Heroes of Healthcare
Heroes of Healthcare

Episode · 3 days ago

Mental Health in Healthcare: Burnout, Anxiety, Depression & Suicide

ABOUT THIS EPISODE

Because they are worried about the stigma associated with seeking help, health care professionals with mental health issues often refuse to seek treatment.

The concern isn’t without merit. Certain states have wording in their license applications that allow them to discriminate against individuals who access mental health resources.

Needless to say, leaving mental health issues untreated can be very dangerous, which is why there needs to be a cultural shift around how we view mental health in healthcare.

Our first returning guest, Dr. Kellie Stecher , OB/GYN and Chief Medical Officer at Linked Inclusion, joins the show to share news from the frontlines of her continuing fight to bring awareness to this vitally important cause. Hear from Dr. Stecher about her new book, Delivering, and how she is creating a movement around Physician Mental Health issues one bite at a time.

Topics covered:

  • Policy updates around mental health and physician licensing
  • COVID from the perspective of the OB/GYN community
  • Why Dr. Stecher decided to write her book titled, Delivering
  • How, as CMO, Linked Inclusion is working to fix healthcare

Resources mentioned during the episode:

To hear this interview and more like it, subscribe to Heroes of Healthcare on Apple Podcasts, Spotify , or wherever you listen to podcasts.

Listening on a desktop & can’t see the links? Just search for Heroes of Healthcare in your favorite podcast player.

There's a certain culture that isallowed to exist in medicine. That is toxic and it's enabled and for us tomake real changes. We have to face that and tackle the issues that actuallyexist. You are listening to heroes of healthcare. The podcast that highlights gold, selfless professionals in the healthcare industry focused on transforming lives in their communities. Let's getinto the show. Welcome to the eras of health arepodcast on realisted Wayne joining us once again on the show is Dr Kelly.Steger Dr Stecher joined us on episode. Sixteen back in May and is rejoining usonce again to give us an update on her passion, project, Patient Care Heroesand her new book title delivering as a reminder to our listeners doctorteckers, an Obgyn with M L, fair new women center in Minnesota. She alsoserves as chief medical officer to linked inclusion, a virtual platformbased community of individuals facing the common challenges of exclusion andCo founder and president of patient here, heroes that I mentioned earlier.Doctor Stecher has won the Minneapolis Saint Paul Magazines. Top doctor isrising star award for the last three years. Her work has made her an invaluablecontributor to both local and national publications, news and PODCASTS. Herfocuses on advocacy and policy change. Centering out safety and equity weredelighted to have doctor Stacker back on the heroes of health care. Welcomeback to the ears of health care, doctor stecher thanks so much for having mewell, we are delighted to have you back your episode. I don't think I told thisbefore your episode is number one out of all of our episodes. Wow, I didn'tknow o yeah it, as I looked at that the other day. So thank you for yourpromotion. I think you're your following is continued to bring peopleto us and hopefully got your word out as well, so feeling that we should haveour number one guest back on. I look back a man. It's been about six monthssince you joined us last time in many ways seems like yesterday. In many waysit seems like lots of gone by and- and you always impress us that you're neverslowing down and now he's doing lots of new things. So we'll talk about thattoday and jump in, but lunch catch up the listeners what's new with you alittle bit of some more new role and some new things going on, tell uswhat's going on on what's going on with patient Care Heroes, so I have beenreally fortunate enough to meet many people on the way with patient cureheroes and through so my advocacy work. I actually met the individual who wasCEO for a start up, which is called linked inclusion and was offered thechief medical officer role with them, which I accepted, and that is going tobe a huge amazing opportunity for us to create social change and use that inwellness right. So some of the things will tackle it, material mortality,mental health and make sure that we're making sure that everyone hasaccessible access to care. So I'm really excited about that, especiallysince mental health is such an issue right now we're seeing the rates ofburn out anxiety, depression and position, suicide increase and Stanley,also among nurses, and we're losing a lot of amazing individuals. Just sayingI've had enough: I'm not going to be a health care any longer, so these areissues that we really need to continue to tackle. The other thing I'm reallyexcited about what you know is my book that came out. It's actually thepublished Datas October sixth and is called delivering, and so that is kindof like my baby, that I created over the Ovid time span in your spare time.But you know we all have a lot of that right. That's right, yeah, well, that'sexciting, and I want to think into that a little bit more and by the time thisreleases, the book will be out, and so we'll definitely put a length of thaton the site and do that. But I remember patient care heros launched in January,and that was your website and your cause. You talked about short termgoals, being education and educating...

