Ep 60: Becoming a Boss with Dr. Amy Vertrees

Dare to Dream Physician Resources:

Dare to Dream Physician, Life Planning for Physicians

https://daretodreamphysician.com

Dare to Dream Physician on Facebook

https://www.facebook.com/daretodreamphysician/

DreamPhysician on Instagram

https://www.instagram.com/dreamphysician/

Dr. Amy Vertrees Resources:

Website
https://www.bosssurgery.com/

Business of Surgery Series (BOSS) Podcast
https://podcasts.apple.com/us/podcast/boss-business-of-surgery-series/id1601568503

BOSS Business of Surgery Series on Spotify Amy Vertrees, MD on Spotify
https://open.spotify.com/show/4uVQ1nxdjDNP7Koil84cyo?si=f0bbfaf61b134ad5

Dr. Amy Vertrees on LinkedIn
https://www.linkedin.com/in/amy-vertrees-md-20192a8b

BOSS Business of Surgery Series on Facebook
https://www.facebook.com/groups/249619353796932

amyvertreesmd on Instagram
https://www.instagram.com/amyvertreesmd/

@AVertrees on Twitter
https://twitter.com/AVertrees

Transcript

Dr. Gray, Host 0:00

Welcome back to another episode of the dare to dream physician podcast. I am so excited and so honored today to bring your guest. We're gonna have an amazing conversation. She's an amazing human being. And, we have the doctor, Amy Vertress. She's a general surgeon and she's gonna tell an amazing story and I will just have her introduce herself.

Dr. Vertrees, Guest 0:26

Thank you, Dr. Gray. I cannot tell you how honored I am to be here. you and I have been like in similar circles for so long, I've been a huge fan of yours for a while. So this is like a huge honor to be invited. So thank you so much. I'll tell you a little bit about myself. I'm a general surgeon and, I had an interesting course. I, I went to the only military medical school. many people don't even know it exists is uses uniform services, university, the health sciences in Bethesda, Maryland. So, I was a commissioned as an army officer and I was there at the time from 2000 to 2004. So in my second year medical school, I was there for September 11th. I was there in DC area. saw September 11th happen and. When I became a general surgeon in residency, it was at Walter Reed. So I was there for the Heights of the wars. And, when I finished residency in 2010, I ended up deploying to Afghanistan twice in Iraq, once myself, I served my seven year commitment in the military, you know, of course learning a lot of lessons along the way. And at that time I was also very involved in the American call to surgeons. So I created this, boss business of surgery series as some, meetings. For the American college of surgeons to boost our attendance for meetings, cuz you know, everyone struggles with getting people to meetings. And I said, if you're gonna have a meeting, you have to have something to offer. And it was no coincidence that it's things that I needed to know, negotiating a contract, coding, all the things that we really aren't taught in residency. So back in 2015, when I created that it was under that. Goal of learning lessons, not taught in residency because there's so much we needed to know and weren't taught, but there's important things. We are learning in residency. So maybe there's not a role quite yet, but there's certainly a huge gap in our knowledge. So, I ended up going on my third deployment in 2016, to Iraq and kind of like let the boss drop a little bit. And then I got out of the military in 2017, I became an employed general surgeon in Tennessee. And over three years, of my contract, it was a great hospital, great job, all the things. And, but I struggled a little bit in clinic, with influence of the people around me. And I remember as I was contemplating signing my contract, renewal, and I looked around thinking, I was like, is this really what I want? am, am I really on the right track? I was complaining of things in my head and I. I could see myself complaining for the next 15 years and nothing ever changing. And I finally, through a very series events, tried to make some changes in the clinic, ran into some roadblocks and, ended up like deciding to just not ruin my contract relatively suddenly. I think it was in the, the mid, the back of my brain. But I think I, at that time had discovered coaching and I decided, you know what, actually, maybe I'm just gonna go out on my own. And it took a lot of mind work for that too, cuz it was really a bold move at the time. And, but I really felt like it was the right thing to do. So I made a huge life shift. and. Opened up my own private practice. And I became a coach when I realized like the power of coaching is what got me to, to do those big, bold moves. And that's how I was really able to believe in myself and the changes. And as it evolved, Went back to this concept of the boss business of surgery series. And it evolved for initially thinking like the coding and the negotiating, the contract, like the nuts and bolts, and it evolved into the like, how do you deal with a difficult partner? How do you deal with complications? how do you negotiate for what you want and how do you run a clinic and, influence the people around you, especially in the times when we feel so powerless. And so that's how I, came back to this journey of the boss business of surgery series, which turned into a podcast and group coaching and one-on-one coaching and, and things like that. And interacting with really amazing people like yourself.

Dr. Gray, Host 4:12

Wow. I, I love this story and, tell me what is Bo this boss is Boston acronym or is it just like. I'm a boss.

