Transcript

[music]: [00:00:00] Knock, knock, hi! 

Will: Knock, knock, hi!

Hello, welcome to Knock, Knock, Hi! With the Glockenfleckens! I am Dr. Glockenfleck and also known as Will Flannery. 

Kristin: I am Lady Glockenfleck and also known as Kristen Flannery. 

Will: My coffee is going strong. I see that. I’m like at the peak of serum concentration of caffeine. You 

Kristin: know what’s funny? Uh, you got, uh, your medication this morning.

I got my testosterone. You got your testosterone injection. I did. You got back and I’m like, can you tell the difference already? And you’re like, no, you can’t, it just takes forever. But then you were like on all fours playing with our dog and it was just such a ruckus. And then now you’re just like raring to go.

You had all sorts of questions for our guest today. You’re just, I’m like, yeah, it takes a while, doesn’t it? Yeah. 

Will: Guys, [00:01:00] it’s. It’s pretty amazing. I didn’t 

Kristin: realize the difference that it makes like testosterone. Is not just about like your sexual development or whatnot. It is very much involved even as a, you know, full grown man in your like energy levels, your mood, 

Will: energy and headaches, 

Kristin: bone health, like.

Why does it do so many things? My bones 

Will: are like, right now, they, or, because it was, there was a gap. I got my testosterone implant, so I had to get the testopil, so I have to go into, and they do like a thing. We should mention 

Kristin: for people who are not intimately familiar with your medical history, um, That you have had, um, a bilateral orchiectomy due to testicular cancer two times, and so you make zero endogenous 

Will: make my own testosterone.

Kristin: So I gotta go and 

Will: So it’s a big deal. 

Kristin: Once every 

Will: three months, I go to the urologist, and they, um, 

Kristin: And your insurance denies you once every three months. [00:02:00] 

Will: Yeah. And then it was this whole thing. They denied me like particularly hard this time. So I was about a month, four to six weeks late, which is a long time to go without much, uh, I was, I was, I was getting real low.

And, uh, so finally I got it to go in today. I got to the, the, the technician came in and prepped my ass and then, um, uh, and then I just like lay there. 

Kristin: What is that procedure called? It’s not an injection. 

Will: Oh, it’s, they have to make a tiny little incision. It’s a little surgical, 

Kristin: but not like hugely surgical.

It’s 

Will: like an office procedure is what we’d call it. Is it 

Kristin: a bolus? 

Will: Well, they inject me with numbing and then, and then they just kind of. 

Kristin: I’ve seen the tube. It’s. Oh, you have? I, yeah. I came with you one time. That’s right. Cause your insurance was denying you for so long that you were like almost not a functional person anymore.

And I had to step in. And so. I saw things that I can’t unsee. 

Will: Oh, what’s not that [00:03:00] bad? I just, I just, I just sit there bare ass, uh, waiting for my doctor to come in. 

Kristin: No, I know. But the tube that like saw, saw some of the procedure that I can’t 

Will: unsee. Oh, 

Kristin: okay. That I would prefer. I didn’t mean to, I tried not to be looking, but just, it’s hard to, there’s a small room.

There’s only so many places. . 

Will: It is a small room. Anyway, 

Kristin: you get that? I 

Will: got it Done. 

Kristin: Yeah, you get that inserted into your buttock. 

Will: Yes, I get to alternate. Then they asked me, which buttock would you want today? That was a question today. Oh, yeah, I got it. I got it. I got a choice. 

Kristin: Hey, 

Will: left. I don’t know. 

Kristin: Did left today.

Will: I feel like, cause I think it was right last time. I tried to alternate, you know, but they’re like, I was like, Shouldn’t you know, like which one you did? Yeah, isn’t that in the 

Kristin: chart somewhere? 

Will: It probably is, but anyway, I chose left. 

Kristin: So now are you like sitting on the right a little lopsided today? I’m 

Will: a little sore, a little sore, but you know.

Nothing 

Kristin: like a full day of sitting at a desk after that procedure. Anyway, [00:04:00] you’re feeling great. Yes, 

Will: so that’s why I’m feeling good. I’m ready to go for our guest today. Before we get to our guest, though, we’re coming to Denver. 

Kristin: Yes. 

Will: What’s your favorite thing about Denver? The mountains. Ooh. 

Kristin: I do like the mountains.

I’m a mountains kind of person. I like 

Will: the rolling kind of hills without any trees. It’s kind of cool. The big sky. The big sky and like just grassy hills. 

Kristin: Yeah. 

Will: Uh, it’s kind of cool like when you’re outside the city and you’re just like driving in and, 

Kristin: right. 

Will: It’s relatively flat, but not like too flat and I don’t know, I just kinda like that.

Kristin: Yeah. 

Will: It’s kind of cool driving in from the airport. Mm-Hmm. going to, I 

Kristin: like the fresh air too. Like they’re up so high, fresh air. 

Will: It’s good. Mm-Hmm. . Yeah. It’s big fan. 

Kristin: Yeah. We like Denver. So 

Will: we’re coming, we’re coming to Denver. I’m excited about this one. It’s going to 

Kristin: be good. 

Will: Life and death. A sold out crowd.

Um, by the time this airs it better be. Are 

Kristin: you willing that you’re just going to manifest that? I am manifesting 

Will: that with my words. It’s selling, it’s selling fast. It is. It’s not sold out yet, but I am, I am. Manifesting that it [00:05:00] will be by the time we get there. Perhaps by the 

Kristin: time this podcast airs it will be.

The Denver 

Will: Improv. So go to our website. Glockenflecken. com slash tour. Nope. 

Kristin: Nope. 

Will: Slash live. 

Kristin: Glockenflecken. com slash live. 

Will: If there are any tickets left, go there and find them. Alright, let’s talk about our guest. Yes. Dr. Nisha Mehta. So Dr. Nisha Mehta is um, the architect Of two enormous physician groups on Facebook.

So we have physician community, which has over a hundred thousand members, like they’re all physicians and physician side gigs, which is another 30, 70, 000 members, enormous numbers. I think she estimates there’s like 20 percent of the whole physician workforce is in one of those communities or both of the communities.

Uh, and, um, And so 

Kristin: I think you’re in them, right? 

Will: I am. I, I am a member. I don’t, I’m 

Kristin: not allowed to be in them because they are very strict with their policy that you must be a physician. I don’t 

Will: post, I don’t [00:06:00] reply. In fact, I, I’m not on Facebook frequently. I’m very infrequently. I might, I’ve got, I do other things that other platforms that people didn’t realize.

I don’t know. So, so Facebook doesn’t get a lot of my attention, but I do. Good. You know, come across the posts on the, those communities and it’s interesting stuff, like all kinds of stuff. So we talk about that, those, her communities. And, but, but what’s really cool is that she does a lot of advocacy work through those communities.

So we talk about something that we worked on together, prior authorization reform in New Jersey and, um, getting. Uh, also she was able to help, uh, get some pandemic dollars, uh, to physicians and physician practices. So really, just really cool stuff on what you can do with a community of that size. 

Kristin: Yeah. I feel like healthcare workers and physicians in particular are not, uh, so used to like joining forces and combining their voices and things.

And so it’s a really cool, um, Way to do that. And she’s done some cool things with it. 

Will: So here she is, Dr. Nisha Mehta.[00:07:00] 

Today’s episode is brought to you by the DAX Copilot from Microsoft. To learn about how DAX Copilot can help you reduce burnout and restore the joy of practicing medicine, visit aka. ms slash knock knock high. That’s aka. ms slash knock knock high.

Alright, we are talking today to Dr. Nisha Mehta. Nisha, thank you so much for joining. It’s nice to finally talk to you in person. It’s great to meet you guys 

Nisha Mehta, MD: too. Yeah. Well, as close to in person as we’re going to get soon, I’m sure. I’m excited. My, uh, I do a lot of these podcasts, but this is the first one in a very long time that my kids are actually excited about because they’ve actually seen you guys on Tik Tok.

So 

Will: I’m a fan of the kids. That’s good. Can I tell you one time I, we were at a conference and, uh, a physician brought his kids up to me. And they acted out one of my skits, 

Nisha Mehta, MD: like in front of me. That was probably the 

Will: [00:08:00] highlight of my career so far. I mean, I’ve done some things, but that kind of trumps it right there.

Nisha Mehta, MD: Yeah. I think that that’s, my kids always call me fake famous. Cause they say that the only people that know me are doctors and they’re probably right. So we’ll usually like board a plane and somebody will be like, Hey, are you Nisha? And they’ll be like, are you a doctor? And I’m like, guys, just stop. Stop.

Do you get 

Will: recognized a good amount? It’s like almost every physician on Facebook is like in one of your groups. So, 

Nisha Mehta, MD: um, yeah, I guess more, I mean, 20 percent technically, but, but yeah, it feels like a lot and my kids are pretty convinced. So, uh, that only doctors know me. So they’re like, you need to expand your reach.

