Navigating Burnout and Promoting Well-being in Healthcare with Dr. Megan Melo (#005)
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[00:00:00] Megan, thank you so much for being here on the podcast. It's incredible to meet you. To begin with, I'd just love to hear a little bit more about how you got into healthcare and just maybe why it is that you chose this as a career for yourself. Yeah, thank you so much for having me.
[00:00:16] I'm a family and obesity medicine physician and practicing in Seattle, Washington, and I'm one of the type that grew up wanting to be a doctor. Ironically, I am the daughter of two nurses and the granddaughter of a nurse and I've got a smattering of other healthcare professionals in my family.
[00:00:35] I joked the rest of them were hypochondriacs, but that's a different story.
[00:00:41] But from a very young age, I grew up really admiring my family doctor who took care of everybody in the family, seemed to know everything was just really kind. And I really absolutely wanted to do the same. And I considered other career paths such as teaching. I was also an English major, so I [00:01:00] always really loved writing and literature, but ultimately I knew what I wanted to do was to take care of people.
[00:01:06] And so I had a very, I don't know what I look back on now is a very stereotypical pine sky kind of imagination about what doctoring would be. I still love many parts of being a physician and really consciously choose to still practice, things have shifted as we'll get into in terms of what is it actually like to be a physician, be a part of healthcare there's a lot of struggles.
[00:01:32] So share with me a little bit about how that has shifted for you and what kinds of things are you noticing that have maybe, robbed some of the joy from you on being a practicing physician. Yeah, I think none of us really expects the level of burden that can come along with being responsible for people and the way that health care is set up right now, there's a lot [00:02:00] more commercial pressures than there have ever been.
[00:02:02] And I don't know how true that is in Canada, but in the United States. Not only are we being judged on quality metrics, and using evidence based medicine and, taking excellent medical care of our patients, but we've got so many additional sort of customer service pressures wanting to be well rated by patients wanting to make sure that we are cost effective.
[00:02:24] And yet also having patients, coming in and having expectations that they can request a full body MRI, or some kind of non evidence based care. And so there's this very. real tension that can develop there. And each room that you go into to take care of patients is a little bit different, right?
[00:02:44] You might have somebody in one room who is dealing with extreme stress and chronic disease and really, doesn't have a lot of resources and you might go into the next room and. somebody in there is, expecting [00:03:00] a lot of care that might not be appropriate. Since there's a lot of juggling of these things.
[00:03:06] And, a lot of these business pressures of customer service and making sure that you're on time. And somehow satisfying the patient's desires, but also, staying within the bounds of, a 15 or 20 minute visit, a lot of things going on. Yeah, I would say that Canada we wouldn't define them probably as commercial pressures, but we still have the same kinds of pressures that you're describing as well.
[00:03:32] And obviously, I can't speak from a physician's perspective, but what I can say is that. There is a constant pressure coming from government in terms of the way that we the Ministry of Health, making sure that we're adhering to the way that their perception and vision of patient care is. Then of course, there's the patient's perspective on what it is that they're receiving and whether or not they're getting the kind of care that they feel they need and deserve.
[00:03:58] And then of course, there's just [00:04:00] the reality of The, the inventory on the shelf in terms of how many people we have to provide all of that. And it's just, woefully less than what the demand is that we're way out of whack with the supply and demand, the amount of patient interactions that physicians are being expected to have as well as nurses, clinical leaders, et cetera, is just incredibly high.
[00:04:24] And so one of the big questions we are wrestling with here that I'm curious about your perspective on is. What do you do? I didn't hear how you manage yourself and all of that, because you're a human being at the end of the day. And so I'm curious, how are you juggling all of that and taking care of yourself in the middle of all of that?
[00:04:42] Yeah. I'll tell you, part of my story is very much that I wasn't taking care of myself in the middle of all that for a lot of years, too many years and going through kind of repetitive cycles of burnout. And each time I, would have to step back and take a break and that looks different ways at different times.[00:05:00]
[00:05:00] But I'll tell you that for a lot of it, each time I came back to work, I tried to toughen myself up. I tried to armor up as Brene Brown says where. It's okay, I just have to work a little harder. I have to, be a little firmer on these things. I just have to suck it up.
