Latest / Coffee Playdate Podcast with Dr. Olga Deengar / From Burnout to Mosaic Ep 40: How Dr. Alexia Gillen Reclaimed Medicine on Her Own Terms
Transcript
- Dr. Olga Deengar: Welcome to the Coffee Playdate podcast. I have a very special guest with me today, Dr. Alexia Gillen. Welcome. Dr. Alexia Gillen: Thank you, I'm excited to be here. Dr. Olga Deengar: Alexia, do you drink coffee? Dr. Alexia Gillen: I do? Dr. Olga Deengar: And how do you like your coffee? Dr. Alexia Gillen: I'm mostly black if I'm drinking it at home. Otherwise, if I go out, I will typically have an oat milk latte with a little honey. Dr. Olga Deengar: I love that. Perfect. Dr. Alexia Gillen: Yeah. Dr. Olga Deengar: We're going to start off with our first game. This is a rapid fire questions game. I'm going to ask you to choose between one answer or the other. You don't have to give an explanation. Just go with your gut instinct. Here we go. When pivoting from traditional medicine to functional medicine, the hardest belief to let go of was the identity of being a traditional doctor or that safety net of having a steady paycheck. Dr. Alexia Gillen: the idea of not being a traditional doctor. Dr. Olga Deengar: Yeah. All right. The next question is the best thing about owning your own practice is the total autonomy over how you practice medicine or building those real relationships with your patients. Dr. Alexia Gillen: Building the real relationships with my patients. Dr. Olga Deengar: Would you rather be known as the doctor who changed how women understand their bodies or made functional medicine accessible to everyone? Dr. Alexia Gillen: Be the woman who made women understand their bodies. Dr. Olga Deengar: Nice. And the last question here, the most underused supplement for weight and metabolic health is magnesium or vitamin D. Dr. Alexia Gillen: Vitamin D. Dr. Olga Deengar: and I'm excited to kind of dive deeper into these because I think there's a lot to unpack there as well. But Dr. Alexia Gillen: Sure, yay. Dr. Olga Deengar: we'll go on to our next game. This is a take a sip game. And the first question here is busy and productive or spacious and intentional? Dr. Alexia Gillen: I'd like to say patient and intentional, but I'm not very good at that. So I'm actually more the other way. So I need to be more patient and intentional. Dr. Olga Deengar: So you're more busy and productive. No, no sips here. I'm going to choose the intentional one. The next Dr. Alexia Gillen: Love it. Dr. Olga Deengar: question here, what's more important, alignment or ambition? Dr. Alexia Gillen: alignment. Dr. Olga Deengar: alignment. Me too. Cheers! Would you rather have a cozy latte at home in pajamas or at a tiny cafe in Greece? Dr. Alexia Gillen: in a tiny cafe in Greece. Dr. Olga Deengar: Me too. Something you get a lot of, right? Dr. Alexia Gillen: Yes. Dr. Olga Deengar: And the last question here is hiking in the Black Hills or taking a walk by the lake? Dr. Alexia Gillen: taking a walk by the lake. Dr. Olga Deengar: Oh, I want to go with hiking. I love hiking. Dr. Alexia Gillen: The problem in the Black Hills Olga is that the hiking is typically by a body of, or you could do both, by the lake or body of water and hike. And so the trails that I'm thinking of are by water, but we're still hiking. So maybe both. Dr. Olga Deengar: Yeah, I love it. So Alexia, I know a little bit about you, but can you tell our listeners a little bit about yourself and the incredible work that you're doing? Dr. Alexia Gillen: Sure. So I'm a family medicine physician by training. I took a lot of different pivots and squiggles in my career and currently am the owner of Mosaic Medicine, which is a functional and integrative clinic, mostly focusing on weight and hormone health, but do a lot of autoimmunity and gut health too. I'm the mother of two. They're both adults. They're 19 and almost 21. and married for almost 30 years to my husband who's a nurse in electrophysiology. Born and raised in the Black Hills, left for a long time, but came back when we started having kids because it's a great place to raise children. So yeah, that's me in a nutshell. Dr. Olga Deengar: That's amazing. How are you doing all of this? Raising a family and growing your business. I mean, that's a lot to have on your plate. Dr. Alexia Gillen: Yeah, you know, I had my kids at the end of med school and internship a year of residency. And so I don't think I really gave myself permission ever to slow down. And I think like a lot of women, we just do it, right? We don't think about how we did it. We just got through to the other side and not quite sure how we did it. So, I mean, looking back at those years when the kids were younger, especially, I wouldn't have been able to do it without help. husband did take some time off to stay home with the kids when I was early in my career and then when they got older he went back to work but I don't think without that flexibility we would have been able to do it because I was always just work forward which you know I don't know that I would have done it a different way because I just know who I was at that time in my journey but looking back I wish I would have had a little bit more grace or acceptance for time for myself that wasn't always work. You know, launching both the kids in the last couple of years has been hard. think opening the clinic has been a little bit of a way for me to find something else to do with myself and not be bored where I was at my previous position. And so it's helping a little bit fill the blank of now what with both kids gone. So yeah, I