WEBVTT 00:00:13.900 --> 00:00:16.899 So welcome to Our Voices Our Future, the podcast 00:00:16.899 --> 00:00:19.280 where we amplify the voices driving change and 00:00:19.280 --> 00:00:21.859 equity within medicine and beyond. Brought to 00:00:21.859 --> 00:00:23.940 you by the Gender Equity Task Force, a committee 00:00:23.940 --> 00:00:26.219 of the American Medical Women's Association. 00:00:26.699 --> 00:00:29.059 We're here to challenge norms, break barriers 00:00:29.059 --> 00:00:31.940 and ignite conversations that matter. I'm Rhea 00:00:31.940 --> 00:00:34.820 Manohar and each episode will bring you candid 00:00:34.820 --> 00:00:37.759 discussions with leaders, change makers and advocates 00:00:37.759 --> 00:00:41.259 working to create a more inclusive and just world. 00:00:41.679 --> 00:00:44.670 No more silence, no more waiting. you're listening 00:00:44.670 --> 00:00:47.630 to Our Voices, Our Future. Let's get into it. 00:00:47.929 --> 00:00:53.009 Today, we have Dr. Jatoo Sinesi. Dr. Sinesi is 00:00:53.009 --> 00:00:57.270 a board certified obstetrician and gynecologist, 00:00:57.530 --> 00:01:00.630 current transformational success coach, and passionate 00:01:00.630 --> 00:01:03.579 advocate for sustainable living. A native of 00:01:03.579 --> 00:01:06.819 Washington, D .C. metro area, she graduated magnum 00:01:06.819 --> 00:01:09.599 cum laude from the University of Maryland Baltimore 00:01:09.599 --> 00:01:13.099 County with a degree in biological sciences before 00:01:13.099 --> 00:01:15.780 obtaining her medical degree and completing her 00:01:15.780 --> 00:01:18.840 residency in obstetrics and gynecology at Emory 00:01:18.840 --> 00:01:21.739 University School of Medicine in Atlanta, Georgia. 00:01:22.159 --> 00:01:24.939 After a successful career in private practice, 00:01:25.439 --> 00:01:28.700 Dr. Snesi made the bold decision to retire from 00:01:28.700 --> 00:01:32.540 clinical medicine at age 35, embarking on a mission 00:01:32.540 --> 00:01:35.719 to help others harmonize high achievement with 00:01:35.719 --> 00:01:38.439 personal fulfillment. As a certified success 00:01:38.439 --> 00:01:40.939 coach, she focuses on supporting early career 00:01:40.939 --> 00:01:43.579 professionals, especially in service -oriented 00:01:43.579 --> 00:01:47.739 fields who face overwhelming and burnout. Passionate 00:01:47.739 --> 00:01:52.319 about assisting, recovering, pathological altruists. 00:01:52.620 --> 00:01:55.900 Dr. Sinesse empowers her clients with the tools, 00:01:56.519 --> 00:01:59.480 mindset shifts, and systems necessary to achieve 00:01:59.480 --> 00:02:02.239 success aligned with their wellbeing through 00:02:02.239 --> 00:02:05.519 personalized coaching, engaging workshops, and 00:02:05.519 --> 00:02:08.139 inspiring speaking engagements. Well, thank you 00:02:08.139 --> 00:02:11.120 so much for being here today. Thank you so much 00:02:11.120 --> 00:02:14.460 for having me. Thank you. So with that, I just 00:02:14.460 --> 00:02:16.770 kind of want to get us started. Can you share 00:02:16.770 --> 00:02:19.050 your journey into medicine and how you first 00:02:19.050 --> 00:02:23.169 became interested in coaching? Absolutely. I 00:02:23.169 --> 00:02:27.889 will do my best to be brave. I decided I wanted 00:02:27.889 --> 00:02:31.830 to be an OBGYN at 12 years old. And because in 00:02:31.830 --> 00:02:35.090 the typical overachiever fashion, I laid out 00:02:35.090 --> 00:02:38.370 a plan and I stuck with the plan. So I was fortunate 00:02:38.370 --> 00:02:42.090 enough to apply to a STEM high school. go to 00:02:42.090 --> 00:02:45.810 us and get admitted into that. I applied for 00:02:45.810 --> 00:02:49.750 a STEM scholarship in college and was unfortunate 00:02:49.750 --> 00:02:52.250 enough to participate in that. So I got not only 00:02:52.250 --> 00:02:55.830 scholarship money, but support in undergrad and 00:02:55.830 --> 00:02:59.110 support with getting into medical school. Then 00:02:59.110 --> 00:03:02.110 once I got into medical school and got into medical 00:03:02.110 --> 00:03:06.250 specific training, interestingly enough, it was 00:03:06.250 --> 00:03:09.840 the experience of of it wasn't what I had hoped 00:03:09.840 --> 00:03:12.860 it would be. I always did fine. I didn't like 00:03:12.860 --> 00:03:15.479 it as much as I thought I would at any given 00:03:15.479 --> 00:03:18.199 stage. However, at every stage, everyone says 00:03:18.199 --> 00:03:20.699 the next step will be better. When you're in 00:03:20.699 --> 00:03:22.860 classes, it was like, oh, when you get on the 00:03:22.860 --> 00:03:24.360 wards, it's going to be better. You're going 00:03:24.360 --> 00:03:27.319 to enjoy it. And when you're on the wards, like, 00:03:27.460 --> 00:03:29.560 oh, well, you want to be an OBGYN. So once you 00:03:29.560 --> 00:03:32.680 get away from all the heart disease and rotavirus, 00:03:32.919 --> 00:03:36.330 it's going to be great. And the thing is, every 00:03:36.330 --> 00:03:39.150 step, it did get better. It just never really 00:03:39.150 --> 00:03:44.330 felt good. And even getting through residency, 00:03:44.629 --> 00:03:46.150 everyone's like, okay, well, when you're in attending, 00:03:46.229 --> 00:03:48.229 you can control your schedule, you have more 00:03:48.229 --> 00:03:50.669 autonomy, you have more agency, it's gonna be 00:03:50.669 --> 