Sheena Franklin's Vision for Equitable Skin Care for Women of Color

What if you could revolutionize skincare for women of color by addressing a glaring gap in medical education? On this episode of the Wellness Musketeers podcast, we welcome Sheena Franklin, the visionary founder of K'ept, as she tackles the monumental challenge of health disparities in dermatology. With a startling revelation that less than 3% of medical textbook images cover skin conditions on skin of color, Sheena shares how her company is taking bold steps with tele-dermatology to fill this void. We'll unpack the complexities of forming academic partnerships and crafting a comprehensive dataset that aids physicians at the crucial point of care, ultimately aiming to reduce the burden on dermatologists and enhance healthcare outcomes for women.

As our conversation unfolds, we delve into the historical mistrust communities of color face in healthcare, rooted in injustices like the Tuskegee Study and the story of Henrietta Lacks. Sheena discusses how K'ept is leveraging technology to foster an environment of trust, enabling women to safely share skincare data in their own spaces. We also confront the systemic changes needed in the healthcare industry to genuinely engage with marginalized communities, examining how familiar methods like photo data collection can reduce misdiagnosis and improve health conditions that disproportionately affect women.

Rounding out our discussion, we explore the promising yet challenging frontier of telemedicine and AI in skincare. Sheena envisions a future where these technologies are seamlessly integrated into places like pharmacies and retailers, bringing skincare solutions closer to those who need them most. We'll touch on the logistical hurdles of tele-dermatology, the critical role of dermatologists in initial assessments, and K'ept's ambitious goal of reaching a million women. Join us as we face the broader issues of trust, poverty, and accessibility in healthcare, and discover how slow but steady progress can lead to more inclusive solutions for everyone.

Learn more about K'ept Health and Sheena Franklin's work:

• K'ept Health App
• Sheena D. Franklin Website
• The Velvet Lab Newsletter: Women's Health, Femtech, & Technology In Healthcare

Chapters

• 0:11 Health Disparities in Dermatology Education
• 5:27 Improving Skin Care Access and Representation
• 16:17 Expanding Telemedicine for Skin Care
• 23:31 Virtual Dermatology Care and Access
• 34:44 Advancing Women's Health and Skin Care

Transcript

Sheena Franklin: 0:11

Less than 3% is the images in medical textbooks show skin conditions on skin of color. Unless a doctor is doing their residency in a city that has a higher population of skin of color, they're not going to naturally have that expertise.

Dave Liss: 0:39

Welcome to the Wellness Musketeers podcast, your guide to navigating the world of health, wellness and the art of living. I'm your host, dave Liss, a journalist and podcaster based in Washington DC, joined by my co-host, dr Richard Kennedy, an internist with over 36 years of clinical expertise. In a world inundated with wellness advice, we aim to provide actionable strategies to help you thrive. Today, we are thrilled to welcome Sheena Franklin, a trailblazing senior healthcare public policy professional and women's health advocate. Sheena is a founder of KEPT, a groundbreaking digital healthcare company, and the fourth behind the health advocacy initiative.

Dave Liss: 1:21

All in, join us as Sheena shares insights into CAPT's business and strategic growth objectives and shed light on the critical health need and disparities facing women and their families across the United States. Sheena will guide us through CAPT's business and strategic growth objective and help us to better understand the needs and health disparities that women and their families endure across the United States. Before we begin, please remember to subscribe wherever you listen to this podcast and, if you're there, please also give us a review. Five stars do amazing things for the podcast and we'll keep bringing you all the different gurus in the health and wellness faith to explain to you all the different ways you can live your best life. And with that, here's our conversation with Sheena Franklin.

Sheena Franklin: 2:11

So less than 3% is the images in medical textbooks that show skin conditions on skin of color. Unless a doctor, dermatologist, is doing their residency in a city that has a higher population of skin of color, they're not gonna naturally have that expertise right. And so that's what we're talking about. And then I'm ronald is that when we first started out, you know we thought we would be able to use open source, you know, data, data, research, that we could partner with different academic institutions, but what we quickly find out that there was just a dearth of like data on skin of color images, and so it became well, how do we tackle that? Is it necessary? How do we do that? And so, in order for us to actually have the teledermatology platform that we wanted to have, that we need to figure out how do we build out this data set.

