Subscribe to The Podcast by KevinMD. Catch up on old episodes!

Listen to conversations that uncover the unique perspectives of health care professionals and the transformative power of their work. Tamara Beckford, an emergency physician, reveals her remarkable journey from the front lines of the COVID-19 pandemic to entrepreneurial success. And, Robert Kornfeld, a pioneering podiatrist, discusses his transition from traditional medicine to holistic healing and patient-first practices. Bringing them together is Kim Downey, a physical therapist and physician advocate.

Kim Downey is a physical therapist. Tamara Beckford is an emergency physician. Robert Kornfeld is a podiatrist.

They discuss the KevinMD article, “Doctors rediscover joy in practicing medicine, on their own terms.”

Careers by KevinMD is your gateway to health care success. We connect you with real-time, exclusive resources like job boards, news updates, and salary insights, all tailored for health care professionals. With expertise in uniting top talent and leading employers across the nation’s largest health care hiring network, we’re your partner in shaping health care’s future. Fulfill your health care journey at KevinMD.com/careers.

VISIT SPONSOR → https://kevinmd.com/careers

Discovering disability insurance? Pattern understands your concerns. Over 20,000 doctors trust us for straightforward, affordable coverage. We handle everything from quotes to paperwork. Say goodbye to insurance stress – visit Pattern today at KevinMD.com/pattern.

VISIT SPONSOR → https://kevinmd.com/pattern

SUBSCRIBE TO THE PODCAST → https://kevinmd.com/podcast

RECOMMENDED BY KEVINMD → https://kevinmd.com/recommended

GET CME FOR THIS EPISODE → https://earnc.me/oVz63v

Powered by CMEfy.

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 Kim Downey, Tamara Beckford and Robert Kornfeld. Kim is a physical therapist, Tamara is an emergency physician, and Robert is a podiatrist. Today we’re going to talk about the KevinMD article “Doctors rediscover joy in practicing medicine, on their own terms.” Kim, Tamara and Robert, welcome to the show.

Kim Downey: Thank you.

Kevin Pho: Kim, I’m going to start with you. You are a renowned physician advocate. I see you on LinkedIn, and thank you for bringing everyone together, as you always do. So let me start by asking you, how did you find Tamara and Robert?

Kim Downey: Sure. So that would be LinkedIn. I looked back, and Tamara was one of the first connections I made on LinkedIn. When I reached out to make the connection, she actually got back to me and was curious about how I found her. She actually said, “How did you find me? What made you interested in connecting with me?” So we went back and forth a little, and I told her why, and we continued on. At one point I asked her if we could Zoom, because I thought she could have some information that might help me help my other doctors, and she graciously agreed to do that. We did, and we’ve communicated back and forth since then.

And Robert, I reached out to make a connection with him on LinkedIn, and as I was making more connections, and they were all making more connections, we kind of ended up in a little cohort. There’s a group of physicians who support each other’s posts, and I was kind of in that little group even though I’m not a physician, and I just try to support them and their work and their posts.

Kevin Pho: All right, so the theme of today’s conversation is rediscovering your joy in practicing medicine on your own terms. So Tamara, just briefly share your story and journey to where you are today.

Tamara Beckford: Absolutely. Thank you, thank you again, Kevin, for having me on here. As you mentioned, I’m an emergency medicine physician, and prior to the pandemic, I realize now that we’re learning about burnout, I was getting to the point of burnout. So I started to invest in a lot of personal growth, reading all the personal growth books, and listening to and watching podcasts. I had already started working on a morning routine and on myself, and then the pandemic hit, and it hit hard. I started to notice that a lot of my colleagues around me were really suffering during the pandemic. As an emergency medicine physician, you can imagine how it was: a lot of anxiety. We didn’t know what this virus was, how it was going to affect you, or whether you were going to take it home to your family.

