Returning Joy to the Practice of Medicine with Diane Shannon MD

Tune in to this episode where Dr. Diane Shannon tells us her story of physician burnout and what she knows now. Dr. Diane Shannon is the co-author of Preventing Physician Burnout: Curing the Chaos and Returning Joy to the Practice of Medicine. Her focus for 20 years has been drawing attention to ways to address clinician burnout, system inefficiency, and patient safety problems.

“There was no talk about physician wellness or burnout or any of that and I did not see any other options. In part, because I didn’t ask for help.” -Diane W. Shannon, MD, MPH, ACC

In this episode, Master Certified Coach Jill Farmer welcomes Dr. Diane Shannon to the podcast. Dr. Diane Shannon is the co-author of Preventing Physician Burnout: Curing the Chaos and Returning Joy to the Practice of Medicine. Dr. Shannon experienced paralyzing burnout as a new primary care physician which prompted her to make the difficult decision to leave medicine. Unfortunately, as she shares in this episode, at that time she didn’t see another choice. Dr. Shannon shares her story of burnout, what she wishes she would’ve known back then and how she is now helping physicians as a Certified Coach. Tune in to hear a powerful story and tips to help you return to your joy. 

 

Diane W. Shannon, MD, MPH, ACC-

After experiencing paralyzing burnout as a new primary care physician, Dr. Diane Shannon made the difficult decision to leave practice and pursue a career in writing. Her focus for 20 years has been drawing attention to ways to address clinician burnout, system inefficiency, and patient safety problems. She is co-author of Preventing Physician Burnout: Curing the Chaos and Returning Joy to the Practice of Medicine, which was published in 2016.

Dr. Shannon’s personal experience with burnout and her desire to support physicians motivated her to become a certified coach 3 years ago. As a transformation coach, she empowers individuals to find the places where they have agency and make choices that better match their core values. Since the pandemic, Dr. Shannon has focused on helping women physicians find the clarity, confidence, and courage they need to move from overwhelm, burnout, and self-doubt to lives where they can thrive again.

Dr. Shannon attended Williams College, Jefferson Medical College, and Harvard University. She completed training in Internal Medicine at St. Elizabeth’s Medical Center in Boston and practiced general internal medicine before making the shift to writing and coaching. 

Find her on LinkedIn and at www.dianeshannon.com. Sign up for a coaching consultation at www.dianeshannon.com/liftoff.

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Please enjoy the full transcript below

Diane: There was no talk about physician wellness, or burnout, or any of that, and I did not see any other options, in part because I didn’t ask for help.

 

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Jill: Hi, everyone. We’re so glad you’re here on DocWorking: The Whole Physician Podcast. I’m Jill Farmer, your host for today and a lead coach at DocWorking. And we’re brought to you by DocWorking Thrive, our subscription coaching service, where we help physicians thrive by coaching, peer mentoring, and other courses that can help you be your best in medicine and life. Today, we’re going to have a really interesting conversation about a very important topic right now, which is burnout. I’m really excited to have Diane Shannon, MD joining us for the conversation today. After experiencing paralyzing burnout as a new primary care physician, Dr. Diane Shannon made the difficult decision to leave the practice of medicine and pursue a career in writing. Her focus for 20 years has been drawing attention to ways to address clinician burnout, system inefficiency, and patient safety problems. She’s the coauthor of the book, Preventing Physician Burnout: Curing the Chaos and Returning Joy to the Practice of Medicine. Diane, thank you so much for being with us here today.

 

Diane: Thank you so much, Jill. It’s great to be here.

 

Jill: Let’s start with your story. What led you to do the work you’re doing today? What was your experience that has informed the way that you show up in the world in service of other physicians now?

 

Diane: Yeah. I was drawn to medicine, like a lot of people, I had a family member in medicine. My mother was a midwife, and I just loved seeing her interactions with her patients, and hearing her talk about her career. When I entered clinical practice, I had expectations about those sorts of connections. Even back in training, it was like, “This isn’t exactly what I expected.” I saw so many ways that system issues got in between the physician and the patient. And also, some really significant patient safety concerns. Now, when I look back, I can say, “My way of trying to work in that system and protect my patients in that system burned me out.” I didn’t know that at the time. I just knew eventually, after just a few years in practice actually, that I needed to get out. It was a really, really difficult decision. I thought, “I’m not trained to do anything else. What am I going to do with myself and really struggling with that?”

 

I did eventually land in medical writing and then in health policy writing. Loved that. And eventually, realized, “Oh, there’s this thing called professional burnout and that’s what I experienced. With the help of a coach I was able to overcome my shame about that and write about my experience. And that eventually led to the book, speaking about burnout, and having a better understanding of it. Three years ago, I think it was, I became a coach myself because of wanting to not just write about the problem, but also be able to affect change. I walk this interesting intersection between understanding, burnout is caused by workplace stress. That is what it’s caused by. Individuals have agency that can really change their experience of work every day and their experience of their whole life. Where is the place that it makes sense to advocate for system change and where is it that individuals have within themselves the ability to make some changes that really impact their lives?

