Franziska Haydanek: It's equally intellectually lazy to write something off completely immediately as it is to believe something fully. As physicians, we kind of have to say like, this is what we know, you know, this is what we don't know. This is why we recommend something, which is very different than the wellness space that just comes 100 % at you. It's like, boom, this is factual. It's like, well, you have nothing to back that up, right? And we have a more nuanced view of that. But I think that nuance doesn't sell well in a 90 second. you know, clip. Welcome back to I Did My Own Research. I'm Dr. Fran and today I'm joined by Dr. Victoria Hasselhoff. Dr. Hasselhoff is a board certified family medicine physician. She attended the George Augusta Universität Göttingen in Germany for medical school and completed her family medicine residency at Mercy Health St. Elizabeth Hospital in Boardman, Ohio. She has worked as a locums physician for the past five years, working all over the United States. Online she posts that friendly family doc and she also happens to be my little sister. Welcome. Thank you so much for having me. So excited to be here. We are temporarily Dr. Hasselhoffs together for one year, but no longer. OK, let's go a little bit into your history, because I think it's fairly unique in medicine that you have done trainings in two different countries, and you kind of keep beat-bopping between the two of them. So just quickly run us through your education so people kind of understand where you're coming from. Sure. So I kind of always know I wanted to do medicine. And then towards the end of high school, I kind of decided that I wanted to to do medicine in Germany. In Germany, you don't do undergrad. You go directly to medical school. So when people are done with school here, even at like 18 or 19, they will go directly to medical school. Now for me to come from the States to Germany, I sort of had to prove myself in a certain way. So I did end up doing a freshman year at UW Madison in Wisconsin. Go Badgers. Woohoo, go Badgers. To essentially bridge the time where I was getting all this stuff together to go to Germany. But then after my freshman year at UW, I went to Germany. And the medical training in Germany is six years. So while the first semester is a bit of like chemistry for physicians, physics for physicians, botany for physicians, or so really from then on out everything is... Say botany? Botany. Yeah. We have like six weeks of... for physicians. Botany for physicians, yes. Yeah. you know, right. So that was kind of a hodgepodge of all kinds of things. And then from there on really out everything was medical though. So it's a six-year program in Germany to finish medical school. And then I always knew after... medical school that I would do my residency in the United States because in the United States as many people probably know if you want to do residency in the United States you have to start from the beginning. There's no acknowledgement of any time outside the United States and I wasn't about to do two residencies if I could avoid it. I always knew that after medical school in Germany I would go to the States. Parallel to my German state exams I also did the USMLEs, the American exams. which then allowed me to get my ECFMG certificate, which then allowed me to apply for residency. And then I did my three-year family medicine residency in Boardman, Ohio. And then after that, I did locums, as you said, for five years, kind of really from one coast to the other. Yeah, not just coast to coast, but also like islands. Tell us a little bit about the work that you did in your locum's job, because you have been all over the country doing this work, including like remote islands. So tell us like what drew you to being a locum's tenants physician? Did you ever consider being a staff doc and how that life has been? So I did not even know that locum's physicians existed until my first year of residency when I went to a conference and the locum companies were there and they told me about it. I have always been a traveler from like as soon as I was able to travel by myself. I did, that's where my money went. I've always been up and at it. So when I found out that this was an opportunity or a thing that I could do as a physician, was nothing else mattered at that point. So really there was never the intention or the thought that I was gonna sign like a three-year contract somewhere. I couldn't even tell you where in the United States I would wanna do that. So having the opportunity to do locums in a specialty that is very much needed, family medicine all over the country. was really, really attractive to me. There's also some other perks, you know, you're self-employed, they give you an apartment, a furnished apartment or house to live in, they give you a rental car. So it was kind of fun that every six months or so you would change scenery and get to live in different places and really get to know these places, not just visiting them as a tourist, but actually living in those places. And then, you know, having the opportunity to see all these different places in the United States, essentially being paid to see different places. was extremely attractive to me. So from that, already from my first year on in residency, I knew that was going to be the