Latest / Lean Out Podcast / Time with Maria Colon-Gonzalez

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Time with Maria Colon-Gonzalez · Lean Out Podcast

• 0:01
  Welcome to the lean out podcast.
• 0:03
  I'm your host, Dr.
• 0:04
  Don baker.
• 0:05
  Are you looking for a new approach to finding authentic and sustainable work-life balance?
• 0:10
  You've come to the right.
• 0:11
  Place.
• 0:11
  For inspiration.
• 0:12
  information.
• 0:13
  and a community.
• 0:14
  community.
• 0:14
  of like-minded.
• 0:15
  Professionals.
• 0:16
  Let's get to the show.
• 0:23
  Hello.
• 0:23
  Hello.
• 0:23
  Thanks for being here.
• 0:25
  I hope your January is off to a great start.
• 0:28
  We've had a lot less snow on our mountain homestead than normal, but it's still very cold outside.
• 0:34
  This winter we've been going snowboarding again, which is something that I used to do a lot when we lived in salt lake city, but I haven't done for about 15 or so years.
• 0:44
  I had even gotten rid of all of my gear and had to get brand new gear in order to restart snowboarding.
• 0:51
  Being the beginner again has been a humbling and yet fun experience.
• 0:56
  And one of the things that I teach in my upcoming confidence course is when we challenge ourselves with low stakes and enjoyable activities, it reminds us that we can do the really hard things when they happen to come up, like doing a negotiation at work or leaving a particular role that everyone is expecting you to do, or even just changing jobs altogether or starting your own business.
• 1:22
  If you haven't done.
• 1:23
  So make sure that you go to the page practice balance.com/l O C C to get on the interest list for the course.
• 1:31
  So that you'll know when it's open and ready.
• 1:34
  It should be maybe at the end of this month.
• 1:37
  That's what I'm hoping.
• 1:39
  I've gotten great feedback from several beta testers and the feedback is still coming in.
• 1:45
  So I'm very excited to release this to the public very soon.
• 1:50
  Today's show features Dr.
• 1:51
  Maria cologne, Gonzalez.
• 1:54
  She's an integrative and lifestyle medicine doctor based out of Texas.
• 1:58
  Her approach to care is your body tells a story and you can rewrite the narrative.
• 2:04
  She's also the author of healing, the wounds of medicine, stories and journaling for physicians.
• 2:10
  In our conversation, we talk a little bit about the ins and outs of an integrative practice, but we also talk a lot about how she manages her time and energy with a lots of things on her plate.
• 2:21
  I hope you enjoy this conversation with Maria.
• 2:27
  MCG-Dawn: Maria, welcome to the lean out podcasts.
• 2:30
  MCG-Dawn: I'm really happy to see you here.
• 2:32
  MCG-Dawn: Can you tell us a little bit about yourself what you do and how your work life balance is different than other people in your profession?
• 2:40
  MCG-Maria: yes.
• 2:41
  MCG-Maria: So I am a physician.
• 2:44
  MCG-Maria: Originally from Puerto Rico I migrated to the state about 14 years ago and that's when I was doing residency and then my fellowship and I have been a little bit all over.
• 2:57
  MCG-Maria: So I was first East Coast, Northeast and right now I am in Texas, specifically in Houston.
• 3:04
  MCG-Maria: What I do is primarily as a holistic physician.
• 3:09
  MCG-Maria: Some people do know what functional integrative medicine is.
• 3:13
  MCG-Maria: Some people do not.
• 3:14
  MCG-Maria: So that's why I like to use the term holistic medicine.
• 3:19
  MCG-Maria: And precisely in terms of like how my life balance is different I think that I have been very purposeful about trying to create that.
• 3:29
  MCG-Maria: And what I mean by that is, so very early on in my career, what I learned was, it's a lot of hours.
• 3:38
  MCG-Maria: And I remember, I have a uncle in Puerto Rico who is, now a retired physician, radiologist.
• 3:44
  MCG-Maria: But he told me, oh, if you think that things will get easier after medical school, it won't.
• 3:50
  MCG-Maria: And for me, he was right in terms of the amount of time that a lot of the times you need to devote to patient care.
• 4:00
  MCG-Maria: And it's a lot of time that patients don't even like see and they do not know that you're actually working like for them.
• 4:08
  MCG-Maria: When I realized that and I realized how much that affected my social life, because sometimes you're working evenings, you're working weekends, and that affects your quality of life.
• 4:20
  MCG-Maria: So not only socially and being able to have friends, but overall, your amount of time that you might have to exercise, if you want to go have a spa day.
• 4:32
  MCG-Maria: Um, it was very challenging and I thought well I'm in a residency now and in your first year you're doing a lot of calls.
• 4:39
  MCG-Maria: So I thought it was just that and then in my fellowship Um when you start with a new panel of patients and all the patients are new and you're reviewing Records and I realized like, oh, this takes a lot of time a couple of things that I learned specifically in my profession that have been able to help me.