Dr. Vertrees, Guest 4:21

clearly I'm a boss, but

Dr. Gray, Host 4:22

yes, you are

Dr. Vertrees, Guest 4:24

I'm just kidding, but really it's, it's the boss business of surgery series. And so back in 2015, when I was trying to come up with a clever name for it, it, it turned into this. This acronym, because really what it was, it is learning the business of surgery and that's, what's missing is the business aspect of it. we're told all the time, and I know you and I are big Dr. Una fans. that we're told that we're not good at business, which of course is not true. It's just, we weren't taught some of those concepts. So, what I wanted to do was fill in the concepts for myself, honestly. I always joke around the fact that I'm kind of like, lazy and self-serving, I, I just want people to help me learn all these things I need to know. And it just happens to benefit other people

Dr. Gray, Host 5:07

That's not lazy and self-serving at all. you're making a resource for yourself and for others who are seeking the same thing.

Dr. Vertrees, Guest 5:15

I, I joke about it too, but really this feels effortless, to find the lessons that I want to learn. And then simply believing that it's possible to ask other people, to tell me about it and to share the stories. And you and I were talking about this. this is the reason why we became podcasters and interview podcasters is that you get to interact with amazing people. There's so much knowledge. In the world and, it serves both people. I was just talking to someone earlier today about this idea of influence, and what we have to offer. And we were talking about medical students, at every stage of our career, we have this sense that I don't have anything to offer. And a medical student is a great example of this because they have a tremendous amount to offer. I totally appreciate our medical students because what they have to offer me. Is, excitement about the job reminder of what it's like of why we did this in the first place. when we're having a hard day, I can look at them and say, I remember what it's like to be so excited. They ask me questions, which I really am supposed to remember some of these things. And so it keeps me on track and it keeps me honest. I didn't have a student yesterday, so I didn't do anything in order, like I was supposed to do. I wasn't really trying to model good behavior for anybody. So then I messed it all up but anyway, it's, it's a great example of realizing that how often we tell ourself we don't have anything to offer and it's absolutely not true.

Dr. Gray, Host 6:38

Hmm. Oh, I love that. Oh, can I just say, we we've been, we, we chatted for maybe 20 minutes before the podcast and then, we're like five minutes into the podcast and I just, I just love your, your attitude so much. And I don't know, were you always this way? You, you have a, And, and barring this term because I heard it before a, what is it a beginner's mind where, you know, you you're always, like looking to, to learn from things and, looking to just you're really curious. And, and I just love that approach. Is that how you always have been.

Dr. Vertrees, Guest 7:10

Oh, you're so kind. I, I don't know. I think I certainly have really honed in the idea of O observing what other people are doing, what I've done. And, I, the, the biggest part of like coaching and mind work is just recognizing, Why we got things right. And why we got things wrong. We, we of course learned this in, in school of like, why we get answers, right. Why we get answers wrong. But, you know, I think really the three most powerful emotions that I tap into is curiosity. Why do we get the results we want? Why do I feel the way I want? Or why do I feel the way I do curiosity, gratitude, being grateful for any experience. All bad things are lessons. envy tells us what we really want. someone setting us off a trigger, tells us what, where we need to work. it's the gratitude for any experience. and then the third one that I've been leaning on lately is certainty. certainty is like one of those really powerful emotions of you don't have to be right all the time, but I could be certain, I'm gonna try my best. Learn the lesson. And so the one thing all the mind work has led me to do is to really think of the powerful thoughts, the good questions that we ask ourself and the emotions that we lead with that are gonna give us the results that we want. And this gets to the, the point of influence, like how do we influence the people around us? We wanna change people. we want them to act in different ways. We want them to do different things and that never works by the way. But if we look internally and we change how we think and how we act, then we approach situations in a different way and that influences the way around it. And so I think that there were, I think I was probably born with a positive mindset and that just let me show up in ways that was consistently reinforced over time. And so I built on that. It's only, now that I really actually understand how that actually played out.

Dr. Gray, Host 9:01

Yeah. Oh, you know, as you're saying, these are the three things, especially the first two things that you really value. It just, it was so obvious to me, like just, starting and starting to talk to you. And, and I love that how, the things that you really value are just obvious to others who, and you're not saying even before you said it to them, that's really amazing.

Dr. Vertrees, Guest 9:20

sometimes it's undoing what we think that we have to be, as a surgeon, especially, we have this idea of what a surgeon should be. We have this idea of what, a doctor should be. we have to take charge and be domineering and, and that's actually. That's an alpha way of looking at influence, but there's certainly something like the beta way of, of looking at influences that helps it's like creating the environment that you work in rather than telling people what to do. I think that when we are our true and authentic self, then we interact with people and we actually bring out their true and authentic self. And that's actually how to change people. That's that power of influence that's so powerful.

