Arpita: Hello everybody. And welcome to another episode of doctors living deliberately. I am excited to be here with one of my friends that I met at one of our conferences that we've been going to, and she is a ball of energy and fun. But before I get to her and introducing her, I want to introduce my cohost, Dr. Michael Hersh, welcome Dr. Hersh. How are you doing? 

Michael: I am, I'm happy to be here. I always have so much fun talking to new people, new physicians that I have not met before and seeing all of the amazing things that that people can accomplish. And so I'm excited for today's episode, and I'm going to let you intro.

Arpita: Yeah. So we have, like I mentioned, my friend, Dr. Tanya Altmann, who is a nationally recognized child health expert. So in addition to being a UCLA trained pediatrician and working mom, she's the author of several bestselling books, some of which us pediatricians might recognize the AAP book, caring for your newborn and young child birth to age five. We all know that book. She's also the founder of Calabasas Pediatric Wellness Center, where she provides personalized and integrative, comprehensive pediatric care. It's a mouthful and has done so over 25 years. So she's really well, well versed and experienced in this area. 

And I think one of the things that I found most unique and exciting when I got to know her was learning about how she has positioned herself as an expert in the area with regards to media, talk shows and news programs. She communicates complicated medical issues and makes them very easily understandable for the general public. She discusses breaking medical news stories and as well as controversial parenting issues in her role as this media expert. And so she's done this on various platforms. So I am super excited to have Dr. Tanya Altmann here with us today to talk about all the things. Welcome Dr. Altmann. 

Tanya: Thank you for having me on your show. I'm so excited to be here. 

Arpita: Yes. Tell us, so if I befuddled anything or just didn't make it clear, feel free to clarify anything in your bio. What did I miss? 

Tanya: I think it sounded amazing. Thank you. I also have three kids, so they do keep me very busy and they span ages eight to 18.

Arpita: Wow. Yes. And do you have a college age kiddo now?

Tanya: We're currently doing college applications, so it's coming soon. 

Arpita: Yes. We're on the same boat. I'm feeling the pain with you. Although now it's second time around for me. So it's kind of like, I hope you get it done because I'm, I'm out. You're on your own buddy.. So tell us a little bit about you, like I mean, if you look at your background, it's definitely not the traditional, let me go to med school and residency and then start my pediatric career as an employee somewhere, and then just run with that. You've done a lot of different things. So tell me and tell our audience a little bit about how this has transpired and how you kind of chose to do the things you're doing. 

Tanya: Yeah. So I grew up with a lot of physicians in my family. In fact, I like to joke that my mom was a Jewish tiger mom and she raised me and my sister to go to medical school. And after we went to medical school, then we could figure out what we wanted to do with our life. Right? So I'm so glad I went to medical school. I love being a pediatrician, but I think growing up, I had so many other interests as well. And so as I went through medical school and during residency, I was always thinking, you know, what are some other things that we could do? And I went to med school and residency in the nineties. So it was a long time ago. The internet wasn't what it was today. There was no social media. And I was always really interested when I would watch like the news anchors on TV and there were just very few doctors back then doing TV and it was something I was interested in and since I trained at UCLA, they actually had a whole journalism program. So I would run post call exhausted to sit in on the journalism class at the journalism school and take classes with young UCLA students who want to be entertainment reporters. And I was the only professional and that was how I first got exposure and did some of my training. And I also was very involved in the American Academy of Pediatrics again, more because a family friend was on the board and would pick me up from residency and drag me to the meetings and she really pushed me to get involved and so that was sort of how I initially got involved in public speaking and writing for magazines in doing news programs. I, back then we had VHS tapes so you actually had to make your own VHS tapes and deliver them to news stations and you would basically try to sell yourself and say, Hey, I'm available to do your morning news programs, you can ask me any questions you want. And if you were willing to get up at four in the morning and do your own hair and makeup they would put you on because it wasn't like it is now where everybody wants to be on TV and the media on social media. It was a less desirable of something back then, you didn't get paid for it. And I kind of considered it my extra public health work. 

