Life Changing Moments: Navigating the Pivot, with Dr. Jessica Mendelsohn

Transcript

[0:00] Yes, I am a physician, but that does not define who I am as a person.
It’s part of who I am, and it needs to be synergistic with the rest of my life.
There are times in our lives that change the way we see the world.
Navigating these challenges can take insight, trusted confidants, or even a coach.
Let’s explore those moments.
In this companion podcast to Rx for Success, we will discover ways to learn and write our our own success stories together.
I’m Dr. Dale Waxman, a physician coach with MD Coaches, and this is Life Changing Moments.

[0:39] Music.

[0:45] Are you now or have you ever been an employee of a company, healthcare system, or healthcare group and felt that the only way you were going to be able to work in the way you wished was to create it for yourself.

[1:00] But when you entertain the possibility of hanging up your own shingle, it was a short-lived dream because you told yourself that you just couldn’t do it.
Well, today’s guest found herself in just that situation, except she didn’t listen to that inner voice telling her that she couldn’t do it.
I’m delighted to have Dr. Jessica Mendelson join us for today’s episode.
Dr. Mendelson is a family medicine physician and the owner and lead physician of New South Family Medicine in Fort Mill, South Carolina.
Previous to this professional chapter, Jessica held leadership positions in family medicine, hospice care, and advanced care planning for a healthcare system.
Jessica’s path into medicine story is chronicled in Rx for Success Podcast number 120, which you can access on the MD Coaches website or in your podcast app.
Was also a resident in the program in which I was a faculty member and has become a close friend and colleague since her residency graduation. We’ve had many conversations over the years about how we can best bring our strengths to patients in ways to enable them to achieve optimal health and healing. And I’m really proud to see that Dr. Mendelsohn is actually doing that. She’s actually living that dream of bringing optimal health and healing to, patients in the community. So, Jessica, welcome to Life-Changing Moments.

[2:28] Thank you so much for having me. I appreciate being here. Oh, it’s great to have you back to the MD Coaches family of podcasts. We really enjoyed having you the first time. So, first, can you just sort of, you know, what is your current practice situation right now.
Sure. I own New South Family Medicine and Med Spa. We are in Fort Mill, South Carolina, which is also where I live. And I opened the practice in 2019, solo by myself. And it is sort of two practices in one. It is a direct primary care practice, which the model is becoming more common and people understand it more. It’s a subscription-based model of care. And it’s a full med spa which opened in 2021. And so we function as two practices, but have a lot of blend and overlap between the two.

[3:26] Yeah, great. And just to give us a little bit of a picture, the number of people that you have working on your team.
So I went from myself to now 10 folks. About half of them go between the two practices.
So we have two patient coordinators, two part-time RNs, a full-time physician’s assistant, a full-time nurse practitioner, two estheticians, a virtual assistant, myself and my husband, Dave Mendelsohn, who is our other physician that joined us in October.
And so I’m guessing that listeners like me are sort of really noticing that you said you started this solo, just yourself.
And I think you had one assistant just three, four years ago.
Yes, I did not hire her until six months in. So for six months, I really was scrubbing toilets and seeing patients and answering phones by myself, yes.
Yeah, so for those who know DPC model, this is pretty extensive growth in a pretty short amount of time.

[4:41] DPC model tends to be low overhead and initially that was the case, but I sort of always knew I wanted to do a little bit more than just myself and one-on-one patient care.
So I knew going in that it would expand in a couple of other directions.
Yeah, nice. And we might be able to get into what’s ahead for you later on in the podcast, because I know there’s some exciting things ahead for you as well. But what I want to do now is bring us back to a moment where a lot of our listeners might be, which is before you launched into this professional chapter, what was going on for you professionally before you made this pivot?
Mm-hmm. So really to go back to residency and what I saw my career looking like at that time.