So when I tell them I’m on these other podcasts, they’re like, yeah, yeah, yeah, whatever. But when I was like, oh, I’m doing the glockenspiel, like a month, I don’t even know if I said that right, but when I said that I was doing that one, they were like, we know who he is. We’ve seen him Of course you have.

Will: Yeah. Glaucum flecken doesn’t actually show [00:09:00] up in any scans. So you wouldn’t see it, uh, in the course of your life as a radiologist. But our, um, our paths have crossed before. I think the first time we interacted, was it when we, with the new, New Jersey, uh, prior authorization thing? 

Nisha Mehta, MD: I think so. I think we’d exchanged a few emails before then, but that was the first time that we’d really kind of talked about things, which thank you again for helping us get that thing passed.

Will: People about that, because I, I think it’s, I love highlighting like wins that we’ve had within the healthcare system. So tell us what happened with that. 

Nisha Mehta, MD: So that was really cool because, um, you know, we, one of the great things about having all the people in the communities is that we’re able to leverage them sometimes to do cool things, right?

So we like worked with Pelosi’s office during the pandemic. We are like able to kind of sometimes. Like use whatever fake star power I have to kind of mobilize people. And, um, one of the things that we’ve really been wanting to do is. Right. We all, we all complained about these things in our echo chambers, but then there’s always like, can we actually do [00:10:00] anything about it?

And I do think that we have more power than, than we think we do. If we can actually get patients on our side, right. And with so many of these issues in healthcare, patients and physicians are on the same side. Almost everyone’s on the same side. And then you’ve got the insurance companies on the other side.

Right. So, um, and, With PriorAuth, I feel like it’s such a slam dunk good for one person, one entity, the insurance companies and basically bad for everyone else. And so, um, when we started this thing, um, this initiative of patients and clinicians together, one of the first things we wanted to tackle was PriorAuth because it was just an easy thing to bring, um, people together on.

So there’s actually 28. 29 states right now in the country that have pending legislation for prior stuff. And, um, we identified a state where they’d actually had legislation sitting in, um, just sitting there for a few years and it’s just never been able to get passed. And we reached out to the congressional leaders there and they were like, Yeah, well, nobody cares about it.

Like nobody’s contacted us about it. So we haven’t done anything about it. And I was like, that’s funny because I hear about it like 18, 000 [00:11:00] times a day. Um, so I’m like, I’m pretty sure we can leverage people that can care about this, um, and get this thing across the finish line. They’re like, you guys bring it across the finish line and we’ll.

We’ll do it. Um, if we can get, if we can get some support. And so it was actually really, really cool because we, um, you know, we reached out to a few people like you and, and really tried to mobilize a bunch of doctors who then mobilize their patients as well. Um, and basically within a few weeks, um, in part due to one of your TikTok videos, um, we were able to get thousands of letters sent to the legislature.

And as soon as the insurance companies saw that they came to the table to bargain. Um, and we were able to. Passed some pretty significant prior auth reform. Nothing’s perfect, obviously, but, um, definitely a step in the right direction and we’ll definitely be back for more. So, 

Will: yeah, I just have to like, say something like, 

Nisha Mehta, MD: imagine that, right?

Will: Like, I mean, this legislation just sitting there and they’re like, Oh, okay. I mean, no, this is not a priority, but it is for so many people. And I think that’s telling [00:12:00] right there. Squeaky wheel 

Nisha Mehta, MD: gets to go. It’s the grease. I mean, literally this thing had been sitting there for three months or sorry, three years or something like that.

And we got it passed in three months, the minute that we just kind of decided to cause a ruckus about it. And so, um, yeah. Use your voice. Yeah, 

Will: absolutely. Um, the other, another thing I wanted to talk with you about, um, about the, on the radiology side, we’re going to get, I mean, you do so much with social media and like, you know, advocacy and bringing physicians together in these communities, but you, you still practice radiology, right?

Yeah. 

Nisha Mehta, MD: I do. 

Will: Yeah. Do you have, uh, do you do this from home? Are you? 

Nisha Mehta, MD: No. I go 

Will: in. Okay. All right. I you have like a lair in your house, like, that’s all dark and You know, I’ve been 

Nisha Mehta, MD: hoping for a lair, but my employer does not seem to want to give me one. So, but it’s actually probably good cause I do a lot of work from home also.

So it’s a nice opportunity to like actually go in and talk to people and Yeah. Change of scenery. So my one, 

Will: my one question about radiology is, um, uh, I figured we’d do something kind [00:13:00] of light and easy to, to, that won’t piss off anybody. Um, tell us, uh, what, how does radiology as of this field and you feel about whole body imaging?

Because I feel like this is, yeah, it’s 

Kristin: like becoming trendy and like wellness optimization space. Yeah, 

Will: it’s all, it’s 

Kristin: scans. I 

Will: feel like I’m seeing more of it and maybe it just comes in waves. I don’t know, but I think it does come in waves. 

Nisha Mehta, MD: Obviously certain social media influencers can make it come in bigger waves.

Um, you know, at the end of the day, right, I think. We all see the appeal, right? I mean, if somebody told you that you could magically look inside yourself and see everything that could potentially be going, you know, wrong or down the pipeline, there are a lot of people that would say yes to that. Um, I think I’ve seen enough scans to say that I would say no to that because there are certain things that I just don’t want to know about because they’re never going to kill me and, and I really just don’t want to have to worry about them.

Um, Um, so I’ve always been that person, you know, in radiology when we had to, like in residency when we had to scan each other’s thyroids to see, I was [00:14:00] like, nobody’s scanning my thyroid. I don’t want to know about any nodules, I don’t want to follow anything up, like I just don’t want to go there. Um, and so, yeah.

It’s your personality to some degree, but I think as somebody who does that, and then I’m also breast imaging fellowship trained and the number of like incidental things that I see that cause a lot of stress. I just like, I imagine that multiplied times a gazillion. And so am I a fan of it? No. Um, do I think it’s coming regardless of?

What the doctors think probably because I think market forces are going to dictate that you know I mean if you look at other countries around the world There are other countries around the world that offer screening CTS and things like that that you can cash pay for and they’re obviously in demand so 

Will: Right?

I think it’s coming. That’s what people are doing. Kristen, what are your, as a non medical person, what are your, what’s your like gut reaction to like hearing about this? Like you can go, you can pay a certain amount of money and get a whole body MRI. 

Kristin: I get the appeal because it’s like the healthcare system is [00:15:00] so laborious.

Right. To get through as a patient, you have to go, you know, start with your PCP and then get a referral to some specialty and then get a referral to a different special. Like if you’re, if you have something that you’re concerned about, it takes a lot of steps and then that translates to a lot of weeks to get anything actually addressed.

So I get the appeal of just like this one and done, like let’s just see what’s going on in here. Right. Get all the blood work, get all the scans, get whatever. Um. But I also see the, like, I’m kind of with you. Like, I don’t, if it’s not actually a problem, I don’t want to know that it’s there necessarily. Or at least if I do know it’s there, I want to know that it’s not a problem.

And I don’t know how well that’s going to get communicated. And also, anytime that we do these, like, really technical things, you know, release it to the public for just, you know, You know, without doctor supervision or close communication or something, it’s going to get misinterpreted and people are going to end up being misinformed and so I’m, I’m, you know, [00:16:00] wary about that, but I do see why people would, would want to, like, it’s a lot of, it makes you feel a little more in control to know what’s, what’s happening in there because I think doctors sometimes forget that what you don’t, you know, what you know, You take it for granted that everybody might know that, and most people have a much lower understanding of their body and biology and physiology, so, um.

Will: Yeah, these wellness influencers just need to chill. Yeah. Need to cool a 

Kristin: little bit. Yes, like, I’m not in favor of making a quick buck in a way that is ethically questionable. 

Will: It’s a good, and plus, you know, why don’t people, you could just go to the emergency department and get a whole body ultrasound. I don’t 

Nisha Mehta, MD: Why spend the money for the MRI when you could do that?

They will, 

Will: they will, they will bring out that ultrasound so quick and just all over you. 

Kristin: Yeah. There you go. You don’t even need anything else. 

Will: Just for a disclaimer, I don’t know if that actually happens. 

Kristin: Again, I [00:17:00] have to say this podcast is not medical advice. 

Will: That’s right. You know, you don’t want to ask an ophthalmologist about things that happen in the emergency department.

And I’ll be the 

Nisha Mehta, MD: first one to dig at the radiologist. So if they see something they’re gonna comment on it and they’re gonna cover themselves and say, maybe you should follow this up and you’ve probably signed yourself up for about 10 new studies after that. So just be aware that you decide to pursue this route.

It will probably not be your last imaging study. Right. 

Will: That’s the thing. It’s, it just, you know, all these other things. More 

Kristin: questions. 

Will: Exactly. But it might, 

Kristin: I mean, sometimes those questions are appropriate questions, right. And it might do things to benefit people. And that’s what’s going to 

Nisha Mehta, MD: happen. But it’s like, you’re going to have that one success story, right.

