Breaking the Stigma: Dr. Rob Tanguay

Trauma can take many forms. Veterans and frontline workers (like the police) face indescribable events. 

But, how do we treat it?

Dr. Rob Tanguay speaks about the incredibly innovative treatments being offered through: The Newly Institute.

But, that’s not all – we also talk about: the state of the public health care system in Canada and what we can do within our own limits and the limits of the system. 

Transcript

SPEAKERS

Dr. Tanguay, Nicki Kirlin, Jenna Fortinski

Jenna Fortinski  00:02

Welcome to the simply Jenna podcast. This is breaking the stigma, a special miniseries. Join us as we interview different people and talk about their journey to wellness. If you’ve thought about getting support, but we’re afraid or afraid of what others might think this series is for you. Stay tuned for some really good stories. Welcome to another episode of The simply gentle podcast. This is breaking the stigma.

Nicki Kirlin  00:33

Yes, we’re back for another exciting episode with Dr. Rob Tanguay, who is a practicing psychiatrist, and also co founder and chief medical officer for the newly Institute. So in this episode, we chat about his new exciting adventure with the newly Institute. And it’s a really fantastic conversation about some maybe controversial things.

Jenna Fortinski  00:56

Yes. It’s exciting. We hope you like it. Alright.

Nicki Kirlin  00:59

So thank you so much, Rob, for joining us today. Can we kick off by maybe having you tell us a little bit about yourself? Maybe your hometown, your occupation? Maybe a fun fact if you have one?

Dr. Tanguay  01:11

Sure. We’re so seriously. Enjoying wine? We have professional Yeah, professional. Okay. Do that. Yeah, we won’t talk about anything. We’re talking. No. I grew up in southern Alberta. I was born in northern Alberta, but grew up in southern Alberta. Okay. And yeah, I think pretty normal childhood. I grew up. single mom, little brother. You know, she, my mom worked full time went to school at night. Wow. So we learned really early. Do the dishes make suppers chores, a lot of expectations and responsibilities. And I think that sticks with you. Yeah, absolutely. You learn responsibilities. You learn dedication to what you’re doing. And if you don’t do something, you’re gonna have to deal with it. Yeah, yeah,

Nicki Kirlin  02:04

absolutely. So a fun fact.

Dr. Tanguay  02:08

Fun. Fact, from I used to sell vacuums. I really did sell vacuum cleaners. Door to Door. Oh my god. Not not just for a little bit. I am the 1990s I got kicked out of college. Medicine Hat. Pretty fun time. I enjoyed the entire experience medicine accept school. Yeah. I never went. Yeah. And I didn’t really have any study habits anyway. So yeah, so I went to medicine out of 17. After a year, we just we partied a lot. Yeah, school, I was just a disaster. So afterwards, it was, you know, 9293 and around there in 1993. And the economy was not good. I really wanted to be a bartender, because that’s where the action was people everything and I couldn’t get a job because I’d never done that before. And I answered an ad set up in display department. So I actually thought I was setting up mannequins at Sears. Hi, Tom tops are easy. And I went to this job interview and he was in this little office, it was pretty nice and younger guys there. And they, you know, were really nice. And I left the interview. And I was like, Well, that was really good. And I remember going home I was like, so what, what was the job about? I have no idea. No. clue. I had no not even remotely and I just know, you know, it was an office and I thought, wow, yeah. Excited to be cool. You know? Yeah, we’re wearing ties. Yeah. So I get the phone call the next day. You got the job? Awesome. Tell me mom. I got the job. What is it? I don’t know. She’s like, Alright, well, you got a job. Now. You don’t quit that till you get the next one. Okay. Yeah. And so right before that, I smashed up my mom’s car. And again, single mom. Yeah. You know, didn’t screw around with the car. Yeah. And so I did and it was kind of this. Get a job. Fix my car. Get out. Yeah, those are your choices. Yeah. So it was like, Okay, I get this done. So then, I got on my first day training. Yeah, it’s in the evening. Go through this kind of flip binder, you know, and they’re talking about dust mites. And how I didn’t know those things crawled in my carpet. my pillow was disgusting. And then that was it. And I’m like, wow, and we practice flipping the book together. Right? Yeah, I got it. Yeah. Yeah. Pretty simple script. Yeah, go home. What’s the job but I still don’t know Yo, what’s going on? So go on day two. And I’m like, wow, a lot of people out here anymore. Yeah, you know what happened to all the other? Yeah, seems pretty interesting. Yeah. Tell me more about these these mites. They do they start talking about all the dust in the air. Yeah. Cool fact that’s bringing them in right now my God. They pull up this machine and it starts purifying the air. And I’m like, Oh, that’s cool. Yeah, go home. So what are you doing? I think I’m thinking maybe selling air purifiers? Pretty cool. Yeah. See the ship we breathe in? We got to get one. Yeah. And sold right. Yeah, we sold.

Jenna Fortinski  05:41

Yeah, of course.

