Bloomberg Businessweek Daily Live From NYSE with LifeMD (Part Two)

Summary

Bloomberg Businessweek Daily Live From NYSE with LifeMD (Part Two)

Date: May 19, 2026
Hosts: Carol Massar & Tim Stanweck
Main Guests: Dr. Joan Low Revere (Boston Children's Hospital), Dr. Stephanie Faubion (Menopause Society/Mayo Clinic), Dr. Karen Koffler (Miami Whole Health)

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Episode Overview

This episode focuses on the evolving intersection of health care, technology, and women's health, with a particular emphasis on the potential and limitations of AI in medical settings, the persistent gaps in research and treatment for women (especially regarding menopause), and the rise and role of functional medicine in personalizing and enhancing health outcomes for all, but especially for women.

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Key Discussion Points & Insights

1. The Rise of AI in Health Care: Promise and Pitfalls

Guest: Dr. Joan Low Revere (Senior VP and Interim Chief Medical Officer, Boston Children’s Hospital; Board Member of LifeMD)
Timestamps: 02:24 – 13:43

• AI's Explosive Adoption in Health: Over 200 million people are using chatbots like ChatGPT for health and wellness weekly. There's growing concern about the accuracy of AI-sourced medical advice, as a recent BMJ Open study found that "AI-driven chat bots are giving users problematic medical advice about half the time." (Carol Massar, 02:24)

• Potential for Transformation:

  • "I think AI has the power to be transformative in our world." (Dr. Joan Low Revere, 03:54)
  • AI can speed up diagnoses, help clinicians with decision-making, and automate administrative burdens (like medical note-taking), freeing up doctors for more patient care.

• Data and Inclusivity:

  • Need for better, inclusive data sets: "We haven't historically done a great job of including women in clinical trials." (Dr. Joan Low Revere, 05:22)
  • Real-time data and targeted studies on women’s illnesses can enable personalized medicine.

• Pivotal Moment in Health Tech:

  • "This is 100% a pivotal moment... It's like an industrial revolution is taking place." (Dr. Joan Low Revere, 06:56)
  • Generative and geospatial AI are unlocking new ways to see care deserts and address inequities.

• Building Smart Data Sets:

  • Movement toward "vertical" (domain-specific) AI trained on high-quality, focused medical data.
  • Not all big data sets are equal—it's about using robust, evidence-based datasets for AI training (Dr. Joan Low Revere, 08:27).

• Drug Development Revolution:

  • AI offers hope to reimagine drug discovery, especially for rare diseases and personalized therapies.
  • AI may streamline the identification of eligible patient cohorts (phenotypes) for targeted therapies (10:04).

• Challenges Beyond Technology:

  • Infrastructure, regulatory, operations, and market inefficiencies must evolve alongside technology for these advances to be fully realized.

• Equity and the Global Promise:

  • AI and digital medicine can "close the distance" for underserved and global populations, provided there’s local trust and access to technology (12:40).

Memorable Quote:
"This is 100% a pivotal moment... It's like an industrial revolution is taking place." (Dr. Joan Low Revere, 06:56)

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2. The Neglect and Future of Women's Health & Menopause

Guest: Dr. Stephanie Faubion (Medical Director, Menopause Society; Mayo Clinic)
Timestamps: 15:51 – 24:54

• Progress and Persistent Gaps:

  • Menopause is finally being discussed publicly, which marks progress.
  • However, most care and guidance rely on “old data”—notably the now-outdated Women’s Health Initiative (WHI) study from 2002, whose findings were based on hormone therapies no longer in use (16:58).

• Systemic Underfunding:

  • Securing funding for large-scale, modern clinical trials remains a massive hurdle:
    "We estimate it's going to cost about 200 million to do this trial over again...but it's still a lot of money." (Dr. Stephanie Faubion, 17:22)
  • The lack of research on women's health is echoed globally; "Nobody else is doing this to a greater degree than we are already." (18:40)

• Why the Gaps Persist:

  • Societal priorities and lack of interest: "We know more about the bottom of the ocean than we do about women's health and specifically about menopause. And that is because the government cares about the bottom of the ocean." (Dr. Stephanie Faubion, 18:08)
  • Need for decentralized, cooperative approaches to research funding and data gathering.

• Educational and Clinical Gaps:

  • Menopause is natural, not a disease, but symptoms vary and most women experience them.
  • Whole generations of doctors were never trained in menopause management after the WHI findings led to a pullback from hormone therapy discussion and education (20:34).
  • Effort is underway to push targeted menopause education to clinicians who may not realize its importance.

