Episode 76 - The Doc Is In Talking Burnout
Greenway Chief Medical Officer Dr. Geeta Nayyar will guest host this episode featuring Dr. Jeff Livingston of MacArthur Medical Center in Irving, Texas.
Burnout is one of the hottest topics in healthcare today and we'll hear from physicians how they experienced burnout, what helped them overcome it, and what advice they have for providers dealing with it currently.
Dr. Nayyar: Hello and welcome. I'm Dr. Geeta Nayyar, Chief Medical Officer of Greenway Health. And welcome to this episode of "Putting Possibility into Practice." I'll be your guest host for this episode. If you are a returning listener, thanks for tuning in again, and if you're a new listener, we are happy you found us. On this on this episode, I'm joined by Dr. Jeff Livingston of MacArthur Medical in Irving, Texas. We'll be discussing one of the biggest topics in healthcare today, physician burnout. Dr. Livingston, thanks so much for joining me this morning.
Dr. Livingston: Yeah, good morning. Thanks for having me back.
Dr. Nayyar: So Dr. Livingston, I know that we're going to be talking about burnout today, but I'd like to start with what got you into medicine and what made you want to be a doctor in the first place.
Dr. Livingston: Yeah. So I decided in high school I wanted to be a doctor and then choosing your specialty in high school I never would've thought I would've been an OB-GYN, but as I went through medical school and I really learned something about myself, which is I really liked being around happy people. And OB-GYN is one of the only specialties where our primary purpose is taking care of healthy people going through the most exciting thing in their life. And for me, that was just something that motivated me and I really enjoyed and I ended up in the perfect specialty for my personality.
Dr. Nayyar: Wow. That sounds so delightful. So, you know, burnout has become such a hot topic in the healthcare industry and I'm glad that you mentioned that, you know, part of the reason you went into medicine was to be around happy people and happy patients. What in your mind, as a physician, as a doc, that really values that contributes to physician burnout?
Dr. Livingston: Well, yeah, it's such an interesting topic. And as you know, social media is something that we utilize in our practice a lot. And one thing I've noticed over the past year or two is the number of posts promoting the idea of physician burnout that are popping up into our Facebook feeds. So I've noticed that locum tenens companies, OB hospitalist companies, they're constantly putting into our feeds, messaging about, are you tired? Are you feeling burned out? Are you in the wrong job? And I think this is a manipulative marketing tool by these companies that really spreads this message to physicians, and the power of social media is just something that we can't underestimate. One of the things that I've done in my own life because I've experienced burnout as well. We grew a company from a small company to now 158 employees in 4 locations in 4 cities, and so I've experienced that myself. But one of the things I think that is missing in the discussion of physician burnout, mostly what you see online, it talks about tools to fix it and it talks about the reasons behind it. But one of the things that I really like to do in my life is to understand why I'm feeling that in the first place and then to address the underlying cause and then to make the changes in my life around that to address that. Does that make sense?
Dr. Nayyar: Completely. It's the etiology, right? It's the root cause of what's going on. If you don't fix that, then you're really just putting a band aid on it, right?
Dr. Livingston: Right. So if we just spend time talking about why physicians are burned out but instead think about the underlying thoughts in your head that are making you feel burned out. Okay? So like for example, today, if I think through, I'm really tired from being on call last night. I've got a surgery to do and then patients in the office and I'm gonna be late to the office and I'm backed up on my charting and all these labs and tasks are coming through, and then I start the day in a certain mindset. But instead, you know, if I start my day thinking about I have an amazing opportunity to run an amazing company where we can impact the lives of people all over the Dallas-Fort Worth metroplex, then my whole day changes. So a few years ago I created my own personal mission statement and I used that as something every day to guide the way I think about my life. And I think that's been really, really helpful for me.
Dr. Nayyar: I love that. That's so beautiful. Personal Mission Statement. Sometimes we forget why we're here, right?
