Interview with Pamela Wible, M.D., on The Doctor Paradox with Dr. Paddy Barrett. Warning: EXPLICIT language. Listen to interview here. (Paddy is an Irish guy and it kind of sounds like we’re in a bar.)
PB: Hello. Paddy Barrett here and you are very welcome to another episode of The Doctor Paradox. The Doctor Paradox is about rediscovering passion in medicine. It’s about investigating why physicians are so often unhappy in their work but more importantly what we can do about it. To address this issue we interview a range of guests, from psychologists to authors but mostly physicians themselves who have gone through this journey and found fulfillment in their work.
Today we have a very special guest because after too long of a delay we have our first female guest but more importantly she is someone who truly inspires you to be the doctor that you always knew that you wanted to be. She is a practicing physician in Eugene, Oregon, and she is the founder of the Ideal Medical Care Movement, whereby she flipped conventional medicine on its head and defined a medical clinic in a family practice setting—for patients, designed by patients. She also host retreats for physicians who have somewhat lost their way in medicine and has spoken extensively including TEDMED, TEDx and those talks of been incredibly well received. Ladies and gentlemen, Dr. Pamela Wible. Pamela welcome to The Doctor Paradox.
PW: Thank you! Good to be here.
PB: Pamela, it is really fantastic to have you on. I think you are very unique personality within the field of medicine and I think you really practice the type of patient care that most physicians would aspire to or had originally thought that that is the way that they would be practicing clinical medicine. Both you and your patients seem incredibly happy within the health care ecosystem. I know it didn’t immediately begin that way for you and I was hoping you could take us through that journey that got you here and really explain what your early days in training were like and take us through that story.
PW: Well I was fortunate because both my parents are physicians and I went to work with them as a child so I saw medicine in it’s heyday and is was really, really fun. My mom’s a psychiatrist. My dad’s a pathologist and, although he had many other jobs (like working at the methadone clinic) he worked with live patient’s too. It was really fun to just be in the thick of it you know as a four-year-old going to work with my parents seeing how they interface with people during critical times in their life, whether it be death or drug addiction or psychiatric admission to the state hospital.
I just saw that you could make such a huge difference in people’s lives and really be there for them and it was just absolutely captivating to me. It’s a beautiful mix of science and human drama (laughs) and psychology! and I just love all of it and so I went into family medicine because I thought it had the breadth and depth of all of, you know, being able to just literally be there womb to tomb for an entire community. I just fell in love with family medicine. I graduated from the University of Arizona Department of Family and Community Medicine wanting to be a doctor for a town and just deliver that those house calls and be there for people.
But I found that all my job options were literally assembly-line medicine jobs. You know, putting me into like a Toyota-manufacturing-plant style of medicine. And the reason I mention Toyota is I ended up at the hospital library one night (you know I am one of those people who likes hanging out in the medical library). I’m a lifetime learner sort of person and I found a whole section of books on Toyota manufacturing!! And I was like “What are these doing in here?” There are people out there literally modeling health care off of assembly-line manufacturing plants and it makes no sense! We’re people. We’re not cars. We’re not, oh my gosh I could go on forever about this, but there are people who are just so stuck in this reductionist medical mindset of looking at people as machines. They’ve absolutely undermined our entire profession and and dehumanized everything from medical education to actual health care delivery. It makes no sense.
I found my way out of this when I started looking around and noticing physicians don’t look happy, patients don’t look happy. We’re not supposed to be on an assembly line and I went and did a series of town hall meetings and asked my community to design their ideal clinic and I told them I would work for them. Write my job description. I want to be your doctor. I wanna work for you and it’s been beautiful ever since.
PB: Now I mean the idea of these town hall meeting (and I’ve heard you speak about this before) but I was wondering if you could explain a little bit more about this in detail for our listeners because it is such a unique concept and I think if you could explain that in more detail that would be fantastic.
