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#025 -👨🏻‍⚕️ Dr. Jimmy Turner MD


Jimmy Turner MD on the incubator podcast

Dr. Jimmy Turner is a practicing anesthesiologist at Wake Forest. Dr. Turner hosts the physician philosopher podcast and blog where he take an uncurated and unapologetic look into physician life. He also cohosts the podcast Money meets medicine with Ryan Inman where they discuss finance topics that healthcare providers desperately need to know. He is also the author of the book The Physician Philosopher's Guide to Personal Finance. And finally, he is the founder of the alpha coaching experience which helps empower physicians who feel trapped in medicine and helps them practice medicine on their own terms.







 

The transcript of today's episode can be found below 👇



SUMMARY KEYWORDS

physicians, medicine, patients, burnout, work, feel, nurses, doctors, talk, podcast, life, book, day, burned, training, attending, moral injury, icu, listen, situation

SPEAKERS

Jimmy Turner, Daphna, Ben


Ben 00:46

Hello, everybody, welcome back to the podcast Daphna. How's it been going?


Daphna 00:50

I'm good. You know, we have a new puppy. So I think I got more sleep on call the other night than I have.


Ben 00:58

As if life was not already as complicated. You decided to add a variable, the puppy variable to the equation?


Daphna 01:05

I mean, did you really live through a pandemic if you didn't get a puppy during this time?


Ben 01:12

That's right. That's right, making things harder. We're very excited about the guests that we're hosting today. And we're both big fan of his work. So without further ado, I will introduce today Dr. Jimmy Turner. Dr. Turner is a practicing anesthesiologist at Wake Forest. And when he's not taking care of patients like a superhero, he takes on the identity of the physician philosopher, he hosts the physician philosopher podcast and blog, where he takes an uncreated and unapologetic look into physician life. He also co hosts the podcast money meets medicine with Ryan Inman, where they discuss finance topics that healthcare providers desperately need to know. He is also the author of the book, the physician philosophers guide to personal finance, which is available on Amazon, audible Kindle, anywhere you find books. And finally, he is the founder of the Alpha coaching experience, which helps empower physicians who feel trapped in medicine and helps them practice medicine on their own terms. Jimmy, thank you so much for being on with us.


02:14

Thanks for having me here. What an introduction, you really went, went through it all.


Ben 02:19

I think I think I was not familiar with your work until very recently. And I want to give credit, to Daphna for introducing me to the physician philosophers podcast, which then led me to money meets medicine podcast, which led me then to the blog. And so I think I think everything that you do is of high quality. And that's why I wanted to highlight every single thing in the intro. So yeah.


Jimmy Turner 02:41

Well, thanks. Thanks for having me on. I'm super excited to chat with you guys. And to to dive into any and all of it.


Ben 02:47

Sounds good stuff. Now. I'm gonna give you the lead today.


Daphna 02:51

Yeah, well, you're, you're quite humble, but I, you know, I want I think it's useful for our listeners to know that you know, what your credentials are looking like that you really have gained so much expertise in this space, and in really a pretty short amount of time, which is very, very cool. So why don't you kind of just tell our listeners a little bit about at least, you know, maybe they've never even heard the term coaching. So tell us what you do there.


03:21

Yeah. So basically, I help burned out, doctors create a life that they love. And so a lot of us, you know, were promised certain things in medicine, and then got to the end of our road and found out that it wasn't necessarily the dream job, we all expected it to be that things weren't, you know, adding up. And then we have some trouble kind of figuring that out. And so I basically end up, I'd say, I don't know, 90% of the people that come into my coaching program that have coaching experience are in transition, like they are thinking about changing jobs, they're thinking about going part time, they're thinking about leaving medicine or starting a side gig, or they just know that they want something different than what they have, that the fulfillment and the happiness that they were looking for in medicine didn't pan out. And so they're trying to figure out how to how to rekindle that or find that and unfortunately, I'd say the vast majority of you know, falling back in love with medicine, which which I love watching, because they come in thinking that they're gonna figure out how to transition out of this terrible situation. And then they get the skill set to learn how to actually love what they currently have. And so it's a really fun experience. But yeah, I came about that myself because in a complete twist of irony writing about personal finance for burned out doctors for the last four years, I ended up getting burned out myself. And so I really mastered the money side of this first, but then ended up burning out myself and and all of the financial freedom that I had created in my life didn't save me. So money is still a huge part of what I do. And I still love talking about it. I'm a self proclaimed money nerd, but it is. Yeah, it's it's it's been a small part, at least at this point.


Daphna 04:55

Yeah. Well, you know, I think and we have a range of listeners we even Have some parents who listen in and parents of NICU infants. And so they may be, you know, confused about some some of this lingo, we have some trainees who listen, and I think medicine is inherently rewarding, but some of the some of the barriers, you know, dealing with insurance dealing with the logistics, trying to get care for your patients that you, you can't get, you know, spending so much time away from your family and difficult hours, they start to really wear and tear on you over time, some jobs sooner than than others. So, you know, burnout or moral injury is really kind of a hot topic these days. And so what do you think are kind of the top? The top issues that are causing this kind of moral injury in physicians?


