June 26, 2017

Considering Pharma? Check out the DIA 2017!

pharma reseracherLast year was a big year for pharma at the Doctor’s Crossing. Four of my clients landed great jobs in pharma and I attended the inspiring world-renowned pharmaceutical conference – The DIA Global (DIA – Drug Information Association).

One of my four clients had no prior pharma experience and she is now working happily as a Drug Safety Officer for a large pharmaceutical company. She is proof that you can get into pharma without having experience in clinical trials or research. 

In my on-going efforts to learn more about pharma, scout for opportunities for clients, and get a better feel for the community, I attended the DIA’s annual conference in Philadelphia last year. I was one of 6,454 participants and I loved every minute. There was an electricity in the air which I attributed to being amongst so many bright individuals who are passionate about improving the health of patients in profound ways. Before I share specifics about the conference, I want to give you an idea of positions open to physicians in pharma.

  1. Drug Safety Officer  (Pharmacovigilance)– involved with reported side effects from drugs, labeling, SAE’s (serious adverse events). Can include involvement in preclinical studies. clinical trials and post-market stages. Public education.
  1. Medical Monitor – advises on clinical trials, planning, and implementation. Monitors patients enrolled in trials for safety, side effects and suitability for study enrollment and completion.
  1. Clinical Trial Researcher – participates in and oversees clinical trial design and implementation. Actively involved in running trials and design.
  1. Medical Affairs Director– bridge between drug development, marketing, and public education. Involved with medical information, communication, launch and post-market strategies.
  1. Medical Science Liaison –a knowledge expert in a therapeutic area, develops relationships with KOL’s (Key Opinion Leaders) externally, resource for physicians in practice; educational and communications role. Frequent travel.
  1. Medical Writer– prepares regulatory documents, slide decks, scientific articles, white papers, covers scientific and medical conferences, etc.
  1. Regulatory Affairs Director – knowledgeable about FDA regulations, prepares and submits regulatory documents, negotiates for market authorization for drugs and devices, keeps informed regarding legislative changes.
  1. Health Economics and Outcomes Researcher (HEOR) – concerned with the cost-effectiveness of drugs and devices, value, as well as the impact of treatments on patients.

 For a more complete description of these positions for physicians, please click HERE. (Note – the job opening links are no longer active).

Click HERE specifically for the Medial Science Liaison.

Sameer Thapar (PharmD), Director of Global Pharmacovigilance for Oracle, and one of the speakers at the DIA, shared a simple way to think about the complex array of jobs in pharma. He said, “There are the Makers, the Sellers, and the Defenders.”  The Medical Affairs and Medical Science Liaison positions help to bridge these three areas (my addition).

When considering a transition to pharma, you may wonder whether or not you would miss patient care and if you’d feel like you were making a difference in a meaningful way.

Dr. Kelly Curtis, my former client who now works remotely as a Medical Director and Medical Monitor for INC Research said this about his transition, “I find non-clinical work very rewarding and feel like I make more of an impact on the future of oncology in this role than when I was in academia.” 

I personally know a pediatrician who works remotely for pharma and he does a few pedi-urgent care shifts a month to keep his clinical connection to patients.  Although maintaining some degree of patient care while working in pharma is not the norm, some doctors find ways to do this through volunteering, medical trips abroad, or attending in a teaching setting.

The satisfaction from helping an individual patient can shift to helping entire populations of patients. Dr. Larry Brilliant, who gave the DIA 2016 Keynote address, recounted his fascinating involvement in eradicating smallpox and his on-going efforts to prevent and treat blindness in millions of individuals in developing countries. You can read about his amazing life’s work intertwined with his spiritual journey in his hard-to-put-down new book, Sometimes Brilliant

Here are some of the Hot Topics on tap for DIA 2017:

  • Data/Big Data/eHealth – informatics, data integration, bioethics
  • Disruptive Innovation – innovative science, technology and therapies: stem cells, regenerative therapies, gene therapies
  • Medical Affairs – MSL (medical science liaison), medical writing, medical affairs roles throughout product lifecycle
  • Patient Engagement – patient-centric practices, advocacy, culture, tools
  • Safety – best practices, post-market safety considerations, monitoring
  • Regulatory – advertising and promotional laws, regulatory writing, document management, compliance
  • Special Populations – Rare diseases, pediatrics, women’s health, aging
  • Preclinical and Clinical Development – discovery, clinical research, recruitment, clinical trial data disclosure, outcomes, statistics
  • Value and Access – drug pricing, reimbursement, access, real world outcomes

For additional information on the Hot Topics for DIA 2017 please click HERE.

