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We’ve all heard the stories. Your neighbor started the adoption process and got pregnant in the middle of the process. A cousin gave up on conception after 3 years and was pregnant within a month. Is there something internal going on that helps this happen? On this episode of Inside Reproductive Health, Griffin talks to Marc Sherman, founder of Organic Conceptions. After two unexpected pregnancies amidst a journey with infertility, he wanted to investigate this phenomenon. Teaming up with a psychologist, Organic Conceptions created an online program for couples struggling to conceive. Their program helps to reassess patient expectations and help them through their mental and emotional challenges.
Learn about Marc Sherman and his company, Organic Conceptions, by visiting www.organic-conceptions.com or by clicking here.
Watch the video about identity Marc mentions here.
Read the NYT Article: “The Lasting Trauma of Infertility” here.
To get started on a marketing plan for your company, complete the Goal and Competitive Diagnostic at FertilityBridge.com.
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Welcome to Inside Reproductive Health, the shoptalk of the fertility field. Here, you'll hear authentic and unscripted conversations about practice management, patient relations, and business development from the most forward-thinking experts in our field.
Wall Street and Silicon Valley both want your patients, but there is a plan if you're willing to take action. Visit fertilitybridge.com to learn about the first piece of building a Fertility Marketing System--The Goal and Competitive Diagnostic. Now, here's the founder of Fertility Bridge and the host of Inside Reproductive Health, Griffin Jones.
GRIFFIN JONES 0:56
Today on Inside Reproductive Health, I'm joined by Marc Sherman. Marc founded Organic Conceptions. He had been in corporate America for 20 years. The idea came to he and his wife, Erin, after they had struggled with infertility. They decided to adopt and then unexpectedly found themselves pregnant! So realizing that this occurs to lots of people with similar stories, they partnered with Kate Webster, who is a PhD who conducted a multi-year study that uncovered nine key emotional transitions that were common across the stories throughout the infertility journey. The research has been turned into an online cognitive-based program for women and couples. That's what we're going to talk about today. The journey to parenthood and beyond helps couples identify, name, and address, and overcome the suffering involved when struggling to conceive with these nine issues resulting in healthier patients and better outcomes. We hope to explore the applications for clinic partners today on the show. Mr. Sherman, Marc, welcome to Inside Reproductive Health.
MARC SHERMAN 2:04
Oh, thanks for having me. I appreciate the time.
JONES 2:06
So you've got data, is that what you're saying here? You’ve got data to talk about?
SHERMAN 2:11
Yeah, but I think what's most exciting about the conversation, Griffin is that, you know, as you know, and all the work that you do there's certainly a lot of the emphasis for care is on the physical way in which we're treating couples and there's no question that has advanced and there’s protocols and there's amazing stuff that's happening in that place, but what's not as clear as how do we address some of the emotional and mental facets that are just the reality of any particular person or couple that’s struggling to conceive? And there's very little in terms of protocol on what we do and I think that any visibility and awareness we can give and then things that exist to help support people in that way is an important part of the equation.
JONES 2:53
And this is a business show and I tried to bring on people with backgrounds in mental health or talking about the patient experience because I see those as requisite to improving the business. I don't think it's immediately obvious where business and where operations and where the standard of care begins. I think the more that society advances and subspecialties become even more specialized and complex, the less clear that delineation becomes. And so I think that this type of service is necessary for the standard of care. I think part of the reason why it doesn't get as much attention as it maybe should is probably twofold. The first is just bandwidth--people really have to focus on clinical outcomes and that takes up a lot of study and mental bandwidth. And the second is I just think they're not sure--many people aren't sure how this actually benefits clinical outcomes, how it improves the standard of care. There's some data here and there, but the more clear we can be, and with the value proposition, the more data to support it, I think is what ends up getting adopted.
SHERMAN 4:14
Yeah, I think you're right. And I think that just you know, our position is that--we are not in a position to ethically say that going through a course is going to lead to an unexpected surprise natural conception. That was what happened to my wife and I on two separate occasions, which led me for years to say, Oh, my gosh, you know, is there more to this equation? While not discounting the importance of physically caring for couples, but is there not not another dynamic that can be brought into it? And through this research with Dr. King Webster, you started to understand that psychologically, there was this process that we're moving through, there's these stages that couples are transitioning through. And I will just tell you, just like stages of grief--we had a doctor recently say that these nine steps and stages started to remind him that there's this common process that we're moving through. And I don't think any of us should discount that when you can just normalize what someone is experiencing and validate some of those extreme thoughts and emotions, the rumination and what-if scenarios, once you meet them where they are, I just think we're naturally in a position to help them emotionally find themselves, better understand how they're processing what they're going through versus suppressing it, how they can get on to stay trusted, connected, and emotionally healthy and well during a process that for many is traumatic, Griffin, there's plenty of data on that.
