Tanika Gray Valburn, founder of the White Dress Project, and board-certified OB-GYN Dr. Veronica Gillespie-Bell join host Dr. Charis Chambers for a forthright and honest conversation about uterine fibroids in Black women and the disparities in medical care that they face.
Tanika Gray Valburn, founder of the White Dress Project, and board-certified OB-GYN Dr. Veronica Gillespie-Bell join host Dr. Charis Chambers for a forthright and honest conversation about uterine fibroids in Black women and the disparities in medical care that they face.
Tales from the Uterus
Episode 3: Dialogue on Disparities
Introduction
Dr. Charis
Welcome to all of our listeners, to Tales from the Uterus. Today we will be discussing a dialogue on disparities. I want to start by sharing a quick disclaimer. This podcast is for US listeners only and is intended to be listened to as it was originally produced by Pfizer and Sumitomo Pharma America.
This podcast has been paid for by Pfizer and Sumitomo Pharma America, and the participants have been paid by Pfizer and Sumitomo Pharma America for their time. The information provided is for educational purposes only and is not intended to replace discussions with a healthcare provider. This promotional activity is not certified for continuing medical education.
Uterine fibroids disproportionately affect Black women
Now that we've gotten that out of the way, let's hop into today's topic. We're going to dive into one of the more common disparities in reproductive health, which is that of uterine fibroids. So, we know that uterine fibroids disproportionately affect Black women at a higher rate, but I do want to talk about what uterine fibroids actually are. So, this makes me think of our episode two, where we discuss uterine fibroids and other period issues. So, feel free to check that out if you have a chance.
Uterine fibroids are essentially benign growths that come from the muscle layer of the uterus. The symptoms and severity of uterine fibroids are dictated almost primarily by their location and size. We do know that the prevalence of uterine fibroids in all women is typically pretty high around 70 percent but can be as high as 80 to 90 percent in Black women specifically. It's also important to highlight that the symptoms that Black women experience tend to be more severe than their White counterparts. This can include anemia, longer and heavier periods, and significant pelvic pain. I'd like to welcome my first guest, our guest patient, Tanika Gray Valbrun. Tanika is an award-winning journalist, educator, and nonprofit founder with a passion for women's health. After her personal struggles with uterine fibroids, including two myomectomies, Tanika's passion for women's health inspired her to create the White Dress Project, a nonprofit organization dedicated to providing support for women suffering from fibroids and to raise awareness for fibroid education. For everyone listening, a myomectomy is the surgical removal of fibroids, and so that can be done with a variety of approaches but ultimately, it's leaving the uterus in place but taking away the fibroids. Tanika, welcome. How are you today?
Tanika Gray Valbrun
Hi, Dr. Charis. It's so great to be here with you. It's so great to have this discussion. Thank you so much for the opportunity. I'm really looking forward to it.
Dr. Charis
Oh, thank you so much for being here. I always love hearing your stories and hearing just your perspective on the topic of uterine fibroids. So, Tanika, can you share your story and experience with uterine fibroids, specifically highlighting what symptoms you experienced and how those symptoms impacted your daily life?
Tanika Gray Valbrun
Yeah, you know, when I hear that question, I'm always thinking to myself like, Dr. Charis, how much time do you have? Um, because it's been a really, really long journey for me. And for so many women who are managing life with fibroids, I, started my journey with fibroids really during my teenage years. I've always known myself to have a very heavy period, always bloated, always had to use the restroom. I was always that girl in college that, you know, we can't go on a road trip with Tanika because I'm gonna be the one who has to stop at every rest stop because I just had to always use the bathroom that way. And I really just built my life around having periods this way.
