unPAUSED with Dr. Mary Claire Haver - How to Get What You Need From a 15-Minute Doctor's Appointment with Dr. Lucy McBride

Episode Date: August 18, 2026

In this episode of unPAUSED, Dr. Mary Claire Haver sits down with Dr. Lucy McBride, a Harvard and Johns Hopkins trained primary care physician and author of the new book Beyond the Prescription: A Doctor's Guide to Taking Charge of Your Health. Dr. McBride has spent twenty five years watching patients bounce between a rushed medical system and a wellness industry.The conversation opens with a hard truth about modern healthcare: doctors interrupt patients within eleven seconds of them speaking, and fifteen minute appointments leave almost no room to understand the whole person behind the diagnosis codes. Dr. McBride explains why this happened, how insurance incentives reward volume over conversation, and why trust and rapport, not just lab values, are the real birthplace of health. She and Dr. Haver share stories from their own practices, including patients who were given thousands of dollars in tests but never asked a single question about their actual lives.Guest links:Dr. Lucy McBrideDr. Lucy McBride (Instagram)Dr. Lucy McBride (LinkedIn)Dr. Lucy McBride (X)Dr. Lucy McBride (YouTube)Dr. Lucy McBride (Ackerly McBride Group)Beyond the Prescription (Apple Podcasts)Are You Okay? By Dr. Lucy McBride (Substack)Books“The New Perimenopause,” by Dr. Mary Claire Haver“The New Menopause,"⁠ by Dr. Mary Claire Haver“Beyond the Prescription: A Doctor's Guide to Taking Charge of Your Health,”by Dr. Lucy McBride

I think the problem is that when you don't have context around it and when you have access to unfiltered information, chat GBT, Google, you can make yourself crazy. You can diagnose yourself with pretty much anything you want to. It's interesting. If you look at studies of how chat GPD compares to actual doctors, there's studies to show that chat GBT actually does better than doctors. But remember that in the studies, the questions were being asked. asked by doctors. So the framing was already there. When you're a patient, you don't know what question to ask. And so in real life, people are being misled by chat TPT more often than they're being misled by doctors. The views and opinions expressed on unpaused are those of the talent

and guests alone and are provided for informational and entertainment purposes only. No part of this podcast or any related materials are intended to be a substitute for professional medical advice, diagnosis, or treatment. My guest today is someone I've been wanting to sit down with for a long time. Dr. Lucy McBride is a Harvard and John Hopkins trained primary care physician, practicing clinician, and one of the clearest voices I know when it comes to what is actually broken about the way we take care of patients. She writes the Substack Newsletter, Are You Okay, with nearly 39,000 subscribers,

host the podcast beyond the prescription, and her first book, also called Beyond the Prescription, a doctor's guide to taking charge of your health is out this month, and I had the honor of writing the forward for this book. The book is Lucy's attempt to solve a problem she sees every day in her practice. Patients caught between a healthcare system

that treats them like a checklist and a wellness industry that sells them false promises. Neither one actually gives people what they need, which is agency over their own health. So Lucy has a five-step roadmap for becoming the CEO of your own health, not by rejecting medicine, not by becoming your own doctor, but by learning to ask better questions, advocate for the care you deserve, and make decisions that are actually aligned with your own values. She brings 25 years of clinical experience to this

conversation and what she's really talking about is a shift, from passive patient to empowered partner. Awareness, acceptance, and agency. It sounds simple. but it changes everything. And if you've ever walked out of a doctor's appointment, feeling dismissed, confused, or like you were handed prescription instead of an answer, this conversation is for you. I'm Dr. Mary Claire Haver,

a board certified obstetrician and gynecologist and certified menopause practitioner. I'm also an adjunct professor of obstetrics in gynecology at the University of Texas Medical Branch. Welcome to Unpaused, the podcast where we cut through the silence and talk about what it really takes for women to thrive in the second half of life.

Here's something I think a lot of us get wrong. When our skin starts looking dry, dull, or just a little tired, we immediately think we need more products, more steps, more things to add to the shelf. But most of the time, we don't need more. We need better ingredients. That's one of the reasons Primely Pure caught my attention. They're a female-founded brand focused on supporting your, skin with thoughtfully sourced nourishing ingredients instead of harsh chemicals that can

disrupt your skin barrier. And like so many of you, my routine needs to fit into real life. Between seeing patients, recording the podcast, and everything else that fills my day, I want skincare that feels simple and intentional. Primally purest plumping collection is exactly the kind of routine I'm interested in incorporating. It includes a serum, mist, and cream formulated with Bukuchi oil, a gentle plant-based alternative to retinol that helps replenish moisture, soften the appearance of fine lines, and leave your skin looking plump, healthy, and radiant without the

irritation. Because healthy skin isn't about doing more. It's about giving your skin what it actually needs. Use code unpaused to get 15% off your primarily pure purchased. That's www. p-r-I-M-A-L-L-Y-P-U-R-E dot com and use code unpaused at checkout for 15% off your order. You know what I've stopped doing? Saving the good jewelry for special occasions. Life is the occasion. I want jewelry that works as hard as I do. I don't want to think about taking it off before a workout, a hike, or jumping in the shower.

I want to put it on and forget about it. That's why I've been wearing Jenny Bird. Whether you're someone who lives in a pair of statement hoops, love stacking bracelets, are just once one everyday piece you never have to think about, Jenny Bird has those go-to pieces that instantly pull a look together. And every single time, someone asks, where did you get your jewelry? That's when you know it's good.

The quality is incredible. It has that elevated luxury feel without the luxury price tag. and they're the kinds of pieces you'll reach for again and again. If you're looking for something a little more special, their new fine collection has beautiful, modern diamond designs that are meant to be worn, not save for someday. Because the best jewelry isn't the kind you keep in a box waiting for the perfect moment.

It's the jewelry you love so much you never want to take it off. You can get 10% off your first order with Ginny Bird by visiting jennie-dash-bird.com. and using code HelloJB at checkout. All right, Dr. Lucy McBride. Welcome to Unpaused. Mary Claire, I am so excited to be here. I am just thrilled.

I woke up elated. I want to talk about the book. Great. Are you down for that? Why on earth would you write a book? Why this book? I wrote this book because I've been caring for patients for 25 years. And I was seeing the same problem again and again.

Patients being churned out by the, medical system, frustrated by 15-minute appointments, and then naturally turning to the wellness industry and wellness influencers for advice on how to be well, but feeling just as confused as when they left their doctor's office. So this book is a guide to getting what you actually need for your life, for your health, and it's not a recommendation to ditch your doctor. We all, want to be well, it's a roadmap to make sense of your health and then ask the right questions and get what you need. You are still in traditional practice, correct? Yes. I started my own practice in 24. I was in a practice for 19 years in a big group and I wanted to run my own place.

