Interview with Dr. Frieda Wiley
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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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:
- depression,
- feelings of isolation,
- trouble unplugging from the online world,
- lack of external stimulation, and
- 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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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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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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