05:49

Yeah. So I think it's actually in part, the answers and part of your question, which is the two terms, so burnout and more moral injury. And, and I, it's kind of interesting, it's been a journey, figuring out exactly what my stance is on this. For a long time, I used to kind of worry about offending people. And I'd say, Well, you know, moral injury and the way that I would define moral injury is basically you have the skills, you have the abilities to help somebody save somebody, and the system does not allow you to do it. And so basically, you have to you watch harm happen to somebody else, because of a systemic or systematic problem that prevents you from providing the care that you know, you can provide. So, you know, I was recently intubating patients on a hospital and Community Hospital for that didn't even have the ability to have a true ventilator on it. And the reason why is because I'm in a pandemic, working in a hospital that's overflowing with COVID patients. Yeah. And I know what's right for them. They're on pressors. And drips, they're intubated on ventilators on a floor. And like that is the definition of moral injury. You know, it's like I had four patients on the floor that needed to be in an ICU, and they were like, number 30, or 40. On the list. Yeah. You know, and so, you know, when it comes to burnout, I think that burnout is is separate, I don't think there's actually the same thing. I think burnout is the phenomenon that happens within a physician, oftentimes because of moral injury. And so I have a distinction between them. And I think that that's important, because a lot of the conversation around this recently is has been like, Oh, no moral injury is a better term. Because, you know, burnout, it makes it sound like it's the fault of the physician, it's the physicians fault for being burned out. And we shouldn't be victim blaming, or victim shaming anybody. And, and I used to agree to that. And actually, I get really mad if people like implied that burnout was was, you know, in any way, shape or form, something that the physician had a responsibility to fix. And, and as I've coached, I don't know, hundreds of doctors at this point, like I really, you know, I'm kind of unapologetic at this point about it. The biggest distinction, the biggest difference or transition I see people make is when they stop positioning themselves as a victim and say, You know what, like, this situation is not good. It's not ideal, the system's broken, we all recognize it. But I refuse to be a victim. In this situation, I'm going to be, you know, the hero of my own story and rewrite this thing. And, you know, there are examples of this outside of medicine, right, Nelson Mandela, who was a prisoner, and, you know, despite that didn't act like a prisoner. I mean, he refused to let them own his mind. And, you know, there, there are so many examples of this outside of medicine, but burnout. You know, I think that the biggest problem honestly, with it is two things. One is the victim placement that doctors put themselves in, and in the way that I show people that is to say, like, you know, do you really want this broken medical system that again, we all know, is broken, we all know, has systemic systematic problems that cause moral injury? Do we really want that system to have control over how you feel like you're handing the keys over to that system? And then saying, hey, you know, I just do your worst and and it does, and doctors, you know, get crazy burned out? Or do you want to realize that, like, your external circumstances, can be what they are, but you can choose to, you know, feel differently about them. And these ideas go back as far as you know, 2000 years ago with stoic philosopher. So this isn't like a new idea. It's just been repackaged rebranded into a modern, you know, model that makes a ton of sense. But you know, I think the victim placement honestly, is a huge, huge issue. Because until we have enough empowered physicians, the system's not going to change. We need doctors that are empowered enough to stand up to medicine and say, Hey, we're not going to take this anymore. And that's going to require doctors to say, I'm not the victim, I'm going to be the hero. And I'm going to stand up and we got to talk about how to empower physicians to do that. But I think that a second thing is actually, you know, there's an experiment on on German Shepherds actually, that showed this, this idea of learned helplessness, and I recently had a podcast that came out I think, actually, I think came out today the day we're recording this, but ironically, and so, but you know, it's really this idea that when you get beat down so many times and you try to make changes you try to change your circumstances you try to go part time make suggestions to administrators, you know that that go on heard. Eventually you learn like, oh, there's nothing I can do. I'm just trapped. And that is a terrible place to be In. And so until you kind of unlearn this helplessness that we have in medicine, you really can't fix it. But the cause of all of that, like, that's how we empower physician, the cause the cause of all of that are these systemic systemic, you know, systematic causes of, you know, a broken electronic medical record system, and administrators and insurance companies that run our lives and pre authorizations and all these things that we don't have any control over. And so we feel like we can't do anything. But I think that we can, and I think that when we empower physicians to stand up to a lot of those things, that that's when real change happens.


Daphna 10:31

Yeah, I what I like actually, about the way that you framed that is that it's gonna take all of us, right, physicians, nurses, Artis staff, patients, really advocating for change in the medical system to make a difference in it. And it matters, right, it changes patient outcomes, if we have a system full of burnt out doctors, so under percent, it's a cyclical thing that we all should be working together towards.


11:03

I couldn't agree more.


Ben 11:05

I think this is very interesting. And you've I forgot where I listened to you say that, but you said something, and you say it almost provocatively, saying physicians come first. And you let that sit a little bit? And you expand on that? And I think it is it is it, it goes back to what you're saying? Where you explain that, in order to take excellent care of patients and of others, we need to make sure we can take care of ourselves. I think it was on on your masterclass on burnout that you mentioned the analogy to the airplane where you say they tell you to put on your mask first so that you can help others because if you don't have the oxygen flowing, you'll die and you won't be able to help anybody. And so I guess my question to you is, what does that look like? Practically speaking, when you say the physicians have to bend together with the rest of the providers and the nurses and everybody to change a broken system? I am beyond frustrated with the electronic medical record system, I feel like you said, we're being paid to build patients. And this has nothing to do with medical care or medical delivery. But in your view, in an ideal world, how does that pan out where the revolution happens? And the system is going on track to getting fixed? Yeah, so


12:19

many thoughts. So yeah, I mean, I mean, we all recognize that you can't fill anybody else's cup if your cup runs empty, right. And so you have to take care of yourself. First, you have to put on your oxygen mask first before you can help other people. And and medicine doesn't teach us that medicine teaches us that the patient comes first in the hospital comes first the administrator comes first and the nurses come first. And everybody comes first except for the doctor because we just like society and ourselves. And we just expect ourselves to be good soldiers and just, you know that we're We're fine. We're supposed to be fine. But we all know that doctors aren't fine. And so I think it's it's actually, you know, not helpful to pretend that we are, you know, and so it's it's really, for me, you know, there might one of my favorite guest posts probably my favorite guest post I've ever written on my site when it was just a pure blog was you know, by vagabond, MD who's you know, a non anonymous blogger or not, not even a blogger comment or he's just so prolific that he seems like a blogger. You know, he had this post that the hospital will not love you back. And and I think that when you get to that reality, and you're like, look, I I've done everything, I've given my soul, my time I sweat my tears to this profession. And it just continually doesn't care about me, or that's the way it seems. Eventually you start realizing, oh, like Okay, so the answer is not to try to change system because we've all done that. And it doesn't particularly work. And so for me, the answer is empowering individual physicians that can then band together as a collective to make the system change. And the way that we teach that, you know, to our clients is in a three part system where we help people basically master their mindset work, first, their thought work first. And, you know, it goes back to some of what I talked about before, you know, refusing to place yourself in the position of being a victim or refusing to feel helpless and learn how to not be helpless, and that your thoughts actually lead to all of the feelings, actions and results in how you show up in this world. And when you realize that which has been taught from I mean, I mean, so many different points of view. And you start to realize, oh, wow, that really is true. Like my perspective, my paradigm. And you know, the example I give all the time I give it on that masterclass, you alluded to, you know, is that that story shared by Stephen Covey in the seven habits of highly effective people where he has that story of the man on the subway, right? Who, and I'll give the abridged version but if people are really