PW: Many people are familiar with the town hall meetings were politicians come in and give you the latest on what they’re gonna do for us and we listen to them and I guess ask questions at the end and hope they listen to us. As opposed to that type of town hall meeting, I really wanted to put the town in charge of the meeting so it was more like a listening session. I came in and was quite vulnerable in explaining that I was really depressed and having recently experienced suicidal thinking and it was all occupationally induced! Thinking that I couldn’t be this doctor that I really wanted to be for them. All the jobs that existed were pretty much assembly-line medicine jobs and it wasn’t making me happy and it certainly wasn’t making my patients or community happy.
Essentially after just a five-minute intro of explaining kind of my state of despair over health care which I think resonated with the group I asked them to dream it up. Tell me your wildest ideas. Nothing is too off-the-wall. I gave them all sheets of paper and some time to write down their just craziest ideas. If you could have anything! If you could design an ideal clinic and an ideal doctor you know what does this look like, taste like, feel like? What would you like the experience to be like when you see your ideal doctor, your ideal clinic? They completely mapped it out for me and it was just fabulous!
Could be a little bit scary I would guess for some people [other doctors to lead town halls]. First of all public speaking is scary for people. Second of all the idea that you would ask the community to tell you what they want and that you would promise to deliver it and you don’t even know what they’re gonna tell you is a little bit like going out on a limb there but for whatever reason I have faith in this process. All the feedback I got back (which was 100 pages of written testimony) I was able to adopt 90% of what these people wanted and we were open in one month with no outside funding!
PB: Wow, that’s incredible I think ya know we often unfortunately look at our patients in terms of what our patients need and it’s rather prescriptive but you’ve entirely flipped that on its head and I’m curious to hear some of the consistent themes, what patients asked for that we often don’t provide or what is that they were really desire since we really are not meeting their needs.
PW: The number one theme is a humanized experience, a human scale as in I want to walk into a living room and feel like I’m sitting with my friend who happens to be my doctor. So people want to feel like they are connected with you. Eye contact, you know honest vulnerable communication and not feeling rushed. Appointments start on time. All the kind of human skills that you would need to sustain any relationship like a marriage. You wouldn’t leave your husband or wife sitting in a restaurant for an hour two waiting for you to show up, I mean you wouldn’t. Sitting and typing on the computer and not looking at your spouse in the eyes? I mean you know it’s a sacred relationship and it needs to be on a human level!
So that was fantastic because that’s all I wanted to do. I mean literally theses people echoing back my own personal dream. The second thing that came up is an integrative approach meaning they don’t want any pills and interventions. They want to know what they can do with their diet and their lifestyle with massage, you know maybe an acupuncturist. They want no drug therapies which Western medicine has not trained us in and so that’s an educational deficit, unfortunately, that we have. So I was I was happy to move in that direction because it makes a lot more sense. There’s better outcomes and that’s what people want. Other themes came up like you know to see everyone regardless of their ability to pay and to have mutual respect. The top two that really stand out were a humanized experience and an integrative approach. And what was amazing that stood out to me is that nobody in like 100 pages of written testimony nobody asked for high-tech equipment or any sort! No technical gadgets or anything that people focus on so much when you read articles like in the New York Times and things like that about what “experts” think patients want. They don’t want any of that shit! (Host laughs) They don’t!
PB: I think so much of what you’re speaking to harkens back to the idea of you describing you couldn’t be the doctor that you wanted to be and so many of us end up in positions of practicing in such a way that does not reflect those original ideals of what is it is that you wanted to do and why you wanted to do it. And it also reflects as you said the idea of the human experience. That is why we we got into this profession in the first place. It wasn’t to learn specific technical skills. It was those technical skills could work alongside and augment our human experience of dealing with people and I think it also speaks to the idea of the integrative approaches is so critical it is a huge shortfall in our training and partly to do with the idea that you can’t measure it in objective. In many ways you can but you know if if you can’t measure it doesn’t exist and therefore you can’t improve it and you can’t bill for it. I think those patient needs are equally reflecting the needs of the physicians out there and I personally think that the idea of not being the doctor that you want to be is is one of the most fundamental underlying themes of why so many physicians are dissatisfied with their work today.
