Should Fertility Doctors Become Advocacy Leaders? An Interview Dr. Serena H. Chen, MD

In this episode, Griffin speaks to Dr. Serena Chen, director of the division of REI and OB/GYN at Saint Barnabas Medical Center and clinical associate professor at Rutgers and St. George’s University. Dr. Chen strongly advocates physicians embracing social media to maintain cultural competence; she and Griffin discussed how this commitment to connection helps doctors communicate with patients and how embracing advocacy can prevent physician burnout. You can find her on Twitter and Instagram at @drserenahchen.

Griffin Jones: Today, I’m joined by a very good friend, Dr. Serena Chen. Dr. Chen graduated from Brown University in Rhode Island, she went to Duke for medical school, she caught her first baby there and decided to become an OB/GYN. She then did her OB/GYN residency at Johns Hopkins in Baltimore, MD. She has come on to become the director of the division of REI and OB/GYN at Saint Barnabas Medical Center, as well as IRMS, the Institute for Reproductive Medicine and Science. She’s also a clinical associate professor at Rutgers at their Robert Wood Johnson Medical School, and at St. George’s University School of Medicine. She’s been named top doctor a whole bunch of times, she is all over Twitter, and is easily the quickest to respond to any message, I feel. Dr. Chen, Serena, welcome to Inside Reproductive Health.

Serena Chen: Hi, Griff! It’s so nice to be here!

GJ: I’m really excited to have you, because we’re both sort of hitting a stride, with messaging, with connecting with people, with sharing thoughts with the community, and I feel like we’re gonna go down some good rabbit holes today.

SC: Ok, that sounds good!

GJ: I’m gonna start with a quote you sent me, and if I remember correctly, I don’t even think I paraphrased this before I put it into a blog. I feel like you sent me this all in a text message, so listening audience, I’m gonna read this to you: “Not to use social media platforms is to be culturally incompetent. As a physician, we’re supposed to give medical advice in a language a patient understands. Not doing so is considered to be medically inappropriate and can lead to adverse outcomes. If large segments of the population get the majority of their information digitally, isn’t it incumbent on healthcare providers to provide information in an accessible way?” Dr. Serena H. Chen, circa 2018.

SC: *laughs*

GJ: For those of you who don’t have the privilege of having long text message conversations with Serena, this is the type of nuggets that you got. This is what you're missing out on. Let’s talk about that. That’s a really coherent thought, a pretty solid affirmation, and I wanna have you explain more of it.

SC: It’s not that I composed it like spent a long time composing it, we were talking and I just blurted it out in a text. But I’ve been thinking about it for a long time because I started… I think I started maybe like… seven years ago or six years ago, I can’t even remember when I first got on social media. But before I got on social media, I thought about it a lot, because you could see… when did social media become big? It’s been over a decade since people have been communicating by social media. I was interested in it for a long time because there seems like there’s a lot of excitement about it. Initially, I thought, “This would be a good way for practice marketing like we should… it would be a good way to market our practice.” Reproductive medicine, in particular, there does seem to be like a lot of patient engagement. Maybe because patients aren’t critically ill. They’re very, very passionate about having a baby and getting good care. In the New York metro area and New Jersey, where we are, there’s a lot of choices. And New Yorkers and New Jersians are kind of famous for seeking a lot of opinions, second opinions. For people who are not critically ill, who have an issue they’re very passionate about in this area, they’ve always done a lot of shopping. In the old days, like in the 90s, we did a lot of stuff online. We had IVF chatrooms, we answered questions online. A lot of doctors in a lot of fields didn’t do that. I feel like reproductive medicine…

GJ: Do you feel that, were a lot of IVF doctors doing that? It seems to me like there’s a lot of folks who want to stay the heck clear of it now, much more than in the 90s.

