A burnout coach saved my medical career — and possibly my life [PODCAST]

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“I almost quit my job in 2014. I didn’t like my life, and I didn’t like myself. I had a lot of problems personally and professionally, and I wondered if I was good enough to solve them. I often felt weak and powerless. People were coming to me for answers, but I sometimes felt like a fraud.

My usual strategies of working harder and reading more books weren’t helping me, and I knew it, but I didn’t know what to do. I felt frustrated, angry, sad, tired, and lonely. All I knew was I wanted these feelings to go away.

And then I would shame myself for feeling this way. I kept asking myself: What is wrong with you?

Brett Linzer is an internal medicine-pediatrics physician.

He shares his story and discusses his KevinMD article, “A burnout coach saved my medical career — and possibly my 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, 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. Rate and review the show at KevinMD.com/rate. Subscribe at KevinMD.com/follow. Today on the show, we have Brett Linzer. He is an internal medicine-pediatrics physician. He wrote the KevinMD article, “A burnout coach saved my medical career, and possibly my life.” Brett, welcome to the show.

Brett Linzer: Thank you for having me, Kevin.

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

Brett Linzer: Sure. I’m an internal medicine-pediatrics physician in a suburb of Milwaukee, where I’ve been for 22 years. I have a primary care practice here, and as part of that, I also precept and coach medical students from the Medical College of Wisconsin. With fourth-year medical students, I have the good opportunity of working individually with one of them for a whole month, almost every day. I also coach first- and second-year students in two different coaching programs that they have at the medical college. During my time here, I also served on the executive committee at our local hospital for 12 years and served as chairman of pediatrics, chief of staff, and chairman of peer review.

My journey to coaching started when life was very difficult for me. I had a number of personal and professional challenges that I didn’t really understand, and I also noticed that I had a lot of negative emotions. I had never heard the word burnout before. All I knew was that I had anger, frustration, sadness, confusion, fear, and also boredom, and I didn’t really know where to turn or what to do with those. All I really wanted to do was get rid of them. I just wanted them to go away, and I didn’t know how. All the methods and skills that I used from my training and from my early life weren’t working.

In my article, I talk about how three of my physician colleagues and friends during my training committed suicide, including my chief resident. I started to think, “How am I different from those guys? What is the difference there?” And I wondered, did they feel these negative emotions? Were they struggling in a similar way that I was? It wasn’t that I had a major crisis moment or attempted suicide or something like that, but I didn’t know where to turn, and I didn’t know who I could trust. Really, I was just feeling disconnected and overall numb.

At some point, I realized that my relationships were suffering and that if I didn’t allow or feel some of these negative emotions, I couldn’t experience some of the positive emotions. That was very confusing for me. Also, at that time, I just started asking myself, “What’s wrong with me?” I’m an introvert. I started to wonder, “Do I have a fatal flaw? Is there something about me that I can’t figure this out?” All I really knew was that something needed to change. I knew that if I continued on with what I was doing, my relationships would break and life wouldn’t be good for me.

One of the few people I trusted at that time was my wife, and she helped me connect with a burnout coach, a physician burnout coach. When I first started working with the burnout coach, he made me realize a few very important things. The first was that I wasn’t alone, that some of the things that I was feeling were very common among physicians. That was very comforting to me, because again, I thought, “What’s wrong with me? Do I have a fatal flaw?” He assured me that that’s not the case.

The other important aspect of working with him was that he made me understand that there are patterns of behavior among physicians that I was experiencing. I thought I had all my special problems, and what I learned was that I was experiencing common patterns of behavior, and I can share a few of those with you today. But one of the key things was that I realized if there were patterns, then I wasn’t broken, and I could learn about the patterns, and then I could change. I could change my patterns, and I could change my life. That’s exactly what happened with me. For the past eight years, I’ve been working with two coaches, and I am a coach to the students, as I mentioned, and it’s just been an overwhelmingly positive journey for me.