Dr. Tanguay  05:42

I go in day three training. And they pull out other parts. And I’m like, it’s a fucking vacuum. You know, there’s two of us left. Like I started 15 ready for trades. And I’m looking at this other guy. And he’s looking at me and we’re like, are we fucking settling back? Yeah. Yeah. And they’re like, you take this home and go show your your friends and family and I’m like, all right. I go home. What are you doing? I’m like, Oh, I gotta show you. Yeah. I show this this vacuum demonstration. She’s like, you don’t quit till you have another job. Oh, my God. Mom. I was totally quitting is that you do not quit. Do you have another job? Wow. All right. So I caught my best friend’s mom. Yeah. Hi, Donna. I have this this new job. And I’m supposed to show off these these air purifiers? Yeah. Oh, no. And she’s like, Oh, come on over. So I go over I show she buys it. Oh my god party versus Yes. Like That was my fucking car fun. Like your mom’s got a new vacuum. Yeah. And they gave me a couple 100 bucks. And I’m like, wow, that’s good. So I was I was into it. And then then, first day at work, they’re like, Okay, get in the van. And we’re going I’m like, Where are we going? Yeah. We drive to cardston. And we started knocking on doors. Oh my god. They didn’t teach me this. Yeah. So I ended up selling a whole bunch of them. And I actually you know, you get pretty bought into it and you really believe in it. Yeah, you know, you think it’s a pretty great product. I ended up owning franchises. I ended up corporate real I ended up expanding the company to New Zealand and Australia. And I ended up living in New Zealand for three years before I I actually I quit and the goal to go back to school because I failed out of college. Wow. God so there’s something that a lot of people don’t know about me, but now they do, I guess yeah, that’s right. That is that’s incredible. Great. The next question I have for you so that’s awesome. I did struggle about your cocaine use

Nicki Kirlin  08:09

That’s incredible. Yeah, that’s Yeah, that’s quite a quite a story. Yeah.

Dr. Tanguay  08:14

Certainly what I didn’t think I would be doing Yeah. 19 to us 2019 to 28 Wow. 2929 and then I went back to school Yeah. You went back to school at 2929 with like I read in high school read it undergrad rear that I failed. I started Lethbridge college and I didn’t apply I just did yeah, part time courses. So you can just pay for the course and do it and write the exam. I did a few courses with a 4.0 and then was like okay, I had enough confidence Yeah, they’re not gonna say no to me at last chance college was the nickname LCC and so I, I applied for general studies and I love school, they you know, the best thing about college and university is, you know, I was corporate VP of Marketing. I was helping build franchises. I was basically a therapist that work because yeah, commissioned salesperson not doing well, you know, something’s going wrong at home. Sit down with people crying in my office all the time. You wonder I became a shrink. And like, you know, all of a sudden, I’m thrust into this. All that matters is my grades. Nothing else. I know kids. Yeah, I had no responsibilities. I had enough money to like, I wasn’t wealthy by any means. But I bought a little house in Lethbridge. Little Honda. Yeah, I really had no responsibilities except grades. So you know, I came from this world of you work 1618 hour days, you’re building these things up to here I am in college and all I have to do is sit here for 16 hours every day and study right and you know, the grades came with it. And so ended up at University of Lethbridge. And neuroscience and then UFC medicine. Oh my god, psychiatry addiction pain medicine 15 years later. Wow, that’s incredible. is a fun time. And I ended up having kids in university and getting married and yeah, suddenly had more responsive to what’s going on here, like the beginning school and studied and then hit the bar and went home. I know. Yeah,

Nicki Kirlin  10:32

that’s, that’s quite the story and good on you. Yes. for committing to that and seeing it through and despite everything that you would have been facing in that whole journey, right. Like, that’s, that’s quite incredible.

Dr. Tanguay  10:44

Yeah, you learned young commitment because your mom kicked your butt. Right. So that’s, you know, that’s you learned it from the beginning, trying to do the same with my kids, which is hard, because they won’t want for anything. Right. That’s right. So trying to instill those same values in in a much different life. Totally. Yeah, absolutely. really working on that, which now, we’ll see how it goes. Yeah. There’s no manual for parenting. Yeah. I subscribe to good enough parenting. Yeah, they’re alive and they love surviving here. Right.

Nicki Kirlin  11:19

survival.

Jenna Fortinski  11:20

I think everybody is on that train. No, right now. Yeah. Yes. Yeah. And yeah, there is no right way. It’s what works for you.

Dr. Tanguay  11:28

Great. In my opinion, yeah. Well, there’s a lot of wrong ways. Yeah. We don’t find out. I was gonna say, let’s talk about that. No, don’t do that.

Jenna Fortinski  11:45

Nothing like creating a little bit of anxiety right now. Oh, my gosh. So since becoming a psychiatrists, and you have some exciting new projects in the works, can you tell us a little bit about where you’re headed in the next little bit what you’ve been working on?

