We all want to achieve our highest ideals in personal health, to be the healthiest versions of ourselves — and to empower our clients to do the same. Yet there are often barriers to achieving this goal built into the medical system itself. That’s why Dr. Efrat LaMandre (Dr. E) wants to change the system.
“I would like to achieve more of a systemic ideal, which is a world where patients are not gaslit … where patients are genuinely heard, respected and receive appropriate care,” says Dr. E, medical gaslighting expert and founder of The Knew Method. Medical gaslighting undermines patient health, leaving people feeling dismissed and invalidated.
But this isn’t just a problem for the healthcare system to navigate. Medical gaslighting also makes it hard for you, as a financial advisor, to help your clients make better health and finance decisions.
On this episode of Making the Ideal Real, we’re speaking with Dr. E on the importance of recognizing and addressing medical gaslighting, and ways you can help clients navigate their healthcare challenges. Listen in to learn how to integrate wellness into your financial planning strategies.
Understanding the Impact of Medical Gaslighting
Medical gaslighting refers to a situation where medical professionals dismiss or undermine a patient’s concerns, often attributing symptoms to age, weight or mental health without thorough investigation. This dismissal leaves patients feeling unheard and invalidated.
“Medical gas lighting is basically when you’re asking for help, and instead of being offered options, you’re told that you’re fine, or it’s in your head, and it’s anything except for, ‘I believe you,’” Efrat explains.
For financial advisors, understanding this issue is crucial because it can lead to increased healthcare costs and emotional stress for clients. When clients face persistent health issues that are dismissed by their providers, they may seek multiple opinions and treatments, often paying out-of-pocket for alternative care. Advisors can play a key role in helping clients budget for these potential expenses and encourage them to advocate for their health.
Reclaiming Our Power in Medical Conversations
We can learn from the problem of medical gaslighting in other ways, too — starting with recognizing the limitations of each provider. Only then can we, as patients, reclaim our power.
“We need to take the power back and understand we come from a world where we think the doctor knows best,” she says. “They know a lot … but they don’t know everything, and that’s okay. So we go to them for what they know, and then we go somewhere else for more.”
Dr. E compares it to going to an advisor who simply says, “Well, I looked at your bank account. You have some money in there. I think you’re good.” Taking such a narrow view doesn’t account for the variety of elements that make up financial health, or the basis needed to advise clients to meet specific goals.
When you encounter these types of providers, you don’t have to take their word as gospel. You just need to recognize that their tool sets are limited, and keep seeking advice from other sources.
Taking Steps Now to Protect Long-Term Health
Health erodes over time, Dr. E says, and the same goes for financial health. “There’s this natural decline of mitochondria. There’s a natural decline of muscle mass,” Dr. E says. “There’s this natural decline that’s going to happen when you stop working. There’s going to be a natural depletion of your funds that you saved. So how much funds are you putting in? How much did you replete your health so that you can manage this decline?”
Thinking of financial health in these terms gives you a greater perspective on how to advise clients in the long term. Dr. E points out that functional exercises slow down the natural decline that happens over time, putting people in a better position to maintain their health as they age. “Think of it really concretely. If it’s hard for you to go up the stairs right now, it’s going to be twice as hard in 20 years,” Dr. E says. “That’s how you create your training program. Start doing functional exercises so that you’re able to do it when that decline comes.”
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Dr. Efrat LaMandre: LinkedIn
Transcript
Dr. Efrat LaMandre:
And then, there is the patient who is well and wants to save for retirement. Those who are my patients who are focusing on longevity, because it is not enough to go into this age with living paycheck to paycheck. Not financially, and not health-wise. You wouldn’t suggest that financially, it’s not healthy. It’s not enough to just not be sick. What are you doing to invest in your health bank?
Ryan Goulart:
That’s Dr. Efrat Lamandre. We’re talking about living a life of wellness. I’m Ryan Goulart, and you are Making the Ideal Real.
I have with me today Dr. Efrat Lamandre.
Dr. E, welcome to Making the Ideal Real.
Dr. Efrat Lamandre:
You almost had it.
Ryan Goulart:
I know, I was so close.
