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Join Ketan Kulkarni, a physician entrepreneur. We’ll delve into the pressing issues of burnout and discontent among health care professionals, particularly physicians, and explore strategies for achieving holistic success and happiness in both personal and professional life.

Ketan Kulkarni is a physician entrepreneur.

He discusses the KevinMD article, “Breaking free: Health care workers pursuing purpose-driven careers.”

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast, get CME for this episode by clicking on the CME link in the show notes. Today we welcome Ketan Kulkarni. He’s a physician entrepreneur. Today’s KevinMD article is “Breaking free: Health care workers pursuing purpose-driven careers.” Ketan, welcome back to the show.

Ketan Kulkarni: Thank you so much, Kevin. It’s always a pleasure and so glad to be here today.

Kevin Pho: So Ketan has been on about a year ago. Go to KevinMD.com/podcast to hear his story and prior episode. But today let’s jump right into your most recent KevinMD article, “Breaking free: Health care workers pursuing purpose-driven careers.” Tell us about this article.

Ketan Kulkarni: Yeah, so over the last year it’s been so much of growth, development, and challenges globally, but particularly for health care professionals, particularly physicians. I notice there’s been so many websites telling doctors how to quit medicine and do alternative careers. And not just that, I think the data that I saw both from the US and then now more and more hearing from peers and friends and colleagues and collaborators in Canada, we know that we’re sitting on a health care crisis.

There’s a huge amount of dissatisfaction, name it, burnout, visceral discontent, unhappiness, despite the fact that doctors make good incomes, they look externally successful, they have families, they have friends, they have circles. Yet there’s this gap, there’s this void that exists. And that became more and more apparent to me.

And then I thought that it was important to highlight that part of the solution is that we do need to understand the true definition of success. We talked a little bit about that last time, but also to highlight that our journeys are equally important as the destination, right? We cannot imagine some hypothetical future that we’d be happy when retired or whatever else it is. I think the pathway we are following, the intentional purpose-driven careers that we need to follow, is as important as that.

And then that is the gist of our new novel, second novel, which we published in the traditional way. It’s called Soar: A Soul’s Quest. We truly believe that everybody has a Soar in them. Soar is this eagle with anthropomorphic qualities that undergoes a transformative, life-changing journey after a major event in their homestead. So the point is that we don’t need to wait for a major event like burnout, or some sort of loss of a friend or family, or some career problem, or a health issue, to start that journey. We want to really highlight that we have a Soar in us, we need to nurture it, we need to have the intention, identify our authentic self, and then embark on the journey, right? So I thought the article really came out as a calling, more than anything else.

Kevin Pho: So tell us about that gap. You said doctors may seem externally successful but perhaps inside less so. What are you hearing from your colleagues that really illustrates that point?

Ketan Kulkarni: Yeah, and I’ll quote so many friends and colleagues. A lot of people say, oh, I work too many hours, that’s a common thing that comes through. A lot of people also say, I’ve got good income or great income, but I don’t have the time or the freedom to sort of go whenever, wherever I want. That’s important. The stress level at the job is high. For most people the academic demands and career demands are high. People are moving towards a little bit more of a holistic approach. A lot of people don’t seem to have enough time for their friends, family, and loved ones. They’re not able to pursue their hobbies, they’re not able to pursue their acting career or music career or writing career or whatever else there is.

And for good or for bad, we live in this capitalistic, achievement-driven culture where we hinge our success parameters on extrinsic success. That, I’ll be a full professor when I have 100 papers. I’ll be happy when I’ve billed so much for my clinic. When I have 2,000 patients in my practice, I’ll be happy. Or whatever the external goal yardsticks are. But there’s somewhere a mismatch. I rarely see people asking, do you feel happy? Do you feel that you’re intentionally driving your career? Do you feel that you’re doing everything you can to make some progress in all aspects of your life?

Work-life balance is a tricky word. I think we don’t want to get into that for such a short discussion. But I think overall, if people were to rate each aspect of their life, I would easily see, I see a pattern, that yes, there’s a high level of achievement in clinical research work areas, but often at the cost of other aspects of life, not with other aspects of life. So eventually we know that the ship is tilted, and we know what happened to the Titanic. So yeah, we don’t want to be there.

And I think why this is important, I feel, is because not everybody can leave medicine, right? I mean, we need a healthy, capable, well-trained, powerful workforce to care for our populations, and that is just essential. So I don’t see this as an escapist solution. I think that we’re going to have to make well-being part of the curriculum, start from the get-go, and really have that culture shift, that we are able to be well, healthy, well and alive, so that we do the best for our patients and everywhere else in our lives.

