Jenny Lee and Stacey Ishman 051126
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[00:00:00] I am very excited to be bringing a new guest to us today. This is Jenny Lee, who is joining us as the senior associate dean from Johns Hopkins. But she's way more than that. In fact, we've known each other for a couple decades, since we got the opportunity to work together. So if you don't mind starting off, why don't you tell us who you are, and you can probably do a much better job than I just did.
So including the fact I didn't even mention you're an anesthesiologist, so why don't you let us know- ... how you would like to be known and what you're doing these days. Stacey, thanks so much for having me, and yes, we do go back decades, back to the operating room, actually. You were one of my favorite surgeons.
So I'm Jenny Lee. I'm the senior associate dean for faculty development at Johns Hopkins. I'm also a professor of anesthesia and critical care medicine and pediatrics, and I'm a coach. And I know Stacey from all of the tonsillectomies and adenoidectomies that we did day after day, and I'm so happy that we can reconnect here in your podcast.
This is [00:01:00] fantastic. Oh, thank you so much. I was so excited when it turns out we've both taken some parallel paths and are really working on things now. So I want you to tell us what made you decide that faculty development was worth the level of investment you've put in with all the coach training and organizational training that you've done over the years?
So I've been very fortunate to have a coach with me since 2018, and I would say around and after the pandemic, I hit a very difficult period of burnout. I was running a brain science lab. I still am in brain research, but as a co-investigator now, but at the time, I was a principal investigator of a large lab.
Working in the operating room, raising two kids, dealing with the pandemic, and burned out and nearly quit medicine and nearly quit research, and my coach guided me through it and without her, I don't know where I would be. And I said to myself, "I'm going to put on my bucket list that I want to be a [00:02:00] coach one day because I want to serve people and help people the way she helped me," and, indirectly, she helped so many patients by helping me stay in medicine.
And one day it was my birthday, and I was like, why wait?" And so on my birthday, my gift was signing up for coaching training, and that was at the end of the pandemic or maybe mid-pandemic, and I never looked back, and I loved it. And outside of Hopkins, I started a professional development and leadership program for pediatric anesthesiologists, and I started that in 2018.
And I called it my hobby, but it turned to Be more than that for me. I just put my heart into it, and it grew and to over... I think we have over 250 anesthesiologists now in the program. Wow, okay. More than, yeah, more than 70 institutions across the US and Canada, and a chapter in Australia and New Zealand.
And I was like, "I love this." I really love helping people realize how important they are, and help them feel [00:03:00] valued. And so a dean's office position opened, and I applied, and I got it, and here I am. I love this story. So one of the things that I'm pretty passionate about is being proactive in helping people build and love the career that they're in.
I think we do a really reasonable job when people start burning out of recognizing and en- enlisting resources. But I think it would be so much better if we created systems where people don't get there. So if you could tell us how this program that you've put together addresses sort of those dual ends of the spectrum, like starting off in a way that's gonna be very fulfilling and keep you from burning out, and then also what do you do for the people who are already in some stage of that burnout?
How does it support? I think that we have to recognize that burnout happens, and that burnout is not a fault. And there's nothing wrong with you that you've burned out. You haven't made a bad choice, [00:04:00] and I wish we could educate ourselves better. I think we're doing better now than we were six years ago in recognizing signs of burnout in ourselves and in our colleagues, and being willing to step in and say, "Hey, you're looking really tired.
Why don't you take the rest of the afternoon off? It's okay for your notes to be finished tomorrow, and go do something that will bring you joy." And that includes maybe getting enough sleep for once, how much of us are running on very little sleep? I think one of the keys is aligning what we really care about, so our personal values, with our careers, and they need to be aligned and going in similar directions, ideally the same direction, and that can really help a lot.
When we feel like we're having the impact that we want our life's impact to be, if it happens to align with work, then we're less likely to burn out at work. Yeah. When the two are going... If, when your values go a [00:05:00] different direction from where work is taking you, I think you're a probably 10, 20 times higher risk of burning out.