Dr. Efrat Lamandre:
Leave it in as it is, it’s perfect.
Ryan Goulart:
Good, good. How are you doing? Welcome to Making the Ideal Real.
Dr. Efrat Lamandre:
Thank you for having me. I appreciate it.
Ryan Goulart:
You’re a new guest. Newly minted guests get a question from us. What does making the ideal real mean to you?
Dr. Efrat Lamandre:
I really love this question. Making the ideal real, because I think it is literally the mantra, the internal mantra of every successful person. This is what we do. It doesn’t matter, whatever you define success. Making the ideal real is taking your highest aspiration, your hopes and your dreams, and turning them into a reality. It’s taking your ambitions and making them concrete. Whatever that is to the person. If that means you want to climb a mountain, and then you take the steps to make that a reality. Or whether it’s get a job, or reach a certain goal. It is taking thing that you’ve always wanted to do, and then the work in progress to get there.
To contextualize it for our upcoming conversation around healthcare, I think this is very powerful in two ways. First, for anyone listening personally, the patient that wants to achieve better health. That’s the ideal, whatever your ideal is. To lose weight, to get my diabetes better, to be pain free. And then, creating the steps necessary to make that ideal real.
Then for me personally, I would like to achieve more of a systemic idea, which is a world where patients are not gaslit, where gaslighting is not there. Where patients are genuinely heard, respected, and receive appropriate care. All of us here are in the process of making the ideal real.
Ryan Goulart:
I love how you said that because it definitely frames up our conversation today really well.
What we’re talking about today is a phenomenon that you’re an expert in, you’re a subject matter expert. It is medical gaslighting. The terminology was new to me. Before we jump into what that looks like, tell our audience a little bit more about how you’re defining that, because I know the minute you start defining it, they’re going to be thinking about that time that happened. What is it?
Dr. Efrat Lamandre:
Yeah. In fact, every single time I talk about it, every single person will say, “Oh my God, that happened to me.” It’s so universal, unfortunately.
Medical gaslighting is when the medical provider, doctor, NP, PA, whatever, dismisses your symptoms, and makes you feel like your concerns aren’t real or aren’t important. They might say, “Oh, it’s your weight. It’s your age.” Or even insinuate that it’s in your head.
This is the scenario. You don’t feel well. You feel something’s off. You go to your provider, and they do whatever testing, and then they say, “You’re fine.” Or they say, “It’s just aging.” But maybe intuitively, you know that there’s something more. Something has to be more, you just feel it. But the medical professionals are telling you that it’s fine.
Medical gaslighting is basically when you’re asking for help, and instead of being offered options, you’re told that you’re fine, or it’s in your head. It’s anything except for, “I believe you. Let’s explore this.” Anything short of that is medical gaslighting.
Ryan Goulart:
I know you and I have talked about this before. Even now, I’m still going through it in my head of, “You know, I remember that one time when …”
Dr. Efrat Lamandre:
I know, it’s so sad. We’re smiling in this podcast. But every time I talk about this, because it’s the book I’m writing, it’s the speech I give, and everyone’s like, “Oh my God, this happened to me.”
Ryan Goulart:
It’s not ideal. I would imagine that, you’re a medical provider, you’re someone that is in this industry, and you’ve seen it happen. It’s not an ideal patient experience. It’s not an ideal customer experience. It’s not what they intended to go into the profession for.
What are some things that you’ve noticed in a highly specialized, highly trained profession like those in the medical profession? What have you noticed on the doctor side, or root causes if you will, of what’s going on in their head?
Dr. Efrat Lamandre:
This is really important because understanding this, your listeners, if they understand this, they will also know how to navigate and overcome medical gaslighting. We think that medical gaslighting, especially if you’ve experienced it, we think, “Okay, is my doctor malicious? Are they an evil person?” Am I just the only kind provider out there?
Does that make sense that they’re malicious? Well, I don’t know, because it happened to this person, and this person, and this person. Is everyone in on it? Did medical doctors spend seven years of their life going to school, studying medicine, just so they could wake up in the morning, kiss their spouse goodbye, go to the office just to be horrible to their patients? No. That’s not the case. We have to start breaking that down a little bit.