just do my best and we just keep moving forward. Dr. Olga Deengar: you're empty nesters! No! Dr. Alexia Gillen: Yeah, I heard my daughter was further away for her first two years of school and then she transferred to a university that's only an hour away here now. And so she was home a lot more on the weekends this fall. And I saw a reel that said that were college nesters, not empty nesters, because they fled in and out. And you're like, whoa. and then they're gone again. So then you have to figure out, now they're gone again. How do we manage this? So it's an interesting phase in life actually. Dr. Olga Deengar: I can imagine. And I'm excited for that phase too, although I'm very far away from it. My eldest is six years old. Dr. Alexia Gillen: embrace it so much that the current age is it goes so fast. Dr. Olga Deengar: Now I want to shift gears just a little bit to get to know you a little more and ask about how did you come up with the idea for Mosaic? Dr. Alexia Gillen: Yeah, I mean, really when I think back at where just the idea of holistic medicine came from, I remember in the early 2000s when I was still in residency, Dr. Andrew Weil was just kind of up and coming in the integrative medicine world. And I was on a pediatric rotation. And I remember turning to my husband and saying, that's what I want to do. I want to do something more holistic and take care of the whole person. We also knew that we wanted to be back in the Black Hills and I just couldn't see at the time a way to make that possible. And so I just kept trucking in the traditional medical world and growing my career to a place that just wasn't serving me. And so I was part of a leadership team at our community hospital and was just a little disappointed and disenfranchised with how traditional medicine and decisions are being made. and knew that patients were suffering for that, but also that us as physicians were struggling. And so I went on a journey into life coaching, because I had gone through a few different phases of burnout. And the first time was in 2013, and we weren't even really talking about burnout. weren't, it didn't have a name. It was definitely that period of time where it was like, something's wrong with me, pull up my big girl pants, make a change, work harder, work smarter. that obviously doesn't work. And so, you know, in 2019 and definitely in 2020, when we really started acknowledging that burnout is a real problem, I went and got some chief wellness officer training and was trying to bring wellness to our healthcare system. It just, it wasn't going in a direction with my, with the executive leadership that I felt it could go. And so, you know, I sat, for a really long time at a leadership table that I sort of outgrew and didn't feel like I belonged anymore. And so then I thought, well, what are you gonna do? I had actually quit seeing patients entirely for about three years because the transition from, I was the medical director of the urgent care, I was seeing patients, I was a medical information officer, and especially during COVID, that was a lot. I was never home. so then I... quit seeing patients entirely and thought I would never go back to patient care. I was just burnt out for sure. And so I knew that something was missing when I was sitting at the executive tables and going something's just not right. And really at my core, the reason I went into medicine, like the majority of us, was to make a difference in people's lives. And I just couldn't see that I was making a difference in IT. And so I decided I was just gonna go practice medicine the way that I wanted to and to serve people in a way that I felt they deserved to be treated. I know I can't serve everybody and that's been a limiting belief, right, as I opened a cash-based model here at Mosaic, but I knew that I wanted to take care of the whole person. And I remember early on in primary care, all the patients that I really only got to spend 10 or 15 minutes with, but you knew that there was more that they needed to talk to you about. There was more to their story and we never really got to hear it. And it really impacts their health in a way that I don't think we're able to acknowledge in traditional medicine. so opening Mosaic allowed me to spend time with people and to sit and have a cup of coffee and just really talk about how are they doing and then wrapping in their physical health into those conversations. Dr. Olga Deengar: It's a whole other way of kind of looking at the whole person because with a 10 minute visit, you can only kind of scratch the surface and address the most acute issue that they have. But when Dr. Alexia Gillen: Yes. Dr. Olga Deengar: you have an hour or 45 minutes to really sit down and talk with the patient, it opens up so many more things like you never even knew how the sleep was affecting them or that they were having all of these other problems that were not kind of being surfaced at the shorter visit. Dr. Alexia Gillen: Yep, exactly. And oftentimes in primary care, your visits are just focused on, they did their labs, I need to get through their labs, I need to refill their meds, and then you walk out the door. And really they have so much more that they need to talk to you about, but we're just not built as a system to honor that. Dr. Olga Deengar: Yeah. And when you first started out, did it feel kind of scary making this big transition? Dr. Alexia Gillen: So scary. I mean, I was ready. I had been dreaming about Mosaic for probably a good four years before I actually took a leap of faith. You know, the scariest