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Join Tomi Mitchell, a family physician, as we tackle the pressing issue of physician burnout. This episode delves into the stark disparity between perception and reality in medical careers, exploring strategies to combat burnout and prioritize well-being. Gain insights for health care professionals and discover how we can collectively redefine the future of medicine.

Tomi Mitchell is a family physician and founder, Dr. Tomi Mitchell Holistic Wellness Strategies. She can be reached on Twitter @DrTomiMitchell, Facebook, Pinterest, and Clubhouse.

She discusses the KevinMD article, “Painful physician burnout truths.”

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast and get CME for this episode by clicking on the CME link in the show notes. Today we welcome back Tomi Mitchell. She’s a family physician, and she’s the founder of Dr. Tomi Mitchell Holistic Wellness Strategies. Her KevinMD article is titled “Painful physician burnout truths.” Tomi, welcome back to the show.

Tomi Mitchell: Thank you so much.

Kevin Pho: So I think we last spoke, I was looking back, back in November of 2021. How have you been since then?

Tomi Mitchell: I have been doing great. I have been on my own journey of burnout recovery, growth and really just living my authentic life. So it’s been a lot since we last spoke, but I mean, it’s been all right.

Kevin Pho: Well, tell me about the changes. Tell me about the transitions you made.

Tomi Mitchell: Back then, I was running a busy medical center with multiple care providers, pharmacy, lab, X-ray. I was gung-ho. And then we’ve had a pandemic since then. I had a realization that, you know what, I needed a break, and I took a pause from medicine. I sold what had become my identity, my medical center, me being an MD, and rediscovered myself through holistic healing, which is not all weird and herbs, which is what people often think when they think of holistic. It’s really looking at your life, like at the wellness wheel: How are you doing financially? How are you doing emotionally? How are your relationships? And really evaluating that and empowering oneself. So it’s been a lot, but I’m so grateful.

Kevin Pho: All right. So you said that when you made that transition, you had a little bit of a loss of your identity, because for many, many years you were known as a family physician and had a relatively traditional medical practice. Now, how difficult was it to face and process that loss of that physician, or traditional physician, identity?

Tomi Mitchell: In the beginning, because I had been known for that, people were like, “Oh, Dr. Mitchell, are you retiring?” I’m like, “No, I’m not retiring. I’m taking a break. I am still a doctor. I’m just pausing.” Because up until this point, I had run myself ragged. I had two children, and they were still in diapers or pull-ups, and I didn’t even take a break post having babies, post residency, post getting into medical school. From 2004, when I first started medical school, until that current date, I was on the go, because that’s what we’re trying to do. That’s what we have to do, at least we tell ourselves.

Kevin Pho: So what’s your practice like now? Take us through a typical day.

Tomi Mitchell: A typical day is, I no longer run a medical center. I work there, so I pick my hours. I’m in the Canadian system, so it’s a little different, at least than when I was living in the U.S. So I run my hours. I see the number of patients I want to see, and then I might go home and write articles. I’m working on a book right now that’ll be coming out in the fall. I might get in a podcast. I might go for a walk. I might go do some physical activity. That’s my day now, and I spend time with my family, obviously.

Kevin Pho: All right. Well, sounds wonderful, and we’re going to talk more about that and your KevinMD article, “Painful physician burnout truths.” Now, how did this particular article come together?

Tomi Mitchell: Right. Because when I finally paused and reflected, I mean, actually, when I finally decided to pause, it was one of those moments where you were scolded for not being 100 percent available, by a patient, to staff, and I got wind of it. But you know how that is: “Oh, the doctor’s not available. That’s my doctor.” And at that point I was already hitting my head against the wall, but I was like, “You know, this is what my response is going to be: Here’s my notice, 90 days, I’m done. Please find a new doctor.” I did it, obviously, with more fluff and dignity than that, but I got my point across. I needed time to pause and heal from the trauma and stress of the past few years, and even just working in this crazy health care system.

