Today we rewind back to one of our most popular episodes on DocWorking: The Whole Physician Podcast.
“Your life becomes fused to what we do and it’s very hard, especially for physicians or healthcare workers, to say, ‘Well, you know, I’ve done this all my life and maybe that’s not what I need to do now.’” -Simon Maltais MD Ph.D.
In this episode, Dr. Jen Barna has a very honest conversation about burnout and recovery with Cardiac Surgeon and author of the book, Healthcare Anonymous: Put Yourself First to Avoid Anxiety, Addiction, and Burnout, Dr. Simon Maltais. You would be hard pressed to find someone more driven or accomplished in his field than Dr. Maltais. At the top of his game and publishing a new article nearly every two weeks, Dr. Maltais realized that he was experiencing burnout. Dr. Maltais shares his story of taking a step back, considering leaving medicine, changing his definition of success, and ultimately creating a hybrid way to continue the work that he loves while making more time for himself and his family. Tune in to hear an honest and candid story of burnout and recovery and hear what Dr. Maltais believes is the future of medicine.
For more information about Healthcare Anonymous: Put Yourself First to Avoid Anxiety, Addiction, and Burnout and offerings, please go to here.
Dr. Simon Maltais is an active cardiac surgeon in the United States. He is French Canadian and board-certified in Canada in cardiac surgery. He is an internationally recognized leader in the field of heart transplantation, mechanical heart devices, and alternative cardiac interventions. Before 40, Maltais had led two world-renowned programs in his specialty and has pioneered numerous novel approaches for advanced cardiac surgery interventions. At the age of 35, he was among the youngest promoted associate professors at a nationally recognized institution. He is a frequent keynote speaker, has published more than 160 articles and has contributed to numerous books. As he worked in two different countries and health systems, Maltais has a unique perspective on the delivery of care and its inherent challenges for healthcare workers.
Dr. Simon Maltais earned his Medical Degree from Sherbrooke University, his Master’s Degree in Physiology from Sherbrooke University, completed his Adult Cardiac Surgery Residency at Montreal Heart Institute, Montreal University. He completed two fellowships, one at Buffalo University and the second, a fellowship in Heart Transplant and Mechanical Support at Mayo Clinic School of Medicine. He obtained his Doctoral Degree in Biomedical Sciences (Ph.D.) at Montreal Heart Institute, Montreal University. He currently works at HCA Healthcare in California.
Find full transcripts of DocWorking: The Whole Physician Podcast episodes on the DocWorking Blog – https://docworking.com/blog/
DocWorking Coaches Directory – https://docworking.com/physician-coach-directory/
If you like our podcast please give us a 5 star review wherever you listen to your podcasts. We would be extremely grateful!
We’re everywhere you like to get your podcasts! Apple iTunes, Spotify, iHeartRadio, Google, Pandora, Stitcher, PlayerFM, ListenNotes, Amazon, YouTube, and Podbean.
Some links in our blogs and show notes are affiliate links, and purchases made via those links may result in payments to DocWorking. These help toward our production costs. Thank you for supporting DocWorking: The Whole Physician Podcast!
Below is a transcript for this episode.
Announcer: Welcome to Doc working the whole physician podcast, helping physicians achieve the best in life and medicine. We hope you enjoy today’s episode.
Dr. Simon Maltais: Your life becomes fused to what we do and it’s very hard, especially for physicians or healthcare workers, to say, well, you know, I’ve done us all my life and maybe that’s not what I need to do now.
Dr. Jen Barna: Welcome to Doc working the whole Physician podcast. I’m Doctor Jen Varna and I’m here today with Doctor Simon Malte. I’m very excited to have you as a guest today on the podcast, Doctor Malte, because as a world renowned cardiac surgeon originally from Canada, but also you’ve worked at the Mayo Clinic as a vice chair and you’ve published over 160 articles. So extremely well known and well published in your field, you have made a transition over into advocating for healthcare workers for their mental and physical health and to advocate for prevention of healthcare worker depression, burnout and anxiety. Welcome to Doc working the whole physician podcast.
Dr. Simon Maltais: Thank you so much. I appreciate the invitation.
Dr. Jen Barna: I’m so excited to have this conversation with you because of the important work that you’re doing now and to hear about what caused you to make this pivot.
