Join today's episode's host, Dr. Rojas, along with her guests Dr. Grunch, Dr. McCutchen and Dr. McDonald, as they share their experiences as women working in medicine. Together they explore the triumphs, challenges, and insights that they've experienced breaking gender barriers in healthcare. Anything and everything is up for discussion from diversity and empowerment to work-life balance.
Tune in for an inspiring and empowering conversation that celebrates the achievements of women in healthcare.
You can also watch the full podcast episode here on YouTube!
Thank you for listening to our podcast! If you have a topic you would like us to discuss, please visit nghs.com/podcast.
Follow us on Instagram and Facebook!
Join today's episode's host, Dr. Rojas, along with her guests Dr. Grunch, Dr. McCutchen and Dr. McDonald, as they share their experiences as women working in medicine. Together they explore the triumphs, challenges, and insights that they've experienced breaking gender barriers in healthcare. Anything and everything is up for discussion from diversity and empowerment to work-life balance.
Tune in for an inspiring and empowering conversation that celebrates the achievements of women in healthcare.
You can also watch the full podcast episode here on YouTube!
Thank you for listening to our podcast! If you have a topic you would like us to discuss, please visit nghs.com/podcast.
Follow us on Instagram and Facebook!
Episode: Trailblazers in White Coats: Women Redefining Medicine
00:00:08 Dr. Erine Raybon-Rojas
Hello and welcome to the Health Perspective podcast.
00:00:12 Dr. Erine Raybon-Rojas
We are coming to you from beautiful Gainesville, GA and I am your host doctor Aaron Raymond Rojas.
00:00:18 Dr. Erine Raybon-Rojas
I am a pulmonary intensivist director of diversity.
00:00:20 Dr. Erine Raybon-Rojas
Equity and inclusion for graduate medical education, and I have some fantastic guests here today.
00:00:26 Dr. Erine Raybon-Rojas
I have a lot of girl power in the room, so I'm just going to go around and introduce who we have here.
00:00:32 Dr. Erine Raybon-Rojas
Today doctor April McDonald, we have Doctor Betsy Grunch and we have Doctor Asia Mccutchen.
00:00:38 Dr. Erine Raybon-Rojas
I am super excited to have these ladies here.
00:00:41 Dr. Erine Raybon-Rojas
They took some time out from their busy schedule so that we can speak to you guys, our GMA community, our employees and our community at large that we have the privilege of serving.
00:00:52 Dr. Erine Raybon-Rojas
To let you know our perspective on some issues that could be really important.
00:00:58 Dr. Erine Raybon-Rojas
To you so it.
00:00:59 Dr. Erine Raybon-Rojas
Is lady doctors talking about lady issues?
00:01:03 Dr. Erine Raybon-Rojas
Alright, so I did a brief introduction of my guests, but I want to give them an opportunity to toot their own horns, so I'm going to start with doctor April MacDonald and let her introduce herself.
00:01:14 Dr. April Mcdonald
Hello everyone so I'm April McDonald.
00:01:18 Dr. April Mcdonald
I'm a pulmonary critical care and interventional pulmonologist.
00:01:24 Dr. Erine Raybon-Rojas
How many board certifications is that?
00:01:27 Dr. April Mcdonald
So therefore, including internal medicine as well, that's right.
00:01:33 Dr. Erine Raybon-Rojas
And Doctor Betsy Grinch.
00:01:35 Dr. Betsy Grunch
I'm Betsy grunch.
00:01:36 Dr. Betsy Grunch
I am a board certified neurosurgeon and I did a fellowship in spine surgery.
00:01:42 Dr. Erine Raybon-Rojas
Fantastic. And doctor Adrian McCutcheon.
00:01:45 Dr. Aja McCutchen
Thank you, Doctor Rojas.
00:01:46 Dr. Aja McCutchen
My name is Doctor Asia Mccutchen.
00:01:48 Dr. Aja McCutchen
I am a gastroenterologist.
00:01:51 Dr. Aja McCutchen
And I serve as the national chair for Diversity, Equity and inclusion for independent GI.
00:01:57 Dr. Aja McCutchen
And I also serve as the vice chair of the American Research Foundation for the American Gastroenterology Association, period.
00:02:06 Dr. Erine Raybon-Rojas
So as you can see, we have a lot of talent at this table today.
00:02:10 Dr. Erine Raybon-Rojas
So we are really going to.
00:02:11 Dr. Erine Raybon-Rojas
Get into it.
00:02:12 Dr. Erine Raybon-Rojas
So today we're going to be talking about be competitive.
00:02:15 Dr. Erine Raybon-Rojas
Disciplines within GM E and really the lack of women representation that we're seeing across the field.
00:02:25 Dr. Erine Raybon-Rojas
We're also going to be talking about some issues that are related to being a physician, a woman, physician, practicing women physician.
00:02:34 Dr. Erine Raybon-Rojas
So we are going to just.
00:02:36 Dr. Erine Raybon-Rojas
Jump right in.
00:02:37 Dr. Erine Raybon-Rojas
So the first question that I want to ask Doctor Grunch, I want you to give me the breakdown of how many colleagues.
00:02:50 Dr. Erine Raybon-Rojas
You work with that have working fallopian tubes and ovaries, IE women.
00:02:59 Dr. Betsy Grunch
In this area at our institution, I'm the only one in the United States. There are about 3500 to 4000 board certified neurosurgeons and out of that there are only 219 that are women. Wow.
00:03:16 Dr. Erine Raybon-Rojas
How about women of?
00:03:17 Dr. Betsy Grunch
Color women of color. There are 33, so that is .5% of all practicing. Neurosurgeons are women of.
00:03:25 Dr. Erine Raybon-Rojas
Color and I want to get your perspective on why you.
00:03:30 Dr. Erine Raybon-Rojas
Think that is.
00:03:32 Dr. Betsy Grunch
I think it's, you know, an incredibly competitive specialty that is not really.
00:03:41 Dr. Betsy Grunch
Attractive to women.
00:03:44 Dr. Betsy Grunch
I think by nature a surgical sub specialty like neurosurgery is just thought of as a male dominated field and and in that in that environment women as medical students are.
00:04:01 Dr. Betsy Grunch
You know, you shouldn't do neurosurgery.
00:04:03 Dr. Betsy Grunch
I can't even tell you how many times that I should do that.
00:04:05 Dr. Betsy Grunch
You can't do that and have a family.
00:04:06 Dr. Betsy Grunch
You can't go in a surgical field and and and have a happy life.
00:04:12 Dr. Betsy Grunch
So why are you even doing that?
00:04:13 Dr. Betsy Grunch
And so I think the more you hear that, the more you really internalize those feelings and think, why am I, why do I want to do that?
00:04:19 Dr. Betsy Grunch
I don't want to do that, and so the more you hear it, the more it just kind of, you know, gets in your brain that that you can and so really takes.
00:04:26 Dr. Betsy Grunch
A certain breed.
00:04:28 Dr. Betsy Grunch
Of a person to really push beyond that to to to push the boundaries.
00:04:34 Dr. Betsy Grunch
I think we're getting better, but I think it's going to take, you know, a lot of of of ingraining that into women that that is not really true.
00:04:43 Dr. Betsy Grunch
I mean, you can have a work life balance in any specialty and I think it's important to know that there are plenty of women in my field.
00:04:51 Dr. Betsy Grunch
That that do it all the time so.
00:04:55 Dr. Erine Raybon-Rojas
What made you pick neurosurgery?
00:05:00 Dr. Betsy Grunch
No, I so I actually grew up in this area and my mom was a police officer.
00:05:09 Dr. Betsy Grunch
This is in the 90s.
00:05:10 Dr. Betsy Grunch
And so at that time, women in law enforcement were extremely rare unicorns.
00:05:14 Dr. Betsy Grunch
And I just was.
00:05:18 Dr. Betsy Grunch
Really, I just.
00:05:19 Dr. Betsy Grunch
I thought she was so cool.
00:05:22 Dr. Betsy Grunch
She always inspired me to, you know, being in a male dominated field.
00:05:26 Dr. Betsy Grunch
She always told me, you know, you can do anything you want to do, Betsy, like, growing up.
00:05:30 Dr. Betsy Grunch
And so I I really want to emulate her.
00:05:31 Dr. Betsy Grunch
I just thought.
00:05:33 Dr. Betsy Grunch
You know what she did was very empowering and and what the community needed and help people.
00:05:39 Dr. Betsy Grunch
She's very passionate about her job, and then when I was 13 years old, she was injured in a line of duty.
00:05:46 Dr. Betsy Grunch
She was shot at her vehicle, shot at and she was instantly paralyzed in a car.
00:05:51 Dr. Betsy Grunch
Incident about four miles from here.
00:05:54 Dr. Betsy Grunch
So she she was quadriplegic and I really wanted to understand.
00:06:00 Dr. Betsy Grunch
Why that happened?
00:06:01 Dr. Betsy Grunch
I really wanted to fix people like her.
00:06:04 Dr. Betsy Grunch
I wanted to fix her, so I worked with her neurosurgeon here and shadowed him in high school.
00:06:11 Dr. Betsy Grunch
And just really, you know, I I told myself and said I don't want to.
00:06:16 Dr. Betsy Grunch
I don't want to be a police officer anymore.
00:06:18 Dr. Betsy Grunch
I want to I want to be a doctor.
00:06:19 Dr. Betsy Grunch
I want to.
00:06:19 Dr. Betsy Grunch
I want to.
