Why Confident People Can Feel Powerless in a Medical Setting with Dara Parker
Off The Charts Podcast
Hosted by Dr. Bobby Parmar
Dara Parker: Is it me? Am I the problem? Consistently across multiple provinces in Canada—I’ve lived in Ontario and BC—I have felt intimidated and underserved by a healthcare system that just feels sexist and a little homophobic.
Dr Bobby Parmar, ND: So as a woman in this world, and seeing what’s happening in society, and bringing up even the word sexism—I think that’s very important.
Because when I say these kinds of things, I feel like there’s a lot of pushback from medical providers and the medical system at large. Because there’s something about being labeled sexist that is so offensive.
Dara Parker: I’m a fairly confident person, and I would also locate myself as very well resourced in the world. You know, I have a lot of power and mobility to navigate systems, to express myself, to assert myself. I am really anxious in a healthcare setting.
Part of my vulnerability is physical in nature. Because if you are literally naked or half naked and you have a practitioner who’s doing some kind of physical exam, I can’t think of a more vulnerable context to be in.
[Dr Bobby Parmar, ND] (0:00 - 0:08)
Hi, Off the Charts, welcome back. You know who I am. I'm introducing you to the Dara Parker.
[Dara Parker] (0:09 - 0:12)
Sure, I'll take that. I'll take the additional honorific.
[Dr Bobby Parmar, ND] (0:12 - 1:06)
It's well-deserved. Dara is one of, like, my long-term friends and she has been with me through thick and thin over the many years but also has been a, like, peanut gallery for all things happening in medicine and in society. She's one of the smartest people I've ever met in my life and I really love her perspective on things so I've invited her here.
We'll have her bio and things like that separately and later but I really wanted her here because I love talking about society and medicine and society and health in general and a lot of things about my identity as a queer person, as a brown person, as a woman come to play regularly in our conversation so I really wanted to introduce these kinds of concepts in addition to, like, talking about PCOS and talking about endometriosis, talking about hormone therapy.
So welcome, Dara Parker, to the podcast at Off the Charts.
[Dara Parker] (1:07 - 1:18)
Thank you so much. Let me translate what Bobby just said. I'm going to bring a non-technical lay perspective and a user perspective because mostly I experience the health care system as a patient.
[Dr Bobby Parmar, ND] (1:19 - 1:33)
So let's get right into it then. As a patient, what is your actual, like, experience from your perspective as a patient in our health care system as a woman specifically? Because I want to talk about, like, women's health a lot from that perspective.
[Dara Parker] (1:33 - 2:08)
My favorite subject is women and so in a nutshell, mediocre. Yeah. That sounds terrible.
I know and I have asked myself over the years because I'm now middle-aged ladies so I have many years of experience, is it me? Am I the problem? Consistently across multiple provinces in Canada, I've lived in Ontario and BC, I have felt intimidated and underserved by a health care system that just feels sexist and a little homophobic.
[Dr Bobby Parmar, ND] (2:08 - 2:16)
That is, I believe, most women's experience, if not most people's experience when they really think about it. You share that understanding?
[Dara Parker] (2:18 - 3:01)
Yeah, I know a lot of people that have been underserved and, you know, I reject the binary. I have moments of brightness. In fact, I just, I'm one of those Canadians who hasn't had a primary care provider for most of my adult life and my partner and I just found a nurse practitioner that's taking on new clients and we've had a really positive intake.
And, you know, it was pro-woman, pro-queer. I think they brought like racial literacy and it was a young brown woman who is our partner and so I think her own social location, that doesn't guarantee that kind of experience but it probably increases the odds.
[Dr Bobby Parmar, ND] (3:02 - 3:05)
Yeah, I feel you put me on to this place as well until I've had an intake there as well.
[Dara Parker] (3:05 - 3:07)
Oh, and? How was it?
[Dr Bobby Parmar, ND] (3:07 - 3:08)
I'll tell you about it later.
[Dara Parker] (3:08 - 3:10)
Okay, wow, a teaser.
[Dr Bobby Parmar, ND] (3:10 - 4:39)
So as a woman in this world and seeing what's happening in society and bringing up even the word sexism, I think that's very important because like when I say these kinds of things, I feel like there's a lot of pushback from medical providers and the medical system at large because there's something about being labeled sexist that is so offensive. Right. And both personally and then to say that the system that these providers are working in also is labelable that way kind of condemns them or condemns…
[Dara Parker]
Actors in the system?
[Dr Bobby Parmar, ND]
How do you feel about that? And like do you think, because even today, I'll tell you this, like somebody put a post and like I'm obviously on social media and a lot of what I put out there is quite direct about this kind of thing. They're like, oh, we're in a sexist system.
The reason that we got to where we are with even like menopause therapy, how did we go 25 years without providing hormone therapy to women who needed it? How did that happen? Why was it taken away?
And it's everybody sort of parses and says, oh, a study was done and the study sort of said things were bad. And so all doctors decided this is a bad thing. Estrogen is terrible.
We should just stop using it, even though the evidence suggests otherwise. And if you really looked through and understood what was happening, you'd be you'd question all of it. So my explanation is it's because we are in a sexist society and medicine is therefore sexist as a result of being part of that society.
So, of course, that's why that happened. But people don't like when I say that.
[Dara Parker] (4:40 - 4:43)
No. Why do you know? Why do you think the resistance to that idea?
