The Scientific Philosopher: Sanj Katyal, MD

Dr. Katyal holds a Bachelor of Science with University Honors in Chemical and Biomedical Engineering
from Carnegie Mellon University, and a Medical Degree from New York University School of Medicine. He
is the Founder of Positive Psychology Program for Physicians and President of Optimal Life Imaging
Group, PC.

The CME experience for this Podcast is powered by CMEfy – click here to reflect and unlock credits & more: https://earnc.me/BDBxrK

MD Coaches, LLC provides leadership and executive coaching for physicians by physicians to overcome burnout, transition throughout your career, develop as a leader or meet your individual goals. Remember, you are not in this alone. Reach out to us today!

PHYSICIANS BY PHYSICIANS. It showcases unique physician talents, whether it be in the form of writing, painting, creating cookie masterpieces, or storming capital hill in the name of healthcare advocacy. Use promo code RxforSuccess to get three months free when selecting the monthly option. https://rxforsuccesspodcast.com/physicianoutlook

Sanj Katyal, MD

Dr. Katyal also holds certifications in Positive Psychology and Positive Psychology Coaching from Whole Being Institute. He has published and lectured extensively on well-being and the Science of Happiness to audiences ranging from college students to physicians. Currently an Adjunct Professor at La Roche University, Dr. Katyal teaches the class “How to Flourish: Lessons from Positive Psychology”.

His research interests include developing a new model of optimal wellness incorporating principles from psychology, organizational leadership, health neuroscience and medicine. He is currently investigating the effectiveness of positive psychology interventions on physician well-being and is a co-founder of the course Thrive Rx: A Practical Guide to Flourishing for Physicians by Practicing Physicians.

Sanj is the author of the Amazon #1 Best Seller Positive Philosophy: Ancient and Modern Wisdom to Create a Flourishing Life.

Sanj lives with his family in Pittsburgh, Pennsylvania. His hobbies include kayaking, writing, and traveling.

Dr. Katyal’s Prescription for Success:

(Editor’s Note: Dr. Katyal took this opportunity to pen a letter to his younger self as his Prescription for Success. We include that letter here)

You have a life of achievement ahead of you. You are highly motivated and hardworking you will find much success out in the world. Right now you feel incomplete you’re searching for that next level in life to be able to finally relax and be happy. You want to advance in your career, you want to make more money, you want to start a family, you want to have some fun, all the important aspects of life.

Here’s a realization that it took me 50 years to understand: what you’re looking for will not be found in your bank account, your job title, or your accolades. You are looking for lasting satisfaction in a place that can never provide lasting satisfaction. Let me explain.

Everything that you do will be an attempt to feel better because most of the time you were filled with varying degrees of discontent. There’s always something that seems a little off, one final piece out there that is forever missing. Relax, is not just you this the default state of most people.

[36:39] The reason you’re trapped in this state of what I called visceral discontent is because you’re trying to find fulfillment through your mind which by its very nature cannot be fulfilled. You see at the most basic level the brainstem and limbic system our concern with autonomic function and hostile environments. The mind adapted to constantly search for threats and opportunities in the wild. Watch how a dog behaves, constantly on the lookout for drop food or opportunities and strangers, threats. But as we evolved as a society the mine drew the prefrontal cortex to be able to effectively deal with these societal interactions. The mind is created this I Persona or identity that you see when you look in the mirror. We call this ego – not in the sense of bravado – but as this manufactured self. This ego is still the mind and only concerned with survival. This ego still constantly searches for threats and opportunities. It can never fully rest because resting with threatened it’s very survival.

The mind or ego will never be saturated no matter what you achieve out there in the world and this is why we take for granted stimuli in our lives that are constant, which is hedonic adaptation as we become enamored and focused on new stimuli this hedonic treadmill keeps us locked firmly in the future, chasing the next level.

Remember the thrill of getting into medical school which is quickly replaced by the stress of matching into good residency. Or the excitement of making partner’s quickly replaced by dreams of retirement. The mind is clever. It keeps us toiling away looking forward to the fruits of our labor but in the end of fruit is not as sweet or as lasting as we thought it would be.

And this is the truth: The mind does not care about our peace, happiness, or contentment. It only can cares about survival. It cares about building up your ego, making your manufactured self strong, and always looking to the future to make sure it’s still around.