Dr. Gray, Host 9:58

Mm, wow. There's, there's something so powerful there because when you are being in your authentic self, and then you are acting in a way that's drawing that out in others. what the gift that you're giving to people is agency. and this is something that if you are leading, I guess what you're saying in this alpha way, like my way or the highway, I have power over you, I'm your boss, I'm your whoever's working above you and, do it my way. people may do it right. You may influence people, but, but what you didn't influence is the they're not doing it out of free will and there's something very powerful and, That when, when someone does something because they're motivated to do it, cuz they're, they're like, Hey, I have agency and I'm doing this, they show up very differently. And so that culture that you're building when you are influencing people in this authentic way and helping them be more authentic is, is, sounds like an amazing culture. And as you alluded to, you quit your, your employed position job and you opened your own practice. and I don't know that much about it, but the little that I hear, I think you hired, a second surgeon. sounds like it's going wonderfully. So do you wanna tell us a little bit about that?

Dr. Vertrees, Guest 11:10

Yeah. I think that's really great because, we're told all the time, oh, prefer practice is dead and you can't do it. It's too hard. and the first mind shift that I had to have is, know, recognizing. appreciating all the work that I had done to that point. I didn't have student debt because I was in the military, which involves some sacrifice I've been working for a while and living, still like a resident, mostly. And so I had a lot of savings and so the first mind shift was, was recognizing that I had enough. Money to like, I could stop working for a year and be comfortable because I knew, the, the value of, of work. and so, or what I'd done before. So I realized that I actually had a lot more control. I was not at the mercy of a job for the first place. So that in itself was so freeing. So then, the second part was questioning, like, what do I want out of life? I think a lot of times, and I'm seeing this in people that, I talk to a lot is that the first few years. In our career after residency, it's like we're being shot out the cannon. There's like this linear thing. And then a couple years later after this hustle culture, like wears awful, we stop and go like, no, what are we doing? What are we doing here? And so I kind of like wanted to go to a greater purpose. I needed a little bit more challenge, I'm, I'm a good surgeon. I know what I'm doing. And I could do a lot of those things and I needed like, what's next.

Dr. Gray, Host 12:20

Mm.

Dr. Vertrees, Guest 12:21

And that's when everything starts rubbing you raw, by the way, is like when the administration comes down to you with these things and the people you interact with is, is, recognizing when you're, it's not really burnout, that's not quite the right word. It's the, sort of like, I need something what's next. So I was in that position, as well. And so then I thought, well, why not? Why not me. what's the worst that could happen. And so the third piece of that is like dealing with the idea of failure. like what if I fail? I'd heard a lot of people talk about success and failure, which boiled down to the biggest basics. And I talk about success a lot. success is achieving a stated outcome. So my stated outcome was I'm gonna open up a private practice. if that didn't work, it would be considered a failure. And a failure is not an achieving stated outcome. And I realized it wasn't gonna die. If it didn't happen. I wasn't, necessarily even gonna be in a terrible position. I may waste of time, but why not do those things? And so it's first the. Belief that you could do it, and then it's not a problem if you do do it. And then the third is like dealing with the overwhelm about that. That, that was a huge lesson that I learned is the number of things that you have to learn to do. That is a little bit overwhelming. And, so I learned how to deal with that because overwhelm is just an emotion and it gives you no direction. And the one thing that, when I coach folks is. What is the emotion that you're having and does it give you a direction? Overwhelm gives you no direction. And so I started leading back in again to this certainty. I don't know what I need to do, but I'm gonna figure it out. And so I just sat down and I started writing things down. And instead of letting that list overwhelm me, I was like, I'm gonna do this tomorrow. I'll do this. And then things that weren't like, didn't make it on the calendar. Went on this ubiquitous, vague. The list. And in fact it became like a running joke of it's on the list. Meaning I, I may it to, it may not. but that's probably, I can point to each of those lessons that came along the way. And I tell people a lot too. There's the thoughts that come up that changed everything. The very first thing was what are you tolerating? Because once you ask yourself that question, you stop tolerating it. I was tolerating an office that wasn't working for me. And then the second is, how did I start this private practice? And I've talked about this a lot, but I think this is really helpful is, when I started this, the thought that I leaned into is I wanna make as few mistakes as possible. And the, that statement helped me so much because I acknowledged the fact that I was gonna make mistakes and I normalized it, neutralized it, and, I'm gonna make'em, but I'll make as few as possible. So that gave me a direction. it allowed me to fail. It allowed me to make it not mean anything. so those are the things that I led with. And then I just sought information and, that's, pretty much all that it is. I had been in a private practice, Facebook group for a long time. And I realized alls I had to do is figure out the phones, figure out this, figure out that, and just created a list and went with it.

Dr. Gray, Host 15:16

Amazing. so, so many things that, that you said there that, that I wanna ask you about. but one observation I was gonna make is, when, when you said, how am I defining success? And, successes, if I open up a private practice and, and, and you said, and so if I failed, then, maybe I wasted time and, and knowing your attitude, I don't think you would've wasted time at all. You would've drawn many, many lessons from whatever failure, if there was actually even one step that fail you, would've drawn lessons and. And probably pivoted another way. And so I think that the way that you approached it, you, you almost couldn't fail because, even if there was, a momentary failure, the long term, you would've, you would've gained from it. Just, just knowing who you are from, our chat conversation in the last 30 minutes.