No, I love what you're saying. I will tell you, one of the first steps I usually take with almost everybody I work with is to start with looking at th- our values and making sure that our time audit is a- aligned with what we care about. But I've found most people, myself included, when I first did this exercise- don't really know their values.
They know them underneath, but they haven't really articulated them as values, and if you ask them to give you a list of values, I don't think it's something we're particularly good at, 'cause we've been very disconnected from those kinds of conversations. So how do you start? What do you actually pres- put in front of people so they can figure it out?
This is a coaching question. I often start by saying "Imagine that we are at your retirement party, and you are so proud of everything that you've done, and your family is there, and your best friends are there, and they're talking about you and giving a [00:06:00] toast and saying, 'This is what Dr.
Did.' And you're so thrilled, because everything that they're saying, you're just so proud of it." And then I say, "What are they saying?" And then as my client starts thinking about it sometimes I'll make it the 100-year birthday party to take it out even farther, they start listing what's really important to them, and they almost always list spending time with family and spending time with friends and knowing that they made their patients realize that they were more than just a slot on the schedule, and all of their colleagues, and feeling like they helped their colleagues go in a direction that was important to them as well.
And then the values start to come out. I think it can be a little awkward when we say, "What are your values?" Because at least where I was trained, or when I was trained in med school we didn't really talk about our values. We were told what to value. Yeah. And that's- That's a really good point ... an issue in medicine.
Yeah. And yeah, I [00:07:00] was co-teaching a seminar last week on emotional intelligence and conflict management, and I joked, but I was like, our emotions are beaten out of us in medicine. Don't feel, just work." And it's no wonder that we lose touch with what our values are, and we never get a chance to articulate them.
Yeah. I did a workshop where we talked about emotions, and the number of emotions that the physicians I was talking to could name compared to people who are not physicians was significantly lower. Even just the knowledge- ... of what are emotions, what are my feelings it's amazing once you start looking at it and trying to name it.
Somebody was... We were literally sitting in a room and I was talking to a whole bunch of physicians, and maybe the list had 15 or 20 feelings or emotions. They were looking at some positive and negative ones, and there was a non-physician who was like, "I have 62." And one of the physicians was like, "I don't even know 62 emotions."
I don't even think I could write out 62 emotions. So it was a it's... I do think what you're saying means a lot to me, because I know I really felt like I was [00:08:00] told I'm not important, the patient's important. And you're supposed to subjugate your emotions in order to do your job well, which I think we've all finally figured out- Isn't the way to have a healthy, beautiful life, and then therefore not the best way to take good care of patients.
Like you said, it's, if you don't come back from burnout, you can't be the person that you wanna be in order to take care of them and yourself. Yeah. We're in a field where we learn to not eat, not drink, and then not need to go to the bathroom all day because we're so busy. Yeah. That's crazy.
Especially yours. Yeah. Yeah. We gotta turn the room over. Yeah. Yours too. So when you think about your experience, you've got Hopkins experience, you've got countries all, programs all over the country and all over the world now, what's the gap you most consistently see where departments are failing to provide what faculty actually need?
I think what I'm seeing most commonly is that people don't feel valued. There's not a sense of belonging and a sense of what I do and contribute to this department is really important, and you need me here. [00:09:00] You want me here. Yeah. I think a lot of clinicians are feeling like a cog in the wheel.
We're assigned that shift, we show up, and then, oh, dismissed, done at the end of the day. And I think people we feel like cogs in the wheel. We feel devalued. And yeah. Now, when you talk to leadership, I'm sure they would tell you they do value those people that are working with them and feeling devalued.
How do- Yeah ... what kind of recommendations, what kind of things can we do in our own departments that are gonna help our faculty recognize we, we care about them, but we're also worried about the bottom line? And so sometimes the conversation turns left to that instead of the pe- things that make people feel valued.
Yeah. I think it's a two-way street. So we have to remember that our leaders are extraordinarily busy. And I joke, but I think it's probably true, department chairs have maybe 30, 40% of their time is dealing with HR issues where people are not [00:10:00] performing up to par or doing their jobs correctly or getting into conflicts, and then we're worried about the finances and all of the regulatory issues.