thing that I do. Yeah. And what places have you been? I started off in South Dakota, in Lee Deadwood, South Dakota. That was right in the pandemic. I got there. End of my training in residency was sort of the first wave of COVID. And then I got to South Dakota when they had their first wave. So was the only physician in the hospital actually that had any sort of knowledge or experience taking care of COVID patients. So that was really interesting. So that was my first assignment. Then after that, I went to Eugene, Oregon. Then after that, I was in Wisconsin for about half a year. Then I went to Molokai, Hawaii for a year. Which for those of you who don't know where Molokai is, it is a very remote... island, you have to take a special plane to get there. Isn't there like two grocery stores on the whole island? Essentially. I did not, again, had you asked me what are the islands of Hawaii beforehand, I would have been like Oahu, Kauai, Maui, that's it. I did not know that Malacca was an island until the job came across my desk. I was like, hmm, let me look into this. And it is, it is a rural island. There's only one airline that services it. It is not the best airline in the world. And there are truly just like... two grocery stores, mainly in the main city, as you can call it that, of Molokai. I had an amazing time. It came with its challenges, but it was such a cool experience to be able to go to this remote island that most people don't go to and take care of that community, which was wonderful. And then after my year there, I, let's see, then went back to Oregon, this time near Portland for a while, very short stint in Eugene, and then I went to Wolfiburro, New Hampshire. was my last assignment. and that kind of goes back to the going back and forth between Germany and the US because now you are in Germany and you plan now to practice there indefinitely. Correct. So my plan was always when I have children and they are old enough to attend school that I would come back to Germany and work here so that they could attend school here. So we're getting close to that timeframe where my oldest kid is going to be entering school. So it was time to come over here. and sort of start the process of having my board certification, my family medicine board certification acknowledged here in Germany. Yeah. So currently working through that process. Now, how did you get into content creation? I know it's because you have always looked up your big, big sister and you wanted to be just like her. Absolutely. That is absolutely true. So it's funny. during... So first of all, I think it's important to say, because you've mentioned in your intro to the show too, is that like you've been online for such a long time and in different ways. As of high in... of different way. Like I blogged all through sort of my teenage years of my travels. I blogged during medical school as well under the wannabe MD to kind of also document that journey. It was only just up over like a kind of a personal diary online really. I never monetized it or anything like that. It was just, you know, people were interested. They followed along. I thought that was nice and it was a nice way of me to kind of document what I was doing. And then during residency, I'd actually brought up the idea to my residence to be like, hey, I'd really I think it'd be great if we did educational videos for patients. know, these conversations we're having in the office over and over and over and over again. Why don't we tape them? Why don't we have like a link that if somebody has diabetes, we can give them this link to go to after a visit. They get this information where we may not have the time in the office visit to go over it. Really wasn't accepted or taken on so much. So it didn't really go much further than that. But that was really the first time I was like, ⁓ you know, medical content. didn't think of it as in that sense, but. would be a really nice thing for patients to access. And then I kind of, you know, saw what you were doing and how you were growing on the platform. And I didn't really want to venture into that because I didn't want to kind of crowd your space. I didn't really want to go into because, well, because it was your thing and I didn't want it to seem like, you know. I was copying you or I don't know. I just felt like that was your thing and you were doing so great in it that like that was not a place for me to enter. So it wasn't really until you actually encouraged me when I had like slightly mentioned that I was interested in it. Yeah, it was really nice of you. To kind of welcome me into that space, I think, you know, with siblings, there's always sort of this little kind of rivalry and we don't want to take away from other people's things. So that was really what, you know, where I was hesitant to get into it. But then once you sort of showed your support. encouragement to do it. That's really what motivated me to start. that's really funny. I didn't know that part of the story. It's interesting because I just gave a speech or talk at a medical society meeting and several doctors there were like, well, I don't know if I need to be online because someone else is already online. I was like, well, there is plenty of room for all of us. They were, think, an oncologist who has said that to a GY oncologist. I