Physicians need growth days [PODCAST]

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“We can move from being a reactor to creator. Creators think of the future and make it start happening today. Reactors are just dealing with the crisis at hand, not progressing, feeling stuck, feeling like life is unfair. Reactors are people-pleasing, reacting to everything said, constantly worrying about how to win the approval of others. That’s the trouble with people-pleasing: You are always reacting. We think we are making others happy, but we despise ourselves and resent others. We should start taking the time to please ourselves. It is only from this space that we can start helping others.

If you think this will be a waste, or you can’t take a break because there is work to do, your brain will find ways to prove this thought true. If you tell yourself this is stupid and a waste of time, then you will squander the day and prove yourself right. If you tell yourself they can’t live without out you (and your confidence depends on them wanting you), you will allow the interruptions. If you find yourself saying you really can’t take the time off, then you have a non-sustainable job.

Give yourself permission. Start to develop strong boundaries. Understanding what we can and cannot do in a day. Setting aside days for us to reflect, listen deeply to our inner thoughts, and strategize the path we are meant to live are keys to a successful life. If we’re too busy and never take time to stop, we will never see the path in front of us.”

Amy Vertrees is a general surgeon and co-founder, The Common Thread Women Surgeon Coaching.

She shares her story and discusses her KevinMD article, “Physicians need growth days.”

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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show, we have Amy Vertrees. She is a general surgeon and physician coach, and she wrote the KevinMD article “Physicians need growth days.” Amy, welcome to the show.

Amy Vertrees: Thank you so much. It’s a real honor to be here. I really appreciate your time.

Kevin Pho: So we’re going to do the article in a little bit, but first off, can you just briefly share your story and journey to where you are today?

Amy Vertrees: I trained at the only military medical school we have, Uniformed Services University. Then I did my general surgery residency at Walter Reed Army Medical Center when it was in D.C. I was there for the heights of the war in Afghanistan and Iraq. Afterwards, I stayed on as staff. I went to Afghanistan twice myself and Iraq once, and after 17 years in the military, I left and came down to Columbia, Tennessee, where I’m currently working.

I was an employed surgeon for about three years until I started realizing that I was still missing something. I joined the Leverage and Growth Summit last year with Peter Kim and learned that there was a lot more than just surgery out there. And so I started exploring the world of coaching as well, and also real estate, and that kind of led me to think, with this employed job, that maybe there was a little bit more out there. So I left my employed position after my contract was up. I bought a building and renovated it, and I became a private practice surgeon and kind of found what I was looking for.

Coaching helped me a lot with that. You know, there’s a ton of mind drama when it comes to changing jobs and such, and so I actually ended up becoming a coach myself. So about seven months ago, I met with Kelly Casperson, of the podcast You Are Not Broken, and Jess McMichael, who does The Clean Blue Towel. We linked up together, and we joined The Common Thread women surgeons group. We started off with a Facebook group. We’re currently at about 750 women surgeons, and we have a private group coaching called Room One. And we’re working to really empower women surgeons and change the culture associated with surgery.

Kevin Pho: So tell me some of the issues that you’re seeing in your coaching practice that face women surgeons today.

Amy Vertrees: It’s funny, because the more that we coached, that’s how we came up with the idea of The Common Thread: We all actually have very similar problems. You know, there’s time scarcity. There’s, you know, “What do people think of me?” There’s, of course, dealing with complications. You know, surgeries are very difficult. You go in there, and no one really knows the right answer sometimes, and you just do the best you can with the experience that you have. And so it’s really just, you know, sharing our experiences and realizing that we all have the same, similar problems, and there’s a way out of it.

Kevin Pho: You also made that transition from being an employed surgeon into private practice, and that’s not always an easy transition. So can you share some of the challenges that you face in making that transition into private practice general surgery?

Amy Vertrees: Yes. I was fortunate that my house was very supportive, because really, they recognize that I’ll still bring money to the hospital. I think the main thing that I learned, and, you know, want people to understand, is that we bring so much to the table. I think that administrators do want to work with us. They have to keep the hospitals afloat; we have to keep that in mind. But we have to understand what we bring. We bring them money, we bring them patients, and knowing our worth is helpful. And so knowing my own worth helped me open my own private practice, because I know what I’m bringing, and I’m a little bit more confident, really thinking that I can manage anything that comes up.

And private practice is very, very different, you know, dealing with insurance companies and things like that, too. Over the last several months, we’ve worked through some of those challenges of, you know, how do we make sure that we’re checking insurance and getting things paid and following all the boxes that are different for all the insurances. And so it’s a huge learning curve in a different way, but we’re navigating that OK.