But I really enjoyed it. When I first started, I was not good. I looked like a deer in headlights. I look back at some of my old Santa Barbara morning news programs I did, and they were bad. I was so nervous. The first time I did the today's show, I remember so they had called me through the AP to ask if I had come to a segment. I had just delivered my second child. He was one week old. So I was on maternity leave and I had really wanted to do the today's show. And they called and I looked at my husband and he said, take your breast pump and go. I got the kids. So I literally, you know, you just had a baby a week ago. So I was still all had all that equipment with me, right? My breast pump. I was walking on the tarmac and they called my old flip phone because we didn't even have smartphones back then and said, we still want you to come out, but we want to change the topic. And I was like, okay, I was supposed to talk about potty training and they asked if I could talk about a new study on ADHD and food additives coming out the next morning in the Lancet. And I knew that was my moment. I either said, yes, I could do it and get on the plane and be on the today's show. Or I said, Ooh, that's not my area of expertise. And you know, they would never call me again then. Cause that's what happens when you say no. 

So I said, yes. And as I was walking down the plane, I called a good friend of mine who's also a pediatrician who was kind of in the AAP media I said, this is what I'm doing, I need you to rally the troops. And this is why I always love, I love collaborating. I have friends that do what I do all over the country. I need notes on this study. I need all the information you can get me because when I land at the hotel at midnight, I'm going to log in with dial up into my email. And I would love if I had emails there if you guys could send me the information that you can find because we didn't have Wi Fi on planes back then and I was getting on a plane not knowing anything about it. And it was actually Dr. Jennifer Shu and Dr. Ari Brown and they came through for me and I got to the hotel in New York. I dialed on. I read everything I could not knowing anything about the topic, the study. Went on without sleeping all night, did the segment and I felt so sick to my stomach afterwards. I called my husband, he's like, how'd it go? I said, I'm never doing this again. It was the worst experience of my life. And then the executive producer called me downstairs and said, that was great. Can you come back next month and talk about potty training? And that turned into once a month, me flying to New York and doing the today's show for over two years.

Arpita: Wow. That is crazy. Wow. Wow. Wow. 

Michael: I love so much of that story and as somebody whose job in high school and college was working in a video store, there's a part of me that just loves that we were able to incorporate VHS tapes into this conversation. So thank you for that. Absolutely. Be kind and rewind. But I think, you know, I think there's so much here, right? We, I think as physicians, there is a lot in our training that teaches us to always say yes, right? We never really learn how to say no to the things that we don't really want to do. But I think you highlight a really important point of saying absolutely yes. When the opportunity that you've been waiting for presents itself. And I think that when we're talking to physicians and we're telling you to create boundaries and learn to say no, it's not for the things that you really want to do. And I love the fact that they made that call and even though you weren't entirely sure how you were going to get it done, you just went with it and you did it and it turned into an incredible arc for you. And I, and I love that. It's such a great story. How did you kind of continue down the path? You said this turned into a two year thing. How did you continue going down the path and developing that aspect of your career?

Tanya: Well, you know, I think when you're available and when you're helpful, you will keep getting asked back. So when I do media training for younger physicians, this is what I, what I tell them is that producers will ask those on that they know are going to do well and make their job easy. So if I'm not available, and although I used to say yes to everything after working with Arpita I've learned that I can't say yes to everything. And so what I'll do now is I'll say, you know what I'm sorry, I'm not available, but let me find you an expert who is. And so I never say no, even when I get asked to be on boards, I turned down two board positions over the last few months. Thank you, Arpita and Dr. Alana Levine for teaching me to say no. I find them someone else to fill in my spot. And that way they still, I feel like I'm still helping. They appreciate you and they will ask you to come back. The other thing is that, you know, when I do show up to be on TV. They know that I'm going to research the topic and that anything they want to ask me, I will have an answer to, even if that answer is, you know what, that's a really important question and I don't know that we have the answer to that yet, but you know, since you brought it up, I'm going to look into it. I'm going to get back to you with more information to maybe when I'm back here next week or next month. 

