Episode 49 Dr Laura Dalton CMOO Planned Parenthood and Poppycare.org

In this episode, Dr. Laura Dalton, CMOO of Planned Parenthood in Marmonte, shares her personal journey through menopause, the challenges women face in accessing care, and the innovative Poppy Care Telehealth service designed to support women in menopause and perimenopause.

Planned Parenthood of Marmonte, and Poppycare.org for more information.

Disclaimer: This is general information and education. This is not therapeutic or medical advice. 

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Transcript

SPEAKER_00 0:00

Hi everyone, and welcome to Take a Pause with Metapals, where we will talk about the pause and all of her glory and not so glory, but we will bring real conversations which are honest, real, and well, sometimes funny. I mean, you have to have fine some humor with what's happening with us, right? At some point. Very true. Yeah. So I'm happy to have my partner in MeniPals, Raquel, on with us. Raquel, and today we are so happy to have um Dr. Laura Dalton, who is the Chief Medical Operating Officer of Planned Parenthood in Maramonte. And allow the Jersey to just take over that word. We'll have Laura explain where that is and what that is, but we are so glad to have you here. So welcome.

SPEAKER_01 0:51

Thank you. It's great to be with you both today. Thank you. Thank you, Laura.

SPEAKER_00 0:55

Yep. And um, how we always uh like to start is we like to give everybody just the um opportunity to explain like their journey, where they've gone, how they got here. So we would love to hear about you and your story and um what you've been doing.

SPEAKER_01 1:12

Great, thank you. Well, I sort of think of my journey as two paths in parallel. So I have a kind of deeply personal story. Um, so I was in my early 40s and starting to feel all the symptoms of perimenopause. And it's like, okay, I think it's time to get on hormones and start feeling like myself again, and perhaps maybe I could start sleeping again. So I was kind of gearing up for that when I was diagnosed with estrogen-positive breast cancer. Um, so no hormones for me, can't cannot take estrogen with that type of cancer. And now I'm on tamoxifen, which is a selective estrogen uh modulator. So it kind of in your body, it sort of tries to tell certain tissues, you know, block the estrogen and it tells other tissues it's okay. But really, it just um exacerbates like menopausal like symptoms. Um, and so, you know, I live in this world where I could access hormones because as a physician, um, I could write them for myself or, you know, have a conversation and really advocate for myself, and knowing that I wanted to do that, always wanted to be on hormones when I started to have symptoms and now in this position where I can't, and feeling those symptoms every day and not sleeping, and then also kind of going through that battle of is it like what's worth it, right? Like, is it, you know, when we talk about quality of life, which I think is such like the key thing about menopause, right? Is quality of life and exactly and so like you know, do I stay on the tamoxifen? Do I just take the hormones and risk it because my quality of life is bad? Do I risk a recurrence of cancer? You know, so it's just this challenging thing. And I think um just makes it just makes my awareness and thinking about patients who are struggling with accessing care or um don't know what's going on, it just uh makes it much more personal to me. And then the other path in parallel is my professional path. And so, as the uh chief medical operating officer for Planned Parenthood Mamonte, we're the largest Planned Parenthood in the country. We have 30 health centers um in central and northern California and all of Nevada. And so I'm always paying attention, what's going on in the community, what do our patients need, and really thinking about how to be innovative and responsive. And I started noticing kind of like I said, in parallel at events, all the women standing around talking about their perimenopause and menopausal symptoms, and interestingly, their inability to talk to their primary care providers about it. So these are women who are established in a healthcare system, have a primary care provider, often like their primary care provider, and are going in with their symptoms, and the things that are being said to them are horrific, right? So maybe labs are drawn and maybe they're normal, which is happens, of course, right? And so then these providers are telling them things like, well, you're fine, but you know, maybe you could just like eat a little better and you should probably exercise more. Have you tried meditation? And that is, I think as a woman, um, you know, we tolerate so much. And when we don't feel well and we go in and we ask for help when we make the time to do that, and we near not heard and not validated. I think it's just it's I mean, there's just there's not much that's worse than that. And so after hearing all that, I was thinking, I have to do something for these women. They're not our target population, right? We typically in our health centers care for patients who don't have insurance or who are on Medicaid. But I said, these women probably used our services when they were young. And while they don't need our traditional services anymore, we can help them. So we created a kind of concierge perimenopause menopause program called Poppy. So excited about this. I really am. I know. Same. It's amazing. So it's Poppy Light the Flower, the California State Flower, P-O-P-P-Ycare dot org. And the goal is to just reduce all the barriers for patients and to get that individualized treatment. Um, and so patients can call in, speak to a clinician same day, right at that moment, or schedule an appointment and really be heard. And so these things are happening in parallel. Like I feel like I'm I'm sort of suffering and trying to figure out how how to how to live this new life while launching this new service um to help. And so that's that's my journey in a nutshell.

