Life Changing Moments with Dr. Randy Cook

In our inaugural episode of Life Changing Moments, Dr. Dael Waxman speaks with Dr. Randy Cook about what it was like to change his career from his surgery practice to leadership of a wound care center.

Life Changing Moments is a new companion podcast to Rx For Success, and the best news is that if you are subscribed to Rx For Success, then you’ll download the LCM shows automatically!

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With more than four decades of bedside practice as a general and vascular surgeon, he is a well-respected clinician, educator, and organizational leader. He holds certifications from the American Board of Surgery and the American Board of Preventive Medicine in the Undersea and Hyperbaric Medicine subspecialty, as well as certifications from the American Professional Wound Care Association and the American Board of Wound Management. He is a Fellow of the American College of Surgeons and the Southeastern Surgical Congress, and formerly served as a designated medical examiner for the Federal Aviation Administration.


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Access the Show Transcript Here

Transcript

[0:03] There are times in our lives that change the way we see the world. Navigating these challenges can take insight, trusted confidence, or even a coach.

[0:13] Let’s explore those moments.

[0:15] 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.

[0:29] Music.

[0:37] Welcome to the inaugural episode of Life Changing Moments. We explore the times in our lives when we are confronted with the choice to go in a different direction or that choice might have been made for us and we find ourselves in,
new territory. We learn a lot about ourselves during these inflection points. The intent of this podcast is to extract those lessons from our guests through conversations. In so doing,
we hope to bring their counsel and wisdom to listeners who may be experiencing similar branch points in their lives. It is fitting that my first guest for this show is the same person who inspired,
it. Dr. Randy Cook is the podcast host for Rx4Success, the program from which this one was birthed.
Dr. Cook is a renaissance man. He has been a broadcaster.

[1:28] A lab supervisor and orderly, a general and vascular surgeon, a wound care specialist, educator, organizational leader, private pilot, physician coach, and podcast host.
Betwixt and between many of those roles came, I’m sure, reflection and discernment that enabled his professional success. Let’s tap into some of that wisdom now as we welcome Dr. Randy Cook.

[1:57] To life-changing moments. Hey Randy, welcome. Hi Dale, good to talk to you. Good to talk to you too. I know that we know each other and we have a good time and we’ve had lots of conversations and I’m looking forward to having our listeners listen in a little bit about some of our conversations.
Well I have to say, this is going to be very interesting. I’ve never really visualized myself as a Renaissance man, but who am I to argue with a guy like you?
Well, there’s only a few of the things that I know about. You’re also an amateur photographer and well-read individual as well. I just wonder, as we talk about that Renaissance, all those
different roles that you have had, what’s it like to hear that just as I kind of counted those off?
What’s it like for you? You know, Dale, it’s really sobering. It’s not something that I spend a lot of time thinking about or reflecting about or any of those sorts of things.
And I think that’s probably common for most of us who are well into our eighth decade.

[3:05] That’s a lot of days behind us. And I think all of us are always in the process of doing things.
There were a lot of times when I was doing things that were obviously, based on your list rather exciting and personally fulfilling. So it’s kind of nice to reflect on what I.

[3:28] Have behind me and it makes me hopeful about what’s in front of me.

[3:32] That’s awesome. But, you know, as we think about it, you know, some of it, some of those roles had relationship to other roles and some of them didn’t necessarily.
I think what I’d like to do is just kind of jump right into one of those transition areas of your life since that’s what our show is about is kind of learning about what happens in those transition moments.
The one that I’m thinking about as I reflect on the podcast, which is episode one of Rx for Success, it’s when you were presented with the opportunity to become medical director of wound care.

[4:13] And then came another unexpected turn. Early in 2003, I was invited to become part of the physician staff at my hospital’s newly opened wound care and hyperbaric medicine center.
When it opened, the Wound Center only had one physician, and I was asked to participate primarily to allow him a little flexibility in his schedule.
So I was committing to a total of two half days and still running my surgical practice at full speed.
Two things made that a lot more challenging than I expected.

