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Dr. Mickey Lebowitz - Books4Guys · Books4Guys

• 0:15
  SPEAKER_00: San Diego.
• 0:16
  SPEAKER_00: I actually had someone on her episode.
• 0:18
  SPEAKER_00: She's a corporate coach.
• 0:20
  SPEAKER_00: Her episode will be coming out shortly through the Books for Guys podcast.
• 0:24
  SPEAKER_00: And she's in San Diego as well.
• 0:26
  SPEAKER_00: And she was like, I can never ever complain about weather again because it is just too nice.
• 0:31
  SPEAKER_01: Yeah.
• 0:32
  SPEAKER_01: I was always like, people said, Oh, the the weather's incredible.
• 0:34
  SPEAKER_01: And I'm like, Oh, how good can it really be?
• 0:36
  SPEAKER_01: And I'm like, it's that good.
• 0:38
  SPEAKER_00: Yeah, it's that good.
• 0:39
  SPEAKER_01: It really is.
• 0:41
  SPEAKER_00: Well, Dr.
• 0:41
  SPEAKER_00: Mickey, it's a pleasure to have you on the podcast.
• 0:44
  SPEAKER_00: And I'm personally very interested because of what you write about.
• 0:48
  SPEAKER_00: My mother and sister are both nurses.
• 0:51
  SPEAKER_00: And so they have been for a long time.
• 0:54
  SPEAKER_00: And I've seen some of the things that you write about and some of the you know, I'm I'm going to share this episode and your book with both of them.
• 1:02
  SPEAKER_00: Thank you.
• 1:03
  SPEAKER_00: But obviously know a lot of other nurses and and medical professionals as well.
• 1:07
  SPEAKER_00: And it's interesting that your book um focuses on them, the EQ prescription.
• 1:13
  SPEAKER_00: Uh, haven't seen too many doctors seem to worry too much about the nurses and the and the assistants and those those professionals who do so much.
• 1:23
  SPEAKER_00: And um, but Dr.
• 1:24
  SPEAKER_00: Mickey, I would love for you just to give an overview of of yourself and your work um and what you do, and then what led you to seeing the importance of this particular topic and writing about it.
• 1:35
  SPEAKER_01: Well, uh, just really briefly, uh I'm an endocrinologist, so I take care of people who have diabetes and other hormonal uh conditions, and uh I was in private practice for about 17 years, and then um I left private practice um in 2007.
• 1:51
  SPEAKER_01: Um I was really I had very high expectations about what it might be like to be a physician and caring for the people in our country who who are at their most vulnerable times, but the expectations weren't met, and uh I felt like um I needed to give voice to the people who were in the trenches, I call them the trenches, doing uh the quote unquote hand-to-hand combat every day, seeing patients all day, every day, and letting people know that not everything's okay in the world of healthcare.
• 2:19
  SPEAKER_01: So I left, I was beaten down, broken up, and frankly, I was burnt out.
• 2:23
  SPEAKER_01: And I want to let people know my story because I think my story might be other people's stories also.
• 2:29
  SPEAKER_01: So with that, I um and you're a sports guy, so my book was written with a lot of sports metaphors because as my son used to say to me, Dad, sports is my life, and frankly, sports was my life also.
• 2:40
  SPEAKER_01: So when I talked about in the book, I talked about all the players in the game, and they all start with the letter P.
• 2:47
  SPEAKER_01: And it's the patients, the physicians, the payers, the politicians, the plaintiff's attorneys, the pharma.
• 2:54
  SPEAKER_01: And I really didn't have a good solution to the book and the challenges that healthcare is putting on individual clinicians, nurses.
• 3:01
  SPEAKER_01: But I said, well, let's put all the peas in a pod and don't let them out until they come out what's best for most, recognizing everybody has to give up something.
• 3:10
  SPEAKER_01: So, with that, that was pretty naive and that wasn't gonna happen.
• 3:15
  SPEAKER_01: So, with that, I was like, well, what is the solution?
• 3:17
  SPEAKER_01: How how could people who are in healthcare, clinicians, nurses, the students who are gonna be clinicians or nurses, what can they do to survive the system short of changing the system?
• 3:28
  SPEAKER_01: And with that, I kept looking for a solution.
• 3:30
  SPEAKER_01: And what I came up with was the idea that the only thing that we can really control is ourselves.
• 3:36
  SPEAKER_01: I can't change a system, but I can manage myself through the system.
• 3:40
  SPEAKER_01: Then the question is, how do you do that?
• 3:42
  SPEAKER_01: And that's when I came upon uh emotional intelligence.
• 3:46
  SPEAKER_01: And uh, I think emotional intelligence gives us the best opportunity to recognize how we think and feel, how others think and feel, how to manage ourselves, how to manage relationships and get what we really want and want to avoid, despite the system making it so hard for us.
• 4:01
  SPEAKER_01: So that's a short story about why I wrote the book.
• 4:04
  SPEAKER_01: I just feel like there was a need and avoid in healthcare.
• 4:07
  SPEAKER_01: Just a very quick story.
• 4:08
  SPEAKER_01: One of the CEOs I was working with said to me when I was the quality director at the hospital I was working at, they said to me, Well, how do you get things done?
• 4:16
  SPEAKER_01: And I said, Well, I develop relationships.
• 4:18
  SPEAKER_01: And they said, Well, how do you do that?
• 4:20
  SPEAKER_01: And I said, Well, that's interesting.
• 4:22
  SPEAKER_01: You know, how do I do that?
• 4:23
  SPEAKER_01: You know, the CEO, you don't know how to develop relationships.
• 4:26
  SPEAKER_01: But I I played along and I said, Well, I developed trust.
• 4:29
  SPEAKER_01: And then they said, Well, how do you do that?
