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The Legal Drug Dealer Podcast

Getting Pharmacy as a profession Closer to The Patient

May 12, 2020

#22 Another 13 things Good doctors wish that patients knew (Part 2)

With Joanne Davis Jarrett, MD & Marilena Grittani, RPh

This episode (Part 2) will show you a different way to perceive your doctors, but from a more global stand point, told by an actual physician herself! Joanne Garret.

Some of the most relevant points she made are:

  • Doctors don’t know everything
  • They make mistakes
  • They refer you because they can’t help you.
  • They need you to always tell them the truth
  • Among a ton more….
Joanne Davis Jarret Mom and Family Medicine Physician

" If your doctor says "I don't know", the next thing they should say is, this is what we're going to do: bring in more people to help us figure this out, or we're going to get these tests or we're going to send you to this specialist, she should guide you to help you get answers "

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Joanne is not only a very charismatic person, she is truly down to earth. I had so much fun talking to her. 

Don’t forget to listen to her podcast, you will laugh out loud with it. I promise!

Her podcast name is Fancy Free Podcast. 

Let me know what you think about our conversation and if you have any questions!!!

comments@thelegaldrugdealer.com

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doctor and old man

" Doctors are human too, whether people believe it or not. Yeah!, doctors are allowed to have a bad day. They might not sleep the night before, because her baby decided just to have a party all night, he didn't let her sleep all night and now she is really tired... "

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Episode Transcripts

Marilena Grittani, RPh  0:11 

Hola, and welcome to The Legal Drug Dealer podcast Marilena Grittani here, I am a registered pharmacist and also your host. Thank you so much for listening to this new episode number 21. Or we are going to do part two of the previous episode number 20 where we talked to Joanne Jarret, she is a physician, a family practitioner, about the 13th things that could doctors wanted to know. She has the other 13 things that she wrote about the same subject. So this is what we’re going to be talking about today. We are basically going to discuss what global physician physicians for different parts of the world have mentioned to her that they would like for you patients to know. So here they are. We’re going to talk about it. As always, we’re gonna have a blast and a lot a lot. So don’t go anywhere. Listen to this.

Wecome back Joanne it’s so good to have you back.

Dr. Joanne Davis Jarrett, MD  1:08 

Thank you for having me back today. It’s so much fun to talk to you as always.

Marilena Grittani, RPh  1:12 

That is true. And it’s not only like we

Dr. Joanne Davis Jarrett, MD  1:15 

I am a good time.

Marilena Grittani, RPh  1:17 

You are you are. You are, you know, I will not be su but first. And secondly, I think that it’s not only that we are very close to our professions, you know, pharmacists doctors worked really close, but also the fact that you are not the typical nerdy physician that is what grew, grew, grew, grew grew. Thank you for that. That’s why I like it so much.

Dr. Joanne Davis Jarrett, MD  1:40 

Right, Right back at your sister.

Marilena Grittani, RPh  1:41 

Yeah. So this comment goes right along to the number 14 of the 13 more things that doctors want you to know. And that is that you guys want to know, always the truth. So absolutely. What is that about? What are you talking about?

Dr. Joanne Davis Jarrett, MD  1:59 

Well I bring it up, because it seems like it would be pretty obvious. However, patients can be embarrassed. And I get that because we’re patients too, right? So there are certain things that you think oh my goodness, I just don’t want to share this with my physician. And the thing is that doctors have seen a lot. They’ve heard all kinds of amazing, crazy circumstances and stories. So I promise you a couple of things. Number one, very little shock fest or success or even embarrassing, you know, because we have to talk about it all. And and the other thing is, we know we haven’t walked a mile in your shoes. So if you feel afraid that your doctor might judge you. Just remember that your doctor knows that your situation is specific to you, and that they know they don’t have a right to judge you for that they have not walked in your shoes. But in order to provide you with the very best care. We need the straight truth period that includes Telling us all medications you’ve taken legal and not legal because, right? Like there might be some kind of medication interaction that’s really dangerous. And then we don’t if we don’t know about it, we can plan for it. It’s not like we’re asking you what drugs you’ve taken to, to put you down or to call you out. It’s just because we need to make sure we’re doing what’s right for you. And we need to know everything that’s going on in your system that you know about. It includes if you go into surgery, and they told you don’t eat after midnight, and you maybe ate something at 1am because you thought, What’s the difference? Well, the thing is that your doctor is not just trying to be bossy and strict. And that includes answering honestly regarding sexual encounters. Now, this doesn’t mean your doctor wants all the sordid details. It’s just that if they decide, like for instance, I had a patient once who came to me she’s a type one diabetic and she could not figure out why her blood sugar’s were out of control, okay, just couldn’t figure it out. She went through all the usual things, of course. She was controlling your diet. Of course, she was taking her insulin as she should. Of course, she was doing the amount of exercise she usually does. She knew she was didn’t have a fever. She knew she wasn’t under an inordinate amount of stress. She wasn’t on any kind of new medications. It was so crazy. So I had to really think and you know, it’s my responsibility to figure out why this is going on what occurred to me, okay, what infections can be completely asymptomatic, sexually transmitted diseases sometimes can but those can still increase your blood sugar. So I asked her about that and she just like had this look of panic for a second and I said, I’m only asking you because I’m trying to get to the bottom of this with you. Well, then we she was positive for chlamydia. She didn’t know it. We treated that the blood sugar’s went back to normal. And see she was brave enough to be honest with me and we got to the root of her problem. So that is, that’s what I mean by that.

Marilena Grittani, RPh  4:52 

And also in our cases is that they say oh, boom, taking the pill every day. And then they have the blood pressure high. I’m like Are you sure because if this is true, then we need to change the drug. Exactly the

Dr. Joanne Davis Jarrett, MD  5:04 

implication change depending on the information you need the right information to, to react appropriately. Yeah, if they’re only, you know, if they’re afraid to admit to you that they can’t afford the medication. So they’re taking half of the pill instead of a whole pill like these things we need to note because we can work with you if we know these things, but we can’t make appropriate decisions if we don’t have all the information.

Marilena Grittani, RPh  5:24 

So one thing I wanted to comment about that there’s companies that will either give you samples to the physician so the patient can get through it, if we need to work through a prior authorization to get that approved, then we can go with that or they also have companies that will give you one month’s supply specifically for that for you to get through it. So the doctor might give you that so if the doctor gives you a coupon, even if you have the best insurance ever bring it to us because that could be the bridge for you to start your treatment while we work in the background for the authorization which is a pain in the butt and I have an episode dedicated Just to that, because oh tricky on my podcast, I think is Episode 14 isn’t like the my website but anyways, the it takes up to a month, it could be minutes, but it could be up to a month and then is the doctor to have to send stuff we have the pharmacy has to stop and meanwhile, you are not getting your medication. So even if you have the best insurance if and the doctor gives you a month free of medication, bring it over, because you might need it. And if we don’t use it, we can give it back to you and use it whenever it’s not that we’re going to keep it and use it for other people. That’s not what happens.

Dr. Joanne Davis Jarrett, MD  6:37 

Okay, so

Marilena Grittani, RPh  6:38 

yeah, to be honest, tell the truth and help us understand what’s going on so we can make appropriate changes.

Dr. Joanne Davis Jarrett, MD  6:45 

It’s like help me help you.

Marilena Grittani, RPh  6:48 

Sometimes I don’t like that the weight or the height. I’m two inches more taller than I’m really why is that for who went with that? Exactly. Okay. So this lines a lot with them with the next one. So people can give you non true answers. And that can frustrate you because you don’t know what to do.

