Learning how to self advocate for wellness and career advancement

I've recently been meditating on personal and professional development and in a lot of ways, maintenance. Part of it aligns with recently discussed concepts of wellness and work-life balance. Part of it also has to do with this intrinsic unsettled feeling I'm experiencing with work. I attended an academic conference recently which I believe was clarifying and is helping me to frame my approach.

Health

This all started with a dive into self care, specifically, trying to make sure that I was taking better care of this 41 year old body of mine. I had not been to a dentist in 15 years. Yes. You read that correctly. I had not seen a dentist since before medical school. Part of it was because I'm irrationally terrified of the dentist... part of this fear probably came from all those times my mother forced me to sit with her and hold her hand through many root canals and extractions while she squirmed, wiggled and held a vice grip on my hand. The other part of it was the silly thought, "If it ain't broke, don't fix it." The final factor was the disease of busy. I flossed. I brushed. I have a nice smile. I'm fine.

It wasn't until my little one bravely sat through the first couple of dental appointments during which we found out he had multiple cavities between all of the molars, necessitating 8 crowns, a failed attempt at in office nitrous and subsequent trip to same day oral surgery center with a pediatric anesthesiologist that I finally made an appointment. So I did it. I had a couple of cavities, needed scaling (which is a special kind or torture) and am now getting teed up for a root canal. I suppose it's not bad for 15 years. At least I'm keeping all of my teeth, for now.

Let's move on to fitness. I'd topped off the scale at 5 pounds over my full term pregnancy weight. I hated what I saw in the mirror. Inside I was happy. My outside didn't match my insides... maybe I wasn't happy. Regardless, I've spent the last year trying to make sure to make time to do tedious things like plan healthy and nutritious meals and get some exercise. I found a colleague and now friend who was an online health coach. I found a supportive environment of other busy, professional women who found time and prioritized this portion of self care and found that they ended up being happier, more patient and feeling more fulfilled all around. I found tools which were easy to implement (albeit requiring some behavior change), accountability partners and fun exercise options. I enjoyed it so much that I myself became a coach.

With everything we give to our patients, our learners and our hospitals, we absolutely must prioritize ourselves in there somewhere. Working out may not be your thing, but you have to identify what it is that recharges you and make time for it. Put it on your schedule or it will not happen. It will ebb and flow, but you've got to take care of you before you can take care of anyone else.

I still need to schedule that Pap and Mammo... I'm a work in progress.

Personal Development

Part of the company's philosophy is ensuring that you spend some time each day on your own personal development. This created an opportunity for me to read some personal development books (the former four letter "self-help" category). Below you will find the books I've gone through over the last 6 months (good grief, whoever created audiobooks is literally the best because I become narcoleptic while reading).

I've read (or listened to in audiobooks) "You are a Badass: How to Stop Doubting your Greatness and Start Living an Awesome Life" by Jen Sincero. She's not a physician, but she's been through some things and many of her struggles and insecurities resonated with me. She is also remarkably sarcastic and funny and I had many a laugh while listening to her book.

I followed that with "The Compound Effect: Jumpstart Your Income, Your Life, Your Success" written by Darren Hardy. This dude for all intents and purposes is a self made gazillionaire and did it all with hard work and discipline, specifically with small changes every day. He had an authoritarian for a father, so we have that in common. It focuses more on the business world, however if I ever consider entrepreneurship, I'll probably revisit it.

I followed that with bits and pieces of several books from Brene Brown... "Rising Strong" and "The Gifts of Imperfection," both of which hit chords with me. Let's figure out how to pick ourselves up after we fail at something because that is what bravery truly is. It takes no energy to stay down after you take a hit. Facing the day, reflecting on how you may have been responsible for whatever you've experienced is an important lesson. Reading her book is like sitting in a therapist's office, without the $200 price tag. She's a shame researcher and she hits the nail on the head when she discusses the mountains of self imposed guilt we shoulder unnecessarily. She's also witty and sarcastic from time to time.

Next was "The Subtle Art of Not Giving a F*ck" by Mark Manson. Now, if you can move past the fact that this guy is a bit like a frat boy in his use of language, there are some important lessons to be learned. Some things just don't deserve our energy. Seriously.