Kevin Pho: So when these physicians come to you in scenarios like these, how are you coaching them? What are you telling them the next step is?

Ketan Kulkarni: I think my single most common answer is to get started. That was the driving force to write Soar, that you need to take the one step. Yes, is it difficult? Yes, it’s not a one-step, quick-fix solution. A lot of people are asking me, can you tell me in 30 minutes what to do? Sure I can, but you cannot implement those things in 30 minutes. We cannot fix the financial journey for somebody in 30 minutes, we cannot fix their relationships or whatever in 30 minutes, we cannot fix their health in 30 minutes.

But equally important is the fact that we can take that first baby step. We can start that by reading a book, talking to a friend, getting some mentorship, getting a coach, writing that article that you wanted to write, maybe watching a TV show that you wanted to, taking a walk in the park, and then slowly build on that.

I think it’s not like the New Year’s resolution. We just had the new year. You start on January 1st, and January 4th we are back to the baseline. I think we need to cultivate those habits and work together, build our tribe, and really see a shift in our mindset and culture. And it’s already happening. There’s so many groups that are giving a positive message, and everybody’s sharing their stories. I follow a lot of your guests on the podcast, and I know a lot of them personally, and it’s incredible. I think the fire is spreading, but we need to keep it alive, right? And until every person kind of embarks on their personal journey authentically, I think we need to keep going.

Kevin Pho: Sometimes we feel that the culture of medicine isn’t quite ready yet for that mindset. So if someone implements what you’re saying, they may encounter pushback from the traditional medical culture. Tell us a little bit about that tension.

Ketan Kulkarni: Oh, 100 percent. I agree 100 percent with you. I think it’s not ready across the globe, not just in North America. But then, if not now, then when? I mean, are we going to wait till we just sink? And you’re 100 percent right, but I think the answer is still the same. I think we need to take our first baby step.

For example, when we introduced a mini financial MBA course, it’s freely available online, to our med school, we had to do it as a research study, because like you said, it’s very difficult to have no conflict of interest. And then when we tried to publish it, it was so interesting that so many medical journals thought that this is a personal issue, it cannot be a medical education issue, because at least in Canada medical education is subsidized by the government. So we had to really work around it to kind of get that message out there, that really, when people become financially literate, it’s not going to impact your workforce, it’s going to make it better. They look at it as something that should be avoided. And that’s one aspect.

And then some of the other experiences across the country have been that if a hospital or a system has a mental health support system, or even a coaching system, the uptake is very low, right? Because people feel, oh well, if I tell them that I’m stressed or whatever, it’s going to be used against me. So I think we’re not quite there yet.

And some of our colleagues in Ontario have done a great job. They’ve set up confidential peer-to-peer coaching systems. That seems to work better. It’s much easier to go to a colleague with a coffee and know that they’re going to help, they’re not going to report against you or something.

And then there’s other groups and initiatives. People are doing financial entrepreneurship together, people are doing sustainable venture capital. There’s so many approaches to it. I think one of our friends from Ontario has launched a physician-specific pension plan that is really ingenious I think, and leverages some of the common goals for physicians, because still, most physicians don’t have a proper pension plan for their retirements, right? So I think there’s so much gap that exists. And the good news is that the system may or may not be ready, the change is coming. I think there’s change that’s already started, we’re building up in different areas, and I only see it catching more fire.

Kevin Pho: So you alluded to this several times earlier, about the importance of financial literacy, the importance of physicians paying off their debt, like financial freedom sometimes may lead to an improvement in burnout. Tell me how those two aspects are intertwined.

Ketan Kulkarni: Yeah, I agree. And the answer begins just with a fact check. Across Canada and even across the US, we know that physicians are reasonably well earning regardless of specialty. They at least have six-figure or multiple six-figure income, sometimes seven-figure incomes. But if we suddenly shift the lens and ask, well, what’s their net worth? Yeah, answers are not so pretty.

I’ve helped so many people figure out their net worth, and they really don’t know. They add whatever, and you have to really walk people through how to calculate net worth, and then it suddenly shifts from high income earning but not wealthy people. Because with the income comes very prolonged work hours, often very prolonged work, I don’t want to generalize to everybody, but then high spending habits, and then small savings, and the long training years. Like I was training 14 years, right? So there’s no way you can simultaneously save enough money unless you ran a side gig from the early years or so, but I did not. So for most people it’s kind of delayed earnings, so even if they earn higher, they have multiple six-figure debts and really no knowledge of investment. So overall in the long run, the high income doesn’t seem to translate to wealth unless people are naturally inclined to be financially savvy.

