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Welcome to the Clinician Researcher podcast, where academic clinicians learn the skills

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to build their own research program, whether or not they have a mentor.

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As clinicians, we spend a decade or more as trainees learning to take care of patients.

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When we finally start our careers, we want to build research programs, but then we find

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that our years of clinical training did not adequately prepare us to lead our research

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program.

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Through no fault of our own, we struggle to find mentors, and when we can't, we quit.

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However, clinicians hold the keys to the greatest research breakthroughs.

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For this reason, the Clinician Researcher podcast exists to give academic clinicians

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the tools to build their own research program, whether or not they have a mentor.

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Now introducing your host, Toyosi Onwuemene.

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Welcome to the Clinician Researcher podcast.

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I am your host, Toyosi Onwuemene, and I'm super, super excited to be bringing you this episode

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because I have a unique guest on the show, Dr. Mary Leung.

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Mary, welcome to the show.

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Thank you so much for having me today.

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Although Mary, you're a unique guest on the show because I've usually interviewed a lot

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of clinician scientists, and you are a clinician who actually helps clinician scientists do

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their job better.

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So I want you to just introduce yourself to the audience and tell us about what you do

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that is relevant to our audience.

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Yeah, sure.

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So I am Mary Leung, and I am a hematologist and medical oncologist for adults, and I am

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also a life coach for physicians.

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So during the day, my full-time job is I'm a clinician.

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I mostly do clinical work.

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I don't really do research, and that's what Dr. Tiosi is doing.

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And so I work full-time.

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I see 20-some patients a day.

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And during my spare time, I actually help physicians who have trouble getting their

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work done on time to go home on time and have better management be more efficient during

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their clinical time so that they can do whatever they want outside of the clinical hours.

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And your situation is really to do more research.

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Awesome.

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Okay, Dr. Mary, this is really, really helpful.

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And I want to thank you because what you help people do, you help people close their charts

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on time.

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So that they can go home and do all the other things they want to do.

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And in this case, from my audience, it's clinicians who want to be able to do more research.

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And so many of my clinician audience, many members of my clinician audience are actually

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full-time clinicians who are trying to make the transition to research.

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And so being able to shrink their workload into the time allotted for it is very difficult.

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And many of my clinicians say, I don't have enough time.

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I can't do research because I'm so busy clinically.

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I am excited to hear what you're going to share.

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So how do you do it?

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How do you...

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You're seeing 20-some patients a day and you're closing charts before the day is done.

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Some of my clinicians are not seeing that many patients and they're struggling.

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So how do you do it?

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How do you close your charts on time?

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Yeah.

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So I think I'll start off with, I'll just share with you a little bit about my own journey.

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So not too long ago, I was actually in a similar situation that...

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I mean, I was still working full-time, seeing 20-some patients, but I wasn't able to leave

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work around five o'clock.

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I would start seeing my first patient at eight o'clock and my last patient was supposed to

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be done by around four, but I would still be charting, answering phone calls, doing

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all these other things up till past seven.

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And then at that point, I told myself that while I really wanted to see my kids before

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they don't recognize me, and I would just go home, spend some time with them.

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And when they went to bed, I would be charting some more.

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That was miserable.

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And so I wasn't really living life.

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I felt like I didn't sign up for this and how did I get into this?

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I felt like I was stuck.

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I was frustrated.

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I was angry.

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All these negative emotions until the pandemic came and I had a taste of going home on time

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because I was just seeing a third load of the patients during that time.

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I mean, I wasn't in the first line of defense in terms of the pandemic, so we were just

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trying to see all the chemo patients and whoever that really absolutely needed to be seen.

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So I thought, what if I could do this, going home on time while seeing a full load of patients?

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And that would be amazing.

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So during that time, I had opportunities to explore other things outside of medicine.

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And I came across something called life coaching and I had no clue what that was, but I thought

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anything, I would try anything to make my life better or just to make my life to be

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something that I was living and not just going through the motion.

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So I did and I joined this coaching program and I was working with one of the coaches

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to because my biggest obstacle at that time was really just to finishing my work on time.

