RX Podcast_DrBridgetWilliams: Audio automatically transcribed by Sonix

RX Podcast_DrBridgetWilliams: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

John Shufeldt:
Hello everybody and welcome to another edition of Entrepreneur Rx, where we help healthcare professionals own their future.

John Shufeldt:
Hello everybody, welcome back to Entrepreneur Rx. This week we welcome Dr. Bridget Williams, she's the owner of Green Harvest Health, a medical cannabis company and life coaching clinic. She's a leader in educating physicians and professionals and patients regarding the benefits of cannabis and CBD and also demystifying the misconceptions. Bridget, welcome to the podcast.

Bridget Williams:
Thank you. I appreciate you having me come on today.

John Shufeldt:
My pleasure. As I mentioned to you, I have zero experience in this, so I'm going to be literally all ears. How did you get into cannabinoid medicine?

Bridget Williams:
Yes. So I have a 20 years experience at the Cleveland Clinic and probably a little bit too early on, I started getting a little frustrated with traditional medicine. So Family Doctor, Board-certified, you know, you're on that 15-minute clock, every time there's a diagnosis, there's a pill, you don't like the pill, add another you've got side effects and one more. And I felt a little frustrated. I felt like I knew more and I could do more. And I felt that my patients were frustrated as well. And so I started actually kind of long story-short, helping patients get off of their medications by really digging into life change. And one of those patients mentioned cannabis as a way to kind of help with their symptoms. She was just cleared from breast cancer, just diagnosed diabetic, and her teenage daughter was diagnosed bipolar, so she was very stressed, very overwhelmed, and I'm a Reagan kid. So when she mentioned cannabis, I took a step back or two, right? Nancy taught me well, but it was a time, this was about 15 years ago or more, so it was a time when I had a lot of patients and were talking about homeopathic approaches to medicine. I would always look it up and give them my medical opinion. I looked up cannabis, I thought it was going to be kind of a joke and it was. I was blown away by the information that was even available 15 years ago, and I followed her, decided to follow her and her journey was reading feverishly as she was using cannabis for her symptoms and she, her blood sugars were normalizing, she was actually losing weight, sleeping better, stress was better, and was more productive with work in her family, and that really got me intrigued. So then fast forward when medical cannabis became legal in Ohio, I wanted to take a part, so I got certified, got offered a job with a clinic that said, we don't really care what you know, we just do cards. And so I wanted to take a leap and I became certified as a cannabis educator as well as a life coach because that was a big part, I didn't even know what life coaching was originally, but that approach to helping people was a big part of what made me successful years ago, and here I am!

John Shufeldt:
So that is amazing, okay, so let's back up. So you, when did you go to medical school and where

Bridget Williams:
I went to college in Human Medicine, Michigan State University, and I graduated 2001.

John Shufeldt:
And then did a family medicine residency.

Bridget Williams:
Cleveland Clinic.

John Shufeldt:
And then did you? Did you have experience with cannabis before? Like when you're in college and medical school?

Bridget Williams:
No, I'm, I guess I want to say, like a lot of people in medicine, but that's not necessarily true, but I had zero experience. I, growing up my best friend's cousin who was a little bit older, was very scary to me and smelled of cannabis all the time. And so neither one of us ever thought about it, tried it, even considered it. I found out years later she was self-medicating for bipolar disorder, and she was actually brilliant in how she was coping. But of course, as a kid, I did not understand that, so I was terrified of it.

John Shufeldt:
Yeah, it's so funny. I told this story before our one time I was playing basketball with my neighbors when I was 16 and their older friend came over, put me in a headlock and held what he said was a joint up to my lips. And they're like struggling and fighting and not inhaling, it's like Bill Clinton and not inhaling, funniest part of the whole thing, his last name was Roach, and I didn't know, I didn't even make the connection at a time, how ironic it was that some guy named Roach is forcing me or trying to smoke pot. And then when I was in college, I was an RA and a hall director, and I never did. And so I've really been, you know, now not as old as Moses and I still haven't. But there's clearly a group of people out there that really benefit from marijuana, and I, like I said, don't have any background in it. So did you ever think looking back and connecting the dots backwards that this is where you would end up?

