How to Maximize Your Annual Doctor’s Visit

Summary

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Podcast Summary: Am I Doing It Wrong?

Episode: How to Maximize Your Annual Doctor’s Visit
Hosts: Raj Punjabi-Johnson, Noah Michelson
Guest Expert: Dr. Milna Rufin (Internist, NYU Langone)
Date: May 21, 2026

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Episode Overview

This episode tackles the sometimes anxiety-inducing experience of the annual doctor’s visit. Hosts Raj and Noah, alongside Dr. Milna Rufin, break down the differences between various checkups, how to prepare for your appointment, what to expect (and what’s outdated), how to advocate for yourself, and what it really means to have a strong doctor-patient relationship. The tone is honest, conversational, and filled with useful, non-intimidating advice for anyone looking to make the most out of their medical care.

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Key Discussion Points & Insights

1. Annual Checkups: Physical vs. Wellness Exam

[03:28–06:59]

• Physical Exam: Lays on of hands (listening to heart/lungs, palpation, etc.). Mostly a head-to-toe look and doesn’t have as much impact in healthy people as once thought.
• Annual Wellness Exam: Focuses on discussing medical history, family history, lifestyle habits, and risk factors. Essential for mapping out an individualized healthcare plan.
  • Dr. Rufin: “There’s actually a checklist… tailored to how old you are, where you’re from, what organs you have, what your risks are.”
• Hybrid: Most people end up with a combination of both, tailored based on health concerns and history.

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2. Timing Your Visit for Maximum Benefit

[08:38–10:25]

• Advice:
  • For older adults, avoid visits in icy weather to reduce fall risk.
  • Don’t schedule around the holidays: “People get sad when they get blood work done in the holidays… If you get like a cholesterol level and it’s super high, that’s a really sad time to tell people not to eat.” (Dr. Milna Rufin, 09:19)
  • After/before your birthday is a helpful annual reminder.

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3. Reducing Medical Anxiety & Building Trust

[10:41–16:53]

• Preparation Tips:
  • Gather close family history before your visit (parents, siblings, aunts/uncles, grandparents—especially for cancer and heart disease).
  • Write down key ages and diagnoses.
• Choosing a Doctor:
  • It’s crucial your doctor’s personality aligns with your comfort level.
  • Dr. Rufin: “If you are scared to say something to your doctor, that’s a flag that this is not the right relationship.” (14:19)
  • Having a relationship with a primary care doctor gives you individualized, nuanced care—urgent care can’t replace that.

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4. How to Prepare (and What Not to Stress Over)

[17:03–19:24]

• What to Do:
  • Shower if you want, but doctors don’t care as much as you think!
  • Don’t eat a huge meal right before bloodwork. For cholesterol, fasting (4–6 hours) is best.
  • Avoid caffeine within 30 minutes of appointment—can spike blood pressure.
  • Don’t workout immediately before (can skew blood results).
  • No alcohol benders the night before (can affect liver values).

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5. Blood Work: What Tests Matter and How to Save Money

[19:24–22:10]

• Start cholesterol and blood sugar checks early if you have family history.
• New test alert: Lipoprotein Little A—becoming more widely recommended as insurance coverage improves.
  • “If you have any family history, definitely get that done once… I ended up paying like 40 bucks.” (Dr. Milna Rufin, 20:51)
• Get labs drawn at independent labs (Quest/LabCorp) rather than hospitals to save money.
• Pro tip: Get blood work a week or two before your exam so you can discuss results in real time with your doctor and not panic about online reports.

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6. Honesty About Habits, Vices, and Identity

[22:40–25:25]

• Doctors expect underreporting (“If you tell me four drinks a week, I’m thinking seven.”)
• Be open—even about recreational drugs or mental health—so you can get safe, holistic care.
• If you worry about something being in your chart, tell your doctor.
• If you’re uncomfortable being honest, that’s a sign to find another provider.

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7. Dealing with Guilt, Bias & Finding Supportive Care

[25:57–32:02]

• Weight, mental health, and other stigmatized issues: More doctors are being trained to avoid bias and shame.
• “People who are overweight often get treated differently.” (27:13, Dr. Milna Rufin)
• If a provider makes you feel ashamed or dismissed, you’re empowered to look elsewhere.
• Being asked, “Do you feel safe at home?” is vital and unique to the medical setting.
• “If you haven’t been to the doctor in years and finally go, you should be proud of yourself.” (33:44, Dr. Rufin)

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8. When the System (or Your Doctor) Isn’t Working

[34:01–38:09]

• Overworked or disengaged physicians? It’s often a system issue, not the doctor’s fault.
• Solutions:
  • Give feedback to the practice or institution.
  • Seek out nurse practitioners or physician associates if MD appointments aren’t available.
  • “If it doesn’t feel like it’s working, being willing to say, we’re not doing this and I’m going to find somebody else, and that’s okay, too.” (Dr. Rufin, 12:21)

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9. TikTok Tests, Full-Body Scans & Genetic Screening—Worth It?

[38:56–47:26]

• Direct-to-consumer "Cancer Guard"/full-body scans: Most not ready for prime time for the average person—false positives and negatives can cause harm and anxiety.
• "They will point out everything… it freaked her out." (44:00, Raj/Dr. Rufin)
• If there’s a significant family history of cancer, consult a genetic counselor first and only pursue advanced screenings if they are specifically recommended.
• Pro tip: Get life/disability insurance before genetic testing since results can impact insurability.

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10. When You Disagree with Your Doctor

[47:33–51:25]

• Reflect on why you disagree—fear, stigma, misunderstanding? Discuss these honestly.
• Ask for alternatives: “What are my other options? Can I try this first?”
• If you feel dismissed (especially common for women, queer folks, POC): Push back, ask for a broader look, or get a second opinion.
• Remember: “Medicine still doesn’t know everything.” (Dr. Rufin, 52:18)

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Notable Quotes & Memorable Moments

• On Honesty:
  “If you tell me you’re having like, four drinks a week, I’m thinking more. It’s like seven.” (Dr. Milna Rufin, [23:21])

• On Trusting Your Doctor:
  “If you are scared to say something to your doctor, that’s a flag that this is not the right relationship.” (Dr. Milna Rufin, [14:19])

• On Medical Education Reform:
  “It’s not just about the medical knowledge. It’s all about how do you use that knowledge, how do you use that with language that works for everybody.” (Dr. Milna Rufin, [27:53])

• On Full-Body Scans:
  “For the wrong patient, it can be debilitating… you’re probably going to need confirmatory testing. See your primary care doctor or one of your trusted doctors and ask for an appointment because you want to have a real conversation.” (Dr. Milna Rufin, [46:39])

• On Making the Appointment:
  “When you do make that appointment and when patients are in that room and they’re a new patient… I’m like, but you’re here now. Like, you should be really proud.” (Dr. Milna Rufin, [33:44])

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Better in Five: Top Takeaways

[57:03–57:50]

1. Find a trustworthy primary care doctor you’re comfortable with, not just any provider.
2. Before your visit:
   • Avoid alcohol and heavy workouts the night before.
   • No caffeine within 30 minutes of your appointment.
3. Know your family medical history (esp. cancer and heart disease), including ages and diagnoses, to inform your care.
4. Schedule your exam when it’s least stressful—avoid holidays if health anxiety is an issue.
5. Beware viral “miracle” tests and full-body scans; they often create more anxiety than answers for the average person.

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Final Thoughts

• Prioritize building a relationship with your doctor—it impacts your health outcomes.
• Don’t be afraid to prepare, ask questions, and advocate for yourself.
• It’s not just about “going”—it’s about making the annual exam a true tool for prevention and peace of mind.
• If it’s not working for you, keep looking: “Doctor shopping” is okay if it means finding the right fit for your health.

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“As long as there are things to get wrong, we’re going to be right here to help you do them better.” (Raj, [59:21])

Transcript

[Narrator]

48 million people in the United States are adolescents between the ages of 14 and 24. They're working, parenting, leading, sometimes all at once.

[Dr. Milna Rufin]

I'm balancing work and being a mom at the same time, and I'm still on track to graduate with my bachelor's next year.

