Dr. Shelley Meyer: Hey it’s Dr. Meyer and welcome back to my channel if you’re new here welcome if you’re returning I appreciate your support please like subscribe if you haven’t done so already please like subscribe and share this video if you find that it would be relevant to anybody you know going through burnout I’m a doctor I am a family doctor and a functional medicine doctor if you haven’t followed any of my videos or social media before so I’ve been highlighting lately a lot of other physicians that I’ve been talking to as far as their experiences with burnout and you know how they’ve changed how they’ve done something creative or interesting or made it easier to deal with burnout or helping other women deal with burnout so that’s what I want to focus on today but I want to focus on my story because I haven’t shared that yet so I started out my career after college and graduate school I went to university of Florida undergrad and got a degree in nutrition and then I did got my master’s degree at Georgia state and nutrition so I worked as a dietitian in an underserved community clinic and I really liked it I really enjoyed teaching people about nutrition and how what they put into their body affects their health but I wanted to do more and I was really fascinated with what the doctors were doing at the clinic that I worked at and I talked to the doctors and I just decided hey I’m going to try I’m going to do it you know when you’re in nutrition you have a lot of the prepress that you need for medical school so I only had to do a couple more prerequisites I think it was some kind of chemistry and I don’t remember what the other one was it’s been a long time so then I applied to medical school and I went to medical school in Kansas city and then I had since I worked with so many family doctors I decided that’s what I wanted to do I wanted to be a family doctor because you never get bored as a family doctor there’s always something interesting you’re doing working with babies at the residency program that I went through we um worked we delivered babies we delivered a lot of babies and then we’re working um you know throughout the lifespan into the elderly years as well and there’s always something interesting coming through your door so I really liked the training um so then I went to my residency which is your three years of in family medicine the three years of training you do after medical school I did that at set Anthony’s in Denver Colorado and I live in Denver now so that was interesting and exciting did a lot of deliveries of babies did a lot of high-risk patients worked with a lot of high-risk patients we at one point in that part of our training you know they had just instituted the 80-hour rule which was this big thing that we only had to work 80 hours a week can you imagine now 80 hours a week was the limit or that luxury they gave us after all those years of just working residents non-stop whoever they needed or wanted to so we were lucky that when I went through residency it had just been instituted so we couldn’t work more than 80 hours a week so you talk about burnout that starts your whole cycle of burnout is that lack of sleep um that you know constantly being on and dealing with a lot of intense situations so at the time at the residency I was at we delivered babies like I said we I worked with the NICU the neonatal intensive care unit we worked with the er so we would do the admissions for the family medicine department you know basically being the primary care doctor inpatient the hospitalist for certain patients and then you know we had our own patients as well so at some point on what we call naked call we were never naked but that meant we were by ourselves so we would have four pagers at one point our personal pager our er pager our neonatal intensive care pager and our OB pager that was crazy um I don’t know how they do it now I hope they have more limits on that but that was insane a lot of times we would have some support with somebody else there with us another resident or an older resident or um maybe a new resident if we were already in our later years but a lot of times we did have that naked call so that was rough and that sets you up for burnout so you’re already working I working and then you finish and then I finished um residency and I had done the national health service corps scholarship program where the government you know I went through interview process the government agreed to pay for my three years the second third and fourth year of my medical school training in exchange for me giving my time and working in underserved community when I finished residency I was all on board with that I had worked in an underserved community prior so I was excited about that but at the time I wasn’t married dating or you know having a family so I was like I’m flexible I can move wherever but then you know in residency I met my husband got married in my I think my last year of residency so it was harder to move anywhere they wanted me to and I was having a hard time finding something in Colorado I did find something and I got a little screwed over by that position that I helped to create so I had to find something in the last month of my residency so I did move to Nashville which is a great place to live and I worked at an inner city community there which I mean an inner city clinic there which sounded great sounded a lot like the clinic I did my dietitian work at which was Grady hospital clinic systems in Atlanta but it turned out to kind of be a big mess where I worked the medical director there was very unsupportive had his favorites I clearly was not one of the favorites um he tended to uh kind of disgrace