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We delve into the critical issue of physician burnout and the transformative power of mindfulness in health care. Our guest, Seema Desai, a dentist and life coach, shares her expertise on how mindfulness can benefit health care professionals. We explore its practical applications, its impact on patient care, and hear real stories of doctors who have found balance and resilience through mindfulness practices.

Seema Desai is a dentist and life coach.

She discusses the KevinMD article, “Physician burnout during COVID: Bringing ancient practices to modern medicine.”

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast, and you can get CME for this episode by clicking on the CME link in the show notes. Today we welcome Seema Desai. She’s a dentist and life coach. Today’s KevinMD article is titled “Physician burnout during COVID: Bringing ancient practices to modern medicine.” Seema, welcome to the show.

Seema Desai: Thanks so much for having me.

Kevin Pho: We’ll get into the article in a little bit. First off, briefly share your story and journey.

Seema Desai: Yeah, so I kind of did the good Indian girl narrative. I went to school and became a dentist; that was my way of getting back at my parents, becoming not an MD but a DDS. I married the right guy, did all the things, had the kids, and I was sitting there, as I was practicing dentistry, wondering, “Why am I so unhappy?” I felt like such a failure. I felt like everybody had it figured out but me, and I think that set me up for a lot of stress and strain. At one point I was in a very, very dark place, which caused me to go on this deep dive into what it is that makes us happy and why.

I always tell people that finding yoga quite literally saved my life. But it manifested in other ways, too, in terms of my being an angry mom and then feeling the guilt about it, and I would see it in how I showed up with my patients and in various interactions all throughout life. When I got help for that through coaching, it was life-changing. And here I am, through just following the breadcrumbs and following my passion. Now I get to be an intuitive leadership coach for other ambitious leaders who are trying to figure out how to go from busy, stressed and overwhelmed to productive, fulfilled and happy.

Kevin Pho: So on the show, of course, we talk to a lot of physicians about burnout. You’re a dentist, and I actually don’t talk to a lot of dentists on the show. So what’s it like in the dental burnout space? Are dentists as burned out as physicians are?

Seema Desai: Absolutely. First of all, it’s difficult for anyone to really grasp the physical toll that it takes on you to be in such a restricted space. Even though I haven’t practiced dentistry in a few years now, my body is still feeling the effects. I’m still working to undo the damage, because when you’re 25 and fresh out, you think that you’re kind of invincible. So yes, I definitely see that for dentists the physical toll is there, and the mental toll is there. Of course, if you are an entrepreneur and you own your practice, then there’s a whole other ball of wax. So absolutely, while we’re really just a subset of the broader spectrum of health care, we’re right there with you in terms of physician burnout.

Kevin Pho: So like you mentioned before, as part of your journey you went the traditional route into dentistry, but over the last few years you’ve transitioned into being a life coach, and you coach other high-achieving individuals. So tell us about that transition.

Seema Desai: It was one of those things where I just realized that continuing to practice was not my calling. I found great value in doctoring. I learned a lot, I grew as a person, and I think by the end of my time in the operatory I really was a much better doctor, and it was a result of how I was life hacking. I would have my colleagues tell me things like, “Well, this is hard,” or “Patient care,” or this or that, or “The kids,” or “My husband,” or “Yeah, I want to eat right, but I just can’t seem to get it together.” And I was starting to see these problems sort of fall away for myself, and the only difference was me changing my perspective and, importantly, me understanding the bridge between what my body and my breath were telling me, especially in moments of stress.

So again, I mentioned I had received coaching myself, and I thought, “You know what? I think the next right step for me is to support others who are in a similar place in life.” Because it doesn’t have to be hard. I’m not saying that there aren’t going to be challenges or stresses, but we can absolutely learn to navigate them in a way that’s actually going to create even higher successes than we might have previously imagined, all while honoring our well-being and our sense of peace, which is why we tend to work so hard in the first place.

