In this episode, Haitian-American physician Gabriella Dennery, MD, OMC shares her personal story about how she left medicine after burning out. Dr. Dennery is a Life Coach at Doc Working who is also an ordained minister, composer, and musician. She is now coaching healthcare professionals on how to create healthier ways to answer their calling to medicine. She partners with physicians to help create authentic action plans that work for them and engages physicians to take steps that are achievable, practical, and fun. She’s also passionate about looking at her client’s internal resistance to transformation with compassion and honesty. Physicians often do not seek help when they’re stressed. The shame and lack of support from other colleagues may make stressful situations even worse. Dr. Dennery wants to help you overcome these obstacles by sharing her own personal experiences so that you can prevent burnout. You will not want to miss why she thinks a simple “Thank you” is an important key to burnout prevention.
Welcome to the Practice Impossible Podcast where your host, Jude A., Pierre MD, also known as Coach JPMD, discusses medical practice topics that will guide you through the maze that is the business of medicine and teach you how to increase profits and help populations live long. Your mission, should you choose to accept, is to listen and be transformed. Now, here's your host Coach JPMD.
Coach JPMD 00:24
Today we're going to have a conversation with Dr. Gabriela Dennery, MD. Dr. Dennery is a life coach for physicians at Doc Working. She graduated medical school at Howard University College of Medicine in 1992 and completed her Internal Medicine Residency program in 1995, at Duke University Medical Center. She's a certified wellness coach and an ordained minister. Our conversation is going to be around physician burnout and what physicians can do to avoid burnout. So here we go. Today we're with Gabriella Dennery, MD and life coach at Doc Working. And I want to let Gabriella introduce herself and give us a little background as to who she is and what she does.
Dr. Gabriella Dennery 01:08
Well, thank you, Jude. And I'm so excited to be on your podcast and congratulations! This is exciting news!
Coach JPMD 01:14
Thank you. Thank you.
Dr. Gabriella Dennery 01:17
Well, you know, as you said, my name is Gabriella Dennery. And thank you for the correct pronunciation of my name. I appreciate that. And I'm a life coach at docworking.com. And I used to practice medicine. I was specializing in internal medicine, I decided instead of sub specializing to just go straight into primary care. And so I did adult primary care for about seven years. I practiced about five years in Harlem and then I did two years in Brooklyn. And I specifically worked in underserved areas, because that was what was my calling, my mission was to work with patients who didn't necessarily have consistent or good access to health care. I do confess that I burnt out though, it's tough work. And I chose to work for institutions, as opposed to private practice.
However, you know that there are pros and cons to all of that. And at the same time, I think that I did not really take care of my self care that well, as I was practicing, and it's only at the tail end, where started finally realizing that maybe I needed to change how I approached my life and my work. At the same time, I had other interests. And so the combination of the two kind of created that perfect storm, that there was something pulling me out of medicine, which is music, I'm a composer, and something kind of pushing me out of medicine, which is burnout, bottom line. And so I made the decision to leave. In the meantime, as I was shifting or transitioning between the two. I discovered live coaching. And I actually, I think I was just bumped into on the internet. And then one of my sisters is a life coach.
And so we started talking about it. And as I was looking through different programs for certification, I bumped into a health and wellness certification program for life coaches, which is called Well Coaches. And it was very well thought out course, evidence based and so I signed up and I took it, and at the same time actually enrolled in a personal spiritual development course for my own spiritual growth and health and support. Because this is something that was very important to me, but I was kind of doing it on my own. I was also working with the therapist in the tail end of my attending years, but something was missing. And that was my spirit, that last component, if we look at mental, physical, emotional than the last component, which was spiritual health. I still needed to kind of fill that hole.
And so as I was enrolling in the life coaching program in the health and wellness coaching program, I was enrolling in Yama Vincent's Institute for Spiritual Development, which is founded by Reverend Dr. Iyanla Vanzant. And so I took her program for two years very intensive, it's like 10 years of therapy, packed into two years, it was amazing. And then eventually, I went back to do my ministerial certification ordination, which I was ordained in 2019. So my road from medicine to what it is now, this road is a 16 year road. I left medicine in 2005. I wasn't quite sure where I was going, but I knew it had something to do with music. I knew I had something to do with my relationship with God.
