Dr. Natasha W. Lewry Beauvais and Dr. Jen Barna discuss what happens when medical teams care for each other.
“If we really focus on good care for each other, we are in a much better position to offer good care for the patients. ”
– Dr. Natasha W. L Beauvais MD, MPH
What happens in a medical organization when the healthcare team learns how to care for each other, and how does that impact job satisfaction and patient care? How does it impact employee retention? Cohost Dr. Jen Barna talks with Dr. Natasha W. Lewry Beauvais MD, MPH about her practice and implementation of programs that do just that. As a physician at Northern Virginia Family Practice Associates, a concierge medical practice, Dr. Beauvais shares how her practice has established their positive workplace culture by first recognizing what you can do to make those around you succeed. By asking what you may do to support your coworkers, Dr. Beauvais and Dr. Barna talk about the importance of maintaining high levels of trust throughout your team and how to perpetuate the want to care for your teammates and how that leads to better patient care. How does this approach lead to a shift in mindset so that you may find more joy practicing medicine with those around you?
Book mentioned in the podcast:
What Got You Here Won’t Get You Here by Marshall Goldsmith
Natasha W. Lewry Beauvais, MD, MPH is a physician at Northern Virginia Family Practice Associates (NVFP), a family medicine practice that offers full-service concierge health care in the Northern Virginia area. With more than 16 years of professional experience, Dr. Beauvais understands the importance of providing care for the whole family through every stage of life and values the continuation of long-term patient care.
Dr. Beauvais specializes in serving teenagers, new mothers and those requiring end-of-life care services. A home-birth advocate who has personally experienced home birth herself, she cares for women throughout pregnancy, birth and beyond, helping them connect with their newborns and providing them with breastfeeding support.
In her experience, the early stage of the parent-child connection is a pivotal moment for children’s continued growth and wellbeing, especially during the young adult period. In addition to providing resources for families, she encourages parents to keep up with their children’s yearly check-ins to help develop a stronger doctor-patient relationship so kids can stay educated about their health and feel supported by their doctors as they grow.
Prior to joining NVFP, Dr. Beauvais served as a physician at Unity Health Care in Washington D.C. and co-founded the Women’s Mentoring Program for the American Medical Women’s Association. She has received the Joseph Collins Award for Excellence in Arts and Letters and the University of Connecticut Family Medicine Award.
Dr. Beauvais holds a Bachelor of Arts in American studies and science from Yale University, as well as a Doctor of Medicine and Master of Public Health from the University of Connecticut School of Medicine. She completed her residency in family medicine at SUNY Stony Brook and Mount Sinai School of Medicine’s Jamaica Hospital Family Practice Residency in New York City. After work, Dr. Beauvais enjoys taking family hikes and gardening. She currently lives in Alexandria with her husband and four children. For more information, please visit www.nvafamilypractice.com.
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Podcast produced by: Mara Heppard
Please enjoy the full transcript below
Dr. Natasha: If we really focus on good care for each other, we’re so much better positioned to offer good care for the patients.
[DocWorking theme]
Jen: Welcome to DocWorking: The Whole Physician Podcast. I’m Dr. Jen Barna. And today, I’m excited to introduce to you our guest, Dr. Natasha Beauvais. She is a physician at Northern Virginia Family Practice Associates, also known as NVFP. Dr. Beauvais is a family medicine physician and works in a Concierge Healthcare in Northern Virginia. Prior to joining NVFP, Dr. Beauvais served as a physician at Unity Healthcare in Washington, D.C. and co-founded the women’s mentoring program for the American Medical Women’s Association. She has received the Joseph Collins award for Excellence in Arts and Letters and the University of Connecticut Family Medicine award. Dr. Natasha Beauvais, welcome to DocWorking: The Whole Physician Podcast.
Dr. Natasha: Thanks, Jen. It’s nice to meet you and good to be here.
Jen: It’s so great to have you here. I’m really interested in hearing about your journey and I’m so thrilled to have you as a guest on the podcast. How are things going there? You’re in Northern Virginia, Alexandria, right?
Dr. Natasha: Yeah, I’m in Northern Virginia. We’re doing well. It’s good to be mostly back in normal medicine mode.
Jen: When you say, back in normal medicine mode, do you mean since the pandemic began?
