Welcome to the Clinician Researcher podcast.
I'm your host, Toyosi Onwuemene, and it is such a pleasure
to be talking with you today.
Today I'm talking about a topic that I find
to be very important and very serious.
And it's about why you must choose to live differently.
And I think it's so important
that I actually say why you must.
And I feel very strongly about it.
And I just wanna let you know upfront
that perhaps this is a little biased,
but I hope that you'll take some time and listen
and see for yourself how much you agree or disagree.
And I'd love to hear your thoughts and opinions as well.
But yes, I'm talking about why you must choose
to live differently.
One of the reasons that I share this is because
when I started my faculty career
and I was very, very big on moving forward into research,
what I didn't realize is that it's not the norm
for clinicians to do research.
And it's not the norm because we spent a ton of time
doing clinical training.
And although people say, well,
every clinician should be doing research
or should be doing some type of scholarship,
they're not really saying clinicians
should be leading research programs.
And if they're seeing that,
there's a lot of what I should say
is lack of support for that idea.
And so just because people say
we support clinicians doing research,
the real question is, is there a show of support?
And as I came through on my journey,
I didn't have support.
I didn't realize I didn't have support.
I didn't realize what was needed
to build a research career.
And that is financial support,
institutional support, and mentoring support.
There are all kinds of support to really get someone
to really succeed as a researcher.
Now, don't get me wrong,
clinicians have a lot of support.
They have a lot of support to do their clinical work
to a great extent,
but not so much support to do research.
And so even when institutions say,
well, we want our clinicians to do researchers,
when they don't supply them with the time
to do the research,
it's actually the same as if you were saying,
I don't support you,
except you say I support you,
but then you don't give people the support they need.
And when I started, I thought,
oh, okay, maybe this was unique to me.
But now that I look around,
I realized that this is the norm.
And more often than not,
clinicians are not supported to lead research.
And it makes sense because, say,
clinicians, they're trained to do patient care,
and patient care and research are not the same thing.
They are very, very different.
And so then any clinician that says,
well, I want to lead a research program,
is really doing things differently,
is really saying, I want to choose to live differently.
And living differently is challenging.
And I'm gonna talk a little bit about the challenges
of living differently,
but why you must take on the challenge
of living differently.
And I'm talking to clinicians who are growing as scientists
and also bucking the trend to a great extent,
because if you are going to live out a career
that is fulfilling,
you're gonna do what's not status quo,
because status quo is fine.
I mean, status quo is fine,
except that there's more.
And if we've already seen something,
then we desire something new,
something better, something greater.
And so if, for whatever reason,
we're able to help patients control their blood sugars,
we know that we can do more.
How much more can we improve on diabetes care, right?
And so it's one thing to see patients clinically,
it's another thing to say, well,
what's the next frontier
in terms of the fight against diabetes?
How do we make things better?
And so living differently really does mean
rejecting the status quo,
but that's the space,
that's a place in which we get to fulfillment, absolutely.
And as clinicians and people
who've gone through clinical training,
we've fought or to some extent,
we've transformed all along our journey, right?
We started as medical students
and we transformed on the journey to become interns.
We transformed from interns to residents.
We transformed from residents to faculty members
and the transformation has to continue.
Because when it doesn't,
then we feel stagnant and stuck
because for at least 10 years or more of our experience,
we've transformed every few years.
And so transformation is part of our physician experience,
but staying the same
sometimes is the expectation of our environment.
And if we're going to thrive,
if we're going to do things,
if we're gonna have a successful and fulfilling career,
we do need to choose to do things differently.
Okay, so I wanna just talk about seven things
that you should think about about living differently.
Okay, so the first thing I wanna talk about
is the fact that we live in a cultural milieu.
We live in our own culture,
we're surrounded by culture.
And whether we accept what the culture,
whether we accept the norms of the culture or not,
we are kind of subject to or bound by the culture
in some way, shape or form.
And culture has been said to be like a conversation
between two fish and one fish asks,
well, how's the water?
And the other fish is like, water, what water?
And it's the obliviousness to what defines
our very environment.