Dr. Simon Maltais: Absolutely. Well, it’s certainly been an interesting two years, so to speak, you know, for the reasons that we know about. And I was at the point in my career where, you know, I went through professional and personal challenges myself. And it started to be a journal for me, you know, and I started to get up in the morning or write at night, you know, what was wrong, what went well. And as I started to get better, I started to make things better. I started to speak up about it. And that means connected with my colleagues, friends. And I was realizing that a lot of people were going through the same things. And so it became sort of a slow calling where it became pretty clear to me that I need to write and write about mental illness and healthcare workers. And then I went on and it was completely what I usually do, but did a coaching, health and life coaching training. And then through all this, I started to write the book every morning. And it came together over the last, let’s say 18 months.
Dr. Jen Barna: So your upcoming book, Healthcare Anonymous, learn how to put yourself first while pursuing a calling, is coming out this spring, is that correct?
Dr. Simon Maltais: That’s right. So it’s now available in preorder on all the usual suspects and it will be available April 5 is when it’s coming out.
Dr. Jen Barna: Fantastic. So would you mind telling us a little bit about your personal journey? You mentioned that you went through some difficult times. And I know as a physician, sometimes it’s difficult to talk about that.
Dr. Simon Maltais: Yeah, I’m absolutely willing to do that. And it’s part of the process. Right. The book is going through some of that as well. I was reading recently the book from Matthew McConaughey, but I had a lot of green lights in my life. You know, I went through school pretty easy. Med school was easy. Went to the hardest possible specialty I could get in, was very successful at it. Graduated very quickly to be an associate professor before 40, vice chair of departments and world leading institutions. But then slowly, you know, things were chipped away. Whether it was personal or professionally. I had less and less time for myself, for my family, for my son. I thought I could keep it all together as we all think. And then gradually, you know, it started to affect my professional career, my decisions, my ability to work. Of course, you know, being 50, 60 pounds heavier makes it harder to go through your days every day and started to have a bit less of empathy for people I care for. These are sort of early sign of burnout, and all of a sudden really had this moment where something needed to change and change sort of quickly. I wouldn’t say overnight because that’s sort of cliche, but I decided to make a transition and let go and start saying no and then leaving a lot of my responsibilities and things I had to do, not clinically, but professionally. I used to travel 50,000 air miles a year for meetings, for presentations, for publications. I always had something to do. And then I was president of the International Society of Heart Lung Transplant. Just decided to stop. And it was hard, you know, to realize that the profession that had brought you so much and that is bringing you so much still is slowly destroying you in some ways. And then to me, for others, it will be different. And we talk about this in the book, for me, was realizing, and that’s what we go and describe in the book, that I’ve had developed healthcare disease. And that’s sort of a weird thing to say because in some ways, the system that heals you is making in some ways also people that work into it sick. And for me, it was to realize that the mechanism I have developed, the models I’ve had over the years, my personality traits, the things I acquired over the last 15 years were slowly impacting all aspects of my life. You know, from one day to the other, I started to peel off. I took almost six months off in Thailand by myself, sold everything after changing profession and then start over. And the book is sort of this story about the last sort of three to five years. But mostly, you know, what I went through personally and putting it all together and, like, what I see as maybe a process that a lot of us, and I’m talking about physicians, but healthcare workers and healthcare workforce, go through at some point in our career. And I was also very tired to see other people going through things and not knowing where to go, whether it’s burnout, whether it’s even clinical manifestation of stress and anxiety. I’ve had colleagues that unfortunately passed away from that, I think so, yeah. And so it became a necessity for me to just act upon it. And in the book, it’s fairly easy, sort of described as a disease, where I see the event, whether it’s burnout or anxiety or depression or any other of those sort of addiction development, alcoholism are the end result of something more chronic. And that we acquire. It’s hard for us to rewire brain to sort of see things differently, and we feel like we need to continue. And then in the middle of the book, we have almost 20 healthcare workers that have been nice enough to share their story. We separate them in four different classes. And then towards the last part of the book, we give steps for potential recovery. And what helped me throughout the process.
Dr. Jen Barna: So how long would you say the process was that you were feeling the symptoms of burnout, which you describe before you actually sort of woke up and realized, this is something I have to address. How long would you say that process was, in retrospect, right?