But deep inside, our core being, our unique potential remains unexpressed and held hostage by this protective shell of our mind, and the tension between our core beings unfulfilled potential, and our minds demand for survival is why we often feel irritable, anxious, depressed, and discontent. We look for a relief from this pain no matter how brief. And we Chase various forms of pleasure – money, titles, alcohol, distractions, all in an attempt to feel better. This insight allows us to finally understand the futility of this chase. All chases only lead to more chases. Nothing in the world lasts and all pleasures fade eventually either the unfortunate event is replaced by an unfortunate one, or we adapt to it and eventually take it for granted. With inner exploration and understanding you can stop searching for satisfaction out in the world. You can move beyond the emotional rollercoaster of stress and anxiety to access a deeper level of flourishing through the realization and fulfillment of your unique potential.

So search inward and discover your true core being. Understand the patterns and inclinations of your mind. Most of the self-help movement is concerned with downstream techniques to modify behavior. Go upstream to the source. Watch your thoughts and emotions as they cause desires within you. Understand them, and most importantly know that you are separate from them. You are not your mind, you’re a divine core being with unique potential ready to be fulfilled. This is your only true search in life, and those are my prescriptions for success.

Connect with Dr. Kaytal

Website: positive-medicine.com
Book: Positive Philosophy: Ancient and Modern Wisdom to Create a Flourishing Life

Notable quotes from Dr. Kaytal’s interview:

Our health, our impactful jobs, our patients, our families, our kids, – all of these things are are just taken for granted.

I want to keep good people in medicine but I want to give them the tools to really be able to practice at a high level.

I took the goals of philosophy with the more evidence-based research findings of psychology and combined them into a framework for optimal living.

We will eventually take for granted everything in our life that’s constant.

The absence of burnout does not equal wellness.

Systemic factors are huge and they’re not going to go away by mindfulness classes and resilience modules given to physicians.

Access the Show Transcript Here

Transcript

[0:00] The problem for us Randy is at the things that fade into the background of our lives are the very things that make life worth.

[0:08] Our health our impactful jobs for patients our families our kids all of these things are are just taken for granted.

[0:19] Music.

[0:24] Paging dr. cook paging dr. cook dr. Kirk you’re wanted in the o.r. dr.

[0:31] Music.

[0:56] 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 to overcome burnout transition your career.
Develop as a leader or whatever your goal might be visit empty coaches on the web at my MD coaches.com.
You’re not in this alone my guest today took a rather circuitous course on his journey to becoming a physician.

[1:31] Now he has some rather profound ideas about how all Physicians might benefit.
From A New Perspective on their career goals by taking advantage of positive psychology and mindfulness so.
Let’s hear a doctor Sanjay Patel tell his story I’m really looking forward to my conversation today with dr. Sanjay Gupta how.
Up in the Pittsburgh area stange I have been absolutely fascinated with the work that you’ve done and I’m really looking forward to our conversation so welcome to prescription for success.
Thank you very much Randy I’m happy to be here so as always I’d like to get started with your,
origin story Sange in your young life were there any influencers that would eventually.
Point you toward a career in medicine where their physicians in the family what’s the story on that I was born in India my parents are first-generation immigrants here I came over when I was a year old.
So the Indian culture it’s very important that kids are educated they.
Are often strongly encouraged to go into you know medicine law or engineering.

[2:50] And so you know my dad is a PhD in Biochemistry taught at the University of Pittsburgh School of Medicine,
ran on research lab for for his entire career.
Was you know self-funded with grants and so he was very much pushing me towards medicine and I was
not completely sold initially I thought I might want to go to business I went to Carnegie Mellon for engineering just because I like math and science.

[3:19] And I thought I’d probably go to the Wharton School of Business or,
or something like that or maybe go to become a patent leather attorney what and I that was a question of mine when I when I looked at your bio your BS
you were actually an honors graduate in chemistry and biomedical engineering,
and looking at that it does I wouldn’t have guessed that you would be on your way to becoming an expert at mindfulness and psychology,
but what was there any interest in those more humanistic Endeavors at that time or not.

