Episode 37: Redefining Success

Dr. Kara Pepper is a primary care internist, executive coach, and founder of Micropractice Mastermind. Based in Atlanta, Georgia, she’s a passionate advocate for physicians building sustainable, joyful careers—on their own terms. She’s a true example of leadership. 

In this episode, she dives deep into her own journey through burnout and career reinvention, and provides incredible insights for any physician seeking to reclaim their autonomy, values, and purpose in medicine.

Here are my takeaways from this heartfelt conversation-

• Burnout is not a personal failure. Dr. Pepper shares how she once believed her struggle with burnout meant something was wrong with her, when in fact, it was the system that was misaligned with her needs and values.
  
  
  
• Rest is not optional—it’s essential. True healing and clarity require extended rest and nervous system downregulation. A two-week break isn’t enough; Dr. Pepper needed months to fully recover and reconnect with her purpose.
  
  
  
• You’re not “just” anything. Whether you’re a pediatrician, internist, or neurosurgeon, you have deeply transferable skills that can apply far beyond traditional roles in medicine.
  
  
  
• You are not stuck. If your current role no longer fits, it’s okay to change. So many physicians unnecessarily settle for survival instead of fulfillment. 

Connect with Dr. Pepper here-

www.KaraPepperMDCoaching.com

@KaraPepperMD on all socials

It's Not Just You podcast

Transcript

0:08

Welcome to the Purposeful MD Podcast. As a physician, you've sacrificed so much of your life for other people, your patients, your family, your friends, and your colleagues. What would it feel like to spend time doing what you enjoy and to live without guilt? I'm your host, Dr. Laura Suttin, a family physician, certified coach, and business owner. If you're a medical professional on a journey towards your most purposeful life, a life with more time and energy, and ultimately more joy, then this is the podcast for you. Welcome to the Purposeful MD Podcast. I'm so excited to have our guest today, Dr. Kara Pepper. Welcome to the podcast, Kara. Thanks for having me. Yeah, so good to, so good to see you, thanks for being on. So I'll read your bio here, and then I wanna hear your story as well. So, Dr. Kara Pepper is a practicing primary care internist and executive coach in Atlanta, Georgia. After 14 years in private practice, Dr. Pepper built her own 17 state telemedicine practice for adults across the southeast, especially folks with eating disorders. In addition to her clinical practice, she provides executive coaching, and is the founder of Micropractice Mastermind, a community for physicians transforming healthcare through solo practice. I love that. Dr. Pepper is the podcast host of, It's Not Just You, stories of survival, humanism, and career sustainability. Thank you so much for being here. I'm just, I'm so grateful to talk to you, and I just can't wait to dive in, for you to share your journey, and how you got to be where you are. Thank you. Yeah. So yeah, let's start from, your days in private practice. Take us through your journey as to where you are here. I know we, we were chatting before we hit record. Um, I've heard you speak a couple different times at different conferences, and so I know you, you have the, the expertise on how to build a practice, and then your own coaching related to eating disorders, and, um, perfectionism, and imposter syndrome, definitely wanna get into that. So yeah, give us a background and tell us how you got to where you are now. Yeah, uh, I never thought I was gonna go to college. I was a ballet dancer, um, out of high school, and got a job dancing and, uh, when eating disorder injuries and, uh, basically ended my career, I had to figure out what I was gonna do, thought I was gonna be a physical therapist, but my orthopedist said my personality was better suited for medicine, which I think is a nice way of saying I like to be in charge. Um, so instead of dealing with the grief of leaving dance, I just did what I was really good at, which is to like put my head down and work really hard. Um, and, I did fine, but good on paper. You know, went to a great residency here in Atlanta, and then joined a typical, um, private practice that was large, 18 docs at the time, and grew very quickly to about 70 docs, was bought out by a hospital system, and I worked there for 14 years. Never thought that I was gonna leave that practice, really just thought all the feelings I was having about feeling trapped, or overwhelmed, or continually trying to contort myself into this role of this, you know, as the screws kept getting tighter and tighter on productivity, just thought like, there's something wrong with me, if I could just fix myself, then I could accomp, you know, assimilate here a little bit better, um, to every couple years would try to do new things, change my schedule, change my hours, change my clinical focus, change, you know, my part of town, reduce my commute. I try to do all these things about seven years into my career, just epically, burned out, could not get outta bed anymore, and felt profoundly ashamed, like