Sheena Franklin: 3:08

So that's one of the things that we're doing, so that physicians can have the recommendations. You know, at the point of care that, yes, or like, this is the skin disease severity level. Well, this is also the skin tone. And then, also because we focus a lot on women, we look at the underlying health emissions. That may be, you know, like just like a little recommendation, but not having our AI replace the physician, we're like, we're all about, like how do we make the physician you know more precise? Like kind of decrease that burden that they have of being overworked, and then just having it right there, because what we found out a lot of times when we were doing research with dermatologists, they were pulling up like six different screens, like in the office, trying to figure it out, and then, like having them go to notebooks where we're like, ok, let's just make it right there based on that patient and everything comes to you so you don't have to figure it all out. Peace, malik, tell that to R. Smell it, yeah.

Dr. Richard Kennedy: 4:06

So can I ask a silly question you guys reach out to the Howard Morehouses and Maharis of the world, and what will their response? Because one would think almost all of them are in regions where there's a large percentage of people of color. And you would think that? Because, to me, as a physician, one of the things that has always been the issue is there's studies going on all the time, everywhere, but for people of color, the access then first of all, there has to be a way for them to be made aware that it's even there you have to get through. The bias that exists is that we don't trust the healthcare system and that the first thing you look at is that any research on us is I'm being used as the guinea pig for some nefarious thing. I was wondering how, when you reached out to them, to the Howards, the historically black institutions, what was their response? Because one would think that if anybody has access to a greater cadre of people of color, they have.

Sheena Franklin: 5:27

Yeah, so we talked to Howard. So one of my advisors, who's in the company, is a professor over at Howard, and so we got very far along in conversations and, disappointingly, they decided to work with GW so a professor that actually was a sponsor for me to get funding for the National Science Foundation. So he decided that he wanted to create a database of images that are only going to be used for education purposes, that are only going to be used for education purposes. So they are working with him to build out this system, which creates like we were trying to work together.

Sheena Franklin: 6:16

But because they're collecting this for education, it can't be used for commercial reasons, right? So like there's all these stipulations, right. And so then, you know, I have, like the Eli Lillies of the world coming to me like, hey, can you provide us with images? And I'm like, well, not yet, but you know, maybe in the future, because they have that same problem too, it's like we need. They were doing a big study on contact dermatitis and they just didn't have enough images. A big study on contact dermatitis and they just didn't have enough images, and so it's just a big scope. So they decided to work with that institution instead of working with. That's what happened.

Dr. Richard Kennedy: 6:54

Okay.

Sheena Franklin: 6:55

That's probably another different type of podcast.

Dr. Richard Kennedy: 6:57

But yeah, but it's the thing is important to know, because the it sure is fine. It creates the difficulty of what you're trying to do and sort of try to target something that really is not present out in the community. You always find a way to say well, how is it that we keep talking about the health disparity? Keep talking about the health disparities? You know, you hear about it on Capitol Hill, you hear about it in every institution and everybody states how much they want to, you know, get rid of it and eliminate it. But they don't think they have a good plan on how to reach out. Because until you reach out to the communities affected and make them feel welcome in some way, shape or form, health disparities is going to continue.

Sheena Franklin: 7:56

I definitely agree Two things. One, I think it's expensive. To be honest, it'll be expensive. It's hard, and the reason makes it hard is I found working with them and some other life sciences companies that I was interested in working with, you can't use this lame model. Right like you have to change the model and you have to create the environment where it's more comforting. Right like I feel like the person who's doing the research the nurse that is there is welcoming to me, like you're not just coming in this one-time shot and then I never see you again. Like what are you doing before and after? That's creating this environment of trust.