Dr. Tanguay  12:07

Yeah, I mean, in December, I had an opportunity to have a discussion. Yeah, I mean, at the end of the day, we work in a in a health care administration system that’s so broken and doesn’t care about its patients. And it just came to a point where it was time to do things, right. And that’s what we’re trying to do. So we’ve developed the newly Institute. At the end of December, I went to a colleague of mine, Dr. Marshall Ross, who, you know, top 40, under 40, the two of us develop the Suboxone in emergency protocols, we actually started the first kind of study process of this, which, you know, the emergency SDN took over, and Heather hair and her amazing work, and, you know, and so I went back to him and was like, Hey, man, like, we’ve done some good stuff. He just developed this new billing company. And, you know, there was there was an opportunity A few years ago, I met with some some guys that were involved in Blackberry, before was insignificant. So they had done well for themselves, and they’re trying to develop a new idea. And we started talking about developing these kind of mental health rehabilitation programs. So, you know, there’s, there’s these great addiction programs, these great pain programs, but there’s nothing in the in the mental health space. Right. And so, you know, I kind of talked to him about it. And we started talking about, look, there’s, there’s kind of this psychedelic movement right now. Right? What do you think of opening a psychedelic clinic? I was like, Well, you know, there’s some interesting data. It’s not like cannabis. It’s like, really driven by data. So, you know, I started looking into it was like, Yeah, man, like, if we could use psychedelics as a way to develop, you know, these mental health programs, these disability and vocational rehabilitation programs, and we use psychedelics for those individuals who aren’t responding to evidence based therapy, really, the foundation of everything we’re doing, and why not and there’s opportunity. So he’s like, Alright, well, I got a buddy who’s a lawyer. We met him, he met with Arthur, who was an investment bank, who had already kind of started the process. And we sat down with him, and we sat down. I mean, it’s COVID. So we called him Yeah, yeah, we started, we started talking about what we want to do. And he’s like, Look, I got this team, and this is what we’re doing. And we signed in fredericton. We’re looking in Calgary and we’re like, interesting. And he showed us his, his kind of his medical team and medical advisors and I was like, nope, yeah, I don’t know any of these people. They all look like cannabis people. I’m not interested. You know, if I’m going to Do this, I’m going to leave my academic career and everything I’m doing. I’m going to do it right, right. And he literally pause for a second. He’s like, they’re all fired. You’re gonna have good, everything you’re in full control. We want you as the chief medical officer. You develop the advisory board, you build all of the physicians that we need, and I was like, it, you know, and you know, it was just kind of one of those things of like, Okay. Oh, what did I just say? Yeah, yeah, I have a full time job and a whole bunch on top of that full time job. What am I gonna do? Yeah. And then the next morning, I woke up and was like, Wow, this is amazing. This is amazing. We’re gonna we’re gonna really do this. And, and Marsha was the Chief Scientific Officer. And we started talking lots and then I was like, You know what, I’m just gonna call, you know, all the people I know, across the country who are experts in their specific fields, sleep, ketamine, addiction, pain, you know, trauma. And I, I put out a bunch of calls, and they all basically said, Yes, wow. And it was like, holy cow. Here we go. Yeah. And so now we’ve developed kind of a national set of clinics of intense outpatient programs dedicated to the treatment of trauma and mental health and first responders as well as addiction. Yeah. And you know, a lot of people spend a lot of money to go to these really fancy inpatient programs. But, you know, if we follow what the guidelines tell us, they’re supposed to fail all the outpatient programs first, but there’s not a lot out there. Right. So we really, were trying to fill a gap. Yeah, that exists, and we’re doing it across the country. So now we’re, we’re opening currently in Calgary, Edmonton, Ottawa, and fredericton. And, you know, the, the goal is Victoria, Vancouver, Toronto, Halifax on top of that, and then start looking stateside, so Wow. Yeah, it’s a it’s awesome. And in the best part about it is how, how much support that we forget, you know, you’re really worried as a physician, you’re, you’re leaving HS. Yeah. Going into the private world? Yes. Like, am I gonna get butchered by my own colleagues? Yeah. And instead, it was the exact opposite of, you know, you needed to do this right thing. You know, our first responders and police officers and veterans deserve better. And I believe that 100% Yeah. And, yeah, that’s we’re gonna do give them the best health care that they can get. That’s incredible.

Nicki Kirlin  17:40

Good for you. And what a service that’s needed. Right. So that’s fantastic that you’re going to be able to fill that gap. Yeah. And offer that? I think so. Yeah. So that’s, that’s amazing. So considering that trauma is going to be a focus of the work that you’re that you’re embarking on? How do you define trauma?