SPEAKER_02 5:45

Well, first of all, thank you so much for sharing because that is so deeply personal. And I I genuinely appreciate you sharing that because I think that will help women talk about it. Because I don't think that we allow ourselves to talk about things because, like you said, we walk into the doctor's office and we'll take so much. And when we don't feel good, and we just finally have hit that wall where we show up and we get told things like just eat less or maybe it's depression, you're under too much stress, like it infuriates us. And it's not that we're like being raging crazy because we want to be raging crazy, it's because we've hit a wall. So I I just want to acknowledge you and and appreciate you and and I appreciate that you're bringing uh this kind of like poppy care to this population because there are a lot of women that you know, there's people that are uh like realtors, for example, that don't have insurance. And so this would be absolutely something that they could, you know, contract work uh workers out there need some type of direction and it's expensive, it gets really expensive.

SPEAKER_01 6:48

Absolutely. And I think too that you know, I I it's kind of like what do you do when you're in an established healthcare system, like an HMO, right? And part of our territory um has a large HMO, and then you're hitting these walls, like where are you supposed to go? And so I think also um for those that don't have access to insurance or their insurance premiums are too expensive, or they have insurance, but it's just like you're in a broken system. And so having the opportunity to come to us. And I think the other thing that I really like about poppy care is that our kind of like the the main value is like trust women. And so I've you know, I've seen a lot of other telehealth type menopause programs popping up. And I I mean it's great, right? Access is great. Oh, yeah, but I hear a lot of things about like, you know, subscription fees or they kind of hold your medications hostage. And so every two to three months, you have to have another visit. And so for us in Poppy Care, we trust women. And so we tell women these are the things to look out for to let us know if you're having issues. And otherwise, we're gonna give you a year's supply of hormone therapy or whatever other treatment is best for you, and you'll come tell us if there's an issue. And so I think that's also really important. Like, we don't need to um like belittle women or put up more barriers when we are all doing all the things already. Like, who has time to have an appointment every three months to say I'm doing fine on my medication? Please recall it.

SPEAKER_02 8:17

Yeah, I know exactly what you're talking about.

SPEAKER_00 8:21

Yeah, I'm actually doing something like that because I could not get um testosterone here on the East Coast. It's taboo in case you didn't know. It's bad. Um, so I couldn't get it. So yeah, I am doing an online and I have to pay monthly, even though the it and I'm doing injectable, so the vial will last 28 weeks. I'm like, okay, perfect. I'll see you in another 28 weeks. And they're like, Yes, because you're gonna keep paying monthly. And I was like, I'm what? But there's nothing else I can do because you know, I have had every provider that I have gone to is like, nope, you no, we don't do that. No, we don't believe in that. No, that's not something that we do. And there's no I in there. I was like, well, I'm the patient.

SPEAKER_02 9:08

I'm the patient, you know.

SPEAKER_00 9:10

So it's you know, so that is what you you end up having to do. So just the fact that you're allowing a woman to be her true own CEO. Like, we know when something's wrong. Right. You know, you know, so you would have the ability to contact and be like, hey, something's wrong. I don't feel the same way that I did on my patch, or I don't feel the same way with this, and you'd be able to be your own CEO. That to me is is the best part of this whole entire um concept that you said with poppy care, because for me, I feel like I am being held hostage by paying uh a substantial amount monthly just to be able to get my testosterone.

SPEAKER_02 9:52

Well, you're already being held hostage by your body and all these changes.

unknown 9:56

Yeah.

SPEAKER_02 9:57

The last thing we want is to be held hostage by the healthcare system. I have raised four children personally, and I could tell you every single symptom. I could tell you, like, oh no, that's this medication's not gonna work for him because of this. You know, you you've learned a lot raising children or and living 50 plus years. Yeah. So like if you can't by 50 plus years understand a little bit of offness in your body and kind of identify that, uh you need these help, you need this help. Like you need somebody that's gonna pay attention and like, like you said, trust you. So I I can appreciate this in its entirety. Yeah. I I'm curious, are you guys seeing like pat shortages? Or are do you how are you addressing that? And I know this is kind of just like the topic now because FDA just released that box thing, but I thought I'm sitting here thinking, I'm like, how, how is this being addressed?

SPEAKER_01 10:51

No, that's a great question. So I think the thing that's really cool about Plant Parent and Mamonte is that we're very patient focused and we have built centralized teams over the years to really ensure that our patients have a quality experience. So we get it, right? And like if you you finally have this appointment with us and you heard, you leave the appointment like a little bit lighter and you go to your pharmacy and they're like they say your patch, you know, that they're around shorter. Like that's completely like not what we're trying, you know, trying to do. So our coordinator teams monitor the pharmacies um to see which ones have the patch on allocation. And then we let the patient know, we have them their preferred pharmacy, and then we might say, oh, actually, you know, CBS as an example has it in stock right now. Let's do that instead of Walgreens as an example. So we do that work ahead for our patients. Um, and so far, we've always been able to find a pharmacy that has patches available. And so we've been able to move around for the patient. Now it's not ideal. In an ideal world, the patient will go to the pharmacy that they want. But I think um, you know, at least us doing that extra step and helping the patient is really, really important because I mean, can you imagine you're so close and we finally have the person and then you can't get the medication? I mean, just yeah, I'm perioding.

