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new jersey business [music playing] [music playing] >>welcome to caucus new jersey i'm steve adubato you know women often put the healthcare needs of their family before their own. so what are the consequences of all this? here in the studio to discuss the steps that women can take to lead a healthier life we have joy cohen who is a patient at the women's primary care and wellness center doctor nermin lazarus who is the lead physician at virtua's women's primary care and wellness center doctor glenn gero has been with us before is a naturopathic doctor marjorie nolan cohn is a registered dietician with us before as well thank you all for joining us and talking about women's health. is it true that women often put their healthcare needs way in the

back beyond everyone elses? >>yes very true and that's why we came up with our practice women take care of their children their husbands their homes their aging parents and they always put themselves last >>because? >>because we're nurturing by nature. we take care of others and we don't think about our own issues and we try to take care of everybody else so that they succeed in life and we forget about our own needs >>but when that happens bad things happen for women right? >>absolutely i call it women's syndrome >>women's syndrome? >>i call it women's syndrome and 70 percent of my practice are women and women are always putting themselves last they're taking care of everybody and they really have to carve out some space of their own so it's really important that they take care of themselves first because the most selfless thing that they can do is to take care of themselves because they can't take care of anybody else unless they're well >>you know i introduce you as a naturopathic doctor actually

at the holistic naturopathic center. describe for folks on what a naturopathic doctor is. because i am not convinced most people watching know that. >>well you're probably right a naturopathic doctor does virtually everything that a family doctor would do a medical doctor but instead of employing pharmaceutical drugs and reccommending a surgery we'll try to employ natural therapies lifestyle measures that are gonna get people well >>give us a for instance >>um i'll give you an example today i had a woman that had severe rheumatoid arthritis a woman that was 30 years old in severe pain she came to see me originally three weeks ago she was on multiple medications was not getting well she wanted to die >>at 30 years of age? >>at 30 years of age she had nothing to live for within three weeks she came for the first time in years with a sense of hope because we're able to relieve quite a bit of her pain and get her to be more

functional than she's been probably in five or six years >>through? >>through natural therapies fish oil mega three fatty acids natural antiinflammatories and a number of lifestyle measures including moderate exercise that are going to get her more functional than she would have been if she was on the drugs alone and by using the therapies that they had reccommended she was able to titrate off or reduce the number of medications that she had been on >>but you know what's interesting and we'll talk about the diet piece as well in just a second but joy what's interesting is as our producers put the material together about all of the wonderful things that i heard is that you told our producers you were very quote doctor phobic >>it's true >>what did that mean? and then you said when you met doctor lazarus things changed what did you mean you're doctor phobic? >>well i think that you're nervous about what you're going to hear and you need

somebody to comfort you as well as bring you through embarassing moments and having somebody that you can identify with and talk with and feel comfortable as a woman particularly to get past a certain age it's very comforting it's helpful >>what were you afraid of? >>bad news [laughter] >>so what would you do? just i heard that you said alright when i had a headache you have kids right? >>i do grown kids >>okay so you had a headache and you said well if i'm wrong push back cause i heard you can push back too >>[laughter] >>so if you had a headache you said if i have the headache next week maybe i'll do something about it >>maybe i'll go maybe i won't >>[laughter] >>yeah maybe i'll go see somebody maybe i won't like it's just we as women we you know when i get everything else done i'll make that call so you need a doctor or a facility that like reminds you know you are due for something and it's much harder to put it off >>what happened when you met? >>um there was a chemistry and i got

>>with doctor lazarus? >>with doctor lazarus and i could kind of be myself and show that i was terrified of being there and she was going to bring me down a notch to make fun of me >>[laughter] >>in a very nice way [laughter] >>[laughter] >>[laughter] >>oh is that what you got? >>well that's what maybe she's in therapy >>how much of it is a human connection? >i think it's a great part of it i think that any woman would agree that if... >>is that right? >>absolutely. absolutely. >>what did that do for you? >>it calmed my nerves. it made me ask questions i might never have asked before. it made me seek some help especially you know things that you might find embarassing like i suffer from some depression and you hate to admit that because it's like a sense of failure and >>which it's not? >>well it... i have grown enough through doctor lazarus tutelage to find that it's not >but at the time you're thinking >>oh i think i am you know this is the way everybody feels and but there's things you can do about it and she helped me a lot with that and the practice in general was >>and you're healthier now? >>i am. and happier.