• 4:59
  MCG-Maria: So, 1, the importance of having boundaries, and I think that a medical school and a medical training, and this can be a little bit different for.
• 5:09
  MCG-Maria: People coming from different schools.
• 5:11
  MCG-Maria: Again, I trained in Puerto Rico, more, a little bit more conservative, a little bit more patriarchal.
• 5:17
  MCG-Maria: So you get taught about the patient comes first, no matter what.
• 5:21
  MCG-Maria: And I remember my first day of medical school, uh, the dean of student affairs, she told us, if you need to come to one of your rotations with an IV, you come to the rotation with the IV.
• 5:35
  MCG-Maria: So, very, yeah, very.
• 5:39
  MCG-Maria: I use the word very codependent, right?
• 5:42
  MCG-Maria: They, it's almost like they wash your brain to become codependent in what you have realized is that yes, you don't want to become irresponsible towards the patient, completely not, that's not what I'm saying, but sometimes what can be seen as the need to put the patient first or a patient emergency really actually even trumps your own health.
• 6:08
  MCG-Maria: So, I learned that, one, I should take my lunchtime and my bathroom breaks, sleep is very important, and I also realized that there are certain types of structures that permit that more than others, unfortunately.
• 6:26
  MCG-Maria: When you work in a structure where you have patients that have like multiple types of insurance and you need to keep track of what insurance pays what and how you need to work, that makes your job more difficult.
• 6:42
  MCG-Maria: And when you work in a system where they are Putting four patients in a 40 minute block and you have no save over that, that also affects, and it all trickles because if you are not able to see the patient and do your notes as you're seeing the patient, that will trickle to home.
• 7:02
  MCG-Maria: And things like start to accumulate.
• 7:05
  MCG-Maria: So I have been able to find life balance by slowly starting my own practice, because it has been one of the ways that I have been able to then, maintain certain boundaries so that I It's not that you do not want to take care of patients is that those boundaries permit me to be a better doctor.
• 7:28
  MCG-Maria: Believe it or not.
• 7:30
  MCG-Dawn: And offline, you had said that you did a traditional practice for a number of years after training.
• 7:37
  MCG-Dawn: Can you talk about what was your original training that led you to the functional medicine?
• 7:45
  MCG-Dawn: Because I'm sure a lot of people are interested, but they don't know if they have the right background to do that kind of medicine.
• 7:53
  MCG-Maria: Yes.
• 7:53
  MCG-Maria: So I'm board certified in family medicine.
• 7:57
  MCG-Maria: I practice full spectrum family medicine for my first 4 to 5 years after residency.
• 8:05
  MCG-Maria: And for me.
• 8:08
  MCG-Maria: So the one thing that helped me in terms of like, I'm going to make this transition one for my own personal health journey growing up.
• 8:18
  MCG-Maria: I had a diabetes.
• 8:20
  MCG-Maria: I had asthma, chronic back pain.
• 8:22
  MCG-Maria: So three medical conditions that sometimes people think of older people or people that do not take care of them, of their health or, um, they're obese.
• 8:34
  MCG-Maria: And the reality is, I didn't fit that pattern.
• 8:38
  MCG-Maria: And in my own health journey, even thought I would go to my doctor, and I would see the PMR doctor, and I had my MRI done.
• 8:46
  MCG-Maria: Really, all of that would help in terms of like, make it less, but I was never truly living my life to the fullest.
• 8:57
  MCG-Maria: And it was my own reading, my own studying, my own changes.
• 9:03
  MCG-Maria: And I wouldn't say that necessarily I lived like a very unhealthy lifestyle, but the reality is because of the culture, the Puerto Rican culture, there were some things, you know, in the food that could be modified and, and some things that I did modified in terms of my lifestyle, those were things that had an impact.
• 9:23
  MCG-Maria: I started to practice yoga.
• 9:25
  MCG-Maria: So these elements that helped me in my own health.
• 9:29
  MCG-Maria: Once I was in practice, and it was probably maybe my second year of residency, I became so frustrated because I'm like, you know, what we do is see patients prescribed, see patients prescribed, like, going to medical school is really more like pharmacology.
• 9:46
  MCG-Maria: That's, that's what you learn, symptoms, prescription.
• 9:50
  MCG-Maria: And people are never, you know, getting better.
• 9:54
  MCG-Maria: And sometimes I would, I would find it really boring just to see four patients for the medication refills.
• 10:01
  MCG-Maria: Once I was also in fellowship that really reinforced that because I was seeing patients that were, They really could improve if the approach of the health system was, one, a little bit different and probably live a healthier life and depend less on medication.
• 10:22
  MCG-Maria: So I realized, like, oh, my vision was very different than what medical school and residency and training is.
• 10:33
  MCG-Maria: what I decided to do was just, okay, I know things that have helped me, and they're also evidence based, there's studies of these, things helping people.
