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Dr. Jen Gunter

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2018-08-13
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2018-08-13
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  1. Yeah, yeah, I know, I know. And I think it's really hard because people share stories and they don't even realize that even to share something to sort of make fun of it actually helps propagate the information. Right. So I think we could all learn better internet hygiene about how to prevent the spread of myths too.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  2. Absolutely. Right, or not understanding about something. Well, a lot of those issues, climate change, anti-vaccines all rocket around the internet. It's funny that a lot of these things, that's where they thrive and live, where people get too much of the information. Yeah.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  3. Yeah. So it's hard. I think the other thing that we could all focus on is more scientific literacy, right? Absolutely. So teaching more people about, you know, what it means. I mean, we have people don't believe in, you know, climate change. So, I mean, this isn't just unique to medicine about wanting to believe or not understanding about science

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  4. And so We're over here Any soup up fancy ones with M's or any weight loss brownies? We just have the regular ones, but they're good. And it's a multi-part answer that's going to take years. We don't want that because we're used to answers immediately.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  5. That is your big person Yeah, thank you. I mean, I think that science is sexy in a lot of ways, but it's also not the fast answer. And so it's really hard when everybody online is looking for like the cool flash and you're science standing in the corner going, no, hey, we're over here. Come, come, we just have the regular brownies, not any souped up fancy ones with M&Ms or any weight loss brownies. We just have like the regular ones, but they're good.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  6. And my kids are loving it. We're trying new food I spend less time in the grocery store, and that is my big personal wellness.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  7. Yeah, there are Canadian shoe manufacturers. I should be, I wear all their shoes. So what do I do online for wellness? I have an app. I use Lose It to keep my weight in check. I'm a calorie counter. I lost 60 pounds about eight years ago. And so I keep it off that way. And so that's my biggest app. And then my big wellness thing is I now do one of those meal delivery things where they deliver it to you and then it's all fun. And then you prep it. You cook it yourself because I hate the grocery store. I hate the grocery store more than anything else in the world. And so anything that keeps me out of the grocery store but helps get me good food. Good food. And I just, I've been doing it just for about.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  8. I know. They're really astonishing quotes. And it's really interesting because it's a piece of mind thing, I think, more than anything else. And you're right. It just makes me feel better. Like there was a Marcus Aurelius. Think of yourself as dead. You have lived your life. Now take what's left and live it properly. Sounds good to me. But what do you recommend? That's mine.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  9. On death And they pop up on your screen, and they're great. They're really great. Now, I'm telling you, and it does make me feel better. You know what I mean? You think about death and it doesn't scare you and it doesn't, and it's really, it's called Waitrick. So this one is today is drink your tea slowly and reverently as if it was the axis on which the earth revolves slowly evening without rushing toward the future. I feel good about that.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  10. Not something Better sleep. Probably the answer Yeah, so what do you recommend people doing? I recommend, I have this app I talk about all the time called We Croak. You ever heard of it? No. $99. Okay. It's apparently in Bhutan they think about death a lot, right? They think about death. And it gives you five amazing quotes every day.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  11. Yeah, and it's just, you know, we need maybe friendship and we need medicine to tell us it's not cancer and it's not heart disease and it's not something serious. But then when we're left with sort of other things, then diet and exercise are probably and better sleep are probably the answer. But it's just these crazy schemes have been around for a long time