[3:58] Yeah I mean you know thinking back so first of all in college they’re definitely where I almost got a minor in philosophy.
So I took a bunch of philosophy classes at Carnegie Mellon.
That’s really interesting and really enjoyed them you know it’s very one-dimensional engineering curriculum and.
Leaves very little space for any outside Endeavors but I had three or four philosophy classes which I really enjoyed.
And you know thinking back to my childhood we would visit India to see my grandparents every three or four years and I remember
you know looking at books when I was probably 9 or 10 or 12 in these bookstores and out had naturally gravitate towards books from this guy J krishnamurti who is a,
pretty famous Indian philosopher and you know I’ve always kind of gravitated to books to that help us explain how to live better sure and so I think that that’s always been kind of there,
inside me so what was the next step when you had when you got that BS in your hand.
Well I realized that I didn’t want to make money just for the sake of making money and the biomedical engineering
side kind of exposed me to you know the human body and and so I decided to apply to med school and that happened fairly quickly.

[5:23] Yeah I mean I was a little late I had to take a year off I worked as an engineer and studied for my mcats that year but what was that like what was it like being an engineer.
I was not too bad it was it was not too bad because I knew I wasn’t going to do it for the rest of my life let’s put it that way I see.
I mean I was in like these you know
steel treatment plants in the middle of Kentucky and you know setting up their chemistry labs and stuff so you know for a 22 year-old you know making a little bit of money and traveling that’s pretty exciting
but do you know I I knew I made the right decision not to work as an engineer for the rest of my life for sure I.
And so the next step was medical school at NYU and when you got there did you feel immediately like you were where you belong.
Not quite because I had started dating my now wife back during that year I took off.
She was working in Pittsburgh and I had.

[6:26] Significant kind of doubts about whether I should have been at the University of Pittsburgh medical school versus NYU but I just you know I apply applied and I entered NYU because it was just a better right medical school and I wanted to,
live somewhere else for a little bit so I had a little little growing pains in New York City for a while but.
Very happy that I went to NYU made some great friends had awesome training July go to York.

[6:56] I love New York and I think everybody could do well having a short stint living in New York because you’re not that you’re that you’re not afraid to come back and
explore the city and you know it really is a great place to visit especially really is how to navigate it.
If I were going to relive my life I would I would probably try to spend a little of my youth and that City because it’s really a great place to be but the academic.
Approach to medicine as in contrast to what you previously experienced and chemistry and biomedical engineering was that was there any dissonance there or what sort of effect did you feel.
Yeah it was totally different I mean engineering was all about you know we had open books it was just all about problem solving medicine was just,
you know to me was just rote memorization in med school you know until obviously you got to the advanced clinical years and then you started seeing patients and try to figure figure out diagnosis and stuff.

[8:01] For the most part the education was was totally different than what I was used to and then.
You know it took a few months to and several tests to figure out that you know I really needed to.
Retool things I couldn’t just simply understand Concepts but I really needed to,
memorize to a very detailed level and at what point did you begin to feel like Radiology was going to be your eventual specialty.
I took a rotation NYU is a pretty much of a Powerhouse in Radiology still is.

[8:35] Did a rotation of the third year and you know I saw all these Physicians from every specialty come in and get their answers from from the radiologist and.

[8:47] You know they were involved in the care of basically virtually everybody in the hospital or from every specialty
and so I thought that was really cool and I obviously is an engineer I love the
the high-tech stuff the machines the Sierra Nevada is MRIs and and did some early stuff and Interventional Radiology and pet scanning and did some research in that.
So you so you went ahead with the decision to go into Radiology did you have
any feelings at that point about what the long-term would look like would it be private practice would it be Academia or were you just taking it one day at a time,
yeah I didn’t really think too much about that back then I just kind of wanted to match into a good residency and and pit had another was another.
Big Powerhouse Radiology especially the kind of the fathers of body CT so liver Imaging and.
Belly Imaging both two of the three big ones were at Pitt as chairman and vice-chairman so I applied.
They’re obviously I wanted to return to pit to because that’s where my.
Fiance was at that time and so that’s what happened and it’s been it was a great great experience I did Internship for years of residency and then body fellowship at Pitt.

[10:13] And so when you were finished with your training what was the next step for you the chairman was trying to get me to stay on a pet as faculty.
And there was a private
group that was kind of Quasi academic that had a radiology residency across town here and the head of that group was actually the president of the American College of radiology so who is a bigwig.
And he contacted me so I went and interviewed and I figured I could always come back to pit if I wanted to but it’s hard to leave the institution.