Sheena Franklin: 8:37

I don't think people you know in these communities are saying no, we don't see the value in participating. It's what are you doing to tell me what's going to happen, even after this study? Like what's going to happen? Like I think there's like all these nuances where people are like just oh, just come up, we can just have a Black woman and she'll bring everybody and then just go on about our business and who cares? That's kind of the attitude, yeah it is.

Dr. Richard Kennedy: 9:05

It's a. I admire you. I respect everything you're trying to do. It is a monumental task to me, partly because if you just randomly talk to any person of color, whether they have an interest in health care or not, almost everybody heard about the Tuskegee study. Almost everybody's heard about the Tuskegee study. Mm-hmm, or what happened to what's the name? The woman?

Sheena Franklin: 9:29

Henrietta Lack.

Dr. Richard Kennedy: 9:30

Henrietta Lack, henrietta Lack. And so we'll find a way because, again, yeah, lots of good information did come out of all of those things. The problem is that one, some of it was done in secrecy decades, and then, even after that had happened, the distrust is just there. It's palpable.

Sheena Franklin: 10:00

Yeah, yeah, so well for us. There's a couple of things. One, so we don't do clinical trial research Like that's my R. That's one thing, Right. That makes it a little bit easier for us. The second thing that makes it easier for us is because we're doing skin care, which fundamentally women are always taking pictures of their skin anyway, Right, are always taking pictures of their skin anyway, right. We're like we'll go to Ulta, we'll go to dermatologists, we'll go somewhere like help us figure this out, right. So that's kind of our approach there, which helps us out a lot. So like, if you go to our mobile app, it's like we're just helping you do what you already do and we're saying, by the way, because you're doing this, you're helping to expand us, to get better care for you down the road, Right? So like it's that type of attitude. So we're not saying participate in this clinical trial.

Dr. Richard Kennedy: 10:55

OK.

Sheena Franklin: 10:56

Yeah, yeah, yeah, but we still go out and educate people on you know why it's important just to share your data, like just why you should share it in general, and it's happening. So then, how are you more proactive when your app and your phone is taking all your health data and you just really don't know it in general?

Dr. Richard Kennedy: 11:21

That's very helpful. So now, how, in the perfect world, how do you think this would benefit particularly women? But, like you say, women are more conscientious and aware of their physical attributes and are more willing to address it let's put it that way compared to men.

Sheena Franklin: 11:41

Yeah, so with our company, our whole goal like our health moonshot goal, if you will is to decrease the rate of misdiagnosis of skin diseases and their underlying health conditions that disproportionately impact women, right? So like there's all these studies that come out and one that just came out that said dermatologists are usually the first people to spot, like, those illnesses because it's impacting our hair, like hair loss Right? So like that's our goal and that we want to be able to decrease that and while decreasing it for all women, to make sure that women of color are on par with their white counterpart. We're not just ignoring them. So like that's our health like moonshot. Right, like on that day-to-day basis, it's just getting women to a quicker diagnosis, right, and getting them to a doctor quicker. So if it's taking people three months, like how can we get someone to the doctor when they're on our platform within 24 to 48 hours to get that initial diagnosis and then triage that care? Right, and knowing that everything can't be treated telehealth Right, we know like hey, this is a severe issue Then how do we get someone into the doctor within a week? Right, so that's like the goal and then helping them maintain that and manage those flare ups. That's our goal there.

Sheena Franklin: 13:11

And then, thinking about our company bigger is like we're having this data, so how do we create what we call like a FEM index that has that information there? And then how do we de-identify all that data and package that up so like we can help advance research just in women's health, or advance research for government institutions who are trying to appropriate funds for women's health and research, right Like that stuff. So that's our goal. But initially, the core of what we do is making sure that we're getting women care that they need. Okay, we see it as a cycle. Yeah, we all need each other in order to get to the next point.

Dr. Richard Kennedy: 13:57

Good, that's actually great. Do you also, as you mentioned earlier, getting earlier diagnoses and getting people to be seen in a timely fashion? Have you already started to create a?