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  12. Been these crazy ideas around for a long time. And I think that we, I think it just goes to show that a lot of the symptoms that people turn to wellness for, like bloat and fatigue and enui.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  13. You must. So there's a guy called John. I think it's Binkley or Brinkley. I can't remember. This was in about 1920s. He failed out of medical school. And so he went to Kansas and started implanting goat testicles into men for loss of vigor and other things that, you know, are quasi-sort of medical things. Where did he implant them? Like in their scrotum and lower abdomen, and he did it for some women too. And obviously a lot of people got sepsis and really ill. For sure. But he made a lot of money off of it and he bought a radio station. And so he was controlling the local media and he paid off the governor. And there was this whole, there's an animated movie, I think, that just came out about it. I saw something about that online. It's a fascinating book about it's called Charlatan, which is a really great read. But, you know, he was doing the exact same thing that, you know, in the, you know, 1920s and 30s. So there's always.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  14. Kensington Publishing. So Right, right, absolutely. And when you're thinking about health online and how you do, like, when you're thinking about health, I do think it's really laudable that you've done this because I think what does happen is there's this quackery just gets amplified. Quackery has been around since the beginning of time. They used to have those tinctures and tonics, and this will do that. Even Kellogg started, right, as well.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  15. Yeah, as it gets updated, absolutely. I mean, obviously some of it's up to the publisher, it's Kensington Publishing. So, you know, they make decisions that, you know, I'm just trying to produce good content.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  16. No, it won't be. Actually, it's going to be dedicated to every woman who's been told something nasty by some dude about her vagina. Okay. All right. Really. And it's called the Vagina Bible. It's everything you need to know about the vulva and the vagina so you can wade through the stuff on the internet so you can speak with your doctor so you can tell your girlfriends your boyfriends your family what they should or shouldn't know or what you know it's it's all the information that I think everybody should have

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  17. I mean, I think the Russians sort of like tech and investing is, you know, we make gains on healthcare over the long term, not over the short term. And if anything sounds too good to be true, it almost always is. Oh, always.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  18. I mean, the wellness has become a bit corrupted, I think, in the sense that people have confused it with things that can make you live longer or necessarily healthier. Doing things because they make you happy or fine. I mean, there's not really good data on massages helping chronic pain. But if you have chronic pain and you go get a massage and it makes you feel better, that's okay. Right, right. Right. But you're being honest about it. It makes me feel better. I like it. But the problem with a lot of the company wellness things, I think, is the whole idea is to improve productivity or, you know, I mean, I think that

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  19. Right. Well, I guess what I would say is that investing in health sounds like you're investing and making money off of health. And investing in health to means helping people get better. And helping people get better requires quality research. So I would say that if they're really interested in helping people as opposed to selling product that they would invest in quality research.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  20. Yeah, yeah, I would just say that it wouldn't be something I've done and I wouldn't be something I would do. But I've heard, you know, people have swabbed their dog's mouth and sent them to 23andMe and got, you know, a human result back. Yeah, I think I read that. Maybe I'm incorrect. But I'm pretty sure I read something like that.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  21. Right, right. But they're prevented too. They were initially quite full of information that you then would bring to. Some of them are affiliated with doctors. Now, these reports go to the doctor, and so the doctor gets more information.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  22. Yeah, I don't know about all of them, but I know about, you know, for example, instead of spending your money on 23andMe, spend your money and go to a geneticist and find out if you actually need to be tested because the problem is a lot of these results we don't know what to do with. Right, right.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  23. Because apparently you don't have to do according to. Right. Well, I think that, yeah, if you go to either, like if you go to these wellness conferences, a lot of this is an investment in how to stay young forever. And I think, well, I want to enjoy life. And so I think that it's interesting because none of these things, you know, we kind of know the real basics that aren't being done. And most people don't eat healthy diets and most people don't get enough exercise. I'm still like whatever 17% of people smoke. So there's still a lot of things that we could do. And the problem with a lot of these supplements and things like that is people do that instead of exercising or they do that instead of eating right. And if you have an extra 40 or 50, $60 a month, invested in a quality diet, don't invest it in supplements.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  24. You know, You actually want to make a difference. Right. How do you look at there's a lot more, a lot of people going into the healthcare, there's color genomics, there's 23andMe, they're all different in their ways. There's one, the heart one. It's the EKG machine and stuff like that. There's a lot of investment going by technologists, all of which to me points the fact they don't want to die. Yeah. Apparently you don't have to do right.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  25. Yeah, wouldn't it be great if, you know, I wish I could raise a billion dollars off a thought. You know, I don't know. That's why I'm not in Silicon Valley, I guess. So I think all these people who claim that they can do these things, I would say that there's no way I would ever recommend your product without a quality study showing me that it made a measurable difference. And if you have all of this money instead of investing in putting it in the hands of celebrities, why don't you invest in some quality research if you actually want to make a difference?

