Episode 29

full
Published on:

20th Apr 2023

Kale, Underwear, and Reproductive Rights w/ Dr. Coley Barbee, MD

Note: This episode contains talk of cancer, infertility, and access to abortion. If this is something that you'd prefer to skip we hope to see you back here next week.

Today we're talking to Dr. Coley Barbee, MD who is a practicing rural physician, YouTuber, and the one doctor brave enough to see Caite's family! Coley is working towards a double board certification in Integrative medicine and has a YouTube channel where she presents cooking videos featuring accessible vegetable based dishes for the "meat and potatoes" folks she sees. We also talked about the one thing she can't keep alive, why you shouldn't shave your legs before appointments, and why she'd love to be paid in chickens.

Thank you for joining us today on Barnyard Language. If you enjoy the show, we encourage you to support us by becoming a patron. Go to Patreon to make a small monthly donation to help cover the cost of making a show. Please rate and review the podcast and follow the show so you never miss an episode.

 You can find us on Facebook, Instagram, and TikTok as BarnyardLanguage, and on Twitter we are BarnyardPod. If you'd like to connect with other farming families, you can join our private Barnyard Language Facebook group. We're always in search of future guests for the podcast. If you or someone you know would like to chat with us, get in touch.

 We are a proud member of the Positively Farming Media Podcast Network.



This podcast uses the following third-party services for analysis:

Chartable - https://chartable.com/privacy
Transcript
hunter]:

I'll try now. Yeah, I don't think, yeah, that is better.

hunter]:

you fix something. That's good.

[caite]:

Yay, yay me.

hunter]:

I'm gonna go. Today we are excited to be talking to Dr. Koli Barbi, who's

hunter]:

a family physician in Iowa. We start each of our interviews with the same

hunter]:

question. So this is a way for you to introduce yourself to our listeners

hunter]:

and we ask, what are you growing? So for our farmers farming guests, that covers

hunter]:

crops and livestock, but it can also cover families, businesses, career,

hunter]:

all types of other things. So Koli, what are you growing?

[Coley Barbee]:

I am currently, I am not at all a farmer, and currently actively killing

[Coley Barbee]:

some basil, so. Ha ha ha.

hunter]:

Perfect.

[Coley Barbee]:

to Iowa and once I was here learned a lot about farming. I'm originally

[Coley Barbee]:

from Maine, there's a lot of aquaculture there so I know a lot about the

[Coley Barbee]:

ocean and fishing. I know next to nothing about farming and am not a very

[Coley Barbee]:

good grower but I try so hard. But my sad sad

hunter]:

Enthusiasm

[Coley Barbee]:

basil,

hunter]:

counts for a lot.

[Coley Barbee]:

yes my sad sad basil is kind of testament to my growing ability right now

[Coley Barbee]:

I think so.

hunter]:

totally fair.

[caite]:

else. Yeah, no, I know

hunter]:

No.

[caite]:

it's me. I just wasn't sure if Koli had any career or family or anything that she

[caite]:

wanted to mention while she's at it.

[Coley Barbee]:

Oh, well, I mean,

[caite]:

Besides

[Coley Barbee]:

I

[caite]:

your

[Coley Barbee]:

would

[caite]:

dead

[Coley Barbee]:

say

[caite]:

basil,

[Coley Barbee]:

that I'm...

[caite]:

which.

[Coley Barbee]:

My dad basil. I am currently kind of growing my skills in integrative medicine.

[Coley Barbee]:

I'm currently enrolled in an integrative medicine fellowship, so I have

[Coley Barbee]:

about nine months left. And that has been a really good addition to my

[Coley Barbee]:

family medicine practice. So I would say I'm growing in... knowledge and

[Coley Barbee]:

commitment to using.

[Coley Barbee]:

kind of holistic ways of treatment and healing in addition to Western modalities.

[Coley Barbee]:

And that has been really exciting and interesting. I have about nine months left

[Coley Barbee]:

in my program and then I hope to be double boarded in family medicine and

[Coley Barbee]:

integrated medicine. So.

[caite]:

So can you tell us more about what integrative medicine is and why it's

[Coley Barbee]:

Absolutely.

[caite]:

important?

[Coley Barbee]:

Integrative medicine at its most basic really is looking at a person holistically.

[Coley Barbee]:

I think family medicine in general does this pretty well. We don't look at people

[Coley Barbee]:

as being just one body system. We look at you as a whole person, but integrative

[Coley Barbee]:

medicine is kind of taking that to the next level. So you are looking at people's...

[Coley Barbee]:

exercise habits, eating habits, their family, their spirituality, the community

[Coley Barbee]:

that they're a member of. You are using, you know, you use all of the conventional

[Coley Barbee]:

pharmaceutical medicines, but in addition to that, you know, work on... diet

[Coley Barbee]:

changes to help with certain health conditions, supplements, just a more

[Coley Barbee]:

holistic way of looking at medicine. So that's the brief definition. You could go

[Coley Barbee]:

very in depth and there's a lot, it is a two year program that I'm doing,

[Coley Barbee]:

so there's certainly a lot to learn, but that's the basic explanation.

[caite]:

So how did you end up in rural medicine and how did you end up in Waukon, Iowa? For

[caite]:

that matter. I mean it's not a... it's a nice town, don't get me wrong. But it's not

[caite]:

like a hotbed of

[Coley Barbee]:

Yeah,

[caite]:

anything, really.

[Coley Barbee]:

so the reason that I went to medical school is because I wanted to do rural

[Coley Barbee]:

medicine. I grew up in a small town of about a thousand people. It was also

[Coley Barbee]:

rural, kind of in the middle of nowhere. And what I noticed is it's really

[Coley Barbee]:

hard to cobble together a living in a rural area sometimes. And people's health

[Coley Barbee]:

suffers as a consequence. And one of the biggest... factors that determines

[Coley Barbee]:

how healthy a person is, is actually the zip code they live in. I thought

[Coley Barbee]:

that was deeply unfair, and so the whole reason I went to medical school

[Coley Barbee]:

was to do rural medicine. I thought I might go back to Maine to do that,

[Coley Barbee]:

but it turns out the Midwest is really a great place to practice family

[Coley Barbee]:

medicine. You get to do a little bit of everything. And so... I did my residency

[Coley Barbee]:

outside of Milwaukee. It was my first experience in the Midwest. And I really

[Coley Barbee]:

loved it. And I honestly had interviewed at a job that some of my residency

[Coley Barbee]:

mates thought that I might like the Prairie du Chien area, which is just across

[Coley Barbee]:

the river in Wisconsin. And I honestly... said, well, if I'm going all

[Coley Barbee]:

the way out there, I might as well do another interview and just literally

[Coley Barbee]:

close my eyes, circle the finger and dropped and walk on. And so very much on

[Coley Barbee]:

a whim, had never been here before, had never been to Iowa before. And

[Coley Barbee]:

when I came, I met the people who worked in the clinic that I now work in

[Coley Barbee]:

and just realized, these are my people. And just, I knew I wanted to work

[Coley Barbee]:

there because the... group of people that I now work with I just love and

[Coley Barbee]:

I said this is exactly the type of thing I want to do and where I work now

[Coley Barbee]:

allows me to do a little bit of everything. I see patients mostly in clinic,

[Coley Barbee]:

I also see patients in the hospital, I do some ER work. Up until about six months

[Coley Barbee]:

ago I delivered babies and so I see a little bit of everything. I'm never

[Coley Barbee]:

bored and I'm continuously happy that I moved here even though If you'd asked

[Coley Barbee]:

me before I started here, Iowa would have been the absolute last place that

[Coley Barbee]:

I saw myself. But I love it here and Midwesterners are very much like Mainers,

[Coley Barbee]:

so it feels like...

[caite]:

Well, I have to say I'm incredibly glad that you ended up here, no matter how

[caite]:

randomly it was.

[Coley Barbee]:

Me too!

[caite]:

For our listeners who might not have guessed yet, Colie is the family physician

[caite]:

that my family sees, and I have to say we're incredibly glad to have a family

[caite]:

doctor that sees all of us for everything that we need. Colie delivered our younger child,

[caite]:

she sees all four of us, and from an integrative perspective, it's amazing to see...

[caite]:

one medical team for everything, you know, and who sees our whole family, who sees

[caite]:

us for everything that we need, who's, you know, even if we have to be passed on to

[caite]:

a specialist, that we still have a team who knows us as humans, because especially

[caite]:

once you start getting shuffled up into larger facilities, you become a patient

[caite]:

number in a file pretty quickly, and it's really nice to have. somebody at home

[caite]:

who knows you for something besides, you know, what's in your chart.