SPEAKER_02 12:06

Or you just get started and barely evened out in your like ebb and flow of hormones, and then they're like, oh, sorry.

SPEAKER_00 12:13

Yeah. It's like that dream that you have, right? When you're like running down the hallway and you see the door at the you're like, oh my gosh, thank I'm at that door. And then they're like, Nope, there's another door now because keep running, keep running. You know, it's it brings anxiety, like it gives me, and I'm sure other women anxiety. And the fact I'm looking at the patches and I'm just like, well, can I call it in quicker? And the answer is no. No, no, you can't. Not with my uh insurance. They're like, we will wait until you get down to three patches and then we'll refill it for you. Meanwhile, you know, you're like sweating. Like, can I uh anything else?

SPEAKER_02 12:51

Uh yeah, because then you got to rely on shipping because for me, I'm I'm forced to use an online like subscription. Yeah. So I'm like it has to be shipped. Shipping? Like, where the heck, you know, then you you're tracking it after you just spent two weeks talking to some online guy that gives zero craps about what you've got going on. And you're like, where is the patch? They're like, sorry, we'll add you to a list.

SPEAKER_00 13:14

Yeah, what list? What's the list? I don't know. It's crazy. I mean, it's like back in the 80s and 90s when you were looking for that cabbage patch kid. Like you had to find that what you were going, you were like, Where do you call in friends? Do you have it? I mean, people are calling, does your pharmacy have it? Do you have the patch? It's like so true.

SPEAKER_01 13:35

And it just it shouldn't be that way. I mean, I just I don't, you know, because we have a done this pack about um men, but I think it's this real issue in healthcare that I think that as men were put in this situation with critical medications that they want and need for their quality of life, you know, like it's just when does that happen? And so I think that that's really, you know, it's just one of those, it's another layer of the menopause piece, which is just really how women are seen in healthcare and really what's acceptable.

SPEAKER_00 14:07

Oh, yeah. Laura, don't let me get on that crooked commercial because we all know that medication is like in the millions of how many pills supplied there is. Yeah, that's never gonna run out.

SPEAKER_02 14:27

Which I think is like incredible. Yeah. The moment I found out I was spinning out, because like I once I actually figured out what the heck was wrong with me, because I had gone through like a several years of not knowing and just like all these crazy like medical events, like to the point of almost dying. And like it's like once I found that out, I was like, oh my gosh, I have to get these hormones. And then you know, you just get that little taste of relief. And it's never really exactly what you used to be, but there's enough, right? Where you can get through and you can identify who you are going forward. But I can't imagine them just being ripped out from underneath you, like, oh, we're out. Like, how is 5% of the women on this and we don't have enough? I don't understand it. It just doesn't come. It's scary in my head.

unknown 15:12

Yeah.

SPEAKER_00 15:12

That surely is the scary part because if really if everybody was on there that needs to be on there, you know, and the the shortage would be even vast. It would be huge, you know. And the fact that there's only five percent roughly, and we're still in a shortage, to me, it's like, are they getting the memo? Like, are the companies that are they like creating patches? Like I would have, okay, we're gonna work day and night. We we gotta get these patches or moneymaker boys need to work. Exactly.

SPEAKER_01 15:47

Yeah, and my guess is that is happening. I mean, I don't have the insider different patches, but I do work a lot with pharmaceutical companies. And my guess is like we were saying, you know, once the black box warning came down and once all the evidence that's now available, um, you know, and then there's all this work, like the work that important work that you all are doing, um, and more advocacy. You know, I think that the pharmaceutical companies are seeing that and the shortage will be the splip in time and then perfect.

SPEAKER_02 16:14

Yeah, I I do too. I'm excited about that. Well, so I think it's amazing that you guys kind of look around for these people at Poppy Care because that's almost like concierge to me. So I'm like, oh, tell me more. Maybe I'm gonna start going to Planned Parenthood. I love that. How how are your parents your parents or your patients? How are patients receiving this? Are they excited? Have you seen people come in and like get like thrilled about it? Are they kind of like, what the heck? This is more of a you know, younger clinic, or what what are you seeing?