[Narrator]

So what do today's young people need to truly thrive? Tune in to good things from Lemonada Media to hear the six part Thrive series.

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[Dr. Milna Rufin]

Foreign.

[Raj Panjabi Johnson]

Hi, I'm Raj Punjabi Johnson, head of

identity content at HuffPost.

[Noah Michaelson]

And I'm Noah Michaelson, head of HuffPost Personal.

[Raj Panjabi Johnson]

Welcome to Am I Doing It Wrong?

The show that explores the all too

human anxieties we have about trying to

get our lives right.

[Noah Michaelson]

Hi Raj.

[Raj Panjabi Johnson]

Hi friend.

[Noah Michaelson]

This week my burning question for you is, are you going to the doctor wrong?

[Raj Panjabi Johnson]

I go to the doctor whenever my pinky toe hurts, so I don't think I'm doing it wrong. I'm one of the really, really lucky fortunate people who has insurance.

[Noah Michaelson]

Yep.

[Raj Panjabi Johnson]

So I be twerking that shit.

[Noah Michaelson]

You're using it?

[Raj Panjabi Johnson]

Yeah, I'm using my insurance. This is my sticking it to the man. So I go, I think I'm doing it. I have notes ahead of time. I want to get the most out of my whatever, 20 minutes or 30 minutes if you're in a physical. So I think I'm doing it right. What about you?

[Noah Michaelson]

I did too. I had cancer when I was five and so I've always had a yearly physical because they were just like, you just need to get a checkup. I have so many friends who don't go. Every year they go like every five years. That works for some people, I guess. But like, I think it's important to go. So I love it. I love to talk about myself. I love when they ask you the questionnaire. Yeah, I love giving them answers it's kind of pathetic, but it excites me.

[Raj Panjabi Johnson]

It's not pathetic at all. It's like loving on yourself to make sure that you stay well.

[Noah Michaelson]

It's like, you know, 30 minutes where I could just talk about me and someone's just attention is on me.

[Raj Panjabi Johnson]

I like that. I need to give you more attention.

[Dr. Milna Rufin]

That means.

[Raj Panjabi Johnson]

Okay, well, today we have with us Dr. Milna Rufin. She's an internist at NYU Langone and the clinic site director for the residency program. There's.

[Noah Michaelson]

Check us out, Dr. Milna.

[Raj Panjabi Johnson]

Okay. Dr. Milna, thank you so much for being here today. We're so excited to have you.

[Dr. Milna Rufin]

Thank you for having me. I'm excited to talk to you guys about primary care. I love that.

[Raj Panjabi Johnson]

The sexiest of topics.

[Dr. Milna Rufin]

Yes. So sexy.

[Raj Panjabi Johnson]

All right, so we have a lot of doctor questions always. But today we're going to focus on getting a physical. So from what I understand, there's two types of kind of, like, checkups that you get every year. It's the annual wellness visit and your physical. Can you tell me about any differences between.

[Noah Michaelson]

Yeah, I had no idea that they were even different things or that I just kind of feel like they were used interchangeably. So I was kind of shocked by this.

[Raj Panjabi Johnson]

Yeah, just that for that scary day, you go to the doctor, right? Yeah. Yeah.

[Dr. Milna Rufin]

And I mean, it is kind of used somewhat interchangeably in some respects. There's. There's kind of like the actual physical exam part. It's literal. Like, it's a physical exam where the doctor's kind of like, looking at you head to toe and doing, like, the laying of hands of a doctor, you know, listening to your heart, listening to your lungs, palpating your neck, things like that. And so that's like what the physical exam is. People do that once a year, and you can do that during your annual wellness check.

[Raj Panjabi Johnson]

Okay.

[Dr. Milna Rufin]

But there's kind of like two different things. When you're saying, I'm getting my physical today, it's often just like a head to toe. Look at everything, make sure everything's going okay.

[Noah Michaelson]

Yeah.

[Dr. Milna Rufin]

And, like, when you look at the literature, like the medical literature, physical exams, when. When we actually, like, listen to somebody's, like, heart or lungs and they don't have any physical complaints. We're just doing it as, like a preventative thing. There's actually not that much data that shows that, like, that physical exam part is like the thing that makes or breaks. Or like, okay. Or like, is like that high yield in that situation. Like, the annual wellness exam is like, where you're talking to the patient about their medical history, about what their family's medical history is, what their routines and their habits and what their lifestyle is like. And then you can kind of take all that information and create a plan for how to optimize their health. And then there's this something called. Called a healthcare maintenance list. And it's like, basically a checklist of things that a primary care doctor or nurse practitioner or PA Will go through that's kind of tailored to how old you are, where you're from, what organs you have, if you were born a female or a male at birth, if that was your sex assigned at birth. Right. And what are the things you're at risk of. And I think of things in buckets, like, I like to. Buckets that I run through in this healthcare maintenance thing. My first one is, like, your cardiovascular health, your metabolic health. So I think about things like that. And then my second part is, like, the habits you have, which also kind of go hand in hand with the cardiovascular stuff. So, like, do you smoke cigarettes? Are you vaping? Like, those kinds of things, right? Then I start thinking about cancer prevention, right? And so I'm like, I. Are you old enough to. Is it time to get a colonoscopy? Are we gonna get mammograms, Pap smears, things like that? So I think about cancer next. Then I started thinking about, like, kind of women's health things. If, like, you know, it's related to cancer. I go from the Pap smears. And then I start talking about, like, periods and, like, sexual health. And then for everyone, I talk about, like, sexually transmitted infections. And then I go into infections, like, other infections, which I can prevent with vaccines. And so then I start talking about vaccines. And last but not least, I think about mental health. So there's actually a checklist that primary care doctors have to get through for the annual wellness exam. And it's different based on your age and often your gender.

[Raj Panjabi Johnson]

Okay.

[Noah Michaelson]

I think that I get, like, a hybrid of that now. So I had cancer when I was five. So I go every single year. I think some people don't actually go every year, but for me, I'm like, no, I should go. And I don't get the full physical, but she'll do some elements of that. Like, she will listen to my heart, she'll look in my ears, but, like, she's not, like, palpating my stomach or things like that. And then we go over sort of that checklist. So it seems like I'm Having, like, a combo of things.

[Dr. Milna Rufin]

Right. And that's kind of what I do. It's like, because the physical exam, like, I think that, like, really there isn't that much status that shows that, like, if you do, like, literally every part of the physical exam, like, if I'm doing a prostate exam on everybody, like, it's not like, it's not worth it, actually, for the patient and for us, because my fingers are actually short, I'm not going to be able to touch everything. And so doctors, I've never thought about, literally, doctors are actually not that good at prostate exams. Like, urologists are great at it. This is, like, what they do all the time. They're doing what we call digital rectal exams all the time. Primary care doctors, like, depending on how long your fingers are, like, how often you're doing them, you're not going to be that good at them, actually.

[Raj Panjabi Johnson]

Okay, so Lena is a special.

[Dr. Milna Rufin]

Leave it to the specialist. And does the exam actually change outcomes? If I do this, how many cancers will I actually catch? And if I do the prostate exam, if I don't feel anything, am I confident that I didn't miss anything? Right. For me, with my short fingers, I don't have much confidence in that. So I don't really do that. And most primary care doctors don't do prostate exams as often as they used to.

[Noah Michaelson]

And you can do a blood test, and there's a blood test for that, too, which seems to be more accurate. This might seem like a silly question, but is there a better time of the year to go for your annual checkup?

[Dr. Milna Rufin]

And this also depends on your age. So for my older folks, I tell them to avoid going to the doctor during the icy times of year because they're just going to fall on the way to city. So don't get your annuals. If your city weathers, like our city does in New York City, like, don't come in the icy weather time. So, like, that's for older folks. I think that people get sad when they get their blood work done in the holidays.

[Noah Michaelson]

Correct.

[Raj Panjabi Johnson]

I have done it.

[Dr. Milna Rufin]

Don't do it.

[Raj Panjabi Johnson]

Let me tell you.

[Dr. Milna Rufin]

I mean, it's just personal experience.

[Raj Panjabi Johnson]

It's terrible.