• Holistic and Accessible Care:

  • Menopause care shouldn’t be limited to gynecologists—primary care and all practitioners need education.
    "We don't have enough gynecologists to take care of all the menopausal women." (Dr. Stephanie Faubion, 22:15)
  • Telehealth and remote licensure are expanding access, but holistic approaches (addressing bone, heart, and brain health) are key.

• Advocacy for Patients:

  • Women must advocate for themselves and seek out clinicians with up-to-date menopause management expertise. "If they're told that there's nothing that can be done for their menopause symptoms, that's not the right answer and they should be seeking care elsewhere." (Dr. Stephanie Faubion, 24:00)

Memorable Quote:
"We know more about the bottom of the ocean than we do about women's health and specifically about menopause." (Dr. Stephanie Faubion, 18:08)

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3. Functional Medicine: The Root Cause Approach

Guest: Dr. Karen Koffler (Director, Integrative and Functional Medicine, Miami Whole Health)
Timestamps: 26:46 – 38:13

• What is Functional Medicine?:

  • Focuses on identifying and addressing root causes of illness by considering genetics, lifestyle, and environment, as opposed to just treating symptoms (27:34).

• Why Outcomes Differ:

  • "If you are just treating symptoms without actually looking for the source...you're not ever really able to shift the person away from a disease state." (Dr. Karen Koffler, 28:18)
  • A lifestyle-focused, "root cause" approach creates opportunity for long-term well-being.

• Lifestyle as the Foundation:

  • Health ultimately comes down to diet, sleep, movement, and purpose—"No pill will ever replace all of that...those are the key pillars." (Dr. Koffler, 29:17)
  • New drugs and supplements (like GLP-1s or creatine) are useful but cannot substitute for foundational health habits.

• Integration and Collaborations:

  • Functional medicine is gaining ground in both clinical and academic settings. Some specialists are training in it, and some medical schools now include it in their curriculum (30:18).

• Patient Empowerment:

  • Patients are encouraged to bring questions about the roots of their symptoms and be involved in collaborative care.
  • AI and chatbots are often used by patients to collect information as a starting point for these conversations.

• Skepticism and Social Media Misinformation:

  • Recognition of legitimate skepticism from traditional medicine regarding the way some functional/integrative medicine is marketed or communicated, especially on social media.
  • Cautions against "miracle cures" and overhyped supplements but notes some (like creatine) have accumulating evidence (34:42).

• Women's Health and Respect:

  • Functional medicine can help address gaps and the tendency for women's symptoms to be dismissed.
  • Solutions for women aging well post-menopause center on "fundamentals": sleep, strength, diet, and self-care.
    "Many of us, myself included, thrive afterwards...but we need to get serious about how we're taking care of ourselves." (Dr. Koffler, 36:09)

Memorable Quotes:
"No pill will ever replace all of that...those are the key pillars." (Dr. Karen Koffler, 29:17)
"We should do an experiment and take all 50 year old men and completely take away all testosterone so that they have a sense of, of what a woman goes through when she goes through menopause." (Dr. Koffler, 36:09)

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Notable Quotes & Moments by Timestamp

• AI and medicine:
  • "AI-driven chat bots are giving users problematic medical advice about half the time." — Carol Massar (02:24)
  • "I think generative AI was the first next milestone." — Dr. Joan Low Revere (07:08)
• Data equality:
  • "We haven't historically done a great job of including women in clinical trials." — Dr. Joan Low Revere (05:22)
• Women's health research neglect:
  • "We know more about the bottom of the ocean than we do about women's health and specifically about menopause." — Dr. Stephanie Faubion (18:08)
• Functional medicine basics:
  • "No pill will ever replace all of that...those are the key pillars." — Dr. Karen Koffler (29:17)
  • "If you are just treating symptoms without actually looking for the source...you're not ever really able to shift the person away from a disease state." — Dr. Karen Koffler (28:18)
• Self-advocacy and community:
  • "If they're told that there's nothing that can be done for their menopause symptoms, that's not the right answer and they should be seeking care elsewhere." — Dr. Stephanie Faubion (24:00)

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Timestamps for Important Segments

• AI & Chatbots in Health Care: 02:24–13:43
• Women’s Health & Menopause Research: 15:51–24:54
• Functional Medicine & Root Cause Health: 26:46–38:13

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Overall Tone and Takeaways

• The episode is optimistic about the future of AI and technology in health care but remains pragmatic about the current limitations and the need to address social and structural barriers.
• There is a clear call for more inclusive research, greater attention to women's health, and a patient-empowered, holistic approach to care.
• Speakers stress fundamentals—data quality, education, self-advocacy, and lifestyle—as the bedrock for future improvements in both technology and women’s health outcomes.

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For more, tune in live on YouTube weekdays 2–5pm ET or catch up on the Bloomberg Businessweek podcast.