[4:46] First of all, it was difficult being available for the Wound Clinic at their regular hours while at the same time working my unpredictable surgery schedule around the wound clinic schedule.

[4:58] The second challenge was a little bit of a surprise. With 30 years of surgical experience behind me, I was very confident that I knew everything there was to know about wounds.
That turned out not to be the case.
In the years since I first studied wound healing, a lot had been learned and a lot had changed.
Still, I felt like I needed to prove myself, So I joined the teaching faculty for the largest wound care management firm in the world.

[5:30] In the midst of all that proving, there was another profound change in my professional identity.

[5:36] After just one year as a part-time physician in the wound clinic, the original medical director retired, and I was asked to take over his duties.

[5:47] Now, that was a really big deal. It would mean closing my surgical practice and devoting myself full time to the wound center and it was not an easy decision.

[6:02] And I just wonder if you could take us back to that time. Like, what were you doing and what was in front of you as a possibility?

[6:08] I wish I could remember exactly how old I was, but I can’t. But I was in a solo surgical practice.

[6:18] I was, quite frankly, on up in years, either close to 60 or maybe right at 60.
I was operating a solo general surgery practice that because of circumstances that are not really worth talking about required me to be on emergency
room call at least four or five times a month, pay employees, pay rent, all the things that go along with managing a private practice, which are substantial, particularly in this day and age.
And I had not honestly been doing any constructive thinking or intelligent thinking about how I was going to manage to continue. But the truth is that there were a lot of potential
obstacles there. And to be very honest with you, Dale, I think I was kind of whistling in the dark,
and just not facing up to that. And don’t misunderstand me. I don’t think I’ve ever been,
happier than when I was in the operating room, but those details become very important.
So at that time, the hospital administrator for the hospital where I was practicing came to me, and we had had a little wound center based within that hospital for probably 15 years.

[7:42] And the person that had been the original medical director had decided to pull up and leave, and he went to start a wound center in a neighboring hospital, a competitive hospital.
So the hospital administrator came to me and said, you know, I really don’t want to lose that service line. And I wonder if you would think about.
Taking it over. And to shorten the story as much as I can, I did think it over. One very interesting part of it was, whereas the wound center before was just that, it was a wound center, this new,
project was going to include hyperbaric medicine. And that kind of intrigued me a bit.
So to be very honest, I did give it some serious thought for about a month, discussed it repeatedly with my best business advisor, which just happens to be my wife. And I decided that I would do it.
And with that decision, paying the rent on my office went away. Worrying about patient referrals went away. Being on call in the emergency room went away. The malpractice insurance price came.

[8:46] Down dramatically. So in spite of the fact that I was a little sort of nervous about it at first, it was a little hard for me to imagine a day when I wouldn’t be in the operating room. All of a,
of a sudden there were some substantial advantages that reduced the sting of that.
So at the outset, I was actually feeling pretty good about it.
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.

[9:23] 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.

[9:32] Or if you’re feeling 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.

[9:52] The support you need today, visit us at MyMDCoaches.com to schedule your complimentary consultation.

[10:01] Again, that’s MyMDCoaches.com because you’re not in this alone.

[10:09] 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,
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,
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[10:56] Team-based care. And prescription for success listeners can get three months free when you enter our promo code, RxForSuccess, and select the monthly option at checkout. That’s a really great deal on this stunning publication.
And now let’s get back to today’s interview. Pete There’s a couple of pieces to that I’d like to kind of go back to. One is something that you said that you’re at this stage in solo practice and there were things that were going on. You
said, I don’t know that I fully recognized, you know, what was happening. And I’m just curious about that? Are you saying that you weren’t sort of proactive about what’s going to happen with this practice? You had mentioned in your 60s, and was it just sort of something that I’m just going,
to shove it aside and not going to think about this and let it take care of itself? What was that?