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So in about three months, actually under three months, I just slowly went a little bit faster,

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a little bit faster.

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And three months later, I was able to go home on time, basically 5, 5.30 with all my charts

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done and I'm not taking work home with me.

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Wow, Mary, that's such a great story.

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As you were sharing your story, I'm resonating.

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I spent three days once in my office, I spent the weekend in my office just trying to close

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charts.

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And I know that there are clinicians out there who are literally on the hamster wheel of

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trying to close charts.

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How did you do it?

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How did you go from staying late every time to being able to go home on time with charts

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closed?

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Yes, and with seeing the same number of patients.

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So it actually all starts with how you start your day.

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And this is how I also guide my physician clients during our one-on-one coaching program.

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It's how you start your day is very important.

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When you wake up, the first thing you do in the morning, what do you think about?

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If you're thinking that, oh, I have too many patients to see, or if you're thinking that

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I can't possibly close all my charts on time, then you're already starting on the wrong

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foot.

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So say if you're thinking that today is going to be a manageable day, how are you going

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to feel?

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You're going to feel probably more calm, more peace than, say, if you think that I'm not

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going to be able to go home on time, you're probably going to feel something along the

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lines of frustrated or anger or something kind of unpleasant or negative.

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So we as human beings are driven by our emotions.

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And I think it is very helpful to have somewhat of a positive or more pleasant emotion to

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be your fuel, to be your driver throughout the day.

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So how you start your day is very important.

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And of course, that's kind of like, because we're thinking about different things all

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day long.

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Sometimes we don't even think or we're not even aware of what we're thinking.

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And so be really mindful of what you're thinking and how you're thinking about things, because

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that really affects your performance and what you do and how you do things.

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So that's the first things first.

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Second is that you tell yourself that you're able to handle the day.

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And so you want to see the patient and do the charge right away.

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So one of the biggest mistakes that I've had in the past was that I thought that I had

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to keep my patients to be as close to the scheduled time as possible, because I thought

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that if I didn't do that, I was a bad physician.

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And so how I changed for that was I sacrificed my own time.

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And so in the beginning of the day, I would be able to really finish most of the patient's

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shards after they were being seen.

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And then usually as the day went on, especially the second half of the day, I had trouble

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and I thought, oh, I was already running late, 15, 20, 30 minutes late.

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No, you know what?

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I'll just finish the charts later so I could bring in the next patient.

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And what ended up happening was at the end of the day, I would still have sometimes five

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charts, not too bad.

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Sometimes it would be 10 charts or 13 charts.

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And I started to feel tired.

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I was frustrated.

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I thought that I should have finished those charts already, but I still have so many charts

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to do.

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And my brain was slowing down.

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I was getting tired.

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So it would take me two or three more times the time that I would use to finish the chart

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if I finish it right then and there.

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So seeing the patient, doing a chart right away is very important because it's so fresh

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on your mind and it is okay.

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Just give yourself some grace.

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It is okay to let the next patient wait for a little bit because guess what?

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When you're done with this patient and the chart, then you can 100% focus on the next

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patient and not think about, oh, I forgot to write that.

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I, you know, forwarded that other patient.

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So I think it's important to do that.

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And the next thing is really to be really, really focused on doing one thing at a time.

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I know, you know, we physicians, we think that we can multitask, we can do a lot of

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different things at the same time.

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But what we're doing is actually we're task switching, meaning that our brain is just

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kind of switching from one thing to another.

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And it actually takes time for your brain to recover from one event to another.

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So if you do that multiple, multiple times during the day, you actually spend more time

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to do one thing or to do the three things that you wanted to do.

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So I think that, you know, those are really very, very helpful things that help me to

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cut down on my, you know, clinical time.

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The other thing is also a lot of, I think a lot of us are doing really outpatient work.

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So for outpatients, you know, you have your set schedule.

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And also you usually have staff members working in your clinic, you know, say the medical

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assistants, nurses, or the front desk.

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So I think one of the things really, really helpful is to minimize the interruptions that

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are created by your staff members.

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So, you know, it will be helpful to have kind of a protocol to let them know when to absolutely

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necessarily interrupt you during, while you're seeing patients, as opposed to every single

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phone call to find you.

