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How One Doctor’s Burnout has Inspired an International Conversation

Burnout Prevention, by Coach Jill Farmer, Physician Burnout, Physician Coaching, Physician Wellness, Podcast

 

Dr. Katie Cole shares with Jill Farmer how her burnout inspired her to pursue a career in healthcare.

“It took me several years of going down that path to really realize that trauma healing is a journey, it’s not a destination, and to have grace and compassion with myself. And when I was able to do that, I think my impact as a physician changed.”
-Dr. Katie Cole, D.O.

Burnout in health care is real and we would just like to let everyone know upfront that we will be discussing suicidal ideations in physicians, as well as trauma healing for physicians and health care professionals. We have Dr. Katie Cole who shares with Jill Farmer what inspired her to pursue a healthcare career. Her father was in the medical field and struggled with depression and mental illness, which then led her to study and practice psychiatry. She received a PTSD diagnosis due to childhood abuse and also lost her father to suicide, which led her down a path of deeper self-discovery.

Dr. Cole & Jill discuss the stigma and shame around struggling with mental illness as a practitioner and how it impacts your approach to working in the field. Trauma healing is a journey, not a destination, and keeping that in mind helps you foster compassion for yourself and be a better caregiver. Dr. Cole believes that burnout in the medical community needs to be an international conversation and it’s her mission to be a voice and an advocate for physicians and healthcare providers.

Dr. Katie Cole is known as “The Healer’s Healer.” She’s an award-winning holistic psychiatrist, organizational well-being consultant, and change agent. Her passion for physician and medical practitioner well-being is fueled by her own struggles and feeling burned out in her career. This led her to identify unique solutions for burnout and to find her true passion in medicine, which is helping healers to heal themselves. Dr. Cole is board-certified by the American Board of Psychiatry and Neurology and has pursued post-training in functional and integrative medicine, spiritual medicine, transformational coaching, and physician leadership. She is also a Reiki master and energy healer.

What’s Inside:

  • Dr. Cole’s journey and how her personal experience shaped her career.
  • Why trauma healing is a journey, not a destination.
  • How working with a coach and changing your perspective can help against burnout.
  • What’s in store for the future of healthcare and well-being.
  • Information on the Lorna Breen Initiative.

Mentioned In This Episode:

Dr. Katie Cole on LinkedIn
Dr. Katie Cole’s Website
Addressing Health Worker Burnout

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Please enjoy the full transcript below

 

Dr. Cole: I was very fortunate that I had a really good support system and I had a great friend that intervened and said, “Kate, you know, I’m really worried about you. You’re really detached. You’re really numb. You’re not who I met a year ago. Are you suicidal?” And I remember looking at her and saying, “I think I am.” You know, and I wasn’t – and it kind of just happened over time and I wasn’t really paying attention to it. But now, looking back, I understand that a majority of our thoughts every day are subconscious.

Jill: Hello everyone and welcome to DocWorking: The Whole Physician Podcast. I’m one of the co-hosts of the podcast, Jill Farmer, as well as a lead coach at DocWorking, and we’re in for an important conversation today. I’m really glad you’ve joined us for this conversation, but we do want to let you know up front that we will be discussing suicidal ideations in physicians, as well as trauma healing for physicians and health care professionals. So we want to let you know upfront that will be part of what comes out in our conversation today. I feel really lucky to be joined today by Dr. Katie Cole. She’s affectionately called “the Healers Healer.” She’s an award-winning holistic psychiatrist, organizational well-being consultant and change agent. Her passion for physician and health care organizational well-being is fueled by her own struggles and feeling burned out in her career. And this led her to identify unique solutions for burnout and to find her true passion in medicine, helping healers to heal themselves and the health care systems that foster burnout. She’s recently launched her own podcast, Hope for Health Care, which I hope you check out, a solutions focused podcast highlighting key health care leaders and stakeholders on data driven initiatives to resolve burnout, enhance organizational beings and professional fulfillment. Dr. Cole is board certified by the American Board of Psychiatry and Neurology and has pursued additional post-graduate training in functional and integrative medicine, spiritual medicine, transformational coaching and physician leadership. And she also has her master’s in Reiki Energy Healing. Katie, thank you so much for being with us for this conversation today. 

