In this episode, Dr. Joel Gaurav Warsh, a pediatrician in Los Angeles, California, talks about the impact of the recent school lockdowns and the impact on children. Dr. Warsh talks about how important it is for kids to be around other people and have a sense of community, especially in the wake of a crisis like the one that has been unfolding since September 11th, 2001. He also discusses the importance of early identification and early intervention in order to prevent long-term effects of a pandemic like the ones we have seen over the past few years. He also talks about what he has seen in the aftermath of the crisis and offers advice to parents on how to keep their kids safe and well-prepared for a crisis of this nature. This episode is sponsored by the National Suicide Prevention Lifeline. To find a list of our sponsors and show-related promo codes, go to gimlet.fm/OurAdvertisers and enter "sponsors" to receive $5 and receive $10 off your first purchase when clicking the discount code "AdvertiserID" at checkout. We are working on a new ad-free version of the show that will be available in the coming weeks. Thank you so much for listening and supporting the show! We really appreciate it! and we look forward to hearing back from our listeners. If you like the show and want to support the show, please leave us a review and/or share it with a friend! or tell us what you think we can do to help us reach more listeners! in the next episode! and spread the word out there about the show. Thank you! . Cheers! Dr. Aaron Warsh is a Canadian pediatrician, thank you, Joel Warsh! -Joel Warsh - Thank you for listening to this episode. - Dr. Gaviravaravarajan Warsh and I appreciate your support and support of this podcast! Thankyou, Joel, I appreciate it. Thanks, Joel thank you for coming on the podcast. and I hope you're listening! XOXO. xoxo, Sarah, Sarah - Sarah, Sarah, Thank you, Sarah and I love you. Sarah - - Sarah Sarah's Dad, Caitlyn, Amy, Rachit, and Joe, Rocha, and Matt
00:00:07.000Joel Gator Warsh, who grew up in Toronto, Canada.
00:00:10.000He completed his undergraduate training at Toronto York University before going on to earn a master's degree.
00:00:19.000In epidemiology and community health at Queen's University, where he was honored with the Canadian Institute of Health Research Master's Award.
00:00:28.000He was the CEO of the International Innovation Media and Design, Inc., and was the Ontario Student Entrepreneur of the Year in 2009.
00:00:37.000He's an integrative medicine doctor, functional medicine doctor, who has also expertise in traditional Chinese medicine and homeopathy and functional medicine and every kind of integrative medicine.
00:01:20.000I mean, it's been tough on everybody, but it's certainly been tough on children.
00:01:23.000I think we've, you know, we've been seeing this increase in chronic disease and mental health concerns over the last, you know, even few decades.
00:01:32.000But what was already there, I think we threw some gasoline on the fire when it came to the pandemic.
00:01:38.000and my practice went a lot from colds and coughs and runny nose and earaches and all the normal stuff to a lot of mental health concerns, anxiety, stress, worries.
00:01:48.000And I think that was just a very unfortunate turn of events for everybody and especially for kids.
00:01:54.000It's just really been very tough on them.
00:01:56.000And I have thankfully seen things improve somewhat, but there's definitely a lot of long-term complications, stress, anxiety from what's been going on the last couple of years.
00:02:07.000How does a child express the stress or anxiety when they come into your offices?
00:02:13.000Do the parents bring them in and say there are mental health problems here?
00:02:46.000They can be a little bit more depressed or sad.
00:02:48.000So sometimes we'll just see changes in mood, but other times it will be the parents will actually physically come in.
00:02:53.000And that even more so over the pandemic, you know, it wasn't usually the parents were coming in and saying, oh, my kid is depressed or they're very anxious, but that became the norm.
00:03:01.000Almost every teenager, almost every child that was going to be like four to 12 or 15 years Those were the calls I was getting every single day.
00:05:04.000Important to be safe and to be conscious about what is going on there, but what was certainly missed over the last few years has really been the greater implications of everything that's been done, and so there's going to be positive and negatives with everything that we choose, but a lot of the mental health aspects to this were really forgotten, were really secondary, and I don't think they're as secondary anymore.
00:05:28.000I really do think people are starting to recognize how much of an impact this has.
00:05:31.000And you're starting to see research and studies and more discussion about the impacts and really, you know, trying to, to decrease the impacts long-term for children and most kids, you know, overall, I think in the long run we'll do okay.
