Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes!
We dive into the critical issue of physician burnout and the challenges facing primary care providers with family physician Santina Wheat. Discover practical strategies for reclaiming joy in medicine, setting boundaries, and rediscovering purpose amidst the demands of the health care system. From leveraging technology to cultivating positive relationships, we explore how small, intentional changes can make a significant difference in both personal and professional well-being.
Santina Wheat is a family physician.
She discusses the KevinMD article, “Reclaiming joy in health care: Taking control amidst systemic challenges.”
Our presenting sponsor is DAX Copilot by Microsoft.
DAX Copilot, by Microsoft, is your AI assistant for automated clinical documentation and workflows. DAX Copilot allows physicians to do more with less and turn their words into a powerful productivity tool. DAX Copilot automates clinical documentation—making it available in the EHR within minutes—and clinical workflows, including referral letters, after-visit summaries, style and formatting customizations, and more.
70 percent of physicians who use DAX Copilot say it improves their work-life balance while reducing feelings of burnout and fatigue. Patients love it too! 93 percent of patients say their physician is more personable and conversational, and 75 percent of physicians say it improves patient experiences.
Discover AI-powered solutions for clinical documentation and workflows. Click here to see a 12-minute DAX Copilot demo.
VISIT SPONSOR → https://aka.ms/kevinmd
SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast
RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended
GET CME FOR THIS EPISODE → https://www.kevinmd.com/cme
I’m partnering with Learner+ to offer clinicians access to an AI-powered reflective portfolio that rewards CME/CE credits from meaningful reflections. Find out more: https://www.kevinmd.com/learnerplus
Transcript
Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast. Today, we welcome Santina Wheat. She’s a family physician. Today’s KevinMD article is “Reclaiming joy in health care, taking control amidst systemic challenges.” Santina, welcome.
Santina Wheat: Thank you so much for having me.
Kevin Pho: So let’s start by briefly sharing your story and journey.
Santina Wheat: Sure. So I am a family physician, and I have been working hard to become a family physician for my entire life. To be honest, I just thought that one day I would be there. I would be practicing, I would have that role that I wanted, and I would be happy. It didn’t really go that way, and I really wondered why it was that other people were happy and I wasn’t.
For me, it really came to a head when my mom was dying, and I was watching all of the frustration in health care. I was trying to just sort of get through on both the caregiver side and the physician side. Ultimately, after she passed, the pandemic also hit, and so that was a horrible time for everyone.
I realized that if I wanted to stay in medicine, I had to figure out a way to reclaim my own joy and look at how I could make things better in a system that is definitely broken and needs a lot of change.
Kevin Pho: Alright, so during that difficult time when you were struggling as a caregiver but also working where joy wasn’t necessarily there, just take us through that thought process. What exactly were you feeling during that time that made you think that medicine isn’t quite what you expected?
Santina Wheat: For more information, visit www.FEMA.gov. Yeah, so I’m an educator, and every place my mom was going was a residency hospital, and I was really just watching that when she was ill, they were treating her as just somebody else to learn from. They weren’t getting to know who she was, all of the amazing things that she did, or even potentially caring about the fact that I was a physician myself and understood what they were talking about. So much so that I watched other attendings stop them and say, “Hey, you really need to pay attention here.”
For me, that just brought up this idea that medicine has lost its humanity. It’s lost the fact that we care about the people we are looking after. As someone who really felt called into medicine, that was a hard realization. It was hard to realize that empathy and the human element were floating away from what I thought it was going to be. I just really wanted a way to get that back for myself and hopefully for the others around me as well.
Kevin Pho: You talk more about that in your KevinMD article, “Reclaiming joy in health care, taking control amidst systemic challenges.” For those who didn’t get a chance to read your article, tell us what it’s about.
Santina Wheat: I think this article really gets to the point that we have autonomy in this. We don’t have to just look at health care and say it’s broken and that we can never be happy or fulfilled anymore. Just like you might need to make a plan to work out and stay healthy, you can also take a plan and have action steps to bring more joy, both at work and at home.
I walk through some strategies that individuals can use to help them find more joy, particularly if they want to stay in medicine. That was the hard thing for me. I thought about leaving medicine, and that felt bad when I had really felt called to do this. The strategies I walked through helped me rediscover my own fulfillment and joy in this really harsh environment.
