Interview with Dr. Jennie Byrne – 354

Today's episode features my interview with the author of Moral Injury: Healing the Healers.

We explore the concepts of burnout and moral injury within the healthcare profession through a detailed discussion with Dr. Jennie Byrne. Dr. Byrne shares her insights and experiences, highlighting the evolution of these issues, their impacts on healthcare professionals, and potential solutions.

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The Evolution from Burnout to Moral Injury

Burnout has long been recognized as a significant issue in healthcare, intensifying in discussions since the 70s and 80s. However, Dr. Jennie Byrne and others have shifted the focus to “moral injury” as a more accurate description of what healthcare professionals experience.

Moral injury involves:

1. participating in or witnessing events that conflict with one's personal or professional values,
2. under directives from superiors,
3. in which high stakes are involved.

This concept, originating from military contexts, provides a deeper understanding of the profound, soul-wounding experiences of many in the healthcare field.

Personal Stories and Systemic Issues

Dr. Byrne shares her journey and experiences in healthcare, from her varied educational background to her work in psychiatry and healthcare consulting. She highlights the systemic issues that contribute to moral injury, including the intense pressures and emotional challenges faced by medical professionals.

Personal anecdotes, such as her experience with a medical board investigation, illustrate how non-workplace-related events can also inflict significant wounds. These stories underscore the complexity of moral injury, extending beyond workplace stress.

Healing Strategies and Systemic Changes

Addressing moral injury requires both personal and systemic approaches. Dr. Byrne emphasizes the importance of open conversations and peer support as initial steps toward healing. Creating safe spaces for healthcare professionals to share their experiences and feel seen and heard is crucial.

On a systemic level, having dedicated resources such as a Chief Wellness Officer and structured support systems can provide lasting solutions. Additionally, small acts of kindness and advocacy work play a significant role in the healing process, fostering a culture of empathy and support within the medical community.

Summary

Dr. Jennie Byrne can be contacted and found through her professional website DrJennieByrne.com, where you can learn more about her background, services, and resources. Additionally, she shares insights and updates on her LinkedIn profile, where you can connect with her professionally and stay updated on her latest activities and contributions. Dr. Byrne's blog, also accessible through her website, offers information on various topics related to her fields of expertise. 

NOTE: Look below for a transcript of today's episode. 

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Links for Today's Episode:

• Dr. Jennie Byrne's LinkedIn Profile
• Dr. Byrne's Website
• Dr. Byrne's Private Psychiatry Practice
• Moral Injury: Healing the Healers, by Dr. Jennie Byrne (This is an Amazon affiliate link).
• Dr. Warren Kinghorns's LinkedIn Profile
• Amy Story's LinkedIn Profile
• Humans in Healthcare
• Monica Bean, BSN's LinkedIn Page
• Dr. Tammie Chang's Website
• Dr. Paul Dechant's Website
• Preventing Physician Burnout: Curing the Chaos and Returning Joy to the Practice of Medicine (This is an Amazon affiliate link.)
• Purchase Your All Action Pass Videos and Bonuses from the 2024 Summit (Use Coupon Code 30-OFF)

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 354

How to Recognize and Overcome Moral Injury in Healthcare

- Interview with Dr. Jennie Byrne

John: The concept of burnout's been around for a long time, I don't know, maybe decades if not centuries, but it seems like in the 70s and 80s, it started to be applied to healthcare just because of the intensity and the long periods of education and so forth. And I remember talking about it with colleagues, early in my career in the mid 80s. And then at some point, it started to evolve into this concept of moral injury as a better descriptor of what's actually happening. And so I thought it was about time that we just address that issue here on the podcast. So to that end, I'm very happy to have Dr. Jenny Byrne here on the show today. Welcome, Dr. Byrne.

Dr. Jennie Byrne: Hey, great to be here.

John: I'm really looking forward to picking your brain. You know, you've got the book and I was able to go through the book, but it definitely hits all the points that I'm interested in hearing about. So I'm glad to have you here and have you talk us through this. But I always wanna give my guests a chance to talk about themselves for a few minutes. I've had a very long and illustrious career, but talk about your medical training, what you do, what you do now for the most part, and then we'll get going into the topic of the day.

Dr. Jennie Byrne: Great, so I'm originally from Pennsylvania, and I don't know, I know you have a lot of physicians listening. I did not know I wanted to be a doctor when I grew up. I was a music performance major. Going into college, became a French major so I could live overseas. And it really wasn't until I came back, took a class in brain and behavior and fell in love with it. So pretty much my whole career circles around brain and behavior in some form or fashion. So I did an MD PhD. I don't know if you have any MD PhD listeners. Mudfud's out there, but I did an MD PhD in neurophysiology. Again, love the intersection of human brain and behavior. So I trained as a psychiatrist. I did my MD PhD at NYU, and then I did psychiatry at Mount Sinai. So I lived in New York City for a very long time, which was very exciting. And then I did a leap of faith down here at North Carolina, which is where I live now and I love it here. And I've done a whole bunch of different stuff. I'm always curious, I'm always learning, and I'm always saying yes to things and that's led me in a bunch of different directions. I've had a outpatient practice that I sold a couple of years ago. I grew that out over about nine year period. So I've practiced psychiatry for over 20 years. I got involved in Medicaid in North Carolina, helping design programs for integrated care, worked a lot with primary care docs, real fondness for primary care. Then I went to work as a national executive for a company called CareMore out of California. ran all of behavioral health and specialty for them nationally. So I saw what like a fully scaled healthcare organization looks like and kind of behind the curtain of what it's like to be an executive at some of these companies. But I love early stage. So that's what I do now. I advise early stage healthcare companies, a lot of which are mental health, but also value-based care and really just human behavior because that's pretty much everywhere in health, including physician behavior. You know, we're, human too, even though we don't like to admit it and we do dumb human stuff like everybody else. So that's what I focus on now. I do see patients a little bit and I have a practice that is not publicized, but for you all listening may be interesting, I take care of other physicians. So I have a really cool AI hybrid infused practice where I can care for other physicians as a psychiatrist, a therapist, or a coach.

John: That's all very interesting. And you talked about the healthcare advising that you do, I think, and there's probably at least five or 10 different things we could talk about on another podcast episode. But so I'm really glad you took the time to join us though to talk about this topic, moral injury. You know, I just, you know, like the book is what attracted me and because I had this question, a lot of bunch of questions about moral injury and what it means. And so let me, let's go to why did you write the book?

Dr. Jennie Byrne: While I was thinking about it, and I have to say, writing my second book in under a year wasn't really on the top of my list for this year. Um, but the reason I wrote it was because I, I feel passionate and I felt there was a real urgency to talk about this, now this year. And it really started where I was just having conversations with folks like your listeners or you, or, you know, colleagues, physicians, other clinicians. And maybe because I'm a shrink, people just tell me stuff, but What I heard really upset me and worried me. It's really bad. It's really bad out there Medical students are ready to leave the profession before they even get started Residents are ready to leave. People who are amazing clinicians are ready to leave people retiring early. I mean There's a reason for all of this and my kids Pediatrician left and it really threw me for a loop. I was like this was someone who was I don't know maybe late forties, early fifties, seemed to love her job and, and she just kind of disappeared and that really, you know, struck a chord with me. Like what is going on? And of course, in my private practice, I've taken care of physicians and I know that, you know, sometimes we look at our peers and they seem like they have everything together, but behind closed doors to their psychiatrist, you know, they'll tell me they're thinking about suicide or they're, they're paranoid or not to go off on a negative tangent, but you know, it's really bad. So I really wanted to figure this out and I wanted to know what was going on. So I started just doing some research, talking to people and came across the idea of moral injury from a colleague in North Carolina, whose name is Dr. Warren Kinghorn. He is a psychiatrist, but he also works with the veterans of the VA. And he also has a divinity degree. So he's got this really interesting intersection of faith, military and psychiatry. And he told me about moral injury. It's a concept that comes from the military.

John: You know, I have to admit too, that I've heard the same thing, because I'm talking to people looking about getting out of medicine. And what I've heard is that, you know, the med students will say, oh, I got to tough it out. You can't get any worse. And then they get in the residency and the burnout, whatever you want to call it, seems to be worse. And each year it gets worse, you know, depending on the residency. And it's just not very hopeful at this point, if that's kind of the way our system is built.

Dr. Jennie Byrne: So, so the definition of moral injury. So this is where kind of this topic about burnout versus moral injury. I think that words matter. I'm a psychiatrist. I think words matter. I think it's important for us as physicians and others to articulate what we feel inside. And that's particularly hard for us because our culture is one of, you know, repression and denial and all those coping skills we got to get through school. So we feel bad inside and we don't know why. So moral injury, the definition is threefold. The first is that you are part of something, do something, witness something that goes against your values, whether that's personal values or professional values. Second, that it is ordered or condoned by somebody superior to you. And third, that the stakes are high. So you can imagine all these military folks coming back from maybe combat zones where they weren't really in the line of fire, but they just really struggled to reintegrate into their lives and it wasn't PTSD and it wasn't depression. And it was really this like, I think about it as like a wound on your soul. And that's different than burnout. Burnout is more of this industrial energy concept that we're tired and fatigued and burned out and we just need to go recharge our batteries or take a vacation, do some yoga and come back and we'll be just fine. But I think it's like this wound, this metaphor of a wound really resonated with me. And so that's why I really liked this concept.

John: So that kind of gets to the root causes, I guess, is what's behind it. I mean, we have, like you said, what we're doing generally, depending on the circumstances, they're high stakes and yet we don't feel supported, we're being told what to do that may be against even what we think we should do. I know, did you get the sense during the pandemic that this was just like an overdrive?

Dr. Jennie Byrne: The problem predated, clearly the pandemic, right? Clearly, but the pandemic just put it into stark relief. And then post pandemic, there wasn't a period of healing. So the wound, if you think of, I talk in the book about staging it like a wound, the wounds were bigger, right? The pandemic really, really made those wounds gaping. And then we didn't have any opportunity to heal post-pandemic. So those wounds are still there and they're for most people still pretty gaping wounds.

John: Yeah, I think that was one of the notes to myself was to ask you to expound on that issue of like sort of using the pressure ulcer as, as you mentioned in the book, and I thought it was a pretty good analogy.

Dr. Jennie Byrne: I love the good visual, right? So I told a story in the book about one of my worst rotations in med school. I was at Bellevue training and I had to do vascular surgery because I couldn't get my top elective choice. For some reason, they put me in vascular surgery. I don't know why. And it was awful. And I got to know wounds really, really well during that rotation. And some of them were just horrific. And so this idea of what it really means to heal wounds. I think that's a great metaphor for a moral entry because you can look at a pressure, we stage pressure wounds in particular. So you kind of say, okay, stage one, there's redness, maybe a little tenderness. You can tell something's brewing in there, but if you just let it be, it'll probably be okay. To me, that's kind of the burnout, like take a vacation, change jobs. you know, something like that, that'll heal on its own. Then you break the surface, you know, the stage two, the surface is breached. Okay, well now the burnout's worse, and I don't think it's just gonna heal on its own. It needs something, maybe your own psychotherapy or coaching or adding consulting, doing something different, you know, maybe that will heal it, maybe that gives you enough to heal. And then you get to stage three where it's pretty messy. It's a pretty messy wound and there's really, you need systemic healing to be in place. You need the system, the environment around the wound to be properly maintained. It has to be clean, it has to be dry. Maybe it needs antibiotics. You know, you gotta do some stuff for that to heal. And then you get to stage four where you're, you know, you're in there looking at the bone. And that's what I remember from my vascular surgery days. You know, there were days where I was packing things where I could see the bone. And that is a whole other ball game. And some folks are at that place. And that's where, unfortunately, physicians in particular can internalize and go to really dark places. Or they can externalize and get really angry and hostile, which can lead to other problems. So I like this idea of a wound, because we can all kind of imagine that and understand healing, not fixing. I don't like the fix. I don't like burnout that we're gonna fix it. I think these are wounds, and wounds require healing, not fixing.

John: Now, the other thing that has occurred to me thinking about this topic is, and you mentioned the military, and we're talking about medicine. It's basically a workplace-related situation, is it not? I mean, I guess there might be other circumstances, but in most cases, the things that you've described are happening in a workplace of some sort. So it would seem to be something that OSHA or some other organization besides just the maybe the physician or the others affected by this, the military and so forth would have to address. What do you think about that?

Dr. Jennie Byrne: I think yes and no. I think sometimes that wound is the workplace. You know, the death by a thousand cuts, the EMR clicking and the, you know, 10 patients an hour and the blah, like, yes, yes. But there's more to it than that. And I think this is where the conversation gets interesting for me. So in addition to the workplace kind of injurious things, you know, I opened the book with a very personal, vulnerable story about an incident that somebody reported me to the medical board. That had nothing to do with the workplace. That was purely about me having to deal with someone questioning my values and my skills as a clinician, even though I was not in the wrong. And at the end of the day, it didn't really matter. But I had to go through this huge process where other physicians on the medical board had a process which wounded me. And I had to go take a class on controlled, on opioid prescribing, which was ironic because I wasn't even prescribing opioids. And when I went to that class, they flashed slides of jails where they send doctors who prescribe opioids. That was what I sat through, you know, and that wounded me at such a deep level. I can't tell you, even writing about it for the book really was painful. And my hope is that by writing and sharing the story, it heals me as well as maybe healing others who have had similar things. So Sometimes the injuries don't come from the workplace. Sometimes they come from a lack of respect in the community, the way we're treated. Sometimes it comes from our peers who injure us, whether intentionally or not. Sometimes it comes from just the difficulty of managing chronic illness with so much information that we can't possibly keep up. Our human brains can't possibly keep up. Sometimes it comes from trying to manage this increasing intersection of things like gender and politics and sexuality and like culture and like, you know, and it's really hard. It's not like it used to be. I have a grandfather that was a doc in the 40s, you know, and I have his little black bag sitting over here. You can't see it. Things were a lot different back then and it's just not that way anymore. So I guess the answer is yes to the workplace but also other things which we don't talk about as much.

John: Well, that in my mind also kind of points to, let's say being sued, a lawsuit, I would think. That adds like a whole another layer of pressure.

Dr. Jennie Byrne: And I'm sure you have people listening who probably have had these things happen and they've never told anyone. I didn't tell anyone about my medical, I was so embarrassed, ashamed, you know, pained by it. I didn't even tell anybody. So I'm sure there are folks listening who've had, like you said, a malpractice suit, a patient complaint, a medical board issue. You know, people don't talk about these things. I'm sure that people out there have had this happen and I'm sure that it was wounding to them the same way that it was wounding to me.

John: This is a little bit of a left turn just for a moment, but one of the things that you just mentioned is I did an interview some time back about sham peer review, where the peer review process was actually being sort of misused to get someone off staff, destroying their career and so forth. I don't know if you've experienced, if you've coached, if you've treated people under that, that could be almost unbearable kind of pressure.

Dr. Jennie Byrne: I have. And it's something that unfortunately that's kind of part of our culture, you know, the old school medical culture, right, of being a resident and being shamed, publicly shamed in front of others as the way to learn. That's just kind of part of our culture and it doesn't make it right. But we still do that to each other. And it's not, I don't blame, I don't blame the other physician doing it because when you're in a negative, stressed burned out, time crunched, injured mindset, is very easy to injure somebody else, whether intentionally or not. So I don't blame them. I have deep empathy for them as well, because I know that under other circumstances, they probably wouldn't do that to their colleague.

John: Well, I think we should shift gears and talk about what are the solutions or what can we do to at least ameliorate, if not eliminate this problem eventually. What thoughts do you have on that?

Dr. Jennie Byrne: Well, one of the best news is, I know this is kind of a serious topic, but one of the best news is that just talking about it is part of the solution. So we know this from the military. Just talking about it, being able to identify that feeling that's inside of you, being able to share your story in a safe place, not that the other person can change what happened to you, but feeling seen and heard by a peer is incredibly healing. So, talking about it, having the words to describe what's going on, and having others in our ecosystem listen to us and giving them the language to talk to us about what's going on. Because I can tell you, I work with a lot of administrators, executives, tech people. They're not greedy, evil people. I know that's the narrative that's convenient. No, it's a convenient narrative. And sometimes it's true, but mostly they're trying to do the right thing and they could make money more money doing something else too. So they lack the understanding of what it's like and we don't help them. We don't give them the language to talk to us and we act like we're perfect. So I think just talking about it and giving others the tools to have real conversations is something which actually doesn't cost any money and is incredibly healing. So that's the first thing. Yes to the system change. Yes to the like designing clinical products for clinicians, understanding the psychology of clinicians. Yes to all of those things too. And then I think, you know, I write about in the book, I do believe in butterfly effects, especially from one clinician to another. Or as a patient, like I'm a patient, we're all patients too, right? It's not just us as clinicians, we're all patients too. And I always tell someone, you know, when you see your clinician, tell them thank you for all you do. Just do that. Like small acts of kindness, they don't fix the wound, but they can really help. So the more small acts of kindness and empathy that you can show others or call your peer. I had a psychiatrist that was a mentor of mine send me an email today. He said, I read your story in the book and I can't believe I was so upset by what you wrote. And he said, I had something happen to me like that. And I never told anyone. And I was like, I can't believe, you know, and just so that sharing and that kindness, especially from one peer to the other. So taking that five minutes to write that email to your peer, like, you know, I was in a really tough spot the other day and you came and you told me this, that really helped me. Or if you see your colleague who's struggling, say, I don't know what's going on. It seems like something's gone on and I'm here if you want to chat with me or what, you know, like these small things I believe really matter. So in addition to the bigger systemic change, I do think there are things that we can do right now that actually don't cost any money.

John: You know, as you were talking, it occurred to me something else that I've experienced for times in my life where there were issues. One was a support group for divorced men and I for a reason that I won't disclose now, but I mean, I attended Al-Anon and you know, those are supposed to be private and not anonymous per se, but they're not discussed outside and it's supposed to be supportive and all that. Have you ever seen that ever used with physicians?

Dr. Jennie Byrne: Yeah, so for example, some resources to check out for your audience, so Amy's story, She is a PA by training. She has a company called Humans in Healthcare, and that's exactly what they do. It's clinician groups where they share stories. Sometimes they grieve together for patients that have died or their own losses. She's doing amazing work. There are a ton of coaches out there. So if you're a nurse, probably don't have nurses listening, but. There's a woman, a nurse, Monica Bean, who does this for nurses. She's a nurse by training. Trying to think of some others. I could, you know, have people reach out to me. I can share some of these resources, but there are lots of groups of physicians coming together. There's one woman that focuses on moms, physician moms. And I did forget to mention one thing that's important for your audience to know that. One of the ways you can heal that I've heard from my interviewer interviewees is through advocacy and through feeling like you're part of the solution. So if folks are thinking about advising other companies, taking a leadership mentorship roles or being an advocate for even if it's just a single patient or another physician or that really can help you heal too. So If you find a way to have an impact that's not just your day-to-day with patients, often that's quite healing.

John: Well, I just took a quick peek back at the index of the book, Moral Injury, and I think a lot of these things are really addressed there in much more detail, so I would encourage everyone to get the book. So let's talk about that. How do we get the book, and where do we find it, and so forth? And how do we find you?

Dr. Jennie Byrne: So if anyone else has written a book, you'll know that Amazon is where all the books are. So the book is on Amazon as well as my first book which is called Work Smart. And if anybody is interested in a book club or sometimes we'll go do a talk where we get a whole bunch of books, just reach out to me if you're interested in anything like that. In terms of getting a hold of me for questions about advisory work, again, LinkedIn is a great place to just send me a message. I do have a website, drjennieburn.com, which is kind of a list of some of the stuff I've done. And then I'm gonna share with this group. I don't share this with all the people I do podcasts with. I have a small private practice that is not advertised where I care for other physicians, whether that be coaching, psychotherapy, or I think 12 states I can do medications as well. And that is called constellationpllc.com So you can also just reach out if you need help. If I can't help you, I'll do my best to find somebody else in your state or wherever you need help.

John: I'm gonna put a dig in here against the industry right now just for a second, only because I think I read in the book that the number one cure for moral injury is not resilience training. Is that my off base there? But because I get offended when they tell me that, that's the solution.

Dr. Jennie Byrne: I think that's happily falling out of favor this year. My statement in the book is I believe clinicians are inherently resilient. I don't know how on earth anyone gets through all that training without being resilient. I mean, seriously. So that doesn't mean we're not human and we need help. But I think if my point is if a clinician of peers, they're not resilient, you should be asking what's going on.

John: Hmm, because they've reached -they've gone way beyond the point where it's not dangerous, you know. Have you seen any big organizations? This is what I keep looking for because I know of physicians who have addressed burnout, moral injury, you know as a coach or something and they'll spend a lot of time with an organization But have you seen any put into place something that is lasting and is effective over time?

Dr. Jennie Byrne: So I think the most effective long-term solutions come from leadership when they put, when they basically put money into it. So when a leader, a CEO or something, you know, creates a wellness group, like a chief wellness officer, and really devotes significant resources to it, that's probably the best long-term solution is to actually have people internal to the organization who are driving it forward. So I, one of the people I talked to was Dr. Tammy Chang. So she's been doing this for a long time. She's a great resource to reach out to. She's at a health system as their chief wellness officer and she's just a wealth of information. And then there's some others who do like private interventions, but company solutions. So Dr. Paul Duchant does that. So he's a good resource. He and Diane Shannon wrote a really good book on physician burnout, which I recommend as well. So there are folks who do it. Now, he leans a little heavy on the operational end of things, and I'm more the shrink. I really think that the healing has a lot to do with our hearts, not just operations. So we, I don't wanna say we disagree. We don't disagree. I just, I think we undervalue the emotional component of change. And I think it's, it's actually easier than we think it is sometimes to connect with someone at that like heartfelt level, and make a real difference in their life. I don't think it always has to be fixed the EMR fixed. I mean, yes, do those things, but and have that human connection that heart part because I think that's how we heal. It's not just our bodies, right? Like our hearts have to heal.

John: Very good. But I appreciate you taking the time and sharing all this with us, giving me a little more clarity on exactly what it is. And like you said, the metaphor, the pressure ulcer, trying to explain it to people. And you gave me a little hope there at the end that there are people that are making a difference in this area. So I'm going to have to let you go soon. We're pretty much out of time. But I guess, do you have any last words of advice for, let's say, the listeners who might feel... I mean, one of the reasons they're looking sometimes to change their career or their life is because they're having this particular problem. Any other advice for them individually to how to find a solution for themselves?

Dr. Jennie Byrne: Yeah, the main thing is really you're not alone. There are a lot of us out there, we're feeling the same way, we may not be talking about it, and you're not helpless. A lot of us, we get in that negative mindset, we feel very helpless, you're not helpless. You have tremendous skills, you're in tremendous demand, you've come a long way, right? Like you have more control than you think you do, and there are people out there who will help you. So I guess my only precautionary thing would be, leaving the practice of clinical medicine altogether may not heal all those wounds. So I still see patients, it's important to me and I do advising for a living. So just a little like, you know, it may not heal everything just to leave. So if you are interested in doing clinical practice and doing something else, you can do both. You don't have to give up one for the other. It may not fix all your wounds just to leave clinical medicine because it's probably, there was a reason you went through medicine in the first place. And that part of you is important.

John: I used to focus almost entirely on like, what are the options for just getting out? But I'm convinced now that there's so many options for staying in. If you can kind of carve out the things that are making your life miserable or that you're just reacting to in whatever way you're reacting to, get rid of the bad parts, keep the good parts. And there are more and more ways of doing that, even though the employment has been going up, I think we're reaching a point where you can do DPC and whatever, other forms of practice and just set boundaries and write your list of your must haves and really start to take control. But what you said earlier, people don't even realize that they're in the midst of burnout or moral injury. So they don't really look at it that way and take a step.

Dr. Jennie Byrne: And one final thing would be too for those who are a little later in their career, a little older like me, sometimes being a mentor, being a support for younger early stage folks, that's really rewarding too. So if you decide I just can't go back to clinical practice and maybe you wanna do advisor or other work, but you can still find ways to support those who are coming up who maybe have a little more energy. And maybe you can prevent them from feeling so wounded so they can go and do that good work. That can be a really wonderful way to stay connected with clinical medicine in a way that maybe supports you in whatever stage of your career that you're in.

John: Awesome. Thanks for that. Thanks for taking the time to talk to us today. I really appreciate it. I advise everyone get the book, go to Amazon, Moral Injury. Let's see, what's the byline? Moral injury?

Dr. Jennie Byrne: Healing the healers.

John: Healing the healers, okay. I had that written down here somewhere, but it's really good and it's pretty comprehensive. I mean, there's a lot in there starting from recognizing it to even potential solutions. So it's a great resource. Okay, thanks Jenny, I really appreciate it. And hopefully maybe we can have you come back and talk about some of the other things you're up to at some point.

