Dr. Jen Barna and Jill Farmer, co-hosts of DocWorking: The Whole Physician Podcast, discuss why physician & healthcare coaching should be incorporated into your normal work schedule.
“ ‘I’m scheduled from 7 in the morning until 7pm and then have hours of paperwork after that and I don’t have time to eat or even pee during the day.’
I just want to say first of all, I see you. I hear that those are the conditions that have been created by the system for you, and I also want to say to you, that’s not ok.”
– Jill Farmer, Master Certified Life Coach, Cohost of DocWorking
Cohosts of the Podcast Jill Farmer and Dr. Jen Barna talk about the professional and personal development value of normalizing Physician & Healthcare Coaching as a key to staying connected to purpose and meaning during a career in medicine. In this conversation, Jill and Jen discuss why healthcare organizations should be carving time into the workday for doctors and other providers to engage in coaching and associated professional development in order to build leadership, communication, growth mindset, stress and time management skills, and work-life integration in order to make the practice of medicine sustainable as a long career. If this type of professional development for physicians, PAs, Nurse Practitioners and nurses does NOT happen, Jill and Jen point out that dedicated physicians and other clinicians may leave their practice earlier, shortening medical careers. The DocWorking team is here to help you clarify what brings meaning and purpose in your own life, arm you with the tools needed to put yourself in the driver’s seat of your life and career, and provide ongoing coaching and peer support to guide you toward your goals in a sustainable and effective way. In addition, this episode focuses on how you can start to build in time for coaching and make it a priority so that you may continue to find joy in practicing medicine.
Books mentioned in the podcast:
Jill Farmer is the Lead Coach at DocWorking, a company focused on helping physicians and other healthcare professionals thrive. Jill’s expertise has been featured everywhere from The Washington Post to Inc. Magazine. She travels the U.S. delivering keynotes and teaching her acclaimed programs at top healthcare organizations. Jill is the co-host of the top-rated podcast DocWorking: The Whole Physician Podcast with over 20,000 physician listeners. She was an Emmy Award winning TV journalist who is now a master certified time and stress management coach specializing in supporting physicians since 2010.
Jill Farmer is also the author of “There’s Not Enough Time… and Other Lies We Tell Ourselves,” a time management bestseller and a favorite of many in medicine.
Jen Barna MD is founder and CEO of DocWorking, a company that helps physicians and other healthcare professionals maximize meaning and purpose in life both in and outside of work, by combining expert coaching, peer support communities, and highly interactive courses that have maximum impact using minimal time. DocWorking also provides coaching and peer support through career transitions in medicine, helping physicians and advanced practitioners to successfully navigate relocating to a new community and starting a new job. Dr. Barna is the co-host of DocWorking: The Whole Physician Podcast, ranked as a top physician podcast. She is a board certified radiologist, and practiced in New York and Maine throughout her career. She earned her MD and completed her Diagnostic Radiology residency at the University of Tennessee School of Medicine, a masters degree in Molecular and Cellular Biology from Washington University in St. Louis, and her undergraduate degree from Stony Brook University in New York. She is the mom of two successful young adults, both born while she was a medical student. She started DocWorking to help physicians stay in the driver’s seat of their own lives.
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Please enjoy the full transcript here
Jill: I’m scheduled from seven in the morning until 7 PM, and then have hours of paperwork after that, and I don’t have time to eat or even pee during the day. I just want to say, first of all, I see you, I hear that those are the conditions that have been created by the system for you, and I also want to say to you, “That’s not okay.”
Jill: Hey, we are so glad you’re with us at DocWorking: The Whole Physician Podcast. I’m Jill Farmer, one of the co-hosts of the podcast being joined today by the other co-host of the podcast, Dr. Jen Barna, MD, the CEO and Founder of DocWorking. If you are like most of the healthcare professionals that we work with at DocWorking, you’re interested in your best life. You want to figure out how to do that. And that means you’re in the right place. Because what we do here at the podcast is we bring guests that can make your life better starting today. So, thank you for being here and tell your friends and colleagues, because these conversations are designed to help you thrive in your life and in your work. So, Dr. Jen Barna, I’m so excited to have this conversation with you. I love it when we dive in for doctor and coaching conversations about things that are pertinent to the doctors and healthcare professionals in our audience. So, great to have you here today.
Jen: Yes. It’s so great to be here with you, Jill. It was wonderful seeing you recently in person in New York City at the Healthcare Burnout Symposium. It’s been terrific to spend some time just catching up lately.
