EP205: Lessons in Leadership and Legacy with Dr. Thomas Helm

Balancing Careers and Family: Insights from Dr. Thomas Helm

In this episode of The Girl Doc Survival Guide, Christine invites Dr. Thomas Helm, MD, for his second appearance on the podcast. Dr. Helm, former Head of Dermatology and Director of Dermatopathology at Buffalo Medical Group, now working at Penn State Hershey Medical Center, shares his extensive experience and personal anecdotes. They discuss generational changes in the medical field, challenges faced by women in medicine, and the importance of work-life balance. Dr. Helm emphasizes the significance of understanding work culture, making intentional career decisions, and maintaining work-family harmony. He reflects on his career transition to academia and the rewarding relationships he has built along the way. The conversation delves into the importance of community, mentoring, and the profound impact of prioritizing meaningful relationships over individual autonomy.

00:00 Introduction and Guest Welcome

00:45 Personal Anecdotes and Family Influence

01:22 Changes in Medical Field Demographics

02:10 Challenges for Women in Medicine

02:39 Balancing Career and Family

04:50 Mentorship and Career Advice

06:46 Prioritizing Relationships and Community

10:53 Transition to Academia and Personal Growth

18:52 Final Thoughts and Gratitude

Transcript

Christine Ko: [00:00:00] Welcome back to The Girl Doc Survival Guide. Today I am very happy to be with Dr. Thomas Helm, MD. This is his second appearance on this podcast. Dr. Thomas Helm was Head of Dermatology and Director of Dermatopathology at Buffalo Medical Group for 30 years. For the past three years, he has been at Penn State Hershey Medical Center. He received his MD from Albany Medical College and his BS from Rensselaer Polytechnic Institute. He is currently President Elect of the ADA and is a wonderful mentor, teacher, role model for others in dermatology as well as dermatopathology. Welcome to Tom. 

Thomas Helm: Hi, Christine. Thanks so much for having me. It's a great pleasure. 

Christine Ko: Pleasure for me as well. Can you first share a personal anecdote?

Thomas Helm: It'd be my pleasure. I really enjoy your Girl Doc themes and topics. In thinking about that, one really unique aspect for me is that my [00:01:00] paternal grandmother, my mom, my wife, both daughters, and my daughter-in-law are all physicians, so I've looked at the physician career from lots of different angles and over a very long time span, and that's given me a lot of interesting perspectives.

Christine Ko: Do you think it's changed over those generations? 

Thomas Helm: For sure. It has. Just last week I was giving a presentation at the University of Pennsylvania, and it was pretty much flipped over what it was when I was a medical student. I did a rotation at Mayo Clinic and Cleveland Clinic as a med student, and it was about 80 to 90% men and about 10 to 20% women. And now it was exactly the opposite. There were more female residents and fellows, and I think that's very exciting. 

Christine Ko: People will talk about a leaky pipeline, that even though, in terms of trainees, residents, medical students, at least half are women, that still in positions of power, like [00:02:00] chairwoman or chairman of departments, or program directors, or other leadership positions, or even more tenure track faculty positions, that they're still predominantly men. Do you have an opinion on that based on your years in Buffalo as well as now at Penn State? 

Thomas Helm: I do. I think it's very hard for women physicians if you want to have a family and embrace your career. I see a lot of creep in terms of morning meetings, evening meetings. Just now with the cold weather that we had, schools all of a sudden say they're gonna have a late start. What do you do? Interestingly, my wife and I feel that we're kind of a bridge here. One of the things I really love about my current job is I can kind of cover clinics or help out when there's a need, and I really wanna empower the younger stars to be able to have the reassurance that someone's got their back and that someone can cover. That's one of the beauties too about Dermpath, [00:03:00] that I can always do the slides a little bit later. I can help out in a clinic. So that's something I've really enjoyed. The culture here in our department is very supportive for that, but it's hard, and I have to say that I've had a number of colleagues and junior mentees that have taken a pivot because it just became too much. This is why I like that many of your podcasts cover burnout and balance. I really want to see a situation where meaningful work and meaningful relationships come together, where your work and your passion can align. 

