Dr. Errin Weisman is a family physician in rural, southwest Indiana, and a life coach, speaker, blogger, and a podcaster. We talk about three ideas she wishes she could teach her younger self and each has its own actionable step to help us all live more fulfilling lives. We also flipped the script on an old formula. On previous episodes, we’ve had specialists discuss what they think all physicians should know about the specialty, but this time, she told us what she wants all specialists to know about being a rural family medicine physician.
Dr. Weisman faced professional burnout early in her career and speaks openly about her story in order to help others, particularly female physicians and working moms, know they are not alone. She wholeheartedly believes that to be a healer, you must first fill your own cup. She is also a farmer’s wife, athlete and mother of three. You can find out more about Dr. Weisman on her podcast “Doctor Me First,” her website truthrxs.com or hang out with her on social media @truthrxs.
This and all episodes have been expertly produced by voice-over artist @caringilfry at GilfryStudios.com
Find this and all episodes on your favorite podcast platform at PhysiciansGuidetoDoctoring.com
#truthrxs #burnout #moralinjury #qualityoflife #familymedicine #somedocs #podcast #medtwitter #healthcare #medical #medicine #physician #doctor
Disclaimer: This is the transcript to the episode. This transcript was created by a talk to text application and the function of having this here is to improve the page search engine optimization. This transcript has not been proofread, so please listen to the episode and don’t read this. The information contained herein will inevitably contain inaccuracies that affect that quality of the information conveyed and the creator of this content will not be held liable for consequences of the use of the information herein.
Unknown Speaker 0:00
Dr. Aaron Wiseman is a family physician in rural Southwest Indiana, and a physician coach, speaker, blogger and a podcaster. We talk about three ideas she wishes she could teach her younger self, and each has its own actionable step to help us all live more fulfilling lives. We also flip the script on an old formula here at the podcast. on previous episodes, we’ve had specialists discuss what they think all physician should know about their specialty, but this time, she’s told us what she wants all specialists to know about being a rural family medicine physician.
Unknown Speaker 0:33
Welcome to the physicians guide to doctoring A Practical Guide for practicing physicians, Dr. Bradley Block interviews experts in and out of medicine to find out everything we should have been learning while we were memorizing Krebs cycle. The ideas expressed on this podcast are those of the interviewer and interviewee and do not represent those of their respective employers. Those on this podcast except no liability for the outcomes of the medical decisions based on this information as the radiologist like to say clinical correlation is required. This is not medical advice. And this does not constitute a physician patient relationship. If you have a medical problem, seek medical attention. And now here’s Dr. Bradley Block.
Unknown Speaker 1:15
Welcome back to the physicians guide to doctoring. On today’s episode, we have family physician and life coach Aaron Wiseman. She’s a family medicine physician in rural Indiana. And she also hosts her own podcast, helps physicians as a life coach and has an active blog at truth RX is calm, truth prescriptions, but the abbreviation our exes.com. So, Dr. Aaron, thank you so much for being on the show today.
Unknown Speaker 1:45
Absolutely. It’s my pleasure to join you.
Unknown Speaker 1:48
So first, just tell us a little bit about your training where you went to medical school and did residency and what you’re up to now.
Unknown Speaker 1:55
Yeah, so I am a do from Kansas City University out in Kansas City, Missouri. I’m originally from Southern Indiana. And when I was looking around at medical schools, I have to say we are a boilermaker Purdue University faithful so I my family, not that they were against IU School of Medicine, but they were like maybe you can look at some other things because that rivalry runs deep here in Indiana. And so I went out to Kansas City, I love the osteopathic mindset. And so it was one of the first places I interviewed and that’s where I decided to stay. After finishing medical school, I went to deaconess family medicine residency in Evansville, Indiana, kind of down in the toe of Indiana and got my training there and didn’t do any kind of fellowship or specialty afterwards, just got busy and jumped into practice.
Unknown Speaker 2:48
So where is it you’re practicing now?
Unknown Speaker 2:50
Well, it has been a journey my friend, let me tell you so a few weeks after I got out of residency, I realized things were not good. hindsight is always 2020 I was probably already burned out in residency, and having only taken Labor Day weekend off and start into my new practice. I was really pedal to the metal. I got out into practice, and it wasn’t different than residency is actually harder. And that’s when I started looking around and being like what I want to do with the rest of my life, because at that point in that place, I knew I couldn’t do that for the next 30 some odd years of my career. So I ended up practicing in the office for about three years and then transitioned away from traditional outpatient family medicine. I had a real nasty non compete that I had to get away from so for about 1215 months, I practiced emergency medicine here in rural Indiana. And right now clinically, I’m doing a lot of fun stuff with telehealth and telemedicine.