• 10:43
  MCG-Maria: Well, let me get trained in these areas.
• 10:45
  MCG-Maria: And I started to get trained in these areas.
• 10:47
  MCG-Maria: It was very empowering.
• 10:50
  MCG-Maria: And then what I realized is that if you continue to be in the traditional healthcare system, It's very hard to practice that way, and to provide that care, because that's not what the traditional health care system does.
• 11:04
  MCG-Maria: So that's when I also decided, I need to.
• 11:07
  MCG-Maria: Slowly move away from the traditional structure of the health care system, because it's not only about the knowledge of the physician,
• 11:19
  MCG-Dawn: So it sounds like you had some personal health experiences that led you to want to seek more training beyond the traditional medical system that we all know and love.
• 11:37
  MCG-Dawn: Was it frustrating to be trained with the non holistic approaches when you knew that there was something else out there
• 11:47
  MCG-Maria: I think that in medical school, you're just trying to navigate, getting everything in and taking all the tests and passing I think that when it started to sink in was probably more, as I said, late residency and fellowship where I just felt that I was just working and working and working and patients are not, you know, not getting better.
• 12:10
  MCG-Maria: So you feel very frustrated in terms of like, what am I doing?
• 12:15
  MCG-Maria: Are you really helping people?
• 12:18
  MCG-Maria: If you're only prescribing one prescription after the other or just increasing the doses or just providing refills When you know that there are things that can be done To improve quality of life.
• 12:34
  MCG-Maria: So even if they still have a medical condition or illness, you can still help improve their quality of their life.
• 12:41
  MCG-Maria: And I think that that's when I started to become very frustrated.
• 12:45
  MCG-Maria: 1st, I thought that it was.
• 12:47
  MCG-Maria: Oh, well, I need a different set of like tools and knowledge and when I look back and even yesterday, I was speaking with a colleague that was asking me.
• 12:58
  MCG-Maria: Oh, I don't know if to do the fellowship and I'm thinking of integrative medicine or functional medicine or lifestyle medicine.
• 13:03
  MCG-Maria: And I was like, look.
• 13:04
  MCG-Maria: The reality is that if you are a physician, you have the capacity to self study and learn a lot of this.
• 13:13
  MCG-Maria: And looking back, what I realized is, it was not necessarily a lot of lack of knowledge.
• 13:18
  MCG-Maria: It's more that the way that the system is set up, because again, I had already learned a couple of things taking care of my own diabetes.
• 13:27
  MCG-Maria: Taking care of my own chronic back pain and that's knowledge that I had so looking back what I do realize this More than getting the training and the skill It was more about being in a system that would empower me as a physician to practice that way and empower Patients to receive that type of care.
• 13:52
  MCG-Dawn: Your point is very valid that it's not just about getting another certification or a, training program or a fellowship.
• 14:02
  MCG-Dawn: But what would you recommend to people who are in a similar kind of a practice that are wanting, to get into this type of field?
• 14:13
  MCG-Maria: Yeah, it's really a good question.
• 14:15
  MCG-Maria: So first of all, I would say Do a really good heart shag.
• 14:23
  MCG-Maria: And why do I say this?
• 14:25
  MCG-Maria: Well, because I have also known a physician that once they start the training, they realize that it's such a different way of practicing and taking care of patients that then they realize like, oh, I'm not sure that maybe they have like the energy to put into it.
• 14:44
  MCG-Maria: So before you even start it, do a really hard check and make sure that this is a transition that you want to make, because in a way it's almost like starting a new career.
• 14:55
  MCG-Maria: So ask yourself, is that something that you want to do?
• 14:58
  MCG-Maria: Then people ask what's the difference between lifestyle medicine, functional medicine, integrative medicine?
• 15:05
  MCG-Maria: And this is the best way that I can explain it, at least from my perspective.
• 15:12
  MCG-Maria: So lifestyle medicine, I think it's super good because it's like the base of what I think that all patient care should have.
• 15:22
  MCG-Maria: And it's not only nourishment and movement, there's a lot that goes into lifestyle.
• 15:29
  MCG-Maria: That being said, lifestyle medicine focuses a lot on the individual.
• 15:35
  MCG-Maria: Me in particular, I like integrative medicine, a little bit more than functional medicine because integrative medicine, I think it does a better job at incorporating the mind, body, spirit side of caring of people.
• 15:52
  MCG-Maria: They look into like ancient or more traditional eastern, medicine.
• 15:58
  MCG-Maria: So like Chinese medicine, Ayurveda, and functional medicine is really good at Doing like specialty labs, knowing supplements that you can use to what they they call fix the root cause.
• 16:15
  MCG-Maria: So at the cellular biochemistry level, which I think that again provides really good tools, but I like a lot the aspect of integrative medicine of looking at the whole individual.