Kevin Pho: Now, before talking about some of these strategies and about the field of medicine itself, what in particular about it was robbing your joy from practicing?
Santina Wheat: I think a lot of things were taking away from it. One was the feeling on the caregiver side, knowing that I knew a lot about medicine and still wasn’t experiencing what I had hoped for my mom. It was just sort of a battle against everything. Some of that had to do with insurance issues, some with not having enough people around—there are never enough nurses, never enough support systems. Some of it had to do with seeing people at their worst.
We all know that in the hospital, particularly residents, are exhausted. That feels bad. I was experiencing that on the other side, too. I was taking care of my mom and had two young children. I have an amazing husband who was helpful, but that didn’t mean I wasn’t exhausted at all times, so I wasn’t at my best either.
Every complaint, every insurance challenge, not being able to get medicine for my patient, or some random thing that administration was saying—those were all adding up to this feeling that health care was horrible, and that’s really how I felt at that time. I still think there’s a lot that needs to change, but now I’m able to find opportunities to be fulfilled in this system.
Kevin Pho: You talked about some strategies you used to turn things around. Where did you go for help? How did you find out about these strategies?
Santina Wheat: I really just started by asking for help. I talked to my mentors, and I really did think about leaving medicine. That was actually the first step for me, to figure out if I really should leave or not. Then I went to some different conferences about well-being and trying to figure out what to do. Honestly, most of them encouraged me to leave medicine, and I didn’t really want to do that.
I had spent my entire life getting here. Then I found coaching, which was absolutely amazing. I initially sought coaching for my faculty, not for myself, trying to be a good leader and model that you should do these things. I found true value in it myself, and it reminded me of when I was an athlete and had a coach who helped me get better. Coaching is a valuable step to living a more fulfilled life at work and at home because they are so intertwined.
Kevin Pho: You went to these conferences that were supposed to help with burnout, and for the majority of them, their solution was simply to leave medicine. Is that true?
Santina Wheat: It felt that way. It might have just been the ones I happened to attend, but that was the theme—go to real estate, do something else, consider another path. That just felt wrong in my gut. For some people, that’s right. For some, medicine isn’t the answer, especially if you were pushed there. But medicine was part of my journey for my entire life. Letting go of that could never feel totally OK for me.
Kevin Pho: Talk to us about some of these tips and strategies that you implemented in yourself and your colleagues.
Santina Wheat: First, recognize that it’s a process. These are strategies you have to keep working at, not a one-time thing. Number one is to rediscover your purpose—remember why you’re doing this and see if that’s still the reason. The thing you said on your medical student application or your residency personal statement may not still hold true. You need to find out why you want to be here now.
Second, think about boundaries. Realize that boundaries aren’t just about saying no to someone else but about prioritizing the things that are important to you.
The next one was really hard for me in medicine. I think people relate to it: celebrating the wins. We tend to be perfectionists and really hard on ourselves, so learning to celebrate the small things that go well, even if it’s that a patient said “thank you,” can help increase your joy when you keep track of those moments. I also think the pandemic made us neglect our relationships. So recultivating relationships that are meaningful, not just hanging around people who vent all the time, is important. Find people with whom you can laugh and talk about happy things.
Lastly, prioritize self-care. I can’t be happy when I’m not sleeping or taking care of myself, or finding ways to refill my cup, like going on vacation. It’s all of these pieces together. They each sound simple, but we forget to do them. We forget to prioritize ourselves, especially as physicians in a caregiving role. We have to remember that if we don’t take care of ourselves, we can’t show up as our best for our teams and our patients.
Kevin Pho: Let’s talk about boundaries. I speak to a lot of physicians who have gone through coaching and coaches themselves, and that seems to be a recurring theme. How do you set boundaries or prioritize what you need to do? What are some specific tactics you use to approach that?
Santina Wheat: It starts with the first thing, which is knowing my purpose. I created a personal mission statement, just like an organization might have one, but for myself. If something new comes up, I ask: does this support my personal mission statement? My mission includes both work and home life. If it doesn’t support something in that vein, it’s easier for me to say, “This is not right for me right now, but maybe I can provide someone else for you,” or “Come back to me in six months.”
