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Let’s Talk Honestly About Why Being A Doctor is So Hard Right Now with Victoria Silas MD

Podcast, by Coach Jill Farmer, Physician Coaching

Today we talk to Dr. Victoria Silas about why being A Doctor is so hard right now!

“This is why in coaching we talk so much about how important it is to stay connected to your purpose and your values. Because this is something you can return to in times of crisis and it will get you through.” -Victoria Silas, MD

In this episode, Master Certified Coach, Jill Farmer and Certified Coach, Victoria Silas, MD discuss why being a doctor is so difficult right now. During this discussion you will learn that if you are feeling angry, overwhelmed, frustrated, etc., you are not alone. Victoria shares about her experiences and feelings practicing medicine as a pediatric orthopedic surgeon and how she dealt with negative emotions. The DocWorking Coaches will give you proven ways to manage and move through your feelings while staying connected to your values and what matters most to you. 

Victoria Silas, MD is a board-certified Orthopedic Surgeon and certified coach with 21 years experience in practicing medicine and 10 years experience in coaching. Now retired from medicine, Victoria helps other physicians cultivate a sense of calm and control in their personal and professional lives, as they regain their love for medicine and rekindle their sense of purpose and professional excitement. She can be found as a lead coach on the DocWorking THRIVE team, as well as at www.medicalmindsconsulting.com.

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Podcast produced by: Amanda Taran

Please enjoy the full transcript below

Victoria: This is why in coaching we talk so much about how important it is to stay connected to your purpose and your values. Because this is something you can return to in times of crisis and it will get you through.

 

[DocWorking theme]

 

Jill: Hi, everyone. We’re so glad you’re here for this important conversation on DocWorking: The Whole Physician Podcast. I’m Jill Farmer, one of the hosts of the podcast, as well as a lead coach at DocWorking. Today, I’m really excited to be joined in this conversation by Victoria Silas, MD. She’s a board-certified pediatric orthopedic surgeon turned coach. One of my colleagues here at DocWorking, who leads our online coaching program for our Thrive subscription program for physicians. Victoria, today, you and I are going to be talking about something that is on most, if not all physicians’ minds right now, and that is folks are tired, it is a hard time to be a doctor. Thanks to the two years now that we have been dealing as health care providers with the pandemic. So, thank you for joining me to talk about this from a coaching perspective today.

 

Victoria: Thanks, Jill. I’m super happy to be here and to talk about this important subject that is really impacting all health care workers at this time, not to mention the rest of society as well.

 

Jill: I think what prompted part of this conversation is something that you and I have heard from physician clients and people have reached out to us to get support and coaching within our Thrive community at DocWorking and they’re saying, “What do we do when we are just tired and angry as physicians right now and overwhelmed?” We feel somehow, we should be able to deal with something as big as this, but we just really feel overwhelmed, angry, and exhausted.” So, what do you say to that? 

 

Victoria: Well, at first, I really do think we need to acknowledge that people are exhausted. At the same time, I think it’s normal at this time to be exhausted and to struggle between the commitment we have made as doctors to approach our patients with compassion, and the very normal anger at people’s refusal to accept the virus as a real thing, and the vaccines as safe and effective. There appears to be an inherent selfishness of those who refuse the vaccine juxtaposed with the selflessness that many of us possess in order to commit to practicing medicine in the first place.

 

Jill: Yeah, I think that’s really important to say. I think this has come up in several of my coaching sessions with physicians. There’s this idea that they put their lives and their family’s lives at risk, particularly, especially if you think back to the time before there were vaccinations, to be able to be out there. The people who are minimizing it are saying, “It’s no big deal.” They’re refusing to wear masks or get vaccinated. It can feel as a physician that that’s almost an attack on you or a disrespect to the work that you’ve done. What are your thoughts on that?

 

Victoria: Yeah, I think that physicians do really feel disrespected, because they’ve been putting themselves and their families at risk for the collective good for two years. There are these other people, who refuse to do what appears to be the barest minimum for the collective good, and it’s just really hard to accept that apparent juxtaposition.

 

Jill: I think that brings us to something that both of us like to start with when we’re working with physicians is to validate that those feelings that you’re having, whether it’s exhaustion, anger, frustration, hopelessness, that those feelings are justified and real. As a physician, you’re human and we need to make some space for you to allow yourself to feel those feelings. Can you talk a little more about that? 