00:03:54.729 better. And again, better. Still was like, this 00:03:54.729 --> 00:03:57.129 was not what I envisioned when I was 12 years 00:03:57.129 --> 00:04:00.710 old. Loved taking care of patients. Loved, the 00:04:00.710 --> 00:04:02.750 reason I decided I wanted to do OB -GYN is because 00:04:02.750 --> 00:04:06.229 I liked the intellectual stimulation. of medicine 00:04:06.229 --> 00:04:09.949 and of maternal fetal physiology and all those 00:04:09.949 --> 00:04:11.889 kinds of things. I liked the connection that 00:04:11.889 --> 00:04:14.389 I was able to make with my patients. I was able 00:04:14.389 --> 00:04:18.170 to take care of them. Even when I was going through 00:04:18.170 --> 00:04:20.610 that kind of taking care of your patient from 00:04:20.610 --> 00:04:22.949 like the beginning to delivery, that model was 00:04:22.949 --> 00:04:24.750 kind of going away, but you still got to see 00:04:24.750 --> 00:04:27.009 most of my patients during prenatal care and 00:04:27.009 --> 00:04:30.170 got to deliver some of them. So I enjoyed the 00:04:30.170 --> 00:04:32.889 patient care part. It was a lot of the other 00:04:32.889 --> 00:04:37.680 stuff. administrative things, and just OB -GYN 00:04:37.680 --> 00:04:39.800 is a very physically and mentally challenging 00:04:39.800 --> 00:04:42.259 specialty. So it just never was quite what I 00:04:42.259 --> 00:04:46.240 had hoped it would be. And so when I finally 00:04:46.240 --> 00:04:48.360 finished with all of the testing, which for me 00:04:48.360 --> 00:04:52.060 was my oral boards two years out of residency, 00:04:52.560 --> 00:04:54.519 I was like, OK, I've done all the things. I've 00:04:54.519 --> 00:04:56.980 hit all the benchmarks. I've been blessed to 00:04:56.980 --> 00:04:59.639 have followed the path and not really hit obstacles 00:04:59.639 --> 00:05:02.949 in the path. Why don't I like this more? And 00:05:02.949 --> 00:05:06.129 so that was my first existential crisis. That's 00:05:06.129 --> 00:05:10.170 when I actually ended up working with a therapist. 00:05:10.189 --> 00:05:12.009 I was like, there must be something wrong with 00:05:12.009 --> 00:05:14.230 me because clearly other people have gone this 00:05:14.230 --> 00:05:16.149 path and they seem to be doing fine. So what's 00:05:16.149 --> 00:05:18.689 wrong with me? You know, the self -flagellating 00:05:18.689 --> 00:05:22.910 began. And I ended up taking some time off during 00:05:22.910 --> 00:05:27.110 my third year out of residency. It took a randomly 00:05:28.239 --> 00:05:30.899 designated 100 -day sabbatical. Why 100 days? 00:05:31.199 --> 00:05:34.060 No real reason, just picked it. Took some time 00:05:34.060 --> 00:05:38.019 off, came back, made some changes to how I was 00:05:38.019 --> 00:05:39.720 practicing, was like, okay, this is gonna make 00:05:39.720 --> 00:05:42.620 it work. And again, better, still wasn't quite 00:05:42.620 --> 00:05:46.079 what I wanted it to be. And at that time, I thought 00:05:46.079 --> 00:05:48.339 I had exhausted all the different options to 00:05:48.339 --> 00:05:51.279 make clinical medicine work for me. With the 00:05:51.279 --> 00:05:53.860 beauty of 2020 hindsight, I realized I did not, 00:05:54.000 --> 00:05:58.240 but. The combination of youth with its naivete 00:05:58.240 --> 00:06:00.459 and hubris made me think, I'll go do something 00:06:00.459 --> 00:06:04.600 else. So I left clinical medicine without a plan. 00:06:05.000 --> 00:06:07.939 Don't recommend that. And so a lot of people 00:06:07.939 --> 00:06:10.160 think that I left clinical medicine to become 00:06:10.160 --> 00:06:13.120 a coach. No, I left clinical medicine and three 00:06:13.120 --> 00:06:16.540 years later hired a coach. And when I was working 00:06:16.540 --> 00:06:18.800 with the coach at that time, I was like, oh, 00:06:18.899 --> 00:06:22.259 as much as... values I got from working with 00:06:22.259 --> 00:06:25.899 my therapist is like a lot of this coaching tools 00:06:25.899 --> 00:06:28.879 and mindset would have been helpful to me back 00:06:28.879 --> 00:06:30.959 when I was a clinician, even thinking of different 00:06:30.959 --> 00:06:33.680 ways to make clinical medicine work for me. And 00:06:33.680 --> 00:06:35.899 that's when I was like, oh, I think that that's 00:06:35.899 --> 00:06:37.660 what I want to do. I think that I would like 00:06:37.660 --> 00:06:41.319 to help others, whether they decide they want 00:06:41.319 --> 00:06:43.220 to stay in medicine or leave medicine, but just 00:06:43.220 --> 00:06:46.600 be more intentional about how they design their 00:06:46.600 --> 00:06:50.129 lives after this long time. all this time and 00:06:50.129 --> 00:06:53.170 all this money invested in being a physician. 00:06:53.329 --> 00:06:56.769 So that's the circuitous route of how I went 00:06:56.769 --> 00:06:59.649 from being a practicing clinician to being a 00:06:59.649 --> 00:07:03.509 coach. That was super interesting. I kind of 00:07:03.509 --> 00:07:06.649 want to break that down a little bit. For a lot 00:07:06.649 --> 00:07:08.829 of people in your situation or even throughout 00:07:08.829 --> 00:07:11.750 medicine, I know I've encountered several people 00:07:11.750 --> 00:07:14.389 who've kind of had the same kind of self -doubts, 00:07:14.430 --> 00:07:16.930 whether it be do I want to still be in medicine 00:07:16.930 --> 00:07:20.560 or I planned my entire future around this specific 00:07:20.560 --> 00:07:23.000 specialty. And now I realized that once I got 00:07:23.000 --> 00:07:25.980 into clinicals that I just don't like it. So 00:07:25.980 --> 00:07:30.160 what kind of advice or how would you approach 00:07:30.160 --> 00:07:32.519 it for students that are in that experience? 