there was something wrong with me. And in that window, a lot of folks came to me like I had some answers. I had no idea what to tell them, but I just figured out that they were really burned out, and overwhelmed, and struggling too. So, um, kind of came back to the practice, tried to reinvent myself, and then Covid happened, and it became very clear to me that I could be dead within a week, and I would regret the way I was living my life. I wanted to practice medicine, but definitely did not wanna practice it that way. And so, thought maybe I could write out my non-compete with a telemedicine gig. So started a telemedicine practice after two years, went back in person. So now I've got a cute little micropractice office where I see patients and, um, help support colleagues who are trying to do the same. So it's the, that's the short of it. Yeah. Lots to dig into there. Yeah. Thanks so much for sharing that. I'm, I'm, I'm so happy to hear that you've overcome that burnout yourself, and that you're doing something that you just love and, um, that just makes me so happy. Tell me, take us back to that time when you were really burned out and what, what was it that helped you move through that, and come out of that on the other side? Uh, I think the shortest answer is that I needed a way to truly rest and down regulate my nervous system. That's not what I would've told you I was doing at the time. The first time where I couldn't get out of bed, I took a leave of absence. I have this great mentor who said I needed to take a leave and I said, okay, great, I'll take two weeks. And he was like, you should take a year. And I was like, no, I mean there's just no way. Like, can you imagine taking a year? So I took six whole weeks, cause that's a maternity leave, so that's like the most I would give myself permission for. And as someone, who cares for physicians, they are my patients, and also cares for them, because they're my coaching clients, and having lived through this experience, really six to eight weeks is the minimum. It's really the shortest period of time where you can just not feel like you're on fire anymore. But I spent that time, uh, cooking, and taking my kids to school, and doing yoga, and basically nothing else, I just needed time to just like settle. Um, and I definitely did not feel ready to go back to work, but I felt like I did, I could at least, marginally tolerate it. Um, and then I kept, you know, tweaking things, and then the second time I burned out, was as I was leaving my practice. The pandemic was happening. I was leaving, and the process of leaving was so exhausting, and overwhelming, and I was doing it alone, which I think was part of it. I didn't have a community of docs, who were doing similar things, that I was carrying this emotional load, I probably didn't have any business carrying, and so, I thought I was gonna open my practice, six weeks after I left, and it was clear to me in the first week, I was like, there is no way I am gonna be ready. Like I just need time to like, settle. And every month that went by, I would think, oh, I feel so much better. And then like another month would go by, and be like, oh no, actually this is what it's supposed to feel like. I started the practice after three months, but it really took nine months for me to feel human again. And so, time is a luxury that we don't often give ourselves permission for, but, in whatever way you can get it, we can't make really great intuitive, grounded decisions when, when, when we're in survival mode, and so downregulating, so we can actually rest and recover, that's where our next step answers always lie, is in that rest, it's diastole, right? Yeah, you said downregulating a couple times and, and what comes to mind for me when I hear that is, that's not a process that we can rush, right? We can't. That's right. We can't do that ourselves. Right? Yes, if there's some efficient way, and believe me, I tried to do it efficiently, I would, drink wine on the weekends, I would like, go on a vacation, I would do yoga, you know, retreats. I would try to do these things, but, your body did not, learn how to live in fight or flight mode continuously, you know, overnight. Like it took us, years and years of practicing medicine to kind of get there, and so, it takes a long time to unwind those behaviors, if you're someone, who just the thought of sitting in silence on the couch makes you wanna cringe, like you'll know what I'm talking about. Yeah, yeah, that, that thought that, well, if I'm not doing something productive, then I'm useless, I'm not good. Good to anybody's, right? Yeah, that's right. That's right. Yeah. Yeah, yeah, that survival mode that you talk about, I, I, I hear a lot of my own story in what you share, and stories that I hear from my clients as well, my physician clients, and just colleagues about, the fact that we're trying to contort ourselves into this, put a score peg in a round hole or whatever that is. Yeah. That you thought there was something wrong with you. Mm-hmm. And, I hear that so much, I felt that myself, when I was in a, also a large corporate environment, also for 14 years. Um, worked with incredible people, amazing