• 4:31
  SPEAKER_01: And I'm like, Oh, well, if they don't know and they're the CEO, then maybe there's an opportunity to offer people how actually to develop relationships, how to manage themselves the significant stresses of that is to be in healthcare.
• 4:46
  SPEAKER_01: So a little quick story about uh how I got to where I am today.
• 4:50
  SPEAKER_00: Yeah.
• 4:50
  SPEAKER_00: Well, I love your your mission and purpose behind this, and and my family is certainly familiar with endocrinologists.
• 4:57
  SPEAKER_00: My wife's a type one diabetic.
• 4:58
  SPEAKER_00: Oh, okay.
• 4:59
  SPEAKER_00: And more recently diagnosed.
• 5:01
  SPEAKER_00: So we've had a lot of learning to do and and finding good good doctors and good uh people to work with us on that.
• 5:08
  SPEAKER_00: And you're right, Dr.
• 5:10
  SPEAKER_00: Mickey, it's um probably like yourself.
• 5:12
  SPEAKER_00: There's a lot of us who focus a lot on our health, like like nurses do, and the system is it can be very frustrating.
• 5:20
  SPEAKER_00: And it's refreshing to hear you kind of say the same, you know, hey, this is not the best way of going about doing things, and we may be hurting ourselves more than helping, but again, it it is very refreshing to see someone like yourself step up and say, hey, let's figure out a different way to do that.
• 5:34
  SPEAKER_00: And you're right, the the the the quickest and best route is to work on yourself, and hopefully you can instill some of that focus and motivate others to do the same.
• 5:43
  SPEAKER_00: When did you exact when did you speci leave your practice?
• 5:48
  SPEAKER_00: Was it before COVID or post-COVID?
• 5:50
  SPEAKER_00: Because I know that era definitely uh I guess broadcasted maybe some of the struggles that nurses and others were starting to or have been going through, but that really broadcasted it, it seems.
• 6:02
  SPEAKER_01: Oh, absolutely.
• 6:03
  SPEAKER_01: I just I do want to uh respond to, you know, to your uh your comment that your wife has now has uh type 1 diabetes.
• 6:10
  SPEAKER_01: And you know, they used to call it juvenile diabetes, but now it's really type 1 diabetes because there are many uh people, you'll probably your wife included, who develop diabetes, quote unquote, later in life, like after the age of 20.
• 6:23
  SPEAKER_01: So that's one thing.
• 6:24
  SPEAKER_01: And the other thing I'll just uh comment about is I've taken care of a lot of people with diabetes and I've done it for a very, very long time.
• 6:30
  SPEAKER_01: Uh and I have a saying that I I'll say take a little bit of credit for, it's original.
• 6:34
  SPEAKER_01: If you ever had to have diabetes, this is the year to have it.
• 6:37
  SPEAKER_01: And the reason why I say that is because every year the diagnostics and treatments are better than the year before, and next year is going to be better than this year, and so on and so forth.
• 6:46
  SPEAKER_01: Even though it really does stink to have diabetes and it it does really change how you live your life.
• 6:52
  SPEAKER_01: There are so many other benefits now compared to the past to allow you to live your life as normal as possible.
• 6:58
  SPEAKER_01: So I just wanted to comment on that.
• 7:00
  SPEAKER_00: She's got her her Dexcom, and she's like, I don't know how I would have been able to do this without being able to have because she's such an at her doctor says she's the ideal person to work with because she eats healthy, works out, all that stuff.
• 7:13
  SPEAKER_00: But even with being so disciplined, obviously it's very challenging.
• 7:16
  SPEAKER_00: But she's like, I don't know what I would have done without the technology that helps me keep up with this, you know, on a day.
• 7:22
  SPEAKER_00: So you're absolutely right.
• 7:23
  SPEAKER_00: It seems like there's more and more equipment and technology coming out to help manage that.
• 7:28
  SPEAKER_00: But nonetheless, it is a nasty disease that I you know, a lot of people don't realize, you know, what it is.
• 7:33
  SPEAKER_00: They get it kind of confused with type two.
• 7:35
  SPEAKER_00: My wife's always like, I wish they called it differ something different than diabetes because it gets confused a lot.
• 7:40
  SPEAKER_00: But right, but it is a fascinating thing that we learn a lot about.
• 7:44
  SPEAKER_00: And it again, she's gonna love listening to this too because she's you know, that that's her life.
• 7:49
  SPEAKER_01: And so Yeah, those uh those continuous glucose monitors like the DEXCOM, the Libre, those are game changers, and uh and even those are gonna get better.
• 7:58
  SPEAKER_01: But anyway, I wish I wish her well.
• 8:01
  SPEAKER_01: And uh again, next year will be even better than this year.
• 8:03
  SPEAKER_01: And uh if she is disciplined and diligent, and uh she'll e she'll do even better than than than most.
• 8:08
  SPEAKER_01: Well, to your c to your question, I I left in 2007 and it was pre-c obviously pre-COVID.
• 8:14
  SPEAKER_01: Um, you know, at that I felt like I was ahead of my time because I burnt out, and at that particular time, people really weren't talking about clinicians or nurses burning out.
• 8:23
  SPEAKER_01: I mean, if you admitted that you were burning out, maybe you were a quote unquote weak uh, you know, person, a weak doctor, and you couldn't and you couldn't take it.
• 8:31
  SPEAKER_01: I mean, after all, our training was so intense.
• 8:33
  SPEAKER_01: We used to work 36 hours on and then tw two 12 hour days in a row and then another 36 hours, 120 hours a week, you know, and uh so you know you had to be stoic and and and fight through it.
• 8:44
  SPEAKER_01: But what I learned over the course of time is that beginning in like the mid two 2010s articles started coming out specifically from the male clinic uh from uh uh Dr.
