“When I get scared, I avoid things. It is a natural human tendency, and I think more physicians need to talk about our human traits that we have, especially when it comes to our health, so that we can make people feel less stigmatized and less than when they're talking to us about their issues, because we might be able to help them.”
Dr. Darien Sutton is an emergency physician, a correspondent for ABC News, and a doctor-influencer with over 2 million followers on TikTok. Darien uses his platforms to educate the public, combat misinformation, and advocate for a more equitable healthcare system.
On this episode of How I Doctor, Offcall co-founder Dr. Graham Walker talks with Darien about the value of teaching patients health literacy, the importance of doctors looking like their patients, and Darien’s shift from full-time physician to media figure. Darien weighs in on physician pay transparency (we need more of it) and the new specialty he’d invent (doctors for anxious 30- and- 40-somethings). And he shares all sorts of insights about TikTok, including how the platform helped him find his voice, why creators need to be their own super fans, and how avoiding trends helps his content take off.
Here are four highlights from an episode with one of the leading physician voices of his generation.
“We often talk about risk factors in terms of blood pressure and cholesterol, but I think it's so important to make a note of someone's understanding … if the patient doesn't understand what's going on, their chances of "complying" with your plan are slim to none.”
Health literacy can have a measurable impact on a patient’s health. When Darien was working in emergency medicine, he found it frustrating to see patients spend all day in the ER when they didn’t need to be there, simply because they didn’t understand the ins and outs of the healthcare system. Darien has found it validating to create educational content that teaches people how to ask questions in healthcare settings. When he can empower someone to effectively communicate about their health, he knows they’re already on a better foot than they were the day before.
“I think that when you are creating content, if you are evoking emotion or using some level of emotion in the setting of health, I personally take it as a red flag.”
Darien’s advice for any creator is to avoid being sensational and to prioritize quality over quantity. And, regardless of what you put out, he says there’s one person who absolutely needs to find it incredible: you. Being a fan of his own content has driven his success. There have been moments in Darien’s TikTok career when he’s felt the urge to jump on a trending topic. But he’s held off, because he’s realized that, while chasing trends might lead to views, he wouldn’t watch that content himself. He believes this quality-control strategy has propelled his growth.
“Sometimes I wish I could simply be a scientist and teach the way Bill Nye taught us when we were kids about cool scientific experiments. But I also know that my lived experience, as a Black man, as a gay man, and as less than 2.5% of physicians who look like me, is a very valuable experience … and I need to make sure that not only my patients, but my peers understand why that is important to understand.”
The data doesn’t lie: We know that patient-provider concordant care — in terms of things like race, class, and language — helps reduce healthcare disparities. Put simply, Darien says providers should look like their patients. That can’t happen without more diversity in medicine. To make the field less exclusionary, we need to lift barriers early on. For example, it’s not just med school that’s expensive. As Darien points out, the testing process to get into med school is cost-prohibitive for many people.
“I need someone who specializes in middle-age anxiety. Many of us don't see regular doctors. What we need is a reinforcement of primary care so that we have more doctors available to answer these everyday questions from people who seemingly are healthy, but need to do certain things to reduce their risk later on in life.”
If Darien could design the next new specialty, he’d be selfish and give adults on the cusp of middle age their very own physicians. The importance of pediatricians and geriatricians is well recognized. But what about that phase of life where you need to start acting like an adult who’s proactive about their healthcare? Accessible, equitable primary care for people in their 30s and 40s — let’s make it happen.
Connect further with Darien on LinkedIn here.
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Darien Sutton:
I think that we do a disservice in general to our students and our trainees because there's so much of this dogma that we should be quiet about pay, which is completely ridiculous. I just disagree.
Graham Walker:
Welcome to How I Doctor, where we're bringing joy back to medicine. Dr. Darien Sutton is a board-certified emergency physician, medical correspondent for ABC News, and social media powerhouse with over 2 million followers on TikTok, and most importantly, a fellow ER doctor who trained in New York City. Dr. Darien uses his platforms to educate the public, combat misinformation, and advocate for a more equitable healthcare system. Welcome to the show, Dr. Darien.