anybody’s name that quit that he didn’t like so there was that you knew you weren’t going to get a good review from him when you left and then also the clinic was all about your productivity like most of them are now still are now um and this was quite a while ago so RVUS are the term now back then I don’t know what the term was but we would have these meetings once a month for the whole set of clinics and it would review how productive you were and everybody’s name would be on there and your productivity would be on there so it’s kind of shaming if you don’t go as fast as everyone else and my goal as a doctor was and is not to go fast through my patients not to rack up numbers and treat my patients like a number it’s to really provide them good care and we had really complex patients with diabetes and hypertension and you know heart attacks and we were seeing high-risk moms that were pregnant and we were doing you know procedures and different things and we had a whole hallway full with flags up left and right that I had to see and I had 10 minutes to see these patients sometimes I would get 20 if I had a well child check or a well-woman exam that’s not enough time to really address somebody’s high needs and you know that’s only enough time to really say hi ask what the symptoms are write your prescription we had just started using the EMR so there was that whole level of complication so basically I was writing prescriptions and that’s the main care I was doing for my patients I was trying to do more and have more discussions but I did not have enough time um so my productivity was not as strong as they wanted it to be I did not get fired I mean I left after I committed my time that I needed to give the government but I was clearly not favored or looked upon as a productive employee at that time I was also trying to get pregnant and I went through infertility treatments and that was a huge big stress I lost a baby early on and at first they were very understanding about that and gave me a little bit of a flexible schedule although it was still working my amount of time that I was supposed to be working but then I got a lot of flak about that and how I was being manipulative and working the system and I that’s what I was told I wasn’t in my eyes being that way so it was just insane the amount of patients you know we would see 25 30 patients a day sometimes I less sometimes it was 15 to 20. but even so then having to do all the charting on a new EMR after that that’s only going to set you up for burnout and no one cared no one cared they only cared about the numbers there wasn’t any talk about how we were doing how they could support us um how we were handling the new EMR or how we are handling such complex patients or any kind of support it was just get your numbers in that’s how you will be rewarded is if you see more patients so I knew that i had three years there and I knew towards the end of that three years I can’t do this I can’t keep this up so yeah I looked around I knew I wanted to we knew we wanted to move back to Denver and adopted a baby at that point and then by the end of that three years I actually got pregnant didn’t think I could but I did so we had a I baby and then I was pregnant so I knew I had to get out of there and really take care of myself so I was looking into starting my own practice I found the imp ideal medical practice community and there were forums back then there wasn’t a lot of Facebook going on or groups or anything back then so it was forums and they were super inspiring it was like low overhead practices don’t hire a lot of employees don’t spend a lot of money just use your expertise and just start small and so I really studied that and I learned how to start small so I started um I found a place actually I didn’t start small with my I office because I envisioned having a wellness center and so I found an old Victorian house in my neighborhood I got really lucky I was still in Nashville but in my Denver neighborhood we still owned our house a little tiny house that we still live in um and it the Denver Victorian house that I was zoned for business and um and personal or residential is on the same block that I mean not this on that same block the same street that I live in so I got really lucky finding a property that was um just four blocks down the street from where I lived or was going to move back to so we bought it um we did some work to make it into offices because it was still a house and I envisioned you know having a wellness center but then realized the overhead on that would be huge so we rented out space in all the offices and I took um two of the offices at that point and I started my own practice and I hired my mom at that time she was my front desk person it’s hard to work with your mom but it can be done and we worked things out and it was somebody I trusted and you know we had a good relationship and um you know just started I was taking insurance at that time I got on a bunch of different insurance plans and that’s how I found people to come into my practice as patients and also I was in the community and there’s a busy little village kind of setting that I’m in and so people would see the sign and be curious and come in because we I named it highlands health and wellness so you know just gradually built it up and then after from 2017 to like 20 no from 2011 to 2017 I accepted insurance then I got tired of them being my boss in the insurance companies because they decided how much they were going to reimburse me they didn’t see they weren’t there they aren’t physicians they didn’t know how complex that patient was and I started an integrative medicine practice because I had done