Chrissie Ep 25 (Tonya)
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Tonya: [00:00:00] you can have joy in the midst of difficult circumstances, and just resetting that negativity bias can be everything. Where are you finding joy in your work now? How can you get more of that?
Chrissie: to have somebody who you identify clearly as your, long term mentor is a really beautiful and sacred, relationship. It is a way to have a legacy and to pass on your legacy as a devoted medical professional and as a human,
Tonya: perfectionism is something that a lot of us struggle with. it doesn't mean you can't strive for mastery. It doesn't mean that we like just become mediocre. And that whole like light switch, right? Like either I'm trying to be perfect and hit this ideal, or I'm going to be off and I'm mediocre, like dialing it down in a way that feels good.
Chrissie: You're listening to Solving for Joy. I'm your host, Dr. Chrissie [00:01:00] Ott.
Hello, everyone. Welcome to this week's episode of solving for joy. So glad to have you here. My guest today is my dear friend and accomplished Physician coach, Dr. Tonya Caylor founder of Joy in Family Medicine, and Tonya is a veteran of academic medicine. She is a professional certified coach, a fellow at the Harvard McLean Institute of Coaching, the co director of AMWA Evolve, a coach within several, um, programs including Better Together and Coaching for Institutions.
I'm thinking of your work as kind of being a pipeline coach, Tanya. You are thinking about the product coming out of the pipeline, our trainees. You're thinking about the production team, and you were thinking about the pipe itself all the time. You are in service [00:02:00] to all of these things. And we have this beautiful beautiful word joy in common in our practice titles. So I'm so glad that you're here with me today. Thanks for being here.
Tonya: Thank you so much, Chrissie for having me and really. Um, I think that joy intersection between our, um, you know, focus and our intentions is a really important one.
Chrissie: Yeah. It's, um, it's not one that we're led to in medical training all that often. Um, but it does deserve to be really honored and sought out. Um, I think it carries us through so much of the hard stuff about medicine, right?
Tonya: It does. And even just saying that, recognizing, um, that you can be going through really hard stuff and find joy at the same time. I think that's maybe one of the key takeaways I hope people leave with. And you just started [00:03:00] with it. So thank you.
Chrissie: I love it. Tanya, I know that you were not dropped fully formed out of Zeus's head, like Athena, into the spot that you find yourself in today. So I really enjoy learning, um, more about your like my guest's backstory, and I know that listeners are probably curious. So, you know, what, what is like a, a thumbnail sketch of how you ended up here caring about the things that you care about so deeply?
Tonya: Um, you know, going back to even residency, I think there's a certain percentage of residents who really enjoy teaching, right? And so I was one of those. I think a lot of residents actually enjoy teaching, um, but it really meant something um, deeply to me. And when I was out in my first, first job out of residency, um, I didn't have the option that wasn't on my radar for where I was working to be able to work and be an educator.
And I was also missing the [00:04:00] academic piece of it, right? So, like, I was the person when I finally went to the board review, um, course that I was like, It was like a breath of fresh air. Like, Oh gosh, we can actually get back to like what we really know. Right. Um, and so I, I determined from that time on, I really wanted to get into academics. I was in a city that did not have that as an option.
Um, fast forward through various iterations and, um, being a really good wife and following my husband to Alaska of all places from Florida. Um, They had a position opening and I was like, this is it. And I started my career in academics up here 18 years ago now and fell in love with every single aspect of the job. And for those of you who are faculty members, you know, how many hats and how many roles and how many tasks you have on your plate, but, and I loved every single one. Um, and I didn't see it as that risk for burning them because I loved it so deeply, [00:05:00] everything. And I've had a little bit of perfectionism issues.
And so I ended up before I knew it was a term burnt out, um, about, you know, eight years into that and not, I, I thought maybe, you know what, maybe I just don't have what it takes to be a faculty member, um, maybe my personality doesn't fit. And, um, so left core faculty remained as on call faculty because I knew I still loved it and I to this day I'm still what's considered on call faculty and in our hospital system. That's the term.
And went to work with a husband and wife in a private practice that they set up to maximize in joy really and decrease the You know burdens Uh, which meant probably they didn't make as much profit as they could have and it was just a fantastic place. So I recovered from my burnout, but he hadn't learned any of the mindset pieces I didn't even know I had [00:06:00] mindset issues. What is a mindset? Right. What does that mean? Um, and so at a friend's urging, when I was looking at, I had built in too much margin and I was like, I have too much and I'm missing a lot of the things like, what do I want to do? And the friend urged me to hire a physician coach.