• 16:30
  MCG-Maria: So I would say, study the differences and, and if you're going to embark, especially if you're going to invest in a fellowship and say, I'm going to sit down and take another board, which right now there's functional medicine, it's not recognized by the American Board of Specialty Medicine, Integrative Medicine is, so if you're going to sit down and do another fellowship and sit for another board.
• 16:53
  MCG-Maria: If that's what you choose to do, know the differences.
• 16:56
  MCG-Maria: I will say that again, there is a lot that you can learn by going to the right conference.
• 17:03
  MCG-Maria: So we all have to do CMEs.
• 17:05
  MCG-Maria: You can look for CME conference that are specific, to those topics.
• 17:10
  MCG-Maria: And there's really good books out there that are good evidence based books that you can learn and study some of these topics and just choose your passion.
• 17:22
  MCG-Maria: So I think that you don't necessarily have to embark in another four years.
• 17:28
  MCG-Maria: Integrative medicine takes two years, functional medicine is going to take you about, like, 18 months also.
• 17:34
  MCG-Maria: So you don't have to embark in another four years of studying.
• 17:40
  MCG-Maria: To gain a lot of the the tools that you would need.
• 17:44
  MCG-Dawn: So tell me about what your practice looks like now.
• 17:47
  MCG-Dawn: How many days a week are you seeing patients?
• 17:50
  MCG-Dawn: How many patients per day do you see?
• 17:52
  MCG-Maria: Yes.
• 17:53
  MCG-Maria: So it's a direct to patient care practice.
• 17:56
  MCG-Maria: I think that really, really helps in terms of this life balance.
• 18:03
  MCG-Maria: And I have extended visits.
• 18:05
  MCG-Maria: So all of my appointments are one hour.
• 18:08
  MCG-Maria: I use a 15 block between patients in case.
• 18:15
  MCG-Maria: have to, again, go to the bathroom or do anything.
• 18:18
  MCG-Maria: So, it's about six patients per day at the most.
• 18:22
  MCG-Maria: It's not more than that.
• 18:23
  MCG-Maria: Some days it's actually even less.
• 18:25
  MCG-Maria: I do see patients, Monday through Friday.
• 18:29
  MCG-Maria: But that being said, I don't start seeing patients until 11.
• 18:32
  MCG-Maria: 30.
• 18:33
  MCG-Maria: So I use the morning time to exercise, walk my dog, do all of these other things, take care of some of the admin stuff.
• 18:42
  MCG-Maria: Because at the same time, what I realized is that in the traditional setting, you might not necessarily have a block for, um, Patient messaging, reviewing charts, like that sort of work.
• 18:57
  MCG-Maria: And then the other thing that I realized is, is you don't necessarily even have blocked time for CME unless you go to like a CME conference.
• 19:07
  MCG-Maria: And the reality is that nowadays, you know, we have to do.
• 19:11
  MCG-Maria: At least I have to do 75 hours of CME per year and then on top of that, I have to do like all the questions and all of the other stuff that the American Board of Family Medicine wants us to do.
• 19:24
  MCG-Maria: And I realized that it's a chunk of my time.
• 19:29
  MCG-Maria: That because Monday through Friday, I'm seeing patients eight to five, and then, you know, the time that it takes you for like work and then the time after work to finish your notes, all of that, then that will always go into my weekend, right?
• 19:43
  MCG-Maria: Which is, and then you don't have, again, it starts to affect your life, your social life.
• 19:48
  MCG-Maria: So.
• 19:49
  MCG-Maria: Even that now, I see it as part of my working hour, and basically what that means is, just as I block time to see a patient, well I block time to do a CME, or I block time to do administrative, things related to the practice.
• 20:07
  MCG-Maria: So if you are a physician and you're thinking about your own practice and starting your practice, it's really important that you also start to see your time that way, I think, and that you start to divide it, because that is what at the end will start to create that space for you to breathe.
• 20:25
  MCG-Maria: And some people say, Oh, well, you know, it's just that it's the type of lifestyle that you have.
• 20:30
  MCG-Maria: And we know that there's research that shows that when you are in residency and you're doing your 30 hours and you have not slept, that it's the same as, having alcohol in your system.
• 20:44
  MCG-Maria: So if I were to drink alcohol and, you know, present to the hospital, with a high alcohol level, that would be your back doctor.
• 20:52
  MCG-Maria: But then if I stayed up, it's the same process in my brain.
• 20:56
  MCG-Maria: Well, no, you're, you know, a super good doctor.
• 20:59
  MCG-Maria: And I'm like, it's the same thing.
• 21:01
  MCG-Maria: And it's not good for the physician, right?
• 21:04
  MCG-Maria: For me to work that way.
• 21:05
  MCG-Maria: And it's not good for the patient.
• 21:08
  MCG-Maria: So what I have learned is that when you are in a type of profession of service, when you need to keep up today with, science and all of the intricates related to practicing medicine, I actually feel that, that yes, you need more of that space so that you can actually continue to practice, good quality.
• 21:34
  MCG-Dawn: I love that.
