What if burnout isn’t a sign that you need to leave medicine but a signal that something in your life needs to change? In this episode of the Direct Well-Being Podcast, Dr. Anders Apgar sits down with Dr. Diane Shannon, an internal medicine physician and physician coach, to explore the slow drift into burnout, the danger of making medicine your entire identity, and how small, intentional changes can help physicians build careers that are both meaningful and sustainable.
Burnout rarely happens overnight. It often begins quietly, with lost sleep, neglected hobbies, less time with loved ones, irritability, dread about going to work, and the gradual loss of the person behind the physician.
In this deeply personal conversation, Dr. Diane Shannon draws on her own experience leaving clinical medicine and her years coaching physicians to explain what she sees in physicians who feel stuck, exhausted, or unsure whether they can continue practicing. She emphasizes that coaching isn't about telling physicians what is wrong with them or giving them a predetermined solution. Instead, it creates space for awareness, reflection, and better questions.
Dr. Shannon and Dr. Apgar explores the difference between dedication and self-sacrifice, the unique pressures experienced by women physicians, and how identity can become so intertwined with medicine that stepping away, or even imagining a different career, feels almost impossible.
The discussion goes beyond burnout recovery to ask a bigger question: What does a meaningful and sustainable career actually look like for you? From finding time for what you love to recognizing when you're on the wrong “ladder,” this episode offers physicians a practical framework for pausing, reassessing their lives, and rediscovering the possibility of joy in medicine.
Episode Highlights:
About the Show:
Direct Well-Being is hosted by Dr. Anders Apgar, MD, FACOG, M.S., An Ob/Gyn physician leader and nationally recognized voice in clinician well-being. The show is a trusted, peer-driven space for honest conversations about what actually supports physicians, beyond resilience training and surface-level wellness.
Each week, Dr. Apgar sits down with physician leaders, partner organizations, and frontline clinicians to talk about the real drivers of distress: financial stress, mental and emotional health, family dynamics, and the systems in which physicians practice. Conversations are evidence-aligned, research-informed, and grounded in lived clinical experience, never promotional, always physician-first.
Produced as a Direct Self Care production in partnership with the Doctor Podcast Network, the show draws on insight from the Well-Being Index, Champions of Wellness, Tend Health, and the broader Direct ecosystem to move listeners from awareness to agency.
About the Guest:
Dr. Diane Shannon is an internal medicine physician and professional coach who has spent the past seven years coaching physicians and healthcare leaders. Her work focuses on helping physicians create sustainable careers and navigate difficult professional and personal transitions.
Drawing from her own experience leaving clinical medicine and later working as a healthcare writer, Dr. Shannon brings a deeply personal understanding of physician identity, burnout, career change, and the challenge of rediscovering who you are outside of your professional role.
She uses a coaching approach centered on awareness, powerful questions, and small intentional changes rather than prescribing one-size-fits-all solutions.
Website: dianeshannon.com
About the Host:
Anders Apgar, MD, FACOG, M.S., is a physician leader dedicated to transforming clinician well-being. As host of the Direct Well-Being Podcast, he leads honest conversations about the real drivers of distress : financial stress, mental health, family dynamics, and broken systems, for physicians and the organizations that support them.
A trusted voice in health care, Dr. Apgar blends lived clinical experience with evidence-aligned insights. He’s part of the Direct Ecosystem (Direct Self Care, Direct Wealth Care, Direct Practice Care), partnering with organizations like Tend Health, the Well-Being Index, and Champions of Wellness to move the conversation from awareness to agency.
Connect with Dr. Anders Apgar:
directwellbeingpodcast.com , dwbpodcast.com
Emails:
[00:00:00] Okay, everyone, welcome back to the Direct Wellbeing podcast. Today, I am very pleased to have my very special guest, Dr. Diane Shannon. Diane Shannon is a internal medicine physician and has spent the past seven years as a professional coach for physicians. And this is also a little bit personal.
Diane, first of all, welcome to the show. Thank you for being here. Thank you for having me. It's a real honor. Oh, this is great. Today's conversation's a little different for me because before you were our guest on today's podcast, thank you very much, you were my coach. And so at a point in my career when I was questioning what came next, you helped me see things that I couldn't see on my own.