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  26. Yeah. Anyway, every doctor I knew and everybody I knew in lab medicine said this is no ain't going to work. Yeah, fairness. Yeah, there's no way this is going to work. This is impossible. Yeah, my brother.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  27. I guess I would say that it's very hard to advise anybody when people don't invest in high quality studies. And so I think that many people put stuff out in the hopes that it's just going to sell and then the studies will come later. And a lot of times the basic science is actually really poor. So I would say like, for example, oh, I'm blanking on the name of the blood company with the micro.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  28. It was interesting for me. So in certain cases in medicine, radiology might be replaced with an AI or something like that because it's better diagnosis. Computers can do it. In other cases, you're right. Care doesn't matter. So I want to finish talking about sort of where things are going, especially in the wellness industry. Right now in Silicon Valley, there's all kinds of things about diets, like fasting and things like that. There's stuff around these pills that people are selling, these wine, there's all kinds of pills. There's nootropics. I've had that guy on where he's where you take different pills for your mind to bring. There's a huge interest in this. And then recently I had Michael Polland on talking about psychedelics, which I think is actually interesting to replace opiates and various pain medications. I'd just love to get your thoughts on any and all of these topics.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  29. You know, in one case, especially with elderly people, it's a nice thing because it's an interface. And in other cases, they never can get the eyes right. And so people are always off put by the eyes.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  30. Yeah, I care. It's really important. Well, one of the issues around the robots I was talking to MIT was they can't have these robots because there's about 10 things that everybody has like that is pretty easy to diagnose certain different things that they could use that they don't need to repeat, lather rins repeat, essentially and they can't get the eyes right.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  31. It is when you get something really sucky, having somebody sit down and just put their hand on you and just kind of sit with you. Yes, care. Yeah, care is really important.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  32. Yeah, I know, but you know, also too, as somebody who's had, you know, really gone through a lot medically, I don't know, man, the personal touch is also really, it is.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  33. Yeah, and especially if you're talking about sexual health, like it's really personal for you to disclose something. So I think if you know that your doctor's like a real person, it makes a difference. Absolutely.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  34. Which I just don't think that's true. I mean, when a patient comes to see you in the office, there's a big power differential and people are afraid. And once they know that you're a real person, they disclose more about themselves so much easier.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  35. I mean, I think that's been really understudied how best to communicate with people. And the thing is, different people need different types of communication. So you can't just say we communicate with patients this way because there's so many, as many different types of people. And so people learn differently. And so I just, I think that we have to try to invest more time and effort in learning that.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  36. I think lack of a better word Explain that. You're like, wait, what happened? Like your remote control's broken. You love me. I thought you love me because it really is. It's not like it was a cholesterol thing and I just want to know is this higher low? Like it was so, and there's all these new medical things that are coming out. Forward and others that try to sort of technologize. Your healthcare And it's just bells and whistles, really. It's just here's a cool, it was just an easier way to hear it, which I think, you know, people were criticized. I was like, but it actually was an easier way to interpret it. Face with it and to talk to your doctors and stuff like that, which I thought was interesting.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  37. It looks like a nose. You know what I mean? And it shouldn't be like that. There should be a better user interface for, I think, lack of a better word. We need to be more like dogs and less like cats. Right. Explore that. Well, you know, dogs always look at you like, how can I help you more? And, you know, cats, one minute you're petting them and they love it and the next minute they're biting you and you're like, wait, what happened? Like your remote control's broken. You love me.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  38. Everybody And then figure out how to answer that proactively. Right, exactly. And also getting information of your health online, eat more easily. I think the medical industry has not been good at that. I mean, I just was trying to go on the Sutter. And I'm real good at it.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  39. Oh, everybody's an e patient. Everybody looks everything up. And to assume that they're not, if someone says they haven't, then I don't, you know, I'm like, sure, whatever, but I'm sure they have. And I think that's great. I'm really all pro-research. And so I think that you can't tell people not to do something. I think what you should do is be directing them how to do it appropriately. And I would say that I have yet to have somebody be unhappy with me telling them where they can get better information. Right. People are unhappy when you say, don't look it up. But they're very happy to get good direction. Right. And so that's what I would encourage all physicians to do. Whenever I lecture on the subject, I always say, you know, you should look up your most common diagnoses to see what your patients are finding and then figure out how to answer that proactively. Right.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  40. And that's exactly right. So sometimes it's better to just say, you know, I don't have an explanation, but what I do know is this isn't cancer. This isn't going to end your life. This isn't going to do this. And then a good thing to be to say, and then, hey, this is what the national hematology society has to say about it. And here's their patient handout on this. And so I think that the conversation needs to continue in ways until a person is satisfied and feels comfortable. And that's something that is missing a lot in medicine. Right.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  41. That I actually could define. Right. But, you know, the thing is, if you sit down and take the time and explain it to somebody, then I think once people have more information, they really do so much better.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  42. Yeah. So a few things that I've read on there have been fine, but it's hard to know. I think it's important for us to teach people some really, and you brought up a really good point about that's a symptom, not a diagnosis, but sometimes they're the same thing. And the best example is headache. Headaches a symptom and it's also a diagnosis. And I think that doctors need to learn better how to communicate that to patients in ways they can hear it. And I think that's not taught enough. No, they would just give me.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  43. Well, I think, first of all, what's good to do is to start with properly curated sources. And until recently, data has told us that.gov sites are the most reliable. I'm not sure if the funding for medical librarians at the National Library of Medicine is going to continue with the current administration. But.gov sites, the National Library of Medicine, medical professional societies often have really great information, patient portals and other things. And that's the place to start, not WebMD or Wikipedia or places like that at all. Right. You know, anybody obviously can go in. I mean, I haven't read everything on there. And so obviously, very...

