Joe Kerschner
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[00:00:00] Welcome back to the Academic Medicine Strategy podcast. I am very excited to be talking to Joe Kirschner today, and I have given you all that information about who he is in the intro, but more importantly to me, he has been a mentor and a friend of mine since I was a resident with him starting in 2000.
So thank you very much for joining us today. And if you didn't hear earlier, Joe has smartly wrapped up his tenure as dean at the School of Medicine at the Medical College of Wisconsin, where he also served as provost and executive vice president, but he's now a senior partner at Chartis Consulting, and maybe you can start by telling us What's that transition been like?
Yeah, sure. Stacey, really great to be here with you and your guests. It's really my honor, actually, to be able to engage with you and them in this forum and really looking forward to our time together. But yeah, I, Look, my life has been in academic medicine and I came into the dean's office probably way too young.
I was the youngest dean in the country by quite some timeframe when I took that job, [00:01:00] and had the good fortune to do the role for 14 years. The average lifespan for a dean of a school of medicine's about four or five years, so I maybe was in the salt mines about three times as long as as most people do it.
But because I started young, I have a runway left to do some other things, and was very interested in continuing to contribute in some meaningful ways. As I spent really my entire career at the Medical College of Wisconsin. I went to medical school there. I did go to South Florida for my ear, nose, and throat residency training, but I came back on the faculty, did my fellowship in pedes there.
Rose through the ranks administratively, as we've talked about. And so I was very interested in learning more, in more depth about other academic health systems, other ways in which US medicine was moving forward. I did have the great privilege of serving as the chair of the board for the AAMC which oversees medical schools and academic medical centers in an organized medicine fashion.
So I [00:02:00] had insight into many places, but not really the kind of insight you can get by if you will, parachuting in and spending three, four, six months in an organization learning their senior leadership teams and what they're trying to achieve. So for me, that was like the perfect laboratory to go to next.
You'll see that I'm sprinkling in some vocabulary from my roles as a clinician scientist as well. But I... and it's been fantastic. It's been absolutely fantastic. First of all Chartis is a wonderful firm. Has the right ethos that fit my personality and concepts about what a firm should be, but also just wonderful people.
And it's been a pleasure to actually just jump into that work and be at academic health systems medical schools across the country. So I've been doing that since last August. Still have research grants and biomedical startup companies, so I'm still connected to academia. I'm actually talking to you from a little office that I retained here at Children's Wisconsin.
And I do mentoring still for faculty here and engage [00:03:00] here. I actually had breakfast with the chair of pediatrics here at MCW this morning. So still involved in, in, in many ways, but this next path was really a great transition for me. That sounds amazing. So since you mentioned mentorship, I guess I'm gonna dive in a little bit there.
What people may not know is that Joe has actually been my mentor for a very long time, and he has helped me through a lot of critical inflection points in my own career, including many times when I asked him when I could stop being from the first institution I worked at and be known for my academic national reputation and not just for the place where I worked.
So helping me navigate that early career time was fantastic. But as you've moved your way through your career, I'd love to know your views of mentorship now when you look at it at scale. So as opposed to being able to help everybody, it's great you can meet with the chair of pediatrics, but you can't meet with every chair, and you definitely can't meet with every division director and all the way down.
So how do you build systems that provide that kind of mentorship both at the individual level but also at that scale so that you can help with things like [00:04:00] retention? Yeah. Such a great question. I'll say a couple of things on that. And I think actually regardless of what else we talk about today, I would say that mentorship, if you will, paying it forward thinking about those kinds of things is probably one of the most critical, important aspects of medicine writ large, not just academic medicine.
I like to say that the the currency of leadership while when I was in the dean office dean's office, oftentimes it felt like it was money and that was the real currency. But the currency of leadership is really time. That is the most critical thing that you have to give to people. And so to your point you can't you can't be a mentor to everyone.
