Dr. Asha Padmanabhan:  Hi everyone. Welcome to the Leadership Prescription podcast. My guest today is Dr. Amy Pulido, who I am honored to know and have known her for several years. She is the Chief of Anesthesia at Memorial Regional Hospital, which is a big hospital system here in the South Florida area. It's a large level one trauma center. And prior to being chief of anesthesia, she has also served in several leadership positions, including the surgical services executive committee, the multidisciplinary peer review. And she was chief resident when she was an anesthesia resident at University of Miami Jackson Memorial Hospital. 

[00:01:14] Amy and I have known each other for several years and she has been a strong supporter of the Women in Anesthesia leadership movement. Both within the company we both work for, which is Envision Physician Services.

[00:01:27] And also in her own hospital and the local community. She has also been chief proponent of the Lean In local physician circle. And I'm going to have her talk about that in a little bit, but to start off Amy welcome to the show. And I'd like to start off with the beginning. Can you take me back to when you were a chief resident?

[00:01:50] And what the future looked for you at that point, what you were hoping to do in your career at that point. 

[00:01:57]Dr. Amy Pulido: Hi. Thank you very much for having me Asha. I'm honored to be speaking with you and sharing my story. The chief resident position was definitely a big role. 

[00:02:09] As far as my leadership development. I had no aspirations of taking that on. Like many anesthesia residents, I wanted to learn how to become a great physician and take perfect care of my patients. And I had been approached in my intern year to get involved with a committee of interns and residents which is the local union at Jackson Memorial for the resident physicians. And, I didn't have big political views or anything, but it, I felt that if someone was asking me to lend my voice, to represent my group of anesthesia interns and residents, that was something that I should try to do.

[00:02:58]And I worked with them and, learned a lot. And I think that kind of had me stand out when they were making their decisions in regards to who to ask to be the chief resident. And again, I shared the responsibility with my co-chiefs who are amazing people and we just all figured it out as we went along and learned a lot about other people during that time. 

[00:03:32] Dr. Asha Padmanabhan: So let's take off on that. So, learned a lot about other people, because what I tend to find is women in residency we tend to focus on being good physicians and learning all the skills. And you figured out early on that the people skills, from what it sounds like, as what took you to the next step.

[00:03:52]Dr. Amy Pulido: Yeah, I've always been a people person. And so connecting with patients is one way that I satisfy that. But serving, especially in anesthesia, serving your colleagues is, a great way to connect with them. Yeah. Yeah. 

[00:04:12] Dr. Asha Padmanabhan: So what happened next? So first job out of residency and then what?

[00:04:17]Dr. Amy Pulido: I began working at Memorial Regional Hospital, that was my first job out of residency. And I remember one of my colleagues at the time, who's now my regional medical director, said to me, we need to get you a title. And I had no interest in getting a title or anything like that. 

[00:04:36] But I think that he along with many of my, partners saw in me the desire to want to help my colleagues and, found that as, being an important part of leadership. And it's so funny because I was thinking back cause I have two young children. I have two boys who are seven and nine, Nathan and Evan.

[00:05:01] And I think about my own experiences. And compare it to them and theirs. And I remember being that young and having many, teachers talk to me about leadership and leadership development. And I really had no interest. I didn't know what it was. It was such a vague term that they would talk about leadership development and children.

[00:05:27]And I feel like it was just, it was such a nebulous term and I still feel like it's nebulous in a way, what is leadership? And I think it's different things to different people. And to me, leadership is making things better, using your voice to make things better for your colleagues, your patients and the people that you're interacting with every day.

[00:05:52] Dr. Asha Padmanabhan: That is so important, because what I've heard from you is a couple of things. As other people recognize the leadership qualities in you before you recognize that yourself.

[00:06:01] Dr. Amy Pulido: Certainly.

[00:06:03] Dr. Asha Padmanabhan: And that's something we all do. Yes. I think that part is a little different for women physicians or women in general, where we don't recognize that in ourselves, or even aspire to that a lot of the times until someone points it out to you or you get thrown into leadership positions.

[00:06:22] And it's interesting that you with. With your kids now it's, hard to figure out it is a very nebulous term. And how do you train, or how do you guide someone to be leaders even at that young age, but you remember that from that age. So obviously there was something there that was seen and felt and recognized.

[00:06:46]Okay. So after you're in your first job, how did you, what was the progression then? 

[00:06:52] Dr. Amy Pulido: So the progression was that I began taking on small projects. There were certain things that coming from whenever you start a new position, you come with a fresh set of eyes and things that the people who have been working in there probably don't realize that they're missing.