people. Mm-hmm. And, yet kept getting the message that, I'm not enough. Mm-hmm. And I'm not valued, and, and, that my work wasn't important. And really what I loved, which was coaching and position engagement, wellbeing, mental health, just wasn't, that wasn't enough of a, a line item, you know? Mm-hmm. Um, to really make an impact, and so it's this message that, well maybe, yeah, like you said, maybe something's wrong with me. Mm-hmm. Maybe I'm the one that needs to change, and, so I think that's something that a lot of physicians can relate to. I hear that a lot feeling like, well, if I go somewhere else, it's not gonna be any better. Or, I could, I could do telemedicine, or I could start my own practice, but, you know, I, I don't have the skill sets. Um, I hear things that break my heart like, well, I'm just a pediatrician. Mm-hmm. I'm just a X, Y, Z. I actually heard the other day, um, I'm just a neurosurgeon. I was like, what? You're literally a brain surgeon. Like that's the joke about the most intelligent people in the world. You're literally a brain surgeon. Yeah. Um, so as a coach, how do you navigate that when you hear that from your clients? Several, ways. Several, several things. So one, we are in pursuit of excellence, but we often get that confused with perfectionism. Like, I can be enough when I'm okay. I can be enough when I'm, creating product, productive things in my life, I can do it when I've suffered enough. Like some of the questions I'll ask people is like, how do you know you've done enough work for the day? And often people are like, well, I'm just like brain dead, exhausted, or I don't know, I'm falling asleep, driving, or I am really irritable with my family. Like, like those are not metrics of success in my mind, you know? So we're just taught that, you know, what, how much is enough? More, more is enough. Um, and what I would like to offer is that there is, no more patients that you ever need to see for the rest of your life. Your moral debt is paid, people are alive, because you are the med student, the resident, the fellow, the attending in the room, and, you know, asking yourself like, how many more patients do I need to see in order to know that I made a dis, difference in this world? And the answer's zero. Uh, that's my opinion. And getting people to, to get to a place where they believe that the work that they're done, they've done is valuable, I think then opens up the possibility of change. Like, okay, yeah, anything I do from here moving forward, even if my student loans are paid, my mor, are not paid, my moral debt is paid. And so whatever I do from here, moving forward is by choice. And this idea that we have no transferable skills, is total bologna. I mean, we have so many skills, and so much education, it's just how do you wanna apply that? And so if you can do crash c-sections, or operate on someone's brain, or manage a complex family dynamic, because you're their pediatrician, like you can figure out how, how to build a business, how to make another source of revenue. Like those are just learned skills, just like the ones that you currently have. So we're never stuck. And what you're not changing, you're choosing. And so, you can say that you're stuck, but like that becomes your choice. Like I'm choosing to stay here, and be miserable, and you deserve better than that. Yeah, absolutely. Absolutely agree. I think we sell ourselves so short, and it's so, it's just so interesting where this voice comes from. A lot of it is, I mean, your background as a dancer and your, some of the, the messages that you likely received about who you are, and your body, and all of those types of things, um, I'm sure played a role, and the messages that we receive as physicians, in our training about who we are and, and who we have to become, and, we have to be perfect, we can never make mistakes, we can never show any signs of emotion. We can't take care of ourselves. You're stuck in a nine hour case. You can't go to the bathroom, you can't eat, you can't sleep. All of those messages that we get that just tell us that we're, we're only as good as our outcomes. We're only as good as the pa, the next patient that we see, or that next case. And I'm curious, do you, do you feel like the culture of medicine is shifting at all, either in the training environment, or just, physicians, who are kind of standing up and saying, this is not okay anymore? Yep. I mean, I'm not a, a traditional academician. I don't work in academics, so I don't really know what's happening inside those walls. But what I can tell you is that the folks who are graduating, have watched us burnout, die by suicide at higher rates than the population, get divorced, and leave medicine and, if you are, over the age of 40, you need a mentor, who's under the age of 35, because the way that they look at our field is dramatically different than how we were trained, and that is what is going to save healthcare in America, is people looking at this with fresh eyes, we know that the average length of stay for new physicians, within the past years of grad, six years of graduating from residency, is about two years. Meaning they take their first job, and they