Trading Secrets - 166. More Than Money:  A new baby on the team! Board certified Dr. Shieva Ghofrany dives into the worlds of OBGYN, IVF, fertility and the delivery of Evan Sahr’s (Jason’s biz partner) new baby boy, Nate! Born on 5/4/24, 8 lbs 1 oz at 5:59PM!

Episode Date: May 16, 2024

This week, Jason is joined by board certified OB-GYN since 1999 and co-creator of Tribe Called V, Dr. Shieva Ghofrany! Dr. Shieva played an extra special role to the Trading Secrets family as she played a role in delivery of the newest addition to the team with Evan and Betsy’s new baby Nate! Evan breaks down their meeting with Dr. Shieva and how she delivered baby Nate, Betsy hops on the call to talk about the delivery of the baby and her trading secret about going through the IVF journey, Dr. Shieva answers all of the questions about what you should know about OB-GYN and general health. It’s an episode you can’t afford to miss!  Host: Jason Tartick Co-Host: David Arduin Audio: John Gurney Guest: Dr. Shieva Ghofrany Stay connected with the Trading Secrets Podcast!  Instagram: @tradingsecretspodcast  Youtube: Trading Secrets Facebook: Join the Group All Access: Free 30-Day Trial 

Welcome back to another episode of More Than Money. Today we are joined by Dr. Shiva Gafrani, a board certified OBGYN since 1999 and co-creator of Tribe Called V, her virtual platform to connect with women on social media and help them increase knowledge and decrease anxiety around their OB-GYN health. When started as an endeavor, she connected with other women on Instagram and now has over 57,000 followers led to multiple consulting and speaking engagements live and virtually. As well, she is frequently quoted in online publications such as Self Magazine, Huffington Post, Mind, Body Green, discussing an array of women's issues, having gone through six miscarriages, three births, endometriosis, weight loss,

surgery in ovarian cancer, among other issues, Shiva harnesses her personal experience, coupled with her professional observations to genuinely help achieve a calmer perspective. Today, we are going to chat with Shiva on everything there is to know about the knowledge and business behind the life as an OBGYN. SHIVA, thank you so much for joining us on more than money today. Jason, thank you. I love, I love hearing that from a male perspective, by the way. I'm used to being on a lot of podcasts that are female driven. So even your cadence and your pronunciation of OB, GYN, totally different. I love it. Nice. We nailed. And we also know how important it is. And, you know, a lot of our listenership is women. And we know so many things, whether it's

professionally, financially, personally, like everything is changing in this space, especially from a health perspective. We're seeing the wage gap to start to decrease. We have a thesis on trading secrets. Not only is it going to decrease, but it's going to flip. So we are in good company, and this is a subject we got to cover. But more importantly, why we got to cover this is because one of the owners of trading secrets, one of the co-founders of rewired talent management, one of my closest friend's family to me, Evan Saar, had called me. I asked him all about it. He just had a baby boy, Nate with his wife, Betty. Nate was a miracle.

They went through five rounds of IVF for Nate to come through. And Nate sure did come through. And Dr. Shiva, you were responsible for bringing Nate to this planet. So I called Evan. I was like, Evan, we got to do a more than money episode. Not only on Dr. Shiva, because you speak so highly of her, but I want some behind the scenes. I want her perspective. We're your perspective.

What you would have done differently. This just happened a week ago. So for everyone listening, we will get in to some of the questions you're wondering as it relates to health and wealth with Dr. Shiva's career track. But before we do that, Evan Sarr, congratulations. Tell me how we feel and how does it feel to be a father? Oh, man, it feels it's a euphoric feeling. There's nothing like it. Words can't explain it.

Every day, wake up. And, you know, since May 4th when Nate was born and it's just, it's a blessing. It's a miracle, and I can't wait to watch Nate grow old and super excited about it. So it's unbelievable. I can't wait for 21 years from now when we are throwing down and party with Nate on his birthday because I am going to get hammered. But anyway, one thing I want to ask is this is like real talk, more than money, right? This is the purpose of it. Let's be real here.

