Myth, Magic, Medicine, and everything in between - two doctors talking.
Hello, and welcome to Myth, Magic, Medicine again. And today I'm going to be talking to Melinda Williams Willingham. Is that right? Yes, it is. It's terrible. We've known each other for a while now, we've been accountability partners for a while. This Melinda. Melinda is, like me, trained in pediatrics, but she stuck with it. And she is just opening her second practice. And I don't know quite where this conversation will go. But I'm really excited to be having it and sharing it with all of you. Hi, Melinda, thank you so much for joining me today.
Okay, so thanks, Denise, for inviting me to come have a conversation with you about quite a few different topics. So I'd love to start opening up our conversation. I am a pediatrician, as Denise mentioned, and I wanted to talk to everyone and just share a little bit about my journey, and share some tips for others out there who might be considering whether or not they are walking in the footsteps and the path that they have imagined for themselves, especially at this point in your life, particularly the the middle age point of our life in our career.
Do you find that you work with other people that are doing this? So you help guide people, you're a coach as well? Do you find that that people make dramatic changes? Or is it little tiny shifts that they make? Do people realize that they're allowed to change their mind about what how they want to spend the time they have on this earth?
Absolutely not. So I am not a coach. Instead, I think my expertise lies more in as you mentioned, guidance, consultant work and mentorship. Where I definitely received quite a few calls from individuals that know my journey know my story that I have, you know, previously been in a very large medical practice setting with four or five locations and subsequently pivoted to something a little bit more in intimate, more boutique like. And they also know that I've done some nonprofit work as well. And they have a lot of questions about what made me pivot from the traditional outlay of what people think about when you become a doctor. All I knew was my family said, Hey, if you want to be a doctor, go to medical school, be a doctor and that's it..
You come out minted and that's it. Because they don't teach the business side of things.
Definitely don't teach you the business side. And you know, I think just as others are, we are not just one dimensional human beings, we often have many talents, interests, etc. And there are so many different ways to incorporate what you love what you're passionate with, along with other interests. And I am a strong believer that if you have such a gift or talent, it's there to share with the world, you can help others along their journey, and continue to make an impact and hopefully make whether it's your personal family or your community or where you work, hopefully make it just a little better place.
But whilst you're filling and by doing that work energizes you as well not to not to allow yourself to be drained by service such that you then become resentful fof the service. I think there's a lot of that in medicine, I think that's a lot of us suffer from that. Why am I still doing this? Why can I go home to my own kids? Particularly in pediatrics!
What I didn't know at the time was that some of the early work that I did actually was the antidote to burnout. And I'm not here today to talk about burnout. But I just want to just talk a little bit about how you have to really stay true to yourself and stay in alignment with your core principles. I find that when you tend to deviate from that, and you start to kind of contort yourself to align with what you know, corporate world says or wherever you happen to work. I think that's when a lot of people become unhappy and not satisfied and they become disengaged.
So can we back up a little bit what has been your journey is okay, we know you went to medical school because you've got an MD and you went to pediatrics. Where did you do your residency?
My residency training was in New Jersey at the time it was called the University of Dentistry and Medicine of New Jersey, they subsequently have been, I believe all networked into another larger institution. So it doesn't exist anymore. But New Jersey,...
but they still have a medical school in New Jersey. [Rutgers New Jersey Medical School] Yes. Yeah. So did you go straight from you did straight residency? Did you do fellowship? Or did you I did not
to, I did not do a fellowship at all. So I attended Howard University Medical School. And from there, I went to the UMDNJ, in New Jersey, and I thought about doing a fellowship, but actually became a mom, I actually had one child in my second year of medical school. And I had my second child in my second year of my pediatric residency training. And so my thought process and what I valued, changed a little bit. And I no longer wanted to really go into fellowship.
