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We sit down with Sogol Pahlavan, a pediatrician, and hear her powerful story of personal transformation. Join us as she shares her journey from achieving the American dream to discovering the importance of self-awareness and self-acceptance. Learn how she overcame chronic fatigue and redefined self-care beyond the surface level, offering valuable insights for listeners seeking a deeper connection with their true selves.

Sogol Pahlavan is a board-certified pediatrician, co-founder, managing partner, and CEO, ABC Pediatric Clinic. She is also the co-founder, SOULpreneurMD, which helps female physician entrepreneurs create profitable, hassle-free businesses, and can be reached on LinkedIn.

She discusses the KevinMD article, “From immigrant to pediatrician: a midlife transformation.”

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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 Sogol Pahlavan. She is a pediatrician, she’s the CEO of ABC Pediatric Clinic and a co-founder of SOULpreneurMD. Today’s KevinMD article is titled “From immigrant to pediatrician: a midlife transformation.” Sogol, welcome to the show.

Sogol Pahlavan: Thank you so much for having me, excited to be here, Kevin.

Kevin Pho: So let’s start by briefly sharing your story and journey to where you are today.

Sogol Pahlavan: Yeah. So like many physicians, I am an immigrant. I came from Iran about 35 years ago to Houston, Texas, and that’s where I’ve been since.

Our options as kids in the immigrant family was medicine, engineering, or law. So I was horrible at math, I didn’t really like to write a lot, so I chose medicine by default. Went through the whole training, became a pediatrician, fell in love with the kids, trained at Texas Children’s Hospital. And I actually was planning on doing a PICU fellowship and got accepted to UCLA, but because I got pregnant and family and got married, I gave up that fellowship and stayed in Houston.

So when I graduated residency I kind of didn’t have any plans, because my plans had fallen through. Like I think most immigrants, all of the members of my family, my cousins, my uncles and aunts, are all business owners of some sort in some industry. So that was kind of the normal path for me. I said, OK, I’m a doctor, everybody kind of owns their own business, so I guess I should own my own business of being a doctor.

So my sister and I are both pediatricians, so two years out of residency we started our own pediatric clinic. And the beautiful thing about this is it was very mission based. It’s in an underserved Hispanic community, and that is the community, when I went through training, that really resonated with me. I loved the patients, it was a more heart to heart connection. So that was about 15 years ago. We’re now nine clinicians, serve about 20,000 patients from five, six different counties, a staff of 40.

And through that journey is where I come to my midlife kind of transition. I always say, what got me here is not going to get me there. And the way I want to explain that is, the identity, the things that I did, the beliefs that I had, the emotions that I had, that really created that clinic for me, that created my life as being, I’m a physician, I’m an entrepreneur, I’m a wife, I’m a mom, a sister, kind of the whole American dream, right?

I got to my American dream and at the end I didn’t feel good. Everything looked perfect on the outside and I didn’t feel good. And when I really paused, and I started blaming everyone like everybody does, right, oh it’s the insurance companies, oh it’s the patients, oh it’s the staff, it’s my teenagers, it’s the husband. And when I really paused to take that responsibility and say, what is my role in all of this, because I can’t to a point control anyone, right? So what is my role, how can I approach this?

This is where I found mindfulness and the practice of mindfulness, and I kind of dealt with that for a good two years, threw myself in there, used a lot of the mindfulness techniques on myself first, and then it kind of rolled to my children and then the staff and kind of the clinic in a sense.

And so where I’m standing now is, I’m bringing together with my partner, Dr. Parastoo, we’re bringing together the entrepreneurship experience that I have and the mindfulness experience that I have, and we are blending those two in our program called SOULpreneurMD. So that’s where we are now, we’re super excited about it. It has completely transformed the whole mindfulness practice, how I am as a person, and then everything else around me.

And my mission is to really, I was always passionate about just entrepreneurship. I think especially with everything that’s going on with medicine now, I started this 15 years ago where no one talked about business medicine, right, everybody was corporate or academic or whatever. And I think there was just a calling, a soul’s calling that I followed, and there were no things like KevinMD or any of the other courses or the coaching or any support or any communities. It was just us solo kind of sitting down and making a zillion mistakes until some of them worked.

