In this episode, Andrea interviews Sharee, a registered Psychologist and Executive Coach. She considers mindfulness the most effective way to bring sustained change and focus to life. Sharee has worked in the public, private and not-for-profit sectors over the last 25 years building a unique combination of expertise in organizational, health, and counseling psychology. She is the author of The Thriving Doctor – how to be more balanced and fulfilled working in medicine.
Check out Sharee's website: https://www.coachingfordoctors.net.au/
Order a copy of her book, The Thriving Doctor. Andrea has read it cover to cover multiple times and feels it should be mandatory reading for any aspiring or practicing doctor.
Sharee recommends the book, Immunity to Change for developing a more receptive approach to challenges.
Sharee also facilitates the Thriving Doctor international book club. The International Thriving Doctor Book Club is about helping doctors to thrive, we will share what we know and invite you to share too. This is an exploratory space designed to open up your field of vision, your thinking, and our collective possibilities. Andrea is a member and highly recommends it; she enjoys connecting with colleagues across the globe in this virtual format.
Check out Andrea's other interview with Sharee on The Emergency Mind podcast, episodes 48A and 48B, https://www.emergencymind.com/podcast.
EM Revitalized: Celebratory Networking Event At ACEP SA
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Sharee Johnson: How Physicians Can Regain Agency & Lead
Sun, Nov 20, 2022 3:49PM • 1:05:13
Doctors, physician, leaders, patient, leadership, medicine, doctor, coach, listening, conversations, work, skills, recalibrate, system, thinking
Andrea Austin and Sharee Johnson
Andrea Austin 00:00
Welcome to The Revitalizing Doctor podcast, we explore with our guests how you can move from surviving to thriving as a physician. We know that when you connect with your values and authenticity, you can live a life that is fulfilling, and not only good for you, but drives the necessary transformation in healthcare to take better care of our physicians, which means better care for our patients.
Hi, there, so glad that you've joined us for episode two of season two. And we're going to be talking about physician leadership, which dovetails very nicely into a program that we're going to be offering at Revitalize called the women leadership mastermind, which will launch on February 22. So this is a program geared towards women, physician leaders. And if you're listening to this podcast that includes you, and we will have groups of six to eight women that will come together to hold each other accountable, challenge ideas and really grow as physician leaders. We are very committed to developing leaders that are going to disrupt the status quo in health care and make innovative solutions and have intentional actions that lift up other physicians and make the health care system better for both patients and physicians. So if this sounds like a fun endeavor for you, and you're looking for that confidential group support, reach out to us, you can shoot us an email at email@example.com. M stands for mastermind, and we'd love to set up a time to talk with you and make sure this program is going to be a good fit for you.
So without further ado, we'll jump into this week's episode with Sharee Johnson. I am so happy this afternoon to be alongside my dear friend and colleague, Sharee Johnson. She's a psychologist and executive coach, primarily for physicians and she practices in Australia, although she has an international presence and works with many American doctors as well. She is just a luminary in the field on physician well-being and what the future holds for making a system that's better for doctors, health care workers, and most importantly, I think our patients, so I'm not going to be labor Sharee’s introduction because I just want to start a conversation. So Sharee, thank you so much for taking time to be on the podcast. And for our listeners who haven't had a chance to listen to my interview with you on our very close podcasts the emergency mind, could you tell the audience a little bit about you?
Hi, Andrea, so lovely to be talking to you across the seas again. And thank you for that introduction. So I'm a psychologist, as you said, I work as a doctor coach, and I'm also a meditation teacher. So deep practice and love of mindfulness and compassion practices, I think they bring a lot to our work. And I came to working with doctors because of my husband's cancer, which I won't tell the long story about that. But after four years of that journey with him really had my eyes opened to I guess what was happening in healthcare for health professionals and particularly for doctors. So made a very rapid turnaround from thinking I would become a patient advocate to wanting to really support and work with doctors and learn more about what it's like to be a doctor, and was pretty shocked really to find out how little support there was for doctors, and how narrow the training was in terms of, I guess the technical skills, and that there was really a lot of scope for doctors to be more well and perhaps perform more well. If they had the compared the soft skills, what we traditionally call the soft skills, which I like to call intrapersonal and interpersonal skills. So really, I've spent the last eight or nine years learning a lot from doctors and working with doctors in how they can develop the skills of what we sometimes call the art of medicine.
Andrea Austin 04:33
Well, I would highly encourage our listeners to listen to the interview you and I did on the emergency mind. And in that interview. We talk a lot more about burnout and we're definitely going to talk about emotional regulation today. But specifically today we really want to focus on leadership and for the listeners of the podcast I I want to tell you a little bit of out why we're focusing on leadership today. So my co-founder of Revitalize, Linda Lawrence is an executive coach. And she's worked in the C suite of medicine for years and years and is also an emergency physician like me. And we feel very passionate that the problems going on in medicine are not going to go away without improved physician leadership. So part of what's going to be going on at Revitalize in 2023. And this is a bit of a primer, we hope to have a mastermind group focused on physician leadership development, but specifically among women physicians. So with that background, I want to start with a pretty hard hitting question, a phrase that I've said myself more times than I'm proud to say. It's the system Sharee, we can't do anything about it. I mean, the administrators have taken over HMOs, put any initial you want. We've lost and there's just not a lot doctors can do. Yeah.
