AHLA's Speaking of Health Law

After Dobbs: The Impact on Providers and Women’s Health

August 30, 2022 AHLA Podcasts
AHLA's Speaking of Health Law
After Dobbs: The Impact on Providers and Women’s Health
Show Notes Transcript

Providers and women face an uncertain landscape in the post-Dobbs health care system. Delphine O’Rourke, Partner, Goodwin Procter LLP, speaks with Dr. Somi Javaid, Founder, HERmd, about the impact of the Dobbs decision on providers and the future of women’s health. They discuss the unanticipated impacts on women’s access to care, what lawyers can do to help providers navigate the confusing legal environment, insurance coverage and supply chain concerns, and gender disparities in health care. Dr. Javaid is a leading women’s health expert and board-certified OB-GYN.

Listen to all of the episodes in AHLA's "After Dobbs" series here

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Speaker 1:

This episode of ALA, speaking of health law is brought to you by HLA members and donors like you for more information, visit American health law.org.

Speaker 2:

Welcome I'm Delph O'Rourke partner with Goodwin and lead of our women's health and wellness industry practice. And it is a privilege to welcome Dr. Somi Javi to our podcast today, Dr. Javi is a leading women's health expert. She's a board certified OB GYN and is a thought leader and nationally known internationally known, um, because patients come to her from around the world, uh, and for women's health, generally with a focus on menopause and sexual wellness. So it is a real pleasure to welcome Dr. Jaine and have the opportunity discuss the impact of jobs or post row world on providers who are not only treating patients day to day, but also have a macro perspective on the future of women's health. So thank you, Dr. Jaine, that'd be great for listeners. If you could just share a little bit more about the work that you're doing and that her MD is doing, you are the founder of Herm D and it is expanding, um, uh, dramatically and serving women all over the country. So, um, would be great to hear more.

Speaker 3:

Thank you so much for having me today. I'm always so excited Delphine when you and I get to chat. And so, as Delphine mentioned, I'm a practicing OB GYN. My name is Somi Java. I have been practicing for 20 years. Um, I started a practice in Cincinnati, Ohio called her MD, and it was focused on, uh, sexual health and menopause, but also everything, um, bread and butter gynecology. We were started with the mission of empowerment education and could see, and really wanted to subspecialize in menopause and sexual healthcare. I had witnessed for years, um, women repeatedly being dismissed at the hands of their healthcare providers and being lost in the greater, um, hospital systems. And I truly wanted to create a safe space where women would feel empowered, feel visible and be partners, um, in their healthcare, um, decisions. And so you're right. We successfully went through a series, a fundraise, um, and we are now expanding our footprint beyond our two existing clinics in Ohio and Kentucky into Indiana and Nashville and New Jersey and California, and many more states to come.

Speaker 2:

Let's talk about the unanticipated impacts. There's been a tremendous amount of coverage on how is it going to, how, how is the, um, Supreme court decision and the triggering laws, the laws and restrictive abortion laws are gonna impact abortion providers, both in, in person and medicated abortion. Let's talk about women's health beyond, you know, and, and whether it's contraceptives or IUDs, or just a chilling effect on women's willingness to access primary care. Love to hear it from you as a provider in the women's health space. Who's also a thought leader nationally and globally.

Speaker 3:

I was so shocked, um, you know, about all of the unknown, um, complications, outcomes and things that are occurring, um, because of jobs and what happened. Uh, I think that things were definitely not thought through. Um, and I think we're experiencing, you know, the full fallout. And so for us at her MD, you know, we don't perform medical or surgical abortions, but we definitely provide contraceptive care and just starting there Delphine, uh, I've seen it on social media. I've heard from patients that, um, pharmacists are sometimes reluctant to fill even regular birth control. Um, and, uh, and then also, you know, there's a concern about plan B and confusion about is it plan C. And so, you know, plan B is what everyone knows is the morning after pill. It has the same active ingredient in any as any of the IUDs that contain medicine. Um, and so, you know, some states, I know we're targeting even plan B and plan B primarily works, um, the same way that oral contraceptive does by stopping, um, ovulation. Now it does also inhibit implantation. It depends on, you know, where it's taken in the cycle. And so I think that was the great debate that I wasn't expecting. You know, everyone being able to define when life begins, whether it's at the moment of, you know, conception where sperm and egg meats, or whether it's implantation and then trying to take the stance that well, anything that stops implantation is therefore not birth control, but an abort patient. And, you know, um, that's not true medically. Um, and you know, I know that some states we're talking about Ella and Ella is another, um, type of plan B. It's a, um, an emergency contraception option. That's how we talk about it now, very different from plan C, which is a combination of two medications, which does lead to a medical termination. Um, you know, and think, I think the fallout aside from oral contraceptive and plan B, um, I was shocked, you know, that I saw two legislators, um, debating about IUDs and whether they are abort of patients, definitely it was an old fashioned way to perform an abortion when you placed an I U D in a pregnant uterus, but IUDs that are, um, containing hormone work in a multitude of different ways. They Stu sperm, they thin the uterine lining. They stop the fallopian tube from working as a conduit and bringing egg and sperm together. They do sometimes stop ovulation, so no different than an oral birth control pill. Um, so I was shocked about that. I was shocked when my colleagues were reaching out to me and talking to me about the fact that they were waiting for, uh, women who had ectopic pregnancies. So a pregnancy, right, that is not within, uh, the uterine cavity that may be sitting on an ovary or a fallopian tube or in the abdomen that they were waiting. So these are not viable, right? Delphine, they, they are not viable. They are actually the leading cause of maternal mortality in this country. And so we are risking a living, breathing, human being because some hospitals were so concerned about dos and what happened and the legal implications, or they didn't understand dine were not lawyers. And so they were told that until the patient becomes medically unstable, you are not going to operate on this ectopic pregnancy of hers. And all of a sudden you're taking, you know, minimal risk of surgery and creating a much greater risk for the patient. And the poor provider is they are sitting thinking, I can't deliver the care. I want to also worrying about malpractice. And so you can imagine the conundrum that this has put a lot of physician surgeons anesthesiologists in. Um, and then one more thing at our own practice. You know, there's a drug called Meza protal. It's used for stomach ulcers. It's used to induce labor. We use it to make I U D insertion more comfortable. We had pharmacists refusing to fill it, um, and asking our patients why they were getting it. And so we've had to change operationally with our patients permission, and we actually have to put on the prescription that the patient is getting an I U D. Um, and so it's, it's pretty insane. Uh, the things that are going on on the day to day basis in the gynecology world.

Speaker 2:

So there's a lot there that I'd love to unpack because our audience are mostly lawyers. And this is where we have an opportunity to support providers, to support patients, to support the national dialogue in explaining what the laws require, at least to the extent that we can, because there's, there's still a lot of confusion and vagueness. Um, because what I'm hearing is that providers, whether it's the pharmacist, whether it's the physicians. Um, and I imagine there are many other providers in the health system who are left to interpret what the law may be. And when I say the law, it's, it's really, it's not just one law, it's a Supreme court decision, and then every triggering state. And again, not that doesn't, it doesn't even end there. What is the interplay between, between state regulations? I mean, you brought up the issue of conception, um, even how is conception defined? You use the term viability, which is a medical term that is no longer central to the legal conversation. So it seems like you are, you in a global sense are in a position now put into a position where you have to interpret the law to make your medical decisions. And what I'm also hearing and I've heard from many others is that there is a fear, understandably it can be medical malpractice, or it could be criminal exposure. Uh, the Texas that has a, you know, long arm, there's a private right of action, where it could be an individual who's pulling you into a lawsuit or based on this aiding and Abett concept. Um, so from a provider, what would be helpful? What could we do, whether it's as an organization or for the public, or maybe it's the, you know, medical associations to help providers? What can we all do, particularly those of us who work with health systems and physicians to help you and your colleagues navigate all of this.

