Providing a space for physicians to thrive with dr Elizabeth ebueng

Episode Summary

Dr. Cruz sits down with Dr. Elizabeth Ebueng, a board-certified family medicine physician with Trinity Health in Wilmington Delaware, to speak about issues facing the medical field and potential solutions to solve them.

About Guest

Dr. Ebueng is a Board Certified family physician currently serving as an assistant program director to a family medicine residency program in Delaware. She went to UCLA for undergrad, received her master's from California State Polytech University, and completed medical school at the University American University of the Caribbean School of Medicine. Then she went to Philadelphia to complete her residency in family medicine under the Drexel University Family Medicine Residency, where her focus was on community and underserved care.

Full Transcript

Janet 0:08

Welcome to the Stay in Medicine Podcast. I'm joined today by Dr. Elizabeth Ebueng. So Dr. Ebueng is a Board Certified family physician currently serving as an assistant program director to a family medicine residency program in Delaware. She went to UCLA, for undergrad, received her master's from California State Polytech University, and completed medical school at the University American University of the Caribbean School of Medicine. Then she went to Philadelphia to complete her residency in family medicine under the Drexel University Family Medicine Residency, where her focus was on community and underserved care.

I have had the privilege of knowing Liz, for now, four years, she is absolutely a doer, she's innovative and a connector. And for those patients that have had the privilege of having her as a provider, as well as other colleagues, we all know she is deeply compassionate, caring, and a brilliant physician as well as an amazing educator.

So Liz, thank you so much for spending time with us today. Before we delve in, I do want you to talk a little bit about your route to medicine because it's a little bit untraditional. So let's start there. tell tell us about your route to medicine.

Liz 1:32

Sure. Well, thank you so much for having me on this podcast and it super excited to be here and joining today. Um, so non-traditional definitely describes my route to medicine. I think for those that may not be familiar with the traditional route, generally, many medical students will go through undergrad with some kind of science major, go directly into medical school and start residency right away.

To be perfectly honest, I did not think I would ever be a doctor. Seriously, if you asked me, you know, 15 years ago, if I would see myself as a physician, I would have laughed at your face. I think a lot of that was I just never really envisioned that and the prerequisites to get into medical school, math and science. And so I got my degree in American literature and culture and was really set on never having to pick up another, you know, textbook.

So I got my undergraduate degree, and I thought I was going to do something in either education or law. And so I actually volunteered at the Superior Court in LA, in family law. Yeah, and it was great hearing people's stories. But it was missing an aspect, there was just a lot of paperwork. And I knew that it just wasn't the right fit for me. And so I knew I liked working with people, helping people and I thought that maybe going into education might be a better fit for me. So I actually got my masters of arts and education at Cal Poly Pomona. And during that time, I actually was working just to pay the bills, basically. And so I was doing project management work.

I met my now-husband there, and we actually both went to the same undergrad and just happened to land in the same position for the same reasons. And we literally had dinner one day, and he told me that he wanted to pursue medicine and that I should join him. And I laughed in his face like but we started talking about it more seriously, because you know, each of us in our respective families had family members that were going through various health issues, and we just knew that there was a space for us to be able to help explain things to our family members and help me help them make better decisions for themselves.

So that's when I really started thinking seriously about it and went back and took all the prerequisite classes. And to be honest, that took a while because it was really hard to get into, you know, certain classes because a lot of them are for nursing and other you know, Allied Health fields and so it took me I think two years to finish all my prerequisites while I was working, studying for the MCAT. And before, like, I know it I'm here. Yeah, it's crazy. It's so crazy. We, we just finished interviewing for our, our next class, and it just blows my mind that, you know, I was once in their shoes and to think about, like all the steps that it takes to get there, it's —

Janet 5:32

Yeah, and for a lot of our listeners out there that feel like, you know, especially for our individuals that are in high school and are in college, for those that think it's too late to get into medicine, it's not. It's not. If that passion is there, do it. Because we need people that look like me, that look like you, to take care of my mom, my dad, you know. In previous episodes, I've kind of talked about kind of how I stumbled in medicine, where I just, I just needed to go to college, like I grew up pretty poor in the US, I didn't know I was poor until I got to college, I was like, okay, because I had everything I needed. But I knew, like I needed to go into college to take the next step forward. But I, for me, a lot of my experience was translating from my parents and interacting with a medical system.

