The Dr Louise Newson Podcast - 004 - Education about the menopause - Practice Manager Sarah Baker & Dr Louise Newson

Episode Date: July 3, 2019

Menopause education is not mandatory for healthcare professionals. Dr Newson discusses the importance of menopause education with Menopause & Wellbeing Centre Practice Manager, Sarah Baker who previously worked in a private hospital and ran educational events for doctors on various subjects. Sarah describes how women’s health events were always popular and, in her experience, doctors have a real thirst for knowledge regarding the menopause and safe prescribing of HRT.  Sarah Baker's Three Take Home Tips to Help You on Your Menopause Journey: Do your research! There are so many great resources available, such as menopausedoctor.co.uk, and if you have the right information it will help when you visit your GP. Be brave and talk to other people - you may find a lot of your friends are going through the same thing and you can help and support each other. Talk to your family and involve your partner. You are not on your own and there is help out there! Learn more about Sarah Baker

Welcome to the Newsome Health Menopause podcast. I'm Dr Louise Newsom, a GP and menopause specialist, and I run the Newsome Health Menopause and Wellbeing Centre here in Stratford-upon-Avon. So today I thought I'd do something slightly different. Rather than speaking to healthcare professionals, which I've spoken to before, I've dragged in my practice manager Sarah Baker to talk to her about, a bit about her past. where she's worked before and how she feels about working here in my Manafort Centre. So hi Sarah. Hello. So just tell us a bit about what you were doing before you came here.

So before I started to hear, Newson Health, I worked in a private hospital for the Spy Group and I ran sort of the educational strand for the consultants and the GPs. So very interesting and it was certainly very interesting to be part of the private sector. Yes. So there's a couple of things really that I wanted to tease out. Firstly, about private medicine because certainly I've worked in the NHS for a long period of time. I qualified in 1994. And I always thought I would continue working in the NHS because it's so important to me

that everyone should be able to access the same care. It's not about how big your wallet is. It's about what your health is and how to improve it. So I dip my toe in the water starting in my clinic, as you know, a couple of years ago in the hospital where you used to work. But it's not all bad, is it private? Just explain your thoughts about it. Well, the private sector certainly has changed enormously in the years. And you're right, you know, a decade ago it was very much for the elite, those that had the income to pay for private medical insurance.

And the private hospitals focused solely on those that had private medical insurance. insurance, but people just don't have that many of these days. And unfortunately, the NHS is changing. Exactly. People have got to fight their own corner and do their own research, find the person they want to see. So private hospitals now focus much more on those that pay as you go. Yes.

So those that don't have private medical insurance and that can pay a one-off fee for their surgery or for their consultation. And that's a big market now because people are realizing that they need to, do their own research and find that person that specialises in their work, what they need treated. I'm no set with my mother who had, she's had a couple of hip replacements, and I've dissuaded her from having private health about 20 years ago

because she was spending a very expensive, about 100 pounds a month. I said, oh gosh, actually, don't stop because you're otherwise healthy, but then she had a hip replacement, but wanted it locally so I could help look after her, went to your hospital then, and self-funded. And, you know, it is a bit like buying a car you can sort of negotiate when you're paying yourself. Absolutely.

And you can set up finances. Yeah. There's all sorts that can be done, aren't there? Yeah. And there's a much bigger market now than it's ever been. But then, obviously here we only do with the menopause, which really frustratingly isn't covered by any private health insurance scheme, is it? It's a foregone conclusion, the menopause, so no insurance would cover it. Which I battle quite a lot, and I have spoken to some of the insurance companies, because although the menopause is a natural phenomenon, we'll all go.