JONES 5:33
Well, tell us about this study. I want to hear about the 9 key emotional transitions, but I'd like to hear about this study that you did with Dr. Webster and what did that involve?
SHERMAN 5:45
Yeah, so it was you know--so here I am just a dad of three that had this very difficult experience over the course of eight years. You sometimes wonder why certain things happen in your life and for many, many years, I just felt we had this instance on two separate occasions where we became that annoying story of the couple that shifted their path and had the surprise. And after living it twice, there was no question like deep in my heart, even my wife would tell you that we just felt that there was more that changed in the act of adopting and that psychologically, emotionally, the way my wife looked at ourselves and her body, our relationship, decisions we made--there's a whole bunch of stuff that just felt different in. So yeah, Dr. Kate Webster is a PhD in multivariate statistics. She's a research psychologist. We partnered with a research organization out of the University of Utah who helped to conduct and formalize the first ever study to look at all variations of people that struggled for years and then had the surprise. And through this work--and Dr. Kate, you would love her she was on, she said, early on, she said, there might not be a common thread. There might not be anything that statistically links these stories together and you have to be mature enough to know that, but it was the complete opposite. Every story would map to these nine stages and once we realized that we had something, we continued to put it out there with focus groups and slowly started to build an online course that's helping to address the emotional health and wellbeing for couples. And again, it's not to suggest an unexpected conception, but the measurements we look at have to do with the change in their quality of life around three key constructs that were critical that came out of the data. Measurements as it relates to someone's sense of self, where very easily in this process, Griffin, you feel damaged, less than, you're defining yourself by what's not happening, you lose trust in yourself, efficacy in your body. So there's a sense of self-construct and measurements underneath it, that we want to move from a negative place to a positive place. Their ability to cope became another construct that really became very difficult for couples where they move from hope in a given month to despair and as that cycle keeps happening, this is where the anger, the jealousy, this is withdrawing from society and social events. So there's a coping piece that the program is geared to improve. And then lastly, their engagement with life for so many, life goes on hold and many times we give up living because we're living to try. So our everything that we focus on is moving people to more positive outcomes as a result to quality of life. We can't suggest what can happen next, but we do you think that if you're emotionally well, we certainly think that that impacts our stress, our hormone levels, and other things that can help our reproductive health be in a better position for success.
JONES 8:28
How do you measure that? How do you measure those different indices?
SHERMAN 8:32
Yeah, so there is a fertility quality of life assessment that we found, it was done from a bunch of doctors years ago, I think it's out of England, it's called Fertile QOL. And when Dr. Kate saw this, she just said, there's no reason to reinvent the wheel. There's a way in which they put that assessment together really touches on what it's like for someone to emotionally be dealing with fertility and how it impacts their quality of life, intimacy, social settings, and whatnot. So what we've done is we pull a subset of those questions that we really think are applicable to the design of our program and when someone completes our program, that's the survey we send them to say, where were you before and then when they complete the program, where are you after. But I will tell you Griffin I mean, we talk to couples all the time, we have to sometimes tell couples that if you see this is a to do item to conceive the baby, don't do the course. This is about self growth. It's about actualization. It's understanding how we're getting through this and there's a couple dynamics that's in play. A lot of times women own this process, and they ultimately feel like it's their bodies, their fault. So this is a course that's really trying to design to reach the couple in the privacy of their own home, to help them get through this experience--not just get through, I feel like that's reactive. I want to put our emotional health that's in a position that's actually contributing to your reproductive health, not just emotional health for the sad and depressed and not well, they need to see therapists. And we work with a lot of therapists that use our program in collaboration but we want to hit all the people that aren’t seeking out help and they're just trying to get by every single day.