And I was like, you know, what, like, this is, this is where I need to be, I need to be an advocate for them. You know, so for those out there that think like, hey, I need to know that I'm going to be a doctor when I am like six years old, not true. Not true. And here we are amazing physicians know, trying to provide care for patients that at least for me, that looked like me that maybe you know, didn't interact with the medical system, or didn't have great interactions with the medical system. And you know, how we can improve that. So tell me in terms of given your background, I mean, you went from not necessarily thinking of medicine, okay, I'm in medicine, like I'm in it, and then going into an inner-city program going into, you know, program that is really focused on community, what was that like for you?

Liz 7:31

Yes, so great question. I think once I finally realized that medicine was the right path for me, I knew for sure that I was going to be found in medicine. You know, I think there are people or students or applicants that their sister type that family medicine is the backup specialty. And people only go into Family Medicine when they can't get into their first choice. That's complete BS. I was I was. So it's, it's funny that you talk about, you know, these, these experiences with healthcare that really turned people off, right patients from seeking care, I actually was really fortunate to have an amazing family Med Doc, when I was growing up. And so she really was my first introduction to medicine in the field. And I just remember how she made me feel. And I wanted to be able to do that for other people, right, make them feel safe and comfort them and listen to and so when I was applying for residency, I actually did the couples match. So Mike and I, we were very specific and looking for programs that had a um, that serve similar communities then where we grew up in Southern California. And so, but we spread a wide net kind of geographically, and ended up at Drexel in Philly, which is, was amazing to train at. And so being a part of, of giving back to that community and caring for patients that are truly underserved. Hahnemann Hospital was where was our training hospital? And, you know, talked about the whole trauma about that.

Janet 9:37

So with a lot of our listeners, they're not, Hahnemann, right, just to give a little bit of background has historically been, you know, the hospital that really takes care of Center City, West Philly area and a lot of the services, you know, are aimed at, you know, really community-driven services and for our listeners that don't know, so Hahnemann Hospital closed? A couple years, it hasn't been it's been like, what, two, almost two years now. Right. And a lot of it was finance-driven, you know, but so for our listeners, you know, that was a hospital that gave services to the community. And unfortunately, because of the health care system, and because of, you know, how expensive it is, you know, to provide health care, as well as the finances behind taking care of, you know, underserved communities, it was a hospital that ended up, you know, closing. So I just wanted to give our listeners a little bit of background, but go ahead in terms of Hahnemann Hospital, like what was your experience there? And, you know, how was that in line with, with, you know, the population that you wanted to take care of?

Liz 10:56

Yeah. So kind of piggybacking on that the history of Hahnemann, so basically, it's the safety net hospital for the area. And basically, nobody was turned away from. And so it was such a great place to train at, because you saw such a variety of pathology, and you were working alongside, you know, other specialties too. And so just from a training perspective, it was an experience that I could not have imagined, but I'm so grateful for, because after taking care of patients that are, you know, truly sick, and have, you know, a lot of multiple medical problems can be very tricky to care for, but thinking about, like, the psychosocial aspect of knowing, you know, as family physicians, we look at our patients holistically, right. So it's not just, you know, the uncontrolled diabetic in front of you that's in decay, but it's also taking into consideration, okay, why aren't they controlled, you know, is it because they couldn't afford their medication is it because they didn't have, you know, power to, to keep their fridge on to keep their insulin, you know, regulated. Or sometimes it's making that tough choice where, you know, I can't afford insulin this month, because I have to pay for food. So, really, having that kind of understanding and an appreciation for the patients, really helps motivate you to, to keep going through those, you know, rough days and times, because, you know, someone on the other end really needs your help, and really needs your care. And, and the patients are oftentimes so grateful, you know. And I think that that honesty is what, you know, keeps you going. Because, you know, medicine is not the easiest thing, if it was you know, everyone would be doing it, but no.

