The Onc Doc: Bridging Gaps in Oncology and Beyond

This episode of the "So You Want to Work in Healthcare" podcast features Dr. Sanjay Juneja (you may know him as @theoncdoc), a hematologist-oncologist, entrepreneur, podcast host, and social media personality. Host Leigha Barbieri delves into Dr. Juneja's journey into medicine, his passion for teaching, and his personal experiences that led him to specialize in oncology. They discuss the challenges of work-life balance in the medical profession, the complexities of healthcare bureaucracy, and the importance of patient education. Dr. Juneja also shares insights on the impact of iron deficiency on health and the importance of addressing gender bias in medicine. Additionally, they touch upon the role of social media in healthcare, the responsibilities of medical influencers, and the work of Medfluencers, an organization co-founded by Dr. Juneja to support and protect healthcare professionals on social media. The conversation concludes with Dr. Juneja offering advice to aspiring medical professionals, emphasizing the importance of reevaluating one's goals and the need to have a plan for personal and professional growth.

- Dr. Sanjay Juneja's Social Media: @theoncdoc on TikTok and other platforms
- Podcast: Target Cancer Podcast
- Medfluencers: An organization co-founded by Dr. Juneja to support medical professionals in social media endeavors.

Contact Information:

- Podcast Contact: Leigha Barbieri (Host) - helloimthepa@gmail.com
- Guest Contact: Dr. Sanjay Juneja

Closing Remarks:
Leigha thanks Dr. Juneja for his insights and encourages listeners to follow his work for more valuable information on oncology and healthcare. She also reminds listeners to subscribe to the podcast for future episodes.


TIMESTAMPS:
00:00:00: Introduction to the podcast and guest Dr. Sanjay Juneja
00:00:41: Sanjay's early interest in teaching and impactful teachers
00:02:05: Why Sanjay chose medicine and his experience with vision loss
00:05:26: Why oncology and the impact of a physician's teaching
00:08:19: The role of an oncologist in patient and family education
00:10:22: The emotional strength required in oncology
00:12:55: The challenges of balancing clinic hours and hospital consults
00:14:06: Sanjay's path to medical school and his residency experience
00:17:08: The decision to go straight into med school from undergrad
00:19:39: Sanjay's work in hematology and the importance of iron levels
00:21:54: The impact of iron deficiency on health and mortality
00:22:20: Reflections on the path to becoming an oncologist
00:24:04: Sanjay's involvement in social media and his agenda
00:27:57: The Target Cancer podcast and its notable guests
00:29:33: The importance of sharing accurate medical information
00:31:46: The creation of Medfluencers and its purpose
00:34:31: The role of Medfluencers in protecting medical influencers
00:37:

*Not Medical Advice. Our views do not reflect the views of our employers.*

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Transcript

Leigha Barbieri [0:00 - 0:41]: So, you want to work in healthcare, but you're not sure where to start. I'm Leigha, your host of this podcast, and I'm bringing you the inside scoop on healthcare professions. From doctors to pas to healthcare administrators and crnas. My goal is to let professionals tell their stories and give honest reviews of the careers they have chosen. So whether you're considering a job in healthcare or you simply have an interest in what we do, this show is for you. Welcome to the so you want to work in healthcare podcast today. I'm so excited to introduce doctor Sanjay Juneja. He is a hematologist, oncologist, also an entrepreneur, podcast host, and social media personality. So welcome. 

Sanjay Juneja [0:41 - 0:50]: Thank you for having me. Yeah, it's exciting to be here. We've gotten to know each other well. Your content's hilarious, so it's fun to get together. 

Leigha Barbieri [0:50 - 1:09]: Thank you. Yeah, I remember you were one of the first people who messaged me on TikTok back in the day, and I was like, wait, what? He just. This guy likes my content. This is crazy. It was before I knew what I was doing at all. It was. I was very green. This is cool. So thank you for giving me the encouragement to continue with that. 

Sanjay Juneja [1:09 - 1:24]: Yeah, it's hard to find valuable content. That's also where you want the character of the person and the nature. There's just so many, it's hard to know what you're getting. And so when you find a creator that's like, means, well, integrity, it just really shows in your content. 

Leigha Barbieri [1:25 - 2:04]: Well, thank you. I appreciate that. So the whole point of this podcast is to help guide people who might want to go into the medical field, become a physician, a PA, nurse practitioner, whatever it may be. So my whole goal with this is to just interview as many people as possible and get your story, see what you did to get to where you are today, and hopefully give students some tips on how to do what you're doing and then talk a little bit about how you also have branched out into the entrepreneurial world. So my first question I like to start with is, why medicine? And when did you know you wanted to go into medicine? 

Sanjay Juneja [2:05 - 5:25]: Yeah. So I guess mine is a little unique, but not really when it's full circle. I really wanted to be a middle school teacher for a long time, so I had a couple of very impactful teachers in third grade, Miss M and a. Miss Raynor in fifth grade still remember their names. And then Mister Duvall in middle school. And it was because the level of reward or magic that happens when something makes sense when you make a connection or sense of something in the world around you, it just, I think, really increases the value and really the humility at the end of the day, of how beautifully orchestrated our world is. Whether it's in physics, like I was thinking of doing, or biology or physiology, it's. You appreciate things more when you know about them, right? Like, if you see like this, some of my friends, like, look at that car, do you know this? Whatever. I'm like, oh, it's. Yeah, it's nice, pretty. And they're like, oh. But then they tell you everything about the engine, then. Now suddenly there's more value to that. And I think the world in some ways actually lacks that today. Like, and I think would make us appreciate how many, you know, things are at play. But all that to say, that's what I wanted to do. And then I got into a pretty bad car accident in high school, and I lost my eyesight completely in my left eye. And the trauma caused legal blindness considerably where I really couldn't make out a face in both. And then people would ask after the fact, which I recovered the site, like, weren't you terrified? How was it to think that you wouldn't see again, blah, blah, blah. And I was like, why wasn't I more terrified that I wouldn't be able to see and just living in fear? It was really because my ophthalmologist, doctor Grinier, basically, I didn't know anything medical at this point. And he told me everything that was going on with my eyes. You have terrible iritis, and, you know, it's all kind of torn up, and the pressure is 30, 35, and when it's high, it's pushing back on the fuel and energy source that makes, you know, your retina C and all this stuff. And so he's telling me the drops and why I hated them. Like, it hurts so bad, like the light when you have iritis coming in. But when I understood why, the pain became not only tolerable, more. A little more tolerable, but almost like a good pain, right? And so that is what I kind of recognized was the reason that a very otherwise scary experience that really had a lot more room to be terrifying and cause anxiety was significantly reduced. And that is what made me go into medicine, because a doctor in the latin term is teacher. That's why phds are doctors, and they were the first doctors. And so it was a bridge of teaching. And though I still love physics and all this, I probably. My kids already hate me. I'm sure they're eight, six, and four, like, guys. And I'm always teaching, like, isn't it amazing that the suggested speed limit is because of the, you know, the average tread on a tire and the frictional, you know, the coefficient, but. But now, you know, it's very humbling to do that for a scary process. And I think there's, you know, little as scary as cancer. So I was like, cancer is terrifying, whether it's stage four or it's curable, and there's a lot of room on the shelf that's left on how terrifying or what that experience is like. And I think the way to unlock that is the education, much in the same manner that I had for my accident and really my head space for my eyesight restoration. 