Dr. Tanguay  17:59

You know, that’s, that’s a fascinating question. So I’m doing a lecture for Cambridge University. Okay, coming up. And that’s exactly what we’re going to talk about. Yeah. Is everything that we look at in mood and anxiety disorders related to trauma. So we hear all about treatment resistant depression, right, bipolar disorder, borderline personality disorder, thurl trauma. Now, that’s that’s not necessarily true, true bipolar with true manic events where, you know, you’re talking to God and God’s talking back to you and you don’t sleep for days. That’s it. That’s a really severe illness. It has nothing to do with what I speak about, but so many people are mis diagnosed in that area. Right. And so many people, you know, the ICD or the International Classification for disease, which is, you know, our Diagnostic and Statistical Manual, which we use in North America is the European model, right, and they’ve already included complex PTSD. Okay. And this is about, you know, our adverse childhood traumas that then have an impact on our personality development and our ability to cope, leading to depression, anxiety, panic attacks, insomnia, you know, relationship difficulties, all these kind of pieces. And so, you know, in North America, we don’t have that diagnosis yet, but it’s coming. Right. And so when when you really ask what is what is trauma? trauma is anything that someone can’t get over. Okay, so it doesn’t need to be a horrific car accident, right? We’re seeing your friend die. Yeah. Or almost dying yourself. It could be, you know, the bully from grade three, that you just can’t get over. The invalidation from mom when you were 14 years old. After you know, Uncle Tom was a dick, right. It’s whatever you personify with that you were then invalidated about and you’re unable to get over. Okay. That is a big focus for us. Now for the area we’re working in, in in first responders and in in veterans, it’s it’s obvious obvious in many cases, yeah. You know, our officers who dedicate their lives to protecting hours also dedicate their lives to motor vehicle collision, homicides suicides, that they see Absolutely. Some of the worst things, the childhood abuse cases, all of these, these traumas that become continuous that they see over and over and horrific, horrific things. And then you tack on, you know, the unfortunate culture we live in today of defund and police are bad. And, you know, imagine the horrific things these officers are going through people who, who decided I want to go help society, and are now being villainized and butchered in the media. And yet, you know, we’re looking at a five second clip with note now, there’s some of them their absolute right, yes. Yeah. Can’t kneel on someone’s neck for you know, yeah. That’s horrifically disgust. Yeah. But that is not a representation of all office, that’s a town and and to be painted that way. It’s, it’s really quite horrific. So it’s a passion of mine, I believe. We owe it to them to give them the best care. And that’s what we want to do. Yeah.

Jenna Fortinski  21:34

So we know, like part of the work that you guys are doing with the newly Institute is working with war veterans. Can you speak a little bit about what’s unique about the trauma that’s faced by war veterans?

Dr. Tanguay  21:44

Yeah, I think similar to a lot of, you know, officers and first line responders, there’s a lot of trauma intermixed, but it’s the moral distress, the taking of someone else’s life. The belief that you’re going to do this for the betterment of something and the realization, what are we bettering? What are we, you know, what are we doing in some of those horrific stories of, you know, having a gun pointed at a child or a mother and realize, holy shit, what am I doing? The depth, the policing, the moral distress of this doesn’t fit my values. I, I came here for this reason, and now I’m doing that. And I’m not allowed to question. I think that’s, that’s a big piece. And that’s true in policing. You know, that’s true in first responders. It’s true in a lot of areas, but I think in veterans, that’s a huge piece. And then, you know, you’re, you’re a part of this tribe, this group, and then you’re done. Yeah. And then you go home, and people don’t get it. And the people around, you don’t get it, and nobody understands what you went through. And then your friends start committing suicide. And then the people that were there with you, your people are all dying after your other people died there. Again, the these these people who, you know, chose to join the military to, to, again, fight for our freedoms, and for what we believe in and to support what they believe going to other countries and fight for those people who are disadvantaged. And they come home not well. And they’re scared. And they, they’re also you know, mental health is weakness. So they don’t want to, they don’t want to go and they don’t want to talk about it. And they don’t want to tell everyone about it. And they don’t want to, they’re trying to avoid it. And that’s what trauma is right? avoidance. It’s just push it, push it, push it, and and the more you push, the more it bounces back. The more irritable the more angry, the more dead inside, the more empty, the more flat, the more shameful the more guilt, the more devastating it is on a person. And then, you know, you got idiots out there saying Don’t worry, Time heals everything Time heals. Time just makes you used to how you become and everyone else leave you. And so, you know, same thing, you know, like, like our boys and blue. And and ladies and blue. Our veterans deserve the best care period. No,

Nicki Kirlin  24:31

I agree. 100%. Okay, so you spoke a little bit at the beginning about the newly Institute and some of the services that you’re going to be offering. So one of the services is a psychedelic therapy. So can you tell us a little bit more about psychedelic therapy and why it’s effective?

