October 1, 2017 marks the one-year anniversary of my medical practice relocating from Tujunga to the Healthcare Partners/DaVita Verdugo site right next to Verdugo Hills Hospital. I’m asked by patients all the time how I like the move, so I thought I would share a few thoughts about the past year with everyone.
I must admit, life this year has been full of changes and therefore quite challenging. It was a bit like moving out of the home you’ve lived in for over 20 years into someone else’s house. Then finding out you’re throwing a dinner party the next night for 20 people. And that you aren’t allowed to cook with any spoons. Not that you know where the spoons are anyways. Everything was different… this traffic going to work, the rooms, the staff, the leadership. Stuff was in boxes (some of it still is) and I didn’t know the names of everyone in the office for a month. There has been a huge struggle in all the logistics of absorbing extra patients since we lost 2 doctors and a third one in the building retired. Patients were showing up at the wrong office or getting stuck in traffic or ending up at the wrong building. There weren’t enough appointments available. There weren’t enough doctors.
I think the biggest adjustment for me as a physician is the huge difference in mindset of taking care of patients in private practice versus taking care of patients in a corporate setting. During all the years I spent in Tujunga practicing as a country doctor, the things that I loved the most were the things that I did for patients that reflected love, relationship, and community. I remember going in on Saturdays to stitch someone up with no insurance. I remember staying until 7pm so that someone could get a breathing treatment instead of going to the ER. I remember sending my staff to the pharmacy to pick up medication for the patient because they were so sick. One of my husband’s patients had no family and was put in a board and care. We used to go to his apartment to get clothes for him and bring him his mail. We took his checks to the bank to deposit them for him. We went to see him on Christmas Day and brought him See’s candy because he had no one else. These are the things that I miss most about Tujunga.
Medicine has changed into a game of metrics and pseudo-efficiency. We now practice with administrators who time how long the staff are on phone calls and don’t allow Pap smear bottles or tubes of KY jelly to be in the rooms for fear that patients will drink the liquid or swallow the gel. Life is ruled by policy and procedure with no common sense to balance it out. I think we’ve lost the ability to think critically and as a result, made life too complicated and inconvenient.
The demoralization that I wrote about a couple of months ago stems largely from my grief in witnessing the slow death of the art of medicine. I feel like staff and patients are viewed as electric plugs that can be plugged in and pulled out. The HCPs of the world think that theoretically, all the plugs should work the same. But I know the truth. People want to be valued, loved, cared for, and inspired. People want to be recognized for their unique gifts. People want rich relationships and a deep sense of community.
At times I find myself tearing up with sadness. It seems that every few weeks I have a resignation crisis when something really soul-sucking happens at Verdugo. Some patients have just elected to pay cash and see me for their office visit in Tujunga where I have more time and I’m not bound by so many rules and regulations.
Where do I see this going? I don’t really know that answer. I don’t want to give up medicine because I love it so much. If I had enough money to live on and didn’t have any debt, I’d just see patients for free because it’s so fun. It’s all the other heavy stuff that goes with an insurance-based practice run by a huge corporate entity that’s so very hard to deal with.
Right now, I’m trying to find ways to ground myself. I’m trying to give feedback to our leadership in the hopes that they use the information to learn how to inspire confidence, trust, and loyalty amongst employees and patients. I’m trying to figure out how I can continue to treat each person as perfect and holy (including myself) while staying within the guidelines that dictate what I can and cannot do.
Yeah, it’s a tall order. But I guess that’s what life is all about, no?
Every so often I try to find one word to describe how I am doing. And my word the other week was “demoralized”. Usually, I am a very positive person, but things were just getting to me. It was one of those weeks where I was slogging through a train-wreck pile-up of days where mindless scheduling produced an endless string of 15-minute appointments with people showing up 20 minutes late. Not only that, the air conditioning at Tujunga was not working, computers were freezing up, Dessie’s phone was not working, my nurse took 3 weeks off, I ran out of spring mix in the middle of the week because I did not have time to go to the store, the air conditioning was not working. I was staying at work until 7 pm to get charts done, I had 84 tasks and patients were complaining that I had not called them back about their rash. And did I say the air conditioning was not working??? I came home at the end of the week exhausted and depleted, and I laid on the couch to watch a marathon of House Hunting shows with my husband, imagining what it would be like to search for a beachfront property like those people on TV. By the time I went to bed, I was thinking about how to get out of my funk. I wasn’t feeling like the normal me! Over the years, I have learned to build up my resilience but I was really down in the dumps about how irritating every little thing was, and I had lost all my patience.