Speaker 3:

I think breaking down legalese into everyday pros so that it's digestible and understandable much akin to when a physician breaks down a medical consent for a patient, you know, will use an anatomically correct, um, nomenclature, but we will explain things to them much differently than we would a colleague. And so when I'm speaking to lawyers and legal teams, I always ask them, I, you know, I'm not a lawyer. You, you need to please break this down for me, um, so that I can understand. And so I think, you know, there's so much gray for us. Uh, we're asking you to get rid of the gray<laugh> and make it as black and white, as you can given, you know, the laws in those individual states, so that we're not sitting there waiting to operate on a patient and wait for them to actively start dying. That we are able to take care of, um, ectopic pregnancies, that our patients can get the medications that they need and deserve. Um, and that they're not turned away. And I think the other thing that would really help is helping physicians and providers understand their rights. If we feel like someone's life is in, um, peril, you know, can we act sooner or are, are we obligated to wait for the hospital legal team or legal decisions? Um, so I think those two things breaking it down and then making it clear as to what we have autonomy over when, uh, regarding medical decision making for our patients.

Speaker 2:

There's so much there, that's practical, that's actionable, whether those are conversations with the medical staff, whether it's the MEC that has those conversations, whether it's the pres there's so many different formats, but to your point to get it down to really granular level, this is what you can do. This is what you can't do. If you have questions, how long do you have to wait? Now, an issue that I've been hearing is, is physicians who are maybe credentialed or who are credentialed in two states and are concerned that if they perform, um, you know, let, let let's use the adopted pregnancy example. If it is legal in one state where they are credentialed in practicing, but illegal in another state, um, what's their exposure. Could they lose their medical license in the restrictive state? Do they have an obligation to report? Could they impact, um, their licensure and ability to practice in the less restrictive states? I mean, there's so many issues that really hit, um, you know, really at the heart of physicians', um, ability to, to practice medicine. And, you know, we're also seeing, you know, there's Texas representatives who, who are targeting a, a law firm in Texas. So, um, as well as Lyft, you know, and saying that they were, um, that their support for employees, uh, was a, I think it was egregious violation. Don't quote me on that one of their shareholder responsibilities. So these attacks on again, law firms, physicians, large corporations are, are creating widespread fear. Are, do you, are you hearing your colleagues or just within your network conversations about insurance coverage? That's a question that I've been getting, is there a way to ensure against some of, um, some of the risk associated it could be beyond medical malpractice?

Speaker 3:

I haven't heard any pushback about whether or not, um, patients, colleagues, or providers are worried about insurance coverage, um, regarding some of these issues. I definitely have though engaged with like, uh, a company called, um, favor they're one of the largest online, uh, retailers of oral contraceptive plan B because we are preparing for problems with accessibility and then co cost if it's not covered. Um, and so what they companies like favor have done have made it very accessible, but also have negotiated really, really low rates, even self pay rates for these medications, so that if something does happen with coverage, that patients will likely still be able to afford their medications. And so I know that practices like mine that, uh, practice across multiple states, you know, as telehealth is, uh, more and more popular, um, we're finding ways to ensure that our patients will not, um, meet any further barriers, um, than need be.

Speaker 2:

What about supply chain? I mean, we've heard about, you know, immediate rush on contraceptives, um, on, on other prescriptions, do you have concern we're putting, separating the issue of whether or not you can access contraceptives, but a supply chain concerns. Are you hearing anything about those and do you have those concerns? You know, you just can't get, you know, again, can't get contraceptives, um, when they're necessary for treatment of uterine fibroids, cause they're just not manufactured.

Speaker 3:

No, I'm very worried about a lot of the medications. Um, we, uh, you know, the company, I mentioned favor who, um, deliver plan B and contraceptives, they saw a 5000% increase in demand for their services right after this announcement was made. Um, we, um, are seeing a tampon shortage as well, um, in regards to this. So yeah, for sure. I think we're gonna see issues, um, with, uh, pharmaceuticals with products specifically in the female healthcare space. Um, I'm very concerned about that. I know that people were buying up things, uh, people are trying to keep their cycles, um, very private. I think we're gonna be in trouble with pregnancy tests. I can see a lot of issues, um, with supplies and, um, women not being able to have access to what they need. So