So my passion has always been to be independent, be a physician, always be an entrepreneur, give back to the community the way I feel like I want to give back to the community, making the impact that I want, that really aligns with that deeper calling. Because I think all physicians have a deeper calling, that the reason they went into medicine is because of a calling of their souls. And with everything that’s happened, we feel drained, exhausted, derailed, hopeless, gaslit.

And this is how I can bring back and really support my colleagues, into helping them create, even if they have a business that they’re burnt out in, helping them bring back that joy into that business. Or if they’re burned out in something and they want to create a business, then I want to help them really create it from a place of mindfulness, alignment, purpose, and passion, rather than all the other things that the traditional business coaches teach that are very much external metrics.

Kevin Pho: So you tell your story in your KevinMD article, “From immigrant to pediatrician: a midlife transformation.” So I want to ask you about your entrepreneurial experience, because what you said, 15 years ago people didn’t talk a lot about business and medicine, and honestly I think outside of our world here a lot of people still don’t talk too much about business and medicine. So for those physicians who have that entrepreneurial spirit, how can they kindle that, how can they have that entrepreneurial spirit blossom? Because everything you said about medicine today, corporate, academic, it’s even more so today than it was 15 years ago. So how can physicians today nurture that entrepreneurial spirit that they may have?

Sogol Pahlavan: Yeah, I think the most important part is starting with the self, and for me it was pausing. We don’t pause as much in the physician world, right? We’re very overachievers, very competitive, this is how we were conditioned probably as kids and definitely through undergrad and med school and residency. And so we’re chronically on this path of like, go go go go go, I have to get somewhere.

Especially entrepreneurship, I think, is a level beyond physician. It’s like, OK, now I really have to go, I’ve got the MD, now I’ve got to do the business stuff. And when your body, when your mind, when your soul, when you as a human being are in that go mode, we know about the pathophysiology of it, right? It’s stress, it’s cortisol driven, which cortisol in a sense is good in some areas of life, but you can’t live in chronic stress long term. And that’s what I really want people to understand and be intentional about.

So if you are an entrepreneur and you’re completely, like, I wanted out, I was done with my clinic. It was profitable, it was seven figures, but I was like, I want out. And it wasn’t because of the clinic, it was because of my state of being, it was the way that I felt.

So another thing is, sit down and see how you feel, because everything we do in life is about how we want to feel ultimately, right? That’s why we do stuff, it comes from an inner state of being, which is usually a feeling.

So if you feel burnt out, please pause and reflect, go back to yourself, stop pointing the finger like I did at everybody. Yes, there are a zillion problems out in the world that probably are causing stress in your life, and you can’t control those people, but what you can control is how you show up.

And I was in such a reactive mode all the time, that when I really paused and questioned myself, simple things like, do I really need to work full-time as an entrepreneur now that I’m 15 years into my business? Can I delegate? What is the fear behind delegating? Why can’t I let go, right, the control, the fear of letting go, the fear of rejection, the fear of failure, if I let go then it’s my fault kind of thing, the fear of delegation.

Look at all those choices that you are making, probably unintentionally, on a subconscious level, because that’s what has brought you success, right? You’ve had all the weight in the world on your shoulders, you’ve been doing everything, you’ve been multitasking, you haven’t been delegating. But again, what got you here cannot get you there, and that starts with you and looking at yourself. So it’s a lot of self-reflection and pause that will get you to your joy and rekindle it, once you go through that journey.

Kevin Pho: So you mentioned that a lot of physicians may benefit from that blend of mindfulness and entrepreneurship. So what exactly does that mean, and what would that look like?

Sogol Pahlavan: Yeah, so mindfulness, the easiest way I could, because my mom is into mindfulness and has been lecturing me for years and years, and I was like, live in the present moment, what does that mean, be in the moment, like what do you mean? I didn’t get it, I didn’t understand it with that definition.

So the way I would explain it is two words, which is, what are you thinking and what are you feeling. OK, what are you thinking and what are you feeling. Like when you wake up in the morning, just ask yourself, that’s when you can be present with yourself, you’re taking a minute in your day and just checking in on yourself and be like, how am I feeling?

That’s the first step. Because most physicians, including me, when you ask them how they feel, first of all their vocabulary of feelings is very limited. It’s usually like some sort of noise, it’s not even a word, or bad or good. Mine was like, I feel bad or good. OK, let’s look at that, let’s expand upon that a little bit more.