Kevin Pho: But you mentioned that you were feeling these negative feelings before you went to see coaching. How did that affect you when you were seeing patients and when you were practicing medicine?

Brett Linzer: Yes, those negative feelings affected everything about my life. I had difficulty and conflict with the triage nurse that I was working with. I felt tired and frustrated. I had more arguments with my wife. I felt overwhelmed in the clinic. We started a new EMR system at that time, and I felt overwhelmed. I was taking work home. I wasn’t efficient.

Then, in my leadership area, I felt like there was a common pattern that kept happening to me, and maybe to other physicians as well. It’s where people say, “You’re a smart guy. We’ll put you in these positions. We won’t really train you or give you feedback or help you, but you’ll figure it out.” I found that over and over again. True, I wasn’t failing, but I really wanted to do better, and I didn’t know how. It wasn’t until the coaching that I began to have the skills necessary to work with these feelings.

Kevin Pho: Now, what’s changed over the years? What are some of the specific things that your coaches suggested or did to improve your situation?

Brett Linzer: One of the patterns that I was experiencing was that when I had a problem, I would just work harder. When I had frustrating problems or relationship problems, I would go in my office and close the door. I would read books on the subject. I would just work longer hours. I would just try harder to fix things, because that’s what worked for me before. I learned that that was an important skill set that I had in training and in my early career, but now, in my mid-career, those skills weren’t helping me. They weren’t working, and I knew it, but I didn’t know what to do.

What I needed to learn, and what the coaches helped me with, was that I needed to experience these feelings. I needed to understand them. Where are they coming from? Why do I have them? What can I do about them? Often, they were about opening myself up and sharing my feelings with trusted people. I was actually scared, I think, of my feelings. From an early age, I felt uncomfortable with strong feelings, and in my training, it became apparent to me that my strong feelings weren’t really always welcome. So my defense mechanism was to build walls around me and protect myself and protect my feelings. But later on, those weren’t serving me, and they were holding me back in my relationships with my kids, with my wife, with my nurses, with my patients, and ultimately with myself. The process of taking down those walls and experiencing those feelings is what really transformed me.

Some of that was related to some experiences I had in training, what would be considered, and what people explained to me were, PTSD, difficult experiences that I had that I just shut down. I didn’t talk about them for many years, and that led to a sense of shame and a sense of holding, and it took energy to hold that in. As I started sharing some of those stories and experiences with other people, which was hard at first, I realized, wow, it did a few important things. I could release some of that shame and energy that was built up in me, and then it provided trust for other physicians. They could share some of their stories with me, and we could connect on that level. That turned out to be so important for me, and then I found myself connecting in all these different ways, including with the students that I work with. Those are just a couple of the key learnings. I can tell you a few more if you like.

Kevin Pho: Sure, absolutely.

Brett Linzer: There was the sense that I wasn’t good enough, and then that translated into my actions. In working with the coaches, what I realized was that that’s a common experience. A lot of people feel that way. I felt that way, and I just needed skills to improve myself. It was my experience in medicine that I’m highly skilled in certain areas, diagnosing and treating pathology, but I’m not highly skilled in other areas: communication, running meetings, and dealing with feelings. That was very important for me. When I started to learn advanced communication skills and meeting skills, things transformed for me. I could take a problem that we had at the administrative level that took three or four meetings and change it into a 30-minute meeting, because I was more skilled and I could hone in on exactly what was going on. What are the feelings? What are the dynamics of the group?

There was this idea of boredom, too. Nobody ever told me that I would be bored in my job, but 12 or 13 years into my practice and 50,000 or 60,000 patients later, I sort of knew what was behind the door. It wasn’t as exciting. I wasn’t learning like I was back in my early training, and I missed that, and I needed that.

The other couple of things: It was difficult for me to accept positive feedback. When people told me I was good or they appreciated me, I would brush it off, because it was hard for me to accept that. It was back to the days when I took a test, and if I got 95 right out of 100, I would focus on the five and beat myself up about that.

