Direct Specialty Care Doctor
Dr. Becky Kaufman Lynn is the CEO and founder of Evora Women’s Health.
A southern California “valley girl”, Dr. Lynn completed her undergraduate degree in Economics and Spanish at the University of California, Berkeley. She graduated from medical school at Georgetown University in Washington, D.C., and completed her residency at Washington University in St. Louis. She also received her MBA from Saint Louis University.
She is a board certified gynecologist and a world-renowned expert in menopause and sexual health. She is a frequently invited guest speaker on women’s sexual health and appears regularly on numerous podcasts, television shows, radio shows, and in print. Known for her patient/partner education YouTube channel, and her research on the effects of cannabis on the sexual experience, she has been featured in MORE magazine, SELF magazine and Martha Stewart Living.
Dr. Lynn is an International Fellow of the International Society for the Study of Women’s Sexual Health (ISSWSH), where she serves as the advocacy chairman and a member of the Board. She is the Immediate Past President of the St. Louis Gynecologic Society and on the Advocacy Committee of the North American Menopause Society. She is also an Adjunct Associate Professor of Obstetrics and Gynecology at Saint Louis University School of Medicine.
Dan Savage Podcast with Dr. Lynn:
ARTICLES BY DR. LYNN
Resources mentioned by Dr. Lynn:
Website:Evora Women’s Health
Welcome to the podcast. Dr. Lynn, thank you. Thanks for having me. I'm so excited to be here. It's such a pleasure talking with you. I went to Creighton and so St. Louis is not too far away, so it's, it's not something to speak with you. Yeah, and I was born in Omaha. Oh my gosh. I grew up in California, so, yep.
Born in Omaha. That's awesome. We switched paths. I was born in Sacramento, went to Omaha for medical school. That's so crazy. Yeah. Thank you so much for joining us today. And I wanted to start off with. Something that I found really beautiful on your website. And one of the very first things that you read on your website is the quote, helping women find solutions to uncomfortable problems in a comfortable environment.
And I just love that because I feel like that is the type of energy and inclusion that I would love to feel as a patient. And I would love to have all of my family members be a part of. So I wanted to ask, how did you come up with this? And what does it mean to. So a lot of what I do as a gynecologist is I specialize in sexual problems in women and menopause.
That's my niche. And as you can imagine, talking about sex is really difficult for people. It's not difficult for me as a gynecologist. I can say the words, but for many women we've been taught, oh, it's shameful. You're not supposed to enjoy it. And so a lot of what I do and, and where I think. My skills are, is I feel like I can put people at ease and I'm nonjudgmental and I make people feel comfortable.
And when I sat down to do my website, I was just trying to come up with something. How do I put all of what I do and what I can provide for patients in one sentence, it's not very easy. And I have a really good friend who I run with all the time. I'm a runner, and she's listening to me talk about starting up my direct care practice.
And she really understands what I do for women. And she came up with that tagline. And when she said it, I was like, oh my gosh, that's it. That is definitely it because it just encompasses and embodies what I can do for people. And what I enjoy doing for people kudos to her and kudos to you for practicing what is behind that statement?
Before you opened Avara woman's health. What was your life like in terms of your experience as a physician that pushed you into opening your own? You know, I've been in practice for 17 years and when I started practice it, wasn't what it is today. I had spent the last oh 10, 11 years in academic medicine.
I love teaching. I love academics, but it had become so burdensome and so cumbersome, even in academics, because this is my opinion, because reimbursement goes down each year, big hospital systems need to do more, to bring in the same revenue. And so what was going on in my institution was you need to see more patients.
You need to see more patients. They took away our academic time, teaching time. They took away our research time and they said, you need to see more patients. And so I would see tons of patients during the day. I was, I did deliver babies at that time. I don't now. So I work overnight. We had to work the next day a half a day, which I'm not a good physician on no sleep.
I didn't like that either. Every other institution I had been at, they let you have the next day off, but it's all about the revenue, right? If you don't work the next day, you're not bringing in revenue. And then I did all of this. I don't even know how many hours a week that I worked. And then I would come home at night and I would have to do all my charting.
So my life was working all day, minimal sleep, charting, working on my electronic medical records at night. And it was like, this is not. You can't do this for the long term. And because there were so many, there were so many things that were going on and I don't want to say negative things about my organization, but there were a lot of things going on that need that lifestyle.
Unsustainable. And the other thing that I didn't like, there were a couple of things that happened that made me say I can't do this anymore. One in particular. So I see a lot of women with sexual pain that is not a five minute visit. You're not going to be a good doctor. If you try and uncover what's going on in five minutes.
