Introducing: Life Changing Moments

Transcript

[0:00] Music.

[0:07] Paging Dr. Cook. Paging Dr. Cook. Dr. Cook, you’re wanted in the OR. Dr. Cook, you’re wanted in the OR.

[0:14] Music.

[0:37] Welcome to the Prescription for Success podcast with your host, Dr. Randy Cooke. Hello everyone and welcome to Prescription for Success. I’m Dr. Randy Cook, your host for the podcast, which is a production of MD Coaches, providing leadership and executive coaching for physicians by,
physicians. To overcome burnout, transition your career, develop as a leader or whatever your goal might be, visit MD Coaches on the web at
MyMDCoaches.com because you’re not in this alone. Well, on today’s episode, we’re going to feature Dr. Dale Waxman. Dale has been a guest on two previous episodes of RX
for Success, and he’s also a valuable member of our coaching team. In this episode, we’ll be talking about a companion podcast to go along with RX for Success. Dale will be hosting
this new podcast that we’re calling Life Changing Moments. So, let’s hear the conversation.

[1:38] Music.

[1:44] So this is a really special episode of RX for Success, special for me because I get to re-interview someone that I have interviewed in the past.
Dr. Dale Waxman was our guest for episode number 31 back in October.

[2:05] Of 2020. So Dale, welcome back and can you believe that it’s been more than two years since we had that conversation? It’s hard to believe. There’s a lot that’s happened in two years, but it also seems like not that long ago. There has been some water under the bridge,
as they say. And one of the things that I would like for you to let our audience know about is when we last talked, you were actively involved on the faculty in the Department.

[2:38] Of Family Medicine at Atrium Health and there have been some changes since then.
You want to tell us about that? Yeah, sure. So I retired from Academic Family Medicine after 37 plus years of being involved as a practicing and teaching
family doc. And so for almost a year now I’ve been doing exclusively coaching and consulting, some workshops and some teaching. And I still do get to do a
little bit of work back with my old department. It’s not clinical though. It’s mostly teaching some of the things that I enjoyed teaching when I was there
as well. So it’s been a significant shift. It’s been delightful. It’s It’s really nice to be, as one of my friends said, being able to do what I want, when I want, with whom I want, whenever I want.
There’s something to be said for that, right?

[3:36] Yeah. It’s different than being an employee, definitely.

[3:40] It sounds like you’ve got your time, your whole calendar is pretty well filled in. Do you even notice that you’ve retired?
If you ask me to list the things that I do and the different places that I get to and the different organizations I work with. It looks kind of intense.
It really isn’t.

[4:01] It’s, you know, some of the work is periodic. And, but I would say I’m more at about 25 to 30 hours a week.
There are some that are more than that. And there’s some that is less than that in terms of actual work around coaching and consulting. It’s, it’s just right for me. It’s just right.
So that leaves you a little more time for kayaking.
At least a lot more time for kayaking. Kayaking and travel and yeah, being able to do some fun stuff.
That’s a good thing I bet. Yeah, it’s awesome.
Well, the big reason that we wanted to have you here today…

[4:38] Is to talk about a companion to the RX4Success podcast that’s going to be released pretty soon. The new podcast is called Life Changing Moments and you’re going to be our esteemed host.

[4:55] And I am really looking forward to this thing because it’s going to give us an opportunity to hear from some of the people that I’ve interviewed in the past. So why don’t we begin? Maybe you can can just give us a bird’s eye view of where the whole idea of life changing moments came.

[5:14] From.
Yeah, sure. One of the things that we do at MD Coaches, and MD Coaches is about coaching for physicians and other healthcare professionals, and one of the things that was intriguing to me as
I listened to the RX4Success podcast was these, you know, as people were telling their path,
into medicine story and what’s important to them now. I was hearing these transition points in their lives that for many of them was a significant shift for them to make their life even more,
purposeful and meaningful. And in the RX for Success, of course, there’s a lot to tell in their narrative. And what I wanted to hear more about was what went into those, what I call inflection points. There’s this moment where you had this opportunity that showed up and,
it either showed up spontaneously or it showed up and you had some opportunities to decide to go one way or the other. And in your podcast, they just sort of, they’re there and a little bit of
exploration about how you got there. But I’m really interested in, boy, this is, some of these are significant pivots and I’m sure there were some conversations internally as well as with some others to assist with going in the direction that they ended up going in.

