Life Changing Moments: Succeeding Slowly, Dr. David Weill

Transcript

[0:02] Before we get into today’s interview, I’ve got a very important message for those of you about to enter the residency match in the spring of 2024. MD Coaches is excited to be offering, highlighting your unique value. This is a special four-week group coaching experience specifically designed to help you identify and present your best self during match interviews. All participants receive one individual coaching session and four group coaching sessions. The first cohort begins Sunday, September 17 at 7 p.m. Eastern. A second cohort begins on Sunday, October 10 at 7 p.m.
Eastern. Cost is $475. There is a special discount for American Society of Physician Members.
So get more details and register on the web at mdcoaches.store.

[1:06] 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 Let’s discover ways to learn and write our own success stories together.
I’m Dr. Dale Waxman, a physician coach with MD Coaches, and this is Life-Changing Moments.

[1:34] Music.

[1:41] Here’s a question to ponder. How do relationships with your family members influence your professional life?
We all know the importance of support and how critical this is in the training of a healthcare professional, especially physicians.
And we’ve heard stories about that before on this podcast.

[1:59] Today I’d like to take another angle and explore ways that family has informed decision-making about our career trajectory.
My guest today is Dr. David Weil.

[2:10] Dr. Weil spent many years on the front lines of transplant medicine and then transitioned into his present position as principal of the Weill Consulting Group, which focuses on improving the delivery of pulmonary, ICU, and transplant care.
Dr. Weill is a frequent guest and contributor in many media outlets, and is also the author of a memoir entitled, Exhale, Hope, Healing, and a Life in Transplant, which has enjoyed rave reviews.
Dr. Weill’s path into medicine story is chronicled in Rx for Success podcast number I really encourage you to listen to both his riveting story and much of the wisdom that he imparts there.
So, Dr. Weil, welcome to Life-Changing Moments.
Thank you, and thanks for having me so it’s great to have you on this you were just sharing with me a little bit It’s a it’s a hot day in New Orleans. It is it is indeed. I’ve stayed inside a lot today, Yeah, we are that we are recording this in the middle of July although it’s but it’s gonna be published a little bit later But thank you again for being here. So for our listeners who may not have heard that rx for success podcast just yet, Can you say just a little bit about what you’re doing professionally right now?
Yeah, so when I got out of the front lines of transplant care when I left Stanford in 2016, I thought I learned a thing or two about the delivery of complex medical care and particularly about.

[3:36] Transplantation. So I wanted to continue to contribute to the field. I certainly wasn’t done with the professional part of my life.
I was 52 years old, so I thought at least relatively young and I thought that the best thing for me would be to try to to help transplant programs improve, whether it’s from a clinical standpoint, administrative, infrastructure, financial, you name it. And it’s allowed me then to work with several programs at a time and be coach rather than quarterback and try to get them to a spot that they want to be in.
So, it very much allows me to stay connected to the field, which I love and always have and probably always will. Yeah, nice. And I know one of the things you mentioned with Randy is, you know, it’s a step removed from direct clinical care but it’s still very much an impact and I loved that imagery of this is more coaching than.

[4:31] Quarterback in our front lines.
Yeah, absolutely. And it took an adjustment. I’ll be totally transparent about that, you know, because instead of having that direct one-on-one patient contact, which is so difficult to replace, I feel like I’m having contact with younger people in our field. And in a lot of ways, that’s my human connection to the field now is working with, you know, doctors, nurses, administrative people who are trying to get this job done.
And so I feel like that is also rewarding in a different way, but rewarding.

[5:08] Yeah. Some of us, um, you know, who are in coaching, especially with healthcare professionals, where we’ve kind of shifted from caring for patients to caring for those who care for patients, you know, still having that impact.
That’s awesome.

[5:22] Well, thank you. I want to kind of bring us up to our theme for the day, which is sort of family influences. And in the conversation with Brandy in the podcast, you mentioned that there were several factors that contributed to your transition out of the frontline transplant medicine, including the emotional toll of losing patients, especially those who were waiting on the transplant list. And you specifically mentioned, you know, you lost one that was the same age as which is one of your children.
But then also there was this piece about you yourself being a family member of a transplant patient, namely your father.