Leigha Barbieri [5:26 - 5:38]: Cool. Yeah. So that kind of answers the next question, why oncology? So, because you had this great experience with this physician, and then you see this kind of, I guess, would you say a gap in the care. 

Sanjay Juneja [5:38 - 5:39]: Yeah. 

Leigha Barbieri [5:39 - 5:41]: Inspired you to go into that field? 

Sanjay Juneja [5:41 - 8:19]: Yeah. So, you know, took out the loans, did all that to med school, thought I was going to be an ophthalmologist, and then ended up hating it. Like. Like, it's. I know. No, it's. I'm just not somebody and bless the people that are, but if I lose the autonomy to scratch my nose when it itches, when it itches for the rest of my life, which is the equivalent of being in an or, as, you know. Well, like that. Just like, consider me that older son indian prince thing. That's a. That's a cultural joke that they have it. But the truthfully, it's not that I hated it, but I just. I was like, I don't know if I want to be surgical, necessarily. And then I was thinking about ICU critical care, because it's very. It's a closed system. Like, you really understand the. The relationships of the physiology and pathophysiology that relate from the heart and all that. Like, I love that, but I wasn't able to teach or know my audience, quote unquote, or, like, the patient well, right in the family. So it's hard to navigate these very difficult decisions without knowing them. And then I had a couple of very foundational experiences at the VA and stuff on my rotations where I would get a letter or two. I still remember my first one. They said, hey, I know you were thinking about cancer, but this is me telling you. And I think personally, God and the universe, whatever you believe, there's some will of the world that facilitates signs. And I think that's where we find distress, when we're not open to the signs, when we think, what do I want to do? And you, it's almost impositional in the universe. Instead, say, what does the universe want me to do? And that letter was like, I can just tell you, my husband, in 49 years, we didn't make 50. But, you know, Don Southern, kind of backwoods guy, he's like, he's only told three men in his entire life that he loves them. His father and his two sons. You are the fourth. Like, that was, you know, in that first letter, and that happened a couple of times. And I realized not just what happens during someone's care, we're all finite. Like, there's a date above my head, you know, that when I will expire, I don't know what it is, and it's scary, but it's also, in a weird way, encourages you to make the most of things. I realized that being a part of that experience in cancer and oncology also permits you not just for the experience of the patient or the person, but really what everyone that loved them is left with that was involved in the care. Like, even that can actually marry. Somebody's rested their life with what they saw and happened with their father or mother or the kids and didn't know that, understand why chemo makes people sick. And now you're just wondering, should I have ever let my dad go through that? And you're left with that for the rest of your life. But if you're taught and you're on board and you're excited about it, a good pain, right, then all of a sudden, that person's life is ameliorated, too. And that's why I like the outpatient setting and the relationships, because you're really. You are given the purpose and responsibility to affect not just one, but many lives and the quality and emotions that come after something so challenging. 

Leigha Barbieri [8:19 - 9:03]: Yeah, yeah. And it takes a strong person to do that. And I commend you for it because, I mean, I work in orthopedic surgery, which is, like, the least serious. Right. And I still have a hard time taking on people's emotions all day because it is, like, super emotional. They're about to go through this big surgery. Sometimes it's their first surgery, and then you have to, you know, make them feel comfortable, make the family member feel comfortable. So I can only imagine how much more magnified that is when somebody has cancer. It's, you know, it's an elective surgery versus cancer. It's like, not a comparison. But you must be a special person to deal with that or not deal with it to. To really want and love to do it every day. 

Sanjay Juneja [9:03 - 10:22]: Yeah, I mean, I think that's a. The way I put it, usually is. Like, it's like I could never do that. Too depressing. And that always hurts my feelings, because it's like I'm not free of emotion. If anything, I'm soft, you know, emotionally. But the lens of the optics for me is that happened. The cancer happened, this person needs treatment, and the family's going through this, and it's more like, can you just, like, with the example I used, can I make the experience? And I take that responsibility very seriously, as doable as possible. Like, within, you know, outside of what it is. I think there's a huge variation on what that experience is like for both the patient and the family. Very, like, you know, there's several degrees, like, 270 degrees out of the 360. And I think that is where the responsibility. I think oncology is a calling in any capacity, whether you're np treatment nurse treatment nurses are so foundational because they see them every day of their treatments, and they build a relationship. But I've noticed that anyone in oncology has that sense of responsibility. I'm just gonna make a scary process less scary, and I'm gonna do everything I can to accomplish that and to make you your most confident and reassured self, because having. Having a lack of confidence or doubt can be very psychologically debilitating for both the patient and the family involved. 

Leigha Barbieri [10:22 - 10:40]: It's so important. Yeah. Awesome. I mean, it's great what you're doing. I mean, I assume that you love it. Cause it comes off that way, and not just on social media, but right now. Like, it just comes off that way. From an outside viewer, it seems like you really like what you do. 

