Dike Drummond, MD- How to Stop Physician Burnout

Check out Dike Drummond’s interview! As a matter of fact, this is the very first podcast episode that I ever recorded.

Dike is an amazing guy and I know you’ll love the interview. Please forgive the audio quality as I called in on my cell phone- I sound like crud, but Dike sounds clear.

Anyhow, what’s so great about this episode- Dike is on a mission STOP the downward spiral of physician burnout with field tested, doctor approved techniques discovered through thousands of hours of one on one coaching with physicians facing career threatening burnout.

He is a Mayo trained family doctor, executive coach, speaker and consultant on burnout prevention for physicians in all specialties. He is CEO of TheHappyMD.com – where you can find the tools so YOU can be a Happy MD. His online community of over 4000 physicians from 63 different countries has allowed him to create and test the lessons in the real world of practicing doctors in this rapidly changing healthcare environment.

This interview reveals the following:

– The top indicator of physician burnout and what your family can do to help

– How to deal with the head trash of your inner critic

– How doctors can transition to create new income streams and have less stress

Enjoy and let me know if you like this throwback episode! I’m planning on having one or two come out every single week for the next month.

Transcription

Physician Burnout Interview with Dr. Dike Drummond, MD

DAVE: My name is Dave Denniston, welcome to a very special interview today on Physician Burnout. Well I have the pleasure of being at the Minnesota Medical Association Conference a couple of months ago and here the speaker, Dr. Dike Drummond.

Dike had some incredible advice at the conference and that would be great to pass on to you. You’re talking about this love-hate relationship a lot of docs have with their jobs. You love the patient, you love helping others and you love the money that comes with it but at the same time you might be wondering “yeah sure not keep going for this much longer” or maybe you’re saying “there is no one I can talk to about this, no one who can understand what I’m going through” or maybe even “this is crazy, am I crazy?” Well Dike is on this mission to stop the downward spiral of physician burnout with some spilled tested doctor technique discovered through thousands of hours of one on one coaching with physicians they think career threatening burnout. He is a male trained doc, he is an executive coach, speaker and a consultant on burnout, non-burnout prevention for physician an all specialty. He is the CEO of the HappyMD.com where you can find tools so you can also be a happy MD. He has a great online community that has four thousand doc from over sixty three different countries. It allows him to create and test these lessons every day for practicing docs where they have this crazy rapidly changing healthcare environment. In addition to all of this, he has articles all over the place, KevinMD, the Huntington post, doctorsweighsin.com. In addition he has been speaking a lot lately at Chicer MD Anderson McKinson, Us Oncology, the group practice and so on and so on and so on, it goes on forever. He also had a new book that he just finished, that he let me checked out called Stop Physician Burnout: What to Do When Working Harder is Not Working. Well welcome Dike.

DR. DIKE: Hey Dave thanks for having me, it’s a pleasure to be here.

DAVE: I’m so glad to have you here, I think you have so much good advice that we can pass on to docs, my client and other people out there. Let’s kick this one off. Tell us a bit about yourself. Well you’re an MD and then you took this focus on physician burnout, how do you get going on this?

DR. DIKE: Well the basic reason is that I burned out on my practice back in 1999 when I was forty years old. So the whole story is that I trained at Male and then I did residency in California and I moved up to the city of Washington in a little town called Mt. Vernon that is about halfway between Seattle and Vancouver BC and joined a forty doctor multi-specialty group and within a year I was the chairman of their executive committee and I was there manager medical director back in the days decapitation. In 1999 when I turned forty for some strange reason I couldn’t figure out for years, over about six weeks all the joy went out of my practice and instead of being excited by my patients and the work I was doing, I actually felt when I come into the office like my life was being drained out of me. I took it as a battle thinking I just needed my batteries recharged but after a month off when I didn’t do anything work related, within three hours I knew that it was not going to work and I actually put in my notice that first day back and walked away from my medical career. Then I became certified in Interactive Guided Imagery having this alternative medicine practice and get certified as a coach, coaching docs and entrepreneurs. And then my now ex-wife and I developed a successful business, teach and leadership facilitation The Lean Six Sigma Black belt in the United States Navy. Then that marriage came to an end about three years ago when I was burned to the group all over again, so I decided to look back at the people who were burned out like I was back in 1999 and I looked on Google and the only thing that you can see was prevalent studies. I thought that that was pretty depressing so I wrote an article about my experience of burnout, launched the happymd.com and it just been an exponential growth curve for us. This year I did twenty four speaking engagements, we’ve got almost five thousand people on the mailing list now and it turned out to be extremely rewarding for me helping docs all around the world. Basically you see the blind spots that get them stuck and burnout and end their career.

DAVE: It was so cool going through your book that you just got done and I really enjoyed it as a doc or not, I think one of the comparisons I thought was really intriguing that you went over about. You talked about that when we have stress there’s burnout, there’s a relationship between the two. Tell us a little bit about that. What’s there between stress and burnout?

