WCI #460: What Actually Drives Burnout in Physicians

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All right. Welcome back to the podcast. Hope you enjoy the podcast. I'm grateful for you out there. I have had uh a surgery recently. I'm recovering from surgery again. I had a little revision done on my wrist. And uh I'm grateful not only to my surgeon, but uh numerous white coat investors. I got a whole bunch of second and third and fourth opinions.

sending my CT around and and ended up having uh uh a removal of my distal pull of my scaphoid and my hardware. And hopefully that gives me a little better outcome on my wrist. long term. But uh had a great experience and uh you know I was pretty amazed. Uh by post op day one I was on Tylenol. By post op day three I was on nothing.

So wonderful experience for uh for healthcare interaction and uh and got to use my HSA. So that's always wonderful. But um thanks for what you're doing out there. Nobody said thanks for it. Let me be the first today.

Okay, our quote of the day today is about leadership, a topic we'll be addressing during the podcast. This one comes from Jack Welch, who said, before you are a leader, success is all about growing yourself. When you become a leader, success is all about growing others. Okay, WC Icon is coming up.

And uh and we're having a sale on our virtual version of the conference for WC Icon twenty six, uh between uh the twenty third of February And the twenty fifth of march, if you use code WCI Con one hundred, we'll give you a hundred dollars off, the virtual version of the conference.

Uh it's not too late to come in person though. I mean our hotel's sold out, but we've got another one. It's right down the street. No problem attending that. I mean you've all been to medical conferences where you couldn't be in the conference hotel. It is still well worth coming to the event.

just because you're not sleeping in the same building you're going to, you know, the the presentations, that's okay. It's still gonna be a wonderful experience and we encourage you to come. So check that out. Whitecoat investor dot com slash WCI con. or you can go to wcievvents.com and sign up. We'd love to have you. All right. Great interview today. This interview is actually with going to be with one of our speakers.

from the conference, uh, a fellow by the name of Rutherford Pascal. And uh I'm just getting to know him, but uh I think you're gonna like what you hear in this interview. My guest today on the White Coat Investor Podcast is Rutherford Pascal. He's a certified John Maxwell leadership trainer, coach, and speaker.

And he's gonna be a speaker at the physician wellness and financial literacy conference in a few weeks from now. So we're excited to have him on, get to know him a little bit better. He's also the founder of Glasswall's Leadership. uh where he trains people to be leaders and uh delivers not only dynamic keynote presentations like we're gonna be hearing at the conference.

but does transformative leadership training and impactful coaching to unlock unprecedented growth and elevate leadership skills to new heights. Rutherford, welcome to the podcast.

Right. And there's there's things that that are exciting that really fit who you are and who you want to be. And really what I talk about is understanding and finding your genius. and thinking about your genius and and really architecting your life around that genius, around those things to make yourself financially successful and just successful in every

shape, matter, and form. This financial success, but it's also this the success of doing the right thing for people, patients, and society. And that's part of what we talk about too.

But also a lot of people at the conference are kind of getting to mid career and facing some wellness challenges. They're feeling the stress of their workplace, of their profession. Uh they're feeling burned out. You know, the burnout rates in medicine are are, you know, hover around fifty percent these days. What what are they gonna learn from your talk that's going to help them deal with those challenges?

Let's think about burnout, right? If you plan your day, month, week, quarter, year, whatever you do, right, in a way that you give yourself time deep work time. Right. If you read the book by Cal Newport called Deep Work. Spectacular for that, right? You do the or time blocking was something you can you can use for that. But then you put time in where you're not working. where you are actually resting your m in your mind, your body, system. So it's really about the preparation.

Did but that's also intentionality, right? So you have to be intentional about what you do, how you do it, when you do it. So sometimes you do more by doing less. you do more by greater focus. of time greater focus on a on a task skill or something or whatever you're doing, but you spend less time doing it, if that makes any sense. Right. So you give yourself this deep work, this time to focus.

But then you also give your times plenty of rest to recharge and reload and typically by not thinking about it. So it's that whole thing of being prepared, but being intentional. And that intentional that intentionality will help curb, if not completely eliminate burnout. Right? Preparation and intentionality will do that.

Because you won't be doing things on a consistent basis on a hamster wheel where you feel like, oh, I'm doing the same thing over and over. You're going to figure out exactly where do I operate best, where where's my greatest and best use? either give this task tool to somebody else or it's now down at ninetieth on the prioritization list instead of everything being a priority and e that's when you go crazy. So that's really what I talk to you about. I I talk to people about how to think.