Dr. Tanguay  24:50

Yes, we have the cool chat earlier. You know, psychedelic therapy is like spending 10 years with Freud in five hours, right like, you know, it And if that I believe this was David nuts, I’m paraphrasing, I’m going to do is that a Freud would have kept going past cocaine, and would have just tried mushrooms that we would have been doing this years ago. Right. And, you know, cocaine wasn’t helping anyone and it wasn’t helping Freud. So, you know, I think, what what really the psychedelics do is when we’re taking someone who’s not responded to all other treatments, that’s how we’re looking at it today. Now, of course, the best of the best, we should probably always do first. But that’s not how medicine works. So, you know, we’re gonna, we’re going to take these people who haven’t responded to anything else. And we’re going to introduce the psychedelic assisted therapy. And the idea is we want to break down all the barriers that they put up, that are preventing them from getting the trauma therapy and responding to the therapy. And we’re going to open up that individual to become more vulnerable. And we’re going to let them see themselves for the way they are, why am I the way I am? Why do I act the way I am? Why are things happening in my life the way they are what happened? And it builds insight and introspection to everything that’s happened to you. And then it also seems to work really well on the sympathetic nervous system and bringing that down and stabilizing people so that they can start doing some of the skills work. And and really, I think the best wording for it, it’s a catalyst, it speeds up therapy. Is it is it the answer in of itself, like, you know, most of Albert nbcf sat around the fire eating mushrooms at one time in their life, maybe having a few beers, and they weren’t magically cured, you know, and, and most of Europe has done some MDMA in a in a, you know, a club, right. And there’s still mental health there. It’s not the answer in the molecule, the molecule catalyzes the therapy? And the answer is in that there.

Nicki Kirlin  27:08

Okay, interesting. Oh, that’s amazing. Yeah.

Jenna Fortinski  27:13

So we’re wondering, from your perspective, what drew you into this work with working with frontline responders working with the police working with war veterans, like what brought you into that?

Dr. Tanguay  27:25

So, again, I’m an addiction psychiatry, so I did my psychiatry, I did an addiction fellowship. And then I did a cross appointed fellowship with anaesthesie in pain medicine. And you know, there’s there’s a lot of similarities, a lot of struggles with coping a lot of emotional dysregulation, a lot of depression, a lot of personality disorders. And, you know, early in my career, it’s just what I chalked it all up to and then, you know, I developed a spinal surgery pain program than a D prescribing program. We opened up our rapid acts Addiction Medicine program, and what what I was sit down with the residents and trainees and start talking about what what is your formulation, and it all seemed the same. And we started, okay, I got a I gotta start digging for trauma. And the rates of PTSD were unbelievable. And, you know, I’ve been talking on and off of the OSI for years, and you know, they’re their clinical lead had been talking to me, and we’d met many times Marnie, and Caitlin was there. CMD, who’s a good friend of mine, and I finally just said, Okay, I’ll come. And they’re, like, great, like, how much I’m come for a couple days a week, I’m gonna get out of this and that and and then I started and that was just to get more expertise in treating trauma. I had, you know, worked at a DBT clinic where we got trained on DBT prolonged exposure, and I had done some EMDR work and some mindfulness work and but I had not learned truly working in in a program that treats operational stress and psychological injuries, like trauma. And I really, really, really liked it. I yeah, it’s it’s every, every time I meet someone, it’s like hanging out with the boys from home, and we just chat and like, there’s a lot of shit going on. And they responded well to treatment. And I was like, This is fantastic. But I always wondered, you know, when I fill out this template, it says they’re going to be well in 12 to 24 months. Why would I have never read a protocol in research that said you had to do therapy for 24 months before you’ll be well, and that’s where I started looking into IO PS this intense outpatient programs and seeing someone every day and enhancing this and the outcomes suggested I O PS and in that 24 month program, have the same outcomes, except How is that the same for the person who’s living with it and suffering with trauma so I can suffer for 24 months before I feel good, or one month? Ah, I think there’s some different but when we do research, that’s not how we look at we look at the outcomes. And the outcomes of the same boat, the big difference is the retention. So IO peas have much higher retention rates, you know, trauma therapy, data suggests about 50% end up dropping out, because hard, whereas IO peas have much higher retention rates. So but we can’t call it better, because the outcomes are the same. But when we look at retention and time, there’s there’s a dramatic difference. So yeah, it just kind of all. You know, we talked about this earlier, is there luck, is there, not luck. What is luck? You know, in my opinion, luck, is a little bit about opportunity meeting preparedness. And we were prepared, and then we found the right opportunity. And and now here we are.

Nicki Kirlin  31:07

So would you say then we and I think you touched on this at the beginning. But you know, our aim with this podcast is to break the stigma around getting and receiving mental health support. So would you say that there is a stigma that exists for maybe war veterans or frontline workers or those that are exposed to trauma as part of their profession? Is there a stigma around for those people that are seeking and receiving mental health support? Of course, there’s sames thing? Yeah. And why do you Why do you think that is?