I wanted to really drill down into the relational aspects of care, to be able to have time with patients to understand the whole person because there's so many aspects of health that aren't measured in a blood test or on a scan. It's about a conversation. It's about trust between patient and doctor. Yeah. And our system isn't designed to care for the whole person. Right. It's not designed to understand that your diabetes is informed in part by your lack of child care that makes it impossible to chop broccoli and meal prep. So you have to have time with a doctor. You have to have a partnership for there to be trust and rapport. Patients tell me things that they, that, they They wouldn't say out loud to anybody else.

And if I don't have that trust and rapport with them first, I can't really help them in a really meaningful way. I feel the same. I, you know, was trying to crank out as much empathy as I could in these 10-minute visits, where half of that was her uncomfortable in stirrups and me coaching her through how to get through this pain, you know, with this little pain as possible. And then trying in three minutes to cram in everything else about her. her health, and it just, it's impossible. It's impossible. So take my 80-year-old patient I saw last week.

He's on six medications. He just lost his wife, and he's got hip pain. If I had only five minutes with him, I could barely scratch the surface of what's actually going on in his life. What's most interesting to me and what's most relevant to his health is his grief and his loss and how that informs his compliance with his medicines. So again, it's really difficult to take. care of patients in, you know, hurried 15-minute appointments, it's nearly impossible to understand the whole person. Right. Let's talk about the system for just a second.

It didn't start out like this. We weren't, you know, this whole 10, 15-minute visit thing is really new in the last 10, 20 years. Like, how did this happen? It happened because of the insurance industrial complex. Insurance rewards doctors for volume. Right. For transactions.

for prescriptions and referrals over and conversations and procedures. You're more likely to see a doctor and get a prescription and a referral than you are to have a conversation. But dialogue, rapport, trust is the birthplace of health. It's not just trusting me.

It's about me understanding you. So it's not just about the patient has to trust me and do what I say. It's equally important for me to understand who you are, what are your goals, what are your needs, what is your tolerance for risk? Because I think what has happened in medicine because of the system through no fault of doctors is that we end up assuming that our tolerance for risk is the same as our patient's tolerance for risk.

Right. That my goals are your goals. But take a patient who is facing the decision to pursue further chemotherapy for her cancer, or prioritize quality of life. That decision is so personal, so individualized, but the oncology space, for example, would say, treat the cancer at all costs. That's it.

No, we're living this in our family right now. Whereas my job is to center the cancer, of course, but really to center the patient. She may decide I would rather go to my grandson's baseball games and feel alert and aware than suffer. the brain fog from more chemotherapy. It's not my decision to make. It's hers. Right. But if I don't understand why she's alive in the first place or what her goals are, it's very hard to guide people in making decisions. So you open the book with two patients. Yes. One who got dismissed by traditional

medicine and fell into the dark hole of wellness culture. And then another one who got $12,000 worth a test and no one even talked to her about what was going on in her life. So, you know, which version of this brokenness do you see most often, or is it equal? So I see both. Obviously, I see all different comers. But I see a lot of people who have been disillusioned by the medical system. They've been treated like a set of body parts, a bag of organs. And they have gone other places for advice, specifically it's the wellness world, which I'm very much part of. I mean, I want my patients to be well. If I don't want you to be well, there's something wrong with me. It's a doctor. I also see people who have been given a lot of tests and a lot of scans, but never been asked, what's going on in your life?

So the patient I opened the book with is someone who had abdominal pain, didn't have a primary care doctor, went to the ER, got $12,000 worth of tests, and no one has ever asked her, what's going on? Turns out she was stressed over having a home situation that was stressful, that she was drinking more coffee, taking Advil, and she was. She didn't need a liver biopsy or more tests. She needed someone to say, hey, I wonder if your stress and your default to alcohol and Advil are affecting your liver and your belly. And they were. And they were.

So when you have someone who comes in and says, I've given up on traditional medicine, what do you say? I start with empathy. I say, I get it. I've been a patient. I have been treated like a set of organs, a set of diagnosis codes. In fact, I went to medical school to become the doctor that I never had. I also get curious, what happened? Tell me the story. The amount of dismissal and over-medicalization is really astonishing. And again, it's not doctor's fault. If you're a doctor and you have five minutes, it's just, very difficult to understand the nuances of a patient's life and how their stress affects their relationship with food. It's very difficult. So again, first thing is I understand. Let me understand why you feel disillusioned. And let's meet you where you are. And let me tell you how I work and

tell me how you feel about being cared for. You wrote that knowing your numbers, which I think is important is not the same as understanding your health. I say something similar about, you know, hormone therapy, you could have a normal estradiol level and still feel terrible, like not everything is metapause. But what are we both kind of pointing at here? What I'm talking about is that you can have two patients with the same high cholesterol level. And one of them got there because she's going through a divorce and is binge eating. And so she doesn't need Lipitor. She needs a divorce lawyer. You could have the same person with the same cholesterol levels who's exercising every day and eating a high protein, low cholesterol diet, and just has a genetic predisposition to

high cholesterol. That person may need cholesterol medication. So the numbers don't tell the whole story. The numbers are the starting point, not the end point. This is going to sound very familiar to patients who are listening. In the book, you mentioned that doctors interrupt patients within 11 seconds of them starting to speak. 11 seconds, you get interrupted. Is this a fixable behavior problem, or is it a system design problem? I think it's a systems design problem.

Most of us in medicine, I'm assuming you're the same way, Mary Claire, went into medicine to care for human beings. Totally. So I don't think that a doctor who's interrupting a patient wants to be interrupting. they just know they have three other people in the waiting room, a whole inbox full of messages, and they're just trying to get through the day.

So we can talk about this later in the show, but we need a whole scale reinvention of the health care system to allow patients to be heard. 11 seconds. Amazing. One of the good and bad things about modern medical care is, you know, our patients are having access through, you know, my chart. these companies to their portals that give them access to their labs and results, often with no context. So sometimes getting cancer diagnoses or incidentalomas found on imaging. You wrote about a patient whose brain MRI results popped up showing nonspecific white matter changes. She Googles it,

as per any human would do at this point, or now go to Claw or AI, and was convinced herself she had multiple sclerosis. And then her headaches got worse. from the anxiety and the actual cause in this patient was workplace harassment. Should we be giving patients access to this data? I mean, how dangerous could that be? Are you a fan of it? Just to be clear, her headaches were from the workplace harassment. The answer to your question, Mary Claire, is that, of course, I believe that patients have a right to their own health care information. I think the problem is that when you don't have context around it and when you have access to unfiltered information, chat GBT, Google, you can make yourself crazy. You can diagnose yourself

with pretty much anything you want to. It's interesting. If you look at studies of how chat GBT compares to actual doctors, there's studies to show that chat GBT actually does better than doctors. But remember that in the studies, the questions were being asked by doctors. So the framing was already there. When you're a patient, you don't know what question to ask. And so in real life, people are being misled by chat GPT more often than they're being misled by doctors, if that makes sense. I love chat GPT. I love clot.