Dr. Jennie Byrne: Thank you for having me and to everyone out there listening, be well, please take care of yourselves, please. Please get help if you need it.

John: All right, bye now.

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Begin Your Career Transition in Earnest

In today's episode, we revisit the topic of 5 persistent myths that clinicians believe when they begin to contemplate a career transition. This presentation was given at the 2023 Licensed to Live online conference.

In today's fast-paced healthcare landscape, many professionals find themselves yearning for a more fulfilling and rewarding career path. To embark on this transformative journey, the first crucial step is recognizing the widely held beliefs or myths that hinder progress. The prevailing misconception that the only way to succeed is by adhering to the status quo may be one of the main barriers preventing professionals from embracing a more fulfilling path. 

Our Sponsor

We're proud to have the University of Tennessee Physician Executive MBA Program, offered by the Haslam College of Business, as the sponsor of this podcast.

The UT PEMBA is the longest-running, and most highly respected physician-only MBA in the country. It has over 700 graduates. And, the program only takes one year to complete. 

By joining the UT Physician Executive MBA, you will develop the business and management skills you need to find a career that you love. To find out more, contact Dr. Kate Atchley’s office at (865) 974-6526 or go to nonclinicalphysicians.com/physicianmba.

5 Persistent Myths

Once the myths are dispelled, a world of possibilities opens up. This journey often involves exploring alternative career options where one can leverage their expertise and training to make a meaningful impact in unconventional roles. Embracing a different direction, such as pursuing a nonclinical career or venturing into healthcare innovation, allows professionals to find new avenues for personal and professional growth.

In this list, we debunk the following persistent myths:

1.  “There are no jobs.”
2.  “I'm not qualified.”
3.  “The salaries are low.”
4.  “I'm abandoning patients.”
5.  “I won't be respected.”

Best Kept Secret

The first of the 5 persistent myths pertains to available jobs. In fact, there are several large industries that hire thousands of physicians each year to do nonclinical work:

• Hospitals and health systems,
• Pharmaceutical and medical device companies,
• Medical publishers,
• Educational institutions,
• Consulting firms,
• Federal, state, and local governments, and,
• Life and health insurers.

Additional Training Not Required

The next of the 5 persistent myths pertains to necessary training and skills. For most of these new careers, the primary qualification is the completion of medical school. Such physicians have broad exposure to the life sciences, an understanding of the U.S. healthcare system, and how to interact with patients. Additional education during residency and fellowship and board certification are sufficient to qualify us for most of the remaining positions.

Sometimes, additional certifications and degrees may be preferred. But for the most part, it is the physician's unique background, training, and experience that prepares them for these nonclinical jobs.

Incomes Improve

The next of the 5 persistent myths pertains to income levels. Salaries may be less than those for clinical work initially. But that will be offset by improved lifestyles and work-life balance. Benefits and vacation time are often quite generous. And most physicians experience opportunities to quickly advance and enjoy very attractive income levels over time. 

What About the Patients?

You'll be helping patients in new ways and sometimes much broader ways and in larger numbers as you can one patient at a time…

In pharma, you'll help develop life-saving drugs. You'll reduce pain and suffering for large groups of patients in public health. And in consulting, you'll bring new and improved models of care to hospitals, and help implement new service lines.

Reputations Improve

The last of the 5 persistent myths relates to your reputation and identity as a “doctor.” Generally, these positions have an impact on larger groups of patients. And physicians become content experts, managers, and leaders over time by combining their medical expertise with skills in their new industries. 

Summary

In the ever-evolving healthcare landscape, it is vital to challenge long-held myths and beliefs that may hinder professional growth. By breaking free from corporate-style, high-volume models of care, healthcare professionals can unlock their true potential and enjoy their work again. Leveraging one's medical expertise in innovative ways is the key to unlocking a fulfilling and purpose-driven career when the traditional healthcare system fails us.

NOTE: Look below for a transcript of today's episode. 

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Links for Today's Episode:

• How to Kill the Myths About Alternative Jobs for Clinicians – 252
• Month One of the 12 Month Roadmap to a New Career – 269
• NewScr!pt

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 309

Let's Dispel These 5 Persistent Myths About Nonclinical Careers

John: All right, nonclinical nation. Let's get right into today's presentation in which I do my best to dispel five persistent myths about nonclinical careers. Let's start by talking about Dr. Brenda M. She's two years into her first job as a hospitalist, and she's feeling very unhappy and disappointed.

Now, when she was in medical school, she really enjoyed it, although at times it was a little bit overwhelming, but all in all, she felt maybe some slight burnout during certain parts of that for a year program. And then she went on to her internal medicine residency anticipating becoming a hospitalist. And during that time, again, she was happy to be there, but she really started to feel as though she was getting burned out. There just was too much work to do. There wasn't enough support and not enough recovery time before the next shift or the next clinic and that sort of thing.

But she thought, "Well, I'm going to try and find a really good job in a location that I'm interested in, and by then, things should get better." And we've all heard this, right? And some of us have felt it recently. It seemed like the burnout from medical school to residency to practice just kept building on each other.

But she joined a group. She thought, "Well, it seems like the coverage is good. There's enough of us to take care of this hospital." She was promised a certain number of days off each month, and things were going well at first, but then the support staff seemed to be falling off and not being replaced. And the volumes that she had to see during those two years kept increasing to the point she felt like she never really could keep up. She had to go back and do her medical records when she was at home online. And she just thought that things were not going the way she anticipated.

Now, she was really starting to think, "Well, maybe this just isn't what I thought it would be, and maybe I need to do something else." But every time she had those feelings, she sat back and thought "There's just no way I've spent my life learning to do this job. I don't really have other options. I'm going to see a drop in my income." With still having some outstanding loans, even though there was some partial payback through her employer, she felt constrained. That's what someone in the past called the golden handcuffs, in a sense. You make a good living, but at the same time, there's huge pressures. The income doesn't really seem to go up unless you just work longer and harder. And it also seemed as though she would be letting people down if she were to not continue on in her clinical career. Her family, her friends, and even her patients.

This is a common thing that we see in today's healthcare environment. And if you're frustrated or disenchanted about your work in healthcare, if you feel as though you're being ignored and taken for granted, or that you've been forced to forfeit your autonomy to do what's best for your patients, then it is entirely reasonable and even necessary to consider a nonclinical career in order to maintain your integrity and maybe even maintain your sanity.

You certainly aren't alone. In fact, tens of thousands of clinicians over the last decade have come to the same conclusion. However, many of us like you are hesitant to do that because of several myths that our employers and training programs promote in order to maintain the status quo.

We continue to suppress our feelings that something is wrong and delay implementing the solution to these problems. So, what is the solution? Well, for the most part, it is to take the next step in your professional life and join all the other professions who make at least five to seven job changes, and try and find a career that leverages your training and experience outside the traditional unrewarding assembly line corporate style approach that is currently the predominant way that healthcare is being provided.

But to do that, one of the first steps we must take is to recognize these widely held beliefs or myths that hold us back and dispel those myths and enthusiastically embark on the next phase of our professional lives. That is really the major solution. Other solutions would be to retire early, do something else. If you're independently wealthy or you have a spouse who's willing to provide the financial while you do other things, that would be great. But basically what we need to do is set ourselves on a new path. But first, most of us have to try to overcome these widely held myths that hold us back.

All right. So, let's talk more about that. I think if Dr. Brenda does the same thing, she will find herself in a better place. And so, I want to answer these questions today as we go through this discussion. First of all, what do I mean by nonclinical career or nonclinical job? What are the five most common persistent myths that we encounter? And how can I dispel those myths and prepare you to find a nonclinical or non-traditional career, if that is your goal?

All right, what I'm talking about today when I'm talking about a nonclinical or non-traditional career, it's an alternative career, an unconventional career, one that is based on your background, your education, training, and experience in medicine, or even nursing or dentistry or pharmacy. Because a lot of the concepts I'm talking about today apply to those other clinicians that often find themselves on the same team and in the same situation as we are in which is we're being overworked, we're being abused, and we need to try something different.

Now, those nonclinical jobs usually include a term that indicates that it's still within the healthcare system. For physicians, it means it might include the term physician or medical. For nurses, it'll include nurse or nursing. And dentist, dentist or dental, those kinds of things.

For example, I'm talking about careers like physician advisor, medical director, medical writer, executive medical director, chief medical officer, chief medical information officer. It could be the same thing. Chief nursing officer, nursing director, that kind of thing. And these kinds of jobs also apply to those other specialties in other fields that I mentioned a minute ago.

Now, I'm not addressing what some might call self-limiting beliefs, the feeling that I'm not good enough, I might fail, there's something wrong with me. It's too much to learn, it's too hard to do. Those are internal, again, self-limiting beliefs that are really generally pretty easily overcome. We had to overcome those kinds of thoughts when we contemplated going to medical school or nursing school, or get our PharmD or our DDS, those kinds of things.

I'll list the five most common myths that I encountered. I'm going to list them, state them in a way that is at the extreme. What we're saying to ourselves, what our former instructors and professors and employers wanted us to think while we were in training and even in our current positions.

And these are the kind of things they want us to think we fall victim to. One is that there are no jobs for us that aren't within healthcare, per se, in patient care, that I don't have the qualifications. I have no qualifications. I'll make no money. Obviously, you'll make some money, but the money I'm going to make is going to be completely inadequate. That I won't be helping patients anymore, which is what I really went into healthcare and medicine, or nursing or pharmacy to do. And then I'm going to lose my stature. I'm going to lose all my respect because I'm just going to step away and do something that's not as noble in a way.

I'm going to take each of these individually, describe them in more detail, and then address how to really understand why these are myths and therefore, kind of take away those barriers to you moving forward with your next professional advancement and next stage in your professional career in that field. You can be a physician, you can be a nurse in the nursing field, in the medical field, but not in the same clinical way that we've done in the past.

I remember a colleague and a mentee of mine, Dr. DH, I'll use his initials. He was a vascular surgeon, and he really got to the point where he just felt like he could no longer do his job. He was in this situation, we often find ourselves in, particularly if you're a specialist, which is relatively uncommon. What happens is you end up working somewhere and there's a few number of you helping each other, supporting each other, and covering for each other.

So you go to, let's say, even a big academic center, and they say, "Look, we need to have a service of three or four vascular surgeons." Okay, great. That's a profession that takes a lot of training. So you're careful. You do all your interviews, you find you're going to join this group of three other vascular surgeons, you're going to be able to do this surgery that you want to do, and not be doing general surgery, for example, when really you were trained to do vascular.

And some of the vascular surgeons even narrow that down further, of course. Well, Dr. DH found that he was there and things were good at the beginning, and then they had EMR issues, and they had to change EMRs. And all of a sudden he was having to do a lot of documentation at home and on weekends, because it wasn't really that efficient. They were still trying to bring it on and develop better protocols and order sets and so forth. So that didn't help.

And then the staff, again, I mentioned this with Dr. Brenda, the staffing was cut back on the areas where he was working, whether it was in his clinic or even in the OR. And then it turned out one of his partners left and they dragged their feet. Even though he was recruited to be one in four, they dragged their feet, then he was one in three call, and then if someone took vacation, it was one in two call for a week or two at a time.

And there seemed to be no effort to really find a replacement and no ability or desire to hire locums, even to provide some temporary relief. And so, he found himself in an untenable situation. Meanwhile, his kids were growing up, he was working long hours, he didn't get enough time to spend with them, and he found it was time to make a change.

At first, he thought "I'm going to have to look for a different kind of clinical job because of this myth of I don't know how to do anything else or I can't earn enough money." He was a really good one to remind me about this common myth that "There aren't any nonclinical jobs that a vascular surgeon can do. I hear about my primary care friends doing these jobs, but I don't think there's anything I can do."

I'll come back to his story in a moment. But before I finish off with Dr. DH, I want to explain something to you about maybe one of the best kept secrets in medicine and healthcare, and that is this. What we're taught and what people talk about, especially in medical school, in our residencies, in our fellowships, is that there is this process.

You go from medical school to residency, you may have a fellowship after that and then you make a choice. You go into an academic practice, maybe you go into an employed situation that's not academic or in a small percent, you may even find yourself in an independent practice. And that's it. Basically, that's what you have to choose from. You have to kind of make a choice. Academic, large employed, maybe you can do something independent with two or three partners come in initially as an employed physician, and then later become a partner.

But what's going to happen in all those situations is as payments to physicians go down, even though you're sheltered a little bit from that in an academic setting or an employed setting, eventually it's going to trickle down to you that you need to produce more RVU and see more patients and do more procedures to maintain the income that justifies your salary.

Some large institutions, especially procedural ones, an ortho, other surgeries and cardiovascular can subsidize that through those procedural activities. But the bottom line is you're going to have to do more, and you're going to have to do them faster, and you have to see more patients to feed into that. And so, the whole system kind of breaks down, and it usually leaves us really disappointed and disillusioned.

What most people don't really realize, especially while they're still in their training and early in their career, is there is something beyond those options. In fact, as I think about it, I can define and describe at least nine major industries, all of which hire hundreds or thousands of physicians every year to do nonclinical or non-traditional work. Let me just go through that list. And again, your instructors, your professors, your employers, they won't tell you about this, but sometimes you'll see it. It's obvious. If you're working in a hospital system, you'll find out, "Wow, there are people who are leaders, who are managers in these health systems." Whether it's a freestanding hospital, a three hospital system, a large academic system. They all pay physicians and other non-physician clinicians to do management and leadership.

Pharma companies hire tens of thousands of clinicians every year to work full-time jobs in pharma that do not involve direct patient care. The insurance industry that includes disability insurance, somewhat more so life insurance. And then the big one is really health insurance. They hire a lot of physician advisors, medical directors, who become senior medical directors, who become chief medical officers. There's a lot of education by physicians in which they're doing straight education. It doesn't have to be in the context of direct patient care. It could be at universities, at medical schools, at PA schools, nursing schools. It could be online.

And there are, again, thousands of jobs. There are medical writing jobs. That's one of the most common nonclinical careers. There are consulting jobs, both freelance, individuals, small groups, consulting, as well as national and international companies that hire consultants.

There's consumer health, which means teaching the consumer about medical care, about the healthcare system, about anything related to that. There's government jobs, and a lot of those are in public health and so forth. And then there's lots of nonprofits that are related to the healthcare field that have to hire physicians with their expertise.

Again, I just wanted to remind everyone of this first one, that it's foolish to think there are no jobs. In fact, there are thousands of jobs. And it turns out that these jobs are available for every specialist in any area with any length of training, with any degree of experience. That's myth number one that we need to really put aside. You have to realize there are a lot of jobs out there.

Sometimes you've got to learn and do a lot of research to find the jobs, and there's some strategies to that. I'm not going to get into that today, but let me just say, go on LinkedIn, look up medical director, and you'll see page after page after page of jobs, and then it's necessary to figure out which of those might be appropriate for you, located in the appropriate places, and then begin the process of trying to find them.

That's exactly what Dr. DH did. He really started doing research. He was involved in a mastermind that I was running. So he had the opportunity to engage not only with myself, but with other physicians in various stages of their career transition. And he really did reach out to other past colleagues, did some networking, and within a very short period of time, had two or three options. Some of them were part-time clinical options, doing just a very smaller part of his specialty.

And he was looking at wound care and vascular, but other types of non-traditional jobs that did not require being on call, did not require long hours, didn't have complicated and difficulty use of EMRs. But ultimately he found a utilization management job in which he could apply his vascular background. And he became a UM physician advisor or really a medical director when you, when you're working for a healthcare plan. And he was the vascular surgery specialist as well as doing some general reviews. And he's been very happy so far.

Okay, that's myth number one. Now, what is the second myth? Well, that is like I said, "I don't have the training. I have no expertise." Sometimes I hear this put as "Well, all I know is medicine." And if you think about that, in a way, medicine isn't a thing in and of itself. We obviously talk about as though it is, but to provide medical care is really a compilation of many, many skills in different areas that one outside of medicine wouldn't think of putting together necessarily. I usually like to go through this thought experiment where you're at a large ship and the ship is sinking and everyone's jumping into the life rafts to try to get somewhere safe, to someone can come by and pick you up or find yourself on a desert island.

And in the experiment, just think about the professions of the people you would like to be in the boat with. Just think of all the people you run into. Sales people, managers, directors, instructors, police, welders, taxi drivers, you name it. If you were going to be able to choose the people in the boat with you, and there were two people you'd want to be with you in that boat, who would they be? And I contend that they would be an engineer and a physician. And some of this relates to the broad experience, a broad education both of those types of people have.

But how many times the people come to you to ask a question, whether it's about chemistry, whether it's about their pets, experts in medicine. There's many, many sub, I guess I would call them, expertise that we have that makes us attractive. And we're excellent employees.

I'll give you an example too of Dr. MA. She was a foreign medical graduate, basically, and she also did some work in preventive medicine, but she was having difficulty finding a position in the US because she couldn't get licensed. She started networking, she started taking a lot of courses, and she became aware of the fact that there was a job called the medical science liaison, which is quite often open to those without residency or a license or board certification.

And after about a year of networking and taking courses and joining the MSL society, she landed her first job. And really everything that she does as an MSL does use her skills as a physician, as an MD or some places would be an MBBS and so forth. But everything that we know is included in the curriculum applies to jobs like this. The biochem, the pharmacology, physiology, pathology, microbiology, anatomy, epidemiology, statistics, laboratory interpretation, physical examination, interacting with patients, radiography, interviewing skills, teaching and presenting to colleagues, healthcare, economics. There's just so many areas that we become experts in when we're going through our medical education. And there are many jobs even for those with the medical school background, a medical degree without residency.

If you're a physician, if you're a nurse, especially with an advanced degree in MSN, definitely an APN. If you're a physician assistant, if you're a PharmD, you have a lot of skills, knowledge, and also work habits that employers are looking for.

And so, let's really dump myth number two is that you need special qualifications, or you need an MBA, or that all you know is medicine, when in fact you know a lot and the combination of things that you know put you in a position to fill a lot of these jobs, otherwise, you will not be qualified for.

Now, the big one that also affects us more so in the last 10 to 20 years is this idea of really making no money or making an inadequate income because a lot of us have loans and those have to be paid off. And sometimes you get a clinical position where they're going to help you knock off $10,000 or $20,000 a year on your loan. But if you've got $150,000 out there, it's going to take a long time to get that paid off unless you're making a really, really super high salary, and you can accelerate that. And thinking, "Well, I know I'm going to take a big hit in this career in my salary, this nonclinical career, then it'll really hold you back."

I can think of Dr. ML, who was an OB-GYN, and she was very busy. A lot of OBs, a lot of weird hours, a lot of call, similar situation. Staffing was cut back. Some of her partners left, even though she was part of a large multi-specialty group. She was employed, and it just became quite miserable. And she thought, for sure, I don't have any special skills and there aren't that many jobs out there in a nonclinical field for an OB-GYN and also it's not going to pay enough for me to pay my bills.

Well, she ended up looking around, networking, working on her resume, working on her LinkedIn profile, and she ended up landing a job after several months of search, working for a Medicare MAC. For people that work in the hospital that have anything to do with billing, they will know that a MAC is a Medicare Administrative Contractor, and it's an intermediary that processes the payments between CMS and hospitals. And she became a chief medical officer at a MAC.

And so, she made a very good income. She had to work fewer hours. In fact, mostly now she's working from home, which was enhanced a little bit by the pandemic. But she has children at home so she can be available for them, work for this Mac, make a very good income that is commensurate with her clinical income.

And again, as I mentioned before, our incomes are going down, Medicare's paying less for each patient care visit, not keeping up with inflation. And a CMO job pays very well. In fact, if you look at some of the stats out there, this is from last year, from salary.com, the typical physician advisor, which remember includes some that are not licensed, that simply have the medical degree, would be about $134,000 a year. Now, that's a median. So people make more, people make less.

If you're an experienced clinician, you become an MSL and you've already got some contacts for that job, you're definitely going to make well over $200,000. Overall average for a medical director is $295,000 per year. And quote, chief medical officer is over $400,000 a year.

I don't know what she was making per se. I would say that she's probably at least in the 300 thousands. I think those higher salaries are for CMOs and hospital systems, pharma and big insurance companies. But definitely if you have a CMO position, that is usually a very awesome, well-paid position.

So, this whole idea that there's inadequate income, it's a farce. And plus you have to compare apples to apples. If you end up working a job like she's doing, which is for sure no more than 40 hours a week, most times, most of these nonclinical jobs are 40 hours a week, sometimes even less. Often they offer complete or at least part-time remote work from home and while traveling. To compare that to a OB-GYN who's doing 60, 70 hours a week of work minimum, being on call and having a really disastrous schedule, because you never know when you're going to have to leave home, really, there's no comparison if you have to take a little bit of a pay cut.

But everybody that I've talked to that's started a nonclinical job, within two to three years, they have surpassed their clinical income because now they're really hitting their stride and really providing benefits and support, and really are doing something at the job that really helps their employer succeed. That's three of the myths.

Fourth one, patients. "I dedicated my life to patients, and I won't be helping any patients in a nonclinical career. And it's hard for me to do. I don't want to abandon people." Well, here's the thing. If you look at it from a different perspective, there are reasons these jobs exist, and there's reasons why these jobs need a physician, because a physician or a nurse or a pharmacist is providing the expertise that's going to benefit patient care. That's the whole point.

You can go through almost every industry, and maybe it's not 100% across the board, but if you're working for a hospital system, you're probably helping with quality and improving quality improves patient care. If you're working in pharma, you're developing new drugs to either save lives or improve lives. There are some extreme examples. Imagine the people that worked on Gleevec. Now there's a drug that took what was a pretty much uniformly fatal disease and turned it into nothing. If you take Gleevec every day for that particular illness, you will never have a recurrence. I personally know a family member that's been using this drug for 15 or 20 years now. And there's hundreds of those drugs coming out every year.

And so, obviously, if you're a physician working in pharma, as a medical director or a chief medical officer, you're definitely benefiting patients. What if you're working in UM in the insurance industry? Well, I'll just say that you will on occasion stop patients from having a procedure or surgery that really was unwarranted to begin with, and you've avoided a possible death or disability or error resulting from that procedure. You're teaching in any capacity. You're helping bring on the next group of nurses, pharmacists, doctors, PAs, NPs, who are going to help patients.

Writing. You're educating by writing or doing journalistic writing or doing technical writing to protect patients. Again, I can go on and on. Consultants are bringing new services to hospitals and pharmacies and pharmaceutical companies and home health, consumer, health wellness nutrition, helping patients, sometimes better than the actual physician is helping them. When you step into a nonclinical, non-traditional clinical job, oftentimes you are greatly enhancing patient care, community care, and so forth.

All right, the last one that I want to talk about is "I won't get any respect." It reminds me of Rodney Dangerfield. Do you remember the comedian? He's been deceased for a few years, but he always talked about not getting no respect. He gets no respect. I guess I'll use myself as an example. We all have a decent amount of respect and admiration and a certain recognition in our communities as physicians. Everybody knows it's hard to do. It's a difficult career to pursue and maintain. It's a lot of hoops to jump through. And there's licensing and there's board certification and recertification.

And so, we think, well, we have that stature in the community, and it's fun, and it's good. It helps to interact with people, and it puts us in a position that helps us to help people actually. So, if you go into a nonclinical job, your reputation, your influence is going to be gone. Could say your gravitas as a physician might disappear.

But I'll use myself as an example. I was a physician, family physician, and back in the day when I first started, I was working at the hospital. I had admitting privileges, I had nursery privileges, and I even had OB privileges. I knew a lot of people. I did all those things as long as I could so I could grow my practice and over time I started to cut back. And I also did other things because I was interested in that. So I did physician advisor for a while and medical director for a family planning clinic and some other things.

But I was one of a hundred primary care doctors on staff at that hospital. I had no special sway or pull, people didn't listen to me a whole lot like the other family physicians. They had a little more likelihood of being heard if they had a concern or a request at the hospital, at least if they were a surgeon, particularly an orthopedic surgeon, neurosurgeon, cardiac surgeon, and so forth.

But over time, as I became VP for medical affairs and then chief medical officer, instead of being one of 500 primary care doctors that didn't bring a lot of revenue to the hospital, I became basically one of the most well-known and go-to physicians on the medical staff or in the medical and administrative hierarchy because I was responsible for quality and safety and hiring new physicians and recruiting groups to work for our hospital. I was over the lab in the pharmacy and people would come to me talk about formulary.

Really, when you get into these other positions, you're still a physician. Everybody's still calls you doctor, but now your influence and reputation in certain areas will actually be much more enhanced. And so, I've never really felt or heard or talked to anyone who said that as a result of them moving into a medical director role, or chief medical officer, chief quality officer, any chief role, for sure, that they had less of a reputation or felt like they were contributing less, and that it was recognized than when they were a physician.