Bridget Williams:
Not at all. I, I could foresee maybe doing, you know, I have a B.S. in psychology from the University of Michigan. I was always interested in coaching and counseling as it evolved over time, so I could have seen me approaching medicine and a different manner. But never in a million million years did I think I would incorporate cannabis.

John Shufeldt:
So you do physician coaching as well, right?

Bridget Williams:
Yes. So that's actually most of my coaching practice is helping physicians that, kind of, lost their way, lost their confidence and helping them kind of get back on the right track. So most of my coaching practice is that though I do what I consider medical motivational coaching where I work with patients to kind of help them get beyond their diagnosis. But my training from the Physician Coaching Institute is really about helping other healthcare workers kind of get it together again.

John Shufeldt:
And when did you take this, as somebody took this entrepreneurial leap at the Cleveland Clinic forever, and all of a sudden you're like, ..., I have seen enough, I'm gonna do something else. What made you take that leap?

Bridget Williams:
I think there was a, I really thrive in being creative, and I think that's always been a part of who I was. And so I was always looking for ways to make even medicine more interesting for my patients. And so long before any of this happened, I actually owned a small business, difficult to run when you are working full-time for the clinic. But I was making custom party hats for, that were puppets and I had a manufacturer and I was very, very busy and was winning awards and all of that. And so I always had this entrepreneurial spirit. I took a step back because it really got so busy, I had to decide between medicine and party hats, and I chose medicine. But that was always a part of something that really was exciting to me. And so when this kind of evolution of my career happened, the idea of adding my entrepreneurial interest to medicine was a perfect match.

John Shufeldt:
That is really amazing. And then because of that one patient and the benefits she had with it, that was your impetus to say, okay, I need to learn more about this.

Bridget Williams:
Yes, absolutely.

John Shufeldt:
Wild. And in your physician coaching now, do you, do you coach physicians say, hey, you know you're suffering from x, y, z? Maybe you should try an edible, maybe this would help you.

Bridget Williams:
Hmm. Never, early, I mean, I don't I shouldn't say never. But to be honest, they're so separate that many times my physician clients probably are unaware or ultimately aware that I have a medical cannabis practice, and so they, no, it doesn't really come up. No, I'm not against saying that, but it's just hasn't ever really come up.

John Shufeldt:
You know, when I learned all about you, I'm like, this one is really cool, I got to talk to her. I was, that's why, that's what prompted the question. I'm trying to figure out how those two things that are said is like, I'm not sure I'd want to counsel physicians to start using marijuana.

Bridget Williams:
No, no.

John Shufeldt:
Because I think this is such a potential risk for providers, even if they have a medical marijuana card to do, I mean, if they're, you know, alcohol's easy. If you have alcohol in your system, something goes wrong and they test you, you're kind of stuck, with marijuana, stays in your system for quite a while, right? And so I wonder how that plays out, because how do you prove you are? How do you prove you're not?

Bridget Williams:
Intoxicated at the time.

John Shufeldt:
Correct!

Bridget Williams:
Absolutely. So that is a problem. And obviously, there's a lot more work that needs to be done in that area because not only is this an issue in the medical field, I have, I have a small amount of physicians that have cards that have come to me, I have a large group of nurses that have cards that have come to me, right? So this is in the medical field. We need to have better testing because the fact, we need to look for another metabolite, we need to approach this in a different way. Because just because you test positive for THC metabolite does not make you intoxicated at the time of the testing, right? So and I'm not anti, obviously, I'm not anti-cannabis, but it just really hasn't been a focus of what I do with my physician coaching.

John Shufeldt:
Yeah, no, I get that. I've always just wondered, you know, in Arizona, marijuana's legal as well. I've got a friend of mine who was one of my partners, his wife owns a big cannabis processing plant and the dispensary, and I've always had this, you know, I've had people approach me and asked me if I wanted to invest, and I've always kind of stated, I've always really stayed away from it because again, I don't understand it as much, but I've always kind of wondered about this juxtaposition of healthcare workers who use marijuana and then it shows up in their system, if they have a bad patient outcome, how are they going to disprove that it was related to their impairment if they have any from cannabis .... cancer?

