Send us a text with a question or thought on this episode ( We cannot replay from this link)
Finding the right endometriosis surgeon can feel like searching for a needle in a haystack—especially when you’re already dealing with chronic pelvic pain and the emotional toll of the disease. The wrong choice can cost you years of suffering, but the right surgeon can change your life. In this episode, Dr. Melissa McHale, a gynecologic surgeon specializing in minimally invasive endometriosis excision surgery, shares a proven step-by-step framework to help you confidently choose the right surgeon and reclaim your quality of life.
You’ll discover:
- Why traditional ways patients pick surgeons often fail—and how to avoid being misled by those who simply tell you what you want to hear
- How to research a surgeon’s qualifications, training, mentors, and real-world excision surgery experience
- Where to check public medical board records, license status, and malpractice history for surgeons and their practice partners
- How financial structures in a gynecology practice can influence care quality and surgical flexibility
- What a thorough preoperative workup should include, from advanced imaging to detailed preparation
- How to critically read patient reviews and spot patterns across multiple platforms
- Why transparency matters—surgical documentation, photos, and post-op explanations are key to trust
- How to evaluate a surgeon’s communication style and whether they give detailed, thoughtful answers
- The importance of a multidisciplinary care team in successful endometriosis treatment
- How to combine instinct and objective evidence when making your final decision
Whether you’re just beginning your search for an excision specialist or are feeling stuck after disappointing care, this episode will give you the tools and confidence to find the right endometriosis surgeon for your needs.
DOWNLOAD FREE SURGEON VETTING WORKSHEET HERE
Website endobattery.com
Introduction to Dr. Melissa McHale
Speaker 1
0:03
People
used
to
ask
me
how
do
I
pick
a
surgeon
?
And
I
really
,
I
think
historically
,
have
fumbled
the
answer
to
that
and
I
don't
know
that
there's
really
a
great
framework
out
there
for
how
to
pick
a
surgeon
.
There
are
a
lot
of
lists
out
there
that
are
like
ask
your
surgeon
if
they
do
excision
,
ask
them
this
,
ask
them
that
.
But
often
your
surgeon
knows
what
you
want
to
hear
and
so
what
are
the
things
you
should
be
looking
at
?
And
that
book
was
like
total
clarity
for
me
.
I
was
like
,
oh
,
like
now
I
know
how
to
think
about
this
,
and
what's
ironic
is
the
book
I
was
reading
at
the
end
of
Summit
is
actually
like
the
inspiration
for
the
conversation
we're
about
to
have
,
because
I
was
reading
Malcolm
Gladwell's
book
Talking
to
Strangers
,
strangers
and
the
whole
time
I
was
reading
it
I
was
like
,
oh
,
this
,
this
is
like
I'm
having
having
a
clarity
moment
here
about
how
we
understand
other
people
.
Speaker 1
0:54
And
there's
this
one
case
of
a
spy
that
they
talk
about
a
lot
,
who
was
a
CIA
agent
,
who
was
also
a
spy
working
,
you
know
,
for
the
Cuban
government
.
And
why
is
it
that
no
one
picked
up
on
these
people
being
up
to
no
good
?
And
the
truth
is
,
some
people
did
pick
up
on
it
,
the
people
who
hadn't
met
them
,
right
,
the
people
who
were
just
looking
at
,
like
what
have
they
written
?
What
have
they
done
?
And
people
would
repeatedly
say
like
hey
,
I'm
pretty
sure
this
is
a
Ponzi
scheme
.
And
then
people
would
go
interview
Bernie
Madoff
and
they'd
be
like
he's
such
a
nice
guy
,
it
can't
possibly
right
,
like
he
said
he
wasn't
going
to
invade
Poland
,
I'm
sure
he's
not
going
to
invade
Poland
.
And
,
like
you
know
,
we
all
know
how
these
stories
ended
.
And
so
Malcolm
Gladwell
really
breaks
down
like
okay
,
what
are
the
traps
that
we
fall
into
?
And
then
I
tried
to
you
know
,
sort
of
use
those
traps
to
think
about
like
,
okay
,
what
are
the
ways
that
you
can
talk
to
a
surgeon
and
really
think
about
whether
they're
the
right
fit
for
you
?
Speaker 1
1:49
Yeah
,
I
think
transparency
is
essential
and
,
and
it's
funny
,
there's
transparency
in
sort
of
two
different
senses
.
One
is
the
obvious
.
Like
I'm
transparent
about
what
happened
inside
your
body
while
you
were
sleeping
.
I'm
going
to
give
you
complete
documentation
,
not
the
op
note
.
You
get
the
pictures
and
you
get
my
explanation
of
the
pictures
and
why
I
did
what
I
did
.
It's
the
.
Here's
my
mental
math
on
whether
or
not
,
you
need
an
ostomy
and
it
doesn't
matter
what
the
question
is
.
Right
,
you
could
ask
me
any
of
the
questions
on
those
lists
of
questions
to
ask
your
doctor
,
and
I
mean
some
of
them
have
like
a
very
black
and
white
answer
,
right
?
Speaker 2
2:40
Welcome
to
EndoBattery
,
where
I
share
my
journey
with
endometriosis
and
chronic
illness
,
while
learning
and
growing
along
the
way
.
This
podcast
is
not
a
substitute
for
medical
advice
,
but
a
supportive
space
to
provide
community
and
valuable
information
so
you
never
have
to
face
this
journey
alone
.
We
embrace
a
range
of
perspectives
that
may
not
always
align
with
our
own
,
believing
that
open
dialogue
helps
us
grow
and
gain
new
tools
.
Join
me
as
I
share
stories
of
strength
,
resilience
and
hope
,
from
personal
experiences
to
expert
insights
.
Strength
,
resilience
and
hope
,
from
personal
experiences
to
expert
insights
.
I'm
your
host
,
Alana
,
and
this
is
Endobattery
charging
our
lives
when
endometriosis
drains
us
.
Welcome
back
to
Endobattery
,
Grab
your
cup
of
coffee
or
your
cup
of
tea
and
join
me
at
the
table
Today
.
Speaker 2
3:22
I'm
excited
to
welcome
Dr
Melissa
McHale
,
a
gynecologic
surgeon
specializing
in
minimally
invasive
endometriosis
surgery
.
Known
for
her
compassion
,
patient-centered
care
,
Dr
McHale
combines
advanced
surgical
skills
with
dedication
to
truly
listening
,
educating
and
creating
individualized
treatment
plans
.
A
graduate
at
Boston
University
School
of
Medicine
,
she
completed
her
residency
at
the
John
Hopkins
University
Hospital
before
training
for
two
years
with
internationally
recognized
endometriosis
specialist
,
Dr
Andrea
Vidali
.
She's
also
highly
skilled
in
dynamic
ultrasound
to
map
and
diagnose
endometriosis
.
Dr
Miguel
takes
a
multidisciplinary
approach
,
often
collaborating
with
specialists
from
other
fields
,
and
has
a
special
interest
in
patients
with
conditions
like
hypermobility
,
POTS
and
MCAS
.
Her
mission
is
to
improve
early
diagnosis
,
reduce
delays
in
care
and
help
patients
everywhere
reclaim
their
quality
of
life
.
I'm
thrilled
for
you
to
hear
from
her
today
,
so
please
help
me
in
welcoming
Dr
Melissa
McHale
to
the
table
.
Thank
you
,
Melissa
,
so
much
for
joining
me
today
and
sitting
down
at
the
table
.
I
think
I'm
excited
for
this
conversation
,
for
various
reasons
.
Speaker 1
4:31
Thanks
.
Thanks
for
having
me
.
I
love
your
podcast
so
I'm
very
excited
to
be
here
.
That's
very
kind
of
you
.
No
,
I
do
,
I
do
.
I
mean
it's
great
that
I
get
to
sort
of
hear
what
other
people
think
and
how
other
people
do
stuff
you
know
.
So
you
know
,
when
you're
in
the
endo
world
,
you
want
to
see
the
other
parts
of
the
world
.
Speaker 2
4:49
It's
true
,
I'm
excited
to
welcome
you
because
,
first
of
all
,
I
saw
you
on
social
media
first
time
I'd
ever
seen
you
,
and
the
thing
I
loved
about
you
is
that
you
are
so
funny
and
personable
and
yet
relatable
,
and
you
allow
How to Choose the Right Surgeon
Speaker 2
5:07
people
who
have
endometriosis
to
see
endometriosis
in
a
different
light
,
that
it's
not
all
serious
,
but
there's
lessons
to
be
learned
in
it
.
How
did
you
get
into
endometriosis
?
How
did
this
become
a
thing
for
you
?
Speaker 1
5:20
Well
,
actually
I
first
got
interested
in
it
in
medical
school
,
which
I
know
is
like
a
very
uncommon
answer
because
most
people
are
like
you
know
,
I
had
20
minutes
of
endometriosis
education
in
medical
school
.
But
I
got
very
lucky
.
I
went
to
BU
and
I
did
a
rotation
with
Kip
McKenzie
who
is
,
you
know
,
like
old
school
he
just
retired
endometriosis
surgeon
and
he
basically
talked
me
out
of
general
surgery
and
into
gynecology
and
like
the
rest
is
history
.
So
you
know
I
did
that
.
Then
I
did
my
residency
at
Hopkins
and
afterwards
I
trained
with
Andrea
Vidali
because
I
was
like
I
want
all
endo
all
the
time
and
you
know
this
is
the
best
way
for
me
to
get
the
skills
I
need
.
And
you
know
it's
just
sort
of
snowballed
.
And
now
here
I
am
,
all
endo
all
the
time
.
Speaker 2
6:04
What
keeps
you
going
,
though
,
because
this
is
not
an
easy
field
to
get
into
.
What
keeps
you
striving
for
better
?
What
keeps
you
striving
for
more
?
Speaker 1
6:19
I
would
say
there's
two
things
.
One
is
the
patience
right
.
There's
nothing
more
rewarding
than
hearing
back
from
your
patients
and
I
will
say
a
lot
of
people
in
my
life
make
fun
of
me
for
the
texts
I
get
.
Like
,
you
know
,
I'm
the
only
person
I
know
where
someone
will
text
me
like
I
I
pooped
this
morning
and
I
thought
of
you
because
it
didn't
hurt
,
and
I'll
be
like
,
yes
,
and
my
husband
will
be
like
what
?
And
then
you
know
the
other
thing
is
is
honestly
.
And
then
you
know
the
other
thing
is
is
honestly
.
Speaker 1
7:02
You
know
,
in
in
my
practice
,
I
have
this
great
community
of
other
people
who
are
just
as
passionate
about
,
about
endo
as
as
I
am
.
And
and
it's
like
you
know
,
vicky
,
vicky
Vargas
,
my
,
my
partners
,
people
hate
hanging
out
with
us
because
all
we
talk
about
is
endometriosis
,
like
our
husband
,
you
know
.
But
but
you
know
,
anytime
and
and
you
know
,
vince
,
my
colorectal
colleague
,
vince
Obvious
,
anytime
he
and
I
are
like
,
oh
,
what
if
we
do
it
this
way
,
we
could
try
this
.
I'm
like
we
get
so
into
it
and
it's
,
it's
energizing
.
And
and
then
you
know
when
,
when
we
have
patients
who
continue
with
Jen
,
our
nurse
practitioner
,
and
she's
like
she's
doing
great
and
this
and
this
with
Jen
,
our
nurse
practitioner
,
and
she's
like
she's
doing
great
and
this
and
this
,
and
we're
like
.
You
know
,
this
is
like
this
community
.
It's
like
we
feed
off
of
each
other
on
coming
up
with
the
best
ways
to
take
care
of
our
patients
,
and
so
I
would
say
,
like
those
two
sort
of
different
groups
of
people
really
keep
me
going
.