...the market place long term ideas andvisions on wellness, so tell us over the last six months: what's evolved,what's changed and our things going with the site and how's it getting outyeah, so patient Care Caro is obviously is a labor of love for me, becausewe've seen so many individuals struggling with mental health issuesand one of the big things I wanted to tackle is the advocacy end of this,because there's positions that are legitimately concerned that they willlose their license if they seek mental health care, and we worked on a lot ofthese issues in the state of Minnesota, where I'm at and with Minnesota MedicalAssociation, and so we successfully have been able to change the morning onthe physician license application, so they don't discriminate against peopleseeking mental health resources. That's great, you know, that's you know, stepone. That's really important and we're doing a lot of this work with MinnesotaMental Health, advocacy programs and three McConnell. Who is a greatindividual working on these issues as well, and so we're using kind of themomentum from that to buildl to hopefully create changes across thecountry? I Know Corey Fist from the Green Foundation is such an amazing,inspirational man, and I don't know if you're familiar with his story, but itwas his sister in law, Lorna Breen, that died by suicide in New York, andso they created the Breen Foundation and we were able to get the Breen Actpast, and so this is going to allow a lot more resources for even doingresearch on what is causing some of these concerns in the health carecommunity. Unfortunately, we have to have the numbers to back us, becauseyou know anadot. L evidence is not enough for people to actually spendmoney and create changes, especially in health care systems, to the the GreenAct that Corey plane and you guys got helped get behind, because that wasthat just for New York or is that that's everywhere, O yeah, that'snational piece of legislation and Tim can and Tina Smith were individualsthat worked on that Kine Smith is one of our senators here in Minnesota andis really passionate about mental health. So that's was a nice way tosegue our involvement in Minnesota, with them. That's great awesome, and so,and what is specifically the act address is that I address theprotection from mental health and with it with the job. You know I wish it did.We tried to get some Odendaal on there. It's mostly financial assistants, andthings like that, so we do have a long way to go. This is a great historicalpiece of legislation for us. However, I would love there to be universallicense applications right now, the individual state licensureorganizations, the boards can basically exist independently and have their ownquestions, and so the difficulty with that is each state is essentiallyacting like its own fiefdom, and then people are treated completelydifferently and in the state of Minnesota. It's very interestingdicotomy, where we have some individuals. For example, we've had aclassic surgeon who was mail have years and years of sexual, predatory behaviortoward female patience, and his license was not taken or suspended and in factthe only reason we know about this is because one of the big systems said no,I'm not going to credential you here. So we've got that on one end and on theother end we have women who are afraid just to seek mental health care forpospo anxiety. We had another amazing physician. Mom died by suicide shortlybefore she was supposed to come back from post part of leave and when youlook at people who kind of are just operating independently doing whateverthey want versus women who are in our system,trying to decide if they're going to care because they're worried abouttheir license. It's just it's very polarizing. To look at the differencesthere show when you talk about universal license application. Is thatsomething that you're looking at where each state would continue to licenseunto their wrong rules and regulations, but the application was universal sothat certain ability to question or ask certain things would be eliminated. Youknow, I honestly think that there needs to be a complete overhaul and whatwe're doing for applications. I think that it should be a national entity,because many states have failed their...

