Listen on to how to prevent burnout and promote wellness in medicine with Dr. Janice Brown. She shares the secrets how she moved through her burnout. Come and be encouraged on your own journey today!

During this episode you will learn…
[0:00] Charting Mastery, Intro
[2:33] Dr. Brown’s journey to becoming a physician.
[4:19] How she experienced burnout
[8:25] Burnout is a big problem for physicians.
[12:56] How coaching helped her navigate her burnout.
[17:06] What balance means as a physician these days.
[20:42] The importance of self-compassion in coaching.
[25:15] Dr. Brown’s advice for other physicians who are facing burnout.
[30:42] Find what works for you and don’t be sorry about it

Does charting in medicine seem overwhelming at times? The tens or hundreds of charts that you still have to finish and sign…it’s exhausting right?

Charting Mastery™ is a 6-week- long group coaching program, led by Dr. Ryan Stegink, where physicians like you, will get equipped with the skills and approach to finish charting at work and get home sooner for what matters most to you.

The first cohort launches in early November 2022. You can get on the waitlist and be one of the first to hear when you can become a founding member by going to…

https://www.chartingmastery.net

There will be CME available through reflections on the material, powered by CMEfy. 

To learn more about Dr. Janice Brown and her work, go to https://www.betterhealthandrehab.com

Above are the episode show notes and below is the transcript via www.temi.com. Some episode transcripts have been edited more than others, but they are up in the meantime to help those who would rather read and for searchability on the web. Extensive editing has not been prioritized as I seek to both produce regular content and maintain my own wellness. See the website disclaimer if you have questions, since this is all for your education and entertainment only. Enjoy!

Transcript

Dr. Ryan Stegink 0:00
Does charting in medicine seem overwhelming? The queue of messages, labs, patient calls, that never seems to get smaller, the pile of pre authorizations awaiting your input, the 10s or hundreds of charts that you still have to finish and sign. It’s exhausting, right? And still, all you want is to be able to go home with your work done. To be able to spend time with family, hang out with friends, practice self care. I want to invite you to join me for a six week long coaching program charting mastery, where you will get equipped with the skills and approach that you need to get home sooner and leave that work at work. To check out more info, and to join the waitlist, head over to chartingmastery.net You will be among the first to hear when the doors open so that you can join me on this journey. There will be opportunities to reflect and earn CME after the different sessions as well. And now on to today’s show. Welcome to the MedEdWell podcast, empowering physicians to get work done at work, and then be able to reflect and choose what is important for both their life and medical practice. I’m your host, Dr. Ryan Stegink, general pediatrician and life coach for physicians. Hello, everyone, and welcome to another episode of the MedEdWell podcast where physicians come to be encouraged and equipped to take the next step in their own wellness journey. Thank you so much for subscribing, and sharing these episodes and for engaging with these concepts. Today, I am joined by Dr. Janice Brown. Dr. Brown knew from an early age that she wanted to be a doctor. But her path to medical school was the road less traveled from an undergraduate degree in Spanish to massage therapy, research, medical school, physical medicine and rehabilitation, acupuncture, and now life coaching. Dr. Brown brings a wealth of experience as she promotes health for her patients, her clients and herself. Dr. Brown, welcome to the show.

Dr. Brown 2:33
Thank you doctor Stegink. ,

Ryan Stegink 2:53
So welcome. Thanks for being here. So tell us a little bit more about yourself and your journey to medicine.

Dr. Brown 2:59
So, you know, for me, I I guess I’m one of those people that knew that I wanted to be a physician. And now, you know, looking back, you know, years later, I think I just was interested more in healing people and making sure that you know that they were living their best life. And I think, personally for me, I think that all physicians are natural healers or people who have the capability or the need to heal others. So but yeah, I kind of knew that since I knew myself, which was kind of around the age of five. That’s what I told myself around five is when I kind of knew I wanted to be a physician.

Ryan Stegink 3:50
From there as a five year old who knew that you wanted to be a physician, how did you end up where you are today?