Obviously, when you found out that Betty was pregnant, it was 99% excitement and joy. But there was that 1% of like a little hesitation. Like, oh my God, I'm a father and can I be a father? Like, how's this going to work? How do I do it, right? I want to just tell me about how and if that's changed from like the second Nate came out from your perspective. Like, did that 1% go away?

Did that 1% increase? Tell me about that. Yeah, so just quickly too, just the journey, right? So our journey was a long one. So it started in December 2020 with the IVF journey and the reason. And I think this is great to talk about too, just, you know, with this episode is the reason that we ended up going through the IVF process is because of Betsy's low ovarian reserve being at the age, you know, in what she's at, which is, you know, upper 30s. And so, you know,

because of that and some other factors, we ended up going the IVF route. And so through five rounds of IVF, through changing of fertility clinics, which then brought us to the recommendation of Dr. Shiva and the coastal OB clinic, that's, you know, that's where we are today. And so that's kind of just some background. Obviously, we can get granular with that as well. But super excited to have Nate here and to answer your question, you know, it's, I think it's when once you see this blessing and this beautiful child, you know, like in front of you, not, you know, obviously within Betsy's the woman anymore. It's just like, oh my God, you're responsible for this, the rest of your life. And it's like, wow, but it's like nothing can beat that feeling ever. Nothing has in my life. I'm sure nothing

as that season. So it's, it's unbelievable. It's a beautiful thing. It's a miracle. We're so, so excited for you. And I cannot wait to meet Nate. It's really, really so special. So with this episode, though, what I'd love to do is go behind the scenes a little bit, right? Evan, I know that you and Betsy were just like a little bit, like, as every couple would be like a little bit nervous. Like, how does this work? You know, what do I kind of expect? I know, Evan, you and I both share white coat syndrome. Like, we hate hospitals. We hate this. And you were so complimentary of this process. So Dr. Sheva, I want to kick it to you. What are some behind the scenes things when you met Evan and Betsy? What are some of the questions they asked? How did some of the questions

compared to like what most couples ask and just your perspective as the doctor going through this from start to finish last week? I mean, I love those questions. I will tell you that what what I loved most is when I first met Evan and Betsy in the office, which was only that one time. Evan came right out and said, I'm going to tell you, I'm really nervous. I'm get really anxious. I don't like being around medical issues. And that was valuable because I can't tell you how many people think they are not anxious and supplant their anxiety with like very brazen questions or just a lack of transparency and understanding of themselves or of the process. And so it makes it much harder because then we have to kind of traverse a relationship as the doctor and patient

that's like weird and complicated. But when you put it all out there, it's so much easier. And And the truth is that people who actually say they're the most anxious end up, in my opinion, kind of being the least truly anxious because they get it. They know their limitations. We have men, for example, who are like, no, it's no big deal. I can watch anything. And then they pass out in the delivery room, which means we have to tend to them instead of their wives.

Evan was very clear about what he did not want to see. So it actually, without exaggeration, made our job so much easier as the doctors and nurses taking care of them. So I love that. And that's like one piece of advice I would give everyone is really know yourself. and be honest with your doctors and your nurses because they want to help you and it is easier for us to do our job well

if the people involved with us are transparent with us. Yeah. Right? And that goes with everything. Meaning if you explained to us maybe something we did or said that was off putting to you in a gentle and kind way,

then we can help pivot and iterate and moderate and then it just works out better. It is so wild because we talk about this podcast, right? We've had billionaires come on. We've had sharks from Shark Tank, you know, Hall of Fame athletes. And what's interesting is almost in all those realms, there is this thesis that connects to the idea that vulnerability is the root of all connection and really helps accelerate things.

And it is wild to hear that that same connection and thesis actually goes for having a baby and communicating with your doctor and putting your ego aside and saying, hey, I'm not good at this. Talk me through it, work me through it. So it's wild to see in almost all spaces that connects. Evan, I want to ask you. I know you guys are, you were very prepared. you had a million questions you had expectations right so now you're through the process you've worked to dr sheva when you from the minute you entered that hospital to walking out of that hospital what would you say is one expectation that was completely bang on like you were prepared for it

you knew it and it was what you thought it was and then conversely what is one expectation that was like completely way off like you had an idea of what would be and it couldn't have been more different than what was. Give me one in one for your process, especially coming fresh out of the hospital. And then real quick, because I know Dr. Goprani mentioned this a couple of minutes ago, but the reason we only saw her once was, so the OGBIN clinic that we went to, there's about five different OBs that work there. And so we meet all of them. That's throughout the whole journey of Betsy being pregnant. So we'll have an appointment with Dr. Cahill, which was one of them, Dr. Axel, which is another. And so we then were just looking.