And so I'm gonna attack it in two ways. One is as a mentor you have to, I don't know if jealousy is the right, jealously is the right word, but you have to guard your time to be able to be that mentor to those people. What do [00:05:00] I mean by that? Some people say I'm an important person," and so everybody that sends a, "Will you mentor me?"
into my inbox, I'll say yes, because I wanna be that good, good person that gives back to people. That's the wrong answer because mentees don't need, they don't need three seconds of your time. They actually need your head space. They actually need, when Stacey Ishman calls you, to say, "Look, we need to meet at this meeting," you actually create that time to actually sit down and actually have a meaningful conversation and actually have thought about it.
And and then also have kept notes. Actually I confidentially obviously keep notes on people that I have mentor/mentee relationships with so that I can check in with them and check on things that we've talked about. So I think in order to be a really good mentor, you have to guard your time and say, "I'm not gonna mentor everyone."
We could talk about if you wanted, how you choose the mentees you agree to mentor. But you have to be choosy, like everything in life, right? We don't have enough time to do all the things we want. [00:06:00] To the point about scale, so I would say again the most important thing you can do is if you're in an organization and you have a leadership role is teach people how to fish rather than, giving everybody a fish, right?
Don't give everybody three seconds of time. So pick those people who you think will give back, mentor them, ask them to mentor people along the way. And then I think you need to build a team that are experts. What we did at the Medical College of Wisconsin when I was in the dean's office is we literally built a team that understood faculty development, understood mentorship.
For all the leaders that I recruited during my 14 years as dean, they all got the privilege of having an executive coach. So that was a way in which they would benefit from institutional resources going into a different kind of mentorship. It's not mine, but it's- ... but it's coaching. And I will say for me, moving along my academic career and my leadership career, having a coach, an executive [00:07:00] coach be able to say, where you're thinking correctly, giving you feedback.
So yeah, choose your time. Put in institutional resources if you can, and then teach people in your organization how to be good mentors and set up the processes that allow that to happen I love the point you made too about taking that, that... You called it headspace, but taking the time to think outside of maybe that meeting about what they're doing, making sure you're checking in on them, I think that's a really critical piece that we forget to teach people.
The time, I think, is not one everybody focuses on 'cause it's hard to find it. But once you've decided to do that, I think taking some extra time to really think through how, what they need and what you can provide and who else you might be able to connect w- them with is a really critical part.
So I, I appreciate you, you bringing that forward. Yeah, 100%. So the other thing I would love to know, you go back to your first day as a dean and you think about what you've done in consulting now, you think about MCW, you think about the AAMC experience. What's one structural thing you would go back and do [00:08:00] if you could around faculty development and retention?
I'm sure what you did was great, but if you were like, "I'm gonna design the perfect system," what would it look like today? Boy, that's such a good question. I think, I think probably it gets back to having enough resources, one. So I think at times at times when times are tough especially, you might skinny down those resources.
I think I'll say this very poignantly and this from the depths of where I started. I did not... Again, I started too young. I... There were so many things I didn't know. I think I approached mentorship, faculty development in too much of a one-size-fits-all. In other words, okay, here are the building blocks that you need.
Just here's the Lego set. They're all gonna be red, blue, and yellow blocks. Just work with these Legos and build your faculty development with these blocks. It's nonsense. [00:09:00] It's complete nonsense, right? So people need purple blocks, and they need green blocks, and they need things that aren't even in the Lego set, right?
So I think as I matured and I would say- I, I would say I left the organization understanding this much better. So I think if you would ask people they would agree that that this came into development over time. But, you have faculty that come from very diverse backgrounds, fa-faculty that have just really different experiences.
They've traveled a different journey. You think about your women faculty that even from the standpoint of fair pay and all of those other kinds of things. You think of your faculty who are from racial backgrounds of color that have just really different experiences.
You think of your faculty that are in the community primarily. You think about your s- quintessential academic faculty whether they're triple threats or whatever, but they're clinician scientists versus people that aren't there. And your [00:10:00] educators versus people who mostly want ... i-it is the beauty of, humanity, I would say, but the beauty of academia oftentimes is that there is this diverse richness of an organization.