Jill: That’s right. I always love any conversation with you even when I’m just having it two dimensionally or electronically. But it was so great for us to be able to be there in person, and listen, and learn from some of the top people in the field talking about the crisis of burnout in healthcare. And then also to understand that so much of the work that we’ve been doing for these past couple of years is on the forefront of this. We heard a lot of things that we already knew and that we’re already addressing with our physician clients and with healthcare professionals and organizations. And so, I thought that was really invigorating to know and to be able to know that we’re supporting people on the right track on the forefront of where the national conversation is as well. Did you feel that way?
Jen: Yeah, I really did. It was significant to actually be part of that conversation and to understand the seriousness and really feel the breadth of attention that this topic of burnout is beginning to garner. And also, to realize that we have to be coming a part of the solution and to recognize that there is a problem, but also to recognize that we need solutions that are going to help change the system, but also to protect individuals. I think it’s been a real shot in the arm for me to just see that what we’re doing is making such a difference and that we have to see each person as an individual and help them in order to have them be able to come back to the table to help negotiate the bigger changes that we need where our system is failing.
Jill: One of the things we’re going to talk about today that I’m really excited about this topic, because it just comes up so often when I’m coaching individual physicians, which I’ve been doing for over a decade now, as well as coaching physicians in our small group circles at DocWorking Thrive is, this idea of the experience of having physicians recognize that they want to do something, is part of their professional and personal development to change what’s not working. And coaching is one of the ways that we know it’s been proven, research at Harvard and other places, really does help physicians and other healthcare professionals to change what’s not working in their life.
Yet, compared to other industries, which I’ve had the privilege of working in as well, everything from finance to manufacturing, to education, in medicine, it’s still considered this thing you do in your extra time, whether you’re getting coaching or any kind of professional development stuff, is this thing that you do in your own time. I’ve wanted to have a really honest conversation as somebody who coaches and consults in this industry to say that there needs to be a change there. We need to start recognizing that these kinds of things, getting coaching, getting support as a physician, needs to happen within the framework of the day-to-day job in order to support the sustainability of being able to do this for any length of time. So, what are your thoughts on this, as well, based on your experience, both as a working physician and supporting physicians at DocWorking?
Jen: Well, I really have to commend you for introducing this initiative really, because when you first introduced this concept to me, I definitely agree that on principle it sounds like a needed change and it makes complete sense that we should be doing this at work. Because it is part of our professional development and it impacts our work and our productivity so significantly to be able to prevent burnout and have coaching around helping us to stay focused on what matters to us, so that we can really come to work with that sense of purpose. At the same time, my initial thought when you first talked with me about this was, “How can I fit that into my work day?”
I really initially struggled with that question, because the workday is already at a level that previous to the pandemic, we would always be able to finish it. But it would might take an extra hour or two depending on how many add-ons you had that day and how many committee meetings you had that day that were just thrown on top an already full schedule. My initial reaction was, “How in the world would we be able to do that?” Then when I came back around and asked you that, I’ve really been encouraged by what you said to me. So, if I can throw that question to you again, now, I would love to hear what your opinion about it is.
Jill: I love this topic. If you’re listening to this, it makes you a little uncomfortable because you’re like, “What do you mean I’m supposed to take time out of my workday to do things like get coaching or learn things that support my professional or personal development?” I get it. It has not been baked into the system in any way, shape, or form in healthcare, really, in any aspect of the work that I’ve been doing in coaching and consulting in this industry for a long time. I just want to say, clearly, it is in other sectors. Even in places like law, accounting, finance, manufacturing, education, there is a more openness to recognizing that making time for things like getting coaching or taking a group course together that takes an hour a month or an hour a quarter is actually really, really important for not only people’s work performance and work-related outcomes, but for their willingness to stay in a job in a sustainable long-term way.
In other words, it really helps with burnout. Adam Grant and others who are leaders in the organizational psychology and workplace psychology have been preaching about this for years and years and years. I think it’s just finally dawning on healthcare, thanks to unfortunately this mass exodus of physicians and healthcare workers due to burnout, that they’re starting to say, “Wait a second, we might have to think about this completely differently.” So, on the macro level, the crisis of staffing, I think is beginning to help these conversations have a little more impact. On the micro level, as you talked about, is a great question. You’re like, “Okay, Jill that sounds excellent that I can just take an hour a month to get individual coaching in my very busy schedule, where I’m already pressured to see more patients every day than I am and I’m scheduled from seven in the morning until 7 PM, and then have hours of paperwork after that, and I don’t have time to eat or even pee during the day.” I just want to say first of all, I see you, I hear that those are the conditions that have been created by the system for you, and I also want to say to you, “That’s not okay.”
