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Join us for an engaging podcast conversation with Kim Downey, a physical therapist, and Stephen Lewellis, a dermatologist. They share their unique professional journeys, discussing the challenges and insights they’ve gained in their respective fields. From navigating the intricacies of health care settings to finding ways to maintain a positive mindset, Kim and Stephen offer valuable perspectives on personal and professional growth.

Kim Downey is a physical therapist. Stephen Lewellis is a dermatologist.

They discuss the KevinMD article, “A message of hope for physicians.”

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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 Kim Downey. She’s a physical therapist. And we welcome Stephen Lewellis. He’s a dermatologist. We’re going to talk about Kim’s article, “A message of hope for physicians,” and go into Stephen’s story as well. Kim and Stephen, welcome to the show.

Kim Downey: Thank you.

Stephen Lewellis: Thanks for having us, Kevin.

Kevin Pho: All right, Kim, you’ve been on multiple times. Just tell us about the events that led you to meet Stephen.

Kim Downey: Well, that would be LinkedIn. I’m not even exactly sure how we met, but I’ve been sending out connections to physicians in my work to try to help physicians, and he would have accepted my request. Then I think we ended up becoming friendly with the same group of physicians on LinkedIn, so we follow each other’s posts and things like that.

Kevin Pho: I follow you and your posts on LinkedIn, and you’ve been such a fierce clinician advocate. You’ve connected with so many physicians who found joy outside of medicine and made us realize that physicians are more than their degrees. Tell us a little bit about that journey, about some of the physicians you’ve met, and how difficult it was to find these physicians.

Kim Downey: That all started with Michael H., my physician coach. I was trying to find other doctors to help me help my own doctors. At first I found some through KevinMD, in the articles, and once I reached out to them, I asked Michael about LinkedIn, because I had fewer than 150 connections, none of them were doctors and I never went on LinkedIn. He said he found it to be a helpful, supportive community. I didn’t even know how to make a connection. I said, “I can see how I can follow you, but not how I can connect with you.” So he connected with me, and then, since he does a podcast, I connected with his co-host and then some of their guests, and it just snowballed. I was reaching out thinking that those doctors could help me help my own doctors, and it became a process of figuring out that sometimes I could help them as well, by promoting their book or sharing their posts that resonated with me. It’s just gone from there.

Kevin Pho: So you shared a bit of Stephen’s story in your article, and Stephen, of course, is now on the show. Stephen, you’re a dermatologist. Tell us a little bit about your story and journey to where you are today.

Stephen Lewellis: Sure, I’d be happy to. Thank you again for having us both on. I would like to extend my gratitude to Kim for, as you said, being such a fierce advocate for physicians. She’s a clinician herself, and she has seen what her own physicians seem to have been experiencing recently and saw an opportunity to help, even though she’s not a physician, which I think is so remarkable. She has done a lot of great things connecting physicians and putting our stories out onto larger platforms, like your platform, for instance, so I’m really grateful for that. I’m grateful to LinkedIn as well. I think LinkedIn is the most misunderstood social media platform by far. There are a lot of preconceived notions about it, and it is extremely useful, especially for physicians who want to build their brand and make connections.

A bit about my story: I’m originally from eastern Pennsylvania, near Philadelphia, and I currently live in Wisconsin with my wife, two small children and our dog. I am a board-certified dermatologist, and I practice general medical dermatology. I love seeing patients who have complex medical conditions, where maybe another dermatologist they’ve been to didn’t quite get it on the mark or didn’t give them what they were looking for in their journey, and I can often give them a little bit above and beyond what they’re expecting. Over my four years of practicing, that’s what I’ve come to enjoy most about my medical practice: making connections with patients who haven’t yet been fully satisfied with their typical experience in our medical system.

Right now, I’m going through a transition, from a very typical employed position with a large hospital corporation to opening my own practice, where I can be much more creative and really expand on that idea of meeting patients who aren’t feeling seen and heard and aren’t getting better within the system. I can also take care of people who might be struggling with access, and I can have ways of getting patients in sooner than three months after they get the referral, which is what it was like where I was working previously.