>>that's so interesting >>and happier >>what did you do for her? >>one of the things i tried to do with all my patients is identify with them so if i know that the're very upset over or nervous about being there i put them at ease we joke a little bit. i identify certain things and basically help them reach whatever goals that they need or whatever help that they need to get in a more personal way. at first i meet with my patients in my office to get to know who they are not just medically >>time out i heard you meet for almost an hour if not more >>we do we do >>we're unique >>what's that about? >>well just like joy said when you get to know the person they ask questions that they're more likely not to ask anybody else when they don't feel rushed when they feel that they're being heard when they're in an environment where it's accepting and they feel that they can be validated and not just oh you're a crazy woman and it's just menopause and things like that so when they're in that environment the questions that are asked have never been asked before in other types of doctor's offices. traditional doctor's offices. >>do you know that you need to make that human connection before you offer clinical advice? >>it's the most important part

of the doctor patient relationship. >>the most? >>the most >>let's talk nutrition >>well the biggest obstacle i find is a registered dietician working with women is that the conversation and the consultation is not about the woman it's about her family inevitably she comes in needing to lose weight reduce cholesterol maybe prevent diabetes and what we wind up talking about are her kids the husband the parents that she's taking care of and how do you fit in the reccommendations this is my challenge how do i help this woman become healthier through all these things that she needs to do with and for her family? and so the nutrition edication and the reccommendations are really being filtered through that work that the mom an adult woman who's taking care of everyone else needs to do for everyone else in her life first. how do you get your

healthy meals ready for your kids but you actually sit down and eat with them at the same time and so really i'm always looking at the family dynamic as a whole even though this one person is in my office >>marjorie i want to put you on the spot cause my wife jennifer we have three younger children and i see her struggle with this and she tries to do the right thing and eat right and exercise on a regular basis but i also watch when she's cooking for them she's trying to cook a different meal for herself, which is really challenging. is that the norm? >>quite often and actually that's a great point you bring up cause i talk to a lot of my moms about just that. what are healthy easy recipes for the whole family and how may you need to tweak your own to accomodate your health needs and also your children's to accomodate their taste and preferences >>is this doable? >>it's absolutely doable >>do you believe it's really

doable? >>oh i believe it's doable because i do it every day for myself and my husband who has a digestive condition and we truly need different meals and we need different seasonings and ways of preparing those meals and it's the same base ingredients. chicken, rice, potato, be it quinoa or something like that but i may have to cook in two separate pans on the stovetop and it really is literally that that major and minor of a difference. i'm having to clean one extra pan because i have two different skillets going >>you talk about producers those small differences the small changes can make a big difference? >>huge difference. it's a huge difference because then over time it adds up it's like anything else and one of the flaws that we have is trying to do too much at one time and nutrition is very complicated and there's a lot of misunderstanding and misinformation out there and as women and perfectionists and those of us

taking care of everyone else we feel like we need to do it all and we need to do it all right right away. and that's really impossible for everyone so it's these little changes that you can institute that make a big difference. >>how much of this is truly different? treating a woman versus a guy same age, same job, same i don't mean professional job >>mm hmm >>they may have different responsibilities in the home okay they usually do but just they may or may not but how much is it really different from your practice treating a woman and a man comparable income comparable professional situation comparable age truly different? >>well it is different. when i'm treating women first of all women are more attuned to the way they feel. they're they will respond... i think women will respond in ways

that men don't even realize a man will >>for instance? >>well, women are much more in tune with their bodies and i really believe that women internalize a lot of things where men will... they'll sluff things off more readily men will not seek out my counsel as readily as a woman would. women are just more sensitive to specific needs but they're also in a way very selfless where they're not... they're not putting themselves first >>hold on wait a minute there's an inherent contradiction here. a woman from your perspective may be more insightful may be more aware may sense there's something that she needs to check out but less likely to get it checked out