Dr. Brown 3:57
So like I said, like you said in the intro the journey, at least my path was a little bit less travel, but maybe not so. There’s a lot of people who take time off in between medical school, or at least undergrad and medical school, but for me, because I knew that I wanted to, you know, help people in work, you know, improving their well being and their health. I actually started getting involved in healthcare with there was a program at my hospital in St. Croix, where I’m from, I think it was called candy cane. And basically, what they did was pair high school students for a program within the hospital. And so you went around the hospital and you did various activities, different, you know, just, it wasn’t anything major, like maybe bring in a patient guiding them from, you know, one department to the other. But it was Candy Stripes was the name of the program. I’m not sure if that was something that was, you know, national. But I actually started doing that in I think I recall it being an eighth grade actually. And so anything that I could do for the pertain to health care, I kind of just gradually graduated to doing, it was just, it was just something that I did. So when I started medical school was actually six years after I finished my undergrad. And in that six year period, I actually became I got licensed massage therapist in the state of New York. And I was able to practice in a chiropractor’s office where there was actually an acupuncturist, a physical therapist, as well as actually a team on our doc, who was doing the nerve conduction studies. And you know, I just I got experience from that I did research, I went to Uganda, and did research in Uganda studying Kaposi sarcoma, and pretty much I’ve just always gravitated to doing something in medicine. My first job out of undergrad was actually as a research assistant over at former like, they called it at that time, Columbia University. So I was on the campus and do research on children’s vaccines, actually. So for a while, I thought I was going to be a pediatrician. And so yeah, it just, I think I’ve always just graduated, or at least, was drawn towards doing anything in the medical field. I tried teaching for a while, because my mom and my, my sister are teachers, but I don’t think I just, it just didn’t settle with me. I needed to be in a space where I was helping to care for people care for their bodies and help them improve their health.

Ryan Stegink 6:36
Yeah, so it sounds like you took your natural passions and interest and the opportunities that were in front of you. And that really blossomed as you went through high school and then your time doing massage therapy and medical school and to lead you kind of to where you are today.

Dr. Brown 6:57
Yeah, it was fun pathway to.

Ryan Stegink 7:02
Yeah. So you have a really broad perspective on, like, all the areas within the medical field more broadly. How would you kind of survey, like wellness and burnout, and even how you define that for medical professionals today.

Dr. Brown 7:20
So, you know, it’s kind of interesting, I actually experienced burnout, my first burnout was at the age of 16. I remember being in high school. And the reason for my burnout was that I was just doing a lot, my I was volunteering, I was participating in sports, I was in advanced classes, I was just doing a lot I didn’t work in high school, I never, you know, had like a job that paid. But I did a lot of volunteer work. And I think I just remember just feeling almost disconnected with myself and just tired and just like, I can’t do this anymore. I read I remember having that thought, like, I can’t do this anymore. And when I look back, I’m you know, it resonated with me that truly, I had burnout, because I was just doing way too much. And so when we define burnout, burnout, in my opinion comes from doing probably way too much and our energy levels allowed. We may force ourselves and say we could do it, we could do it and get, you know, little to no sleep practically. And the research shows now that, you know, we need to sleep and sleep is important for us to, to be able to regenerate our gut health help with brain health. But it also, in my opinion, stems from when you’re not able to do the things that you want to do. And I think with a lot of physicians, now, the pandemic sort of brought in or ushered in, at least pushed it more the concept of burnout because it was always there. You know, especially when the medical industry was taken over by the health insurance companies. And we were started, I guess, as physicians, you know, we pride ourselves in being able to prescribe different things to help our patients to get them better, whether it’s a medication or a particular, like say physical therapy or some type of what’s the word, I’m looking for some type of therapeutic intervention, as well as diagnostic studies, right? So we’re now being told that we can’t do certain things because we didn’t you know, there’s not a criteria so everything is based upon criteria. But we know that medicine is an art and part of being an art is you, trusting your intuition, combining your intuition with your observation, along with basically the tools that you’ve learned in medical school, on how to evaluate someone. And so when we are no longer allowed to help our patients get them the care they need, it leads to burnout, in my opinion, and it’s a big, it’s a big problem. Now, I think the pandemic like I said, the pandemic ushered in and least brought more to the forefront, because a lot of physicians were forced to take care of patients who were infected with COVID. And they themselves that COVID, many of us died, unfortunately, in those early months when the, you know, the pandemic started, and we didn’t really know what was going on. So, you know, I truly understand burnout. I mean, I went through it again, not just at 16. But when I was in a position where I knew that where I was working at wasn’t a good fit for me, you know, it was working under a supervisor who just wasn’t necessarily supportive of what I wanted to do. And so that in and of itself created burnout for me, because I couldn’t, every time that I confronted him, or at least had to deal with him, I became emotional. I know, one of your questions thumb, you know, talked about, like, you know, how do you manage that, and, you know, mindset and all this stuff, but I was able to overcome and overcome that with with just understanding how I can control my thoughts. I’m the controller, I am the boss, if you want that state of my mind. And so that allowed me to get through that, like his period of burnout, in addition to coaching to so coaching was really key for me.