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You know, sometimes they may be already taken care of by your nurses or if you have PAs

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or MPs, you know.

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So have a protocol set that will be very helpful.

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And also in terms of interruption, to not to interrupt yourself, meaning that, you know

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what, in the middle of seeing patients or in between seeing patients, minimize the really

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the time that you use to check emails or go on social media, you know, just really avoid

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that temptation.

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So I think with kind of like these kind of like the outlines of what I do and what I

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teach other physicians to do, and I think just even implementing two or three things

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that will be really, really helpful.

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Wow, Mary, thank you so much.

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You've given so much and having like my mind blown in this moment.

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Okay.

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So the first thing I'm hearing you say is, to some extent, to summarize everything you

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said, it's like you've got to be very focused and intentional about ending the day with

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your charts closed.

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It's like your mission.

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So because it's your mission, your first start to the day, the way you even think about your

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day has got to be that it's possible, you're able to do it, and none of the negative, oh

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my gosh, I can't believe how many patients I have, it's going to be another terrible

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day.

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It's really preparing your mind for the mission of closing charts by the end of the day.

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Then I also hear you talk about how it's okay, your patients are, you're going to be a few

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minutes late to the next patient and it's going to be okay, because by the time you

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get to the next patient, you'll have that chart done.

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And that's important rather than saying, I'll just leave it till the end of the day when

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it's your time and then you're the one kind of, and you're tired, your brain can't do

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as much because you've left it all to the end of the day.

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So the importance of not letting the anxiety of, oh my gosh, the patient's waiting, I can't

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finish this, for you pushing it away so that you can focus.

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And then I also hear you say the task switching, oh, that's such a big one.

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I have some follow-up questions from this one where either your staff are interrupting

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you or you're interrupting yourself.

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Okay.

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So one of the thoughts, the questions that came to my mind is, what if you're in a big

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work room and you have all these, your colleagues are in the room, your PAs and MPs are in the

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room, how can you work in a work room full of people and still be able to focus on getting

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the notes done?

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What do you recommend?

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I think one of the things is, if you're all working together, it may be helpful to have

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kind of like a regular meeting from time to time to see how we can all improve things.

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Because you know what, if you help each other do things better, you all win.

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So in a room like that, sometimes you may have informal discussions, and maybe we can

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just kind of like set an informal rule in a sense that just to say that, hey, unless

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it's necessary, we'll try to just do this work thing together, but individually, as

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opposed to be kind of constantly interrupting each other.

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Because I think that of course sometimes there could be some more urgent things that of course

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there are always exceptions.

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But I think in terms of the workflow and who you're working with and how the day goes,

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it's of course, sometimes you have to individualize and tailor to the culture of the work.

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But I think as physicians, you're kind of like leaders for your staff or for your PAs

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and MPs.

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So in a sense, sometimes it's an experimental thing.

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You may try something to see if that works, if it works great.

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If not, then maybe you just want to tweak it a little bit.

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So I think that just reminds me of how, because sometimes I do do inpatient work.

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I think once about every eight weeks or so, and I'll spend Monday through Friday just

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inpatient and I will be working in a work room with other clinicians also.

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And we just kind of do our own thing.

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Sometimes some people like to chat and I would just kind of politely either say, let me finish

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this first because I really want to finish my thought before talking about things.

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And I think after a while, if you do it more like that, people do realize that, hey, you

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know what?

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We kind of try to respect one another's time and we try to get things done.

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Wow.

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Thank you for sharing that, Mary.

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As you're talking, what I'm hearing is that it's a cultural shift, right?

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It's shifting the way you believed up until this point or behaved up until this point.

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Because up until this point, if you're struggling to close charts, you're struggling to close

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charts because your process currently doesn't work for you.

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But in order for you to get to a point where you're telling your staff, don't interrupt

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me except for these elements or the people working in the work room with you, hey, I'm

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finishing a thought, give me a few minutes.

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It's not something we're used to doing.

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I think as physicians, we're very much like, oh, I'm always available to help you at all

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times.