You're still a physician. You'll always be a physician. You're likely going to end up managing a team. You're usually seen as a content expert. That's why they're hiring you in the first place as a physician for that role. And you're often a leader. In the hospital setting, you've always got a CEO or COO, but you've got a chief medical officer, chief nursing officer, and so forth. Same thing in pharma, same thing in health insurance. You're going to end up there if you persist.

That's what I wanted to talk about today. There were five common persistent myths that I hear about all the time and that are concerns to physicians, nurses, pharmacists, trying to move into a nonclinical career so that they can have a better lifestyle, they can have more control, more autonomy, and less feeling like an assembly line worker.

And so, these myths are wrong and there are a lot of jobs. You are already qualified for most of those jobs. In some cases, you might need to do a little bit more. You'll learn on the job for sure. Sometimes getting an MBA or an MHA or an MPH or something would be helpful or another certification. But basically you've already got the qualifications you need.

You will make a similar salary and you'll have the opportunity to make even more. I made much more as chief medical officer than I would as a family physician. You'll be helping patients in new ways and sometimes much broader ways and larger numbers as well than you can one patient at a time, and you'll still be respected. You'll still have that gravitas or that recognition.

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In today's episode, Dr. Frieda Wiley shares her secrets for thriving in a remote healthcare job.

Frieda is a pharmacist who worked remotely for several years and is the author of Telecommuting Psychosis: From Surviving to Thriving While Working in Your Pajama Pants.

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By joining the UT Physician Executive MBA, you will develop the business and management skills you need to find a career that you love. To find out more, contact Dr. Kate Atchley’s office at (865) 974-6526 or go to nonclinicalphysicians.com/physicianmba.

Telecommuting Psychosis?

Telecommuting Psychosis is not a recognized clinical condition. However, Dr. Wiley used it in order to draw attention to the potentially severe consequences that can occur from the isolation and lack of direct human contact that results from working remotely.

Frieda wrote the book to shed light on this issue, and to share techniques for preventing and reversing the adverse effects. Simple self-care measures that are described in the book can greatly help to eliminate these effects. 

Effects of Working Remotely

The drawbacks of working remotely in healthcare vary depending on your field and industry. But some of the more common psychological effects include:

1. depression,
2. feelings of isolation,
3. trouble unplugging from the online world,
4. lack of external stimulation, and
5. feeling invisible

There are direct medical effects resulting from long hours spent working remotely, such as elevated lipid levels, heart disease, low vitamin D levels, and weight gain. And there is the frequently encountered reduction in career advancement due to less direct interaction with supervisors and others in the workplace hierarchy. 

Dr. Frieda Wiley's Advice

 Just know that you have to be your own advocate for your work environment and for your health and that there's no shame in seeking help.

Thriving in a Remote Healthcare Job

Dr. Wiley has several suggestions for thriving in a remote job. To maintain mental health be sure to manage your social health, use an accountability partner, create a social calendar to enhance human interactions, develop a daily mindfulness practice, and “become a tourist in your own town.”

To improve your physical health you should first check the ergonomics of your remote working environment, schedule physical activity and formal exercise, supplement Vitamin D if needed, and take breaks every 20 minutes to address eye strain and dryness.

Properly integrate childcare into your workday, if necessary. Keep workspace separate from other areas. And set boundaries with friends and people who live with you. 

Summary

Dr. Wiley addresses these topics and others in much more detail in her book. Go to her website to order it. If you have any questions regarding any of these subjects or would need coaching on how to identify and deal with the drawbacks of working remotely, you may use the contact form on her website, or send her an email at frieda@friedawiley.com.

NOTE: Look below for a transcript of today's episode. 

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Links for Today's Episode:

• Telecommuting Psychosis: From Surviving to Thriving While Working in Your Pajama Pants
• Dr. Frieda Wiley's LinkedIn Page
• Add Discipline to Creativity to Be a Successful Medical Writer – 179
• How to Shine as a Technical Medical Writer – 155
• How to Become a Medical Writer with Dr. Mandy Armitage – 022
• How to Find Freedom as a Freelance Medical Writer with Dr. Emma Nichols – 056
• NewScr!pt

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Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 278

How to Go from Surviving to Thriving in a Remote Healthcare Job

- Interview with Dr. Frieda Wiley

John: When I was thinking about bringing on today's guest, I was really positive about it for a number of reasons. When I was chief medical officer at the hospital I worked at for 14 years, one of the people I worked most closely with was a pharmacist, a PharmD like our guest today who ran the pharmacy department at the hospital, and the whole system for that matter.

I'm also very fond of writers, medical writers in particular. And so, I'm really pleased to be able to have today's guest join us and talk a lot about these different things and about a book that she just recently wrote and published. So, with that, I'll say thanks for joining us today, Dr. Frieda Wiley.

Dr. Frieda Wiley: Thank you for having me.

John: All right. Most of my guests are usually physicians, although anyone dealing with nonclinical careers comes on the podcast that we can get on here to learn something from. Obviously, Frieda is a PharmD not an MD, but like I say, I have a very strong affinity for pharmacists because I worked with so many in the past.

But the thing is, I was not aware of a couple of things. Of course, I knew that there were non-physicians that do medical writing. There are actually people that aren't even clinicians that do medical writing. So, I'm interested to hear about that from Frieda today.

And the other is this whole concept of telecommuting and telemedicine, telehealth. I guess I kind of knew in the back of my mind if pharmacists did that, but I really had no idea the scope and the amount that they did. I'm looking forward to learn about that and about some of the downsides of telecommuting. I guess you would put telehealth in that category. A lot to talk about today. Tell us a little bit about your background, your education, Frieda, and then your early clinical work.

Dr. Frieda Wiley: Sure. As you mentioned, I am a pharmacist by terminal training. I actually had a previous career as a chemist in the aerospace industry. It's a brief career as a break between degrees. So, my undergraduate degrees are in biochemistry and Spanish.

John: Interesting.

Dr. Frieda Wiley: Yeah, I mixed it all in there. And when I went to pharmacy school, I kind of focused more on industry. That was my goal to actually work in the pharmaceutical industry. And that was really my introduction into medical writing. I went into standard or more traditional pharmacy practice I should say when I started.

So, I started as a community pharmacist originally as a floating pharmacist where I was traveling to different pharmacies and leaving other pharmacists who were on vacation or gotten sick. I was working for a small grocery store chain that was based predominantly in East Texas, rural areas. And about three months into that I was approached by management to work in medication therapy management, which ultimately became my introduction into remote work because I became a hybrid worker. Because I was a floating pharmacist who already had experience with different stores in different regions, different pharmacies. It made sense to have me travel to these different pharmacies and meet with patients 101 to review their medications. And because there wasn't a central office and I had a lot of administrative work to take care of phone calls, paperwork and things of that nature, then I worked from home at a regional office one to two days a week.

John: Okay. Yeah. So, you got a little taste of that at that point.

Dr. Frieda Wiley: Right. And then I stayed in that role for about another year and then transitioned into working for a managed care firm where I did the exact same thing but in a completely remote setting. I was hired originally as a Spanish speaking pharmacist, serving the greater New York City population. And originally, I was under the impression I was going to have to move to Hoboken, New Jersey or somewhere in the New York City vicinity for that job and obviously become licensed in that area.

Telemedicine laws, as I'm sure you're aware, can be different, a little bit more flexible when it comes to licensure per state. And so, when the company found out that I had some remote experience already under my belt, they pitched me the idea of being fully remote because they wanted to get a head start and they knew it would take me a while to relocate.

John: Okay. I was just to say that can sound quite attractive. And again, I have to remember that there's probably different roles in let's say pharmacy and pharmacy services versus let's say a physician. But the physicians I talk to, they're like, "Oh yeah, the thing I love about telemedicine is I have more control. I can do it when I want to do it. And I don't have to really worry about getting dressed up and putting on a tie or whatever." But it sounds attractive, I would think to you as well. But I think you then later learned there were some downsides to it.

Dr. Frieda Wiley: Yeah. There are downsides to it. And I think it depends on the industry you're in and the type of work that you do. There are many other areas in which there are pharmacists who are involved in patient care working remotely and using telemedicine. But in my case, I wasn't able to work what I wanted to. In my first pharmacy job, I set my own schedule because I'm scheduling appointments with patients and different things.

Well, in this case, they had the administrative part already taken care of and my entire work day was scheduled from 08:00 to 05:00. It became frustrating when it came to networking and what if I needed to go to the doctor. I would have to take vacation leave in order to do that because I didn't have the flexibility in my schedule that other telecommunicators sometimes enjoy.

John: Yeah. Actually, that reminds me of another example. And I do think there are some physicians who are locked into those kinds of schedules as well and other clinicians. For example, one of my children is a social worker and she ended up wanting to work remotely because she was moving at several different times. And she's starting to do, basically, it was utilization and case management type job remotely.

But you're right, they supplied the computer, she couldn't leave the house when she was working. She had set hours. So actually, it made her life no more flexible or easy to adjust to things than it was when she was driving into work. It's not always what you think. And some of those are definitely locked into a normal 09:00 to 05:00 routine, which can be more than 09:00 to 05:00. In fact, in a lot of these cases, they have a certain number of cases they have to do. And if they don't get it done in their eight hours, they might end up working nine or 10 hours. I don't know if that applied to you or not.

Dr. Frieda Wiley: In some cases, it did because, especially towards the end of the year with that particular company, they had numbers to meet and for some reason they realized that first year that we were way behind on our numbers in September. So, then our working hours were extended and, in some cases, we had to work weekends. So that quality of life that originally attracted me to that position, it went away very quickly.

John: Okay. Now I would like to put a pause on talking about this particular part of your life and how it led to writing the book only because I wanted to get a glimpse into this because you did mention, of course, that you were working at the pharma companies and you've done medical writing. And I'll just tell the listeners and I'm going to bring up your website right now, friedawiley.com. It is a place where you can purchase the book that we're going to be talking about.

But it's a good example for people that are interested in medical writing or maybe they're just getting into medical writing, it's an excellent website. It kind of puts everything out in different pages as an overview of what you do. You've got testimonials, I believe. You've got examples of the kind of writing you do. You've got a tab that says portfolio, for example. So, tell us how you got into medical writing, just a glimpse of some of the writing you've done and who you've done writing for.

Dr. Frieda Wiley: Yeah. As I kind of alluded to earlier, when I was in pharmacy school, I had some rotations in the pharmaceutical industry, and specifically back when they still had a pharmaceutical division before they divested. And even though my internships were mainly in regulatory affairs, there were times where I supported the medical writing team, especially during that second summer, which introduced me to the concept. I'd never heard of it at that point.

And so, when I began practicing, I started freelancing while I was practicing. And it started out with, I remember sitting in a doctor's office one time and I saw this magazine. And at the time it really looked more like a slightly more glorified patient handout. I remember reading the content thinking I could do this. I had already written some pamphlets and things when I was on rotation with Indian Health Services. And I saw that as kind of a translation of that.

And so, I actually reached out to the company and I told them who I was and what I wanted to do. Not really the best approach. I really didn't understand the concept of pitching and things like that, but I didn't really hear anything else from them until a year later. And the editor reached out to me and said, "I'm sorry it took so long to get back to you, but we'd be interested in having you write for us."

And then also with doing the medication therapy management, because I was responsible for creating documents that went to the patient back then, this was before the government had set standards for how the documentation would look and different things like that. So, I had to come up with my own templates. I had to come up with a core messaging and phrasing that I might want to use, and then also customize the information that was included, going to each patient as well as to the prescriber.

That skillset helps me become bilingual, not just Spanish English, but in terms of being able to communicate in plain and scientific language. And I leveraged that as I pursued other writing opportunities.

John: Another example of each one of us has certain skills that we accumulate over time, and your set of skills might be different from mine, but they can all be leveraged in a different way for a particular job or series of jobs. It's just a good example of someone who's been a freelance writer, that's made a good living and enjoyed it and leveraged their clinical background and so forth. That was like I said, one of the reasons I wanted to have you come on and talk about that a little bit. What kind of writing have you done besides what you just described? Just some samples of some of the kind of writing that you've participated in.

Dr. Frieda Wiley: Right, sure. I have written slide decks. I've written needs assessments, advisory board summaries, executive summaries that they require. I have written scripts not only for presentations, but also for e-learning, webinars, different things like that. I have also written patient handouts as well as marketing information that would go to physicians as well as general audiences.

John: Yeah, I think it's easy to say, okay, wait, I can only write, let's say maybe CME manuscripts and maybe something for the public. But there's so many different variations, and I've heard this before, needs assessment, learning needs, slide decks. And you're doing something for the advisory board, is that what you said?

Dr. Frieda Wiley: Yes.

John: Those things are beautiful, awesome presentations. You've got to really have some skills to do that.

Dr. Frieda Wiley: Thank you.

John: Because I've been on the receiving end of some of their presentations and they're almost overwhelming sometimes and the way they're created. There's a lot of information and it's very professional. It kind of ties into what you did later and what we're talking about today is writing your book. Obviously, you're a writer, you know how to write, and so you leveraged that to write something that wasn't in that category of medical writing, per se.

Dr. Frieda Wiley: Yes. I loved writing as a child, and that was sort of a childhood dream. And it's one of those things where as you get older and you find out the whole thing that you can do anything is kind of a myth. I had "writing a book" as one of my goals, especially once I started medical writing. It rehashed that dream. And when I became a fully remote employee, I noticed that I just didn't feel as awesome as I did when I went to the office every day. Every job, every setting has its stressors, but I started to notice that I wasn't going out as much. I wasn't socializing as much. I was depressed. I became depressed. I felt isolated even more so because initially I was the only remote worker on my team, and everybody else was in New Jersey and New York. That didn't help either.

And this was back before most companies had the infrastructure to support different types of engagement. So, all of our meetings, I would dial in via phone, a lot of times the call quality would be bad. And because my voice doesn't carry very well and everybody starts talking, I would get drowned out. I would just kind of sit there twiddling my thumbs until there was a break.

John: Yeah.

Dr. Frieda Wiley: Yeah. That's what prompted me. I started journaling initially because I reached out to people and I was telling people, family, members and trusted friends "Look, something's not right. I don't feel myself." And people, we're dismissive because the thought is "You have the dream job when you work from home."

John: Yeah. Well, let me mention the name of the book now before I forget to do that. "Telecommuting Psychosis: From Surviving to Thriving While Working in Your Pajama Pants." You can get that book if it's intriguing, which it sounds to me. I've looked at it and at friedawiley.com/book. So, if you go to her website, you want to look at all the other information if you want to be a medical writer, but then she also has a page with the book on it where you can order it or you can go directly to Amazon. But that sounds pretty extreme "Telecommuting Psychosis." That's a little more than feeling something wasn't just right. So, how did we get to that point?

Dr. Frieda Wiley: Right. Yes, as an obvious disclaimer that it's not an official clinical term, it doesn't show up in the DSM-5 for whatever. But the reason why I chose that title was to call some attention to the situation. And kind of extrapolating from the concept of postpartum psychosis versus depression.

No, I didn't have thoughts of harming myself or harming someone else, but I did reach a point of just extreme mania where I was frustrated. And a lot of that had to do with the fact that nobody seemed to understand or empathize with what I was going through. And I later came to realize that the telecommuting concept, the mental fallout that occurs with it, is something that oftentimes people sweep under the rug.

At the time when I became an overnight telecommuter, unexpectedly, like many people during the pandemic, I didn't have the luxury of having this open forum where people spoke out about it and supported each other. There were very few studies available at the time that talked about it. The pandemic changed that. So, that was also to finish the book because suddenly I had the data to back up everything that I had been saying.

John: Then you applied the skills as a researcher that you did for your medical writing obviously for this book. I'm trying to think what's the easiest way to go through this in not great detail, but what are some of the common effects, adverse effects, and then later we can talk about ways to counteract them or prevent them. And I know you had the eight or nine myths that you talk about, which maybe also relates to that. So, go ahead and just tell us more about this topic and the potential adverse effects of it.

Dr. Frieda Wiley: It's many of the things that I mentioned earlier. The isolation, the depression. And obviously with depression and having a sedentary job and all of that, then you can also expect to see an increase in poor outcomes, poor biomarkers and different things like that. So, LDL, heart disease and things that fall out from that. The lack of vitamin D because you're not getting outside as much or you're not getting outside during the peak hours in which your body would absorb natural vitamin D that has been linked to heart disease, cancer, mental illnesses. We know that people who live in Scandinavian parts of this world are actually more likely to have heart disease and schizophrenia. And there have been studies to show that there's an association between those conditions and the lack of vitamin D. So, those are just a few of many examples.

John: Since you found the research that people are starting to recognize this, are you and others recommending certain ways to counteract these things? Just take it from there.

Dr. Frieda Wiley: Yeah. A lot of it, unfortunately, has to do with self-management. Acknowledging that you have a problem is the first step, or saying that something's not right. Because mental health still carries a stigma. The pandemic helped to erase some of that, but we have to create a safe space for people to say that they're not okay and to seek help.

So, my goal with the book was to take the guesswork out. Start paying attention. We need to be more self-aware. Are you taking breaks? You need to be taking breaks every 20 minutes or so anyway for your eye health. That's one part of it. And making sure that you're moving, making sure that you are sticking to a plan, make up a plan for yourself where you make sure that you are chunking your time, you're managing your time wisely. And part of that includes the self-care element. Self-care not only in terms of physical health, but mental, because it all works together.

John: It's easy to say of course, but I know for a fact that I should exercise three times a week minimum, probably every day. But it's like you almost have to pick your phone up and put it in there as a scheduled event. And if you can do that, great. And you're talking about the same thing. And if you're at a job that doesn't allow that or doesn't enable you to do that, then you should seriously think about not doing that job and finding an employer that has a little more flexibility and allows you the freedom or a little bit of those breaks. On a 09:00 to 05:00 job, you should have 30 to 60 minutes for lunch, for example.

Dr. Frieda Wiley: Yeah. And you raise a point about putting it in your phone or scheduling it. And I was serious when I said that. Sometimes it's an accountability thing. Having an accountability partner that can be very helpful. One of the things that I did pre pandemic is I used to drop in on teleworking groups. For example, I used to go to one in particular that would meet up in different places in Austin when I was in the Washington DC metropolitan area. It was during the pandemic. And so, the co-working groups had all gone remote if they were still active, but we still had times where we would work together. And sometimes that would include scheduling little mini breaks where we would do meditation exercises or get a move around scheduling into the breaks, all system socializing, because still some type of human interaction is very important. We're not meant to be isolated from each other.

John: Yeah, absolutely. Let me do this. There's so much in the book that you address in terms of recognizing and then trying to take these steps to prevent it. Again, let's talk directly to the listeners here. You're doing some kind of at home remote work similar to what Frieda has described. Because we tend to ignore how we're feeling, we tend to ignore what's happening to us. Again, maybe two or three of the symptoms or two or three physical findings that you think people better get to stop and think about this and get the book and figure out how to overcome it.

Dr. Frieda Wiley: Yeah. One side would be noticing that you're not moving around as much anymore and may start to have weight gain. Maybe your back starts to hurt. That's another thing. You have to be your own ergonomics adjuster. You have to figure all of that out. And so, being mindful of that. And you may also notice that if you're not careful, seriously, a few days may go by without leaving the house. Especially if let's say the kids take the bus home or they're driving, why do you need to leave the house? You can have your groceries delivered.

So, making sure that you're keeping track of that. Have I left the house today? Have I socialized outside of my work socializing and thinking about, "Okay, well before the pandemic or before I went remote, what did my social life look like?" Because it's those little interactions sometimes that really add up. And that's something that I really started to miss. And it applies to people, regardless of whether you're introverted or extroverted. I am very introverted. And so, that's another reason why it really threw me off because I was used to doing my own thing and being okay with it.

John: Yeah. I can imagine, I can think of an example like going to the coffee shop. If I'm at home for a week, I would miss that. I don't go every day, but I know when I do go and I am an introvert, I just like to fool around in a sense verbally with the people behind the counter, whatever's going on, mention something. Not political, not controversial. Just to have that interaction with another human being. It's just kind of fun.

Dr. Frieda Wiley: Yeah. The casual banter. And I even talked about that in the book because I missed that as well. So, then you have to think about, "Okay, yes, this is my new office now, maybe it's not going to be the same experience as what it was when I was driving every day, but how can I recreate some of that or capture some of those elements?"

John: It does remind me a lot about the whole issue of burnout and medical care and healthcare in general. And we can get into a very deep hole, deep in the burnout syndrome before we even realize that we are. And so, this sounds like it's the same thing.

One of the things that I tell my listeners and coaches, mentees and so forth, is that it does make a difference where you work. And some places are awesome to work for and some are terrible because they ignore things like this. Are there any ways to figure out as you're looking? Because a remote job still sounds good. I can be home, maybe I have to be home when my kids get home and or I have an elderly parent I'm helping to take care of. I need to be nearby. Okay, fine. But what can I look for in an employer or let's say if you're a freelancer, it's a little different, but you're still a 1099 employee in a sense. What do I look for?

Dr. Frieda Wiley: Yeah. I actually included a little questionnaire at the back of the book to help readers. So, a lot of it starts with the interview process. You need to be very specific and focused about the questions that you ask, making sure you have a really good understanding of that working environment. So, asking what the level of engagement looks like. How do I interact with other employees?

And this may sound obvious now, but because of my frame of reference, it really wasn't. Find out if you are going to be on a team where there are other remote workers. That's important just because of employee conflict, jealousy, animosity, backlash, things like that. Finding out what sorts of infrastructure they have in place that will support remote workers.

And also, there are different things you can talk about to try to get a full understanding of your work. Sometimes the hiring manager will give clues that they maybe are a micromanager or don't really respect work-life balance. So, what I have found is that sometimes the core messaging and the core values that may show up on a company's website may not necessarily align with the role that you're in. It really depends on who your direct line of management is and how much they are working to support that culture. And then of course, if you're able to talk to people within the company offline, and also reviews. So, the nice thing now is if there are so many company reviews that you can kind of do some research and that will also help guide some of those questions that you want to ask.

John: Yeah, that makes sense. And it's related to looking for any job really, to try and get some honest feedback from maybe people that weren't set up to interview you or for you to meet, but that are just there. Like in a hospital you go talk to just some of the nurses or some of the staff or the maintenance man or whatever. Just because you need some hopefully unbiased feedback before you make a final decision.

All right. Tell us again where the website is and the name of the book and all that, because we don't want to forget about that before we let you go.

Dr. Frieda Wiley: Yeah. The website is friedawiley.com and the book is called "Telecommuting Psychosis: From Surviving to Thriving While Working in Your Pajama Pants."

John: Okay. And they can get it by going directly to Amazon or going to your website.

Dr. Frieda Wiley: Both. Go to my website if you can't remember the title and it will take you straight to the Amazon page.

John: Okay, great. And of course, I'll put links in my show notes. I have a last question. If someone who has maybe not done telehealth or telemedicine or telecommuting or remote job, any last bits of advice for them before they take the plunge?

Dr. Frieda Wiley: Yeah. Don't be afraid of it just because I wrote a book about losing my mind. Just know that you have to be your own advocate for your work environment and for your health and that there's no shame in seeking help.

John: Excellent. Thanks. Thanks for that. That's very useful. And I will also remind you, my listeners here in the nonclinical nation, to go to the website if you're a medical writer or a fledgling medical writer because you'll get a lot of good ideas from what Frieda has done. And yeah, pick up the book while you're there.

All right. Well, thank you very much. I appreciate this Frieda, and hopefully we can keep in touch. Do you have any plans to write a new book anytime in the near future?

Dr. Frieda Wiley: I actually have some children's books in the works, so I'm excited about those.

John: Just let me know. I have no problem sending out a little announcement in the podcast or in my emails if you get those published. So, keep us informed.

Dr. Frieda Wiley: Thank you. And thank you for this opportunity.

John: You're welcome. All right. Bye-bye.

Dr. Frieda Wiley: Bye-bye.

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Many of the links that I refer you to are affiliate links. That means that I receive a payment from the seller if you purchase the affiliate item using my link. Doing so has no effect on the price you are charged. And I only promote products and services that I believe are of high quality and will be useful to you.

The opinions expressed here are mine and my guest’s. While the information provided on the podcast is true and accurate to the best of my knowledge, there is no express or implied guarantee that using the methods discussed here will lead to success in your career, life, or business.

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The post How to Go from Surviving to Thriving in a Remote Healthcare Job – 278 appeared first on NonClinical Physicians.

This week, we discover that the Medical Matchmaker has a traditional solution for burnout: joining the right medical group.

Dr. Lara Hochman is a Family Medicine physician. She graduated from the University of Texas School of Medicine and finished her family medicine residency at St. Anthony North Hospital in Oklahoma City.

Solving the Burnout Problem

Our Sponsor

We're proud to have the University of Tennessee Physician Executive MBA Program, offered by the Haslam College of Business, as the sponsor of this podcast.

