June 6, 2024 • 41 mins
In this episode of the TMA Practice Well podcast, recorded live at TexMed 2024, Dr. Toi Harris moderates an insightful panel discussion on fostering relationships for improved physician well-being. Joined by esteemed panelists Joshua Baker, Dr. Lane Aiena, and Dr. Cheryl Hurd, the conversation delves into the significance of both professional and personal relationships in enhancing health and happiness.
Discover strategies for maintaining meaningful connections despite the challenges of a demanding medical career. Learn from real-life experiences shared by the panelists, including the vital role of mentorship and the impact of strong personal bonds.
The episode also explores the importance of empathy, active listening, and effective communication in supporting colleagues through difficult times. Audience questions and reflections further enrich the discussion, providing practical tips for integrating well-being into everyday practice.
Don't miss this opportunity to gain valuable insights and actionable advice to foster relationships that contribute to your overall well-being. Claim your CME credits for this episode by following the link in the description.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:04):
Thank you for listening to TMA's Practice Well podcast. TMA,
helping you improve the health of all Texans.
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(00:25):
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(00:47):
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(01:08):
construed as establishing medical standards of care for the purposes of litigation,
including expert testimony.
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Music.
(01:40):
Hi, I'm Cheryl Krhoviak. I produce the TMA Practice Well Podcast,
and I'm the director of the TMA Education Center, where physicians can find
CME and training for thriving practice.
This episode was recorded at TexMed 2024.
TexMed is TMA's largest annual meeting where physicians can attend CME talks
across various specialties, all geared toward educating on newest best practices
(02:04):
and empowering the physicians of Texas.
Dr. Toi Harris moderates this interactive panel discussion between the panelists
and a live audience about fostering relationships.
My name is Dr. Toi Harris, and as the chair of the Physician Health and Wellness
Committee, it's my pleasure to welcome you to our session about relationships.
(02:25):
If you're not familiar with the committee, we are solely about improving the
health and the lifestyles of physicians, medical students, and residents in Texas.
We do that through advocacy, support, education, and liaison.
We also provide recommendations to the council on legislation.
(02:46):
Our objectives today, we're going to look at the impact of personal relationships.
And when we say relationships, we mean everything from friendships to romantic
relationships to professional relationships on well-being.
Strategies to really enhance our relationships, as well as to look at differences
(03:08):
that we might see across the physician life cycle.
I'm joined by my esteemed panelists. And as I said, my name is Dr.
Toi Harris. I am an SVP and Chief Equity, Diversity, and Inclusion Officer,
as well as a child and adolescent psychiatrist at the Memorial Hermann Health System.
And I will pass it on to Joshua Baker to give his introductions.
(03:29):
Hi, y'all. My name is Joshua Baker. I'm a graduating medical student from the
Texas College of Osteopathic Medicine, aspiring radiologist,
and unfortunately, moving for residency next year out of the state,
but hope to come back to Texas in the future.
Thank you, Joshua. And Dr. Aiena? Hi, my name is Dr. Lane Aiena.
I'm a family medicine physician in Huntsville, Texas, married father of four.
(03:51):
I've got a little radio show that I do once a week there called Thursday Morning
House Call and a podcast called Doctor of the Future.
I am currently in my seventh year as an attending.
So I'm a young physician for about 20 more minutes. And as soon as that's over,
I'm just a regular old doctor. Okay. Dr. Hurd.
My name is Cheryl Hurd, and I'm actually a later mid-career physician.
(04:12):
So I'm still in the middle of
my career, but I'm going to be a late career physician another five years.
But anyway, I am 34 years married next month. I have two adult children, three fur babies.
I'm bringing all this up because, of course, we're talking about well-being.
I am a practicing psychiatrist in Fort Worth, and I'm also a professor and academic
coach at the Burnett School of Medicine at TCU.
(04:32):
Thank you, Dr. Hurd. I'm similar as well. OK, so we definitely want to hear
from everyone with your perspectives.
Before we share and really start with the panelists, we wanted to set the stage
talking about a longitudinal study that was started in 1938 with sophomore males at Harvard.
Now, of note, President Kennedy was one of the sophomores in that class,
(04:57):
and the study is still going on.
It has expanded to all genders and to include others that don't attend Harvard.
But one of the things that they wanted to really find out is learn insights
into what it takes to live a healthy and happy life. And so from that, Dr.
Waldinger, a psychiatrist at Mass General, is connected with the study and Joy says.
(05:24):
Was really joy and having personal satisfaction in your relationships was really
one of the hallmarks to living a healthy and happy life.
So his quote, loneliness kills is as powerful as smoking or alcoholism.
In that same study, they found that relationship satisfaction at age 50 was
(05:46):
predictive of health at age 80.
Other studies have gone on to validate, you know, the importance of relationships
and what loneliness and isolation can do for your health and well-being.
A study of physicians found that about 70 percent of physicians felt that they
did not have adequate time to maintain healthy relationships.
(06:09):
So that is definitely going to be a focal point of our discussion here today.
Day, not only, you know, what are the strategies or how relationships have supported
our well-being, but what are some of those tips to help keep us on track,
given the fact that so many of us struggle to do so?
So at this point, I'm going to turn to the panel. The first question that I
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have is, at this point in your career path, can each of you describe the role
professional relationships are playing in your own personal health and wellness?
Alrighty, I think I'll just take it away as someone at the start of their career in medicine.
And as a medical student, I feel like the professional relationships definitely
embody more of like my side, like a mentee role when physicians serve as great mentors.
(06:55):
I feel like medicine's like training for a marathon, you know,
if you trade too hard, you get chin splints.
And so I found in my professional relationships that, yes, the scientific questions and medical questions.
I need those to pass my boards. But also when physicians share about their family
or, you know, different things related to wellness and how they've been able
(07:16):
to balance their life and their practice, that's exceptionally helpful.
And so professionally, it's definitely for me, definitely more of a mentee role. Sure.
Sure. And I can kind of segue from that and that I'm in a fun part of my career.
I have been very fortunate to have a great mentor, a guy named Dr.
Wells. He worked at my clinic and he has been every bit of the doctor I've wanted
(07:38):
to become and it's really taken me under his wing.
But I'm also at a point in my career where I can become a mentor for other people.
Key Rose in the crowd, he's a resident locally and I've been trying to mentor him as best I can.
And we've got a new young physician in our clinic. And I remember being there
just, you know, seven short years ago.
So I have found it comforting.
Dr. Wells just retired, unfortunately. So kind of kicked the baby bird out of
(08:00):
the nest here. But I find it comforting to have a mentor like Dr.
Wells there that I could go to and talk to, not just with medical questions,
but during COVID, for example, when it just felt like everything was against
us and we weren't going to make it just to sit down and talk to someone with
the wisdom to know what to do and that we could get through it.
But but then the the fulfillment that comes with being a mentor is really,
(08:22):
really so good for the soul and something I recommend.
If you've got somebody that's younger and looking up to you and you've got that
opportunity, man, it's not a whole lot of extra time, but it sure does make your day feel full.
And it helps you to help more people through them.
So fun part of my career that I get to kind of see both ends of that book.
Would y'all believe that I'm still a mentee? I actually am.
(08:43):
My current senior vice president of my clinical practice, Dr.
Deborah Atkinson, some of you may know, is still continuing to promote and advocate
for me and get me involved and voluntold.
And I have been a mentor for the majority of my career since I basically moved
back to the DFW area and originally joined the county hospital in Tarrant County
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and then later joined the medical school,
medical students and residents both.
It has been almost my passion to mentor, not just to precept and to teach,
but to truly mentor, help them in their careers, help them network with people.
And while I am a psychiatrist, my heart and soul is getting young,
(09:29):
budding physicians into the discipline they want to be in.
And so that's my latest is being a mentor to medical students as their coach
at TCU and helping them find their fulfillment in what they do.
So as far as professional relationships, I've run the gamut and I still run the gamut.
(09:49):
And it's just been very enriching in my life, not just my professional life,
but just in my life and my satisfaction.
Thank you. So anyone in the audience want to add to that, just in terms of the
role that professional relationships have played,
you know, for your own health and well-being or how you have helped to impact others.
(10:09):
Hello. So when I was in pediatrics residency, I remember, you know,
it was very challenging in my first year because everything's an adjustment.
It's all new. You're out of medical school and suddenly you're making decisions
that are going to be a little bit more important.
And I think one of the things that I really benefited from a lot during my first
and second year was having not only a professional, like, you know, faculty mentor,
(10:31):
but also an informal kind of like senior resident mentor who I actually basically
sought out for, you know, not just advice about patients, But just in general,
like life's advice and just it was just nice to talk to someone else who was just a year ahead of me.