[10:47] That you trained at once you once you stay there and so I figured I’d give it a shot and I’m happy I did I was with that practice for.
But nine years teaching residents learning how Private Practice groups work how in insurance reimbursement works.
And I kind of shifted the focus from.
The content in research of radiology more towards the business side of medicine and Radiology during that time period mhm what kind of.
Did that have on your general Outlook about where,
medicine in the u.s. is headed as you began to get more familiar with the financial structure that holds it up firstly I was fairly dismayed that I hadn’t learned any of this stuff.
In med school really had no knowledge of any of this and then the key drivers that make you know.

[11:46] Doctor’s practice is successful and so that was an eye-opening experience and then I realized that I needed to get
not just me but Physicians needed to get better at becoming well-versed in the financial and business aspects of medicine otherwise we were just going to basically become commodity Factory workers
which in a lot of cases that’s what we become
well as that that was going to be my next question and it certainly seems that way to me and people that have conversed with me on this subject before have
heard me say many times that the instant that a physician begins to work for anybody other than the patient it’s a bad thing for the patient
yeah was that was that you’re feeling as well or am I just being too Pollyanna here no I mean I think that’s that’s an ideal that we all have to that we all should be held to.

[12:39] And I think that’s that’s true
I think there have always been probably some incentives that aren’t aligned with patients even in the olden days would private practice and and fee-for-service and and all of that stuff but I think it’s
it’s become much more flagrant that the bottom line is the bottom line and you mentioned that
you had a moment of sort of why didn’t somebody tell this to me before as you begin to learn about the business of medicine how do you think we should be making unmistakable efforts
toward educating not just medical students but the residents on exactly
how medical economics works yeah absolutely I think I think that they should have a 6-month mini MBA or Executive MBA or whatever is part of medical school so everybody comes out with the same level of
business Acumen that the mbas come out with because you know they can’t learn to do what we can do but we can easily learn to do what they can do
good point and that’s that’s the problem and that’s part of you know when we can get into why i convened a
group of experts physician experts to create the course that we wish we had a medical school that was the that was a big.

[14:01] Part of the reason for doing that is because I want to keep good people in medicine but I want to give them the tools to really be able to practice at a high level.

[14:10] And successfully and so financial literacy and business principles is that those are big big parts of it that we have to become more expert in other things along
those lines that I have found most intimidating is that in that world of.

[14:29] Economics there is a completely different language that’s spoken and it can be at least to me very intimidating and it can make a person feel as if Will G there’s there’s no way for me to participate even in this conversation.
Did you ever feel that way or do you think a lot of other people feel that way
think about the language of medicine think about the words that we take for granted you know that that’s far more extensive than the business language that the business people use you know so.
I learned all this stuff because I joined a private Radiology startup app as my second job I was recruited by another radiologist to head up clinical operations there and I’ve managed a group of 100 radiologist and.
Wow brother helped grow the business from to hospitals to 40 plus hospitals over a span of you know nine years or so.
But during that time I interacted myself and the chief medical officer.
Interacted very closely with the CEO and the CFO of the on the business side of the practice.

[15:33] And you know there’s not it’s not that hard I mean it just takes a little bit of time I took a couple of courses,
from the American college physician Executives on like Financial decision-making and then there’s some other stuff on just financial terms learning what ibadah means you know key performance indicators of a business all these things.
But it’s not that hard it’s much easier for us to do that and you clearly became a really
important person in your Radiology Group that sounds like and and and very successfully it appears that was fairly satisfying because it was something you know I’m probably like yourself and other Physicians,
listening we’re kind of constant Learners and curious people and and so learning this whole new side of medicine and radiology and you know I learned about private equity and you know met with,
hi I’m Rhonda Crow founder and CEO Forum D coaches here on RX for Success we interview a lot of great medical professionals on how they grew their careers
how they overcame challenges and how they handle day-to-day work I really hope you’re getting a lot of great information.

[16:59] But if you’re looking for an answer to a specific problem management or Administration challenge.
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 now it’s not counseling it’s coaching.
RX for success is produced by MD coaches a team of Physicians who have been where you are I know you’re used to going it alone.
But you don’t have to get the support you need today visit us at my MD coaches.com to schedule your complimentary consultation.
Again that’s my MD coaches.com because you’re not in this alone.