Dr. Livingston: Yeah. So my personal mission statement is pretty simple. My mission statement is to become the best version of myself and to impact as many lives around me as I can. And so that motivates me to do all of the things I need to do to achieve that goal. So I kind of evaluated the things that I'm doing in my life. So what am I doing in terms of my physical health, my emotional health, and my physical health? And when I address those three pillars, then I don't end up in the fixed mindset of physician burnout. And instead, I transition into a growth mindset where I can constantly improve my life, myself and work on my personal mission statement.
Dr. Nayyar: That's beautiful. I love that. Do you have any advice to any other docs or staff that also might be, you know, on the edge or possibly suffering from burnout? Do you recommend doing something?
Dr. Livingston: Yeah, absolutely. So what jump-started this for me really was reading, but reading one book in particular, it was called the "Miracle Morning" by Hal Elrod. And it's a short book that people can read it in one or two days. But it just goes through this very simple idea that we all work so hard to create this amazing life for ourself, but then we never actually stop and take the time to enjoy the amazing life we've created for ourself. And so the simple message in the book that resonated for me was the only time in the day that's safe and protected is in the morning before your day starts. And for me, that just registered. I thought that's exactly true because the second I leave the house, the text messages start, the emails start coming. Things happen at work, things happen at the office. Your kids are texting you for more screen time. Your wife needs you to do this. You've got errands to run. It just never stops. And so in this book, there's a pathway that he lays out in six steps that you do each morning and you can do it in six minutes. I now do it for about 45 minutes, and I wake up just a little bit early and I follow those steps. And over the last three years, I've read more books in the last three years than I have in the previous 30 years. I started running again. I just finished my first 10 K, I'm now training for a half marathon.
Dr. Nayyar: Wow, congratulations.
Dr. Livingston: Yeah. But more important than that, I personally transitioned from a fixed mindset to a growth mindset. And once I did that, I was able to take those skills that I was doing personally and translate that and scale that across our company. So our company created a mission statement and core values, and then we're doing things within the company to really transition all of our employees, physicians, non-physician providers, and office staff, we try to help them transition from a fixed mindset to a growth mindset. And so a lot of my focus right now is really scaling that across the process.
Dr. Nayyar: Jeff, I love the points you're making, right? Because part of the addressing the root cause of burnout is comprehensive, right? So you're talking about personal growth, personal wellbeing, sort of personal purpose. And, you know, at Greenway, we're really jazzed to work with your group at MacArthur Medical and be a partner on the technology side to addressing issues or contributing factors to physician burnout. All these other pieces, it's kind of a comprehensive... Truly you need a comprehensive solution, but you also need the right partners at different stages along the way.
Dr. Livingston: Absolutely. You need the right tools in your tool belt.
Dr. Nayyar: Exactly. It's funny because when people talk about the EHR, they never use the word tool. And I always say it should be just like a stethoscope. It should be just like a reflex hammer. It should just be something that's part of how we get through the day and just let doctors be doctors, let us get through what we need to for the business of the day, but it's meant to be a tool and not to be intrusive. It's definitely, definitely the goal.
Dr. Livingston: Yeah, I think that that's a great way of thinking about it. And there are some really basic things that practices can do and partner with Greenway on these to transition technology from a source of burnout to a tool that solves your problems. And so, what I think happens a lot of times with really any technology, and your brand new iPhone is a great example. People buy their brand new iPhone and they use the tools on the phone that they already knew, and maybe, maybe they pick up one or two new things, new features that the phone can do, and then they start using that. But there's like 100 other things that the phone can do but it would take a little bit of investment of time and energy to learn what those tools are.