At the burnout conference, I had a really deep and wonderful conversation with a couple of people, who are in leadership and wanting to change coming at things from the physician wellness perspective. They said just like in the late 1800s and early 1900s, factory workers who were being abused by being forced to work in almost inhuman conditions, not almost, in truly inhuman conditions had to say, “Wait a second, this isn’t right. We can’t create conditions for humans where they literally can’t take care of their most basic needs, and do it in a sustainable way.” And so, what I often have happened when a physician will come to me and say, “I got to quit. I can’t do this anymore. I’m going to leave medicine and go work in a bait shop in Miami or a flower shop.” There’s been all kinds of places where they want to go work that aren’t in medicine anymore.
The first place we start is asking, what are the conditions that will allow you to reconnect to enjoying and finding the practice in medicine meaningful again, and lay those out. Reasonable hours. The ability to do professional development or to get support from somebody like me or others who are experienced at this, and time to actually do paperwork and administrative work. The first place we start is to go back and ask leadership for the conditions they need in order to stay. And so far, in literally every case where we’ve done that, to the shock of the physician who’s been working with me, their requests have been taken a lot more seriously and great attempts have been made to try to accommodate those requests.
What I find very often not because physicians are doing the wrong thing or they’re not amazing, incredibly intelligent, fantastic people, because across the board, hardworking and resilient,well above what we see in the general population. But what does happen is the conditioning of the extreme nature of medical education often causes people to forget where they have agency and the ability to ask for what they need. And then by the time they really dare to go ask, sometimes, they already have a foot out the door. And so, if you’re a physician or a healthcare professional, I know these conversations are hard and I know that you’re not often going to be patted on the back with, “Gee, thanks for coming to me to ask about the scheduling thing.” But I think more and more and more people are being brave enough to start the conversations, and even though it’s counter-cultural, now, I think it’s what’s needed to start to change the culture, which is what really has to happen. So, I said, probably, way more than you [chuckles] were looking for in that answer, but obviously,I have some thoughts on the subject.
Jen: Yeah, I love what you said and I feel hopeful. I think that if you’re a physician, you have one foot out the door, because you just have been pushed and pushed and pushed and it’s at a point where you feel it’s just not sustainable anymore. The idea that you could come back and negotiate some change and make leadership aware that what you’re dealing with is not sustainable. That is a win for leadership. Because that as you often point out, Jill, it’s not black and white. There are options in between and you don’t have to leave. It’s not 100% or nothing or 199% or nothing. [laughs] It is possible to negotiate something that can work long term. While in the short run, they may need to get additional staffing, because quite frankly, maybe other people are going to come forward as well to say, “Yes, we agree. This is not appropriate or sustainable. And how did we even get here as physicians? Because we know that’s not appropriate or sustainable and we wouldn’t recommend it for anyone else.”
If you think about what you would advise someone you care about, someone who you love, your son or daughter, if they were in this situation, would you say, “Oh, well, it’s okay. Just work the extra 17 hours or cram more patients into your 12 hours.” No, that’s not what we would advise, of course, to someone that we care about. And so, when you turn that on yourself and ask yourself the question as if you’re answering it for someone that you love and that you care about, it can give you a new perspective and it can be a reminder that even though in the short run, it’s a painful conversation to have and maybe one that you have put off for a long time, because you’re afraid of it or you dread that awkwardness of, “Okay, but what are we going to do, if you don’t do this?”
Well, the bottom line is, you as a physician don’t hold the responsibility for whatever can be put on the schedule without limitations. You have the responsibility to work what is a reasonable day and whatever you have negotiated as a reasonable day. If there is short staffing, it’s not your responsibility to then take that on and make up for that. I can say, firsthand, because that happened to me the very first job I had outside of residency, that it’s easy to make that mistake and say, “Oh, well, there should be three people here, but I’m the only one here. So, I guess, I just have to redo everything and just never leave and basically try my best to be a machine until I just can’t do it anymore.”