But I had no clear plan or picture, I just kind of dived. So life took me in those directions, which also included life coaching. And part of the training at the innervisions Institute was spiritual life coaching, which takes the life coaching to really different level and deeper level. And so I saw a place for me in all of these travels, where I can kind of combined my background as a physician, my aspirations as a musician, and creative, you know, as an artist, and how to have that kind of coaching conversation with people. Because it's a very different conversation than the medical conversation. And I think part of the burnout was I got tired of talking about impossibility with patients, what was not possible. No, you can't do this. No, you can't do that. Always restricting a person's life.
But people have lives outside of clinic walls. And they have all sorts of other variables that come into play, many of which I didn't know, as a primary care doc, in 15 minutes or 10 minute visits, it's really kind of hard to ask. But when I started asking, let's say, there was a day where a bunch of patients missed their appointments. And I could take a little more time with those who came in, I started asking those questions. Where do you see yourself five years from now? Where do you see yourself 10 years from now? What do you see for your life? And you know, a few of them kind of looked at me funny. It's like, what the heck are you asking? Rather than just going through the review of systems? Any chest pain today Mrs. Jones? No. I stopped those kinds of questions, because it's the same routine every time. And I started asking about their lives.
And a few answered, and it blew my mind, absolutely blew my mind that people no matter how tough the circumstances may be, and unfortunately, don't have permission to use the stories, I'm not gonna, I have one patient in mind, a couple patients in mind, where we had those kinds of conversations, just open the doors to possibility to what was possible, even in complicated circumstances. So the aspirations were just tremendous. So one patient, you know, without sharing names, or anything, you know, I was asking about, well, what is your aspiration? And she was kind of conforming to what was expected of her? Oh, well, I guess I'm gonna get married and have kids and, and she looked absolutely miserable. And it's like, is this what you really want? And she said, No, it's not. But I don't know what else to do. I was like, well you got to think about this.
Because you can either be unhappy or happy. And it's truly your choice. What would make you happy? So about six months later, she comes back in a business suit, just from head to foot looking fly. And I said, What happened? And she said, well, I opened my own business. Yes, yes, yes! Because that was a conversation about possibility. And she came back to she didn't have an appointment, but she came back to show me dressed in her business suit. And that was so exciting to me. And so over time, there were hints like that, when I started opening up the question, and coaching does that it opens up the question, and that your client has the ability to fill in the details, because your client already knows the details.
Coach JPMD 07:41
Yeah. So you said so much in the first couple minutes of this podcast. So it's just wonderful. But it's great, because it lends a question as to why you did you go into medical school? Why did you go into medicine?
Dr. Gabriella Dennery 07:56 Oh, wow!
Coach JPMD 07:57
Right, because, because I think training in medical school doesn't allow us to understand what you just described. And sometimes it takes 5, 10, 15 years in practice to realize that, and I have similar situations where my 65 year olds just retired, very well off, they could probably not work for 30 years. But they look lost, they're obese, their diabetes is out of control, their blood pressure is out of control. And I asked them, "What do you want for the next 30 years?" And they look at me like, "What do you mean?" I said, Yeah, what do you want? "I don't know, Doc, I've never been asked that question." So it's interesting to see even successful people who are 65 years old, with multiple medical problems, and not understand where they need to be in life.
Dr. Gabriella Dennery 08:42
Coach JPMD 08:42
And so, as a physician, where did you see yourself when you were in medical school? Were you pushed by your parents? Were you? Was that an influence in your decision?
Dr. Gabriella Dennery 08:53
Oh, it was a huge influence in my decision. Mom is a doc, dad is a doc. My father, my mother in particular, she held up that Haitian five hands, okay. Those five fingers, that you could do whatever you want in life, if it's one of these five things, medicine, law, dentistry, engineering, or agronomy. Yes, agronomy was the thing. And so since I was at least five or six years old, I would see that hand, okay, choose what you want. And medicine was the family business. That's all I understand as the profession to be. And it was very clear that that was the preferred route. And you could go into law, but you know, that it's better to go into medicine, right? So that was that push on the one hand, but on the other hand, I also had a calling to help people and to me, medicine and helping people was one in the same thing, because that's what I was exposed to. My father wanted to open a hospital in Haiti. He's from Ocai, and he loved Agile beach. And so he had this imagination. He was going to open a hospital in neurological, he was a neurosurgeon, so a neurological specialty hospital in Agile. And he actually had an architect draw up all the plans. And I remember seeing the plan, he would lay them out on the kitchen table and show, you know, say "Dad show me the plan! Show me the plan". Because I would imagine, okay, Dad you're a neurosurgeon? I'm going to be a neurologist, and I'm going to go work in the hospital with you. So there was that part of the vision back then when I was a little girl, because it's like, I wanted to be working with my dad, and I wanted to help people. And the idea of being in Haiti and working in Haiti was just so exciting to me. And I said, "Yeah, I'm gonna, I'm gonna work in your hospital with you, and I'm gonna help you run your hospital with you". Yeah, that was the childlike fantasy. So there, yes, I was pushed in that direction and accepted that push. At the same time, I kind of made it my own.