How to think about what they're doing. And if you put those rules in place, those bright lines which I talked about. through preparation, through intentionality, you're not going to burn out.

you're going to master yourself from a financial basis because you you would have architected your life and what you're going through from not for today, but for weeks, quarters, years.

Well, when you're not in charge of hiring that person, when you're not in control of having that person, sometimes those tasks all load up on you. Uh any thoughts on uh on how to manage that conversation with an employer, with a supervisor, et cetera? to uh uh receive that level of support to make sure you're operating, you know, practicing it at the highest level of your license, for lack of a better term.

But again it's it's the mental or or mindset framework of how you do this. So in some of those situations you can talk to your organization about timing. How much time do I have to do this? And they will oblige as long as they get in the what they want, right?

And if that's not the case. They're mandated on where you're seeing a patient every seven minutes or you know, you're you're you're working from this, you're you're you know, they they mandate the number of patients you're gonna see a day, right? Then it's just about how can I do this to be more efficient with my work? What tools am I not using that I should use? There's always a way to become more efficient within those constructs.

There's always somebody within the organization that is managing their time well and is not getting burned out and is still following the rules of that organization. And I think it's talking to those people or it's figuring out for yourself. How can I do this in a way that satisfies everybody, my company, the patients I see, the staff in a way. I will tell you, I've I've left teams for my entire career.

And I always tell people there's five there's always five ways to do things. There's five answers. Some of them are answers you don't want, right? But there's always five answers. And people have to challenge themselves to think about, huh, I I could do that. I should do it that way. And I'm not giving you a direct answer because every situation's different.

You have to look at your situation and say, you know, instead of having the the my sister nurse come in after, why not have them come in with me and they can take, you know, so it's things like that. like you can you can adjust and change that might help the situation, might curb burnout, might curb some of the things that are restricting the physician or or from being happy and productive in their course of the day.

something to drink, you know, those sorts of things. Just because I come out of the patient's room and I can't see anybody. There's nobody else around to do it. So I go and do it. And sometimes especially i i you know, in my particular situation the the hospital is not my employer, but if it was my employer I oughta be thinking about the cost

to them of me and my time and my expertise to be, you know, taking patients' blankets. Maybe that's not they're not getting the bang for their buck that they'd like to be getting out of that.

And just being able to talk to them in in terms of of what they understand and and really every sort of discussion looking for more support. is a negotiation. I mean you're really moving into negotiation with your manager or your supervisor. And uh I I'm not sure a lot of, you know, physicians realize how often They're entering into negotiations i in their lives and in their daily, you know, career work.

success in surger certain types of surgeries, whatever they're they're known for, increase. They they want AHIDA scores. I mean whatever whatever it is, right? And if you you're right, you're you are spot on. If you're speaking in their language. they will listen and they could change because you said, Hey, what if we had one person That was in charge of water, blankets, blah, blah, et cetera, that come in. And they, their job was every single time a physician walked out, they did it.

That would give me more time to be more efficient. I could see two more patients a day. But I'm gonna tell you if you say, you know, I'm gonna say two patients today and if you if you multiply by the number of physicians, even if it's one patient or a half a patient. I'm gonna see a half a patient a a day more. They're gonna say

Done because that's what they're looking for, right? So if you're bringing solutions in that way and speaking their language, that is absolutely what you can do and should do.

I'm I could be meditating. It doesn't matter. It's you. Nothing there's nothing that's universal. You have to figure out I I I'll just tell you me. What I do when I'm in I'm in this room in my office. and I'm working for an hour, two hours straight on something, whatever. I will get up and I'll go in to the other room and I will put on a show that I've seen

four hundred times the episodes, which is typically law and order. Like I've seen every episode like at least four or five times. And for ten, fifteen minutes I watch it, it's mindless. I I don't think about the last two hours. But it gets me prepared, my mind blanks and I'm ready, re energized for the next two hours block or hour block, whatever that is. So it's really about who you are. And by the way, I do that I don't do that all the time. Lots of times I just I walk.

because that also resets my time. So it just depends on on weather, on situations, on where I am, on you know, what I'm working on. But I will tell you, if you think about people who are successful They reset their mind. And by the way, it could be going and taking three deep breaths.