through if we live long enough, it's, as you know, a marker for future disease. So women who have gone through the menopause without treatment have an increased risk of heart disease, osteoporosis, diabetes, arthritis and even dementia, we know that women who go through the menopause are more likely to have a hip and knee joint replacement. Yet if the insurance company's considered that, they wouldn't be paying out quite so much money later. That's enormous foresight on your part. Unfortunately, the big insurers won't think about it. We wouldn't think about it. No, because when I have approach quite important people in very well-established insurance companies. They've laughed and said menopause, what do you mean? Because this concept of this crazy hormonal woman is what

people think about the menopause, isn't it? Absolutely. And, you know, education is the way to go, but we've got a long way to go in terms of education for the medical profession, the insurance and general public and doing themselves. Yeah. And it's helping. I think the media have got it wrong with so much about menopause and HLT. And as you know, some of the media work we do is helping to educate and hopefully these podcasts are helping but talking about education you used to you i mean you're super organized and you did some amazing events in parkway at the hospital's working and thankfully i even presented a couple of them but we you've always said there was an interest in women's health i mean you did every specialty didn't you did we covered all the specialties

um so just to explain that the um education strand um was somewhat marketing yeah the consultants could promote themselves in front of the GPs, but also GPs need to have continual professional development. So it was for their benefit. We put the events on for free. The GPs could get their points for their appraisal

and also learn about any advances or red flags need to look out for when they see their patients. And obviously I would set up different conferences and seminars and by far and way the most popular if I put HRT or anything menopause on the schedule, we would be sold out for whatever.

So that's really interesting, isn't it? So even, because women's health is always interesting, isn't it? Yes, the downy ones were always well attended. Yes, but you think menopause was totally. Without a doubt. Yeah. Without a doubt. And unfortunately, those, we'd have sort of several speakers in the course of the day.

So anybody speaking on HRT could only scratch the surface. Yes. At those short talks. Yeah. But as a hospital, we wouldn't be able to put on a full day, which you can do for that one particular topic. It's too narrow for the whole hospital. Yeah, no, totally. And actually, I was very lucky to be able to run my clinic there because as a GP, it's very hard to find a place to run a clinic.

And I was very fortunate, the managing director at the time believed in my mission to help more women through their menopause. but for a hospital facility, actually me running a clinic is not very cost effective really, is it? So you can see why for them. But in a bigger picture, which luckily people did have vision, they could see how it would help it at a bigger scale. But it's interesting, isn't it? Because I know when I was an undergraduate and a postgraduate, and I've done a lot for hospital qualifications and general practice qualifications,

my menopause education was very minimal. I didn't, I'm sure as a student I didn't have anything, might have had a little bit in gynecology, but the odd talk in a, or usually in a consultation if someone came in. But I never thought about it as a bigger picture. I didn't think of it as a marker for future health problems. So I can understand that people want knowledge, but it's great that there's such this need. And it's not just younger doctors, was it? Or is it all ages? Oh no, all ages and all genders as well. Yeah, so that's good.

I think when general public go to the GP because they're, I talk about their periods or whatever it is, they tend to opt for a female GP. So then we get this kind of swing towards the females. It's having more education in this area. But in fact, more so really the male GPs would say that I've got little or no knowledge of this. So, yeah, it was important for them too. And I think the thing with the menopause,

it's so multifaceted and a GP has to be a jack of all trades, that it is really difficult for them to treat a woman in that eight minute or whatever consultation they've got. Yeah. I think it's also hard because a lot of GPs now, aren't they? It's one problem, one consultation. Yes. And ladies say to me, well, I've got headaches. I've got joint pains.

I've got tiredness. I've got low mood. And I've got sweats and I keep getting urinary tract infections. So which do I talk about? And actually we're sitting here knowing that all of those are related to one diagnosis which will be... And I think even the women themselves, if they don't have that hot sweat, the night sweats, which is so commonly known, you don't think about it. You wouldn't even put it in the bracket of menopause. Yeah.