[Dr Bobby Parmar, ND] (4:43 - 4:55)
Because it feels confrontational and it feels like I'm minimizing complex systems, which is weird because I'm trying to maximize it.
[Dara Parker] (4:55 - 4:56)
Yeah.
[Dr Bobby Parmar, ND] (4:56 - 5:06)
Minimizing complex systems of public health care funds and research funding and like safety and all of that down to, oh, you're blazing. It's the system. It's the system.
[Dara Parker] (5:06 - 5:48)
It is the system. That's the unfortunate answer, friends, is that I do think that is a more complex analysis translated simply. But of course, systems are us.
I think sometimes we think of systems as big, audacious, you know, complex infrastructure that exists out there in the world. That's true. But they also live within us because we create the systems like we've designed the systems.
And so there are intangible components of the system that really are rooted in our values, our beliefs. And the world is sexist. We live in a sexist world.
So the health care system is a fractal of the world at large. And therefore it is.
[Dr Bobby Parmar, ND] (5:48 - 6:26)
I told you that's the reason that she's here. This is why I just love having this kind of perspective shared because I speak to this. I love having a woman say it in the way that you were saying it because you say just better than me, I think.
And it's- you do. And I love that. I get to have other people not sort of like clap back at me for this and say, like, no, like, you're right.
That's what it is. And not sort of find ways to tear down my argument or or like try to find the sexism, because it kind of people will say that me doing that is creating more problems than trying to solve the problem.
[Dara Parker] (6:27 - 7:02)
Well, we have to understand the problem if we want to try and change it. And so let's just have a realistic conversation. And I think I get the defensiveness.
Which of us wants to be complicit in being sexist? I don't. In the same way, I don't want to be complicit in racism as a white person.
For me, there's some relief in understanding these are forces beyond individual choices I'm making. It's not “I don't like women and therefore I will act sexist in a sexist manner.” Like my embarrassing story as a lifelong raging feminist is and I have many.
I choose one embarrassing story for this podcast.
[Dr Bobby Parmar, ND] (7:02 - 7:03)
Can't wait for those.
[Dara Parker] (7:03 - 7:21)
I'm at essentially a queer women's party, my people, and making small talk with someone who talks about their shift work and why they can't maybe join this event next week because they work shifts. I was like, oh, and I knew they worked in the health care system. And my response was like, oh, are you a nurse?
And guess what, Bobby?
[Dr Bobby Parmar, ND] (7:21 - 7:22)
I already knew the problem.
[Dara Parker] (7:25 - 7:26)
They weren't a nurse.
[Dr Bobby Parmar, ND] (7:26 - 7:28)
I'm embarrassed to hear the rest of this story.
[Dara Parker] (7:28 - 8:06)
I'm embarrassed to tell this and record it forever. My point being, so, spoiler alert, she was a doctor and nurses and doctors are all important health care practitioners. However, I made an implicit assumption that I was deeply embarrassed about making because I know better.
I know women can be doctors or nurses or many other things in the health care system. But my point is, it's so deeply embedded that, you know, none of us can individually extract ourselves from the system and we get caught in different moments and we have different degrees of awareness. I have a pretty high degree of awareness and I still did that.
[Dr Bobby Parmar, ND] (8:06 - 9:22)
Yeah, I say the same thing, too. I'm sexist. How could I not be?
I'm born out of a… I'm the product of a sexist society. The things that I'm saying to my patients, my female patients, I need to be checking in with myself regularly about like, and I do this. That's why I speak to you and I speak to other women and other queer people and others all the time to try to understand, do I have it right in the way that I'm speaking?
Are my intake forms correct in the way that I'm writing or the way I'm delivering? And it's never going to be perfect ever. But the idea for me is I should probably be checking in with myself and other people to understand if I'm on the right path and having the conversations, because there's no way I escape sexism.
There's no way I escape racism. So I will be actively making without knowing about it, actively saying and making decisions that are rooted in. I mean, we just had this conversation earlier with a group of doctors about.
So there's an understanding there, I don't know if you know this, but. In gynecology, there's an understanding and it's old, but it still pervades that women gynecologically at the level of the cervix do not feel pain.
[Dara Parker] (9:24 - 9:24)
Cool.
[Dr Bobby Parmar, ND] (9:25 - 9:25)
Yeah.
[Dara Parker] (9:25 - 9:27)
That they don't feel pain. Scientific.
[Dr Bobby Parmar, ND] (9:27 - 9:29)
Yeah. So we don't offer.
[Dara Parker] (9:29 - 9:31)
Did we test this on men to get to this conclusion?
[Dr Bobby Parmar, ND] (9:32 - 9:34)
I guess the answer to that. No.
[Dara Parker] (9:35 - 9:40)
No, I feel like maybe the data set was men and they're like, look, men feel no pain in their cervix. Done.
[Dr Bobby Parmar, ND] (9:42 - 10:15)
The craziness of how the smartest human beings on the planet, the people who had to go through rigorous, like critical thinking analysis, examination after examination, they go through that process. I love doctors. They're the best people in the world in terms of saving people's lives.
But they go through this whole process at the end of it. Practicing for five, 10 years are like, we don't need to offer pain medication for women because they don't actually experience pain when you insert a foreign object into their uterus through their cervix opening. They don't feel that.
And so we don't offer it.
[Dara Parker] (10:16 - 10:17)
Well, that's good news to women.