...clinicians and I don't think that thestates should be able to operate independently. At this point, I've beenat some of the Minnesota bord meetings at this point and a lot of theindividuals who are making these decisions are not educated on theissues that are affecting physicians right now. So I know that there is, andI'm trying to scramble here and try to remember how it would what you do itstands exactly for, but there is the I mls, which is the interstate medicallicense cooperative. I think it is medical I compact, so it is close, andwhat about that? I mean we hear more and more that where you have thesestates that our esirt Ng it's not a direct whereby of a license in onestate. It applies in the other state, but it makes the licensing faster. It'sa little bit more of a fast track, provided that you are a what they calla clean provider. You don't have any big medical malpractice suitsoutstanding or any other things like that. Have you had any love or any talkwith there is at a place to start. You know, there's also national federationsof organizations that are trying to put recommendations out for licensing right,but all that is is recommendations and the Individual Policy Committees forthe individual medical boards have to put that forth. Have to have adiscussion on it have to elect to push it forward. For a vote I mean so all ofthese organizations are kind of flock when it comes to actual rubber meats,the road changes, and so I think, if we're going to have states that are outof touch with what is actually needed, then we need to circle back and takecontrol of that, because we've allowed them to exist in isolation. For far toolong, we also have a number of individuals who have been reported forvarious things that are pages safety, related sexual misconduct, related EXC,etc, and because the individual boards have so many reports, and I the ratioof reports to staff is so low. A lot of these things go on answer, and sothat's not a safe thing either, and so, if the argument is, we can't havephysicians who are seeking mental health care for anxiety because ofpatient safety issues. Well, the way you're doing this is not appropriate.The other issue is born out is going to lead to depression, anxiety and suicideright we've seen this process happen time and time again, and the issue withthat is okay. Well, what effect does burn out have on patient safety? Wellsignificant, and so we are leaving a whole crew of individuals untreated,which we can prove as detrimental effect on patient safety and patientoutcomes. And so again, if the argument is work, task was trying to create asafe environment for patients, we're completely going about it, wrong, HMMYEAH! So, and you know I just got to go back on so he said so when you'retalking about they are putting a level of mitre. I understand you're, puttinga level of scrutiny around the mental health issues that they see on thelicenses, but they are not being consistent and how they apply that samescrutiny or criteria to other things, other what we might call socially badbehaviors, exactly okay, and so I think the problem with having individualfiefdoms and being human right so we're all human is. We cannot separateourselves from more bias unless we're working really hard at that, and sothat goes into the whole gender bias racial bias. How are people treateddifferently in academic institutions versus community institutions? There'sa certain culture that is allowed to exist in medicine, that is toxic andit's enabled and for us to make royal changes. We have to face that andtackle the issues that actually exist well, and so yes- and thank you fordoing that- and I guess getting the likes of Tim Cane and Tina Smith-definitely gets you a higher little INVESCO or or escalation but disabilityin the marketplace to get some people who have the larger influence you knowgetting behind this, hopefully, will...

...continue to be. The spark thatcontinues to drive that forward, yeah and cory face is amazing. I'm verythankful that I can say. I know him now because he's an individual who is justsuch a hard working advocate for all of us in health care. That's awesome! Weneed more of that. So tell me a little bit about whathappened in the last six months. What have you learned in the Obgyn communityabout Ovid that has been either the biggest Aha or you're excited about or affirming towhat we believe earlier? What's changed if anything over last six months,everything's changing so fast. So I will tell you I it's interestingbecause we have this conversation way. It feels like a hundred years ago,and I was very pro vaccine, because I was looking at the data that was comingout and really it's affirmed what my thoughts were. I also knew that there'sno way that pregnant people were going to just kind of get off easy like theywere claiming before, and I don't know if you remember when the Kanemiinitially started, they were thinking that potentially pregnant people had acertain level of protection because they were pregnant, and so they werenot seen as a high risk category and I think every Ogi Ju in and the countrywent. I don't know if that's necessarily true, and so that gave usall a little bit of hesitancy and we're taking a lilt back, because weobviously know how the flu works in pregnancy and people are a lot sickerwith the flu in finance, which is one of the many reasons we want people tohave a flu vaccine. So we definitely want people to have that. However, withOvid we are seeing significantly worse outcomes and pregnancy, and so yourrisk of severe disease and death is a lot higher than the average person andthe CDC actually does came out and I'm sorry and that's that's in women whoare contracting coved, who are Grex exactly to be clear on that? Yes, sothe CDC actually put out some information. The last couple weeks, Iactually think like four or five days ago, really urging people who arepregnant thinking about becoming pregnant to get the vaccine, and I cansay with one hundred percent confidence. This is not going to cause infertilityissues. This is not going to jeopardize your ability to have kids in the future.This is not changing DNA. This is not getting into the fetus in some hartfulway. None of that is actually reality. Okay, so good news when we played thedevil's advocate here, okay, so the question I think, would they would sayand I'm putting on the spot. So I apologize. But how do you know right?That's I mean, I think the big piece around the whole vaccine is iscontinues to be it's new and I asked a previous episode to someone. Okay, theFDA is now approve. This thing is everybody going to get on board andthey said no they're, not because they're going to say the FDA rushed itthrough. So everybody is under this perception that this thing has beenrushed and crushed, and we talked about on the show that it's not newtechnology, it's been around for a while, but all that sort of stuff. Butso I love your affirmation, and I love that fact that those listeners who havethat fear of infertility due to vaccination, you're saying that's notgoing to happen. Their question is: How do you know? So what gives you courageto make that statement? Well, I mean I worked pretty far for my career and Iwould have bet my career on it. But looking at the information- and this iswhat really is frustrating, because people will hear something or see something or readsomething, and if it's the first thing they read or see that kind of sticks intheir mind, and so it's hard to correct some of this misinformation, which isreally frustrating as a condition. But the way I explained it to one of mycolleagues on Linden is okay, so you have a boyfriend or girlfriend andtheir perfume smell right that trigger something in you right. So you see them.You smell their smell. It triggers a reaction. Now, if you're like walkingin the department store you broke up with them, you smell the smell. It'sgoing to trigger the reaction right. So I like to look at the vaccine kind oflike that. So you've got the summer an...