Speaker 2
7:39
Yeah
,
what's
funny
about
that
is
this
ties
into
how
we
met
,
because
we
met
at
the
endometriosis
summit
and
we
met
in
the
elevator
and
you
were
going
up
to
go
to
bed
.
I
was
for
sure
not
going
up
to
go
to
bed
,
because
I
don't
sleep
at
the
summit
,
because
the
people
there
are
my
friends
and
they
fuel
me
and
I
leave
the
summit
just
ready
to
go
.
Speaker 2
8:09
You
know
like
I
get
ideas
and
I
want
to
serve
people
.
I
want
to
help
people
more
and
I'm
re-inspired
to
continue
with
advocacy
,
which
is
not
always
an
easy
thing
to
do
when
it's
so
tiring
a
lot
of
times
.
And
so
you
and
I
were
in
the
elevator
.
You
were
going
to
sleep
.
I
was
not
.
How
.
How
did
you
do
that
?
Because
I
am
not
someone
who
,
you
know
,
values
sleep
very
well
.
Sometimes
I'm
not
great
at
it
.
I
would
like
to
get
better
at
it
,
but
you
clearly
have
mastered
this
,
because
I
would
have
not
done
what
you
did
.
Speaker 1
8:38
Well
,
I'm
,
you
know
,
I
I've
been
trying
to
prioritize
certain
aspects
of
my
self-care
that
may
have
been
neglected
,
particularly
through
training
and
things
like
that
,
and
one
of
them
is
sleep
right
.
So
,
and
especially
at
the
endosummit
,
you're
like
mind
is
going
a
mile
a
minute
thinking
about
all
these
different
things
.
And
so
one
thing
one
of
my
,
like
you
know
,
recent
past
year
or
so
resolutions
is
working
on
my
sleep
hygiene
.
So
I
always
read
before
I
go
to
bed
and
and
what's
ironic
is
the
book
I
was
reading
at
the
end
of
summit
is
actually
like
the
inspiration
for
the
conversation
we're
about
to
have
,
cause
I
was
reading
Malcolm
Gladwell's
book
talking
to
strangers
,
and
the
whole
time
I
was
reading
it
I
was
like
oh
,
this
,
this
is
like
I'm
having
having
a
clarity
moment
here
about
how
we
understand
other
people
,
and
so
what
we're
talking
about
today
,
which
is
how
to
,
how
to
,
you
know
,
choose
the
right
surgeon
for
yourself
.
Speaker 1
9:35
People
used
to
ask
me
how
do
I
pick
a
surgeon
?
And
I
I
really
,
I
think
historically
have
fumbled
the
answer
to
that
,
fumbled
the
answer
to
that
,
and
I
don't
know
that
there's
really
a
great
framework
out
there
for
how
to
pick
a
surgeon
right
.
There
are
a
lot
of
lists
out
there
that
are
like
ask
your
surgeon
if
they
do
excision
,
ask
them
this
,
ask
them
that
.
But
often
your
surgeon
knows
what
you
want
to
hear
and
so
what
are
the
things
you
should
be
looking
at
.
And
that
book
was
like
total
clarity
for
me
.
I
was
like
,
oh
,
like
now
I
know
how
to
think
about
this
.
Speaker 2
10:06
Yeah
,
if
you
want
to
talk
about
deception
in
the
eye
of
the
beholder
,
like
that
relational
deception
,
like
you
get
to
know
someone
and
then
you
know
the
Bernie
Madoffs
or
the
what
was
it
,
amanda
Knotts
?
Speaker 2
10:20
Everyone
thought
she
was
,
or
they
thought
she
was
guilty
,
and
so
it's
about
perception
,
right
,
like
it's
about
how
they're
being
perceived
when
you
meet
them
,
when
you
look
at
them
,
and
if
you
look
at
them
from
a
distance
or
you
look
at
them
from
a
personal
lens
,
how
you
make
your
decision
making
.
That's
kind
of
the
title
of
the
book
,
right
?
Speaker 1
10:39
Yeah
,
so
the
whole
point
of
the
book
is
basically
why
is
it
that
we
are
so
bad
at
interpreting
the
behavior
of
people
we
don't
know
and
we
can
never
sort
of
do
a
good
job
of
assessing
whether
someone
is
trustworthy
,
whether
someone
is
capable
,
and
so
you
know
,
with
the
examples
you've
talked
about
,
those
,
those
all
come
up
in
the
book
,
right
,
and
there's
people
you
know
like
people
who
are
up
to
no
good
,
like
the
Bernie
Madoffs
or
the
Hitlers
or
whoever
of
the
world
,
right
,
there's
this
one
case
of
a
spy
that
they
talk
about
a
lot
,
who
was
a
CIA
agent
,
who
was
also
a
spy
working
for
the
Cuban
government
,
and
why
is
it
that
no
one
picked
up
on
these
people
being
up
to
no
good
?
And
the
truth
is
,
some
people
did
pick
up
on
it
,
the
people
who
hadn't
met
them
no-transcript
.
Speaker 2
12:16
Find
a
surgeon
.
Speaker 1
12:18
So
the
first
step
really
is
establish
whether
or
not
this
person
is
qualified
,
right
,
and
so
you
know
some
of
the
things
.
It's
like
do
the
background
research
on
this
person
right
?
Like
,
did
they
go
to
medical
school
?
Right
?
Like
,
yes
,
I'm
sure
they
did
if
they're
a
surgeon
.
But
like
,
where
did
they
go
?
Where
did
they
do
residency
?
Did
they
do
a
fellowship
?
And
then
,
who
taught
them
to
do
endometriosis
surgery
?
Right
,
Is
this
something
that
they
learned
in
fellowship
Did
?
Is
this
something
that
they
learned
in
fellowship
?
Did
they
have
a
specific
mentor
?
Did
they
learn
it
after
fellowship
?
Speaker 1
12:46
Like
,
really
try
to
figure
out
.
Like
,
okay
,
if
even
most
fellowship
trained
gynecologists
in
the
US
don't
know
how
to
do
a
complete
excision
of
endometri
,
find
anyone
at
the
University
of
whatever
who
you
would
trust
to
do
your
surgery
,
OK
,
well
then
,
if
this
is
where
that
person
trained
and
they
taught
them
everything
they
know
,
is
this
person
really
qualified
or
not
really
Right
?
And
sometimes
someone
got
extra
training
after
fellowship
,
they
were
mentored
by
somebody
,
these
kinds
of
things
.
Sometimes
someone
got
extra
training
after
fellowship
,
they
were
mentored
by
somebody
,
these
kinds
of
things
.
You
know
,
everyone
has
a
different
journey
and
it's
not
always
necessarily
about
where
they
did
fellowship
.
But
figure
it
out
.
Don't
be
afraid
to
ask
like
when
did
this
become
your
focus
?
Is
this
something
you
learned
on
your
own
?
Did
somebody
teach
you
?
Did
somebody
mentor
you
Right
?
Researching a Surgeon's Qualifications
Speaker 2
13:55
If
you
wouldn't
let
their
mentor
operate
on
you
,
consider
whether
or
not
they
should
operate
on
you
.
Right
,
like
you
know
,
and
some
of
who's
not
.
How
do
we
decipher
that
as
a
patient
if
we
don't
really
you
know
,
like
you
and
I
,
we're
kind
of
in
this
endo
community
,
pretty
thick
into
it
,
you
know
.
So
we
know
who's
really
good
,
we
know
who's
credible
.
But
for
people
who
don't
know
and
they're
just
starting
this
journey
how
would
you
go
about
figuring
out
if
someone
is
credible
or
not
?
Speaker 1
14:26
starting
this
journey
.
How
would
you
go
about
figuring
out
if
someone
is
credible
or
not
?
So
there's
a
few
different
,
you
know
a
few
different
things
you
can
look
at
.
Right
,
there's
all
these
different
lists
,
right
,
people
talk
about
lists
on
social
media
and
those
kinds
of
things
of
who
is
qualified
,
who
believes
in
excision
,
all
those
kinds
of
things
.
Right
,
you
can
look
at
the
sort
of
reputation
both
from
patients
and
we'll
get
into
that
more
later
in
our
discussion
like
what
are
their
reviews
,
that
kind
of
stuff
.
But
also
what
do
other
doctors
say
about
them
?
Right
,
because
often
you
know
you
can
sort
of
tell
what
doctors
associate
with
other
people
whose
whole
world
is
endometriosis
.
Right
,
if
somebody
is
spending
all
of
their
time
with
other
people
who
totally
focus
on
endometriosis
,
it's
because
they're
like
you
and
me
.
They
feed
off
of
constantly
thinking
about
how
to
get
better
at
providing
endometriosis
care
.
Right
,
if
they're
totally
on
their
own
nobody
refers
to
them
,
they're
not
doing
all
of
these
things
to
forward
their
knowledge
then
you
know
that
should
give
you
pause
.
Speaker 2
15:28
Yeah
,
Is
there
.
I
mean
we
talk
about
red
flags
with
surgeons
.
We've
talked
a
little
bit
about
,
like
you
know
,
if
,
if
you
don't
trust
them
or
you're
not
,
you
wouldn't
have
the
other
surgeons
,
what
are
some
other
red
flags
when
people
are
researching
these
surgeons
that
we
should
be
aware
of
?
Speaker 1
15:48
Yeah
,
that
gets
into
the
next
element
that
I
think
you
should
be
discerning
online
,
which
is
whether
or
not
somebody
is
trustworthy
.
Right
,
is
the
surgeon
trustworthy
?
And
so
you
obviously
like
look
up
,
you
know
,
okay
,
you're
vetting
a
surgeon
.
You
have
their
name
,
you
have
every
name
they've
ever
had
.
Right
,
like
,
I
changed
my
name
when
I
got
married
,
so
like
my
medical
degree
is
not
under
my
current
name
.
Right
,
like
,
come
up
with
every
name
for
this
person
and
their
partners
.
Right
,
who
else
is
in
the
practice
?
Because
birds
of
a
feather
flock
together
.
Right
,
and
if
one
of
their
partners
is
sketchy
and
they're
they're
endorsing
their
partner
,
their
partner
might
cover
them
when
they're
on
vacation
.
Right
,
you
might
be
rounded
on
by
the
other
people
in
the
practice
.
So
you
look
at
everybody
who
they
associate
with
and
then
you're
looking
that
person
up
.
Speaker 1
16:36
Right
,
every
medical
board
complaint
is
a
part
of
the
public
record
.
Right
,
and
every
medical
license
is
a
part
of
the
public
record
.
So
,
for
example
,
I'm
licensed
in
five
states
New
York
,
new
Jersey
,
maryland
,
the
District
of
Columbia
and
Virginia
.
So
you
can
pull
my
license
from
every
single
one
of
those
places
and
you
can
Melissa
McHale
Medical
Board
,
Virginia
.
Melissa
McHale
Medical
Board
,
maryland
.
See
what
comes
up
,
right
,
if
my
license
has
been
suspended
in
Maryland
and
I'm
,
you
know
,
and
that's
why
I
operate
in
Virginia
,
that's
something
you
should
know
about
.
My
license
has
not
been
suspended
anywhere
.
I
don't
have
it
.
Speaker 1
17:12
Go
,
please
,
you
won't
find
anything
,
but
this
happens
,
right
,
like
I
see
patients
who
have
seen
physicians
who
have
lost
their
licenses
in
some
states
and
the
patient
has
no
idea
until
after
the
surgery
didn't
go
very
well
,
right
.
So
look
it
up
,
right
.
How
do
they
have
any
medical
board
complaints
?
It's
something
you
want
to
know
.
And
does
anyone
in
their
practice
have
any
medical
board
complaints
?
And
then
also
,
part
of
the
public
record
are
court
cases
,
so
you
can
their
name
and
malpractice
,
their
name
and
lawsuit
,
their
name
and
the
major
newspapers
of
where
they
live
,
right
,
right
,
all
of
these
things
like
it's
.
It's
going
to
come
up
if
they're
getting
into
trouble
or
they're
getting
sued
.