A few mornings later I was still thinking about the demoralization thing. I talked to my sister on the phone when she called, and I asked her, “Do you feel demoralized at work?” And she said, “of course, everyone there is like that.” So I asked her “well, how do YOU deal with it?” And she gave me some food for thought that I have been digesting ever since. Here are 3 gems she gave me to think about which I want to share with you all:
These tidbits of wisdom really helped me get through the week. Maybe it will give you food for thought when you go through your next period of demoralization!
Years ago, I kept a journal. I started in high school and kept it up for years. All through college, I wrote pages almost every day and I have a xerox box in my attic completely full of spiral notebooks, all hand written. I used to write out my goals at the beginning of every year. Then med school, residency, and the electronic age came in. I didn’t have time to write like that anymore. So I started keeping a small notebook in my white coat and scribbling in it when I got the chance. My journal was reduced to a “Scut List”, a post-it note with a list of things to do. After I could not find replacement pages for that notebook, I started trying different electronic methods. I remember using a Handspring Visor, where I could write with a stylus and take notes. Somehow that didn’t last. Over the years as my life got more overwhelming and chaotic with work, I kept struggling to find a way that worked for me to keep track of lists, organize my life and write random thoughts and ideas down. I have never been one to organize my life on my phone. I just don’t type fast enough on it, and I found there was something sorely missing without the organic touch of pen on paper. So eventually I gave up on that, too.
This weekend I was tackling Project 365, and while I was reorganizing the dresses in my closet, I was thinking about ways to increase my creativity. I looked up definitions of creativity online, and I read articles on how to increase it. One click led to another and I ended up on Pinterest looking at posts on bullet journaling. And I thought, “what in the world is that???” My curiosity led me to Ryder Carroll’s original video on how to start a bullet journal. I was totally confused about how to use the symbols and how to organize it, so I kept watching videos on YouTube of various people showing how they did their spreads in their journals. I’m hoping that the built-in customization and flexibility of creating my own bullet journal will work for me.
I just started my journal last night so I’m just at the very beginning of it… but optimistic that I will eventually discover some system that works for me. So here are 3 lessons that I learned from this weekend:
See you next week and stay tuned for updates!
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Lately I have been reading and thinking about intuition a lot. It’s that 6th sense that is knowing without knowing! We’re all born with it, but many of us just dismiss those gut feelings when our brains tell us something different. Here are some techniques that I have learned from intuition expert Sonia Choquette. I have been practicing them in order to increase my intuitive skill:
1. Go with your hunches. A lot of times we get a feeling that we should do something but we dismiss it and don’t pay attention to it. Our brain thinks that it doesn’t have any logical reason to go in that direction so we don’t act on our inner voice. People who are intuitive don’t question why they have a gut feeling, they just go with it.
2. Live in the present. When you are thinking about stuff in the past or the future, you are not mindful of what is going on right now. Intuition is an ability to tune into energy right at that moment, to feel whether or not there is a resonant energy. An example of this is when you meet someone and you know right away whether you have a good feeling about them or not. One way to ground yourself and get back to the present moment is to take slow deep breaths. If you are thinking about your breath going in and going out, it will bring you back to the present.
3. Increase your receptivity to the subtle. Another exercise I learned from Sonia is to wonder about 100 things a day. The last few days I have been driving to work asking myself out loud, “I wonder why the sky is blue… I wonder what patients are coming in today… I wonder what lesson I am supposed to learn today… I wonder what we should make for dinner… I wonder where I should go for my next vacation…” This exercise opens your mind to receive energy from the Universe. Just be open to receive.
4. Be creative. I love this exercise called “19 Solutions”. Normally we are trained to think in a linear fashion. Things are right or wrong. We tend to come up with only 1 solution for a problem. In this exercise, you think of a question you have, and then you list 19 different solutions to it. This opens up the possibility that there are multiple solutions, and there may be more than one that works, or it may work in a combination. Using your creativity like this activates your intuition.
5. Dance. Spontaneous movement encourages your Spirit to embody flexibility and to practice not being rigid and resistant.
Try these techniques in your own life and see how your intuition shows up!