And I never really thought about it. I just thought that this was normal. I thought that this was a woman's plight. You know, since I got the gift of, having a uterus, then this was just my journey. And, um, I really just went on with life, knowing that my periods were out of control this way, knowing that I was having so much pain. I've always been pretty slim, but I've always, always had a protruding belly. So just imagine, going through middle school with that and going through high school with that and going through college with that. You know, just the stares, the looks, people always thinking you're pregnant. So those were the majority of my symptoms. One other symptom that I failed to mention was my grave anemia, which is low iron in your blood.
By the time I was about 24, I had already had probably about five blood transfusions due to my severe anemia. So, I just, I just kind of went on with life though, all through college, all through high school, I was just career focused. And just knew that I had to manage life with fibroids. I knew that I could never wear any white clothing, hence the name for our organization. I knew that I always had to pack a bag of clothes with me, extra underwear, leggings, like it was just my life. I always say that, you know, I've never bought a car with cloth seats because I know that you can get stains out of leather seats easier. And you know, when you're a poor college student, leather seats is always the upgrade. So, it wasn't always something I could necessarily afford. But for me, it was a way of life. It was something that was a necessity. It was something, that I had to have.
And it wasn't until about, I think, age 25, after these multiple blood transfusions, a physician said to me, have you ever heard of uterine fibroids? And I said, the thing my mom has? Like the thing that my mom had, quote unquote, the surgery for? And I'm like, no, there's no way that I could have that same thing. And I remember my mom sharing stories with me. And I think, just for so many people in our community and so many people who are managing life with fibroids, you don't think, that it's not, the symptoms aren't abnormal, right? You just tend to feel like this is a period. I'm a woman. This is what's happening.
So, for me, it was very alarming when I heard, any type of diagnosis because I was just thinking that this was normal life. So fast forward to, I got married, went to a doctor to talk about our options for children, and he said to me on the very first doctor's visit, he said to me that I needed to forget children, have a hysterectomy, because my uterus was way too compromised. And I remember my husband and I walking out into the parking deck and literally I fell apart in the parking deck. Crying, just so disappointed because you feel like you live life the way you're told to live it or you're supposed to live it or the way that, will give you the most success. So, in my household, it was you study, study, study, you get a great education, you go to a great school, you get a great job, you meet a great guy, you get married, and you have children. Now, I'm not necessarily vouching for that way of life or those thoughts, but it was the way I was taught. So, when you think about doing all of those things, appropriately, let's say, right? And you hear someone tell you that it doesn't matter that you've done any of that right, it's not enough. It was extremely devastating. So, I hope that kind of summed it up.
Dr. Charis
Oh, absolutely. That answered the question beautifully and you know heartbreakingly as well. So pretty much your symptoms affected every aspect of your life from the type of car, interior you would potentially be willing to get to, you know your hopes for a family. Now you know one of the things I do want to touch on is the frequency with which Black women sometimes delay seeking treatment. And a number of the reasons in which this occurs or for which this occurs, I think you touched on some of them. The idea of the ways in which sometimes we normalize the abnormal, because our frame of reference would be our mothers, our sisters, our folks around us who may be dealing with the very same thing. And that's just kind of the nature of a health disparity where it looks one way for someone else.
And if you're surrounded by people that look like you, you may all be suffering in a similar way. But I do want to delve a little bit deeper into the process by which you sought treatment and diagnosis. It sounds like you've gotten some blood transfusions and things, so what were your interactions, with healthcare providers? When did you say, I need a diagnosis, I need treatment here? And were you taken seriously?
Tanika Gray Valbrun
I often think of where I am in my life and the resources that I have, the access that I have. And I think about the experiences that I had, even with the access and the resources and I still experienced, a level of dismissal, a level of, disbelief or physicians not believing that my pain was as bad as I said it was. I remember during those years before being diagnosed with fibroids, doctors would say to me, I just, we can't figure out why you're bleeding. To the point that one of the first treatment options that I received for my heavy bleeding, which now I know was not a treatment option I should have gotten, was a D&C because they could not understand why I was bleeding this way.
