Ever wondered how to tackle the beast of burnout in medicine, or how to differentiate between self-doubt and imposter syndrome? Join us as we explore these vital topics with Dr. Diane Shannon, a former primary care physician and a well-regarded burnout expert. She shares incredible insights on how to identify and manage external sources of self-doubt, such as gaslighting and microaggressions, which can lead to burnout. Additionally, Dr. Shannon offers invaluable strategies for finding allies and mentors, and for confronting imposter syndrome head-on.
In our enlightening conversation, Dr. Shannon also sheds light on the importance of striking a balance between productive, enriching, and non-productive activities in our lives. We delve into how neglecting non-productive activities can potentially lead to burnout and how the culture of medicine has changed, making self-care vital for a sustainable career. Dr. Shannon provides practical advice on how to reclaim your time and well-being, presenting a hopeful perspective for those feeling overwhelmed. Step into this riveting conversation for expert advice on managing burnout and moral injury, and start the journey toward better self-care in medicine. Don't miss out on the opportunity to learn from Dr. Shannon and transform your journey in medicine!
Though I am a physician, this is not medical advice. This is only a tool that physicians can use to get ideas on how to deal with burnout and/or know they are not alone. If you are in need of medical assistance talk to your physician.
Learn more about female physicians' journey through burnout to thriving!
https://www.theworthyphysician.com/books
Let's connect for speaking opportunities!
https://www.theworthyphysician.com/dr-shahhaque-md-as-a-speaker
Check out the free resources from The Worthy Physician:
https://www.theworthyphysician.com/freebie-downloads
Battle of the Boxes
21 Day Self Focus Journal
Ever wondered how to tackle the beast of burnout in medicine, or how to differentiate between self-doubt and imposter syndrome? Join us as we explore these vital topics with Dr. Diane Shannon, a former primary care physician and a well-regarded burnout expert. She shares incredible insights on how to identify and manage external sources of self-doubt, such as gaslighting and microaggressions, which can lead to burnout. Additionally, Dr. Shannon offers invaluable strategies for finding allies and mentors, and for confronting imposter syndrome head-on.
In our enlightening conversation, Dr. Shannon also sheds light on the importance of striking a balance between productive, enriching, and non-productive activities in our lives. We delve into how neglecting non-productive activities can potentially lead to burnout and how the culture of medicine has changed, making self-care vital for a sustainable career. Dr. Shannon provides practical advice on how to reclaim your time and well-being, presenting a hopeful perspective for those feeling overwhelmed. Step into this riveting conversation for expert advice on managing burnout and moral injury, and start the journey toward better self-care in medicine. Don't miss out on the opportunity to learn from Dr. Shannon and transform your journey in medicine!
Though I am a physician, this is not medical advice. This is only a tool that physicians can use to get ideas on how to deal with burnout and/or know they are not alone. If you are in need of medical assistance talk to your physician.
Learn more about female physicians' journey through burnout to thriving!
https://www.theworthyphysician.com/books
Let's connect for speaking opportunities!
https://www.theworthyphysician.com/dr-shahhaque-md-as-a-speaker
Check out the free resources from The Worthy Physician:
https://www.theworthyphysician.com/freebie-downloads
Battle of the Boxes
21 Day Self Focus Journal
When we take care of patients, we want to do our best, and yet, if we question ourselves, how do we tell the difference between self-doubt and imposter syndrome? This is a question I asked Dr Diane Shannon, a physician who is now non-clinical and focuses on coaching women physicians as well as discussing burnout. I had the pleasure of meeting her in Los Angeles back in February of this year and she has expertise in this area and she can help tease out these two topics. So let's dive in. Welcome to another episode of the Worthy Physician. I'm your host, dr Sapna Shahok, reigniting your humanity and passion for medicine.
Speaker 2:Hey, thanks, dr Shannon, for coming up. Yes, you're welcome. I'm happy to be here. I really appreciate your work and just your expertise. You have quite a bit of experience with physician burnout, moral injury and working with really high achieving women. As far as coaching, yes, that's right. For the ones that have not listened to you before, can you please introduce yourself?
Speaker 3:Yes, my name is Diane Shannon and I am a former primary care physician. I trained in internal medicine and burned out during residency, but pushed myself to finish and take my internal medicine boards and practiced for a few years. I pushed through the burnout, but what happened when I was practicing is I kept looking for a setting where I was sure I wouldn't burn out again and I did not find one At the time. This was many years ago. There really wasn't the discussion that's going on today. I was just not aware of burnout and what it is and how to address it and how to prevent it. Really, at that point, it was a really dark time, a very hard decision, but I chose to leave medicine and went into writing and was a freelance writer for 20 years, writing about our healthcare system and health policy. As part of that, I got the courage to tell my story about burning out and leaving practice. When I did this was back in 2011 or so. Physicians contacted me and said they didn't know anyone else felt the way they did.