Or perimenopause. So, you know, we're going to educate women as well. Totally. And I think it's also, I think it's really important if women can be empowered with the right information, then they can go and even, say she's a GP, I think it might be my perimenopause or menopause because my periods have changed or my periods have stopped and I'm getting these symptoms because then it changes that consultation very quickly, doesn't it? Absolutely, absolutely. But I don't know, maybe we have to rethink this completely because I, from my short time here, I've come to

realize actually that the menopause is so big in terms of symptoms and how it affects you. then perhaps that eight-minute consultation at OGP isn't the right place to do it. I totally agree. I mean, we've already talked earlier to other people, but about the whole education, even in schools. You know, I mean, you've got young children. They get sex education. Not all of them are going to have sex. They have sexually transmitted diseases information, not all of them, hopefully, are going to have sexually transmitted infections.

You know, they get drug information, which is really important, but hopefully most of our children won't, or won't have, you know, experienced drugs. But so that's really important. Absolutely. But actually the menopause, although it only affects women, as in the women will go through the menopause, it usually affects men as well. We witness the husbands and partners that come,

that, you know, sometimes carry their partners through the door. And it's sometimes them that phone for the appointment, sometimes the men because they've lost their wives and their partners to this. Yes. And the women are not able to see it. Perhaps their mood's too low, or they, you know, they don't feel they can address it. for whatever reason so the husbands do it um and yeah you know one of my roles here is to make sure that

the clinic is well staffed and staffed with the right type of person and the receptionists definitely following my remit and it's imperative that those receptions can sit and talk yeah and take time out yeah they don't appear to be busy or you know distract totally and i think that's really key isn't it is having time and yes i feel certainly the NHS has changed so much in the last 20 odd years and there is little time and obviously there's little resources but it's not just about money it's about the time that people need isn't it? And we see time and again that that is what is so important sometimes just the initial telephone call we have with patients. You know I've heard so many times women say gosh I feel 10 feet tall now. Yeah. We haven't done anything. You've just

listen to them on the phone and it's something I talk to the stuff about a lot here is that are the time it takes to book in a patient is longer than any other clinic. Yeah. Because the women are sometimes confused, very low. They take time to make a decision. So we have to balance up that need to answer the next phone call. Yes. But meet the needs of the lady booking in.

And, you know, we're all so passionate about this course that we're happily spend half an hour on the phone to one of the ladies. But it's quite different, isn't it? to, like you say, if I, if you were booking up because your knee was sore and you wanted to an orthopedic consult for example, two minutes done, isn't it? Yeah, absolutely. It's, and it takes a lot for women, I think, just to phone and get some understanding and to admit that they're having these symptoms because I don't know, I had symptoms for quite a few months and just thought it was because I was working too hard. And if someone had asked me if there was a problem, I would

say, oh no, I'm fine, I'm just a bit stressed. And then to almost, then to pick up the phone and then to say, look, I'm really struggling with quality of my life. And I know actually when I did finally phone my consultant, Nick Pane, who's an amazing person, very knowledgeable, his secretary, said, well, he's got no appointments for months. And I got really cross. I was really rude with her on the phone. Do you know who I am? I need to be seeing that. I can't work like this.

And I actually said, forget it, I'm going to email him and I slam the phone down. And, you know, that's awful. It's so irrational, but I was irrational at that time. And so, you know, you've got to have quite thick skin. Yeah, and we do. And sometimes if we get, you know, that bad call, sort of put the phone down, a bit of a group hug. She's a mental hug.

She's mental. But that we understand that. Yeah. But it's hard, isn't it, for the NHS? Because, you know, receptionists and GP surgeries don't have a luxury of time, do they? And so it's trying to, like you say, empower and educate women so they feel more prepared, trying to get them to get the most out of their precious time with their GP. And then I feel part of my role remit really is to try and help educate primary care professionals.