Unknown Speaker 3:46
Well, that must give you a whole lot more freedom.
Unknown Speaker 3:48
Absolutely. It does. And it’s fine. I’ll be honest, I am definitely a millennial and I love what we are doing with technology right now and marrying that with the clinical skills of healthcare
Unknown Speaker 4:00
So, one of the things that I think is very helpful for for burnout is having a creative outlet. So one of your creative outlets is is your podcast. So tell us a little about your podcast.
Unknown Speaker 4:12
Yeah, absolutely. So it was around the turn of the year 2018. I had a business coach at that time and she had a really amazing podcast I’d really got into podcasting with all the foam the free open education that emergency medicine was doing, you know, having jumped into that really want home.
Unknown Speaker 4:33
I’ve actually seen that hashtag quite a bit and yeah, know what’s what’s foam. Aside from this thing that pretentious restaurants will put on your food?
Unknown Speaker 4:43
Yeah, free open access information. So I think the M is medicine or anything, but it’s pretty much everything that’s been locked down before we either had to like join an association or like be a part of particular hospital. Now the thought process is we need to disseminate this information faster. And we need to make it more available to the masses. And actually, emergency medicine is one of the fields that has really taken to this. There’s a lot of great podcasts out there right now, bringing up to date, journal information, new techniques from different hospitals on a variety of topics. And so, family medicine is starting to get a little bit into it. There’s a few podcasts that are popping up. But essentially, the thought processes behind it is if we’re doing something great, or we learned something great. We need to share this with our colleagues and an unencumbered way, you know, not through a journal that you’re not going to have time to read, not through a members only access online, but actually making it available through a podcast.
Unknown Speaker 5:53
I love it. That’s, I think what we’re both trying to do here, so So what’s your podcast? What’s it called and what do you talk about?
Unknown Speaker 6:00
Sure my podcast is called Dr. Me first. And it’s all about authentic conversations between female physicians. I am the only female doctor in my county here in Southern Indiana. And I was really lonely. And you know, that’s another thing that goes along with burnout is isolation. And so kind of in my own selfish way, I was like, You know what, I’m gonna start talking to other female colleagues, and I’m going to start recording them. And when I did, there were just some amazing conversations that happened. Recording wise, I’m up to like episode number 50. I’ve launched about 25 of those. But we talk about everything life and medicine and practice and motherhood and being a woman in medicine, and just really putting that dialogue out into the world. I recently had a comment on my Apple iTunes where it was a non physician, but she had commented that was so great to hear that doctors have problems too. So I mean, it’s particularly for physicians, but I’m loving That non clinical people are listening to it too, because the things that we struggle with, perhaps they’re a little bit more magnified, but everybody else is struggling with it you.
Unknown Speaker 7:11
We’re not as special as we think we are.
Unknown Speaker 7:12
No, no. Sometimes we’re a little bit more pathologic than what we think we are.
Unknown Speaker 7:19
What Why do you call it Dr. Me first?
Unknown Speaker 7:22
Well, it goes back to
Unknown Speaker 7:25
Unknown Speaker 7:26
2017, I really sat down and I wanted to write a book. I wanted to write the book that I needed when I was in the middle of burnout, that would have helped me. And so in 2015, I started doing life coaches training, and some of it jives with my clinical science type a brain and some of it didn’t. So what I did is I sat down and I wrote a workbook taking those things that I learned and life coaching training and marrying it with my science brain, and the project was named Dr. Me first so it is a special self guided workbook. For anyone who knows that there’s more to life. We just don’t know where that is. Or for that person who’s just feeling super crispy and just totally in the middle of burnout, you know, no empathy for patients depersonalization, not even knowing what they’re calling is, it’s something they can pick up, put pen to paper and work through it. And my hopes at the end as you come out a better person and a better doctor. Wow.
Unknown Speaker 8:29
Yeah, so from that I just kept the theme and I thought well, might as well name this doctor me first too.
Unknown Speaker 8:34
And I think it’s important, right? We all make that analogy, or rather, I’ve heard this analogy before to to affixing your oxygen mask on before you help someone else right in the airplane. That’s because it loses pressure so quickly that if you don’t get it on really fast, you know you’ll I think it’s from like the partial pressure of oxygen it’ll it’ll leave your bloodstream and you fall unconscious. You don’t happen if it doesn’t happen fast enough. So if you don’t get the mask on fast enough, so You always have to put your own mask on first before because you’re not you’re not as effective. A physician, caretaker family member, community member, if you don’t look out for yourself.