PW: Yeah, correct and then the major shortfall just starts in medical education which is still a very fear-based training modeling. Reductionist medicine does have a fatal flaw in that it’s basically the opposite of holistic medicine which is mind-body-spirit integration. Reductionist medicine looks at peopla as machines—it’s a mind-body-spirit DISintegration model of training which, of course, would be very damaging to the students. They come out and they’re a shell of the person they once were, the beautiful person that wrote their personal statement as they entered medical school with their hopes and dreams alive. They leave with them shattered by a medical education system that literally should teach three skill sets and only gives half of one skill set.
These three skill sets that should be taught in all medical schools are the technical skills, the human skills and the business skills of being a doctor. We receive no business training which leaves us completely open prey for third parties to just financially (you know) destroy us. Not to mention the high debt during medical school. The human skills you know like how you tell a family their child died in a car accident, like what you do with your grief. You love these people in your community and they’re dying and you have tell them that they have cancer and how do you handle the human side of the doctor? How do you set boundaries with people? How do you cry? You are not allowed to cry you know these are all things that are never addressed and we are only given the technical skills and the very narrow Western technical skills. We’re certainly not taught the value of acupressure, acupuncture, nutrition. When I was in med school (I was vegan at the time) a surgeon at a lecture was making fun of people going to health food stores buying fiber! I mean it’s just like crazy I mean really? You guys are gonna make fun of people who want to be healthy? Anyway it’s a very odd, it’s an odd situation.
PB: It certainly doesn’t align to the model of what actually patients want—an integrative overall approach. I think much of the advancements we have made in medicine have been obviously very specific areas and we have niched down and become hyper-specialists but we lose that sight of as you described it that womb-to-tomb journey. When you are interacting with a patient in a very narrow portion of their experience in life you begin to lose the overall journey and that’s why I think it’s so critical that you do try and develop as you have that that womb-to-tomb experience. Your parents advised you not to do medicine. You described them working in the heyday of medicine. Why do you think they they told you that?
PW: Because they could see government intrusion and all sorts of third parties coming to take their piece. They just saw less and less autonomy for physicians and of course they knew how brutal the medical education training model was. Being an idealistic young teenager I didn’t have any idea what I was stepping into. I just knew the end results that I wanted to be this great neighborhood doctor but they I guess were trying to protect me from from the injury that I would sustain.
PB: You know there is kind of this brutal training environment. I think of all that I’ve gone through those very difficult phases and they have been difficult but they have been incredibly formative. But there are boundaries that are often exceeded and a recurring theme that’s just becoming more and more apparent but certainly was always present was this issue with physician suicide. You have had quite a troubling exposure to physician suicide. Why do you think so many doctors are killing themselves?
PW: Well they’re trapped in a mind-body-spirit disintegration model called reductionist medicine which devalues the heart and soul—and that’s the only reason to be alive. The things that we can’t measure are the things that were living for—hope, love, joy, all the beautiful parts of being a spiritual being having a finite human experience. To just niche that down into like all sorts of medical minutiae that just focuses on the mechanics of being human without allowing us to have our humanity and our hearts and souls in our bodies is very damaging to the human psyche and spirit.
PB: I couldn’t agree more. It’s that disconnect between our expectations and the realities of what we’re currently practicing in that ecosystem that exists now. You mentioned the term burnout. For me personally I will say that I didn’t understand what burnout actually was. I thought that when you burnt out you just physically gave up collapsed on the ground and the world passed you but what was surprising to me was that you could be burnt out and still practicing your day today work and maybe not even realize that you had burnout. Can you explain to us what burnout actually is and how it manifests?
