Thursday, July 20, 2017

Great article on STAT on female leadership and health care reform.

Genmedmom here. I simply to call attention to a wonderful article on STAT written by a kick-ass healthcare administrator/ CEO and mother of SIX children (yes, six, and TEN grandchildren, per her profile) Annette Walker. It's titled More female leadership: a different kind of health care reform and it's spot-on.

She points out that "women hold only 26 percent of hospital CEO positions and 21 percent of executive positions at Fortune 500 health care companies even though they make up 78 percent of the health care work force". This despite the fact that "Study after study has demonstrated that organizations with gender-balanced leadership are more successful than their homogenous counterparts."

The best part of this short piece is her emphasis on solutions. What she has accomplished in her own hospital system can surely be adopted in others. She lists:
  • Flexible work arrangements
  • Training opportunities for women to build leadership skills
  • Increased visibility of female role models
  • Connecting junior employees with female senior-level mentors
  • Transparent advancement opportunities and clearly charted pathways to leadership
  • Shining a light on the challenges of balancing family and work needs
  • Support for community programs that promote opportunities for women in our service areas
  • Emphasizing STEM and academic programs for women
I love what she's saying and admire what she's accomplished. I mean, all this and SIX kids, I just can't even imagine. Two kids has almost put me over the edge. Holy cow.

This blog is certainly helping to "shine a light on the challenges of balancing family and work needs" of doctor-moms, so let's acknowledge what MiM brings to the battle! We can also take a look at this list and think of what may be applicable in our own practices, hospitals, and medical schools.

Ladies, let's take some inspiration and motivation from Annette Walker, impressive mama and hospital CEO.

Monday, July 17, 2017

The Devil You Know - A Book Review

I get really annoyed by those people who declare, "I only read non-fiction." And it's ok, if that's you, but don't say it snootily at a party when someone asks you if you've ever read this great fiction book. That's left me speechless and a bit shameful on more than one occasion - the person acts like fiction is non-fiction's red-headed bastard stepchild. And really, if I could go back in time - let's do that right now - I'd tell that person off. Fiction, I'll argue, is way more difficult to pull of than non-fiction. And I'll be damned if you can draw a straight line between the two. Fiction authors often weave autobiography into their own work, but instead of just spitting out what already happened they birth a new child. And that's pretty impressive, in my opinion.

I met Fizzy on Mothers in Medicine years ago when I first started. We became e-mail friends, she supported me through my divorce, I learned a little about her life. She is a very private person. I've met her for dinner once and I still don't know her last name. I respect that, and it comes with mystery and intrigue. We don't e-mail as regularly as we used to, but when she asked for me to read her new book a few months back and let her know what I think I felt like I had received an e-mail from Madonna (that's a nod to the book, by the way). I read it in one afternoon. Well, it bled into the evening a bit.

I read the first book, The Devil Wears Scrubs, years ago. I loved it, and talked about that here. What I loved about that book was how it captured the angst of medical school and training. What I love about this more is it captures the angst of mothering and working as an attending. It is a stand alone book - you don't have to have read the first one, but it was fun for me to reminisce about old characters as they were brought up again throughout the book.

Warning: This book will make you laugh out loud. A lot. Fizzy has always had a great sense of humor and in The Devil You Know she doles it out constantly. There was this one part about glitter - I almost put in a quote but I don't want to ruin it for you - where I was laughing so hard I had to put the book down. She perfectly combines the mayhem of being a doctor and a mother and a spouse - and doing it very imperfectly perfect. If you are taking yourself too seriously this is the book to pick up. I read it again to make this review better and it was a bunch of fun the second time around. One of the best things about it for me was I got a great big glimpse into my very private friend's - one whose blog - A Cartoon Guide to Becoming a Doctor - I've followed for years - life. No one can write a book like this without experience.

I could go on and on about the hilarious patient interactions and bumbling cast of characters at the VA (one of my favorite places on Earth where I trained) but Fizzy herself would stop me - I tend to get long-winded. JUST GO GET THIS BOOK ALREADY: HERE. You won't regret it!!


Side note to Fizzy - who ribbed me years back for never having read a book on a Kindle etc. - I have now read one book on my computer and phone exactly twice - yours.

