Andrea Austin, MD:
I am really excited to be speaking with Dr. Kimberly Ko. She is a board-certified ophthalmologist and diplomat of the American College of Lifestyle Medicine. She is the co-founder of Ketamine Startup, an online course that teaches physicians how to open their own ketamine infusion clinic. Dr. Kim Chan Ko created Ketamine Startup with her emergency medicine physician husband after several years as the creative director of their own ketamine infusion clinic, Reset Ketamine in Palm Springs, California. Welcome to the podcast.
Kimberly Ko, MD:
Thank you for having me. I'm just super excited to talk and share and I've really enjoyed the other people you've had on your podcast, so I’m just excited to be amongst them.
Andrea Austin, MD:
I think I'm gonna jump in with a bit of a juicy question. You are an ophthalmologist, and I know a few ophthalmologists in my life and, especially compared to emergency medicine, it kind of feels like the grass may be greener in ophthalmology and that it's a great lifestyle specialty, but it sounds like your day-to-day is no longer ophthalmology.
Kimberly Ko, MD:
That is right. I mean you hit a really good point with the whole “grass is greener” because you know, as you mentioned before, my husband's ER and I would be jealous of how when he was done, he could turn it off. I mean as physicians, we really can't turn off helping and wanting to take care of people. But I'm like, “Oh when you're done, you're done,” unlike me, I might see Mr. Smith again in like three months and it would just keep coming with me. So while it's true for many ophthalmologists, it is a great lifestyle. I mean we're one of the few surgical specialties where you get to sit during surgery. I mean come on, it's a good life but it wasn't for me.
It could be a combination of where I was practicing. I practiced at the institution that I trained at, so I was a junior attending, no matter how long I was there. I was still a junior attending even if new people came on. There's pros and cons to that. I don't like to just throw being female, but it also is there. Having a family, having these responsibilities, I think that combined with where I was working, which was a level one trauma center with a huge catchment area. We'd be getting people from Arizona, New Mexico, all the way up to like Irvine up to L.A. just because of the nature of that location. And I would do so many ruptured globes. So for me and the way the practice was, I would get a lot of these difficult patients and really difficult eye situations. It would just be seeing them week after week or people knew that they could trust me with watching their patients if they went on vacation. I felt this duty-bound responsibility to take care of people and for me personally, I couldn't turn it off. That's for me and I think that's the key: knowing oneself. I finally got to a place where I realized it is easy for other people who find it more lifestyle supportive, but it wasn't for me.
Andrea Austin, MD:
Tell us about your journey to really discovering what you wanted to be doing, because that space of “this isn't working” to finding something that is working can be so long and so arduous and a big part of what we're trying to do at Revitalize is to make that process more clear. Knowing that everybody needs to go on their own journey, but there are some pretty common steps that if you kind of start looking into that, we can shorten that learning curve for women
Kimberly Ko, MD:
I wish I could say there was something super straightforward and easy. For me, it was this kind of circuitous path that I wasn't clear on what I wanted to do but I was very clear on what I didn't want to do. And I think that's a good starting place. At least it worked for me. I just knew that I needed more of a creative outlet because I was good at repairing broken eyes. There was something very satisfying, especially with imposter syndrome of thinking, “I'm not as smart as the next person but I can work really hard and I can fix things that are broken.” That worked for me, but then it wasn't as fulfilling.
So I knew I needed something beyond that. So first off, recognizing what I didn't like doing but then also recognizing within medicine and clinical practice what I did like. What I enjoyed was the patient education. I did so many diabetic eye screens and it's figuring out new ways to really drive the point home and figuring out how I can approach getting this message of my patients taking care of themselves for the sake of their vision not now, but maybe in 20 years. That's going to make a big impact. I loved interacting with residents. I think I stayed in medicine and clinical practice longer than I wanted to because there was something that just felt so good when I was with residents. Not because they were doing extra work for me but the feeling of having a mentorship role, sharing the struggles I went through. It's that human connection, that sharing of information, which at that time I didn't realize would translate to marketing and teaching other physicians later on. But I dabbled with that and then just leaned into whatever kind of came up. Saying “yes” in the sense of being open to something that you may not expect.