[Dr. Milna Rufin]

It'll be Thanksgiving. And I'm like, you need to lower your cholesterol intake, you know, like, stop eating ice cream. Like, and it's like, that's a really sad time to tell people not to eat.

[Raj Panjabi Johnson]

So this past year, I canceled mine. It was on December 23rd.

[BetterHelp Ad Reader]

Yeah.

[Raj Panjabi Johnson]

And I moved it. And my brother, who.

Who was a Physician was like, why

would you even do that? And I get anxious anyway, just such good advice.

[Dr. Milna Rufin]

I think if you're not an anxious person, go ahead, do it. But if you run anxious or have guilt that you're dealing with, whatever cultural thing did to you to make you have self guilt, you should probably hold off until another time of year. Cause it's gonna make you sad during the holidays if you get like a cholesterol level and it's super high. Yeah. So that's the. In terms of the time of year, probably not the best time if you're anxious. Otherwise, it doesn't really matter.

[HomeServe Ad Reader]

Yeah.

[Noah Michaelson]

Okay.

[Dr. Milna Rufin]

I tell people often to go, like right after their birthday because that's like, kind of like it's a reminder, oh, it's my birthday time. Like, I turned another year. Like, this is maybe time to get another, like, annual wellness check.

[Raj Panjabi Johnson]

I've changed my cadence to now in the summer, I'm in the best mood in the middle of summer.

[Dr. Milna Rufin]

I'm just like.

[Raj Panjabi Johnson]

And I'm eating better. Like, it's. It's fine. Speaking of anxiety, and I told you guys this before, I'm kind of a doctor's pet. Like, I go to the doctor when I need to. I go every year. I go in between if, like, funny things are happening. I'm just comfortable there. I have a really good primary care physician. She makes me feel comfortable.

[Dr. Milna Rufin]

I love that.

[Raj Panjabi Johnson]

But still, when I get in there, my blood pressure is high because it's a doctor's office. Right. So, like, can you talk to us about reducing anxiety, medical anxiety? When.

If you want to be this person

that goes every year, what should we be doing beforehand?

[Dr. Milna Rufin]

There's a little bit of homework that actually really helps to do Right. Before, like in the weeks or so before going to your doctor for your annual wellness check, talk to your family members, get updates on what their medical issues are. And by family members, I don't mean like your distant cousin, like, you know, Uncle Rory's like, you know, blood pressure child. You know what I mean? Like, it's like you want to talk about, like, what your, your parents are doing if they're still around, what your siblings are, like, what's happening in their lives, even if they're half, like, half siblings. Your aunts and uncles, like first degree, or your parents, siblings, and what your grandparents, what happened to them? Because often that could have happened many years ago. And you have no idea how Pappy passed away, but it might be helpful to know that he had this when he was 40. And your mom might know that, your dad might know that. The opportunity to ask your parents if you have a relationship with them where you can ask things like that, that'd be really helpful to have your past family.

[Raj Panjabi Johnson]

That's really important. The genetic indicators, like, you guys are really looking at that.

[Dr. Milna Rufin]

Super, super important. So I'm looking at that heavily and I often want to know the ages when people have these things. So it's like. And the buckets again, I'm a bucket er. So the buckets I really think about are cancer. Right. So history of cancer and how old they were when they were diagnosed. So if somebody had prostate cancer but they were 70, I'm probably not as worried as you're like, oh, my dad had prost cancer and he was 35.

[Noah Michaelson]

Right.

[Dr. Milna Rufin]

And that, like, oh, that my spidey sense starts to like, elevate because of that. The other bucket that I think about is cardiovascular disease. So, like, if anyone had heart attacks or strokes or any heart problems, like, I want to know about that. Diabetes, cholesterol issues. So that's like some of the homework that I love. When patients have beforehand in terms of like, the anxiety component, it's about the relationship that you have with this doctor. So if you have a relationship already and you found somebody that you trust and you feel comfortable. Comfortable with, that's awesome. Just like with your therapist, you're not gonna jive with literally any doctor. So some. Sometimes you're gonna have a relationship where you just don't feel comfortable with that person. And it's okay to get another doctor if you don't feel like you are. Are comfortable around them. You want to find somebody that you can connect with, that you can be honest with, that you don't feel, like, shamed by. Right. And so that's like, number one is just like finding a doctor that really works well with you. Like, if it doesn't feel like it's working, being willing to say, we're not doing this and I'm going to find somebody else, and that's okay too, you know? So think about your doctor as like, the personality of your doctor also matters and that it jives with you.

[Noah Michaelson]

You know what? I. So when I was young and I first kind of had like my first primary care doctor, he was like a hot gay guy. And I was like, absolutely not. Like, I don't want to talk to him about sex stuff. Like, I feel uncomfortable. So now it's only women for me. And I love it.

[Raj Panjabi Johnson]

I love that, like, you might be too hot for people as well, like,

[Noah Michaelson]

I love thinking about that.

[Raj Panjabi Johnson]

You gotta think about who you're gonna feel comfortable with. Right.

[Noah Michaelson]

When you get in that room.

[Raj Panjabi Johnson]

Yes.

[Noah Michaelson]

And what do you want to tell them? You just don't want to have to feel worried about it.

[Dr. Milna Rufin]

Do I want to talk to this doctor about this thing that's coming out of my vagina? You know, like, he's too hot, right?

[Raj Panjabi Johnson]

Yeah.

[Dr. Milna Rufin]

He doesn't get to talk about that. And if you are scared to say something to your doctor, that's a flag that this is not the right relationship. And I think that that's why I think people should have primary care doctors, is because it's a relationship. You can chatgpt. You can get all this information. That's a lot of it's quite good, and some of it's crazy bad, but a lot of it's good. So you can get a lot of great medical information online and through urgent cares and all those kinds of place. What you won't get is a relationship. Right. And so what doctors have been trained to do is to distill an enormous amount of information, Read the literature, understand when the literature is trying to trick us, when the literature doesn't really actually apply to this patient in front of us and applies to a different subset of population that takes decades of practice to really master. There's so much nuance there. And then they have to balance that with, who are you? Who's the person right in front of me? What are your values?

[Raj Panjabi Johnson]

What's your history?

[Dr. Milna Rufin]

What's your history? Where do you come from? What drives you? What do you want from life? Right, like, priorities. What your priorities are. And then, like, do you. Like, how do you balance those two things? Like, what I know will work for most people versus what I think will work for you now that I know you. So having that relationship is like. It's like. I mean, doctors have existed for, like, millennia, and they were shamans, right? They were like, they were people's, you know, often like the people that they came to for that wisdom. And that wisdom is not just like what you learn in a book. It's also like, what I understand of you as a human. You know, I mean, a lot of

[Raj Panjabi Johnson]

people go to urgent care and will skip their yearly visit, but I do see the value of having that relationship. Like, my. My p knows what my goals are. Like, I have. And they're not everyone else's goals. Like, do you know what I'm saying? I'll be like, I want to be hot. Can you help me? And she's like, okay, Raj.

[Noah Michaelson]

And for everyone else, like, you also have a history of what we've been through before and, like, preventative stuff. You're not going to get that at urgent care either. They're not going to be taking care of any of that.

[Dr. Milna Rufin]

No. And, like. But urgent cares, they feel like a big gap in medicine, but it's not

[Raj Panjabi Johnson]

to downplay urgent care.

[Noah Michaelson]

I go to them all the time.

[Dr. Milna Rufin]

Yeah, but it's not. But it's not going to get what you. What you want out of primary care, out of preventative medicine. You're not gonna get the preventative piece

[Noah Michaelson]

there before we show up. Like, on a more practical level, what should we do or not do? I would think you want people to take a shower.

[Dr. Milna Rufin]

Oh, yeah.

[Noah Michaelson]

You know what I mean? Especially if you're gonna be doing some of the more intimate parts of the exam. I just think people showing up stinky would be bad for you.

[Dr. Milna Rufin]

Yeah. I mean, I don't really mind that. I actually have a poor sense of smell, so it really is.

[Noah Michaelson]

You are looking for a doctor with.

[Raj Panjabi Johnson]

And you don't want to shower, and

[Noah Michaelson]

you don't want to shower. Dr. Milner.