stay for two years, and they're like, this is not it. I joined for the money, but the culture of the administration here is not it. And so they are, they want to take great care of patients, they want to provide excellence, but they are not willing to be the cost of that, and, that is how you create a sustainable system, because it forces the system to reconcile where those gaps are. And it's really interesting to me as I coach, mid-career and senior career physicians, they are so resentful. Like, oh, these millennials don't wanna work. I'm like, no, no, you're pissed off, because they have exactly what you want. They go home, they have boundaries. They, are unwilling to sacrifice themselves endlessly, and you have that choice too, but it re, requires a lot of introspection, and rewiring of our brains, because, after 20 years of self-sacrificing, it's a hard, hard habit to change sometimes. Yeah, that generational gap, I mean, I'm, I'm a, I'm a young Gen Xer, and I see that in physicians who were trained a little bit more in the, well, a 36 hour shift is just normal. And the younger generation, even the Gen Zers, coming out of medical school and residency now, um, that are not, putting up with some of those things, and not going to tolerate it. And, and there's all these conversations about the work hours and the, the argument that really, the only argument that I hear from, um, from older physicians that, and I don't think this passes a sniff test at all, it's like, well I had to do it, so they should too. And I know there's labor shortages, and, and some of those types of things, and mean, if you can make the case around, following a patient from start to finish, and that type, that, I think there's a, something to be said there, but at the same time, I mean, our pilots need rest, right? How many times have we, you'd probably bet on a flight that was canceled, because it was delayed long enough and the crew time's out, like I don't wanna get on a plane, when that pilot's been awake for 16, 17 18 plus hours. Um. I mean, the que, the question really, when we have these conversations, is who benefits from the suffering? Right? And it's not the patients. It's not the clinicians. It is truly that our government does not have to fund additional residencies or longer residencies, and that hospitals get, free labor or heavily discounted minimum wage labor. And, and for me, when you trace down the money, like who's benefiting from the suffering? It's a good question for any problem. It, it really, it's easier for us to pit generational doctors against each other, but the answer is like, we are all in this together. Right? Like you didn't, you 60-year-old doc, you didn't need to work 36 hours to learn how to practice medicine. Mm-hmm. You just needed a different system that didn't exist at that time. And so, healthcare is not, it is on a crash course for implosion with de, you know, decreasing reimbursement and elevated costs. And for people who are stepping off that system to say, I want to do this differently. I wanna create a sustainable career. I want an environment that's healing for me and my patients, it can be done within the insurance model, but it cannot be done in the way that we're currently doing it. So leveraging technology, leveraging new, um, modalities, like, the, the folks who are coming out of, of, um, training, are looking at our healthcare system with fresh eyes, and are able to reinvent these things. So, I actually am optimistic, and that despite, despite all evidence pointing otherwise Yeah. Um, that we can really make something beautiful out of this, but what we've got right now has got to change. Yeah. I mean, we used to leach people for a living. We don't do that more, right, like we can change. Right, exactly, exactly. I love that question you said a couple times, who benefits from the suffering that, uh, that's, that's brilliant. I, feel like I need to use that in my own life a lot of times, because, mm-hmm. Um, it's yeah, the likely, the answer is well, nobody. Yeah, or the people that we don't want to incentivize, right. Right. Like we're trying, if we truly are in this for the patients, then sometimes that means taking these really hard stances. Yeah. Yeah. Tell us about what, what a micropractice is, cause a lot of our listeners might not know, and then, how you've built your practice, and then your, your, your coaching and consulting model around it. Yeah, uh, so, micopractice is exactly what it sounds like, it's a really tiny practice, and in my world that looks like, just me. I have a virtual assistant, who helps with some scheduling, and lots of administrative work, and keeping me organized. But, if you are a patient, you self schedule, you come to my office, I have one exam room. Uh, I draw your blood, I do your EKG, I spend an hour with you. Um, you know, I'm the person answering the emails, and I built a practice model around that. Um, it can evolve into, smaller practices, like you start hiring people. Um, and certainly I'm an internist, so I'm not doing OR work, I'm not, I don't need major procedural space, but it's, the smallest, it's like an atom. It's the smallest little unit of what a practice