was like, there are actually so few of you that... Even if your friend is doing it, you should just both do it and support each other and share each other's stuff. But there's always going be people out there who are looking for information and maybe they'll find your video or they'll find the other person's video. But I don't think there's ever an overcrowding of medical content creators. There's an overcrowding of people who don't have the education, speaking on things they shouldn't be speaking of. But we definitely don't have an overabundance of doctors out there doing this work. If you feel similarly to Victoria saying like, well, my friend does it or Fran does it or Victoria does it, like that's fine. Like the more the merrier, like please join all of us. It's interesting because you now being in Germany, it's a, you know, not only is the medicine very different, the healthcare systems are obviously incredibly different. The money and how it's very different, but also interestingly, doctors on social media is very different in Germany. So I know you're learning some of that right now and maybe you don't feel like a complete expert to speak on it, but what have you learned so far about doctors on social media in Germany versus doctors on social media in the United States? Yeah, so I think the biggest difference is how things are regulated. So Germany is very regulated, especially when it comes to the profession of a physician. Physicians are not allowed to advertise. The only thing that they can advertise is... Like I could advertise my practice and say, is my practice, this is the location, these are the hours that we're open. And you know, these are even maybe the services we provide, but I can't, you know, I can't be like, I'm the best PCP in town, come see me. I, you know, give some kind of offers or deals. If it has to be very factual, essentially just informative for the patient, like is this the doctor, what's our location? Do the opening times work for me? Do they have the services I need? That's it. I, physicians can't do advertisements for other people. They certainly, there's a different law that governs like you can't advertise medication, not even in your office. So you can't have like a little stand for, I don't know, you know, whatever medication you want it to be because that's not allowed. So it's all very regulated. So this is all obviously pre sort of doc influencers, social media, that these, laws of the land, but these of course now also apply in the social media world. So There are doctors online in Germany. I'm slowly starting to kind of find those. My algorithm is starting to sort of show me those. And there are some with significant followings, know, half a million or so. But when you do look at their content compared to, you know, the US counterparts of that, it is very informative. It is very factual. And you're not going to see any specific products that are being advertised, specific medications. You're not going to hear those things. So somebody might say like, okay, if you have skin problems, know, it's still like acid. but you're not gonna get like this product, right? So there's definitely the platform for medical information. I don't know the statistics, know, Germany compared to how many Americans, I know there's a huge percentage of Americans who go to social media for their medical information online these days. I don't know what that percentage is like in Germany. I'll have to kind of look into that, but there's definitely doctors out there. There's a duo, a pediatrician duo, I love, they're really fun to watch. They do great videos, informative videos. But again, you're not gonna find any sort of product placement. or collaborations with clothing or so. Those are all absolutely off the table. Yeah, and I think it's very interesting. It just goes down to almost like the core culture in the different places. I think we all are used to in the United States, walking into a doctor's office and seeing, you know, different drug names. mean, Victoria and I grew up in the 90s, and our father was a PCP and then veered off into emergency medicine for a while, but for a long time was a primary care doctor, and this was the height of the 90s, and... We had basements full of like pharma good, thousands of pens, clocks, apparently Viagra teddy bears as she has shared recently. don't think, I think she actually is remembering the medication. but. like, you know, you would go on trips, you would go to dinners, like pharma and like selling to the customer, AKA the patient was like very mainstay of that era of medicine. Now a lot of it has like. Dutton pulled a lot back, probably for very much the better. There are a lot more regulations on like, especially if you work for big hospital systems, like I've never had a single drug rep come to my office in the five years I've worked there, it's not allowed. And so I think we are starting to pull back a little bit, but the world of like doc fluency is different online too. And I think, you know, I obviously work with brands and you have to be very mindful of who you work with and... That's all of the learning process for sure, but it's interesting to see already just like the culture differences between, you know, capitalism in the United States versus like highly regulated other