For the Agenda for the DIA 2017 please click HERE.

I particularly enjoyed a panel presentation on “Big Data” with oncologist Dr. Brad Hirsch, CEO at SignalPath Research. Dr. Hirsch continues to see patients as well as work in pharma in the areas of informatics, innovation and gene-based therapies. You can tell he loves caring for his patients, and also being at the cutting edge of finding cures for the cancers that threaten their lives.

If you’re considering pharma, attending the DIA will give you a deep dive into this area, as well as the chance to make helpful networking connections. And your attendance would be an undeniable indication to any hiring authority of your genuine interest in this career direction. This is just one of a number of ways to increase your chances to land a pharma job.

Even though my time at the DIA was beyond busy, especially since I made a point to network at all of the exhibitor booths (pens anyone?), I left energized and uplifted. Call me pollyanna, but I felt that I was among a large group of people who really care about giving patients the chance for healthier and longer lives.  As physicians, and as individuals with loved ones, we know personally how devastating having an untreatable condition is, or having a poor quality of life due to illness. Pharmaceuticals are, of course, only part of the answer to good health, but when nothing else works, the right drug is truly a miracle.

The DIA 2017 will be in Chicago, June 18 – 22. 

 

 

 

 

 

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Parental Pressure to Be a Doctor – Did This Happen To You?

mount-everest

I was lucky. I had parents who never tried to push me into a specific career direction. They held pretty loose reins and let my brothers and I chart our own futures. We became a physicist, an engineer, and a physician. When I announced I was going to be an Art History Major, I’m sure my mom and dad bit their tongues and scratched their heads. But they let me make my own decisions and my own mistakes. After a year of studying Italian Baroque painters, I was scratching my head too.

I know a lot of you have not been so fortunate. I hear your stories. One physician told me his mother recounts how she would push him around in his stroller, proclaiming to strangers, “This is my son and he is going to be a doctor.” He tried his best to live up to her expectations, but when he was in medical school, he called his mother up to tell her this decision was a mistake. She wouldn’t accept it and made it clear how devastated she would be if he quit. To help himself make it through, he used to imagine his medical school was made of glass. Pretending that he could see through the walls made him feel less trapped. Decades later, this physician is dealing with a deep sense of regret for having followed a path that was not his own.

He was able to make it through (for better or worse) but for some, the body and mind can revolt. One young physician, who had been “directed” into medicine by family pressures, began experiencing depression in medical school, which continued into residency and was compounded by chronic fatigue-like symptoms. Being unable to perform to expectations, despite having been a top-notch student, she left residency.

Over a period of time, her depression and symptoms resolved, yet if she took steps to return to residency, the symptoms abruptly recurred. She is trying to figure out the right career path for herself, but the challenge is compounded by external pressure. She shared with me, “Now my entire family (including extended family) is in a united front to convince me to continue in medicine, as long as it is a specialty acceptable to them. Overall, there was and is a lot of controlling in my family as it relates to my career… Parents really should give kids the opportunity to explore careers and decide for themselves!! At the end of the day, I have to learn to trust myself, right?”

Right! I wholeheartedly agree.

I do believe most parents genuinely want their children to be happy and successful. Many work very hard and make significant sacrifices so their children can have the best chance for a fulfilling life. However, when these good intentions are muddied with parental attachment to a fixed idea of what their son or daughter should do or be, there is no longer a clear space for direction to come from within. I’d be rich if I had a nickel for every time someone told me that growing up they heard, “You are going to be a doctor, a lawyer or an engineer.”

Medicine can be a great career but it’s challenging and places a lot of responsibility on the individual. There are considerable sacrifices – the years of studying and training, countless sleepless nights on call, the challenge of balancing work and family, the long hours, giving up outside interests, etc. The decision should really be one’s own. When we become doctors, we are the ones who are responsible for our patients. When there is a bad outcome, it’s our responsibility. When a patient dies, it’s on our heart. If we are sued, we are the ones in court. The joys are ours too, but they come with a price, and we need to have consented freely to that cost.