[00:05:17] And that was not a terribly helpful strategy, but I also didn't see other options at the time. Ultimately when I participated and received coaching. And coaching by a physician, I was really able to see how my own thoughts and feelings about circumstances occurring were contributing to this pressure I was putting on myself, as physicians, we're high achievers, right?
[00:05:45] So we can drive ourselves harder and harder. But there's still limits to what we can handle as human beings, and it's not a terribly successful strategy, when we get to a certain level there's only so much sleep [00:06:00] deprivation, we can have, there's only so much, denying our emotions we can have and you see that manifest in physicians as Cynicism, as numbing out with alcohol or Netflix or overworking and, trying to avoid difficult emotions.
[00:06:18] It looks a lot of different ways. The stereotypical surgeon who starts throwing instruments in the O. R. when they're upset. All of these are different manifestations of burnout and, a human being who's really being pushed to the limits again and again. So once I was able to really see those connections, I can still 100 percent recognize that our medical systems are very broken, but I now see it as.
[00:06:46] Necessary for me to take care of myself for me to tune into my emotional state to me to recognize when I'm getting, triggered or overwhelmed or, pushing myself harder and to dial it [00:07:00] back and say, this is too much. This doesn't feel good. What parts of me are people pleasing?
[00:07:07] What parts of me are thinking that I can't make mistakes or I can't take a break or say, I don't know, and really leaning into that as part of self care. It's not bubble baths and massages, although I love those things, right? Being in tune with my emotions and my thoughts. And that's what I teach to other people as I coach.
[00:07:26] SO I love what you're sharing in terms of that coaching space. One of the things that I know I've experienced as an executive leader, but also as a professional coach too, is that there's a lot of magic that can happen in a safe space when it's created. And what you're describing is that you're learning how to, first of all, generate that.
[00:07:47] For yourself in the middle of a chaotic system, and then also coach others with that, too. And so I'm curious if you had to, lean into a step by step or sort of a paint by numbers[00:08:00] what is a safe space? And how are you creating that for yourself and for others? , it's a great question and a big question.
[00:08:09] I think that many of us as physicians have come to feel that if something is not going right for the patient, That it is our lack of knowledge, skills or expertise that is causing the problem and that can include a metastatic cancer or some kind of surgery or uncontrolled high blood pressure.
[00:08:35] And really, when we look at the literature, when we look at what is out there. It's actually a very small amount of the medical care that contributes to the health of our patients. So we tend to flip the numbers, but my influence on my patients accounts for something like 20 percent of the outcomes of their health, whereas things about them and what they do and [00:09:00] don't do and have in their lives counts for about 80 percent of their health.
[00:09:05] But I think most physicians would assume and we're trained to believe that it's 99 percent me that's responsible for their health and like 1 percent them, right? There was a study that I talk about a lot in that came out in medical economics last year in August. that showed that a primary care physician, for example, needs 26.
[00:09:25] 7 hours per day per 24 hour day to take full care of their full patient panel. So acute care visits, chronic care visits, vaccines, preventative care. So you've figured out how to add another four or five hours into the day and the day, right? There's no time to eat, sleep, none of that.
[00:09:46] I think for me, And, what helps to break into physicians minds is that when we can recognize that it's already impossible, to do all the things that we think we're responsible [00:10:00] for, we can start to dial down that over responsibility. And to see our jobs is different.
[00:10:07] Now, of course, there are circumstances, right? There are medical emergencies. There's, complex surgery there, there's a number of things that are very highly technical, detailed, extreme circumstances. And that's a little bit different, but a lot of the care that we're providing is not that extreme.
[00:10:25] And even if we are providing that extreme care, we need to take really great care of ourselves to show up and perform at a high level. And reframing some of these ideas for people is really important as part of their healing. Because so many of us have internalized these ideas that like we are a hundred percent responsible.