Where like somebody caught this cancer really, really early. And everybody’s going to be like, that could be me. But you know, as somebody who reads follow up MRIs and things like that all the time, it’s sort of like, okay, I see a spot. Like it could be any number of things and without any clinical context and without somebody telling me, [00:18:00] this is why we were looking at this.

I have no idea why it’s bright. You know, I mean, now you’re going to follow it up and we’re going to see, does it go away? Does it get bigger? Does it, whatever, you know, and some of that stuff can be bright for years and you don’t really know why all the time. Um, so yeah, I don’t know. If you go chasing something, you’ll, you’ll find something.

The question is, is, was it worth finding or not? 

Will: We got a lot of limp nodes. They can do a lot of different things. Um, all right. So you, but you also, also have this whole other life. And so I want to tell us about going from, you know, full time practicing radiology to, to cutting back on that. When did, how long ago did you make that decision?

Nisha Mehta, MD: Yeah. So officially five years ago, I cut back to doing per diem work with the work that, or with the group that I’m now full time on. And that was, that was definitely a transition in the making about like, So I guess 2015, my husband graduated from fellowship. We had these great jobs lined up in the Northeast.

We were all going to go there. Uh, we had schools and houses picked out, all the [00:19:00] things. And then, uh, at the very last minute he got an offer down in North Carolina that we couldn’t refuse. My husband’s a plastic surgeon. Um, and so he was coming out of this job. P. G. Y. 9 pathway. And yeah, it was great. I was, I was very supportive.

Will: General surgery, then plastic surgery that you have. Don’t 

Nisha Mehta, MD: forget the research years in between. So yeah, it was really great. And then he wanted to do a super fellowship, but at which point I told him. I may go move in with my parents and in a year we’ll see what’s going on with our relationship, at which point he smartly made the decision to stop training.

How’s he enjoying his 

Will: research career, by the way? 

Nisha Mehta, MD: Yeah, definitely not doing research. He’s in private practice, plastic surgery, still does a lot of reconstructive surgery, but, um, But at least 50, there’s no research. Hopefully 

Will: he, hopefully he got some people, some nice promotions though. That’s, that’s probably good.

Nisha Mehta, MD: I’m very sure that he did, but we still get a lot of PubMed like emails saying that his, his work has been cited somewhere or [00:20:00] the other, so I’m sure he’s changing lives somewhere, but, uh, we, we just don’t know where exactly. Um, but yeah, anyways, um, we were coming off of that, which was just. The three years of his reconstructive fellowship were probably three of the hardest years of our marriage, our kids lives.

Um, just, I mean, he was home maybe like four or five hours a day and that’s including nighttime. My, my younger one was then, um, a year old and had legitimate stranger anxiety with my husband. Like literally he would wake up in the middle of the night to nurse and he’d see my husband and flip out. 

[music]: Um, and 

Nisha Mehta, MD: so we were like, all right, something’s got to change.

Um, and so, um, When my husband got this job offer in North Carolina, it was the polar opposite of the job he was looking at in the Northeast. And we just decided as a family, it was a better, better thing to do. Um, and because of that, at the very last minute, like a month before fellowship started, we switched gears.

And so, or before fellowship ended, we switched gears. So I was left without a job. [00:21:00] Um, and while I was looking for a job, I started writing and speaking just a little bit about the culture of medicine and all the things that I wanted to see changed. Um, During that time because I had this one year old that was sleeping all the time and I had never had time off.

So what was your 

Will: You were writing like what was your platform? Where were you putting all these the stuff out? 

Nisha Mehta, MD: So, you know, I was just submitting like op eds to you know, random places So like I got some stuff published in like PBS NewsHour Forbes like all these random places and at the time Nobody was writing about burnout Right.

So, um, I like wrote my first article on physician burnout and literally got like 15 emails from mentors of mine from like Penn and NYU. What are you doing? Like, nobody’s ever going to give you a job. You can’t talk about this stuff. And I was like, yeah, I mean, this is like, it’s hard to imagine. Right.

Cause now you can’t go anywhere without people talking about physician burnout, but this is 2015 and people weren’t doing it yet. 

Will: That’s not what, that’s not the reaction. I thought you were going to, I thought you were going to be like, you got a lot of support. Oh, [00:22:00] wow. You said, you said all the things that I haven’t been able to say in my job, but no, it was like, shut up.

What are you doing? Okay. It 

Nisha Mehta, MD: was literally like, you will not get a job. You will not get a promotion. And I was like, well, that’s great. But I’m like leaving academics to move to Charlotte, which doesn’t have a medical center or like an academic medical center. And I’m VA. So there’s no like upward mobility.

So I can say whatever I want to say, um, and so that was that phase of my life. And so I started writing and, and that stuff like just, you know, I think it hit a nerve in the public, right? Like obviously my mentors didn’t love it, but like everybody else did. Um, and so, yeah. You know, like that was really great for the first year or two, because I felt like I got to raise awareness of this issue.

And I was talking about changing demographics in medicine and women in medicine and all these things of like, you know, people telling me that, like, I should quit my job because my husband was a surgeon and raise my children, all, all the things that like, you know, right, exactly. Um, and so I’m just like writing about all these things that I think so many people in medicine could [00:23:00] identify with.

And, um, while I was doing that sort of, I guess, my awareness. in the general public. You guys know this story. People just kind of get to know you a little bit. Um, and then it was sort of like, well, what do I want to do with that? Right. And I think it was really great while we were writing sort of the let’s create awareness of burnout wave.

But then it was like, okay, now everybody’s talking about it. That’s not really what I want to do anymore. Like, how do you find solutions that actually move the needle? Um, and that was when I really started shifting into, like, what can we do to actually empower physicians? What can we do to actually change policy?

Um, and so I took kind of a hard right at that point and, and started shifting towards Um, and then how do we leverage the power of bringing all, and as the communities continued to grow, it was like, now we’ve got, you know, 2 percent of the physician population. Now we’ve got 5 percent of the physician population.

What can we do with that? [00:24:00] Um, and so, and then the pandemic hit, um, well, so basically the communities have gotten big enough that I did decide at some point that I couldn’t do both things. Um, you know, my husband was like sending me podcasts on the importance of sleep at 5am every morning when he woke up and I, like, he’d see me pass out on my computer.

Oh, he’s one to talk. PGY9. Right, right, right. But now he makes up for it. Now if he doesn’t get like seven hours of beauty sleep a night, we’re, you know, I’ll hear about it for the rest of the week. Um, so, so he’s, he’s definitely shifted into makeup for 10 years of, of no sleep, uh, mode. But yeah, so he would like, he’d wake up and he’d be like, what are you doing?

Like, you need to, you need to make some changes here. You can’t do both things, blah, blah, blah. And I was kind of like, oh, but I kind of really love this. I don’t really want to give it up. So I need to find a way to make both things work. Um, and so we did make the decision like mid 20 or 2019 for me to cut back, um, clinically and, and start to do more of those things.

And then the pandemic hit in 2020, and I just launched full into sort of [00:25:00] advocacy mode. So, um, the pandemic hit, we basically heard that no private practices were going to get any money in the stimulus package. And I was like, this is crazy. Like, you know, we’re hearing all these stories on the community of people like going in without their masks.

Or without any PPE and people not having money to run their practices and having to furlough everybody. And we’re like, what can we do? Um, and so through some connections we connected with Pelosi’s office and we were like, are physicians gonna get money in the stimulus package? And they were just like, we don’t give money to physicians.

And I was like. Well, that’s great. Cause you’re calling everyone healthcare heroes and you’re like talking about how everyone’s awesome and they’re like living in trailers in their driveways so they don’t infect their families but you’re going to let them go bankrupt and like, 

Will: you 

Nisha Mehta, MD: know, um, 

Will: practices fail and you know, and by the way, and it’s not just like the physicians, it’s their practices and the people they employ.

Right. So. And the patients that 

Nisha Mehta, MD: they see, right? Like now there’s no practice. So where are they going to go? They’re going to go to the emergency room, which is exactly where you don’t want them at the beginning of a pandemic. So, I mean, [00:26:00] the whole thing was completely ill cooked and we were just kind of like, Hey, like you got to do something for the doctors.

And she was like, We don’t give money to doctors. And I was like, well, they’re ready to strike. You know, I mean, there were people on the communities talking about striking. There were people talking about unionizing all these things. And she was like, doctors don’t strike. And I was like, well, um, I was like, this is not really the time to try it.

And so, you know, we got. We got on CNN. I went on like Wolf Blitzer, Anderson Cooper. We got about 300, 000 signatures on this document and took it to her. And she actually held up the stimulus package for 48 hours and got a 70 billion, which hit private practices, uh, like bank accounts about a week later.