[00:07:12] And so one of the things I worked on was updating our consent form for Jehovah's Witness patients, because I felt the form did not do an adequate job of prompting a good conversation between the physician and the patient. And so I worked with the local ministry and the lawyers of the hospital and that was a pretty big project to undertake.

[00:07:38]But I persevered, I learned how hard and difficult it is to, change even forms, especially legal forms at a large institution. But I think the fact that I persevered with that and was able to connect with people, not just in medicine. I think that a good leader reaches out to those other, like the ministers and really tries to involve as many voices as possible when they're trying to improve things and change things.

[00:08:12]I think that was something that helped. And then there was opportunities to join certain committees, basically they, kept on asking me, and I mostly said yes. Which I think is a trap for women. I said yes, because I wanted to, I am fortunate that I have a lot of support at home with my husband.

[00:08:33] He does more than 50% of the household responsibilities, even when he was he's staying at home now with everything that's going on. But even before then he was really involved. And so I had that support to do those extra tasks, because that takes extra time. I was not given time to do that at that point.

[00:08:57]What I would like to see to move the needle is, I would like to see that men or women are given time to do those kinds of development projects built into their work and allow that separation of work life and home life to the degree that they would like it to be. 

[00:09:18]But so anyway I took on those responsibilities and those projects, one thing led to another I was asked to be on the hospital's peer review committee, which I felt was a great honor.

[00:09:27] I still continue to serve in that role. And it's really educational and collaborative with the other physicians in the hospital. And then vice chief and then chief. 

[00:09:37]Dr. Asha Padmanabhan: Yeah. So I heard a couple of things. And the first thing was you volunteered for something that interested you, but you weren't asked to do, and you learned a lot of things.

[00:09:48] And you said yes to a whole lot of projects, which I think a lot of women physicians, when they look at how do you get, they ask, how should, how do I get involved? I want to get involved. And that's, I think one of the key things where you volunteer for things that, sometimes other people don't want to do.

[00:10:06] And you do it to your best that you can. And as you, you learn skills and you get seen and noticed and you get given more responsibilities and that's the slowest step-by-step to leadership. But the second part also that I want to touch on is you talked about the support you had at home and for so many young physicians, that's one of the stumbling blocks sometimes where you don't know how to fit in.

[00:10:37] Being a mom, being a wife to, also taking on these extra leadership roles at work where you don't necessarily have dedicated time to it. So you touched on your husband is very supportive, but can you tell our audience a little bit more about how they can play those roles? 

[00:10:59] Dr. Amy Pulido: Absolutely. I am fortunate to work with some really great women physician mentors who have been trailblazers and have gone down the road of being a mother, being a physician.

[00:11:13]Dr. Lauren Kimmel early on. Just gave me this advice and I take it to heart and give it to every other man or woman: outsource what you can. Get someone if you can, if you're financially able to outsource, cleaning your home and doing just different things. I even outsourced potty training, which is a whole nother story.

[00:11:36]And I do highly recommend that, but I in order not to - my husband is, one side of support, but he can't be burdened to a high degree either. And I think you never feel like you're winning in every aspect of your life. I just don't think that's a reasonable goal. 

[00:11:58] I think it's just important to feel like you're, good enough at your mother role, your work role, your wife role, your friend role. And we all would prefer probably to move that piece of the pie graph and make it make certain areas larger and other areas smaller. And you just have to take those opportunities when you can.

[00:12:20] And when you can give that attention to your spouse or your kids, you try to focus. Very much on them because there will be other times, like now with COVID that I'm having to focus so much with work. And that's okay. Because I've tried to build what we needed ahead of time with my family, if that makes sense.

[00:12:45] Dr. Asha Padmanabhan: Absolutely. And that's something that outsourcing was hard for me to do in the beginning, but eventually you get there. But something that a lot of young women physicians should probably look at as soon as they can do. Financially, I think we are in a better position sometimes to do that once we are attendings.

[00:13:04]But to really outsource because if you want to be in leadership and that's something that they've gotta be, as you said, you can make the plate bigger, but certain things you cannot get off the plate. 

[00:13:16]So, now as chief at your hospital, what are some of the challenges you face as a leader? Whether that has anything to do with you being a female physician or not, we can touch on, but as a leader, what are the challenges that you face. 

[00:13:32]Dr. Amy Pulido: I think, I don't know. I don't know if your audience is mostly anesthesiologists, but I think that being an anesthesiologist, but also being a physician is a challenging role. And it's more than I probably realized when I started this career. 

[00:13:48] Because of that tight rope, you walk with taking great care of your patients, which is cannot suffer or, being you can't negotiate on that, one, but surgeon relationships, administrative relationships, colleague relationships there's a lot of give and take there and just working with the different personalities.

