The Breakroom

Updates From Syria, Feedback on Healthcare, and how to break up with social media

Welcome to the Water Cooler

Last Friday, our longtime friend and frequent contributor to the show, Kerry Boyd Anderson said she’d love to come back if there was an outbreak of peace in the Middle East. The fall of the Assad regime in Syria is not quite that, but it is good news, and we wanted to share this follow-up email from Kerry.

Hi, ladies!

I just wanted to share some initial thoughts on the fall of the Assad regime.

When we talked last week, we bemoaned the lack of good news. This morning, I'm taking this as good news! I'm thrilled to hear stories from all sorts of different types of Syrians who are celebrating the fall of the Assad regime. The release of prisoners from Assad's hellish prisons is wonderful to see. One journalist who lives in Damascus described the sense of being freed from an open-air prison. I love the stories of Syrian refugees hoping to return home.

The Assad regime was truly horrific and never could have survived so long without support from Iran, Hezbollah, and Russia. I am happy to see it fall.

I'm also well aware of all the reasons for concern. Hayat Tahrir al-Shams is no movement for democracy and equal rights. Religious minorities, journalists, women, and others in Syria have reasons for serious concern. The risks of renewed conflict are high. HTS has embraced pragmatism over ideology in recent years, but that could always change.

But those concerns must be set against the reality of life under Assad, which is exactly why I think we're seeing such celebrations. If HTS can work with other partners to provide some stability, allow many displaced to return, meet some basic human needs, and provide a tiny bit of economic improvement, that would mean significantly better lives for many Syrians.

So, today, I'm celebrating the good news of the fall of the Assad regime.

Best,

Kerry

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As a reminder: you’ll get your new episode of Pantsuit Politics in your feed later this afternoon.

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Pantsuit Politics Bulletin Board

• Reminder: We’re adjusting our calendar in December. Our Tuesday episode of Pantsuit Politics will be in your feeds later this afternoon. Sarah and Beth are recording today

• More to Say:

  More to Say about Rising Drug Prices

• Good Morning:

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A Few Things We’re Reading

• The US believes journalist Austin Tice is alive after disappearing in Syria in 2012, Biden says (Associated Press) Austin Tice’s family has been faithfully trying to bring him home for over a decade. We are hoping that in this moment of tumult and transition in Syria that he is finally able to return home.

• Spying on Student Devices, Schools Aim to Intercept Self-Harm Before It Happens (The New York Times)

• Facebook turned off the news in Canada. What happened next? (The Economist)

• Preparing for this week’s conversation: Compulsive Overconsumption and the Dopamine Economy with Dr. Anna Lembke (Mind Tricks Radio)

• Fishing, pickles and mountains: Pinterest casts 2025 trends (Axios)

From the Spice Cabinet

Last week, Sarah and Beth talked about money and healthcare and our listener,

Katherine Cartwright

, shared a little about her experience as a provider in our healthcare system, and it brought so much to the conversation that we wanted to share it with all of you.

I'm an OB/GYN. While I know this conversation was more nuanced than a single comment, and I acknowledge I have a hard time not being insanely defensive when it is implied we should/would do our jobs for less compensation, I have to just say how demoralizing it is that discussions of healthcare costs so quickly turn to physician salaries. Physicians (and multidisciplinary teams- NPs/PAs, nurses, medical assistants, imaging and respiratory specialists, pharmacists, etc)- are the only ones in this massive convoluted system who are actually providing CARE. For-profit insurance companies and massive hospital corporations are intermediaries who have injected themselves into OUR care relationship to get theirs, diverting money that should go directly to care. There is this idea that doctors are overpaid (we aren’t) and, therefore, the problem. Physicians just took yet another CMS fee cut this year and are paid less in gross salary numbers than our mentors from 30 years ago. Adjusted for inflation, I already make almost 40% less than partners in my practice did in the 90s. And they didn’t have loans or malpractice anywhere near what we have now.

The reality is that on a Saturday night I am charting and catching up on labs and results for patients I squeezed into every possible second of my days and nights, consistently working well over 80 hours weekly. This is significantly more than 2 full-time jobs and is more the norm than the exception in my field. At least half of this is uncompensated work. Just this week, I spent hours trying to get insurance companies to cover things like pelvic and breast MRIs, a second opinion for aggressive breast cancer treatment in a young mother, a very needed hysterectomy, and the RSV vaccine in pregnancy, which United continues to deny despite FDA approval an insistence they'll cover it(!). There aren’t enough of us, and the number of patients waiting for care is daunting and endless.

I see and appreciate comments on how many other professions have long hours, risk of bodily harm, etc, for too low wages. Firefighters are up all night and risk their lives; they should be paid more. Teachers have become heroes to me in so many ways, and I'm SO grateful for them. So many people deserve better pay. At the same time, you'd be hard-pressed to find a profession that has the combination of hurdles and challenges that medicine does. I spent 14 years, which is ALL of my 20s and into my 30s in classrooms and clinical settings 80+ hours a week, going half a million dollars into debt while chasing my passion and “life’s calling” (not sarcastic- I absolutely love my work and would probably do it for free to the financial ruin of my family if they let me). I continue working hours that leave me missing my kids and get woken up at all hours of the night. I have to pay ungodly malpractice premiums and ALSO worry that I would be a felon for doing my job ethically in half of America today (and who knows what tomorrow will bring). I do not seek pity here- I chose and love this life, and I'd choose it again every single time. But honestly, I don't want my kids to choose it. And the idea that without MASSIVE reform of education costs, length of training, physician pay schedules, physician liability, etc, we would just do all the above out of the goodness of our hearts alone is so disappointing.

I worked in public health on my road to medicine and have long advocated for some kind of universal program that cuts out our private for-profit insurance model entirely. But unless the money that is poured into private insurance gets poured into this theoretical universal program, it doesn't work. Medicare For All doesn't work at current CMS rates- I would have to close my practice immediately if the Medicare rates were the rates for everyone. I wouldn't be able to pay my front desk staff and my rent, let alone make a dollar of my own to keep. And there remains an issue of limited resources- government "rations" care while private insurance "denies your claim"- these are two sides of the same coin. We certainly have endless problems in healthcare with only painful and complex potential solutions. But physician salaries are NOT the problem. Our endless moral injury and the speed with which we are leaving our life's work may add to it, though.

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Today’s episode is about our fraught relationship with social media. Our longtime listener,

Katie Loveland

let us share a list of social media alternative that she shared with her book group after she “pulled the plug” and if you’re looking to break up with social media, we thought these ideas were a great start!

ALTERNATIVES TO THE UTILITY OF SOCIAL MEDIA

• Sharing photos with family » Aura Frame

• Looking back on memories » creating real photo albums

• Listening to interesting voices/writers/journalists » following specific Substacks

• Having substantive convos about topics » Patreon/Substack chat of favorite Podcasts (may we humbly suggest you join the Pantsuit Politics Spice Cabinet?)

• Staying abreast with businesses and events » Checking local events pages, getting newsletters from local venues, telling your friends to invite you to things

• Political engagement/awareness » Specific engagement with organizations that I care about that help me activate politically. e.g. Montanans Organized for Education Newsletter

• Consuming the news » actually paying for subscriptions (NYT, Washington Post) going directly to websites (give them your clicks!) Montana Free Press

• Conversations with friends/keeping up with friends far away » Marco Polo and Voxer

• Funny diversions/commentary » Group chat!

• TikTok/Instagram posts (can’t scroll!) » a newsletter that compiles funny Tweets every week (e.g.

  Erin H Moon
  Lil’ Swipes)

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