And it was very helpful. I credit that person with really helping me feel like
I really enjoyed my residency after the first few months of feeling a little
(10:52):
bit like not really sure about whether or not I was in the right place.
Thank you. So that near peer mentorship. Very important. Yeah. Yeah.
OK, so let's now shift and talk about what are some of your tips to maintain
these professional relationships, even though they're challenges, time constraints?
If you could speak on that. Yeah, I think started off and then communication is important.
(11:14):
There are some challenges, at least from the mentee side. You know,
I think it's just helpful to give a little polite reminders,
you know, being a physician's busy. I'm not even fully there yet.
But from what I can see, it's super busy from the administrative side to taking care of patients.
And so just good communication, following up on that.
And then also, I think just for good communication, I think defining what the
(11:37):
purpose of it is, explaining how you want that to go about and making a plan
like those three steps. That's really helpful.
Sitting good check in points as well as my mentors and like,
hey, like, you know, I want to check in halfway through this rotation.
How am I doing? What's good? What's not?
Things like that. And just continuing to take responsibility for maintaining
that professional relationship from my end is very important.
(12:00):
I think you have to make it a priority. I think that all of us are very busy.
And I think it's really easy at the end of the day to go home.
But what I tried to do and what I was fortunate enough to have mentors do is
at the end of the day, swing in my office and say, how are you doing, kid?
And that's what I do for our new doctor, too. Now, it's almost a joke.
Now, I'm like, hey, are you in there sport?
And it's a funny way to do it. And it's a kind of an icebreaker way to do it.
(12:22):
But it's so easy to get caught up and go to work, treat patients, do paperwork, go home.
But those relationships at work can be so fulfilling and good for you,
both from the mentor side and the mentee side.
There are other things in our lives that we make time for and we prioritize.
And it didn't mean that I was going to go spend 30 minutes in Dr.
(12:44):
Wells's office. I have a family to prioritize as well.
But just swinging in to his office and saying, how was your day, man?
Can you believe what happened before lunch or you want to believe what one of
your patients said to me?
It really helped us quite a bit. And then like all important things in life,
you have to make it a priority to make time for it.
And when you make time for it, as neurotic as it sounds, schedule time for it.
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It really helps to foster those relationships and keep them healthy.
I would echo everything my fellow panelists said, but also kind of give a shout
out to things like this, because this is another way to connect.
Some of my mentors and mentees are here at TexMed and meet up with them while I'm here.
I mean, I'm in a hotel room by myself. My husband's at home watching the dogs.
(13:27):
So why not go have dinner with somebody who I'm helping in their career, who's helping me?
So, you know, networking and events like this is something I would add to that.
Also say as a clinician and busy and going home and after clinic,
I am still available to my mentees in the evening.
Luckily, my kids are long grown and out of the home and my husband has activities
(13:50):
that can keep him busy if a student reaches out and needs to chat with me for
15 minutes or so. So availability.
Thank you. So we're going to pause now and see if there are any other reflections
from the audience or questions for our panelists about professional relationships.
Hi. So my name is Nora Vasquez and I'm an internist. And when I first joined
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TMA, I remember like the first time coming to one of the conferences,
it was a little overwhelming as new to the group. And so I just remember feeling a little intimidated.
But having been a part of TMA over the years, this has become my home,
my community. and I've met so many wonderful people, so many,
developed so many great friendships.
(14:31):
And I think the one thing that really made the difference for me was,
I think in the beginning, I didn't feel like I belonged.
And it's a little mindset shift, but you can actually just decide that you belong.
And I think that can really help one make connection. You get to decide that
this is my home, my peers, I'm among friends and reach out to somebody and make a friend.
(14:53):
And since that, you know, I have lots of friends now, but I just want to acknowledge
for the introverts like me that were first new to TMA, it may feel a little
overwhelming, but give it time and just you get to decide you belong and get
to make those friendships.
Thank you so much for that, as well as calling out organizations are really
a pathway for professional relationship.
(15:15):
And so I'll ask the panelists, if you have anything you want to respond to that
in terms of TMA or other organizations that have helped you cultivate your professional relationships.
The first step is the hardest step, right? I mean, I think you hit the nail
on the head with, you know, especially if you're a more introverted person.
The first meeting is the hardest meeting. Obviously, we've all kind of gotten
past that. Here we are. Right. But I think that was very insightful.
(15:37):
The Texas Academy of Family Physicians is where I really cut my teeth,
if you will, for organized medicine. And it just was so intimidating to get started.
It's you don't know any of these people and you're going to leave your family
in your comfort zone. Go be around a bunch of people you've never seen before.
But turns out they all go to work five, six times a week, too.
And they have the same struggles you do.
And they just want to vent about it just like you do. And they want to try to
maybe one day make a difference. And organized medicine makes that difference.
(16:00):
So if you've got a colleague that you can reach to that was where we were initially
too scared to get started.
Don't reach out. Give them that hand. Pull them up. Get them out here.
I think we do a lot of good through organized medicine and not just on a bigger
level, but on a personal level.
It helps us recharge to see other people that are out there fighting the fight like we are.
I would echo that and also say that as a result of coming more often,
(16:21):
the first time I went to TMA meetings when I was a brand new grad,
moved back to Texas after training in Arizona.
And then I actually had someone to watch my kids and my fur babies.
And my husband came with me. So it wasn't completely long, but he didn't go
to any of the stuff with me. Right. And it was a little overwhelming.
And I'm an extrovert. So you can imagine.
But I did have an opportunity to start meeting people. And that grew into becoming
(16:44):
even more and more involved, getting involved on the PHW as a committee member,
then eventually as chair and now as a consultant because I rolled off.
But it also led to more and more opportunities even in leadership, which is as fulfilling.
It gives me an opportunity. I'm a member of the Council on Medical Education now.
And since medical education is one of my passions, I've just really been so
(17:06):
fortunate. But I wouldn't have been able to necessarily get that appointment
if I hadn't networked and got to know Gary Floyd before he became president of TMA.
So, yes, it has significantly helped me in some of my aspirations to help in
advocacy and policy development being in an organization like this.
(17:26):
It has also actually taken me out of my state comfort zone and pulled me into
the national arena because I'm also a delegate to the AMA at this point.
And again, if it weren't for some of the connections and my own mentors within
the TMA organization, I would have never been able to do that or felt comfortable doing it.
And currently now I'm an old pro at it. I get to be a chair of one of the ref comms in June.
(17:49):
So really, really, really excited and glad to be a part of organized medicine.
Yeah, and I would just kind of agree that TMA, there's a lot of stuff here.
My involvement, the TMA seems very supportive of medical students and young
physicians and residents.
And then there's lots of ways to get involved. This place definitely does feel
like home and everyone I've met has been really friendly.
And so I agree, like just, you know, coming and just being involved and saying
(18:13):
like, this is my place is great. And I've had a great, great experience in the TMA. So, yeah.
Yeah, I'm Steve Sargana, a pediatric neurologist here in Dallas at Scottish
Rite for Children. I'm also affiliated with UT Southwestern.
And regarding institutions, I mean, I like to pitch UT Southwestern because
they've got a wonderful wellness program.
(18:34):
They've instituted a coaching program where physicians can go and contact somebody
confidentially, fellow physician, and work with them regarding whatever comes
up, whatever strike for career management, that type of thing.
And then also there's a poster, it's called Lean on Me, and they talk about
(18:54):
the concept of second-person victimhood, which is like you've dealt with a difficult
patient situation, but you are the second victim.
So second-person victimhood, again, the concept that you as a practitioner,
a physician, have encountered some strife.
And same concept where somebody in the institution is supporting you and,
(19:16):
you know, again, confidentially. So the institutions, I mean,
maybe bring this back to your institutions.
I mean, some are probably small practitioners who may not have that,
but that whole concept of doing something with the institution to help physician wellness.
Thank you so much. So in addition to organized medicine, your institution can
(19:38):
also implement things to help you out professionally and for your well-being.
Okay. Anything else? All right. Right. So now we're going to shift to personal relationships.
We're shifting from the professional to the personal relationships.
And I'm going to start with you, Dr.
Hurd, if you want to comment on the role that they played in helping you with
(19:58):
your health and well-being.
Nothing like being married and pregnant during your first month of internship.
So let's just say one of the most helpful relationships in my entire life for
my well-being has been my marriage.
My husband is rock solid.
(20:20):
Now, having said that, no, it's not a perfect marriage and we bicker like an
old married couple. Like I said, 34 years married come June.