Speaker 2:

Let's a lot there, incredibly valuable. Um, we're talking about women's health, there's an impact beyond, um, what, you know, part of what we're already seeing data around is women's reluctance to go to their primary care physician, for example, um, out of just a, you know, a general concern, no, one's quite clear what's happening with their, with their information. And that could be, you know, a primary care exam or an annual exam where you also get a mammogram or where cancers could be detected or, and because of a concern, particularly among, um, communities that, you know, historic mistrust of the healthcare system, if you're concerned that your physician is now gonna hand over, um, rightly or wrongly the concern, but if you hand over your medical information to law enforcement, that's having a chilling effect on women accessing care overall for variety of different conditions. What, what's your reaction to that?

Speaker 3:

It makes me so angry for patients that they have to live in fear, and it may prevent them from, let's say getting a mammogram because no, one's gonna proceed with the mammogram, unless you have a patient declare they're not pregnant, right. You're not gonna take them in for unnecessary radiation. And so I have had so many patients share with me that other than their gynecology office, that they're not going to be offering up any information about their menstruation or, you know, their sexuality and the thing for me too, as a gynecologist Delen, um, menstruation is another vital sign. You know, it, a healthy patient's menstruate, uh, menstruation can give us so much information about what's going on in the body. And if, um, patients are afraid to share this knowledge and this information, um, rightfully so, right, they're scared. They don't understand. Um, then it's gonna lead to some delays and care potentially diagnosis and some barriers as well. Um, so it, it, it really number one as a healthcare provider angers me, but, um, as a woman, it infuriates me

Speaker 2:

As a health system. We've been moving aggressively towards preventive care, you know, for, for so many different reason. Um, and, and this seems like the unintended consequence is a move away from preventive care. And we're also seeing some other attacks on the ACA and coverage of preventive care for both men and women. And this is interesting. It's coming at a time when in, in 2022, we saw UN unprecedented investment in the women's health and wellness industry, whether it was digital apps or direct services, um, counseling, telehealth, psychiatry, just across the board, uh, women control, you know, say their chief medical officers and chief financial officers of the home making decisions, medical decisions, not just for themselves, but for their family members, their kids, their significant others, their parents, et cetera, uh, as well as driving consumer decision making. So, and in the, in the health community, we've always known that labor and delivery was one of the key times when women start engaging with the, with the, uh, health system and then developing a relationship with that health system for their entire lives. Um, so it's interesting that this decision is coming down at the same time that we're seeing such an explosion of, you know, growth and solutions and demands made by women who are saying, I don't want the care that I've received. I, I want delivered to me differently. I want it like many other groups saying, you know, we talk about putting in the patient at the center. Um, and, and historically that hasn't always been the case. Um, and also seeing a trend in love to hear about this from you on this point. And I see it from the founder perspective, I see it from what investors are looking at is women saying the fact that it impacts the quality of my life is sufficient to require a solution. The standard of well menopause isn't gonna kill you is, is no longer the consumer standard. And I mean, you're such a trailblazer in this area, you know, talk to us about the growth in the menopause market and how health systems can really partner with innovators and, and providers like yours who have the specialization. Cause that's one of our barriers we don't have enough providers were trained in menopause, um, to really move the needle on women's health.

Speaker 3:

Yeah. You know, um, I've done a lot of consulting. I sit on a lot of, uh, pharmaceutical, um, and product advisory boards. I teach physicians, I talk to patients and, you know, it drives me insane when an answer to, why do we not have funding? Or why are women still underrepresented in, in every single clinical trial? Or why are people, um, not giving, um, fem tech and female innovators enough money? Like yes, last year was great. It was record break. Um, but it's, it's just the tip of the iceberg of what's required. Um, because unfortunately, and I'm not saying, I'm gonna say this right now, men deserve all the medical care, all the funding, all the research they have, all I want is equal access for women for the same clinical trials, for the same funding, for the same options. Um, because for far too long, there's been two great of a gender disparity and this, you know, notion that if it's not gonna kill her, then we don't have to investigate it or study it or fund it. And it's crazy because half the world's population, if they're lucky enough to live long enough are gonna go through menopause and menopause affects women from head to toe, whether you're talking about cognitive decline and not being able to, um, you know, function in the workspace, right. When they're getting to the C-suite or maybe the top of their career, like you and I both saw the articles and the headlines last year, 900,000 women left the workforce in the UK due to undiagnosed or untreated menopausal symptoms. You know, there's change in sex drive. There are problems with incontinence. I've had patients thought they would have to leave the workspace because they were dealing with incontinence and they were embarrassed, or they were having hot flashes. I've had news anchors come to me and say, they're, they're sweating profusely on TV and they don't wanna live this way anymore. And so, um, menopause is so much more than a hot flash. It impedes cognitive ability. It leads to anxiety and depression. It can cause great problems in a relationship because there can be loss of intimacy and loss of desire. It can negatively impact self-confidence. It can lead to weight, gain and changes in skin and joint pain, and can really inhibit, you know, a woman's ability to enjoy her family, to work, to have a, a satisfying relationship. And as you mentioned, that women are the CEOs of their families, they are the decision makers. And so to say, yeah, you know, maybe for the next 35 years, you know, cuz life expectancies are getting longer in this country. You're just supposed to live this way. And so, you know, what hospital systems and, um, employers, um, can benefit from I with, uh, you know, adopting menopause care or menopause solutions or partnering with a company like her MD is number one education, right? Answering all those questions for those patients. Um, number two, providing them with menopause experts, um, less than 20% of OB GYNs are comfortable even discussing menopause. Um, less than 30% of us actually get formal training in these area. That's crazy to me. Um, and the third thing is, um, and talking to a lot of hospital systems found out that a lot of the schedules are filled with pregnant patients because there need to be seen on such a frequent cadence. And so a lot of times their menopause patients or their GYN patients wait 30, 60, 90 days to get on the schedule and because of telehealth. And because we don't see pregnant patients, we're able to take on a very high volume of patients per provider, which is very different, cuz our schedules aren't filled with those weekly OB appointments. So we're usually able to get a patient in within, um, two to three days. And so you don't have lost work time. You don't have undue suffering, you have improved, um, quality of life and patients feel educated and empowered, um, about their bodies and are understanding that they don't just have to grin and bear it.

Speaker 2:

So we're also saying that this isn't just about healthcare. I mean, when we talk about the employer conversation, then it's every employer, um, who has a population or as of, of employees who, who are experiencing not just menopause, but perimenopause postmenopause the, a lot of people don't appreciate that perimenopause can, um, you know, begin in your twenties and your thirties. So you're really looking at your entire workforce. And you mentioned the UK, which is far ahead of us in their, in their policies and practices. And there are very significant international multinational companies in the UK that now have menopause benefits for their employees. And I very much hope that that's the direction that employers in the us will go towards recognizing that if you wanna have, uh, gender equity or come close to gender equity in the workforce, you need to, to protect and address the underlying health issues. Uh, the other aspect, which is the flip, I mean, we, you mentioned health equity, we need gender equity. Um, we know that, you know, whether it's abortion or, um, a lot of the inequities, when you add a racial component to it, women are again disproportionately impacted and women, um, who are black and brown. Um, you know, it becomes the, the, the aggregated impact becomes so acute that it can be measured in life expectancy. It can be measured in, um, you know, heart health, et cetera. Talk to us about that because I think that's part of the conversation that is sometimes difficult to have and say whether it's dogs or lack of research or lack of funding, once again, it's women of color who are

Speaker 3:

Gonna be yeah. You know, so Delphine talk about pulling at heartstring. So you know, that I went into, um, women's healthcare because I nearly lost, um, my mother at the age of 45. Um, so I am, you've probably guessed from my name. Um, I'm not, uh, Caucasian, I'm a minority. Uh, obviously my mother is as well. My mom's Pakistani and, um, you know, she was repeatedly dismissed at the hands of her healthcare providers and at 45 years old, it nearly cost of her life. She had an abnormal EKG and, um, kept being told, well, women's EKGs look different, or she was patted on the head and told, you know, maybe she needs to cut back on her caffeine and intake. And, you know, she had shared with them that her mother had died at 50, that she had lost a sister in her forties due to cardiovascular disease and, and science and data at the time just could not explain why a thin non-smoking 45 year old woman would ever present with four vessel disease. You know, she ended up finally getting, um, diagnosed and treated and is alive to this day. Um, but there was a very eye-opening study that women are much more likely to die from their cardiovascular disease, um, due to dismissals at the hands of their healthcare providers. And when you add those metrics of being, um, minority woman, uh, it's why, you know, fibroids, for example, very passionate about my fibroid, uh, patients in the work. I, I have partnered with a advocacy group called the white dress project. And, you know, for years fibroids affect, uh, 90% of, um, black women. By the time they reach the age of 50. And so disproportionately affect minority women. And for years, we saw very little progress with innovation, minimally invasive treatment options, medications, research funding, um, because you heard things like, well, no, one's gonna die from fibroids. What you actually can if you become so profoundly anemic. Um, but what was so eye-opening to me was listening to stories, um, of women losing their relationships because, you know, fibroids can lead to infertility, uh, horrific pain. Uh, so they don't wanna engage in intimacy, anemia, repeated transfusions. Um, so fibroids, um, are just one example and the lack of innovation in the space of how we are creating even a more barriers to care. Um, for minority women, you combine that with provider bias, lack of funding, underrepresentation, um, with decision making, uh, and in clinical trials. And it's a disaster in the making.

Speaker 2:

So I'll add one more layer, which is reimbursement or paying, you know, for, for some of the treatments out there, they are, you know, cash pay and some women are able to pay for them. Some insurance covers certain treatments, but when you look overall at reimbursement for women's health, um, again, an area for opportunity, um, whether it's Medicaid or Medicare or private insurers, give us your perspective and what you think would be really impactful again, um, to move the needle on access because you can have great care, um, available, but if you can't pay for it, we know we know the cycle and again, it, it disproportionately impacts the same communities over and over. And, you know, we, this could be linked to a conversation around maternal health outcomes in the us, uh, both maternal deaths and, and morbidity. And we see the same cycles, you know, the same black women are three times as likely to die. Um, Latina mothers, similar similar rates. How do we break this cycle overall? Not just about, I mean, it's, it's a it's along the continuum and get more reimbursement, um, shift, possibly reimbursement from, from other areas. I mean, you're in it. What would be your recommendation? We might have members in this audience who are part of the organizations who, who look at C P T codes and other reimbursement structures.

Speaker 3:

So I think the first thing that needs to change, because you've got a nerve there, two Delphine, because I'm in it right now with insurance companies. And I've explained to you how long we spend with our patients and our care delivery model. And, um, our rates of reimbursement are not great when you compare them just to national average. And, you know, it's because I started as an individual owner and they're, they, insurance companies have way too much control over what they can reimburse. And so for the same surgery or the same visit, it can be astronomically different what they pay someone. And so that really then, um, deteriorates our healthcare system because the providers who are on the low end of reimbursement, are they gonna fill their schedules? And they're gonna try to see 40, 50 patients a day to make the same amount of money that maybe another provider down the street only has to see 20 patients. So physician burnout, it leads to almost a 30% plus increased risk of medical error. Um, those patients then are deprived of time, right? 10 to 15 minutes to discuss your entire medical history, get a physical exam and a treatment plan. I don't think so.