Dr. Vertrees, Guest 16:02

Well, I and there's the thing is. That is a choice. It's a choice available to all of us. And I think that when we don't recognize it as a choice is when we fall into trapped, we could still have a great life, but not really realizing that we do have one because we chose things. And, I think really what I want to do is just bring back people's power and people's choices, especially physicians, we really do need that, that reminder of how much we've done. and this, this idea of feeling special and unique. Is a problem for us when we're raised around people who are doing all the same things. But if you look and see, like to become a physician, you have to be a college graduate. You're already higher than a lot of people in society. You have to get into medical school, you've passed a huge bar there. You have to finish it. You have to go to a residency. You have to, be successful, then find a job like the number of steps that we've already taken, just to become a practicing physician. puts us in the top. 1% of the I'm making this up, by the way. I have no idea what the statistic is, but, it puts us in such a higher echelon of success already, and we don't even have to do anything else, and I think really pausing for a minute and saying leaning on the lessons that we've already learned about ourself. We are already so highly successful. And reminding ourself of that is, giving yourself evidence that has, is we all have right now of how successful we could be because we already have been.

Dr. Gray, Host 17:26

Mm. and the, one of the first things that you said as you're talking about, your motivation for starting, from, from leaving your, employed position and then starting your private practice, and you mentioned about the sense of purpose, that's how that's really important to you. And, and that's one of the things that I love focusing on part of, being. Then this podcast, but then also just the work that I do with my life planning clients. And I love for, to hear a little bit more about that. did it just come up to you like, oh, I have to have a, I need to lean into my purpose and, just tell me how you went about that.

Dr. Vertrees, Guest 18:00

I would love to say that that was true. it was like an accidental thing of looking back and saying This was all meant to happen this way. in my mind, I was just gonna, open up this little office and I got a big building. Cause I was like, I'll just rent out half of this and I'll take this little corner of it and I'll just run my little practice and all these things are, are great. And and I took the advice like buying the biggest building. You can cuz you could always rent it out. Well, we we're taking over this whole building. I mean it really has grown. I had no idea what it was actually going to create. So, this is actually what I've done. And this is where I'm, I'm like recognizing I was always meant to do this. I worked for an O B G N for a year beforehand. And, I remember her like paying attention to me and giving me a chance and I saw how she interacted with other people. and so. In this business now that I have, I'm actually giving other people chances too. the people that I work with my office manager had not even quite finished school. Like she didn't know she could do it and watching her take up the challenge and becoming like the best version of herself and believing that she, she could do it and doing like these amazing things that amaze her. And of course amaze me and everybody around her, watching that develop and realizing that I helped make that possible is like a big deal. We have a lot of, single mothers that, that work with me now too. And one of them, I, had her go to a course for billing and coding and, giving her an opportunity to realize like she can do it. Of course, I ended up getting really busy, which was a great problem to have. So I hired a nurse practitioner and, She tells me all the time. She's I didn't know that I could do this, but you're showing me that I can. So I'm not doing these for them, simply like giving them some space so they can do what they wanna do. And I think that that's probably my greater purpose is to give people space and elevate. Cuz that's the exponential growth that you see. I I can only do so much by myself, creating an environment where people can learn and grow and the next thought that I'm having about all this is you. People are supposed to leave, and I think at some point they're going to, and that's okay. They're supposed to, and that has actually not been a discouraging thought to me, that's an encouraging thought, like I'm getting them ready to launch. And so when they leave, this is not gonna be terrible. This is gonna be time for them to move on as someone else to come in that we're supposed to influence. And so, having a business is a different challenge in itself, but it's so rewarding. Because we have the ability and the skills and the opportunity, now it's not about making money now it's about, elevating the people around you, and your life purpose lives in other people. And that's been the most fun.

Dr. Gray, Host 20:31

That. Oh, I get chills as I'm listening to this, because have you heard what most people say in private practice?

Dr. Vertrees, Guest 20:39

Oh no.

Dr. Gray, Host 20:40

that goes on

Dr. Vertrees, Guest 20:42

I feel some of that too. Let's be real. like the, the mind drum of, of money, it, it can get so unfair too. So let's, talk about some of the negative things about that, because I think that's, I think you have to know what you're getting into as well. Like you have to be able to look at your financial statement and realizing how unfair the insurance companies are. you know, how I think someone said it best, Dr. Wynn, who was on recently, she said, the insurance is the house and the house always wins. And. It's true though. Oh my gosh. It's so frustrating. And those parts are probably the downside of private practice. And to be honest, everyone experiences this, but employed you're sheltered from it, with CMS coming in saying that we're at a cut, your, the reimbursement greater, the 4% in a time of unprecedented inflation is ridiculous. And you can sit there and say, oh, thank goodness I'm employed. It's not gonna affect me. It's going to, it's going to, and. I think, some of the negative things can really get you down. And certainly I have my days to where it does. but. At the time. I think that's, what's really, really important, especially the good times is to remind yourself why you did it in the first place, because that was a thought that was offered to me by a friend when I was in the biggest throes of overwhelm of starting the private practice is, know, she kinda looked over me. She goes, you, you remember you did this for a reason, right? Cuz I had forgotten in that moment. And so, and I, I think is recognizing that there's certainly a lot of challenges, not all private practices are going to survive through this. but I think that that's when you lean on the idea of I'm doing this for more than just money, know, I'm doing this for my patients, I'm doing this for the people that work for me. I'm doing this for, the strength of the other physicians around me. I think reminding ourself of that greater purpose will help us. Get through some of these hard times, we do have to be honest about how hard some of the times can be.