So I, if I had a piece of advice to somebody that was thinking about faculty development mentorship, it would be stop for a minute, understand how many diverse places these people are coming from, and then try and design a system that recognizes that, appreciates that, but then also really puts in place the resources that allows every individual to be the best faculty member that they can be.
I think I have it now at 61 years of age. I think I've understood that. But I definitely, when I took the first breath in the dean's office, that was your timeline, at 45 years of ~o-age, ~I didn't have a full breadth of that. And I'm grateful grateful to people not yourself.
So that's the other thing about mentorship, ment- right? You get it... [00:11:00] If you're doing it well as a mentor, you're getting as much as a mentor as you're giving to your mentees. So individuals like yourself I have two daughters who are in medicine as residents. Believe me they kept me honest about understanding some of these things.
But many other people just gratitude to an individual like Valerie Flannery. Y- people may not know her on this podcast, but a Black woman in pediatric ENT who we've had many conversations about where people are coming from in a journey. And people like yourself and Valerie and my daughters who We don't care that you're the dean.
We don't care, we're gonna tell you how it is. So that's another thing y- you... If you're developing these relationships for a mentor perspective, you wanna be able to have real live conversations, right? It's not on the surface. It's not like at, very skinny depth.
You wanna be able to go into real deep conversations. So th- that takes time, right? It takes time to build trust, a bidirectional trust. But the best kind of those relationships have a trust where you can actually talk about real topics and not worry too much about [00:12:00] all the jumble that comes with that.
So a- as I look back at what you're saying here, so first of all, I love that you individualize it so that you're making sure you're not trying to put everybody in the same block. But I'm gonna ask the next cl- question that seems logical to me. I know it feels like this is the place where we can save money when th- times are tough, and times right now are tough, for almost every academic medical center or non-academic medical center.
And so I do think faculty development is an area where people think they can save money. I just spoke at an institution whose faculty development budget was, like, less almost than my travel costs were. Like, it was almost nothing. But the cost of losing a faculty member is huge. We're always looking at the data, and it's not just your salary.
It's the lost productivity. It's all the people who are left behind who are doing double duty. It's recruitment. It's all those things. So how as a, at the dean's level, at the provost level, how do you balance those? Or how do you help people look beyond what looks like a tough budget to understand that there's [00:13:00] probably a huge ROI on just investing in faculty?
And if you look at Mayo, they got a 1.7x on coaching compared to what they put into it. So there is data out there. Yeah. But it doesn't seem like it's necessarily permeating into our medical centers. My favorite MLK quote is about the arc of the universe bending towards justice, but it's slowly.
It's slowly. So I think I think he had it right. I do think the arc of the universe bends towards justice. And it doesn't, certainly not a straight arc. Like sometimes it's going flat, and sometimes it's going backwards. But I think it... I think over, over eons, I'm sorry for the long timeframe, but I think it does bend towards justice.
And so why do I start there? I start there because I think in any one person's career, or certainly an- any one person's timeframe at an institution, it may seem like you may be at a point in time where it seems like that arc is non-existent or even broken, right? Yeah. Yeah. What I will tell you just from a senior leader perspective just [00:14:00] taking the data point that you're talking about when I started in the dean's office, there were very few medical schools that had invested in faculty development in the way we did at MCW.
Very few medical schools that were using y-you said it, there's data. There's actually scientific ways in which you can think about people development. We were decades behind you've heard me say this, the real business world, where you look at people that are out in other industries, and they understand all the things that you're saying, right?
So they heavily invest in it. It's interesting being in, in, in consulting now. Consulting is a, i- is a industry just in general where they really understand that, like early on the babies in the company need to have development. They need to have... And- Yeah. Yeah ... most businesses do.
Not every business does it it's incredible, Stacey, to think about, the journey I'll say in 20 years from where I was going around to medical schools talking to deans, and they're like, "Yeah, we don't do any of that." It's tough to find a medical school [00:15:00] now that doesn't have a much more robust understanding of this and the data you're talking about.