So thank you very much, first of all, for that. I appreciate that. But you've coached countless physicians, particularly women physicians and healthcare leaders. But I think the questions we're gonna explore today really apply to every physician who's ever wondered, "How do I keep practicing medicine without losing myself?"
And so our lead off question really is, when physicians feel like they've lost themselves, [00:01:00] where do you begin with them?
Yeah, so I'm thinking about a physician who's come to me interested in change. They feel like-- often feel like they're at the end of their rope. And where I start with is simply listening. Where are they? What are the factors that have led them to be where they are? What do they think the biggest challenge is?
And really letting them tell me what the problem is. So I'll tell you that a lot of times in that first call, physicians get really emotional because often within their workplace, they can't talk about some of what's frustrating or what's really getting them. And then they've already spoken at home so many times about what's wrong that they feel like they don't have a place they can just vent and say, "Here's what I'm experiencing.
What do I do?" And so the beginning is really just being that space. Wow. And we talk a lot [00:02:00] about burnout and we-- almost to the point of making that cliché, but burnout rarely happens. it doesn't happen overnight. What does that slow drift look like personally and professionally when you see it in physicians?
And as I experienced this myself, which led me to leave medicine years ago. And so I left in the late '90s. Back then, I'd never heard the word burnout, and we didn't talk about wellness, so I had no idea what was happening. I just knew I had to do something different, and I didn't see a lot of options.
I like to be that person who helps people see options now. But in terms of that slow drift, I think for me it was continuing to push through when I needed something as a human being, whether that was sleep or perhaps time to connect with people I loved hobbies. I let all of that go. That was the beginning.
And then more and more of me got [00:03:00] lost. And then the burnout showed up, the components of emotional exhaustion and depersonalization, like really feeling like, "Oh my gosh, it's just another case, another patient." And then also that feeling that whatever I'm doing, it's not enough, I'm not good enough, and my work isn't good enough, that performance insecurity.
And I see the same thing with my clients. Often they come to me in a pretty severe state of burnout. Some of them have medical issues now because of that, cardiac issues. The stress has just truly affected their bodies. Insomnia. But I'll tell you some of the two signs that are early on I wish I'd known about are when someone says, "I dread going to work"- or, "I'm irritable, and this is not me." And so those are two of the signs I've found to... When I hear those, that is-- that's burnout to me. Wow. And physicians will typically we're [00:04:00] used to hearing more resilient. Be more resilient, be this, be that, work harder, you'll get the grades, and things like that.
How do people confuse things like dedication with self-sacrifice? How-- where do they draw that line? First of all, I'll tell you, I really don't like the word resilience for that reason. Because physicians are incredibly resilient. That's not the problem. Yeah. In terms of drawing that line, I think it really is what is the cost?
What is the cost to me? And I can give, and it's great that, what draws us to medicine is our altruism, and that's amazing, and our ability to empathize. I think that crossover point is where the cost to us is too great, and it's easy to lose sight of that because we are high achievers. We are people who wanna give to others, and it feels good.
At what point do we tip over? And one of the things that I do when I finish an engagement with a client is I help them to come up [00:05:00] with red flags, and those are things that they know are the sign that they're slipping back, and that they can say, "Oh, it's when I start waking up at 3:00 in the morning," or, "It's when I am not exercising for, some period of time."
And so they develop these ways of seeing when they're starting to slip. And I think those-- that's really important, is to know yourself and what those signs are. Yeah, and I think when you first start out as a client myself included, you don't see those. Those are things that you really don't understand to identify.
And so let's go back to our relationship. When you first met me, what did you see that I couldn't see? And I know you have a different version of this question, so I'm interested in both an, an answer and a question. so what I said when I saw this question was, that's not how I approach it, because I don't diagnose my clients.
I don't s- come in as an expert in [00:06:00] the other person and say, "I know what's wrong with you. This is what you need to do." Instead it's really asking the questions that help my client to be more clear on what the problems are, and then to go upstream to see what's driving those problems. Because often people come and they'll say, "It's my schedule."
