How to Efficiently Create More Fulfilling Patient Relationships with Dr. Bradley Block

You went into medicine to help people, but how do you do that when you only have 15 minutes to see each patient? Having unfulfilling patient interactions is a huge contributor to burnout in the medical field. This is why I’m so excited to bring in Dr. Bradley Block to talk about the art of effective communication. Dr. Block is an experienced private practice ENT in Long Island and the creator of the popular Physician's Guide to Doctoring podcast.

In this episode, you’ll learn how to start creating more fulfilling and meaningful relationships with patients (in a time-efficient manner).

We discuss:

• 2 quick and easy questions to ask patients that instantly build rapport while also assessing their chief complaint.
• How to politely interrupt in a way that actually builds patient trust
• Identifying and fixing the low-hanging fruits of your burnout

This conversation is full of practical gems for improving relationships with patients and developing a more fulfilling career on your terms.

GUEST LINKS:
Website: https://www.physiciansguidetodoctoring.com
Facebook: https://www.facebook.com/physiciansguidetodoctoring
LinkedIn:https://www.linkedin.com/in/bradley-block-md-1712a6127/

REACH OUT TO CHELSEA:
FREE downloads for if you are feeling lost or burnt out in your career:
https://coachchelsmd.com/free/

Ready to create a joyful life and career? Here’s how I can support you through my online courses and coaching programs.
http://coachchelsmd.com/offers/

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Transcript

Chelsea Turgeon: 2:24

Hello, my loves. Welcome back to another episode of the Life After Medicine podcast. Thank you again for pressing play today. Today I have here with me a special guest, Dr. Bradley Block. He is a private practice e n T in Long Island, and creator and host of the Physician's Guide to Doctoring podcast with an incredible tagline that I love's called everything that We Should Have Been Learning while we were memorizing the Krebs Cycle. And this podcast has been around for about. Maybe five years now. It's like pretty old. It's been going around for a while and it's a practical guide for practicing physicians and training and all allied health professionals. So thank you so much for coming on the show today. Thank you

Dr. Bradley Block: 3:01

for having me. I've really been looking forward to this.

Chelsea Turgeon: 3:03

And so can you give us a little bit of your backstory, how you decided to start this podcast in addition to being a busy E n T, what was the impetus for that? And then how has podcasting for these past few years impacted your life?