Dr. Charis
So, for everyone listening, a D&C is a dilation and curettage, and so it's a surgical procedure where we try to remove some of that uterine lining typically to improve symptoms or to even get a diagnosis. Sorry to interrupt, Tanika.
Tanika Gray Valbrun
No problem. Thank you for that definition.
Tanika Gray Valbrun
So when I think about, like I said, having the access that I have, having the resources that I have, having the education that I have, and still feeling like I'm being dismissed, feeling like I'm given treatment options that, that if there was some more investigation that had happened, maybe that physician wouldn't have given me that particular, actually, you know what, I'm just gonna be transparent that, you know, I don't think, I don't think there was that much investment in me as a patient, right? Let's just be real about it.
So, I don't even want to give the credit because I wanna speak to the women that experience that, right? And there is just not enough credit given to our lived experiences. And I have a grave issue with that. So, with all of that, I had just that terrible experience with the D&C when I finally got diagnosed, um, and then that physician telling me that a hysterectomy was my best option on the first visit. It was all so much, but what I've learned through all of that is that even if a physician is not your best advocate, you have to be your best advocate.
But we have to think about how we are best serving ourselves as our own patient advocate. You know, I think we sometimes put in context or paint this picture that dismissal, disbelief, ignoring, all of those things are things of the past, right? And those are things that have happened to our ancestors and to our grandmothers. But the fact is that there is still limited access to healthcare for Black women in not just the management of uterine fibroids, but in many cases. And still today in 2023, there are racial biases, within the healthcare system that lead to inadequate diagnosis or inadequate treatment options for Black women.
Dr. Charis
Absolutely.
Tanika Gray Valbrun
So, we still got to talk about that because it's still happening today. And we sometimes put these issues in like a historical context, like, you know, I can't believe they did my grandmother like this, but I can't believe they did Tanika like this two years ago or a year ago, or I can't believe they did my best friend like this six months ago.
So, I think we always need to keep that at the forefront, that this is still happening and have discussions like this that can call out how things need to change.
Dr. Charis
Absolutely, that was so well stated. You know, you mentioned the differences across generations and some of the things that have remained the same. My next question is related to just like family dynamics. You know, we have been taught, a lot of us, that the doctor's always right and that you don't question authority and that's something that has certainly been passed down from generation to generation, especially in Black households where, you know, looking or appearing to be, difficult or disruptive, all of these labels that we can be labeled unfairly, we really seek actively to avoid.
And so, one of my questions is, did you face any pushback from family or friends? In your route to seeking treatment, the way you were seeking treatment, maybe declining some of the recommended options? How was that navigating that with your family members and maybe some people who were older than you?
Tanika Gray Valbrun
Oh, it's such a good question. I think about the time that I was starting the White Dress Project and decided that I was gonna share my story for the very first time. And I didn't share this part, but when I finally got to a doctor who was willing to, um, have surgery and treat my fibroids with a myomectomy, that physician during my first surgery took out 27 fibroids. And I remember when I was starting the organization and wanted to share my story publicly, um, my sweet, sweet Jamaican mother said to me “Honey, don't tell everybody you had 27 taken out.” And I remember saying to her like, “Mommy, like why? I did, you know, like I don't get it.” And you know, it wasn't because she was embarrassed of me, it was what she was taught. And then ultimately what she taught me, right? Which is, as a woman, as a lady with grace, as a woman of sophistication, as a woman who is going to be a boss in the world, you don't talk about those issues, honey. You don't talk about issues below the belt.
And so, I think back to all the cultural taboos and the stigmas that are in, as a Black woman, I can speak to that, as a Black woman who is of Caribbean descent, so I'm Jamaican, there is just that, ideology that these are not things you talk about. You don't mention them, and you are a person who was born with a uterus. So, this is your plight. This is what you have to go through. So therefore, it doesn't need to be discussed, broadcasted exactly what is this Instagram and what is this Twitter you're talking about. And that is not the way you do it. So, I remember her apprehension and her trepidation when I was starting the organization. Obviously, she wanted the best for me, and she just didn't want anything to taint, my image or what she perceived would taint my image.