Unknown Speaker 9:09
Yeah, I definitely look at it this way. I mean, 95% of us the stats, say went into medicine because we wanted to help and care for other people. So we really are very percent say, I think it’s money and personally.
Unknown Speaker 9:23
Those are the honest ones.
Unknown Speaker 9:24
Hey, maybe. But so I would say majority of us went into it for good reasons.
Unknown Speaker 9:30
And so at times, I feel like that kind of gets used against us when we’re in training. And then by the time we come out, we’re super self sacrificing. Like we will take care of other people, whatever the cost it is to us. So I really emphasize people that it really is about filling your own cup and your healing art should come from the overflow rather than you turning your cup over and shaking every last drop out of it. So yeah, I the oxygen mask has been used. I like the cup analogy. I love the one that Dr. Dre, Dr. Almond uses to with the canary in the coal mine about how we all need to put our own gas mask on and in the environment of, you know, toxicity that we work in at times. So yeah, any of those I think are great analogy.
Unknown Speaker 10:18
So before the show we had talked about
Unknown Speaker 10:23
and I think some of these probably come from your your workbook as well. Three lessons that you wish you had before you went through your your recovery, burnout, and recovery, three life lessons, and then three action steps that you recommend people take, whether it’s a physician that you’re coaching, or really anyone else, simple action steps that they can take in order to address that lesson that you learned. So the first one you mentioned was life is a journey. There’s no arriving. So what do you mean by that and what The action step that you take in order to, to manage that.
Unknown Speaker 11:04
Well, I think for me, this goes all the way back to getting into medical school, that it was like, Okay, I get into school and and then it’s going to, you know, it’s going to get better then we’ll get through first year and then second year and then third year. And like it was like always pushing towards that, like next mile marker. And then like when I got through all those years and got out my training, like that’s when I was going to like, summit the top of that mountain after climbing and climbing and climbing up. But little did I know that that was just one mountain in the pathway of the journey of my life. And so I think I put so much expectation on finishing, finishing, finishing pushing through hammering through that. I didn’t enjoy the steps along the way at all. I mean, I barely remember the first year of my first child’s life. I was an intern at the time. You know, not that my program was malignant. It was just, it was it was rough. It was rough being a new intern, being a mother, just figuring it all out. And I look back at baby pictures. Now I’m like, I don’t even recall that I only remember that holiday and a lot of the pictures, I wasn’t even there. And so I just tell people, you know that making sure when you’re walking your path that you’re actually like looking around and engaging instead of getting to the point like I did when I summited the top of the mountain and I was like, Holy hell, I’ve climbed the wrong mountain. I really thought after I got a residency that I had made a huge mistake. By going into medicine, I was ready to hang up the white coat, throw the stuff stethoscope in the trash can and like go find something else. Because I was I had just turned 30 at the time and I was like, I, I can do something else I can change. But I think it’s that delayed gratification that we’re really really good at as physicians that we really need to pump the brakes on as well. So my action step with that is life is happening now. And for a few minutes, we gotta stop thinking about the delayed gratification and do something that brings richness into our life today, not waiting for when the rotations over not waiting for the next time we go on vacation. But we we need to know how we can more fully experience life today. Because we all see that death is around us illnesses around us. And we’re not going to evade it either.
Unknown Speaker 13:34
If I if I may make a suggestion to supplement that. If you’re looking for something specific within that action step, you know, human connection is is so hugely important. And sometimes in medicine, even though we’re seeing patients all the time. We’re not really, you know, there were there to help them. You know, they’re not we’re not really talking about ourselves or Connecting about ourselves. So in terms of the delayed gratification and doing something now, for that for a couple minutes a day, reach out to someone that you haven’t spoken to in a while, just send an email to someone that maybe you haven’t spoken to a year or two or three and just tell them how you’re doing and ask them how how they’re doing. And even something as simple in that can add some richness that some of that richness that you’re talking about and some of that depth to your life.
Unknown Speaker 14:31
Yeah, are absolutely like one thing that I had a client she decided to do to bring the riches into her life. She brought like really expensive coffee, like the stuff that’s you like, you don’t want to spill it’s so expensive. And each morning, she would make her really expensive coffee and sit with it, smell it, drink it just take five minutes to really like taste this coffee and and and just be with it. She felt like that was a really centering, a really great experience for her to say, you know, I’m sitting in my home, that, you know, I’ve worked really hard for in my kitchen that I love drinking this really expensive coffee.