Dr. Natasha: Mm-hmm. Right. Yeah. We have a Concierge Family Practice in Northern Virginia and we’re just about to open another one in D.C. in September.
Jen: I’d love to just hear about your journey in medicine. I just read a little bit about your background, and you trained at University of Connecticut, and then did your residency at Stony Brook. I was at Stony Brook as an undergrad. I have so many questions about your whole journey, because I see also that you were one of the developers of the women’s mentoring program at the American Medical Women’s Association and also that you have four kids. So, I have [laughs] a ton of questions about how you’ve managed it all and everything that you’ve chosen to do. Would you mind just backing up and telling us just an overview of your journey?
Dr. Natasha: Sure. I think my role in the American Medical Women’s Association is pretty discrete. I just was a part of starting that group up for students, 25 years ago when I was in medical school, for my local chapter. It was pretty, pretty discrete. I’m very passioned about women in medicine. I think I’ve gotten a lot out of women’s leadership courses about physicians in leadership. So, those have been very meaningful to me and very life changing as I got further into my career.
I do have four children. I had my first child during residency and my second one the month after residency was over. Thanks to some really lovely encouragement from my residency director, I did finish my residency on time, but I was open to doing it halftime and taking a few more years to get it done. And then I worked part time for a long time, probably, almost 15 years, as a way of being more home after school than not. However, I’ve been having so much fun really in the last few years at my job that I’ve just decided to take on more and more. And my youngest child is 12 and he does not get the benefit of having mom home after school like my older children did when I was working less.
Jen: How did you find the difference between having a child during residency versus after residency just out of curiosity for anyone who may be listening and trying to decide when they might want to have kids? I had both my kids as a medical student. So, I’m curious about your experience as a resident and post residency.
Dr. Natasha: I think every time is fine to have kids and no time is perfect to have kids. You just have to figure it out and not really let your career override, because there’s only a finite number of years you can have kids and a finite number of opportunities. I think honestly it would have been much harder to have my kids in medical school than in residency. So, I’m sure there’s a challenge, burden to carry and a blessing that goes along with it no matter where you do it. It’s just a matter of having to say, “Okay, how can I figure it out?”
In residency, I took, my director was very flexible. I had a month off and then he allowed me to do research month. I was doing research, but it wasn’t extremely demanding at all and I was really home with my daughter. I don’t even remember how we handled the third month or maybe I was only off for two months. I really can’t remember how I handled it. [laughs] It was a long time ago. But I was very, very grateful to do that. I had the benefit of my mother-in-law, who would babysit twice a week and she would actually take the subway with the baby to my residency where I had a lunch meeting every day to do lectures and I would get to nurse baby during my lunch meeting twice a week. So, that was really taking care of me, as well as taking care of the baby and I was so grateful to her for making me feel I could still be a mom.
Jen: That is wonderful. It’s amazing to be able to have that kind of support. It sounds like that’s influenced your practice as well.
Dr. Natasha: We’re family physicians. Actually, we now have two internists as well. We really do primary care for the family. I do see a lot of women, but I have a lot of male patients as well. I did have an instantaneous moment in a job interview very early in my career that helped me realize how important it is to focus on what other people need in their work. I was applying for a job at Unity Healthcare, which is a public health umbrella for lots of public health in Washington, D.C. The director was interviewing me for a very tiny job, a very part-time starter job for me that was mostly designed to keep my toe in the water while I was mostly at home with two children.
During the interview, the doctor who was interviewing me said, “Oh, well, what you need is–” I don’t even remember what it was. It was something about scheduling or flexibility. I just couldn’t believe that she was asking me what I needed during my job interview. That was a tiny sentence that represented a huge shift to me and how all of us can approach work. What does the person need to succeed? What does the person need to accept the job to feel they have their bases covered and to feel supported? I do hope that that’s what we try to do in our work now as employers is to try to listen to what people need and if people have a different scheduling need, one of our staff members needs to leave at 2 PM, we can work on figuring that out.
I was very lucky for my whole career to work part time for the first 15 years. I think that’s something not everybody realizes that’s possible. I still have another 30 years of [chuckles] work to do. So, I think if you’re happy enough, it can morph into something that where you take on more and more work if you choose to or maybe people are happy doing less work and that would be fine, too, because then we wouldn’t be healthy and still be able to provide care for others.
