The Quarterback: Scott Paviol, MD

Transcript

[0:00] It all started with what I called my med life crisis, which was about two years into private practice, When I kind of had an oh, oh crap moment where I paid off my student loans I was very busy at work and I was like, oh is this all there is?
Paging dr. Cook Paging dr. Cook Dr. Cook you’re wanted in the OR Dr. Cook, you’re wanted in the OR.

[0:29] Music.

[0:53] Welcome to the Prescription for Success podcast with your host, Dr. Randy Cook.
Hello everyone and welcome to Prescription for Success. I’m Dr. Randy Cook, your host for the podcast, which is a production of MD Coaches, providing leadership and executive coaching for physicians by physicians.
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My guest today is a dermatologist in Charlotte, North Carolina, where he’s very interested and topics related to both personal and professional well-being for physicians.
So let’s hear my conversation with Dr. Scott Paviol.

[1:51] I am really looking forward to my conversation with Dr. Scott Paviol today. Scott is coming to us from Charlotte, North Carolina. He has some really interesting things to talk about. Scott, thank you so much for taking the time to be with us. I’m really looking forward to the conversation.
Oh yeah, thank you Randy. It’s really a pleasure to be on here and get to chat with you.
Well, let’s get right into it. As we always do, we like to know a little bit about your origin story.
I know that you are a Pennsylvania native and did your undergraduate education at Franklin and Marshall in neuroscience. Am I to conclude that you maybe wanted to be a neurosurgeon one day?
You know, I actually never really wanted to be one. I did get recruited to be one while I was in medical school and then I realized that because there are so few neurosurgeons, they’re always on call and that just wasn’t what I wanted to do even though I do really like working with my hands and such.
But I just never was one for standing in the OR for long periods of time, so it wasn’t cut out for me.
Yeah. So you did actually have some interest in neurology in the beginning.
Yeah. I would say the thing about neuroscience and cognitive neuroscience that always interested me was the psychology component of it.

[3:12] And apparently, you had known for a while that medical school was where you were headed, is that correct?

[3:22] Yeah, you know, I think that I always succeeded, I had a very traditional, let’s say, upbringing, you know, played sports and excelled in academics and, you know, kind of just followed the path that was kind of approved of, I would say, without much thought. But I did always like science and, learning and scientific method. And then it just kind of led me to medical school. But I didn’t I didn’t really have anything else I wanted to do.
Awesome. And there were moments that because I hadn’t questioned much.
Where I tried to get a little bit outside the system and get perspective.

[4:03] Took a year off of medical school and did some research and did my intern year in San Diego, which was far away from home. And kind of it allowed me to renew my love of learning and science and being a doctor. But yeah, it was just kind of a path that no one, you know, everyone says, yeah, being a doctor is great. So you’re like, yeah, I want to be a doctor. And then all of a of a sudden you’re, you know, eight hours of studying both days of the weekend, you’re like, what am I doing here? Is this the right path for me? So I definitely had some moments where I think a little more introspection earlier in life would have avoided those kind of existential crises.
That says a lot for your level of maturity at that time, because I think most people, I know certainly I had the attitude during my formative years in medicine that I wanted to get in school and get it done and get to work.
But for you to decide to take a year off and sort of catch your breath and look around at some other things that you might like to give consideration to really says a great deal about a maturity level that I think most medical students don’t have.
I don’t mean to embarrass you with flattery, but did you have the feeling that you sort.

[5:22] Had a different attitude about the schedule that you should be on compared to your classmates?
Scott Cunningham That’s a good question. I’ve always just kind of gone to my own beat in that respect. I never really – yeah, I just always kind of did what I thought I should be doing and I think I’m very internally competitive but mostly with myself as compared to others. So I think, yeah, I did kind of do my own thing. I always would, you know, I knew when to work and when to play. And in a lot of ways, I was very blessed to be able to be selfish in that way. I did not have a lot of distractions.