up okay who in advance who was going to potentially be on call for the delivery of april 30th you know in advance and so it was dr sheva and we didn't really ask that until like a month out and we had never met dr sheva yet because you know dr sheva i think you only are in the office once a week right there's betsy and so for us you know we heard great things about you but we never had met her before so we didn't know what to expect and then we met you and it was like a dream and we were like, there's no one else that we would want to deliver our child besides you based on the calmingness that you, you know, the vulnerability, the transparent, you know, nature that you obviously spoke to us about. And so once we met you, super excited. And I think

then to kind of segue that, that was where Betsy and I's calmness, I think, really lied. Like, that's what our expectation was spot on in that, because the idea, the process for us going to the hospital was we didn't plan it. So, you know, we went to our 40-week growth scan on May 2nd. That's Thursday. That was at 9 in the morning. And then, you know, the doctor, they do a, it's called a, I just wrote it down, actually. It's called a physical profile. And so they do that at the 40-week check-in. And so there's five different movements that they want to see from the baby in which you get two points each for them. And so we went to that appointment. We only got a four out of 10 and so the doctor told Antonius told us you guys need to go to the hospital so that we can make

sure everything's okay and the baby is monitored and dr. Shiva was on call she's out of the hospital so you know that was that process because we didn't have anything ready we didn't bring any hospital bags with us to the appointment so we were just having a normal Thursday right or at least thought we were and then we went to the hospital and then that's when you know ultimately sheva was there walked us through everything had you know the the baby be monitored and dr. Shiva if you want to even going to kind of what that looked like once we got in there. I think that would be great. Well, hang on. We got to take a quick pause here because we just had the one and only Betty Sarr join us here. Betsy, you got to come on for a second. Congratulations. You are now

a mother. Before we get into questions about the process or things that you learned, I just got to know, how the hell did you look like you walked out of a magazine front page after you gave birth to this beautiful child? What is the secret to be glowing and looking like? that when you just had a baby. Well, thank you for the kind words, Jason. And I really appreciate everything. You know, you got to do it. You got to do.

There's some things that you just can't go, one of which is makeup. So when it was time to push, I said, hold up. I want to put a face and makeup on to get ready, feel awake. I use my iPhone. And we did it. And I had my fan the whole time. And, you know, that's how it went. And you looked so good, honey.

You were pushing while having makeup up. Correct. And somehow I didn't break a sweat. I don't know. All right. We got to give a shout out to whatever makeup company this is. What brand was it? Ilya.

All right. There you go. There you go. I'm impressed by that. All right, Betty, give me this. And then we're going to go to. And Dr. Sheba, are you okay if I call you Dr. Sheva? My grandfather was a oral surgeon.

His name was Leonard Gross. And I always called him Dr. Lenny. And I feel like we're already friends. Is that appropriate or inappropriate? You correct. Jason, you can call me Dr. you can actually call me Shiva either one. Don't call me Dr. Gofrani. That makes me feel old. I appreciate it. Accomplish, not old. All right. Betsy, give us one big, you know,

obviously podcast, trading secrets. This is a more than money episode. But give me a trading secret. Like you went through what you went through five treatments of IVF. I mean, you were in the hospital for a couple days. Correct me if I'm wrong. I think it was two, three days. So it was a journey to bring Nate to this life. What is like the biggest trading secret? What is one thing maybe you wish you wouldn't known that you didn't know or something that you learned to this process that could help educate our listeners. Yeah, that's a great question. You know, I have a twin sister who got pregnant incredibly easy.