[Dr. Milna Rufin]

Yeah. Yep. It really served me well during residency because when I was in the ER and, like, smelling all the things, I was like, all right, this is both. I can't smell, so I don't really mind about that. I don't think doctors care that much. We have to have very hearty stomachs for the things that can be considered gross to other people.

[Noah Michaelson]

Right.

[Dr. Milna Rufin]

It just, like, doesn't bother us anymore. So don't feel weird. You can come in right after a workout. I don't care.

[Noah Michaelson]

Okay.

[Dr. Milna Rufin]

What I do like is, like, so try not to eat, like, a huge meal beforehand. You don't necessarily have to fast. A lot of cardiologists love for people to fast because then your cholesterol levels are more accurate. It mainly affects cholesterol. So if you're gonna check cholesterol and you're interested in that, a fasting level, meaning don't eat anything like, maybe four to six hours before your blood work is gonna be done. I would say caffeine the day, the morning of is fine. Try not to have coffee like, 30 minutes before you're gonna be seeing your doctor because you're gonna get your blood pressure checked, and within 30 minutes, there is some thought that, like, your blood pressure can spike, like, 30 minutes after a cup of coffee.

[Noah Michaelson]

Okay.

[Dr. Milna Rufin]

And so it's fine to have it, like, that morning, but if you have a 10:00am appointment. Just try not to drink coffee. Like 9:30.

[Noah Michaelson]

Great.

[Dr. Milna Rufin]

Yeah. If you work out right beforehand, your blood work might look a little weird.

[Noah Michaelson]

Okay.

[Dr. Milna Rufin]

Because your body's, like, dealing with, you know, all of the enzymes that are kind of being metabolized during your workout. So just know that your blood work might look a little off, but your doctor probably won't be worried about it. Okay. So don't freak out. And then if you have like, a lot of alcohol the night before, your blood work will look weird too. Your liver function might, like, be a little off and then it goes back to normal after like a couple of days. So I'd say, like, don't do a bender before the night before your blood work. But these are more like blood work things.

[Raj Panjabi Johnson]

And I have. I have more questions about blood work because, you know, we should be doing that every year, I think. Yeah. How does it change? I know you said it's very personal, depending on your family history, etc. But like, as we age, what should we be perhaps expecting as far as what we're getting tested for and what might we want to ask for? If we're just concerned, really?

[Dr. Milna Rufin]

If you have like, family history of any heart disease or strokes, like the earlier, you know, what your cholesterol levels are doing, what your sugars are doing, which is a hemoglobin A1C and then like a lipid panel for the cholesterol, that's like, really important. I think that the guidelines for primary care will change in the coming years where they will recommend that everybody gets lipoprotein Little A testing, which is like this new test. It's not new, but it's fairly new in that insurance hasn't covered it previously. But I think more and more there's great uses for this blood test. And so I think that that's something that if you have any family history, definitely get that done once. And that's a fasting level.

[Noah Michaelson]

What was that test called?

[Dr. Milna Rufin]

It's called a lipoprotein Little A.

[Noah Michaelson]

If our insurance doesn't cover it right now, should we still ask for it and pay for it out of pocket?

[Dr. Milna Rufin]

I think that if that's like, available to you.

[Noah Michaelson]

Yeah.

[Dr. Milna Rufin]

If, like, if that doesn't put you out and you're not, like, you're still able to pay rent.

[Noah Michaelson]

Yeah.

[Dr. Milna Rufin]

Then yes, you should.

[Noah Michaelson]

It's a good one to get.

[Dr. Milna Rufin]

It's not usually that expensive.

[Noah Michaelson]

Okay.

[Dr. Milna Rufin]

I recently got mine checked and with insurance, they covered a portion of it and I ended up paying like 40 bucks.

[Noah Michaelson]

Oh, amazing.

[Dr. Milna Rufin]

It really depends on your insurance and where you get it done. So if you get it done, like, pro tip, if you get your labs done at a hospital, like, if it's located inside a hospital, your labs will cost more than if you got it done at Quest or Lab Corps.

[Raj Panjabi Johnson]

This is really important.

[Dr. Milna Rufin]

It's really weird that they can charge for the same thing, different prices at a hospital location versus a non hospital location.

[Raj Panjabi Johnson]

Because anxiety also involves financial.

[Noah Michaelson]

Absolutely. And who's gonna go if they have to pay or don't have to pay. Yeah, my. My tip is. And some people don't have time to do this, but I like to get my blood tests done a week or two before my appointment. And then when I go to my appointment, my doctor has all of my blood tests and we can walk through it. Because now there's this thing where they send you the results of your blood test the minute they get them back. And everything is, like, abnormal this, abnormal that. And I'm like. And then I get there and she's like, no, it's not abnormal. Like, this is within range. You're fine. And I've been freaking out about it. So I like to be able to, with my doctor and say, what's going on?

[Dr. Milna Rufin]

Right, right.

[Noah Michaelson]

But not everyone has time to go to two appointments. I get that. But for me, I think if you

[Raj Panjabi Johnson]

do, it makes your life a lot easier, though.

[Noah Michaelson]

It's great.

[Dr. Milna Rufin]

I love it when my patients do that. Some offices are not, like, well equipped to, like, do that ahead of time. And if you do that, like, there's something. There might be something that comes up during the exam, like, during the actual, like, visit that you want to get tested. Want to get tested. You might end up like, that's okay if you're willing to get blood work done twice, basically, if you don't mind getting stuck twice. If you're very, like, scared of needle sticks, then I would, like, maybe wait till the appointment.

[Raj Panjabi Johnson]

We talked a little bit about this, but how honest do we need to be about our vices?

[Michaels Ad Reader]

Okay, so, like, I mean, I. I drink.

[Raj Panjabi Johnson]

I was telling you before the podcast that, like, I need to know if I'm drinking too much for my age and body. Whatever. You know, my doctor has asked me, like, are you smoking? What are you smoking? And I'll be like, cannabis once a week, max. Like, this is. And I feel comfortable with my doctor. But, like, how honest do we need to be about the drugs we're taking?

[Dr. Milna Rufin]

You can be totally honest, and then you can even say to your Doctor like, we actually want you to be very honest. And sometimes, like, people were historically not honest with us. So we actually, like, have it in our minds that, like, if you tell me you're having, like, four drinks a week, I'm thinking more. It's like seven.

[Raj Panjabi Johnson]

I totally plan my number.

[Dr. Milna Rufin]

So we round up because we don't think that people are going to be as forthcoming with us.

[Raj Panjabi Johnson]

Well, you're right.

[Dr. Milna Rufin]

We want you to be as forthcoming as possible. And if you don't want it written in the record. Right. If you don't want it written in the chart, just tell us.

[Noah Michaelson]

We are.

[Dr. Milna Rufin]

I'm happy to, like, not write something in the. In the chart if you. If you don't want me to. So I talk to my patients about everything I want to know about. Like, if you dabble in ketamine every once in a while, like, I want to know, and how are you doing it? Like, what's the route of. Of the use? Because then that helps me make you more comfortable. Yeah, right. Like, and. And safe. Because there's ways to, like, ensure your safety depending on what you're using. And, like, so I want to know, like, are you doing, like, you know, like, microdosing psilocybin and where you're getting it from? You know, like, I talk to my patients about that all the time, and we've heard it all. So it's not like, oh, we're not judging youg pearls. Like, no. We want to figure out a way to help you be healthy. And then if some of these things are not serving you, we can talk to you about how to lower that, how to work around it. If there's medications that can support you in that process. Because there are. There are actually a lot of medications that can help with those kinds of things. Or if it's a therapist that you need or, like, you know, mental health referral that you need to help with those kinds of things. Are you treating depression with these things that, like, maybe a different thing would be better for you also?

[Raj Panjabi Johnson]

Interactions. Right. I learned too recently that you should not consume weed and Benadryl at the same time. Like, you can pass out. Like, the interactions are important, but just, like, regular stuff.

[Dr. Milna Rufin]

Yeah, absolutely.

[Noah Michaelson]

I also think we aren't alone in that doctor's office. Like, we do go in, a lot of us with guilt and with a fear of judgment.