[6:38] And the reason that that kind of fits for MD coaches is that’s what we do in coaching. I would say, I might argue that all coaching people are in transition of some sort. And so
what we do in coaching is help people, we magnify all the issues that are in front of them to help them make some conscious decisions and intentional decisions about where they’re going to go next
with all the data that they have. So life changing moments is this opportunity to really extract.

[7:13] From their story these times in their life when they were confronted with this opportunity for something different and to really explore what was that like for them? What was that,
conversation internally? Who else did they turn to and what kind of advice did they get? And how How did they go ahead and make that decision?
What were the pulls? What were the pushes to go in one direction or the other? And that’s a nice kind of parallel with what happens in coaching as well.
And I see that as something that’s helpful to the listeners, not only because it could help them by listening to stories,
that they could identify with, but also it might trigger them to go, boy, I’m dealing with the same thing right now and maybe coaching could be helpful to me.
You know, that’s what you’re talking about is something that stirs in me every time I do one of these interviews.
You know, we look at the, or what we try to do at RX4 Success is kind of look at the entire career trajectory of these people that I have the honor of talking to.
And so as I understand it, what you’re going to do is….

[8:24] Kind of take a look through a different lens go to the high-powered lens And focus on some particular points.

[8:33] Along the way. Can you can you enlarge on that a little bit? Can you think of anything in particular?

[8:40] Or can you tell us how you find those inflection points when you listen to those interviews? Yeah, sure so what I’m listening for is when a,
guest is saying, you know, something wasn’t quite right.
And I felt a pull towards something a little bit different or thank goodness I got fired because it made me realize that I was missing out on whatever,
you know, blank.

[9:14] These real interesting moments that all of us have in our life, some of them are subtle and some of them are really, really dramatic, like getting fired. So I listened
for those pivot points, if you will. I listened for this opportunity to do something a little bit different, basically what I’m listening for.
I see. So I’m going to ask you to go to an even higher objective in terms of how you look at things and let’s talk about the audience. What kinds of things or what
types of things do you think our listeners are gonna pick up from all this? Yeah, great question. So I think that a lot of health care professionals
more so than any time in my career, and I’m not just projecting here, I think that they are contemplating.
Is there something better than this? Is this all there is? And we, you and I, and a lot, you have talked with a lot of your guests about why we’re at this place in healthcare.

[10:25] For, there’s a lot of, as you’ve said, there’s a lot of non-medical pieces to our work that we have to attend to. There’s lots of organizational changes and shifts.
There’s a lot more things that physicians especially have to do that we didn’t used to have to do. We used to just spend our time diagnosing and treating and some charting, but now there’s a whole lot of other stuff that’s part of the job.
And so many, many, many clinicians, physicians, healthcare professionals are in this space more frequently of this doesn’t quite fit.
It’s okay, but it’s not fulfilling as I imagined it would be.
It’s not as satisfying or maybe frankly disillusioned and all the way to burnt out.

[11:17] And so the stories that we’re doing the higher objective, if you will, are in people who, your guests for the most part are pretty fulfilled individuals and their trajectory, either they
They found, here’s what I want to do, and they found their way doing what they want to do, and they’re very happy doing what they want to do.
Or as you’ve heard in many cases, something happened in their career that made them want to shift into doing something else and to add something else on to what they’re doing to make it that much more fulfilling for them.
And so what I want, you know, one of my goals is for listeners to hear those stories about those shifts and changes people made when they too were feeling a little disillusioned,
or feeling, is there something else here for me?
Or it’s not quite as meaningful as I had hoped it would be.

[12:16] But importantly, not only that they did it, but what was the process that they went through that got them from point A to point B, from not just thinking about it, but actually going ahead and doing it.
And it’s not as easy as the Nike ad, you know, just do it. I know. I mean, it isn’t, you know, right? We’ve all, you’ve been through it, I’ve been through it.
It isn’t a just do it. There’s a lot of other things to consider.

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[13:54] Consultation. Have you ever had a moment in your life that altered your future?
To see that we have this bottleneck with residency that so many people don’t get that chance to get that so needed training. Have you ever wondered why you chose the direction you went?
When I had left my prior position, I didn’t plan on going back to practicing medicine. Coming this month, it’s Life Changing Moments, hosted by Dr. Dale Waxman.
The parts of your job that are professionally fulfilling, can you say a little bit more about that?
In this companion show to Prescription for Success, we will explore those decision points with our former guests and provide you with the wisdom and insight to make those choices for yourself.
What can I do for the country other than the psychosocial assistance? Getting the new show is easy.
If you are already subscribed to Rx4Success, you’ll get it automatically.
But if you are not subscribed, now is a great time to do so. You can find the Rx4Success podcast on Apple, Spotify, Amazon, or wherever you listen to podcasts.