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And sometimes that, you know, now shifting to a place where it's almost, it almost feels

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like being selfish.

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Can you speak to that kind of mindset?

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Because I think as clinicians, we feel like we should always be available and always be

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able to help, but it does impede us from finishing our work.

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How do you overcome that mindset?

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Oh, yeah, it took me a while.

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So it is very true because, you know, we're always kind of, I think, taught indirectly

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that we should always be available, you know, even sometimes even after hours, we should

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be available.

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And that is kind of the biggest lie.

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I would say, you know, of course it takes a while to really realize that it doesn't

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have to be the case.

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During your work hours, of course, you know, it's very helpful to be available, you know,

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as much as you can, but at the same time is if it's after hours, if you're not on call,

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you know, it's okay not to answer a page or call or you redirect to whoever is on call

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because otherwise, you know, are you going to really, if you enjoy doing that, that's

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my guess.

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But if that's not something that you want to do or if that's not something that is in

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alignment with your values because you want to spend time, you know, for whatever you

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enjoy doing or with your family, then, you know, I think it is important to really have

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a very clear boundary that you're giving out, you know, not a wishy washy one, but, you

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know, let people know that when you're on duty, you're 100% available, you know, of

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course, you have your own work to do, like say if somehow something about research is

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contacting you while you're seeing patients, you know, depending on the severity of the

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situation, you may want to just finish seeing that patient first and then answer to that

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call as opposed to interrupting the whole patient encounter to answer that call.

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So I think that just, you know, it takes practice to even to rewire our long time thinking to

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say that, hey, you know what, we're going to be doing our best and we're going to be

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available for however much that, you know, we're responsible for.

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And outside of that, it is okay to have your own time and be your own person.

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And we don't have to please everybody all the time.

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You know, of course we, you know, we're team players.

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We work well with other people.

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That doesn't mean that you have to be available 24 seven.

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Wow.

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I love, I love, I just love all the, all the insights that you're sharing and I can, I

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can already hear people's hearts pumping faster and saying, what you mean?

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Is it, is it okay for me to, to not be available 24 seven?

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And again, it goes, it's counter cultural, but you know, as you're alluding to, it's

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like the other work you have to do is important too.

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And so being able to fit the work that you're supposed to do at this time, within this time

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helps you be more effective in all your other jobs because spending time with our families,

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for many of us, we're still working even as we're doing that.

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Or for many of my clients who are also scientists, like spending, spending time away from clinic

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many times means more time to actually do the science that you came to do.

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And so, wow, how important it is to be able to establish those boundaries so that we can

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do well in both jobs because, oh my gosh, to be able to close charts by the end of the

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day, everybody loves a clinician who can close charts and, and for clinicians to walk away

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from their clinic, to be able to go do their science, that's an important thing as well.

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But it definitely will take a lot of work.

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And that's why you're a coach.

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That's why you support people to do this work that is super hard to do on their own.

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So I want to ask you, like if people who are listening want to work with you, how do they

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do that?

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Thank you for mentioning it.

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So before that, I do want to add one more thing is that, yes, how we start our day is

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very important and kind of like have a goal in mind, you know, that think about why you

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want to finish your charts on time.

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You know, you want to finish your charts on time so that you can enjoy time with your

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family or I want to finish my charts on time so that I can have more time to do my research

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that I really want to do, you know, something positive.

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So it has, you know, got to be something that is a strong enough motivation throughout the

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day.

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And you remind yourself that, you know, I'm finishing my chart on time so that, you know,

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you fill in the blanks.

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So I think that will also generate more of a positive feel like such as focus, determination

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or confidence, you know, that you need to be your fuel to see the patient, do the charts

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and finish your clinic on time.

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And I think, you know, this is not something that happens overnight and it may take weeks

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or even longer, especially if you have hundreds of charts open.

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And I do have, you know, people that have, you know, hundreds of charts open and you

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have to kind of like backtrack and slowly close them up.

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It is doable.

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It is doable.

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So I encourage you all to really try, you know, what we talked about today.

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And I am not really anyone special.

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I know Dr. Toyosi said I'm unique and thank you.

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I think everyone is unique, but I'm not, you know, I'm not someone with super power.