It doesn’t have to be that way. I think in retrospect, I would never advise someone to do that. If I had spoken up, I could have changed that probably right at the beginning instead of setting a pattern of accepting it. So, if you’re finding yourself in that situation and you need some encouragement to have that conversation, we’re here to help you to take the courage to do that. And also, if you’re in a situation where you can speak to leadership and incorporate these kind of programs into your schedule at work, so that it doesn’t take away from your time away from work, you want to protect that at every opportunity possible. And so, if you can encourage a culture at your workplace that will allow this for everyone, it will ultimately build a better culture of caring and a better environment for working together as teams, because people will be coming in to work in a higher productivity mode, feeling more purpose in what they do, and will be learning ways to manage stress. So, there are so many ramifications that ultimately benefit the institution itself.
Jill: It’s just 1,000%. Being in an activated stress state is guarantee that you are causing yourself to be less efficient and to overwork or overuse your energy, because it’s just very hard to do things in a meaningfully productive way when we’re in an activated stress state. And so, understanding, by taking time to get coaching, to take a stress course, you know – I’m not asking anybody – I just want to say really on a practical tactical level, this is based on not just me making this up, but dozens of physicians saying, “Gosh, I wish I would have taken the time to get once or twice a month coaching much earlier in the process before I was so fried to a crisp. But now, I’ve got to really work hard, [giggles] which I don’t have the mental resources to do that work right now in order to get out of that hole. And them saying to me, “If I could have just taken the time earlier on to recognize some of these things, it would have been a much simpler and easier process.” And so, that’s part of the motivation for me is to say, don’t wait until you feel like, “Oh, I just can’t do it anymore. I’ve failed” or whatever, that is, recognize that it’s implicit to the way that the system is set up and the earlier you can recognize that–.
When I first started coaching physicians, I bought into it, too. They would say, “Oh, we can only get coached on nights and weekends.” I was like, “Okay.” And so, I would schedule that availability on nights and weekends for physician clients. And you know what, they were completely exhausted when we were trying to get together and it was so hard to have meaningful conversations and/or they just would cancel all the time, because they just couldn’t add one more thing to what they were trying to do where they felt pressure, of course, to want to do what they shouldn’t be doing in the time when they’re not working, which is to recharge their batteries and not do work on themselves in this way.
And so, when I started saying, “Hey, here’s my availability.” People started recognizing, “Yeah, it’s worth it for me to prioritize that one hour a month or two hours a month, 5 or 10 minutes a week to take this very easy online stress course.” When they started readjusting the schedule giving themselves permission, they’re like, “Oh, it’s amazing what a difference it makes.” When I schedule my time, it’s similar to what I hear people say when they start to make a little time for exercise in their life. They’re like, “I kept waiting, then I was too tired, and I never did it, and that made me more tired.” When they make just even a little time for that 10 or 15-minute walk, how much more energy it gives, clarity of thinking that it gives, the other benefits that it gives for processing stress, and you start to realize, that’s where the prioritization needs to be and the other stuff all falls into place.
Jen: That is so true. And another question that I’ve heard lately from healthcare organizations is, “How do we set up a culture of wellness?” and then in the context of physicians who are paid on a productivity basis, and one thing that I would encourage people to be creative about if you’re in this situation and if you happen to be in a leadership position and you have the ability to make this choice, to encourage this on behalf of your institution by creating some sort of productivity benefit to attending the coaching, taking the time to do the needed few minutes a week to do StressPal course, for example or other courses that can really move the needle on how to manage time and stress.
And also, for small group coaching and one on one coaching, if you build that into the schedule in a way that people actually benefit from doing it, not just personally benefit and professionally benefit, but even benefit in terms of their productivity numbers, then you really are setting up a system for success. Because if you are paying people on a productivity basis and then you’re asking them to take an hour out of their day and do something that doesn’t count toward that productivity, it feels to the person you’re asking to do that, like, you’re adding something on. You’re still expecting them to be as productive without it. But now, you’re taking an hour away from them during their day.
Personally, the way I always would think of that was, you’ve just added an hour to my day. Because I’m still going to do the same amount of work before I leave and now, I have this hour that I have to do this other thing. I think it is really important, if you’re an executive or person who’s in a leadership position and you’re implementing these programs, as people should be doing as a matter of course, in order to survive this healthcare epidemic of burnout, the organizations that are going to succeed are going to implement programs that not only have ways, real tangible ways that people can learn to prevent and deal with symptoms of burnout, and manage stress in an effective way, and balance work and life, but they’re going to implement that in such a way that people can benefit from it if they’re going to stay within a productivity type of model.