PW: Well I actually can’t stand the term burnout because it’s a victim-blaming term that’s used by our oppressors to label us and make us feel personally defective. If you made it to medical school or your residency or you’re practicing physician in this country, you’re already in the top 1% of resilience compassion and intelligence. The fact that you can take these high-functioning people who are like valedictorians in their high schools and such and after just a very short period of time in medical school or in practice turn them into like the majority of them having a condition called “burnout” that means that it’s a system problem and not an individual problem. The system doesn’t spend a lot of time focusing on what they’re doing that they could change instead what they do is send us to resilience training courses! As if we are resiliency deficient! Couldn’t be further from the truth! You know what I mean? We are high-functioning people in an abusive system so I don’t choose to use the term “burnout” that much. I really have a problem using terms of oppression that are victim-blaming terms.
I think it’s much more accurate to say we have a highly abusive and toxic medical system that is destroying the humanity in our idealistic, beautiful healers. I think it’s so important to point that out because often the solutions that are are offered are Band-Aid, temporary solutions and they are obviously not going to affect any meaningful change if they’re simply within the environment of a very toxic environment. You’re just gonna continually feeling the way that you do now—abused.
PB: What would you say to somebody who was struggling right now with where they are, say in their training. They know they have to go through certain steps but they just know intrinsically that there’s something off and and they’re struggling with their career. What would you say to them to enlighten them or get them back on path?
PW: Well it would be good for them to reach out for help. I think that medicine is an apprenticeship profession so it’s very important to have mentors who you look up to that you want to emulate because that’s how we learn how to be doctors—we study other doctors. What’s troubling is many medical students they tell me that medical school is more like an anti-mentorship program meaning they meet a lot of doctors they never want to become. So you’re just exposed to the cynical jaded doctors out there who have been successfully dehumanized by their medical education and traumatized.
Many of them have PTSD and don’t recognize it—which I think is probably a more widespread situation even then this oppressive term “burnout.” It’s just not recognized because it has not been discussed so you know the issue really is when you get right down to it we need a proper diagnosis to come up with the proper treatment plan. I think all physicians would agree with that if you are calling something pneumonia and it’s really sepsis or something completely different you’re unlikely to save the patient. So to use the term “burnout” which is a victim-blaming term and not the correct diagnosis, we reinforce in an individual that they’re defective in some way. And we are not at all getting to the root of the problem which is a system that has taken high-functioning people and destroyed them! So what I recommend is that anyone who is suffering talk to other physicians who seem to have figured it out, you know what I mean? If you’re a family doctor and you don’t like your job, try to find another family doctor who looks like they’re loving their practice and loving their patients and then just hang out with them. I think you need to have great mentors. In med school we are certainly not being exposed to enough happy doctors from the community who are successfully practicing solo medicine for example.
They are not teaching this in these tertiary care medical centers medical and students have a lack of exposure to what’s really working out in the field. So ask for help. That’s the main thing—ask for help—but ask somebody who’s figured it out because if you go and ask another cynical doctor what to do you’re gonna get cynical advice. See what I’m saying?
PB: Absolutely I think that is so important. The theme of mentorship is something that runs consistently throughout this show but I also believe in the idea of peer pressure. Peer pressure gets this negative connotation but you will develop the mean attitudes of the people that you’re surrounding yourself with and as as you described if people that you’re looking to for guidance and direction are people who have become incredibly cynical within the system you will get led in the wrong direction. I think it’s important to look further out and find those people who resonate with you in terms of an ideal philosophy of how you practice. Many people feel trapped in terms of how they will actually step out of this system that is very difficult to work with and often leads to feeling very disengaged as you have described. You have a concept called an ideal clinic and I am hoping that you could explore and explain a little bit more detail what the ideal clinic is?