Ben 14:30

sorry, no, no, yeah, head. It's so cool. Yeah,


14:33

it's a great story. So like, you know, he's sitting on the train and it's a Sunday morning, it's back in the 80s. The cell phones didn't exist. So people were looking at newspapers instead. You know, they are enjoying a great, you know, day during the weekend. It's quiet. It's in New York is on a subway, that's not common, even back then. And a few stops later, this guy and his kids get on and they start running around. They're knocking papers out of people's hands. They're you know, being rambunctious and loud and it's gone from a very calm mean, you know, serene scene to this very annoying, frustrating experience for everybody. And after about 10 minutes, everyone's looking around, like making eye contact with each other, like, can you believe this guy like, he needs to get control of his kids? And so coffee ends up being sitting next to the guy. He's like, Hey, sir, you know, I don't know if you've noticed, but your kids are being quite loud, they're bothering people, do you mind just seeing if you could talk to him or rein him in a little bit and, and the dad as like, had his eyes down, and you know, his head down, his eyes closed and looks up and finally realizes what's going on. He says, you know, I'm sorry. You know, their mother, we just found out died an hour ago in the hospital. And, you know, I don't really know what to do. And it seems like, my kids don't either. And so everybody was really frustrated, annoyed, mad that these kids are running around ruining a peaceful morning. And then when they realized that their perspective shifted, because they knew the whole story about what was going on. All of a sudden, they had empathy and compassion, right? And so when when you start to realize the your it's not the circumstances, not the kids running around, that's bothering you, it's your thoughts about why that's happening. And you can't control it. And that Hey, Dad, can't you can't you fix this situation for me. And you realize that you can tell yourself a different story, a different perspective, a different paradigm is the word that cover uses, that your feelings very much dramatically change. And so the first part of that system, is that thought work. And And then and only then can you really start to talk about the other stuff, which is what everybody starts with is what I started with, and how I screwed this up in my own journey, which is the financial piece, like the money is the gas that you put in the car to get to where you want to go. And so money is important, but it is a tool. It's a it's a means to an end. It's not an end itself. And and so, most people go there, though, that's why there's, you know, Facebook groups with 80,000 doctors in it on specifically on physician side gigs, like, they're like, doctors work 60 hours a week, on average, like, Do we really have the time to start side gigs? You know, and so, but we do, because we're trying to escape our situation. And you know, once they finally, you know, have those two pieces mastered, then we can start talking about, okay, what does your ideal life look like? How do we get there? And so those are the three pieces that we teach doctors to empower them, and help them realize that they can do all of those things without the medical system having to help them at all. And once you do that, I mean, now you have the ability to say no, which may be the most powerful word and let you know, in English language, no, I'm not doing that. No, I'm not doing the online module. No, I'm not doing the extra. You know, BLS training, when I'm an anesthesiologist and I run codes, and you're like, I'm not doing that. It's not happening.


Ben 17:34

That's right. And that's what I think that's where your paradigm I think is. So it's so powerful, because you define your podcast right as this an apologetic look at what needs to be talked about. And you do talk about money. And I think this is very important, because not many people realize that for most doctors coming into your profession after training, where most of us are shackled with significant amount of debt. I mean, in my my, my personal expenses that my wife and I are about $600,000 in debt since after training, and, and you talk about this feeling of being trapped. And I feel like if you're not in the profession, if you're not a physician, you may say trapped from what you guys are making a good live a good living, you could walk away if you wanted to, but it's not true, right? We have these monthly payments that were attached to, and and we have these non compete clause and these very elaborate contracts. And the idea of feeling trapped is is very real. And we've seen that def nine i when when we transition from one hospital to the next where people really felt like they couldn't leave where they currently were because their situations were already too tight as as it was. And, and I think it's very interesting that you're, you're have the guts and the courage to talk about finance and money. I'm wondering if when you started this this side business, that's a business now where you're coaching and you're you're you're providing advice to people on podcast, did it take a moment for you to say I'm gonna be talking about money? How do you get over that step? Or was it seamless for you because you had become a nerd and you wanted to all about personal finance?


19:13

No, it was actually a really hard journey for me. So I by nature, I'm a people pleaser, and so is extremely hard for me to say no to people. It's always been hard for me. To this day, it remains hard to me. And so you know, that's constant work. And so, when you I mean, you start a business, particularly one in online spaces, whether that's in social media, blogging, podcasting, videos, whatever. Most people spend a lot of their time in obscurity and they're like, watch I just can't figure it out. Like I'm putting out a good product. I feel like what I'm saying is important. And oftentimes part of the reason why is because you know, when you when you don't stand up for something, you don't really stand for anything, right? And so like, until you have so Don't think to say that is to some extent, like the word you used earlier provocative. You just kind of mix in with the rest. And the reason why people do that is because they're usually afraid of what people are going to say. And so, you know, a great quote, in this arena is like, you can either be judged or you can be ignored. So if you're big enough, and you've actually said something that's opinionated, people are going to disagree with it. And if that hasn't happened to you yet, it's only because like, you haven't reached enough people, there's no way in our polarized country right now that you're going to have a podcast, video, you know, blog come out that that everyone agrees with, it's just not going to happen. And so you just want your people to find you. But yeah, it was actually a really tough journey. Because, you know, as that business grew, and I started, you know, having some success with it came all sorts of challenges. I mean, I had, I mean, I can't tell you the number of times I've had somebody send me, you know, a message or an email, or a social media, you know, tweet or whatever that said, something that I wasn't, you know, obviously a huge fan of, you know, they weren't, they weren't huge fans of me. And, and so it took me a lot of my own thought work to learn how to deal with that, and to realize that, you know, part of that being in the arena, and so, but in that journey, I went from being burned out in medicine, interestingly, to, you know, so from physician burnout to entrepreneur burnout. And so I experienced that, too. And, and it's an interesting thing that I tried to escape one situation by moving to another, and that's one of the things that we talk so much about with our clients is that, you know, most the biggest mistake that doctors make, or one of the most common, the least, is that they try to change their situation, thinking that by doing that, they're going to actually make their burnout get better. And that's actually not the way that it works. Because the burnout is caused by your thoughts, your thoughts about the situation, not the situation itself. And if you don't believe me, go change jobs and and see if your burnout gets better. But I can't tell you a number of people that have changed jobs, and they've made, you know, differences in their life in terms of circumstances, and they're still burned out. And so yeah, it's, it's, it's an interesting journey, but it's one that often you have to take before you really believe that.


Daphna 22:14

Well, and that's, I think you briefly touched on it. And what I loved about a number of your episodes was that, you know, for a lot of physicians doing a side gig or hustle is, is, is not, it's not to make more money, it's so they can leave medicine, you know, exactly what you were saying, and, or so that they can, you know, really work hard and those first decade, two decades, and then get out and really start to enjoy their lives. And what I really like about your perspective is how can we help doctors, you know, settle into medicine, so that they'll really have longevity, and so that they will continue to find passion in the work, continue to care for patients, and especially in the current climate. That is, that is tough, and we have people I think leaving medicine in in droves more than ever before. And so I think this couldn't come at a more important time.


23:15

Yeah, I appreciate that. And I think the reason, I mean, ultimately, people just want to be happy. I mean, in coaching, we talk about something called the motivational triad to the idea that you're trying to seek pleasure or avoid pain and do either of those things as efficiently as possible. And so when you're burned out as badly as some people aren't medicine, the only thing that they see, the only thing that they are concerned about is how can I make this pain less painful, and so that they will think of and do anything that they can to try to fix that problem. And, and, and what they end up missing is that they're so focused on the end, that they can't enjoy the journey. You know, and so like, and I did that, I mean, that's, that's where all a lot of this came from, is that, you know, my life was a living example of all the stuff that I talked about, and I'm not as part of what I do I share my struggles and everyone, everyone that space says, oh, no, you can't you can't talk about your struggles until you've overcome them. And I'm like, well, that's completely unhelpful for like the people that are like going through it. Like they feel like oh, wait, but you're already on the other side. It's like, no, like, I absolutely struggle with things. I'm still in, you know, the Man in the Arena, as they would say, you know, and so like, it is really, really important to learn how to enjoy that journey. But it seems so hard to do sometimes because of those those things that you know, trap you in medicine. But yeah, in getting to the point where you can enjoy the journey. That is what prolongs your career, that is what allows you take great care of patients and provide the outcomes that all of us want. Because, you know, like I and I'll tell you right now, like sometimes, you know, people will say like going part time is the, you know, the answer to this or making, you know, making money. A side gig is the answer to this. Like, there's 40 You know, 40,000 different things that people propose. But at the end of the day, you know, really, you just want to be able to enjoy the journey wake up and like your job and enjoy taking care of patients and feel like these other 47 things aren't getting in the way of doing that. You know, and that that's the goal, right to love the life you live.