00:06:20 Dr. Betsy Grunch
I want to help people like her.
00:06:21 Dr. Betsy Grunch
To learn about neurosciences, I want to learn about spinal cord injury, and so that's that's kind of where it started.
00:06:28 Dr. Erine Raybon-Rojas
Doctor April McDonald, first of all, I want you to tell our audience what exactly is an interventional pulmonologist so.
00:06:40 Dr. April Mcdonald
It's a subset of pulmonary pulmonary medicine where we use minimally invasive techniques.
00:06:48 Dr. April Mcdonald
In order to 1 diagnose various lung pathologies, but also to intervene in therapeutic and perform therapeutics on these into these blowing and plural diseases.
00:07:04 Dr. Erine Raybon-Rojas
I have known all of these people for several years, but for specifically Doctor McDonald, just for the community at large to know what a skill set that we have in her, the type of procedures that she offers and the and the level of care that she provides to this community.
00:07:24 Dr. Erine Raybon-Rojas
Our community here in Gainesville, honestly, you have to drive to Atlanta to get her skill set.
00:07:30 Dr. Erine Raybon-Rojas
So we are very, very fortunate and privileged to have her here with us.
00:07:34 Dr. Erine Raybon-Rojas
So my question for you, Doctor McDonald, how do you think exposure changes?
00:07:42 Dr. Erine Raybon-Rojas
A Med student or a residents perspective of what they see or what they think that they become, can become as an attending physician.
00:07:54 Dr. April Mcdonald
Exposure is key.
00:07:57 Dr. April Mcdonald
You know, the more that those physicians or physicians in training see people who reflect them.
00:08:08 Dr. April Mcdonald
In sub specialties that are not traditionally thought to be, include them gives them the opportunity to say you know I can do it, I can become, you know, the neurosurgeon or the gastroenterologist or the interventional pulmonologist or whatever else is usually traditionally thought of as male dominated.
00:08:30 Dr. April Mcdonald
I think that our presence is of the utmost importance in all of these these fields.
00:08:38 Dr. Erine Raybon-Rojas
Alright, doctor McCutcheon.
00:08:41 Dr. Erine Raybon-Rojas
So tell us a little bit about what you specialize in gastroenterology and then I'll have a follow up question.
00:08:48 Dr. Aja McCutchen
For you. OK, perfect.
00:08:51 Dr. Aja McCutchen
So I am in the field of gastroenterology, but I specialize in two areas, one is Women's Health. So specifically looking at challenges with the pelvic floor and continents where you don't have control over your bowels, Constipation and bloating, that's a big.
00:09:12 Dr. Aja McCutchen
And who amongst a lot of my female patients?
00:09:15 Dr. Aja McCutchen
And I'm also an inflammatory bowel disease specialist.
00:09:19 Dr. Aja McCutchen
And So what is that so inflammatory bowel disease is a chronic condition.
00:09:23 Dr. Aja McCutchen
It comes and goes, so we call it a relaxing and remitting condition of the intestines.
00:09:29 Dr. Aja McCutchen
And it is what we.
00:09:30 Dr. Aja McCutchen
Consider an immune dysregulation disorder.
00:09:34 Dr. April Mcdonald
It is a.
00:09:35 Dr. Aja McCutchen
Disease or disease where the immune system is not regulated it.
00:09:42 Dr. Aja McCutchen
We used to think of it as an autoimmune disease where the body was sort of quote, attacking itself, but we have.
00:09:48 Dr. Aja McCutchen
Since changed our.
00:09:49 Dr. Aja McCutchen
Thought process and it.
00:09:51 Dr. Aja McCutchen
Seems more like the immune system is just not regulated in a fashion that is compatible with somebody having sort of an optimal gut.
00:10:01 Dr. Aja McCutchen
Experience, if you will.
00:10:03 Dr. Erine Raybon-Rojas
Thank you for that explanation.
00:10:05 Dr. Erine Raybon-Rojas
So my question for you, when we talk about.
00:10:10 Dr. Erine Raybon-Rojas
Quote UN quote competitive disciplines amongst you know ourselves as physicians. What does that mean to you? What does competitive discipline mean to you?
00:10:21 Dr. Aja McCutchen
Competitive discipline means that you probably need to be in the top of your class to actually get a spot, and not only that, but you probably need to have done work outside of sort of the traditional spectrum of what is expected.
00:10:41 Dr. Aja McCutchen
And you need to have high high letters of recommendation, so people need to highly recommend you for the that particular specialty.
00:10:50 Dr. Aja McCutchen
And when I think of a competitive specialty, I also think of sort of you know in terms of ratios that the number of applicants is going to be disproportionate, disproportionately high to the number of available positions.
00:11:08 Dr. Erine Raybon-Rojas
All right, Doctor McCutcheon.
00:11:09 Dr. Erine Raybon-Rojas
So there have been so many studies and so much dialogue.
00:11:13 Dr. Erine Raybon-Rojas
About patient outcomes and what we can do to optimize patient outcomes.
00:11:19 Dr. Erine Raybon-Rojas
And there was a really interesting article that came out that was talking about patient outcomes.
00:11:24 Dr. Erine Raybon-Rojas
Specifically, I believe women, the outcomes for women when they are taken care of by women physicians.
00:11:30 Dr. Erine Raybon-Rojas
Can you speak to that a little bit, doctor Mccutchen?
00:11:33 Dr. Aja McCutchen
We I'll start by saying that I don't think any of us were surprised by that data. As women, we wear many hats in any given week, even if we have very helpful spouses or partners. We have about 8 1/2 more hours of administrative or home duties that we're responsible.
00:11:54 Dr. Aja McCutchen
And so I think that translates as well in the office and there's been multiple studies that have shown that we have significantly more tasks in paperwork to be frank, as it relates to taking care of our patients.
00:12:01
OK.
00:12:07 Dr. Aja McCutchen
But I think you know, as women.
00:12:10 Dr. Aja McCutchen
We are also a.
00:12:11 Dr. Aja McCutchen
Unique population with unique needs and we have a unique journey.
00:12:15 Dr. Aja McCutchen
And we're able to share that journey and translate that empathy and to the care that we provide for our patients.
00:12:21 Dr. Aja McCutchen
So in this particular article, the the stats were that.
00:12:26 Dr. Aja McCutchen
Patients that were taken care of by a female surgeon versus a male surgeon were 32% less likely to die and 16% less likely to experience complications now, not to knock our male counterparts. But I think this was really highlighting the fact that we have made a mark.
00:12:48 Dr. Aja McCutchen
And our presence should be respected.
00:12:50 Dr. Aja McCutchen
We all, whether we're male, female, cisgender, female, whatever we are, we bring something special to our respective work.
00:13:00 Dr. Aja McCutchen
Places and you know, when we look at ageism and everything else that is happening in the workplace, it's kind of sad because what makes the world so special and in such an enjoyable place is diversity.
00:13:17 Dr. Aja McCutchen
And to bring that diversity into the into the workplace and have it embrace.
00:13:22 Dr. Aja McCutchen
And and actually for people to feel like they can sort of live their best lives and find love and work is essential.
00:13:31 Dr. Erine Raybon-Rojas
And that translates based on this paper, into improved outcomes.
00:13:35 Dr. Erine Raybon-Rojas
We have talked about.
00:13:37 Dr. Erine Raybon-Rojas
Darker Mccutchen brought us some great stats, and we talked about how.
00:13:41 Dr. Erine Raybon-Rojas
Diversity has a positive impact on patient outcomes, but we all here have our own personal experience coming up through training.
00:13:51 Dr. Erine Raybon-Rojas
So I want to for you to give me a scenario where you've encountered some.
00:13:59 Dr. Erine Raybon-Rojas
Situation that was less than appealing to you that that, you know was from you being a female physician, how you navigated it and the last follow up after that is I want you to give advice to the younger you coming up next.
00:14:15 Dr. Betsy Grunch
Oh, those are good questions.
00:14:16 Dr. Betsy Grunch
I could talk for a long time about that.
00:14:19 Dr. Betsy Grunch
So in terms of, you know, challenging experience, I mean, I think as female physicians we run into this like almost.
00:14:27 Dr. Betsy Grunch
Probably every day, but a situation that happens to me commonly, you know, as I'm in, I'm in a patient room seeing a seeing a console or something, which is kind of an unfamiliar territory to colleagues, I guess and.
00:14:44 Dr. Betsy Grunch
You know I.
00:14:45 Dr. Betsy Grunch
As a surgeon.
00:14:46 Dr. Betsy Grunch
I'm always in my scrubs, rarely wear a white coat, have my badge on, but I have I in the room talking to a patient.
00:14:56 Dr. Betsy Grunch
And another physician would can come into the room and, you know, automatically starts talking to the patient over talking me, assuming that, you know, I'm not a physician.
00:15:08 Dr. Betsy Grunch
I am someone else that's in the room, either family or a different, you know, a nurse or respiratory therapist or what.
00:15:16 Dr. Betsy Grunch
Have you and so those situations are always kind of interesting to kind of overcome or to to discuss like, hey, I'm I'm actually interviewing the.
00:15:28 Dr. Betsy Grunch
Another you know another situation that we run into and I think probably all of us have experienced this and this happened to me when I was just starting is I get a patient on call and and the patient doesn't want me as their doctor.
00:15:45 Dr. Betsy Grunch
They want a male male surgeon.
00:15:47 Dr. Betsy Grunch
And I've been told that many.
00:15:48 Dr. Betsy Grunch
Lines I either directly by the patients family or indirectly by.