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It's just shifting our mind to think and focus on what we need to focus.

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So I think for physicians who are interested to know more about me, can visit my website

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at www.shiningwithgratitudemd.com and you're welcome to also email me to find out more

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about my one-on-one physician coaching program.

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And the email is shiningwithgratitudemd.gmail.com.

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I do write two blocks a week and you can find me on LinkedIn at MarylandMD or Facebook Maryland.

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Mary, that is so awesome.

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I just feel like your work is so important, even for clinicians who are not trying to

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be scientists, clinicians who are just trying to get their lives back, right?

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Just being able to close charts.

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And I'm hearing you say that even if you have hundreds of charts open, and it sounds like

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you had clients or at least a client or two who's had hundreds of charts open, it is possible

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to get them closed and stay caught up forever with the strategies that you teach.

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I wonder if you just want to, in closing, just encourage the provider who is a couple

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of tens of, you know, actually maybe a couple of hundred charts behind and just encouraging

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them about what's possible with your strategies to help clinicians close these charts and

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stay on top of their charts.

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You know, looking back, I think in the beginning of the journey before coaching, I didn't think

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that it was possible for me to go home before seven o'clock.

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I thought going home at seven o'clock without any work, you know, left behind, that was

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already amazing.

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But now I'm going home at five.

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I'll just say, yeah, really five and sometimes a little bit earlier even, after seeing 20

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some patients, I can never go back to where I was.

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It's you know, you get transformed to be someone totally different.

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You have a new identity because you're the patient, I mean, you're the physician who

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finishes your work on time and you're not bringing any work home.

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So I think that it's start with the belief that it is possible.

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Don't think of it how, just yet.

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Just believe that it is possible because when you have the strong belief, you're going to

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work toward it.

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You know, it's just like the book, I forgot which book, I apologize, you know, the formula,

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the miracle equation, I think it's the unwavering faith.

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And with the extraordinary effort, you're going to create a miracle.

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And of course, finishing sharp on time, it may sound like a miracle right now.

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It did sound like that to me, but it is possible.

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And just what we talked about during this session is it's really, it sounds kind of

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simple.

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It is not the easiest thing to do, but it is totally doable.

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So I encourage, you know, physicians who have hundreds of charts left behind, just do it

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little by little, you know.

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It's kind of like when we encourage patients to lose weight, when you tell them to lose

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50 pounds, it sounded very, very scary.

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And if you tell them to say, hey, how about one to two pounds a week?

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I would just say most people say that, yeah, it's doable.

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So it's the same thing, you know, maybe instead of going home two and a half hours earlier

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than you normally do, try 15 minutes at a time.

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It's doable.

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I love it.

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I love it.

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This is going to change people's lives.

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Mary, thank you so much.

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Wow.

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You just shared some really amazing insights and I feel like it is going to liberate so

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many clinicians who feel like I just am too busy clinically.

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There is no way I can move on to do my research.

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And it sounds like it's possible.

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You can help them.

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And definitely I will add your information to the show notes so that they're able to

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connect with you as well.

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Mary, it's just been such a pleasure having you on the show.

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Thank you so much for just the insight that you provide to clinicians.

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You're changing lives and I just want to appreciate you for coming on the show and sharing your

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insights.

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For having me.

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All right.

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Everybody, you've heard Dr. Long.

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It is possible.

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You can do this.

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You can close your charts and keep your charts closed so that you can be liberated to do

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all the other work that you want to do.

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And so definitely connect with Dr. Long, make an appointment and she's the person for you

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to help you get charts closed and keep them closed.

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Thank you everyone for listening.

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Mary, thank you for being on the show and I look forward to connecting with you all

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the next time.

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Thanks for listening to this episode of the Clinician Researcher Podcast where academic

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clinicians learn the skills to build their own research program, whether or not they

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have a mentor.

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If you found the information in this episode to be helpful, don't keep it all to yourself.

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Someone else needs to hear it.

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So take a minute right now and share it.

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As you share this episode, you become part of our mission to help launch a new generation

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of clinician researchers who make transformative discoveries that change the way we do healthcare.