Bridget Williams:
And the problem is, is that we're still looking at this, obviously as a scheduled drug, right? And the fact of the matter is, is that it can do so much, give so many benefits to people. It is no different than any other substance that you use to help a condition. The one thing I think people are unaware of is that you can very easily use cannabis and never experience a euphoric high. There's ways to balance out your CBD and THC, and a great majority of my patient population are trying to avoid the high. They don't want the high, they just want the benefits of the plan, right? And so we need, as I feel, sometimes almost even embarrassed that as a medical community, we haven't kind of stood behind this and realize that this is a better option than your Percocet or oxycodone, that it can give better some results for anxiety than a lot of the antidepressants and less addictive than your benzodiazepines, and it's a safer alternative and it's effective, right? And so we're always saying that we're waiting for more double-blind, randomized testing, but we need to be smarter and really stand up for our patients as well as for ourselves, for that matter, right? Responsible use is always important, and I really advocate for that. But right now, we are making choices that don't necessarily lead to responsible decisions as far as healthcare for ourselves, as well as for our patients.

John Shufeldt:
Totally. And I just, you can tell by looking at my, I just walked out of the emergency department and you know, the benzodiazepine and opiate is rampant and diagnosed all the other drugs. So it certainly can't be any worse than what we've been prescribing for years and certainly less addictive. When someone comes down and they say, so is marijuana in Ohio legal or is it only with a medical card? Is it legal?

Bridget Williams:
Oh, it's only medical. You have to have a card.

John Shufeldt:
So when someone comes in and says, look, I think I want a card, what sort of conditions or complaints are you given a card for? Like what's the boundary?

Bridget Williams:
Absolutely. So we have a little over 21-22 conditions that we're able to provide a card for, and in Ohio, they have to have medical documentation of some sort, right? Some states you can simply state the condition and that is enough to get a card. But you do have to have medical documentation here and the conditions range, you know, chronic pain is going to be number one, PTSD and fibromyalgia, those are the top three. Then after that, we're looking at obviously cancer, hepatitis, sickle cell, inflammatory bowel disease, I don't know if I said Trek's, AIDS, cancer, there's a number of conditions that apply that people can benefit from.

John Shufeldt:
Interesting. And then when you start someone on today, so I want to smoke this or I want an edible or I want to do both, how is it prescribed?

Bridget Williams:
Right, so we don't officially have prescriptions, but yet we give recommendations. Many of the physicians stay clear of it completely because they just haven't invested in the cannabis or cannabinoid medicine education. Smoking is also prohibited in the state of Ohio, so we, they don't want to combust anything because that combustion leads to a release of carcinogens, so they actually recommend vaping of flower or even cartridges, which really allows you to get the flower to a boiling point that releases the cannabinoids, right? So smoking is not something that we discuss, but typically I look at what their conditions are, and then I create a treatment plan that I think will address that, meaning the type of modality that they want to use, meaning edibles are great for bedtime and sleep because they last for six to eight hours, a vaping is great for someone that has migraines because it is kind of an abortive treatment, and I'm always very focused on cannabidiol, and that is really the cornerstone of cannabinoid medicine and that making sure that it fits in there some way because that's what's going to repair our endocannabinoid system, keep our receptors healthy, let our natural endocannabinoids that we currently have in our system work better and longer. So I try to make sure that patients are not totally focused on THC because, THC's the icing on the cake and should not be the cake itself.

John Shufeldt:
It should not be the reason they're doing it. Interesting. So I mean, this took a lot of vision. If you look back and say, do you think your practice is going to get where it is today? I mean, when you look back and say, gosh, this is going to blow up, because I have the senses, it's like, for you, it's kind of blown up. I mean, it's probably become, you're probably super popular.

Bridget Williams:
It's gotten busy.

John Shufeldt:
Is it a cash-only business or does insurance?

Bridget Williams:
No, people can use cards for, it's like any other doctor's office that does not take insurance, Yeah. Is that what you mean that, that we don't take? Yeah, we don't take insurance at this time.

John Shufeldt:
So it's pretty much cash for the user HSA card. Do you think this will be one of these things in the future that 50 years from now we're going to look back and say, Oh my God, where we naive back then that we should have been doing this for years?

Bridget Williams:
Yes, without a doubt.