Dr. Gray, Host 22:30

Yeah, absolutely. Yeah. I trained as an anesthesiologist in residency and, by the way, I loved your podcast episode where you just read out, why people went into surgery. That that was so such an amazing, just series of response. And it really actually brought me back to, to medical school because I, I don't know if I've ever said this on a podcast before, but. Surgery was by far my favorite rotation. I just, I love, when the surgeons, wrote why they went into surgery and they're like, I, I just went into the, or, and I knew I couldn't do anything else. even though I could picture myself doing something else, and I was one of the ones who convinced myself not to do surgery at the end of medical school, I totally saw it. Right. It's. Such an amazing place you're like in, in the zone, you're in the moment. I there's nothing more amazing than opening someone up and then fixing them and putting them back together. and it's an amazing thing that, I just, all my risk, as an anesthesiologist, like one of the reasons why I, chose to go and do residency in that is because I, I love, I love surgeries and I love actually working with surgeons. I mean, some of them were unpleasant. Let's be honest here. but it's, it's an amazing group of people. I people who chose to do this and to be honest, I the sacrifices that surgeons have to make to even in their training is a lot more than what most, even most of the other doctors had to make. And so I think this group of people are just so amazing. And one of the things that always angered me, is why do the general surgeons reimbursement are, are, so poor it's, it's a very difficult job. And the thing that was ironic, I even though I was a resident, so it was mostly shielded from this, but even when I was interviewing. for anesthesiology positions, one of the attendings, who I interviewed with was he was a surgeon and his wife is an anesthesiologist and he's like, oh, my wife gets paid more than me. I'm like, how is that? Even? And they work at the same institution. I'm like, how is that even possible? I mean, yes. not to downplay anesthesia, like that is also a very important role and, and, very important skillset

Dr. Vertrees, Guest 24:28

You actually keep the people alive. We do appreciate that.

Dr. Gray, Host 24:30

yes. Yeah. That, right. So, but at the same time, I'm just like, I'm pretty sure he takes more call I'm, I'm pretty sure there's there there's a lot more. And, and so it doesn't make, I mean, the reimbursement to me never made sense. but it's, it's politics. Right. And it's stuff that's beyond our control, whether. In private practice, you it's just that the veil is open. So, so now you see all the things when you are the business owner, whereas when you're an employee position, they only tell you what you need to know, which can be frustrating. And that's probably one of the reasons why you didn't wanna be in that situation. but where was I even going with this aside from just expressing that I, I think surgeons are an amazing group of people and, I think the other thing you know, with, with purpose is, that I just wanna recognize here, as we're talking about it is, surgeons. Trained so hard to get to where you are, and you've made more sacrifices, more years Def you know, more hours usually in the training and physically, it's, it's a difficult, it's a difficult job As a sleep doctor now if someone chopped off my hand, gosh, I hope nobody does that, but it's not a huge deal. Like I could still do what I do. you can't do that, right. Even if you one finger wasn't working, that's, that's gonna be a problem for surgery. And so. The stakes are so high. And, as you're saying how, a lot of the surgeons, like when they, once they finish their training, this is like true arrival fallacy, right? Like you get to you, you finally become an attending and you can operate on your own how amazing that is. Cuz you work so hard to get to that stage. And then you learn about all the things that, I hear this all the time, surgeons that work for big institutions. they're bad asses. Like they're amazing. They're, opening people's chest and, saving their lives. And yet there's administrators that are saying, well, basically telling them that they're stupid. this is how they're summarizing it. And I just, it just boggles my mind that, That there's not a, a respect for the work and, and that's true for all physicians, but I, but since we're talking about surgeons and since you're a surgeon and you're here, like I just have this utmost respect for, for surgery because I loved it as a medical student. And I see the, the sacrifices that one has to make to become a surgeon. And so I think that the pain of, you said, what am I tolerating? Right? In some ways I think surgeons maybe can feel more stuck because it, they, they have to give so much more to get to where they are. And then when, when they get to, become an attending and let's say they're in this system where they're saving lives, whoever they're working for is telling them that they don't know what they're doing. They don't understand business, then they keep having to give them salary cuts or whatever it is. I can see how that is even more painful than, for a neurosurgeon. and so I just love that you're going out there and you, you're putting a different solution to this problem. And to this pain that you felt.

