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My journey to coaching

I've been asked to tell how I ended up in this physician coaching space a few times over the last several weeks. So, I decided to do some reflective writing about my journey.


Four major experiences overlapped and culminated in the creation of Joy in Family Medicine Coaching Services®.


First, my own personal burnout story reached the pinnacle in March 2015. Mine was mid-career in timing (16 years in). I was absolutely loving academic medicine and all the many hats I had to wear. I really felt like overall, I was doing a good job. Retrospectively, I aimed for an unhealthy perfect standard in each area and over-relied on external validation. I determined to finish my to-do list every day. That led me to work through each and every lunchtime, develop lectures at night, and forego socializing with colleagues as I was bent on getting all the tasks done, and chit-chat slowed me down. (I had no idea the fundamental importance of connection for mental fitness).


Interestingly, the slow decline to burnout was almost imperceivable until I was in deep. One minute I thought everything was fine, and I was just working hard. The next, I found myself sitting on the sofa at night, unable to engage in meaningful conversation with family. Every task seemed overwhelming, such as picking my daughter up from a friend's house across town. I'd become impatient with colleagues and detached from patients. I didn't notice I was burned out. I just thought it was time to find a job that made me happier and that maybe I didn't have what it took to do the job. So, I joined a private practice part-time in a setting the owner physicians' had set up to enjoy the practice of medicine rather than maximize profits. I remained on-call for the residency and began the recovery process. I started to feel like myself again, with only patient care responsibilities at a reasonable pace in a supportive environment. (Read more about the career lessons I've learned over the last 24 years)


The second experience that led me to coaching was getting involved in physician social media groups. I began to notice the number of physician posts increasing in private groups wanting to leave clinical medicine altogether. Many wanted to know how they could use their training and pay off their loans while leaving medicine because they were so unhappy. I read a thought-provoking article written by a new orthopedic surgery graduate about his colleague who, after finishing an elite fellowship, was leaving medicine. Why is the practice of medicine causing so many physicians to be so unhappy after pursuing a noble career and devoting much blood, sweat, tears, time, and money to it – wanting out almost as soon as they start? Besides major systems changes (which thankfully are beginning), how could we change this phenomenon?


The third thing that happened was attending a women's physician's conference created by Dr. Sasha Shillcutt, who I've mentioned previously in my blogs. Four years after leaving core faculty, I listened to Ellen Zane (former CEO of Brigham Women and Children's and Tufts) and other extraordinary women leaders. I knew it was time for me to contribute more than part-time clinical medicine again. My friend Kristen explained the concept of "margin" in life, like the blank spaces around the paragraphs in a book that can be used as a room to augment one's story. You want to have a margin so if something else comes up that you want or need to do, you can fit it in. I determined I had created too much margin. I developed a whole list of ideas to fill in the margins, but by themselves, none seemed right. Ideas ranged from culinary coaching,  healthy lifestyle development, community mentoring, helping residents, curricular development, and consulting. My friend introduced me to Dr. Ali Novitsky, a physician coach, at that conference because she felt Ali could give me clarity.


So, the fourth and final development was hiring a physician coach. In my initial consultation with her, I showed her my list of options with all the pros, cons, root motivations, and honest objections in color-coded form, along with my concerns about not being full-time in the workforce. She listened patiently and globally. She then said, "I wonder where the overlap lies?" I stared at her, awaiting an explanation. The wheels started turning. An idea - working with residents, forming curricula, encouraging healthy lifestyles, and helping the next generation not burn out, and maybe even flourish in their chosen careers. Increasing the number of physicians who sustained and enjoy impactful careers. You know those moments when the lightbulb clicks on? Everything within me resonated with the idea. She offered to hire her as my personal coach and take her group coaching course. I am so grateful I took her up on both portions. Throughout that 12-week group course, I watched physicians transform their lives from personal to professional - negotiations, department restructuring, relationships, balance, and reclaiming their mental and physical health - with tools I never knew existed. These are the tools all physicians need, especially those in training and those who do the challenging yet rewarding work of educating, mentoring, sponsoring, and advising. The puzzle came together. (Read more about physician coaching)


I was convinced that coaching and its tools can prevent burnout and improve well-being. And now, there are also studies backing up that belief. What started as an idea of coaching residents grew into a deeply passionate belief that we can help physicians stay in their chosen careers, not gritting their teeth the whole way until retirement but enjoying their challenging, noble, chosen profession. The blood, sweat, tears, time, and money do not have to be wasted. I completed an intense coaching certification course with purpose. Joy in Family Medicine Coaching Services®, LLC was created in January 2020.


I have enjoyed customizing coaching approaches, topical content, and programs based on the needs of residency programs and individual physicians. I remain clinically active both at the residency and our FQHC to fill in when my colleagues take vacations. However, my main focus is partnering with physicians to live their best life despite medicine's challenging circumstances. 


Have a joy-filled day,  Tonya

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