So not just doctors, but nurses, pharmacists as well. Because it's a whole journey. And so a lot of women we see in the clinic, obviously it is private because some of you might know I can't actually get an NHS job in a menopause clinic because they're closing a lot of them and I've been to different health authorities and there's no finances for me to run a clinic. So although this is private,

lots of women don't keep coming back here, do they? No. And that's something that we are... You talk about on the phone to them because sometimes in a very long booking process, the problem is money. Yeah, of course. So what we can say is that, you know,

we'll have you for our initial consultation and we can do you a follow-up. We will also, the doctors will also empower you to go back to your GP and say, look, this is what I want, this is what I've been described, and this is what it's been suggested I'd take. And, you know, many GPs are grateful for that kind of template

to just carry forward then. So not so. But, you know, it's, so we've got to think about this as not a long-term financial burden on these patients. No, totally. But the initial consultation that gives them the tools to carry on with the NHS. And we're, you know, I hope you're in agreement that we think that it's great.

Once we've set them up, we can set them free in the NHS. And that's what we do, isn't it? I mean, we've got now 11 other GPs working here. We've got nurses starting, we can see a patient, which is brilliant. But we write really detailed letters, don't we? Which, again, takes a lot of time with our team. But a lot of it is for the women. It's really important they get the right information.

But if the woman's agreeable, we send a copy to them. their doctors, don't we? So then we hope, and we already hear stories that the doctors then learn from that woman's experience and that can ripple and help others, which is really important, isn't it? Yeah, absolutely. And, you know, you have a number of GPs that come and sit with you and we run the education events. It's all about getting the information out. I mean, if we were running a business that was just, you know, with our capitalist hats on, we'd be shooting ourselves in the first. Yes, it's not a great financial model, but it feels the right thing to do.

Yeah, we're very fortunate for the education events. So, so it took us through because we had one a few weeks ago, which you really kind of organised, but it was a lot of interest, wasn't there? It was really easy to do because there was so much interest, so I didn't have to mark it too hard for that one. But some doctors came from quite far away as well. They did, they'd travel. I mean, I suppose the downside of it is that we attract the ones that are keen and interested.

Yes, totally. And so this is a long-term plan, isn't it really? We've got lots of plans. Because there was lots of registrars that wanted to come along, which was great. So where they're still in their training for their GP before they become fully qualified GPs. So I sort of feel at the moment that we're helping those that have already... Preaching to the converses.

We're preaching to the conversing. So we've still got a long way to go in terms of reaching those ones that are a bit set in their ways, perhaps not as keen to help the women. And when we still hear on the phone, horror stories of GP saying things like, oh, well, it happens to everybody. Or it was on the other day, oh, it's just all in your mind. Or it's very fashionable at them to talk about menopause.

Yeah. And that's not helpful, is it? No, it's not. In fact, someone on my Instagram put the other day that the doctor said to them, oh, you just need to wear linen pants and drink some soy milk. Okay. So, not that help. But it's difficult because, you know, I'm not here to be rude about GPs,

but, you know, like GPs have grown through this era where people were really scared of HRT. And so then if they didn't have education or the education they had was very negative, then they automatically dismiss HRT and don't see that it's a treatment option. So it is, like you say, it's being able to reach those people

because, you know, there are some things that I'm not as comfortable with because I've got less experience. So, for example, the diabetes drugs have changed phenomenally since I was qualified, and half of them I can't even pronounce anymore. But I won't always see a diabetic patient, and if I did, I would often help them to make the diagnosis or the initial treatment, and then I would say, well, you should go and see Dr. Blogs because he's the expert in the surgery.