And I remember that I saw a patient and I was in a rush because I had people waiting because you're overbooked and I left the room and I'm like, that was not good care. I didn't have the time that I needed to devote to her. And I felt so horrible about it. I emailed her later. I'm like, did we not get a chance to discuss this?
Did we not get a chance to discuss that? And I was like, It can't be done that the care that women need, and especially on embarrassing things like sexual problems or menopause, which like there's a long list of symptoms that happen to women. When they go through menopause, it can't be done in a five to seven minute visit.
And I just really wanted to practice good medicine and give patients the time that they needed and deserved. So that's why I left. It just makes me think how, when you share that part of your story, when you share that part of your history, I'm picturing none of that is what you envisioned your life would be like in medicine, in the real world, those of us who went into medicine to be caregivers as a profession and as a calling, it is so heartbreaking to hear those words and those words evoke in all of us that frustration.
That we've experienced in a system that's employed and run by insurance because it, it makes me also think that the administrators, the people who are pushing us and not standing up for us and our patients don't feel that guilt that you described when you were feeling so terrible about your care for another person because of time.
Yeah. No, they don't. They're very far removed from that. And it's all about the money for the big, I call it corporate medicine. It's not about patients and there's, yeah. It's not a system that is patient centered at all. It's not patient-centered absolutely. And I we've talked about this on the podcast before, but I want to see again, I am very glad that patients are becoming more and more aware of that, especially because of the.
Nope. Now I want to ask you about teaching, because you said that you loved the academic part of your career, and that was taken away from you little by, little as you were pushed. So when you were exploring direct patient care, direct specialty care? What did you envision in the realm of academic medicine when you decided to transition over?
I feel like there's two parts to academic medicine. One is research and one is teaching and I love them both. And I felt like our teaching time was being taken away. Our research time was taken away and I also am a big believer in. Conferences and networking. Like I consider myself a specialist, I'm a specialist in menopause and sexual medicine, Lana, a gynecologist.
And I really believe that part of calling yourself a specialist is knowing what the latest data shows, knowing what the evidence shows and truly being an expert. And you get a certain amount of CME time. And when I started my organization, we had two weeks, they took away one week, we had one week they gave you limited funds to go and you, and so I really felt I was, I remember when I found out that they were taking away CME time and I was so flustered because in general, Physicians in academic medicine make less money than in private practice in general.
But we do that because we love teaching and we love research and we love conferences and we love evidence-based medicine. So when they took away that CME, I was so upset because one of the joys that I get from practicing medicine is learning. I'm a lifelong learner is learning. What is the evidence show learning about something new learning about the latest treatments.
And, and I really was very flustered with losing that. And I also really had no flexibility within my schedule. And that was another issue I had to give them two months notice before taking any time off. Yeah. Okay. Conferences in advance when they are, but like I have two children. And so I didn't always know two months in advance when something was going to happen.
And I feel like that was really tough. And I understand why they do that because you don't want to have to reschedule so many patients, but that really got in the way of me being able to. Do the kind of networking and conferences and learning that I wanted to do. So that was another reason or how I envisioned going into practice myself is that I had control of my schedule when I wanted to do a conference.
I didn't have to ask anybody if it was okay. I just went to, that was, that was something that was really important to me. Cause like I said, I am a lifelong learner. Can you share with us some of your most treasured experiences as a teacher? Yeah, I would say I've taught a lot of medical students in my time.
And when people come back to me and say, you're the reason I went into OB GYN, or I remember that night when I was on call and you were on call and we had this great delivery like that. The most rewarding thing ever, because you feel like you just, you it's almost like we're, we've become physicians because we like to help people.
So it's almost like I helped them like get to where they wanted to be in their career. But I do love that. I love, I'm always interested to know where my medical students got their residencies. Where are they practicing? I love it when my former students or residents will like text me or email and ask me a question about a sexual problem in a woman.
I just, I love it. Super rewarding. I just, I think back on my days in residency and I think less so in medical school, but definitely in residency for me, your attendings, especially if you are in a very close knit program, they become like a big sister or big brother to you. And they really. I mean it, especially if you're lucky enough to be in a program where you feel that you are so supported and your attendings are helping advocate for you getting the best training and the best education possible.
And those experiences are absolutely life-changing. I still there's one doctor who is in his eighties and he he's a former attending who goes skiing up the hill where I am, and he stops by and we have in a non pandemic year, we would have dinner together every time he would be around here. And I just, I love that because you're really describing that the relationship that you have because of your passion for teaching others and because of your passion for being involved in moving other people's careers forward.