Sheena Franklin: 14:10

referral network. Right now we have 150 doctors and estheticians and a couple nutritionists, dietitians as well, and we're continuing to grow that over time. And one thing that I love that we're looking into right now is how do we partner with, like the skin of color clinics, like at the Cleveland Clinic, the Mayo Clinic, and to bring them into our network as well, to expand it. So, instead of like one doctor here, one doctor there, one association there, I think we're doing that but forming those partnerships as well.

Dave Liss: 14:51

One question I was wondering about is if I'm in Mississippi and all of your care providers are not in Mississippi, can I still get care from them on your network, or do they have to be in my state?

Sheena Franklin: 15:05

Yeah, so that's the law, the telemedicine law the doctor has to be licensed in that state. Now say, for example, I could have someone on my team that may have practiced, let's say, like in Georgia, right, and Georgia has blanking out on the word right now. But you can get a multi-state license, but it's usually by region. So like I could have someone who's in Florida or Georgia, but they have a license for Florida, alabama, mississippi, right, but they have to have that license there. So that's how we do it. But also, we'll also provide people a listing of names. I say, for example, we don't have that person, we're not in Mississippi quite yet. We will provide you with a list of vetted doctors and people that we would say, hey, go visit this person. Like that's a challenge with growing a telehealth company, right, it's like getting all those ducks in a row.

Dr. Richard Kennedy: 16:04

Yeah, Since the pandemic, there are regions and much of the United States is set up in sort of reciprocal acknowledgement. So when I was in Maryland, I had a license in Maryland, DC and Virginia. When I was in New York, I had a license that was New York, New Jersey and Connecticut. Oh, OK, so now that I'm in Texas, you know one, because I decided I don't want to practice anymore. But Texas, Oklahoma, New Mexico, Colorado are part of the conglomerate. There's a website where a physician can go and sign up one time, because the real problem in the past you'd have to individually go to each jurisdiction and apply for the license. Yeah, which pricey you know $800 to $1,500 a pop.

Sheena Franklin: 17:06

Yeah, depending on what state it is. Absolutely yeah.

Dr. Richard Kennedy: 17:09

And so well, what they've done now is that, because telemedicine is here to stay and the federal government has sort of said, yeah, this kind of makes sense, because there's going to be times where people it would be ideal in many respects to see someone in the locale where you are it makes perfect sense Also just to develop a relationship, because telemedicine has its benefits. But if I'm in California and the patient I'm seeing is in Virginia, we may have a wonderful time each time we go to our television. But in that crisis emergency in the middle of the night at 2 am, when I need an answer, now I may have an on-call service that'll help, but the standard reply is going to be this is an emergency, call 911 and go to the nearest facility and it would make sense to have somebody who's locally there who can look in, look out.

Sheena Franklin: 18:13

I agree Absolutely.

Dr. Richard Kennedy: 18:15

What you're undertaking is a wonderful thing and actually you're right Thinking out of the box and not thinking of it solely from the perspective of television, but also a combination of in-person visits and television.

Sheena Franklin: 18:34

Exactly it has to be. And then, once our AI gets more mature, what we plan on implementing is, once you start that visit, you will scan your skin and if, immediately, we know like this is a high severity case, we're going to route you automatically to an in-person visit. Or if we see something like now we have these underlying health conditions, like someone we're like, oh, you have like a butterfly rash, we think this might be lupus we're going to send you right off of the platform. We're not just about making a buck right, like go make enough money Right. So that's one of the things that we're also working towards and that also helps us reach our moonshot of, like decreasing this misdiagnosis rates all the way around.

Dave Liss: 19:19

this misdiagnosis rates all the way around. Two things I was wondering is is men a universally different consideration, or would men be something you would evolve into over time and you know, I think like somewhere we would probably want to talk about, like your one, three, five year vision, for, like you know where you are now, where you want to grow, and like articulation of sort of the how that would evolve into the moonshot. Yeah.