Transcript

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is Bloomberg Business Week Daily reporting from the magazine that helps global leaders stay ahead with insight on the people, companies and trends shaping today's complex economy. Plus global business, finance and tech news as it happens. The Bloomberg Business Week Daily Podcast with Carol Massar and Tim Stanweck on Bloomberg Radio.

[Carol Massar]

You know we came across some research. It talked about the explosive growth of AI chat bots and how it's made it a very popular tool for people looking for guidance on their ailments. And OpenAI has said that more than 200 million people ask Chachi Beat health and wellness questions every week. And yet there's also been a study out in the medical journal BMJ Open. This was published last month. They found, Tim, that AI driven chat bots are giving users problematic medical advice about half the time. So highlighting the health risks of the technology.

[Tim Stanweck]

Yeah, you just have to push back. So integrated and it says actually you're right about that.

[Dr. Stephanie Fabian]

I think you make a really good point.

[Tim Stanweck]

I will say one of my friends who's a doctor did show me this chat bot that doctors are allowed that doctors have access to. They have to use. Is it much better license number that they have. And it only uses. It's only trained on journals and it's pretty cool.

[Carol Massar]

So it's only as good as the data that goes in, which is what we want to get into. Great to have back with us someone who understands AI technology and medical care. Dr. Joan Low Revere. She is senior Vice President, Interim Chief Medical Officer in Boston Children's Hospital. She's also on the board of Life, Maryland. So nice to have you back with us. How are you?

[Dr. Joan Low Revere]

Thank you, Carol. It's lovely to be back again.

[Carol Massar]

So what do you when you hear about. I I feel like everybody we're talking to mentions that it has a lot of potential great uses for health care in the medical community. How do you see it and how are you seeing it in your world?

[Dr. Joan Low Revere]

Well, I think I has the power to be transformative in our world. I don't think that's a hard thing to understand or see. But we have to be cautious as we use it. I think as we were discussing earlier, it's. It's not quite there yet in terms of being trained to a point where you're certain of its accuracy. And there are lots of moves within platforms to improve that accuracy. But you can see the road ahead, how it's going to help us understand, get to diagnosis quicker, help clinicians. I think it's going to be incredible adjunct. It already is. You know, I see how much we are using those tools to bolster our capabilities, to check, to push back and really try to understand to get to the most accurate diagnoses for patients. There's lots of uses obviously within automation and helping ease of work. We're using ambient technologies, you know, to be able to record conversations and create the first templates of our notes so we can focus more on one on one time, personal time with patients. So I think it's a vista ahead of us but needs to be done smartly so that we really include the data for all populations in the models that we build in the answers that we give.

[Carol Massar]

You mean like women?

[Dr. Joan Low Revere]

Like women. I think that's a focus of your segment today. We haven't historically done a great job of including women in clinical trials collecting data on women understanding. But to your point around technology with real time data. Right, Real time data sets on women, coupled with studies targeting women's illness, I think we're going to have a much more nuanced and personalized understanding of disease

[Carol Massar]

when today

[Dr. Joan Low Revere]

we have to do this. I feel like I do not want my daughter's generation to be sitting here with the same conversation, conversation. And I think it took the unlocking with the tools that are coming to us to make that a possibility.

[Tim Stanweck]

I guess what I'm curious about is how quickly you see this happening. Not right now to Carol's question when, but like, if we look at this as a moment in time over your entire career and the way that you're seeing tech actually move the needle when it comes to what you do and what your doctors and nurses do every single day at Boston Children's. Are we in a moment where we are going to see us be able to make leaps and bounds when it comes to development of new therapies for certain ailments, new diagnosing tools? Like, is this a pivotal moment?

[Dr. Joan Low Revere]

This is 100% a pivotal moment.

[Tim Stanweck]

Like the biggest in your career at this point.

[Dr. Joan Low Revere]

Absolutely. It's like an industrial revolution is taking place. You know, it's that type of moment in time. From my perspective, I think that you see stuff happening.

[Tim Stanweck]

Very important perspective for health care.

[Carol Massar]

Yeah, totally.

[Dr. Joan Low Revere]

I think generative AI was the first next milestone.

[Dr. Stephanie Fabian]

Right.

[Dr. Joan Low Revere]

And that was three years ago. Right. And then the agentic piece that's come over the last year or two is unlocking all new capabilities. So I think that it's the evolution and the geospatial AI is going to have its moment. So when you start to be able to understand where are the medical deserts in care, you're able to use agentic workflows across data that can bring back information that you really couldn't see. You wouldn't have the scale and the capability.

[Carol Massar]

Who's building the data sets? Like, I think about that and one of the things that we, I think through people we've talked to, how it's shifting to. It might not be that everybody's using these large language models, but you'll have very specific vertical data set, especially for like health care or medicine, that so that when you are working within it, it's a really smart, appropriate database. So who's building those databases? Are you guys doing your own? Are you working with other medical organizations? Like, how does that work?