Dr. Bradley Block: 3:15

So first when I. Finished my residency and I'm at my first job, like I'm 12 years, I've been attending for 12 years and I'm still at my first job. And I, have no intent on changing, but I looked in my exam room and I have two exam rooms and I was like, okay, so these are the exam rooms I'm gonna be using for the rest of my career.'cause after going from like college to medical school, medical residency, like everything's always changing and evolving and there's always the next step to look forward to. I was like, Okay, so this is it. That's a little daunting. So that was one of the reasons, that, went into it. Another one was that I could see that my partners were more efficient at seeing patients than I was. And they were able to see four, five patients an hour. And I was struggling with three. And the question is like, what? Was I doing differently that they were, that I could learn how to do because this is all. Learnable, right? It's all teachable. You know the research of Carol Dweck, which everybody talks about mindset, right? You gotta have a growth mindset. Can I learn to be better at this? Absolutely. And so the question is what are those skills that I then need to learn? And who even has those skills? And like you said, I started podcasting five years ago when there are not many physician podcasts out there. So I looked into other podcasts and they were about, Social engineering, and now social engineering, if you Google it, it's about like how to steal somebody's password. It's like compat about computer hacking but social engineering, when I was first learning about it was more discussing like how to engineer a social interaction. This is more professional interaction, but nonetheless How do you engineer that interaction to optimize it? And a lot of the people that we're talking about this on podcasts, we're talking about sales, we're talking about dating, we're talking about networking. We're talking about executives, not physicians. Now we do learn in medical school. That doctor patient interaction we do, but the stuff that I was taught in medical school was like, make sure you sit down because time seems to pass slower for the patient. If you stand up, then it seems like you're rushing, even if you do spend more time. And also make sure you listen and listen. And it really didn't speak to the fact that how do you do this but efficiently? And so I thought I didn't, I haven't interviewed this. Person yet, but there's a book like how to get someone to Like You in 90 Seconds or something like that. So what can we learn from someone who, studies that about how to get your patient to like you in the first 90 seconds. Great. And so that's how the podcast started. The other thing. That I, that the impetus for starting the podcast was actually my wife. So my wife in a social setting can go to a cocktail party and walk around the room and talk to everybody, and at the end, everybody's gonna leave thinking that she's their new best friend. When I go, I get a drink, I stand on the wall and I make a mean face so that nobody will talk to me. And what I realized is I do that not because I don't like talking to people'cause I don't know how to talk to people. It took me a long time to realize that I have social anxiety. Like I'm constantly did I say the right thing? Did I say the right thing? What should I be saying next is like that this, these lines in my head that this is not something I'm good at. And the reason I don't like it is because I'm not good at it. And so how do I get better at it? And so all of this went into starting the podcast. And originally it wasn't gonna be a podcast. I was gonna take everybody's research, all these like ideas that I find and compile them into a book. But then you need to sit down and write a book. And I was never gonna sit down and write a book. And I was gonna start a blog. Oh. But I was never gonna sit down and write a blog. Okay, so what's an easier way to do this? How do I lower the bar even more? Oh, I'll just get people on my podcast and I'll talk to them and I'll interview them. And also the questions that I want have answered to and, The way that I started the podcast is I reached out to my circle now. Given our backgrounds we're typically friends with the other people who are towards the top of our class in high school. And we went to strong colleges and we're friends with the high achieving people at those colleges who are now experts in their fields. And then in medical school we went to people, we went to medical school and became friends with people that are now. Experts in their field. Like you don't have to be the chair of the department. And this is where I think physicians have a little bit of imposter syndrome. You don't have to be the chair of your department to be an expert in something. You are an expert in something. You are a world, whatever your specialty is, you are a world-class expert in that. And so like every, everyone that I went to medical school with isn't expert in something. So what I first did when I started the podcast is I just reached out to my friends. My former classmates and, figured out what are they expert in that physicians need to know about. So one of my friends is in medical device sales. Actually. he's an engineer and he's actually working on three D, printing, biologic, three d printing. So one of my first episodes was like, if you have a medical device idea, how do you present it to industry? If you don't wanna build the company yourself, but you want to just sell the idea, like how do you do that? So this had nothing to do with the doctor patient relationship. So then I expanded the scope of the podcast. Two, really just everything that I think would be useful to a practicing physician. One of my first episodes was like advocating for our, for your for your patients, for your. Your specialty efficiently. And when I say advocating, I mean like policy, like lobbying, like talking to your governor, talking to your congressman. Like how do you make sure you're using your time most efficiently?'cause we're all short on time, so how do I make sure that what I'm doing is efficient and in my own best interest. So lots and the topics just exploded from there. And so then the tagline evolved into everything we should have been learning while we were memorizing Kreb cycle. But, The doctor-patient interaction is still something that's like core to what's important to me, and when I do speak, that is often what I speak about.

Chelsea Turgeon: 8:56

Yeah, I love that and I love the way that it just evolved and that's what I've noticed with my podcast as well is that you just once you get started, it really does evolve. And so one thing that I heard from you is that like one of the reasons it started was from this desire for having another outlet for progression in a sense, because in, in med school residency, we're always moving towards the next thing, and then you got to your. Practice and you're like, okay, here we are. And which is great. And it's not like you've mastered everything at that point. There's still more to learn, but how do you think having the podcast and putting energy and time into curating it and interviewing guests and just being in that energy of creating something, how do you think that impacted your career as a physician?