Tuesday, July 11, 2017

Bridging the Wellness Gap

I have to give a shout out to my hospital (University of Utah*) and my department (Anesthesiology). We are trying. In the age when burnout is rampant and physicians are frequently leaving clinical medicine, we are working to foster camaraderie and resilience. A few examples:

The women in my department recently held an ad hoc Ladies' Lunch. We do this every once in a while, approximately once a year, but we should work on making it more frequent. It's merely a casual potluck lunch held at a faculty member's house for all the female anesthesia residents and attendings, but for me it represents more. Because I work part time in such a large group, I can go weeks to months without seeing some of the other faculty. Anesthesiologists practice their specialty alone, so in order to process work-related issues we have to consciously make an effort to seek out those connections. Our blue scrubs and hats were replaced with sundresses and sandals, and the conversation turned from patients to children, schools, and summer vacation plans. Resident MDs who have yet to venture into practice ate lunch alongside veteran tenured professors. Many of us are moms, with children ranging from 8 weeks to 19 years old. I learned some useful school information from a few of my colleagues with grade school-age girls. It was also interesting to talk to a couple of the ladies who work exclusively in the pain clinic, sharing stories about work environment and frustrations with the medical system. Two babies even made appearances: one wide-eyed, active 11 month old and one brand new infant attached to her mother's breast at the buffet table!

We started an intra-department monthly wellness newsletter (managed by my colleague Dr. Jennifer DeCou), which not only includes interesting personal tidbits about faculty members but also links and info for wellness resources. In addition, Jen has spearheaded a plan for immediate support, in the forms of work relief and counseling, when any anesthesiology practitioner experiences a sentinel event or a bad outcome in the OR.

Our hospital just opened a Resiliency Center on the medical school campus. It provides a space and some resources for relaxation, but the main advantage of this addition is a dedicated space where for on site, free and confidential counseling services. I have personally utilized the services of the third party counseling group on two occasions during my employment already: once when I experienced a health scare during my residency, and again when I underwent infertility treatment. It was invaluable to me, and now it will be even easier for employees to access the benefit since it will be in such close proximity to our workplace.

The piece de resistance... our hospital recently opened a faculty lounge that feels like an airline sky club. Attending physicians from all specialties are invited to use it for eating, changing, working, conferencing, meeting, sleeping... it has all of those features. Not to mention two fully automatic coffee drink dispensers! We have never had a physicians' only lounge before, and I'm excited to socialize there more with doctors of other specialties.

Where we could do better: childcare. As physicians, our schedules are often unpredictable and out of our own control. I live in fear of the midday call from my daycare that my child is sick on a day that my husband is unavailable to extract her, or the moment I get stuck in the OR with no one to pick her up at the end of the day. Some physician friends work at places where there is on sight, low cost childcare with extended hours, which to me would be the ultimate benefit. Within the past year, my hospital has at least added a backup care resource to their benefit package, but my experience using it so far has not been seamless.

Does your hospital, clinic, or practice group offer any unique services or facilities to enhance your work experience and promote wellness? Share them here so we may all get ideas to bring back to our own places of work!



* The opinions expressed here represent my own experiences and are not those of my hospital or department.

Wednesday, July 5, 2017

Refining

So this is my introduction to you! I’m excited to be a regular contributor to Mothers in Medicine. I practice family medicine by day and wrangle my brood of three small children by night. My oldest just finished kindergarten and my youngest just turned one. I’m approaching my ninth year in a busy primary care practice in the Pacific Northwest. I enjoy the privilege and challenge of caring for a variety of patients, from newborns to nonagenarians. I used to practice obstetrics as well, but haven’t since having my own babies. I miss it sometimes.

After finishing residency, I studied tropical medicine in London and have worked at a rural teaching hospital in Kenya. My teacher husband and I dream of living and working abroad with our young family; maybe when the majority of them are out of diapers.

I began writing in earnest after I had my first child in 2011. I did write throughout medical training but it took the refining aspects of motherhood to get me to take my writing seriously. Nothing like even less time and an unveiling of your faults for some forced self-introspection! I’m curious if any of you have found motherhood to be similarly clarifying? I’ve studied narrative medicine and bioethics and have taught narrative medicine workshops. Particular interests include medical ethics, global health, motherhood as vocation and the intersection of religion and science. I blog regularly on these topics, among others, and I’m currently working on my first book. I still always cringe a little when I hit “publish” or “send.” I imagine it will always be hard, as a type A introvert, to put myself out there.

