Myth, Magic, Medicine, and everything in between - two doctors talking. Hi, welcome again to Myth, Magic, Medicine with me, Denise Billen-Mejia, the host, and my guest today is Sujin Lee, who is a physiatrist specializing in people withtraumatic brain injury, stroke, etc. And also a coach who helps physicians with the trauma of medicine. That's, maybe I'll let you speak as I have some trouble today,
Oh, you're good, you're good. They're all correct. And then, you know, we chatted a little bit before we kind of talk about what I do. And, you know, I still practice 50% of the time in as a core faculty for residency program. So I teach medical students and residents and I also mentor and coach, early career early to mid career physicians who goes through the transition in their lives. Many of them are a woman physicians, and especially physician moms because we kind of go into medicine thinking once we become an attending, everything is roses, and daisies and rainbows, but in reality, you know, we put on hold of a life part of it when we go through the medical training,
and it's and it's such a long training, it's a good 12 years that taken out. So you're a mother yourself, right?
Yeah, my kids are fortunately, they're all grown up 23 and 21. But I went to medical school with a two young children, I It's my second career, I was a music major music teacher before going to going into medicine. So I kind of experienced burnout or the demand or the challenges as a mom with a two young children what it feels like to be in a medicine field. I guess that helped me to not taking a full time, clinical practice. So when I finished my fellowship,
Oh, so you went straight to a modified schedule, so that you didn't...
Yes, yeah. So during residency, I knew I had an interest in education and research. So I got some grants during my residency, and fellowship. So I was already practicing medicine, like 50% of the time, towards the end of our residency, and throughout my spinal cord injury fellowship. So when I was finishing up fellowship, I knew I didn't want to go back to full time clinical practice, partially because my passion for other things, you know, leadership and education. And I think the main thing was, I kind of missed out a lot of time when my kids were young, because I was in medical school and residency, there was no choice going part time at the time. So when I was becoming an attending, okay, there's a choice, I can do part time medicine, and then I can do something else that drives me having passion at the time, it started with the research and mentoring. And because of my specialty, I work with a lot of patients who goes through significant transition, that's a trauma with physical trauma. And also they go through the emotional psychological changes, too, which is kind of tied in to the coaching that I do, you know, in life is a transition all the time, sometimes it's more dramatic, sometimes it's a little more transient. And I felt that there are many people who are looking for those transitions and kind of feels a little bit lost, where to start, or where are the resources? I think that's where my coaching part kind of grew into.
when when when somebody first comes to you - a physician, or they're coming to you and they've already decided, okay, this has got to change, I need to pivot, or are they coming to us with "Why am I so miserable in medicine?", and they're not quite at the point of realizing, isn't it isn't everything, there's a life beyond?
Yeah.In the beginning, you know, when we start coaching or any kind of business, we attract many different people. And then the more I coaching, my niche gets a little bit narrower. So in the beginning, I had some clients who felt like I'm really burnt out and I don't know what to do. Most of them were already taking time off because they just couldn't work anymore. So I Yeah, so they already on the past state, you know, I'm, I stopped practicing medicine last week or I stopped seeing patients I just couldn't go in and they're looking for something. Some clients, some physicians need a little bit more time until they can heal, because, you know, they have this emotional trauma.
We used to worry, I'm sure people still worry about being away from medicine. Oh, I haven't practiced for three months. How will I explain this? Are you seeing more acceptance of that? Not only from your clients, but do you think that the world of medicine is ready for, for seeing doctors as human beings who sometimes need a break?
You know what, because I'm in the space, with the people with other physicians who are more accepting, non traditional way of practicing medicine either part time or telemedicine or DPC, some, you know, a little bit less popular way to practice medicine, I will say alternative way of practicing medicine. So I see more people are okay, when they're doing something else. Maybe I'm biased, because I'm in that space. But if I go into mainstream academic medicine, because I interact with a lot of academic physicians, it's still very having some hesitancy about going part time. But if you look at the physicians who are in the academia for a long time, they have some type of a non clinical time is either administrative time, or they are in the leadership. So they practice may be 70% of the practice, and then have a 30% of leadership role or administration time. So even their full time, they are not really 100% clinical, they kind of don't. They're not aware of that. So I think in the longevity of the career in academic medicine, or practice, private practice, what eventually happens is they start with 100% clinical work and you know, whatever the timeframe is five years out the practice, or 10 years down the road, they tend to pick up some non-clinical side of it. For example, one of my friends, she has the private practice or built her practice. So she's been doing like 100% clinical work for five years or six years, and then now her practice doing well. So she hire other physicians and APPs, Nurse Practitioners, so she has a one day administrative work. So she wants to grow her practice a little bit more. So she even she's 100%. she practice seeing the patient about 80% of the time, and she has a 20% protected time. So that's the combination,
Unlike the really traditional because I'm from 40 years ago, I came where it was full time is full time, and then you add those other things on top. You can seriously burn out.