Or it's some aspect of my work. It's the workflow. It's so frustrating. And that, that's true. But then we go deeper to say, what are some of the factors driving that frustration, and which of those do you have control over? Even if it's a tiny bit of control. So really for me, it's not, again, it's not about me being the expert in the other person and saying, "Here's what I see and here's what you need to do."
It's how can I help you to become more aware of what is going on for you? I like [00:07:00] that. I like awareness. Much of your coaching, Diane, has been focused on women physicians and women healthcare leaders. And they often face unique challenges that deserve to be recognized and discussed as a separate entity.
But at the same time one of the reasons your expertise is so valuable to our listeners is that I believe the deeper issues we're talking about today, things like identity, purpose, boundaries, and building a sustainable career really are very universal. By understanding both the differences and the common grounds, I think every physician can learn something from this conversation.
And but specifically, what are some of the unique pressures that women physicians experience that may not always be visible to their colleagues? So I'm trained in Gestalt coaching, which is meaning I'm not trained only to coach physicians.
I'm trained to coach people, and it's a particular approach that I really like. I decided to focus on physicians because of my experience, my background, and it's something I really care about. When the [00:08:00] pandemic started, I noticed that the burnout numbers, the gender disparity in burnout began to increase, and I wanted to understand why.
And so I did a research project to understand what some of those challenges are that women physicians were facing that were leading to those changes in the numbers. And so that's why I focused more on women physicians, but I coach men and women. I coach folks across the healthcare spectrum, and I also coach some people outside of healthcare, which has been really nice to have that broad perspective.
In terms of again, I'm very interested in this question of why do women have higher burnout rates? They also have higher rates of leaving clinical medicine and earlier, and there's recent research that just came out a few months ago looking at those numbers. So some of the challenges and what I find interesting is it's not just one challenge.
It's not... Often we would think, years ago we'd say, "Oh, it's [00:09:00] because women have additional responsibilities at home." They often carry more of those tasks at home, the caregiving, whether it's children or parents and also the cognitive load that goes along with that. But that's not the whole picture.
There's much more. Women physicians do different work, meaning they get more inbox messages from patients. They get more inbox messages from staff. They're often interrupted more during their day with questions from staff. One of my clients asked her MAY, and she said because you respond." So there's this different dynamic that's been often set up, and unless that's made really visible and the, the group or the clinic comes up with a policy for distributing those questions, sometimes this can happen.
So women are doing different work. They are also still experiencing bias in the workplace, are still paid less for the [00:10:00] same work. So there are a whole bunch of different factors that are leading to to those kind of differential pressures. At the same time, there are many pressures that both are experiencing.
And so how does burnout look different to male and female physicians? I'm not sure it looks different. I think it might be how perhaps the words people use might be different. Again, I hear a lot from women physicians, "I feel irritable." From male physicians, it might be more anger I don't know if I can go on, and I don't like this."
But I think underlying it's very similar, and yeah, again, I'd say there are more similarities than differences. Wow. That's a great perspective. Are there lessons that you've learned successfully or taught successfully coaching women physicians that could benefit men as well? Absolutely, and I think-- You know I did a TEDx talk in February about [00:11:00] micro changes, and I also shared my experience learning how to surf, which was really fun to- That's awesome
connect the dots. Yeah. And what I'll say is that what my physician clients have taught me as I've watched them is that these micro changes, so small intentional changes made over time, have a huge impact on their work experience, and that surprised me. I didn't realize or didn't think that some of these small changes that they would come up with, "Maybe if I tweak this, maybe if I do this a little differently, maybe if I for instance, take a step back with the people-pleasing I've been doing, maybe if I use a different script when I enter the exam room," right?
These little changes made a huge difference for them in their ability to recover from burnout and prevent it happening again. Interesting. So it, burnout isn't necessarily a [00:12:00] you flip a switch and you're done. It's very small things, and I'm hearing that as a theme, that burnout is just a little by little thing.
But correcting it, it sounds like, can also be a little by little thing. Yes, with the caveat that if it's extreme burnout, some folks really need a time away. They need medical leave, they need an extended vacation, something to reset, because there are these physical effects, the stress effects on our body from the burnout.
Amazing. And that's-- some of that brings us to the question of identity. If medicine becomes our entire identity, regardless of who we are, how do we begin to separate the physician from the person if they've melded too much? Oh, gosh. This is a very important question, and I'll say that when I left practice, I didn't realize how much of my identity was invested in being a physician.