Ever since I got back from my trip to Mexico 3 weeks ago, it seems like the Universe has been challenging me with all kinds of annoying things. Stuff like being completely overwhelmed with work to catch up on, irritating snafus (yesterday I spent an hour writing this post and it somehow got accidentally deleted so here I go again), encountering people in nasty moods who are spewing poison at anyone in their immediate vicinity, energy-sucking sadness emanating from people all around me, etc., etc., etc.. I notice that I have been in this 24/7 low grade internal roiling muck almost all of the time. My chest feels constricted and my days are punctuated with fleeting moments of panic followed by a wish to throw breakable things at high velocity in an attempt to produce that sweet, satisfying sound of breaking glass . So what’s a girl to do?!?
1. Breathe deeply. This sounds so obvious but I think we forget to do the simplest things when we are stressed.
2. Organize and strategize. I just paused and took 10 minutes to write down everything that is overwhelming or irritating me. Then I crossed out everything on the list that I can’t do anything about because it’s not in my control. Now I’m left with a list of stuff that I can actually work on. I am going to pick out which ones get top priority for today. At least this makes me feel like I have a plan of attack. I’m letting go of the stuff that I can’t do anything about.
3. Do the best I can. And don’t beat myself up for not getting everything done. I know that I think I should be Wonder Woman but really I am just human.
4. Recall the lesson that the Universe is self-correcting and self-organizing. That means that everything will work out OK. Really.
5. Breathe deeply again.
6. Tomorrow repeat steps 1-5.
I’m implementing this strategy this week. How about you?
I promised this week to tell you about my afternoon experience in the horse pen at Martha Beck’s ranch, so here goes. For those of you that missed reading last week’s report, I’m referring to a session I had during the opening workshops of the Whole Health Medicine Institute last month. It’s an amazing mentoring program designed for visionary physicians who want to change the face of healthcare, and I can say that there is nothing else like it out there right now.
After my energy work with the horse in the morning, I moved to another pen for the afternoon. It was interesting to see how this session was so incredibly different. I watched 2 women go before me into their sessions that brought up a lot of deep, hidden feelings. The doctor before me talked about having to always be perfect, to do everything right. And that struck this chord of recognition. Suddenly I had this thought come into my head… and in a flash I saw how the horse pen experience was an analogy for life. I was doing something that I had no idea how to do, without any instructions. And everyone was sitting there watching me. And I was going to look stupid.
This flash of insight opened the floodgates. The tears started streaming down my face. I felt incredibly vulnerable. I suddenly saw so many places in my life where I expected to be perfect and I was so afraid that I was not. Even worse was that sinking feeling of no escape, that everyone else would see my imperfections and criticize.
It was my turn. I walked up to the Master Coach with tears streaming down my cheeks. “What is this bringing up for you?” she asked. I told her my thoughts about being scared to do things that I don’t know how to do, to feel uncertainty about things that I cannot control, and the big thing about people seeing me out of control and clueless. We talked about it a bit, and she told me that there was no right or wrong way to do it. Just walking into the horse pen was enough. To show the courage to try it was enough. OK, so the gate opened and I slowly walked into the middle of the pen. I just stood there. I felt quiet. I didn’t do anything. After a few moments the horse came right up to me, his face right in front of me. I touched him. He kind of nuzzled me. I walked a few steps away. He followed me. I walked a few more steps. He followed me some more. I just didn’t have the energy to try asking him to trot. The Coach asked me what my intention was… did I want to direct the horse to do anything in particular? And I remembered the feeling that I get when I wake up in the morning and my cat is lying on my chest purring. I hug her and I can hear the birds outside my window chirping. Those moments give me such a sense of peace. I felt this same sense of quiet peace with the horse. I just wanted to enjoy this quiet time, walking with him and feeling his energy with mine. We ended up circling slowly around the periphery of the ring. The horse followed me everywhere. At some point Martha Beck told me to put both my hands on the horse and stand so that my heart was very close to the his. I could just feel the energy that exists in all things.
Finally my time was up and the gate opened and I exited the pen. Everyone came up to me and gave me lingering hugs. It was such a deeply emotional experience for me. I will never forget the lessons that I learned from this one exercise:
1. Be courageous enough to do things that you are scared to do.
2. Not everything you do has to be perfect.
3. It’s OK not to know everything about everything.
4. No one else expects you to know everything about everything.
5. Other people don’t judge you as harshly as you judge yourself. Try to be more like everybody else in this respect.
Since I had this experience, I have become much more conscious of what situations scare me. I decided to work on courage by purposefully choosing to do the very things that scare me the most, things that actually give me a physical reaction in my body. After all, that’s how we make ourselves sick. Once I made the connection that a feeling in my body was from thinking about something I was afraid to do, I immediately wanted to make myself do the exact thing that I was afraid of. Because I don’t want to be afraid anymore.