00:15:54 Dr. Betsy Grunch
Having a nurse?
00:15:55 Dr. Betsy Grunch
Call me that they want a different they.
00:15:56 Dr. Betsy Grunch
They want a male surgeon and that that has not, I will say that it's not happening in a long time, but when you first start and you're unfamiliar to the community and to the area, I mean that that happened me several times.
00:16:08 Dr. Betsy Grunch
And so navigating those situations.
00:16:10 Dr. Betsy Grunch
Are are always challenging.
00:16:11 Dr. Betsy Grunch
Fortunately, I have excellent partners that help me navigate that situation successfully, but but yeah.
00:16:19 Dr. Erine Raybon-Rojas
So it sounds like you know it.
00:16:21 Dr. Erine Raybon-Rojas
You know, I'm sure we all have that collective experience, but it sounds like, you know, your your partners really.
00:16:29 Dr. Erine Raybon-Rojas
Having your back and you know, standing with you beside you has been helpful in, you know, making sure that you create the space for yourself to be the fantastic neurosurgeon that you are.
00:16:44 Dr. Erine Raybon-Rojas
Right.
00:16:44 Dr. Erine Raybon-Rojas
That you, MacDonald, same question.
00:16:47 Dr. Erine Raybon-Rojas
You may repeat the question.
00:16:48 Dr. Erine Raybon-Rojas
I can, if I remember it.
00:16:52 Dr. April Mcdonald
So I think what I've noticed or what I noticed early on when I was first starting out, my practice is just the idea of having to prove myself.
00:17:05 Dr. April Mcdonald
And so I would enter into spaces where you know I'm the.
00:17:09 Dr. April Mcdonald
At this point I'm done with training, and so I.
00:17:12 Dr. April Mcdonald
Yeah, I was the the, you know, the interventional pulmonologist and yet.
00:17:17 Dr. April Mcdonald
My my management, my you know what the plan was in regards to the procedure were questioned by nursing by the tech, by the anesthesiologist.
00:17:30 Dr. April Mcdonald
Everyone questioned and said, you know, do you think?
00:17:33 Dr. April Mcdonald
You can do.
00:17:33 Dr. April Mcdonald
This or you?
00:17:34 Dr. April Mcdonald
Know should we be doing this or do we need?
00:17:36 Dr. April Mcdonald
To check with the surgeon about this.
00:17:40 Dr. April Mcdonald
It was challenging at first.
00:17:42 Dr. April Mcdonald
You know, I think that if I didn't have the wherewithal of about myself and my own skills and and confidence in knowing that I know what I know and I know how to do what I do.
00:17:53 Dr. April Mcdonald
Then, you know, I certainly could have been or felt defeated in that in those situations.
00:18:00 Dr. April Mcdonald
But what I say to all women, you know, those who are just starting out or who are are in their field and you know, sometimes feel that discouragement, you know, you just have to.
00:18:09 Dr. April Mcdonald
You know that you're here for a reason.
00:18:11 Dr. April Mcdonald
You're here for a purpose.
00:18:12 Dr. April Mcdonald
You are there to shine.
00:18:14 Dr. April Mcdonald
You're there to bring quality care to your patient.
00:18:17 Dr. April Mcdonald
And so all of that noise that tries to distract you from your mission and your goal and what you need to do, just, you know, build, pull from whatever is in.
00:18:29 Dr. April Mcdonald
Inside and and keep going because you are.
00:18:32 Dr. April Mcdonald
There is no mistake that you are where.
00:18:34 Dr. April Mcdonald
Are in your journey.
00:18:36 Dr. Betsy Grunch
Absolutely, that's 100% correct. I think those feelings of impostor syndrome start to get in your head, and I think you have to internalize that and realize that you, you, you belong here and.
00:18:48 Dr. Erine Raybon-Rojas
And that you're just as skilled as the person next to.
00:18:51 Speaker 5
Or more exactly, Doctor McCutcheon.
00:18:56 Dr. Aja McCutchen
I I'd like to echo what everybody else has said.
00:18:59 Dr. Aja McCutchen
I think within our respective fields and in medicine in general, there are, in addition to being questioned about what you're doing, being questioned about your skill set.
00:19:12 Dr. Aja McCutchen
There is a double standard and that double standard exists not only internally, but also externally.
00:19:19 Dr. Aja McCutchen
So if you go online and you look at reviews, it's she won't stand and you know, acted like she knew me or what I was going through or what I was experiencing.
00:19:31 Dr. Aja McCutchen
I would hope that I walk in with confidence, right?
00:19:35 Dr. Aja McCutchen
And if I were a male?
00:19:37 Dr. Aja McCutchen
Then you would want me.
00:19:38 Dr. Aja McCutchen
To walk in with confidence, but.
00:19:41 Dr. Aja McCutchen
It it's the double standards is.
00:19:43 Dr. Aja McCutchen
The historically, there's been some behaviors that have been accepted from our male counterparts that were, if we were to dare to behave in a way that.
00:19:58 Dr. Aja McCutchen
Involved, you know, mishandling instruments or whatever it is, we will be reprimanded and it would be a serious reprimanding.
00:20:08 Dr. Aja McCutchen
And I think you know I.
00:20:09 Dr. Aja McCutchen
And education time, all of these things have improved, but they have not completely been eliminated.
00:20:17 Dr. Aja McCutchen
So it it's the double standards that I think I still continue to have a challenge with.
00:20:25 Dr. Aja McCutchen
I think as after lunch alluded to, you know over time.
00:20:30 Dr. Aja McCutchen
People begin to know you.
00:20:31 Dr. Aja McCutchen
They know your skill set.
00:20:32 Dr. Aja McCutchen
You're not questioned as much, but it's the undertones, and sometimes it's the undercurrent that kills and.
00:20:39 Dr. Aja McCutchen
So so you know, you have to sort of, you know you again you like, Doctor McDonald said you have to fix.
00:20:45 Dr. Aja McCutchen
Yourself up every day.
00:20:48 Dr. Aja McCutchen
Find a trusted group of people they don't have to be women.
00:20:52 Dr. Aja McCutchen
We probably have all been very fortunate to identify male mentors and sponsors, because if I didn't have male mentors and sponsors, I certainly wouldn't be sitting in some of the positions that I've been fortunate enough to be a part of and that I've been able to contribute.
00:21:10 Dr. Aja McCutchen
To have a voice and be the voice of change.
00:21:13 Dr. Aja McCutchen
But yeah, it it's the double standards.
00:21:15 Dr. Aja McCutchen
OK, those were great answers.
00:21:17 Dr. Erine Raybon-Rojas
So Doctor Grunch and then Dr.
00:21:22 Dr. Erine Raybon-Rojas
I, doctor Grunch, I want to follow up with the question advice to the many me that you.
00:21:27 Dr. Erine Raybon-Rojas
Have at home.
00:21:29 Dr. Betsy Grunch
I think just to echo along the same same lines.
00:21:33 Dr. Betsy Grunch
You know, I think as women, we tend to internalize our feelings a lot and and and want to let our inner thoughts come in.
00:21:42 Dr. Betsy Grunch
And and I I you know, mentioned impostor syndrome or feeling like you don't belong.
00:21:46 Dr. Betsy Grunch
You don't deserve there don't deserve to be there or something that I I think we do as as women.
00:21:53 Dr. Betsy Grunch
And then we hear these undertones, we hear, you know, these double standards.
00:21:58 Dr. Betsy Grunch
And then we question ourselves and I think that I would tell my.
00:22:01 Dr. Betsy Grunch
Younger self that.
00:22:02 Dr. Betsy Grunch
Hey, I mean, you worked your **** off to get where you're at and you belong here.
00:22:09 Dr. Betsy Grunch
Have to question yourself.
00:22:10 Dr. Betsy Grunch
You shouldn't have to.
00:22:11 Dr. Betsy Grunch
You feel like you have to prove.
00:22:13 Dr. Betsy Grunch
Yourself, so that would be it.
00:22:16 Dr. Erine Raybon-Rojas
Doctor McCutcheon advice for your younger self.
00:22:19 Dr. Erine Raybon-Rojas
And let let let me.
00:22:23 Dr. Erine Raybon-Rojas
Advice for your younger self going to college?
00:22:27 Dr. Erine Raybon-Rojas
I want to make it.
00:22:28 Dr. Erine Raybon-Rojas
Real specific for you because.
00:22:29 Dr. Aja McCutchen
And mine for my younger self going to college.
00:22:34 Dr. Erine Raybon-Rojas
If there's one piece of advice that you could go back and be like, ah.
00:22:40 Dr. Erine Raybon-Rojas
You know now that you wish, you would have known then that.
00:22:43 Dr. Erine Raybon-Rojas
You could share.
00:22:44 Dr. Erine Raybon-Rojas
College before you, before you.
00:22:48 Dr. Erine Raybon-Rojas
You know, before you even entered Med school, before you've gone on this.
00:22:51 Dr. Erine Raybon-Rojas
Trajectory like when you're.
00:22:53 Dr. Aja McCutchen
At that, got it.
00:22:54 Dr. April Mcdonald
You know, I I think.
00:22:55 Dr. Aja McCutchen
That college is a stepping stone.
00:22:58 Dr. Aja McCutchen
I think college is sort of where you.
00:23:01 Dr. Aja McCutchen
You can make mistakes.
00:23:03 Dr. Aja McCutchen
That's the time to make mistakes.
00:23:04 Dr. Aja McCutchen
I don't know if I allowed myself to make enough mistakes at that time.