A
lot
,
right
,
like
this
kind
,
this
kind
of
thing
.
It's
,
it's
not
a
secret
,
and
so
if
you
go
looking
for
it
and
and
they
have
,
you
know
,
a
track
record
of
this
,
you'll
find
it
,
yeah
,
and
I
think
that's
and
you
have
to
look
at
that
.
Speaker 2
18:14
And
then
you
have
to
look
at
what
the
complaint
is
,
because
I
do
know
like
there's
certain
providers
that
say
,
do
excision
and
others
that
don't
believe
in
excision
and
they're
like
they're
taking
too
much
tissue
,
do
excision
,
and
others
that
don't
believe
in
excision
and
they're
like
they're
taking
too
much
Financial Considerations and Transparency
Speaker 2
18:27
tissue
,
like
there
is
that
element
of
it
.
So
you
have
to
kind
of
like
is
this
valuable
information
to
me
?
Is
this
going
to
break
my
trust
or
is
this
going
to
?
Is
this
,
you
know
,
skill
set
or
is
this
you
know
?
So
I
think
that
you
have
to
look
at
all
of
that
.
It's
not
just
like
,
oh
,
they
have
a
complaint
,
I'm
not
going
to
use
them
.
You
have
to
look
through
that
.
Speaker 1
18:48
Yeah
,
of
that
.
It's
not
just
like
,
oh
,
they
have
a
complaint
,
I'm
not
going
to
use
them
.
You
have
to
look
through
that
.
Yeah
,
absolutely
,
there's
a
difference
between
you
know
,
they
lost
their
license
for
gross
negligence
and
,
like
someone
sued
them
over
something
that
wasn't
malpractice
and
,
like
you
know
,
it
didn't
go
anywhere
.
Obviously
,
like
,
every
surgeon
has
complications
Every
single
surgeon
if
you're
doing
high
volume
of
surgery
,
you're
going
to
have
complications
,
and
the
more
complex
the
cases
you're
taking
on
,
the
more
likely
you
are
to
have
complications
,
right
.
If
you're
doing
ablation
of
endometriosis
for
people
who
don't
have
complex
disease
,
you're
going
to
have
a
really
low
complication
rate
,
right
,
but
that's
not
what
you
want
,
and
so
I
think
it's
very
important
to
like
read
these
things
and
take
them
with
a
grain
of
salt
.
If
someone
got
sued
over
something
that
isn't
a
known
potential
complication
of
something
and
it
wasn't
malpractice
,
obviously
that's
not
a
reason
to
not
see
a
surgeon
.
Speaker 2
19:36
Right
,
and
that's
,
I
mean
,
malpractice
is
one
thing
,
and
so
you
just
have
to
kind
of
weed
through
that
,
and
that's
what's
tricky
about
this
disease
is
like
if
you
aren't
familiar
enough
,
it
can
be
challenging
,
and
that's
one
thing
that
I
always
tell
people
like
get
a
community
,
talk
to
those
people
in
the
community
.
You
know
,
I
think
understanding
the
surgeons
and
how
they
operate
is
is
key
.
The
other
thing
that
I
think
is
important
is
not
everyone
has
access
to
pay
out
of
pocket
,
or
they
don't
have
access
to
be
able
to
,
you
know
,
see
a
specific
surgeon
.
What
would
your
take
be
on
the
financial
aspect
of
that
too
,
because
that
does
play
a
role
in
how
we
choose
our
surgeon
.
Speaker 1
20:23
And
I
think
it's
really
important
,
as
a
patient
,
to
both
think
about
your
financial
limitations
and
also
think
about
the
financial
pressures
that
a
surgeon
might
be
under
right
and
it's
not
.
You
know
,
this
is
not
something
where
I
would
say
to
you
like
,
do
or
don't
have
surgery
with
someone
based
on
the
financial
setup
of
their
practice
,
based
on
the
financial
setup
of
their
practice
,
but
it
is
something
to
be
aware
of
,
right
.
Do
they
own
their
own
practice
or
are
they
owned
by
private
equity
?
Do
they
work
for
a
for-profit
hospital
?
These
are
all
things
that
it's
just
important
to
know
,
because
someone
both
faces
different
pressures
of
how
long
they
get
to
spend
with
you
and
how
many
cases
they
have
to
do
a
week
,
and
all
those
things
based
on
who
they
work
for
.
And
similarly
,
like
you
know
,
if
they
work
for
in
a
practice
where
the
people
making
most
of
the
decisions
are
either
people
in
finance
or
hospital
administrators
,
those
people
are
going
to
say
you
can't
cut
this
person
a
discount
for
surgery
,
no
matter
how
bad
their
case
is
,
no
matter
how
much
they're
suffering
,
no
matter
their
financial
limitations
.
It
costs
what
it
costs
and
that's
not
up
to
you
,
right
?
Surgeons
who
own
their
own
practice
do
have
more
wiggle
room
.
And
so
,
as
you're
thinking
about
what
your
financial
barriers
are
,
also
ask
them
when
you
make
an
appointment
.
Speaker 1
21:47
You
can
ask
what
it
costs
to
see
the
doctor
.
You
can
ask
what
the
out-of-pocket
cost
for
surgery
is
and
you
can
say
do
you
guys
ever
offer
discounts
for
people
with
financial
hardships
?
Do
you
offer
payment
plans
?
These
are
all
reasonable
questions
to
ask
.
It's
not
insulting
to
ask
how
much
it
costs
,
right
,
just
like
if
you
were
,
you
know
.
Speaker 1
22:08
If
you're
buying
or
paying
for
any
other
service
,
it's
reasonable
to
ask
what
it
costs
.
You
can
ask
your
doctor
what
it
costs
and
if
they
can't
tell
you
or
no
one
you
know
often
it's
not
the
doctor
who
knows
who
who
has
that
conversation
but
if
whoever
the
administrator
is
or
the
coordinator
or
whoever
can't
tell
you
how
much
it
costs
,
then
you
know
that's
sort
of
oh
like
.
They
often
can't
tell
you
specifically
,
right
?
Often
it's
going
to
be
like
well
,
your
deductible
is
this
and
your
out-of-pocket
maximum
is
this
,
right
,
they
can't
always
tell
you
exactly
what
the
cost
is
going
to
be
,
but
they
should
be
able
to
set
reasonable
expectations
.
And
if
you're
paying
,
if
you're
self-pay
because
you
don't
you
know
it's
an
out-of-network
practice
and
they
don't
,
you
don't
have
out-of-network
benefits
,
then
yes
,
it
should
be
a
specific
dollar
amount
.
This
is
what
it's
going
to
cost
you
.
Speaker 2
22:55
Right
,
Well
,
and
I
think
too
,
is
it
worth
when
we're
talking
about
the
trustworthiness
,
is
it
worth
?
Looking
into
what
doctors
are
being
paid
from
pharmaceutical
companies
or
surgical
companies
.
Things
like
that
Are
those
things
that
we
should
be
looking
for
as
well
when
we're
looking
at
the
financial
aspect
of
finding
a
surgeon
.
Speaker 1
23:16
I
think
looking
at
whether
or
not
someone
is
paid
by
a
pharmaceutical
company
is
always
valuable
.
I
don't
think
it
disqualifies
a
surgeon
,
right
.
But
if
you
know
,
if
your
surgeon
got
fit
you
know
$15,000
last
year
from
the
makers
of
Lupron
then
like
you
should
ask
them
like
how
does
this
impact
your
practice
?
What
do
you
do
with
this
?
You
know
and
,
again
,
you
should
feel
at
liberty
to
ask
your
doctor
about
those
kinds
of
things
.
Speaker 2
23:43
Yeah
,
I
think
one
of
the
things
that
you
know
we
kind
of
alluded
to
this
a
little
bit
,
but
the
surprise
billing
aspect
of
endometriosis
.
So
asking
what
your
price
is
going
to
be
for
this
surgery
also
means
that
you
probably
need
a
preoperative
workup
to
know
exactly
what
you're
going
to
be
charged
for
.
How
do
you
recommend
going
about
that
Is
this
,
you
know
,
figuring
out
how
your
provider
the
one
that
you're
considering
is
practices
.
Do
they
do
imaging
first
?
Do
they
do
the
price
check
first
?
Like
,
what
is
your
recommendation
for
that
aspect
of
surgery
and
pricing
?
Speaker 1
24:23
I
mean
,
I
think
it's
very
reasonable
to
ask
like
what
does
the
appointment
ahead
of
time
cost
,
right
?
And
then
what
is
?
You
know
what
the
workup
is
often
is
determined
by
the
visit
you
have
with
the
doctor
,
right
?
Some
doctors
are
doing
like
dynamic
transvaginal
ultrasound
and
really
like
mapping
endometriosis
in
the
office
and
those
kinds
of
things
.
Some
doctors
aren't
doing
that
,
right
,
and
people
obviously
charge
differently
sometimes
depending
on
whether
or
not
they
do
the
ultrasound
,
but
sometimes
they
don't
right
,
sometimes
it's
included
in
the
visit
,
but
certainly
I
wouldn't
choose
a
surgeon
because
they
do
less
workup
and
therefore
the
workup
is
cheaper
.
Right
,
because
you
know
and
I
think
we'll
get
into
this
more
later
but
preparation
is
essential
for
surgery
and
I
think
that
I'm
a
big
believer
that
all
of
the
preoperative
workup
is
critical
.
And
so
you
know
,
depending
on
who
you
are
and
what
your
case
may
need
,
the
workup
may
be
different
the
workup
may
be
different
.
Speaker 2
25:25
Yeah
,
it's
interesting
that
we
are
like
talking
about
the
workup
,
because
it's
not
something
that
I
had
really
considered
prior
to
my
excision
surgery
and
I
wish
I
would
have
,
because
I
think
it
sets
patients
up
better
,
knowing
what
they're
going
to
have
done
in
the
operating
room
,
and
I
think
that
if
you're
on
the
same
page
with
your
surgeon
you
have
a
better
outcome
.
You
know
,
I
think
that
just
planning
is
huge
and
so
,
looking
at
,
okay
,
how
do
they
,
how
do
they
do
the
billing
for
this
and
do
they
include
the
preoperative
imaging
or
consultation
or
whatever
I
think
that's
,
I
think
that
should
be
part
of
the
consideration
in
choosing
a
surgeon
.
Um
,
because
I
think
it
speaks
volumes
about
their
approach
to
your
care
.
It's
individualized
at
that
point
.
Just
that's
my
personal
take
on
that
.
Speaker 1
26:11
Right
,
and
Preoperative Preparation and Imaging
Speaker 1
26:12
I
totally
agree
with
you
.
I
think
you
know
you
can
figure
out
that
financial
piece
before
you
decide
to
meet
with
them
.
But
once
you
have
made
the
decision
to
meet
with
a
surgeon
,
that's
when
you
should
be
looking
really
hard
at
what
is
their
preparation
like
for
your
surgery
,
right
?
How
are
they
building
that
mental
map
that
they
have
of
what
they're
going
to
expect
and
how
are
they
talking
to
you
about
it
?
Right
?
I
don't
think
it's
ever
fair
for
a
surgeon
to
ask
you
for
a
blank
check
,
to
do
whatever
with
no
preparation
ahead
of
time
,
right
?
You
know
,
I
have
a
colorectal
surgeon
in
my
practice
,
which
means
that
,
like
,
if
you
need
a
bowel
resection
,
you're
going
to
get
a
bowel
resection
,
but
you
should
be
prepared
for
how
likely
it
is
that
that's
going
to
happen
,
right
,
and
so
that's
what
I
find
is
essential
.
Is
that
expectation
management
?
So
when
I'm
doing
the
dynamic
ultrasound
in
the
office
,
I'm
actually
looking
at
your
rectal
wall
,
right
,
like
I
can
look
at
the
muscular
wall
of
your
rectum
and
I
can
trace
it
from
you
know
where
it
leaves
your
body
,
all
the
way
up
to
your
pelvic
brim
.