[15:03] We’ll get back to our interview in just a moment, but right now I want to tell you a little bit about Physician Outlook.

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patients who still believe in physician-led, team-based care. And Prescription for Success listeners can get three months free when you enter our promo code Rx4Success and select the monthly option at checkout. That’s a really great deal on this stunning publication.

[16:09] And now let’s get back to today’s interview. So here’s a bit of a screwball question for you.
One of the things that really weighs on me when I talk to many of the guests that I have on our X for Success is there is this recurring story of, you know, I got into medicine and,
I’m not for some reason as fulfilled or as happy or as gratified as I thought that I was going to be.

[16:48] I hear a lot of that. In my career trajectory of 44 years, there was the grumbling and the groaning and the complaining, but everybody was always complaining about the same sort of things.
Most of the time, if we were honest, it was relatively trivial.
But it seems to me that people are unhappy in medicine today for reasons that are entirely different.
And I’m not sure if I’m over reading that, but I’m very interested to know if you think that’s true or there’s some barriers and obstacles and landmines that people are stepping on that we didn’t have to deal with during my time in the business.
Absolutely. So there’s a lot of different ways to think about this.
So…
I’ll go ahead and say the burnout word because it is something that we’re seeing more of but you know I think you said in a in a podcast that you know episode one when you’d recorded yourself.

[17:51] You know burnout was certainly has always been present, but it wasn’t something that we talked it wasn’t it wasn’t like common You know household language You know there’s always somebody that got burnt out.

[18:03] But now it is a real real challenge is real prevalent And so we know that it’s there, we know what some of the components are that make that happen, and that we could do a whole episode on that.
But I will just say that the shifts and changes over the, especially the last 25 to 30 years, have, you know, there’s a real difference between when you and I trained, and you trained before I did,
but when we trained, the training prepared us to.

[18:36] It was all about how do you diagnose and how do you treat?
And yeah, you have to do some charting along the way, but for the most part, it was just make the diagnosis and just come up with the right treatment and then just do it, just do that.
There are a whole lot of layers that have been added on over the last 20 to 25, 30 years that get between me just doing the diagnosis and the treatment.
A real easy one to identify is just the treatment itself, the whole concept of prior authorization.
That didn’t used to be there. I realized there are some good intentions behind that in some cases, but it is just a nagging barrier to me being able to do what I was trained to do.
So there’s a real gap between what I was trained to do, what I was reinforced to do, and then what I actually get to do now.
You know, another good example is the whole concept of autonomy. We know from the literature that the more we,
no matter what the profession is, the more you allow autonomy,
you know, there’s certainly guardrails.
You can’t just do whatever you want.

[19:58] Recognizing that people know what they need to do the job that they do for the vast majority of the time, and allowing people to have autonomy to do that, will keep them engaged and feel that what they’re doing is meaningful.
With organized medicine, autonomy has diminished, because there’s more people saying, well, here’s how you have to do things.
And by the way, you and I were trained, all physicians are trained to be very autonomous.
I mean, first day of your internship, you’re in the deep end and you got to figure out how to do this on your own. And then all of a sudden, after all that training of being, I got to figure out
how to do this and operate well on my own, somebody’s saying, well, here’s how you have to do it instead. And they may not even be anybody that’s medical. That’s a significant.

[20:51] Shift. It’s a significant detractor and it’s a significant dissatisfier. So I think those are just a couple of examples of why we’re dealing with what
you’re noticing. Yeah, I’m interested in if you would agree with me or if I’m simply imagining something that makes no difference. But one of the big things
that I see in today’s world of healthcare delivery is that a substantial And in fact, I think the numbers have been looked at and I think the number of employed physicians significantly outnumbers the physicians that are in private practice nowadays.
And I wonder if you think that has had an effect on the level of satisfaction that a person can expect.