Yeah, but that's the way that used to be and we try not to go into that direction. So I had a conversation with another colleague that full time physician is two full time for other jobs, I feel the standard or average working. Yeah, 60 to 90 hours, if you look at other industry full time is 30 to 40 hours. Yeah. So I think that's the main thing that we kind of have a different mindset in terms of our full time is actually double time of other workforce. That's something that we kind of wants to be aware of it. We are so used to having 30 hours straight 16 hours straight from the training. And I think we're started having reversing that, you know, thoughts that we have to work 60 hours a week, which is not really sustainable. If you have a family, even your single person. Probably that's not the healthiest way to having longevity of the career. Yeah.
They expect us to work long hours and having all the responsibilities in the healthcare system and, you know, medical, legal work, and even the patients. I see this in other corporate work, too. I had a friend coach friend, she was coaching a big company and working so hard. And then she actually had a ministry open. She was like in her 20s. So she learned that she needed to slow down but she continued until she worked she became depressed and having major events in her life. So it it happens other industry too, but I think in health care physicians are the one. I think we are the one have most of our compassion towards others. That's why we became...
but to fellow physicians. Oh, yeah, I truly think I think it's a talisman thing. I think it's, I can't admit it could happen to me. So it can't be happening to you because you were so much like me, because there's a physician label I'm sure that's what it is.
Yeah, so that needs to be changed. So I really like all the other work, including yourself that try to change the perception of expectation of what physicians are supposed to be. I think that expectation was beyond what a human being human being can do. And it's about time to acknowledge we are humans first being a physician, then, without supporting being a good human or healthy human, how can we be a healthy physician? I think that's where we came to the recognizing this is what needs to be changed. You know, the system change takes longer. And
it does some of it, some of it has changed for the better. There's sort of an attempt to cap hours, there's sort of in a attempt but and, and there are more women in medical school now than there ever were, which is wonderful. I think really, what we need to acknowledge is that we are humans before we are physicians, even though it's hard to do that, because you spent so long getting that physician label.
Yes, we were trained, trained to think like a physician before human. And I think some part is helpful to be as successful and very good at what we do. Because we take care of we deal with life and death situation, sometimes we have to be really perfect or want to be, you know, perfect, close enough to be perfect, not missing. But the problem is we carry that to other aspects of our lives, which is impossible.
There's also the residual that you when you're dealing with a trauma, and everybody that comes in well, almost everybody comes to the emergency room, or to the physician in an emergency situation, yes, is traumatized. And it is a tragedy, maybe a small and recoupable one, but then in the line of work that you are in often it's a permanent change that's happened and it is a tragedy, no matter how old they are. So what you can't sit there and cry with them, because you've got work to do, you cannot help them if you're going to do that. So you're carrying that with you. Plus all the stuff you know what, it's all happening in your own life as well. Yeah. So I think that that is a lot of of the I think that's the tremendous value of having a coach who has walked that walk before and understands what you're saying.
What we're doing here is we're trying to prevent if it's possible in guiding the people who needs transition transformation a little bit easier way a little bit faster, because many of us kind of struggle, like what do we do now? We don't know, what to do?
Well, what I mean is if you if you find a coach earlier in your career, so it's a flow rather than a hard stop and change direction. You want you want natural progression of you're really busy, crazy hours, you can only sustain it for so long, and then have something that feels natural, where all of that experience is going to inform what you're doing next.
It doesn't make it less valuable. Just because you're not running all over it in an emergency room doesn't mean that the research is less important. It's just no no different way of working.
Yeah. And I think one thing that we're not aware of ,many young physicians, or we never learned during our medical education is the career is meant to change throughout our lifetime. It is meant to change. But what the fantasy we have is once we finish training is like this is going to be my next 20 years, 30 years and 40 years. And after a couple years later, five years or seven years, there's a seven year itch of like, Wait, this is not what I signed up for. The life is different. My practice is different. What's wrong with me? This is supposed to be lifetime work, but I don't enjoy it anymore. And they think something wrong with them, which is not true. But we will never told that will come or that's okay to feel that way.