00:23:09 Dr. Erine Raybon-Rojas
OK.
00:23:10 Dr. Aja McCutchen
I think I was fairly rigid.
00:23:12 Dr. Aja McCutchen
I think I was focused.
00:23:14 Dr. Aja McCutchen
I'm not saying I went to University of Georgia.
00:23:16 Dr. Aja McCutchen
Saying I didn't.
00:23:19 Dr. Aja McCutchen
I didn't say that.
00:23:21 Dr. Aja McCutchen
But I don't think that I allowed myself to, uh, sort of interact with as many people from a relationship standpoint.
00:23:30 Dr. Aja McCutchen
I was later laser focused on going to Med school.
00:23:34 Dr. Aja McCutchen
I don't know.
00:23:35 Dr. Aja McCutchen
That I had an opportunity to even fully understand or explore myself.
00:23:39 Dr. April Mcdonald
Who you were, OK?
00:23:40 Dr. Aja McCutchen
Who I am.
00:23:41 Dr. Aja McCutchen
As a person, and I just wish I spent a little bit more time doing that.
00:23:45 Dr. Aja McCutchen
And I also wish that I had an opportunity to travel abroad during that time, just to really understand different cultures.
00:23:54 Dr. Aja McCutchen
Because that early exposure, I think changes your lens OK quicker than it had, you know, then sort of doing it later and maybe not even major.
00:24:05 Dr. Aja McCutchen
And I was an honors chemistry major.
00:24:07 Dr. Aja McCutchen
I love the program.
00:24:09 Dr. Aja McCutchen
But just exploring something else because once you are.
00:24:12 Speaker 5
A chemistry major.
00:24:14 Speaker 5
So you took pecan?
00:24:17 Speaker 5
Oh, I loved pecan pecan.
00:24:24 Dr. April Mcdonald
Ohh chemistry, no one only.
00:24:28 Speaker 6
I got once I got out of organic.
00:24:28 Dr. Betsy Grunch
Thing I ever got was organic.
00:24:33 Dr. Erine Raybon-Rojas
Was like goodbye chemistry, but go ahead.
00:24:37 Dr. Aja McCutchen
Yeah, so having an opportunity to, I mean I, you know a history major cuz you can.
00:24:41 Dr. Aja McCutchen
Major in anything?
00:24:43 Dr. Aja McCutchen
And it just broadens your perspective and so you know, we all come from a specific background.
00:24:48 Dr. Aja McCutchen
We all have our inner trusted circle and then we have our communities.
00:24:52 Dr. Aja McCutchen
But broadening that and allowing myself.
00:24:54 Dr. Aja McCutchen
To explore, make some mistakes, give it a little more grace.
00:24:58 Dr. Aja McCutchen
That's what I would tell my younger self.
00:25:00 Dr. Erine Raybon-Rojas
I love it.
00:25:01 Dr. Erine Raybon-Rojas
Yeah, I love.
00:25:05 Dr. Erine Raybon-Rojas
Talking more about healthcare disparities and and and healthcare inequities.
00:25:13 Dr. Erine Raybon-Rojas
What are some common?
00:25:20 Dr. Erine Raybon-Rojas
Situations or issues that you see come up in your patients.
00:25:25 Dr. Erine Raybon-Rojas
Specifically your your female patients that you wish was talked about more in your prospective disciplines.
00:25:32 Dr. Erine Raybon-Rojas
I will start with you.
00:25:36 Speaker 5
So I think.
00:25:38 Dr. Betsy Grunch
In my specialty, back pain is something that a lot of people experience. I mean, 90% of Americans will have back pain at some point in their life. But I think as women, I think often pain is overlooked or thought as being somewhat normal.
00:25:57 Dr. Betsy Grunch
And particularly in the the pregnant population and the, you know, back pain is something almost every single woman in pregnancy experiences.
00:26:05 Dr. Betsy Grunch
Is and and and and even persistent after delivery.
00:26:11 Dr. Betsy Grunch
I think I recently did a podcast talking with a lactation consultant about pregnancy and back pain and postpartum care.
00:26:20 Dr. Betsy Grunch
We we don't really take good care of our backs during that period.
00:26:25 Dr. Betsy Grunch
Where we're weak from our core from.
00:26:27 Dr. Betsy Grunch
You know diastasis from just the abdominal wall being weak, pelvic floor being weak from delivery and then we're having to care for a newborn, bending, picking up things, doing things that we're naturally not doing, changing diapers and and and and back pain that back pain is is not normal.
00:26:44 Dr. Betsy Grunch
And so I think it is.
00:26:47 Dr. Betsy Grunch
And it is often not cared for appropriately and I think it continues to be a a persistent problem in in women moving forward in their life.
00:26:56 Dr. Betsy Grunch
So I wish that that was looked in and care upon by physicians a little differently.
00:27:02 Speaker 5
Doctor McDonald, what are your?
00:27:03 Dr. April Mcdonald
Thoughts regarding women in pulmonology and their experience.
00:27:08 Dr. April Mcdonald
I think that you know, we hear about shortness of breath a lot and I think that unfortunately when someone comes in, a woman comes in talking about shortness, shortness of breath or that's something that she's had for years.
00:27:23 Dr. April Mcdonald
You know, sometimes people's decision making happens within the first 30 seconds and then there's not that listening component thereafter. And so there are misdiagnoses that happen just because.
00:27:35 Dr. April Mcdonald
Position in front of them did not listen, so I I I think it's unfortunate.
00:27:41 Dr. April Mcdonald
I I see a lot of it in my practice as far as people coming in and saying you're coming in for another diagnosis.
00:27:47 Dr. April Mcdonald
I've I've been told that your physician listens to me.
00:27:50 Dr. April Mcdonald
Who you know, takes the time.
00:27:53 Dr. April Mcdonald
And just by listening.
00:27:55 Dr. April Mcdonald
Here and then you know, I'm like.
00:27:57 Dr. April Mcdonald
Really like, this wasn't discerned a long time ago.
00:28:00 Dr. April Mcdonald
You've gone through this for months and and only now are we getting to this point and it's just by virtue of list.
00:28:06 Dr. April Mcdonald
So I wish that was that that attribute were was more present and and more of.
00:28:12 Dr. Erine Raybon-Rojas
My colleagues got it OK, doctor Mccutchen.
00:28:16 Dr. Aja McCutchen
I'm going to keep along that same vein.
00:28:18 Dr. Aja McCutchen
I think we as specialists and women specialists, are tapped because we listen and and GI we have some diseases that are invisible.
00:28:31 Dr. Aja McCutchen
So the person looks OK, but they're experiencing.
00:28:32 Dr. Erine Raybon-Rojas
Right.
00:28:37 Speaker 5
Right.
00:28:37 Dr. Aja McCutchen
And so our patients that have Crohn's disease, ulcerative colitis.
00:28:42 Dr. Aja McCutchen
They even their family members are like, well, you look fine, you know, but they don't know that they've mapped out every restroom from their house to the nearby school.
00:28:53 Dr. Aja McCutchen
Then they're taking their kids to or that they are intentionally skipping their grandchildren's games because they might have an accident.
00:29:02 Dr. Aja McCutchen
The stand so they become isolated actually because of the sort of invisible Ness of what they have.
00:29:11 Dr. Aja McCutchen
The same thing with pelvic floor issues.
00:29:13 Dr. Aja McCutchen
You know, I have women come in and they are like I'm examining them and I find a diaper.
00:29:18 Dr. Aja McCutchen
Why are you wearing this diaper?
00:29:20 Dr. Aja McCutchen
Oh, I have to make sure I don't have accidents coming over.
00:29:23 Dr. Aja McCutchen
How often do you have accidents?
00:29:24 Dr. Aja McCutchen
Do you know we can do something about this?
00:29:26 Dr. Aja McCutchen
I will tell them.
00:29:27 Dr. Aja McCutchen
You do not have to live like this.
00:29:29 Dr. Aja McCutchen
We have sacral nerve stimulators.
00:29:31 Dr. Aja McCutchen
We have, we have options.
00:29:33 Dr. Aja McCutchen
We have pelvic floor therapy, but it is not taking the time to fully listen.
00:29:39 Dr. Aja McCutchen
To the concerns of the patient.
00:29:42 Dr. Aja McCutchen
Not treating the patient as a whole and when we have, we have functional disorders which are where like irritable bowel where there are symptoms, but you can't find any, there's no cancer.
00:29:54 Dr. Aja McCutchen
So we're comfortable with functional disorders, but people leave the office.
00:29:59 Dr. Aja McCutchen
OK.
00:29:59 Dr. Aja McCutchen
You have irritable bowel, but they're not satisfied.
00:30:02 Dr. Aja McCutchen
Because they would tell.
00:30:04 Dr. Aja McCutchen
OK, you have irritable bowel.
00:30:05 Dr. Aja McCutchen
Go live your life with no solutions.
00:30:08 Dr. Aja McCutchen
So our women don't get direction or guidance once they have been ruled out for other, more serious diseases.
00:30:17 Dr. Aja McCutchen
And so it's important that again, you treat the whole patient just because it's not a cancer does not mean that it's not affecting them like a cancer.
00:30:24 Dr. Erine Raybon-Rojas
Absolutely. Yeah, I love.
00:30:26 Dr. Erine Raybon-Rojas
That because it's not a cancer, doesn't.
00:30:27 Dr. Erine Raybon-Rojas
Mean it's not.
00:30:28 Dr. Erine Raybon-Rojas
Affecting them like a cancer, all right.