But without his support, his unwavering assistance with young children and just
managing changing much of the household during very critical times in my training.
Wouldn't be sitting here in front of you being so enthusiastic about being a
(20:40):
physician. I can tell you that.
So that intimate relationship of a partner is just so critical.
And I did help it while he's not practicing.
My husband is a physician. He did go through the same rigors of medical school
and early training a little bit ahead of me.
He decided early enough that that wasn't his cup of tea and stepped out,
(21:01):
but he was able to support me since I thought it was my cup of tea and it has been.
So that's been one absolutely just hands down necessary relationship in my life.
It's helped me stay sane, stay sober probably, and stay working as a psychiatrist,
having to deal with a lot of struggles of my patients.
But also friendships and parenting, that's important too.
(21:23):
Being able to take time to be a good parent, go to my daughter's senior show
or take some time off to go to my son's baseball game or something.
That is also very enriching and helped me move and stay focused and stay in
my career and stay available after hours.
Because it really isn't work-life balance. We all know that.
It's work-life integration and you do spend a lot more time at work.
(21:47):
But if you love your work, you're not trying to escape from your work.
So it is part of your life. So maybe that's where the balance comes in.
But friendships and maintaining friendships. I have I've lost some major contact
with co-residents and stuff. We moved away.
We basically still just send Christmas cards.
But I've got some new enriching friendships in my career, moving back to the
(22:09):
DFW area and making time, as we said, even for the professional relationships,
making time, scheduling time to go to dinner or have a weekend barbecue or something like that.
But for those friendships for me and my husband, both have also been just enormously
valuable in me maintaining my well-being.
Yeah, hard to add to that, right? I agree. To start with my marriage,
(22:32):
I've been married, it'll be 10 years and 28 days. It's our 10-year anniversary.
So we're really excited. I would not be here without the support of my wife. She's incredible.
She is kind. And she is so supportive of my hobby, which is organized medicine,
among my many other hobbies.
And the only reason I can do these things is because she's supportive and she's with the kids.
(22:53):
And what I've tried to do, think that we as physicians, to borrow a sports metaphor,
we leave it all on the field when we go to work.
We go to work, we smile, we talk about our families, they dominate our conversations,
we've got their pictures on the wall.
And we get home and we're the shell of a person. I'm tired, I'm cranky,
you look at me and say, I've talked all day, I don't want to talk.
I think it was important when, and COVID was when that really peaked,
(23:16):
when I recognized that I was sabotaging our relationship because I was giving
all of myself to my patients.
And I think that the realization of that and the carving out of time,
making it a priority to work on my marriage and doing little things like,
look, let's once we get the kids down and we get the chores done, we're hanging out.
You know, I'm not going to a different room where we're hanging out.
(23:38):
And just little things like that have really helped continue having a strong relationship.
I've got we've got four kids. We stay very busy. You can imagine I've got a
year and a half old twins, a five year old and a seven year old.
So the fact that I'm here tells you how strong of a woman my wife is for friendships.
You've got to schedule it. Like, no, I can't come in that weekend.
Last weekend, I had a crawfish boil and I had my friends over and I didn't answer my phone. And it was...
(23:59):
And I recommend everyone do the same. I'm still very close friends with my high school friends.
We carve out at least two weekends a year minimum that we all meet up and camp
and we hang out and we've got a Facebook chat group that we're active in all day.
We stay talking. And it's just it's when we go to the office, you're Dr.
So-and-so. But when you see your friends, you're Lane,
you know, and then the people that keep you grounded and keep you down to earth
(24:20):
and keep you happy and have those inside jokes.
And again, you've got to prioritize maintaining those relationships because
we've all had great friendships that we remember fondly, but we just let go.
So you've got to find the important ones and keep them going.
And you've got to prioritize the intimate relationships, so to speak,
as well, to make sure the romantic relationships keep going.
Wow. Both of those were great. I've been married for one and a half years, so relatively recent.
(24:43):
And I'd say after getting married, I've realized when people think their family
members, whenever they achieve some success, the role that they play,
now I can personally experience that and say that my wife has definitely been
my greatest supporter throughout med school.
School and just always there and supportive at home and whatnot.
So that's been really good. It does help that she wants to pursue a PhD.
(25:04):
And so she's in the sciences. And so she kind of understands what medicine is
like. That has been helpful.
You know, communication has been helpful and having time to spend with each
other and then kind of clarifying what our schedules looks like for sure.
And then friendships. Friendships are great. I think quality over quantity is
what's really important.
I also think it's good if you have a friendship or a group of friends.
(25:25):
If there's something external you're involved in that you consistently do, I think that's helpful.
So for me, it's through my church. I mean, it's nice that if I leave town for
a month and that group is still meeting every week that I can come back and
join that and pick off where I left, you know?
And so I think schedule and medicine is kind of hectic sometimes.
And so it's nice to always have a group that's meeting consistently and I can
(25:46):
always jump in and out of if needed for work or for school or whatever it is.
And so that's been really good as well.
Thank you. So I would also agree. My spouse of 28 years has been extremely supportive
of my career through rearing the children.
And then also at this phase that we're in is we have the privilege of being
the primary caregivers to both of my parents.
(26:07):
So that is also another dimension of relationships as well.
So it sounds like the three of you are doing really well in your relationships.
What advice would you give to someone who isn't? So if there are individuals
that are struggling in one of those dimensions of personal relationships,
(26:28):
what advice could you give?
They all looked at me, probably not because of my age, but because I'm a psychiatrist.
As we all know, communication is key and nobody can read anybody's mind,
not even a psychiatrist.
I'm a psychiatrist, not a psychic.
My husband and I stumbled a little bit in our marriage because of the lack of
(26:49):
communication. Luckily, we learned to do that. But it's kind of the same for your friends.
Things fester. Little slights become big ones if they're not addressed or discussed.
If your feelings are hurt, tell somebody. Don't brush it aside and then hold
a grudge against them. That's just detrimental to any relationship.
And when I say you, I mean the collective you.
So encourage that in your friends, too. If they're not as receptive,
(27:12):
if they're not reaching out as much, maybe say, hey, can I call?
Can we meet for a cup of coffee? Again, communication is the key when you're
struggling, whether it's an intimate partner, a friendship, a parental relationship,
being the child of adult parents, whatever it is, communication.
I have a question. Yes. I feel so sad because I have colleagues that are women
(27:35):
physicians, and they feel very, very stressed out. And I'm very lucky.
And I know that they may be undergoing a divorce.
And I don't know what to say because I'm not buddy with them I am a colleague
of them and they're not always you know in my circle they might have been someone who I mentored,
and I always struggle with the fact that did I did I support them enough I mean one of the awful
(28:01):
ones and is I know I don't want to break her confidentiality but she was a mentor
of mine I mean, I was her mentor. She was an NT.
And it took COVID and us going up to Ohio for an event to finally tell her,
I'm so sorry. I was a very terrible mentor.
And I'm so sorry. I was such a harsh upper level. And then she forgave me.
(28:24):
But then I still felt that I wasn't there for her when she was undergoing her divorce. course.
So do you have any, cause I get, I'm, I'm, I have another person that I know
that's also doing, I'm trying to be there for her. What would you recommend?
I think the fact that you took time to listen is important. I don't know that
they're expecting you to solve their problems if they're coming to you.
(28:46):
And I think when people come to us with bad news, we all very much stress out
about what am I going to say.
But at the end of the day, if I'm coming to you with bad news,
I think I just need you to listen.
And I think that's coming at it from that standpoint of they trust me.
What an honor that they're coming to me with this trust. I'm going to be there
for them. I'm going to take the time out of my day. I'm going to listen.
I'm going to be the one that supports them. I think that's the key thing right there.
(29:10):
That's true. But lots of times what happens is it's like, hi, how are you doing?
And they go, I'm fine. But then you're working with them and you know they're not fine.
Well, I think in times like that, it's important to find the right time to bring it up.
Obviously, if something like burnout is impacting patient care,
you need to prioritize time.
But when they just found out that the organization is pushing out another demand
(29:32):
of them, that's probably not a good time to ask, how's your marriage going?
But maybe during lunch or after work when things are calm. You know,
there's a big difference between an observation and an accusation, right?
Well, yeah, but I've tried that with a nursing staff and it blew up. So I don't do that.
I don't ask them. Sure. Is there any right now I've learned to stand there and
bear witness and just, you know, be as, you know, whatever that person wants to do.
(29:58):
Sure. But I was wondering if there's anything else besides that while you're
working with people like that, what would you recommend?