thing was anytime you start a business, takes at least two, typically three years to reach like a growth or noticing that you've got some cash flow and I was refusing to acknowledge that. I'm like, no, that's not going to be me. So the reality of that hit pretty hard within the first six to eight months that life had to change because mom made some decisions that really impacted all of us. And I had refused to sort of acknowledge that, which was fine. mean, I've... We sort of planned for that because we tried to listen to other people, but at the same time, really seeing that was the scariest part because like the question you had asked earlier, was it scarier to leave a consistent paycheck or the other option? I think when I look back at when I was early on in my career, I had joined a multi-specialty privately owned practice and it was definitely a reap what you sow environment. You learn how to work really hard, really fast, but you also learn quickly about how high the overhead can be. I didn't have a lot of autonomy in that organization to be able to make decisions about how we were spending our money because there were so many physicians. But I do remember one day I had worked all month very hard, but the overhead was high that month and I didn't get a paycheck. And I remember saying to myself, I refuse to feel this way again. And so that was close to when I left that private practice group and went to the healthcare organization where I had just a steady paycheck. And so it surprised me when I thought, I can go back to a month where I don't make any money. And I did it for a lot of months. And so that was definitely, I was obviously in a much different phase in my life, but it is scary. It was scary. Dr. Olga Deengar: It is, yeah. And what do you think was one mindset shift that helped you get through that period of time? Dr. Alexia Gillen: So I knew I wasn't gonna turn around. I mean, I think as high achieving women physicians, know isn't an answer sometimes, even though no is a complete sentence and a complete answer. I'm not very good. That's one limiting belief that I need to consistently work on is that no is an answer. But for this environment, just... I knew and I believed enough in Mosaic that I needed to keep going. And so I had to keep telling myself, you did the right thing, you made the right decision. People will see you, people will hear about you, just keep going. And the tide really started to turn about a year in. So I started paying myself about a year into the business. And so I just needed to tell myself that I wasn't gonna turn around. And this is the direction I decided to head. Dr. Olga Deengar: Yeah, you were fully committed and this was the right path for you. Dr. Alexia Gillen: Yeah. Dr. Olga Deengar: I love that. Was there any challenge that you faced and how did you overcome that and what you learned from it? Dr. Alexia Gillen: personally or professionally? You Dr. Olga Deengar: Either one. Dr. Alexia Gillen: know, in the position that I was in at the healthcare organization, I was the leader of several hundred IT analysts. And so every time I had an idea, every time I had a project that we needed to meet, I had a team of people around me where I could very easily delegate and guide and say, this is what we need to do. And it was... it was relatively easy to get to the end goal of the project. Here, it's just me. And that has been, I hate being the rate limiting step, but in a lot of the things that I have for ideas and things that I want to do with the clinic, am right now the rate limiting step and that bothers me a lot. some of it is delegation, like getting better at delegating and finding the right person to do it, not for me to figure out how to do it myself, because I was stuck there for a long time. And so now I've gotten a little more brave. I've tried to hire people out from like Fiverr or, I'm forgetting the other company I used. Anyway, where you can hire people just to do little mini projects where you don't have to bring somebody on for an entire, like as an entire employee or 1099. And so, I've been more of the mindset of who, not how, and not making it have to be a ton of money, rather than all of that laying on my shoulders. Dr. Olga Deengar: Yeah, because if you're the one doing everything, I mean, it's sucking up all of your time and then you don't have the time to be present at home with your family. And that's a huge loss. And that's actually a bigger cost than a lot of our physician entrepreneurs realize because our time is so valuable. Dr. Alexia Gillen: Yes. And I would say that like, I mean, for the first probably 10 months, I did work all the time. The stupid computer was in front of my face all the time. And I could tell it was taking a toll on my relationship with my husband. could tell, you know, it was about the time that my youngest was graduating from high school, but I could tell I just wasn't really present in dealing with a lot of the emotions that come with graduating your last kiddo and opening a business. So I did take a handful of things off my plate that I knew, it's not changing the way I practice. It's not changing the clinic. Just get rid of those things. it is. time is valuable and I've learned about myself that I have to like physically be in the car or in a place where I can't put the computer in front of me to really detach. And so that's something that I'm working on is how to be, how to slow down and have better boundaries and to, you know, the work will still be there and it's not going to make or break patient care or the