So like shortcuts is an example on the new iPhone. If you've learned how to do shortcuts, your life got easy, but my guess is 99% of people that bought an iPhone haven't even clicked on that app yet. So Greenway is kind of the same thing. Greenway constantly does upgrades to make your life easier, but inertia kicks in a physician practice. So if we don't learn those new tools, if we don't integrate those new tools, then we have an upgraded product that could be making our lives so much easier but we didn't invest the time and the energy to do so. So it's really important for practices, on Greenway, or really any other EHR ARC system to put a process in place within the practice where there is a superuser who stays up to date and in contact with Greenway to learn the new features. And that's step one. That's the easy step. Step two, is the practice needs to have a process in place to integrate and scale those new features across the practice. And if you've ever worked with doctors before, and you are one so you know, we're not the easiest people in the world to get to try something new. Once we learn a way of documenting in the EHR, that's it, we're done. We don't want to change anything. So having a process in place within the practice to show doctors the new features, the quick text, quicker, faster, more efficient ways to do their job, physicians can adopt that and their life becomes easy.
Dr. Nayyar: Dr. Livingston, you bring up so many good points. I really appreciate that. I was thinking in my head, do I know about shortcuts on my iPhone? I'm gonna have to do that after this call.
Dr. Livingston: See, it's there. It's probably on like page four. You just gotta scroll and click on it.
Dr. Nayyar: That's right. I always use the analogy with my car. I'm pretty sure my car parks for itself and drives for itself and I haven't figured out how to turn that on just because I don't need to, right?
Dr. Livingston: Let's say you're about to leave work and you wanna tell your partner that's you're on your way. You can just click Shortcuts, click one button, and it'll send a text to your spouse, tell him where you are, how far you're away, what time you will be there and you did it in one click.
Dr. Nayyar: Oh my God.
Dr. Livingston: Life got easier.
Dr. Nayyar: Jeff, you just made my life easier. Thank you so much.
Dr. Livingston: See, there you go.
Dr. Nayyar: I'll send you a text after this. Last question, Dr. Livingston. You covered so many good selling points and all really, really good advice. What's your last, you know, sort of tidbit for young physicians just getting into the medical field today to have a successful career? And I like to use the word thrive, right? To have a thriving career. We always talk about burnout, but let's forget about burnout. Let's do the opposite. How do you start off in medicine today with an aim to thrive?
Dr. Livingston: Yeah, that's such a good point. And I wish in residency or maybe even in medical school that there was a course on personal development, mindfulness, all of the things that we tell our patients to do, but then we ignore ourselves. I wish we were taught those kinds of life skills in our training because I wish that I had known these things at age 30 and didn't have to wait to be in my 40s to learn that eating right and exercising and sleeping are important aspects of being a happy, healthy person, but it turns out they are. So I think young physicians coming out of residency, going in to train, I think the first thing really it's just sort of sit back and think, what do you want your life to be like? Don't get so tied into which job and which city, but really big picture, what kind of life do you want for yourself? What does that life look like? And then sort of map out, "All right. If that's the life I'm gonna create for myself, how do I get there?" And kind of keeping that big picture in mind will help frame all of the little decisions you make along the way.
And in the early days of your practice, you've got to grind it out. You need to go meet people, make connections, build your referral network, establish your patient population, provide excellent optimal care to every single patient, show compassion, be empathetic, do all of those things. But, you also need to step back from the beginning and make sure that you're taking care of yourself. How is your body and how is your mind? And if you let those things slip, which I did in my 30s, I let those things, then you're going to spend time playing catch up. If we stay focused on our mission and we stay focused on our personal development, I think we can avoid all of the pitfalls of physician burnout. And in fact, we can even reject the underlying assumptions of physician burnout because these are all things that we can control within our own mind by designing and creating our own lives.
Dr. Nayyar: Dr. Livingston, I really can't thank you enough for taking the time to be on our podcast. I'm looking forward to future discussions in the next episode with you. Thank you so much for listening to this episode of "Putting Possibility into Practice." I'm Dr. Geeta Nayyar, Chief Medical Officer at Greenway Health. For more information on the solutions and services we offer your practice, please visit us at www.greenwayhealth.com, and don't forget to subscribe to our podcast on your favorite podcast platform of choice to receive notifications when new episodes are published. Thanks for listening.