So when it was time for my turn, I didn't see that for my journey. I wish I had more education on checking your levels, what my ovarian reserve look like, maybe in my early 30s. And honestly, what held me back was maybe not getting it covered by insurance, which is a silly thing to say, but that's the reality of the situation. So I was pretty much in shock when I got the news I got back in 2022. Interesting. I think that is such a good piece of advice for the listeners back home. And you also think about, okay, we talk money here, what it would have cost you to do that in your early 30s? While it would have been expensive, I have to imagine, correct me if I'm

wrong, but I have to imagine looking forward to where you are today, that the price of doing that would have been well worth it, knowing that you're proactively preparing and probably putting yourself through less strain down the road. Is that true or false? Yeah, I would say that is true. Evan, you can also weigh in on this, but, you know, everything works out the way it's supposed to work out. That's kind of what I believe in. We weren't really in a place to start a family, which is why we kind of did not proactively look into this. So again, my track record was just different, and I was in between jobs and, you know, focus on just my career and not so much. family. And so it just, you know, it just depends really what's important to you. And that wasn't

as important to me. I knew I wanted it, but I wasn't happening at that moment, which is why I put it on the back burner. I love it. I love the vulnerability there, Betsy, because life is in a blueprint. Life doesn't work out to the timelines that meet our expectations. We have to move at our own pace and we see this happening day in and day out. And you did it your way. And it all worked out for the right reason. And now you have Miracle Baby, Nate, here with both of you. Dr. Sheave, I want to kick it to you because we're going to get into the career and money talk here in just a second. But I want to ask, like, from your perspective, you delivered this baby, behind the scenes with Betsy and Evan, something that we should know about the whole process,

a learning experience. Give us something that we wouldn't otherwise know unless we were there in it happening. Okay. There's so many things. I will keep it quick, but I talk fast. So first of all, Betsy truly did the work. I mean that genuinely. Like I'm glad I was there. I'm glad I was able to guide them. They would have done this without me with someone else and it would have worked out well. I'm glad that I was able to make it, I think, more fun and engaged in many ways. But Betsy had to work her ass off. And she was there for four nights because she was there for two nights of the induction process and then two nights after the baby was born. So a couple points that are really valuable for people out there to listen to. Evan and Betsy hadn't met me yet in our practice, mostly because I'm not in the office as much

as I used to be. But four of us deliver, four out of the five us deliver. And we actually encourage slash require our patients to meet all four of us because we really want patients to know us so that they trust us. And I want to know the patients because I want to trust them. It's a two-way street. Like this is what I have to do every day. So I want to feel good about it. So I urge every patient out there, even if your practice doesn't encourage or require it, try to meet everyone in the group because you don't know who's going to be on. And you want to have a healthy relationship with them and trust them. You don't always get your choice, but at least you'll know them a little bit. The other part to know is, and Betsy realized this, we can all say, like, this is how we thought

it was going to go, and then shit takes a different turn. Like, we all thought we were going to get pregnant. We all had years as women of, like, avoiding pregnancy and being scared we were pregnant until we're in our mid to late 30s and we can't get pregnant. So I think that was such a good point. And I do think that speaking from a place of privilege, I wish women could see their OBJUA and earlier, get preemptive knowledge earlier, get testing, maybe even get to the point where freezing eggs is more affordable. And that would be something that if we can get to that point in the future, women could family plan much easier or plan not to have a family, but have the backup if they need it. And then with regard to the birthing process, as Evan and Betsy heard me say a lot,

what did I keep saying, Evan, when you were like, well, what do you think? I'm like, it depends. It all depends. It depends. When is the baby going to come? It depends. How is the baby going to come out? It depends. So you really have to be flexible in your thinking, which is why when it came to the makeup, by the way, this is an important point. The nurses and residents came out to me and they said she's fully, but she wants to put on the makeup first. And I think they thought I was going to be like the impatient doctor because doctors are impatient. And I was like, of course she has to put on makeup. And by the way, let her take all the time she wants. Because if that gives her a feeling of that's what I can

control, then that's valuable. Because I know the other thing she can't control and I can't control. I don't know how the baby's still going to come out. She's going to have to push. I don't know how long it's going to take. So that's another part. That's really good for like life and parenting and birthing, but life in general. Pick those things that you can control and give up the need to control the other things because it will make you crazy if you think you can control the birthing process. You can't. But you can control the doctors you pick, the makeup you put on, the hospital you're going to be at, the clothes you're going to take the baby home in, right? Like what the room is going to smell like, what music you're going to listen to. That's the stuff you can control and you

should. Otherwise, you just can't. And it's like a losing battle if you try. Evan said you're one of a kind. And just in that answer, it is clear that you're one of a kind. I mean, what an unbelievable perspective, especially, you know, especially now and in hospitals and in healthcare, you're seeing, there's a lot of private equity companies that now own these groups and you're seeing just churn and burn. And I think, you know, some people feel like they're missing out on that bedside manner. And to hear that perspective from someone like you at your level is so refreshing and it's absolutely incredible. And I don't really get into politics much on this podcast at all, but couldn't agree more with everything you said.