[Coley Barbee]:

And

[caite]:

So

[Coley Barbee]:

I

[caite]:

there's

[Coley Barbee]:

love

[caite]:

that.

[Coley Barbee]:

seeing the whole family and it is really a good opportunity for me too

[Coley Barbee]:

to, you know, you might bring one of the kids in and I'll just say well,

[Coley Barbee]:

how's that thing we talked about last time? And you know, it's a great way for

[Coley Barbee]:

me too just to keep a good eye tabs on everybody and make sure everyone's

[Coley Barbee]:

still doing really is healthy and doing well.

[caite]:

Yeah, and it is, it's nice too to know that our children can see the same doctor as

[caite]:

babies, as they do as children, as they can as adults, hopefully. I know I saw

[caite]:

the same doctor a few years ago that delivered my husband,

[Coley Barbee]:

I'm sorry.

[caite]:

you know, so he saw patients that whole time and it's nice to have that continuity

[caite]:

of care with the clinic. especially if you end up seeing them a lot, like if you

[caite]:

have a higher risk pregnancy or something, and you're spending a lot of time there. It's

[caite]:

really nice to see the same folks. So we're gonna start with some super in-depth,

[caite]:

serious questions. First thing, do you notice it or care if patients don't shave

[caite]:

their legs? This is important stuff right here.

[Coley Barbee]:

you know i never notice and people constantly apologize constantly so i

[Coley Barbee]:

would say at least once a week someone says oh i'm so sorry i didn't shave

[Coley Barbee]:

my legs i'm like oh my like it's winter in iowa do you think anybody is

[Coley Barbee]:

like no so i honestly never noticed that what i notice more is people that

[Coley Barbee]:

I would expect to have hairy legs that don't have hair on their legs because

[Coley Barbee]:

then I worry, oh, do you actually have a vascular problem or diabetes?

[caite]:

Interesting.

[Coley Barbee]:

So I need much more attention to that than I do people shaving their legs.

[caite]:

So what you're saying is we should not shave our legs so that you have a better

[caite]:

view of our cardiovascular health?

[Coley Barbee]:

I think that would be very reasonable.

[caite]:

Cool. I'm gonna go with that, I like it.

hunter]:

especially

[caite]:

So,

hunter]:

in the wintertime.

[caite]:

yeah.

[Coley Barbee]:

Especially.

hunter]:

I'm from Canada, so I don't want to shave my legs in the winter either.

[Coley Barbee]:

Absolutely.

[caite]:

So the other thing that has come up in conversation fairly recently, why do we

[caite]:

all hide our underwear at the doctor? You know, we put on the gown and we fold our

[caite]:

clothes and we always put our underwear like hidden in there. Like presumably you assumed

[caite]:

that we're wearing them. So why do we hide them and do doctors hide them when

[caite]:

they go to other doctors?

[Coley Barbee]:

That's a great question and yes we absolutely do. I fold up the little

[caite]:

So weird.

[Coley Barbee]:

packet just like everybody

[caite]:

Yeah.

[Coley Barbee]:

does with me and I have no idea why. Just fold them up in the pants, you know,

[Coley Barbee]:

tuck them on the chair.

[caite]:

Yeah,

[Coley Barbee]:

I

[caite]:

it's

[Coley Barbee]:

have

[caite]:

so

[Coley Barbee]:

no

[caite]:

weird.

[Coley Barbee]:

idea why.

[caite]:

Yeah, I was talking to a friend about the fact that even at the fertility clinic

[caite]:

or going in for OB appointments that you still hide your undies despite the fact

[caite]:

that your doctor's gonna be in there. You're like,

[Coley Barbee]:

Mm-hmm.

[caite]:

they can't know I was wearing underwear when I walked through the door.

[Coley Barbee]:

hahahaha

[caite]:

I would think they'd want to know that you were wearing underwear. Anyway. Okay, well

[caite]:

now that we've... really hit the hard

hunter]:

Okay,

[caite]:

topics.

hunter]:

yeah,

[caite]:

We can move on.

hunter]:

that's the good stuff right there.

[Coley Barbee]:

Burning questions.

hunter]:

Yeah, for sure. So you already touched on the idea of, well, I guess exercise

hunter]:

and nutrition and those types of things, but one of the things that that

hunter]:

kind of comes around to is weight, which ends up being one of those things

hunter]:

that gets talked about a lot, both in adults and children. How can we discuss...

hunter]:

weight as a possible risk factor when it comes to health, but also not shame

hunter]:

people into thinking that all their health problems would just disappear

hunter]:

if they were to lose weight. Because some fat people, you know, their experiences

hunter]:

with doctors is that their doctors won't even discuss their medical concerns

hunter]:

outside of telling them lose weight first and then we can deal with it.

[Coley Barbee]:

I think that's an excellent question. I don't think it's ever helpful or

[Coley Barbee]:

kind to shame someone for the way they look. And honestly, the conversation

[Coley Barbee]:

tends to shut down. If that's the first thing that you lead with, no one

[Coley Barbee]:

wants to talk about, well, how can I be healthier? But by the same token,

[Coley Barbee]:

like you said, obesity is a risk factor for a lot of other disease processes.

[Coley Barbee]:

in order to be healthy, being at a healthy weight makes it easier to avoid

[Coley Barbee]:

some of those down the road health concerns. But like you said, there is

[Coley Barbee]:

such a thing as skinny fat. So just because people have a BMI between 18

[Coley Barbee]:

and 25, which is what we deem normal, does not mean that they're metabolically

[Coley Barbee]:

healthy. There are actually estimates if you look at people's... So fasting

[Coley Barbee]:

insulin levels is not a test that we do for very many people, but it is

[Coley Barbee]:

one of the most sensitive indicators if people are metabolically healthy, like they

[Coley Barbee]:

are processing their food and sugar in a way that, and how it's supposed

[Coley Barbee]:

to. And there are estimates that up to 90% of Americans are not metabolically

[Coley Barbee]:

healthy. If you look at those more sensitive indicators, which we are not

[Coley Barbee]:

really trained to do, really the functional medicine doctors do that more

[Coley Barbee]:

than pretty much anyone else. It's not very mainstream in Western medicine

[Coley Barbee]:

to test those things, but when they look at population-wide studies, most

[Coley Barbee]:

of America is metabolically unhealthy. And we know that leads to problems,

[Coley Barbee]:

but. Like you said, I don't think that you can, you can't just look at

[Coley Barbee]:

a person and say, you're metabolically unhealthy. You have people who maybe have an

[Coley Barbee]:

elevated BMI, but are very physically active and fit. And that makes a big difference.

[Coley Barbee]:

So I think it's a difficult and complicated question and one that I...

[Coley Barbee]:

I think everyone struggles with. We all know that we need to do things to be

[Coley Barbee]:

healthier, so we have a long life and a long health span, but it's a lot

[Coley Barbee]:

easier said than done. And I don't think shaming people into improving their

[Coley Barbee]:

diet is useful or helpful. I think you really need to be open about it.

[Coley Barbee]:

have an honest conversation, but people need to be supported and not shamed.

[caite]:

I know, too, as a patient, it's a lot easier to address things like weight and healthy

[caite]:

eating when it's seen as one risk factor in a whole array of things versus it's your

[caite]:

fault because you're fat and that's the only thing we're going to talk about. And

[caite]:

also, anything else is probably because of your anxiety. So

[Coley Barbee]:

I'm

[caite]:

that's

[Coley Barbee]:

sorry.

[caite]:

it. Problem solved. Yeah. Um, Erlene, do you have anything else?

hunter]:

No, I don't think so. Sorry, we may have some gaps here today, just sometimes

hunter]:

it's freezing up on us, so we're, but then you kind of catch up and I

hunter]:

know it's recording on your end. So

[caite]:

So

hunter]:

I just

[caite]:

we'll

hunter]:

wanted

[caite]:

fix

hunter]:

to mention

[caite]:

it in

hunter]:

if

[caite]:

editing,

hunter]:

there's, yeah,

[caite]:

but...

hunter]:

if

[Coley Barbee]:

Okay.

hunter]:

there are pauses, that's just because sometimes it's freezing on us, but

hunter]:

I know that you're still talking.

[Coley Barbee]:

Okay.

[caite]:

So one of the things that's kind of like a stereotype of rural medicine is that,

[caite]:

you know, the doctor would fix your kit or something and they'd pay you in, you

[caite]:

know, a patient would pay in chickens or whatever. So if we were just going to skip

[caite]:

insurance and all that shit and go back to paying in trade, what would your preferred

[caite]:

payment currency be?

[Coley Barbee]:

Oh my god, I have said so many times, I would love to just work on the barter

[Coley Barbee]:

system. So I feel like, you know, we all have skills that we can offer.