DS:
What an introduction. Thank you for having me.
GW:
Maybe you can just tell our listeners a little bit about your social media success story. What made you start? Did you start with TikTok? Did it start during COVID? That's certainly what got many of us, myself included, onto the platform and onto social media. Where did this all start?
DS:
It actually started before a lot of this. It feels very much like I've been doing this for a long time, but like anyone's success. I think when you look at it from the outside eye, it often feels like, wow, that was just sudden.
GW:
He's a natural.
DS:
He's natural. In reality, I started this process probably 10 years ago. I started a concept called bus stop medicine, which is when I was in residency, I was like a second year resident. It was when I was learning new things about the body, how that affected us, how things presented in terms of their symptoms and how we diagnosed and treated and managed conditions. And I knew immediately that I was most interested in trying to figure out how to translate the things that I was learning in residency, in medical school to the everyday person at the bus stop. I would start with basic cases about a pilonidal cyst or what is an ear infection? What exactly is a heart attack? How does a stroke come to be?
And then that slowly evolved into an audience where people were genuinely curious. And a lot of my friends who were not in medicine found it really comforting that they had a friend who was learning about this and they felt as though they were getting a little bit of an experience of medicine and medical school and residency training, so it was naturally interesting to them. And I always made it my purpose to make sure that what I was teaching was understandable to everyone. And that slowly grew 10 years later into what we
all see today.
GW:
And resonates with me as an ER doctor because I think so much of what we see in emergency medicine is people who don't understand their bodies. Our patients tend to skew a bit lower on health literacy and access to care as well. So I think so much of what we often see in the emergency department is stuff that is not well understood by many people in the United States and across the world about, like you said, about their own bodies.
DS:
And we know that health literacy contributes to chronic disease. We often talk about risk factors in terms of blood pressure, cholesterol, but I think it's so important to make a note of someone's understanding. Because you can say all you want in terms of making sure that you found the right diagnosis and you've gotten them the correct treatment, but if the patient doesn't understand what's going on, their chances of "complying" with your plan are very slim to none.
GW:
That's a much more optimistic version of what I say, which is probably a bit more pessimistic, which is like, listen, when you're in the ER, I have like six to eight hours to impact you. I have relatively a minimal impact on an actual human being's health outside of what pills I can give them, if I can put them in a splint if they broke their ankle. Versus if you can educate somebody about their bodies and their health, 99.999% of people's lives are spent outside of the care of a hospital or a doctor or a healthcare system. So it's so much of those behaviors and those attitudes and those understandings of the world is actually what impacts their health far more than what you and I do.
DS:
That experience is mutual and I'm sure felt among many providers even outside of emergency medicine. I think being in emergency medicine operating as a safety net for society, we see a lot of the realities of society as people come in without an understanding of how systems work. Often, I would be left feeling frustrated because I would see a patient come in who did not need to spend their entire day in the emergency room, but it was simply due to a lack of awareness.
I love it when I meet people outside and especially if they've known me and known the way that I produce content for a long time. They'll just say, "Hey, you've taught me so much about how to ask questions." That, to me, is really validating because being able to empower someone with the words and the language to have a clear communication about their health, I already know they're on a better foot than they were before.
GW:
What have you learned about how do you make something that's engaging? I think a lot of the times, a lot of physicians probably think our stuff's kind of dry. It could be kind of boring.
DS:
I think everyone has their own style. And I think that my advice personally for anyone who's creating content, whether that be a provider, a doctor, a nurse, avoid sensationalizing things. Emotions are important and I think that we should put a high value on them. So I think that when you are creating content, if you are evoking emotion or using some level of emotion in the setting of health, I personally take it as a red flag. I take a step back and I say to myself, "Why is this person using or evoking such a strong emotion with this?"
So my advice is stick to the facts. Don't try to keep up with the quantity of other creators because that can also lead you to creating poor quality content. And remember that regardless of what you create, it has to have one fan that finds it educational and finds it incredible, and that's a super fan, and that fan has to be you. You have to be a fan of your own content and then that is what drives your style and your education.
GW:
I love that. That is true. I have to be a fan of the stuff that I write too, otherwise it's like, well, it's not... This doesn't represent me or I'm not proud of this.