Sanjay Juneja [10:40 - 12:55]: I do, but I don't get to do what I love to do most of the work week. Right. That's the problem, is that the actual qualitative stuff I'm talking about is maybe 40% to 50% of the woes of practice, and the other 50% is not any of that. Right. It's like anything where I make that extra phone call to the father that couldn't make it or the brother that's time away from my family and my children, and they're eating the cost of that every single day, and my kids didn't sign up for that, so. And that's because the day doesn't permit, like, the time for those calls. Like, that's the moral injury. At what point do you make your kids soccer practice and not then go back to the hospital so someone else can basically get the treatment for red tape that shouldn't exist. Like, it's like I have to decide to call for the prior authorization or just say, this is the world. It is. I'm making my kids practice and it's going to take a week versus if this was my father and my sister, I'm going to call, I'm going to sit on hold for 45 minutes because that way I can get it approved in two or three days. And every single day I have ten to twelve to 20 of those choices of something that's purely red tape or bureaucratic. And so the moral injury happens either way. It's either that you didn't do it for that patient, that you would if it was your family member. I opt for doing it, but the edict cost is the moral injury that I take upon myself is like, I didn't make my kids practice repeatedly. I didn't, like, get, like, I don't work out anymore. Like, because my thing is busy and it's like, there's just no. So I'm working to, like, basically open it up to where hopefully I can have 30 minutes visits on the patients and just say, look, the cost doesn't matter. The, the, you know, so that in that sense, the practice is a little different than the field itself. And in this country, in America, it's not nearly, you know, even 90% of that. And, but I'm doing a lot of things to try to fix that with tech and automation. And I think anyone listening, if you're in pre med, I mean, it is going to be a different world. And there's no question you're not going to be burdened by these kind of things where I'm documenting the same rote things over and over and over again or the patient's going to be stuck with a bill. But it's like, what doesn't take an MD to document the same thing over and over again? And there's, yeah, dot phrases, you know, that's a whole, that's a whole different podcast, I guess. 

Leigha Barbieri [12:55 - 14:06]: Yeah, I like that you got right into this because it's actually usually when the last questions I ask when I structure these interviews is, what don't you love about your job? And I like that you're being so honest about it because this is when I started this podcast, I. That's what I wanted. You know, I didn't want to just make another podcast or whatever videos where I'm. We're just talking about how wonderful our jobs are because they are great and we all go into medicine for different reasons, but in the end, it's not all wonderful. And you have to be able, if you're going to want to go into this field and you're going to want to be a physician or a PA, you have to know that all that annoying paperwork and whatever it is, prior authorizations, that's going to be part of it. But like you said, then you made a really good point. You think that maybe it won't be part of it for them, which would actually be great because then they can focus on treating the patients and helping them and helping their families. But yeah, I, I remember seeing something about prior authorization reform and I think it was actually in New Jersey where I live, where I'm from, and I never followed up on that. 

Sanjay Juneja [14:06 - 15:21]: Yeah. And there's a lot that needs to be done. Alliance for Patient Access. I work with them a lot. They have lobbyists and policymakers in DC. The thing is, when you're in practice, it's just you're so buried. Like I said, like that's your day, right? Like just getting through 70% of that day and having stuff, you know, on the table that you start at 09:00 p.m. Till midnight at least as an oncologist, a lot of those hold ups I think slow down policy change because when do you pull yourself out and be able to go to DC and sign that say, hey, this is ridiculous for patients and for doctors. And I think that's why things are so slowly or slow in evolution, but the resources are out there to make it better. But it's definitely burdensome. And I would just encourage anyone listening that if you feel like you're doctor is kind of a jerk or catalyst, like, I think more often than not you would be surprised how soft they are. When you just approach that conversation or visit differently on an emotional sense, you'll get to uncover a version of them that they would, you would be very surprised by. But it takes that level of tightness to even make it through your day to again be home for dinner kind of thing. And I do think it seems like it's desensitized, but it's a whole different bucket of problems on the medical side of things. 

Leigha Barbieri [15:21 - 15:40]: Yeah, yeah. The other thing that you said was that your family does kind of take the brunt of when you have to stay late and care for a patient. So how do you deal with that work life balance like, do you have a boundary? Can you even have a boundary as an oncologist? How do you do that? 

Sanjay Juneja [15:40 - 17:08]: Yeah, so, like, you know, my wife is also an oncologist, and so we're both in the same practice. We're both on call every few nights. And that was one thing. When we went in, I was like, I just don't believe that you can't set your own boundaries, that, like, if you decide you're gonna end at five, like, you're gonna end to five. Like, I'm like, I refuse to believe that. Let me tell you a very simple example. Like, if my clinic schedule, people need to be seen. There's a huge deficiency of patients with cancer and getting care, right? That's. That's all over the news. So you have to pack in your clinic just so people can even be treated like that. You know, the treatments. You have to drive sometimes once a week. Like, you can't just go 2 hours and then go every 2 hours for months, every week, so you have to pack it up. And then when you do, if somebody. Not if. When your patients get admitted in the hospital and you're their oncologist, you're taking care of them for months or years, like, you get the consult one, you know, most days will be one or two, like, they got admitted, but someday you have four. That's all happening between eight, eight to five. And a hospital team is saying, we need to see this patient. We need racks. You can't. So what do you do? Like, how do you not go see the patients when your clinic day is over at 430? This is impossible. So that in itself. So one solution is potentially to then end your clinic at two, so you can make sure you see the consoles. But what happens when a console comes in at three or four? Like, that's where if somebody would have said that, you know, I don't know if anything would have been done differently, but that's a very easy example to appreciate of how setting those hard times, at least in oncology, is very challenging. 

Leigha Barbieri [17:08 - 17:24]: Well, let's back up a little bit, and I want to know the actual process. The path you took to going to med school and then how your residency was. Did you go straight into med school from college, from undergrad? 