[17:43] We’ll get back to our interview in just a moment but right now I want to tell you a little bit about physician Outlook
if you haven’t discovered this remarkable magazine please do so very soon it was created by physicians for Physicians to showcase the intersection between clinical and non-clinical interests whether it’s writing
painting cooking politics and dozens of other topics physician Outlook gives a physician perspective
it’s available online and in print it’s really unique among physician lifestyle magazines and like the prescription for Success podcast
physician Outlook amplifies the voice of any physician who has something to say it also engages patients who still believe in physician-led
team-based care and prescription for Success listeners can get 3 months free when you enter our promo code.
RX for success and select the monthly option at checkout that’s a really great deal on this stunning publication.

[18:46] And now let’s get back to today’s interview and so the next very interesting thing
that comes along in your Evolution at least it’s very interesting to me here you are you are very well educated and competent and a highly technical specialty and then you become very well educated and very effective
in the understanding and the execution of medical economics and
the next step for you is you wanted to become involved in positive psychology and I’m interested to know when that idea occurred to you and the why of it as well
that was kind of an unexpected twist you know when I was working as a physician executive I would visit a lot of these hospitals in various States and I met with like the physician leadership
what I began to notice this is probably I don’t know 2011-2012 was a it was a growing discontent among most of the Physicians that I that I encountered back then it didn’t matter what specialty they were
and
they just seemed unhappy and then you know I looked around at my own group and you know and I remember driving home one day from one of these hospitals and I you know wondering to myself.

[20:02] Why I wasn’t happier and it’s not that I was unhappy I mean I had achieved pretty much everything I had set out to do in life you know I was married to my best friend we have for healthy
kids both sets of parents are alive
you know so I began to really worry to myself that if I couldn’t figure out how to experience more joy and more meaning when things were this good how was I ever going to deal with any real adversity when you know I knew would inevitably come
which by the way it has since then that’s when I really decided to shift Focus because I realized that all these things that I had achieved didn’t provide lasting fulfillment and I need to understand why
so I began to study philosophy psychology and organizational leadership and various things and I stumbled upon a book by.

[20:51] This guy tal ben-shahar who’s a Harvard psychologist called happier
and I reached out to him and told him what a great book it was and asked him where I could learn more and he invited me to apply to this positive psychology certification two-year program that he was running and that’s
basically the start of my entry into positive psychology that’s very insightful.
At that particular stage of your career and as you say having night faced any serious adversity at that point in your life you already felt the need to be,
prepared for it you have any idea what it was in your life that put you in a position to have that realization
I mean I think I’ve always been interested in how life works and how to live kind of a optimal life
but you know I don’t know that I use the those kind of words but I was always trying to figure out why things happen the way they happen why I acted certain ways.
You know I remember reading books in high school called you know I mean I read.

[21:56] I’m okay you’re okay I read power of positive thinking I read Dale Carnegie’s classic books I mean so these were kind of natural inclinations of interest of mine do you think.
Dad your exposure to Eastern thinking and Eastern philosophy may have put you in a better position to
come to that realization perhaps I mean I think that you know East is always been much more focused on inner
development largely to the expense of Pinot outward material gains.

[22:32] And the West is probably just the reverse so I think
yeah my natural inclination is more towards the east my early exposures is is from that side and so armed with that amplification of your Insight about
mindfulness what was the next step for you I mean did you wake up one morning and say it’s time to write a book or probably wasn’t that simple where did you take it from there
yeah I mean I completed the certification program I also did positive psychology coaching and you know I continue to practice.

[23:06] At the
private startup till about 2017 and then we had some leadership change on the business side and it became fairly antagonistic to Physicians and
which I wanted no part of because I was only there as long as it was good for Physicians like if I could tell a radiologist that I was recruiting that this is a good place for you to work
and I’m going to ask you again in a year and you’re going to tell me yeah you were right and that’s what everybody told me
but when we have leadership changes I couldn’t I couldn’t say that anymore so I left and wasn’t really sure what to do but I wanted to write,
some of the realizations that I had experienced over the over my life but particularly over the last you know eight to 10 years for my kids and so
the book idea was really just a continuation of the final project that I had in the certification program I want to write something that I wish I had read when I was you know 20 years ago and I wish my kids could read if I’m not around
yeah that’s the first line of your introduction and I’m.

[24:11] I can tell you I absolutely cannot wait to read the rest of your book but the introduction by itself is is very impressive.

