April 11, 2024 • 22 mins
Today we rewind back to one of our most popular episodes on DocWorking: The Whole Physician Podcast.
“Your life becomes fused to what we do and it’s very hard, especially for physicians or healthcare workers, to say, ‘Well, you know, I’ve done this all my life and maybe that’s not what I need to do now.’” -Simon Maltais MD Ph.D.
In this episode, Dr. Jen Barna has a very honest conversation about burnout and recovery with Cardiac Surgeon and author of the book, Healthcare Anonymous: Put Yourself First to Avoid Anxiety, Addiction, and Burnout, Dr. Simon Maltais. You would be hard pressed to find someone more driven or accomplished in his field than Dr. Maltais. At the top of his game and publishing a new article nearly every two weeks, Dr. Maltais realized that he was experiencing burnout. Dr. Maltais shares his story of taking a step back, considering leaving medicine, changing his definition of success, and ultimately creating a hybrid way to continue the work that he loves while making more time for himself and his family. Tune in to hear an honest and candid story of burnout and recovery and hear what Dr. Maltais believes is the future of medicine.
For more information about Healthcare Anonymous: Put Yourself First to Avoid Anxiety, Addiction, and Burnout and offerings, please go here.
Dr. Simon Maltais is an active cardiac surgeon in the United States. He is French Canadian and board-certified in Canada in cardiac surgery. He is an internationally recognized leader in the field of heart transplantation, mechanical heart devices, and alternative cardiac interventions. Before 40, Maltais had led two world-renowned programs in his specialty and has pioneered numerous novel approaches for advanced cardiac surgery interventions. At the age of 35, he was among the youngest promoted associate professors at a nationally recognized institution. He is a frequent keynote speaker, has published more than 160 articles and has contributed to numerous books. As he worked in two different countries and health systems, Maltais has a unique perspective on the delivery of care and its inherent challenges for healthcare workers.
Dr. Simon Maltais earned his Medical Degree from Sherbrooke University, his Master’s Degree in Physiology from Sherbrooke University, completed his Adult Cardiac Surgery Residency at Montreal Heart Institute, Montreal University. He completed two fellowships, one at Buffalo University and the second, a fellowship in Heart Transplant and Mechanical Support at Mayo Clinic School of Medicine. He obtained his Doctoral Degree in Biomedical Sciences (Ph.D.) at Montreal Heart Institute, Montreal University. He currently works at HCA Healthcare in California.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Announcer (00:04):
Welcome to Doc working the whole physician podcast, helping physicians achieve
the best in life and medicine.
We hope you enjoy today's episode.
Dr. Simon Maltais (00:15):
Your life becomes fused to what we do and it's very hard, especially for
physicians or healthcare workers, to say,well, you know, I've done us all my life and
maybe that's not what I need to do now.
Dr. Jen Barna (00:31):
Welcome to Doc working the whole Physician podcast.
I'm Doctor Jen Varna and I'm here today withDoctor Simon Malte.
I'm very excited to have you as a guest todayon the podcast, Doctor Malte, because as a
world renowned cardiac surgeon originally fromCanada, but also you've worked at the Mayo
Clinic as a vice chair and you've publishedover 160 articles.
(00:55):
So extremely well known and well published inyour field, you have made a transition over
into advocating for healthcare workers fortheir mental and physical health and to
advocate for prevention of healthcare workerdepression, burnout and anxiety.
Welcome to Doc working the whole physicianpodcast.
Dr. Simon Maltais (01:16):
Thank you so much.
I appreciate the invitation.
Dr. Jen Barna (01:19):
I'm so excited to have this conversation with you because of the important
work that you're doing now and to hear aboutwhat caused you to make this pivot.
Dr. Simon Maltais (01:30):
Absolutely.
Well, it's certainly been an interesting two
years, so to speak, you know, for the reasonsthat we know about.
And I was at the point in my career where, youknow, I went through professional and personal
challenges myself.
And it started to be a journal for me, you
know, and I started to get up in the morningor write at night, you know, what was wrong,
(01:51):
what went well.
And as I started to get better, I started to
make things better.
I started to speak up about it.
And that means connected with my colleagues,friends.
And I was realizing that a lot of people weregoing through the same things.
And so it became sort of a slow calling whereit became pretty clear to me that I need to
(02:12):
write and write about mental illness andhealthcare workers.
And then I went on and it was completely whatI usually do, but did a coaching, health and
life coaching training.
And then through all this, I started to write
the book every morning.
And it came together over the last, let's say
18 months.
Dr. Jen Barna (02:30):
So your upcoming book, Healthcare Anonymous, learn how to put
yourself first while pursuing a calling, iscoming out this spring, is that correct?
Dr. Simon Maltais (02:39):
That's right.
So it's now available in preorder on all the
usual suspects and it will be available April5 is when it's coming out.
Dr. Jen Barna (02:48):
Fantastic.
So would you mind telling us a little bit
about your personal journey?You mentioned that you went through some
difficult times.
And I know as a physician, sometimes it's
difficult to talk about that.
Dr. Simon Maltais (03:00):
Yeah, I'm absolutely willing to do that.
And it's part of the process.
Right.
The book is going through some of that aswell.
I was reading recently the book from MatthewMcConaughey, but I had a lot of green lights
in my life.
