#405 - 🔵 [NEO CONFERENCE] - How can direct networking redefine the neonatology job search? (Dr. Zubin Shah)

Hello friends 👋

How does individualized medicine shape both patient trust and neonatal careers? Live from the NEO Conference, Ben and Daphna catch up with Dr. Zubin Shah, Clinical Ambassador for Pediatrix. The team explores the power of tailoring bedside conversations to individual babies—whether discussing targeted hemodynamics or framing RSV prevention with nirsevimab—rather than relying solely on generalized trial data. Dr. Shah also sheds light on the evolving landscape of neonatal recruitment, emphasizing how peer mentorship and direct networking can help new physicians find practices that balance rigorous clinical care with research and quality improvement.

Link to episode on youtube:

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Short Bio: Zubin Shah, MD, FAAP is a Neonatologist with Pediatrix Medical Group at Baylor University Medical Center and an Assistant Professor of Medicine at Texas A&M University School of Medicine. He completed his pediatric residency and neonatology fellowship at Nationwide Children's Hospital in Columbus, Ohio. His interests include clinical epidemiology, point-of-care ultrasound, and advancing care for extremely preterm periviable infants. He also serves as an ambassador for The Incubator, where he is passionate about mentoring fellows and early-career neonatologists entering the workforce.

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

Ben Courchia MD (00:01.006)

Hello everybody, welcome back to the Incubator Podcast live at the NEO conference. We are joined by our good friend Zubin Shah. Zubin, how are you?

Zubin Shah MD (00:08.052)

I'm good, how are you guys? It's so good to see you both here.

Ben Courchia MD (00:11.704)

Same, same. It's a friendship that began in the virtual world and has blossomed outside in the real world.

Zubin Shah MD (00:19.534)

I remember I was a fellow just commenting on the podcast, and I think back when I was a lot more active on X, just our exchanges.

Ben Courchia MD (00:37.998)

You said X was good for you. I feel like we've grown. What's X? You are here at the NEO conference. Anything specific you're excited about? We'll talk about your work on recruitment and really talking to late trainees or new career NEOs. But anything at the conference that you're particularly excited for?

Zubin Shah MD (00:55.298)

Yeah, I think we were just discussing, almost like in Back to the Future, you're not thinking fourth dimensionally. How to think hemodynamically about things. Like a new frame shift or even mindset about approaching our patients. Souvik gave an amazing talk just now about the PDA. I think a lot of institutions and a lot of programs are now recognizing that we'll probably have to at some level—and everyone's at a different level of this—start involving a closer dive into how we assess each individual patient. I'm really excited about that.

Ben Courchia MD (01:36.746)

I think the PDA specifically and the hemodynamics really provide something from the resource standpoint that we haven't had until now, which is you could echo a PDA every 12 hours if you wanted to, just to get a sense of how things are evolving in the context of other clinical evolution. Which is quite interesting specifically as interventions are being titrated up or down; it's very difficult to get the cardiology team to come and echo repeatedly, so hemodynamics, just the added data points alone add so much to the clinical picture.

Zubin Shah MD (02:13.442)

You know, it seems like the emerging theme between yesterday and today is specific patient-directed evaluation. We were talking about gene therapies yesterday. We were talking about using rapid whole genome sequencing to figure out what's going on with your specific patient. And now today we're using another form of evaluation.

Ben Courchia MD (02:38.292)

And what is not being said in general, not just at this conference, is that as we are talking about our relationship with families, it is what will build back the trust between the medical community and families. When parents actually see you thinking about their baby and say, "Well, the textbook says one thing, but I'm thinking about your baby's physiology. I'm thinking about your baby's risk factors." They will follow you to the ends of the earth because you have shown that you are not just putting their child in a bucket and saying, "Your baby fits this mold and here's the package that we're going to do." We'll say, "Hey, I'm actively thinking about what information your baby is giving me and how we're reacting to that." I found that is usually the best catalyst for trust between clinicians and families.

Zubin Shah MD (03:25.89)

Yeah, I wonder how we can teach that sort of language. We're really good with evidence-based medicine, communicating with each other, using "This was a large randomized control trial," where we talk about numbers and generalizability. But at the same time, when we sit with an individual family, can you teach the scripts and even framing to be like, "I'm thinking about, just as you said, your baby and your situation."

