Life Changing Moments: Taking a Leap of Faith, with Dr. Russ Greenfield

Transcript

[0:00] Literally, my breath was taken away, I’ll never forget it. And I don’t know where that came from.
But if any of your listeners ever has a moment like that, I guess the only thing that I would say from somebody who’s been extraordinarily fortunate is at least listen to what comes to you in that moment because you never know what might happen if you really act upon what you’ve heard.
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 own success stories together.
I’m Dr. Dale Waxman, a physician coach with MD Coaches, and this is Life-Changing Moments.

[0:53] Most of the time, our life-changing moments are not really marked by one specific moment at all.

[1:00] But rather a culmination of several moments of reflection, contemplation, discussion, and decision-making.
But sometimes there actually is one instant that changes our life forever.
That’s what happened when today’s guest was casually reading a magazine article some 25 years ago.
At that moment, his professional and personal journey went in an entirely new and different direction.
We’ll learn how he navigated the very strong pull into that uncharted but very gratifying territory.
My guest today is Dr. Russ Greenfield. Russ is double-boarded in emergency medicine and lifestyle medicine.
He was, as we’ll hear, in the very first class of fellows in integrative medicine at the University of Arizona.

[1:50] Since that training, Russ has held clinical leadership roles in integrative medicine in several organizations, including three major healthcare systems.
Russ’s path into medicine story is chronicled in the RX for Success podcast number 79, which you can access on the MD Coaches website or in your podcast app.
Russ is also a close friend. We have had hundreds of conversations over the years about everything from the privilege of being able to be with and serve patients, to parenting, to bring in the concept of health more into focus in contemporary medicine.

[2:34] Russ, welcome to Life-Changing Moments. Thank you. It really is a privilege and quite a pleasure as well.
Yeah, I think this will be interesting for audience members to kind of eavesdrop a little bit on some of the conversations that you and I have had, which have always been very enriching to me. Thank you.
So first of all, just to kind of get us going, you know, what are you up to right now? What’s happening in your professional and personal life? So, you know, we talk about those moments. I’m actually in the midst of a joyful one right now, which is that I’ve left my position with one of the healthcare systems that I have recently worked with and am going back to some independent work, starting my own practice, something I have done in the past for a period of a little over 10 years. It’s a space that I find actually quite joyful. And as I’m getting a little bit older, I think having that flexibility and independence is something that I have realized more and more is something that feeds me. And I’m actually very eager to get back into it.
Together with that, I continue to do some outside consulting with the Central Office of the Veterans Affairs with regards to a very wonderful and unique program that they offer called whole health for the veterans, Just as an aside here. This program got started around 2010 and has expanded in.

[4:02] Wonderful wonderful ways so much so and in such positive ways that literally within the past two months, Not only the National Academies of Medicine but also the Surgeon General of the United States, have both put forth statements saying that whole health should be a part of the future of the healthcare system for the entire nation.
So it’s quite a privilege for me to participate in any aspect of that.
So I feel like I have a full and very rich and rewarding professional life right now.
That’s awesome. Well, you know, it’s as as often happens when we talk Your passion for what you do just sort of really emerges through.

[4:38] You know you’re the energy and just chatting with you in your your language and your expression and I know you could talk about all the things That are happening that are really awesome that you were, Really at the origins of kind of creating some of this movement in the country And so, I want to take us back to that, you know, that moment, if you will.
And so, just to kind of go back, what I know about you is that you’re this director of emergency medicine for a local community hospital here in Charlotte, minding your own business and feeling very happy being an emergency medicine physician and, you know, directing the whole darn thing.
And then you happen upon this article.

[5:28] Can you take it from there? I can. If I might offer just a momentary background here for listeners, I never would have believed I was made this way.
And what I mean by that statement is once I got into emergency medicine, I honestly knew I was going to be there forever.
I mean, that’s what you do in medicine. You know, it’s just you, you choose your career and that’s the path you’re going to stay on.
And maybe there’s roles within that career that might be a little different, maybe more administration, maybe more clinical work in a different way, maybe teaching.
But I never thought that I would actually leave the fold and explore something different.