It's like the culture is everything around us
that we take for granted.
The way we have expectations for how news is consumed,
how presidential elections are run,
how we interact with legislators, how lawyers behave,
how children are educated, right?
There's a cultural expectation
that many times we don't think about.
As clinicians, there's a cultural expectation
for how clinicians show up.
For PhD scientists, there's a cultural expectation,
depending on where you are in your career,
there's a cultural expectation
for how faculty members show up, for what faculty members do.
So culture is all around us,
whether we acknowledge it or we don't.
Sometimes there are parts of the culture
that we notice a little bit more,
especially where we are disadvantaged in any way.
For example, let's say you are in wherever you work,
the gender or religious minority or a minority in any way,
you can tell the difference.
You can tell the difference between the norms of the culture
in your experience.
So for example, as a woman, perhaps people say,
well, we don't really have women faculty
leading divisions, right?
I mean, in general, division chiefs tend not to be women.
So women who are division chiefs tend to be a minority.
And there's a cultural expectation
of who the division leader looks like,
or who the division leader is,
or what the division leader looks like.
And because of that, there's just this tendency
towards fulfilling the expectation
of what a division leader looks like.
And so opportunities that may come to women
don't necessarily come because,
why would you want this opportunity?
Division leaders are men.
But it's subtle, it's in the background.
People don't go out to discriminate overtly,
at least not usually, but there's the subtle,
just everyone kind of regressing to the mean to some extent.
So that there's a cultural milieu in which we live
that kind of assigns people expected roles,
that kind of has an expectation of people.
And it's just the way we live, right?
It's the way we love the routine of our experience.
We love the routine of our lives.
And so we like things to fit.
We love routine, we like things to make sense.
And so where people are changing
or doing things that are outside of the expectation,
it does make people uncomfortable.
So that brings me to number two,
is that people tend to reinforce cultural norms.
Whatever the culture says about how clinicians are,
tends to be reinforced by many.
So for one, one cultural norm
that's not necessarily helpful to physicians,
is this idea of the physician is the hero.
And this is a double-edged sword
as far as cultural norms and expectations.
But it's this idea of, oh, the physician is hero,
which means that people look at you with an air of respect
and reverence, like, oh, you're the physician, ooh.
Actually, in some circles,
they're like, you're the physician, so what?
Depends on your circles, right?
But this idea of the physician is hero means,
well, as the hero, you sacrifice your life to save humanity.
What do you mean you want more pay?
And I think the whole idea of physician payments
from Medicare decreasing
against the grain of inflation over time
is an example of that.
It's like, hey, you physician,
of course you can handle cuts to your pay over time.
You'll find a way to figure it out.
And I know it's an issue that people are working to solve,
but that it's been an issue for so long,
is I think one of the evidence that we have
of this institutional or societal expectation of,
well, the hero should be able to make sacrifices for us
because what they do is they live to help to save the people.
And so many times too for physicians,
because we feel like, oh, well, our job is to help.
Sometimes we don't advocate for ourselves very well,
because it's like, well, I don't wanna look
as if I'm just about the money.
But the reality is that we're not just about the money,
but not thinking about financial concerns
hurts our ability to do work well, right?
Hurts our ability to serve the people who come to be served.
And so if we're overworked
and needing to see a lot more volume
to make up for reduced physician payments,
that increases the stressors upon our lives.
That means that we're not able to do the scholarship
that we want to do.
It means that when we show up,
we're somewhat grumpy and annoyed with little things.
That means that things bother us more.
We don't show up as well.
And so one of the challenges with cultural expectations
is that we tend to reinforce them
because it's like, well, I'm the hero physician.
This is the life I live.
And other people are like, well, you're the hero physician.
This is the life you should live.
And any tendency to buck that trend
is not always accepted by all.
And this is the thing about people.
People reinforce what they know to be true.
And it's subtle.
And that's why it's so interesting.
People don't come out and say,
physician, you can't live differently,
but they kind of resist it subtly, right?
You say, hey, I wanna do research.
And people say, well, of course you can do research.
Why don't you do it on your own,
on your own time, at nights and on weekends?