They're wonderful. And I do think that they sometimes have more empathy than physicians do, right? They say, oh, I'm so sorry about that toe pain. That sounds horrible. I mean, that's much more empathetic. That's how they lead, yeah. They are much more empathetic than I might be about someone's toe pain. But there's really no context being provided.

And so you can convince yourself that you have the flesh-eating bacteria or a brain tumor if you don't have access to someone to help you make sense of your data. Patients often see multiple specialists, and we've both seen this, who are not talking to each other. Right. So you describe a shared plan that travels with the patient to every appointment. We used to have this in OB. Yeah. The patient had a pat, we called it a passport. and we would fill in whatever information from whatever visit because she was going from

clinic to clinic and we were the high risk kind of end of the road. She had her passport in her pocket. She'd pull it out and I could look back and see all of the visits that she'd had and kind of have an idea of what was going on with her care before then. But, you know, why don't you think, you know, most patients have access to something like this? Because medicine and the U.S. is so fragmented. And you have a digital avatar of your... your health in every place you've ever been for medical care. So your pharmacy has a digital

avatar of you as someone who's received these three vaccines and got these prescriptions. The ER has a digital avatar of you as someone who had an appendectomy and had a baby. And then your primary care doctor maybe has an avatar of you as someone who has hypertension and high cholesterol. But they're not connected. Right. And one of the hardest parts of being a patient in the U.S. is the lack of integration of all of those pieces of information. Is anybody doing this well? Any country? It's not us. The VA hospital actually does a fantastic fantastic job. So the VA hospitals in the U.S. have a wonderfully integrated tech platform. But what if you step outside of the VA? If you step outside the VA, it's the Wild West, right? You are a

different person in different electronic medical records and no one is keeping it together in-house. I mean, that's what I do as a primary care doctor is I spend an enormous amount of time myself and asking my staff to help me pull information from different electronic medical records to house it at home. The medical home is the primary care office job. But that's not accessible. A hundred million Americans in the U.S. do not have access to a primary care doctor. Primary care is meant to be a hub for problem solving, a home for the whole person. where mental health, physical health, nutrition, body mechanics, meet. And referrals are meant to be there for when the primary care doctor needs help.

But we can solve a lot of problems in-house when we have time with a patient, when we have time to understand someone's grief and loss and vulnerabilities and connect the dots with their labs. And then hand that information to the patient so they can be well, in the 365 days a year, they're not in my office. Right? Health is not about me or the moment you see me. It's about you in your regular life. How is that going for you in your new practice? It's great. I mean, I am the luckiest person alive to be able to care for patients in the way that I wanted to when I was in high school. That I can care for patients. I understand that their blood pressure is informed just as much by their insomnia and work stress as it is by their medications. or their genetics. So my job as a primary care doctor is really not to lecture people is to help them understand what choices they have, to help them understand where they have agency and where they have to let go. So you can't change your genetics. You can't change, for example, that you have a

predisposition to breast cancer or heart disease. But what you can do is understand how to mitigate those risks and how to make choices lifestyle, behavior-wise, medication-wise, to be able to let go of the anxiety you have about these predispositions. So my goal as a doctor is really to hand power from guidelines and the medical establishment back to the patient for them to operationalize whatever plan they need to feel well. Do you think the magic is time? What is the biggest difference from the traditional way you practiced, you know, in the big practice where you were under time constraints to the way you're practicing now? I think it's time with the patient to be understood. You know, when I was in medical school, at Harvard Medical School in the 90s, we had one class

called patient doctor where we learned how to talk to patients, and I loved it. So I had this patient, we had these actors that would come off the key. Yeah, yeah, yeah. And they, I remember this guy, he was, I read about him in the book. He was wearing pink leg warmers. He kind of sure. He kind of off his day, whatever his day was, came in, and I had to deliver bad news to him. I had to deliver to this actor patient that he had prostate cancer. And I thought this was the coolest thing ever, that I had five minutes to establish rapport and to help him trust me and then deliver hard news. So I think that we don't get enough education in medicine, at least I didn't, on how to relate to other people. We talk about body parts, we talk about diagnosis codes, we talk about

prescriptions, but we don't necessarily get an education on the whole person. So I think the difference I see in my practice as it is now is that I have time to talk of patients, time as a requirement for developing rapport and trust. And then I also, because of the time I spend with patients, I have a deep understanding of the relationship between people's mental health, their biography, their story, and the choices they make and the barriers they face to execute on the things that doctors recommend to them all the time. Eat more protein, eat less sugar, exercise every day. Those are wonderful recommendations. I recommend those all the time. You do too.

Those are essential. Everybody knows. Most people know that exercise is good for you. and that strength work matters and that protein is kind of utilized. Yeah. The challenge I see isn't so much that people don't know that, although there's plenty of people who don't know that, is that they don't know how to operationalize a plan around it. They have a barrier to entry on the recommendations.

So they are feeling ashamed and less than because they can't get protein with every meal. They can't wear the weighted vest. I love the weighted vest. It's wonderful. But if I have a patient who has chronic shoulder pain and depression, my job is to help her fix those things first before we can actually get her in that weighted vest and on the treadmill. This podcast is sponsored by Middy Health. You've heard me talk about my menopause toolkit. It consists of nutrition, exercise, hormone therapy, and other medications, stress reduction, sleep quality, and community connection. When you put those pieces together, they don't just ease symptoms. They support your long-term health.

That's why I recommend Midi Health. They put your toolkit to work for you. Midi is a virtual clinic built by leaders in women's health with clinicians who understand the science of female aging and who take the time to understand you. Through one-on-one visits, they listen to your symptoms, your goals, and your concerns, then create a personalized care plan tailored specifically to you.

And best of all, Midi is covered by most major insurance plans, making expert high-quality care accessible and affordable for every woman. All of which is why Midi should be part of every woman's menopause toolkit. Book your virtual visit today at join midi.com. That's join, M-I-D-I-D-com. You write that when the healers are sicker than the patients. They are supposed to treat. The system is not just broken,

it's actively harmful to everyone it touches. You know, we see a lot about, there's a difference between burnout and moral injury. Can you talk about the differences? So I have been burned out in my life. I'm guessing you have too. Totally. I had my first child when I was an intern at Johns Hopkins Hospital.

And I didn't know what burnout was until later, and that was it. Yeah. Where I was burning the candle at both ends, and I wasn't as good of a doctor because if I'm not caring for myself, it's very hard to take care of other people. So burnout is, you know, part of the problem in medicine. It's imperative that physicians apply the same level of self-awareness and self-care that we recommend to our patients.

We are not good at that as a general rule. Doctors are not generally very good at taking their own advice. At least I have not been historically. Moral injury, I think of as the inability. because of a systems problem to take care of patients in the way that you want to, that you need to, for your core values. So take the pandemic, for example, we saw a lot of moral injury during the pandemic where people were not able to care for patients, say a patient who is at the end of their life and in the ICU and not able to see their loved ones at the end of their life. That's moral injury to a doctor who's empathetic.

