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Physician Wellness, Telemedicine, a Busy Practice & Fatherhood with Dr. Alfred Atanda

by Jen Barna MD, For Your Kids, Life Journey, Physician Coaching, Physician Wellness, Podcast, Work Life Balance

Today we talk Dr. Alfred Atanda Jr. about telemedicine, physician wellness, fatherhood and work-life balance!

“So imagine if you could hit the ground running and have all the tools that you need.” -Dr. Alfred Atanda Jr.

In today’s episode, DocWorking Founder and CEO, Dr. Jen Barna talks with Dr. Alfred Atanda Jr. about telemedicine, physician wellness, fatherhood, and work-life balance. Dr. Atanda Jr. is a pediatric orthopedic surgeon at the Alfred I. duPont Hospital for Children in Wilmington, Delaware where he serves as the Chief of the Center for Sports Medicine, the Director of Clinician Well-Being, and is also an Assistant Professor of Orthopedic Surgery at the Sidney Kimmel Medical College at Thomas Jefferson University. You will hear Dr. Atanda Jr.’s tips for telemedicine, his thoughts and ideas on physician wellness, and how he balances a busy practice with fatherhood and his many interests. 

Dr. Atanda Jr. is a graduate of the University of Pennsylvania School of Medicine, he completed residency at the University of Chicago Medical Center. Dr. Atanda also completed fellowships in pediatric orthopedic surgery, at Alfred I DuPont Hospital for Children, and in sports medicine surgery, at the Rothman Institute at Thomas Jefferson University.

His clinical interests include sports medicine, orthopedic trauma, general pediatric orthopedics, and injury prevention in youth athletes. With his expertise in these areas he is frequently invited to teach and lecture locally, regionally, and nationally.

His future goals and aspirations are to re-imagine how healthcare is delivered by leveraging digital health and telemedicine technology to appropriately triage, navigate, evaluate, and treat orthopedic patients. He is the chief editor of the world’s first textbook solely dedicated to telemedicine in orthopedic surgery and sports medicine. In his non-surgical role, he has been working to optimize the physician experience, bringing awareness to the many ramifications of physician burnout, lack of well-being, and suicide. He not only works with individual physicians but also is instrumental in creating and implementing an overall physician well-being strategy for his organization. 

He is a physician expert for numerous telemedicine companies organizations providing strategic advice and e-consultations to urgent care, emergency department, and primary care physicians, as well as a second opinion directly to patients. He is a speaker at wellness spas and resorts, is the director of the physician well-being podcast for the orthopedic surgery educational platform “OrthoBullets”, and has also launched a telemedicine concierge service for the parents of youth athletes: “SportsLinkMD”. 

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Podcast produced by: Amanda Taran

Please enjoy the full transcript below

Dr. Alfred: So, imagine if you could hit the ground running and have all the tools that you need.

 

[DocWorking theme]

 

Jen: Welcome to DocWorking: The Whole Physician Podcast. I’m Dr. Jen Barna and I’m thrilled today to have Dr. Alfred Atanda, who is inspiring and is doing so much outside of his incredible work as a pediatric orthopedic surgeon at the Alfred I. duPont Hospital for Children in Wilmington, Delaware where he serves as the Chief of the Center for Sports Medicine, the Director of Clinician Well Being, and is also an Assistant Professor of Orthopedic Surgery at the Sidney Kimmel Medical College at Thomas Jefferson University. 

 

His clinical interests include sports medicine, orthopedic trauma, general pediatric orthopedics, and injury prevention in youth athletes. With his expertise in these areas, he is frequently invited to teach and lecture locally, regionally, and nationally. 

 

His future goals and aspirations are to reimagine how health care is delivered by leveraging digital health in telemedicine technology to appropriately triage, navigate, evaluate, and treat orthopedic patients. He’s the chief editor of the world’s first textbook solely dedicated to telemedicine in orthopedic surgery and sports medicine. In his non-surgical role, he has been working to optimize the physician experience, bringing awareness to the many ramifications of physician burnout, lack of well-being, and suicide. He not only works with individual physicians but also is instrumental in creating and implementing an overall physician well-being strategy for his organization.