My third, and presumably last, baby just turned one and I finally feel like I can breathe again. It feels like a milestone, reaching this point, after having three children in five years, settling into my primary care practice, letting myself take my passion for writing seriously and expand into that vocation.

My life has been disrupted many times in the past year with unexpected challenges and writing and community have pulled me through. I think much in medicine and in motherhood is refining: the pressures of medical school and residency, the intensity of caring for babies and children who need so much.

I’m excited to join you all in this journey; to learn from your wisdom and laugh alongside you. If medicine and motherhood have taught me one thing, it’s that we all need each other desperately - for kindness, for encouragement, for understanding. These are the things to cling to and to provide for each other in this world. Thanks so much for having me.

Monday, July 3, 2017

Time To Move On



Hi, I’m new here.  And very honored to be here, at that.  I’m a pathologist, in private practice for > 5 years (settling in to the flatter portion at the top of the exponential career curve of knowledge/abject terror), but < 10 years (I suspect, the point on that curve at which cynicism overrides all other basal functions and drives one towards a retirement countdown sticker chart).

I’m in my second post-training big-girl-pants job, and I’ve been here for a little over 8 years.  I briefly tangled with a super-crap job, lasting only six months right out of training, working for a very bad man rocking various personality disorders.....but that will be another story for another day.  This current job is where I became an adult.  And this job is where I damn near had my love for pathology drained of my brain completely.  But it’s time to move on, and I’m doing just that.

Over a period of years, I had somehow found myself struggling to get through the work day, doing twice as much work as is safe to do, getting paid a quarter of the money being made off of my back.  I had become everything to everyone in my office and to the clinicians in the hospital, and nothing to myself professionally. I hated every minute of it.  And my marriage was suffering for the long hours, which I finally figured out after hearing myself in every conversation trying to justify my absences. It just didn't sound authentic to me. Working 60+ hours a week as a pathologist is not particularly normal. But it took a while for me to figure this out -- Stockholm syndrome is real, ya'll. And then, nearly exactly two years ago I had a gorgeous baby girl, induced at 36+1 weeks for oligohydramnios, weighing in at a whopping 4 lbs 15 oz.  And my placenta was just as small as that tiny girl, 5th percentile.  Everything was "fine" until it wasn't.  I've since learned that many of the births to female docs in similar situations to myself are premature for various reasons, commonly for oligo……………can’t help but think there is a link there. 

I’ve worked with some wonderful people over the years while doing this job.  Most of the ones who have stayed for longer than a year are the type that persevere long past the expiration date, and they just keep on going.  Each seems to have his or her own reason for doing so:  'finish what you start', 'I cannot be defeated', 'everyone will like me eventually', 'it’s not really that bad', 'I deserve this pain', 'it is too hard to change'.  What is my reason?  I’ve already made too many mistakes.  This can’t be another one.  I can make this work.  My family is depending on me.

Life is too short to stay in a job that is soul-crushing.  No job is perfect certainly, but no job should harm your psychic core or fizzle your spark.  If you don’t recognize the person that you were, that idealistic nerdling resident, marveling at those exquisite enterocytes mingling with those gorgeous goblet cells, and you can’t find her deep down in there somewhere………..it’s time to make a change. And preferably before that gal has packed up her shit and moved to the outer recesses of the universe, never to be seen or heard from again.  Mistakes will always be made, some big and some small, but they can always be corrected.  Be the change, as they say (whoever they may be).  You always have the power to make things better.  I have become a path beast during my time here, and now I’m doing my best not to become a pathological beast.  Put yourself into the situation that you want to be in, whatever that may be.  It could take awhile, sometimes may even take eight years and some major life changes.  Remove yourself from the people and entities who take everything from you and give nothing back in return.  I’m doing just that in short order.  Even though it’s a move to a more backward state than the one in which I currently reside, but that’s yet another story for another day………

Take care of yourself first, the rest will follow.

Progress and peace to my fellow burnout warriors :0)
TheUnluckyPath