Kevin Pho: So this was post-COVID, well, post-COVID so to speak. So was it a single event that made you take that pause, or was it the culmination of years and years of microtraumas in the Canadian medical system? Tell me about the events leading up to this.

Tomi Mitchell: Yeah, so it was microtraumas, but primarily the macrotraumas. I think I’ve written another article about how, when she was four days old, my baby stopped breathing. Her oxygen sats went down to 51, 60, 71. She was in the peds unit, and I remember being told, “It’s just reflux. She’s fine.” I’m seeing my baby seize, and just not being listened to, as a female, even as a physician, but as a mom, a woman of color, just not being listened to, and having horrible things happen to me, like almost bleeding to death, bleeding out, and people not taking it seriously.

So that really made me snap, because that’s hitting the root of who I am. I’m a mama bear. I’m a mom. You can do everything else to me, like as a kid in school, and disappointments, but when it’s my own cub, OK, that’s when you cross the line. So the Canadian health care system is good, but it’s far from perfect, and it varies depending on where you’re living and where you’re practicing. Some places are almost utopian; other places, it leaves much to be desired.

Kevin Pho: Now, did you consider any other options instead of taking that pause?

Tomi Mitchell: No, because I was burnt out. I had nothing left to give. I didn’t want to hear my name. The name “Dr. Mitchell” just made me cringe. I didn’t want to hear, “Oh, prescription renewal,” or “Oh, Dr. Mitchell, we need you.” I didn’t want it. I didn’t want to see a document. I didn’t want to do paperwork. I was done. And I stopped laughing. I’m a doctor that dances and laughs, and you can hear my joy from a mile away. It was gone. I had nothing left to give.

So yeah, that was the only option, because I had ignored the warning signs up until that point, or at least I had buried myself under this responsibility, so that it was very challenging, at least I thought, to take a pause.

Kevin Pho: Now, what about your colleagues, your fellow family physicians up in Canada? Are they going through similar stories to what you just described?

Tomi Mitchell: Yes. Burnout is rampant. Depending on the study you read, it can be anywhere from 40 percent of physicians reporting burnout to as high as 70. So yes, they are. But the thing is, not everyone is recognizing that they’re burned out, and I think the majority perhaps are not, and they’re maybe not taking the steps necessary to really work on the healing process, because it really takes the brain two years to recover from burnout.

So, you know, that’s why I do what I do and I talk about it, because I see some of my colleagues burnt out. I see it. But it’s a denial stage, or they just think this is normal, and they’re missing out on joy and just life.

Kevin Pho: Now, when you gave notice of your pause, because you’re clearly mid-career, at what should be the peak of your medical powers, and then you gave notice that you’re going to take a pause, what was the reaction from your colleagues?

Tomi Mitchell: There were ginormous ripple effects. Where I was living then, basically, we have our provincial capital, and I always call it the Mambo Palace. My name was mentioned the following day: “Dr. Mitchell from such and such, she’s leaving due to XYZ.” The opposition was like, “What are you going to do about it?” Waves happened. There were waves.

Kevin Pho: Tell me more about that. So your name was actually mentioned in Parliament as a spotlight on the tribulations that physicians are going through?

Tomi Mitchell: Oh, yeah. It was kind of like I finally was the one that just broke that glass, and people were after me. They really started talking about it, because I’m vocal for various reasons. But yeah, it was mentioned in Parliament. News interviews and speaking things came out of it. People were asking me questions, because I don’t sugarcoat things. Some came up to me later, like, “Dr. Mitchell, I’m so proud of you for saying that,” and others were like, “Why would you say that? You’re just putting yourself out as a target.” I’m just like, “I was always a target. I was born a target. What do I care at this point? This is the truth, and the truth needs to be known.”

And you know what? It’s been over a year now. I actually announced my resignation on International Women’s Day, I think it was March 8, last year, and not a whole lot has changed from when I left. So I’m like, if I had waited there, I had already finished one decade, going into the second, what was I doing? All the empty promises.