So it was really cool. And that was my first taste of sort of like, Grand scale advocacy and, and it’s really just kind 

Will: of propelled a lot 

Nisha Mehta, MD: of things forward. 

Will: And I, I personally appreciate it too, because I mean, I’m in private practice and it, you know, we had to, you know, let all of our employees go and we were able to get that money to help, you know, keep the practice going.

[00:27:00] Yeah. Hire 

Kristin: them back up. 

Will: Hire them back. Um, but you, you mentioned, uh, eventually that this community, because obviously you started from. What, who was like the first member of it was like you and your husband was like, 

Nisha Mehta, MD: uh, no, I don’t, my husband wasn’t actually on it. It actually started as a female only group.

So my husband was definitely, and to this day, my husband is not really a side gig. Uh, you know, I mean, he, he helps me with all the private practice content and he helps me with our transition to practice series for the residents and fellows. But he is, uh, he’s very much living his private practice life.

So, 

Will: um, it grew eventually it must’ve grown to the point where it’s. It kind of becomes its own organism in a way, right? Yeah. All the members, they’re talking to each other, they’re commenting on each other, but so help people understand like the work behind the scenes that that made your husband be like, okay, you got us.

You gotta do something , change something here. Yeah, because it’s taken up so much time. What, where does that time go in managing a [00:28:00] community like this? 

Nisha Mehta, MD: Yeah. So, um, one verifying that everybody’s a doctor, we’re, we’re pretty strict about that. Um, in terms of, of making sure everybody on the communities is in fact a physician, cause we really want us to be a safe physician space.

So to this day, we actually have a wait list of 30, 000 people that we are trying to verify our physicians. Yeah. So that’s really great. Cause I’d be up at like 1 AM, like looking up people’s IDs and this and that. And. Obviously something that needed to kind of come off of the plate. Um, you know, cause as the communities grew, people just started adding like a hundred other friends, 200 other friends.

They didn’t like add their entire med school class or their entire residency program or whatever. Um, and so that just started piling up really quickly. So there was that one aspect of things. Um, then there was just, you know, I mean, Anytime you get a group of a lot of people into one place, um, you know, people are, people are always so quick to be like, Oh, this is so toxic.

This is so whatever. And I’m like, listen, guys, there’s 80, 000 people on one community. There’s 120, 000 on the other community. Like. [00:29:00] You go into a football stadium, or I guess three football stadiums with 200, 000 people, probably you’re going to find someone you don’t like there, um, or who you don’t agree with.

And like, yeah, we’re all doctors, but people come from very different lived experiences, and so there’s always sort of the drama that comes along with navigating that. A lot of this stuff where it’s sort of, I want to ask this question, but I don’t know how to ask it in a way where I’m not identified. And Facebook at the time didn’t have the anonymous post functions, so I was posting all the anonymous posts myself.

And, um, you know, and then there was just Because 

Will: there’s a lot of anonymous posts. There’s a lot of 

Nisha Mehta, MD: people asking for resources. There’s a lot of people just kind of, you know, asking for advice on things that they’ve seen other people give advice about. And so I probably get about 200 messages a day. I’m sure you get a ton too, where it’s just the, the inboxes were always full.

There were all these people reaching out and it was sort of like. You feel this thing where you’re like, I have the resources to help. I want to be able to help, but there’s only one of me and there’s 200, [00:30:00] 000 of you. And so, um, yeah, I, I think that work hasn’t really, it only, it only grows by the day and we kept keep hiring people to kind of help us do those things.

But at the time we didn’t have any, you know, we had no money to hire anybody. And so I was just doing all the things until we realized like maybe, maybe that needed to change. And so we’ve grown the team quite a bit since then, which has helped a little bit, but It’s still a 24 7 thing, you know, and things happen that are just, you know, medicine is.

Medicine is not always a great place. And so sometimes we will have like the 2am, you know, I always tell people, I was never on call at the VA as a radiologist, but I am like literally on call 24, seven for these communities. And so if somebody posts that they’re going to hurt themselves or whatever, then we’re on the phone with the police calling in safety checks at 2am or, you know, doing all the things that’s been a 

Will: part of the job.

Oh, wow. I mean, that happens 

Nisha Mehta, MD: probably once every few weeks. So it’s, um, there’s, yeah, there’s a lot going on that I think people don’t realize is happening behind the [00:31:00] scenes, but, um, a lot of moderation 

Will: type of things too. Yeah. 

Nisha Mehta, MD: And you know, as the groups have grown bigger, there’s a lot of people spamming the communities with just random things that, you know, and I shouldn’t even say spam.

There are things that are important to lots of people, but maybe just not appropriate for. 

[music]: Sure. 

Nisha Mehta, MD: 200, 000 people. And so now we shifted to all of the posts getting approved before they go on. So somebody has got to go through and approve them all so that people aren’t posting saying like, Hey, can you go on and help my three year old win this like contest on, you know, whatever.

Vote for my cousin. Right, exactly. 

Will: Their pie baking competition. What, uh, so how big is your team now? 

Nisha Mehta, MD: So we currently have about eight people that come in and out. Not everybody’s full-time, but there’s Sure, yeah. We’ve got, we’ve got people and we’re probably hiring another four or five. So, um, some people are they all in healthcare?

They all have connections to healthcare. A lot of them are med students that are taking some time off or, um, you know, the more permanent members of our team are not necessarily all healthcare, but, um, a [00:32:00] lot of our moderation team is healthcare so that they can kind of understand and have a background.

Kristin: Yeah. How do you decide when you’re moderating the post? How do you decide what, um, opportunities to share with physicians? Or how do you vet the things that people want to post? 

Nisha Mehta, MD: Yeah. So, I mean, PSG is very focused business finance side gigs. So, um, that’s the physician side gigs group. And that’s very, that one’s much easier because Usually those topics are not controversial and they just kind of go out and they’re fine.

Um, physician community can get a little bit dicey, um, at times. It can You know, people are posting about everything from, hey, I had my first lawsuit, to hey, I’m looking for a job, to hey, I hate my boss, to hey, I want, you know, this scope creep issue is, is getting to me, or this X, Y, and Z. Um, and so we’re always walking this fine line between giving a safe vent and be able to talk about things, but also making sure that, you know, we’re not violating any patient privacy, right?

The members are always kind of like [00:33:00] looking, um, or the moderators are always looking to make sure that there’s no HIPAA violations. There’s no, um, they’re not targeting or they’re not using the communities to cyber bully anyone. You know, I mean, anytime you’ve got so many people, um, on the platform, there’s a lot of that.

And then, you know, I think for the most part, it’s what is interesting to people. The Facebook algorithms decide for themselves what’s going to get out there. And what doesn’t like, people are always telling us, you guys have so many relationship posts and it’s funny because relationship posts are actually less than 2 percent of the posts that go out on the communities.

And yet, but the algorithm loves them. And clearly everyone, people complain about it. I’m like, listen, if you guys weren’t liking it and commenting on it, the algorithm wouldn’t. If you’re just 

Will: perusing, sometimes you can easily come to the conclusion that there are no more married people left and I have, I have a couple more questions, I have some questions about the physician side group.

Cause I think that group’s kind of fascinating. Let’s take a quick break.[00:34:00] 

All right. We are back with Dr. Nisha Mehta. Uh, so, so we’ve talked about, you know, physician community. That was the one you started with. It’s so we 

Nisha Mehta, MD: actually started with physician. Oh, you 

Will: did. Oh, yeah. All right. And it 

Nisha Mehta, MD: was when that group got so big, that group, I think, hit about 000 members when people started being like, Hey, I know this is a business and finance group, but my mom fell down.

You know, there’s more doctors here than anywhere I know. And my mom fell down the stairs in California. Is there someone that can see her tomorrow morning? And we were like, okay, we need to split off a physician community to keep this one focused. And so basically PC was started to kind of offer all the other things that people wanted to talk about.

Will: Gotcha. So did it start as physician side gigs or was it, there’s like more business questions? It was supposed 

Nisha Mehta, MD: to be side gigs and that was supposed to be all that it was about. Cause I, you know, when I started writing and speaking, I didn’t have anybody to talk to about like, what should my rates be? Be like, you know, how do I write a good contract that protects me?

What is this [00:35:00] 10 99 form? Like, do I need a solo 401k? What am I doing with this? You know, like 

Will: financial questions, like 

Nisha Mehta, MD: taxes, whatever. And so I wanted a place where I could talk about that with doctors. Cause obviously I think doctors have a little bit different of a profile than some other people that might be doing, um, side gigs and just some different concerns.

And so I just started as a safe place to do that. But then we realized in order to talk about side gigs, you know, People needed to understand business and people needed to understand finance. And so then we expanded that way. We’ve just kind of grown as the communities led us to. 

Will: Yeah, I definitely, and I’ve, I’ve read some, I I’m in that group.

