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.
There were four major experiences that overlapped and culminated in the creation of Joy in Family Medicine Coaching Services, LLC.
First, my own personal burnout story which reached the pinnacle in March 2015. Mine was mid-career in timing (11-20 years out). 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 perfection in each area and relied on external validation. I hadn’t yet started viewing perfectionism as something I could dial up or down depending on the task. I was 100% perfection-oriented on every task. That led to working through each and every lunch time, developing lectures at night, and foregoing socializing with colleagues as I was bent on getting all the tasks done and chit-chat slowed me down. It’s really interesting that 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, such as picking my daughter up from a friend’s house across town, seemed overwhelming. I realized I’d become impatient with colleagues and detached from patients. I felt unappreciated because I relied solely on external validation. I experienced intense dread every morning having to go back to work. The interesting thing is I didn’t notice I was burned out. I just thought it was time to find a job that made me happier. So, I joined a private practice part-time and began a healing process. After a year or so, I started to feel like my normal self again.
The second experience leading me to coach was getting involved in physician social media groups. Before I discuss that, it’s important to understand the context. I had to reconcile my own change to part-time work in the face of a primary care shortage nationwide. I had a lot of mind drama about why I “should” stay full-time for the good of the community. In the end, I realized that being fully engaged part-time was better than showing up detached full-time. Now, back to how social media played a role. 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 then 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 are so many physicians so unhappy after pursuing a noble career, and devoting blood, sweat, tears, time and money it –wanting out almost as soon as they start? It led me to contemplate the myriad of reasons – several of them systemic and seeming out of my reach. (Thankfully, there are people who engage at this broad, organizational level of system change that are currently pushing for transformation).
The third thing that happened was attending a few women physician’s conferences created by Dr. Sasha Shillcutt, who I’ve mentioned previously in my blogs. I learned so much, grew, and made amazing friends. Four years after leaving core faculty, I attended one of these conferences. After listening to Ellen Zane (former CEO of Brigham Women and Children’s, and Tufts) along with an overall amazing line-up of women leaders, it was time for me to contribute more than part-time clinical medicine. At this same conference, my friend Kristen told me about the concept of “margin” in life, like the blank spaces around the paragraphs in a book that can be used as room to augment one's journey. I determined I had created too much margin. I started down the path of discovering the options I could access to best fill it up. I had a whole list of ideas, that by themselves, didn’t seem just right. I had my culinary coaching certification and loved helping people with healthy lifestyle development. I knew I loved mentoring and really missed the routine resident interaction. I really loved curricular development and toyed with contracting as a consultant or increasing my on-call time at the residency. One night at the conference, a friend introduced me to Dr. Ali Novitsky, a physician coach, because she felt Ali could help me with clarity moving forward.
So, the fourth and final development was hiring a coach. In my free 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 work force. She listened patiently and globally as I explained that I couldn’t figure out which to pursue. She then said, “Why don’t you combine them?” I stared at her with a confused look. “You could coach residents, form curriculum, encourage healthy lifestyles during training, and prevent future generation of physicians from burning out and leaving medicine.” You know those moments when the lightbulb clicks on? Everything within me resonated with the idea. She made an offer for me to both hire her as my personal coach and also take her group coaching course. I initially resisted the group part to begin with, since it appeared to offer lifestyle tips. In the end, she’s persuasive and I signed up for both. I am so grateful I took her up on both portions. Over the course of that 12-week group course, I watched physicians transform their lives from professional to personal - negotiations, department restructuring, relationships, balance, and reclaiming their mental and physical health - with tools I never knew existed. The really interesting thing, I realized, had I gone back into full-time work without these tools, I would have just burned out again.
I was convinced that coaching, along with the tools it offers, can prevent burnout. And now, there are also randomized controlled trials backing up that belief. What started as an idea of coaching residents grew into a deep passionate belief that we can help physicians stay in their careers, not gritting their teeth the whole way until retirement, but enjoying their hard, 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.
Residency is hard. Also, I know how difficult the role of core faculty can be and that burnout is real. Attendings directly impact the residents. Imagine a system where faculty and residents both have these tools and the synergy that comes from that. The transition to practice in early career, which often sees a couple of job changes, has brought me some other wonderful physicians to coach. Coaching with the tools I’ve learned is incredibly rewarding. I’m filling my margin, living into my purpose, pouring into others whole-heartedly. I enjoy clinical medicine, but I love coaching physicians.
Have a joy-filled day, Tonya
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