00:05:43.000But I think this is an important lesson that we need to learn and we need to just be mindful of how important community, family, and the messaging that we have around health is because if we're just talking about disease every day, all day, if we're just talking about all these stressful things, then it's no wonder that kids are going if we're just talking about all these stressful things, then They already had enough to deal with and they're already having a lot of mental concerns as it was.
00:06:06.000And then you see 30% increases in hospital visits for mental health concerns and more depression and more suicides and That's a big deal.
00:06:15.000And that's on top of the chronic disease that we're already seeing with the rates that are skyrocketing before even the pandemic was like 50% of kids or so, depending on what study you look at, have a chronic disease.
00:07:46.000I think it's unfortunate that we've forgotten about all of these other modalities in alternative medicine.
00:07:51.000There are so many ways that we can balance between both worlds.
00:07:55.000And again, I'm not against Western medicine.
00:07:56.000I just think that we're way too quick in modern medicine to give a medication.
00:08:00.000We're way too quick to give an antibiotic.
00:08:01.000And if you never learn about supplements or other options out there, then if you have In illness, a parent wants you to do something, and if the only thing you have for them is an antibiotic, then you're going to give that.
00:08:13.000And even in Western medicine, there's so much discussion about antibiotic stewardship and not giving medications when you don't need it, but there just isn't the training and the knowledge in that.
00:08:23.000So for me, I never talk poorly about my colleagues in medicine, especially pediatricians.
00:08:35.000So I think that some people in the natural world, they might have different opinions on how to get there, but everybody wants kids to be healthy at the end of the day.
00:08:42.000And to me, what I think is important is balance and balancing between those worlds.
00:08:47.000And it's really frustrating as a human being and as a pediatrician to see this division and to see people getting so angry at each other and fighting and not discussing and not putting the kids first.
00:08:59.000And that's what we've seen just get worse and worse over the years.
00:09:01.000And I know you know this, but there's no reason why we can't discuss these things.
00:09:06.000There's no reason why we can't find some middle ground.
00:09:08.000And there's no reason why we can't use the best of natural medicine and the best of modern medicine together.
00:09:14.000And I think if you come from that angle and you make sure you're keeping patients safe, Then there's no reason, you know, to be, oh, just think about acupuncture, right?
00:09:22.000Acupuncture used to be woo-woo, you know, 15, 20 years ago, and now it's in every hospital when we use it instead of pain medications with the opioid crisis, and that's the first-line treatment.
00:09:32.000And things do slowly trickle into modern medicine, but it's just slow.
00:09:37.000And I've certainly seen over the last few years more and more practitioners getting interested in natural medicine.
00:09:44.000There's still a long way to go, and there's a wide range of of what somebody can do when it comes to natural medicine.
00:09:50.000You don't have to be the most knowledgeable person, but at least if you're open to learning about it and bring it into practice, then we can bring these two worlds together for the kids.
00:10:00.000That's why I'm here, is just to help kids get healthier because what we're doing isn't working.
00:10:05.000We're great at infectious disease and treatments and, you know, antibiotics and pneumonias.
00:10:11.000We're much better than we were 100 years ago, but chronic disease rates are skyrocketing now.
00:10:15.000And so we need to, I think, change the system and really focus as much on prevention as we do on treatment.
00:10:22.000Yeah, that's one of the things that I wonder about with pediatricians, because I know, of course, like you say, virtually every pediatrician got into that line of work because they love children.
00:10:35.000But I grew up, you know, I had 10 brothers and sisters, so there were 11 of us.
00:10:41.000And I had probably close to 70 first cousins on both sides of my family.
00:10:46.000And I didn't know anybody who had a chronic disease.
00:10:50.000There was nobody that I knew who had diabetes, who had rheumatoid arthritis.
00:11:29.000I'm not exactly sure why we're not looking into the root cause.
00:11:33.000I think one part of it is everybody's just so busy these days and you don't necessarily have enough time to spend with the patient.
00:11:41.000You don't have an hour or two hours to kind of go through our full history and have a full discussion on diet and nutrition and All the things that you really need to be focused on.
00:11:49.000I think there are certainly some people that are starting to really look into it.
00:11:53.000But to me, I think it's crazy that we're not stepping back and saying, look at the numbers.
00:12:06.000I mean, you can say, okay, sure, we might be a little better at diagnosing things nowadays, but there's no way that that accounts for the rapid increase of disease that we're seeing.
00:12:16.000And just like what you're saying, I don't remember anyone really that had a peanut allergy when I was little, you know, maybe one person.