00:07:35.220 --> 00:07:37.259 I'll start broad and then I'll come a little 00:07:37.259 --> 00:07:40.220 more specific. Broadly, what I've learned from, 00:07:40.399 --> 00:07:43.240 you know, there was a learn from your mistakes. 00:07:43.600 --> 00:07:45.660 So what I've learned from what I did not the 00:07:45.660 --> 00:07:50.360 best in my past is it's good to have a plan. 00:07:51.399 --> 00:07:54.740 It is also good to allow for the opportunity 00:07:54.740 --> 00:07:57.680 to pivot within that plan. When you're super, 00:07:57.740 --> 00:08:00.879 super rigid, you may have heard the term have 00:08:00.879 --> 00:08:04.579 a plan and hold it loosely. So allowing for the 00:08:04.579 --> 00:08:07.420 pivot can sometimes help you realize, well, maybe 00:08:07.420 --> 00:08:11.360 I can do this in a different way. Similarly, 00:08:12.259 --> 00:08:14.339 when I left with no plan, I'm like, if you're 00:08:14.339 --> 00:08:18.319 going to pivot, the semblance of a plan, have 00:08:18.319 --> 00:08:20.379 the beginning of something, even if you're going 00:08:20.379 --> 00:08:23.660 to grow from it. And more specifically, let's 00:08:23.660 --> 00:08:25.980 say, like I said, I decided I don't want to be 00:08:25.980 --> 00:08:28.420 an OBGYN when I was 12. And thankfully, that 00:08:28.420 --> 00:08:30.920 actually is the... element of medicine, even 00:08:30.920 --> 00:08:32.360 when I was thinking about leaving, people were 00:08:32.360 --> 00:08:34.379 like, oh, what do you want to do? I'm not going 00:08:34.379 --> 00:08:36.320 to besmirch any other specialty, but people would 00:08:36.320 --> 00:08:39.879 say specialty. I was like, absolutely not. So 00:08:39.879 --> 00:08:42.639 one of the things that if you think I do want 00:08:42.639 --> 00:08:46.240 to do something different, speak to people that 00:08:46.240 --> 00:08:48.940 you, if you have access to them, hopefully you 00:08:48.940 --> 00:08:51.139 can have access to folks who are in that specialty. 00:08:51.519 --> 00:08:56.240 Number one, when you are in training, As much 00:08:56.240 --> 00:08:58.879 as your attendings and the people who are training 00:08:58.879 --> 00:09:02.299 you want to help you, a lot of times they have 00:09:02.299 --> 00:09:05.200 a pretty narrow experience of even practicing. 00:09:06.919 --> 00:09:10.940 I trained in an academic center. They know academic 00:09:10.940 --> 00:09:13.320 medicine. They know some private practice, but 00:09:13.320 --> 00:09:16.080 they don't know the expanse of different ways 00:09:16.080 --> 00:09:18.600 that people practice obstetrics and gynecology. 00:09:18.980 --> 00:09:21.399 So if you can reach out to different people in 00:09:21.399 --> 00:09:23.000 the specialty that you're like, oh, I thought 00:09:23.000 --> 00:09:25.539 I liked this. Maybe I don't. Maybe see how different 00:09:25.539 --> 00:09:28.519 people are practicing. And similarly, if there 00:09:28.519 --> 00:09:30.500 are other specialties that you are considering, 00:09:31.039 --> 00:09:33.580 talk to people in academics. Talk to people who 00:09:33.580 --> 00:09:35.899 are in private practice. Talk to folks who are 00:09:35.899 --> 00:09:38.500 doing locum tenens. If you're internal medicine, 00:09:38.620 --> 00:09:40.759 talk to people who are hospitalists. See the 00:09:40.759 --> 00:09:43.340 different ways that you can practice the specialty. 00:09:43.639 --> 00:09:47.679 I think sometimes we think that there are former 00:09:47.679 --> 00:09:49.860 limits in the ways that we can practice than 00:09:49.860 --> 00:09:53.500 there actually are. Yeah, I think even as a student 00:09:53.500 --> 00:09:56.740 we could run into those challenges so often because 00:09:56.740 --> 00:09:59.860 your main exposure to a lot of these things are 00:09:59.860 --> 00:10:03.500 specifically in your rotations where you do get 00:10:03.500 --> 00:10:07.720 a breadth of what you're learning, but not necessarily 00:10:07.720 --> 00:10:11.019 how you could be applying it. So I appreciate 00:10:11.019 --> 00:10:14.279 you sharing that with all of us. Now I kind of 00:10:14.279 --> 00:10:17.340 want to talk a little bit about pathological 00:10:17.340 --> 00:10:22.929 altruism. This is a newer term that a lot of 00:10:22.929 --> 00:10:24.889 people might not be familiar with. So could you 00:10:24.889 --> 00:10:29.090 first define what that means? Absolutely. So 00:10:29.090 --> 00:10:32.470 I do want to say I am definitely a proponent 00:10:32.470 --> 00:10:37.250 of altruism, healthy altruism, being of service 00:10:37.250 --> 00:10:41.269 to other people and in some ways being selfless 00:10:41.269 --> 00:10:44.850 in that service. That is not the problem. Where 00:10:44.850 --> 00:10:48.970 I come at it and consider it. When I think it's 00:10:48.970 --> 00:10:52.389 become pathological is when that is your default 00:10:52.389 --> 00:10:56.370 mechanism. You are constantly, always considering 00:10:56.370 --> 00:11:00.049 other people's well -being and values above your 00:11:00.049 --> 00:11:04.830 own. When anytime there is an option, it is always 00:11:04.830 --> 00:11:08.710 your first thought is to be in sacrifice mode. 00:11:09.570 --> 00:11:11.970 That does not serve you long term because that 00:11:11.970 --> 00:11:14.769 can't serve you long term. You do. It's not even 00:11:14.769 --> 00:11:17.070 saying, think of yourself above other people. 