You know, I went through school pretty easy.
Med school was easy.
Went to the hardest possible specialty I could
get in, was very successful at it.
(03:21):
Graduated very quickly to be an associate
professor before 40, vice chair of departmentsand world leading institutions.
But then slowly, you know, things were chippedaway.
Whether it was personal or professionally.
I had less and less time for myself, for my
family, for my son.
I thought I could keep it all together as we
all think.
(03:41):
And then gradually, you know, it started to
affect my professional career, my decisions,my ability to work.
Of course, you know, being 50, 60 poundsheavier makes it harder to go through your
days every day and started to have a bit lessof empathy for people I care for.
These are sort of early sign of burnout, andall of a sudden really had this moment where
(04:01):
something needed to change and change sort ofquickly.
I wouldn't say overnight because that's sortof cliche, but I decided to make a transition
and let go and start saying no and thenleaving a lot of my responsibilities and
things I had to do, not clinically, butprofessionally.
I used to travel 50,000 air miles a year formeetings, for presentations, for publications.
(04:25):
I always had something to do.
And then I was president of the International
Society of Heart Lung Transplant.
Just decided to stop.
And it was hard, you know, to realize that theprofession that had brought you so much and
that is bringing you so much still is slowlydestroying you in some ways.
And then to me, for others, it will bedifferent.
(04:46):
And we talk about this in the book, for me,was realizing, and that's what we go and
describe in the book, that I've had developedhealthcare disease.
And that's sort of a weird thing to saybecause in some ways, the system that heals
you is making in some ways also people thatwork into it sick.
And for me, it was to realize that themechanism I have developed, the models I've
(05:08):
had over the years, my personality traits, thethings I acquired over the last 15 years were
slowly impacting all aspects of my life.
You know, from one day to the other, I started
to peel off.
I took almost six months off in Thailand by
myself, sold everything after changingprofession and then start over.
(05:28):
And the book is sort of this story about thelast sort of three to five years.
But mostly, you know, what I went throughpersonally and putting it all together and,
like, what I see as maybe a process that a lotof us, and I'm talking about physicians, but
healthcare workers and healthcare workforce,go through at some point in our career.
And I was also very tired to see other peoplegoing through things and not knowing where to
(05:51):
go, whether it's burnout, whether it's evenclinical manifestation of stress and anxiety.
I've had colleagues that unfortunately passedaway from that, I think so, yeah.
And so it became a necessity for me to justact upon it.
And in the book, it's fairly easy, sort ofdescribed as a disease, where I see the event,
(06:13):
whether it's burnout or anxiety or depressionor any other of those sort of addiction
development, alcoholism are the end result ofsomething more chronic.
And that we acquire.
It's hard for us to rewire brain to sort of
see things differently, and we feel like weneed to continue.
And then in the middle of the book, we havealmost 20 healthcare workers that have been
(06:36):
nice enough to share their story.
We separate them in four different classes.
And then towards the last part of the book, wegive steps for potential recovery.
And what helped me throughout the process.
Dr. Jen Barna (06:47):
So how long would you say the process was that you were feeling the symptoms
of burnout, which you describe before youactually sort of woke up and realized, this is
something I have to address.
How long would you say that process was, in
retrospect, right?
Dr. Simon Maltais (07:05):
Retrospectively, it was probably a longer process than I actually
think it is, but it hadn't been going quiteright for, I'd say a couple years.
I was still, you know, for lack of betterterm, at the top of my game, meaning I was
doing, you know, 400 surgeries a year.
I was on every single committee.
I was publishing a paper every two weeks.
Had a lot of accolades.
(07:25):
But then there are other places in my lifewhere sometimes I made a wrong decision
personally.
Sometimes I would make decisions regardless of
my family.
That wasn't perfect.
Retrospectively wasn't the right one.
And then sometimes with patients, too, I would
have devastating consequences of surgery.
Sometimes you have complications and things,
and it used to really be a moment for me tointrospect, to write down what happened, to
(07:49):
look at the steps and try to make it better.
But it became a bit this job that always part
of it.
A patient was sick.
And so looking back, I think the symptoms of aproblem were there before.
And it's hard to explain how it sort of cametogether, but I would say that it's like I was
looking at myself from the outside in, and atsome point I realized that I was the one in
(08:11):
the highway sort of driving the wrong way.
Right.
And then for people like me, because in someways, what I do is heart surgery, it takes a
fair amount of confidence and ego.
I mean, it's not a secret.
Heart surgeons are egos that are sort of hardto deal with usually, but mine was pretty big.
And the parts that have helped me get to whereI am, the ego is sort of a cash 22 thing,
(08:34):
where the parts that help you oftentimes willhave an impact on other things in a non so
positive way.
You know, the competition, the self criticism.
So those things gradually sort of took a lotof place when I said, well, if all these
things are happening and they got me wrong,they're happening to other people.
But, you know, the common denominator is me,you know, and that was sort of the realization
(08:55):
at some point that I needed to refocus.
I needed to look at the values.
I needed to take a pause to reassess what Iwas doing and how I was doing it.
Dr. Jen Barna (09:04):
I want to take a moment, as you pointed out, to thank our families, by the
way, who do make huge sacrifices that often gounrecognized, you know, as we try to be
everything we can be at work, we do often takea back burner.
