Welcome to the Clinician Researcher podcast, where academic clinicians learn the skills
to build their own research program, whether or not they have a mentor.
As clinicians, we spend a decade or more as trainees learning to take care of patients.
When we finally start our careers, we want to build research programs, but then we find
that our years of clinical training did not adequately prepare us to lead our research
program.
Through no fault of our own, we struggle to find mentors, and when we can't, we quit.
However, clinicians hold the keys to the greatest research breakthroughs.
For this reason, the Clinician Researcher podcast exists to give academic clinicians
the tools to build their own research program, whether or not they have a mentor.
Now introducing your host, Toyosi Onwuemene.
Welcome to the Clinician Researcher podcast.
I am your host, Toyosi Onwuemene, and I'm super, super excited to be bringing you this episode
because I have a unique guest on the show, Dr. Mary Leung.
Mary, welcome to the show.
Thank you so much for having me today.
Although Mary, you're a unique guest on the show because I've usually interviewed a lot
of clinician scientists, and you are a clinician who actually helps clinician scientists do
their job better.
So I want you to just introduce yourself to the audience and tell us about what you do
that is relevant to our audience.
Yeah, sure.
So I am Mary Leung, and I am a hematologist and medical oncologist for adults, and I am
also a life coach for physicians.
So during the day, my full-time job is I'm a clinician.
I mostly do clinical work.
I don't really do research, and that's what Dr. Tiosi is doing.
And so I work full-time.
I see 20-some patients a day.
And during my spare time, I actually help physicians who have trouble getting their
work done on time to go home on time and have better management be more efficient during
their clinical time so that they can do whatever they want outside of the clinical hours.
And your situation is really to do more research.
Awesome.
Okay, Dr. Mary, this is really, really helpful.
And I want to thank you because what you help people do, you help people close their charts
on time.
So that they can go home and do all the other things they want to do.
And in this case, from my audience, it's clinicians who want to be able to do more research.
And so many of my clinician audience, many members of my clinician audience are actually
full-time clinicians who are trying to make the transition to research.
And so being able to shrink their workload into the time allotted for it is very difficult.
And many of my clinicians say, I don't have enough time.
I can't do research because I'm so busy clinically.
I am excited to hear what you're going to share.
So how do you do it?
How do you...
You're seeing 20-some patients a day and you're closing charts before the day is done.
Some of my clinicians are not seeing that many patients and they're struggling.
So how do you do it?
How do you close your charts on time?
Yeah.
So I think I'll start off with, I'll just share with you a little bit about my own journey.
So not too long ago, I was actually in a similar situation that...
I mean, I was still working full-time, seeing 20-some patients, but I wasn't able to leave
work around five o'clock.
I would start seeing my first patient at eight o'clock and my last patient was supposed to
be done by around four, but I would still be charting, answering phone calls, doing
all these other things up till past seven.
And then at that point, I told myself that while I really wanted to see my kids before
they don't recognize me, and I would just go home, spend some time with them.
And when they went to bed, I would be charting some more.
That was miserable.
And so I wasn't really living life.
I felt like I didn't sign up for this and how did I get into this?
I felt like I was stuck.
I was frustrated.
I was angry.
All these negative emotions until the pandemic came and I had a taste of going home on time
because I was just seeing a third load of the patients during that time.
I mean, I wasn't in the first line of defense in terms of the pandemic, so we were just
trying to see all the chemo patients and whoever that really absolutely needed to be seen.
So I thought, what if I could do this, going home on time while seeing a full load of patients?
And that would be amazing.
So during that time, I had opportunities to explore other things outside of medicine.
And I came across something called life coaching and I had no clue what that was, but I thought
anything, I would try anything to make my life better or just to make my life to be
something that I was living and not just going through the motion.
So I did and I joined this coaching program and I was working with one of the coaches
to because my biggest obstacle at that time was really just to finishing my work on time.
So in about three months, actually under three months, I just slowly went a little bit faster,
a little bit faster.
And three months later, I was able to go home on time, basically 5, 5.30 with all my charts
done and I'm not taking work home with me.
Wow, Mary, that's such a great story.
As you were sharing your story, I'm resonating.
I spent three days once in my office, I spent the weekend in my office just trying to close
charts.
And I know that there are clinicians out there who are literally on the hamster wheel of
trying to close charts.
How did you do it?
How did you go from staying late every time to being able to go home on time with charts
closed?
Yes, and with seeing the same number of patients.
So it actually all starts with how you start your day.
And this is how I also guide my physician clients during our one-on-one coaching program.
It's how you start your day is very important.
When you wake up, the first thing you do in the morning, what do you think about?
If you're thinking that, oh, I have too many patients to see, or if you're thinking that
I can't possibly close all my charts on time, then you're already starting on the wrong
foot.