Unknown Speaker 15:15
And that also gets back to gratitude. Because if it’s that level of conscientiousness, when you’re drinking the coffee, you’re enjoying the coffee, you’re grateful for the cup, you’re appreciating the coffee. So that’s, that’s another thing that can kind of tie into this action stuff.
Unknown Speaker 15:31
And there’s a huge lot, a lot of work about gratitude. But you know, the sad thing is, a lot of times when people get to me as a life and burnout coach, they can’t even they can’t even comprehend gratitude, because they’ve just been so hammered down. Just almost like I said, just beat down to the ground. That that’s one of the first things that I work with people about is like, finding something in the midst of the stuff of the suck. That they can they can be gracious for.
Unknown Speaker 16:03
And I have a personal story about the delay gratification as well. My 28th birthday, I think I was a second year end resident, and one of my co residents husband’s was there. And he said, Man, he was a year older than us. Man 20 it was a great year, it’s a shame, you’re gonna miss it. Because we just spend so much time in the hospital. And then our free time is spent studying, preparing a presentation, right? We give up that, that that life. And so that might have been the time that I realized that you know what, I have to have two years left in my 20s I have to find time to be able to enjoy it and not just write another paper and do more research and you know, all the rest of the pressure that we put on ourselves. So the next thing that you mentioned was You are not alone.
Unknown Speaker 16:55
What did you mean by that?
Unknown Speaker 16:57
Well, going back to that isolationism
Unknown Speaker 17:02
So many times, I know that when I talk with other physicians, even in a crowded room, they feel like nobody understands. Nobody’s kind of knows their journey. And also because as a physician leader, it’s not like we can relay those struggles to those that we work with, and definitely not unloading those on our patients. And so that’s a huge one, that when I work with people, I think that’s one of the main reasons they reach out to a coach because they don’t want to be alone anymore. They want to have somebody to tell their story and to understand them again. And it’s one of those things too, that we know with suicide research, that when a person becomes totally isolated and hopeless, that’s the moment at which suicide seems like a really good idea. And as physicians, we don’t get second chances on suicide. Typically, a first attempt of a physician is usually always fatal. So that’s where I, I really want to reach out to people who are maybe in that hopeless state, or who are feeling very isolated and just tell them that they’re not alone. And that, you know, they, we all want to be perceived as competent and strong and capable. But it really, it can lead to some huge amount of isolationism. You know, the, for instance, that I shared with you when we were talking beforehand, is what I felt like was lip service that was given to us in residency, like we were told if we needed help, and that there were services, but in my experience was the same attending would then criticize a resident or student who did seek that help or who maybe came to them and said, Hey, I’m really struggling. And I felt like that was a huge double standard that can no longer be tolerated and that we shouldn’t tolerate and that’s why I think it’s great having other physician calls Who are life coaches, because we can be a totally unbiased, unattached resource for physicians and trainees who feel stuck in their situation. And that’s one, for instance, why I formed my own business. I didn’t want to be part of a hospital group. I consult with groups now. But I wanted to kind of have that autonomy of my own. So people can feel safe to unload their burdens when they do feel so isolated and alone. And so my action step for that was reach out to one person who is safe to you, and have an open, open and honest conversation about how you’re really doing not about you know, how when you put the smile on the white coat on and you walk into the room, like take all that off, and be like, really, how are you doing?
Unknown Speaker 19:51
Unknown Speaker 19:54
yeah, I even though we’re surrounded by our colleagues, we can Very often feel feel isolated. And you know, you know being vulnerable. I think it’s Bernie Brown, who gave the TED talk and does the social psychologist that talks about the benefit of being vulnerable. So yeah, I think there’s there’s a lot to allowing yourself to be vulnerable and how it’s actually a show of strength. Yeah, it’s not, it’s not weakness and strength. One
Unknown Speaker 20:24
thing that I’ve started doing around this because you know, we’re all busy, and we don’t want to go to yet another meeting or anything like that is I’ve started having like, online groups that meet via zoom. That’s the the online meeting that I use, and it does, it provides a safe space, it’s only physicians. And the two questions that you have to answer every meeting is what has been your greatest victories since the last time we talked, and what has been your low point. And so that helps like open up that dialogue. One, because then you can kind of show your wounds to people. But then also you can be a witness to those wounds, and it helps with your own healing. Because here’s the thing most doctors walking around today are wounded warriors. I mean, think about that patient who still comes into your mind and dreams from years ago that you haven’t told anybody about. But you know, it still bothers you. So this is the way that I’ve really helped. My colleagues have that safe space have that place to be vulnerable, and it’s coaching involved, but sometimes I turned into a little bit of a support group. here locally, I have got one live group going and Vincent and Deanna that call women in medicine and it’s along the same lines, it builds community, but then it gives a place to be open. And because when we carry so many burdens around, at some point, you’ve got to unload them or they’re going to crush you. So I think it’s just with the amount that everyone is carrying these days, we’ve got to start relying on each other groups and hospital systems have got to see that they’ve got to provide the safe space for physicians, because otherwise we’re all just going to break under the load, or we’re just going to drop it and be like, wow, and leave.