00:11:17.389 --> 00:11:19.470 Let's at least just have them all in the same 00:11:19.470 --> 00:11:21.730 line. So you're considering all the different 00:11:21.730 --> 00:11:25.230 people who are affected by a decision. When someone 00:11:25.230 --> 00:11:27.730 asks you to do something, and I consider myself 00:11:27.730 --> 00:11:30.409 a recovering pathological altruist, because when 00:11:30.409 --> 00:11:32.509 people ask me to do things, the first thing that 00:11:32.509 --> 00:11:34.750 goes in my brain is, how can I say yes? Like 00:11:34.750 --> 00:11:37.889 my brain defaults to, how do I get to a yes for 00:11:37.889 --> 00:11:41.899 someone else? And it's nice to know that. However, 00:11:42.279 --> 00:11:43.919 sometimes you have to take a step back and be 00:11:43.919 --> 00:11:47.960 like, does a yes to this person make sense for 00:11:47.960 --> 00:11:50.779 my core values, my priorities, what's going on 00:11:50.779 --> 00:11:54.600 in my life in this situation right now? So that's 00:11:54.600 --> 00:11:58.139 where, and people who go into service professions, 00:11:58.960 --> 00:12:02.759 we tend to be altruistic and it's really, it's. 00:12:02.970 --> 00:12:06.850 quick trip over into pathological altruism because, 00:12:07.309 --> 00:12:09.110 especially as physicians, part of our training 00:12:09.110 --> 00:12:11.710 is always be available, always put the patient 00:12:11.710 --> 00:12:15.289 first. And that is necessary. You do have to 00:12:15.289 --> 00:12:18.250 consider your patient. However, there are situations 00:12:18.250 --> 00:12:21.169 where, whether it's inside or outside of work, 00:12:21.289 --> 00:12:24.789 you do need to know when a no is appropriate 00:12:24.789 --> 00:12:27.509 and recognizing that the flip side of every yes 00:12:27.509 --> 00:12:30.179 is a no. And I think a lot of times we think 00:12:30.179 --> 00:12:32.860 the yes and the no for this situation. Like you 00:12:32.860 --> 00:12:35.600 say, give me a ride to the airport. And I say, 00:12:35.659 --> 00:12:38.360 OK, well, if I say yes to Rhea, I can take her 00:12:38.360 --> 00:12:41.019 to the airport. And if I say no, she has to find 00:12:41.019 --> 00:12:43.159 someone else. And that's the only yes and no 00:12:43.159 --> 00:12:47.039 dichotomy we often consider. However, I invite 00:12:47.039 --> 00:12:50.759 you to also consider, I say yes to Rhea. And 00:12:50.759 --> 00:12:54.639 then that means I say no to, let's say, going 00:12:54.639 --> 00:12:57.269 to my nephew's play. So you have to consider 00:12:57.269 --> 00:13:00.629 all the nos and yeses that are in play when you 00:13:00.629 --> 00:13:03.070 are deciding what's the most appropriate yes 00:13:03.070 --> 00:13:07.289 and most appropriate no. So with that I kind 00:13:07.289 --> 00:13:09.889 of want to talk about how do you recognize this 00:13:09.889 --> 00:13:13.090 in yourself or for others specifically like what 00:13:13.090 --> 00:13:15.970 are the common signs that physicians or even 00:13:15.970 --> 00:13:18.269 physicians in training might be experiencing 00:13:18.269 --> 00:13:21.990 pathological altruism? So similar what I was 00:13:21.990 --> 00:13:24.610 saying before like literally if your brain always 00:13:24.610 --> 00:13:27.429 says How do I say yes? If your first thought 00:13:27.429 --> 00:13:30.389 is yes. That's not a bad thing in and of itself 00:13:30.389 --> 00:13:33.549 if that's in your brain. However, catching yourself 00:13:33.549 --> 00:13:37.029 and taking that moment, whether it's in the moment 00:13:37.029 --> 00:13:40.570 to take a breath, to take a thought, or even 00:13:40.570 --> 00:13:43.690 just to say, I'll get back to you with that answer, 00:13:43.730 --> 00:13:46.490 whether it's later today or tomorrow or let me 00:13:46.490 --> 00:13:49.629 check my calendar. But if you always think every 00:13:49.629 --> 00:13:53.200 single time I say yes, end it. Especially if 00:13:53.200 --> 00:13:57.299 those yeses start having a resentment attached 00:13:57.299 --> 00:14:00.379 to them, that's a sign. That's a sign that you're 00:14:00.379 --> 00:14:04.580 doing it out of a sense of duty. And some things 00:14:04.580 --> 00:14:06.500 you do have to do out of a sense of duty. But 00:14:06.500 --> 00:14:10.399 if you feel resentful every time you're saying 00:14:10.399 --> 00:14:13.049 yes to something, it could be that there's a 00:14:13.049 --> 00:14:15.429 lack of alignment with what's really important 00:14:15.429 --> 00:14:19.250 to you and or you don't get to do enough things 00:14:19.250 --> 00:14:21.490 that actually aligned with your core values and 00:14:21.490 --> 00:14:25.809 priorities. Thank you for sharing all that. With 00:14:25.809 --> 00:14:28.309 that I kind of want to dive a little bit deeper 00:14:28.309 --> 00:14:33.090 specifically into challenges faced by women physicians 00:14:33.090 --> 00:14:37.129 who are facing altruism but even the expectations 00:14:37.129 --> 00:14:40.600 placed upon them