• 21:35
  MCG-Dawn: I think the idea of scheduling in some of these things that everyone just does as the afterthought in their
• 21:44
  MCG-Maria: Mm hmm.
• 21:44
  MCG-Dawn: is really important.
• 21:47
  MCG-Dawn: And you mentioned some things that people forget about, like doing CME and things that really do take a chunk of your time if you think about it on a bigger time scale, like from year to year.
• 22:01
  MCG-Dawn: Having a period of time where you can do some research on a topic for a particular patient, or you are reviewing.
• 22:10
  MCG-Dawn: And you talked about doing some personal things in the morning too.
• 22:14
  MCG-Dawn: Tell me a little bit more about the things that you like to do for personal fulfillment and fun.
• 22:20
  MCG-Maria: Oh, so definitely.
• 22:22
  MCG-Maria: I love being outdoor.
• 22:25
  MCG-Maria: And so I walk my dog.
• 22:27
  MCG-Maria: I run.
• 22:28
  MCG-Maria: I hike.
• 22:30
  MCG-Maria: Sometimes I just sit outside in my hammock and read a book.
• 22:35
  MCG-Maria: And that's what I do.
• 22:35
  MCG-Maria: Or I take a nap in my hammock.
• 22:39
  MCG-Maria: I really enjoy that I've been outdoors and eating.
• 22:43
  MCG-Maria: I also enjoy cooking and being able to like cook a really nice meal and then have people over where you just sit and eat without, not only food, but without the stress of the next thing that you need to do.
• 22:57
  MCG-Maria: Right.
• 22:57
  MCG-Maria: So I think that that's really important.
• 23:00
  MCG-Maria: Um, I take some time.
• 23:03
  MCG-Maria: In the mornings, depending on the weather, after I exercise, and I actually sit outside with my coffee and a journal.
• 23:12
  MCG-Maria: And again, that starts to set a tone and intention that is very different than when you are waking up in a hurry and just in the rush, rush, rush to go.
• 23:25
  MCG-Maria: And besides the fact that there is a lot of evidence about exposure to nature and sunlight and what that does for us and our health and our mental well being.
• 23:34
  MCG-Maria: So journaling for me is.
• 23:38
  MCG-Maria: a practice or a ritual, that is really important in terms of awareness, introspection, self examination, and kind of like where am I in, in life.
• 23:51
  MCG-Maria: Um, and then the other thing that I also try to do, which I think that this is very helpful.
• 23:57
  MCG-Maria: So usually on Sunday at some point, I sit down with kind of like my planner, And even thought I have an electronic one.
• 24:05
  MCG-Maria: I also have like a pen and paper, and I look at what has to be done during the week, what appointments I have, and I put it there, and then I look at the blank spaces that I have, and what are the other things that I need to do.
• 24:22
  MCG-Maria: And as in medicine that we learn to triage like patients, then what I do is that I also triage and prioritize the things that need to get done during the week.
• 24:31
  MCG-Maria: What are those really important things I need to get done that I have to do first versus what are the other things that just can't wait?
• 24:38
  MCG-Maria: What are the things that perhaps I, I said yes to, but then I realized, I don't know.
• 24:45
  MCG-Maria: For example, this this week, I had an activity on Monday evening.
• 24:49
  MCG-Maria: I had one and yesterday evening and I'm supposed to go somewhere today in the evening.
• 24:54
  MCG-Maria: And I'm thinking, do I want to do it or do I don't?
• 24:57
  MCG-Maria: So again, I can I can continue to have me.
• 25:02
  MCG-Maria: So the other thing that I do in the morning after my coffee and my journaling is that I look again at the day and it's a reminder, okay, this is what I need to do so that I don't lose track of time.
• 25:17
  MCG-Maria: And that helped me I get organized because when you transition from somebody else being in charge of your time and telling you what you're going to do with your time, now you have to.
• 25:31
  MCG-Maria: It's almost like you have to take ownership again of your time and know how you're going to use them.
• 25:37
  MCG-Maria: Because, this is not like I can just go for an entire day hype every, you know, five days of a week, because if I do that, then we're also having a problem.
• 25:48
  MCG-Maria: So, I think that this retaking of the time is a skill that, You might need to develop.
• 25:57
  MCG-Dawn: Hmm.
• 25:58
  MCG-Dawn: Yeah.
• 25:59
  MCG-Dawn: I love those tips.
• 26:01
  MCG-Dawn: Can you tell me if it was difficult to transition to a DPC practice from a traditional practice in terms of patient volume uncertainty, financial uncertainty?
• 26:13
  MCG-Dawn: What was your experience with that?
• 26:15
  MCG-Maria: Yeah, that's a really good question.
• 26:17
  MCG-Maria: And I will be honest.
• 26:19
  MCG-Maria: It is a transition that I think that if you think it through and you plan for it, it will go better.
• 26:27
  MCG-Maria: Financially.