[5:36] Sort of always knew I wouldn’t necessarily be in a private practice setting forever.
I just had no idea what that would look like. When I graduated, I joined a large hospital group.
There were 11 physicians and three PAs. And I was there for almost nine years. And during that time did a good amount of physician leadership within the hospital system where I worked.
And for the last three years I was there, I was our medical director. I probably started to feel the burnout and stress, I’m gonna say probably five or six years into practice, and started itching a little bit for something different, which is where I thought at the time being engaged and involved in the system as a whole and outside of clinical care alone would satisfy that itch.
And it did for a while. And then I think I completely pivoted when I had my first son, Charlie.
I think that happens a lot for female physicians.
Having your child and now scheduling and looking at your life sort of outside of your career is a big pivot for a lot of women.
And it certainly was for me. So I didn’t know what that was going to look like, but I knew I needed a change at that time.

[7:01] So then I reached out to a colleague who had also been our medical director and was another mentor of mine, much like you’ve been Dale, Byron Walthall.
He was our medical director at that practice prior to myself, and he had joined a hospice group.
I had always had an interest in that, but just never thought it would be possible.
I wasn’t fellowship trained in hospice and palliative medicine.
So I didn’t know what that could look like. That interest sort of stemmed from the loss of a dear friend when I was younger.
And watching her dying process really piqued how I felt like it could be done better.
So I ended up leaving my large practice and joining him. And for five years, that’s what I did part time.
That time I was approached by the hospital system I had just left about a position within the palliative care group, sort of bridging a lot of physician education surrounding goals of care conversations, palliative care, hospice care, with physicians outside of that world.
So I was able to go back and meet with a lot of my family medicine colleagues, with cardiology, with pulmonology, and really talk with them about how to have those conversations with families and patients. And it really sort of got me back into that family medicine interest.
I remember saying and I’ve said this a few times.

[8:30] I kept saying to people, I was where you are, I recognize the challenges and how difficult it is to not only have the conversation, but find the time with people to have the conversation. So, how do we do that and do it well? So, I kept thinking to myself, why aren’t I doing this anymore? I miss it. I miss my families. I miss my patients, but I knew I couldn’t go back to to that same environment.
So that’s sort of how I discovered direct primary care and how New South was born.
Yeah, so let me just ask you, you just said, I knew I couldn’t go back.
Say more about that. What was it about that that you could not go back to?

[9:11] I think it’s a resonating theme across medicine in general with physicians and healthcare providers, even outside of those of us that are docs.
Time, documentation, paperwork, The feeling of not being able to do what we went into medicine to do, which is speak one-on-one with patients and have the time to really help them with their needs.
I think the average visit is seven and a half minutes. And you can’t talk to somebody about their diabetes, hypertension, and, oh, by the way, I’m depressed and I’ve thought about harming myself in seven and a half minutes, which Which then leads to about a half an hour to an hour of documentation, which then leads to checking more boxes and fulfilling other people’s needs that aren’t your patient any longer.
And that is not why we went into medicine. That is not why I went into medicine.
I had to figure out a way to really sit with patients and help them how I felt like they needed to be helped without other people involved in that care or other organizations involved in that care.

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[11:40] Hi, I’m Rhonda Crowe, founder and CEO for MDCoaches. Here on Rx for Success, we interview a lot of great medical professionals on how they grew their careers, how they overcame challenges, and how they handle day-to-day work.
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Coaching. Rx for Success is produced by MD Coaches, a team of physicians who have been where you are.
I know you’re used to going it alone, but you don’t have to. Get the support you need today.
Visit us at mymdcoaches.com to schedule your complimentary consultation.
Again, that’s MyMDCoaches.com because you’re not in this alone.

[12:43] 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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I want to spend a little bit more time on, because I think a lot of our listeners will be female physicians who may or may not have children, but there are some unique qualities of women in this profession.