And many times as clinicians, we say,
of course, I will do that.
I'll do what I can, because I'm used to working hard.
I'm used to working super hard.
I will do this.
But here's the challenge.
Being a clinician is a full-time career,
and doing research is a full-time career.
And so trying to do two full-time careers
where you don't have full-time hours to do both,
and you have a life, you have family, you have friends,
you have hobbies, you have other outside interests,
that makes it really, really challenging.
But the cultural expectation of the physician
as a clinician is something that really is,
any deviation from that can be resisted,
even by institutions, inadvertently.
An institution who says, well, we want you to do research,
but we're not gonna support you to do research,
is an institution that's reinforcing the cultural norm
of the physician as clinician only.
And the challenge is that already there is a change
in the way physician, there's a change
in the way healthcare is being done,
and there's a lag between how we are perceiving
healthcare delivery and what's actually transforming.
And so this idea that physicians need to see more volume
and work harder is kind of pervasive,
such that any clinician who's like,
well, I'd like to book this trend and now do research,
is kind of going against cultural norms,
and people tend to try to reinforce those cultural norms.
Okay, the third thing I wanna share is that if you choose
to go against the grain of your cultural norms,
you will feel pain, you will.
Because we are people who live in community,
and we are people who, you know,
we grow up for social acceptance.
Think about the first challenges on the playground,
who's gonna play with me?
And what it took to be the kid people would play with, right?
There's a certain way you had to conform
to be the person people played with,
if for whatever reason, you dress differently
in your family or you talk differently in your family,
you felt the pain of being different.
And that's why for many of us,
just conforming to the norms of our community
is exactly what we strive to do,
because if we're different, then people isolate us,
or at least they resist us and move away from us.
And so we feel the pain of that rejection.
So in order to not feel the pain of rejection,
we conform to cultural expectations and norms.
I, as a woman who's underrepresented in most spaces
in which I go to, especially in research or as a clinician,
there's an expectation for what a woman clinician
or a woman physician does, whether we accept it or not.
And when I say, well, I want to live differently,
it's like, wait a minute, why?
We don't do that here.
We don't have support for that here.
And so many times when people who are underrepresented
in the academy are looking for mentoring,
they don't have mentoring.
And it's not that there's not qualified mentors around them.
It's not that they don't have access to people
who can help them move forward in their careers.
It's just that sometimes mentors look and they say,
well, you don't look like me.
And so I don't know if I can support you.
And there's the need to conform, but you can't.
You just, can you change the fact that you're a woman
and you have children and you kind of have a pole
that's different because of the kind of your,
I don't know, just what's natural to you, right?
If you're a woman, you have children.
And I'm not saying only women have children,
but I'm just saying that in general,
the burden of childcare falls on women, right?
And so sometimes people look at you and you're like,
I don't know if I can support a woman who has children
and who really cares about our family.
I mean, people say that subconsciously, right?
They don't say that overtly.
Most people don't.
They're like, can I support you?
It's easier to support someone who looks like me,
who has the same challenges as me,
who has the same needs as me.
I don't know if I can support someone who's different.
And so that's what happens whenever we say,
well, I wanna do something different.
It's like, well, I don't know if I can support you.
And you feel the pain because you're trying
to do something differently and you're not surrounded
by a community of people supporting you to do that.
And what's easier, it's just to conform and to say,
okay, well, I guess people like me do full-time
clinical care and if we're gonna make it work
with our families, maybe we do it part-time.
I'll go do that.
Many times I've had young faculty say to me,
like, I would really love to do research,
but I have a family and so I really just need to stay
with clinical care so I can just get my work done
and go home.
And I hear that and my heart goes out to people
when they say that.
And but the challenge is that, yes,
if you're gonna try to do things differently,
you do feel the pain of kind of rejection
or the pain of people pulling away from you
or the pain of not having the support that you need
to live that way.
And I just want you to recognize that,
especially because for us clinicians,
our job is to be clinicians.
And people around you resist your desire to go do research.
And so when you're like, oh, I'm not seeing patients,
I'm going to do research, other people are like,
well, are you better than us?