John Shufeldt:
What do you think then? Do you think the same thing about micro-dosing psychedelics like, OK, guys, we should have been doing this years ago.

Bridget Williams:
You're taking me a little fast. I think there's the potential for that. You know, I'm a fairly conservative person, and it took a lot of research for me to get to a point where I realized that we were missing the point, the missing the boat on cannabis. I suspect that it's very true that with that, that may be true for psychedelics as well, but I can't see him jumping on the bandwagon fast. I would have to do a lot more research.

John Shufeldt:
I mean, a few years, so I used a lot of ketamine in the emergency department, which is now psychedelic .... But there's clearly benefits that I've seen from people using ketamine, that I've had, most of them are friends, but people I know who've been micro-dosing psilocybin and they literally swear by the effects for anti-depression and chronic pain.

Bridget Williams:
Yes, I've read some about that as well. I do think that I think medicine will change. I think patients are going to demand for change. But at the same time, I met people that are creating synthetic cannabinoids, you know, in this country as well as like in Israel and what have you. And I think pharmaceutical companies are going to really jump on that bandwagon and because they're going to be able to get that FDA approved and get insurance coverage, I think there's going to be a swing of the pendulum back to possibly some pharmaceuticals again. But I do think patients are demanding something different and I think we need to be ahead of that. You know, I'm part of the generation that was writing opioids like crazy, and I remember very clearly being told if they have real pain, they'll never get addicted, right? And so I'm very much aware that I, patients need a different option, and I don't think we provide good options.

John Shufeldt:
Yeah, no, that I agree with and, you know, not at least in our state, it's nearly it's not impossible, it's makes this very difficult to write opiates and I never have written a lot of them anyway in the emergency department because this never did. Why, you know, I always thought we should've shut the faucet off and all these patients. So now they're kind of screwed. And so what are they doing? They're going to heroin. And now we've even made the problem worse and have these heroin addicts come and I'm like, I don't blame you, I get it. You started here and now you're here because the spigot was shut off. So what can we do to get you off this total roller coaster of life.

Bridget Williams:
Exactly.

John Shufeldt:
Do you think, have any of your peers looked at you differently since you started doing this? I mean, if you become a little bit of a pariah because I think a lot of physicians are like, oh, you know, with the big eye roll.

Bridget Williams:
Uhm, I don't really hang out with a lot of doctors. I think my roots in psychology are probably a little bit fitting of my personality more than my medical friends. Yeah, I've gotten the eye roll, without a doubt. I think I also kind of hit a point that I didn't care. I think I was getting an eye roll before that, so I don't know if I really care. The difference is, to be totally honest with you, a lot of physicians I know are unhappy.

John Shufeldt:
Yeah.

Bridget Williams:
And that is part of the reason why I started doing physician coaching because I was an unhappy physician. So when I see someone in their structured practice rolling their eyes at me, the difference between me and them, I'm still seeing patients and so helping people, the difference is, is that I'm happy.

John Shufeldt:
Right.

Bridget Williams:
So I think they should get coaching.

John Shufeldt:
So let's change subjects for a second. What do you think of them? Give me the five biggest challenges that the physicians who you're seeing in your coaching world are experiencing?

Bridget Williams:
Number one, burnout. Number two, anxiety, lack of confidence, control issues, lack thereof control, most of the time, being strictly overwhelmed and trying to get a hold, I mean, I could go into family and life balance and all that, but I think that's probably just obvious, but I don't feel like we take good care of our doctors.

John Shufeldt:
Now, if you, I started reading more and more about physician suicide and I was totally sickened and appalled by the rate event, and there was a, read an article about an orthopedic surgeon, I think in Washington DC, they call my doctor happy, it was this great looking mid-fifties year old guy with huge smile on his face, he did rounds ... ... himself or shot himself, it would be like, you know, and this guy was like the orthopedic surgeon to the stars. You know, this isn't.