Well, I think this is a very real experience. I hear this a lot to Andrea in Australia as well in New Zealand. The reality is that medicine is complex. I think Peter Drucker said it's the most complex system in terms of work to manage. The thing that I hear when I hear that is a real loss of agency. And I'm surprised by that in doctors, because I think, as a non-doctor, and in the world, we see doctors, as people who are educated, who have resources in terms of their wealth, and we expect them to drive the system, we think they're driving the system. And then to get inside the system and find out the doctors very often feel pretty helpless and hopeless, is kind of shocking. So when I first was listening to doctors say that they think health systems should be more clinician led, I guess I was pretty confronting to you said it's a hard hitting question. And I would say well, how can you don't have the skills. And I think doctors, generally speaking don't have the business skills. I think some doctors in small business, perhaps primary care in some of those places, have some of these business skills. And some doctors, of course, have become owners of corporate clinics. So they definitely have developed the skills. But generally speaking, doctors aren't taught leadership. And then if they are learning leadership, they've done it through their own volition or their own mission, to learn those skills. So I think skills like really deep listening, where you really desire to connect with a person out of curiosity out of believing that they've got something for you to learn to offer you is really not practiced by lots of doctors, you know, not because of the doctors fault, necessarily, but the doctor is under a lot of pressure, there's a lot of demand, there's too many patients, you know, in the same way that they might lose their empathy, because of those are systemic pressures, they might also lose their capacity to think systemically or think strategically or to think beyond their own silo and get a range of perspectives, possible truths going on in their mind. And to me, that's what a really good leader is able to do, they're able to think systemically and strategically. And so I think many doctors are able to learn those skills. And certainly I've worked with some of them. But on the floor, working clinically, there's not a lot of time for practicing those skills. So my initial response really was, it's a bit of a pipe dream, to have clinician led healthcare. I think we can do it. But we have to be very much more intentional about what we teach doctors, and the space and time we give doctors to learn those skills.
Andrea Austin 09:05
Now a few people listening are going to have a very strong reaction. So I just want to dig in on that a little bit. So that the point that you're making is not lost, because it's hard for me as a doctor to hear that. But I have come around to understanding and also thinking that what you're saying makes a lot of sense. You know, my interpretation of that is during medical school, there really wasn't any. I'm trying to think if I ever had a leadership talk and as far as residency, I would say a little bit more of that maybe than the average resident because I went to a military program and leadership is talked about more and modeled more and it's expected that you're going to have to do a lot of tasks outside of the typical clinician role. So is that what you're saying that right now the system is just not really designed to support doctors to be the leaders that they need to be?
Yeah, I think so. When doctors are in their day-to-day work, leading small teams, absolutely. The nurses, the technicians, that allied health, are all looking to doctors for leadership, I think in the day to day, but it's, you know, you and I've talked a little bit about this difference between management and leadership. And I think that these are not the same, necessarily, don't require the same skills necessarily. And, you know, it's like so many things in communication, it's perhaps the Latin language matters. No. So if I'm talking about doctors are not leaders. Well, of course, doctors are leaders, in many circumstances, even if it's just the doctor and the patient, the doctor might be the leader. But I think we need to expand our vision to include things like partnership and collaboration and to understand who we're leading where. So we don't have we're not a leader, if we don't have any followers, or we might be a leader in the very sort of command and control kind of situation, because our hierarchical position, or our power or status in somehow gives us the position of leadership by name. That's not the same as being a really effective leader. And people following your orders is not the same as people wanting to follow you because they think you are taking them somewhere worth going. And so I think this really effective leadership is about having intent and vision and wanting other people to share that with you and wanting to understand what they bring an offer and making space for them to bring it and offer it in a very kind of more equal inclusive, kind of way. So these are the spaces that I think coaching brings a lot of value for doctors and where there's real room for development for doctors. And I think we will have a different kind of health service, when doctors develop these skills and are more actively engaged in these ways aren't excited by that. In no way do I want to limit doctors capacity to lead because I think they have enormous potential. And I think we also need to recognize that there's some skill development work to do.
Andrea Austin 12:26
Yeah, I think it's important to really emphasize that dichotomy between management and leadership. And as somebody who's experienced a lot of different position leaders in my career, I think that's one of the greatest areas of growth, I would challenge listeners to think about the way if they have some type of leadership role are you managing, Are you leading? I'll give a quick example. You know, I think we have a lot of metrics in medicine. And so clearly, I know the metrics of Emergency Medicine best. So door to doc time, is an example. And managing is I want our door to doc times to be to fit the metric and providing feedback that, you know, we need to be better, we need to be faster, we need to be this metric. And leadership inspires you to hit the metric, and then also to me anticipates the reasons we're not hitting it. And also is receptive to new solutions. Because doctors know we know what the metric is. And if there's a reason we're not hitting it, then it took a pull, go full circle back to what you were saying earlier. You know, that's, that's for that curiosity. And more than just like, what I think a lot of us feel like is we just get like the whip cracked that you have to do better. But most of us are already working on the edge of what we consider our productivity efficiency to be.