00:30:31 Dr. Erine Raybon-Rojas
My next question, I'm going to start with Doctor McDonald.
00:30:36 Dr. Erine Raybon-Rojas
I want to know because I get these questions a lot from my female patients.
00:30:42 Dr. Erine Raybon-Rojas
They come in and they go.
00:30:43 Dr. Erine Raybon-Rojas
Do you have any?
00:30:44 Dr. Erine Raybon-Rojas
Questions and they go.
00:30:45 Dr. Erine Raybon-Rojas
Well, I don't really know what to ask and I realize that I've just given them so much information and they're so overwhelmed.
00:30:51 Dr. Erine Raybon-Rojas
But how can your patients prepare themselves for their upcoming visits with their doctors?
00:30:59 Dr. Erine Raybon-Rojas
Either you know, with their pulmonologist, their neurosurgeon, their GI specialists, their cardiologists, their primary care, their Podiatry.
00:31:08 Dr. Erine Raybon-Rojas
What are some, some, some some questions or some tips that we can give to our patients to make help them make the most of their visit when they come to?
00:31:18 Dr. Erine Raybon-Rojas
See us, we.
00:31:19 Dr. Aja McCutchen
Need an app?
00:31:23
We need to.
00:31:24 Speaker 5
Create an app I've got.
00:31:25 Speaker 5
I've got that.
00:31:26 Dr. April Mcdonald
I've got an app.
00:31:29 Dr. April Mcdonald
Well, when I tell patients though, it's just, you know, write down everything that you're you're wanting to say and that you're interested in making sure that gets addressed during that appointment.
00:31:41 Dr. April Mcdonald
You know when you come in and you're meeting a new provider, there's a lot of information that's disseminated, disseminated at that juncture.
00:31:49 Dr. April Mcdonald
And sometimes you feel like they're talking to you, but you're not getting you know what you're you're wanting to ask out.
00:31:57 Dr. April Mcdonald
And so I tell patients, write it down.
00:31:59 Dr. April Mcdonald
You know, if you have.
00:32:01 Dr. April Mcdonald
Google and you have some questions for because of that.
00:32:03 Dr. April Mcdonald
Then write them down so that.
00:32:05 Dr. April Mcdonald
They can be asked.
00:32:06 Dr. April Mcdonald
And then make sure that you know it's a partnership.
00:32:09 Dr. April Mcdonald
You know the doctor patient relationship is a partnership and so make sure that then the person isn't before you actually takes the time to answer those questions so that you.
00:32:18 Dr. April Mcdonald
Feel satisfied when you leave your.
00:32:21 Dr. April Mcdonald
Got it back to brunch.
00:32:23 Dr. Betsy Grunch
I I encourage patients to record their visits and in their audio or whatever they feel comfortable and make sure they bring a a friend or a family member or somebody that can listen because as you alluded, I mean we we pound them with a lot of information.
00:32:39 Dr. Betsy Grunch
A lot of big.
00:32:39 Dr. Betsy Grunch
Words they don't really may not understand it.
00:32:42 Dr. Betsy Grunch
That first visit.
00:32:43 Dr. Betsy Grunch
So they can.
00:32:44 Dr. Betsy Grunch
Try to, you know, understand what's going on with their body.
00:32:47 Dr. Betsy Grunch
For me personally, I've started utilizing an app where I actually screen record every visit with the patient and send it to their phone so they can rewatch it because I think it's so important for them to understand what's going on with their back.
00:33:01 Dr. Betsy Grunch
Because sometimes you know it's even though we might spend 15 minutes with them, it may seem like 3 minutes.
00:33:06 Dr. Betsy Grunch
And then they don't, and they still come out and they're like.
00:33:09 Dr. Betsy Grunch
I don't even remember.
00:33:10 Dr. Betsy Grunch
What she said.
00:33:11 Dr. Betsy Grunch
So then they go home to their spouse or.
00:33:13 Dr. Betsy Grunch
Their family and then like.
00:33:14 Dr. Betsy Grunch
Well, I don't.
00:33:15 Dr. Betsy Grunch
I don't know.
00:33:16 Dr. Betsy Grunch
So I think it's important to to to write those things down or to bring the second set of ears and and don't be afraid to if you don't get the answers to your questions as Dart McDonald said, I mean, if you feel like your provider is not answering the questions that you have, you can go get another opinion.
00:33:34 Dr. Betsy Grunch
There are plenty of excellent physicians that can answer the questions, and you deserve to get the attention that you need for the problems and understand your your diagnosis so.
00:33:45 Dr. Erine Raybon-Rojas
So it sounds like what you guys both are saying is that there's so much importance on the doctor patient relationship and it's a partnership and you know there is a mutual respect that the doctor and patient need to have in that relationship to make sure that both the goals.
00:34:04 Dr. Erine Raybon-Rojas
Of you know what we're trying to do, which is take care of them, are met.
00:34:08 Dr. Erine Raybon-Rojas
So, you know, being vocal, speaking up and making sure that your questions are answered are really important.
00:34:17 Dr. Erine Raybon-Rojas
Are your thoughts?
00:34:19 Dr. Aja McCutchen
Yeah, I agree with all of that sort of preparing in advance was sort of a thing maybe being able to record some of the conversation is also a great solution on our end.
00:34:30 Dr. Aja McCutchen
Nationally, we have worked very hard on making sure that we are providing linguistically and culturally appropriate.
00:34:40 Dr. Aja McCutchen
Supportive materials as well, so you'd be shocked by communities that are served that do not speak English yet they're receiving instructions in English and lifestyle modifications in English, and no one in the family speaks English.
00:34:55 Dr. Aja McCutchen
And so, you know.
00:34:57 Dr. Aja McCutchen
It's like you said, it's a privilege to be able to take care of people.
00:35:01 Dr. Aja McCutchen
It's also a part of the physician skill set to be able to translate what's happening to that patient in layman's terms so that they understand and can make an informed decision.
00:35:14 Dr. Aja McCutchen
We sign a consent with the patient.
00:35:17 Dr. Aja McCutchen
And the expectation and the standard is that they understand what they're signing.
00:35:22 Dr. Aja McCutchen
So if you identify that your patient barely speaks English or the materials are, you know, perhaps, you know, the words are advanced.
00:35:32 Dr. Aja McCutchen
I'm still in meetings, you know, looking up words.
00:35:34 Dr. Aja McCutchen
So, you know, even the English language is, you know, there's words I don't know.
00:35:39 Dr. Aja McCutchen
I was not exposed to these words.
00:35:41 Dr. Aja McCutchen
So you need to get somebody that understands that and can relate to you.
00:35:46 Dr. Aja McCutchen
You need to be able to relate to your physician and they need to be able to break it down because it's your life we only have.
00:35:52 Dr. Aja McCutchen
20 minutes with.
00:35:53 Dr. Aja McCutchen
You then you have the rest of your life.
00:35:55 Dr. Aja McCutchen
Right 20-30 minutes.
00:35:57 Dr. Aja McCutchen
An hour? Whatever.
00:35:58 Dr. April Mcdonald
But it's a.
00:35:59 Dr. Aja McCutchen
It's a fine night period of time and then you have to carry that information.
00:36:03 Dr. Aja McCutchen
And I think even more importantly in the inpatient setting, when people are critically ill, family members are calling what's going on?
00:36:09 Dr. Aja McCutchen
Well, if no one knows what the doctor is saying, the entire family is confused.
00:36:15 Dr. Betsy Grunch
I don't think gone at the times of paternalism too.
00:36:18 Dr. Betsy Grunch
I mean, there are still patients that like to be told what to do, but I think it's so important to get.
00:36:24 Dr. Betsy Grunch
Them break it down as you say, so they can make decisions for themselves and especially in surgical field.
00:36:30 Dr. Betsy Grunch
I I think so many patients undergo procedures that they don't understand what's happening and then they have it done and they you know they wish they didn't have it done and because they didn't understand the ramifications of what they might have done so.
00:36:45 Dr. Betsy Grunch
I think those are all good points.
00:36:48 Dr. Erine Raybon-Rojas
So even though we are all sub specialty physicians, you know we all know how important it is to take care of your car, get the oil change, get the tires rotated.
00:37:01 Dr. Erine Raybon-Rojas
So, you know, we really should take care of our bodies even better than we take care of our.
00:37:13 Dr. Erine Raybon-Rojas
So what do you think is the importance of preventative health care for?
00:37:21 Dr. Erine Raybon-Rojas
Women that made.
00:37:24 Dr. April Mcdonald
For women, we oftentimes put ourselves last in the way of we have a lot going on around us, and when it comes to our health, we say, you know, we say we'll get to it later kind of thing.
00:37:36 Dr. April Mcdonald
But I I tell patients, I tell my family this, you know, all of these things that are around you that you're holding up are going to fall.
00:37:44 Dr. April Mcdonald
If you do not take care.
00:37:46 Dr. April Mcdonald
And so for that reason, we have to make our we, as women, have to make ourselves a priority.
00:37:52 Dr. April Mcdonald
We need to go and get our preventative health things.
00:37:55 Dr. April Mcdonald
And so, you know, from a from a pulmonology standpoint, if you're a smoker, stop.
00:38:00 Dr. April Mcdonald
But also if you you know if you make the choice to continue and you've been a long time smoker, then go get your lung annual lung cancer screening done.
00:38:09 Dr. April Mcdonald
You know, get your colonoscopy done, get your pap smears.