What I'm talking about is simple. I'm giving you 10, 15 minutes, but it could be just like going to me, just reset your mind, take three deep breaths, and come back. It's all different and it's not it's not universal.

Emergency physician, right? Because it doesn't matter. We do the same thing. We're better. You you know, you don't have to be modest. You know there's certain things that you do better than another another emergency physical. Am I r am I correct?

And they just think you're the genius and uh it it's literally super easy and super rewarding and takes no time and no time to document. I if I could have a whole clinic of nursemaid elbows lined up for the rest of my life, I would die happy.

There's other people that they they see a spreadsheet or they see code and they'll they'll they'll get lost in it for a long period of time. And it's all of a sudden it's I've been working on this for four hours. Oh my God. That becomes your zone of genius where time goes away, you're thrilled to be in it. There's nothing else that's happening in the world because you're you're so deep and you're so Um, you're so good at it and it interests you so much that you can spend time and you can do it.

over and over again. It never gets boring and it never gets old. And your results are fantastic at it. You know there's certain people that you would trust doing your your taxes and you would trust doing construction in your house. And there's other people who have come to your house that have done construction that you would never let back in your house again.

That's not that's their zone. So when I talk about people's zone of genius, it's when they've found the things that are great at. So you so may let me go back to the emergency uh physician situation. So do you know when emergency physicians started to rise in popularity?

that's happening on a regular basis, right? So that's that adrenaline, that is a zone of genius, right? That other physicians don't want. So that's what I'm talking about.

you know, people get their dream, right? They in high school they wanted to be a doctor and so they go to college and they go to medical school and they do a residency and they come out of the training pipeline and they do it for a year or two and now they're thirty five years old. And they're like, Oh, I don't like this as much as I thought I was going to like it. I'm now the center fielder for the Mets and I hate fly ball.

Right. What what what advice do you have for that person that's that's realized relatively early in their career and maybe still with, you know, hundreds of thousands of dollars of student loans hanging over their head that they don't like this?

He was the crying because he he goes I didn't understand I didn't know they would cry that much. I said to him, I said, you should probably think about doing something that doesn't involve kids, maybe it's adolescents or what I mean, you know, doing something else. So this by the way, on I swear to God that that happened. What happens is life changes. And interest changes.

some history, their family, something happened that they they wanna do that. And they haven't investigated a hundred percent of what it is and what it entails. So the good, the bad, the dirty. It's like anything else, you gotta figure out what's the worst part of the position.

And then if you can live with that, then you know you you can you can stay. If kids crying is gonna be a big deal, you should never you should switch. You should go to do something else, right? You can always change. You can always adjust. By the way, you can do this upward instead of going lateral. You can do go up, right? So you can go in a special

So you can get another thing to grow higher. So be even more specialized. If in fact they have zonogeneus and what you like. You could go across. I've known doctors who started as internists and gone to another specialty three, five years later because it's not what they expected or they don't like. So you have that opportunity to do that.

If you don't, then every day you're unhappy. You theoretically can work for 30 to 50 years. If you find out in the first 10 that you do not like this position. The next twenty years are gonna be hell.

Everything's individually individualized, but generally if you hate your position, if you think you're not at your best use and you don't love what you're doing,

Some adjustments is probably the best way to go. And I'm gonna go back to zone of genius because I believe in that. Now typically people change careers seven times. Seven times. From twenty four to fi to ki fi seven times. So this is not unusual. This is this is fairly normal. It's not that you failed, it's that you didn't find out exactly what you were great at early. Or you did find it out and then you f okay, this is I'm gonna change again. I'm closer, but so there's always a change.

mental, there could be short work load cost. because you might be preparing for the next career while still doing that one because you want the transition to be short. But the long term gain, if it's exactly what you want. You'll be so happy if in fact you've figured out what your zone of genius is. And and by the way, it might be less money. But if you're happier, I know a lot of people who are so happy and they decrease their salary by 30 or 40%.

And they would do it over again because you know you got you gotta live with yourself and other people have to live with you. So you wanna make sure you're doing things that that uh are great for you and great for the people around you.

It's how you present yourself, how you are. By the way, you always lead as a physician, you have nurses, you lead them, you have technicians, you lead them. As a doctor, you're always leaving. Tell me if I'm wrong. There's very few situations where there's not somebody around you in the environment where your voice doesn't play uh oversized role.

in that situation of doctors and leaders a hundred percent of the time. Now, there's gonna be people who are quiet who don't speak up and say, I think we should do it this way. There's other people going to be like, I think we should do this way. Those are those are people more leaders. There's other people who are quiet leaders. who they don't say anything but their actions speak louder than their words. They're leaders too.