[Dr. Milna Rufin]

Absolutely.

[Noah Michaelson]

And that makes it hard to be honest, I think. But to your point earlier, like, if you don't have a doctor that you feel like you can be honest with Then maybe it's time to find another doctor.

[Dr. Milna Rufin]

Right, right.

[Noah Michaelson]

Or if they make you feel guilty about things. I mean, I think a lot of people are struggling with weight.

[Dr. Milna Rufin]

Yeah.

[Noah Michaelson]

I know people who go in and they say, I don't want to get weighed. I know what I weigh. And the doctor would be like, get on the scale. Like, I had a woman write an essay for me about that, and she. She stopped seeing that doctor.

[Dr. Milna Rufin]

Yeah. And she's.

[Raj Panjabi Johnson]

For her.

[Noah Michaelson]

Yeah. And she was like, I found a doctor who would actually talk to me about my weight. And it wasn't a judgment. And I was like, that's great. But I think a lot of us are. Doctors have a lot of authority.

[Dr. Milna Rufin]

Right.

[Noah Michaelson]

And they can be scary. And so I think it can be a big deal to, like, look for someone new or to talk back to someone who is treating you badly.

[Dr. Milna Rufin]

Yeah, yeah. I think it's really important to find somebody you trust. I do a lot of work in medical education and teaching doctors how to doctor. And it's really heartening that, like, the new kind of methods of training, you know, young doctors really includes, like, ways to use language that don't include, like, biases and don't include, like, language that could be triggering for certain people language that is shaming. Right. And so we're actually trained on how to talk that. And there's, like, literal, like, fake patient scenarios with actors that we, like, practice this and we use. We, like, kind of do the word vomit to an actor instead of doing it for the first time in front of a patient and, like, totally bombing and, like, then making that patient's relationship with the medical, like, field destroyed again. You know what I mean? And doctors have done a lot of disservice in the past in building that trust with especially specific populations. Like, there's a ton of shaming of people who are overweight. And, like, it's actually been shown that, like, people who are overweight often get treated differently.

[Raj Panjabi Johnson]

Totally.

[Dr. Milna Rufin]

The same medical problems, the same needs of two different patients, but one's overweight and one's not. The person who is overweight will probably get worse care and not be offered the same things that the. That the person who isn't obese.

[Noah Michaelson]

Yeah.

[Dr. Milna Rufin]

And so that's, like, a real problem. But I think that there's a lot of headway with new training to, like, help people understand how to, like, be a better person on top of being a doctor. It's not just about the medical knowledge. It's all about how do you use that medical knowledge, how do you use that with language? That works for everybody.

[Raj Panjabi Johnson]

Hi, this is Raj from HuffPost's Am I Doing It Wrong Podcast. Noah and I have discovered so much from hosting this podcast and we really believe that learning is a lifelong journey. That's why I'm so excited to share that. This episode is sponsored by Study.com Study.com offers over 220 online college courses that help students make progress toward finishing a college degree in a flexible and more affordable way. This includes general education courses such as English, math and history. Study.com is fully online and self paced, and courses transfer to over 2000 colleges and universities. The best part? Study.com is accessible from your phone or computer and it costs just $95 a month. Study.com helps students of any age or any phase in life finish their college degree faster and save money by earning college credit on their own schedule. Go to study.com podcast to browse courses and get 10% off your first month when you sign up. That's study.com podcast the youth mental health crisis is all over the news and we know that social media is a big part of what's driving it. This stat really shocked me. The US Surgeon General warns that children who spend more than three hours a day online are twice as likely to have depression and anxiety.

That's really crazy to me.

I think about how online my nieces and nephews are.

They run the gamut between, you know, five and six years old to 13, 14 years old.

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it kind of worries me a little. Here's the good news though.

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[Raj Panjabi Johnson]

And to be human is to have bias.

[Dr. Milna Rufin]

Right.

[Raj Panjabi Johnson]

So to really address that, I'm watching the Pit, as a lot of people are right now. I learned that, you know, eating disorders are under diagnosed in black women.

[Dr. Milna Rufin]

Absolutely.

[Raj Panjabi Johnson]

And, you know, I ended up reading a lot about it, and I'm like, damn, you really have to beat the bias out of you as a good. To be a good physician, because you

have to be like, what am I missing here?

And why? What am I thinking quietly about my person?

[Dr. Milna Rufin]

Right.

[Noah Michaelson]

Absolutely right. You know, a question I love that I've been getting asked more recently is, do you feel safe at home?

[Dr. Milna Rufin]

Yep.

[Noah Michaelson]

That is such an incredible question.

[Dr. Milna Rufin]

Every new patient. Yeah.

[Noah Michaelson]

And I'm like, I don't think anyone ever asks us that, except for in that room. And if you don't, that might be the moment that you actually say something.

[Dr. Milna Rufin]

Right. Those are the things that, like, can happen in the primary care room. And I can't tell you, I was actually talking to my residents the other day because they're like, every patient that I see, Dr. Rufin, they're like, I like, they're always crying when they come and see me. And it's like, it's because they're releasing, and that's actually like, a really good sign.

[Raj Panjabi Johnson]

Right.

[Dr. Milna Rufin]

That they can feel comfortable with you. And so I honestly, like, I have, like, literally stacks of tissues in my room because I make everyone cry because I make them, like, look at themselves.

[Noah Michaelson]

Yeah.

[Dr. Milna Rufin]

Terrifying. It's gonna feel like walking through mud like therapy does, you know? Cause you're kind of. You're having to take a real good, hard look at what you're doing and how you're treating yourself. For people who are anxious about health and are afraid to come in, a reframe might be helpful. Sometimes I say to my patients, I want you to think about coming to see me as just getting information. What we're doing is we're just Getting information on how I can take care of myself. I can make decisions about how we're gonna take care of myself later. We can figure out what's best for me and we can do it bit by. Have to be all at once. But this is just me getting information. So how on me and how I can take care of myself. It's just advice.

[Noah Michaelson]

I love that.

[Dr. Milna Rufin]

Right. It's not. The earth isn't going to freeze over. You know, like, there's no scorched earth. Like, I'm going to yell at you. It's more like, these are like, here's some data. We're just gathering data. Data, right.

[Noah Michaelson]

Yes. That's a great way to look at it.

[Dr. Milna Rufin]

And so just like. And you should also be proud of yourself. So a lot of people, like, spend their whole day serving others, whether it's their kids or their partners or their parents or their co workers, working hard. Three jobs. You know what I mean? They're just doing so many things for other people. And then when it comes to themselves, they're not spending time to exercise, they're not spending time to eat foods that's going to actually nourish them. I haven't seen a doctor in five years. But when you do make that appointment and when patients are in that room and they're a new patient and they're coming to me and they're saying, I haven't seen a doctor in many years. I like, I just, like, been so bad. I'm like, but you're here now.

[Noah Michaelson]

Yeah.

[Dr. Milna Rufin]

Like, you should be really proud because this is a huge step. This means you care about yourself.

[Noah Michaelson]

Right?

[Dr. Milna Rufin]

Right. And that you care about the next steps.

[Noah Michaelson]

We have a question from Lucinda. She said my GP breezes in and barely looks at me and seems too busy to answer the list of questions I've brought with me. How should I deal with this?

[Dr. Milna Rufin]

That's really sad.

[Noah Michaelson]

Yeah.

[Dr. Milna Rufin]

And like, all too often, I don't think it's rare. It's not rare.

[Noah Michaelson]

I think oftentimes people come in or I hear people too say, like, my doctor didn't even look at me. They just looked at their computer the entire time.

[Dr. Milna Rufin]

Yeah.

[Noah Michaelson]

And it's like, that sucks.