So say if you're thinking that today is going to be a manageable day, how are you going
to feel?
You're going to feel probably more calm, more peace than, say, if you think that I'm not
going to be able to go home on time, you're probably going to feel something along the
lines of frustrated or anger or something kind of unpleasant or negative.
So we as human beings are driven by our emotions.
And I think it is very helpful to have somewhat of a positive or more pleasant emotion to
be your fuel, to be your driver throughout the day.
So how you start your day is very important.
And of course, that's kind of like, because we're thinking about different things all
day long.
Sometimes we don't even think or we're not even aware of what we're thinking.
And so be really mindful of what you're thinking and how you're thinking about things, because
that really affects your performance and what you do and how you do things.
So that's the first things first.
Second is that you tell yourself that you're able to handle the day.
And so you want to see the patient and do the charge right away.
So one of the biggest mistakes that I've had in the past was that I thought that I had
to keep my patients to be as close to the scheduled time as possible, because I thought
that if I didn't do that, I was a bad physician.
And so how I changed for that was I sacrificed my own time.
And so in the beginning of the day, I would be able to really finish most of the patient's
shards after they were being seen.
And then usually as the day went on, especially the second half of the day, I had trouble
and I thought, oh, I was already running late, 15, 20, 30 minutes late.
No, you know what?
I'll just finish the charts later so I could bring in the next patient.
And what ended up happening was at the end of the day, I would still have sometimes five
charts, not too bad.
Sometimes it would be 10 charts or 13 charts.
And I started to feel tired.
I was frustrated.
I thought that I should have finished those charts already, but I still have so many charts
to do.
And my brain was slowing down.
I was getting tired.
So it would take me two or three more times the time that I would use to finish the chart
if I finish it right then and there.
So seeing the patient, doing a chart right away is very important because it's so fresh
on your mind and it is okay.
Just give yourself some grace.
It is okay to let the next patient wait for a little bit because guess what?
When you're done with this patient and the chart, then you can 100% focus on the next
patient and not think about, oh, I forgot to write that.
I, you know, forwarded that other patient.
So I think it's important to do that.
And the next thing is really to be really, really focused on doing one thing at a time.
I know, you know, we physicians, we think that we can multitask, we can do a lot of
different things at the same time.
But what we're doing is actually we're task switching, meaning that our brain is just
kind of switching from one thing to another.
And it actually takes time for your brain to recover from one event to another.
So if you do that multiple, multiple times during the day, you actually spend more time
to do one thing or to do the three things that you wanted to do.
So I think that, you know, those are really very, very helpful things that help me to
cut down on my, you know, clinical time.
The other thing is also a lot of, I think a lot of us are doing really outpatient work.
So for outpatients, you know, you have your set schedule.
And also you usually have staff members working in your clinic, you know, say the medical
assistants, nurses, or the front desk.
So I think one of the things really, really helpful is to minimize the interruptions that
are created by your staff members.
So, you know, it will be helpful to have kind of a protocol to let them know when to absolutely
necessarily interrupt you during, while you're seeing patients, as opposed to every single
phone call to find you.
You know, sometimes they may be already taken care of by your nurses or if you have PAs
or MPs, you know.
So have a protocol set that will be very helpful.
And also in terms of interruption, to not to interrupt yourself, meaning that, you know
what, in the middle of seeing patients or in between seeing patients, minimize the really
the time that you use to check emails or go on social media, you know, just really avoid
that temptation.
So I think with kind of like these kind of like the outlines of what I do and what I
teach other physicians to do, and I think just even implementing two or three things
that will be really, really helpful.
Wow, Mary, thank you so much.
You've given so much and having like my mind blown in this moment.
Okay.
So the first thing I'm hearing you say is, to some extent, to summarize everything you
said, it's like you've got to be very focused and intentional about ending the day with
your charts closed.
It's like your mission.
So because it's your mission, your first start to the day, the way you even think about your
day has got to be that it's possible, you're able to do it, and none of the negative, oh
my gosh, I can't believe how many patients I have, it's going to be another terrible
day.
It's really preparing your mind for the mission of closing charts by the end of the day.
Then I also hear you talk about how it's okay, your patients are, you're going to be a few
minutes late to the next patient and it's going to be okay, because by the time you
get to the next patient, you'll have that chart done.
And that's important rather than saying, I'll just leave it till the end of the day when
it's your time and then you're the one kind of, and you're tired, your brain can't do
as much because you've left it all to the end of the day.
So the importance of not letting the anxiety of, oh my gosh, the patient's waiting, I can't
finish this, for you pushing it away so that you can focus.
And then I also hear you say the task switching, oh, that's such a big one.
I have some follow-up questions from this one where either your staff are interrupting
you or you're interrupting yourself.
Okay.