It's moral injury to the patient and their families as well. But take a more practical example of moral injury. A more practical example of moral injury is simply not having time to talk to patients. So if you don't have time and you have a patient who's crying in your office because of... Anything. Pain with intercourse or depression or they've been confused and been given conflicting advice about some medical problem. it is hard on the caregiver like it is the patient to not have the time to understand what's actually going on with that person. Yeah.

I, you know, trained under what was a charity system at the time. And, you know, anyone who walked through the doors, we took care of. And the state would pay the check, you know. And then I went into private practice and came back on as faculty and the whole system had become more corporate and they got rid of the charity system. And then now it was insurance-based. And a few counties would feed into our hospital that had kind of plans, but not all. And so we would get these patients

who we could cure their cancer with a simple surgery or something very basic, but we had to turn them away because they couldn't pay. And I'll never get over that, having to sit down and tell a patient. You need a simple hysterectomy or you need a, you know, whatever.

And this would 100% cure your cancer, like stage one in a matrile, right? But we can't do it because you can't pay. And that was really, really hard because I didn't, that wasn't how it was in medical school. That wasn't how it was in my training. And then to turn around as like the boss in charge and have to look someone in the eye and say, you're too poor for me to save your life was one of the hardest things I've ever had to do. It's excruciating.

If you think about all the unmet needs out there in the community and all the people who do not have access to, a medical guide who's evidence-based and centered on the patient's needs, it's, it's really soul-crushing. This book is one attempt to help people make sense of this dizzying landscape where most people go to the ER for their primary care. Now, yeah. And then look on the internet for wellness advice. Now, again, we need doctors. We all want to be well. The solution is not to become your own doctor is to be a more empowered patient.

Okay, we'll get into it. You describe patients as being stuck between two extremes, a healthcare system that reduces them to checklists and a wellness industry that can be full of false promises. You know, what does that look like in your exam room really for women in midlife? Because that's our audience. Yeah. Right. Well, you see this too. I see patients who come in who are like 30 years old and they're like, I have brain fog. I think I'm paramedopausal. And they may be. But they may also have brain fog because they're raising children. They're working for. time, they don't have a supportive spouse, and they're not sleeping enough. Sometimes things are much more simple than... Right. Not everything is hormones, guys. That's it. But a lot of it is. I mean, I don't need to tell you, Mary Claire Haverer, that women have been deprived for generations about basic information about their hormonal health and their brains and their hearts and their bones. But what I'm seeing out there is that people are being misled by voices that. are very certain. So if you hear someone talking on the internet, and by the way, I'm on the internet, you're on the internet, and I'm trying to spread truth and facts, but if you hear

someone on the internet who's preaching certainty, who's convinced that you will be better if you just do X, Y, or Z, and do as I say, that's a red flag. I would say the same thing about a doctor. If you see a doctor who says, don't do this, do this, do as I say, that's also a red flag. So, you know, doctors don't speak in absolutes. We speak in ways like this. I wonder if you've thought about how this medication might affect you in this way versus this other alternative treatment. What do you want? That's how we speak. We speak in nuance. We speak in relative risk. But that's how we should be speaking, yes. Okay. What right now, you know, for women, what are you seeing as really dangerous wellness advice? So what is, what is true?

trending out there that you're like, whoa. So I think the biggest problem with some of the voices in the wellness space is suggesting that yoga and mindfulness and kinawa are necessary and sufficient for health. I think it's placing blame and shame on the patient. Absolutely. She walks away from that message feeling like she did something fucking wrong. Yes. You know, that somehow she wasn't yogaing enough or, you know, she wasn't wellnessing her way

out of whatever situation she's in. We preach the same lifestyle, right? Both sides of the fence, but not in absolutes, right? And I just hate when I see these, you know, messages and somehow the woman, especially the female patient, she's always doing something wrong. It's not enough. The problem I have with the wellness space, again, is similar to what you said. It's that it's implied that it's necessary and sufficient to,

you know, lifestyle your way to health. Two, that it's not enough, that you're not doing enough, and that you can always be doing better. And it plays a shame on the individual. And then third, I think it often leads people away from doctors. Now, doctors do a very good job of shaming patients as well. I mean, we are the chief shaming officers in many ways. Take my patients who have suffered from obesity their whole lives.

I mean, they will tell you how shamed they have been by the medical establishment. It is a crying, crying shame. But I think what I'm trying to message in this book is the both and. You can try to be healthy with exercise and life cell and behaviors. You also need a doctor to partner with you, to shepherd you through sickness and health. Let's talk about supplements. Yeah. We, of course, in the medical history, ask about all supplements that patients are taking in our clinic, and I'm sure you do. Are you, what do you seeing in the supplement world? Like, that scares you. I think the reason the supplement industry scares me is because I think people often think of it as a substitute for medical care. So it drives people away from medicine. Now, again, as I just said, I'm a both and person. There's a role for supplements. There's also a limitation that supplements have. Same thing with pharmaceuticals. There's a role for Lipitor, but there's a limitation of Lipitor. Right? Lipitor can lower your cholesterol, but it's not going to change your stress. that's making you overeat. I think the problem I have with supplements is that there's this notion that there's a one-size-fits-all program for people.

I love supplements. I take supplements myself, certain supplements. I prescribe and recommend supplements. But there are limitations to supplements. There are also limitations to pharmaceuticals. So the question isn't, do you maybe need a supplement or do you need a prescription medication? It's what is your goal and what are the limitations of these things you're doing? taking for the health issues that you have. So let me give you an example. I have patients come in

all the time, and they say that I'm taking aschwaganda for my sleep, I'm taking magnesium for my constipation, I'm taking fish oil for my heart, and they have a number of complaints that haven't actually been addressed. And they don't really know that their constipation is because they're not getting in a fiber, that their brain fog is actually menopausal, and their sleep is disrupted because they're drinking too much caffeine. So instead of supplements, I want them on the thing that would actually help them, hormone replacement therapy, fiber diet, higher fiber diet, and understanding that alcohol plus menopause means you're going to sleep. You're not going to sleep. Terribly. So the supplement industry, I think, meets an unmet need, but we want to make sure

we're solving the right problem. Right. Right. Let's talk about the bad boyfriend in the book. Oh, the bad boyfriend? Yeah. Trackers, wearables, shareables, nearables. Are you a fan? So I think an empowered patient is a better patient, right? I understand why people want to track their sleeve, track their steps. I think these trackers are wonderful. It's sort of democratized, you know, medical data. But as we talked about earlier, Mary Claire, data without context isn't particularly helpful. So here's what I tell patients about data. When you want to bring that data to your doctor, bring the patterns, not just a single data point. It's more useful to me to know that your sleep was disrupted when you were laid off from your job than it is to know that you had a bad night's sleep just one off.