Dr. Simon Maltais: Retrospectively, it was probably a longer process than I actually think it is, but it hadn’t been going quite right for, I’d say a couple years. I was still, you know, for lack of better term, at the top of my game, meaning I was doing, you know, 400 surgeries a year. I was on every single committee. I was publishing a paper every two weeks. Had a lot of accolades. But then there are other places in my life where sometimes I made a wrong decision personally. Sometimes I would make decisions regardless of my family. That wasn’t perfect. Retrospectively wasn’t the right one. And then sometimes with patients, too, I would have devastating consequences of surgery. Sometimes you have complications and things, and it used to really be a moment for me to introspect, to write down what happened, to look at the steps and try to make it better. But it became a bit this job that always part of it. A patient was sick. And so looking back, I think the symptoms of a problem were there before. And it’s hard to explain how it sort of came together, but I would say that it’s like I was looking at myself from the outside in, and at some point I realized that I was the one in the highway sort of driving the wrong way. Right. And then for people like me, because in some ways, what I do is heart surgery, it takes a fair amount of confidence and ego. I mean, it’s not a secret. Heart surgeons are egos that are sort of hard to deal with usually, but mine was pretty big. And the parts that have helped me get to where I am, the ego is sort of a cash 22 thing, where the parts that help you oftentimes will have an impact on other things in a non so positive way. You know, the competition, the self criticism. So those things gradually sort of took a lot of place when I said, well, if all these things are happening and they got me wrong, they’re happening to other people. But, you know, the common denominator is me, you know, and that was sort of the realization at some point that I needed to refocus. I needed to look at the values. I needed to take a pause to reassess what I was doing and how I was doing it.
Dr. Jen Barna: I want to take a moment, as you pointed out, to thank our families, by the way, who do make huge sacrifices that often go unrecognized, you know, as we try to be everything we can be at work, we do often take a back burner. All of this, especially with someone who’s so incredibly driven. And I can’t imagine how you managed to accomplish as much as you have. But I’m wondering whether this process has had you redefine the meaning of success in any way.
Dr. Simon Maltais: Yeah, and that’s a very good comment and question. I think the success part is not only redefined through that because you were talking about family, and I think thats critical. And when you face those challenges, the system is pretty good about pointing it out. When youre sort of at the point of burnout or theres a problem with a patient or youre addicted to something, theres a system in place in the system to help you. Now, its just a moment in time where a lot of it is to check boxes from an HR perspective and make it better. If you really want to truly make a change, there’s got to be a question. You need to ask yourself whether you’re in the right field and you’re in the right space and whether this lifestyle is appropriate for you. And you’re right. When you do all these things, your life becomes fused to what we do. And it’s very hard especially for physicians or healthcare workers to say, well, you know, I’ve done us all my life and maybe that’s not what I need to do now. And that part is hard, not only just conceptually to say I’m going to do something different, but also personally. Right? You studied all these years. Your mom will be disappointed, your friends will look at you, you have this second degree gratification from society about work, about things. He’s a doctor. Why do we want to do something different? And so for me, redefining success was important, what it meant for me. And that changes over time, right? And realizing that maybe now the success is, you know, having a good day with my son, going to Universal studio with him, and then tomorrow will be the maybe feel better about my health and overall maybe treating a complicated patient and so not always defining success with the amount of cases you do, the amount of papers you published and then realizing that that’s okay. Now looking back, you know, I loved what I do and I still do and I still publish. Not as much, but I still do. But I do it differently. I do it because I invest in it. I just don’t do it to put my name on something or haven’t, you know, pubmed my name and have the most papers out of, you know, people that were in my medical school, you know, promotion. So doing it from more of a better sort of insight than before. But yeah, success is an important one and it’s a changing concept for a lot of us. And I feel like realizing that is the first step to perhaps making it better. And for some people it will be to leave it completely.
Dr. Jen Barna: So that’s a good point as well. I think a lot of us tend to think in black and white. So it’s like you’re either all in and publishing in your case to the greatest extent that you possibly can personally in your case, which is at a phenomenal level and you’re doing an incredible number of surgeries. And so when you stepped back and made these changes and took some time off, when you came back, did you find a place in between completely leaving medicine and working all the time or did you leave medicine altogether? How did you find the right balance?