[6:02] So I’m just curious, what about your father having a transplant, being a family member now, how might that have influenced your career shift?
I think that what it does when someone in your family gets sick and you’re a physician is it removes the emotional detachment that many of us have and actually rely on as a defense mechanism to get our work done.
So when my father went through the transplant process, I was only five years into my career at that point.
And I was so close to him and so close to his receiving a transplant as a family member that when I looked at my patients that were receiving a transplant, I couldn’t really emotionally detach anymore from them.
In other words, they were somebody’s father, they were somebody’s mother, they were somebody’s daughter or son.
And in a lot of ways, that emotional distance went away when my father got transplanted.
And I think that that became ultimately really important in my career, because I didn’t look at it quite the same way anymore.
I, if anything, dug in harder and tried to get outcomes that everyone wanted even more, more strenuously than I did before my father got transplanted, because I was looking at every patient as a family member of my own, if you will.
Yeah, I wonder if we can.

[7:32] Explore that, just discuss that a little bit. There’s a part of this that’s, there’s the positives, there’s the advantages of this, of becoming more emotionally invested, but there’s also the downsides.
Yeah, and I noticed this in a lot of my colleagues, and I looked at them for comparison, really, to how I was doing the job versus how they were doing the job, and some of them care deeply about our patient group.
Most of them care deeply about our patient group. I care deeply about our patient group, But somehow being able to go home at night and unlock, you know, and uncouple from the hospital experience was something that I didn’t do particularly well.
And I don’t know exactly why that is, but that was a feature of my career.
Whereas I think some in our field, and it’s not a criticism at all, in actuality I’m kind of envious of them, were able to do that in a much better fashion than I was.
And so I think that that’s just the variability in humans. Some of us feel things a little more deeply and that’s kind of the way it is.
But I do think that my ability to distance.

[8:47] Keep myself emotionally distant from the outcomes of our patients was influenced not only by my father’s transplant, but also having children of my own.
I think that, you know, all of us become different people when we become parents and, you know, children touch us, I think, in a very special way.
I think after I had kids of my own, I again started to look at parents of our transplant recipients and really empathize with what they must be feeling and got closer to the whole experience because I understood what it was like to have a kid, although thankfully I don’t understand fully what it’s like to have a sick kid because my kids are healthy.
Hi, I’m Rhonda Crowe, founder and CEO for MD Coaches.
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.
I really hope you’re getting a lot of great information, but if you’re looking for an answer to a specific problem, management or administration challenge, or if you’re feeling.

[9:59] Just a bit burnt out, like maybe you chose the wrong career? Well, then there’s a faster way to get the help you need. No, it’s not counseling, it’s 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 Visit us at mymdcoaches.com to schedule your complimentary consultation.
Again that’s mymdcoaches.com because you’re not in this alone.

[10:36] 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.
If you haven’t discovered this remarkable magazine, please do so very soon.
It was created by physicians, for physicians, to showcase the intersection between clinical and non-clinical interests.
Whether it’s writing, painting, cooking, politics, and dozens of other topics, Physician Outlook gives a physician perspective.
It’s available online and in print.
It’s really unique among physician lifestyle magazines. And like the Prescription for Success podcast, Physician Outlook amplifies the voice of any physician who has something to say. It also engages 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.

[11:39] And now let’s get back to today’s interview. ♪ Permittee, can we go just a little bit deeper in this?
And my question is, if you were one of your patients or family members of your patients at that time, how do you think they experienced you during that time?

[12:00] I think from what they’ve told me, you know, then and now, as they’ve read my book and they’ve actually, you know, heard me interviewed and things of that nature, I think that they really felt like they had an ally, somebody in the fight with them, you know, fighting for them as they were fighting for their own life.
And I think family members of my patients and my patients appreciated that and understood that in real time.
What I don’t think many of them did or could understand is how much their experience was impacting my family’s experience, and whether that’s the relationship between me and my wife, or me and my kids, or me and my friends.
The work I did in the hospital impacted all of my personal life.
And I don’t say that with any degree of pride, it’s just a matter of fact.
Sure. And so I think that, and again, I’ve heard from patients tell me this directly, they just didn’t know that their doctor brought all this home with them.
They tend to look at us as robots in certain ways. They see us come in and out of the exam room, in and out of the hospital room.
And I think there’s a tendency to think that we’re not absorbing all of this emotionally.