Janet 13:08

Yeah. And it's interesting, because, you know, as physicians, you know, working at Hahnemann as well, for some time. patients don't know what's going on, you know, they just know that they can't afford their medications, they don't know that prices are inflated, because of the system that we live in, in the US. You know, they're not aware, you know, of the services that they can have. But maybe their insurance doesn't cover it because they're underinsured. You know, it is, a lot of times we end up being the advocate, we have the bird's eye view, we understand, you know, what's going on from a business standpoint, that really prevents the services for individuals that are of, you know, certain socio-economic classes, unfortunately, right? In the US. And for me, you know, I went from military medicine, where it's socialized medicine, I didn't have to worry about getting people their insulin, they got their insulin, you know, or if they needed studies, like an MRI, I didn't have to worry about, you know, battling or armoring up, I felt like, you know, to get them an MRI or to get them the image data that they want it.

So for me entering that it was a little bit of a culture shock for me, I was like, wait, what do you mean, we can't give them insulin? Or what do you mean, we can't give him you know, this life-saving drug because it's too expensive, and their insurance won't pay for it? You know, so it really again, like, you know, brought to light a lot of things that I was very naive to leaving the military, in terms of the cost of medicine and the services that we provide. And somehow, when we worked at Hahnemann, it got done. You know, we had a team where they needed that. We figured it out, it got done. You know, so to really see that hospital closed down? That I mean, that hit, I know it hit you and hit a lot of physicians. Really, in terms of like, just, for me, I kind of mourn a little bit, you know, because, again, these are patients, like my mom, like my dad that maybe would not be able to get care or now care is delayed, because they have to go into, you know, other systems that have longer wait times, you know, so it was a very interesting experience.

And I think, for me, it'll work, you know, really what's going on in the background, that's impacting our care. So, in terms of your training, because I mean, you came from a community-based, a, really training that really focuses on service. And now you've transitioned from being the trainee to the trainer. And now you are, you know, in a position where you're educating others. So, tell me a little bit about how your experience as a trainee has influenced now in your new role as an educator.

Liz 16:15

Yes, so part of our residency training, we have a rotation where we act as Junior preceptors. So I think that experience planted a seed about how I enjoyed working with others, and I think kind of tying back into the, you know, my background getting my MA was, was actually an education. So I think from that really sparked that, oh, you know, maybe I can do this, you know, lifelong, my found myself every time where I was working with students, or, you know, my co-resident and, and helping them, you know, get that aha lightbulb moment, filled my cup. And it was something that really brought me joy.

So it was an easy decision for me towards the end of residency to really want to pursue an academic position. So becoming the trainer was a no-brainer for me. To be perfectly honest, I guess I'm a more self-serving reason as well as because I want it to be surrounded by others still, you know, I knew that I wasn't going to be the only attending or the only faculty person. And so it brought me comfort, knowing that I'd still be surrounded by people that I can, you know, tap into for questions and feedback and advice. And so that really appealed to me as well.

And then being able to help train the next generation of family physician physicians specifically was really nice. So I was fortunate to get a position where I'm at now. I think it's going on almost a year of core faculty 100% of the time, and I still have to, like pinch myself like to be like, this is my job yet.