[6:06] So I was fortunate to be a speaker for the American College of Emergency Physicians and was on a plane ride home from one of the lectures that I was giving, and the plane was late.
So I was literally just looking for something to do I was walking along the different stores in the airport and came across one that sold magazines.
As I’m looking through the stacks, there is a magazine that must have been something like Look Magazine or something of that nature.
It was primarily photos. On the front cover was this bald, white-haired, white-bearded guy, all covered in mud, holding a plant.
The title of the article is, essentially, can this guy transform medicine?
I thought, well, that’s interesting. I picked up the magazine just to take a look.
I thought I might know who the guy was on the cover. He’s a fellow by the name of Dr. Andrew Weil, but I really wasn’t sure.
As I picked up the magazine, my flight got called.

[7:07] I don’t usually pick up the magazine. you pick up magazines in airports and stuff like that but i was like yeah you know so i went ahead and i bought the magazine put it in my red backpack at the time and flew home when i got home it was a, little bit late and both of our kids and diapers were asleep my wife was in the kitchen i decided i would just go through things and i picked up this magazine and again it’s primarily pictures But for some reason I started to read the article and about a third of the way into the article, There is a statement saying that dr Weil and his colleagues at the university of arizona college of medicine are starting a brand new program.

[7:47] Called the program in integrative medicine with the stated purpose Of riding the ship of health care and actually making it be about health and in that moment And Dale, I’ve never had a moment like it prior or since.
I literally, I still remember it, involuntarily had my breath taken away.
It was just an involuntary, and I read this because in my experience in the emergency department, I was one of the most fortunate people I know.
But it was not uncommon to walk into the emergency department and find that I was one of the only people who is relatively happy in the emergency department because these patients are certainly unhappy, my colleagues were often unhappy, the staff was understaffed and unhappy, administration was unhappy, certainly the insurance companies are unhappy as were the on-call physicians. And I would look Look around and see.

[8:41] You know, what is wrong with this picture? And one of the unfortunate aspects is that the emergency department is somewhat of a common pathway. People often end up in the emergency department.
And while we can do a great job taking care of people for their physical maladies that are urgencies or emergencies, they often find their way back. And the other aspects of health and well-being are rarely touched upon. And so sometimes band-aids are placed without really having an impact on health and well-being, it’s just putting out fires. And then when I would speak with my colleagues in the community, they often felt the same way. We’re just putting out fires until folks come back again in a couple of months. And it struck me that this really wasn’t healthcare. It was industrialized medicine in a sense. And it wasn’t what we all thought that it could be either as practitioners or as patients. And so reading this about this opportunity inspired me and so I decided to look further into it. And then I was extraordinarily fortunate to be accepted into the program, one of the first four. And then the experience was literally life-changing and in very positive ways.
Yeah, we may get more into the experience of the fellowship. I want to just dial it.

[9:54] Back just a moment. And this is something maybe I didn’t, that I wasn’t listening to you well some of the other times you’ve told the story, but it sounds like you had been contemplating that this concept of health and that there’s something there is some discrepancy between what you were offering professionally and what you thought was also possible.
Is that fair to say?

[10:20] It was not solid in any way. It was just, it was kind of a sense that, you know, there’s no other option besides medicine, and yet it’s not doing what it should do in general, and how sad that was.
And so I started looking into things like Chinese medicine just because the philosophy to me was actually quite beautiful.
And you’re just viewing people in a different way and an inherent belief in the innate healing capacity that each person has within them and using a different way to bring that forward.
And I thought how beautiful that was, but it didn’t necessarily translate well into Western conventional medicine.