Dr. Tanguay  31:39

I think it’s a cultural issue. It’s it’s a belief that the requirement for asking for help is weak. Right? Right. And the best way it’s, you know, we hear all this work about stigmas about changing the language now it’s not it’s about making it okay to ask for help. That’s how you break stigma, make it normal, when you’re struggling to go ask. So in my opinion, if you want to look at, you know, who are we going to promote, you know, Option A, no problems has been perfect. Never, never met any psychologists must be amazing. Option B has been seeing psychology here and there throughout to better himself. Well, to me, option B is way better, because he can actually see what’s going on. Whereas option A she’s in full denial. Right? So and this isn’t a gender thing, of course, but you know, I think asking for help and the ability to do so. And the ability to better oneself should be an absolute for promotion, but we end up promoting a and so when you have full leadership in all aspects and the culture is asking for help is weakness, which is no different in the corporate world. no different in the health world, no different in any world, right weakness. When when we when we start to connect, mental health weakness, that’s where we bring, you know, the stigma. And so yes, it’s it’s chock full of stigma, but no different than anywhere else. And, and really, the best way to break it down is it’s okay to ask for help. And in fact, we want you to do it, yes, it should be mandatory should check up once a once a year and, you know, the, the therapist should be in house and, you know, they should be badged up or, or whatever the case may be, and whatever gig they’re in and be a part of the whole crew. There’s actually a detachment to police detachment, Alberta, that has a yoga studio in it. Oh, they have to do 30 minutes of yoga, every shift. Isn’t that awesome? Like, just amazing. So we know, there’s another one looking at building a mindfulness studio in it. We’re seeing the shifts occur, but it takes time to change a culture.

Jenna Fortinski  33:57

Yeah, absolutely. It does. And I think especially given all the stuff that’s happened recently, of course, in the in the media, right, and the pressure that all these people are under in their positions, it just further creates this, you know, microcosm of, you know, be afraid to don’t ask for help, and we can muscle our way through it. Right. And, and yeah, it’s just it’s hard because there’s, we’re trying to break the stigma, stigma, we’re working really hard. But then there’s this other rhetoric that’s happening in the background of Yeah, you just need to muscle through it and get your job done. Right,

Dr. Tanguay  34:28

the fear of not getting your promotion, right. Yeah, if I ask for help, I’ll never get further than I am today. I have to be strong, I have to show everyone I’m competent and on top of it, whereas admitting weakness has to be the stronger person. We have to admit that. And I’m sure you’ve met many people on your podcast saying the same thing, practice as well. And, you know, those people who can go through that transformative aspect of therapy to get through the traumas that they’ve been through I I mean, those people are amazing. They become huge advocates of this area. And there’s another part of breaking stigma, have people experience open their voices? Yeah. You know, share your story. Yeah,

Jenna Fortinski  35:11

yeah. And that’s something we’re trying to work hard with in terms of, you know, having people come on that are able to share their stories and their experiences. And it’s so valuable, because we all know for that one person that speaks up with their story, we know God knows how many are suffering in the exact same way. Right. So we want to ask you a little bit about your perspectives on the public health system versus a private services across Canada. You know, people kind of have this perception that the public health system is free and accessible. And it’s great that in Canada, we have this opportunity. Is this the case?

Dr. Tanguay  35:49

Well, it’s I think it’s all true, I think there’s massive health inequity. And you know, the person living up north who has to travel, you know, 10 hours to get to their clinic, and then stay in a hotel and then see their doctor, stay in the hotel that night, and then drive all the way back taking three days off for their workplace, versus the person who works downtown in his next door to a clinic and just slips over and comes back massive inequities. But there’s no question that the public health care system is is paramount, to, you know, the needs and requirements of of our most vulnerable. The problem with healthcare is about public versus private. You know, I think that opening access to some private, it’s not a bad idea to some, it’s a terrible idea. It really has to do more with the human resource. If we don’t have enough human resource in one area, and we want to try to open privatization, it’s a disaster. If we have too much in that area, it seems like the only option. But the real problem comes down to that that health inequity, and how do we make sure that someone living in tuktoyaktuk has the same treatment as someone in Toronto? And that is not the case right now. But, you know, I absolutely think public health care is important. But you know, I would, I would quote, a colleague who said, you know, public health care is the floor, not the ceiling. and public health care can stifle innovation, we often have to look to other countries, for innovation and for new treatments and new protocols and new growth. And when we do get one in Canada, I mean, it’s celebrate that Canadian doctor figures this out, and it’s like, Whoa, the whole countries and praising. But, you know, it shouldn’t be that way. Right. It should be a daily occurrence. And we have some of the brightest minds in the world here. Often stifled by an administration program in the public system. You’re gonna get me in trouble.

Nicki Kirlin  38:05

We’ll stop that part of the call. Yeah. Just stop. Yeah. On the edge of the controversial

Jenna Fortinski  38:10

Yeah, conversation.

