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

Physician advocate and physical therapist Kim Downey, physician coach Erin Hurley, and patient advocate Dawn Veselka discuss their article, “Spreading hope one card at a time: How small acts of kindness can make a big difference for doctors.” They highlight the emotional toll of medicine, noting a concerning shift in how physicians describe their work—from fulfilling to exhausting and demoralizing—contributing to burnout rates near 50 percent and high suicide rates. Kim, Erin, and Dawn champion the power of simple acts of kindness, like handwritten notes, to combat this, referencing Erin’s personal experience receiving encouraging cards during medical school. They introduce the expansion of Dawn’s Cards2Warriors Happy Mail program to include doctors, challenging listeners to write a note of appreciation by Doctors’ Day (March 30) to refuel and rekindle hope in physicians. The conversation emphasizes that such small gestures can create a ripple effect of positivity throughout the health care community, ultimately improving well-being and potentially patient interactions. Actionable takeaways include writing a thank-you note to a doctor, signing up for or supporting the Cards2Warriors program, and organizing local card-writing events.

Our presenting sponsor is Microsoft Dragon Copilot.

Want to streamline your clinical documentation and take advantage of customizations that put you in control? What about the ability to surface information right at the point of care or automate tasks with just a click? Now, you can.

Microsoft Dragon Copilot, your AI assistant for clinical workflow, is transforming how clinicians work. Offering an extensible AI workspace and a single, integrated platform, Dragon Copilot can help you unlock new levels of efficiency. Plus, it’s backed by a proven track record and decades of clinical expertise and it’s part of Microsoft Cloud for Healthcare–and it’s built on a foundation of trust.

Ease your administrative burdens and stay focused on what matters most with Dragon Copilot, your AI assistant for clinical workflow.

VISIT SPONSOR → https://aka.ms/kevinmd

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

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

Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast. Today we welcome back Kim Downey. She’s a physician advocate, and she brings together Erin Hurley, a physician coach, and Dawn Veselka, a patient advocate. Today’s KevinMD article is “Spreading hope one card at a time: How small acts of kindness can make a big difference for doctors.”

Kevin Pho: Everybody, welcome to the show.

Kim Downey: Thanks, Kevin.

Erin Hurley: Thank you. Appreciate it.

Dawn Veselka: Good to be here.

Kevin Pho: Kim, as always, how did you bring Dawn and Erin together?

Kim Downey: I had introductory conversations with each of them last fall separately, a few weeks apart. I learned about Dawn’s Cards to Warriors program, and I learned how passionate Erin was about supporting her physician colleagues. I thought they would enjoy getting to know each other. I had them on my YouTube channel at the end of January, and we titled that episode “Spreading hope, one card at a time: Uplifting doctors, patients, and caregivers.” They really hit it off, and we wanted to collaborate further and make a big impact for Doctor’s Day. We wrote our article, and I’ll let them share their perspectives about some of the ripples that have come from our work together so far.

Kevin Pho: All right. Dawn, tell us about your Cards to Warriors program.

Dawn Veselka: First, Kevin, thank you so much for having us. We’re so excited to be here. Cards to Warriors was born out of a need to meet people in the moment where they’re at. There are so many amazing organizations doing great work with advocacy, funds for a cure, all of the big long-term projects, but sometimes we realize people just need a little bit of love dropped on them in the moment to say, “Hey, we see you. We encourage you. We know it’s hard. You’re having a really hard day or a really hard time, and we’re just here to support you, send you love, and give you that little oomph to keep going on those super tough days.”

That’s really where it was born from, and it has turned into this whole magic-in-the-mail project where caregivers, illness warriors, and now physicians and medical professionals can receive a little bit of love and encouragement that they can look at over and over again on those days when they need to be grounded and reminded of their purpose.

Kevin Pho: Dawn, give us an example of some of the messages that these health care professionals are receiving from your program.

Dawn Veselka: We have two different kinds of mail. One is handwritten mail; those would come from the actual patients that have treated them, and those are obviously always the most rewarding. We’re right now in the middle of our campaign called “Thank Your Favorite Medical Warrior.” We’ve sent cards out, and the patients, illness warriors, and caregivers are receiving them. They will write a message telling that doctor or nurse exactly why they made a difference in their life, exactly what about their care was life-changing.