Daphna Yasova Barbeau MD (03:54.278)

But you know, I think you just did it. I think medicine has this idea that the patients won't get it. But I think plenty of our patients' families would get it if we just sat and said some of these things to them.

Ben Courchia MD (04:06.99)

Specifically now with AI. Back in the day, I used to think about it in terms of assuming this mother, this father, these parents are going to go online right now and Google something. What are they going to find? And I put myself in their shoes.

Daphna Yasova Barbeau MD (04:20.514)

You could literally do it. You could find what they're going to...

Ben Courchia MD (04:22.51)

It will be broken down to their level of education. Let's say you have somebody who's an attorney who has no medical knowledge whatsoever. AI will do it for that person. So even more reason to, like you said, go from the general and then get to the specific thing. Here's how we think about babies in general, but here's something specific about your baby.

Zubin Shah MD (05:11.15)

An example from my experience just recently, it's nirsevimab, right? We've been giving it to a lot of babies and it's recommended for RSV, especially in the climate...

Ben Courchia MD (05:22.37)

The passive immunity for RSV. You should know, but I'm just doing it...

Zubin Shah MD (05:31.478)

In the climate right now surrounding vaccines and stuff, you could go one route to try to explain how it's not an active immune response, what the vaccine is, and all that sort of stuff. But I found that I've created this script where I'm like, "Hey, Johnny has had a pretty rough respiratory course." And all of it frames around the specific patient. "This is why I think it's important as Johnny leaves the NICU that we set him up for success," rather than focusing on, "Yes, it's recommended now for everybody," but rather what makes it special.

Ben Courchia MD (06:07.754)

Absolutely. And if anybody is listening...

Zubin Shah MD (06:10.38)

Using that baby's own name and "for your baby," that sort of stuff helps.

Ben Courchia MD (06:16.492)

I've been on a journey to try to not use the word vaccine for nirsevimab, for flu, for COVID. Because I tell parents, "There are certain diseases where when you get vaccinated, you will not get it. But RSV, COVID, flu—you could still catch the flu if you have the flu vaccine, but obviously you're trying to mitigate risk." So I say, "These are risk attenuators. You could still catch RSV." You have severe illness, that's what we're trying to prevent. And I think that this has helped. I'm wondering if...

Daphna Yasova Barbeau MD (06:52.398)

The nuances of the conversation I think are important.

Zubin Shah MD (06:55.171)

Yeah.

Ben Courchia MD (06:55.468)

Because again, when we talk about, "Hey, if you're vaccinated against polio, you're not going to catch polio." Just not. It's not like you're going to get a milder form; no, you're just not going to catch it. But with the flu and everything, it's like, "Well, I got the flu vaccine and I got sick as shit." And it's like, "Okay, but that's why maybe the term vaccine is not good for these specific ones where we're trying to attenuate risk instead of immunizing the person completely."

Daphna Yasova Barbeau MD (07:17.454)

Well, I mean, to your point, we have a relationship with these families. Sometimes over months. We had a family recently, a very preterm baby, who needs to do some travel. They're like, "We'll just do it later." And I was like, "But look at all the work that you've put into your baby, that your baby has done. This is the cherry on top. We've just got to get everybody home safely." We don't even have herd immunity anymore, so babies are more at risk than ever. And I found that explaining that this is their baby's specific scenario has been very valuable.

And earlier today we were talking about this concept of risk-benefit. I think a big argument is, "Are there risks to medications?" Yeah, there's a risk to everything we do, but we have to balance that with the risk of not doing it. And that's for some of our babies like a slam dunk. The parents say, "Well, I don't want a setback that'll keep us here five more days." I say, "Can I tell you that your baby won't have an event after we give a vaccine? No, I'm not going to tell you that; they may have an event after we give the vaccine. But the event of not giving the vaccine is coming back sick, hospitalized for a totally new admission." And then the parents say, "Okay." Because not doing something is still a risk, still a decision. So framing it that way has helped me. But it's an important discussion. We know that you're going to want to catch some of the next things out there. They're calling us to get to the next session. But you've got an interesting new role in recruitment of physicians. I like the way you described your new role, saying that regardless of how physicians have to make a decision about where they're going to practice, who they're going to practice with, it's nice for them to speak to other physicians who are doing it.

