110305 Finding Joy Again in Academic Medicine Through a Career Pivot FINAL
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[00:00:00] I don't know. Glasses. No glasses, I can't tell. But this is Stacey Ishman, and today I wanna talk about finding joy again in academic medicine through a career pivot. And this is my story. So several years ago I stepped away from medicine for 18 months to build a utilization management program at a children's hospital.
It was a major change, and instead of treating one patient at a time, I really wanted to have an impact at a broader level. I wanted to be able to create systems that could make health better for lots and lots of kids. And at the same time, I wanted to learn leadership skills that I didn't think I would learn in the operating room or in the clinical space where I was already functioning.
But here's what surprised me. The thing that I missed the most was not only the patients, but really it was the trainees. It was coaching and mentoring and sponsoring them. It was the young physicians that I worked with who were just starting their careers, and I could really help give them some tips that would help [00:01:00] launch them.
And that daily rhythm of teaching and encouraging and helping the next generation was what gave me energy. So when I went back to clinical work after 18 months, I carried both perspectives with me. I had that broader system level view, which I really enjoyed, and I really did feel like I was giving an impact to the kids and the members who I was taking care of.
And a renewed appreciation for the day-to-day interactions that made academic medicine meaningful. Now, while this matters for faculty is if you're a faculty member, you may recognize some of these feelings. Your days are filled with clinic and cases, but you can't get time to finish a manuscript or prepare a grant.
And that administrative work seems to be piling up even if it's electronic and not in a pile, and you begin to wonder how you're really contributing. Now you may be doing service work, but it doesn't always match up with your interests. You may be on the promotions committee, but what you really wanna be on the curriculum committee, and you may feel stretched, many of us feel stretched, is you try and get both your professional life and your personal life in order and somehow to [00:02:00] integrate or match up.
So the real truth, however, is you don't need to leave academic medicine for 18 months in order to reconnect with your purpose. There are small shifts that can help make a big difference. One of them is that I had a colleague who just shifted her clinic time. She realized she didn't need as many clinic spots.
She actually had an OR that was full for six months. What she could do is take that time where she wasn't doing her academic work. Use it. So she had taken all of her academic time and she'd turned it into clinical time. She said yes to every add-on case. She said yes to add-on clinics and maybe some committee meetings here or there.
And what really ended up happening was her academic output had dwindled to almost nothing. She was so backed up in clinical work that she couldn't possibly see everybody in the next six months and she didn't feel like she was getting things done. So all she had to do, and it took a few months, to be honest, 'cause she had all those things scheduled.
Was just take back the administrative time that she had already been given and actually use it to be able to enjoy what she was doing. ~I do realize I said be able, in any case, she was able so. ~The next thing I [00:03:00] wanna talk about is somebody that I worked with who really was thinking about blocking out a mentor hour on her calendar.
She wanted to meet with residents. She wanted to meet with her fellows. She wanted to be able to give them that time, and it was something that gave back to her. She really found it valuable and I completely relate to this. And so all she had to do, instead of taking some huge amount of time. She took 45 minutes at the end of the day, I think it was a Thursday, so that she could quickly find some time.
And everybody knew when they could count on her or come to her or ask questions, and it became the most energizing part of her week. And there's oftentimes others who will really be looking at what they wanna start at the beginning of their career. And I encourage them to envision their ideal career and then set it up.
Many of us didn't do that. We started and we, you know, got busy and all of a sudden we realized ~the, ~what our calendar looked like didn't align with what our priorities looked like. And that's the opportunity to go back, do a time audit and figure out if there is any incongruity between the two. Now, sometimes the answer's a larger shift.[00:04:00]
I know somebody who took a big education leadership role after being a surgeon for many years and they really enjoyed it. They became a residency director in the last third of their career and it re their work around mentorship and curriculum development, things that they really enjoyed, ~but they hadn't given themselves to do that given them, I know a surgeon who stepped into an education leadership role as a residency director and they re their work around mentorship and curriculum design.~
But they hadn't given themselves the time for that decade prior, and they felt like things had gotten out of balance. They'd lost this opportunity, and this really helped them recenter to their values and really align their work. There are also times when researchers. May transition from what looks like basic science or translational research to something else.
