What do physicians really want in life? [PODCAST]

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“It is no wonder that in 2020, a Doximity physician compensation report revealed there were no specialties in medicine in which women earned the same or more than men. We can all agree that many things could account for this, including structural barriers and lack of diversity or mentorship. It may also include factors such as women not maximizing billing knowledge, not knowing how to negotiate, not asking for the same or more of what is offered and just not thinking about what they really want. Instead as women, we think of others first, or what others expect of us.

Yes, we know we want the job or the position. But is that position truly, truly, taking you towards your true purpose? Becoming chief of department, manager or CEO, are remarkable goals and should be pursued. But are the pursuits authentic to what you consciously found your purpose is? It is not about what your family thought you should achieve, but about doing something that truly takes you and continues to propel you on your true-life purpose.

If you have not thought about it, then I challenge you to find introspection. Find consciousness and think about your true purpose. Continue to follow its path to experience joy so it will not leave you with regret when you look back.

Find your purpose.

Ask yourself, ‘What do I really want in life?’

And do it today.”

Diana Londoño is a urologist and can be reached at her self-titled site, Dr. Diana Londono, and on Twitter @DianaLondonoMD.

She shares her story and discusses her KevinMD article, “What do you really want in life?”

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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, 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 Diana Londoño. She is a urologist, and she wrote the KevinMD article “What do you really want in life?” Diana, welcome to the show.

Diana Londoño: Thank you so much. I’m so grateful to be here. Thank you so much.

Kevin Pho: And we’ll get into your article in a little bit, but first off, can you share your story and journey to where you are today?

Diana Londoño: Sure, of course. Thank you. So I’m a urologist in Los Angeles. I’m one of the 10 percent of urologists now in the U.S. We just hit 10 percent this year, so we’re slowly growing. It’s an exciting time to have a lot of room to improve and to change and to be part of this community.

Kevin Pho: Tell me some of the challenges you face being a woman in urology.

Diana Londoño: Well, I find that actually, even the 10, I mean, I do actually overall think it is a very supportive place, from the group and from our colleagues. I do think that some of the challenges are probably things that have been studied and seen, pay equity, especially in industry, for example. There is research and data that shows that women are paid 50 percent less than men in industry, which is quite shocking, as well as obviously being paid less than men overall for salary. So there’s a huge challenge there, and room for improvement. And actually, we’re tackling that in the Society of Women Urology with some task forces to bring awareness to this and tackle some of these challenges.

Kevin Pho: If you look at the studies that show that pay disparity between men and women physicians, what are some of the reasons that explain that?

Diana Londoño: Yeah, that’s a great question. I think there are so many facets that we’re still trying to understand, whether it be structural, personal, implicit bias that can play a role in it, mentorship, even just the ability for women to negotiate better, learning how to negotiate, asking for what they want. And so there are probably a lot of components to it, and again, we’re still trying to figure it out exactly so we can make those changes. But I don’t think it’s just an individual problem, a problem with the individual. We like to sort of blame that, and it isn’t. There’s a structural thing, there’s implicit bias, societal expectations, all the roles that women may play, not only in their job but at home as caretakers. It takes a lot of other factors into account as well.

Kevin Pho: So when you talk about physicians, or some physicians, who need to negotiate better, what exactly do you mean by that? Because this is one area where I agree with you that physicians need to be trained in negotiations. So when you talk to other doctors and you feel that they need to negotiate better, what exactly does that mean?

Diana Londoño: I think it does apply to men and women, for sure. But when we get a contract as a physician, especially as a woman, when we get it, we’re just like, “OK, here, I’ll sign.” Half of us probably don’t even read it. But we never sort of ask for more, especially as women. We just sort of take it. We’re like, “Oh, thank you so much, we got a job.” I think men are a lot better at that skill, just asking for more right off the bat, without thinking about it twice. But we have some sort of intrinsic guilt about asking for more. Are we being greedy? There are a lot of thoughts that I think women have, subconsciously or consciously, and then we don’t ask for more or renegotiate a contract, especially.

And I think there’s a skill we have to learn. There’s some confidence we have to learn, trying to tackle our beliefs about even money, or what it is to ask for what you want, because we tend to feel it’s like a dirty word to ask for what we want, to say, “This is what I want, this is what I’m worth, this is my value.” So I think those are really important beliefs that women may or may not be aware of, consciously or unconsciously, that really do affect what we get compensated a lot of times.

Kevin Pho: And for those physicians who are interested in learning more about this and improving their negotiation skills, do you have any resources that they can turn to to help them?

Diana Londoño: Yeah, well, I actually think a great resource is a book from Chris Voss, learning to negotiate. It’s a great book, actually. I’ve read it. It was life-changing for me, just for everyday things, not even big contracts, because every conversation, every interaction, is a negotiation. And if you think of it that way, it really changes your perspective. And I think when you think of it that way, and you practice it every day with little, no-stakes things, like even just going to Starbucks or asking somebody for anything really, then when it comes to those important decisions, it’s much easier, because you’ve practiced it. So that’s a really nice resource, a great book, for sure.