...a it's very fragile okay, and that'swhy I has to be kept at a certain temperature. It has to be handled verycarefully and administered precisely, and so it's not going to survive in theworld in your body like it's just not going to it's not going to happen, notcould be incorporated into anything, but it leaves that memory right, and sothen you have that visual reaction to it. So then you can mount an immuneresponse if you ever see that antigen or that smell that smell, if you willright so it's a weak enough particle that it is not going to do anything toyou. It's not going to incorporate anywhere it's just, not how itphysically is made it's impossible for it to do that. So it's not as evasivein your body and your system as some people see that to believe it is somepeople believe. Okay. This vaccine is now taken over my body exactly and it'severy place that it is, but it's really just that it's! I love that I love theanalogy. It is that little memory molecule in your brain that istriggered it will come out, but if not, it kind of just sits there waitingexactly and so. Okay, then we can monoamine response right. So that'sreally how vaccines have worked forever. We get t taste of it so that we canrecognize it in the future, so we actually can combat a response, and sothis is another issue that we're seeing is these anti vaccine rhetoric issueshave created anti vaccine rhetoric for things that have been around foreverright so again were seen more measles and define things coming out, and so wetend to have these ups and flows of o breaks of different things. That shouldbe eradicated by now, because the RETOC as so toxic to us, trying to make surethat our patients are safe, m yeah yeah, I just just for the sake of continuingon this show to support that we are you pro vaccination. The statistic thatcame out of the episode last with Memorial Hospital from the head of theICU was we've had fifteen hundred deaths from Covin and we've had zerohospitalizations from the vaccine. So He's saying what you know you know: whyare we so against it when it continues to prove itself out and and and why dowe listen to since? When do we listen to our politicians over our medicalproviders? Exactly so and there's there's a document out of one of theRome safety projects and there's thousands of positions signing it tobasically reaffirm the physicians, have no place in pushing their politics ortheir a Gundo right. It is our job to do. No harm is our job to make surethat patients are given the most up to date, accurate, safest information. Soit's not my job to give you my opinion on a birth intra or a vaccine, or some political debate is my job to makesure that you are safe and taking care of and have the options that you needand that's informed consent well great. Well, I know them, I'm glad that that'sbeen affirmed for you. I hope our audience will continue to listen tothis and we'll continue to go ahead and just continue to feel that safe to go,get vaccinated and now we're coming around with boosters right. I had mine.I had mine on like eight days ago and I ly signed up, because I was more thaneight months out from my series, and you know I work with enough individualswho protect coved that I, for sure will stay up to date on these things. Icertainly don't want to risk me, bring it home to my six eight year old, whohaven't been back stated he on yeah and then the last message again. I want totry to continue to reaffirm. Is You know so many people are also sayingwell, especially who a big portion of the unvaccinated community today aresaying: I'm Young, I'm healthy, I had it and it didn't didn't get too bad, soI don't need the vaccine and all that, but the data that's coming out withwhat they're calling long, fallers or all of this post effect of brain fogand in different heart situations, long...