And as a result, I think it becomes like an avoidance fallacy, right? I mean, what you avoid doesn’t go away, it just comes back with more vengeance to bite you. And I truly think that the argument I would like to make is that not everybody needs to become an ultra-high-net-worth person. That’s not the purpose. I think we need to identify what that particular person’s money blueprint is, what do they need for their ideal lifestyle. Maybe it’s $100,000, maybe it’s 50, maybe it’s 500. It’s for somebody to make that decision and then supply that income for themselves. And then it doesn’t matter how much Jeff Bezos or Mark Zuckerberg made. You’re living your ideal lifestyle.

And then I really think there’s a space there, because then you’re not working to supply your income needs, you’re working because you want to work. I think you just bring a different person at work, and a slight mind shift. I would like to compare it to the difference between a response and a reaction, right? I mean, people are working because they have to, or they want to. I think the difference is big. I think that’s where the freedom is. I really don’t think that because people were more financially savvy and more independent they would lose interest in work. I think they would actually be more interested in working because they are purpose-driven. It goes back to our article.

Kevin Pho: So tell us a success story, it could be real or hypothetical, where you would implement some of your ideas and really move the needle or made a difference in a physician’s life.

Ketan Kulkarni: Yeah, I think there’s many, and that’s the best part of this. And it relates, actually I can cite it from our first book. Our first book fortunately won the best self-help book award for 2023 from BBA, and we didn’t know when we wrote it what it would do and how it would help people. But then many people read the first book, which is called The Legendary Quest, and that really made them pause and reflect.

And so it’s been a couple years. I could cite so many people that have kind of paused and really re-evaluated their goals in life and embarked on different journeys. One person started their long-awaited entrepreneurial journey, another person started their music career, a third person diligently started investing. Some other people have come saying, well, I need to, even early career trainees or residents, they’ve come saying, well, this makes a lot of sense, what do I need to do now, what are the goals, what kind of residency should I do, where should I live, cost of living areas. And some of the more closer friends, as a result of some of our work, they have actually started some joint ventures. Some of them have started real estate ventures. It’s really nice to see the impact coming. Some people are even kind of pursuing their political careers. So I think there’s many success stories, but we would like to keep building on the steam and kind of see it through. I think it’s early days.

Even some of my lawyer and accountant friends, one of my lawyer friends, he looked at our second book right now, and he just stopped and he almost had tears in his eyes. I mean, they’re real, right? He just felt like, oh my gosh, he took me back, this is interesting. He said, you took me back 25 years, when I had nothing, and I was the happiest then. He’s a very well off, very established lawyer, and he’s been reading diligently and we’ve been having more chats. So amazing to sort of see that shift immediately happening, right? It’s almost like neuro-linguistic programming, right, NLP training? I mean, you just see an instant shift in people. So I think it’s very heartening. The impact, sometimes we don’t even know. Sometimes people say, oh yeah, I read that, it really made meaningful sense to my life.

Another friend who was not a physician, he called me this week and said, I read Soar’s story and it really, he’s 67, he said it really made me think. He said, these were his words, he said it told me I don’t need to have a certain bank balance, he told me I don’t need to have X, Y, and Z to keep up with the Joneses. He said it helped me to understand what gratitude is, and appreciate and cherish my relationships. And he’s now committed, he committed himself to periodically meeting with his friends and catching up with his family, monitoring his expenses. And really, he has a lot of experience with housing issues and tenancy act issues, he’s starting a free or nearly free service for landlords and tenants alike to resolve disputes and issues. So I think there’s no age limit to it, right? You’ve got experience, from impact on a 20-year-old to a 70-year-old and beyond. So I think the impact is coming, and it’s very gratifying to see that, and we would only like to scale it up.

Kevin Pho: We’re talking to Ketan Kulkarni. He’s a physician entrepreneur. Today’s KevinMD article is “Breaking free: Health care workers pursuing purpose-driven careers.” Ketan, tell us some of your take-home messages that you’d like to leave with the KevinMD audience.

Ketan Kulkarni: I think my biggest take-home message is that you all have a Soar in you. It really is true. I think everybody’s journey is important. The first step is to take the step, and I think the second step is also to take the step too. So I think get started. Find out what’s truly important to you and then go after it.

And I think medicine will serve our patients better if they are purpose-driven careers rather than done for paying your expenses. So I think purpose-driven careers will serve our populations way better, with a healthier workforce in the long run. Those would be my two, three take-homes.

Kevin Pho: Ketan, thanks again for coming back on the show, sharing your time and insight.

Ketan Kulkarni: Thank you so much for having me.