Ryan Stegink 11:52
Thanks for your vulnerability and sharing. I think burnout is something that’s become more talked about, I think, with like a pandemic, and it was there, certainly, certain elements of it have been made worse. And then there’s also the moral injury part of some of these things, that we know that we helpful for our patients. And for whatever reason, they’re not able to, to happen. And that lack of autonomy, I think, is what really leads to that lack of self efficacy and feeling like, okay, that I can do this well, and it’s like, am I a good doctor? And, and all of that to say, how is this gonna to work and what you said about the mindset and having help from, in some cases, coaching, it can be really helpful, just reminding yourself that, regardless of what the circumstances are, however much they may legitimately need to change. It’s like, you can still choose how you respond to that. Absolutely.

Dr. Brown 12:58
Yeah, that’s so true. I remember, with my last, when I went through my last burnout, you know, they did not renew my contract. And as most physicians can relate to, when you work for a large healthcare organization, they’d have you sign a contract that’s valid for X amount of years, they did not renew that. So essentially, I was fired. So I had the option of either, you know, being sad about it, crying, being upset, or, you know, using it as an opportunity for me to really spread my wings and pursue what I want to pursue. And that’s pretty much what I did. I chose the latter.

Ryan Stegink 13:39
So did you experienced coaching at this point? Was that part of what helped you navigate that? Or was that something you’ve you found after?

Dr. Brown 13:45
It really helped me renew your contract? Yeah, it really helped me navigate that, because when I worked with two different coaches, and they really inspired me and helped me realize that this was not my doing. Because, of course, when you when you hear the news that, hey, your contract is not going to be renewed as a physician, you know, you’re thinking, hey, my position is secure. I’m doing a good job, bringing in revenue, you know, most large healthcare systems use an RB system RBU sorry, RBU system. And, you know, here you are, you know, you’re gaming, you know, you’re looking at your numbers, it’s like, oh, I’m over my allotted RBU that I’m supposed to bring in. So that’s a good thing. You know, you know, patients say they like me, but that doesn’t really count anymore. It’s surveys, that counts. So you could get a bad survey, and that will be sufficient enough to say, hey, you know, you’re a bad doctor, but you’re not. And so, with coaching, it really made me realize that it just wasn’t, it wasn’t me, I was working in a system that this is just how they did things. And that in and of itself was a circumstance. Right? And so that’s a luck that allowed me to really see that, hey, you know what, I, the only thing I have control over is how I manage now, it was a good thing, because I knew that I wasn’t, that wasn’t the place I needed to work at. So it actually worked out.

Ryan Stegink 15:16
So in working through that, and doing that mindset work and using some of those skills you’ve learned from your coaches, where does that lead you to now?