Jen: And be able to provide better care for others, I would say as well. I think you’ve hit on something that is so critical, especially in this time where there are conversations going on everywhere about retention, and of course, about physician burnout and how to prevent physician burnout, which is something that we specialize in at DocWorking. The whole concept of focusing on the needs of employees and building a culture that strengthens resilience, knowing that healthcare workers are already resilient. But resilience isn’t static and it’s really important to have programs in place that help us to appreciate each other as team members, that help us to see the strengths in the other people on our team and be able to really pull together as a team and ultimately provide better care because we’re meeting the needs of each other first.
I think if that’s the kind of culture that you’ve been able to create in your practice, then it really can serve as a model to other practices and it certainly can send out an important message to anyone who’s wondering how they could improve their recruitment and retention, and that is to find out what people need and find a way to provide that, so that people can stay long term. You can really build a team that works well together that is there for the long haul, and that serves patients better. Patients don’t want to be changing doctors and changing providers, clinicians, every couple of years. So, I think it also helps in a competitive environment, because patients want to go somewhere they know who they’re going to be seeing and they know that they can rely on the staff there. How did you decide to go into concierge medicine?
Dr. Natasha: I was working as the traditional doctor in a doctor’s office that was hybrid. There was a concierge branch and a traditional care branch. When my former employer retired, he asked me to take over his patient panel, something I really had to think about for a couple of years before I decided to do it. I went into it with a bit of caution, I think. But I’ve been extremely happy to be practicing that way. I think what you’re talking about, the doctor doesn’t go away, the doctors in this model are very stable, like, we don’t have any turnover. [chuckles] People are here because they love medicine. They want to do it in a more thorough way. And so, that’s what this practice allows.
The other thing that we’re really learning about in terms of not just preventing burnout, but in terms of really providing a road to job satisfaction for everyone, not just for the physicians, is we’ve been working with the science of adult cognitive development and something called Immunity to Change, which was developed by some professors in the education school at Harvard. They have a system that we’re just really starting to implement it. But it’s starting to help us give skills that help take roadblocks away for all of us, for the physicians, for the nurses, for the receptionist, for the biller, for the administrator. I think it’s been really, really interesting in the early pilots that we’ve been doing to allow us to see a place that we don’t realize we’re stuck. That has been very life giving. And then when people feel like they’re growing at work, work is fun. Work is more fun, I think, when there’s new stuff to be learned.
Jen: That really ties into everything that we do at DocWorking with coaching and then our foundational course. We partnered with StressPal and our coaches are on the platform there. It is for the whole care team with the concept that everyone on the team can work better together as they’re growing as individuals, and also see the benefits of knowing the same vocabulary, and the same type of retraining in order to retrain your brain to deal with stress in the heat of the moment, and find ways to thrive in that environment. And so, I really am interested in hearing about your experience with that type of a program, because there’s such a huge need for this all over the world really right now in healthcare.
I think providing this type of training, and this type of mindset of resources and ongoing support to the healthcare teams to ultimately benefit them both personally and professionally, leading to that high level of job satisfaction, which then leads to better patient care is such a critical concept in an environment where we’ve gotten a little bit away from that. I think people are feeling overburdened by charting requirements and requirements that get them away from patient care, and people really want to get back to that sense of purpose. I think it’s a way of also learning to recognize where you have control, so that you can put your energy into those areas. So, tell me about your experience a little bit more. How big is your group and how long have you guys been participating in this program?
Dr. Natasha: Our group is currently about 20 and growing gradually. Really, I got interested in this work just before the pandemic. We did a quick and fast trial of doing the work really early on in the pandemic, which completely failed, because my ramp up to the project was not well executed. But I think it was enough to get me really, really curious about how it could work. And so, I did several workshops myself to learn the science and read a few books about it.
And then in just in December last year, we started with a very small pilot group within our office, about, just to have an outside facilitator help us learn the process. We all had a collective work goal that we were committed to working on and we were mostly just helping ourselves see where we were with respect to that particular project. We’ve now done two pilots and we’re about to start a third one next week. I would say what was surprisingly meaningful in the very first one was the simple act of having a meeting with stable people and doing a check-in. And three out of four of us had very substantial significant things going on outside of work. During that check-in, we were really able to just recognize each other in whatever was happening in and out of the office.