[00:14:11] I think women actually are very well suited for leadership because typically women have very high emotional intelligence, which I think can help you navigate those different worlds with ease. And I think that it's, a process and, we're all learning and growing every day finding your voice and being comfortable in your own skin, everyone struggles with that off and on. 

[00:14:38]And just realizing that when you mess up just you can't beat yourself up, you just have to try to learn from it and move on. Because we all make mistakes. 

[00:14:49] I compare myself to my male colleagues because that's all I've had here. As far as leadership And I find actually a lot of similarities.

[00:15:00] Some of the things they get away with, I don't as much, but I realized that because people have certain expectations just based on your gender. And I don't know that you can completely separate that. And I don't think they're bad. That's almost just human nature. I think it's not something you can [inaudible].

[00:15:18]Recognizing that, I try to understand that I sometimes have to take what they're going to be expecting from me in consideration. Now I still am myself. I'm still, true to myself. I think that's very important. Part of all of this is. That I am always true to myself. I've always been very outspoken and I don't plan not to be. But I do as a leader, I've learned when to keep my mouth shut and what battles to fight and how not to take the bait.

[00:15:53] That's been, I think, a very a very important role or important lesson that I've had. 

[00:16:01] Dr. Asha Padmanabhan: Can you give us some, examples of that? Cause that's 

[00:16:03]Dr. Amy Pulido: Engaging with certain personalities who have power and want to yield it, and when you step out of line, they like to bring it up the chain.

[00:16:17] And I've always had a lot of support from Envision, with my leaders and bosses with protecting me from that. But just sometimes I'm someone that I like to fight for injustices, but I've learned that there's a time and a place to do it. And sometimes at the front of the, front board in front of everyone is probably not the best time to get in a high pitched argument with a power - a high volume surgeon And it's not that I'm giving in to them.

[00:16:50] I've just found other ways that are more successful to get what I want to accomplish than just going toe-to-toe all the time. Certain personalities, you can do that with, and certainly you get to learn how to read people. And you understand, if you can understand what their motivations are, then you can negotiate better with them.

[00:17:11] Dr. Asha Padmanabhan: I think that's a key point if, once you figure out what their motivation is. But that's a really good learning point where I think even personally, a younger me would probably want to stand my ground and fight. But as leaders you realize you need to take a step back. And as you said, the front board is not the place to have a knock-down argument.

[00:17:33] You can take it out outside of the room. So you were talked a little bit about the mentors that you've had. Can you expand on that? Because that's, something, I think a lot of us either lack or don't have enough of.

[00:17:49] Dr. Amy Pulido: Certainly. I have been really fortunate to not just have mentors who are people that give you advice like, like Lauren Kimmel but also sponsors.

[00:18:00] So people that are ahead of you, above you and have leadership roles and have talked to their colleagues and the other people in leadership roles that this is someone you need to develop this as someone that has a lot of potential. Jean Miles has been someone that's been a big sponsor.

[00:18:21] Joe Loskove has been a big sponsor. These are people who. Not only are giving advice, but also able to say this person needs to be developed and we see their potential. I guess it's kinda you know what you were saying before, back in residency, it wasn't something that I strove for, but someone said you would be good at that.

[00:18:44]I don't know if you can find a sponsor. I think, the sponsors gravitate towards those people that they know are interested. I think one way you can find a sponsor or get, a sponsor to do that for you is to let them know you're interested. And that's been a big reason why I worked with Lean In and some of the other anesthesiologists in the area.

[00:19:11] Because I think as women we're so - I think women are just more often humble which is a good thing in a leader, which is, I think, necessary in a leader. But because of that humility, when someone says you would be a great chief, we say no, and we brush it aside. And I think we have to get comfortable as women to say I never thought of myself in that role.

[00:19:40] And thank you for the compliment and let it go. And I've certainly tried to work with the women around me to mentor them and sponsor them also. And, teach that, but that's, I had a conversation with someone who was a vice chief, a female who I think very highly of, and that was the conversation she was saying to me.

[00:20:00] I said, when are you going to be chief? And she said, no, I don't want yeah. But she was obviously doing it because actually the vice chief role is probably the hardest role. Cause you're balancing a lot more when you're in that role and I just said, I think what you're doing now is extremely difficult and you would do a great job. 

[00:20:22] So I just think that if you say no, then other people will, they think you don't want it and they'll pass you up. So you have to be a little more, maybe just open to not brushing it off. 

[00:20:37]Dr. Asha Padmanabhan: Yeah, exactly. And that was going to be my question on how do you find a sponsor, but you don't you basically, as people recognize certain qualities in you, and you own up to it.

[00:20:48] And like you're sad. It's may not be something you thought of right then, but I'm sure that's going to give you some thought when you go back home and sit down and think that this person thinks me capable of this and maybe I should. And so say it, part of that is also then saying yes to a lot of things that may make you uncomfortable.

