has to do with I am interested in meeting the needs of this population. And what I've found is you either lean into differences and see the differences as opportunities to learn and connect on a different level and a more complex level. Or you are scared of different. [00:17:00] An example for myself where I practiced before, we had a large South Asian population, one of my patients had a continuous glucose monitor. I was like, oh, what's going on with this pattern? And I found out that he was a drummer and he was drumming at festivals and they were late at night. And so he was like, I'm drumming. I don't have good food choices. And that's what's happening when I'm at the festivals and some of my patients of Hispanic Latino culture, Christmas tamales, like I know this <laugh>. I wouldn't have [00:17:30] known that if they weren't willing to share. If I just say, oh, is it tamale time? Or for Koreans? Oh, it was New Year's. Did you have rice cake soup? They might be afraid I shouldn't be eating that. Mm-hmm. <affirmative>. But it's like, no, this is part of your culture. That is part of who we are as people. Yeah.

Speaker 2: I love that. Just being thoughtful of the whole person and yep. Not shaming people for their choices, but really, you know, being inclusive. I wanted to ask a question about user reviews. People either have a great experience or they have a terrible experience and so it's really hard to understand a middle ground. [00:18:00] How do you think about that? Mm-hmm.

Speaker 1: <affirmative>, yeah, over 50% or close to 50% of Americans will use health grades at some point looking for a provider. That's a huge number and that's a huge responsibility that we are helping people make decisions about where they're going to receive their care, who they're going to receive their care from. When I go online and I go to health grades, there's five star, four star, three star, two star, one star. And the percentage, [00:18:30] the overall rating. But then how that broke down. So there's a column for what went well, what didn't go well, how many people, how many votes were there in each of those categories. And so for myself, that makes it easier to kind of get a snapshot because it is challenging sometimes to just try to read through paragraphs Yeah. Of reviews and try to pick out what people thought was relevant or not.

Speaker 1: And so I think in terms of information sharing and kind of making meaning of the reviews, [00:19:00] it becomes easier. And that is something that I really resonate with as a mom. I heard on a parenting webinar, we are meaning makers for our children. And that's something that I realized retrospectively that as a physician, I was a meaning maker for my patients. Is this scary? Is this dangerous? Am I gonna be okay? I do appreciate that health grades tries to make meaning to assist [00:19:30] with and inform the consumer to feel confident that they are being empowered, they're making informed decisions. Yeah.

Speaker 2: The way that you speak about your work in the profession feels very like philosophical, spiritual almost to me. Especially your comment about the meaning making and translation. And that just makes me think about how we are meaning making machines and like how do we hold these different truths and think about that. And so I'm just wondering for you, is there like an overarching [00:20:00] philosophy or something that sort of guides that approach that you take?

Speaker 1: Yeah, I wanna thank you for that question. My daughter recently went on a field trip and there's a slogan, it says, experience is the teacher. And so for myself, as I experienced what it was to be so vulnerable and not to know, I didn't know what to do. And I remember telling my physician the one thing, this ship can't go down [00:20:30] cuz you know I cannot go down. Yeah. And I remember praying, I just need to be here long enough for my daughter to be independent. And when I personally hit that loss of health, I realized that impact is so huge. Yeah. Whether somebody is well and they're just preventing illness or they're really sick and they need your help, it's a sacred space to be able to look at someone [00:21:00] and say, you are coming to me for something that can impact your life. And I think that phrase, the impact of life is difficult to really comprehend until you've been at a space where you face the loss. And to really understand, wow, today I'm not short of breath today, I could walk the dog. And I think that that has shaped an overall life perspective for me. Mm. Also the [00:21:30] privilege speaking here with you both to be able to let people know those times come. Yeah. We can lean into those times of vulnerability and difficulty and uncertainty and we can make meaning of them as we choose. Yeah.

Speaker 2: I love it. I mean, you are like the doctor I wanna have, you know, and I'm sure everybody wants to have, and again, it's just these words of wisdom and humanness and holding space and compassion. And so I wonder for you if you have [00:22:00] any insight for some of our listeners who maybe don't have this type of relationship with their physician or their provider hasn't had some of the life experiences that you're talking about that have given you this sort of like gentleness and this sacredness through which you view your work. What would somebody be able to do to create a space where they can bring that part of themselves into the doctor's office?

Speaker 1: Yeah, that's a great question. It's hard to be yourself. It's hard to [00:22:30] be myself because there's always the chance that I will be misunderstood or dismissed or they don't care or it doesn't matter. But I would say it's so important, especially the person wearing the coat or the stethoscope or with the hands on the keyboard. It's especially difficult because that is a position of power and it's hard to see that person maybe also as a human [00:23:00] being, but they are human beings. If people can have the courage to bring themselves into those moments and share who they are, the more that you can open up or share something that's important to you, the more you will have the opportunity to create connection. Cause I think that is probably the key is can we connect at some level so that you can hear me and I can hear you.