So I think places are investing in it. They realize this. ~But w-what~ I always say to individuals is, like, when you're thinking about going to someplace, when you're thinking about signing up for your next career move, like those are great questions, like your division chief, your department chair.
Like what does this institution do for this? What do they do? If I'm lucky enough to ascend to a leadership role at this organization what resources will I have to invest in the people to make sure that I can keep the people that I really want, that I worked so hard to get here?
And you know whether you should sign that contract within about seven seconds of asking that question. Because if the person that you're asking it of is fumbling around and they don't really know, and they can't talk about the ac- the Office of Faculty Affairs and Development, or they can't say what they've done for coaching or what they do for their own faculty and what they do for their division chiefs, like anybody that you're interviewing for a job at an academic institution [00:16:00] or not should be able to tell you what they're gonna be able to do for development for you personally or writ large for your division, your department.
And if they can't, or if they can't respond back to that question immediately, like just say, "I'm going to the airport, it's been nice to meet you. I'm gonna work someplace else." I'm being a little bit hyperbolic here, but- Yeah ... you know what I'm saying. So I love the answer, and I think what I took from that is I love the question, what resources do you have to develop faculty?
I think it's actually important whether you are listening to this as a faculty member or you're one of the leaders and thinking, "Oh, this is a question I need to be prepared for." So if we're gonna turn it back around, 'cause you talked about your two daughters who are both in training, and we had a very brief conversation before we started talking on the air about your recommendation for them.
Academic medicine, private practice, like what does the world look like ni- right now? And I think it comes back to what is the thing about academic medicine that pulls you in and back through it even during what might be the hard years? 'Cause I think a lot of people think [00:17:00] these are the hard years right now.
I think public- Yeah ... funding for institutions is- Yeah ... is tough. And I try not to mention that I work in a Medicaid insurance company, but it's tough over there. It's, I don't know anywhere that I'm working right now that people are not worried about the dollars and the cents. So what is the joy about academic medicine that you are telling your kids, "This is why you should do it"?
Yeah. Thank you. I'll say, so I'll start with- Medicine is tough anywhere you go. So i- so academic medicine is tough but if you're not in a non-academic place in m- many geographies, most geographies, depending, there are some special circumstances. But I think we're struggling in this country with the concept of, what we wanna be as far as who we care for how we care for them, what resources are placed there.
We struggle in this country, I think as a healthcare design system about, like who has access and how do we pri- prioritize primary care [00:18:00] versus specialty care. We struggle from the standpoint of what I'll say is a lack of comparability from a pay scale. We're the only, really the only healthcare system in the developed world that has such wide disparities between how we compensate different specialties.
And so that's a different podcast. I'm happy to come back for that one. Trying to stick to the question though- So I think again, going back to the where you come from, what's your journey what I love about academic medicine is the diversity of what it offers you or what drives you or what makes you wake up and happy to go to work.
I just had a conversation with somebody in this world that I'm in. Chartis does a lot of funds flow designs and compensation plans for academic and non-academic places. But we were talking about incentives for physicians, and so I like to break it down into sort of in- intrinsic versus in- extrinsic incentives.
And so l- let's just stay there. Th- for me, [00:19:00] the most powerful incentives are the intrinsic incentives. And so you have to know yourself what those intrinsic incentives are. And the beauty of academic medicine is it a- it, it affords you many intrinsic incentives. So let's, again, start medicine writ large.
The intrinsic incentive, I think for most of us that, that crossed that threshold into a medical school was, I wanna be a doctor, I wanna help people. I want, I, I want to do something for humanity that really is very proximate to helping people at a really difficult time through illness, healing, all of those things.
So all of medicine has that. So that's a powerful intrinsic driver, I think. In academic medicine though, there's if you wanna be an educator, like th- that calling to be an educator, and we-- you think back about your teachers, the people you had in med school, the people you had in residency or fellowship, the people that you still think of fondly
You're like, "Wow, man, that person really had it." That person passed along so much wisdom and [00:20:00] that, that circle of life, like whatever you pass down, that person... it's, that's a powerful thing. For me I think research, especially clinical translational research, is hope.