Sheena Franklin: 19:49

So I will say we, right now we are a women's health focused company, just because there's like some health disparities there, just in general. Now, when we look towards the future, yes, I want to get to the point where we are caring for men as well. Obviously, that's going to take like different branding, different marketing, but that is a goal. And then we also want to move into adolescent care as well. So, like those are like the long, like 10, 10 year goals, if you will, for the company, and moving to those different patient populations and then also five years from now. Basically, what we want to be able to do is I tell people you know, we want to take care of women today and folks today on their mobile phones, but in the future at their favorite, like pharmacy and retailer, because again, we're doing the skin, scanning the skin.

Sheena Franklin: 20:39

What does that look like, right? So say, for example, let's take a rural area right, there's always a Walmart, a Subway and a Dollar General, like you can always bet on one of those three things, right? So what does that mean if a farmer is coming into Walmart and they do like there's a cat station there and they can have a scan and they can go through the, the doctor can look at these different things and then they can say, okay, now I can schedule these visits, you know, and so I can only take one trip. That's going to be three hours in the city for the doctor and I can have the doctor can have this information. That's what that looked like for us. Or it can be as simple as someone's at Sephora. Right and Sephora, you know, they're not really trained Like, let's just be honest right, one week they're at Selway, the next week they're at Oak.

Sheena Franklin: 21:34

So it's like they're scanning their skin. They're like, oh okay, like we think this will help you with your condition. You can set up your profile and then you can monitor your skin, like throughout the process, and then if something comes up, then you have that telehealth opportunity directly on the move. So like it's about a complete picture of skin health, as we call it.

Dr. Richard Kennedy: 22:01

So how do you reach the individual, the time that you reach them to the time that they end up in chair somewhere? You sort of take me through those steps, how the process works, and also me not being technologically advanced at all, with you saying scanning and this and that at all, with you saying scanning and this and that. How would a person who's 60 years old, who's not familiar with all this technology, who's concerned about their skin because they want to you know, they got to get ready for their daughter or their son's wedding want to look good? How do you help them along the way?

Sheena Franklin: 22:40

Sure thing. So I said there's's a couple ways that people learn about us, right? So we do do a lot of direct to consumer because just the nature of skincare, dermatology right, so people can find out about us through, like, ads we don't do a lot of ads, but some ads right, we work with a lot of women's groups and organizations and then we work with a lot of, like, other types of physicians and dietitians and wellness experts who refer people to the mobile app. So you download the mobile app, right, you log in, you will do. You have an option of doing like a wellness questionnaire that asks questions about supplements, your diet, your exercise, because this all will help inform the physician that you're connected to.

Sheena Franklin: 23:31

So you come on for your visit. You click on I want to do a visit, okay, perfect. So then you do your standard medical intake form, which is required by law, right? And then we ask you to take three photos of your skin. We give you instructions about. It needs to be, you know, well lit, no makeup, no glasses. Then we instruct you to take one close up, a regular length and then far away, so the doctor can have these three different visuals to look at. And then you at the end, when you reach the end of the visit, you click submit. So this is all asynchronous, right? We don't do synchrony, so store and well, I don't know that, so asynchronous, no, live visual. You click submit, Then that goes to the back end, which I'll get to, but we're just focused on the patient, which I'll get to, but we're just focused on the patient.

Sheena Franklin: 24:22

And then, within 24 to 48 hours that you will get a ping in your mobile app that says, hey, your treatment plan is ready. Then you log back in, you click on, we have a section that will have all of your visits with us and it's labeled by date and you will open it up and it will say this is your diagnosis, this is who you saw, this is the date, this was your concern. Again, this was the diagnosis. These are a prescription. If you need it, click this button so you can do your, get your prescription filled. E-prescribing we don't do that on the back end. We have a service that does that. And then we'll also offer, like, some lifestyle tips. Right, like that says, like we know this, that you know you have rosacea, like loss of drinking is going to make that worse, so you might want to just general tips, cut down on that use like a light moisturizer and then come back for a follow-up visit in six months, because it's not necessarily that severe and that's all it takes it's that simple.