could look like. Um, and after being in a big corporate system, I wanted to practice medicine differently. It's the number one thing my coaching clients say to me. I just want time with my patients. Um, but I wanted to have the nimble, ability to beta test things, try and fail, and, and augment the, those things, and really customize a practice around the patients that I'm serving specifically. Um, how did I build it? I had no idea what I was doing. I came home to my husband, and told him I quit my job. And, then when he was like, what's your business plan? I was like, my plan, is that I'm gonna see patients, and they're gonna pay me money. Like, okay, like we're here. Wow, okay, this is, it's not a plan babe. Um, so I had no like, real training in how to do this, but again, it's not that hard. We have the ability to ask questions. We have the ability to do research. We have the ability to network, we have the ability to lead teams. And so, I just kind of elbow greased my way through it. And in doing so, similar to when I was burned out, and people came to me for burnout advice, I built a solo practice, and was happy practicing medicine again, so people came to me for, for, hey, hey can I just take you out to coffee? Hey, can I ask you, about how you built your practice? And so, I decided finally that all those people need to be in the same room, so built this coaching program called, Micropractice Mastermind, where, folks who wanna build their own practices come, and we go through from nuts and bolts, like, how do you choose an EMR to what, what is marketing, to what's a business plan? And so, it's been amazing, because I knew even though I'm a total introvert, and love not having a lot of noise in my, day-to-day, I really, wanted to be in a community of people, who are practicing that way, so we've got this nationwide community of physicians, and then I built, um, a solo practice docs group here just in Atlanta for just local folks, so there's like 50 of us in there. So it's been really connected even though I'm in solo practice, which is really cool. That's awesome. I love that. I love it. Are you still doing telehe, telehealth? Yeah, so it's a big part of it, because in those two years I was writing up my non-compete, I grew to, um, 17 states. And so I see folks from all over, and like I mentioned, I do eating disorder care. There's really not a lot of adult medicine doctors who do that. So there's a real gap. So people see me remotely. But I have an in-person office too, and, uh, people see me in person when they can. Um, and that's been really interesting, because even though reimbursement, and the government is kind of leaning away towards telemedicine, it is absolutely necessary to close the gap in access to care for not just my field, but many, many fields. And honestly, there's so much of what I do as a, you know, thinking brain doctor, not a procedure doctor. Like, I don't need someone to drive across town for me to have a conversation about what their mood is like. So, mm-hmm, it's, it's, I mean, convenient, um, if not anything else. So that's been really neat. Yeah, that sounds really fulfilling. I can just see the, the energy in your face as you're talking about it. That's really great. I just, um, it was clear to me, um, during Covid that I could be dead next week, and I would have really, really regretted living my life the way I was, even though it looked great on paper, even though I was making good money, even though, I was serving a lot of patients and, you know, was in a really reputable practice. I just knew in my bones that I would regret not making those changes, and, perhaps I just felt mortal for the first time. Um, but I just wanted to do it differently, and it was something that I'd known for a long time, but I couldn't unknow that, and so I just needed to, to get started. And so it was scary, but it was necessary. And, when we talk about behavior change, um, for our patients, for example, you know, you're counseling someone on lifestyle changes, there needs to be a really acute reason, you know, when people come to me for physicals, they'll say, I wanna be healthy, which is like, so nebulous, what does that even mean? So I'll ask them, what does that mean to you? And they're like, oh, I think I need to lose weight. I'm like, okay, why do you need to lose weight? And they're like, well, I wanna be able to, get on the floor, and play with my grandkids, and get up again. I'm like, okay, so we're talking about mobility, we're talking about pain control, we're talking about social connection. Those are reasons, not just like healthy, cause healthy doesn't get you out of bed to like, put on your running shoes. And so, I think from a career standpoint, yes, I knew that I wasn't feeling well, my husband and I would, just kind of shrug it off, and be like, oh, this is adulting. You know, it's just, work is suffering, and then you die, you know? Yeah. But then it became clear to me like, I, I don't want my life to be like this, and like, I may be actually dead next week, so I just need to like, as they say in Shawshank Redemption, like, get busy livin, or get busy dyin, like, it is time, and so, it felt acute to