So feelings, we’ve got a lot of unprocessed feelings that are stuck in our bodies, that’s the emotional toll that you’re feeling, and that’s the first place that you need to start. And then you go back and you say, I’m carrying this feeling, where is it coming from, what am I thinking?

My thoughts were like, I’m not a good CEO. When people would leave I would blame myself and be like, it’s your fault, you didn’t give them enough PTO, you gave them too much PTO, you didn’t say hi to them the other day. It was just self-sabotaging narrative that created this emotional, like, back on me every day, and it just accumulated with everything that happened.

So, what am I feeling? And then look up the feeling wheel, Google feelingwheel.com if you can, and that’ll give you a very good array of feelings. And as you practice it every day, every day, what am I feeling, just get up and say what am I feeling, and you don’t need to do anything about it, just identifying the feeling is the number one thing that you could do and the easy thing that you could do.

Kevin Pho: So you had a private practice, you owned your own company, you were CEO, so that gives you some semblance of control over your professional life that the majority of physicians actually don’t have, as you know, they work in corporate settings or employed settings. Now what about those employed physicians who feel a little bit of that emptiness, where they may not have that control that you do as a CEO? What’s your advice to them when they’re working in a more restrictive setting?

Sogol Pahlavan: Yeah, number one word, boundaries, boundaries, boundaries. Before I talk about boundaries, let me just say, I was my own CEO, I didn’t have an administration above me telling me what to do, but I still got burnt out. That’s the crazy part. A lot of people say, yes, it’s administration, it’s corporate, it’s this, this, this. I was my own corporation in a sense.

So again, look at yourself, look how you’re talking to yourself, look at your habits, look at your patterns. When you’ve done something for so long a certain way, that doesn’t mean you should continue to do it that way, right? Like shifting the perspective, first of all identifying what that is, and then shifting the perspective.

And for me, I did not think I had issues with boundaries at all, because I’m a very upfront person, I’m not much of a people pleaser. But I found out, once I started delving into it, that the biggest boundary I didn’t have was with myself. So it looked like, oh, you can squeeze in another five patients during your lunch hour, patients are calling, they want to be seen, you don’t need a lunch break, right? Oh, it’s OK that that patient yelled at you, they just might be stressed, you don’t have to discharge them, you can have them come back. So the trauma just continued, because I was afraid to set these boundaries. Oh, it’s OK that this staff doesn’t have any PTO left, let’s be nice and give them that PTO.

So in the academic setting, a lot of the pediatricians that I’m speaking to, the administration is squeezing their teen well child check from 30 minutes to 20 minutes. Right, OK, no, I cannot do that. They need you. I don’t think we’re dispensable in a way. If you think that you are, and if you think that they don’t need you, then they’re going to push a little bit harder. But once you really set that boundary, even if it’s the first time, and if it’s a place where, like, I set the boundary and they let me go, OK, that’s not a bad thing, that means that you saved yourself a lot of time, because if they push that early on they’re going to continue to push.

So really understanding what that boundary is, and start small. You don’t have to do anything big, start small, because setting boundaries has a lot to do with nervous system safety. We do not feel safe setting a boundary, we do not feel safe saying no, because probably in our past, in our childhood, in our upbringing, the way we were socialized, when we tried to set a boundary as a kid we got a lot of pushback and it didn’t feel good. So we felt rejected, we felt scared, or some of us were hit physically, some of us were verbally told stuff. So when you’re an adult that inner child still works, it makes a decision on your behalf. So understanding that aspect of it too, it’s like, yeah, setting a boundary, I freeze. I have people tell me all the time, I can’t, I can’t. Really going in and delving with that as well. But boundaries is the biggest thing, and start super small.

And the other thing I will say about boundaries is, anticipate that the other person that you’re setting a boundary with is going to have a complete temper tantrum. So anticipate what that temper tantrum is going to look like before you go in the meeting, and practice it, so your body doesn’t reject it as much, so you’re not so scared.

Kevin Pho: So give us a practical example or a story, because I completely agree with you, I think setting boundaries is absolutely key to helping physicians with some of their burnout struggles. So give me a success story where you coached or mentored someone to set those boundaries and it made a measurable difference in their professional life.

Sogol Pahlavan: Yeah. So I was coaching, this is one of my really good friends, she has an executive role in a large hospital system, and she’s a chief medical officer of a large system. And when she got hired on, there was, like any administration, a lot of issues going on at different places. And so she’s the CMO, and so she has a CEO above her.