00:38:13 Dr. April Mcdonald
And so make these things priorities.
00:38:16 Dr. April Mcdonald
And I cannot state enough.
00:38:18 Dr. April Mcdonald
I think, Doctor Wrench said this earlier.
00:38:20 Dr. April Mcdonald
You know, if you have a physician who is not advocating for you to get these things or doesn't bring it up, you bring it up.
00:38:27 Dr. April Mcdonald
If you're not getting the results that you want, find someone else who may be more in tune to the your needs as a as a patient.
00:38:33 Dr. April Mcdonald
Because if you have one life to live and so.
00:38:36 Dr. April Mcdonald
It's important that you take the best.
00:38:37 Dr. April Mcdonald
Care of yourself?
00:38:39 Dr. Erine Raybon-Rojas
And since you brought up one cancer screening because it.
00:38:42 Dr. Erine Raybon-Rojas
I think and me being a pulmonologist, also those who, you know, we talk a lot about Pap smears and colonoscopies and mammograms, but speak a little bit about lung cancer screening, the importance of it.
00:38:54 Dr. Erine Raybon-Rojas
And when a person should start getting lung cancer screening.
00:38:59 Dr. April Mcdonald
So when it comes to lung cancer screening, if you have been a smoker, on average one pack per day and your age, excuse me if your age 50 and above.
00:39:09 Dr. April Mcdonald
Smoking one pack per day for the last 20 years, or if you have quit within that 15 years of quitting, you should be getting annual low dose CT scans to look for lung nodules, which could be a precursor to lung cancer and how important.
00:39:28 Dr. Erine Raybon-Rojas
Is that meaning?
00:39:31 Dr. Erine Raybon-Rojas
What's the the time frame?
00:39:32 Dr. Erine Raybon-Rojas
Because people could say, well, every year maybe I need it every month.
00:39:35 Dr. Erine Raybon-Rojas
Maybe I need it every six months.
00:39:37 Dr. Erine Raybon-Rojas
So talk about why it's important to.
00:39:39 Dr. Erine Raybon-Rojas
Do it annually.
00:39:41 Dr. April Mcdonald
So you don't need to get into any more frequently than annually.
00:39:45 Dr. April Mcdonald
There have been studies that have looked at this, but when they say a low dose CT skin, it means that there's low radiation dose.
00:39:54 Dr. April Mcdonald
And then sometimes I know the old teaching it used to be just getting X-ray of chest X-ray know that chest X-rays.
00:40:02 Dr. April Mcdonald
You must be an CT scan to look for these lung nodules.
00:40:05 Dr. April Mcdonald
You want to do this annually because you want to catch.
00:40:08 Dr. April Mcdonald
If you're going to have a lung cancer, you want to catch it.
00:40:10 Dr. April Mcdonald
Early so that it can be diagnosed early and that something can.
00:40:13 Dr. April Mcdonald
Be done about it.
00:40:14 Dr. April Mcdonald
Early the later you wait, or if you're not getting screened, then when we if we were to find a cancer and at the late stage there are less options as to address it.
00:40:24 Dr. Erine Raybon-Rojas
OK, Doctor Grinch, same question.
00:40:27 Dr. Betsy Grunch
I think I alluded to the fact of spine health and pregnancy, but I think paternally to women and preventative maintenance.
00:40:35 Dr. Betsy Grunch
At least in regards to how it is.
00:40:37 Dr. Betsy Grunch
To your spine.
00:40:38 Dr. Betsy Grunch
I think often we neglect to get our get bone density testing.
00:40:45 Dr. Betsy Grunch
I see so many women that come in at 405067 years old that have extremely severe osteoporosis and and have spine issues related to that, whether it be.
00:40:56 Dr. Betsy Grunch
Compression fracture or or what have you and I think and.
00:41:00 Dr. Betsy Grunch
And I often wonder, I see you know patients with scoliosis that need surgery.
00:41:04 Dr. Betsy Grunch
But then I screen them for their bone density or not a candidate because they have osteoporosis.
00:41:08 Dr. Betsy Grunch
It's been untreated for years.
00:41:10 Dr. Betsy Grunch
That get missed and I think you know, women should often know what.
00:41:16 Dr. Betsy Grunch
They need to.
00:41:16 Dr. Betsy Grunch
Do in terms of requesting that bone density.
00:41:18 Dr. Betsy Grunch
So I I typically recommend that any woman over 50 years old get a a bone density test every two years.
00:41:26 Dr. Betsy Grunch
I think it even extends as in your younger self just.
00:41:30 Dr. Betsy Grunch
Making sure you're, you know, getting exposed to sign, getting vitamin D, taking calcium supplementation.
00:41:36 Dr. Betsy Grunch
If you're not getting.
00:41:36 Dr. Betsy Grunch
Enough calcium and and those are weight bearing exercise.
00:41:41 Dr. Betsy Grunch
Maintaining a healthy weight, not living a sedentary lifestyle.
00:41:44 Dr. Betsy Grunch
I could go on and on and on, but I think that's something that I I see that's that often is is neglected.
00:41:51 Dr. Aja McCutchen
So in my field, just to piggyback off of what doctor Grunch?
00:41:56 Dr. Aja McCutchen
Said about bone health.
00:41:59 Dr. Aja McCutchen
Our patients that have been exposed to steroids because of chronic inflammatory bowel disease, we encourage them very early to start getting their bones checked from a straight gastroenterology perspective.
00:42:12 Dr. Aja McCutchen
Of course, there's two major, major areas that we focus on.
00:42:17 Dr. Aja McCutchen
One is colorectal cancer screening.
00:42:20 Dr. Aja McCutchen
And I want to be careful with my recommendations because in the United States, colonoscopy is the gold standard and the reason it's the gold standard is because it is an opportunity to actually serve as a preventive.
00:42:34 Dr. Aja McCutchen
School, meaning we're checking for polyps.
00:42:37 Dr. Aja McCutchen
We're removing polyps and most colon cancers do start as a.
00:42:41 Dr. Aja McCutchen
Polyp that's allowed to grow.
00:42:43 Dr. Aja McCutchen
There are other screening modalities.
00:42:46 Dr. Aja McCutchen
They're stool based tests emerging or some liquid biopsies and etcetera.
00:42:53 Dr. Aja McCutchen
And those if somebody cannot.
00:42:55 Dr. Aja McCutchen
Undergo A colonoscopy.
00:42:56 Dr. Aja McCutchen
For whatever reason, they don't want to.
00:42:59 Dr. Aja McCutchen
They don't, they're not covered or whatever.
00:43:02 Dr. Aja McCutchen
Something is better than.
00:43:04 Dr. Aja McCutchen
Nothing globally, the geopolitical capital structures are different and the economics are different.
00:43:14 Dr. Aja McCutchen
And in other countries and so they may use a stool based test to try to.
00:43:18 Dr. Aja McCutchen
Reach the masses.
00:43:20 Dr. Aja McCutchen
But if you can get a colonoscopy here, that's the gold standard because.
00:43:25 Dr. Aja McCutchen
Do a stool test?
00:43:26 Dr. Aja McCutchen
It's negative this year.
00:43:27 Dr. Aja McCutchen
It's negative this year.
00:43:27 Dr. Aja McCutchen
It's positive. Oh.
00:43:29 Dr. Aja McCutchen
Now we're worried, right?
00:43:30 Dr. Aja McCutchen
We want to actually look and we are very fortunate now.
00:43:35 Dr. Aja McCutchen
We actually have some artificial intelligence that we have incorporated into.
00:43:41 Dr. Aja McCutchen
This is and it allows us to detect even pit pattern changes. It's called GI genius, but I'm sure there'll be multiple iterations of this particular technology that will eventually even outsmart what we can see with our traditional endoscopes. But the scopes are in over 9095%.
00:44:01 Dr. Aja McCutchen
Accurate and as they are and you improve adenoma detection rates even further with colonoscopy.
00:44:08 Dr. Aja McCutchen
The second screening test that we do often is for reflux long standing, acid reflux.
00:44:16 Dr. Aja McCutchen
We're looking for a condition called Barretts and that's where the lining of the esophagus changes as a result of exposure to acid and acidic environment, and that lining becomes more like the stomach lining.
00:44:28 Dr. Aja McCutchen
And it is a precancerous condition. And so we want to make sure that that those individuals that are at risk for that middle-aged white men long standing, acid reflux, that we do an appropriate screening modality. Again there is endoscopy, but there are emerging and available alternative tests.
00:44:47 Dr. Aja McCutchen
Well, that are looking for those precancerous changes.
00:44:52 Dr. Erine Raybon-Rojas
So sounds like you need to get your colonoscopy.
00:44:58 Dr. Erine Raybon-Rojas
Just because you have reflux, you should just say or or heartburn.
00:45:01 Dr. Erine Raybon-Rojas
You shouldn't just say, oh, it's just.
00:45:02 Dr. Erine Raybon-Rojas
A little heartburn and and pop tones for five years that we we.
00:45:06 Dr. Erine Raybon-Rojas
Should go get.
00:45:06 Dr. Erine Raybon-Rojas
That checked, looking at our bone and skeleton.
00:45:12 Dr. Erine Raybon-Rojas
And then if you are a smoker or if you are consistently short of breath, really getting in to see your lung specialist to be able to have the opportunity to detect illnesses earlier so that we can actually improve outcomes and really improve and.
00:45:31 Dr. Erine Raybon-Rojas
To help people maintain the quality of life that they are in, oftentimes I know all of you guys see this people come to us and.