All of this, especially with someone who's soincredibly driven.
And I can't imagine how you managed toaccomplish as much as you have.
(09:30):
But I'm wondering whether this process has hadyou redefine the meaning of success in any
way.
Dr. Simon Maltais (09:38):
Yeah, and that's a very good comment and question.
I think the success part is not only redefinedthrough that because you were talking about
family, and I think thats critical.
And when you face those challenges, the system
is pretty good about pointing it out.
When youre sort of at the point of burnout or
theres a problem with a patient or youreaddicted to something, theres a system in
(10:00):
place in the system to help you.
Now, its just a moment in time where a lot of
it is to check boxes from an HR perspectiveand make it better.
If you really want to truly make a change,there's got to be a question.
You need to ask yourself whether you're in theright field and you're in the right space and
whether this lifestyle is appropriate for you.
(10:21):
And you're right.
When you do all these things, your lifebecomes fused to what we do.
And it's very hard especially for physiciansor healthcare workers to say, well, you know,
I've done us all my life and maybe that's notwhat I need to do now.
And that part is hard, not only justconceptually to say I'm going to do something
different, but also personally.
Right?
You studied all these years.
(10:41):
Your mom will be disappointed, your friends
will look at you, you have this second degreegratification from society about work, about
things.
He's a doctor.
Why do we want to do something different?And so for me, redefining success was
important, what it meant for me.
And that changes over time, right?
And realizing that maybe now the success is,you know, having a good day with my son, going
to Universal studio with him, and thentomorrow will be the maybe feel better about
(11:06):
my health and overall maybe treating acomplicated patient and so not always defining
success with the amount of cases you do, theamount of papers you published and then
realizing that that's okay.
Now looking back, you know, I loved what I do
and I still do and I still publish.
Not as much, but I still do.
(11:26):
But I do it differently.
I do it because I invest in it.
I just don't do it to put my name on somethingor haven't, you know, pubmed my name and have
the most papers out of, you know, people thatwere in my medical school, you know,
promotion.
So doing it from more of a better sort of
insight than before.
But yeah, success is an important one and it's
a changing concept for a lot of us.
(11:47):
And I feel like realizing that is the first
step to perhaps making it better.
And for some people it will be to leave it
completely.
Dr. Jen Barna (11:56):
So that's a good point as well.
I think a lot of us tend to think in black and
white.
So it's like you're either all in and
publishing in your case to the greatest extentthat you possibly can personally in your case,
which is at a phenomenal level and you'redoing an incredible number of surgeries.
And so when you stepped back and made thesechanges and took some time off, when you came
(12:21):
back, did you find a place in betweencompletely leaving medicine and working all
the time or did you leave medicine altogether?How did you find the right balance?
Dr. Simon Maltais (12:33):
Right. When I took a step back, day was filled with time.
You know, it was amazing.
You know, it went from, I was in between jobs.
So I said, I'm going to take a break operatingand take an extended period of time before I
start a new one.
So I had this possibility and I went, as I
said, different country in Thailand, you know,for a period of time and you know, let go all
(12:55):
the emails and the responsibilities and sosuddenly you face with yourself a lot and then
we talk of about this in the book.
And there's only really three ways to avoid
having a disease in general, right.
It's to change your exposure to it, right?
Say I'm leaving and I'm not getting exposed tothis bug or this bacteria or this melure.
It's to remove yourself from it, right.
(13:16):
To say I'm going to change myself or develop a
certain way to immune system or some, youknow, therapy to make it better or I'm going
to change my interaction with it.
It's the conditions that are in it.
And so for me, while initially it was that Iwent to these meetings in Chicago, I remember
physicians that want to move away frommedicine and fair enough, there was like 500
people looking to do something different.
(13:37):
Im going to open a coffee shop, you know, im
going to travel around the world and make itlike a humanitarian type situation.
I think the best solution for me out of thosethree was to find a way to interact better
with the system.
And so answer your question.
When I came back, I establish a series ofbalances that for me were way to, we talk
(13:59):
about this in the last portion of the book,virus scan myself and a lot of ways, you know,
the books called Healthcare Anonymous.
I know there's a step within the alcoholic
anonymous recovery that talks about how to,you know, check yourself and then make sure
that when you feel tired, when you feelhungry, when you feel like you have a craving,
you know, you have a problem and you're takingon too much.
(14:20):
And so I try to be alert on every day and Itake moments during the day that are always
the same ones.
Usually it's after my first surgery, I'll, you
know, eat out and they'll take a moment for memyself.
No meeting, no discussion about the next case.
Now I'll try to assess why I'm at in my day.
Am I tired?Am I sort of stressed?
Am I thinking about something else?And usually that's a good, if I'm at peace and
(14:42):
I'm happy what I did and I feel it's a goodday.
Usually it's because I'm in check.
Now if I feel like I'm missing time, I got to
call this, I got to do this.
I'm running between cases.
That's because I failed the vera scan test,you know, and that means then letting go
things, maybe doing more meditation, maybetaking a time off, maybe reducing my caseload
(15:02):
and so I've learned on a daily basis to tryto, and it's a learning process to try to do
that.
I try to meditate a little bit.
My wife's trying to get me into that more, butI try to meditate and, and do breath work,
which has been helpful.