DS:
There are so many moments in my career where I have felt the urge to follow in suit, to attach myself onto a trending topic. But inherently, I would know I wouldn't watch this video. It might get a lot of views, but I wouldn't be interested in this. And I think the reason why people follow my content and enjoy my content is because I really focus on that quality.
GW:
Darien, let me just ask you about transitioning to traditional media. You are now a medical correspondent for ABC News. How did that job evolve?
DS:
That process actually started, I would say seven, eight years ago. I had gotten an internship here at ABC and the goal of that ABC internship was really simply just to review the medical studies that come in. People might not know how this works, but studies are often released to journalists earlier than they are published and they're released under an embargo, meaning that you have to keep it private. But it gives you an opportunity to review it so that when that study is published, that is what allows a headline to immediately say, "This is what this study is about."
And then after I participated as a med unit intern or medical unit intern, I continued to participate just kind of in and out of journalism while I completed my residency. And during the pandemic, that was when it became a time where information about our health was incredibly important. And then it became a little bit of a, "Okay, Darien. This is actually something that you're interested in, communicating with the public is something that you love. Lock in, figure out how to be good at it and keep working."
And then about a year and a half ago, I was promoted to full-time correspondent. So a year and a half ago is when my life went from full-time emergency medicine, part-time media to full-time media, part-time emergency medicine.
GW:
Those are very different platforms. How do you have to change the way you communicate to an ABC News audience versus a TikTok audience?
DS:
There is a personality to each platform.
GW:
Yeah, absolutely.
DS:
And then when TikTok came out, I was like, "Oh, this is a completely different personality." And it was one that I was so interested in because I had spent so much of my time dressing up, buttoning up, being so proper, forward and very much putting things inside of a box. And it allowed me, in a strange way, to find my voice. In being real, in being rugged, quote unquote, on TikTok, I found that I could use my own voice while communicating science. I didn't need to morph myself into something that I thought was proper or that I thought was what a doctor, quote unquote, looked like. On TikTok, I could be myself. I just happened to be a board-certified physician, and I would like to talk to you about a problem.
And it was the most comfortable experience I've ever had. And I think one of the reasons why I grew so fast is because I separated my cases into two parts. I would say, "These are the presentation, the symptoms, the history. And in part two, I'm going to tell you the answer." That is one of the reasons why it exploded. And everyone is inherently nosy. Everyone inherently wants to know what is going on with everyone else, but also everyone also wants to know, well, if that happens to me, how would I answer this?
GW:
This is the first time you and I are actually talking to each other, but I feel like I already had a sense of who you were because it is very personal and you don't... The culture of the personality is to not hide who you are. It is to be authentic in often the best of the ways, worst, or at least the most human ways. I remember seeing videos about people with schizophrenia. I've never had that level... I've treated hundreds, thousands of patients with schizophrenia. When was the last time I actually had some insight into their life?
DS:
Yes. People living-
GW:
Like never. Never.
DS:
with substance use disorders are not requiring medical treatment and managing their condition.
GW:
Thank you.
DS:
It opened up my eyes-
GW:
Oh my gosh, yeah.
DS:
... to the lived experiences of so many that you and I see every day, but we only see their worst days. So I thought it was so helpful to see someone's good day while dealing with a condition which I have developed so much, I realized, so much bias to. It really opened up my eyes to this world.
GW:
That is totally what it's done. It's taken my version of seeing a person with a particular disease state or a person with a particular issue, and they become more of a complete person.
DS:
In many ways, stripping people down of their vices is, in a way, dehumanizing. I think TikTok allows that ability to humanize medical problems and diagnosis disease and complications and risks. And I think for me, it leads me to reading more, which is surprising because in and of itself, it's screen time, but there are many times where I go, "I need to pick up a book and read about this because I had no idea."
GW:
Let's talk a little bit about humanizing people. I think that's what you do really well and you advocate for people especially who have less of a voice. How do you think your platform, how has that allowed you to address and discuss disparities in healthcare?