Because that's part of leadership, right? Because you don't have to be the loudest voice in the room. And I'll be frank with you, the loudest voices in the room are typically not the best leaders.

I don't know if you're a football fan, but the person who won the Super Bowl this year, Mike McDonald, he's the he's the he's the head coach of uh the Seattle Seahawks. I no one would ever call him charismatic. No and that as a matter of fact, he himself said he at the beginning of the year apologized to his team for not speaking the way he should about the team.

to reporters and other people he is I have to get I have to be a better speaker. But what kind of a leader is he? He's a spectacular leader, right? But he's not charismatic. Leadership's about influence. How can I influence or how do I influence somebody to do something the way that I think it should be the way that's best for my patients, the way it's best for my team, the way it's best for whatever, right?

What do I do? And that's why I'm saying you don't have to have the loudest voice. If your actions influence others, you're a leader. It's about influence. It's nothing else, nothing more. I mean and and people put way too much emphasis on somebody who is charismatic. I I understand it. It's what we're used to. It's what we see. But the really, really effective leaders People follow them because they make that person feel special.

they have some type of foresight as far as what people should you know, direction people should go. And because that person's been correct, they've helped other people. People follow them wherever you y wherever they go. That's when you t that's when you understand real leadership is when somebody says something and people start walking in that direction.

And and maybe it would be uh less offensive if we called it leader instead of influencer.

That's a really positive statement. You might say, oh, influence. I don't want to be an influence. But the context around how that's being placed on you is very positive.

So if you if you think about when you were thirteen and you said to somebody, your friend, hey, I'm gonna be an I'm gonna be a physi ER physician, and your friend said, No way, you're not that smart. Right, right. To them, to people, that was an irrational he's irrational. He's never gonna be a doctor. He's never gonna be this. He's never he can't do this. This belief this belief you have to have in yourself.

is single minded. It has to be that way. When every single thing that's ever been accomplished greatly like this phone, that was irrational ten years ago. This phone was a rational in the seventies. This this is more this is more powerful than Apollo eleven. Right? This thing we have in my hand. When that was first told people taught a personal computer in my pocket? Crazy. Irrational. So that's the glass walls that people put around themselves. They they wanna be hyper rational.

They want to be, they want to conform to what everybody else has done. This is how you do it. This is how you proceed. This is how you grow. And as I said, there's many different ways. And if we as a society thought like that, there would never be open heart surgery. There would never be all these different things that happened in the in the medical space because there was somebody that was so irrational about how they were thinking, right? There's things that you do now.

How long have you been an ER physician?

you know, uh a couple hours later I've I've got the results. So that's that's certainly been practice changing for for a lot of emergency physicians, I think.

Right? Because that patient, instead of staying there for five, seven, eight days, you can figure out with the MRI exactly what to do. They can they can get treated and leave, hopefully, within a day or two.

and the lives of the people around you better. And especially in what you do, the patients. And what you're doing is is is showing people how much control they have to you know, to make you know themsel so that makes themselves not burn out and to create a barrel of financial life for themselves. They have control.

They need to get rid of the glass walls they have around themselves, understand they can do for themselves to make themselves and their family, their staff, the patients better. They are in control.

the conference at that point virtually. You sign up for all of that at WCIevents.com. Thank you so much, Rutherford, for coming on the podcast.

Not only do you have more time for your investments to compound, you have more income that you can save as you go through, you delay Social Security longer and your Social Security benefit is larger, all kinds of wonderful things happen when you're able to work.

One more time at SoFi dot com slash Whitecoat Investor. SoFi student loans are originated by SoFi Bank NA member FDIC. Additional terms and conditions apply. NMLS six nine six eight nine one. Don't forget about the discount off the virtual version of uh WC Icon. Use code WC Icon100. uh when you go to whitecoat investor dot com slash wc icon, you can get$100 off the virtual version of the conference.

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Uh, for everybody out there in Whitecoat Investor Land, I hope you're having a great day. I hope you're having a great week. I hope you're making progress. Toward your financial goals. You can do this. There's a whole community standing here trying to help you do it. Keep your head up and your shoulders back. Don't give up. You're going to get there. We'll see you next time on the podcast.