Dr. Brown 15:28
So once I was introduced to the idea of coaching and what it was about, which is essentially teaching you to be more conscious, live consciously, I call it, I make the analogy that a lot of times in life we kind of surface live. So being from the Caribbean, we go snorkeling. And so snorkeling is the at the surface, right? You don’t go down, you know, to really experience what’s below you. You know, you only can see what is in front of you, or down below you. However, when you go scuba diving, that’s when you really see the beauty. And you appreciate it and you see everything, because now you’re looking from the bottom and you’re looking up and you can see everything. So I always think about that analogy, because one I like the beaches, and I love the water, and I’m from the Caribbean. But it really rent lens truth to what life coaching teaches you, it basically teaches you how to scuba dive, in your mind, and then your thoughts. So that way you can go deeper and understand. Okay, why is it? Well, first of all, it teaches you how to stop and think about your thoughts. What are you thinking, okay, and then it allows you to see that your thoughts is truly what is driving the outcomes or results in your life. And so I think it’s I once I, once I discovered that I was like, Okay, this is it. And so, for me, what I’ve turned it into, is applying it to improving the lives of those people who want to have better health. They want to have, they want to feel better, they want to be had the energy to be able to, you know, play with your grandchildren. Do the activities, go hiking, go traveling, you know, as a physical medicine rehab specialist, I see those patients who are pretty much they’ve lost function. No one, I mean, they’ve gone through ortho, they’ve seen you know, the neurosurgeon, they’ve seen practically everybody, and everybody just kind of like, oh, I give up. That’s it. And I’m able to work with them, and provide them some hope, some truth. And if there is the ability to improve their function and get them back, I have the tools to be able to do that.

Ryan Stegink 18:12
So as you think about, yeah, lending that deeper perspective, and how you support, wellness and sustaining and regaining a function for many of your patients, how does that give you different perspective on what balance means as a physician in medicine these days? So that’s

Dr. Brown 18:33
interesting, before I was a big proponent of balance, oh, you know, it’s all about balance, you know, you think about scales, you know, suicides, you know, you want to make it equal. And as I’ve gone along in life, I’ve realized it’s really hard to keep everything in basically they weighted the same. Their days, when, you know, I may need to put more weight with my family. Other days, I may need to put more weight with my job. There are days when I may need to put more weight on me. And so for me, balance just means that you at each moment you’re putting the weight, or that in this term weight means the attention and the effort to where you need it to be in that moment. So for me, that’s what, that’s what balance is. And I don’t fret over the fact that some days I can’t be necessarily the best mom, the best wife, the best position, the best life coach. You know, there are times when I sometimes have to take a backseat and just do the best that I can. It may not always be what people expect. You know, there are times when I have to tell my kids I’m like, you know, Mommy has to, you know, do some work, I have to finish notes, or I have to go to this event or I have to do a meeting, like today, you know, being on a zoom call my daughter, my youngest one, she acts like, Mommy, can you read them? And no, Mommy has to do a podcast. And so you know, it just, it’s it fluctuates. And I don’t no longer beat myself up about it, or get overly upset about it. Because I realized that there’s no way that I can keep everything, you know, with that same week, each time. So, yeah.

Ryan Stegink 20:46
Well, I think those just kind of reflect how some of the priorities. Yeah, it’s not always equal. Never. Just, and just acknowledging that allows you to have self compassion, which I think having the awareness of what your needs are in that situation, and what you’re able to give and bringing your whole self to that situation. I think really, like it really overlaps really well with kind of the principles of coaching and saying, all right, how do we, yeah, what’s, what’s going on? And what’s driving the things that we’re we’re doing, and the thoughts and feelings that go along with that to kind of create the results that we have? Absolutely.

Dr. Brown 21:35
Yeah. I mean, it’s, it’s sometimes it’s not easy. There are times when I do feel guilty. And you know, that’s going to be an emotion. So always going to be possible, and present sometimes, not all the time. But I always remind myself, that, you know, I’m only one person. And it’s okay for me to, you know, put that energy to where I need it for that moment. And there’s going to be people that’s going to be disappointed, you can never please everyone. You know, that’s one of the things I teach as a life coach is be compassionate. Self Compassion is so key self love, the work of Kristin Neff is just She’s done an amazing job of bringing that to the forefront, and putting it in such a way that people understand it.