It's helpful for me to know that your headaches and your migraines got worse when you slept less than six hours than just handing me a spreadsheet. I think what's most interesting about the explosion of the wearable. is that it shows us just how disconnected people often are from their own bodily cues. Right. We live in a hustle culture. We live in a culture where we can have access to the internet 24-7. And I think it's interesting that some people need a aura ring to understand that they're tired, or they need a device to tell them that they're hungry.

And I think it says a lot about society and modern hustle culture that the devices are so popular. I also think they're wonderful in many ways. What about I'm seeing a lot of, you know, contention around the continuous glucose monitors? I've tried them. Yeah. And out of curiosity, I had insulin resistance. I've gotten it managed. And I was curious, right? And they offered me a free one. So I'm like, sure. I had more anxiety from, you know, I do wear an aura ring and I've made peace with it and I use it, I think, in a healthy way. Yeah. But that glucose monitor made me crazy. Well, that's the bad boyfriend I was talking about. So I recommended to one of my patients to take off her aura ring because it was making her feel bad about herself.

It was demanding more and more from her. It was like a bad boyfriend. And she took it off and she finally slept. She was having insomnia because she was so stressed about the lack of sleep she was getting. So the CGMs, the continuous glucose monitors, can be really useful. I recommend them all the time for patients who have diabetes, of course. That's a standard recommendation. But someone who's otherwise metabolically healthy?

For someone who's metabolically healthy or who has an elevated hemoglobin A1C that's pre-diabetes, it can be really informative. Because everyone's metabolism is a little bit different. And it can be useful to get a microscopic view of what in your daily life affects your blood sugar and why. So in the spirit of empowering patients with information, they can be very empowering. but they can also be an albatross and cause people to restrict and overthink eating. And then it's a net negative. You write in the book, and I see this all the time on social, you know, some of the darker side of wellness culture is you are ill because you didn't try hard enough. You got sick because you failed at wellness. Talk about that.

The ease with which the medical establishment and the wellness culture we live in shames patients is pretty astonishing. I think people know that exercise is good for them. Like, I don't know if we need more studies to show that exercise helps with brain health, with heart health, with metabolic health. We all know that. Everybody agrees. Everybody agrees. Agree.

Yeah. We all know that broccoli is good for you and, like, eating sheetcake is not as good for you, right? I would argue that sheetcake is good for you every now and then, right? It's like part of joy. So what I want to tell patients, and this is part of what is in my book, is that, health is very personal. It's not about a specific protocol. It's not about a specific diet. It's not about someone else's version of health. And we can reduce shame and feel like we're enough when we understand what our actual needs are first. So in the book, I talk about five elements for being healthy and

being an empowered patient. Okay, what are those? One of them is understanding what health is to you. Not everyone wants to be exercising seven days a week and optimizing their macros. And that's okay. Not everyone who has an extra 10 pounds on them or 50 pounds wants to lose that weight. That's okay. I mean, of course, being obese, having extra weight on you carries risk. But my first question to my patients isn't what do I want. It's what do you want?

It's also to help them understand, okay, if you were to lose this 10 pounds, these sort of menopause weight gain, here's what that would require. And here's the risk of keeping it on you. And then helping them make decisions that work for their life. But all of society is telling them those 10 pounds are bad. Every magazine article, every picture of a celebrity who's over 50 now on the red carpet. And so when all of the messages are coming from, you know, we need to. to look like 14-year-olds. Right.

You know, how do you counsel your patients about that? I really want patients to give themselves permission to understand what health looks like for them. For some people, that's feeling comfortable in their own body. So for other people, it's not living in pain. For some people, it's not being depressed. For some people, it's being a certain body size, and that's okay, too. but the biggest question you can ask yourself as a human being, in my opinion, is what does health look like to me? What is that defined by? Is it a certain cholesterol level? Is it a certain body mass index? Is it a certain, is it an appearance?

Or is it a sense of agency, a sense of purpose, a sense of having access to guides when I run into problems? the healthiest people in my practice who are in their 80s and 90s are patients who don't necessarily have the perfect labs, but they're patients who have understood where they need to relinquish control and where they have agency. They've made peace with the parts of their health and their life. They cannot change. So it's a little bit like the serenity prayer of health is what I'm talking about. I think, you know, in our 20s and 30s and 40s and 50s, women in particular are told that health is about a certain number of steps per day, a certain weight. A certain amount of protein.

A certain amount of protein. A certain supplement stack. And that's not wrong. But there's more to health than a set of protocols or someone else's version of health. So if I had one message to patients at the end of reading this book that I've written, it's stop and ask yourself, what does health actually look like to you? You know, if you talk to enough people at the end of their life, you want patients who are not at the end of their life to have that kind of wisdom and self-reflection and ability to pull down the sort of defenses and the shoulds. And you want to apply that knowledge to you right now. That's what I try to do in my life now. I've had to define health. It's not just about a set of labs or a certain BMI. It's about a sense of agency and purpose and meaning. It's about relationships with other people.

people with food, with alcohol. It's also about knowing where you need help. So I don't think health is a one-person job. I think it takes a team. And you may need to assemble a team to help you be healthy that includes a yoga instructor, that includes a cardiologist, that includes a walking partner on the weekends. So one of the things I talk about in the book is how to build your team. It doesn't have to be expensive, it doesn't have to be fancy, but you want to make sure that you are solving the right problems and not solving someone else's problem for you. August is National Dog Poop Month, which yes is apparently a real thing. And while that might sound a little ridiculous, if you're a dog owner, you know your dog's digestion can

actually tell you a lot about their overall health. That's one of the reasons my daughter started feeding her dog racks, Ali's fresh dog food. Their human-grade recipes are made with high-quality, gut-friendly ingredients, gently cooked to preserve nutrients, and developed by chefs alongside veterinary nutritionists. Everything is delivered right to your door and portioned specifically for your dog. My daughter has noticed a real difference since Rex made the switch. He's as excited as ever for meal time, and his digestion has been much more consistent with healthier, firmer stools, a good sign that his food is agreeing with him.

Plus, the Ali app gives you free, on-demand vet support for any weird tummy troubles, along with a personalized well-being score to help you stay on top of your dog's health. Ali makes it easy to feel confident you're giving your dog the nutrition they deserve. This summer, treat your pup to better food and perfect poops. Head to ali.com slash unpaused and tell them all about your dog. Use the code unpaused to get 70% off your welcome kit when you subscribe today. It's super easy and risk-free with their obsession guarantee. That's OLLI-E dot com slash unpaused and intercode unpaused to get 70% off your first box.

Ali, feed the obsession. Here's something I've realized. The best beauty routine is the one you'll actually stick with. I don't want a dozen products or a 20-minute routine. I want my makeup that makes my skin look like skin. just healthier, fresher, and more radiant. That's why I've been loving Jones Road Beauty's Miracle Bomb. It gives me that effortless glow in seconds,

and I can use it as a blush, a bronzer, highlighter, and even a lip tint. It's one of those products that simplifies everything, whether I'm heading to the studio, traveling, or just getting out the door. And if you're someone who likes a little more coverage, Jones Road's foundation stick follows the same skin-first philosophy. The lightweight buildable formula evens out your complexion without hiding your natural skin, while seramides and squaline help keep skin looking fresh and feeling hydrated. Plus, it's available in 30 shades to complement a wide variety of skin tones.