00:13:15.000And even if you are making it yourself, you're buying from the store, the fruits and the vegetables and everything that we're getting isn't nearly as good as it used to be.
00:13:21.000And you're literally built of what you eat and you're made of what you eat.
00:13:25.000And so if you're not getting the nutrients, then how is your body going to be able to And we're also just surrounded by more chemicals.
00:13:32.000We're exposed to chemicals all the time in the air, in the water, on our clothes, everything that we spray down.
00:13:38.000And so if you're just increasing those chemicals on a daily basis and over years, and you're not getting nutrients that you need, how are you not going to get sick?
00:13:47.000There's no logical way that it's not going to happen.
00:13:51.000That's why we're seeing these rates increase.
00:13:53.000But at the same time, Many of the families that do focus on these things and are cognizant of the food that they eat and the chemicals that they're surrounded by, their kids can be very healthy.
00:14:05.000Anybody could be healthy or could get sick, but you by far and above see...
00:14:10.000I think, and certainly I've seen in my practice, the families that are just cognizant of this and take small steps to decrease the chemicals in their life and to eat healthy and buy from farmers markets and buy locally and plant a garden.
00:14:24.000By and large, they're not nearly as sick as the other kids that I've seen over the years.
00:14:28.000Why doesn't the American Association of Pediatrics or Academy of Pediatrics, why aren't they taking on these issues?
00:15:10.000You mentioned about the pharmaceutical companies, and I think that's an important piece.
00:15:15.000Again, I don't think most pediatricians think about things in that way.
00:15:19.000I think we have to step back and think about marketing, and we've certainly been marketed to by all sorts of companies, but everybody has on every single issue.
00:15:27.000Most doctors are not getting huge payments from, you know, drug companies or whatever.
00:15:32.000I think that's not really, really what it is.
00:15:35.000I think it's just more of being very focused on your patient panel and just seeing patients and trying to keep them, trying to treat what you do see.
00:15:44.000But There isn't or hasn't been this wave of movement yet, at least amongst doctors or pediatricians, to really think about the root cause and really identify just chronic disease in general as a major issue, and then really focus on prevention.
00:15:59.000And, you know, when you talk about companies, a lot of things do come down to money, and there's not a lot of money in Improving your vitamin D or eating healthier.
00:16:09.000And so that's what is talked about and what's focused on.
00:16:11.000I do think if, you know, maybe if there's a movement towards thinking about prevention more and talking about prevention more and the ability for doctors to do it, I mean, the payments from insurance companies and the amount of time to do it, you would see more focus on it.
00:16:25.000But it's really nearly impossible to do what you need to do in three minutes when you see a patient or five minutes when you see a patient.
00:16:32.000And unless you're in A private practice where you don't have that many patients and you have, you know, maybe some concierge or whatever.
00:16:39.000I mean, when I was working in the hospital, you might have to see 10-15 patients in an hour, at least 5-10 at a minimum.
00:16:46.000So there's only so much that you can do in...
00:16:49.000You know, those five minutes, you want to make sure that they're healthy, and they're not going to go to the hospital, but you can't spend 20 minutes talking about their diet.
00:16:56.000And my hope and my dream one day is that, you know, maybe these worlds will come together, natural medicine world, and, or, you know, just talking about nutrition, and maybe we'll be more like a dentist, where you'll go to your doctor's office, and you'll spend 20 minutes with a nutritionist, and, you know, another 10 minutes with a coach, and then you'll, you'll spend 15 minutes with your doctor, whatever it is, but Unless we change the system around to be able to offer doctors longer time to speak to patients, it's really not practical to spend an hour with everybody.
00:17:23.000So we have to find some middle ground.
00:17:24.000And at some point we have to say, you know what, this is a big problem.
00:17:31.000And as important as treatment is, and it is important, we do want to, you know, cure cancer and do other things like that and treat disease.
00:17:38.000That's important, but it's just as important to prevent.
00:17:41.000And if we don't change something, every kid's going to have a chronic disease.
00:17:45.000So we have to find a way within the system to pay doctors appropriately so they can do this, so they can spend the time or find a system where patients can spend that time to actually talk about diet for half an hour or do whatever they need to do with it for that patient on that day.
00:18:27.000And, you know, we eat pretty healthy, and we do a lot of the things that I think you need to do to stay healthy, but it's terrifying to think that the numbers state that if I have another kid, there's a good chance that one of those two is going to have a chronic disease.