 

He is a physician expert for numerous telemedicine companies providing strategic advice and e-consultations to urgent care, emergency medicine, and primary care physicians, as well as second opinions directly to patients. And has also launched a telemedicine concierge service for the parents of youth athletes called Sports Link MD. In addition to all of this, Dr. Atanda is a father and I don’t know whether to be intimidated or inspired,-

 

[laughter] 

 

Jen: -a lot of what I talk about is balancing life and medicine and I am so excited to hear about how you do everything that you do and help so many people on so many levels. Welcome to DocWorking: The Whole Physician Podcast, Dr. Alfred Atanda.

 

Dr. Alfred: Thanks, Jen. Thanks for having me. That’s a wonderful introduction and it makes me seem a lot more excited than I feel. But now, thanks for that. That’s great. Great to be here.

 

Jen: Well, it is terrific to speak with you. I have so many questions. You’re doing so much and of course, all of this is on top of a successful career as a pediatric orthopedic surgeon. Your telemedicine interests, I think are relevant to so many of our listeners, how have you managed to integrate telemedicine into your busy practice? I think maybe that would be the first question.

 

Dr. Alfred: For me, personally, telemedicine, it’s been a very interesting journey. As you know, COVID and everything has really put telemedicine on the map and I like to say I was doing it before it was cool. I started back in 2015 and it was really just by chance, I just started really thinking about the value that I’m providing to a lot of folks in the clinic. I realized that a lot of what I do is really centered around information transfer, whether it be providing knowledge, providing guidance, providing advice for postoperative patients, surgical discussions, reviewing MRIs, and imaging studies. I felt that’s really the value of what people were getting from me. In a lot of instances, they didn’t really physically have to come here. I guess, it really dawned on me when I went and visited– We’re up in Wilmington and the Delaware beaches are about an hour and a half, two hours south of here, and there was a patient of mine, his dad begged me to come to his store. He could give me some free swag, thanking me for operating on his son. 

 

I’m from the Jersey Shore and I’m a little bit of a snob, but I was like, “Fine, I’ll go to the Delaware beaches.” When I drove down there, it just struck me like, “How far?” It’s a hundred miles from our hospital. I was like, “There’re so many kids and so many schools down there and they all come up to see me, including this kid and his dad.” I was like, “Well, I just operated on him and he’s going to come up in a week.” I was like, “Well, why don’t I just FaceTime with him while I’m down here?” Because the kid was at home, he wasn’t at the store. I just FaceTimed him, because his dad said he had some questions, he couldn’t figure out how to use this brace. I was driving home, I was like, “Well, this kid’s supposed to come and see me in a week or two. He might as well just stay down there, because I just did a visit.” That’s literally where I got the idea and I was like, “Well, if I could do it for him, I could do it for all sorts of other kids.” 

 

Obviously, when you’re doing anything innovative and new, it’s hard, and you’re like a pioneer, and you’re forging your own path, and a pandemic really blew up telemedicine. But everybody says, “Oh, a pandemic must be great for you. Now, everybody’s doing Zoom, and Teams, and this. To be quite honest, it actually had a negative impact on me and my telemedicine experience mostly, because what I was doing it, it was new, it was novel, I could educate people, I could do consulting, where I can go to different practices and lecture to them about it, and be compensated. Now, everybody knows what it is. So, like, the cat’s out of the bag, it’s like, “Oh, telemedicine, what platform are you using?” Everybody knows and you ask about wellbeing. I’ve just shifted and just pivoted, because I really like to be doing things that are cutting edge that most people don’t know about. Once everybody knows about it, I just lose interest. [chuckles] I still do it and it’s still fun, but that’s when the whole wellbeing thing, I just pivoted towards that and it took off a little bit.

 

Jen: For a physician, who may be listening who’s interested in delving into some telemedicine as part of their work, do you recommend contracting them with multiple companies? How would someone approach that? Do you have any tips?

 

Dr. Alfred: It depends what you want to do. There’re lots of different ways to do telemedicine. Some people do it full time and then there’s people like me who do it on the side. I am a full-time surgeon and I have a practice. I fill up my nights and weekends with telemedicine consults. And it has to be in a way that’s convenient for you. If you want to quit your traditional job and go full force in telemedicine, that’s fine. There’re a lot of opportunities out there. Most of what you’re going to be doing is like urgent care and sick visits. But you can also do specialty visits as well. A lot of the big companies tell you about your Amwells, your MD Lives, InTouch Health, those are going to be the ones that can get you those contracts.