And what I found was when I moved into writing after I was a physician, I [00:13:00] was a healthcare writer for 20 years, and when I introduced myself in a social situation Before when I'd introduced myself as a physician, there was this immediate interest and this excitement. People wanted to know what I was doing and where I practiced.
And when I introduced myself as a writer, that was gone. It's amazing. And so I had to get used to the idea that I was still a valuable person in the world, even if I didn't get that kind of response, even if I didn't have that prestigious title of being a physician. I think it, it can very easily become our identity, and when you think about when we start, it's somewhere in the junior high school even, we are preparing for that next step, and we get on that train, and that is who we are.
Those are our next-- our next signposts are, what do I need to do to get to the next point, right? And I think the other [00:14:00] part of that is during training, my experience was training was so intense that I gave up a lot of who I was, hobbies, exercise, reading that I like to do and my identity became more and more what I was doing at work.
I think that happens to a lot of physicians, and it can be a tricky place to be when that's not working. When you develop stress symptoms or burnout, or you become, disillusioned with your job, what do you do then when it's so much a part of you? And I think it's a matter of beginning to expand what you know of yourself, and that you are more than your job.
You're more than your career. And that, that takes some time to, to really re- rebuild your connection with those parts of yourself. Yeah, 'cause it gets to the question of the difference between dedication, and denying thyself [00:15:00] type of thing. It... Our identity is so much... It becomes, because it's what you study, it's who you become.
And there's a whole generation of physicians that I still work with who are old enough that they deserve to retire. And it's not meant to sound ageist, it's just you've done your job. You've done your job, now take that career, take that beautiful career, walk into the sunset, and take care of you, take care of your family, your grandkids, or, your children, or whatever it is that you have.
But you've earned that right, and some of them, they get to that point where there's some slippage, and it starts to tarnish their career. We've got some examples and again, everyone knows my wife is an OBGYN as well and there's just some people that just can't let it go. And you think to yourself y- you're tarnishing what you've earned, and you don't need to do that.
It's I, I'm a big baseball guy too, and you-- when you look at the back of baseball cards, you see their best years, and then you see those years where they hang on, and you see the statistics just aren't as pretty, and you're like, wow, y- when to get... When do you get out? Is there a, is there-- How do [00:16:00] you know when to get out?
Is there do you see this? Is there a good, is there a good trigger? Like I'm s- okay, now's the time to go. I will say that I think you're right, and often it's identity that's holding people back at that point to really take pause and ask the question: Do I want to stay? Do I want to be doing something else?
Is it the best thing for my whole life that I'm continuing? I will say too that I don't work with as many physicians at the end of their career, because the highest peak in burnout is mid-career physicians. So those early on sometimes because they're making that that steep learning curve to finishing training to becoming an attending or a practicing physician, and then mid-career.
But I think you're right in that it, it's a tricky place and it brings in, again, this question of identity, and if we have denied parts of ourselves, the parts that are creative or the parts that, wanna be truly present with [00:17:00] children or other relatives and that part's been squashed or denied or made small it's a really hard thing to make that leap when it feels like there's nothing there.
And it-- That can-- Like that's a great transition point to begin to explore what do I love? What do I love to do? What do I-- How do I love to spend my time? And I actually love working with physicians that are at different transition points- ... because I think it's such a fertile time for asking those questions and really turning your life towards something that's more rich and fulfilling.
Amazing. Do you think there's a standard point at where medicine stops being what we do and starts becoming who we are? Is there a standard point there? Is it training? You mentioned obviously when you go back to junior high when "I wanna be a doctor," and... or is it training? Is it medical school?
Or is it when you're in private practice and you're finally like, "Okay, I'm doing something. I'm providing for a family. I've got this career." And what-- I- is there a standard point where it [00:18:00] becomes, who we are? I don't know. For me, I think it was residency because that was the point where there was so...
And I trained before there were any duty hour restrictions, so- ... it was truly giving up other parts of myself in order to complete what was required in training. I think that was the change. But I also think it could happen earlier or later for folks. What we do in our training from very early on when we think about in high school we need to get good grades to get into a good undergraduate.
