Have you reached the roadblock of considering whether or not to practice clinical medicine? In this episode with Dr. Raquel Harrison, she shares her own journey grappling with this decision, emphasizing the importance of considering personal well-being alongside professional aspirations. Drawing from her experiences, she highlights the significance of fostering, maintaining, and valuing meaningful relationships. Tune in to this week's episode as Dr. Harrison provides invaluable insights into this multifaceted issue.
"It's really that idea of kind of finding the joy again, and just the opportunity to take a step back and look at it more objectively and more relationally, you know that ability to kind of have a new lens towards your clinical practice really helps."
My special guest is Dr. Raquel Harrison.
Dr. Raquel Harrison is an emergency medicine and lifestyle medicine physician. Her story is not just about changing schedules, but about transforming patient care and rediscovering one's passion. She discusses how she found harmony in the diversity of her practice, recognizing that oftentimes those who present to the emergency department often have opportunities to interweave lifestyle medicine interventions that are great for patients and improve her sense of fulfillment and meaning . Dr. Harrison shares how working clinical shifts is grounding and offers a chance for reflection. By seamlessly integrating both aspects of her practice, Dr. Harrison expresses how she found a sense of purpose and fulfillment that transcended the confines of any single specialty, embodying the value of holistic, interdisciplinary medicine.
In this episode you will be able to:
Find personal fulfillment and well-being when navigating between different avenues of medicine.
Discover ways to maintain balance and gain a sense of purpose with clinical medicine.
Foster connections with patients, colleagues, and the broader healthcare community to not only enhance patient care but also to find support, inspiration, and professional growth.
The resources mentioned in this episode are:
Visit Dr. Raquel Harrison's website, Acute 2 Root to sign up for the Foundations Course to find balance and establish a healthy lifestyle.
Use code: Rev15 for 15% off of the Foundations Course
Connect with Dr. Raqu
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Speaker 1:
Welcome to the Revitalizing Doctor podcast. We interviewed trailblazers in medicine that embody the revitalized women vision to empower women to innovate and influence medicine to value authenticity, respect and work life harmony. We recognize the challenges in medicine and we're committed to providing coaching, informed strategies to help you go from surviving to thriving. I'm thrilled to have Dr Raquel Harrison back on the podcast. She has been a guest before and today we are going to be talking to her about some updates in her work as both an emergency physician and a lifestyle medicine physician, and this is going to be a great episode. If maybe you're thinking about do I still want to practice clinical medicine, and I think where our stories converge a little bit is we both came pretty close to maybe not doing any clinical medicine. So in this first part let's focus on this tension between practicing clinical medicine and not practicing clinical medicine. So what are your reflections on that?
Speaker 2:
Andrea, thanks for having me. It's so great to be back with Revitalizing. I love what you guys are doing and there's so much power in it that just creating a space and a conversation about some of these issues that a lot of us struggle with and we never have a chance to kind of hear what other people are doing. And so I love, love, love what you guys are about. It's interesting.
Speaker 2:
I went part time and I think I talked about this in the podcast a bit, but I went part time probably about five years ago really trying to understand what my life clinically was going to look like.
Speaker 2:
And you know, as an emergency physician big, large, academic urban centers, that's what I've always known.
Speaker 2:
And in that kind of part time journey I found lifestyle medicine, which is almost in some ways like the flip side of what we're doing.
Speaker 2:
But as I've kind of gone through that journey and started to do more with lifestyle medicine, even in some ways reduced my time in the emergency department more and more, I haven't wanted to let it go, and part of it's because there's always kind of that nagging of I've worked so hard to get there, but also it's grounding right, it's that ability to remember why I'm even having some of these lifestyle conversations in the first place, and a lot of it is, you know, if we really kind of peel it back.
Speaker 2:
Those patients that we're seeing in the emergency department are often the culmination of a lot of bad lifestyle decisions, and sometimes it's actually just one life stuff and decision, depending on the patient. But it's that culmination and so it's a little bit of that reminder for me why even, you know, opted to take the other approach for a little bit, and so I still practice a few times a month and I'm blessed to be in a position where I can do that with my boss and with my family as well. But it's definitely giving me a bit of a different perspective on my clinical work in the emergency department.