I know, several doctors have told me they had children during medical school, but I just can't get my head around it. I have my first child in second year of residency, also, the second one in fellowship. The third one was a whole different experience. I wasn't attending, I could take time off and did it was amazing. So so that does, obviously motherhood changes, where you think your life is going, often getting married changes, where you think your life is going, when did you move to Atlanta,
I moved to Atlanta in 1998. And subsequently, I took a position with a local hospital in Gwinnett County. And actually, at the time, I took a position with a pediatric outpatient clinic, and they only accepted Medicaid, which is very interesting. And there were a lot of problems with our state Medicaid, and a lot of physicians just decided they weren't going to accept Medicaid at all. So the hospital created a clinic for those who were underserved.
Okay, was that included the HMOs that were folded into Medicaid or just plain Medicaid.
So at the time, it was just plain Medicaid, the HMOs came later, okay. But after doing that for three years, and realizing, oh, my gosh, I still feel like I'm a resident, I had to get up in the middle of the night to admit patients. And that was definitely not the career that I had imagined after completing residency, I did not want to continue that. So subsequently, I began my search to look into private practice. There are some classes of course pros to working for a hospital system. But I found it very bureaucratic. And it became very difficult for me to begin to incorporate some of my thoughts or ideas and how I can help you know, patients or help make the workplace better.
"What a lovely idea. Why don't you form a committee? And we'll think about it." Yeah. So what was your next step? Did you strike out on your own? Or do you have some similar minded fellow to join you?
So I did not strike out on my own. But I did find a practice that seemed to be in alignment with my philosophy on practicing medicine. And so I joined as an employed physician initially for the first three years. And then subsequently, I became a partner of that pediatric practice. And I remained there for about 20 years. And we went from about one location to four locations at the time that I subsequently left in 2021.
And so it was time for you to leave. What did you want to do next? And how much soul searching did you have to do before you reached that decision?
Speaker 2 9:03
Oh, that's such an interesting question. I think I realized in probably 2017 that I wanted to practice medicine differently. I wasn't sure exactly how I was going to do that. But I had just attended a Tech conference. And usually all of my experience has been going to the traditional, you know, medical conferences, etc. But it gave me a different vantage point on where healthcare was trending towards. And it started to spark some different ideas and innovations in my mind. So to back it up just a little bit. Shortly after that, is when I became part of one of the founders for a nonprofit organization, that utilized telemedicine at the time and 2017 and a mobile unit to bring access to care for those patients that really didn't have adequate access of care. And in this case, it was children in their schools. So I definitely did that for quite some time. And I also realized how much politics, governmental rules, policy, all these things, really sometimes could create a barrier to delivering here the way that you would like to. So why, also, during that time period, I became chair for the legislative committee for the state of Georgia, the Georgia Chapter of the American Academy of Pediatrics. And I still am the Chair, I think it's been about 15 years now. And subsequently, I was appointed to the National American Academy of Pediatrics, their committee on federal government affairs, my term will be ending next year. But again, it was just another opportunity to be able to vocalize how I thought that I could make impact, or have entered the conversation about how I could help make healthcare better. So long story short, I decided to branch out on my own, it's very interested still on delivering medicine in a very innovative way, in a very patient centric way. Where I don't have to see 35 patients a day, and come home totally exhausted, from work, to your own children, yeah, to my own children. So launched my solo practice, in the middle of a pandemic. Wow, I don't know that the timing was, you know, perhaps optimal. But in retrospect, I think it was fantastic. It was the perfect timing for me, and we've continued to flourish, we're continuing to grow and impact our community, which outside the Atlanta area, you would not think that there exists. deserts or pockets where people have difficulty accessing health care. But there, there still really is such a large need that exists,
it's a difficulty because of insurance problems, or just there physically aren't pediatricians around for them to see,
That's a combination of both. So in our state, approximately 60 counties do not have a pediatrician, and as growing, and that has a lot to do with reimbursement rates, etc, different pressures that face you know, physicians and health care. So it's hard to recruit, hard to recruit.
The major health centers are all all in Atlanta, unfair advantage, geography. Scottish Rite in Atlanta, am I confused?
Exactly right, Scottish Rite is in Atlanta. However, I think part of the issue are the challenges for a lot of the rural communities out there, they may have to drive, you know, four or five hours to access care.