PW: I believe the most evolved way of looking at the definition of an ideal clinic is that it’s a clinic that is designed by the community and the patient’s. Meaning it’s really patient-centered not all this kind of lip service like the patient centered medical home that does not put the patient in the center of designing the practice. The patient is still held hostage to a physician or administration-designed clinic. What I’m talking about is actually having the faith and trust in your patients—the end users—and asking them what they want and allowing them to design their own ideal clinic because who would know better than the person (the recipient) what would be ideal. Of course, we understand you know how to treat various diseases from a western medical standpoint and I’m not asking the patient to come up with algorithms for diseases but as far as designing a clinic, you know, where should it be located, the colors, the overhead. What time do you want the clinic to be open, how do you want to access your doctor, all those sorts of health care delivery questions—the patient should absolutely be in charge of that and you’ve got to remove these $400 per hour consultants who are not on the frontline of health care delivery. I know what patients are talking about [and what they want] and in every community they may be a little different in what they want. What works in the middle of Nebraska might be totally different then whats going to work in the middle of Manhattan. I live in a small little hippie town. People have a certain concept of what type of doctor they would like to have here and its definitely not a conservative Western doctor who is just gonna be narrow. They want a broad approach so listening to people being respectful and delivering healthcare in a way that they feel like they’re part of the community clinic and they have a sense of ownership in these clinics because they created them.
PB: I would imagine it seems almost foreign to us now to actually put the patient—the ultimate user of our healthcare system in the middle. It seems like that the purpose of clinics is to have the clinic rather than to serve the needs of our patients. So can you explain how each ideal clinic may be different, will serve the individual needs of its population. What does your clinic look like and maybe some ways it might be different to the classic and conventional structures?
PW: Just probably harkens back to the original pre-1965 model before we had Medicare and third parties inserting themselves and codebooks and all this other stuff that’s really unnecessary in primary care. I really want to preface this by saying primary care and tertiary care are two different animals completely. If you need a lung transplant you do need a five-story hospital, a helipad, and the whole team, and lungs on ice, and a high staffing ratio, and overhead is higher and all that. What I do in my clinic is Pap smears, ingrown toenails, bronchitis and things like that. I don’t need a hospital and, in fact, the more stuff you have as far as square footage, staff, overhead and third parties, the worse the care. You know what? I just need to be left alone with my patients. My 280-square-foot office that they designed—a nice little clinic with a shaggy carpet on floor, beanbags, lots of comfy pillows. Feels like a little living room in a studio apartment with a bathroom attached. I have an exam room but I don’t put people on the exam table unless they’re actually gonna get an exam. Most of the time they are sitting on the couch and I’m in the wicker chair.
It’s an amazing experience in that it’s just normal. I’m looking at them and I have my laptop and I do keep notes but I’m not like tied to the computer. I’m not using electronic medical record that was created for me by somebody who has no idea what I do, you know. I created my own electronic medical record with software that came with my Apple laptop and so it makes sense to me I don’t have to spend inordinate amounts of time just staring at the computer. I’m looking at my patient. We’re connecting as human beings and it’s absolutely beautiful, The appointments start on time all the time for 30 to 60 minutes. I still accept insurance but I streamline everything. Easy!
PB: There’s a lot of jealous physicians out there listening to your ideal model who only hope that they could someday achieve that. Your parents were physicians so you got an insight into the life of the physician. But for most people it was what their family doctor was to them when they were young. Ideally what would harken back to the the model that you’re describing and it’s amazing to see happy doctors and happy patients engaging in that.
PW: This is the only model that really works for primary care. You cannot use a tertiary care payment model and delivery structure and overhead to deliver primary care or you’ll destroy primary care. What is basically happening now is that we’re dealing with ingrown toenails with the same coding book, the same staffing ratio, the same infrastructure as we are for a lung transplant. Come on! This stuff is simple. You wouldn’t call your car insurance company for the rock chip in your window or every time you pull into a gas station. Would you ask their permission to get an oil change or to fill up your car? I mean it’s at the level of ridiculous right now that we’ve involved so many people in such a simple interaction. Most people’s problems can be solved just much easier if everyone else would get out the way. Too many cooks in the kitchen sort of thing.