JONES 10:04
That's why we're having this conversation because I think business is already tangential for some people that work in the field, meaning they're clinicians first. This show is about business. It's for practice owners. It's for executives. It's for practice managers. And sometimes even business itself is tangential. And then now we're talking about wellness and emotional wellness and different paths of the journey. And that temptation is often, how do these things connect? And that what I've posited is that people are coming to a fertility clinic for a solution to their problem. And a baby is often a good enough solution to solve a lot of what's going on with what they're coming for. But one, it's not the only solution, but two, we don't have 100% success rates, nobody has 100% success rates. And when people get negative reviews online or they have something with their online reputation, they'll often come back and say, “Well, it's because that person wasn't successful and they just wanted to take it out on someone.” And maybe there's some truth to that. If there is truth to that, it suggests that people are still coming to the clinic for some sort of solution. And the more solutions that someone can offer someone going through infertility, that isn't just a healthy live birth because we can't guarantee that 100% of the time--the more solutions we can offer, the better position we are to have that person be satisfied with their experience that isn't 100% reliant on clinical outcomes.
SHERMAN 11:51
Well, I think that's it and I will tell you--and I appreciate you echoing that--is that I was meeting with Dr. Fady Sharada at Virginia Center for Reproductive Health and his words stick in my head forever, which is it's not about the outcome. I think we think that once I have this answer, this fix, this baby problem solved, and what he said is there's so much loss, there's so much damage to relationships and even resulting in divorce, that the outcome is not necessarily--it's not the fix, as you described! It is how is a couple enduring through this process together emotionally? And I will tell you the New York Times and I'm happy to send the article, they just talked about infertility being lasting trauma, and again, regardless of outcome, and regardless of how many years later, this actually shows back up in our lives somehow. So our take is how do we improve that patient experience, address the elephant in the room--which is no person walking in any clinic that's really excited about where they are in their lives and I've been there and there's constant thought and rumination and what-if scenarios I'm running--and our ability to acknowledge them as a whole person, provide them a resource--what that does and I think why a lot of doctors now are just include our program as a standard part of care, we have a small monthly fee that a doctor pays, the price of an electric bill, in every single couple gets access to our course. They can do this in the privacy of their own home. And what we are finding is we're forgetting that the staff feels that burden, Griffin. The staff is emotionally doing the best. I had a nurse crying and said, “You have no idea how much this has been transferred on me and I'm trying my best. We deliver a lot of bad news.” And this wears down the staff, increases full time equivalency in terms of the staff. So I think that our resource needs to be deployed, but I think a lot of clinics have struggled with what is the best way in which we do it and I hope that we're just one part of that solution.
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JONES 15:35
The other thing that we have to figure out from a business challenge in this field is about conversion to treatment and patient retention. We can't help people if we don't retain them. We can't help people clinically if we don't convert them to treatment. There's key emotional transitions that people have to go through and several different pitfalls--potential pitfalls in the journey that people fall off. So I think this might map well in parallel with the nine key emotional transitions that you've uncovered. What are those?
SHERMAN 16:12
Yeah, so there's a--it's a seven hour course that we created for couples. But at the highest level, we have this pretty unique journey map--happy to make it available--but we built a program on these three chapters, if you will. There is a chapter called the conception of doubt and this has to do with a couple sense of self and within that chapter, there's these three transitions that couples move through, then we have our couples kind of lose patience and take on that patient mentality. Doesn't mean it's not okay to be a patient. Everyone seeks help, but it's more of a patient mentality, the labeling, the identity, the compliance in where people's lives get disrupted, upside down, backwards, loss of intimacy. And then there's this surrendering, not giving up on their journey, but a complete change in how they approach themselves. And within each of those chapters, there's these three stages that just naturally happen. And, you know, would you like me to walk you through the nine? I just feel like if I can at a high level, maybe?
JONES 17:05
Yeah, let's do it at the high level of just bringing us through. Let's just bullet it with maybe just a description of each.