[Dr Bobby Parmar, ND] (10:17 - 11:06)
And now we know. We always knew this, but the fact that we had to study this to like, know this, know this, that there's loads of nerve endings in the cervix. Of course you feel pain there.
Of course that makes sense. So we should be offering trauma informed pain management to these people when we're inserting foreign objects into their bodies. But that hasn't.
How, where, how did that get missed? So of course we're products of that society because we're still making decisions that are based off of that sexism that exists. And, and yet we're, we have to like analyze all the things that we're doing from that lens at the beginning of the day, at the end of the day, to be like, could that be a problematic thing that I'm doing?
To even ask the question, I think. But we don't ask ourselves the questions enough.
[Dara Parker] (11:08 - 11:14)
Do you think healthcare practitioners center humility in their practice?
[Dr Bobby Parmar, ND] (11:14 - 11:14)
No.
[Dara Parker] (11:16 - 11:48)
Because I think this is true for many professions and this is outside of mine, but I think that's a key to unlocking, knowing what you don't know. And the more I learn about medicine, the more it feels like a combination of science and witchcraft, just getting art, that there are a lot of unknowns. But truly, I think it's a combination of art and science and there are many unknowns.
And so if that is true as a baseline, then entering the practice with some humility feels like a core characteristic of practicing good medicine.
[Dr Bobby Parmar, ND] (11:49 - 11:56)
What are the cliches that are based in reality about doctors? They have God complexes. Do you hear that often?
[Dara Parker] (11:57 - 12:05)
I have experienced a level of certainty and superiority within the healthcare system that troubles me. That's my more diplomatic way of saying it.
[Dr Bobby Parmar, ND] (12:05 - 13:17)
Yeah. Me as well, from my perspective, knowing what I know, being like pretty aggressive with my approach to things when I feel like there's an injustice happening to me, to show up in a medical setting and then also be gaslit, knowing that I'm being gaslit about something. And then I'm like the rage that I have, but I'm unable to find a way to get that provider who's on the other end, who's the one lighting the match, for them to see that that's happening.
Because there's this power dynamic. And that's as a man, fine. It's a brown person and all that goes with it.
And queer person, all that goes with it. Like, it's hard for me to break through that with that person because there's an ego. There is a ready defensiveness and a boundariness against what I'm about to approach that person with.
And it feels confrontational when it's not. So I think there's a setup. It's a setup for it all to sort of be like, how is there going to be humility if there's already this feeling that something is going to be critical of that person?
[Dara Parker] (13:18 - 13:33)
Yeah. And I do. I have tried to put myself in the doctor's shoes and I have some empathy for in the age of information and misinformation on the internet, a patient coming in being like, well, I googled this and I think this is my diagnosis.
[Dr Bobby Parmar, ND] (13:33 - 13:34)
No, it's chatqueening everything.
[Dara Parker] (13:35 - 14:24)
Chat is my best friend. But I get that. Like, I get some hesitation if I've, you know, if you come into my office and something I've worked in for 25 years, and you googled it and feel like we're equals.
Okay, I have some hesitancy. And we have to start from where you started that the entire system was constructed on a sexist and racist and homophobic infrastructure. And so let's be open to that.
And, you know, it's not either or. It's not good or bad. We have to, for me as a patient who's had mediocre experiences in the healthcare system, I am sensitive to, this is not my area of expertise, but I'm looking for a doctor who wants to partner with me, share their expertise and not, you know, drop the God complex at the door.
[Dr Bobby Parmar, ND] (14:25 - 14:37)
Do you think that the medical system is able to escape the constructs that are flawed in society as a separate thing? Or does society have to be the change?
[Dara Parker] (14:37 - 15:42)
What's the order of operations? No, it's at both ends. I mean, change in complex systems is nonlinear.
And so you're tackling it from all different places. And there are bright spots in the healthcare system. She looked at me when she said bright spot.
I think so. Not only, I mean, you're my friend first, but also sometimes my naturopath. And it's been a refreshingly positive experience.
You know, I feel like I can walk into the space and there is a degree of trust that I won't be dismissed or intimidated or assumptions won't be made. You know, that's very frustrating. And, you know, there are other bright spots.
So I think change happens in all different kinds of ways. And it's individuals and it's policy advocates and it's the meta conversation and it's funding pathways. You just fund women's health.
If we want to get quantitative about it, the research dollar is going to understand women's health issues compared to men's health issues are wildly disproportionate. So there's lots of ways that change needs to happen.
[Dr Bobby Parmar, ND] (15:42 - 15:59)
It's amazing how some studies, there's one recently where it was a study on understanding men's perspectives on things. And I think it was a very expensive study. Men's perspectives on what happens to women in health care.
And it was like, wait, why?
[Dara Parker] (15:59 - 16:00)
Why? Who funded this?
[Dr Bobby Parmar, ND] (16:01 - 16:09)
Why do we want to know this? It made the news. It was just like, why do we spend money on understanding or caring what men thought about what's happening to women in health care?
[Dara Parker] (16:09 - 16:11)
Maybe because they have so much influence on the system?
[Dr Bobby Parmar, ND] (16:11 - 16:13)
Probably. It was probably some curiosity.
[Dara Parker] (16:13 - 16:16)
I mean, I'm not immediately dismissive, but I'm still like curious.