Daphna 25:10

And remember why you got into medicine, you know, a lot of us really love the work. And so helping physicians find that, again, I think is, is critical. And, you know, it's not just about these kinds of, you know, we're talking about in kind of vague terms about unhappy physicians, but But you know, it's a real problem, right? And you've written about this, that depression is found in, you know, about a quarter of physicians, nearly a quarter of resident physicians experienced suicidal ideation, and that suicide is the second leading cause of death in residence. And so it's a real, it's a real problem that, you know, we can't just ignore hospital systems can't ignore patients can't ignore because it affects everybody. Totally.


Ben 25:59

It's, since we're talking about burnout, I think what's interesting about it is that as a physician, you're trained to residency fellowship, and residency and fellowship training almost involves burnout practice, where I remember as a fellow we used to have the symptoms of burnout posted on the in the on the wall in the fellows office. And when you was your service month, you You checked each box, as the days went by, until you reach the end of your month. And you're like, Yep, that's it, I meet all criteria now. And then you go off to research for a couple of weeks, and then you come back, and we get trained about this, oh, I'm burning out and then I'm going to get over it and come back. And that's why it almost feels familiar when you become an attending. And so I know you speak a lot about that in your podcast. But what do you think, is the solution for trainees? And where do you think we can impact training? When it comes to preventing burnout? Both in training and after we leave fellowship?


26:54

Oh, man, if I haven't already said opinionated things, yet. That's not something I talk a ton about. But yeah, I've got lots of thoughts on this. So man, I think it's just a categorical failure of leadership in in, in medicine, like, we have this mantra in medicine. Now, that's just the way things are like, we literally say that out loud, like as if nothing could change. And it drives me insane. Because it's like, okay, just just because we train that way, doesn't mean we have to continue to train people that way. What if imagine this crazy world where we take really good care of patients, we train our, our residents, our trainees very well, and they don't hate their life in the midst of that, like, does that, like those things aren't mutually exclusive, but we talk about them as if they are? And, you know, I think it really, you know, in terms of getting practical about it, it just kind of depends, right? So the way that I explained stuff like this is just being intentional about how you set up programs and what you like, it's great, you have a poster on burnout, fantastic, you know, like, I can check off the boxes as I go and just make sure that I really am burned out. Or, or we you know, we could treat it like a 401k. Right. So we know that studies show that if you are opted into a 401k, and you have to opt out to get out of it that more people are likely to contribute, they're more likely to participate to take part. And so why don't we opt in residents into coaching or counseling, so that they have sessions booked for them and days off that we have provided and said, Hey, you have half a day off, you have a counseling session that we've arranged for if you don't want it, you can opt out of it. But otherwise, we are encouraging you to attend. Right? And by doing so, you're saying hey, we support wellness, and physicians and we recognize that you probably need to talk about some things, right. And by doing that, you're not stigmatizing it. You're not saying hey, opt into this, if you need it, broken physician, you're saying, Hey, we're all broken. To some extent, we all need to talk about things. And hey, even when things are going well, it's usually really helpful to talk to talk to someone else, and which, you know, comes up in coaching all the time, like, Hey, I'm not burned out, is this for me? And like, yes, like, you can go from good to great, like you don't have to be burned out to benefit from coaching, right? And so until our our paradigm, our perspective on wellness becomes proactive. And we are not only saying with our words that we care about this, but we're actually building programs and solutions that show that, you know, it's not going to change, but if we had program directors, Assistant Program Directors, leaders and health care out there, that made this normal, that made it expected to take care of yourself and that they did that by actually building processes that showed that they did like the one I just mentioned, like that, that's going to help a ton. Because right now, it's all it's all just lip service. It's all lip service.


Ben 29:34

It's it's a module, right? It's it's Do you know how to address physician fatigue, do you know how to recognize it? And it's like, yeah, that's great, like, but there's no outlet for me to address it if I cannot come to work because I am in this


29:46

module is causing my physician. So can I stop?


Ben 29:49

Right? You know,


29:50

like, I mean, it's the they really, I mean, really the end of the day, they are checking a box, right? Like there's a box that they feel like they more Believe it or, you know, whatever, for whatever reasons they have to check, maybe it comes from, you know, healthcare requirements nowadays, I have no idea. But until they actually legitimately care about the problem enough to come up with unique solutions, and, and the other thing too is, if you look in industry, and this is, you know, a personal pet peeve of mine, I'm 35 years old, I've got lots of things to say about this, you know, I'm only five years out of training, and therefore I have, you know, I'm not qualified, and I'm have gray hair to to have a qualified, you know, say on this on this topic. And if you look outside of health care, like in, in very big, successful organizations, they will actually bring in people that are younger, why? Because they relate to the people that are having the problems. And they say, Hey, you know, we just want your help and thinking through this and thinking outside the box, you know, like, what, what are some things that we could be doing? And then new ideas come out, right, but medicine is so stuck on tradition, and the way that we've always done things, that that's just such a foreign idea, and we're always 2030 years behind the rest of business, where, you know, they bring in fresh ideas, and think differently. And, you know, great, a great read on this exact topic is Simon Sinek when he hears the last fantastic book and explains exactly what's going wrong in medicine right now. I mean, it's pretty good for that. Yeah. And the books out about medicine, by the way, but But you read that book and like, Oh, yes, what is what's going on?