I admit, it’s not the easiest thing to do. But isn’t that the whole point of practicing courage?
As many of you may know, last month I began a 9 month program with Lissa Rankin, M.D. and her Whole Health Medicine Institute, and I’ve been wanting to share some of my experiences with you. During our initial 4 day workshop, one of the most powerful exercises that I did was on the day that I spent with master coach Martha Beck on her ranch near San Luis Obispo. Each doctor had a morning session and an afternoon session in which we each would enter a horse pen and get some one on one time with a horse. No prior instructions were given to us on what to do or how to handle the horse but we were each asked about an intention we wanted to address in our lives just before walking into the horse pen.
In my morning session, I said that my intention was to have a lack of emotional attachment to the outcome and to play with energy. When I had watched the doctors who had gone before me, I noticed that gesturing to the horses sometimes made them move and sometimes nothing happened. Sometimes the horse stopped. I slowly figured out that gesturing to send energy towards the horse’s shoulders made her stop and gesturing to send energy to her hind quarters made her move forward. This took a number of attempts because I really had no idea what I was doing. I just started trying different things. I found that I had to make certain movements to communicate with the horse and tell her what I wanted. Once the horse understood what I wanted, she complied. I also noticed that the more movement I made, the more lively the horse became, as long as the movement was in the right direction. Eventually I was able to ask the horse to trot to the right, then turn around and trot to the left, back and forth. After my session, I debriefed with my coach and talked about the experience and what I learned from it.
Here are the lessons that I learned from this amazing experience:
1. You need to be clear about what you want. The Universe is here to respond to you. If I gestured to the horse and she did not know what I was trying to communicate, she did not respond. If you cannot articulate clearly what it is that you want to receive, the Universe does not understand how to respond either.
2. If you send a lot of energy in the wrong direction, you will not produce the result that you want.
3. If energy is properly directed, it does not take a lot of energy to get a large animal to move.
4. If you try something and it does not produce the result that you want, don’t keep doing the same thing. Make some adjustment and try it again. Do that over and over until you get the result that you want.
5. Know that the Universe is not against you. When things don’t happen the way we want, we tend to create these stories in our head. Oh, the horse does not like me. I’m putting in all this energy and nothing is happening. I suck. Know that the stories you make up in your head about what is going on are just things you fill your head with that are not actually Truth.
I will never forget this amazing experience. Next week I will tell you about my afternoon session which was even more powerful! Until then, think about how you are spending your energy and see if any of the lessons I learned apply to you too!
Woo hoo!!! I am so excited that our new website is up and running!!! I am looking forward to having fun with it and being able to communicate with everyone about what’s new:) … But even more so, I am super excited about having a way to express a little bit more of my personal thoughts on medicine, beauty, life, and anything else that comes to mind. Four months ago, I played a game called “The Wish” with some of my very close friends. The game involves each person writing down their wish and randomly picking a stone which represents something about their wish. All throughout the game the players take turns rolling a pair of dice; depending on which space is landed on, cards are picked that give that person some insight about their wish. Well, I think we all got a lot of interesting and thought provoking stuff to think about that evening! I ended up printing my wish from my computer and taping it to my bathroom wall so that I could read it every day:
“I WISH TO HAVE THE BUSINESS OF MY DREAMS WHICH WILL INVOLVE WORKING WITH MY CLOSEST AND MOST INSPIRATIONAL FRIENDS WHO ENCOURAGE ME TO FOSTER AN ATTITUDE OF ABUNDANCE. I WISH TO HAVE MORE FREE TIME, MORE WORLD TRAVEL, MORE MONEY, MORE LAUGHTER. I WISH TO INSPIRE AND ENCOURAGE OTHERS THROUGH MY BUSINESS TO TRANSFORM THEMSELVES PHYSICALLY, MENTALLY, EMOTIONALLY, AND SPIRITUALLY SO THAT THEY MAY LEAD LIVES OF JOY AND SIGNIFICANCE.”
Today I am thinking about the many ways that my wish is coming true! I just want everyone to know that anything you dream of is possible…it all starts with a small idea in your head and it can grow from there. I hope you all share a little bit with me as I go down my chosen path in the months and years to come!