[11:00] Now, wouldn’t necessarily be a good fit in the emergency department, of course, because we have to jump in and literally make some, oftentimes, life-changing interventions for folks.
But in other aspects, might there be a way that we could keep people out of the emergency department better?
And that’s part of what I started thinking about, but I really didn’t know of any other options.
And then I found out about this program. And the reason for me, Dale, that it is, I hope, of interest to your listeners, is that again, I would never have believed that an opportunity like this might exist, let alone that I might be able to participate in it.
And just as you said, that sometimes the life-changing decisions we made are come about in a moment.
I never would have believed that this moment would have arrived.

[11:51] And I’m not sure I ever would have believed that I would have been open to it.

[11:56] And so I think one of the things that I might share with your listeners that I don’t know if it will resonate or not is that I didn’t think I would ever be open to a big change like this.
I mean, it literally meant going back to school.
It meant selling our home and traveling across the country. It meant giving up a very solid job with a solid position.

[12:19] It meant giving up on what might be a straight, narrow, but very good trajectory within my chosen field.
And yet something, I don’t know how another way to put it, something called to me in that moment that resonated deeply.
And I’m just so grateful that I had the partnership with my wife and other people that I could talk to in a trusted manner who said, listen to that voice.
Because it would have been really easy to say, well, I can’t do that, you know, because it’s giving up everything.
And nobody even knows what integrated medicine is.

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[14:15] 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.
I really hope you’re getting a lot of great information.
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No, it’s not counseling.
Coaching. Rx for Success is produced by MD Coaches, a team of physicians who have been where you are.
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Visit us at mymdcoaches.com to schedule your complimentary consultation.
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[15:19] 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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[16:22] And now let’s get back to today’s interview. There may be some listeners out there who have confronted something very similar or are going to at some point.
And here you are, you’re not going back to school, but financially there’s probably a a shift that’s going to be happening too, going into fellowship, you’re moving across the country.
There’s a lot of changes. So at that moment, what were some of the, it sounds like you had some support.
Were there any forces that were wanting to hold you right where you were?

[16:58] What were the pushes, what were the pulls? You mentioned some of them as just, financially, it was a huge hit.
I mean, we lost 90% of my income in order to do this, except what I could do if I had any time to moonlight, which I could on occasion, but remember we had my wife and two small kids and there’s a lot of change, and so I wanted to be home as much as possible too.
Beyond that, just there was the concern about what will my colleagues think?
And what will anybody think about this? going to some unproven, unknown program with this pie-in-the-sky idea of working with others to try and create a better healthcare system for all.
Well, that sounds great, but how am I gonna keep a roof over my family’s head?
And so nine out of 10 of my colleagues.

[17:52] Understand that i was director in this emergency department thought i had lost my mind and they were like what are you doing russ the other one out of ten literally said to me i wish i could do what you’re doing russ and i think that’s part of what i want to share again with listeners is that it’s kind of like we talk to our kids sometimes about if there’s an opportunity sometimes you just go for it it’s really really hard to do that When you have a stable job and a family and a home and a perception in the community and so it’s not it’s not for everybody but at the same time it may be the opportunity.
You like that fire of inspiration and that opportunity to participate and make something different of our careers that we never believed it could be what happened to me.

[18:48] Has been unbelievable, has been extraordinary. The opportunities that I’ve had through this, nobody could have ever written and made it sound like it was even possible, at least for me.
The only way it happened is to say, maybe the richness is to step outside the straight and narrow, and then my good fortune, I should underscore, is back in those days, if things didn’t work out, I knew that I could return to emergency medicine somewhere.
So I had quite the safety net that some listeners may say, well, if I go and do this unique opportunity, I may not have the same safety net that Russ did.
You know, I know that your wife, Julia, is from Charlotte. And what was her reaction to all this at that time?
You know, honestly, it was quite extraordinary because this is my wife’s hometown.
She’s raising two little critters.
All of her support system is here. All that she’s really known is right here.
All of our family is here in North Carolina.
And as you’ve heard me share before, she literally said to me, you haven’t starved us yet.
You need to do what you need to do.