Dr. Cole: I’m honored to be here, Jill. Thank you for having me guest on your podcast. 

Jill: So, let’s start at the beginning. We’ve already touched in your bio people understand that burnout is something that you’re passionate about. But let’s go back to the beginning for you. Why did you have the dream of being a doctor? Why did you want to pursue a career in health care in the beginning? 

Dr. Cole: Well, yeah, you know, it’s really interesting, Jill. I knew I wanted to be a doctor at the age of four. And I think, you know, my dad was an oral surgeon and I had family in health care. And so, I think I really enjoyed the profession and heard my dad telling stories and coming home. And so, I really knew that that was my journey. However, my father did, you know, suffer from depression and some mental illness. And so, I think that’s sort of what catapulted me into deciding to go into psychiatry, because I wanted to learn more about mental health and how to help my own family. 

Jill: And so, you did that, right? You did the really hard thing. You were able to get your medical education, launch a career in a practice in psychiatry, and then walk us through what unfolded for you as you were in those early years of practicing medicine, what you were learning about yourself. 

Dr. Cole: Yeah. So interestingly, you know, in medical school and in residency, we don’t really learn much about leadership training. We don’t really learn a lot about like who we are as a person. We don’t learn about our leadership style. And so, it was really – I felt like I was just taking things one step at a time. And I became chief resident and I had some mentors, but I was making a lot of mistakes in my leadership and how I was leading and, you know, a tough resident. And I don’t think I was as compassionate as I could have been looking back. I also was dealing with, when I was in psychiatry residency, we talked about how I had some flashbacks of past childhood abuse. And so, I ended up getting myself into therapy and I had to actually come to terms to the fact that I had PTSD as a psychiatric physician. And it was a really hard diagnosis for me to understand because I’ve always been such a resilient person and able to bounce back. But I started to see how my own PTSD was showing up with my patients, and one of my mentors said, “Kate, you know, you can only take your patients as far as you’ve come and you clearly have some childhood blocks. And that is why you’re struggling with your patients in therapy when they have childhood trauma. So, we need you to work on that for your own good and for your own teaching.” So, you know, I was open minded. I got myself back into therapy. And then it was just like a culmination of life events that happened in the span of a couple of years. I moved to a new city and didn’t know anyone. I ended a long-term relationship that had been with my partner through med school and residency. Then I ended up – there were so many things that happened. I already lost my mom to breast cancer right before I started med school. And so, all of that grief work was coming back and I was working on that because now I had the time to do that. And then I ended up losing my own father to suicide. And I think that just put me over the edge, to be honest. So, it was a really kind of painful time for me, and I was very fortunate that I had a really good support system and I had a great friend that intervened and said, “Kate, you know, I’m really worried about you. You’re really detached. You’re really numb. You’re not who I met a year ago. Are you suicidal?” And I remember looking at her and saying, “I think I am.” You know, and I wasn’t – and it kind of just happened over time and I wasn’t really paying attention to it. But now, looking back, I understand that a majority of our thoughts every day are subconscious. So, we have 10,000 thoughts a day, and we know that about 1000 of the thoughts we’re aware of. There’s 9000 thoughts circulating throughout us throughout the day that we’re really not aware of. And I think I had a deep seeded depression, and I was still trying to heal my trauma. And my body was trying to tell me that I needed help. And I wasn’t really listening. 

Jill: So, yeah, and that’s so powerful. And I just want to say upfront, I really appreciate your candor and I know so many of our physician listeners will as well, because that’s one of the great changes that I think people are telling us, who come from the fields of psychiatry and trauma healing, that sweeping this under the rug and just pretending that traumatizing events didn’t happen and not seeking the help that we need in partnership with professionals through therapy and other modalities doesn’t make it go away. Right? It just makes it manifest in maladaptive ways that we end up suffering. And in your case, you could see that it was really not allowing you to be the practitioner that you wanted to be. I’m curious. You were in, right, a discipline in a specialty that obviously is all about mental health and being healthy. In other disciplines, I see physicians much more afraid of really looking at their own backgrounds, helping to heal their own trauma, taking care of themselves from a mental health perspective. Do you observe that as well? 

