076 - Learn 2 Things That Can Help You Prevent Physician Burnout After Residency Training - (Replay)

Join us for a captivating episode of The Independent Physician's Blueprint, hosted by Coach JPMD, where we delve into the world of physician wellness and burnout.

In this (replay) episode, we welcome Dr. Gabriella Dennery, MD - a certified wellness coach and ordained minister, who shares her compelling journey from medical practice to life coaching. Dr. Dennery's story is a testament to the resilience and transformation that many physicians can relate to and be inspired by.

Discover two key actionable insights as Dr. Dennery discusses the critical issue of physician burnout, highlighting practical strategies to reclaim joy and balance in both professional and personal lives. Her unique perspective as a former physician and current life coach offers valuable lessons on navigating the complexities of medical practice while maintaining mental, emotional, and spiritual well-being.

Tune in now to hear Dr. Dennery's empowering narrative and gain tools to help prevent burnout, enhance your practice, and live a more fulfilling life. Don't miss this transformative conversation that could change the way you approach your career and personal growth.

Chapters

00:00 Introduction and Dr. Gabriella Dennery's Journey
04:12 Transitioning from Medicine to Coaching
07:08 The Impact of Medical Training and Parental Influence
11:21 Challenges Faced by Physicians as Coaches
14:44 The Power of Gratitude and Expressing Thanks
19:31 The Importance of Support Systems and Mentors
22:13 Book Recommendation: 'A Simple Act of Gratitude'
26:52 Preventing Burnout: Self-Care and Delegation
29:17 Conclusion and Where to Find Dr. Gabriella Dennery

Discover how medical graduates, junior doctors, and young physicians can navigate residency training programs, surgical residency, and locum tenens to increase income, enjoy independent practice, decrease stress, achieve financial freedom, and retire early, while maintaining patient satisfaction and exploring physician side gigs to tackle medical school loans.

Transcript

Coach JPMD (00:00.056)
By the end of this episode, you'll discover two amazingly simple things that you can do to help prevent burnout without it costing you a dime. Welcome back to another episode where I help younger physicians decrease stress and increase income by transitioning from corporate to independent practices, even without any business experience. In this episode, you'll discover these three things. How our guest, Dr. Gabrielle Denry, went from internist to successful life coach.

two blueprint items that can help you stay clear of physician burnout, and the simple practice of gratitude and how it can help you live powerfully. Well, thank you, Jude. And I'm so excited to be on your podcast and congratulations. This is exciting news. Thank you. you. Well, as you said, my name is Gabriella Dennery and thank you for the correct pronunciation of my name. I appreciate that.

I'm a life coach at docworking .com and I used to practice medicine. was specializing in internal medicine. I decided instead of subspecializing to just go straight into primary care. And so I did adult primary care for about seven years. I practiced about five years in Harlem and then I did two years in Brooklyn. And I specifically worked in underserved areas because that was what was my calling, my mission was to work with patients who didn't necessarily have.

consistent or good access to healthcare. I do confess that I burnt out though. It's tough work and I chose to work for institutions as opposed to private practice. However, you know, there are pros and cons to all of that. And at the same time, I think that I did not really take care of my self care that well as I was practicing. And it's only at the tail end where I started finally realizing that maybe I needed to change how I approached my life and my work.

the same time I had other interests. so the combination of the two kind of created that perfect storm, that there was something pulling me out of medicine, which is music, I'm a composer, and something kind of pushing me out of medicine, which is burnout, bottom line. And so I made the decision to leave. In the meantime, as I was shifting or transitioning between the two, I discovered life coaching. And I actually

Coach JPMD (02:19.086)
I think I was just bumped into on the internet and then one of my sisters is a life coach and so we started talking about it. And as I was looking through different programs for certification, I bumped into a health and wellness certification program for life coaches, which is called Well Coaches. And it was a very well thought out course, evidence based, and so I signed up and I took it. And at the same time, I actually enrolled in a personal spiritual development course for my own spiritual growth and health and support.