SPEAKER_01 16:47

No, our I mean, our patients who call in for poppy care are just, I mean, the things that I've said, like they'll say, I'm finally I've slept for the first time in 10 years. Yeah, you know, or I feel so much lighter, or I finally feel heard. You know, all the things that we were talking about, you know, are obviously very true. And the patients um tell us that. And they talk a lot about how thorough our providers are. Our providers at work in poppy care are 100% poppy care. They're sitting there waiting for you to call. Um, and so they have a lot of time to dedicate. This isn't that rushed in and out with a provider who's like, yeah, yeah, okay, fine. It's really going through all of the symptoms and then really asking the patient, like, what is important to you? Like what, you know, not just okay, you have this symptom, I'm gonna give you this medicine, but what like how do you want to feel? Which things are causing you problems? Um, and so I think that patients really talk about that kind of like personalized experience with it. And then um, for our patients in the health centers, because some more of our traditional patients, you know, we've always provided um menopausal care to those patients. I think now there's just more emphasis, like enhanced training to our providers, people are more aware. But I think really, you know, when I think about sexual and reproductive health, right? Like that's that's how I reference the services that Plan Parenthood um provides. Like to me, menopause is part of reproductive health, right? It's when your whole, and we're really at Plant Parenthood, we're really experts at it, right? Like we have helped women prevent getting pregnant uh using hormones. We assess hormones when there's abnormal bleeding or there's no period. We help women in their initial stages of infertility workout, right? And so then as your hormones start to decline and perimenopause, and then through menopause, like that's it's for it's like a very natural state because we're really experts at helping women with hormones. So um, yeah, I think the patients I patients seem to be very much like, well, of course. Like, yeah.

SPEAKER_02 18:49

In my mind, it made sense. It was such a transitionary phase, right? Like, because I went to Planned Parenthood as a kid, like in my you know, teens. Like that's where I went because I just, you know, I didn't really want to establish with a in my head at the time at 16, 17, I was like, oh, I don't want to go to an OBGYN, I'm not getting pregnant. You know, so to me it was Planned Parenthood. That was option B, and that's that's just where I went. And so uh I saw it when I heard about poppy care. I was like, oh my god, that's brilliant. Because why wouldn't you guys talk about hormones and reproductive health and menopause? Because that's the space you have lived in for the last however many years. When did poppy care come out?

SPEAKER_01 19:32

When did it come out? Um we started it in uh early November. Our website just live a few weeks ago. Um, but we did very, very soft launch um because we're utilizing new technology. So it's really it's really nice that you can call and you call into a dedicated line so that the people who answer the phone, it's not just a general call center. So it's people who have more experience in menopausal care. Oh nice. And then you get asked, like, do you want to are clinicians available right now? Like, do you want to talk to her, him right now? Um, and then you get transferred or you can get schedule an appointment. Yeah. And then we send over consents and forms um over the phone. So you can just your phone, you can just sign it, you know, all the things you need to look out for. And then we send um you pay over the phone too. So we just send that electronically and then you pay. So it's really nice. And perfect. Yeah. And then we're working on asynchronous. I'm hoping in the next month or two, but to me, that's the ideal dream, right? Like, I don't want to talk to anyone on the phone, honestly. So, like at 2 a.m., you go on, you answer your questions in the app. And then the next morning, one of the clinicians or providers will review your questions, make sure everything's good, and then they'll just send your prescription in. I mean how could I mean it's just amazing. And then, but if you want to talk to the provider, like because that's very important for a lot of people, that's still an option. But if you're like me and you're like, nope, I just want to take care of this at 2 a.m.

SPEAKER_02 20:53

when I can't sleep, then you're just gonna say, when you can't sleep, that's the best time because you're like, F this, I'm gonna do this, this, and this.

SPEAKER_00 21:00

Yeah. Well, you forget about it too. Like, you know, with a busy day, like I'm sure you're busy, you know, it's you get home, you like eat dinner, it's like, oh, I gotta hurry up and get into bed because I have to get up and do it all over again. It's like my regiment. I forgot to call the office. Now they're closed. Now you you know, you have to wait, but no, with you, you just get on there and it's all on there. Just it's it's the easiest thing to do. I I just love that concept.

SPEAKER_02 21:26

I'm literally looking at my to-do list and at the top it says call insurance for patches, and that has a line down for every single day because I have not gotten to it. And it's either brain fog that I completely forget, or just too busy that I completely forget. So that is so brilliant. I think that is absolutely amazing for people going into the poppy care.

SPEAKER_00 21:50

And is it through all states, like all the states, or is there great question.

SPEAKER_01 21:55

Right now we're just California, Nevada, and we're waiting to see as we've been getting you know more and more media attention and it's starting to grow and we're starting to advertise more which states kind of pop up as interests and then we will Pennsylvania. Oh I'm sorry. I didn't I didn't know if you were looking for I was like Pennsylvania. Pennsylvania we could do that. Yes our you know all it our providers just get licensed in the states where we have interest and then we'll be able to prescribe um and see patients in those states.

SPEAKER_02 22:24

That's amazing. I I genuinely am so excited. I actually in fact started telling friends about this in Florida. I'm like so anyways have you heard about poppy care? Because she was saying you know I don't have insurance right now and I I've got this going on and that going on I'm like girl look it up yeah I mean I didn't realize that it was only California Nevada at the time but I I'm gonna let her know that it's only California Nevada now. Well spread it she can spread to all her friends in Florida and then we'll expand.