And so the leaders are exhausted themselves. And I often tell leaders, I coach a lot of leaders in, in like department chairs and higher, and division chiefs, "If you don't take the time to take care of yourself, you won't have enough energy to truly and genuinely thank the people in your department who are doing a great job."
Yeah. Because sometimes we start to take it for granted. 80% of my department is just cruising right along, but if we don't tell that 80% thank you in a personal way, they don't feel like they're appreciated. But at the same time, it's important for the faculty and the clinicians to Toot your own horn, if you will.
This is the self-promotion to say- Yeah ... "Hey, department chairs, I want you to know I just had a big win. We just enrolled our first [00:11:00] patient," or, "This clinical program that I've been dreaming about, we're putting the team together," or, "I just got something published," or, "My mentee presented a poster." And a lot of my clients say I don't wanna bother my chief with that."
And I'm like, "Are you kidding? That's the best news." We never hear good news. Nicest thing they're gonna hear all day. So let people know about the important work that you're doing. If you're uncomfortable with self-promotion, you can phrase it in the way of, look at who we're benefiting. Look at this great thing we created for these patients, for this patient population.
Their needs weren't met, and then everybody's day is better, and hopefully that creates an opportunity for a leader to say, "Wow, thank you." And the person who tells them that, the clinician who lets them know the good news, they just made their leader's day a lot happier too.
It's "Oh, this is- Absolutely ... this is fantastic. Look what my department's doing." Yeah. Yeah. And it's not the complaint [00:12:00] that I thought I was gonna be opening in this email. That's right. That's right. Yeah. I love the visibility conversation you're having. So when you talk about making things visible in your department, I think that's important, but I also wonder, what are your thoughts around the really productive people in your department who become invisible at the national level 'cause they're so busy holding that world together?
What kind of advice do you give those folks when you're working with them? Yeah. We all have a set size plate, and we can continue overloading it and hoping that our plate will somehow get bigger, but it won't. And so if you're going to put more on your plate and choose to, say, get more involved in national society committees or go to more conferences and give invited talks or deliver workshops, you've got to take something off your plate.
Yes. Otherwise, you'll burn out, and then you also won't deliver the job that you want to because you'll be tired. [00:13:00] And so decide what it's time to let go, because you're also creating an opportunity for somebody else. If I'm gonna stop doing this maybe Dr. Down the hallway is going to love this opportunity, and then you can go pick something else up.
But don't try to do it all at once. Yeah. And I love the suggestion of sponsoring somebody else. I talk about this all the time. I think it allows people to get rid of the guilt that comes with getting rid of something or saying no to something that, that they may think is valuable but maybe not the right thing for them.
Yeah. That guilt is powerful and difficult- Yeah ... and it doesn't serve us. Stacey, how do you deal with guilt? I actually spend a lot of time focusing on the shoulds. When people really talk about things they should be doing, it's oftentimes something they're not invested in, and it leads to this guilt feeling.
And so understanding the motivation behind it, I think many women, I think we're programmed to feel guilty for n- saying no, just a no, even if it's an appropriate no. So a lot of [00:14:00] times what I do is I try and help people, I think the things you're talking about. So I think if you feel like you can highlight the team instead of saying it's about me, or if I realize I can give somebody else an opportunity that they might really want and would build their career when it's something I don't want.
My example is that at one point in my career, I was on five editorial boards and I was the associate editor of a journal, and I didn't even like the work. I did not enjoy it. I understood the value of it. But at some point, somehow I just felt, I don't know why I kept saying yes. I know, maybe one or two of those would've been useful to show my national reputation, but five was thoroughly unnecessary, and one of the best days of my life was the day that I got rid of all five of them.
But I didn't do it until I was taking a national leadership role when I was taking a job as the chair of the board of governors for my academy, which would put me on our exec committee of the board of directors. So I felt like I had justification, but I didn't need to wait for some giant thing to happen to, in fact, recognize that it wasn't the right thing for me, and I sponsored five [00:15:00] people who were all ecstatic to be doing those jobs.