When my Uncle Tom was dying from lung cancer, he asked me to take him to a talk on the difference between love and attachment. The speaker held out a clenched fist to illustrate the concept of attachment. He explained that when we are coming from attachment, we hold tight and cling to what we want – whether it is a person, an idea or an outcome. Attachment stems from fear of loss and makes us resistant to other perspectives. He then opened his hand and stretched out his fingers so his palm was facing up. “This is love,” he said. He explained that love comes from trust and gives space to others. Love is not invested in having things be a certain way, but desires for truth to be revealed, even if it is painful.

In order for each of us to find the truth of who we are, we need the chance to figure out our own calling and purpose. It is one of the big mysteries and joys of life.

When I think of people such as Martin Luther King, Elizabeth Taylor, Georgia O’Keefe, Ben Franklin, and Ghandi, it’s hard for me to imagine them being anything other than who they were. What if they had all been told to be doctors? It’s hard to even conceive of this. What they did was so much a part of who they were. Whether we become famous or not, whether we have a “do-or-die” calling or not, we should still have the chance to find out who we were created to be.

No one else should be selecting our destiny for us. I doubt there are very few individuals who climbed Mount Everest because their parents wanted them to. Becoming a physician is akin to climbing a kind of medical Mount Everest. The choice should be yours. Everest needs to be calling you.

The physician stories were used by permission.

Using Your Internal GPS for Career Change

Is your internal GPS telling you it’s time to change your career direction? Is it saying “Recalculate! Recalculate!” but leaving you stranded at the crossroads, failing to provide any further instruction?

If so, it can feel overwhelming, daunting, and confusing.

 

give-me-a-map-woman-final

Uncertainty is uncomfortable. It’s natural to wish for some kind of roadmap to guide us through a process of change.

It makes sense that we feel this way. To become a physician, we had every step mapped out for us. Yes, it was quite a climb, but even Everest has a summit and there is one way up. If you don’t give up and make it to the top, you win. There is guaranteed employment, a career with status, and a paycheck.

 

stair-step-cartoon

 

There is a sense of security in such a well-trodden path where the finish line is visible before you even start. However, as our high physician burnout rates reveal, there is no guarantee of happiness. There is no certainty that the rules of engagement won’t change or that expectations will be met.

The shifting sand at the top of the seemingly sturdy staircase has left many considering other options. Instead of using the staircase that guided us, we now have to create our own path.

If we were wired like Lewis and Clark, we wouldn’t have gone into medicine. We’d be bushwhacking with Sacajawea by our side, discovering new lands – not practicing evidence based medicine.

But in spite of our predilections, we may find ourselves staring into a great expanse of non-clinical career terrain, wondering where even to take the first step?

Since we don’t have the prefab staircase outside of traditional practice, we have to use a different approach. Siri had the right idea. We need to use our internal GPS. We need to be able to listen to ourselves and hear our own guidance.

The connections may be a bit rusty if we’ve had to push down that inner voice in service of our career. It may take time to start hearing our true inner voice and what we need and want. When we start to listen, we might be confused by the presence of two voices, one coming from fear-based thinking (The False Self) and the other coming from trust-based thinking (The True Self). Here are some identifying characteristics to distinguish the two:

The False Self – fear-based and self-doubting

  • Sees problems rather than possibility
  • Jumps to the “What if’s” – what could go wrong
  • Is accompanied by anxiety
  • Sells your abilities short
  • Has to see all the steps before starting

The True Self – confident and trusting

  • Focuses on possibilities rather than problems
  • Is able to imagine success
  • Creates a sense of calm internally
  • Does not over or underestimate your abilities
  • Is comfortable taking steps without having all the answers

How do we turn up the volume on the True Self and mute the False self?

1. Start noticing anxious, fear-based thoughts. Write these down and note the frequency.
2. Look at the fears objectively and see if they make rational sense.
3. Take stock of all you have already accomplished and the challenges you have met.
4. Give yourself permission to accept whatever feelings you are having. Get curious about their origin, rather than judging them.
5. Practice mindfulness or meditation techniques to help quiet and train the mind so it is not so reactive.
6. Do things you enjoy and love. This will awaken the heart, which is part of the internal GPS
7. Believe in the value of your individual uniqueness. Embrace your path and don’t worry if it doesn’t look like anyone else’s.

Our Internal GPS = an awakened heart + rational, non fear-based thinking

To get started on your career transformation, you don’t need to enter a specific destination into your GPS. You can start with a commitment you make to yourself. It can be a simple statement such as:

“I want to enjoy my work.”