Nicki Kirlin  38:13

So I guess on that note, one more question for you then, is, what advice would you give to people who are struggling then and who, you know, kind of knowing the state of the public health system and, you know, being cognizant of maybe wait times and all of those things, and maybe the cost of accessing private services? What advice do you give to those folks that are kind of caught in between the

Dr. Tanguay  38:38

you know, when we talk about public health care, here’s the biggest problem. Mental health is basically not covered. Right? Right. So, you know, it kind of like dentistry is just completely ignored. And why like, Why are my teeth not important? Why is my mental health not important? You know, why? When I’m skiing off zone, breaking the law and I break, my leg is fully covered, we’ll take good carry a man. But when I’m feeling depressed, and I need to speak with a psychologist, that’s not covered. And, and I think that’s one of the biggest problems. You know, our system is designed for how long does your society live? So that’s important, and what are the amount of infants that die? And don’t get me wrong? Those are super important processes. But it doesn’t give a shit about Are you suffering? Yes, yeah. What about chronic complex care, chronic pain, mental health, addiction? And in fact, these are the areas that we allow private care. Yeah, you know, it’s not okay to have a private Surgical Clinic but it’s just fine to have a private addiction clinic. That’s stigma right there. Right. And that’s the stigma in mental health. That’s the stigma in addiction. You know, in similar in chronic pain, like You know, the only thing covered in chronic pain is the prescription for the medication, often an opioid, but not the mental health part of it, not the physiotherapy part of it, not the massage therapy part of it, not all the other treatments that are often a better evidence in the medication. You know, and that’s really the biggest problems that we have, you know, we got into this massive opioid crisis, because the only thing we covered was the prescription for the opioid. Now that the problem is about illicit phenols today, but we got here because of our prescribing in the first place. And that was because we simply didn’t cover any other area of pain medicine. And so the biggest problem is we don’t measure suffering. We don’t measure quality of life. And we do like we have dailies and qualities, and you know, who does all of this, but nobody really cares about that. Right? You know, you don’t hear about that in the news. Oh, Canada’s dailies are in a lot of trouble right now. Like, that doesn’t come out, ladies and gentlemen, children of all ages, Canada’s fifth on the daily, you know, like, just doesn’t come out. You know, it’s about you know, Canadians are living longer, you know, and great. So Canadians are suffering longer. So you know, that that’s the big thing is, we don’t focus, you know, if you were to have a stroke in Calgary, man, the care you’ll get have a heart attack while you’re gonna have the best of the best. But if you have pain after that heart attack, you know, maybe your GP can help you. Yeah, no. And the GPS, like what? Yeah, we’ll get you into a specialist somewhere. Well, you know, it’s about a two year wait to get in there. So that’s, that’s the problem. We got to change how we measure health, it should be health and wellness, not health, and you’re still alive? Yes. Yeah.

Nicki Kirlin  41:49

That’s a really good point.

Jenna Fortinski  41:51

So like, last words of the wise, you know, for those who are suffering, how do they advocate for themselves in the system that we have? Do you recommend that? How do we how do people get the support that they need?

Dr. Tanguay  42:06

Oh, man, that’s a hard question. I don’t know. I honestly don’t I mean, there’s more and more organization. There’s, you know, help Alberta’s pain and Alberta talks pain we’ve, we’ve really bolstered to help Alberta’s pain. And I mean, Tracy Fossum and the crazy work she does there. She’s amazing. We’ve started Alberta tox pain more in that lobbyist area, and really how to make change. there’s not as many of those mental health Oh, there’s not big mental health advocacy, there’s huge, you know, addiction advocacies and, you know, plain straight up activists, where it gets kind of confusing, are you are you advocating for people to use drugs or for people to get well from addiction? I mean, I don’t know what’s going on here. But you know, we don’t see it in mental health, which just continues to talk about how stigmatized this area really is. I’d love to see, you know, some sort of advocacy group come together. You know, we can, we can advocate all we want to governments and so forth. But, you know, the reality is, is our healthcare systems, one of the most expensive parts of a government’s budget, and a government’s gonna look at it and say, well, we can’t spend any more. So how do we shift it? I don’t, I know, I don’t have an easy answer for it. Other than, you know, nobody wants to hear raise taxes. And nobody wants to hear, you know, we need a health tax. And nobody wants to hear, but everybody wants to hear, you know, we need more ICU beds. And why didn’t we figure this out? Well, that’s really expensive, dude. Like, you know, sure, we could do that. But then we’re more taxes, and we’re gonna take more money away from you. And you don’t want that either. So it’s a it’s a bit of a catch 22. And, you know, what we really need we got to be really prepared in modern history, every time there’s a recession disability rates tank, right, because everybody’s hanging on to their job with their skin of their teeth. Because if they give any reason to be let go, they’ll be fired, then they don’t have a job. So everybody hangs on and then the economy picks back up. And then everybody who’s not doing well is like, wow, I’m out and disability rates go up. COVID is the first time that we see disability rates going up, as the economy’s been coming down. So when the economy comes back, the disability rates are going to yet dakotah, an excellent corporate executive at one of the disability programs, we’re gonna see a tsunami of mental health concerns, and most provinces and jurisdictions are not ready. Many don’t even believe in it. It’s corporate mumbo jumbo to try to get us to spend money and all that crap, but it absolutely know it. You know, we know our hospitals this hallway medicine is occurring. Right now, but it’s been occurring for years in our healthcare system is always at the cusp of collapse. And so when one little thing adds to that collapse, we’re in a disastrous position. And unfortunately, human beings as a whole, are very good at being proactive. So neither are we, as governments, neither are leaders. And neither are administrators, which is really what leads healthcare as administrator. So don’t expect to see much change. I don’t know how to advocate, you know, the proverbial write your MP, you know, write your MLA, you know, don’t vote for next time, and then do the same thing again next time go vote for that one here, because no one seems to fix it. So it doesn’t seem to matter if you’re orange, or blue, or purple or green, or, you know, I’m a big Rhino fan, it doesn’t really make a difference. None of none of them have figured it out. Yeah. So, uh, you know, this is where, you know, we’ve got to really sit down and start talking about what what really is the best way to care for our most vulnerable, you know, and it’s, we’ve got to stop thinking writing a prescription as the answer more skills, less pills. But we we live in a society where we’ll cover drugs, and we won’t cover therapy. It’s crazy. It is.