SPEAKER_00 22:53

Yeah yeah that's true that would be great yeah they they should have you should have a number Laura with people calling in to say what states be like hey we would really like and um you know I'll get on there and I'll be like you know numerous calls they'll be like oh that Pennsylvania woman was on again saying Pennsylvania we now recognize her voice. It's voice detection.

SPEAKER_01 23:16

Pennsylvania I know I mean well my dream is like this should be for everybody right and so I think you know we're just getting started with it and it's going well and now we can start expanding and so why not have every see right and I think being credible. Yeah yeah and I think to your point about being busy too is I think trying to make time to go to the doctor's office or even for a telehealth like with um a different company is hard, right? Like they're like you have to join 15 to 30 minutes before and then you have to wait for them because they're running late. And so just like having that chunk of time is so hard. And so our my dream was really you're a busy person, you finally look at your to-do list or you're a member and you're like oh I have 10 minutes right now I'm just gonna and then there's a provider for you. Like that's the dream is like seize the moment of when you have that and not having to carve out such a huge chunk of your day.

SPEAKER_00 24:07

I think that and the fact that then every woman who is doing that also feels seen and you know validated that like yes you have a problem we will get help for you. And they again the call and they're like the relief. You know they just feel like somebody listened to me and listen to what I'm telling them. Like because like you had said in the beginning I have also gone in you know you go into the doctors and you know I always said that the you know like I'm all always achy or whatever and it's always stress. And I'm like no my my body hurts when I wake up like how does it hurt I did I slept sort of you know and but I think it's great in the sense that you get off the phone and you're like oh my gosh okay I know help is on the way like that to me is what the best takeaway would be for women after they get off the phone.

SPEAKER_01 25:02

And that you're not crazy. You know I um thank you I I have a I gave a talk this last weekend about women's health and part of it was on menopause and like that is one slide that I have it's like no you're not crazy because I think that we are all made to feel that way. We have these symptoms and we go in and then yeah they tell us oh you're depressed you're stressed you're eating the wrong foods and you feel it makes you and because we don't talk about it a lot right you just feel so isolated and you feel crazy. So I think that's such an important thing is just to be validated. No and your symptoms are real and you don't have to feel this way.

SPEAKER_00 25:38

It is true because yeah yeah you would leave there I would leave there thinking how did I get here? How did I get to where I am now like obviously I don't know what's wrong with me. Like you know what I mean you're like obviously I must be wrong because I'm telling them this never I never felt this way before and they were like I'm sure you have no no I'm I'm telling you I but you know what happens is you see so many different ones sometimes because now you're trying to get the appointment your regular practitioner may not have one so you're like I'll just see anybody get me and now you have to explain and then they're looking at you like do you really feel it and it's like yeah this is new.

SPEAKER_02 26:16

Yeah no it's yeah and a lot of times I felt like people thought I was like pill seeking and I'm like I'm not pill seeking I'm just telling you that I do not feel like myself like these panic attacks that are coming out of nowhere and I'm freaking out like like I don't even know like Beetlejuice. Like I don't this is not normal. This is not my baseline. Like I'm telling you this is not where I I've not gone 50 years freaking out like this.

SPEAKER_00 26:41

They would have committed me believe me. Right. And it's like yeah we're not crazy and it's like but you yeah I mean that that should be I'm glad that is a slide and I'm sure a lot of people appreciate it women especially appreciated that because it's is also like letting you know yeah yeah this is something that you're feeling and you don't know what to compare it with. You know you have a stomachache you're like oh man last time I got food poisoning it felt just like this and yes that's it. You know you get these symptoms you're like oh the last time I went through a menopause never this is new.

SPEAKER_02 27:16

Now when you feel off you start thinking okay what is it? Did I not exercise enough? Have I not had enough omegas? Okay, what did I do? Did I miss a vitamin? Yeah how much protein did I have all right where am I at in my like do I need to change a patch you at least have things that you can identify that could be the impetus of what is wrong. Yeah yeah we're getting we're being our own case study and we're figuring it out we're like oh but you have tools in your toolbox at least you know like when I first started out I had no tools and I tell you that 15 minute visit even though it was just like hi yeah no bye okay here's a prescription off you go like that to me was like my life vest I was like oh okay there's a reason I'm not just going out of my mind yeah yeah yeah yeah no I remember just like being so like oh my god I can't like I just would look around and it's like everything just felt like it was closing in on me. So I feel so happy to hear that there are resources coming online for women.

SPEAKER_01 28:21

Oh absolutely and I think just and and for them to be accessible right like I think it's just is so important and you know high quality evidence based I think all those things are really important. And that's you know I think one of the nice things about being Plan Parenthood the the program is called Poppy because we really want to differentiate it in the sense that you know we know that a lot of women who are accessing it don't need Pen Parenthood's traditional services but it's Poppy powered by Planned Parenthood Marmonte. And so the goal is really to kind of lean into the experiences that I think most of us had as uh young adults of you know we have nowhere else to go and knowing that it's a trusted uh source of medical care. And so like now you're in this new phase of life and you can trust us again um you know just under a different name.