>>mm hmm >>mm hmm >>that makes no sense or it does make sense because the nature of women? >>it makes perfect sense >>it makes perfect sense >>it makes perfect sense? >>it makes perfect sense >>to you? >>mm hmm >>absolutely absolutely because we're great multitaskers and putter offers and trying to maneuver everybody else's live as oh it makes perfect sense >>but did you sorry for interrupting if say you had a really had a sense that there might be something going on did you really say i don't want to know? >>yup [laughter] >>[laughter] >>i've heard it >>yes >>you've heard it? >>you heard it? >>don't tell me i don't want to know >>don't tell me >>did she actually say don't tell me i don't want to know? >>verbatim >>and you said to her? >>you're gonna find out >>you're gonna find out >>and we're gonna take care of it and it'll be okay >>i heard her voice on the phone it's like... no >>[laughter] >>[laughter] >>did you hold her hand? you couldn't do that on the phone but...? >>but pretty much >>but pretty much >>absolutely >>pretty much >>you need your hand held? >>i think it's even as much as going ahead and making the appointment for me >>woah woah woah hold on time out >>[laughter] >>if we... what are you...? >>eleven? >>[laughter] >>[laughter]

>>so you needed your hand held and the appointment made? >>yes i had a cancer scare and was sort of paralyzed and >>tha'll do it >>doctor picked up the phone and called and made the appoinement for me >>yes >>necessary? >>in many cases in many cases and in not necessarily for the fear but for busy women, women who are working all the time and women are more likely to follow through whether there's a scare or not if the appointment's made for them, if they know that we're on the other side there for them whenever they need us >>so therefore what i'm hearing is that the entire healthcare model seems to you know has to change >>it's not working it's not working >>it's not working? >>correct. it's not working because patients given a phone number a five minute visit with a doctor and out the door and things don't get done they're confused they're scared and then thigns just you know spiral downhill and what we're trying to do is slow that down. take the time to listen to take care to coordinate. to follow through and follow up afterwards >>it's a woman concierge

service >>pretty much pretty much >>well women need more time women need more time with their practitioner. a man that comes to see me wants a quick fix and he wants to be ut of my office in 15 20 minutes >>just tell me doc just tell me doc tell me what i have to do and that's it >>exactly exactly but a woman i really have to nurture i have o spend the time i will spend an hour hour and a half with a female patient the first time i'm with her and i have to give her assurance that whatever i'm implementing s going to work. i've gotta give her a sense of hope. there's a sensitivity there that really needs to be nurtured. and that's basically what naturopathic medicine is all about and i applaud you doctor lazarus for taking the time because the medical model today is really broken. and medical doctors are beset by the fact that they're getting fewer reimbursements they've got to see more patients and there's and we all are limited by the 24 hour day >>mm hmm

>>so most doctors are trying to get rid of their patients within ten minutes so >>so hold on time out >>yeah >>stay on that >>so >>is this the exception? >>this is truly the exception and it's remarkable with what you're doing to spend that much time with a patient this is what patients need. this is what patients really crave especially a female patient and you should be applauded for doing that >>thank you >>are you getting pushback from some of your colleagues saying come on what are you doing? >>more jealousy [laughter] >>[laughter] >>are you serious? >>because everybody would like to spend the time that they had >>well how are you... hold on there... how are you able to do that given the healthcare model that your colleague just described reimbursement is not being what you want them to be and everyone knows what they are right? >>right >>they're not changing anytime soon they're gonna get more challenging >>right >>how are you able to do that? >>well let me tell you with the help of virtua and the system that we've created with our specialists with our nutritionists with our fitness