Dr. Bradley Block: 9:39

In my specialty of otolaryngology, I'm a general otolaryngologist, right? I don't specialize in rhinology or head and neck cancer or complex pediatric cases. And that's happening, like that's happening at the academic centers. I think where you're really, you'll take these complicated cases and you'll really try and push the envelope and evolve technique and push things forward. One, because I'm a generalist, and two, because I'm not an academic setting that's just not what I'm around. And that's just not what we do. We do what we do. Like it's in, in fact, a lot of what we do could be even considered primary care. And so we're on the other end of the spectrum. And I live in New York, so if I see something complicated, I'm not gonna oh, let's try it and see how well the. No, I'm gonna refer it to like Columbia, Cornell, Mount Sinai, Northwell, like one of these high powered n Y U, one of these high powered academic institutions where this is what they do. And so then what makes me special? Like what's different about my brand? So then my podcast became like my fellowship in communication. So I would make sure that what am I best at? What am I better than everyone else around? And I'm. Listen, I'm a work in progress and the reason that I started the podcast is'cause I was starting from a place that was, far okay, not far behind, because when you're talking, you're not talking about competing against a bunch of salesmen here. A bunch of public speakers, a bunch of standup comedians who are like amazing at communication. It's a low bar when you look around and see the physician community, we're not really, that's not what we're selected for. We're selected for a, our ability to grind through work, right? Our ability to push through work and just get it done. So when they talk about these exams don't select for good physicians. These, these gut courses that we take don't select for good physicians. No, that's not their function. Their function isn't to choose good physicians.'cause how do you even define what's a good physician? No, what they select for is our ability to get the work done. So that's what we're good at, right? That's what all of us are good at. We're all rock stars at just like grinding and getting it done. Whether it was like studying a massive amount of information and storing it for a really short period of time, or. Whether it was like your list of things to do on after rounding on, like on all of your patients so that you're, you get it done by the end of the day we grind through work, so communication is not our strong point. That being said, so I'm not, I'm comparing myself to, the general population, not physicians where it may or may not be our strong suit. So I was starting, I'm not starting off as the best communicator around, but yet that's what I am. Trying to really hone and each time I'm interacting with a patient, I really try and, it's a little bit of a dance. You try saying this, you try saying that didn't work. You take a step back it's an iterative process. And so that became my goal is I was going to become the best communicator that I could possibly be with my patients, because a lot of times the diagnosis, the treatment, Options, they can be elusive because we just haven't gotten the information that we need, interpreted the information from the patient that we need, or communicated effectively with them on what they need. We often even have different goals of care. Like when the patient walks in, what's their goal? It might be different from what our goal, what are they worried about? It might be completely different from what we are. Worried about. And that was my fellowship, so to speak. Yeah,

Chelsea Turgeon: 13:23

I love that.'cause then it allows you to approach podcasting from a student perspective, right? And you're really bringing that growth mindset in and you're coming at it with a sense of I wanna learn. You guys, like I'm here learning right alongside with you guys, and I think there's just a lot of power in that as a perspective and also as a permission for other people that they don't have to know everything before just starting something. Especially, you can start something like that from the perspective of being a student and

Dr. Bradley Block: 13:49

learning. Oh yeah. My podcast is grounded in the fact that I'm not the expert. I don't claim to be the expert on the show. I'm the one that needs the experts in order to learn. Now, after, as you said, after five years and 250 episodes, like I. Now I've I feel like I have developed a certain expertise in this, but I'm still the perpetual student. That's why I plan to continue.'cause I just love it so much for two reasons. One, actually for more than that one so I can keep learning. To the networking, like meeting people like you is, I see like we've been like in each other's orbits online for a long time. But I've never actually spoken with you before, but now you know you're part of my network, right? So the networking the social interaction, the professional interaction is great. And then just the. Having the creative outlet, right? Oh, how's work going? How's the practice going? Oh, yeah. I've been doing it for 12 years. It's like the same, right? Like the complaints I see the same, a lot of the patients I see are the same. It's not oh, I had this really cool case where someone had this like extensive skull-based tumor into the orbit, and then we managed to save the eye and avoid A C S F leaking. I'm not doing those cases. I'm not doing those cases. So the often the most interesting part about what I'm doing is related to podcasts or the ideas that come from the podcast and then sprout into other things.