Christine Ko: I'm just pausing a little because, honestly, I'm a little embarrassed, but your comments just now brought tears to my eyes. It was so stressful, I found, as a mother of young children, 'cause we don't have family around here. If there was some kind of snow day or delayed opening, it was always a relief when I knew [00:04:00] it was dermpath for me that day. My dermpath colleagues, they're all very kind, and if they could cover, they would cover for me. Clinic was a different matter. Not that my dermatology clinical colleagues wouldn't be willing to cover. It's just they're not just free.

Thomas Helm: Exactly. 

Christine Ko: Other people would have their own schedule, so it's not like they can just all of a sudden take on my whole schedule of clinic patients. I'm always blown away when someone or the system really thinks about that and tries to create a mechanism by which there is a backup. That's absolutely amazing.

Thomas Helm: Well, I appreciate your comments. I know where it was difficult. I knew where our marriage was under stress 'cause my wife, as an allergist, was very busy. I came to see how I could better partner with her. And one of the things I really enjoy is talking to some of the residents now that are looking at career options and really talking about work culture [00:05:00] and having them identify, Is this a performance oriented culture? Is it a learning culture?

Christine Ko: Yes. You'll talk to people, residents, or trainees or anyone seeking a new job about culture. What will you tell them? 

Thomas Helm: Well, it's very interesting because a lot of the residents here will have me look at their contract. How do I go into this negotiation? Since I was on the other side of that, I have thoughts in terms of how they can make their comments land the best without making it a confrontational relationship. One of the things that I've noticed, especially in dermatology, if you look at the residents that we ,, they did great in high school. They did great in college. They did great in medical school. Derm is a competitive field, so they're always looking, too, for that external thing, and how do I excel? But now it turns: you have to decide, well, what am I choosing? I help them sort out by listening in terms of what they want. One of the things that people don't do early enough is get the dialogue [00:06:00] going in terms of what would work. And things are particularly complicated these days in terms of relationships. Do I move with my partner? Do I live further away for a year? When do I start a family? There are so many complex issues, and luckily I feel that I've developed trusting relationships with a lot of the residents and fellows. I can have a coffee with them. We will just sit down and chat so they can sort out their feelings. 

Christine Ko: I didn't know enough when I was younger and looking for jobs to really think about the culture as a factor. Do you have other advice on how to navigate your career when you have young children and your career's just starting?

Thomas Helm: Dirk and I recently had the opportunity to be part of a celebration of Wilma Bergfeld's career. Another strong woman I should mention is Wilma, who is my mentor and program director in dermpath. The year that I was her [00:07:00] fellow was the year that she was president of the AAD. So she was out of the office a lot, and I had a very close relationship with her to keep the service running while she's at meetings and giving presentations. One of the things that Wilma always prioritized was really understanding your priorities before you're actually pushed in a situation, 'cause when you have to make a quick decision, it may not be so easy to carefully think it out. For me, my beliefs, my faith, my values come first. Then comes my spouse, then come the kids. Then come relationships with family and friends, and then comes my job. And I think of that old saying, with the sand and the rocks, you have to put the big rocks in first or you overfill. I became a grandfather at 53. My wife and I embrace that. We have seven grandchildren. We want to be very active, going to their sporting events, going to their important cultural events. My wife's super excited [00:08:00] for two of the grandkids. She's gonna go to school for Chinese New Year and she has scallion pancakes and dumplings ready to go, and she has a presentation she gives to the kids. That's something that we intentionally make time for. We make sure we're not traveling. I make sure I'm not in clinic. In advance, I know that being part of their life is an opportunity. If I had to do it over again, I think I felt a lot more pressure to succeed at my job. I think I overshot my mark in terms of people pleasing and doing too much. Thank goodness my wife's very flexible. I give her a lot of credit 'cause when I think when our relationship was under stress points, she often made the decisions that got us back on track.

Christine Ko: I think that's very wise, what you just said, to, in advance, know what your priorities are.