My latest read is "Feminist Fight Club: A Survival Manual for a Sexist Workplace" by Jessica Bennett. I came upon this book on my way to the aforementioned conference. I knew I was specifically attending a workshop designed to appeal to women interested in leadership in academic medicine. I was looking for something which would light my fire and help me think outside the box a bit. Jessica Bennett is a journalist who specifically writes about issues of gender, sexuality and culture. In her book, she highlights the research which discusses not only how institutions may unknowingly or overtly be preventing growth of their female professionals, but also behaviors we may be demonstrating which hinder our own progress.

I take each of these books with a respective grain of salt, but it's really kind of opened my eyes to some self reflection and highlighted some things I may want to work on within myself. When we spend so much of ourselves in tending to other's needs, our own needs and need for growth can get lost in the mix.

Professional development

So, I'm an academic. I teach medical students, PA students, residents, fellows, faculty. I have sought opportunities to develop my educational niche, my ability to provide feedback, teach a skill, develop a curriculum, pitch an idea to my department chair. I teach a lot of things... probably too many things, which is why I find myself feeling stale and unfulfilled here. I feel like I've spread myself so thin that I'm doing an ordinary job at all of the things for which I'd prefer to be doing an extraordinary job. I feel like an octopus juggling knives which are on fire. Is this imposter syndrome creeping in? Perhaps, but I know I could do better with my time and efforts if I peeled away from some things.

I officially mentor some and unofficially mentor others. I've not received any training per se in mentoring, save observation of folks I hope to emulate. I don't know what the steps are. I don't know what skills to hone. It's kind of like teaching, but also very different from teaching. There should be a program for mentoring the junior mentor. There probably is, but I've not yet had the bandwidth to seek out or discover it, but it is something I need. What I found most interesting in the sessions at this conference was the focus on not necessarily seeking out the most sage mentor. Sometimes peer mentors are actually better for you as you navigate different challenges in your career.

I've been at this academic gig for 6 years now. At the conference I attended, many of the female leaders commented on "cycles" and feeling unsettled after a certain amount of time doing each of the jobs they did. That hit home for me. I feel unsettled. I want to do what I'm doing differently and I need to advance my position from my current title to the next. As such, I've been meeting with my closest mentors, having heartfelt talks about what I thought I wanted when I started, what I've done and where I see it going. I see now that I've invested a tremendous amount of time and emotional capital in one path. It was my hope that by working hard and contributing, I'd be rewarded with position. Boom!!! Words from all of the books came to mind and highlighted for me that I in fact cannot do it all and I should be asking for compensation in some way for what I am doing. You will not get 100% of the things you DO NOT ask for. I must focus my efforts on those things which are most meaningful to me in my professional life. I need a new goal. I need a promotion. So, I'm going to spend the next couple of months working on my dossier, writing papers, reviewing and revising the curricula that I am responsible for and pouring the energy freed up by letting go of tasks held by one of my octopus tentacles.

It's exciting and anxiety provoking to have this new approach and challenging in that I've never before created a dossier or gone up for academic promotion. Why didn't someone tell me about all of the stuff that goes into this? Why didn't someone tell me to keep better track of all of the lectures I taught, programs I developed, mentees I invested in, meetings I attended, evaluations I received??? This wasn't part of orientation when I became faculty. It was discussed as an afterthought in my annual meetings "You should be ready for promotion in a couple of years." After reading my most recent book, I wonder if the experience is the same for my XY colleagues. Is the assumption that because I'm a single mother, I must not be interested in promotion or advancement, so I don't really need the guidance or personal investment? To adapt a quote from Jessica's book, "No one gets shit done like a mom."

I'm trying to figure out what my professional and personal mission statement is. What are my values? What do I hold dearest to me? Do my actions align with my values and my mission? How do I parlay these reflections into actions moving forward and be sure I'm looking out for my own professional interests, professional development and advancement?

Great article on STAT on female leadership and health care reform.

Genmedmom here. I simply to call attention to a wonderful article on STAT written by a kick-ass healthcare administrator/ CEO and mother of SIX children (yes, six, and TEN grandchildren, per her profile) Annette Walker. It's titled More female leadership: a different kind of health care reform and it's spot-on.