“I want my work to be fulfilling.”

“I want to have quality family time.”

“I want to make a difference in a way that is meaningful.”

“I want to use my creativity.”

“I want to use my brain more and be challenged.”

Your internal GPS will start to work on the initial steps, and as you gain more clarity, keep refining the destination. Staircase or no staircase, it’s OK to “recalculate” so you end up in the right place – for you.

Burning Out? Recommendations For Your Personality Type

I really, really wish I could change the healthcare system so it would stop burning out so many hardworking doctors. I would gladly be out of a job if it meant this soul-crushing medical system cared half as much about doctor satisfaction as it did about patient scores.

But sadly, I know I alone will not change the system. So every day I ask, “How can I help my doctor clients avoid burnout?”

It’s not a magic wand, but what I offer here is a tool to help you better understand your risk factors for burnout based on personality type, and provide recommendations for healthy coping strategies.

My approach is based on the Enneagram Personality System, which has 9 basic personality types (ennea means nine). If you don’t already know your type, you can take the most accurate $12 Full RHETI test – by clicking here. Alternatively, you can read through the descriptions and see which ones best fit you. Even though you will only have one primary personality type, aspects of the other types are present in you to a lesser or greater degree. This is a long blog, so it is fine to just read the section for your type!

enneagram type 1 mThe Reformer/Perfectionist: High standards, wants to do the right thing, disciplined, focused on improvements. Wants to avoid mistakes, can be self-critical, judgmental of others.

Risk Factors

  • Working in an environment where integrity & respect are lacking
  • Being obsessive/compulsive regarding charting and tasks
  • Feeling guilty when relaxing and not being “productive”
  • Having difficulty delegating and trusting others to do a good job
  • Having a harsh inner critic

Recommendations:  Since you have a very high degree of integrity and care deeply that things are done correctly, you can suffer greatly in a work environment that is not aligned with your values. You may be spending extra time and energy trying to change a system that does not see things as you do. If this is the case and conflict is arising, you may need to find a different approach or a better job fit. You have high standards for your work, including documentation, but if charting is taking an inordinate amount of time, do a trial period of more succinct notes for two weeks. You can always go back to the longer notes, but perhaps shorter notes (with even a few typos) may be acceptable. The Type One has a very strong inner critic, which can be very hard on itself (and others). See how it feels to take on a kinder, more forgiving tone with yourself. There is often a subconscious fear in Ones that if they give themselves a little slack, they will turn into slackers, but this is not a risk! Allow yourself more freedom for guilt-free indulgence, and simple, pure fun.

enneagram type 2 mThe Helper: Enjoys doing for others and being needed. Warm, compassionate, connecting. Can over-do and get caught in people- pleasing.

Risk Factors for Burnout

  • Becoming overcommitted
  • Having difficulty saying “No” and setting boundaries
  • Allowing others to take advantage of the desire to please
  • Losing focus on your own needs and wants
  • Being overly empathic and suffering compassion fatigue

Recommendations: You truly enjoy helping others, connecting and seeing how you can meet the needs of others. As a physician, this can put you at high risk for compassion fatigue and burnout from giving too much. Examine your current personal and professional commitments. Where are you being stretched too thin? What can you let go of? Before saying “yes” to additional commitments, press the pause button and consider whether this obligation serves you. Is it something YOU want to do? Take stock of your self-care and personal time. Is all your time going towards work and family, with little left over for you? Try putting yourself first for a few weeks and see how that changes things. To do this, you will likely need to ask for more from others and redefine some boundaries. If others’ needs are so important, why would yours not be just as important?

Enneagram type 3 picThe Achiever: Focused on accomplishments and getting things done. Motivating, efficient, adaptable. Likes to check off boxes and climb the ladder. Image conscious, competitive.

Risk Factors for Burnout

  • Looking to achievement for self-worth
  • Being a workaholic
  • Losing self in the pursuit of goals/status
  • Letting relationships suffer from neglect
  • Having difficulty slowing down and just “being”

Recommendations: You excel at setting goals and achieving. You thrive from performing well and having the high regard of others. Doing so can result in career success and a great CV, but it can also leave you feeling empty and disconnected from your heart. Ask yourself what is important about your goals, why do they matter to you? What have you had to sacrifice to achieve your goals? Are there other things more important to you now? As an achiever type, you may have put your feelings aside to reach your goals. Slow down in order to find out what is driving the achievement. Ask yourself if there is something else your heart desires. Even in spite of significant achievement, Threes can have self-esteem issues. A good counter to this is fully accepting who you are, and letting go of comparisons with others. Finding your own authenticity and being comfortable with all aspects of yourself, including your appearance, will create more inner peace than any outer achievement.