...situations and all that you know thatwas the other reason why it's? Okay? Yes, you are young. Yes, you probablywill survive a dose of it. But do you want to have these long lasting effects?I know you're, not epidemiology, but you know one of the things I've seenthat is lime. Disease is a neurological, my understanding virus that you get andit has long term effects that you have it. So No no difference in the sense of whyyou should go out and get you know this, even though you think you're young andhealthy and can withstand it. Honestly. If you look at the data from the Deltavariant, which is the predominant variat, now we're seeing young peopledie and be on Col and we've had children on ECM in the twincities, and I don't think it's anything that should be messed around with.There are people with risk factors, obviously being overweight or obese, isa risk factor which, to be honest, is a huge portion of our country. Right, Imean I got. I could have gotten my booster just because I'm overweightright, so we all need to make sure that we're protecting ourselves and thecommunity that we live in just to make sure that we're doing the right thingsfor people around us, not just for you, said to explain what that Moi. So it'sa specialized machine, basically, because individuals can't explain itkind of in a more simplistic way, just kind of like the heart one functions.We need to help support that for those individuals and so the problem thatwe're seeing is we have a final amount of resources right, so resourcesinclude staff right so for not taking care of them and their mental health.We won't have them to help take care of anybody. Other resources are buds great,and so it's not just because coved exists that nothing else exists right.People are still falling off ladders, people are still getting into fights,people are still having heart attacks and strokes, and so we need those bedsto protect people that leave them for various other reasons as well and thenyes covet on top of it, and so the thing that physicians are worried aboutas we continue on this way, and we see flu in different things, are we goingto run out of the resources that are more scarce, yeah and when again,you're, just echoing, but we've been hearing through the show from otherother doctors and providers, saying let us treat some of the other people whohave other serious things by just being smart okay. So, let's shift gears herea little bit and tell us about the book delivering is the title of the book toBe Released October. Sixty said yeah, so two days were October. Fourth wererecording this so be in d. So again, as as listeners here, it I'll be out andavailable. Yeah so tell us about why the White Book. So when I started thiswhole ovid journey, I guess and started patient Caraher Os. I was really tryingto figure out how I could have fact some sort of tangible change in thehealth care community because, as we've discussed before and I'm sure, you'vediscussed with many other people there's a real need for cultural shift,and I think that people have a fear of being vulnerable and authentic andtelling their story. Because everyone has a story, and I wanted to be able totell my story and talk about some of my experiences as a physician as a womanas a mom and kind of getting in the middle of all of us and training, tomake sure that people understand they're, not alone in some of thesesituations and that they have support and they don't have to feel likethey're like the random out wire person struggling through this. And so Ireally wanted to make sure that they knew that. There's people rightalongside them that have some of these concerns and some of these issues andthe biggest thing that I wanted to communicate is you know again talkingto people about physician, suicide and mental health issues. People tend toisolate themselves in the medical profession. They don't want to talkabout. Maybe they added history of a salt. Maybe they had a history of abuse.They don't want to own that they don't want to talk about it. They feel shameabout that, and so I wanted to make...