Unknown Speaker 22:20
Yeah, excellent, powerful points. The last thing that that I think that really dovetails well into what you were just saying, is it’s important to listen to yourself. So if you’re having some inner turmoil, right, it’s important to recognize that that’s there. So, when you’re gonna, you’re gonna have an open and honest conversation with someone. I think first you need to listen to yourself. So is that is that what you meant? Well,
Unknown Speaker 22:48
I think so. Yeah, you do have to first. I mean, that’s one thing that we are, we have gotten so good about not doing is self awareness. I do a talk residents and I like so tell me what your body feels like when you need to pee. And you know, a lot of people will be like, Oh, you know, like, I get super crew blood pressure and like that and I’m like, No, really, like tune into that. What does it feel like when you need to pee? And then I’m like, Okay, everybody go take a break, because I know you all need to pee right now. And then come back and tell me what it feels like after you’ve emptied your bladder. Because for so long we have denied ourselves that we we don’t even have self awareness when it comes to our own body urges, let alone our feelings and emotions. It’s a huge one. You know, so many times we’re like, oh, we’re grouchy cuz we’re tired or Oh, we’re angry that but really when you start looking at it and kind of getting a little bit deeper doing that in your head kind of work that nobody really wants to do. You’re like, oh, maybe I’m angry because x y&z maybe something else is going on? Maybe I’m having like some perpetual thoughts. So really learning exactly to like, Listen to yourself. That like squirmy feeling that you have inside of you when something is just not right. Or somebody said something and you’re like, I just doesn’t feel good. I don’t know about you, but so many times, I would just be like, illogical push it to the side. But now I’m starting to learn. I’m like, No, that’s a body cue, like, I need to tune into that what is this telling me? It could be something good, bad, neutral, whatever it is, at least pick up on the cues now. And and like I said, that’s been that’s been intriguing as I’ve been working with physicians, you know, we think we know the body really well. And we know other people’s bodies pretty well. We have no clue on our own. So then, I think that leads further into burnout because then when we can’t even pick up on our own cues, be it thought cues or body cues. We just spiral downward until we like get to the bottom of the pit and then we feel so stuck and desperate and alone and isolated and broken. We don’t even know where to start. Because we don’t even know how to sit with our feelings and our thoughts to kind of Wade all through that. So that’s why I encourage people to like, stop and start examining that. I mean, how many of us can sit with ourself in silence? I know it took me a long time and I still struggle with that. Like, it’s always like, you’ve got to be busy, you got to be doing something. For me, it’s because I always feel like my worth was always kind of based on what I’m doing, what I had accomplished, what I’ve got going on, which, you know, paper, am I working on presentation and we pay patients on my scene, what am I going to do tomorrow, when in fact, we need to take that time to be like, what’s going on with me? You know, a lot of people there’s a lot of like mindset work or mindfulness going on, you know, meditation, yoga, it doesn’t matter, whatever term you want to call it. But pretty much all those are about centering back into yourself, and really getting real with who you are and the body that you live in.
Unknown Speaker 26:00
So is there a specific way that you recommend I you just said, whether it’s meditation or yoga, but there’s meditation, there’s journaling, go for a walk, is there a
Unknown Speaker 26:13
Unknown Speaker 26:15
Unknown Speaker 26:16
coloring is one. There’s like listening to like ambient music. There’s, there’s so there’s many different ways as there are people. And so there’s no right answer to that. Is there a frequency?
Unknown Speaker 26:33
Like, like five minutes a day, five minutes every other day? 10 minutes, you know, is there is there some some type of structure that you think is is necessary to have, let’s say a minimum effective dose?
Unknown Speaker 26:49
We all want that. Don’t wait because we’re the number
Unknown Speaker 26:50
Unknown Speaker 26:52
Okay, we’re good for the day. We
Unknown Speaker 26:54
got my five and a half minutes.