Chelsea Turgeon: 15:17

Yeah, I love that. And so as someone who's been, taking this fellowship in communication for five years now, and someone who's been really just actively studying and working on the doctor patient relationship, I'd love to hear more about how we can optimize it. Because when I heard you talk about social engineering, what I'm thinking of is like using psychological principles to optimize. The communication or to optimize the doctor patient relationship. And so I'd love to hear what you've learned and how you approach, like what are some of the gems that you take with you to optimize that relationship, especially given the time constraints that most practitioners tend to have in in those patient visits.

Dr. Bradley Block: 15:58

Yeah I love that question because there are, I just actually gave a lecture to some fourth year medical students on there. They're about to turn into residence, and so there's a whole series on for them, on, things to learn. And so one thing a lecture that I just gave it's the perfect office visit. So it, it ended up being two hour lecture, so we don't have time for all of it. Right now. But there are, there are a couple of phrases that I've introduced them to that I think will help, the patient feel more fulfilled, and maybe get a little information from those patients where the visits tend to be a little long to, to tighten them up a little bit. And so one of those things is it's really important to express empathy for what the patient is going through. And it can be a simple phrase like that. Oh, wow. That sounds really uncomfortable. Or you can even like, oh, that sounds miserable. Patients come to me with vertigo is defined as the sensation of room spinning. Like spinning, not oh, I get a little dizzy. That's not vertigo. Spinning is vertigo. So they come to see me with vertigo and if you have something like Vestibular neuritis, you could be spinning anywhere from hours to days, and then you're like off balance for anywhere from days to weeks to months, right? It's miserable. And so just saying something simple oh, that sounds awful. The patient then recognizes that you recognize. The gravity of their discomfort and the seriousness of their situation. So it takes a second to say, but it will really engender some trust there and will help the patient kind of move along in their story. cause then they won't feel this urgency to explain to you just how awful they've been feeling.'cause now they know that you've you get it. Another question is, What about this bothers you? Or what about this concerns you? Because often there's something that I call the question behind the question. I, there's a guy that wrote a book called The Question Behind the Question, so I actually reached out to him and I had him on the show, but he was talking about something completely different. He was talking about like personal responsibility, like taking responsibility for your own, actions at work and the outcomes of your actions at work. And the, so that's not the question behind the question that I'm talking about. The question behind the question that we're talking about is when the patient comes in, there's their complaint, and then there's the thing that they're really worried about. And so people comment often, come to see me for something called globus. Globus is just the sensation of a lump in your throat, right? And what they're really thinking nine times outta 10 is, I have throat cancer, or I could have throat cancer. And so if they don't leave, With you. Having said that, I looked at your throat and there's no evidence of throat cancer. You could even say you don't have throat cancer. There's nothing that I can see that looks like there's, I checked for, make sure you say, so they know that's specifically what you were looking for, but you're not gonna know that unless you really inquire about it. So what you're gonna ask is what really bothers you about this? What worries you about this because then it gives them the opportunity to say I, it's been keeping me up all night.'cause I'm worried that I've got throat cancer. And then rather than them you being like, oh, it looks like it's reflux or, crico pharyngeal spasm or whatever it happens to be that's causing their GLO sensation. Unless of course there's we're getting into summer where people are gonna be grilling so they could have cleaned their grill with a grill brush and it ended up in, the little wire ended up in the hamburger and then they swallowed it and they actually got, so I don't recommend if you're cleaning your grill, don't use a grill brush.'cause we do have to remove those little metal spikes from people's throats every so often. So we'll make sure if you take that out, then it's oh my God, I feel so much better. Which is one, one of the most fulfilling visits you can have. But if you haven't verbalized it, they're gonna leave. He didn't look for it. They're gonna be worried about it and then they're gonna, or they might perseverate during the visit because you haven't addressed the concern that they haven't verbalized it. And as the physician, the onus is on us to figure it out, even if they have trouble verbalizing it. What about this bothers you? So those are just two quick things that you can ask or say that'll help, the patient, endear them to you and to help to move things along.

Chelsea Turgeon: 20:13

Yeah, I think those are powerful because it's like you said if there's something they're worried about, but they're not saying there's gonna be a barrier of communication the whole time until you're able to help them verbalize and maybe they don't even realize they're worried about it, but just holding that space for them to really ask and get to the deeper heart of it.