• 8:53
  SPEAKER_01: Schannenfeld, and uh he was describing the number of people in healthcare who were burning out.
• 8:59
  SPEAKER_01: And the numbers were staggering.
• 9:01
  SPEAKER_01: Half the docs are burning out, and the old jokers, the other half just lie about it, and it actually just could continue to get worse.
• 9:08
  SPEAKER_01: And COVID really exacerbated the whole problem.
• 9:11
  SPEAKER_01: And it really hasn't returned back to even pre-COVID times.
• 9:14
  SPEAKER_01: So people are are burning out still.
• 9:16
  SPEAKER_01: So the question is, what can you do?
• 9:18
  SPEAKER_01: And this um what I put together was this concept called the emotional intelligence zone, which is really two well-known concepts.
• 9:27
  SPEAKER_01: One is emotional intelligence, which was described first back in the early 1990s by uh John May and Peter Salve, two academics, and then really made popular by Daniel Goldman in 1995.
• 9:38
  SPEAKER_01: He wrote a book, Emotional Intelligence and Why It Matters More Than Intellectual Intelligence.
• 9:43
  SPEAKER_01: So I took that concept and I connected it with another concept called the resiliency zone, which was made famous by a woman named Elaine Millacaris who worked with uh first responders like firemen, policemen, paramedics, EMT.
• 9:57
  SPEAKER_01: And I was going around New York State with a friend of mine who's a PhD psychologist, uh, and he was working with Elaine Millacaris and uh using this zone concept.
• 10:06
  SPEAKER_01: And we were going around New York State talking to anybody in healthcare who's willing to uh listen with us or talk with us about how to use the zone to reduce their risk of burnout, to enhance well-being, professionalism, professional fulfillment, patient care.
• 10:22
  SPEAKER_01: So I just thought it was a natural to combine the two together.
• 10:24
  SPEAKER_01: So after COVID, we stopped doing our, well, during COVID, we stopped doing our tours around New York State.
• 10:29
  SPEAKER_01: And I just said, well, in order to use the zone, I think you use emotional intelligence to connect to it.
• 10:35
  SPEAKER_01: I'll tell you why, because the zone is just a very simple visual of two horizontal lines.
• 10:41
  SPEAKER_01: It's a visual.
• 10:42
  SPEAKER_01: So if you could, if you, if you're your best self and people see you as your best self, you're between those two horizontal lines.
• 10:49
  SPEAKER_01: But naturally in life, things will narrow your zone, you know, not enough sleep, not enough exercise, being hangry, too much to do, not enough time to do it.
• 10:57
  SPEAKER_01: And then the things in life that will widen your zone, like getting enough sleep and having exercise and eating well.
• 11:02
  SPEAKER_01: Uh, but the question is, how do you know if you're in your zone, if it's narrow or wide, or even if you're bumped out or not?
• 11:08
  SPEAKER_01: And that's where emotional intelligence comes in, because you know, are you self-aware enough to know that you're in your zone?
• 11:14
  SPEAKER_01: Are you socially aware enough to know that the person you're interacting with is in their zone or not?
• 11:19
  SPEAKER_01: How do you manage yourself to stay in the zone or get back in it if you're bumped out of it?
• 11:23
  SPEAKER_01: And how do you manage your relationships to so you and them could stay in their zones?
• 11:28
  SPEAKER_01: And then uh what do you in the end, what do you really want each day with each uh interaction?
• 11:33
  SPEAKER_01: And what do you want in general in life?
• 11:35
  SPEAKER_01: So I put them both together, and that's really the gist of the book is this emotional intelligence on it, and that's the prescription.
• 11:42
  SPEAKER_00: Yeah.
• 11:43
  SPEAKER_00: No, that's great.
• 11:44
  SPEAKER_00: And Mickey, one of my questions for you, because obviously, you know, it seems like this is this is the first step in recognizing where you need to be at, you know, within your zone to be your best self for your patients, but also in your life so you don't burn out.
• 11:59
  SPEAKER_00: My question to you would be how how challenging is it for nurses to expand that zone?
• 12:07
  SPEAKER_00: Because I'm thinking of all the stuff you hear, like shortage of nurses and and and the pressures, there's there's too many patients and and how obviously their responsibility is to take care of so how do they turn that off, knowing they can they have the ability to help and keep going.
• 12:22
  SPEAKER_00: How do you coach people on or walk them through how to really find that balance and to prioritize that zone when there's so many things that's tugging at them to go in a different direction?
• 12:35
  SPEAKER_01: Yeah, that's a that's a great question, Chris.
• 12:37
  SPEAKER_01: You know, uh first of all, let me just give a shout out to nurses because and I just gave a talk the other day to nurses and I just wrote an article for this uh journal called Nurse Approved.
• 12:46
  SPEAKER_01: I say this and I start with every talk I give to nurses behind every good doctor is a great nurse.
• 12:52
  SPEAKER_01: And I've had the the wonderful experience to have had many, many great nurses behind me to help me be as good a doctor as I could possibly be.
• 13:01
  SPEAKER_01: So shout out to the nurses.
• 13:03
  SPEAKER_01: I will say that um that the nurses are the cog and the wheel.
• 13:08
  SPEAKER_01: They are fundamental, foundational to healthcare.
• 13:10
  SPEAKER_01: And without nurses, the system crumbles.
• 13:13
  SPEAKER_01: And to your point, at our hospital, I work at a hospital in Syracuse still doing the inpatient endocrine and overseeing the diabetes program.
• 13:20
  SPEAKER_01: But we've had challenges with making sure we have enough nurses.
• 13:24
  SPEAKER_01: And and it is, it really wears on them.