because this is something that was very important to me, but I was kind of doing it on my own. I was also working with a therapist in the tail end of my attending years, but something was missing and that was my spirit, that last component. If we look at mental, physical, emotional, then the last component, which was spiritual health, I still needed to kind of fill that hole. And so, as I was enrolling in the life coaching program, in the health and wellness coaching program, I was enrolling in Iana Van Sant's

Institute for Spiritual Development, which is founded by our Reverend Dr. Yann LaVance. And so I took her program for two years, very intensive. It's like 10 years of therapy packed into two years. It was amazing. then eventually I went back to do my ministerial certification or ordination, which I was ordained in 2019. So my road from medicine to what it is now, this road is a 16 year road. I left medicine.

in 2005. I wasn't quite sure where I was going, but knew it had something to do with music. I knew it had something to do with my relationship with God, but I had no clear plan or picture. I just kind of dived. So life took me in those directions, which also included life coaching. And part of the training at the Intervisions Institute was spiritual life coaching, which takes the life coaching to really different level and deeper level.

And so I saw a place for me in all of these travels where I can kind of combined my background as a physician, my aspirations as a musician and creative, you know, as an artist and how to have that kind of coaching conversation with people. Because it's a very different conversation than the medical conversation. And I think part of the burnout was I got tired of talking about impossibility with patients.

Coach JPMD (04:40.878)
what was not possible. No, you can't do this. No, you can't do that. Always restricting a person's life. But people have lives outside of clinic walls and they have all sorts of other variables that come into play, many of which I didn't know as a primary care doc in 15 minutes or 10 minute visits. It's really kind of hard to ask. But when I started asking, let's say there was a day where a bunch of patients missed their appointments and I could take a little more time with those who came in, I started asking those questions.

Where do you see yourself five years from now? Where do you see yourself 10 years from now? What do you see for your life? And you know, a few of them kind of looked at me funny. It's like, what the heck are you asking? Rather than just going through the review of systems. Any chest pain today, Ms. Jones? No, I stopped. I stopped those kinds of questions because it's the same routine every time. And I started asking about their lives. And a few answered and it blew my mind. Absolutely blew my mind.

people no matter how tough the circumstances may be. And unfortunately, I don't have permission to use this story. So I'm not going to, have one patient in mind, a couple of patients in mind where we had those kinds of conversations, just open the doors to possibility, to what was possible, even in complicated circumstances. So the aspirations were just tremendous. So one patient, you know, without sharing names or anything, you know, I was asking about, well, what is your aspiration?

And she was kind of conforming to what was expected of her. well, I guess I'm going to get married and have kids. And she looked absolutely miserable. And it's like, is this what you really want? And she said, no, it's not. But I don't know what else to do. I was like, well, you got to think about this because you can either be unhappy or happy and it's truly your choice. What would make you happy? So about six months later, she comes back in a business suit, dressed from head to foot, looking fly at

I said, what happened? And she said, what? I opened my own business. Yes, yes, yes. Because that was a conversation about possibility. she came back to, she didn't have an appointment, but she came back to show me dressed in her business suit. And that was so exciting to me. And so over time, there were hints like that. When I started opening up the question and coaching does that, it opens up the question and your client has the ability to fill in the details.

Coach JPMD (07:08.62)
because your client already knows the details. Yeah. So, so you said so much in the first couple minutes of this podcast. that it's just one of, and you know, but it's great because it lends a question as to why did you go into medical school? Why did you go into medicine? Right. Because, because I think training in medical school doesn't allow us to understand what you just described.

And sometimes it takes five, 10, 15 years in practice to realize that. And I have similar situations where my 65 year olds just retired, very well off. They could probably not work for 30 years, but they look lost. They're obese, their diabetes is out of control, their blood pressure is out of control. And I asked them, what do you want for the next 30 years? And they look at me like, what do mean? I said, yeah, what do you want? I'm like, I don't know, doc. I've never been asked that.