[21:41] In the practice of medicine today or am I just making up something that really doesn’t make a difference? What do you think? Employees versus private practice?
Well, I think it does get to that autonomy issue, right? Yeah.
So, you know, that’s not to say that all employed physicians are not autonomous, but it is, you are, when you are employed, you are, and I was always employed, so I can speak from experience,
I was always in academics, I was always employed.
Yeah. When you are employed, you are saying that in order for me to join the system, in order for me to get my paycheck, there’s a certain degree of me letting go of that, me saying what I get to do with all my time.
Somebody else has some say over that. I think we can extrapolate from what we know of the direct primary care practitioners’ data.
Their satisfaction, if you go to direct primary care folks, their satisfaction with what they do professionally is just like off the charts. They’re not even talking about burnout because
they are like 90 plus percent are very, very satisfied. Well, direct primary care is an independent model of doing things. There are some groups I’m aware of, but it’s an independent model. Yeah, much more independent than anything that I ever saw during my career.

[23:04] Right, right. And so I think we can extrapolate that. There’s a lot of reasons in that model that things may make things more satisfying, but a significant piece of that is they get to do,
what they think is right. There is very little barrier between the clinician and the patient.

[23:26] Very little barrier. There’s almost no barrier. That’s the whole point of direct primary care, there is no third party in between us, telling, you know, having an influence on what we do.
You know, one of the reasons that we do RX for Success is because, you know, we want to give people an opportunity to look at many different ways in which people find
success and learn something from it. And I’m just curious, do you have some notion in your head of kinds of things that your listeners to life-changing moments, what are they going to learn?

[24:01] I think the focus for them to learn is on listening in for the inner dialogue that occurs for people when they are confronted with an opportunity to do something different.
I think all too often, Randy, people don’t avail themselves of other things that are possible for them.
I think there’s a lot of physicians that are just hunkered down and saying, well, I guess this is the way that it’s going to be. And literally I’ve heard people say, This is just a paycheck for me.
It’s no longer the calling, this is just my paycheck. And that really saddens me because I don’t think, pretty sure most of them that wasn’t their intention.
It really was a calling, it was a passion and now it’s become a paycheck.
And that can be okay if that all you see, your job is only providing you the opportunity to do everything else in your life, I think that’s okay.
But the reason it saddens me is because I know they didn’t start out that way.
Yeah, absolutely. And so, life changing moments is an opportunity for people to identify with that inner dialogue,
that people have when they are getting this opportunity.

[25:31] To think about something else that might be possible.
And then to actually hear the story of taking that inner dialogue, making it an outer dialogue, talking with other people, perhaps a coach, and making whatever else was possible for them a reality.
So my hope is that people will be able to identify with the stories that are on life changing moments so that they too can begin thinking, maybe that’s possible for me too.
Yeah, and we’ve got over 130 really engaging stories stories with all kinds of lessons that can be learned in there.
What kind of people do you think, what kind of listener is going to be in a position to really benefit from life-changing moments? Can you give us a model of who should be interested?
Well, I think the first one is somebody who is in that stage of contemplating, is this all there is and feels disillusioned, unhappy, unsatisfied, and is contemplating, but also
feels stuck.
So I want them to be listening for the stories and life changing moments. So like I said, the listening for these people that have…

[26:55] Been able to create something else for themselves, but most importantly, what they did to make that happen for themselves. So that’s number one. But then the other is for people who are just
interested in hearing how people stay open to different possibilities. So you might be very happy in your situation and not really thinking about anything different for yourself right,
now.

[27:27] But it can be nice to listen to our extra success or life changing moments just to know that there’s some other things out there that people are doing to make yourself aware of because at some point you probably will have a moment where you are wondering, maybe this is time to close this chapter.
I need to look at something else. I think many people feel this sense of trap of, I kind of, you know, I mean, you know this, Randy, a lot of people go into medical school, then they go into practice and they just sort of assume,
I’m just gonna be in this practice forever and then I’m gonna retire and then I’m gonna do whatever I do.
And so many stories of people not doing that. So you will be, most people will be confronted with some decision point in their life, a branch point.
And so you can learn something in listening to life changing moments about the process by which to take yourself forward.
Yeah, and I’m wondering if it might not also be useful to particularly more experienced,
experienced, more mature practitioners who might feel that they can.

[28:40] Be a source of help for people who are struggling. I should think there should be some learning moments for those kind of people as well. Would you agree?
Oh, I agree. I think at really any stage along your path, but also, as you know, you were just saying that I was thinking, you know, people who are mentoring others, you know, mentoring,
junior partners might be listening in and having an awareness to send a podcast to one of their junior partners or somebody that they’re thinking about that parallels their own struggles,
parallels their own story. Yeah, absolutely.
And what about listener involvement? Are you going to try to get the audience to get involved with the program in any way?
Absolutely. First of all, we want feedback, but also I think one of the things that propels us forward is dialogue and then developing community.
And so we have, as you know, we have the MD coaches community on Facebook and that’s a great place for people to put in their thoughts.