Like when you think of the sick people that you've known in your life, the people that have really struggled and the hundred things that we can offer them today don't actually fix their condition. Clinical trials or research can be that. So if you're in that, if you're in that head space you can really wrap your arms around it and think about that.
Most medical schools now have a community engagement as that fourth pillar. We talk about the tripartite mission. It's really four now. So the way in which anchor institutions like medical schools, health-- academic health systems are these anchor institutions that are supporting our communities, often supporting our communities from the perspective of less well-advantaged less well-resourced communities Man, I tell you, getting up, I, that was what drove me.
That was what drove me, and that's what continues to drive me to, in, in my consulting work I'm primarily in the pediatric space and the [00:21:00] academic space. So I'm going to pediatric institutions, which, have all of these things on steroids, if you will, wanting to help the less well-advantaged and those populations that can't vote for themselves and those kinds of things, but also academic institutions.
So I haven't, I real- I haven't left that behind. I'm doing it in a different way, but... And I talk to my daughters I think I know what drives them. At least one of them I know. If she is not teaching at some point in her life, and there's way to, ways to do that, of course, if you're not in academic medicine.
You can teach people i- you know, in the clinic and in the OR and your patients and families and other kinds of things. But I know she will be disappointed, so she's gonna do academic medicine, not because I say she should, but her intrinsic drivers are going to make her gravitate there.
So I think a lot of people dream about being academic physicians. I think we all, that's the vision we have in medical school and residency, are people who are teachers and researchers and great clinicians. Community engagement wasn't as big a [00:22:00] part of training when I was coming through as it is now, so I think that's a great addition.
But I also think the point you made earlier about the support of early career folks, I think you called them babies to the organization- ... which I think is really important. I think we walk in the door, and this is why I've really focused on how we onboard people, is because we walk in the door and somebody shows you how to use the EMR, and hopefully they point you to where the emergency room is, which you hope not to go to a lot unless you're an ER doctor.
And then you get left on your own. And so I think the conversation about what faculty development do you have is great. I talk to people now, and I'll even say the people who teach you the EMR, at the beginning of your career, I can't even pick up all that stuff, right? I'm still trying to figure out where the clinic is and what my schedule should look like and when do I have time to do scholarship.
And so I think building that stuff in as you go along is the key to keeping people, because I think that the dream for most of us was to become the people who taught us to be who we are. [00:23:00] Yeah. And I find it so I don't know the right word for it, but I feel sad about the people who try to do that, spend three or four years, and then leave academic medicine, not 'cause it wasn't the right place, but because they couldn't figure it out or they didn't feel like they understood what the next step was.
I finished my first three years and I thought I was for sure on track for promotion, and I was all over the place. I was writing on a million different things that didn't fit together. I was doing this, like the check marks if you looked at my boxes, but they didn't fit together and I didn't understand I needed a story.
So as you're looking around at that phenomenon, are there things that you would tell people, like this is the easy button for how you can onboard faculty? 'Cause the numbers are pretty bad. Like what, almost half of faculty leave within their first three to five years in some specialties, and that's a lot of investment and a lot of broken dreams, which I think is the saddest part of it, what, based on all of the things you just said.
So if you could give us like the one way, or what are you telling the folks that you're talking to about the best [00:24:00] way to keep these early career faculty, even if it's just one or two tips that we could say, this is the secret sauce"? Yeah. So I'm gonna flip that question a little bit sideways and say I think the biggest difficulty that faculty have, and probably just in medicine in general for physicians, again, it gets back to time.
So if you think about what is being asked of you oftentimes as a junior faculty member, but just as a physician in general. So we know, for instance, that burnout, the number one thing that's identified for burnout is the EHR. So again, EHR was developed as a billing tool. It's become a documentation tool.
And thankfully, most health systems are now trying to invest in ways to think to think about this in a way that can help. But I think
I think burnout, let's... I think burnout in [00:25:00] general is just a, it's a epidemic in medicine. And again, it's not just academics. It's- Yeah ... it's everywhere. And if you look at medical students they're pretty much on par from a burnout and depression scoring for their peers in engineering and business and other things.