Kevin Pho: So, Stephen, in Kim’s article you talked a little bit about your experience with burnout. Talk more about that.

Stephen Lewellis: Sure. It’s not surprising to hear doctors talking about burnout very early in their careers these days, which is really unfortunate. I didn’t feel like I was necessarily burned out; I was just never satisfied from the beginning. I think a lot of early-career physicians feel that as well. They get out, they take a job, and after they get their bearings and feel like they’re finally doing the job well, and they’re not feeling so much imposter syndrome and things are going OK, they get this feeling: “Is this it? Is there anything more? Am I just going to go in and out of rooms all day, try to keep up with the demands of the medical record, sign my charts, try to get home to my family and not spend too much time on the computer at home?”

I feel like that’s what led me to a community of physician entrepreneurs who were doing something more, not leaving medicine. I do not like the trend of really solid, amazing clinicians and physicians leaving medicine entirely for something else. That happens, and that’s OK for people who really need to do it, but I love the idea, like Michael H. has, and I’m glad you mentioned him, Kim, of using entrepreneurship as a way of thriving in medicine rather than leaving medicine. That’s one way I dealt with my dissatisfaction. I got rid of the victim mindset. I said, “Hey, I have to take responsibility for this. I can’t just stop learning and growing after residency and think that everything will just come to me, this amazing job that’s perfect for me.” So that has taken a lot of self-development and self-growth, being willing to be uncomfortable and investing in certain things, and it has brought me to people like Kim and Michael H. and all these wonderful people you meet along that journey.

Kevin Pho: So, Kim, when you connected with Stephen, listened to his story and got to know him a little better, what about his story resonated with you?

Kim Downey: I just thought he was so honest and so real, because it seems like even just a few years ago, before the pandemic, physicians largely weren’t talking about these things. Now they talk about what’s going on in their own lives and in medicine, and these are people problems and human problems, but doctors often feel like they have to act like they have it all together. The fact that he was willing to be vulnerable and share some of his own personal struggles on LinkedIn really touched me, and I felt that it could help other physicians.

Kevin Pho: And, Kim, as you talk to more and more physicians who share that vulnerability on LinkedIn and KevinMD and other social media platforms, do you feel like it’s becoming more normalized? Are you finding more physicians feeling comfortable sharing their stories of vulnerability?

Kim Downey: I think they are, because you see it more and more on LinkedIn, and some physicians reach out to me privately as well, and even in our initial communication they’ll share some things. I feel like the more people talk about it, the more it normalizes what should be normal, because we’re all people, we’re all human, and we all have some issues and struggles and problems. It’s important to shed light on them.

Kevin Pho: So, Stephen, as you were talking about your journey, you said you were looking for something more outside of clinical medicine and you connected with a group of like-minded entrepreneurial physicians. Tell us the next step in the story. What happened after you connected with these physicians? What kinds of ideas did they give you?

Stephen Lewellis: They opened my eyes to the possibilities, and to the fact that it is possible and it’s not such a huge mountain to climb if you just get around the right people, start taking small actions and, like I said before, are willing to be uncomfortable, just like we were in med school and residency all the time. We’re so good at that when we’re essentially forced to do it to get to the next step. But once we’re no longer being forced to get to the next step, the next gold star or whatever motivates you, some people choose to stop growing. They showed me that if you’re willing to take those steps, these things are possible. It’s possible to start a private practice. It’s possible to start whatever your passion is.

Whereas the voices I was exposed to before that, in medical school and residency, were predominantly those of burned-out physicians, to be honest: people who were not happy with the direction medicine was going but also weren’t doing anything about it. They just said, “It’s bad now, and it’s going to get worse, and you can’t start a private practice. Overhead and insurance costs are going up, and reimbursements are going down.” That’s all we heard, and when you’re around that, it’s hard not to get indoctrinated into that feeling. You know the saying that you’re the average of the five people you spend the most time with. If you’re around people who are doing things, not accepting the status quo, taking action and building things, then you’re going to feel like you can as well, and you’re also going to learn strategies. So that was the next step. It was all about that mindset, rather than actually doing something or getting an LLC. It’s not those things. It’s about changing things up here, and then those little things become so much easier.