[6:06] From my family of origin or life events over that time in my life. So I was able to be extremely focused and dedicated to school and learning, which was a privilege of mine, I now see in retrospect because it allowed me to really do well through all that.
Yeah. And you spent some time actually administering health care to the truly underserved in South America and Ecuador.

[6:32] And was that during medical school or right after medical school? When did that happen and what was it like?
Yeah, that was in my fourth year of medical school. It was through a, you know, that was kind of one of the gifts that I was able to take advantage of.
When I took a year off, my class went ahead of me and so a group in that, my original class did a month in Ecuador and they found it to be very rewarding.
So I kind of said, hey, you know, maybe I get a group of people in my new class and do that.
So yeah, we went down to Ecuador. Part of it was to try to learn Spanish with that, which I failed at.

[7:09] And part of it was, you know, to see healthcare being delivered at an underserved area and be immersive because we were down there for a, an entire month through a program with South Florida. I was very lucky.
My best friend from high school was actually in that class. So I made the trip with my best friend in high school.
We went to the same, ended up, he joined a year later, but he ended up eventually in my medical school class.
So we did that trip together with a couple other kids from our class.
Well, I gotta hand it to you. That really does show a lot of ability to look around and see the entire landscape that I think a lot of people just haven’t arrived at yet at that age.
And I’m sure that you felt like it was really significant in your professional development.
And then I guess at the conclusion of that or near the conclusion of that is when you decided to move to the other side of the US and see how they were practicing medicine on the West Coast.
You did your internship in San Diego at Scripps. At that point, did you think that you were headed for dermatology or were you still thinking things over?

[8:23] Well, yeah, let me let me speak a little bit more to that Ecuador experience because I do think, you know, I draw from that occasionally when I’m in clinic and I have so many things that I’m thinking about billing and HIPAA and OSHA and prices of prescriptions all simultaneously going into decision making processes.
And it’s very calming for me to think, you know, if we can just get to true medicine, which is the physician and the patient and the provider and the patient, like that’s really what it’s about.
And that’s what it was there. You didn’t have fear of being sued.
You didn’t have to follow a specific algorithm based on insurances and drug companies.
And you know, you’re really just truly helping people.
And everyone was so grateful for your help.

[9:08] And it, you know, made studying worthwhile. And so I think that’s one of the things I think that in the US we have got to get back to everything is so top down now with these big organizations, big healthcare organizations that are regional now.
But I think it has to go the other way. It has to start with the physician and the patient in the room and build the system around that. And it’s got to go that way because that’s what we’re here for.
Yeah. That’s, again, a really insightful observation. I’ve heard that from so many other people that have had that experience of doing healthcare in underserved areas, particularly outside the US.
Notion that you have to be defensive in what you’re doing.

[9:57] It just never arises because you’re there for a purpose to deliver something that people need and that the people in need are grateful to have.
And I’m sure that you’ve had plenty of instances where you reflected on that once you were underway in the delivery in this country.
Yeah. And another formative event that affects the way I practice as well is I was named in a A lawsuit, when I was in residency on a skin check for a patient, did a biopsy of a mole and it was benign.

[10:33] But four years later, the patient who was a frequent tanning bed user came back to a clinic and ended up having an invasive melanoma.
And, you know, did I miss, you know, my attending saw the patient as well and we did a good exam and everything was documented well, but still you hate a bad outcome and, you know, It was certainly possible and even likely to develop a melanoma in a tanning bed patient over four years.
But it made me feel like if I could get named on a lawsuit for something like that, you could get named for anything.
And I just decided that I’m not going to practice in fear of being sued.
I’m going to practice the way I want to. And if I go down like that, then it wasn’t meant to be.
And I’ll find another way to be impactful in medicine.
If I practice defensively, I’m costing every person my true opinion and what I think needs to be done in every circumstance.
I’m a sports guy too, so it’s like, you know, I don’t want to play not to lose because you know what happens when you play not to lose? You lose.