But actually, because every female will become menopausal, I feel it's not an excuse to say, well I'm sorry I don't see menopause because you will even if you don't realize. Yes, exactly. It creeps into everything. It does, totally. And I think even if they're not confident in prescribing HRT, they should still have that initial knowledge to be able to direct women to the right sources of information. As you know, we've got a lot of written information here, which is really useful for women to have to. And actually, as a doctor, we often learn from our patients too when they come and bring information or.

have an idea then we think right we've got to learn about this because we're going to help them and then we'll help other people too and that's one thing about you that i admire is that you're not afraid of change in anyway so you know if you do learn something you know you implement it you research it you look at it you implement it and you're you know we're constantly changing and evolving to meet the needs of the women um whether that's just to make the visit more pleasant or um with education yeah yeah yeah so um you know you can't be um no you're not scared of it still. So, yeah, so just to talk really about the sort of education that we're doing,

what was great about the last meeting we had, we had got some external speakers, didn't we? Yes. Yeah, so that was something else that perhaps our world's are fully aware of is that we talk about menopause and HRT and you think, well, that's just one speaker, surely. But as I mentioned before, it is multifaceted. So, you know, we had somebody speaking about hair, so we're talking about breast cancer. and HRT, which obviously has got a very bad press, but those women have the right to choose.

Yes, totally. And then you talk about the urinary infections, dry vaginas, end of uteriosis. There's so many elements. Did you realise that before you came here, do you think, when you were organising your talks, was it sort of... No, I didn't. I didn't.

Yeah, I was very unaware that... Your hair, losing your hair, you know, and that's so important, isn't it? I suppose it's not that I didn't realize it. I just didn't think about it. Yeah, I know exactly what you mean. I think when you're busy, you just deal with what's in front of you. And a few years ago, I would always treat people if they needed it.

But I wouldn't think about the bigger picture. I wouldn't think so much about the impact it has on people's lives and their jobs and how, you know, everyone thinks about the hot flushes, but they don't think about the psychological impact. And it's those symptoms that we're. really people are coming for help, aren't they? Absolutely. And sorry, it's a bit of a side track here. But I think at the moment, and we don't want to be negative about GPs and the NHS.

But what are the time in history? Have there been so many women in senior posts? You know, we recently had a female Prime Minister. Totally. How did she get through her menopause and have such a senior role in the police? There's so many senior roles. So we're in a moment in history in a time where, you know, This is so important.

Going back to GP saying, oh, it's so fashionable, it isn't fashionable. No, it's not. And because we are women, we tend to put up with so many things. You have, you know, women with terrible periods, all their lives. They never get help. And never get help because they think that's their lot. And the menopause, lots of women think this is their lot. Yes.

I know it's very interesting. I was talking, wasn't I, just now, people in the office that we were talking about in the Victorian times, the average age of the menopause was older, 57, whereas now it's 51. But then the average age of death was 59, so a couple of years later, whereas now, hopefully, it's about 82, 83. So for most of us, we'll have 30, even 40 years of being menopausal. But that has a big effect on our bodies for... Yes, being menopausal and being so important in society. Totally. I don't want to be at home, falling asleep on the sofa every afternoon.

Someone said to me, the day of the day of the same clinic, even picking my children up from school, feels like climbing Mount Everest. I sat an alarm on my phone at 3 o'clock and I have this, because I have this overwhelming fatigue and I really, my joints are stiff, I feel dreadful. She was only 38, she's got early menopause, but it's that, and that's what's stopping people

from functioning and working. Absolutely, but don't we owe it to society? I agree. Those senior police officers are still working to help the community alive. I think it's such an important part. Well, it is, I mean, I am a crack record, but I've said many times, you know, it's the biggest travesty to women's health that people have been so anti-HRT for the wrong reasons. And not just HRT, but it's that whole menopause taboo, isn't it?

People get very scared of talking about it. I know even myself when I finally realized about my symptoms and said to a few friends, oh, gosh, I just realized I'm menopausal. Oh, but that makes you say I'm really old. Gosh, how awful. It shouldn't really be awful, should it? Absolutely not.

I hope you don't mind me saying but you actually say recently I'm quite excited about my men and I can't wait to have all those. Well, I see women walk in feeling tired and low and I see them a couple of months later or even I speak to them on the phone

a couple of weeks later feeling fantastic and flying and I suppose it's that element I see I see the heights and I want to be part of that. But you do, we see a difference don't we and I think mentally, physically and actually you were just saying before earlier today about how you hadn't really appreciated this risk of heart disease and osteoporosis.