Arpita: Yeah, I think it's part of it. What you're saying, you're saying no to the things that don't necessarily bring you joy that may not help get you to the ultimate goal that you're trying to get to and I know like we didn't work together a ton, but just some of the messages like some of the teaching points was you know, or were what brings you joy? And what's the fear of saying no, right? We're losing out on potential opportunities if we say no or they're not gonna ask me again or they're gonna Be upset with me, right? And so when we start to realize that it's not necessarily the case, there are other ways that we can address the request without feeling like a jerk, you know? And without feeling guilty, also feeling like an asshole, or feeling guilty if we say no to something that we're asked to do.

So tell me, do you believe that of the things that you're doing now which ones bring you the most joy and which ones do you or if you're even willing to talk about this, which are things that you might see that you're shifting away from or might be changing up or what are some dreams that you have that you might be shifting towards?

Tanya: Well, you know, I turned 50 last year, and so I feel like right now my whole goal is to sort of still do things I enjoy, but make my life easier, right? I don't really need to, you know, become famous to like, quadruple my practice. Like I just want to keep doing what I'm doing and enjoying it. And I'm happy to help other physicians that want to do similarly, you know, do that. In fact, I'm trying to bring somebody else into my practice. And you know, my whole thing is, listen, I'm happy to teach you how to do what I do. I don't need to make money off of you. I don't want to like franchise, but yes, let me help you so you can cover for me and allow me to go on more vacations. I think I am trying to filter out not a lot, but some of the volunteer positions that I have, whether it's editing books or being on boards, that it's not that I don't, I don't enjoy them, but you know, they just take up so much time away from my family. And, you know, we have limited time with our kids as we mentioned one is going to be going to college next year. I still have an eight year old and I do have a concierge practice. So I am available for my family's 24 seven, but I am trying to be better about setting boundaries. And when I have a physician covering for me, when I go away, as my office manager keeps telling me, do not look at email, do not respond to those texts. We have it covered. Do not get involved. And it's so hard for me because I feel that like I care about them. I love kids. That's why I'm a pediatrician. Like I want to give them my opinion when they're stuck in a crossroads. But I'm trying to, you know, set up that boundary so I can be present with my family, enjoy more vacations, and more time off.

Michael: I mean, that's a fantastic point to be at, which is that you can just be happy with all of the things that you've created in your life and you can make the important decision to put up boundaries, not because you don't enjoy the things, but because you want to enjoy all the aspects of your life, right? You don't want to go so far down the path of exploring one part of your life, which so many physicians do, myself included, for a very long time, really devoted on my medical career, and not really exploring all the other aspects of life. So, kudos to you for identifying that there are parts of your life that you love, and are willing to put boundaries up to make sure that you're reserving part of yourself for for your family, for the other aspects of your life. 

Arpita: So you talked a little bit about. And the media part of it, like how you got involved in that. And you talked a little bit about like your authoring of the books and how that kind of came about. Talk now a little bit about how you picked concierge practice. Like, you know, a lot of times that's not, I would say the majority of times that is not the way most people come out of residency and say, okay, I'm going to go into a concierge practice and that's what I'm going to do. So how, I don't know if you started with that or if that's what you kind of shifted to, but talk a little bit about that for what, what drove you to go that way. 

Tanya: So I didn't start with that. Out of residency at UCLA I joined a very busy practice with a handful of other doctors. We had two offices, seven doctors total. They were amazing. I learned a lot. And I was there for 14, 15 years. I really enjoyed it, but I felt like I wanted more time with every family, more time to talk about sleep, about your child's nutrition, about why they weren't doing well in school, and how can we help them? Do we need to reorganize their routine? Do we need to get them a tutor? Do we need to do some testing? Do they need a different school? Things that, unfortunately, our current You know, messed up insurance system in the country, if I can say that right now. You know, doesn't necessarily always do as well as I would like to. And I do blame a lot of this on insurance. But you know, that's not what this podcast is about. We can talk about that, you know, some other time. And I also want to study integrative pediatrics. So I was working, working, working, getting burnt out, seeing, you know, 30 patients a day, then going home and trying to talk to all the specialists that saw my patients, you know, return emails. 