in the medical field. Obviously, 00:14:40.639 --> 00:14:42.460 with the American Medical Women's Association, 00:14:42.620 --> 00:14:45.580 we work a lot with women physicians and women 00:14:45.580 --> 00:14:49.940 trainees. And we've heard resounding feelings 00:14:49.940 --> 00:14:55.399 about unrealistic expectations or overburdening 00:14:55.399 --> 00:14:59.500 in some capacity. Absolutely. Yeah. So as I was 00:14:59.500 --> 00:15:02.500 saying, just as physicians in general, we tend 00:15:02.500 --> 00:15:07.450 to inherent nature in our training tend to put 00:15:07.450 --> 00:15:10.789 us down this pathological altruism track, then 00:15:10.789 --> 00:15:13.389 when you add on top of that fact that women in 00:15:13.389 --> 00:15:17.110 this society are just naturally considered caregivers, 00:15:18.169 --> 00:15:21.929 whether they do believe oftentimes is not conscious, 00:15:22.629 --> 00:15:25.529 people will ask you, you will be the first person 00:15:25.529 --> 00:15:28.049 who's asked to do something extra. They say, 00:15:28.090 --> 00:15:32.379 oh, we need to squeeze in another patient. in 00:15:32.379 --> 00:15:34.580 the schedule, everyone's double booked, but they're 00:15:34.580 --> 00:15:37.080 like, ah, she's most likely to say yes, so they'll 00:15:37.080 --> 00:15:39.460 come to you. I need someone to switch a call. 00:15:39.580 --> 00:15:42.159 I need someone to take an extra call. You tend 00:15:42.159 --> 00:15:44.799 to be the person that gets picked. If you happen 00:15:44.799 --> 00:15:48.440 to be a woman who is unpartnered with no children, 00:15:48.700 --> 00:15:50.960 you're on the top of the list of women who gets 00:15:50.960 --> 00:15:53.120 asked. And so these are the things that tend 00:15:53.120 --> 00:15:55.799 to come up for women. And this is, again, where 00:15:55.799 --> 00:16:00.100 that knowing when to say no having those boundaries 00:16:00.100 --> 00:16:04.159 is really important. And it really it's, it's 00:16:04.159 --> 00:16:05.879 not comfortable at first, especially if you're 00:16:05.879 --> 00:16:08.100 not used to doing that. And this is just something 00:16:08.100 --> 00:16:12.539 we don't have a lot of practice honoring our 00:16:12.539 --> 00:16:14.960 own priorities and making decisions that honor 00:16:14.960 --> 00:16:18.879 ourselves. And so I really do encourage you to 00:16:18.879 --> 00:16:22.740 practice even on low stakes things. So what just 00:16:22.740 --> 00:16:25.399 getting the reps in anything that you get good 00:16:25.399 --> 00:16:27.539 at all the other things in medicine, you're like, 00:16:27.659 --> 00:16:30.720 okay, do another H &P, do this, you get good 00:16:30.720 --> 00:16:33.139 at it by practicing it. And because we don't 00:16:33.139 --> 00:16:36.220 have practice, we don't have the practical practice. 00:16:36.559 --> 00:16:38.960 And then there's just this subtle mindset that 00:16:38.960 --> 00:16:42.940 makes you think that that's wrong. So part of 00:16:42.940 --> 00:16:45.039 changing that mindset is actually getting those 00:16:45.039 --> 00:16:47.820 reps in and starting with low stakes things. 00:16:49.399 --> 00:16:53.139 And it could be literally something little. Sometimes 00:16:53.139 --> 00:16:55.720 it could just be. I don't actually want to do 00:16:55.720 --> 00:16:57.840 a thing. And maybe it's not at work. Maybe it's 00:16:57.840 --> 00:16:59.720 at home. Maybe it's outside of work. Somebody 00:16:59.720 --> 00:17:01.379 invites you to do a thing. You're like, oh, I 00:17:01.379 --> 00:17:04.839 feel like I should go. Oh, that's another sign. 00:17:05.299 --> 00:17:09.579 Should. If you are saying should a lot, that 00:17:09.579 --> 00:17:12.859 can be a sign that you are falling into pathological 00:17:12.859 --> 00:17:16.640 altruism. If you can replace should with I want 00:17:16.640 --> 00:17:22.839 to, I need to, that is more aligned with something 00:17:22.839 --> 00:17:26.000 that that tends to be more aligned with like 00:17:26.000 --> 00:17:29.119 your priorities and your values. If it's, if 00:17:29.119 --> 00:17:30.940 should is just should, because somebody else 00:17:30.940 --> 00:17:34.119 thinks I should do it, that can sometimes be 00:17:34.119 --> 00:17:36.460 a red flag that I'm doing this out of a sense 00:17:36.460 --> 00:17:39.660 of duty that doesn't really make sense for me. 00:17:41.220 --> 00:17:43.920 Those are some helpful strategies. I do kind 00:17:43.920 --> 00:17:47.339 of want to talk a little bit about, we've discussed 00:17:47.339 --> 00:17:50.900 strategies that we can internally do. But as 00:17:50.900 --> 00:17:54.009 you noted, there are these environmental and 00:17:54.009 --> 00:17:58.529 societal expectations, how do we kind of break 00:17:58.529 --> 00:18:03.170 out of those moles as institutions or greater 00:18:03.170 --> 00:18:06.630 society, almost deprogramming how we place these 00:18:06.630 --> 00:18:12.230 burdens on? Oh, 100%. I think that a lot of the 00:18:12.230 --> 00:18:17.049 issue is, might sound lame, but the individuals 00:18:17.049 --> 00:18:21.720 within the institution, I think that I know people 00:18:21.720 --> 00:18:24.019 who are in leadership situations and they're 00:18:24.019 --> 00:18:26.000 just like, okay, I understand the importance. 00:18:26.460 --> 00:18:29.640 My general feeling is that intentional wellbeing 00:18:29.640 --> 00:18:32.640 is the antidote to the pathological altruism. 