[Dr. Milna Rufin]

Yeah, it really does suck. I really feel bad for Lucinda for having experienced that. And also I really feel bad for that primary care doctor because I guarantee you that primary care doctor did not go into medicine to, like, look at a screen and just like, be making one with your computer. I did not go into medicine to be on computers. I spent a lot of My time on computers, looking at the data. But it's not what drives me. In fact, it drives me crazy. But the fact that this doctor is acting like that, it just means that the system is failing her or him and the patient. And there's many places where Doctors are given 20 minutes to see a patient, and then they see 30 patients in a day. So they're just churning through patients, and they have so much stuff to do that then they end up becoming less connected. And, like, the whole reason that they went into medicine, it seems out of reach to them. And so that might mean that the system that you're getting your care in might not be treating their doctors very well, and that maybe it's a switch to a different situation might be better. But primary care is under a lot of duress recently, and I felt it, and I happen to be at an institution that has a lot of support systems in place, but it's still hard, still super hard to, like, keep up with the volume. Mainly because there's not that many primary care doctors. There's a lot of, like, nurse practitioners and PAs, and that they're gonna be taking a, like, a bigger role in primary care. But we. It hasn't been quite well defined, like, what that partnership, like, should look like. There are lots of really great places where they work in tandem, and then there's some places where, you know, NPs and PAs are kind of working alone. And they're great. They can be really wonderful. But. But there's just so much volume. And so that's probably what's happening to that person, to that doctor, is that they're like, kind of. That's a sign of burnout, like, that you can't connect with your patient. And so it sucks. But it might mean that, like, a change might be in play, or if you're already. If you know that doctor and they weren't like that before writing a letter and saying, like, you know, I noticed that, you know, this doctor was really busy, and I think that it's impacting the relationship that we had before. And so sometimes getting the sense from patients, the institution actually listens to patients more than they listen to the providers. To be honest. A lot of doctors are employees now. A lot of them don't have private practices anymore. They are their own bosses. So we don't really dictate how much time we get with our patients. I would love to spend, like, a whole hour with my patient, but I get 40 minutes, which is actually really good.

[Noah Michaelson]

Yeah, that seems great.

[Raj Panjabi Johnson]

Yeah.

[Dr. Milna Rufin]

And So I get 40 minutes. If you are a very simple situation, which is good, that's ideal. Like, then we have lots of time to talk a lot about a lot of stuff. But if you're really complex, then that's not enough time to talk about. To do that whole checklist that I talked to you about and to talk about, like, your chronic conditions and to kind of optimize your health and to talk about health, nutrition, your exercise plan, how you can tweak things. Like, that's not gonna be possible in 40 minutes. And then if you have five other questions that are specific, it's gonna be hard. And so for me, it's like, if I want to be a good doctor and do a good job at it, I need time. And that is not. That's not like a luxury that most people have.

[Raj Panjabi Johnson]

Unfortunately, that's also probably why it takes so long to often get a year. Mine, I booked mine out eight months before that. 40 minutes is much longer than the regular 15 minutes. Like I have a problem kind of thing.

[Dr. Milna Rufin]

Exactly. So this is something that people don't realize is that, like, you don't have to wait until you're annual to talk to your doctor about your problems.

[Noah Michaelson]

Right.

[Raj Panjabi Johnson]

Oh, okay.

[Dr. Milna Rufin]

Like, you can call and make an appointment, go on your MyChart or whatever portal you have, ask for an appointment. If, like, there's nothing listed as available, that doesn't necessarily mean that there's nothing available. So, like, what's listed on, like, the portal as availability? Just, like, use that as a guide. But if there's nothing there, message your doctor's team and ask them, like, can doctor so and so see me sooner. I'd love to talk to them about, you know, my aunt who just had breast cancer and now this is my third family member with breast cancer and I want to talk about my risk.

[Raj Panjabi Johnson]

Okay, so what are your thoughts about the full body scans that are available now? That's part one and part two is speaking about full body scans. There's a lot of stuff on TikTok that people are like, you should get this test. And I can't tell if it's like an actual medical thing or some ridiculous, like, wellness industrial complex thing.

[Noah Michaelson]

Yeah. The new one that I just saw too is called Cancer Guard.

[Dr. Milna Rufin]

Oh, so Cancer Guard. Yeah. So this is coming up.

[Noah Michaelson]

Yeah.

[Dr. Milna Rufin]

And like, they are commercially available, but they're not performing well enough yet for it to be prime time and paid for by insurance. Like, insurances are gonna want to see the data that shows that this improves outcomes and that it's right. And it doesn't miss patients and that it's not always falsely positive.

[Noah Michaelson]

Cancer Garden is from the makers of Cologuard. If people see that one, we're like, you don't have to get a colonoscopy. Or this can be a first step. You poop in a bucket, you send it in. They test it. Now they supposedly have a blood test.

[Dr. Milna Rufin]

Blood test, yeah.

[Noah Michaelson]

Where they're testing for a whole bunch of cancers, or what is it Exactly?

[Dr. Milna Rufin]

Right. So it's a test that tests for a bunch of different cancers. And there's actually a couple of these coming out, like, over the next year. I believe there's going to be several of these blood type ones. And they test for markers of different kinds of cancers. Some of them are testing for DNA that is associated with those cancers. Some of them are testing for an antibody that is associated with those cancers. So different things that they're testing, but not cancer itself. Not cancer itself.

[Noah Michaelson]

More like things that are likelihood indicators

[Dr. Milna Rufin]

that can be a signal. But there's something called false positives and false negatives.

[Noah Michaelson]

Right.

[Dr. Milna Rufin]

So there's some people who have cancer, but they will be falsely negative. And this test will make you feel like, oh, I'm good, but you're not actually good. Right. And then some people will have no cancer and it'll be positive. And then they're freaking out for the six to eight weeks that it takes to prove that they don't actually have the cancer. So it's like there's an emotional turmoil. Point to that. So these tests are gonna be revolutionary once we get them to the point where they're what we call sensitive enough and specific enough. Yeah, okay. Right. But those things, like, they're coming up, and I'm really excited about all of these. I don't think that they're prime time yet. And so if you do end up getting one of these things, you gotta talk to your doctor about it. Like, set up an appointment. Like, don't just, like, my chart. Message your doctor and say, like, what do you think about this cancer guard test that I got, like, a deeper conversation to have than, like, a mychart message. And, like, you're not gonna get the nuanced, like, answer that you want from my chart.

[Noah Michaelson]

Would you say the average person should be getting these tests now, though?

[Dr. Milna Rufin]

No, I don't think so. Yeah. When? I mean, not prime time yet. I wouldn't give it to everybody. Okay, but like, say, for example, you have, like, an uncle who had pancreatic cancer, then Two of your aunts had ovarian cancer, and then, like, another aunt had colon cancer.

[Noah Michaelson]

Right.

[Dr. Milna Rufin]

Then, like, those things might be helpful. You know, there's a lot of genetic testing, too, that you can do. And so when people have, like, multiple family members with cancers, I do recommend that they talk to a genetic counselor. And then once they talk to the genetic counselor, you, like, write down all of the family members that you can think of that have cancer, when they got it, what kind of cancer. And then the genetic counselor will then look at that information and help you decide, like, these are the tests that I would send for.

[Noah Michaelson]

You got it.

[Dr. Milna Rufin]

And then you can get a list of anything that you come up positive for. And then I can look at that and be like, okay, you have, like, a predisposition to getting colon cancer. You're 24. But, like, normally I would have gotten your colonoscopy or the cologuard when you're 45. We cannot wait that long.

[Noah Michaelson]

Move it up.

[Dr. Milna Rufin]

You know, we're gonna move this up. We're probably gonna do this earlier for you, and then we'll figure out the interval, like, how long, how often we should do this. It can be helpful. One pro tip, though, is that if you get genetic cancer testing, you have to do it, like, after you've decided to get, like, life insurance or disability insurance. Because those things, like, you can say, like, oh, I have the BRCA gene. And then, like, you want to get life insurance, but they're never going to cover anything that's related to your.

[Raj Panjabi Johnson]

Oh, my God, this is such a good tip.

[Noah Michaelson]

Yeah.

[Dr. Milna Rufin]

So I always tell my patients, like, I want genetic testing because me and my husband are about to, like, like, get pregnant. Or, like, me and my partner are gonna get pregnant, or, like, our surrogate, like, you know, is gonna donate the egg. And, like, we wanna do genetic testing with, like, my husband. I'm like, well, like, get your life insurance ready first, because you will not be covered for that. If that's wild.