Or then, you start thinking maybe it’s conspiratorial. Maybe you heard some things. Maybe they get some kickbacks. Maybe if they give you these medications, they get kickbacks. I’m here to tell you that that’s not it either. There’s no kickbacks from pharma. Maybe in the ’80s there was. That is not legal, hasn’t been legal for a long time. So there’s no incentive. And if you think about the medical gaslighting you’ve experienced, you might remember that they actually didn’t prescribe anything. Is it pharma? That doesn’t really make sense.
What is actually happening? Because there has to be a common denominator, because I just told you that every single person I speak to is going through this. The common denominator is not malice, it’s not greed, it’s not kickbacks. It’s indoctrination. Indoctrination, let’s just define what that means. It means that, when someone is taught something, not that that something is necessarily wrong, but it’s taught that this is the only way to solve a problem. It discourages any out-of-the-box thinking. It discourages questioning of the material.
This indoctrination is actually at the crux of all medical school. We call it evidence-based medicine. Evidence-based medicine is medicine, studies have been done it, and algorithms are created from it. They’re important, you need these algorithms. They keep us safe, they keep the patients safe. It is so important to have those algorithms. At no point am I saying that we should not have the algorithms. It’s a really valid tool. The problem with indoctrination is that, when you’re in school, they teach you that this is the only tool that’s valid.
That type of thinking forces a clinician to say, “Well, if I ran my tools on you, and it showed nothing, the only conclusion is that you’re crazy.” They really, truly feel, “Okay, Mr. Smith, let me run all these tests for you. Let me do all these things for you because I really want to help you.” They do the tests, the MRIs, they send you to specialists, and nothing comes of it. There’s no world where they could say, “Huh, maybe there’s something I’m missing.” In fact, they feel that they’ve turned every stone. The only conclusion is it’s in your head. You’re crazy.
Let me give you quick case study that I see over and over again. The patient, maybe 40s or 50s, who starts experiencing brain fog. You know, “I can’t remember where things are.” Now if you try to go to a neurologist, the neurologist would say, “You’re fine,” because neurology only manages you once you have dementia, once you have Alzheimer’s. They’re not dealing with brain fog. You go, you get the MRI, and you do whatever you can. Everything’s fine. You don’t have a tumor. Your blood work is fine, everything is fine. But you feel like you’re just not as sharp at work anymore, or you just can’t remember things as much. But you’re told you’re fine, so then you go home and say, “Lose some weight, get some more sleep. Maybe it’s your stress. Maybe you’re really depressed or anxious.” I’ve actually had people, they’re like, “I don’t think I’m depressed or anxious, but I take these meds because maybe I am depressed or anxious.”
When I come to me, because I also practice some functional medicine which is different than conventional medicine, nine times out of ten, this type of scenario, it turns out they have mold toxicity. Mold toxicity is something I could test for, I could treat, I could test for cure. There’s a lot of objective findings about it. But it’s not part of the algorithm. You have these people, they do all these things, and they go through the algorithm, and they’re told they’re wrong. But there’s a whole world of testing that’s outside of the algorithm that is just not accessible to these providers.
This is exactly why it happens. Understanding that, once you understand that, the heart of this is not malice, then you also have less frustration. When you go into the room and that doctor doesn’t give you the answers that you want, then instead of saying, “Well, what’s wrong with you? Why aren’t you listening to me?” Or going to another medical provider and getting the same result, or going to five medical providers and getting the same result. We need to understand, they’re not going to understand, we need to understand that their tools are limited. Then we say, “Thank you so much for not finding anything with your tools. That’s great news. I don’t have cancer, I don’t have a tumor, that’s awesome.”
Then you take yourself, and you find another provider who has a different set of tools. You keep going, and looking for set of tools, until you get the answers that you deserve. But you use each person for what they need. You don’t go to a plumber and ask them for electric. You don’t get mad at the plumber for not doing electric. We need to take the power back and understand we come from a world where we think the doctor knows best. They know a lot, they’re amazing, they’re my friends. But they don’t know everything and that’s okay. We go to them for what they know, and then we go somewhere else for more.