me in a way that it never had, and so, that's I think the thing that finally got me over the hump, which I've been thinking about for a long time. Yeah. Yeah. I mean, it sounds like, you know, you talk about what are the different pictures of health, and what does health mean to different people? Mm-hmm. That the environment that you were living and practicing in, was not healthy for you. Yeah. And so you needed to make that change, so that you could, mind, body, soul, all of that. That kind of, that that stool. Yeah. All that health, yeah. Yeah, yeah, that's right, that's right. Yeah. So I was coaching someone earlier this week, um, she came to me for, you know, burnout and work-life balance related stuff. And it's been interesting to help her dissect this down into from a business modality, like, they have what they call KPIs, key performance indicators. And so like, how do you know, that you have work-life balance for her, she's a surgeon, so she's like, I wanna be out the door, an hour after my last patient, with no work to do. I'm like, okay, so let's like, retrofit that. Let's like, reverse engineer, like where are all the barriers that keep you from getting out? There's administrative stuff, there's insurance stuff, there's staffing stuff. So we kind of looked at all of those things, and so she came back to me this week for kind of an update, and was like, oh my gosh, everyone's all bored, it's so exciting, the business people know that I'm speaking their language now, and they can, um, help me curate these goals, and get the staff trained, and all those things. And she's like, yeah, so I think, I can like, get outta work on time, and I was like, that's great, like, that's step one. I'm glad you're doing that, but like, I don't think you're dreaming big enough. Like what would be great for work? She was like, I mean, I just wish work was like fun. And I was like, yeah, like you can make that your goal. That doesn't mean you're not serious. It doesn't mean you're not excellent. It doesn't mean you have great surgical outcomes. It means you've decided that you wanna create an environment where it's not okay just to have the status quo. You want it to feel easy, you want it to feel connected, you wanna look forward to it. You wanna feel purposeful, like, I don't know what your goals are, but it's, it is okay to dream bigger than the, than, frankly, the kind of, pile of poop that we've been handed, that's our healthcare system, like, you have the capacity to reimagine this. And when we give ourselves permission to do that, sometimes it feels really scary, because that means like, I have to reconcile that things are not perfect. But it also gives you possibility to know which you're, which direction you need to move in next, instead of just learning how to cram yourself into this box that is no longer a fit for you. Yeah, I see that too. It's so interesting, um, that we've forgotten how to dream. You know, mm-hmm, we had, we had dreams of being a physician at some point in our lives. Mm-hmm. We had to have, or we wouldn't have gone through everything that we did, mm-hmm, to become one, and so where, where did that switch get flipped, where we no longer dream about this, having this life that we love. So, yeah, I, I see that too, in my, in my clients, and my physician colleagues, it's like, oh, I just, I, whatever that example is a great one, I wanna leave an hour after my, my last patient is done. Um, but why aren't we, why aren't we dreaming bigger, why don't we think that work can be fun, and we can enjoy it, and be fulfilled by it? Well the truth is, if you're in, you're fight or flight state, if you're in that continuous survival mode, that is not where our brain is hardwired to do. Right. It's designed to like, problem solve, and complete the task at hand for survival. And it really isn't until we get into diastole, until we get into that parasympathetic space, where our creativity, our intuition, our problem solving comes on board. It's like, when you're walking the dog, or you're like standing in the shower, all of a sudden you have this like great idea or solution. It's that feeling, and, that's not what it feels like to practice medicine most of the time, so of course we're not dreaming bigger. Our goal is to figure out how can I survive today? And, our patients deserve better, we deserve better, our country deserves better, so it's on us. No one's coming to save us. Right. We get to save us. Yeah. That's scary and empowering at the same time. Um, and as physicians are, are losing autonomy in a lot of places around the country, I think it, I I, I agree with you that, I'm optimistic about the future of healthcare, when more physicians can step into their own power, and step up and say, this is, this is not okay. Mm-hmm. And then if we have patients that are also chanting that, um, mm-hmm, when they're the consumers of healthcare, then I think we can, we can make a lot of progress. Yeah. Yeah. So if somebody is, I just wanna ask you real quick, if somebody is, is considering starting a Mac, a Micropractice, mm-hmm, where should they start? Oh, um, there's lots of resources out there, which I'll point to in a minute, but I