You know, if you also bring people to be
around you as a community, and that's notbeing, like, a guru type person, but, like, if
(15:24):
you inspire this environment around you, ithelps you keep yourself in check.
Right.
So I encourage some of the nurses to speak up.
I try to be nice, and being a heart surgeonand being nice is sort of this antagonistic
sentence, but I tried to do that and work hardto do that, and that's helped me to sort of
keep myself in check.
So I went back.
(15:44):
I practice now this as much.
I still do sort of high end surgeries, but I
do it in a more of a Simon controlled way.
Dr. Jen Barna (15:53):
That's an excellent solution.
And all really good advice.
It actually reminds me when you talk aboutgoing to that conference where physicians were
all there and someone had to open a coffeeshop and someone to leave and travel the
world, it reminds me, I don't know if you eversaw this show years ago called mad about you,
but I remember when I was a medical student, Iused to watch it.
The main characters in the show had a friendwho was a cardiologist, and he quit his job
(16:15):
and went to work in a coffee shop as a waiteror in a restaurant.
Restaurant as a waiter.
As a medical student, I remember watching that
and thinking, that is so ridiculous.
No doctor would ever do that.
And now, of course, I can completelyunderstand why someone would want to do that
and maybe step away and remove that immenseresponsibility, you know?
Dr. Simon Maltais (16:35):
Absolutely.
You know, when you get to this point where
your identity is challenged, where all you'velearned is you're afraid of talking about it
because you feel being judged.
You know, we had so much conversations with
one of my friend who was going through similarprocess to say, why don't we just open a
coffee shop and then just be our own bosses?But the reality is, if you don't treat the
problem right, you're going to carry it towhatever you're going to accomplish.
(16:59):
And it's hard because we talk about charactertraits in the book, how we develop our
character traits, you know, and basicallybetween 15 and 30 years old.
And after that, everything's pretty muchfixed.
Well, while we're in medicine or training,that's where we're on call.
We are at the hospital all the time.
We learn how to, you know, react a certain
way.
We have to having the maturity to do it.
And so I wonder sometimes, and I wonder at themoment, whether some part of medicine would
(17:24):
have been a better fit for my skills.
You know, it would have been recognized
before.
Maybe heart surgery wasn't the right choice,
you know, for my personality.
Maybe I would have done something different
that would potentially be more fulfilling, youknow, or avoid being in this sort of process
at 40, some years old, you know, and that'spart of education.
Maybe some education we need to bring early onin training and in the hospital system.
Dr. Jen Barna (17:47):
Well, another thing that comes to mind, listening to your story that I have
to commend you for is the financial ability tostep away at the time when you needed to.
And that's something else that I feel reallypassionate about, is just helping physicians
to educate themselves about how they can putthemselves in a position to be financially
(18:07):
free or to be financially independent so thatthey can get into a safety zone where if they
ever need to walk away for any reason or tostep back and work less that they have that
option.
And I think for a lot of physicians, of
course, we have the debt problem in the UnitedStates, you know, especially early in our
(18:28):
careers, which can make us feel likeindentured servants.
But I think if people do take the steps to getthemselves into a secure position, it's not
necessarily, you know, what you mightultimately be aiming for, but just to aim for
a number that gets you into a place ofsecurity where you could live frugally if you
need to.
(18:48):
That, I think, gives a lot of peace of mind.
And so even if you don't walk away at all, butyou then have the peace of mind to feel like
you're in control gives you a little bit more,I think, power to come back around to maybe
help fix some things in your own world or inthe system that might be broken, as opposed to
feeling overwhelmed by those things or to beat the table, I guess, with some potential
(19:10):
solutions.
Dr. Simon Maltais (19:12):
Yeah. And I think to be at the table and to surround yourself with like
minded people, not that it's a bad thing to beon, and people that just work, work.
And I have friends that are certainly stuck inthis sort of mindset still, but I think doing
it in what you described is doing it more of ahybrid sort of way, where you sort of start
identifying values and things you like to dooutside of work and maybe how you can turn
(19:33):
this into a business.
For me now, it's become being a book author
now perhaps spreading a word out.
And then we are also launching our coaching
business.
So for high performing people.
So healthcare clients being a part of that, sowe have professional athletes and musicians
and business people that are within the same.
(19:54):
I mean all the themes are common, right?
It's like the dedication to your work, it'sthe family, it's the values.
And so we're starting sort of a conventionaland functional medicine helped program for
this group of people.
And it's finding a way to sort of make
yourself or changing a bit your identity frombeing just someone that goes to work from
Monday to Friday and on call every four andthat's okay.
(20:16):
And I think medicine in general, I was justreading this Harvard Business review on
hybrid, you know, with COVID A lot of peoplehave gone home and do this hybrid sort of work
now.
Now while telemedicine has been forced, I
think a lot of on healthcare, I think a lot ofplaces for right or wrong reasons are trying
to move away from it now that COVID is gettinga little better, I think that's the future.
(20:38):
A lot of enterprises and Google tech companieshave realized that.
And I think it would also increase thesatisfaction and family values if physicians
or healthcare workers would have this abilityto leverage and be more efficient at work, you
know, and leverage some of the technology.