[24:21] It’s called positive philosophy ancient and modern wisdom to create a flourishing life if you are asked to describe what someone might learn from your book and 60 seconds what would you say.
Positive philosophy is basically taking the best of philosophy
which I think are the goals of philosophy of learning how to live better I think that’s the goal of philosophy the problem with philosophy is that it’s been
it’s just a bunch of guys opinions with no with no kind of evidence-based proof of anything that actually works and I took the goals of philosophy with the more evidence-based.
Research findings of psychology are really positive psychology and combined them into a framework for optimal living
Pino I think positive psychology has some decent science behind some of its findings but it’s often mixed in with the pop
psychology or self-help movement with platitudes and things that just have no basis in reality and so I wanted to take the best of positive psychology which is evidence based research findings.
Were the original goals of philosophy which is how to live better and combine them.
And discard basically everything else from both sides can you talk about a few maybe two or three or four of those key points.

[25:43] In a more grounded life that that you get from the ancient philosophers
well the stoics backed over 2,000 years ago believe that we should be indifferent to our external circumstances as they relate to happiness.
Because they eventually don’t.

[26:03] Make that much of a difference over time so what they what they focused on what Aristotle focuses on and Socrates and all those and all the
the Western philosophers is character development and virtue basically you live you develop excellence in character or what they call virtue and that is the key to living a good life
and don’t worry about anything else positive psychology
study that same process is called hedonic adaptation which basically means we adapt everything in our life that’s constant and this is an evolutionary wiring
and so every stage of our life
getting into med school was so awesome but it quickly became your new Baseline right finishing residency and becoming an attending and making a you know much more money was was great at first,
but then you got used to it your lifestyle expanded and it became your new Baseline.

[26:56] That’s hedonic adaptation basically we will eventually take for granted everything in our life that’s constant that’s an evolutionary trap of our minds and evolutionary protective mechanism because if we couldn’t adapt,
or get used to things in our life and our surroundings that are constant we wouldn’t be able to recognize new stimuli or potential threats.
From old ones that should really just fade into the background the problem for us Randy is that the things that fade into the background of our lives are the very things that make life worth living.

[27:30] Are our health our impactful jobs for patients our families our kids.

[27:38] All of these things are are just taken for granted and I’m speaking strictly from personal experience first and then from working with lots of Physicians over the years that’s the human default condition,
that’s what that’s one
kind of big one that I talked about in the book and then there’s some antidotes to that that I get into but basically forcing ourselves to pay attention to the to the things in our life while they’re still around is how we remember them
and how we how we stopped taking for granted and that’s the power of you know there’s a lot of talk now about gratitude journaling
cultivation of gratitude that’s why gratitude works because it’s an effective antidote to hedonic adaptation you’re actually involved as I understand it currently and some research
in the area of effectiveness of positive psychology I have to tell you for
sort of a black-and-white surgical type of mentality like I have I have a hard time understanding how you study that and what you might have learned can you
enlighten me a little bit it’s definitely a soft science so you know it’s not.
Weren’t there’s no bench researchers know you know randomized controlled trials and and stuff like that I mean,
the way to tell if something works or not or the effectiveness of a positive psychology intervention is to use statistically validated questionnaires that are basically self-reported.

[29:06] Right so right there there’s some room for interpretation and stuff but you know there are there are a few
interventions that when studied and that that have been replicated in multiple
populations in multiple locations across different cultures of the world and you know putting together
a program that just takes the best interventions the the fewest that are needed but to give you the biggest bang for the buck is what
what I’m studying you know along with a few other people in across the country.

[29:42] Together to just figure out what’s the most effective for Physicians well sand it certainly sounds like you’re in a position to
have a fairly profound impact on this thing that we like to call physician burnout
and you know this is something that I think most of us agree is the real thing but what’s behind it what causes it and how to deal with it I don’t think has really been elucidated particularly well at all
but it sounds to me like you’re probably right on top of it.
First of all would you agree with that assumption well I mean I don’t know if I’m right on top of it but I I’m certainly very interested in understanding it and and,
I really don’t even use the word burn out because I think Physicians and I think people in general.
Deserve much more than just the absence of burnout I was very impressed that that terminology was absent from any anything that I’ve seen of your writings or your conversations but go ahead I apologize for the interruption yeah.