The UT PEMBA is the longest-running, and most highly respected physician-only MBA in the country. It has over 700 graduates. And, the program only takes one year to complete. 

By joining the UT Physician Executive MBA, you will develop the business and management skills you need to find a career that you love. To find out more, contact Dr. Kate Atchley’s office at (865) 974-6526 or go to nonclinicalphysicians.com/physicianmba.

Happy Day Health Services

Dr. Hochman loved medicine but detested the healthcare system. So, she founded her company to provide a remedy for the burnout it produces. She steps in to act as a medical matchmaker, connecting doctors to physician-owned practices.

Happy Day Health assists physicians in locating practices that closely reflect their personal and professional values. In the process, it helps practices find physicians. Dr. Hochman also provides advice to physicians about creating their resumés, understanding their contracts, and preparing for interviews.

Building the Medical Matchmaker Business

During the interview, Lara describes how starting a business requires accepting uncertainty and learning as you go. In medicine, we are taught to aim for perfection and spend many years learning the rules. In business, however, it is sometimes necessary to learn on the fly, make mistakes, and course-correct as needed along the way. 

This process can be exhausting and emotionally distressing, but it will lead to a point where you feel confident in what you're doing. By following your instincts, and maintaining a commitment to make a difference you find satisfaction and encouragement to keep going. 

Challenges for Physicians Going ‘Private'

When comparing private practice with hospital-based practices, salary is often the driving factor that influences a physician's selection. But that can be short-sighted. In a small practice, you have an opportunity to be a decision-maker. And the long-term benefits of autonomy and becoming an owner should be considered. 

Working with and for other physicians is a much more collegial situation. It is less likely to create an inflexible corporate environment driven by patient volumes and the need to push downstream revenues.

Dr. Hochman's Advice

When it comes to salary… it can actually potentially be much higher in private practice. You just have to be able to delay gratification a little bit longer… Also, if you find a practice that you feel will treat you well and pay you a salary that you're happy with, do it. Don't wait. 

Summary

Dr. Lara Hochman has dedicated herself to connecting physicians with private practices run by other physicians. In the process, she is helping to prevent and overcome the burnout that occurs when working in a high-volume corporate environment. And by doing so, she overcome her own disappointment in the U.S. healthcare system and discovered her purpose. 

NOTE: Look below for a transcript of today's episode. 

EXCLUSIVE: Get a daily dose of inspiration, information, news, training opportunities, and amusing stories by CLICKING HERE.

Links for Today's Episode:

• Happy Day Health
• Dr. Lara Hochman's LinkedIn Page
• How to Save Healthcare, Satisfy Patients, and Fix Physician Burnout – 256
• Who Can Help When Private Practice Matters? – 174
• NewScr!pt

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Right Click Here and “Save As” to download this podcast episode to your computer.

Podcast Editing & Production Services are provided by Oscar Hamilton

Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 273

How the Medical Matchmaker Provides a Solution to Burnout

- Interview with Dr. Lara Hochman

John: In the town that I work in, well, I still work here, but when I used to practice here, both hospitals, small town outside of Chicago, I would see these groups come and go where a physician would hire a partner and then they'd leave after two or three years. And it's really uncommon to find a really well-run practice. But I have a friend who's a gastroenterologist, he's got eight partners. They've had a practice who's going for over 30 years and it just runs so well. And they have no trouble recruiting and they're all happy. They like what they're doing. So that's what we're going to talk about today.

Now we normally talk about nonclinical jobs or careers, but one of the principles I go by is that I think physicians should be happy, and I believe in physicians working for other physicians as opposed to working for corporations. So, with that, I want to welcome today's guest. Hello, Dr. Lara Hochman.

Dr. Lara Hochman: Hi. Thank you so much for having me today.

John: You're welcome. Yeah, this is not going to be about a nonclinical job. This is how to find a clinical job where you can be happy and fulfilled and wake up in the morning and actually look forward to going to work. So, tell me and our listeners here who you are, what you do, and maybe a little bit about your background.

Dr. Lara Hochman: Sure. I'm the medical matchmaker. I help physicians find practices that will really closely align with their value systems. And on the flip side, I also help practices find physicians. And then throughout that process I really help out with a lot of kind of coaching through what to talk about in the interview, all of those things. Negotiation, all that stuff.

I'm a family medicine physician. I still practice. I do locum tenens here where I work, where I live locally. And that's because I actually still love medicine. I do this in large part because I personally have been burned out and thought I hated clinical medicine and left medicine entirely thinking I was going to figure out what else to do. And then just this seemingly perfect job felt in my lap. It was terrifying because I was like, "But I don't like medicine anymore."

I decided to just take a risk and do it and figured out that I loved medicine. It was just the system I hated. I see that over and over again in so many people and I would like to be a part of the solution. I think once you're past the point of no return, then of course, clinical medicine may not be for you anymore. But there's so many of us that love clinical medicine and love everything. We just don't like the system. So, I'm out there to try to change it.

John: That's fantastic. Now when I think of clinical situations that physicians might enjoy, I do think about locums because although it's hard to necessarily set it up initially, it actually provides a lot of options and flexibility and so forth. I think of DPC and concierge care. But obviously, I also know of people, as I mentioned in the opening, that are working in jobs that they like because they have partners that they like. They have a practice that works well, the patients like them, and they're actually practicing traditional medicine even though we're in a system that tends to not favor that. Definitely I like to hear stories like this about someone who's doing the matchmaking.

So, how did you make that transition? It is difficult to start a new career and starting a new business is very challenging. So just a little bit about how you overcame some of the mindset issues and did you have to deal with family and say "Here's what I'm going to do." How did that come about?

Dr. Lara Hochman: Oh, my goodness. That is such a big question. Yeah, it was very interesting. There were parts of my family that I thought would be supportive that weren't, and there were parts that I thought would not be supportive and were. So, it's interesting. I think overall they accept and support me in what I'm doing. They're there to cheer me on and to pet my back when I'm feeling down. But it really was a challenge. There are no words for how difficult it was. It puts medical school to shame.

John: Oh, really?

Dr. Lara Hochman: And it's a different type of difficult. Medical school is like this firehose of information. This was more "I taught myself how to do what I'm doing." I had no training in business, no training in I would say traditional recruiting. I don't consider myself a recruiter, but I didn't know how to find people. I'm not a salesperson. All those things that I have no idea.

I was teaching myself something how to do something very difficult. I don't often feel comfortable talking to new people. And so, here I am calling complete strangers. I've learned a lot of what to do and what not to do and what I can deal with. But talking to strangers is tough and that's a huge part of what I do.

There were so many challenges and the financial part of starting a business is just... There's a lot. The first thing that I did was even just deciding to start the company. There was a lot of mind drama that I was having about it. I never wanted to be a business person. I never wanted to start a business. I'm a physician at heart, that's what I love. I never saw myself doing this. I actively did not want to do it. But I just felt there was so much that needed to be done for physicians. And so, that kind of mission of trying to be a part of the solution really just overtook that. And it turns out I actually love it. This was such a nice surprise.

I would say the first step, even before I started a business, I've been working on facing my fears for years in other ways. And so, that probably helped as a precursor. In medicine, we're trained to do what we're told, we're trained to follow the steps and study what we need to study. And so, that was a big shift in "I'm going to do what I'm going to do, and there's no blueprint for it."

That was really interesting. Like most people that probably are listening right now, I'm a total perfectionist. I don't like to do something unless I already know how to do it, which you can't do in entrepreneurship. Someone once said, not even to me, it was in a conference, they said, "Start before you're ready." And I was like, "Oh my gosh, okay, I'm not ready. I'm starting." And I started that day.

John: Nice.

Dr. Lara Hochman: That was huge. And realizing that I'm going to do it imperfectly, and that's okay and I have to make mistakes in order to be better, that was okay too. All of the mistakes I've learned from. And there was a period of time, near the beginning, where I would sit down every morning, and have a big old cry. It was so hard. And then I was like, "Okay, what's bothering me?" And then I'd kind of think through "I don't know how to do this" or "I'm having a challenge with that."

I would actually take that. I was so drained and emotionally sad and I would just take that and turn it into, "Okay. Well, obviously something is not working. Let me see what I can fix." And it was lots of little changes over time that I had to figure out what to do. I think I will be figuring it out till the day I die. But it's gotten to the point now that I'm so much more comfortable with what I'm doing. I've figured out so many things and it's satisfying. I'm so satisfied with being able to create real change and affect lives and have an impact far greater than I could if I were still just seeing patients myself, which I still love doing.

John: Nice. A couple of observations. When you have such a principle or a passion, whatever you want to call it, something you're committed to, that can push you through the end a lot of times. So, that's awesome. And you said you were teaching yourself. Well, you had a great student because you're a physician. You've already demonstrated your ability to solve problems and research things and read and learn. That's one thing we forget. Yeah, if we go through med school and residency, we can certainly learn how to start a business if that's our desire. And I do think it's definitely needed.

Now I have interviewed several people that had startups of various sorts. Some were selling products, but typically the ones that are doing more of a service are connecting, are usually connecting one person to another. They tried to start a locums company, recruiting company or some other type. And it's always a chicken and egg because you're doing the recruiting on both ends at the same time. You need physicians who are looking for a job and then you need the companies that are looking for physicians. Was that a challenge for you or did you find a simple solution to solving that problem? How did that come about? Where did you start on that part of it?

Dr. Lara Hochman: Yes, that will probably be my biggest challenge always. Because my whole business is predicated on finding people and speaking to people. It came from putting myself out there just saying, "Hey, this is what I do." I was one of those people who wasn't on social media. I don't like my face in public. I'm a very, very private person. Sort of. I'm an open book, you can ask me anything, but at the same time, I was never that person. Just putting myself out there and letting people know what I do was big. Something that I'm still learning to do is tell people, "Hey, tell other people about me. Do you have friends? I can help you. I can help your friends." That was really important and still is. Going out and meeting as many people as possible is part of my job. And I actually love that. I may be shy on the inside, but I'm actually an extrovert. I love being around people.

John: Okay, nice. Now what kind of things do you look forward in a practice? Or do you have some way of knowing that "Okay, since I'm promoting that I'm going to match somebody with a practice where they're going to be very happy?" Are there certain characteristics of those practices that hopefully will at least try to ensure that there's going to be a good fit? There are always personalities and so forth, but just give us your take on that.

Dr. Lara Hochman: Yeah, the first thing that I look for in a practice, even deciding if we're going to work together or not, is how I feel that they would treat their physician. A part of it is "are they financially stable?" Does it make sense financially for them to hire someone? Because if they can't, then you have a physician who maybe even moves cross country to work there and then they close their practice or they're not happy, you're not able to be paid. That's scary. Making sure they're financially stable is super important.

And then of course, just as important to that is the feeling that I get on how they will treat their doctors. A lot of it is what they say and what they're looking for. And a part of it is when they talk about "I want someone to be happy here." The kind of person that would really fit well as someone who is comfortable. Whatever it is. I want to hear from them why it's good working for them and I hear such great things. And of course, not everyone is going to be happy in every other environment. What is perfect for you would be different from what's perfect for me is different from what's perfect to the people listening. It's not necessarily that I'm looking for a specific thing other than I feel like they are going to be valued and have a voice and really cared for in a way and respected. Those are the main things I look for.

John: Are you able to find out what kind of turnover there has been at some of these practices? I suppose if they're pretty large, you can just ask around. Because to me that would be evidence of it. That's what I was talking about as I was introducing you, is that I've known many groups here where I am with one or two doctors to hire and they're just turning through them every two years because what they do is they treat them like residents. They never really talk seriously about partnership. And so, I figured they're always going to be a failure, but there's this other group that is very stable. So, is it possible to kind of get that information and to kind of key some of your decisions on that?

Dr. Lara Hochman: Yeah, that's huge. I think the biggest way of knowing if a practice will treat you well is how many doctors have come and gone. A lot of the practices that I work with are just single-physician practices that are ready to expand. I'm not going to get a good sense of if the physicians have come and gone. But I do get a sense of how they talk about their practice, how they talk about what they're looking for, how they talk about the kind of person that they would be to work with, and the rest of their staff turnover.

One of the practices I'm working with now, it's a single physician. She's had her practice for 12 years and she's looking for a true partner. She's looking for someone who will bring ideas and who will not just be a partner financially and business side, but really come up with their own ideas and be a part of running the practice. And her employees have been there six years or longer. More than likely, she's going to treat her physician well if she treats the rest of the office staff well.

John: Absolutely. Well, let's see. We've seen in general over the last decade or two or longer, migration to more employment with large corporations, hospitals, health systems and so forth. Which brings me to the next question. The reason for that is it seems like they have more money sloshing around and they can buy your practice or they can recruit you even if things don't work out and they end up firing you in two years, they have you tied in.

So, what kind of things do you tell your clients, the physicians, in terms of what to expect when they're looking for a job like this? And are they going to have to take that into consideration that they might benefit on this side, but maybe the monetary will be later? How does that work?

Dr. Lara Hochman: Yeah. And before I even go into that, I'll say that different physicians are at a different point of being able to hear that, like truly hear that or be open to that. That conversation isn't really important to them. When it comes to hospital versus private practice, I would say probably the biggest one that affects people is salary. We forget that we are still in a business. The practices that we're working for still have to make money. The smaller practices are putting a lot of money into.

The physician owners actually don't take a salary while they pay you your salary versus the hospitals who are getting money from the imaging and the labs and the referrals and all the things that they do. And some of them are hiring people who will order more of those tests and make more money and that's where your salary is coming from. So, they are happy to lose money on the clinic visits themselves because they know they're going to make it up in all these other ways. I do hear from physicians, "I just want to be paid fairly" without a true understanding of what that actually means.

One of the downsides of private practice is that it's a smaller system and this could be a benefit, pro or a con being smaller, but one of the cons is that it doesn't have those large systems set up to be able to provide these giant salaries and amazing health insurance benefits and paid time off. But with that, that's what we call the golden handcuffs. So, you go work for these systems and you get used to be paying whatever salary it is that you're used to, and then you feel like you can't leave no matter how they treat you.

That's one of the most important things that I see, I see doctors who go work for hospitals and maybe have an idea going into it that they're not going to be so happy, or it's wonderful, but then administration changes and it's time for them to get out of it because they're just miserable.

The biggest thing is to really prepare for those circumstances. That means not signing a non-compete where you wouldn't be able to work in the city you live in if you were to leave them.

If there is a non-compete, there has to be a way to get out of it. If they fire you, maybe the non-compete is void or you can have what's called a sunrise or a sunset close on your non-compete where it's not valid after a certain number of years working there. There needs to be some sort of wiggle room so that when you sign that contract with the hospital, you have a way of leaving them. Because they know that they've got us, they have us. We are not leaving because they're giving us the salary, they're giving us the time off and the health insurance and all these things that are amazing. And if we leave, we have to leave town. They don't care about us. If they actually cared about their physicians as human beings and medicine in general, and patients, they wouldn't be doing these things. They'd be retaining us by treating us well rather than retaining us by not giving us a choice otherwise.

John: No, that's absolutely true. And it's a reason you need to have a good attorney look at these contracts because there's usually some wiggle room. But if you don't even ask, you're not going to get the concessions. It's a really good point.

The other thing that I've seen in the past when I was working as a CMO is we would try to put the onus for the malpractice sometimes, or at least part of it on the physician. If they left after a year or two, they were going to be subject to tail coverage or something like that, which I've come to believe that's just ridiculous because it's a cost of doing business. If they won't do that, you shouldn't even consider working with an institution like that because again, it's the worst of the handcuffs and it's not fair.

Given that though, you might have to go with a private partner and what have you. The income at first might not be as high as what's published by hospitals, but long term you're going to be a lot happier and have a lot more satisfaction. Let me pause here, by the way. Give us your website address right now so I don't forget. Some people don't listen all the way to the end. So, we're going to find Happy Day Health where?

Dr. Lara Hochman: It's happydayhealth.co. And you can find me on LinkedIn as well. It's Lara Hochman MD.

John: Okay. We'll put that in the show notes and we'll talk about that again at the end here. Have you gotten any feedback from people that you've placed with these practices? Have you heard back from how things are going three, six months in?

Dr. Lara Hochman: Yeah, they're doing great. They're so happy. One guy said I saved his life, and there are no words for that. They're just happy and they're like, "I didn't realize, I had no idea what I was missing" or "Thank you for opening my eyes up to." I had a DBC recently, "Thank you for opening my eyes to DBC." Even a physician who I didn't place has said, "Thank you so much. You've changed the way I practice. You've changed the way I look for practices." So, it's a lot of fun. It's very rewarding and doctors are just happier. Some of these were physicians who were considering leaving medicine entirely and they're really enjoying it.

John: Any general advice now? Because someone who's been in practice has been burned out, they know they're looking for something different. But let's say you're coming out of residency and you really don't know, and again, you're going to be pulled into that funnel, you're going to see all these ads. Other advice or just things that they should think about a little bit before necessarily ruling out one of these potentially lower-paying but more life-affirming positions?

Dr. Lara Hochman: Yeah. Oh, my gosh. I have so many things to say. When it comes to salary, the few things to know are to look at the starting salary and the potential earnings because it can actually potentially be much higher in private practice. You just have to be able to delay gratification a little bit longer. Also, especially for the new grads, I see very frequently where doctors want to interview at so many different places and then in the process, they may actually lose the perfect job where they know it's the one they want, but we're not used to making decisions and so we overanalyze it and take too much time and then can lose that.

I would say if you find a practice that you feel will treat you well and pay you a salary that you're happy with, do it. Don't wait. You don't want to lose out on something awesome because you were just kind of all over the place.

And I understand if you've never worked in a practice before as an attending, then how do you know what you're looking for? But as long as you protect yourself like we spoke about with a non-compete and all of those things, then you're good. But yeah, I would say pick the practice that will treat you the best because life is a journey. We're not racing to retirement. You want to enjoy every day.

John: Maybe if you're a resident or fellow and you're coming out and you've been in an academic situation or something, maybe you need to spend a little bit of time just talking to a couple of people who are in private practice as opposed to maybe everyone who's surrounded and they're in an academic practice or they're in a large hospital practice. Maybe talk to a few of those people that have been by themselves or in a small group or even a large group that's run by doctors. Maybe that'll give them a little insight into trying to make those decisions. Because you're right. It's easy to fall into that thing of just going with the higher salary and the upfront benefits, but later on you might regret it.

Dr. Lara Hochman: Yeah.

John: All right. Again, the website is happydayhealth.co. They can reach you, Dr. Lara Hochman on LinkedIn. I think this is really exciting. I hope you all the success. You need to keep us posted. Even if you want to do a little recruiting here, let me know. I'll put the word out if you're really having a hard time finding somebody because I'm sure some of my listeners are like, "Yeah, nice practice is just as good a way to solve burnout as becoming an MSL or something." Anyway, it's been my pleasure talking to you and I really appreciate you coming on the podcast today.

Dr. Lara Hochman: Yeah, thank you so much for having me.

John: Okay, you're welcome. Bye-bye.

Dr. Lara Hochman: Bye.

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The post How the Medical Matchmaker Provides a Solution to Burnout – 273 appeared first on NonClinical Physicians.

In today's podcast, Dr. Cherisa Sandrow explains how she created a life with freedom of time, place, and means (money). 

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We're proud to have the University of Tennessee Physician Executive MBA Program, offered by the Haslam College of Business, as the sponsor of this podcast.

The UT PEMBA is the longest-running, and most highly respected physician-only MBA in the country. It has over 700 graduates. And, the program only takes one year to complete. 

By joining the UT Physician Executive MBA, you will develop the business and management skills you need to find a career that you love. To find out more, contact Dr. Kate Atchley’s office at (865) 974-6526 or go to nonclinicalphysicians.com/physicianmba.

Life with Freedom of Time, Place and Means

Dr. Cherisa Sandrow will be launching a new course called, “From Here to There – Leveraging Virtual Medicine“. She was inspired after participating in the Empowering Women Physicians Programs.

Sandrow Consulting gives physicians tools to create a life with freedom of time, place, and means by using telehealth to replace income; especially physicians who are exhausted, stressed out, burned out, or who need flexibility and independence for other reasons.

This new course lasts for 10 to 12 weeks and is supported by a dozen other career transition experts.

Dr. Sandrow will assist you with upgrading your résumé, LinkedIn profile, and bio as part of the application process. The program includes instructions on how to set up the telehealth workspace, the medical component of telehealth, what to expect from physical exams, and then how to document properly and efficiently.

Dr. Cherisa Sandrow's Advice

We live in this world of mentorship and colleagues… there are people that have done what you want to do that can guide you… and that's always been my mindset… the other thing is that we all have this incredible resilience…

Summary

Telemedicine is a proven solution. However, it is not necessarily the end goal. With the freedom and flexibility it offers, we can create space to rediscover our passion and sense of purpose in life.

You can learn more about From Here to There: Leveraging Virtual Medicine by going to nonclinicalphysicians.com/freedom/

NOTE: Look below for a transcript of today's episode.

EXCLUSIVE: Get a daily dose of inspiration, information, news, training opportunities, and amusing stories by CLICKING HERE.

Links for Today's Episode:

• How Do I Generate Awesome Income with Telemedicine Services? – Episode 222
• From Here to There: Leveraging Virtual Medicine
• Dr. Cherisa Sandrow's Website
• NewScr!pt

Download This Episode:

Right Click Here and “Save As” to download this podcast episode to your computer.

Podcast Editing & Production Services are provided by Oscar Hamilton

Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 266

Create a Life with Freedom of Time, Place, and Means

- Interview with Dr. Cherisa Sandrow

John: I'm always looking for new programs, courses, books, other resources that will help physicians find more freedom and satisfaction in their lives and maybe also transition to a newer career that builds on their background in medicine. But anyway, that's why I'm bringing back today's guest who's been here before, and she's going to tell us something more about what we spoke about last time and some new things going on. So, with that, I'd like to welcome Dr. Cherisa Sandrow. Hello, and welcome back.

Dr. Cherisa Sandrow: Hi, it's great to be back. It's great to see you again.

John: What you taught us last time and talked to us about last time was so practical. Now it's been almost a year and you've got a new program coming up. And so, I just wanted to catch up with you and kind of figure out what's going on and how it might benefit you, my listeners out there. So, tell me a little bit about what's happened since we last spoke almost a year ago.

Dr. Cherisa Sandrow: Yeah. Great. The world has opened back up which has been awesome. COVID was such a time of isolation for so many. And so, my family and I moved from the Portland Oregon area to Bend, Oregon, which has been our vacation place. It's been one of our favorite places to visit over the past 10 years.

And so, the move is awesome, but also has been a little challenging in regards to community. Between working from home and moving to a new town and COVID, it's challenging to create community, and I know I'm not alone. I actually just saw a post on a Facebook page about a similar situation. I feel like so many physicians and I can speak more directly to female physicians. So many female physicians just feel isolated and are seeking connection. And I'm sure that's true of everybody.

When I in the fall had decided I wanted to put my curriculum onto video, I had been listening to Sunny Smith coach on a semi-retired MD course that I was taking. And as I was listening to her coach, I decided that I wanted to enroll in her summer EWP, the Empowering Women Physicians coaching course. And so that just wrapped up, and it was such a powerful summer of connection and community.

During that course, actually very early on in the course, I was inspired to create this entirely new direction for my consulting business. And so, I'll be launching a course called From Here to There - Leveraging virtual medicine. And I am just in such a different space going into it. I actually was saying I'm feeling like I am lacking joy and connection in my life. And now I feel like I have this entire community and I feel so much more inspiration in my life. So, that's really where I'm at and my girls are just starting school this week.

John: Nice. A little trivia here for the listeners. I'm going to quiz you on this maybe six months from now, but I actually have been in Bend, Oregon once and I was rock climbing with a coach or a guide. It's the only outdoor climbing I've ever done in my life. I'm not a rock climber per se, but Bend, Oregon is an awesome place. It's just like you are living in constant vacation, aren't you, when you're in that part of the country?

Dr. Cherisa Sandrow: That is why people move here. The people that move here are avid outdoor adventurists and love to be active. Basically, it's a town of people that are wanting to live in that environment. And it's grown so much, especially during COVID. Many people from California have moved here, which I think that Californian have moved everywhere.

John: Well, it's a rock-climbing Mecca from what I understand. So, you and your whole family has to learn how to rock climb if you're not already doing it.

Dr. Cherisa Sandrow: When we moved here, it was almost one of the things, not the highest thing on our list of reasons to move here, but it was on that list. So, my oldest daughter is a little rock-climbing prodigy. And so, when we put her on a rock wall a couple years ago, she just went right to the top and we were like, "Holy cow." And so, she rock climbs regularly. She's on the rock-climbing team.

John: Oh boy. Yeah. You're going to have to send some photos out on LinkedIn or something.

Dr. Cherisa Sandrow: Okay. I'll do that.