[11:54] Dr. John Baxter Yeah, I think you’re pretty close to it. The idea of being a solo practitioner and a general surgery practice, general slash vascular surgery practice was something that you just didn’t see it at that time. In fact, I remember,
I had previously been part of what was originally a four-person surgical group. One person dropped out that left three of us. And a time came when the original founder of the group, who owned the
whole thing, we were not partners in this business, he came to us and said, I don’t want partners anymore. So you guys are out. And so I had to think about how I was going to deal with that.
I talked to a business consultant who had actually worked with that group to ask his advice. And he went through all the things that you could consider doing. You can join another group.

[12:51] You can become a hospital employee. You can open a solo practice on your own. And interestingly, he said to me, the least attractive of those, particularly at your age, is starting a solo practice.

[13:06] So I turned around and started a solo practice. That’s how that came about. I hear you, but when you say you got to this point where you said, I didn’t see it,
what was it that you didn’t see? Well, the difficulties of being able to operate a profitable business in that framework. I gotcha.
One surgeon paying rent on the office, paying multiple employees, paying malpractice insurance, all those kinds of things.
The realities of having to have a good plan for being, for operating a financially sustainable business.
I wasn’t really paying enough attention to that. I see. How long were you in that solo practice before this opportunity came forward to you?
Before the Woon Center came along? Yeah.
I’m going to say pretty close to 10 years. Okay. So it was pretty well established. Yeah, yeah, yeah, yeah.
I had plenty of patience, plenty of work to do, but the bills kept getting higher and higher.

[14:06] Yeah. So in some ways, this opportunity that emerged for the wound care, there was a lot of positives to pull you toward it.
Absolutely.
And what were, you know, at the time, if you can recall, what were some of the pieces that made you want to hesitate?
Well, to repeat myself, it was difficult for me to imagine myself doing anything that didn’t involve an operating room. Simple as that.

[14:31] Yeah. And you said that it took about a month to kind of go through this decision-making process, you consulted your wife, and was there anybody else that was helpful to you in this decision-making process?
Well, at the time, I had trimmed down my office staff. I was down to one employee other than myself. This was my front desk person, business manager, one person show. And I talked to
her about decisions that I was trying to make. And she said, well, I don’t know what you’re going to do, but wherever you go, I’m going to be there.
So there was that. And understand what I was doing, I was not becoming a hospital employee. I still operated Randall G. Cook MDPC, but my only source of revenue and patients would be this wound center.
And the hospital paid me a monthly fee, a monthly stipend to hold that medical director role, but the lion’s share of my income still came from patient contacts.
Mm-hmm.

[15:38] There’s a real, you know, as you mentioned in the podcast, there is this, it’s very interesting because it’s a time of your professional life.
A lot of people are thinking about, you know, what else can I do, especially physicians? You mentioned it very, very nicely.
I know the OR, I’m comfortable in the OR, that’s where I’m happiest. And then you’re at this point where like, I don’t know if I wanna keep up paying the bills and the malpractice and can I actually do this?
Reimbursement is going down.
And a lot of our listeners are gonna be able to identify, if not already, will at some point identify with this.
What else is there for me? What other things can I do? And really, while wound care is certainly something that is part of being a surgeon, it’s also way more extensive than that.

[16:29] And so I’m just curious if there were any concerns that you had about going into, I got to learn a whole other stuff, you know, at this stage of my professional life. I was an absolute maniac about re-educating.
Myself and at the time there was not there still is not a specific board certification for wound care that is recognized by the american board of medical specialties but there were a handful of organizations at all said okay we got the board exam for you and i took everyone of them and i did not it was not a requirement for me to get board certified and hyperbaric medicine which there was,
an American Board of Medical Specialties certification available for, but I decided to do that.
I went and took another board examination. So there were a lot of things that I felt like I needed to do to convince myself that I was truly capable of functioning in the capacity of a wound
care physician. And just kind of accidentally, I got involved in the broader wound care world.
I became connected with one of those organizations that did offer a board certification examination and chaired the exam committee for the physician part of the examination.

[17:53] And I took part in the big meetings that we had in the world of wound care. I got to know a lot of very smart people that I learned a lot of things from and just sort.