Ryan Stegink 22:31
And I think that’s really important to hold on to, like for each of us, for me, for those listening for those in training, especially that you’re only one person and to have that self compassion. You even if the system isn’t being supportive?

Dr. Brown 22:52
Well, yeah, that’s true. I mean, our society expects us to, you know, to be perfect, this idea of perfect that I keep telling, I tell my I tell my children, I’m like, listen, there’s no such thing as perfect, because one man’s perfection is another man’s, I guess, imperfection, right? Same concept that you always hear to think one man’s trash is another man’s treasure. So what’s perfect for me may not be perfect for somebody. So it’s all relative. And once you recognize that you like, wait a minute, why am I paying attention to what everybody else is saying? You know, just, and especially, I think as physicians, we we are groomed to compete, we’re grown to compete against each other. Right? You know, medical school, you know, they had the name for the, for those who were at the top of the class of gunners, right, that people are like getting straight A’s, but then you look on the hood. And you see and they were some of them were like, burning the midnight oil, not getting the sleep, not getting the rest that they need sacrificing and, you know, not getting good self care. I think for me, just recognizing that, like, Hey, I don’t really need to compete, and maybe because I took that time off. And I think in that the time off that I took between undergrad and medical school. I just was living a regular life, you know, and kind of doing my own thing. You know, just if I wanted to go to the movies and hang out with my mom and go to a Broadway show, because I was in New York City at the time. You know, I dit it and I think that aspect, the fact that I you know, experience what it was like to live not necessarily in school all the time, like outside of school gave me a different perspective and I can I And definitely relate to most people. I think that’s just one aspect of, or at least one of my experiences in life that allows me to do that.

Ryan Stegink 25:15
It’s really helpful just to think about how do we bring that perspective of what our expectations are, but also how we then care for ourselves and others, because it really does make a big difference, if you can, can relate to like someone who’s still in training someone who walks into your office as a patient, there are different different experiences that we each bring to the bring to the table. And so I appreciate you sharing some of yours. Yeah,

Dr. Brown 25:50
you’re welcome. You mentioned something really key, though, because you said that expectations. That’s another reason I think that a lot of us physicians are facing burnout is because of expectations. When we have expectations that are unrealistic, and we’re expected to meet them, because as a physician, you’re supposed to do everything you’re supposed to do or being perfect right, then and when you don’t meet that expectation that in and of itself can lead to burnout.

Ryan Stegink 26:30
Well, I think there’s some of that are intrinsic, that, that perfectionism that maybe kind of the unspoken expectations that we keep on ourselves. It’s like, okay, I have to do this, I have to know everything, I have to be perfect. Whether it’s answering questions on rounds, as a medical student, or my patients, or now the residents are coming to me with questions, and it’s like, well, I need to, I need to know it. And then there’s also the external expectations of, well, I need to close all my charts in this timeframe. And I need to have this for billing and this for quality. And, yeah, it’s, it’s about managing, what are reasonable expectations? Which ones do I just let go of to say that I, I can’t please everyone, and I’m still a good doctor, even if someone said, okay, they took a little bit too long. And maybe I was giving that other person a little bit extra time because they needed that. And that’s human connection. So yeah.

Dr. Brown 27:37
And maybe that’s what I think draws us as physicians, like you said, you know, that human connection and wanting to help your fellow human.

Ryan Stegink 27:50
Yeah, I think that’s really a huge part of it. And for me, why? Yeah, I went into medicine, it’s like that desire to help people be a part of their healing and health. And as we wrap up, what advice or pearl would you have for other physicians, maybe earlier in their career, as they think about wellness for themselves and how they support their patients and their colleagues.

