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Medical training hands you a ready-made group of friends. Then it ends, and many women physicians find themselves starting over alone in a new city. Cassie Burton Greenbaum is a pediatric critical care physician and the founder of Off Service Mom Co., a friendship matchmaking service for physician moms. This episode is based on her article “Physician loneliness is driving women out of medicine,” published on KevinMD. You will hear why friendships get harder to build once you are the attending, and how a schedule with no pattern to it pulls you away from everyone who works ordinary hours. She explains how chronic loneliness turns into burnout and lost career satisfaction, and how the shame around the word lonely keeps physicians from ever saying it out loud. She describes the six-week pilot she ran with 20 physician moms and what made the matches work. Press play for the specific moves she recommends, starting with the reason that waiting until you feel less busy never works.
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Transcript
Kevin Pho: Hi and welcome to the show. Subscribe at kevinmd.com/podcast. Today we welcome Cassie Burton Greenbaum. She’s a pediatric critical care physician. Today’s KevinMD article is “Physician loneliness is driving women out of medicine.” Cassie, welcome to the show.
Cassie Burton Greenbaum: Hi, thanks, Kevin, for having me.
Kevin Pho: All right, let’s start by briefly sharing your story and telling us why you decided to share this particular article on KevinMD.
Cassie Burton Greenbaum: Sure. So, like you said, I’m a pediatric critical care physician. I’m based out of Albuquerque, New Mexico. I’ve lived here for six years, and I have wanted to be a physician my whole life. Took the conventional path. Here I am.
And since there’s a lot of moving around and relocating with medical training, I’ve done that three different times across the country, having to rebuild community from scratch each time. And I realized that it’s the hardest when you’re the attending, because you’re no longer in that container of training.
I also have my husband, who’s followed me since medical school, and he’s non-medical, and then we have a four-year-old daughter. And so I had my own experience with loneliness as an attending physician as I’ve gotten into my career, and as a physician mom. And so I went on a journey for myself, but I also wanted to help other women physicians who would be experiencing loneliness, and help build friendship and community.
So based on that, I founded Off Service Mom Co., which is a friendship matchmaking service for physician moms, specifically geared to curate friendships for these women who are too busy. So that’s my background.
Kevin Pho: So you mentioned that the relationships that you form and the people that you meet are much different as an attending versus residency and fellowship. Now, for those who perhaps are outside of the medical training field, just give us some examples of why that may be.
Cassie Burton Greenbaum: Yeah. So in medical school, and then when you go on to residency, and if you do a fellowship training, you are generally with another group of people who are experiencing the same thing that you are. So there’s the shared experience, this proximity, and we talk about trauma bonding based on these experiences. So you have this ready-made friend group, and your proximity, like I said, and the constant interaction with each other. It’s almost hard not to make a friend in those situations.
When you remove those containers and you’re an attending now, you may work with a group of people and be lucky to have some colleagues who become really close friends. But you might be a solo practitioner, or as a woman, you might be the only woman in the group, or the other colleagues in your group might be outside of your life stage. So a lot of the things might not line up, and so it’s harder to cultivate friendships in that situation. And so then you’ve got to go outside of your work and find them, and that margin is very small, I think, especially among physician moms, who are stretched across many different responsibilities.
Kevin Pho: You know, we’ve talked on this podcast about the death of the physician lounge in the hospital. Back when I first started, we would have a thriving physician lounge where physicians could socialize and meet other doctors. But physicians have become more siloed, right? And you mentioned the private practitioner, but there are physicians who never go to the hospital. They just stay in a clinic and never meet their colleagues at a hospital. I can only imagine how difficult it is to meet and form friendships, especially in a new city without any support, without any connections. Now, as an attending, how does this loneliness and this trouble meeting other people affect physicians professionally?
Cassie Burton Greenbaum: Yeah, I think it can impact every aspect of their lives, but it becomes an issue, I think, with yourself, as far as happiness and fulfillment. And I think as the loneliness becomes chronic, you begin to experience symptoms of burnout: the disengagement, the lack of career satisfaction. Then you just don’t enjoy maybe your home life as much, your personal life or your professional life. And so I think it’s really important for us as physicians to focus on continuing to build community and those connections, because it impacts so many different aspects of our lives.