And so, um, Allie Novisky is who I hired and she, she does mainly focus on, you know, workouts and, you know, physical health. And I was like, almost didn't hire her because of that. But actually she's a fantastic coach, um, on things even unrelated. And she, implored me almost, um. begrudgingly into her group's coaching in addition to my one on one because she wanted me to see the power of coaching, um, because she knew what I was looking for and she just had this, you know, intuition and wow, watching those, that group really take some of the principles that I had no idea were there and then watching the power of coaching and people having their own insights and finding, [00:07:00] you know, empowerment to make changes in their work and their lives.
And I was like, this is it. This is what's missing from residency programs. And so, um, so I created join family medicine coaching. I went and, you know, did all the training. I've done lots of trainings. I'm a lifelong learner, no matter, it turns out, no matter what. Um, and. Um, really talking about that pipeline initially was focused on trainees thinking about the next generation and then recognize that other faculty are in the exact same place that I have been where they're feeling burned out and thinking they need to leave academics and thinking, wow, with these tools, what's possible?
And so really expanded to being able to work with faculty members. And just it's such a great role that I just feel so privileged to be able to play this role and come alongside people and help them figure that out. So that's how it kind of how I got here. And then [00:08:00] you know, there's more evolution from there, but we'll stop.
Chrissie: So good. Thank you for sharing that part. Um, a couple of things stood out to me as you were speaking. One is that you thought that you were going to be immune to this thing that you didn't even know existed called burnout because of how much love you had for the practice of family medicine, which is, um, a fascinating falsehood, right? That we can start off loving our devotion to medicine, loving our craft, loving our vocation, and still be vulnerable to that. And this is applicable, of course, to any, any role, not just in medicine. I love being a parent, but I have absolutely felt parent related burnout. Right? Sure. Isn't that fascinating?
Tonya: Just every role. And, and I think It's interesting that, um, even before the pandemic, there were a lot of academic papers written about burnout that I had no idea existed, you know? [00:09:00] Um, Yeah. And the love, similar to the fact that you can have joy in the midst of difficult circumstances, you can love your job and burn out at the same time.
Chrissie: So many important paradoxes to hold. And then when this experience came to visit you, the first thing you did was doubt yourself, right?
Tonya: Yeah. I would say it was beyond doubt. I didn't, because doubt implies that I had some thing to hold onto. And I was just like, Oh, like it was done. There was no doubt. It's like, I'm just not cut out for it.
Chrissie: The thought feeling action triplet was like, Oh, it's me. It's completely me. It's a done deal. I'm moving on. Like the action was obvious because the thought feeling complex was so dense. Yep. That's it. Man. And what do you see now? I mean, like, let's, let's get into like, if you were to coach your, yourself then
Tonya: nobody's ever asked me that. [00:10:00] Um, isn't that interesting? Cause I work, I have a lot of really good friends and colleagues that are physician coaches. And so I'm surprised nobody asked me that, but let me think.
One of the things that when you asked that that stood out to me is I don't think I would start at the part burnout. I, Would start earlier and I would even start I was let me like this came back to me when you asked that I was sitting in a faculty retreat, early on, maybe the first year in, maybe I was a good year in, and one of our kind of community faculty who had helped started a program, and so she was still around some, even though she wasn't core faculty anymore, you know, was floating around the tables and just checking in on people, and she said, How are you doing? I'm like, Oh, I'm great. She's like, How are you finding the balance? I'm like, Oh, I have never had work life balance like this. This is perfect.
Like I kind of think that's when it needed to start. I thought everything was perfect. [00:11:00] Um, because I was so heavily invested in about, I know, at least five large projects, if not a few others, I had a family. Um, you know, I was doing things in the community. I was keeping up with my health. And so if you were to check boxes, I was checking a lot of the boxes. And so in my mind, I was balanced. So, um, yeah, I think I would, um, check in with myself starting then.
Chrissie: We might think of that as masking now a little bit. I mean, a really skillful observer might have said, Oh, that's actually one of the archetypes of burnout, right? The over committed, um, archetype or like that's the at risk behavior itself. Yeah. So wise. I think to, um, to take that question further back.
I, [00:12:00] I wish that I could send myself a fairy godmother coach, um, back in past time. I think I've said this before, even on the podcast, but I believe that if I had had a physician coach, And a, and a physician coach relationship in particular, during the years that I had my solo micro practice, I probably would have figured out a way to pivot and continue that work.