And the idea of making this stuff more affordable and available anywhere and everywhere so that people can live the lives that occur and not be forced or pressured into having a child when it's not right is so important. And the idea that there is some pullback or restrictiveness associated with it to me is just it's it's grotesque and it's not going to put us where we need to be as we move forward so I couldn't couldn't agree more we only have so much time with you and you have you are a wealth of information betty and evan hang tight because I'm going to get a more than money tip from you guys at the end of the episode but I want to go into more of like a rapid fire because there are just so many questions I have for you the first one is a health question

for anyone listening how often should a woman visit an OBGYN every year every year year, even if your doctor says you don't need a pap smear every year, which you don't need a pap smear necessarily every year, please go see your gynecologist every year. Because there are other things that we do, and we, ideally, we do some preemptive teaching, and we look at other parts of your body. Okay, amazing. So once a year. Then what are some things that this is a big one, right? We go to restaurants and we look at reviews everywhere we go. We go to hotels, like, think about the planning we do for things that are inconsequential to our overall health and wealth and happiness, but we don't do it with doctors. What are things that individuals need

to look for when it comes to finding a good OBGYN? Like, what's a trading secret to make sure you're finding a good one? Oh, this is a good one. I love this. When people find us through Google, I always laugh. I'm like, first of all, don't Google your doctor because, A, your doctor could be super nice and get good reviews, but actually suck medically. Conversely, like my practice is an independent private practice. We have no big, like we're not owned by the hospital. So we actually just don't have as many reviews because we don't push out a request for reviews like big practices do. But people still find us that way, which is ironic, because we relatively speaking don't have a ton. The best way I think to find a good doctor, crowdsource through one of the social

media like mom's groups, things like that. But back it up by calling the hospital, ask for labor and delivery, and ask the nurses who they themselves use. They will typically give you one or two of the groups. Sometimes they'll say like we're not allowed to say, but let me just look at some names on the list. But you know that that means they're probably indirectly telling you who they themselves use because the nurses see us how we act in labor, how we act in surgery, how we behave with our patients, what kind of complications and how do we manage our complications? So that to me is the best pro tip. Ask the nurses as well as your friend. That's an insider tip right there. I've never heard of that. It's absolutely brilliant. Another one I got for you that I always ask my doctor

this because I'm curious. It feels as though everything in the world right now is unhealthy. Like there's one article like eggs are good before you. Eggs are bad for you. Alcohol's terrible for you. Don't eat this. Don't eat this. Don't eat this. Don't eat this. Don't do this. And so I always like to ask doctors, especially you being centered around women's health. As a doctor yourself, what is one thing that you would just never do as it relates to your personal health? Like something that you're like, I live and swear by this and it's true. Something you stick to every day because of the information you have. All right, I'm going to give you two things because you ask for one.

So one is I always take vitamin D3 because unless you are essentially like walking around naked, you're probably not going to get adequate D3 from the sun and you really can't get it very easily from food. And most of the data shows that we're D3 deficient and that we will do best from like cancer perspective, all kinds of infectious diseases, our immune system in general, if we were pleat with vitamin D3. Ask your doctor. I'm not your doctor, but that's what I would do. The second thing I don't do for the most part when I can control. is I try really not to drink and eat out of plastic.