Dr. Cole: Oh, yeah, completely. And you know, it was even…so I’m lucky because I was in a psychiatry residency that was very dynamically oriented, which means we were more holistic in our approach to patient care and we minimized medication use and we were more about learning about therapy and other trauma healing techniques. So, my…the culture around me at the time was, you know, most residents were encouraged to have a therapist to talk to. And so, in that way, I was supported. However, you know, as a new attending on faculty, I felt very afraid to let anybody know I was in therapy and I hid it from even my boss because I was – had shame around having PTSD and not recognizing it sooner. I felt like a failure as a psychiatrist, like how did I not see this with myself? And so, I hid it from everyone and I hid my depression. And that’s part of the reason why I moved to a new city to start over. So, it still impacted me. 

Jill: And so, once you were able to identify the challenges and to work with qualified therapists and used these different modalities to help you move through that, how did it change the way you were able to practice medicine and to help the patients who needed your particular brand of healing? 

Dr. Cole: Yeah, that’s a great question, Jill. I think it was a combination of things. And you know, in the beginning, you know, I approached trauma healing as a destination, not a journey. And so, I, you know, how we get dispositions were really intense and I approached it as a full-time job. I said, “Okay, I’m going to give myself like a year or two years to get this, like, trauma stuff done and then I’ll be good, right?” So, I dove into it and I had a therapy coach, I had a spiritual medicine teacher, I was learning meditation, I was training with Deepak Chopra, getting trained in integrative medicine. And I really kind of overdid it, Jill. And I kind of burned myself out, to be honest. And so, it took me several years of going down that path to really realize that trauma healing is a journey, it’s not a destination, and to have grace and compassion with myself. And when I was able to do that, I think my impact as a physician changed because I was able to say to my patients instead of, you know, referring them to five different people when they came in to do diagnosis of PTSD, I would say, you know, “Let’s do one thing at a time and let’s not overdo it because this is going to be a journey for you, just like it’s been for me.” And I think that was a big takeaway that I learned, and this is a very real podcast discussion today. And so, the reality is, is that all of this trauma happened to me decades ago and even 12 years ago. However, I’m still working on my own trauma healing journey. It’s not over in a couple of years. And I think if you have that approach, you’re going to be more patient with yourself and have maybe less depression or less self-criticism. 

Jill: And just to reflect back to your own words, too, it’s helped you be a more patient and, you know, one might presume, better caregiver for your patients because you understand the process and you understand that thinking it’s a destination may actually be an obstacle or an impediment to them getting to be able to experience some peace and freedom that comes as you move through the healing process as well. So that’s really powerful. So from this and your lived experience, not only did you want to take it into the way that you help your patients and serve as a psychiatrist, you also wanted to have a much larger conversation, like a huge conversation, a national, international conversation around burnout and what this is, the way that we pressurize physicians in health care settings, in medical education, in the secrecy around things like the need for mental health and mental health healing, all of those factors and many, many, many more are conspiring to create such a crisis as it relates to burnout and qualified health care professionals and physicians leaving the practice in droves. So, talk a little bit, pivot a little bit, if you will, about how your experience informed your desire and mission around burnout and the conversation around burnout. 

Dr. Cole: I would say, first of all, I almost left healthcare multiple times. So of course, in you know, when I had -I lost my father to suicide, it was devastating. And I was like, I don’t know if I can continue to do this. Like, this is – it’s too hard to be in health care or take care of patients. Health care is not a nurturing and supportive environment for me, and it’s very triggering. And so, I almost left health care. But then I decided to pivot my career in integrative medicine and thought, “Well, this will be a more of a nurturing environment, right?” I was kind of on the right track, but it was still healthcare, right? So, and then again, you know, a couple of years ago, I almost decided to leave health care again and I hired a coach. So, I recommend any physician, any health care practitioner listening to this podcast, it’s all about changing your perspective. And we know that, and I’m sorry, I’m going around in a circle here, but 80% of burnout is related to really system drivers and the way that hospitals are set up, our culture of medicine and things like that. Less than 20% of burnout is actually related to the individual physician. So, you know, if you can somehow manage to change your perspective, you can really impact that 20% of the individual drivers of burnout. And that will really make a difference and be a buffer while we’re waiting for our health care system to change. So, I really do believe in that. And I hired a coach. I have two coaches; I have a therapy coach and an executive physician leadership coach. And they really helped me understand that there is a place in the calling for me staying in health care, and that is to be a voice and an advocate for physicians and other health care providers. And so, I decided to stay in health care so I can continue to try to advocate and make a difference. 