Bridget Williams:
Right, but you never know. I think another part of it, besides the fact that at one point I was the unhappy physician, when I was in residency, one of my peers, so I was at the Cleveland Clinic and I was at one of the satellite hospitals, which is, you know, Cleveland is set up with tons of bridges and valleys, and one of the residents jumped off the bridge. And again, you know, there is no face of depression and suicide, right? It's that it could be the happiest person you know. I think when you add all of that together, I took things, I was aggressive about I own my own happiness and I have to be able to own that and pursue it. And so I wanted to be able to be effective with other doctors. And I mean, I talked to a lot of residents and medical students that are just, the process sometimes the hazing that still exists, the insecurities, I mean, it's a it's a very unhealthy career and you have to own, you have to take ownership to make it healthy.

John Shufeldt:
Yeah, no. I totally agree with you and the people that you coach, is there a demographic that skews one way or another? Is an older, younger men, women, surgeons, non-surgeons?

Bridget Williams:
Oh gosh, I probably see more women, but I don't know if that's because they're seeking me out as a woman, but I see a lot of, I don't know about where you are, but more hospital health systems are actually creating some sort of department or support for these type of services, right? So I've developed contracts with some health systems so that if they have a medical student resident staff physician that they feel could utilize assistance, you know, I'm not in-house, so there's a lot of safety with that, and they connect me with them to be able to give them that backing to kind of build them back up again.

John Shufeldt:
I mean, really, thank God because you hear these little enclaves of residents and medical students who all of a sudden three or four people kill themselves in the same class, the same residency, I think it just happened this year, actually, and it's such an absolute waste. And there was a, I read about a physician who tried to kill himself, and it didn't, thankfully. And he said, for him was a kind of a split-second decision after months of frustration. And it wasn't something that he thought a lot about, it was like, You know, screw this, I'm done, boom, and fortunately, he survived it. But you know, there's, I guess, death by a thousand cuts that led him to even get into that point.

Bridget Williams:
I mean, in my perfect world, I think every physician needs some sort of coaching, we don't all need therapy or counseling, right? But I do think we need a balance, someone that can help make sure that we're treating ourselves well, treating our patients well so that we haven't lost our way. And there's a lot of things that can go wrong in being a physician, whether the pressure, the ego, the imposter syndrome, there's so many things that can go wrong that having someone that can kind of be on the outside and looking out for you, I think would be wonderful.

John Shufeldt:
... You're right, wonderful for everybody. And you know, I always said this for years, if you're not in medicine and if you're not a physician, it's pretty tough to understand what we do or at least what all the potential of how we feel about things. You know, I remember sitting I had three drowning kids literally in the course about three or four hours one day, and I went out and sat on the helipad and a friend of mine calls me up who has worked with me and he goes, hey, you okay? and I go? Yeah. He goes, why did you call and ask me? Because I'm watching you. There's a helicopter red at a news helicopter and I was down to me, and my hand on my face, my hands. I'm like, oh, great, you know? Hey, but I remember thinking, You know, unless you're in the game, it's pretty hard to understand what that feels like.

Bridget Williams:
Yeah. And it's impossible to be in this career and not have experiences along that line of some sort that where you are beside yourself, right? And we have HIPAA and we don't really discuss cases and we have to have a, have a stone face and be there just for the support and for the medicine, right? And so I think it is unreasonable to just say, you know, you should know how to suck it up because everyone doesn't know how and it does lead to some behaviors sometimes that can be self-destructive one way or another. Physician marriages are not doing well if you look at the numbers. And so I think we don't work hard enough to take care of our own.

John Shufeldt:
Yeah, you know, you said, suck it up. And I mean, I'm in the era, you know, I've got some years on you, but I'm in the era that it was like one, if you are a woman that we go to 10 times harder than a guy did and you know, the whole suck it up thing was, what are you complaining about? You know, I did this, now you're doing this. And so fortunately, I think hopefully that's changing a little bit, but it's still obviously pervasive.

Bridget Williams:
Yeah, absolutely.

John Shufeldt:
Interesting. How has COVID impacted your, your business? Have you've seen your, have you seen the volume of your patients go up and the volume of your coaching?

Bridget Williams:
Absolutely. So first of all, I think pretty much nationwide, I suppose that the cannabis industry was considered essential because a lot of people have gone off their traditional pharmaceutical medications and replaced it with cannabis. And so it gave people an opportunity that didn't have time to consider it, it gave people an opportunity that were really struggling with everything that went into COVID and job loss and the anxiety of it to see cannabis as an option for treatment. I definitely, my coaching definitely went up during that time more that it was, I usually have set programs that I do for longer term coaching, but I was definitely doing more short, concise coaching because people are afraid to make that investment into coaching at the time. So but, yeah, I've been more than busy.