Janet 18:33

I will tell you first couple years there is that battle of imposter syndrome, where you are where you're meant to be. I mean, just because I've seen you teach other residents and I've seen you, you know, do that sort of work, and you're phenomenal, you know. So I do want to ask like, and you know, there's so much that you learn in your first year as an attending, you know, at least for me, well, I feel like I'm constantly learning. My first — yeah, but my first year as an attending, I was like, oh, man, did I actually do a residency? Because there's so much, you know, that I just didn't know, like, for me, the biggest Aha, you know, or the biggest, like, Oh my gosh, like, I need to really figure out leadership, I need to know the business of medicine. And for me, as well, like, they were just things in medicine, I just didn't know, I was like, oh, man, I've never seen this before, when I was seeing patients. So now that you're you know, you're training others you're in, you know, you've had your first year as an attending already under your belt. Now you're training others. What are the things that you wish you knew, you know, in, like maybe residency or maybe things that you feel as an education system that we don't provide our trainees?

Liz 19:56

Yeah, so I think there's a lot of things that I wish I knew. But I think that we kind of touched upon the big thing is, is that the whole sense of imposter syndrome? Or, you know, am I good enough? Or, you know, can I really do this? I feel like that never really 100% goes away, like some days are better than others. I think in medicine in particular, you know, things are always changing, whether it's new guidelines, new medications to know, you know, new, you know, whatever it may be, like, we'll never know, 100% of all the information that's out there. And so med students and, you know, residents, I feel that we hold, you know, our attendings. I'd like be all know. And I remember, I remember when I was on the inpatient service during residency, and one of the attendings was on service. And I think I questioned him, and I was like, how do you know that? And I remember, he told me, like, What are you talking about, he's like, I look up stuff all the time before, I'm all done up to date. And like that, okay. And it was just very reassuring. Like, it reminded me that at the end of the day, we're all human, and we need to, you know, refresh ourselves and look up, and there's nothing wrong with that.

Janet 21:32

There is nothing, and in fact, in my mind, that's what makes you a better physician. So it's kind of a dichotomy, too, right. So where are we experts are in our field? But at least for me, internally, I never felt like I was the expert in my field, because I was constantly learning. No, I was constantly looking at new literature. But that's it in medicine, you are the expert of your field, and you're still you will never know everything, you know, and that's that growth mentality that, that is really needed, you know, and that's really required to be an excellent physician over the course, you know, of several years. And, and I understand now, why they call it the practice of medicine, where you're like, you know, there's certain things where, you know, I've never seen. But I'm honest with my patients, “Listen, I've never seen this before, I'm gonna get back to you in a couple of days, let me do my research.” And I feel like, patients appreciate that. They feel listened to, they feel like you're not going to miss things, right? Instead of saying, Oh, this is, you know, this is XYZ, just try some of this and, you know, come back. You know, like, the way we were taught, you know. I know, in training, at least the training program that you came from, you know, a lot of it is, okay, we need to follow up on this, we need to keep reading, we need to keep pushing ourselves to know more. To honor our patients, right?

Liz 23:03

Definitely, I know, when I'm working with my medical students in my residence, that's something I'm always kind of stressing is that I'm the first to admit that I do not know everything, but part of my job and part of my job as healthcare physician is knowing how and where to find the answer for your patients. And so, just having that sense of humility, I think in acknowledging that we don't know everything, but we're gonna figure it out. And, and yeah, I feel like, patients appreciate that. And, and, you know, I appreciate that from my colleagues, to hear that as well. Like, okay, well, we'll figure it out together. Like, okay, phew it's not just me.

Janet 23:57

Do you feel like I'm in the system that we're currently in? You know, I know, it's always a challenge to find time. Right. I, you know, it's that perception that we're always racing against a clock to get everything done. In our current training programs in our current system, do you feel like we have that time or space that, you know, that allows for that? Or, you know, that time and space to really continue this growth mentality?