[Coley Barbee]:

So I'm, and I'm not picky, I'll take anything. I will take the chickens, I

[Coley Barbee]:

will take the produce. I will like, you know. someone wants to trade their

[Coley Barbee]:

skill in painting my house, like I don't care. I just, I love the idea

[Coley Barbee]:

of the barter system because I do think we all have talents and gifts and

[Coley Barbee]:

what a better way to share than just to offer somebody what you're good at

[Coley Barbee]:

in return for what they're good at.

[caite]:

So the actual harder hitting side of that is, I know that I've seen more articles

[caite]:

and patients talking about, especially in bigger places, how much of their doctor's

[caite]:

salary and career path is based on patient satisfaction and reviews and how much

[caite]:

that impacts what kind of care doctors give because there's so much. so much weight

[caite]:

put on making people happy versus necessarily what is healthiest or most effective or telling

[caite]:

people no or whatever. So I'm wondering what your experience has been with that.

[Coley Barbee]:

Yeah, the incentives in medicine are so backwards. Like, insurance will pay

[Coley Barbee]:

for things that research has shown is not helpful. They will not pay for

[Coley Barbee]:

things that take a little more time and might be more expensive but work a

[Coley Barbee]:

lot better. They will pay for medicines but not physical therapy. Doctors

[Coley Barbee]:

are paid to perform procedures that are minimally effective versus spending

[Coley Barbee]:

time to actually... sit down and talk with patients, you know, and give

[Coley Barbee]:

them an exercise plan and say, hey, this actually will fix your problem. But

[Coley Barbee]:

they don't get paid to do that, they get paid to do the expensive $20,000 surgery

[Coley Barbee]:

that may or may not be effective. So all of the incentives in medicine are so

[Coley Barbee]:

backwards. I would say, I think it is true that more, more and more places

[Coley Barbee]:

are going toward. using physician ratings and things like that as part of a compensation

[Coley Barbee]:

package. I don't think we'll ever get to the point where it's the only consideration,

[Coley Barbee]:

but it certainly is part of it. And I'm sure we've all received the questionnaire.

[Coley Barbee]:

Once you leave your doctor's office, tell us how your visit went. and the

[Coley Barbee]:

administrators really do put a lot of weight on your grade, I guess, from

[Coley Barbee]:

patients. And it's sometimes really hard because, I mean, there's a lot

[Coley Barbee]:

of health information out there now, which I do really think is a good thing.

[Coley Barbee]:

I think informed patients coming in can be really helpful. But the flip side

[Coley Barbee]:

of that is, There's a lot of information that isn't accurate, doesn't come

[Coley Barbee]:

from reliable sources, and it's hard not being a medical professional sometimes

[Coley Barbee]:

to differentiate between what's good information from a good reputable source

[Coley Barbee]:

and what's not. And it takes a long time to kind of talk through people

[Coley Barbee]:

when they come in and say, I want this, and you have to say, well, in my

[Coley Barbee]:

medical judgment, I don't think that's a good idea and here's why, but it takes

[Coley Barbee]:

a long time explaining. And when they want you to see more patients in

[Coley Barbee]:

less time, sometimes it's easier to say, fine, whatever you want. But I've realized

[Coley Barbee]:

any time I've done that, I've only gotten bit in the ass. So it's worth it

[Coley Barbee]:

to me to take the time to say. I hear you, I understand what you're saying

[Coley Barbee]:

to me. Here's why I think that's not a good idea and I'm not gonna do it. Um,

[Coley Barbee]:

funny, a side story. My nine year old stepson, we have this constant battle

[Coley Barbee]:

about screen time because there's all this research showing how detrimental excessive

[Coley Barbee]:

screen time is for developing brains. But he, you know, he's nine and he

[Coley Barbee]:

wants to watch TikTok and YouTube and play his video games. So it's this constant

[Coley Barbee]:

battle. And we were negotiating recently. And he's like, oh, can I have 30

[Coley Barbee]:

more minutes a day? And I was like, no, but it can cause brain damage. I

[Coley Barbee]:

don't think it's a good idea. He goes, Cole, you can't believe everything

[Coley Barbee]:

you read on the internet. Which I just thought was hilarious. And. But that's

[Coley Barbee]:

like the conversation that I have a lot of times with patients, they bring

[Coley Barbee]:

it to me and they say, well, but I read this and it has to be true. And

[Coley Barbee]:

it just takes a while to explain, maybe not a good idea, but I mean, I definitely

[Coley Barbee]:

have gotten poor ratings from patients who say, like, I went there and I

[Coley Barbee]:

wanted an antibiotic and she didn't give me one and they're upset by it.

[Coley Barbee]:

And I try to explain why I didn't think that was a good idea and. Some people

[Coley Barbee]:

take it well and some people not so much. I just, I'm at the point in my

[Coley Barbee]:

life where I've realized you can't please everybody. So let's stop trying.

[Coley Barbee]:

We're all just doing the best we can.

[caite]:

Well, I'm gonna bump my next question up then and I wrote these questions at 4 a.m

[caite]:

So at first it just said doctors versus patients who's the bigger jerk and I wasn't

[caite]:

sure what I meant by that But I realizing I think what I meant was that this is one of

[caite]:

the other real benefits of seeing the same doctor Consistently is that it does make

[caite]:

it easier to know when your doctors saying no to something because it's actually

[caite]:

not the best option versus I don't give a shit what you think

[Coley Barbee]:

Mm-hmm.

[caite]:

and I'm the doctor and I'm saying no. So I'm wondering how we can enable more patients

[caite]:

to advocate effectively while recognizing that doctors presumably know more about medicine

[caite]:

while patients presumably know more about themselves and what they're experiencing

[caite]:

and how we can do research without seeming and or being presumptuous jackasses

[Coley Barbee]:

Okay

[caite]:

about what we're finding when we do it. I know I do really appreciate that generally

[caite]:

when I come to you with something I've found, I know there have been times that you've

[caite]:

gone a different direction, but it's nice to know that I'm being considered before

[caite]:

I'm being shut down on something, you know, and it's It's nice to have the relationship

[caite]:

where I trust that you are actually considering what I say, even if I'm totally

[caite]:

full of shit, and we both know it. So I'm wondering how we can empower more people

[caite]:

to have a good relationship with their medical staff.

[Coley Barbee]:

I think I really like when patients come in with information. There's also this

[Coley Barbee]:

thing in medicine where even really good research takes on average like

[Coley Barbee]:

eight to ten years to trickle down to... to actual medical providers before

[Coley Barbee]:

it gets incorporated into guidelines and before we're aware of it. And so I will

[Coley Barbee]:

never say, oh, I know everything about this subject matter because I know that

[Coley Barbee]:

I don't. So I think the best thing patients can do is if you find good research

[Coley Barbee]:

and a good source, I am always happy to look into it because I know there's

[Coley Barbee]:

stuff I don't know.

[Coley Barbee]:

But you know by the same token, someone coming in and saying, well my great

[Coley Barbee]:

aunt Sally on Facebook says doesn't hold the same weight as, look I found

[Coley Barbee]:

this journal article, would you mind looking at it? So yeah, I think bringing

[Coley Barbee]:

good quality research to your doctor is never a bad thing. And you know,

[Coley Barbee]:

I will be totally, being totally fair. there absolutely are doctors whose ego

[Coley Barbee]:

gets in the way and says, well, I know everything about this and I don't need

[Coley Barbee]:

to listen to you. So there are those doctors out there. I will not pretend

[Coley Barbee]:

that there aren't. But I think most of us, and I think especially like primary

[Coley Barbee]:

care doctors who really do form long-term relationships with patients, by and

[Coley Barbee]:

large most of us are very happy if you bring in something, a good. but a piece

[Coley Barbee]:

of research that we can look at and say, oh, well, I didn't realize this,

[Coley Barbee]:

but this actually looks like a pretty good study and that seems like a reasonable

[Coley Barbee]:

thing to try. I think that's the best thing for patients to do to advocate

[Coley Barbee]:

for themselves.

hunter]:

You've been talking a lot about having relationships with people and especially

hunter]:

in rural medicine. I mean, those relationships often kind of extend outside

hunter]:

of the doctor's office, like for example, being on one of your patients'

hunter]:

podcasts. So what

[Coley Barbee]:

Mm-hmm.

hunter]:

is it like for you personally to have to do things like give bad news to

hunter]:

people that you know well or, you know, even, you know, in a smaller scale,

hunter]:

like maintain boundaries around, you know. This is not a doctor's office. If

hunter]:

someone asks you for advice in the grocery store versus like in an appointment,

hunter]:

like how do you, I guess, how do you look after yourself being a rural doctor?