00:18:32.940 --> 00:18:37.880 So if you are intentional and not kind of incidental 00:18:37.880 --> 00:18:40.380 about incorporating wellbeing into your life, 00:18:40.440 --> 00:18:43.019 if you think, before I do this thing, let's figure 00:18:43.019 --> 00:18:47.579 out how... I can have the experience that aligns 00:18:47.579 --> 00:18:50.220 with me feeling well. I have the sense of peace. 00:18:50.380 --> 00:18:52.599 I have the sense of joy. I feel intellectually 00:18:52.599 --> 00:18:56.200 stimulated going into it. A lot of times we get 00:18:56.200 --> 00:18:57.920 caught up in something and once we start to feel 00:18:57.920 --> 00:18:59.460 poorly, then we're like, well, how do I feel 00:18:59.460 --> 00:19:03.519 well on the back end? If you start with the intention 00:19:03.519 --> 00:19:06.720 of I'm going to have these benevolent acts of 00:19:06.720 --> 00:19:09.440 doing, and I'm also going to have a sense of 00:19:09.440 --> 00:19:12.380 well -being. as I have these benevolent acts 00:19:12.380 --> 00:19:16.660 of doing, you're much more likely to be well 00:19:16.660 --> 00:19:21.519 and avoid that sense of burnout. And I say that 00:19:21.519 --> 00:19:24.700 to say, the more people who you have in your 00:19:24.700 --> 00:19:27.059 organization, particularly people who are in 00:19:27.059 --> 00:19:29.859 leadership, who recognize the importance of intentional 00:19:29.859 --> 00:19:32.900 well -being, the more likely those systems and 00:19:32.900 --> 00:19:34.960 those institutions are to change because you 00:19:34.960 --> 00:19:38.299 have people who support their direct reports, 00:19:38.680 --> 00:19:40.579 making decisions that align with their sense 00:19:40.579 --> 00:19:42.640 of well -being. And then you also have people 00:19:42.640 --> 00:19:45.579 who are modeling that. Because I have friends 00:19:45.579 --> 00:19:49.700 who are in leadership who they know, like mentally 00:19:49.700 --> 00:19:52.759 they know, but actually practically being like, 00:19:53.980 --> 00:19:58.140 oh, this person needs to take time off for the 00:19:58.140 --> 00:20:00.279 death of a family member. It's like they know 00:20:00.279 --> 00:20:02.420 they'd only make sense for this person to take 00:20:02.420 --> 00:20:03.700 time off, but then they're just like, I have 00:20:03.700 --> 00:20:05.940 to change the schedule and all these things. 00:20:06.279 --> 00:20:09.160 And the more again, the more reps you get in 00:20:09.160 --> 00:20:11.119 and the more you realize you actually can't allow 00:20:11.119 --> 00:20:13.640 people to honor their sense of wellbeing and 00:20:13.640 --> 00:20:17.359 keep the system, keep the practice and keep things 00:20:17.359 --> 00:20:20.119 running in the way that they need to. And sometimes 00:20:20.119 --> 00:20:22.980 you might have to reschedule a patient. You don't 00:20:22.980 --> 00:20:26.559 love to do that. Sometimes that may actually 00:20:26.559 --> 00:20:29.950 have to happen. So that's kind of on a institutional 00:20:29.950 --> 00:20:32.529 level. And then again, the individuals within 00:20:32.529 --> 00:20:36.089 an organization. I really think on the personal 00:20:36.089 --> 00:20:38.769 side, many times we underutilize the resource 00:20:38.769 --> 00:20:41.970 of our schedule and our calendar. Part of it 00:20:41.970 --> 00:20:44.589 I do think is because at work, sometimes we can 00:20:44.589 --> 00:20:46.509 feel so over scheduled and like somebody else 00:20:46.509 --> 00:20:48.529 has control of our schedule. And so every second 00:20:48.529 --> 00:20:52.089 of our day is monopolized by something that we 00:20:52.089 --> 00:20:55.839 feel reluctant to put something on our personal 00:20:55.839 --> 00:21:00.119 calendar because it feels too rigid. Again, I 00:21:00.119 --> 00:21:02.599 invite you to practice. Just test it out. Even 00:21:02.599 --> 00:21:05.920 if you're just setting aside, this is my decompression 00:21:05.920 --> 00:21:09.460 time. This is my reflection time. Just putting 00:21:09.460 --> 00:21:12.319 those things in your calendar, it also will make 00:21:12.319 --> 00:21:15.559 you. So when somebody asks you to do something, 00:21:15.599 --> 00:21:17.599 you're like, let me check my calendar and you 00:21:17.599 --> 00:21:20.680 say, oh, I had said that I'm just going to sit 00:21:20.680 --> 00:21:24.509 down and watch Netflix for an hour. You put it 00:21:24.509 --> 00:21:26.890 on your calendar because, again, that is aligned 00:21:26.890 --> 00:21:29.829 with your sense of well -being. And you can decide 00:21:29.829 --> 00:21:32.109 to do whatever for the other person at that time. 00:21:32.369 --> 00:21:34.549 However, you see that you have been intentional 00:21:34.549 --> 00:21:37.289 about setting aside that time to take care of 00:21:37.289 --> 00:21:40.369 yourself. So just doing those kind of things. 00:21:40.589 --> 00:21:44.009 And really, a lot of it just starts with reflection, 00:21:44.369 --> 00:21:47.890 which, again, we don't do a lot of in health 00:21:47.890 --> 00:21:50.250 care and as health care professionals, reflecting 00:21:50.250 --> 00:21:54.460 on What does well -being actually, how does it 00:21:54.460 --> 00:21:57.519 feel for me? It's very interesting. I will do 00:21:57.519 --> 00:22:00.539 workshops with rooms full of physicians and ask 00:22:00.539 --> 00:22:04.500 them like, what qualities do you associate with 00:22:04.500 --> 00:22:08.680 a sense of well -being? People cannot think of 00:22:08.680 --> 00:22:11.200 anything. If I say, what are the, what words 00:22:11.200 --> 00:22:13.279 do you associate with like having a bad day? 00:22:13.559 --> 00:22:16.319 Oh, just all sorts of things. I'm frustrated. 