Dr. Simon Maltais: Right. When I took a step back, day was filled with time. You know, it was amazing. You know, it went from, I was in between jobs. So I said, I’m going to take a break operating and take an extended period of time before I start a new one. So I had this possibility and I went, as I said, different country in Thailand, you know, for a period of time and you know, let go all the emails and the responsibilities and so suddenly you face with yourself a lot and then we talk of about this in the book. And there’s only really three ways to avoid having a disease in general, right. It’s to change your exposure to it, right? Say I’m leaving and I’m not getting exposed to this bug or this bacteria or this melure. It’s to remove yourself from it, right. To say I’m going to change myself or develop a certain way to immune system or some, you know, therapy to make it better or I’m going to change my interaction with it. It’s the conditions that are in it. And so for me, while initially it was that I went to these meetings in Chicago, I remember physicians that want to move away from medicine and fair enough, there was like 500 people looking to do something different. Im going to open a coffee shop, you know, im going to travel around the world and make it like a humanitarian type situation. I think the best solution for me out of those three was to find a way to interact better with the system. And so answer your question. When I came back, I establish a series of balances that for me were way to, we talk about this in the last portion of the book, virus scan myself and a lot of ways, you know, the books called Healthcare Anonymous. I know there’s a step within the alcoholic anonymous recovery that talks about how to, you know, check yourself and then make sure that when you feel tired, when you feel hungry, when you feel like you have a craving, you know, you have a problem and you’re taking on too much. And so I try to be alert on every day and I take moments during the day that are always the same ones. Usually it’s after my first surgery, I’ll, you know, eat out and they’ll take a moment for me myself. No meeting, no discussion about the next case. Now I’ll try to assess why I’m at in my day. Am I tired? Am I sort of stressed? Am I thinking about something else? And usually that’s a good, if I’m at peace and I’m happy what I did and I feel it’s a good day. Usually it’s because I’m in check. Now if I feel like I’m missing time, I got to call this, I got to do this. I’m running between cases. That’s because I failed the vera scan test, you know, and that means then letting go things, maybe doing more meditation, maybe taking a time off, maybe reducing my caseload and so I’ve learned on a daily basis to try to, and it’s a learning process to try to do that. I try to meditate a little bit. My wife’s trying to get me into that more, but I try to meditate and, and do breath work, which has been helpful. You know, if you also bring people to be around you as a community, and that’s not being, like, a guru type person, but, like, if you inspire this environment around you, it helps you keep yourself in check. Right. So I encourage some of the nurses to speak up. I try to be nice, and being a heart surgeon and being nice is sort of this antagonistic sentence, but I tried to do that and work hard to do that, and that’s helped me to sort of keep myself in check. So I went back. I practice now this as much. I still do sort of high end surgeries, but I do it in a more of a Simon controlled way.
Dr. Jen Barna: That’s an excellent solution. And all really good advice. It actually reminds me when you talk about going to that conference where physicians were all there and someone had to open a coffee shop and someone to leave and travel the world, it reminds me, I don’t know if you ever saw this show years ago called mad about you, but I remember when I was a medical student, I used to watch it. The main characters in the show had a friend who was a cardiologist, and he quit his job and went to work in a coffee shop as a waiter or in a restaurant. Restaurant as a waiter. As a medical student, I remember watching that and thinking, that is so ridiculous. No doctor would ever do that. And now, of course, I can completely understand why someone would want to do that and maybe step away and remove that immense responsibility, you know?
Dr. Simon Maltais: Absolutely. You know, when you get to this point where your identity is challenged, where all you’ve learned is you’re afraid of talking about it because you feel being judged. You know, we had so much conversations with one of my friend who was going through similar process to say, why don’t we just open a coffee shop and then just be our own bosses? But the reality is, if you don’t treat the problem right, you’re going to carry it to whatever you’re going to accomplish. And it’s hard because we talk about character traits in the book, how we develop our character traits, you know, and basically between 15 and 30 years old. And after that, everything’s pretty much fixed. Well, while we’re in medicine or training, that’s where we’re on call. We are at the hospital all the time. We learn how to, you know, react a certain way. We have to having the maturity to do it. And so I wonder sometimes, and I wonder at the moment, whether some part of medicine would have been a better fit for my skills. You know, it would have been recognized before. Maybe heart surgery wasn’t the right choice, you know, for my personality. Maybe I would have done something different that would potentially be more fulfilling, you know, or avoid being in this sort of process at 40, some years old, you know, and that’s part of education. Maybe some education we need to bring early on in training and in the hospital system.
