“Looking at choices, being brave enough to ask for what you want, can be an effective way for you to take some power back and to avoid that stuck, spinning place of learned helplessness.” Master Certified Coach Jill Farmer
In this episode, Jill has a conversation with Master Certified Life Coach and business consultant Bridgette Boudreau about understanding learned helplessness in physicians, with tools for doctors to put themselves back in the driver’s seat of their life and reconnect to their purpose. Here you’ll find some great advice that can be put into practice starting today!
Bridgette Boudreau is a Master Certified Coach and creator of the Mosaic Life Purpose Framework. Bridgette has been a Master Coach for 14 years, trained thousands of life coaches as lead mentor and CEO of a coach training organization, and has specialized in turning around distressed businesses as a C-level executive and business consultant. All of these experiences informed the Mosaic, along with Bridgette’s experience of frustration at not being able to connect with her own sense of purpose.
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Jill: Looking at choices, being brave enough to ask for what you want, can be an effective way for you to take some power back and to avoid that stuck, spinning place of learned helplessness.
Jill: Hello, and welcome to DocWorking: The Whole Physician Podcast. I’m Jill Farmer, one of the lead coaches at DocWorking. Today, we’re going to be talking about ways that you can get your power back. You might say, “I don’t know where my power went.” But we’re going to be talking about a pattern that I have seen in my physician clients now for almost 10 years that is something that you might not even be aware of, but you might be aware of, but you’re not exactly sure what to do about it. It’s a situation that psychologists would call “learned helplessness.” The definition of learned helplessness is a state that occurs after a person has experienced a stressful situation repeatedly, and that person comes to believe that they’re unable to control or change that situation. So, they don’t even try to change it even when opportunities for change become available. My hypothesis around this is that the grueling nature of medical education with its very high pressure and low autonomy can create a pattern of behavior or a set of beliefs in doctors that they don’t have any agency.
The person that I wanted to bring in to have this conversation with is a dear friend and a brilliant coach by the name of Bridgette Boudreau. Bridgette is now over almost 15-year experienced coach. She also is a business consultant. She’s been a leader, CEO, and also has had the privilege of coaching physicians just like you, and has also recognized occasionally this pattern of learned helplessness. We’ve talked about it kind of behind the scenes, but we thought it would be interesting to bring the conversation from a coaching perspective to you guys to give you some insights and perspectives on this. Bridgette, thanks so much for being here with us today to have this conversation.
Bridgette: So great to be here, Jill. Thanks for having me.
Jill: When someone feels unable to change a situation, in your experience, what are examples potentially of a consequence that they might experience?
Bridgette: Oh, gosh. Depression, lack of motivation, feeling of a downswing, lack of feeling of personal agency, all of that. One of the big things is a sense of frustration and powerlessness. That is such a terrible feeling. I also wanted to say I feel learned helplessness is kind of a rude term, isn’t it? I don’t love the term. I also want to say in my work with docs, here’s what really struck me about this phenomenon, is I had a group of doctors that I had the pleasure of working with, a group of women. They were all so incredibly talented. We would give them a note or a reframe, or something, and they just took it and seemed to integrate it so fast. I was blown away by the power, the intelligence, the commitment just top to bottom. I just want to say, I am impressed by doctors, just impressive people that care so much.
The part that made me truly sad was when we started to talk about what was going on in their day to day, and I was having this cognitive dissonance moment. Because here are these, powerful women on one hand, and just so able to move quickly and think big picture, and everything. And then, on the other hand, to talk about the powerlessness that they felt in their day to day, it just really struck me, and it broke my heart. I think, “Wow, here is this incredible bank of talent and knowledge and wherewithal and motivation that is just not being fully utilized because of the system that they’re operating in.” So that was kind of the basis for our conversation on this topic. And then, I kind of checked that out with you, and you were like, “Yeah, I’m seeing that too, friend.” So, let’s unpack that a little bit more.