Unknown Speaker 26:57
The life coaching me says no, the Because one day, you may need five minutes and the next day you need to may need to do five minute boluses every hour. So it really comes down to who you are and what really helps you. So like me personally, I I struggle with meditation. I’ve tried it, I’ve done the podcast, you know, I’ve got that like headspace app, like I really tried it. But for me, really tuning into my body and really listening. I need movement, I need motion with it, I need to be like burn off that like top 10% of energy. So that then I can like really get focused in on what’s going on. So I’m an outdoors person. So I do a lot of trail hiking and trail running. And that’s my, like, checking in with myself time. Like I said, other people have other things that they do. So I think you have to know first, who you are and what your personality type is. When you’re thinking About activities and thinking about things, when you almost get like lost in the flow of it. I mean, journaling, that’s a really good one for some people that that helps them kind of check back in. When they’re doing that, like free thought on paper. There’s a lot of research to about journaling, like connecting thoughts brain and actually writing it down the tactical side, we can get into that later. But I don’t think there’s a perfect recipe for this. And I think you’re always perpetually figuring out and then tweaking and figuring something out and then tweaking
Unknown Speaker 28:35
around, I need my assignment. I need my very specific time period and tasks so I can take it off my list
Unknown Speaker 28:42
Unknown Speaker 28:46
Because you know, here’s the thing too, when I work with our colleagues, they want the solution. You know, they want the piece of paper that they do XYZ, so many minutes a day for so many weeks, and they will get it done and then they will be healthy. I’m like, it doesn’t work like that. I’m sorry. And if anybody is selling that to you and calling themself a coach, you need to turn around and go the other way. Because that is not how it works. I have people who are like, Well, how do I sign up and work with you? And I’m like, Well, you know, I have a lot of different options. Because for everybody, it’s a little bit different. Some people come to me, and they’re all gung ho, and they’re ready to go. And then I start asking the hard questions, and they’re like back off, because either they need some more time to think about it, or they’re just not ready. And so like I said, there’s no like, if you do this, you will be fixed, because you first have to realize you’re not broken. There’s just things that are off that need to be set back online.
Unknown Speaker 29:44
So just to circle back around the three points that you made. One, life is a journey, there’s no arriving. So wherever you are with your training, or you’re in the thick of residency, or your new attending, you have to record dies, that there’s always going to be that next step. So make sure you’re doing something to enjoy your life. Now, make it more enjoyable, make it more fulfilling. Number recommend recommendation was number two was, you’re not alone. So be sure to reach out to someone on a regular basis to have an open and honest conversation about what’s really going on in your life because your patients are going to be constantly bombarding you with their issues. This is what we do. But you need to be able to have an open and honest conversation with with someone else. And then the last one is you need to have an open and honest conversation with yourself. So you have to schedule in some alone, quiet, uninterrupted time, whether it’s some type of physical activity or journaling or meditation, where there’s no distraction from your thoughts, and you’re really stuck with them so you can reflect on on how you’re feeling and how you’re doing
Unknown Speaker 31:00
Unknown Speaker 31:01
So there is one more thing that I wanted to talk to you about because you’re you’re a family medicine physician and, and we’ve had orthopedic surgeons and ophthalmologists, and I’m an otolaryngologist, we had an anesthesiologist, and every, every one of them wanted to talk about what they think every physician should know about their specialty. So as a family medicine physician, you’re a generalist, right? You’re responsible for everything. So what is it that you would like us specialists to know about a family medicine physician either? what it is that you you struggle with when you’re seeing your patients, or what it is that you feel is the strength of the specialty? what it’s like being anything that you think it would benefit us to know about what it is about something about family medicine?
Unknown Speaker 31:54
Sure. So I can only talk from my own perspective when it comes to family medicine and family Medicine is so diverse, and what people choose to do within their practice. What they don’t do within their practice. So like I said, I’m going to come from the perspective of me. But I think the first thing I would want a specialist to know as a family medicine doctor is there is so much psychosocial that we take care of, and that we know about in our patient in their lives, in their family, those nuances that don’t always make it in to the the EMR, that maybe we did something a little bit quirky, with a medicine or the referral or something like that. But But I know for myself, there’s usually a rhyme or reason.