SPEAKER_00 29:12

And it's kind of cool the name itself too it's like it just just saying it's like poppy care. It's like makes you sound happy you think of the little flower you know you're like okay I don't know it's just yeah it is all no I love it.

SPEAKER_01 29:27

I um I just bought a new phone case that it has poppies all over it because I'm just like so into it.

SPEAKER_02 29:32

It's good. Yeah. I love it. So I have to ask is was this poppy care your brainchild or was this kind of like a collective of the board?

SPEAKER_01 29:40

The the concept of poppy care um was mine. I certainly I have an amazing team that um and I kind of sort of supervise they're all high level senior directors and VPs but I kind of give vision and certainly they all had their input in making it come to life. But the idea of it was really just like I said that's you know and that's really my work is to be strategic and respond to what's happening in external environment. And then Poffy uh we went around and around with names and we really landed on um a flower or like a fragrance or you know something like that that is feminine but not like too much. And then um that's the hard part perfect. And then our amazing graphic designer designed the website um with the drawing of the poppy and I just like I fell in love with it and I was like this is it let's do it.

SPEAKER_02 30:39

Yeah I absolutely love it. I think that's so cool. And I love that you give your team credit too because a lot of people are like oh no that was mine.

SPEAKER_01 30:46

Yeah no I mean I I often say like I I might have the idea or I might have the veto but like the actual work like all the work of setting up the technology staffing training our providers all my team did all that I didn't I don't do any of that. I just like you know give input um oversee it but no my team is amazing and they do all the really hard work.

SPEAKER_00 31:10

Well that's perfect. I'm thank you I'm so glad that you did have this yeah idea because I mean that's what it takes. It always takes someone that has the idea and then you're like okay this is the idea now I'm gonna have people help that can get this into fruition. So that's yeah that's the best.

SPEAKER_02 31:27

Yeah so you took so it started in November so have you seen an influx of people coming through have you I know you did like a soft launch but are you is it starting to finally grow in popularity because I would love just nothing more than to see this take off.

SPEAKER_00 31:42

Correct yeah I agree.

SPEAKER_01 31:44

Yes absolutely so it's um we did an exclusive with the Wall Street Journal of all of our new services. So we had Poppy and aesthetics and Ivy hydration and so we couldn't advertise before the exclusive came out and then of course and we've had tons of media of course most of the media is on aesthetics even though my team is like what about poppy should we focus on poppy so I'm certainly in some of the articles there's a mention of our program and so we've seen it in flux since then um but really we just finalized the website and so now we're gonna need to go forward with more intensive um advertising and marketing and so we should see a significant influx um after that. But yeah we we definitely have seen growth since we started in November.

SPEAKER_00 32:29

That's that's awesome. I think that's amazing yeah totally.

SPEAKER_02 32:34

What are some of the things that Poppycare does do I know that we've talked about labs and I know it you know you can kind of do like the questionnaire online but are there other services outside of that that you know you can get through Poppy Care like like um I can't even think of the word thank you brain fog um you do whatever a mammogram I was going to just start doing charades no it's totally I love I have the same same problem.

SPEAKER_01 32:59

I'm always sitting in meetings like what is the word for that really specific to the menopause treatment um so you pay the $250 and that gets you a prescription in your supply of whether it's hormone replacement therapy or you know other non-hormonotherapies that maybe are ideal for that person. We also do microdosing GLP1s. So we really think that microdosing GLP1s is going to will significantly help people who are experiencing uh perimenopausal menopausal symptoms and we liked microdosing because you don't get all the side effects and you can go off of it. So we, you know, it's obviously not a requirement but we offer that as part of it too. And then patients have complimentary texting with our providers. So you know if a week later you're like oh I can't remember how to do this or you know what I'm starting to feel better but I need a slightly higher dose you just message the provider and then they help you. And so you don't have to like pay or call in or anything you just message the provider. So like that's kind of the realm for that. Most of the patients we're seeing right now like I was saying kind of have established healthcare providers. So they um can they're accessing mammograms and cervical cancer screening through Gorega providers. But certainly if a patient needed those services then we absolutely could do that. It would likely be routed through the health center so they could get all the necessary things. And at our health center for a lot of our patients who come into the health centers they either qualify for Medicaid or they qualify for FPAC which is a family planning program in California. And so it covers um preventive careful cancer screening breast cancer screening um contraception um all those types of things so patients can also access services that way and then in Nevada or if somebody doesn't qualify for those services we have a sliding fee schedule. So certainly if somebody calls us and you know they're happy to be helped with the perimetopause but they or menopause and they have other things going on, we certainly can help them um at our health centers too that's that's amazing.

SPEAKER_00 35:10

I mean it is one stop shopping basically like totally I was just like thinking the same thing like man you guys have thought of everything. Do you guys do anything with um infertility or anything like that or like consulting or that's a we do we do kind of like what I say is like the first first level infertility.