As I continued to thrive during that time, I realized that I should probably share my techniques with others, which is one of the many things that I do now. And I’ll say that one of the ways I thrived was through community, through the physician community, realizing that there are other physicians who had the mindset of entrepreneurship like I did. For those who are listening, I’m part of the EntreMD Business School. I get to help my physician colleagues through that, and I also get to help physicians who have private practices. I help them really get their private practices to thrive by bringing their team together, having the private practice owners cast their vision onto their team, and really helping them with their profitability and proficiency.

So all of that has made me realize that it’s not only about me; it’s about what I can do for the community around me, and that is helping me to thrive. I find a lot of joy in what I do, and it all started with self, because I worked on myself before this whole thing started, and now working on myself has brought the compassion and the energy to help all my other physician colleagues. So that’s my story.

Kevin Pho: So Tamara, let me ask you. During the pandemic, you mentioned that you felt burnt out, like a lot of emergency medicine physicians, but there’s a difference in your story: You took action and created these entrepreneurial ventures, whereas so many physicians I talk to feel stuck and are not sure what to do. So what separates you? What made you take action when so many of your peers and colleagues felt stuck?

Tamara Beckford: One of the things that really separated me, I think, is the fact that I started working on myself before the pandemic started. So once the pandemic came, I was already in full gear, realizing what the landscape looked like, recognizing the signs of burnout, and recognizing what I needed to do to keep myself levelheaded and to bring joy within myself. I knew what it looked like, and so when I saw others around me turning downward, I had already gone through that period, so I already had the inner strength. That’s not to say that my colleagues were weak, because we have all ended up building ourselves up as a result, but I just started a little earlier than my colleagues, and that’s the difference.

Kevin Pho: Robert, you’re a podiatrist. Please share your story and journey to where you are today.

Robert Kornfeld: So when I completed my training, I went into practice, and of course, as you can see, I’m not a young doctor. It was well before managed care, well before all of the CPT codes and ICD codes. I opened an office, I put an ad in a local Pennysaver explaining what I did, and the practice began to take off quickly. I was on staff at a couple of area hospitals, I was doing lots of surgery and seeing lots of patients, and within about two and a half years I was up to 50 or 60 patients a day. I was going home for dinner at 10 or 10:30 at night.

Unbeknownst to me, things started to shift in my personality and in the way that I was seeing things. When I got to the office, if I saw a really busy schedule, I felt stress and anxiety, and within maybe two years I had all the signs and symptoms of what we now call burnout. I was depressed, I was anxious, I was fatigued, I couldn’t think straight, I didn’t want to go out, I had no time for anything, and I didn’t really know what to do about it, because I was feeling ashamed of what was happening to me. So little by little I tried to pull myself out of it, but I still had to go to work and work like a dog. Then I decided this isn’t something I can handle on my own, and I went for help.

It became very clear to me that I was working against my innate nature. I had always been a very conscious human being. I was into meditation and yoga, I was a macrobiotic vegan, I liked to be out in nature, in the woods, and here I was in a world of drugs and surgery and black and white. When I finally realized that that was happening, I asked, how can I bring my lifestyle into my practice? So I began investigating what they then called holistic medicine, or alternative medicine. Probably by 1987, I started finding organizations that were teaching things, I was going to seminars and training myself, and I started to bring it into my practice, and I started to feel really happy.

Unfortunately, what I soon found out is that insurance companies weren’t happy to pay for anything I was doing that was natural. So I had to separate my practice into two parts, the typical conventional medicine and the holistic. The holistic patients paid me, and for the others I would accept insurance. Then managed care came along, and I thought, oh, what a great idea: I don’t have to market myself, I don’t have to kill myself. I joined up around 1992 or 1993, probably 1992. In 1999, I got a notice from Blue Cross Blue Shield that they wanted 40 of my charts. I sent them, and before long they asked for a refund of $87,000. I said, “For what?” And they said, “Well, we don’t cover what you do.” I said, “I didn’t charge you for that. I only charged you for the evaluation and management of these patients. I did not charge you for any of the holistic therapies and regenerative medicine.” And they said, “Well, that’s part of it, and we don’t want to pay for it.” I said, “Well, I have a chronic pain practice. Did you want me to do the same thing that already failed seven times on these people? What I did worked.” Long story short, of the 40 patients, 38 agreed to come and support me in court, and I told them that, and then they backed off and disappeared.