I'm a little self-conscious continuing to talk next to a psychiatrist,
and I'm afraid I'm going to speak out of turn.
I think that you nailed it when you said that listening is the most important part.
But like I was saying, between an observation and actualization,
if it's affecting them and you don't think they want to talk about it,
(30:22):
you can say, hey, I noticed that your charts aren't getting in on time like they used to.
I noticed that you're a little more flippant about patient complaints than you used to be.
Are you OK? What's going on? Be open about it. Be open. And if they say I'm
fine, then, OK, you tried.
Maybe revisit it. But that's a lot different than, hey, why aren't your charts getting done on time?
I think that how you approach it, using it as an observation,
coming from a place of caring that you want to support them will get them to open up.
(30:46):
And it's the right time. It's not in the middle of clinic. I think that's important.
I would also add, you know, the TMA, as well as other organizations, have lots of resources.
So, you know, just sort of bringing that up in terms of the TMA,
the Physician Health and Wellness Committee. There are resources out there.
The gentleman spoke about what they have at UT Southwestern.
(31:10):
So I do think also pulling that in, as Dr.
Lane is saying, when the timing is right.
I would add one more thing, because there's a lot of times when people are stressed
and it's not necessarily impacting their ability to provide high quality patient care.
But you care for them as a colleague and also a friend. And it's okay to observe.
(31:33):
They say they're fine. You can say something along the lines of,
well, it doesn't seem so, but I just want to let you know I'm here when you need me.
And so kind of just lay out that general, I'm here, I'm available.
That's also very supportive.
So any other questions from the audience about anything that's been covered
(31:53):
or anything that hasn't related to relationships and physician health and well-being?
Oh, yes. Please come to the microphone.
So I guess my question to the psychiatrist on the panel, if you don't mind,
I think the last question was very profound because a lot of our colleagues go through divorces.
And, you know, some were close to, some were not close to. But maybe if you
(32:17):
can clarify the difference between empathy and sympathy and why empathy is so important.
And why is it that, you know, just being able to listen and share deep feelings
in itself is helpful, but feeling sorry for somebody is not?
That's actually an excellent question, and I appreciate you bringing that up.
(32:37):
One of the things I like to try and make it easy, so I tell medical students
something along these lines.
Empathy, and yes, it goes along with compassion. Empathy is that you can understand
that somebody is going through something that's really rough.
You can be there to support them and listen to them, but it doesn't really necessarily
bring you down with them so that you can be actually a little objective and
(33:00):
maybe a good sounding board for them.
When you have sympathy, you are experiencing every emotion they're also experiencing.
So it'll bring you down and you'll lose your objectivity and you may not be
as supportive as you think you are because you might feed into some of their
own mistaken beliefs or grudges they're holding or something and support them
in a way that's not healthy.
(33:22):
So that's kind of how I describe it to my medical students.
I hope that makes sense to the audience. I hope that answered your question
because, yes, feeling sorry for someone doesn't really help them.
But being willing to be a listening ear does.
So I'm going to ask, what advice or what guidance have you received that hasn't been helpful?
(33:43):
We know we've talked a lot about mentor-mentee relationships.
What has not been helpful for your well-being? I think that would be important
for us to explore that as well, as we're all trying to build our repertoire,
if you will, on how to be effectively supportive of colleagues.
Yeah, I've been pretty lucky to get good advice from all my mentors. That's a hard question.
(34:06):
But thinking on times where maybe I've received advice that was kind of not as helpful.
I think when it sometimes, you know, if it needs some direction,
it's maybe not super evident to someone that's new to the situation,
what you're referring to.
And sometimes advice that's too brief or too doesn't explain exactly what they're
trying to get across for someone that is new to a situation,
(34:28):
new to a problem, new to, you know, an area of medicine that can be quite difficult to interpret,
you know, and it can be interpreted differently by the person receiving it.
And so I think the mentors that take the take the time to ensure that whatever
they're trying to share with the mentee are, in my case, with me is being received the way they intend.
That's that's the most helpful. And so I don't have any specific bad ones to
(34:49):
share, but that would be my answer to that question.
I don't have a specific example, fortunately, but I do think it's important
that you pick your mentor correctly. I think that finding someone to look up
to and who you're going to model yourself after is critical.
And you have a feeling about if they're the doctor you want to become.
And then there's a lot of different styles out there and different practices.
(35:10):
I think that that is important. Unfortunately, with advice, sometimes it's too
late when you realize it was bad advice, right? It's, oh, I already did that and that was bad.
So I think it's important to pick the correct mentor when you see someone who
is showing, not telling, showing the style of practice that they do.
And it's a style of practice that you want to hear.
So things that have not helped my well-being
(35:31):
that have occurred in my many years of
training and practice well we need you to
do this no you're not going to get paid more yes
you're going to have to work more hours but it's for the good of the patient
it's for the good of the student it's for the good of the residents so kind
of continuously reinforcing that self-sacrificing without giving any thought
(35:51):
to the impact of having on the individual that's being told to And it was myself
and some of my most of our colleagues.
So that definitely was not helpful. And at some point, it was very valuable
when a different mentor told me, Cheryl, you got to learn how to say no.
In modern times, I'd say for half of my career, I was gaslit.
(36:14):
And if it weren't for my friends, family and well, just rock solid husband,
as I mentioned earlier, my well-being would have suffered. Right.
Thank you for that. So we certainly want to hear from you.
These are things that the TMA is currently doing. And I think we touched on
some of these, the Wellness First program.
If you're not familiar with this,
(36:35):
this is a free program where you can get counseling and crisis resources.
There's a suicide and crisis lifeline.
And then through our committee with the TMA, there are CME activities and programs.
But we want to hear what is missing on this list. What do you think would help
your colleagues, help you with relationships and well-being.
(36:58):
Dr. Harris, we nailed it. We got it all. Yeah, well, the TMA nailed it, right?
No, honestly, I mean, the TMA is very interested to know what additional resources are needed. Yes.
So I think this is a great start, but perhaps other things that aren't so crisis-focused
and maybe just like, you know, more like just general non-crisis addressing issues.
(37:23):
Like if we're working on relationships, it doesn't have to be,
you know, counseling and crisis resources and suicide and crisis lifeline.
It could literally just be, you know, more of an emphasis on,
not to call it preventive care, but you know what I mean.
Maybe everything is not a crisis. Sometimes you might just need,
you know, maybe some more mentoring stuff up there or other stuff that's not
(37:43):
so heavy and serious because people might not necessarily need that degree of
support, but they might still benefit from other things.
That's all. Thank you.
Dr. Harris, that brings to mind what one of our other gentlemen mentioned.
And yes, that's part of kind of what I do at TCU now, and that's coaching,
professional coaching. Good suggestion.
(38:04):
Absolutely. We will definitely take that back. Yes, sir. I have a question about,
I guess, the opening remarks regarding loneliness loneliness and how that is
a risk factor for health.
How can you determine when someone who, for example, is has gotten divorced
(38:24):
and maybe is not that interested in dating?
How can you tell when they are so comfortable with their solitude that they
aren't ever going to develop perhaps another close romantic relationship?
And is it something is that something that is possible to be and still be healthy?
(38:47):
That way? Or is it, are there signs that a person is leaning toward the unhealthy aspect of loneliness?
Well, thank you. That's an excellent question. It's also very complex.
One of the things that I think it's important that we all can wrap our minds
around is it's, we don't have to be in a romantic relationship to have healthy,
(39:12):
happy interactions with others.
Not being with an intimate partner does not mean we're lonely.
Yes, it means we may be alone in that aspect. That's where friendships come
in. That's where family relationships come in. That's where the things come in.
So when it's unhealthy is when somebody isolates all of their relationship.
If you see somebody who's gone through a divorce and then stays at home and
(39:35):
won't go to the usual monthly,
you know, coffee break on a Saturday to vent about patients or whatever it may
be that they had previously been doing, that might be a sign to start,
you know, being a little worried to reach out, check on them as your friend.
You know, if they're still engaging in a lot of their other other relationship
type activities, they may be perfectly fine.
(39:57):
They may be processing through what happened to them and just may take them a bit more time.
But not everyone needs to have a romantic relationship to be healthy.
OK, well, I think we are right at time. I want to thank our panelists again,
and certainly for the audience participation,
we will take back with us your reflections as well as your recommendations about
(40:18):
what else the TMA can do to help with our well-being. Thank you so much.
We hope you found this episode valuable and take away tips that you can use
to foster relationships that are beneficial to you, your colleagues,
and anyone important in your life.