So it's interesting to see even successful people who are 65 years old with multiple medical problems, not understand where they need to be in life. And so as a physician, where did you see yourself when you were in medical school? Were you pushed by your parents? Was that an influence in your decision? it was a huge influence in my decision. Mom is a doc. Dad is a doc. My mother in particular, she held up.

that Haitian five hands. Okay. Those five fingers. You could do whatever you want in life. If it's one of these five things, medicine, law, dentistry, engineering or agronomy. Yes, agronomy was the thing. And so since I was at least five or six years old, I would see that hand. Okay. Choose what you want. And medicine was the family business. That's all I understand as the profession to be.

And it was very clear that that was the preferred route. And you could go into law, but you know, it's better to go into medicine, right? So that was that push on the one hand. But on the other hand, I also had a calling to help people. And to me, medicine and helping people was one in the same thing, because that's what I was exposed to. My father wanted to open a hospital in Haiti. He's from Ocaille and he loved Joliet Beach.

Coach JPMD (09:26.75)
And he, so he, he had this imagination that he was going to open a hospital, a neurological, he was a neurosurgeon. So a neurological specialty hospital in at Julie. And he actually had an architect draw out all the plans. And I remember seeing the plan. He would lay them out on the kitchen table or show, you know, say, dad, show me the plan. Show me the plan. Because I would imagine, okay, dad, you're a neurosurgeon. I'm going to be a neurologist and I'm going to go work in the hospital with you. So there was that.

part of the vision back then when I was a little girl because it's like, wanted to be working with my dad and I wanted to help people. And the idea of being in Haiti and working in Haiti was just so exciting to me. And I said, yeah, I'm going to work in your hospital with you and I'm going to help you run your hospital with you. That was the childlike fantasy. yes, I was pushed in that direction and I accepted that push, but at the same time, I kind of made it my own.

Yeah, that's a great story. And I think other physicians, especially physicians from our background, because I'm also from Haiti, as you know. yeah, there is a big push to push our kids into doing something that's better than what we did and to really help the country because we know that our country is in dire need of help, especially health care help. And I think we have the opportunity as physicians who have done this, have practiced and now have transitioning or

looking to transition either a year from now, five years from now, 10 years from now, and coaching other physicians coming out to know how to live, how to practice. And so what are some of the struggles that you see coaches face or physicians face as a coach? What are some of the obstacles that you see them in facing in their journey as human beings? Physicians for the most part are very smart, pragmatic people.

like as a cohort. And so to kind of break that pragmatism down, perfectionism is a big thing, accepting that it's okay to have to make 80 % rather than 110 % for absolutely everything in your life, being less logical and less practical sometimes and be it's okay to be introspective. Vulnerability and accepting being vulnerable. That vulnerability is not weakness.

Coach JPMD (11:50.38)
But to get a physician to understand that, it takes a windy road, little by little by little, you chip at it little by little to get to the core of that person. I know that in my own journey, understanding that having emotions was a good thing, that being able to cry and to release was a good thing. To admit when I did not know something or that I was overwhelmed or feeling overwhelmed was

actually what could actually save my life. I understood that after I left. But while I was in it, it was very hard to accept because there's always that push to be perfect. There's that push to have it all. But that push then spills over to the home life. It spills over to from, you know, cooking a meal to, you know, planning an outing with your family to it spills into everything. You can't say that I'm one way at work and one way at home.

It's all connected. And so to be able to, you know, if you show up at work at home in a certain way and you'll show up at work that same way, et cetera, et and vice versa. And so I think those are the challenges really is one, understanding the importance of self care to being able to accept vulnerability as your humanness and the beauty of your humanness. And number three, letting go of perfectionism and having it all together all the time. Yeah. Yeah. And, it,

really comes from our training. think it comes from how we're trained and how, you know, if we are not the best and we don't do the best, that we don't get the best program matches or we don't get the right job because it's very competitive. And so in a coaching world, how do you measure success for those physicians that you're coaching? What are some of the metrics that you use or if you do, do you have metrics that you use? Not figures, not facts and figures.