So I just really love that. And again, it just, it makes me feel the same feeling as when I read that statement on your website, it was so how did you learn about drug specialty? So I actually really didn't know much about direct specialty care. I knew nothing about DPC. And I knew though that people in my specialty, especially in sexual medicine, there are a couple of very smart, very successful, very well known physicians.
And on the coast, I'm in Missouri and I knew they didn't take insurance. And I always thought, oh, I can't do that. No one's going to pay like they don't. But with all that was going on, I was like, other people are doing it. Other people are not taking insurance. So I started looking into it. I started talking about it and the, what does, she's like one of the marketing people at my organization, my prior organization she's oh, Dr.
Lou just left and she opened a direct primary care practice. And I didn't know anything about direct primary care. So I called her, I emailed her, something got in touch. She told me all about it. She left my same organization about six months before I did. And she's the one that introduced me to the DPC Facebook group, which has just been a godsend of wonderful information.
So I guess that the answer is that I really didn't know about DPC, but I knew that there were gynecologists who were not taking insurance. And so I knew it was possible, but then I found out about DPC later and I'm so glad I did. That's awesome. It makes me think about my conversation with Dr. Katherine Agricola, who said DPC found me.
And so I really love that, that you, as a specialist, Heard about this movement and are actively a part of it. That's wonderful. And I want to say like for I'm sure your guests have said this over and over again, but like DPC cut out the middleman. There's so much cost savings. If you just go directly between you and your physician and you don't end up with those same time constraints or nobody calling you back for three days, because they're so busy, there's so many benefits to the patient to being a part of DPC or direct specialty care.
There's just so many. And with you mentioning how part of your academic career has been in research and just being interested in research and ever-changing medicine. I want to ask, how do you keep up on things now with your practice? Not necessarily always being in an academic center. Yeah, I still keep really close ties to academics.
I still take medical students, but I still work really closely with some of my former partners whom I love by the way. So my organization has a pelvic pain center and I still, we send patients back and forth between us because they do, they have a MIGS program with minimally invasive gynecologic surgery for endometriosis.
And then I deal with the painful sex due to endometriosis. I'm also a sexual counselor, so I can talk about the relationship and work on that aspect, but we go back and forth. And before the pandemic I was going to grant. Which I love, but then the pandemic hit. And so I stopped going to grand rounds and then they started them up again, like in the fall I went to one or two and then they went away or went just virtual.
So I do try and maintain ties to academics. And I love doing that. And I had just wrote a paper with one of my former residents. Who's now an attending at my former organization and we wrote it on what we know about cannabis and pelvic pain. So it was super fascinating and it just got accepted for publication.
So I do try and maintain those ties. And even just today, I had a patient I'm not a Euro gynecologist, I'm a general gynecologist and she had some major bladder issues. So I'm just texting my friends, my former partners. And they're like, okay, we'll try this. So there's still that exchange of information that allows both of us to learn wonderful.
Hopefully. Those words can provide some reassurance to people who are also in academia or heavily involved in academic medicine. That could be and stepping away from that or doing less of that could be potentially something that's scary for them. So I hope those words help inspire others to say it. It can be scary, but this is one way that I'm dealing with it.
I think the scariest thing about stepping away really is starting a new business from scratch. That is the scariest part, right? Like you go from being a salaried employed physician with health insurance to being, you have no income when you start. And like you might, if you were the person who provided health insurance for your family, you may not have health insurance after Cobra ends.
But I think that is the scariest thing for, it was for me leaving, walking away and going, I'm not going to have a paycheck in two weeks here a month. I'm not going to be getting that paycheck. That's, it's scary if you're supporting your family, the point that you made the decision to open up a Varroa women's health.
What was your financial status in terms of, did you have loans to worry about when you decided to open up your, I did not. So I, when I got out of residency, I went, I left St. Louis. I went to Jefferson city where I'm, the salaries were much higher because it was hard to get physicians to go just cities, pretty rural.
And I was so lucky in that I paid off my medical school loans and my husband's law school loans before I went into academics. So I did private practice paid off loans. Then I went into academics and I took a pay cut to do that, but I loved it. I'm not sorry I did that at all. So, no, I feel fortunate in that when I left, I didn't have burdensome huge amounts of debt at all.
So that's very helpful. And as a specialist, just thinking about family medicine, residency versus somebody who's in specialty medicine. I know that the training can definitely be longer in terms