center we're finding outcomes make way better of a difference than reimbursement... >>talk about the outcome issue and how that's connected to federal governments reimbursement regarding outcomes? is this the is this the accountable care model? >>it's reimbursement... correct correct >>explain that to folks >>what happens is when patients take care of themselves when they have a physician that helps them when their health improves over the long term we're finding out that they cost less in the long run, the government's a little slow to find that out but they're starting to help with the accountable care and patient centered medical home to be able to reach out to patients to avoid hospitalizations readmissions frequent doctor visits and to take care of more of preventatively for instance >>so it's interesting the federal government is now saying if the outcomes are better if you don't go back to the hospital to be readmitted we will reimburse you, you'll reap some of those benefits but it's a long term committment? >>correct >>can you give some quick tips to some women and others particularly women watching right now saying hey i'd like some breakfast tips dinner tips whatever right now that can be really helpful

to me and my family >>really utilize convenience foods. single serve portions things that you can eat on the go cheese sticks whole wheat crackers cereal and yogurt we even have a lot of companies now have these little yogurt containers that you can drink from if you're driving to work versus eating with a spoon these are products that while they're convenience foods they can also be very nutrititious foods not all fast food is bad food and so invest in them they may cost a little more but in the long run it really may be worth your time and the effort that you put out monetarily to have easy quick foods at your fingertips for both yourself as well as your family >>are you against bars? >>no not at all >>protein bars? >>i think you need to pick and choose and look at the ingredients and be conscientious and aware of what you're eating but there's a lot of really great bars out

there that are good products that i eat myself on a regular basis >>can i show you the bars on the way out of here? >>absolutely >>you tell me >>[laughter] >>cause [laughter] i just and also how many in a day um let's do this in the time we have so many women watching right now and so many women who struggle with these issues who are very concerned about the health again of those in their family will often say i'll worry about myself later on but when you do that for too long and you do that too often there are clearly medical conditions that creep up on you and if you don't take care of them they get worse. correct? >>correct >>such as? >>such as high blood pressure such as the depression such as diabetes. and when you don't take care of the very early symptoms of the very early problems or when it's very easily treatable the heart attacks strokes sudden cardiac death those kind of things that women would never even think to watch out for

early on and they won't be there for their kids and their parents or their husbands to take care of when they're not well themselves >>that's the irony >>mm hmm >>just in terms... just exercise exercise and nutrition >>mm hmm >>mm hmm >>right someone might say well that's not a medical issue but it is isn't it? >>i believe it is >>talk about it >>uh i think you need to make time for yourself. i think that the small investment in time for exercise and nutrition is probably one of the greatest paths to good health >>what have you done? >>what have i done? well funny you should ask i just cut as per my doctor i'm trying to cut sugar out of my diet >>you are trying to cut sugar? >>i am >>[laughter] >>for how long has this been going on? >>four days [laughter] >>four days? [laughter] >>[laughter] >>[laughter] >>where are you... come on >>truth it's the truth i am it's just >>what precipitated this? >>elevated blood sugar and you know other things but it was time to take a stand the doctor said better now

than later and i gave myself a challenge i'm gonna talk to you later to see if i can really make a change i'm gonna be 60 and i want to live a longer healthier life so >>wow >>yeah >>anything else you're giving up? no that's okay [laughter] >>that's enough [laughter] >>[laughter] >>[laughter] >>i'm only kidding >>that's plenty >>but you're exercising as well? am. i'm relatively good at that i like to walk and ride my bike and that's not my problem my problem is a sweet tooth >>so you do have a sweet tooth? >>i do >>hold on if you're giving up sugar i just want to clarify what that means >>[laughter] >>where is... where's the sugar found for you? >>well it's found probably you would be the expert not me i am making a conscious effort to give up the obvious sugar places. like sugar loaded things you know candy or chocolate and chocolate >>you're giving up chocolate oh see if you said sugar that's one thing you're giving up chocolate >>i'm gonna try >>okay >>she's doing great >>i'm... four days >>jump back in and then jump back in >>jump in... i need your help >>[laughter] >i think i just really wanted to point out i'm also a dietician