So, so many times in our community, we hear women talking about, you know, my mother didn't say anything to me until I was being rolled into the ER, right? And it's like, mommy, grandma, auntie, like why y'all didn't say nothing? And once again, I think it's this these cultural taboos, these stigmas around women's health issues, our trepidation in talking about these issues publicly is kind of what's gotten us in this position, and what's gotten us to the point that, we've so normalized these symptoms that we go around and we're like, girl, everybody have fibroids. And we have so trivialized it, but we are all on the bathroom floor in fetal position suffering.
Dr. Charis
Suffering. Yes. Oh, that was, that was perfect. And I wanted to allow you to speak to the nuances of generational conversations and how our mothers and foremothers taught us certain tips of behavior that were learned in a system that often mistreated them, that if they had the, you know, courage or the, I don't know, the gall to bring up their periods and complain, what would they have been met with? You know? Would they have been treated differently, let go from their jobs, painted as, you know, a bad person, bad mother, bad caregiver, bad whatever, what opportunities would have been taken from them? And so really to understand it, we have to really know that historical context and look at the landscape of their existence and what was happening at that time and that helps to understand why we were taught these things. When I started my period, my mother taught me I mean it was like I was entering the Secret Service. She was like this is what you do okay, you take this and then the closing argument was like no one should know you're on your period I was like, whoa, that's a big ask.
But then as I started to really understand and unravel this, I said, why are we doing this? And then it made me want to ask the questions, like, mommy, why did you teach me that? What happened to you? Why did you say that we had to put it in a trash bag and take it to the big trash can because no one could see that we were on our period in a home with majority women? Why was that the case? And it made me wonder, when was she mocked for someone finding a soiled, you know, and really building grace? And so, I say that to say, the conversations they require grace, they require understanding, they require context, and they require our courage to make meaningful change. Um, so I really appreciate what you said there. That was beautiful.
Disparities in care
I want to pivot into our next session of our podcast, which is Disparities in Care. I wanna welcome our expert guest, Dr. Veronica Gillespie-Bell. Dr. Gillespie-Bell is a board-certified OB-GYN and associate professor for Ochsner Health in New Orleans. She is also the medical director for their minimally invasive center for the treatment of fibroids and is an expert on heavy menstrual bleeding associated with fibroids. Hi, Dr. Veronica, welcome, how are you?
Veronica Gillispie-Bell
I am well, thank you so much for having me.
Dr. Charis
Absolutely, thank you for being here and lending your expertise to this conversation. Um, so, I do want to, you know, kind of go back to the disparities in care that Black women face. Tanika shed light on her personal experience, but I do want to kind of step back and say, what do you know from a care provider viewpoint when it comes to Black women and just the disparities that they face when it comes to their care for uterine fibroids compared to White women, especially, and then why these disparities exist.
Veronica Gillispie-Bell
You know, it is so unfortunate and so heartbreaking to hear Tanika's story and to know that she is not the only Black woman that has that experience. I see patient after patient that tell me that they have sought me out because they've been told a hysterectomy is their only option. And just to clarify, a hysterectomy is removal of the uterus. Usually, that includes the cervix as well, plus or minus removal of the ovaries.
These are women that have never had children who desire to have children, or they may just desire to keep their uterus because they want to keep their uterus and it is their right to keep their uterus, which is reason enough. But they've been told that a hysterectomy is their only option, which is mind blowing because there are so many options that are available now for treating uterine fibroids and treating the symptoms that are associated with fibroids. Definitely there are more Black women that come into my practice that have been told that a hysterectomy is their only option. We know that even when we adjust for a body mass index, for this uterine size, all of those factors, we do see that Black women are less likely to be offered even a minimally invasive option, even if they choose hysterectomy. And so, when we think about where and why we see those disparities.