• 13:26
  SPEAKER_01: So if you don't have enough nurses, then the ones who are left behind still have that much that still have to do all that work more than what they would normally do because there's less of them.
• 13:36
  SPEAKER_01: So the question is, how do you, how can you use the zone to help them, or how can nurses or people in general use the zone to help them through challenging situations?
• 13:45
  SPEAKER_01: Well, the first again is to, you know, going back to the the basics.
• 13:49
  SPEAKER_01: Do they recognize that they are feeling, you know, beaten up, broken down, and burnt out?
• 13:55
  SPEAKER_01: And and by the definition of burnout means that they have emotional exhaustion, their depersonalization, you know, it's just another diabetic, it's just another gallbladder or something.
• 14:04
  SPEAKER_01: And uh can they sense, uh can they have some feelings of personal accomplishment?
• 14:09
  SPEAKER_01: Christina Maslak described all that back in the early 1980s.
• 14:13
  SPEAKER_01: Uh, she's kind of the godmother of of burnout and describing burnout.
• 14:17
  SPEAKER_01: So can you first of all recognize how you think and you feel?
• 14:20
  SPEAKER_01: And if you can, and you're not feeling like you are your best self in your zone, what can you do to widen your zone?
• 14:27
  SPEAKER_01: Well, first of all, it's good to know the things that can widen your zone so that you can, those would be your go-tos to do.
• 14:34
  SPEAKER_01: So if you need more sleep, then then try to get it.
• 14:37
  SPEAKER_01: If you you need to take breaks and eat during the day and you know, be physically active afterwards or you know, to to be to be as physically strong as you can, et cetera.
• 14:46
  SPEAKER_01: So all know all the things that could widen your zone.
• 14:48
  SPEAKER_01: And then there are a bunch of strategies that people can use to help them stay in their zone, especially when the zone is narrow, they're feeling that they're getting bumped out of it.
• 14:57
  SPEAKER_01: I'll give you a couple of quick examples.
• 14:59
  SPEAKER_01: Well, the first thing to do is to do a check-in with yourself and say, hey, am I in my zone or am I not?
• 15:04
  SPEAKER_01: Is it wide?
• 15:04
  SPEAKER_01: Is it narrow?
• 15:05
  SPEAKER_01: Am I bumped out?
• 15:06
  SPEAKER_01: So the check-in, and I do this all day, every day.
• 15:08
  SPEAKER_01: Am I am I in a good spot or not?
• 15:10
  SPEAKER_01: If I'm not in a good spot, what do I have to do to get in a good spot so I could do the work that I can?
• 15:15
  SPEAKER_01: Because it's really hard to do good work if you're not in your best mindset.
• 15:19
  SPEAKER_01: So you check in with yourself, and if you're not in your best spot, what can you do?
• 15:23
  SPEAKER_01: Here's a couple of really quick ones.
• 15:25
  SPEAKER_01: Number one is um name it to tame it.
• 15:29
  SPEAKER_01: And there's a lot of physiology behind that.
• 15:31
  SPEAKER_01: So just say, hey, I am really feeling very stressed right now.
• 15:34
  SPEAKER_01: I am very anxious right now, I feel very angry right now.
• 15:38
  SPEAKER_01: I am uh, you know, whatever.
• 15:40
  SPEAKER_01: Just name it to tame it.
• 15:42
  SPEAKER_01: So that's one thing.
• 15:43
  SPEAKER_01: Another one, another quick strategy is something called box breathing.
• 15:47
  SPEAKER_01: So many people are familiar with this, but in short, you breathe in for four seconds, you hold it for four seconds, you breathe out for four seconds, and then you repeat.
• 15:57
  SPEAKER_01: So it's a little bit of a box.
• 15:59
  SPEAKER_01: So people could box breathe.
• 16:00
  SPEAKER_01: I like sighing, uh, you know, just deep breaths.
• 16:03
  SPEAKER_01: You know, some people can use what's called a moment meditation.
• 16:07
  SPEAKER_01: So they could just for one moment, uh, you know, a minute, just I'm gonna I'm just gonna relax, I'm gonna let everything else go.
• 16:14
  SPEAKER_01: I'm gonna kind of uh bring myself back to equilibrium.
• 16:17
  SPEAKER_01: Some people use a 5-4-3-2-1 grounding, resourcing type of exercise where they could uh smell five things, uh, five, four things, feel three things, etc.
• 16:27
  SPEAKER_01: So they could do that.
• 16:28
  SPEAKER_01: I will tell you, and this is maybe a little bit funny and off-color, but I I I like to go into a little bit of a private place and drop a couple of real explicatives and you know, a couple of F-bombs, and uh I but and I wrote about in my book, and I was like, man, am I like psychotic or something?
• 16:44
  SPEAKER_01: Maybe so.
• 16:44
  SPEAKER_01: But I researched, you know, the benefits of a good curse word.
• 16:48
  SPEAKER_01: And it feels and the science behind it, it gives you power over the situation.
• 16:52
  SPEAKER_01: I'm not recommending it for everybody, but for some people it works, which is actually the point.
• 16:56
  SPEAKER_01: And that is there's no magic wand, there's no silver bullet, and what works for some might not work for others.
• 17:01
  SPEAKER_01: So people have to recognize what their go-tos are to help them stay in that zone when the heat is on, and frankly, in healthcare it's always on.
• 17:09
  SPEAKER_01: And um, to use those types of strategies, you know, some of the ones I named, and people might have other ones to use in real time when when the when the poop is proverbial poop is hitting the fan.
• 17:19
  SPEAKER_01: So those are the recommendations I would have, at least to start.
• 17:22
  SPEAKER_00: Yeah.
• 17:23
  SPEAKER_00: I love a good cuss word and I love the uh name it to tame it.
• 17:26
  SPEAKER_00: Uh I like the tagline there.