Liz 24:31

Yeah, I think the phrase is the days are long, but the years are short. Now, I think that's because that's how I feel my whole like, medical journey has been so far. You know, when when I look back, and I think back on it, I think when it comes down to the whole time constraint and talking about you know, pajama charting and whatnot. I think we're finally at a point where we realize that in order to provide, you know, high-quality, compassionate, effective health care, we need to have a space and an environment physically and psychologically, where we can thrive and do that. And so the changes that were made with documentation this year, for note-taking, is huge, it's been a huge game-changer for me on how to count every single component and make sure that I need the, you know, the minimums for billing and billing. Yeah, that was huge. And so I find that I am able to talk to my patients more, because I'm not like mentally calculating all those little pieces says, I think it's going to be great once, I think my residents still haven't caught up or realized that they don't, you know, put every single, you know, surgical social history in it and really focus on, you know, the medical decision making and why the patient is here. I think once that really has been cemented in our practices, I think will, will help ease that burden, because a lot of it is just charting.

Janet 26:31

Yeah, it’s just fluff. I mean, it's so interesting that you, you, you know, point that out, because, you know, part of, at least my mission, you know, is to help physicians, you know, keep seeing patients and really stay in medicine, right. That's the whole point of this podcast. And, you know, like my vision, I want to make the environment better, so that physicians will stay, you know, and in the current or at least, you know, previously, for a lot of people that don't know, you know, for primary care, especially for primary care, there were different bullets that you had to ask, so that the insurance company would pay you back for the work that you did, you know, so then, you know, a lot of patients complained that their providers were documenting while they were seeing them, they felt that they weren't listened to, well, of course, you know, where the mission of the healthcare system and the mission of a physician were kind of at odds. And I mean, to a certain extent, they still are, you know, they feel that way, sometimes, but I agree with the new CMS guidelines with the new guidelines, where it say, Hey, we just want you to take care of the patient, and, and document, really your decision making, and all of these other bullet points that we used to don't matter anymore. For me, I agree, like, I think that's made things easier, I think we could still absolutely keep approved, you know, improving on that. So that at the end of the day, it's just me talking to a patient, it's just me delivering that care, we need to get back to that, you know, someway somehow, and I think we're making strides to doing that.

But it is a change in mindset, you know, that we're going to have to reteach our physicians and that we're going to have to, you know, have a buy-in from our administrator. Sometimes they don't, you know, they don't see both sides and somehow meet in the middle. And I feel like, that's what we're all trying to do. We all have, you know, I think for the most part, good intentions, and we, you know, we want to provide the best sort of care. But sometimes it's difficult to do so or when we do it is at great sacrifice to ourselves. You know, I can't tell you how many times I've had the pajama time, you know, or I've had to call patients after hours. Because the way we stack our appointments, right, are just back to back, back to back. And it's, you know, you don't have time to use the restroom, sometimes let alone, right, let alone call the patient back. And I think as a system, we're realizing that you know, and trying to figure out the best ways to deliver care and still be human to our physicians and the people providing and be cognizant of their needs as well.

And it's not like we're asking, at least for me, I don't feel like I'm asking for a lot. But, you know, to have that freedom to say, you know what, I need to look this up. This is actually more complicated than I thought, you know, and that 15 to 20-minute visit back to back doesn't allow for that sometimes. So that restructuring or rethinking the way we deliver care. And you know, is going to be critical over the next couple of years, I think anyway.

Liz 29:42

Yeah, definitely. I think from talking to two colleagues that went into other practices, private practice. It's exciting to hear the innovations that other offices are doing with scribes they have like google glasses. And so my hope is one day, that's just standard everywhere, you know, to be able to get back to the root of, of medicine and just taking care of patients. No, that's, I think, why all of us are most of us went into medicine, to be able to take care of people. And so yeah, changes like that, hopefully, will enable more of that.

Janet 30:30

So I know for you, you're doing a lot in terms of your residency, you're very humble, you're doing a lot within your residency program, to really deliver holistic care, you know, incorporating this social, you know, model and, you know, really integrating medicine. What do you have planned for the future? Like in terms of like, what, what do you see that that is your mission over the next year? Or your undertaking to really make medicine just a little bit better for all of us?