[00:10:47] We are highly if our patients are not getting better, it's our fault. When you know much of the time things are out of our control for a number of reasons, right? That's the process in that patient's body. [00:11:00] It's you know, their ability to participate in their treatment. It's you know, how soon they showed up for care.
[00:11:06] It's you know, what resources their family has. It's socioeconomic factor. Like it's just so much that goes into the majority of their outcomes. Yeah, you're describing a really interesting trend that I've noticed in health care. I've noticed that there's this really pervasive belief system where if I had to describe it really bluntly, people think that if they sacrifice themselves, that somehow that's going to be really helpful for the people that they're trying to help
[00:11:31] What I noticed is that there's so many responsibilities that people are abdicating to take care of themselves, and then they're using all that energy to try and take responsibility for things that they're completely powerless over, like you're describing.
[00:11:45] Other people, whether or not people even take their medication that they have prescribed, which I know is statistically low. I'm just thinking, I'm trying to remember that. It's probably freakishly low. I have no idea actually. I come to you as a doctor and I say, okay what do I need to do?
[00:11:58] And then it's like a [00:12:00] very low percentage of people actually. take the prescription. So of course you're powerless over what somebody is going to do. And so when you think about those self care responsibilities and start to go, okay if I let go of all of that energy and responsibility that I am taking inappropriately, and I can refocus my energy to.
[00:12:23] Create a safe space for myself to take care of myself to say no when I want to say no and say yes, but I want to say yes, even simply is that what are some of those decisions that you've made to take responsibility for yourself that have really served you? Yeah, it's a great question. I think, it's an evolving process, but I have been giving myself permission more to decide this is not something that I'm going to take on when there is a situation that is more complex than I'm trained to handle or [00:13:00] I that I recognize can be better handled by somebody else.
[00:13:03] I is the primary care provider and choosing to say. Thank You know, what we're going to do next is we're going to pass you on to, this person who has more expertise and that is a real change because. And, of course, there's privilege involved with that, right? Because I'm assuming that we're going to be able to connect them with a specialist, which has actually been more complicated than the last several years in particular, as our healthcare systems have been quite strained, but I can spend a lot of time and energy trying to figure out what the next steps are for something that I'm not expert in.
[00:13:37] Thank you. Or I can choose to start passing them on right to somebody who has that expertise and can take care of this in a much more efficient way. It's not always what my patient would want, but it allows me to show up every day and function in the primary care role when I know that I'm out of my wheelhouse.
[00:13:56] And I need someone else. The system that I trained in [00:14:00] very much wanted us to hold on to as much as possible. And so I very much had that mindset of I have to do all of the things. And I was providing really birth to death care, including deliveries for about 11 years. And parts of that I loved, but I realized looking back how much extra burden I was putting on myself rather than.
[00:14:19] getting help from people who are highly trained in, whatever the condition was. So there's some elements of that. There's some elements as well of choosing to be okay with disappointing other people in order to take care of myself and set boundaries. I'm going to disappoint people. I'm going to say no to people who are kind and really have a lot of trust in me.
[00:14:42] And, some people who are maybe not presenting as well. bUt that's one reason that many of us struggle so much with boundaries is it's not that we think boundaries are a bad idea, but when we start to practice boundaries, especially if we've been somebody who, doesn't operate that way.[00:15:00]
[00:15:00] We will run into people who we are disappointing. We are not meeting their expectations. They were hoping that I would handle everything and give them what they want and what they think they need. I'm choosing to say now, in my medical opinion, this is not justified, or this is not something that I offer, or, I'm happy to connect you with so and but that's not going to be, that's not going to be something that I do.
[00:15:23] I'm not going to order that for you. So choosing and being willing to tolerate, disappointing other people is also part of self care. And I'd rather choose that discomfort than that frustration, resentment that would come if I'm doing something that I don't feel is right, or, isn't within my scope.
[00:15:43] Not to mention the physical reality that burnout is going to have a huge negative impact on your life. In every way that you can imagine. So let's shift gears a little bit. I'm curious about how you apply what you just described. You've been talking about patient care and that direct [00:16:00] interaction.