I think just having a place where something that was happening out of the office had a place to be aired, allowed everyone to just recognize where everyone was at, and then move forward, and created a lot more trust between the four of us as we were going through that few months. And then at the end of the process, I felt we were just able to speak much more honestly with each other and the level of trust between us had changed. So, that was the first pilot that we did. That wasn’t really the intent. I didn’t realize that what we needed to do going into it was build trust, but that’s what felt the most meaningful coming out of it.
Jen: What was your goal going into it? That is really valuable that increased trust came out of it. I’m just curious going into it what your intention was.
Dr. Natasha: My intention and the intention of the project is to help each individual notice some things that they’re committed to that are perhaps getting in their way. And so, there could be good things. Take a very, very simplistic example. I would like to be a better communicator with my team, but I’m also committed to seeing patients and I’m also committed to seeing my kids. And so, if I’m committed to seeing patients over and above communicating with my team, then I’ll never get it done unless I change something about how I’m approaching it. So, that’s a very, very simple level.
The other thing that happens is, I think you’ve mentioned something about, what do you have the capacity to control. I think that this program really helps us develop insights about where we can focus our energies and where we will have an influence. And so, to take my own example, again, in this model, I was frustrated about people not responding during meetings. If I focus that frustration externally and I’m irritated with other people, because they did not respond, then I can just stay mad and not really get anything done. But if I recognize in myself that I have an opportunity to do some research, and learn how to run a better meeting, and create a system that feels more secure, so people will be more willing to talk during meetings or backup even further and create tiny meetings for other people to begin to develop their own sense of trust amongst the team before they’ll even ever talk in a meeting. Then I can look at myself and my own capacity and what I can do to change that situation.
And so, that’s an example for me. That’s been very meaningful and it was very helpful for someone to point out to me that I wasn’t doing research about how to have a better meeting. If that can be taken on by each person individually to recognize their own locus of control and their own capacity for changing things. If they recognize the phone isn’t getting answered, for example, wouldn’t it be cool if the person who can recognize that also can work to change how the phone is getting answered instead of waiting for two other levels of people to make a decision to change it, which won’t happen for a long time? So, I think it helps us shift our own mindset. I’ll be the first one to admit it’s shifting my mindset.
Jen: It is tremendous. I agree. I think starting from a place of overwhelm and feeling lack of control, it is a huge mind shift. When you begin to realize where you do have control, you realize you have more options than you thought you did, you realize you can influence things that you previously maybe just assumed were in the control of someone else. But actually, as you mentioned, even something as small as someone answering the phones, that’s something that could give you a lot of peace in the course of [laughs] your day, if you can have some influence to get a problem like that solved and chances are you can.
When you begin to realize that you do have some agency over a number of little things like that that can improve your day considerably. When you get the whole team involved, it really gets everyone into that troubleshooting mindset. People are interested in hearing other people’s ideas and interested in implementing them. Have you seen any other simple changes that have been really significant to you and your practice?
Dr. Natasha: I think one of the most powerful things is realizing how critical it is for us to be cultivating skills in others instead of just problem solving. And I would say this is true for me and it’s also very true for people who are part of our administrative management group, is to realize that perhaps, we came into this job, there’s the book what got you here won’t get you there. [laughs] And so, maybe we all came into this job with a certain set of skills and a certain mindset or approach about, “Okay, I’m a doer. I’m going to get everything done.” And then I think one downfall of any organization is to rely on those people who naturally are the doers and get everything done and never work to grow the skills of all people.
Then the doers get really, really tired. They have [laughs] nothing left to give. But I think what began to become visible to us within these groups is, “Wow, I’m limited by my own time.” On the very shortsighted approach, I might want to just do everything today because I know how to do it and it’s going to be faster if I just do it. However, that will mean I never get to do anything else besides do all those things that I already know how to do today. If I work to train someone else and if my manager works to train someone else, then all of us get to do something different. The newest person gets to learn the skills of the more seasoned person, and the more seasoned person gets to learn the skills of the top people, and the top people get to grow the organization and do really different things. And so, each person, if we recognize that our most important job is to grow others, suddenly, we really shift how we approach any problem. We’re not really just supposed to get everything done.
Jen: That is beautifully said. I love the concept of cultivating skills in others, because ultimately that does lead to a stronger, more resilient institutional culture, but also, it leads to a culture where people have a higher job satisfaction because if you think about it, it’s a culture of care and we all went into this profession because we want to care for other people. But we also want to be cared for as individuals. And so, if you’re going to work and you feel you’re in a culture where people care about you, then you can turn your energies into caring for someone else.