[Dr. Joan Low Revere]

I think it's something that's evolving.

[Carol Massar]

Okay.

[Dr. Joan Low Revere]

There's lots of data sets that have been built over time.

[Carol Massar]

Right.

[Dr. Joan Low Revere]

In terms of electronic health records, data sets within Registries, there's, there are many data sets. And you raised the right point, making sure those are solid, good evidence based data sets, that this is the, this is the data you want to be using. There's the UK Biobank, there's, there's, there's large data sets, right, that are unlocking this sort of potential. And I think we're now having this real time data collection capabilities that is going to be very interesting to see. Instead of say a glucose test once every three months, you have a continuous glucometer running, you have continuous glucose data set. So I think of it like my perspective, my cardiac icu, I'm dealing with continuous data streams now. There's a, an ability to analyze continuous data streams in ways that were just so challenged before. So I think it's that unique moment

[Tim Stanweck]

in time we are told drug development, drug development, drug development is, is a real opportunity too. Is that true?

[Dr. Joan Low Revere]

Yes, I think it is very much a real opportunity.

[Tim Stanweck]

So how, I mean, look, drug development's expensive, it's high, slow, slow. It's high stakes. You know, you see sometimes like, it's almost like every day the biotech companies are some of the biggest movers to the upside or to the downside. They take big risks, very volatile. Does the, does the development of AI, does it change sort of the drug development cycle meaningfully?

[Dr. Joan Low Revere]

I think that is the hope that everybody has right now. And there are many companies that are, you know, spinning out and doing that sort of work. Big pharma has arms that are doing that sort of work. You know, think about it in terms of the rare disease space and the sort of like children that we care for, say at children's. What an opportunity to be able to potentially bring things to market that, you know, weren't, weren't possible. And then when I think about, you know, the long, the long term care of patients and understanding the full patient profile, the phenotype of the disease, we have new ways of actually understanding the patient cohorts that may unlock new possibilities in terms of developments of therapies for them.

[Carol Massar]

You know, we've always talked about individualized medicine. Is that still a thing? And increasingly that is a thing. And will I help it so that we can look at each of us, you know, because ailments obviously impact people differently.

[Dr. Joan Low Revere]

They do, they do. And I think you had Dr. Doug was on here earlier talking about bone health.

[Carol Massar]

Yes, yes.

[Dr. Joan Low Revere]

And how do you personalize things to an individual? I think this is part of this moment in time that you can personalize your Physiology is going to be different than my physiology. And maybe how I live my life needs to be a little bit different to the way you live your life based on knowing your lab values, your genotype, your phenotype, that then we could get ahead of understanding what disease you have the potential of developing and intervening earlier such that you may either delay or not end up with that disease trajectory.

[Carol Massar]

So are we there again?

[Dr. Joan Low Revere]

I think it's, it's an infrastructure build.

[Carol Massar]

Yeah.

[Dr. Joan Low Revere]

And it's not just technology. I think that's an important point. Technology is not the only thing that you need to think about in solving for this. It's, you know, market inefficiencies, it's operations, its regulations and that that spans the globe. We really need to think about that. And I think that's where I say we're in a revolutionary time in the sense of everything is changing and how do we build the right and most appropriate structures.

[Tim Stanweck]

Global health is so important to you. Just 30 seconds in this changing the game for underserved communities, underserved populations. Yes, it will.

[Dr. Joan Low Revere]

It will.

[Tim Stanweck]

If they can get the tech.

[Dr. Joan Low Revere]

If they, I think it's, it's the tech that's designed for the local community. Trust, building trust. I think it unlocks the ability to, I think, more expanded data around all of humanity, you know, not just like a US Population and being able to understand, I think, how you can deliver better, more targeted data care. I mean, we're already using some of this tech in terms of collaborating across geographies. I think that's one of the things, it closes the distance. I mean, we personally, with the Foundation, Virtue foundation, are already using some of that technology.

[Carol Massar]

You have a book coming out later this year. I'm just going to say we have to wrap it Crossroads in Global Health.

[Dr. Joan Low Revere]

Crossroads in Global Health, published with me and my colleague Dr. Abdullahi coming out with from Taylor and Francis in September.

[Carol Massar]

You guys have to come back and then talk to us once you have the book out.

[Dr. Joan Low Revere]

Thank you.

[Carol Massar]

Dr. Joan LaRvere. She is Senior VP, Chief Medical Officer, Boston Children's Hospital.

[Tim Stanweck]

Stay with us. More from Bloomberg businessweek Daily coming up after this.