• 26:28
  MCG-Maria: So I'm a single woman.
• 26:31
  MCG-Maria: So if I do not work, it's not like I have, I know other physicians that their partner are either physicians or lawyers.
• 26:38
  MCG-Maria: I don't have that.
• 26:40
  MCG-Maria: And what has helped me, so one is, I've had some savings, so I would say look at your savings, can you, even if it's just temporary, can you scale down?
• 26:53
  MCG-Maria: So like scale down on your home, your expenses, your travel.
• 26:58
  MCG-Maria: Look at everything.
• 27:00
  MCG-Maria: Look at, memberships that you have, subscriptions that you have.
• 27:03
  MCG-Maria: Like really go deep and think about, do you really need to buy wine every time that you go to the grocery stores?
• 27:10
  MCG-Maria: Or for example, I, I flouters at Trader Joe's and I'm not going to do that every time that I go shopping anymore.
• 27:19
  MCG-Maria: And so look at your finances and then know that you will have to develop language and conversation with patients around the fact that they're not going to be using your insurance.
• 27:34
  MCG-Maria: And unfortunately, still, there's a lot of patients that think that insurance means access to care, but we know nowadays that that is not the case.
• 27:45
  MCG-Maria: So you do need to think about developing language of how you're going to tell patients.
• 27:51
  MCG-Maria: Even if you're not going to use your insurance, these are the benefits.
• 27:55
  MCG-Maria: So you need to know about HSA, flexible spending account, offer them an e super bill.
• 28:00
  MCG-Maria: And then know that still, if you have that language, there are patients that either will just say no, or they will do it one time, but then they, you know, they won't for whatever reason.
• 28:13
  MCG-Maria: So the insurance challenge will be there.
• 28:19
  MCG-Maria: As more, physicians are entering the arena of direct to patient care, I think that there's also going to start to be that shift where the patients will realize like, okay, this is, this is the new thing or the new way.
• 28:36
  MCG-Maria: And I think that people will start to be a little bit more open to it.
• 28:41
  MCG-Dawn: From a standpoint of other physicians or people that are in the traditional system, have you had any sort of pushback?
• 28:50
  MCG-Dawn: Has there been any difficulties there with your transition and the way that people perceive you?
• 28:56
  MCG-Maria: Yeah, so unfortunately, yes, I, I won't lie.
• 29:00
  MCG-Maria: Not all physicians believe that practicing holistically is evidence based.
• 29:07
  MCG-Maria: I do medical acupuncture and there are studies that prove that there are certain points that are even better than your sofran for post op, nausea and vomiting.
• 29:20
  MCG-Maria: I just see it as like, if they have not read the papers, then that's why they believe that it's not evidence based, right?
• 29:28
  MCG-Maria: And for some physicians, they see that doctors that decide to go direct to patient care is they're looking for a lifestyle, which, again, at the beginning, you're actually not even having that lifestyle.
• 29:44
  MCG-Maria: Um, so that's 1 and 2.
• 29:47
  MCG-Maria: Sometimes there are physicians that feel that you're doing it more because of the money.
• 29:52
  MCG-Maria: That you are against helping people that have financial constraints, which again, that's not true.
• 30:00
  MCG-Maria: Because, for example, this past weekend on Saturday, I was doing some community acupuncture, as a way again to make it accessible for people that maybe cannot go to traditional acupuncture and pay the three figures for it.
• 30:15
  MCG-Maria: There's people that will always judge from the outside, and what I have learned about that at first, it will kind of like, cringe a little bit on me, but then what I have realized is like, It comes from a place of lack of knowledge.
• 30:34
  MCG-Dawn: Yeah, I think that's a great point.
• 30:37
  MCG-Dawn: You have to remember that your initial feeling about something that someone says to you or a perception that they have is not necessarily personal.
• 30:47
  MCG-Dawn: It's not necessarily true as well.
• 30:49
  MCG-Dawn: And so think about it from the perspective of the naysayer.
• 30:53
  MCG-Dawn: What is it in them that is making them have this reaction?
• 30:58
  MCG-Dawn: I've had that personally myself with just doing non traditional medical care and a lifestyle that is different from other people.
• 31:07
  MCG-Dawn: It's not about.
• 31:08
  MCG-Dawn: It's about us.
• 31:09
  MCG-Dawn: It's about them.
• 31:10
  MCG-Dawn: And it's about their insecurities or their lack of information.
• 31:15
  MCG-Maria: Absolutely.
• 31:16
  MCG-Dawn: Well, one other random question that I wanted to ask you is about your yoga practice, because I know you're a yoga instructor.
• 31:23
  MCG-Dawn: So how does that work into your work life balance right now?
• 31:28
  MCG-Maria: Yeah.
• 31:29
  MCG-Maria: So, I was, at the beginning of the year, I was teaching at some point.
• 31:34
  MCG-Maria: I think it was like five classes a week.