[00:21:07] And so let's talk a little bit about that Lean In circle because you've run a couple of groups that I've attended and they have been very empowering. 

[00:21:15] Dr. Amy Pulido: Thank you. Yeah, so I had started that with the diversity inclusion initiatives that Envision was starting up and we were luckily able to get sponsored for some meeting time with dinners and it was a cross specialty events. 

[00:21:34] And it was very helpful. It really liked reaching out and meeting some of the other people that worked in our, in my company that live in the area. And it's been, I think very well received. And my challenge is always finding someone to take that on next. My goal is to start it and pass the Baton, and I wasn't, I wasn't successful in doing that so much. 

[00:22:02]I, it's been taking a backseat right now with everything that's going on, but it's, still always out there. And I have several new women physicians that are joining my group. And I plan to talk to them about their interests and what they'd like to do.

[00:22:20] Dr. Asha Padmanabhan: Yeah. So outside of medicine, what is your passion? 

[00:22:25]Dr. Amy Pulido: Outside of medicine, my passion is the ocean. I love everything about the ocean. I grew up sailing Hobie Cats on Fort Lauderdale beach. And  I really love it. Now that my kids are older. They're definitely able to share those things with, me more.

[00:22:43]Evan did some sailing lessons last year and he, thankfully liked it. And. Yeah, I love snorkeling, scuba diving, boating, all of it. 

[00:22:54] Dr. Asha Padmanabhan: Yeah. So there is no such work-life balance, but how do you balance your life? 

[00:22:59]Dr. Amy Pulido: There is no such thing. I got a lot of flack for doing work at the dinner table. So having the Apple watch was my way of being able to be connected because staffing always was happening right at dinner. And it was a little bit less obtrusive than me pulling out my phone, answering my scheduler and then maybe checking Instagram or Facebook or something like that. Once you have it out, you might as well just see what else is going on. And be more present for my family.

[00:23:34] The watch was my cheat to feel like I'm still available for work, but also it minimizes what I can cause I'm not looking on Instagram or anything on my watch. That was my, little success story there. And I Just continue to strive to take as good of care as my, of my family and and my colleagues and my work family as well.

[00:24:01]It's a struggle.

[00:24:03] Dr. Asha Padmanabhan: It is, and the more we talk about self care and all those things. Do you give yourself some time to unwind and do other things? Do you schedule it? How do you make it work? 

[00:24:16] Dr. Amy Pulido: One of the CRNAs I worked with had this massage therapist that would come and she would come to her house and she had such a long drive.

[00:24:24] She'd always schedule her to come to my house because I live nearby. So that was nice. We don't have that anymore though. Cause she decided, the massage therapist decided she was going to stay stationary. I try to, I do massages every now and again. We're very fortunate that we have some close friends with kids similar ages and our husbands get along so we try to get together with them.

[00:24:48] It's been really hard during COVID because we haven't been doing that. And just read a good book or listen to a good podcast. 

[00:24:56] Dr. Asha Padmanabhan: There you go. There you go. Okay. Last question. 

[00:25:01] For a woman physician right out of residency within the first five years of practice who is maybe starting to think about, I would love to be involved or have my voice heard. What would you, advise me? 

[00:25:14]Dr. Amy Pulido: I, my advice is to certainly not dismiss someone. If they give you a compliment about your, presence or your leadership abilities. 

[00:25:27] I would say that you should certainly be open to taking on more projects if they're meaningful to you. Obviously boundaries are very important for women in leadership and you certainly want to make sure that you are not sacrificing your own personal time, for this potential. 

[00:25:49] I think that being able to have in your mind what those boundaries are taking on projects, like I said, that you feel are going to reward you. And it doesn't, it's not always monetarily, but there should be some something to gain from doing projects. 

[00:26:07] A lot of times, for me, it was educational. I was happy to, learn about a different system. And I felt like I was getting something out of it, but you don't want to take on projects that you don't feel like you're getting something out of it because then you're going to burn out.

[00:26:20]Say yes to, to things that people are offering you. And I think just to support one another before we got on the air, we talked about our tribe, right? Having a group of women and men. That are supportive of you having a voice? I think leadership is, to me is not about telling people what to do.

[00:26:45] Leadership is having a voice. And I think it's very important for, all of us men and women to, feel like we have a voice as physicians are at a time that we need to find our voice and be United with that. 

[00:27:03] And that is the perfect way to end this. We need to find our voice. Thank you, Amy.

[00:27:09] Thank you so much for joining us. 

[00:27:11] Dr. Asha Padmanabhan: Thank you for having me. It was so nice to see you.