[Noah Michaelson]

If you get genetic testing, what about the full body scan?

[Dr. Milna Rufin]

I feel like you would be a

[Noah Michaelson]

person who would like that because there's so much data.

[Raj Panjabi Johnson]

I'd be terrified, but also want it.

[Dr. Milna Rufin]

Yeah, I have feelings about it. Yeah, please tell us, because it causes so much anxiety.

[Raj Panjabi Johnson]

So much anxiety.

[Noah Michaelson]

My friend got it done, and she was like, same thing. She was like, do not get it if you have any anxiety, because they will point out everything like, oh, this disc looks like it's starting to deteriorate in your. In your neck. And, like, you should worry about this. And she was like, it freaked her out.

[Raj Panjabi Johnson]

Just the tooth one. At the dentist, they have, like, the teeth one. I did that. And they were like, you need a new mouth.

[Dr. Milna Rufin]

I was like, you're like, okay, this is not helpful.

[Raj Panjabi Johnson]

No, we can't do this.

[Dr. Milna Rufin]

The thing about these MRIs is that when you get an MRI for a specific part of your body, each one is protocoled very differently. Okay. So there's a different set of timing for how they. You know, how they set the mri when they give the contrast, when they don't have the contrast. The MRI works with magnets, and what the magnets are working on is basically some of, like, this, like, the protons in your cells. And so it'll change the position of the magnet based on what you're trying to look at. And so if I'm specifically interested in looking at a patient's breast mri, then there's a specific protocol for that. There's a specific protocol if I want to look at the pancreas, and then there's a specific timing for when we're supposed to give the contrasting and not give the contrast. And so. And then there's a radiologist who reads this who is specific to that organ. Right. There's literally, like, a radiologist who does MRIs for the head, and that's, like, all they do. Then there's ones who do CT scans of the abdomen, and that's all they do. Right. So you get, like, really, really granular, wonderful reads based on the radiologist you have. If you have this full body scan, it's like one radiologist reading everything who doesn't necessarily have expertise in all of them. Okay. So you have to take it with a caveat. Right. And that if they find something, you're gonna have to get a repeat test

[Noah Michaelson]

of that specific area. Right, right.

[Dr. Milna Rufin]

And then it's gonna take time for that to happen. Like, first off, like, you can get it, and then, like, you can't get an appointment with your PCP for, like, a month or two, even. Even more, maybe. Then you finally talk to your doctor, and then they put in a referral, and then you can't get an appointment for that for another two weeks.

[Raj Panjabi Johnson]

This is when Dr. Melna gets a test text from me randomly being like, remember that podcast you did with me? Can you look at my skin?

[Noah Michaelson]

Yeah, totally.

[Dr. Milna Rufin]

And then you Google it, too, right? You're put it into, like, chat GPT. You're going to, like, look at. You're going to ask Claude what they think about Your. You know about your imaging study, and Claude might have some good opinions, but Claude's going to, like, some of them are going to tell you you have cancer.

[Raj Panjabi Johnson]

Sure.

[Dr. Milna Rufin]

Right. And so, like, there's a lot of fear and anxiety that will happen when you get these full body MRIs. And I'm not against them. I just think that for the wrong patient, it can be debilitating. For that person, take it with a grain of salt, because you're probably gonna need confirmatory testing. See your primary care doctor or one of your trusted doctors and ask for an appointment because you wanna have a real conversation about whether or not it's worth it to get. Get further testing. When you get the confirmatory testing, try to take deep breaths and, like, don't come to any conclusions on your own. Like, this is why we're here, to hold your hand through this.

[Raj Panjabi Johnson]

Jumping to conclusions is my favorite.

[Noah Michaelson]

Absolutely.

[Raj Panjabi Johnson]

So I'm gonna stay far away from that.

[Noah Michaelson]

Me too.

[Raj Panjabi Johnson]

As much as I love data.

[Dr. Milna Rufin]

Yeah.

[Raj Panjabi Johnson]

Okay, so what if you're. You're at your appointment and your doctor tells you something that you totally disagree with, Whether it's like you read something on Google that you feel strongly or, you know, you have family history of something else? Like, how do you go about that?

[Dr. Milna Rufin]

I think it's, like, it's really hard because you want to maybe make sure that you reflect on why you're disagreeing. Right, Right. Like, why am I so against starting this cholesterol medication? Like, what am I willing to do that might be adjacent to it? And does it make sense that I'm not willing to take this? Right. So, like, so, for example, I have a lot of patients who are, like, totally afraid of statins because they, like. Statins get a really bad rap. But, like, if you ask any doctor or cardiologist, they're all on statins.

[Raj Panjabi Johnson]

Yeah.

[Dr. Milna Rufin]

Like, I'm about to be done breastfeeding and I have bad cholesterol. My family has, like, lard as blood, and we just.

[Raj Panjabi Johnson]

Delicious.

[Dr. Milna Rufin]

It's. It's amazing.

[Noah Michaelson]

It's just.

[Dr. Milna Rufin]

It's really bad. And so I'm gonna go on my satin again once I'm done breastfeeding. And so I asked my patient, like, so, okay, you have really strong family history. Your dad, like, died when he was 45. Like, you grew. You grew up dadless because of heart disease. Right. And it's something that you got passed down to you. Right. This is, like, something that runs in your family. And I'm seeing, like, the patterns of the things that could lead to you having these issues. But I have patients who are like, nope, don't want to take a satin. I've heard too much. Too much about it. But they're, like, taking five supplements, right? So it's like, girl, so what's the. I guess the hesitation about this pill that is, you know, a medication, and, like, why are you worried about that and not using the same, like, hesitation with the other things that you're taking? What's. Is there a difference there?

[Raj Panjabi Johnson]

It sounds like a therapy moment, and it is.

[Dr. Milna Rufin]

And it can be, because it's also, like, when you take a medication versus a supplement, is it. Is it that, like, does it feel like failure? Like, do you feel like you've failed in some way? Like, is it, like, are you feeling guilty or ashamed about having to take a medication?

[Raj Panjabi Johnson]

Do you have, like, a fraught relationship with prescription medicine?

[Dr. Milna Rufin]

Right. Like, what was what. What is that about? Like, if. So if it's a medication decision that you disagree with with your, like, doctor and they're recommending something and you don't really want to take it, that one, I would say, like, think about, like, why you're stopping yourself. And it's not wrong to not want to take a medication. I don't want to give you medications, but if I really think you need it and if I think it would benefit you, I'm going. It would be, like, malpractice for me not to talk to you about it. Right. And so, like, so it's actually a good thing if your doctor's trying to offer you things. But if they're not talking to you about the risks, the benefits, the alternatives, maybe those are things you should press them on. Like, well, what are my other options? Right. Instead of saying, I just don't disagree with them, push them. Go ahead and push your doctor to be like, what are my other options? This is what I want to prioritize. Can I try this first? Is that reasonable for me to try? Right.

[Noah Michaelson]

I think on the flip side, too, a lot of people, especially women, especially queer people, people of color, they aren't believed by their doctors.

[Dr. Milna Rufin]

Oh, yeah.

[Noah Michaelson]

And so they have to disagree in the other way because they're like, no, there is something wrong with me.

[Dr. Milna Rufin]

Right? Right.

[Noah Michaelson]

So many, especially women, like, with autoimmune diseases, things like that, like, you're just tired or you're just anxious.

[Raj Panjabi Johnson]

You're anxious.

[Noah Michaelson]

Yeah. And it's like, no stress. And then years later, they had lupus or they have all these things.

[Dr. Milna Rufin]

And.

[Noah Michaelson]

And so. So I think that's something Too. Like you said, push back. Ask them for other options. Other.

[Dr. Milna Rufin]

And just say, like, I don't feel well. And so say. Say you've had, like, a million tests already done and you've seen multiple second opinions, and that's something that I also really recommend is getting second opinions.

[Noah Michaelson]

Yeah.