00:19:05.000I think it's a mix of medicine becoming more corporate and I think it's also just a mixture of the way...
00:19:12.000I can speak about what I do and insurance reimbursements seem like they just continue to become...
00:19:19.000They're not keeping up certainly with inflation and with the increasing costs.
00:19:24.000You can only be open as a practice for so long.
00:19:28.000If, let's say you get paid $20 or $30 to see a patient, but, you know, you have a certain cost to keep that office up, so you have to see more and more patients.
00:19:35.000And that, I think, is one of the reasons why so many practices close over the pandemic.
00:19:39.000There was some huge amount of practices that close over the pandemic, because a lot of them are volume-based, and when the volume dropped...
00:19:45.000Then you just can't keep up financially.
00:20:21.000But if you need to keep up your numbers, because that's what you're looking at.
00:20:24.000And if you, let's say you're a private practice and you wanna keep your doors open, then there's a certain amount of patients that you have to see to make enough money to stay open.
00:21:12.000I think overall, it depends on what's going on for you.
00:21:18.000I think that you can have to wait a really long time in Canada for things, so that can be an issue.
00:21:23.000But overall, potentially, a lot of people are very proud of their healthcare in Canada, and they definitely love and respect their healthcare overall.
00:21:31.000So I think maybe generalized care is better.
00:21:34.000I think you can You can potentially get better care here in certain places, but I think you can get worse care in other places.
00:21:39.000I think overall the problem with American healthcare is it's so diverse, and there's such a wide range of quality of care and accessibility to care.
00:21:48.000In Canada, it's kind of standard, so you know what you're going to get, but you might have to wait a while for certain things, but you're not going to have to wait if you need to go to the hospital for something that's emergent.
00:22:02.000Also, if you have a lot of health care bills, right, that's better in Canada, I would say, probably because they're going to make sure that you're never going to go bankrupt, but you might have to wait a year for a procedure.
00:22:10.000You know, what advice do you give parents in terms of how to have a healthy family?
00:22:19.000I think the most important thing that we need to realize at this point in time is that nobody is going to take care of you or your family or your health.
00:22:26.000You have to take that into your own hands.
00:22:28.000And there are so many things that we can do to make a difference.
00:22:38.000You don't need to be overwhelmed by this, but if you can make small changes that improve their health, 1% here, 1% here, 1% here, then by and large, most kids are going to do okay.
00:22:48.000So just think about the simple things that you can do, like eating healthy, buying organic, preparing more food at home, making sure your kids get out and exercise, making sure that you're Thinking about the toxins reading the labels on everything that you buy reading the labels on every skincare product cosmetic if you buy a couch just think about those things because we're exposed to enough chemicals already so any place that you can decrease that a little bit is going to be helpful because at some point everybody tips over the edge and that's what we saw over the last couple years right we saw that
00:23:18.000By and large, the people that had a lot of trouble during the pandemic were those that already had lots of health complications.
00:23:25.000That's very common sense, logical stuff to most doctors, that if you have a pre-existing condition or other things going on, then you're just not as likely or not as capable to...
00:23:37.000And that's true now and it's going to be true in the future if there's another disease that pops up or whatever comes our way in the future.
00:23:45.000The healthier that we are in general, the more we're able to cope and the better we're able to cope with whatever comes our way.
00:23:50.000But if we're not eating healthy food and we're not exercising and we're not getting sunlight and we're stressed out all the time and we're stressed out on social media and everybody's arguing all the time and your kids are seeing this and they're always stressed out then They're going to be sick.
00:24:09.000So if something doesn't change, every kid is going to have a chronic disease or most kids are going to have one in the future.
00:24:15.000But at the same time, this wasn't happening 20, 30, 40 years ago.
00:24:20.000So there's a lot that we can obviously do because the same reason that this is an issue is the same reason it can be Fixed or it can be improved because this is so much to do with what we're doing in our environment.
00:24:31.000And so if you're thinking about those things, you can create the environment for your family that lets them thrive and lets them succeed and lets them be healthy.
00:24:39.000And if everybody starts thinking that way, then these trends are going to change and we're not going to see the life expectancy keep going down.
00:25:21.000And I know, you know, sometimes people don't always say everything that's exactly, you know, even when you listen to what you say versus what's talked about out there.
00:25:28.000But there are so many people that appreciate everything that you do.