Earlier on, you had mentioned that you do some of the editing for the podcast. So I started editing video back in high school, back when it was really not cool to be sci-fi nerd and video yearbook editor type, working on the computer making content and stuff. Little did I know that later on, it's really important and a lot of people want to do that, but I was starting to kind of dabble in videos and if you search the depths of Youtube, you're gonna find some clips of me and some videos where i'm trying to come up with lifestyle and advice for residents and med students. I thought if I could do it one-on-one, I can scale it and teach others. I just tried it and my husband was like, learn how to do YouTube, maybe you'll have some fun with this. And I realized it wasn't the direction I was going in. Ultimately, it wasn't what I ended up doing. I realized I don't want to be a medical influencer or Insta doctor. We all have our paths and all that good stuff but it wasn't for me. Fast forward two, three, four years later, I'm using those skills to make the videos for the course we made for our ketamine clinic. It's the seeds of that journey and just getting on that journey of figuring out what do I want that ultimately you'll see that if it doesn't go anywhere at the beginning, later on those would be like the building blocks to help create what you want to do in the present or in the future.
Andrea Austin, MD:
I really like that message. You just need to get on the journey and maybe not every single step will seem linear or lead to something immediately but it's part of you and your experiences and you don't know how that's going to weave into something that you do down the road.
Kimberly Ko, MD:
Exactly. I think that's the misconception. Especially when we go through that medical education, everything was very clear from high school to college to med school. It’s a very linear path and so we're used to that or we anticipate that. But for many of us, a linear path is kind of meandering. It’s the reality of what's going to help you figure out what you want and I had to embrace that because I really had struggled and felt I had to be very logical and that I should just figure out something that I already have some skill level in from all the years of training. It's like, let's leverage that, but that wasn't for me. Sometimes it's not clear, sometimes it's just meandering, kind of thinking, “I like this thing, I don't know why. It’s fun, but let me figure out how to utilize it.”
Andrea Austin, MD:
In the materials that you sent me when I was prepping for this interview, you did some personal development courses and I find among the physician community, there's a lot of hesitancy around various types of personal development and coaching programs, that there's this idea that maybe they're snake oil sales people, but what was your approach? How did you find coaches or resources that were actually helpful to you?
Kimberly Ko, MD:
I mean it's so true. When I was starting to take some courses and workshops, whenever I had attendings or fellow residents or colleagues ask “what do you do?” I'm like, “I'm going to a leadership workshop.” because I wasn't in that place to feel confident and strong enough to be like, “I'm learning how to live my best life and ask deep probing questions to dive in.” So yeah, it's very true. Even back then and how I feel currently. So finding those resources, luckily my husband was having a similar journey. He's a few years ahead of me and so he had discovered the Co-Active Training Institute, formerly known as CTI and he had taken some weekend courses. I was so busy working as a physician, as we all are right, and so he would go off on the weekends and i'm like, “okay great, i'll have the house to myself or I can catch up on charting and we won't feel bad that we're both busy because you're off doing this coaching thing with people and crying and sharing thoughts and all that kind of stuff, whatever.” I mean, I was dismissive at first too. I was thinking if there’s science to back this up? Where's the evidence-based research for all this? But he would come back and he was like “you might enjoy this.”
It's not all that different, at some level, from when we are teaching medical students or teaching residents. When we're teaching them and talking with them with soft, less technical things.
This was an easier transition for me because I was already enjoying the teaching interaction and so you know just diving into that and thinking that maybe this is another skill set of not just being able to provide better care for my patients and teach better, but also I went through this the training, I was thinking that physicians need this. Once I was done with my training for life coaching, I was like, “I want to coach other physicians,” but I realized that wasn't for me, or the way I was marketing wasn't getting people that were ready or were open to it. So I realized that I didn't know how to market for life coaching and all that. I don't know if that really answered your question.