Dr. Brown 28:20
I always believe that it’s important for you to make sure that you yourself are well, like when I say that, because as physicians, you know, people think that we don’t get sick. I don’t know why people have this, like society has this idea that oh, physicians don’t get sick. So, you know, when when they hear that their physician, you know, has an illness or had to, you know, stop work for a period of time. It’s like, oh, my gosh, it’s catastrophic. But I’m like, we’re humans, too. Right. And so for that reason, my pearl of wisdom, that I will tell anyone who’s going through the medical training, whether they’re in medical school, they’re in residency or they’re an attending is make sure that you take care of yourself. And that doesn’t mean like sitting down and binge watching, you know, tons of your favorite show. What it means is learning how to love yourself. Understanding what self compassion is, learning to talk to yourself nicely. Don’t be harsh to yourself. If you’ve made a mistake, admit it, that you’ve made a mistake because that shows that hey, I am human. It also means taking care of yourself physically, mentally, emotionally, from a physical perspective. I know that you know, exercise, I don’t even call it an exercise. I call it the movement because our bodies are designed to move and If we don’t move, that’s when the seas setting. So I encourage people to, you know, whatever it is that you enjoy get moving, even if it means you put on your favorite music and you just dance on your own without anybody there, get moving. If it means taking a walk, get moving, get a sweat up. Because we know that, you know the ways to remove toxins from the body is you either urinated through feces, sweat, or respiration. Those are the four main ways that you get rid of toxins. So find movement some way in your life. I think unfortunately, in this day and age, everybody’s like pushing, you gotta meditate, you got to do this, you got to do that, right? Just find what works for you. Meditation may not work for you. And it may not work for everybody. And there’s people who they have a deep faith, and they are part of a religious, you know, organization. Prayer, if prayer works for you do it. So you’ve just got to find what works for you. And don’t be like, apologetic about it, just do it, you know, irrespective of what anybody else thinks. So that’s my advice.

Ryan Stegink 31:29
That’s really helpful. And I think people take it to heart, myself included, I think that’ll really help us take that next step and our wellness.

Dr. Brown 31:38
Oh, yeah and that’s what I promote. By work with people and just tell them it’s like, Hey, listen, let’s design a plan. A wellness plan that works for you, that fits your budget, fits your lifestyle fits your time, fits what you want to do, because not you can’t do what everybody else is doing. There’s no way it’s not going to work.

Ryan Stegink 32:05
Thank you so much, Dr. Brown for joining me on the MedEdWell podcast. If someone wants to learn more about you and what you do they want to work with you. How would they find out more.

Dr. Brown 32:15
So my email address is janice@betterhealthandrehab.com. I’m actually in the process of revamping my website, and I hope to have it redone by the end of this month, we just literally started September. So I’m hoping that by the end of September, I will have an up and running, I once had my own practice. And I ended up giving that up and moving towards focusing at least from my from my business, focusing on life coaching, and so that my website is going to be redesigned to focus on the life coaching aspect. And so yeah, they can still go ahead and check out my website, it’s still up there, they can read a little bit about me and what I do on my, you know, day to day basis, in terms of my physical medicine and rehab practice, and my acupuncture and everything else that I do.

Ryan Stegink 33:11
Thanks so much for joining me and sharing such amazing insights and welcome. So for all of you listening, I want you to consider how you can apply what you’ve learned from Dr. Brown in today’s discussion. And then please share this podcast with another doctor in your life. And go ahead and subscribe if you haven’t already. You can help change the culture of medicine and promote wellness for your patients, your colleagues, and yourself. Thank you so much for all that you do, and have a great day. And now for our important disclaimer. Dr. Ryan Stegink is a practicing general pediatrician. But the MedEdWell podcast does not reflect the views, opinions or beliefs of his employer nor his affiliated University. Additionally, the MedEdWell podcast is for educational and entertainment purposes only and should not be considered advice regarding financial, legal student loan, medical or any other specific topic. In such a case, you should seek consultation with a certified professional in that particular area. Again, thanks for joining us on the MedEdWell podcast and have a great day