Dr. Joanne Davis Jarrett, MD  7:09 

Yes, sometimes the information we’re getting is inaccurate and it muddies the picture and it makes it so we cannot figure out what’s going on. That’s really, really frustrating. But what’s really frustrating is when we get all the information we need, we have everything in front of us. And it still isn’t clear. And that is because medicine is a you know, it’s a work in progress. And we are, we have serial discoveries occurring all the time. But some of medicine is still a mystery. And I used to always tell my patients, what I would love more than anything is to be able to climb in and take a look around. Like I need to see it with my own eyes. It’s the same way like when my kids asked me for help with a math question, honey, I can’t do it inside up in the air. I got to see it. Once I see it. I can figure it out. Well, we just can’t always see everything in medicine. And so you know, imaging studies do help sometimes But sometimes things will remain a mystery. And it’s okay to get a second opinion. If your doctor the thing we hate to say, but we will have to say it because we need to be honest with you is, I don’t know. And sometimes it’s going to be, I don’t know. But if your doctor says I don’t know, and then makes you feel like it’s your fault for having some strange symptoms, that’s a bad sign. So if your doctor says, I don’t know, the next thing they should say is, this is what we’re going to do to bring in more people to help us figure this out. Okay, we’re going to get these tests or Okay, we’re going to send you to this specialist or Okay, we’re doing Do you know, I don’t know either many number, any number of things.

Marilena Grittani, RPh  8:41 

A little bit more research on the doctor side too, because they might not know anybody that is a specialist. And then did you find out

Dr. Joanne Davis Jarrett, MD  8:49 

you know, there’s always a first time for seeing Yes, in real life. And when I was practicing in Nebraska, for instance, I had only practiced in Reno. Previously, and there was there were certain skin lesions that I’d never seen because I didn’t I didn’t know what a detasseling injury was from a cornfield, because we don’t have any cornfields in Reno, you know. So there are sometimes your doctor will be seeing something for that there’s always a first time and so sometimes they may need to go educate themselves, and that is, if they’re willing to do that, and they’re willing to admit that that’s actually a good sign. But it is frustrating. We hate saying I don’t know,

Marilena Grittani, RPh  9:27 

it is true. And actually, in my personal experience, I had a labral tear which is a little opening in the little socket where my femur goes in my leg in my head, and they did an MRI and the MRI from the radiologist said no tears, and then the specialist saw it and he said, I see a tiny teeny tear, but I’m not I don’t know if insurance is going to cover it or see it. So I said you know what, I’ve done everything just go for it. He took a picture with the scope because That’s how they did the surgery with the suture end. It’s like a, like a hook that you used to fish. And he put it through, it was like a mouse. It was like long and very, very skinny. And then he was overlapping. So then the image didn’t show it. But as soon as he opened it up, it was like a month you open this thing, goodness you tear was huge. It was very painful. So nobody

Dr. Joanne Davis Jarrett, MD  10:26 

documenting that that way. That was really that was smart.

Marilena Grittani, RPh  10:29 

So then again, that’s why they they get frustrated and the tests might not tell you exactly what it is until they go there. So whenever the doctor says we need to see what we find when we go there. That’s what they mean because the technology is really good, but it’s not perfect. That’s right. Okay, this is a subject that I absolutely love. And I’ve talked about it a lot in this podcast. Why antibiotics hurt? Okay, well, you have a cough and you have a drippy nose. Give you an antibiotic z Pak doctor calm. This fix this.

Dr. Joanne Davis Jarrett, MD  11:01 

Oh, that’s, you know, that is something that I think is really, really dangerous. A lot of doctors are people pleasers. And when you come in with a problem, we want to fix it, you know, so I, you know, the worst was when people come in with a cold or when people come in with a viral upper respiratory tract infection, an antibiotic is not going to help that it’s a virus, antibiotics only work against bacteria and the antivirals that we have are not effective against the common cold. Furthermore, the possible side effects make them not worth it to us for the common cold that we can get over with get over by ourselves. And so if you take an antibiotic when you don’t need one, it’s not just a neutral situation, it can hurt you because it can cause some side effects and that is definitely Oh, so it can cause it can cause complications and side effects within your body like some antibiotics can hurt your liver. So now antibiotics hurt the ligaments in your body. They’re just things that, you know, these aren’t completely clean medications. And if they can cause antibiotic resistance, which is why we have so many resistant infections, to the point where now like my mother in law had coordinate a pacemaker place and they checked her for MRSA, and before they would do the surgery, because it’s just so rampant and they need to know, you know, what you’ve got going on MRSA as the methicillin resistant Staph aureus, and we are getting bacteria now that are the bacteria are evolving more quickly than our antibiotics are involved evolving. And so we’re, we may at some point in the near future, be in a real world of hurt where we have certain infections that we don’t, and we’re kind of seeing that with a Corona virus. It is an infection that we are not prepared for. So there are reasons why these antibiotics can hurt and so do your doctor a favor and don’t try to talk them out. giving you an antibiotic when you don’t need one because there are medications that will help your symptoms. You can use a humidifier, a cool Mist Humidifier in your room, you can take an decongestant, your doctor can even prescribe you a 12 hour decongestant slash expector that will really make you feel a lot better. So that’s what I always liked to write for when I was practicing and I had people with an upper respiratory tract infection because sometimes people just want to feel like they’re doing something and there’s symptoms you know, you need your symptoms to improve you’re feeling terrible. It’s not that we don’t want your symptoms to improve it’s that we don’t want you to give you an ineffective and and potentially dangerous to you and to society medication. So your part in that is to not try to insist on an antibiotic when you don’t need one. A good doctor will not cave, but we’re human and every now and then somebody will cave and we just don’t want that to happen. So that’s that’s your role in it.

Marilena Grittani, RPh  13:52 

And also, some doctors are my big having a hard day and they’re like, Is that what you want here? We’re here go and You know, it happens to all of us because you guys are human to whether people believe it or not. Yeah, doctors are human to have a bad day. They might not sleep that night because the baby that they had at home or the twins that they have at home decided just to have a party all night and then they’re tired. So sometimes they might have

Dr. Joanne Davis Jarrett, MD  14:18 

a patient with chest pain in the next room, and they’re like, I’ve got to get over there. You know, you just never know. Yeah, so

Marilena Grittani, RPh  14:24 

don’t don’t don’t think that you know more than your doctor. Sometimes you might be educated but doesn’t mean that the doctor doesn’t have a point. Okay, that also goes with it, watch and wait.

Dr. Joanne Davis Jarrett, MD  14:36 

watch and wait is such a bummer. Okay. So, sometimes the best thing to do is to give your symptoms or your situation some time, time is the great clarifier in some situations, it will help things to become clear, it will help symptoms to either develop or resolve. It kind of shows us whether or not we need to be more concerned or we can just kind of get past Something but it feels a whole lot like doing that thing. So and if our first reaction is you know what, it’s too early to knee jerk we need to watch and wait. Please just be patient with your doctor because if they jump to a test that may not be necessary or they jump to a medication they’re not sure is right for you or if they jump to some kind of imaging study. This is just a can of worms that can either be expense expense that you don’t need to incur or it can be exposure to something that you don’t need to incur. So, if your doctor wants to say, let’s just watch and wait, oh, come back in two weeks and we’ll talk they’re not brushing you off. They don’t like it either. Because we’re not only are we people are people pleasers, but we’re fixers right so we want we’d rather just but but if watching wait is what is appropriate, then that’s what needs to happen. So you guys are both just gonna have to wait two weeks and get back together and figure it out or Six months or whatever, it isn’t so hard to wait. But sometimes wait is what’s appropriate.

Marilena Grittani, RPh  16:04 

But then the patient needs to be able to take ownership on their health and say, okay, the doctor said two weeks, I’m gonna be there in two weeks, the doctor says a month, and then observe anything that

Dr. Joanne Davis Jarrett, MD  16:16 

yes, take notes during that time, try to collect data that your that your doctor may find useful. That’s exactly very good point.

Marilena Grittani, RPh  16:23 

And then whenever something changes, or happens, even when you’re not all the way to the length of time that you agreed that you were going to wait, just communicate, Hey, I just don’t know if this is important, but this is what happened. And then the doctor might say, no, yeah, calm right now because it’s already happened. And I thought it was going to take longer. So remember that the doctor has thousands of patients, you have just one of you. So it’s your responsibility to be aware for yourself. That’s perfect. Yeah.

Dr. Joanne Davis Jarrett, MD  16:49 

Okay, good.

Marilena Grittani, RPh  16:50 

Yeah. This happens to every human and we don’t want to accept it. We don’t want to recognize it. But it truly happens. And because again, you guys are human. You can make mistakes.