spaces and like, you know, that's a plus or a minus in many different ways, but I think it's very interesting to see the differences between the two countries right now. absolutely. you know, I mean, I've only been here, you know, just a few months and... are all things I'm going to continue to learn and see and you know, so things as an example, use these doctors who are online to write like this pediatrician do that I follow like they're on tour right now, you know, and do talks or like they're on tour like going in like doing yeah, you know, they just they released a second children's book, I know some other doctors who are online who have written their own books. So that's okay, because that scene is like you're providing medical information versus selling a product, especially for somebody else you It even goes so far that, let's say I was a radiologist and I got a new MRI machine and I was so excited to share it with my followers online. If I show the machine, like the company name of that MRI machine cannot be prominently seen because that would be seen as like product placement. Yeah. I mean, you insured, or maybe it was in the comments in one of your posts about this, that plastic surgeons can't even post before and afters. And I actually took a little bit of like a patient offense to that because, you know, for anyone who's ever like looked for a plastic surgeon, I think I would assume that the majority of them now are online because that's where they're going to find patients and like show their work and you can see the work that they're doing. And I like, if I was searching for a plastic surgeon, I would follow a lot of plastic surgeons. So I see that what they're doing and I'm always like, ⁓ I like the work that they're doing. If I were to want to get a nose job, I would see that person because their work aligns with what I want. I think it's interesting. that you can't even do that. So you can in the office settings. So if you go see a plastic surgeon, they can do that. But they can't advertise with that. Again, the back story to that, think, is just the regulations are all put in place to protect patients. Or that's the thought process behind it. So I guess their thought there is if you are just posting your best work, well, that might set the wrong expectation. of what you might be getting with that surgeon. So I think that's the backstory to it. So it's totally fine to show those things from my understanding if you're in the office and they're showing you their work, but just not as advertisement. but if you're window shopping from the internet, then that's not allowed. Yes, that's not gonna work. Which is very interesting. And I know you haven't really started working in Germany, but when it comes to especially like the medical misinformation, do you feel like people in the German healthcare system might be a little bit more protected from some of this because they have... in some ways more access to care? That's a good question. So again, since I haven't seen patients myself, I don't know how far the misinformation is there. I think one of the biggest topics that also there is a population of people within Germany too, I mean, we have anti-vaxxers here as well, right? And I'm sure that their information also spreads online as it does in the United States. That's probably the biggest sort of area of misinformation, especially within family medicine that I can think of. So that is certainly, I mean, there's strong anti-vax movements here in Germany too, unfortunately, overall the vaccination rates are still very high, but that is certainly there as well. So I can't really say it, not having seen patients like what other topics there are. And again, how much are people going online? Because I think it all sort of connects, right? Being a content creator online takes a lot of work, you know? And we do it, I think our motivation obviously is because we want to get this information out there, we want to help people. But then at some point it is kind of nice when you're in a place where you can sort of monetize on to sort of get a little bit back for the hard work you're putting in. I think in a system like in Germany, where you just know right off the bat, you're not going to be able to do the sponsored posts, you're not going to be able to work with companies, you're not going to be able to make that money. Maybe that also will deter people from... being online as well, because until you make it to a certain amount of followers and then you're getting money through views, that obviously takes a lot of time to build up. So I think there's probably less doctors overall in general online providing information. So I don't know if there's a lot of people in Germany going to social media for their medical advice at this point. I bring that up because one of my running theories on why we got to the place we are now with medical-medical information online in the United States is because many patients are limited in their access to doctors because health insurance is expensive, deductibles are high, getting in to see us is hard because there's not enough of us. Not that other countries with socialized medicine don't have that problem, right? There's limited doctors and all of that. I sometimes wonder if part of the problem is that we don't get more FaceTime