And
so
there
are
patients
where
I
can
say
,
like
,
look
here
,
like
see
this
line
,
we're
following
it
up
and
right
here
it's
fused
to
the
back
of
your
cervix
and
see
this
bump
here
like
this
is
something
that
looks
like
an
endometriosis
nodule
,
and
based
on
that
,
I
stratify
you
as
higher
risk
for
needing
some
type
of
bowel
surgery
.
Speaker 1
27:35
Right
,
and
then
we
get
into
the
different
types
of
bowel
surgery
.
What
do
I
think
you
need
,
right
?
Most
likely
the
most
common
type
that
we
do
in
our
practice
is
a
discoid
bowel
resection
.
And
so
here
you
know
,
here's
what
that
looks
like
.
And
if
your
disease
is
more
extensive
,
then
you
would
get
a
segmental
.
If
it's
less
extensive
,
then
you
would
get
a
shaving
.
But
I
stratify
you
as
highest
risk
for
needing
this
type
of
bowel
surgery
rather
than
just
saying
I
don't
know
,
we'll
see
when
we
get
in
there
,
but
we're
prepared
for
anything
.
You
could
wake
up
with
a
negative
you
know
negative
pathology
.
Or
you
could
wake
up
with
an
ostomy
and
you
know
who
knows
.
Right
,
that's
not
fair
.
That
is
not
fair
because
at
this
point
we
have
the
tools
to
be
able
to
give
you
appropriate
expectations
about
your
surgery
.
Imaging
is
not
perfect
.
Doctors
are
not
perfect
.
Surprises
happen
.
But
we
should
be
able
to
stratify
you
as
high
risk
or
low
risk
for
bowel
surgery
,
for
example
.
Right
so
that
you
can
go
into
it
knowing
what
you're
going
to
expect
.
Speaker 2
28:38
And
there's
usually
indications
of
deeper
disease
in
imaging
and
if
you
know
what
you're
looking
for
,
you
can
tell
pretty
instantly
,
like
that
there's
going
to
be
more
significant
disease
than
superficial
.
And
that's
where
,
like
I
think
that
conversation
always
comes
up
a
lot
of
times
is
,
like
imaging
is
it
useful
,
is
it
not
?
Well
,
it
probably
is
if
you
have
deep
infiltrating
endometriosis
,
like
,
I
think
it's
a
good
map
to
be
able
to
see
and
if
you
have
an
expert
looking
at
it
,
they'll
know
.
Speaker 1
29:09
Mm-hmm
,
a
hundred
percent
.
And
this
is
something
I
get
into
.
Anytime
I
talk
to
someone
who
says
,
like
you
know
,
I
had
prior
surgery
,
I
had
a
myomectomy
or
something
and
then
we
discovered
,
surprise
,
stage
four
endo
,
like
it's
.
It's
not
usually
a
surprise
,
you
know
,
like
it's
.
This
is
one
of
those
things
where
it's
like
if
you
close
your
eyes
and
cross
the
street
and
you
get
hit
by
a
truck
,
like
surprise
you
were
hit
by
a
truck
,
right
.
Speaker 2
29:37
Right
,
that
was
the
surprise
.
Speaker 1
29:40
Right
Like
it
shouldn't
be
a
surprise
.
Right
Like
good
.
If
,
if
we
hold
ourselves
to
the
higher
standard
of
like
needing
and
,
like
I
said
,
like
surprises
do
happen
.
I
don't
mean
to
say
that
I've
never
gone
into
a
surgery
and
been
like
man
.
This
is
worse
than
I
expect
.
No
,
that
definitely
happens
.
We
all
know
endo
is
a
tricky
,
tricky
disease
and
our
imaging
for
endometriosis
is
notoriously
bad
but
it
is
getting
better
.
And
there's
a
difference
between
saying
our
imaging
isn't
perfect
and
so
I'm
not
even
going
to
try
to
look
,
I'm
not
even
going
to
try
to
stratify
your
risk
,
and
saying
,
based
on
all
of
the
information
we
have
,
here's
my
expectation
of
what
your
surgery
is
going
to
look
like
.
If
it's
more
,
we're
prepared
for
it
.
If
it's
less
,
great
.
But
here's
what
I
think
,
based
on
my
hundreds
of
cases
of
experience
,
what
I
think
you
know
,
this
is
my
expectation
of
what
your
surgery
is
going
to
be
like
.
Speaker 2
30:36
Yeah
,
I
also
think
that
it's
imperative
,
before
we
even
get
to
that
step
,
to
really
read
what
other
patients
are
saying
.
Like
we
talked
about
this
a
little
bit
,
because
I
feel
like
you're
going
to
get
a
good
sense
of
how
a
practice
runs
and
how
a
doctor
practices
by
listening
to
the
other
patients
.
Now
,
take
it
with
a
grain
of
salt
sometimes
,
because
there
are
going
to
be
those
patients
that
nothing
is
going
to
be
right
and
maybe
it
wasn't
a
good
fit
.
Maybe
they
didn't
.
They
weren't
a
good
fit
for
this
provider
,
but
what
do
you
suggest
for
people
when
they
are
Reading Patient Reviews Effectively
Speaker 2
31:09
seeking
out
advice
from
other
patients
?
How
,
how
would
you
go
about
that
and
what
are
some
things
to
listen
for
that
would
make
a
red
flag
or
a
green
flag
for
people
?
Speaker 1
31:20
For
sure
.
I
mean
,
first
of
all
,
look
for
the
consensus
,
right
,
and
the
consensus
means
go
to
more
than
one
source
,
right
?
Somebody
may
be
like
loved
on
and
they're
hated
on
Reddit
,
right
?
Or
their
reviews
are
great
,
but
you
know
,
again
,
a
lot
of
these
things
.
People
find
ways
to
curate
reviews
and
that
kind
of
stuff
.
So
,
like
,
look
for
lots
of
different
sources
,
right
,
and
then
don't
,
you
know
,
read
the
whole
review
.
Speaker 1
31:44
Don't
stop
at
like
I
had
surgery
and
it
was
great
,
right
,
because
sometimes
it's
like
I
had
surgery
yesterday
and
it
was
great
and
you're
like
,
okay
,
you
may
still
be
under
the
influence
of
anesthesia
if
you
had
,
if
you
like
,
just
woke
up
from
surgery
and
you're
writing
this
review
,
right
,
and
it
doesn't
really
speak
to
,
like
the
long-term
experience
of
how
you
feel
,
and
that's
okay
,
it's
,
it's
perfectly
fine
to
write
a
review
that
just
says
,
like
they
were
a
compassionate
doctor
,
they
got
me
in
for
surgery
,
the
hospital
took
good
care
of
me
,
like
these
are
all
important
factors
,
like
what
was
your
experience
at
the
hospital
?
What
was
your
experience
getting
ready
for
surgery
?
But
it's
not
a
global
review
of
,
like
,
the
ultimate
result
and
,
similarly
,
sometimes
people
will
write
a
horrible
review
and
it's
mostly
about
the
hospital
rather
than
surgeon
,
or
it's
mostly
about
the
billing
office
or
the
coordination
of
the
surgery
,
right
,
Like
things
that
are
often
outside
of
the
surgeon's
control
,
especially
if
they
work
for
a
big
organization
.
If
your
surgeon
works
for
a
hospital
,
they're
not
in
control
of
who's
scheduling
the
surgeries
or
what
time
your
surgery
was
,
or
the
billing
or
any
of
those
things
.
If
they
work
for
such
and
such
hospital
,
all
of
those
things
are
out
of
their
hands
.
So
,
especially
if
they
have
bad
reviews
working
for
that
hospital
and
they
don't
even
work
there
anymore
,
definitely
I
would
write
like
don't
,
don't
bring
that
review
into
your
thought
process
.
Yep
,
and
sometimes
,
you
know
.
Speaker 1
33:12
Another
thing
to
keep
in
mind
is
sometimes
there
will
be
.
They'll
say
like
this
doctor
is
wonderful
,
and
then
when
they
describe
the
course
of
treatment
,
it
gives
you
pause
,
Like
we
were
just
talking
about
you
know
surprises
If
they're
like
the
doctor
was
wonderful
,
they
believed
my
pain
,
they
got
me
in
for
surgery
,
and
then
they
were
surprised
that
I
needed
a
bowel
resection
so
I
have
to
come
back
for
surgery
in
a
month
or
two
,
but
they
were
really
fantastic
,
right
,
like
that's
something
that
should
give
you
pause
.
And
again
,
I'm
not
saying
that
should
disqualify
them
as
a
surgeon
,
because
surprises
happen
.
And
so
if
your
surgeon
was
surprised
and
the
general
surgeon
on
call
is
someone
they
don't
trust
to
operate
on
you
,
you
would
rather
come
back
for
another
surgery
than
a
bad
surgery
,
right
?
And
so
in
that
case
,
ask
the
doctor
about
it
.
Speaker 1
34:04
You
can
say
,
like
,
how
often
do
you
get
surprised
?
What
happens
if
you
get
surprised
?
Who
do
you
call
if
you
need
help
?
And
again
,
look
at
reviews
for
the
whole
team
.
Look
at
you
know
,
are
they
using
the
same
colorectal
surgeon
over
and
over
again
?
Does
that
person
have
good
reviews
,
right
?
These
are
really
really
important
things
because
you
know
,
endometriosis
is
a
team
sport
.
Speaker 2
34:27
Right
?
Well
,
I
think
not
.
Every
person
is
going
to
mesh
well
with
every
surgeon
.
Do
you
think
it's
reasonable
for
people
to
get
multiple
consultations
with
different
surgeons
?
Is
that
a
reasonable
thing
for
patients
to
do
in
seeking
their
care
?
Speaker 1
34:44
Totally
.
Speaker 1
34:45
I
mean
I
think
,
listen
,
you
need
to
have
peace
The Importance of Multiple Consultations
Speaker 1
34:48
in
your
heart
about
your
surgical
plan
.
It's
okay
to
be
nervous
for
surgery
.
It's
normal
to
be
nervous
for
surgery
.
But
if
you
meet
with
a
surgeon
and
something
doesn't
seem
right
,
or
they
said
something
that
gives
you
pause
or
you're
just
not
sure
,
if
you
trust
them
,
by
all
means
get
another
opinion
.
I
think
sometimes
people
say
you
have
to
have
multiple
opinions
.
I
don't
think
you
have
to
have
multiple
opinions
.
If
you
feel
confident
,
right
,
the
doctor
has
gone
through
your
case
,
they've
reviewed
your
symptoms
,
they've
reviewed
your
imaging
.
You
feel
at
peace
with
the
plan
.
You've
connected
with
that
surgeon
.
Speaker 1
35:20
I
don't
,
you
know
,
if
you're
suffering
and
you
want
to
have
surgery
soon
,
I
don't
think
you
have
to
wait
two
months
to
get
a
second
opinion
from
someone
else
,
just
so
that
you
know
another
doctor
can
rubber
stamp
that
plan
Like
no
,
that's
not
necessary
if
you
feel
peace
in
your
heart
.
But
if
you
don't
get
another
opinion
,
you
don't
owe
the
doctor
anything
.
And
you
know
,
I
tell
people
all
the
time
if
you're
sitting
in
the
doctor's
office
and
you're
having
a
visit
and
they
say
something
where
you're
like
this
is
not
like
,
this
is
not
for
me
,
I'm
good
it's
.
This
is
not
algebra
class
.
Like
you
don't
have
to
stay
till
the
bell
rings
,
you
don't
have
to
stay
till
the
end
of
the
appointment
.
You
can
say
to
somebody
like
,
thank
you
so
much
for
your
time
.
I
appreciate
you
know
,
I
appreciate
everything
that
we've
talked
about
,
but
I'm
I'm
all
set
,
I'm
good
and
you
can
excuse
yourself
Like
you
don't
.