Kevin Pho: So you’re a pediatric critical care physician. Tell us a little bit about your story, because I can only imagine that sometimes your work hours don’t coincide with people who aren’t in the medical field. I’m going to assume you work a lot of nights, you work weekends as a pediatric critical care physician. How did loneliness affect you? Tell us a little bit about your own story.
Cassie Burton Greenbaum: Yeah, I think that’s actually a big issue, the schedule. I don’t work a nine to five. I don’t work five days a week. And there are some weeks where I have four or five days off, but then the next week I turn around and I’m on for four days, and then I work a night. And in the job that I’m in now, my schedule is even more irregular. There is absolutely no pattern or regularity to it at all. So in a given month, I can work 13 day shifts and then one to four night shifts. And then of course weekends, it’s like, what is a weekend? It’s just a regular day for me. And then throw in holidays; those don’t exist either for us.
It’s hard to align that sort of schedule with people who have after-work hours. After five, they can socialize, or they’ve got their weekends, where they can distribute their time with their family and then have some margin for community and friendships. And I just don’t have that regularity.
Kevin Pho: So what was the breaking point for you? Because obviously you founded Off Service Mom Co., and you’re already very busy, not only with your job, but a young family and whatnot. What made you take that next step and say, “I’m going to do something about this”?
Cassie Burton Greenbaum: Yeah. So I think this chronic loneliness got to a point where it was impacting my marriage, and my husband was also dealing with a chronic health condition. So we had that layer, plus my own loneliness, plus a four-year-old, without any family support around us. So it just compounded and got to a point where I realized that that feeling was loneliness. And once I admitted it out loud to myself, it’s like getting a diagnosis. You can now pursue that treatment.
And so even though I felt like I had been trying to find friends and build community, I don’t think I was doing it as intentionally as I had hoped. So I made that my mission for myself, and realized I could bring that to other women physicians and physician moms. And so that’s how the idea for Off Service Mom Co. came about: Why don’t I serve as a matchmaker and see if I can make it easier and lower effort for women physicians to make and build friendships?
Kevin Pho: Now, you talk to a lot of physicians who may be in similar situations. Typically, what options are available to them, and how feasible is it to maybe move to an area where they would have more support? What do they do? What kind of options do they have?
Cassie Burton Greenbaum: Well, I think it probably depends on your life stage. So if we’re just going to talk about a mid-career female physician, a physician mom, their opportunities are different than your single women, who I think can have a little bit more flexibility with their time. But as a mom, you do have a lot of opportunities as far as mom groups, or women physician or physician mom Facebook groups. Then depending on how big your city is, I’m sure there are a lot more opportunities in the bigger environments than in the more rural areas.
But I think the issue that I found sometimes is that I wanted someone who understood my life, right? The struggles as a female physician, and specifically as a mom. And it’s hard to find that in the stay-at-home mom group, right? And oftentimes their schedules are definitely not aligned with mine. So when you’re trying to cultivate friendships among other physician moms, trying to align your schedules is almost impossible as well.
And so I think if you’re not, I guess, lucky enough to maybe live in a close neighborhood, or you’ve got a good group at your hospital or clinic or wherever you work that’s built in for you, and you’re having to go out there instead and make these friends, then you have to actually put the effort in. You make the conscious decision that “I am going to choose to not have dinner with my family tonight, but instead go to this meetup and dinner with other women physicians, so that I can start to build community and connections.”
And I think that’s hard for us, hard for us to take that time for ourselves, and our time, our energy capacity, is already low. And so when it comes to that moment where you want to leave the house, it’s easier to say, “Well, I’ll do it next time.” And then the next time and the next time goes on and on, and then it turns out six years later you didn’t do anything. So I think the effort is the key: You have to be willing to put it in and to be inconvenienced to make these friends.
Kevin Pho: How difficult was it for you to admit that loneliness was an issue? And in talking to your other female physician colleagues in general, how difficult is it for them to admit that they were lonely in some cases?