[Coley Barbee]:

You know, the grocery store questions happen much less frequently than

[Coley Barbee]:

I was worried that they would happen.

hunter]:

Well, that's good.

[Coley Barbee]:

It is good. But you know, it is a balance to be part of a smaller community.

[Coley Barbee]:

And you know, especially with, you know, the giving bad news. And you know,

[Coley Barbee]:

frequently the bad news is something like... Oh, I think you might have a problem

[Coley Barbee]:

that I don't know how to fix and you need to go see some specialist, you

[Coley Barbee]:

know, you need to see oncology or surgery or cardiology and you know, a doctor

[Coley Barbee]:

or provider with a skill set that I don't have. So one of the hardest things

[Coley Barbee]:

for me is not. not having enough information to give to somebody to say, here's

[Coley Barbee]:

exactly what the process will look like. You know, like if I have to hand

[Coley Barbee]:

a patient off to a specialist because they have something that I don't know

[Coley Barbee]:

how to deal with or I don't have the skillset to manage, yeah, one of the

[Coley Barbee]:

hardest things is I can't answer their questions all the time, you know? I don't

[Coley Barbee]:

know all the steps that are gonna come next. So that's really, that's difficult

[Coley Barbee]:

for me. And I try to find out as much as I can before delivering the bad

[Coley Barbee]:

news. Like, so I at least know the next step. Like we have this appointment

[Coley Barbee]:

set up for you and you are gonna see the specialist type of thing. But you know,

[Coley Barbee]:

it's challenging. And I like most of my patients. So it's never nice to

[Coley Barbee]:

give bad news to someone that you like. But it's just, you know, fortunately

[Coley Barbee]:

I don't have to do it. Fortunately, I get to give good news more than bad news,

[Coley Barbee]:

I think.

[caite]:

It's my question, isn't it? I was just over here thinking about bad news. My next

[caite]:

question just says access to reproductive care, WTF. And I know this is something that's

[caite]:

connected with the having to give bad news to people and being a patient who's been

[caite]:

in that position with you. How can we...

[caite]:

I'm trying to even think of how to put this. How can we effectively stop the government

[caite]:

from inserting themselves in the doctor-patient relationship? When I was in the position of

[caite]:

having to make these decisions, I don't really want the state's opinion on it, and

[caite]:

I don't really want the state making that decision. When I was in the position of

[caite]:

having to decide whether... to abort the boy child for the safest treatment path

[caite]:

for the melanoma, I don't really want to have to skip all the doctors that are consulting

[caite]:

to go to a medical board at the state and get their permission to do something. So

[caite]:

I'm wondering what your thoughts are on this and how we can tell them to shut it

[caite]:

because Canada is a different situation but I'm sure they're not immune to these things

[caite]:

either.

[Coley Barbee]:

This is a really difficult question and one that I am very passionate about. I

[Coley Barbee]:

feel all the time, like all kinds of outside groups are inserting themselves

[Coley Barbee]:

into the doctor-patient relationship. The one I honestly have the most difficulty

[Coley Barbee]:

with is insurance companies. When I say, this is the best treatment, and

[Coley Barbee]:

insurance company says, nope, sorry. Pick a different thing. We're not gonna

[Coley Barbee]:

cover this one. And I don't have a good solution for that. And I also don't

[Coley Barbee]:

have a good solution for how to keep

[Coley Barbee]:

politicians and the state from inserting themselves, especially into issues

[Coley Barbee]:

they don't understand, is the most frustrating thing as a healthcare provider.

[Coley Barbee]:

When I see the debates on abortion happening and it is just... blatantly false

[Coley Barbee]:

information. Like, we're just gonna...abortion doctors throw live babies

[Coley Barbee]:

into trash cans and all this other ridiculousness. I'm just thinking, who

[Coley Barbee]:

thinks this is true? But obviously people do. So everything is so caught up in

[Coley Barbee]:

misinformation and just incorrect things not based at all on medicine or science.

[Coley Barbee]:

That's what I find the absolutely most frustrating. So I keep telling people

[Coley Barbee]:

to vote, but unfortunately that's not being very effective. So I'm not sure.

[Coley Barbee]:

I'm not sure what the best course of action is, except for as medical providers

[Coley Barbee]:

continuing. I write letters to my representatives all the time. every time

[Coley Barbee]:

they vote on something stupid, I write a letter and I say, here's why you're

[Coley Barbee]:

wrong. So I think that's a really important thing for medical people to do because

[Coley Barbee]:

so many of these debates are completely surrounded by misinformation and

[Coley Barbee]:

because, and there are not very many health care providers in legislators,

[Coley Barbee]:

in legislatures at the state or the federal level. So. So it's challenging

[Coley Barbee]:

because they're making laws on things that they don't, they're not fully

[Coley Barbee]:

informed about, I don't think.

[caite]:

it seems like that's so much of it too from a patient perspective is if it seemed

[caite]:

like they had any actual knowledge about what they were legislating on

[Coley Barbee]:

Mm-hmm.

[caite]:

and then they made a well-thought-out informed decision it might be different but

[caite]:

when it's people saying you know if a woman doesn't want to get pregnant her body

[caite]:

has ways of shutting that down and

[Coley Barbee]:

Yeah.

[caite]:

you know no no abortions after six weeks when so many people don't know they're

[caite]:

pregnant until well after six weeks and this, that, and the other that I'm just

[caite]:

like, you guys, there's no actual basis in fact here. So no, I don't have a lot of

[caite]:

faith in your decision making at this point.

[Coley Barbee]:

Yeah.

[caite]:

And yes, insurance companies, just insurance companies, whatever.

[Coley Barbee]:

Yeah, and there are so many other layers to providing abortion care. You

[Coley Barbee]:

know, a lot of residency programs actually take place in Catholic hospitals,

[Coley Barbee]:

and so OB-GYNs coming out of those programs don't even learn how to perform

[Coley Barbee]:

an abortion, or sometimes even like tubal ligations, because the Catholic

[Coley Barbee]:

hospitals don't allow those procedures, and so where they train, they don't

[Coley Barbee]:

learn how to do them. And... There's a lot of barriers set up. So for instance,

[Coley Barbee]:

when I came to Wacom, I really wanted to, so the Mifepristone, which is commonly

[Coley Barbee]:

known as the abortion pill, it's actually one of two pills that you use

[Coley Barbee]:

for medical abortion, but you need to be specially licensed in order to prescribe

[Coley Barbee]:

it. So not everyone can prescribe it. So when I came here, I wanted to do that,

[Coley Barbee]:

and my employer basically said, well, if there are complications, you don't

[Coley Barbee]:

have the surgical privileges to do a DNC if there's bleeding or complications.

[Coley Barbee]:

So we're not gonna let you get your license to prescribe if prescribed. And

[Coley Barbee]:

I said, well, then can you teach me how to do... DNCs and they said well what

[Coley Barbee]:

happens when you're not there? There's no backup or coverage for you. So no

[Coley Barbee]:

So it's really an uphill battle even for people like me for whom you know,

[Coley Barbee]:

I I think abortion is a human right and Pregnancy is a very difficult journey

[Coley Barbee]:

in life There's a very decent chance, at least in the United States, that

[Coley Barbee]:

a woman dies during part of pregnancy and childbirth. And I feel like that's

[Coley Barbee]:

not a decision to be taken lightly. And if there's any reason that you want an

[Coley Barbee]:

abortion, you should have access to one. But even for me, feeling very passionately

[Coley Barbee]:

about that and wanting very much to provide that care, there are all these

[Coley Barbee]:

barriers. And so it's something that I've not been able to do.

[caite]:

That's so frustrating as a rural patient too, because I don't even

[Coley Barbee]:

Mm-hmm.

[caite]:

know where our closest abortion provider would be, but I'm guessing it's at least an

[caite]:

hour and change away. And

[Coley Barbee]:

I think.

[caite]:

that's not feasible. It's not.

[Coley Barbee]:

Yeah, I think Des Moines is the closest, so

[caite]:

And

[Coley Barbee]:

I

[caite]:

that's

[Coley Barbee]:

mean,

[caite]:

what, four hours from here?

[Coley Barbee]:

yeah, three and a half, four hours. So

[caite]:

more or less.