Sanjay Juneja [17:25 - 19:11]: Dude, I did everything straight, and I don't recommend it. I really don't, because there is just not. There is a severe stunting of growth and maturity and everyday life stuff that occurs until you're out. It just is. It's just school on and on and on, and it's like when you finish high school or college, you grow up fast, right? In the real world, adulting, as they say on social media. I never knew this adulting being was hard. Your adulting doesn't start until your thirties, like, if you're an oncologist and you're way behind. So I did college for four years, and then I, like, had, you know, a couple of fields of studies. That was where I was trying to get the breadth of my education. So I did like, philosophy and sociology and all these things that I was interested in because it's going to disappear for a decade. If you want to be an oncologist, there's no, no time for the next ten years to learn those things. So I would pack in college as much as possible and edify yourself in whatever capacities you can, and I would encourage you to do something different than medicine. Like, yeah, I was pre med, biology, but I did philosophy and these other things because that's your one chance. That's your last chance to, like, you're not gonna be chilling, reading books for the next ten years outside of, you know, doing what you're doing. And then you do med school. If you get in, you know, your first year, it's four years, and then you apply to residency, internal medicine, which is required, and that's a three year residency. And then you apply at the end of residency for a three year program in hematology and medical oncology. That's two specialties put together as a three year program. Or you could go in on a two year program to just medical oncology, but then you wouldn't have heme or, you know, so that would be challenging. So it's, after college, it's the soonest it can be done is four, five, 6710 years. 

Leigha Barbieri [19:12 - 19:15]: Okay. And did you do a fellowship as well? 

Sanjay Juneja [19:15 - 19:20]: Yeah, that's like, you have to. You can't do the fellowship in oncology and hematology until. 

Leigha Barbieri [19:20 - 19:21]: That's what you were saying. 

Sanjay Juneja [19:21 - 19:24]: Yeah. So four years of med school, three years of internal. 

Leigha Barbieri [19:24 - 19:39]: Three years of internal medicine, and then the fellowship. Sorry. Yeah, that makes sense. How much of the hematology side do you do? Is it kind of 50 50 or you focus more on the oncology side? And do you see just heme patients as well? 

Sanjay Juneja [19:39 - 21:35]: Yeah, it totally depends on what you want to do and where you're located. But, I mean, I want to stay sharp on both. So I see plenty of heme, and heme can be broken down into benign hematology, which means non cancer related. And then obviously malignant hematology, which is, you know, multiple myeloma, lymphoma, leukemia. And. But I'm passionate about beniheme because, you know, I talk a lot about iron deficiency on my social media, I do think, not think. I think it's pretty known that medicine is inherently quite, you know, sexist or has been, at least on the shoulders of things, slanted more seriously for male dominated diseases compared to females. Hopefully it's being, I think, rectified at a faster rate than before. But, like, iron deficiency is one of those that not only show quality of life measures and debility, but actually increased mortality for women, like, you know, between 16 and 30 years old, because they're just basically, nobody takes their iron deficiency seriously. And there's a huge article that came out in the week over the summer that shows there is an actual mortality difference if the iron is not replete. And I'm not talking about iron deficiency with anemia. I'm talking about just iron deficiency, like, even without being anemic. So, you know, if your MCV, the size of your red blood cell is getting small, you have fatigue, you have, like, kind of these restless legs at night, and you're having difficulty sleeping, decreased libido, sex drive. You know, for a long time, it was always like, oh, you're depressed. Are you anxious? Whatever. But, like, chuck an iron, bro. I mean, if somebody's having heavy cycles like that, that makes. You'll see hundreds of comments at this point on my socials that are like, I've been on three medications for restless legs. Three. Like, I'm like, I'm zonked out all day. The next day I saw your podcast and comes three months later. Or I saw your video and I'm off of all of them there. This is obviously an extreme example, but it had probably 175 likes. People, like, reflecting the same thing. I'm off of all my RLS meds, so that's all benign. And then blood clots and bleeding disorders and stuff like that. 

Leigha Barbieri [21:35 - 21:45]: So that would be. I'd say your tip for the general public is to make sure your doctor is checking your iron levels. 

Sanjay Juneja [21:45 - 21:47]: If indicated. Yeah. 

Leigha Barbieri [21:47 - 21:50]: If indicated, yeah. I did not know that it increased mortality. 

Sanjay Juneja [21:50 - 21:54]: That's kind of came out in Jama, I think. Jama or Asco, one of the big ones. Yeah. 

Leigha Barbieri [21:54 - 22:19]: Wow. Wow. I feel like the an, I already know the answer to this, but do you feel like you would have done anything differently in your. In your path to where you are now? I know you said you went straight through and you wouldn't recommend it. I don't recommend it either, because, I mean, I'm a pa, so I have a lot less schooling than you did, but I still don't recommend going straight through because I was completely burned out. So what about you generally? 

Sanjay Juneja [22:20 - 23:24]: You know, and this is anecdotal, but for example, my wife, like, she was six years. Like, she. She spent years before she went to med school. Her mom got breast cancer and all that. So she was, like, doing forensics, like, you know, CSI stuff and then teaching at a university and then decided to do that. And her and all the kind of older, the people that came to medicine later, there's just a poise, you know, durability in my anecdotal experience that you find, and that's because they had to grow up before they went through something extremely psychologically and emotionally challenging. And I think for that reason alone, you're a more accurate version of yourself, a more defined version of yourself when you've been out there, informed. Like, if you're play doh and you take shape over time and over experience, you get to shape yourself a little bit more. That way, your feelings and emotions are better bridled than something that's fairly germinal or nascent and still taking shape. And you're kind of stunted in this grown up high school world for, you know, ten years after college, you know? 

Leigha Barbieri [23:24 - 24:04]: Yeah, grown up high school world, that was just hilarious. I don't know. You can't get back those years, but I think there's also now better opportunities to take some time off and maybe take a sabbatical and cure your burnout. Yeah, I would have done the same thing. I would have taken at least a year off. All right, I want to talk about, since being a hematologist oncologist is so time consuming and takes up a lot of emotional energy, too, how do you do all the social media? I mean, you do such a great job with it. And then also, why did you choose to go. Go the social media path? What's your agenda with that? 