It’s really interesting when you say a lot of doctors are jealous or would like to do this. I would just encourage them to do this but the problem that’s holding them back is not the lack of business skill because I teach these retreats for physicians in which I’ve been giving them business skills for a decade now. What really is the bottleneck here is the physicians with PTSD and their self-esteem has decreased and their self-confidence has decreased through their medical training and they have had psychological damage from an abusive medical education and medical workplace. That’s exactly what they need to have restored so that they can open these clinics. It feels a little bit to me like talking to somebody in a domestic abuse relationship. You could talk to them till you’re blue in the face and try to convince them that prince charming exists. They just don’t see it because they’re in an abusive relationship and so all they know is that they’re afraid and they don’t know how to get out of it. It’s so easy to start a clinic and I love my patients and my life is wonderful. It’s really hard to help people who are so wounded psychologically.
PB: I totally understand. It must be amazing to to see that evolution of physicians going from such a place of difficulty to being so much happier and content with their work and that kind of brings us back to the idea of what you mentioned about specific retreats directed at this very problem. Can you tell us what what does the retreat actually involve and what is it that the people do get out of it?
PW: It starts with a teleseminar and weekly 60 to 90-minute phone calls over at a 10 week period in which people (including medical students and anyone in health care) are actually invited to participate. They get the business skills and human skills they need to be a doctor, meaning to get what their medical education did not give them. I give that to them. And they get the camaraderie of being with a bunch of like-minded doctors who our ready to break free of their abusive workplace and really be the doctors that they had originally described other personal statements when they entered medical school. So it’s an amazing experience for people who for the first time feel supported and feel like there’s a family atmosphere of like-minded healers. Then they’ll get all these incredible skills which they can put to use. Then at the very end of the 10 week, we have a 4-5 day retreat in the woods of Oregon on 150 acres at the hot springs which is incredible where they are off the grid and are not on call and just with each other! I limited it to less than 60 people and I keep it very intimate and these people are able to finally heal from the PTSD the trauma the abuse that they have sustained from medical school.
The beautiful thing about it is that I almost don’t even need to be there to facilitate this because when you get a group of healers in a room together and you don’t distract them with ICD-10 codes and a bunch of bullshit, they naturally (check it out) want to heal each other!
PB: We see this in the social environments that we’re in that we naturally trend towards those discussions and conversations but putting it in that environment is just so much more I would imagine. Now over the course of the show, I’ve had several in female listeners contact me in terms of looking more at the female perspective of medicine. Do you think that there are unique challenges for females in medicine today?
PW: Yes there are unique challenges. I’ll preface this with I love men. I do not have any problem with men, but I do have a problem with a patriarchal medical system that devalues female traits. So that’s what we’re in. We are in a medical education model that values, speed, and graphs, and charts, and things that you can “prove,” and all that jazz. Yet the most meaningful things in life are things that you can’t measure like love, affection, joy, hope. These are the things that keep people alive and wanting to live on planet earth. This is what women are naturally good at.
Women are more relational than men. It’s how we are built. We like to hug and kiss and we cry easier. The medical system devalues that difference. And when (by the way) you ask patients what they’re lacking in medical care, they want all these female traits. When they say they want a humanized experience they are talking about wanting their doctor to look at me, and cry with me, and laugh with me, and hug me, and all those things. Those are things hat women naturally do all day long with their kids and their relatives and they would do it if it were okay at work, but they are freaked out that they’re going to get written up for unprofessional behavior! So this is horrible that we are not allowing women to be women. In fact, medicine really masculinizes women which I find so disgusting. I’m listening to these women speak and they sound like detached men. They even start to dress and behave in masculine ways. They are just not feeling safe to be women. I would like women to be welcomed to medicine as women, to be paid equally with men, to be respected for the complementary skill set that we are born with. Come on guys! We’re not gonna bite!
And the thing is for every woman we lose to suicide in medicine we lose seven men! Is that not screaming out for female values? I want men to reach out and ask us to help them. Our solutions might actually save your life.