Jenna Fortinski  46:20

It’s crazy. And it’s unfortunate that we are in such a setting people up for failure mentality. Right. And, and it’s awful that that’s where we’re stuck in. And yeah, it’s it’s so hard to know what the answer is. And I feel like we can all sit back and look and say, you know, we should be doing this, we should be doing that. But the reality is, is that it’s so much more complex, like you said, Rob, is that there’s so many moving parts, right?

Dr. Tanguay  46:46

I’m who wouldn’t want to say we should just cover all mental health? But imagine what that budget looks like. And where do we take away from? Right, and and how do we balance any sort of budget? I mean, nobody seems to care about balancing budgets for the last little while. But yeah, we still got to be somewhat fiscally responsible. So it’s really tough. I’m a huge advocate that we should do it. But we’ve got to sit down and figure out how to do it right, and to maintain sustainability. And that’s where we really got to rely on our third parties. And, you know, how is it that you know, that we were meeting with a police precinct in Alberta? Today, who told us their officers get $300 a year for mental health? And it’s like, well, that’s why we have a problem. Yeah, like, you know, change your benefits, improve access through third party. And, you know, like, I don’t think this is intentional, I don’t think a city or a police precinct is like, they don’t need more and screw them. It’s more of well, it’s just the way it’s always been. And so we need to start looking internally, we need to fix some of these third party payers. And, you know, we and this is all, you know, private medicine. And so we’ve got to figure out how we, as a public system can work with a private system. And or, you know, we need to crank up our GST. And we can call it the GST HST. The goods and services and health tax, so g sh. T, I guess, there you go. A lot of people aren’t gonna like that. I’m sorry, everyone at home? I don’t know, I’m just making shit up right now. I mean, there’s no answer here. Don’t Don’t yell at me.

Jenna Fortinski  48:32

And I think like the take home message is that, you know, the reality is with COVID. Is that, like you said, there is a tsunami coming? Right. And, you know, as even with talks of Alberta reopening fairly quick and people feeling anxious about that, and I think the take home message really is is you know, start your process sooner than what you think you should and, you know, try to get access to services as soon as you possibly can. Because, yeah, things are going to wrap up. It’s, it’s we’ve gone through something that nobody that’s living today has really correct. Right. So salute, you know, we’re all navigating this together. And it’s a you know, it’s it’s so difficult and everybody is struggling. So, please try and access sooner rather than

Dr. Tanguay  49:16

No, I agree. I, I mean, you want to really advocate advocate to your workplace, get me better coverage, you know, and and get your unions together and, you know, get get everyone together to support and this isn’t about I want higher wages or I want more money or I want to be taken care of when I can’t take care of myself. You know, I deserve better. And just like we’re advocating for better you have to do the same. And that’s that’s about the best that you can do. Or you can write your MLA Yeah, I think it’ll help wise words Ain’t gonna matter. Take an elastic approach pocket. Oh my goodness. It goes the professional. Okay, we’re

Jenna Fortinski  50:15

all human beings. Yes, absolutely. Thank you. Yes. Thank

Dr. Tanguay  50:17

you Rob so much. Of course, it’s been a pleasure. Happy to come back happy to. Yes. I won’t say anything more. Yeah. To come back.

Jenna Fortinski  50:28

Awesome. And we’re happy to have you and we are so excited for the newly and, and hopefully to get a glimpse of it and to see what it’s all about. And yeah, we’re so excited for you.

Dr. Tanguay  50:40

Totally. We’ll have you open or we’ll have some open houses come when you know, COVID lets us write. love to have you come over. Yeah, check it out, walk you through it. And really excited to show you what we’re doing.

Nicki Kirlin  50:51

Excellent. Sounds great.

Jenna Fortinski  50:53

Thank you, Rob. Thank you. As always, we would like to end this episode with a quote. This comes from Martin Luther King Jr. Our lives begin to end the day we become silent about things that matter.