That's a heck of a long drive. That's crazy.
You're correct and, you know, even though we have several specialists in our community, you know, for example, certain health insurance, there might only be two pediatric dermatologist for the whole state, you know, so, of course, that creates the access issue. But so I picked Snellville Georgia, where it's a wonderful mix of people from all over the world, and just a wonderful community for me to watch this.
What do you think is the in what way do you feel you're practicing that is different than some guy to two roads over? Or maybe five hours away from you? Do you practice differently?
One of the ways that we practice differently as we are, I definitely embrace the philosophy of treating the whole child and the whole family. So we do have a psychologist within our practice. Obviously, mental health has been a concern for quite some time in pediatrics and the epidemic and the concerns are just rise exponentially. Exactly. And so I love having time with my patients as well. So, you know, previously I might have had about five or 10 minutes. The way that we schedule our appointments, I certainly can have up to at 20 to 30 minutes. With our appointments, which I absolutely love, I get a chance to really understand what that family unit is in order to raise a thriving and successful child. And that is our whole focus. So we're looking to add additional ancillary services within our practice later this year, that will continue to incorporate with wellness. And particularly nutrition is another area that I'm very passionate about is well, and the rising epidemic of not only obesity, but type two diabetes in the pediatric population, it's especially during the pandemic, there are a lot of needs that need to be addressed. And you just simply cannot do that in a five to 10 visit.
For the people who who worry about finances, most of us how, how well does that work, and you still can pay yourself a salary even though you're taking twice as long with a patient.
So I think one of the ways that you can help make sure that you have a sustainable business model is, first and foremost, looking at the structure of your staff and your overhead. We live in a time where you can certainly leverage technology in many different ways. And you can still achieve and perhaps even exceed your previous outcomes by leveraging these features. So for example, one thing that can happen, unfortunately, could be medical errors. And particularly when you're busy in pediatrics and you have a lot of children that are in your office for immunizations or other medications, using a system that I won't, I won't say their name, but using a system that actually if I place an order in my electronic health record, it actually will dispense the correct medication or correct vaccine, it will not dispense anything that is expired, which is absolutely fantastic. It helps with inventory management. So it does a lot of the physical demands that used to take quite a lot of time from my medical assistant. So you know, it allows me to run a little leaner, and also just knowing how to code appropriately, I think helps a business owner be able to make sure that their profit margins are where they need to be to continue to move forward offering the services that they like to offer.
You do much in the way of telehealth with your community.
Yes, yes, I fell in love with telehealth, like I said probably in 2017. So I continue to utilize telehealth. And I think also it's another way for me to be able to build that intimate trust with my families. I think that's another area that's very concerning. There's a lot of misinformation and disinformation, of course that exists on the internet and in families. And, you know, parents are often conflicted with what information to trust. So somebody gets sick, like, for example, I had somebody yesterday, they thought their child had pinkeye. And they were contemplating going to the emergency room, one of the most expensive ways, of course, to treat a very simple condition. So we were able to offer a telemedicine visit even after hours. To be able to assist with that feelings means it was convenient for them. It was pretty simple for our staff as well. And we deliver that service. And I think the other concept I'd like to stress is within the medical home. There certainly are, you know, opportunities and there are definitely reasons why direct to consumer platforms should exist. But in a lot of instances, being able to have a similar platform but delivered within the medical home can be even that much more
fragmented care is such a big issue. Yes, " I don't tell you about that because Dr. So and So takes care of that". No, I need to know all the things about your health. So what would you advise a new graduate to think about or even somebody who's reached their middle of their career They assume they've okay, this isn't really working for me anymore. I'm exhausted when I go home., what would you what would you suggest they do first other than take a deep breath?