Yeah. Yeah. I think that's right. So if I was going to bring it into kind of some sort of nutshell, the skills that I think, differentiate the manager and the leader, it's exactly the things that you're pointing to that the leader is, you know, looking at all the phases and stages, if you like they are, they're looking forward. They're creating a vision, a place that we want to go, they're helping paint that picture. But they're also inquiring and curious about what's happening now, where are we now and they don't assume to know all of all about that. They remember that they've employed and I understand that you know, that the employment process is a separate process in most health organizations, but these people have been employed because they're skillful, and they're knowledgeable and they have something to contribute and they want to contribute. And a really effective leader remembers that holds that is kind of sacred. And one of the things that doctors Talk about often in my experience is their lack of autonomy or their loss of autonomy. I think, you know, there's fantastic leaders, a cognizant of that they try and reduce that feeling, they look for opportunities where doctors are making the decisions and contributing to the bigger decisions and, and are able to have voice you know, one of the problems we have with sort of command and control or more. What's the word more kind of autocratic management is this loss of voice, people give up, they feel like there was no point we'll just do my job and get out of here. And that's a sign of burnout. When we start having that experience a lot. We don't want to create that we want leaders who are collaborative, who listen deeply with curiosity, who listen to learn, who have this kind of deep desire to connect, who are systems thinkers. And I think this this servant leadership model has a lot to offer in this way. So that's Robert Greenfield talked about that in the 1970s, which was pretty amazing. We were deep in command and control at that time in in business, and he was talking about how can leaders be servants to their staff and or to their employees? And how can we help them have more healthier lives more well, being more or more autonomy? There's many places in medicine, in my experience, where that idea is completely counterculture. For the, for the workers for the doctors?
Andrea Austin 16:34
Yeah, absolutely. So when I think about my own leadership style, or what I aspire that to be, and what I think there's a few words that come to mind, for me for the type of leaders that we need in medicine. So one word that we actually use at the Uniformed Services University, which is the United States only military medical school, is they really emphasize adaptive leadership, which is linked to emotional intelligence, that they're depending on the how quickly something needs to be decided. And you know, the risks and other factors, the expertise of your team, you have to adapt your decision making and leadership style. So that's one word what what's your response to adaptive?
Oh, yeah, I think it's another counterculture, kind of word in medicine that, you know, there's so much emphasis on the technical skills, so much emphasis, emphasis on the science. And of course, we love that the science and the technical skill is essential to delivering great medicine. And these other skills, that we're talking about our ability to adapt our ability to think outside of what the normal circumstance would be, which is critical when you're in the business of people, because people find workarounds, and new ways, all of the time your patients come with new complications all of the time, you can't have seen everything. So yes, I think our ability to be to adapt, and these other interpersonal and interpersonal skills, enhance the science, they help us be better technically. So yes, I totally agree that adaptive leadership offers so much potential for this transformation that health is going through.
Andrea Austin 18:33
And that brings me to the next word I use a lot is a transformational style. And to me, a transformational style involves a lot of being inspiring to the people around you. And empowering those are probably the two words that I link to transformational. And the last thing I'd say about that is that you become you're the type of leader that's cultivating a team, that if you don't show up to work for a day, a week, a month, the intentions are already there, and the culture is already there, that things should be okay.
Yeah, that'd be lovely to work in that space all the time. In terms of transformational makes me think of Robert Kegan's work around adult development. And his idea of, you know, we moving from being self authoring to being transformational in our in our way of, you know, management of our self and in our leadership, too. So self-authoring, I'm designing my life I'm really censoring, right the right word. I'm designing what I look for what I see what I select out of the environment, what I share, and what gets into me and this is the Immunity to Change work, which you might know that book when I'm transformative I'm not just looking at the world, from myself referential point, I'm kind of looking from the balcony as well, I've got more perspectives, I'm looking through life, I'm looking at myself in my life. And this is the self-awareness that we really see in very effective leaders that much more self-awareness. And so I think Robert Kegan's work around the Immunity to Change has a lot to offer this kind of physician development, where we're thinking about, okay, I can see what's happening here in my team or with my patient or through this diagnosis process. And I can also see myself I can see how I'm behaving in this process. And I welcome new information that is in my blind spot that I didn't notice before I'm you know, disruptive ideas, or other thoughts or other ways of being I welcome. Whereas when we're in self authoring, we tend to kind of bet that away unconsciously, we don't let that stuff in with we behave as if we know all there is to know about our own life and our self. When we can move into this more transformative space, there's a different level of curiosity, we really think it's messy and involves head, heart and gut, we're more curious about the emotions. More countercultural moves, because medicine is really training doctors, I think it's changing a bit now, but has trained doctors to be pretty averse to emotion, you know, don't show emotion, don't feel emotion, don't share emotion, keep everything at arm's length. We really know that that's not how humans operate now. But it's a big shift for doctors to move out of this. designing my own managing and protecting myself managing my own emotions, keeping everything under control, to saying, Okay, I want to go into this lean into this transformative space is going to be disruptive, I might not feel as protective, I might say or do or feel something that I don't want other people to see. So yes, transformation, again, personal transformation and systemic transformation. I think we're, we're in the in the midst of if we can open ourselves to it. And I just say that at the end, because I've had several conversations in the last week with doctors in groups and individually, where we're proposing all sorts of things. And the doctors continually say, well, we can't do that, because you don't have time, or there's too many people. And it's just evidence to me that that, you know, yes, if we keep doing it the way we've done it. But if we can start trying some different things, we might find that time or demand is different. But we've got to be open to these, this experimental sort of phase. And that's a huge challenge individually. And collectively.