Jill: Wow. That’s really powerful. And, you know, I’m a big fan of coaching, right? I’ve been… 

Dr. Cole: Absolutely. 

Jill: I’ve been doing it for the last 12 years. I’m working with so many physicians. It’s such a privilege and an honor to do that. And then also getting coaching through all of that as well. I mean, I think we all need it. We all need that trusted thinking partner to help us, to give us that perspective shift, to help us reframe situations, not to pretend that reality isn’t happening, not to pretend that the health care system is just fine and it’s all about us. You know, we still need to be advocating and part of conversations for change and navigating courageous conversations around saying, you know, the system just can’t stay the way the system is. It’s unchangeable. But I really do think it can be such a helpful part of the journey of a health care professional to get that support. 

Dr. Cole: Yes. And Jill, you bring up a really good point, that as a physician, if you hire a coach, you’re not admitting that it’s your fault. You know, what you’re really doing is you’re saying I’m ready for a different perspective. How I’m thinking right now is creating my current situation. And so, what if there’s a different way to look at things? You know, what if there’s a side gig or another passion that I can be working on, on the side, that’s going to fuel my passion for medicine again and bring joy back into health care. And so, I really like your point about that. 

Jill: And so, from all of this and part of your inspiration and your pivot to wanting to help be part of the change and to support other physicians doing good work and practicing good medicine and support their patients, you started a podcast and so tell me a little bit about what your intention is for having these public conversations around the subject of burnout in the podcast that you launched, Hope for Health Care. 

Dr. Cole: Yes, Jill, thank you for asking me about that. You know, it really started in January. I went to the first national symposium in San Francisco and Paul DeChant and I had been talking and he invited me to come and listen. And I was really overwhelmed with joy and optimism because I had no idea, Jill, how many solutions are out there for our health care system and for burn out. I had no idea. And as I started talking to my colleagues and friends, they didn’t really know either. And then I was having all these amazing networking meetings, meetings with Paul DeChant and meeting with Tina Shaw the recent advisory surgeon general. And I thought, you know, these conversations are so empowering. I really want everyone else to have access to these and to really know what’s going on behind the scenes in real time and what we’re doing right now for solutions. So that was the whole point of my podcast. 

Jill: So, when you get to be part of these conversations on the podcast or in the – earlier in 2022 that you mentioned in San Francisco, the Burnout Symposium in New York City, where you and I had a chance to connect with each other as well. What’s standing out to you from your perspective as good news on the burnout front? What do you think is happening that you want to be part of that trumpeting that it isn’t all bad news here. There is good news on the horizon as well. 

Dr. Cole: Yeah, well, I just want to remind everyone listening today that we do have a very dysfunctional culture of medicine and health care system. I want to acknowledge that. It was built in the 1800s. It hasn’t pivoted very much since. So, we know that. But we also have a lot of great things working for us in health care. And so, it’s a matter of identifying what’s not working and then tweaking that and bridging that as we create a new foundation for our health care system. So, the good news is, is that, first of all, the surgeon general, Dr. Vivek Murthy, is an advocate and very passionate about health care, workforce well-being. And he wants to see our national health care system change, our culture of medicine change. And he published the Surgeon General’s National Advisory Report, I think it was back in March. It’s about an 80-page document, and I can provide those links for you guys today. And so, he really was outlining a path for the movement and for change. And he also collaborated with the National Academy of Medicine on their Well-Being Committee, and they are actually publishing a report coming out in the next couple of weeks, which will be more of a specific framework in terms of the different avenues in health care to address. So, for advocacy in policy, we’ve got Corey Feist on the forefront, you know, fighting for credentialing changes and trying to break down barriers for mental health access for physicians. And he’s with the Learned Brain Heroes Foundation. There are several different groups on the advocacy front. I know Dr. Tina Shaw is also an important key stakeholder with advocacy. And then I think, you know, there are a lot of solutions in place stemming from professional fulfillment with the Stanford Model of Well-being with Dr. Tait Shanafelt. There’s human factor ergonomics that’s also a wonderful framework and I know Dr. Michael Privitera spoke at the conference in June. So, it’s really great to see so many different groups coming together to try to solve our crisis. 