Drinking eat out of plastic. Interesting. Out of plastic. I really try to use metal or glass. When I can. I mean, again, I'm not a purist because I can't be. And I think the anxiety that is caused by this like horrible clean movement and and fear of toxicity is probably worse than actually the toxins that we're getting in because there's so

much, there's so much unknown. Okay. But I try not to drink out of plastic. Interesting. All right. That's good to know. Let me ask you about this. We're seeing obviously IVF.

treatment is becoming more and more prevalent, especially as it connects to, you know, conceiving children naturally. People are getting married later. They're having kids later. And I just think about what are some things that women should know coming from an OBGYN that can proactively help the reproductive organs. And then secondly, kind of touching to this conversation, your perspective on women freezing their eggs. Is this something that should be done at a younger age? We just had Colton Underwood on, he talked a lot about the idea of freezing, actually, your sperm at a younger age and people that go, like, serve for our country in international wars actually have to freeze their sperm because what they might be exposed to while, like, actually

serving and how it could have a huge impact on the quality of their sperm. So I'm curious, from your perspective, what your take is. Yeah, I mean, I think that, listen, I'm so conflicted about it because on one hand, I'm in OBGYN. What I do is, is deliver babies. I have three babies on my own. That said, I also think there's a huge amount of pressure on women to be defined by birthing. And I really wish for the future that that men and women could both agree that having babies is great, not having babies is great in totally different ways. That said, it would be nice to be able to preserve the ability so that you might decide, I don't want children. I want to grow my career and have a really robust

life with my family and friends. But then you might turn 45 and decide you want to. So I think that being able to, like you said, be proactive. We're getting better at egg freezing. The technology has improved. The cost is coming down. The knowledge is improving. It's still not equitable, right? Millions of people don't have access to it because of knowledge or money. But as that number comes down, people will. So do I think in the future that would be amazing? It would. And just so everyone knows, freezing eggs is different than freezing embryos. Eggs mean it's just the egg. Embryo means it's the egg in the sperm together, which means by definition you have to know who your sperm donor is. And most women at a young age aren't coupled up yet.

And they don't want a random sperm donor. So they freeze their eggs alone. And that's a different technology that is newer. But I also think that, listen, being proactive and preemptive means figuring out knowledge ahead of time. Most women do not learn anything about their OBGYN health. And it's not their fault. There's no venue in school to learn about it. Our mother's, my mother's a doctor.

She was brilliant and amazing. But she didn't know a lot of the details that I ended up learning because of my own journey with endometriosis and miscarriages and all the things I've learned. So I really encourage younger women, learn more about your cycle, learn more about your period and ovulation and all of the things that nobody teaches us that I try to teach. So that's why I'm here. But I think it is it is part of something that we should be learning in school, just like money. I always say like they should teach us about mortgages and rent and taxes. They don't teach us that. Right. They teach us things that are irrelevant. It's all the things that like we need to know that we just aren't taught, which is so quite frankly

just like ask backwards. This might be a goofy question, but just my natural curiosities are coming to fruition here. Is there, there are so many things out there that you can do where there are suggestions of don't do it by a certain age or make sure you do it by a certain age. When I think of this process, the whole egg freezing process, is there a recommendation that you would say like, not holding it to it, but just an overall idea, an age that you would say, you know what, if you are this age, you're younger, you might.

you likely shouldn't have to think about this, but if you're this age or older, it should start to be a thought process if you want the option. Yeah, I mean, listen, I think that if you were like, you know, 25 or younger, you don't have to think about it. That said, the truth is if a 25, if a 20 to 25 year old could think about it, had the money and the knowledge and the understanding of what it takes and could freeze their eggs, that is a great time because you've got a ton of eggs at that point, right? The realistic answer is most women don't start thinking about it until at the very least, it seems, their late 20s, and that's if they're very forward thinking, or they're early to mid-30s. I have many patients who 35 plus are starting to think about freezing their eggs, and that's

harder, because once you get past the mid-30s, the number of eggs goes away. Like, we're born, do you know this, Evan? I mean, Jason, and Evan, and Betsy, we're born with all the eggs we're ever going to have as a woman. You are born with all your eggs. And then over a time, we're they go away. You either obulate or they kind of just go away during your cycle. So if you could do it prior to 35 is kind of like an easy answer, but younger is better. But again, just like Betsy was saying, it's so hard. You're young. You're like in your 20s. You can't even like save money to buy a good quality drink. You're buying cheap wine, right? So you're definitely not thinking you had to lose your embryos or your ovaries. Gotcha. Amazing. Okay. Ramen says hello. So I want to