Speaker 3:Now there's plenty written. You can read lots and lots about burnout, but back then there wasn't as much. It really inspired me to focus on addressing burnout. I wrote a book with another physician on how to understand and look at and prevent the system factors that drive burnout, because those really aren't. The key drivers are not the individual, it's the system. It's how professional burnout is defined. Then, after that, I thought I really want to do something in addition to speaking and advocating for change. I want to do something that led me to training, certification, which was about four years ago Now. I focus specifically on helping women physicians to create lives that actually work. I love my work today. I'm so inspired by the physicians that I work with.
Speaker 2:That's awesome. Thank you for that, because in medicine, the hours that many times we are expected to put in or we choose to put in can become unbalanced with other aspects of life. Recently, you spoke at the Women in Medicine conference. Is that correct?
Speaker 3:That's right. Yes, actually, just a few weeks ago now, it was a summit in Chicago put on by Women in Medicine, which is now a nonprofit organization. It was incredibly inspiring to be there at the summit, one of my all-time favorite conferences I think I've ever been to. While I was there, I led a workshop on self-doubt and understanding self-doubt and where it comes from. I led it once and then repeated it. It was really a great experience for me.
Speaker 3:I think the feedback I got was very positive in that one of the important things to understand about SAUT is that it can come from internal sources, and that's what often is referred to as imposter syndrome, but it could also come from external sources in the form of your environment, especially if there's gender or other forms of bias in your environment. There's a great hard business review article that's called stop telling women they have imposter syndrome, and so much of what I said is inspired by that and also by an understanding of imposter syndrome. Take on, it is that both exist. That imposter syndrome, those feelings of not being good enough, of I'm going to be found out because I don't have the credentials that I think I should, of not being able to accept accolades or achievements really own them. That does exist and, at the same time, it's really important to discern whether there are elements in your environment that are actually causing self-doubt.
Speaker 3:So if you are, for example, there's gaslighting going on, which is where someone in a position of power is telling someone else that their experience isn't actually happening.
Speaker 3:So if I'm experiencing gender bias and maybe I'm being passed over for promotions and I approach someone and point that out and they, oh, no, no, no, that's not why you were, you were passed over, it's all of these other reasons, right, and that keeps happening, you begin to think, well, maybe there is something wrong with me, maybe I am really not eligible for those positions, when actually there is this. There may be this element of bias going on in your environment. So we talked about gaslighting and what it is, how to recognize it, microaggressions, what they are, and the point being that when you're experiencing something in your environment like that, when the self-doubt is coming externally, that you really need to join with other people. You need allies, you need a mentor, you need that support to really begin to own your own reality and then do something about it, whereas with imposter syndrome, there's a lot more that you can do internally to address some of those negative messages that are driving the self-doubt and why?
Speaker 2:how is that related to burnout in your opinion?
Speaker 3:Again, burnout is really fostered and fueled by the system factors and health.
Speaker 3:We know what those are. Right, it's the productivity pressure, the time pressure, the amount of the workload, the documentation that takes us away from the meaning of medicine. So, though that's all true, at the same time there are places where individual factors or characteristics can exacerbate systems or situations where they're already stressed and make them worse. With foster syndrome specifically, one of the characteristics is trying to work extra hard to compensate for those feelings of not being good enough of I may be an imposter, so I've got to really work extra hard here, and so that can lead to burnout or exhaustion just because of trying to do more and more. And especially if you're in a workplace that is not set up to be reliable or is not, there's all sorts of workarounds and there's all sorts of extra work piled on to the physician, then that is a set up for burnout Sure.
Speaker 2:And before we started recording, we had talked about how self-doubt can sometimes plague women more than men. Is that what you have? Has that been your experience, or is it across the board?
Speaker 3:What I understand is that, at least with imposter syndrome, supposedly it affects both men and women. Yet it shows up differently and I can speak just from my experience in terms of working with women physicians, and that is that it tends to show up as in holding back. So if there's a job posting and it's something that, oh, that would be great, it would just be a step forward. Allow me to have greater impact in something I care about. And yet I look at the criteria and I say, oh, but I don't have that one criteria, so I'm not going to apply.