Sanjay Juneja [24:04 - 27:57]: Yeah, so I was never someone, you know, there's two kinds of quote unquote creators, people that have been doing it a long time. YouTube and other things. Before Instagram and TikTok, that was not me at all. I ended up my chief fellow year. My wife was already starting practice kind of 4 hours away and had the kids. So I drive down every weekend, which was a whole nother thing, but I downloaded TikTok to basically just kind of stimulate the right side of my brain, like it was just, you know, I love the anonymity. Like every other platform, you have volitional following based on research for your friend and all this stuff. And TikTok wasn't like that, you know, especially at the beginning. And so I just did dances and stuff. You know, I'm a Gemini, so I had this, like, performance stuff, and then it started getting very, like, you know, quote unquote viral or whatever, and it kind of ties back to, you know, a fundamental concept. I have that, like, I just don't think you should. I think it's dangerous to do anything in vain. Like, if. If you don't, if you receive anything positive from the world, whether it's followers or likes or attention or thirst, whatever. Name your metric, right? I think it's parasitic if you don't take it to say, what is the reason for this? And so that was some concept in my indian culture, and my mom really instilled on me, so I was like, what do I talk about? And at first, I talked about kind of gender bias in medicine because my wife has the same three board specialties. She actually had a master's before, and we were treated very differently, right, by males, females, everything. We had different experiences when we consulted surgery, for example, and things like that. And so I talked about kind of how discordant that was, and then that went or transformed into, well, let me talk about what I really know and what's really scary. And there's a huge deficit of. And that's cancer information. There's so much fear mongering, gaslighting, misinformation. And what I think is particularly vile is just sinister, is actually capitalizing on hope with e commerce and stuff and selling black oil, you know, snake oils, and saying, look, this is a non chemo way, and this happens way more than anyone listening understands. I'm talking dozens of thousands of dollars spent by somebody that's middle income because of the kind of older culture of not sharing as much. Like, oh, don't do that. It's a doctor, it's liability, and it's more complicated. And I think we just got to scrap it because people are taking advantage of the. Of fact that with education and information is trust. And so they're providing these things that may or may not be factual, and we're staying quiet. And I was like, that's not okay. Especially when it relates to preying on someone's hope for life in cancer. And so that's what then kind of drives and facilitates that, which is, again, what is the need of the universe. What did the universe do for you and position you? I think there are thousands of more people more deserving to have gotten into med school, residency, everything that I've done, you know, and I hope everyone feels that way to some degree. I didn't have a single parent that had to work twenty four seven and me take care of my, you know, little brother. If I did, then there are people that do, then, you know, it becomes more challenging. So even that's a liberty. Having your five senses is liberty. And so what do you do with it? And for me, it was okay. Fulfill a need. And I think. I think anyone, if you're unsure of what to do, both examine what you're passionate about and fulfills you, what you're good at, really. What are the trades you've been blessed with, equipped with? Are you a good talker? Are you a good, like, at reading people? Are you good at, like, execution and algorithms? And then examine what the world needs. And I think that helps alignment more than not doing the second part, because now it may be. It may be more, you know, stress or impositional. And I think there's harmony found when you think of it as input and output, you know, connectors. And that's what social media is, to me. 

Leigha Barbieri [27:57 - 29:33]: Cool. Yeah, I can relate to that a lot. I think in almost every way, just. Well, I'm a Pisces, so I'm a bit more emotional, maybe. But what I get emotional about is, like, making sure that the people know the truth. And then I kind of applied that to medicine. And my field, which is, again, is orthopedics, but it's. I just get very passionate about people who are either being taken advantage of or are not given the right information, but they believe it because this one doctor told them they needed surgery, but really they don't. And so this is the kind of stuff that I like to put out, too. So I understand that. And then also just about my profession. Cause there's a lot of people out there who still don't totally understand what a PA is. So then that's kind of how my TikTok started, was when I started making PA videos. Cause I didn't know what I was doing. Like I said, I was just, like, dancing or something. And then came the student loan things, which is so important for anyone who wants to get into medical field, because a lot of you guys are gonna have student loans. And it's important to understand what that means, and not only when you're taking them on, but afterwards, and how to, like, budget and things like that and the different programs that are out there for like, forgiveness and grants and things like that. So anyway, yes, I agree, my social media agenda is very similar. I just wanna make sure people are taken care of, basically, I guess. 

Sanjay Juneja [29:33 - 31:46]: Yes, exactly. I mean, it's like, it's, you were gifted insights and experience, and I think social media offers a way to really just catalyze people's evolutionary process again. And knowing themselves and knowing how to navigate. Like, we lived in a world where you had to, you're at the mercy of someone you ran into within the 30 miles radius or wrote a letter, but nobody's going to write you a cold letter to now, having this vast access to basically have the roads that had to be otherwise explored independently now pay for you. And that's what, that's what social media, I mean, you can just have all these paved roads. And I've experienced, it's like reading books on, you know, biographies. Like these are high value experiences that take decades or lifetimes that you can just basically aggregate and grow yourself, hopefully the best version of yourself for the world. Like the second part, I think is so important. Like, you can't just take it all and then go get on the boat like you just stole. I feel like the universe just kind of goes like, like, you know, like we did, we all, everything was positioned and then they didn't do anything with it. I think that's why, oddly, I was saying this to somebody, you know, people like Leonardo DiCaprio and like Bill Gates and stuff, I mean, they get very wealthy and successful and you find this, like, you know, it's not a pr stunt stunt. They get very passionate about something. Like, Leo is all about global warming and stuff almost to where you like, it's like, oh, is he a fanatic? And then like Bill Gates with like, you know, third world. But I think that's where the universe doesn't have to sigh a heavy sigh, but it's like a celebration because it's like you feel like towards the end of this success and this positioning, somebody is doing something not for themselves, not because Leo did or Bill did it, but because I believe they feel the same way, that now what, what do you do? What was the reason for all of this in my lifetime? The success, this optics, the visibility, the money that I think is fulfillment. When you're on your deathbed, you know, there was a quote that said something about like the money, you know, any of that, the thing, all that dies with you, all of it. But what does grow and continue ripple wise, and not because of the vanity of it, but just because of the moving forwardness of it, is. Are the ripples that you were able to create in that lifetime. 