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[Tim Stanweck]

Well, as we mentioned, we are live from the New York Stock Exchange where we're continuing our deep dive when it comes to health care and specifically when it comes to women's health.

[Carol Massar]

Yeah, and what's interesting is I want to jump right in with our next guest. Dr. Stephanie Fabian is with us. She's medical director of the Menopause Society. It's a nonprofit with the mission of empowering health care care professionals and providing them with the tools and resources that they need to really improve the health of women during the menopause transition and beyond. It was founded back in 1989. Dr. Fabian, first of all, welcome. You are also the Penny and Bill George, director of Mayo Clinic's center for Women's Health. You were there for over 10 years. Still are still.

[Dr. Stephanie Fabian]

Yes, absolutely.

[Carol Massar]

So let's just jump right in, if I may. What's gotten better about women's health? What is still just so tricky? Is it just the lack of R and D and awareness or what is it?

[Dr. Stephanie Fabian]

Well, I think in terms of the menopause space, what's gotten better is we're actually having a conversation about it. You and I are here chatting about menopause, which even five years ago wouldn't have been the case. What is still tricky is that we still don't have really great data and we still need more. There needs to be more research in the women's Health Space in general. And we're still largely acting off the Women's Health Initiative trial results, which were published in 2002.

[Carol Massar]

That's old data.

[Dr. Stephanie Fabian]

It's, it's old. And that data is on hormone therapy formulations that we don't even use anymore. And so we have, we're working on some outdated data.

[Tim Stanweck]

How do you get updated data? How do you get money for clinical trials?

[Dr. Stephanie Fabian]

Thank you for asking questions.

[Tim Stanweck]

That's always follow the money and that always seems to be the challenge when it comes to this stuff. Why we use old data is because we don't have new data. Why don't we have the new data?

[Dr. Stephanie Fabian]

Well, it costs a lot of money. So the Women's Health Initiative was funded to the tune of about $750 million and it was a line item in the Congressional budget. So it's not going to happen again. And the NIH doesn't have that kind of money and that kind of. We estimate it's going to cost about 200 million to do this trial over again, which is much less expensive in that we can do it in digital way and so we can decentralize it. But it's still a lot of money. And when you're looking for single source funds, it's, it's still a lot.

[Carol Massar]

So any gaps along this line for men in terms of like, why is it this gap? I mean, we talk about gaps so much in society still between men and women and it just seems like, why is this still a situation?

[Dr. Stephanie Fabian]

Yeah, I, I mean, it's historically been the case. I heard a funny statement that it was, we know more about the bottom of the ocean than we do about women's health and specifically about menopause. And that is because the government cares about the bottom of the ocean. So I think it's, it's interest. I think it's, you know, a lack of emphasis where it really needs to be.

[Tim Stanweck]

Is it happening anywhere in other countries? Like, are we from other countries that are investing in this?

[Dr. Stephanie Fabian]

No, I would say no. Nobody else is doing this to a greater degree than we are already. So I can't say that other countries are ahead of us in terms of research. But it takes a lot of money and it's going to take effort from, you know, we're going to have to coordinate efforts. We can no longer say that that one entity is going to take care of figuring all this out. We're going to have to rely on a bunch of different people and a bunch of different data sets.

[Carol Massar]

So what are we missing by Women not being more active, or we're thinking about menopause and the care that needs to be done, or even the preventive care going into it. I mean, you can't prevent it, obviously, but there are certain things that we're learning, whether it's hormonal treatments, hormones.

[Narrator/Commercial Voice]

Like what?

[Carol Massar]

So I don't know, as a woman, like, what's the message to them? Do we just have to ask for these things or.

[Dr. Stephanie Fabian]

Well, I think the message is that not all. So first of all, menopause is not a disease.

[Carol Massar]

Right.

[Dr. Stephanie Fabian]

It's a universal life event that happens to all of us, and we shouldn't be thinking about it in terms of it being a disease.

[Carol Massar]

It doesn't happen to all of us, does it?

[Dr. Stephanie Fabian]

Some women never have a single symptom. My mother asked me, why are you writing the menopause book in 2016? Like, why are you writing the menopause book? And I said, well, what was your experience, Mom? And she said, I might have had a hot flash once at a cocktail party when I had a glass of wine. No, that's not okay. Well, clearly it wasn't an issue for you and that some women are like that. You know, maybe about a quarter of women are like that, but the majority of us are going to have symptoms.

[Tim Stanweck]

Does the treatment that is at the vanguard right now, in your view, how does that get transmitted to a wider population of doctors? So then patients can be. So patients can get that treatment. Do patients actually have to ask specifically for it? Like, you know, I'm trying to understand, like, how a doctor would.

[Dr. Stephanie Fabian]

Yes.