• 17:28
  SPEAKER_00: Yeah.
• 17:29
  SPEAKER_00: I'm sitting here thinking as you're as you're talking, Dr.
• 17:31
  SPEAKER_00: Mickey, I'm thinking your book is is not just a good book for people in the field to to learn how to better find that zone, but I'm thinking of even leadership and managers and directors and leaders of hospitals to be able to recognize what their their teams of workers are going through because I know uh, you know, and again, I have people in my family who are nurses and some of they feel that pressure from above to to do their job, and it's not necessarily always their own um pressure and internal thoughts keeping them, but it's it's from the top down a lot of times of hey, you know, we we have a job to do, like you gotta do it no matter what, and there is no time to to rest or whatnot.
• 18:17
  SPEAKER_00: But I'm assuming that your book would be pretty universal in the space to where everybody can understand the challenges and then everyone can if if you are a nursing director, you can better understand what they're going through and and maybe you can implement some, I don't know, some mandatory instruction to help minimize that burnout.
• 18:37
  SPEAKER_00: But um, and and and you may already be like, yeah, it is it is made for those as well.
• 18:41
  SPEAKER_00: But I'm curious, do you share your your strategies and topics and the story across the board?
• 18:47
  SPEAKER_01: Yeah, I'm I'm really glad you brought that up because you're absolutely right.
• 18:50
  SPEAKER_01: I mean, my niche was healthcare.
• 18:52
  SPEAKER_01: So I, you know, focused my attention on healthcare, and those are my brothers and sisters, and you know, some of the greatest people I've ever met were in my medical school class, or some of the people I trained with, some of the doctors I worked with, and certainly some of the nurses, uh, as I mentioned before.
• 19:08
  SPEAKER_01: And I was a medical director of a PA program in Lemoyne at Le Moine College in Syracuse for many years up until just recently when I moved out here to San Diego.
• 19:17
  SPEAKER_01: But the book, the strategies in the book aren't really s unique or specific for people in healthcare.
• 19:23
  SPEAKER_01: Um, it it really is transferable to you know per people's professional life.
• 19:27
  SPEAKER_01: In fact, I was given a talk recently, and one of the uh people in the crowd, uh, a physician, said, When I'm in the office, I use your strategies.
• 19:35
  SPEAKER_01: But when I get home and with my kids, I don't use them, and I really should use them back, you know, at those particular times.
• 19:40
  SPEAKER_01: I, you know, I I'm a guy, you know, I'm a I'm a I was, you know, in the practice.
• 19:45
  SPEAKER_01: I I I did a lot of leadership also, but the book was written, there's a lot of books written about EQ and leadership.
• 19:52
  SPEAKER_01: I wanted to write the book for the people who are actually, you know, seeing the patients all day, every day.
• 19:56
  SPEAKER_01: That said, um, the book is really for people in healthcare administration also.
• 20:03
  SPEAKER_01: So, you know, in order to be a really good leader, being highly emotionally intelligent, it really goes a long way.
• 20:10
  SPEAKER_01: In fact, most leaders who are successful have high EQ, and EEQ is uh really is uh 80% of your success is due to EQ, whereas really 20% is due to competency.
• 20:23
  SPEAKER_01: You know, and high EQ, the benefits of high EQ and healthcare in general are enormous.
• 20:28
  SPEAKER_01: Higher job satisfaction, better patient satisfaction and outcomes, less risk of malpractice because you make better decisions and you have uh better relationships, less risk of burnout, higher leadership, you know, uh, and leaders set the tone.
• 20:44
  SPEAKER_01: And uh and if they set a tone that is what they call psychological safety, where it's a very nice place to work, then it's much easier to recruit and retain people in those organizations.
• 20:55
  SPEAKER_01: And the cost of losing a nurse or losing a physician or what we call advanced practice uh providers is enormous.
• 21:03
  SPEAKER_01: So you really do want to set up an organizational culture and climate such that people want to come and they want to stay.
• 21:10
  SPEAKER_01: And that's where the leadership part and the stuff in the book really helps people who are in leadership how to manage themselves because by doing so it sets up not only great culture, but it also sets up great relationships with people and they're gonna wanna stay.
• 21:24
  SPEAKER_00: Yeah.
• 21:24
  SPEAKER_00: No, I love that.
• 21:25
  SPEAKER_00: And I th I'm sitting here thinking of just in in simple terms, you know, the book really boils down to just take care of yourself.
• 21:32
  SPEAKER_00: And I'm sitting here thinking, you know, we uh I'm I'm laughing.
• 21:35
  SPEAKER_00: It's not funny, but it's kind of funny.
• 21:37
  SPEAKER_00: You know, my wife and I, we both tell my mother and and my mother in law, we're like, Hey, you've gotta you've gotta take care of yourself.
• 21:44
  SPEAKER_00: They're just so in nurses like this too, you're so they want to take care of everyone else 'cause they can, you know, and that's their that's sending them to help.
• 21:52
  SPEAKER_00: Um, but you can't help others unless you are taken care of first.
• 21:56
  SPEAKER_00: If you're not healthy and you can't do your job well, well then then you Don't have the ability to do your job.
• 22:01
  SPEAKER_00: You know, you've got to be able to have that ability and take care of yourself first.
• 22:04
  SPEAKER_00: So I just like that message because I feel like people are kind of starting to realize that needs to be the case in order for you to do your best job.
• 22:12
  SPEAKER_00: You've got to be your best.
• 22:14
  SPEAKER_00: And I think that message has started to get out there a little bit more.
• 22:18
  SPEAKER_00: You're the first person I've seen actually kind of broadcasting that in the medical specific space, which again is fascinating.