And by the time we get to, attending level it's, it's it's terrible. The data is terrible. And so there's a lot of systemic issues within medicine that lead to that burnout. And so I think some of it in academia is it's heightened because you have these things that contribute to burnout.
But then I always say I, I do think academic medicine is a harder path to choose, right? Because you have to be an excellent clinician, but you're also expected to do some other things, right? So already being put in this treadmill, if you will, where we know burnout is really terrible and you stack things on that, I think people look for the escape hatch because they're like, I can't do one more thing.
I'm being burnt out by all of these other things." "Let me just go back to where I started when I was [00:26:00] starting medical school and be a good doctor. And so I totally get that. I totally get that. And throughout my career, I think it's gotten worse.
I think docs in general, physicians in general I think our phenotypic selection process says, "I'll do that one more thing." Because I had to do that one more thing to get into medical school, and I had to do that one more thing to, get honors or whatever so that I could do the residency I wanted to do.
And I had to do that one more thing when residency 'cause I wanted to do this fellowship, and on. So I think phenotypically we, we attract a herd that does that one more thing. And I think that has been medicine over the last 20, 30, 40 years. Yeah, let's ask the docs to do one more thing.
One more thing from a credentialing standpoint, one more thing from a board standpoint, one more thing from a EHR standpoint. And a- and at some point there's a breaking point for a lot of people. So the home message to all of that, I haven't really answered your question, but, and this is also another podcast, but I think the home message to that is this is the first moment I think that I've seen in my academic career [00:27:00] where there is actually in an innovation a technological solution for this, and I think we're on the corner of it.
Not everybody's gonna think that AI is a great thing, and I know there's a lot that, like I said it's probably 10 podcasts. But- Yeah, that's a lot of podcasts ... but I do think that we're at a moment and I think physicians have to grab hold of this chassis and help drive it.
But we're at a moment where if you think about what's likely to be possible in the next five years and the firm I'm with, we're investing lots of money in AI and I'm actually create, helping create these modules around research. And what I'm talking about to clients oftentimes is lowering the cost of care, lowering the cost to cure, and lowering the cost to educate.
And what that mostly means is taking out the the mundane things or the things that you can't do. I'll just give one example just to show that I'm not just all about Children's Wisconsin or MCW all day all the time. But I was at a talk recently at the AAMC's spring meeting for deans where NYU came in and did a presentation.
And basically they're using AI, an agent that they created. [00:28:00] If you're a medical student, the patients you touch, they basically know-- the agent knows that. It pulls the best papers on that, allows you to have those before rounds the next day. And so the medical students are getting this this seamless, really highly curated ability to enhance their education in a way that doesn't require the residents and fellows and faculty that are overburdened to say let me give you this paper that I wrote 10 years ago.
By the way, it's outdated and I don't know if it's even being cited anymore." So that's just a, that's just a very simple example. But my point of telling that story is there are a thousand or a million examples of where that's gonna come to the forefront. Think about this the burden of writing grants and getting things through IRB.
Yes, you're still gonna need humans that are gonna have to look at the ethics of the IRB, but being able to hit a few buttons and feed in your proposal and the and an agent actually cleaning up the IRB, having it ready, actually having some- an agent there 24/7 to be able to... What slows down our trials, it's like by the time they get back to me [00:29:00] I'm like, "Ah, I'm in the OR, I've got blah, blah, blah."
It takes an extra two months. This stuff is gonna clean up, and I think I think the burden that you have for the EHR is gonna clean up. What I worry about is that if this stuff cleans up, then well, okay, we'll go see an extra 20 patients this week because you don't have- Yeah
that administrative burden. So I think organizationally, to finally get back to your question is the one thing I would say is you have to be aware that the individuals providing the care, whether it's physicians, pharmacists, nurses, physical therapists, speech pathologists, whatever it is, there is only so much that a human organism can do.