Coach JPMD 10:52
Yeah, that's, that's a great story. And I think other physicians, especially physicians of, from our background, because I'm also from Haiti, as you know, and there is a big push to, to push our kids into doing something that's better than what we did, and to really help the country because we know that our countries is in dire need of help, especially healthcare help. And I think we have, we have the opportunity, as physicians who have done this, have practiced, and now have transitioning or looking to transition, either a year from now, five years from now, 10 years from now, and coaching other physicians coming out to know how to live, how to practice. And so what are some of the struggles that you see coaches face or physicians face as a coach? What are some of the obstacles that you see them in, facing in their, their journey as, as human beings,
Dr. Gabriella Dennery 11:47
Physicians, for the most part, are very smart, pragmatic people, like as a cohort. And so to kind of break that pragmatism down. Perfectionism is a big thing, accepting that it's okay, to have to make 80% rather than 110% for absolutely everything in your life. Being less logical and less practical sometimes and it's okay to be introspective. Vulnerability, and accepting being vulnerable. That vulnerability is not weakness, but to get the physician to understand that it takes a windy road. Little by little by little, you chip at it little by little to get to the core of that person. I know that in my own journey, understanding that having emotions was a good thing. That being able to cry and to release was a good thing. To admit when I did not know something, or that I was overwhelmed or feeling overwhelmed, was actually what could actually save my life. I understood that after I left, but while I was in it, it was very hard to accept. Because there's always that push to be perfect. There's that push to, to have it all. But that push then spills over to the home life. it spills over to from you know, cooking a meal to you know, planning an outing with your family, to it spills into everything, you can't say that I'm one way at work in one way at home. It's all connected. And so to be able to, you know, if you show up at work at home in a certain way, and you'll show up at work that same way, etc, etc. and vice versa.
Coach JPMD 13:29
Dr. Gabriella Dennery 13:29
And so I think those are the challenges really is one, understanding the importance of self-care. Two, being able to accept vulnerability as your humaneness and the beauty of your humaneness. Then number three, letting go of perfectionism and having it all together all the time.
Coach JPMD 13:44
Yeah. And really, it comes from our training, I think it comes from and how we're trained, and how, you know, if we are not the best, and we don't do the best, so we don't get the best program matches, or we don't get the right job, because it's very, very competitive. And so in a coaching world, how do you measure success for those physicians that you're coaching? What are some of the metrics that you use? Or if you do, do you have metrics that you use?
Dr. Gabriella Dennery 14:13
Not figures, not facts and figures. But I would say, let me say something about programming. I think that's an important point that you bring up is that yes, that programming is very deep and ingrained from undergrad to med schools through to residency training, fellowship, training, whatever other kind of training or, you know, etc, etc. And so yeah, there's these, the brain has now adapted to this kind of way of living and undoing those patterns or creating new ones is the biggest challenge, working with physicians as as a life coach. So I just wanted to bring that up, because that we have been trained very well for decades.
Coach JPMD 14:55
Dr. Gabriella Dennery 14:56
It's not just a few years, it's decades and so on. Do that programming and still be able to practice is the challenge to be able to see ourselves in a different way.
Coach JPMD 15:05
Yeah. And I discussed that in my first episode where it takes about 66 days to create a habit. And that habit becomes part of your subconscious. So when you're when you're turning right, at a light, you don't say "I'm returning right so I'm going to put my right turn signal on and then turn right". It's all automatic.
Dr. Gabriella Dennery 15:25 It's automatic, right.
Coach JPMD 15:26
So it's an automatic behavior that, that you learn through repetition. And after 66 days, it becomes part of your subconscious. And so now, it's, it's how we act, it's how we practice is how we treat our patients. It's how we treat our staff. So..
Dr. Gabriella Dennery 15:42
And our families.