[14:05] Can you say a little bit more about what shifted for you after you had your child, your first child?
I know you have two children now. Yes, so I wasn’t sure I wanted children when I met my husband.
And as you know, we met in residency and we actually got married, not sure if that’s what we wanted. So when that decision was something we talked about and it was something we wanted. We had a hard time.
At the time when I realized I thought I might want to be a mom, I was 34 and well into my career.
And we were doing well financially.
I was able to, we were able to buy a house together. I was paying off my student loans, doing all of those things that we normally do when we finish residency and start practice.

[14:55] But then I went into having issues with fertility and experienced the heartache and what felt like loss every month, if you will, for two years. So both of my boys are IVF children. And I think I realized if I’m going to leave them to do something outside of our home and not be with them and not and potentially even miss milestones, it sure better be something that’s meaningful.
And so, as much as I hate to say it, my job where I was in a large practice didn’t feel as meaningful as I thought my career should feel in order to leave my son.
And that’s probably the biggest pivot for me.

[15:42] Wow. So just the energy expenditure, if you will, that may not be the best way to put it, but just all of the energy you put into choosing to start a family and then actually the challenges of actually starting the family and then having the family and then all of that said, boy, in order for this to really be worth it, if I’m going to really be a good mom here, then the rest of my life has to be working really well as well.
Yes. And I think on the flip side of that, in order to be a good physician, in order to to be a good anything, I felt like I needed better balance.
And I just did not have that. And I found myself becoming a bit resentful.
I don’t think I’m out of the ordinary.
I think probably most people that are listening to this podcast have or do have similar feelings with their careers in medicine.
But it wasn’t until I left that large hospital system that I was really able to see what else is out there.

[16:45] And man, there’s a lot out there. And that’s when I think realized I can do this better.
Yeah, so let’s talk about that.
What did you see that pulled you towards where you are now or maybe some other directions that you explored.
Mm-hmm. You know, I haven’t talked about burnout. I think that’s sort of a key word and resilience and all of those sort of key things that we we talk about a lot in medicine.
But I was truly burnout. And when I went back after maternity leave, I, for a minute, I had this sort of honeymoon period where I thought I can do this, but realized quickly, it just wasn’t right.
And so, I had a little bit of a break from that. When I did hospice work, it was part-time, it was away from a hospital system.
I had the ability to sort of calm my frazzled nerves, if you will, for a few years and to be able to ponder and think, is this what I want to do?
Whereas I think a lot of people don’t have that. They are either the breadwinner of the family or they’re in a financial situation midlife that they’re not, they don’t feel that they can leave where they are.
Kids in college, et cetera, you name it. There’s a lot of different things, but until you start exploring and seeing, yes, there are still possibilities.
You just don’t necessarily feel that and see that. And that’s where a lot of that depression and burnout kind of comes into play.

[18:14] I was lucky enough to be in a situation where I could let those nerves calm down and do something different and think about it wholly.

[18:24] Yeah, so you’re in this situation where you can relax a little bit, let the nerves calm down, and allowed yourself to be open to some other possibilities.
And what showed up for you in terms of those other possibilities?
Quite honestly, mentors and people that I’ve had tremendous respect for over the years, talking, conversation, other women physicians who’ve done similar things before me. I really just started asking questions and looking and seeing what else is out there. And I believe at the time, that’s when you were in training for your coaching career. And we used to have conversations about it as well. And really just focusing in on, I don’t know what it’s going to to look like, but this isn’t it. And in doing that, discovering, I discovered somewhere along the lines, direct primary care. I knew a physician colleague from medical school had a practice, so I reached out to her. I knew there were other folks in the Charlotte area and in Rock Hill, so I reached out to them and really just sat down and asked questions and thought, gosh, this really would be a great platform, not only for patient care, what if down the road, there’s even other things that I want to do?

[19:49] And is this an environment in which I can pivot and do other things to take care of people and it really has become that for me.
So taking some time to really explore by asking lots of questions and learning from others what are there some of the other possibilities.
Can you say a little bit about what was going on, sort of the inner voice in your head during this time that you’re, you know, one thing is, oh, there’s some things that are possible.
That’s kind of cool. Was there anything that was kind of maybe holding you back, any voices in your head?
There’s always a little bit of those, I think, for all of us.
What do they sound like?
Sometimes they can be really loud. Honestly, on the other side of this, it was my children.