SHERMAN 17:13
Yeah, so at the highest levels, it started with Expectations--isn't that the key to life? There was a very common set of expectations and thoughts that people had when they began and started their journey. And understanding our expectations and our thoughts and the way in which we thought things would happen is important. And those five key, kind of, expectations that came to the top. Again, expectations aren't wrong. It's just understanding really what's driving us in terms of how we saw this process happening. The reason that's important is our expectations then start to collide with this month-to-month delay. I don't like calling infertility, I don't like labeling people, but it was this delay. And what we found is that within just several months of our expectations, conception delay, it started to come--we started to internalize, we started to personalize it, we started to create a set of thoughts about, oh my gosh, I knew this might be a problem. I always wanted kids and I was fearful this might happen. Or I was on birth control too long, maybe that's impacting my body! We're starting to create a little bit of early thoughts and belief systems around what's happening. And this is where doubt is conceived. We call this chapter The Conception of Doubt. But ultimately, then all of a sudden doubt is starting to take over our thoughts, the way in which we define ourselves, our identity and it's this natural, slow process. So many women go through the program, they said, it's just like reading my mind. Again, we're not telling people what to do, what to eat, what to drink, we're helping them understand how we get to this place where we've completely distrusted ourselves, we feel worn down, we feel broken, we feel damaged. And that's the three steps it's just Expectations and Pressures, then there's a Delay in Conception, and then we call it the Power of Doubt. Doubt is conceived and then doubt starts to drive our thoughts would start to move us into how we start to act, behave, our attitudes, which is the next chapter that we get into.
JONES 19:01
Expectations could be an episode in and of itself, because so many of the challenges that are faced in patient-provider relation are rooted in that first stage of the expectations that they had.
SHERMAN 19:22
It's completely--we had a woman that just completed the program. She had two failed IIVFs, someone had suggested the course, went through the course, and decided to go back again. But she said, When we went back, we were different people! The amount of stress and anxiety we had based on our expectations of that treatment working and what if it didn't and all those scenarios they're building in their mind of what-if, she said, We were completely different people! They did have success. We can never suggest that as the outcome, but they had a completely different mindset. And by the way, expectations are normal, who doesn't in today's society not plan and think about how we're going to move from our careers into building families? For most of us, there's a certain timeline and expectation and how we see it all working very naturally. And for many of us, life generally goes the way we plan--we can work hard and get our job and degrees and the house. And now all of a sudden, we're dealing with something that's not going as planned. And I think we got to get to the root of the thoughts and the expectations in order for us to ultimately reshape--you know, we meet them where they are first, but through the program, we're trying to help them to then reframe. You can’t ask them to reframe and think differently until we understand what it is that we're thinking about, how we're interpreting it, the meaning we're giving it, and how we're acting and creating a life around those thoughts.
JONES 20:37
So what's the next chapter? What are lessons four through six?
SHERMAN 20:42
Yeah, the lessons with four through six have to do with how we start. Because of the way in which we're thinking about ourselves and thinking about our bodies, we naturally start to create kind of an identity around this. I have an incredible clip of a woman that talked about her entire life was consumed by this identity of being infertile. And this became literally, Griffin, it’s a powerful clip, a minute clip, I'll share it, but literally she talked about her whole life was consumed in two facets; one, I need to find the fix, I need to make this go away. And she described herself in a jungle, cutting her way through to find the next answer, the next fix, not looking at anyone or anything around her, which is that's somewhat normal. We've heard that probably a million times--interesting how she described it. But secondly, she goes all the things I wouldn't do in a given month because what if I'm pregnant--I'm not going to have that drink, I'm not going to go run--she actually likes swimming and diving--she was even talking about buying a car and I should wait because what if I have triplets, I maybe need a different car! She said my entire life was being consumed, engulfed, essentially paralyzed. So in chapter two, we're helping them to understand the way in which they're thinking that starts to become their lifestyle, their environment, and it has to do with the identity and kind of taking on that patient mentality. It could be my diagnosis, it could be my age. There's some core root identity that--maybe how long I've been trying, Griffin--and then every story started to become their view and their lens on the world. All we have to do is bring recognition to it. We can't tell-- it's their job to look at this and say, how was that piece manifesting in my journey? I tell people, the courage and vulnerability for someone to do a course like this is far greater than changing your diet, removing toxins, and all the other million things. They’ve gotta have the courage to do it. So it's about taking on that identity. There's a compliance that comes with our identity. When we start to see the world a certain way, we've labeled ourselves in a certain way, and the compliance is where people get completely obsessed with fixes and answers. For my wife and I, every part of our life, our existence, our intimacy, what we ate, drank, did, the way in which we had to--I mean, everything was under the microscope. We couldn't eat sushi because she was told raw fish might do this. And all these little seemingly innocent decisions, once again, not telling people what decisions to make, but it's checking in our intentions, Griffin, behind the decisions we're making. And if we are leaving ourselves out of that equation, not trusting our intuition, not doing things that matter to us--like my wife and I, our sushi night, that was a drive to our favorite restaurant, it was a connection, it was a conversation it was--and you start to make lots of little seemingly innocent decisions, and all of a sudden your life is robotic and mechanical. And you've kind of given up living because you're living to try. So it's about identity, compliance, and then helping them to realize how their thoughts and their identity is starting to show up and manifest within their lives and their physical environments.