Coach JPMD 15:44
Yeah, they become a part of that automation process. And I think sometimes it takes a shock. Sometimes it takes a life event. Takes, unfortunately, sometimes it takes a burnout. But you know, I think we're in the business of preventing that.
Dr. Gabriella Dennery 16:00
Coach JPMD 16:01
Because if we can prevent it, then then we have more successful physicians and more successful people in this world.
Dr. Gabriella Dennery 16:07
I agree. So back to your question of success, and how do I measure success? I don't have metrics, I'll be honest with you, for me is, you know, when I go into a coaching session, I set my intention to say if I can create an atmosphere, one of trust, that's fundamental, where somebody can find that "aha" moment that will shift their direction, even if it's by a half a degree, by their standards, whatever their standards are. Then I did my job, then I am successful. To be it for somebody to say, "Oh, I didn't think about it that way. Or, oh, you know, I"... that, to me, is the biggest, most amazing "aha" moment. So that recalls, one of my clients where busy professional, who, frankly, high performer used to being a high performer in absolutely everything that she did. And then we've talked about what's wrong with a C plus, instead of an A plus? How would that feel? And it took a while and the way we got to that point was for her to enlist help from a colleague. Which she was loathing to do, because oh, this person is too busy. I can't disturb her. But I know she can answer my question. But I'm not going to ask. I said, "Well, why don't you just ask one question?" Just one, and see how that works. So she did. And guess what happened? The person answered and said, "Hey, whenever you need help", because this person had more experience, "whenever you need to help you don't hesitate to knock on my door". You know, so it was just breaking through that 100%, 110% mentality, that maybe I don't need to know everything, right, to get my work done. I can solicit help from other people. And there's nothing wrong with that. It doesn't, you know, there was a sense of shame tied to asking for help. And so we, you know, little by little, we were working towards a breaking that sense of shame for her to enlist the community around her so that she wouldn't feel so overwhelmed at work. And she was also overwhelmed at home. So it's like, let's change this dynamic. So just by learning to ask a question is a way to ask for support. Just asking a question is a way to ask for support. And I think that "aha" moment happened. And I'll say, okay, yes, I did my job.
Coach JPMD 18:33
Yeah, it's very interesting. It's also interesting that I've done a couple of interviews, a couple podcasts, and the word shame has come up in different areas, when dealing with speaking about physicians and in finance and physicians in their health, their mental health, and dealing with getting help. Because we are, it's ingrained in us that if we get help, then we may be shamed, or we may be belittled. And, and I think some of it has, I think a lot of it has to do with just the way we were trained. But I think we need to have an episode just on shame. And how we can break that.
Dr. Gabriella Dennery 19:11
I think that's, it's a tough one. Because it's, it's, I know, when I was starting therapy, what inspired me to start therapy when I was an attending physician, was one of my mentors. And that too, is important. You know, having mentors, having people that you can go to, you know, under any number of circumstances, and it shouldn't, you know, shoot, when I tell my clients is shoot for five or six people, because everybody has a different role. You can't have one person who just is can help you with absolutely everything. Everybody has a slightly different role. And so find five in different roles and fill that up. And if you have these holes, then make it your mission to fill that hole because that's what's going to get you through. Through med school, through training for residency training, and through your attending years. So I had by chance, a mentor at one of the in Harlem, it kind of just happened organically. I didn't seek it. But we kind of struck up a friendship one of the pediatricians there was an absolutely amazing physician who burnt out, left, and then came back. She was a whole different woman when she came back, oh, my God, the smile on her face, the relaxed nature, the kind of more philosophical more, you know, being able to see herself in the bigger picture and see her practice in a bigger picture and say, "Well, what did you do?" I want, inquiring minds want to know, and so because I was feeling very restless at the time, and I knew that I had to make a change somewhere, somehow. So she talked very openly about being in therapy. And I was shocked. Because this was back in the, you know, early 2000s. And still, even back then it's like, we didn't even talk about burnout. We didn't even know what that was, the word was not even in our vocabulary. And at the same time, you know, you didn't talk about mental health in physicians. What if somebody found out? What if, because my life, my health insurance is tied to my job? What if somebody in the office looks at the diagnosis that the therapist gave me? And the ICD-9 codes that said, major depression, and PTSD, that's what was on my sheets. And it's like, oh, my God, what will happen to my career? If somebody finds out? So I started paying out of pocket because it's like, oh, no, I don't want a record of this. Because there was that, that stigma, and that shame associated with it. And it's like and that pride, the physician pride. Imagine that you are your first client that you are your first patient, would you recommend to your patient to take care of everything themselves? If they needed support? What would your recommendation be? So why would you want to fix it yourself and trying to fix you, yourself? When you wouldn't recommend that to your patient? It makes no sense.