Andrea Austin 22:49
Yeah, I was just thinking back on some of the various leaders that I've seen. And, you know, I do want to touch a little bit on burnout, because what I've witnessed in some leaders, is they have great potential, and they get into the job. And let's just use something concrete for people listening. So let's say you become the department head or the chair of your specialty, at the hospital or clinic. And it's inevitably hard, right? There's too many problems, there's not enough time. Like that's, that's I actually don't know any of my friends in leadership, whether it's medicine or outside that, that don't feel that way. Like it's always about shuffling. But what I often see among doctors is they haven't ever really learned how to have boundaries. And so then when they get into that leadership role, they aren't able to set limits on time, they have some of those in something you and I've talked about before those personal skills of managing yourself. So then when they get into that leadership role, they really struggle, and then they burn out. Because they're, you know, working too much clinically. And then they're an extra 20 hours doing admin. And maybe they underestimated it's a combination of things. But I just wonder with the number of physician leaders you've worked with, if that's a pattern or an issue that you have some advice on.
It's really complex, isn't it? I mean, I'm mindful listening to you that we're making these sweeping generalizations. So just wondering, that to the listeners that when we have these conversations, it's quite different to sitting with an individual person and trying to work out what's going to work for them. We think about her gets into leadership positions, which doctors find themselves as the chair or the director of the department or the chief Medical Officer or so on. These are the doctors who want to make a difference. You know, they systemically I think most doctors want to make a difference, but they want to make some sort of systemic difference. And often they've been looking at their own leaders thinking in some shape or form that they could do a better job. And then they get into the job and start to see all of the complexity that they couldn't see when they were looking from below if you like. And this is a very challenging place to be that you have this vision that you believe you can do better, or that you're going to improve things. And then you get into the position and you find out that it's much harder than you thought it was ever going to be. And that perhaps you do have these big gaps in your skill set, just from that point of view, any person can feel demoralized by that. And, and so, yes, they, these people often then start to work much harder, much longer hours, they're trying to work out how to keep as many people happy as they can. And boundaries become a very important issue. When you work shift, your shift finishes, even if you have to stay late at some point, the shift finishes. And that creates a boundary for you. When you work in leadership, there's not always that kind of a structural thing, that just means, Okay, it's time to go home and you can go home and I know many doctors are still charting and so on when they get home. But one of the things that happens is we change our meaning making when we get to leadership, if we're doing it well. So we have to be really clear about our mission. I think that this is one of the very important things for any doctor in a small team or in a leading a whole hospital team that we must be able to lead ourselves first, the more effective we are at leading ourselves, the more effective we can be in leading others. And pretty much every leadership program around the world starts with that. How do I lead myself? What can I raise my own self awareness. And that's really essential for boundary making. I think this word mission, some people prefer vision or purpose or meaning, is really central to this work. Why am I here? What am I doing? What am I willing to do first? What am I willing to disrupt? What do I need so that I can disrupt? What's the most important thing to challenge or to question? And I'm not talking about change for changes sake, I'm talking about being able to welcome new thoughts, new ideas and stimulate other people's thinking in this way. So fantastic leaders provide a lot of sponsorship, I was listening to one of your other revitalized podcasts, and I can't remember who the person was. But they were talking about the importance of sponsorship. And I think that one of the things leaders can do for new leaders is create sponsorship for them, or people in teams that look like they might emerge as leaders, how do we sponsor situations for them? How do we champion them? How do we walk beside them with encouragement, and, you know, uplift them, in their in their capacity, because leadership can be a very lonely place, especially as a new leader, when you looking at all your team, they're expectedly, looking at you, you're looking at the people above you thinking, well, they all know what they're doing. And I don't know what I'm doing. So I think these words, collaboration, partnership, sponsorship championing, these are the things that we can do better, to help each other in leadership in medicine,
Andrea Austin 28:30
As physicians, you're even told, when you're going into medical school, you know, part of it's because you want to be the captain of the ship, the head of the team. And as we're, you know, we grow into this, and we see how complex these problems are. There may be a leader in title, but you need a team, and you need these relationships and this lone leader idea, you know, we really have to let it go
medicine is sort of defensive in a way, isn't it? Like, you know, I'll protect my team, or I'll protect my silo, or I'll protect my department or I'll protect my craft, you know, my sub specialty or, you know, I think there's a lot of it's not sustainable. It's clearly not sustainable. We don't have the workforce to keep upgrading in this way. I don't know what the perfect new way is. But I think it requires much more supporting each other across across all those self imposed boundaries. I'm going to complicate our conversation by using that word. I think we, we need more personal boundaries, and we need clarity around what we can and can't do. And we also need the capacity to adapt as you said before, we were saying, even the very simple things of saying, Who are the other leaders in the other departments physically around me? Do I have a relationship with them? Do I know who the head of department or the acting head of department is, on the next floor, or in the ward across the way? Or, you know, how can I build some relationship with them? Can I be curious about what they might teach me, you know, this sort of opening up in the vulnerability is Brene, brown, and many others talk about that we learn, right. And while we're kind of protecting ourselves by, you know, looking like we know what we're doing, we limit ourselves in our learning, we limit our relationships. And I think we limit the growth and development of medicine. And that's, that's limiting for patients.
Andrea Austin 30:39
So I want to maybe pivot a bit and get your thoughts on the idea of courageous leadership. And, again, I'm going to speak from my perspective as an American emergency physician coming out of COVID. And I'll just give one brief example, I had a colleague that said, well, across the United States, and I'm sure it was across the world, it wasn't uncommon for volumes in places that didn't have COVID initially to drop severely. I mean, some places the IDI visits were 20% of normal volume in the first few days and weeks of the pandemic, but that changed fairly quickly, honestly, most places, within a couple of months were back to their normal volumes. But this physician shared that their emergency department staffing, decreased and never went back. And I just, we've got so many problems right now, in which I really, we need leaders that can have the courage to have hard conversations with the hospital CEO, with insurance, you know, all the different stakeholders that we need more time with patients that we need more resources to be able to go on, I think they've essentially asked us to cut and squeeze as much as we can. So what's your advice? To inspire courage? Or what is what do psychologists know about courage?