Or they job-hop "This This administration is horrible. Let me go find another one. "
Well sometimes, you know, some people get lucky. So you got to limit for one. So I wouldn't say that's not the right way. Having awareness of what's exactly going on inside of us and it's okay to desire for changes. It's okay to have a life outside of the medicine. And you know, especially female physicians, if they have children, that becomes the priority. My patient is not my priority anymore, sometimes at home, my kids are priority, and that's perfectly fine. But when you see the patient in the working environment, yes, your patient is your priority. But when you're done with their work,
You have to be able to turn off.
So do you do you coach people at the earlier stage of their career? How about medical students and residents?
Residents, they coach them unofficially because I work with the residents all the time. I'm a core faculty so all my clinical service have residents and so at a time I usually have two to three residents with me in different roles. So, and then, because I'm a core faculty, I do like a routine mentorship and evaluation. And when I see some residents kind of struggling in their performance or their life, then I kind of bring in the concept of a coaching to do a little bit more than just a simple mentorship. Medical students, I'm a mentor for the interest group for my medical school where my residency program is, but there, I'm a little bit kind of one step further down because they're their pathways a little bit different. So I haven't had a chance to focus on the medical students that I know some other coaches do. So I coach residents through my residency program, not with the program itself, it doesn't have a separate program, but I kind of coaching one on one basis. My clients are usually who are already attendings. I have some clients only their phase about two to three years out and also have five to seven years out. I tend to work with a little bit more younger, early to mid career physicians, I think that's when they try, they started seeing that something needs to be changed or something is different from what I expected. And they're kind of looking for what other people are doing. I think the first thing is, is it normal for me to feel that way. And a lot of people feel I'm not normal, something wrong with me. So that's where we start. And then the next thing is, it's okay to feel that way. Then we kind of tried to figure out where do you want to go next? A lot of times, we don't have that idea. Like what's next, because we never thought there's going to be a next once you become attending.
I remember, I don't know if it's really burnout. It wasn't just me. I know, as I got older in residency, I saw it in the very junior doctor was that I was almost I wasn't suicidal. I was really depressed that like the third fourth, fifth month of internship initially WOW! I'm really a doctor? And then it was like, This is it. It was just it was just physical mental overload. It was just all the time.
Yeah. Internships are hardest part, I believe because you know, the gap that you have the learning curve that you have to pick up finishing medical school and then be Yeah, it's like, it's like almost vertical, I have to catch up, otherwise, my patients gonna die on me, kind of thing. So the stress and expectation, the identity shift from medical student and being a full physician, it takes gradual change. So a lot of new attending, stay read. I have a question. Who do I ask? And then Oh, I see attending, I have to make a decision. We all have that moment. Like, where's the attending? And then you realize, Wait, I am the attending.
It's not impostor syndrome is the first time I'm doing something.
Yeah, that's it. Okay. And, you know, internship is the one of the hardest time because the physical demand and the cases you see are very dramatically difficulty you got to have, you know, having some difficult conversation with your patients and their families. And I remember when I didn't have a good outcome with my patient, I have to tell the family how to counsel those, as a young intern, like, we don't have that much of a life experience, how am I expected to have an end of life discussion with the people who has a lot more life experience than I do? We learn very quickly. But the first couple times are definitely challenging. And we rarely have time or awareness of those things needs to be processed. You know, we have to go through our own process. I think
there are a few programs, but very few that have coaches within the medical school counselors. I mean, obviously, there are a few nice attendings who will take some time and talk to you if you're struggling. But I, I really feel that the system could do a lot better could have a lot more support.
Well, good thing is I think we're going to that right direction. I think a lot of support and recognition comes from physician coaches. And you know, I see more studies coming out more papers coming out, that's a good positive thing because academia definitely rely on scientific basis and research base. So those are good signs. And I really hope, you know, every residency program, every medical school have the coaching program in you know, in a long term, that's going to be one of the goal and also all the health care system, you know, in a without even residency or medical school, all the healthcare system has the access to the coaches, because still getting therapy is you know, it's looked upon negative negatively.
Yes, exactly. That you can get away with using the word coach
Yeah. I mean, obviously, if somebody's truly having a major depression, a coach is not the right person i, yeah, you need to do therapy. But we need to get over that stigma.