John: All right. But let's get back to the matter at hand here. Now you have been going through a lot of different things, but one of which is creating this program and kind of expanding it from what I understand.

Dr. Cherisa Sandrow: I'll start with why me, why would I be the person to teach this? So many physicians are wanting to transition to telehealth in the last couple of years. COVID just brought it to the forefront, but it's challenging to know how to even get started and how to make it lucrative, how to actually replace your income with it. And so, I'm a family practice doctor for the first 10 years of practice. I practiced full spectrum family medicine with OB.

And I started working in telemedicine in 2015. I stayed before it was cool and I was doing a little bit of telehealth on the side. And so, I I did that for a year and a half where I was just working with one company, like moonlighting with them, essentially. And in 2017, I transitioned to telemedicine full-time and I was able to not only replace my income, but essentially double my income and cut my hours that I was working in half. And that's what physicians want to do.

And in 2020, I had a lot of physicians that were reaching out, asking me how I did this. And so, I decided to create a curriculum to teach others and I have been coaching one on one over the past two years with using this curriculum. And so, I've created this freedom and flexibility in my life, and I'm super passionate about teaching other physicians who are burnout and wanting a change, how to reclaim and transform their life.

Sandrow Consulting is the name of my company. We help physicians acquire the skills, the tools and the mindset so they can leave their practice and use telehealth as a vehicle to replace their income and give them more time and freedom to figure out what else they want to do in their life. And so, I will take people through all of the steps in the process to get up and running and actually replacing your income will provide the one one-on-one end group support through that transition.

My husband is actually going to be partnering with me on this next phase of our journey. He's been kind of the silent partner as of now, he's been foundational for me though in creating the success that I have. He also is a recovered burnt-out sports med chiropractic physician. He owned a practice, and he has been in the coaching space for the last eight years. And his focus has been really functional medicine and wellness, and his expertise that he's bringing is this is business ownership mindset productivity and system creation, and creating a sense of wellness. And so, our goal is to help physicians just rediscover our purpose and reignite our passion.

Why we went into medicine? We went into medicine because we're super passionate about serving and helping other people. And there's a deep sense of purpose that got us there because in order to get into medical school, we are the top. We go above and beyond. Then you get there and you just spend more than a decade in training and you sacrifice your life and you put everything else on hold and you go into hundreds of thousands of dollars of debt thinking that after you're done with your training, life will be awesome.

And then we get there and life doesn't feel awesome for a lot of physicians and we feel trapped because what else are we going to do? We have all this money to pay back and how else are we going to make a quarter million dollars a year? And we don't realize how much we actually are capable of doing and how many opportunities are out there in the world, which is why I love everything that you do because you start planting seeds and opening people's eyes.

And so, I had my husband go through a program with Caroline Leaf, who is a neuroscientist. She wrote a book called "Switch On Your Brain" and another book called "Cleaning Up Your Mental Mess." She has this neuro cycle program that helps us change our toxic thoughts and rewire our brain. She's studied neuroplasticity for 35 years. And so, she started a facilitator program this year. The goal for me having my husband go through this training is that cleaning up those toxic thoughts and helping people rewire their brain is foundational in recovering from burnout because we just get stuck in a certain way of thinking. And actually, if somebody were to change from a clinical practice or a hospital practice where they're burnt out and they start doing any other thing, if they don't change the toxic thoughts and the patterns that we've developed that is like this work course, just drop work till you drop sort of mindset, we're just going to do the same thing in another field. And so, along that journey of transition, a huge piece of the transition is changing the way our mind is working. And my husband is going to bring that element.

And then the other piece of it is prior to the transition that we made, we were struggling. I mean, we were so close to divorce and we had two children. And my older daughter has some high needs and special needs. And so, through this transition, we were able to heal our marriage and just redefine our core values and redefine ourselves, our own way of thinking. And we are functioning in the world, we are showing up in the world. And so, we are such a great example for other people who are kind of in the same space.

John: Yeah. That gives me a pretty good idea, I think and the listeners too, what kind of got you here. I will say this, that it's funny. Physicians become so desperate to leave, but it's funny because they feel like they're compelled to do something. And the question I get all the time is "I don't know what to do. I don't know what to do."

And I think by addressing all the issues you mentioned in addition to what to do as far as the actual job, but to have the job included, look, here's an easy... Well, it's not easy. It takes work and it takes learning, but here is a proven solution, telemedicine. You can make the same amount of money unless you're a multimillion-dollar high RVU interventional something or other. And you're going to make good money and you're going to have flexibility and freedom and time if they do it the way you do it.

So, I like it. It's not going to be perfect for everybody, but it's going to get people into something quickly and to still pay their bills and pay back their loans. And then if they even want to shift, it sounds like they could do something a little different later, but they have a solution right now.

Dr. Cherisa Sandrow: Yeah, that's absolutely my vision. Telemedicine is not necessarily the end goal. It's freedom and flexibility in our lives and reigniting our own passion and purpose. And telemedicine is a vehicle that I've used. And so, I can teach other people. But then once you get that time back in your life and you heal a little bit from the burnout, then you have the capacity to explore what else you might want to do.

And truly telehealth, the future of telehealth is way more than what most people realize. The American Medical Association adopted a policy back in 2016 that was aimed to ensure that med students and residents learn how to use telemedicine in their clinical practice. And so, this has been like even before COVID a plan for the future of our healthcare system. And in that, they had said as innovation and care delivery and technology continued to transform healthcare, we must ensure that our current future physicians have the tools and resources they need to provide the best possible care for their patients. And for sure, I think once people get into the telehealth world and they start to realize how many opportunities are available, it starts to become more clear how much telehealth and the virtual medicine world is really going to be able to transform our healthcare system. And so, that's definitely exciting.

John: We're talking about, "Well, you could be burned out, you could just be unhappy." What have you. But I'm assuming in your mind, you have a clear picture of who is this ideally, the program you've already been doing with your coaching and so forth, who is the ideal person that would take advantage? I'm sure it's not someone who just had a thought like, "Oh, I'm just a little unhappy." It's probably someone who's really kind of... They don't necessarily have to be burnt out. Tell us about that. Who would be the ideal person?

Dr. Cherisa Sandrow: Yeah. I feel that it's important for people to be in practice a few years before transitioning to telehealth. And so, I don't know that I will turn somebody away who is straight out of residency, but I'm absolutely going to encourage them to do some in-person practice in addition to telehealth, if they want to start doing telehealth early on. And so, really my work is geared towards helping physicians that have been in practice and are struggling to balance work, family and their own life, their own wellness. I think that's most of us though. But not everybody wants to leave practice actually. There's a lot of people that are not even considering the options.

My client is the person who's tired, stressed, and burnt out, or needing flexibility and freedom for some other reasons. When I first put the course together, it was during COVID. And so, my mindset was maybe they're caring for an elderly and they don't want to be exposing them to COVID or maybe they need to be available for their kids that are homeschooling. But there's always life situations that happen and our typical practice doesn't give us the freedom and flexibility. Maybe it's a single mom, a newly single mom or newly single parent, who just has to have more flexibility than our typical practice allows.

John: Yeah. It seems obvious, when you think about telehealth or telemedicine as opposed to traditional practice, one of the big differences besides being on call and having going to the OR in the middle of the night or something is just usually at 08:00 to 06:00. I wouldn't say 09:00 to 05:00, but there's set hours. Whereas I think in most forms in telemedicine you can choose to have more flexibility. You can be taking calls on the weekends or at night or different time zones. So, that part of it, that's where it sounds like it's very flexible, but you have to be disciplined, I would assume.

Dr. Cherisa Sandrow: Yeah. That's actually very true. Well, we are so used to being so busy with somebody else controlling our schedule that when we transition to probably a lot of remote work, but when we transition to business ownership, we have to create our own schedule. Or we will either end up just doing the same thing, working like never leaving your office or you won't ever get work done, because you'll do laundry and you'll have this appointment and that appointment and you want to work out. And so, it is important to learn how to create a schedule, which is actually something that I teach. I think it's important enough to focus on and learn. We don't learn that.

John: The other question that I come across this fear of the unknown is that the physicians that are looking to make a change, they can't really envision what the steps are. They don't know what they should do. "Should I do a CV? Should I start looking? What do I do?" And I think when they have someone like you that can sort of walk them through the steps, there's certain milestones or things that you'll be looking along the way. So maybe I'm assuming that your program kind of addresses those. Are there some big major milestones that people have to kind of get through in this process?

Dr. Cherisa Sandrow: Yeah. Absolutely. And we do all of that. State licensing, getting licensed in multiple states is the thing that kind of takes the longest. And so, we start that process. We help people start that process really in the very beginning, because that is really the piece that we're going to be waiting for at the end is for those licenses to come through. And then we help people first figure out "What your vision is for your life? What do you want your life to look like? What do you want your practice to look like?" And that helps guide us as to where we're going to go with what companies and what direction we're going to go. And so, we focus in the beginning on rediscovering what our strengths are, what our purpose is, what we're passionate about and how we want to show up in the world.

And then we start identifying what the telehealth business vision is and what our goals are. And then setting up a business foundation is huge. And so, I'm going to have a telemedicine lawyer come in and speak. I have a small business accountant who will come in and speak and a bookkeeper who will come in and speak. I will help people with the things that need to get done. And so, setting up an LLC and talking about business ownership, tax write-offs, that kind of stuff. And then we're exploring the companies and which ones to apply for, which is very overwhelming. There's so many. How to review the contracts with the different companies to make sure that you're aware of what you're committing to.

And non-competes are an issue with a lot of the companies. And it's a reason why I never took a job with any of the telehealth companies, because most of them have these non-competes that make it difficult. If you sign a non-compete in the telehealth world, you can't do anything anywhere in the country. And so, I know that a lot of physicians are struggling with their local non-competes and I think it's really important that if somebody wants to transition to telehealth, then they are looking at taking a job with one of the telehealth companies that they're aware of the implications of the non-competes that they may be signing.

And then as far as the application process I help with updating your resume and updating your LinkedIn profile and creating a bio, and then setting up the telehealth workspace and all of the medicine part of telehealth, what's expected from the physical exams and then how to document. And so, all of those pieces along the way, I'm walking somebody through. And so, yeah, there's actually a lot of pieces in the transition that can become very overwhelming if you're not supported through that transition.

John: I was kind of chuckling a little bit because I had this vision. I have a friend and I think you know this friend I'm talking about. I thought the place where you do this is in a chair on the beach or something.

Dr. Cherisa Sandrow: It could be.

John: It could be.

Dr. Cherisa Sandrow: Actually, if you're not doing video calls, if you're taking phone calls or with asynchronous telemedicine, you can be anywhere. And so, if you're doing video or phone visits, you still want to have a HIPAA compliance sort of space and privacy, it still applies.

John: Okay. Well, it sounds like there's a lot of pieces here and it's probably not all crammed into one week. So I'm just curious how does your program look right now in terms of trying to get through this? And not to get through it, but they have time to digest it, maybe ask questions. So, what kind of a timeframe are we talking about that people would commit to, if they were to pursue this?

Dr. Cherisa Sandrow: It will be 10 to 12 weeks. And I have about a dozen experts that I'm bringing into speak that will help encourage everybody when they're hearing other physicians that have create... It's not just me. There are others that have created this similar success in the telehealth world. And hearing other people's stories and how other people were able to create the success and what their journey looked like is of course encouraging. And then we'll have Q&A time with all of those experts as well.

John: Well, that's 12 weeks, basically, if you're saying to go from A to Z, to go from not even have ever set foot in telemedicine, so to speak. And then at the end to be able to do telemedicine, telehealth, whichever version of the approach you're taking. That's quite a transition in a quarter. But it sounds like there's enough time to really dig into each topic and optimize it and make decisions. Because like you said, I'm getting that there are just so many different versions of telehealth that you can choose from. And I know in our last interview, people should go back, I'll put a link to that, but you explained in detail how to overlap some of these things, or it's not really multitasking, but if there's a downtime in this, you've got this other one you can adjust.

Dr. Cherisa Sandrow: Like how to stack them.

John: Stacking. Exactly. That definitely is something that you want to learn as early as possible, but it does take time I'm sure, once you get going to get that experience and to feel comfortable and to become efficient.

Dr. Cherisa Sandrow: Yeah. I think the important thing though to know is that medicine is still the same. And so, the practice of medicine is still the practice of medicine. And we know that, we've been doing that. The delivery changes. And so, we need to learn, there's a lot of mindset shift and there's a lot of belief that has to happen, but the core skill set, we have that.

For me, the business ownership piece of it is important because we are not trained to be business owners and you can take a job with a telehealth company, but you're not going to have as much freedom and flexibility and ownership of your life and you're not going to be as profitable if you take a job with a company because then you are only able to work in that job. And so, teaching business ownership I think is a huge piece.

John: No, that's absolutely critical, I think, to have that freedom, otherwise you're just kind of back in a rat race to some extent, and you're controlled. And when you were talking about the issue of non-compete, that applies probably to both whether you're employed or even if you do have your own business, if you don't sign the right contract. Because you can get stuck with a non-compete, even if you're an independent contractor.

Dr. Cherisa Sandrow: Yeah. We have to read the contracts and be careful with them, but it can. I think the intention of the telehealth companies with the non-competes is that you're not working with another telehealth company. There is only one company that I've encountered that only required that non-compete of physicians and leadership position. And it was around proprietary information, which makes sense to me. But when a company says you can't work with any other telehealth companies, then if that company is slow, and if you're not busy, then you can't do something else. And then in a lot of them, that non-compete limits you if you decide to leave that company. So, then you can't continue doing telehealth. It's just important to be aware of that.

John: Let's see. Let me refresh the audience's memory here on your site. Your website is sandrowconsulting.com. They can go there and see where things stand. If they want to use a link that I can provide, that's nonclinicalphysicians.com/freedom. And that will take them also to that now. I am helping to promote it. And so, I'll probably come up with some kind of bonus for someone to use that link, but either way they can definitely track it down and I'll put that in the show notes. And yeah, I would love to hear the results of some of your clients, customers four or six months down the road. We'll have to track some of them down and maybe I'll get them on the podcast.

Anything else you want to tell us about the program or any other words of advice or wisdom or encouragement you'd like to give us today?

Dr. Cherisa Sandrow: I just want to encourage physicians to recognize how well trained we are as physicians, but our preparation is to be an employee. And so, we have this really extensive training, but then we end up being put into a job where we're the clinician, we're the practitioner. And that's amazing, but it makes us feel like that's all we can do.

And I want people to understand that there is so much, there are so many opportunities that are available, and there are so many experts that are in these different areas that are available to help guide them. And our whole training model is in this mentorship model. Throughout med school and residency, we're mentored. And even going into practice, we run things by our colleagues all the time. That's how we work. You get another set of eyes to go look at your rash, or you review an X-ray with a colleague or you call the specialist to run something by them.

We live in this world of mentorship and colleagues, but then if we decide to transition out on our own, we think we need to figure it out on our own. So, there's a plethora of information on the internet if we start trying to figure it out on our own, but there are people that have done what you want to do that can guide you. Whether you're wanting to go into pharma or coaching or whatever, real estate, there's these mentors. And I think that's something that I valued always.

And so, when I first started out, I reached out to people and I hired Tom Davis to help me when I first started creating my curriculum because I knew I didn't have some of that business skills. And that's always been my mindset is to hire other people to help me because that's how we're trained, but not everybody realizes the value and importance in that. And so, I think that's really important.

And then the other thing is that we all have this incredible resilience just from going through our training, let alone the rest of life that we've experienced. But as physicians, we are resilient beyond belief. And so, what we have proven in our life that we've already overcome and that we've already have achieved, can get us to whatever that next phase is of our life that we want. And so, I think that it's important for us to recognize that we can do it, whatever it is that we want to do.

John: Yeah, absolutely. We've got the brain power, for sure. We just need a little help and some of these steps to learn things that we're not really aware of or have been exposed to. Physicians are somewhat resistant to coaching in general. They feel like, "Well, that's like asking for help and I'm not supposed to." It doesn't make any sense really. Companies, big hospitals and insurance companies, they've been using business coaches for years and years and they love it. And it's what helps them progress even quicker in their career transition.

So, that's what physicians need to learn. It's that by getting some coaching or training or online courses, or what have you, in a particular field, you could just accelerate your progress so much more. That's why I love bringing out guests like you that have created something that is really valuable and can answer a problem or solve a problem for physicians. So, I really appreciate you coming on today Cherisa and explaining this and dropping a few pearls along the way. That's always useful.

Dr. Cherisa Sandrow: Thanks so much for having me.

John: I encourage everyone to go and listen to the previous episode, because you really gave a good overview of telemedicine and telehealth at that time. This is just a lot of misconceptions about it, for those that haven't done it before. Again, thanks a lot for that. And I will put these links in the show notes and I wish you the best of luck.

Dr. Cherisa Sandrow: And can I just add that you are going to be one of my guest speakers? That is exciting too, I'm really happy about that.

John: I'm looking forward to that because I love talking about this stuff and I'm going to try to dispel some myths from my perspective, as well as give the thumbnail of career transition and how I would approach it briefly. But basically, it just echoes what you've already said here today and that you're teaching in your course. So, I think it'll be fun. It'd be great.

Dr. Cherisa Sandrow: Well, thanks so much. It was great to see you.

John: All right. You take care. Bye-bye.

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The post Create a Life with Freedom of Time, Place and Means – 266 appeared first on NonClinical Physicians.

In today's podcast, Dr. Chelsea Turgeon explains how to face burnout head-on and create a life after medicine.

Our Sponsor

We're proud to have the University of Tennessee Physician Executive MBA Program, offered by the Haslam College of Business, as the sponsor of this podcast.

The UT PEMBA is the longest-running, and most highly respected physician-only MBA in the country. It has over 700 graduates. And, the program only takes one year to complete. 

By joining the UT Physician Executive MBA, you will develop the business and management skills you need to find a career that you love. To find out more, contact Dr. Kate Atchley’s office at (865) 974-6526 or go to nonclinicalphysicians.com/physicianmba.

Residency Drop Out

Dr. Turgeon wrote the book when she started working with healthcare professionals. She noticed that when she talked to others about her decision to leave clinical medicine they often asked the same questions:

• What are you doing about your loans?
• Didn't that seem like such a waste?
• How did you decide how to use skills outside of medicine?

The first part of the book talks about her journey. The second part addresses all of those common questions and concerns. It also addresses her perspective and how to think about them differently.

Life After Medicine

Chelsea discovered that her burnout resulted from the misalignment of her career and her true self. Unable to use her zone of genius and natural gifts caused her to take drastic action. She combined travel with earning a living and making a positive difference by moving to South Korea to teach English as a second language.

That provided the time and income to pursue coaching training and certification. And she created a remote online business that she loves and allows her to travel while working. 

She does all of her marketing through social media. And she produces her own podcast, Life After Medicine. Those are things she can do online. She has created a thriving coaching practice, meeting clients on Zoom and WhatsApp.

Dr. Turgeon's Advice

Honor your discontent because it matters. If you're not happy… if you are feeling burnt out and unfulfilled… more often than not, that matters… If you don't know where to start, start with what you want. – Dr. Chelsea Turgeon

Summary

Besides being an enthusiastic coach, Dr. Chelsea Turgeon is courageous to follow her instincts to work and travel the way she does. There is much to learn from her approach to life after medicine.

NOTE: Look below for a transcript of today's episode.

EXCLUSIVE: Get a daily dose of inspiration, information, news, training opportunities, and amusing stories by CLICKING HERE.

Links for Today's Episode:

• Dr. Chelsea Turgeon's Website
• Life After Medicine Podcast
• Life After Medicine Facebook Group
• Residency Drop Out by Chelsea Turgeon, MD
• Dr. Chelsea Turgeon on Instagram
• NewScr!pt

Download This Episode:

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Podcast Editing & Production Services are provided by Oscar Hamilton

Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 246

How You Can Forge a Wonderful Life After Medicine

John: To me, there's nothing better than talking to someone who is a role model for career transition. Someone who is leveraging her healthcare training and experience in new ways. That's the ideal guest for this podcast in my mind. It's just like today's guest. Hello, Dr. Chelsea Turgeon.

Dr. Chelsea Turgeon: Hey, thanks so much for having me.

John: I became aware of you, I don't know, it's been maybe a year or so longer. I'm not sure when. You're going to tell us about your story. But then I just started seeing you on Facebook and then I saw you were doing coaching and I didn't really know about your book until maybe... Well, I guess it was funny because when we got ready for this podcast interview, I thought I was going to go and download the book. And when I did, I found out I already had it. That was like, "Oh, I've downloaded. I just never read it." I had to take a quick peek through the book and that was very interesting. I'm talking too much. I'm just so glad to have you here today.

Dr. Chelsea Turgeon: Yeah. I'm so excited to be here.

John: Okay. We're going to start like we often do and just ask you to give us a little bit about your background and education, and then this whole transition that you went through. I think it'd be very interesting to hear your story.

Dr. Chelsea Turgeon: Yeah, absolutely. I'll just start out by saying that I went into medicine for all the wrong reasons, but that is me looking at hindsight. When I was going through it at the time, I didn't really have that awareness and I didn't have that sense of realization that it was the wrong career path for me. And it wasn't wrong so much as they were more superficial reasons. And I think that's one of the problems that happens with choosing our career path when we're 17, 18 years old, and we're picking our college majors because we're so young and we don't know that much about ourselves at that time.

And so, I always loved psychology. I thought I was going to do something with psychology, whether that was to go into psychiatry and practice medicine in that way, or get my PhD in psychology. So that was always the initial plan. I realized that when I told people that those were my two ideas, whenever people heard the medicine path and being a doctor, I got so much validation. I got so many of those "Wow, you must be so smart. Ooh. Being a doctor." And I actually had a lot of friends whose parents were doctors, and I just started to associate that with kind of like the highest level of status that you could achieve in society. And so, kind of unknowingly to me, that was one of my main drivers that was putting me through all the pre-med courses and making me want to go to medicine. It was all of that external validation I would get when I talked about that as a career path.

But what I ignored was the fact that I didn't like shadowing at all. I didn't like being in the hospital. I didn't like my hard science classes. I really loved my psychology classes obviously, but organic chemistry, biology, I really wasn't interested in that subject. But it didn't really matter to me at the time. What mattered more, what was driving me was kind of this drive for achievement, this drive for external validation. And so, that drove me all the way through medical school. And then I got to that place where I matched in residency. And I matched in my top choice residency, I got AOA in medical school. And so, I did so well. I achieved everything that I thought I ever wanted. And it felt so empty. I remember on match day I was thrilled for about 30 minutes and then I came down and I was like, "Is this it? Is this what I've been going after this whole time?"

And I made it into residency, but it wasn't long before I really started to realize this is not the right path for me. And I made it to about my second year when I hit this really big burnout. And I ended up taking a five week leave of absence from residency and from the hospital. And during that time, I realized it was more than just burnout. It wasn't just that I was exhausted from working 80 hours a week and doing 24-hour shifts. It was more than that. It was really the career, there was like a values misalignment and it was a gifts misalignment. Like I wasn't really using my zone of genius and being in my gifts.

And so, I realized it was just the wrong career entirely for me. And on top of that, I had this pull to go do something else. I had this pull to travel. I had this pull to write. I had this pull to help people in a different way, with deeper one-on-one connections. And so, I made the decision to leave residency and I didn't have a huge plan as to what that would look like. I bought a one-way ticket to South Korea. I got a job there, teaching English in a school. Literally I went from being a doctor one week to the next week I was in South Korea teaching English to third graders. And then through that year, working in South Korea, I spent time doing a lot of soul searching, learning a lot about myself and also learning a lot about building an online business. And so now for the past two years, I have been running my own online business, traveling the world and working remotely.

John: All right. That was a very good summary of what's been going on for these past few years. I have to comment. I would've thought that things have changed, but I'm like a couple decades ahead of you in terms of when I went to med school and all that kind of thing. But it was the same thing. Like how could we be so stupid?

But the thing is, it's true. When we decided to go into medicine, many of us were basically children. Yeah. We're making a decision like you said based on someone's advice, the fact, "Oh, that sounds really nice." And everybody likes thinking about going into medicine and being a doctor. So, it seems like things don't really change. It's interesting, the thing about Korea. That was going to be my first follow up question because it was like, "Okay, wait, she just decided to leave the country and go to Korea." Now, as you mentioned that though, I remember that I have my wife's niece. She and her husband went to Korea to teach English. Is there something that attracts people to Korea or do you know someone in Korea? Why the heck did you choose Korea?

Dr. Chelsea Turgeon: Yeah. Yeah. Essentially the rationale for all of this was when I was leaving residency the big driver for that was, I want to travel. And it's strange because I wasn't someone who'd done a lot of travel before that. I traveled for the interview trail and I went to Germany one time when I was 16. But other than that, I really didn't have a lot of travel experience, but it was just on my heart. On all of the weekends, I was off in residency, I was watching every single travel documentary on Netflix and I just felt this to do it.