00:22:16.420 --> 00:22:19.880 I'm this and that we have a very broad lexicon 00:22:19.880 --> 00:22:23.000 for negativity. And we tend to not spend a lot 00:22:23.000 --> 00:22:26.180 of time thinking about what do I associate with 00:22:26.180 --> 00:22:30.200 feeling well? Oh, I'm joyful. Oh, I'm curious. 00:22:30.500 --> 00:22:34.339 Oh, I'm excited because we're just on the grind. 00:22:34.400 --> 00:22:37.339 And so just even taking time to reflect what 00:22:37.339 --> 00:22:40.839 does feeling good for me feel like for me? And 00:22:40.839 --> 00:22:44.339 then taking the next step, what actually elicits 00:22:44.339 --> 00:22:46.960 those positive feelings in me? And a lot of times 00:22:46.960 --> 00:22:51.289 it's much less grandiose than you think. It doesn't 00:22:51.289 --> 00:22:53.650 take a trip to Dubai. Sometimes it just takes 00:22:53.650 --> 00:22:55.450 a walk around the neighborhood and you actually 00:22:55.450 --> 00:22:57.250 can get that little dopamine hit that'll get 00:22:57.250 --> 00:23:00.109 you a little bit further in your day. I love 00:23:00.109 --> 00:23:03.490 these little and practical strategies that you've 00:23:03.490 --> 00:23:05.789 shared with us thus far. And I think we've kind 00:23:05.789 --> 00:23:09.730 of danced around this topic a little bit. But 00:23:09.730 --> 00:23:11.950 obviously a lot of the strategies that you've 00:23:11.950 --> 00:23:17.579 provided for us are to help avoid burnout. But 00:23:17.579 --> 00:23:20.299 if we implemented these on a larger scale, how 00:23:20.299 --> 00:23:22.460 do you think this would affect burnout specifically 00:23:22.460 --> 00:23:25.519 for women physicians who are thinking about leaving 00:23:25.519 --> 00:23:28.759 the practice altogether due to these expectations? 00:23:30.599 --> 00:23:33.960 I will. So I've talked about small things you 00:23:33.960 --> 00:23:37.640 can do. I will say for some people, those small 00:23:37.640 --> 00:23:41.160 kind of low key strategies can be helpful. I 00:23:41.160 --> 00:23:43.920 will say if you are kind of deep in the depths 00:23:43.920 --> 00:23:48.480 of burnout, sometimes taking Some time off actually 00:23:48.480 --> 00:23:52.119 is somewhat necessary. I'm not saying put it 00:23:52.119 --> 00:23:55.440 all together. But I will say, again, from my 00:23:55.440 --> 00:23:58.160 own personal experience, I will say when I took 00:23:58.160 --> 00:24:03.519 my sabbatical and came back to work, one element 00:24:03.519 --> 00:24:07.460 that I think hindered that change from being 00:24:07.460 --> 00:24:10.460 as successful as it could have been is I decided 00:24:10.759 --> 00:24:13.480 I made the plan for the change at the beginning 00:24:13.480 --> 00:24:15.539 of my break. So I was still in the depths of 00:24:15.539 --> 00:24:17.779 burnout when I was just figuring out, when I 00:24:17.779 --> 00:24:20.039 was deciding what changes needed to happen to 00:24:20.039 --> 00:24:22.559 make it better. So it was better, but it still 00:24:22.559 --> 00:24:25.779 wasn't ideal. I think that sometimes truly your 00:24:25.779 --> 00:24:30.000 nervous system needs some time to recover. Some 00:24:30.000 --> 00:24:34.319 folks depending on on the reality of your life, 00:24:34.359 --> 00:24:37.599 your financial situation, your job situation, 00:24:38.160 --> 00:24:41.640 your FMLA. If you can take some time off just 00:24:41.640 --> 00:24:46.799 to kind of reset and reassess. I mean, I'll do 00:24:46.799 --> 00:24:48.599 a little bit of a plug. Sometimes working with 00:24:48.599 --> 00:24:51.880 a coach can be helpful to help you be really 00:24:51.880 --> 00:24:56.380 clear and identify what do I actually want my 00:24:56.380 --> 00:24:58.660 life to look like inside and outside of work? 00:24:58.859 --> 00:25:01.700 And what are the strategies that I think will 00:25:01.720 --> 00:25:04.440 help me get to that vision and to that goal. 00:25:05.920 --> 00:25:10.640 So if the things that you were doing, the smaller 00:25:10.640 --> 00:25:12.839 things you're doing aren't working for you, sometimes 00:25:12.839 --> 00:25:14.980 you maybe do need to take a step back so that 00:25:14.980 --> 00:25:17.599 you can figure out what works for you. If you 00:25:17.599 --> 00:25:22.880 aren't to that point yet, again, the knowledge 00:25:22.880 --> 00:25:25.880 that I borrowed this from a coach friend of mine, 00:25:26.359 --> 00:25:29.539 a strategy that she shares with folks is come 00:25:29.539 --> 00:25:33.980 up with a list of seven activities that you know 00:25:33.980 --> 00:25:38.640 bring you joy. Things you can do on a daily basis. 