Liz 31:06

Oh, wow, that's a big question. So, so honestly, I think, in terms of the next year or two is really just building on the initiatives that my organization has really kind of set up. And I think a lot of our society these days are also taking a harder closer look at is just inclusivity diversity. I think, at least for me, personally, it really kind of just stems and filters down to creating a change in our work environment, work culture, where it's okay, and I want people to feel welcomed and having these may be tough or uncomfortable conversations, right. And that's how we learn. And that's how we grow. Just making it and continuing to foster a safe space where we can have discussions like that. And hopefully be able to, you know, recruit others to, you know, join this family medicine revolution.

Every medical student that works with me, I, the first question I ask them is look, so have you thought about what you want to specialize in? And it's always my mission to plant that seed and get them to really consider going into family medicine. They think the beauty of the program and in is it really is full spectrum. We're the only residency program in the hospital. And so our residents do OB they do everything. So their first assist on everything. And so students are really surprised about the scope of Family Medicine, do about who we get to treat. And so it's really exciting when I see them, and they’re like, Oh, I didn't realize that, you know, our hospital has urgent care office space. There are so many different, you know, practice models so that we can go into and so I think just building on that. That kind of FM revolution making primary care ‘primary’ again, you know. This statistic, I got it, I was just reading the other day that we're, by 2025, will still be lacking, or will have a need for, 52,000 more primary care physicians.

Janet 33:53

Yeah.

Liz 33:54

That's in what?

Janet 33:54

That's just not —that's not that far away! Yeah. And it's so interesting, though, because, for me, I just feel there are so many barriers, for one to become a physician, there is a significant financial investment. That's, that's saying that you know, like you're looking at people going at least 200k in the hole, just to become a physician, right? But then as a system, we're like, oh, my gosh, we have this shortage of physicians, we have this shortage, you know, we're really worried in the next couple years that we're not going to be able to fill in, we see these, these holes within our medical system. But where's the solution? You know, like, so you're asking someone to make a leap of faith and go 20 or 200-300 thousand dollars in the hole to get this medical education, to fill a need a real need that we need in society, where you're you're not really making money until like you’re what, like late 20s, early 30s when you're trying to get out of debt, you know.

So as a system, we recognize that we need these physicians. But then where is that, you know, that return where you say, listen, come into our fields, it won't be that, you know, we’ll help you with the debt. You'll fill a need that we need in our society. Hey, you know, and we've all outlined this as, you know, barriers, at least for me. Had I not joined the military, I wouldn't have been a doctor. Because it's, I, you know, I came from very humble beginnings. And, you know, our, our mentality with finances and savings was very different.

So if I walked into a situation where I knew I would be, you know, hundreds of thousands of dollars in debt, I would have definitely thought twice. Yeah, you know, I mean, I thought three times before joining the military to pay for it, you know, but, um, it is, you know, you, we, we are much aware of these deficits. But then, how do we address these barriers, right, we want more people that are diverse going into medicine? How do we address these barriers that we know exist?

Liz 34:13

Yeah. And I, I think that's one of the things that you're talking about when I was thinking about, you know, this, this, our conversation today, and, you know, the goal of bringing more underrepresented minorities into the health system to medicine. And, and I would love to see increased loan forgiveness, right. And, and also for, you know, kind of across the board, you know, different states offer incentives for loan repayment and whatnot. It's crazy how there's such a mismatch that there's this obvious need.

So it's—that's why it's so frustrating sometimes—because it seems like the answer is so simple, but we know that there are like a million other things affecting it. I would say, though, that and, and I know, it's probably also not necessarily easy for me to say, but I wouldn't necessarily let strictly finances hold me back. Because if there's a will, there's a way. And it's just a matter, I think of connecting to people to help get you to where you need to be. Because if it wasn't for, you know, my friends, my family for Mike, I would not know how to navigate the system. So reaching out to others, to help you get to where you want, and where people need you to be. So financially, yes, it is a big, big investment. But you know, the return as well. If medicine is what your heart is set on, this is worth it. Totally worth it.