Ryan Goulart:
Yeah. It’s fascinating, just to listen to you talk about it, too. One of the things that such a big thing, particularly in our society, is that statement that doctor knows best. You almost have to have the inverse of that. Have compassion for the provider, because the provider is only using the set of tools … They only know what they know.
Dr. Efrat Lamandre:
I don’t know that I would ask patients to have compassion, because the patient whose been wronged or feels wronged, to now ask them to have compassion. I think that it would be lovely if we all showed compassion to each other, that would just be a wonderful world.
Ryan Goulart:
Yeah.
Dr. Efrat Lamandre:
While that would be lovely, I think that would be a huge ask. What I’m trying to do is explain why it’s happening so that they get the power back.
Ryan Goulart:
Yeah.
Dr. Efrat Lamandre:
I know that you’re steeped in the financial world. You make an appointment to go see who you consider to be a financial person. You know there’s all different levels. You go, and the person says, “Well, I looked at your bank account. You have some money in there. I think you’re good.” You’re like, “My dude, I have credit card debt, I have six cars, I have 400 children. These are my goals that I want.” They’re like, “No, no, no. Your bank account has money, you’re good.”
It would be clear to you that this person has limited tools. They don’t know how to assess the rest of it. You’re going to be like, “All right. Well, thanks for the analysis of my bank account. I’m going to have to go find someone who’s also taking into account all the other things that I need to really make a diagnosis of my financial situation.” That’s how I want you to approach your doctors now. “Thanks for your perspective on this one thing that you are seeing in my overall health.” I don’t necessarily need to have compassion, but I’m also not going to be mad that person. I’m going to be like, “Okay, this person’s limited.”
That’s how you gain power back. You say, “Okay, I understand that this person only does this,” and then this one. Then eventually, you might need … I have an accountant and a CFO. Each one of them brings different things to my financial world. And a bookkeeper. Each one of them brings a different perspective to the finances. That’s how you have to start looking at it. But not just the specialists. You have to include your alternative professionals as part of your wheelhouse of people you’re going to go to.
Ryan Goulart:
Hey, listeners. Ryan here. It’s that time of year. Evolve is around the corner. This year, we’re talking about values-based decisions. Evolve’s dates are October 29th and 30th, here in Minneapolis, Minnesota. Hope to see you there.
It is really fascinating to me. I’ll just use myself as an example. Things like acupuncture. When I was going up, my idea of what care was didn’t include that. Then it took experience for me to realize that acupuncture is care. I think it’s I go to my acupuncturist for things that, if I have a cold, I know I can go to him and he’s going to help me immediately on caring for myself before going to my provider. Even though I have insurance, it’s just not the same thing.
Dr. Efrat Lamandre:
You nailed it right there. What we’ve decided are the professionals are the ones covered by insurance. Question that. For everyone out there, question that. Your acupuncturist is not covered. I do functional medicine, it’s not covered.
If we’re going to share a personal story, I’ll tell you a story about my wife and how I got into this 10 years ago. This is how I start my story. When I met my wife, she was a vampire. That’s not because she was immortal, but because she had a very significant autoimmune issue called PMLE, which basically meant she was allergic to the sun. She went to all the professionals. They told her they had two choices. Heavy duty meds, which may or may not work. Or just live with it. So she just lived with it. She had to change her entire life. We couldn’t go out in the daytime. Then she developed another autoimmune issue. Again, heavy duty meds, nothing we could do, shoulder shrug. Amazing. Always covered.
She’s in medicine, I’m in medicine, our friends are in medicine. We were all in medicine. I call myself a recovering gaslighter. I used to do the same thing. Eventually, it led us to functional medicine. Out-of-pocket expense, but completely cured her. Completely cured her. Autoimmune gone. Life back. In the sun. Just amazing. That is what took me down this rabbit hole. I took another class, eventually got certified, got the PhD because I was like, “This is crazy. There’s a whole other world here.” But this entire world is outside of insurance.
To your point, you made the decision to go outside the box thinking. This is what I’m encouraging everyone to understand that, just because it’s covered by insurance, doesn’t mean that’s the entire Venn diagram of what’s available to you. We also have to teach our medical providers that, just because it’s not covered by insurance, doesn’t make it less valid.
Ryan Goulart:
It gets back to that key phrase you used, of evidence-based.
Dr. Efrat Lamandre:
Yeah.
Ryan Goulart:
I’m just, again, reflecting on how a doctor just even responds to something like acupuncture. I know there’s been a few studies, a delta that has gone up in a population like yours.
Dr. Efrat Lamandre:
Let’s talk about studies for a second. Studies are important. Evidence-based medicine is important. Don’t get me wrong. I’m a huge proponent. Every Monday, you see me in my conventional medicine practice practicing evidence-based medicine. However, to create evidence-based medicine, you need a double-blind controlled placebo study. They’re very expensive. Phenomenally expensive. The only people who can afford it are pharmaceutical companies. When we’re looking to see if a pharmaceutical drug is appropriate and has efficacy, we’re going to do an evidence-based double-blind study. That informs our evidence-based medicine. Okay.
Now let me tell you that almost all my patients, when I take them off dairy and gluten, their eczema fully resolves. Who is going to fund that study? There’s no medication. Who is going to fund the study of an absence of gluten and dairy, and inflammatory foods taking away eczema? There is no funding for that study. I’ve been to dermatological conferences, and I’ve gotten my head bitten off. They’re like, “There’s no study that shows that.” I’m like, “You’re right. I have 20,000 patients. I’ve been doing eczema, psoriasis care for so long. It just works. I can’t run a study because I don’t have that kind of cash.”
While evidence-based medicine is amazing, there is still a whole world that cannot afford to run these studies that are still effective. I tell clients, “What do you have to lose? I can’t harm you by taking you off of gluten and dairy, there’s no side effect. It doesn’t work, it doesn’t work.” There are things that are really great, and they are an important standard, but they’re not the only tool.
Ryan Goulart:
And also, not to think in absolutes, which I think is fair for most of life, to not be so constrained by absolutes. Which is probably it’s easier said than done, because it does create some certainty in certain things, and decreases anxiety if you believe that this is the only way.
Dr. Efrat Lamandre:
Yeah. The algorithm is important, and it works obviously most of the time. But you need to leave room for the outliers.
Ryan Goulart:
Especially for a lot of the clients, or customers, or listeners of this podcast that are financial professionals. They have to consider healthcare costs for those that are about, for the first time in their life or for a very long time, to be without income. They’ll be going into retirement. They need retirement income now. There’s a ton of energy that’s put into building plans that can help that person live a long life, or be prepared for a prematurely shortened one.
The things that you’re saying here, it’s not only to make sure that you’re signed up for the right Medicare plan. But there’s also additional expenses to consider, outside of the scope of the traditional way of thinking about health. That includes empowering yourself for things like acupuncture, that are out-of-pocket expenses that do great work but can add up.
Dr. Efrat Lamandre:
Absolutely. I think we get lulled, once again, when we go into insurance, we go for the annual well visit. If there was ever a misnomer, this is it. Because what you do in a well visit is you do testing to see if you have illness. Lack of illness is not wellness. It should be a called a lack of illness annual exam. “Oh, if your cholesterol is good, and you’re not diabetic, and your kidneys are fine, then you’re good. I’ll see you next year.” That’s not good. That’s not sick. It’s not the same. Once something is flagged, you’re now sick.
I always tell my clients, for years, that when you look at health, you have to look at it like finances. I have three types of clients that come to me. The clients that are in credit card debt, the clients that are living paycheck to paycheck, and the clients who are planning for retirement. The clients who are in credit card debt are clients who are really unwell. They have chronic issues, it’s affecting their daily living, and we need a certain set of tools to help them get to a different place where they could just get off the couch. I eventually get them to a place where they’re living paycheck to paycheck. Which is okay, they’re not chronically ill, but they really, at any moment, could have a flare. The smallest thing sets them back. This is the person, paycheck to paycheck, if their engine goes, they go right back to where they started. It’s a really fragile state to be in. That requires a certain set of tools.
And then, there’s the patient who is well and wants to save for retirement. Those are my patients who are focusing on longevity, because it is not enough to go into this age with living paycheck to paycheck. Not financially, and not health-wise. You wouldn’t suggest that financially, it’s not healthy. It’s not enough to just not be sick. What are you doing to invest in your health bank? There are really concrete things that we can do. We need to have that conversation also.
To your point, when we’re planning that, we also have to gauge where they are in their health. If they’re at a place where they’re really unwell, they’re going to need a little bit more. If they’re in a place of longevity, they’re still going to need some support definitely outside of healthcare, because healthcare is just working on once you’re sick. But a different conversation as well, and that should be part of the portfolio.
Ryan Goulart:
It’s such a great metaphor to consider where you might be on that spectrum, too. Then also, add into the fact that what you eat, how often you exercise, all of those components.
What are some habits, or what are those things that someone who is listening to this right now, whether it be a financial professional, or a runner, or someone who’s on a train right now, what would you say to them about some actions they could take to improve their health wellness?
Dr. Efrat Lamandre:
Absolutely. Also, too, the advisors themselves, who are very worried about their clients, but we have to worry about ourselves, also. We’re advising people, you can’t pour from an empty cup.
Okay. First and foremost, sleep. Sleep, lack of sleep, is causative for dementia and Alzheimer’s. If you’re not sleeping, you’re at a higher risk for dementia and Alzheimer’s. We’re all scared of dementia and Alzheimer’s. I don’t care how much gluten-free ice you’re eating, if your sleep is not on point, you are not healthy. That means you have to make certain decisions during the day to optimize your sleep. You can’t just show up and just be like, “I don’t know why I’m not sleeping.”
Well, I don’t know, is it the 3:00 PM latte? Is it the glass of wine that you think makes you very fancy with your dinner, but in fact will disrupt your sleep? What decisions had you made? Is it the fact you decided to answer all your work emails at 9:00 PM, and you’re stressed out? Or watched the news? Or go to sleep with a really high intense show. If you have trouble sleeping, you have to understand that it’s a continuum. You can’t have espresso, and wine, and stress, and then lie down. There has to be intentionality to get to sleep.
The other thing I want to say is that, regardless of what we do, we all die. There is going to be a natural decline. Your mitochondria, powerhouse of the cell, high school biology, I’m sorry. The batteries in your cell slowly die out. That is what aging means. There’s this natural decline of mitochondria. There’s a natural decline of muscle mass. There’s this natural decline that’s going to happen. When you stop working, there’s going to be a natural depletion of your funds that you saved.
How much funds are you putting in? How much did you replete your health so that you can manage this decline? I’m going to give you a concrete example. If you want to be able to carry your groceries up the stairs at age 80, that means now, at age 50, you should be able to carry double the amount, double speed because that natural decline is going to take you there. If you’re struggling to do that now, it will not get better. You have to put away for the future. If you want to lift your suitcase overhead because you have all these travel plans because you saved all this money, and you’re struggling to put that overhead right now, there’s no shot you’re going to do it at 70. You have to start thinking this way. Well then, I need to practice at home with a heavier suitcase. Obviously under supervision, please don’t go do this and hurt yourself. A heavier suitcase.
Whatever you envision yourself doing with this money that you saved at 70, 80, 90, if you’re struggling doing that now, you need to double down. You need to start making … Think of it really concretely. If it’s hard for you to go up the stairs right now, it’s going to be twice as hard in 20 years. That’s how you create your training program. Start doing functional exercises so that you’re able to do it when that decline comes.
Ryan Goulart:
I’m already going through in my head of, “I want to do all that.” Thank you very much for coming on. This has been fantastic.
Dr. Efrat Lamandre:
It was a pleasure and an honor.
Ryan Goulart:
All right. Thank you.
As we wrap this episode, we’re committed to helping you Make the Ideal Real. If you found this program helpful, share it and help someone else make their ideal real, too. Until next time, for Think2Perform, I’m Ryan Goulart. Take care.
That’s Dr. Efrat Lamandre. We’re talking about living a life of wellness. I’m Ryan Goulart, and you are Making the Ideal Real.