 

Victoria: Yeah, we need to normalize allowing ourselves to experience our feelings rather than fighting them as bad or unacceptable. Judgment is a normal human response, anger is a normal human response, frustration, also normal. And guilt is also a normal response when you’re experiencing emotions that we’re not supposed to as physicians. We’re not supposed to feel angry at our patients. And yet, it’s human for us to do so. We would be better off accepting that emotional response than constantly trying to fight it and to make ourselves “wrong” and “bad” when we do that.

 

Jill: Yeah, I think that’s excellent. Feeling the emotion again and again, doesn’t mean you have to necessarily act from the emotion. A lot of times we get confused with that. We feel like we’re feeling emotion, we either need to stuff it down or act from it, and act from the anger and that doesn’t always deliver the best results. So, instead, I think it can be important to pay attention to what the emotion might be trying to tell us. What maybe is the anger telling us? What do you think about that?

 

Victoria: Well, I think judgment, anger, and frustration are simply telling us that the boundary between our personal sense of right and wrong has been crossed by another individual. Guilt is telling us that we’ve crossed our own internal boundaries for our values, so that whole progression is totally normal. There’s an invitation here to accept and allow those emotions to have the breath of air that they need, allow them to exist, and they will pass through you, and your normal compassionate impulses will inevitably return, because it’s who you are as a physician.

 

Jill: I really liked that. One of the things we’ve talked about is, you can say, how do you accept that? You can actually have a little bit of an internal script that you give yourself as you begin to practice what it looks like to feel an emotion, to help normalize emotion, to let an emotion as you said, “Get the breath of life,” so it can be processed and move through you. What we talk about there is saying “And that’s okay.”  So, can you give us some examples of what we mean by the, “And that’s okay,” internal script?

 

Victoria: Right. When you notice that you are having the thoughts, “I’m frustrated,” then you just add that little phrase. “I’m feeling frustrated and that’s okay.I’m feeling angry and that’s okay. I am judging this person and that’s okay.” Or my go to when I was on call, “I hate everyone and that’s okay.” 

 

Jill: I’m a big fan of the work of Steven Hayes in Acceptance and Commitment Therapy. A lot of my work around time and stress management came from their work, because a lot of times by thinking their thoughts like, “There’s not enough time.” It elicits a reaction-action cycle that delivers results that aren’t necessarily taking us in the direction we want to go. One of the things that they talk about a lot, meaning Steven Hayes and the other therapists who helped develop his way of thinking in the world, is to notice what it is we’re feeling. Sometimes, I’ll work with clients who will say say, “I notice I’m having the ‘there’s not enough time’ thought again” which can create a much different reaction in you than, “There’s not enough time!” right? So, what do you think about using those, “I notice” thoughts as another way to help your internal script process the emotion in a healthy way?

 

Victoria: Well, all of these techniques help you distance yourself from your thoughts and therefore from your emotions. I notice that I’m judging, I notice that I’m angry, I notice that I hate everyone right now, which is usually my sign that I need to take a break. If I’m on call and I can’t take a break, then I just notice I hate everyone and I know when I get off call, I need to do something restorative, because I’ve reached that point where it’s really not working for me anymore.

 

Jill: We’ve had this conversation before. I love the example you give of noticing in your own life and practice that you can have an emotion as a physician. The scenario that you talk about is being awakened at 2 AM to come in and deal with a case. Talk about that as an example for how we can trust that processing our emotions is going to happen if we give it space? 

 

Victoria: Yeah, so, as we’ve talked about before, I was an Orthopedic Surgeon taking calls at a Level 2 Trauma Center. Stuff frequently came in in the middle of the night or by the time they worked people up, it was the middle of the night. You get that 2 AM call and they tell you that they have a patient, they’ve done the workup, they cleared everything that needs to be cleared, and this patient has an injury that has to be treated right away. Can’t wait until morning or if it can, the operating room can’t accommodate it in a timely fashion. When that happens, as I’m getting out of bed and getting ready to go back to the hospital, I’m angry. I’m angry at the circumstances. I’m angry at the person. Interestingly, I never got angry at why I chose this profession. I think it’s really telling that my anger was never directed at that long ago choice, but the immediate circumstances. 

 

Here’s the thing that was so interesting to me. I’m angry this whole time I’m getting ready. I’m angry when I’m driving to the hospital. But as soon as I’m confronted by the patient, when I’m at the bedside with the patient who needs help, that anger just miraculously evaporates and I’m not angry anymore. I think my natural compassion is like, “Okay, so, we’re done with that and let’s get on with it here.” Because I am fulfilling my mission and my purpose. This is why in coaching we talk so much about how important it is to stay connected to your purpose and your values. Because this is something you can return to in times of crisis and it will get you through.