that training when I was at that other job knowing I’d use my CME money knowing that that’s what I wanted to do because with my nutrition background I wanted to provide alternative kind of solutions as far as holistic solutions with nutrition and lifestyle and supportive nutrients and all of that and talk about all the pieces of somebody’s life stress and not just prescribe that medication I was over the prescription mill part of my life which I didn’t really practice that way before but that’s all I had the time for so I tried to fit in whatever I could as far as integrative medicine goes at my other job so these insurance companies were telling me how much time they would pay me for with the patients and it wasn’t enough time to address the patient in a complete way and really address their issues and their past and their present and their stress and their nutrition and their nutrients and testing and all that so I just said you know I want to be my own boss truly so having your own practice you are your own boss but when the insurance companies are involved they are your boss in today’s climate so in 2017 I changed over to a direct primary care practice where people would pay me directly they could use their HSA and that has evolved over the years where that’s more acceptable that people can use their HSA for direct primary care so what they do is they pay a monthly fee and then I take care of them as far as functional medicine goes because then I went and did all my functional medicine certifications I had done that in 2017 before I changed over and family medicine they have direct access they will contact me text me we have a secure app on our end called spruce which I love and you know my patients can directly interact with me I have now I have a different employee my mom did retire so I have one full-time front desk employee who I’ve known for a very I’ve long time and trust completely and then I have a health coach now who also is a phlebotomist and so she’s a certified health coach channel phlebotomist so she does our blood draws and I coaches for us one and a half days per week so full-time employee and a part-time employee so people pay me a monthly fee they can talk with me directly on the weekends after hours if they need me and even then that can induce burnout when people have constant access to you but I need that to be able to be supportive to them and it helps me understand what they’re going through and when be there when they need me and then just develop a really close relationship with them but you know it doesn’t work out with everyone I have contracts with patients 6 months or 12 months and sometimes it might not be a good fit between us and that’s fine and that’s going to happen I do keep my numbers low particularly lately because I felt like I was getting more into a burnout stage or not there but I could potentially go there so it’s not like I’m making all the money in the world a millionaire and I stopped taking patients because of that it was because I’m taking care of myself I needed to set some boundaries and some limits so I did stop accepting patients recently new patients I still have all my patients that were already existing I didn’t kick anybody out but that was just to kind of have enough time for them you know so I could really be there for them but also really have you know boundaries for myself so that I wasn’t over committing so I think that’s really important if you’re a doctor or professional person or have a family and working full time and you have some control over you have your own business or you know can advocate for yourself in your current climate to do that to set those boundaries to take care of yourself to honor your own feelings and your own stress levels and just not get yourself into a situation where you’re just over promising and can’t keep up and can’t do your job the way you want to do it you know I want to be able to practice medicine the way I feel good about and that I respect what I’m doing and I’m I feel like I’m trying to do a good thing in the world and be the best that I can be in my practice or in my profession and that’s what I think we all need to do to feel good um to handle stress better so I think advocating for yourself setting boundaries not focusing only on the money or the I prestige or the position the focusing more on yourself and you know what you need so if you’ve enjoyed this please leave me a comment down below if you’re struggling please leave me my comment down below if you want to support the mission to help women in medicine reclaim their mental health and their physical health and reclaim the love for medicine please join me on my patreon there’s a you can support the channel that way I know my prior um videos or a lot about functional medicine hormone health gut health and there still will be some of those to come but I’m intermixing you know like other kind of another mission that I feel very strongly about as well so I really appreciate you supporting the channel watching this video please like subscribe and share it out if you’re listening to this on my new podcast I forgot to mention that earlier it’s called um women in medicine be the change and that’s so you can help be the change you want to see in the world so please support the podcast that’s brand new and I know a lot of women or professional women that are working might listen to a podcast so that’s why I’m kind of doing the YouTube and the podcast too so please listen to that um leave me a review good review hopefully on um on wherever you’re listening to your podcasts and subscribe to that so that we can uh help grow that as well so I thank you so much and I’ll see you next Friday.