Hey! Let's Ask Dr. Joe Sherman About Healthcare Workers and Burnout - S03E11

On this week’s show Kristin and I are talking to Dr. Joe Sherman a pediatrician, coach and consultant to physicians and healthcare organizations who helps healthcare professionals find the joy in their work, survive and hopefully thrive in their careers.

Dr. Sherman helps healthcare professionals transform their relationship with the unrelenting demands of their jobs and discover a path toward meaning, professional fulfillment, and career longevity. He believes the key to personal and professional success lies in bringing “soul to role” in your medical practice. Dr. Sherman is a consultant to physicians and healthcare organizations in the areas of cross-cultural medicine, leadership, and provider well-being.  He is a facilitator with the Center for Courage & Renewal and a Master Certified Physician Development Coach with the Physician Coaching Institute. 

Dr. Sherman has been in pediatric practice for over 35 years concentrating on healthcare delivery to underserved and medically complex children in the District of Columbia, Tacoma, Seattle, Uganda, and Bolivia.  He has held numerous faculty positions and is currently Clinical Associate Professor of Pediatrics at the University of Washington.

You can reach Dr. Sherman at joe@joeshermanmd.com

JoeShermanMD.com
Kristin's Website
Ralph's Linktree

DISCALIMER:
The views expressed on the Hey Let Me Ask You Something Podcast are solely the opinions of your hosts Kristin Wood and Ralph Andracchio and are based on their years of practical and clinical experience. These opinions do not constitute any kind of advice, diagnosis, or treatment of any mental, physical, or emotional issues. If you are having an emergency or any serious ongoing situations please contact your local hospital or a trusted professional.

Transcript

The Hey Let Me Ask You Something Podcast
Season 03
Episode 11
Hey! Let's Ask Dr. Joe Sherman About Healthcare Workers and Burnout

[MUSIC INTRO PLAYS]

Ralph Andracchio  
You found The Hey Let Me Ask You Something Podcast the show dedicated to inspiring more people to ask more questions and have more interesting conversations. On this week's show. Kristin and I are talking to Dr. Joe Sherman, a pediatrician, coach and consultant to physicians and healthcare organizations, who helps healthcare professionals find the joy in their work, survive and hopefully thrive in their careers. 

Dr. Joe Sherman  
We are programmed to believe that boundaries are self centered boundaries are selfish boundaries are for weak people. And the reality is that if we set boundaries, we become better healthcare providers. If we set boundaries so that we can actually say No, I have to leave at this time to get home to my family. Then we come back renewed and refreshed. 

Ralph Andracchio  
The best way for you to help us inspire more conversations and easily find more of our killer episodes is to hit that subscribe button and share this show with your friends. And check us out on YouTube if you want to see us as well as hear us. And remember, we love that you're listening but this show is for entertainment and we are not your therapist or your coach. We are not providing professional advice from either us or our guests. Give the full disclaimer in the show notes a once over for more info on that Alright my friends. Let's start the conversation

Kristin Wood  
Am I sitting too close? Am I alright?

Ralph Andracchio  
Do you feel like you're sitting too close to me?

Kristin Wood  
I don't. I like to be close to you Ralph.

Ralph Andracchio  
Alright good. Well, then that's because you've been in Florida this whole time. 

Kristin Wood  
I know I brought the sunshine. And a tan that's already fading. 

Ralph Andracchio  
There is no sun here. Do you Did you forget to unpack it?

Kristin Wood  
I know I did when I first got here because I flew in on Friday night. And it was 75 Still at eight o'clock when I got here. I was like yes. And then it was like Saturday. Beautiful. I was like yes, Sunday not beautiful felt freezing cold. At 55. And I was like oh reality.

Ralph Andracchio  
Mm hmm. Yeah. And it's been that way ever since. So. 

Kristin Wood  
Yeah, but I missed seeing you in person

Ralph Andracchio  
Yeah, no, I missed you too. And I've been this past week. I've started my exercise routine again. I do a lot of Apple Fitness plug Apple if you're listening. I could use some free anything from Apple. But I'm I hurt and I can't move a lot. So 

Kristin Wood  
Yeah that's tough when you start out it feels good. But it's so good right. 

Ralph Andracchio  
Yeah. And I'm not I'm not overdoing it. I'm taking my time I'm starting small but even starting small My body's like what

Kristin Wood  
What happened? Where's that winner?

Ralph Andracchio  
Are we still in the cave? Yeah. No, I but it's all for a good because I've I'm not ashamed to say I think I've gained like 20 pounds 

Kristin Wood  
Really? 

Ralph Andracchio  
Yeah. 

Kristin Wood  
I don't see 20 pounds on you. 

Ralph Andracchio  
Well you're a saint. I appreciate you and everything. But you're a liar. No, I hide it. Well, it's all it's all in my legs and my feet. It's all in my cankles

Kristin Wood  
Your cankles? Oh, yeah, I did notice those. 