[19:58] And so with her amazing support, we told our families, we sold our home and gave up my nice income, and moved to the middle of the desert to start an extraordinary family adventure as well as a professional one.
And so that was invaluable. There’s no way to speak of it other than in those terms.
But I will say that the other person really helped me out in this regard was my brother, who when I told him about this, who is.

[20:32] Typically much more, oh, in some ways, just more conservative in his perspective about the way to move forward financially, certainly. He said, you know, there’s a benefit to being first out.
And so if you have the opportunity to be in that first class, this would be the time to take it.

[20:53] And he was absolutely right.
Neat. So, just going back to those nine out of ten colleagues who thought you were crazy, did that give you any pause? It certainly did because I can’t tell you that I’m above worrying what my peers think of me.
And so, you know, I had been very fortunate to complete my emergency medicine residency training at a highly thought of institution, then did fellowship training in emergency medicine at that same institution, there are some who thought that I would be going down a leadership path in that field. And I felt that pull and I felt that responsibility because I really did feel fortunate to receive the type of training that I had. I had been involved in academics, was now moving up the administrative chain, and really thought that my career was pretty much laid out before me, only to take this major turn. And I think my colleagues all thought the same thing, you know, essentially like, again, what’s wrong with Russ? Or literally, is there something wrong with Russ? And why is he leaving? And I had to sit with that a little bit because I didn’t think there was anything wrong with me. I really didn’t.
And it wasn’t like I didn’t like emergency medicine. And, you know, again, it was my.

[22:13] In fact, my financial planner said, he literally recommended that I stick it out.
Those were his words. Because we were on a path where we’re going to be able to retire as you might expect, I had a good life and we were doing just fine.

[22:31] But it, I didn’t, I felt like doing so on a personal level, even though I was so privileged, it felt like I was settling.
And here was this opportunity to participate in something extraordinary.
Even if it was pie in the sky, I think for some of your listeners, sometimes there’s something that calls to us and says, what if I could participate in that?
What if there were a way that I could have a meaningful contribution towards something that is way bigger than myself.
Literally the stated purpose of the program was to transform all of healthcare for every person with a focus on health, not simply disease management or as difficult as that can be sometimes.
And so it was that aspiration, but it was the idea that what if the aspiration could meet reality and what if I could be a part of that?
There’s this, you know, when you say no to something, you’re saying yes to something else, or in your case, I’m saying yes to this.
And there were so many signals to you, psychologically, mentally, physically, even in your body, it was breathless.
There’s something very right about this, and I need to say yes to this.

[23:50] But at the same time, I wanna, again, I don’t want anybody to misunderstand think that I was full steam ahead, because I knew it was a long shot for me to get into the program because there were a lot of people applying.
You would think, you know.

[24:07] Especially when talking with folks about how can they take care of themselves and optimize their health and well-being, that doesn’t really sound like an emergency medicine type of approach.
And so, you would think this would probably be for folks who are more primary care or internal medicine, pediatrics, whatever the case may be. And perhaps it was at that time, because.

[24:27] My colleagues who joined me, the other three were two internists and a family medicine doc.
But number one, I would say that, you know, there’s a lot of primary care that’s done in emergency medicine, unfortunately, the way our healthcare system is these days.
But the other thing is that once I got in, I mean, my wife and I were thrilled, we were like, we got in. Then our next question was, what do we do? Do we actually take this position?
Is this crazy?
And because there were all these little voices in my head going, this is crazy.
You know, you can’t give up your job.
You can’t make your wife and kids move across the country away from all family, not knowing.

[25:09] What to expect and not even know if there’s going to be an integrative medicine.
This is brand new, so brand new, Dale, if I might share, that I kept asking in the beginning of the program, how are we defining integrative medicine?
I never got an answer until the spring of the following year when the directors said, Part of the reason we brought you for here is to help us define what it might be, which, I think is really wonderful now.
But at the time, I was like, what the heck? I sold my house, gave up my job, and we don’t even know what we’re talking about.
It was quite astonishing.
But in that next moment, I realized I was freed.
Because I wasn’t going to be parroting somebody else’s words. I was going to be imbibing my experience and speaking it for myself so that I could share with other people. All to say that when, again, back in 1997, when we were accepted, I say we, my family and I accepted into the program. I didn’t accept immediately. I told them I needed a couple of days to talk with my family and my wife. They were somewhat disappointed at that, but that was just real. I need to, you know say okay we actually got in do i jump and it wasn’t.