SPEAKER_01 35:28

So we do the initial workup for both the um male partner and then the female partner and then we can start Clomid which is one of like the first line medications help with ovulation and then once it gets once a patient starts getting beyond that point and they need you know more complex table then we'll refer them off to um a specialist but that kind of initial work we definitely do and getting a lot of that workup done is really important. It is important yeah and accessibility right because we know that infertility care is really not accessible. No maybe it's changing California you know there's new laws that are being passed but right now it's really just not accessible especially in Nevada. And so we do a lot of that initial work to help patients.

SPEAKER_02 36:11

Well and it's so expensive when you do infertility care. I think that that's the big cutoff for everybody. They're like oh my God I can't even imagine it. So to get started with Planned Parenthood would be amazing because you're kind of offsetting some of that cost and maybe identifying the root cause or part of the issue and then you can go forward to like utilizing your insurance benefits on something else. I I mean I don't I don't know but I think that would be cool. No it I no it's great and a lot of women do great on c on climate and get pregnant on Clement and so if that saves them having to go to infertility specialist like that's excellent right and yeah I'm just hearing like benefits aren't being utilized as much I'm hearing less from you know for corporations that are gonna have to spend on benefits like this is a really like huge advertising piece for Planned Parenthood I think.

SPEAKER_00 37:01

Exactly because it is literally from like the start of Mensies until the end and everything in between and I had no idea you don't I don't know like I never even thought of it but now I really need that number Laura to get Pennsylvania on that list. I don't know how much I can say well don't worry Laura I will make sure she doesn't call six, seven times a day well you promise to tell all of your friends on Pennsylvania I will get my team um on it I told them because just the fact that you know like a lot of times you know I'm paying like I said monthly for something that's not needed. I already have the testosterone but I still have to pay it and lucky I can and I know some friends can't do that. So now they're you know it's like what are where do they go? And you know all you have are these other online services that there is always a fee. So it's like if you can be like oh hey Planned Parenthood they have this and it would be amazing. Like I I think that would help women really know that the one place that they can continue to go to is Planned Parenthood. Right. Right.

SPEAKER_01 38:15

And yeah thank you for saying that because that's that's how I want women to feel is that we're here for you regardless of what's going on right like your life circumstances may have changed and so you know you don't need us for XYZ but we're still here for you. Yeah yeah absolutely and I think you know the thing with your testosterone is so frustrating to me is I imagine you feel a lot better on testosterone. Oh my gosh, I do. Right.

SPEAKER_00 38:40

And so what I'm super jealous I don't have testosterone yet because my provider doesn't allow testosterone prescribing yet yeah I mean it's crazy and you know and I keep on saying to the my the the big argument that I had not an argument a discussion I will say you know with my provider my provider it was that you know if I was diabetic would you refuse to give me insulin? And you know they were like well no okay well I was born with testosterone uh there's that and they were like yeah but and I'm like but what but what you know so so it it you know I just yes I I think it's a amazing what you're doing. I I continue to I will continue to tell people whatever state we're at. I mean we're you know on the podcast when this gets out I mean we're in a lot of different cities a lot of different states so I am sure I am telling every woman out there to just go and just be an advocate for yourself and you know choose Planned Parenthood because they've always been there. No judgment or anything wherever you are in life no judgment on their part. So that's what you have to do.

SPEAKER_02 39:57

Is hormones and reproductive health for I mean how long has Planned Parenthood been in existence? I mean years years.

SPEAKER_01 40:04

Almost wow yes years getting close to 200 years right yes that's right and that's I mean that's what we do right we understand how hormones do different things in your body and them and we're also just not you know I think one of the issues with why there's only 5% of women using hormone replacement therapy is because providers are just scared and nervous and they don't understand it. Right. And so we had you know obviously the black box warning we had that study that wasn't good and you know I went through medical training during that time when right like that's how I was trained is like okay you can have uh the smallest amount of hormones for the shortest amount of time you know like this like very like fear right and I think that that we're seeing that with providers of testosterone too you know and certainly should we do more studies on testosterone for women in menopause? Yes, of course like we should do more studies on a lot of things but that doesn't mean you can't have an informed decision with a patient about you know is your quality of life so impacted that it's worth trying this medication and seeing how you do right and so I just um yeah I just think it is so it's so what we do and um we're yeah we're the experts and so until the rest of medicine catches up you come to Planned Parenthood and exactly I mean that should be your that's a bumper sticker that I I was gonna say that's a great really good slogan right there.

SPEAKER_02 41:28

But it's true I mean over 200 years of hormones and that's really the only thing that you guys have really kind of dealt with I mean my gosh that's that's 200 years of data you know that's 200 years of like understanding a woman's body and not not that I'm poo-pooing men and not that I don't want them to get care or Viagra or whatever they need. I I just think like we just have to have a little bit of space in the room and I think I you know if I went into a provider and they were like acknowledging me and acknowledging the things that I'm saying I would just feel better with just that you know like that's a starting point for me.