Ralph Andracchio  
Thank you. But speaking of health, see how I did that? 

Kristin Wood  
Oh, every time 

Ralph Andracchio  
Every every time 

Kristin Wood  
Sometimes I do it, and I'm very impressed with myself.

Ralph Andracchio  
Sometimes you do it, but this time I'm doing it. We have a really great guest on today. I don't know how we snagged him. He's slumming it today for our little dog and pony show. Today we have on Dr. Joe Sherman. He is a pediatrician, a coach and a consultant to physicians and healthcare organizations in the areas of cross cultural medicine, leadership and provider wellbeing. He is a facilitator with the Center for Courage and Renewal and a master certified physician development coach with the Physician Coaching Institute. My god leave some for the rest of us. Dr. Sherman helps healthcare professionals transform their relationship with the unrelenting demands of their jobs and discover a path forward toward meaning, professional fulfillment, and career longevity. Dr. Joe Sherman, thank you for being here today.

Dr. Joe Sherman  
Thanks for having me. I appreciate it.

Ralph Andracchio  
We appreciate you. My goodness, that is quite the resume that you have there.

Dr. Joe Sherman  
Well, very flowery words, to say that I try to help healthcare providers survive and hopefully thrive.

Ralph Andracchio  
Yeah, that and that's one of the reasons I wanted to have you on the show we met. We were connected by a mutual connection in the networking world and the first conversation I had with you was fascinating because I've never met somebody who does what you do, which is like in a nutshell, generally help physicians or people in the medical world with like, enjoy their job better and handle stress and like bedside manner and all that stuff. And I know Kristin and I, we've talked about that a little bit on the show.

Kristin Wood  
Yeah, you've been you have to have been even more busy than ever the past two years. I can't even imagine. I mean, it's already a stressful line of work. But given COVID Probably was like, on steroids in that way, like trying to deal with all that.

Dr. Joe Sherman  
Yeah, yeah, it was mean surprisingly, at the beginning of the pandemic. It was there were like two groups of, of healthcare providers. There were the ones that were on the frontlines kind of every day, working their butts off trying to do everything they possibly could to keep up with everything. And then it was the other group that was on the sidelines. All of the ones that were in primary care, ones that did elective procedures and surgeries. They were kind of like off to the side. So their concern actually was income and how to keep their staff paid and in those types of things. So there were different stressors for different groups.

Ralph Andracchio  
How much of an impact I know people have seen maybe seen numbers and statistics on the evening news, but I don't know if you can shed any more light into like how big of an impact COVID really has had on the medical field in the United States?

Kristin Wood  
That's a big question.

Dr. Joe Sherman  
I can say that the area that I'm primarily concerned about which is the well being of healthcare providers, as far as the impact of that even before the pandemic, there are surveys that are done for for physicians across the board of all medical specialties. And there was a burnout rate that people who are physicians in clinical practice who self report as being burned out was a burnout rate that was somewhere close to 40%. That was before the pandemic, and now, after the pandemic or at the tail end of the pandemic or whatever you want to say we are I don't know limbo? That number has increased to as high in some specialties as high as 60%. So that's saying, you know, and I would say the average somewhere in between somewhere between about 43 to 60%, somewhere in there. So that means these are practicing physicians. That means that as you go in, either to see your primary care provider, or into a hospital or definitely an emergency room, those specialists at the top of the list for burnout then for emergency room, about 60% of those people who are attending to you have already said that they're burned out or done. So it's pretty dramatic.

Ralph Andracchio  
Is there a well, maybe let me say it this way. Before COVID. Was there a shortage? I'm or is it the way the system set up? Why do you think there's so much self reported burnout in the medical care field?

Dr. Joe Sherman  
Yeah, I think what's I think most important is kind of defining what we mean by burnout because people have different ideas. And, and frankly, I think it's kind of an overused term, I think. But there's classically it's actually in the DSM five or whatever is a diagnosis, which is the manual that health that behavioral health professionals use. But there are three components of it. The first component is emotional exhaustion. So this is emotional exhaustion of just being involved so much and so much kind of like traumatic types. of interactions that you're emotionally exhausted. The second component of it is depersonalization and dissociation. It means that as you're doing your job, all of a sudden you're no longer having that meaningful relationship with the patient. You're basically just kind of like mailing it in you're just going through the process going through the motions of just doing your job. And then the third component of it is this lack of a sense of meaning or purpose in your work. So if you think about being emotionally exhausted, going through the motions and really feeling like you're, you doesn't, you're not making any difference anyway. That's what's going on with a lot of health care providers now. And the and what's happened is during the pandemic, the big difference now is that there is this new component of all of this of, of the public, the general public who is just fatigued by the whole COVID pandemic thing. A lot of times they're turning on the health care providers themselves. So something now that health care providers report a lot. Is this. This abuse, they would say, either verbal abuse or whatever, by the patient's themselves, and everyone's frustrated and health care providers are an easy target for to get your frustrations out on.