JONES 23:32
And then, so to round it out--?
SHERMAN 23:36
Then the last stages were couples in our research, they just there was a complete change in their quality of life around their sense of self, ability to cope, and their ability to stay engaged in life that let and then yes, some of these people had a surprise, unexpected conception. But it came to these stages where at some point people decide to summon a change. We called it rawness--where at some point in time, people decide to actually think differently about themselves, their bodies and this journey they're on. A lot of people described it as going from resisting and suppressing to actually acknowledging I don't have the control I thought I did. And they start to open themselves up into where their journey might take them. So there's a rawness stage of, kind, of summing a change. You can't force people to change, but have they maybe missed some areas where they just could say, enough's enough, I need to bring myself back in. Again, this doesn't mean stop treatment does to them to understand how they've been powering through themselves and not giving themselves a chance to be present in this situation. Then there was a reaching back stage where people we reach back to each other, lost activities. And then we have this other stage of renewal. This is where just people start to reimagine themselves in this journey with a level of trust, connection, soundness. And for many, they're just they release that grip that is holding them back from living forward, moving forward with life plans, and knowing that this is a journey that they're on and it will be unique. It's not going to play out like your best friend’s, and how we start to open ourselves in and get back to having intimacy and connection and thriving in life, not just getting by every month.
JONES 25:09
So let's conclude with the product that you developed, but specifically, how you work with clinics to use this module. How do you propose that you help them with this?
SHERMAN 25:28
Yes, I think you said at the very beginning, which is clinicians are busy. There's so much they're up against. There's no one that I ever meet and train staff that ever acknowledge that this isn’t important. But we sometimes lack that protocol, we can tell someone do yoga and meditate and, and I'm not suggesting that those are important things, but we got to cognitively get to the root of our thoughts for lasting change. You could do something and feel better for the day or the hour, or the week, but the thought will be back in their heads. So the way we're working with clinicians--and I'm so lucky for so many doctors that have embraced us and helped us morph our model, our business model--but it's where they literally subscribe to a monthly fee. The clinician has a private website that allows them to register each couple. Each couple gets three months access to our program. We have this beautiful workbook and journal kit, that we co-brand with the clinics name on it so they can hand them the course materials, along with access to the digital course, and the couple gets three months access to the program. In addition, Griffin, we're not looking to own this information ourselves. We have a practitioner training, a three and a half hour practitioner training, to help the staff, the nurse, the people better understand and empathize what’s behind the eyes of that couple they're looking at. I had a hospital recently go through with a head nurse. She said, “I went through your training.” She said, “I see all my couples now through your stages, the way in which they talked to me I can actually stage them.” So our goal is to help the staff be more aware of the emotional piece in a bit more of a structured format. But the most important thing is there's not any one person that could give the right advice. The couple has to heal together at home. And I think when we give them the course, as a compliment to treatment, we're addressing the physical and emotional and I think the patient experience and quality of life of that patient will be much better. And I think we have a business model that's made this very, very simple for doctors to just include us as part of their overall preconception care model.
JONES 27:21
I look forward to learning more about this. I'm very interested that you're coming to this issue and challenge and set of thinking with a standardized digital solution because I think it's just, it's time for that. And I look forward to seeing more of it, learning more about it. And for those that want to check out Marc's work, they can visit organic-conceptions.com. Marc Sherman, thank you very much for coming on Inside Reproductive Health.
SHERMAN 27:57
Thanks so much for having me. Thanks, Griffin.
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You’ve been listening to the Inside Reproductive Health Podcast with Griffin Jones. If you're ready to take action to make sure that your practice drives beyond the revolutionary changes that are happening in our field and in society, visit fertiltybridge.com to begin the first piece of the Fertility Marketing System, the Goal and Competitive Diagnostic. Thank you for listening to Inside Reproductive Health.