Less time getting ready, more time living your life. That's a routine I can get behind. Modern day makeup that's clean, strategic, and multifunctional for effortless routines. For a limited time, our listeners agree with your life. our listeners are getting a free full-size mascara on their first purchase when they use the code unpaused at checkout. Just head to jones roadbeautcom and use code unpaused at checkout. After you purchase, they will ask you where you heard about them. Please support our show and tell them our show sent you. Okay, let's talk about self-compassion. So you wrote, sometimes our bodies need fresh chemistry,

new behaviors, and deeper self-awareness all at once. Yes. Two or more things can be true at the same time, but no prescription will work efficiently without a dose of self-compassion. I think you know this, but we all have an internal narrative in our minds, right? We have the critic, we have the governor. You have that voice in your head that says, you shouldn't have done that, or, ooh, you really blew that. Or, wow, if only you were X, Y, Z, then you'd be better. That narrative, if it occupies too much brain space, too much real estate up there, it can inform your health more than any prescription well. So one of the things I talk to my patients about

and one of the things people need to ask themselves about is what are the stories you're telling yourself? What are the voices in your mind, the shoulds, the what ifs, the oh my God, the catastrophization? What are those voices telling you? And how do those affect your everyday habits? So if you have a narrative that says you're not thin enough, you're not fit enough, and then you skip lunch, and then you overreed at night because you're hungry, because you're human, and then you feel ashamed the next morning. And then the voice tells you you ate too much last night and you keep doing the same pattern.

Then you have a problem with your relationship with food and maybe your weight's going up. You don't need Ozzypic. You just need lunch. Maybe your negative inner critic is born from someone in your life who, you know, you need distance from. The point is self-awareness is a superpower. And if you can understand what you're telling yourself, that can help you immensely show up as a more informed consumer of health care and a more powerful agent of change in your own life. You wrote about a patient in her 60s who came in asking for OZempic, a stronger pain medication, and a sleep aid. Okay. And you realized, after talking to her and getting to know her, what she actually needed was a dose of self-compassion. Walk me through what you saw in the room with this woman. So you see this patient. I see this all the time.

People come in. They've looked up online, what their complaints are. They come in with a list of things they want, pain medication, OZempic, and something else. And those are things I prescribe. I think Ozepic is a wonderful medication in the right context. But before we start solutioning problems, I want to understand what we're actually solving. So this patient had been bullied and shamed by her dad since she was a kid. She was told she was fat and lazy since she was 10 years old.

Those narratives die hard, right? When you are an adolescent and young adult, our brain. brains are extremely plastic. And the narratives that we literally hear from our parents, the narratives we hear from society, those thought patterns can get laid down like concrete highways. And it takes a lot of self-awareness and sometimes therapy to help reroute those thought patterns. So when I took a minute to understand what was going on, that she was having pain because she had a hip problem. and the hip problem resulted from her weight problem and her weight problem resulted from a shame problem.

She didn't need OZempec and pain meds. She needed a dose of self-compassion to understand that the narrative that she was telling herself, the story that she was telling herself of unworthiness, was coming from her childhood. Did it work? Absolutely. How did you do that?

Are you a therapist? Well, I kind of am. No, but I said, look, I asked the question. I said, you're getting emotional when you're talking about how frustrating it is that you can't lose weight

and why you skip lunch and you do it all over again. And she started crying. And that's the moment where you say, pen down, laptop clothes, what's going on? Well, she said,

my dad shamed me for being lazy and fat since I was 10 years old. Okay. Let's talk about that. First of all, I'm so sorry. And second,

of all, let's address that because that is probably informing a lot of your everyday choices in ways that you may not even be aware of. And I'm not going to do therapy with her, but I'm going to have her see someone who will help her untangle the relationship with food and the relationship with her dad. Right. So let me just say this too. It's a lot easier to prescribe ozempic and pain pills than it is to have that conversation. And that's where medicine is falling down, not being able to understand the whole person. Right. I mean, I have patients coming in on polypharmacy, meaning multiple different prescriptions. when everyone's like siloing each symptom.

Okay, we're going to give you a sleeping pill. So we're going to give you a benzodiazepine for your sleeping habits. We're going to give you a beta blocker for your palpitations. We're going to get, you know, and so they end up on multiple meds, each individually treating problems

where there's a common thread. There's a common threat. And no one's trying to untangle because we don't have time. We're not trying to do it. You know, and women are very complicated. And then we throw hormones on top of it, you know, and the whole system

goes cattywampus. So let's go to the woman who's pushing through perimenopause symptoms. Yeah. My patients, and I'm sure yours, are busy women. They have built these busy, busy, complicated lives. I mean, they could be CEOs, moms, stay at home, whatever. It runs the gamut. But they are busy, you know, but they had it. They managed it. They had it. They had it under control. The ebbs and flows, the ups and downs, they could manage and still be okay, right? and now they're not okay. They're running on fumes, cortisol's going crazy, hormonal chaos in the background. How do you counsel them? So first, I want people to understand that they're more normal than they think, that it's God's cruel joke that we put people through peribetopause when you're

raising children, you're caring for elderly patients, and you're at that career moment where you're, you know, maybe not the top, but you're almost there and you're hustling. So I want people to understand that they're not crazy, that they're human. And then secondly, I want people to understand that there is help for menopausal symptoms. You know, 10 years ago, we would prescribe antidepressants for the depression really. I was, I was 100% guilty of polypharmacy. I just wanted to help the patients and here are the tools I have. And so I'll give you six different things to treat each and no one had taught me and I didn't understand the common threat of menopause. The root cause. Right? There's almost nothing more satisfying than having the phone call I did last week with a patient who I put on a estrogen patch about a month ago. She's 45. She has an IUD for the progesterone element of hormone replacement therapy. I put her on an estrogen patch for all the symptoms of perimenopause that other doctors had told her was just stress. You know, her boss who's a woman said, you're just working too much. You need to, you know, take a day off. And she calls me and she's like, I can't believe.

how much better I feel. And I said, describe. And she said, the best way I can describe it is I feel like myself. And I said, that is what we want. We want you to be you. She was sleeping better. She was not having hot flashes.

She wasn't having that irritability that comes from your hormones being yanked around. And in the old days, even 10 years ago, and I did this too, you would have prescribed, you know, an antidepressant, a sleep aid,

and sort of patted people on the back and said, you know, use a fan at night and put your foot out of the cover so you don't get so hot. One leg. But we now know so much more. And so it's great to be able to empower people with basic information. So to the woman who says, I feel crazy during paramedopause, I would say, welcome to the club.