[Dr Bobby Parmar, ND] (16:17 - 16:43)
Trust me. It's worthy of being dismissed. So when we look at this for me, and also there's like this element of curiosity, like the reason I'm not dismissive and the reason I mean, there's more than that is I'm always curious as to what your life, what your experiences in this life, like we have very different experiences. I remember at the very beginning of my relationship, I'm with a wonderful Irish man.
[Dara Parker] (16:43 - 16:44)
I like that guy.
[Dr Bobby Parmar, ND] (16:44 - 17:08)
Yeah. Who's, who's white. And at the beginning of those white Irish man is a very, very white Irish man.
Hi Rob. At the very beginning of our relationship, when we were traveling, because we would go back to Ireland and we'd go to other places in addition to Ireland, I warned him of what it's going to be like to be a co-passenger with me traveling through airports.
[Dara Parker] (17:09 - 17:09)
Right.
[Dr Bobby Parmar, ND] (17:10 - 19:05)
And I was just, and he was like, what, really? And I would say that to his family and his friends. I was like, as the years will go on, you'll, you'll be witness to things that happened to me at airports.
And most people, when you say that are just like, there's no way, there's no way anything really materially differently happens to you. And then I get stopped, sent to a different area. I get, I'm randomly searched, even though nobody in front of me for the other 50 people that were there were randomly searched.
I'm the one who is literally physically stopped from leaving the airport. Yeah. After you go through customs, after you go through security, after you've left, you've, you're about to leave the airport.
And somebody who works at the airport, a security person just goes, where do you think you're going? And it's, they get to witness that then. They're just like, what?
No, this person's with me. Okay. Carry on then.
The permission that needs to be had for, for that person, that security officer to know that I'm safe because I'm in proximity to a white person. And they just don't realize. So I live that and I know that.
And then other people get to then see that. And so there's no way I'm going to make any prejudgments about somebody else's experience in this world, about what they felt and how their day goes. And when they say that happened to me, or it's because I'm a woman, it's because I'm Black, it's because I'm here.
I'm like, I'll believe you first. I'm not going to not believe you first. I'll believe you first.
And then hear it from that angle. Be like, yes, that makes sense that there was sexism that happened to you because we're sexist. Yes, racism happened to you because we're racist.
Tell me your story. And then we get to come from that place first, rather than convince me that that happened to you because, because you're a woman.
[Dara Parker] (19:06 - 20:21)
I mean, that's powerful. In my experience, even having lived experience of discrimination in its various forms doesn't naturally translate to believing all other types of discrimination. So I'm glad that's been an entry point for you.
I think I had to do more work personally to understand experiences that weren't my own. I've been the white person in the equation at the airport. And so just acknowledging my own blind spots and shortcomings.
And I think what you're talking about is some conscious work. When your patient comes in, you start from a point of belief. There's so much unconscious bias that's already happening.
You know, you asked me, you started this by asking me about my experiences as a woman in health care. And, you know, if I'm seeing a new health care practitioner, I'm aging. So this question is dropping off.
But I still get questions about birth control right away. And my, you know, so if I, the question is, are you on birth control? My answer is mostly been no.
And then immediately I usually get some form of a lecture on why I should be on birth control. I guess it's paired with the question, are you sexually active? Anyways.
Friends, we all know what the spoiler is here, right? My form of birth control has been lesbianism.
[Dr Bobby Parmar, ND] (20:23 - 20:25)
That's kind of birth control I know.
[Dara Parker] (20:25 - 20:50)
Yeah. So, you know, it's and of course, I'm being a little bit cheeky in the doctor's office because I'm answering your questions. And if I don't trust the practitioner and I don't know how they're going to react to my sexuality, maybe I'm making a judgment of my own about how much am I revealing, how much do I want to share, which will interrupt my ability to receive holistic health care because I'm choosing which information I'm going to share with them.
That's a simple example. I think it's happened.
[Dr Bobby Parmar, ND] (20:50 - 20:51)
That's a great example.
[Dara Parker] (20:51 - 20:55)
Oh, you've surely, this has happened to me many times.
[Dr Bobby Parmar, ND] (20:56 - 20:57)
Yeah, no, I get that it would happen.
[Dara Parker] (21:01 - 21:04)
I get that I'm more obsessed with my sex life than birth control. Okay, doctors.
[Dr Bobby Parmar, ND] (21:05 - 21:14)
What you said, though, after that was like the comfort of choosing what you want to reveal to the person that's supposed to know all things about you in that context.
[Dara Parker] (21:14 - 21:24)
No, I am always selective about what information I'm sharing in a health care office. Always. I said this to our mutual naturopath friend Zainab once and she also clutched her pearls a little bit.
[Dr Bobby Parmar, ND] (21:24 - 21:26)
Yeah, I'm like gooped a bit.
[Dara Parker] (21:26 - 21:27)
Are you?
[Dr Bobby Parmar, ND] (21:27 - 21:27)
Yeah.
[Dara Parker] (21:27 - 21:46)
No, absolutely. If I… because I haven't had a relationship where it's trusted in the long term, it's always restarting and I don't start with trust. I start with nervousness and hesitation and anxiety around being judged.
And so I selectively share information.
[Dr Bobby Parmar, ND] (21:46 - 21:54)
About judged from many things, it sounds like. Not just like you would be selective about more than one area of your life.
[Dara Parker] (21:54 - 22:19)
Yes. Yeah, absolutely. And then the other thing I'll say, because I've thought about this a lot and talked about it with my partner.