I always want to make it very, very clear when I'm discussing any issue that has to deal with health equity, that race is not a biological condition, it is a social construct. So, there's nothing biologically different for why we should have any health disparity as Black women. And so, when I say it is a social construct, it is the social way or the socialization or the way we have been socialized to think about Black women.
And some of it is how we tend we even think about ourselves. And you were kind of hitting on some of it in the other segment, Dr. Charis, but one, of those biases is that Black women are loud and Black women complain. And this is one of the archetypes that have been used to describe Black women. And so, what happens in the healthcare system, then the healthcare system does not listen when Black women say they have issues, they have problems, especially when it, as Tanika was saying, especially when it comes to pain. But then we as Black women do not want to fulfill that stereotype of the quote unquote angry Black woman. And so, we keep our voices quiet, and we don't advocate for ourselves. We don't speak up. We don't say, hey, I know that there are other options.
And so, I think a lot of getting to places of equity are for one, for providers, understanding these disparities, understanding how we are contributing to these disparities, understanding that we have biases and that these biases affect how we deliver care. And then as patients, understanding that we have a voice, that as patients, patients have a voice, your voice is important. I always, it may seem silly, but I use this analogy.
If I was going into a car dealership, I wouldn't walk into the car dealership and then the dealer say, you have to have this car, this color, and these features, that's it. No, the dealer would offer me different options, tell me the risks, tell me the benefits, give me all these alternatives, and together we would decide which vehicle is going to be my vehicle. And healthcare is not any different. And so, if you are not seeing a provider that is doing that for you as a patient, you have every right to seek out another provider.
Dr. Charis
Yes, I'm so glad you said that. So, so glad because, you know, it's the fear of being mislabeled and being mistreated because of that mislabeling that keeps us quiet. And then when we do speak up, it's shown that we're more likely to be dismissed. We're more likely to have to see multiple healthcare providers. We are more likely to feel like our concerns are invalid. And so, it's really a compounding of factors, you know?
And so, I love the, you know, the education and the empowerment, you know, the speak up piece, but there's certainly a systemic component. You've cared for many, many patients, especially as it relates to fibroids, what are some of the reasons that you see, um, for a Black woman waiting longer to see treatment?
Veronica Gillispie-Bell
I think for a lot of patients it's fear, because they do think that a hysterectomy is going to be their only option. They think surgery is their only option, and they don't want to undergo surgery. A lot of times they're told, or they know of surgical options that will require a very long time of being off of work and they don't have the time to be off for that length of time either because they're busy professionals or because they work in positions where they're hourly wage and they just cannot afford to be off for that amount of time.
And so that's a very difficult choice. And so, they're just unaware of all of the options that are available, that may not even require surgery. And so, I think the fear of a hysterectomy itself or surgery itself often causes patients to not come in, but also, I see this in fibroid treatment, but also in the space that I am in, in maternal health equity, that individuals are not wanting to interact with the healthcare system because they know of the disrespect that Black women experience in the healthcare system.
And so, we see this, all the time in the maternal space. I think that's been much more documented in media, but it's true in the gynecology space as well. When you know that you're going to walk into a place and you're not going to be listened to, you know that you're not going to be valued, you know that you're not going to be heard, and we're talking about in a time when you are extremely vulnerable. I think all three of us have had this similar experience about our periods and how we have been raised and it's supposed to be something very private. So, for you to let your guard down with a physician and to open up that part of your life, there's some trepidation that comes along with that. And then to know there's a possibility you may interact with a provider that's not gonna hear you or see you. All of those things and that fear that comes from that. All of those things are the things that my patients tell me are reasons that they have delayed their care.
Tanika Gray Valbrun
I just wanted to add to what Dr. Veronica just mentioned. There's also this, level of reverence that you have for your physician, you have for the people in the white coat that says that you shouldn't challenge anything they say. And trust me, I love my doctors, but I also know that I'm my best advocate and I know that I'm the CEO of my body.