...sure that people knew it's not theirfault, that just part of your story. We just have to kind of learn from it andgrow together. So for the polite show it's not a medical book, it's not abook about Ovid, it's really more a book about the mental health industryand dealing with some of the stereotypes or sting as that medicalprofessionals deal with yeah. I mean it's a memoir it it's you know stuckfrom when I was younger and how I saw things and really I wanted to make surethat we are addressing women's health. We were addressing. You know some ofthe pretty significant issues that exist for women in our culture today,basically address even losing a child. You know so I've been very fortunateenough to have platens, who are amazing and compelling, and also allow me toshare some of their stories in the book as well, and so people again losing atrial is a horrible thing that people have to deal with, and so I reallywanted to look at that and own that and make sure that people knew again. Theyaren't alone, there's people out there. They can help them get through this andwe can push on together so who should get the book. So I mean honestly, Ithink anyone who's struggling. I mean they could just like look at my lifeand think their live is probably better than minds. That might be helpful, but you know women, women in medicine,MOMS people who are working in advocacy, work, people who just want to be moreeducated about the medical training process. People who you know just needa good story, and I think it's important for us to make sure that wecan be authentic with each other. Well, thank you for the effort. How long hasthis been in your mind? To Do? How long have you yet some people say we all have a bookin us, but how long it been, you know we have to have to be kind of called tosay I want to do now is the time I want to do it. So how long has this beencoming over about? You know, honestly, I hadn't written anything before Ovid. I knew I could write. I wrote like inhigh school fright I was in. I was in forensics and sports and play Saxon andall the nerdy things right and I hadn't written articles I hadn'tappeared on shows. I hadn't done anything really until my life kind ofchanged a couple years ago, and I changed jobs and really kind ofrealized. How Limited our time could be in one of to make sure that I washoping as many people as I could and with cobet. I had a little bit ofadditional time, just not taking the kids to all of their sports events andeverything, and I actually end up writing this book in three days andwhatever you are overchief see you er you you're always down on yourself, butyou you're, quite thing fever, so one of my editors said because I was givinghim pages as they were because he offered to do it for free right because,of course, like I don't even know how it's going to get published and I wouldemail him pages as they as I wrote them and he was like I've never seen. Anyonewrite this fast and it took him much longer to do the initial edit than meto write it, which is not a normal thing for him, because he's a speedyguy and from there the publishing world is justa unique world that you kind of have to learn as you go, and you need editorsand sub editors and proofers and that whole thing you need to find someonewho actually believes in your story and things that it's valuable to put offthere into the world, and I was very fortunate to have collegues. I metalong the way with patient care, heros and a publisher heard me talk and talkto me and leaved in my story and decided to go with it. So Fisher Klein,publishing now stuck with me, and so the whole process has been about a year,but it's definitely been a learning moment. Oh Great! Well, that's a veryit's very exciting and I guess what do you as you look moving forward? I meanwhat do you hope comes from the book and how does it relate to the patientKyr Heroes Initiative and they linked her? Are they very separate and and howdoes that movement go yeah? So I think I mean everything I do is kind oflinked right and I mean really. I wrote...

...this book for a lot of the women inmedicine who are struggling to be seen and heard, and when you really look atthe stats, thirteen percent of health care cos are women, and I wouldprobably guess that now, during this pandemic, that number is Sagan downeven more and women would like a seat at the table. They want to be heard.They want to be involved, they want to help make decisions, and I hear all thetime that women are struggling to even exist in their specialty, becausethey're just kind of looked at as this for an entity and not taken seriously.We have people with NDA is and non disparagements. They can't tell theirstories about harassment or even sexual selt in the workplace because ofagreements that they reach, which allegedly or protect to protect them.However, really again we're ennavay people who work predatorial, and so thebook really was to kind of open up people's eyes on things that go on inhealth care and to be a voice for people who don't want to speak up abouttheir things that have happened to them and to hopefully open up some reallyhonest dialogue, because really the gender racial equity issues, in myopinion, is at the root of a lot of the toxic health care culture that we haveand until we can acknowledge that come up with fixes for those issues. We cannever move forward and those are really at the root of the burn out and thewomen leaving medicine and anxiety, depression, suicide, and so we reallyhave to cut things out of the room yeah. Well I mean it's. We love having you onbecause we love your passion around that and you're clearly you're, clearlymaking a difference and having a difference when you think to that, whenyou think about the book, what's kind of, can you give us a little bit ofpreviewing? Just tell a little bit what's one of your favorite storiesthat came out of the book, or what's one of the ones that you think somereaders might find most compelling. I mean everyone's going to relate to adifferent story right, so all of us are going to a true, become kind of enrapped and in different things that triggers different emotions. Fromm us,I think you know I. It was hardest for me to talk about a sexual self that Iexperienced, and so I think that that might elicit some emotion from people,especially sexual sel survivors. I think that it's important for people to put that out there, because I think,there's a lot of denial and, of course, my you know own mother, when I wasseventeen when this happened didn't want it to come out. She was runningfor politics right so that, as basically my bad, I put myself in asituation that wasn't good, but it could not reflect poorly on her, and sowe basically pretended like it didn't happen, and I think we really need totake ownership of how we're talking about sexual assault and consent,because, even if you look at what's going on now- and there was thatfraternity, where that freshman was actually assaulted and his father hadbasically rushed him out of the country so that he didn't have to haveconsequences. If that was my son, then I can guarantee it won't be my son,because I will make sure that no child of mine would do something like that.But that was my son. I would be bringing them down to the play stationmyself. I would make sure that there was accountability there, because thisis how you have serial predators in the world, and I think we really haveenabled individuals to get away with things that they shouldn't be able toget away with tough stuff. I mean those are. Those are hard topics and a thankyou for your horable Y and I'm sure that was not easy to write. Thosesections at zero editor was waiting for the parts of the story, but I know thatthat was I'm sure a difficult time for you and hopefully writing and writingabout. It is a bit of healing for you as well wow yeah. So let's look forwardto with the book delivering coming out very soon as we kind of close up GodTaak. So let's talk about mental health and what are you hearing in the market?Last time we talked there, we are, we were forecasting and believing thatwe're going to see a big sling shot...