We need... all those different places. Once we get on that train, meaning we're thinking we might wanna do this thing of becoming a physician, it is really difficult to step off that train. It's easier to stay on. And so making that choice to say, "Oh, I was thinking about that, but actually I think I wanna do something different," there's a lot of [00:19:00] kind of unseen pressure to stay, and I think then it becomes more and more of our identity.
Where that transition point happens might be different for different people. For me, it was training. And so it's interesting that people should take a look at their lives and see at what point, wow, this is no longer what I'm doing, it's who I am. So th- those are good evaluation points.
Why does it differ... Why-- In your opinion, why does it differ for physicians than it would for, say, an artist? If I were an artist and I were getting lost in my career, lost in my, in whatever I'm drawing or painting or whatever, that would seem Or even writing. You were a writer, right? So why would that seem like a good thing?
Wow, th- she's just lost in her writing. She's writing beautiful books, and that's a-- it almost sounds like a good thing, right? But when you get lost in your identity as a physician, it can sometimes be very negative or dangerous. Why is it different for physicians? My guess is that it's that we are empathetic [00:20:00] people who also are usually high achievers, and we're generally both of those things or we wouldn't be where we are.
Those are what draw us to medicine, what allow us to become physicians, to get through training. And so that, that desire to be high achieving I think is a big part of it. Or being high achieving. We're not even trying to be. That's just part of who we are. And don't have much of a choice.
I'll turn the question around, actually. We were talking about what surprises you about physicians, but what surprises physicians the most about coaching?
What are they-- what are they- Ah ... saying, "Oh, this, I never thought of this"? Yes. I think what surprises the most is that coaching is not the same as training or having a trainer or consultant work with you. A trainer or consultant will come in, and they're the expert, and they will tell you what you're doing wrong and what you should be doing, and that's not how a coach works.
Coaching is much more about holding a [00:21:00] framework and using questions, powerful questions, to help people become more aware. And so I think I would've thought, "Oh, awareness isn't that important." Actually, it's very important, and it is the beginning. And sometimes that awareness, what I've found, it's very interesting, and this comes from my Gestalt training, something called the paradoxical theory of change, which is if there's something about us or something we're doing, a habit that we have we don't like "Why can't I stop being a, a procrastinator?
This is really getting in my way. Why do I do this?" The first step is to-- the awareness of what it's doing for us. How is it effective? How has it been helping us? And appreciating that often leads to this energy, an automatic shift to the other. And that's something I think-- that has been surprising to me how powerful that is, how often that [00:22:00] works, and I think for physicians too.
Yeah. I love that. The, "I'll stop being a procrastinator tomorrow." Or, "I haven't exaggerated in a million years." Yeah, it-- awareness it's interesting in our coaching and again, I can't thank you enough for being there when I needed a coach. But in our coaching was really that, it was that feedback.
It was a lot of feedback and a lot of just being a mirror to hearing the words that are coming out of your mouth and understanding that, that impact. And and I almost feel when you and I met and you were coaching me, I almost feel like I should have done this years ago before we got to that point and maybe, I don't know if things would've been necessarily different, but I certainly could have used that coaching early on for sustainability or even career happiness, things like that.
Is there a time that you could suggest that physicians start to feel something, say something where their careers change? When should physicians seek a coach instead of just waiting till they get flat out [00:23:00] burned out and go, "Nope, I'm done. I quit"? That could-- That's the purpose of this show. let's find a point at which you should make a change.
What-- So when should-- Instead of just quitting, when should physicians seek that coach? Yeah. Great question. Often I see physicians who are really pretty desperate. They are very unhappy. They often say, "I don't think I can stay at this job. I don't think I-- I'm not even sure I can stay in medicine. I'm contemplating leaving."
I think at any point where your whole life is not working, so I don't consider myself a life coach, I don't consider myself a career coach, because what I do is work on both with folks. Because they're so tied, and I think especially for physicians. So when your work life spills over into your home life, that's a common scenario that I see, and it's starting to have impact on you, on your personal health.