You
don't
owe
your
doctor
anything
.
Speaker 1
36:14
At
the
end
of
the
day
,
especially
with
surgeons
,
you're
interviewing
them
for
a
job
.
Right
,
the
job
is
to
be
your
surgeon
.
And
so
like
yes
,
do
a
background
check
,
check
their
references
,
interview
them
.
Are
they
qualified
for
the
job
?
It's
the
same
thing
.
You're
hiring
someone
for
a
job
.
I'm
not
saying
you
should
be
rude
.
Don't
say
to
them
like
you
seem
like
you
don't
know
what
you're
doing
,
goodbye
,
it's
not
necessary
.
We're
all
doing
our
best
.
Speaker 2
36:42
I
promise
it's
not
necessary
,
right
Like
we're
all
doing
our
best
.
I
promise
there
there
are
those
too
that
you're
like
are
you
?
Speaker 1
36:51
are
you
in
this
for
the
right
reasons
?
But
you're
typically
,
if
you
get
to
this
point
,
that's
not
most
people
.
That's
not
,
you
know
,
and
and
I
that
is
something
I
think
it's
important
to
talk
about
Most
doctors
.
We
didn't
go
to
medical
school
so
that
we
could
have
a
sneaky
cover
to
hurt
people
,
right
Like
.
No
,
we
wanted
to
like
.
Speaker 1
37:08
Doctors
want
to
do
the
right
thing
,
they
want
to
help
,
and
I
do
feel
that
the
vast
majority
of
bad
endo
care
because
,
at
the
end
of
the
day
,
there's
a
lot
of
bad
endo
care
out
there
and
it
doesn't
come
from
a
place
of
malice
.
It
comes
from
a
place
of
lack
of
education
,
lack
of
skill
,
lack
of
training
,
lack
of
time
on
the
part
of
the
doctor
.
Is
the
doctor
accountable
for
not
getting
more
skills
and
training
and
all
those
things
?
Yes
,
the
doctor
is
,
but
you
know
,
we're
all
.
We're
all
humans
,
you
know
,
and
we're
all
trying
to
do
our
best
and
we
all
have
a
lot
of
different
pressures
on
us
.
And
so
,
at
the
end
of
the
day
,
if
a
doctor
doesn't
seem
like
the
right
fit
for
you
,
it
doesn't
mean
that
they're
a
bad
person
or
a
bad
doctor
.
It
just
means
that
you
should
politely
say
thank
you
so
much
for
your
time
.
I'm
going
to
go
now
.
Speaker 2
37:57
Yep
,
well
,
and
that's
like
.
I
mean
,
this
is
like
after
you've
had
surgery
and
we
talk
about
even
,
like
if
you've
had
one
surgery
and
it
didn't
go
well
,
and
then
you
go
see
a
new
surgeon
and
they
found
all
this
endometriosis
.
Do
you
take
that
paperwork
back
and
say
,
look
,
they
found
this
.
Is
that
part
of
education
?
Because
we
hear
this
all
the
time
.
Right
,
like
we
should
be
part
of
that
change
.
We
should
be
the
ones
pointing
out
the
flaws
,
if
you
will
,
and
I
don't
think
it's
a
flaw
,
I
think
it's
,
it's
an
educational
moment
.
Not
everyone
is
,
you
know
,
too
keen
on
learning
from
patients
,
but
I
do
think
that
that
is
,
if
a
,
if
a
provider
is
willing
to
learn
from
you
,
I
think
that's
a
good
thing
too
,
in
my
opinion
.
Speaker 1
38:40
I
,
I
totally
agree
,
and
I
think
this
is
one
of
those
things
where
,
like
,
some
doctors
are
open
minded
and
some
doctors
are
closed
minded
and
everyone's
going
to
respond
differently
to
that
kind
of
feedback
.
And
you
know
it
has
to
do
probably
with
their
ego
and
their
training
and
their
belief
system
and
what
they
had
for
breakfast
and
how
their
day
is
going
right
,
how
they're
going
to
respond
to
that
.
But
it
doesn't
hurt
them
for
you
to
tell
them
those
kinds
of
things
.
I
think
the
thing
that's
challenging
is
you
don't
know
why
it
is
that
the
doctor
didn't
help
right
or
didn't
do
a
good
job
right
.
Is
it
because
they
don't
have
the
skill
to
remove
all
of
your
endo
?
Is
it
because
they
didn't
have
the
skill
to
remove
all
of
your
endo
?
Is
it
because
they
didn't
even
see
it
?
Or
,
like
,
I
know
a
lot
of
doctors
who
I
actually
think
do
have
the
skill
to
remove
endo
but
they
firmly
believe
it
doesn't
help
.
The
only
thing
that
helps
is
removing
the
cysts
and
removing
any
of
the
other
disease
.
It
doesn't
help
the
patient
feel
better
and
so
we're
not
going
to
subject
them
to
the
surgical
risk
of
doing
it
,
and
so
in
those
cases
the
thing
that
makes
the
big
difference
is
to
say
to
them
,
like
I
went
,
I
had
surgery
,
they
removed
all
of
the
other
endometriosis
and
now
I
have
my
life
back
.
And
you
can
always
frame
it
to
somebody
as
like
it
seems
like
maybe
this
isn't
your
area
,
because
I
went
and
I
had
complete
excision
surgery
with
another
surgeon
and
now
I
can
do
this
and
I
can
do
that
and
I
can
take
a
poop
without
pain
and
my
life
is
great
.
And
so
you
should
refer
to
Dr
So-and-so
next
time
,
because
I
think
your
patients
will
have
a
very
different
experience
.
And
I
will
tell
you
,
as
a
doctor
,
I
also
do
this
.
So
I
had
a
,
you
know
,
and
there's
a
classic
example
.
There's
a
,
there's
an
OB
,
a
general
OBGYN
in
this
area
.
She's
a
great
doctor
.
I
I
would
happily
like
have
her
be
my
,
my
general
OBGYN
.
Speaker 1
40:33
And
I
saw
a
patient
of
hers
and
she
had
had
,
you
know
,
surgery
for
endometriosis
.
It
was
minimal
,
they
did
mostly
ablation
.
Patient
didn't
feel
better
and
then
she
ended
up
,
you
know
,
ivf
cycles
.
Later
she
comes
to
me
and
I
could
see
on
her
MRI
was
red
as
normal
.
I
looked
at
her
MRI
.
I
was
like
right
there
,
you
have
a
nodule
,
it's
on
your
rectum
,
it
needs
to
come
out
Like
you
have
invasive
disease
right
here
.
Speaker 1
40:58
We
went
,
we
took
,
you
know
,
I
did
the
surgery
.
She
got
a
disc
bowel
resection
.
She
felt
like
a
new
person
and
I
took
the
video
and
I
went
to
that
OBGYN's
office
and
I
was
like
,
hey
,
you
know
your
patient
,
so-and-so
,
I
just
want
to
show
you
.
I
brought
lunch
,
right
,
she
knew
I
was
coming
,
I
brought
lunch
.
Let
me
just
show
you
the
pictures
from
her
surgery
.
This
is
what
I
found
,
this
is
what
I
did
,
and
she's
coming
back
to
you
now
for
her
well
woman
care
.
Of
course
,
the
patient
went
back
for
her
well
woman
care
and
felt
like
a
different
person
,
and
now
I
get
referrals
from
that
doctor
all
the
time
.
I
operated
on
one
of
her
family
members
,
right
,
and
so
,
like
there
is
a
change
,
it
is
possible
for
that
kind
of
education
,
both
from
doctors
and
from
patients
,
to
make
a
really
big
difference
.
But
you
know
it
takes
work
.
Speaker 2
41:48
Would
it
be
worthwhile
and
I
just
thought
of
this
Would
it
be
worthwhile
to
ask
your
surgeon
hey
,
would
you
be
willing
to
have
like
a
meeting
with
this
other
surgeon
so
that
we
can
go
over
my
care
or
this
other
provider
to
go
over
the
care
that
you
provided
for
me
,
to
give
them
a
better
picture
?
Is
that
reasonable
or
is
that
kind
of
like
?
Yeah
,
probably
not
.
Speaker 1
42:09
So
it
depends
.
So
I
do
this
anyway
most
of
the
time
,
whether
the
patient
asks
me
to
or
not
.
If
I
know
the
doctor
or
I
have
like
a
contact
thing
,
I
will
reach
out
to
them
and
say
hey
,
I
saw
your
patient
,
I
want
you
to
know
X
,
y
,
z
.
And
I
do
this
the
most
,
I
will
tell
you
with
the
fertility
docs
.
The
fertility
docs
in
my
area
are
some
of
them
.
It's
like
funny
,
some
of
them
,
I'm
friends
with
them
and
so
the
patient
will
be
in
my
office
and
they'll
be
like
well
,
what
do
you
think
that
my
IVF
doc
would
say
about
this
?
And
I'll
be
like
,
well
,
let's
ask
her
.
I
love
that
doc
would
say
about
this
,
and
I'd
be
like
well
,
let's
ask
her
.
And
then
we
make
a
plan
together
,
right
.
And
I
think
that
that's
Checking a Surgeon's Team and Partners
Speaker 1
42:47
actually
like
those
are
the
people
who
get
the
best
care
.
When
me
,
the
patient
and
the
REI
are
all
on
the
same
page
.
We
make
a
plan
together
.
It's
like
,
okay
,
we're
going
to
do
this
,
we're
going
to
do
this
,
and
then
,
like
,
you're
going
to
feel
better
and
you're
going
to
have
a
baby
and
ride
off
into
the
sunset
,
right
.
Speaker 1
43:01
Whereas
there's
other
fertility
docs
where
I'm
constantly
like
you
know
,
I
have
their
address
and
if
you
look
at
our
correspondences
,
it's
just
unanswered
emails
from
me
being
like
I
wanted
to
update
you
about
your
patient
.
So
you
do
that
though
.
Oh
,
I'm
,
I'm
such
a
pest
,
um
,
but
a
polite
pest
,
I
really
.
I
tried
,
I
tried
to
,
you
know
,
I
tried
to
channel
my
sort
of
inner
puppy
.
When
I'm
such
a
pest
,
but
a
polite
pest
,
I
really
I
try
to
.
You
know
,
I
try
to
channel
my
sort
of
inner
puppy
when
I'm
like
,
hey
,
I
just
some
doctors
are
really
receptive
to
it
,
some
doctors
are
not
.
And
there
are
some
doctors
where
I
will
tell
you
I
don't
,
I
do
not
try
,
I
do
not
even
try
anymore
.
I
know
they
don't
want
to
hear
it
,
and
that's
fine
,
you
know
,
and
and
that's
that's
tough
If
a
patient
asks
me
to
,
then
even
if
it's
someone
who's
on
my
you
know
my
do
not
engage
list
,
I'll
do
it
Right
.
Speaker 1
43:49
I
also
,
you
know
,
anytime
I
operate
on
someone
,
I
also
I
have
like
a
very
set
like
.
This
is
how
we
do
it
I
walk
out
of
the
OR
with
a
really
big
stack
of
pictures
and
I
sit
down
with
the
family
member
and
I
make
them
take
their
phone
out
and
they
take
a
video
of
me
going
through
the
pictures
.
This
is
what
it
looked
like
before
,
right
?
And
I
have
a
very
set
,
like
I
take
a
picture
of
this
and
then
I
take
a
picture
of
this
and
right
.
So
I
go
through
all
the
pictures
,
saying
these
are
all
the
before
pictures
,
and
then
I
go
through
the
after
pictures
.
These
are
all
the
same
things
photographed
after
the
surgery
and
that's
yours
,
right
?
And
so
I'm
like
take
this
video
wherever
you
want
,
show
it
to
any
doctor
.
