164. How To Know It's Time To Transition In Medicine

If you are self sacrificing everything you have, sometimes it's your relationships, it's your health, it's your time, it's your sleep because you feel obligated to your patients, that doesn't serve anyone in the long run. In the long run, it ends up burning out.

Are you a woman in medicine feeling overwhelmed and disconnected from the personal fulfillment that you desire? You're in the right place. Join doctors Joanne and Erin as they rewrite the rules for women in medicine. Let's begin.

Agency changes everything. The moment you realize you get to choose, your life begins to move. Clarity follows choice, not the other way around. And I am here with my Super Co host, Dr. Erin Hurley, who will talk to us about how reclaiming your agency is the most powerful decision you will ever make. Erin, let's get right to it. When you talk about agency, what does that actually look like for physicians in real life?

It means I have a choice. The default seems to be all the choices have already been made for me. Whether it's the system you're working for or if you own your own practice or, or the changes that have made with insurance or reimbursement, or the political changes and all that, we can sometimes assume the choices have all been made for us. And that's not accurate. So when we replace that with I have a choice, you have a choice, we all have choices. And when we focus on those choices that we can make to create different outcomes, that's where agency starts showing up. And I know for my own life, when I, before I started working with a coach, I was stuck in victim mode for a very long time. Oh, poor me, you know, nobody appreciates me. I work so hard. There's all these choices made for me. And with that external perspective from my coach saying, no, you really do have choice. You can set boundaries, you can leave the office earlier, you can say no. Then I realized, oh, my life can be the same. The same marriage, the same kids, the same job. But I no longer felt trapped. And that's the power of agency.

It makes me think of when you say that frequently when we hear victim role, it sounds very dramatic, but it can also show up as times when we think of, oh, they're always going to say, no, I'm not even gonna try. And that learned helplessness of, oh, that's not how they do it there. And we don't even try. And it's also the reminder that it can put us at risk of feeling stuck, like there's no other way out. And then it can put us at risk of them then feeling depersonalization, meaning like we don't find any kind of joy in what we do or we dis. We're very disconnected emotionally. And those are all things that put us at risk for burnout, anxiety, depression. So this is not just about having control or making decisions, but it's really in a very protective way mentally and emotionally. That's. That's what came up for me in hearing you say, say that in such a powerful statement for all of us. Thank you for that.

And we can amplify. We've talked on this show so many times about the RAs, our reticular activating system, the filter our brain uses to process. I don't know if it's billions or millions of, you know, pieces of information, and it whittles it down to just a select few that we remember. We have agency, we have control over what our reticular activating system looks for. Is it looking for, I have no choice, or is it looking for how many areas do I have choice in and how many of those can I make an impact? So we have, again, we can have the same circumstances and we can have completely different outcomes depending on how we look at the situation. And Joanne and I do a lot of this mindset work with our coaching and about shifting things, sometimes turning it on its head to say, hmm, have you ever thought of looking at it this way and challenging our clients to have a different perspective and say, are you sure you don't have any choice in this? And recognizing it's working against your brain wanting to be lazy. Your brain uses so much energy, and these days there's. Our brains are so busy, of course it wants to stay stuck in that rut because that's in its mind, the easiest survival mode to go in, using less energy. So we have to take agency and overcome the maybe outdated mechanisms that our brain uses because it's trying to keep us safe, it's trying to keep us alive, it's trying to keep us surviving. And yet most of us want more than just survival mode. And that's where taking agency, taking control of the circumstances and making them happen even when your brain doesn't want to cooperate.

So powerful. And it makes me think of what are the obstacles getting in our way, because intellectually we understand this, but yet we don't always take the steps to get to that change. And what comes to mind is guilt around change. So let me ask you, Aaron, why do so many physicians feel guilty even just thinking about changing roles or working Less.