And I'm not saying that that would have been a better path than the experiences that I've collected instead. Um, no regrets there, but I do think that it might've had, it might've looked different had I had that set of tools available earlier.
Tonya: I agree, and I do believe, I honestly believe, that I had somebody to come alongside me and partner with me in a coaching relationship because, um, You know, I'm not a fairly resistant personality, right? So [00:13:00] had that wonderful mentor try to say to me, I think this is a problem. I would not have received it. Right. Um, but a coaching approach is really asking questions. I think somebody asking me the right questions would have helped me.
And I think one of the things is like, how did I measure myself? How did I measure success? Because at the time I measured success by checking all the boxes, moving the needle, making change. Okay, let me rephrase. It wasn't moving the needle. It was having the needle at zero to a hundred. There was no, um, progress seen in my mind if it didn't get to a hundred, right?
Um, so there were things that I didn't recognize. I, I became a, um, approval addict. that over reliance on external validation. Um, I didn't see that as a trap. I didn't know that existed, [00:14:00] right? Like it feels good. It, and it should feel good for, to be recognized when you're doing good things. And how do you measure your success without that? And does it have to mean you check all the boxes? And does it mean like you did everything perfectly? Right? So I, there was a lot of things I would coach myself.
Chrissie: Yes, I'm sure. I love the agency of the pause, right? A moment of like, actually, I'm going to choose not to check some of those boxes because I have some other values that are alive in me besides achievement.
Tonya: I used the word margin earlier. Um, I would have loved somebody to challenge me to create some margin or to leave some margin before I filled it all up. So when those things come up, so [00:15:00] when the daughter's bride can't take her to her volleyball practice and suddenly it's on me, I don't have like this explosive frustration within me. It's just a ride. But when your margin is so filled up, many things, especially when combined with burnout, that's what that creates, right? So I would have loved to been challenged to create and prioritize some white space.
Chrissie: Maintain it. It is one of the most challenging things for highly driven, high achieving professionals. Absolutely. Absolutely. So you came to sort of give love to the practice of medicine that you loved by taking on the lens of a trainee first and foremost, and then sort of expanded it out there to, um, to faculty. [00:16:00]
Tell me about your, your vision for like, what do you think is the most important thing for those trainees to hear, learn, or to internalize as they, uh, receive coaching? Um, In this incredibly vulnerable time, in this time with their least amount of, um, assumed power.
Tonya: I, there are three or four big keys, I think, um, that I wish to, I, like, I think if we could create this environment, trainees to know these things early.
One, how to receive feedback in a way that is, um, adaptive. Um, and so by that, I mean, Number one, receiving the good feedback and internalizing that and not dismissing it as part of the, you know, sandwich, right? It's just the bread. Yeah. Whatever. Yeah. Get to the real thing, right? No. Like, [00:17:00] somebody's taking, taking the time to tell you that you did this well. Own it. Celebrate it. Savor it. Um, to really help reset that negativity bias, right? That we all have.
And the other part of the feedback is you're given. We'll say, um, we'll say critical feedback to start with. We'll label it critical. And then from that, what is the constructive feedback . Um, your faculty members are human. On one, some days they may give the best feedback. feedback to you ever, and they may phrase it in the perfect way. And other days they may be a little toasty, and they may not deliver the feedback in the most elegant way, right?
So, you take that feedback, Try it on. None of us, our egos do not like to hear that we're not doing it right, but we're trainees at that point, right? And [00:18:00] even now, please let me know how I can get better, but we, it's just that putting it on, it feels so uncomfortable. Like, okay, get past that. Try it on. What's the learning for you instead of ruminating on what you didn't do well, or what somebody said you didn't do well based on what you've heard, what resonates with you? What do you want to do differently to be an even better physician next time, right? So how to take feedback is critical.
Number two, how to get off the performance stage. I think so many, um, medical students feel like they're performing for a grade, for a letter of recommendation, right? Like, here I am, see me, I'm, how does this attending want me to behave? And, and they're really good at performing and they get in performance mode. And so I like to think of residency as a time where the identity formation that [00:19:00] residents, the opportunity is to get out of that performance identity. And just really be genuinely, um, a caregiver for your patients. You're learning, you're doing, let your, let your faculty see where you are. Believe that they want the best for you.
And If you are not measuring up to a certain milestone or something, trust the process. The process is in place for that to be identified early so they can support you and give you corrective action to make you an even better physician, right? And so when you're in performance mode, your reputation management and everything feels so personal. And like stepping out of that, you really can have that growth mindset and trust that showing up as your genuine self as safe as that can feel right. I know not all people feel this can be in safe situations but as [00:20:00] safe as you can be your genuine self and allow trust that you're attending are going to see you the real you. Some of them may get wrong. I get, I get people wrong all the time.