But I would say, let me say something about programming. think that's an important point that you bring up is that yes, that programming is very deep and ingrained from undergrad to med school through to residency training, fellowship training, whatever other kind of training or, you know, et cetera, et cetera. And so, yeah, there's these, the brain has now adapted to this kind of way of living and undoing those patterns or creating new ones is the biggest challenge.

Coach JPMD (14:14.99)
working with physicians as a life coach. I just wanted to bring that up because we have been trained very well for decades. It's not just a few years, it's decades. To undo that programming and still be able to practice is the challenge, to be able to see ourselves in a different way. I discussed that in my first episode where it takes about 66 days to create a habit and that habit becomes part of your subconscious.

So when you're turning right at a light, you don't say, I'm turning right, so I'm going to put my right turn signal on and then turn right. It's all automatic. It's automatic, right? So it's an automatic behavior that you learn through repetition. after 66 days, it becomes part of your subconscious. And so now it's how we act. It's how we practice. It's how we treat our patients. It's how we treat our staff. And our families.

And yeah, they become part of that automation process. And I think sometimes it takes a shock. Sometimes it takes a life event. Unfortunately, sometimes it takes a burnout. you know, I think we're in the business of preventing that. Yeah, absolutely. Because if we can prevent it, then we have more successful physicians and more successful people in this world. I agree.

So back to your question of success and how do I measure success? I don't have metrics. I'll be honest with you for me is, you know, when I go into a coaching session, I set my intention to say, if I can create an atmosphere, one of trust, that's fundamental where somebody can find that aha moment that will shift their direction, even if it's by a half a degree by their standards, whatever their standards are.

then I did my job. Then I am successful. You know, to be for somebody to say, I didn't think about it that way. Or, you know, I, that to me is the biggest, most amazing aha moment. So that recalls one of my clients where busy professional who frankly high performer used to being a high performer in absolutely everything she did. And then we talked about what's wrong with the C plus

Coach JPMD (16:37.454)
instead of an A plus, how would that feel? And it took a while. And the way we got to that point was for her to enlist help from a colleague, which she was loathing to do because, this person is too busy. I can't disturb her, but I know she can answer my question, but I'm not going to ask. I said, well, why don't you just ask one question, just one, and see how that works? So she did. And guess what happened?

person answered and said, Hey, whenever you need help, because this person had more experience, whatever you need help, you don't hesitate to knock on my door, you know, so it was just breaking through that 100 % 110 % mentality that maybe I don't need to know everything, right? To get my work done, I can solicit help from other people. And there's nothing wrong with that. It doesn't, you know, there was a sense of shame tied to asking for help. And so we, you know, little by little,

we were working towards breaking that sense of shame for her to enlist a community around her so that she wouldn't feel so overwhelmed at work. And she was also overwhelmed at home. So it's like, let's, let's change this dynamic. So just by learning to ask a question is a way to ask for support. Just asking a question is a way to ask for support. And I think that aha moment happened and I'll say, okay, yes, I did my job. Yeah. It's very interesting. It's also interesting that

I've done a couple of interviews, a couple of podcasts and the word shame has come up in different areas when dealing, when speaking about physicians and in finance and physicians in their health, their mental health and dealing with getting help because we are, it's ingrained in us that if we get help, then we may be shamed or we may be belittled. And I think some of it has to, I think a lot of it has to do with just the way we were trained. But

I think we need to have an episode just on shame and how we can break that. It's a tough one because I know when I was starting therapy, what inspired me to start therapy when I was an attending physician was one of my mentors. That too is important. Having mentors, having people that you can go to under any number of circumstances. shouldn't shoot, what I tell my clients is shoot for five or six people.

