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A Fascinating Look at Doctors’ Lives 25 Years After Med School with Dr. Par Bolina

Podcast, by Coach Jill Farmer, Leadership, Physician Coaching, Physician Hobby

In this episode, Dr. Par Bolina – doctor, author and entrepreneur talks about his book “Becoming Doctors 25 Years Later, A Follow-Up Visit” which is the sequel to 1997’s “Becoming Doctors.”

 

“There’s no real particular formula or fit that you have to fall into to consider a career in medicine.” Par Bolina, M.D.

In this episode, Master Certified Coach Jill Farmer talks with doctor, author and entrepreneur, Dr. Par Bolina about his book Becoming Doctors 25 Years Later, A Follow-Up Visit which is the sequel to 1997’s Becoming Doctors. This is a fascinating look at the life and journey of doctors 25 years after medical school. What do they think now after 25 years of practicing? This book not only gives college students a look at what to expect if they go into the medical field but it also gives patients a glimpse into the lives of doctors. Listen to hear one of Dr. Bolina’s favorite stories from the book. 

Par Bolina, M.D., is an internist with a focus on improving physician, patient, and staff experience and safety through innovative clinical workflow design and technology.

Dr. Bolina earned his B.S. from the University of Illinois at Urbana-Champaign, medical degree from the University of Illinois at Chicago and completed his internal medicine residency at Baystate Medical Center in Massachusetts. He was a practicing clinician for more than 10 years at Saint Thomas Health, a subsidiary of Ascension in Nashville, Tennessee where he has lived since 2000. As Chief Medical Informatics Officer at Saint Thomas Health, he led the successful integration of electronic medical records for their ambulatory practices before moving to the private sector to serve as the Chief Innovation Officer responsible for designing and scaling virtualized clinical services for health systems and medical groups across the United States.

In 2018, Dr. Bolina founded Bettehr, a management consulting firm focused on improving clinician and patient experience and outcomes.

He is the author and editor of the books, Becoming Doctors (1995) and Becoming Doctors 25 Years Later, A Follow-Up Visit (2021).

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Podcast produced by: Amanda Taran

Please enjoy the full transcript below

Dr. Par: There’s no real particular formula or fit that you have to fall into to consider a career in medicine. 

[DocWorking theme] 

Jill: Hi, everyone. We are so glad you’re here for DocWorking: The Whole Physician Podcast. I’m Jill Farmer, a lead coach at DocWorking and I want to remind you, we’re brought to you by DocWorking Thrive, our subscription coaching service just for physicians, where we also have a peer community and courses designed to help treat burnout and help you thrive as a physician. Check it out today at docworking.com. 

Today, we’re going to talk about something that I think has proven to be a really fascinating history lesson, at least in the last 25 years on physicians. It’s a project that was started by med students about 25 years ago and now, it’s an anthology that has followed up on those stories from 25 years ago and what I find to be a really fascinating project. It’s called Becoming Doctors. It’s a book, and project, and one of the leads of this was Dr. Par Bolina. He’s joining us for a conversation today to tell us about what inspired him back as a med student 25 years ago to reach out to 90-some peers around the country and ask them to tell their stories about what motivated them to be med students, and then what happened in the follow up in the last years. So, thanks so much for joining us today, Par. 

Dr. Par: Oh, you’re welcome. Looking forward to the discussion. 

Jill: Tell us what motivated you back in that year of 1995, 1996 as a med student to say, “I wonder what it would be like to reach out to other med students to ask them to tell the stories about what brought them to medicine?” Tell us about the origin story of how this was created. 

Dr. Par: I’d finished my first year of medical school at the University of Illinois in Chicago and it’s one of the rare times between first and second year of med school that you still get a summer vacation. I spent it overseas in England and met some very interesting medical students from across the globe. Because it’s the summer, I was doing research, we had plenty of time to get to know them and quite honestly, it was the first time I was spending enough time to learn a bit about their backgrounds. Otherwise, the first year of med school, even the second it’s mostly drinking from a fire hydrant. You tend not to spend as much time socializing other than perhaps just recovering post exams. 

When I went back, I spent the next two years thinking, it would be worthwhile capturing the diversity of all the different types of backgrounds of people and students that come to medicine. Some are older students, some come from families with physicians, others like myself. That wasn’t the case. It was the first go around. Capturing it helped me personally, but it ended up being a book, the original Becoming Doctors book. We ended up giving copies to public high schools in Chicago with the idea that perhaps other high school kids, college kids could realize, there’s no real particular formula or fit that you have to fall into to consider a career in medicine, something that I think isn’t automatically believed. 

Jill: Well, since you saw yourself as kind of, I think the way you’re describing it, you can tell me why I’m wrong, a bit of an anomaly, because you were first generation to go to college, and then you were on to medical school. Were you expecting to find everybody else had some pattern or something about their life in childhood that clearly led down that path? If so, what did you actually find out when you started reading all of the contributions? 