[00:16:00] Now shift it over to the system and some of the work that you're doing with teams and people inside of that system to provide that care. What are you noticing about that kind of a space and your intentional creation of a safe space there. Yeah. Yeah. And it's actually interesting. I used to work as what they called a wellness champion inside a major organization, trying to lead wellness activities for physicians.
[00:16:28] And that was a very frustrating experience because I didn't have any agency to actually be able to make changes for people because When you talk to physicians and health care providers, in the trenches, of course, they'll point to all the system issues coming up, the very legitimate system issues that make their lives hard.
[00:16:47] I decided for me that I no longer was going to focus on that. I'm going to acknowledge fully that the system is very challenging. It has gotten much worse during the pandemic in a lot of places, especially with staffing [00:17:00] shortages. Not only have physicians and, allied health professionals left, but we've, we're also mostly working with really short staff supplies, right?
[00:17:08] And so everyone's being pushed to their limit because of that. What I focus on now, though, is the individual. I focus on individual people and how we can create safety for them, even working in a broken system. Certainly not in a toxic, abusive environment, if that's what they're in, then we're going to be coming up with an exit strategy and building psychological safety for them, as we do that.
[00:17:34] But I want individual physicians and providers to know that they don't have to continue to feel overwhelmed. Frustrated, angry, resentful, cynical, that they can choose to step back from that to start, learning about the connection between their thoughts and their feelings, really start to untangle some of that mess as we've described and learn how to set [00:18:00] boundaries to be able to operate in that broken system if they choose to.
[00:18:04] Because that's really, I think we need that groundswell of people standing up. Against the dominant culture, and being able to take care of themselves and that idea of radical self care despite. All the stuff. Yeah, you're for me, you're describing the difference between an external safety and an internal safety.
[00:18:28] And I, I also want to acknowledge the way that you're doing something that's really counter intellectual in our system, which is to start with one person. Rather than looking at how, Oh, how are we going to scale this across thousands of people? No, it's actually about one conversation with one person at a time.
[00:18:44] And and it's not external safety. In other words, I got to try and control the environment to make me feel safe. It's to shift that to an agency inside of ourselves that says, no, actually I can generate a safe space right now for me. In the way that [00:19:00] I show up by, by recognizing the choices and the efficacy of those choices in this moment.
[00:19:06] So I'm curious now when you look at that one person at a time approach, like you're describing, what kinds of results has that created that are tangible and that you can see. Yeah, it's really interesting. And a variety of things. A lot of people come to me and they're like, I have to leave my job.
[00:19:26] I hate it. I have to get out. I don't know what I'm going to do. And I hold space for that. But I also say, we're going to focus on though, is really helping you to feel better right now, right where you are. So that you can make a clean decision about whether you want to stay or go, right?
[00:19:42] And this looks different for different people. For some people, it's getting, unstuck from the burden of the charting administration sort of work that we do on the back end that many physicians are doing for hours each night after the patients are gone, the kids are in bed, so called pajama [00:20:00] time.
[00:20:00] That is so much a part of burnout. I'll tell you. I used to send a message to the specialist, like at nine o'clock at night, right? Asking them a clinical question. And I get a response back at nine 30, which told me that they were also doing the pajama time, right? I was like, this is so wrong, , right?
[00:20:17] We're spending so much time. Trying to find ways like let's unburden. This so that your administration, your note taking your inbox management is primarily done during the clinical hours that you work, which is a huge thing that has to reduce, the burden of stuff.
[00:20:36] We are also working on being able to set boundaries, right? Really being able to say no. When they want to say no, to be able to say, no, I, I can't take an extra person today. Like I can't squeeze an extra person in, no, we're not going to be able to do, the 15 things that are on your list.
[00:20:56] We're only going to be able to address these two. And [00:21:00] speaking very clearly that it's not the physician as an individual who You know, deciding that they're not going to be kind enough to address all of the concerns of the patient. It's really us as the physician recognizing, what we've been granted in terms of the amount of time and resources that we have to spend with that patient.