Dr. Bradley Block: 20:29

Yeah. So those are Two quick and easy things. Another thing that we talk about, sorry. Another thing that we talk about is is telling jokes.

Chelsea Turgeon: 20:37

Like, how do you tell jokes? Do you have a list of dad jokes that you Yeah.

Dr. Bradley Block: 20:39

That you bring into them? Which are fine, right? If you're a professional comedian, not fine. But we're not, we're physicians and we're all their healthcare providers. It's okay to joke, but how do you make sure that your joke is appropriate? Yeah, and the rule is never punch down. The goal of humor is to comfort the afflicted and afflict the comfortable. If that person is clearly uncomfortable or afflicted, right? That's what makes them a patient. They're afflicted with something. So you're never gonna make fun of the patient. You're never gonna make fun of the situation. But you can make fun of the institution. You can make fun of the E M R. You can make fun of anything that's in a position of power. It's okay for them to be the butt of the joke, but it's never oh doc, is this gonna hurt? It's not gonna hurt me. No. Then you're making fun of the fact that the patient is anxious about this and they might feel uncomfortable no, that's not okay. The master of never I. Punching down is Will Flannery, Dr. Glock, I can't even pronounce it. Glock Flecking, right? Everyone knows who he is. He's like such an incredible comedian. If you look at all of his material, he never ever punches down. And it's harder to do, it's easy to make a joke when you're punching down. It's hard to make a joke. Not so those are the confines and are bad jokes. Okay? Absolutely. Try it. If you're like me and 25, 30 patients a day, you've got plenty opportunities to try new material. And if it doesn't work, if it bombs, just go back to, you know what, I'll stick to my day job. I could see that joke didn't, wasn't as funny out loud as it was in my head. I will stick to doctoring. I will, stay away from comedian to stay away from jokes. But even the bad jokes, like the dad jokes, they'll still endear the patients to you and it'll help you enjoy the visit more. Like you'll have, and if the patient makes a joke, laugh. Laugh. You need to be the best audience for that. Remember? Yeah. You're not the star of the show. They're the star of the show. And so you need to make sure and then one more thing. Yeah. To help that visit, move along. Stop talking about yourself so much. It's okay to talk about yourself a little bit if it helps the patient relate to you and recognize that you you are a human being with, flaws and fallibilities like them, or if you've been through a similar situation, but this is not your opportunity. To tell them about your real estate empire or your short-term rental or how successful your kids are in school or whatever. Like all the stuff that you want to talk about, right? I could sit there and talk about my kids forever, right? But if you try to run on time, recognize that this situation is not about you, it's about them. They're the star of the show. And so trying to keep the talk about yourself to a minimum is gonna help you move things along.

Chelsea Turgeon: 23:27

Yeah. And then also speaking of moving things along too, I think one thing that people struggle with is knowing like how to politely interrupt patients without compromising rapport.'cause it's like you don't wanna be the provider who's interrupting them immediately and just inserting your own agenda into things. But there's times where patients can get really derailed and all over the place. And so it's like, how can you use that polite interruptions to really direct them and to. Just guide them and create that container of the 15 minute visit that actually allows you to get the information you need out of