[Tim Stanweck]

Would. Would treat someone proactively.

[Dr. Stephanie Fabian]

So I think there's several gaps that we're working on here. So one is the gap that women aren't educated about menopause. We have a. We all get the talk when we're about to start our periods. No one gets the talk when you're about to stop your period. So women are unprepared. Then we have a whole generation of clinicians who never got educated on menopause management, because when the WHI results were published in 2002, it was like, oh, we're not going to use hormone therapy then. Therefore, there's nothing to do about menopause. So therefore, we don't need to teach it anymore because it's not a thing. So we have a whole generation of clinicians that never got educated. So the menopause society is working really hard on this. And in fact, we've received a couple of very generous grants that we're working on. How do you disseminate education in a better way? So the easy one is to disseminate education to people who are asking for it so they can pull it. But the trickier question is for those who don't think they need to learn about menopause, who maybe should be learning about menopause. How do you actually push the information? And is it through the medical record? Like we noticed that your patient has seen three different doctors in the last six months about palpitations and mood issues and, and here's some information and here's how you might manage this. So I think it's a combination of things. We need to educate women, we need to educate clinicians, we need to actually be more proactive about providing at the elbow support for clinicians. Like, what do I do with this patient? Here's the scenario. So we're really working hard on that. But it's a multimodal approach.

[Carol Massar]

Well, it sounds like it needs to be more holistic, right. In the medical community, it's not just you go to your gynecologist, right. And have the conversation. It needs to be really everybody.

[Dr. Stephanie Fabian]

I've said this so many, I'm an internist, I'm not a gynecologist. And I can't, I don't think it should live solely in the realm of gynecology because frankly, we don't have enough gynecologists to take care of all the menopausal women. It's those folks like family medicine, internal medicine, the nurse practitioners, the physician's assistants who are all seeing women in primary care settings that really need to take this on and own it.

[Carol Massar]

One of the things I wanted to ask you, we've noticed that it seems like young girls, young women are having their, you know, they're getting their period at a younger age. Are people entering menopause at a younger age? I'm just curious if there's anything that's changed now.

[Dr. Stephanie Fabian]

They're not. So the age of menopause, if anything, has maybe gotten a little older. Okay. Over time, but in general it stayed around 50 to 52 for many, many, many years. So health, general health predicts when you're going to go through menopause. So for example, in war torn areas or with the potato famine back, you know, 100 years ago, women went through earlier. And in third world countries where there's not good health care, women go through earlier. So it has everything to do with general health.

[Tim Stanweck]

Is telehealth helping with this in terms of access?

[Dr. Stephanie Fabian]

I think it's one of the answers to this issue. So I think telehealth can help and we offer telehealth where I work at Mayo Clinic. But you need to have holistic care so it can't be just a menopause visit in isolation from taking care of bone health and heart health and all the other things.

[Carol Massar]

I keep asking everybody who's coming on while we do these series of interviews. It's like, what does a, an individual, what does a woman have to do to kind of make sure that they're an advocate for themselves, that they're either asking the right questions of not just their gynecologist but everybody else in their medical community?

[Dr. Stephanie Fabian]

That's an excellent question. And I think, you know, we have published whole guides on what women should do going into the office. But they have to be an advocate for themselves. And if they feel like they're not getting like, for example, if they're told that there's nothing that can be done for their menopause symptoms, that's not the right answer and they should be seeking care elsewhere. But menopause.org we have, you know, providers who are certified in menopause management and they can be located depending on, you know, state licensure because now we can see people virtually. And so I'm, for example, licensed in five different states, so people don't have to come to me, in other words. So I think that's really important to note. But as you said, it's more not just about hot flashes. No, it's about bone health and heart health and brain health, etc.

[Carol Massar]

And stuff that certainly impacts your longevity or your level of life as you, as you age. Thank you so much. Come back soon.

[Dr. Stephanie Fabian]

Yes, absolutely.

[Carol Massar]

Thank you, Dr. Stephanie Fabian, medical director of the Menopause Society.

[Tim Stanweck]

Stay with us. More from Bloomberg Business Week Daily. Coming up after this,

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[Carol Massar]

We are talking so much about the intersection of health, certainly markets, but also technology.

[Tim Stanweck]

Tim yeah, we've got Karen Koffler with us, Director Integrative and Functional Medicine at Miami Whole Health professor at the University of Miami Miller school of medicine. Dr. Koffler, good to have you on the program. It was so it's looking at your bio is so interesting because it represents this moment in time where, you know, there was a big change that happened when a lot of data was released about hormone replacement therapy and the view really shifted. And now we talk about functional medicine like it's a, it's, you know, a normal, quote, unquote, normal part of the medical profession. But the idea of functional medicine is actually relatively new. It is the popularity of it, it

[Dr. Karen Koffler]

is new, it is new, and it's made a lot more headway in the, in the public eye than it has in the academic world.