Jill: You said two really important things. One is that we want to say loudly and clearly, I’m going to repeat it in slightly different way, because some of you will hear this and be like, “Yes, I’m bad. I have learned helplessness, and this is another thing I need to fix.” We both want to say loudly and clearly that it comes from conditioning. I’m not a psychologist or a psychiatrist and neither is Bridgette, but the roots of this come from real psychological research done by Martin Seligman, who’s a leader in the psychology of thriving called Positive Psychology for Mentally Healthy People.
He discovered that mentally healthy people sometimes stay in situations that are really not great because they forget that they have the agency to move out of them because of conditioning. It was research done on dogs, where they were literally shocked. Then, when they got in a situation where they no longer had to stay in a situation where they would continue to get shocked, they had forgotten how to step out of that situation. So, it’s understanding that why you’re there could be something that you want to unpack with a therapist. And also, it’s more important to understand, to reconnect to your power, I think, in this situation than to beat yourself up for feeling powerless. I think that’s the meaningful part of the conversation, and I love how you said that.
The thing about learned helplessness, again, it’s not that it makes you a bad person, but it can foster the emotion of apathy. Apathy is a place where when my physician clients report feeling apathetic, they lose their connection to why their work matters. The data shows us that when we lose connection to why our work matters, when feeling like your work doesn’t matter, that is a contributing factor to burnout.
Bridgette, I know you have really become passionate about and you really are an expert at helping people get reconnected to their purpose, reconnecting to why their work matters. I’ve heard you say that a key to reconnecting to purpose comes by asking ourselves who we want to be, not just what we want to do. I know there’s so much emphasis in medical training and in other aspects on that kind of extrinsic what we’re doing mode, that that question of who we want to be can be one that often doesn’t get examined by physicians.
Bridgette: Thank you for that. The central tenet of my work comes from a quote by Parker Palmer, who’s a great social justice activist, author, and big advocate for living more purposefully himself. To paraphrase he says, “We’re constantly asking, what should I do?” And he said, “The deeper and more profound question is, who am I?” The reason why I think this is so important is because what should I do is just taking you, like you were saying, Jill, from one task to the next and that’s what most of us are doing. We’re just trying to move from A to B, and get through the day.
My work is about zooming out and creating some space where you can actually examine your life. That question of who am I, which is a big question, so we need to break it down into some component pieces because if you’re just asking who am I, that can put you in a spin as well. A lot of my work is breaking that down into some bite-sized chunks.
The other thing I want to say is that question, who am I, turns you inward. Rather than outward, what can I accomplish? What can I check off my list? It’s like we’re just trying to get that to-do list done so that we can feel okay. I can tell you from personal experiences, that is not where okayness comes from. It’s about turning inward and reconnecting with what matters. In the case of physicians, why did you get in this field in the first place? Who are you here to help? There’s the individual level. What matters to you, revealing your values? Are you living your values? Where are there incongruencies? You also have to look at the context that you’re operating in. There’s two splits that I do there. One, I have people look at their limitations. These are the places where professionally, personally, wherever it is, we’re trying to be that person, that person who can work 12-hour shift nonstop, or doctors, you have to take it up about three levels, 16-18. You’re trying to be that person, you’re trying to get all your coding done, and maybe you’re just not cut out for that.
I think this can be a difficult pill to swallow, but it’s important to understand our limitations because they provide the pivot point to living more purposefully. When you can just say, “You know what? I’m not great at that. I’m not that person,” you can start to shape your career and your life in ways that are more supportive.
And then, the other big piece that I think is important to look at is context. Here is where I started to get a revolutionary feeling for docs, is I would love to see them start to look at the context and the environments that they’re operating in, and start to come together and advocate for the change, because some of this is systemic. If you’re just looking at it on the individual level, sure, we can do mindset, you can change jobs, you can advocate for yourself, but some of this that is pressing on doctors, a lot of it is systemic. That doesn’t mean you just throw up your hands and say, “Oh, I can’t make any change,” but you’re going to have to do that as a collective. It all starts with sort of pulling back and looking at the causes and conditions versus just trying to get that list done.