But at the same time, I was like, I also need an income. I need a way to make money because I didn't have a huge, substantial amount of savings to fund my travels. I didn't know how to leverage my skills to make money online and even doing so, it is a process to learn how to make a substantial income online.

And so, one thing I just came upon is that there's a way to teach English, all over the world, but especially in Asian countries. They're always looking for native English speakers to come and teach English, which is such a privilege that we get to be paid for something that I just grew up speaking this language. And so, I did an online certification to be certified to teach English and I just got the job teaching English in South Korea. So, it fit both of those needs of having an income and then also being abroad and being able to travel on my weekends.

John: Very nice. It makes sense. And I think similar things were leading my wife's niece and husband to do the same thing. Like, okay, here's something people need help with and we can get in. We do a little bit of training, and boom, we're doing something and we're traveling. So, how come you didn't choose some other activity beyond that? What got you into coaching and all that kind of thing?

Dr. Chelsea Turgeon: Yeah. Initially when I was making my decision to leave residency, my thought was I want to be a travel blogger and I would tell people this as a joke. Even before I made my decision to leave, people would ask like, "Oh, what are you doing after residency?" Meaning, are you going to be a generalist? Are you going to go and do a fellowship? And I would just say, I'm going to be a travel blogger. And that was always a joke, but there's a little truth behind every "just kidding." And so, I thought that's what I wanted to do. I signed up for a travel blogging course. I started my blog, the turquoisetraveler.com.

John: Wow.

Dr. Chelsea Turgeon: Yeah, that exists. That's a thing. And then I realized I love writing and I love travel, but I don't love writing about travel.

John: Okay.

Dr. Chelsea Turgeon: I'm not detail oriented so I don't like talking about "turn on this street to get to this place." That's not interesting to me. And what I started to realize is I loved writing about personal growth and the things I was learning and the journey that I was going on to figure out my values and to understand my zone of genius. And I loved writing about that stuff. And then I just started finding out about coaching as well. And that just seemed to go together because I always had such an interest in personal growth and I realized I can basically just help people through their personal growth journey as a coach. And so, then I signed up for a yearlong coach certification program and I did that throughout the year that I was in South Korea.

John: Okay, cool. So, you were teaching English and by definition traveling, you were in a different place, I'm sure you checked it out while you were there quite a bit, and learning something new at the same time.

Dr. Chelsea Turgeon: Yeah.

John: There's really something about coaching. To me, it has all the positives of being a physician with pretty much none of the negatives.

Dr. Chelsea Turgeon: I agree.

John: I'm not surprised at all that a lot of physicians find other ways to help people and coaching is a big one. Now you're not in Korea today. I don't think so.

Dr. Chelsea Turgeon: I'm not, no. After Korea, that was always going to be a temporary situation. So that's something I call a bridge job and that's something I help my clients do as well. Although usually their bridge jobs do not involve teaching English in Asia. But it was essentially a way to pay my bills, to interact with people, to feel like I'm giving back to the community in some way. But then also give me plenty of space and time to figure out my next steps. And so that was always the plan for it to be temporary.

February of 2020, that's when my year long contract ended and that's when I decided I'm going to be a digital nomad, meaning I'm going to work remotely. I'm taking my online business full time. I'm going to work remotely and have that location independence and travel around and be in different countries every month and be able to sustain myself through my online business.

John: It reminds me of the first time I read "The 4-Hour Workweek." I don't know if you know Tim Ferriss?

Dr. Chelsea Turgeon: Yes.

John: I'm actually spousing something that he created. Although I think he's had guests on his podcast to do a lot more of the digital nomad thing than he actually did. So, I have a question. Again, I don't want to get nosy, but what did your family think of this?

Dr. Chelsea Turgeon: No, not nosy at all. That's such a common question. Initially they were pretty shocked and I think a big reason for that was because I didn't open up to them or share how unhappy I was. I felt like I had to present this really positive image of "I'm living my best life. I'm a doctor, I'm achieving my dreams and doing everything I thought I wanted." I didn't ever really open up and tell them what was on with me internally. I just started kind of gradually distancing myself from them. And so, we used to talk for maybe like an hour every week in med school. And then in residency it started just whittling down to where it was like five minutes every other week, because I was just so unhappy and I didn't really want them to know.

But then when I finally told them I'm taking a five-week leap of absence, these are all the reasons why. And I told them how long it had been going on for. They definitely started to realize that this didn't seem like the right career path for me. And no one in my family is a doctor. And so, they really just wanted me to be happy and they didn't realize I was so unhappy. They came around to me leaving medicine. But then also the me traveling thing, that was a whole another situation. They were like, "Why can't you leave medicine, but still stay in the US? Why do you have to leave?" But I'll tell you now, they're like the most supportive people in the whole world. My mom listens to my podcast episodes literally every week the moment they're released and sends me a text message about them. They came to actually visit me in Mexico for my birthday. So yeah, they've definitely become very supportive.

John: One of the things, and it's instructive because this is human nature, I guess. But one of the things I find a lot in the people I've talked to that have changed is that they don't want to tell their families they're ashamed. They feel guilty. And in some cultures, being a professional is unreal. There's so much pressure. I understand why some people actually get so depressed. But the thing that I tell people is I think 99.9% of the time your family wants you to be happy. They don't want you to be miserable. They don't want you to work 80 hours and get burnt out or hate your job just for appearances. Again, you kind of demonstrated that very thing yourself.

Dr. Chelsea Turgeon: Yeah, it's so true. And I would also say your parents usually also want you to be safe. Usually, it's safe somewhere first and then it's happiness. But they think that the way that allows you to be happy is to have a really successful job, to have a high income. But when they start to realize that's not the case, usually your family comes around. I'm very fortunate that mine did, and I think that's been the case for a lot of people I've worked with as well.

John: It's cultural too in the history of what they have gone through. Well, happiness comes from having a job and having some money.

Dr. Chelsea Turgeon: Yeah.

John: Then later it's like, well, not really not. We're in an abundant country. Maybe it's more about being fulfilled. Maybe it's more about following what you're good at. People listening, listeners, don't put this off. Learn from Chelsea and what she's done. Okay. Well, go ahead and tell us a little bit more about once you had the coaching experience and training. Then you decided basically to start your own thing. Tell us more about that and maybe just tell us what you're doing so we can find it and look at it.

Dr. Chelsea Turgeon: Yeah, absolutely. Initially I started just kind of generally life coaching and I started helping others. Just like really anyone who was having a hard time in their life and wanted something more for their life. And so, I just started working with people. When I was in South Korea, I made the goal to just do a hundred hours of coaching just to start really getting good at it. And I would literally coach every single other English teacher on the island after school. We'd go to cafes and I would just practice my coaching skills. And I started to realize I love this. But then what people started to really come to me for was career stuff. They're like, "Well, how did you do that? How did you leave your career? It was such a prestigious career path. How did you just walk away? How did you know what to do next?"

And so, that's a good part of a good business rule is to start paying attention to what questions are people coming to you with, what are people asking you about? So, I started paying attention to that and I started realizing career and purpose and fulfillment. Those were big things that I was very interested in, but then also people really wanted to know from me. And so, I transitioned into more career coaching specifically.

And then about December of 2020, I decided to make the transition even further into healthcare professionals specifically. I think I did need some space from that right after leaving the hospital. But around that time, I started to feel that pull to come back to that world and help people in the healthcare realm, find their own way to career fulfillment. And so, that's what I do now.

John: I didn't warn you I was going to ask about this, but let me ask you this. Because there are some physicians who have a very negative view of coaching. "Well, yeah, anybody can sit down and talk to someone else." Tell me a little bit about your experience in terms of before you went through the training and then after the training and then actually intentionally interacting for those hundred hours or whatever, where you're applying those. What is the difference in terms of the true classical kind of coaching as opposed to just listening to someone's complaints?

Dr. Chelsea Turgeon: Yeah, yeah. Absolutely. And I'll say it makes sense that people have such varied experiences with coaching because for the most part in the US, it's a completely unregulated industry. Anyone can say that they're a coach, anyone can charge any amount of money for it. So, there is no regulation.

It really is based on the integrity of the person offering the services. And there's no guarantee of results. And so, there's no standardization. It makes sense that you could have had a really bad experience with a coach or another thing that might be coming from the fact that it's unregulated, the fact that it doesn't require training. But however, being a physician requires all of this training, it requires so much work and effort and certifications and board licensing and all those different things. And so, if you see people with no training or whatever, just starting to practice and make money and have all this freedom and lifestyle, I can see how you would look at that and have skepticism and a little bit of cringe and all of that. That totally makes sense.

I do think it is really important for each consumer before working with a coach to have... I guess you just have to really trust yourself, trust the reviews. I think referrals are really helpful. And so, it is hard because it's such an unregulated industry. I'll just say all of that. But for me, in my experience, I didn't know much about coaching before I just started to become one. And then I realized as I was going through my training process, I would have people kind of come up to me and scoff and be like, "Oh, you're a coach." And I would have that a lot, but I just loved it so much and I believed in it so much because I've just always loved psychology and personal growth. And what drives human behavior and motivation. And those have always been huge areas of fascination to me, but I maybe just came into it with this innocence and this naiveness of "This is just amazing. I can just make money doing this" and my heart was always deeply in it.

I think when you have a coach who is truly committed to being a coach and has done all the work themselves and has really trained to understand human psychology, you can have profound transformations with a coach like that. Whereas if you have a coach who just kind of went through the motions and is doing it to try to make money quickly, which it's not a good rich quick scheme, you can just have very different experiences. But for me, I'm very committed to my clients and it's something I deeply feel I'm called to do.

John: Yeah. I think there's a method to true coaching, the classic coaching that they usually teach in professional organizations that are certified and so forth. That's why some of us like myself, I will say that I'll mentor, I'll actually be more of a consultant because I can tell you what I did. Some people might call that coaching. That's not really coaching in my mind. It's where you get into how to bring someone along, how to have the proper way of interacting with a person that has insights and then helps them realize. A lot of it has to do more with mindset and how you think as opposed to "I'm going to show you how to get a job teaching English." Well, okay. That's just kind of a mentorship type thing.

Dr. Chelsea Turgeon: Yeah, yeah, totally. The difference between coaching and consulting, mentorship, that sort of stuff. Coaching, this is how I think of it. Coaching is more like I'm guiding you to find the answers within yourself. I'm guiding, I'm reflecting back to you some of the patterns that you're demonstrating. If you're saying one thing, it's really important to me to find fulfillment, but I refuse to leave this job that's making me unfulfilled. I'll just kind of reflect back on things that don't make sense, that aren't adding up. And I'll hold you accountable, hold you to your higher self. Whereas consulting, like you said, is more of "I'm an expert in this area because I've personally gone through this and I have these connections, I know the method to do this thing and I can help you go through these exact steps." Whereas I do some of those things but my true joy, my true love is really coaching.

John: Yeah. If you look at most successful businesses, large businesses, like all the senior leadership get coaching, business coaching, leadership coaching, things like that. It's not about telling them what to do. It's trying to learn those new skills and have those insights. Well, if we want to learn more about you and all what happened to you, of course, there's one easy way to do it and that's to get your book. So why don't you tell us about the book? "Residency Drop Out", that doesn't sound like a real positive. It catches your attention. So, tell us about how you wrote the book, why you wrote the book.

Dr. Chelsea Turgeon: Yeah, yeah. I decided to own it. And one big reason for that is because I have noticed there's a lot of shame around things like leaving a residency, leaving med school. I even remember when I was in med school and I knew of people who had left, it was very shameful. It was like, "Oh, this person left" and we were whispering and no one wanted to talk about it.

I wanted to start to release some of that stigma. And honestly, since I've put my own self out there as a residency dropout, I've had so many people come to me. It's almost like people are coming out of the closet as people who've left during other parts of their training. And so, the reason I started writing the book was when I decided to start working with healthcare professionals, I did tons of market research interviews. I talked with physicians, pharmacists, all across the board for healthcare professionals. And they all asked me about the same 5 to 10 questions of, "What are you doing about your loans? Didn't that seem like such a waste? How did you decide how to use skills elsewhere outside of medicine?"

I just started to take note of all the same questions that were asked of me. And I was like, "You know what? I'm just going to write a book about this." And there was always a book on my heart. I've been blogging ever since I left medicine, literally in 2018, when I made my decision to leave, I wrote a blog post about it and I've been blogging ever since. And so, it came really naturally to me. So, I wrote the book. The first part talks about my journey specifically, and then the second part addresses all of those common questions and concerns and kind of my perspective on those things and ways that you can start to think about them differently.

John: Yeah. It's very interesting. It's just blunt really what you've written there. And I've talked to people that have made those decisions. It's really, really tough. I think in the book you've mentioned you took five weeks off and maybe you mentioned earlier today you had to take time to step back and start really kind of thinking through this process, whether it's just stopping at the end of med school. I got my MD. Forget it. I'm not going to residency. I can't take it anymore. I'm already burnt out. I've talked to so many people that are burnt out at medical school, then they're burnt out in residency. They keep thinking it's going to get better. And then they get out in the practice and then they're burnt out in practice. It's like, it's not getting better. Something has to change.

But I do want to shift gears here, again, because you're an expert in being this digital nomad, I think a term that you brought up earlier, or maybe before we got on the call. One of my favorite books of all time "The 4-Hour Workweek" by Tim Ferriss, it's just such a classic. And he was the first one that really wrote extensively about that.

I've never told this story before, but I actually went to Africa with my family. We did like a week's travel. On the way back, I saw that book in a bookstore in London. And if I look back at that trip, the highpoint of my trip is finding that book oddly enough. But it was so eye-opening. It was like, even this whole career thing, there are things you can do that are completely off the wall and different and whatever. But I want to know and you need to explain this, how does this work? You are traveling and you are finding clients. You wrote the book. You have a Facebook group and these other things. So how do you actually make this work?

Dr. Chelsea Turgeon: Yeah. And so, thank God for the internet because that's how I make it all work. As you know, sometimes the internet connection isn't great. And so, there's a lot of things we have to do about that, but really my business is completely online. So, I do all of my marketing through social media, through Instagram, through Facebook. I have a podcast, all of that. Those are things you can do online. As far as serving my clients, I do all of that online as well through Zoom, through WhatsApp.

And so, because of the internet, I'm able to have my business fully sustained online. And there's plenty of people who do this in the states where they have full online businesses or they just have full remote jobs where they work remotely. Especially now after the pandemic, a lot of positions have transitioned into remote work. So, there's plenty of people who understand the concept of, "I don't go into an office. I work fully online." And actually, my dad actually always did this. He was a programmer and he always worked from home and he would wake up at 07:00 in his pajamas and go to the office, which was just right in our house. And so, I think I had this example of someone who fully can work remotely at an early age. And it just seemed so nice. He had always had so much freedom. He could drive us places. He could take care of anything that we needed at the house. And that was great. And so, I have that full remote setup, but then I take it on the road with me so then I live in different countries.

And so, right now I've been making my way down in Latin America. I don't have an exact schedule or setup but I tend to do around one month in each country. And in that month, I get an Airbnb for a month. And then I will kind of set up my office in that Airbnb and use that as my location. But then I'll go on weekend trips to different parts of the country or even day trips and explore and use this time to really see the world as I'm working remotely.

John: I think I read a quote from you somewhere as I was researching you. Something about doing a job where you don't have to take a vacation from it. But the flip side of that coin is how do you stay disciplined? It sounds like it's fun. You pretty much wake up and go, "Well, I'm going to do this today. Because it's fun. And then tomorrow I'm going to do something different, like travel out into the country." But is there any problem with that discipline or is it just like "Hey, I look forward to doing it every day and I have a plan and it gets done?"

Dr. Chelsea Turgeon: Yeah. Yeah. And so, for me, because I am so heart driven and so connected to my business and the people I want to help and the impact I want to have in the world, I don't have a problem with feeling disciplined or feeling like I don't want to work. Sometimes I do need to reign it back and say, "Okay, I'm going to take the weekend off and it's okay to go do some other things."

I think one of the things that's the hardest for me is when I'm traveling and you meet other people who are traveling and they don't fully understand that you're also working full time and running a business. And then they'll want to go on a hike in the middle of the day or want to do things. And I can technically rearrange my schedule to some extent, but it's not like I'm here just fully on vacation.

And so, trying to explain that to people and then inevitably I don't do all of the main tourist things in every single place I go, because it's just too much. But then you interact with people and they're like, "Oh, you haven't been to this waterfall. What are you doing?" And then you start to feel like, "Oh, am I missing out? Am I doing this wrong? And so, it's kind of that FOMO that happens for me. But again, what a great problem to have you. I have to zoom out and take perspective and be like, "If that's one of my biggest problems, I'm great. That's fine."

John: Well, you have a schedule. If you're doing coaching, you have a schedule. That's partly the schedule. The other stuff that you do in social media and you're blogging, that can be worked around different things. So, it's kind of a combination it sounds like. Do you speak Spanish? Aren't you in a lot of Spanish speaking countries?

Dr. Chelsea Turgeon: Yeah. Yeah. I do speak it, not fluently and I have a hard time understanding. So, people have to talk really slowly to me, but I can definitely get around. And it's definitely transactional level Spanish. It's not super deep conversations, but I'm working on it.

John: Yeah. I might have this fantasy of moving to Italy for six months and taking classes every day and becoming fluent in Italian in six months. I don't think that's ever going to happen. But it's a dream.

Dr. Chelsea Turgeon: Yeah. Well, it's beautiful. It opens up a whole new world when you start to learn a new language. I had never learned a language before. You just learn a lot about yourself as you're going through that process.

John: All right. Well, we're going to run out of time here, my self-imposed deadline. But anyway, we got to tell people. First, everything can be found at your website, right? At coachchelseamd.com, right?

Dr. Chelsea Turgeon: Yes. That's the main hub where you have links to everything else. Yes.

John: And I think now you mentioned the podcast. How long have you been podcasting now?

Dr. Chelsea Turgeon: Since August of 2021. So less than a year now. I'm on like episode 39 or something.

John: Okay. Yeah. I was looking through it. A lot of good guests there. Are they all interviews? No, you do solo episodes too.

Dr. Chelsea Turgeon: I do a mix of solo interviews based on how I'm feeling.

John: Okay. The Life After Medicine podcast. We definitely want people to find that. And they can learn more, not only about you, but about some of the guests that you have there. And we mentioned the Facebook group that's pretty active, Life After Medicine. It's the easiest way to find that. And they can pick up your book on your website.

Dr. Chelsea Turgeon: On my website and on Amazon. You can look for "Residency Drop Out" on Amazon.

John: There's a lot that you put out in the last couple years. It's pretty amazing. Tell me more, some advice now for my listeners or people that are either burnt out or just frustrated or they're tired, or they've been working for 20 years. And to me sometimes working in medicine for 20, 25 years is you are kind of peaked and maybe you should do something else and use those skills in different ways in ways that don't make you work 60 to 80 hours a week.

So, what advice would you have for any clinician? Because you deal with all kinds of clinicians, former clinicians. What kind of advice would you have if they're feeling frustrated and they just really don't know how to get started or what to do?

Dr. Chelsea Turgeon: Yeah. The first thing I would say is honor your discontent because it matters. If you're not happy and it's not like happiness where you have to be joyful and smiling and laughing every single day. But if you are feeling burnt out and unfulfilled and discontent, more often than not that matters. And it's important to honor that and to listen to that and really give it the space that it needs. From there, if you don't know where to start, I always tell people to start with what you want. And that can feel like such a hard question, because we're not used to asking it and we're not used to answering it. We're used to talking about what's expected of me or what's the responsible thing to do or what should I do? What do other people expect from me or need from me?

But if it's important to you to feel fulfilled in life and in your career, you have to start by asking yourself what you want. And that can be a whole process. It can take some time. But that would be the primary question. Like what do I want my day to look like? What do I want my day to feel like? If I could wave a magic wand and really create anything, what would that look like? And that doesn't necessarily mean that's what you're going to go for, but that gives you insight into what is underneath, what are your desires, what do you really want. So, start there.

John: And another thing that I've heard you showed by example too, is that maybe you need to take a break to figure that out. To do it in the middle of working 60, 70 hours a week is almost impossible. You just don't have the mental energy or the time. So, in talking with your clients in whatever field, is there a certain timeframe that unless you take at least that much time, you find it works better than just sort of say, "Well, I'm going to take an hour on Saturday to have those thoughts?"

Dr. Chelsea Turgeon: I would say a month is a good, like minimum length of time. Because even for me, when I was going through my five weeks leave of absence, the first two weeks, all I really did was sleep. And I still have my journal from that time. And I was journaling and trying to figure out my life, but I was like, "But I'm so tired." And I couldn't figure anything out in those first two weeks because I needed to just get myself back to a baseline of health and be well rested. And then it was in the next two weeks that clarity really started to come for me.

John: Yeah. Because when I heard you say that, I thought, "Okay, well, here is what's going to happen. You're going to say I need to take a week off. I'm burnt out and I need to think about things. And so, during that week I'm taking my family to Disney World." No, that's not a break. That's just another week of torture.

Dr. Chelsea Turgeon: You would need a vacation from that vacation. That's for sure.

John: That's right. Okay, Chelsea. This has been very helpful, very inspiring for my listeners. I have been happy that you've been here today. I appreciate it. And with that, I'll just have to say goodbye.

Dr. Chelsea Turgeon: Yeah. Thanks so much for having me on the show. It was a great conversation.

John: You're welcome. It's been my pleasure.

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The post How You Can Forge a Wonderful Life After Medicine – 246 appeared first on NonClinical Physicians.

This week's guest explains why you must put yourself first in order to overcome burnout and “Healthcare Disease.” He is a successful academic cardiac surgeon who fell victim to both of those conditions. However, he overcame them and wrote a book to assist others to do the same. 

Our Sponsor

We're proud to have the University of Tennessee Physician Executive MBA Program, offered by the Haslam College of Business, as the sponsor of this podcast.

The UT PEMBA is the longest-running, and most highly respected physician-only MBA in the country. It has over 700 graduates. And, the program only takes one year to complete. 

By joining the UT Physician Executive MBA, you will develop the business and management skills you need to find a career that you love. To find out more, contact Dr. Kate Atchley’s office at (865) 974-6526 or go to nonclinicalphysicians.com/physicianmba.

EXCLUSIVE: Get a daily dose of inspiration, information, news, training opportunities, and amusing stories by CLICKING HERE.

Healthcare Anonymous: Put Yourself First to Avoid Anxiety, Addiction, and Burnout

Dr. Simon Maltais started writing through journaling. And he held conversations with dozens of experts on the issues leading so many healthcare workers to stress, anxiety, burnout, depression, and addiction. In turn, this system leads to devastating personal and professional consequences for healthcare workers, patients, and society. 

This book offers a guide for healthcare workers to understand these challenges and start a process of healing and recovery.  It is intended as a way to start a movement to address these challenges. It is available through all of the usual channels. And it can be purchased directly from Dr. Maltais's website here.

Highlights from the Book

1. Characteristics and personality traits. Ego, perfectionism, self-discipline, and other traits often found in healthcare workers, and that are nurtured further during training, set us up for healthcare disease.
2. The influence of the environment and the system. Long hours, little time to rest and recover, and prolonged self-sacrifice in the name of the patient, keep us from identifying early signs of stress and burnout. and more. There are also unrealistic expectations by the public. 
3. The way we interact with the system. Healthcare workers cope in ways that further interfere with balance in our lives.

Dr. Simon describes the development of healthcare disease as a process, that develops similarly to other diseases. It involves the agent, the host, and the environment.

Simon's Advice

“For physicians, especially certain types of physicians and especially the heart surgeon, being honest about having a problem, being honest about being at the end of the rope is hard. And taking a pause is even harder because taking a pause from what?…

“But I give tricks and pitfalls there on what I did in terms of removing some of the extra stuff that didn't align with where I was with my values. Basically, what you do there is you start creating time for yourself to think about those things.

“It's creating this extra space and then you have to let things go, and control your schedule.

“Once you get into that recovery, start analyzing every day, because it's like you're diabetic and you work in a chocolate factory, or you're an alcoholic and you work in a liquor store… You've got to find a way to protect yourself.”

Summary

The pain that physicians, nurses, and others in healthcare have been enduring is an epidemic and it is destroying careers and hurting patients. Healthcare workers are leaving their work in droves. Patients are unhappy because the system doesn't work for them either.

Dr. Simon's book starts another conversation intended to open our eyes to the problem, and help push for solutions. 

NOTE: Look below for a transcript of today's episode.