Well, probably not anything more than other people know about courage, Andrea. But, you know, I like the Susan David idea that, you know, courage is fear, walking, courage is feeling the anxiety, acknowledging it, knowing that it's in your body, and choosing to still progress forward. And that's much easier to do if there's a good reason to write. So if you know what your intention is, if you know what your vision or your mission or your purpose is no meaning, then it's easier to walk forward, it's much harder to progress forward for an unknown purpose or reason. You know, if we think about people who, you know, given awards for their courage, you know, they pulled somebody out of the sea, or they pulled somebody out of a burning building. They say that they didn't really think twice, it was just what any was the right thing to do. It's what any normal person would do. In that moment, they know what their purpose is, you know, their purpose is to help another human being survive. And that's built into it's it's hardwired into us this collective survival mechanism of compassion and being in tribes, we, we have that we already have that. The question is, what do I want to do in my tribe or with my tribe? Beyond that, so you don't want to survive? Helping each other in that way? Is survival imperative. So what are we surviving for? What is it that we want to survive for like these are you know, those big What's the meaning of life kind of questions. But I think more of that conversation inside medicine. I read something yesterday, I can't remember all of statistics, but it was about palliative care. It was the number of people who would like to die well, far outweighs the number of people who would like to live a long, long time. I think it's something like 19% of people can't remember the Australian study. 19% of people wanted to be kept alive, and 70 81% wanted to be allowed to die. This is again, the opposite for what happens in medicine. A lot of the time, you know, medicine, doctors are trained to keep people alive for as long as they possibly can, you know, with whatever mechanisms we have to keep them alive. There's a good ethical reason that we made that principle so that doctors know I want to do under stress in very difficult circumstances, but it may not be cognizant with what the community wants. So, you know, I think this question of constantly saying, what is it that we are alive for together as a group? What is it that we want to do? What are we trying to achieve? If we can understand that question? And we know, so for instance, for me, why do I work with doctors, I could coach anybody really, I don't have to coach doctors. But our experience teams and my husband, Tim, in my experience, when he had cancer, was such a visceral experience of how health could go well, or not well dependent on the care and the relationship we had with the doctor. So you know, for me, it's legacy work, it's about making meaning out of Tim's death. And kind of you know, that I can't unknow what I know. So people think, oh, it's amazing that you've done something good out of a terrible thing that happened when when Tim died. It's really about looking after myself in the long run. It's trying to make something that was tragic and awful, have a silver lining be better. People say, Well, you coach teachers, and I do coach teachers sometimes, but, but the meaning making is much more visceral, when I work with doctors. And so I think for doctors, we're all human. This you and I've talked about meaning quite a bit that meaning lets us keep going even when the odds are stacked. So I don't think we can keep doing health the way we do. We are going to have more life coaches, more nurse practitioners, more other jobs that we don't have names for yet. In healthcare, the doctor's role change, because we just don't have enough doctors. So it seems to me one of the really important things doctors can be doing is to be saying, what is it that I want to offer with my skills? How can I be a contributing part in my community that is valued by the community, but is valued by me myself? Because that's what actually keeps me going. That motivation has to come from inside ourselves.
Andrea Austin 37:16
One of the last words you said was value. And while you've been going talking about meaning, I'd really encourage listeners, and it's certainly not a secret, we talk about a lot on this podcast about values. And I'm almost embarrassed to admit that I didn't know what my values were until a couple years ago. I think I'm not unique that most doctors that go to medical school, think that my value is I value health, I value, learning how to be a good doctor and taking care of people. And that was a great value to have and focus on for a very long time. But I think it's pretty immature, honestly, and it doesn't sustain a career for most people. So, you know, I think that's a great place for people to start is what are your values? And how are how does that link to what you're doing and how it's gonna sustain you through these challenges. And, you know, you coach physicians, and I think about coaching, facilitating teaching physicians, which then impacts patients. So that's, you know, where the second arc of my career is really focused on is how do I make the experience of other physicians better because I love physicians, you know, they're, it's very popular in America, I don't know what it's like in Australia to make fun of physicians. And there's a lot of it's a podcast, I really like I won't mention it by name. That unfortunately, one thing, they routinely are down on doctors. And part of it is I understand why they are they've shared experiences that have been negative with doctors, but I think what you and I share in common is, while we don't think that's acceptable, we're curious about, I always immediately like, I really want to know, that doctor story. Like I'm sorry, the patient experienced that. But I want to know more about that doctor,
I can't think of a situation in the same way where there's been open made fun of doctors, you know, as a theme, but I think there's a real disconnect between what patients understand of doctors and it's not the patient's job. You know, sometimes I did some writing recently, trying to express what was happening in a doctor's life as a human being and I showed showed it to a couple of GPs before I haven't published it yet. And they said I don't want the patient to worry about me. It's not the patient's job to think about me or where You bet me. Whilst I understand where that comes from, you know, it comes from patient first and do no harm and these really important ethical kind of principles that medicine is built on. I think it's really limiting. Its limits the human connection, that limits the capacity for the patient and the doctor to really come together. And I don't mean that the doctor comes to work and tells the patient all about what's going on at home, the terrible state that their own families in or whatever, I don't really mean that I just mean that we need to break down this kind of separation, this othering that we do of each other. But if the patient is looking at the doctor, as the person that can fix everything, who's got it all together, who's got plenty of money, who's got plenty of status, who's different to them, then they don't share things that they might need to share with the doctor, they might feel intimidated or embarrassed, and they don't share some of the information. Equally, the doctors will be patient as different to them. And we know from patients from doctors when they get sick. But they have this aha moment. And they say, ah, gosh, it's so different. Being a patient, doctor who's not making that human connection with the patient, does respond to them differently, does treat them differently, does assess their pain differently. So I think we've got a lot to learn, I don't know where all the answers are, just, as you say, curious to learn more about that intersection in the relationship.