 

For me, personally, what I do is I work with a lot of different companies, because each of them will give you probably a few consults a month. If you work with five, or six, or seven companies, you can probably make a few couple of grand every month in surplus revenue. That’s what I’ve done. I just work as an independent contractor. Most of the things that I do is provider-to-provider consultation. As a specialist to PCPs and urgent care docs, and then the second opinion work is straight to patients. But I think there is a lot of flexibility for docs. You just have to figure out what it is that you need. I always tease people and say, “It’s like if you’re online dating, you have to have your profile, you have to have what you want, what you can offer people, and what you’re looking for.” You don’t want to just say, “Hey, I want to do telemedicine.” It has to be something that fits with your life, your lifestyle, your financial requirements, your financial needs, your home life, your kids, your hobbies. 

 

But it’s cool because it is flexible and you choose your own adventure. The traditional practice of being a physician, you’re shackled to your job. You’re trading your time and your energy in an active fashion for revenue. That’s fine, but you’re always going to have to be at work to generate revenue. Whereas these other things, you can still generate revenue, provide value to people and organizations and patients. But do it in a way that you have a little bit of autonomy and control when you do these consults, which is very nice.

 

Jen: Terrific. That’s a huge help. I think anyone listening, who may be interested can get a lot of value from that information. It’s a great segue into talking about physician wellness, because the concept of– 

 

Dr. Alfred: Yeah.

 

Jen: No, even just compromising, if you wanted to do part-time telemedicine, you would increase your flexibility. So, what was it that turned your head toward physician wellness? Did you have any particular experience that made you tune into that?

 

Dr. Alfred: To me, the biggest thing was and on a personal level, I’m divorced now. My kids are now 11 and eight. When we split up, they were six and three. So, they’re pretty young. My ex-wife is a physician. She’s a pediatrician. When we split up, I quickly realized that when I’m with my kids, it’s always me. [chuckles] There was nobody else with them and it hit me like a ton of bricks that I needed to figure out a way that I can do my job, feed my children, be myself, have my hobbies, my extended family and friends, and that’s almost not possible in the traditional aspect of being a physician. I think that was a huge eye-opening experience for me, because I was shackled to my job. 

 

The idea for physician well being for me, personally came from really having the flexibility and autonomy as to how you generate your income and that’s where it all started. Because I was like, “Well, I have to figure out ways that I can be crafty, and innovative, and be a family guy, and be around my kids.” The traditional sense as we know as parents, who are physicians, if your kid comes up to you and says, “Hey, Daddy, I have a field trip next Thursday at 10 AM.” I can’t go, right? I have to tell my administrative staff six weeks in advance if I want to cancel a clinic, and this, and that. That was really wearing on me and it was that thing where it all began. But then it spawned from there and I started thinking of all the other aspects of life as a physician that can be optimized and improved. 

 

Another big thing is, I started giving lectures to residents about all of them, we call them soft skills in surgery that you are never ever taught, but are extremely important to your day-to-day life. One of the biggest things I think is communication. We’re not taught how to communicate with people, we’re not taught how to give and receive feedback appropriately, we’re not taught how to motivate and inspire people. The second corollary to that is leadership. As a physician, you’re a leader. You don’t have to be the chair person or an administrative role to be a leader, you have a secretary, you may have a resident, you may have a PA or something. This is where it all came from. I’d be in the OR, talking to residents about these things like, “Yeah, life as a physician isn’t that easy.” It’s not easy to be an attending, even though when you’re a resident, you think that way. 

 

Over time, I started piecing different topics together and then I came up with a talk, that’s about 45, 50 minutes. Every slide is like chock full of things that the residents could have learned from. As I was doing that, our hospital actually put out a job description for a role, the Director of Clinician Wellbeing. It was very serendipitous how I was coming into my own about these topics, and then when this job description opened up, they also opened up a job description for a Chief Wellness Officer. So, that person is full time. She’s a rheumatologist. My role is about 15%, 20%, something like that. That helped me, because I still want to be a surgeon, I still want to be relevant, I still need to generate revenue. The amount of money I make, no one is going to pay me that amount of money to talk about wellbeing. It’d be nice, but they won’t. [chuckles] I still have to practice. 