Chrissie: And some of them are not psychologically safe at all times, of course. It's a really interesting balance there, right? I love the idea of getting off the performance stage as a, as a learner. And it takes me right back to being, um, a young bun head. So a very sincere, very earnest ballet, like pre professional program, ballet dancer. And we would get, you know, very critical corrections in class about our turnout or our extension or timing or the way our hand was held, like these were very refining details and the feedback was sometimes skillfully delivered and sometimes kind of snappy, you know, to say the least. Right?
And you began to adapt the way you [00:21:00] receive feedback to, I want to be thought well of by this honorable teacher. And we would get these big doe eyes and do these slightly, um, like exaggerated nods. And if anybody listening has a kid or has a history of being in like pre professional ballet programs, you'll know exactly what I'm talking about. It's very goody two shoe energy.
And in medicine there is a little bit of a corollary of like, I want to appear to be a good learner even if I have completely evacuated my body and I'm hovering somewhere up above because I'm scared to death or intimidated or just a little bit traumatized right now. The opposite of that is like embodied presence.
Tonya: Yeah. Yes. Such a good thing. I love that parallel. And I, I suspect that there are a lot of listeners that can take that. So even if it wasn't maybe a delay, maybe it was playing an instrument or yeah, great. [00:22:00] You had to coach. So many things. Yeah.
Chrissie: It's funny. That's actually like, you're supposed to be getting coached, but you're learning as a performing learner.
Tonya: Oh, it's. Yeah.
Chrissie: High risk. High stakes.
Tonya: Yes. Um, one of the other things that I, I think would be really helpful for most trainees to learn early on, um, is where they do have agency, right? So most, most trainees, you say, how much control do you have over your life? They're like zero. Right. And we all resonate with that. We remember that. Right. Yes. Okay. So there's a lot about your day to day that you don't control. A lot about your rotations you don't control, a lot about the EHR, appointment slot times, right? Many, many things that your brain can come up with to prove you have no control.
And, [00:23:00] so then we, let's kind of take it down. Where's the control about you developing your style? How you relate to your patients? How you, um, choose to use your time in the room, how you choose to write your note. You may get feedback on it. You have agency there. Great. Um, and then beyond that, you know, I'm going to relate this to, to something that hits all physicians, prior authorizations you know what?
We all have agency. We can take that and say. Nope, not gonna do it. And then ask yourself, okay, actually I do, I'm gonna do it. Why? Why do you want to do it? I want to do it because that's going to provide the best care for my patient. [00:24:00] But that's exercising agency, and we don't see it as such.
And so I've, I'm done giving any, um, Emotional bandwidth to being shocked at the length the insurance companies will go to, to save money. I'm, I just no longer, it's either, it's just a, it's just a question. Am I going to do it or not? Why, why, if I'm going to do it, why do I want to do it? If I'm not going to do it. Why am I not going to do it? And I'm good with it.
Chrissie: The obstacles are no longer shocking. Right. The question is, will you go over, under, or around it?
Tonya: It's true. So, you know, I mean, we all have choice. And we, we overlook many of the choices that we have. You don't even have to, you know, rounds start at six, let's say. You don't have to show up at six. You have, you have total agency on when you show up. Now, why do you want to show up at six? Right?
But just those little mindset shifts can take a lot of the resentment out of it. It, it actually gets you out of [00:25:00] that victim y mode. Nobody, nobody feels good being victim y, right? Yes.
Chrissie: What do I want to answer for? What do I want to be responsible for? Um, yes, what do I want to be held accountable for and to? And the truth is, I'm not willing to have the conversation that I showed up 30 minutes late to rounds. And that's why it feels like not choice, but it is choice. It is a choice. I choose to comply with the time of rounds because I am not, I'm not doing the crime because I don't want to do that time. I know it's a choice.
Tonya: It is a choice. So, um, I think those are the big three. I had a fourth. I lost it somewhere along the way, but I'm sure it'll come back to me.
Chrissie: You can add it back in. If you think of it later. Um, I love all three of those. I think that those are great points for, for residents and really anybody who is in a pipeline of becoming a professional. [00:26:00] Like there is a reclaiming of power and agency and a little, a little like first step of having your own back in that way.