[26:30] I need it. Yep i’m gonna jump it was well i need to sit with this for a second cuz this is big part of me wasn’t sure i would ever get in and so that would have made it easy.
But when I did get in, I felt so fortunate, I was so excited, but I was also like, whoa.
And then when we made the decision, there were so many things to take into account, you have to move, all those kind of things, I don’t even know anybody.
And it ended up being so rich and so extraordinary, but I could not have guaranteed that at all.
And so I got very fortunate.
But I tell my kids, if there’s something that you really wanna go after, is something that could be extraordinary, go for it.
It may not work out. I was fortunate in that it really has, but there really is only one way to find out.

[27:21] And I encourage people on a consistent basis, if it is something that touches you to your core somehow, like that moment of breathlessness that I had, that, you know, where my, literally my breath was taken away, I’ll never forget it.
And I don’t know where that came from, But if any of your listeners ever has a moment like that, I guess the only thing that I would say from somebody who’s been extraordinarily fortunate is at least listen to what comes to you in that moment because you never know what might happen if you really act upon what you’ve heard.
Yeah, one of the things I heard you say, Russ, as you give advice to your kids is, you know, when that voice, that signal, that magazine article, if you will, shows up and you have the response that you do, it’s only one way to find out.
You have to choose to do it or choose not to do it. As long as we’re talking about our listeners, any other advice that you have, any other of learnings may be a better way to put it from this experience of that decision making that you could impart to the people who are listening to this.
I will venture some ideas that I hope may be worthwhile.

[28:40] So I will share that again in our system of medicine, anytime we step outside the norm, we open ourselves up to judgment either silent or spoken.
Spoken. And so we have to simply be ready for that. And for me, it was okay when that happened because I had the support of the people that I loved and cared about. And I had a growing community of support within the realm of integrative medicine. Because what we were engaged in is possibility. What if we could make things better? And so it really was in many ways more a discussion around values and a sense of meaning and purpose of what could be if I participated in this. I had no illusions about leading a field or anything more than what if I could be an active participant in something that feeds the greater good.
That was really all that it was. Now we can do that as healthcare practitioners, nurses, pharmacists, physicians, we still have that opportunity. We can help people one-on-one, we can help in groups, we can help in committees. There’s lots of ways to do this.

[29:55] I was presented with this idea of what if we could help everybody? And everybody knows you can’t really do that. And yet six months into the program, the program, not me, but the program was doing that, working with the NIH to create programs, working with the Department of Defense, working with the VA, talking about ways to create new programming to help children. All these different kinds of things were suddenly happening. It was like, wow, Margaret Mead was right. All it really does take is a committed group of citizens who are willing to work together and try and make something good happen. I just happened to be a part of that. It has enriched my life in ways I really have difficulty describing. So the offer to your listeners.

[30:44] Is though your colleagues, though society may say you have chosen a path and you need to stick with it, that may not be the way forward. And those voices may not be the ones that create the change that we all need to see. Given the opportunity, though it might seem crazy, but given the opportunity to try something different that might serve not only all those around you, but your sense of self and your sense of meeting the moment, you might take it.
Russ, I don’t think I could have summarized it any better. That was really awesome, the learning that you’ve gotten from this and that you’re imparting to the people listening to this.
But one thing I have a feeling some listeners would like to know, a little bit different than that moment.

[31:40] What pulled you in was this opportunity to transform healthcare.
We’re now 26 years after that moment. What would you say, how would you say that we’re doing with transforming health?
Back in those days, I will say that we had a lot of people coming along saying, This is great.
But rush you’re not going to live to see the fruits of your labors and i remember in my head.