 

This role suited my lifestyle very well. It didn’t take up all my time. It allowed me to still do surgery, but then I started getting more academic about it. Before it was just very anecdotal, but now I go to wellbeing conferences, I read the wellbeing literature, from folks like Tait Shanafelt and Chris Sinsky, people in really huge organizations like Stanford and Mayo, who have been leading the charge with wellbeing. I’m now getting familiar with all those terms and looking at all the systemic level barriers to wellbeing and burnout drivers that exist: the EHR administrative burden, clinical workload, there’s so many things. It’s kind of evolved, I don’t think it was one specific thing, but to be honest with you, I think it was my divorce and checking in with myself as to how moving forward I was going to continue being who I am professionally, but also make sure that my kids got as much of me as they needed and as much of me as I could provide for them, and it just turned into this big monster of wellbeing. So, it’s taken off.

 

To be honest with you, it’s given me a lot more opportunity than telemedicine has. As of late, I spent a lot more time with wellbeing, although, it’s ironic, I make more revenue and income from telemedicine, because it’s still healthcare, it’s still tangible health insurance pays for, whereas wellbeing takes up a lot of my time and my energy, and it is therapeutic for me, but it’s not as financially lucrative. But that’s okay, because it promotes my own wellbeing. 

 

Jen: You brought up so many points that I would love to talk with you further about. First of all, just the concept that each of us as physicians has I think often something that strikes us as the tipping point or really is the thing that we think back to in terms of what was it that made this struggle between balancing work and life. Because at least, traditionally in our culture of medicine, we really are expected to give 100% of our time and energy to work. I think the way we’re trained, it’s mentally what we are thinking is, “Okay, I’m going to give 100% of my time and energy to my work and then after spending 100%, I’m going to still have time to have a life.”

 

Dr. Alfred: Right.

 

Jen: 100% is 100%. The numbers don’t work. It is a struggle. For me, I agree. I had a similar struggle as a parent, that was really where the pull was for me and I didn’t anticipate that before I had kids. I thought I would be fine with it. But once I had them, I just wanted to be with them all the time and I couldn’t.

 

Dr. Alfred: Right.

 

Jen: Like you say, when that field trip comes up and you can’t go or when your child in my case, my son, I remember came home one time and had this really wonderful art project. As he was pretty young. I said, “Wow, that’s so incredible. How did you make that?” He said, “Oh, Jimmy’s mom helped me.”

 

Dr. Alfred: [laughs] 

 

Jen: I was like, “Wait, there were parents there?” He was like, “Yeah, but you couldn’t come, mom. You had to work.” He didn’t even mention it to me, because he knew I couldn’t come and I just was like, “Ah.” 

 

Dr. Alfred: Right.

 

Jen: He was fine with it, but I wasn’t. I still feel guilty about it even now. Not even just guilty, but I just wish I could have been there. 

 

Dr. Alfred: Right. You want to be present? 

 

Jen: Yeah, you really do. I agree. There are ways and I did struggle with it, but found ways to make my kids feel I was present when I was to try to be there 100% when I was there. It sounds like you’ve sorted it out in a way that we could all potentially learn something from you and I’d love to hear your tips on that.

 

Dr. Alfred: Just in terms of time management and in terms of how you present, that’s an extremely hard skill and I am not perfect, I am not an expert. In my talk that I give the residents, I do have a slide about– It’s all about prioritization. Again, we are not taught and given the skills necessary to really balance our lives as a physician. We are taught how to be physicians. Everything in our world of training is about that small box. But nobody tells you about how to live in that box while you’re living in a box as a spouse, as a sibling, as a parent, as a neighbor, as somebody, who loves to run, or bake, or hike. You know what? You don’t get that. So, then you show up and you’re completely unprepared for life.