Speaker 2:

Let's screening preventive screening. That's a conversation that I hear, you know, we're very focused on mammograms on, on pap smears. What about other screening? And I know we're going, we're sort of going off topic, but, but it's all related. I mean, are there certain areas we're saying, you know, if this was recorded and we had more cervical cancer screening, um, and, and, you know, pretty soon we're gonna be able to have cervical cancer screening, uh, reliably at home, but are there certain areas where you're saying, you know what, we could move this out of a, a provider setting and really increase outcomes, decrease costs and have an impact. And again, free up time if you're not doing cervical cancer screenings, they're at home, you have more,

Speaker 3:

No, there's so many things I'm, I'm seeing, you know, being part of this, um, cohort of innovators and entrepreneurs. Uh, you know, I get to hear about the latest, greatest fem tech. And I'm so excited about the things that are going on. Um, whether it's, you know, pelvic floor physical therapy options, you know, um, that are online or a smart vibrator that can actually teach a woman about why she may be having sexual issues. Um, it's amazing to me and some of this at home testing that can help women monitor whether it's sugar levels, whether it's their hormone levels, their, you know, the rings, we've seen them that take care of, uh, you know, measure so much data. Um, I think there's gonna be a lot of room to combine these technologies with, um, in person visits at a less frequent cadence and, um, move to preventative medicine. I think that's been the problem for a long time in the United States is we chase disease. You know, there's a test that we offer, um, at her MD it's called gallery and it tests, uh, for over 50 types of cancers. And over half of those cancers at tests for there's actually no screening tool, um, for, in this country. The problem with gallery though, is that it's exceedingly costly. It's, uh, over$800 per patient. Um, you know, patients can use FSA and HSA. Um, but you know, I wish that those kinds of things were accessible across the board, or at least covered cuz wouldn't an insurance company rather pay for that than pay for, you know, repeated treatments of a stage three cancer. Um, wouldn't they want to see their subscribers live and not get that cancer. Um, cuz you can change that person's life forever in a very positive manner. If you're able to find a cancer at stage one for cancers that are typically found stage three and stage four. And so these are the kinds of things that I would like to see become more accessible and affordable. And also for physicians, sometimes we're a little nervous, um, to adopt change or new technology, but for, for physicians to have an open mind and understand that they're not being replaced by technology, but it's gonna enhance their ability to diagnose, uh, treat and intervene for their patients.

Speaker 2:

The health system is part of that conversation. Um, and, and you see certain health systems that are really leaning into innovation, really leaning into women's health and seeing that there's such opportunity, there's such white space, uh, for improvement. What do, how do you think it's gonna impact women's health over the next six months year? Is it, is it gonna bring more attention to the causes? Is it going to in certain ways like COVID did shown wow, you know, there's some real gaps in care, hospitals need more reimbursement. Is it gonna shine a light on the gaps that are existing and help improve the conversation and the action and the care that women

Speaker 3:

Connect? You know, if I wasn't in the middle of fundraising, I'd tell you, I wish I had a crystal ball, but I've seen this as a rally cry for, um, investors. Uh, you know, a lot of them made the decision last year and the years proceeding that they were finally going to make an investment in the female healthcare space. Um, this has brought a lot of the investors to the table, even in this market. Mm-hmm,<affirmative>, we're kind of on the fence about women's healthcare. Is it a niche? You know, is it just something transient? Um, but it's been a rally cry almost. And what you're hearing from them, um, even if they're male is they have a sister or they have a daughter, you know, they have a wife and they just can't bear to think that they're not helping. And so I think, yes, it's gonna shine an even bigger spotlight on this women's healthcare revolution that is finally, finally here. So I am really, really excited to be at the table with fellow, um, entrepreneurs and innovators and people like you, Delphine who are at the forefront. Everyone has their areas of expertise. Um, I'm so excited to be talking to all these investors who are just as excited now as the, um, founders about women's healthcare. And so I don't think we're gonna take this lying down. I think we're gonna see real change and I think this is gonna amplify the voices even more of those change makers.

Speaker 2:

So me, I would like to thank you. This was a phenomenal podcast and um, I know we're gonna continue the rallying cry because this is really our time mm-hmm<affirmative> it is everybody's time because women's health is everyone's health. It is family's health. It is men's health. Um, and we're all in this together. And as you say, this is a women's health revolution and it is just the beginning and I'm also very excited for what's to come. So again, thank you and thank you to ALA.

Speaker 1:

Thank you for listening. If you enjoy this episode, be sure to subscribe to a HLA speaking of health law, wherever you get your podcasts to learn more about ALA and the educational resources available to the health law community, visit American health.