And I don't need to see patients at my office,
(20:59):
83 year old and he's a percutaneous valve andthey have to travel or 3 hours with their
family.
Honestly, I could see all their tests and talk
with them for 45 minutes and see them the dayof and it would probably solve a lot of the
sort of this back and forth and efficiencies.
I can go from having a coffee with my wife and
having a consultation, going back, playingwith my son and have the same sort of work
done.
(21:20):
But healthcare is a bit slow to adopt some of
that stuff.
And I hope that some places will get me
proactive to sort of leverage some of thatmindset to help people move away from just
being at work with a white coat, you know,from Monday to Friday and then every four
calls, you know.
Dr. Jen Barna (21:38):
Thank you so much doctor Simon Malte.
Wonderful points of wisdom, terrific adviceand I'm excited to read your book.
Healthcare anonymous.
Learn how to put yourself first while pursuing
a calling coming out in April.
But you can pre order the book now and we'll
put a link in the show notes.
Dr. Simon Maltais (21:55):
We have a website where people can go and look at the book and some of
the people that have read it before therelease, and Doctor Friss, which is one of the
leaders of Tennessee, has read the book and issupportive, so we're pretty thankful to have
that kind of support.
Dr. Jen Barna (22:10):
I can't wait to check it out and look forward to talking with you again.
Announcer (22:19):
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We hope you enjoy today's episode.
Dr. Simon Maltais (00:15):
Your life becomes fused to what we do and it's very hard, especially for
physicians or healthcare workers, to say,well, you know, I've done us all my life and
maybe that's not what I need to do now.
Dr. Jen Barna (00:31):
Welcome to Doc working the whole Physician podcast.
I'm Doctor Jen Varna and I'm here today withDoctor Simon Malte.
I'm very excited to have you as a guest todayon the podcast, Doctor Malte, because as a
world renowned cardiac surgeon originally fromCanada, but also you've worked at the Mayo
Clinic as a vice chair and you've publishedover 160 articles.
(00:55):
So extremely well known and well published inyour field, you have made a transition over
into advocating for healthcare workers fortheir mental and physical health and to
advocate for prevention of healthcare workerdepression, burnout and anxiety.
Welcome to Doc working the whole physicianpodcast.
Dr. Simon Maltais (01:16):
Thank you so much.
I appreciate the invitation.
Dr. Jen Barna (01:19):
I'm so excited to have this conversation with you because of the important
work that you're doing now and to hear aboutwhat caused you to make this pivot.
Dr. Simon Maltais (01:30):
Absolutely.
Well, it's certainly been an interesting two
years, so to speak, you know, for the reasonsthat we know about.
And I was at the point in my career where, youknow, I went through professional and personal
challenges myself.
And it started to be a journal for me, you
know, and I started to get up in the morningor write at night, you know, what was wrong,
(01:51):
what went well.
And as I started to get better, I started to
make things better.
I started to speak up about it.
And that means connected with my colleagues,friends.
And I was realizing that a lot of people weregoing through the same things.
And so it became sort of a slow calling whereit became pretty clear to me that I need to
(02:12):
write and write about mental illness andhealthcare workers.
And then I went on and it was completely whatI usually do, but did a coaching, health and
life coaching training.
And then through all this, I started to write
the book every morning.
And it came together over the last, let's say
18 months.
Dr. Jen Barna (02:30):
So your upcoming book, Healthcare Anonymous, learn how to put
yourself first while pursuing a calling, iscoming out this spring, is that correct?
Dr. Simon Maltais (02:39):
That's right.
So it's now available in preorder on all the
usual suspects and it will be available April5 is when it's coming out.
Dr. Jen Barna (02:48):
Fantastic.
So would you mind telling us a little bit
about your personal journey?You mentioned that you went through some
difficult times.
And I know as a physician, sometimes it's
difficult to talk about that.
Dr. Simon Maltais (03:00):
Yeah, I'm absolutely willing to do that.
And it's part of the process.
Right.
The book is going through some of that aswell.
I was reading recently the book from MatthewMcConaughey, but I had a lot of green lights
in my life.
You know, I went through school pretty easy.
Med school was easy.
Went to the hardest possible specialty I could
get in, was very successful at it.
(03:21):
Graduated very quickly to be an associate
professor before 40, vice chair of departmentsand world leading institutions.
But then slowly, you know, things were chippedaway.
Whether it was personal or professionally.
I had less and less time for myself, for my
family, for my son.
I thought I could keep it all together as we
all think.
(03:41):
And then gradually, you know, it started to
affect my professional career, my decisions,my ability to work.
Of course, you know, being 50, 60 poundsheavier makes it harder to go through your
days every day and started to have a bit lessof empathy for people I care for.
These are sort of early sign of burnout, andall of a sudden really had this moment where
(04:01):
something needed to change and change sort ofquickly.
I wouldn't say overnight because that's sortof cliche, but I decided to make a transition
and let go and start saying no and thenleaving a lot of my responsibilities and
things I had to do, not clinically, butprofessionally.
I used to travel 50,000 air miles a year formeetings, for presentations, for publications.
(04:25):
I always had something to do.
And then I was president of the International
Society of Heart Lung Transplant.
Just decided to stop.
And it was hard, you know, to realize that theprofession that had brought you so much and
that is bringing you so much still is slowlydestroying you in some ways.