Janet 38:16

So, in terms of, you know, we talked about this deficit, we talked about, you know, barriers. And for me, you know, now being several years out of training, I'm seeing a lot of my colleagues leaving medicine, they're like, I'm done. I'm done. I'm throwing in the towel. You know, we talked about things that fill your cup. So what is keeping you in medicine right now knowing all of this, you know, what is keeping you in medicine? And what do you think as physicians we need to do to hold us in medicine?

Liz 38:52

Yeah, I think I'm a big believer in little victories. I think a lot of times, I don't think it's unique to my office or anything like that. But there's always something that could be fixed, that could be better, that could be more efficient. Right? And it can kind of snowball into other things. But whenever something like that happens, I try to scale back and think, Okay, well, what's something tangible that we can do? Some something? An effective change, right? Yeah. Whether it's literally like the placement of a basket. So building on that, right and helping people see that these little changes matter, right. And also just let people some, sometimes people just need to vent and just get it out. Right. So listening to people and really listening to them. And seeing what the issue is.

So, for example, when I'm just the other day, one of my colleagues, we were in the precepting room. And she suffers from migraines a lot. And so she just said something about the text or the size of the font on our EMR. And then I asked her, I was like, oh, have you ever thought about changing the size? And she was like, Oh, no, you can do that? And so the point of that is, is just, you know, checking in with your colleagues and doing and then also just, you know, reaching out to when I have questions with the, our EMR, I'm like, there has to be a way to do this easier. And so I'll ask around, I'm like, Oh, yeah, definitely. I used to do this. And it's like, oh, my gosh, game changer.

Janet 41:02

So it's so funny, right? You know, when we look at the teams that we work in, I think as a, as a profession, we're so used to like, Okay, I got to take care of this, I have to take care of this. And we forget that our team is larger than just the physicians, you know, we have our technicians, we have IT, I cannot tell you how much we undervalue or just don't think of IT like as part of the team. And they really do make things a lot easier when you incorporate them and explain, hey, this is the problem. This is what we're having, this is what's preventing me from doing what I need to do, can we think through our process? And I think you make a good point, that for us, you know, I think these conversations that we have in the workplace, regarding our frustrations, you know, we talk about barriers, we talk about all these other things. And the next step to that, and I know you're really good at that is really empowering yourself and empowering others, to start making these small changes that eventually will snowball into larger changes, that really impact someone's experience, both on the physician and on the patient end. You know, like this example, that you—you know, it's just, it's a small thing, but for this physician, I mean, you've just saved her a lot of grief. You know, a lot of discomfort, just by really broadening that team and saying, you know, what, like, hey, let me help you with this. Let's engage with it, let's, you know, we got to figure out a way to make this work for us so that we can deliver care better. I know.

Liz 42:49

It's just like this poor thing the whole time, suffering from this, like, teeny tiny font, I was like, oh, man, I wish I had talked to her earlier about this and realized it.

Janet 43:01

You know, and that proves, you know, the point, like, there are things that we can do in our environments for, for, you know, at least for me, in my, in my situation, I'm in an academic setting, it is hard, but there are things that we can do to help us stay in medicine to help us, you know, take care of patients, and no matter how small or how big, you know, these things are impactful. And they can really change everyone's experience.

Liz 43:30

I think the other thing that I'm also, like realizing too, in the position that I am. So my colleagues are such incredibly hard workers they have—they wear so many hats. And so one of the things when I was thinking about like how I stay in medicine is basically also the value that I have in my life outside of medicine. I remember when I was in residency, we would always make it a point to do some kind of big trip, regardless of like how much time we had. And so having something to always look forward to. So I'm in my new position there, I was kind of surprised on how my colleagues just kind of pushed off their, you know, PTO or their time away. I remember talking to one of my colleagues and I and I told them I said you don't have vacation or you're not taking any time off for like nine months? I was like, are you crazy, like you have to take [time], especially after our COVID year?