[Tim Stanweck]

So explain what it is for people aren't familiar with it.

[Dr. Karen Koffler]

So in functional medicine, we go beyond what we've been taught in conventional medicine to really look for the root causes of why someone has been diagnosed with a particular condition. So in conventional medicine, we often listen to the patient, get a series of labs or studies, put the two together to name what they have, and then decide on the treatment. In functional medicine, we really look at their environment, their genetics, their lifestyle to try to discern what's the root of why you're feeling what you're feeling. And that gives us a different place to treat.

[Carol Massar]

Why is it so different in terms of the outcomes of those different approaches?

[Dr. Karen Koffler]

If you are just treating symptoms without actually looking for the source of those symptoms, you're not ever really able to shift the person away from a disease state. You can relieve what they're feeling. And many of our medications do a fabulous job doing that. And when you're in pain or you're uncomfortable or you're bloated or you're brain foggy, to take something that helps you, if you have a headache, to take something that helps you is of value. But if you. If you have symptoms recurrently and never really search for, well, why is this happening to begin with? You never really have an opportunity to change the course of that person's health.

[Carol Massar]

I'm listening to you and I'm thinking about the craze over the last, what, two, three years with JLP1 drugs. Right. And we used to kind of laugh with our reporter who covered the space. It's like, okay, now what are the GLP1 drugs curing? You know? Right. But it comes down to not being overweight, healthier. Right. It just leads to such better health outcomes. Right. And I just.

[Dr. Karen Koffler]

Lifestyle. Without a doubt, you're right. At the end of the day, I mean, we're coming up with interesting medicines, we're coming up with interesting supplements, but at the end of the day, your health is really predicated on how you eat, how you sleep, how you move, what gives you purpose and meaning. And no pill will ever replace all of that. So that's the infrastructure of health. And then all these other new technologies, new supplements, new medications we can use can add to that. But fundamentally, those are the key pillars.

[Tim Stanweck]

You're trained in internal medicine, but I'm curious how you work with other specialists.

[Dr. Karen Koffler]

Oh, very well, because they have a rich understanding of a disease state that I might not have.

[Tim Stanweck]

Do those specialists. Specialists then get trained in functional medicine.

[Dr. Karen Koffler]

There are increasingly specialists have been become disgruntled with their lack of real understanding or options for patients. And so they've gone on to get trained.

[Tim Stanweck]

Is this taught in medical school yet?

[Dr. Karen Koffler]

It is at our school because we. Many schools are developing medical school curriculum or resident curriculum to help train the future generations of physicians. Yes.

[Carol Massar]

So listening to this too, and I'm just thinking someone who's listening to us right now or watching us. So then what is a patient? As you go to a doctor and hear different, like, what should you be doing? What should you be asking to kind of make sure that we're not missing something that's really important as to why we're either not feeling well or have certain symptoms?

[Dr. Karen Koffler]

Well, just. You're asking that question. Is the question to bring to your physician rather than just alleviating these acute things? Can you think with me as to why I'm developing this to begin with? So that would be a place to start.

[Carol Massar]

It's like being a toddler. It's the why question. Why, why, why is this. Help me understand this and keep.

[Dr. Karen Koffler]

And talk about AI this is an awesome place. Many of my patients bring me information from ChatGPT, and a lot of it is good and not all of it is good and much of it may not pertain to them, but it does give them a place to start and it helps me think through things. I'm happy to get. You know, my patients are an n of 1. They only have themselves to research. I have, you know, hundreds of patients. I'm responsible for many, many different conditions. So I'm actually happy when information is brought to me and together we can go through. Yeah, this makes sense for you.

[Tim Stanweck]

This does not our insurance companies playing ball?

[Dr. Karen Koffler]

Not yet. Not yet. Because what I do takes time. So it takes time to really explore a person's lifestyle. It takes time to understand what were all the prior things. How many antibiotics have you been exposed to? What were your stressors? What was life for you growing up? Were you, were you nourished? Well, all of those things figure into how you feel today.

[Tim Stanweck]

There are some, let's call them, you know, traditional people in the medical establishment who have pushed back on the idea of functional medicine. Not as, not as a whole, but in terms of some of the stuff that's been on social media, the way that some functional medicine doctors are pretty portraying themselves, portraying supplements, those sorts of things on social media. I've certainly seen it in my feed. How do you separate what is real versus what, what's out there just to sell you more stuff?

[Dr. Karen Koffler]

That's such a great question. And you know, to be fair, I appreciate the conventional world's sort of distrust.