To claim CME for this episode, just click the link in the episode description
and follow the instructions provided.
(40:40):
Remember to like and follow TMA Practice Well to receive every episode.
Until next time, stay well.
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Thank you for listening to TMA's Practice Well podcast. TMA,
helping you improve the health of all Texans.
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Did you know that you can claim CME credits for many of the TMA Practice Well
(00:25):
podcast episodes? just go to www.texmed.org forward slash CME to go.
That's www.texmed.org forward slash C-M-E-T-O-G-O to register for your episode
(00:47):
and follow the instructions to claim CME.
Please be advised that the information and opinions presented as part of this
program should not be used or referred to as primary legal sources and does
not replace the advice of your healthcare attorney,
nor should the information and opinions presented as part of this program be
(01:08):
construed as establishing medical standards of care for the purposes of litigation,
including expert testimony.
The standard of care is dependent upon the particular facts and circumstances
of each individual case, and no generalization can be made that would apply in all cases.
Music.
(01:40):
Hi, I'm Cheryl Krhoviak. I produce the TMA Practice Well Podcast,
and I'm the director of the TMA Education Center, where physicians can find
CME and training for thriving practice.
This episode was recorded at TexMed 2024.
TexMed is TMA's largest annual meeting where physicians can attend CME talks
across various specialties, all geared toward educating on newest best practices
(02:04):
and empowering the physicians of Texas.
Dr. Toi Harris moderates this interactive panel discussion between the panelists
and a live audience about fostering relationships.
My name is Dr. Toi Harris, and as the chair of the Physician Health and Wellness
Committee, it's my pleasure to welcome you to our session about relationships.
(02:25):
If you're not familiar with the committee, we are solely about improving the
health and the lifestyles of physicians, medical students, and residents in Texas.
We do that through advocacy, support, education, and liaison.
We also provide recommendations to the council on legislation.
(02:46):
Our objectives today, we're going to look at the impact of personal relationships.
And when we say relationships, we mean everything from friendships to romantic
relationships to professional relationships on well-being.
Strategies to really enhance our relationships, as well as to look at differences
(03:08):
that we might see across the physician life cycle.
I'm joined by my esteemed panelists. And as I said, my name is Dr.
Toi Harris. I am an SVP and Chief Equity, Diversity, and Inclusion Officer,
as well as a child and adolescent psychiatrist at the Memorial Hermann Health System.
And I will pass it on to Joshua Baker to give his introductions.
(03:29):
Hi, y'all. My name is Joshua Baker. I'm a graduating medical student from the
Texas College of Osteopathic Medicine, aspiring radiologist,
and unfortunately, moving for residency next year out of the state,
but hope to come back to Texas in the future.
Thank you, Joshua. And Dr. Aiena? Hi, my name is Dr. Lane Aiena.
I'm a family medicine physician in Huntsville, Texas, married father of four.
(03:51):
I've got a little radio show that I do once a week there called Thursday Morning
House Call and a podcast called Doctor of the Future.
I am currently in my seventh year as an attending.
So I'm a young physician for about 20 more minutes. And as soon as that's over,
I'm just a regular old doctor. Okay. Dr. Hurd.
My name is Cheryl Hurd, and I'm actually a later mid-career physician.
(04:12):
So I'm still in the middle of
my career, but I'm going to be a late career physician another five years.
But anyway, I am 34 years married next month. I have two adult children, three fur babies.
I'm bringing all this up because, of course, we're talking about well-being.
I am a practicing psychiatrist in Fort Worth, and I'm also a professor and academic
coach at the Burnett School of Medicine at TCU.
(04:32):
Thank you, Dr. Hurd. I'm similar as well. OK, so we definitely want to hear
from everyone with your perspectives.
Before we share and really start with the panelists, we wanted to set the stage
talking about a longitudinal study that was started in 1938 with sophomore males at Harvard.
Now, of note, President Kennedy was one of the sophomores in that class,
(04:57):
and the study is still going on.
It has expanded to all genders and to include others that don't attend Harvard.
But one of the things that they wanted to really find out is learn insights
into what it takes to live a healthy and happy life. And so from that, Dr.
Waldinger, a psychiatrist at Mass General, is connected with the study and Joy says.
(05:24):
Was really joy and having personal satisfaction in your relationships was really
one of the hallmarks to living a healthy and happy life.
So his quote, loneliness kills is as powerful as smoking or alcoholism.
In that same study, they found that relationship satisfaction at age 50 was
(05:46):
predictive of health at age 80.
Other studies have gone on to validate, you know, the importance of relationships
and what loneliness and isolation can do for your health and well-being.
A study of physicians found that about 70 percent of physicians felt that they
did not have adequate time to maintain healthy relationships.
(06:09):
So that is definitely going to be a focal point of our discussion here today.
Day, not only, you know, what are the strategies or how relationships have supported
our well-being, but what are some of those tips to help keep us on track,
given the fact that so many of us struggle to do so?
So at this point, I'm going to turn to the panel. The first question that I
(06:30):
have is, at this point in your career path, can each of you describe the role
professional relationships are playing in your own personal health and wellness?
Alrighty, I think I'll just take it away as someone at the start of their career in medicine.
And as a medical student, I feel like the professional relationships definitely
embody more of like my side, like a mentee role when physicians serve as great mentors.
(06:55):
I feel like medicine's like training for a marathon, you know,
if you trade too hard, you get chin splints.
And so I found in my professional relationships that, yes, the scientific questions and medical questions.
I need those to pass my boards. But also when physicians share about their family
or, you know, different things related to wellness and how they've been able
(07:16):
to balance their life and their practice, that's exceptionally helpful.
And so professionally, it's definitely for me, definitely more of a mentee role. Sure.
Sure. And I can kind of segue from that and that I'm in a fun part of my career.
I have been very fortunate to have a great mentor, a guy named Dr.
Wells. He worked at my clinic and he has been every bit of the doctor I've wanted
(07:38):
to become and it's really taken me under his wing.
But I'm also at a point in my career where I can become a mentor for other people.
Key Rose in the crowd, he's a resident locally and I've been trying to mentor him as best I can.
And we've got a new young physician in our clinic. And I remember being there
just, you know, seven short years ago.
So I have found it comforting.
Dr. Wells just retired, unfortunately. So kind of kicked the baby bird out of
(08:00):
the nest here. But I find it comforting to have a mentor like Dr.
Wells there that I could go to and talk to, not just with medical questions,
but during COVID, for example, when it just felt like everything was against
us and we weren't going to make it just to sit down and talk to someone with
the wisdom to know what to do and that we could get through it.
But but then the the fulfillment that comes with being a mentor is really,
(08:22):
really so good for the soul and something I recommend.
If you've got somebody that's younger and looking up to you and you've got that
opportunity, man, it's not a whole lot of extra time, but it sure does make your day feel full.
And it helps you to help more people through them.
So fun part of my career that I get to kind of see both ends of that book.
Would y'all believe that I'm still a mentee? I actually am.
(08:43):
My current senior vice president of my clinical practice, Dr.
Deborah Atkinson, some of you may know, is still continuing to promote and advocate
for me and get me involved and voluntold.
And I have been a mentor for the majority of my career since I basically moved
back to the DFW area and originally joined the county hospital in Tarrant County
(09:06):
and then later joined the medical school,
medical students and residents both.
It has been almost my passion to mentor, not just to precept and to teach,
but to truly mentor, help them in their careers, help them network with people.
And while I am a psychiatrist, my heart and soul is getting young,
(09:29):
budding physicians into the discipline they want to be in.
And so that's my latest is being a mentor to medical students as their coach
at TCU and helping them find their fulfillment in what they do.
So as far as professional relationships, I've run the gamut and I still run the gamut.
(09:49):
And it's just been very enriching in my life, not just my professional life,
but just in my life and my satisfaction.
Thank you. So anyone in the audience want to add to that, just in terms of the
role that professional relationships have played,
you know, for your own health and well-being or how you have helped to impact others.
(10:09):
Hello. So when I was in pediatrics residency, I remember, you know,
it was very challenging in my first year because everything's an adjustment.
It's all new. You're out of medical school and suddenly you're making decisions
that are going to be a little bit more important.
And I think one of the things that I really benefited from a lot during my first
and second year was having not only a professional, like, you know, faculty mentor,
(10:31):
but also an informal kind of like senior resident mentor who I actually basically
sought out for, you know, not just advice about patients, But just in general,
like life's advice and just it was just nice to talk to someone else who was just a year ahead of me.