And you're more normal than you think. Yeah. You feeling crazy is a predictable biological consequence of being in pari menopause. Yes. But we can help you. The funniest story, you know, I was early in my menopause clinic, which, you know, I built like field of dreams. I don't know if any witty will come see me, and I'm just going to try this and see what happens. And I had a patient young, very much perimenopausal.

She came in. We started her in hormone therapy. She comes back for her follow up, and she's stomping down the hall furious. And I'm like, oh, God, you know, throws herself in the chair, sits down. And it's like, I feel great. And I'm like, okay, you know, like good, right? Why are you so upset? She says, because I was allowed to suffer for so long.

No one should feel this way. Right. I'm like, what are we doing? Right. And it took social media for me to learn so much about this. Oh, yeah. You know, we weren't talking about this in clinic. We, in traditional practice, we were just hustling to get from one patient to the other and run to the OR and do all the other.

And then get to soccer practice and pick up my kid and make sure the nannies got food going and whatever. And it was social media and listening to thousands and thousands of voices to realize, one, how much women are being gas. slit. Absolutely. By a system. Yep. Why do you think that's happening? Because doctors don't have time and because we weren't trained. I was at Harvard Medical School in the 90s and early 2000s, and I learned very little about menopause. In fact, I don't think I learned anything. I was at LSU, a very much of state school, super proud of it. We learned the same thing. We didn't learn anything about it. We didn't learn much about nutrition. We didn't learn about mental health. I mean, my mental health education was going to a psych hospital where people were

talking to the walls. Schizophrenia. Right. When, guess what, we all have mental health as part of the human experience. It's ground zero for health. So the point is that we weren't taught these things. And like you, I had to learn about menopause from people like you, from my friends Rachel Rubin and Sharon Malone and, you know, reading and studying and understanding the nuances and continuing my education on it. Right. Because things change. Things evolve. And I think the best thing that doctor can do is to say I have new information and my opinions and views and guidance have changed over time, to have the humility to acknowledge that we have been part of the problem. How do you guide someone back who was dismissed, was gaslit,

turned to alternative sources, was not served there? Yeah. You know, how do you bring her back to evidence-based without making her feel bad or shame that she just was looking for help? To that person who's been gaslit or dismissed by the medical system, I say, I am so sorry. I understand that. And we have been complicit in shaming and blaming the patient. The system wasn't built for the whole person in mind. So to anyone who feels misunderstood or not heard, that's not a problem. It wasn't actually built for the female body. It wasn't actually built for you. So I think, you know, the first step towards gaining trust is being humble about what we don't know. what we didn't know, and acknowledging people's pain. And then you can try to help someone when they trust you and when you feel like they understand where you're coming from and vice versa. Okay. Why would someone buy this book? What are they going to get out of this book?

They're going to get a practical roadmap to getting what they need from their doctor's appointments and watching out for the landmines in the wellness industry. The solution, as I said earlier, is not to be your own doctor. It's also to recognize we all want to be well. But it gives you vocabulary to bring to your doctor's office. Okay. It gives you an understanding of a way to frame your whole health ecosystem. It gives you a visual representation of the health ecosystem. Health is not just about your lab tests or a normal mammogram. Health is about your biographics, your story, where you raised by an alcoholic mother, where you raised in pocket, It's about not just what you eat, but what's your relationship with food. Are you a stress eater? Are you a restrictive eater? Are you an emotional eater? It's about understanding where you are mental health-wise. We all have mental health. It's about anxiety and where do you live on the continuum of anxiety. It's a roadmap to help people ask better questions of themselves and then of their doctors.

What are the first steps that a woman can take to reclaim agency in her medical encounter, even when she's only got seven minutes? So what are your top tips? My top tip is to stop and ask yourself, what do you actually need? How do you feel? What are the actual pain points in your life? Is it stress? Is it insomnia? Is it your weight? Is it lack of access to a doctor who can answer your question when you're up in the night and on doctor? Google. What are the things you actually want? I think we're given so many messages about what health is out there when health actually starts in here. So the first step is self-awareness. Okay. What do you say to the woman who can't afford? You know, she insurances are only option. Yep. Will these guidelines work for her as well? This book is my attempt to reach people who don't have access to a doctor who has time, which is most people. Right.

Again, not through doctor's fault. The system is not designed to take time with people. So it is designed to help you sketch out, map your health ecosystem, your nutrition, your body mechanics, your mental health, your medical data. It's a guide to ask smarter and better questions based on your problems and your needs and your unmet issues. and it's a way to help you prioritize yourself and not someone else's version of health. You want every patient to become CEO of their own health. I love that.

What does that look like practically day to day for a woman under 40s or 50 who's managing her symptoms, her family, and a 12-minute appointment once a year? Right. Let me first say that not everyone does want to be the CEO over their health. if you look at one of the chapters that I put in the book, it's about the patient personality. So one of the ways to have agency of your health is to identify what kind of patient you are. So in the spirit of self-awareness, understand, are you the person who brings reams and reams of printouts from Google to your doctor's appointment?

Or are you someone who just wants a prescription and you don't want to understand the why? That's self-awareness. That's self-empowerment. And not everyone wants to be the CEO of their health. Some people just want, tell me what to do and tell me where to go get it. And other people are skeptical. They've got the one eyebrow raised and they're like, hmm, I know you recommend that medication or habit, but why. So not everyone wants to be the CEO for her health.

I think like some people do. But I think the point is to be able to be an empowered advocate for the needs that you have, which sometimes means asking where to get help. Okay. You've got your appointment. you want to show up at your doctor's office prepared. Yes. What do you recommend?

First thing is know what questions you want answered. Like what drop-dead things do you need to know before you leave? And communicate to the doctor, that. Say, here are the three things I don't want to leave without having answered. Number two is make sure that you've mapped out your health ecosystem. Kind of prepackage yourself before you show up to the... How do you do that? How do I map that out?

So that's what the book is about. Okay. The book is basically a guide to map your health ecosystem. ecosystem to help you understand the different components of your health. It's not just your labs. It's your story. It's your body mechanics. It's about pain, pest injuries. Do you hand this to a doctor? No, you do this before you go to the doctor. So this book is basically prepping you to be a patient. So if you go on my website, beyond the prescription.com, you can get the downloadable map of your health ecosystem. And you can write out, based on the instructions in the book,

the different elements of your health. What's powerful is the downloading of information that you have inside you already. And then seeing how you can connect the dots between your childhood trauma and your relationship with food and your cholesterol. The interesting thing about the health ecosystem isn't just the components.

It's about the relationship between your anxiety and your sleep and your protein and your blood pressure. So if you can do the homework and you're a prepackaged patient by mapping your health ecosystem, you are then going to squeeze more juice out of that 15-minute appointment with your doctor. What do you think about patients ordering their own labs? I think it's a terrible idea.