and a personal trainer so i do both the nutrition and the exercise and what people don't really realize in the vein of what you were saying doctor is that nutrition is the number one determiner of health in... above all else >>well not, hold on wait a minute >>yeah >>it's more important than exercise? >>exercise is number two >>nutrition is more...? >>yeah absolutely what you put into your body is gonna directly change the outcomes of how your body functions and certainly exercise is right up there but nutrition is number one >>number one? you believe that? >>both are important i had a >>go ahead >>patient that came to see me february 28th a1c of 12.8 now at 6.5... >>we don't know what that means >>now an a1c at 6.5 you're official... you officially have diabetes. right? >>mm hmm >>okay >>his a1c was 12.8 his fasting ucose was 338. i just got his... >>that means nothing good i

imagine >>it's nothing good. he had severe diabetes. he had a blood pressure of 185 over 115 >>well i do know that's not good >>i just got his numbers october 15th. his a1c is now 5.9 >>translate that >>he is... well at 6.5 you're a diabetic. the ideal number of the a1c should be somewhere below 5.7 >>right >>so he's at 5.8. he came down from 12.8 >>wow >>to 5.9 in seven months watching his diet, diet modification >>exercise too? >>and exercise >>did you put him on the exercise plan? >>i put him on the exercise program >>do you monitor it? >>i do. i do. >>so you're onto... it's not just hey get out there and go take a walk you monitor what his personal...? >>well i'm a medical exercise specialist as well so i put him on a program his brother in law is a personal trainer so i said have your brother in law contact me i will set up the exercise prescription and between your diet supplementation and your

exercise program we're going to reverse your diabetes now i can't tell people that i'm going to cure them of betes. but this is an individual that was cured of diabetes >>and you were confident that whatever prescription drug that there may or may not have been available to help this person you were convinced that these other methods would be extremely helpful >>well he never went on a medication. he had not seen before he came to see me he had not seen a medical doctor in 20 years. so to cover myself i sent him to a medical doctor >>okay >>just to monitor him he wagered with his medical doctor please let me go on doctor gero's program don't let me go on a medication for 60 days give me a 60 day trial but you're not... listen... it's not either-or, but you do have to check with your physician right? >>you have to know where you always check with your physician especially when it's severe >>absolutely >>but especially with diabetes and high blood pressure if you develop a medical homeopathic naturopathic and fitness and nutrition program you can have outcomes without medication

>>before i let you and everyone out of here and by the way you've been incredibly helpful all of you 30 seconds left someone says oh come on it's too late for me a woman says too late you say? >>it's never too late >>come on >>never too late no matter how old you are you can always get healthier than where you are at this point. always you can extend your life equality of life not just quantity and take care of people have a better life >>you really believe that? >>absolutely wholeheartedly wholeheartedly >>listen all of you have done a tremendous public service in being here and you >>[laughter] >>we'd better not find out that you've been eating chocolate we are listen, i believe in you we all believe in you... >>the preceding program has been a production of the caucus educational corporation celebrating over 25 years of broadcast excellence and thirteen for wnet njtv and whyy funding for this edition of caucus new jersey has been provided by the nea jersey education association td bank berkeley college new jersey natural gas united water md advantage

insurance company of new jersey and by actavis in cooperation with the american medicine chest challenge transportation provided by air brook limousine serving the metropolitan new york new jersey area caucus new jersey has been produced in partnership with tristar studios >>this healthcare message is brought to you by md advantage insurance company of new jersey >>choosing a new family doctor can be confusing. check with your health insurer to see which physicians near you participate with your plan find out which hospitals the doctor uses and who covers when the doctor is away. and remember to schedule an appointment with your new doctor in advance to fill out any paperwork without the added stress of being sick closed captioning provided by aciem studios

captioning sponsored by macneil/lehrer productions >> woodruff: for the first time since election day, president obama hosts leaders of congress at the white house, amid deep divisions and showdowns on the horizon. good evening, i'm judy woodruff. >> ifill: and i'm gwen ifill. also ahead this tuesday:ç we travel to ohio, to hear what buckeye voters have to say about washington dysfunction and how lawmakers can get past it. >> instead of being obstinate mr. president or mr. speaker, don't be obstinate. sit down, shut the door. we don't need cameras in there.ç sit down and find out how we can work together. >> woodruff: plus, this flu season is causing concern. why health officials are urging do