Are you able to exercise? Do [00:24:00] you have time? What's your stress level like? And then also in your whole life as in your relationship with your significant other time for friends and family. Do you have any time for leisure or reset? Like asking yourself those questions, and when that feels out of whack or not where you'd want it to be in any component of your life, that's the time, it'd be ideal to seek coaching.
Now, people may not be willing at that point to seek coaching, and we-- a-and that's okay, maybe that, that isn't the point. Because, that isn't the point for that particular person. Sometimes when people go through a transition, whether that's a career transition or moving to maybe you were you've now had a a leadership title and leadership responsibilities, or maybe it's a, a transition in your personal life, like having a child or getting divorced, or now you have elderly parents you're caring for.
Those [00:25:00] transition points are often also a good time to seek a coach, just to, again, have a handle on your whole life and the impact of your work on your whole life. I love that. And I may have-- please accept my apologies, I may have called you a life coach or a career coach here, and I love how you mixed those two together.
I struggle to explain what I do because I'm not either one of those. You're a sustainability coach, so we-- it, we love to have- I am. That's the best way to describe what I do. It's great words, right? Yeah. And we're trying to really-- that's what we wanna do is design sustainable careers, not necessarily sustainable careers that are purely clinical or purely non-clinical, but create a blend for everybody and so that everybody gets a piece of this and takes it away and creates a better existence for themselves, whatever that means for them.
We talk about building a career that's meaningful and sustainable, and we're examining this topic from mul-multiple lenses to try and find a pathway for everybody. But what does meaningful and sustainable actually look like? Or do they have to be separate? [00:26:00] How can we blend them? that's a good question.
I think they are separate questions because you could have a sustainable career that you are just bored to death with, right? Or that doesn't feel meaningful. It's not something that excites you. You're not getting out of bed and it's like, "Oh, great." And so I think that they're both questions and they're both important because you could ha- have a meaningful career and it's not sustainable.
The pace is not sustainable, the stress level, the workload is not sustainable. So I think they're both questions to really look at. In terms of what that is, that I think is a question for each individual person to look at, and coaching wouldn't tell you what that is. It would help you to define what that is.
So for some of my clients, they'll say "Running or exercise is so important to my whole life. I wanna find a way to fit this in my week. That's really important to me." [00:27:00] Another person might say, "You know what? For me, my goal is walking for 10 minutes three times a week, and because what I really want in this phase of my life is quality time with my five-year-old.
That's where I wanna spend my time." So what's meaningful in the whole life is very different, and also meaningful in your career. For some folks, that means I wanna be ultra narrowly focused in a specialty, and that is-- that's so meaningful to me, or research or writing a book. Another person, it might be the type of patient that I'm working with.
I wanna work with a diverse clientele of patients. And so whatever that is that's meaningful, it's important to have a piece of that in your work. And there's research that shows this. When physicians have at least 10% of their time doing what they're most passionate about, they have a much lower rate of burnout.
That's amazing. I appreciate you [00:28:00] quoting that research. We had a physician, Dr. Ridge Salter, who was on earlier who spoke of that as well c- And he actually put 20%. He was super- Yeah. The study... Yes, it's a study by Sha- Tait Shanafelt, and I think it's 2015, and it's somewhere between 10% and 20%.
Yeah. And if you put that 20%, whether it's clinical or non-clinical, and it doesn't even-- just part of your work week- Yeah ... that's gonna create sustainability. Absolutely. I appreciate that. That's really a great point and it's a good point to continue to bring up for our listeners.
And y- the big question, big hammer question here can medicine be joyful? Absolutely. I've seen it I love that hope. And w- what does success look like after someone recovers or became, becomes aware after burnout? Again it's so personal to what their whole life looks like, and also what phase of life they're in.
It's very different if you have very small children versus children who [00:29:00] are now launched, right? If you're a parent. Or if you have maybe you decided to go back for a fellowship later in your career. Like, where you are in your life is very different. Again, I forgot where I was.
No. they're great questions, but they're very ethereal as well. So success for everybody is really-- it sounds like success is awareness. It's not necessarily, "Oh, I, I made this much," or, "I, I did this," or... But it's awareness that creates joy, r- returning to joy. Yes.