Kristin Wood  
Yeah, Yeah, I was I was thinking with my therapist had on that, that when you went through that definition, which I probably should know if it's in the DSM five, but

Ralph Andracchio  
There will be a test later

Kristin Wood  
Yeah right. No, I didn't know it that well, like you just explained it nicely, but I think the second part of it to me sounds like a defense mechanism too that if you're having all that emotional trauma that you're walking around with, then disassociate and just go through the motions as a protected To me that's what's spoke to me, so protective thing, and then it's all connected, right? And then if you're doing that, because you're emotionally traumatized, then you're not getting any joy or purpose out of your work because you're missing that personalization that you mentioned, and maybe as much attention to the relationship piece as you were prior.

Dr. Joe Sherman  
Yeah, I would say that is exactly correct. I think it's almost like right now what we're seeing is burnout. And part of the burnout is this protective mechanism is if anyone who was traumatized if you can't escape you kind of like go outside of yourself and just and just kind of dissociate from the situation and that's what a lot of healthcare providers have done. But now we're at a phase now where many healthcare providers I'd say keep saying healthcare providers instead of physicians, because I'm talking about physician's assistants. I'm talking about nurse practitioners, nurses, everybody, including all the respiratory therapist, physical therapist, all the people that were involved in caring for very critically ill COVID patients. That everybody now has the large percentage have moved on to actual clinical mental illness, depression, anxiety, and, and this is what we're, we're seeing now in the aftermath of of the pandemic and what has been predicted the whole time by mental health professionals and in public health folks.

Ralph Andracchio  
I think it's so sad that because you have to be a special kind of person to get into any kind of health care, but I think surgeons, physicians, like people on the frontlines that you were talking about that like help the people as they're coming in and like you have to be a special kind of person who wants to do that who loves that kind of work and that kind of field helping people like that and it to me it's it's just It breaks my heart that the people who got into that that wanted to be there who fell in love with it, are now being damaged by that, that calling that they they had that vocation.

Dr. Joe Sherman  
Yeah, it's, you know, my wife who is a psychologist and therapist, and has quite a few physician clients. And she says to me, you know, if somebody asked you right now and said, you're really thinking about being a doctor, I would like to go to medical school. What do you think? What would you tell them? And I and I have to be honest, I I still have hope that our healthcare system and the structure of our healthcare system will change, that somehow we will learn from this experience, that we won't have collective post traumatic stress as a result, maybe we'll have post traumatic change. We will have post traumatic growth that somehow through this natural disaster that has occurred, either on a small scale with with individual offices or hospitals or healthcare systems, or better at a large scale for a whole healthcare system. And somehow we are there is hope. So I would say, yeah, just be aware with eyes wide open about what you're getting into. Because when you commit to going to medical school, and then you gets kind of spat out on the other end, it's going to look completely different than when you went in, right because it's many, many years later that you're going to come out on the other side. And then she she looks at me and she says you got to tell them not to do it.

Dr. Joe Sherman  
And I can't say that. I remember when I was looking at going to medical school, and this was you know, in the late 70s 80s. And, and I would talk to doctors and say I think about being a doctor and back then it was I don't know because there are these things coming along called HMOs and these HMOs are going to take over the world and they're going to tell us exactly what we can or can't do. And that's going to be the worst and so I don't know if I would go into it anymore. And I was like, I don't even know what an HMO is and I don't know what your life was. So I'm gonna go anyway and see if I can make the best of it. 

Ralph Andracchio  
How much do you think I may be getting way too philosophical or off track so reel me in if... your my Jiminy Cricket. How much do you think preventative care, fits into this, like, people are just not taking care of themselves. And so there's more of a strain on our healthcare system, because things that may have been easily preventable. are now like, oh, I'll just go to the ER I'll just go to the doctor and all I'll take the pills and I'll get the tests instead of you know, I'm going to be proactive about my health, barring anything like that's, uh, you know, genetic disorders cancer like stuff that we can't avoid but you know, there's there's a lot of stuff that I feel like we can Is that am I am I off base or is that part of this? 

Dr. Joe Sherman  
Well, I think a lot of it has to do with the the, the lack of relationship that patients have with a primary care provider. And I think that this is something that in my 35 years of practicing pediatrics, I've seen change and evolve over the years. As a general pediatrician, I know that that people families would come to me if I were in the same office over a period of time. The kids grow up with you as their doctor, the family knows you. So, so you become not only their medical provider, but you become a resource for advice. You become the advocate for that for a patient and the family when things go wrong when things really don't go as planned. And because we have so many different insurance companies and switching from one insurance company to another and you have to get a provider who is on this panel and this is the this this particular provider is out of network or in network I can't keep up with it as a patient, much less as a provider. So I think we've lost a lot of that type of relationship. Just recently. We were talking before. I just recently lost my brother he died and he was older. But he had this prolonged hospitalization and the whole time I was saying where is his doctor? Where is his primary care doctor who is calling the hospital and calling the ICU and trying to get information and explain it in terms that his wife can understand. And the reality was there was a primary care doctor but there's a total breakdown between that primary care doctor in the office and the hospital and what's happening in the hospital. So I do think that things have been compartmentalized in our healthcare system and there has been a lack of a an established relationship between patients and providers.