00:45:38 Dr. Erine Raybon-Rojas
We're like man.
00:45:40 Dr. Erine Raybon-Rojas
Two years before, you would have been the exact same person we could have.
00:45:44 Dr. Erine Raybon-Rojas
You know you you had a a lung cancer that was just in one little area.
00:45:48 Dr. Erine Raybon-Rojas
We could have gotten rid of it and actually gotten you a cure, but because of waiting, what we're doing now is talking about other options that could just be making you comfortable or exposing you to chemo and things that may not be necessary.
00:46:03 Dr. Erine Raybon-Rojas
So just to reiterate.
00:46:05 Dr. Erine Raybon-Rojas
It is very important that we focus on our preventative healthcare as women.
00:46:12 Dr. Erine Raybon-Rojas
So we've covered so many issues so far, but what we want to do is make sure that we are empowering our younger generation.
00:46:20 Dr. Erine Raybon-Rojas
We want to see more boss lady doctors and pink scrubs talking about women's issues. So what is a piece of advice that you would tell to, let's say?
00:46:31 Dr. Erine Raybon-Rojas
High school student elementary school student who says you know what?
00:46:34 Dr. Erine Raybon-Rojas
Maybe I think I want to pursue a career in medicine and be a physician.
00:46:38 Dr. Erine Raybon-Rojas
What advice would?
00:46:39 Dr. Erine Raybon-Rojas
You give them Doctor McDonald.
00:46:40 Dr. April Mcdonald
I would say First off you can do it.
00:46:45 Dr. April Mcdonald
That's the biggest thing.
00:46:47 Dr. April Mcdonald
Knowing knowing that you can do this, whatever that dream is and and then seek out mentors.
00:46:55 Dr. April Mcdonald
Mentorship is key to get, you know, to help you get and open up doors and get to the next steps.
00:47:01 Dr. April Mcdonald
So seek out those mentors and it doesn't have to necessarily initially.
00:47:04 Dr. April Mcdonald
Be someone in the medical field, you know, talk to your teachers about your interest.
00:47:08 Dr. April Mcdonald
They may have connections.
00:47:11 Dr. April Mcdonald
Talk to your family members.
00:47:12 Dr. April Mcdonald
You know, they may know someone as well, but what I say is expose yourself as much as possible.
00:47:18 Dr. April Mcdonald
There are various fields within medicine too, so be open, but if you if you want to be a position and you know it within your spirit and in your heart, you know I made this decision.
00:47:30 Dr. April Mcdonald
8 years old I.
00:47:31 Dr. April Mcdonald
Said I am going to be a.
00:47:34 Dr. April Mcdonald
You do it.
00:47:35 Dr. April Mcdonald
You can do it, and don't let anything to tear you from that.
00:47:40 Dr. April Mcdonald
And mentorship very important.
00:47:43 Dr. Erine Raybon-Rojas
And part of our diversity, equity and inclusion efforts here at Northeast Georgia Medical Center as well as graduate medical education, we have opportunities for mentorship, so.
00:47:54 Dr. Erine Raybon-Rojas
You know, if anybody out there wants to be mentored or have conversations with the physicians that you come across with the physicians that.
00:48:03 Dr. Erine Raybon-Rojas
You see here I am a resource e-mail me and I will make sure that you are hooked up with who you need to be hooked up with, but let's.
00:48:12 Dr. Erine Raybon-Rojas
Go to doctor Grunch.
00:48:13 Dr. Betsy Grunch
I think just to kind of piggyback on what Doctor McDonald said as well as what Doctor Mccutchen hit on earlier, I think you don't necessarily have to have a female mentor and especially.
00:48:24 Dr. Betsy Grunch
In a in.
00:48:24 Dr. Betsy Grunch
A sub sub specialty.
00:48:26 Dr. Betsy Grunch
That's not a lot of women.
00:48:27 Dr. Betsy Grunch
I think finding a male mentor is is going to be what you have to do and find someone just as supportive of you.
00:48:35 Dr. Betsy Grunch
I had all of my mentors growing up were were men and extremely supportive.
00:48:42 Dr. Betsy Grunch
And I think you just have to, you just have to find that because it's so, so, so important to be encouraged and know that you're going to hear negative things along the way.
00:48:49 Dr. Betsy Grunch
People are going to discourage you from doing it, period.
00:48:52 Dr. Betsy Grunch
And as long as you know that's what you want to do, you can do it.
00:48:56 Dr. Betsy Grunch
You don't have to be birthed into a family of physicians.
00:48:59 Dr. Betsy Grunch
To do it.
00:49:00 Dr. Betsy Grunch
I was a first.
00:49:01 Dr. Betsy Grunch
Person in my family to to go to to college.
00:49:05 Dr. Betsy Grunch
So you you don't have to have family money.
00:49:07 Dr. Betsy Grunch
Can do that.
00:49:08
So that would be my advice.
00:49:11 Dr. Aja McCutchen
So in addition to the wonderful recommendations that were already made.
00:49:16 Dr. Aja McCutchen
I would encourage people to actually find summer programs, those summer programs that I was personally involved in had those were there in high school actually.
00:49:29 Dr. Aja McCutchen
So there are high school enrichment programs that get you exposure to some basic science or bench research.
00:49:37 Dr. Aja McCutchen
There is opportunities for shadowing that you can do very early on and those may continue through college and selling college.
00:49:48 Dr. Aja McCutchen
There are several organizations that are focused on.
00:49:52 Dr. Aja McCutchen
Helping you to transition into medical medical school and I love what Doctor Grimes said about really finding somebody that just gets you.
00:50:02 Dr. Aja McCutchen
All of us have had people along our journeys that just identified us as being somebody that they did or somebody that.
00:50:12 Dr. Aja McCutchen
Is able to contribute something great to the world, so we're all very fortunate to be identified and it's important for us to give back and identify future physicians.
00:50:25 Dr. Aja McCutchen
And even if you don't want to be a physician.
00:50:28 Dr. Aja McCutchen
So, yeah, I think identifying those opportunities as early as possible.
00:50:32 Dr. Aja McCutchen
And getting exposure to a variety of special specialties will really change.
00:50:38 Dr. Aja McCutchen
This whole narrative.
00:50:39 Dr. Erine Raybon-Rojas
Beautiful, fantastic, perfect answers.
00:50:43 Dr. Erine Raybon-Rojas
So I want to take this conversation a little bit different and I want to talk a little bit about family planning and we've talked about our roles in, you know, in the workforce and in the hospital and in our respective.
00:51:00 Dr. Erine Raybon-Rojas
Is, but the reality is is that medical school and medical education and training takes a significant amount of time.
00:51:09 Dr. Erine Raybon-Rojas
It may eat up your 20s.
00:51:11 Dr. Erine Raybon-Rojas
It may even eat up into your 30s and you know when?
00:51:16 Dr. Erine Raybon-Rojas
When someone is very hyper focused on what they want to do as far as their career.
00:51:22 Dr. Erine Raybon-Rojas
They can kind of let the family aspect go a little bit until they feel like they get settled.
00:51:27 Dr. Erine Raybon-Rojas
Well, we do have statistics that say that.
00:51:30 Dr. Erine Raybon-Rojas
You know, resident physicians and women, physicians experience infertility issues and concerns that come up probably twice as much more than the general population.
00:51:45 Dr. Erine Raybon-Rojas
So I want to speak a little bit to to to that statistic.
00:51:50 Dr. Erine Raybon-Rojas
And why you think that is?
00:51:53 Dr. Erine Raybon-Rojas
And just potential things that we can do about.
00:51:56 Dr. Erine Raybon-Rojas
It well, let's just.
00:51:57 Dr. Aja McCutchen
Say I went against the grain to begin with.
00:52:00 Dr. Aja McCutchen
So I I remember though, feeling very awkward and out of place when I started in Mary and I already had a family, and so the.
00:52:12 Dr. Aja McCutchen
I remember my fellow residents and there were 40 something of us coming into the class.
00:52:17 Dr. Aja McCutchen
Not one single person had a child, not one, and so I didn't.
00:52:23 Dr. Aja McCutchen
And there was nothing to talk about.
00:52:25 Dr. Aja McCutchen
I mean, I were like, what?
00:52:27 Dr. Aja McCutchen
When did this happen?
00:52:29 Speaker 5
How are you doing this?
00:52:31 Dr. Aja McCutchen
And there I I have to say that maybe there was some shame and some guilt associated with that on two sides.
00:52:39 Dr. Aja McCutchen
One was once that reaction, which I wasn't aware because I was the first generation physician, we did have other disciplines in my family, but I didn't know.
00:52:50 Dr. Aja McCutchen
That this was abnormal.
00:52:52 Dr. Aja McCutchen
Until I actually got around a group of my colleagues and they were like, wait, so how are you going to complete your residency?
00:52:58 Dr. Aja McCutchen
And I'm like, the same way I did medical school, I mean.
00:53:01 Dr. Aja McCutchen
I didn't really.
00:53:02 Dr. Aja McCutchen
Understand what the Big deal was, but then I realized that, OK, if my child is sick though, and I mentioned that there's nobody that I can relate to and I'm a trainee, I'm not in a position of power.
00:53:16 Dr. Aja McCutchen
Right.
00:53:16 Dr. Aja McCutchen
But I had had a supportive family structure and all of that, and my husband was able to help me, but it was a little bit.
00:53:23 Dr. Aja McCutchen
You know, I I felt like I had to.
00:53:24 Dr. Aja McCutchen
Keep my baby pictures on.