So, I think there is sometimes a delay as well because you don't want to challenge what they've told you is your only option. So, if hysterectomy is it, well, I might as well go live life. And, you know, if myomectomy is it, then I don't have eight weeks right now to just chill at home because I don't have a job that can secure my wage.
So, I think that's what happens as well. And I think the way that physicians do a disservice to patients is that if they only speak to what they know, their line of expertise, so if you're not a minimally invasive gynecologist, then what we're hearing and what we're finding, and which has been my own personal experiences, that you're not going to recommend that particular thing. So, then a hysterectomy is your only option because that's the only thing I can do.
Right? So, there's no further conversation. So, I think that ideology about the respect and the reverence that we have for our physicians, while it's admirable, I think there is a way to partner with your physician, so that you have the best outcomes. Right? Because I think women are delaying because whatever they heard, they don't want to do that.
Dr. Charis
I'm glad you brought that up. And a lot of it is what we've heard. And it's not even just heard in modern times. What we've heard historically. You know, there's a lot of, especially as it relates to reproductive health. There are crimes against Black women's bodies. There are things like forced sterilization and other aspects that we know have taken place.
There is a lot of weight there, historically, certainly, and just culturally, it's a big deal. And I think that carries into some of the hesitations that we have when it comes to research, right? So, research is what informs a lot of our decision making in the medical space. We always say evidence-based medicine, that's the hope, but what does the evidence show? And sometimes we say, hey, but Black women weren't adequately represented in that study, right?
But there's also some hesitation when it comes to being a part of these research studies. Can you speak to that, Dr. Veronica?
Veronica Gillispie-Bell
Absolutely, I think it's well documented how the bodies of Black individuals, both men, women have been misused for science. And so anytime there is research being done, I think it is understandable that Black individuals, we will always question what is this research really about? What are you really going to do? If we question it all, a lot of times we just say, you know what, I don't wanna have any part of that. I know what's happened in the past. I don't want any part of that. And of course, I'm generalizing as a whole, understandably, we have fear about participating in studies. And then we don't always know then when the data comes out, what does it mean for us as Black individuals, because we were not a part of the study. Either one, because we chose to not participate because of this historical context. Or because there was no effort to include us in the clinical trials. That also happens. But we are really being damaged from history and now future because of what's happened in the past.
How we can solve the problem
Dr. Charis
Yes, very, very good point. I'm so glad you spoke to that. I want to transition into session three, which is basically how can we solve this problem? You know, what are some of the solutions?
So, there are some efforts being done to overcome disparities in uterine fibroid care. And Tanika, because I am familiar with your work, I do believe that you could speak to some of the things that are occurring as relates to Black women in research and even just some policy changes to improve disparities in uterine fibroid care. Could you talk about that?
Tanika Gray Valbrun
Yeah, absolutely. There are, you know, we've spoken about where we're coming from, where we need to go. And I'm happy to talk about the progress that we have made, especially in legislation. Our organization, I'm very proud of the fact that we are the ones, well, I wrote the legislation to declare July as Fibroid Awareness Month.
And while some may deem it as ceremonious. It's very important to our community because what it does, it says that we have a particular time during the year where we can raise our voices around our lived experiences. And I always say lived experiences is, the data that you need that goes along with the science, especially something like uterine fibroids, where there's so many variations in how someone can experience fibroids. Right?
So, I'm happy, about the progress that's been done on Capitol Hill, regarding uterine fibroids and the introduction of bills that have been made outside of July being declared as uterine fibroid awareness month, but we have the Stephanie Tubbs Jones Uterine Fibroid Research and Education Act. And Stephanie Tubbs Jones was a former, congresswoman from Ohio. She passed some years ago, but 20 years ago she introduced this legislation talking about her own personal experience with uterine fibroids.