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  44. Know I'll probably keep calling them out on it. But, you know, I still write about a lot of other things too. Yeah. I mean, I think that they should know that there's other people out there looking as well. Looking very careful.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  45. Well, you know, I just write about things that I think are that women want to know about. Right. You know, so I think that if they're going to keep promoting vaginal misinformation.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  46. It's your body and your choice, and if you want to. Do raw goat's milk for parasites, you don't have, obviously, that is your choice. But it would be correct for you to know that you don't have those parasites and that you could get really ill from, you know. And then you make the decision with the right information. Right.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  47. I just hope people, I want people to learn how to look up good information. I want people to know that they can question their doctors. To say, hey, why do I need to do this? What's the good information? I mean, the thing that makes me most proud is I'll get an email from a patient and say, you know, my doctor told me I couldn't get an IUD because I'd never been pregnant before. And I printed off your blog post and I took it in and I showed it to my doctor. And then my doctor said, Oh, yeah, you're right

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  48. Right, okay. Yeah, but that's not, you know, that's not, I mean, some of the claims in the medical claims in GOOP are really quite outrageous. And, you know, like I said, they pony up with anti-vaccine conspiracy theorists, you know, people who write for them believe that the mercury in your fillings are, you know, causing whatever that, you know, I mean, all name your conspiracy theory. So, you know, you really have this.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  49. All right, they couldn't afford me. They couldn't afford you. So the concept is that they had some issues with Connie Nask as a fact-checking. A lot of this stuff is not something Connie Nass wanted to be.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT

  50. Yeah, I mean, my goal is to get people to learn how to learn how to sort out good information, to learn that studies matter. I get that it's so hard to find good information. So to have a good curated source. So if people know me as a trusted source where they can get information, they can go to my blog and they can say, well, what does Jen say about the HPV vaccine? And then, oh, she's got some links here. And then I'm going to use it as a launching point for discussion with my healthcare provider. And so that's really what I'm just trying to offer people is a way to get good information. Right.

    2018-08-13 · Decoder with Nilay Patel · Recode Decode: Dr. Jen Gunter, OB/GYN · IDENTIFIED FROM THE TRANSCRIPT