Coach JPMD (19:05.472)
Because everybody has a different role. You can't have one person who just is can help you with absolutely everything. Everybody has a slightly different role. And so find five in different roles and fill that up. And if you have these holes, then make it your mission to fill that hole because that's what's going to get you through, through med school, through training, through residency training and through your attending years. And so I had

by chance, a mentor at one of the in Harlem, it kind of just happened organically. I didn't seek it, but we kind of struck up a friendship. One of the pediatricians there was an absolutely amazing physician who burnt out, left, and then came back. She was a whole different woman when she came back. my God, the smile on her face, the relaxed nature, the kind of more philosophical, more, you know, being able to see herself in the bigger picture and see her

practice in a bigger picture. And I said, well, what did you do? I want inquiring minds want to know. And so because I was feeling very restless at the time, and I knew that I had to make a change somewhere somehow. So she talked very openly about being in therapy. And I was shocked. Because this was back in the, you know, early 2000s.

And still, even back then, it's like, we didn't even talk about burnout. We didn't even know what that was. The word was not even in our vocabulary. And at the same time, you you didn't talk about mental health in physicians. What if somebody found out? What if, because my health insurance is tied to my job, what if somebody in the office looks at the diagnosis that a therapist gave me and the ICD -9 codes that said major depression,

and PTSD, that's what was on my sheets. And it's like, my God, what will happen to my career if somebody finds out? So I started paying out of pocket because it's like, no, I don't want a record of this because there was that, that stigma and that shame associated with it. it's like, and that pride, the physician pride, imagine that you are your first client, that you are your first patient.

Coach JPMD (21:20.332)
Would you recommend to your patient to take care of everything themselves? If they need support, what would your recommendation be? So why would you want to fix it yourself and try to fix you yourself when you wouldn't recommend that to your patient? It makes no sense. Yeah. So, so in hearing the stresses of the physicians and hearing what they've gone through, what, what they've struggled with,

Is there a book, one book that you would recommend that physicians, your physician clients read? Yes, there's one book that I simply absolutely love. It's a quick read and I recommend it. It's called A Simple Act of Gratitude. I have it with me now, so I want to make sure that I read it properly. A Simple Act of Gratitude, How Learning to Say Thank You Changed My Life. And the author is John Kralik, K -R -A -L -I -K.

And this was the story, and as I said, it's a nice little book, it's a quick read. And this was a story of a kind of a down and out attorney who was, his business was in a shambles, his marriage was in a shambles, his breaking up with his girlfriend, you know, his relationship with his children was strained, especially the older children. I mean, nothing was working. He didn't know if he could make payroll. mean, everything was just kind of falling apart. And at one point he receives a letter from one of his ex -girlfriend who

who actually thanked him for being in her life. Although things didn't work out, but she was still very grateful to have him in her life. And so, it kind of shocked him. And that coupled with a meeting with a good friend who said, you know, if you're not grateful for where you are now and what you have now, it'll be really difficult to move forward in anything else. And so, once he got that note, he realized that he had never said thank you to anybody. Not in those terms, like,

He knew people who would send these letters, you know, every time you go to dinner, know, somebody sends you a thank you card or say thank you for for having us over and that kind of stuff. And it didn't occur to him to do that. So he started doing it, writing these little thank you notes to his staff, to his to to family members, to his older children, et cetera, little by little, by little by little. And next thing you know, the response was just something that he really did not expect. You know, old clients who finally started paying their bills.

Coach JPMD (23:39.928)
people in the office thanking each other, you know, being appreciative about him and sending him notes and then thanking each other for their work and their hard work, et cetera, et cetera. So, I mean, and it started just kind of snowballing that way in a good way. Why is this important and gratitude in and of itself is so important? Because it shifts the mindset. And number one, it is ridiculously simple. And one of the things with physicians is that they expect things to be complicated to be worthy.

And when you try to convince them that something simple can actually make a massive change in your life, it's a tough one. So I love this story because there's also a body of research around gratitude, which is interesting. just kind of started reading on it. It talks about the physiological effects of gratitude, increase in serotonin levels, for example, the happy neurotransmitters that in, you know, it could potentially be helpful for mild to moderate depression.

that even physical effects of gratitude, including decreased blood pressure, mean, somebody, think there was one suggestion of an improved lipid panel, mean, sorts of wonderfulness. And so on the one hand, it sounds outrageous. It's like, well, how can this, it's not a pill, it's not complicated theory, and it's not complicated medicine, but this is a formula that has worked for thousands of years. And so medicine is finally catching up to that.

and the impact of gratitude on the human body, the human soul, the human spirit and every aspect of life. And so it does create a shift. When you find something to be grateful for, even if it's the simplest thing, you know, I keep a gratitude journal. Sometimes I'll send gratitude notes to friends out of the blue saying, I thank you so much for being in my life. And the response that you get from that, it creates a very different kind of positive shift in mindset personally. And that energy radiates outward.