Ralph Andracchio  
That's yeah, and I that resonates with me because now that I hearing you talk, I haven't had a primary care physician in decades. I don't think like... 

Kristin Wood  
Where do you where do you where do you go to the doctor? 

Ralph Andracchio  
I go to a specific center where I get my health care but like you said, they change insurance. People come and go, doctors leave, they come back. So I go to the same place but I see a completely different crew every time I go there. And so you're right. Like I miss having that. I haven't had a relationship with a primary care doctor. I think once I got rid of my pediatrician once I not got rid of them, but once I grew out of he's nowhere to be found. No. Once I grew out of you know, going to a pediatrician, I think I've had a primary care doctor Oh my god.

Kristin Wood  
I have one but I've only seen her once or twice because it seems when I need to go I'm sick and then you can't be guaranteed to see your your doctor doctor. But I was just thinking about I had a specialist doctor, I guess you consider her and I like loved her. i She was like, I looked forward to going to the bathroom because I get to see her and we just have a really really great report. And just within the past year. She retired I have no idea that's really what happened. But she all of a sudden poof was gone and no warning. And I experienced this as a loss like more than I ever thought I would. I was like What do you mean she's gone? She's younger than me I should retiring already and what's happening and I literally was like I kind of find her and say hi or I was weird. I don't I don't like that. I don't know what happens. I don't I don't they said retired. I have no idea. So yeah, I felt that like last because I had that relationship. And since then then I went back to the same place. And I saw a doctor I wasn't like jazz with her. She was not awful, but she wasn't my doctor. And then I went back again for something else and saw someone else and I liked her and so when I call back like your doctor so and so I'm like can my doctor beat that woman, whatever her name is and they were like yeah, like I want to see her but yeah, I'm I'm very much I guess it's in my profession, a relationship person and you don't get that very often you just kind of connected all those dots for me.

Dr. Joe Sherman  
I'm curious to ask you. What is it about the the doctor that you did see that made you think hey, can I see that one next time or I want that one?

Kristin Wood  
Less formal, less kind of rigid, just say what I'm supposed to say and I'm the doctor. She's just kind of more laid back and direct and had a sense of humor, just sort of more personable. And that was it wasn't my old doctor because no one's going to replace her. But it felt comfortable to me. It's not like the other doctor done anything wrong. I just didn't really feel anything about it. And maybe I would over time but we only saw each other once but I always saw this woman once and I had a totally different vibe.

Dr. Joe Sherman  
Yeah I think that tells a lot about what it means to have a relationship with patients and doctors and I think when I know for me as a patient and I spend a lot of time as a patient now or accompanying family members to doctor's appointments. I really look for people that listen to me that truly ask me questions that that reflect the answers or what I am saying and not just going through the list that's on the electronic health record, because as healthcare providers where there's a lot of pressure for us to have all the right boxes checked on our computer, and to make sure that we do the right charges and and make sure that all of those charts are done and closed and answer all of the inquiries and look at all the lab results and answer and make all the referrals to consultants and all of that stuff, as opposed to sitting down and truly listening to patients and responding and asking questions based on what I hear. So that's often the telltale sign of somebody who's really in relationship and attuned to what's going on with patients. 

Kristin Wood  
That really, I'm sorry, 

Dr. Joe Sherman  
No. Go ahead.

Kristin Wood  
I'm sorry, like struck a chord for me. I have clients with medical problems, medical conditions. I can't tell you how many times I've heard the opposite of what you're saying. They're very frustrated, lose faith in doctors. And it's because they they don't listen, they don't listen. And they don't what you have to recognize is in a way the patient's the expert on themselves in a way and even just validating them and what they're saying can go a long way even if you're like over no gas on it. You know, um, I've had a lot of people that have strayed away when they needed to be pursuing a medical situation because of their experiences like that. So that makes tons of sense to me.

Dr. Joe Sherman  
And I will tell you that if you were to be able to have a conversation with that provider as a provider, because it could be nurse practitioner or PA or whatever and the one that is distracted, totally focused on the computer and just asking questions that seemed to be mechanical. If you were to say, How's the job going? How do you enjoy what you do? How are you getting along with with your work and being able to kind of interact with your colleagues? How valued do you feel? And how much do you feel like you are working with a common mission as your employer and the institution you work for? 