Kevin Pho: So, Stephen, in your journey specifically, what were the things that made you uncomfortable? Was it branching off on your own and starting a private practice? Tell us more about what you did to deal with that uncomfortable feeling.

Stephen Lewellis: Sure. The private practice piece, and I’ll get into that in a moment, because it is a really interesting story and something I want to make physicians, especially young physicians, aware of. But before that, I think it’s about putting yourself out there, even if you’re an employed physician. That’s what I had been for the last four years. I never considered anything else for my first job after residency, because I wanted my family to feel secure and stable, and I wanted a chance to get good at my craft independently without worrying about staffing, HR and all the typical things people worry about when starting a practice. I think that’s OK, but it doesn’t have to be forever.

For me, that transition came a bit sooner than I expected, because as I became more comfortable in my job, I started thinking about other things. I had more bandwidth to ask, “What’s going on with this organization? I’m a little concerned about the direction. The physicians around here don’t seem very happy.” So I started to speak my mind. I started to advocate, and if you’re in a big organization, you can ruffle some feathers that way. I think large health care corporations tend to veer away from physicians like me who speak their mind, because it makes their job more challenging.

A couple of months ago, I thought I was going into a meeting that I had called myself to renegotiate my contract. I had been there for two years, and I said, “Hey, I don’t want my contract to just auto-renew like it says in my contract. I would like to discuss things. I want to know how I’m doing. It’s been two years, no one’s really giving me any feedback, and I would like to renegotiate.” Finally they called me in for a meeting. They said, “Yes, we should do that,” and I was excited. They sat me down, three people in the room, two vice presidents and a person from HR, and said, “We are not renewing your contract, and today was your last day in clinic.” That was completely out of the blue, the biggest career trauma that’s ever happened to me, for sure.

Because like most physicians, I was doing a great job. My star ratings were off the charts. I would hear from my patients again and again, “I’m so happy you’re here. I just hope you don’t leave like all my other doctors.” My staff was great; we had a wonderful relationship. It was only my interactions with senior leaders that were less harmonious. It was a without-cause termination. They did not give me any reason other than that it wasn’t a good fit, and the way it was done was jaw-dropping. I’m really glad I had done work on myself, both financially and psychologically, to make me resilient to that, because otherwise it’s a traumatic experience. I know other people have experienced it, but doctors need to know that this can happen. You can be amazing at your job and out the door the next day, literally the next day, not with a few more months or weeks to say goodbye to your patients and your staff. They didn’t even let me back in the building.

So that made me say, “Yeah, I am basically no longer employable because of my values, so I need to employ myself.” It kicked me out of the nest earlier than I thought, but in the end it’s going to be a blessing in disguise and a very good direction for me. Physicians have abdicated a lot of responsibility, and we need to take that back. That’s part of why the system has gotten to where it is, so I feel responsible for that, and I want to be part of the change.

Kevin Pho: Kim, when you heard that story, where Stephen so abruptly left his larger organization, as he said, what was the first thought that came through your mind?

Kim Downey: Well, unfortunately for me, I could totally relate, because right around the same time, after trying for 17 months to work with my local health care system, I finally had a volunteer job that lasted one shift, and I think it was something similar to what Stephen is describing. I was always well-liked and well-loved at my real, paid jobs, and I ran a PT department for a while; I was the acting head of a department. So for that to happen. But I guess now I look at it like the other doctors do. They’re wonderful; they say, “Think about why it happened for you instead of to you,” because of the shame and humiliation of being let go. So sadly, I could fully relate, while realizing how much more dire the stakes are for Stephen, as the primary provider for a young family, whereas I’m at a different age. My kids graduated from college, and my husband has a good job.