Dr. Vertrees, Guest 27:19

you know, I think a lot of it is just questioning, our, all the things that are around us, And, I was talking to, to a few of my friends too, about like how we take our specialty for granted a little bit too, cuz you know me, I'm like, joke sometimes like I'm a knuckle dragging Sergeant. I just. Carry my knife here and I do simple things and whatever, it's, it's the anesthesiologist that keep people alive. And it's the ICU doctors that keep these, people that have all these terrible problems that I just, try to fix it. But you guys actually do so much, as well, but we don't actually see what we do because it's hard to feel special when everybody's doing it, But I wanted to kind of like speak to this idea of money and reimbursement. And I think, I'm my thoughts on money and medicine are evolving and there's several points that I wanted to make for one thing, patients don't understand how much things cost because we think a doctor's visit is a 20 or a$40 copay. You, they think that's what you're paying because we don't see what the insurance pays, If you ask, how much is my gallbladder surgery gonna cost? Nobody can tell you like nobody, my husband gets these paid injections. He gets them quarterly. And he said every single quarter, it's a different amount. It's the same procedure with the same doctor. At the same place and it's always different. And so there's a natural, there's no one in the system knows how much things cost. they've tried to change as with the no surprises act, but, at the same time still there's so much variability. We don't know how much anything costs. And then the third piece is that we don't know what the value of what we offer is, and this is from a patient's misunderstanding, but our misunderstanding of this too. So I was actually just talking to a plastic surgeon about the value of an elective surgery. So the very first thing is that, you don't, we're not hourly. I think the biggest mind shift is that money is not an hourly compensation. We have to decouple this idea. Of value for an hourly fee because a 15 minute gall butter, I get paid the same amount as a four hour monstrosity of one, And so for one thing, it's not the hourly thing we have to remove ourself of this concept because the value that we bring to that table is the years of training. The years of experience the drama, the call before and after

Dr. Gray, Host 29:26

you don't want me to do the gallbladder

Dr. Vertrees, Guest 29:28

Yeah. Well, exactly. And, and so it's not the, the time in the, or that matters. It's everything leading up to that. It's your time, your experience, your dedication, your all your knowledge, all those things that lead to that time. But then afterwards it's like, what do you. What does this patient get from this? And so if you shift now to an elective surgery, oh, abdominalplasty, 11 to$20,000 and some people charge, a hundred thousand dollars for a facelift, like what the heck is going on. And, it's, it's really recognizing like, what is the value of that? Is the training leading up to it? but especially in those things where someone is choosing to do this, what are you getting from that? you're giving them a lifelong change in how their body looks, you being a sleep doctor, you're changing how someone sleeps. You're, they're changing, you're changing the fact that they can rest during the night, which means they're awake during the day, which means they're gonna hire achieve at a higher level. they're not gonna have the hypertension. That they would've had, if you hadn't been there, they're going to be a little bit more successful in their overall life for years because of this thing that you did. And so we don't actually look at the before and after value of what we have to offer, because everyone's trapped in this money per hour of mindset.

Dr. Gray, Host 30:40

Mm. Yeah. Yeah kudos you, for, for dealing with those things as a, as a business owner, but, but doing it so gracefully because, okay. There's those pains, but then. You're you're finding so much purpose and meaning in, in building your team and, and developing people. Even, staffing is, is a big pain point in private practice and, the way that you are looking at it. first, this is, it speaks volumes and, these are the people that, that have been working for you and, and where, how far they've come along. And that speaks volumes of the culture that you've built, which I'm not surprised at all, based on, what, what we talked about in the beginning. But then even, this idea of, okay, well eventually they are going to go. And that's like usually the biggest fear right in, in a, for a business owner is, oh, I have great staff and, and they're leaving. and, but yet, you feeling ready to. To let them go. If they feel like, that's the right thing for them. And then to, to embrace having a new opportunity to train somebody else up and to see them develop and wow. that's, that's the growth mindset right there. I mean, that's, that's, it's so amazing. And, and how, how you're applying that to, to build a, a successful private practice and also build an amazing culture for people to work in.

Dr. Vertrees, Guest 31:52

Yeah. You know, the biggest concept I want people to take away in interacting with other people is this idea of job satisfaction. I talk about this all the time. Job satisfaction for all of us is mastery and recognition. mastery is I'm good at my job and that's something. We can do and recognition is like, I want other people to notice it too. Otherwise what's the point, and that's what in other people's hand. And so, recognizing that when we go to a job, we want to be good at what we do. And we actually want, acknowledgement from other people, not like a people pleasing. I can't survive because of it. It's just like, we want this empowerment. but recognizing that other people want that too. And. When they have an interaction with you is, is asking yourself, where is the mastery recognition fitting in, in this scenario? are they coming at me because, they don't understand cause they're not good at it. And how could I help them be good at their job? And where are they needing some recognition, are they seeking recognition in that way? Very simple concept of how you can interact. And delegation is a big thing, we get. pathologic ownership as surgeons, I think, and sort of like recognizing that is if we become the bottleneck, we Rob everyone of both mastery, cuz you're never gonna get better and recognition cuz we're basically sending the message that they don't matter. And I think that was probably the biggest. Thing that I was responsible for in my last job that led to, to my being unsatisfied with the job I should have. if I recognized that I could have potentially made some changes a little bit earlier on. And so recognizing even in an interaction that felt I can sit there with my flag of, righteous indignation and say they were so wrong to me, but it really, that was never honestly the case. It was not a bad job. It just. It just wasn't the right thing for me. But looking back, I could have potentially made some changes. Had I known this ahead of time. So that's why I always try to tell people about that.