00:53:26 Dr. Aja McCutchen
The low and.
00:53:27 Dr. Aja McCutchen
All of this, and it was really kind of sad that, you know, I wasn't able to highlight that.
00:53:31 Dr. Aja McCutchen
So I think not only are we hyper focused, but we want to make sure that nothing gets.
00:53:37 Dr. Aja McCutchen
In our way.
00:53:37 Dr. Aja McCutchen
And that we succeed and that we're not judged for not performing because.
00:53:43 Dr. Aja McCutchen
Of a potential.
00:53:44 Dr. Aja McCutchen
Distraction, when really it's a part of life.
00:53:49 Dr. Aja McCutchen
You know us being.
00:53:50 Dr. Aja McCutchen
Able to have children is a blessing, and it's a part of life and it's totally normal.
00:53:57 Dr. Aja McCutchen
And I love the way that that narrative is changing.
00:54:00 Dr. Aja McCutchen
I love to see it.
00:54:01 Dr. Aja McCutchen
I love to see pregnant residents.
00:54:03 Dr. Aja McCutchen
I love to see all of that because, you know, even if it didn't happen for us, for somebody else to have a positive experience, that's a win.
00:54:13 Dr. Aja McCutchen
That's a win for me in my lifetime.
00:54:14 Dr. Erine Raybon-Rojas
Absolutely. Doctor McDonald.
00:54:17 Dr. April Mcdonald
So I think when it comes to fertility and medicine, there's never going to be a good time.
00:54:23 Dr. April Mcdonald
I think that.
00:54:25 Dr. April Mcdonald
So I had my daughter toward the end of my training and actually.
00:54:29 Dr. April Mcdonald
At the very.
00:54:30 Dr. April Mcdonald
When I was actually completed with training.
00:54:34 Dr. April Mcdonald
But there was never a necessarily a good time, right, because we're always going to be working, we're always going to have something.
00:54:41 Dr. April Mcdonald
That's going on.
00:54:42 Dr. April Mcdonald
So I think that I just had to make the choice, but it was time for me.
00:54:48 Dr. April Mcdonald
And then and then go with that.
00:54:50 Dr. April Mcdonald
That being said, I certainly.
00:54:53 Dr. April Mcdonald
Recognize that throughout my training, you know those who did have children or.
00:54:58 Dr. April Mcdonald
You know there there was almost a little bit of a stigma if you were.
00:55:02 Dr. April Mcdonald
You felt I could tell that my classmates didn't feel supported in the way of having children while they're going through training because no one was sympathetic.
00:55:11 Dr. April Mcdonald
If they had to take off, or if they had to not be there.
00:55:13 Dr. April Mcdonald
For a reason and.
00:55:16 Dr. April Mcdonald
So it's challenging, especially as being women.
00:55:19 Dr. April Mcdonald
And then going through this process in our in our what would be considered our prime years of reproduction?
00:55:28 Dr. April Mcdonald
I think that the more that more women that are in the are the fields in the field of medicine in general, but then in sub specialty field surgical fields, I think that there will be this transition will happen over time as far as it being more accepted.
00:55:52 Dr. Erine Raybon-Rojas
I don't know.
00:55:52 Dr. Erine Raybon-Rojas
I don't know.
00:55:54 Dr. Aja McCutchen
I'll say that you know aren't most of us. We don't even finish our training until mid 30s and advanced maternal age is considered 35, right? Right. So we're all coming in as this when we when.
00:56:09 Dr. Erine Raybon-Rojas
We do. Wait, we're.
00:56:10 Dr. Aja McCutchen
Elderly pregnant women, right?
00:56:13 Dr. Aja McCutchen
Like we're literally period woman.
00:56:17 Dr. Betsy Grunch
Very ancient time too.
00:56:21 Dr. Aja McCutchen
And so that's, you know, that's a big contributor to decreased fertility and pregnancy loss.
00:56:29 Dr. Erine Raybon-Rojas
So what do you think some potential solutions are doctor Grunch when we're talking specifically about medical training, medical education?
00:56:38 Dr. Betsy Grunch
I mean I.
00:56:38 Dr. Betsy Grunch
Think you know the point that I.
00:56:41 Dr. Betsy Grunch
Made earlier, when you first asked me like.
00:56:42 Dr. Betsy Grunch
The percentage. Why?
00:56:43 Dr. Betsy Grunch
Are women not going in the surgical sub specialties and it comes down to the questions of work life balance and that's on all the questions I get.
00:56:50 Dr. Betsy Grunch
I would say 90% of questions I get from residents, from medical students, from people desire, women want to go in this field is what is your work life balance?
00:56:59 Dr. Betsy Grunch
Make it happen and and and I think in order to achieve a good work life balance, we have to understand what it takes to get there and so.
00:57:08 Dr. Betsy Grunch
I I think as as developing like how we can emulate that in training is being accepting of people with families being being accepting of women that want to have a family during their training.
00:57:23 Dr. Betsy Grunch
I didn't do that because I didn't want.
00:57:25 Dr. Betsy Grunch
There was no one else around me.
00:57:27 Dr. Betsy Grunch
That were doing it.
00:57:28 Dr. Betsy Grunch
And I didn't want to create more burden on my Co residence and be the outlier that would, you know, need to take off.
00:57:35 Dr. Betsy Grunch
I had one female colleague during my training that that had a child and was pregnant and she absolutely was, you know, discriminated against, not directly.
00:57:44 Dr. Betsy Grunch
To her face, but just.
00:57:46 Dr. Betsy Grunch
Oh, I can't wait.
00:57:46 Dr. Betsy Grunch
I have to do this and this and that.
00:57:48 Dr. Betsy Grunch
And for her because she's sick or whatever.
00:57:51 Dr. Betsy Grunch
And I think that that narrative has to change in order for us to to get more women into medicine and specifically into sub specialties like surgeries.
00:58:01 Dr. Betsy Grunch
That's with these that where where we can accept women for.
00:58:06 Dr. Betsy Grunch
Wanting to have a family.
00:58:07 Dr. Betsy Grunch
And I think it's important because of what you said.
00:58:09 Dr. Betsy Grunch
I mean females do better with female surgeons, their outcomes are better and and we've got to, we've got to do that we got.
00:58:15 Dr. Betsy Grunch
To change change there.
00:58:17 Dr. Erine Raybon-Rojas
So we have covered so many great and interesting topics with our expert panel here.
00:58:24 Dr. Erine Raybon-Rojas
So I really want you guys to.
00:58:27 Dr. Erine Raybon-Rojas
Please reach out to reach out to myself, Doctor McDonald, Dr.
00:58:33 Dr. Erine Raybon-Rojas
Grunch and Dr.
00:58:34 Dr. Erine Raybon-Rojas
Mccutchen, and really quickly.
00:58:36 Dr. Erine Raybon-Rojas
If anybody has.
00:58:37 Dr. Erine Raybon-Rojas
A social media handle how someone can reach.
00:58:40 Dr. Erine Raybon-Rojas
Out to you.
00:58:42 Dr. Erine Raybon-Rojas
Please go ahead and toot your own horn with your social media handle because we want to make sure one of the things one of the reasons why we came together to do this talk is because we want to reach the community, we want to reach people and have and have a voice in a space where we may not have before.
00:59:00 Dr. Erine Raybon-Rojas
And part of that.
00:59:01 Dr. Erine Raybon-Rojas
Is empowering, inspiring and mentoring, UM and mentoring our our our community. So mine is melanin dot Aaron under score E because my name is Aaron with an EE RINE and that's my Facebook and my my Instagram.
00:59:20 Speaker 6
I don't know.
00:59:22 Dr. April Mcdonald
I am actually not a social.
00:59:24 Speaker 6
Media we're going to get Doctor MacDonald on social.
00:59:29 Speaker 6
Yes, we're going to get Doctor MacDonald on Instagram.
00:59:34 Dr. Betsy Grunch
I don't have one here, right?
00:59:37 Dr. Betsy Grunch
You can find me at Lady Spine, Doc.
00:59:40 Dr. Betsy Grunch
And I am on all the things TikTok, Instagram, Facebook, YouTube, Twitter.
00:59:50 Dr. Aja McCutchen
So you can find me on Twitter at McCutcheon MCU, TCH EN doctor and then you can also find me on LinkedIn, Asia, Mccutchen on LinkedIn, and I encourage everyone to get a LinkedIn account.
01:00:04 Dr. Aja McCutchen
There is a lot of opportunities from a professional standpoint on LinkedIn that I think are very beneficial.
01:00:11 Dr. Erine Raybon-Rojas
OK.
01:00:12 Dr. Erine Raybon-Rojas
So we have talked about, like I said, a lot of really important issues.
01:00:16 Dr. Erine Raybon-Rojas
And the one overarching theme is that diversifying the workforce in medicine ultimately will lead to better patient outcomes and better work life balance.
01:00:30 Dr. Erine Raybon-Rojas
For the docs that really have the privilege of taking care of you.
01:00:34 Dr. Erine Raybon-Rojas
So This is why these topics are so, so, so important.
01:00:38 Dr. Erine Raybon-Rojas
But I want to thank everyone for joining us.
01:00:41 Dr. Erine Raybon-Rojas
We really had a good time coming together.
01:00:43 Dr. Erine Raybon-Rojas
We don't often get a chance to just chit chat and talk together to give each other information to encourage each other, to encourage you.
01:00:50 Dr. Erine Raybon-Rojas
So please, like, share, subscribe, comment and let us know what you want to hear more.