Dr. Joanne Davis Jarrett, MD  17:01 

Yeah, the next one is we make mistakes we try so hard not to and the importance of providing thorough and thoughtful medical care. In light of the fact that we’re human is just exhausting and it’s weighty and it’s ever present. Be very wary though of anyone who will not admit that they sometimes make mistakes, because you don’t want care from somebody who thinks they can never make a mistake, because then they’re not trying, they’re not being careful and trying to avoid mistakes, right. So the that’s one of the reasons why I was I was a very good doctor, but I was a very unhappy doctor. And the reason one of the reasons why is because I was so anxious I wanted so badly to to do the exact perfect right thing for my patients. And, you know, it’s just not always going to happen. But I do think that that precipice that we walk on, is right where it needs to be because if you become laksa days old You are going to make more mistakes. So just we are always vigilant. We are always careful. But we’re not always right. And we do make mistakes. So we’re sorry about that. Yeah,

Marilena Grittani, RPh  18:14 

I can tell you that that’s true, because we are the double to the second check for the doctors. So let’s say that a doctor writes a prescription. Thankfully, these days, there’s not that many that are written because they have awful writing. Anybody was awful. And then

Dr. Joanne Davis Jarrett, MD  18:28 

you might notice you’re so crazy

Marilena Grittani, RPh  18:31 

.And then you’d say, hold on Dr. Jarret, I just noticed that this person is supposed to have this three times a day is just a drug that you meant to write because this is not three times a day. And then they’re like, Oh, thank you. Thank you for catching that. I didn’t mean to do that. I meant to do this. Yes. Because you can be distracted things happen again. You mean?

Dr. Joanne Davis Jarrett, MD  18:49 

Thank goodness, we’re not we’re not practicing in a vacuum because we have to watch out for each other right.

Marilena Grittani, RPh  18:55 

So whenever the pharmacists tell you at the pharmacy, hey, I need to call your doctor for Recent, just give us up time because we want to make sure. And also if we make a mistake, which we do, because we’re also humans, right, we can cut you really, really bad damage because you might have I have heard stories of babies that have had recent pressure medication or stuff that are not necessarily what you need, but it happens. So be alert, make sure that the drug that you have is what you need. And whenever you get a different drug that looks I mean, the same drug that looks different, give us a call, we will not we will not be offended by that. And we check and we have ways to, to double check that.

Dr. Joanne Davis Jarrett, MD  19:38 

But that’s actually a really good point. Don’t be afraid to offend us because we’re on the same team. We want you are our priority. Your health is our priority, not our pride, not our ego, your well being. So if you say Oh, but actually I’m on this other medication and I was told not to take this thing with that thing. Oh, thank you for reminding You know, it’s not and we want all that we want all the help we can get. We will not be offended. Just Yeah.

Marilena Grittani, RPh  20:07 

Yeah, work work on yourself. Help us help you. Right?

Dr. Joanne Davis Jarrett, MD  20:11 

Yeah, yeah, my husband. There’s a like an example of a pharmacist calling a doctor to check. My husband’s a dentist and he treats patients for root canals. He does his specializes in root canals. And he treats patients for sometimes oral infections, while there’s a certain type of infection in the bone that he prescribes a medication for at a much higher dose and the pharmacists are used to sending that out. And I love it when they call because it’s like you’re doing your job. This is the right thing. Thank goodness, thank you. You’re looking out for the patient. But actually, no, we needed that that higher dose, it’s not going to damage we’re doing it for only this amount of days. But we need the concentration in the bone to be such and such. But that is that’s the way medicine is supposed to work. We’re supposed to be like, Oh, is that right? And then we talk to each other and we we figured out

Marilena Grittani, RPh  20:56 

that happens. And whenever somebody has a doubt we’re like, yeah, that’s Dr. Jared. She just said, This is what she does it because once you understand the relationship, then it’s easier for everybody to understand it easier for the pharmacist to explain the patient. Communication is key and teamwork as well. Yes, it’s important. It’s a triangle, right? The doctor, the patient and the pharmacists, we need to work together.

Dr. Joanne Davis Jarrett, MD  21:19 

Yeah, absolutely. Okay.

Marilena Grittani, RPh  21:23 

What about the secrets? What about stuff that we don’t want? anybody to know? First of all, he put plays a role. There is a law that protects the privacy of every patient, and it’s a rule you should not break it. You could go to jail, you can lose your license if you make stuff that you’re not supposed to. But how about when I tell them Well, you know what, this is what happened. So it’s like a like a priest for us Catholic people.

Dr. Joanne Davis Jarrett, MD  21:54 

Okay, what I want you to know about this is we are safe confidence. Not only are we not looking to judge you, but we, we are certainly not going to gossip about you. For one thing, there are hundreds and thousands of you. And if you think your story is the craziest one we’ve heard probably isn’t, you know, even if it is the craziest thing we’ve ever heard it, we’re professional about it. So more than anything, we want you to tell us what’s going on with you so that we can make good decisions for you. I had a patient once a long time ago who she was the sweetest girl. I’d seen her for many like health care, maintenance and birth control pills and just like regular things. And then one day she came in and she said, You know what, Doctor, I think I’m suffering from depression. They really need help. And I said, How long has this been going on? She said, like 12-18 months. Oh, honey, why didn’t you tell me and she said, Dr. Jarret, I could tell that you liked me and I just didn’t want to let you down or disappoint you. Thanks my heart and like I want to help you. I’m not looking at looking at you. As any less Have a person because you’re struggling with something that I can help you with. Or even if you’re struggling with something, I can’t help you if I want to point you in the direction, the proper resources. So we not only do we want the whole truth from you, because it helps us make good decisions, we want you to know that we are safe places to bring your secrets to, because that’s what we’re all about. We’re there to help you with things you’re struggling with. And if it’s something we can’t help you with, we can probably point you to a resource.

Marilena Grittani, RPh  23:27 

And if you don’t feel comfortable enough to share stuff that are very intimate to you like that patient of yours with your physician, then you might need another one. If you don’t feel comfortable with that doctor talking about or this doctor is not given the importance to what it is important to you. Maybe you just need to find another one because you are the most important part of that relationship. If you are the problem, you had a problem and their job is to help you.

Dr. Joanne Davis Jarrett, MD  23:52 

Yeah, the patient is central for sure.

Marilena Grittani, RPh  23:54 

Now talk to me about when people are a little bit rude. to you what, how do you feel? What is it their doctor? You’re letting me down. You told me that it was a and he ended up being see how come you didn’t see it?

Dr. Joanne Davis Jarrett, MD  24:09 

Yeah, I want everyone to know that words can hurt us. But we have developed very thick skin. It grew during training and it’s still there. So it’s okay, we can take it. We know that. A lot of times we’re seeing you during the most stressful time of your life. You’re scared you’re, you’re stressed. You’re not only scared about your medical health, a lot of times you’re scared about your financial health. It’s all you know, it’s all intertwined. And got you are not feeling well. You are you just in a bad situation. A lot of times, uh, we know that but remember that we’re human and that your pharmacist and your nurses and your physical therapists are human too. So keep that in mind because and this is kind of an awkward thing to talk about, but it’s important When patients are verbally abusive, or verbally combatant will just continue being professional, but we still are having an emotional response to that. It puts us in retreat mode, or defense mode. And a doctor or a pharmacist or a nurse or physical therapist or whatever that’s in defense mode or retreat mode is not in a position to provide the best care for you. So you are actually negatively affecting your care as hard as we try. We’re still human, so we’re still going to have a little bit of a shift. So you’re negatively affecting your care by treating us that way. And we understand and so there’s a lot of it that we just really, like, I get it. I totally understand I’ve been there too. I promise this is not gonna hurt your care. But if you are really really laying it on thick and being abusive, like in the ICU, we’ve had, you know, patients are combative, sometimes because they’re confused or whatever that’s not going to put it that’s going to put a nurse or a doctor on the defense. But if you are rude or you’re trying to be hurtful, or you are Shooting very pointed arrows of toxicity towards your provider. It’s just normal that we’re going to react. So just remember that you are hurting not only them but you.