[00:21:21] If people are upset that we're rushing them through the visits, they need to speak up and say, the time that I get with my provider is not enough rather than blame the provider. Most of us would choose to spend more time, have fewer patients, right? Really build the quality of connection there.
[00:21:42] And we are not granted that we don't have control over that. We don't have control over the schedules that are booked 6 to 8 months out. There's a lot of factors there that people often ascribe to us that aren't true. But so I work with the physician to really. [00:22:00] Dial down their anxiety down, dial down their responsibility for things that aren't their fault, teach them how to work within the bounds of, what they've got to recognize that they're not a personal failure for not being able to fix all the ills of our health care system or address all the health conditions.
[00:22:17] It's a lot of mental work. It makes a huge difference and I'll tell you most people will end up staying in their role But they'll show up differently. They'll show up feeling much better I had somebody who routinely had 90 open patient charts. She had so much Uncompleted work and now she closes her notes every single day.
[00:22:41] She leaves at 5 She's out the door. Her work is done. And that was a mental shift. It was, I didn't teach her how to do anything fancy with her charts. She needed to decide that she was worth it, and that she didn't owe her patients all the extra hours that she was spending. [00:23:00] Yeah. The tyranny of the to do list is that there is never any end to the to do list.
[00:23:05] You take care of one illness, there's 50 more waiting. yeAh. I'm curious what you would love to share with both executives and clinical leaders, because one of the things that I or the groups of people that I work with a lot are these executives and that are a little bit detached from the frontline point of care.
[00:23:26] And then there's the clinical leaders who are trying to bridge between the point of care and The management and leadership, and that is often a really tough position for those folks to be in trying to bridge. And I was talking to one clinical educator that was talking to me and I described, yeah, you guys are in a really tough position because of that being that bridge.
[00:23:47] And she goes a bridge. I would love it if we were a bridge. I feel more like we're being crushed between the two. So I'm curious from a physician's perspective, what would you like to share with both the clinical leaders in the in between [00:24:00] and also the executive leadership? Yeah, that's a great question.
[00:24:04] I think what I would like to share is helping leaders to understand the burdens that physicians feel that don't match with kind of the business or corporate sort of outcomes that are quite pervasive. It seems to me like there is this mindset that increasing the number of patients we see is an easy task.
[00:24:39] And for so many reasons, it's not because I'm not producing widgets. I am establishing a relationship, a therapeutic relationship with my patient who even if they've been told, that they can come in and address one thing, they still have their list and they still will push it on me. And I, as the [00:25:00] caring professional, we'll address what I can, but then there's often this extra thing that sneaks.
[00:25:06] And by the way, I'm having chest pain. Is that a concern? And that's the hand on the door question. There's all of these things that happen or. I'll tell you, I, I had a patient of mine that I was seeing and she was in for a blood pressure follow up. I walked in, expecting it to be a routine visit.
[00:25:23] She shared with me that her brother had shot himself in the head the day before in front of her to commit suicide after having metastatic cancer. She didn't tell my medical assistant that she didn't cancel the appointment. She knew that I would sit and listen with her. That kind of thing happens all the time in healthcare.
[00:25:46] So we might look at a schedule and I'm talking about outpatient medicine here, right? Go and look at a schedule and be like, Oh, there's some well child visits. There's some, this, there's some, this, there's some very simple blood pressure follow ups. I never know what's going to [00:26:00] explode in the room.
[00:26:00] And so when you tell me that I need to see more patients, and I know that's the reality of what I'm walking into, There's a huge mismatch between that sort of widgetization of care and what the humans in the room. Experience. Yeah, I'm so glad you're bringing this up because I think that the system is filled with human beings and we forget that we're talking about human service and to your point, the complexity of what a human being is going to need for me in this moment is really difficult to equate.
[00:26:38] And I wonder What do we create so that we can be more connected to the humanity of what it is we're doing everywhere in the organization rather than just at the point of care where you're experiencing it? Yeah, I don't know the answer to that, to be honest. But I think [00:27:00] it's going to, it's going to be a shift away from thinking that we can very cleanly and easily predict the needs of the patients.