So one of the thoughts, the questions that came to my mind is, what if you're in a big
work room and you have all these, your colleagues are in the room, your PAs and MPs are in the
room, how can you work in a work room full of people and still be able to focus on getting
the notes done?
What do you recommend?
I think one of the things is, if you're all working together, it may be helpful to have
kind of like a regular meeting from time to time to see how we can all improve things.
Because you know what, if you help each other do things better, you all win.
So in a room like that, sometimes you may have informal discussions, and maybe we can
just kind of like set an informal rule in a sense that just to say that, hey, unless
it's necessary, we'll try to just do this work thing together, but individually, as
opposed to be kind of constantly interrupting each other.
Because I think that of course sometimes there could be some more urgent things that of course
there are always exceptions.
But I think in terms of the workflow and who you're working with and how the day goes,
it's of course, sometimes you have to individualize and tailor to the culture of the work.
But I think as physicians, you're kind of like leaders for your staff or for your PAs
and MPs.
So in a sense, sometimes it's an experimental thing.
You may try something to see if that works, if it works great.
If not, then maybe you just want to tweak it a little bit.
So I think that just reminds me of how, because sometimes I do do inpatient work.
I think once about every eight weeks or so, and I'll spend Monday through Friday just
inpatient and I will be working in a work room with other clinicians also.
And we just kind of do our own thing.
Sometimes some people like to chat and I would just kind of politely either say, let me finish
this first because I really want to finish my thought before talking about things.
And I think after a while, if you do it more like that, people do realize that, hey, you
know what?
We kind of try to respect one another's time and we try to get things done.
Wow.
Thank you for sharing that, Mary.
As you're talking, what I'm hearing is that it's a cultural shift, right?
It's shifting the way you believed up until this point or behaved up until this point.
Because up until this point, if you're struggling to close charts, you're struggling to close
charts because your process currently doesn't work for you.
But in order for you to get to a point where you're telling your staff, don't interrupt
me except for these elements or the people working in the work room with you, hey, I'm
finishing a thought, give me a few minutes.
It's not something we're used to doing.
I think as physicians, we're very much like, oh, I'm always available to help you at all
times.
And sometimes that, you know, now shifting to a place where it's almost, it almost feels
like being selfish.
Can you speak to that kind of mindset?
Because I think as clinicians, we feel like we should always be available and always be
able to help, but it does impede us from finishing our work.
How do you overcome that mindset?
Oh, yeah, it took me a while.
So it is very true because, you know, we're always kind of, I think, taught indirectly
that we should always be available, you know, even sometimes even after hours, we should
be available.
And that is kind of the biggest lie.
I would say, you know, of course it takes a while to really realize that it doesn't
have to be the case.
During your work hours, of course, you know, it's very helpful to be available, you know,
as much as you can, but at the same time is if it's after hours, if you're not on call,
you know, it's okay not to answer a page or call or you redirect to whoever is on call
because otherwise, you know, are you going to really, if you enjoy doing that, that's
my guess.
But if that's not something that you want to do or if that's not something that is in
alignment with your values because you want to spend time, you know, for whatever you
enjoy doing or with your family, then, you know, I think it is important to really have
a very clear boundary that you're giving out, you know, not a wishy washy one, but, you
know, let people know that when you're on duty, you're 100% available, you know, of
course, you have your own work to do, like say if somehow something about research is
contacting you while you're seeing patients, you know, depending on the severity of the
situation, you may want to just finish seeing that patient first and then answer to that
call as opposed to interrupting the whole patient encounter to answer that call.
So I think that just, you know, it takes practice to even to rewire our long time thinking to
say that, hey, you know what, we're going to be doing our best and we're going to be
available for however much that, you know, we're responsible for.
And outside of that, it is okay to have your own time and be your own person.
And we don't have to please everybody all the time.
You know, of course we, you know, we're team players.
We work well with other people.
That doesn't mean that you have to be available 24 seven.
Wow.
I love, I love, I just love all the, all the insights that you're sharing and I can, I
can already hear people's hearts pumping faster and saying, what you mean?
Is it, is it okay for me to, to not be available 24 seven?
And again, it goes, it's counter cultural, but you know, as you're alluding to, it's
like the other work you have to do is important too.
And so being able to fit the work that you're supposed to do at this time, within this time
helps you be more effective in all your other jobs because spending time with our families,
for many of us, we're still working even as we're doing that.
Or for many of my clients who are also scientists, like spending, spending time away from clinic
many times means more time to actually do the science that you came to do.
And so, wow, how important it is to be able to establish those boundaries so that we can
do well in both jobs because, oh my gosh, to be able to close charts by the end of the
day, everybody loves a clinician who can close charts and, and for clinicians to walk away
from their clinic, to be able to go do their science, that's an important thing as well.