Coach JPMD 22:09
Yeah, so in hearing the stresses of the physicians and hearing what they've gone through what what they've struggled with. Is there a book, one book that you would recommend that physicians, your physician clients read?
Dr. Gabriella Dennery 22:23
Yes, there's one book that I simply absolutely love. It's a quick read, and I recommend it. It's called a Simple Act of Gratitude. I have it with me now. So I want to make sure that I read it properly. A Simple Act of Gratitude, how learning to say thank you changed my life. And the author is John Kralik, K r a l i k. And this was the story. And as I said, it's a nice little book as a quick read. And this is a story of a kind of a Down and Out attorney who was his business was in a shambles, his marriage was in a shambles, his breaking up with his girlfriend, you know, his relationship with his children was strained, especially the older children. I mean, nothing was working, he didn't know if he could make payroll, I mean, everything was kind of falling apart. And at one point, he received a letter from one of his, his ex girlfriend, who, who actually thanked him for being in her life, that although things didn't work out, but she was still very grateful to have him in her life. And so he was, it kind of shocked him. And that coupled with a meeting with a good friend who said, you know, if you're not grateful for where you are now in what you have, now, it'll be really difficult to move forward in anything else. And so, once he got that note, he realized that he had never said thank you to anybody, not in those terms, like he knew people who would send these letters, you know, every time you go to dinner, you know, somebody sends you a thank you card, or thank you for, for having us over, and that kind of stuff. And it didn't occur to him to do that. So he started doing it, writing these little thank you notes, to his staff, to his family members, to his older children, etc. And little by little by little by little, and next thing, you know, the response was just something that he really did not expect, you know, old clients who finally started paying their bills, people in the office thanking each other, you know, being appreciative about him and sending him notes and then thanking each other for their work, and their, their their hard work, etc, etc. So, I mean, and it started just kind of snowballing that way, in a good way. Why is this important? And gratitude in and of itself is so important, because it shifts the mindset. And number one, it is ridiculously simple. And one of the things with physicians is that they expect things to be complicated to be worthy. And when you try to convince them that something simple can actually make a massive change in your life. It's a tough one. So I love this story, because there's also a body of research around gratitude, which is interesting. I just kind of started reading on it. It talks about the physiological effects of gratitude, increase in serotonin levels. For example, the happy neurotransmitters and in, you know, it can potentially be helpful for mild to moderate depression, that even physical effects of gratitude including decreased blood pressure. I mean, somebody, I think there was one suggestion of an improved lipid panel, sorts of wonderfulness. And so on the one hand, it sounds outrageous. It's like, well, how can this it's not a pill. It's not complicated theory. And it's not complicated medicine. But this is a formula that has worked for 1000s of years. And so medicine is finally catching up to that, and the impact of gratitude on the human body, the human soul, the human spirit, and every aspect of life. And so it does create a shift. When you find something to be grateful for, even if it's the simplest thing. You know, I keep a gratitude journal. Sometimes I'll send gratitude notes to friends out of the blue saying, I thank you so much for being in my life. And the response that you get from that, it creates a very different kind of positive shift in mindset personally, and that energy radiates outward.
Coach JPMD 26:02 That is correct.
Dr. Gabriella Dennery
And people notice the changes, they do. And you notice the changes too. The level of stress and overwhelm just goes down. The circumstance may be the same for now. But your perception of it, how you relate to it changes.
Jude Pierre 26:17
So good. It's just so so powerful.
Dr. Gabriella Dennery 26:20
It's simple! It's so simple. And yes, healing is simple. What's the old saying, I can do bad all by myself. Yeah, I can do bad all by myself. But it really takes a village to raise a doctor. So part of that village is gratitude. It connects you to people again, it staves off the isolation and the need to figure everything out alone. People come to you, people ask about you, you reestablish relationships when you do that. And that goes a long way to burnout prevention. It goes a long way to treating burnout because part of burnout is isolation. Part of burnout is disconnecting. And imagine this simple little formula, and I tell you simple is best, it doesn't require a massive prescription of anything, all you have to do is say "thank you". And you do this consistently, the longer you do it, it becomes a habit. As it becomes habitual, you notice that how it impacts your life. You can, Oh my god, I love this as a tool. As a coach, I think it's a fabulous tool.