[20:38] So, you know this, and for our listeners, my second child, Henry, has congenital heart disease.
He has got Tetralogy of Fallot. So, we found out when I was pregnant with him that he would need at least one open heart surgery, if not more, after he was born. So I was actually home with him every day for six months, which as we all know in our world can be difficult to take that time. His surgery, it was when he was two months old, but I had that ability to sort of sit and say, gosh, do I want to go back to work at all? I remember so many people saying to me, you spend so long trying to get into medical school and you spend so long trying to get into residency and you spend so long and so much money, why would you ever leave that?” My response generally is, Yes, I am a physician, but that does not define who I am as a person.
It’s part of who I am, and it needs to be synergistic with the rest of my life.

[21:42] And I realized, gosh, I think this could be owning a business, because now I’m a small business owner.
While I know it would be hard work and having the prep time to do it right would be hard work and it was and still is, I can create the schedule I want so I don’t miss things at school.
And that’s very different than 10 years ago when I couldn’t even leave the office to get a cup of coffee because I was going to be an hour behind. Yeah, absolutely. No, it’s helpful to illuminate both sides of this because, you know, we often only focus on the trajectory of success, but there are voices that want us to kind of slow down or to say, yeah, that’s this isn’t going to, this is not a good direction to go. And so one of those, you know, one of those pauses for you was, was your child, you know, this, a child needs me, I should stay at home. Were there any others?

[22:42] Probably. My own anxieties, my own worries, am I going to be a success of my own imposter and drum my own. How in the world am I going to do this? I’ve never owned a business in my life.
I don’t even know what that looks like. What the heck is a P&L? How do you do a website? I mean, there’s just so many things that go into it that I think in many ways can be overwhelming.
You just have to piecemeal it and do the best you can. And that’s what I did. And I’m still making mistakes all the time with it. I’m certainly not the best at owning anything, but.

[23:18] Gosh, being comfortable in that uncomfortableness, if you will, I think is what sort of gets me through. I think it’s important to bring up too, especially as a female physician, there’s so many emotions that go into being a woman in medicine and where is our power, Where is our role? It’s not just in medicine. There’s so many pivots outside.
And one of those being having children and the expectation that our society has on us and how, the guilt that you feel with that, the inadequacies that you can feel with that as a woman on both sides of the spectrum. And so there is that loss of time with your children, but the loss of revenue from having a child. So it’s a constant way back and forth on which one is the priority, and it changes over time.

[24:16] Yeah, there’s a lot of mental energy. I hear this a lot from other women physicians that my male colleagues don’t always think about quite as much about those those tensions of where do I put my energy, where do I put my mental energy, and even some some guilt about I’m not quite the physician I could be because I want to also be a parent but I’m not quite the parent I want to be because I want to do this.
So I love your statement a few minutes ago about synergy between the two, that they both really inform and feed each other. I love that.
That was really nice.
Yeah, and I think that can go both ways. That can be a negative sort of, not necessarily synergy if it’s negative, but it can be a negative back and forth, or it can be positive. And even that day to day or minute by minute can change.

[25:08] Yeah. So you are embarking on this, you know, little by little, you learn that there’s a lot of options and one of the options is direct primary care and that seemed to fit very well for you.
Just for listeners to know, did you have any business or entrepreneurial experience prior to this?
Zero. So, you know, I look back and I think, what was it about me that knew, 20 years ago, I wouldn’t necessarily be satisfied alone in a practice.
Why did I say coming out of residency, I give myself three years in this environment before I’m gonna do something different?
I didn’t know what that was. I didn’t know why.
Did I have a little ADD? Maybe, you know, I didn’t know what that meant.
Now I look back and think, gosh, maybe it’s because I’ve sort of always thought in a broader sense, or in a larger sense, or felt like medicine, again, wasn’t my only.