Kristin Wood  
That probably threw them off their seat, 

Dr. Joe Sherman  
And that... Because what I'm saying is that patients just like I said from before, when when a when a health care provider treats you that way and seems like Boy you're not listening to me all you care about is that computer in front of you. I'm just kind of like one more cog in the wheel. You're just trying to get rid of. And what's really happening is that that provider in many cases is being blamed for what he or she is experiencing behind the scenes. And that's what we see and that's, I think, where I try to work with healthcare providers to kind of say, you know, every now and then I was like, what is it that you really love about what you do? And many of them will say, I love being with patients. I love treating patients being relationship with patients and making that connection. And I just can't do it because I have too many to see or I have to make sure my charts are done or whatever. And I'll say how important is it to have that chart perfectly done? How important is it to have that note perfectly written? And every now and then why don't what's it going to be like if you just go in and say in this visit, I'm just going to sit and listen to the patient. And I'm not going to look at the computer. I'm not going to write anything down. And maybe I'll have a piece of paper or something but my goal for this visit is purely to make the connection and listen and you're going to have so many more satisfied patients. If you were to do that and if you had all the boxes checked on the electronic health record,

Ralph Andracchio  
I'm feeling that like my chest tighten up hearing you say like I'm just gonna sit and listen to you because that has not been my experience when I see doctors You're right. They come in they wheel that laptop on the stand in and they always look so frazzled. They're like okay, who is this? Who are you great. One time. Quick aside, my father and I have the same name everything same first name, middle name, last name. I'm a junior and but we go to the same hospital. And so one time I went in to get blood drawn and the nurse came in with all the test tubes and this notes and everything and she just looks at the stickers and she looks at me. And she looks at the stickers and she goes, What's your birthday? And I'm like 12/8/75 And she's like, Who the hell was born in 1933? I was like, That's my dad, you may want to recheck your chart. She said, Okay, I'll be right back. But that's there. I mean, What I got I'm lucky I was just getting blood drawn and not something else. Like what if they gave me my dad's you know, medication or something. So, there's definitely like danger that can happen if people are so frazzled they're getting patients mixed up and they're not looking at stuff. So what you're saying is not only a nice thing, a nice to have, but in in a general sense necessary to have right for safety.

Dr. Joe Sherman  
Yeah, go ahead. I'm sorry.

Kristin Wood  
I was just gonna say I'm learning all sorts of stuff just I got couldn't, ya know, I was just thinking that's the reason. The reason I picked my primary care because i semi recently started going to this primary care office and it's a big hospital and everything. It's a big practice. But it was it was she's a nurse practitioner. I think it was her because one of the things I noticed right away is when she came in, she was more relaxed, which could for her, I get it. There's a lot going on, but she didn't rush me. I felt like she listened. I felt like I could ask all of my questions without feeling like I was rushed. I felt it she took the time. And that was why I chose her as my physician. So yeah, that makes sense. Because I was like that and the fact that I had been another practices that like I would get sick and they believe there's an appointment two weeks and I was like, I don't know. So that was the other thing when I went in like so if I get sick, I want to be able to come in for in the next day or two. Anyway, so yeah, that was what it was about. You almost had to shop to shop around them like yeah, be able, um, I'm lucky because in this practice, although I've seen other physicians This is different from the other factors referring to the one that left, so different practice. Everyone's been great and that's why I have such a good experience so you don't want to have something her. I really liked people that I've so that says something

Dr. Joe Sherman  
So that says something about where they're working. And that could be where they're working from a big scale or where they're working just in their location. Because I, I did a consultation for healthcare group once that had several different office locations and I spent two days going from one site to the next to the next to the next, just kind of like sitting back watching how people interact and sitting down with with the staff. So both all the physicians, the front desk, people, the nurses, everybody and all of the different sites were just like, oh my gosh, there's so much pressure. There's all these new policies and procedures. They're all these little pop ups that come up on our screens when we're trying to see patients it's just so hard and and just, I could feel the tension and stress at the end of the day. I went into this office, and I walked in, and first thing I noticed was that the entire staff were wearing jerseys of of like teams of like football jerseys or whatever of different, different, you know, sports teams, mostly football, and they were all and I saw them kind of busy. He's just as busy as every other place. But they like all the nurses or medical assistants, they were all asking, you know, can you do that for me? Yeah, I'll go grab that you want to go get this and they were all talking to each other and helping each other out. And I kind of looked around and I said, Can you show me where the medical director's office is? And they said, Oh, yeah, it's in the back. Just keep going there and you'll find it. And I go in and I look in the front door and there's a desk that's right in front of the door. And there is this this woman sitting behind the desk. And I said and I knew that the healthcare that they held that the medical director was male. And so I said to her, I said, Oh, I'm sorry, I'm looking for Dr. Jones's office or whatever. And she said, Oh, this is his office. And I said, Oh, she says his desk is right there and it was like another desk. And I said, Oh, okay, well then. She says come on in and I said, Okay, while I'm waiting, who are you? Are you? She said, Oh, I am nurse practitioner. I just started here last month. I said, Oh, okay. They didn't have room for you. They put you in the medical room. And she said no. This medical director, Dr. Jones, everybody who is new he has sit in a desk in his office so that he is always available to them to answer any questions to make sure that they have any support that they need to make sure that they're not overwhelmed and over scheduled, and so that he can be a resource to them all the time to make sure that they make that transition. Well, wow, wow. Oh my god. And I went and I talked to the clinic manager, the administrator of the clinic and I said tell me what's what's going on with you all what? And she said, it's, it's the way that he leads and the way that we work together, that everyone feels supported, we feel like we're valued, and that we are all we all have a common mission and those are the two factors that are the most important for medical provider, professional fulfillment, those two factors feeling valued by the people you work for and with, as well as feeling like you're working together for a common mission, and you're helping each other out. All the time and that supportive role.