Coach JPMD 27:22
So I think I think you've already described the one of the three things I'm going to ask you that can help physicians Practice Impossible, because we're about figuring out how to help physicians Practice Impossible. And so gratitude.
Dr. Gabriella Dennery 27:38
Coach JPMD 27:39
Expressing gratitude, so what's two more things?
Dr. Gabriella Dennery 27:42
Support, stop trying to do everything by yourself. Stop trying to solve everybody's problems, whether at home or at work, you know, that habit of we go to that person, which was the way I ran my life to. Oh let me come up with a solution for you. Why? People are perfectly capable of finding their own solution. You don't have to be everything to everyone. And in fact, it empowers people, when you say you know what? I trust that she'll figure it out. It empowers people. So that's part of the self-care, delegation is a crucial part of self-care, and letting people you know, grow up and be their own person in finding the solution that works for them. And that's really the fundamental of coaching as well. So gratitude, delegation, mentorship, and support is key. Find those five people in your life, whether it's confidence on the personal realm, professional support, whether it's practice-related issues, patient-related issues, that you're not sure what to do, you know? Doctors have all had mentors back in the day.
Coach JPMD 28:47 Yeah.
Dr. Gabriella Dennery 28:47
I'm not sure how that changed over the years and over the generations that now people kind of operate in silos or be in silos. You always want to have a contact person who can help you discuss patients, who can help you solve some dilemmas, and personal support systems as well. Especially, you know, if you're a sandwich generation physician, when you're dealing with elderly parents, and you're dealing with children, and you're dealing with work. How? You can't do it, you can't do it by yourself. So stop thinking you can. What's your support system? If you don't have one, define one, find it, define it, write it down. Don't just think about it, put it on paper, make that commitment.
Coach JPMD 29:31
Such great, great advice. Gabriella, I can't, I can't express how elated I am having you on this podcast because you've touched on so many things that are important in physicians lives and you know, I want to be able to support you as well. Where can where can our population find you?
Dr. Gabriella Dennery 29:51
Well, you can find me at docworking.com, docworking.com and you just go to the to the website and you'll find the coaching page very easily. And you'll see me there.
Coach JPMD 30:04
But you also have a podcast as well, right?
Dr. Gabriella Dennery 30:06 I do.
Coach JPMD 30:06 Because I was on your podcast.
Dr. Gabriella Dennery 30:08
Yes, you were. And thank you so much for a fantastic guest!
Coach JPMD 30:11 Thank you!
Dr. Gabriella Dennery 30:13
And yes, I co-host with the other lead coach at docworking, Gil farmer, and with Jen Barna who's the founder of docworking, the docworking the whole physician podcast. So you find it on iTunes, Amazon, Audible, wherever you, you know, Spotify, wherever you find podcasting. And so we're very excited about that offering. And we talked about the physician's life and as many different aspects of it as possible.
Coach JPMD 30:39
That's wonderful. Thank you so much Gabriela for coming onto my podcast. And I hope to do this how to do this again, this was fun.
Dr. Gabriella Dennery 30:46
Oh, thank you. Thank you so much. And I know we'll be talking again. And so thank you. I'm excited for you. And I'm excited for this project.
Coach JPMD 30:53
Thank you. What a great conversation that we had with Dr. Dennery. It's amazing how a lot of the episodes that I've been doing are tied into what she discussed in this episode. And I think one of the key things is to understand how to seek help from your colleagues from friends from family. So I remember studying in medical school with a good buddy of mine, Ben Cilento and hopefully maybe I can have him on the podcast as well. He recommended that when you're in a study group, you should always study with someone that has a little bit more knowledge than you do. And someone that doesn't have as much knowledge as you do. So that you can learn from the person that has more knowledge and teach the person that doesn't have as much knowledge, some of the coursework that you're you're working on and that that will help you grow as a student, as a physician. And I find that advice is similar to what Dr. Dennery was saying in this podcast. So I invite you to take a look at the show notes. We have some good resources for you at Practiceimpossible.com and give us some feedback. Let me know what you think. And if you're interested in being part of this podcast and to have a story to tell, or you want to help your colleagues Practice Impossible. Leave me a note and we'll be glad to have you on the podcast as well. Thank you so much for subscribing and listening to my podcasts and we'll see you in another episode.