And it was very helpful. I credit that person with really helping me feel like
I really enjoyed my residency after the first few months of feeling a little
(10:52):
bit like not really sure about whether or not I was in the right place.
Thank you. So that near peer mentorship. Very important. Yeah. Yeah.
OK, so let's now shift and talk about what are some of your tips to maintain
these professional relationships, even though they're challenges, time constraints?
If you could speak on that. Yeah, I think started off and then communication is important.
(11:14):
There are some challenges, at least from the mentee side. You know,
I think it's just helpful to give a little polite reminders,
you know, being a physician's busy. I'm not even fully there yet.
But from what I can see, it's super busy from the administrative side to taking care of patients.
And so just good communication, following up on that.
And then also, I think just for good communication, I think defining what the
(11:37):
purpose of it is, explaining how you want that to go about and making a plan
like those three steps. That's really helpful.
Sitting good check in points as well as my mentors and like,
hey, like, you know, I want to check in halfway through this rotation.
How am I doing? What's good? What's not?
Things like that. And just continuing to take responsibility for maintaining
that professional relationship from my end is very important.
(12:00):
I think you have to make it a priority. I think that all of us are very busy.
And I think it's really easy at the end of the day to go home.
But what I tried to do and what I was fortunate enough to have mentors do is
at the end of the day, swing in my office and say, how are you doing, kid?
And that's what I do for our new doctor, too. Now, it's almost a joke.
Now, I'm like, hey, are you in there sport?
And it's a funny way to do it. And it's a kind of an icebreaker way to do it.
(12:22):
But it's so easy to get caught up and go to work, treat patients, do paperwork, go home.
But those relationships at work can be so fulfilling and good for you,
both from the mentor side and the mentee side.
There are other things in our lives that we make time for and we prioritize.
And it didn't mean that I was going to go spend 30 minutes in Dr.
(12:44):
Wells's office. I have a family to prioritize as well.
But just swinging in to his office and saying, how was your day, man?
Can you believe what happened before lunch or you want to believe what one of
your patients said to me?
It really helped us quite a bit. And then like all important things in life,
you have to make it a priority to make time for it.
And when you make time for it, as neurotic as it sounds, schedule time for it.
(13:07):
It really helps to foster those relationships and keep them healthy.
I would echo everything my fellow panelists said, but also kind of give a shout
out to things like this, because this is another way to connect.
Some of my mentors and mentees are here at TexMed and meet up with them while I'm here.
I mean, I'm in a hotel room by myself. My husband's at home watching the dogs.
(13:27):
So why not go have dinner with somebody who I'm helping in their career, who's helping me?
So, you know, networking and events like this is something I would add to that.
Also say as a clinician and busy and going home and after clinic,
I am still available to my mentees in the evening.
Luckily, my kids are long grown and out of the home and my husband has activities
(13:50):
that can keep him busy if a student reaches out and needs to chat with me for
15 minutes or so. So availability.
Thank you. So we're going to pause now and see if there are any other reflections
from the audience or questions for our panelists about professional relationships.
Hi. So my name is Nora Vasquez and I'm an internist. And when I first joined
(14:10):
TMA, I remember like the first time coming to one of the conferences,
it was a little overwhelming as new to the group. And so I just remember feeling a little intimidated.
But having been a part of TMA over the years, this has become my home,
my community. and I've met so many wonderful people, so many,
developed so many great friendships.
(14:31):
And I think the one thing that really made the difference for me was,
I think in the beginning, I didn't feel like I belonged.
And it's a little mindset shift, but you can actually just decide that you belong.
And I think that can really help one make connection. You get to decide that
this is my home, my peers, I'm among friends and reach out to somebody and make a friend.
(14:53):
And since that, you know, I have lots of friends now, but I just want to acknowledge
for the introverts like me that were first new to TMA, it may feel a little
overwhelming, but give it time and just you get to decide you belong and get
to make those friendships.
Thank you so much for that, as well as calling out organizations are really
a pathway for professional relationship.
(15:15):
And so I'll ask the panelists, if you have anything you want to respond to that
in terms of TMA or other organizations that have helped you cultivate your professional relationships.
The first step is the hardest step, right? I mean, I think you hit the nail
on the head with, you know, especially if you're a more introverted person.
The first meeting is the hardest meeting. Obviously, we've all kind of gotten
past that. Here we are. Right. But I think that was very insightful.
(15:37):
The Texas Academy of Family Physicians is where I really cut my teeth,
if you will, for organized medicine. And it just was so intimidating to get started.
It's you don't know any of these people and you're going to leave your family
in your comfort zone. Go be around a bunch of people you've never seen before.
But turns out they all go to work five, six times a week, too.
And they have the same struggles you do.
And they just want to vent about it just like you do. And they want to try to
maybe one day make a difference. And organized medicine makes that difference.
(16:00):
So if you've got a colleague that you can reach to that was where we were initially
too scared to get started.
Don't reach out. Give them that hand. Pull them up. Get them out here.
I think we do a lot of good through organized medicine and not just on a bigger
level, but on a personal level.
It helps us recharge to see other people that are out there fighting the fight like we are.
I would echo that and also say that as a result of coming more often,
(16:21):
the first time I went to TMA meetings when I was a brand new grad,
moved back to Texas after training in Arizona.
And then I actually had someone to watch my kids and my fur babies.
And my husband came with me. So it wasn't completely long, but he didn't go
to any of the stuff with me. Right. And it was a little overwhelming.
And I'm an extrovert. So you can imagine.
But I did have an opportunity to start meeting people. And that grew into becoming
(16:44):
even more and more involved, getting involved on the PHW as a committee member,
then eventually as chair and now as a consultant because I rolled off.
But it also led to more and more opportunities even in leadership, which is as fulfilling.
It gives me an opportunity. I'm a member of the Council on Medical Education now.
And since medical education is one of my passions, I've just really been so
(17:06):
fortunate. But I wouldn't have been able to necessarily get that appointment
if I hadn't networked and got to know Gary Floyd before he became president of TMA.
So, yes, it has significantly helped me in some of my aspirations to help in
advocacy and policy development being in an organization like this.
(17:26):
It has also actually taken me out of my state comfort zone and pulled me into
the national arena because I'm also a delegate to the AMA at this point.
And again, if it weren't for some of the connections and my own mentors within
the TMA organization, I would have never been able to do that or felt comfortable doing it.
And currently now I'm an old pro at it. I get to be a chair of one of the ref comms in June.
(17:49):
So really, really, really excited and glad to be a part of organized medicine.
Yeah, and I would just kind of agree that TMA, there's a lot of stuff here.
My involvement, the TMA seems very supportive of medical students and young
physicians and residents.
And then there's lots of ways to get involved. This place definitely does feel
like home and everyone I've met has been really friendly.
And so I agree, like just, you know, coming and just being involved and saying
(18:13):
like, this is my place is great. And I've had a great, great experience in the TMA. So, yeah.
Yeah, I'm Steve Sargana, a pediatric neurologist here in Dallas at Scottish
Rite for Children. I'm also affiliated with UT Southwestern.
And regarding institutions, I mean, I like to pitch UT Southwestern because
they've got a wonderful wellness program.
(18:34):
They've instituted a coaching program where physicians can go and contact somebody
confidentially, fellow physician, and work with them regarding whatever comes
up, whatever strike for career management, that type of thing.
And then also there's a poster, it's called Lean on Me, and they talk about
(18:54):
the concept of second-person victimhood, which is like you've dealt with a difficult
patient situation, but you are the second victim.
So second-person victimhood, again, the concept that you as a practitioner,
a physician, have encountered some strife.
And same concept where somebody in the institution is supporting you and,
(19:16):
you know, again, confidentially. So the institutions, I mean,
maybe bring this back to your institutions.
I mean, some are probably small practitioners who may not have that,
but that whole concept of doing something with the institution to help physician wellness.
Thank you so much. So in addition to organized medicine, your institution can
(19:38):
also implement things to help you out professionally and for your well-being.
Okay. Anything else? All right. Right. So now we're going to shift to personal relationships.
We're shifting from the professional to the personal relationships.
And I'm going to start with you, Dr.
Hurd, if you want to comment on the role that they played in helping you with
(19:58):
your health and well-being.
Nothing like being married and pregnant during your first month of internship.
So let's just say one of the most helpful relationships in my entire life for
my well-being has been my marriage.
My husband is rock solid.
(20:20):
Now, having said that, no, it's not a perfect marriage and we bicker like an
old married couple. Like I said, 34 years married come June.
But without his support, his unwavering assistance with young children and just
managing changing much of the household during very critical times in my training.