Unknown Speaker 32:49
And it usually comes off the psycho social on what’s going on with them, for instance, like
Unknown Speaker 32:55
so I’m in the rural part of the state. We don’t even have Uber here that which is totally Sad but transportation is. And so there’s been times that I have had taken care of family members who needed to go to like a similar specialist. And though one is probably sicker than the other, like, I’ve had to request my nurse or even myself call this specialist and be like, I have to have you see both of them because they’re coming in the same, you know, Van together, you know, their their pastor from their churches driving them down, you know, and, and so I think that’s the biggest one and I think the other thing too, coming from the family medicines perspective is that we are a generalist, we we do have to take care. I mean, I took care of cradle to grave and still do and so we know a lot, but not evidently a lot about your specialty. And I know sometimes with some of my friends who are some specialist, you know, they get frustrated with some of the referrals that they get. But sometimes you’ve tried a lot and you just don’t know where else to go. And I think that goes back to maybe as a system we need to get better at colleague colleague calls and just bouncing things off. I’m so I’m, I’m really excited. I always try to get him on the phone when I have the time and also the mental energy to get a hold of a colleague, but it’s like chasing cats sometimes for us to get together, but having those conversations to do what’s best for our patients. I mean, there’s so much pressure right now with formulary changes with what insurances are doing, that the management at the primary care level of these patients is, it’s insane. It’s absolutely insane. And so many times it’s like, if a specialist orders and medicine or particular test and they can get ahold of or Something’s going on. A lot of time that gets kicked back to me. Like I’m the pitch runner that just got thrown into the game. And I got to figure it out. I’m one of those stories I can think of when I first got over residency is being the new doctor in town of course, I was like picking up all the new patients. And I was working at our I had started working at the local one of the local nursing homes, and it was a real young gal. She was like 43 got admitted to the nursing home in stage. CHF. Little did I know that she was like on a 24 hour like infusion with all of these cardiac meds like they were sending her to the nursing home for hospice because they thought that she was just going to die. And so now I’m back to like the inpatient rounds. Taking care of these like, super toxic meds were like drawing troughs every couple hours from the nursing home and in like, also having the hospice talk with this family and like preparing them for what that looks like. And lo and behold, like she started Getting better. And so it was like one of those that just the juggling of that is, oh, it’s astronomical sometimes. And here I’m sitting, like an hour away from any major hospital if something should happen, or, you know, I’m calling up my good buddies from medical school and trying to get the best information that I can from them getting stressed out, just thinking about
Unknown Speaker 36:22
Unknown Speaker 36:22
Ah, it’s amazing. So I, you know, there’s times where I’m at that, you know, people just walk into the office and they’re like, hey, I need to see the doctor and we’re not walking clinic or we weren’t a walking clinic, I should say, since I’m not there anymore. But we had one guy, he came in, he had cut his hand in his workshop, he was retired, and he opens up his towel that he brought in, and I mean, I’m clearly looking at all the tendons in the palm of his.
Unknown Speaker 36:54
And I’m like, a now this is bigger, and I had to literally
Unknown Speaker 37:00
It’s so terrible but I so I know our local Ms. So I get on the phone. I’m like Chris, you got to come to the office. I got a guy here. He’s going to try to drive himself to the hospital. I was like, he’s got a really significant hand laceration. And like, I made him get in the ambulance to go because otherwise he was just going to go home. his dog.
Unknown Speaker 37:19
Yeah. No hope that it secondary intention.
Unknown Speaker 37:22
Yes. Yeah. Yeah, exactly. He was going to probably put some duct tape on it. And it’s like, No, no, we can’t. So I think that’s something to to remember, like, in the middle of a busy clinic day or you’re in the O r, and you get these calls, and you’re just like, what in the f are they doing? Like just remembering on the other side, like they’re probably struggling with something big too.
Unknown Speaker 37:49
Yeah, and as especially as sometimes that’s when I when I walk the patients through why they’re seeing me, sometimes, you know, and I even need to clap What the what the question is? Because that, you know, that happens sometimes just oh yeah, listen, you just know the patients. They’re super sick. They’re super complicated. You’re just guys, I just, I just need a little help. That’s all I’m asking for right now. Like, you know, and so I think it’s important that we, we also communicate with our, with our colleagues, you know, a couple episodes ago I had a radiologist sanj Cottrell, who wrote a book on positive psychology. And one of the things that he said as a radiologist was, he makes it a point to call the referring doctor at some regular interval, just so he can connect with with the referring physician. So he’s not just stuck in a dark room and, you know, reading film after film completely divorced from the patient that he’s somehow helping, you know, three steps away by by reading the film that those those physician connections are really important. It really gets back to what You’re you were talking about earlier, you’re you’re not alone, you know, the connections are important. So even reaching out and speaking to the referring doctor or as a family physician, reaching out and speaking to the, the, the specialist, this is what the patients got going on. This is what I’m worried about, you know, and I think it’s a learning opportunity for everybody. So I think that’s
Unknown Speaker 39:20
really clear because we’ve all gotten lazy about like reason for referral and putting like, chronic sinusitis, you know what I mean? Like, really getting like putting some more information with that, like, you know, failed treatments, how many times you know, what did their CT show, like, really like helping that next guy out down the road? Just taking the few extra minutes to put in
Unknown Speaker 39:48
all the work that you did? Yeah, work that you did all the work that you did as as the primary care provider. This is what I’ve done so far. This is all the work that I’ve put into this patient and they’re still not getting better. You know, where do we where do we go from here? Yeah, I think that’s that’s an excellent way.