Dr. Bradley Block: 23:59

them. Yeah, that's a good point. I cannot, I can't say that I'm the master of this.'cause I've had a couple people recently where I'm like, I'm starting to get annoyed and I'm like you just have to let me finish saying what I'm saying. You just have to stop interrupting me. Just please. Just, you came here. To find out information from me. Could you let me, before you move on to the next subject could we finish talking about your sinus headaches before we talk about your ear wax? Please. But interrupting them, it is okay to interrupt, oh, doctors on average interrupt patients within 11 seconds of the visit. Try to let them finish what they're saying. Do your best to do it. But what I've found is patients tend to, when they're giving their history, tend to do it in order of urgency. But we need to understand when you're hearing a story, you need to hear a story in chronological order. So hearing it in terms of urgency, it's completely all over the place and it really seems chaotic. In their head, they're going over it from most important to least important, but in your head, it's just a chaotic story. So one, you can help them, you can interrupt and be like, listen, just make yourself at fault here. I'm sorry to interrupt. I'm having a lot of trouble following this. Can you help me better understand by starting from the beginning? So you never wanna put them in the situation where makes it seems like there's wrong something wrong with them, for instance. Did I explain that? Like at the end of the visit. Did I explain that? Instead of asking, did you understand that? Because if you say, did you understand that they're gonna be less likely to be like they, they're gonna be, I don't want this doctor to think I'm dumb. Yeah. I'm just gonna tell them I understood. Whereas if you say it in your own voice and in the same way put yourself as the one at with the flaws that need assistance, I'm having trouble understanding. Could tell the story a little different way. And I really apologize, but I need to, I have to interrupt you here'cause I need to clarify this point. There was a really important bit of information there that you were talking about and then you jumped to the next thing and I really need to learn more about that. Those. Really let the patient know that you value their time and you value the information, and all you're doing is trying to make sure that you get the information that you need to better help them. So as long as you put it in those Terms, it's not gonna be like, oh, the doctor isn't letting me talk. It's oh, the doctor's trying to, trying to help me by, focusing my story. And then the other thing I do is I use a dictation software. I use Dragon. And so after they're done with their history, often what I'll do is I will dictate the story. Then they can hear their own story in a more concise, chronological way. And so then it helps them.'cause a lot of times when they come in, their story is not really, hasn't really congealed in their head. It's still a very fluid, like I said, chaotic story. And it'll help them reframe it into a more concise and understandable story and sometimes even that helps them. Oh, when you say it like that, it all makes a lot more sense. But yes, interruption is totally fine as long as you're doing it as a tool to help them in informing them that you're doing it and why you're doing it. But interruption is fine'cause we don't have forever. You can't just let them talk forever.

Chelsea Turgeon: 27:20

Yeah, and I think that's one thing that can almost breed resentment as a provider. If you're sitting there thinking like you have to listen until the whole story is over, although there's gonna be all these points you have to go back and clarify. And so I think just empowering people that it is okay to interrupt just doing it in a way that's super considerate and that's really communicating like that you're, this is a patient-centric interruption that's happening and really just keeping them in mind while you're doing it and also communicating that's why you're doing it. So I think that's really powerful. Yes. Yeah, and I just remember like hearing all the stories,'cause I was in OB G Y N, that was my specialty, and I just remember getting the chaotic histories and just wishing every single person who came to me had a menstrual calendar tracker. Because to me that was the most complicated. I was like, I need a huge calendar on the wall and we can point to the. Things and say it was this date and then this date and the next date. So I feel like there needs to be, I'm sure there's somebody working on an app for that, but there just needs to be more, I think tools for tracking some of those like patient history pieces because you know when symptoms are all jumbled in their heads it's not easy for them to communicate it to us. And so I feel like having them even be able to clarify it for themselves before coming in would be helpful for everyone.

Dr. Bradley Block: 28:28

When patients come in with dizziness in particular, because that's one where they tend to be. All over the map, they use terms like vertigo, that don't actually mean vertigo. And so I found myself often interrupting them even before they get started. I'll say, listen, dizziness is complicated and it's sometimes really hard to figure out, and there's the story that you want to tell and there's the information that I need. And sometimes those two things don't end up intersecting. And so I just wanna apologize before we even get started. I'm gonna be interrupting you a lot in order to make sure the information, I get, the information that I need in order to best help you. So I'm naming the elephant in the room and then, things tend to go better from there.'cause then they know, again, as you said, patient-centric, why I am interrupting them. Why, so then they expect it and then it's oh, he won't let me tell him story. Oh, he's helping me. Tell my story.