[Coley Barbee]:

yeah, and I've had to have this conversation with patients before who say,

[Coley Barbee]:

you know, I want an abortion for whatever reason, and it's really difficult

[Coley Barbee]:

for me to counsel them about, well, you know, you're going to have to drive

[Coley Barbee]:

hours and hours and hours away, or you know, or cross state lines and drive

[Coley Barbee]:

hours and hours the other way. And so it's really challenging to know how

[Coley Barbee]:

to best counsel patients that want that just because it is it's so difficult

[Coley Barbee]:

to access that and the laws are changing constantly now since Roe v. Wade

[Coley Barbee]:

was overturned. It's hard to keep. And we live in a corner of the state

[Coley Barbee]:

where we're actually very close to parts of Wisconsin and Minnesota. And so

[Coley Barbee]:

sometimes it's easier to get health care in a different state than it is

[Coley Barbee]:

to drive to someplace within our same state where maybe the same service

[Coley Barbee]:

is available. But you really have to keep up on the laws because the laws

[Coley Barbee]:

are changing so quickly. on the in sorry the state laws are changing so

[Coley Barbee]:

quickly. It's hard to keep up with well, where is it legal? Where can I send

[Coley Barbee]:

you?

hunter]:

Yeah, sorry. My head's

[caite]:

Thank

hunter]:

going

[caite]:

you.

hunter]:

in a lot of different directions. And I know that my Canadianism is showing through

hunter]:

because there's so much of the insurance side that I just don't understand

hunter]:

at all, right? Like that doesn't compute, but I'm sure

[Coley Barbee]:

Neither

hunter]:

that, you

[Coley Barbee]:

do

hunter]:

know, there's,

[Coley Barbee]:

I.

hunter]:

yeah, yeah, for sure.

[caite]:

Thank you. Bye.

hunter]:

And even, you know, the idea of writing your review of your doctor's appointment,

hunter]:

that is not something I have ever come across. Um, yeah, but I mean, access

hunter]:

to all health services by qualified medical professionals is something that people

hunter]:

in rural areas, I mean, that's who we're talking to, but you know, we understand

hunter]:

the limits of geography and all those types of things, but being able to

hunter]:

access the services we need when we need them is a human right, like you

hunter]:

said, right? And abortion is included in those services that we should have

hunter]:

access to if it's necessary for us.

hunter]:

I'm going to go into the direction of the kind of the more parenting questions.

hunter]:

So what is something that you wish you could tell us parents about our kids

hunter]:

in terms of, you know, like, not like the detailed medical stuff necessarily,

hunter]:

but what do you wish that you could get through to parents when they're in

hunter]:

your office or the things that we worry about?

[Coley Barbee]:

You know, especially when I used to do OB and deliver babies, especially

[Coley Barbee]:

first time parents were so nervous. Like, how am I going to take care of this little

[Coley Barbee]:

human when I bring it home? And what I told all of them and that I hope

[Coley Barbee]:

sunk in is, you know, infants need to be loved and fed. And that's basically

[Coley Barbee]:

it. Like they're probably gonna be fine if they are loved and fed. Like that's

[Coley Barbee]:

it. And if you have a worry, you come to somebody who knows how to evaluate

[Coley Barbee]:

that worry. Like those are the important things. You know, it's not as important

[Coley Barbee]:

to have, you know, all the fancy gadgets and things. And it really is, you know,

[Coley Barbee]:

love your children. That's what you need to do.

hunter]:

Yeah. As they get older, you know, I know that sometimes parents worry about,

hunter]:

you know, whether you're worrying too much or not enough,

[Coley Barbee]:

Mm-hmm.

hunter]:

right? How do you help people decide when they do need more help, whether

hunter]:

that's medically or developmentally, you know, milestones, all that kind of stuff?

hunter]:

How do you support parents who are in that kind of like, I'm just not

hunter]:

sure, or I think something's off, but I don't know.

[Coley Barbee]:

I mean, I may see your child, like even in the early years when we're having

[Coley Barbee]:

a lot of appointments, I might see your child 20 minutes every few months,

[Coley Barbee]:

and you see them every single day. So I have come across parents who are...

[Coley Barbee]:

you know, maybe overthinking it or over worrying. But most often I find

[Coley Barbee]:

parents know their children best. Like if you think there's a problem,

[Coley Barbee]:

probably there is. And, you know, hopefully I can help you figure out,

[Coley Barbee]:

you know, well, where can we get you help? What additional help do they

[Coley Barbee]:

need? You know, there are a lot more services now than there were even

[Coley Barbee]:

20 years ago for kids with developmental delays. you know, chronic health conditions

[Coley Barbee]:

or problems, you know, there's just, there's a lot more resources. And so,

[Coley Barbee]:

you know, my general feeling is usually parents know their kids best. If

[Coley Barbee]:

you think there's something wrong, it at least bears further investigation.

[Coley Barbee]:

And, you know, hopefully your family doctor can be the person to say, well,

[Coley Barbee]:

here's where I think you can get the help that you might need. So I consider

[Coley Barbee]:

that really to be my role.

hunter]:

Oh, sorry, we had a little freeze up again. And I know as a parent, something

hunter]:

that has helped me is when you're not sure, or if you feel like your doctor

hunter]:

is maybe gonna be dismissive, is to have some documentation. Just write some

hunter]:

things down, like really have a list when you go in, because sometimes you

hunter]:

get in that office and you're like, I can't remember what it was I was actually

hunter]:

concerned about. But if you have the list of things, you're like, here

hunter]:

are the things that I'm seeing. that maybe are not the same as other kids or

hunter]:

not the same as my other children or that I'm noticing in these situations, they

hunter]:

might be more willing to listen to your concerns if you've got kind of a bit

hunter]:

of backup and also just that reminder to yourself to be like, these are

hunter]:

my concerns, don't let the office scare you into thinking, oh, I'm

[Coley Barbee]:

Great.

hunter]:

sure it's fine. It's yeah, it's not really a big deal.

[Coley Barbee]:

I think in general a symptom diary for anybody of any age is the best thing

[Coley Barbee]:

to do. Like if you have a concern, write down, this is a symptom I had, this was

[Coley Barbee]:

the day I had it, like these are the associated things. Because it is, there's

[Coley Barbee]:

so many things, and especially when it comes to well child appointments, there's

[Coley Barbee]:

so many things that we wanna ask to assess and make sure that. you know,

[Coley Barbee]:

that we're happy with how your child is growing and developing and if they're

[Coley Barbee]:

meeting their milestones and so forth. So there's a lot of talking we want

[Coley Barbee]:

to do at you. And sometimes I think parents' concerns sometimes get a little

[Coley Barbee]:

lost in the shuffle. And so, yeah, I agree completely. Writing down, writing

[Coley Barbee]:

things down is the best way, I think, to really know. Because a lot of times

[Coley Barbee]:

patients will come to me with a concern. And they'll say, oh, well this hurts.

[Coley Barbee]:

And I say, well, where does it hurt? When does it hurt? What happens around?

[Coley Barbee]:

And they say, oh, well, I don't know. And it gets hard to remember if this

[Coley Barbee]:

is, you know, something that is

hunter]:

Right,

[Coley Barbee]:

not.

hunter]:

and did it start six months ago or six weeks ago? I can't really

[Coley Barbee]:

Absolutely.

hunter]:

remember what day or time or yeah,

[Coley Barbee]:

So yeah,

hunter]:

if I was

[Coley Barbee]:

writing

hunter]:

doing

[Coley Barbee]:

down

hunter]:

a certain

[Coley Barbee]:

symptoms.

hunter]:

activity.

[Coley Barbee]:

Yeah, writing down symptoms is the best thing you can do.

[caite]:

I know too as a patient one of the worst things is when you leave an appointment

[caite]:

and realize that you forgot to ask about something or say something. And then

[caite]:

you have to do things like Facebooking your doctor about the arthritis in your foot,

[caite]:

which is embarrassing. But, yes, I'm also a huge proponent of writing things down

[caite]:

because otherwise I know for myself, especially with something with the kids, if

[caite]:

I'm worried about it, it seems like it happens every day where if I actually write

[caite]:

it down and then I can look back and be like, oh, it's actually only happening every

[caite]:

three weeks. It's just that I'm thinking about it, so it seems like it's an all-the-time

[caite]:

thing. Or, it actually is an all-the-time thing, but it

[Coley Barbee]:

Ahem.

[caite]:

doesn't seem like a big thing, so I'm not thinking about it. And, oh look, it is

[caite]:

happening every day. Maybe I should concern myself with whatever this thing is.

[caite]:

So one of the big things, especially the last few years, has been physician burnout.

[caite]:

And I'm wondering how, as patients and as community members, we can be supportive

[caite]:

of our medical teams. Because you guys are really getting screwed from a lot of directions.

[caite]:

And especially with things like the patient satisfaction surveys and that, it's

[caite]:

really It seems really unfair and shitty because there's stuff that's not your fault

[caite]:

and there's stuff that you

[Coley Barbee]:

Thank

[caite]:

cannot

[Coley Barbee]:

you.