SC: I think there were a few people who were active online, who participated in the RESOLVE answer board, and the American Infertility Association, and reproductive medicine… and you’re right. It wasn’t all of reproductive medicine. But there were definitely a few people who were active. I did a lot of that, and I enjoyed it. I think it helped patients. And I didn’t see that in other fields. When social media came out, it seemed to be a lot more interactive than the message boards. So I was very interested in it, initially for marketing. When I started doing it, I got a lot of positive response, and I met a lot of interesting people. I didn't’ get just positive feedback from patients saying, “Oh, I saw your post on Twitter, Facebook, and that made me feel comfortable coming in to see you,” I also met people like you, Griff, who are also interested in things that I was interested in. We didn’t just meet online, we got to meet in person, and that was really cool! Social media for me was really, truly social. But now we realize that an entire generation of people now use this for communication more than they use their phones or email or texting. This is how they communicate, and we were always taught as physicians, you know, I have to do a CME Credit, it’s part of licensing and things like that to be what’s called culturally competent. You cannot speak in English to somebody who only speaks in Spanish and tell them the risks and benefits of their treatment or surgery and really, truly have informed consent. You cannot tell somebody how to take their medicine that way. If they take it wrong, people can even die from taking medication wrong. Cultural competence is really important in medicine. It just means talking to the patient in a way so that they can really understand the risks and benefits of their treatment and they can really understand what to do with their treatment and their medication. And a lot of physicians are very dismissive of social media because they see it as marketing, they see it as beneath them, they see it as…

GJ: I think both of those are ancillary excuses. I think the real obstacle is it’s one more damn thing that they don’t feel like learning. They don’t feel like mastering, spending time, money, and effort. I think it’s really important to note that you seemingly jumped into social media, but really you were just adapting from a long time ago when you were in chatrooms in the 90s. There were people in the 90s who said, “These things will never take off. Why the heck would I ever talk to a patient in a chatroom? What about risks A-Z?” And they used all of those as reasons to not start engaging with that platform. You were, and when that platform left the desktop world and left the chatroom and went from being anonymous to people’s actual names and went to social media profiles, then it went to mobile from desktop, you were just going along with it because you were… it wasn’t like you were jumping in, learning a brand new language. You were just sort of staying with the language as it adapted a little more closely. I think it’s like, Griffin or Serena or all the other people we have on this show, you want me to do one more damn thing, I’m already swamped, I’m already seeing so many patients, I’m already busy— isn’t that good enough?

SC: It is hard. As physicians, we constantly have to learn new things. But that’s kind of like saying, Well, you know, why do I have to do PGT with NGS with Next Generation Sequencing, when I just learned how to do it with FISH-fluorescent in situ hybridization ? Why am I using ultrasound to guide my transfers when like that’s yet another thing for me to do? Why do I have to use electronic medical records when… it’s basically saying I still think it’s part of technology. It’s not something that we use directly to treat patients, but its communication is absolutely critical, and I guess that’s my point. Digital media is literally a type of language for an entire generation. This is how they communicate. I presented an abstract a few years ago at ASRM called, The Doctor Will Treat You Now. We had data from Zocdoc, which they very nicely shared with us, showing that a lot of appointments are made after hours. That’s when people have time to make appointments. This is just the reality of our lives now. If we create barriers through language or you’re taking care of patients who are in their 20s and 30s and they never talk to people on the phone and they don’t have time between 9 and 5 to call you and be able to make an appointment-- how are they gonna get care? Those are barriers to care.

GJ: Maybe all those barriers seem like a lot of procrastination. At the end of the day, people know what’s coming and what’s already here, and for some reason, if they can just push it off in their minds, if they can just deny it, they feel like they can buy some more time and they don’t have to make a decision now. I remember in 2015, the first meeting I ever went to in the field, I wrote an article that said Instagram is where your patients are. It is the place... I got you on Instagram. It’s the place where people are spending their time in the infertility community. I went to a meeting and somebody was speaking on social media- it wasn’t me- and this person was saying, Yeah, you don’t need to be on Instagram. I think I blew a gasket. That’s when I started talking to people and the blog started growing. But now, it’s like finally, we’re seeing everybody on Instagram. Instagram still is the place, but guess what, it was way more valuable 4 years ago because not everyone was on there…

SC: And there might be something new, like, next week.

GJ: HOw long do we have to wait? Right? There both will be something new next week but still, people will… people have said to me for years,”Griffin, what’s the next thing?” Don’t WORRY about the next thing. The next thing is now. Just start doing Facebook and Instagram now so that you can learn the same way that you learned from being there in chatrooms in the 90s.