In general, I'm a fairly confident person and I would also locate myself as very well resourced in the world. You know, I have a lot of power and mobility to navigate systems, to express myself, to assert myself. I am really anxious in a health care setting.
[Dr Bobby Parmar, ND] (22:19 - 22:32)
You said that to me last time we talked and I was just like, this person is the person who was like, I won't tell you what she does for work, but it probably involves lots of like brain work and communication and technical and.
[Dara Parker] (22:32 - 22:32)
Me?
[Dr Bobby Parmar, ND] (22:32 - 22:34)
Yeah. Yeah. Brain work.
So much brain work.
[Dara Parker] (22:35 - 22:35)
Yeah.
[Dr Bobby Parmar, ND] (22:35 - 22:50)
And then she was on the show called Unfiltered. He's watching all the time. And I was like, she was like taking people doesn't.
What'd you say? Like anxiety from you sounds so foreign as like the two wouldn't match.
[Dara Parker] (22:50 - 24:03)
I mean, I'm human. I feel anxious, but I am specifically pointing out that a place I feel one of the places I feel least confident in the world is a doctor's office. And, you know, this is true for me.
I suspect it's true for other women. There is. So much baggage around our bodies, I think around human bodies in general and specifically women, just we've spent so much time disassociated from our bodies, disliking our bodies, trying to change our bodies.
And, you know, all of that is true for me to some degree. And I just don't. I'm just not comfortable there. And so I think about that and it connects to this trust and then what information I'm going to share with you as a health care practitioner.
And then, of course, we look for signals when we're in a new environment and a signal of are you on birth control? Let me give you a lecture about it is not the pathway to building trust for me. I immediately think, OK, you haven't even considered that I might be queer.
You're not asking any follow up questions. I'm not seeing any humility. And in fact, we went moral.
OK. Maybe you're not. And I haven't had a primary care practitioner for 25 years.
[Dr Bobby Parmar, ND] (24:03 - 24:56)
Like if a person like you who has all the things you described about yourself. Has these hesitations that are based in fear and insecurities around revealing something that might then get like a judgment. Yeah.
Imagine what it's like for everybody else. Like that just means this is such a tell that so many women go through this. All of the training that's done, that society just embeds into all of our brains, but then especially women's brains about how you feel about yourself, how you feel yourself with respect to other people, how you feel about taking up space in the room, taking a space in the medical office.
What is this God going to say to you if you say the wrong thing or reveal the wrong thing? Are you going to get lectured for five minutes about something that has nothing to do with you? Because there was this like complete lack of understanding of who you were in the first place.
[Dara Parker] (24:56 - 25:27)
It's just curiosity. I'm not expecting you to be an expert on me. Ask a question.
Do a quick follow up. Just express a little curiosity. And I'll also stress that part of my vulnerability is physical in nature, because if you are literally naked or half naked and you have a practitioner who is doing some kind of physical exam, I can't think of a more vulnerable context to be in.
So it is not just the emotional vulnerability. Literally, there is a physical vulnerability to the context.
[Dr Bobby Parmar, ND] (25:28 - 25:38)
Why was this new experience you just had so different from what you've had before? You speak of it in a very different way than your history with medicine.
[Dara Parker] (25:39 - 26:16)
Yeah, well, some of it was energetic, honestly, and that's hard to translate to you. But I think it was rooted in there was a queer competency, you know, so I'm describing stories where I imagine everyone does this consciously or not, but you're sort of testing, you're sharing a bit of information and seeing how they react, right? And so in an intake, I might share something about my female partner and I, and if there's like no blank, no, and just like, you know, it's a boring Tuesday morning and they're, I can tell when someone's surprised and when they're right.
So that was one indicator, like zero surprise.
[Dr Bobby Parmar, ND] (26:16 - 26:18)
Do straight people clutch their pearls?
[Dara Parker] (26:20 - 26:28)
Well, so here's maybe a different lived experience. I'm going to take a guess here is that you probably don't get read as straight very often.
[Dr Bobby Parmar, ND] (26:28 - 26:28)
Never.
[Dara Parker] (26:29 - 26:29)
I do.
[Dr Bobby Parmar, ND] (26:29 - 26:30)
Not once.
[Dara Parker] (26:30 - 26:35)
So I get lots of surprise in my life because people… if they don't have me in any context.
[Dr Bobby Parmar, ND] (26:35 - 26:39)
Sorry, correction. Women over the age of 65.
[Dara Parker] (26:39 - 26:40)
You're straight.
[Dr Bobby Parmar, ND] (26:40 - 26:40)
Yes.
[Dara Parker] (26:42 - 26:43)
Well, shout out to those ladies.
[Dr Bobby Parmar, ND] (26:43 - 26:46)
Yeah, women, grannies think I'm straight.
[Dara Parker] (26:46 - 26:49)
And I'm always just like, don't ruin the fantasy for them.
[Dr Bobby Parmar, ND] (26:49 - 27:00)
Yeah. I'm sure your granddaughter is lovely. Also, I'm almost 50.
Yeah, I'm always like, I'm 46 this year. I'm just like, thank you so much, Mary. But no, like.
[Dara Parker] (27:01 - 27:05)
So mostly you are read as a gaylord.
[Dr Bobby Parmar, ND] (27:05 - 27:06)
Yes.
[Dara Parker] (27:06 - 27:22)
And I am often not. And that means I have lots of experience gauging people's reactions to learning this information in different contexts. We're talking about health care, but it happens at work and gauging.