Ben 31:19

I have to share a few stories, because that's, that's just so good. I mean, I remember when I was, I think it was in residency that they did give us a module on fatigue and burnout. And they made it a point to tell us hey, when the ACGME survey comes back, you must check that we addressed it, we did forget that we sent you that module. It's like, that was completely useless. But thank you, I will check the box. And, and people don't realize, but it is very pervasive. And I remember in fellowship, I think it was my first six months of fellowship, I was obviously I'm in we're in neonatologists, I was in the in the ICU, and the baby died. Right. And, and I felt so guilty. And I was like, Did I do something wrong? I didn't know. And when I was, as I was leaving postcode, I think I was trying to find an attending to tell me, can you, like, Can you review the case and tell me if there's something else I could have done that would have, the outcome would have been different? And without looking too much? No, it was fine. But just make sure you do the discharge summary. And I was like, Oh, God,


32:11

yeah. It's, it's really tough. Because you know, Brene Brown, who's amazing love herself. She, she has the distinction between guilt and shame. And, and it's like, these fundamental understandings that if our attendings had them, if our training programs had these, like, we could actually help doctors not have these problems. But like, the idea of guilt is, you know, hey, I made a mistake, something happened, the process, you know, went awry. And like how terrible of a situation that this patient died. And like that, that that sucks. It's terrible, right? That's a very different thing than I am bad, which is shame, right? So like, like, something went wrong. That's guilt. Like, I feel I feel guilty about the situation like, this wasn't the outcome that I was looking for. But shame is, I am bad, I did something wrong. This is about me. Now, I am a bad doctor, which is all like where all of impostor syndrome and all that stuff comes from is the fundamental difference between guilt and shame. And but we don't talk about feelings and medicine, that's not allowed. You know, and I remember I had a patient, you know, young teenager, who got shot, and, you know, was related to the health care system, like, you know, their their parents were in health care. And I did everything I couldn't say the patient ended up dying, young teenage kid. And the next day, I got a message from our billers that said, Hey, you forgot to a test for CPR, and your case. And, and like, it didn't say anything else. It's like, they could see the age of the person that died, they could see what had happened, who was and there was no like, hey, you know, I'm really sorry, that must have been really tough. You know, when you get a second, you know, there are some things that we need to address, but you want to say sorry, like, none of that, like, Hey, you forgot to build, you forgot to build a patient. It's like,


Daphna 34:03

Yeah, well, and I mean, that's the thing about medicine is even, even when everything is done, right? Patients still die. And and, you know, we carry that with us. And we, we still feel like, you know, we should have done something differently or done something better. And even when you've done everything, right, it still feels like you've done something wrong, you know, and that's


34:26

the importance of that's the importance of talking to somebody else about it, because and that's one of the common things that will we'll have conversations you know, about with our clients in coaching calls is, you know, hey, I feel really terrible about this situation like, Okay, well, tell me about it. And they'll tell me the entire thing. And I'll take out all of that narrative, all of the perspective, that they have the story that they're telling themselves about how they're a bad doctor because X, Y and Z, and I'll say, okay, these are the facts, like these are the things that happen that like two lawyers in the court of law would agree upon. These are the facts. If I told you that one of your partners had this happen, and this is what they did well Would you say they're like that they're a good doctor. I'm like, why are you telling yourself a different story? You know, it's because the outcome was bad. Right? But it's, it's it's all about that perspective, that paradigm like that the thought work there is so fundamentally important, but we that's not a skill set, the doctors are taught.


Ben 35:15

And to circle back to education, you said that it's this culture of, of just, it must be tough and rough. Otherwise, it's not training. I feel like it's even worse than that. Because I don't know about you when you went to training. But you always have these older attendings who tell you, it was so much worse when I was a fellow and you have an easy and, and it's like, what is that? So even if I'm going through a rough time, I have it easy. And it was supposed to be worse, like, what does that even mean?


35:39

Yeah, it's the idea. Like, you know, oh, you know, when I was in training, I had to walk uphill and snow both ways. Right. And, and it's, it's a phenomenon that is very real. And, and it happens in a lot of the things that we've talked about and touch to touch on already. Right. So I remember talking to one of one of our older attendings, one of the vice chairs in my department, actually, and and he was, you know, interested in my interest in money. You know, why do you feel like, this is such an important topic to talk about. And I said, Well, how much debt did you have when you finish training? And he's like, Well, I mean, like, $4,000, I was like, so the average now is 210. Right? And that compounds during training, which you can't really do a lot about, you can make huge mistakes, but you're not going to, like, you know, crush that debt during training. Now, trust me, that doesn't mean like you're off the hook from having to learn about it, because you can make a very large six figure mistake by not learning about money. So please don't hear me go and not like just put your hands on. Residency. Yeah, like put please. Yeah, please be in the right program. Because like, I mean, I know, six and seven figure mistakes have happened because of that. So don't do that. But you know, when I pointed that out, I'm like, yeah, so that average turns into 253 350, by the end of training, depending on how long your training is, like, like, what would what would you say, if I just handed you $350,000? Or $600,000? Like you mentioned and right? And, like, how would that change your life? And he's like, Oh, now when you put it like that, you know? And it's like, yeah, so you're uphill both ways in the snow kind of thing. Like that doesn't really work does it? Because we are dealing with more complicated, sicker patients that we can save out of things that you had no business saving back then. Right? And the complexities of healthcare and all the ethical problems that we have nowadays, that back then, like, it was patriarchal medicine. Yeah. Right. So like, you just tell people what to do. And like, they were just okay with it. Like, that's not the same way anymore. Like, there's lots of things that are different nowadays about medicine, and about our situation. And so when people try to make comparisons, I kind of just laugh about it. Because I mean, it really, that's the only thing I can do. And it's like, I make an analogy to him, I basically tell him a story. It's like, okay, so you tell me, if you have two parents and one parents, like, look, you know, you know, everything that I did was harder than that than how you had it. And so therefore, like, you just, I'm just gonna crush you your entire life. Like, and you had another parent that was like, hey, you know, like, I had some hard things that I went through, and I'd like to share those with you so you can learn from them. But I'd also like to learn more about your struggles and how I can help you. Like, which of those parents do you want to be? You know, and like, yeah,


Daphna 38:05

that's a whole different podcast, right? We have parents like, Yeah, but


38:08

like, are we? Yeah, Are we proud of? Yeah. Are we proud that we are administrators that beat down, you know, our physicians, because we feel like they didn't have they don't have it as hard as we do. And they can't understand our struggles, like or do we want to meet them where they are? And you know, another Covey reference, right. But the idea of like, first, you know, seek to understand other people before you be understood, right. You know, like, so much of medicine nowadays. Like we're just told, like, Hey, you just have to understand how it is. And it's like, Well, how about you listen to us? Like, how about you listen to some of the things that we're struggling with, and maybe we could work through this together?


Ben 38:39

That's right. Yeah. I have to I have to give credit to a physician. I used to work with Dr. Garwood. He used to be, I think he's retired now. He used to be a developmental pediatric pediatrician. And he was so nice to residents like the most humane and nice attending to residents. And one day I went to him and I said Dr. Garwood, what, what is the trick to be as nice as you are to residence because I would like to be like you when I am an attending. And he says, I have respect for the resident because of this. And he pulled out the book of developmental pediatrics when he trained, and it was like a brochure. This is, and this is the edition today. And it's like a double volume, big book. And he's like, I had had some things that were easy for me and are much harder for you guys. And I respect that, and it's exactly what you're saying. And he the analogy of seeing the books side by side was like, oh, shoot, you're right. Like the field has evolved since training, and that's awesome. So a powerful example. I know. I know. He was a he was an amazing guy. Yeah, definitely. Go ahead.