SC: Right. And you know you made me start doing stories and Instagram Live, so… I did my (incoherent) you could see today was only my second day and it was totally not slick at all, because I didn’t know how to turn off the live video and now I do n’t know exactly what to do with this video, where to put it. But you were right, you just… baby steps… that’s how I did it. I’m not a techie, so I basically was like, let me start by opening the account. You just do one thing at a time, and then as a busy physician, you have to install an EMR. You don’t do that yourself! You pay somebody to help you! Somebody with expertise. You pay somebody with expertise to make it easier for you. But just because you don’t know how to do it or you’re not really interested in it, if that’s where your patients are and that’s where they get their information, and they understand and engage with their treatment better, you know… an engaged patient is more compliant and a patient who understands whats’ going on is going to do better. That's’ very old-fashioned data. This is not social media data. This is just about basic communication. That’s why we have this idea of cultural competence. You have to connect with people where they are so they understand the meaning of their treatment. You have to understand that a lot of Asian patients are suspicious of Western medicine, so you have to try to communicate with them in a way that… when they have diabetes, just talking to them in a way that they don’t understand is not gonna help them with their diabetes. So it’s not the particular media, it’s just saying, this is how people communicate, this is how people connect, this is how people absorb information, this is how they learn. Medical information is hugely important, obviously, to health and wellness, and as physicians, as caretakers, as providers, we have to provide information in a way that patients can absorb it. If you don’t know how to do it, you don’t have to personally learn it-- we could have somebody like you help us with it. That’s… I personally just like it, because it’s just fun for me.

GJ: I’ll tell you this, I always tell people, if somebody put a gun to your head and you have to text one of your friends and they have to respond to you within 30 seconds. If not, boom goes Griffin, I’m texting Serena Chen.

SC: *laughs*

GJ: You are so quick to respond! It’s just…. You’re in and out… I think a lot of people don’t have the bandwidth for that. To be fair, I don’t have the bandwidth for that speed.

SC: You’re right, you have to know yourself, but to just put your head in the sand and just say that this is not a valid form of communication and we’re not using all the tools and technology available to us to help us take care of our patients, I don’t think that’s right, either. So by no means saying everybody should be doing Instagram live videos every day, obviously that’s not something that everybody wants to do. But there’s a lot of great people out there that can help you with this stuff and can help you take your information and connect with patients and say, Hey, these are things you should be thinking about or things you should be aware of. We just signed up with this great company, engaged them... They didn’t pay me for this… it’s a whole company where they do all…

GJ: Taylor and Jeff, if you're listening you’ve gotta sponsor the show right now. It’s gonna cost you guys.

SC: All this great video content and they know how to take the platform. You don’t have to know anything about making videos at all. They send it to patients and DocuSign and they can make you cool and savvy and electronic. You’ve just gotta give them a check and they take care of that technology. There’s a lot of cool stuff out there that you can be plugged in and high tech without personally having to do it. There is physician burnout, physicians feel that we have too much stuff to do. Like there’s… we have to document, we have to bill, we have to do this, we have to do that, and on top of that we have to do all the busy work of taking care of our patients all day… so it can be...

GJ: You know what my hypothesis is, Serena? I want you to either confirm or reject or add to this. My hypothesis is that as a rule, doctors hate anything less than aesthetically perfect. And the trajectory of becoming a subspecialist is very much at odds with the trajectory of startup entrepreneurship, of tech entrepreneurship, of social media… which you don’t just… because in REI or any other subspecialty of medicine, you don’t just start a new procedure without clinical trials, without research, without a number of processes…

SC: Yes.

GJ: And social media, in content marketing, in the tech space, we do something first and then we iterate. And then we do it again and we iterate. And we do it again and we iterate.

SC: Yes.

GJ: Those two behaviors are very much at odds… I had one client, god love him, he’s a Canadian client, I won’t say his name, let’s call him Dave for this… Dave was so freaking conservative, I could not get Dave to post anything on social media. We just ended up posting social media cards and eventually just said, “Hey, you don’t need me for this.” Even if we just put up a video of them walking… his nurse just walking through the lab… that somebody is gonna watch for 1.7 seconds in their newsfeed. He doesn’t want to put it up, because he only wants his name and brand associated with the absolute highest level of aesthetic perfection.