Chelsea Turgeon: 29:19

Yeah, and that's what I do. I think it's like all about the framing of the conversation. This is what I do when I'm holding like group coaching containers. I like frame it at the beginning of like, All of your problems are really important, but I, what I want you to do is come with a specific question in mind because the real value to you is gonna be in us coming up with a solution, not in us hearing all about the problem. And so if you can summarize your problem and be able to present it with one specific problem or one specific question, then you're gonna get more value, because then we're gonna focus all of our attention and time on helping you with the solution. And so it's like all about how you frame it, I think is the powerful way

Dr. Bradley Block: 29:54

to do that. And that also means what you're asking there is I want you to do a little bit of work first, just a little bit of work. Like just, clarify some things in your mind before you, you come at us with all this information.

Chelsea Turgeon: 30:06

Yeah, exactly. And so for you, I think one of the common. Kind of desires that people come to me with is that they wanna find a way to practice medicine on their own terms, or they wanna find a way to help people and heal people on their own terms. And so it seems like you've created a sort of setup that works for you, right? You have your practice, you have these fulfilling patient relationships, and then you also have the podcast on the side. And so can you just talk with us about how you've figured out. What you need in order to feel fulfilled in your career and how you've gone about creating that.

Dr. Bradley Block: 30:42

You're making it sound like I have it all figured out, and that is very far from the truth. I have good days and I have bad days. I have days where I go to the office and everything seems to be going well, and I have days. Where I go and things are not going well, and I just want to hang up the stethoscope or in, I guess in my case, the otoscope. The podcast definitely adds to my professional fulfillment and helps me answer questions that I need answering. Therapy has also helped, and I'm a huge advocate of it for everybody. I feel like therapy's eating well. Sleeping well, physical activity, social relationships, therapy, you know how often you need to you should go is I think, personal. It's also one of those things where I do, as I say, not as I do,'cause I'm not in it right now, and I probably would still benefit greatly from it. The other things that I'm doing is I'm starting to get into expert witness work. Within my practice, I started something called the I. Patient experience committee. So that's something that I'm really passionate about. It's uncompensated, but it's my practice. I'm a partner and so helping my practice to be better is fulfilling. So I think, what I'm trying to do is, the thing is I still see patients four and a half days a week. I only operate like half a day a week. And those, four days where I'm not operating half a day, it's still a grind. Like seeing 25, 30 patients a day is a grind. And that's not gonna change. I'm trying to set up other income streams so that I don't have to grind for another 25, 30 years. So setting up those Instagram streams also is fulfilling. It's interesting. It adds another dimension to my life and it's another way to leverage my podcast.'cause if I have questions about it, like I had a couple episodes a long time ago about short term rentals. My wife and I have been dabbling with the idea of buying. We still haven't bought one. We waited until interest rates have gotten really high and then we still haven't bought one. Like all of those things, it's a work in progress. I'm evolving. The podcast is helping me evolve, but it's not like I, I have it all figured out and everything is humming, and if I were at some point I don't know, what kind of life would that be?

Chelsea Turgeon: 33:06

Yeah. No, and thank you for being honest about that too, and I you're so right, that fulfillment. In and of itself is a moving target. And so it's not about reaching the static place of perfection where you're like just holding your breath and everything's perfect.'cause it's that's not the vibe that we want anyways. Yeah. And so there is, fulfillment even just in curating these different elements of your life. And I. Progressing in different ways. And so I think, yeah, nobody necessarily has reached this like pinnacle of fulfillment. And if they're telling you they have, there's something, either they're missing or you're missing because I don't think that's really just being a

Dr. Bradley Block: 33:39

human or they've reached Nirvana and they've become one with the universe and they're no longer part of our

Chelsea Turgeon: 33:44

a human brain situation. Yeah. That's what I always tell my clients too, is I'm not enlightened Buddha like I struggle with this too. Yeah. This is what I've learned that helped me. Exactly. Yeah. And so what advice would you give if someone is in a place where they're feeling really unfulfilled in their current medical practice? What advice would you give them, or what sort of things would you encourage them to think about