I’ve been both of these groups, actually. I, I, I find them pretty fascinating. Uh, Especially, you know, the stuff about, like, running a business, posts like that, like, you know, how to do certain retirement things, and, and, you know, the business, financial aspect of things, but I know that there are going to be some people who are not physicians, who are not in medicine, that are going to hear physician side gigs and, and, and think, You’re like all in the 1 [00:36:00] percent already.

Like, why, what is it about physician? Why are you guys like looking for other sources of income? 

Kristin: And it’s similar to Nancy Pelosi saying we don’t give doctors money. Right. Cause the assumption there is doctors have enough money. They make a lot of money. 

Will: And, and there are, you know, There are a lot of, in that group, there are posts about like, you know, how to manage your finances and things that are, I think are very important.

But then there’s also other posts that are like, you know, certain business opportunities that come in, um, and for physicians to try to, to try to open up a different pathway to making money. So can you tell us about your thoughts about why this is so attractive to physicians or why it’s grown so much?

Nisha Mehta, MD: Yeah, so I think that there’s a lot of factors that have come together and the healthcare landscape has sort of propelled those forward. Number one, I think people come out of med school with a lot of student loans, right? Um, and yes, when people picture the doctor [00:37:00] lifestyle, they’re picturing what they see on TV and what they see maybe 20 years into a doctor’s career.

But that trajectory for doctors is very, Like dramatic, right? You come out of the scarcity mentality and residency where, you know, I don’t know about you guys, but like, we were both living in New York city. We had a kid. Um, and you know, we were literally like, do we walk instead of taking the subway? Cause really, do we need to spend the 2 right now?

Right. And we like went from that to then, okay, like now I’m an academic radiologist. We’re making some money. My husband’s still in fellowship. We have two kids. Like, you know, we have, we both had student loans and it was sort of like, okay, we need to get away with it. to get all this stuff paid. So I think you have people that are getting the side gigs primarily because they do need to address the finances and that first decade of practice where finances are generally very tight.

Um, but then I think there were other things that come into play, right? Like most of us, before we went to med school, we’re relatively interesting people that did a lot of activity, right? Like in order to get to college and do whatever, a lot of us, [00:38:00] All right, well, now I’m like done with that and I want to bring back some of these other things in my life.

And like, how do I develop out those interests? There’s a lot of people who just want to use a different part of their brains, right? Like a lot of medicine becomes algorithmic and it’s exciting to do something a little bit different, um, and have a different part of your brain that you’re using or something that’s totally yours and not your employer’s and what the employer tells you to do to something you can kind of do on your own terms.

I think, I mean, I’m sure you guys feel this way. I’ve met a lot of really great people and heard a lot of interesting stories through like the work that I get to do through my side gig stuff. And that’s. Just fun. Um, 

[music]: I think most of us 

Nisha Mehta, MD: are lifelong 

Kristin: learners. If I’m wrong, but it sounds to me like you’re making the audacious claim that there’s perhaps more to life than money that people might want to 

Nisha Mehta, MD: explore.

[music]: Yes, exactly. 

Nisha Mehta, MD: I mean, I feel like for me, like, this is just so much fun. Like I’m always learning. I’m always meeting cool new people and it’s just something that [00:39:00] like keeps things interesting. Like, I think most of us are lifelong learners and we like to kind of Add new skills, um, onto our plate. So I think there’s that.

And then I think the last thing that can’t really be sort of overstated is the fact that as the medical landscape gets more and more challenging, there’s a lot more of us that are sort of like, we need a plan B or at least some leverage to be able to walk away from the table if there’s something that we really don’t like.

And, you know, I will say like, For my husband and I, both of us plan on practicing for as long as humanly possible, because we love what we do. But, but part of the secret to loving what we do has been the ability to do it on our own terms. Um, and, and those alternative income streams that we have, have given us the ability to say like, no, actually, we’re not going to take that extra call or, Hey, we’re not going to do this one procedure that stresses us out.

Or, you know, we’re going to take a little more vacation or. You know, you know, when the pandemic hit, that was a great example because my husband and I were both productivity based physicians. [00:40:00] And so our income went to zero on the clinical front, but then we had this money that was coming in from real estate and whatever that actually we weren’t stressed about where the next paycheck was coming from.

Um, so I think having like a little bit of leverage is so key to physicians that are looking to be able to say, like, no, actually, this is something that I don’t want on my plate. And as administrators get more You know, just are putting more and more on your plate set ability to say no, or that ability to walk away because you’ve got another source of income is empowering.

So I think that those, all of those things coming together, you know, everybody on the group that’s doing a side gig has a different reason. Sometimes it was intentional. Sometimes it wasn’t intentional. Sometimes a lawyer reached out and contacted them and was like, Hey, do you want to do this expert witness case?

Maybe it’s somebody who needs a little more time at home and is like, if I could do telemedicine for half the time and be able to work from home those days, that would be great. Right. We’ve all got our reasons why we want flexibility. And, and I do think that it’s just kind of fun to not be a one trick pony sometimes.

So, 

Will: yeah. That being [00:41:00] said, I can’t imagine a world where anybody would enjoy doing surveys. I, I don’t, I’m sorry. I just like. You never 

Nisha Mehta, MD: know, takes all kinds. So I will tell you that during residency, we lived off of those surveys. Um, so like at the time those survey companies would send you these little credit cards and they were like these magical little things that we would get.

I mean. Like 

Will: a little Visa card or something? Yeah, 

Nisha Mehta, MD: little Visa card. And like, that was whenever we took a taxi. It went on the visa card. Whenever we went out to eat, it went on the visa. It was like this magic money that came out of nowhere. I do think that people over time phase out of that. Um, but you know, it’s like 50 bucks a 

Will: pop or something, right?

It’s something like, yeah, 

Nisha Mehta, MD: I mean, it’s definitely not the most well compensated side gig, but I think it is a, like an entry point. For a lot of early career physicians that are sort of like, Oh, this is, you know, I don’t need any extra training. I don’t need any extra expertise, totally flexible. I’m literally standing in line at the grocery store and there’s this two minute survey, and now all of a sudden I can buy myself an extra [00:42:00] beer without like.

You know, that’s just kind of on my medical knowledge. So there are some people that love it, but it is definitely, um, you know, there’s a love hate relationship that evolves over the course of your career. For sure. 

Will: I think we do. We, uh, we can both probably resonate with, with the, the idea of taking pressure off of one other aspect of your life.

Right. And I, I think about it in a backwards way when I see like social media influencers a lot of brand deals. Some of them are very, you know, a little bit sketchy, you know, as far as what kind of benefit they provide to society. Um, and because like, I am, I have that I’m doing social media. But also I have this other, my, my real career as a physician, I just say, so being a social media person is not a real career.

They’re both real careers, but, um, uh, it having both of those things, it, it makes it to where I don’t feel like, [00:43:00] okay, I got to take this brand deal because I need to pay my mortgage, you know, and that is, that is so freeing to be able to, to have a true. Quote unquote side gig, where it’s just pure creativity, pure, uh, it can be just more on the joy side of the scale versus the work side of the scale.

Right. And 

Kristin: help you make more ethical decisions because there’s not the financial pressure to accept whatever comes your way. Correct. 

Nisha Mehta, MD: Yeah. I mean like the number of pharmaceutical companies that reach out to us where we’re like, no, thank you. Like we had a telemedicine company that came to us and they were like, we’d like to hire these doctors.

And I was like, well, how much are you going to pay them? And they were like 8 a consult. And I was like, never call me again. You know, um, but, but the ability to like, say no to those things, I, um, I think has been what’s allowed us to kind of keep the communities genuine. It’s like, if there are things that I don’t think people want, I don’t need the money, right?

Like my husband’s a plastic surgeon. I’m a radiologist. We have very good [00:44:00] lives. We do what feels good and whatever it doesn’t, we’re just like, we’re good. No, thank you. Um, and that power to walk away really makes it fun. Um, if I don’t like in a particular advertiser, cause I just don’t like their personality or how they like interact with us, we’re very quick to be like, no, thank you.

We’re not doing that anymore. Um, and, and that’s been, again, it’s, it’s much more fun when you can say no. 

Will: So, so that’s the way this group works then. So the, the physician side gigs, these companies will approach you or your team be like, we have. We are at whatever, a survey company, cause it’s, that’s on my mind now.

Um, and we’re offering this amount of money and then you decide, okay, I’m, yes, I’m going to present this opportunity to the group or no, or, or no, you have to raise your price to this amount. Like how that sounds like a lot of work. Number one, 

Nisha Mehta, MD: it is a lot of work. We probably get about 30 partnership requests a week sometimes.

Um, and yeah, We say no to the vast majority of them. Do you have [00:45:00] 

Will: threshold? Like how do you decide? Cause physicians, we, we feel like we have a number for what is worth our time, right? Like what an hourly rate we would have for any particular thing. And so what’s the decision making there in terms of, of what’s an okay.