PB: It’s so true. Many of those traits are repressed in men and also devalued and not asked to be augmented in females. Many females are just better at certain things. There’s a great book, Why Men Don’t Listen and Women Don’t Read Maps, about evolutionary life when men came home after hunting and they were just vaguely aware that there were small people living in the house that actually happened to be their children and the female mind was more set up to picking up the nuances of social behavior and it certainly feeds into how they would deliver more compassionate health care. It’s not to say that it’s unique to females, but it just seems to be maybe more developed. Now say if there were females listening who are finding themselves in that position, what would you say to them in terms of how they navigate that process?
PW: If you are with a malignant instructor in medical school or residency sometimes you just have to bear with it until you get out of it. Once you are free and you are a physician, please be yourself. There is no shame in being a woman—100% female. That’s how I am. I am the same at work as I am at home as I am with my dog. I am always the same. I do not put on a facade as a physician to go to work. I speak the same way. I have the same intonations. I put glitter on (I hate wearing makeup) and it’s just easy because you just put it on your face. I dress the same way. I wear jeans. I wear wrap shirts and maybe some of my cleavage shows. This is just me. I am not trying to cross anyone else’s boundaries. I am comfortable in my own skin and I am dressing and speaking and acting and behaving in a way that is 100% Pamela Wible. I think that is why my patients trust me and why people are attracted to me because here’s the magic formula—I’m not afraid to be myself! Anyone can do it.
PB: It’s so important to point out those key issues, Sometimes we just have to endure and get through a particular point, but when you do have that flexibility to go back to what your core values are, to do what you are doing. It is so amazing to see someone who is so comfortable in what they are doing and who has gone through that process of difficulty and challenge to finding a place of true fulfillment is a spectacular process to witness. I think it is really encouraging to see that.
PW: One thing that’s really funny is that I was speaking at a medical school once and, of course, people will tend to have a lot of questions for me after my talks and I’ll stay there for hours answering questions—everything from mental health to how to run your ideal clinic. One woman came up and her question was, well, she didn’t actually have a question. She says she just wanted to see if I was really wearing glitter! She just couldn’t believe it that a doc could take off the white coat and be a real person—just blows people away. I want to encourage everyone to be themselves. There is no shame in being your true self.
PB: That has certainly been one of the key themes on this show in terms of when people trusted their own internal compass that is when they found themselves where they had wanted to be. So it so important to trust yourself in that respect. We don’t do this alone and the questions that I like to ask people is the question of advice. What’s the best piece of advice you’ve ever received?
PW: I think it’s from my mother because she was always telling me that I could do whatever I want to do in my life and that I could be whatever I wanted to be in the world and nobody could stop me. That is a great piece of advice and I would like more people to believe in themselves. One person living authentically is more powerful than any amount of legislation top-down from Washington DC.
PB: That’s so true and speaks to the concept of following your own internal motivations that truly drives you. Now is there any book that you think everyone in health care should read?
PW: Oh gosh, I would love them to read my book, Pet Goats & Pap Smears, and I’m not about making money. This is not about selling my book. I’m happy to send it free to anyone who wants it. The thing is I wrote it for medical students because they are in such a state of despair and it’s like a “chicken soup for the soul book” for medical students and physicians that allows them to feel like they are following me around for the day. It’s perfect bathroom reading. The subtitle is 101 Medical Adventures To Open Your Heart & Mind. The chapters are 1 to 3 pages each with cartoons. When patients read it they say, “This is exactly he kind of doctor I want.!” When medical students read it they’re like, “This is what I wrote on my personal statement, the kind of doctor I want to be.” When physicians read it they say, “I wish I could do this!” Embedded in the stories are practice management tips which would be irrelevant for a truck driver from Dallas who read it and loved it and hadn’t read a book since high school. The point is you get the depth of the material based on where you are in your life cycle and what profession you are in. I wrote it at a fourth-grade level so anyone could enjoy it. If physicians could see that they have this opportunity to practice in a real way where they can be in a relationship-driven practice with their patients, it would give them an immense amount of hope so that they would know that their dreams can come true. This is not just a theoretical book of one day some day. This is actually following me around with my patients. And I just wish more doctors would recognize that they have the same possibility to live their dreams.