 

Jill: Oh, I think that’s so important and definitely worth repeating that when you allow yourself to center yourself or come back to his home base of your values, which is a fancy way of saying, “Why does this work matter to me, why does this work matter in the world?” It is a really good place to help clarify and make sure that your emotions don’t take over and take you in a direction that doesn’t work. That’s not to say that the emotion of the anger or frustration once processed doesn’t make clear to you that you need better boundaries. Or that you need to get clear on either something that needs to change in your circumstances that you can help use your own agency to make happen, or maybe something needs to change institutionally, which is not going to be as fast of a change, but to help support that values-driven work for you. 

 

What about somebody who’s like, “Okay, that’s all really good stuff?” But again, right now,-

 

[laughter] 

 

Jill: -I’m feeling really overwhelmed. I’ve even heard from a couple physicians who say, “It’s really hard for me to get on Facebook right now, because I’m watching other people just hop on airplanes and go on vacations like nothing is happening” while many hospital systems were asking physicians not to travel at all. The physicians were being so careful while they were watching the rest of the world totally flout those recommendations and that created some frustration, anger in some ways, even resentment. What do you think about that? 

 

Victoria: Well, one of the fundamental things that we come back to in coaching is your zone of influence. We like to think that we can influence other people and we can as physicians, but the bottom line is, you will never have control of what all the people do. You only have control over how you respond to it. If getting on Facebook makes you miserable, don’t get on Facebook. There’s also an opportunity to say, “Getting on Facebook makes me miserable when I see people are taking vacations.” Knowing that, you can program yourself to get on Facebook, recognize you’re going to be confronted with that, and you can choose to not follow people that you normally follow who are doing things you don’t agree with, or you can tell yourself a story about what’s going on, which is that other people are going to do what they’re going to do. 

 

That has always been true, it will always be true, and the only person you have any kind of control over is yourself in the decisions that you make. When you see someone else making a decision that you don’t agree with, there’s again an opportunity to say, “They decide for them, I decide for me.” It’s like one of my favorite Peloton instructors, Denis Morton always says, “I make suggestions, you make decisions.” I think as physicians, we have to accept that we make suggestions and they make the decisions for their lives.

 

Jill: Thank you so much. I think that’s really helpful. To summarize, first of all, we are here to say loudly and clearly, thank you for working so hard, thank you for continuing to do the amazing work that you all do given the unbelievable conditions that many people have experienced over these last two years. I think the invitation from a coaching perspective is to validate whatever feelings you’re having. If your feelings feel confusing and overwhelming, I love these tools that Victoria shared with us. The scripting, “It’s okay, I’m feeling X or I noticed I’m having X.” I think the other side of it is getting connected to why this work matters to you. 

 

And being kind, and gentle, and loving to yourself as you are willing to do what you need to do to recharge your batteries, and to be able to move forward, I think that’s one other final tip I want to leave in our conversation here is that, this isn’t the time probably to make big moves or decisions as a physician just because of a lot of those collective feelings of exhaustion and overwhelm. I think it’s a good time to get support from a coach, from other trusted thinking partners, or from a support network of people and I think it’s a time to pay attention to what you really need. What are your thoughts?

 

Victoria: Well, I think you bring us back to that very important point of continuing to be connected to your mission and purpose. You’ll notice in the example I gave about getting called into the ER, I never in those moments said, “I should have done something else, I shouldn’t have been a doctor,” because I was still committed to that mission and purpose, even though, in the moment, I was frustrated and angry.

 

Jill: Beautifully said. I think that’s something that can be a very powerful value driven home base for people to come back to a place, where they can plug into, to try to help recharge their batteries. Victoria Silas, MD, surgeon turned incredible coach and a very, very valued member of our DocWorking team, my colleague and my friend, thank you so much for being willing to sit down and have this conversation today. 

 

Victoria: Thank you, Jill. 

 

Jill: And if somebody wants to get more information from you about coaching, what’s the best way for them to do that? 

 

Victoria: They can reach me through my website, medicalmindsconsulting.com.

 

Jill: Thank you. Victoria Silas, MD. Thank all of you for tuning in to listen to this conversation. Make sure you check us out on all our social media channels in order to continue the conversation. Tell us what stood out to you, ask us questions that you have for us as coaches, and show us how we may be able to support you in your incredible work as physicians. 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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