Dr. Bradley Block: 34:05

or consider? One would be you gotta sit down and think about what your pain points are. Like what is making you miserable and what can be done about those things. And then, There might be some big picture things like, I hate the administration. I feel like they don't care about me. And that's a big one. With burnout, you're it's, you're feeling like you're a cog in the wheel. You don't have any control over your. Over your day to day over your existence, you don't feel like you're making any kind of a difference. I, I can't imagine being an emergency medicine physician where all of society's problems end up in your exam room and you're supposed to be able to fix it. Oh, I ran out of insulin. You can't fix that person's problem. So some of these things are gonna be insurmountable, but, think about where your pain points are and think about what the low hanging fruit are within the, those pain points. What can I do to fix or any of these easily fixable problems? And start with those, right? Start with the things that are most maybe. You want to end up hiring a scribe, although that really sounds like a little or take like a course on charting efficiently if charting is your problem, right? Try to go for the easy solutions to the easily fixable problems. And start with there. Because what you're gonna do is you're gonna end up proving to yourself like that this is a problem that I can fix. And then you'll gradually be able to step up and get to larger and larger problems. And in the process, your life will have gotten a little bit better and a little bit easier because of that. So just, brainstorm and identify all of your pain points and then put them not in urgency or in how painful they are. But in order of which is the most easily fixable, and then just start. Start with those things.

Chelsea Turgeon: 35:56

I think that's a great approach to it because I think it can be overwhelming to feel like I have to fix my whole life all at once. Or you can be in this place where you're like, everything sucks. What do I do about it? And even just trying to get to this constructive point of brainstorm everything that's going on and then pick one thing that's the most fixable. Start there. And that can give you a sense of agency. It can just give you the sense of like self-efficacy around all of that. And like you said it'll also marginally improve your life and career, little by little. So

Dr. Bradley Block: 36:24

powerful. Yeah. But that sense of agency is, I think the biggest part that comes out of all of it, right? Is realizing that you can, realizing that you can make a difference. And you know what, maybe you end up. Getting a little more involved in your institution's systems so that you can help make it a better place for other physicians. Maybe you want nothing to do with them and that's fine too, but, one of my favorite books is Man's Search For Meaning. Meaning, and the the, one of the principles behind that book is that those that were, that did the best were those that were helping other people. And Trying to identify within your institution what you think needs to be fixed, and then becoming that agent for change within that institution is therapeutic for you too. But you're not doing it for the institution. The institution will never love you back. You're doing it for your colleagues, you're doing it for your colleagues, and you're doing it for yourself. Even some of those more insurmountable seeming problems might have a solution.

Chelsea Turgeon: 37:29

Yeah, and I think even just getting to the place where you are trying to think about how we can fix this, that just feels so much better than being in that place of this sucks this, these are all the problems that it's caused. Like just being moving towards the level of the solution, I feel is a much more empowering place to be than just staying stuck in the level of the problem. So even if you're not able to fix it, even just trying to ask yourself about how I could fix it or what things you could do and brainstorming and trying to get to a solution, I think is That adds just a bit of fresh

Dr. Bradley Block: 38:00

air. Absolutely. Absolutely. Yeah. Changes your perspective, I think quite a bit. Quite a bit.

Chelsea Turgeon: 38:08

Yeah. Thank you so much for coming on the show today, Brad. Where can people like find you and where can you people connect with you if they want to see more of you after the show?

Dr. Bradley Block: 38:17

So I am physicians guide to doctoring.com Is the website LinkedIn on Bradley B block. I'm sure there are a lot of other Bradley blocks out there. So just look up Bradley B block. I've got some long, set of numbers after that. You just gotta look me up. And then I'm at Physicians Guide on Twitter and Instagram. And yeah, check out the podcast 250 back episodes. We're gonna, we're trying to resurrect the Doctor Podcast network gonna be part of that network as well. Check us out, I think it's doctor podcast network.com. So just a little plug for that as well. And yeah, thanks so much for having me and thanks the, for the great work that you're doing with our profession.

Chelsea Turgeon: 38:55

Thanks so much. Take care.

38:59

I hope you enjoyed this episode of the Life After Medicine Podcast. Make sure to leave a review and subscribe to the podcast so you never miss an episode. If you wanna continue the conversation, share your takeaways, and connect with other like-minded healthcare workers, then come join us in the Life After Medicine Facebook group. The link to join the group is in the show notes. I can't wait to connect with you further.