Yes, psychiatrist and therapist. And then when you're looking for looking for the next direction, next goals, I think that's where the coach becomes more useful and helpful.
So what is your research? And I do research in physiatry or do you do research into coaching?
Um, I haven't done research in coaching. I think there's some talk about what other coaches, you know, doing surveys and whatnot. But my initial research as a resident was in my specialty, spinal cord injuries. So I started actually, with the animal research, because my institution has a very well known researchers. So I did some mouse models and spinal cord injury. And then during my fellowship, I did a clinical research fellowship, that's when I did the clinical research. And I think that's, that led to me become a board member for medical device startup. So I'm still do some research work, I'm on a data safety monitoring board for a start up company developing a new device to cure spinal cord injury, one cure, improving the functioning spinal cord injury. So that's my academic research. And, you know, as the faculty, I still do, you know, abstract posters, teaching residents how to present how to write a good abstract and papers. That's what I do academic research wise. But I definitely has a strong interest in looking into more coaching, how it, you know, impacts the outcomes. But right now, I'm more focusing on the practical side of it, how I can help more clients who are looking for transitioning in because I still practice the medicine part time and I have this side business or my passion projects in coaching, and some other work, I kind of want to show this is possible. There are different ways you can practice the medicine and you don't have to burn out and you know, it is okay practice part time doesn't mean that you're less of a doctor. I think that's the main my passion and goals for now.
How do you how do clients find you? However, physicians find you other than word of mouth then
usually, I do a lot of interaction through Facebook, it happens to be my platform, Facebook, I belong to many different groups that who are for physicians looking for transition, either starting a business or finding a different job. So I usually comment, I usually kind of give some advice, share my experience, my clients experience in terms of explaining or showing what's possible and they ususally message me. So that's how we I usually start conversation and I also host a webinar actually I having a mastermind coming, masterclass coming in end of May, May 24. I will be teaching how you can transition from full time to part time with a side business if that's the what you like to pursue, so that you can achieve work life balance through the part-time practice and with a side business.
As your advice to anybody ever been? I know. I should I should rephrase that because coaches aren't supposed to advise, right? We're supposed to allow people to explore , to help guide and explore.
Yeah. And to help them to find the answer within them.
Does that answer sometimes turn out? No, I really need to get out of medicine.
Yes, I think so. I think so. But many people think they really need to leave medicine when they are severely burned out. Probably that's not the best place to make a decision because your brain doesn't work properly. Yes, they're they're already kind of tired and ill condition. And from that place, it's really hard to make a good decision. So a lot of people come to me saying I want to leave medicine. But when we explore more, it's not the practicing medicine itself. It's other things around it. And many people actually decide to continue practicing medicine. But I have seen some people actually make a complete transition to either going to non clinical work in big companies or doing something else or become a entrepreneur. That's another thing that many people ended up doing. Yes.
Thank you. Any other words of wisdom? You must you must send me your information on the webinar so that I can your masterclass so I can
Yeah, so, you know, I what I what I'm working on with my clients or in our healthcare system for other physicians is whatever you decide to do, if you like the reason if you have a good reason, it's okay to do it. It's okay to leave medicine, it's okay to practice part time, it's okay to have a side business, or it's okay to stay in the system that you are, if that's what you decide to do. And many times we look for outside validation, looking at what other people do worry about what other people is gonna say. But what it really matters is, this is my life. This is your life. And the best decision comes within you. And
when you're willing to make the decision. Yeah,
yes. So it's okay to look for help. It's okay to go talk to a therapist to talk to coach so highly encouraged. And I, I see some people thinking, looking for help is a sign of weakness. No, it's not. Actually the people who look for help are the ones that are brave and strong. They acknowledge they need help and go for it. I think that's the real true authentic strength, actually not a weakness.
All right. So the information on how to contact Dr Lee...
You can find me and my website, it's just my name Sujin Lee MD, S U J I N L E E M D dot com And I have a masterclass coming up, join my mastermind masterclass, then, you know, we can talk about how it's possible, I show you three key steps how to make a transition from feeling exhausted and tired as the you know, woman physician, and find the hopefulness and flexibility in your clinical practice.
Wonderful. Thank you so much.
Thank you for joining us at Myth, Magic, Medicine. If you have found this episode useful, you can apply for free CME credits for the link provided in the shownotes. If you're not a medical professional, please remember, while we're physicians, we're not your physicians, so please consult with your own health care professional if you think something you have heard might apply to you or a loved one. Until next time, bye bye
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