SC: Yeah… I guess that’s part of our training, that mistakes, imperfections are not tolerated. And you’re right. Marketing is very different from that. And then there’s the medical liability, so people are trained in that way, but at the same time, that creates barriers between us and our patients. If you’re absolutely perfect and rigid about everything and you’re dealing with a patient that’s really emotionally very, very stressed, if she doesn’t feel some sort of connection with you it makes communication harder. Then the intimidation factor and all of those kinds of things…. Everybody’s different. I can’t say that this works for everybody, but I guess I feel that when I can make a little bit of a personal connection with my patient that they… the communication is better and then I hear about stuff like, “Oh, I wasn’t so happy about that,” or “That made me really uncomfortable, so that’s why I didn’t take that pill the way you told me to, and now I’m telling you about it and maybe if I didn’t feel comfortable with you I wouldn’t tell you and you wouldn’t know why your treatment wasn’t working or why you had this problem,” when I thought everything was going fine. We all know that those things can make a huge difference. Personally, I feel that social media makes you less intimidating, breaks down barriers, it makes patients feel like, “Oh, she seems ok, she’s not that scary, I saw her on Instagram and she flubbed up her video. She’s not that intimidating, I can tell her that I made a mistake also and I can talk about that with her and then we can solve the problem together.” I feel like…

GJ: A hundred percent!

SC: What?

GJ: A hundred percent. We had Dr. Natalie Crawford on the show a couple months ago..

SC: I totally agree with what she said!

GJ: Her point was that we have patients coming in, we’re asking them to give so much personal and sensitive information sometimes that is really painful, and they know nothing about us. How is that supposed to work? She is one of the most influential fertility doctors in America. Period.

SC: Because she struck a chord.

GJ: I’m going on the record.

SC: Absolutely.

GJ: And she’s been out of fellowship, what, three years? She built this herself.

SC: It’s organic, yes. People were just like, “Oh my god. This doctor is talking to me, and telling me a little bit about her life, and she seems like a real person,” and she’s putting out educational content, okay this is what to expect for this, this is egg retrieval, also trying to empower female physicians. I think that’s solid data. Look how many… what is she up to now? Tens of thousands of followers? She didn’t pay for those followers. People are just like, “Oh my god, this is what we want in a doctor. She’s still respected, she’s board certified, she’s making babies with IVF, and yet she still talks about, y’know, her misgivings, and anxieties, and things like that in a very human way.” I think the old school, and I’m much older than Natalie and was trained in a very kind of patriarchal, hierarchical way, and the doctor has to be perfect. If there are any chinks in the armor, it somehow undermines our authority. I haven’t really found that to be the case. I’ve found that when you connect with a patient and you do give a little bit of personal information and it’s not all perfect, you actually end up in a more collaborative team effort in the patient’s care, and I really feel that outcomes are better that way. Patients will be more open and honest and compliant with you because they feel that they can be. They feel that you’re a resource for them.

GJ: Let’s talk about that collaboration, becasue really social media marketing… it’s really just drops in the bucket of this entire dynamic shift that we’re going through in society and human communication and behavior. And I tell people that marketing is really just a gateway drug that I get people in to start participating. Yes, if you do this well, you will get new patients. You can also use it to solve several different problems and adopt different software. How it ties to the tech revolution at large is just a really small piece. Collaboration is a much larger piece that you talk about a lot. One of the things that you really want to do with the content that you’re creating is you really want to break down the barriers that exist between different specialties, between different specialists, between different geographic areas…. Talk a little bit about the barriers that are existing right now and why you want things to be more collaborative.

SC: So I think one really good example of this is oncofertility or fertility preservation for cancer patients. Vitrification is a newer way to freeze eggs and embryos, and we used to struggle with freezing eggs and embryos for awhile until in the 90s and the 2000s, vitrification came into play. We realized vitrification as a freezing technology was like pressing the pause button. So we suddenly had the situation where egg survival and pregnancy rates after freezing eggs was almost as good as fresh eggs. So ASRM and ASCO, American Society for Clinical Oncology and American Society for Reproductive Medicine, in 2013 and 2012, said, We should be talking to all cancer patients of reproductive age about egg freezing so they can decide do they want to freeze their eggs before their cancer treatment. Everybody said, oh, yeah that’s a no brainer. Young people that have cancer are surviving better and better, there’s millions and millions and more and more growing every day of cancer survivors in the United States and throughout the world because we’re so much better at cancer survival now. A lot of people do get cancer at a young age and haven’t started or finished their families. When you ask cancer patients what’s their number one priority, after surviving it’s having a family. Having a family after cancer is a huge priority for cancer patients, it’s a huge part of their quality of life. And we’re very concerned with quality of life now because we’re so much better at survival. So in 2013, dial it up now, I think less than 50% of people who have a cancer diagnosis and are of reproductive age and would like to have a family after they survive and have a good chance of survival, are not even getting any information at all from their doctors about freezing eggs, and don’t have an easy path to be able to freeze their eggs. The way it should happen is, “Ok, you need to get a mammogram, let’s talk to the plastic surgeon, because after the mastectomy, you’re gonna think about reconstruction, and here’s the reproductive endocrinologist, read about the egg freezing, we’ll get them on the phone or we’ll send you to the office if you want to stop by and hear about freezing eggs. You don’t have to do any of these things, but everybody gets that information.” In fact, my office at St. Barnabas hospital, is two floors above the phenomenal oncology center, phenomenal oncologists, but it was so hard-- that silo, that barrier, was very high, to get through the logistics of being able to easily get those patients the information they needed.