When you think about like, a family, for example, the concept of a family is that it’s a group of people who care about each other. You know that those people care about you. If you think about how much time you spend at work, you’re spending 40 plus hours a week and often many more hours than that a week, if you’re working as a physician or healthcare worker. It’s really critical to be working in a place, where there is a culture of care and a culture of resilience. And that cultivating skills in others is a way of showing that you care really, because you’re saying to someone, “You may not know how to do this now, but we’re going to show you how to do this. We have a confidence in you that you can learn this. We’re going to work with you until you learn it. So, we’re not going to just be frustrated. We can take the time and make sure that you learn it.” Well, I really love that. I love what you’re doing and it sounds like it is paying off in spades for the people in your organization as well as the level of care that you can deliver.
Dr. Natasha: Yeah, I like the recharacterization of it as cultivating skills is caring. Because I think what we really try to remember with every question about whatever we’re doing in our practice is, is this good care? And mostly, we’re talking about medical care for patients. Of course, we really want to be caring for our staff as well and we want to really make sure that our culture is healthy for a staff that isn’t good care. For example, if someone’s going to be late, we’re a very good culture now of, we have a group chat and people will say, “I’m going to be 15 minutes late.” That allows people to recognize, “Oh, that person’s job will be unfilled for 15 minutes. I better fill it.” I think that’s a way of caring for your coworker like, “Okay, this person is late. I have to care for that person.”
I think if we really focus on good care for each other, we’re so much better positioned to offer good care for the patients. But sometimes, I think in healthcare, we’re under such high demand to do good healthcare for the patient and we’re so behind all the time that it’s hard to take the time to create a system where we can really focus on being good to each other, which of course would then make us provide better care for patients.
Jen: Absolutely. I really appreciate you coming on the podcast and talking about this concept with me because I think it is so critical to healthcare, burnout prevention, longevity within the field of medicine.
Dr. Natasha: Well, thanks, Jen for having me. It was a lovely conversation and I’d love to learn more about your anti-stress work and how you can create cultures, where it sounds like you’re cultivating the same thing.
Jen: Yes, we are. DocWorking has a program that is an ongoing subscription for healthcare providers, physicians, and everyone on the entire care team. We have different levels of support that we can provide for individuals, we can also provide support to entire institutions. And also, by creating a community of physicians in what we call the doctor’s lounge and then we have a community for PAs and nurse practitioners, and one for the care team itself. That allows people from all over the country to be able to feel a part of a community and to be able to be in a safe space, where we can talk about the struggles that we have. Having a place where you can connect with other people and realize that some of the things that you might feel vulnerable about. Once you begin to talk with people and connect with people all over the country, you start to realize you’re not isolated in that struggle and it’s really helpful, I think, to be able to give yourself permission to be more vulnerable.
Dr. Natasha: That’s great that you have a whole community of people where that communication can happen. Absolutely. Where are you in Virginia?
Jen: I am in Winchester, Virginia at the moment. I was able to find a spot at Shenandoah University in the library here, Smith Library, due to the kindness of the people in the visitor center. [laughs]
Dr. Natasha: That’s great. Yeah, how creative. [laughs]
Jen: I’m really fascinated by the concept of a digital nomad type of work. I don’t do locums currently. I work with a practice that I’ve been with since 2011. But I do have some flexibility in terms of when I can work as a radiologist. And so, I think for physicians, actually, there is a lot of flexibility. You mentioned part time work earlier and there’s also so much flexibility with the ability to do locums, you could do that during your vacation time, or you can do that as a career itself or as a temporary move to give you some flexibility. So, the idea of being able to record a podcast and work remotely is something I am experimenting with at the moment.
Dr. Natasha: Yeah, well, what a great experiment to go do that and especially, to find Wi-Fi in the Shenandoah as you have to work at it.
Jen: [laughs] Yeah. It was a little bit of a challenge. Thank you so much for coming and talking with me on the podcast. I’d love to hear how things go as you’re entering this next stage of this program that you guys are working on. Thank you so much. Dr. Natasha Beauvais, thank you for coming on the podcast and talking with me today and I would love to talk with you again in the future.
[music]
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