[00:27:10] Thanks. beforehand, because right now we don't do a very good job of that. We have lots of mechanisms that we try and call in advance. We try and, ask patients why they're coming in. We, all sorts of things. And there's a number of reasons why we don't know in advance. What's going to happen.
[00:27:29] And so I think we can be prepared to be flexible. I think that we can trust that the physicians and the health care providers going into the rooms are going to do the right thing. But we also have to support. That they are humans in the room as well, right? That they are hearing and dealing with difficult circumstances as secondary secondary trauma, some survivors sometimes, right?
[00:27:59] I'm hearing a [00:28:00] lot of terrible stories, difficult circumstances, and not always having the resources to help if we better equipped. Those frontline providers with resources that they need so that they can quickly pull in a social worker or, somebody to help support with financial assistance or, pharmacist to review medications when we have those kinds of tools and we have flexibility.
[00:28:25] We are much better able to take holistic care of our patients and meet their needs, but so often the way that health insurance plans, they're set up and this might be a little bit different in Canada. Those additional services are not directly reimbursed and so they're considered as unnecessary expenses and it's all put on physicians and healthcare providers.
[00:28:46] We have to get away from that. Yeah. Yeah. I also, what I wonder about too is the the reality of how systemic trauma, whether it's primary or secondary actually [00:29:00] is affecting everybody in the system. So you've got this leader who's driven by profit and widgets and disconnected metrics and metrics that they are actually.
[00:29:13] Just as affected by the systemic trauma that's coming through as well. They just may not be aware of it. And so one of the things that we've tried to do in different ways here in Canada is to invite leaders and executives to engage with the front line and to recognize and acknowledge how that trauma might be affecting them.
[00:29:35] And also. Develop relationships with people that are on the front end too, so that they, start to have humanity inform their decisions back in the boardroom. We find, I think that's one part of, obviously this is a complex problem, but I think if we can connect human beings to one another to start to develop relationship, then things can begin to [00:30:00] change in some way.
[00:30:01] Yeah, and it's messy work and it involves emotions and emotional resilience and, I think we completely underestimate the degree of trauma that all of us have experienced, right? We tend to still think of trauma as, related to extreme circumstances assaults, abuse, war car accident, things like that, but there's so much trauma that's related to Unsafe relationships and unrealistic pressures and moral injury and, any number of circumstances that are very real.
[00:30:36] Yes, you can absolutely talk to leaders who feel so pressured to help physicians and providers that they see suffering and other professionals, but don't feel like they have the leverage to be able to do it because they've got these metrics. There's a lot of impossible asks. That are coming down from, again, more corporate and more system levels that are [00:31:00] putting a necessary burden on people and, it's major part of why people leave.
[00:31:05] tO your point I think that it's the same, there's some simple, system inputs around. Recognizing the responsibility that we each have to take care of ourselves and take responsibility for. I get it. The kind of pressure you're describing that an executive feels. I understand the fear and it's not their fault.
[00:31:25] And it's also their responsibility to, and and I don't mean it's the responsibility to change the external so much as it's their responsibility to recognize the way that they're showing up with that and whether or not that's serving them and the larger system or not. And I think. I think that, it's a fair inquiry to do.
[00:31:45] And when the culture, whether the culture within the leadership or, the culture with, amongst physicians or, the healthcare professionals on the front line is that we suck it up and pretend like it didn't have, pretend we're not having emotions that is not working.[00:32:00]
[00:32:00] I would say. But, everybody feel, is feeling like they have to keep it buttoned up because they see everybody else keeping it buttoned up and they question, I don't even know if other people are experiencing this because no one will talk about it. They are. All you have to do is look at the chronic burnout, the chronic distress, the.
[00:32:18] The absenteeism, the fact that people are leaving health care after they spent the last 15 years developing a career because they're trying to survive. This is real. This is happening. It's real. Yeah, it's real. It's it's toxic. It kills people sometimes, it kills people. Quickly in the names of, accidents and suicides, and it kills people slowly in terms of the burden of, this chronic severe stress, that then contributes to, other kind of chronic illnesses, right?