Marilena Grittani, RPh  26:10 

And that if you treat somebody badly, are you going to expect that person to be nicer to you? That’s not the way that it works. It doesn’t work. So let’s just be kind to each other. Let’s listen to Ellen, one of my heroes, because I want to tell her I mean, What’s so wrong? This just be nice. It’s been nice. Okay. So whenever we see a  box of donuts, and we’re like, oh, but I’m supposed to lose weight, but it’s just one that is not easy to make the mind change. And I can tell you that because I’m going through that process right now. It’s not easy, but you know that right now?

Dr. Joanne Davis Jarrett, MD  26:49 

Yeah. So we know that when we recommend lifestyle changes, it’s like, that’s no fun. That’s way harder than taking a pill. But sometimes lifestyle changes are either The most important thing to change the course of your illness, or they’re a very important thing to partner along with the other treatment that we’re recommending, and we don’t take those things lightly. It’s not like I’m going to tell you to never eat another bite of sugar again in your entire life. But and I know, I mean, there’s probably a dozen doughnuts in your doctor’s break room right now because some, some well meaning person brought them in. It’s hard for us to, but just remember, we recommend lifestyle change because it is really important to how you live. If you can treat something with a dietary change or activity level change, or an exposure change, then it is better for you than taking anything chemically. And of course, we have all these wonderful medications that we can back those things up with. But it is in your best interest to definitely make those lists to actually just however your doctor knows it’s hard. So if you are if you’re like feeling You’re 30% admit that to your doctor because they need to know what there’s what they’re seeing and what the results of actually what’s going on. are so if you if I say, you know, I really feel like you need to cut out some carbs and then you come back to me and tell me I have done that for the most part. But yesterday I did donut and today I had a couple of Yeah, salted dark chocolate caramels from Costco. Oh, so good. I’m gonna say you are trying, you’ve made changes. Good job. I don’t expect you to be perfect. And I and I certainly don’t want to hear that you’re perfect cuz then I might be like, really?

Marilena Grittani, RPh  28:36 

And sometimes patients need a little bit of time to change their mindset and be ready for Yeah, yeah. And I have other situations going on that they can focus on that because it’s very stressful.

Dr. Joanne Davis Jarrett, MD  28:47 

If your doctor recommends a lifestyle change that you don’t think you’re going to be able to implement on your own ask him for a resource. They can refer you to nutritionist they can refer you to a physical therapist to show you how to exercise given the limitations you have. They can refer you to a phycologist, they can refer you to any number of other professionals that can do more for that particular issue that they can do for you. So they don’t expect you to be flapping in the breeze all by themselves. But sometimes they don’t remember that people need help with that kind of stuff.

Marilena Grittani, RPh  29:15 

Yeah. And but then, sometimes the watch and weight might be the way to go with somebody that needs drastic lifestyle changes, because they need

Dr. Joanne Davis Jarrett, MD  29:25 

your head around it. Yes,

Marilena Grittani, RPh  29:27 

yeah. Or the, you understand that too.

Dr. Joanne Davis Jarrett, MD  29:29 

Or you may say, Gosh, I know that you’re probably right about that. But I just feel like I want to be convinced myself Are there some resources that you can point me to so that I can get on board with this? And that’s completely okay to ask your doctor for.

Marilena Grittani, RPh  29:42 

Sometimes I’m like, give me a month just to get my mind together, and I’ll be back for it. But I promise I’m going to work towards it. It’s not to say okay, yes, I’m gonna do it and then you do nothing.

Dr. Joanne Davis Jarrett, MD  29:52 

Or you’re gonna

Marilena Grittani, RPh  29:54 

talk to the doctor and then you don’t have alternatives.

Dr. Joanne Davis Jarrett, MD  29:56 

That is so smart. That’s efficient. Yeah. You If you know yourself well and you know you need some time to change to turn this cruise ship around, just tell your doctor that that you know you aren’t opposed to it, but it is going to take you some time. And that’s okay. If we know that then we know what to expect. So,

Marilena Grittani, RPh  30:16 

so good. So the following one that we have here in the list has a lot to do with us pharmacist because we are the messenger. And you know, you just want to shoot the messenger sometimes, but it’s not us doing it is what it is. So we’re accused of being trying to steal money from people and you’re overcharged just because we’re just mean or to be in a relationship with a company that insurance company or drug companies used to take the most out of the patient. Tell me about the position that doctors have in general with this two particular situations, insurances and drug companies.

Dr. Joanne Davis Jarrett, MD  30:54 

Yep. What I want you to know is that we are not conspiring with Insurance companies or drug companies, when your insurance company tells you no to something that we think you need, or when a medication is prohibitively expensive. It’s so so frustrating to us. It. I used it when I was in high school. I used I worked at sizzler I don’t even know if there’s still sizzler restaurants around. But I did the cash register and it was this steak like a cheap Steakhouse. And I ran the cash register and every time I had to tell somebody that total I was like $16 for two mediocre steaks with a baked potato. You know, I hated that. sticker shock is real man. And so we we understand and believe us, we’re not benefiting from or contributing to your insurance companies decisions or your or the drug companies decisions. We are cogs in the wheel, kind of like you guys are so but we are your advocates. And we are we make you our top priority. I mean we need to make a living but we’re getting our compensation is not coming from insurance companies or drug companies we are all that to say we are your advocates You are the most important thing and just know that just know that we’re on your side and that we’re not getting some kind of we even call it like a kick. Or Yeah, kick back kick back. Yes sir. Yeah, okay, that I want to point something out. That’s the second time that the person with English as a second language has helped me come up with a word. Yes, sister You got skills.

Marilena Grittani, RPh  32:32 

Thank you. Thank you see a doctor to look forward credit is do that. I’m good. See, there you go. And I want to second would you mentioned about the drug companies. I work for pharmaceutical companies for over seven years, and I know that side of the business and I have worked in the other side which is in the pharmacy. So I do understand what it is and I see what happened, but sometimes the insurance company will cover what they cover. And I know people are not that aware of this. But there is normally a variety of drugs that work in a specific situation. And the doctors get to choose. Some of them are cheaper. Some of them are generic, some of them are bad generics. And the doctors don’t want you to use it because they’re not good even though they’re cheaper. So listen to what you have a good communication with your doctor, just talk to them and talk to the pharmacist and working together.

Dr. Joanne Davis Jarrett, MD  33:20 

There may be an alternative that your doctor wasn’t aware of that your pharmacist can let them know about exactly. And now if I say Marilena, is this gonna work equally as well. And she says, Yes, I’m gonna trust that I’m going to go let’s go with that one. And now I’ve learned something,

Marilena Grittani, RPh  33:32 

or do you have anything that could work that is similar to this? What is it out there that might work? We are the advocates. We went to school just to help you. Believe it or not, we did. So that’s our purpose. So please use you use us the way that will benefit you and listen to what we have to say because we have us a first interest that you’re the focus of our profession, period, right? Yep. Okay, so tell me about foreigners and people that are under different races and different accents. Because we see everything on anything and these days in medicine.

Dr. Joanne Davis Jarrett, MD  34:07 

Yeah. Well, after I wrote my first article 13 things good doctors wish their patients knew. I surveyed doctors around the globe to ask them what their additional things with their additional points would be. And this one came up a lot. And again, is a little bit uncomfortable to talk about because we’d like to just pretend we’re all blind to differences, but we aren’t. We’re human. And we see differences and we and fear can trickle in. And fear is mostly the result of not knowing I hate the word ignorant because it just sounds bad, but we’re all ignorant of certain things. Because if we just don’t know we don’t have knowledge, that’s ignorance for you. And, but doctors come in all ages, all genders, all races, colors, shapes, sizes. Some doctors are women, some doctors are minorities. Some doctors are young, some doctors are older. It’s just we but those are not You cannot be informed as to the quality of our care by any of those details. So I just want you to keep in mind that when I was working at the VA when I was a resident, I was pushing a patient down the hall in a wheelchair and he said, Are you my doctor? And I said, Yes, I am. And he said, I don’t want to be taken care of by any kind of a teenager and I was like, it made me laugh number one, because these guys I mean, they’re so fabulous. I love the bluntness. I mean, just does my heart good. Number two, I was young, right? But man, I was gonna do my very best for that guy, and I was fresh out of training, and he was gonna get good care and I was going to be his, his number one fan and his number one advocate. So experience is good. Get having an experienced doctor is really good. But having a doctor fresh out of training is really good too. And just know that we collaborate. So a lot of times if you have a doctor who’s fresh out of training, and maybe he’s seeing something he hasn’t seen before, he’ll Call up an experienced Doctor Who brings someone in and some of your doctors are going to be trained overseas. Some of your doctors are going to have relocated like Marilena did after their training, some doctors are going to look like they don’t take the kind of advice they’re trying to give you but you don’t know what’s going on in their lives. Right. So I had a friend Tell me one time that his doctor was recommending a lower salt diet. I think he had out of control high blood pressure and was really young. And, and his doctor was overweight and he left and he never went back. But maybe his doctor had a thyroid issue or cortisol issue or maybe his doctor had trauma that he was trying not to but he was self medicating with food or you just never know. So you cannot tell the quality of care by looking at your your doctors. External details. You just can’t.