with our patients and don't see them as much as we'd like to. And so therefore they go to the internet and then on the internet people are rewarded for making these like crazy videos. And then they're like, ⁓ yeah, that makes sense. And also I didn't talk to my own doctor about it, but I'm going to follow this like pathway down. Is there any regulation on the other end of people? mean, clearly the doctors are heavily regulated, but are other people heavily regulated or just the docs? Or it's okay if you don't know. No, I don't know. I mean, I'd have to look that up. I think there's probably... It would be really interesting, and I'll have to look this up, if somebody else... I mean, people are selling supplements over here too. So I want to say, I feel like there's probably not as much as a regulation on somebody who's not a physician, because the big point in all of this is like, if you're presenting with your physician persona, right? So if I had absolutely like no professional or physician... know, persona online and I was just this private person, you had no idea I was a doctor. And let's say I had like a lifestyle blog, you know, or something and I was selling you a supplement, but nobody knew I was a doctor. They couldn't come at me for that really, because I'm not presenting as a physician. So it's when I'm in the authority of a physician that I can't be doing these things. But to kind of come back to your, you know, statement about access, you know, I think people do have an easier time. seeing doctors here, they have wait times as well. But overall, I do think that there is a lot of trust in the physicians here so that if somebody does have a question or so, they are going to take it to their doctor, at least in conversations that I've had with my friends here, right? And that's like a very biased view because it's just my experience. But from talking to people here, they're like, oh, I made an appointment with my doctor to talk about this. Or, oh, I'm going to have that conversation, I'm going to have a telephone call with my doctor because I want to discuss this with them. And it doesn't cause them a $50 copay, so they're happy to do it. Exactly. So I do think that that will play into it as well, as to where are people getting their information? How quickly can they access a doctor, for sure? Yeah. Yeah. Well, in places like China, they're starting to regulate who's talking online, which I think is interesting, right? You have to prove that you have a... degree or education or experience in a field to be able to talk about online. And, you I don't want to highly regulate all of communication, but I think there's something to be said about, you know, I went to TikTok headquarters two years ago and we were talking about, it was like a panel on doctors being on TikTok and it was like other people there. And one of the questions was like, how can you point out the people who are like safe spaces online? And I get this question in real life too, like, who should I follow? How do you know if they're a good person to follow? The group I was asking me if they're a good group to follow, I like, well, you guys are doctors. Like if you listen to someone's videos on menopause, you guys are OBGYNs. You're going to tell pretty quickly if they seem legit or not. But I was talking to the people at TikTok and I was saying like, really, I think it makes no sense if you started giving check marks to people. So instead of like a blue check mark, if you're verified, you can get like a red check mark or a red cross or something, you know? that someone has vetted those people as people who have shown a certain amount of correct information or something. But I think it's an interesting thought to like, I don't think we should regulate everyone. That's not like the US way, right? But maybe like pointing to... like experts in the field. And I do this in the office, you I have handouts for my patients where I'm like, follow these people for menopause information and follow these people for PCOS, right? So, and I've had other docs come to me and be like, I have you on my dot phrase. And I was like, that is so nice. Thank you. You know, it's just interesting to see like where, how other countries regulate the information, regulate the content creators. And I'll be interested to know in like a year from now when you've had more interaction with actual patients and like. Do they come in and say like, I saw this on Instagram, what do you think? Or is it more like, I have a chance to talk to you, so you just tell me. Right, well, and I think that, you know, as you said, I don't think everything needs to be regulated. Like if you want to, I don't know, if you're not an architect, but you want to talk about the design of a house, like have at it. But I do think that the consequence of talking about health, you know, is a lot higher. And I do think that at least in that regard, it would be wonderful. to see online some sort of verification because as you've talked about many times, just because someone calls themselves a doctor online doesn't mean they're a medical professional. And sometimes it's really hard to find their credentials. And if it's not smack dab in the bio, you know, and then even that you would have to as a person like go online and verify are these people actually