“If you’re not at the table, you’re on the menu”: Advocacy, systems, and who shapes healthcare with Tammie Lee Demler

Travis Heath sits down with Dr. Tammie Lee Demler—board-certified psychiatric and geriatric pharmacist—for a wide-ranging conversation on psychopharmacology, stigma, loneliness, and what clinicians often miss when they talk about “meds.” From deprescribing and the realities of polypharmacy in older adults to the ethics of access and affordability, Dr. Demler offers a grounded, collaborative perspective that’s especially relevant for therapists who work alongside prescribers. They also unpack the Surgeon General’s framing of loneliness (and how it differs from social isolation), the importance of “noticing,” and why directly asking about suicide can be relieving—not harmful. Along the way, Dr. Demler shares research on teaching to reduce stigma, explores why testing “taboo” hypotheses can still be good science, and breaks down what’s notable (and challenging) about a newer antipsychotic option with a novel, muscarinic-based mechanism.