Nisha Mehta, MD: Yeah. I mean, I think for some things it really is, that’s not worth my time. I don’t have the time to like learn about your company, do the research, you know, figure out a way to put that in front. So there are things that we say no, just because it just doesn’t make sense for my time, um, or my team’s time, which that, that has allowed us to say a little bit, a yes to a little bit more now that the team can do a little bit of the preliminary stuff.

And I don’t have to get involved until it’s really at the end, but for some of this stuff, you know, um, One of the, one of the nice things now is because we don’t count on this money, I do say yes now to more things that really are just good for the community, even if they aren’t great for me, um, because we have the team to be able to navigate them.

So for example, [00:46:00] we do a lot of discounts for like, shoes and scrubs and things like that. And that kind of stuff is never going to It’s never going to make a substantial difference in my life in terms of what the revenue is. Um, but they’re great for the members. They want them. Um, and if we can make it happen, then it’d be really great.

You know, like we’ve got some great partnerships for like medical reference stuff that just, they’re willing to give our members such a great discount that I’m like, why would I hold it back from the members? Even, even if it’s not really very profitable for me. Um, so for that stuff, it’s. It’s okay for the other stuff.

It’s really like number one, how much am I going to have to learn about it? Number two, is it actually something that’s helpful to the community? Is this something they’re talking about all the time? Is this something that they need all the time? Right? Like our attorney database has been one of the most popular resources that we have on our community over the past year.

We just started that last year, but like, you know, 

Will: tell people about that. 

Nisha Mehta, MD: Yeah. So like, you know, I mean, there’s all these questions that come up on the group that are like, you know, I need a contract attorney or I [00:47:00] need a employment attorney for this issue that I have at work, or I need a state planning attorney or I need whatever.

And, you know, I think back in the day we had these doctor’s lounges that we all kind of like went to and hung out in. When we actually had the time to do that right and that’s where we get our information. Um, but nowadays it’s like who has time to research all that stuff and you’re not really you know getting as much time with your colleagues to sort of ask these questions and so it’s been really nice for people to kind of be able to go on to the community and say like hey does anybody have a recommendation for x, y and z and us be like, We have this list of people that has been vetted, you know, and everybody that goes through our partnerships and intake, they have to supply us with references with doctors that we reach out to and speak to about their experience.

We understand, like, you know, their pricing relative to the rest of the market. We try to get a discount for the community members for those services. And so. They can kind of come in there and like be confident that there’s sort of an Angie’s List aspect to it where we’ve vetted it with their colleagues.

Um, you know, does that mean [00:48:00] that people are always going to be happy with everything? No, but at least there’s like some layer of, okay, we’ve talked to eight physicians who said that this person was awesome and, and we believe that, you know, cause like, obviously I can’t, there are some things I can trial, right?

I could trial like a pair of Bomba socks. I can’t trial, Like, you know, five lawyers in different cities for things that I haven’t had. So it’s sort of, how do you use the group, like expertise and the group experience to, to then put together these curated lists of resources for the members and that, that takes a lot of time.

I mean, there’s, there’s two people that work on that all day long, but, um, but I think they’ve come up with a, we now have. Somewhere between 150 to 200 partners, um, that have all kind of come from resources like that, that I think the community members really love. I mean, they seem to always be asking for more of them.

So hopefully something 

Will: good. Well, on the flip side of that, have you, have you, have you approved any that you later thought, Oh, that was a mistake. I shouldn’t have [00:49:00] done 

Nisha Mehta, MD: that. I think that that is happening less and less in the last two or three years, but I think for the first year or two, like There was a lot of, like, naiveness on my part where I was like, oh, they sound really great and they sound like they love doctors and then I’d be like, oh, they really just want to take advantage of people, like, no, we’re not doing that.

So we have had to drop some partners that, um, In retrospect, I’m like, Oh gosh, like if they had come to me today, I would have seen right through that. But 

Will: right. And that’s based on feedback you get from the community, right? If people don’t like the stuff you’re serving them, they’re, you’re, you’re going to hear about it.

Nisha Mehta, MD: And that’s the thing about like, uh, like, I mean, there’s 200, 000 people there. If people don’t like what we’re doing, we’re showing them, we will hear about it. And so it doesn’t take long for a bad actor to be weeded out. Yeah, back to the football stadium analogy. That’s like when the referee makes a call, the entire stadium boos, right?

Exactly. Exactly. So we’ve had a few of those. Did 

Will: you take a, was there any point where you took that personally? [00:50:00] Like, did you, was that cause cause 

Kristin: that’s hard to, cause I’ve, 

Will: you know, obviously I felt my fair share of criticism on social media. It’s a kind of part of being on social media. I’ve, I imagine it has a different Actually, it does, to me, have a different feel when it’s coming from my, like, fellow, you know, colleagues in medicine, right?

And so, tell us about that. 

Nisha Mehta, MD: Yeah, I think that that has been like an evolution over the last five to seven years where like at the beginning, I really wanted to make everyone happy. And I was like, every time somebody said something to me, I was like, Oh my God, how can I fix this? I like wouldn’t sleep that night.

I’d like ask my husband a hundred times in a hundred different ways. Like, should I have done this differently? And he’s like, you had no way of knowing it’s fine. Like move on. Um, and I would just perseverate on it. And I think like, Up now, hopefully have a healthier balance. Although like we’re all human.

Right. And some, sometimes the way people say things just hits differently and you, and you just take it a little bit more personally, I’ve learned not to respond right away, um, which has probably been one of the best [00:51:00] sort of tools. Cause I need to just kind of sit with it and be like, did I do anything wrong?

Is there something I need to change? Or is this just, you know, there are some people that are never going to like you no matter what. And I think it just took me a little bit of time to realize, like, You’re not going to make everyone happy. And, you know, and also, like, sometimes people’s expectations are just unrealistic.

Like, sometimes people yell at me for not getting back to them within two hours. And I’m like, You understand, like, I’m a practicing physician, I’ve got two kids, like, you’re on this community for free. Like, you’re not paying me anything. And like, treating me like I’m your employee is not exactly a productive way to engage with me, you know?

That’s my reaction when people get 

Will: mad at me on, uh, about a video. I’m like, I, this is free comedy. You’re like, you’re not, this is, There’s nothing here. There’s no transactional thing. It’s just all just, you know, for 

Kristin: fun. Yeah, I don’t owe you anything. I’m just trying to help. 

Will: But I mean, but it’s hard because sometimes you do have to listen to like valid criticism, right?

Cause there is [00:52:00] always, you know, no one’s perfect and I’ve, I’ve screwed up certainly, and you acknowledge it. You’ve screwed up sometimes. And so being able to, to. To take that and learn from it is also a skill, you know. 

Nisha Mehta, MD: Yeah. And I think like, honestly, I mean, some of the best things that have come out of the community have been in response to criticism.

So I, I think that that is like, it is good to have that sort of gut check every once in a while. And like, I feel like when you look back on it, you’re like, Ooh, I had a spot. Spidey sense that that might not go well. And like, I probably shouldn’t have listened to it. And so, um, I’ve gotten better at paying attention to sort of like, if anything feels off about it from the beginning, I’m just not going to do it, but like, you know, there’s other things that are just like, not realistic, like sometimes, and I’m sure you feel this, like, There is this sort of pressure to be like, well, why don’t you do something about it?

And I’m like, why don’t you do something about it? You know, like people are like, why don’t you start like a national union for physicians? And I’m like, that is not something that I can just like cook up overnight and serve to you like a day later, you know? And [00:53:00] so, I think like also kind of being easier on myself and being like, Hey, I can’t solve everything.

And I’m just going to keep trying to solve what I can solve and help where I can help. But like, there’s a lot of people that are always like, I feel like sometimes the more you give, the more people expect. And you’re just kind of like, all right, I need boundaries. Too, you know, like I need to be able to take a week of vacation with my kids and not have to like, you know, answer a hundred messages today.

And so yes, maybe it will be a week or two before I get back to you. And that’s just what it is. And if you didn’t get your discount code in time, like, sorry, the world will move on, but like, I need my time. Um, so yeah, I mean, it just is what it is. Like I’ve. I, I realized I was talking actually, um, to Jim Dolly, the white coat investor a few years into this.

And I was like, God, do people say this stuff to you? Like, and, and I think I do get a lot more also because I’m a female sometimes, which like sometimes I would actually, at the time I’d be like, why don’t you go do this on Jim’s communities and see what he’ll say. And like instantly [00:54:00] they’d be like, yeah, no, I’m not going to do that.

And I was like, okay, well don’t, don’t do this. Um, and so there, there is a little bit of like a. Sometimes people think that they can say things to you on social media that they would never say to your face in person. And I think just kind of acknowledging that and being like, you know what, they’ve already made up their mind about me.

I’m not even going to try to win them over. I’m going to go focus on doing the things that I can do for the people that I can do things for. It’s like, it’s just a lesson. You kind of, you just start developing a thick skin. And Jim just kind of said to me, it was like, you know, You reach a certain number of people and a certain number of followers, you’re gonna start finding people that just really don’t like you, and that’s just what it is.