DS:
When I'm teaching, I'm teaching to the younger version of myself that sat in a lot of ignorance and was very naive. When we learn medicine, we learn about finding the root cause, right? We learn about making sure that you understand why they're in diabetic ketoacidosis. Why their blood sugar is so high, is because they weren't compliant with their medications, they didn't follow up to get their A1C checked and they n no ever followed up with the doctor when they should have, and now we're treating these complications, AKA blame the patient, blame the patient, blame the patient.
There were so many moments where I said, "I wish that when I was taught this problem, I was taught in the way where I truly found that root cause." Instead of blaming the patient, I had to realize that food insecurity is a very real problem and not having access to quality food increases your risk of insulin resistance. And how housing is healthcare and how if you don't have an address, how are you going to get mail. And how a job and wealth is necessary to maintain your health. If you can't afford your medications, you're not going to be able to treat that insulin resistance that has grown from that insecurity from food and your lack of access to quality food sources. Now you're landing in the emergency room with high blood sugar and a doctor who's blaming you. For me, it is really about teaching my students about truly finding the real root cause and not stopping at blaming the patient.
GW:
What would you like to see changed, fixed? Where do you think the biggest problems are?
DS:
As many know, our healthcare system is fundamentally flawed and it has humongous cracks in it. And when a system has cracks in it, the most vulnerable fall through those cracks first. And I think it's really important to understand that so that when we look at disparities, for example, we understand why they happen. In many ways, sometimes I wish I could just simply be a scientist and teach you in the way that Bill Nye taught us when we were kids about cool scientific experiments. But I also know that my lived experience as a Black man, as a gay man, and as less than 2.5% of physicians who look like me is a very valuable experience where I need to share that experience and I need to make sure that not only my patients, but my peers understand why that is important to understand.
GW:
Why do you think you need people like you in medicine?
DS:
I think that our providers should look like our patients and we know-
GW:
Could not agree more.
DS:
We know our studies, we understand how when we have patient provider concordant care in terms of a lived experience class, race-
GW:
Language, yeah.
DS:
Language. We know that patients do better. When there is a level of implicit trust because of a shared cultural experience in a community, that is something that you cannot create in medical school. Which is why it is so important to make sure that we continue to advance health equity, but also diversify our students. But also start from the beginning because you can't be it if you don't see it. So a lot of my experience here is really just trying to make sure that I'm representing as well as I can.
Medicine is such an exclusionary experience. If you even are able to get to the process of graduating college, the process of testing to get into medical school is cost prohibitive. There are so many who can't even afford the MCAT lessons that many of my peers have.
GW:
Well, Darien, I know we don't have much time left. Let me just ask you, one the things that we hear and see a lot, we're working on physician transparency, not just salary and numbers, but workload, we are seeing and hearing about gaps and gender and race in terms of I'm doing the same amount of work. I'm also an attending and I'm making less money, or I'm working more hours, or I'm getting the worst shifts than everybody else. Are you hearing of that as a concern with other physicians and residents and medical students that you talk with?
DS:
Absolutely. I just, yesterday, I had the incredible opportunity of hosting a book review with Dr. Uche Blackstock, who, for those who might not know her, she's the author of Legacy. It is a book that she'd be required reading, is an incredible memoir to her mother where she takes you through a journey of her life and her career and the complications and the effects of racial inequities and how deep the inequity goes and how that presents as problems that we see today.
But the reason why I bring her up is because you talked about pay inequity, for example. And yes, absolutely. I think that this is a persistent problem and unfortunately we might see it worsening, given the systemic and policy changes that are looming, the executive orders that have been signed. We have to prepare ourselves to make sure that we're remaining sane in this moment of confusion.
And the way that we combat that, number one is create community, making sure that we find others. One thing that Uche said to me yesterday in her discussion about her leaving academic medicine due to pay inequity, due to not having her promotion and the things that she was deserved of, she's done so many incredible things and created and added incredible value to an institution that did not support her in the way that she needed to be supported. She said, "I wish I would've turned around and asked for help. I wish I would've talked to other people about my experience." And some doctors, after she had left, said, "I had no idea you were going through that. I'm going through the same thing."