[18:06] Of immersed myself in the culture of wound care in much the same way that I had as a surgeon for all those years.
So I don’t know if that’s answering your question, but there was definitely a process of rebuilding myself in the form of a different specialist.
Yeah. So it does answer the question. And what I think some people are interested in is what do I, as I consider doing something else, what would that look like?
And in your case, it was, you may not have had to do all of that training that you did, but it’s a, sounds like a value of yours to say, I really need to educate myself as much as possible to then feel, feel good about myself doing this.
That’s exactly right. In the beginning, I felt like a little bit of a fake. I really did.
There was a little bit of imposter syndrome going on, but it really didn’t take long to get over that.
Yeah. needed to have gone to med school and still needed to have had some familiarity with wound care to be able to do that. That’s not just something anybody can do.
Correct.
Yeah. Well, I do want to get to another transition point for you in terms of your career, which continues on. Before I do that though, just a little bit about, it sounds to me like that was,
pretty rewarding for you, the whole wound care chapter of your life.

[19:28] It really was. It was far more rewarding than I had anticipated. As I said in the beginning, I thought that this was going to give me a way to continue to generate a reasonable income for myself,
before I really reached retirement age, but it became far more than a vehicle for creating income. It was very satisfying and very rewarding from a professional standpoint and from a
just a humanistic standpoint. Yeah, one of the things in one of our earlier conversations I remember you mentioning was the shift that had to occur for you regarding the type of work you had been doing, which is mostly acute care. And people, you take care of things and they get,
you operate and they get better and you do follow-up and they move on. Whereas this is.

[20:24] Lots of continuity with wound care. And that was a character logic shift for you as well.
It was. And I can tell you that there were many times when I would be out in public at the grocery store or whatever and someone would walk up to me and say, oh, Dr. Cook, you’re the guy
that operated on me and I’m so grateful and those kind of things. And it was a little embarrassing for me many times because I simply couldn’t recall. You know, it had been so
long since I had seen those people. But it’s very different in wound care because there is sort of a perhaps uncomplimentary category that wound care world works in that declares,
you never get finished with a wound care patient.

[21:15] You may heal the thing, but they’re gonna come back. And that’s true.
A lot of the patients are poorly controlled diabetics or have advanced vascular disease or some chronic inflammatory disease that makes them much more susceptible to chronic wounds.
And it is a fact that many of the ones that you heal up very nicely will do well for six to 12 months and they’ll be back in your wound center.
And that was, you know, that took a little getting used to is a little frustrating at first because many times when people do that, it’s because they stopped doing the things that you encourage them to do and you feel like a little bit of a failure when that happens.
But anyway, back to what you were talking about, it kept me much closer and up to date on what was going on in the lives of everybody that I touched because I continued to see them for long periods of time, much like you do in family practice.
You said the word humanistic, and I was wondering if this is what you meant by that.
So more of the bigger picture of what’s going on with your patients. Precisely.
But for whatever reason, you become much more involved in their lives.

[22:28] You spend so much more time with them, you learn a lot more about what their day-to-day existence is like. And there is great satisfaction in that, as I know you can attest as a family practitioner.
Yeah, absolutely. Yeah. Gratification comes in different ways, you know, when we’re… It does.
…those kind of, yeah. Well, let’s fast forward to something I don’t know that I’ve talked to you too much about, which is this really a return in some ways to where you started.

[23:01] Before you went to undergraduate, you were in radio broadcasting and did everything in a radio broadcast station. I mean, when I say everything, I heard you did the actual microphone broadcasting,
turn on the machines, get the tubes warmed up.
You wrote advertising, you covered sports, you did all kinds of stuff. And here you are now, not only a podcast host, you’re an award-winning podcast host.
Indeed, I am. And so tell me a little bit about that. How did that come to be?
When the time came that I knew that it was my time to retire, I was in one of those situations where I was simply not getting along with people that had power over how I executed my practice.
In other words, even though I was not per se a hospital employee, it was their wound center. And we would have disagreements over hiring personnel.