Leigha Barbieri [31:46 - 32:16]: So true. I agree. It's really important that you do something with the. What you build and with your knowledge. And I like how you keep saying, like, you. You're gifted, this whatever it is that you're gifted, and then using that. So let's. Let's just pivot real quick and talk a little bit about your podcast. I admittedly have not listened yet, and I need to. So tell me and tell our viewers and listeners, like, what's. What is this all about? Why is it important that we listen to your podcast? 

Sanjay Juneja [32:16 - 34:31]: Yeah. So it kind of mirrors what social media did originally. And I kind of pride myself on being the kind of, you know, lay person with a medical degree, like a blue collar person with a medical degree. Right. Like, I didn't. My parents were doctors, Barry. You know, they're intelligent. I love them. They're amazing. But I'm a guy that is a layperson with a medical degree, like, that understands oncology. And that's what my content is. It's to be able to speak the language with metaphors on, you know, engines and stick shift and the stuff that I just know outside of medicine. And so my podcast is that it's called Target Cancer podcast. And, you know, I half joke, but it's not a joke. It's like, I am an LSU trained. Like, you know, I love LSU. I'm very grateful for everything. It's the only tattoo I have is of Louisiana. But the fact that as a community oncologist in Louisiana, my podcast, you know, I've had Pulitzer Prize winners like Siddhartha Mukherjee wrote Emperor of all maladies, one of the most famous books, Jason Fong, best selling author of the obesity code, the cancer Code, the diabetes Code. I mean, people I have no business sharing air with, like, the first director of cancer, moonshot, like, he worked with Greg Simon, worked with Al Gore and Obama. And it's just, it's been very humbling that I've guessed of this magnitude. And it's all because there is such a deep shared joy and fulfillment with identity and community. And so I'm trying to foster that is like, yeah, I'm a traditional oncologist that writes chemo, but let's have metabolic specialists to talk about the no sugar thing. Like. Like, I think that ultimately fosters trust not to just dismiss. I think there's some truth to every hyperbolic radical statement on social media, the stuff that does kind of prey on hope. There is truth to that. So instead of saying, like, you know, this is like, you know, nonsense, blah, blah, it's like, well, let's explore why, why people think sugar feeds cancer. Right? And so that's what that's fostered, and I hope it's helpful. But it's, again, it's crazy. I don't have any media background or, you know, Harvard education, but I think, you know, about last month or two, we reached in over 100 countries and a million views, and it's been awesome. And that's the power of, you know, birds of the same feather kind of community building that you can find in this space. 

Leigha Barbieri [34:31 - 35:38]: Yeah, well, I can't wait to listen, and I'm sure our listeners will listen as well because it's such an important thing. I mean, you're doing awesome work, and I still don't know how you have time for all of this. I'm hoping you have some sort of social media management team, because, yeah, I don't know how I would do all that. And also, I love what you said about it. Can't just be one way. Like, western medicine is great. It's life changing. Right. But I've always had this thought that I think the perfect combination is, like, listen and follow your doctor, but also kind of like, keep an ear open, an eye open at the eastern medicine kind of situations, because I think it's really a full circle treatment if you're taking care of your body in natural ways, but also following the advice of your physician. I don't know. I just think that it's very dangerous to just kind of have, like, tunnel vision in one direction and not at least listen to what some people are saying and, and pick apart why they're saying it, at least. 

Sanjay Juneja [35:38 - 37:17]: Yeah, I mean, if we have a systemic illness, as people, at least in this country, I think that illness, and I just cannot understand it, is we are so divisional. Like, I don't know why everything is becoming so polarized. And it's like, if you even, like, you know, I just don't get it. I mean, it's like, you know, whether it's democratic republican stuff, whether it's socialized medicine or not, it's like, why does everything have to be so divisional? And it really concerns me, and I think that's in a secondhand way, that is what I'm trying to do with these things. And I've had, you know, I, the CMO of WebMD, and people think one way about WebMd and entrepreneur. Like, I just want to show, I want to humanize ultimately the fact that we're all fucking human, excuse my language, and like, and we're all trying to make things better and yet we're only inhibiting ourselves by being oppositional and divisional. Like, like you can disagree. I'm all about, I was telling somebody last night at this event, I was like, it's fine if people don't believe in what I do. I'm like, I actually respect if they don't support what I do. But to go out of the way to get in someone's lane and to like, you know, thwart it, that to me is, is a lane that I couldn't do, right. Like, so I can, I disagree with things, but ultimately the same thing with traditional medicine versus not, like, why does it have to be so radically divisional? Like, it's like, you know what I mean? And it goes for everything and the gazillion things. And I uncover that more and more. They say as you get older and more wise, you get kind of more bogged down with the depression of, you know, truths. Like I don't believe that wholly, but I can appreciate that sentiment, I guess. 

Leigha Barbieri [37:17 - 37:55]: Yeah. Yeah. Well, I think you and I can continue to hopefully try to unite the people, at least on the subjects we talk about. So, yeah, I agree. It's scary. Scary how polarizing things are becoming. Oh, let's talk about medfluencers. So I definitely want to know how this got started because I am part of it now. So thank you for that. And I really want to know how do you, how you guys came up with this? I mean, it's an awesome concept. I'm really glad you did because it seems like you're protecting medical influencers. So tell me about medfluencers. 