Absolutely. And I think about this with analogy of ladders. If there were a whole bunch of ladders, and the ladder is your career, and it could be-- it's so easy in medicine to hop on a ladder and keep going on that ladder, and keep going up and up with whatever that next stage is, whether you're, you think it's full professorship or it is a, having your own practice and being one of the partners in a huge practice.
We don't often stop to ask, "Am I on the right [00:30:00] ladder?" Yeah. And just because the next person is climbing a particular ladder, that doesn't mean that's the right ladder for me. And so I think success is knowing you're on the right ladder and you're going at a pace that's sustainable for you. That's fantastic.
I appreciate that. It does make me think about Donkey Kong, though, and climbing those ladders and having- ... having the barrels and all that thing, getting crushed by some of them. But that's- Right. ... that's part of the career journey maybe. Yeah ... do you have an example-- I'd love to hear, do you have an example about someone who rediscovered their joy in medicine?
Yes. And I will say, I'm very careful about confidentiality with my- ... clients, and so I'm gonna share a bit about someone who gave me permission to talk about her experience on my TEDx talk. So you can hear the whole thing if you want to. So she was a primary care physician, had been for 14 years, was working .6 FTE, so three days a week in clinic, and when she [00:31:00] came to me, she was totally burned out.
Contemplating leaving, contemplating, "Can I do this anymore? Should I cut back even more?" And we started by looking at what she was doing, and specifically where the stressors were coming from. And when we looked at her work day and her work week, we could see she was working on the computer every single day of the week, seven days a week, in order to finish the charting and the messaging and all of that goes along with being in primary care.
And she said, "I just want one day where I'm off, I'm not on the computer, and I can reset." She also had three small children and wanted to be able to really spend time with them and not be juggling, "Oh, I've gotta go do charts now." And so we looked at what her time was like, where she was spending all, that time, what she was doing, and I asked her the question, "What do you think [00:32:00] could be more efficient in how you're doing your work?"
And she came up with some s- some ideas to try as experiments. So these were micro changes, small changes that she decided that she would try. And a- as I say to... said to her and other clients, if an experiment fails, that is not failure. That is information. So you bring that information back, we talk about it.
What might you tweak or try differently? But that helps people to hold it differently, so it's not "Oh, I've gotta make this work, and if it doesn't work, that's it." It's more like, "Oh, okay, I tried this." So she tried two things at first. Pre-charting, which she hadn't been doing, and also making it intentional to try to finish the note before seeing the next patient as often as she could.
And she came back two weeks later and said, "I had a Saturday off." And both of us were [00:33:00] shocked. I really did not expect it to work that fast. Wow. And so then she kept honing what she was doing. So most of the time she has her entire weekend off, and she's doing less on the days that she is not clinical during the work week.
And again, this really was something that showed me how impactful it can be to just have this time to pause and reflect, ask the question, what might I do differently, and then try small experiments. And I think one of the things that burnout does, I've felt it myself, is you feel helpless. It feels like there's a wall and you cannot change anything that'll make a difference.
And what I've found is making these small changes can actually have a big impact on what feels like a mountain. That's phenomenal. Thank you for sharing that. Thank you to your client who allowed you to share that. And I think I know the answer to this next question, but I'd love to hear it from you.[00:34:00]
Can physicians truly recover from burnout? Yes. I've seen it. And what's been surprising to me again, is often when physicians come, they may be saying, "I don't know if I can stay at this job in this organization. I don't know if I can stay in medicine." And I would say most do find a way to stay where they are.
Very few leave medicine entirely. And I think that really it says something about them and their ability to change and to find these places that have an impact on their experience at work. So yes, I do think it's possible to recover. And-- But I will say again, sometimes that means, depending on how severe it is, a medical leave to really be able to reset your body.
That's a really good point. One thing I want listeners to know is that I'm not asking these questions as someone who has all the answers. In fact, I have very few [00:35:00] answers. But Diane, you coached me through a period when I was trying to figure out who I wanted to be after recognizing that the way I was practicing wasn't sustainable.
That experience taught me that coaching isn't really about giving-- someone giving you all the answers, it's helping you ask yourself better questions, and I hope that's what today's conversation does for everyone listening. Why is asking the right question often more powerful than having the right answer?