But now I’m happy. I am. People comment, like, “You look so good. What’s happening? You’re so much happier.” They’re just in awe, like, “How did you do it?” Well, it takes courage. It takes letting go of your comfort, your comfort security blanket, and still having a plan, but having the faith and the desire that whatever discomfort in the transition you might go through is worth it, because the life you were living is not representing who you are and what you want.

Kevin Pho: So you said that this happened about a year ago. Have you noticed any changes within the physician community since your resignation?

Tomi Mitchell: I have noticed that people talk about it more, and I still get referenced when clinics are closing, but in that community, I don’t see a whole lot happening. And this is one of the truths with physician burnout: You have to recognize that some fights are worth fighting, and others, you just need to throw in the towel and move on.

And since then, I’ve moved on, and I work in a place that I just love, with great support. And again, it’s not perfect, but it’s what you make of it. But if you have leaders that are willing to change and they put the facilities and services in to help the people, it makes a lot of difference. So yeah, it’s all choices. We choose where we live. We don’t choose what we’re born into, but you can definitely choose where you live and work, and that’s the part physicians and other people need to recognize: You have a choice.

Kevin Pho: Now, how did you decide what you were going to do? I know that you do take some clinic hours still here and there, but how did you decide what to do next? Because a lot of physicians, like you said, are tied up with that professional identity, and outside of that identity, they may not know what to do. How did you find that clarity?

Tomi Mitchell: Well, I already knew what I wanted to do as a young version of myself: being in front of a large audience, I was like 15, and speaking and making an impact like that. I cannot forget those thoughts, those visions I had in my mind, right? So when I paused, I was like, “I hadn’t thought about that in a long time. Oh yeah, that was something on my mind.” But then, you know, you get into high school, medical school. You’re so busy getting into school, getting into residency, establishing yourself. I lost myself. There were years where I didn’t even read a book, and I was the girl that was an avid reader, and I used to love writing. I used to take AP English. AP has kind of gone by the wayside, it seems, these days. But yeah, I love to read and I love to write. I had to find myself, and it was things that were outside, or not necessarily directly, clinical.

So many individuals lose themselves in medicine. Their life revolves, their conversations revolve, around medicine. Their jokes are about medicine. And unfortunately, if you do that, you run a high risk of losing yourself in this career, and then it drops you, when you realize you’re replaceable by your employer.

Kevin Pho: Now, for those other physicians who may be in similar places to where you were a few years ago, what kind of questions should they ask themselves to know whether a pause or a resignation or a break is right for them?

Tomi Mitchell: They can ask themselves: Are they happy? Very simple. Truly happy? Are you doing things in your life that recharge you, or when was the last time you did something in your life that recharged you, right? Just be honest with oneself, and that’s really key. And ask yourself, “What is contributing to the way I’m feeling?” And don’t just be like, “Oh, it’s my job only.” Don’t get me wrong, my burnout was not just my job. It was multiple facets. But I took the time, and I was coached, and I talked to people, and I really dug deep.

You need, like, a mirror in front of you, and that could be somebody else, a coach or mentor, to really help you tease that out. Because remember, you are programmed to basically be perfect. You have no fault as a physician. We do everything right and we do our best, and to say that we feel weak is a sign of weakness, and that is horrible, right? That’s our unspoken code. That’s far from the truth. It takes strength to seek help. It takes strength to stand up to yourself.

Kevin Pho: She’s a family physician, and she’s the founder of Dr. Tomi Mitchell Holistic Wellness Strategies. Her KevinMD article is titled “Painful physician burnout truths.” Tomi, tell us some of your take-home messages that you want to leave with the KevinMD audience.

Tomi Mitchell: Yeah. Honestly, you have one life to live, and the only people who are going to remember you when we leave this earth will be your family. And what kind of legacy are you leaving behind? Are you spending time with them? How are your relationships? That’s what matters most: relationships. And that is everything. It’s not the money in the bank. Don’t get me wrong, it’s great, but it’s relationships.

Kevin Pho: Tomi, thank you so much for coming back on the show and sharing your story, time and insight.

Tomi Mitchell: Thank you. You’re welcome.