Jill: Excellent points. A place to start with this again is if your feeling is often not outside. It looks like if only X would change, if only I was better at doing this task, or not sleeping or whatever the condition that’s outside of you, it begins with looking inward with that really powerful question, who am I? Again, when you’ve been in a system that is very extrinsically motivated, what are the grades? What’s your rank? Where do you get residency? How does that rank? How are you measured once you get into your practice? If you’re a surgeon, what are your RVUs? For everybody else, it’s all of the other metrics, the financial aspects of the business of medicine are pressurizing you on. Stepping outside of all that, asking yourself that internal question, I think that’s really powerful and meaningful.
Then, sometimes when you look at some of the limitations that exist within yourself, and then also within the institutions, to say, “I may not be able to wave a magic wand and change the institution, but how can I have a voice in trying to make it better?” I think that’s something that’s sometimes people forget, because we’re used to being in trouble. We don’t want the big hospital system to give us a bad grade. But I think it’s being willing to meaningfully and, as you said, in cooperation with other people who are recognizing the same issues come together and try to be a voice for a meaningful and positive change even in the tiniest steps, that can be a powerful way to start taking your power back.
Bridgette: Well, think about this moment too. We’re hopefully slowly emerging from this pandemic. People are moving jobs and quitting jobs in record, unprecedent in numbers. I had a client who lost 20% of her workforce within the space of a month, and then had new people coming in just as quickly. There’s a lot of movement in the market. What’s driving them, people had it, so you’ve got that, you’ve got high-performing athletes. Let’s take Simone Biles saying, “You know what? I can’t do this.” You have other ones who are refusing to do interviews or other things that are not in service of their mental health. I think doctors coming out of this moment, it’s been so difficult. To take this opportunity and this momentum that is happening societally as well, and start to advocate for change that supports doctors, that supports good care, that supports your own wellbeing.
This is my fervent wish for all of you, and of course, at the individual level, but I would love to see those big brains and all of that talent to just take some of that and harness it in service of yourself, because this is the other thing, I think, doctors give so much of themselves. So, if there’s the individual level thing that I would have them do is to really lean into, I know it’s the buzzword, but self-care, and that doesn’t just mean bubble baths and– [crosstalk]
Jill: Massages. It’s not just massages, right? [laughs]
Bridgette: Yeah. These are the deeper– Like you were saying, is it therapy? Is it taking a hard look at the way you’re moving through your day and making some different choices? Is it, for these metrics and measurements, being willing to look at those in a different way and not have those define you? I think there are definitely some individual pieces as well.
Jill: I really, really loved that. Let’s workshop a situation that came up in real life with a physician. Physician reached out feeling very stuck, very demanding chief expecting at least a minimum of 12-hour clinical days, and then weekends dedicated to research. So, essentially, close to zero time off. The physician felt very stuck, felt there was no real chance to make any change because of these expectations. Let’s workshop this a little bit as two coaches. What would be something that you might coach this particular physician around in this situation, hypothetically?
Bridgette: Well, hypothetically, I’m curious about those different levels, at the individual level, how to navigate that system? Are they literally punching a clock and have to sit there and have face time for 12 hours? I want to unpack what’s the real instruction here and how does that physician want to meet that or not meet it? And then, we have to go right up to the contextual level, because there’s a power differential here. This chief has all the power. Well, not all the power, [laughs] but has power.
This is where I would want to talk about what are the ways to start to advocate for change and also, just to be smart about this position. I’m not a Pollyanna. I understand this may be an important steppingstone in this person’s career. Again, it’s back to what matters. Does this matter enough that you’re willing to do this? If you’re willing to do it for how long, under what conditions? To get really clear, if you’re in choice, then you can say, “You know what? I’m going to do this for six months, I’m going to do it for a year because I’m going to publish a paper and that’s going to take me here.” Great. That’s the choice that you’re now making, but if it’s not your choice, then what other choices do you want to begin to make?
I think too even in within those 12 hours, what’s happening for you in those 12 hours? Is your perfectionism running rampant to where you’re not working efficiently, because you’re so worried about everything being done to some standard that’s never achievable? I want to talk about what’s going on in this person’s mind and body as they’re moving through their day as well. What do you think?