Dr. Gray, Host 33:35

Mm. Oh, I love that. I, I love that. That's so good. I think that's, a good lesson for every doctor is, is, learning the delegation part. I, I'm an employed physician. And I, I recently one of the things that, is hard for me to let go is, is the charting and the documentation, cuz I feel like, oh, everything has to be the way that I want it. And then I finally, opened my mind up to that's the part that I hate the most and I don't, you don't need an MD to do the charting. And so I, negotiated for a scribe at work and then at first, I was like, why do I have to teach? Describe what to do? Like, I can't, I just wanna do it. It's, it's so much faster. And then, I went through that process of downloading what I, this is the way that I would like it. And, but of course she's not gonna always do it the same exact way. and then, once we got in a groove, I'm like, this is amazing why this is so much easier. And now, I get to. To interact with patients and, tell them things and then, and get really focused on, on the interaction. And then after I'm walking outta the room, the note is finished. I I might have to, edit a, a few things, but it it's being able to just delegate and saying, well, why, there are things that I would rather focus my energy on, and there are other things that I might have a hard time letting go, but if I can let go of it, life is so much more freeing.

Dr. Vertrees, Guest 34:55

Absolutely. Yeah. And, You are open to someone helping, which is, important for us to do. And then that has its own learning curve. And, we can be discouraged any step of the way, either not asking for it in the first place. the first time it doesn't go quite the way you want. And then, even over time is just recognizing when a problem arises, how do we deal with that? And, and I've learned how to deal with that by doing it wrong a lot. And. Is recognizing that, we can tell people what to do, but we don't necessarily delegate our thought process and we don't necessarily understand their thought process. And, I'm trying to think of the exact thing. so like it was Karen Crabtree was talking about, Tell show and do, which is you tell someone what to do. You show them how to do it, and then you do it with them. So you share your, your concept of what happens and you, you hear their concept too, is understanding that everyone thinks a little bit differently than we do. And that is something that we don't know how to interact with until we know how they think. And so it takes a lot longer than you think. But if you know that there's some discreet steps along the way, and that there's gonna be pitfalls along the way, then you don't stop at the first problem and think, oh, that's it, this, this proves that this doesn't work and that I'm just never gonna do it again. we're we all do that.

Dr. Gray, Host 36:09

it's a very common, fallacy thought fallacy.

Dr. Vertrees, Guest 36:12

Yeah,

Dr. Gray, Host 36:13

yeah.

Dr. Vertrees, Guest 36:14

exactly. And, especially if we kind of like go in there under the thought that this is not gonna work, then you know, we're going to believe the first time something happens that up, this just shows why it doesn't work. This is why I had the do myself. And then we of go into that catastrophizing, this is why my job's never going to work. This is why I'm always gonna be unhappy.

Dr. Gray, Host 36:33

Mm.

Dr. Vertrees, Guest 36:35

done that many times.

Dr. Gray, Host 36:38

yeah, and the other thing I would just love to ask you about, especially now that, you have your own practice and, and you talk about some of this in, in your podcast tour, and some of your social media posts is, is, is building that life that, that you love. And of course, that's usually the reasons why people discourage medical students from going into surgery. Right? They're like surgery is the thing that you're married to. like this, you, you only do surgery cuz you can't imagine doing anything else because you're not gonna have anything else. And so, so tell me more about how you are living your life and, and maybe some of the changes that you've made and maybe things that you're also looking forward to making.