You
see
,
I'm
proud
of
what
I
do
,
and
so
every
patient
of
mine
has
a
video
of
me
like
chit-chatting
with
their
family
going
through
pictures
in
office
,
Like
when
we
are
talking
about
our
care
,
like
do
you
take
surgical
images
?
Speaker 2
44:47
How
many
surgical
images
do
you
take
?
Do
I
,
am
I
going
to
have
access
to
these
images
?
Those
are
all
things
that
you
should
have
access
to
.
But
to
get
clarification
from
your
surgeon
on
because
I
mean
,
I'll
tell
you
I've
had
multiple
surgeons
and
I
don't
have
as
many
pictures
as
I
should
.
And
,
and
I
think
,
if
you
have
to
have
a
follow-up
surgery
of
any
kind
or
follow-up
care
,
it's
really
helpful
to
know
what
people
have
done
inside
your
body
,
and
that
is
taking
ownership
of
your
body
and
knowing
what's
happened
in
your
body
.
Having
those
images
and
having
those
videos
or
whatever
are
very
,
very
helpful
.
So
asking
those
questions
,
I
think
,
is
key
.
Speaker 1
45:24
Yeah
,
I
think
transparency
is
essential
and
it's
funny
there's
transparency
in
sort
of
two
different
senses
,
right
.
One
is
the
obvious
.
Like
I'm
transparent
about
what
happened
inside
your
body
while
you
were
sleeping
.
I'm
going
to
give
you
complete
documentation
,
not
the
op
note
.
Right
,
like
you
get
the
pictures
and
you
get
my
explanation
of
the
pictures
and
why
I
did
what
I
did
,
and
then
you
know
.
Speaker 1
45:46
There's
also
what
Malcolm
Gladwell
talks
about
in
his
book
as
transparency
,
which
is
,
can
you
actually
see
through
the
person's
face
to
see
what
is
going
on
inside
of
them
?
Right
,
because
there
are
people
he
uses
the
example
friends
right
,
like
you
can
watch
friends
with
the
sound
off
and
you
know
exactly
how
everyone
is
feeling
and
what
everyone
is
thinking
based
on
.
Like
you
know
the
way
that
David
Schwimmer's
face
looks
.
Right
,
with
a
doctor
,
you
can't
always
do
that
.
Right
,
because
someone
will
seem
super
,
super
confident
even
if
they
have
no
idea
what
they're
doing
,
and
so
he
gets
very
much
into
ways
to
figure
out
if
someone's
you
know
,
outside
matches
their
intentions
.
And
I
think
that
that's
sort
of
the
really
important
thing
,
and
I
think
that
one
of
the
best
ways
to
assess
that
actually
is
watching
how
they
answer
questions
.
You
know
,
and
I
think
this
is
again
,
once
you've
gotten
to
the
point
where
you
did
all
of
that
vetting
beforehand
,
right
,
you
read
all
the
things
online
,
you
looked
them
up
,
you've
read
their
reviews
and
all
that
stuff
.
If
you
like
what
you
see
,
meet
with
them
.
If
you
don't
like
what
you
see
,
that's
when
don't
go
see
them
,
right
,
like
,
don't
say
,
like
,
you
know
,
I
don't
really
,
they
don't
really
seem
like
they
know
what
they're
doing
online
.
But
I'm
just
gonna
meet
with
them
and
see
you
know
what
,
what
it
you
know
.
Maybe
maybe
I'll
feel
like
I
trust
them
.
If
I
meet
them
they'll
convince
me
.
Otherwise
,
you
don't
want
to
be
convinced
they're
not
qualified
.
You
don't
want
to
convince
you
that
they're
qualified
.
That's
exactly
what
you
don't
want
to
do
.
And
so
I
think
you
know
I
mean
it's
sort
of
like
the
classic
,
like
the
.
Speaker 1
47:21
He
writes
a
lot
about
this
spy
who
people
would
be
like
she's
doing
a
lot
of
things
that
really
make
it
seem
like
she's
a
spy
.
And
then
people
would
meet
with
her
and
be
like
are
you
a
spy
?
And
she'd
be
like
no
,
I'm
not
a
spy
,
no
,
I'm
not
a
spy
.
And
people
are
like
OK
,
good
,
most
of
the
people
thought
you're
a
spy
.
She
was
totally
a
spy
,
right
,
and
so
same
thing
,
right
.
If
they
seem
not
qualified
,
don't
meet
with
them
.
But
then
,
once
you
do
meet
with
them
,
then
you're
looking
for
transparency
in
their
answers
.
And
so
the
classic
example
I
give
I'm
going
to
give
you
three
answers
to
a
question
and
I
hope
that
you'll
see
which
one
of
them
is
obviously
the
most
transparent
,
because
I've
heard
all
of
these
answers
all
the
time
.
Speaker 1
48:04
Patients
ask
am
I
going
to
need
a
colostomy
?
One
of
the
answers
is
I
don't
know
.
Our
imaging
is
really
unreliable
,
so
like
,
it's
not
likely
,
because
most
people
don't
,
but
it's
always
possible
,
right
,
right
,
that's
one
answer
.
Another
answer
is
no
,
you
don't
need
a
colostomy
,
right
,
no
way
,
yeah
,
Another
Right
.
The
third
answer
is
there
are
two
cases
in
which
I
I
need
to
use
a
colostomy
in
my
surgeries
centimeters
from
the
anal
verge
.
Speaker 1
48:34
In
those
cases
,
you
will
need
a
temporary
protective
ostomy
for
eight
to
12
weeks
to
allow
that
anastomosis
to
heal
and
then
your
colostomy
will
be
internalized
.
Based
on
your
imaging
,
based
on
my
ultrasound
of
your
rectum
and
all
of
these
things
,
right
,
I
stratify
you
as
very
low
risk
for
having
invasive
disease
of
the
rectum
within
five
centimeters
of
the
anal
verge
,
because
I
felt
like
I
could
see
the
muscular
wall
of
the
rectum
within
five
centimeters
of
the
anal
verge
,
because
I
felt
like
I
could
see
the
muscular
wall
of
your
rectum
very
well
at
that
level
.
The
other
instance
is
if
you
have
bowel
surgery
and
then
you
have
a
complication
with
an
anastomotic
leak
,
where
you
have
to
be
readmitted
and
in
order
to
allow
that
leak
to
heal
,
you
need
a
temporary
protective
diverting
ostomy
for
8
to
12
weeks
that's
internalized
later
.
In
my
last
100
cases
an
anastomotic
leak
has
not
happened
.
So
it's
possible
,
but
the
risk
of
this
in
your
case
,
even
if
you
need
a
bowel
resection
,
is
very
low
.
Speaker 2
49:37
Right
.
Speaker 1
49:38
Yeah
,
I
mean
,
I
feel
like
those
three
answers
are
really
different
and
I
feel
like
if
you
hadn't
heard
the
third
answer
,
you
may
have
accepted
the
first
or
the
second
answer
,
right
,
right
,
but
the
third
answer
is
the
most
transparent
.
It's
the
like
here
are
the
.
Here
is
here's
my
mental
math
on
whether
or
not
you
need
an
ass
and
an
ostomy
.
Right
,
right
,
it
doesn't
,
and
it
doesn't
matter
what
the
question
is
.
You
could
ask
me
any
of
the
questions
on
those
lists
of
questions
to
ask
your
doctor
,
and
I
mean
,
some
of
them
have
like
a
very
black
and
white
answer
.
Speaker 1
50:13
Do
you
do
excision
or
ablation
?
You
can't
really
expound
like
ablation
doesn't
work
,
so
I
don't
do
that
.
Right
,
but
for
a
lot
of
these
other
more
in-depth
things
,
what
are
you
going
to
do
if
you
don't
find
endometriosis
?
Or
you
know
I
have
a
hypermobility
disorder
?
How
does
that
impact
my
care
?
Any
of
these
things
?
There's
a
lot
of
different
ways
surgeons
can
answer
those
questions
.
Look
for
the
one
that
is
transparent
.
How
are
they
thinking
about
this
,
as
opposed
to
are
they
just
trying
to
answer
the
question
as
quickly
?
Speaker 1
50:49
as
they
possibly
can
to
get
you
to
sign
up
to
have
surgery
or
what
have
you
?
Speaker 2
50:51
Do
you
think
it's
valuable
to
look
at
their
social
media
accounts
?
Because
you
have
social
media
which
,
by
the
way
,
if
you
don't
follow
Melissa
,
you
need
to
,
because
I'm
telling
you
,
I
laugh
every
single
time
that
you
post
something
.
It's
so
funny
and
so
relatable
and
it's
one
of
my
favorite
things
when
you
come
up
with
something
new
,
like
the
home
Depot
one
,
I
was
dying
,
that's
like
four
times
.
Speaker 1
51:13
It
was
so
I
I
have
so
many
stories
for
you
about
I
go
to
home
Depot
a
lot
.
I'm
one
of
those
people
like
I
.
You
know
I
secretly
love
plumbing
projects
,
both
internal
and
external
,
but
I
know
right
.
But
I
have
had
seriously
at
both
in
Home
Depot
and
in
the
garden
center
.
I
get
stopped
all
the
time
wearing
scrubs
and
people
will
be
like
do
you
work
here
?
And
I'll
be
like
no
.
Speaker 2
51:50
Thank
you
,
but
no
.
Speaker 1
51:55
What
is
it
about
me
that
made
you
say
like
,
oh
that
woman
,
she
works
here
.
Speaker 2
52:02
She
works
in
the
plumbing
department
with
scrubs
on
.
Speaker 1
52:06
Although
I
will
tell
you
the
other
funniest
thing
that
happened
to
me
at
Home
Depot
.
This
is
like
a
total
non
sequitur
,
but
I
was
replacing
a
lock
on
one
of
my
doors
and
I
asked
the
man
who
worked
there
,
who
was
like
an
older
man
,
like
where
do
I
find
this
?
And
he
was
like
you
know
,
I
want
this
one
in
this
finish
.
And
we
went
to
that
aisle
and
he
was
like
,
oh
,
it's
up
there
and
you
know
how
it's
like
those
big
stack
things
.
It
was
on
like
the
second
stack
and
and
there
was
not
one
of
those
moving
staircases
in
the
aisle
.
And
he
sort
of
looked
around
a
little
bit
helplessly
and
I
and
I
was
like
was
like
hold
this
.
And
I
handed
him
the
other
thing
that
I
was
,
um
,
that
I
was
holding
,
and
I
climbed
up
the
the
display
,
like
up
the
little
shelf
.
Speaker 1
52:48
I
climbed
up
to
the
second
level
,
I
grabbed
the
lock
I
needed
and
I
climbed
back
down
with
it
and
he
looked
at
me
and
he
said
you
know
,
nurses
can
do
anything
.
You're
like
that's
.
And
I
and
I
said
I
,
I
agree
with
you
,
but
I
happen
to
be
a
physician
,
and
he
goes
oh
no
,
I'm
so
sorry
.
It
was
like
he
knew
.
He
knew
in
that
moment
that
,
like
you
saw
a
young
woman
in
scrubs
and
he
automatically
assumed
,
like
she
must
,
she
must
be
a
nurse
.
And
it
was
one
of
those
,
like
I
could
tell
the
whole
way
home
that
night
he
was
going
to
be
like
I
feel
so
bad
.
Speaker 2
53:31
It
was
very
funny
,
but
it
also
means
that
you're
going
to
age
so
gracefully
because
you
look
so
young
that
you
didn't
it
doesn't
look
like
you
went
through
medical
school
,
right
.
Speaker 1
53:41
You
know
I
,
yes
,
but
like
it
gets
it's
I
get
a
little
bit
weary
with
.
Like
you
know
I
.
I
get
,
you
know
,
called
.
I
get
referred
to
as
the
medical
student
and
the
resident
and
the
nurse
,
and
you
know
the
the
janitor
will
call
as
the
medical
student
and
the
resident
and
the
nurse
,
and
you
know
the
the
janitor
will
call
me
baby
.