[26:16] Isn’t the only definition of who I am, both personally and professionally, but even professionally.
So I think it was always there, I just didn’t know what it meant.
And even as I was building out what my business plan would be and what it would look like, I didn’t know.
And it’s morphed and changed for the last four years as well.
So, even though there’s no experience and you get comfortable with being uncomfortable.

[26:44] There is this sense that you had that whatever this is, this is better than the alternative.
What propelled you forward, even when there was doubt? Gosh, sheer determination of, okay, I’m very much one of those people.
If I make up my mind, I am going to do it, and I’m going to do it well.
And failure in the traditional sense is not necessarily an option, although failure is good and failure means we’re learning.
And little failures I can handle, but I was fiercely determined to make this work and realized there was a whole world of opportunity that I didn’t know was there.
And there are so many people doing so many amazing things that, wow, I could own a business and be even more engaged in my community and have a more powerful impact on the people that I live with and know.

[27:44] And not just in medicine, but one of our core values within our practice is philanthropy and community.
And I realized I could have a deeper impact in a greater sense than simply seeing one patient after another 25 times during it.
I love that term, the fierce determination. I think that describes you very well.
Or stubbornness. It could be either. Or don’t tell me I can’t.
That’s all going to my mind.
You do it in a… I just want to say for people who don’t know you, you do this in a very calm way.
Not like this, you know, what I imagine some fierce CEOs are like. You do this in a calm and listening way. You really engage with all the people around you to hear perspective.

[28:35] And you don’t come across, I mean, what I imagine is fierce, but you do this in a very calm way.
Dave might say that differently, but…
For our listeners, Dave is your husband. Yes. So, he probably hears a lot of the determination, maybe a little bit more fiercely than other people, but I don’t know. That’s sort of, I’ve always been a collaborator.
Yeah. Before I ask you about what’s happening next, because there’s some pretty big things happening also as your dream is growing, for this period of transition, if you will, you’ve You’ve mentioned talking to lots of different people, lots of mentors, lots of conversations.
Are there things that you’d like to impart to listeners about if they’re contemplating something similar? Just a pivot, not necessarily direct primary care.
Absolutely. What are some things that you’d like to impart to them that you haven’t said yet that were helpful for you?
You know, I think for for me.

[29:37] Moving from a large system where you get your paycheck, whatever that looks like, to, okay, now you are creating your own environment, again, whatever that looks like, doing your due diligence, making sure you have a good team of people that support you, that includes, you know, the right CPA, the right attorney, the right friends and family support and community.
I made a huge mistake in the beginning and had someone who didn’t necessarily understand what I was doing, or I didn’t understand enough to ask, and that created some, you know, financial trouble. All of it’s fine, but it was a huge learning opportunity for me. So making sure you surround yourself with the right people that can guide you through that process, and I think it’s interesting as physicians, we don’t, we tend to think we can do things very well. And not to.

[30:39] Not to burst anybody’s bubble, but we’re not CPAs, and we’re not financial planners, and we’re not attorneys. And there’s a reason why. We say to our patients, trust us with your medical care. Well, I’m going to say to you, if you’re looking at doing something outside of your comfort zone, trust the experts in other fields. And so that is a big piece of this. If you’re thinking about doing it, do it. I’m all for it and believe that we all have opportunities. Even if you’re staying at your current W-2 employee physician job and are looking at other opportunities outside of that, please surround yourself with people who can help you and do it right.
I think there’s that piece of it. I think to look at your leadership style. If this is a private practice situation that you’re looking at, and it’s not something completely out of clinical medicine, or even if it is, if you’re building a team of people who are working for you as, employees or as 1099s or whatever the case, look at your leadership style and make sure you have the culture in place, the vision in place, the before you hire these people.
Think about what it is you want, write a business plan.
If you don’t know exactly because it’s going to save a whole lot of headache on the other end.