Oh, there is so much guilt, not only just being a woman. I think women carry a heavier guilt burden than the men. And we feel this obligation to our patients. And that's again a strength that we want to be obligated to good patient care. And yet, as we're also famous for saying, at what cost? Because if you are self sacrificing everything you have, sometimes it's your relationships and it's your health, it's your time, it's your sleep because you feel obligated to your patients, that doesn't serve anyone in the long run. In the long run, it ends up, you know, burning out mental health issues, looking for a different job, looking for an escape route. And when we can address the guilt and say, maybe this isn't my problem to solve, maybe I have already solved as many problems as I can in this container, in this job, in this role, and now it's time for me to step back and let somebody else do it, maybe in a different manner, maybe in a way that's going to serve things better and we just have to let go of that it, you have to carry it all. That's too heavy. So obligation is a huge piece in that guilt. It's something we're comfortable with as, as physicians, we feel guilty if we get bad outcomes or something happens that is not ideal and we don't want people to suffer. Sometimes we don't want our colleagues to suffer. If I, you know, go to, maybe it's locum's role or fill in role and I'm not taking call anymore, how are the people taking call going to suffer if I back down to less FTE or full time equivalent, less hours per week, how is that going to affect patient access? How's that going to affect my staff? How's it going to affect my colleagues? And we can't own all those problems. Sometimes we have to say, where do I fit in this equation and can I bump myself up to the top of the priorities instead of always waiting till everyone else is taken care of. And again, many of those patterns, the guilt, the obligation, putting ourselves last, those are habits that we're used to. And Joanna and I like to pattern, interrupt, shake things up and say there's a cost to this. What would happen if it doesn't change? What if you're still stuck in the same rut in a year, in two years, in five years, is that going to be okay? And if not, then what do you need to help you get through it and let go of some of those Negative implications such as guilt by taking agency and getting your life closer to where you want it to go. Because, as Joanne shared in a recent episode, it's not going to get there through randomness. You've got to make intentional choices so.

Good and what comes to mind. It's also so often we believe that we need to be close to 100% sure about the outcomes and all the steps and everything ahead of time before we make a decision. And there are big decisions that will never be at 100% or 99 or 95 or even 90. And the way I explain it is sometimes it needs to be like 70, 30, like you're 70 or even 60% sure that that's a decision that you need to make. And there might be like the 30, 40% where the guilt lives or the good things also. Right. Like, I've. I've shared that I recently transitioned from the, like, institutional work that I've been at for 18 years into my private practice. And I would have been fine if I had stayed. There wasn't anything awful going on. It was. It just felt ready to do something different. I wanted a little bit more flexibility with my time. I think that I can serve a little bit different than focusing more in a specific population. And that was tough. And it took me actually several years to finally make the decision and write that letter because that 30, 40% of the good, the guilt, was there as well. The patients, the people I love at work. Again, because it's what I've been doing for so long. It's very safe. I had a secure paycheck, and I really had to step into that 60, 70% were also uncertainty lived, which holds us back sometimes. But then thinking I need to connect with the possibility of the other things that I can do, and especially when. And I think of women in medicine that I coach, that I've helped through many transitions. And it's. I hear that in the background all the time of, like, the what ifs and. Or like, we want to be as close to 100% as possible. And that would make it easier, but then also knowing it's okay that it's not that big of a difference when we put things in the scale. And it's more about what are the things that I am focusing more of now and what am I valuing more. So now what's the ruler that I am using to measure myself? And it's an, an accurate current ruler, or is it an old one or someone else's ruler? And that's kind of what came to mind in hearing you, in talking about guilt, also through difficulties in transition and holding agency in the process.

And I love your, the point you brought up of that relevance. Is this relevant now or am I using old rules and patterns that served me in the past but aren't relevant now? And. And I would challenge our listener to keep bringing relevance to your questions for yourself and making sure the choices you're making are relevant now.

Yes. That's so important. And let me ask you this. You often say something shifts when someone realizes they have choices similar to what we've been talking. And why is support and community so important during these transitions?