Thomas Helm: That's how the transition happened with me 'cause we understood where our energies were. I really love my job. So finding something that aligns with that [00:09:00] and the culture here at Penn State was like a perfect fit. Working with medical students all the time, residents. Just before we got on this call, I was helping two people with posters for a Pennsylvania Pathology Society meeting. So there's always something to learn and something exciting, and that energy has really been a motivator for me. 

I feel that it's important to know when to make room for other leaders. I personally have a bias that I think a lot of great leaders are often between the 45 to 60 demographic. I see my role now as more mentoring and helping. I'm very excited. I really love the mission of this department. There's a lot of volunteer work for the community. I live five minutes away from the med center, so I have like virtually no commute. As a matter of fact, I can walk here or ride my bike. So in this particular circumstance, I knew what I was looking for and a perfect job just kind of popped up.

Christine Ko: [00:10:00] Importantly, one thing that listeners may not know is that your grandkids live near the Hershey Medical Center.

Thomas Helm: Between where my grandchildren live and my med center is where I live. So it's like a linear path. My oldest grandson can ride his bike over to my house. So, this was like a no brainer for my wife and I. 

Christine Ko: And before when you were in Buffalo, that was a lot further away. 

Thomas Helm: Five hour drive. My wife and I would have our bags ready at work on Friday, and when my wife saw her last patient, we'd hit the car. So this is very different. And I'm sort of equidistant from the other kids. I've got a daughter with her four kids in Syracuse, New York, and one daughter in Albany with her husband. So that's the situation. 

Christine Ko: Very nice. Well, the kid with the grandkids who lives right near you is lucky. 

Thomas Helm: Yeah. It's working out well in so many ways. 

Christine Ko: With your transition to academia, what effect has the transition had on you? 

Thomas Helm: I've been able to [00:11:00] restart with a built-in schedule. I've been able to be very intentional about the things that I take on. My wife and I actually go to exercise classes together twice a week. There's a gym very near here. It's actually a community center. Grand rounds is under my purview to organize. I've been able to intentionally build in to my daily rhythm new things. I've been able to have a fresh start and reconstruct things better aligned with my priorities; where things may have not been so well balanced before. Partially my own fault for always saying yes to things.

Christine Ko: You were saying yes to many, many things. And you mentioned people pleasing. People pleasing and not being able to say no to things. 

Thomas Helm: Right. 

Christine Ko: Those are things that a lot of people struggle with, where to be able to set the boundary. Maybe that comes back to figuring out the culture that you want, which you can figure out by knowing your values, like you said before. 

Thomas Helm: Exactly. [00:12:00] Having my adult children grown, my wife and I have met some of our goals. I didn't feel the same kind of pressure I did early on. So you know, now we can be very intentional about making choices where I think I definitely would've had that agency, that ability, to do that earlier, but it didn't come as comfortably as it does now.

Moving and downsizing makes our life a lot easier. It makes it easier for traveling. There's not anything that needs to be so much maintained if we want to go somewhere for a while. There were just so many reasons to this to make a change when the opportunity came. But I don't think I would've had the courage if I didn't have friends that had done something similar. I enjoy being part of the American Dermatological Association, and many of my colleagues there are a little bit older than I am, and I can see how they've handled various life changes. And that's been very insightful for me.

Christine Ko: You just talked about mentors in the American [00:13:00] Dermatological Society, but also others who you saw make a similar transition. And you had actually sent to me an article by David Brooks that talks about what he calls the Great Detachment, and that unfortunately Americans have been, for at least two decades or more, prioritizing autonomy over love. I'll put a link to that article in the show notes if anyone's interested in reading it. But can you talk about that a little bit? 

Thomas Helm: The beginning of the year, January, is often a time for reflection with the new year, and when I was reading my New York Times, January 2nd, David Brooks' article really landed well with me where I was considering what he's talking about. His basic premise is that you can build a culture around loving commitments or you can build a culture around individual autonomy, but you can't do both. And I look at a lot of the things that are going on now in the world in terms of burnout and depression. What has really enriched my life [00:14:00] are the relationships that I've built, and that my wife and I had built as couples. We actually have traveled with some other friends, and that's been really special to me. So I do feel that if you are not caring about the other people in your community so much, it diminishes a lot in terms of the depth of the relationship and life you're living. Interestingly, where I live now too, we've become friends with a lot of our neighbors, widows, retired couples, as well as people that have had my wife watch their kids because they're busy at work, and they have no one else, and their partner is training cross country. So we've been very much integrated into the community here where the neighborhood where I was living before, we had great friends, but houses were a little bit more separate. People were more distant. People weren't just coming over and asking, Do you have a cup of sugar? 