Dave Liss: 25:25

Do you have something like this, like on youtube?

Sheena Franklin: 25:28

no, we have steps on the website. If you come to the website and it's also once you're in the app, like it's pretty gonna be pretty self-explanatory like we walk you through each of the steps.

Dr. Richard Kennedy: 25:41

It's not difficult honestly, are you using mid-level practitioners VA's nurse practitioners who work in dermatology office?

Sheena Franklin: 25:53

So right now we're focused on dermatologists simply because our early target market are women of color. So we are like working with folks who are really experienced in that area or they have an interest in that area and they're going to get continued education, and also folks who are doing a lot with functional dermatology, functional medicine as well. So when we were in our private beta, went through a lot of research, had 2,000 women, a lot of people wanted a dermatologist. Like I wanted my first visit to be with a dermatologist. Like the follow up here that's great, but I want a doctor. So that's who we're focusing on. We're going to try it, see what happens. Yeah, not that many dermatologists.

Dr. Richard Kennedy: 26:40

Have you guys reached out to the NMA National Association?

Sheena Franklin: 26:46

Our advisor is a past president, so they're working with us as well.

Dr. Richard Kennedy: 26:50

Yeah, Because I think the other thing and again this from my own experience is that mid-level practitioners, not that they're not qualified technically, it all depends where they are, what kind of training they've had, how long they've been in practice. Yeah, there's so much variability in that these days, and also in most of the world, we're used to the doctor, and I say that because I was once the physician assistant. And I say that because I was once the physician assistant. I remember all the times I would walk in and say I'm Mr Kennedy and by the time we left they thank you very much, dr. So you know, they hear it all the time and you get tired of trying to explain the difference. Yeah, into a patient, it it suggests that you don't think enough for me to have a doctor come in and deal with. Yeah, but how you know, there are lots of reasons why mid-level practitioners are important, but the reality is is that they still don't have the training that physicians get. That's just a fact.

Sheena Franklin: 28:03

Yeah, absolutely that's what we found too. So you know, it's about finding the happy medium and, like I said, the follow-up care they're like they're a little bit more open to that than the MP. Or admission or something like that. Yeah, or admission or something like that, yeah.

Dave Liss: 28:23

If I'm in Canada or Mexico or Venezuela and I find my way to download an app, can I get care?

Sheena Franklin: 28:27

Sure, that's a good question. So technically, they say you can't. This is the law. Technically, the law says you can't, but it has to be where you're a resident Right, and so that's one of the things that we do is, in the back end, how the technology works. We ask you your address, we're going to know, like, what state you live in, and then we'll be able to tell, like the geo tracking, where you actually are right, right, so we would route you to a physician that's in your state, I mean, if you have that good of the internet access.

Dave Liss: 29:03

But you know, is it also like, like, if I'm 85 years old, I'm 90 years old. I mean, is that within the universe of people that you would serve, or is it like, well, our primary care service area, people in this age, some age range?

Sheena Franklin: 29:23

Yeah. So we're talking about marketing. Like our target market is 35 to, I mean, 30 to 55. Like that's our target market right Now. There's people going outside. Be outside that range, that uses it. Now, when we start talking about, like, elderly, I probably don't think an elderly person would be doing it on their own. They would probably have a family member, a caretaker, not helping them do that, right, that's typically how that would work and the process would be the same. But I would probably think if an elderly person was coming with a skin condition, it probably would be something severe that needs to be seen, like in the office, right. So, like we're asking your age, the doctor sees it or the AIC it's. When it gets to that point we're going to have some checkpoints in there. But theoretically, yes, you can use it, anybody could use it.

Dave Liss: 30:20

So, in an interview like this, what are the three or four most important messages that you would want to get out about what you're doing, what you want to build, what you're building, what you're doing what you want to build.