At that point I said, I really have to do something different, and that was when I decided I’m not going to deal with insurance on any level. By the year 2000, I was out of all my contracts. I was completely direct pay, and I started to notice an amazing shift in how I felt. I had so much more time for my patients, because they were paying me. It wasn’t an $8.40 visit. I was giving all of myself, and the doctor-patient relationships got deeper and more potent. I decided this was something I should teach my colleagues, so I put together a teaching institute. It was a dismal failure. No one wanted to come and learn, and before long I was marginalized by my entire profession, and I just gave up.

Fast-forward to about a year ago, maybe a little more than a year ago. All of a sudden I’m getting tons of emails from podiatrists who had read articles that I’ve written, seen my podcasts, seen me in TV interviews or listened to my radio show, which I had for a number of years, and they were asking me to help. So that meant that this boomer had to learn technology and social media. I built a course and I founded an institute, and it’s now about nine months into it. It’s not a blockbuster. I have a little over 20 podiatrists who are taking the course, learning and being mentored by me, but I’ve never been happier in my life. Because really and truly, what do we want in life? To take care of our patients, to go to work and feel that we’ve made a difference. And after all the training that we’ve gone through, we deserve to make a good living. We don’t deserve to be exploited and abused by insurance companies. That’s what I hope to put forth to all of the podiatrists out there who are miserable and struggling and going through burnout and still trying to push through it.

Kevin Pho: Now, Robert, let me ask you a couple of questions. Number one, how common is that direct pay podiatry phenomenon? How common is it to find a direct pay podiatrist today? And my second question is, how difficult is it for most podiatrists to make that transition from insurance-based care to direct pay? I talk to a lot of doctors, and sometimes they’re a little bit apprehensive about that transition. So talk more about that.

Robert Kornfeld: Well, I think there are very few podiatrists in the country doing a direct pay approach. Maybe you’ll find 10 or 12 of us. Now that I have all these students who are learning, you’ll probably find 20 more pretty soon, but no, not a lot. I think a lot of people are so conditioned to think that their patients won’t pay them, because their services have been devalued by insurance companies, and therefore they have devalued their own offerings. On the other side of the coin, I don’t think any change is easy. You have to be willing to do the work, and those who are looking for an easy fix are not going to find it. If you don’t take the time to create a platform that can be communicated effectively to the public, and know what you’re talking about, it’s going to be really difficult, and a lot of people are going to put their tail between their legs and go back to what they were doing before. But like I do, and like Tamara does, when you have a mentor who’s already been there, done that and come out of it, we can take people from zero to 60 a lot faster than they can get there trying to muddle through it all by themselves.

Kevin Pho: Kim, what specifically about Tamara’s and Robert’s stories resonated with you? I know you talk to a lot of previously burned-out doctors on LinkedIn, and you connect with so many, but specifically, what parts of Tamara’s and Robert’s stories resonated with you?

Kim Downey: Well, when I presented the idea to you of a group of articles about physicians doing different things, I wanted to help other doctors, and I wanted to spotlight different physicians, men and women, in different specialties, doing all kinds of different things, having gone through burnout and now thriving. With a few doctors, I wanted to approach it from an individual standpoint: How did they help themselves? And then another group of doctors went on to receive coaching and support other doctors. And then I was looking for doctors who are not only still practicing medicine but doing other things also, and I immediately thought of Robert and Tamara, because that’s exactly what they’re doing. And of course we’re going to do this again and spotlight some physicians who have pivoted from medicine. What I want to do is show doctors that there are so many different things you can do to help yourself, and that you can find joy in your own work and in doing other things. So it was just that I saw what they had built, that they were successful and that they were happy, and I wanted to spotlight them so other doctors could see that.