Speaker 3:Whereas this is what I've heard for male physicians in that same situation, they may not have a number of the criteria, they'll go ahead and apply and if they get into that position, that's when the imposter feelings may strike. When they have that position and they're being stretched, they begin to have some of that self-doubt, whereas for women, it holds them back from even applying for that stretch position. So again, this is what I have read. My experience is working with women and I definitely see it in terms of holding back, but also in terms of some of the mental strain of continuing to doubt your decisions. So, making a decision, it could be a small decision or an impactful decision, and then wondering did I make the right decision? And spending a lot of energy and cognitive space on that doubt of oneself and one's decisions.
Speaker 2:That's a lot of time spent.
Speaker 1:Yes.
Speaker 2:That's a lot of time spent and then you can just go down that rabbit hole indefinitely if we don't pump the brakes on that. Absolutely yes, and so what is something that a person could do to address self-doubt? Because it comes up that throughout the career sometimes we have bad outcomes of patience, or maybe the system changes, the culture changes at work, so it can be exacerbated. In addition to all the other, I would say, roadblocks that you mentioned before, that we know contribute to burnout 100%. What could somebody do when they're going down that rabbit hole of self-doubt?
Speaker 3:Yeah, I think the first step again is to just do a check and see is there something in my environment that's driving this, and just to be aware of that and then, if it looks like it's internal, what I asked people to do in the workshop was really think about an example of when that comes up. When that self-doubt comes up Either maybe you're thinking about doing a presentation or you're thinking about applying for a position and the self-doubt comes up what are the specific voices that self-doubt is saying? So getting those out on paper, what are a couple examples of those negative thoughts? And then to say, okay, what is the polar opposite, what is the opposite thought and it might be based on an actual strength that you know in yourself, or it might just literally be the opposite and to come up with a couple of those and then to practice those positive statements over and over again throughout the day until that becomes more in the default than that negative thought. I think that can be really helpful.
Speaker 3:The other thing is a reality check and when that doubt comes up, it may be oh my gosh, I never should have been hired for this position. What are my credentials? Why did they hire? What have I done, that would explain their trust in me, in being in this position. And then to look at what have I achieved and really try to hold on to those achievements and see them rather than downplaying them. Because that is what tends to happen with imposter syndrome, is the positive things happen or the achievement happen and then very quickly we move on to oh, but I have to do this other thing or I haven't done this or that instance.
Speaker 3:So I know for myself, when I experienced this in the past, I came up, especially around public speaking, and so for me it was identifying the thoughts that were coming up, not just when I was actually doing the presentation, but even practicing the presentation. Those thoughts would be up and they were so distracting they made me less effective at what I was trying to do. So rooting those out and then having a sense of what might be a more positive frame of mind, trying to hold on to that. And in the beginning we don't believe those positive statements necessarily. They may feel like it's complete fantasy. Right, I am confident I have what it takes, or that the people in this room want to hear what I have to say in this presentation, whatever the positive might be Thank you. Forcing yourself to get into the habit of those positive statements can really make a difference.
Speaker 2:Now. I appreciate you sharing your vulnerability. You know getting up in front of and speaking to people can be daunting and it's a part of your profession that you do now, correct.
Speaker 3:Yes, and I actually have grown to like it.
Speaker 2:Yeah.
Speaker 3:But I do. I recall I was working with a coach actually and she said what are those voices saying? And when I had them out on paper I thought no wonder I was having so much trouble. There's this constant chatter that was going on in my head that was making me inarticulate at the moment because I was so distracted. So by getting more putting attention on that it was, I was able to let it go and really be more in the present without those distracting thoughts.
Speaker 2:That's actually really. I appreciate that because it can also translate to to medicine and how we interact with our colleagues or even the patients, so it's something that can be translated to across the board. And with your other work, I'm a fan of your blog and you just have a. You have a great piece about time. Can you go into that? Because I thought one of the one of the phrases that I really appreciate when I was reading was that if one area is taking up too much of our time, things get off balance. So can you explain those three areas of time, the meaning behind that?
Speaker 3:Kate struck me at one point that basically there are three categories of time, and one is productive time. That might be work, or it might be at home doing something that feels like you're achieving something or getting a task done. And then there's non productive time. That's enriching, so that's something that builds us up it's not necessarily creating something, but it builds us up. Either that might be rest, it might be an activity or hobby that we love, connecting with people and then there's time that's non productive and not enriching, and that's my personal example is binging on Netflix, right. And so the idea is that we actually need all three. It's not that we need just productive time and non productive enriching time. We actually need some of that completely mindless. Let me just escape for a while time.