And just really advocating for why NIH and our additional government agencies needed to do more around this and as it pertains to women's reproductive health. So, we have introduced that, I shouldn't say we, but I've been on the groups and championing this. It has been introduced by Congresswoman Yvette Clark from New York, on the Senate side, Senator Cory Booker and Senator Capito.
So, we have gotten some support for it, but the bill has not been passed. So, there's still a lot of work to do. And just a quick synopsis of what the bill outlines. It outlines giving $150 million over the next five years for uterine fibroid research to understand some of these very things that we've been talking about, disparities, where's the research. Why are Black women disproportionately impacted by fibroids, especially as Dr. Veronica spoke about earlier, that there's no biological component per se. So, it addresses all of those things. And when you think of $150 million to, regular earning people like us, it sounds like a lot of money, but it's really not compared to the way funding is divvied out for other disease states. So, I'm proud of it and I'm proud of what we've been able to do to introduce it and the support that we've given our members of Congress who have introduced it. But there's still a long way to go. I want to add that having conversations like this and partnering with companies and organizations that find these conversations necessary and these stories necessary, tip my hat, chef's kiss, all of the things, because those are the allies that are needed to keep these conversations going.
So that was a long way of saying, we're doing stuff, but we, things are definitely happening. And I'm very proud of our legislators who have decided to share their personal stories. Congresswoman Lauren Underwood is another person who has shared her public story with uterine fibroids. So, I wanna applaud those legislators who have done that because obviously in the political climate that we're living in, sometimes it's hard for these conversations to break through. But it's important to know that it impacts so many people and therefore the conversation has to continue.
Dr. Charis
I love how you stated that, and I appreciate the synopsis specifically highlighting the money that is planned to go towards research, which makes me want to circle back to that. You know, there's so much, um, to be said about the importance of educating around research, the inclusive nature of research and why that is important. We do have some people doing great work. We were able to be at an event with Dr. Erica Marsh who does great work as a physician researcher in the area of fibroids. And she specifically did a study that looked at, how do Black women make choices around their care when they're offered minimally invasive options and all the options? And one of the things she said was, when you're given an opportunity to order, you wanna order from the whole menu.
And what her research found was that Black women were much more likely to choose minimally invasive options when given the choice. And that makes me want to kind of pivot to, you know, it's important that we have that research to show this is where the work needs to happen. This is an issue, not just with us, but with the healthcare system. And so, we're not just pushing patient awareness, which is great. There has to be a focus on increasing awareness among healthcare providers. Especially as it relates to how healthcare providers manage Black women differently and how they may or may not offer these options and Dr. Veronica, I do want to give you an opportunity to speak there because I know that you had the minimally invasive portion of this care and so I know that you have some insight.
Veronica Gillispie-Bell
Yeah, I will say that the awareness is happening all the way around. You know, we did speak a lot about what we have seen our patients, experience with physicians, but I will say that in the time that I've been in practice, I've been in practice now for 15 years, that the way that providers that I am seeing are counseling patients is starting to change.
Again, you know, I primarily treat patients that have fibroids. And as many patients seek me out, I have doctors that refer to me. To your point, Tanika, a lot of times, if doctors only do hysterectomies, that may be what they offer patients. But what I'm starting to see is that the doctors will say, this is what I can do for you, but let me refer you to Dr. Gillespie because she can offer you some other options, from a surgical standpoint that are minimally invasive options. And so, I'm very appreciative, that those doctors are doing that, that they are trusting me with their patients.
But I am starting to see that, as new options become available, that there are doctors that, that's just not what they do, but they are starting to say, hey, I don't know much about this, about this option, but I know somebody that does. And so, I think that's, that's very, very important. I think it's also something that for, through our residency programs, you don't have to be minimally invasively trained in fellowship to be able to do these options. You definitely don't have to be minimally invasively trained to know about the options. So, I do think we need to do more in our residency programs around educating around the different options for treating fibroids. It is the thing that made me go into OB-GYN, um, as a junior in college.