DR. DIKE: Well for me it’s fairly simple, stress is something where your energy level may go up and down over the course of a week or a month, its variable depending on what has happened at work and what’s happening in your larger life but burnout is when stress and your ability to recharge or not matched and your energy level starts to assume this downward spiral or you’re basically circling the drain. Sooner or later a doctor or anybody else who’s burned out, and by the way this information is useful for anybody in any career because the background burnout rate in normal population is twenty five percent. If you say to yourself “I’m not sure how much longer I can keep going like this” that’s a classic first early sign of burnout.

DAVE: One of these things, families you know decides “I can’t go anymore” what should people do and look out for?

DR. DIKE: Well one of the classics symptoms of burnout beside exhaustion is being cynical or sarcastic about the people that you’re supposed to be serving, its known as compassion fatigued. It’s certainly something that you heard doctors and nurses doing when they’re venting about patients and that’s an important one. There’s another symptom that is when you say “what’s the use? my work doesn’t really have any meaning” or you might actually say “I’m not sure I’m doing such a good job, I’m afraid I’m going to make a mistake” or when you come home and you simply can’t let go of worrying about and threading over the things that you left behind in the office, those are all really clear signs that you’re entering that downward spiral.

DAVE: One of the things we talked about a lot inside the medical community, outside of this, going outside of work to recharge your battery but I thought it was really cool what’s in the book, you talked about things that you can do within your work to recharge your battery. What are some things docs should be thinking about this?

DR. DIKE: Most of the time people are really simplistic, you think about “well I got drained at work and I need to recover at home”. So home is where recovery happens, but remember that most of us went into healthcare whether you’re a doctor, nurse, whatever, we went into healthcare to help other people and if you think back if you’re listening to this recording and you’re a doctor or nurse or PA or nurse practitioner, think back to the last really ideal patient encounter you had in the office, that one where you said to yourself “oh yeah that’s why I became a doctor” or you went home that night and you said to your spouse “honey, honey, honey sit down, I have to tell you what happened to me in the office today”. That ideal patient encounter is a marker for you having a connection in the office that is full of purpose. And if you think about that ideal patient encounter, think about what your energy did the rest of the day after that experience, I bet you money it was almost certainly higher. So you can actually recharge and get energetic input, you can get a jolt of energy from your practice when you have those ideal patient encounters. The challenge is this, most people practices the way they function, the way the patient flow through the practice actually gets in the way of that ideal patient encounter rather than funnelling these kinds of people to you.

DAVE: Yes I think that that is so true, I think especially if you want to treat as many people as possible, help as many people as possible, you’re thinking fifteen minutes, ten minutes, turned around to see different patients and there’s a lot of talk today about niches and ideal clients like you’re just talking about. I personally practice these two, for example my practice, my ideal client are physicians who wants to do financial mentor who are open minded, they’re open for advice, they care about paying the least amount of taxes they can, they want to be proactive about investments and much more. This is so much of the contrary of the way that many businesses think, it sounds like you think so too, so if you’re going to create this ideal life, having ideal patient, you talked about how doctors should develop a profile for their ideal patient, so outside of recharging their battery, what should docs be asking themselves as they go about this process?

DR. DIKE: Well and again what happens to a doctor is we go through at least seven years of training, we were focused on all the problems that our patients could potentially have, almost exclusively problem focused and so when a doctor thinks about their practice, they’re almost always thinking about the problems in the practice, the things that they want to change. What I noticed a long time ago is you can solve all your problems and you can still get what you want because what you want is something different, you have to actually focus on what you want, so I encourage doctors to write down an ideal practice description. So they’re writing down, if you have a magic wand and you could wave it what would your ideal practice day look like? Once you have that ideal practice description what you can do is build a VENN Diagram, I called it a VENN of Happiness, one circle is this job and the other circle is your ideal job and you can ask yourself right now, if that was a VENN diagram what’s the percentage of overlap between my current job and my ideal job? And in my experience about twenty five percent is somebody who is burned out, about eighty percent is somebody who’s really happy with their practice. And then you just ask yourself this question “If I was going to move these circles close together, if I was going to increase the overlap between this job and my ideal job, what would I change?” and most doctors can tell me “well I’d change A, B, C, D, E” they’ll make a list right away just like that and my job as a coach is to help them get on it. Grab one of those things and start making changes so they’re always aligning their current practice with their ideal practice.

DAVE: Well so much of what this can revolve around, people can get six, seven or eleven mail, so when you’re taking about happiness and what’s not that can be two different things, what do you think about that argument? You know because Jerry McGuire theme, remember that where he was there as an agent and besides take a lot of money they go and can’t keep his client, do you think something like that is more realistic or can you have it all? Higher revenue, less patient, charging more, that kind of thing.