Tonya: I remembered the fourth and it is related to the perfectionism. Um, I would say, and I'm actually, I, with the residents that I get to end with, I would say this group of current residents is emotionally intelligent beyond what my era of, um, trainees, um, had, right? I really do believe they are advanced in that. And I don't think they get enough credit for that. And, um, still perfectionism is something that I think a lot of us struggle with.
And so it doesn't mean you can't strive for mastery. It doesn't mean that we like just become mediocre. Right. And I think that's it. And that whole like light switch, right? Like either [00:27:00] I'm trying to be perfect and hit this ideal, or I'm going to be off and I'm mediocre, switching that to the dial. Right? So We're going to dial up and down based on the task at hand, right?
Just learning that shift that you don't have to, by the way, Tonya' many years ago, you don't have to check all the boxes perfectly. Like dialing it down in a way that feels good. And some of that might feel uncomfortable if you've always been hitting it. It may feel uncomfortable to lower the effort. It doesn't mean it has to be sloppy or, you know, below par.
Chrissie: Yeah. It's um, I mean, there's so many little pithy summaries of, of that thought that are coming to mind, like getting an A plus and not getting an A plus. Yeah. Really something I've practiced embodying and it's taken some time to like get off of the [00:28:00] momentum of trying to do everything all the time, the utmost level.
I remember actually all the way back to medical school. I don't know if this was a saying in your cohort, when we needed to help ourselves feel better about passing rather than high passing or honoring in a particular clinical rotation, our saying was P equals MD. Like, you know, instead of A's and B's and C's and D's and F's, we had like honors, high pass, pass, marginal pass, or fail. And, um, you know, everybody wanted to at least high pass something. They did because usually if you're in medical school, you have a history of expecting and creating circumstances of high marks in school, right? Yeah. But figuring out that like, um, surgery is not my thing. And I'm going to be really happy to walk away from this relationship, the short [00:29:00] term relationship with a judgment of passing. Thank you.
Tonya: Well, and I think, too, like, there are certain things, like, surgery. If you are in a surgical field, the level of perfectionism, the last, let's use a different word, the level of striving is going to be higher, right? You've got somebody's tissue in your forceps, right? Like,
Chrissie: yes. Yes, and the meter is turned up to high because you actually do want to perform Exceptionally well every time you're inside somebody
Tonya: a corollary to that is when something doesn't go right because you are human is That's the growth mindset. That's not failure. You are a terrible surgeon. That is okay, what do I want to do differently? Again, what can, where's the [00:30:00] learning point here? You know, I'm, I'm, you can't see, I'm flipping the bow on both sides to, to look for a preparation, right? Like that's what came to me. Anyway but when you're writing that note for your patient who came in with a viral syndrome, We can dial it down and it can still be a really good note, a really good note.
You know, if you listen to Sarah Smith, you've conveyed to yourself what you were thinking and to anybody else that reads the note, you've met standard of care, should it end up in a court of law, right? You've met standard of care and your billers say, Oh, you've supported the level of billing. That's it.
Chrissie: That's it. High five. You're out. That's a
Tonya: gold star, right?
Chrissie: Yeah. That's right. Pros. Save that for your free time. Right. Yeah, those are some four good pillars. We will summarize those, I think, for the show notes, because that is, those are some good, good takeaways.
Um, in our pre [00:31:00] conversation, we talked a little bit about mentorship. Um, and what it's like to have sort of mentors and mentees and it, uh, it sparked me this image, I often like have image based thinking. So I was seeing this rope, like the kind of rope that you climb with like knots all up and down it. Right? And in order for it to be an effective climbing rope, we really need all the knots. So I'm thinking about mentorship as the importance of having a knot above you and a knot below you like for us to actually express our full human potential in medicine or elsewhere. It's nice to have a connection that is helping you up and a connection who you are also helping up. How does that play out as you serve coaching faculty, um, and leadership in family medicine and other academic programs?
Tonya: You know, from a [00:32:00] coaching standpoint, I see my role as spotlighting that, um, and asking, right? So, for instance, you know, I'm not here as your mentor. I am here as your coach. However, mentorship is still incredibly important. I love the knot analogy. That's, that's going to stick with me. Um, and just, I feel like so many, even faculty members, especially early in their careers, Um, are kind of waiting for that, like that woman who came around to my table, right? Like they're waiting for the outreach and it's beautiful when it happens and that the two of you connect. And for the most of us, the most part of our careers, those people aren't there, right? It's heartbreaking.