[inaudible 00:16:52] power in separation. There is power in oppression, and the way that it works is it causes distraction. It leads us in different ways where we just try to survive and you don't realize that there are other people who are also trying to survive your same plight. So finding that community, finding the facts and making sure that you're coming with those appropriate statistics. And in the very same way that I create content, deal with your emotion, but bring those facts first.
GW:
We talked about the financial advisor who advises physicians, and he said he thought it was actually intentional that physicians are kind of culturally trained to not talk about money. That it's taboo, it's not appropriate, it dirties the profession. But that it's actually that is being abused by people who want to control and manipulate us as professionals.
DS:
That's a method of control. I happen to have gone to business school. There is a understanding that when you want to control a group, when you want to make sure that you, your costs down, that you create systems where you can't share information in terms of salaries, for example, because then that can create a huge problem in human resources. I think specifically, it's important when I talk to residents, especially residents who are graduating, I'm like, "This is how much I made when I first got out. These are the things I didn't know to ask for. This is what my check looked like after taxes."
If you're curious, it doesn't mean it doesn't... I think it's important to know about. And I remember when an attending shared that information with me for the first time, and I was gobsmacked. I was like, "I had no idea that this would be a problem or this wouldn't be a problem."
And it can be really terrifying stepping out of residency and into becoming an attending, especially if you don't have your wits about you. You just kind of agree to things and you might put yourself in a dangerous situation. Not even just talking about not getting paid appropriately, but dangerous in terms of your medical license, safety, going to these hospitals that might pay you a lot. And then you realize that you're delivering babies between 12 and 4:00.
GW:
Yeah, and you have no backup, no support.
DS:
No backup, no support. These are important things that you should look out for. I think that we do a disservice in general to our students and our trainees because there's so much of this dogma that we should be quiet about pay, which is completely ridiculous. I just disagree.
GW:
Well, Darien, let me wrap up with just a couple of quick questions here. What's the number one thing you wish your patients knew about you?
DS:
That I forget my medications too. As a person that can barely remember to take his vitamin D dose, I am sympathetic and understanding to forgetting. So that's why I'm always like, how can we remember? Stacking our habits, making sure that we're placing our medications by things that we do. And a lot of it also can be tied to anxiety and avoidance, and I understand that as well. When I get scared, I avoid things. I think it is a natural human tendency to do so, and I think more providers and physicians in general need to talk about our human traits that we have, especially when it comes to our health, so that we can make people feel less stigmatized and less than when they're talking to us about their issues because we might be able to help them.
GW:
If you could design a new medical specialty, what would it focus on?
DS:
You know what? We talk about pediatricians, we talk about geriatricians. I need a doctor that can help me with the transition of just becoming an adult.
GW:
The middle age.
DS:
I need someone who specializes in middle age anxiety. I just need a doctor that just all their patients, and this is me being selfish, I need a doctor where everyone they have is a millennial. We're trying to figure stuff out. Listen, I'm an older millennial, help me understand. Many of us, and many of my friends at least don't see regular doctors. What we need is a reinforcement of primary care so that we have more doctors available to answer these everyday questions of people who seemingly are healthy, but need to do certain things to reduce their risk later on in life. So yeah, so I'm probably, it will inevitably always land back on reinforcing improving primary care access and equitability.
GW:
Darien, how can people find you? What's the best place to go and support all the awesome work you're doing?
DS:
Make sure that you understand how policies work within your community. Make sure that you involve yourself as much as possible in the health and support of those in need around you. You can find me at Doctor.Darien, D-O-C-T-O-R dot Darien, D-A-R-I-E-N, on most platforms, most notably Instagram and TikTok. Say hi.
GW:
Thank you, Darien.
DS:
Thank you.
GW:
Thanks for joining me today. If you want to hear from other doctors doing meaningful work, visit offcall.com/podcast. Make an account on Offcall to confidentially share your details about your work and sign up for our newsletter where you can hear more about the latest trends we're seeing in physician pay. You can find How I Doctor on Apple, Spotify, or wherever you listen to podcasts. We'll have new episodes weekly.
This has been and continues to be. Dr. Graham Walker. Stay well, stay inspired, and practice with purpose.