Sanjay Juneja [37:55 - 41:21]: Yeah, and before I do that, I think one important concept that you had somewhat touched on is the whole financial aspect of an education. Right. And what I discovered in the last two years, one of the main reasons for burnout, especially with the medical school loans, your hundred thousand dollars out, is you feel suffocated and stuck because you depend on these rvus or these metrics that the traditional healthcare system has made you believe is the only way to have a ROI, a return on investment of your education. And that I'm here to tell you that is not the case and you will not know it until you leave the world, which I haven't left. And if you're lucky, like in my case again, basically letting you shoulder what I've had to, very serendipitously, either seek out and bless to find out is there are other ways to subsidize and bring a commodity value to your education and investment. It is not just RVus or private practice setting. And somebody says, yes, and that's why I do real estate, because now I'm like, dude, that still, that's actually leveraging your money, that's not actually leveraging your degree. And there are all kind of avenues where actually having your education is valuable. And there's other ways to be able to basically, again, find different streams of value and revenue to that education. So with all that said, you know, with social media, one of my concerns, especially in the cancer space, is anyone can say anything, right? The other concern was people are mean well and are sharing information because they believe it needs to be known. But nothing is equipped for this. Not the regulation terms, not the campaign, like nothing, compliance. It's all a new world. And so with Adam Goodkoff, see the med life him and I co founded, along with Josh J. Mac, a couple of people, let's make sure that this thing is well defined. And then also people try to compensate you basically on your older metrics, like, oh, you're a physician, so we pay physicians this, and that's a fair market value. The same physician, that's like at a university that doesn't have any following, they don't apply the commodity of what a niche following is. They act like it's irrelevant, but they'll pay a celebrity, they'll pay Doctor Sanjay Gupta because like, oh, people know him, but it's like that somehow doesn't apply, even though sometimes arguably, you have a higher volume and concentration of your ideal consumer or client based on years of work, of an aggregated following. So all that to say, medfluencers, most importantly, is for things to be done responsibly because it's gone completely off the rails with no regulation on people taking deals and this, that and the other. So we look into the licensing and all this like very unsexy stuff that nobody wants to do, basically, for lack of a better word. And then also to kind of, you know, basically be an advocate for the very weird and challenging waters that nobody really sees unless you're a creator that have to do with the work that goes into to have something like this happen. And then also what you've kind of fostered and how valuable that is for people getting paid a lot of money. Ten times what anyone does as a creator currently for the same exact thing. But but because you're a physician, it's like you can't commoditize them like that. I don't think that's fair necessarily either, you know? 

Leigha Barbieri [41:22 - 42:12]: Yeah, no, not at all. That's great. I get so many inquiries to do ads and. Or whatever it is, and honestly, unfortunately, TikTok is just, like, filled with it. Now I gotta remove myself from the Cree, from the TikTok shop. Cause it's just. I think it's taking away from, like, our message a little bit. But I love that you guys created this, especially because you're doing the work to look into the different brand deals and things like that. At least that's what I understand. I actually have a meeting with somebody from your team next week to kind of understand how they can help me with something. So I really appreciate that, because I didn't. I don't know what the ins and outs of this industry are. Yeah. And if I'm safe, it'll. 

Sanjay Juneja [42:12 - 43:23]: I mean, it can lose. It can make. The liability is so high, and anyone that's coming to you, the company or the agency, does your best interest is not their best interest whatsoever. The only thing they care about is their compliance and regulation, either as an agency or as the company. That is the maximum amount of, like, caution they're going to use. What happens to you as a consequence of doing this and has to do with boarding and licensing, you know, that is not their problem. And nobody has done anything to say, whoa, who's got the back of the actual creator that's participating? Or do they even know what they're doing and what the liability of this looks like without this having. Being in the contractual terms? And that's. It's not a fun undertaking. It's been exhausting. I'm far more gray than I've ever been in part with patients, but also trying to protect a whole bunch of good people that can be really, you know, put on a stake for something that ultimately trying to do well. And I think that people need and deserve, which is education from trusted individuals and helping bridge the trust of traditional medical system and getting out with this whole patriarchal. I don't need to tell you, you just do. Like, gone are those days. And they should be. 

Leigha Barbieri [43:23 - 43:42]: Yeah. Right. So real quick then, before the people who might be listening, who are influencers, medical influencers, what would you tell them? Do you have any advice for if they get a campaign for something like, I don't know, even just an over the counter medication, that's very dangerous. 

Sanjay Juneja [43:43 - 45:08]: It is. It is. There's a lot of legal. I mean, you can pull it up, you can forget exactly what it's called, but there's, these things are defined. And you can just Google and pull up from these government sites and these licensing sites, depending on what kind of professional you are, and say what is. Look at stark law. Look at all of these things, like what's considered physician kickback. All of these things are very well defined. And you will find a significant portion that by these, what we consider older definitions. So there's a lot of legal work and a lot of money going into having a different definition that we're working on. They are direct infractions. And that's why I've been, you know, if anyone sees my content, they'll see that I actually don't have that many sponsored stuff or ads unless it's organizational or whatever, until those things are defined. Or you can, I mean, of course you can always just come to med funds, but, you know, that's where we help with the. What kind of business, insurance, all that stuff is. It's very important. My one tip, if anything, is anyone that takes a dime from for any reason should not be doing it as a individual. Right on the tax. Like, it definitely should be an LLC. Like that is at the bare minimum, which is very easy to do. But if you sign something, if you received a check with your Social Security number, do not let that happen again, because now you've already, now you've already linked that to your degree. 

Leigha Barbieri [45:08 - 45:49]: Yeah, it is scary. And I definitely, like, I'm so grateful for medfluencers, just me, if not only for this reason, too, just to be protected. Feel like you have somebody on your side. So I thank you for that. Of course, last thing that I ask most of my guests is if you have any tips for upcoming medical students or even high schoolers who are thinking about going into the medical field, becoming physicians, maybe even going into hematopoietic oncology. What are one or two tips that you can give right now to our listeners who might be wanting to go into the field that you're in? 