• 31:37
  MCG-Maria: And I realized, and again, I know, so that's what I was going to say.
• 31:41
  MCG-Maria: And then I realized, oh, that's a lot.
• 31:43
  MCG-Maria: And then it started to also have this effect on me where even bodice yoga, and I was teaching it at nighttime, by the time that I would come home, eat dinner, I was always going to bed past 10.
• 31:59
  MCG-Maria: And I realized this is not good.
• 32:02
  MCG-Maria: So now I have, so I have two really good clients that they still keep me for like private when they're available and I'm available and I do that.
• 32:12
  MCG-Maria: And also because it's private and it's a really different type of setting and in terms of the amount of people and your energy, um, I still practice my, uh, you know, all yoga and then.
• 32:28
  MCG-Maria: In a way there are some of the skills that I use with my own patients, right?
• 32:33
  MCG-Maria: So when I have a patient that comes and is going to have some acupuncture done, we know that it is more effective if they're not in the sympathetic mode and response.
• 32:46
  MCG-Maria: So you can use some breathing exercises, some grounding exercises just to help them in that way.
• 32:53
  MCG-Maria: So I might not be doing a consultation with them.
• 32:57
  MCG-Maria: But I'm still using some of that knowledge and skills to help the patient have a more effective treatment in better outcomes.
• 33:07
  MCG-Dawn: That's really a good point that you are getting at here, which is that even something that seems like it's very healthy can become unhealthy and it can become an unhealthy part of your balance.
• 33:20
  MCG-Dawn: And so figuring out a way.
• 33:22
  MCG-Dawn: to change the schedule so that you're not practicing too many yoga classes.
• 33:27
  MCG-Dawn: You can get burned out doing things that are fun or healthy and I love that you're integrating it with some of your patients and then also some one on one.
• 33:37
  MCG-Dawn: That is a unique way of using yoga training and I have also a yoga teacher training and so far all I have done is Use it to teach at our local jiu jitsu studio that my daughter goes to which is super fun I love doing it.
• 33:53
  MCG-Dawn: I love the creative part about it where I get to Make the lesson up each time, but I told her in the beginning which is like You know, gets at what we were just talking about.
• 34:03
  MCG-Dawn: I told the, the coach that I was not able to commit to more than one adult class and one children class each month.
• 34:12
  MCG-Maria: Mm hmm.
• 34:12
  MCG-Dawn: I just said, well, maybe we'll add more, but this is just what I'm able to do right now.
• 34:19
  MCG-Maria: Yes, yes.
• 34:20
  MCG-Maria: And I think that that is like so important what I realized was that as I move out from the go go go, oh, I need room to breathe.
• 34:32
  MCG-Maria: And then you start to, like, move inside the box, make it bigger, and then create that space to breathe.
• 34:39
  MCG-Dawn: Yeah, that's a great analogy.
• 34:42
  MCG-Dawn: Well, in closing for our interview, I'd like to know if you have any advice for listeners who are feeling burnt out, overwhelmed, or stuck in the position that they're in, feeling like they want to do something non traditional.
• 34:57
  MCG-Maria: Yes.
• 34:59
  MCG-Maria: My recommendation, or this is the way that I would approach it, is take some time to literally be by yourself.
• 35:06
  MCG-Maria: And it doesn't have to be like this fancy, um, escape to, the end of the world.
• 35:13
  MCG-Maria: You can even just try to, if you have a partner, if you have kids, talk to them.
• 35:18
  MCG-Maria: See if you can take, even if it's just like one or two hours.
• 35:22
  MCG-Maria: Go to a place where you can be in contact with nature, and it doesn't necessarily have to be outdoor.
• 35:29
  MCG-Maria: It can even be.
• 35:31
  MCG-Maria: So here in Memorial Park, we have a new restaurant and it has like, all glass and you can literally see, like, all the.
• 35:37
  MCG-Maria: The trees.
• 35:38
  MCG-Maria: So sitting somewhere there going with a journal and sometimes people are like, I don't know what to like journal.
• 35:48
  MCG-Maria: And I would say just start writing.
• 35:49
  MCG-Maria: We know that when we write the right and the left side of the brain start communicating.
• 35:55
  MCG-Maria: So the part that is thinking and the part that is becoming creative and think of where you are.
• 36:03
  MCG-Maria: So if you are in a place where you're really truly burned out or.
• 36:07
  MCG-Maria: If you don't like the word burned out, you know, decide which word you're going to use.
• 36:14
  MCG-Maria: Before stepping into the new, it might be wise to take some time to heal.
• 36:21
  MCG-Dawn: Yeah.
• 36:22
  MCG-Maria: whether, and that can look very differently, that, and when I say heal, that can be, you know, taking some time off.
• 36:31
  MCG-Maria: If you can do it financially, and just reconnecting with family, friends, what you like to do.