[13:27] But my experience is that most of the healthcare workers out there are experiencing all of this emotionally.
And I think it’s one of the reasons I wanted to write my book is I wanted people to understand that.
Yeah, I’m imagining that your patients experienced you as a compassionate, empathic clinician with them and very, very present with them is my guess.
And I think what we’re talking about now that there is a potential toll that occurs as a result of that energy that you put into being compassionate and empathic.

[14:08] Yeah, I think there is. To be frank, it really was not a toll that I understood at the time. Sure.
I knew one way to do my job, for better or for worse. And a lot of times I was that empathic, hand-holding physician at the bedside, but at other times I was a hard-driving, very competitive, results-oriented, perfectionist kind of doctor too, just in full disclosure.
Sure. So, I think that that’s how I knew how to do my job, you know, I had that tool in the toolbox, and it served me well just right up until the time it didn’t, you know. And I think that I didn’t have a great understanding that that’s what was going on, but I knew that’s how I was doing the job. Yeah. So, you mentioned the impact that that had on your family at that time. Can you say Can you say some more about that?
Yeah, I think that there’s the physical presence part of what we do.
Your listeners, I’m sure, go through this all the time.
They miss soccer games, dinners, date night with their spouses.

[15:15] I’m sure that is very common among your listenership. Not unique to me.
And then there’s the physically present but not emotionally present.
That was me as well.
And there’s many nights I can recall where I was either thinking about a patient on our waiting list, thinking about somebody we had just transplanted, somebody that we might transplant.
I was not in the mood to talk about all of this at home. I’m married to a nurse, but we essentially never talked about any medicine at home.
And that was not a reflection of her, that was a reflection of me.
I just didn’t wanna talk about it. So I would read a book, watch a game on TV, and cope with it that way, which I don’t think is the best way to cope with it, but it’s the way I do.
So there’s a somewhat removed from the usual family discourse that goes on as part of the impact of the kind of work that you were doing.
As you look back on that now, and if you were to.

[16:20] If there’s some advice to impart to our colleagues who find themselves so entrenched and aware of the good work that they’re doing, but also the toll that it’s taking. What might you suggest to those individuals?
Don’t isolate. I think isolation is the enemy in these circumstances.
Remain connected to your family, faith, friends, the things that are important to you, and just, recognize that those times you want to be alone or you don’t want to talk about it, may work for a very short period of time, but are not long-term strategies and I think those are the kind of things that that I learned.
Late in my career and You know, it might have something to do with the you know, the way I trained in medicine the era of physicians that I came up with may have to do with.

[17:20] You know being my father’s son where You know, it was you know, he was somebody that I had high expectations of me I had high expectations of myself, you know, I I think there are many of us out there probably most of your listeners have operated under the assumption that the solution to any problem is just work harder.
And that was me. And I’ve learned that lesson that it’s not always just work harder.
It’s reflect, discuss, stay connected. Don’t just assume that if you try harder, things will always get better.
You know, one of the things that is very wise, those are great proactive suggestions.
I wonder if you have some thoughts about, perhaps from your own experience, what are some signs and symptoms that might be going on internally that would say, I need to, instead of going the direction of working harder, I need to start maybe amplifying my connection with family and not isolating.

[18:31] What are some of the signs and symptoms that, as you look back, that you might have been experiencing but overlooking?
Yeah, I think they were pretty clear warning signals that I was getting, and I started to pay attention to them.
You know, it was difficulty sleeping, more irritable, losing weight, for me, you know, was an issue.
When I get under that kind of pressure, I don’t eat. And I think that those are all the kind of signals.
And the isolation from my work colleagues, from my family and my friends is a real warning sign.

[19:06] And I also think that what happened to me very late in my career, and really was a major reason why I stepped out of the front lines of medicine.

[19:16] Was I started forgetting about and couldn’t really focus on the patients we helped.
I only focused on the patients that we lost or that had a bad outcome after transplant.
And, you know, turn those patients over in my head over and over and over and then forgot about the 95% that we had actually done some great things.
And when you start thinking about only those losses and can’t celebrate the successes anymore, I think that’s a warning signal.
Yeah, I’m really glad you said that. I’ve taught residents for greater than 35 years and one of the pieces that I got out of my fellowship is sort of coming from some positive psychology, which is also to talk about what’s going well, what kind of things, what are your successes.
Our profession, just by its nature, is looking for things that are not going well.
And so we spend 98% of our time, and we’re really, we’re sort of, that’s day one of medical school. It is.
What’s the lesion, right? No, no, you’re absolutely right.
And I have this discussion with my wife all the time because she always gently criticizes that I’m always looking around the corner.
But I mean, I was trained to look around the corner, you know, and I think that it’s an interesting mindset.