Kevin Pho: Now, you mentioned that a lot of this started with Peter Kim’s Leverage and Growth Summit, which I certainly highly recommend. Now that you’re into private practice, can you describe how that transition has helped you find what you were looking for in your career?

Amy Vertrees: Absolutely fantastic, because, you know, I went from the military, where we had very little control, to employment, where I had more control, and then I started realizing I can actually have even more than that. And so I could choose the clinic schedule that I want, the practice that I want, and the people that I work with, which was very, very helpful. And as a result, I mean, I finished my notes at the end of the clinic. I have folks that work for me who are motivated to work for me, and that really just made me feel much more confident. I feel much more like a surgeon who people are working for and not against.

Kevin Pho: Excellent. So let’s transition to the KevinMD article that you wrote. It’s titled “Physicians need growth days.” Now, for those who didn’t get a chance to read that article, can you just walk my audience through it and share the story of why you decided to write it?

Amy Vertrees: Absolutely. You know, I think when I coach folks, the most important thing that people realize is that we’re not really listening to what’s going on in our heads. And, you know, as a coach, the very first thing we’re doing is having people start to listen to what’s going on in their mind. And the very first thing people say is, “I can’t. I don’t have time for this.” You know, we’re all overworked and overburdened. And being able to give ourselves some time to focus on just ourselves.

And I wanted to emphasize that this is not mental health days. This is not, you know, whatever. This is just days strategically taken so we can pause and really start questioning the things that we really need to question, to move ourselves forward. Like pausing to say, “How are things going? Am I serving my purpose? What is my purpose? And am I acting in ways that are serving where I want to go?”

And if we don’t take the time to really actively reflect on that, then what happens is that we’re just reactors. We’re reacting to whatever comes up. And, you know, if we’re reacting, we’re people-pleasing at its finest. You know, we’re never progressing forward. We’re never seeing if we’re on the right path. We’ll be lucky and land on the right path, but we’re not really sure. That’s what it is. If you pause, you become less reactor and more creator, and so now you can start to visualize what your future is and start actively creating it for yourself. And you can’t do that without really pausing to think about that.

It’s interesting, because when I encourage people to start taking some time off, the very first thing I ask them is, “What does this bring up for you when you think about taking a day off?” And it’s so entertaining. It’s the “Oh, I can’t. I’ll lose money. I’ll lose skills. I’ll lose patients. No one will think of me.” Like, you know, it’s that scarcity concept. It’s interesting because Brené Brown brings up scarcity, saying that this is, you know, shame and disengagement and comparisonism. And so, you know, we won’t even let ourselves take some time off, which is, I think, a problem in itself.

Kevin Pho: So tell me a little bit about that conversation when you meet that physician who is a little bit hesitant to take that time off for exactly the reasons you say. Take me through the next steps of that conversation.

Amy Vertrees: Well, then I asked them, you know, “How are things going?” “Well, it’s just, I’m overwhelmed. I can’t, I couldn’t possibly stop.” I was like, “What if you take time off to strategically think, like, how can I make people work for me? How can I figure out, you know, how to delegate more tasks?” I said, “You need to at least stop the treadmill.” And that is what these days are: Just stop the onslaught of things, so then you can pause and say, “How can I actually question my current process and make it better?” And I would argue that they could actually gain more time by creating some of these times, rather than just continuing to be a reactor.

Kevin Pho: Now, what are some of the things that you suggest these physicians do during these times off?

Amy Vertrees: Yes, it’s so interesting, because I did have to give a little bit more direction, because when I say take some time off, the very first thing is, “Am I going to do it wrong?” You know, we’re so used to doing everything in a certain way. And I really, you know, gave a little bit more direction over time, rather than just saying take time off, to say this is a time to actively question yourself. And sometimes I’ll give specific questions of, you know, “Really, how’s it going? What is my purpose? How can I make my life a little bit better? And am I on the right path?” So, asking specific questions. And otherwise, I said, you know, “Don’t do anything. Go to Starbucks. Go for a walk. Go for a run.” You know, this is a day that you can determine what you want to be. You can determine what you would consider a success.

Kevin Pho: You’re completely right. A lot of physicians are so used to having that direction that if you give them a lot of unstructured time, they’re not going to know what to do with themselves, right? So can you share a story of a hypothetical or particular client you had in mind where they followed your advice, and describe how that has changed their professional and personal life?