Kevin Pho: Tamara, let me ask. A lot of physicians I talk to have a lot of entrepreneurial ideas but just don’t know how to take that next step, because they don’t have an MBA, they don’t have any business training. The only thing they know how to do is clinical medicine. So for those physicians who have a kernel of an entrepreneurial idea but don’t necessarily have that business background, what kind of advice can you share with them to take that next step and perhaps explore that entrepreneurial idea?

Tamara Beckford: Absolutely. I love that question, because it covers so much of what’s going on in the mind of most physicians. So one: If you do have a kernel of an idea, the biggest and hardest part, and even Robert talked about it, is just to start, because once you start, the momentum keeps going, and there are a lot of other entrepreneurs out there who will help you along the way. So do find a mentor, find a school if there is one, find a business coach. Fortunately, I am a part of the EntreMD Business School, and there I also mentor physicians in a success group every week. So if you are part of the school, or if you do become part of it, you’ll see me there, and we’ll help you get through your ideas, and you’ll get the support.

The other thing is to get out of your mind the idea that medicine is the only thing you know how to do. You are filled with a lot of skills, and these skills are transferable to other industries, and those industries are waiting to hear from physicians, because the way we think is different and the way we analyze things is different. It’s great for them to be able to get people who think and analyze like us in other industries. So do not belittle your mind into thinking the only thing I know how to do is medicine, because in the time you have dedicated to honing this craft, you have learned a lot of other marketable skills. So do not belittle yourself. Write down a list of the things that you like to do, the things that bring you joy, the things that you would love to do and the things you did before entering medical school, and then you can use some of those skills to enter into your entrepreneurship journey.

I’ve seen many people do it. We have physicians who are artists, right? We have physicians who are coaching in many things: in running, in exercise, in health and wellness, in stress management. There are also physicians who love beauty, and physicians who are coming up with inventions. We have a lovely physician, I think she was on here not too long ago, who invented the postpartum ice panties. There are so many ideas, and you have it all within you. So do not think that the only thing you can do is medicine. I think Robert touched on that too: We have a lot of skills that are marketable. So step one is finding out what you like to do in addition to medicine, step two is finding a mentor, and step three is to do it.

Kevin Pho: Let me follow up, Tamara. I talk to some physicians, maybe what we’d call more conventional physicians, who push back against that notion and say that physicians who do things outside the hospital, or who do things other than see patients, are maybe considered, quote-unquote, less of a physician. They believe that physicians should only see patients, because they’ve invested so much time in their education. What’s your response to that type of pushback?

Tamara Beckford: I’d say that’s nonsense. I’m just going to put it out there: That is nonsense. If you look at the physicians who are thriving emotionally, they’re the physicians who are able to balance, and that’s one of the things, and you’re asking me, that gives me a lot of balance. I am seeing the hard clinical patients during the week. I’m still an emergency medicine physician; I still work clinically. And then I get to balance that with the creativity of coming up with ways to help people manage their stress and manage their burnout. I have never been happier in my life than these last few years, when I invested in both parts.

So if we want longevity in medicine, we have to allow both parts of our physicians to thrive, because we have to remember that physicians are not robots. We cannot just do the same thing over and over, especially, as Robert talked about, while dealing with the never-ending oppression of our ideas, thinking that we’re just here to, quote-unquote, serve the clients, who are no longer patients anymore, because now we’re just client-facing. How is it that one expects a physician who has put in the work to emotionally give, and to just consistently give, when the receiving portion has diminished a lot? So how do we receive, and how do we give back to ourselves? It’s through that balance. So no, we are not just physicians here to give, give, give to institutions and to insurance companies and to be marginalized. No, we have the power within, and once you recognize that you do have the power to live life on your own terms, that’s when the happiness and the joy come out, and that’s when you have the longevity in medicine that’s needed.

Kevin Pho: We’re talking to Kim Downey, Tamara Beckford and Robert Kornfeld. Kim is a physical therapist, Tamara is an emergency physician, and Robert is a podiatrist. We’re discussing the KevinMD article “Doctors rediscover joy in practicing medicine, on their own terms.” I’m going to ask each of you to share some take-home messages with the KevinMD audience. Robert, why don’t we start with you?