[20:43] That I wasn’t really even fully aware that I had.

[20:48] You know how it is as a doctor, you have to say, well, I can’t think about what plan A is, I have to think about, I’ll be standing in the ICU taking care of a transplant recipient.
I have to have plan A, B, C, D, E all worked out in my mind.
Now, that’s a great way to be a doctor and it, I think, made me and others like me effective.
It’s not a great way to be a human being, however.
And so, I wish I could turn that off entirely, but I don’t think I ever will.
We have some pretty well laid down neural pathways. Yes. You know, and they may have even been there before we went to med school, really got reinforced when we got there.
So, just to kind of bring it back to, there are some signs and symptoms internally to begin noticing and not…

[21:36] And maybe even notice when you’re denying that something may be going on, but I really appreciate you articulating those when you’re isolating, for you losing weight, for you irritability, losing sleep, things like that. So thank you for that. So I want to open that up a little bit more.
You know, one of the things you said on the Rx for Success podcast was, you know, in this new in this life as a consultant, you have an appreciation for being more involved in your daughter’s lives. Yeah, very much. And the question that came up for me, you’re a consultant and you’re working with these teams and you’re working with people who were you, and I wonder how you’re talking to them about, having ongoing relationships with their families at home?

[22:30] How are they? Yeah, well, it’s been an interesting aspect of the consulting work that I didn’t fully anticipate.
I thought I was gonna go in and sort of fix the mechanics of these transplant programs, and I can do that.
But the one aspect of the consulting work that I really enjoyed, and that has become a more prominent part of it, is dealing with team dynamics and team dysfunction, which in programs that are having difficulties is pretty common.
But also talking to 35 year old, 40 year old, 45 year old physicians and nurses who are struggling with similar things and they mostly know my story.
So they feel comfortable, I think, sort of saying, well, you know, sounds like you might have been through these sort of same things, I’m experiencing them, what do you think?
And we just kind of talk it out. I feel like I’m an older brother to a lot of them.
Thankfully, I can’t be any of their parents, I’m not old enough, but I, although that’ll come too.
Someday. Yeah, yeah, I feel like I can be sort of a safe person person that they can talk to.

[23:47] And say, here’s what’s going on. I don’t want to tell my colleagues necessarily at my same hospital, but I can tell you because you’re just some guy that’s a consultant, you know?
And I think that there’s a comfort level there that I really appreciate.
I think it’s really been great.
I would have definitely benefited from having somebody like that.
Specifically, do you get into, hey, you look like you’re not putting enough time in at home.
Do those kind of things come up?
I do. And more specifically than that, I can see the behavioral traits, you know, I’ve gotten pretty good at them because I recognize them in myself.
And so I see them in folks and sometimes I pull individual docs, occasionally some nurses, pull them aside and just say, you know, looks like you’re holding on pretty tight.
I held on pretty tight.
It’s a tough road. You might wanna consider, you know, backing it down a little bit, you know, get out of the hospital, go out and do something, go get some exercise, whatever.
And I think a lot of the folks I’ve had those conversations with have taken it to heart, because it’s coming from a place of love.
I’m not trying to, you know, criticize anybody. I’m trying to actually increase their longevity in the field which I desperately want because our field needs people to stay in it.

[25:09] Yeah, neat. What a neat driver. Yeah.
Great way to impart that to them. Related to that, one of your prescriptions for success on the podcast was the following.
You said, slow down a little bit, strive for success, but slowly.
Can you say more about what you mean by that? Yeah, I think that there’s, you know, again, wanting to move at mock speed through everything, and there’s every incentive in the world to do that in today’s healthcare environment.
There is no incentive to go more slowly. And I think what we have to do as health care workers.
Is actually force the pace, force the pace downward. As much as we’re being asked to speed up, we’ve got to know for our own health, our own emotional well-being, we’re going to have to slow it down because no one else is going to tell us to do that.
I mean, I don’t know about you, but I didn’t have anybody that I worked for ever tell me to slow down.
And as a matter of fact, quite to the opposite, why don’t you do more transplants?
Why don’t you see more patients? So why don’t you, you know, make the hospital more money?
I think that that’s more common.