 

Jill: Oh, you just so succinctly said what I have been talking about for much of the last 12 years coaching physicians and helping to, again, identify where their agency is, where the system needs to change, and how to overcome tendencies of perfectionism and overwork that are baked into the medical education system that create conditions that make it common for burnout to happen. I want to talk about what’s happening right now for physicians. Even physicians, who two years ago would have said, “Yeah, I’m working hard, but it’s really meaningful work. I’m able to make time for other things that matter to me in my life, I have a pretty good flow going.” COVID changed that and disrupted that for so many different physicians in so many different ways and added just an enormous pressurizing component. We know workplace pressure is another big component of burnout. What about the physician that says, “Yeah, I heard other people talking about burnout and I didn’t think that was going to be for me.” Or, a physician who says, “Oh, I was starting to burnout and geez, this pressurizing situation has made it worse.” What do you say to them right now, Diane? 

 

Diane: Well, we know from the research that there are certain things that drive burnout, like, certain things in the workplace. One of them is the workload. Having enough resources to do the work that you’re there to do. The resource piece I think has really been affected, especially lately with COVID in terms of the loss of support staff. From the physicians I speak with, that is huge. I think that’s a huge issue and just the ability to be able to see where the places are where you might advocate for change, where you might advocate for more resources? When that’s not there, are there ways that you can shift both what you’re doing, how you’re doing it and how efficiently you’re doing it? You mentioned perfectionism. One of the things that I’ve seen is perfectionism can get in the way and make a person churn more energy, where maybe they could pull back or rethink how they’re doing things. 

 

Now, that’s not the perfect answer, because we know what these physicians today are working in the conditions and the lack of resources. We were saying before, there were certain tendencies that we all have as physicians, because those were actually helpful in getting us to where we are. Being very detail oriented is something that is very helpful in getting through training and being a physician. It’s just when it’s taken a little too far or used in the wrong context that it gets us into trouble. Are there places where an individual can begin to look at that? Where they might need to set some boundaries that are very uncomfortable, if you haven’t done it before, to be able to preserve some time for the things that rejuvenate you?

 

Jill: I love that. Really, really sound advice. If you’re a really tired, burned-out physician, I suggest that you pause, rewind and listen to it again, because there were just a lot of good ideas in there. One of the other things you talked about earlier that I think can be challenging for physicians during this time is, a lot of physicians have again achieved what they’ve achieved by being overachievers and really always striving for the gold stars. Always striving to be the people pleasers, always striving to be the person who gets positive reinforcement and positive feedback. Sometimes that means that a system that is set up to try to get the most out of people, burns them out. Because as individual physicians, you might forget to advocate on your own behalf. 

 

You think, if I’m just working hard enough, and I just get a good gold enough stars, and if they just see how incredible I am, at some point, somebody is going to say, “Hey, she’s working too hard or he’s working too hard. We need to give them a break or we need to change the schedule in a way that allows for some more rest and rejuvenation.” Then, it builds resentment, which is another component of burnout. That whole thing as you said churns into the place, where you’re stuck in the mud revving your engine and it really is burning up fast. So, what do you have to say about agency as it relates to advocating for your own needs as a physician?

 

Diane: I think it’s so important and it’s not something we’re taught in training. Training is all about, putting the patient first, keep going, sacrifice, delayed gratification. When we’re young and maybe we don’t have as many responsibilities, sometimes, that works. It took a real cost for me I’ll say for myself. I do think that we have to advocate for ourselves, we have to begin to get better at being okay with having some of those conversations that are hard, setting the boundaries. Even knowing, that’s okay. We start out on our path to become physicians so young and that’s what we aim for. It’s like, we get on this train when we’re in maybe junior high school and we just keep going. It can be so easy to lose sight along the way. “Hey, there’s more to my life. I want to have a family, I want to have hobbies, I want to be involved in sports or whatever” and it can be so easy to just stay funneled or focused on our career. 

 

What I find helpful is to just take a step back for a second and say, “Okay, look at the whole of your life. Where are the places where you’re satisfied, and where are the places where you’re not, and what would it be like to put some focus and time and energy on those places?” It gets to what you’re mentioning before about so many of us are high achievers. Well, that is an incredibly great strength. Where does it have a cost associated with it? It might be the cost to your personal health, to your relationship, to the way you parent, and maybe you’re not happy with the way you’re parenting. There might be a cost there that makes it worth it to you to take a look at, what is the whole of my life, how does this one thinking pattern and way of behaving affect me? Maybe, down the road, I’m going to wish I had addressed this or had learned other ways of being in the world.