Robert Kornfeld: So I would say the first thing that doctors who are unhappy with what they’re currently experiencing need to do is acknowledge the fact that change can be scary, but not let that fear stop them from moving forward. Use that fear, push through that fear. As Winston Churchill once said, if you find yourself walking through hell, keep going, right? Don’t stay there. Empowerment comes from successfully overcoming challenges. If you buckle to them, you spend an entire lifetime feeling beaten down and unhappy, and nobody deserves that. I can tell you honestly from my own perspective: I’m 69 years old, I’m still going strong, and I’m empowered every day. I love going to work, I love helping my students, but I also have time to pursue my own passions, which is another part of what direct care offers. You have time. So I’m a songwriter, I’m a musician, I’m in a band, we play live shows. I am full of joy because I’ve allowed that to come into my life. So I guess my takeaway would be: Allow for change, even though you’re afraid.

Kevin Pho: Tamara, please share some take-home messages.

Tamara Beckford: So the take-home message that I like to share is just like what Nike said: Just do it. If you have the inkling of entrepreneurship, if you have the inkling that you’d like to do something different, there are other people out there who are willing to support you. I know as physicians, as doctors, a lot of times we feel as if we’re in silos, but remember, you’re not. Reach out. Reach out to the community, and find someone who will support you and get you through that uncomfortable change. As Robert just mentioned, there’s uncomfortableness that comes along with change. So do not sit by yourself, do not sit and be depressed, do not sit and be discouraged. Remember, there are others out there who are willing to help you. So take that first initiative and just do it.

Kevin Pho: And Kim, we’ll end with you. Please share some take-home messages.

Kim Downey: Sure. Dr. Amna Shabbir also contributed to this article, and we weren’t all able to be here together today, so I wanted to start by sharing some of Amna’s voice and also by thanking her. She’s doing an incredible job supporting early career physicians through her early career physician institute, so thank you, Amna, for all your work with that. She talks in the article about how important it is to find a community of like-minded physicians who are all advocating for physician wellness, and all of you have spoken today about the importance of community. She shared that when we are in the awful space of burnout, overwhelm and moral injury, everything appears unattainable, and even asking for help is exhausting. She shares that from personal experience; she knows what it feels like. And she says, “Know that things can change and life truly can get better. One must simply take the first step and ask for help. Yes, it can be that simple. I would urge you to take that first step and not wait any longer.” And her takeaway is, “I urge early career physicians to take their well-being seriously and spend time actively working on it. This is how they will have true longevity in life and in their careers.”

In this podcast today, and in the article, we did talk a little about feeling stuck, so I just wanted to expand on some of the things that Amna shared in her message in the article. I just wanted to say that all people, including doctors, need to feel connected to other people. Everyone needs to have people they can feel safe talking to about hard things, and some doctors aren’t sure who is safe for them to open up to, for a variety of reasons. There are so many doctors out there who understand that feeling and have felt similarly. If that describes you, I, or any of the dozen physicians I’ve collaborated with on this group of articles, would be happy to speak with you confidentially and steer you in the right direction. You can search my name in the KevinMD search bar if you want to find the other physicians. I’ve also shared a couple of times on this site and on LinkedIn a list of free and confidential resources for physicians.

Some doctors feel that only another doctor would understand, and there are many physicians who have been there and wish to support their peers, including everyone on the screen and the other doctors I’ve mentioned. And some doctors don’t feel comfortable opening up to another physician, and in those situations there are other professionals, for example on the Physicians Anonymous site, whom you could reach out to. I’ve had conversations with some of them, and I know them to be trustworthy, smart, kind and supportive, with great listening skills. So basically, if you’re feeling stuck, help is out there, and any of us can and would help you find it.

Kevin Pho: Well, thank you all for sharing your stories, time, and insight, and thanks, all, for coming on the show.