Marilena Grittani, RPh  36:51 

I need to make a comment here of thinking that in your podcast. She has a part because that is wonderful and will make your left no matter what about Last stuff that you did that are just what is it that you call it as to are

Dr. Joanne Davis Jarrett, MD  37:04 

not so fancy moment?

No, exactly. So as I said, I had surgery recently on my hip and I went to see this orthopedist. And then this guy was supposed to be. It is he was supposed to be the best on whatever I needed to get done. And I’m waiting into the exam room, you know, waiting and then this guy comes in shorter, not super tall and wearing scrubs. And he looks so young that I thought he was a high school. What is a trainee? And I saw his face and I’m like, directly Who are you? And he said, I’m Dr. Berg. Why I’m like, What? No, you look like a teenager. You’re like, doctor. Yeah. And he did not like it. Because again, he had said, This is not the first time that I heard that. But I am your doctor. Do you want me to examine you do Want me to go on like,Okay,

Marilena Grittani, RPh  38:03 

put my foot in my mouth first of all. Secondly, I wish that was my case that I would look 20 years younger than I am.

Dr. Joanne Davis Jarrett, MD  38:10 

Yeah, I got a lucky.

Marilena Grittani, RPh  38:12 

Yeah. I mean, I stopped judging him for his appearance, because everybody in the area told me that he’s the best doctor. And I can tell you now and again to test you that he did awesome. He didn’t find. I mean, he found something that seven other physicians didn’t. And he’s cute. So we can, you know, Are you with

Dr. Joanne Davis Jarrett, MD  38:32 

me? It’s like, don’t get it don’t look a gift horse in the mouth.

Marilena Grittani, RPh  38:36 

I still get some hard time. But yeah,

Dr. Joanne Davis Jarrett, MD  38:38 

very similar happened. My mom just got one of her knees replaced. And we were referred to the best knee doctor in the area. And he came and spoke to us after the surgery. And I was like, I looked at my dad and I was like, Man, that’s just not what I expected. You know, cuz we all have these expectations in our minds of what the doctor is going to look like. They’re very rarely going to fulfill your expectations because we’re just making these things up in our head based on our I don’t know our previous experience or what we’ve seen on TV or I don’t know. So, um, and it’s okay. You have to remember that you’re coming in with certain predispositions like, my father is a neurosurgeon. And he had prematurely white hair. So my whole life he’s had, he’s this white haired, cute, older guy. And so in my mind, good doctors because of course, in my mind, my dad’s a good doctor, which he is, but good doctors are dead guys with white hair, right? So I am but I didn’t realize that until I was in my training, and I was like, I wonder why I’ve chosen my doctors the way I have and I realized you guys I chose one of my doctors because he kind of looked like my dad and I was like, Joanne, you are selling yourself short.

Marilena Grittani, RPh  39:46 

Yeah

Dr. Joanne Davis Jarrett, MD  39:46 

They don’t have to be older dad guys with white hair to be good doctors. So I’m not accusing you I’m I’ve fallen victim to the same thing. But just keep it in mind because it’ll help you get the care you need.

Marilena Grittani, RPh  39:57 

And sometimes it’s something that important Mmm. No, we have given several examples. But I think that this point is not talked about enough. And I think it’s fair to everybody to do that not only to the doctors that are being discriminated into from politicians because they don’t look average, or the patients that are not getting the benefits from these people. I remember when I came to this country over 20 years ago, I was studying for my pharmacy test, I needed to take a test to validate my license here. And I was so stressed out and I was going, Google and I went to my primary care physician, somebody like Joanne, and this doctor, it was from Egypt. And I didn’t think that she was that good. I don’t know why because she was from another country. I was expecting a wide, beautiful blue eyed blonde hair position for me. And she wasn’t that and I was like, going to work and she said is something else that you need me to know? And I’m like, she said, What’s going on? And I didn’t want to talk to her because I didn’t think she was going to help me. And I kept just trying to I bite my tongue. And she said, I need you to tell me because if you need help, I’m the one that is going to help you to tell me. So I told her I’m so stressed out. This is the test that I’m going to take to be a pharmacist. She’s like, Girl, I went through it too, because as studied by him, he was taking my test. And I know what it is, this is what you need to do. And then we became so close, not only because she understood me, but because she went through it and she listened to me and all prejudice that I had before that went away from any any different looking physicians. So don’t ask Joanne said don’t cut yourself short, because you know what this people experienced this or even if they look like the perfect doctor from the movies and give them a chance because sometimes they’re even better than what you do you think is the perfect image of a physician. So that’s so keep a little bit more open mind for that. Okay. This is truth. I am the most horrible patient ever I forget my pills. I take them on time that is not appropriate. I’m horrible. Are you guys the same?

Dr. Joanne Davis Jarrett, MD  42:09 

Oh my gosh, we can be terrible patients. And you know, I think it’s just because anybody can be a terrible patient. But if you give you give somebody like me some knowledge, and I’m gonna run with it, right. So I, for instance, when I was delivering my first baby, I had delivered a lot of babies. So I’ve kind of figured out exactly how I was going to behave. I had decided exactly how I wanted it to go down. I was keeping an open mind. I wasn’t really sure what I was going to do for pain. I knew a couple of things. I knew I was open minded to an epidural. I knew I didn’t want IV drugs because I didn’t want my brain to be clouded and I wanted to remember the delivery, but I’m pretty reserved person in general. And so I thought, Oh, I’m just going to be this demure, little quiet mouse and just push the baby out and it’s just going to be this wonderful thing. Oh my gosh, you guys, I did not behave the way I thought I was gonna behave. I was telling my doctor. So I was was in pain for a long time. Then I got the epidural. Well then he felt like he needed to turn it off so I could push. Then I pushed for two hours. So it was completely worn off and it was pushing. I think I said to him, it hurts like 16,000 times. He was like, it’s okay. If it hurts Joanne I get it. Like, I was just afraid that he might not have heard me.

Marilena Grittani, RPh  43:19 

Ever heard that from a mom?

Dr. Joanne Davis Jarrett, MD  43:22 

Excuse me. I need you to know that childbirth is painful. Yeah, so, but I was, I was kind of, I was sheepish after that. I went in for my first visit. I was like, no, sorry, bad and I he was like, I can’t believe I acted while I was delivering. He’s like, I don’t even remember what you’re talking about, like pain. And I said, Well, I told you it hurt even though you knew and he’s like, yeah, like five other women the same night you know, but we the other thing is I was looking at the strip. You know, when babe when women are in labor, they have this strip of paper that’s coming out of this. So one line is Showing the uterine pressure contractions and the other line is showing the fetal heart rate. And there are certain patterns that can either be reassuring or concerning or whatever. So I’m watching that like a hawk as if I’m going to be able to do anything should something go wrong, right. So, you know, yeah, we it’s a Do as I say, a novice, I do situation, but at the same time, we understand. So we are, we are all patients too. And we have all been in circumstances that have brought out the worst in us. So we’re not just doctors, we’re patients too and we’re not very good ones.

Marilena Grittani, RPh  44:31 

So but just to help you out not feel that bad is that when you’re sick, you’re not good. You have a blurry in your mind that is because it’s a sickness, whether it’s pain, if it’s an infection, whatever it is. So you cannot practice you shouldn’t be working like everybody when you don’t feel good. You’re sent home not because they love you is because you’re going to make a mistake.