board certified, you know, because anybody can put anything in a bio. So I think it would be fabulous, at least in the sector of healthcare, to have some sort of regulation to be like, you need to prove that you're board certified or you need to prove whatever, and then you can get this check mark, you know. And then obviously there needs to be some sort of review process because not everybody who has an MD or a DO is a good person either. So there would have to be that, but at least this kind of first layer of these people had the training would be fabulous to see. Yeah, and like for anyone listening who makes content or is considering content, like not hiding your credentials, I think is like number one. Like I even saw this the other day, someone's like, ⁓ world renowned surgeon. And they're talking about like certain like plastic surgeries and anesthesia things. And then like they're a Mohs surgeon. And I was like, that is a surgeon for sure. But also... you should put that in your bio. Cause if you're talking about like blepharoplasty, just saying you're a surgeon, like I feel is a little like hiding who you are. Like I could also just in my bio say I'm a surgeon because I am right. But like I'm going to be doing it and I do a specific type of surgery. you know, saying you're- world renowned. always, I love when people say things like that. It's like- Renowned by who? Like who decided that? Who in, you know, I don't know, South Africa is like this person's world renowned. I know them. Even like the top doctor stuff, I get emails like every single day that's like, the low price of $500, MSN will name you top 50 doctors in the United States. I'm like, for the low price of $0, am I doing that? Like, absolutely not. Agreed. Yeah, I get those emails too. And then in the area where I registered my address, I was like, I've never practiced there, but you're the top 1 % in that area. like, I'd like to know where you your information. The internet probably. Probably. Okay. I want to go into a little, just a couple like quick questions for you. And none of them are going to be, who is your favorite sibling? Cause we already know the answer. It's me. Okay. What's your favorite vaccine? There are there. mean, there's so many. I, ⁓ God, I can't play favorites as a family physician. I will say one that I really like counseling people on and I'm so excited when they are educated on and make an informed decision is the HPV vaccine. Amen, sister. Actually, you're my sister, so amen. Amen to you too. Yeah. What's one thing that TikTok consistently gets wrong about our health? Staying on topic, vaccines. I think that's the biggest, as again, know, algorithms are gonna look at what we look at. So I think the thing that I see the most is in my... is going to be vaccines, just vaccine misinformation. Yeah. What's the biggest misconception about primary care? I think that people see it just as, like, a backup or somebody didn't know what they wanted to do or they didn't get into a different specialty. Or that we're not even a specialty, right? And that makes me so angry. I know this was like a short question, but I could go off on that about how... Oh, no, go off. Tell me more. We are a specialty. Like, our specialty is... primary care, knowing a lot about a lot of things. We're not the expert in a narrow field of things, but our expertise lies in being able to see the person as a whole person, taking in all the things that they have, seeing their psychosocial background, you know, just seeing the person as a whole and then also managing their care. think a lot of people underestimate how much of a manager we are for people, you know, managing all these different specialists who just kind of stay in their specialist kind of bubble. And oftentimes we kind of have to bring them together. Like how often during residency I would call the cardiologist and nephrologist and be like, can you all just sit together and figure this out? Because I'm two various things here. two cannot. They cannot figure it out, even if they're sitting next to each other. We're bringing it together. But I think that's the, know, that people are like, ⁓ well, I didn't get into something else. So they went to Prime Maker. It takes a very specific. personality to go into family medicine and be a good family medicine doctor. Anybody can go into family medicine and just refer, refer, refer, refer. ⁓ you have a cough, you're going to go see pulmonology. You have this, you're going to go see this person. But to be a good family physician, it takes a very specific kind of person to do that. And obviously, we don't go into it for the money. Us and our pediatric colleagues are like the least paid, right? Like, if we choose this specialty, it's because we want that long relationship with the patients. We want to help them. holistically as a whole person, you know, and help them and see them and guide them through things and be that person that they come to, the first person. You know, we are at the forefront in family medicine really to like absorb the sort of misinformation that comes online. You know, the misinformation I see online is different than the misinformation that patients approach me with in the office. So it's really interesting, like I'll be told things by patients. You know, most recently there was a