• 22:24
  SPEAKER_00: I know it's a high pressure world and there's that shortage, and there just seems to be a strain in a lot of places, but it's really good that you're out there promoting this specific just idea to focus on yourself a little bit more so that you can do better for your patients and who you're working with.
• 22:43
  SPEAKER_01: Well, you know, it's almost like heresy because when we when we were going through our training, and most people would hold it, most people in healthcare hold it in their pocket that uh it's always about, you know, patients come first.
• 22:53
  SPEAKER_01: So it might seem like heresy that uh that you as the clinician or nurse need to come first.
• 22:58
  SPEAKER_01: And I would I was really turned on to this concept.
• 23:01
  SPEAKER_01: There was a book written by uh Paul Spiegelman and Britt Barrett, and the title of the book was Patients Come Second.
• 23:06
  SPEAKER_01: And everyone was like, what does this what how can you say this?
• 23:10
  SPEAKER_01: That book was about leaders, going back to your point, Chris, leaders setting a um the setting up a culture and a climate for the people in that organization to do their best work.
• 23:20
  SPEAKER_01: So what I've done is I've taken that concept really to the next level and put a little spin on it.
• 23:25
  SPEAKER_01: And because I want I brought it down to the actual individuals.
• 23:28
  SPEAKER_01: And let's think about it.
• 23:29
  SPEAKER_01: I mean, we've all we've all lived life and we've all been through ups and downs.
• 23:34
  SPEAKER_01: And uh I know me, for me specifically, and you might agree with this, and uh hopefully others do too, that when you're amped up, agitated, upset, it's just really hard to do your best thinking.
• 23:44
  SPEAKER_01: And frankly, there's a lot of neurophysiology behind that.
• 23:47
  SPEAKER_01: And I'll I'll give you a quick uh overview of this.
• 23:50
  SPEAKER_01: I'll tell you everything about neurophysiology that I know in one minute.
• 23:53
  SPEAKER_01: And that is we all have a fixed amount of blood in our body.
• 23:56
  SPEAKER_01: But when we're amped up, agitated in fight or flight, that fixed amount of blood goes to the parts of your body that allows you to fight or flight, which is your muscles.
• 24:06
  SPEAKER_01: In so doing, since it's only a certain amount of blood that you have in your body, that blood goes away from the part of the brain, which is called the prefrontal cortex, which is the area of the brain that sits right above your eyes, that does all your uh logical or executive functioning.
• 24:20
  SPEAKER_01: So that blood goes away from that particular area to feed your muscles, to allow you to fight or flight.
• 24:26
  SPEAKER_01: So if you don't have blood going to that part of the brain, you might imagine that you're not gonna do your best thinking at those particular times.
• 24:33
  SPEAKER_01: And we've all been in a situation where like, why did I, why'd I do that?
• 24:36
  SPEAKER_01: Why did I say that?
• 24:37
  SPEAKER_01: And uh, so I think that the physiology behind that is quite clear.
• 24:41
  SPEAKER_01: And that's why you have to really be taking care of yourself first so that that blood doesn't go to your muscles.
• 24:47
  SPEAKER_01: It stays in the part of the brain that allows you to do your best thinking.
• 24:51
  SPEAKER_01: And uh that way you could um you could do your best response, responsiveness as opposed to reacting.
• 24:57
  SPEAKER_01: Because when the blood goes away from the part of the brain, then you're on autopilot and you react.
• 25:02
  SPEAKER_01: And most times when we react to a negative situation, we do so with regrets and remorse afterwards.
• 25:08
  SPEAKER_01: So the key is to stay in that zone, keep the blood flow to that part of the brain.
• 25:11
  SPEAKER_01: And uh, when you're put in a position where it's very stressful, another suggestion I always have to people is hit the pause button, pause, count to 10, allow your emotional brain to connect to your fit to your logical brain, and that way you could respond as opposed to react.
• 25:28
  SPEAKER_01: Because it usually reacts when you react to a situation, usually the stuff goes south and things just get worse.
• 25:33
  SPEAKER_00: Yeah, yeah.
• 25:34
  SPEAKER_00: No, all of that is uh I've heard that before.
• 25:39
  SPEAKER_00: It's hard to act on that, you know, a lot of times.
• 25:41
  SPEAKER_00: I think it takes a lot of practice, but once you do nail it, it is a benefit.
• 25:47
  SPEAKER_01: That's an interesting point, Chris.
• 25:48
  SPEAKER_01: Um I'm I'm man, you're good at this.
• 25:50
  SPEAKER_01: I'm glad you brought that up.
• 25:51
  SPEAKER_01: Because yes, it does take practice.
• 25:54
  SPEAKER_01: However, to even start, it comes down to an old riddle, and that is how many psychiatrists does it take to change a light bulb?
• 26:00
  SPEAKER_01: And the answer is one.
• 26:01
  SPEAKER_01: But the light bulb has to want to change.
• 26:03
  SPEAKER_01: So the question is, are you that person that's willing to make that effort to learn these strategies and practice these strategies?
• 26:11
  SPEAKER_01: Because the more you do it, the better you'll be, just like with anything in life.
• 26:15
  SPEAKER_01: And by doing so, not only will you be better at it, but your brain goes through this what's called neuroplasticity.
• 26:21
  SPEAKER_01: So the nerve the brain uh cells increase either in the amount, which is a structure, or its functionality, so that the more you do it, the better you get at it.
• 26:30
  SPEAKER_01: So that EQ begets more EQ.
• 26:33
  SPEAKER_00: That makes a lot of sense.
• 26:34
  SPEAKER_00: That makes a lot of sense.
• 26:35
  SPEAKER_00: Yeah, just a couple more questions for you, Dr.
• 26:38
  SPEAKER_00: Mickey.