And then to me, for others, it will bedifferent.
(04:46):
And we talk about this in the book, for me,was realizing, and that's what we go and
describe in the book, that I've had developedhealthcare disease.
And that's sort of a weird thing to saybecause in some ways, the system that heals
you is making in some ways also people thatwork into it sick.
And for me, it was to realize that themechanism I have developed, the models I've
(05:08):
had over the years, my personality traits, thethings I acquired over the last 15 years were
slowly impacting all aspects of my life.
You know, from one day to the other, I started
to peel off.
I took almost six months off in Thailand by
myself, sold everything after changingprofession and then start over.
(05:28):
And the book is sort of this story about thelast sort of three to five years.
But mostly, you know, what I went throughpersonally and putting it all together and,
like, what I see as maybe a process that a lotof us, and I'm talking about physicians, but
healthcare workers and healthcare workforce,go through at some point in our career.
And I was also very tired to see other peoplegoing through things and not knowing where to
(05:51):
go, whether it's burnout, whether it's evenclinical manifestation of stress and anxiety.
I've had colleagues that unfortunately passedaway from that, I think so, yeah.
And so it became a necessity for me to justact upon it.
And in the book, it's fairly easy, sort ofdescribed as a disease, where I see the event,
(06:13):
whether it's burnout or anxiety or depressionor any other of those sort of addiction
development, alcoholism are the end result ofsomething more chronic.
And that we acquire.
It's hard for us to rewire brain to sort of
see things differently, and we feel like weneed to continue.
And then in the middle of the book, we havealmost 20 healthcare workers that have been
(06:36):
nice enough to share their story.
We separate them in four different classes.
And then towards the last part of the book, wegive steps for potential recovery.
And what helped me throughout the process.
Dr. Jen Barna (06:47):
So how long would you say the process was that you were feeling the symptoms
of burnout, which you describe before youactually sort of woke up and realized, this is
something I have to address.
How long would you say that process was, in
retrospect, right?
Dr. Simon Maltais (07:05):
Retrospectively, it was probably a longer process than I actually
think it is, but it hadn't been going quiteright for, I'd say a couple years.
I was still, you know, for lack of betterterm, at the top of my game, meaning I was
doing, you know, 400 surgeries a year.
I was on every single committee.
I was publishing a paper every two weeks.
Had a lot of accolades.
(07:25):
But then there are other places in my lifewhere sometimes I made a wrong decision
personally.
Sometimes I would make decisions regardless of
my family.
That wasn't perfect.
Retrospectively wasn't the right one.
And then sometimes with patients, too, I would
have devastating consequences of surgery.
Sometimes you have complications and things,
and it used to really be a moment for me tointrospect, to write down what happened, to
(07:49):
look at the steps and try to make it better.
But it became a bit this job that always part
of it.
A patient was sick.
And so looking back, I think the symptoms of aproblem were there before.
And it's hard to explain how it sort of cametogether, but I would say that it's like I was
looking at myself from the outside in, and atsome point I realized that I was the one in
(08:11):
the highway sort of driving the wrong way.
Right.
And then for people like me, because in someways, what I do is heart surgery, it takes a
fair amount of confidence and ego.
I mean, it's not a secret.
Heart surgeons are egos that are sort of hardto deal with usually, but mine was pretty big.
And the parts that have helped me get to whereI am, the ego is sort of a cash 22 thing,
(08:34):
where the parts that help you oftentimes willhave an impact on other things in a non so
positive way.
You know, the competition, the self criticism.
So those things gradually sort of took a lotof place when I said, well, if all these
things are happening and they got me wrong,they're happening to other people.
But, you know, the common denominator is me,you know, and that was sort of the realization
(08:55):
at some point that I needed to refocus.
I needed to look at the values.
I needed to take a pause to reassess what Iwas doing and how I was doing it.
Dr. Jen Barna (09:04):
I want to take a moment, as you pointed out, to thank our families, by the
way, who do make huge sacrifices that often gounrecognized, you know, as we try to be
everything we can be at work, we do often takea back burner.
All of this, especially with someone who's soincredibly driven.
And I can't imagine how you managed toaccomplish as much as you have.
(09:30):
But I'm wondering whether this process has hadyou redefine the meaning of success in any
way.
Dr. Simon Maltais (09:38):
Yeah, and that's a very good comment and question.
I think the success part is not only redefinedthrough that because you were talking about
family, and I think thats critical.
And when you face those challenges, the system
is pretty good about pointing it out.
When youre sort of at the point of burnout or
theres a problem with a patient or youreaddicted to something, theres a system in
(10:00):
place in the system to help you.
Now, its just a moment in time where a lot of
it is to check boxes from an HR perspectiveand make it better.
If you really want to truly make a change,there's got to be a question.
You need to ask yourself whether you're in theright field and you're in the right space and
whether this lifestyle is appropriate for you.
(10:21):
And you're right.
When you do all these things, your lifebecomes fused to what we do.
And it's very hard especially for physiciansor healthcare workers to say, well, you know,
I've done us all my life and maybe that's notwhat I need to do now.
And that part is hard, not only justconceptually to say I'm going to do something
different, but also personally.
Right?
You studied all these years.
