Ep. 427: Sick Care vs Healthcare: Burnout, Insurance, ACOG Guidelines, and a Midwifery-Led Model with Tracy Burns AKA Modern Day Midwife

This episode is brought to you by Cozy Earth, makers of luxuriously soft bamboo sheets, blankets, and sleep essentials. Because your rest matters, mamas. Cozy Earth makes it easier to get the cozy, breathable sleep your body (and your little one) deserve. Use code HEHE at https://cozyearth.com/ for 20% off your order and treat yourself to the sleep you’ve been dreaming of. In this episode of The Birth Lounge Podcast, HeHe is joined by Tracy aka Modern Day Midwife (a hospital-based midwife in Arizona with a NICU background) for a candid, behind-the-scenes conversation about the realities of modern healthcare. Together, they unpack how the U.S. healthcare system is failing both patients and providers, from provider burnout and lack of mental health support to the pressures of hospital politics, insurance reimbursement, and productivity quotas. They explore the difference between  “Medicine 1.0” (acute care) and “Medicine 2.0” (preventative care, functional medicine, wellness), and how insurance-driven, fee-for-service models often prioritize sick care over true health. The result? Confusing medical bills, rushed care, poor patient experiences, and providers who are stretched thin despite doing deeply meaningful work. HeHe and Tracy dive into the unique challenges facing women’s health, maternity care, and birth: over-medicalization, the cascade of interventions, the limits of 10-minute OB-GYN appointments, maternity care deserts, and the need for individualized care, informed consent, and continuity of care. From ACOG guidelines to ever changing evidence and research, they explore possible solutions including a midwifery-led model of care, better transfer systems for home birth and birth center patients, coverage for doulas and health coaching, and shifting consumer demand away from traditional insurance and towards alternatives like health shares.  Tracy shares her exciting vision for an integrated wellness hub that could include midwifery, obstetrics, pelvic floor PT, lactation, chiropractic care, and community-based health supports, and ends by sharing how to connect with her at Premier OB GYN in Phoenix and via Modern Day Midwife online and on Instagram.   00:00 Why Healthcare Breaks Providers 02:24 Burnout and Speaking Up 04:59 Fear and Privilege in Advocacy 07:18 Who Supports Clinicians 12:32 Medicine 1.0 vs Prevention 17:25 Billing Confusion and Fee for Service 19:06 Burn It Down or Reform It 23:55 Disrupting Insurance and Incentives 26:49 Birth Care Needs a New Model 29:36 Preeclampsia Prevention Debate 30:47 Rethinking Maternity Care Roles 32:04 Money in Wellness Care 34:55 Building a One Stop Birth Hub 37:43 Continuity Across Birth Settings 41:45 Evidence Based Medicine Reality Check 47:56 ACOG Guidelines vs Individual Choice 53:23 Demanding Individualized Care 55:11 Rebuilding Healthcare and Provider Support 56:59 Where to Find Tracy 58:15 Closing Thanks and Resources   Guest Bio: Meet Tracy Burns, Board Certified Nurse Midwife. Tracy graduated from the University of Cincinnati in 2003 with her bachelor's degree in nursing. After graduation, Tracy spent a year in labor and delivery as a bedside RN and then took a job in the Neonatal Intensive Care Unit at Cincinnati Children’s Hospital. Tracy spent the first 13 years of her career taking care of premature infants and mothers before pursuing her advanced practice career in Women’s Health.   Tracy graduated from the University of Cincinnati in 2017 with her Master’s degree in Midwifery. With a big heart for women, Tracy is an advocate for midwifery care for women and the continuity of care model. Tracy has been an active team player in bringing midwifery services to Banner Estrella and Abrazo West. Tracy is passionate about health and wellness. She believes in using a functional/integrative approach to health promotion/disease prevention through an early introduction to nutrition, exercise, mindfulness, sleep, and community. Tracy is committed to caring for