And that was when I ended up getting, having realized I was pregnant with my third and it was another boy. So don't forget my kids are 18, 16 and eight. Third boy, a little sad about that because I kind of wanted a girl, although now I love him. Can't imagine life without him. That's sort of what made me realize, you know what? I have an out right now. I can leave my practice. I retired from insurance based medicine, told my partners I was taking a really long maternity leave. And if I went back to practice, I was gonna do something different. I wouldn't compete with them. I would do cash pay concierge and they were very supportive. I think they thought I would never really do it when you're talking about, you know, about before, like what gave you the courage to do it. So I just left, had my baby, took some time off, looked at all these different ways to really practice medicine the way I want, and I decided, you know what, I'm going to do it. I am going to invest in myself and a practice that I think could be a better way of practicing medicine. And I opened my own practice, and I think that they were shocked, right? Because no one really ever thought I would do it. I think even my husband was like, oh wow, you're really doing this? Okay.

And even now when he looks at, you know, all of my business stuff, sometimes he's like, Wow, you created like a profitable practice. Like, wow, I'm really proud of you. You know, like everybody's like, they didn't think I was really going to be able to do it. And I love it. I'm available for my family's 24 seven, which sometimes is hard, but when you know your family's well, and you train them well, I only get woken up a few times at night a year. Yes I talked to a couple of families every weekend, but I care about them. It takes two minutes to return their tasks right? And you've solved a major issue and put them at ease. So I do like it. It's not for everyone. If I have a family with an issue that I don't know about, I will go out and learn about it. I mean, that's how I got involved in the pandas world because I had a patient five years ago with pandas and I went and spent time at a national panda center because I needed to learn about it to fix my patient and I feel like I'm a better doctor because I have time to learn time to really go through with the families you know time to enjoy. But as I'm looking for people to join my practice and do what I'm doing, I'm realizing not everybody wants to do this, right? Some people like to clock in and clock out and not think about it when they go home. And that's okay too. It really just depends what you want out of your career, you know, as a physician.

Michael: Yeah. I think what you're describing is that fulfillment looks different for all of us, right? And I think for a lot of people, they can have a career in medicine and find their fulfillment there. I think because healthcare is shifting, like you were describing before, it is getting a little bit more challenging to find fulfillment in a medical career. And when you can build something that is yours, whether it is a Media empire or writing a book or or building your own practice, there's an inherent fulfillment that you get to take a step back from this thing that you've been doing with awe and see what you have created and that's something that, you know, for me was not available.

You know, again, clocking in and clocking out, right? You you can derive some fulfillment from that, but maybe it's not enough. And so learning what does light you up and what does bring you fulfillment and giving yourself the opportunity to do it, right? Like you told your partners, I'm going to do this thing and nobody believed you. And then you gave yourself the opportunity to do it. And so that's really an incredible journey. If you had tips for, physicians about kind of exploring the things or what gave you the courage to look outside of traditional medicine, what would you tell them? 

Tanya: I mean, I think that there are so many opportunities available out there and so many things you can do as a physician. You know, outside of just practicing traditional medicine in an insurance based system. But I think you have to want to do it and you have to put in the time and effort. So it doesn't just you know like a lot of people say like, Oh, who did you know that got you on TV the first time? Well, I peddled my VHS tapes around to different stations and worked in Santa Barbara an hour from my office early in the morning and then would drive back and see patients all day because I needed experience being on camera, getting asked random questions, looking into, you know, a teleprompter and a circle lens without seeing who you were talking to. And then when different opportunities arose, you know, I took them. 

And one other little story I was going to say when you're talking about saying no, which I've learned what is still so hard for me. So during COVID, for example, I was getting so many calls from news media about COVID, about school closures. I wrote one of the first articles on how to reopen schools for CNN. So a lot of stuff on that, a lot of stuff on the vaccines. And I remember I was in my backyard, running around playing soccer with my kids one Sunday evening and CNN called me and I'd already announced to everybody I'm not waking up before 6 AM anymore. I can't do it for news. I can't wake up that early anymore. And the producer called and he said, okay, before you say no, can you just give me time to sort of make a case for what we really need you to do? And what they were asking me is they could send a news van to my driveway at three 30 in the morning, because there was going to be a big announcement from Pfizer the next morning.