[11:31] So I just have to, I’ve been able to stay in that mindset of just do the right thing over and over and over. If you go down like that, then I can, I can sleep at night going down like that.
That’s a really great attitude and shows a lot of wisdom on your part.
But getting back to your training.
Yes. the course of doing your internship on the on the west coast, I assume that you obviously were looking for a dermatology residency at that time and you settled on Michigan.
This is puzzling to me. Now you did your medical training at Penn State and your specialty training at Michigan and I’m wondering who you pulled for in the Big Ten. Obviously Penn State.
You know, your first love.
You never forget your first love. I mean, academically, Michigan was great, but I could never get there as far as rooting for them.

[12:28] You know, I took a lot of flack while I was at Michigan. I was going to say, that had to be a lot of flack.
Yeah.
And, you know, if they’re not playing each other, I’ll slightly root for Michigan.
But yeah, the first love, you know, growing up in central Pennsylvania, and I always liked sports-wise, you know, college sports, because you know the high schools some of the kids went to, et cetera.
Yeah, Penn State all the way on that. And yeah, as far as, you know, I kind of grew up in, I call it the Bermuda triangle of Pennsylvania.
So I grew up near Hershey where they make the chocolate. And then I went to a small liberal arts school in Lancaster called Franklin and Marshall.
And then I was admitted to medical school after my sophomore year of college, actually.
They had an early assurance program.
We had a really, really good medical school advisor from Franklin and Marshall.
He ended up going to Hopkins after he was there and he made me aware of that program.
So I applied to Penn State, in state and got in after my sophomore year of college, All I had to do was not.

[13:26] Cause any disturbances in my third, fourth years. Yeah, exactly. So then I went straight to Penn State for medical school. And in retrospect, I think if I would have had a little time, I would have appreciated it a little bit more.
Because right away it was kind of like, whoa, I wish I had time to decompress from college.
But and then at Penn State, I was like, man, I got to live somewhere else. So I did that year and research in DC. And then I decided I wanted to do dermatology during that year. And then I applied to intern year and resident and dermatology residency at the same time. So I matched at San Diego first, my uncle lived out in San Diego and some of my friends from my class that were ahead of me were already there. So I was like, Hey, this sounds like a great year to San Diego.
And then Michigan was the program that I wanted to go to for dermatology was a bigger program, got ranked as a top five program at that time.
And, you know, I think I have a, probably a big 10 mentality kind of in that.

[14:31] You know, kind of workman like, and I liked a lot of the things that, they were really heavy in medical dermatology.
And so, but I’ll tell you the move from San Diego to Michigan was a very tough one.
I hadn’t seen the light from Pennsylvania. I would have gone from Pennsylvania to Michigan, it probably would have been easier.
But once you taste that sunshine, it’s hard to go to Michigan after that.
I was going to say the climate shock must have been awful.
Yeah, so it was already in the cards and you know, you move there in the summer, so it’s not so bad. But yeah, man, in the wintertime, it is tough up there. And that’s, you know, my wife’s from South Carolina. So after residency, we were definitely looking south.

[15:10] Have you ever had a moment in your life that altered your future?
To see that we have this bottleneck with residency that so many people don’t get that chance, to get that so needed training.
Have you ever wondered why you chose the direction you went?
When I had left my prior position, I didn’t plan on going back to practicing medicine.
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[17:21] 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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[18:28] You clearly had in mind some sort of change, whether it be working conditions or climatic conditions or whatever, but you decided to move to the South.
Sounds like your wife had an influence on that, which is understandable.
Yeah, and I mean I actually always was trying to move to the Southeast in college.
When I was applying to colleges, I wanted to go to UNC Duke, Wake, or William & Mary, and I got waylisted at all four or five of them.
So then in applying to medical school, I knew I wanted to go to Penn State because it was in-state tuition and nearby.
But then residency, I would have liked to have gone to UNC or Duke or Wake, but that wasn’t in the cards either. So I figured they can’t stop me once I have my MD in residency.
So I just came down here after that.