Jill: I think the power differential is key here. What I’ve discovered a lot working in that kind of situations is when I start asking questions, like you said, that’s the key in coaching, is inquiry. Finding out more details. What I assumed was this dictatorial, almost power-mongering kind of chief. When I heard the initial description, when I started talking, I realized that there was actually some projection happening on the part of the physician to say, “I’m sure they would think this about me.” What we discovered is two important keys after asking some questions. One was to look at what I like to call “choice harvesting” or “option harvesting,” because when we feel like we’re stuck-
Jill: -in that kind of learned helplessness state where it’s like, “Nothing’s going to change anyway, I won’t even try it.” And then, we get into apathy, and then we lose connection with why our work matters and that leads to burnout, is to say what are your choices here? Some of the choices feel radical to leave, or to step off a promotion track or what those are. When we’re harvesting options, we’re never committing to anything. It’s just changing our brain a little bit from that place of feeling stuck and trapped, to look at what some other options are to consider. So, that’s the one thing that I think was meaningful in this situation.
And then, the second thing that ended up being really meaningful, is I just reminded, and this happens a lot with physician clients, that they can ask for things. This is true. I just had a conversation with another physician leader who was like, “It’s so frustrating for me sometimes, because my physicians will come to me when we’re in crisis mode, and things are about to collapse.” I said, “Why didn’t you ask me six months ago, if there was a different way to think through this?” In this case, this was complete misinterpretation. I think there was some lack of a little bit of emotional intelligence here, perhaps on the leader. This leader said, when the person brought the question forward and said, “Can I do something different, this doesn’t feel sustainable?”, they’re like, “Oh, I just thought you loved doing the long shifts, and then also wanted to be away from the hospital to do your research on the weekends, because that’s how you’ve always done it.”
When they had one of those courageous conversations, about being more honest about expectations, and about what the physician was actually experiencing, and then asking for something different, in this case, it worked well. Now, of course, disclaimer, I know, just because it worked in this situation doesn’t mean we’ve just given you a magic formula to deal with a challenging boss who’s overworking you. But this is one example of where looking at choices, being brave enough to ask for what you want can be an effective way for you to take some power back, and to avoid that stuck, spinning place of learned helplessness. What do you think about that?
Bridgette: I love it. At least give it a try. Here’s the other thing that I think that learned helplessness disconnects you from your creativity. I love that option harvesting, because that’s what I love is when I’m feeling connected to myself, and I’m working with my clients, it’s using your creativity. If you’re so busy projecting and just checking those boxes, you’re not connected to your own creativity. Maybe you’re not ready, you’re not ready to advocate right away, great. Watch your boss, find out what’s important to him or her, and make a proposal that hits those mark and benefits you.
For instance, you might say, “Hey, let’s talk about the deliverables that you want from my research and timelines. Let’s agree on that, and then let’s have me work to that.” Again, it’s not a magic bullet, but this is a conversation that so many people are afraid to have. They’re just afraid to ask or open the door. If you’re having this conversation, and your boss is like, “No, I need you to work exactly 12 hours and weekends,” then I guess good to know because that’s another decision that you get to make about whether that’s okay and sustainable for you.
The other thing you touched on earlier, but I want to weave it back in here, is I think the other place where I see a lot of learned helplessness is people who have been in a job for a long time lose that sense of their value. So, I think another thing that I would encourage a physician in that position to do is maybe check in with some colleagues or check in with your coach and get a clear sense of what your value is in the situation, because are you a rock star researcher that’s moving this thing forward, an asset to the team? If that’s the case, then leverage that.
Jill: Excellent. That’s really common. That’s again communication. Sometimes, doctors are outstanding phenomenal communicators. Sometimes, they have joined the practice for other reasons that they were gold star communicators, and that’s okay.
Bridgette: -[crosstalk] in other ways.
Jill: I can think that can be another way to work through this. Couple more points I wanted to touch on. According to some psychologists, as I was rereading and researching some stuff around this topic of learned helplessness, people with a pessimistic, explanatory style, which is a fancy way of saying it causes them to view negative events as being unavoidable or resulting always from their shortcomings. “Well, what are you going to do it’s this this way, and it’s because I always am bad at blank.” That’s what I think they’re talking about with that pessimistic, explanatory style.