There are others, but I think one of the key things was what I was saying a little bit before, that I felt like I had to have all the answers, that I needed the copper, I had to portray an element of confidence and that I had all the answers. That was instilled in me from my training, but that wasn’t working for me in my relationships. What I really needed in my relationships with my teenagers, with my wife, and with colleagues was humility and curiosity and skills in communication and opening up, and that would really help me and connect me with them. So I practiced that and I learned that, and it’s transformed my life.

Kevin Pho: We’re talking to Brett Linzer. He’s an internal medicine-pediatrics physician. He wrote the KevinMD article, “A burnout coach saved my medical career, and possibly my life.” Brett, you work with medical students, and this is actually probably the first time that I’ve heard of someone working with them not just precepting but also coaching. So tell me the difference between the two when you work with medical students.

Brett Linzer: I think precepting is the traditional thought of, “I have information, medical information, and I need to give that to the student.” They come to my clinic, and we talk about diabetes and hypertension and medication and things, and that’s all very important. The other aspect of that is the connection and the feelings and the opening up of myself and modeling of behavior, that is like, “Hey, I suffered in medical school and residency in these ways. I had these experiences that were very difficult for me. Have you had any experience like that?” That provides trust, first of all, and then it provides a space, an opportunity, for the student to open up and really share on a personal level what is happening in their life. So we can meet sort of colleague to colleague, and that provides such a deeper experience and a willingness to learn on their part, a willingness to open up. It’s transformative, time and again. Over 20 years, I’ve been doing this, and I have four or five awards from students, because they tell me that rarely do people do that kind of thing, and I think it’s really needed.

Kevin Pho: Absolutely. I think that we’ve had so many medical students on this show and writing on KevinMD, and certainly they’re going through a lot of burnout themselves and a lot of behavioral health obstacles. It’s wonderful that not only do you precept them in the clinic, but you coach them as well. I think it’s rare, but certainly much needed.

Brett Linzer: Thank you. The other thing I think it does is that it helps them with an emotional vocabulary. This was very important for me, too, because early on, I wasn’t really facile in emotional vocabulary. People ask me, “How are you doing?” “Well, I’m burnt out,” or “I’m angry,” or “I’m stressed.” I had three or four, and these are sort of common responses. But now I have such a broader emotional vocabulary that I can really tease out what I am feeling and where that feeling is coming from, and then how I can transform that. It’s a much different experience, and it goes way deeper. It’s much more helpful to myself and others.

Kevin Pho: My final question: What are some of your take-home messages that you want to leave with the KevinMD audience?

Brett Linzer: My middle son is a sophomore in college, and he’s on a path toward medical school and becoming a physician. My hope is that along the way, he will have help. He will have more coaching. Institutions will be more open to the idea of emotional support for students and physicians and make the space for them to allow their feelings to be there, to coach and train not just their intellect but their heart and their feelings as well.

The other thing that I really hope is that institutions build on this idea that coaching is important for physicians and students all along the way, that there’s tremendous value in it, and that it’s really an important part of helping our current situation, which is in dire need, I think, of further support and help for physicians. I didn’t trust too many people. I really needed coaching and other physicians to help me along the way. I know that some other institutions are supportive of this. They’re looking for ways of developing it, and I would support that and encourage other physicians to tell their administrators and human resource people, “This is important. We really need to do this.” At my institution, they allow us to use some of our CME money toward coaching, and that’s partly from encouragement from a few people, including myself. It’s been very helpful.

Then, finally, just contact me. My email is [Email address removed by the editor.] You can put it in the show notes. If you’re interested in having me help you connect, I can give you information. I can listen to you.

Kevin Pho: Thank you so much for sharing your story, time, and insight. Thanks again for being on the show.

Brett Linzer: Thank you, Kevin. Appreciate it.

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