I
mean
it's
like
in
the
hospital
,
and
then
people
will
be
like
that's
the
attending
is
her
case
.
That's
,
oh
,
that's
amazing
.
Speaker 2
54:10
Anyway
,
we
digress
back
to
choosing
a
surgeon
.
This
is
what
happens
at
the
summit
.
This
is
why
we
stay
up
so
late
And'm
like
,
okay
,
is
this
,
can
we
verify
that
this
is
actual
good
information
?
And
you
can
do
that
.
You
can
look
at
studies
,
you
can
look
at
verified
resources
and
sources
of
information
and
see
,
kind
of
,
if
they're
saying
the
similar
things
.
And
then
sometimes
you
know
I'm
maybe
a
little
bit
different
in
this
,
but
I
do
write
comments
,
questioning
sometimes
some
of
these
doctors
hey
,
you
said
this
in
this
post
,
what
do
you
mean
by
that
?
Because
that's
valuable
information
.
Speaker 1
55:07
Yeah
,
and
I
think
it
sparks
a
great
dialogue
,
right
,
I
think
that
that's
really
important
and
also
,
I
think
you
know
,
some
doctors
incorporate
patients
into
their
social
media
.
Some
doctors
don't
,
right
,
and
some
doctors
sort
of
present
things
in
very
different
ways
,
and
I
think
that
that's
really
important
.
You
should
look
at
it
.
You
know
this
is
this
is
how
they
conduct
themselves
and
,
as
you
mentioned
,
I'm
the
kind
of
person
who
,
like
my
sense
of
humor
,
comes
through
most
of
the
time
,
even
even
when
I'm
your
doctor
,
obviously
,
like
when
something
serious
is
going
on
,
I'm
not
like
,
but
I'm
but
um
,
at
the
end
of
the
day
,
I
do
.
You
know
that
that
is
,
it's
part
of
who
I
am
.
Speaker 1
55:45
If
that
rubs
you
the
wrong
way
,
I'm
not
your
girl
.
You
know
,
everyone
sort
of
sees
,
sees
different
elements
of
their
doctor
,
whether
they're
incorporating
,
you
know
,
are
they
posting
on
social
media
when
they're
in
the
,
or
Are
they
put
you
know
,
like
all
these
different
things
,
and
then
think
about
you
know
what
your
experience
is
going
to
be
like
as
a
patient
and
some
people
will
be
drawn
to
different
things
.
Like
I
said
,
there's
no
one
right
answer
,
there's
no
one
right
way
to
do
social
media
,
no
one
right
way
to
present
yourself
,
but
when
you're
the
patient
and
you're
looking
for
a
surgeon
again
,
it
tells
you
a
lot
about
who
they
are
Right
.
Speaker 2
56:20
Yeah
,
I
think
it
gives
you
a
good
picture
into
what
it
would
look
like
for
you
as
a
patient
in
that
operating
room
and
as
a
patient
of
theirs
.
But
I
also
think
you
have
to
follow
that
up
,
if
you
go
to
those
providers
,
in
how
you
talk
to
your
surgeons
.
What
are
some
things
that
you
should
be
asking
the
surgeon
in
the
room
to
best
prepare
you
for
your
surgery
?
Speaker 1
56:42
Yeah
,
I
think
Postoperative Management and Support
Speaker 1
56:43
these
are
things
that
are
really
individualized
,
right
,
and
I
tend
,
you
know
,
again
,
I
do
tend
to
struggle
a
little
bit
with
,
like
,
what
are
the
questions
you
should
ask
your
surgeon
,
because
,
again
,
a
lot
of
surgeons
know
what
you
want
to
hear
,
and
this
is
another
thing
actually
.
Again
back
to
Malcolm
Gladwell's
book
.
He
talks
about
how
people
behave
when
they're
interrogated
.
Eventually
,
when
you
interrogate
someone
,
even
if
they're
like
a
really
stoic
person
,
most
people
will
crack
and
they're
just
going
to
tell
you
what
you
want
to
hear
,
Although
he
does
actually
get
into
this
really
interesting
thing
about
male
and
female
prisoners
of
war
and
how
the
female
prisoners
of
war
were
a
lot
less
likely
to
crack
when
they
were
being
tortured
.
And
if
you
torture
the
other
people
that
they're
imprisoned
with
,
the
men
would
like
give
up
national
secrets
to
have
them
not
torture
the
like
female
POWs
.
But
the
female
POWs
would
be
like
go
ahead
,
torture
them
,
you'll
be
fine
,
I'm
not
saying
nothing
.
Fine
,
I'm
not
saying
nothing
,
anyway
,
but
the
point
is
,
you
know
,
with
a
lot
of
these
lists
,
I
think
sometimes
,
like
your
list
should
be
about
you
and
what
your
concerns
are
,
a
lot
of
people
will
go
and
they'll
out
five
different
lists
that
they
found
online
and
they'll
ask
every
single
question
on
the
list
to
try
to
give
their
doctor
,
like
you
got
an
A
plus
.
You
knew
all
the
answers
.
Your
doctor
knows
the
answers
,
and
it's
really
about
how
they
answer
the
question
.
How
do
they
talk
to
you
about
this
,
rather
than
do
they
promise
to
only
do
excision
?
Yes
,
they
should
promise
to
only
do
excision
,
but
it's
more
than
that
.
It's
really
how
much
does
it
seem
like
they
know
about
your
case
?
Speaker 1
58:29
I
think
it's
more
important
what
your
doctor
asks
you
often
than
what
you
ask
them
,
and
you
should
be
watching
them
,
you
should
be
paying
attention
.
Like
,
did
they
ask
me
about
my
bowel
symptoms
?
Did
they
ask
me
about
my
bladder
symptoms
?
Did
they
ask
me
about
my
fertility
goals
?
Did
they
ask
me
about
whether
you
know
if
I
don't
want
children
?
Like
,
do
I
want
my
tubes
removed
?
They
should
really
be
asking
you
about
how
you
feel
and
what
your
goals
are
,
and
then
that
should
lead
to
an
organic
conversation
with
your
doctor
about
,
like
,
oh
,
how
does
this
impact
this
?
What's
your
approach
to
that
?
And
the
doctor
should
be
giving
you
,
like
,
a
thorough
,
well
thought
out
answer
.
Speaker 1
59:05
Why
do
you
remove
the
cervix
at
the
time
of
hysterectomy
?
Here
are
all
the
advantages
to
doing
it
.
Here
are
the
disadvantages
to
not
doing
it
.
You
may
have
you
know
,
you
may
be
worried
about
this
,
you
know
urinary
incontinence
or
prolapse
or
sexual
function
or
these
different
things
Like
they
.
It's
almost
like
they
should
be
anticipating
your
questions
even
before
you
ask
them
.
Speaker 1
59:24
I
believe
that
some
of
the
best
doctors
are
the
ones
where
you're
not
going
to
have
a
lot
of
questions
for
them
,
because
they're
going
to
almost
anticipate
what
your
concerns
might
be
about
the
procedure
that
they're
talking
about
.
And
there
are
times
when
I'll
say
to
a
patient
,
like
,
what
questions
do
you
have
for
me
?
And
sometimes
they'll
be
like
I
don't
know
,
I'm
like
really
overwhelmed
and
I
don't
have
a
question
for
you
right
now
.
And
I'll
be
like
,
okay
,
a
lot
of
patients
at
this
point
in
the
visit
ask
me
about
surgical
recovery
or
they
ask
me
about
this
.
And
they'll
be
like
,
yeah
,
let's
talk
about
that
.
If
the
visit
is
incomplete
and
your
doctor
says
,
do
you
have
any
questions
?
And
you
don't
ask
them
a
question
,
they
shouldn't
be
like
,
okay
,
well
,
call
me
if
you
do
.
Bye
,
right
,
like
no
,
they
should
be
making
sure
that
you
understand
the
whole
care
plan
,
and
so
I
think
that
that's
sort
of
an
important
thing
to
think
about
.
Speaker 2
1:00:17
I
never
even
thought
of
it
that
way
.
I
guess
I
always
.
You
know
,
in
my
mind
I
was
always
like
you
should
go
prepared
,
but
I
mean
you
should
,
but
also
like
you
should
they
should
too
.
Speaker 1
1:00:28
They
should
be
prepared
.
Yeah
,
you
should
be
.
You
should
be
watching
your
doctor
.
It's
again
.
They're
not
there
to
take
a
test
.
They're
there
to
educate
you
about
what
they
have
to
offer
and
how
they
can
help
you
,
and
so
if
they're
not
doing
that
,
then
something's
missing
here
.
Speaker 2
1:00:45
Yeah
,
and
I
also
think
it's
fair
to
ask
them
who
is
working
with
you
,
who's
on
your
team
?
It
sounds
like
I'm
going
to
need
a
Bauer
section
.
Do
you
have
someone
that
you
trust
that
does
that
,
and
what's
their
name
?
I
think
it's
fair
to
ask
who's
going
to
be
in
that
room
with
you
for
surgery
.
Speaker 1
1:01:00
A
hundred
percent
,
a
hundred
percent
.
And
and
you
know
they
should
be
naming
names
right
I
mean
,
when
someone
asks
me
,
who
does
a
bowel
resection
for
you
,
vince
Obvious
,
does
my
bowel
resections
.
He's
.
He's
in
my
practice
.
The
reason
he's
in
my
practice
is
because
he's
really
good
at
this
right
.
We
did
,
however
,
many
bowel
resections
together
before
we
decided
to
be
partners
because
now
we
were
watching
each
other
,
and
same
thing
with
Vicky
.
We
all
have
watched
each
other
operate
and
we
know
how
good
the
other
people
in
the
practice
are
.
Speaker 1
1:01:35
No
one
should
be
deciding
to
be
partners
with
somebody
who
they've
never
seen
operate
.
That
makes
no
sense
.
You
,
as
a
surgeon
,
you're
vetting
your
partners
and
so
you
never
want
the
surgeon
who
is
going
to
do
your
surgery
to
be
like
I'll
call
whoever's
on
call
for
a
bowel
resection
.
I
don't
know
who
that
will
be
on
the
day
of
your
surgery
,
but
like
it'll
be
fine
.
And
yes
,
there
are
times
when
things
that
will
happen
unexpectedly
and
intraoperative
consults
for
whoever's
on
call
do
happen
.
That
does
happen
.
Speaker 1
1:02:05
It's
not
like
you
can
have
,
you
know
,
a
thoracic
surgeon
and
a
diaphragm
reconstruction
person
and
a
general
surgeon
and
a
colorectal
surgeon
and
a
vascular
surgeon
and
a
urologist
and
a
gynecologist
in
the
room
for
every
single
surgery
.
It
doesn't
work
that
way
,
right
,
but
sort
of
knowing
,
like
,
okay
,
who
are
the
other
people
I'm
likely
to
need
and
who
would
that
be
,
and
then
you
know
sort
of
going
from
there
and
again
,
how
does
your
doctor
handle
this
and
part
of
it's
also
where
does
your
doctor
operate
?
If
your
doctor's
in
a
hospital
where
,
like
,
if
they
call
whoever's
on
call
,
that
person's
going
to
be
good
or
they
know
those
people
,
that's
a
very
different
situation
than
you
know
.
They
operate
in
a
place
where
,
like
,
they
don't
have
any
friends
right
.
Speaker 1
1:02:47
Doctors
should
have
friends
.
They
should
have
lots
of
friends
in
other
specialties
.
Speaker 2
1:02:52
Yes
,
and
they
don't
.
You
don't
want
to
have
a
doctor
.
So
,
side
note
on
this
,
I
saw
,
like
this
,
this
doctor
was
doing
a
live
and
I
think
he
was
.
I
don't
know
what
kind
of
doctor
he
was
,
but
he
was
like
cussing
out
his
nurse
for
a
section
.