[caite]:

fix. I mean, that's just how it works. And you know, because we are in communities

[caite]:

with each other and in small towns and we know each other, it seems that much

[caite]:

more important to take care of people. And so I'm wondering how we can, besides, you

[caite]:

know, paying you in chickens or

[Coley Barbee]:

Hahaha.

[caite]:

live basil plants. that you can then kill yourself, you know, how we can do better.

[Coley Barbee]:

You know, I think honestly everybody is burning out right now. You know, not just

[Coley Barbee]:

the medical professionals. The last few years have been really difficult for

[Coley Barbee]:

people. A lot of the social norms that we had been accustomed to were completely

[Coley Barbee]:

upended. There was a lot of... socialization that didn't happen the last couple

[Coley Barbee]:

of years. So I feel like really everyone's burning out. I've started doing

[Coley Barbee]:

a thing called joy prescriptions where I tell patients, you know, I want you

[Coley Barbee]:

to do something every single day for five minutes that brings you joy. And

[Coley Barbee]:

the number of people I get that say, well, I don't know what brings me joy

[Coley Barbee]:

is terrifying. Then I say, well, that's your first assignment then. Figure out

[Coley Barbee]:

like something that brings you joy. And then you have to do it five minutes

[Coley Barbee]:

every day. And I really think that it's, you know, just doing, taking a little

[Coley Barbee]:

time to take care of yourself pays dividends in the long run. And, you know,

[Coley Barbee]:

I know I... for far too long just said, okay, yes, I will do everything.

[Coley Barbee]:

I'm gonna do everything for everyone else and you empty your cup. And then

[Coley Barbee]:

you, you know, there's nothing left for you. And so the other thing I've started

[Coley Barbee]:

doing recently is saying no, and it's the best. Nobody says no enough. And

[Coley Barbee]:

I've just recently started doing it and I love it.

[caite]:

and I'm really glad that you agreed to be on there.

[Coley Barbee]:

I agree to do fun things.

hunter]:

I said no to something recently too and it was fantastic.

[Coley Barbee]:

Yeah,

hunter]:

So

[Coley Barbee]:

it's great!

hunter]:

you have a project coming up, which I'm assuming probably brings you joy.

hunter]:

You're starting a YouTube channel, is that correct? And what is it called and

hunter]:

what are you going to be doing on the YouTube?

[Coley Barbee]:

I am. So we are, I'm in the process of making Cooking with Dr. Coley channel.

[Coley Barbee]:

And this really stems from the number of times every single week I have to

[Coley Barbee]:

fight with people to eat their vegetables. In the Midwest,

hunter]:

I'm guessing it's not just

[Coley Barbee]:

everybody

hunter]:

the children.

[Coley Barbee]:

tells me, well, we're meat and potato folks. It's not, no, I have like 70

[Coley Barbee]:

year olds with like really terribly controlled diabetes and heart disease and well

[Coley Barbee]:

we're just meat and potato folks and I'm like, I just don't want you to have

[Coley Barbee]:

another heart attack. Like really, can we, like I'm not taking away the meat and

[Coley Barbee]:

potatoes, like, but could you fill half your plate with veggies? And people's

[Coley Barbee]:

idea of like a healthy vegetable is like. iceberg lettuce with ranch dressing

[Coley Barbee]:

and I say, well, I don't think that's the healthiest choice. So I'm just,

[Coley Barbee]:

I'm really tired of having the same conversation over and over again. And

[Coley Barbee]:

I really, I really love to cook. It's what I do for like stress relief. And

[Coley Barbee]:

I really, I was gonna offer a cooking class, but it turns out there's all

[Coley Barbee]:

these... like for my patients, but it turns out there's all these rules with

[Coley Barbee]:

Medicare that you can't give free stuff to people and So I couldn't offer

[Coley Barbee]:

this class I wanted to and you know, we just have all these like older midwesterners

[Coley Barbee]:

who are just like so set in their ways Right and not one of them wants

[Coley Barbee]:

to eat a vegetable. So I figured well maybe an easier way to get this message

[Coley Barbee]:

out broadly is to just to start a youtube channel and with just how to incorporate

[Coley Barbee]:

vegetables into your life. Because people think that vegetables don't taste good,

[Coley Barbee]:

they think they're expensive, and that really just isn't the case. So it's

[Coley Barbee]:

gonna be not entirely vegetarian channel, but like plant heavy foods, because

[Coley Barbee]:

I feel like that's what people have the most difficulty kind of incorporating

[Coley Barbee]:

into their diets. so really heavy on vegetables like beans and legumes

[Coley Barbee]:

just kind of plant forward cooking to to try to give people a resource to okay

[Coley Barbee]:

it's not you know you can incorporate it like it's not doesn't have to be hard to

[Coley Barbee]:

incorporate vegetables i won't even take away your meat potatoes just like

[Coley Barbee]:

please eat some broccoli sometimes

[caite]:

So as the wife of one of your patients who might believe that iceberg lettuce with

[caite]:

Ranch bacon bits and cheese on top counts as a salad. Sorry Jim. Apparently it

[caite]:

doesn't Have you thought about

[Coley Barbee]:

Belgium,

[caite]:

maybe

[Coley Barbee]:

I apologize.

[caite]:

running like half a screen of tractor videos at the bottom of your cooking videos

[caite]:

so that they'll watch them or like Interspersing little videos of cows in between

[caite]:

to get them to like Or, oh, what's it called, um,

[Coley Barbee]:

I love this idea.

[caite]:

when you, when you put in like little snippets of something that like your, your

[caite]:

brain doesn't consciously see? Um, like,

[Coley Barbee]:

like the subliminal

[caite]:

yes,

[Coley Barbee]:

messaging? Ha ha

[caite]:

yes.

[Coley Barbee]:

ha ha.

[caite]:

We'll just start putting it in all the tractor videos on YouTube. There'll be

[caite]:

subliminal messaging for like

[Coley Barbee]:

Perfect.

[caite]:

kale, you know. All these farmers are going to start asking it for like tofu and...

[caite]:

curries and kale and shit and everyone who cooks for these people is gonna be like,

[caite]:

what? Alright, you know, it's gonna be amazing. And my husband

[Coley Barbee]:

I

[caite]:

is

[Coley Barbee]:

think this

[caite]:

doing

[Coley Barbee]:

is

[caite]:

better.

[Coley Barbee]:

a brilliant idea.

[caite]:

I'll say that for him. He is making an effort. Yeah, I think subliminal messaging

[caite]:

or some tractor videos might be the way to go. Yeah,

[Coley Barbee]:

I like it.

[caite]:

I think there is a real assumption that eating healthier means all tofu all the

[caite]:

time, and

[Coley Barbee]:

Mm.

[caite]:

never eating anything that you actually want to eat.

[caite]:

And also not controlling your diabetes does really really really bad things so Yeah,

[caite]:

I think people miss What the fallout can be of that?

[Coley Barbee]:

Uh-huh.

[caite]:

And I watched your intro video and it was adorable. So we'll make sure to put

[caite]:

a link

[Coley Barbee]:

Thanks.

[caite]:

in so that people can watch you.

[Coley Barbee]:

I just had, we've learned some things during filming. So my husband is helping

[Coley Barbee]:

me with this. We are not videographers. We don't really

[caite]:

So we

[Coley Barbee]:

know

[caite]:

ask...

[Coley Barbee]:

what we're doing. So we said, we welcome feedback.

[caite]:

There you go. We ask all of our guests if you were going to dominate a category at

[caite]:

the county fair, what would it be? And categories can be real or made up to ensure

[caite]:

that you win.

[Coley Barbee]:

mean I make an excellent cheesecake but those recipes aren't going on the channel.

hunter]:

That's only for the county fair.

[Coley Barbee]:

I think I really could win a cheesecake making contest at the county fair.

[Coley Barbee]:

I really do.

[caite]:

I think

hunter]:

but

[caite]:

I

hunter]:

you'd

[caite]:

could

hunter]:

probably

[caite]:

judge

hunter]:

put

[caite]:

a chicken.

hunter]:

fruit on it.

[Coley Barbee]:

Yeah, totally.

[caite]:

It's got dairy in it.

hunter]:

That sounds delicious. So we'll go ahead and move into our cussing and discussing

hunter]:

segment. We've registered for an online platform called SpeakPipe where you

hunter]:

can leave your cussing and discussing entries for us and we will play

hunter]:

them on the show. So go to speakpipe.com backslash barnyardlanguage and

hunter]:

leave us a voice memo or you can always send us an email at barnyardlanguage.gmail.com

hunter]:

and we will read it out for you. Katie, what are you cussing and discussing

hunter]:

this week?