Dr. Joanne Davis Jarrett, MD  44:53 

That’s right. So say not a mess.

Marilena Grittani, RPh  44:55 

Exactly. So that’s the

Dr. Joanne Davis Jarrett, MD  44:56 

same goes for like, I am a physician, you would think that I would always know the exact perfect thing to do when my kids are sick. But the problem is, I’m a mother too. And so the emotions will cloud things. And so it’s really interesting how unsure I can be about my own child when I am just dead set. sure if that was a patient of mine, I’d be dead set sure what to do. I’m questioning it as a mother because there’s the emotions are involved. And I was not anticipating that. So not only are we bad patients, but we’re bad patients parents. It’s like

Marilena Grittani, RPh  45:27 

it happens. You know who my worst patient is? My husband, who happens to be a pharmacist to Oh, a PC. You know, when you feel like a cold or whatever you have cough or what have you. You go to the pharmacy and you talk to the pharmacist to give you something that is not prescription, he will come to me. Hey, what do I use? This is what I’m feeling. What should I use? I’m like, dude, you are a pharmacist to ask yourself, because he because he’s brain goes to a patient brain and the pharmacist brain doesn’t work that way. A moment. So you You have, you’re not working, you are a patient and I need to give the responsibility to the one that has a clear mind and will help you and not harm you for those circumstances, but that also means that he is very spoiled. I just have to say that and of course, I’m a better clinician that he is. I can’t help but he will tell you that so I’m so cute. I love it. Okay, so tell us about what is a hospitalist? And why not all of you are one.

Dr. Joanne Davis Jarrett, MD  46:29 

Okay, so this is a little bit of a boring topic, but I just I think it bears explaining because, like I said in the first part, there are things that we should be explaining to our patients that we’re not explaining just because we assume everybody understands the system, but they don’t these systems aren’t explained. So. Okay. If you your primary care physician is either a pediatrician, an internist or a family physician or nurse practitioner up here, whatever, but they’re theirs. They’re their primary care physicians. When you are admitted to the hospital. If you are ever admitted to the hospital, you may not Ever see your primary care physician or whoever’s on call for them because that group might use a hospitalist hospitalists or doctors who specialize in hospital medicine. And there are pluses and their minuses to that. The pluses are that they are going to see the thing that’s wrong with you much more frequently than your physician who’s doing outpatient medicine is primarily is going to is going to see because they’re just at the hospital or in hospital medicine. So these their numbers are just they’re just seeing these things more frequently. So say you have new onset type one diabetes, and you’re admitted with diabetic ketoacidosis. a hospitalist is going to have handled that specific situation so much more frequently than a doctor who’s been doing outpatient medicine with just a little bit of hospital here and there for the past 20 years. The downside is that your hospitalist isn’t going to know you and they’re not going to be able to do your follow up. You’re going to be sent back to your outpatient primary care physician when you’re discharged from the hospital. However, there are there are ways that doctors communicate with each other. We speak the same language. So there will be a discharge summary. When you get out of the hospital, you need to make sure that your discharge summary gets to your primary care physician. That’s supposed to happen. But you might want to just make a mental note that you want to make sure before you go to your doctor for follow up that you have possession or your doctor has possession of the discharge summary. That’s how we communicate with each other.

Marilena Grittani, RPh  48:21 

And the other thing is that if you have the opportunity to go to a hospital that is part of the same group that your physician works on is better because they have the same system that a real time they can see the same information. So if your hospitalist is doing this to you, and you have this result, the doctor can access that from there a whole lot out and she can pull it up and see what it is and not necessarily go physically there to see you. But your physician might be monitoring you from the US right? That’s right. Very good. Yep. Okay, so tell me about what do you feel what are your feelings in your thinking about doctor Google,

Dr. Joanne Davis Jarrett, MD  49:00 

thank you. For that one of the guy, one of my good friends that that answered my poll after I after I wrote the first article said, I want you to tell patients, we don’t run to the back and Google their symptoms if Google comes up with the same thing we came up with, and so be it. But we’re not using Google. But I know people do. And here’s the thing. We want you to be self educated, but we don’t want you to be so we don’t want you to consume the improper information. So there is an article that I thought was really good about the use of the internet for patients that are researching medical topics and I will send that to Marilena so she can include that in the show notes. I think it’s a really good article. There are guidelines and best practices for patients who are inquiring the internet regarding medical problems. Sometimes, first of all, please do not go into chat rooms. chat rooms will make you so freaked out they give you bad information. People who do not have medical education do not have any Place giving medical advice, they can tell their story. But you need to know that your story is not going to be the same as their story. And you don’t want to drop parallels, you don’t want to take their advice, you may either get freaked out about something you shouldn’t be worried about, and your doctor can help you decide. Or you you may actually be lulled into complacency and ignore something that actually is a red flag that your doctor want to look into. So, but we don’t hate Google. We Google stuff too, all the time. So in fact, when I know, but my, um, when my grandmother was in the hospital, she was in the emergency room getting ready to be admitted for her last two weeks of life. This was a long time ago when we first started having smartphones. Something my mom and I were passing the time and she said, Oh, I don’t know. Let’s look that up, put it in your Google Joanne put it in your Googles. And that was it. We were stressed. Right. So one point I was like, Mom, you’re Google, you know, and I didn’t mean for her to search it on her phone. She didn’t have you know, it’s like whenever the sun don’t shine, Mom I i I’m here. But now it’s kind of a joke. So if you’re going to put it in your Google, it’s okay. But you need to know that your Google is not always going to come up with the answers that are appropriate. But don’t hide the fact that you googled it from your physician, that’s fine. Just know that because your doctor has a medical education, and has been, has had the benefit of examining you and maybe doing some tests on you. And because they know you and have a history with you, they are the right ones to administer the care. Those elements are all very important. So Google just isn’t gonna cut it. But it’s an okay place to start.

Marilena Grittani, RPh  51:34 

Yeah. And also, they I’ve noticed that a lot of patients go to groups on Facebook that have the same problem, whatever that is, and then they start talking, well, this is what worked for me. But this is my point. And we talked about this the first time that you and me talk on my podcast, and we did it again in the previous episode, and I’m gonna do it again and I don’t care how many times I’m gonna repeat the same thing. You guys are not the same. Even if you are identical twins, you don’t have the same body so it doesn’t work the same. So whatever works for me might not work for you. And actually, it could harm you. So, and this is what I keep telling people. Do you have a medical degree to be recommending that drug? Because if not, that is illegal. You know? Is that true? That’s that simple. I am a pharmacist and I’m an expert in on drugs, but I cannot tell people what to take because that is not my place. It is illegal for me to do it. I need to have a doctor that orders that that agrees with me for a patient to get it because it’s the way that it works. And it works like that because the law is protecting you.

Dr. Joanne Davis Jarrett, MD  52:41 

That’s period. That’s abs. Absolutely. Yep. It is that way for a reason. So take all of the information that you have gathered and gleaned take it to your doctor and then give it to them with open hands because they might have some knowledge or a resource or some experience that you haven’t found your Consider that completely changes everything and just be open to that.

Marilena Grittani, RPh  53:03 

Just discuss it with your doctor. Hey, I heard about this and that is that what is happening? Is that what we need to do? And the doctor my shoulder? Yeah, that’s possible if you had this or that, but this is not your case, this is what it is. And this is what we’re going to do. But don’t judge the answers that your doctor gives you versus what somebody in the chat group or in a Facebook group said, or something that you read in on Google or what isn’t in the pudding that you put in your Google’s because it’s not it is not the same it’s just

Dr. Joanne Davis Jarrett, MD  53:33 

because you put it in your Google doesn’t mean it’s gonna come out of my Google the same way.

Marilena Grittani, RPh  53:36 

If there is actually insulting to compare us with a search engine. We are doctors, we went to school for six, eight years to be specialists in what we do. And then do you think that you go Google something and really quickly you have the same knowledge that we do is not the same.