And going back to agency is who is it? Go back even pre [00:33:00] met, but go back to your hometown, who are the people that you could reach out to and be proactive and asking them to be a mentor? And what do you mean by that and and what commitment would you want for them and kind of think through that because now what I usually do then is take them to who is somebody you're mentoring now? And so many, especially faculty, have residents who have graduated who stay in touch. I'm like, how do you feel when that person reaches out and wants to have a conversation? And they light up. Right? Yes. And like, you could be that for the person you're reaching out to and say, would you mind mentoring me in this?
Chrissie: That is so inspiring. I love that. I have had an experience of like having a peer talk about their mentor and having a sense of a little bit of like envy of like, Ooh, how did I, how did I miss the line to get mentors? You [00:34:00] know, like, Not to say I haven't had mentors here and there, but to have somebody who you identify clearly as your, you know, long term mentor is a really beautiful and sacred, I think, sacred relationship. It is a way to To have a legacy and to pass on your legacy as a devoted medical professional and as a human, you know, to have those talks about values. It's like office hours with your favorite professor. Yeah.
Tonya: Yeah. You know, it's really true. Like, even as you're talking, I'm thinking about, like, I have some of my, I always say my, I don't mean that in a possessive way, I don't work paternalistic way. You're like, I mean that in a, just people I have been fortunate enough to be an attending for who I had, you know, I was their advisor and I was in the trenches with them. And we developed a really close working relationship who now have reached out, um, for coaching. And I'm like, [00:35:00] I'll take a coaching approach if that's what you want, but no, we have this pre existing relationship, right? Like, and. And so I, that is so rewarding to me even now.
And, um, you know, one of the other things I love Dr. Sasha, Shillcut who, who, you know, um, puts on the brave enough conference. Um, one of the things that she was instrumental in helping me understand is that You sometimes you just need, you need a few, like, this is going to be the mentor that helps you maybe with your research and this is the mentor is going to help you like, how do I figure out this whole work life child, you know, call thing, right?
Um, and maybe this, and so having different mentors and sometimes a mentorship does run its course. Usually mentorship is a longer term relationship, but sometimes they run its course and it's okay. But I think being empowered and knowing how good it feels to be a mentor is helpful [00:36:00] in breaking down that barrier to reaching the worst they can say is no. Not right now. Right. And so if that happens, like who's next on your list? Yeah, yeah,
Chrissie: absolutely.
Tonya: I love that. When you said that you had a couple of mentors throughout the years here and there, how did you acquire those couple that came?
Chrissie: Yeah, some of them were natural, um, like just sort of a confluence of circumstances. Um, I think I may have mentioned this at some point before, but my, one of my first medical heroes really was, uh, my infectious disease, uh, attending at the VA in Houston. And, um, I think it was really hard for, this person to accept that I had decided to leave Houston and practice post residency in Oregon, [00:37:00] and I really just got ghosted and it was one of those moments of, you know, like, a pedestal coming down. It's like, I think that that person thought I was going to join their practice.
And that would have been an equally interesting future, honestly, but it was not the one that called the loudest to my innermost heart. Um, but I admire this person's bedside manner and intellectual rigor and, um, you know, just the work ethic and the joie de vivre, like there's just like so much I adored and wanted to take in longer. That was a little
Tonya: heartbreaking. Oh, that's so, so bittersweet. Yeah. you know, um, going back to, we're all human. Right? I had a, um, friend who told me in the beginning of our [00:38:00] friendship, it was just really interesting, but I've taken it with me. She said. I will at some point disappoint you and I want you to know that going in I never intentionally will. But I was just like that was so eye opening but she had been burned in another friendship where somebody had a really high expectations and then they invented they were really were not kind to her and I was like what an interesting thing. And so just started thinking like people are going to disappoint us every single human we interact with is going to and I'm sorry you had to experience that and Um, it is the full experience of the human life, right?
Chrissie: That's right. No guarantees. Um, there was some wonderful gifts among along the way. And then there was a leader in my current health system, um, who actually like tapped me on the shoulder and said, you are leadership material. Like, let me connect you to [00:39:00] opportunities. So there was sponsorship and mentorship and I felt, um, seen and I felt sought. And I felt encouraged in a way that counteracted my previous MO, which was to exist under the radar as much as possible and not really let my light shine too brightly, or just shine it in the places that it, you know, made sense to me, not in places that I needed a lot of external validation or, um, permission.
Tonya: Yeah. Love those when, you know, how powerful that is. And that, that goes to that knot below as you're taking, thinking, I'm like, who are those people that I can be looking for? Right. Um, yeah, I love, I love that you get to experience that as well.