Sanjay Juneja [45:50 - 49:57]: Well, I think I'm going to give one more general, and I think it's important. You know, when people say about cancer, like, oh, it's depressing, this net, like I always say, it's. And it's true. It's very, very humbling. Like, I'm on a daily basis, right, on a weekly basis, I have somebody coming out of law school that has leukemia, and I have somebody that's my age and younger all the time with stage four cancer. And so it makes you appreciate, like I said, that date that's above our head. It constantly reminds you that you are taking something as a. Presumptuously, as a guarantee if you think, you know, 75, 80, any age that you're gonna make. But that's not necessarily depressing. Like, if anything, that's. That is the catalyst to make sure you make the most of the time you have, any of us have. And I find all the time, when I'm trying to mentor people, is the greatest deal of distress sometimes is that goal or that task or that, you know, whatever you have in mind to get in med school, to whatever a lot of distress happens, trying to continue to put that square peg in what you thought was a square hole. And it may have become a circle. Like, it's just not. And even if you got in. But the point is, my point in saying that is more granular. Reevaluate what you think your purpose is. Like, you have to reengage again with the universe, your surroundings, the circumstances, socially and everything your health. To say, is this still what I want? It is not quitting or a failure. If something doesn't feel, quote unquote right, or the destination like it did a year ago or two years ago, four years ago, just not the case. It's like, because you are growing. It's only the case if you didn't grow at all, if you flatlined and you didn't evolve and transform and shape and talk about making the play doh, that, you know, it's just at the beginning, nothing. And then it can be these really amazingly detailed things you. That is happening to you through your lifetime, and re examine each set of new variables and adaptations of the person that you are today, based on who you talk to this past year or whatever, and say, is this still it? And whatever that may be. And the way I have it, my goals is like, somebody else has short term and long term plans. I don't really like those metrics. For me, it's, I have a three to six month plan and I have a two year plan, and I don't really think beyond five, like, or ten years, to be honest. But what that helps with is anything that causes you duress or unhappiness today. Ask yourself, is it still, is there any actionable plan to change that at the three month mark and the six month mark? And if you don't have one, just realize you are letting some impairment or some distress that some stressor just exist with no plan to let it not unexist. So that's very important. And I think I'm telling you that shouldering a lot of grief and emotions and thanks, like, of seeing people pass and come and go and the advice that I get as an oncologist. But, you know, I'm saying that in homage to everyone that I've had the privilege taken care of. It's like, you've got to. You've got to make the most of the time that you have, and the more you listen and feel good about something, then when you fail repeatedly, it doesn't matter, because you know repeatedly that that is where you're meant to be. Or if you're successful and you're like, why am I upset? Why am I anxious? Why am I depressed? I got into med school. I got in the residency I wanted. Like, now you're still forcing it, even though you didn't fail on paper for the admission. But now it may not be a square hole with the square peg that you thought. And that's not failure either to say I quit because it's just not what you want and so. Or, like, who you are today. And that if you do that, there is a place already meant for you and you find that only with reconsidering who you are and where you're headed otherwise, like I said, kind of an overlying theme of the podcast. Otherwise, you're imposing or trying to put a stress with some kind of either stubbornness or pride or belief that it's a failure to do anything otherwise based on a plan that you made on a more nascent version of yourself, which is crazy. 

Leigha Barbieri [49:57 - 50:34]: Yeah. Wow. I feel like everything you just said was very profound, and it really hit home. So I love it. It's. This tip is probably my favorite so far out of everyone I've interviewed. Thank you for that. I agree 100%. You have to have passion for what you're doing. And, I mean, you're not going to love it every day, but if there's no passion involved or you're finding yourself depressed, or, like you said, maybe it's not the right path for you and it's not too late to change, but, yeah, I agree, and I love it. That was awesome. 

Sanjay Juneja [50:34 - 50:58]: Thank you. I mean, you know, summed up on the shirt, it could just say, like, what's the plan, bro? Like, as in, like, if you're unhappy or more days are stressful than not, what's the plan? And it's fine if it's like, in a year, you have the goal and, you know, something's gonna change in a year. That's fine because you have a plan. But if you ain't got a plan, you need to really ask yourself, what's my plan, dude? You know, I mean, like that, right? It sounds so silly, but it's real. 

Leigha Barbieri [50:58 - 51:21]: It's real. And someone I interviewed said something cool, like, it's. We find it so easy to complain. It's easier to sit there and complain about your job every day than it is to actually make a change or make a plan to make a change. And it's so true. But then I think once you do it, you'll probably find it. I mean, as long as you're following your passion, you'll find that it's worth it. 

Sanjay Juneja [51:21 - 52:16]: Yeah. And, you know, if you want to do something, even a step forward. We didn't really talk about the kind of tech stuff and AI stuff I'm involved in, but I'm hedging on the commodity of, like, my investment in my education in some of these things so that people won't feel like I feel about some of the things that burn out. Because at the end of the day on, colleges are needed, and people need a good oncologist and they need education. So, like, that's a way when you can make the most things align one for yourself, but also to hopefully spare someone else of something you have identified to be a problem, then you're really winning in the universe, right? Or the universe is winning. And so the more you can kind of tighten, like, it's like 0234 birds with 1 st. I think that fulfillment and reward can kind of push off burnout even more effectively, but also, it makes you weather less quickly because you're doing it for multiple birds in one hand. 

Leigha Barbieri [52:16 - 52:49]: Right, exactly. I thank you so much for doing this. I think you've brought so much good insight, and hopefully, people. I know people will find this episode helpful. You are actually just. Fun fact, my first physician, non surgeon on the podcast. So this has been really enlightening for me as well. And I wish the best for you. I can't wait to see what you do with your. All of your different projects. Thanks for being on my podcast. 

Sanjay Juneja [52:49 - 53:22]: Yeah, of course. Thanks. You know, for everyone listening, you're trying to do the most for yourself. And honestly, if you're under 30 years old and listening to this, you're. You're in a better position in the world than I. Than I was. Like, you're literally ahead of even me. And I'm. And I mean, I never had the proactivism to just better. So if you've made it to this far and you're listening to right now, you're winning. You're set to win. And I want everyone to basically take home that message. And, you know, if you want to follow any of my stuff, it's the ongoing doc is the handle. It's on blood and cancer stuff, and the podcast is Target Cancer podcast. 

Leigha Barbieri [53:23 - 53:33]: Awesome. Yeah, definitely. Go give Doctor Juneja a follow. You won't be disappointed, I promise. And thanks again, and I hope to meet you in person someday. 

Sanjay Juneja [53:33 - 53:35]: That's a must. Thank you. 

Leigha Barbieri [53:36 - 53:41]: This is the so you want to work in healthcare podcast. Don't forget to subscribe to stay up to date on the latest releases.