Speaker 2
1:03:05
It
was
like
something
that
she
couldn't
control
and
he
live
streamed
this
and
I'm
like
,
if
he's
treating
his
staff
this
way
and
the
people
in
the
OR
this
way
,
Does
he
have
your
best
interest
in
mind
?
I
mean
,
we
don't
always
have
access
to
that
,
but
it
was
just
one
of
those
things
that
I
was
thinking
to
myself
.
I
would
never
want
someone
to
operate
on
me
that
treated
someone
else
like
that
.
Speaker 1
1:03:27
Yeah
,
I
think
a
hundred
percent
.
I
think
a
lot
of
this
is
about
the
doctor's
mindset
and
how
,
whether
they're
humble
enough
to
have
friends
because
they
know
they
can't
do
it
all
themselves
.
I
,
like
,
loved
my
medical
school
.
I
think
BU
is
the
greatest
place
on
earth
,
and
my
advisor
,
when
I
first
got
there
,
we
called
you
know
,
hi
,
Dr
Wittsberg
,
it's
nice
to
meet
you
,
blah
,
blah
blah
.
And
he
was
like
you
got
to
call
me
Bob
,
because
I'm
a
big
believer
that
if
some
people
on
a
team
are
using
an
honorific
and
some
are
not
,
that
creates
a
power
imbalance
and
in
the
circumstance
of
a
power
imbalance
,
people
are
less
likely
to
speak
up
in
the
event
of
a
patient
safety
issue
.
This
has
been
demonstrated
.
This
is
not
a
like
.
I
think
there's
data
to
support
that
.
If
the
nurses
and
the
medical
students
are
calling
me
doctor
because
I
insist
upon
it
,
then
they're
less
likely
to
say
hey
,
do
you
see
?
Like
you
know
,
do
you
see
that
over
there
?
That's
concerning
the
doctor
should
not
be
yelling
,
they
should
not
be
intimidating
people
.
They
should
.
They
should
behave
in
a
collegial
way
.
Speaker 1
1:04:31
There's
a
lot
of
hierarchy
in
medicine
and
some
of
it's
there
for
a
reason
,
but
not
the
toxic
kind
.
There's
everyone
.
Any
person
who's
involved
in
patient
care
can
prevent
a
medical
error
.
They
can
,
and
medical
errors
are
a
big
deal
and
they
happen
all
the
time
to
all
of
us
.
Nobody
,
nobody
,
is
safe
from
medical
errors
,
even
with
the
best
surgeon
in
the
world
.
And
so
,
at
the
end
of
the
day
,
like
if
your
doctor
is
treating
everyone
in
a
collegial
way
,
such
that
you
know
,
okay
,
if
someone
in
the
world
and
so
,
at
the
end
of
the
day
,
like
if
your
doctor
is
treating
everyone
in
a
collegial
way
such
that
you
know
,
okay
,
if
someone
in
the
room
is
concerned
and
they
bring
it
up
,
the
doctor's
going
to
take
it
seriously
.
That's
huge
.
Speaker 2
1:05:03
That's
huge
.
Well
,
and
I
also
think
that
that
gives
you
power
in
the
relationship
.
Now
,
I
don't
want
to
say
power
,
but
balance
in
the
relationship
between
you
and
your
provider
,
because
if
you
,
if
they
are
on
a
power
struggle
,
they're
not
going
to
want
to
listen
and
have
you
be
part
of
your
care
,
and
I
think
that
we
need
to
be
the
ones
driving
the
train
in
our
care
a
lot
of
times
.
Speaker 2
1:05:24
I
think
that
makes
a
huge
difference
in
how
we
drive
that
train
,
and
if
we
have
that
co-pilot
or
whatever
it
is
in
a
train
,
I
don't
know
what
it
is
A
teammate
,
have
that
co-pilot
or
whatever
it
is
in
a
train
I
don't
know
what
it
is
A
teammate
Teammate
,
I
think
your
success
is
going
to
be
significantly
better
in
your
care
all
around
.
Is
it
important
for
us
to
talk
to
our
providers
about
other
providers
that
they
work
with
?
Is
that
a
deciding
factor
for
a
lot
of
people
,
as
far
as
like
,
if
you're
having
a
hysterectomy
and
you
have
to
have
a
nephrectomy
?
Speaker 1
1:05:56
You
don't
have
to
have
a
nephrectomy
unless
you
have
cancer
or
a
familial
cancer
syndrome
and
someone
tells
you
you
have
to
have
a
nephrectomy
,
I
think
you
should
get
a
second
opinion
.
That
said
,
it
seems
like
what
you're
getting
at
is
postoperative
management
,
right
,
like
if
you're
having
ongoing
symptoms
after
surgery
,
how
is
your
doctor
going
to
handle
that
and
do
they
have
a
plan
?
And
I
think
that
that
is
.
It's
one
of
those
things
where
it's
tough
,
right
,
because
some
people
do
travel
for
care
and
it's
important
if
someone's
going
to
travel
for
care
that
they
ask
you
about
this
.
But
obviously
there's
more
barriers
there
,
right
.
But
,
for
example
,
in
our
practice
we
have
someone
built
into
the
practice
.
We
have
a
nurse
practitioner
who
focuses
on
hormone
replacement
therapy
,
hormonal
suppression
for
people
who
need
it
,
a
lot
of
sex
medicine
,
right
,
sexual
pain
,
that
kind
of
stuff
Final Advice on Finding the Right Fit
Speaker 1
1:06:48
,
and
then
just
a
lot
of
the
non-surgical
elements
of
pelvic
pain
,
and
we
have
her
there
specifically
for
this
reason
.
Not
only
is
she
more
available
than
a
surgeon
to
help
patients
with
this
on
an
ongoing
basis
,
she's
actually
better
at
it
.
Like
,
at
the
end
of
the
day
,
like
I'm
a
big
believer
in
staying
in
your
lane
If
a
problem
is
not
surgical
,
someone
who's
not
a
surgeon
is
often
the
best
person
to
deal
with
it
.
Speaker 1
1:07:12
And
so
often
when
people
go
to
the
surgeon
,
the
patient
will
say
I'm
still
having
symptoms
,
and
the
doctor
will
be
like
well
,
I
guess
you
failed
surgery
.
And
it's
like
no
,
you
failed
surgery
,
like
get
out
of
here
,
right
,
and
sometimes
the
answer
is
like
no
.
Pelvic
pain
disorders
are
like
bananas
.
They
often
grow
in
bunches
and
so
the
right
answer
is
like
okay
,
we
fixed
this
element
of
it
,
what
things
might
remain
that
can
be
treated
to
actually
get
you
feeling
better
,
and
who's
the
right
person
to
quarterback
that
part
of
your
care
?
Because
often
the
answer
is
the
surgeon's
not
the
best
person
for
that
.
Speaker 1
1:07:45
And
it's
OK
for
your
surgeon
to
not
be
everything
.
You
know
everyone
and
everything
for
your
care
Right
,
and
I
don't
think
it's
wrong
.
But
your
surgeon
should
have
a
plan
.
They
should
have
somebody
where
,
like
this
is
the
person
that
we
have
available
to
you
to
manage
this
on
an
ongoing
basis
for
you
.
And
sometimes
if
you
travel
for
care
,
then
if
they
have
that
person
in
your
practice
,
for
example
,
with
us
,
you
can
see
that
person
in
consultation
and
then
you
can
do
telemedicine
with
them
going
forward
,
because
you've
met
them
and
there's
so
many
murky
laws
around
telemedicine
,
but
at
the
end
of
the
day
,
like
often
,
doctors
can
have
a
plan
for
this
if
you
ask
them
.
Speaker 2
1:08:38
Are
there
any
other
pieces
of
advice
or
tidbits
that
we
can
take
away
to
help
us
navigate
finding
the
right
surgeon
or
provider
for
us
?
Speaker 1
1:08:43
I
would
say
you
know
,
this
is
one
of
those
things
.
Again
,
go
through
all
of
these
different
things
.
Look
at
the
objective
things
.
If
the
objective
things
don't
add
up
,
then
you
meet
them
.
If
you
meet
them
and
your
gut
tells
you
something's
not
right
,
listen
to
it
.
You
need
to
feel
like
you
have
a
therapeutic
bond
with
your
doctor
and
so
,
at
the
end
of
the
day
,
I'm
not
the
right
doctor
for
everybody
and
I'm
okay
with
that
.
Look
for
someone
who
is
the
right
doctor
for
you
.
We're
all
you
know
everyone's
looking
for
something
different
when
they're
seeking
care
and
it's
okay
to
listen
to
that
feeling
.
Be
like
you
know
what
they're
really
qualified
,
but
something
about
them
rubs
me
the
wrong
way
.
You
can
find
another
really
qualified
person
to
see
.
Don't
trade
the
qualified
person
for
an
unqualified
person
who
seems
really
nice
Please
don't
do
that
.
But
you
can
find
a
different
really
qualified
person
who
you
vibe
with
Right
and
that's
who
you
should
go
with
.
Speaker 2
1:09:41
Yeah
,
and
these
are
all
things
that
I
think
we've
heard
like
the
general
answers
,
but
these
are
also
tangible
things
that
we
can
do
to
find
a
really
good
provider
for
us
.
But
it
is
going
to
take
a
little
bit
of
work
.
If
you
want
quality
care
,
I
think
we
have
to
put
the
work
in
,
unfortunately
,
to
find
that
.
But
,
that
being
said
,
you
have
created
a
document
where
people
can
take
this
and
kind
of
go
down
the
list
and
it
kind
of
explains
different
pathways
to
figuring
out
if
someone
is
the
right
provider
for
them
.
So
everything
that
we've
talked
about
today
,
you
have
been
amazing
to
put
into
a
form
that
people
can
take
and
they
can
fill
it
out
for
themselves
so
that
they
can
just
map
out
their
plan
and
map
out
their
provider
to
figure
out
who's
best
for
them
.
So
thank
you
for
doing
that
.
I
will
put
that
on
my
website
.
I
will
put
that
on
the
bottom
of
this
description
of
the
episode
so
you
can
find
it
there
as
well
.
Speaker 2
1:10:38
Last
,
pieces
of
advice
or
pieces
of
wisdom
that
you
would
want
to
bestow
on
someone
.
What
would
it
be
?
Speaker 1
1:10:49
I
would
say
if
you're
not
finding
what
you're
looking
for
,
keep
looking
.
There
are
people
out
there
who
can
help
you
.
Don't
settle
yeah
.
Speaker 2
1:10:59
And
then
also
go
follow
Melissa
on
her
Instagram
,
which
what
is
your
handle
?
This
is
Dr
Melissa
McHale
.
I
didn't
have
,
like
a
creative
thing
.
I
couldn't
do
it
.
The
creativity
is
in
the
posts
.
Okay
,
I
try
.
They're
so
fun
and
and
so
I
think
that
it's
good
to
just
laugh
in
this
disease
because
it
can
take
a
toll
.
So
I
appreciate
when
,
especially
,
doctors
come
with
humor
.
I
don't
know
why
it
just
brings
so
much
joy
to
me
.
So
thank
you
for
doing
that
and
thank
you
for
taking
the
time
to
do
to
sit
down
with
me
and
to
go
over
all
of
this
and
to
make
a
sheet
for
us
to
learn
more
.
This
is
going
to
help
so
many
people
who
have
felt
like
maybe
some
of
these
answers
weren't
answered
before
.
Speaker 1
1:11:44
There
you
go
,
so
thank
you
so
much
for
for
doing
yeah
,
thanks
for
having
me
,
thanks
for
having
me
.
This
was
,
this
was
great
yeah
.
Speaker 2
1:11:51
You're
welcome
back
anytime
.
You're
welcome
to
sit
with
me
at
the
table
.
Oh
,
be
careful
I
know
it
could
be
really
random
.
Honestly
,
with
my
ADHD
,
we
could
have
a
great
time
.
Until
next
time
,
everyone
continue
advocating
for
you
and
for
others
.