Speaker 3: [00:23:30] You referenced choice several times in the conversation. People change, you know, places of worship or schools for their children all the time. My question to you is, when people feel that it's time for them to go get another physician, how would you advise them?

Speaker 1: Yeah, that's a great question. In fact, as a physician, I try to reassure my patients I'm not offended. [00:24:00] And in fact, sometimes I recommend it. Why don't we get another opinion? The doctors I trust are the doctors that know what they know and then know what they don't know. And we can't know everything. And we can't be everything to everybody. And sometimes it's not a knowledge issue, it's a personality issue or a connection issue. There's something to be said for do I feel comfortable with this person? Mm-hmm. <affirmative>. And so I think that it's so important for people. We can call ourselves patients, [00:24:30] we can call ourselves consumers, but know that we have the choice. It's so important to be able to say, mm, I don't know if this is working well or I just wanna double check. You don't have to tell your provider.

Speaker 1: It's not a betrayal if you do or you don't. If you go to another doctor, you are advocating for yourself. You can get your own records. That is your information. You want to [00:25:00] bring your story with you and then present that. Because every touch along the way is going to help build that story and make that second opinion or that change super helpful. And also when you meet the other provider, let them know, this was my experience and this worked, this didn't work. I'm here. Because again, these are essential parts of the information. You can call it data, just [00:25:30] as important as that lab number on that sheet might be to know you were scared. Mm-hmm. <affirmative>, you didn't feel heard or you couldn't even let them know, I'm just here for a second opinion, I love my doctor. Whatever the case, just understand that the choice is yours. And the most important thing is to understand that if your intention is to be, well, hold on to that, like the north star. Mm.

Speaker 3: I love that. And you get at expectation setting. [00:26:00] And you know, I mean that's something that's been talked a lot about on the physician side in terms of proper expectation setting. But I think it's also important for the patient as well. What are the expectations here? What is everybody looking to accomplish? And let's find out if we're both in a position to accomplish those things. I really appreciate the way you put that. So why don't we go into the lightning round? Callie, you usually jump these off, but I'll give the first question this [00:26:30] time. We'll start with what gives you hope?

Speaker 1: I think being here with you both now, two years ago, I would not have imagined myself here. So the fact that I can be here, share my story, maybe give hope to somebody else that is truly amazing and something I wouldn't have thought possible.

Speaker 2: What is something new that you've learned recently?

Speaker 1: Growth is non-linear. I have always expected growth to be [00:27:00] just one way. And if things are not changing then things are broken. But we were driving home from school and I saw a field next to us and it had all these cabbages in it. And I go, where did those come from? They weren't there a week ago. And I realize often growth is happening even when we don't see it. And we may not see it until the rains have finished and the sun's now out. But growth is there. Mm-hmm.

Speaker 3: <affirmative>. And then who's inspired you or had a big [00:27:30] impact on who you are today?

Speaker 1: I would say my daughter. She inspires me every day to be better, to grow, to have compassion, and to have self compassion. And she inspires me to stretch and to find joy in every moment.

Speaker 3: That's awesome.

Speaker 2: Beautiful. Thank you so much for joining us. This was such a great conversation.

Speaker 1: Oh, thank you. Thank you both.

Speaker 3: [00:28:00] It was interesting with Dr. Reid that it was being a patient that made her really reflective and grounded and set her up for the career that she has right now. I thought that was interesting.

Speaker 2: Yeah. I really felt like she had a very spiritual, like deeply connected to humanity perspective. Yep. That also was grounded in her own experiences. And [00:28:30] I think that humanity is something that when it comes into the four walls of a clinic, it just, it makes the biggest difference. Yeah. I really appreciated where she was coming from and it also just made me reflect on, yeah, if more doctors could have this orientation to their work and feel connected to that, even in the midst of how complicated this system is and how many things doctors are responsible for doing in a day, I think that would really change the experience that people [00:29:00] have. And then to your point, it's like that changes the trust that potentially changes a bunch of other things in people's lives and the experience that they have with their health. And I think that's really powerful.

Speaker 3: Yeah. You talked about the human element, which is so huge, and I think that's extremely insightful from a patient perspective, is remembering that their physician is a human on the other side and everybody wants to finish at the end of the day and get home or go exercise or go to happy hour or go to their kids' game or just go read [00:29:30] a book or whatever. Right.

Speaker 2: Yeah. This is really helpful to understand the other perspective. And I learned a lot in this episode and I really appreciated this conversation. So next weekend, our bonus episode, we'll talking about the one thing you can do today to develop a better and more transparent relationship with your doctor and care team. That's it for today. Thank you for listening.

Speaker 3: Make sure to follow up, subscribe wherever you listen so you can get notified when a new episode is live. Catch you next time.