Unknown Speaker 40:04
And I think we’re all going to have to work on capturing that time back. Like, we really need to push back and say, you know, having that time to be like, even if it’s carved out your schedule being like, no, I need to have that so I can talk to, you know, my referring physician or my primary care. Because, I mean, I think that’s part of where we went wrong in the culture of medicine. When we start digitalizing everything we just assume that our message would get across through that EMR and an absolutely doesn’t. And I think that’s the important of having the connectedness within your medical community. So that like, you know, I remember as a student like going into still when doctors lounges were still a thing, and and knowing the people in there and and being able to know a face with a name and I feel like That’s been part of our problem is we don’t even know who’s who. We don’t even know how to talk to each other because we’re not sure the roles that everybody’s playing or the patient type or even, you know, maybe there’s something that you’re really good at, but because we don’t have that personal connection anymore.
Unknown Speaker 41:20
That’s happening and that’s a detriment to us, and it’s a detriment to our patients.
Unknown Speaker 41:25
And I definitely need to get a lot better about that I need to get a lot better about contacting my referring physicians. And for those who are just starting out in practice, hugely important for building your practice. Whenever referring doctor says even if they didn’t send the patient to you, even if they ended up in your office, because you’re available because you’re the new doctor in town, you’re the one with the open schedule, contact that referring provider and let them know what’s going on with their patient. it’ll it’ll help you enjoy your job more. It’ll be better care for the patient. And That’ll end up building your business. So
Unknown Speaker 42:02
well the other thing to them like as the family practice, then I’m like, Hey, I know I can get ahold of Dr. Block. You know, he, he, he seemed like a nice guy. It seems like this will be a good fit for this patient. Because then you have that can congeniality between the two of you, like I can even think now of specialists that I rotated with as a family medicine resident? Yeah, I refer to them all the time, because I know them. Yeah, I know, their kid, I can attest to their character. And, and I know that if anything happens, like they have my cell phone number, if they really need to get ahold of me, and I think I think that’s where it comes back on pushing back on administration and being like, you’re protected time like, you should have protected time to be able to get to these medical staff meetings. You should have protected time. Somewhere in your schedule that if you are a specialist, like you said, being able at the end of your day, to try to contact somebody having the protected time to get A way to local CMEs to meet other physicians is so vitally important and we really need to push back on that and say no, this is important to us. We need to protect it. We need to have this in our life and in our practice.
Unknown Speaker 43:15
Excellent point. Excellent point. So Baron Wiseman, where can people find you online?
Unknown Speaker 43:21
All right, they can Google me it’s Aaron with two R’s. And Wiseman is spelled V is man. You can also type in truth prescriptions, and I will hopefully pop up at the top of that. You can hang out with me at Dr. Me first on anywhere that you listen to podcasts. And you can find me I like hanging out these days a lot on Instagram and LinkedIn. Facebook is not my friend right now. I’ll be perfectly honest. So you can find me at the handle truth or access. And, again, my name Aaron Wiseman do on LinkedIn.
Unknown Speaker 43:55
Well, this was a great conversation. I certainly learned a lot about the life of Family Medicine. physician and ways that I can improve my life. So I hope our listeners have and I’m sure they have. So thank you very much for your time. It’s been a pleasure.
Unknown Speaker 44:11
That was Dr. Bradley Block at the physicians guide to doctoring. He can be found at physicians guide to doctoring calm, or wherever you get your podcasts. If you have a question for a previous guest, or have an idea for a future episode, send a comment on the web page. Also, please be sure to leave a five star review on your preferred podcast platform. We’ll see you next time on the physicians guide to doctoring.
Transcribed by https://otter.ai