Zubin Shah MD (09:30.882)

Yeah, absolutely. And we've kind of moved away from that model historically. Pediatrix is launching a clinical ambassadors program.

Daphna Yasova Barbeau MD (09:43.342)

So you're a clinical ambassador. Thus, it's been launched.

Zubin Shah MD (09:46.574)

Yes, I'm a clinical ambassador to the country. I have the fancy cars with the flag. You go to a lot of booths, and not just Pediatrix, but any large group or any hospital, and often you'll meet recruiters who know a lot about what job opportunities are available, what the general structure is like. But some of the day-to-day, what does clinical practice look like?

Daphna Yasova Barbeau MD (10:15.598)

Yeah, there's no way they know that.

Zubin Shah MD (10:16.354)

What does the schedule look like, or all those details which are so important not just for fellows, but even if someone is shifting from one position to another, they actually maybe know a lot more questions to ask, and some of the tough questions that might be hard for a recruiter. And so this way we're working together with the recruiting team and also physicians who can speak to it. The team is built up of people like me who might be early career, mid-career, or later career who could speak to a whole...

Ben Courchia MD (10:45.716)

Well established, you said they call them... The old ones.

Zubin Shah MD (10:47.893)

Yeah, well established.

Daphna Yasova Barbeau MD (10:50.67)

We don't call them that. We'll be there soon enough. But it's funny because just now the community is saying peer mentorship is so important for parents in the NICU. Well, peer mentorship is just as important for physicians, right? To say, "What do I want my life to look like? What will my practice look like?" And neonatology is so cool because there are so many different types of practices.

Ben Courchia MD (11:18.752)

You're relatively new in this role, have you had a chance already to speak to a prospective neonatologist?

Zubin Shah MD (11:24.192)

There's actually nine fellows here at NEO and I've met personally with four of them so far.

Daphna Yasova Barbeau MD (11:36.056)

What are they asking?

Zubin Shah MD (11:37.416)

It's funny. You were just sharing that video from the Amy Poehler podcast about what's money. And the next generation thinks very similarly. They're not like, "Hey, what's the compensation?" They're asking, "What is the time that I could have to pursue some of the interests beyond the bedside clinical practice?" And what I think I get to speak to that maybe the classical recruitment team may have not gotten to is the breadth of what a private practice could look like. I think we've been fed this dichotomous model of there's academic practice and then private practice. But really it's more of a spectrum. For example, in my own group that I'm a part of, we do a lot of epidemiology work with the Clinical Data Warehouse. Kashif Ahmad does a lot of clinical trial work. Robert Ursprung at the Fort Worth group does a lot of quality and QI work. And there's just so much variation you could get in your job. And that's what I want to showcase to fellows. Lauren Ruoss is a part of a Pediatrix group, but they do a lot of POCUS, not just doing it, but even educating about it. So I just want to show fellows that, honestly, if you're really passionate about it, you could carve into it for sure.

Ben Courchia MD (13:10.606)

Sure. And I think that this is what is transpiring in neonatology. But I think it's every aspect of the workforce. I've been reading some Harvard Business Review articles and podcasts. I think the new generations want to find a job that will provide some form of meaning. And I think saying, "Hey, am I just going to be doing routine clinical care or is there something a little bit bigger that I can potentially aspire to?" I feel like the way I look at it, it's kind of like a TV series these days; each patient is its own episode, but what is the arc of all these patients? What is going to give myself something to actually delve into? And I think that this is going to be a priority for whoever is trying to recruit anybody in neonatology. And it's going to be harder because, as we've spoken on the podcast before, we have fewer people coming through the pipeline. A medical student was asking me about that. I was like, "You will have a job."

Daphna Yasova Barbeau MD (14:07.954)

Yeah, well, and that's the truth. People will have their pick of jobs, new trainees that are entering the workforce. And I think it's really cool. For a while there, medicine was very much a calling, right? The art of medicine. I think because of our system, we've had to deviate from that a little bit. And I think people are finally saying, "This is important to me. I don't want to practice medicine without understanding my patients or moving the science forward." And I think that's really exciting. I think that we'll be better able to serve our patients as a community. Very cool. So thanks for sharing that with us.