Folks with that kind of preset are more likely to experience learned helplessness. Research has shown that people who have more of an optimistic explanatory style, and in coaching, we might call that reframing. It’s not something that you’re stuck with. Either you have your negative or your positive, but we can do something sometimes in our brains to reframe a situation that can be helpful, I think, in situations where doctors are feeling stuck, or trapped in a work situation. But I know you and I both want to approach reframing from a rather nuanced perspective. So, let’s chat about that for just a second. How do you see it working? What’s the nuance that we want to make sure we include when we talk about it?
Bridgette: Where I see it working is, that’s one of the reasons why limitations are actually such a big part of my work, because you brought up the example of the doc who’s maybe not a great communicator. So, here’s the reframe. Instead of saying, “I can’t advocate for myself, because I’m terrible communicator, and I can’t clearly articulate my ideas,” that’s the first example. The reframe I would propose is to say, “You know what? I’m not the best communicator here. But I know people who are. I can talk to my coach. I can talk to my colleague who’s an amazing communicator. I’m going to run this scenario by them. And because I’m not a great communicator, I know I need to get help. I’m going to get my three bullet points and I’m going to go present that.” That’s a recognition of who we are, and what we’re good at, and maybe what we’re not so good at in a way where we don’t have to shred ourselves in the process. I think those are the reframes that I go for that actually allow us to sink into our humanity.
The caution, Jill and I think we both share this, is the relentless reframe to the positive that doesn’t take into account any emotions that you might be feeling. It’s a bypass. It’s like, “Don’t feel bad, don’t feel sad, don’t feel upset, because we’re just going to reframe what’s going on for you into something that’s relentlessly positive, so you don’t have to have this feeling of discomfort.” I am a big believer that this discomfort that you’re feeling is a huge teacher, it’s a rich goldmine of information for you if you’re willing to sit with it and be with it. That’s my compare and contrast on reframing.
Jill: Yep, I agree 100%. Reframing can be really helpful to give you a fresh perspective, a new idea as a way to get out of a spinning or stuck spot, but it shouldn’t be used as a way to avoid feeling emotions. I say let yourself feel the emotion. I know you do too. Emotional agility, we’ve talked about in previous podcasts. In various ways, we talked about it in our STAT course, that’s part of the THRIVE program. It’s saying, “Yep, I’m having this emotion, I’m feeling this emotion.” Letting yourself feel it so that it doesn’t necessarily drive the bus and take you somewhere you don’t want to be. And then saying, is there another way of thinking about this that’s more helpful than the thought cycle that I’m feeling stuck in? It’s an art to learn how to do that, but it’s worth playing with it when we can begin to notice that beating ourselves up perpetually is not proactive. It often is a contributing factor in our subconscious for keeping us stuck. I love how you gave us an example of ways that we can think about that differently.
A lot of the things that you’ve talked about in terms of inviting people to turn inward, ask themselves the question about who am I, looking at strengths as well as limitations to be able to integrate those into decisions are part of your process you’ve created called “The Mosaic Method.” Are there any other parts of your Mosaic Method that you can see being helpful for doctors who are in a situation where they’re feeling a little bit like, “Ah, I’m here, and there’s nothing I can do about it”?
Bridgette: Yeah. My mind went to a couple of different places for docs than I would probably normally go. Another piece that I teach, and I mentioned it a little bit earlier, is to look at your whole life in context. Normally, we tend to think of the pieces of our life as discrete pieces of pie. I have my professional life, and I have my personal life. My activities that I do on my spirituality, whatever comprises that pie, family, fun. What people tend to do is attribute their energy level to one of those pieces of pie. So, it’s like I have 100% for work, and I have up to 100% for personal and 100%, over here and over there. No, you have 100% for your whole life. You can’t just look at the component pieces.
One of the things I have people do when they’re feeling overwhelmed and they literally don’t have bandwidth in their life, is I have them look at all the pieces and assess where is the energy going. The way that I do it, you actually get like a little picture of where the energy is going in your life. People find this so helpful. Especially if you’re kind of a type A, achievement-oriented person, there’s always places where you feel like you’re falling short but if, for instance, your career is taking up a ton of bandwidth, this allows you to acknowledge that and then you can consciously work with. If you want to give more bandwidth to your family or whatever, then you can start consciously working with that. It’s a great way to think about your personal energy, how much you have to give and where it’s going, and then maybe you can cut yourself some slack if you’re not at 100% on all the pieces of your life, which you can’t be.