DR. DIKE: Well if you’re going to accept insurance you’re going to accept the value exchange that they offer you. The only way to make more money if you’re in an insurance environment is to see more patients. But my experience is this, money is a piece of a happiness quality of life equation. It’s not the only thing. If you find that the only reason you’re still seeing patients is for the money, wow when you’re on your deathbed, is it really going to feel, are you going to be happy about the fact that you saw more patients and you did it just for the money? So when I talk to doctors who eventually quit a job, it’s never about the money, right? It’s always about other things. When I talk to doctors, even the most burned out ones they tell me they still love seeing patients, never had a doctor say he or she didn’t still like seeing patients. So when it comes to money it’s always a trade-off, you have to decide how hard you want to work, how much money you want to earn and where your happiness lies. if it turns out that you’re not getting a lot of joy in your office, you aren’t having an ideal patient encounters more frequently, you can increase the frequency of them if you work on it, the real question is how much do you want to work and how much time do you want to spend outside of your practice if that’s where most of your joy really comes from.

DAVE: How do you think that’s going about finding that ideal patient, we’ll see if you created a profile and you have that VEN Diagram and maybe twenty percent of your time is spent the way you want to, how do you go about getting yourself that ideal patient for having them come to you.

DR. DIKE: Well first you have to know who they are, right? Now we’re switching from my ideal practice to ideal patient. But as an entrepreneur I am always looking out for my ideal client, right? If I don’t know exquisitely, precisely who that is, I can’t begin to bring them to me more effectively. So for instance let’s just give an example, let’s say you’re a family doc and you’re forty five and see twenty five patients a day and what you find you really like working with is acne. You really love working with kids that have acne, and maybe its adults that have acne or maybe its rose asia and you work in a group of fifteen doctors, well you know not a lot of doctors like working with acne but that’s what you really love to do and you start telling your colleagues “hey I like working with acne patients, send them my way” all of a sudden you can have a lot more of your ideal client sitting in your day and be doing a lot more of the work that you really love doing rather than some of the stuff for instance like diabetes management that you might not enjoy as much as of the partners do. So you have to know who your ideal client is and then go looking for opportunities to attract them to you more effectively.

DAVE: So it can be pretty easy, setting up referrals with other physicians that didn’t like those kind of people but love what you do.

DR. DIKE: Yes and its sort of like an informal mini specialty, it’s not like you’re board certified as a dermatologist or anything, you just have some expertise and experience in acne management and you like doing it, other people don’t necessarily don’t like to do those things.

DAVE: Cool. Well we’re running out of time here and I wanted just to hit on a few more points. You have a whole chapter that is dedicated tossing out the head trash, I think there’s five of them in the book and one of them that you talked about that I can personally relate to is dealing with your inner critic and I think so many physicians, so many docs they are over achievers and I can relate to this, I want so badly to be best at doing what I do, I hate losing, I hate falling a short of a client’s expectations or this is importantly falling short of my own expectations, so when I fall short I’m beating myself up and questioning what if I could have done this or done that, how could I have not known and I know a lot of docs go through this too, wondering if they should prescribed a different medication or a different procedure. How can you deal with this inner critic head trash?

DR. DIKE: Well first of all notice that it’s a normal part of everybody’s personality. Normally it comes as a little voice in your ear that says “why did you do that? Why did you do this?” and what it is is a part of your personality that is developed to help you be more effective with what you do. I mean imagine if this voice was not there, you would probably not hold yourself to as high as standard. The real problem is with when you have an inner critic that is so strong that it actually can hijack you. So when I hear a voice tell me something I already know, right? You know maybe you should have thought about this particular medication in this hypertensive patient, and I already know that and I thought about it and chose a different one and when you hear a voice in your head, what you can say either out loud or to yourself is “thank you for sharing” and see if the voice will back off a few, okay? If it’s a big deal where this inner critic is saying “no you really blew it this time” there’s a process I use called an after action review. it’s actually something that comes from the military where you basically ask yourself series of questions to debrief that experience, to see what else do you might do differently in the future and because this is a recording and people can go back over and over just let me give you the questions real quick. Question one is “what was your intention?” Number two “what do you do?” Number three is “what happens?” Number four is “what worked?” Number five is “what didn’t work?” Number six is “what did you learn?” Number seven is “what are you going to do differently in the future?” Inner critics like taking you through that question structure but that will help you get the most learning you can out of the situation where your critic is pointing at something you might have done differently.

DAVE: Just take your time to reflect and go through those kinds of things.

DR. DIKE: Yes let’s look at it systematically.