Zubin Shah MD (14:50.742)

Yeah, so if anyone's interested, I hope people can reach out to you guys or get in touch with me.

Ben Courchia MD (15:00.334)

Yeah, absolutely. I have notably moved away from Twitter for some time. It's not been working out for me on that platform. But LinkedIn, I think you are on LinkedIn. And I think that for this particular purpose, it's a great way to connect with you.

Zubin Shah MD (15:16.622)

There's a story I tell about how I even got my first job. And I agree, I've moved away from X. Back when we were really active there, a lot of corporate America used LinkedIn so robustly. I'm just starting to learn how to set up your LinkedIn. But on X, we were just having discussions.

Ben Courchia MD (15:44.042)

Shooting the breeze.

Zubin Shah MD (15:45.486)

And as a fellow, I kept reading a lot of these papers coming out of the Pediatrix Clinical Data Warehouse. And I kept seeing Viral Tolia's name. And so I was like, "Who is this guy? Where does he work?" Before then I actually didn't know. Under the authors, it lists their affiliations, and I thought, "Wait a second. I thought that's a private group. How's that happening?" And it just sparked this curiosity that I DMed Viral and said, "Hey, I just want to know how you got to the position you're at." And he said, "I'm on call tonight, here's my number, maybe tomorrow when I'm post-call we can have a chat." Long story short, we had a conversation about how his career arc went and he's like, "Do you want to come down here to Dallas and interview?" That's how I got my job, and I saved screenshots of it as an example to tell other fellows, like, "Shoot your shot." Don't be afraid to DM someone or even at a conference like this, just walk up to people. We're the type of people in our field that are very approachable and love talking about what we do.

Ben Courchia MD (16:57.656)

You're making a good point. I think this paradigm of saying, "To look for my job, I will have to reach out to a recruiter who will then put me in touch with some people who will then give me an interview..."

Daphna Yasova Barbeau MD (17:08.599)

Yeah, I'm not gonna lie, yay!

Zubin Shah MD (17:10.389)

And like these boxes, I think...

Daphna Yasova Barbeau MD (17:12.589)

I mean, but that was true even not just with private practice, even certain academic institutions, you were going through their HR department. It felt very clinical.

Zubin Shah MD (17:25.854)

A cover letter and CV. But that wasn't the first step. That was like a format. This was how it actually kicked off.

Ben Courchia MD (17:37.964)

To get into the house you could go through the front door or go through the window.

Zubin Shah MD (17:41.582)

Wave through the window. Don't break into anyone's house, but feel free.

Daphna Yasova Barbeau MD (17:45.566)

Now it feels like you're being invited in for coffee as opposed to like you're trick-or-treating, you know? Finding a job is exhausting. And you want to say, "I want to commit my life theoretically to this team." You got to know a little bit about it.

Ben Courchia MD (18:04.494)

Also highlighting what was brought up yesterday, which is that when you're looking for a job, beyond the name of the institution or the employer, it's the people, right? If you find the right people, you're in good shape. That's how I found my first job. I met with the group that I ended up working with and I thought, "These are nice guys. These are people that I want to work with and learn from."

Daphna Yasova Barbeau MD (18:26.562)

We ended up at the same group. I felt they would support us, and they did. That was really important for me. I asked for a second look to go back to where we started, and that solidified that it was the right place. They were like, "Sure, come hang out." So I love that. And the last thing I wanted to highlight is you're right. We've moved away as a community from social media and there was a lot of positive stuff happening there. Networking, clinical cases, discussing evidence.

Ben Courchia MD (19:02.498)

That's why I left Twitter as well. I felt like on Twitter we were able to create this little fenced area. It was very healthy, and I felt like somebody broke the fence and things started coming through that were unhealthy. LinkedIn, I think, is a lot more professional, so I feel like it's a lot more contained, but it is like an ocean. It feels much bigger, but maybe more alternatives in the future, we'll see.

Daphna Yasova Barbeau MD (19:07.138)

Community, for sure.

Daphna Yasova Barbeau MD (19:31.039)

We're working on it. So that's a good point.

Ben Courchia MD (19:32.942)

Thank you so much for dropping in.

Zubin Shah MD (19:36.536)

Thanks for having me. Look forward to catching up more. Sounds good.

Daphna Yasova Barbeau MD (19:41.304)

Thanks.