[24:04] And different products to be stocked and this sort of thing.
And as time went on, the tension just…

[24:13] Grew and grew and grew. So that had been underway for a very long time. And frankly, I reached the point that I just didn’t want to face that anymore.
My wife had been ready for me to retire for a couple years, but I just didn’t want to be away from the patients.
But in any case, it finally got to a point where I realized that I couldn’t stand it anymore.
And I had decided that I was going to pull the plug And I was driving back home. We had moved about 45 miles, I guess, from Montgomery where I was practicing.
So I had this long drive and I was on my way back home one afternoon and I got a phone call from Rhonda Crowe, who is the founder and CEO of MD Coaches.
So she said, I want to talk to you about something.

[25:08] And here’s the deal. I’m going to start a company for offering coaching services to physicians and other medical health care professionals. And I want to publicize it with a podcast.
And she had heard me confess at a meeting that I had attended down in Jacksonville, Florida, where I used to be on the teaching faculty for a big wound care company.
She had heard me. We were at one of these dinners.
So as a conversation started, we were asked to tell something about ourselves that probably nobody knew.

[25:46] I announced that as a teenager, I had been a disc jockey on a radio station. And she said, she wrote that down and she decided that it was going to become useful for her,
sometime in the future. So my phone rang, I was about five miles from home and And she said, I’m going to start this company.
I want to publicize it with a podcast and I want you to be the host.
And Rhonda might have.

[26:15] Take and leave of her census. But in any case, I did give it some thought. I again discussed it with my most trusted advisor and my wife said, you know, I think that’d be really good for you.
And that’s how it started. It was as simple as that.
Chris Just out of curiosity, were you, at the time that you started this, were you still engaged in your previous employment or had you been retired for a bit?
No, I was still working at the Wound Center and it would be another, I think, four months or so before I would actually officially stop working there.
So you started this podcast before you stopped that?
Well, I made the commitment to do the podcast before I had finished up my work in the Wound Center, but I think I saw my last patient at the end of April in whatever year that
it was, and we got right to work on putting the plan for the podcast together at that point.
And my recollection is that we published our first episode in October of that same year.
Yeah, I think 2019.

[27:26] Yeah. So, you know, Randy, what this brings to mind is that some of our listeners are, if they’re not contemplating retirement, they’re going to be at some point.
And there’s all kinds of literature about making that transition into retirement and what that means and what to do to continue to have a sense of meaning and sense of purpose,
in one’s life.
And I’m just curious how has this landed with you?
I know you do more than just being a podcast host, but how has this landed? I think it might not be.

[28:07] A great exaggeration to suggest that it might have, if not saved my life, extended my life. Because like I say, I had made the decision that I was going to get out of medicine,
but I had not made any plans beyond that. And what this meant was that I had something lined up to do. I had responsibilities that I would have to meet. I would have a schedule that I
would have to attend to and there would be a reason for me to get out of bed every morning.
And I think that that is important. And interestingly, I’ll give you a little side story here. At the time that I made the decision that I was going to retire, I went to my financial advisor, the guy who
had been managing my profit sharing plan and keeping up with everything that I had been able to say. And my wife and I walked in the office and I sat down and I said, okay, Bob, I’m going to retire. I’m going to be whatever number of weeks I’ve got left, but it’s time for us to start,
deciding how we’re going to rearrange our finances in the face of that.
And he got very serious and he looked at me and he almost had a look of, well, it wasn’t almost, He had a look of great concern in his eyes. And he said, now look, I want to tell you something.

[29:33] Very important. You need to listen to me very carefully and you need to take it seriously.
And that is you need to immediately find something to do. The reason being, and he said in his words, which he had.

[29:47] Ushered many dozens, possibly hundreds of people into retirement over the years that he had been in business. And the ones that don’t have anything to give them some purpose typically are dead
within a year. So if you want to be somebody that lives to be a ripe old age, you need to find something to do right now. And of course, I said, well, that’s already been taken care of.
With those kinds of statistics from your particular financial advisor, really, this really has saved your life. I think you would probably be glad to take credit for that.