• 26:38
  SPEAKER_00: I'm curious to know your just kind of overall opinion of where we're at with healthcare as a whole.
• 26:45
  SPEAKER_00: And I love that you're focusing it seem, and you've kind of said like to make changes, the people are gonna have to, you gotta focus on the people because the system is very difficult to change.
• 26:56
  SPEAKER_00: And and I'm kind of thinking of this now just with my wife and I and her type one, just the frustrations we've had in certain situations, insurance, finding a good doctor that actually cares and spends the time with you and understands your lifestyle.
• 27:10
  SPEAKER_00: It just seems like there's so many of a of a numbers game, like a lot of things, you know, there's a lot of money involved, and we get all that.
• 27:17
  SPEAKER_00: But what's your, I guess, your outlook on where we're headed?
• 27:22
  SPEAKER_00: And and is it positive or or do you see a lot of challenges that we better try and fix quickly, or it could go even further kind of out from where it needs to be for everyone to have the proper experience, proper health care.
• 27:37
  SPEAKER_00: Just curious, your overall, because you're a doctor, you know, you've been there, you've done that, you're you're helping people.
• 27:41
  SPEAKER_00: Just what's your personal take on all that?
• 27:44
  SPEAKER_00: Really, really good questions.
• 27:45
  SPEAKER_01: So let me let me uh turn the clock back a little bit to 2007 when I was I was in private practice at the time, but I was an employed physician in a family practice group, a great bunch of people, no question about it.
• 27:57
  SPEAKER_01: But they and I was working really hard, seeing patients all day, every day, and and the work never really stopped.
• 28:02
  SPEAKER_01: You know, when I left the office, I still had all the work to do at night on the weekends.
• 28:05
  SPEAKER_01: And so, but at the end, they said to me, Hey, you have to see more patients to make the same amount of money or make less money seeing the number, same number of patients.
• 28:15
  SPEAKER_01: And I was like, I said, Are you kidding me?
• 28:17
  SPEAKER_01: I'm on the list of best doctors in America every year.
• 28:20
  SPEAKER_01: I have a waiting list the size of California, and um, and you and you want me to see more patients.
• 28:25
  SPEAKER_01: I can't physically do it and do it in a way that I think is safe for me and for the patients.
• 28:30
  SPEAKER_01: And I was kind of left with uh an op, you know, continue on the path or or or as in the words of Robert Frost, take the take the work road less traveled.
• 28:38
  SPEAKER_01: I had decided to take the road less traveled, even though I continue to take uh to be clinical.
• 28:43
  SPEAKER_01: But the point I really want to make is that was really where the begin to me, the business of medicine started to creep in to healthcare.
• 28:52
  SPEAKER_01: You know, the uh people, the administration were counting beans, if you will, and uh you need to do more.
• 28:59
  SPEAKER_01: And I so but it's only gotten worse.
• 29:01
  SPEAKER_01: I think the pendulum has swung really far to the business of medicine, and um, and there's a lot of money in the game.
• 29:09
  SPEAKER_01: And unfortunately, I this is my personal opinion, people could agree, they could disagree, but the money is in uh administration and pharma and uh and it's not to give care to the patients.
• 29:21
  SPEAKER_01: And my my hope is that one day soon, hopefully soon, that this pendulum where the business is really taking over how we practice medicine starts to swing back and we actually focus more on the people who are delivering the care to help for the people who are receiving the care.
• 29:38
  SPEAKER_01: Because right now, I think a lot of my a lot of my colleagues, they can't count the days till they can retire.
• 29:44
  SPEAKER_01: And it m it Chris, it makes no sense at all because I will tell you that to get to, you know, go through undergrad, get really good grades, go to go to medical school, internship, residency.
• 29:55
  SPEAKER_01: I was a chief resident for a year, uh fellowship for a couple years.
• 29:58
  SPEAKER_01: I mean, there was so much time, effort, energy, sacrifice, and money spent to get there, and for us not to enjoy what we do and and and and and to have guys want and guys, men and women want to leave what they do because they're burnt out.
• 30:11
  SPEAKER_01: It it's a sad story.
• 30:12
  SPEAKER_01: I think the pendulum has to come back eventually, but uh when that happens, I I don't know.
• 30:18
  SPEAKER_01: I think people, you know, uh you know, we'll get fed up eventually and and say that's enough.
• 30:24
  SPEAKER_01: And we've had it.
• 30:24
  SPEAKER_01: We'll need leadership from our medical societies to do so and whatnot.
• 30:28
  SPEAKER_01: But that's my my feelings of the state of medicine.
• 30:31
  SPEAKER_01: It's very heavily business slanted right now, and it's not really what I think it's intended to be, which is is to do something that is incredibly gratifying to take care of pe people when they're at the most vulnerable state.
• 30:43
  SPEAKER_01: And that's why I went to medicine.
• 30:45
  SPEAKER_00: Yeah.
• 30:46
  SPEAKER_00: Well, and you're right.
• 30:47
  SPEAKER_00: Hopefully there and we'll we'll swing it to a positive part of it.
• 30:50
  SPEAKER_00: There's a lot of great doctors and great nurses, and we've we've found, you know, several that work with us now that we're so thankful for because they do care.
• 31:00
  SPEAKER_00: You can tell they sit down and they care so much.
• 31:03
  SPEAKER_00: And hopefully there will be more and more of those that can help make a difference and help with that swing back to where things really need to be.
• 31:11
  SPEAKER_00: And so time will tell, but hopefully that is the case.
• 31:14
  SPEAKER_00: But Dr.
• 31:15
  SPEAKER_00: Mickey, I've got one more question for you.
• 31:17
  SPEAKER_00: And I ask everybody that comes on the podcast this question just for a books for guys, you know, purpose of it all.