Dr. Par: My med school class at the University of Illinois in Chicago was quite large already. I could tell it was going to be fairly diverse. Yes, perhaps, there were a lot of biology majors, but there were enough people I met in Chicago that looked like there was going to be a pretty interesting group. What I didn’t know was their writing, that it would be pretty captivating or interesting. The parts and the pieces submitted, whether they were essays, poems; a few of the students actually did drawings and we included again, whatever we felt reflected in a positive way the students’ experiences, though almost all the experiences were intense. A lot covered anatomy, our first patients, our first exposure to death or losing a patient. But it was a nice breath of first, second year experiences versus the clinical experiences, which there’s a huge stark contrast once you get into the clinical space, that’s when your patients whether you have a long white coat or a short white coat, they really see you as their physician or clinician, and that’s when it hits you like, “Hey, this is really close to us being responsible for other people’s lives.” 

Jill: So, that original anthology was 91 physician submissions from med schools all over the United States– [crosstalk] 

Dr. Par: Yeah, half the medical schools. 

Jill: Yeah, so that gave a really nice synopsis and it sounds like a variation of experiences and the window into that first, second year of med school. Now, fast forward to 2021, you say, “Hey, I wonder what these physicians would have to say today after practicing for 25 years.” You went out then and ended up creating another anthology Becoming Doctors 25 Years Later, a Follow-Up Visit. What did you discover? I’m so curious as you put those two submissions next to each other, because you have the original submission by the med students with your submission years later. What stands out to you from those that made it into the anthology? 

Dr. Par: We’ve reached out to the original 90, we found 80 of them. Again, we started right before COVID. End of 2019, we knew 2020 was going to be the 25-year anniversary. Then of course, COVID happened, which really made us uncertain whether the physicians would have time, because it was pretty wildly crazy, for almost all of them were in difficult positions. But remarkably, we found 80 or so. We probably received 50 submissions by our deadline, and we ultimately picked 25, because we were including, like you mentioned, their original work next to what they wrote that the experience of the previous 25 years has been. 

Of the 25, two-thirds are women physicians, one-third men. The message we tried to capture in the preface in the back of the book is overall very difficult and challenging times, but immensely rewarding. The challenges mostly came by the responsibility with family and duty to the patients. Juggling those two was probably never easy, but made perhaps even more difficult over the last 10 plus years with the introduction of electronic medical records in technology. Things that were supposed to help that perhaps out of the gate may have made things harder. So, those struggles are very real. 

These are all high achievers, who want to be amazing with their patients, their colleagues, the business side of medicine, but at the same time, want to be great parents and spouses. Those expectations are extraordinarily high and to meet them it requires constant, extraordinary effort. I don’t think we always felt like we lived up to it in the realm. So, there is quite a bit reflected about the choices one has to make and live with the consequences. 

Jill: The age, I’m just doing quick math, would be around 50-ish on average. 

Dr. Par: Yeah, that’s right. 

Jill: Most of them are still considered mid-career. They’ve still got some years left to practice medicine in many cases. You heard about looking back over the 25 years and what’s been surprising, what’s been harder, what’s been more rewarding. Any talk about where they are now and how that informs them as they’re looking forward? 

Dr. Par: Yeah, so it’s interesting. There’s a good mix of some stayed in pure private practice, others elected to stay in academics. From an age distribution, you’re right. Most of us are probably in our early 50s or mid-50s. Some perhaps may have started med school a little bit later, are actually close to retirement. One of the stories Dr. Strasberg writes about is his psychiatry practice in California, where he’s packing up, and it’s his last day, and he had two goldfish that looked over his shoulders as he took care of patients for years and years in his office. He’s packing up, and heading home, and beginning the phase of life that involves retirement, and he’s very much looking forward to this next phase in life. But definitely a majority of us are still midstream, probably, in positions of responsibility. Some are overseeing training programs in academics. Others, if they’re in private practice, are probably the boss of younger physicians and have responsibilities on the business side. You get a bit of a flavor for the challenges and the excitement they feel related to their specific choices. 

Jill: Who would be the ideal audience you think for reading this anthology other than people that knew you guys and would be interested just in what your thinking was as a person in their mid-20s versus early 50s?

Dr. Par: Pre-COVID, I would have said for sure college students, premed students, but definitely medical students, residents, fellows, and physicians that have just come out of training. The upside of getting a chance,165 pages, to quickly go through the personal perspective of 25 physicians from varying specialties, it’s a pretty nice way to get a preview of what’s to come. Because there’s no doubt, we will all have some shared choices to make about the amount of time and effort we focus on the business side, the patient side, the family side. I think there’s real value. Post-COVID, I think or have gotten feedback and found that, not just the patients of the physicians within the anthology, but just generically, patients perhaps don’t have as much insight into the journey of what we do behind the curtain. Some staff at health systems, or hospitals, or clinics have come back and said it’s immensely helpful to see the personal side and the purpose behind why physicians choose their field. Patients have come back and said, “This is quite helpful or insightful in learning the human side of what their physicians go through to take care of them.” 