Dr. Joanne Davis Jarrett, MD  53:55 

Here’s an actual actual, a really interesting example of that. When I was a first year medical student, we did a little bit about reading EKGs EKGs are electrocardiogram. So they’re there, those squiggly lines and sheets of paper that after they put the electrodes on you they to look and see how your heart’s doing. Well, my grandfather had had a heart attack and he was in the hospital. And I was looking at the EKG tracing and I was trying to draw conclusions from the EKG tracing that was above his head, an ICU. But what I didn’t know is that was not a 12 lead EKG, that was just a rhythm strip. That’s not giving me all the information, but I had just enough information to draw the wrong conclusion from that. So and the, the Cardiac Intensive Care Unit nurse sent me straight appropriately. She was kind, but she was like, No, this is you know, and she was right. But see, I had some knowledge, but I didn’t have all the knowledge I needed to evaluate the situation. So a little bit of knowledge could be completely had you in the wrong direction.

Marilena Grittani, RPh  54:53 

And this is the conclusion that I always come up with to my patient. You don’t know what you don’t know. You Yes, that’s my feeling really bad.

Dr. Joanne Davis Jarrett, MD  55:02 

That’s what it was. I didn’t know what I didn’t know. So I thought I knew at all.

Marilena Grittani, RPh  55:06 

Yeah. And it’s normal and that nobody knows everything. Even doctors, right, doctor?

Dr. Joanne Davis Jarrett, MD  55:10 

That’s right. Nope. In fact, I have a girlfriend from medical school who decided to do ob gyn and I thought she was going to do Family Medicine like I was. And she finally said to me, You know what, Joanne The thing is, I just need a smaller knowledge base to master. I just feel like I need I can’t master everything that family medicine requires me to master and I thought,

Marilena Grittani, RPh  55:32 

nope, well, oh, that’s a good point. But you’re hurting them by the way.

Dr. Joanne Davis Jarrett, MD  55:38 

Yeah, so um, General physicians have a lot of knowledge about a lot of things, but they’re not necessarily going to have completely in depth knowledge about specialists, especially things and that’s why they send you to specialists. So and that’s a fine balance to them. And that’s something else we didn’t really talk about was when is it appropriate to refer to a specialist every doctor has their own threshold and every doctor has their own education, which is different in regional areas, like some doctors, some family doctors perform, you know, practice ob gyn some don’t some programs really get you ready for that some don’t. So it just kind of, you know, depends on where your doctors coming from when they’re going to want to refer you out to a specialist or plan. And what we’ve talked about is that, it doesn’t mean that they don’t want to see you or they want to get rid of you. Yeah, they recognize mutations and because whatever they have, or the patient has, they are not good at it. Feel actually relieved that they did. Yeah, because that’s the help that you need Brad. loss. Yeah, they’re not putting you off. They are doing you justice by calling it an expert.

Marilena Grittani, RPh  56:44 

So do you want Do you have anything else that you want us to know that you guys would hope that we knew?

Dr. Joanne Davis Jarrett, MD  56:50 

Yeah. So the first 13 things that good doctors wish their patients knew are these I’ll just rattle them off really quickly. I’ll talk a little bit about them. The first one is that we will Worry, we worry about you, we don’t just walk out and forget all about you. In fact, some of us sit up in the middle of the night freaked out sometimes not about every patient and not every time but we do worry, I want you to know that. We The second thing is we wonder, if we saw you, we’re going to wonder about you. So good occurs to you to let us know how you’re doing. If maybe you’ve moved away or your doctors moved away, or doctors retired touch, let us know how it’s going. We do we wonder about you. The third thing is we forget and this might seem in conflict, but it isn’t. And what I mean by we forget is that the things that we’re doing for you feel very alien to you, maybe even in a violation in a certain way because you know, maybe we’re doing a rectal exam, or we’re doing a pap smear or whatever. Those are very routine things for your doctors. So if you run into your doctor at the grocery store, they’re not going to remember what your cervix looked like or anything like that, but they’re gonna remember they’re fond of you. So say Hello, we’re going to forget about those specifics, but we still know were funded, thank goodness. Yeah, the next and that includes me, I’m glad my doctor doesn’t remember what my cervix looks like when he sees me at the hospital. So, um, the next thing is that we scraped by four years medicine is not something that is super lucrative. Think about the fact that we paid tuition, four years of college, four years of medical school than we did on the job training for a minimum of three years of residency where we’re getting paid a very small salary, which actually pencils to about minimum wage when you consider how many hours were working. And then all of a sudden, here you are in your late 20s. And you haven’t really made any and you have money and you have this big debt. So remember that doctors are not wealthy, they’re not do we, you know, if we if wealth was our first concern, this is not what we would have done. It’s just it. I don’t really know why people don’t understand that it’s just the way it is. But anyway, I wanted to let you know, there’s lots of people in their early 30s who are still very financially unstable because they’re paying a lot of debt back and they are starting To make better money in there, you know, it is specialists to specialists and make more but not right at first, and the ones that make more to have had to do a longer residency. The next one is, we do a lot behind the scenes. Marilena will link to the article that I wrote so that you can look at the specifics. But I just want you to know that if you are admitted to the hospital, or if your doctor sees you for 10 minutes, that they don’t just stop working on you, the minute they walk out of the room, there are lots of things that they do, there’s thinking that they do their tests that they order, there are results that they consider all along the way. And they’re they’re available for communication regarding that stuff. So

Marilena Grittani, RPh  59:37 

and that happened before they see you as well. They get ready.

Dr. Joanne Davis Jarrett, MD  59:40 

Yes, they’re preparing. Yeah. So it especially I was in into the hospital one time and I saw my doctor for like five minutes and then I didn’t see any doctors for 24 hours. And I thought have they forgotten about me What’s happening here? So it’s just really helpful to know that there is a system in place. The next one is that we know you’ve already answered the questions and we are so sorry. We have to ask again. But the doctor is where the buck stops. So not only do we need to gather all of the information, we’re going to have more questions for you it is somewhat appropriate for those questions to be asked him in a less specific way. When you call to make the appointment when your room because there are reasons why those questions are pertinent. So by the time we get by the time you get asked by us, you’re already sick of answering and I’m so sorry about that.

The question that I have is that when you asked me on every visit that if I started smoking at 50, that is not annoying, you need to know because if I haven’t by now, I don’t think I will start. I’m just saying, anyway, sorry.Sorry.

You’re so cute. Okay, the next one is we define fever in a very specific way in an infant three months or younger if a temperature of 100.4 or above rectally is a medical emergency. But if you’re in any other category besides an infant or an immuno compromised person, or very elderly person, if you’re tempted Your skin or tympanic is not above one on one, we don’t consider it a fever and fever is a very nonspecific symptom. So we do need to know if you’ve had a fever or not. But there aren’t going to be a lot of very specific decisions made just just based on your temperature or the color of your nasal discharge. Let me just throw that in there too. Okay, the next one is, some of us have PTSD, which is post traumatic stress disorder. Even as a family physician, we do all of the specialties during training. So I’ve seen women who think they’re going to die tell their father to take good care of their boys. I’ve seen babies take their last breaths, and everyday doctors, you know, traumas additive, and everyday doctors show up for more. So just keep it in mind when you are dealing with your doctor. Just know that they’ve been traumatized in there. That’s just the way it is. Okay, the next one is that we can be idiots because we’re human, and we already talked about that today. Then we hate medication ads, we actually kind of have about that a little bit today to just remember when you see an medication ad, the pharmaceutical company is trying to manipulate how you spend your money, end of story. So they are not the best way to become educated on

Marilena Grittani, RPh  1:02:11 

like them either pharmacies, just so you

Dr. Joanne Davis Jarrett, MD  1:02:13 

know. The next one is we do respect your time but the thing is that we can’t don’t confuse urgent with emergent become urgent with important because I know you’re here to see me at 11 o’clock. And but if I have a patient who was at 10:45, who had an appointment for a sore throat, they tell me they’re suicidal, I’m gonna have to deal with that. And so your 11 o’clock is just not gonna happen at 11 o’clock, but I tell you what, I’m going to give you the time you deserve and need to. So but it’s sometimes it comes off as a lack of respect and I, I don’t want you to think we don’t respect your time.