Ralph Andracchio  
Wow, just good leadership skills in general. I think that whoever that doctor was was a great leader in terms in what he was doing. And this is a good I think this is a good way to lead into telling everybody a little bit more specifically about what you do how you like you gave a good color to it with that story about visiting the office but what specifically do you do and how do you help medical professionals?

Dr. Joe Sherman  
Well, most of what I do has to do with my direct experience of burnout and of being misplaced in in various jobs that I've had as a pediatrician, and I have worked in is definitely somebody other day. I haven't had one job for more than five years. And some of those switches have occurred because of life. Circumstances, you know, moving to another place in the country because my, my wife had a different job or that we decided to move overseas, which we did a couple of times. But some of those switches had to do with me feeling like I pretty much played out everything that I can in this role, and that things were starting to change. I was feeling like I needed to change. So somebody else was coming along with more enthusiasm, well handed off to that person. But it did get to a point where I was in one position and I just felt like I was trying to fix everything I felt in the culture of physicians especially is that if there's something wrong, then we feel like we need to do something to make it better. Now we can complain about what's going on, but in the end, there is this self critic inside of us that has been very developed during our training that tells us work harder, do it better. You're the one responsible keep going keep doing it and I got caught in that cycle until I just went down in flames. And I ended up leaving a job and resigning because the reality was I was depressed and anxious and I couldn't stay in the job anymore. So I quit completely and really started to look back at my life. And I read this book called Let your life speak by Parker Palmer. And that's where the center of recursion renewal comes in. And this was all about looking at your life and the experiences you've had in life. When have you been most excited, most alive? What have you done where you felt like, Oh God, I hope this never stops or I can't wait to do this again. Because that's what you want to look at. That tells you who you really are that tells you what values you have and what it is that that makes you come alive. And so I started looking at that and I said, wow, you know, I love being a teacher and a counselor. And I love being this cultural ambassador where I'm in another country and I'm trying to figure things out and help other people figure those things out. And those are the things that really make me excited. And teaching and counseling. And the other is medicine to as long as medicine included all that other stuff. I was rolling that was great. But as soon as those other things were gone, I crashed. And so for me, I wanted to help other people decide and determine what is it that makes me excited about what I do. And when things aren't going well. What can I do to change that? And to help organizations make the changes so that everybody can do that? Who works for them so that you have a happy staff, and you have people that will stay on and work with you for a long time and not leave? And so that's really where where I got excited about the work that I do so I became a facilitator for retreats for physicians and healthcare workers. And then became certified as a coach, a professional development coach for physicians to help them and coach them into trying to find more fulfillment in their work.

Kristin Wood  
That's amazing. 

Ralph Andracchio  
Wow. Questions.

Kristin Wood  
What, I don't know if you've already answered this question, I was just curious what is the most common or is there a most common question Question mark that the physicians or healthcare providers that you work with get stuck at? I don't know if you answered that already. Let me know. 

Dr. Joe Sherman  
No, no, no, I think it's a good question. I would say that the most common situation that I deal with in my clients is feeling either that I'm already burned out and I'm stuck. Because this is all I know how to do. My whole identity is wrapped up into being a doctor. And everything else in my life comes secondary to that. And that's the way it started from the time I was a pre med student in college. And it's been that way ever since. And all of a sudden I look around me and I'm not happy, I'm miserable. And I called my friend across the country and she's just in the same situation. So I don't know if the grass is greener on the other side. I don't know what's going on. I don't know if I need to quit. I'm not really sure what I need to do. And I just need some help because I don't want to make any drastic decision that has this lifelong impact and regret it so I need to talk to somebody to help me process this. And that's usually the most common thing that I run into. I would say secondly would be the person that sees that coming or sees their colleague in that situation and doesn't want to be in that situation and wants to do something proactively to try to prevent it.

Ralph Andracchio  
I know a lot of people and a lot of clients I work with one of the biggest things they need help with is work life balance. You know, I don't want to live to work I want it to fit into my life. I want like a lot of what you're talking about. I want to feel fulfilled in everything I do with people in the medical field medical professionals, I think I would think as an outsider that would be more difficult because the kinds of shifts that you all work or have a heck of a lot different than the shift to the rest of us work. So how hard is it to find that work life balance and what you're talking about? Like I feel fulfilled, I have room to do other things so I'm not getting burnout. How hard is that?