Will: So, here’s my question. Um, give me like, The top three ways that someone can get kicked out of one of your communities. 

Nisha Mehta, MD: Um, yeah, so, and, 

Will: and have you personally kicked people out or do you have someone do that for you? 

Nisha Mehta, MD: Do you have a bouncer? We do have [00:55:00] bouncers. I have realized from my own mental sanity, I need that to be very algorithmic.

And so it’s actually, as much as everybody’s.

It’s actually, it’s a very calculated process, 99 percent of the time, I don’t even know about it. And somebody will send me a message being like, why did you kick me out of the community? And I’ll be like, oh, you were kicked out of the communities? Didn’t know. Let me check the moderation lugs. Um, so actually like they have a very strict process.

It’s sort of, if you violate the rules a certain number of times, you get a warning, then you get suspended. And then if you still continue to do the same thing, at that point, they will kick you off. There are some things that will automatically kick you off without warning. Um, one of those is posting screenshots from the community.

We feel very, very like we want to protect it as a safe space. So if you take a screenshot of the community and you share it to another community or you share it on your social media or whatever, that’s like a, no, [00:56:00] there’s no going back from that. We just, once you’ve decided that you’re willing to violate the space, You’re out.

And honestly, I don’t have the time to listen to what excuse you had for doing it. So that’s just kind of, that is what it is. Um, that’s probably the number one thing that gets people geeked out is sharing it. 

Will: You have some private investigators that are, that are scouring social media for screenshots.

You would be 

Nisha Mehta, MD: surprised. I think a lot of people think that. Feel a lot of loyalty to the communities ’cause it’s helped them in some ways. So they do actually send us a lot of screenshots. Oh, okay. Okay. So they’ll come back to us kind of community moderation. Yeah. They’re monitoring 

Will: the, their own community, right?

Yeah. Yeah. So that’s, that’s helpful. Yeah. So that’s 

Nisha Mehta, MD: probably where the majority of our things, um, happen. Um, there are some people that just will not stop soliciting on the communities, you know? Oh yeah. My husband is a. Mortgage agent. My wife is a financial advisor. Like, you know, they’ll start messaging people nonstop.

Like they, if they know they can’t get away with it on the group, they’ll cold message people. 

[music]: As soon as somebody 

Nisha Mehta, MD: messages us telling them that they’ve been solicited by [00:57:00] somebody in the communities. They’re out. Um, and that’s probably like, those two things are probably 95 percent of what gets you kicked out.

The other things are really just sort of an unwillingness to, like, if you’re going to continue to, like, engage poorly with members after being asked not to do so, you know, like, some of those things. There’s some people that will try to dox people and be like, I’m going to, you know, we’ve had people that have gone on to other people’s, um, like health grade site and left negative reviews.

I mean, any of that kind of stuff will get you kicked out really quickly. Uh, but for the most part, we try really hard not to that being said, there’s a lot of different personalities and there’s some people that just will take no, won’t take no for an answer. And at that point I’m like, I don’t have the time if you’re going to message me and like attack me.

You don’t pay me. I, I’m sorry. I don’t have the time for it. Um, and, and those are the kinds of things that I’ve become a lot less apologetic about. Like before I’d be like, okay, fine. Like, why don’t we try to work this out? But now if somebody messages me and like, chooses violence [00:58:00] from the beginning, I’m like, You chose violence.

Like I’m not even engaging in this conversation. We’re done. Um, so I’m like, do you respect me? I will have a very like open, nice conversation about it with you. I may not agree. We may agree to disagree, like whatever, but you won’t get kicked out for that. But if you start messaging me attacking my husband or attacking my children or you know, whatever, like.

We’re, 

[music]: you 

Nisha Mehta, MD: know, we’ve had people send threats. Like I’ve had to send things to my lawyers from people being like, I know where you live. I’m like, really? You know where I live? Okay. That’s going to my lawyer block. Um, so there’s just, there’s some of that stuff that happens and I’ve just come to realize it’s part of the job.

So. Well, 

Will: what’s, what’s the newest, uh, or what’s coming up with the community? You got anything that you want the, our audience to know? 

Nisha Mehta, MD: I mean, I think we’re always building resources. Um, right now we’re gearing up for our start of our transition to practice series, um, which is kind of one of our favorite things that we do.

Um, so my husband and I basically just like. Bring a [00:59:00] cup or like a glass of whatever our favorite beverages. And we tell, uh, the residents and fellows that are graduating to do the same. And we basically have a whole year long program where we walk them through all the things that we wish that somebody would have told us when we were graduating.

Um, so we start out with like, how to find a job, then contract negotiations, how to buy your first house. business of medicine. And then we end the year with like personal finance 101. Like, what is this 401k? How big is your paycheck actually going to look after taxes? What do you need to know about 

Kristin: life?

Is this all like Facebook lives or how does this happen? We do it on zoom. Um, okay. 

Nisha Mehta, MD: Yeah. And then we broadcast them to the group, uh, for people. But yeah, we basically just have We have a few thousand residents a year that we get to do it with and we get to know them throughout the year. It’s really fun.

Um, it’s totally free. And you know, I used to, before the pandemic hit, I used to run around the country doing these lectures at Um, at residency programs, and I just realized we could, we could, number one, reach a lot more people if we did it virtually, um, and number two, I think it’s good for them to have my [01:00:00] husband’s opinion too, because I’ve, you know, I’ve worked at academics, I’ve worked government, but my husband’s private practice, and obviously I think the female male thing also, it’s just always good to have two perspectives on things, so sometimes I’ll say things and he’ll be like, yeah, right, like if you applied to my practice, I would never hire you if you said that.

And I’m like, okay. It’s Good. It’s good for them to know that. Um, so yeah, it’s been, and it’s a fun thing for us to do together to kind of whatever. So that’s launching, um, our 2024, 2025 version is last launching in a, in a few weeks, but, um, you know, we’ll still be going through it whenever this comes out.

So, uh, how many, 

Will: how many residents, how many trainees usually get. 

Nisha Mehta, MD: We’ve had a few, we had a few thousand last year. It grows every year. Oh, wow. That’s awesome. That’s great. It’s been really fun. 

Will: Well, um, uh, you know, good luck with that. And I just, I love what you’re doing with the advocacy, you know, harnessing the power of this group.

I mean, there’s, there’s not many places that have that many physicians like in one place, right? We talked a lot about 

Kristin: kind of the downfalls of doing something like [01:01:00] this, but there’s also so many, um, you know, benefits to it as well and like things that. That really can make a difference in bringing good to the world in addition to the physician’s communities.

So, 

Will: yeah, if you look at other, other communities in medicine, just in general, not like Facebook communities, but just communities, you know, of, of, you know, nurses or, you know, PAs, or, you know, they’re, they’re just, I, in my world, like optometrists, they have, they’re really big, organized community. And, and so physicians, I think have been lacking that for, for probably a host of different reasons.

Uh, and so it’s cool to see. What you can accomplish, you know, especially with like on the prior authorization reform and, and there’s any number of things, you know, 

Nisha Mehta, MD: I know we had the non compete thing going strong until last week. Cause I got knocked down, you know, I mean, there’s, it’s been fun to see what they can do.

And I think, you know, even [01:02:00] irrespective of that, I, I hope that it’s a play, you know, like I feel like at 11 o’clock at night, if somebody posts that they had their first lawsuit, like And they get a thousand people telling them within 10 hours, like, Hey, it’s going to be okay. There’s, there’s like some power to all of that, that I, my dad, my dad’s a cardiologist.

And when he had his first lawsuit, he didn’t tell my mom about it for literally a year and a half. And he would go down into the basement and be on the phone with his best friend from residency. for like hours to the point where like my dad or my mom finally one night came downstairs and she was like yelling at him we were like what’s going on she’s like if you’re having an affair just like tell me about it right now like i need to whatever my dad’s like no no no i just no it’s much worse than that much worse than that he’s like i got sued and the funny thing about it was actually we were out of the country When this lawsuit, or like when this alleged thing happened.

So he literally was not, he was, he thought he may be like, I guess somebody got prescribed something on call that they shouldn’t have gotten [01:03:00] prescribed and they pinned it on him. But he wasn’t, it turns out he wasn’t even on call that night cause we were literally in Mexico and. My parents had bought a timeshare at the time.

So we had like all this documentation that we had been on this trip and there was no way that he could be on call. And so of course the lawsuit was dropped literally the next day. And my mom, like to this day now, you know, almost 30 years later is like, this is what happens when you don’t tell me about things like, you know, I think like those are the kinds of things where it’s sort of, we, we hold a lot inside as doctors because we just, we don’t have safe spaces to share them with.

And I think that part has been really Really just I mean I think for all the drama that happens on the communities if you look at all the good that happens on Them and how much people kind of step up to support each other when they need them That’s been really cool. But like yeah for me now It’s just been really cool to say hey if we can take all these people and actually channel all these things And I love that.