[19:18] But first you don’t succeed. I gotta think that the proximity to your wife’s childhood home had to have had an impact, but what a great place to be in the Schmalt area.
It’s got the best of just about all the worlds that I can think of, would you agree?
Yeah, I just love the Four Seasons, and it’s just a warmer version of Pennsylvania in that respect, but you still get the snow.
That’s one thing about San Diego that was interesting. It was like being on a movie set sometimes because it was so sunny and nice every day.
I like some very, I actually like weather.
So I really like the Carolinas, I think.
And I like being on the East Coast too. I love it here.
Well, let’s talk about your practice situation that you moved into in Charlotte.
Now were you in a multi-specialty group from the start?
Tell me the story of that.

[20:11] Yes. So I interviewed several places coming out of Michigan and some private practices, one in Boone, one in Charleston, South Carolina, Hilton Head, Pinehurst, and Charlotte. And the group I ended up choosing actually was a physician that my original partner was a physician that graduated from Michigan a few years ahead of me. I didn’t know her at the time. She was part of a a physician-owned multi-specialty group in the region.
So it is very physician-friendly in a lot of ways, meaning the group originally started with a bunch of practices that joined together in the 90s for just a bit shared resources.

[20:55] HR, billing, coding, and then insurance leverage.
And it’s evolved from there and gained a lot of steam. And it’s a little different than some of the bigger groups that you see because it is physician boarded.
So everybody on the board is a physician outside the CEO and the COO.
Their model is essentially really nice income, low buy-in, no real estate.
And basically you get a salary and then however you run your practice is an independent business unit.
You pay them a certain percentage off your top line revenue and then you get to be as productive as you want to be.
So it’s an incentive based model, which I really like and they kind of leave you alone as long as you’re doing well.
Nothing wrong with that. I think I love the autonomy and the decision making.
I think I’m a general, like a sports GM at heart.
I really like building teams and offices and it allows you the freedom to choose who you’re working with and how you want to structure your office, which is gives me a lot of pleasure in in medicine is having that autonomy.
So it’s pretty big organization 70 locations. Is that correct?
And are they all in North Carolina?

[22:12] They are all in North Carolina, yes. I’m a little surprised that it hasn’t spread.
I think it’s one of the better models in healthcare for physicians. For the reasons I spoke about before, I think one of the things holding Piedmont back is due to the structure that it is, which is you have offices that can run how they would want to run, but that comes with the expense or the downside of, you know, not everyone is as unified in their vision and direction of the.

[22:50] Organization. And it started as just some smaller offices. So how do you stay with that model, but also have the ability to have some uniformity and some familiarity between offices? So I think I think that’s what they’re struggling with a little bit now.
My impression of that would be maybe it’s not such a big problem.
My impression nowadays is that unfortunately in the medical world, like all businesses, we tend to think that bigger is better.
The banks have gotten bigger and the grocery stores have gotten bigger and everything has gotten bigger.
But when you’re talking about something as personal as healthcare delivery, I don’t know that that’s necessarily the right mindset to be in. Would you care to react to that attitude?
Yeah, this very rhymey phrase came to me the other day, and it’s probably been said before.
I don’t know. Maybe I heard it. But you care a lot more when your name’s on the door.
I like that. And so, you know, I mean, it’s just true because every patient that’s coming in and out of your office at Paveo Dermatology, part of Piedmont Healthcare, that’s my name.
And so I care about it. I’m not handing off patients. I’m not checking in and out.
It’s the totality of the patient experience is ultimately what I’m responsible for.

[24:15] So yeah, I think that smaller is better. It’s kind of like Chick-fil-A franchise owners have to be in the store every day.
I do think that is a good model.
And I’m really very impressed when I look over your resume that you appear to have a much bigger picture outlook than a lot of young physicians in terms of an awareness of the things that are going on around you that are important, that can affect your way of life, that can have an impact upon how you practice.
And I’m thinking specifically about the Mecklenburg County Medical Society where you’re very active, I have to tell you that back in the time when the earth was cooling and I was getting into practice.