Well, I look at it from my lens as a physician coach, and I've been through my own transitions and I bring that expertise in that experience when I'm meeting with other clients. So sometimes that comes with clarity. And it's that they get clarity. They don't want to transition and they want to stay in that position. They want to lean in, maybe take on a leadership role. And with another set of eyes, from the coach's perspective, I can give them an outsider's perspective with them at the center of my focus. And if you don't have that clarity and you're trying to solve it all on your own, it can get really confusing. And sometimes it's also that clarity that what I'm doing is no longer relevant and I can't stay doing this any longer. And then what's the support you need to reassure you that it's going to be okay? You can do this. You do have choice. And whatever you choose to do next is not going to be perfect. So sometimes it's what's that extra perspective that's going to help you recognize what are your blind spots and what can you look to make sure you know what that you know, how big is your gap? Is it a 30 or 40%, unknown or unsure? Is it a 50 to 60%? And how can you narrow that and know that it's time to make a leap? And sometimes it's just making a leap of faith and with my own. Like I've shared this before when I made my own coaching journey choice to get that support that I, I didn't know I needed. By hiring my first coach, I had no idea what I was getting myself into. I didn't know anybody who was getting coached. I just knew I had to do something differently. And trying to solve all these problems on my own for two decades was not getting me the clarity and the change I needed. So I took a leap of faith. And I made that decision and recognized it was, it was a good choice. And I'm glad that I was able to make that decision on my own. And then that leads to also there's not one right decision for you to transition to. Not if you, if you're looking at different jobs, which one's the right one for you? There may not be one right one. So again, if you can get the right support to look at what are the positives and negatives, what's the risk, what's the benefits and help you kind of not get blindsided by your own emotional ties to one choice or another and making sure that you're having as kind of a like a broad as needed perspective to then make that choice. And then once you make the choice, then can we remove some of those emotions that aren't serving you, like the guilt? What's going to happen if I transition? What's going to happen if I back down on my my to part time status and then fully get behind your decision to say I took all the information I had and I made the best decision with the information I had and now I'm going to fully support myself. And what I see when I see clients going through these big decisions, and I've had several clients just recently go through some big transitions when they recognize they do have agency, they don't have to be stuck. It's like this deep breath that they take and I can kind of see the tension rolling off their shoulders and I'm like, okay, the light bulb has gone off. I have the power to make change if I so desire.

Yes. And often women in medicine feel that they have no agency, which is not a safe place to be. And if that's something that you felt and it stayed with you, support is definitely a life changer because we sometimes need to borrow belief from someone else before we have it ourselves. And that's how we move forward. We don't want anyone feeling that they're stuck. More so than, than the reality there's, without minimizing the facts that things do happen, but the reminder of there's always options and the possibilities. And frequently when we're in that place, when we feel like we have no agency or it's on and off, support can make a difference. Having someone like Erin was saying help you see what else is out there for you. And again, we want to avoid getting to burnout or depression or anxiety or that learned helplessness that so often unfortunately we feel. So thank you for bringing all this important information Erin, anything that you would want to add to our audience?

Not only is support so powerful, it's also about the timing of support. And Joanne and I have shared women physicians and healthcare providers have such a high pain tolerance. We function so well even when things are falling apart. And my biggest encouragement is ask for help early and often. And it's amazing how much weight you will relieve on yourself by practicing asking for help. Not just asking it once and then saying, oh, I'm good, but getting more comfortable with it, practicing it more frequently, more often, and see what even the energy you might have to then. As I shared before, your brain doesn't want to make change. So by asking for that help, it might boost your energy, which is going to help you then step into taking that agency and letting go of the things that aren't serving you.

Thank you. I am so glad that we're having this conversation. And if there is someone in your life that you know might have struggled through this or has said things like, I'm exhausted, I'm stuck, share this episode with them. Help us also be in front of more people. We're here to serve. And with that, stay tuned because our next episode is coming right up.

Do you want exclusive resources and the opportunity to connect with us? Then visit createmeaninginmedicine.com now, where you'll dive deeper into how you can create meaning in medicine. And if you're serious about optimizing your results, take two quick steps now. Number one, connect with us on the website. And number two, tune in to the next episode.