[32:03] And I’m saying this with a business coach. I did not know a lot of these things in the beginning, but I’ve hired a business coach and they’re phenomenal. And they have really helped me sort of capture the why behind a lot of what I’m doing. And I wish I’d had them three years ago.
Yeah, very nice. And a lot of lessons along the way. And those are great things for all of us to think about is especially knowing what your limitations are. And then And once you know those, then pull people in that are very good at those things that you’re not good at, that’s awesome.
So what are you building these days?
What’s next? Buildings? Did somebody say buildings?
We are actually 10 people in a 1,300 square foot space currently.
And I went from looking at that space when I opened, thinking, how in the world am I ever going to fill this, to now we have no room and we’re building modular walls and trying to find space for people to grow without physical locality.
So I have delved into the world of real estate and we purchased land and are building a 600 square foot building about three miles from where we are right now.
And so, we have that going on.

[33:31] So you said 600, did you mean six? 6,600, so 6,600 square feet. Wow, wow, wow.
So in the process of all of that, I’ve realized, gosh, this is pretty interesting. I like this too.
I am looking at leasing out part of that to another medical practice and figuring out what that process looks like.
So, I went through the SBA process for the Small Business Administration to learn about lending for new businesses.
I am learning about commercial real estate and construction and what it’s like to design a building and the process of constructing that building.
So, there’s always learning to be had and most of my learning now is business development and real estate, and to be quite honest, not as much medicine.
Obviously, when I see patients, I’m on various sites and looking at things every day, but my main focus is developing my business.

[34:36] Understanding commercial real estate and other forms of real estate because it’s an exciting, different place to, especially as a small business owner and now entrepreneur, build wealth.
And now that Dave’s not a traditional W2 employee either, he’s my employee, we have to be – we think a little bit differently or I think a little bit differently now in terms of what, we want out of the next half of our lives.
So, I want to just kind of go back to something that you said earlier about recognizing that even back when you were a resident, this orientation of impermanence, if you will.
It’s like, I’m going to go give this a shot and see how this fits.
And having that attitude of, I’m going to be open to what fits and what doesn’t fit for me at every stage of my life. And then be willing to dive in and take some risks so that I really am living a very fulfilled life and being always aware of whether this is fitting or not fitting. I think that’s a wonderful offering to the world and I’m really looking forward to having people hear this podcast. So thank you very much for being with us today.
And of course, I look forward to our future conversations as well.

[36:00] Absolutely. Thank you so much for having me. It’s been awesome.
Here are some wise takeaways from Dr. Mendelsohn.

[36:10] Number one, first and foremost, your profession, in this case being a physician, does not define who you are as a person. It is a part of who you are and it needs to be synergistic with the rest of your life. I love Dr. Mendelson’s insight when she said, quote, if I’m going to leave my children to go and do something outside our home, it better be something meaningful.
And on the flip side, in order to be a better physician, I need a better balance outside the office.”.

[36:42] Number two, in discerning what is meaningful work, you may need to pivot.
Number three, in considering a pivot, keep the following in mind.
A. In medicine, realize that there is a lot out there besides being a W-2 employee.
B. In your exploration of options, ask lots of questions. C. Pivoting can be challenging and it can be helpful to allow yourself to just get comfortable with being uncomfortable.
D. If you do explore something that is unfamiliar, such as starting your own business, realize that you don’t know everything and be sure to surround yourself with the right people, friends, family, business coach, accountants, whatever fits the purpose.
Well, I hope you enjoyed this conversation with Dr. Jessica Mendelsohn as much as I did.
If you, like she did, find yourself seeking a more meaningful, professional and or personal life but not sure where to start, consider consulting us at MD Coaches.
Our coaches have all been there so we can relate. Even more, we can assist you on your way to a thriving and more meaningful life.
You can find us at MyMDCoaches.com.
Thank you for listening and be well.

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