Chrissie: This past summer, I, um, Served at a rural, um, hospital doing some pediatric hospitalist work and there were family medicine residents and I hadn't [00:40:00] really had a lot of resident interaction for a while. I mean, sometimes on my night shifts as a hospitalist, I would, um, you know, admit with residents, but they're, you know, brief interventions, brief interactions. And, um, this was like, you know, a whole week long. And I thought about you cause I had so much delight and joy, um, teaching these learners about, you know, some bread and butter pediatric stuff. And remembering, Oh yeah, I have all of this information that I'm not using on a daily basis that I can just roll out at the drop of a hat.
And their eyes get big with the dopamine of learning and they're like, Oh, that makes so much sense. Oh, that act that, you know, mnemonic is so useful or like, um, what a gift. Yeah. Yeah. Reminded me how much I love medicine. You need that reminder sometimes when we've, uh, been through the ringer and the [00:41:00] Healthcare industrial complex for a while, you know, for sure. Yeah. Yeah. Hmm. What is a way that, um, you have solved for joy that you found surprising tonya?
Tonya: Oh, surprising. Um, early, early on in the, in doing some of this work, I found, I found it surprising that you actually can find joy in the midst of really difficult circumstances.
You know, being there for a family who's making a really tough decision, um, for their loved one and craziness is happening over here in the clinic, and craziness is happening over there in the hospital, and administration's craziness is going here, and then in the midst of that, and in the midst of even somebody suffering, being able to be there, supportive, walk [00:42:00] through that with them, give them, you know, accurate advice, maybe not even advice, accurate information, so they can make their own best choices. And being thanked. They didn't even have to thank me. That's the external validation. But like, when that, that happens, like, that fulfillment, you know, that's what it is, is that professional fulfillment that I was supposed to be here and help this person in this moment. And It accomplished a purpose.
And I think that's one of the things that gets stripped out as people are trying to struggle with work life balance. And like, maybe I'm just going to make work, I'm just going to clock in, clock out. I'm not going to expect any fulfillment from it. And I mean, that's your choice. And what if you can have both, right? What if you can find a way to [00:43:00] enjoy pieces of that work? Because it is such meaningful. We are so privileged to do, to walk alongside patients and their most vulnerable times. And seeing that you can find joy there so you don't have to just treat it as a clock in clock out, right? And I understand that that is a symptom and a reaction to the pressures that we're faced with right now. Um, and I still believe that there's a way to find joy.
You know, I was talking to, um, uh, a resident not too long ago, um, who was, you know, quite frankly, thinking she might just graduate, maybe take a year off, maybe never return to clinical medicine. And you know what? I don't pretend that I know the perfect path for anybody. And I just said, when was the last time you felt joy at work? She was like, it's been a long time. I was like, okay. I said, when's the last time you're really proud of something you [00:44:00] did? And she thought for a few minutes, and she came up with a scenario about how she navigated this really, um, psychologically complex patient. Um, she navigated some really tricky issues and made some major progress with them and was able to like do a follow up visit and see the improvement in that person's psychological condition, but also how it was affecting their lives.
And then, um, by the end of the conversation, she was like, you know, I actually do really like this job. Do you think we get so weighed down with all the chaos, right? It's like watching too much news. If you watch too much news, you're going to feel weighed down and unhappy. I don't want you to be uninformed. It's okay to stay up with current issues, but like, we're going to need to know about the chaos that's happening in our world. And that when we focus intentionally [00:45:00] on how we're helping people, how we're making a contribution, how we're not just clocking in a lot of times you can find joy and just resetting that negativity bias can be everything.
Chrissie: Yeah, I love that answer to to what surprises you. One of my suggestions for a definition of joy is a combination of meaning, alignment, and delight. And in that scenario where you're providing, you know, accurate information in an embodied present way connected with these people, it's so full of meaning and alignment, so full of service and fulfillment. It's something that only someone with your training really could do. Right. And. There is delight, even when the outcomes are hard, because the connection and like the calling part of it, that holy moment of connected service, [00:46:00] fully, wholly aligned, there's nothing like that. There really isn't. It's like flow state plus it's ecstasy
Tonya: and you know, I think getting back to that all or nothing thinking do I wish every single physician could have that 100 percent of the day absolutely, and
Chrissie: Not realistic.
Tonya: It's not. However like when they've done I think it was um, Tait Shanafelt of the study rate showing like and this was Burnout, not fulfillment. And I understand that fulfillment and joy are not just the lack of burnout, but even just, if we look at just burnout, every 1 percent increase of meaning in your day. decreases the risk of burnout up to 20%, 20%. If you can make 20 percent of your day meaningful, right. That is so protected against burnout.[00:47:00]
And like, so what are, what are the things you can do to move the needle 1%, right. Or even a half a percent at a time. Where are you finding joy in your work now? How can you get more of that?