Andrea Austin 41:31
Yeah, it's very interesting. Thinking back to medical school, I mean, that's indoctrinated, and you very early, that you will be stoic, and that you will not share anything that's going on with you, if you're tired, hungry, hurt, whatever, whatever just you walked in from the last room. But life is obviously so much more complex than that. And some emergency departments still have kind of open base. And it's always been very interesting to me from like a human psychology standpoint. You know, we tried as doctors to keep everything separate. But it then patients will see something like, I can remember one night I was single coverage overnight, and I had a patient come in that they were doing CPR on and just the physical space, there was only so much we could do to make it private. And the other side of the ER could see a lot of what was happening. And kind of selfishly, I was happy because a lot of the people on the other side had less acute things. And I think they some of them would have been really mad with me because I was in there for like almost an hour. And several of them said, don't even it's fine. No explanation needed. I saw, I saw what happened. And I was like, Is that such a bad thing for people to be a little bit more aware that like, this is a system, whether you come in as a patient or the doctor or the nurse or whatever. And it's a very imperfect system, especially something like an emergency department. That's a safety net. You know, what, how, what's the cap on how many people that can come through an ER door there? Is that?
Right? Right. We have a really salient example happening right now next week in Australia. So you know that Queen Elizabeth died. And as a result, there's all these protocols in the Commonwealth countries of which Australia is one where we have a certain number of days where we don't have parliament and so on, because we're in mourning for the queen. We have a public holiday that was announced yesterday, a new public holiday just for this year, to recognize the Queen next week. And the result is that lots of clinics are closing because they have to pay double time and so on for their staff and they can't afford to be open. So all those patients need to find new times with their with their people that they would say specialists and primary care practitioners. And they the clinicians are saying we can't we can't operate because we won't have any nurses or techs, they'll be on leave or this health system can't afford them. And the people have nowhere to go. So where will the people go? They will go to the emergency department. Now it's you know, we've got 10 days I suppose to know about that. But there's nothing the IDI can do, constantly open backstop whatever else is happening in the world.
Andrea Austin 44:46
This conversation has just flown by. I want to pick your brain quickly on a physician listening right now. Maybe there's somebody that's still In residency or a year or two out and they're like, you know, Sheree, I get what you're saying, I think it's, it's great. But I just learned my craft, I'm still trying to perfect my craft, and maybe they're developing chest pain listening to us going like, don't tell me I have all this other stuff to do, what's a small step that they could take to start to grow some of their leadership skills,
But you don't have to grow your leadership skills at work. So that would be the first thing, if you can be curious about your own self outside of work, that's a great place to start. So I think any self awareness work that you can do outside of work, perhaps it's that you get a coach, perhaps it's that you join a some sort of program, some leadership program, or some self personal development program, maybe you go on retreat, and be willing to experience something different about yourself. So perhaps you do, you know, an outward bound kind of thing. Maybe you do a meditation course, maybe you read five books over the next five months, one, one a month, that's on leadership, anything that can be a feeding your curiosity, I think the biggest trap for young doctors that I see in coaching is this desire to demonstrate how much they know. You know, it's part of building our professional confidence. And it's part of building our professional reputation. And also can blind us to, to our own self. And so it's, you know, make the smallest version of this is just to make a commitment to yourself, to be curious about yourself. So instead of just looking at the world from yourself, inquire of yourself. So you might be driving home or walking home, you could make a practice that every time you're driving home from work, you just ask yourself, what did I learn about myself today. And there might be one thing you might learn that I that really triggered me that really pushed my button. Or it might be one of the nurses that you really enjoying your relationship with one of the nurses and that you notice that you're more relaxed when they're working? Just inquiring of yourself every day, you can formalize that in a journal kind of practice. But I think just asking yourself this one question, what did I learn about myself today can be a bit of a portal into just raising your awareness opening this part of your, your learning?
Andrea Austin 47:31
Yeah, and I would just add to that, you know, that's, that's introspection and reflection, which are key interpersonal skills. And then when you're stuck, reach out, you know, there were things I would just keep falling flat on my face on. I definitely benefited personally from coaching. But even in formal, there were just people that I knew that excelled at some of these various skills. And so I would bring some of the situations and challenges to them. And, you know, you have to, I think, part of the mark of going from kind of a more immature to a mature person is that you can synthesize advice that getting counsel from someone doesn't mean that you're necessarily going to do what they say. But you're able to interpret it through your own lens, pause, reflect, not immediately act on any piece of advice that you get. That's certainly been really important. growth for me the last few years is I think Brené Brown talks about the temptation to poll people versus taking advice and that extra step of really synthesizing it into your own life. No.