Speaker 1:
That's so interesting. I just had another call with a senior emergency medicine leader that shared a very deliberate decision to keep doing one shift a week and we explored that because she was in a position where she could have said I'm not doing any clinical and the thing I keep coming back to is the thing that got you into clinical medicine may not be the thing that keeps you in clinical medicine. How does that land with you?
Speaker 2:
That's an interesting way to phrase it. So that idea of the clinical not actually being what keeps you clinical, it's interesting. I think that does resonate for me, you know, because in some ways I have an opportunity to go in, not be overly frustrated, not feel burned out. I'm going in because I enjoy it. I enjoy the opportunity to kind of interact with different kinds of people that I don't otherwise interact with on a day when I'm not working clinically. But also and I think I used this word earlier but that idea of staying grounded not only to kind of the realities of medicine, the realities of health and staying healthy and what that looks like, but also grounded to like my own journey within medicine, and so it's a good reminder on a fairly regular basis of my own motivations and my pathway through all of this to try to really hone in on who I want to be in the future as well.
Speaker 1:
One of the other things I've noticed about my clinical time is, of course, you know it's about the patients and you want the patients to have a great experience and be safe and that's that's kind of almost a given for me, like I'm saying it. So it's very clear to anyone listening that the patients are always the top priority. But at a certain point, when you've had this much training and this much experience, it is a given that that's what you're going to do on a given shift. And so you're bandwidth and capacity to be accessible in different ways. And you know, I had a shift recently where it was a newer attending that I actually knew from when he was a resident and we were sitting side by side and I love that in this particular emergency department that you sit next to another emergency physician and you help kind of field calls.
Speaker 1:
The calls aren't always going to one person and there were all these different things that kind of popped up during the day and I was able to, you know, just kind of say, you know, when I had something similar, I found this was helpful and I did it in a way that you know I've had people insert themselves into my cases very rudely and very condescendingly. So I, you know, asked permission. Could I, you know, share something with you? Or could I tell you, like, how this happened? The similar situation went down with that consultant, you know, in a previous situation and it ended up being a really fun shift because I could see him about to step in some big piles of poo and I just like helped them step around it and I think that was more rewarding to me. Like, honestly, the patients I saw that day there was really nothing that exciting or interesting. I had some nice conversations with them, but it was the interaction and being there for my peer that provided a lot of meaning to that day.
Speaker 2:
I would absolutely echo that. I mean even just the opportunity to you know, when people ask you how you are, when you walk in and you've got a smile on your face because you're there for different reasons, or you're able to be there in a different capacity because you're doing other things when you're not there, that also offer that fulfillment that you like. For years, angered on your clinical work, providing right, you know you're not looking for that anymore and so you can offer yourself in different ways.
Speaker 1:
Yeah, and the other thing that I've been on the verge of do I go, you know, full time into whether it's coaching or simulation work, and leave clinical behind? And the interesting thing that has got me really taking pause is, like you said, we've accumulated a huge amount of wisdom and experience and, honestly, if this podcast gets forwarded to an administrator, what should keep you up at night is losing your mid career docs Because, let's be honest, some of your really at the very edge of their careers do a great job, but a lot of them the data actually shows that after the 10 year mark, people, if they don't do very deliberate things, will lose expertise. Your new docs they're great. You want to keep them happy too, but your mid career people that are exiting to me should really be concerning to folks.
Speaker 2:
I agree You're talking numbers, repetitions, all the things that we highlight as really important, particularly in emergency medicine, right, that ability to understand the algorithms and deviate when needed. All of that comes with good training. But also an accumulation of just cases, right, when you start talking about like kind of try to extrapolate the numbers of patients. You've seen over time an emergency physician in a big urban emergency department working full time. You'll cover 3000 to 5000 patients potentially in a year, right, like I mean, that's a lot of repetitions, that's a lot of accumulation of cases over time and it's an important piece.