Like, we're seeing patients, you should see patients too.
Well, I mean, we're taking calls six nights a week,
you should be doing that too.
Anyway, so what they're not understanding,
what they're not realizing is that,
hey, if I'm going to succeed in research,
that means that taking calls six nights a row
is not going to be part of what I do.
I mean, taking calls six nights in a row
is not gonna be part of what I do
because in order to succeed in research,
I do need to be able to invest a significant amount of time
in my research and my writing.
I do need to be able to invest a significant amount of time
in my research and my writing.
And people who don't live that life don't understand that.
And so they're like, you have too much free time,
what are you doing?
And so we feel that pain, we do.
We feel that pain because sometimes people feel like
we're not pulling our weight,
but what we're doing is choosing a different life.
And that can feel painful because people don't understand
the choices we're making.
Okay, but here's the thing, and this is number four,
living out your career and a career that is true to you
is a responsibility, it really is an obligation.
To go back to the hero analogy,
you are obligated to make use of the gifts
that you're given.
But there is this idea that if you have a great gift
and a great talent, you should use it to its fullest.
And if you live below that, the manifestation
or the highest capacity or the highest capabilities
of your gift, you feel unfulfilled, you do.
If for whatever reason, you know you want to do research
and you know you want to change patient care
in a different way and you don't do it,
you are living below your capacity,
you're living below your full potential.
And there is a certain regret that can come later in life
when you look back and say,
you know, I kind of wish I had done this now.
I wish I had been courageous enough to try to do this thing
that I wanted to do.
And so every time we look around and say,
well, let me just conform to what the environment says
I should be, what we're doing is missing out
on the opportunity to live to our fullest potential.
And we have an obligation to live life to the fullest.
We absolutely do because you know what?
The life is short and we don't know
how long exactly we have left.
Or you might look at it and say, well, I have a long time.
I can do that later, but there was no time like the present
to seize the opportunity.
And so we have an obligation to take advantage
of the opportunity so that we can live
at our fullest potential.
And if we do anything less, we actually experience
the feeling of living life short.
We feel unfulfilled.
We feel as if we've settled.
You know, when the dust settles,
we feel as if we settled and maybe we shouldn't have.
And so if we're gonna not have those regrets
20, 30 years from now, we're gonna wanna live
exactly as we feel like we're supposed to live now
and not just conform to the norms of our environment
or shrink away from the pain.
Okay.
The fifth thing I will share with you
is that if you're going to do that,
if you want to live to your fullest capacity
as a faculty member, if you're gonna do the things
that challenge you, then you're gonna need support to do it.
It takes courage to live differently.
Or people say, well, we don't support clinicians
to do research and you're like, well,
that's exactly what I want to do.
It takes courage.
You're gonna have to ask for resources.
You're not given the resources.
You're gonna have to ask for it.
If you need mentoring, you don't have the mentoring you need,
you're gonna have to ask for it.
Or you're gonna have to go out
and get support that you need.
For many of us, coaching has been our pathway
to succeed in research.
And if you're gonna do that, you're gonna have to ask
for the resources to pay for the coaching
that supports you to do the research
that many people think perhaps you're not qualified to do.
It takes courage to do those things.
And so if you're going to go against the grain
and we've established that you must
because you must live life as you have this deep sense
of responsibility to do, you need courage, you need support.
The sixth thing I'm gonna share is that you're gonna be,
need to be in the right community.
Your greater community has an expectation for you
that involves being a full-time clinician,
for the most part.
And so when you say, I wanna go out
and do something differently,
if you live among full-time clinicians,
the expectation is that your life should look like theirs.
And if it doesn't, there's a sense of like, well, why?
And you can feel the pressure of conforming,
conform, look like you're doing what we're doing
even though you're living a totally different life.
And so you have to live, if you're going to succeed,
you have to find a community of people who will support you,
who'll say, yeah, we understand what you're doing.
We recognize it because we're doing it too.
We recognize that it's hard.
We recognize that it's hard and we support you doing it.
And those communities don't exist naturally.