[caite]:

Well, I wrote down children are humans, but I do actually remember what I meant by

[caite]:

this. It's so, so easy, and I am saying this as a reminder to myself, it is so easy

[caite]:

to get so caught up in, my kids should be excited to go to school, they should do

[caite]:

all their chores without ever talking back, they should do this, they should do this,

[caite]:

they should never talk back or complain or want anything different or cause problems

[caite]:

or whatever else. And I mean, my kids are just barely six and four. And if I really

[caite]:

think about it, if somebody pushed me around to do all the shit that I expect

[caite]:

them to do without complaint, I would lose my mind. And, you know, the boy child

[caite]:

this morning was saying he didn't want to go to school because he doesn't want to

[caite]:

learn anything else. His brain is full, he's done, he wants to stay home and play tractors,

[caite]:

he doesn't want to go to school, he doesn't want to,

[Coley Barbee]:

Thank

[caite]:

you know,

[Coley Barbee]:

you.

[caite]:

he's done. And I'm sitting here thinking about I'm trying to learn this new editing

[caite]:

software for the podcast, and my brain is full after like five minutes of trying to

[caite]:

learn new stuff. But I expect my four-year-old to just trot happily off to school every day

[caite]:

to learn more stuff. You know, it can take me an hour to get going in the morning

[caite]:

and to get dressed and eat breakfast, but I expect them to be able to do it in 15

[caite]:

minutes when they don't get to choose what they're wearing or what they're eating

[caite]:

or where they're going, and that they should just shut up and go do it, and don't

[caite]:

give me a hard time about it. And... It is hard because on the one hand, just shut

[caite]:

up and go eat your breakfast. I, you know, you're four, I don't care what you think.

[caite]:

But I do very much care what they think. And it's hard to balance caring and wanting

[caite]:

them to feel like they have some agency in their lives with also knowing that sometimes

[caite]:

you just have to shut up and eat your breakfast and go to school. And it's hard to

[caite]:

take it too seriously when I know full well what he's learning in preschool. And it's

[caite]:

not like they're, you know, it's not like he's in a military academy or something.

[caite]:

So anyway,

hunter]:

Yeah,

[caite]:

children

hunter]:

it's

[caite]:

are

hunter]:

a hard

[caite]:

humans.

hunter]:

one to remember though, especially when it impacts your, you know, you've also

hunter]:

got in your head like, if you don't leave now, we're gonna be late, you know,

hunter]:

all the things that as adults we're keeping track of at all times, right?

hunter]:

Like if my kids are gonna miss the bus, then I'm gonna have to drive them,

hunter]:

you know, like all the down the road consequences where you're just like,

hunter]:

can you just do the thing? But

[caite]:

Let's

hunter]:

yeah,

[caite]:

just do it.

hunter]:

yeah. But they're also allowed to have feelings apparently. Ha ha!

[caite]:

All right, Colby, what do you have to cuss and discuss?

[Coley Barbee]:

Oh goodness.

[Coley Barbee]:

What have I been thinking about recently?

[Coley Barbee]:

Mmm.

[Coley Barbee]:

Is this something that I think about that makes me want to cuss? Is

hunter]:

It

[Coley Barbee]:

that

hunter]:

can be, yeah, this

[Coley Barbee]:

the point

hunter]:

is

[Coley Barbee]:

of

hunter]:

just

[Coley Barbee]:

this?

hunter]:

like, yeah, the random, either like the little tiny thing that bugged you

hunter]:

this morning to like society at large, whatever. This is free rein.

[Coley Barbee]:

Gotcha. I've honestly been really thinking about how, like, why is winter so

[Coley Barbee]:

long? I know this is something I can do nothing about, but we're only a month

[Coley Barbee]:

in and I'm sick of it already. And

hunter]:

Agreed.

[Coley Barbee]:

this is awesome. I just am thinking like, you know...

[Coley Barbee]:

Can just the whole world just move south during the winter? Just... Or shouldn't

[Coley Barbee]:

we all just live in the template zone? I don't know.

hunter]:

Yeah,

[Coley Barbee]:

Maybe I just need to do that. Maybe I just need a vacation.

hunter]:

maybe.

[Coley Barbee]:

Maybe

hunter]:

Yeah,

[Coley Barbee]:

that's

hunter]:

that

[Coley Barbee]:

what

hunter]:

could be

[Coley Barbee]:

the...

hunter]:

it. Yeah. There's something about

[Coley Barbee]:

Really?

hunter]:

the longer nights too, the darkness. You know, in the daytime when it's

hunter]:

cold, I seem to be able to cope better. But, you know, once it's dark

hunter]:

and cold, then that's a harder pill to swallow.

[Coley Barbee]:

I agree.

[caite]:

I find that interesting, Arlene, because I prefer when it's dark, because then nobody

[caite]:

expects me to go outside. When it's light, I feel like there's some expectation

[caite]:

that I might leave the house.

hunter]:

Yes, but like today I'm looking outside and there's snow, but at least the

hunter]:

sun is shining. So it's like, you know, I can look out there and think that

hunter]:

it's, it's not that bad. But yeah, when it's dark at four o'clock, then

[Coley Barbee]:

Mm-hmm.

hunter]:

yeah, I don't want to do anything, whether I'm inside or outside.

[Coley Barbee]:

No. Okay.

[caite]:

So Arlene, what do you have to custom discuss today?

hunter]:

So this one is semi, like medically related, I suppose. And I'm not blaming anybody.

[caite]:

She's

hunter]:

It's

[caite]:

got

hunter]:

just

[caite]:

a rash

hunter]:

one of

[caite]:

to

hunter]:

those.

[caite]:

show you, Colleen.

hunter]:

No, I do not, no. It's just that thing where you call the doctor's office

hunter]:

and you need to book an appointment and it seems semi-urgent to you. And they're

hunter]:

like, ah, yeah, the closest appointment we've got is like six weeks or

hunter]:

two months away. And you're like, well, like. guess that's my only option,

hunter]:

I will take it. But then, you know, say that there's a prescription that

hunter]:

needs renewed or any of those types of things, then there's all those extra

hunter]:

hoops that you have to jump through where it's like, yeah, well, I don't

hunter]:

have another doctor's appointment for another two months, so I guess you have

hunter]:

to fax my doctor or whatever technology they use now to talk to doctors.

hunter]:

I think they still use faxes at my pharmacy. I don't know why they do.

[Coley Barbee]:

They still use faxes. It's the most, that is worth cussing and discussing.

hunter]:

Yeah,

[Coley Barbee]:

Why

hunter]:

the use

[Coley Barbee]:

are

hunter]:

of fax

[Coley Barbee]:

we still

hunter]:

machines.

[Coley Barbee]:

using faxes?

hunter]:

Yeah, yeah, yeah. So then, yeah, that drawn out process of, okay, so yeah,

hunter]:

I do have a dark disappointment, but then the prescription is another whole

hunter]:

thing. And yeah, just the delays. And I get it, everybody's overworked. And sometimes

hunter]:

you can't fit more appointments into a day, but I just don't like waiting for

hunter]:

that kind of stuff. But.

[Coley Barbee]:

Can I pick a new custom to discuss?

hunter]:

Absolutely, get another one.

[Coley Barbee]:

Because I think this is, like understaffing of medical clinics, I think is

[Coley Barbee]:

a problem in many, many places, but especially rural places,

hunter]:

Mm-hmm.

[Coley Barbee]:

it is ridiculously hard to recruit people to come work. And it does mean longer

[Coley Barbee]:

wait times for patients. And and that your medical providers are overworked

[Coley Barbee]:

and you still aren't getting to see them in a timely fashion. A lot of people

[Coley Barbee]:

in the US will say, oh, well, we can't have a single payer system or socialized

[Coley Barbee]:

medicine because then care will be rationed. And I think what people don't

[Coley Barbee]:

understand is that care is already rationed. We just don't ration it in an intelligent

[Coley Barbee]:

or

[Coley Barbee]:

in a way that makes any sense. We're not deliberate about it.

hunter]:

Mm-hmm.

[Coley Barbee]:

So instead what happens is there aren't enough healthcare professionals and

[Coley Barbee]:

where there are some mostly suburban type environments where there are

[Coley Barbee]:

plenty of doctors and you don't have to wait. but in the more difficult places

[Coley Barbee]:

to practice that have fewer resources like rural places and like urban

[Coley Barbee]:

places, we are rationing care, we're just not talking about it.

hunter]:

Yeah,

[Coley Barbee]:

So.

hunter]:

and it's probably not being done in an equitable, across the board way,

hunter]:

right? Where

[Coley Barbee]:

No. Not at

hunter]:

some

[Coley Barbee]:

all.

hunter]:

people are maybe not seeing that it's being rationed because they're maybe

hunter]:

in a different system than the other people who are waiting.