Jill: Yeah, I can see that. We’ve had conversations on the podcast before about how, partly because of cultural norms, partly because like it or not, doctors get put on a pedestal, sometimes it can be hard for them to be really open or vulnerable, particularly in a lot of different settings. I do think sometimes that the downside of that is sometimes the physicians become, the expectations are that they’re superhuman or even dehumanize. I think to hear the honest stories and the candor about what this experience is like, both the challenges and the incredible rewards, I can see where that would be really enlightening for both young medical students, or for residents, or for anybody considering moving into the career of medicine, as well as deepening relationships with patients from a human-to-human level. 

Dr. Par: Absolutely. Particularly, residents. Once you’re in med school, the sunk cost is enormous and you’re likely going to go through residency and fellowship. Just to survive, we tend to focus on the near term. I don’t think, outside of surviving those few years and then getting your first job, we don’t tend to have much of an opportunity to look up and look ahead or even ask. At least, I didn’t. All my close friends were those that were either in med school or residency and we’re all going through it at about the same time. Building relationships with physicians that are 10, 15, 20 years ahead of you is not always an option or at least not easily accessible to some of us. For me, books have always been an opportunity to see, and hear, and experience things. Otherwise, you wouldn’t. That does come across as an opportunity for many young new trained, graduated physicians to get a sense of what’s ahead. 

Jill: I know that this fascinating and unique anthology has a lot of stories, too many for us to go into all of them here, but can you leave us with one of the most impactful stories that really stuck with you if you could in the Becoming Doctors 25 Years Later follow-up visit anthology that’s just come out. 

Dr. Par: Okay. I’m the editor, so obviously, I loved every one, so we had so many to choose from. Frankly, we couldn’t include more and we would have liked to. Dr. Joanne Wilkinson leads off the book with her story. Both get to read what she wrote as a student. But what was so remarkable from my perspective, and there were many that echoed some of the same themes was, she describes a day in the life of finishing up seeing her patients and having one in particular that had gotten the procedure done, an older woman, that she went to go see in the hospital and wasn’t there. So she had to circle back at the end of the day, but she has a young daughter with her, because the plan was after work to go out to eat, but she needs to circle back and see this one last patient. 

The way she describes that encounter where she finally finds the patient by herself, the procedure is done, they speak briefly. The patient squeezes the hand of the physician and says, “But weren’t you supposed to have dinner with your daughter?” She says, “Yes, she’s in the waiting room,” or in the doctor’s lounge, I don’t remember where. She’s like, “I’ll be okay. You go take care of yourself.” That story just encapsulates the dedication, effort, and commitment extraordinary physicians have to balance their duty, and desire to do well by their patients, and trying to fit family in, and yet, the patients in some cases completely understand, recognize, and are almost in some ways looking out for us as well. I found it extraordinarily insightful, and moving, and it was one of my favorites for sure. 

Jill: That sentiment is a beautiful thing, I think for all of our physician listeners to hear. And I really appreciate you sharing this fascinating story of the inspiration to create this anthology of medical students, and then to follow up 25 Years Later with the new anthology Becoming Doctors, A Follow-Up Visit. Dr. Par Bolina, thank you for this conversation. How can folks find a copy of the anthology if they’re interested in reading it or sharing it? 

Dr. Par: Thanks, Jill, for inviting me on. Obviously, online, Amazon, Barnes & Noble, is probably the easiest way. If you’re buying it for students, perhaps the eBook, it’s a little easier to let everybody have a gift copy than the paperback copy. Of course, because we love books and local bookstores, you could take a little extra time and order it through your bookstore. It might take two or three days for them to get it to you, but that’s always a really nice way of doing it if you have a local bookstore that you want to support. 

Jill: Good. Any of our listeners that are as fascinated as I was by these stories and want to check it out, all the places where you’d like to get your books, it sounds like you’re able to get your hands on this for sure. 

Dr. Par: Absolutely. 

Jill: Thank you so much for your time. It was a great conversation and thanks to all of you, who joined us for this conversation. Don’t forget to tell your friends and colleagues about DocWorking: The Whole Physician Podcast and this is your year to thrive. So, please go to docworking.com today to check out our subscription coaching program just for physicians. We have peer mentorship, we have courses that can help you, move through burnout, and all kinds of resources to help you thrive. Until next time, I’m Jill Farmer. 

[music] 

Amanda: I’m Amanda Taran, producer of DocWorking: The Whole Physician Podcast. Thank you so much for listening. Please don’t forget to like and subscribe and head over to docworking.com to see all we have to offer.

 

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