 

Jill: Well said. I think your situation, your story hits home with a lot of people, because you knew that the way that you were being churned by the machine and medicine was not sustainable. It was burning you out. And then, you said, “But I don’t know what else I’m going to do.” I hear that all the time from physician clients. And particularly when they’re feeling really pressurized and stuck is, “I don’t think I can keep doing this, but I don’t know what else I would do.” I love the subtitle of your book, because you say “Curing the Chaos and Returning Joy to the Practice of Medicine.” I think there is a percentage of people that maybe for them it’s time to exit the practice of medicine. But I think a lot of people feel it’s their only option for burnout, when it isn’t their only option for burnout. So, I want you to talk a little bit about that. Even though it was the option that you took, it sounds like you have a slightly different perspective on it now.

 

Diane: I do Jill. I’m so glad you brought this up, because back when I left, which was more than 25 years ago, there was no talk about physician wellness, or burnout, or any of that. I did not see any other options, in part because I didn’t ask for help. I did not seek out a mentor, a coach, a therapist, anybody to bounce ideas off of. It was simply, “This doesn’t feel like it’s sustainable. I guess I better go.” What I hope now is that physicians have more options and that when they’re in that place, even before, even leading up to the point of, “Oh, my gosh, this is really intolerable,” that they begin to have some support and help and options, so, they can see the breadth of what their choices are. I think it’s a tragedy that my only choice that I saw was leaving. Because I loved practice, I loved patient interactions. I landed on my feet, I don’t regret the course that my career took. But I do think that it would be great for physicians to have those choices and to be able to imagine a career where they can have a life, have a full life, and a career that will be sustainable. Where they can thrive and not be drained every day and thinking, “How am I going to make it through tomorrow?” 

 

Jill: Really, agree with that 100%. You just completely and succinctly summarized our mission behind DocWorking THRIVE, which is our subscription coaching program for physicians. It has been one of the great joys in my life to have had a number of the physicians, who initially joined us in that group program saying, “I’m really burned out, I think it’s time to leave medicine.” After even just a few months of being part of a group, rethinking some of the things that were really grinding them down and making them feel they were, as you said, just churning all the time. In very simple ways, they were able to make some changes and it really did help them rethink the idea that they were going to have to exit the practice in order to live the life and be the people they wanted to be. I really resonate with everything you said, based on our experiences there. 

 

For someone, who is on the beginning stages of burnout, because ideally, you want to talk about prevention of burnout, what would you say are some key things that they should begin noticing about themselves and perhaps thinking about shifting, so that they can avoid going into full burnout mode and having to deal with those consequences?

 

Diane: I think sometimes, self-care doesn’t sound like such an important aspect of our lives. But I think it really is for everyone and I think as physicians, again, we’re not trained to prioritize or really value what it means to take care of ourselves. Stopping, and pausing, and saying, “What does my whole life look like? How’s my physical health? Am I exercising? Am I eating well? How am I sleeping? And do I have time to connect in a meaningful way with people who are important to me?” I focus on working with women physicians mostly, and most of them are mothers, and one of the things they’ll say to me is, “I’m being irritable with my kids at home and that’s not me. I don’t want to be like this.” 

 

When you begin to notice those costs and then thinking about your whole life, and where is your level of self-care? One of the pieces, as tricky as it may be and as maybe uncomfortable or unfamiliar as it may be, is to begin to prioritize the self-care activities that you need in order to bring your best self to work, and be your best self at home. That’s different for everyone. But I’ll tell you, when I ask the women I work with, “What are the preconditions for you being at your best?” Almost always. The number one is sleep. So, what can you do to shore up your sleep, even if it’s trying to get to bed half an hour earlier this week, or setting a bedtime and sticking to it, or getting off your devices a little bit earlier? But begin there.

 

Jill: Yep. It is very powerful. As we say here, sometimes, all it takes is a one or two-degree difference in steering the ship in a different direction and over time, you end up on a different continent that’s more in line with where you want to be. Diane Shannon, this has been a great conversation. You obviously have the lived experience of understanding burnout in a way that so many others can’t, if they hadn’t been through it. So, thank you for sharing your wisdom, and for sharing what is working as you’re coaching physicians in their life, and work as well. If somebody wants to be in contact with you or to learn more about what you do, how can they find that out?

 

Diane: Yes, my website is dianeshannon.com and I am on LinkedIn at Diane W. Shannon.

 

Jill: Wonderful. Thanks again for being with us. We really appreciate your insights and thanks to all of you for listening. If you found this helpful, we hope you will tell a colleague, tell a friend, tell them to listen in and hopefully, they’ll find some encouragement, ideas, and some things to help treat their burnout as well. Until next time, I’m Jill Farmer on DocWorking: The Whole Physician Podcast.

 

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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.