But it definitely will take a lot of work.
And that's why you're a coach.
That's why you support people to do this work that is super hard to do on their own.
So I want to ask you, like if people who are listening want to work with you, how do they
do that?
Thank you for mentioning it.
So before that, I do want to add one more thing is that, yes, how we start our day is
very important and kind of like have a goal in mind, you know, that think about why you
want to finish your charts on time.
You know, you want to finish your charts on time so that you can enjoy time with your
family or I want to finish my charts on time so that I can have more time to do my research
that I really want to do, you know, something positive.
So it has, you know, got to be something that is a strong enough motivation throughout the
day.
And you remind yourself that, you know, I'm finishing my chart on time so that, you know,
you fill in the blanks.
So I think that will also generate more of a positive feel like such as focus, determination
or confidence, you know, that you need to be your fuel to see the patient, do the charts
and finish your clinic on time.
And I think, you know, this is not something that happens overnight and it may take weeks
or even longer, especially if you have hundreds of charts open.
And I do have, you know, people that have, you know, hundreds of charts open and you
have to kind of like backtrack and slowly close them up.
It is doable.
So I encourage you all to really try, you know, what we talked about today.
And I am not really anyone special.
I know Dr. Toyosi said I'm unique and thank you.
I think everyone is unique, but I'm not, you know, I'm not someone with super power.
It's just shifting our mind to think and focus on what we need to focus.
So I think for physicians who are interested to know more about me, can visit my website
at www.shiningwithgratitudemd.com and you're welcome to also email me to find out more
about my one-on-one physician coaching program.
And the email is shiningwithgratitudemd.gmail.com.
I do write two blocks a week and you can find me on LinkedIn at MarylandMD or Facebook Maryland.
Mary, that is so awesome.
I just feel like your work is so important, even for clinicians who are not trying to
be scientists, clinicians who are just trying to get their lives back, right?
Just being able to close charts.
And I'm hearing you say that even if you have hundreds of charts open, and it sounds like
you had clients or at least a client or two who's had hundreds of charts open, it is possible
to get them closed and stay caught up forever with the strategies that you teach.
I wonder if you just want to, in closing, just encourage the provider who is a couple
of tens of, you know, actually maybe a couple of hundred charts behind and just encouraging
them about what's possible with your strategies to help clinicians close these charts and
stay on top of their charts.
You know, looking back, I think in the beginning of the journey before coaching, I didn't think
that it was possible for me to go home before seven o'clock.
I thought going home at seven o'clock without any work, you know, left behind, that was
already amazing.
But now I'm going home at five.
I'll just say, yeah, really five and sometimes a little bit earlier even, after seeing 20
some patients, I can never go back to where I was.
It's you know, you get transformed to be someone totally different.
You have a new identity because you're the patient, I mean, you're the physician who
finishes your work on time and you're not bringing any work home.
So I think that it's start with the belief that it is possible.
Don't think of it how, just yet.
Just believe that it is possible because when you have the strong belief, you're going to
work toward it.
You know, it's just like the book, I forgot which book, I apologize, you know, the formula,
the miracle equation, I think it's the unwavering faith.
And with the extraordinary effort, you're going to create a miracle.
And of course, finishing sharp on time, it may sound like a miracle right now.
It did sound like that to me, but it is possible.
And just what we talked about during this session is it's really, it sounds kind of
simple.
It is not the easiest thing to do, but it is totally doable.
So I encourage, you know, physicians who have hundreds of charts left behind, just do it
little by little, you know.
It's kind of like when we encourage patients to lose weight, when you tell them to lose
50 pounds, it sounded very, very scary.
And if you tell them to say, hey, how about one to two pounds a week?
I would just say most people say that, yeah, it's doable.
So it's the same thing, you know, maybe instead of going home two and a half hours earlier
than you normally do, try 15 minutes at a time.
It's doable.
I love it.
This is going to change people's lives.
Mary, thank you so much.
Wow.
You just shared some really amazing insights and I feel like it is going to liberate so
many clinicians who feel like I just am too busy clinically.
There is no way I can move on to do my research.
And it sounds like it's possible.
You can help them.
And definitely I will add your information to the show notes so that they're able to
connect with you as well.
Mary, it's just been such a pleasure having you on the show.
Thank you so much for just the insight that you provide to clinicians.
You're changing lives and I just want to appreciate you for coming on the show and sharing your
insights.
For having me.
All right.
Everybody, you've heard Dr. Long.
It is possible.
You can do this.
You can close your charts and keep your charts closed so that you can be liberated to do
all the other work that you want to do.
And so definitely connect with Dr. Long, make an appointment and she's the person for you
to help you get charts closed and keep them closed.
Thank you everyone for listening.
Mary, thank you for being on the show and I look forward to connecting with you all
the next time.
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