Speaker 3:What I've seen in physicians is they tend to have productive time and then the non productive, enriching time around the edges, but we're missing that middle category and I think really having some of all three is important when you're so tired or when you feel like you're barely keeping up with the productive time, like the work time, and then when you're home, trying to get the whatever it is the dishes done or the laundry done or the kids settled, it feels like there is zero time to do anything.
Speaker 3:That's recharging and whatever little bits you have you want to spend doing the distracting time, and that makes sense, like your bandwidth is really full. The idea is that if you can translate a little bit of that time, either by becoming more effective at work, by delegating, by deleting something that you're doing, saving some time and energy for yourself so that you can have more of that enriching, so that you're getting more of that than just that little bit around the edges of going through Facebook or Netflix or whatever it is that you do that's distracting. So having more of that's really going to refill you for the next day or the next week, or to be the person that you want to be at home.
Speaker 2:I appreciate that. I really do. It's just it's nice to hear the same thought about self care or time for yourself, maybe in a different way or from somebody else. The more somebody hears that, I think, the more it resonates. And, to have it more mainstream, this is not something that was talked about when I was a medical school or residency.
Speaker 3:Right? Absolutely not.
Speaker 2:Yeah, I would even say there's a generational gap. I think I've talked to older physicians and this is in the past and I don't think it was not malicious, but I think it was the difference when, okay, you go into medicine and you give everything 100% all the time, where I think, with as much as medicine has changed, we have new, there's the EMR and then there are the patient satisfaction scores and the different to care that change every six months depending on which college you look at. So for somebody like me I have other interests outside of medicine, I have a young family For me, it's really important to have that time. So this conversation with something like yeah, I'm tired, oh, what are you talking about? I do X, y and Z, your generation. You want to get paid, but you don't want to do the work, and I said, no, I think we do want to do the work, but we're figuring out that there's more to life than work. So to hear that from every now and then is very appreciative.
Speaker 3:Absolutely. What you're reminding me of is at one point I was doing some writing on history of medicine In the past, early on residency was male physicians who came and lived at the residency hospital. They were not allowed to be married, they didn't have children, they didn't have a spouse. It was 100%. Your time is ours and you lived. You lived at the hospital, and so I think sometimes vestiges of that still linger and thinking this is how you need to train or this is what you need to give up for your profession. And the way I look at it is if you want to have a happy, sustainable career, you have to be a full person.
Speaker 3:I do believe that the burdens have shifted and changed and that from my perspective, there are more burdens today. There is more being asked in terms of all of the administrative work. That is really not what drew anybody to medicine. Nobody wants to go through medical school to be a data entry clerk just not what it's about and yet so much of the time is now devoted to that. So I think things have changed in that way and we're not the same society that we were. We're not the same. It's not that anyone is living 100% of their time at the hospital in residency and literally not allowed to get married in the past. So we need to catch up, we need to accept that the culture has changed.
Speaker 2:And I think the culture is changing, just not fast as what we'd like it to. But what are some last-minute pearls that you would like to leave the listener with? Because I've learned a lot about delegating and just hearing it again to carve out that time and make sure time is balanced and really find what works for you as an individual. And then we just touched on the culture of medicine, so we've covered a lot, but what is a message that you would like to leave our listeners with?
Speaker 3:Yeah, I think it's that if you are feeling like you're treading water and you're having trouble keeping up, that there is hope.
Speaker 3:And I think so often it feels like there's nothing that can change and therefore it's not going to get better, like your daily life experience as a physician is not going to get better, and I believe it can. It does take that like just sticking your head above the water long enough to look around and maybe carve out a little space and a little energy to be able to focus, and whether that's I'm going to decide on a way to set agendas with patients more strictly, keep on task, or I'm going to be more careful in my policies about getting double-booked or triple-booked, so there may be places where there are boundary setting or changes that you could make that then free up just a little bit more time and energy to do something else and so just to not give up hope that there is always a possibility of change and as we continue to get that bandwidth, then we can advocate for the system and practice level changes that will make a big difference for everybody.
Speaker 2:And if somebody wanted to get a hold of you or reference your writings. Read your book. Where could we find you?
Speaker 3:Sure, the best place is my website and you can find my book there and my blog there. Or you can email me at dianne at dianshanoncom. My website is dianshanoncom. Or I am on LinkedIn and fairly active there, so those are the best places to find me.
Speaker 2:Thank you so much for your time and, as always, I've learned quite a bit, so thank you very much.
Speaker 3:Thank you for having me.
Speaker 1:Next week we're going to start our four-part podcast series discussing revenue cycle management and, instead of releasing on Wednesday, I am going to be releasing on every Monday for this series. So stay tuned, take notes, because knowledge is power and that allows us to understand how we, as physicians, get paid.