It’s not necessarily a hard no; it’s just not right for what I’m trying to accomplish at this moment. That was the hardest part for me—understanding that boundaries aren’t about saying no, but about helping me achieve my mission.
Kevin Pho: And in terms of working through each of these tips, is this something you did yourself, or did you work with a coach, a team, or anyone else supporting you?
Santina Wheat: I did a lot on my own, which meant it took way longer than it needed to. I probably stayed in burnout much longer than I had to. I also went through some leadership development where these things came up, and I realized, “Oh yeah, this is when I started to feel better. These were the things that helped.” I had hired a coach for my faculty team, and when we did group sessions, I put some of those pieces together.
That realization led me to consider positions I would never have considered in the past, and it allowed me to feel so much happier in my clinical life.
Kevin Pho: Can you share a story that contrasts what you were like before these tips and after, so we can see how this looks in practical terms?
Santina Wheat: Absolutely. By nature, I’m an introverted and serious person. I used to walk around with a super-serious face, and people didn’t want to be around me. They thought I was mean. Some of that was my introversion, and some was burnout and frustration.
Now that I’ve done a lot of work on myself, used some of these strategies, and practice more gratitude, someone recently came up to me and said, “Wow, you are the most positive person to be around.” I was startled because I’d never received that feedback in my life. It has changed how others interact with me. People can come to me with questions they wouldn’t have asked before. It’s allowed for a more productive workspace.
Ultimately, I don’t have to work as hard to accomplish the amazing things I’ve always wanted to achieve. It makes them feel much more possible.
Kevin Pho: You were seriously considering leaving medicine before you implemented these strategies. For a lot of physicians, hopefully it doesn’t have to come to that. What can you share with early-career physicians to help them stay in medicine—particularly primary care—without having to face quitting first?
Santina Wheat: The most important part is to know many of us reach a point where medicine isn’t what we expected. It’s not what it looked like on TV before we got here. Acknowledge that first. Second, realize it might not be the exact job you envisioned or what your faculty looked like. The early physicians around you may not be on the right path for you.
I encourage you to find a mentor or a coach and be honest about how you’re feeling. They might have gone through it themselves and can help, or they might point you to a different path. Our education doesn’t show all that’s out there. Many are doing clinical medicine in ways beyond traditional routes—like DPC practices, locums, and more. Those aren’t always presented to you initially.
Checking in with people who’ve faced what you have can be meaningful. It can help you be happier much earlier in your practice.
Kevin Pho: Like you, I’m in primary care (internal medicine), and we both know the challenges that lead many to burnout. For medical students or prospective students considering a career in primary care, tell us what you love about it and what keeps you going in primary care today.
Santina Wheat: Absolutely. There’s a statistic that prompted me to write this article, because I think there’s such amazing joy in being a primary care physician. When a patient walks into the room and is so thankful for the care I provided for their family, it’s wonderful. That happened last week: I saw multiple families with an older parent and children who were there, and I could relate after my own experience with my mom.
You can really connect with those experiences because patients invite us into their lives. Not all specialties get to see that as closely. We get to pull back the curtain and be a meaningful part of our patients’ lives in primary care. For more information, visit www.FEMA.gov. Of course, there are challenges—insurance barriers, paperwork issues. I’m thrilled to see some companies thinking about how to prioritize primary care. But when a patient says, “Wow, you solved this for me,” or “You took the time to listen,” if you love people, this is an amazing field because you get to experience that.
Kevin Pho: We’re talking to Santina Wheat, a family physician. Today’s KevinMD article is “Reclaiming joy in health care, taking control amidst systemic challenges.” Santina, let’s end with some take-home messages you want to share with the KevinMD audience.
Santina Wheat: Absolutely. Remember that the pathway to joy is indeed a pathway. You have to keep implementing strategies that work for you. You wouldn’t expect to run one marathon and be healthy forever. In the same way, you need to keep working to ensure you have joy both at home and at work.
Kevin Pho: Santina, thank you so much for sharing your story, your time, and your insight. Thanks again for coming on the show.
Santina Wheat: Thanks for having me. I appreciate it.