Enneagram type 4 fThe Individualist/Romantic: Values self-expression, creativity, and finding meaning. Well-developed aesthetic sense, stylish. May be moody and overly sensitive.

Risk Factors for Burnout

  • Working in an environment that is a mismatch for your True Self
  • Being hypersensitive to criticism, feeling shame from mistakes
  • Being prone to moodiness, melancholy, depression
  • Becoming quickly dissatisfied with accomplishments, circumstances or people
  • Allowing emotions to get in the way of staying on task, not being disciplined

Recommendations: You are highly creative, intuitive, and seek meaning and connection in your work. As you like to express your ideas and unique approach, a work environment that is too confining and does not value your individuality will not be a good fit. Having a job primarily for income will not be sustainable. Look for ways to custom tailor your work to match you. Allow yourself time for creative pursuits in your personal life: writing, music, interior design, acting, cooking, etc. If your emotions are getting in the way of finishing more mundane jobs such as charting and completing projects, habitually schedule specific times for these tasks on your calendar. Melancholy is pretty common for this type; but if you find yourself slipping into depression, seek help. See where you can acknowledge the goodness in yourself and what you have created in your life and find satisfaction there, without anything having to be different.

Enneagram type 5 fThe Investigator/Observer: Tireless learner and experimenter. Perceptive, innovative. More comfortable acquiring knowledge and working with ideas than interacting with others. May feel socially awkward. Likes time alone for thinking.

 Risk Factors for Burnout

  • Excessive patient and staff interactions (strong introversion)
  • Having to be in a noisy, busy clinic or hospital setting
  • Feeling intellectually stagnant in routine practice
  • Avoiding dealing with issues because of emotional content
  • Being preoccupied with “what if’s” – worries, scary thoughts

Recommendations: You are an innovator and deep thinker. Your ideal work setting is one where you can focus deeply without interruptions and work independently in your area(s) of interest. A clinic setting with high patient volume, interruptions, and too many routine cases is going to burn you out quickly. Diversifying patient care with research, teaching, and projects can be helpful. Try to find a quiet place to do your work and ask others to minimize their interruptions. Wealth and prestige are not huge motivators for you, but internal success is. You do what you do because it fascinates and intrigues you. If your work is not feeding this need, it may be valuable to reexamine your job/career.


Enn type 6The Loyalist/Questioner: Dependable, hardworking, reliable. Wants to know the rules, do what’s expected. Engaging, loyal. Concerned with security and preparing for the future. Prone to “what if” thinking and anxiety. ***At least half of my clients are Type 6’s. Very common for doctors.

Risk Factors for Burnout

  • Over-working and preparing in order to exceed expectations
  • Worrying about patients and catastrophizing
  • Focusing on problems instead of possibilities
  • Staying in a bad situation out of loyalty
  • Being uncomfortable with uncertainty – (change is hard)
  • Experiencing self –doubt (second guessing decisions)

Recommendations:  You excel in organizations due to your hard work, problem-solving abilities, people skills, and desire to exceed expectations. Able to make sense of large amounts of complex information, you can readily explain things to others in simple terms. You easily over-work yourself, so set healthy limits on your own expectations and set boundaries in your work environment. Because anxiety and self-doubt can be an issue, make a realistic assessment of your abilities and have more confidence in your own decision-making capacity. Try to avoid spending unnecessary time second-guessing yourself and asking other’s opinions. Pay attention to how often you are worrying about the future. See what you can take care of in the moment to relieve your anxiety, and counter the habit of perseverating. Trust that you have the resources, both internal and external, to meet what the future holds. This trust can help you move forward if you need to face uncertainty in order to make positive changes.

enneagram type 7 mThe Enthusiast/Adventurer: Optimistic, social, multiple interests and activities. Resists limits. Can become easily bored, scattered.