I mean, we're not in-and-out burger. It's not that I'm saying I'm better than in-and-out burger. I'm not morally superior to an-out-burger. I'm just saying that, like, I do have some training. You've had some training. You know a few things about how to apply medical knowledge to the data in front of you and the person in front of you. So I think that if you look at the landscape out there,

basically we're moving to a place where we're asking people to be their own doctor. Download your labs into this chatbot, operationalize a plan, and here's the protocol, print it out, put it on your fridge, and do that. And what that does, it deprives people of agency because it doesn't help them connect the dots between their everyday experience,

the limitations in their lives, their fears, their vulnerabilities, their problems, they're embarrassed to say out loud. It just assumes a certain risk and risk tolerance. It assumes a certain set of goals. And there's no human element there, which is really essential for providing care and for receiving it.

Do you think we'll ever get there that they'll train the algorithm? So this is actually my fantasy. This book is not an ego project. This book is actually my calling card to be part of the health reform movement? What is the health reform movement? Well, what would perfect health care look like?

I've lived overseas. I've seen the positive and negatives of socialized medicine. Yes. Right? Like in the UK, clinicians, physicians mostly, practice in a very narrow set of protocols. Right. And if they step outside of the protocol, as that was put together by a very small group of people sitting in government-type agencies, they could lose their license to practice.

So I'm not recommending socialized medicine. This is the United States of America. I don't think that's ever happening. Okay. Even if it were a good idea, I don't think it's happening. What I think it needs to happen is that we need to scale primary care and dispense it to communities all around the country. Let me say this.

If you look at total health care spending in this country, 95% of health care dollars go to damage control hospitalizations, ER visits, and damage control medicine, 5% to prevention. There's no shortage of evidence in the medical economics world to show that when you dispense primary care into communities, people live longer and they live better. And we save money. So that is not up for debate. Like, it's already been decided that. Then why isn't it happening? Because the insurance companies have a hold on the medical system. They have a hold on doctors. Should we get rid of the insurance companies?

I don't think you want to get rid of insurance companies. Because the number one cause of bankruptcy in the U.S. is medical debt. Exactly. So. But there's an easy solution to it. All right. I'm not saying it's going to be simple to execute. Simple is different than easy.

But easy. I mean, this has been shown again and again. Like, just like we don't need more studies to show that exercise is good for you, we don't need more studies to show that primary care, when deployed nationally and when scaled, saves money, saves lives, when you have a doctor who knows your name and not just your diagnosis codes, who can connect the dots between your sleep, your stress, your grief, your cholesterol, your blood pressure, and then help you make a plan that works for your life, that is medical care. So there's no mystery as to how we solve the health care crisis in this country.

It's by scaling primary care and deploying it nationally, not just for people who can afford it, but for every American. Every American needs unfettered access to a primary care medical home. And the primary care medical home needs to be a hub for problem solving, not just a gatekeeping apparatus and a prescription mill. That's what medicine should be. That's what I thought I was doing when I went into primary care as a field. AI has a role in the healthcare transformation space. But if we use AI to replace the patient doctor relationship, we're no better off. What we need to use AI and technology to do is to elevate the patient doctor relationship.

And for AI and technology to do all the crap work that is required to do the back end of, you know, running a primary care practice and all the grunt work that doctors do that could be done, better by AI or some technology. That is going to happen if we have doctors shepherding technology in the appropriate way. But if we let AI and AI alone reinvent the health care system, then health care is going to be this. It's going to be a chat bot and a physician extender for their license to just prescribe medication. Well, that's the way corporations will make the most money. So what needs to happen? You need a populist movement.

You need a movement of empowered patients one at a time to demand what they don't even know is possible. I don't think people know what is possible in health care when you have a relationship with a doctor who understands you and not just your medication list. People don't know to ask for it because they don't know that exists. But more and more doctors are leaving the system and voting with their feet and saying, look, this is not a health care system we have in this country. We have a health insurance system, but we don't actually have a health care system. of a sick care system. Right. We need Congress to pass more legislation to allow doctors to practice medicine and build practices that honor the patient, not just their diagnosis codes. We need to incentivize medical students coming out of medical school to go into primary care fields. Why would you

decide to choose a primary care field when you're graduating from medical school if you look out there and you're getting paid minimum wage to be a primary care doctor and see, you know, They're terrified AI is going to take their job away. Well, and they also see the burnout and the moral injury in primary care fields and the low pay. So we need to incentivize financially medical school graduates to go into primary care fields. And we need to empower patients one at a time to demand the kind of care that is not just about a pill for every body part and a doctor for every complaint. You need a medical home. You need a primary care provider who knows you.

Having a relationship with a patient is why any of us went into medicine. I mean, maybe not if you're a surgeon or an anesthesiologist. You wanted them anesthetized and, you know, like under. Right? But most of us went into medicine because we want to help people, not just right prescriptions. Right. So you wrote a piece on aging gracefully. Yes.

That I keep coming back to. So you had a patient in her 80s told you she only needed four things. Yes. A doctor she could trust. a friends that she could lean on, a sense of humor, and a good hairdresser. Right. What did that teach you about what actually matters? I'm assuming this girl was thriving.

This woman is thriving. And that's what I meant earlier when I said that my healthiest patients aren't the people who are necessarily optimizing in every way they can all the time or they don't necessarily have the perfect set of labs. They are people who know themselves. They know where to let go and they know where to lean in. So this patient has a sense of humor and a sense. of acceptance over the things she can't control.

She's not trying to fix every wrinkle. She's not trying to optimize everything in her body. She's understanding that, you know, health is not guaranteed. And she's going to center pleasure and joy and levity. And she's going to take care of herself by getting her hair done. I love it.

What are the top three things that you want people to take away from the book? The three things I want people to come away with from this book are, number one, feeling less alone and feeling less shame. from the medical system. It's not a you problem. It's a systems problem if you've ever felt dismissed or unseen by doctors.

Number two, I want people to have a practical vocabulary to bring to their doctor's appointments, to know what questions to ask and to make sure they're centering their actual problems, not someone else's problem. And then third, I want people to be able to stop and pause and ask themselves what they need to be well. I want people to have permission to stop chasing someone else's version of health. And that would be a job well done if people could come away with those three things. Well, Dr. McBride, so great having you on on pause. Thank you so much. Mary Claire, thank you so much for having me.

Dr. McBride's new book, Beyond the Prescription, is out August 11th and is available anywhere books are sold. You can visit Dr. Lucy McBride.com to find out more. Subscribe to her newsletter, Are You Okay, or listen to her podcast Beyond the Prescription. you can follow her on Instagram at Dr. Lucy McBride. I'd love to hear from you about this topic and anything else that's on your mind. You can find me on Instagram at Dr. Mary Claire and get honest and accurate information on health, fitness, and navigating midlife at thepawslife.com. My new book, the new perimenopause, is available now everywhere and anywhere you buy books and through our website. You can also find full episodes on YouTube at Dr. Mary Claire.

Unpaused is presented by Odyssey in conjunction with Pod People.