Amy Vertrees: It’s interesting, because I think the most common thing that I see, the very first thing, and again, I changed my advice over time, is when they took time off, all they think about is overwhelm, all the things they could do. And so once I started giving a little bit more direction, asking specific questions, the most rewarding thing was they came back and said, “You know, I actually started delegating a little bit more, and I started realizing there are so many of these tasks that I could pass off to someone else.”

And that’s another lesson that people learned: Sometimes it’s hard to delegate other tasks because we feel like we’re bothering people. And then, you know, what happens is that you devalue your team. And so it’s really kind of reframing, stepping back and saying, “Let’s look at my team, and how can they help me?” And so I’ve had a lot of folks come back and say, “You know, now I can actually help them, or have them help me get my notes done a little bit faster. I feel a little bit more calm during the day. And now I’m actually looking forward to taking more time off, because I see the value of it.”

Kevin Pho: Now, how often do you suggest physicians take time off? Is there a set amount of time, or is it whenever they feel a certain degree of overwhelm? Is there a set schedule? How often does this happen?

Amy Vertrees: No, there are absolutely no rules at all. For me personally, I just took two days off a month. So when the monthly calendar, like the call schedule, came out, I just picked this day and that day, and it didn’t matter if it was a clinic or an OR schedule. I just picked a day, and I said, “I’m committing to it.” And so I committed to that day. And so I encourage people; it really just depends on their schedule. But I think a minimum of like two days a month is probably a good starting place.

Kevin Pho: When you realize that it can actually make you more efficient, you can even potentially build more time off. A lot of doctors I talk to, they’re a little bit hesitant, especially in the employed setting: “You know, what would my administrators think about me? I’m just taking these administrative growth days, and I’m not building up my RVUs. I’m not being as productive.” And there are a lot of doctors who are a little bit hesitant to speak up and take these growth days. So what kind of advice can you give to these doctors to just go ahead and take it, and have them be more assertive in taking these days?

Amy Vertrees: I think really this is where you can start working on your dialogue with your administrators. You know, a physician partner is real, and no one exactly knows how. I mean, there’s lots of great advice, but, you know, you don’t want to get to the point where you’re burned out and then start taking this advice. And I think that it’s really making a case to your administrators, to say, “I need to build in some of this time to be more efficient and work on the team. This will stop burnout. This will save me in the long run. It’s more likely to keep me employed here and successful.”

And I think that if you make a good case for your administrator, and even just try a trial, say, “I’m going to try this, and then maybe we can meet later and see.” And so you can start building that evidence for yourself, because this is not something that currently has any kind of randomized control trial or whatever. But I think this is also an exercise to build a relationship with your administrators. And I think it is a dialogue, and it is a relationship that you want to cultivate. And the more that you show respect to them and say, like, “I understand where your concerns are, but I think that I’ll actually be more efficient.” And really, what you want to do is see it from their perspective, and then you sell it as: They have a problem. You are offering this as a solution to their problem. And then check back with them, and then show the progress and really support that relationship.

Kevin Pho: We’re talking to Amy Vertrees. She’s a general surgeon and a physician coach, and she wrote the KevinMD article “Physicians need growth days.” Amy, in your coaching practice, what are some of the other issues that you see affecting physicians today, and what are some of your solutions to tackle them?

Amy Vertrees: I think the most common thing that I see is that people don’t realize that everyone is thinking the same thing. Everyone is wanting to do the right thing. Everyone wants to, you know, have a positive outcome with the patients, and, you know, in surgery, everyone wants to feel confident. And there’s always a little bit of self-doubt there, and I think normalizing that is most helpful.

And with The Common Thread, when we start showing everyone that we are all having the same problems, it’s reassuring. For one thing, we realize there’s nothing wrong with us. And that really shines light on the shame and the disengagement that we have, and really starts letting us reach out to each other in engagement. And then, you know, starting to see that other people have some solutions, and by sharing this, we can actually really, you know, raise each other up.

Kevin Pho: And my final question: What’s your take-home message that you want to leave with the KevinMD audience?

Amy Vertrees: I think that I want to challenge this concept of scarcity, that we can actually start taking some time off to cultivate our own identity, embracing this sense of worthiness and boundaries and engagement with those around us. And that’s actually how we fix burnout: by knowing our own self-worth and raising awareness with everyone else.

Kevin Pho: Amy, thank you so much for sharing your time and insight, and thanks again for being on the show.

Amy Vertrees: Thanks, Kevin. I appreciate it.

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