[Coley Barbee]:

Yeah, absolutely.

[caite]:

Arlene, I'm going to add a second cussing and discussing too,

hunter]:

Bring it on.

[caite]:

since we have fun.

[Coley Barbee]:

I'm going to go ahead and turn it off.

hunter]:

It's a double cussing kind of week.

[caite]:

This concept of the way the government controls prescription writing, if it seemed

[caite]:

like it was actually fixing the opioid epidemic, fine. But this crap about things

[caite]:

like not being able to get ADHD meds for more than 28 days at a time, if I didn't

[caite]:

need meds to make my brain able to remember things... I might have a chance of

[caite]:

getting my meds filled on time, but there should be some route that if I can prove

[caite]:

that I'm taking my meds and I'm a 41-year-old mother, I'm not selling my meds to a bunch

[caite]:

of college kids on the street, I feel like I should be trusted with more than 28

[caite]:

days' worth of medication. Or... when, say, my insurance company refills... refuses

[caite]:

to pay for a prescription because they disagree with my doctor about what my prescription

[caite]:

should be or pharmacies that second-guess your prescriptions or anybody else I just...

[caite]:

you know... it's... if it seemed like it was fixing anything it would be different

[caite]:

but we still have all these drug problems and it's... It's still a pain in the ass to

[caite]:

get stuff filled. So that's my thoughts

[Coley Barbee]:

Well,

[caite]:

on

[Coley Barbee]:

and

[caite]:

that.

[Coley Barbee]:

it just, it really is, I mean, it makes life harder for patients and for medical

[Coley Barbee]:

providers because, I mean, if somebody is stable on a medication, you know,

[Coley Barbee]:

on their blood pressure medication, I will give them a month's worth with a few

[Coley Barbee]:

refills and say, you know, hey, come back for a recheck in six months or whatever.

[Coley Barbee]:

But you know, I can't do that on... with the controlled substances. Like

[Coley Barbee]:

I need to write a new prescription every single month after you call in and request

[Coley Barbee]:

it. So it's harder for everybody.

[caite]:

Yeah, I think

[caite]:

Yeah, that's exactly the problem is that it's not in any way efficient for anyone

[caite]:

involved. It's not efficient for the pharmacy either because they have to, you know,

[caite]:

jump and do it when it does finally come through. And it's just a pain in the ass.

[caite]:

Anyway, Arlene, did you have a second cussing and discussing you wanted to add?

hunter]:

I think I'm good for today. I feel like I'm gonna, as a Canadian, I need

hunter]:

to curtail my comments a little bit, other than saying, yay, socialized medicine.

hunter]:

I know there are problems in the system, but yeah, I know that hearing the

hunter]:

two of you talk about it and all the other stories that we hear from here,

hunter]:

you know. yes, there's issues in our system, but don't let your politicians

hunter]:

and your insurance companies convince you that it's all that bad because

hunter]:

there's a lot of good that's happening. I think that

[Coley Barbee]:

Mm.

hunter]:

hopefully that if other systems are looked at critically and without all the

hunter]:

biases and often that comes from that's... where it's coming from, who's

hunter]:

getting paid, right? So, but look at what other countries are doing and

hunter]:

actually, yeah, make some decisions based on facts rather than believing the stories.

hunter]:

Anyway, thank you so much, Dr.

[Coley Barbee]:

Thank you

hunter]:

Coley,

[Coley Barbee]:

guys, this has

hunter]:

for

[Coley Barbee]:

been so much fun.

hunter]:

joining us today. If someone wanted to get in touch or follow your YouTube

hunter]:

channel, not in get in touch in terms of like asking for medical advice.

hunter]:

But yeah, if people want to watch your cooking videos, where will they

hunter]:

be able to find you?

[Coley Barbee]:

So the channel is just called Dr. Coley. So like D-R-C-O-L-E-Y.

hunter]:

That is great. We will look forward to watching them and see whether there's

hunter]:

a tractors involved or not.

[Coley Barbee]:

Gonna add some now.

[caite]:

Maybe you could even just line some toy ones up on your counter

[Coley Barbee]:

Mm-hmm.

[caite]:

Or just some tractor books or something. We have

[Coley Barbee]:

I'm

[caite]:

some

[Coley Barbee]:

going

[caite]:

you could

[Coley Barbee]:

to

[caite]:

borrow

[Coley Barbee]:

go to bed.

[caite]:

if you need

hunter]:

There you go.

[Coley Barbee]:

Sorry.

[caite]:

them

hunter]:

Thank you so much.

[Coley Barbee]:

Yeah, thank you.

[Coley Barbee]:

Yeah, it was super fun.

[Coley Barbee]:

You know, it's really, well, and it's really hard because it feels like,

[Coley Barbee]:

you know, it's, it's kind of a boundary. Like, I honestly, I do have this

[Coley Barbee]:

collection of patients who I'm just like, I want to be their friend, but I

[Coley Barbee]:

mean, it's hard to make friends as an adult, I feel like, anyway. And then

[Coley Barbee]:

you add that extra layer in and it just gets kind of, you're like, is it

[Coley Barbee]:

weird? But like. Right? I think so too. But yeah, I get, I'm like, is it weird

[Coley Barbee]:

to, like, I don't want, it's not awkward for me, but I'm always kind of

[Coley Barbee]:

like, I don't know, like maybe many people don't want to share their medical

[Coley Barbee]:

problems with their friends. Like, where, you know, I just, I look at, maybe

[Coley Barbee]:

it makes them uncomfortable if their friend looks like, looks at their

[Coley Barbee]:

vagina, like, I don't know.

[Coley Barbee]:

And I'm just like, oh, I don't know.

[Coley Barbee]:

It honestly doesn't... I mean, all like, and I go, at first, at first I was

[Coley Barbee]:

kind of like, I was, I was in the same boat, because I needed my IUD changed.

[Coley Barbee]:

And I was like, ah, should I go all the way up to gynecology? Because that

[Coley Barbee]:

is just kind of a pain. And then I decided I was just going to have Jenny

[Coley Barbee]:

do it. Jenny's one of the PAs that works in our clinic. And so, you know,

[Coley Barbee]:

we're, we're friends and we hang out outside of work. We work together

[Coley Barbee]:

every day and I'm just like, Jenny, can you change my IUD? And she's like,

[Coley Barbee]:

sure, no problem. So that's what we did.

[Coley Barbee]:

Mm. You know, everyone's intestines look pretty much the same. Ha ha ha ha ha.

[Coley Barbee]:

Cheers.

[Coley Barbee]:

Yeah.

[Coley Barbee]:

So they actually, like right before I stopped doing OB, they actually got

[Coley Barbee]:

like the clear drapes so that you can see now. I know, and I was just like,

[Coley Barbee]:

why couldn't we do this a few years ago? I brought it up and everyone just

[Coley Barbee]:

acted like I was like insane, but.

[Coley Barbee]:

Yeah, so they got him on board. Yeah, yeah, exactly. So like, you know, you

[Coley Barbee]:

just yeah, you can see through it. It's just like clear plastic instead of,

[Coley Barbee]:

you know, normally it's like paper. You can't see. So yeah, somehow they

[Coley Barbee]:

got Yi on board. And and so that's what they do now. You can have the option

[Coley Barbee]:

of a clear plastic drape so you can see. I have another one so you can

[Coley Barbee]:

have that experience.

[Coley Barbee]:

I know, I know, right?

[Coley Barbee]:

That's really nice.

[Coley Barbee]:

That's a really nice benefit though.

[Coley Barbee]:

Hmm.

[Coley Barbee]:

Uh-huh.

[Coley Barbee]:

It looks real sad guys, real sad.

[Coley Barbee]:

Yeah. Mm-hmm.

[Coley Barbee]:

So what do I need to do to make sure it uploads? It's just going to do it automatically.

[Coley Barbee]:

Okay, so I can hang up and then just leave this open? Okay, perfect! Alright,

[Coley Barbee]:

this has been really fun guys, thank you! Yeah, good to meet you! Bye-bye!

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About the Podcast

Barnyard Language
Real talk about running farms and raising families.
Real talk about running farms and raising families. Whether your farm is a raised bed in your backyard or 10,000 acres and whether your family is in the planning stages or you've got 12 kids, we're glad you found us!

No sales, no religious conversion, no drama. Just honest talk from two mamas who know what it's like when everyone is telling you to just get all your meals delivered and do all your shopping online, but your internet is too slow and you've got cows to feed.

About your host

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Caithlin Palmer