And what I want to say about boundaries is, it’s not that that other person is bad and you’re good, this has nothing to do with how you view the other person. It’s how I feel when I go into a meeting with the CEO and I don’t feel seen and heard, and she keeps putting all these extra, she was like carrying five different titles. It was insane, and she couldn’t say no, because she was asked all the time. And the fear was like, I should be able to take on this role, even though it’s five different titles.

So her predominant thought was like, I’m not good enough if I don’t do all these things that my CEO tells me, I’m not good enough, I am a failure. That fear of failure is huge in physicians, right? So we had to work through that thought in itself, like, why do you think you’re a failure? Do you think that one human being can carry five different roles?

And we worked through that, it took a while, three to four months for her to slowly, slowly make those changes in her belief. And at the same time there was a lot of issues that had come up in her childhood and her relationship with her caretakers, where the fear of failure came up, so she had to produce and she had to act a certain way to be able to get validation. So this, it’s not just a coincidence of what you’re doing in that time, it’s really what you carry and what the experiences that you’ve had all of your life. So we worked with the past, we worked with the current.

And she was able to go in a meeting, and we practiced, practiced, practiced, and she was able to go in a meeting and actually say, these are five roles that I’m carrying, these are the roles that I like to do, I can no longer carry these three or four or whatever, how can we work together for both of us to be happy?

Because if you’re employed and you’re not coming to the plate with your full relaxed, energetic, like everyone, when you’re employed as a physician or even as a CEO, everybody has a gift. When you carry so much burden with you, you can’t tap into that gift. So you do the five jobs that you have, you do it inadequately. So if you could just focus on that one job that you had, which is the gift that they hired you for, then everybody would win, the whole system would win.

Kevin Pho: And I want to emphasize that this is a process, right? Because you talk about trauma, medical training, going through premed courses and becoming an attending physician, that’s a process almost in people pleasing, right? And it takes time to kind of undo all that damage and be able to set those boundaries. So I just want to emphasize it is a process and not something that could be done immediately.

Sogol Pahlavan: Yeah, this is not like the microwave technique where you buzz it in and then it comes out and it’s hot and it’s great, right? This is growth, this is healing, this is what we need to do as a community. There’s no fast button or reset button or anything like that, you have to put in the work. There’s a lot of Band-Aid techniques that you can use, but again it’s only good in the short term. The long term, you’ve got to put in the work. And I encourage people to work with people, be in these communities that are doing the work, get coaching, get therapy, get a psychiatrist, whatever you need, get whatever that is, because it’s very individualized.

Kevin Pho: We’re talking to Sogol Pahlavan. She’s a pediatrician, she’s the founder and CEO of ABC Pediatric Clinic, and she’s also the co-founder of SOULpreneurMD. Sogol, let’s end off with some of your take-home messages that you want to leave with the KevinMD audience.

Sogol Pahlavan: Yeah, so I want to put some thoughts out there, and just see, when I say these sentences, see how you feel. Your body will either have like a very, whee, or like, oh, that feels awful.

Rest is productive. That is a thought that I had to work on for two years, and that’s a lot of nervous system safety stuff, right? Understanding that I don’t have to be running around doing stuff to be productive.

And then something that goes along with that is that your productivity, what you produce outside of you, does not equal your self-worth. You are worthy because you were created by whatever your belief is that you’re created by, as a soul that’s here on Earth.

And the third one is that all of our souls crave growth and evolution, and growth on Earth, change and challenges and difficulty. So the next time that you’re stuck in this place of change, or something’s coming up that didn’t go your way, instead of thinking, oh my gosh, why does this always happen to me, this is horrible, I can’t ever get over this, I can’t ever do anything right, I’m such a failure, just pause and be like, huh, perhaps this is the challenge that I needed for my soul to expand, to grow. Perhaps this is a challenge that I needed to uplevel myself to whoever I want to become, or I am becoming in that journey.

And the last one, which is the hardest one for me, which takes you back to mindfulness, is that it is not the result and the outcome that matters, y’all, it is the journey. It’s the day to day highs and lows and cheers and sadness and screaming and love that matters. So really keep bringing yourself back to that moment, that day, that half a day, that week. Really focus on the journey and not the end outcome, which we’ve been taught in medicine to do for so long.

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

Sogol Pahlavan: Thank you so much.