 

Jen: Yeah, and it’s almost like you’re trapped in adolescence. Because your whole world for this period of training, which is a very long time, is limited by just everything we do at work, and when you come home, you do whatever has to be done at the end of day. Honestly, a lot of times you come home and read to prepare for the next day at work. [laughs] 

 

Dr. Alfred: Right. That’s what you do. [laughs] 

 

Jen: Even your time at home is taken up with work really. Meanwhile, all of your peers in other careers are out in the world learning about how to be an adult, how to manage money, how to do all these things, and we’re really just focused on this one thing. Yeah.

 

Dr. Alfred: I use the analogy of Michael Phelps, the Olympic swimmer. Imagine the way he was trained. He swims in Olympic sized swimming pools at a certain temperature at a certain pH, it’s got people there, testing the water, blah, blah, blah. Imagine if you took him and threw him into the middle of the Pacific Ocean, he’s not going to drown, but he’s not going to thrive and perform at the top of his level either. But that’s not what he’s used to. He’s like, “Wait, what’s with all these waves, and sharks, and jellyfish, and the cold water, and everything? It is dark out here. I can’t see.” That’s what it’s like. At least, that’s the way I felt. I was trained a certain way, and then they plop you into a job as an attending, and there’s all these other things that you don’t know how to deal with. They just expect you to deal with it and they look at you weird if you ask for help or you show that you’re uncertain or scared. 

 

Jen: [crosstalk].

 

Dr. Alfred: Yeah. Everybody else flounders around. Like I said, Michael Phelps isn’t going to drown and he’ll get used to it eventually, but it’ll probably take him 10 years to get– Imagine, if you can hit the ground running and have all the tools that you need, and back to your original question, time management is key, because you actually have less time as an attending than you think as a resident like, “Oh, attendings are never here, they don’t have to round, they don’t have to do notes, and this, and that.” Yeah, but they have families, bills, and debts, and this, and that. For me, personally, the biggest thing I tell people is just to really compartmentalize your life. When you are with your kids, you set aside however long it’s going to be, like, for two hours, “I am going to be with my kids. I turn off my phone, I don’t go near a computer, I literally just do whatever they want to do.” It’s hard, because I’m like, “Oh, man. Tomorrow’s Journal Club and I have to read that article. Oh, really doing that hard ACL–” You start thinking, but I’m like, “No, I’m here, I’m going to play their little games, and do Trivial Pursuit, play air hockey, and ping pong, and all the stuff we do.”

 

Then after two hours like, “Okay, kids. Go and do your thing.” Then I say, “Okay, for an hour, I’m going to get through my email.” And it’s all about email. Make sure the kids are fed, make sure there’s no disturbances, and I just focus on that. That works for me, because the whole multitasking thing, which, again, physicians usually do. When you’re a resident, you’re running around, you have to multitask. It doesn’t work that way in real life, because nothing gets 100% of your attention that way. Everybody gets 50% of your attention. But I want to be intentional about what is in front of me. If it’s my kids, then I’m a dad for two hours. They understand that I can’t be a dad 24 hours a day, but those several hours that they get me, they get all of me. When I’m in my email, I’m there. 

 

Right now, I’m doing this podcast. I’ve gotten about six phone calls and three text messages. Two of which are from my chairman, he’s going to be very upset. But I’m here. I’m with you. I’m not going to like, “Hold on, one second.” It’s hard to learn those skills, because that’s not how we were brought up and nobody ever really taught us that. You just learn it on the job. Some people, unfortunately, they never get good at it and we’re just stressed, and spread thin, and just never really fully present ever.

 

Jen: Speaking of that, how are things going as the Chief Wellness Officer in your institution? I’m not asking really, specifically to judge in any way your institution. [giggles] I think at any institution like that is going to be similar to others and that’s why I’m asking. What does it feel like to be in that role right now, where we are in the world at this time in 2022?

 

Dr. Alfred: Yeah. And just to clarify, we have a Chief Wellness Officer, that’s not me. I don’t want to take anything away from her. I’m the Director of Clinician Wellbeing. But yeah, I work closely with her and it’s hard. I feel physicians are really struggling. COVID has not helped and I feel there’s been so much thrust upon the backs of physicians for so long that this initial time period, where we’re actually listening and hearing them, peeling that onion back and just getting through the layers of burnout and stress that people are feeling, it’s almost this big cathartic release for people. The initial time period that we’re going through now is that we’re just on our early part of our journey, which is hard, because it’s so uncomfortable for people to even open up about these things. But I think as we move forward, and we permeate wellbeing throughout all aspects of the organization, it’ll become easier. But it’s tough. 