Where I live now, it's kind of [00:15:00] retro. A retro situation where the community is really strong, and I have commitments and relationships with people at all age groups, people that are in their twenties, people that are in their eighties. Like literally my wife has all the ingredients that she needs for great Asian cooking. So if they want cilantro, they could come to our house.

Christine Ko: I read the article, and it did strike a chord with me. I do think that relationships are the most important thing, and I feel sometimes somewhat hypocritical when I think that because I don't live close at all to my parents or my older sister. They're both in Southern California, and I'm in Connecticut, and so I feel like I should be able to do something about that if relationships are so important to me, but it's just hard, I think, in practice, to follow through? 

Thomas Helm: Well, here's where I'll go with my priorities that I mentioned. I think the most important thing for [00:16:00] someone that has a partner is that partner. And it took me a while. For kids growing up in a healthy coupled marriage, that is the most reassuring and fulfilling thing. They don't necessarily need stuff. They need mom and dad to model good behavior, get along, and love. And so, you're with your life partner and your kids. In many ways, that's the critical relationship. In my thinking, the relationship between your mom shouldn't be more important than the relationship between you and your spouse. If his career is moving along and your career is moving along. One of the statistics I showed at a recent meeting is only 50% of people say they're very satisfied with their work. So if you're very satisfied and he's very satisfied, you're already in the top 25%. Right? That's something to not discount.

It's a give or take. It may change at different periods. My mother-in-law had to make the choice to move from New York to be with us 'cause we weren't going to her. Our kids were thriving, and we really tried [00:17:00] to accommodate her. Again, it's a give and take. I absolutely don't buy into the idea that you owe to your parents to meet all their needs. That's a different kind of trap. I'm very forward looking and this is what I like about spending time with kids and young people 'cause it's kind of more future conscious. Does that make sense? 

Christine Ko: That's very helpful. Really. I never thought about it that way.

Thomas Helm: People ask me how do I have so many grandkids? My wife says that my daughters had an idea of who they were looking for in a life partner because we were able to work certain things through; in our relationship. We're very open to our kids. And I get along really wonderfully with my daughter-in-law and actually all of their extended families. I count my blessings. I never would've expected this. Seven grandkids: I really want to be in everybody's life and have them know me well. So that requires changes, you know? And we don't expect them to come to us. The downsizing made it very clear. [00:18:00] We're gonna come to your house if you invite us. We're not expecting that, but it's a little bit of a different paradigm, 'cause I've had some friends that have a really big house, and they're expecting everybody to come to their place. Well, that's holding onto control that you don't have with your adult kids. One rule that I'm not so good at, but my wife's much better at, is no unsolicited advice for adult children. And she lives by that. Once they hit 18. They know that they can ask mom for advice, but she's not gonna tell 'em unless they ask. They all love and appreciate her. I have to bite my tongue some or she'll kick me under the table.

Christine Ko: That's amazing. Your wife, Aries, she seems like a very special person, as are you. So you guys found each other 

Thomas Helm: Well, that's the thing. We found each other and that was probably the most foundational thing for all these other things in my life, quite frankly. 

Christine Ko: Well, on that note, do you have any final thoughts? 

Thomas Helm: My final thoughts are to thank you for what you do with your podcasts. [00:19:00] I've enjoyed listening to them. You have varied topics that are very timely, so I want to encourage you with what you're doing. And I also have to say you've personally shared so many things about your journey and that's been very impactful to a lot of people. My final thought is to thank you for having me on, and thank you for all that you do, Christine, and I hope we talk again sometime soon. 

Christine Ko: Yes, definitely. Thank you, Tom. Thank you for your time and all of your good thinking.