...coming out of this. I think- and youcan tell you who you agree. I think it's been a little masked, because thehealth care community has been forced to rally again due to this dealt thesearch that we're having the way I've been power, phrasing or summarizing.Some of the conversations I've been having with doctors on the front lineis they are exhausted and they're angry, especially this time around, becausesome of it could be prevented but and they're just they're, just tired, andit's just you know every time you think. Okay, this is going to be the downslope and then I can catch my breath. You know here it comes around the curbagain. So obviously, maybe there's that's why I said maskedyou know mental health stress because they're row there, you know it's kindof like you get that a driving rush again and you got to be on the call ofduty but at some point we're going to crash and burn. So what are you hearingout of the mental health community? And what do we think is going to be some ofthe ongoing challenges we're going to have yeah? You know, and I think you'reexactly right, because people rally, even if you look at positions who were suicidal before they died by suicide,they did their shit. They made sure that their patients were cared for. Youknow, I think, that that really is intrinsic in most of us, because wewant to be a team player. We want to go out there, we want to make sure peopleare protected, and so it is the delayed reaction where we see some of this kindof self medicating and then suicide. So I do project it's going to be after wekind of have a break from the action, so we haven't seen the crash, yet Iknow still micras I mean, I hope not. I mean we're still having our waves right,and so I don't think it's going to be a long time before we're seeing theactual effects on mental health and what the consequences are going to be.However, I can say with certainty that we are losing many amazing individualsto burn out and just done with health care, and I think that that just scareeveryone- because we are seeing shortages- that I haven't seen in overtwelve years- I've never had to deal with staffing shortages like we likewe've had, and my concern is that these individuals will just give up on HealthCarol together and we'll lose some very talented people, including positionsright. So we know we know your pro vaccination provaccine we've established that any thoughts on you know that that seems tobe this kind cushion pole that the health systems are wrestling with rightnow, where they want to mandate the vaccine. They believe it's the rightthing for patient care, but to your point, the staffing shortages are sogreat. The concern is as if I put this out- and I have mass resignation orthere's a chunk of my people who do not come back because of that. Where am Igoing to? What am I going to do like you know more ready under staff? How doI do something that pushes that out and it's that balance? But you said earlier,which is doing the rightthing or you know doing that convenient thing orthe thing that is going to hopefully allow you to keep giving the care thatyou need. Honestly, I think that the mandates are great. I A hundred percentsupport them. I want to make sure that my patients are not exposed to anindividual who is coved positive, especially in my pregnant population,where we know that the outcomes are worse and honestly, if you are anindividual that works in health care, could not look at the science. I don'tthink that I would trust you taking care of my patients, especially myvulnerable patients. I don't want to take care of a nicky baby, that'stwenty four weeks and it's going to be very vulnerable to these things. So Ithink that the health care systems are doing the right thing by man dating it.I don't think that anyone that works in health care should have to have amandate, because they should be able to read the journals, read the data andmake their own decisions. However, at the point where we are going to putother staff and patients at risk, unless they have a mandate, then that'sexactly what they should do. Yeah well...