SPEAKER_01 42:04

Mm-hmm that's why that part is so important to me because you know especially going through the cancer diagnosis and treatment I've spent a lot of time in doctor's offices when I normally would not because I don't like going to the doctor. And and they all know I'm a physician and yet they still treat me the same way like you know not validating very dismissive I'm sure you have that symptom or you know I'll say like I'm not sleeping on tamoxifen and then my oncologist will say well you weren't sleeping before the tamoxifen and I'm like well does that make it okay right and so like I you know I get it too and that's why it's so important to me that the services that I'm responsible for overseeing that we don't do that to women that you know making the patient the center of every visit is number one right you just that's what there's that's the most important thing.

SPEAKER_02 42:58

That's an interesting perspective too that you're a physician and you're getting kind of the same like you're okay off you go you know it's demoralizing.

SPEAKER_00 43:08

I mean it truly is demoralizing I mean I used to work um and uh at another hospital and they would always be like hey whatever the parents say it was a children's hospital and they would whatever the parents say they're the expert for their kid no questions asked like you say that your kid's acting weird they're gonna do every test right so we go in there we are our own experts you are your own expert and you can say I'm not you know I'm not doing well with this chemo I'm not sleeping well you know you're with you 247 and to have somebody be like no I would be like I know I've said things like have you lived in this body?

SPEAKER_02 43:53

Do you understand what it's like to live in this body like I'm the one suffering here. I'm the one going through this like physically me And they're like, mm-hmm, yeah, okay, well have a good day. And I'm like, Yeah.

SPEAKER_00 44:04

Yeah. It's demoralizing. And I just hope that I hope that everything in in your journey is going well and as best that it it can for that. Because I think um yeah, women, we need to basically, and when uh it's another woman telling you that, it's even more demoralizing for me. But I I think that women, if we would stop and just help each other straighten our crowns instead of like pushing it off or saying she don't deserve a crown or you don't know. Walk in that woman's shoes, and then you can tell me how you should feel. So I absolutely yeah.

SPEAKER_01 44:39

I love that. Can I use it?

SPEAKER_00 44:41

You sure can.

SPEAKER_01 44:42

Oh yes.

SPEAKER_00 44:43

You gotta put the jersey flair in it though.

SPEAKER_01 44:48

And that's great. I mean, because I feel like we all people try to say that and it doesn't, you know, it's like, I don't know, it becomes very cliche, but I love that so much that, you know, if we all just supported each other and listened and said, Yeah, me too. Yes.

SPEAKER_02 45:04

And when you when you support people, like actually mean it. You know what I mean? Because I've had so many people that are like, oh, but then they're off and they, you know, you you could just tell that they're not genuine and you can tell that they're not really listening. And so then you don't keep talking, even though you have about eight hours worth of things that you need to say. But when you feel that they're just not genuine and like hearing you, you just shut down even further. So I I do appreciate that. Like, let's just listen and really mean it.

SPEAKER_00 45:36

Yeah. And I'm sure based on just this, you know, episode that we have and just getting a sense, I am sure that you treat this poppy care as like it it is your, you know, baby. Like, and you want women to feel heard. And that to me is like one woman understands you would think, but sometimes not. But I know you, you do. You're the woman that wants to help other women. So that to me is the most inspiring thing that there's women out there, girls that are out there trying to to help, trying to support, and trying to make you feel seen. So that I thank you for, truly.

SPEAKER_01 46:18

Thank you. Thank you. I appreciate that.

SPEAKER_00 46:21

And we will, yes, we will. Well, again, Pennsylvania. So I'm gonna keep saying. And so I'm in Nevada, so I'm safe. You don't hear anything from the peanut gallery over here. Whatever, Raquel, whatever. Here on the East Coast, and um, so and you can be found just so everybody knows, it's at poppycare.org. And everybody has to go to it. I mean, truly out.

SPEAKER_01 46:46

Yes, yes, thank you. And we're gonna get started on Pennsylvania right now.

SPEAKER_00 46:50

Okay, thank you. I feel so good. Thank you. And I just wanted to say um, you know, uh to everyone out there, if you enjoyed this, please continue to follow us on Spotify, YouTube, and Apple Podcasts, because that is how we're gonna get it out there, Laura. Yes, and on Instagram, and thank you to our affiliates of Good Day Chocolate, Pantry Products, Isogenics, Small Pics, and Parlor Games. So these are all um affiliates that we have tried and true, and we know that they are beneficial for everything. So we can't thank you enough.

SPEAKER_02 47:25

No, and we'll have to get an update. We'll have to get you back so we can get an update because I'm as soon as Pennsylvania's online or sooner. Because I really would love to kind of continue to like update people on like the progress and how to like how this is working, because this is such a huge topic for people and so needed, so so needed. Yeah.

SPEAKER_00 47:46

I think definite uh an update would be, yeah. We'll plan uh like um a few months from now, and that would be perfect. Sounds great. I would love to love it. Well, cool. Well, thank you. And as we always like to always end, Raquel, we will have uh everybody that we will see you next Tuesday.