GJ: I’m glad you brought that up. That you’re in the same office as them. A lot of people are listening and thinking, “I’m an independent practice and my office is a little bit further away and the big hospital system or the big oncology hospital, the cancer center, is 20 miles away on the other side of town, so I don’t really have a relationship with those groups.” But it’s not really geographic.

SC: It’s not geographic. At all. And now we’re finally-- because the oncologists are like, “Oh, wait a second-- what are those hormones? What’s that egg retrieval?” Because they don’t have training in this area- nobody has training in this area except the people who are sucking the eggs. I don’t know anything about oncology, I know cancer is bad and you have to take chemo and radiation. I don’t know what they do. They open their mouths, they speak English, and I’m like, I have no idea what you’re doing and I’m a physician. And I’m a good one. Same way with them. We’re running around like a nutjob, I’m trying to make babies, they’re trying to save lives. We’re working really really hard. How do we make this workflow work? There are these huge systematic barriers, and that exists in every single aspect of medicine. So we need to talk more with each other, social media, perhaps, is a tool, except a lot of doctors don’t like using social media, so we have these barriers between us. I finally, the amazing oncologists, in the Barnabas system, the RWJ Barnabas healthcare system now, phenomenal healthcare there. Basically, whenever I see an oncologist, I say, “Here’s my cell phone. If you have a cancer patient, text me. I’ll talk to them on the phone right away. They can come in right away, we’ll get them a doctor, or I’ll just talk to them on the phone. If they don’t want to freeze, that’s fine, but just say something to them.” After all these conversations and talking and talking and talking and talking and doing talks and them really learning and me really learning about them and their process, now we have more process. We still have a long way to go, it’s still not easy and automatic. Even though technically, this is the standard of care now. That’s just one small example, in our field, of how silos can have a huge impact on outcomes and patient care. We have those in every single field of medicine. There are so many cool things going on. Like what about genetics, what about data science, what about artificial intelligence, what about social media as a communication tool and all the things we do… how can we break down barriers and use all these tools together to do a better job and make people healthier? And improve wellness and cure disease? You know…

GJ: I see where these threads link together, social media to distribute ideas more clearly to the public, to also break down the barriers and silos that exist between healthcare providers as a means of making healthcare more accessible… how does this all tie into advocacy?

SC: Advocacy is also hugely about communication. I think that people… they don’t realize how difficult it is for people to access reproductive medicine treatment and advice in the United States. If you haven’t gone through it, you don’t realize that a lot of this stuff helping people get pregnant when they can’t get pregnant is very, very difficult, extremely stressful, not covered, not enough accessible services out there. ADvocacy is also… we have to raise awareness, number one, so people understand and know that it’s an issue. If you haven’t experienced it personally you don’t know about it. Obviously, getting our voices out there and reaching the public and reaching the legislators and getting patients and doctors together is hugely important to break down barriers. I don’t know anything about the legislative process, I don’t know how those things work. And that’s how you and I first met, was at advocacy day. That was such a great experience. It was so nice to know you on Twitter and meet the real live Griffin Jones with all your hair in person-- that was amazing! Then to work together, we have very different tools and backgrounds and skills and experience, yet here we were working together, hopefully helping patients access care and ultimately have a family becasue of better insurance coverage and more awareness about that kind of care that’s needed. I also feel that this kind of addresses that other thing about bandwidth and provider burnout. There are actually strong data and evidence, and there was actually an article in the New England Journal of Medicine, maybe an Op-Ed piece, saying that physicians… to get physicians… if they get more involved in advocacy, even though it’s another thing to do, it can actually decrease burnout. A huge part of burnout is that we’re swamped with all this stuff that seems meaningless and doesn’t seem to help patients and here we are, our whole lives we’ve been striving to help patients and we feel like the system is in our way. If we do things like advocacy and meet people like Griffin and the people at RESOLVE who actually know how the legislative process works and do the work for you and say, “Hey, Dr. Chen, we’ve done all the research, but we need you to talk to this senator or this representative and explain IVF And what you do. You’re still in your comfort zone, but since we’re collaborating together, we’re accomplishing things you’d never be able to accomplish,” you’re communicating, you’re advocating, you’re doing something for yourself. This is something that gives my job a lot more purpose and meeting. You meet a legislator and you see from their perspective what they see, what they want for their constituents, and they hear what you do every day and you think it’s routine and maybe a little bit boring becasue you do it every day, and you see how inspired they are and how excited they are about what you do… it really… it’s really very gratifying and makes me enjoy my daily grind more and gives me more purpose and meaning and I think that helps with the whole burnout thing, too.