...again, we're pro with it as well too,but obviously, but the C Mo is you know like in the role you're helping with,and then you know the big health system chief medical officers, it's a real,it's a real struggle. I think Noman announced the North Carolina healthcare that they were going to have about a hundred and seventy five terminationsor letters that they put out. If they were these pedi individuals didn't showproof of first vaccination and the thing I mean it's a big number to haveto lose out of your El System. Well, it's frustrating, I think, on my end aswell, because when you look at it, we all had to bevaccae to be on the wars in medical school like as a third and fourth year.I D, a my titers drawn. I had to like bring my little card from mypediatrician copy them. I had to submit it so that I was allowed to care forpatients TV right, pollutive, my TV, you know Manto test every year you know,and so I do not understand what the resistance is. Yes, if we didnot have literature that supported it, if we did not have literature thatproved its afficit and safety than fine, okay, great, but but sure we do- and soat this point, when we have an FDA approved vaccine for health care workers to not be ableto take a step back and reflect on the choices that they're making it how thatcould potentially affect other individuals. I think that that show isa certain level of Negletto. No, I don't don't disagree. So, what's nextfor the ever busy Dr Stepper, where do you want to see patient care heroesgoing and what would be a big wind to close out the two thousand and twentyone year to guys? Well, I'm just really excited about linked inclusion beingthe C Mo for them and we're probably going to roll patient care heroes intosome of the work we're doing with them as well, and what will be great aboutthat as we're hoping to have more impact greater population of people whoneed resources so tell if you get what tell us a little bit in the last fewminutes. Ere will tell us a little bit about linked inclusion, so beingassigned the SMO, but but want to share with the listeners. Who are they andwhat are they? What are they doing and why you're excited to be there yeah? Soit's it's again. It's a start up. I'm really excited to be part of it,because we're looking at individuals who essentially have been excluded fromthe conversation right, whether it's black men right like look at black menin the medical field right. So we have not even had an increase in thoseindividuals applying to medicine. If you look at the data, it's not thatwe're not accepting them its thet, we're not even having them apply, andwhy is that? And it's probably because of cultural issues in the field ofmedicine. If I knew I was at coille treated appropriately by the culture Iwas entering into that, I probably won't enter into it, and so we'retrying to look at all of those little nuances and do what we can to fixhealth care systems. The world of health care were trying to look at howwe supply health care and we're trying to look at overall wellness andwellness really is not just going to the doctor right. Well, this is themental health aspect, wellness es how you see yourself in your community,while this is being able to get clothes that fit you as a plus sized persontrying to apply for jobs and to feel good about yourself. You know, and sowhat I'm excited about is a really a new generation of people looking at howto really take care of people in their entirety. That's awesome, so we willput more information to them on the website with this, so we can get morepeople again. We have patient care. Heroes is on the link from the lastepisode will repost that will put linked inclusion and let's justcontinue to to kind of get this message out as we wrap up. I know we alwaysclose our episodes with who is your gro last time you told this with BaderGinsburg. We said we said rock on. That was a good one. W We were that was. Wewere happy with that. That was a good...

...answer. We like that, but when youthink about just you know, maybe something out of the book or somethingthat you know even in your past, is there somebody else you want to give ashout out or do we want to do we want to stay with our BG? I don't know I wasthinking about this. I think I'm sticking with R BG I mean look atwhat's going on in Texas, I mean we, you need people who are going to standup and to set when something is not right when it's not a human right, andwhat makes me really disappointed with the legislation in Texas, especially iswe have a topic. Pregnancy is that we diagnosed after six weeks right and inthat case, a mom and a baby are are dead right I mean people are notlooking at the nuances of what legislation can mean medically, and Ithink that particularly the government should notbe able to legislate what we kind of can't do for someone. If it's going tokeep them safe and healthy and alive, HMM, yeah, okay or BG. I have to gowith that. No Hen this he got a good one. You stay with it right. You got agood hand, you play it, that's what they say a to the block to her, andthis was before she died, God, roster soul. I wrote this and I and I'm likereally sad. I can't mail or copy right, because she she was a phenomenal womanthat well then, I'm glad I'm glad we double that on her. That's awesome,well, Doctor Specker pleasure. Thank you always your time. Thank you forworking tirelessly for these very important issues that you are sopassionate about you're, a great doctor, great mom, great advocate, and weappreciate you being part of the show thanks for joining us. Thanks forhaving me you've been listening to heroes of health care for moresubscribe to the show in your favorite podcast player, or visit us at heroesof health care, podcast com e.

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