And a lot of the things that you were saying, Tanika, resonated with me as a junior in college. My mom was diagnosed with fibroids. I didn't know what that was. I certainly was not gonna ask her about it because that was not something that you talk about. She just told me she was having a hysterectomy because of fibroids. I knew nothing about fibroids, didn't know what they were, started, um, doing, my own research, realized there were no options available other than a hysterectomy And so, I decided that was it. What I focused on are making sure that women have treatment options. And I've put it out there to my medical community that, that is my goal.
Dr. Charis
Yes, yes. and that's so important because, you know, the change needs to be full circle. It needs to be all the way around. It needs to include everyone, from people who have a uterus to people who love those people with a uterus. And I do think that, you know, highlighting these issues with implicit bias. Highlighting the fact that not every doctor provides the same, you know, options or opportunities, that's important.
And I do think it would build trust. It would build trust for me if someone I'm going to says, you know what, there's someone who does this better, and I want to send you to them. There's someone who offers what you're looking for, let me send you there. That to me is a trust building practice. This isn't a failure if I can't fix everything. It's more so guiding that patient to the right person who can.
Yes, any parting words Tanika and Dr. Veronica?
Tanika Gray Valbrun
Just to add to your last point, I think, you know, Dr. Charis and Dr. Veronica, you two obviously are excellent physicians. It's apparent that the patients that come in contact with you, that you care about them deeply. And I wish that the people that I meet in our community had the opportunity to meet physicians that have the level of empathy and care that you two have.
But unfortunately, that's not happening a lot. So, I would ask, as a patient advocate, that because both of you have the platform that you have to share with your fellow physicians, spread that message that if I don't do it, it's OK to refer. Offering the education and referring is also something that I think needs to be wrapped up in there or be reminded of because it's troubling to me that we're just seeing so many people in our community and knowing that I experienced it myself that aren't getting that level of care and not getting that level of empathy.
Dr. Charis
Yes. Thank you, Tanika. Dr. Veronica?
Veronica Gillispie-Bell
Yeah, I think for me, for the physicians, um, that are on the call, that are on the podcast and are listening to the podcast, just understand that your patients, want to have transparency. They want to participate in shared decision-making. And remember that any relationship is founded in trust. And so, as part of trust, making sure that you are listening to your patients and truly listening. Listening to understand what are their symptoms. What are their goals of treatment and making sure that you offer them, first of all, discuss all the options, but make sure that you're together choosing an option that centers that patient and centers their desires.
And understand it's okay, we cannot be jack of all trades if the patient desires an option that you do not perform or you do not have access to, it's okay to transfer that patient because remember, patients need to be informed consumers, and we have to respect their decisions and choices.
Dr. Charis
That's so beautiful. Patient-centered care. That's the goal. Um, I do want to thank you both, Dr. Veronica and Tanika, for your candor, for your honesty, for your expertise. This has been a beautifully vibrant conversation. You know, it's sometimes hard to talk about disparities. It can be very triggering emotionally. It can make you think of all the people in your families who were mistreated by care providers or had not so great experiences with their health care, but I'm hopeful that there's a tiny seed of power and empowerment that we may have planted in the hearts and minds of our listeners that says there can be change. You have to kind of know where your role is as a change maker, but we all have the ability to create change. And with all of those combined efforts, hopefully these disparities will actually be a thing of the past and in our lifetime. That would be a beautiful thing.
Outro
So, I do want to also thank Pfizer and Sumitomo Pharma America for sponsoring this discussion and giving us this platform to have this much needed conversation. As you stated, Tanika, it is partnerships like these and platforms like these that really keep the conversation at the forefront of people's minds so that we can move the needle and push the conversation forward.
And that's it. That's it from Tales from the Uterus. I'm Dr. Charis Chambers. Thank you so much for listening.