And also, there are some coaches that help you with negotiations. That’s what they specifically help you do or look at, not the lawyer part of looking at the legal terms, but just learning how to do that. There are some specific coaches. Linda Street, I know, is one, but there are many in the space who are actually physicians trying to help other physicians in this, and I think that’s a starting point that can be very helpful.

Kevin Pho: So I’m going to second your recommendation for Chris Voss’s book. It’s titled “Never Split the Difference.” And as you know, Chris Voss is an FBI hostage negotiator, and he utilizes some of his tips from while he was working at the FBI in the negotiation space. And I completely agree with you that every physician needs to read that, Chris Voss, “Never Split the Difference.”

Now let’s get into our KevinMD article. It’s titled “What do you really want in life?” 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?

Diana Londoño: Well, I’ve been very fortunate to contribute a few articles on your platform, so I’m very grateful. That’s one of them. Probably the first one was about consciousness, but it kind of ties into this. And it really just means we have to have some consciousness and some awareness of sitting back and really thinking, what do we really want in life, kind of like your north star to follow. What is your true purpose? Where are you going? Because I think if you don’t really sit back and think about it, you’re kind of going to be, I sort of think of the analogy, like a plastic bag in the wind, just going with the flow, and you land wherever.

And you’re going to fill your day with things to do that are important. You have to go get your kids, you have to do some presentation. There’s a lot of stuff that’s going to fill your day, and of course it’s going to seem productive. But the article is really saying, OK, you could do all that, of course, but is that really truly serving your purpose? Because I think a lot of what happens is that we fill our day with things to do, and they seem noble, and again, we may not say no to things. We don’t know how to say no, and then if you don’t know how to say no, you don’t say yes to other things, and then we’re not really going to our true purpose in life, and it may lead to greater unhappiness.

So I think it’s really important, whatever you’re choosing to do, to really find some time, some reflection, some awareness, to figure out if that’s really the purpose. And of course, when we got into medicine, we all had that goal to get there, of course. But then we get here, and we’re like, “Oh, what’s next?” And you kind of become unfulfilled, or you don’t know what to do, or it’s not exactly how you hoped it would be. You don’t realize all the challenges. And I think it’s always about evolving, not being stagnant, and continuing to grow, to learn, because otherwise stagnation will lead to basically depression and unhappiness, because you’re not moving your mind, you’re not learning new skills. So it’s just about reflection, basically.

Kevin Pho: When did you realize this? Because as a urologist, of course, you’ve gone through many, many years of training, and I assume you’ve been practicing for a while now. But when did you realize that the true purpose of life was so important?

Diana Londoño: Yeah, I mean, I think I’ve always had a thought about what I really want to contribute to the world. It really wasn’t “I want to be a doctor” for me, but I always had these thoughts and reflection. I was pretty young. I think when the pandemic hit, for me, it really started to brew very strongly: What do I want? What is my purpose? Is this what I want? Is this what fulfills me? Can I see this, 20 years from now, five years from now? Is this what I want to be doing? And it took me actually a long time. It took me probably the whole year of the pandemic, and I was really burned out the whole pandemic, and really just thinking about it.

I was burned out, and for me, I found coaching, like life coaching, just free podcasts, listening to life coaching, and to me it was so powerful, because life coaching really is about mental fitness. It’s about thinking about your thoughts and how that affects how you feel and how you act and what your results are. So by doing that, by thinking about your thinking, it’s actually consciousness. And when you practice that, it really starts getting to your beliefs, like, why am I doing this? Why, and why again? And then that kind of leads you to, well, what do you want to do? We always know what we don’t want to do. We have a huge list. We can say really quick, “I don’t want to do that.” But what do you really want? So I think that time during the pandemic, I think the time with coaching was really very powerful for me.

I find it so powerful. I mean, I’m now enrolled to be a life coach, because I think it is so powerful. Our awareness is very important. It’s not anything new. I mean, we think it’s trendy, but it really has been around since, like, 400, Buddhist scholars have been thinking and talking about these concepts. So they’re not new. People think they are. Physicians sometimes find it hard to sort of embrace it, even though famous athletes, movie stars, and entrepreneurs all have some type of coach, whether it’s a business coach, a life coach, all kinds of coaches. It’s just somebody to help you get to the next level. Just like any sports coach, they help you be the best in your game. So when we start thinking about that, it really is life-changing to think that way.

Kevin Pho: So maybe paint us a picture, maybe a before and after. Tell me what kind of changes you made specifically in your personal and professional life, and the transition that you made, before life coaching and then what you are now.