Dr. Joe Sherman  
I think it's it is. It is very, very difficult to do I think as a physician, and I know that when I went into medicine, my thought was work life balance isn't going to happen. This is my identity and I'm going to be a doctor and everything will be secondary to that. In today's healthcare world, if that's your approach, then you're guaranteed to be burned out because medicine now is so high tech so complex, and take so much out of you that you have to learn how to set some boundaries you have to learn to say no, you have to learn when to turn it off and go home and be able to refill your tanks because your tanks get empty throughout the day and hopefully you can find those things that bring you joy in your job and really allow those experiences to to really marinate inside of you and say wow, so I asked my clients often I like what, give me an experience that you've had since the last time we met where you really felt really glad that your doctor that you really were glad you were there. And stop and think about and think about it and I said just tell me a time that you felt like like wow, I am so glad that I'm here in this moment. Because that's the moment that you want. To try to amplify and replicate more and more throughout your day. So I think that right now work life balance, and I just call it Life Balance because your work as part of your life is to be able to say I need to cut it off I need to go home and I need to be able to kind of compartmentalize my work as best I can so that I can be fully present to the people I love.

Kristin Wood  
Yeah, I tell my clients all the time, no one's gonna create boundaries for you. No one's gonna create them personal relationships as well as work relationships. I mean, people might put their own boundaries in place, but they're not going to put boundaries in place for you. And if you don't put them in first and everybody starts to have these expectations of you like I talked about this with clients starting new jobs, of starting with good habits and good boundaries. And that way you set the tone versus somebody that doesn't have good boundaries and good habits and then all of a sudden is like this isn't working and wants to change it. Well, now everybody's used to the old so and so and the way they would work which probably worked out great for them. And it's harder to take that to make that change

Ralph Andracchio  
That old so and so 

Kristin Wood  
I was couldn't think of anyone's name I was saying Susie and I was like that's... 

Ralph Andracchio  
Susie's a valid name. Well how Dr. How, how feasible is that what you're talking about? Because when I think about doctors and nurses and nurse practitioners, everybody you you've mentioned I don't see them having that freedom to say going home everybody work life balance. So and what happens when they can't do that?

Dr. Joe Sherman  
Yeah, that's a great question because I can't say that I was you know, the expert and work life balance too and I was in the peak of my practice. Some people do it by seeking out positions and jobs that do have external limitations and structure. So a lot of people become go into the field of Emergency Medicine that has shifts or hospital hospitalist now, because a hospitalist will have a certain number of amount of time and when you leave you check out to the next person and they take over but it is possible to do in some small ways. And I think sometimes what happens is that we are programmed to believe that boundaries are our self centered boundaries our selfish boundaries are for a weak people and the reality is that if we set boundaries, we become better healthcare providers. If we set boundaries so that we can actually say No, I have to leave at this time to get home to my family. Then we come back renewed and refreshed. So sometimes I Well, what's happening now, I believe, is that in order for healthcare organizations to even have any workforce at all, they're going to have to be able to accept boundaries set by providers, because there's already been something like I don't know 21% of the nursing workforce that has left the profession, and physicians will be next. And I think that there's going to have to be external structure in that. A lot of that has to do with offloading the bureaucratic and administrative tasks that providers have. The thing when I came out of residency and I started my practice, back in 1989. The first thing that when I saw a patient and I walked in, and I saw a kid and they and that child had an ear infection, you know, I could open up a paper chart and literally write down left ear infection, amoxicillin and sign my name, and then there'll be a little slip of paper, I circle a number and then I move on to the next patient. I'm done. That's it. I don't have a stack of charts left on my computer to answer because if a if a parent called in about a sick child, the receptionist would answer and refer to a nurse was in the office. That nurse would make a decision to schedule that patient or not. If a lab result came in, there would be a nurse that would look at the lab result. And then say to me as the provider, this is something that you need to look at or act on. Otherwise, that nurse would call the family and say oh, the The labs are all normal that you were concerned about. Do you have any questions called Dr. Sherman or I'll have Dr. Sherman call. So there were different people to offload a lot of this extra work toward. Now all of that gets filtered into this computer screen. And so healthcare institutions, all of a sudden, they don't have they've gotten rid of people like nurses and social workers and and extra administrative staff to try to take care of those things. So it is very difficult at the end of the day, there's something like two to three hours of charting for every hour of patient care for providers now. Oh, so you just think of that administrative burden with no extra time built in that you get paid for to do that. It's just expected that you spend the extra time to do that. So that's where institutions can really make a difference by changing that a little bit. Give some space in between for administrative time for providers to do their charting. Have some people that you can offload some of these administrative tasks to you're gonna have happier people that stay longer in their jobs.

Ralph Andracchio  
Is there anything... sorry, did I cut you off?

