Pseudo-vergilian

I am hoping that I can share the things that helped me find peace in my busy life as a mother and obstetrician-gynecologist.  I’ve been doing this work in small ways for years.   If you have known me for more than a few years, you probably own a few things that I’ve talked you into buying, listened to some podcasts I’ve recommended and maybe even travelled to some interesting destinations with me.

I am hoping I can share something bigger.  I want to help walk you through the process that brought me out a deep hole of frustration and grief surrounding my career and into sustainability and gratitude.  I can’t do it for you. I can’t tell you what to do. I can tell you where I’ve been and where I am today. I can share the signposts that marked my path.

Welcome to Invoke MD.

Uncomfortable Truth

During the toughest times of physician burnout, I used to dream of someone helping me find a way out of the mess I’d made.  You know what? No one showed up.

 No one noticed the struggle and approximately zero people said, “Hey man, why don’t you take a 6 month sabbatical and then I’ll help you figure out what to do next.”   

  

I had to confront a bitter truth.  There is one person who cares about your future and wellbeing more than anyone else in the entire world. 

 

You. 

  

Not your mom or your spouse or boss.  Not the “greater good.”  The person with the biggest investment in your personal n=1 study of life is YOU, my friend. 


 

As the one investor 100% all-in on your future, it is time to look around and determine where you are today.  Assess the value of each part of your life.   Look at the time you are spending on each of these things.  Does the percieved value match the allocation of resources? If not, you are creating a great deal of personal discomfort.

  

So much of our human discomfort comes from these discrepancies. The gaps between what we value and how we spend our time and money. Gaps between our expectations and the reality of daily life.

 

   

Closing the gap will lead to less discomfort.   There are just a few ways to make this happen.  We can  change our expectations OR we can change our reality.  We can change our values OR we can change how we invest our resources.

  

There is another approach. We can dig our heels in deeply and examine our thoughts.  We can create sustainable thoughts that generate desired outcomes.  We can close gaps by impacting our expectations AND our reality simultaneously.  

  

This approach is infinitely harder and requires uncomfortable work and personal insight.  It doesn’t happen accidentally or instantaneously.

The payoff is huge.  Once you tap in to the power of thought creation, you can close those gaps in an incredibly efficient manner.  

  

No one can do it for you.  You are the person with the most on the line. No one else has nearly as much at stake. Live with the discomfort or make change, the choice is yours.


Money Matters

Talking about money is uncomfortable.  We are healers and we have a calling. Sure, we should get paid… but this isn’t the stuff of dinner conversation.  Right?

 

WRONG.  We SHOULD talk about money.  When searching for my hospitalist gig, compensation transparency was very important to me.  We need to know what we are worth and how we will be paid.  I was willing to walk away from any situation that lacked full disclosure and equity amongst partners.  

 

We need to ask for what we are worth and accept nothing less.

 

The behavior among physicians to skirt the issue of salary and avoid negotiation hurts all of us.  When you sign a contract for far less than what you are worth, you decrease the value of each of our careers.

  

Does the thought of negotiation intimidate you? Look for tools to help. You can get a great contract attorney to help protect you.  Read up on negotiating strategies. Find a mentor to help bolster your confidence and practice difficult conversations.   

  

Do you not KNOW what you are worth? Find the salary data for your specialty. Ask to sit down with the compensation team at your facility or with the billing folks at your private practice. This information is readily available.   

 

Stick up for yourself. Demand what you are worth.  Be valued.

If I could click my heels and go back…

I’ve 908-498-6437 the background on the years proceeding my ‘burn out.’ I know the term is debatable and yet for me, it feels comfortable and accurate. I was on fire in my career, then the fire was simply and utterly GONE.


In the early days of recognizing my burn out, I spent a lot of mental energy playing with “what if.”   If I hadn’t taken on an administrative role. If my group hadn’t grown in so many ways. If I hadn’t tried SO HARD to be as productive as possible.

 

I completely wasted my time on those thoughts.  There is no going back. There are NO do overs. Spending time searching for a reason isn’t at all productive. I had to release my desire to fix what had gone wrong before I could design my future.

I still occasionally observe my self engaging  in this same trap.


If I had learned earlier the life changing fact that all feelings are optional? IF I knew that ‘no’ was a complete sentence as a young attending?  If we hadn’t [fill in the blank]… bought the doctor-house, worked so much, missed so many moments

These futile thoughts create negative feelings- regret, shame, sadness. 

The truth?

I am supposed to be where I am today.  I choose to be  where I am today.  


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My story is not your story. I want to share a bit of it, so that you might know that another physician has struggled as well. The grief and embarrassment of “burning out” has long since passed. 

Residency

I found out that I was pregnant with our second child at the end of interview season and just before rank lists were due.  The big dreams of far-off places and big academic programs were balanced with the realities of an early pregnancy and all the associated unpredictably.  Ultimately I chose to rank a local community based program first. 

My son was born in August of my intern year. I had our third at the the beginning of my PGY3 year.  The only way to survive was to become extremely efficient at work.  I learned to dictate while pumping and to round efficiently.  I had no time for any extra steps and learned the habit of being “all business.”

These years spent creating effort and habit felt so important.  Little did I know that they would set me up to absolutely self destruct in the world of physician productivity, accounts receivable and professional status.

Private Practice

I joined a fabulous independent group with my residency mentors.  I took a full time position and my practice grew quickly. I filled my days with obstetric patients and contraceptive counseling- these are the patients that wanted to see the “new young lady doctor.”

Our group was busy and successful. We were determined to stay independent and worked on growing our presence in the community. We joined forces with a smaller group and expanded services to include a second delivery hospital.  My day was limited only by the number of exam rooms.  Business was BOOMING.

I was chosen as associate medical director of our Women’s facility in my second year of practice. I knew it was early and I also wanted to build my future. I threw myself in to the role and became the medical director 6 months later.

Life became unrecognizable.  Mornings were 6am meetings and surgeries. Rounds at two hospitals.  6pm meetings. Emails. Charts. 30-35 patients each day, call doubled by delivering at two hospitals.

 I added an office day to help support my growing patient panel and to try to make up for the hours lost to administrative time; my gyn surgery volumes were dropping as my schedule filled with returning OB patients.  

Trying to do ALL the things.

Somewhere in the midst of this, we bought a new house. I took and passed my oral boards. My youngest was ready to start school. Life was racing by me while I sat in exam rooms and board meetings.

Maxed OUT

During my 3rd year in practice, I was working more than my residency hours and spinning my wheels in the office and at home.  I just could not get ahead.  The grind of daily OBGYN life started to feel so very heavy. 

It wasn’t any one thing. It wasn’t my administrative position or the pain of trying to make change happen in a sluggish industry.  It wasn’t my clunky EHR or my busy office.  

The sum of each thing was greater than the individual parts.  My work life had reached a critical mass. It was taking more from me than I had left to give. 

The burnout thoughts started smoldering.

I can’t do this forever. I can’t do this tomorrow. I have no space. I can’t breathe. Countered by the seemingly insurmountable students loans and the very raw fact that I chose this exact path.

This is what I’d always wanted and I was drowning.