It's easier to do this stuff when you hang around with other people who do this stuff. And so I think that's part of what we're doing Recalibrating, our group programs. And I think that's part of what you and Linda are doing in your group program to your mastermind, looking to how can we bring people together and create spaces for them to do this work because it is counterculture, it is hard to find these people sometimes it's hard to, to know it feels risky, to say out loud, some of this stuff at work to your colleagues. And often once you find the people you can't stop saying these things. But it's hard to find the people. So I think, you know, using some of these mechanisms, there's lots of people now and of course, what we do at Recalibrate what you're doing it Revitalize in front of mind for us these kinds of programs that bring people together to do this work much easier to do it in company.
Andrea Austin 49:51
So tell us a little bit as we're closing about Recalibrate, I know you have a group starting relatively soon or we should start Are you thinking about it?
Yeah, so we're opening our registration that the group doesn't start till next year 2023. But we opened our registration in a fortnight, which is very exciting, Andrea, I always feel very excited when I'm meeting the new people who have decided they're ready to do this work. So and our programs are growing like we have doubled the number of programs this year, we'll have doubled the number of programs next year, there are many more doctors starting to recognize this work is important. So So for recalibrate, we run a program that has runs over four to six months, depending on the length of time the groups come together. So we're going to go back to live programs, some live programs next year, which is also exciting. Someone zooms on live. So people have six coaching sessions with me individually, they work on whatever they want to work on in terms of their own goals. And sometimes they work on things that have come up out of the group. And then we have between four and six master classes over six months where the people come together, we limit the group to 10. So that we can have an intimate setting where people feel safe to speak. And I co facilitate that with the doctor, we have a couple of doctors who work with us. And the work is really around these intra and interpersonal skills. So self awareness, and, and communication and interaction with other people. Mindfulness compassion, we do quite a lot of work on identifying unconscious bias and how to respond to that when we do when we do notice it or somebody points it out to us, and all of that compassion, empathy. And all of that culminates in trying to bring those those threads together, join those dots a bit of what you're talking about the synthesis. So that we can prevent, be preventative in our behavior, prevent burnout, and so that we can lead more effectively so that we can learn to lead. And then those people come into an alumni community, which is, you know, probably the loveliest part of the whole program, because they continue to do that work and supporting each other and looking after each other and continuing to learn and have opportunities to introspect together and to ask each other questions and and we have some live retreats so that they come together. So that's the recalibrate groups themselves ran in a very tight cohort, just they're eight or 10 people. But when they come into alumni, they come all together, so they meet people across group, and they're from various specialties all over Australia. We have some New Zealanders in that in that community now, too. So I'm excited about that group, I think the ripples that they make together, is is part of our future in terms of, you know, expanding the work way beyond any
Andrea Austin 52:39
Looking at the times that that you'll be meeting, if somebody in America wanted to join Recalibrate, they should be able, right?
Yeah, I think so. Yeah, I think the times work, we try and make them work, they can't join the live group, unless they're going to come to Australia four times, or stay for six months, which would be lovely, we welcome you to do that. We have talked at different times about running specific groups for other countries. And we're certainly open to that if there's anybody listening and knows that they can get eight or 10 people together, we'd love to do that. But we really want to refer and recommend your program as well. So I guess our program is men and women. So that's a point of difference between with what you're doing.
Andrea Austin 53:20
Yeah, absolutely. You know, my feeling and talk to many friends that are in this space, is the truth is, there's a lot of doctors that need help. So I never feel like we're competing. I always feel like we're working together. And yeah, we you know, Revitalize focuses on women physicians. So it's great that Recalibrate in the work that you do is not associated with gender.
Yeah, I agree with you, there's plenty of work, you know, would be my feels like a fantasy at the moment. But I think it would be just so wonderful if every doctor had a coach, and whether that was an individual coach or a coach through these programs where there's a peer element to the coaching. I just, you know, as a psychologist is who's had to have a supervisor in terms of that professional development and that professional grounding. It's amazing that the doctors haven't had to have some of that kind of more formalized support, in my view. And we really are astounded that every single time we have a group of graduates from recalibrate, the consistent feedback is this should be considered compulsory for all doctors. So I think you know, once people are ready to come to these programs, once they're able to find the time and the space to prioritize themselves. You know, they're available to do this really powerful work and it makes a huge difference. Very often they say that they've their families are saying that they're different, and their families are celebrating. Within a couple of months of starting the program. I just think that's such a joyful thing for me I just feel so privileged to, to be in that space with the doctors who are doing this kind of work, I think they really have enormous capacity to create a different kind of healthcare. But more than that, it's making them sustainable. If they decide, let's say, some of them decide ultimately to leave medicine, well, that will be a shame for our community, but it's wonderful for them in their life. So far, we haven't had anybody during the program who choose to leave medicine. It's more the other way where they say I've fallen back in love with medicine, I'm glad to be. But I think the value of coaching is that people remember their own agency, they feel empowered, they can do that process of looking at themselves as well as from themselves. And you know, so the whole landscape can change in terms of what they experience in their life.
Andrea Austin 55:51
That is so beautiful. How can our listeners connect and learn more from you?