Then, the other piece is, a little tool I like to call, “What’s your problem?”
Bridgette: I’ll just give the quick and dirty on it. This is basically a lot of my clients come to me, and they’re trying to solve the wrong problem. Again, it’s like, “Let me just get all the emails out of my inbox. Let me just do all my charts,” whatever. People are just constantly trying to get things done and then thinking, “When this is done, I’ll feel okay.” So, actually, asking yourself with compassion, “What is my problem here?”, and taking time, you can do a little brain dump of what’s going on. Let’s say you’re having an issue with your boss, you just do a little brain dump of what’s going on, and y’all are scientists and then you go back and you take your what’s my problem statement from that, and really to reflect. There may be a real difference between what you thought your initial problem is, and what the actual problem is. What I’m working toward is having people write a problem statement that they can actually solve versus this unanalyzed, unconscious problem that we’re always trying to solve. It’s this bringing it into consciousness, getting really clear, and articulating a problem that you can actually go and solve.
There’s other pieces to the mosaic, but basically, the crux of the mosaic is just like it sounds. That our life purpose is not this linear path as a sort of burning bush that people think, “Oh, no, it will just become clear to me someday all at once.” It’s more like you’re constantly gathering the pieces and you’re making your very own life purpose mosaic.
Jill: Yes, identifying challenges are problems that you have, even the tiniest bit of agency, those of you who listen a lot or take any of the courses that I’ve done for DocWorking, it’s what’s in your locus of control in that circle, and redistributing your energy and focus on the things that you can make a difference with, it’s incredibly empowering and much more helpful, which is the opposite of the learned helplessness we’ve talked about.
Bridgette, this has been great. For those of you that are like, “Ah, this is so wonderful.” Bridgette is in the process of writing a book. So, I promise you all, as soon as the book is done, we’re going to get you all the information on how you can dive into the book and learn more about this process for yourselves as well. Bridgette, thank you so much for sharing your wisdom and helping us take on a subject that can be a little bit challenging, can be hard to think about, but to give people some really great ideas. I’ve really enjoyed this conversation.
Bridgette: Thanks so much for having me. I had a lot of fun.
Jill: For the rest of you, if you would like to know ways that you can begin to be proactive around these challenges in your life when you’re feeling stuck, I have great news. At DocWorking, we have put together a new subscription service called DocWorking THRIVE. It basically is all of the things that you as physicians have asked us for in one package. It is group coaching by professional coaches around problems and challenges, specifically for you, that is completely private and confidential. We also have a private and confidential Facebook group, so you can join in community with other physicians and also there, it is facilitated by professional coaches, physician coaches who are physicians themselves or people who have been coaching physicians like me for a really long time.
We have three self-paced courses. You can take them totally on your own time, no grades, chockful of information on how you can become a better leader, a better communicator, or how you can have quick wins to get your life back around time and stress management issues. We have guided meditations and ways for you to become more mindful in your life as well that are included in this package and more. So, if you are interested in getting some support already designed for you, just for physicians, you’ve got to go over to docworking.com, check out the information on our DocWorking THRIVE subscription. I think you’ll really be glad you did. We’d love to have you. Until next time, this is Jill Farmer on DocWorking: The Whole Physician Podcast.
Amanda: Hello, and thank you for listening. This is Amanda Taran. I’m the producer of the DocWorking podcast. If you enjoyed our podcast, please like and subscribe. We would also love it if you checked out our website, which is docworking.com. And you can also find us on YouTube, Facebook, Twitter, and on Instagram. On Instagram, we are @docworking1, and that is with the number one. When you check us out on social, please let us know what you would like to hear on the podcast. Your feedback really means a lot to us. If you’re a physician with a story you’d like to tell, please reach out to me at amanda[email protected] to apply to be on the podcast. Thank you again, and we look forward to talking with you on the next episode of DocWorking: The Whole Physician Podcast.