I don't have the right answer for someone else. That, that's basically it. I try to approach coaching with humility to say, "I'm good at my job, which is holding the framework, but it-- I'm not-- I don't have a crystal ball. I can't read it and say, 'This is what-- This is where the problem is. This is what you need to change.'"
'Cause I'm not that person, and their experience, their values, their personality, that all comes into, to what's causing the problem and what will be a good fix or solution or change for them. So it [00:36:00] really... The powerful questions, and I found this for myself with my coach, is that sometimes that, that perfectly timed powerful question opens something up I couldn't see before, and I think it does that for my clients as well.
I love that. That's that's really powerful stuff. And even, I think our listeners should hear that even the coach has a coach. Some of the best hitters in baseball, all of the best hitters in baseball have coaches. All the best golfers in the world have coaches. All, all-- Most, if not all successful people, I don't wanna say all all or none, but successful people have coaches who may not even be as good as they are at their craft but they are good at coaching them at their craft.
I think that's great. I'm gonna try a new exercise here. I want you to finish the sentence for me. Healing begins when... People access help of some kind. And one habit every physician should develop, here's the action item everyone, one habit every [00:37:00] physician should develop is Pausing to look at their whole life and how satisfied they are with all the components of their life.
That's great. And the last one, success is Whatever you define it to be I love that. It seems a reasonable conclusion that many physicians spend so much time taking care of everyone else that they forget that they deserve a meaningful life too. if someone listening recognizes themselves in this conversation, anyone wondering if there's a better way to practice medicine, what would you tell them?
Yes. If you're questioning it, there probably are tweaks that would help. I think, again, here's where a pause would help. And assessing what does my week, what does my day look like? Where am I hitting a point of frustration? Where am I having negative emotions come up? Whether that's frustration, anger, resentment bitterness.
Those are clues that there's something happening and [00:38:00] things could be different. And I really believe that's possible. And I will say, as I mentioned before, most people that I coach end up staying at their jobs. Sometimes that's not possible. Sometimes they're in a situation where they cannot make enough change and they need to find a new place.
In those instances, what we do is we work on helping them be totally clear on what it is they are looking for so they don't hop out of the frying pan into the fire. So I will say I think that's important too. We spoke a little bit about substituting the word should.
Get rid of the word should, actually. Forget substitute. And use, if you can put the word deserve instead of should, the sentence sounds a whole lot different to everybody. And we had a lot of great conversations. And again, I really appreciate the time you took and spent with me. If people would like to continue that conversation with you, 'cause I think you're an outstanding coach if my opinion matters to any listener out there, I think you're a [00:39:00] fantastic coach with the awareness.
But where can they learn more about your work? Yeah. on my website, dianeshanon.com, or on LinkedIn, and you can contact me through either. That's great. And if with your permission, I haven't asked you before the show, with your permission, we'll put that up on our website too so people-
can get in touch with you and- Absolutely ... and really delve into that resource. You're a fantastic resource. Is there anything today that we're not talking about that we should be?
I think the joy and the hope. A- and that's why I continue doing this work. It is incredibly rewarding to w- witness, to watch a physician who is really miserable, really suffering, go through an arc and get to the point where they feel joy and passion about medicine. So medicine is really an amazing profession, and I hope to be that resource that I wish I'd had when I was at that decision point.
And again, it is just incredibly rewarding to watch that and to see the [00:40:00] joy in medicine return. That's really powerful. Thank you for that. Last question today, and again, thank you so much for being with me. If you could change one thing tomorrow or change one thing for physicians or your clients tomorrow or today immediately, what would that be?
I have to say two, not just one. Okay. One is how we pay for medic- for healthcare in this country, because I think that has a huge impact on physicians. And the second is that what I would change is that leaders of healthcare organizations began investing in their people. I think too often leaders are looking at this quarter and balancing the budget for this quarter, not thinking about if we invest in resources, more sta- support staff coaching, if we invest in our people, we will [00:41:00] actually save money in the future, and we will retain a vibrant physician workforce.
So those are the two things that I would change if I could, if I had a magic wand. Those are great points. Great points to end on, too. Very mu- very much what we all need to hear. Thank you so much. Dr. Shannon, Dr. Diane Shannon, thank you so much for being with us. Thank you for having me.