• 36:36
  MCG-Maria: That might be maybe work part time and then and the rest of the time dedicated to yourself Do some coaching and do some non traditional therapy Whether it is somatics EMDR something that helps you getting more in contact with the body dancing creative arts Again, those are tools that can help you just even discover what you truly want Because it might not even be that you need to again leave medicine if you're a physician or even leave your career.
• 37:11
  MCG-Maria: Sometimes it is just that you need to structure it in a different way that allows you to breathe and you can continue to do what you love if that's what you love to do.
• 37:22
  MCG-Maria: And if you are in a place where you do not need healing, where you're like, I'm just tired, but I think that I can just, I don't know, quit my job and in another week, just start something new.
• 37:35
  MCG-Maria: And then I would say still take that time in that week to make sure that what you're starting new It's what you truly really want so that you are not in this kind of like limbo.
• 37:48
  MCG-Maria: And most of all be honest and Truthful to those people that can be of support in this journey And that will understand without judgment.
• 38:02
  MCG-Maria: And what I mean by that, at least as a physician, and I have heard this also from other physicians, if you say that you're stepping out of medicine or traditional medicine, you even get pushback from family members because, you know, being a physician, being a doctor comes with certain historical or cultural, prestige, if you want to put it that way.
• 38:29
  MCG-Maria: And I think that it's important then to know who are the people that can be of support in this journey, independently of what your choice and decision are, without that judgment.
• 38:42
  MCG-Dawn: Yeah.
• 38:43
  MCG-Dawn: Yeah.
• 38:43
  MCG-Dawn: Very good advice.
• 38:45
  MCG-Dawn: Well, maria, thank you so much for being on the show and for telling us a lot about your time themed, practices and advice.
• 38:55
  MCG-Dawn: I really appreciate it today.
• 38:58
  MCG-Maria: Thank you.
• 38:58
  MCG-Maria: Thank you, Dawn, for having me here, and I hope that this was helpful for your listeners.
• 39:06
  Thanks to Maria for talking us through the differences in alternative medicine specialties, and also giving us her wisdom about time management.
• 39:15
  Here are my takeaways from our conversation.
• 39:18
  Number one, take some time to plan out each week.
• 39:22
  And when you do so, make sure to design your weekly schedule to include non-work tasks as well as work ones.
• 39:29
  If you have trouble making it to the gym, block it off in your schedule.
• 39:32
  So nothing else falls in that space.
• 39:35
  If you've been trying to integrate a regular yoga practice into your life.
• 39:39
  For example, even if you're doing it at home with a video or a book, put that time slot into your calendar.
• 39:46
  Maria shared that she blocks out time for work-related, but not direct to patient care tasks like learning and CME.
• 39:54
  As well as walking her dog journaling and having time to just sit in her hammock.
• 39:59
  It was refreshing to hear all the simple pleasures she makes sure to find time for in her days and puts into her calendar.
• 40:08
  Number two.
• 40:10
  Even doing things that are billed as healthy or holistic can cause you burnout.
• 40:15
  This is also true for the dream job.
• 40:18
  Anything you do too much of, or that's not quite in alignment with your personal values, can over time.
• 40:25
  Cause burnout.
• 40:26
  Maria's example was teaching too much yoga and needing to peel back on teaching.
• 40:31
  So many classes.
• 40:33
  There are other ways you can incorporate a healthy pursuit into your schedule.
• 40:37
  Maria now doubles up and practices yoga with some of her patients before they're about to get acupuncture.
• 40:43
  And she conducts occasional one-on-one sessions instead of several group classes in a week.
• 40:51
  Number three.
• 40:53
  Time was a big theme in this conversation.
• 40:55
  If you're leaning out to start a micropractice do locum tenens or per diem work or starting your own business suddenly no one is telling you exactly what you have to do with your time.
• 41:06
  And at first, this can be kind of scary or disorienting.
• 41:10
  As Maria counseled us in this conversation, you have to learn how to take ownership of your time again and use it wisely to get done what you need to get done while still incorporating the small pleasures that you want to have in your life.
• 41:26
  My parting question for you today is what thing that you've been wanting to do for yourself.
• 41:31
  Can you start scheduling into your calendar so that it has its own block of time?
• 41:37
  I want to hear what yours is.
• 41:38
  So leave a comment on the blog post associated with this episode@practicebalance.com or send me a DM.
• 41:45
  On Instagram at practice balance.
• 41:48
  Thanks for listening to the lean out podcast.
• 41:51
  If you find these conversations inspiring and useful, please forward them to a friend and also leave a review on iTunes or Spotify so that other people can find them easier.
• 42:03
  If you want to get in touch with me, you can find me at my website, practice balanced.com, where you can subscribe to my newsletter and get updates regularly about new podcast episodes, blog posts, speaking, engagements, and coaching services.
• 42:20
  You can also support my work by buying my book, lean out a professional woman's guide to finding authentic work-life balance for yourself, a friend, family member, or coworker.
• 42:32
  Have a great day and we'll see you next time