[26:23] I think that we have to have a self-protective mechanism in place where we actually take care of ourselves and we try to take care of each other because I don’t think anybody else is gonna do it.
I just, you know, I wonder if we can have a little brief discussion about, you know, what does that look like to, for us to drive slowing it down?

[26:45] Yeah, I mean, I- Do you have any thoughts about that? I do, and I actually talked to some folks that I’m working with on a consulting basis. I said, you know, you wouldn’t believe the power of the 15-minute break from the day.
Go outside of the hospital, walk around the place, bring a book with you to hospital, read one chapter of a novel.
I mean, you know, it sounds insane because I know the pace at which folks are working.
I really do, but I think they’re gonna have to do these kinds of little micro relaxation techniques.
And I don’t think it has to be meditation or yoga or anything formal.
I really don’t, but if that’s your thing, do it.
I think that there has to be these little mini breaks throughout the day.
And, you know, a lot of it I think involves getting outside to the extent possible.
I think that there’s too little of that and, you know, taking a walk outside of the hospital I think is very therapeutic.
You know, in my own field in primary care, my entire career I felt this isn’t enough time to do what needs to be done in the visit in primary care.
That just got even more compressed over and the patients got more complex as you know, as we know.
And I was like, this is crazy. We’re working on a 1950s model of.

[28:06] They were, our 1950s primary care physicians didn’t have a whole lot of tools.
And they, so they did a lot of acute care, which didn’t take a whole lot of time. That’s right.
So it was, you know, so for us, so for listeners in the primary care, The internal slowing it down is just to negotiate and say, this is how many patients I can handle in a half day.
It isn’t 50 anymore. It’s not even 30. It’s 30 in a day. It’s like 8 to 10 a day.
That’s just the way that it is with complex situations. But I totally agree with you that we need to be the ones saying, this is what, we’re the ones that know our work.
We know what we need to do for our work. Well, David, this has been great. Thank you very much. Anything else that I didn’t ask you about, especially in this theme of family and family influence on our professional lives, our career trajectory. Anything I didn’t ask you about that you’d like to impart to our listeners?

[29:07] No, except to say, you know, and I look back on, you know, the care and the time that I spent with other people’s families, taking care of other people’s family members and children, you know, and I think it’s important that we remember that our home team, the people at our house, also need that same kind of attention.
And that’s something I’ve tried to really work on as I’ve left the hospital.
I think that that’s really, really important because they’re also bearing a lot of the burden of what we do. So that’s something I try to remember.
Well, those are really wise and wonderful words for us to end on.
So David Weil, thank you so much for being a guest on Life-Changing Moments and I really appreciate the time you took today.
Thank you, I enjoyed the conversation, appreciate it. ♪♪ I very much appreciate David Weil’s contribution to the national discussion of physician well-being.
He has generously and courageously shared his experiences with compassion fatigue and burnout nationally in service to the profession.
There are so many pearls to take away from this conversation with him, and it was difficult for me to limit it to just a few.
But here are the most salient takeaways for me.
Number one, be aware that our work impacts those at home.

[30:34] You know, in addition to the obvious, missing our kids’ games and dinner with our spouse, often, even when we are physically present, We’re not emotionally present.
Which brings me to number two. So when we become aware of the lack of emotional presence or irritability or preoccupation with work, first, don’t isolate. Instead, find yourself connecting with others and sharing what’s on your mind.
Number three, strive for success slowly.
We need to force the unsustainable pace that medicine has adopted to be slower for our own mental health and our own well-being.
4. Finally, we spend a lot of time and attention caring for other people’s families.
Recognize that people in our home need that same amount of attention.
Well that’s it for this episode of Life Changing Moments. Remember if you find yourself struggling with isolation or dissatisfaction with your professional life, consider coaching to help you sort it out and get you on a path of better health and balance.
You can find us at MyMDCoaches.com.
As always, thank you for listening and be well.

[31:57] Thank you for tuning in to Life Changing Moments. If you enjoyed this episode, please be sure to rate us 5 stars and leave a review.
Doing so helps our podcast reach more listeners. Have something to share?
We’d love to hear your thoughts. Visit the MD Coaches community on Facebook groups.

[32:16] This dynamic virtual space is a place to continue discussion about life-changing moments and perhaps share some life-changing moments of your own.
Join the conversation today.