Jill: Yeah, I would agree with that 100%. We have public conversation, right? We’re shining the light where things are being sort of slipped under the rug in many cases, which I think is in both trauma healing and in systemic change. That is sort of step number one, which I agree is such a healthy part of the process. And then really bright minds are coming together and less siloing and I think starting to say, “Okay, what are some of the things that we need to change?” And including the nation’s top doctor speaking loudly and clearly about the important change. As you said, Dr. Murthy’s being outspoken about the need for a cultural change is powerful. So, yeah, I love all that stuff. So, one of the things I want to circle back around to, Katie, is you mentioned it a few minutes ago, is the Lorna Breen Initiative. Can you – I know some of our physician listeners and healthcare professionals may know a little about that, but I’m sure many don’t as well. Can you talk a little bit about what that is and why it matters? 

Dr. Cole: Sure, Jill. Absolutely. So, Corey Feist lost his sister-in-law to suicide and she was an E.R. physician and practicing on the frontline in New York during the pandemic. And she was a leader in the department as well. And she was becoming overwhelmed with grief and losing so many patients and having lack of resources and at the same time developing depression. She also got COVID and had some brain fog with all of that, too, and her family was trying to get her to see a therapist. However, she was worried about losing her license as a physician because for any doc, you know, for credentialing purposes, for insurances, for hospital credentialing and for state board licensing, you have to check if you’ve had any kind of mental health coaching or counseling. And so, she was not wanting to get any treatment because of that. And she was feeling like there was no solution for her and no respite. And she ended up taking her own life. And that happened a couple of years ago. And out of that, Corey and his wife are attorneys. They started the Lorna Breen Heroes Foundation. And the purpose of that was to bring awareness to physician suicide and also to work on changing our credentialing nationwide. So, she was able to pass the Lorna Breen Heroes Act; it is now a law. And he partnered with Tim Kaine and several other important figures in government to get this law passed. So, we’re all very excited. And what it does is it’s brought over $103 million in funding for organizations that are dedicated to investing programs into organizational well-being for health care. 

Jill: Now, it’s really powerful. And people like you I mean, I really have to give you so much credit because it’s the candor and your willingness to be open about the very human situation that many, many, many millions of humans have been through in one variation or another of trauma, PTSD, the challenges of healing from that, depression, being more open and honest about that, is better for everybody in all of our society. But particularly the light needs to be shined there for health care professionals. So, thank you so much, Kate, for being part of this conversation, for inspiring all of us to be more open and candid about what’s happening, and then for creating the forum on your podcast to have deeper conversations about things like the Lorna Breen Initiative and other things that are happening where we’re saying something needs to change as well. I really appreciate you taking the time to be with us here today. This was a rich and meaningful conversation for me. 

Dr. Cole: I agree, Jill, and thank you for giving me the opportunity to just have a really authentic and deep conversation around some of these topics. It’s not every often I get a chance to really do this. So, I really appreciate your willingness to host me today. 

Jill: So, if people want to learn more about what you do in the world, what’s the best way for them to connect with you? 

Dr. Cole: They can connect to me on LinkedIn, Dr. Katie Cole. You can access it or find anything you need on my website and that’s www.drkatiecole.com, and I can give you that link as well. So, it’s an easy way to reach me and to follow the podcast as well. 

Jill: Great. Make sure you guys check out the show notes for this podcast. There’s a lot of rich information for you guys to be able to access some resources and information. And again, thank you so much for being here, Dr. Katie Cole, psychiatrist and advocate for physician wellness and supporting physicians to be able to thrive in their life and work, as well as supporting your patients in the way you do and your practice in California. So, thank you again from the bottom of my heart for being here. 

Dr. Cole: Thank you, Jill. It’s been a fabulous discussion. 

Jill: And thanks to all of you for joining in on this conversation. We hope you share this conversation far and wide with your colleagues and people you know, because I think it’s an important one that we have out there in in the public. And then hopefully it inspires you to take action to support your work as a physician, health care worker and healer. Until next time, I’m Jill Farmer on DocWorking: The Whole Physician Podcast. 

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