 

I’ll tell you what, we have a lot of priorities, and initiatives, and endeavors, and wellbeing is one of them. But we can’t look at it that way. Wellbeing has to be something that’s permeated and intricately woven into every single decision that’s made like, “Oh, how is this going to affect the physicians? How is this going to affect the end users?” Because oftentimes, as you know, administrators, people with non-clinical priorities come up with something that they need physicians do for whatever reason, whether it’s a legal issue, a compliance issue, a financial issue, and then they work on it for six months or a year, they vet it, they do all this stuff, they buy some expensive platform, and then they thrust it upon the physicians, and guess what, the physicians don’t want to do it, or they don’t like it, or they push back. And now, you have a problem, because they want us to do it, you don’t want to. 

 

It’s this kind of battle that all physicians experience in all organizations. Now, we are actually exposing this and really uncovering it. It’s great for organization, because it’s one small baby step towards that utopia that we all want to live in. But that initial run-in period, it’s like you have your attic, and it’s full of junk, and you have to clean it. When you first open the door, and you see the mice, and the cobwebs, and it smells terrible, it’s an awful feeling. But once you get the ball moving and rolling in some momentum, it starts to feel better. We’re not there yet. We’re still in the initial stages. It’s tough. Every group I meet with every doc, they’re just stressed and burdened. I’ll tell you what, I have my own problems. [chuckles] I have a full-time practice, I have my own stressors. This is something I didn’t expect. Now, I have to learn how I can do my job, and be a dad, and a friend, and a spouse, and all this other stuff that I want to do plus share the load and the burden of a lot of other people, who are now counting on me. They’re like, “Oh, great.” 

 

Now, there’s a complaint department for physicians. There never was. There’s a complaint department for patients, but we don’t have that. It’s been a wild ride, because I’m learning every single day and I’m experiencing things that I didn’t expect to experience. But it makes me feel really, really good to provide value to my organization in ways that’s not just seeing patients in the clinic and filling out notes. That’s great and that makes revenue, but at the end of the day, that’s not what really moves me. I’m just thankful that I have a way that I can give back to the organization that’s lifting me up and filling my tank, so to speak. So, yeah, it’s tough, but I think we’re moving in the right direction.

 

Jen: Dr. Alfred Atanda, thank you so much for joining me today on DocWorking: The Whole Physician Podcast. I’m looking forward to talking with you again in the future to delve in on some of these issues that we barely touched on today. Because you have a lot of insight, and experience, and I love your tips and suggestions for our listeners. Also, you’ve really hit on a lot of the key concepts that I feel really strongly about as well that physicians can benefit from ongoing coaching. As you said, we are all working progress and we’re all-

 

Dr. Alfred: Definitely.

 

Jen: -constantly trying to maximize our potential, whatever that is as defined by each of us as an individual. Ongoing coaching can help us with not only dealing with and/or preventing burnout, but also, gaining communication skills, moving forward in terms of developing leadership skills, and attaining goals in a more time efficient way, stress management, time management, so that instead of being Michael Phelps in an ocean that takes 10 years to adapt with some coaching and preparation, then you can get to whatever it is that is your personal goal in a more time efficient way and all of us are-

 

Dr. Alfred: Of course.

 

Jen: -most limited with time, which is, of course, a resource we can’t get back. So, how can people reach you if they want to get more information? You have a terrific YouTube channel for example and other ways. Tell me about that.

 

Dr. Alfred: Yeah, YouTube, the name of my channel’s Alfred Atanda MD. The other big place I’m on is Instagram, it’s @alfredatandajr, and then sportslinkmd.com is the website for my telemedicine concierge service, and then I’m just Alfred Atanda on Facebook.

 

Jen: Terrific. Thank you, again, and I look forward to our next conversation.

 

Dr. Alfred: Thanks for having me. I appreciate it.

 

[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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