00:25:39.000 --> 00:25:42.579 Ideally, small things. So you have this list 00:25:42.579 --> 00:25:45.059 of seven. And then at the start of your day, 00:25:45.680 --> 00:25:48.460 identify three things that you're going to do 00:25:48.460 --> 00:25:52.380 that day. So you know that you have the power 00:25:52.380 --> 00:25:54.980 to bring joy to your life. And you know that 00:25:54.980 --> 00:25:57.480 there are at least three different moments in 00:25:57.480 --> 00:26:00.059 the day where you're going to bring yourself 00:26:00.059 --> 00:26:03.599 a sense of joy. So that's one thing. I'm also 00:26:03.599 --> 00:26:06.319 a fan of affirmations, because that's, again, 00:26:06.319 --> 00:26:08.980 just starting your day in a positive mindset, 00:26:09.279 --> 00:26:12.019 thinking of the things. And again, your brain 00:26:12.019 --> 00:26:15.759 automatically goes negative. So if you can put 00:26:15.759 --> 00:26:20.079 your brain on a positive thought process at the 00:26:20.079 --> 00:26:23.380 beginning of the day, and again, the reflection 00:26:23.380 --> 00:26:25.539 and the paying attention and seeing what are 00:26:25.539 --> 00:26:28.940 the things that you can do every single day, 00:26:29.150 --> 00:26:33.109 that help you maintain a baseline sense of wellbeing. 00:26:33.809 --> 00:26:36.690 I have a system that I call the five essential 00:26:36.690 --> 00:26:39.009 strengths for success with satisfaction. And 00:26:39.009 --> 00:26:42.789 the number five step is sustain personal policies 00:26:42.789 --> 00:26:46.369 for self -care. So what are the things that you 00:26:46.369 --> 00:26:48.630 do? And not, you know, people think many petty 00:26:48.630 --> 00:26:51.289 spa, that's lovely for self -care, but what are 00:26:51.289 --> 00:26:54.049 the just baseline fundamental things you do? 00:26:54.410 --> 00:26:58.430 I generally say, eat nutritiously. Drink enough 00:26:58.430 --> 00:27:03.210 water. Get enough sleep. Move your body. Those 00:27:03.210 --> 00:27:06.029 four things alone, like most of us don't do even 00:27:06.029 --> 00:27:08.170 three of the four regularly. So you can do four 00:27:08.170 --> 00:27:11.869 of those. And then outsource. This is especially 00:27:11.869 --> 00:27:15.970 for women physicians. Outsource as much as makes 00:27:15.970 --> 00:27:18.230 sense and is possible. If you don't really want 00:27:18.230 --> 00:27:20.549 to do it and you can get someone else to do it 00:27:20.549 --> 00:27:23.490 for free or for money that you can pay, for the 00:27:23.490 --> 00:27:27.640 love of God, outsource. And particularly for 00:27:27.640 --> 00:27:30.859 if you were people think that if you were don't 00:27:30.859 --> 00:27:33.579 have kids and don't have a partner, it doesn't 00:27:33.579 --> 00:27:35.420 make sense for you to hire someone to clean your 00:27:35.420 --> 00:27:37.319 house. If you don't want to clean your house 00:27:37.319 --> 00:27:39.400 and you want your house to be clean and you can 00:27:39.400 --> 00:27:41.400 afford it, hire someone to clean your house. 00:27:42.240 --> 00:27:45.160 I'm a big believer in outsourcing whatever is 00:27:45.160 --> 00:27:50.529 possible. It's life changing. So with that, you've 00:27:50.529 --> 00:27:53.589 shared so many interesting strategies with us 00:27:53.589 --> 00:27:57.869 at really all levels of the medical career. So 00:27:57.869 --> 00:28:01.670 do you have any final advice or thoughts to give 00:28:01.670 --> 00:28:04.710 to our listeners who are maybe struggling with 00:28:04.710 --> 00:28:13.910 satisfaction and balance? My basic fundamental 00:28:13.910 --> 00:28:21.269 recommendation is reflect more and do less. So, 00:28:21.529 --> 00:28:24.789 reflect on what's working for you, what's not 00:28:24.789 --> 00:28:28.130 working for you, and do less. Sometimes that 00:28:28.130 --> 00:28:30.690 involves outsourcing, sometimes that involves 00:28:30.690 --> 00:28:34.589 resigning from a thing. Going back to the things 00:28:34.589 --> 00:28:38.750 that women physicians get pulled into often and 00:28:38.750 --> 00:28:40.950 be like, don't you want to be on this committee? 00:28:41.089 --> 00:28:43.779 Which it looks like it's a good idea. but it's 00:28:43.779 --> 00:28:46.400 maybe something that isn't particularly influential 00:28:46.400 --> 00:28:49.720 in terms of policy change or they don't resource 00:28:49.720 --> 00:28:51.920 you that much. And you might just be like, I 00:28:51.920 --> 00:28:54.220 remember having a client once who was on like 00:28:54.220 --> 00:28:56.440 17 committees. This was somebody who was in education 00:28:56.440 --> 00:28:58.880 and not in a position. And I was like, maybe 00:28:58.880 --> 00:29:02.019 we can get done at like 11. So maybe some of 00:29:02.019 --> 00:29:05.680 those you don't need to be on. So reflect more 00:29:05.680 --> 00:29:10.319 and do less. Well, thank you so much for sharing 00:29:10.319 --> 00:29:13.140 with us and spending time with us. That's a wrap 00:29:13.140 --> 00:29:15.740 on this episode of Our View of Voices, Our Future. 00:29:16.099 --> 00:29:18.819 We hope today's conversation inspired you, challenged 00:29:18.819 --> 00:29:21.460 you, and reminded you of the power of raising 00:29:21.460 --> 00:29:23.900 your voice. The fight for equity doesn't stop 00:29:23.900 --> 00:29:26.460 here. Join us in the movement. Subscribe wherever 00:29:26.460 --> 00:29:28.799 you get your podcasts. And if you loved this 00:29:28.799 --> 00:29:30.680 episode, share it with someone who needs to hear 00:29:30.680 --> 00:29:34.180 it. Until next time, stay bold, stay vocal and 00:29:34.180 --> 00:29:37.119 keep the conversation going. This is our voices, 00:29:37.359 --> 00:29:37.900 our future.