Daphna 39:34

I'm sorry. No, I was. I mean, what I was gonna say is i i had a faculty member who in the in the NICU again, she's probably the reason I'm in neonatology and I feel like I that's what I said I want to be like her and I haven't figured out how to be like her yet. But you know, once a week she no matter what was going on in the unit, even I mean, if things were falling around around us she'd find out A for us to get help for the unit to be covered for the patients to be safe. But for us to just take 20 minutes, once a week at least, and have breakfast together, and she just cared about us, right and just showed that she cared about us. And it made the rotation, a totally different experience. And so, you know, I'm hoping we can give our listeners some concrete things that we can do to model like how, for lack of a better word, just how to be how to be a person, right in medicine. And because I think that's how we can change the system, you know, not all of us have the ability to rewrite the fellowship program or the residency program, we're dictate what they do with their time, but when we engage with learners, I think we all have an opportunity. So you know, I'm sure you've seen some examples, or could give us some feedback.


40:53

I think that you're, I think that you're on the right track, right. And it all starts with empathy, like all of it, if you just treat other people like human beings, and try to understand where they're coming from, like, it's all that, like that 20 minute breakfast, where, you know, she could ask questions and find out what's going on in your life? And what's going well, what's not going well, like, what can we work on what, you know, what are we doing great, and just have those conversations, right? That goes so far, and nobody, nobody in this life listens to anybody without knowing that the person cares first. And yet in medicine, we start with the other side, where we're like, No, you'd have to listen. And it's like, well, but I don't know that there's like any buy in, in this relationship, right. And like, we wouldn't do that in any other part of our life. And so when you have someone you know, has the pamphlet and shows you the textbook and says, Look, I understand your situation, that's what that's what got buy in is the empathy, like the understanding the person had for your situation. And so as faculty members, I think it is our responsibility, to not make sure that they understand us, but that we understand them. And until we flip that script, you know, because classic teaching and education and I'm an academics, right, so it's like the sage on the stage kind of mentality, where, you know, they're their job is to listen to all of the profound wisdom that we can provide in their life, as opposed to being you know, what's called a guide on the side, right, someone that walks along with them on this journey, and recognizes they are intelligent, educated physicians in training, and that our job is to support them and help them when they need it. And to understand when their struggles are, you know, coming up that maybe something else is going on like that. I think that honestly, that that's one of the biggest points of contention and a lot of wrestlers will have is like they're having a hard time and, and they walk into office and the person tells them like, hey, like, this is what you need to do, like, you're not doing this well enough, you know, fix these three things. Instead of saying like, hey, like, you know, just checking in and be like, Hey, is everything okay? At home? Like, how are you doing? I just want I just wanna make sure that everything's okay. And like seeing what's going on, because there are a lot of things that impact, you know, our work in the hospitals outside of just, you know, a bad decision or not knowing something like, you know, and so, I always tried to come from and the attendings that I loved and training, and I had a great training experience my residency program, like, despite me, you know, having opinions to blogging and podcasting about stuff for a while, my training partner was incredible. You know, and so I loved where I trained, awake. But my favorite attendings were the ones that tried to show me that they cared that sought to, you know, be empathic that really wanted to learn more about me outside of just what we were doing that day, right?


Ben 43:36

I have a good example for that. I mean, not not so much about finding what's going on at home and things like that. But we I had two types of attending, right. And as you know, as an ICU fellow, things are busy. So you had two types of attendings, the one that would send you to conference and didactics with your pager on and the one who would say, give me your pager and then go to conference. Right. And that made like you said, one cared that I got something out of this conference. The other one was like, that's your problem. Like, I'm not helping you check. So that makes


44:04

that's a great, that's a great, that's a great one, right?


Ben 44:07

And I think it boils down to boundaries. And I wanted to ask you about that because I have, I have like an 11 year old daughter, and we're reading about and reading a lot about technology and social media. And really, there's this concept that's very well known in cyber bullying that kids today they have no more boundaries, right? If you were facing bullying at school, back in the 1980s. Once you got home that was safe, right? You went home and that was protected. Nobody could intrude, could sort of be intruding on your private space. And I feel like today the cyber bullying is happening from the healthcare industry where I see my wife who is a cardiologist and works as a as an outpatient physician, the inbox everything. It's so intrusive, even after your shift is over even after you left the clinic or the hospital. And so I'm wondering for the for the physician and the providers listening who are dealing with this constant and true version of notifications in basket critical values. How do you change flip the script a little bit and regain control? Because it does feel like you said like, it's a trap, and there's no way out.


45:12

Yeah. So it goes back to a little bit of the idea that you have to fight against this idea of like, that's just the way things are. Because they don't have to be that way. And this, I mean, I check my emails on Thursdays and Fridays, I work two days a week in medicine now. And if I get an email at work, it will knock like I literally had, like, 12 days off in a row, because I took a week off. And so I went from a Friday to off that week, and then on to the next Thursday, so I had like, like, 13 days, I didn't check my email. And like, people were like, Oh, my gosh, like, like, you're not checking your email for two weeks. You know, and so, like, you absolutely can set boundaries, like, Hey, I respond to messages between 8am and 5pm. And if I get a message after 5pm, I will address it the next day between 8am and 5pm, Monday through Friday, right? You know, and you might have to get creative as a group, like if there are certain things that that your group as a whole, you expect to be responded to more quickly than that. Okay, well, who's the on call person just like, do things get shifted to them? Like, how do we protect people's family lives and lives outside the hospital so that we can make sure their cups aren't empty, like we were talking about earlier? Because the problem honestly, is that people play the short game. So we're all concerned about the immediate urgent needs that come up. And we're ignoring all the long term things that have much greater impact on people's well being and lives. You know, like, there's a reason why people don't have time to exercise or eat well, or do any of this other stuff. It's because they're busy doing all these other things. And so, you know, we spend a lot of time like talking about the fact that like, those are all choices, like, I know, it sounds strange, but everything in your life is a choice, like you don't have to go to the hospital, you don't have to get out of your car, you don't have to go into the clinic, like those are all volitional, like, you don't have to do any of that. And similarly, like, you don't have to answer an email after five o'clock if you don't want to. And if you set that expectation, like no one gets mad at me, like I don't get emails every week saying, I can't believe you haven't checked your email for five days. Like, you know, what happens is people email me back and be like, I wish I had that in my life. Like they don't like thank you for sending a clear expectation for me. And that, that is a phenomenon that I think is so important to manage, because everything everybody does have access all the time to an internet connection. Right? And, and honestly, you can do that too, right? Like, as crazy as it sounds like you can turn off your smartphone when you get home. And amazingly, all those notifications don't come through, like you don't even know they exist. Like, I know that sounds crazy. But that's a choice, you can do that. And honestly, I do I do that sometimes.