Wouldn't be sitting here in front of you being so enthusiastic about being a
(20:40):
physician. I can tell you that.
So that intimate relationship of a partner is just so critical.
And I did help it while he's not practicing.
My husband is a physician. He did go through the same rigors of medical school
and early training a little bit ahead of me.
He decided early enough that that wasn't his cup of tea and stepped out,
(21:01):
but he was able to support me since I thought it was my cup of tea and it has been.
So that's been one absolutely just hands down necessary relationship in my life.
It's helped me stay sane, stay sober probably, and stay working as a psychiatrist,
having to deal with a lot of struggles of my patients.
But also friendships and parenting, that's important too.
(21:23):
Being able to take time to be a good parent, go to my daughter's senior show
or take some time off to go to my son's baseball game or something.
That is also very enriching and helped me move and stay focused and stay in
my career and stay available after hours.
Because it really isn't work-life balance. We all know that.
It's work-life integration and you do spend a lot more time at work.
(21:47):
But if you love your work, you're not trying to escape from your work.
So it is part of your life. So maybe that's where the balance comes in.
But friendships and maintaining friendships. I have I've lost some major contact
with co-residents and stuff. We moved away.
We basically still just send Christmas cards.
But I've got some new enriching friendships in my career, moving back to the
(22:09):
DFW area and making time, as we said, even for the professional relationships,
making time, scheduling time to go to dinner or have a weekend barbecue or something like that.
But for those friendships for me and my husband, both have also been just enormously
valuable in me maintaining my well-being.
Yeah, hard to add to that, right? I agree. To start with my marriage,
(22:32):
I've been married, it'll be 10 years and 28 days. It's our 10-year anniversary.
So we're really excited. I would not be here without the support of my wife. She's incredible.
She is kind. And she is so supportive of my hobby, which is organized medicine,
among my many other hobbies.
And the only reason I can do these things is because she's supportive and she's with the kids.
(22:53):
And what I've tried to do, think that we as physicians, to borrow a sports metaphor,
we leave it all on the field when we go to work.
We go to work, we smile, we talk about our families, they dominate our conversations,
we've got their pictures on the wall.
And we get home and we're the shell of a person. I'm tired, I'm cranky,
you look at me and say, I've talked all day, I don't want to talk.
I think it was important when, and COVID was when that really peaked,
(23:16):
when I recognized that I was sabotaging our relationship because I was giving
all of myself to my patients.
And I think that the realization of that and the carving out of time,
making it a priority to work on my marriage and doing little things like,
look, let's once we get the kids down and we get the chores done, we're hanging out.
You know, I'm not going to a different room where we're hanging out.
(23:38):
And just little things like that have really helped continue having a strong relationship.
I've got we've got four kids. We stay very busy. You can imagine I've got a
year and a half old twins, a five year old and a seven year old.
So the fact that I'm here tells you how strong of a woman my wife is for friendships.
You've got to schedule it. Like, no, I can't come in that weekend.
Last weekend, I had a crawfish boil and I had my friends over and I didn't answer my phone. And it was...
(23:59):
And I recommend everyone do the same. I'm still very close friends with my high school friends.
We carve out at least two weekends a year minimum that we all meet up and camp
and we hang out and we've got a Facebook chat group that we're active in all day.
We stay talking. And it's just it's when we go to the office, you're Dr.
So-and-so. But when you see your friends, you're Lane,
you know, and then the people that keep you grounded and keep you down to earth
(24:20):
and keep you happy and have those inside jokes.
And again, you've got to prioritize maintaining those relationships because
we've all had great friendships that we remember fondly, but we just let go.
So you've got to find the important ones and keep them going.
And you've got to prioritize the intimate relationships, so to speak,
as well, to make sure the romantic relationships keep going.
Wow. Both of those were great. I've been married for one and a half years, so relatively recent.
(24:43):
And I'd say after getting married, I've realized when people think their family
members, whenever they achieve some success, the role that they play,
now I can personally experience that and say that my wife has definitely been
my greatest supporter throughout med school.
School and just always there and supportive at home and whatnot.
So that's been really good. It does help that she wants to pursue a PhD.
(25:04):
And so she's in the sciences. And so she kind of understands what medicine is
like. That has been helpful.
You know, communication has been helpful and having time to spend with each
other and then kind of clarifying what our schedules looks like for sure.
And then friendships. Friendships are great. I think quality over quantity is
what's really important.
I also think it's good if you have a friendship or a group of friends.
(25:25):
If there's something external you're involved in that you consistently do, I think that's helpful.
So for me, it's through my church. I mean, it's nice that if I leave town for
a month and that group is still meeting every week that I can come back and
join that and pick off where I left, you know?
And so I think schedule and medicine is kind of hectic sometimes.
And so it's nice to always have a group that's meeting consistently and I can
(25:46):
always jump in and out of if needed for work or for school or whatever it is.
And so that's been really good as well.
Thank you. So I would also agree. My spouse of 28 years has been extremely supportive
of my career through rearing the children.
And then also at this phase that we're in is we have the privilege of being
the primary caregivers to both of my parents.
(26:07):
So that is also another dimension of relationships as well.
So it sounds like the three of you are doing really well in your relationships.
What advice would you give to someone who isn't? So if there are individuals
that are struggling in one of those dimensions of personal relationships,
(26:28):
what advice could you give?
They all looked at me, probably not because of my age, but because I'm a psychiatrist.
As we all know, communication is key and nobody can read anybody's mind,
not even a psychiatrist.
I'm a psychiatrist, not a psychic.
My husband and I stumbled a little bit in our marriage because of the lack of
(26:49):
communication. Luckily, we learned to do that. But it's kind of the same for your friends.
Things fester. Little slights become big ones if they're not addressed or discussed.
If your feelings are hurt, tell somebody. Don't brush it aside and then hold
a grudge against them. That's just detrimental to any relationship.
And when I say you, I mean the collective you.
So encourage that in your friends, too. If they're not as receptive,
(27:12):
if they're not reaching out as much, maybe say, hey, can I call?
Can we meet for a cup of coffee? Again, communication is the key when you're
struggling, whether it's an intimate partner, a friendship, a parental relationship,
being the child of adult parents, whatever it is, communication.
I have a question. Yes. I feel so sad because I have colleagues that are women
(27:35):
physicians, and they feel very, very stressed out. And I'm very lucky.
And I know that they may be undergoing a divorce.
And I don't know what to say because I'm not buddy with them I am a colleague
of them and they're not always you know in my circle they might have been someone who I mentored,
and I always struggle with the fact that did I did I support them enough I mean one of the awful
(28:01):
ones and is I know I don't want to break her confidentiality but she was a mentor
of mine I mean, I was her mentor. She was an NT.
And it took COVID and us going up to Ohio for an event to finally tell her,
I'm so sorry. I was a very terrible mentor.
And I'm so sorry. I was such a harsh upper level. And then she forgave me.
(28:24):
But then I still felt that I wasn't there for her when she was undergoing her divorce. course.
So do you have any, cause I get, I'm, I'm, I have another person that I know
that's also doing, I'm trying to be there for her. What would you recommend?
I think the fact that you took time to listen is important. I don't know that
they're expecting you to solve their problems if they're coming to you.
(28:46):
And I think when people come to us with bad news, we all very much stress out
about what am I going to say.
But at the end of the day, if I'm coming to you with bad news,
I think I just need you to listen.
And I think that's coming at it from that standpoint of they trust me.
What an honor that they're coming to me with this trust. I'm going to be there
for them. I'm going to take the time out of my day. I'm going to listen.
I'm going to be the one that supports them. I think that's the key thing right there.
(29:10):
That's true. But lots of times what happens is it's like, hi, how are you doing?
And they go, I'm fine. But then you're working with them and you know they're not fine.
Well, I think in times like that, it's important to find the right time to bring it up.
Obviously, if something like burnout is impacting patient care,
you need to prioritize time.
But when they just found out that the organization is pushing out another demand
(29:32):
of them, that's probably not a good time to ask, how's your marriage going?
But maybe during lunch or after work when things are calm. You know,
there's a big difference between an observation and an accusation, right?
Well, yeah, but I've tried that with a nursing staff and it blew up. So I don't do that.
I don't ask them. Sure. Is there any right now I've learned to stand there and
bear witness and just, you know, be as, you know, whatever that person wants to do.
(29:58):
Sure. But I was wondering if there's anything else besides that while you're
working with people like that, what would you recommend?
I'm a little self-conscious continuing to talk next to a psychiatrist,
and I'm afraid I'm going to speak out of turn.
I think that you nailed it when you said that listening is the most important part.