Dr. Jen Barna: Well, another thing that comes to mind, listening to your story that I have to commend you for is the financial ability to step away at the time when you needed to. And that’s something else that I feel really passionate about, is just helping physicians to educate themselves about how they can put themselves in a position to be financially free or to be financially independent so that they can get into a safety zone where if they ever need to walk away for any reason or to step back and work less that they have that option. And I think for a lot of physicians, of course, we have the debt problem in the United States, you know, especially early in our careers, which can make us feel like indentured servants. But I think if people do take the steps to get themselves into a secure position, it’s not necessarily, you know, what you might ultimately be aiming for, but just to aim for a number that gets you into a place of security where you could live frugally if you need to. That, I think, gives a lot of peace of mind. And so even if you don’t walk away at all, but you then have the peace of mind to feel like you’re in control gives you a little bit more, I think, power to come back around to maybe help fix some things in your own world or in the system that might be broken, as opposed to feeling overwhelmed by those things or to be at the table, I guess, with some potential solutions.
Dr. Simon Maltais: Yeah. And I think to be at the table and to surround yourself with like minded people, not that it’s a bad thing to be on, and people that just work, work. And I have friends that are certainly stuck in this sort of mindset still, but I think doing it in what you described is doing it more of a hybrid sort of way, where you sort of start identifying values and things you like to do outside of work and maybe how you can turn this into a business. For me now, it’s become being a book author now perhaps spreading a word out. And then we are also launching our coaching business. So for high performing people. So healthcare clients being a part of that, so we have professional athletes and musicians and business people that are within the same. I mean all the themes are common, right? It’s like the dedication to your work, it’s the family, it’s the values. And so we’re starting sort of a conventional and functional medicine helped program for this group of people. And it’s finding a way to sort of make yourself or changing a bit your identity from being just someone that goes to work from Monday to Friday and on call every four and that’s okay. And I think medicine in general, I was just reading this Harvard Business review on hybrid, you know, with COVID A lot of people have gone home and do this hybrid sort of work now. Now while telemedicine has been forced, I think a lot of on healthcare, I think a lot of places for right or wrong reasons are trying to move away from it now that COVID is getting a little better, I think that’s the future. A lot of enterprises and Google tech companies have realized that. And I think it would also increase the satisfaction and family values if physicians or healthcare workers would have this ability to leverage and be more efficient at work, you know, and leverage some of the technology. And I don’t need to see patients at my office, 83 year old and he’s a percutaneous valve and they have to travel or 3 hours with their family. Honestly, I could see all their tests and talk with them for 45 minutes and see them the day of and it would probably solve a lot of the sort of this back and forth and efficiencies. I can go from having a coffee with my wife and having a consultation, going back, playing with my son and have the same sort of work done. But healthcare is a bit slow to adopt some of that stuff. And I hope that some places will get me proactive to sort of leverage some of that mindset to help people move away from just being at work with a white coat, you know, from Monday to Friday and then every four calls, you know.
Dr. Jen Barna: Thank you so much doctor Simon Malte. Wonderful points of wisdom, terrific advice and I’m excited to read your book. Healthcare anonymous. Learn how to put yourself first while pursuing a calling coming out in April. But you can pre order the book now and we’ll put a link in the show notes.
Dr. Simon Maltais: We have a website where people can go and look at the book and some of the people that have read it before the release, and Doctor Friss, which is one of the leaders of Tennessee, has read the book and is supportive, so we’re pretty thankful to have that kind of support.
Dr. Jen Barna: I can’t wait to check it out and look forward to talking with you again.
Announcer: Thank you for listening to Doc work, the whole physician podcast. If you enjoyed this episode, then please give us a five star review wherever you listen to your podcast. This will really help us reach a larger audience. You can find more resources to help you achieve the best in your life on our website, docworking.com.