Risk Factors for Burnout

  • Becoming bored from limitations of routine practice
  • Being impatient and seeking adventure can lead to impulsive decisions, risk taking
  • Getting scattered from too many spinning plates
  • Becoming dissatisfied with present, focusing on future
  • Avoiding underlying issues/anxiety by keeping busy

Recommendations: You are a glass is half full kind of person and bring energy, high spirits, and a sense of adventure and fun to those around you. You will do best in a work environment with a lot of variety, stimulation, and interaction with others. Jobs where you can take on new projects and then move on, such as consulting, or jobs with excitement and the fast pace of the ER are good options. If you’re feeling bored in your career, take time to understand yourself and your needs before leaping into something else. Be careful not to overload yourself with so many activities that you get scattered, impatient and drained. The desire for adventure and excitement, and avoidance of anxiety and pain, can make it hard to be present and enjoy the now.

Enneagram Type 8 pic maleThe Challenger/Asserter: Assertive, big energy, likes to be in control, lead others. Entrepreneurial, may be a risk taker. Will suffer in order to protect others. Not overly concerned with others’ opinions. Avoids vulnerability.

 Risk Factors for Burnout

  • Pushing beyond healthy limits, overworking
  • Getting into conflict/power struggles
  • Not wanting to show vulnerability, not seeking help
  • Taking risks that jeopardize financial stability

Recommendations: As a Type 8, you like challenges, autonomy, truth, and being able to be your own boss. You may be in a surgical subspecialty and or have a leadership role. You are no stranger to hard work, and may put in longer hours than your colleagues. However, know that you’re human too, and need rest and healthy limits. Take a look at your weekly schedule. Are you overdoing it? Is there any downtime? Try to understand what is driving you to push yourself so hard. What do you want to achieve from your efforts? If you tend to be overly self-sufficient, see where you might allow others to meet some of your needs and provide support for you. There may be times when you are feeling passionate about something, but others may interpret this as anger. A rousing discussion to you could feel like an argument to someone else. If you are experiencing conflict with others, it could be helpful to hear their perspective and solicit feedback.

Enneagram Type 9 PicThe Peacemaker: Grounded, calm, agreeable. Goes-with-the-flow and keeps peace at any cost. Able to see all sides of a situation. Patient. Non-confrontational.

 Risk Factors for Burnout

  • Putting others needs, wants, and preferences first
  • Failing to advocate for self by being conflict avoidant
  • Having difficulty knowing what you really want
  • Procrastinating, escaping reality (reading/TV, etc)
  • Discounting your value, selling yourself short

 

Recommendations: You bring a calm, accepting energy to your workplace and like to be in a comfortable environment where you feel connected to others and valued. You listen deeply and have a gift for seeing things from someone else’s perspective without judgment. These are great things, however your adaptability and sensitivity to others can cause you to lose sight of your own needs and wants. Often there is something you need to express or ask of someone else, but you discount its importance or do not want to stir up conflict. Try writing out exactly what you want to say or ask for, whether it is to your boss, spouse, colleague or friend. Find a diplomatic way to then address the issue. It is important for you to know that you can have a voice and express yourself. As a type 9, you may be staying way too long in a job that you don’t like. Inertia can take over and days can turn into years. Procrastination is rarely due to laziness. There is usually some underlying fear, concern, or false belief that is maintaining the status quo. Give yourself a pinch, set a deadline for action, and know that when you align with your own inner driver, you are unstoppable.

Final Note. One reason I like the Enneagram system is because it is a tool for personal transformation. For each of the nine types, the Enneagram system describes nine levels of psychological health, offering a roadmap for moving up the levels, thus enabling us to live from our highest, truest self. The things that challenge us about our type, often become our greatest gifts, as we learn who we really are, beyond the structure of the personality

Want to learn more?

Enneagram Institute Website

Books:

The Wisdom of the Enneagram by Riso and Hudson

Bringing Out the Best in Yourself at Work: How to Use the Enneagram System for Success by Lapid-Bogda

The Career Within You: How to Find the Perfect Job for Your Personality Type, by Wagele and Stabb

The resources above were used to help create the content of this blog. The focus on physician burnout is my own and does not necessarily represent the views or opinions of the authors.

I Was A Sick Superman!

superman

We’ve all heard about doctors with a Type A personality, and how these individuals can be workaholics, driving themselves to burnout. While it’s true this type can definitely suffer from burnout, all personality types have risk factors.  In two weeks in the blog, I’m going to detail the different risk factors for the most common personality types I work with, giving recommendations for avoiding burnout. But today, I have a special interview to share with you; Dr. Arcadio (not his real name) is one of my great clients who shows how his personality type led to burnout and how he recovered to enjoy his practice again.