Marilena Grittani, RPh  1:02:46 

Tell us the trick.

Dr. Joanne Davis Jarrett, MD  1:02:47 

The trick. The trick is if you want to be seen on time, the best thing you can do is get the first appointment in the morning or the first appointment after lunch. It’s no guarantee but it’s the way it’s the best thing to try. Okay, the next one is Some of us are jerks. Just like in every profession. There are good. Most people are good. People are doing the best they can and trying the hardest, they can do the right thing, but some people just are not. And if you get the sense that your doctor is not putting your best interests at the forefront, move on, find another doctor and

Marilena Grittani, RPh  1:03:18 

another one.

Dr. Joanne Davis Jarrett, MD  1:03:18 

Yeah. And the last one is we like to feel appreciated. And it’s not because we want you to toot our horn. It’s just because we work so hard. We try so hard for you, we care so deeply that you get good care. And if you recognize that and feel glad about the care that you’ve been given by your pharmacist or your physician or your physical therapist, just if you just say thank you so much I value what you’re doing for me, that just does our hearts good and it’s just it can make our day. So remember that.

Marilena Grittani, RPh  1:03:49 

That is so true. So thank you note for for thank you cards for physicians, they will appreciate that. Imagine I would have a wall full of them getting down. I’m like, let me just read My card some feel happy. So think about that. Thank you.

Dr. Joanne Davis Jarrett, MD  1:04:03 

Yeah, actually, my dad is a retired neurosurgeon. And every doctor, every, every neurosurgeon over the course of their, their career is going to have some bad outcomes just because of the nature of the different things they’re dealing with. And of course, he keeps a file of, of different things that he needs to keep for his malpractice insurance and stuff. You know what else he keeps in there. He keeps every thank you card, and every thank you note he’s ever received in his over 50 years of practice, because those are the things that remind him that even though sometimes things do go wrong, sometimes patients are going to blame him for an outcome that they weren’t that they weren’t hoping for. There are patients who love him and appreciate him and this is a neurosurgeon. I mean, you wouldn’t think they’d be sentimental and he would not know that to meet my dad, but they’re there. Yeah,

Marilena Grittani, RPh  1:04:54 

like my favorite neurosurgeon ever. Derek shepherd. Yeah, he was the heart.

Dr. Joanne Davis Jarrett, MD  1:05:01 

An easy on the eyes. Oh

Marilena Grittani, RPh  1:05:02 

yeah, yeah, for those that don’t know, that’s my dreamy that is the Grey’s Anatomy doctor. That’s my favorite. Sorry. I have to say that she’s so cute. He is adorable. So Joanne, tell us about you tell us where people can find you. What do you do? What other avenues to get to you? Yeah.

Dr. Joanne Davis Jarrett, MD  1:05:21 

Okay. Well, the the most recent thing I’m doing right now is that I have a podcast and it’s called the fancy free podcast. It’s so much fun. And the point of that podcast is to tell our most embarrassing funny stories, not only so that we can all feel less alone in our imperfections, but to illustrate the intimacy and connection that comes from showing her underbellies being vulnerable and laughing together. So it is it is so much fun, but it’s, but even more importantly than that, it kind of gets you in the mindset of watching your life for funny stories, being ready to share those funny stories with other people that might receive them as gifts, and just connecting and furthering into To see with people in your life by looking at the world that way so that is so much fun you can find that on fancy free podcasts calm. I also blog at cozy clothes blog calm because I have designed a line of women’s lounge where that that is being manufactured and that will come out that is called shelfie shop. But it’s not open quite yet but you can link to that from my blog.

Marilena Grittani, RPh  1:06:20 

Perfect. So now you know I’m telling you if you want to listen to the episode that we recorded together, we’d had so much fun

Dr. Joanne Davis Jarrett, MD  1:06:26 

it was so good

Marilena Grittani, RPh  1:06:27 

but we were not so hard.

Dr. Joanne Davis Jarrett, MD  1:06:29 

Oh my gosh, it has created this relationship that Marilena and I have with each other and it’s kind of a perfect illustration of what can come from sharing these moments because every time I have a guest Tell me what their embarrassing moments I always have something like oh, that happened to me Do let me tell you really quick even though it doesn’t make it to the episode it

Marilena Grittani, RPh  1:06:47 

sometimes it was worse What happened to you? So if you need if you need a little pickup, what is the word pick up time you can’t get me up time if you need a reasonable To laugh and you don’t have a source at that moment, go to her podcast pick any episode, and you’re not going to make fun of them. You’re going to laugh with them.

Dr. Joanne Davis Jarrett, MD  1:07:10 

That’s right. We’re not laughing at people we’re laughing about we’re laughing at ourselves together and it is so fun and it’s just such a healthy way to you feel like

Marilena Grittani, RPh  1:07:18 

you’re in a cafe with friends having fun is so good.

Dr. Joanne Davis Jarrett, MD  1:07:21 

Good. Good girl time belly. Yes. Yeah,

Marilena Grittani, RPh  1:07:23 

it is. And even these days that we’re feeling alone because of what we’re recording this during the Coronavirus era and listening to that it’s a great way to laugh just because you can do that at three in the morning anytime it’s a podcast so go Go for it. I will be there for you. Yes. To laugh with you. Well, thank you so much. It was always fun. And thank you for giving us a different view of what a physician is. And for us to understand that you’re people to

Dr. Joanne Davis Jarrett, MD  1:07:52 

awesome thank you so much for having me. It’s been so much fun. Marilena.

Marilena Grittani, RPh  1:07:57 

As always talking to Joanne it’s such a fun time. She is a very down to earth physician. And that’s why she’s here because I want you to have the sense of physicaians being people being having feelings, having making mistakes, and not knowing everything, as our culture has taught us that physicians do. That is not true. And that’s why I keep encouraging you to take ownership of your own health, because most people leave their health on the doctors hands. And that’s not their responsibility. They’re there to help you but you are the one that is responsible, you are the one that has to do the follow up and you are the one that is deciding what to do with your life. So it is important that you know all that. And also you need to get the information that you need to make the most educated decision for your health, the health of those that depend on you like your kids, your spouse, or maybe your parents or grandparents. And also, to make sure that’s trust that generation Not knowing and not being involved will be gone. And that will be a great thing to partner with when you are having medical situation that you have to deal with. And that is exactly the reason why I’ve created the summit that we’re going to be talking about next week. So basically, it’s going to be called taking control of my health summit. And that is because I want to provide to all of you enough information, so you know what to do, under certain circumstances whenever it happens to you or to people that you love, and then you will know what to do or at least where to go to find answers. This is going to be a free summit that we’re going to start in June, the third week of June. And I will give you more details next week on episode number 22 is going to be filled with a lot of information and I am going to have a special treat for you guys that listen to my podcast. So it paid off to be more listener and I retribute in you that loyalty with a specific summit and also with a little trick for you. So please don’t forget to tune in next Tuesday, and we will talk about the taking control of my health summit. I am very excited about this. I’ve been working for months on this, I have so many good speakers that you have no idea. It’s gonna be fun, and it’s going to be a little bit for everybody and anybody. So don’t forget to come over for that other episode. So with that, that’s it for this episode. Thank you so much for listening. Don’t forget to subscribe to the podcast, give us a review. If you have time to read my reviews, please. And then if you have a question or whatever you need to talk to me, I’ll be happy to receive it at comments at The Legal Drug dealer.com and I will respond directly or maybe I will put it in one of the episodes because is that important and relevant. Also, please go ahead and visit TheLegalDrugdealer.com website and then look around to see what I have for you and sign up to our mailing list because that’s the way that you’re going to have stuff that nobody else will have access. But you and I will remind you about new episodes every Tuesday through that email list. So don’t forget about next week’s episode number 22. About the summit that I designed I created just for you called taking control of my health summit. And you would like it trust me on that one. So with that I’m done. But before I go on, just in case no one has told you today, I wanted to take a minute to remind you don’t forget that, that you’re awesome. And how awesome you are, and how lucky are those that have you in their lives. Thank you so very much for being the awesome you that you are. Have a wonderful rest of your day. This is Marilena Grittani, The Legal Drug Dealer.

Bye for now.

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