Kevin Pho: So let’s talk about your KevinMD article. It was written back in ’21, in the midst of the COVID pandemic. It’s titled “Physician burnout during COVID: Bringing ancient practices to modern medicine,” and I’m sure you don’t need me to tell you that the ramifications for the mental health of our health care professionals have persisted until now. So tell us how this article came together.

Seema Desai: Honestly, I think the pandemic didn’t create a new problem. It just precipitated and very much highlighted something that was already pre-existing. As I mentioned, my husband is also in health care; he’s a physician, and many of our family and friends are physicians. Looking at things especially from the Indian American perspective, growing up, my parents, especially my dad, would tell me, “Do yoga. You should meditate.” And it all seemed really woo-woo, and it almost created that hard aversion to anything our ancestors did in terms of breathing, diet and how they just lived life in general, because in my very limited scope of understanding then, there wasn’t a lot of evidence to back it up. So I would just lean into what we practiced and learned here to become doctors.

And then I started to find, no, wait, actually, you become unwilling to look at something until the problem becomes so insufferable that you’re like, “I’ll try anything,” right? So that’s kind of where I was. I had postpartum depression with my son, and I was just so desperate to find something, and that’s how I reconnected with my roots and started learning about all of these practices. Once I started to find benefit in them, it turned out there is actually a ton of research, more so now than before, I think, about why all of these things are deeply effective in staving off physician burnout, reversing physician burnout and, importantly, creating an even better version of the doctor than you maybe thought you could be.

Kevin Pho: Now, you mentioned that while you were having episodes of burnout, you reconnected with yoga specifically, and you said that was life-changing. So talk more about that.

Seema Desai: Our bodies hold our emotions; they hold our stress. I remember being in school and learning about the parasympathetic nervous system and the sympathetic nervous system and so on, and the vagus nerve, but no one teaches you, when you’re becoming a doctor, how to leverage that. I think yoga, while not in medical terms, is an amazing pathway to help support your body and undo and rewire how things are felt in your body, so that you can actually return to a place of what I call wise thinking, where you’re thinking clearly and you’re able to see solutions that you cannot see when you’re under stress.

That’s really how yoga helped me. Initially, it was just a workout. It was just a way to escape. But when you do it more and more and more, you start to get these lessons: No, it’s more than that. It’s definitely not about being upside down or twisted into a pretzel, although that is something I can do now after 12 years of practice. The most effective yoga I do is actually bringing it back to my breath, bringing it back to my mind and helping myself understand: All right, what’s actually happening for me? Where’s my body tensing up when I’m sitting? How is my breath changing? All of those things sort of meld together and help you get perspective that’s going to help you get to where you want to go, as opposed to keeping you where you’re stuck.

Kevin Pho: Now, when you talk to other burned-out clinicians, do you incorporate yoga as part of your advice? How do you incorporate it going forward in terms of helping other clinicians?

Seema Desai: I try never to give advice, because what’s right for me is not what’s right for you. You’re the expert in your own life. But I do encourage all of my private coaching clients to start a meditation practice, and for those who haven’t ever tried yoga, I periodically do in-person workshops and bring that in, just so they can start to see even more, “Oh wow, I never noticed how being in an uncomfortable and new position brought up a lot of the same stresses that running a code brings, or having a difficult conversation with the parent of a patient.” All those things tend to show up very similarly.

So in my private coaching, it’s a lot of breath work, simply because not everyone has the space and time to roll out a yoga mat and do the thing. What I do practice in those private coaching sessions are the other limbs of yoga: the non-judgment, the ahimsa, right, the non-violence toward others but, importantly, toward the self. How are you talking to yourself? Is it in a way that is compassionate, so that you can take that compassion and reflect it outward?

Kevin Pho: Can you tell us a case study or story? It could be one of your clients, or it could be a hypothetical situation, where you incorporated some of these ancient practices and really moved the needle for that client.

Seema Desai: Yes. I had a client once whose job, by its nature, is to see critically ill children. These children are oftentimes in life-or-death situations, and everyone tends to freak out, especially when it’s a child. I don’t care how many times, even if this is your job and you’re acclimated to the fact that it’s a child, you tend to see your own kids when those patients are there in front of you.