Yeah. So I think you made the first step, which is, take a deep breath, you have time to reflect and determine what works best for you. And I think if you still live by that guiding star, your Northstar of what your true principles that will allow you to navigate that pathway. So I also would suggest, take off the limits and the boundaries, I think we're so conditioned to think about delivering health care in one way, there are many different ways that you can make a difference. And that can be a small way or as big as you'd like it to be. But first of all, you can't even recognize that if you don't take those limitations off of yourself. So I definitely think that's really important. The next thing I would say is finding other people who are doing what you think you may want to do. And become a, you know, go back to your childhood, just become a continued avid learner, learn as much as you can about what you want to do. So do your research, find others that are doing that within your community and begin to network. I think when I reflect on when I first finished training, I get a little intimidated, initially, you know, going to conferences, going to meetings, and what in the world do I have to offer I just got finished. There's so many different things that you have to offer. So I think that's really important. And honestly, the same principles apply. In the middle of your career, I think people, again, begin to think that Well, I'm getting older, you know, I'm winding down, I don't have it the way I used to have it. And well, certainly there's no way that I can do this now. So I'm stuck with what I know. And it's just too much of a problem, right or too difficult to start and embark on something else different. And again, that's that's totally not true. And I think being geared with like minded individuals. And like you said, Denise, I'm so happy and thrilled that you're my accountability partner. It helps you navigate, you know, the path for you. And then lastly, one foot in front of the other very simple, basic, you know, recommendation or advice that we hear all the time, but truly, that is what it takes just start and just, you know, take those people and I
think realizing, especially if you're coming from a hospital system, or fresh out of residency, and some people start their medical career later anyway, they're already, you know, in their 40s, perhaps when they're finishing residency, just because the hospital says this is the way it has to be doesn't mean it can't be reimagined. But you do need a network of people to help you. Bounce ideas up, bounce some ideas off of people, which I think ought to segue into what if you're not a coach, how do you help people?
Then so actually, one of the other hats that I wear is being a Medical Consultant. So I have consulted with individual physicians, as well as health centers, my biggest experience comes with like FQHCs and other small to midsize practices, helping them optimize their workflows and help them in my old days, I did a lot of implementation with EHRs, as well as just improve other efficiencies as well. So the TriStar Medical Solutions is the name of my consulting company, and I have always enjoyed doing that. And it's interesting how that all got started, was because nobody else knew how to do that, or configure those templates for your EHR, etc. And so I was getting frustrated with how challenging that was to actually help me finish my day. So actually, I've been on EHR since 2001. Way before EHRs were popular but required, required Exactly. And, you know, I could realize immediately that this definitely was going to be the way way that our industry was going to navigate towards, but it was so clunky, it wasn't intuitive, it made it more cumbersome. And still, even today, I think if things are not configured or templated in a correct manner, um, some people find that they go home with mountains of charting to do after work, you know, so.
So is that is that part of your consulting work helping people to figure out how to not go home with a mass of work?
Absolutely massive. Absolutely. And then on the business side, taking a look at your organizational structure, looking at ways that you can integrate other types of technology within your, within your practice or within your company, where you can streamline your efforts. And again, begin to increase your outcomes, hopefully increase your bottom line as well. And in the meantime, improve and increase the customer experience as well
Not sure about calling them customers, but okay.
If I'm putting my consultant business, I realized that if I go back to the absolutely, they're just they're our patients or our families. And since I am in the middle of my career, I really enjoy seeing the second generation now. Right?
Yeah. That's the wonderful part about pediatrics. I think that you absolutely. Yeah, that's wonderful. So are you do you do this across state lines? Do you just consult for people in Georgia? Are you able to reach out online to people?
That's a great question. So initially, my experiences all been within the state of Georgia. But more recently, I've assisted a client in Florida and one in Maryland. So I am in the midst of kind of revamping my consultant company, because of course, a lot has happened within the area of technology and innovation, particularly within the healthcare space. But my goal is to continue to expand my reach a little bit further, geographically and across the US and maybe even across the world.
Good. It's gonna be an empire. Yes. And I have to say, I don't think we have to, it doesn't matter whether your goals are tiny or big. They have to be your goals, they have to fit with the rest of your life, we aren't just physicians were evil.