Speaker 2:
You know, medicine doesn't change with that much frequency. That 10 year mark, I think, is pretty critical. It's also probably why I would say I feel comfortable doing a reduced shift load, right, and still being okay being in the emergency department when I am, because I do feel like I've accumulated that experience and can draw on that. I do get that question a lot Do you feel comfortable, even though you're working so much less, and it's to that point of, after accumulating a certain number of cases, you really do have an expertise? That's important and it's not a matter of like inflating myself, it's just. It's really just that mid-career physician that I think you highlighted.
Speaker 1:
I also want to explore this idea of. I think both of us went through periods of burnout to some degree and I think a lot of the burnout self-help books, resources, coaching programs, whatever you know you put in burnout physician into Google what pops out is this is really bad and here's something you can do to make it better. And it's almost like you know, if you had an infection, you know like, okay, we got to pop this abscess and get you on antibiotics. And one of the most powerful things that like came to me in the last six months and one of them is a past episode with Michelle Woolhouse that really introduced me to this concept is what happens if you took away the idea that the burnout was bad and that it's something that has to be reversed and instead you followed it down Like you didn't repress it, you didn't try to figure out a way to like fix it.
Speaker 1:
And I don't feel burned out now, but it was almost like if I could have befriended that time, if I could have said this is actually trying to teach me something and what it was trying to teach me was how to reshape my career to move in line with my values, boundaries and priorities. So all the quick fixes like okay, well, I'll switch to this job or I'll reduce shifts here, it's almost like a tummy tuck. You know you're trying to like do the tummy tuck instead of lifestyle medicine approach, and it wasn't working. And it was really going through like the sole pain of like what is this trying to teach me? And I think you know, looking back, I'd burned out a few different times and it was only the last time that I just really leaned into. No, it's like something's happening. There is no quick fix. It's going to take a retooling, revitalization of my career in order for me to keep doing this work. So I wonder what your reactions are to that, or if you had a similar experience in any way.
Speaker 2:
Yeah, I think it's an interesting concept, an interesting idea of like, how do you just keep kind of peeling back the layers in a sense right to try to really uncover the why, befrying the burnout, right, and in some ways I feel like I probably came right up to it and maybe I was burned out like fully, but I think, kind of coming up against it being forced to because of you know, some personal health things I was going through, and maybe it's my optimistic perspective that's like I wasn't quite at burnout, yeah, just a butted next to it, but it's really the why that sticks out and kind of embracing that in some ways and allowing myself to be frustrated with what I was doing. Every day we get really stuck on this idea of, like man, I chose this path and it was a really long, hard path, and so you almost feel like you were supposed to be victorious at the end and you're not right and you're just slain and frustrated.
Speaker 2:
It's not what I thought it was going to be and there's never like reverse or at least it feels like there's no reverse.
Speaker 2:
But I love about what you said is it's a little bit of okay, having farnished it and then take it potentially just in a little bit of a different direction and it's not a full reverse but a pivot per se. That's. Lifestyle medicines really offered that because I'm able to leverage my perspective in emergency medicine and actually when you start talking to people about their habits, their lifestyle choices, their day to day, that ability to read people quickly, translate really complex medical concept into lay terms very quickly and have things resonate really like tools I use regularly with when I'm doing more of the lifestyle medicine work. And so ultimately it's the frustration with kind of that day to day feeling like I was only putting band-aids on people, just really fancy band-aids and then not feeling like I had much to show for it and not really getting at the heart of what actually prompted me to go into medicine in the first place.
Speaker 1:
Yeah, as we close out, like this first part about how your clinical time evolves over your career, I'd like to give some people some practical tips or things to noodle on. I think one thing is you should recognize that the amount of investment that went into your clinical expertise is huge financial time, all of that and given the moral injury and things that happen to people throughout their career, it can be very tempting to just let it go and do something else. Every physician is incredibly smart. They can definitely succeed in real estate or whatever thing you want to do, and there's nothing wrong if that's ultimately what you choose to do. But make choices from a place of strength and not from a place of fear or desperation. And the other thing too is like, if you're going to go completely non-clinical, make sure you understand what that means and what doors you will close.