growth of the clinic if I don't do something over the weekend. Dr. Olga Deengar: And what are some strategies that you've put in place already to help you kind of put up those boundaries? Is there one little tip that you can give? Dr. Alexia Gillen: Yeah, you know, I actually just started a couple of weeks ago. I intentionally am leaving my laptop at the clinic. Yeah, there's no Dr. Olga Deengar: Nice! That's a good idea. Dr. Alexia Gillen: other computers at home. You know, there's the iPads or phones and I can get on, you know, obviously from my phone and do things. But yeah, I've decided that a couple of weeks ago, was like, let's leave the stupid computer at the clinic. don't you're not going to get on tonight anyway, right? Because I'm so tired when I get home. Like, what do I think I'm bringing this home for? So that's That's what I've started to do the last couple of weeks actually. Dr. Olga Deengar: And have you noticed that your energy levels started changing a little bit more, like you're more present and you're able to connect better with everybody at home? Dr. Alexia Gillen: Yeah, I can. I know that, you my husband and I can sit down and watch a show or the weather's getting nicer so we can go out for a walk. My son has been home for just about a week from college and so we only have him for a short period of time this May. And so it's been nice to just be present for them. Sit out. We have a little area we can build a campfire in our backyard. So we've done that a few times and I don't have to worry about you're not going to work anyway. Yeah, I just need to keep going. Dr. Olga Deengar: Very. That's right. And then I know that you've had a lot of experience, especially in the info tech world with regards to medicine and been through a lot of things and it's been a long journey for you. Would you do it differently if you, if you had a chance? Dr. Alexia Gillen: You know, I have a faith and I believe that God had a plan for me and that I knew I just needed to be open to things. I am a person who gets bored really easily. And I think that's why family medicine served me well initially. You know, like in residency, you're. every couple of weeks you're doing something different and you're with all the specialties. And so then I do remember getting out of residency and going, oh my God, this is it. Like, I have to Dr. Olga Deengar: you. Dr. Alexia Gillen: do this every day. And that contributed to a little bit of my burnout. I just couldn't imagine doing it for 25 or 30 more years. Like, are you kidding me right now? And so... It was the beauty of primary care or family medicine is that I could take those skills and pivot so that I pivoted to urgent care, grew in leadership roles within the urgent care, which again, made me not stay bored there. And then went into IT when we implemented EPIC, everybody's favorite, at our healthcare organization. And that journey was only supposed to be a year, but then I ended up actually doing it for another seven. And so it just, and then it became my full-time job. I learned so much during that time. It was nice to be able to take my medical skills and knowledge and relate it to the infrastructure behind all that we do every day and taking care of patients and understanding why we have to do things a certain way with prescriptions and authorizations and orders and why sometimes that doesn't work or how can we make it better? using AI to help improve the way that we practice every day. So those things were great. I I learned to work with vendors. I learned to manage contracts. learned to help put together budgets, hire and fire people, build the right team. And so I would never do that differently. wasn't even a side of medicine that obviously existed when I first went into and we were still on patient, you know, paper charts. And so it wasn't even a career pivot that I knew existed. So no, I wouldn't do anything different. I think everything I did served me in a way and allowed me to grow and have experiences I never would have had before. So no, I think my career just kind of ended the way I'm where I'm supposed to be. Yeah. Dr. Olga Deengar: Yeah, it definitely sounds like it. And especially with all the skills that you've gained, you're able to transfer those skills into becoming your own boss, know, in your own clinic and having that freedom that you're seeking. So I do in fate as well. We all have Dr. Alexia Gillen: less. Dr. Olga Deengar: the knee and we are where we're supposed to be. Dr. Alexia Gillen: Yeah, I agree. Dr. Olga Deengar: Now, what kind of advice would you give someone who might be starting out in a similar space as you? Dr. Alexia Gillen: What I would say is, like I jumped in with both feet. I think, you know, there was a period of time early on in the practice where, of course, I hardly had any patients. I did do some telemedicine remote work for another company. So what I would say to somebody for starting out is that either number one, create a micro practice if you're able to, but still keep the job that you're thinking about leaving, right? Slowly build this one. Or, try to support yourself while you're growing with another job. I didn't start the telemedicine job until I think four months in. I do, as I look back, I wish that I would have had that right away because it did help cover cost of living and that sort of thing. what I would say is, number one, that figure out how you're going to support yourself without using all your savings or definitely not dipping into your retirement plans and that sort of thing. And then The other thing I