Jill: I love that. Oh, my gosh, that was so good. I just want to play that [laughs] back over and over again. That is just really clearly said and succinctly said. I haven’t been nearly to as many healthcare conferences as you have. I’ve spoken at the American College of Cardiology. We just attended the Burnout Symposium. I’ve been to other healthcare conferences and conventions over the last 10 years. One of the things I noticed that I was talking to you about Jen, when we were in New York is, they have the schedule pack. Here, we are talking about burnout and this schedule was packed literally from eight in the morning until the very end of the day with very little space for breathing room in between. And so, that’s my other call. If you’re in any decision maker process when you’re setting up a conference for physicians or healthcare professionals, for gosh sakes, recognize that packing more stuff in is not necessarily a good way for people to take in information and learn stuff. We got to start thinking about putting more breathing space around what we’re doing in both healthcare programming and in the way that we think about healthcare professionals balancing their professional growth with a sustainable, long-term career. Because otherwise, doctor is going to start being a 5- or 10-year career for people. When you’ve put anywhere from a minimum of 8 to 12 years or beyond is part of the education, that’s not going to attract a lot of people to the career when they’re only in it for 5 to 10 years. I want to help be part of the change that makes it back into a more sustainable long-term career.
Jen: Well, I think you’re off to a terrific start in being part of that change and it really has been such a privilege to work with you and to learn from your expertise as we’ve developed all of these programs at DocWorking that are based on success stories from your own coaching over the years and being able to pull everything together while talking with physicians all over the country about what matters to them and recognize, as we have learned over time, as we were developing these programs, that there are limits and people do want to have things that are very concise in terms of making change in a short amount of time.
And they also don’t want to be overwhelmed with 10 courses at once. To design a program that moves people forward in an effective way with very little time is really key. I think that I’m very encouraged by what we’ve seen at the Healthcare Symposium on Burnout, that people are beginning to recognize that these types of programs need to be a normal part of healthcare organizations and be provided for their employees and staff. I’m very hopeful that we can survive this storm and certainly as individuals, I think it is imperative that we put the mask on ourselves first, the organization you work for is probably not going to put the mask on you. So, it is important to take the steps to take care of yourself and don’t wait for someone else to do it for you.
Jill: Beautiful. It’s going to help make your career sustainable for you. Something that you can keep doing that matters to you for a longer period of time, and you’re going to be part of a bigger culture change. We’re starting to see it. Organizations are having to get more honest about things like staffing, because not just women, but men are taking family leave when there’s a birth in the family. Things like that that just used to not happen in medicine and honestly, a little behind other industries, are starting to get normalized I know not everywhere, some of you are going, “But wait, in my organization, we’re still not doing it.” But I’m seeing the change happen and I’m seeing it happen fairly quickly, so that it does give me hope and I know it gives you hope, Jen, as well.
We’re both passionate and it’s one of the things that makes us get up in the morning to make this incredible career of being a physician and the incredible work that you’re doing to save lives every day be something that you get a lot of meaning and reward out of, so that you want to keep doing it for the long haul. So, thanks for being part of this conversation to all of you. Jen, you’re the best. I love having this talk with you.
And right now, one thing that you can do for yourself that will take a minute is to go to docworking.com. I want you to take the burnout quiz to see where you are on the balanced to burnout continuum. It’ll just take a few minutes, but you will be so glad and get so much out of the results. I want you to check out the programs that we have that start with just even a few minutes a week to help you be less stressed and able to thrive in your life and your work. So, Thanks, Jen, again, for being with us here today.
Jen: Thank you so much, Jill. It’s always a pleasure. And thank you all for listening. Thanks for being with us on DocWorking: The Whole Physician Podcast.
Jen: At DocWorking, we’re here to help you maximize your potential on your own terms and help you live your best life. You told us what you need and want and we built this for you. Whatever your journey is, you have options, you can choose to live the life you want to live. We see you, we get you, and now, let’s get you in the driver’s seat of your own life, so you can find purpose in your work and everything you do and every choice you make.
Top executives, athletes, actors, all achieve greatness with the support of professional coaches. As a healthcare professional, you deserve ongoing coaching support toward achieving your career goals and living your best life as you define it on your own terms. We have created this specifically for you with CME credit at docworking.com. Please go to docworking.com and check out our quick balance to burnout quiz to see where you are on the balance to burnout continuum right now. The results might surprise you. Taking this simple first step may change your life for the better. And until next time, thank you for listening to DocWorking: The Whole Physician Podcast.