Diana Londoño: Like I sort of mentioned, for me, I was pretty burned out. I’ve been burned out twice, and it’s really funny, because you know it intellectually, and you don’t know what it is until it really hits you in the face. I didn’t really know I was burned out. But for me, the before was, even though I’m actually a pretty positive person, I was in this vortex of negativity. Everything was so negative, in my thoughts, in what I was saying. The stress was so severe that I lost 10 pounds, and I don’t have a lot to lose. I’m already skinny. But I lost 10 pounds. I had awful GERD. I was on Protonix. It was so severe I got sort of like asthma from it, because of the reflux to my lungs, so my pulmonary function test was showing asthma, even though I don’t have asthma. I started to get joint pain, and my rheumatoid factor was up, even though I don’t have rheumatoid arthritis. I ground my teeth so badly that I needed to have two root canals and two crowns. I got a two diopsis for like four months, which was excruciatingly painful. It’s just the physical manifestations of the stress and the burnout, plus just my thoughts, I mean, negativity and productivity, and probably somebody you didn’t want to be around, really.

And then after, I’m not on medications anymore. I started to run again. I was a runner in college. I was always running. I never ran the whole pandemic; I was in that place. I started to run again. I am not on medications, like I said. I’m just way more calm. I’m not as reactive. I really spend a lot of time just consciously thinking, like, what am I saying, what am I not saying, how am I answering? I just feel a sense of calm, and that gave me a lot of thoughts about, like, what do I want to do in life? What do I want it to be like and look like? What are things that bring me joy?

And in that, it was finding my voice, really, and, you know what, writing. I mean, I was never a writer, but if you look at your past, well, you’re not going to have to find evidence of that. But if you start looking at your future, dreaming, what do I want, you just start producing a different future. So I began writing, and I’m very thankful. I have, I think, eight or nine articles with you. I’m in Outlook Magazine, Doximity, a lot of different areas, which I never thought about, that I could be there. But it’s really changing what my outlook is.

I started, like I said, life coaching. I’m going to be finished in October. I just started, and actually launched this week, a program called Physician Coach Support. It’s basically a platform where we’re onboarding physician volunteers, our life coaches, to give free coaching to physicians who are struggling, just with thoughts, not, obviously, for suicide or depression, but just trying to really reframe what’s going on in your mind so that you don’t get to the severe burnout, depression, and all the cascades that are affecting all of us. So yes, I’m going to have my own business, of course, coaching, but this really is a service, because I really do believe in helping each other and having community, just like this space or any space, and coming from physician to physician is so powerful, so important. So I mean, obviously that’s something I would have never imagined before, because it was not there.

Becoming an entrepreneur, all that is things that I was never up, and I actually have had a private practice. After my second sort of job, I had a private practice, but I really knew nothing about business. And so now it’s just changing my mindset of not saying, “I don’t, I’m not an entrepreneur,” just changing it to, “Well, I’m becoming one. I am learning new skills.” It really changes how you show up. And the self-talk we do is so important: “Oh, I don’t know how to do that. I’m not an entrepreneur.” Well, you never will be if you think that way. We have to change how we say things, how we even text. And so there’s a lot of consciousness, really, and I think that has been my before and after.

And I’m really excited about what else we can do. Like, what are the limits? And the limits are your thoughts. What you can dream of is so, so powerful. Your mind’s so powerful. It can definitely lead you to disease or health. I mean, the thoughts were exactly what led me to that awful state. The circumstance was exactly the same. Whatever was causing me that, I thought it was the circumstance. It wasn’t. It was my thoughts about everything, because the circumstance hasn’t changed at all. It’s exactly the same. So I think that’s really, really pretty powerful.

Kevin Pho: We’re talking to Diana Londoño. She is a urologist, and she wrote the KevinMD article “What do you really want in life?” Diana, what’s your number one tip you could share with other physicians who may be burned out, to help them find out what they really want in life?

Diana Londoño: Yeah, I mean, I think we are always running and running, go here, go here, go here. But really centering, starting the day with a little bit of awareness, a plan for the day, a little breathing, and I know it sounds woo, but when in doubt, check your own pulse or your breathing. So we have to breathe, center, and start the day with some awareness and gratitude. I think that’s number one, and then you go tackle your day. I think that’s just an easy tip that doesn’t cost money. It doesn’t take time. You don’t need somebody else to do it for you. It’s all within you. So having that at the start of your day, or at the end of the day, a little reflection of what went well and what you can improve on, is really powerful.

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

Diana Londoño: I think my take-home message is, dare to dream, dare to believe, and that there’s hope. I mean, I guess that’s three messages, but really, just hope. There’s hope. If you feel like there isn’t, I want to tell you there is, and the answer is really, truly within you. It is within you, your thoughts. And I just wish you the best. You can reach out to me. I’ve been burned out twice; I don’t want to be the third time. So I’m happy to ever speak to anybody about it and help you, give you some perspective. That’s really it. Thank you.

Kevin Pho: And how could people reach you?

Diana Londoño: You can go to my website. It’s dianalondonomd.com. Also the same on Twitter. You could also follow me on LinkedIn, any of those platforms. And you could also, if you want to, sign up to volunteer, and hopefully, when our services are there, physiciancoachsupport.com.

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

Diana Londoño: Thank you so much. I’m really appreciative. Thank you.

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