Ben 47:39

I actually took advice from one of your podcasts where I signed up, I have now a second phone, which is my work phone. And guess what, when I get home, I turn it off. And the other phone can only be sort of available to family and, and so I know that if it rings, it's either my dad, my mom, my sister, my brother, and that's it. But it won't be work. And I can turn off work whenever I want. And that's been a game changer for me. And yeah, definitely go ahead. I'm know we're running short on time.


Daphna 48:04

It's not a it's not working for you, because I text you on both phones. So it's around the clock. Okay. But I you know, I kind of wonder, you know, like, it almost seems like you said it's the short game can can we imagine what medicine would look like if doctors were happier, right? Like we'd engage in our multidisciplinary teams better, right? We wouldn't have this, you know, dichotomy that happens in some places between physicians and the rest of the staff, right, we wouldn't have such these aggressive, angry physicians who, you know, nurses don't even want to come talk to you. And I mean, patient outcomes would be even better, right? So if we can invest in the system, I think it would pay dividends. And there are countries who are doing this, right. The American healthcare system is not it's not perfect, right? There are things that we can do in our in our outcomes are not the best in the world, either. I just, you know, imagine how how can we impress upon people who make decisions? To say like this is in your best interest in the best interest of the system in the best interest of patients? Well, I


49:20

think that we see this, I mean, not not just in physicians, right. So like, the nursing staff in the O R. 's right now. Okay. So we, as a system, and I'm sure that my hospital is not the only one in this situation, right? So where we just keep running cases, we run cases all day long. We have a system. I mean, this is this is, I think, a good example, although, you know, I'll see if I end up in my chairs office for this, but so, you know, like, we have a system where we're surgeons are paid by RVU. And so there's a conflict right off the bat, you know, search and operates, they get paid, okay? So instead of them having, you know, a salary where they just do a reason amount of work during the day, the more work they do, the more they get paid. So what does the surgeon do? They want to book as many cases as they possibly can every single day that they operate. And so what does that do to our nursing staff? Well, our nursing staff who we say, hey, we promise that you're going to be going home by three o'clock, five o'clock, seven o'clock, whatever, they end up going home an hour or two hours, two and a half hours later than they're supposed to. And, and and it's an interesting phenomenon, what is what happens in nursing, where they have very clear expectations and boundaries on their time? Like, have you ever tried to transition care? Or do a procedure on somebody during a shift change over seven years? No, that doesn't work. Why? Because they protect that time. Right. And so but in the operating room where we don't do that, and nurses are continually late. Now we have a nursing shortage, we, you know, and there, it's multifactorial, but this has been happening for a while. And a big reason why is because we don't respect our nurses time enough to say, No, we're not going to add on that case that can be done tomorrow, right? So that we can protect our nurses make them love working for us and have a better quality of work, instead of focusing on quantity. And if they would do that, then we wouldn't be running over staffed or hours later, the evenings, paying people additional time, and now having to shut down multiple hours at the beginning of the day, all of those things cost money, because we're not really respecting our nurses time. You know, it that's not the that's not the main focus of you know, the alar, though, are supposed to make money. So therefore, let's do it's actually you're making less money, because we're running rooms at an extra cost. And we can't run all the rooms we have, because we don't have enough nurses, they left because you miss treated them. Like that doesn't pay off.


Ben 51:39

And that's the same everywhere, by the way you were worried about likewise, this minute, no, ambulatory services, double book every every patient every slot, because again, it's our views. And if one doesn't show up, then we must make sure that somebody else will be there to take their place. And and patients aren't happy because they wait to doctors can keep up. And and I think the worst thing we haven't talked about is that then the pressure is on the physicians to just work faster, maybe sometimes cut corners. And that's, that's that's where it gets very dangerous. You know, and I liked what you saw. I liked what you said about the nurses, I want to tell that story because we had a sassy nurse in the ICU. And one day one of the physician says What if a patient gets sick during sign out time, and the nurse says even the patients know that this is sacred, and they won't get?


52:22

Yeah, but that's a boundary right? And how powerful is it as an example, and like that's not a nurse not caring about a patient? No, that's, that's a nurse playing the long game saying, I'm going to be a better nurse, if I take care of my work life balance. And the next time I come back, and I'm recharged and refuel, to take better care of this, this group of patients the next time I come back, but in medicine, we drive ourselves to the ground until we can't anymore.


Ben 52:46

And we see that in our ICU where if there's an admission at 7pm, all the nurses get together be like we're going to help you deal with this admission so that you're not here for three hours. And we're going to get this done together in like 35 minutes, so that you can actually go home, which is again, a testimony to their dedication to preserving that work life balance.


Daphna 53:05

Well, and it's like sign out, that is a critical time to transfer information, right. That's where mistakes happen. And so if we don't protect those times, if we don't respect that that time, then then things are worse for everybody. So you know, and I think exactly what you guys are describing is where that feeling of frustration comes from where doctors say or outpatient providers, they went into medicine because they like thinking about patients, they like working with patients, I like talking to patients, and now they don't get to do any of those things that they really cared about. And so, I mean, gosh, we could just talk about this all day long. And but I did want to transition because, you know, I think your tenants, your principals, that's why they're valuable, not just for physicians are valuable for everybody on the team. They're valuable for people who aren't in medicine, right? Because everybody's jobs are doing the same thing, this kind of creep into, into your home life into your personal life and your weekends into your nights. And so I feel like as a society that, you know, we've lost all of our boundaries between between work and personal life. So I think what you're doing is so, so important. And I think what you've been able to shape like for yourself is that when we read your bio, or when people hear your bio, I mean you You really seem to be doing it all even while maintaining some boundaries. So so how does it work?


54:40

So as is my style, truth and transparency, right, it doesn't sometimes and so, and actually I don't know when this episode airs might come out on your podcast before mine, but I am. Yeah, so I'm pressing pause on both my podcasts to write a book because I can't I can't do it all. So you know It means Madison is going to be on a break for a few months. And and this philosopher probably won't be quite that long, but it's gonna be on a break too. And the reason why is because I want to write a book. So I spent two and a half hours this morning, you know, working on one of the chapters in my book, and and when it came, you know, so and there's a long background to this, but a few resources I'll point people to so there's some great, great work on on this this kind of topic, which is Essentialism by George McCune. I think it's George McCain, I should look that up before I say that, but it's called essentialism. And, and so he points out an interesting thing, which is that the word priority used to be singular for like, I don't know, Greg McCune, sorry, the the, like, first couple 100 years that the word is around, because like the word priority means like the thing that's prior to all others, right? And then after a few 100 years, we decided, Oh, well, but we can have multiple priorities right. And, and that's not really true. Like you only have one true priority in life, one thing that's prior to all others, and that idea has slowly crept into, like, oh, but all of these things are important. And if you ask somebody, Hey, I know you got 40 things going on, I want you to pick three, you just get three things you want to do really, really well. And then like you can make it like specific about like a job like, Hey, you have three three roles at your work, okay, taking care of patients is one of them. You're a doctor, you get to other things, you can't do anything else. Like what what would you choose? And like actually force people to go through that process. They're like, nope, and they get like a list of like, their list of 10 goes like nine, like they can't get down to three. And, and so it's it's and the reason why is because we really do tell ourselves a story that I can do all things like, no, no, you can't You're human multitasking is not a thing. There's lots of evidence to show that we're really, really bad at that. And so you can do a lot of things really poorly, or you could do a few things really well. And I choose to be in the latter group that focuses on doing a few things really well. And the podcast will come back, you know, but for right now for this season of life. I've hit pause on that, right. And so, you know, really asking the question about, like, I feel like we all just assume that life has to be hard. And for last six months, I've really been focusing on like, how can I make everything in my business in my life, light and easy and simple. And so, you know, focusing on that, I've gotten rid of a lot of things like a lot of stuff. And so yeah, so now I have my group coaching program. I've got my one on one coaching clients that I coach, and I am writing a book.