GJ: Service to the community is like insurance for long-term cultural relevance.

SC: *laughs*

GJ: When you serve the community, you get so much back. Here, we have a group of people who are really suffering, who don’t know much about their problem, they get really lousy advice from friends and family. They hear dumb stuff like just stop worrying about it and you’ll get pregnant. They have no idea how much IVF costs. They don’t know… I was talking to someone who bought a less expensive form of progesterone and had a bad reaction to it and blamed themselves for it. There’s so much stuff that these folks are suffering from that they’re asking for a leader. By definition, a reproductive endocrinologist is a leader. The only missing piece is stepping up to say, I’m here to serve this community, to listen, and then to give my thoughts and connect with you and take you as much as I can. And you really are very good at that, somebody that really is into the community. In concluding, what haven’t I asked you about breaking down barriers, about building a more collaborative healthcare system, about changing the delivery of medicine to what you want to see it in the mid 21st century? What thoughts do you want to conclude with?

SC: I guess… I guess one of the big things is that the… I think it’s important for patients.. I want… I feel like a lot of this is about communication and reaching out and connecting. I think that not only addresses patient care-- so patients should reach out and connect with their doctors and communicate and don’t be afraid to speak up. There really is no question that is stupid, and if you’re made to feel stupid, you probably have to go find another doctor. Even intimidating doctors, if you reach out to them and communicate, I think you’ll be surprised that they will respond to that. A huge part of your care and your outcome is you participating in your own care, participating in your own life, and communicating. You’re gonna get better care that way. And listening to podcasts and doing some reading, but not going totally crazy, can be helpful. For physicians, I feel like physicians need to not feel so intimidated by all this new digital technology. It’s here. This is how people communicate. Hire somebody to help you! I took Twitter lessons. I had some lady come to my house, for a like a hundred bucks she spent a few minutes and was like, “Okay….”

GJ: *laughing* I love that! That’s awesome!

SC: I had Twitter lessons! She was like, “Ok, this is what you do…” From really basic… there are tons of people out there who do it. Probably, if you paid your college neighbor or the high school student who lives next door if you give them a few bucks…

GJ: Yeah, don’t call Fertility Bridge for that. Sometimes we have clients who say, “Show me how to….” *laughs*

SC: Or you can get much more professional advice from Fertility Bridge.

GJ: Yeah, call me when you want to grow your egg freezing program, have the college neighbor show you what Instagram stories are.

SC: *laughs* It doesn't’ have to... Even if you use a nice professional firm, like Fertility Bridge, it doesn’t have to cost a zillion dollars and we have data to show that the ROI is huge. If you’re out there, you’re more connected, patients are just gonna feel better about you, you’re gonna get your name out there, and you don’t personally have to do the social media all by yourself. I think if you stick your neck out there and do a little bit more connection, it’s also nice inter-professional connecting. We need to get our heads up from the grindstone, out of the computer every once in a while and take a few minutes to do that to remind ourselves why did we go to medical school in the first place? Why did we spend all those hours and time and money? We’re here to help patients and we have to take care of ourselves, too. Feeling good about what you’re doing, connecting more with patients and professionals, for me at least, and doing advocacy, has been hugely helpful in lowering my burnout because I run around like crazy. Sometimes I’m pulling my hair out. Nobody’s immune from that. We need to take care of ourselves and think about solutions for that so we can continue to take care of our patients. Oxygen masks on first and then help the other person.

GJ: Dr. Serena Chen, thanks so much for coming on to Inside Reproductive Health.

SC: Thank you, Griff! Have a great day!