patient who came in who... two different accounts brought stuff to me because of social media, something that he had seen on social media. One was bone smashing. I don't know if you've heard about this, but it is where men are hammering their face with a hammer because they're trying to get a chiseled jawline. That is terrible. It is awful. And I was like, who are you following? And he showed me and I was like, and this is a person you look up to. He's like, yeah, well, I just really want that chiseled jawline. I was like, you're smashing your face with a hammer. Like, let's talk about all the damage that can be done with this, okay? So that was the one thing. then, you know, but I think it's important to approach those things that's like in my mind, I'm like, that sounds crazy. But what I said was tell me more about this. approaching it with curiosity, because you don't want to, you know, make the person feel bad for having like following this or believing this. having them feel like it's a safe space that they can come to you when they see those, you know, a little insane things, like work through that together. Because otherwise if you... immediately judge them for it, it does drive a divide. So I think that's an important thing for any clinician to listen is like your patients will come to you with stuff on the online. And I think, you know, and I got, you know, talked about this recently in a different space that like, sometimes you can just ask them what you, what they saw because what they may be seeing could be like, for example, I bring this up with like treating recurrent BV. I've made videos that there's new studies out that if you treat the male partner, it decreases the rate of recurrent BV. Patients are going to see that and they're going to go to their doctor and say, well, I saw online that if you treat my partner, that my symptoms might go away. If you haven't read that study and had not heard of this, you may drive a divide with your patient by saying, ⁓ that's not true. But instead, you could say, can I see where you saw this? you can watch the video together. And if there is like a board certified OB-GYN who shows you the study from, I think it was in JAMA, maybe it was in like the New England Journal of Medicine. I think it was New England Journal of Medicine where I'm saying like, here was this real study and here are the real results. Not only now is your patient gonna get better care, but you also learned something. So I wouldn't immediately write off any patient who says like, I saw this online, but I think like you said, like, we're like, show me where you're seeing this. It's equally intellectually lazy. to write something off completely immediately as it is to believe something fully, right? Like to have that curiosity about... Yeah, that's We should build out a T-shirt. Well, it's true, right? Because like, well, and this is what I find so difficult with like misinformation because we also have to acknowledge that not everything is studied, right? And this is gonna be interesting in Germany because Germany, there's a lot of medicine around, you know, nature. So from plants and herbal things. It's a big part of medicine in Germany that I'm gonna have to learn about. Yeah, I have felt it's always been a big part of like Germany as a whole, right? It's like very like cough drops made out of bees pollen. It's just like a part of nature, a part of like the culture of Germany. Like you have like the cold water bath and that's like a normal part of everyone's life. It's a lot, I don't want to say like natural. That's not the right word. I don't like that word either because it goes into what like that has different meaning in America. It's not like co-opted by people, but it's a lot more like, yeah, I just got natural and like the true word, not the way that the internet has made it spun. Less medicated, more lifestyle oriented. like tees. Like, I mean, when I had my second child here in Germany, know, like before the birth I was... you know, the midwife recommended a specific sort of tea for me afterwards, like, because its baths were with like herbal, a certain herbal salt or so. It's just, it's way more integrated here to use products from nature, you know. So, and so I tell patients when they're like, ⁓ well, what about this? I was like, you know, the unfortunate thing is that we're not studying all these things, that the big studies are not happening for these products. Cause I would love... huge studies on like, is cinnamon good for diabetes, right? There's like smaller ones that say that. So like, I would love to know those things, but who's funding studies and what's their motivation behind it, right? This is where like people like, I don't know, Bill Gates Foundation or so that has a lot of money, right? You're not, you don't have to make money. Why don't you study some of these things? Right? we got- Call us Melinda. But really, I mean, that's the hard thing, especially in primary care, because they come to us with everything. And then if I just like say like, well, we don't have studies for that, that's not going to work. I usually say like, know, we may, we don't have, I'll look to see if we have studies for that regarding that information, but we may not. That doesn't mean it doesn't work. That just means I can't tell you