(10:41):
Your mom will be disappointed, your friends
will look at you, you have this second degreegratification from society about work, about
things.
He's a doctor.
Why do we want to do something different?And so for me, redefining success was
important, what it meant for me.
And that changes over time, right?
And realizing that maybe now the success is,you know, having a good day with my son, going
to Universal studio with him, and thentomorrow will be the maybe feel better about
(11:06):
my health and overall maybe treating acomplicated patient and so not always defining
success with the amount of cases you do, theamount of papers you published and then
realizing that that's okay.
Now looking back, you know, I loved what I do
and I still do and I still publish.
Not as much, but I still do.
(11:26):
But I do it differently.
I do it because I invest in it.
I just don't do it to put my name on somethingor haven't, you know, pubmed my name and have
the most papers out of, you know, people thatwere in my medical school, you know,
promotion.
So doing it from more of a better sort of
insight than before.
But yeah, success is an important one and it's
a changing concept for a lot of us.
(11:47):
And I feel like realizing that is the first
step to perhaps making it better.
And for some people it will be to leave it
completely.
Dr. Jen Barna (11:56):
So that's a good point as well.
I think a lot of us tend to think in black and
white.
So it's like you're either all in and
publishing in your case to the greatest extentthat you possibly can personally in your case,
which is at a phenomenal level and you'redoing an incredible number of surgeries.
And so when you stepped back and made thesechanges and took some time off, when you came
(12:21):
back, did you find a place in betweencompletely leaving medicine and working all
the time or did you leave medicine altogether?How did you find the right balance?
Dr. Simon Maltais (12:33):
Right. When I took a step back, day was filled with time.
You know, it was amazing.
You know, it went from, I was in between jobs.
So I said, I'm going to take a break operatingand take an extended period of time before I
start a new one.
So I had this possibility and I went, as I
said, different country in Thailand, you know,for a period of time and you know, let go all
(12:55):
the emails and the responsibilities and sosuddenly you face with yourself a lot and then
we talk of about this in the book.
And there's only really three ways to avoid
having a disease in general, right.
It's to change your exposure to it, right?
Say I'm leaving and I'm not getting exposed tothis bug or this bacteria or this melure.
It's to remove yourself from it, right.
(13:16):
To say I'm going to change myself or develop a
certain way to immune system or some, youknow, therapy to make it better or I'm going
to change my interaction with it.
It's the conditions that are in it.
And so for me, while initially it was that Iwent to these meetings in Chicago, I remember
physicians that want to move away frommedicine and fair enough, there was like 500
people looking to do something different.
(13:37):
Im going to open a coffee shop, you know, im
going to travel around the world and make itlike a humanitarian type situation.
I think the best solution for me out of thosethree was to find a way to interact better
with the system.
And so answer your question.
When I came back, I establish a series ofbalances that for me were way to, we talk
(13:59):
about this in the last portion of the book,virus scan myself and a lot of ways, you know,
the books called Healthcare Anonymous.
I know there's a step within the alcoholic
anonymous recovery that talks about how to,you know, check yourself and then make sure
that when you feel tired, when you feelhungry, when you feel like you have a craving,
you know, you have a problem and you're takingon too much.
(14:20):
And so I try to be alert on every day and Itake moments during the day that are always
the same ones.
Usually it's after my first surgery, I'll, you
know, eat out and they'll take a moment for memyself.
No meeting, no discussion about the next case.
Now I'll try to assess why I'm at in my day.
Am I tired?Am I sort of stressed?
Am I thinking about something else?And usually that's a good, if I'm at peace and
(14:42):
I'm happy what I did and I feel it's a goodday.
Usually it's because I'm in check.
Now if I feel like I'm missing time, I got to
call this, I got to do this.
I'm running between cases.
That's because I failed the vera scan test,you know, and that means then letting go
things, maybe doing more meditation, maybetaking a time off, maybe reducing my caseload
(15:02):
and so I've learned on a daily basis to tryto, and it's a learning process to try to do
that.
I try to meditate a little bit.
My wife's trying to get me into that more, butI try to meditate and, and do breath work,
which has been helpful.
You know, if you also bring people to be
around you as a community, and that's notbeing, like, a guru type person, but, like, if
(15:24):
you inspire this environment around you, ithelps you keep yourself in check.
Right.
So I encourage some of the nurses to speak up.
I try to be nice, and being a heart surgeonand being nice is sort of this antagonistic
sentence, but I tried to do that and work hardto do that, and that's helped me to sort of
keep myself in check.
So I went back.
(15:44):
I practice now this as much.
I still do sort of high end surgeries, but I
do it in a more of a Simon controlled way.
Dr. Jen Barna (15:53):
That's an excellent solution.
And all really good advice.
It actually reminds me when you talk aboutgoing to that conference where physicians were
all there and someone had to open a coffeeshop and someone to leave and travel the
world, it reminds me, I don't know if you eversaw this show years ago called mad about you,
but I remember when I was a medical student, Iused to watch it.
The main characters in the show had a friendwho was a cardiologist, and he quit his job
(16:15):
and went to work in a coffee shop as a waiteror in a restaurant.
Restaurant as a waiter.
As a medical student, I remember watching that
and thinking, that is so ridiculous.
No doctor would ever do that.