She points out that "women hold only 26 percent of hospital CEO positions and 21 percent of executive positions at Fortune 500 health care companies even though they make up 78 percent of the health care work force". This despite the fact that "Study after study has demonstrated that organizations with gender-balanced leadership are more successful than their homogenous counterparts."

The best part of this short piece is her emphasis on solutions. What she has accomplished in her own hospital system can surely be adopted in others. She lists:

• Flexible work arrangements
• Training opportunities for women to build leadership skills
• Increased visibility of female role models
• Connecting junior employees with female senior-level mentors
• Transparent advancement opportunities and clearly charted pathways to leadership
• Shining a light on the challenges of balancing family and work needs
• Support for community programs that promote opportunities for women in our service areas
• Emphasizing STEM and academic programs for women

I love what she's saying and admire what she's accomplished. I mean, all this and SIX kids, I just can't even imagine. Two kids has almost put me over the edge. Holy cow.

This blog is certainly helping to "shine a light on the challenges of balancing family and work needs" of doctor-moms, so let's acknowledge what MiM brings to the battle! We can also take a look at this list and think of what may be applicable in our own practices, hospitals, and medical schools.

Ladies, let's take some inspiration and motivation from Annette Walker, impressive mama and hospital CEO.

The Year in a Word Cloud

How Many Balls Can I Juggle?

I've been trying to dig deep and reflect on my own work-life balance... I feel like I'm living in a world in which my mantra to my learners and advisees is "Do as I say, not as I do."

I love to teach. I'm in an academic position because I thrive on teaching while working clinically. I teach medical students, residents, fellows and am engaged in faculty development. I'm encouraged by my mentors to "be academically productive" however I'm not entirely clear what that means. Write, publish, be educationally innovative, do research, stay sane and be a good mom and a good doctor. 

I need a new organizational scheme. My most successful portion of my organization is my google calendar. I literally cannot do anything without it. I've got it color coded and labeled. My week in view is dizzying with color coordination and notes. My to do lists, however, are scattered between different notebooks, notes on my phone, loose pieces of paper that find their way into the ether. I need a new work flow solution. I need to find a way to keep track of things and move my academic work forward in meaningful ways.

I sat down in a coffee shop the other day to try to make sense of it all and stratify things into columns and was overcome by this subtle feeling of butterflies and anxiety in the pit of my stomach. I've never really been ridden with anxiety, however this discomfort is rearing its head more and more frequently... feeling like I'm missing something, am forgetting something, am going to drop a ball, be found out as a fraud who cannot "do it all."

While I'm not junior in life, being a "non-traditional" physician, prior career as a nurse, I am early in my career as an academic physician. As such, I feel this pressure to continue to do things which further my personal and professional development. At the same time, I want to be sure that I am giving my son the time and dedication he needs from his mom.

As an ER doc, my schedule is widely variable, shifts in the day, evening, night, weekends, holidays. Sharing my son with his father affords me the opportunity to work academically without interruption about half of the time. There's still work which needs to be done when I have him. So, I try to balance it by not working while he's awake. Sometimes I'll have a random Tuesday free and we do arts and crafts, read, go to the park, ride bikes, run around playgrounds, run errands. These are the precious moments I hope he will remember and treasure... I know I do. We make meals together, he shares his days spent with my nanny and daycare and at night, I tuck him into bed, sometimes dozing with him. He looks at me beforehand, puts his little hand on my face and says "Mommy, I love you bigger than the Earth." After drifting off with him for a bit, I get up and set my sights on my late evening tasks... emails, curriculum development, evaluations, mentoring grand rounds presentations via chat mediums or Google Hangouts or FaceTime. 

I sit here sipping my chai tea, reviewing important dates for the next academic year, the next evolution of my growth and development as an educator, curricula which need updating and modification to be in line with current educational methodology, exploring alternative ways in which to teach and engage learners in an overall curriculum which has less and less "time" for what I feel needs to be included. 

I feel fortunate to have been given some incredible opportunities to take on leadership positions and influence our future doctors. How many of these am I capable of managing? Am I giving each of these precious opportunities the time and dedication required? Am I being the best educator and physician that I can be? Am I being the best mom I can be? Am I seeking out mentorship appropriately to optimize my productivity? Am I interfacing with the right people? Am I serving my learners to the best of my ability?

My life is a concept map.