Dr. Vertrees, Guest 37:17

Yeah. Oh my gosh. The, the misconceptions that we have all the everywhere. I I still have people. I mentor, PA students as well. So they'll come along and say, well, I, I wanted to be a surgeon, I want a family. I'm like, you wanna see mine? You, you want to see the 3000 plus, Facebook group of women, mother surgeons, So I think that. Society offers us thoughts all the time. And these thoughts stack up into these beliefs where we think aren't true. And so I think that we always have to continually challenge this belief that we should be doing this. And I think that, especially the millennials are offering all these thoughts of you don't have to be married to your job. You don't have to do all these things, I'm I know of, and I think we all know of these, like the surgeon who won't ever quit, because they've never actually cultivated anything else in their life. this whole idea, We do something for so long and we wrap our identity around it. What happens if we suddenly get ill elegant work, or we suddenly decide I wanna take trips and things like that. And so I try to offer these counter thoughts all the time. when I was our associate program director of our general surgery residency, in the military, in our interviews, we're not supposed to ask. So I would just tell'em. I was like, I just want you to know it's okay to have kids. It's fine to have kids. You could be a good surgeon to have kids. I brought my kids on rounds this weekend, I don't just tell them, I show them and you offer your thoughts. So then you could start challenging their concepts. you don't have to ask them, you don't have to get nosy. You just tell them what is possible. And, I just tired a new partner, something that I never thought was possible, she's amazing by the way. but she, she's well, I don't know how to tell you this. They're like, what. And she's I want to go sailing with my dad for, like two and a half months. And so I'll be gone and like, okay. And she's, you're okay with that. I'm like, yeah. Yeah. I want you to have a life outside of this and people offer thoughts too. Oh, well, you can't do that as a surgeon. You can't just, I'm like sure you can cuz people are doing it.

Dr. Gray, Host 39:06

Mm. Wow. that's amazing. but of course, every time you say something amazing people who are listening, who maybe not living that reality are probably thinking of well, yes, but what if my partner says no way Jose I, there's no way. I, I know lots of surgeons and doctors. Who, whose you know, partners or bosses would not have them? not, not, we're not talking about even, two months, but even two weeks,

Dr. Vertrees, Guest 39:34

Well, that's actually pretty easy to address if someone comes to you and say, oh no, at Chris boss, wrote this never split. The difference has a great approach to this is that alls you have to do is ask them. like in, in ways that he's, much more clever at, but oh, we can't take two months. So tell me, what are your thoughts on this? Well, what are the patients gonna do? I'll have a plan for them. Okay. Well, what about the money? Like I've already saved for this. So if you go through the objections. Then, basically what that does is it gives you a list of things to address. So if you, if you stop at no, then you're never gonna get anywhere. If you say, okay, I, I hear your, no. Why don't you tell me your concerns and those concerns become a list of things to address?

Dr. Gray, Host 40:17

Yeah. And you know what I, I'm also a Chris VO fan. one of my favorite quotes from, from his book is, every, no gets you closer to it. Yes.

Dr. Vertrees, Guest 40:26

Yes. Exactly. And how many times would we not succeed if we stopped at no. Like how many times were we told no in our life. And if we never believed them, we obviously went past it. you can't be a woman and be a, a, a doctor. Well, you and I obviously evidence, that's not true. Well, you can't be a surgeon. Oh, evidence. Can't be surgeon with kids here. I could pick my kids at a lineup I've been married for, 23 years. there's all kind of things. There's, there's evidence around. If you look.

Dr. Gray, Host 40:55

Mm, amazing. Amazing. I, I love this so much. I'm so grateful that that you came on the podcast. I, would love for you to share with the audience, how they can find you the resources that you have. And even if they wanna work one on one with you, cuz as I was mentioning to you before, like I even asked you, is this. Is this the only podcast that's out there that's for surgeons. And you are offering resources for surgeons that I, I think are very special because there's not a lot of resources out there for, for surgeons as compared to the general, physician pool resources.

Dr. Vertrees, Guest 41:30

Yeah. The, the first place to start is, my website, boss surgery.com. And so that's gonna show you where, you can access the podcast, the boss business of surgery series. it also has a link to, to work with me one on one and I'll, If you just wanna see one session to see what it's like, just sign up for just one. I do have group coaching that I'll be, probably next couple weeks, start, I've got a free offering of, stop hating clinic as a webinar. So I have webinars every now and then just for fun. I'll offer free group coaching, every now and then just for fun, cuz all this is really just, I just enjoy it. I, Also have a free Facebook group, the boss business of surgery series, Facebook group, I've, it's mostly surgeons, but I have let other people, cuz these are just lessons not taught in residency. So you don't have to just, not be a surgeon or you can be a surgeon and come, you could not be a surgeon and come. and we just talk about, lessons not taught in residency. I'm writing a book, that'll come out next year of, success beyond residency because really that's what we're working on is all these lessons and. Do we stop getting our own way so we can like actually appreciate all the things we've worked so hard for. so those are probably some of the main things, but the, the website should at least give you the information. If you opt into the mailing list, you'll get emails from me. So you see what I'm offer.

Dr. Gray, Host 42:37

Fantastic. It's so, so fantastic. And it's, it's just been an honor. So thank you so much for your time and for coming on. And, I can't wait to connect with you again.

Dr. Vertrees, Guest 42:48

Likewise end that degree. Thank you so much for your podcast. I dare to dream, like I was talking about this beforehand, like what an amazing concept. And I think that, your. What you are offering everyone too, is this, we have the right to dream. We should dream. And it's not even necessarily daring is why not. Of course we're supposed to do this. you are offering all this to everyone that that's so helpful. So I really appreciate your mission as well.

Dr. Gray, Host 43:10

um, thank you.