[30:27] It’s really great. It’s a great story. I heard similar things from my financial advisor, but he did it a few years before I was retiring. Basically, I think they see it more than we see,
it. Right? I think they do. Yeah. Yeah. So what is fulfilling to you? What gives you purpose around RX for success right now? What makes it worthwhile? I certainly have a feeling of,
worthfulness at, if you will, because I feel like I’m a pretty good employee for MD coaches. I feel like I’m a part of the team and I feel like I’m contributing to something that is certainly.

[31:12] In some ways bigger than myself. And that’s a good feeling. I don’t think anybody would like the feeling of sitting alone at home and wondering if anybody even knows that you’re alive and having
the responsibilities of keeping this podcast in motion and making myself available as a physician coach certainly makes me feel like there is good reason for me to be around.

[31:41] It’s a good feeling. Yeah, nice. And I just want to say for those who haven’t heard the Rx4Success podcast, one of the things you do so very well is you elevate people’s stories beyond just their dinner table.
And there are some stories, and you really pull out these qualities in people that are important for everybody to hear.
And I think that is such a service to not just the people who are being interviewed by you, but also the listeners to hear the multiple textures to people who are in healthcare.
And I know is I’m going to direct once again people to the very first podcast, which is you telling your story.
A major driver behind this for you is the wellbeing of our healthcare professional community. the drive is we need to assist ourselves with continuing to do well so that we do well by our patients.

[32:41] It’s so true. And, you know, I practiced for 44 years and things have changed in that period of time. And obviously some of the changes have been for the good.
We know so much more. We have treatments that are so much more effective. There are things that we can do for patients that we were not able to do five decades ago,
but the ability to find fulfillment in participating in the healthcare system, I think, has been diminished.
And there are lots and lots and lots of reasons why that has come to be. We could do multiple shows on that.

[33:23] I think it’s important for people to recognize and have conversations about and shine a light on those things about being a healthcare professional that are truly special.
It’s getting harder and harder and harder to do that, it seems to me.
And I think a lot of that has to do with healthcare economics. The other part of it has to do with the sociological changes in human beings.
Graduating from undergraduate programs today have an entirely different attitude and expectation about what their lives should look like as opposed to what I experienced way back when.
And to have this platform, to have people come to my podcast, our podcast, and talk at length about how they succeeded within the framework that existed for them, I think is invaluable.
Things that everybody can learn. I mean, even if I’m talking to somebody as old as I am about what it was like to succeed in that era, I think there are lessons to be learned. And to,
to give people an opportunity to tell those stories and give people an opportunity.

[34:40] On the other hand, to hear those stories, I feel like, I certainly hope that that’s a good thing that we’re doing and I really feel good about it.
Yeah, I think that we should feel good about it. You do a wonderful job of illuminating what is special about individuals and then putting,
some highlights on what are the lessons and especially giving people an opportunity to share their lessons.
You know, the actual prescriptions for success. So along those lines, I want to just say thank you to you for being on this inaugural episode of Life Changing Moments. There’s a lot of nuggets in here,
that people will pull out also that they can apply to their own lives about the lessons that you’ve given us as a result of recounting your life changing moments. So thank you again, Randy.

[35:37] Well, I hope you’re exactly right about that. This has been fun. Kind of being on the other end, it’s kind of fun. Yeah, I wondered about that, how this was going to be for you. It’s so great. Thank you again.
Thank you very much. It’s been a lot of fun. Maybe we’ll do it again in 10 years, huh? Maybe we will. Let’s put it on the calendar.

[35:59] Thank you for tuning in to Life Changing Moments. If you enjoyed this episode, please be sure to rate us five stars and leave a review. Doing so helps our podcast reach more listeners.
Have something to share?

[36:12] We’d love to hear your thoughts. Visit the MD Coaches community on Facebook groups. This dynamic virtual space is a place to continue discussion about life-changing moments and,
perhaps share some life-changing moments of your own.
The conversation today.

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