[Tim Stanweck]

Yeah. For it.

[Dr. Karen Koffler]

But at the same time, everything, everything new that we have began with someone having the idea that maybe this isn't good enough, maybe there's another way to do this. And I think in integrative and functional medicine, we really value, we really study and we value your innate healing capacity. So the cells capacity. When we learn in medical school how the cell functions, we learn its extraordinary capacity to regenerate. How it does it, the specifics of how that's done. And so you can appreciate that you have within you the ability to heal. Our job is to figure out how to augment that. What are you doing? That's blocking that? What can we do to augment that? And we want to do it in the most natural, least aggressive way to reinstate a quality of homeostasis. I do think as typical of everything in our culture, it seems we can get extremes. Like this one supplement, like right now, it's nad can fix everything. You know, and it's like with the GLP is it can fix Everything. Because we're first of all a consumer oriented society. We like to take stuff. A lot easier to take a pill than it is to go to bed at 9 o', clock, get a good night's sleep, get off your screen, you know, to do the things that it really takes to build health. So we sort of glom on to something that you can take and some things can be beneficial, but you know, creatine. Okay, all right. I will say that data is actually very good for creatine.

[Tim Stanweck]

Okay. And every. And you and adults across of all stripes should be taking creatine.

[Dr. Karen Koffler]

Yeah.

[Tim Stanweck]

In your view on. That's a question. I'm not saying that this is not medical advice.

[Dr. Karen Koffler]

Don't get it.

[Carol Massar]

Go right out and buy it.

[Dr. Karen Koffler]

No. But I do think that there is strong data emerging, particularly around brain health, certainly about, around sarcopenia or muscle loss as we age. And that since my orientation is to keep people strong as they age. Creatine, totally naturally occurring amino acid. You have it in your body. I don't think there's anything wrong with taking it. You do need to let your doctor know because it can alter your kidney function studies a little bit.

[Carol Massar]

All right, so. All right, dude, you stop talking. I want to talk about women because I do feel like the thing that the message that we've had and we've done women's health segments, Bloomberg and our show particular for a while now is the lack of R and D and the lack of kind of respect when women say something and you know, a doctor can be dismissive. So all that you're saying is how, how do we make it better for women to age, better to get through menopause, better to not have all these things that seem to impact them. And it just seems, it's often dismissed by some members of the medical community.

[Dr. Karen Koffler]

I mean I think if a woman does feel dismissed by the symptoms that she's sharing and really wants to work with someone who's going to help them make sense of all that. They need to find somebody that's willing to do that, work with them. Yes.

[Carol Massar]

Like how do women age better in this world?

[Dr. Karen Koffler]

Yeah.

[Carol Massar]

From a health perspective, I don't care about wrinkles or anything.

[Dr. Karen Koffler]

But like from a health perspective, it goes back to exactly what I said. I mean what happens in menace menopause is there's a relative dropout of important hormones and you know, we should do an experiment and take all 50 year old men and completely take away all testosterone so that they have a sense of, of what a woman goes through when she goes through menopause. Because we have receptors all over the body, Every tissue in the body virtually is affected by the change that we go through in menopause. And yet many of us, myself included, thrive afterwards. So even though there's changes in the brain, there's changes in the heart, in the blood vessels, in the bone, et cetera, we can thrive afterwards. But it does mean without the support of those hormones, we need to get serious about how we're taking care of ourselves. We need to take stock in how we're eating. We need to take stock in how we're sleeping.

[Carol Massar]

We have to move more.

[Dr. Karen Koffler]

We have to look to get stronger, we have to sleep more. So we have to go back to those fundamentals. And it's not easy. That's not the easy part, but it is doable. Sleep, sleep.

[Tim Stanweck]

I feel like that's the hardest part.

[Dr. Karen Koffler]

Good quality.

[Carol Massar]

I feel like every doctor will say that, like, how are you sleeping? And it's, that's new.

[Tim Stanweck]

I feel like, I feel like I

[Carol Massar]

get asked that a lot more than I used to.

[Dr. Karen Koffler]

Yeah. Because now we appreciate the regenerative capacity of sleep. Now we appreciate what happens with the immune system when we sleep, what happens with the adrenal system, what happens with a variety of symptoms that help restore us in preparation for the next day.

[Carol Massar]

Don't go.

[Dr. Stephanie Fabian]

Sorry.

[Carol Massar]

I feel like after every conversation. Can you hear my doctor?

[Tim Stanweck]

You gotta go to Miami.

[Carol Massar]

Come back, come back, come back. We would love to continue this conversation. Dr. Talking with you, Karen Koffler. She's director, Integrative and Functional Medicine, Miami Whole Health, joining us right here on Bloomberg.

[Podcast Host/Announcer]

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