ask a couple of career questions and money questions just because I have you on. We got to. But like the salary ranges for OBGYN versus other doctors in certain niches. How does it compare? I mean, listen, I think it doesn't compare. I don't want to act like, oh, we're so poor. We make money on volume most of us if we take insurance. And the range is broad. You could make anywhere from like 200,000 to a million depending on who you work for, how you work the volume you see. When you compare what we go through in training to, for example, neurosurgeons and you compare what we pay in malpractice to neurosurgeons, we make a fraction per, like per surgery, for example, per pregnancy. We make a fraction of what they make. So it's crazy.

And part of it, this is a fact, not to get political, but it's because we are mostly women in the field. The pay is decreased. And we're taking care of women. We don't value women's health. Evan heard us talk about this. For an entire pregnancy, our reimbursement from Medicaid, if you take. take care of some of the entire pregnancy and the delivery and the six-week postpartum visit. No matter how many times you see them, know how much complication there is, we get $2,750.

Which anyone out there listening if they've had back surgery, if they've gone for blood work, if they've had an epidural, they know that everyone gets reimbursed more than that. Private insurers will pay us like, because we're an independent private practice, we don't bargain for as good rates as the bigger groups. But even then, it's like $4,000 to $6,000 unless you don't take insurance, in which case you get reimbursed like, $10,000 to $20,000. But this is for 11 months of care. It's what's called a global fee. It's crazy, crazy. That said, most of us love what we do. But the truth is when you look at it from a financial perspective, you pay for medical school. You get paid like $30,000 to $60,000 as a resident.

You often don't start saving. I did not start my retirement until I was 34 when I was already a private practice position. Like for a money guy, that sounds crazy. I'm 54. I've only saved for retirement for 20 years. It's crazy. Interesting. One question I got for you then is we had a doctor come on before and he said because of some of the issues that you have mentioned here, he would not recommend his child get into health care. And he said all of his, he said in his quote, I think was 95% of all my doctor friends talk about how we tell our kids to go into a different profession unless they have just this absolute utter drive and desire to be in the profession to make an impact.

Do you agree or disagree with that? I agree with the second party, Woody said. Meaning, it sounds like he's saying the same thing I am. I would not encourage or discourage my kids to go into medicine. If they loved it, I would love for them to do it. But much like my parents, who were both doctors, they never encouraged it, but they didn't discourage it. They said, if you're going to love it,

if you're not going to love it, they would never, like many immigrant parents who have forced their kids into it. My parents would never have done that because it is miserable if you don't love it. Like even if you're making a steady living, it's never going to be enough money because you're exhausted. I mean, Evan and Betsy, you know, like I was there last week, several nights of the week. I didn't sleep the next day. I had to go to the office the day after I was on call for a week. It's not an easy life.

So if you don't love it, you're not going to make enough money for it to be worth the stress and anxiety of what you go through. So I, but I, but listen, if my parents, if my kids said they loved it and they wanted to do it, I would be thrilled because I think it can be the most beautiful career when, when done correctly. but still with huge amounts of anxiety and stress. Yeah, perfectly said. Wouldn't encourage or discourage, but the impact and probably the fulfillment of thinking about how many babies and lives you've brought to this planet, not many people could say that with your own hands. I mean, that is such a beautiful thing.

The last question I got is relates to just the money aspect of this, is a C-section versus vaginal births. Is there a difference in like the money that is made or the cost to the couple? Okay, I already love you for so many reasons, and this is the best question. This is so important for everyone to hear. I actually have to make a reel about this soon because people often think, you would think, a C-section entails more and everything. Of course, they should get more at surgery.

We, in fact, yesterday in my office, I asked my biller again, and I said, convince me and show me the numbers, we make either zero more or at most will make $3 to $500 more per entire global fee, which remember I just told you, is anywhere from $2,700 to $6,000 if we do a C-section. So that legend that doctors are doing C-sections to get home for dinner, as I joke, ask all your friends who are OBGYNs, how often have they been home for dinner, ask their families, or to make more money, is absurd. Most of us genuinely do a C-section because it's necessary.