DAVE: That helped a lot, so take time and do that everybody. Now one of the other things that I tell a lot of docs that they should do and one thing that you obviously dealt twice now is all about creating businesses and I often suggests to a lot of different of docs to try and get ten ninety nine income through businesses, that’s something that their spouse does or something they do because there some pretty awesome tax right off that they can get or maybe like yourself, if they feel like they’ve burned out, they‘re looking for a transition, maybe looking for a second career, well you’ve done it, you’ve reinvented yourself twice and made a whole new career. What’s your suggestion to some docs that maybe a then where you’re at and they want to start a process of getting themselves out there, becoming an expert in something related to medicine but maybe not seeing patient, or maybe they can get a little bit of the dough and transition to that overtime?

DR. DIKE: Well I would say the first thing to do is not use me as an example. I would never, ever again walk away from my practice and so if anybody is listening to this and they’re disgruntle with their practice and you’re not set aside with it, please don’t walk away because if you walk away you put yourself under pressure that doesn’t need to be there. If you decide that you’re going to quit your practice and start bringing in some extra income in some way without quitting, go ahead and start working on that. Make a structured transition but don’t walk away from your practice because your practice can be a bridge that supports you and your family. Doing things you already know how to do so that you don’t have to feel like you’ve leaped off a cliff. And then the same process I think works really, really well, if you’re saying “I’ll keep doctoring but I want to add a cash line of business to my office” or “I want to start doubling in something on the side, my intention is to become a business” make sure that you focus on, hey in this particular cash line of business in your office, so there’s new business on the side whose your ideal client? Who are the people that you love to work with? What is the problem that they have that you love to solve? Example I was just talking to a client right now, he said he wanted to be a coach for doctors but when I was listening to him talk about it there was absolutely no energy in it. He also happens to be a marathon runner and he lives in the northwest here where it gets darker on the ways, he’s got this little halogen flashlight that he straps to his wrist with a piece of Velcro and he’s already had three people stop him on the street saying “that’s cool, where can I get one of those?” So he’s going to explore making a strap on halogen wrist flashlight for runners in the Pacific Northwest. He likes hanging out with runners and this is something completely different than being in the office so he may take that idea and run with it. Certainly what you do when you decide what you want to do is just take the first baby step and see if you enjoy it the way you thought you would.

DAVE: A lot of it comes down to what your passion, right? Is it in medicine or outside of it, I know you and I have a common friend in Kevin Foe where he started doing blogging and started getting interviews and now he has this website and he still have his practice but I don’t know if he is driving the numbers or anything but I’m sure the website is doing really well for him in addition to the practice.

DR. DIKE: And let me just say too, you and I assume that people would want to do something they’re passionate about, I can tell you that that’s not true for everybody, right? So there’s plenty of people on Wall Street that don’t give a reap about anything but money, right? But for me that’s different, for me if I’m not doing something I believe in or making a difference that I can smile about at the end of the day, if there’s no passion or purpose in it I’m not interested, that’s just me. That’s why you do know that it’s not everybody, for you to be a financial planner, right? Somebody who helps people around numbers like this and to be connected with purpose when you do it is rare, so congratulations. and I think that is one of the things that you have to do is ask yourself “Am I passionate about this?” because passion will help you do the things you need to do to build the business because sooner or later you’re going to be nothing but fumes and you’re going to need that passion.

DAVE: Well that keeps you going you know, when there is faith or something like this, it helps you do what you needed to do. So let’s wrap this all up, you wrote the book, you have a lot on your website, if people have questions how can they get in contact with you and where can they pick up a copy of your book the Stop Physician Burnout: What To Do When Working Harder Isn’t Working?

DR. DIKE: The website is called thehappymd and I’m a jolly guy and I’m not the happy MD, this is a place for you to get the tools so you can be the happy MD, so its thehappymd.com, that’s my website, there’s a contact form there. It’s a free blog post and video trainings and all sorts of things. To get the book you can go to thehappymd.com/book or if you’re overseas go to amazon.com and just type in the search bar Stop Physician Burnout and it will pop right out for you.

DAVE: Beautiful, go to thehappymd or go to amazon, it’s all there. Do you have any other thoughts Dike as we close this out?

DR. DIKE: I always work with people and its almost always this case who know what they don’t like about their life and their practice and what they do is instead of changing, what they do is they’ll vent to somebody and keep doing what they’ve always done. There’s a very famous person who is quoted to having this definition of insanity. Insanity is doing the same thing over and over and expecting a different result. The quote is from Einstein and so what I typically am doing is helping people begin to take new actions to get new results so they don’t keep acting crazy and doctors do this very, very commonly. So if you have an area of your life, of your practice that you’re not happy with you can change it and you’ve got to change. It doesn’t even matter what you do differently, do something differently and watch how it changes your results because about that, it’s just craziness, that’s what I help people with.

DAVE: Awesome. Well I think this will help a lot of people today. Thank you for your time Dike and maybe we’ll check back in the future.

DR. DIKE: You’re welcome Dave, have a great day.