So I think so much of it is coming back to, I talk to people about the dread factor. What are the things you're doing that you really don't even want to? You're just, "Ugh, I have to do that thing tomorrow, or that job." "Those are the first things on your no list." And when I coach people, in those stage you're talking about, especially when you're like teetering on that burnout or you're thinking about a bigger job somewhere else or a different job, we talk about the no list.
I'm like, I... We'll literally, we start with wins, then I'm like, "What'd you say no to?" "What are all the things you said no to, and what are the appropriate yeses, and what did you balance it with?" 'Cause I think that guilt is a really big, powerful thing. I was listening to a podcast with Kristen Bell, who literally couldn't even tell somebody that she didn't want two creams in her coffee.
She just wanted one, 'cause she didn't want her to dislike her, and I'm pretty sure she's doing pretty well in the world. So it made me be like, "Okay, I feel fine that I hit the fifth editorial board, but I'm never doing that again." And you also have to remember that if you trade places and pretend that you're asking somebody to do something, and they [00:16:00] say yes to you out of guilt- Yeah
chances are, one, they're not gonna be invested. Two, you're going to be able to feel that they're unhappy. And who wants somebody to say yes out of guilt? It's better to just be honest and say I'm working on this instead. I have this other leadership direction that I'm taking," or, "There's something else that I'm working in," or, "I'm having wild success in my new program.
I think Dr. Would be great." So Stacey, you gave five other people career opportunities because of that, and that's amazing. I also think if you have trouble with this, you don't have to say no right now. I think that's where people get stuck. Yeah. I tell people to just give a very, "I will have to look at my obligations and get back to you," or find a phrase like that so that you can- Yeah
really decide is this a yes or a no, and do it when you're not deer in headlights. Yeah. I call it the power of the pause. Yeah. And so never respond right away, especially if somebody is running past you in the hallway and shouting out, "Can you give the [00:17:00] lecture on Tuesday?" And of course, what do we all say?
Sure." And then you're like, "What did I just say yes to?" Yeah. So never respond right away, and then get out of the work environment and go home. And then when you're surrounded by family and all of the other things that you have in your personal life, then assess how will this fit in, and then respond the next day or a few days later.
But do respond and let them know- Yeah ... Stacey, like you just said, "I've gotta check my other obligations. I'll get back to you by Thursday." Then do. But don't make a split yes. I think that's great, and I also like the advice that if you didn't... If you don't think you'd say yes if I asked you to do it tomorrow, don't say yes to do it in six months.
Because If you're not gonna be excited to do it tomorrow, You're gonna be even less excited in six months. It's just because you're pushing it off, it feels "I'm gonna be fine with it." And I like at least that framework, even if it's not your ultimate decision maker.
Yeah, absolutely. And then in terms of six months, if the thing that you said yes to is in six months, imagine how you're going to feel in six months. [00:18:00] Are you gonna be excited then to do it? Yeah. If the answer is no, then think twice. Yeah, absolutely. And also, I would tell y- if you... I've had point
I don't know about you, but when COVID hit, I had a whole bunch of those things on my calendar, and I was actually very excited that I couldn't travel. There was things I didn't wanna do, and I was like, "This is... I need a reboot," because I need to really recognize I'm saying yes to things I don't wanna do.
It was this exact filter you're talking about. And so if you think about if everything ended tomorrow and you can't do the things that are on your calendar, which ones are you really gonna be sad to miss? That's right. That's a great exercise to do. What will I be sad to miss? Yeah. Yeah. And then you can kinda rebuild it again, which I love.
Absolutely. I have one question, for you that I wanna make sure that we get to. And if a chair is listening right now, what is one structural change they could make that would meaningfully improve faculty retention? I'd love to hear your perspective on that. Oh, my goodness. One?
You can give us more than one, but it- Tell us what you [00:19:00] think. I'm sure you have more than one, so this is not a limiting question. I think that it's retention within the institution, but also right now retention within academic medicine. Because we have a lot of people... it depends on your subspecialty, but people who are moving to private practice.
In my field, in anesthesiology, we have a ton of people going to locums. And so I think that one of the most important things would be to have regular meetings with your faculty, and I know it's very time-consuming, especially if you have a department with 200, 300 faculty. Our Department of Medicine at Hopkins I think has almost 800 faculty.