But like I was saying, between an observation and actualization,
if it's affecting them and you don't think they want to talk about it,
(30:22):
you can say, hey, I noticed that your charts aren't getting in on time like they used to.
I noticed that you're a little more flippant about patient complaints than you used to be.
Are you OK? What's going on? Be open about it. Be open. And if they say I'm
fine, then, OK, you tried.
Maybe revisit it. But that's a lot different than, hey, why aren't your charts getting done on time?
I think that how you approach it, using it as an observation,
coming from a place of caring that you want to support them will get them to open up.
(30:46):
And it's the right time. It's not in the middle of clinic. I think that's important.
I would also add, you know, the TMA, as well as other organizations, have lots of resources.
So, you know, just sort of bringing that up in terms of the TMA,
the Physician Health and Wellness Committee. There are resources out there.
The gentleman spoke about what they have at UT Southwestern.
(31:10):
So I do think also pulling that in, as Dr.
Lane is saying, when the timing is right.
I would add one more thing, because there's a lot of times when people are stressed
and it's not necessarily impacting their ability to provide high quality patient care.
But you care for them as a colleague and also a friend. And it's okay to observe.
(31:33):
They say they're fine. You can say something along the lines of,
well, it doesn't seem so, but I just want to let you know I'm here when you need me.
And so kind of just lay out that general, I'm here, I'm available.
That's also very supportive.
So any other questions from the audience about anything that's been covered
(31:53):
or anything that hasn't related to relationships and physician health and well-being?
Oh, yes. Please come to the microphone.
So I guess my question to the psychiatrist on the panel, if you don't mind,
I think the last question was very profound because a lot of our colleagues go through divorces.
And, you know, some were close to, some were not close to. But maybe if you
(32:17):
can clarify the difference between empathy and sympathy and why empathy is so important.
And why is it that, you know, just being able to listen and share deep feelings
in itself is helpful, but feeling sorry for somebody is not?
That's actually an excellent question, and I appreciate you bringing that up.
(32:37):
One of the things I like to try and make it easy, so I tell medical students
something along these lines.
Empathy, and yes, it goes along with compassion. Empathy is that you can understand
that somebody is going through something that's really rough.
You can be there to support them and listen to them, but it doesn't really necessarily
bring you down with them so that you can be actually a little objective and
(33:00):
maybe a good sounding board for them.
When you have sympathy, you are experiencing every emotion they're also experiencing.
So it'll bring you down and you'll lose your objectivity and you may not be
as supportive as you think you are because you might feed into some of their
own mistaken beliefs or grudges they're holding or something and support them
in a way that's not healthy.
(33:22):
So that's kind of how I describe it to my medical students.
I hope that makes sense to the audience. I hope that answered your question
because, yes, feeling sorry for someone doesn't really help them.
But being willing to be a listening ear does.
So I'm going to ask, what advice or what guidance have you received that hasn't been helpful?
(33:43):
We know we've talked a lot about mentor-mentee relationships.
What has not been helpful for your well-being? I think that would be important
for us to explore that as well, as we're all trying to build our repertoire,
if you will, on how to be effectively supportive of colleagues.
Yeah, I've been pretty lucky to get good advice from all my mentors. That's a hard question.
(34:06):
But thinking on times where maybe I've received advice that was kind of not as helpful.
I think when it sometimes, you know, if it needs some direction,
it's maybe not super evident to someone that's new to the situation,
what you're referring to.
And sometimes advice that's too brief or too doesn't explain exactly what they're
trying to get across for someone that is new to a situation,
(34:28):
new to a problem, new to, you know, an area of medicine that can be quite difficult to interpret,
you know, and it can be interpreted differently by the person receiving it.
And so I think the mentors that take the take the time to ensure that whatever
they're trying to share with the mentee are, in my case, with me is being received the way they intend.
That's that's the most helpful. And so I don't have any specific bad ones to
(34:49):
share, but that would be my answer to that question.
I don't have a specific example, fortunately, but I do think it's important
that you pick your mentor correctly. I think that finding someone to look up
to and who you're going to model yourself after is critical.
And you have a feeling about if they're the doctor you want to become.
And then there's a lot of different styles out there and different practices.
(35:10):
I think that that is important. Unfortunately, with advice, sometimes it's too
late when you realize it was bad advice, right? It's, oh, I already did that and that was bad.
So I think it's important to pick the correct mentor when you see someone who
is showing, not telling, showing the style of practice that they do.
And it's a style of practice that you want to hear.
So things that have not helped my well-being
(35:31):
that have occurred in my many years of
training and practice well we need you to
do this no you're not going to get paid more yes
you're going to have to work more hours but it's for the good of the patient
it's for the good of the student it's for the good of the residents so kind
of continuously reinforcing that self-sacrificing without giving any thought
(35:51):
to the impact of having on the individual that's being told to And it was myself
and some of my most of our colleagues.
So that definitely was not helpful. And at some point, it was very valuable
when a different mentor told me, Cheryl, you got to learn how to say no.
In modern times, I'd say for half of my career, I was gaslit.
(36:14):
And if it weren't for my friends, family and well, just rock solid husband,
as I mentioned earlier, my well-being would have suffered. Right.
Thank you for that. So we certainly want to hear from you.
These are things that the TMA is currently doing. And I think we touched on
some of these, the Wellness First program.
If you're not familiar with this,
(36:35):
this is a free program where you can get counseling and crisis resources.
There's a suicide and crisis lifeline.
And then through our committee with the TMA, there are CME activities and programs.
But we want to hear what is missing on this list. What do you think would help
your colleagues, help you with relationships and well-being.
(36:58):
Dr. Harris, we nailed it. We got it all. Yeah, well, the TMA nailed it, right?
No, honestly, I mean, the TMA is very interested to know what additional resources are needed. Yes.
So I think this is a great start, but perhaps other things that aren't so crisis-focused
and maybe just like, you know, more like just general non-crisis addressing issues.
(37:23):
Like if we're working on relationships, it doesn't have to be,
you know, counseling and crisis resources and suicide and crisis lifeline.
It could literally just be, you know, more of an emphasis on,
not to call it preventive care, but you know what I mean.
Maybe everything is not a crisis. Sometimes you might just need,
you know, maybe some more mentoring stuff up there or other stuff that's not
(37:43):
so heavy and serious because people might not necessarily need that degree of
support, but they might still benefit from other things.
That's all. Thank you.
Dr. Harris, that brings to mind what one of our other gentlemen mentioned.
And yes, that's part of kind of what I do at TCU now, and that's coaching,
professional coaching. Good suggestion.
(38:04):
Absolutely. We will definitely take that back. Yes, sir. I have a question about,
I guess, the opening remarks regarding loneliness loneliness and how that is
a risk factor for health.
How can you determine when someone who, for example, is has gotten divorced
(38:24):
and maybe is not that interested in dating?
How can you tell when they are so comfortable with their solitude that they
aren't ever going to develop perhaps another close romantic relationship?
And is it something is that something that is possible to be and still be healthy?
(38:47):
That way? Or is it, are there signs that a person is leaning toward the unhealthy aspect of loneliness?
Well, thank you. That's an excellent question. It's also very complex.
One of the things that I think it's important that we all can wrap our minds
around is it's, we don't have to be in a romantic relationship to have healthy,
(39:12):
happy interactions with others.
Not being with an intimate partner does not mean we're lonely.
Yes, it means we may be alone in that aspect. That's where friendships come
in. That's where family relationships come in. That's where the things come in.
So when it's unhealthy is when somebody isolates all of their relationship.
If you see somebody who's gone through a divorce and then stays at home and
(39:35):
won't go to the usual monthly,
you know, coffee break on a Saturday to vent about patients or whatever it may
be that they had previously been doing, that might be a sign to start,
you know, being a little worried to reach out, check on them as your friend.
You know, if they're still engaging in a lot of their other other relationship
type activities, they may be perfectly fine.
(39:57):
They may be processing through what happened to them and just may take them a bit more time.
But not everyone needs to have a romantic relationship to be healthy.
OK, well, I think we are right at time. I want to thank our panelists again,
and certainly for the audience participation,
we will take back with us your reflections as well as your recommendations about
(40:18):
what else the TMA can do to help with our well-being. Thank you so much.
We hope you found this episode valuable and take away tips that you can use
to foster relationships that are beneficial to you, your colleagues,
and anyone important in your life.
To claim CME for this episode, just click the link in the episode description
and follow the instructions provided.
(40:40):
Remember to like and follow TMA Practice Well to receive every episode.
Until next time, stay well.
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