And they didn't know what the announcement was and they couldn't tell me anything about it. I'm like, okay. I figured it was the pediatric vaccine coming out. Like, how do I not have any info? They're like, well, we'll have it at 3am. So if you can be ready, we will get you the info at three. You'll have a half an hour to prep and then you're going to jump into the news van on the driveway. And I was like, I've been trying to say no, I've been trying to say no. I've been trying to say no, but I feel like this was important. It was like monumental groundbreaking. And of course I came up and said, yes. And so I did cover, you know, when the first pediatric COVID vaccine came out. So I think sometimes you do have to give in and I think it was great, but it was also exhausting. So I would say, take those little opportunities when you get them, but make sure that you're prepared. I did a lot of research that night. I talked to specialists all over the country, trying to get little hints out of them of what was coming out, what the dosing was going to be, you know, I talked to infectious disease experts, pharmaceutical experts. And I really worked. So that way I knew when I woke up at 3 30, I would be able to have a, like, you know, an intelligent conversation. And so I think it can pay off, but it's not always going to get, you know, dropped in your lap. You do, you do have to work at it.

Arpita: And that's a perfect example of how it can shift too, right? Like we oftentimes think that we're like set in our ways, like, okay, I've decided I'm not doing anything before four and I'm going to stick to it. And that, like you mentioned, can sometimes prevent us from having certain opportunities. So it's okay if we want to shift on a rule that we might have created for ourselves or an expectation that we have for ourselves if it suits us in that period of time, right? And going back to your why, for why you're doing it, right? What is bringing you joy in this moment of shifting if it's needed? I think those are all important points that we have to consider when we are deciding which way we want to go. 

And I just love the fact that you mentioned, like, you know, nobody thought I could do it, but the practice, like even myself, I wasn't sure if I could do it. Right? And those are what we've recently talked about too, is limiting beliefs that we have. What keeps us kind of stuck in what we're in without allowing us to see what we're capable of and creating in the future. So if we can kind of move past it and just test it, like, what's the worst that's going to happen if we try something out? If it doesn't work, you go back to what you're doing. If it does work, it's amazing, potentially what you can create. So you just have to give yourself the opportunity to do that. 

So. Well, Dr. Tanya Altman, I think it has been so much fun. I love your energy. I'm so appreciative for you to come on and talk to our audience a little bit about how you've done all the things you've done. Tell us a little bit about how they can get in touch with you or learn more about you if they have interest in meeting up with you. And even if you want to, that might be something that you want to say, no, nobody can get in touch with me. I don't want to talk to anybody. But tell us all the things.

Tanya: Yeah, so I'm on social media at Dr. Tanya Altmann and most of it is my name, Dr. Tanya Altmann. My website is actually dr tanya.com. That's how long ago it was that I started doing news media. I was able to get the domain, dr tanya.com, because I was the first Dr. Tanya on tv. And also my practice is Calabasas Pediatrics. I'm very accessible. I do get people reaching out to me every day about breaking into the media, about starting their own concierge practice. And I do try to get back to as many as I can. Sometimes I like to group people together to do little educational sessions because I remember all those doctors and experts that helped me out when I was getting to that point and how you know, nice they were, but I also remember the ones that weren't. And so I don't want to be one of those who isn't. But sometimes you have to give me a little bit of time if I'm too busy, but I promise to try to answer questions and help out because I think everybody should be able to do what they want. And I would love to have more doctors on the news and in media giving accurate information, and I want more people to enjoy their practice because we need doctors to see patients. That's really what we need. So we have to figure out how to make it enjoyable, affordable and effective so we can actually help people get better and not just keep tripping them from specialist to specialist.

Arpita: Yes. 

Michael: I love that. Yes. 100 percent all of that. Dr. Tanya Altmann, this has been amazing. Loved this conversation with you. Thank you so much for being here with us today. And thanks to all of you for listening. We will see you next time on Doctors Living Deliberately. Take care. 

Arpita: Bye.