And so this can be delegated to division chiefs as appropriate, but regular meetings with a touch base that says, "What are you working on that you are enjoying?" "And where do you want to go, and what can I do to help you get there?" And then within that same conversation, people will usually respond with what they're not enjoying, and then you can say [00:20:00] how can we reduce that?
We do have to keep our division or our department running, but perhaps I'll need to reallocate some things so we can better match duties with what people's goals and interests are." And that individual attention shows that people are valued or that you value them as the department chair or chief. The main cost is time, but it speaks worlds when somebody can actually tell you where they want to go and sometimes you can just send an email or send a text to one of your colleagues to help them get to where they want to be.
And so- Yeah, I agree with that ... I think that individual time is important. I will say one of the things I've found, we do some departmental career coaching, and we serve as an extension of the chairs and the division chief, and knowing that conversation was something that the chair was investing in and the time for them, I think also it's not a substitute for talking with your chair or your division chief, but I do think it's a nice addition that really [00:21:00] helps expand the reach of somebody who's really busy, like you're talking about.
If you've got hundreds of faculty members, or quite honestly if you're a busy anesthesia chief or surgeon chief who has 50 people or 100 people, it takes a lot of time to have those connections, and if some of that can be consolidated, I find that's also useful to package it up so you can send it back and have what's probably a more useful conversation where it's really that chair or division chief who can help you move into the things you need less when you have some more clarity about what you're doing.
Absolutely. And then that also includes clarity about the ask, because you may only have 20 minutes with your department leader. The appointment may be booked for 30 minutes, and then somebody comes late, and then somebody barges into the door and cuts your meeting short. So be- Yeah ... clear on what you want, what you're asking for, and what you're willing to follow through on.
I love it. Okay, here's my closing question even though it sounded like that last one was, but I- Oh, okay ... I lied. So what do you wish more institutions understood about what coaching does do and what it doesn't do? [00:22:00] Yeah. I wish institutions understood that the coaches serve the clients.
We are there for the client. Whatever they bring to us, at least this is my style, is what we will work on. What we don't do is turn somebody into somebody that they're not. So this happens a lot with remedial. Yeah. Somebody is not doing the work I want them to do, and the reality is that they don't want to do that work and they're not motivated to do that work, and there's no coach in the world that's going to change who they are and what their motivations are.
I love it. That's what I wish people would understand, yeah. Yeah. No, that's perfect. Perfect. I have many people, I'll have a division director who will ask me to work with a faculty member, and it's because they're not doing X, Y, and Z, and they should be doing X, Y, and Z.
And it turns out it's totally incongruent with their values and what they want to do. But I will also say, if you can help them do that exercise we just talked about, where you make your time align with your values, I find those division chiefs are [00:23:00] happy with a happy faculty member who is successful in the area that they're doing a lot more often than they think they will be.
So they may not be doing whatever you wanted them to do over here, number, task Y. But if it turns out they're really leaning into task X, and S, and T, I think it helps get people right back in line, even if, quite honestly, oftentimes I'm not getting people to do the thing that the division chief or chair was saying.
They're not doing this. They're probably never gonna do that, but we need to have where they do provide value, and when they're excited, and happy, and energized again, it's a very good- Yeah ... conversation. And I also will say- to people, it's not the right job, and it's okay to actually get to a place where you're neutral in that decision and it's not an emotional decision moving forward in a positive way.
Totally agree. Now I am gonna end things, 'cause I really do want to be respectful of your time it's so good to catch up again, and I don't know if everybody knows this, but Jenny's gonna do a little work with us too, so doing a little bit of coaching work together.
I appreciate everybody who's joined us today, and if you are interested, please check out our website at Academic [00:24:00] Medicine Strategy Group. Our podcast is the Medicine Strategy Podcast. And if you have any interest in faculty excellence and retention initiative please check us out and get in touch.
In the meantime, we look forward to talking to you next week, and thank you Jenny so much for joining us. Thank you, Stacey. Have a great day.