And now, of course, I can completelyunderstand why someone would want to do that
and maybe step away and remove that immenseresponsibility, you know?
Dr. Simon Maltais (16:35):
Absolutely.
You know, when you get to this point where
your identity is challenged, where all you'velearned is you're afraid of talking about it
because you feel being judged.
You know, we had so much conversations with
one of my friend who was going through similarprocess to say, why don't we just open a
coffee shop and then just be our own bosses?But the reality is, if you don't treat the
problem right, you're going to carry it towhatever you're going to accomplish.
(16:59):
And it's hard because we talk about charactertraits in the book, how we develop our
character traits, you know, and basicallybetween 15 and 30 years old.
And after that, everything's pretty muchfixed.
Well, while we're in medicine or training,that's where we're on call.
We are at the hospital all the time.
We learn how to, you know, react a certain
way.
We have to having the maturity to do it.
And so I wonder sometimes, and I wonder at themoment, whether some part of medicine would
(17:24):
have been a better fit for my skills.
You know, it would have been recognized
before.
Maybe heart surgery wasn't the right choice,
you know, for my personality.
Maybe I would have done something different
that would potentially be more fulfilling, youknow, or avoid being in this sort of process
at 40, some years old, you know, and that'spart of education.
Maybe some education we need to bring early onin training and in the hospital system.
Dr. Jen Barna (17:47):
Well, another thing that comes to mind, listening to your story that I have
to commend you for is the financial ability tostep away at the time when you needed to.
And that's something else that I feel reallypassionate about, is just helping physicians
to educate themselves about how they can putthemselves in a position to be financially
(18:07):
free or to be financially independent so thatthey can get into a safety zone where if they
ever need to walk away for any reason or tostep back and work less that they have that
option.
And I think for a lot of physicians, of
course, we have the debt problem in the UnitedStates, you know, especially early in our
(18:28):
careers, which can make us feel likeindentured servants.
But I think if people do take the steps to getthemselves into a secure position, it's not
necessarily, you know, what you mightultimately be aiming for, but just to aim for
a number that gets you into a place ofsecurity where you could live frugally if you
need to.
(18:48):
That, I think, gives a lot of peace of mind.
And so even if you don't walk away at all, butyou then have the peace of mind to feel like
you're in control gives you a little bit more,I think, power to come back around to maybe
help fix some things in your own world or inthe system that might be broken, as opposed to
feeling overwhelmed by those things or to beat the table, I guess, with some potential
(19:10):
solutions.
Dr. Simon Maltais (19:12):
Yeah. And I think to be at the table and to surround yourself with like
minded people, not that it's a bad thing to beon, and people that just work, work.
And I have friends that are certainly stuck inthis sort of mindset still, but I think doing
it in what you described is doing it more of ahybrid sort of way, where you sort of start
identifying values and things you like to dooutside of work and maybe how you can turn
(19:33):
this into a business.
For me now, it's become being a book author
now perhaps spreading a word out.
And then we are also launching our coaching
business.
So for high performing people.
So healthcare clients being a part of that, sowe have professional athletes and musicians
and business people that are within the same.
(19:54):
I mean all the themes are common, right?
It's like the dedication to your work, it'sthe family, it's the values.
And so we're starting sort of a conventionaland functional medicine helped program for
this group of people.
And it's finding a way to sort of make
yourself or changing a bit your identity frombeing just someone that goes to work from
Monday to Friday and on call every four andthat's okay.
(20:16):
And I think medicine in general, I was justreading this Harvard Business review on
hybrid, you know, with COVID A lot of peoplehave gone home and do this hybrid sort of work
now.
Now while telemedicine has been forced, I
think a lot of on healthcare, I think a lot ofplaces for right or wrong reasons are trying
to move away from it now that COVID is gettinga little better, I think that's the future.
(20:38):
A lot of enterprises and Google tech companieshave realized that.
And I think it would also increase thesatisfaction and family values if physicians
or healthcare workers would have this abilityto leverage and be more efficient at work, you
know, and leverage some of the technology.
And I don't need to see patients at my office,
(20:59):
83 year old and he's a percutaneous valve andthey have to travel or 3 hours with their
family.
Honestly, I could see all their tests and talk
with them for 45 minutes and see them the dayof and it would probably solve a lot of the
sort of this back and forth and efficiencies.
I can go from having a coffee with my wife and
having a consultation, going back, playingwith my son and have the same sort of work
done.
(21:20):
But healthcare is a bit slow to adopt some of
that stuff.
And I hope that some places will get me
proactive to sort of leverage some of thatmindset to help people move away from just
being at work with a white coat, you know,from Monday to Friday and then every four
calls, you know.
Dr. Jen Barna (21:38):
Thank you so much doctor Simon Malte.
Wonderful points of wisdom, terrific adviceand I'm excited to read your book.
Healthcare anonymous.
Learn how to put yourself first while pursuing
a calling coming out in April.
But you can pre order the book now and we'll
put a link in the show notes.
Dr. Simon Maltais (21:55):
We have a website where people can go and look at the book and some of
the people that have read it before therelease, and Doctor Friss, which is one of the
leaders of Tennessee, has read the book and issupportive, so we're pretty thankful to have
that kind of support.
Dr. Jen Barna (22:10):
I can't wait to check it out and look forward to talking with you again.
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