Andrea Austin, MD:
No, I think it totally did. What coaching program did you end up doing?
Kimberly Ko, MD:
A Co-Active Training iInstitute, I think that's what the new name is. The class that hooked me in was called their Fundamentals or the Fundies and so it was really learning about how to ask these powerful questions or how to sit with asking a question and then allowing the client to answer and be open. I think the really cool and interesting thing I learned from that was this was the first time that I could have a role of helping and being in that doctor role but I didn't have to have the answer, which I thought was really cool. I was able to create a space in which a person can answer for themselves and I think that a light bulb turned on. But at that point, I didn’t exactly know how to translate this into other things that I do.
Andrea Austin, MD:
That's a really great message and you mentioned if there is evidence behind this and I'll put a couple of articles in the show notes. There is emerging research showing that the coaching style is effective for physicians and you phrased it beautifully that it's a lot about asking questions in a way that gets the learner to think through things and maybe think about something from a different perspective. So I think that's really cool. Anything else you want to comment on? I want to spend quite a bit of time on your ketamine practice but maybe one clarifying question, do you practice any ophthalmology right now?
Kimberly Ko, MD:
As of right now, no. After I had my daughter, I didn't really have a desire to go back after my maternity leave and that was right in the middle of the pandemic too. So no, I haven't returned yet. I don't know if it's a sabbatical or a new chapter in my career but of course I worked darn hard for my board certification, so I'm keeping up all my maintenance of certification just in case.
Andrea Austin, MD:
Maybe we can just spend a moment on that, because I interact with a lot of women physicians that are struggling with identity and a lot of their personal identity is linked to their specialty identity. How have you navigated that space well?
Kimberly Ko, MD:
I think what helped was I always felt like a bit of an odd duck being an ophthalmologist. I always felt a little bit like I didn't fit in. I'm not like everyone else. I felt like all my other colleagues were really into eyeballs and they really loved the research and everyone seemed super excited at grand rounds and really engaged, and I was struggling to be really focused here and really excited about it too. So I think what helped. I already felt a little bit like an outsider which, you know at that time, when I'm in the middle of it, it was a struggle. I mean, that's why I was thinking that I need to figure something out because I'm not happy. But that allowed me to be a lot more fluid with my identity of not saying necessarily, “I am an ophthalmologist.” We were really trained at our institution, which I'm very grateful for, that you're a physician first, then an ophthalmologist and so I really took that to heart. So the fact that I'm not looking through a slit lamp, repairing ruptured globes, doing cataract surgery anymore, I was like, “I am a physician, I think it's being of service and to help the health of the individual,” that has helped me shift my identity to something that is much more aligned with me. I’m still working on vision and clarity, but in a different way. And so thankfully for me, what was a struggle and painful when my only identity was an ophthalmologist was that I was uncomfortable in it, so it was a blessing in disguise at that time.
Andrea Austin, MD:
I think there's so much in there for listeners to really contemplate, and one little pearl I would add in there is changing the way you introduce yourself. Instead of, “I am a doctor,” or “I am an emergency doctor,” is “I practice emergency medicine,” or “I practice medicine” and that helps us think about the other things that we do, and that we are a multi-faceted individual and that we still have worth and value that's not tied to what we do.
Kimberly Ko, MD:
Totally. I think it's the power of the “I am” or “I am doing” that really made it clear to me that I am a multifaceted individual. I remember shouting that out during one of my coaching trainings and that helped me realize that this is just one aspect of me and I'm just practicing ophthalmology. Wonderful pearl, I love it.
Andrea Austin, MD:
Yeah, so anyone in their car right now, you can pause us and maybe shout that a few times.
Kimberly Ko, MD:
Shouting is good, in the right place and in the right setting.