Lots of ways, I want to give our book club a little plug, first of all. So we have an international book club, and we meet once a month, it's very cheap for the connections in the network that people would have the opportunity to make if they want to join the book club. So that's all everything's on our website coaching for doctors.net.au. If you're looking for a kind of low level way to start talking and thinking about these kinds of ideas, then the book club is a simple way for people to participate in these kinds of conversations. And, as you know, Andrea, you're a member of the book club, too. And we essentially are focused on how to help doctors have well being so the broad range of conversation there with doctors from lots of different countries. If people want to do coaching with me again, same thing coaching for doctors.net.au. At this time of the year, it is getting a little bit hard to to find an appointment with me, but there are still a few. So if people want to do that, I'd love to chat with you. And you can we can have a half hour complimentary, you know, just chat to see if I'm the right person for you or not. So that's easy, again, no obligation. And then Recalibrate. As I said, we're opening our doors in a fortnight for people on the waitlist. And first of October for people who aren't on the wait, this is no obligation to be on the waitlist, it just means that you find out a week earlier. And you know, we really try to be in the business of supporting doctors. So if you look at our programs and you feel confused, or you want something that's not quite there, please just send me an email, I'm really fully immersed and happy to have conversations with doctors, it's important for my learning as well. We're really trying to develop the supports that will work for doctors. And whilst most of my clients are in Australia and New Zealand, I think these conversations that Andrea and I are having with each other and with many other doctors around the world, are helping us create collectively supports and an understanding that will help medicine go well and be sustainable. So I think there's no real limits to those conversations. I'm on LinkedIn, I'm on Instagram. Come say hello.
Andrea Austin 58:16
Yeah, and for our listeners who haven't heard, burnout rates among physicians are pretty similar across the world. Doesn't matter what system you're in. In America, we often think that the Canadians are the Aussies, they've got it all figured out with their socialized health care. And that's not the case. So it's been very therapeutic for me to get to be in the book club, and connect with the physicians there and our mutual friend, Cheryl Martin, as well. But these are universal experiences that transcend the exact way your system is comprised. And there's been a lot of community, but it's also caused me to reflect a lot that okay, well, if other doctors have this issue with different systems, that maybe it's not just the system, oh, maybe I need to do what Sheree is suggesting and do some work on me. Darn it. It's
Really powerful insight, Andrea? I want to just maybe say that, you know, Margaret Mead said that I wrote it down to try and remember the quote properly. I don't know if I can say, Never doubt that a small group of thoughtful committed citizens can change the world. Indeed, it is the only thing that ever has. And I really believe that I think that you know, whilst we say it's the system, we give our power away to something else. That doesn't care that doesn't have the capacity to actually think anything through and change its ways. It It's, it's the manifestation of human action. And so I just really feel like if we can say, What can I do and find the other people who are also saying, I want to help with that, too. But that's the way forward that we do want government, and we do want big health systems to make changes and see our executives having insight and so on. And I hope they do, and I hope we can help them. And I can't wait. It's not, it's not for me to sit and wait. I think there are things I can do in the interim, to help make the case if you like, and Corey Feist. I think I'm saying his name, right. Yes, Lorna Breen’s, brother in law. You know, he's actually I think, is a perfect example of this, his and his wife's, whose name I can't think of my apologies to her. But you know, that action where they've created legislative change in America, it's incredibly powerful example of how a group of people who felt who cared enough to put their head, their heart and their guts, so to speak on the line, can make a huge difference. So I don't claim to be in the same realm as them. But I think that the work we're doing is making a difference to many doctors, and their families, probably, and hopefully, their patients.
Andrea Austin 1:01:26
Absolutely. And the one thing you didn't mention that we'd be remiss not to say, is you are the author of The Thriving Doctor book. And that would be the first thing I would ask all of the listeners to do is buy your book, many of the listeners have received a copy of the book from yours truly, I gave it to nearly every doctor, that I counted as a close friend, which maybe I shouldn't say out loud, because if you didn't get a book for me last year, I'm sorry, maybe it's coming this year, I gave out a lot of them. Because it's absolutely and when you say your Recalibrate should be compulsory. Your book absolutely should be required reading of everyone thinking about going to medical school in medical school, doctoring, please read that book, it's fundamental, and I think provides a really good framework for anybody who cares about this at all, which hopefully, is everyone. But you know, it really does give doctors a really good footing on how to structure their own past personal professional development. And then if you're in charge of helping other doctors, I think your book is just the quintessential roadmap, I can't think of another book, and I've read most of the physician wellbeing books out there. Yours is the top of the list.
Thank you, Andrea. It's very sweet of you to say we've had we've we have really had fantastic feedback from all around the world about the book. So it does seem to have landed well. And I think, as you say, the different systems have the same problems. So you know, thank you, for your very kind words about the book. I do hope that when I wrote the book to try and reach more doctors, and so thank you.
Andrea Austin 1:03:25
Well, this has been an absolute joy and the time flew by way too quick as it always happens when we're talking. Thank you from the bottom of my heart, for everything that you're doing. I 100% know and believe that you have saved many doctors lives and that you 100% have changed. Doctors lives and therefore patients and I'm getting teary eyed even saying it. But it's truly a powerful presence and legacy that you're shaping. And I thank you.
Thank you so much, Andrea, it's just a pleasure every time to talk to you. Thanks for having me.
Andrea Austin 1:04:10
Thanks for listening to The Revitalizing Doctor podcast. This podcast is brought to you by Revitalize Women Physician Circle founded by Dr. Linda Lawrence and Dr. Andrea Austin, your host. You can connect with us on our website at https://www.peoplealwayshcc.com/revitalize. You can tweet at us at Revitalize Women. And please connect with us on LinkedIn at Revitalize Women Physician Circle. We look forward to helping you go from surviving to thriving. This podcast represents our opinions and the opinions of our guests. It does not represent any entity that we work for or with including the military, the government or any other institutions. Thanks for listening and we'll see you again soon.