Kevin Pho: We’re talking to Kim Downey and Stephen Lewellis. Kim is a physical therapist and a physician advocate. Stephen is a dermatologist. We’ve been talking about the KevinMD article “A message of hope for physicians.” Now I’m going to ask each of you to share some take-home messages with the KevinMD audience. Kim, why don’t you go first?

Kim Downey: Sure. I wanted to share some takeaways from Dr. Diana Londoño and Dr. Jillian Rigert, because they were also featured in that article, and we weren’t all able to be here together today. When this article went live, Diana shared it on LinkedIn and wrote a post about it, and I took a few excerpts from there. In regard to our broken health care system, Diana says: “We need everyone’s help. This is not just physicians trying to save each other with support groups or coaching programs. This is about others getting involved in doing something, anything. We all have a voice. If they are not listening in one place, then go elsewhere and make a ruckus.”

Then she spoke to what I’m trying to do, and what inspired me. She said, “If you’re a physician, know there is help, there is support, there is a way through this while we all collectively work on destroying the coal mine. Your life is irreplaceable. There is always a solution. Sleep may be a commodity you have not had, which is making it difficult to see the choices and hope. Please get rest. Reach out. There’s always hope.” And her best tip is to “be yourself,” and there’s a lot of wisdom in those two words. I also have to add: If you haven’t seen the video in the article link that features Diana dancing, you’ll absolutely want to watch it. It’s a beautiful testament to joy and a vision of hope after struggling with burnout.

Dr. Jillian Rigert shares: “We must continue to tell our stories. Sharing our story saves lives, including our own. Reflecting back now, six years later, I can clearly see the errors in my thinking. The difference is that at the time, I thought it was just me. Thinking it’s just us, and that we are the problem, often heightens the distress and the isolation. Community is essential, and finding one that supports you holistically and makes you feel safe, valued and seen is key. While we continue to work through the barriers to wellness at the system level, we must be intentional every day about taking care of ourselves and our loved ones. I’ll never stop saying it: Nothing in your career is more important than your life. Nothing.” Jillian’s key question for her colleagues, one they often don’t stop long enough to consider, is: What do you really want for your life? And her best tip is: “Create a life in alignment with your core values and grounded in your why. Break free from societal pressures that often lead you astray.”

So my takeaway is that amid all the challenges physicians currently face, there are lots of physicians who have discovered ways to thrive. My hope is to inspire or motivate even one physician who is struggling to take a step toward a positive change in their own life. There is a lot of support available, including free, confidential resources for physicians. The links to Dr. Diana Londoño’s physician coach support and Dr. Jillian Rigert’s YouTube channel, A Life True to You, are in the article, and I could resend you the links to the additional support resources that we shared in the last podcast, if you would like me to do that.

Kevin Pho: Thank you so much for sharing that, Kim. Stephen, we’ll end with your take-home messages for the KevinMD audience.

Stephen Lewellis: Sure. Thank you, Kim, for sharing the wonderful advice and experience of both of those amazing physicians, whom I’ve also gotten to know through LinkedIn and their other online platforms, which shows how important that is. I couldn’t agree more about sharing our stories. Stories are nourishing. We can feed each other and take care of each other with our stories. We humans are storytellers naturally; that’s what our brains do, and we thrive on it when authentic stories are being told.

My take-home message is short: It just doesn’t have to be this way, if you are willing to tell yourself that and act on it. Realize that it doesn’t have to be this way, but it does require accountability and responsibility on your part, and taking action, even if you feel like something was done to you, even if something was done to you. If you’re feeling unsatisfied or you’re not aligned, it doesn’t have to be that way. There is so much help, and there are so many wonderful examples of people who are further along the journey, not better than you, just further along, whom you can learn from and reach out to. It’s such a supportive community. All these people want to do is serve.

Kevin Pho: Kim, Stephen, thank you so much for sharing your stories and time, and thanks again for coming on the show.

Kim Downey: Thank you.