Well, yes, exactly.
[Dr Bobby Parmar, ND] (27:22 - 27:22)
G-A-Y.
[Dara Parker] (27:24 - 27:30)
Oh, I see what you did there. The best jokes are the ones that are explained, but I should spell more. Yes.
[Dr Bobby Parmar, ND] (27:30 - 27:34)
Sorry for mansplaining that. G-A-U-G-I-N-G actually. Yeah.
OK.
[Dara Parker] (27:35 - 28:28)
We're all on the same page. I was like, I'm missing something here. You're like, let me spell it.
So I have experienced that in doctor's offices and, you know, it just chips away at the confidence. So back to what felt good about this, there was a queer competency. My partner also saw the same practitioner separately, but felt really good about racial competency, which is important to my overall family well-being.
There was a much more consent based approach to engaging me. Are you comfortable with this? Can we do this?
I've had experiences in doctor's offices. They're like, now you're going to get undressed and I'm going to do this. Like, OK.
So it's like those are subtle shifts. I think that all contributes to the energetic. I feel like, OK, I'm in like I feel comfortable here and I feel like I can build.
[Dr Bobby Parmar, ND] (28:29 - 28:42)
And this person, because they also live in some of these worlds, like in a person of color world, they might come at it differently. Not always the case, because they also live this life from that lens, too.
[Dara Parker] (28:42 - 28:53)
Yeah, I'm connecting those dots. Again, it's not that I've had negative experiences with female doctors as a woman. So I don't think about your social location.
[Dr Bobby Parmar, ND] (28:53 - 28:57)
Oh, I've had my experience with gay professionals. Just like, are you kidding?
[Dara Parker] (28:58 - 29:12)
Yeah. So it doesn't automatically translate, but I think it increases the likelihood. And, you know, similarly, I think you could have a really positive experience with somebody who doesn't have that social location, but it takes some active unlearning.
[Dr Bobby Parmar, ND] (29:12 - 29:37)
I'm so glad you found somebody, because if you've had this history, there's vulnerability like checkpoints to be like, how vulnerable can I be with somebody who's meant to be the most vulnerable with these people so they can know us because it's our bodies and the things that happen to us and are embarrassing bits and the things that happen to us that we don't want to tell anybody else, but we should be able to feel like we can trust this person to help us figure that thing out.
I'm so glad you found that person.
[Dara Parker] (29:37 - 30:12)
Well, let's not get ahead of ourselves. It's early days, but I feel maybe it's just their name just yet. No, we can't show this.
No, I feel optimistic. And I intentionally, when the opportunity presented itself, went with a nurse practitioner because I felt like there might be a different mindset around how they approach medicine. Similarly, working with naturopaths over the last 15 years, I feel like the mindset is different.
You know, it's not so literally the system is different in that it's not a 15 minute visit or it doesn't it doesn't start with a 15 minute visit, which mainstream public health care does.
[Dr Bobby Parmar, ND] (30:12 - 30:33)
Yeah, I've been told that too, that the public system doesn't have the time because the visits are short. They have to get right to the point, like parse through everything else, nor the funding to care about sexism and racism and homophobia.
[Dara Parker] (30:33 - 30:34)
Expensive.
[Dr Bobby Parmar, ND] (30:34 - 30:55)
Yeah, it's too expensive to like spend time on those kinds of things because we're still busy saving lives, catching cancers, et cetera, et cetera. That is just like that's not realistic for how our system is built. So what do you do?
Sure, go see a private provider who's able to offer you those kinds of things, because that's not the way this works, honey.
[Dara Parker] (30:55 - 31:27)
And you're just like, OK, I guess that's a disappointing response. And I would agree with the assessment that the system is not designed to provide optimal health care, that the system is really focused on symptoms and not root causes and efficiencies and was, you know, designed by white men to serve white men. So the system is doing what it was supposed to do.
The question is, is that still the outcome that we want to achieve?
[Dr Bobby Parmar, ND] (31:27 - 31:30)
It's disappointing in itself that that was the aim from the get go.
[Dara Parker] (31:31 - 31:55)
But I think most people have a higher aspiration around not just band-aiding the solution, a very conversation, but really trying to understand, you know, what are the root causes of someone's health issue? And, you know, that takes into account social determinants of health. And how can you possibly provide holistic health care that's going to fundamentally help people if you're only looking at one type of…
[Dr Bobby Parmar, ND] (31:55 - 32:51)
That's why I mean, this isn't a horn tooting thing. It's it just makes sense that you would then not want to be part of a system that doesn't allow for you to then spend the kind of time that you would like to have in order to understand these kinds of things, to spend the kind of time like reading and learning about these biases that are going to influence the way you're going to deliver care because you are. Some years ago, I think it was 10 years ago that medical school graduates were asked in a sort of like a creative way in surveys how they would offer pain medication to different groups.
And it was understood through the analysis of these surveys that they would offer pain medication and pain management at a 50 percent less rate to black women than they were to everybody else.
[Dara Parker] (32:52 - 32:57)
This is not… I mean, there have been multiple studies on this. Black women don't feel pain.
[Dr Bobby Parmar, ND] (32:57 - 33:26)
No, which is over and over again. This is just this is literally in the last 10 years and that we know those things are true and they still reveal themselves to be true. And yet we're not really having the conversations to be like, how do we then correct that as one?