[25:00] We really didn’t want to have well people my age didn’t want to have anything to do with County medical societies and state medical societies because they were always attached at the hip to the AMA.
So, tell me about that. Tell me about your experience and your interest with organized medicine.
I like to think of myself as a positive disruptor and it all started with what I called my medlife crisis which was about two years into private practice when I kind of had an oh crap moment where I paid off my student loans.
I was very busy at work and I was like, oh, is this all there is, you know, which is not that bad.
You know, I was taking good care of patients, but I was searching for, it was kind of like the learning of residency had, you know, I kind of taken off from reading journals because I was really fresh out of school. So I was up to date on everything.

[25:58] And then I was like, okay, I paid my loans off. This is all there is.
I just ended up reading an email that said, healthcare leadership and management program from North Carolina Medical Society.
I was like, you know, I hadn’t learned anything in a while. Let me take this course.
And it was a really great course. And I got to know a lot of really good people.
And it really taught me that there are a lot of docs out there that really think differently.
And sometimes you just get so siloed and your nose is down in the chart so much that it was extra work, but it gave me energy in a different way.
So it kind of revived my belief in medicine.
And just through that, it’s just funny when one door opens, like everything can open.
So from that, I met a couple of people.
Like my mentor is Tina, not a dog who’s a head of physician development at North Carolina Medical Society. So I decided to get a mentor and then I decided to take another course the next year.
And I kind of recruited some of my friends to take the course with me.
And then those friends are the ones that invited me into beyond the North Carolina or on the Mecklenburg County Medical Society.
Now granted, nobody really wanted to be involved in that. And I generally don’t join a lot of groups.

[27:13] But I just wanted to hang out with them because I knew that they were great people.
And I had started a blog with one of the people at that point, Mark Carruth, about just our ideas and musings on the future of medicine, how to make medicine better, some of the stuff we experiment with in our practices.
And then, you know, basically nobody else really wanted to be president, but I was to a point where, you know, I developed this career mantra of being physician led change in healthcare.
And you know.

[27:42] It got to a point where it was like, I didn’t study this hard and work this hard to go down like this, to be someone that doesn’t have impact on a larger scale for physicians because I believe in medicine and I believe in doctors.
I just saw so many people giving up. I don’t know. I like to empower people.
I see a lot of talent and I see things in people.
I just think that if we can get docs to really be who they can be and stand up, we have so much power to influence change in our profession.
And ultimately, you know, that’s, you know, physicians should be the people dictating how to treat patients.
I mean, that’s just what I believe. It got to be the point where it’s like, if it’s not me or if it’s not us, then who is it going to be?

[28:29] And, you know, I don’t like to be told what to do by somebody that I don’t feel like should be doing that. And so here we are.
But yeah, the Mecklenburg High Medicine Society, I view it as one of the few places where physicians actually can be empowered and spoken for because everybody else talks to you.
And no one’s really representing physicians. I see a lot of physicians, I call it like a washout, but everybody calls themselves providers now.
And I think that’s a veiling of being able to kind of blur the line between nurse practitioner, and physician. And not to say I love PAs and nurse practitioners, but you know, at the end of the day, I have a lot, you know, physicians have a lot more schooling than them and they, can work in tandem, but there’s no substitute for medical school. That’s just the reality.

[29:22] Yeah. It’s very refreshing for me to hear somebody reinforce a message that I think is being lost in all the noise. And that is that there is something that makes a physician different and you can’t do all the things that a physician is capable of doing unless you do the things that it takes to get there.
I’m going to read a little quote from your bio page, I think, that I’d like to get some comments on, Leadership College scholar Scott Paveol shares how he transformed their office space and incorporated mindfulness techniques among their staff.
I want to talk about that a bit. I mean, this sounds to me like you have figured out that if you’re going to do the best that you can do for your patients, everybody around you has to be on the same page, has to be on the same team.
So can you talk about that a bit?
Yeah, and you know, I think this, you know, works well with what I said before, you know, I’ve got.

[30:28] You know, work with PAs. And if you put your PA in a position to succeed, meaning, you know.

[30:34] In a proper scenario where they have appropriate oversight, you’re in the, you know, you’ve trained them or you’re available for them at all times, and you give them the right patients and the right conditions and then you know your medical assistants are they influencing the patient, experience and the front desk are they you know they play a role it’s kind of like football you got a quarterback you’ve got a running back you’ve got all different positions and if everybody plays their position you don’t want five quarterbacks because that won’t work so everybody plays their position and I often say I mean it goes kind of both ways but I think normally what often happens happens if people will put up with staff for a good physician or a great physician. But a lot of times offices, you know, you have a great physician in a crappy office experience and they just bail it out every time they’re running late or whatnot. But you know, what if you could synthesize an office where, and I preach this every day to our staff is like.

[31:35] The staff sets me up. You know, the front desk sets the tone with a smile and knowing the names and yeah, it’s extra work, but it’s rewarding. It’s like anything. If you work really hard at it, you can take pride in it. And then the medical assistants, you know, let’s get them involved in the process to their maximum talent. And you know, kind of my vision is having a growing office where everyone’s being developed at all times, whether it be learning knowledge that they can do or, you know, really, you know, working on stuff that they want to improve about themselves.

[32:08] And if you can build that, that is more rewarding than salary, it’s more rewarding than recognition because you’re helping people gain skills that translate in all aspects of their lives as well.
And I want to get a little bit deeper into that in that same piece that I was just reading from.
You talked about incorporating mindfulness techniques among the staff. Yes.
How do you do that?
Well, that was more out of necessity than anything. So, you know, it’s like anybody’s struggle is their strength. But, you know, I felt like, and you probably know this sometimes too, when you’re talking to a patient, you’ve got a lot going on in the back of your mind. You’re synthesizing their symptoms they’re presenting with, the person that they are, what insurance they have, what’s something that’s going to cost them. And it’s really easy to just, you know.

[33:02] Kind of be doing that and putting up almost like an automaton face. But I needed to be more present and be able to do those things. And also when I’m at home with my wife or with my friends to be able to be present. And so I realized that I got by with that because I’m very affable and smiling, but it prevented me from having deep connection with patients for a while. And so I just I was experimented with meditation and slowing down.
And this is kind of where I got into coaching stuff too. It’s like, what got you here won’t get you there.
So, you know, my unilateral focus and knowing the complexities of the Krebs cycle is great and all, but patients don’t really care about that.
They want you to be able to hear them, you know, see what’s bothering them and be able to come up with a solution that’s specific to them and their life.
And sometimes the best impacts I’ve had with patients have nothing to do with any medication or diagnosis I do.
As hearing them being with them.

[34:06] So, the mindfulness, then seeing how much it helped me, I wanted to share that with staff and show them that what is presence.
Mind you, this is something I still struggle with on a daily basis, but what is mindfulness and what is being truly present with the patient, taking an extra second, really seeing, and this is in the coaching world too, but what’s not being said.
Those are the moments that make a difference in patient care.
And so that’s been very valuable to me and it’s one of those things that again gives me energy instead of drains it from me is really trying to be with the patient and be with your staff and be with the person you’re with in a world where everything is trying to pull you away from that.

[34:54] It’s very insightful on your part and I have a feeling that the turnover rate in your office among the staff is probably pretty low, would you say? I’m right about it.
Very low. We’ve had some people leave and then they come back. They ask to come back.
I said, I joked with the one and I knew she was going to come back. I said, fine, that’s fine to come back. But yeah, another staff we just hired, she went away. But I tell staff, we’ll develop you. What do you want? I would love to be a place where you started your career and You could say I am where I am because I started at Paveo Dermatology and they gave me the skills and obviously we try to keep everybody, but we take young people that are good people that are talented and we try to give them their best career as well.

[35:41] But yeah, we do not have a lot of turnover and yeah, I get a call a couple weeks ago from a medical assistant that she wanted to take another job and at that time at my last I said, I think that’s a good move for you.
And it would have been selfish for me to say stay. It would have been helpful for us because we wouldn’t have to replace her because she’s great. But then three years later, she called and said, hey, I want to come back.
My situations have changed. So we just brought her back and I’m very excited to have her.
So I always try to be somebody that can have a positive influence in someone’s life path.
Sounds like a great place to work and it sounds like a great place to be a patient as well.
So I want to offer my congratulations on that. Scott, I really enjoyed the conversation.
What I’d like to do at this point is move along to what we really came here for, and that’s where I get out of the way and give you a chance to say what you have on your mind. So I’m going to close my mic and audience.
Dr. Scott Paviola is going to give us his personal prescriptions for success.
My personal prescriptions for success are one, choose your significant other.

[36:52] Really carefully and well. I think your significant other determines so much of your success in life, and they’re able to see you at your best and at your worst and push you to, if you choose well, to accomplish great things in life in your essence.
And they can be such a great source of support and love and nourishment.
So I don’t think you see very many truly successful and happy people without someone by their side that they really trust and love. Number one. Number two. I always encourage and have benefited from taking action in the direction of your vision. Really trying to get out of your head and make one step towards where you’re going with the vision and beginning with the end in mind as Stephen Covey would say. And taking action in the best form for me is providing value regardless of return. So continuing to put positive things over and over regardless of the immediate effect. Just continuing to trust that if you put out good things and kind things in the universe, it’s rewarding in itself anyways and no one loses with that approach. I also believe in being so good, they can’t ignore you as Steve Martin said. So again.

[38:18] Regardless of outside circumstances, just do the best that you can possibly do. Know the most, be the best person.
And then the cream always rises to the top. Number three, when in doubt, invest in yourself and take a chance on yourself. You.

[38:33] Never lose by investing in yourself. And that’s, you know, something that is a very refreshing thing for people. It’s scary and you may not always win, but you’ll never know if you don’t try.

[38:47] Number four, have lighthouse friends, I call them. So some people that may not be your best friend, but someone that you can say, hey, if I’m not acting as the person you think that I am, will you please let me know?
And they’ll tell you the truth. They’ll say, hey, that’s, you know, you’re I don’t think you’re right on this one.
And because the higher you climb as far as title is concerned, the less people will tell you know or tell you how they really feel.
And it’s really important to have your squad that you can rely on to tell you, hey, yeah, this is in that.
Hey, yeah, this sounds like a good idea. This is in alignment with what you believe, et cetera.
Et cetera. So you’ve got to have people in your corner that will check and balance you.

[39:31] And I’d say lastly, allow time for daily or at least regular reflection of what’s gone on and what is to come.
And also have at least a vision in mind of where you’re going.
I’m a very visual person, so paint the picture in your mind.
And again, going back to one of the previous points, take action towards that.
And if you just do that over and over and over again, you might just end up somewhere in that picture.
Those are my prescriptions for success.
Well, Dr. Scott Paviola, thank you so much for sharing your wisdom with us.
And there is a lot of wisdom in there.
I know that undoubtedly you must have a very happy office staff and probably lots of happy patients as well.
And I know that’s very gratifying for you. Before we go, I want to give you an opportunity to tell our audience where you can be found, whether it be websites or email addresses, personal appearances or anything that you’d like to share.
Yeah, luckily I think I’m the only PAVEO MD in the country, so I have a very unique last name.
So you can find me at paviodermatology.com, pavioderm on Instagram, and I like LinkedIn as well.
I think the community there is great. So those are the best places to find me.

[40:56] And I’ll mention as well, I do a lot of snooping around in everybody’s life before I get them on the show.
There is a great YouTube video that you participated in some time ago involving a mindfulness exercise.
And if people go to YouTube and in the search box put Scott Paviol MD, they’ll find it right there and I encourage them to do so.
And Scott, once again, thank you so much for being with us on Prescription for Success.
It really has been a pleasure.
Scott Cunningham Thanks for doing this. We need more of it out there.
It’s been a pleasure.
Thank you so much for joining us today.
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And remember, be sure to fill your prescription for success with my next episode.

[42:21] Music.