Exactly. We are people exactly. And so learning how to utilize other modalities to begin to disseminate the information that you have within yourself to help others along their journey. That's why I love masterminds or, you know, digital courses, there are a lot of different ways to begin to still disseminate that information, I do have a limited capacity of what I can do, and how many individual organizations that I can take on, you know, hands on one on one, but there's still opportunities to be able to make that impact and disseminate that information.
Do you speak on this subject with formal conferences, or go there more as a listener?
Yeah, I started off more as a listener, I have definitely spoken professionally, in this space. And looking to do more of that, I would state that currently, most of my experience now as a professional speaker, is aligned around the business of medicine, as well as advocacy, since I've been doing that extensively for 15 years, and how you can take your advocacy efforts. And actually, if you so choose, you know, start a nonprofit organization or start some other company that again, begins to move forward with the area that you're interested in advocating about.
It, it's great. Learning more about you every time we talk. So what what, where do you okay, this is a typical coaching question here. Okay, where do you see yourself in five years?
That's such a loaded question. And that's actually part of what I'm working on. This weekend, actually, I am five years I see myself with the current practice just, I can see the additional ancillary services that we have, not only with our psychologist But is there an opportunity for doing more wellness programs within our pediatric space that's very commonplace within the adult space. But within pediatrics, you often don't see that as much. So I'm writing the roadmap and my vision towards that. I see myself also, in the next five years, working more on some of the things that are in my journal, journaling for the past 15 years. And I probably have, oh, I don't know about 30 titles, and I'm not quite sure if I would like them to be a podcast or a book. But I've always had an interest in doing more in that space. And I can see myself having more time, now that I've created a practice that better suits my hours and reflects a little bit more, what I'm looking so looking to practice what I preach about having, you know, personal time and space for yourself, I'm dusting some of those journals off and taking a look at what was I think, five years ago? And does that still resonate today with my core operational principles? And what do I want to bring forth? Do I want to bring that forth in the format of a book, or a guide, or what I prefer just to do a podcast. So I've written lots of things over the years. And I definitely see myself, I'm still working and seeing patients. But I definitely think that instead of like 95% of my time in patient care, that will be reduced. As I begin to add others to help me operationalize my dream, my mission for the practice. I can see myself reducing direct clinical care, and we're more of a manager for Yeah, and being more than manager for that, and working on those other projects that have been emergent.
Do you see yourself being a sort of incubator would would more junior doctors come work with you alongside you to help you grow your business, but then go off and start their own satellite or just their own space? Because, honestly, your noses to the grindstone so long, getting to school, getting through school, getting through it, I mean, just getting some time to sleep in residency is a challenge. So you know, you have to be able to take a breath and look around to see what else is possible.
Absolutely. So the incubator, I think sometimes is the highest compliment. I think one of my I don't want to use the word motto and the word is definitely escaping me but one of the principles that I like to live by is that whoever comes into my sphere, whether I'm there to guide them or to mentor them, I hope that they do leave, you know, better, their tools, they're better equipped to move forward with whatever their journey is to do. So I am very grateful and thankful to some of the mentors that I've had over the years. I am who I am because of my family and a lot of good guidance and and it's incredibly important. So yeah, I don't mind being an incubator, I would love one or two to stay behind so that when I decided to sell it, just assume over the practice. But yeah, I definitely don't mind that at all.
Sounds great. Thank you so much for joining us today. Before we go though, do you would you like to just shout out your contact information for anybody who has been inspired by this wherever you are, if you're if you're in Australia, Melinda'd really like to talk to you.
Right so if anybody finds it intriguing or inspiring or you just have general questions, you can reach me with multiple different methods so on Twitter I'm always there is @mwilllingham7 Instagram is @drmelindawillingham the same thing on Facebook as well. So just reach out to me and on LinkedIn, it's also Dr. Melinda Williams,Willingham, you can look and find me there. Show notes of course as well. Love to continue the dialogue and conversation.
Thank you so much, and I'll see you next accountability meeting. Thank you.
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 healthcare professional if you think something you have heard might apply to you or a loved one. Until next time
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