[32:07] Going you know they just don’t know because we’re going to be the change all these people are going to be joining us and together it’s going to be a wave and we’re going to create this change and changes have happened i mean you know people are taking more responsibility for their own health and well-being they are you know eating more healthfully they are trying to do what they they can with vitamins and supplements, they’re managing stress, they’re learning mindfulness, all these things are happening, but it is still not available to the vast majority of people and especially to those who are in underserved parts of the country.
And the question still comes down to it, now, 26 years later, who’s going to pay for this?
And that remains the problem. And it’s one of the reasons why the VA Whole Health System is so inspiring because within the VA, as long as there are data showing that these kinds of approaches serve the veterans well, and if that can be shared with Congress, it will be paid for.
So the VA is actually far ahead of what is happening here in the community.

[33:13] Because health promotion and disease prevention is paid for.
In community medicine, there are many people who say, well, prevention is paid for, because you’ve got mammograms, you’ve got colonoscopy, all that stuff is paid for.
You know, that’s not prevention, that’s early detection.
And so we really need to move towards a system where we focus on not only disease prevention, but health optimization, and helping people to be as healthy as they can be in order to reach their own senses of meaning, purpose, and aspiration.
So I think we’re still stuck, unfortunately, because…

[33:50] Though we are moving towards value-based reimbursement, still so much of medicine is fee-for-service, and the powers driving medicine right now aren’t going to create change very quickly.
Until there’s reimbursement for health promotion, disease prevention, health optimization, I fear that what we’re going to be left with is trying to help people to take better care themselves without there being much support from the industrial aspects of medicine.
I know that you celebrate success and you also tend to, you’re very humble about the impact that you’ve had in the places that you have been.
I also know that you will not rest until this is something that everybody has access to, that this way of thinking, I just know that, I know that about you.

[34:44] And so I’ll just say that my appreciation to you for what you bring to the community that I live in, but also to the community at large, because you’re, you, even though you’re pretty humble, you’ve had an impact.
And so gratitude from the thousands and thousands who have benefited from your contributions and, and thank you for spending this time today to, because I hope my hope is that some listeners are gonna, when they’re caught late and they’re playing as late and they see a magazine article or they have this moment where they something catches their eye and it really gives them that aha experience, they will step into it in a way that they may not have not having listened to this. So thank you again Russ for being with me today. If I might just end in saying we talk about trying to bring forth the possibility within each person to be healthier, the possibility within our healthcare system. For your listeners, I never would have guessed this, but now, looking back on it, stay open to the possibility of what presents to you because there might be something even larger for you to participate.
Great words to end on. So once again, Russ, thank you so much. Thank you.

[36:04] As I listened to this conversation to prepare for the recap, I was struck not only with the wisdom that Russ imparts to us, but also the gentle and humble way he does so.
Within each of his suggestions is the invitation to pause, to get quiet and attend to ourselves.
Instead of taking the expert role and providing advice, Dr. Greenfield inspires us to recognize that we mostly just need to listen to our inner voice and allow ourselves to sit with those moments where we are sparked, where something we experience deeply resonates. We are invited by Russ to remember that we are the experts about ourselves. With that scaffolding, here are three comments that Russ made that I feel stand repeating.
1. If there’s something that touches you to the core that just takes your breath away, at the very least, pause and listen to that.

[37:01] 2. If that something remains something extraordinary that you want to go after, go for it. It may not work out, but there’s only one way to find out.
3. When going for it, your colleagues and society may remind you that you have already chosen a path and you need to stick with that. However, that really may not be your best way forward and those voices may not be the ones that are most helpful to you as you follow your unique path.
Well, I hope you enjoyed the listen today. If you’ve had a life-changing moment like Russ had when he read the article and you’re struggling a bit with going for it, coaching can be an excellent way to help you clarify where you’re heading and get you firmly established on your unique path.
We at MD Coaches are here to help. You can find us at mymdcoaches.com.

[37:53] Thank you for listening and be well. Thank you for tuning in to Life Changing Moments.
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