And so if we get more efficiency, it isn't go see, 20 more patients that day. What I do think though it will be is when you're with your patient, there's going to be an automated system that basically does all the stuff. So if you have a 15-minute visit and you're only spending three minutes with your patients, I think your 15-minute visit is gonna be 15 minutes with your patients.
And I think that will bring a lot of joy back [00:30:00] into medicine for humans that really started this journey wanting to have those conversations with their patients and wanting to actually spend time healing rather than interfacing with a computer. I know we're doing that now, and this is fine. But interfacing with a computer and clinking away and then spending two hours of pajama time, catching up on your cha- charts.
Nobody went into medicine to do that. Yeah. Not a single person. No. Yeah. So I'm gonna tell you, even though you said you didn't answer my question in the first half, what I heard was that people can't always be one more thing forever or else you're gonna break, and that the burnout from that absolutely gives you moral injury, which is part of the reason that people leave medicine to get back to what they came here in the first place which was noble purpose.
I also heard you say there's system and infrastructure fixes, which I think are absolutely critical so that we can help people on the right path, and that the u- in the end, we need to be able to come back to the humanity of it. 'Cause you're right, three minutes of our visit, which turns into six to 10 minutes of our note doesn't feel like you're living the mission that you actually joined us for.
So- Yeah. [00:31:00] I'd like to work- I love that answer. Even though you, you said that you talked around it. Yeah. I think the, I think... I think your summary was great, and I think that concept of moral injury is a real one. Absolutely. Now, I don't necessarily wanna end the podcast on the concept of moral injury.
But I really do appreciate you being here today. Do you have a word of wisdom you want to end us with? Yeah, we talked about some challenges and hopes. I think it's a message that I give to anybody, and I still mentor pre-med students and things. I think it's an enormously wonderful calling to go into medicine.
I think a- as we talked about from academia standpoint, I think it's a wonderful space still to be. And I would just encourage all of your listeners to do a couple of things to end with. One is if they're feeling burdened by things or feeling burnt out, first of all, make sure that you reach out.
Don't suffer in silence. Again, that the phenotypes that we choose, it's worse in surgery just making [00:32:00] generalizations but we know that physician suicide is real if you're feeling burnt out or you're feeling stressed find people to reach out.
Find a safe spot to to be able to converse. Everybody should have at least two mentors that they really can trust, so those should be people that you can reach out to and have those honest conversations. Whatever else you're doing in medicine, make sure that you're spending time to cultivate those relationships.
And then finally I think we all get you mentioned reflect back on you, checking all the boxes and stuff. Try to be less Brownian motion. Try to think less about checking the boxes, and more spend time to actually think about what is the most important one, two, three, five, probably not more than that, things for you.
And so how can you actually emphasize those things that are really important to you that will move things down the path for you because you'll be able to see that. And then linking it finally back to the whole conversation we had on mentorship, making sure you're testing those things with somebody that you consider as a mentor so that so that [00:33:00] you can focus.
I think excellence through focus is is a real thing, and mediocrity through lack of focus is also a real thing. And I think trying to find that, that directional excellence through focus is a better spot for most people to be That's fantastic. So we are ending with that we really wanna make sure everybody stays safe, everybody finds their mentors, they talk to them when they need help.
And if you don't have those mentors, there are other people you can talk to, whether they are your colleagues or your family, please do reach out. And the other is prioritization and focus, which I think all of us, if you start a career out by understanding your values, or if you're halfway through your career and you can't remember what they are anymore-
those, I think, are really great things to come back to. I didn't figure those out at the beginning, but I did figure them out in the middle. Yeah ... and I think they're really nice talismans for me to go back to when I'm feeling a little bit lost. Yep, 100%. Agree 100%. Thank you so much for joining me today.
I'm glad I got to share your wisdom with the world, although lots [00:34:00] of the world has gotten to know you already in the intervening 26 years. And I will probably take you up on one of those other 14 podcast ideas you had in the middle, so thank you. Happy to do it, Stacey. It was great to, to converse with you and glad you're doing this work.
It's important. Thanks. Yep. And out. So how's Jane? She's good. She's packing up for the summer in Door County, so