For me specifically, my daughter’s doctors saved her life. You can’t be more grateful than that: that you saved her life. You’ve just nurtured her along the way, found things that would work when nothing else was working. Those are the kinds of messages.

We also have cards that are just printed that we send en masse. Those kinds of messages would be like: Everybody’s a warrior in our world, whether you’re a medical warrior, a patient, an illness warrior, or a caregiver warrior. Everyone’s a warrior because we’re all on this journey together. They say things like, “Hey Warrior, we see you. We know that you deserve to be loved and cheered for. Thank you for your contributions that you’re giving to all of us.” Those kinds of messages: just hope and encouragement and love.

Kevin Pho: Erin, when you heard about this program—and you’re a physician coach—tell us a little bit about how you heard about it and what your thoughts were after hearing about this program.

Erin Hurley: I just want to say Kim Downey has a magical way of putting the right people together. When she connected Dawn and I in January and I heard about this mission… I sit on a statewide executive committee called the Oregon Wellness Program that helps put confidential mental health appointments with vetted professionals in front of caregivers and health care providers. I also am on the board of my local medical society and on the wellness committee. Learning about this event actually started the wheels turning. I remember talking to a good friend who was so appreciative of her cardiologist and her primary care doctor; they made life-changing adjustments in her and her husband’s life. I said, “I want to write your doctors a card.” This was a coffee date with my friend six months ago. This planted a seed.

Then Kim said she wanted to write letters beyond her circle, and we all came together. I thought, “I’m going to start an event. I could host an event; I love planning them.” We created an event called “Notes from the Heart” in Salem, Oregon, where I’m at. The medical society sponsored it, and some local businesses sponsored it. We had a local artist, a high school student, create the artwork for the cards we printed. It was such a beautiful event where patients and caregivers came together, writing notes to each other.

Unexpectedly—I don’t know if I’ve shared this with Dawn or Kim—one of my good friends that I’ve known since residency came to the event, and one of her patients came. It wasn’t planned. We had people who nominated their physicians or their health care providers who came, and we knew they were going to say some words. The dad came up and said, “Hey, I didn’t realize Dr. Pearson was going to be here. Can we say something about her?” His son had had cancer multiple times, and she was the pediatric hospitalist that created the hospitalist program at her local hospital so kids could stay local and not have to go an hour away to be cared for. It was such a serendipitous moment for this patient family to share gratitude and then for the physician to say what a meaningful impact that patient had.

We had a card-creating station where kids—there was a whole group of toddlers there with their parents—were creating cards. This magic happened because Kim had the intuition to put the two of us together. I see this as an ongoing, maybe annual event, or I would love to host another event. It was just incredible.

Kevin Pho: Erin, tell us about the morale in general of some of the physicians that you’re talking to. You mentioned the impact that this small token of appreciation had on that one particular physician, but in general, give us a sense of what the morale is like. You’re on the wellness committee, so I assume you talk to a lot of physicians and health care professionals about some of the issues they’re facing today. What’s the morale like, and how can appreciations like this lift them up?

Erin Hurley: I know that the numbers of physicians in burnout have gone down slightly, and yet they’re still close to 50 percent in primary care, which is where I work, and among women in medicine. It’s not great. I just had a call with a new coaching client, and her life was so messy; she’d just given up hope of making any change, and that seems to be the norm.

One of the things I love as I started coaching—mostly women in medicine and health care providers—is to get more done with less time and energy, to shift their perspective, and take control over the things that they can control when they can’t control big corporate medicine. The morale can change, but we have to be in the right community. That’s where Kim connecting different people, people coming together, and your podcast sharing not only the pains and the low morale in medicine but also those things we can do to turn things around, to get in community with other people who are not going to take things for status quo.

I talk about how in medicine, we’re used to the saying, “When you hear hoofbeats, think horses, not zebras.” For my people, I say, “I don’t want you to be a horse,” because the normal outcomes aren’t really great right now with suicide rates and depression, anxiety, and burnout rates. I don’t even want you to be a zebra. I look at it as: let’s create unicorns and a new norm where we can support each other and create something different in medicine. By coming together like we are today, that just builds the momentum and increases the impact we can all have instead of trying to do it individually.