PB: Wow! Pamela, I just want to say this has been a really fantastic conversation and so enlightening and encouraging. What you are doing is possible and you are giving people the framework to actually do that. And I just want to say thank you for taking the time to be in the show to let us know your insights and perspectives that will be so incredibly valuable to all the listeners. And finally where can our listeners find out more about you?
PW: IdealMedicalCare.org is my website and I return every single email and phone call. I am very much accessible to anyone who needs me, whether it’s a patient, medical student, a physician. I find that it is really important to be accessible and to have open lines of communication so anyone anywhere in the world feel free to contact me.
PB: Wow. You heard it here. Pamela, thank you again for being on the show. It’s been a fantastic insight.
Thanks Pamela. These stories are truly chicken soup to me. I look forward to meeting you one day, perhaps through your seminar. I encourage others to check out your website. I would like to know the schedule because I have a daughter getting married end of April but hope to join the next one i can fit into my life.
Schedule is listed on the site here: https://beahappydoctor.com/sales
Teleclasses are from your home (or wherever) all dates listed in the syllabus online.
The next retreat is May 3-7 (the last day is an optional day to relax).
Hope you can join us!
Happy holidays to Dr. Wible, one of the top leaders in healthcare and THE advocate par excellence on behalf of the abused physician.
LOve ya Elias! Hope to meet you in real life soon.
Well I am pleasantly astonished!
This is the first time I have heard another doctor say that the “system” is abusive to doctors. The problem is, like an abused spouse/partner, we continue to believe that if we do better we would be appreciated. In the mean time we are destroying ourselves and each other. The system is toxic and the handlers are abusive. The good news is we are capable of disengaging.
Aha! Then you will love all the other blogs I have on here such as “Burnout Is Bullshit” for example –> https://www.idealmedicalcare.org/blog/burnout-is-bullshit/
I have an entire category on my blog devoted to physician oppressors and abusers here –> https://www.idealmedicalcare.org/blog/category/physician-abuse-bullying/
The truth shall set us free!
Wow! I enjoyed reading this and feel enlightened about what is REALLY going on behind the scenes. I appreciate you telling it as it is!
Is there any way I can participate in this movement, and promote this noble cause, without being a medical doctor myself?
I am a non-licensed naturopath doctor and author of 8 books, mostly on health and healing. I’ve done a lot of public speaking, and am quite good at it. I am in contact with Medical Doctors regarding how to reduce Adverse Drug Reactions by using pharmacogentics testing. I did leave you a phone message regarding this 1 or 2 months ago, but did not hear back from you.
So is there a way for me to participate in spreading the truth to MDs so they too can escape this abusive dysfunctional system and become better servants for their patients?
Best way to participate in the movement is to be the change you want to see in medicine. Maybe you are already doing that. Please share any of the resources on my blog, websites that may inspire others to take action. The key is taking action. Speak. Write. Love. Heal. How do you feel you could serve the movement best with the skills yo have?
I’ve found myself lost in your writing all evening. I hated the first 2 years of med school because of the environment and culture I was surrounded by. Being in the hospitals under the scrutiny of attendings is nothing in comparison to the rules/restrictions and fear mongering of our administration. My school has a “zero tolerance” policy for suicide (what does that even mean?!?) and if you are found to be “mentally unstable,” for whatever reason, you are banned from campus unless you are escorted by security. My favorite policy is that if you seek help through the school counselor/psychologist there is no confidentiality and if they refer you to outside counseling (probably why you are going there in the first place…) you are REQUIRED to sign a release of information from that new provider to the school. I can’t imagine more unwelcoming, shaming, stigmatizing and mental health policies for medical students.
Anyways, the reason I am commenting on this post is your comments about Toyota’s management practices. Part of our curriculum is a series healthcare management courses, which is based around Toyota’s operations. How ironic…