Kristin Wood  
No, I just I just took a sigh. 

Ralph Andracchio  
Oh, sorry. I didn't mean to cut your sigh off. Is there anything patients can do from our end that can help with anything we've talked about today with physician burnout and you know, all this kind of stuff.

Dr. Joe Sherman  
You know, I hate to put the burden on patients but I will tell you I will tell you this. If you want better medical care, ask of your medical provider how they're doing. When you go in and perfect story I tell a story all the time but my wife has migraine headaches and she goes to a she's a horrible migraines and you know, right now she's doing well. Knock on wood. We went to this headache specialist. And I happen to know this doctor because we work for the same institution. So I knew who she was not really well, but my wife came back from an appointment and she said, Oh my God. I said, I overuse the medication. I use too much and it's all my fault and she was like in tears. It's like, this is not the Dr. Smith I know. And I said well let's go in the next visit I went in too and and she came in and she looked at my wife and looked at me and said hello and everything. And it said oh yeah. How are you doing? And I said, I said Dr. Smith there have been a lot of changes. I know that it's been impacting me. How are you dealing with things? I know there's been a lot of stuff and a lot of stressors how how's it been for you? And she just if she didn't break down thank God but but she did she just started telling me all the different things they want to move by clinic, they want to move in near this construction area. All my patients have headaches, it's all gonna make that worse and they've taken away half my staff. It's like, Oh, my God, I just listened and listened to her. I didn't have any answers. I didn't have any ways to fix it. But I listened to what she had to say. That was the best visit my wife had that ever with that doctor. So I do think saying something like, boy, I know the pandemic has been really tough on all healthcare people. And I can imagine that it's been difficult on you in some ways. How have you been? You know, how are you dealing with it? And, and, you know, that that provider may say, oh, you know, thanks for asking. I'm doing okay, you know, but just the fact that you noticed and you inquired, it really makes a difference that people really know that it's been a challenging time. 

Kristin Wood  
I think Yeah, cuz I think when you're on the doctor, you're you're all focused on yourself. This is about me, which it is but this is about me and whatever's going on. If I don't feel I can be grumpy if I don't feel good in the doctor's office I'll admit. Yeah, but I think remembering that there are people too, they have bad days. They're experiencing stressors, just like you are and that's a very simple thing that we we definitely all should be able to do.

Dr. Joe Sherman  
Yeah, I'd say the other thing is, when you do when you are talking about going into that office, and everybody is like oh, I liked everybody here, you know, is is to say that now I'll go in from my medical care. I go to the receptionist and that receptionist is friendly to me and goes out of his way to kind of then I say thank you so much. You are so kind. Thank you for your compassionate care. I really appreciate that. Thanks for going out of your way for doing that for me. And, you know, the bonus is that you get good care. But you know, it feels good. That'd be appreciated. So I think that that means a lot and that's something that everybody can do. 

Ralph Andracchio  
I we could talk to you for literally five more hours. I personally would love to have you back on at some point if you would be open to it because there's so much more. I have 150 more questions in my head that we don't have time for because it's already been like almost an hour. If there are any medical professionals listening to our show, I'm sure there are I know they're out there. And they're interested in what you're saying. How can they get in touch with you or learn more about what you do?

Dr. Joe Sherman  
Wow, thank you so much. I do have a website, joeshermanmd.com And it's very simple. It's my name joeshermanmd.com. And there's a lot of information there about programs that I have and and resources or if you just want to email me directly joe@joeshermanmd.com. And, and I I'm happy if you send that email goes directly to me, I'm the one who answers it. I am a one person shop right here. And and we'd be happy to answer any inquiries or or any questions that people have.

Ralph Andracchio  
Excellent. We're going to put all that in the show notes so it's available for everybody, any parting

Kristin Wood  
No, I just really appreciate you I appreciate your time what you're doing and I think it's really cool how you what make what gives me pleasure, it gives me joy and you took that and you and you made a career shift. I wouldn't say a total change, but to do just in fact that and you're still continuing to very much help other people and be a healthcare worker or provider by doing what you're doing just in a different way. Thank you.

Ralph Andracchio  
Yeah, thank you for what you do, and it's really necessary.

Kristin Wood  
Yeah,

Dr. Joe Sherman  
Thanks for having me. I really enjoyed talking to you. 

Ralph Andracchio  
Absolutely. All right.

Kristin Wood  
Till next time, doctor.

Ralph Andracchio  
Till next time we're gonna have you back. Thanks, everybody for listening and doctor's information will be in the show notes. Like I said, you can send us an email heyletmeaskyousoemthing@gmail.com. We're everywhere on the social medias. We are not hiding. Come after us. 

Kristin Wood  
Yes. Come find us. 

Ralph Andracchio  
Come find us. Ah, that's it. Another great show. 

Kristin Wood  
Another Great show. 

Ralph Andracchio  
All right. So see everybody later. Godnight.

Transcribed by https://otter.ai