would say is don't be afraid to go seek other education. I think it's hard in traditional medicine. I feel like a lot of my colleagues tend to have blinders on and there's so many ways to take care of people and it doesn't just have to be in the way that we were trained. And if we're stuck there, we're never going to grow and change with our patients who are looking for something more. And so I think what I would say is take off the blinders and be curious and look to see what else is happening in medicine and be open to being part of a care team that allows patients to find another way to take care of their body. Dr. Olga Deengar: Yeah, and as physicians, have that natural curiosity. We're always looking for ways to learn and grow and figure out what's the latest, what's the greatest. Dr. Alexia Gillen: 100%, and with social media and AI, mean, patients are, they have the, it's not, they have the access to the information, but they don't know what to do with it. And if we can't be a guiding light or a source of truth for them with all the information that they bring in, that doesn't feel good either, right? I mean, when they come in and we don't have the answer, typically, I think people will get defensive or they'll, or put down what the patient is bringing in when actually there might be some validity there. And so I think keeping with information coming at all of us so fast, it's really just kind of curious and making sure that they're coming in with questions. And if we can't answer them, either send them to somebody who maybe can, or just tell them you'll find out, right? I think in a busy clinic where you're seeing 25 and 30 patients a day that sounds sort of overwhelming. But then then I think that's where you need to be open to finding people practicing like I am, where you can just say, hey, go see so and so where they have more time and space to talk about that. So yeah. Dr. Olga Deengar: Yeah. And on that note, actually, because we know that there's a lot of misinformation out there on social media. Is there, let me ask it this way. How do you make sure that you convey the right message to your audience through your social media channels? Dr. Alexia Gillen: So I try to give a little bit of information but not enough to like sway them or make them believe. That's a hard question. I want to share a little bit, they all have then a bunch of questions. And so you want to make sure that they're either coming in for a visit or you're debunking some of the myths that they're throwing around out there. And so I think on social, it's more dropping things that I know are medical facts or that have good studies behind them so that I can support what else they're seeing on social media. I know there's a little trend going on right now about like, why are physicians trying to be influencers? And it's because influencers are trying to be physicians and that's the information that's not awesome. And so I love it when I see other physicians out there trying to spread a message that we know are based on studies and facts. And so it's mostly sticking with information that I know is valid and true and I'm giving accurate information to them and then they can do with that what they want. Dr. Olga Deengar: Yeah. And so we talked about social media, but what are some books that have influenced you and maybe do you have a book recommendation for our listeners today? Dr. Alexia Gillen: Yeah, so I thought about this question a little bit because I knew it was going to come and you know the book that has impacted me the most especially as I've walked through the transition of deciding if going out into the world on my own was the right thing for me is the book Worthy by Jamie Kern Lima. The reason I say that if you have you read that one? Dr. Olga Deengar: I haven't. Dr. Alexia Gillen: It's so good. It's really about the journey of believing that you are enough to put yourself out into the world. I've read it, I've had to read it a couple of times, because the first time you read it, it really does hit home, I think, for a lot of women, especially. I've actually lost a few copies to some patients, because I give it to them, which is great. I mean, take it and go. And I just keep buying another one for the clinic. Because one of the most common questions that I get kind of a blank stare from people, or I'll get tears that will come, One of the things I focus on is what are you doing for self-care and rest and filling your cup? And a lot of women don't know. They don't know the answer to that anymore. They've forgotten what that even means. And so I think the book Worthy helps us understand that we are, we're enough the way that we are. We're worthy of dreaming. We can grow and become whatever we think we want to set our mind to. And and that you're enough in the way that you do it. And so I really do love the book. You should check it out. Dr. Olga Deengar: That's a beautiful message. I have to it on my list of books to read for sure. Now, Alexia, as we wrap up, I'd love for our listeners to be able to find you. So what are some ways that they can connect with you? Dr. Alexia Gillen: Yeah, for sure. So my website is mymosaicmedicine.com. On social, I'm on Instagram, alexia underscore Gillen. And then for Facebook, it's mosaic medicine. And that's where I am. Dr. Olga Deengar: That's perfect. Thank you so much for being with us here today. I had such an amazing conversation with you and we got a lot of great insights. So I'm really grateful for having you on my show. Dr. Alexia Gillen: Yeah, thank you so much for having me, Opa.