We really made a point to, regardless of whatever plans we had, everyone has to take, you know, at least, a three-day weekend to mentally, physically, emotionally recharge. And so I think part of that, too, is, is also making sure that you are, you know, taking care of yourself and your loved ones and everything outside of here in the medical world too. Because it is easy, it's easy to kind of push that aside when you know you have patients that you have to get back to, and charts done, and presentations to prepare for. Just, you know, taking a pause and remember that there's life outside of medicine as well.

Janet 45:39

No, absolutely, absolutely. And, you know, I think that culture of like that delayed gratification and delay, it really sets up, sets us up for not taking care of ourselves sometimes, you know, and absolutely agree. So, over the next year, you know, hopefully, we're out of COVID, although I do anticipate that we'll have a little bit more to go with COVID. I feel like it's made me think about the way we deliver care. You know, so for example, for the next year, I would love to see a little bit of deregulation in medicine, so we could continue telemedicine. I actually like telemedicine, right. So, for example, I could see people's backgrounds, you know, so when patients are depressed, I was like, okay, yeah, you feel depressed, I see what's going on in the background, I said, Let me get you some help, you know, or, you know, you could see people's social networks as they walk by the camera, you know, as we're trying to do a video visit with them.

Liz 46:47

They actually have their medicines with them. So yeah.

Janet 46:50

How many times right, they walked with their phone, let me go check, and they'll walk to the bathroom, they'll get, their, you know meds for me. I feel like the medical system really has dictated to us the way we should be delivering care. And because of COVID, we've had to pivot. And the insurance has had to pivot with it. And it created a phenomenal opportunity, where we expanded the way we deliver care. Right? Yeah. And it showed us around the world, like why are we obligating patients to come in? Like, why? I know why. Because if they, if we provide telemedicine before COVID, they would have to pay for that. That's why, and now that insurances are paying for it. Patients are all for it. They're like, Yeah, no, this is great. Like, I can't tell you how many patients will squeeze in a visit, before they have to go to class, where before they wouldn't be able to see us, right? You know, going to the doctor was like a two-hour venture, you got to go in and go to the office find parking, you know, sometimes there's a wait time, and it really took all of that out.

Liz 47:58

And that's for your patients that have the ability to access a car.

Janet 48:03

That's true. You know, for some, it might be more hours of adventure, they got to take a bus or they have to take, right. So for me, I would like to see, you know, physicians, look at the way we're delivering care now because of COVID. And look at lessons learned, like, Can we deliver care a little bit differently, you know, lessons learned, and really push out a system that really hasn't, for me an antiquated way of seeing patients, you know, where we're stuck in the office. Is really seeing in a brick and mortar and we're expecting people to come out of their comfort environments, you know, and like you said, you know, like, it's so much easier, just get their medications. They're like, Oh, Doc, I got it here. And here it is, you know, let me run to the bathroom, let me get you—No, and for me, it's been a time saver, both on the patient and as a provider. So for me, that's kind of, you know, what I am, I think of when, you know, over the next year, lessons learned with COVID. There's change that needs to be, you know, done in our system. And it's evident now, you can't ignore it can't take it back. Yeah.

Liz 49:17

No, take-backs. No, I agree. I think telehealth has been a real game-changer and has opened up access for so many patients. And I think and I'm hoping that it is here to stay because there really is no good reason why it shouldn't be. So so I'm excited for that. Yeah, definitely. I'm glad that's part of our —

Janet 49:46

Part of our repertoire now.

Liz 49:47

Yeah, for sure.

Janet 49:50

All right. Liz, thank you so much for joining us. You know for this episode of Stay in Medicine. It is always a pleasure talking to you. So for our listeners to hear more if you want to learn more about our guests, please check out StayinMedicine.com and take a look for us whenever podcasts are available. For you know, for individuals that are really you know, interested in continuing this or figuring out a way to stay in medicine, make sure you get your copy of staying in medicine, how physicians can move past burnout and regain control on amazon.com.

So once again, thank you and we'll see you next episode.