Speaker 1:
It was interesting when I talked to a locums company. They look at your cases from the last two years. You actually can't get malpractice insurance if you haven't had a certain amount of caseload in the last two years, at least for a lot of the locums companies. They look at volumes of the places you work and the breakdown of patients peeds versus adults, and when I did the calculation that they were giving for EM, it came out to roughly about eight shifts a month over a two-year period. We can argue whether that's right or wrong or whatever, but it does, I think, behoove you to find out and do some research about.
Speaker 1:
If you ratchet down your time or you walk away, what would it take to walk back through the door? So you know, because the other thing I'm starting to learn with some of the non-clinical work is we saw kind of the EM workforce be stretched and stressed during COVID. If you go into a non-clinical role and your hospital decides to cut back on admin, you could be on the chopping block. And then what does that mean? You know, if you're very tied to a geographic area and you can no longer go back into a clinical role and you need to stay at a certain level in a non-clinical space, then you're looking at moving. So those have been some of the things I've been thinking about as I ratchet down my clinical time and I think these are really complex things and it helps to keep notes and it helps to talk to other people. What are some practical tips you have for things that I've said that you want to double down on or that are relevant for you.
Speaker 2:
Probably the thing that stands out the most to me is maintaining relationships right, that idea of understanding, and it's part of that, keeping the doors as open as possible, because all those things you just highlighted is, how do you keep your doors open? That gives you the most, or the ability to pursue what you want to pursue and have options later. And so I think, as light changes as your priorities change, or your current season of life changes a little bit as an aside, to highlight one of the things that Revivalize does so well is like helping you really think through and find those priorities, creating boundaries around them, putting those in the forefront and then, as you kind of look at like, okay, what's doable, what's practical, within the constraints of things that are important to me, whether it's geographic reason or time with family or kids or raising kids what I think's been key for me is making sure I maintain good relationships within that clinical space, one so that I could have good conversations with the people I work, with, my boss around these concepts, right, like what do I need to do to make sure that I'm staying up to date clinically but also able to kind of continue to be a contributing member of the team, even though my hours are reduced. But then also it's funny because in medicine we don't typically network, but it really is important and it's a really big piece of like that diversification.
Speaker 2:
People in business are phenomenal at this. But just that checking in every now and then with somebody you used to work with or because, depending on the circumstances, if you are in a situation where you're an administrator and the position gets cut and it's not about you personally, if you've maintained a network, you can make several phone calls to just start conversations. That's a really big piece of this. And I think actually a really big piece that I've just increasingly moved more towards is the idea of just relationship in general and trying to rethink the way I look at medicine as a relationship, whether it's with colleagues, with my patients, rather than a transaction, which is fortunately where I think so much of it has gone, and so to switch into that framework of what's the underlying relationship here has been really powerful for me too.
Speaker 1:
Yeah, any other closing thoughts before we move into part two, which will be more focused on lifestyle medicine, about how clinical time has evolved for you?
Speaker 2:
We touched on it a little bit, but it's really that idea of kind of finding the joy again and just that opportunity to take a step back and look at it more objectively and more relationally. That ability to kind of have a new lens towards your clinical practice really helps.
Speaker 1:
Well, thank you. This has been such a joy to have you back on the podcast and rethinking how our clinical time evolves and how there might be new opportunities to rekindle joy, even in the midst of some challenging circumstances in healthcare right now. Thanks for listening to the Revitalizing Doctor, a project of Revitalized Women Physician Circle. Our mission is to connect women physicians and allies through innovative, value-based coaching methods to ignite the courage and clarity necessary to create change and thrive. If you are interested in working with us, check out our website peoplealwayshtccom. Slash revitalize. This podcast represents the views of our hosts and guests. It does not reflect the views of any institution we work for or with Podcasts. Production Assistance is provided by Caitlin Dinn and Ally Dinges. Sound editing for this podcast is brought to you by Better Podcasting Services. You can find them at betterpodcastingservicescom.