John Shufeldt:
That's all. I mean, that's great. I mean, it's been an incredibly tough time for people, obviously. But if it's, if people like you are out there helping physicians cope and get through and patients coping and get through it, it's a huge positive. Let me ask you a medical question. I see a lot of people in the ED who I suspect have cannibinoid hyperemesis.

Bridget Williams:
Hmmm.

John Shufeldt:
... Explaining to them and they're looking at me like, you're an idiot and no, I don't. And then they give it back and I'm like, ohh yeah, you haven't stopped yet. Well, what should I be telling these people? Because my sense is, once you get it, you're kind of screwed, I see this every time.

Bridget Williams:
No, there's still such a lack of understanding around this, right? But the basic understanding of this is that if you are a cannabis user and you're a chronic cannabis user, that for some of them, they end up in a situation where they have this intense, ongoing vomiting that occurs, right? I think originally they thought there was some sort of pesticide involved in Australia, and there was all this stuff that people though a long time ago. But that's not the case now, clearly, and it's simply related to people that have chronic use, and they've tried different approaches to this, changing the strain they use, changing the amount that they use, but at the end of the day, if your body starts to respond to cannabis in this way, it's nearly impossible to change it. Your only option is literally taking in a lot, lot less. What I tend to do with patients that I try to really wean them off of it entirely, really start them on a CBD regimen to, because a lot of times your endocannabinoid system becomes dormant if you're using a lot of THC. So I try to get them completely removed from this, CBD actually can repair your endocannabinoid system, but it's hard, I will tell you, I'm not necessarily very successful with keeping people off of it for any long period of time because they're not quite sure what the outcome is going to be.

John Shufeldt:
And the people that I've seen on a, the people I've seen on that're diagnosed, they are miserable vomiting. I mean, they're not just throwing up once or twice. they are.

Bridget Williams:
It's horrible

John Shufeldt:
Hyperemesis gravidarum. They are miserable. These are the THC or is it the cannabinoids or does anybody know?

Bridget Williams:
As far as they know, well, I don't know if they know entirely. Like the focus has always been that it's THC, that if you're using just like a CBD product, you're not going to have that same problem. But in whether you're using a cartridge, like a processed form or whether you're using actual natural flower plant, people still get this response. Like I said, my best approach has been to start over, right? Get it out of your system completely, repair your system and then see if there's any potential for you to kind of pull back.

John Shufeldt:
Yeah, I can picture these people too, after the third time I finally convince them to maybe trying not do it, and then six months later, they'll come in. I'm like, oh, you tried it again? And they were like, yeah.

Bridget Williams:
Yeah.

John Shufeldt:
I haven't done anything for six months and I smoke whatever, and now I'm miserable. I'm like ugh.

Bridget Williams:
I've seen some studies where people are using Haldol to control the response in the ER, and it really kind of puts a little, I think, Benadryl and that that was working a little bit, but I think we're still in an unknown state.

John Shufeldt:
Yeah, I wish ... was still around, but for the ... thing. Well, Doctor Williams, this is really, really enlightening for me because it's one of the millions of things I know little about, so this has been great. Where can people find out more about you?

Bridget Williams:
Absolutely. So my website is Green Harvest.Health, where people can read out, reach out there ... health. And also you can reach me at DrBridgetMD.com.

John Shufeldt:
.... Can people see you and get a marijuana card virtually?

Bridget Williams:
So no, we do, do virtual visits still in Ohio, but you do have to be a resident of Ohio with an Ohio license or state ID passport. But yes, people do, you can easily anywhere in the state of Ohio, you can do a virtual visit.

John Shufeldt:
Yeah, well, listen, this has been eye-opening. Thank you very much. I really appreciate your time and good luck with everything.

Bridget Williams:
Absolutely. Thank you again. I appreciate you.

John Shufeldt:
Thanks for listening to another great edition of Entrepreneur Rx. To find out how to start a business and help secure your future, go to JohnShufeldtMD.com. Thanks for listening.

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