Ben 57:28

That's awesome. We're coming to the end of the episode, and I wanted to ask you this question because you do brand yourself as the physician philosopher, and the more I listened to you and and your your student of stoicism. And so I was wondering, you're not the stoic physician, you're the physician philosopher. And I'm wondering if you are pulling from other schools of philosophy, for your outlook on medicine, and life in general? I don't know. Are you also a cynic? And I was wondering, because, yeah,


58:02

I pull from all sorts of places. So you know, I'm Christian. So I pull from that I pull from stoicism I proof my roots as a philosophy major in college. And, and really, I think that there are so many things that, you know, so many truths that come from different, like just different perspectives. And, and for me, when I see like, oh, wow, this is being said, by, like, five different things right now, you know, from very different sources and like that, that must be kind of something that's true, right? That seems like a principle that we could apply across the board here, right? You know, and so, I think that, you know, for me, I really pull from anything that, that that follows that kind of mantra, when I when I start seeing multiple sources, and multiple, you know, backgrounds and beliefs and perspectives and paradigms, say similar things, that's when I start to kind of tune into it and say, seems like this is a principle I could apply to my life. You know, and like an example of that recently is the one that I was just talking about. So, you know, essentialism and effortless, which are, you know, both by the same author, and then, you know, from a Christian paradigm, there's a book called the ruthless, ruthless elimination of hurry written by Pastor, I'm at the Pacific Northwest. And like it when you look at it, like all of them are saying the same thing. Like, they're all saying, like, hey, when you live this constant light of life of stress and hurry, and you never take time to rest, it turns out that in the end, like the long game, that's really, really bad for you. And so, it turns out that, you know, I mean, most most religions have a day of rest most philosophies believe in meditation or mindfulness, you know, like, all of those things kind of say the same thing, which is that you know, it's really good to take a pause and to like, turn your phone off and to just be intentional with your time and your thoughts and the family and friends that are around you that you love and that are supposedly the priority, right? Like an actually make them the priority. And, and so for me, like, I'll pull from any from anything that that's kind of speaks that that same grain of truth from multiple perspectives and And that's what I love latching on to and kind of making principles out of.


Ben 1:00:03

And that's the cool thing about philosophy is the human nature of it, where people may define themselves as different things, different religion, different schools of philosophy, but then the, the intellectual queries are always the same and focusing around similar ideas, and we 99% of the time come to the same conclusions.


1:00:20

Yeah, I mean, we're all humans on a human journey. Right? And so sure, and I love that. I mean, for me, you know, I teach this to my kids, like, like, there's not a person in this world that I can't learn something from. And so, you know, I never want to assume that I'm right about everything or something like I always am open to hearing other people's point of view and perspective. And I think that when I, when including my residents, by the way, I apply that to them, too. So I don't come across as like this, like, you know, I know, everything kind of attending, like I learn from my residents every day. And so, you know, when you have that sort of philosophy, like you just look for look for truth everywhere, right. And I think that a lot of it comes back to a very common human shared experience that a lot of us relate to. That's right.


Daphna 1:01:04

Yeah, so funny. I feel like this last year, last 18 months, I feel like the person I've learned the most from is my daughter. You know, we we've been homeschool we homeschooling and and homeschooling, we've been virtual schooling, which is not the same as homeschooling. And and she finally went back this, you know, whatever, six weeks ago, and I, I realized, like, I miss that time with with her. And I wonder, you know, I feel like did we waste all this time this year that we had this opportunity to really do something special, and we were so worried about so many things and getting our stuff done while she was home? And I think these are times where we can reset and say like, okay, how can I, like you said, be intentional about about my life. And I think that's so important. And, and we can do that at any point in time, right? We don't have to have a worldwide pandemic to reset.


1:02:01

Well, I think you're tapping into something that's really important, which is that and people will use this all the time for anything, is like, well, I'll do X, Y, or Z when and like, finish the sentence. When I have more money when my student loans are paid off. When I have more time when my kids are in school, like we will, you will come up with an excuse for not doing things that are really, really important in your life. And that you know, over the long term will just be profoundly full of joy and satisfaction. And you'll come up with an excuse not to do it. And that's why the tagline of my podcast is start before you're ready. Start by starting start now is because like, stop, stop making the excuses. You know, this is important. Find a way to get rid of other things that aren't so you can do what's important right now. You know, live that life. Enjoy that journey right now. You don't have to wait for tomorrow. You don't have to wait a year from now when things are different or better or whatever. But but we do that all of us, myself included all syndrome


Ben 1:02:53

of New Year's resolution. It's just so bad. Just start by starting I love that so much. Absolutely. Well, Jimmy, thank you. Thank you so much. This was a lot of fun. I feel like we could clip every answer and make it a highlight of the podcast. But we're gonna have we're gonna have to break it down anyway. It's, it was a lot of fun talking to you. Thank you for everything you're doing. I'm looking forward to that book that you teach.


1:03:15

Yeah, thanks. I really appreciate you having me on. I was it was a ton of fun. Thank you. Yeah. And


Daphna 1:03:21

I hope our listeners take note, I hope they tune in whether they're physicians or not, honestly, because I think everybody can learn, like you said from the basic principles that that that you're teaching, and we'll put all of that information in the in the show notes. Thanks so much.


1:03:36

Thank you.


Ben 1:03:40

Thank you for listening to this week's episode of the incubator. If you liked this episode, please leave us a review on Apple podcast or the Apple podcast website. You can find other episodes of the show on Apple podcasts, Spotify, Google podcasts, or the podcast app of your choice. We would love to hear from you. So feel free to send us questions, comments or suggestions to our email address NICU podcast@gmail.com. You can also message the show on Instagram or Twitter at NICU podcast. Personally, I am on Twitter at Dr. Nikhil spelled Dr. NICU, and Dafna is at Dr. Dafna. MD. Thanks again for listening and see you next time. This podcast is intended to be purely for entertainment and informational purposes and should not be construed as medical advice. If you have any medical concerns, please see your primary care practitioner. Thank you

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