Sheena Franklin: 30:34

What you're building, yeah, the first one is that one we want to help get women the care that they need in a timely matter Right, and when they're doing that, we want to ease the frustration and anxiety that women experience, and women of color experience, when they go to the doctor. That's the first thing. The second thing is, like we're going to help you get the most accurate diagnosis the first time around, right, like that goes to decreasing that diagnostic rate. And then three we're gonna stay around to help you manage your skin concerns or any other health condition you may find out. Right, we're not just dropping you off. And those are the three important things that I want people to know. The bonus would be by joining our community and, you know, using our app, you're helping to better the care of other women in your community, just like you.

Dr. Richard Kennedy: 31:28

Sounds word of mouth.

Sheena Franklin: 31:29

Mm-hmm.

Dr. Richard Kennedy: 31:30

It might become word of mouth. I'm assuming you've launched it already.

Sheena Franklin: 31:35

So we launched part one, and what I mean by part one is I was saying to the day before, we're still building out the back end with the EHR, like with our vendor.

Dr. Richard Kennedy: 31:46

Yeah.

Sheena Franklin: 31:47

Everything else is there, so right now you can download the app and if you need to see, see someone, you will click on the button. Tell us what your concern is and then we send you back a list of all of our doctors in your state that are in our network, and they will work with you to set up appointment. In the fall, you'll be able to have that full telehealth experience. It's just okay taking a lot. Are you already connected? And the reason why I say that is because the company that we're working with they're called Open Loop, and so what they do is they found the paperwork for us to be practicing that we can practice in every state. Now it's just about finding dermatologists in those states.

Dr. Richard Kennedy: 32:47

In those states.

Sheena Franklin: 32:49

Exactly, so we can practice throughout the US. It's just about are we going to find the number of doctors that we need in those states?

Dr. Richard Kennedy: 32:57

You're saying that they're not in Mississippi when they're in Meharry.

Sheena Franklin: 33:01

So Meharry isn't Meharry in Tennessee, mississippi, alabama. They're very different states, right. And then you have a lot of the population that have government assistance, which makes it a little bit more difficult for us because we are a cash pay right, because sometimes dermatologists they like cash, like they don't accept lots of insurance and Medicaid and Medicare and all those things, so they help provide. Yeah, yeah, yeah, yeah.

Dave Liss: 33:36

So would it be the kind of thing where, maybe five years now, I have United Healthcare and they would say download this tab and then that'll help you with your skincare guide?

Sheena Franklin: 33:48

Yeah, that's possible.

Dave Liss: 33:51

Yeah, but I think no, they do it.

Sheena Franklin: 33:54

It's just because we don't take insurance. A lot of the payers don't necessarily want to work with us because we don't take the insurance. The insurance company is an insurance company, that's all.

Dave Liss: 34:08

It was interesting a couple of years ago, this pre-pandemic, I worked with an organization they're trying to do telehealth and basically chronic conditions like blood pressure, diabetes, things like that, and then the issue was none of these doctors wanted to work with it because they didn't believe in the idea of telehealth. And then you know, come the pandemic, it's the most viable option out there. The pandemic, then it's the most viable option out there. And I don't know how some cataclysmic event is going to encourage something like this adaptation.

Sheena Franklin: 34:43

That was interesting. I think it's also I'm not a physician, I only talk to them and I have them on the team, so I'm just going to give my layman. Perspective is, I don't think they understood how it would benefit them. I think they were thinking that they weren't going to have the same level of care, right, or they weren't going to be able to see the same number of patients and somehow they weren't going to get reimbursed by the insurance companies, right? So like that was. I don't think fundamentally like they knew it will work. But it was like all the other little tangibles, if it was going to be worth me doing it, right.

Dr. Richard Kennedy: 35:21

It was the backing.

Sheena Franklin: 35:22

Yeah, it's the backing. And then a lot of times, to be quite honest, now that I have anything against, like my fellow founders who are in healthcare, it's like a lot of the tools are so burdensome just to even incorporate into your practice, right? So now you want me to spend hours and hours training someone to do something and then it doesn't work and it's just a lot, right, Like sometimes those systems aren't just easily integrated into what the doctor is already doing and it just becomes a hassle and it's clunky on the back end. You know, like I'm trying to enter a CPT code and then the code won't go in, so then I have to go exit out of your system and then just go back to the way I was doing it, right? So you know there's a lot of different things.