You have to pursue them, find them, create them,
but you do need to live in a community that supports you
because people don't succeed in isolation.
When we think about animals in the wild, for example,
the animal that's part of the pack,
that's part of the herd does well.
The one that's kind of straggling behind
or is completely left alone
is at the mercy of the predators, right?
And so if you're going to succeed,
you wanna be in community,
but recognizing that you choose to live differently,
you do need to actively proactively choose
a community that supports you.
Number seven is that it will take people
who love you to support you.
And I do mean mentors, I do mean sponsors.
And when I say love,
I'm not talking about people who are like,
a gushy about you, like, oh my gosh, you're so amazing.
But people who let you be, right?
I think one of the greatest examples of love
is that we don't try to make people change
so that we can love them.
Like, if you would just conform, I can love you, right?
They just love you for who you are.
And one of the great examples of this
is the unconditional love of a parent,
which I hope you experienced, some people didn't,
but the unconditional love of a parent that's like,
well, this is who you are and I love you
just the way you are.
You don't have brown eyes, great, I still love you.
You don't have blonde hair, I still love you.
The sense of like, no matter what you are, I accept that.
In academic environments, sometimes there's a sense of like,
well, if you don't conform to the pattern
of what we expect a researcher to look like,
I don't know if I support you.
Could you go back to do this?
Or until you conform to do this particular research project,
I'm not going to support you.
There's a lot of that in academia.
But people who love you, people who want you,
who want you to live to your fullest capacity say,
well, how can I help you achieve what you want to achieve?
I may not be able to help you get there directly,
but I can support you.
And in life, if you say, hey, I no longer want to be
a full-time clinician, I want to lead research,
people should support you to do that
rather than put obstacles in your way
or encourage you not to.
They should say, well, if this is what you want to do,
how can you, how can we support you to do that?
And so I'm encouraging you to look for people in your life
who allow you to live your life to the fullest,
who don't restrict you, who don't say, no, this is impossible,
but who say, huh, if this isn't your heart, this matters.
How do we help you make it happen?
How can I support you, even if I can't necessarily
do much to help you?
And this is important because, I mean, even a chair,
for a chair to say, oh, this is what you want to do,
well, it changes the landscape.
That means I need to hire more FTEs
to fulfill the clinical role
that you're no longer going to be doing.
How can I support you to do it?
Or it's like, well, I'm not able to support you,
but where else can you go that will support you to do it?
And so I want you to pay attention to people
who are willing to help you be who you're going to be.
Now, it means you're gonna have to do the work
because the environment may not necessarily stand up
and try to push you in that direction.
You're gonna need to do the work,
but you wanna make sure that there are people
who don't try to change you.
Like, oh, no, no, no, that's not who you wanna be.
Let's fix you.
You are not the problem.
And so nobody should be trying to fix you.
Like, oh, no, let's try to help you love clinical care more.
It's not about love for clinical care.
It's about a responsibility to the scholarship
that you know you need to do,
the research program that you know you need to establish.
And so you want to be surrounded by people
or you want to surround yourself with people
who encourage you.
And if they're not able to help you,
get out of your way so that you can find the help
that you need.
All right, there are seven things I talked about
in the need to choose to love differently
and is to recognize the true expectations of the culture,
recognize that people tend to reinforce cultural norms.
If you choose to live differently,
you will feel the pain.
If you're gonna live out your unique career path,
it's your responsibility to yourself
and your maximum potential.
If you're gonna do that,
it's gonna take courage and support.
That's number five.
You're gonna need to find the right communities
that support you.
You're gonna wanna make sure that you're supported
by people who love you.
And by love, that's people who let you be.
Get out of your way or support you
rather than trying to make you conform to a certain norm.
All right, it's been a pleasure talking with you today.
As always, I'm always in the market to coach.
Actually, I am now.
I don't have any individual slots,
but I do have group coaching slots if you're interested.
Send me a DM, especially on LinkedIn.
I'll be happy to talk with you.
It's been such a pleasure talking with you today.
Thank you for listening.
And I look forward to seeing you again
on the next episode of the Clinician Researcher podcast.
Thank you for listening.