Kevin Pho: Kim, you have a unique perspective. You’re a physical therapist, so you have that perspective from a health care professional side, but you’re also a patient advocate. Tell us about the impact of appreciation. Is it done enough, do you think, among the health care community? Talk again about the impact through both of your perspectives.

Kim Downey: Sure. I think it’s not done enough, and I think everybody tends to take each other for granted. It’s interesting because I was on my town’s Facebook page—they have a local business and happenings page, but now I’m so busy I don’t really go on anymore. I remember the last couple of years I wanted to make a big impact for Doctor’s Day. A couple of times I put a message on the Facebook page asking, “Does anybody want to join me?” There were crickets, like one or two people, and it never got off the ground. But if you mention a lost dog or a new restaurant, a couple of hundred people will comment. Simultaneously, over time, if you wanted a new doctor, if you posted, “Who’s the best pediatrician?” people will write notes on that Facebook page about these wonderful pediatricians. They might, if somebody asks them, “Hey, do you have a doctor you like?” share that, but they aren’t sharing that with the physician.

I thought I could quickly share how things can come about. We mentioned in our article the Butterfly Effect or, as Dr. Todd Otten would say, ripples of change. Speaking to your question about the impact this has had: for those that haven’t heard yet, Medicine Forward hosted an open space technology event prior to the Burnout Symposium in New York City last November where we called the question, “How can we restore and nurture the human connection so needed in health care today?” One physician raised his hand and said, “We have so much empathy for patients, and we’re expected to. Sometimes they don’t understand our struggles. How can we foster empathy in patients for us?” A discussion group formed around that called “Patient Empathy for Physician Wellbeing.”

The following month, we hosted a joint online event with the Health care Reinvention Collaborative. I facilitated that breakout room, and we asked, “What could we do? What should we do?” About a dozen people were in that room, and they wished to continue the dialogue further. I organized an online gathering in January. When we met, I suggested we start right out of the gate by trying to make a big impact for Doctor’s Day. Again, we discussed what we could do and what we should do. Many ideas were generated, from wearing a certain color on Doctor’s Day to creating flower bouquets with petals comprised of patient thank-yous to designing social media profile frames and Zoom backgrounds. We thought simple would be best for this first go-around and chose to get the word out about sending a note of thanks to a doctor who has impacted your life.

Personally, I shared posts about it on LinkedIn, some of which were reposted, including my interview on Erin’s podcast—she interviewed both Dawn and I. I wrote a letter to the editor of a local newspaper. An announcement was made at my church; the youth group wrote messages. Of course, I sent my own doctors heartfelt cards of thanks. All of that happened because one doctor raised his hand.

Kevin Pho: That’s a wonderful story, Kim. Dawn, let me ask: Kim mentioned that when she asked for comments on her town’s Facebook page about appreciating doctors on Doctor’s Day, there wasn’t much response. Sometimes I see that health care professionals often get lumped with all the problems in our health care system, and sometimes that appreciation is hard to come by, right?

Dawn, what’s your sense? Do you find that sometimes it’s hard to generate that appreciation for health care professionals, given all the systemic problems in our health care system?

Dawn Veselka: Yes, I think doctors often bear the brunt of it because the patient perspective is that the doctors control everything at the hospitals or the clinics, and honestly, they often have very little to do with it other than direct patient care. We see that over and over again. Everyone’s got their doctor horror story; they want to gaslight the doctors, they want to blame the doctors, but no one ever pauses and says, “Oh my gosh, but what is the good they’ve done? How can I show that gratitude?” Even if they do feel the gratitude, they rarely take that extra step to show it.

Poor doctors are just getting beat up every which way, from the hospital administrations to the things they can’t control. They’re battling the number of hours spent just battling insurance on behalf of the patients, especially in our community where everyone’s rare or unique, and they’re fighting for the drugs that they need for their treatments. Doctors spend so much time behind the scenes working extra hard, and they rarely get recognized or credit. They just get blamed when it doesn’t get approved, or they get blamed when the patient has to wait, or they get blamed. They bear the brunt of all of it.