Cassie Burton Greenbaum: It varies, right? I think loneliness is associated with a sense of shame and embarrassment. And in fact, I don’t think I’ve ever had anyone come up to me in a conversation and be like, “Hey, I’m feeling kind of lonely. You want to hang out?” And that’s just not how I think we talk to each other, especially as physicians, right? We are independent, self-sufficient, competent. We don’t have any weaknesses. We don’t show vulnerability. We have our professional armor. So while that makes us a good physician, it makes it harder to be a human, a good friend.
And so it’s easier to use the excuse of, “Oh, I’m just busy. I’m too busy. I’m tired. I have all of these other responsibilities. This is my season of life. I’ll wait.” And you can wait indefinitely, because we all know it’s not going to get less busy.
And again, it’s having to make that conscious mindset shift of, “Hey, I’m actually lonely. I’m missing something,” whether it’s just that sense of belonging and community, or it’s actually that deep connection with someone who sees and understands you. And admitting that to yourself, and then making the effort to reach out, to be a little bit more vulnerable, to let people see you. And that’s hard. I think it’s really hard as a physician.
Kevin Pho: As you mentioned before, you are the founder of Off Service Mom Co. So give us an example of how your service works, and maybe tell a story of how someone who used your service found it made an appreciable difference in her life.
Cassie Burton Greenbaum: So I’m still early on. I ran a pilot for six weeks earlier in the summer with 20 women and matched each of those in pairs. And then currently I’m running my second cohort with a much smaller group. But I was still surprised when I got the intake forms at how many women were reflecting what I was feeling, validating for me that what I was assuming was a shared experience is.
And after the follow-up at the end of the pilot, of the ones that completed the survey, I think it was about 60 percent of them who said that they actually did find this connection beneficial. The biggest factor that helped that connection was life stage. Their kids were a similar age, maybe the women were similar in age, and so they really connected on that level. And this connection is a gift, right? They can continue to connect with each other.
And most of the women were not in the same location, so a lot of this was taking place over text or phone. And so just to know that I helped a few pairs of women connect with someone they wouldn’t have otherwise met was enough to give me more motivation to continue this and move forward.
Kevin Pho: Now, were all these women physicians?
Cassie Burton Greenbaum: They were all physician moms.
Kevin Pho: And do you find that there are potentially similarities between physicians and other professions, adjacent to what females are going through in medicine?
Cassie Burton Greenbaum: Absolutely. And I initially had that broad audience I wanted to address, but decided, with my own personal experience, this might speak more to the physician moms. But definitely, I think women in any profession, law, tech, tech is probably a really big one where there’s a lot of male dominance, and any of those professional fields, and working moms in general, I think are all going through something similar.
Kevin Pho: Now, for those women physicians who may be listening to you here and may not have access to your service, just give us some pieces of advice that you can share with them if they are having some of those similar feelings that you had.
Cassie Burton Greenbaum: I think the biggest thing is to stop waiting to feel less busy, and just make that mindset shift. If you truly desire these friendships, which I think we all do, that’s not the problem. It’s the ability to sustain it. So you have to be willing to be inconvenienced. I think that is also a key, and to put yourself in situations where you can meet other women, and to be open.
I think that’s another thing I learned: Just having physician mom friends, while great, can also be narrow. So I think having a lot of shared experience with other women is important. So try to find, rediscover your hobbies. What do you enjoy doing? Put yourself in those classes where you actually talk to each other, not the yoga class where everyone is quiet. Reach out to maybe a new colleague, someone else who just joined your practice or your clinic or the hospital, and set up a coffee date. And stop saying, “We should get together sometime.” Make it a concrete date and time, because no one’s going to make that plan for you.
Kevin Pho: We’re talking to Cassie Burton Greenbaum. She’s a pediatric critical care physician. Today’s KevinMD article is “Physician loneliness is driving women out of medicine.” Cassie, let’s end with your take-home messages to the KevinMD audience.
Cassie Burton Greenbaum: Yes. So ultimately, medicine is losing its women physicians, and it’s not because we’re not strong enough, resilient enough or grateful enough. It’s because we’re exhausted. We feel isolated, and no one built that infrastructure to keep us connected. And remember that friendship is not just a luxury. It’s the difference between surviving your life and actually thriving within it.
Kevin Pho: Cassie, thank you so much for sharing your story, time and insight, and thanks again for coming on the show.
Cassie Burton Greenbaum: Thank you.
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