We don't have the time. Who is going to pay for it and then who's going to train on mass hundreds of thousands of providers who are already built into a bias system?
[Dara Parker] (33:27 - 33:55)
I mean, yes. And we literally have infrastructure across the country training people en masse to learn about these things. You know, some of the shifting of the system is about political will and incentive, like we're not starting from scratch in terms of how we educate the masses, you're talking about retroactively, you know, supporting practitioners in the field. I'm just making the point there is a continued pipeline of practitioners who are being framed as we speak.
[Dr Bobby Parmar, ND] (33:57 - 36:06)
Yeah, I'll say not from a pessimist perspective, but from my perspective. That it's going to be a very long, arduous uphill battle to see these changes, and that's honestly the reason why I want to sit with you here with these mics, because if even one clinician is watching this and makes a spark in their mind to be like, maybe I should like one of the things I was saying to somebody else not too long ago was. I guess at the beginning of class, if we're in a gynecology class…
[Dara Parker]
Never been there.
[Dr Bobby Parmar, ND]
But if we're in a lecture, there's 500 of us in the very first gynecology class.
They told the history of like gynecology, and in that history for five minutes, they just revealed a lot of the things that we learned were from violently, coercively using black women's bodies as experimental bodies. Without pain, when we cut into them, without pain medication, on purpose, because we want to see how much pain that we could cause. How painful is it to cut into a uterus?
How painful is it to cut into a vagina? How painful is it to remove a uterus? How painful is it to surgically treat a fistula in a body, but the bodies that are available that we can use because access to a free body that can't do anything about it is a black body.
How we learned a lot of what we know in gynecological surgery came from a handful of black women who were tortured, who were absolutely tortured. If gynecology class started with that, if we just learned the history of where some of our shit came from, and maybe like it would spark something in the class who may be the majority not black, majority not women, majority not, not, not, whatever it is, maybe their brains would just go, are you serious? Is that how we got here?
[Dara Parker] (36:07 - 37:02)
I love the idea of introducing more history. I think that's important. And the sociology of medicine, which I think is my impression, is it's undervalued.
Yes. And that's so critical. What I want to emphasize is sometimes people's reaction to this kind of information, maybe to some of the stuff you talk about on this podcast, is guilt and therefore defensiveness and therefore like shut down.
It's not helpful. And I would express caution around introducing that kind of information in a way where it fosters that guilt because that's not the point. And that is not particularly helpful.
And, you know, one of the ways I think about this in social change is to be hard on the issues and soft on the people. You know, and even in this conversation, I hear judgment from you on the doctors who don't get it and won't do anything.
[Dr Bobby Parmar, ND] (37:02 - 37:03)
Oh, I get pissed.
[Dara Parker] (37:04 - 37:04)
I get it.
[Dr Bobby Parmar, ND] (37:05 - 37:08)
Oh, it's like a great inferno.
[Dara Parker] (37:08 - 37:09)
Yes.
[Dr Bobby Parmar, ND] (37:09 - 37:09)
It's a rage.
[Dara Parker] (37:10 - 37:19)
I will offer you the invitation to consider if that helps advance your cause.
[Dr Bobby Parmar, ND] (37:19 - 37:39)
I'm not sure. And this is not an area where I will say that I have like a learned competence in communicating and delivering this. I just show up as I am and I haven't done any kind of training to try to make a change here.
I just have the conversation and fight. But I know that's probably not. I get it.
[Dara Parker] (37:39 - 38:38)
I practiced a lot of that in my 20s and 30s, and my data sample has suggested it's spectacularly unsuccessful. And I mean, it's great at, you know, feeling some rage release at the frustrations around what doesn't work in the system. If that's the goal, if the goal is more than that, you actually want to shift the conditions.
You want practitioners to bring these lenses into their practice. I honestly don't think it's right to hold individuals accountable to some degree. Yes.
I mean, we make individual choices, but we've started by acknowledging this is a system that's greater than any of us. And helping people get out of the guilt feeling bad also removes some of the paralysis or the, you know, forget it. I'm out of the shutdown.
And I really don't think so. Yeah, I've said this a few times. I don't think it's helpful to feel guilty.
It's helpful to be knowledgeable. It's helpful not to ostrich it. Is that the bird that's their head in the zoo?
It is.
[Dr Bobby Parmar, ND] (38:38 - 38:39)
We know her well.
[Dara Parker] (38:39 - 39:01)
So all of that is helpful. Sharing history is helpful, but doing it in a way that invites reflection, perspective, you know, shared accountability without moving into that paralysis, guilt, defensiveness. And I think we… many of us change makers unintentionally lead to that outcome when we get judging, when we get judging.
If you just knew, then you would act differently.
[Dr Bobby Parmar, ND] (39:02 - 39:09)
I think like. Yeah, I, I, I have the humility because we talked about that.
[Dara Parker] (39:09 - 39:10)
We talked about it.
[Dr Bobby Parmar, ND] (39:11 - 39:12)
Wait, hold on. Let me get my off…
[Dara Parker] (39:12 - 39:12)
Yeah.
[Dr Bobby Parmar, ND] (39:12 - 39:34)
Out of the sand. And I have some humility to know that there are things that I definitely need to improve on in this way so that if my goal is to try to enact some change in this, I need to deliver the message in a way that is not guilt inducing and not defensive inducing. It's just I'm so used to having the person on the other end get already defensive.