• 31:23
  SPEAKER_00: And I'm sure you this may be a tough because uh I'm sure you've read a lot of great books in your lives.
• 31:30
  SPEAKER_00: But what is one or two books that has meant a lot to you, either personally or professionally?
• 31:36
  SPEAKER_00: And what's a book you like to recommend to other people when they ask you for one?
• 31:40
  SPEAKER_01: Oh my god.
• 31:40
  SPEAKER_01: There are so many, there are so many, Chris.
• 31:42
  SPEAKER_01: And when I give my talks, I'm I'm um I'm always bringing up all the different books that I've read that contribute to my experience and my understanding about medicine and in specific and life in general.
• 31:54
  SPEAKER_01: I'll I'm gonna start with one.
• 31:55
  SPEAKER_01: It's a real oldie, but it is still a goody, and that is the Dale Carnegie book, How to Win Friends and Influence People.
• 32:02
  SPEAKER_01: That book was written the first time in like 1930, and there's been many uh revisits since then, rever uh revision since then.
• 32:09
  SPEAKER_01: The book has a lot of great pearls in it that are, I think, are really uh really meaningful.
• 32:16
  SPEAKER_01: So I would I always recommend that book to people, How to Win Friends and Influence People, because uh developing relationships with people, there's a lot of EQ stuff in there.
• 32:24
  SPEAKER_01: You know, EQ, even though it was that that term was framed back in the 1990s, really EQ was, you know, you may be using different words, but Dave Carnegie's book is all about EQ back in the 1990s.
• 32:36
  SPEAKER_01: That's that's one book I would uh definitely recommend.
• 32:38
  SPEAKER_01: I like David Brooks' uh book on how to how to know a person.
• 32:41
  SPEAKER_01: Uh that came out more recently.
• 32:43
  SPEAKER_01: I read that.
• 32:44
  SPEAKER_01: Uh How to Make Decisions by How We Decide by Joan O'Lera, Blink uh by Malcolm Gladwell, and Outliers by Malcolm Gladwell.
• 32:53
  SPEAKER_01: Well they come to mind.
• 32:54
  SPEAKER_01: I will I will pro uh my book, uh I wrote a book about why I left my practice of medicine back in uh 2007.
• 33:00
  SPEAKER_01: It came out in 2009.
• 33:02
  SPEAKER_01: That book is is is called uh Losing My Patience, why I left my Why I Left the Medical Game, going back to your uh first question about sports.
• 33:11
  SPEAKER_01: But I think that book tells a really good story about it's a little bit of a memoir, but it also gives people insight into how the medical system is w works and how it's being used to really beat down my team of physicians, clinicians, nurses, and students.
• 33:27
  SPEAKER_01: So uh though those are a few.
• 33:29
  SPEAKER_01: The patients come second by and Barrett that comes to mind.
• 33:33
  SPEAKER_01: Boy, I probably could come up with so many more.
• 33:35
  SPEAKER_01: But those as a place to start, those are the ones that I I refer to not infrequently in my book.
• 33:41
  SPEAKER_00: Yeah.
• 33:41
  SPEAKER_00: No, those are great recommendations.
• 33:42
  SPEAKER_00: And I've got some of those on the website.
• 33:45
  SPEAKER_00: I've got to get some of the others.
• 33:46
  SPEAKER_00: I've got the EQ prescriptions, I've got your newest book out.
• 33:48
  SPEAKER_00: I need to get your other one on there as well and share that one.
• 33:52
  SPEAKER_00: And so thank you for bringing that up.
• 33:53
  SPEAKER_00: I'll get that one on there to share with everyone as well because it goes right in with this conversation and uh leads right into the work you're doing now in your latest book.
• 34:02
  SPEAKER_00: So we'll for sure get that one on there.
• 34:04
  SPEAKER_00: And uh yeah, those are a lot of great.
• 34:06
  SPEAKER_00: I'm a big Malcolm Gladwell fan.
• 34:08
  SPEAKER_00: I love his books.
• 34:09
  SPEAKER_00: Um I recommend those a lot too.
• 34:11
  SPEAKER_00: Dr.
• 34:11
  SPEAKER_00: Mickey, this has been a pleasure and and thank you so much for taking the time to do this, do this, and thank you for doing the work that you're doing and really being outspoken about the health and wellness of the people who are doing so much for others.
• 34:26
  SPEAKER_00: Again, like I said, you know, I've got family members that are in that space, and I see that, and uh, they recognize they they they've got to find that zone.
• 34:34
  SPEAKER_00: And so just just an honor to have you on to speak more about that and hopefully you can continue to have an impact on people to get this, get this more broadly out there so that our health care system maybe swings back into that place we need it to, so that everybody loves what they do and people get the proper care and we can find that balance again.
• 34:55
  SPEAKER_00: And so just can't say thank you enough, Dr.
• 34:58
  SPEAKER_00: Mickey.
• 34:58
  SPEAKER_00: This was awesome.
• 34:59
  SPEAKER_01: Thank you so thank you so much, Chris.
• 35:01
  SPEAKER_01: Hey, listen, thanks for the opportunity to give me the uh to give me the opportunity to tell people how I think and and the books that I've written.
• 35:09
  SPEAKER_01: Um, and I I hope it makes a difference in people's lives.
• 35:12
  SPEAKER_01: I mean, that that would be that that makes an old man, i.e.
• 35:15
  SPEAKER_01: me, happy.
• 35:16
  SPEAKER_00: Well, no doubt they will make a difference.
• 35:18
  SPEAKER_00: So thank you, Dr.
• 35:19
  SPEAKER_00: Mickey.
• 35:20
  SPEAKER_00: You bet.
• 35:20
  SPEAKER_00: Thank you, Chris.
• 35:21
  SPEAKER_01: Appreciate you.