[29:48] And to put out some questions, put some questions out there for other people to respond to and increase the conversation.
And before we go, one other thing that just occurred to me, I know you’ve already recorded a few episodes.
Can you mention one or two or a few of those and talk a little bit about how they caught your attention, why they caught your attention, and the sorts of things that people can expect when they listen to the new podcast?
Yeah, sure. So one of the more recent RX4Success was with Dr. Siata Dunbar,
who herself had quite, as you might recall, quite a trajectory in her life.
So very interesting inflection points in her life, not the least of which is moving from a career in architecture and project management,
and then making a shift into medicine later in her career than most people do.
And so there was that shift for her and what that must have been like for her.
And as you’ll hear in that podcast.

[31:06] She said, I don’t really call this a calling, but I call it these nudges for me to move.
Into this path that seemed to be pulling me in. Yeah.
I was really fascinated by that terminology, the nudges. Yeah, yeah. It was, so yeah, we just got to chat just the other day and it was great to have her talk about what that was like.
But think about this, she had a very successful career and then she decided, I got to go do pre-med stuff, I have to do post-baccalaureate stuff, and then medical school stuff.
And she was single, she didn’t have any other means of financial support, so that’s quite a shift at that time of your life.
It really is. So that’s just one of the shifts that she had, but she had others within the world of medicine itself,
including she was in primary care and then did a fellowship, but then really found herself in the path of lifestyle medicine and that really spoke to her.

[32:14] And as you’ll hear in the podcast, it really was a theme for why she wanted to go into medicine in the first place,
was to really bring lifestyle medicine to prevent illnesses that were, I wanna give it all away, I don’t want to do a spoiler alert.
That’s the impetus for her to get into medicine was to be helpful to people on the front end so they didn’t end up having illness in the back end.
And so that was a shift also because moving from a successful primary care practice to something that’s pretty new and insurance doesn’t necessarily reimburse for, what’s that all about?
And how has she successfully been able to create a tremendous amount of professional meaning for herself when all the models of our profession don’t necessarily.

[33:12] She’s creating it, she’s pioneering it.
And so I want people to hear that. I want people to hear her story. Yeah, I’m really excited about it, Dale.
As you can imagine, in every single one of these episodes that we have recorded, the RX for Success episodes that we’ve recorded up to now.

[33:32] I mean, I could easily have just talked and talked and talked and we’re always constrained by the time limits that we artificially or otherwise put on ourselves.
But the stories are just amazing.
I’m really excited that you’re gonna take the opportunity to magnify some of those stories and I’m looking forward to hearing more about some of these people that I’ve already interviewed.
I’m wondering, I don’t even know if you and the production team have decided when episode number one comes out, but is there any information on that that you can share?
I know that it’s mid-January and I also know that you are the guest for the very first podcast. Wow! Yeah.
So we get to, so listeners get to have an opportunity to hear your story rather than just you asking the excellent questions that you ask about some of your inflection points. That’s going to be a lot of fun.
Yeah, it will be a lot of fun. So we get to get to switch roles here just a little bit. Well, dr Dale Waxman, listen, I want to tell you first of all that it’s been really a lot of fun and professionally and personally gratifying to me to.

[34:55] Be involved with you on the MD coaches team And now in the podcasting world as well. So thank you so much for for being with us today and I really look forward to life-changing moments.

[35:08] Well, thank you, Randy. And thank you for the excellent job you do in interviewing your Rx4Success guests that illuminate these moments that we really want to hold on to and expand on to then create this life-changing moments podcast as well. So I’m really looking,
forward to hearing how well they complement each other.
Well, thank you very much. I’m flattered and I’m looking forward to the new show.

[35:35] Thank you so much, Randy. Thank you so much for joining us today. As always, we really appreciate a review from you, and a five-star rating helps us a lot. Those ratings improve our visibility and help us reach,
more listeners. If you’d like access to exclusive content, please check out our Patreon page where,
you can see membership-only material, including personal rapid-fire Q&A sessions with our guests and more. To be sure you never miss an episode, visit our website at rxforsuccesspodcast.com,
to subscribe. As always, special thanks to Ryan Jones, who created and performs our theme music.

[36:16] And also to Craig Claussen and Claussen Solutions Group, who edits the show. And remember, Be sure to fill your prescription for success with my next episode.

[36:28] Music.