So that's not, there's no reason to do it because of the money. And in fact, you have to see the patient more at the hospital. You have to see the patient potentially more in your office. It's not worth it. We would all love women to come in, plop their baby out, and be done. That would make our life easier. But that's just not how the business of medicine is. But there's a lot of misconception.

And I think it's misplaced anger towards the system and, frankly, insurance companies. But doctors are an easy target. And then unfortunately, there has been a lot of misogyny and medicine and women are dismissed a lot. And that's on the hands of doctors too. And so it's easy to kind of be like, oh, you just want to do C-sections because you make more money. If C-sections were going to make me money, I would be filthy rich. And I'm not. That is so interesting to hear.

I appreciate the honesty and just giving us a little sneak peek into the industry things we wouldn't otherwise know. Really cool episode of More Than Money. I'm going to end with this, Betsy, Evan, Dr. Shiva. Let's go to one more than money thought on the whole process, A to Z, what listeners might not know that they should know.

There's maybe something about your experience, you otherwise wouldn't have known unless you had gone through it. Why don't we start with you, Evan? We'll go to you bets, and then we'll wrap with Dr. Shiva. Evan, fire away. Sure. I think my more than money tip would be to be in complete communication and on the same page with your partner.

Whoever that is, make sure that you two or three, whoever many you are, are in communication, and you are communicating on the same page. You support one another through and through, I think that is what really helped us get through not only the journey of pregnancy over a year, but through the labor delivery process as well. So that would be my tip. That is a great one.

And we even learned about that in the early parts of this episode when Dr. Shiva told us about your communication and how that had a huge impact on the actual process. So that's a great more than money tip. Betty, the new mother. What do you got for us? Well, I guess I'm going to talk about kind of the induction. most people go into labor net like they think oh your water breaks you go you go into the hospital and you have a baby that is not the case always so you know a lot of people don't even know

this induction process can take two days alone so it's it's very you don't even you don't even realize it so two days of just nothing happening and waiting and you know it's hard on both you know you and your partner. So again, like kind of what Evan said, you need that level of support. And, you know, it goes such a long way. We were, you know, very calm with each other the whole time. You know, I'm shocked just how well we did together in these, you know, those days together because it was, it was a lot. That's all, you know, it's a lot. That is such a good piece of advice, but we otherwise wouldn't have known. I had no idea. And to think you were there for, I think about the total was, what, four, four days. I mean, unbelievable. But congratulations.

All right, Dr. Shiva, what is one more than money tip you can leave us with? Okay, this is going to be shameless plug for tribe called V.com, which is my online platform. But all joking aside, no doc, even me who talks a lot and talks fast, there would be no way during these visits for the doctors to be able to transmit all of the possibilities preemptively to patients. I wish we could because it would make their lives easier and our lives easier. And that's why my business partner I built our online platform with a pregnancy class that literally goes over a lot of these. these tips in quick video format, you can listen, you can watch, because it will be who you and your doctor and your partner to know some of these things, but in a calm voice where it's not like, you know, you might be there for four days, but it's like, hey, here's

how it might go. These are some things that might happen. It might be quick. It might be long. It might be a C-section. It might be a vaginal birth. These are why all of these things are okay. And I think if women could, again, I'm going to keep using the term preemptive knowledge, if they could gain that preemptive knowledge, they would feel so much calmer about the whole situation. I love it. That is such good advice. Everyone that's listening, if you want to go check out Nate and see what he looks like, go follow Betsy. Her tag is Betz Ansar. Go follow Evan. Evan Ensar. You can follow their journey and ask how many questions you have. And Dr. Shiva, go frani. You are an absolute star and a superhero, not all wear capes. And you are in that mix.

The work you do is incredible. And I'm sure there's going to be so many people that listen to this. that need and want more of you. So where can they find everything you have going on? I mean, mostly on Instagram, so I'm at Dr. Shiva G, which, by the way, V-A-G, I laugh. I was born into that name, or on TribeCalledVey.com, soon to be rebranded, but for now it's tribe-called V.com. And thank you. That was fun.

Amazing. What an episode of More Than Money. Betsy, thank you for joining us. Evan, thank you for joining us. Dr. Shiva, so nice to meet you. Hopefully, everyone back home thought this was. one they couldn't afford to miss.