Kevin Pho: Erin, you’re a physician obviously, and I know when sometimes I get a thank-you card or a gift basket from a patient, that’s sometimes something that I remember for years to decades later. Maybe you could speak personally: whenever you receive a note of thanks or a patient goes above and beyond to thank you for something that you’ve done, how does that resonate with you? How does that stick with you?

Erin Hurley: During the 25 years I practiced medicine—I’ve retired and am actually looking at going back into practicing a special type of pediatrics—when I received a drawing or a card, I still have them. I would put them up on my bulletin board. I remember sitting at my desk sometimes thinking, “Am I even making a difference?” Then I’d look up at those cards and realize the power behind something I did that I had no idea about at the time. That’s where, if we can trust that we are having an impact even when we don’t see it, or we might see one tiny percent of it… If we recognize that’s just one tiny grain of sand on a whole beach full of people whose lives we impacted, but most of the time we don’t get the opportunity to see that.

That’s where I love this event and this ripple effect created with Dawn’s organization, not just for the patients who need it but also for recognizing the care team. Sometimes it takes a tiny, heartfelt, quick text message: “Thank you.” It might take 10 seconds. When I’ve interviewed individuals who’ve been suicidal, who have had significant burnout and depression, sometimes that’s the one little event that turned their life around. It might have cost you 30 seconds, 60 seconds. Each of those little things can fill the tank back up.

Doctors are not robots; we are people, we’re humans. Unfortunately, many of them are going through struggles as well. The card-writing event that we created allowed each other to see each other as human beings, not just in some 10- or 15-minute appointment. When patients understand the constraints that physicians and health care teams are going through—many of them understaffed, under budget, all of these things—then they can recognize, “Oh, that’s why there’s this delay. Oh, now I understand.” Adding that human component, oftentimes just creating ways we can help each other better understand… The same thing goes for physicians understanding the patient perspective, right? They’re not just a patient or a diagnosis; they’re a human being that needs our care and empathy.

Kevin Pho: We’re talking to Kim Downey, physician advocate, who has brought together Erin Hurley, a physician coach, and Dawn Veselka, a patient advocate. Today’s KevinMD article is “Spreading hope one card at a time: How small acts of kindness can make a big difference for doctors.” Now, I’m going to end by asking each of you for some take-home messages you want to share with the KevinMD audience. I’m going to start with Dawn, then go to Erin, and we always end with Kim. Dawn, why don’t you go first?

Dawn Veselka: OK. First, to the KevinMD audience: Thank you. Thank you for all your hard work, thank you for your dedication, your lifetime of commitment. We don’t say it often enough, but thank you for all that you do. Our goal is to bring together the patients, the caregivers, and the physicians so that everyone’s working as a team, everyone feels appreciated and seen, and we’re all collaborating together. We’re going to continue to show love and appreciation one card at a time for all of you.

Kevin Pho: Erin, your take-home messages?

Erin Hurley: Change is possible. If you are experiencing feeling down, depressed, or burned out, look at your community. If you don’t have the right community of support, go find somebody’s community. Reach out. Kevin has this great community, KevinMD. You can get to a different place with the right support, whether that’s a therapist, a coach, or a friend. Look for that because you can make change. It doesn’t have to take a long time, and it gets much easier when you have the right support.

Kevin Pho: And Kim, finally, we’ll end with your take-home messages.

Kim Downey: Sure. I was thinking of you on Doctor’s Day, Kevin, so again, thank you. Thank you for everything that you do. We all know these are challenging times for doctors and patients, and some people are feeling discouraged and don’t think there’s anything they can do. From coaching, I learned to ask: “Is that true? Is that really true? What if the opposite is also true?” We gathered a small group of doctors, patients, and health care leaders from around the country—Erin and Dawn joined us—and we were able to make a huge impact for Doctor’s Day without needing permission from anyone; we just went ahead and did it.

Our group is now in the process of defining our mission, vision, values, and name going forward. I see us growing and forming small catalyst groups. Whether right now you’re looking for more community support or a more action-oriented role, or both, we can help you find your people. Reach out to us.

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

Dawn Veselka: Thank you so much.

Erin Hurley: Great to be here.