[00:32:44] Anxiety, depression, heart disease, diabetes, all of these migraines, all of these things. Yeah, so I find myself curious about the beginning of your sort of origin story and how you shared about the influence of your family and nursing [00:33:00] on your choice of career. So I know I have a lot of clinical nurses and nurse leaders that listened as well.
[00:33:07] I'm curious, how has nursing informed or contributed to your practice as a physician? This will surprise no one who works as a nurse or a nurse leader. It absolutely fed into my thinking that like my job is to serve everyone and put everyone first above myself. So my mom was an RN and most of her career was spent in clinical leadership roles, and managing departments.
[00:33:35] My dad was a nurse practitioner. CRNA. So a nursing anesthesiologist and both of them, I saw not taking care of themselves putting others first working so hard with that mindset of, I just need to get to retirement, and that's when I can enjoy myself. A lot of numbing behaviors a lot of frustration, a lot of, kind of resentment and there.
[00:33:58] They're lovely, wonderful people.[00:34:00] But that absolutely informed what I thought was the way to do things. And... It's honestly led to some disruption in relationships, on, on the other side because one is absolutely taking care of themselves now and the other one is absolutely not and has, deteriorated and, it just highlights for me the critical importance of learning how to take care of ourselves. Yes, we need better systems, but even if our systems are better, if those of us who are working now don't learn to recognize that we need to be taking care of ourselves, that we need to put ourselves on our list.
[00:34:44] The external can't change us. Yeah. EvEn if our employer comes to us and says, you've been working really hard, you seem stressed have a month off. If we don't make any changes, we might get to rest some during that [00:35:00] month off, but we will come back, extremely stressed and worried and anxious about returning to exactly what we left and maybe more because there's often work piled up waiting for us.
[00:35:11] Yeah. Absolutely. Absolutely. Megan. Thank you so much for that. How can people get in touch with you if they'd like to reach out and connect with you? How can your work get accessed by others? Yeah. So I have a website, which is www. healthierforgood. com. There's links on there to connect with me and have a one on one discussion.
[00:35:33] There's links on there from my blog and my podcast. My podcast is called Ending Physician Overwhelm and I share a lot of these insights and kind of self care and thinking about perfectionism and people pleasing and lack of boundaries and how that contributes to burnout as well as feature physician guests who are sharing their stories.
[00:35:53] And a lot of people, tell me that it really resonates with them to [00:36:00] hear the different challenges that they're going through reflected in, what is shared on that podcast. And so again, that's ending physician overwhelm. And so I'd love to hear from people. Absolutely. Thank you so much for your time, Megan.
[00:36:13] I really appreciate you. What's one thing that you'd like to leave everyone with that you feel, is important for people to remember? There is, there's so many things, right? I think just one thing, the meaning of life in one sentence. No, I'm just kidding. Yeah. There is a difference between excellence and Perfectionism and what drives excellence right is a desire to, show up and do the best work that you can and recognizing that we're all imperfect humans.
[00:36:51] But what drives perfectionism, however, is really ultimately shame avoidance. This idea that if I am perfect [00:37:00] enough, if I, smile enough, if I know enough, if I speak a certain way, thank you. Expertly enough that I can avoid criticism, disappointing others bad outcomes, mistakes.
[00:37:14] I can avoid all of it. And people won't know how I feel inside. I'll just I'll be considered good enough. And I think that's really important to understand because when we're talking about perfectionism, often people think the options are either that I'm perfect or I'm sloppy or lazy, and there is absolutely a difference.
[00:37:35] I strive to provide excellent medical care, but I know that I'm not perfect. And I know that I can't do it all. And I can't do it alone. And our systems. Put limits on, what is available to people. And when I can really hold on to that, then I get unstuck from this idea that I'm not enough.
[00:37:57] Thank you for that. Thank you for that. [00:38:00] It's been wonderful to be with you, and I wish you all the best in your work. Thank you so much. Yeah. Thanks, Megan.