And, um, I’m [01:04:00] going to go ahead and wrap it up for today. Thanks for having me. one. 

Will: Well, where can people find you? 

Nisha Mehta, MD: Um, so you can find me across all social media handles at Nisha Mehta MD, except for TikTok. I don’t do TikTok, so, um, 

[music]: sorry. 

Nisha Mehta, MD: But, uh, I mean, I’m just not funny. I think that’s what, like, it was funny when you’re, when you’re a coordinator.

Send me a message being like, so tell us a few funny stories about your career. I was like, I can’t answer this question. I’m not a funny person. I’m sorry. Uh, yeah. My team keeps trying to tell me to do tech talk and I’m like, story was pretty good. 

Will: I liked that one. So, uh, and then your website, right. You have a lot of information there.

Nisha Mehta, MD: We’ll take you to all of the things in our communities. And if you’re a physician, um, [01:05:00] how to join them as well. 

Will: Well, thank you so much for joining us. It’s awesome to talk to you. Thanks for having 

Nisha Mehta, MD: me. Yeah. All 

Will: right. Take care. 

Nisha Mehta, MD: You too.

Will: Hey, Kristen. 

Kristin: Yeah. 

Will: I’m full of Demodex mites. 

Kristin: Oh, I see that. 

Will: Are you? 

Kristin: I have no Demodex you one. Thank you. 

Will: Well, you have another one. 

Kristin: Okay. 

Will: All right. This one goes on your head. 

Kristin: Oh, okay. All 

Will: right. I’ll put that there. Keep them on. 

Kristin: Okay. Yeah. 

Will: Do you know what those guys do? 

Kristin: They cause red itchy eyelids. 

Will: Yeah, they’re, well, sometimes they do.

They can cause demodex blepharitis. Red, itchy, irritated eyelids, crusty, flaky buildup on your eyelashes. You look a little grossed out by that. 

Kristin: Well, it’s not my favorite thing. 

Will: But they’re so cute though. Look at them. 

Kristin: Yeah. Is this what they look like? They do look 

Will: like this. They’re not like soft and squishy.

They’re probably a little bit more. Sturdy and crunchy, but don’t get grossed out. All right. Get checked out. That’s what you need to do. [01:06:00] To find out more, go to eyelidcheck. com. That’s E Y E L I D check. com to get more information about these guys, Demodex and Demodex blepharitis.

Yeah, I was about to say that I, I, I don’t think I could like run like a group that that’s a lot of people to like run. 

Kristin: It’s a lot of moderating to be done. 

Will: Yeah, but then I also do have like a big group of people that follow me, but it’s like less, feels like less work. 

Kristin: You don’t have to moderate them.

Will: That’s, that’s true. They are 

Kristin: a, just an independent, self 

Will: organizing. I think I prefer it that way. 

Kristin: Yeah. 

Will: I don’t want to do any moderating. So more, I definitely came away from that interview, like. Like an appreciation for what goes into those groups. There’s a lot going on like behind the scenes there that takes a lot of work.

And a 

Kristin: lot of like, it’s kind of a thankless job too, I bet. Like, you know, you only hear about the complaints [01:07:00] and then you don’t hear, you don’t, you probably don’t get very many like posts of appreciation. 

Will: Yeah, I, I, that’s true. And although I’m sure she does a great job with her community, so I’m sure she probably does get a lot of good feedback.

Um, but uh, let us know what you guys think. Uh, we’d love to hear your thoughts. Thoughts, uh, and we didn’t do a game this time. I was just too, like, I just wanted 

Kristin: to, I do have a lot of questions. Very curious this time. 

Will: Anybody, I mean, this, cause she’s like a, a social media person that’s like different than what we’ve talked about before, right?

Kristin: She’s not like front facing. She, she has groups, but, um, 

Will: she doesn’t have 

Kristin: to put her face out there as much. So I 

Will: find it fascinating just to learn about, you know, how, you know, Different, different subspecialties within social media work, 

Kristin: right? Subspecialties. Oh my goodness. 

Will: So, um, lots of ways you guys can reach out to us, email us knockknockhighathuman content.

com. Hang out with us on our social media platforms. We’re on all of them. Hang out with [01:08:00] us in the human content podcast family on Instagram and TikTok at human content pods. And thank you to all the wonderful listeners, leaving feedback and reviews. We love you guys. We love all those reviews. The good ones, at least.

We love those. If you 

Kristin: have a bad review, then, um Keep it to yourself. No, you 

Will: can tell us, just like The 

Kristin: constructive ones. Just constructive. 

Will: Yeah. Anyway, if you subscribe and comment on your favorite podcasting app or on YouTube, we can give you a shoutout. Like today, at Sokomas Prime on YouTube said, Let the record show it only took 47 seconds to get a model eyeball on the show.

Kristin: Only took 47 episodes Excellent point 

Will: episodes. 

Kristin: Yeah, 

Will: it should have taken 47 seconds But now 47 episodes to get a model eyeball in which I have I actually have it looking at me right now Yeah, 

Kristin: it just stares at us 

Will: not not we record. You know, I just featured it in a knock knock I figured yeah, but no, it’s looking right at me.

The people are right in the visual axis [01:09:00] Full video episodes up every week. You said hmm like well, you just 

Kristin: always have to have someone looking at you

Will: Full video episodes up every week on our youtube channel at Glock and Fleckens We also have a patreon lots of cool perks bonus episodes react to medical shows and movies hang out with other members of the night knock high community We have frequent get togethers. We, you know, we talk and ask questions, answer questions, and just chat about life, as people do in a community.

Early ad free episode access. See, we have a community. 

Kristin: We do. 

Will: Yeah. 

Kristin: Yeah, our Patreon community. 

Will: It’s almost 170, 000 people. 

Kristin: Well, It’s got a ways to go, but, but I like the intimacy of a smaller community. I do like the 

Will: intimacy of a smaller community. Get to 

Kristin: know each other. 

Will: Interactive Q& A live stream events, much more, patreon.

com slash glockenflecken or go to glockenflecken. com Shout out to all the Jonathans, should we do that? Oh yeah, let’s do that. So shout out to Jonathans, Patrick, Lucia C, Sharon S, Omer, Edward K, Steven G, Jonathan F, Marion W, Mr. [01:10:00] Grandaddy, Caitlin C, Brianna L, KL, Keith G, JJ H, Derrick N, Mary H, Susanna F, Jenny J, Muhammad K, Aviga, Parker, Ryan, Muhammad L, David H times 2, Gabe, Gary M, Eric B, Medical Mag, Bubbly Salt, and Pink Macho!

Patreon with a lot of time. 

[music]: All right. Random 

Will: shoutout to someone on the emergency medicine tier. Boo! Denae! Thank you, Denae, for being a patron. And thank you all for listening. We’re your hosts, Will and Krista Planting, also known as the Glockenpleikins. A special thanks to our guest today, Dr. Nisha Mehta.

Our executive producers are Will Finnery and Krista Planting, Aron Korney, Rob Goldman and Shahnti Brooke. Editor engineer is Jason Portizzo. What a wonderful person Jason is. 

Kristin: Yeah, he has to put up with a lot from us. He puts up a lot of stuff. There’s a lot that you don’t hear that Jason does. Uh, thankfully takes out for us all 

Will: the foul language, everything.

Our executive producer is Omer Ben Zvi. Our music is by Omer Ben Zvi. We can’t get Omer to be an executive producer. I don’t know. To learn about our Night Night Highs program, disclaimer, ethics, policy, [01:11:00] submission, verification, and licensing terms and HIPAA release terms, go to glockenplugin. com or reach out to us, nightnighthighathuman content.

com with questions, concerns, or fun medical puns. Knock knock high is a human content production

Hey, Krista, what would you like Jonathan to do for you 

Kristin: all of my chores 

Will: all of them? 

Kristin: Yes every last one 

Will: Yeah, yep. I want 

Kristin: him to Make my bed clean my house Children 

Will: everything. 

Kristin: Yes. 

Will: Well, I don’t know if he can do all of that. But let me tell you about an alternative. 

Kristin: Okay 

Will: The DAX Copilot from Microsoft. 

Kristin: Oh, it can do many things.

Will: It can’t do all your chores, but it can help physicians with their documentation, all the administrative burden that sucks the joy out of practicing medicine. 

Kristin: Yes, and makes the [01:12:00] doctor patient interaction worse. 

Will: Exactly. 85 percent of patients say their physician is more focused when they use DAX Copilot.

93 percent of patients say their physician is more personable. and conversational. 

Kristin: Yes, because you can be a human and actually look them in the eye and talk to them. 

Will: It just allows you to obtain work life balance that is becoming harder and harder to obtain these days in health care. Learn about how DAX Copilot can help you reduce burnout and restore the joy of practicing medicine.

Visit aka. ms slash knock knock hi. Again, that’s aka. ms slash knock knock hi.