Chrissie: Yes. Yes. It's very Zen to just, you know, move the needle a 1 percent at a time. And, you know, thinking about what's actually likely, what's realistic. I mean, even if you're just surfing, you're not spending every minute of the day on top of a gorgeous wave, right? You're spending a lot of time waiting, a lot of time paddling. I think, yes, we get to crest those waves sometimes they're gorgeous, amazing, but a lot of time is preparing. A lot of time is waiting. A lot of time is in between time and that's okay.
Tonya: I love your images. They're perfect. It's like the fan. That's the best metaphor,
Chrissie: right?
Tonya: Yeah.
Chrissie: Yeah. If there was no wave ever, we probably [00:48:00] wouldn't keep going with the surfing. Right. I feel like we call it something else. We call it floating. I'm going floating today. Right.
Tonya: Exactly.
Chrissie: Hmm. Thank you so much, Tonya. I'm so grateful for your insights and your presence and companionship on this path, hoping and working for a better, different future in medicine for so many of us and for so many reasons.
Tonya: Thank you so much for the work you're doing. I just, I love if, if you're not getting her newsletter, sign up for her newsletter. Like it's, it's actually just short to the point and impactful.
Chrissie: I'm so honored. Thank you for that kind feedback. I was reflecting with my coach just this week, like a year ago. The year ago, [00:49:00] me, um, was not ready to, uh, share as frequently or as, honestly as I am in my occasional emails now. And, um, it is, it's a much truer creative flow state for me and my wishes for it to be enjoyable and useful a resource and an inspiration.
Yeah. Thank you, Tonya. Listeners thank you so much for hanging out with us today. And I haven't asked this for a little while, but it's just on my mind right now. So I'll throw it in there. Um, I would love if some of you would go and give us a little rating, give us a review. It helps get the podcast into more ears and fuels the work that we do and ripples outward in larger and larger concentric circles. So please consider doing that. Thank you so much in advance, joypointsolutions. com for all the things that we're offering right now. And [00:50:00] to find Tonya
Tonya: you can find me, joyinfamilymedicine.com
com.
She's
Chrissie: amazing. Thanks everybody. Have a wonderful day.
Before we wrap up, I want to take a moment to share something truly exciting. This year I have the incredible honor of stepping into the role of stewarding the physician coaching summit. This is the premier gathering of physician coaches. It is our national conference and international conference. It's a space that has inspired and connected so many of us over the years. I am so grateful to Dr. Kathy Steppen, whose vision and leadership have made this summit a cornerstone for our community. She has built something truly extraordinary and I'm humbled to carry it forward into its next chapter.
The 2025 Physician Coaching Summit is going to be more than a conference. It's an experience. It's a space where we don't just learn, we connect, discover, and renew. And this year it's all happening [00:51:00] November 6th through 8th at Savannah, a breathtaking wellness resort in carefree Arizona, just outside Phoenix designed for exactly this kind of experience. It's a place where you can exhale, where you can slow down, stay present and step into deep connection with yourself, with others and what's next.
Our theme this year is having our own backs. It's all about reconnecting with what truly matters, stepping into your power and holding space for growth, rest, and everything in between. Whether you're looking to reignite your coaching practice, cultivate your joy, or simply reconnect with yourself, the summit will meet you where you are. If this speaks to you and you were a physician coach or physician coach in training, or perhaps you're a well aligned potential sponsor or exhibitor, this is the perfect time to join us.
Early bird pricing is available for a limited time until March 1st. And if you feel called to share your expertise, we are open for speaker submissions as well. All the information is available at the physician coaching summit. [00:52:00] com. So check it out, grab your ticket and get in Reach out to us at hello at the physician coaching summit. com with any questions. Details will be in the show notes. May we honor what's been built, embrace what's next and have our own backs together. I want to take a quick moment to acknowledge our incredible team. This podcast is produced by the amazing Kelsey Vaughn, post production and more handled by Alyssa Wilkes, and my steadfast friend and director of operations, Denise Crain. Our theme music is by Denys Kyshchuk cover photography by the talented Shelby Brakken and a special appreciation to my loyal champion and number one fan, Suzanne Sanchez. Thanks again for tuning in everyone. May we continue caring for ourselves, caring for others, and may we continue solving for joy. Take care. We'll see you next time.