[Dara Parker] (39:35 - 39:35)
Yeah.
[Dr Bobby Parmar, ND] (39:35 - 39:49)
That it's already like a foregone conclusion that is going to be a frustrating conversation. Even the idea. Oh, you, you, you did this.
You did this years ago. You used the expression feminist forward medicine. You said in my house.
[Dara Parker] (39:49 - 39:49)
Have we trademarked that?
[Dr Bobby Parmar, ND] (39:50 - 39:50)
No.
[Dara Parker] (39:50 - 39:51)
Oh, we should.
[Dr Bobby Parmar, ND] (39:52 - 40:13)
It's a feminist forward medicine. And she said those. And I said, oh, my God, I love the way that it's my brain.
And I got it. I was just like, yes, I want to consider myself a feminist forward. Not meaning that I'm like exactly right as what I'm doing right now.
It's just that I would like to be.
[Dara Parker] (40:13 - 40:14)
Yeah. An intention, a commitment.
[Dr Bobby Parmar, ND] (40:14 - 40:23)
Yeah. Yeah. And I've had that in my brain on any post I'm writing about.
I say feminist forward and I don't credit you. Saki. Understood.
[Dara Parker] (40:24 - 40:29)
Royalties we slow down the podcast and just freeze here and here.
[Dr Bobby Parmar, ND] (40:29 - 40:38)
Oh, what a great episode. Everybody catch you later. The.
But when I say feminist forward to other people, there's this like.
[Dara Parker] (40:39 - 40:41)
Well, it's one of those polarizing words.
[Dr Bobby Parmar, ND] (40:41 - 40:41)
Yeah.
[Dara Parker] (40:41 - 41:04)
So you love it. I love it. I love the word feminist.
I am strategic about when I use it. If I think it's going to be an impediment to the conversation, I don't use… I don't lead with it. Not because I'm afraid of it.
Not because I reject it. I actually love the word. And often it is the right word.
But I am more interested most of the time in trying to have an engaged conversation. And there's lots of trigger words that shut people down.
[Dr Bobby Parmar, ND] (41:04 - 41:05)
Right.
[Dara Parker] (41:05 - 41:07)
And that's one of them. Feminist is one of them.
[Dr Bobby Parmar, ND] (41:07 - 41:21)
Yeah. I've learned that. Yeah.
It's just the moment I say that word, there is a kind of. Fear that like penetrates the space that it's they're going to judge that it's going to go somewhere uncomfortable.
[Dara Parker] (41:22 - 41:22)
Yes.
[Dr Bobby Parmar, ND] (41:22 - 41:27)
And that the person who used that word is in some way going to come for them.
[Dara Parker] (41:27 - 41:28)
Yeah.
[Dr Bobby Parmar, ND] (41:28 - 41:41)
Because you and it's I'm just it's shocking. It's actually shocking every time. I'm just like so that it's revealing a lot about you, actually, who had that reaction to me.
And my instinct is to be like, oh, let's figure out where this goes.
[Dara Parker] (41:42 - 41:50)
But I mean, I really… this is a really rich conversation, as I anticipated. And I think the opportunity here is to reflect on what are you trying to do in that?
[Dr Bobby Parmar, ND] (41:50 - 41:51)
Change their minds.
[Dara Parker] (41:52 - 42:19)
Then I would broaden your vocabulary. I would find different on-ramps into the conversation to get at the same point. And I just, you know, white supremacy.
So a trigger word, you know, privilege. Don't I know it's privilege even just using the word privilege, total trigger word. So there's lots of language that I scrubbed from my vocabulary, not exclusively, but in a lot of context, because it's just not helpful.
[Dr Bobby Parmar, ND] (42:20 - 42:29)
The word privilege makes people already think that you are going to devalue the struggles they've had in their lives.
[Dara Parker] (42:29 - 42:30)
Hundred percent.
[Dr Bobby Parmar, ND] (42:30 - 42:33)
Automatically. And I've learned that. No, I've actually.
So I've learned that.
[Dara Parker] (42:33 - 42:35)
Yeah. So it might be in that same can.
[Dr Bobby Parmar, ND] (42:36 - 42:49)
The moment you say privilege and I try not to say it anymore because it automatically makes you don't know what I've been through. And you're just like, well, that was all that was about. And I would love to have a conversation with you about how that's not what it's about.
[Dara Parker] (42:49 - 42:53)
But then I'm just like, well, we are changing this into the Bobby and Dara Podcast, are we?
[Dr Bobby Parmar, ND] (42:54 - 43:32)
No, Unfiltered 2026. Speaking of Parker, you have parking that's up. So, wow.
So you did there. So we're going to cut it here because it's already been a lovely hour. But thank you so much for joining us.
And I think this is going to be very exciting for people to sort of hear this kind of thing on a medical podcast where we talk about more than just like, oh, what do we give for this? I really want to give out more than that. And that's why it was so important for me to have you here.
And so thank you so much, because it was already more than I could have ever hoped for.
[Dara Parker] (43:32 - 43:36)
I love what you're doing. And it's always a treat to be in conversation with you. Thanks.
[Dr Bobby Parmar, ND] (43:36 - 43:37)
I'm back.
[Dara Parker] (43:37 - 43:38)
Bye, everybody. Bye.
Disclaimer: This transcript may contain errors, omissions, or inaccuracies. It should not be considered a verbatim record of the conversation. For context or clarification, please refer to the original audio or video recording.