Links for Today's Episode:

• HealthcareAnonymous.com
• Breakthrough Points
• Simon Maltais, MD, PhD, LinkedIn Page
• Root Causes of Physician Burnout – Interview with Dr. Dike Drummond – 028
• Burnout and Career Transition – Interview with Dr. Kernan Manion – 007
• NewScr!pt

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Podcast Editing & Production Services are provided by Oscar Hamilton

Today's PNC Podcast Transcript

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Transcription PNC Podcast Episode 243

Why You Must Put Yourself First to Avoid "Healthcare Disease"

- Interview with Dr. Simon Maltais

John: I feel it is my duty to promote books written by physicians, especially when the book itself addresses burnout or some of the dysfunctional aspects of our health system in which most of us either currently or in the past have worked. That's why I'm thrilled to bring on today's guest. He just released the book called "Healthcare Anonymous: Put Yourself First to Avoid Anxiety, Addiction, and Burnout." Hello, Dr. Simon Maltais.

Dr. Simon Maltais: Hi, John. Thank you for having me on the show.

John: This is going to be really great. I love to talk to physicians that have written books, and again, particularly when they are so applicable to my audience, many of whom have gone through burnout or doing different jobs or side gigs or things to avoid it. This is going to be great. Why don't you tell us a little bit about your background, your training, your education, what kind of work you've been doing, and then what actually led you to writing the book?

Dr. Simon Maltais: Yeah. Well, thank you first and foremost for having me on the show. I'm very thankful for the opportunity, and really this has meant to really open a platform for conversation. I'm originally from Montreal, so I'm French Canadian. Sometimes if my accent comes out, it's more of a background thing than anything else.

I did my cardiac surgery turning over there. I did a PhD in biomedical engineering. I did a fellowship in heart failure, heart transplantation, mechanical heart at Mayo Clinic in Minnesota, to then start my career in Nashville in the south of the United States, at Vanderbilt University. I helped build a program there and then went back to be staff at the Mayo Clinic in Rochester for almost four or five years.Focusing my practices again on heart transplantation, mechanical heart, and then less invasive surgery and robotic heart surgery. So, pretty busy clinical practice. A fair amount of research as well. I have an interest for research and education in that field specifically, clinical outcomes mostly.

And over the past two, three years, I have had some personal and some professional challenges myself that were not all of abrupt, but were progressively affecting my practice and my overall life. It really started by journaling. It's interesting because journaling is kind of special with this book called Greenlight, where he basically reports journaling and how journaling has brought him a lot of positivity in his life.

And it's really started by journaling, writing what went wrong, what was positive, what was negative. And then all of a sudden, it started to make a lot of books and writings. And so, I thought, well, maybe I should think about maybe telling my story. And then that opened up to more conversation with people, and led to more stories that people wanted to share. I'm really fortunate to be the person that was able to bring these people together, to express what we're all feeling into a nonfiction book. And so, this is all that came together.

John: Awesome. That's very interesting. And I think you probably experienced some of the things that many, many physicians have experienced, obviously, that's I think what you're writing in the book.

Just to kick things off, I know a couple of terminology or a couple of terms I should say that I notice in the book. Just the title for example says healthcare anonymous and then healthcare disease as sort of the condition. Maybe you can start by defining those. I didn't catch the healthcare anonymously until like the third or fourth time. And I'm like, wait a second. It sounds like something else anonymous.

Dr. Simon Maltais: Well, yeah. Healthcare anonymous, it's a bit of a wing to alcoholic anonymous. It really depicts the structure of the book. I know at a certain point in my life I had to read that book. And the way the book is built, it really gives you the shades of what alcoholism can look like. It's not always when you see someone on the street and lose everything. Most people are just functional. They have jobs and things like that.

And so, the book is really about depicting those shades of burnout or anxiety or telling stories. And that's how this book is built, telling stories about people's life stories that depict some of the variations of what we can go through, through our career or through a career in healthcare. Healthcare disease, it's also sort of a term that, of course, I created. But I was trying to put together everything. The stories, what went on beforehand and when the anxiety or the burnout comes over and the recovery.

And as I was talking about building the book, it came to me pretty easy as a format to say, "Well, it's really like a disease where you have the susceptibility phase, the med school, the personality traits, the influences. Then you get into the preclinical phase where you're exposed to some of these environment changes, the constraints of a healthcare system. Then you get the disease manifestation and that's all burned out anxiety at different stories and then the recovery." That's how we just decided to build the term. To say it's a chronic adaptation problem that people develop within the system, that has both influences from the person that's in it, the environment and the way that people interact with it.

John: Yeah. Excellent. Well, I'm glad you kind of mentioned that. The way that you broke it down, because I want to ask some specific questions about each of those sections, and maybe we can highlight just to get as much as we can. Obviously, there is a lot in the book. I think it's 10 chapters and there's just a lot of background and detail, but I think the highlights will be very useful as we walk through it and give some of the listeners things to think about.

You alluded to what sets us up as healthcare workers that might be susceptible to this healthcare disease. A couple of questions. Can you go into a little more detail and also, does it affect everyone on the healthcare team? Is it the same for the nurses, for the therapists, and so forth? Does it affect doctors worse? What would you think?

Dr. Simon Maltais: Yeah, I think from that second part of the question, it's meant to be really a healthcare book. And so, while there's some doctors in the book, there's stories about different specialties, there's a technician, there are nurses talking in the book. And so, it's really expanding to healthcare workers.

The principles are the same, whether you're a doctor. Of course, there's references to medical training and what that entails and things like that. But altogether, I think a lot of the constraints that the nurses or others evolving in the healthcare systems go through are applicable to all the systems.

We really got to describe the disease manifestation as a process. That fits within a triangle. The example I give is any disease, you have to have a certain host. The person that contracts the disease. You have to have an environment. For example, E. coli, you have to have a warm environment, anything like that. And you have the agent, the bacteria.

I go through the same stuff within the book. I describe for example, what are the characteristics, what are the traits of personality that people in healthcare have in common. As a host that could put people at risk of developing the disease. And when I say disease, it is to make people realize that when it comes to the burnout or the anxiety or the addiction, that's the end result of suction, that's when the disease becomes apparent. We go into detail into ego, perfectionism, the positive and the negative stuff, the self-discipline, and the internal traits or characteristics that people have to develop or that are forced on them during medical training without necessarily the emotional maturity of being able to process them. That's the first part of the book.

Then we go and talk about the environment and we really expand that to changes in the system. Just what it looks like to work in healthcare. The long hours, having difficulties eating good food, the self-sacrifice in the name of the patient, and expanding that to the environment as a whole. The perception of healthcare from the public and how it affects us. What is represented in healthcare in those TV shows, how should it look? How does that influence people in training, people in practice? Because oftentimes you see these burnout doctors, you see people that just take on too much that have broken relationships that make out in the room, and are angry at work. And so, that's the influence that we're looking at.

Then I get into the agent and that's a bit of more of a concept, but it's the way you start interacting with the system. It's the mechanism that you develop to balance your life, to act a certain way in the system. Then the disease happens when all these three things become maladaptive together or become this regulated. That's how the book is sort of constructed around.

John: Okay. Yeah, that makes perfect sense. We'll get into, I guess the last section, which is about what we can do about it. Let me see if I have any other questions about the rest of it though. Do you think there are things that can be done even as early as med school, or even before med school to maybe pick those that aren't as susceptible to this healthcare disease?

Dr. Simon Maltais: Sorry to interrupt, but I think there's a lot of things that could be done in med school. And I remember med school or any sort of time where you get accepted into these healthcare trainings. A lot of it comes from identifying big problems, people with major issues functioning in groups. They don't really know how to select people, necessarily. Although they're getting better, some of the schools rely only on grades which is oftentimes a bad reflection of how good of a doctor you could be. I think a lot of my friends that are much more balanced emotionally stable could be better fit for medicine and for this patient sort of empathy you need to have.

That question, it could be better. I think it could be better about analyzing what are the specific characteristics or traits of character that people have that could make them a better provider or not. From that standpoint, I go over some of them. Perhaps for me, competition, perfectionism was really strong. And so, there's absolutely nothing else I would've done than heart surgery because it was cool, because it was an ego sort of boosting.

Now, thinking back now through recovery and still maintaining recovery, I realize that I'm good at different things. I pay attention to some other areas of medicine, maybe that I could have been a better use of my knowledge. And so, I think early on perhaps, helping people being influenced by people that are similar, have similar characteristics. Helping with mentors that are associated with what you want to do and identifying some of these things to sort of tone down some of these characteristics of people throughout training.

John: I think that's a great insight and I look forward to reading more about it in the book. If you ask most physicians, what they'll tell you is when they've gotten to a point where they've recognized it or in the middle of it, or have even overcome it, they will say, it's not because I'm not resilient enough, it's not because there's something wrong with me. It's because the system is completely out of whack. It's dysfunctional, expects things that it shouldn't expect, and there's no way to break out of it other than just quit. You go to get help and there's not a lot of people listening. Number one, is that true? Number two, has that changed? And have you ever seen an organization that's been really good at recognizing and addressing it?

Dr. Simon Maltais: Yeah, I think to that point, I'd say, I partially disagree. I think we have to own a part of the responsibility. Because it's always easy to say, yes, it's always easy to do more. It's always easy to put your family second. It's always easier to talk about medicine all the time, be at work and have this piece of the pie that is 90% work and 10% other stuff.

So that's on us in some ways. But it's also the way we were brought up. To put the patient first, to always do the work. I'd say I agree partially because the system is what it is. You can change it. You can swear about it. You can try to change things, but the system will change just because it's just powerful. It's this sort of machine that has to evolve over time to adapt to patients, to the economy, and things. It's the way you start interacting with it that I think is clear.

To your point, I think sometimes the only solution can be to leave it behind. I tend to be a bit more half full. I mean, for some people that will be it. And in the book, we have stories of people that have done it. We have stories of people, unfortunately, that are too late. By the time they realized they needed to do something. We have one very particular story where the wife is speaking about her husband that's now passed, from just being sick and depressed in healthcare.

But I think the better avenue is to really take a pause and maybe assess how you really interact with the system. And that's easier said than done because even yesterday I was having frustrating conversations and frustrating things at work. And I have to really reset myself because it's easy to get caught up in the vortex, I call it in the book.

But yeah, I think it does require an adjustment, how you interact with it, how you put your limits, how you scan yourself every day to see if you've done too much, not enough. That is active work. It's like realizing you're sick that you have a chronic disease to deal with, because if you get burned out, it's a chronic problem that finally manifests itself.

But then going back to the exact same place. Sometimes it's got to change. And hospitals are pretty good about pointing out when it's not well. When you come to work, you're drunk, where you sort of make mistakes, when you're angry, they point at you. And they're pretty good about that. The prevention of it, not so much.

Then the treatment of it, not so much. They'll send you the charm school. They'll check a HR box and they'll bring you right back. That part, I'm not entirely sure. And I do see some changes. Especially with COVID I think people realize that's a significant issue. And by the way, whether I do surgery through a hole like this, or a big hole like that, whether I do it with or without the pump, I don't think that's what's going to be the end of my specialty. It's how we treat ourselves and how we manage stress moving forward after all this stress over the last two years.

John: Interesting. Well, I will say to your point about maybe we need to really make better decisions about certain things. People that I talk to, physicians, who are trying to make a change, a lot of times they haven't even approached their boss, their partners with the problem, like, "Well, they're not going to care. They're not going to do anything." And in reality, when you do that and have a conversation, that's a real conversation, half the time, they'll say, "Okay, you want to cut your hours back? Okay. You want to do a job share?" There's not a lot of that, but most of us don't even think to ask about it. We just keep plugging along until it's too late.

Dr. Simon Maltais: It's too late. I think if there's some specialties that have been sort of, and I talk about historically built into that kind of mentality, where if you say "no" it's not good. Do the right thing. We used to say that. You're tired, you can't drive home because you haven't slept for 24 hours. That extra phone call, the word was DTRT - Do the Right Thing. That's how we were trained. And so, you just keep piling it on. And as I said, at some point, it's just too much.

John: Now at the end of the book, again, not having read it, which I should have gotten that Kindle version and read it before our interview here, but I've got the hard copy on order. But you come up with some suggestions, some job observations, some advice for the readers. And I didn't know if you could maybe just pick a few of those and give us some things to think about in terms of what we might do differently.

Dr. Simon Maltais: It wasn't easy to break it down because I try to build on my own experience, but I try to discern also what was common among the 20 plus stories I've had in the book. These stories are categorized into different clinical manifestations of the disease, whether it's physical, psychological, behavioral, and others, divorce and all that stuff. Which I think also is a sign of not taking care of your family and for many reasons it could lead to that. When I talk about recovery, I start from that, and then try to discern five steps that at least have helped me throughout the process. And it's not rocket science, but the first step is really to be honest and take a pause.

For physicians, especially certain types of physicians and especially the heart surgeon, being honest about having a problem, being honest about being at the end of the rope is hard. And taking a pause is even harder, because taking a pause from what? Just leave it. But I give tricks and pitfalls there on what I did in terms of removing some of the extra stuff that didn't align with where I was with my values. Basically, what you do there is you start creating time for yourself to think about those things. I'm reading this book. It talks about this space as a unicorn space. I think about it the same way. It's a bit different from what she talks about in the book, but it's creating this extra space and then you have to let things go, control your schedule. And I give tricks about that.

I think that's applicable for a lot of things in medicine. It's realizing that you are not God. And that doesn't really relate necessarily to the individual thinking he's better than everybody else. It's realizing that you are part of a process, that you are trained a certain way. Whether you're a nurse, you're a doctor, you can't control the outcome. You're just another bozo on the bus. So, you're not driving the bus, you're not following the bus. You're just another guy on the bus or a woman on the bus.

I think that when you start realizing that everybody has a role to play, first, it gives you a perspective. And it allows you to forgive yourself and to say, well, if I've done everything right, and the outcome is not good. I don't have to be angry. That's what we do. And sometimes there's an external force that's just stronger, it can take patients away or have them have complications.

I don't want to go through all of them, but I think the third most important one, I call virus scanning yourself. And it's to find time for yourself during the day, during the morning to do things that will allow you to reset time within a busy environment. And I think that's important for anything. Whether you're an athlete, whether you're a CEO, a lot of the coaching tips and pitfalls are to find a time to say, "Am I stressed today? Well, how do I feel? Where do I feel it? Is it in the back of my neck? How can I change things to feel differently?"

I think it's important steps. Once you get into that recovery, start analyzing every day, because it's like you're diabetic and you work in the chocolate factory or you're alcoholic and you work in the liquor store and you have a disease. You interact not so well with an environment and you put yourself right back into it. So, you got to find a way to sort of protect yourself. That's another big step I think that we try to identify or we try to give people insight into.

John: Yeah. And there's a whole lot more as you allude to, but I want to spend the last few minutes actually talking about the book and how to get the book and what's going on with the book. Why don't we just hit that? For the listeners, when this is being recorded, it has not been released yet, but it will have been released by the time I publish this. And I think the release date is April 5th, so it's a few days ago in the future. Where's the best place you can find the book, number one?

Dr. Simon Maltais: Well, you'll be able to find the book at most of the major stuff. It'll be distributed in all the Barnes & Nobles and the regular venues. You can have it on Amazon, Books-A-Million, and all the online things. You also can go to healthcareanonymous.com, which is a website we've created to have easy access to ordering the book. You can have order bundles, which comes with a certain work around it, where we can go to your workplace to do what's called the SWOT analysis of your workplace to try to help your team and people be better in the environment. Sometimes it's little things. It doesn't take much to make people happier and decrease turnover and certainly, it's valuable to do that.

But more importantly, I want to mention, for those of you that I think want to pass a message or start a company, I was just listening to the TED talk from Simon Sinek who wrote the book, "Start with Why." I always come back to, "Why am I doing this?" And it's not to sell books. It's not to formalize a therapy for Simon. It's to really start a movement because I do think that that's going to be the challenge for the next 10 to 20 years for healthcare, to manage the people within the system, to take care of their workers that can then overly take care of to foster.

There's not a week now, for those of you that are in the system that will resonate. There is not a week now that I hear another partner, yet another person that either leaves medicine or healthcare in general. A nurse that transfers to something for better hours, or leaves medicine altogether. A surgeon that has left another hospital for "issues."

That is the real threat I think to healthcare. There were thousands of nurses missing to take care of patients. They're out there. They just are going through something real. The real "why" on this is to raise the movement and try to have people understand that that's a real threat. We provide even more help through a site called breakthroughpoints.com where I've aligned myself with other doctors from around the country and professional athletes to raise even a bigger, because I think a lot of the themes are common, whether you're in healthcare, you're an athlete, you're a CEO, a lot of the themes are common and we're proposing a system there to help people get through this and have a better life.

John: Excellent. Yeah, that is great. I recommend people go to healthcareanonymous.com. It's a cool site and there's some testimonials and you explain a little bit about again, why you wrote the book and all that. Plus, it has the opportunity to buy boxes of copies of the book. Maybe if you're part of a team, you want to share it with other people. That would be a good starting point. I appreciate that. And I'll put the links to that and to breakthroughpoints.com in the show notes. Maybe we'll reach out to you again in a year or so and see if things are getting any better.

Dr. Simon Maltais: Yeah, this is the hope. I've gotten really good feedback and I've got a lot of opportunities now to speak and meet people and that's been great. Just spread a message of hope. One of the guys tends to summarize it pretty well. He says, we were called heroes. And now that the system has to recover from all this, there's only one word difference between "hero" and "zero". Unfortunately, that's what we're seeing. We're seeing people closing, getting fired, because they have to recuperate money somewhere from all those two years of COVID. So, it has a significant impact on everybody. I hope that your listeners will not only just get the book, but spread the message.

John: Your point is well taken. I don't think that the people in charge, whoever that is, realize the pain that physicians, nurses, others in healthcare have been enduring and the fact that they are leaving in droves and they're not being replaced effectively. And patients are already unhappy. Every patient I used to see was unhappy because I was rushed. I couldn't spend time with them. The system didn't work for them. Accidents happen, mistakes are made. Man, hopefully, something like this will be recognized and followed like you said, to fix it.

Dr. Simon Maltais: I was just reading this Harvard business review. The companies have adapted better, the tech companies. When you come in, you propose hybrid work and that kind of stuff. It's better received than our culture where there's more history where you have to wear the white coat, you had to be there in your office all day waiting. Actually, I've proposed now. I'm very fortunate. During COVID I've been proposing that model to a hospital. And actually, my three partners have the same. We're here, we work hard. We have this hybrid ability to take time off. And I think a lot of systems would benefit to have rested people and allow some of that flexibility.

John: And I think some of those big, massive companies are actually creating their own health systems like within their borders in a way, the Googles and that. Maybe that'll be an option down the road. All right. Well, Simon, I will let you get back to work. I thank you very much for talking about your book today and we'll keep an eye out to see how things progress over the coming years with this problem, not just with the sale of the book, obviously with this problem.

Dr. Simon Maltais: Well, thank you again for the invite, John. I'm very fortunate and I thank you for the invitation.

John: All right. You take care. Bye-bye.

Dr. Simon Maltais: Thank you.

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Transcription PNC Podcast Episode 233

How to Survive and Thrive on the High-Pressure Healthcare Battlefield

John: I'm really pleased to present today's guest. She's a radiologist, a podcaster, and a business owner, but her business is devoted to helping physicians find and express meaning and purpose in their lives. It's basically really sophisticated coaching services the way I look at it. Hello, Dr. Jen Barna.

Dr. Jen Barna: Thank you, John. I really appreciate the opportunity to be here with you on this podcast, which is one of my favorite podcasts. I love the concept of nonclinical career options, and I'm very excited to speak with you today.

John: Very good. Well, I'm glad to have you here because we're going to pick your brain and try and learn everything we can from you in the next 25 minutes or so. This is going to be fun. We always start out by giving you a chance to give us the short version of what you do, your education, your training, and maybe exactly how you're balancing whatever you're doing today.

Dr. Jen Barna: Okay. Well, I am a board-certified practicing radiologist. I practice part-time while I run DocWorking, which is my business. That is a business that's based on helping physicians to maximize their potential by identifying what matters to each individual person and managing time and stress, and basically keeping your eye on the prize, for what is most meaningful to you as an individual. I'm a mom, I'm a wife and all of the things that we do outside of medicine. And I'm really interested in physicians finding a way to integrate their work lives and maximize potential there while also living the best life they can outside of work.

John: Okay. Now, what I'm getting through what you just said you're doing is there's an obvious reason for it. I want to ask you a little question here, put you on the spot. What were you observing that prompted you to feel like, "Well, this is something we need?"

Dr. Jen Barna: Well, that is a great question. And for me personally, it really comes down to experiencing some burnout that in retrospect started even in medical school for me. I had both of my kids as a medical student, which was almost unheard of at the time. I've been practicing for a while now since I graduated from medical school in 2001.

When I began that journey, ultimately, I felt this constant pull between work and wanting to spend more time with my family. That was the struggle for me going through at the beginning of my career. And then as I went through my career, I think some of that actually held on, even though I began to figure out how to balance it all over time.

What I noticed is that in dealing with all of that, I felt very, very isolated, really. I didn't want to ever admit that I had any issues while I was at work. And of course, when you're at work, you're working, you don't have time to talk about it. We don't talk about it as physicians. And so, initially, I thought the best way out for me was going to be to leave medicine. And that's really how I got interested in nonclinical careers and why I find what you're doing so interesting. I became interested in business and side gigs and what other things people can do, not just as physicians, but just in general as business people. And I thought that was going to be the path I would go down. And as I began to learn over time about coaching, I began to find some really phenomenal coaches. They were able to help me to really focus on what mattered to me. And I experienced a mind shift really.

It's an ongoing process. It's not something that is just like a quick fix, but it made me realize that I didn't actually want to leave medicine. And that there's a lot of in-between. It's not just black and white. I was able to find a way to stay in the career that I love with a group that I've been with for 11 years or so, and also find a way to prioritize what mattered to me outside of work. I wanted to bring that to other physicians, and bring the value that coaching can add to our lives as physicians in a way that also helps physicians to save time. There are many coaches out there. I wanted to find the best coaches, bring them to one platform. And then when you go to docworking.com you know you don't have to spend your time sorting through thousands of people. You can go there and know that that's where you can find the best resources.

John: Very good, very good. I could tell that you went through a similar thing that I've gone through and many of my listeners have gone through and many physicians have gone through. And it's particularly difficult I think, as a woman with children in residency or medical school, that'd be just... I can't even imagine that. Closest I came was getting married while I was in med school and that was a nightmare. I find that very interesting and yes, I've talked to coaches before, but I think you've designed something that's very unique that we're going to get into, even in more detail in a minute.

But I don't think we've mentioned, except maybe briefly in the intro is that you're a podcaster. You have a podcast. I want to get that out of the way, so to speak. I don't really want to get it out of the way, but I want to talk about that for just a couple of minutes before we get into really the big topic. Did this come from the very beginning of starting your business? Why did you start the podcast and how would you describe the podcast in terms of who you interview or who you talk to and just kind of lay it all out for us?

Dr. Jen Barna: Thank you for asking about that. Our podcast is DocWorking: The Whole Physician Podcast, and it's on all of the podcasting platforms. And what we did is when I started DocWorking, I brought two phenomenal lead coaches on, Dr. Gabriella Dennery and master certified coach Jill Farmer who's nationally known as a coach and has been coaching physicians for over a decade.

I brought them together and the three of us decided to start the podcast last February because we really wanted to create content that would give physicians something that they could listen to and walk away from and put into action immediately. We do a combination of coaching topics, which relate to leadership and confidence and visioning and time management, stress management, communication. All these different topics are really helpful and you can take something away immediately.

And I also wanted to hear about the lives of other physicians, because since we don't have time to really delve into that and get to know each other often at work, I think we do as medical students and often as residents. But then when we get into private practice or into a career, you think that you're as busy as you're going to be when you're a resident or fellow. And it turns out that you are busier when you finish, which was a bit of a shock to me.

I wanted to bring physicians on and hear about their lives. It's a combination of physicians who are just at the top of their game and often have gotten there with the help of coaches. And these physicians often are using coaches in an ongoing way and hear about how they did that, and how they're doing everything they're doing, but also balancing their lives outside of their career. And then also hearing from people who are out there in the trenches, dealing with real-life in rural settings or settings all different types of ways we can practice medicine non-clinical and clinical, and even medical students, residents, all the way up to retired physicians. We really are enjoying just exploring the voices of medicine and combination.

John: Excellent. Here are my comments on that too. Of course, we're all listening to podcasts, we love podcasts and that's why we have a podcast. And I appreciate the listeners that are listening right now. I've had several guests over the last few years and many of them are podcasters, but we can all get in our little bubble. It's the bubble around John Jurika and who he knows. When I was looking and listening to some of your episodes, number one, it's just a fresh perspective. I wasn't even aware of what you were doing until just recently. And I was going through all the guests you had and 99% of those guests, I've never talked to personally.