No, of course not because it's not talked about, is it? You hear about the negative size about how it can give you breast cancer, but you don't hear about the fact that it can stop you, you can protect your heart and your bones and we just don't hear about that enough. Totally. Yeah. Which is really important because our life's a choice, isn't it? you decide whether you want to get in the car, whether you want to cross the road,

whether you want to do high-risk activity, like horse riding. And it's our choice. So therefore, I really strongly feel, and I know we all do here, that women should have a choice about their menopause and their health as well. And obviously we've talked about HRT, but we're really lucky here, aren't we, because we've got a yoga studio. Yes. So I know everyone thought I was crazy thinking about having yoga in there,

But you've dabbled with yoga and you can't enjoy it. I do. I enjoy it very much. And that space is used for lots of other things as well. We've had, you know, trichologists in talking about hair loss. We do the yoga. We've got, you know, other things in the pipeline of sleep workshops. Even fun evenings like colours and gems and things that we're planning the moment.

So that space is used a lot for the other part of the... And that, obviously, you didn't have that at the hospital. Oh, absolutely not. wasn't holistic at all. It was just... Are you finding that quite... You know, you're enjoying that? Yeah, absolutely.

Well, it's a different part of the job. And, well, yeah, it's great just to dabble and see what are the things we can do and thinking up. But it is, isn't it? There's a great movement at the moment about nutrition, because that's something else. We never got... Well, I certainly never got talked about in medical school. And, you know, there's that all same we are what we eat. And obviously, it's not just about what we eat.

But it is so important. and it's very easy as a doctor to give a prescription and think that you've helped. Yes. But actually I've always sort of said there's no point having HRT and then going and eating at McDonald's and smoking 20 a day during their exercise. It's part of a healthy lifestyle. Totally. Yeah. And we've got to be able to give that to the way.

We've got to be able to provide that. Yes. Yeah. You know, we have our nutritionist here as well. Yes. She's brilliant, isn't she? Ella Ellis Flint. And some of you might know has come from, well she's English, but she's been in Australia for

a long time, hasn't she? And the other week she came, didn't she? Just for the staff. A little evening after work. Everyone was a bit frazzled from a long day. And she came and she talked about probiotics, prebiotic food. She did some interesting things. Very simple ways of cooking. Absolutely. Down to worth. Not talking, you know, about things that we just don't understand. No. And it was very tasty as well, wasn't it? Really tasty. I like the eating bit best. So it's great. So good. So hopefully you're here to stay working with me because I can't survive without you. So just finally before we finish, I would really appreciate if you could just give three take-home messages that women could maybe just reflect from what we've talked about today.

But three things that maybe will help them in their journey, wherever they might be in their perimenopause or menopause. One of the important things is to do a bit of research. Yes. So we're not saying that you have to come to a private clinic like ours. No. But if we're, our website, or Louise's website is loads of information. So do a bit research before you go and see your GP to help them as well. They're busy, short.

I think be brave. Yes. Because like you said, sometimes we don't even want to talk about it with our friends. Yeah. And if we've got friends of similar age, they're going through it too. So you can help other people by talking other people. So be brave. and talk to other people.

And I think, oh, what's the third one? Perhaps talk to your family as well. I mean, involve your partner. We have a lot of partners that come here. We mentioned it before. And they may have noticed, even if you think lots of women say, I think I'm going mad.

Yes. And they're too frightened to talk to their partners, and their partners might go, well, actually, I've noticed this and this and this. Perhaps we should. And they're pieces together that jigsms. Yeah. And so you're not on your own. That's a big thing.

You're not on your own. There is help out there. And we're happy to support you initially and then set you free in the NHS, if that's the... Brilliant. That's great. Thank you ever so much. Oh, really kind. Thank you.

Thank you. For more information about the menopause, please visit our website www. www.menopause doctor.com.