with evidence backing me up whether or not something works. And this is where medicine is so nuanced. And I think as physicians, we kind of have to say like, this is what we know. You know, this is what we don't know. This is why we recommend something, which is very different than the wellness space that just comes 100 % at you. It's like, boom, this is factual. It's like, well, you have nothing to back that up. right? And we have a more nuanced view of that. But I think that nuance doesn't sell well in a 90 second clip. No, it absolutely does not. And that's like the hard part. It is. So that's going to be interesting. Circling back to the patient with the bone smashing, I was really curious because I had never heard of this. is this supposed to do? Show me. I had him pull up his phone and show me the account he was following. And I was like, OK, so tell me why this is important to you. And it came down to some self-confidence stuff. he... you know, really wanted to for girls to like him more. And I had a very open conversation with him. was like, listen, like, this is the damage that can happen. This is why I wouldn't recommend doing it, blah, blah, whatever. Couple weeks later, he's on my spedule again. I was like, all right, comes back, you know, and because we had such an open conversation that first time around about that topic of something he saw on social media, he's like, well, I want to talk to you about Lotes-Hostrum, which is something I get so often from men in the office because it's something that's online. I was like, okay. Sure, let's talk about what are your concerns, right? Well, I'm not getting as much muscle as I want to. want to, you know, I followed this guy on, you know, fake talk and funny if he's like, yeah, he takes testosterone. Well, he also admitted that he does meth and I was like, okay, so when we look at people who are maybe worthy of following, how do we feel about this person? And then explaining that only, you know, okay, so this is your concern. this is what you think you may have. Now let's talk about the pathophysiology of that. And are you actually having signs of hypokonetism, right? Which is the conversation I have with any male that comes in as like, I think I have low T. I'm like, well, let's talk about what that is. So I think it's really important that if they are feeling comfortable enough to share this information with you that they found online, that we as clinicians approach that with curiosity and with empathy because... They obviously believe in this for some other underlying reason. And this brings me back to family medicine, where we are just uniquely positioned to receive these conversations and then, you know, help educate patients. Yeah. Okay. Definitely a rapid answer for that one. No, I encourage you. just I told you it was gonna go off. No, I love it. And then last question, who are your three favorite creators right now that don't have to be medical? Okay. So I am gonna mention the one medical one, as I mentioned earlier. which is that pediatric duo in Germany right now. really like... Stands for, for a non-homophobic... Yes, sorry, that's for hand foot mouth. So like hand foot mouth disease since they're two pediatric docs. Then it's your bestie, Misha, which I just love watching him because he just tells fun stories and sticks up for people and is, yeah, it just, you feel good after watching his videos. And then a friend of mine who kind of started... her page around the same time I did my medical content. She's under Mom hoch drei, which means like mom to the third, I guess, in German. She is a mom of three kids. Her first child, her son, is what's called a Sternjunges, star child. I don't know what that's called in ⁓ America when you have like a... When you have a late-term pregnancy loss. ⁓ okay. Rainbow baby is what we call those. Aren't the rainbow babies after? you have ⁓ I thought that's what... Okay. No, no, no. So that's the name for the child that passed away. Right. So she had a late-term pregnancy loss in her first pregnancy and has two girls. So she does a lot of like mom content, daily life content, but also is very open about having had this late-term pregnancy loss for the reason of making it more visible so that parents who have gone through this don't feel so alone. And I think that's such a powerful and vulnerable... share with the world. So I really respect her for ⁓ online and being that presence ⁓ people who have had similar situations. ⁓ know that the other people who have gone through similar, it's a community, a community that no one wants to be a part of, but when they find the community, are thankful to have them. So I agree. It takes a lot to put yourself out there all the time like that, but there are a lot of people who ⁓ comfort in that. Okay, well, on that super positive note... ⁓ Dr. Hasselhoff, for those people who aren't following you online, can everyone find you? So I'm sort of on all the channels. So on Instagram, TikTok, YouTube, threads. What else is there? Facebook. FriendlyFamDoc is the handle for most of those. yeah, or, you know, they can find up a post for you, or I'm gonna post with you on your page and follow me from there. Occasionally I'll make a cameo. That's right. Well, thank you for being here and thank you for listening to I Did My Own Research.