For those listening who have heard all of my guests in the past, some of whom have been repeat visitors, there's a whole world that Jen Barna has created, and a whole new podcast with a lot of new perspectives. I think there are a lot of obviously common threads, but I would recommend people just check out the podcast just to get a whole new perspective from your whole corner of just career transition and just thriving in the general universe. That's my recommendation.

Dr. Jen Barna: Thank you very much. I appreciate it.

John: If you want to learn more, just listen to that podcast. Now, we're going to talk more about this very interesting, and I think somewhat unique approach to coaching, coaching service, and support service for physicians that come through DocWorking THRIVE. It's the main brand. Tell us again, why did you decide to do it the way you're doing it? How is it different from, let's say, other coaching programs? I know you touched on earlier, but let's get into that in a lot more detail.

Dr. Jen Barna: Thank you. Yeah. I think the main emphasis that we have in our program that makes us unique is that first of all, the coaches that we have are experienced, they already know how to get results. They have been doing this for years. They know how to work with physicians. They know the unique problems that we face. As physicians, they understand that. They understand our limitations with time.

Everything we've designed in THRIVE is created to accommodate a busy physician's schedule so that you can pick up value in very short increments based on small group coaching, and also peer support. Because again, as physicians, we often don't have that interaction at work with other physicians in a way that allows us to be vulnerable and allows us to share our struggles. From speaking with physicians across the country, I've found that people often have a sense of isolation and by being in an environment where there is peer support in an ongoing way that is facilitated by coaches, that is very valuable to the physicians who are in our group.

And additionally, we do the small group coaching that comes with an ongoing subscription. And there are several courses that are virtual courses that you can also tap into at your own whim and do however much time you have, a few minutes in this course, or that course, STAT: Quick Wins to Get Your Life Back, which was designed by master certified coach Jill Farmer and Dr. Gabriella Dennery. And then there are leadership communication and resilience courses that are built into the program.

All of these facets allow you to come in as a physician. And perhaps right now you're needing some help dealing with feelings of burnout, or maybe what you're doing is you're wanting to get that next promotion, and you want to focus your energy on that. All of the things that happen in life, maybe you're just saying like, "I don't really remember why I'm doing this in the first place. What was my purpose in this? Can I find that again?"

Whatever it is at any given time, there are always new things to focus on to really maximize your potential and figure out what matters most to you that may change over time as well. So, what matters to you now and what we can help you to achieve may change over time. That's why I wanted to create a program that's ongoing. It isn't just a course that ends. And then you get what you get out of it. We wanted to provide support in an ongoing subscription type of format.

The other concept that's different about what we're doing is it's preventive. Rather than wait until you get to a point where you're at the end of your rope, and you're having to leave medicine altogether. Although of course, everyone has their own choice. And if that's what's best for you, then absolutely, we support whatever the individual wants to accomplish. But rather than feeling like you're at the end of your rope, and you have to make decisions because you're too burnt out, we are trying to help people prevent that from ever happening. It also helps healthcare institutions and healthcare organizations, because by supporting their physicians in this way, the physicians can really thrive, which ultimately benefits the organization, and of course, benefits patients.

John: Okay. That is one of the things I noticed. I had a chance to look through some of the courses and the videos that are in there and read more about it inside. And I also noticed that somehow, you're making this available to organizations to help them with, let's say, their medical staff or their physicians are working at their clinic. How does that work? If an organization wants to implement something like this, do they just register a bunch of their physicians or how do they integrate that into what they want to do and what THRIVE does?

Dr. Jen Barna: Yes. It's very customizable in terms of how different organizations want to implement it. In an ideal world, they would put all of their physicians in it and provide this support to them, which ultimately, would benefit the organization. Some organizations are wanting to put their wellness council in so that they have the support of coaching as a backup as they are providing coaching within the organization. It's a fantastic opportunity for them.

And it's also helpful to have it as a backup for even an institution that has a strong wellness program in it, because as you know and I think all of us know, and certainly from talking with physicians, I universally hear people say, "I don't want to go for coaching inside of my own institution. I really would prefer to go outside."

It's valuable to have coaching available at an institution. But even what the wellness council coaches are telling me is that often by the time someone comes to them they are having some problems that are more serious. And again, what we're trying to do is help people never have to get to that point. We're really about helping you maximize your potential with coaching. And that can have to do with making the best of your life. You don't have to be in a difficult position trying to work out of it, although we can help with that as well.

John: Okay. Yeah. That's an awesome point. And one thing I wanted to come back to is that there are a lot of physicians that actually resist the idea of coaching. I didn't resist it in the past. I just didn't know anything about it. When I was a CMO over the hospital, of course, like many hospitals C-suite teams, we all had coaching as part of just working there. The CEO started first, he had a coach for like a year or so. And then he said, "Wait a second. I should bring this in for my team." And so, we had a coach who was coaching the team as a team and was doing individual sessions. So many businesses incorporate just constant coaching from day one so that their leaders can really move forward a little easier, a little more quickly, coaching just helps them focus and figure out what's important, what's not important, that kind of thing. I did notice that in what I was looking at on THRIVE. Do you want to comment on that?

Dr. Jen Barna: Yeah. I love that you brought that up because I am an example of a person who thought they didn't need coaching. It took me years of thinking I had figured it out and I was figuring it out and I was fine and I didn't need any outside help. And once I had some coaching and I realized what a huge mind shift it was for me, I realized, "Wow, I could have accomplished what took me 10 years to accomplish, I could have accomplished it in such a shorter amount of time if I had done this early on."

It is true that culturally within medicine, I don't think we've recognized yet as physicians, the value of coaching. And I think that there's huge potential for physicians, especially because we are lifelong learners and we have a tendency to be very high achieving individuals. And I think for people who are like that, coaching can especially provide a huge benefit. And like you say, it's well recognized in business, in acting, in sports that ongoing coaching is hugely valuable. So, it's a little bit late. We're a little bit late to the game as physicians.

John: One of my colleagues who is a physician leader, was a CMO and he's done other things. And one of the things that he does when looking for a new job is that having a coach would be a condition of his employment. That would be part of his contract. "I'm going to get regular coaching, business coaching." And I thought that was smart. Why didn't I think of that? Just build that into your employment, if you can.

Okay. Let's see. There were other questions I think I had about the program. It's kind of multimedia in a way, you've got the videos. There are certain things in coaching that come up over and over and over again. So, it makes sense to sort of put that into a video, like, okay, you're all going to have to think about this, or at least most of you, here they are. If you've already got this mastered, then just skip that lesson. Then you have group sessions, pretty much monthly. Is that how that works?

Dr. Jen Barna: Yes. With the videos, what we really are thinking, and first of all, we're in process of adding a new course, which will be available that gives CME credit that's in the portal as well. And that course is about resiliency. We, as physicians, are already resilient. It's not about needing to be more resilient.

John: I know, some people, oh boy, they get their hair off on the back of their neck when they say, we need to be more resilient. Like we are the most resilient people on the planet. But go ahead.

Dr. Jen Barna: I hear you. I feel that, yes, I totally agree with that. But this is a phenomenal course and it does help. All of our courses really are designed to give you the basic concepts of some time management skills that you can put into use right away. And all of the things we've already talked about, but also mindfulness and visioning and some tips on resilience, but also some vocabulary to use with your team, as a physician leader around resilience. And it's a bit higher level. It's not to say that you're not already resilient because clearly, we are all resilient and we are still standing here because we are. I think we're in the living proof phase of that, for sure. Now more than ever.

John: Well, let me jump in. Maybe if you even get the skills to negotiate with your employer or your coworkers in terms of like, okay, we want to promote this resilience, but resilience may need something like rest or not doing things in a dysfunctional way, fixing a process rather than just toughen it out, tough right through it.

Dr. Jen Barna: That is a huge part of our culture that I'm really interested in shifting because culturally we created it ourselves, I suppose, over hundreds of years. But what we have as a culture of self-neglect, just put everything out there on the line and don't acknowledge what you need to take care of yourself, we are seeing right now that that is not going to be sustainable. With 60% of physicians now reporting symptoms of burnout, 25% to 40%, depending on where you look, are reporting considering leaving the profession altogether.

Obviously, we need to make some changes. And what we're trying to do with THRIVE is to help people to have a fresh perspective on leadership with a concept of a new era of leadership, how we as leaders, all physicians are leaders, as we're leading teams we can help to facilitate a culture that is healthier for all of us, including our ourselves and our teams.

The idea is to empower physicians so that instead of having that sense of overwhelm, we can realize where we can make changes in our own lives. What can we change? What can we not change? And focus on what we can change. And then there's a financial part of it as well in terms of getting into a stable position financially so that you're coming from a point of power and confidence to be able to come back to the table and help change the culture of medicine in a positive way for everyone.

John: All right. I have a couple more questions, but I want to stop just for a second and say that we can find this at docworking.com. Correct? That's your website?

Dr. Jen Barna: Yes, docworking.com. And there's a button there on the homepage for THRIVE, where you can click and see more specifically about what we offer. You did ask me about the coaching and I apologize I didn't answer your question about the small group coaching, which is once a month currently. Although, the way we do it is as the group grows, we are adding more small group coaching sessions. And so, if you're in the group and you want to come to more than one session a month, you're welcome to come to any and all sessions. It's not limited to once a month.

And we are finding that some people really find value in coming to the small group coaching sessions. Some people are finding value in the courses. Some people are finding value in the Facebook group where the coaches are interacting and you can submit questions anonymously if you choose to. We have a lot of people who describe themselves as being introverted, so they don't want to come out and ask the question directly. They prefer to ask anonymously and the coaches will answer it in an anonymous way. It helps everybody.

John: Well, as far as the group coaching goes too, for those listeners who maybe have never done any kind of like a mastermind group or group coaching or anything like that, or support group, I don't want to call it that because this is not therapy. But the thing is you just attend, you don't even have to open your mouth because you just learn from the other questions that people are asking or the challenges they have, because most challenges are not really new challenges.

That's one of the reasons I like mastermind groups, although, in a mastermind group, everybody has to participate. I kind of like the situation sometimes where you have the option of participating, at least in the way I do my mastermind group. But anyway, that's awesome. You are kind of using all different techniques.

Dr. Jen Barna: We do give the option.

John: Yes. And they go to more in a month if they're happy to be more so that's cool. The other thing I want to suggest again to my listeners is I focus on nonclinical careers, of course, that's just so I can niche down and focus on one thing. But the reality is, I've talked to many coaches who, whether intentional or not, a huge percentage of the clients that are physicians end up going back to clinical medicine. Because they didn't know they could do something different clinically than what they're doing now. It sounds like you've definitely hit that group as well.

Dr. Jen Barna: Yeah. I love the concept of not having to just have one or the other. There's so much in between. And what's all of those options that are in between, that's a different choice for different people. But we as physicians have a lot of options, and from what I've seen of the people who are in THRIVE currently, I've witnessed people say at the beginning, "I feel like I need to leave medicine. I don't know what else to do." And then I've seen them over a relatively short amount of time say, "You know what? I'm rethinking that because this is part of who I am. And I don't really think I want to leave." There are ways to have it, as we say, have your cake, ice it and eat it too.

John: Nice. You kind of read my mind in answering a question I was going to pose about what have you learned from what's been going on and the people that have been through it. So, you just mentioned that one. Anything else you've learned or "aha" moments? I know just doing the podcast for me, I have all kinds of "aha" moments I didn't know that talking to different people. Either in the podcast or through THRIVE, anything else you've observed that you were surprised by?

Dr. Jen Barna: Well, if you listen to the podcast, you'll probably pick up on the fact that I'm learning literally as we are recording the podcast. First of all, I learned from the coaches, we record conversations and I'm sure you can hear that I'm just learning as we're talking because I have picked up much information. My kids are young adults and I talk with them about these concepts all the time. They're really universal concepts and I've had a lot of people reach out and say, "I'm not a doctor, but I love the concepts that you guys talk about."

So yes, I would say, I've picked up some really useful tips about ways to think about time and ways to manage time and how to focus and prioritize and understand that we only have a certain amount of time. To overbook yourself in a way that is not realistic is, ultimately, not helpful and puts you in a position of not being able to achieve what you think you should. But by the same token, you can achieve anything you put your mind to, but you really have to focus on that and prioritize it.

And the other thing I've really moved into the forefront of my mind that I've learned from the coaches is you have to prioritize your own wellness. And that's not something that I've ever been good at doing. That has been a mind shift for me as well.

John: Nice. Yeah. Those are good bits of advice from what you observed. It's true for everybody. If you don't put it on your calendar, it's probably not going to happen. I do emails every day. It's kind of stupid and crazy. But one of them I did recently was like, okay, if you want to start a habit to be healthier, here's what you have to do. Number one put it on your calendar. It's not going to happen unless you do that.

Dr. Jen Barna: Yes, I read your emails.

John: Yeah. I want to know before we go because we're going to have to end soon here. Any last bits of advice for my listeners, you kind of have a sense of the audience and a lot of them, they may be burned out, they may be just frustrated or just not happy with what they're doing. So, what would you like to tell them before we go?

Dr. Jen Barna: I would say, number one, you're not alone. You may feel isolated, but you are not alone. The struggles that you are going through are personal and I'm sure they do differ from individual to individual, but probably you may be surprised at how many of us are going through similar struggles.

And secondly, I would suggest and challenge people to be part of the change in our medical culture by getting themselves in the driver's seat of their own life. And I say that coming from a place where I've felt very overwhelmed before, and I'm very familiar with that sense of overwhelm that makes you feel like you have to make decisions based on that. You can get to a place that you don't have when you start to sort out what you can control and what's outside of your control. And it's not all black and white, there's a lot in between.

John: That is good advice and good comments. The thing about doing it for yourself is you then become a model for other people. That in itself can change the culture. And getting back to what you were talking about earlier about being leaders in doing this, well, it starts by modeling it.

I remember way back when I was still in med school, I saw an OB-GYN who worked part-time, he was happy. He loved his patience. He was never overworked, and he was like the perfect role model, but I never did follow up on how he did that. But when you see something like that, it really sticks, and maybe you can come back to that and this is something that can help. Oh, we forgot to mention too, that Jen has given us a little boost here, a little opportunity to try THRIVE at a little reduced rate, which is nice. I think you said that if they go in there, they like what they see, they decide they're going to sign up, and they can use a coupon code TWENTYOFF.

Dr. Jen Barna: Yes. And it's spelled out T-W-E-N-T-Y O-F-F.

John: Okay. I'll put a reminder in the show notes too, but if you're in there and you say this really looks for me and oh, I can get twenty off, then I'm going to use a coupon code TWENTYOFF. That's fantastic. I appreciate that.

Dr. Jen Barna: Yes. And I appreciate you being in the group. The current cohort of THRIVE members is just full of really phenomenal people. And having that support from other physicians to find out "What did you do? How are you doing that?" is really valuable in and of itself.

John: I've done some of the courses. I've got to sign up for one of those monthly group meetings.

Dr. Jen Barna: There's one next week.

John: I'll look for that. Awesome.

Dr. Jen Barna: Yeah. I hope to see you there.

John: All right, Jen. Thank you very much for being here today. I've really enjoyed it. I think the listeners have learned a lot. We will have to catch up again sometime down the road.

Dr. Jen Barna: Definitely, John. Thank you very much for the opportunity to speak with you. I love your podcast. I recommend it on my podcast, which is DocWorking: The Whole Physician Podcast. And listening in the near future you will hear Dr. John Jurica as a guest on DocWorking.

John: Yes, that was fun too. All right. Thank you, Jen. Take care and bye-bye.

Dr. Jen Barna: Thank you.

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Disclaimers:

Many of the links that I refer you to are affiliate links. That means that I receive a payment from the seller if you purchase the affiliate item using my link. Doing so has no effect on the price you are charged. And I only promote products and services that I believe are of high quality and will be useful to you.

The opinions expressed here are mine and my guest’s. While the information provided on the podcast is true and accurate to the best of my knowledge, there is no express or implied guarantee that using the methods discussed here will lead to success in your career, life, or business.

The information presented on this blog and related podcast is for entertainment and/or informational purposes only. I do not provide medical, legal, tax, or emotional advice. If you take action on the information provided on the blog or podcast, it is at your own risk. Always consult an attorney, accountant, career counselor, or other professional before making any major decisions about your career. 

The post How to Survive and Thrive on the High Pressure Healthcare Battlefield – 233 appeared first on NonClinical Physicians.

Pennie Sempell has spent much of her adult life answering this question:  How do I boost my resilience? In today’s interview, she explains what she and her colleagues have produced to answer that question.

Pennie Sempell completed her undergraduate degree in Psychology and her law degree at the University of California.

She is the co-founder and CEO of StressPal. The company recently released its proprietary program designed to improve psychological flexibility.

Our Sponsor

We're proud to have the University of Tennessee Physician Executive MBA Program, offered by the Haslam College of Business, as the sponsor of this podcast.

The UT PEMBA is the longest-running, and most highly respected physician-only MBA in the country. It has over 700 graduates. And, the program only takes one year to complete. 

By joining the UT Physician Executive MBA, you will develop the business and management skills you need to find a career that you really love. To find out more, contact Dr. Kate Atchley’s office at (865) 974-6526 or go to nonclinicalphysicians.com/physicianmba.

For over 25 years Pennie has provided training in stress resilience, health advocacy, and conflict resolution. Her students are primarily medical professionals in hospital and outpatient settings. She is a professional mediator and pioneer in integrative health education. And she has authored and produced multiple award-winning multimedia tools for adults and children in behavioral medicine topics.

Can I Boost My Resilience?

StressPal brings behavioral health training tools to fight stress-related conditions. It is an interactive program that applies evidence-based interventions. Fortunately, these tools enable clinicians to change how they respond, adapt to, and recover from stressors.

In a nutshell, it is an evidence-based, self-paced, multimedia program designed to prevent and overcome burnout.

Psychological Flexibility Can Be Improved

The root cause of burnout is the unrealistic conditions under which physicians often work. Yet, some physicians seem to remain psychologically unscathed, while others suffer tremendously from the stress of their jobs.

Psychological flexibility is an attribute that can prevent burnout, and allow us to think and plan more clearly. Hence, this flexibility allows us to deal with stressful situations we cannot avoid. Improving our resilience can also provide the focus needed to pursue an alternative work environment if it is truly toxic.

Be aware of these three core strategies:

• cultivate self-awareness…
• assess what you value… what's important to you?… what do you stand for?
• and answer this question: what is your willingness to flexibly try a more workable strategy?

StressPal is a program with tools to address these concepts and enhance our resilience in stressful situations.

Summary

You can learn more about StressPal, and how it can be used to fight burnout in your practice or hospital by going to stresspal.com. StressPal is one of the most innovative programs I've seen to boost my resilience and that of my colleagues.

Links for Today's Episode:

• StressPal
• Persistent Stressors and Resilience on KevinMD
• Combating Burnout in Frontline Workers: The Clinical Case for Resilience Training on Physicians Practice
• The Best Solution to Burnout Is an Interesting Side-Gig
• Root Causes of Physician Burnout
• Burnout and Career Transition
• Email Penny Sempell at training@stresspal.com

Download This Episode:

Right Click Here and “Save As” to download this podcast episode to your computer.

Podcast Editing & Production Services are provided by Oscar Hamilton

Disclaimers:

Many of the links that I refer you to are affiliate links. That means that I receive a payment from the seller if you purchase the affiliate item using my link. Doing so has no effect on the price you are charged. And I only promote products and services that I believe are of high quality and will be useful to you.

The opinions expressed here are mine and my guest’s. While the information provided on the podcast is true and accurate to the best of my knowledge, there is no express or implied guarantee that using the methods discussed here will lead to success in your career, life, or business.

The information presented on this blog and related podcast is for entertainment and/or informational purposes only. I do not provide medical, legal, tax, or emotional advice. If you take action on the information provided on the blog or podcast, it is at your own risk. Always consult an attorney, accountant, career counselor, or other professional before making any major decisions about your career. 

The post How Can I Boost My Resilience? – 183 appeared first on NonClinical Physicians.

Today’s guest found a new passion and learned how to offer help for burned-out physicians, as a result.

Jill obtained her medical degree from Emory University School of Medicine. Then she completed an Internal Medicine Residency at the University of Washington Medical Center, in Seattle.

She worked as a hospitalist and Director of Education in her division at a Chicago area academic center. Unfortunately, she also developed significant levels of frustration and overwhelm. In our interview, she describes how she discovered a way to reduce her feelings of overwhelm. Subsequently, that took her career in a new direction.

Our Sponsor

We're proud to have the University of Tennessee Physician Executive MBA Program, offered by the Haslam College of Business, as the sponsor of this podcast.

The UT PEMBA is the longest-running, and most highly respected physician-only MBA in the country. It has over 700 graduates. And, unlike other programs, this program only takes a year to complete. Economist Magazine recently ranked the UT Haslam Business School #1 in the world as the Most Relevant Executive MBA.

By joining the University of Tennessee Physician Executive MBA, you will develop the business and management skills you need to find a career that you really love. To find out more, contact Dr. Kate Atchley’s office at (865) 974-6526 or go to nonclinicalphysicians.com/physicianmba.

Today, Dr. Jill Wener explains how she found and fell in love with Vedic Meditation. After beginning her daily meditation practice, the stress and burn out she was experiencing melted away. Later, she discovered that she could help others by teaching them how to meditate. 

Jill Provides Help for Burned-Out Physicians

Jill started teaching meditation to provide help for burned-out physicians. Over time, she became a clinician wellness expert. Now a nationally-renowned expert in physician wellness, Jill has published several articles on KevinMD.

She leads physician wellness programs around the country. And she lectures at the national level on stress and the benefits of meditation and tapping. She has also been interviewed on TV and radio, and on numerous podcasts.

In addition to her online and in-person meditation and tapping programs, Jill leads meditation retreats all over the world. She is the co-founder and Chief Wellness Officer of the TransforMD Mastery Retreat for Women Physicians. She also hosts the Conscious Anti-Racism podcast.

During the interview, Jill explains the healing benefits of meditation and tapping. She also describes the transformation she has experienced, and of others she has helped.

Summary

I feel as though I have just barely scratched the surface with Dr. Wener. You can learn more by following the links below. You can also find Jill on social media on LinkedIn, Instagram, and Twitter. As she mentioned, she has a page just for physicians at jillwener.com/for-doctors/.

Remember, too, that Jill is a Mentor for the Clinicians Career Cooperative, an online forum where you can learn about dozens of nonclinical and unconventional careers for clinicians from 15 career experts. It's another way that she finds to offer help to burned-out physicians.

Look for the Category called Clinician Wellness to reach out to Jill in the Cooperative. The low monthly membership fee is slated to increase in January 2021 so sign up now if you want to lock it in.

Links for Today's Episode:

• Conscious Health Meditation + Wellness – Dr. Jill Wener's Website
• Jill Wener's Doctor's Page
• TransforMD Mastery Retreat for Women Physicians
• Conscious Anti-Racism Podcast
• Jill Wener's LinkedIn Page
• Jill Wener's Instagram Page
• Clinicians Career Cooperative

Download This Episode:

Right Click Here and “Save As” to download this podcast episode to your computer.

The Nonclinical Career Academy Membership Program recently added a new MasterClass!

I've created 18 courses and placed them all in an exclusive, low-cost membership program. The program provides an introduction to dozens of nontraditional careers, with in-depth lessons on several of them. It even includes my full MSL Course. There is a money-back guarantee, so there is no risk to signing up. And I'll add more courses each month.

Learn more about the Academy at nonclinicalphysicians.com/joinnca. It will be closing to new members on December 11, 2020, so start the new year right by signing-up and beginning YOUR career journey now! It's a great gift to give yourself.

Thanks to our sponsor…

Thanks to the UT Physician Executive MBA program for sponsoring the show. It’s an outstanding, highly rated, MBA program designed for working physicians. It is just what you need to prepare for that fulfilling, well-paying career. You can find out more at nonclinicalphysicians.com/physicianmba.

If you enjoyed today’s episode, share it on Twitter and Facebook, and leave a review on iTunes.

Podcast Editing & Production Services are provided by Oscar Hamilton

Disclaimers:

Many of the links that I refer you to, and that you’ll find in the show notes, are affiliate links. That means that I receive a payment from the seller if you purchase the affiliate item using my link. Doing so has no effect on the price you are charged. And I only promote products and services that I believe are of high quality and will be useful to you, that I have personally used or am very familiar with.

The opinions expressed here are mine and my guest’s. While the information provided on the podcast is true and accurate to the best of my knowledge, there is no express or implied guarantee that using the methods discussed here will lead to success in your career, life, or business.

The information presented on this blog and related podcast is for entertainment and/or informational purposes only. It should not be construed as medical, legal, tax, or emotional advice. If you take action on the information provided on the blog or podcast, it is at your own risk. Always consult an attorney, accountant, career counselor, or other professional before making any major decisions about your career. 

The post Can Meditation Offer Help for Burned-Out Physicians? – 172 appeared first on NonClinical Physicians.