HF: Can you tell me what factors led to your burnout?

Dr. Arcadio: I have a type A personality. No, probably triple A. Growing up in an immigrant family, and being the first to go to college, I was driven to make something of my life. Getting my degree was a huge accomplishment, and it made me believe I could do anything. I started my own practice and kept telling myself I could work harder and see more patients. I kept doing this until I became a “Sick Superman.”

HF: What did your life look like when you realized you were a “Sick Superman?”

Dr. Arcadio: I was working 6 days a week, 12 -18 hrs a day, and seeing over 70 patients in a day. I was in an underserved area and the patients needed me. I’d been doing this for a number of years, and then one day I started to feel strange. A once very cheerful and kind physician became someone who started to hate being around patients. When I had a difficult patient my head would get really hot and my scalp would start to itch like I was going to blow my top. It was hard to control my temper. My family life was suffering and I was miserable.

HF: Besides working so many hours, what else contributed to your burnout?

Dr. Arcadio: It was not one thing, but I felt attacked on many fronts. Today’s healthcare is “managed” now from the very top of government to the insurance companies, and even pharmacies. And as I mentioned, the physician personality is partly to blame. We like to be perfect, and are expected to be perfect. This includes never calling in sick, being available late at night and for weekend emergencies, and even while on vacation. I felt like I needed to take ALL insurance plans and squeeze patients in even when I was very booked out. I had to see referrals promptly and keep the referring physicians happy. Then there were all of the business decisions and office management to keep the practice going. I felt like I had created a monster that I needed to feed.

HF: How bad did the burnout get?

Dr. Arcadio: Twice I had suicidal thoughts. It was right before I called you. I didn’t have a plan but I just didn’t want to be here and couldn’t see a way out. I have never ever been depressed, so this was very strange for me.

HF: What else was going on in your life during this time?

Dr. Arcadio: I was involved in a bunch of charities and did medical missions in the US and elsewhere. Before I knew it, the frequent, “Sure, I’ll help you with that,” turned into being heavily involved in 8 non-profit organizations… As part of my “burnout treatment” I now must say “No.” Not because I don’t love helping, but it is part of my treatment plan. I’m afraid I have disappointed most of the organizations I used to help, but I have to get better. I will help again, but I’ve had to realize it’s OK to have limits.

HF: Did you know that burnout was common for physicians?

Dr. Arcadio: I had no idea! I got a shock when I called a local doctor whom I’d always admired and respected. When I asked him if he had ever experienced burnout and he said, ”Yes, many times,” it was such a surprise to me. Something I never would have expected. I felt better knowing it was not just me.

HF: What other steps have you taken to counter the burnout?

Dr. Arcadio: Lots. I have cut my hours back significantly. I often leave the office by 3 pm. I have another doctor who alternates Saturdays with me and I am recruiting for an associate so I can scale back even more. I take more days off to spend with my wife and kids. One of my loves is investing and managing rental properties. Now I can devote more time to this as I’m pretty hands on and like to do the work myself. I have to constantly be on guard, and remember that I’ve been a “burnout patient” and make sure I don’t go crazy with over-doing. You don’t just simply get “treated” and go back to normal. To me, physician burnout is like being an addict. You must have a treatment but you will struggle daily with this condition to keep your sanity. I now feel a lot of joy, which was something lost to the “old me.”

Dr. Arcadio’s personality type in the Enneagram System showed him to be very high in the Type 8, which is referred to as “The Challenger,” or “The Leader.”  This type is especially driven, energetic, confident and likes to be in charge. In medicine they are often surgeons. Famous type 8’s include Franklin D. Roosevelt, Barbara Walters, Martin Luther King, Jr. and “Dr. Phil” McGraw.

In the Enneagram Personality System, there are 9 types, and the test results give you a quantitative distribution among the types. Your highest scoring type is usually your primary type. If you don’t already know your type, but would like to find out before next week’s blog on burnout and personality type, visit the Enneagram site and take a free RHETI test, or the  more accurate Full RHETI test ($12) and discover your type!

Resources:

Books on Amazon for Physician Burnout

The Wisdom of the Enneagram by Don Riso and Russ Hudson