It might be outcomes, it might be qualitative research. It could be clinical outcomes. You know, whatever really floats your boat. And it may be that you continue to be a grant funded researcher and you shift into a different area. It may be that that stage of your life changes as you move into administrative roles or leadership roles, and those are very natural pivots.
The last is a clinician I worked with who took on a leadership role within the hospital and really leaned into some of the things that they [00:05:00] hadn't been able to learn before, including the finance and the policy and the quality initiatives that hadn't been in the purview of their job previously. They had a lot of groundwork that had made them perfect for these roles going on, and in each of those pivots, the faculty members were given the space to reconnect with what they valued most.
And the key to that is they took the time to figure out their values. Now, why does this matter at the department level? If you're a chair, do you really want your people to pivot? Yeah, you do. And the reason for that is not just individual fulfillment, which by itself is a fantastic thing, but also it helps the department thrive.
There's a lot of really great data that physician turnover costs are extremely expensive. Anywhere from 500 to a million dollars, or at least ~three times, ~two to three times a physician's salary. And so that accounts for onboarding and recruiting and lost revenue and all of those things. But if you do these kinds of coaching activities and help people align their values, you are much less likely to see burnout and much more likely to retain your [00:06:00] faculty while saving money and stabilizing your team.
It also helps your reputation. When faculty are supported in aligning their work with their passions, they become more visible and they become more productive. And so oftentimes you'll see that they're taking their scholarship on the road, they're speaking at meetings, they're publishing. It's obvious, and it's great for your department because that visibility is good for departments across the board.
The other thing that's really important is culture. So coaching fosters a culture of resilience and mentorship and collaboration. In one department I work with. These group coaching sessions actually improved cross generational communication, helped some senior faculty, really mentors some junior colleagues much more effectively and really helped close that understanding gap that was happening.
And if you have a really great culture in your department, it really does help attract new, exciting young members, whether they're those you've trained or those coming from the outside. The other thing that happens is promotion. Is much more easily seen if you have joy in what you're doing. And oftentimes you can find your purpose, you can find your [00:07:00] story, you can tell me I was doing this.
~And it led to that. And this led to this. ~That clear documented story is what actually helps you get promoted and your enthusiasm around it makes everybody want to invite you to give the talk or be on the panel or sit on the committee. 'cause we all love working with those people who clearly have a joy for what they're doing.
So in short, when faculty thrive, the department thrives. Now my pivot into utilization management did not take me out of academic medicine. It reminded me what I loved about it and helped me come back to work with faculty and with residents so that I could really help move the needle forward. And your career can evolve too.
Sometimes you just need support to pivot, whether small or large. Now I wanna give you just a few quick facts that I want you to remember, and that's ~that turnover costs two to three times a faculty member salary. So if you're worried about burnout, take the time and get back to ~that. Turnover costs two to three times a faculty member's salary.
So if you're worried about burnout, this is something to keep in mind. Take care of people so that you don't lose them. The other thing is that coaching interventions do reduce burnout and improve professional fulfillment and [00:08:00] faculty who feel supported or more likely to be promoted to stay longer and to bring national recognition to your institution and your department.
But more importantly, they enjoy their job more. So my call to action is to think about departmental coaching and finding the joy. Again, find the pivot. Figure out if it's internal, if it's small, if it's large. But oftentimes you can do small things that really can make your day so much better, whether it's time management techniques or clarifying your vision and making sure what you do aligns with them.
Build promotion pathways that are achievable and strengthening the department culture are all things that we talk
about in the Faculty Excellence and Retention Initiative that my group has put together. When departments invest in coaching, everyone rises together. Thanks so much. I hope you find some joy in your every day.
If you need any help trying to figure out what to do, please drop me a line or DM me and please subscribe or follow this podcast whether you're watching it on YouTube or on a podcast app, and please get in touch if there's anything we can do to help. I look forward to talking to you next week.
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