[Dr. Milna Rufin]

And then honestly saying, like, I don't. I'm not feeling heard right now, like, using those words like, I'm not feeling heard right now, like, that I'm suffering. I think that that can go a long way. You can say to your doctor, like, can we take a pause? I just feel like I'm suffering, and I just really need help. And I just really want somebody to look at the whole picture. Right. That's okay to ask for that kind of help. But there will be some times where we've looked everywhere, and it's really frustrating. And something that everyone should know is that medicine, we've gone so far in so many things, but we. We still don't know everything. Right? We really don't.

[Raj Panjabi Johnson]

I feel like there's so many advances that have been made, especially in breast cancer and stuff. I have so many friends who have had it in the past couple of years, and a lot of them, their physicians have been like, okay, here's what we're gonna do now.

[Dr. Milna Rufin]

Yeah, yeah.

[Raj Panjabi Johnson]

And there's a journey. It's.

[Dr. Milna Rufin]

You know, it's a journey that's also

[Raj Panjabi Johnson]

worthy of being like, okay, maybe it's not a really bad one, or it looks like there's a way to treat it.

[Noah Michaelson]

We always like to ask people, like, what's the number one thing that we should take away from this episode? And it feels like, for me, like, whether you have something that you know is easily treated or whether you're being told that you have pancreatic cancer, like, having a good relationship with a doctor that you trust, that you like, that you feel like you can talk to without guilt or shame, that seems like the best thing to do.

[Dr. Milna Rufin]

Yeah, yeah, absolutely. I think that that's going to make a huge difference. Actually. There have been studies showing that, like, that your relationship with your doctors makes, like, all the difference in terms of your experience of that. And then if it's an end of life thing, getting a palliative care doctor involved early, because people think, oh, that's just end of life. But any diagnosis where you're dealing with symptoms that cause discomfort, that's what a palliative care doctor is. That's the word. Palliative. It's about treating the pain, treating the. The Points of discomfort. And those doctors make everybody's experience so much better, and the patient feels better heard and overall just better taken care of. And so I think there are certain doctors in each realm that really help with that. But it all depends on the relationship. Right. And so, like, my biggest advice for patients is that if you don't feel like you're building that relationship with your primary care doctor, it's not your fault. It's often not even the. The doctor's fault. It's probably, like, the symptom of a really diseased system of healthcare. Right. And that if the doctors don't feel like they can connect with you, then you might need to go somewhere where doctors seem lighter, seem easier to connect to. And so there's, like, a word in the doctor world where people say, oh, this patient's doctor shopping. So they're trying to find the right fit for them.

[Raj Panjabi Johnson]

And.

[Dr. Milna Rufin]

And some doctors think that that's kind of, like, annoying. But I think it's a good thing you're trying to find somebody who fits you. Not every doctor's gonna give you what you need.

[Noah Michaelson]

Yeah.

[Dr. Milna Rufin]

Yeah. And so you have to find ones that fit better for you and can have the relationship that you want out of a doctor. Yeah.

[Raj Panjabi Johnson]

I think it's a great place to end.

[Noah Michaelson]

Yeah. Dr. Milne, thank you so much.

[Dr. Milna Rufin]

You're so welcome. I hope this is helpful.

[Raj Panjabi Johnson]

Definitely.

Okay. I have to tell you, I was

[Dr. Milna Rufin]

just looking on ebay, where I go for all kinds of things I love. And there it was.

[Noah Michaelson]

That hologram trading card. One of the rarest. The last one I needed for my set.

[Raj Panjabi Johnson]

Shiny like the designer handbag of my dreams. One of a kind. Ebay had it. And now everyone's asking, ooh, where'd you

[Dr. Milna Rufin]

get your windshield wipers? Ebay has all the parts that fit my car. No more annoying, just beautiful. Millions of finds, each with a story. EBay. Things people love.

[Paige Desorbo]

Hey, this is Paige Desorbo from Giggly Squad, and this episode is presented by depop. Okay, be honest. How many things in your closet are just sitting there waiting for their next main character moment instead of staring at them? List them. You can list an item in just a few taps on Depop, Snap a photo and their AI powered listing fills in the details, and you're done. It's not giving stressful and it's giving efficient and make money easily. With no selling fees on depop, no seller fees means what you earn is yours. Your personal taste has value. Someone is literally looking for what you're not wearing. Download the depop app and list. Your first item today.

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[Noah Michaelson]

All right, it's time for Better in five. These are our top five takeaways from this episode.

[Raj Panjabi Johnson]

Number one, having a primary care physician that you actually like and are comfortable with is crucial to your health.

[Noah Michaelson]

Number two, consider not drinking the night before your appointment. Maybe don't work out right before your appointment and then about 30 minutes before, before you go in. Don't drink caffeine.

[Dr. Milna Rufin]

Okay.

[Raj Panjabi Johnson]

Number three, try and note all of your family history before you come into the appointment. It's really, really important.

[Noah Michaelson]

Number four, consider scheduling your appointment when it's going to be the most peaceful for you or maybe when you're not shoving Christmas cookies in your mouth every day.

[Raj Panjabi Johnson]

Fair. And number five, experimental tests that you might see on TikTok, such as full body scans, can be useful for some people, but for many of us, they're just going to be a bad bastion of unneeded anxiety.

[Noah Michaelson]

Yeah, you and me.

[Raj Panjabi Johnson]

That's right. Okay. So, Noah, were you going to the doctor wrong?

[Noah Michaelson]

I. I was not. I feel pretty good about my doctor going, but I will say I did learn some things. Like I didn't know the stuff about before you go, like don't have caffeine within 30 minutes or don't work out before. It makes total sense, but it's not something that was on my radar at all. So I don't think I'm doing it wrong. I think I can like this show teaches me every single week. I can always do stuff better.

[Dr. Milna Rufin]

Love that.

[Noah Michaelson]

So I like that. What about you?

[Raj Panjabi Johnson]

I mean, I think I realized that

going whenever I want to is not the same as doing it right. I mean, it was fine. But you know what? I did also learn a lot. And the thing about noting your family history, really important. I think I can prepare in a different way for my doctor's visits now by being like oh, this thing happened to this person maybe. What blood work should I be getting just cause I am. She's right.

I am very data driven and I'm

the type of person that I want to love on my friends and family for a long time. So if I know something, I'm gonna work on it.

[Noah Michaelson]

And I love the idea too of like this is a chance to get information about your body and your life.

[Raj Panjabi Johnson]

Yes.

[Noah Michaelson]

And it doesn't have to be a scary thing. And if it is a scary thing, like there are ways to mitigate that.

[Raj Panjabi Johnson]

I mean the earlier you know any scary thing, the better.

[Noah Michaelson]

Absolutely. Also, just another shout out to all of our listeners who've been writing us. We love the emails. If you want to email us, it's amidoitronguffpost.com People send us show ideas. People send us feedback. We love all of it.

[Raj Panjabi Johnson]

We'd love it. We thank you so much.

[Noah Michaelson]

Yeah. And until next time, as long as there are things to get wrong, we're going to be right here to help you do them better.

[Raj Panjabi Johnson]

Stay well

Am I Doing it Wrong?

Is a co production between HuffPost and Acast.

[Noah Michaelson]

Our producers are Eve Bishop, Carmen Borca, Carillo and Malia Agadello.

[Raj Panjabi Johnson]

Our executive producers are Jenny Kaplan and Emily Rutter.

[Noah Michaelson]

Special thanks to HuffPost's head of audience,

[Raj Panjabi Johnson]

Abby Williams, Head of Video Will Took,

[Noah Michaelson]

as well as Kate Palmer, Marta Rodriguez and Terry d'. Angelo.

[Raj Panjabi Johnson]

And we're your hosts, Raj Panjabi Johnson and Noah Michaelson.

[Paige Desorbo]

Hi, it's Paige from Giggly Squad and this episode is sponsored by Experian Boost Summer Glow Up Check Credit Glow Up. Even better, boost your credit scores instantly by getting credit for bills you're already paying. Your phone, utilities, rent and insurance. I wish dating kind of worked like that. Connect your bank account, add those on time payments to your Experian credit file, and your FICO score updates right away. You could instantly raise your FICO score by an average of 14 points with Experian Boost.

[Dr. Milna Rufin]

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[Narrator]

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[Raj Panjabi Johnson]

Something that we would hear often was

[Dr. Milna Rufin]

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