think the first step, is to make sure, one of several things, one is, what are you trying to create and why? Like, what are you solving for? Some people will say, okay, great, well, I just, I feel like burnout in this practice, so I'm just gonna go build a new one. Well, guess what, your brain comes with you, so you're just gonna create the, so, same patterns, so really understanding what you're solving for, and, getting outside of your echo chamber. If you are just talking to the same people who are doing it the same old way, like you're not gonna get any new ideas. So, this is a great opportunity to listen podcast, to podcasts outside of medicine. Like, listen to business stuff, listen to people who are artists, listen to people who are just reimagining things. Um, talk to doctors who are really happy practicing medicine. What works for them, what doesn't? I mean, that's a lot of what I talk about on my podcast. There's a lot of people happily practicing medicine, you get to hear their stories. Um, and I think pragmatically making a financial plan, that's the number one question people ask, is like, how much is this gonna cost me? And how long will it take me to be financially viable? And whether you decide you're gonna borrow money from a bank or a person, or you're gonna self-fund, you need a financial plan. And so, the first step may be, I don't even know what I wanna build, but I need an escape from this place. It may be that you just need to start saving some money, putting some money aside, so that you have this, runway, so that you have a, a window to, to get out of your current job. Um, in terms of resources, um, if you can find me, I have links to a lot of the stuff on my website and social media. Kara with a K, Kara Pepper, MD is my social media handle and my website is Kara Pepper, MD Coaching and there's like, I have checklists, literally just like for a good old checklist, like the things that need to get done in order to, to build a practice. I have lots of webinars on there that you can like, learn about all the mistakes that I've made, as I built my practices. Um, on my podcast, we talk a lot about the pragmatics of that. There's a new podcast that's out called, um, How to, How to Hang A Shingle. I think that's what it is, or Hang A Shingle, and it's a family medicine doc, Dr. Anderson in um, uh, Alabama, who is very pragmatic about how to build a practice. Um, and I would just say listen to people who are doing things differently, because if you're just listening to the same old thing, it's gonna be recreating the system that you don't already like. So give yourself a financial cushion, and then just start imagining again. Those would be the two main things. Yeah, I love that. I love it all. And yes, we'll put links to your website and your social media in our show notes, um, for folks to find you because I, if, if I were going to start a micropractice, you would be my first phone call. So, um, I, uh, I, I know our listeners, will find a great deal of resources, and what you're sharing and, um, the mastermind, I mean, that's the great part of community, right? You're hearing about what other people are struggling with, and, and you can share that experience with people that are on the journey with you. Yeah, that's exactly right, I did it alone, I don't recommend that, so doing it in a community of people where you can literally be like, where did you get the sign for your front door? Or like, who's your attorney? You know, it's, it's very helpful to have people who are struggling with the same thing. How do I find staffing? All that kind of stuff. Yeah. Thank you so much for being here. Is there anything else you'd like to share with our listeners? Uh, just that you are not stuck. This is your life, yours, and you could spend it however you want, and you are not stuck doing the thing that you've been doing for a while. It is okay to change and evolve. My husband, who's not in medicine, is an MBA and he, if he was still in the same job he had when he graduated from business school at 27, people would think there's something wrong with him. They would be like, have you not imagined more for yourself? Have you not developed any new skills? Are you really still 27? And so it's expected that people change jobs every couple of years, and it is, a sign of personal growth, if you feel like you no longer fit into the space that you created for yourself, it is okay. Yeah. It's okay to change. Love that. Chat it from the rooftops. Mm-hmm. Thank you for having me. Thank you so much for being here. Yeah, absolutely. While I am a physician, the information presented in this podcast is for educational purposes only and should not be considered medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment. Please consult with your own healthcare provider before making any significant changes to your lifestyle or routine. By listening to this podcast, you are not creating a physician patient relationship. Thank you for listening to the Purposeful MD Podcast. If you like what you hear, please rate and review the show. Please also visit my website, www.thepurposefulmd.com for free downloads or to discuss working with me as your coach.