Dr. Richard Kennedy: 36:10

So where do you see yourself in the next three years?

Sheena Franklin: 36:14

Oh my gosh, in the next three years we will definitely be able to have our AI like functioning right, so that will allow us to bring on more of those mid-level doctors or less experienced doctors, because the AI is going to be making more accurate you know recommendations to them. I want to be close to having served at least a million women, like getting closer to that number and building out that FEM index so that we can help other agencies, you know, medical device companies. That's where I see ourselves in the next three years, and maybe, maybe, working with a larger health system and spreading the message of like what we're doing, like partnering with them in some type of way.

Dr. Richard Kennedy: 37:05

That's going to be an interesting task for you, just because people like to have their own what's the best way of saying it? They want to always take credit for things they didn't always do, and you're clearly doing something that's different. And it is interesting that you're starting with skin Because, as Dave mentioned earlier, there are lots of people who talk about diabetes, hypertension, depression, anxiety, et cetera, and cancer, et cetera, things like that. But you've sort of really targeted First of all. I think it's ideal that you've targeted women, because if you targeted men first, you'd still be at the drawing board two years later. Men first, you still be at the drawing board two years later, just because, as they say, we have to be dying to get in the door. You know there's a whole lot of issues with them and that's across all culture.

Dave Liss: 38:02

Yeah.

Dr. Richard Kennedy: 38:09

But if you add the fact that people of color and the lack of trust in the system and doing good by you, so it's better. If it's not bothering me, I'll get to it when it bothers. Unfortunately, that's what leads to the greater terminal and the higher mortality rate in Black men in this country. It's that because we're no different than all men, except that since we don't trust, we'll just push it to the side. And if you add poverty to that and you're trying to make ends meet, you know where you have to decide. Am I going to pay for this medication or I'm going to put food on the table or feed the family? You know, then, kind of no real choice. Yeah, yeah, it is, but it no real choice.

Dave Liss: 38:54

Yeah, yeah.

Dr. Richard Kennedy: 38:55

It is, but it is a reality.

Sheena Franklin: 38:57

Yeah, and that's just the complexity of the healthcare system, right, like you need it, but sometimes you don't trust it and then the cost can just be so detrimental to your family, right? Oh?

Dr. Richard Kennedy: 39:11

yeah, healthcare is extraordinarily pricey and also, you know, I've always been a firm believer that it should be access for everyone, hardless, and that's never been the case. I mean it's never been the case. And because everything is so tied to all of the newer invention, the newer drugs, the newer drug, all of those things cost content, morgan, that becomes an issue. You never learn. So things that we should be addressing that would improve the health of all. We don't because it costs too much.

Sheena Franklin: 39:50

It takes too much time, but we'll get there. Maybe not in our lifetime.

Dr. Richard Kennedy: 39:54

Yeah, that's true, we're trending there, right?

Sheena Franklin: 39:59

Is that what they say? We're trending in that direction.

Dr. Richard Kennedy: 40:04

The long road, but you have to keep trying and that's all you can do, one step at a time. For sure, they say small step, small victories, with bigger each time. No, no question.

Sheena Franklin: 40:16

Yeah, absolutely.

Dave Liss: 40:18

Well. A huge thank you to our guest, Gina Franklin, co-founder of Kept, and All In. To learn more about Kept and their work on advancing women's health and skin care, please visit https:// www. kept. help. Thank you for joining us for Wellness Musketeer. Tune in for upcoming episodes to learn how to live with a greater understanding of the world we experience together. Please subscribe, give us a five-star review, and share this recording with your family and friends contribute You can contribute through the link provided on our program notes. To allow this podcast to grow, let us know what you need to learn to help you live your best life. Send your questions and ideas for future episodes to David Liss at Davidmliss@gmail. com. Thank you.