[30:46] So yeah I mean I think you know the absence of burnout does not equal wellness and that’s something that we you know
hi I try to drive home because you know we’ve worked really hard and a lot of people are in the cross different fields work really hard and I think we all deserve to do more than just function to,
get through the day look forward to the weekend or our next vacation you know we deserve to have a life.
Of joy of meaning of purpose of enthusiasm and so to me the absence of burnout is very low hanging bar
I think if we can figure out how to move people towards flourishing we’re going to move those people away from burnout as a natural side effect that’s a very optimistic way to look at it
and I’ll tell you I I really do make an effort not to personalize these interviews too much but people who listen to the podcast too.
Heard me say that for nearly four decades in my practice I never experienced anything that felt like burnout in fact I couldn’t wait to get to work the next day and where it changed for me was as I approached retirement
I entered into a relationship.
With the hospital where I was I was subject to their control the
they were running a business as they saw it and they were exerting a level of control on me that I felt to be invasive and intolerant.

[32:16] Of or at least an unwillingness to hear my side of the story.
Which was at least to my way of thinking to be there for the patient and it was at that point that I really became to be
massively disappointed,
and that was when I decided to get out of it looking back on it I wish I had had the presence of mind to
understand what was actually happening and maybe even to read your book that might have saved me at that point but but nevertheless I’m doing something now that I feel is a substantial contribution.

[32:53] But my point in that rambling was.
Was simply to say that you know a lot of people think that burnout has always been there and I don’t think it has I think it’s a new phenomenon and I think it has something to do with the new relationship where we.
We’re Physicians work for a company and.

[33:12] Not for the patient do you think that could possibly be true there’s no question I mean it’s just emic factors and the
changing culture of medicine is a huge part of it and that’s why Financial Independence and the ability to work on your own terms.
Is something that has to be taught at an early stage of our careers because there are five to ten.

[33:36] Key financial principles and five to ten common Financial mistakes that young Physicians make.

[33:42] And there’s they’re very common and.
To basically organize those and say Here’s what to do here’s what not to do and by doing this over your career you’re going to have more ability to call your own shots so in the example you provided.
You are fortunate because you were you know you had that and you could just walk away but if there’s a young physician that’s just starting out in that environment that they’re not going to have the 40 plus years of great practice that you had they’re just going to have misery.
From day one and so I think financial literacy and Independence is key because you can you can then say well I’m not going to do that
I’m going to go somewhere else from going to do something else
and then also being able to evolve on the business side of things if that’s your natural inclination to be able to have more physicians in leadership positions to be able to counter simply the bean counters that’s another.
Avenue away from that.

[34:43] Systemic factors are huge and they’re not going to go away by mindfulness classes and resilience modules given a Physicians.
I mean to wear where the most resilient people out there.
We don’t need we don’t need more resilience training well I have really enjoyed having this conversation with you sanj.
You’re remarkably insightful and I think you’re providing a tremendous service for.
The Physicians the new Physicians that are about to enter our world and will be taken care of us as we get older.
And I appreciate you taking the time to be with me today we are at the point in the program that I actually enjoy the most and that’s where I get out of the way and I’m going to close my mic and listen quietly
as dr. Sands qatal gives us his personal prescriptions for Success okay thanks Randy I decided to write a letter to my younger self so
here it is you have a life of achievement ahead of you you are highly motivated and hardworking you will find much success out in the world.

[35:50] Right now you feel incomplete you’re searching for that next level in life to be able to finally relax and be happy.
You want to advance in your career you want to make more money you want to start a family you want to have some fun all the important aspects of life.
Here’s a realization that it took me 50 years to understand what you’re looking for will not be found in your bank account your job title or your accolades.

[36:15] You are looking for lasting satisfaction in a place that can never provide lasting satisfaction let me explain.

[36:22] Everything that you do will be an attempt to feel better because most of the time you were filled with varying degrees of discontent.
There’s always something that seems a little off one final piece out there that is forever missing relax is not just you this the default state of most.

[36:39] The reason you’re trapped in this state of what I called visceral discontent is because you’re trying to find fulfillment through your mind which by its very nature cannot be fulfilled.

[36:49] You see at the most basic level the brainstem and limbic system our concern with autonomic function and hostile environments.
The Mind adapted to constantly search for threats and opportunities in the wild.
Watch how a dog behaves constantly on the lookout for drop food or opportunities and strangers threats.

[37:08] But as we evolved as a society the mine drew the prefrontal cortex to be able to effectively deal with these societal interactions.