This one particular client had given orders and thought that everybody was on the same page, nursing, the resident and they themselves, and thought they had a game plan. They basically left and came back, and when they revisited the patient a couple of hours later, they realized, “Oh my gosh, the dosage on this medication was actually 10 times what I had prescribed.” You feel like, “What the heck? Did you not hear me? Hello?” There’s a lot of judgment that can very understandably come into play, and by judgment I mean black-and-white thinking: This is right and this is wrong. There’s an expectation that hasn’t been met. And as easy as it was for this particular client to spin out, they were being perceived as unapproachable. Honestly, people were scared of them. And there’s no room for that when you’re seeing a patient, whether they’re critically ill or not, but especially when they’re critically ill. There’s no time to be stuck in indecision and fear. You’ve got to have a lot of trust in the team.

So in working with this client, they took a lot of what I discussed in the article: having that mindful drive in, setting an intention for your shift, reconnecting with why it is that I’m here in the first place. And because we had practiced, because we had coached, when things were happening with this particular patient, they took a step back. They breathed, they reconnected with their body and they got a handle on it. They knew exactly the types of thought patterns that were going to keep them on this path, and they also knew where they wanted to go instead.

What happened as a result was that, because they had this awareness, they were able to shift through a process I call crossing the bridge. When they crossed the bridge, they were able to approach the situation with a lot of compassion and curiosity. When that happened, not only did they have eye-opening insights, like, “Oh, these are the things residents might have sticking points with, and here’s how we can fix this and communicate better.” Was the issue between nursing and the resident? Is the nurse afraid to talk to the resident? Is the resident not being clear with the nurse? Or did the nurse see the problem and not feel comfortable and safe coming to the physician? It could be any one of those things, but it led down a path of curiosity and open conversation, and quite honestly, that pediatric ICU is functioning better than it ever has before, simply because this leader and their partners took steps toward mastering their thoughts and understanding their bodies.

Kevin Pho: Now, for those listening to you who want to take that first step, and who may think, “Oh, I don’t have time to incorporate these,” just give us a sense of how easy or difficult it could be to take that first step.

Seema Desai: Easy and hard are so relative, right? If I told you to put in a central line, I couldn’t do it; it would be really hard. So it really just depends. Yes, expertise comes into it, and practice comes into it, but the reality is: How long are you willing to make yourself wait for the better version of you, the best version of you? It’s really up to you. It’s really about how invested you are in making the change happen for yourself. Books are great, and podcasts are great, because they can give you insight, but if you’re not going to take that insight and put it into action, you’re not going to see change as quickly as you would otherwise. That’s why, at least for me and my clients, both my working with a coach myself and my working with my clients, it’s so powerful: You have the accountability, you have the support and you have the clarity, so you know exactly what you’re going to do, why you’re going to do it and how you’re going to do it, and you just get to experiment in the best way and watch life unfold.

Kevin Pho: We’re talking to Seema Desai. She’s a dentist and life coach. Today’s KevinMD article is titled “Physician burnout during COVID: Bringing ancient practices to modern medicine.” Seema, tell us some of the take-home messages that you want to leave with the KevinMD audience.

Seema Desai: Well, first of all, I would say have compassion for yourself, and watch how you talk to yourself. How you talk to yourself is exactly why you’re living the life that you have right now, whether that’s in your finances, the relationship with your spouse, the relationship with your kids, or the relationship with your patients and your team. I think that was the biggest thing when I started out. If I could go back 20 years and tell myself anything, I would say, really take the time to understand how you’re speaking to yourself, because that’s the lens through which you’re making the decisions that are creating the reality you’re living right now. So you’re basically living the life that you’ve chosen to live, and if it’s not one that you want to live, then instead of blaming the system, and yes, the system is broken, yes, this, that and the other, remember that we have incredible power to choose our own thoughts, which ones we believe and which ones we take action from. So I just want to empower you to recognize that you do have that power. You have every capacity to create anything you could ever want, have or need, and it’s right inside of you.

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

Seema Desai: Thank you so much for having me.