And people notice the changes, they do. And you notice the changes too. The level of stress and overwhelm just goes down. The circumstance may be the same for now, but your perception of it, how you relate to it changes. And it is just so simple. It's so simple. And yes, healing is simple. What's the old saying? I can do bad all by myself. Yeah, I can do bad all by myself, but it really takes a village to raise a doctor.

Coach JPMD (26:02.446)
So part of that village is gratitude. It connects you to people again. It staves off the isolation and the need to figure everything out alone. People come to you. People ask about you. You reestablish relationships when you do that. And that goes a long way to burnout prevention. It goes a long way to treating burnout because part of burnout is isolation. Part of burnout is disconnecting. And imagine this simple little formula. And I tell you simple is best.

It doesn't require a massive prescription of anything. All you have to do is say thank you. And you do this consistently. The longer you do it, it becomes a habit. As it becomes habitual, you notice that how it impacts your life. can't, my God, I love this as a tool. As a coach, think it's a fabulous tool. So I think, I think you've already described one of the three things I'm going to ask you that can help help physicians practice impossible. Cause we're about

figuring out how to help physicians practice impossible. so gratitude, gratitude, expressing gratitude. What's two more things? Support. Stop trying to do everything by yourself. Stop trying to solve everybody's problems, whether at home or at work. You know, that habit of, we go to that person, which was the way I ran my life too. let me come up with a solution for you. Why people are perfectly capable.

of finding their own solution. You don't have to be the everything to everyone. And in fact, it empowers people when you say, you know what, I trust that you'll figure it out. It empowers people. that's part of the self care delegation is crucial part of self care and letting people, you know, grow up and be their own person in finding the solution that works for them. And that's really the fundamental of coaching as well. So gratitude, delegation, mentorship and support is

he find those five people in your life, whether it's confidants on a personal realm, professional support, whether it's practice related issues, patient related issues that you're not sure what to do. know, doctors of old had mentors back in the day. I'm not sure how that changed over the years and over the generations that now people kind of operate in silos or be in silos. You always want to have a contact person who can help you discuss patients, who can help you

Coach JPMD (28:30.742)
solve some dilemmas and personal support systems as well. Especially, you know, if you're a sandwich generation physician when you're dealing with elderly parents and you're dealing with children and you're dealing with work, how you can't do it, you can't do it by yourself. So stop thinking you can't. What's your support system? If you don't have one, define one, find it, define it, write it down. Don't just think about it. Put it on paper. Make that commitment.

Such great, great advice. Gabriella, I can't express how elated I am having you on this podcast because you've touched on so many things that are important in physicians' lives and I want to be able to support you as well. Where can our population find you? Well, you can find me at docworking .com, D -O -C -W -O -R -K -I -N -G dot com.

and you just go to the website and you'll find the coaching page very easily and you'll see me there. But you also have a podcast as well, I do have. Because I was on your podcast. Yes, you were and thank you so much. We're a fantastic guest. Thank you. And yes, I co -host with the other lead coach at Doc Working, Jill Farmer and with Jen Barna, who's the founder of Doc Working.

Doc Working, the whole Physician Podcast. So you find it on iTunes, Amazon, Audible, you, know, Spotify, wherever you find podcasting. And so we're very excited about that offering. And we talk about the physician life and as many different aspects of it as possible. That's wonderful. Thank you so much, Gabriella, for coming onto my podcast. And I hope to do this again. This was fun. thank you. Thank you so much. And I know we'll be talking again. And so thank you.

I'm excited for you and I'm excited for this project. Thank you.