[37:15] The mind is created this I Persona or identity that you see when you look in the mirror.
We call this ego not in the sense of bravado but as this manufactured self this ego is still the mind and only concerned with survival.

[37:30] This ego still constantly searches for threats and opportunities it can never fully rest because resting with threatened it’s very survival.
The mind or ego will never be saturated no matter what you achieve out there in the world and this is why we take for granted stimuli in our lives that are.
Which is hedonic adaptation as we become enamored and focused on new stimuli this hedonic treadmill Keeps Us locked firmly in the future chasing the next level.
Remember the thrill of getting into medical school which is quickly replaced by the stress of matching a no-good residency.

[38:03] For the excitement of making Partners quickly replaced by dreams of.
Yeah the mind is clever it keeps us toiling away looking forward to the fruits of our labor but in the end of fruit is not as sweet or as lasting as we thought it would be.
And this is the truth the mind is not care about her peace happiness or contend it only can cares about survival.

[38:25] He cares about building up your ego making your manufactured self strong and always looking to the Future to make sure it’s still around but deep inside.
Our core being our unique potential remains unexpressed and held hostage by this protective shell of our mind.
And the tension between our core beings unfulfilled potential.
At our minds demand for survival is while we often feel irritable anxious depressed and discontent.
We look for a relief from this pain no matter how brief.
And we Chase various forms of pleasure money titles alcohol distractions all in an attempt to feel better.
This Insight allows us to finally understand the futility of this Chase all chases only lead to more chases.
Nothing in the world lasts and all pleasures fade eventually either the unfortunate event is replaced by an unfortunate one,
or we adapt to it and eventually take it for granted with inner exploration and understanding you can stop searching for satisfaction out in the world.
You can move beyond the emotional rollercoaster of Stress and Anxiety to access a deeper level of flourishing through the realization and fulfillment of your unique potential.

[39:39] So search in word and discover your true core being understand the patterns and they kleshas of your mind.

[39:46] Most of the self-help movement is concerned with Downstream techniques to modify Behavior.

[39:51] Go Upstream to The Source watch your thoughts and emotions as they cause desires within you.
Understand them and most importantly know that you are separate from them you are not your mind.
You’re a Divine core being with unique potential ready to be fulfilled this is your only true search in life and those are my prescriptions for success and dr. Sanjay Patel we.

[40:14] We are blessed to have had the opportunity to converse with you today and we appreciate you sharing your wisdom with us
before you go I want to give you an opportunity to tell our audience where they can find you and you can tell us anything that you would like for us to.
For and it can be websites or email addresses or where to find your book or anything that you like what do you have for us
well I’ve collaborated with four other Physicians to try to create a course that we wish we had met School in the Genesis of this is really I got tired of
all of these businesses out there trying to help Physicians leave medicine and I wanted to do something to keep good people in a good profession.
And so all of us are practicing Physicians we have noticed no interest in retiring we have no interest in leaving medicine we don’t run this course or create this course as a profitable side gig we do it out of our passion
but it’s basically a course called Thrive RX which is a practical guide to flourishing for Physicians by physicians and you can find more on that course at.
Positive Dash medicine.com which is my website and you know check it out it’s seven and a half CM e hours.
And it’s priced just to cover CME it’s really just our our attempt to give back to the profession it’s been so good for all of us.

[41:40] And it’s focuses on personal well-being professional fulfillment and financial Independence all three pillars.
Which are I think very important for Physicians to.
To create a flourishing life in medicine and the title of your book again book is positive philosophy ancient and modern wisdom to create a flourishing life that’s on Amazon,
it’s on Amazon both in print and through Kendall I think.

[42:09] Yes and I have read the introductory pages and it looks like it’s a great work so.
I’m looking forward to getting into that can’t with that dr. Sands qatal thank you so much for being with us today it’s been a lot of fun thank you Randy my pleasure.
Thank you so much for listening today remember.
You can get more information about our guests as well as hear them face my rapid fire questions at our patreon site.
And while you’re there you can also subscribe to the podcast give us a rating and Hope.

[42:42] Offer suggestions on what you’d like to hear in future episodes thanks very much also to Ryan Jones who composed and performs our theme music.

[42:52] That’s all we have for now so please be sure and fill your prescription for success with my next episode.

[43:00] Music.

%d bloggers like this: