Ep 19: Stop Running Away from Burnout with Dr. Liz Aguirre

This episode is the third and final part of a profound conversation with Dr. Liz Aguirre where she shares her very personal experiences of what caused her to shift from being a hospitalist for 10 years to a non-clinical position.

Dr Aguirre also shares:

• How she repeatedly entered burnout despite changing her work circumstances multiple times.
   
  
  
• How doing mindset work empowered her to eliminate burnout completely.

• Why physicians can't wait for someone else to save them.
  
  
  
• The importance of giving herself permission to create the space to prioritize the care of herself, and the one crucial thing she had to do in order to create her desired life and pursue her passions.

Find out what that one crucial thing is, and more insightful gems…



Resources for Dr. Liz Aguirre:

Liz Aguirre, MD, Professional Speaker at https://www.lizaguirremd.com

Course on Meditation for Doctors with CME credit (use code DARETODREAM10 for 10% Discount) at  https://www.theresttechnique.com/courses/meditation-for-doctors-a-guide-to-the-rest-technique


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/

(Note: The vetted resources above may contain affiliate links and promo codes.  Any proceeds are used to support the mission of Dare to Dream Physician. Thank you for your support!)

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Transcript

Note this document may have human or computer-generated errors in transcription. Refer to the audio file for the actual conversation.

SPEAKERS

Dr. Aguirre, Guest, Dr. Gray, Host

Dr. Gray, Host  00:00

This is the Dare To Dream Physician podcast. I'm your host, Dr. Weili Gray. Many physicians today are feeling overwhelmed and unfulfilled living a busy life based on someone else's terms and expectations. My mission is to help physicians figure out what they really want out of life, and how to make their dream life come true sooner than they ever imagined. My fellow physicians, your time to live your only life is now. Become a Dare to Dream Physician. Great things are going to happen. Make sure you hit subscribe and share this podcast with another physician you care about. 

Dr. Gray, Host  00:49

Welcome back to another episode of The Dare to Dream Physician podcast. Today we're picking up on the finale of a three part interview with our amazing guest, Dr. Liz Aguirre who worked as a hospitalist for 10 years before transitioning to a non clinical position. And now also making an impact as a professional speaker on health and wellness. She shared so many gems in the last two episodes, Episode 17 on respecting the power of the mind, Episode 18 on facing the discomfort of silence, if you have not had a chance to listen, please go add both of those episodes to your playlist after you finish listening to today's episode. Now the finale of our conversation is my absolute favorite part. She goes really deep from the anatomy of burnout, to embracing our agency has physicians, the next 25 minutes are just pure gold. And I hope you get to sit back and enjoy this conversation. You never know, this may be the conversation that changes your life.

Dr. Gray, Host  02:01

You have so many great pearls in this conversation, I wanted to make sure that you still have time. But the part that I was also really excited to talk to you about and hear from you was that transition from clinical medicine to non clinical medicine.

Dr. Aguirre, Guest  02:19

Yeah, so I made that transition because of burnout, just full disclosure to the audience. And I think it's very relevant and pertinent right now, because of the amount of physicians facing burnout. So I actually tell people I'm triple certified and burnout. I went through burnout, not once, not twice, but three times. And the third time was very, very eye opening for me. Because the first time I was going through burnout, I did what I felt was the right thing to do at that time. And that was run. So I was working as a hospitalist in a very, very busy market. And I was seeing between 20 and 28 patients a day, and in the hospitalist world, that's a lot of patients. And during those encounters, I wasn't just seeing, you know, patients around me on him I was admitting patients to and then introduce I had twins. And then it was just like this is just not sustainable. I there's no way I can keep doing this. And guess what I talked to all my supporters and all my friends who agreed that this job was ridiculous. And that is crazy. And I can't believe they're making you do this and all the things. And so then after I had my girls, it was just not, it was not possible. So what happened is I went back to work from maternity leave. And I went three full days without seeing them. I left to work in the morning before they woke up. And I would get home after they were in bed for the night. And after the third day, I was like, I just broke down in tears. And I was nursing. So I called my husband and said, Do not under any circumstance, put the girls to bed. I haven't pumped I'm about to explode. Do not put them to bed. I'm going to nurse them as soon as I get there. I will be there by 730. And so of course as you would have it, I was late leaving from work. And so I got home at eight o'clock instead and my husband is waiting at the bottom of the stairs, empty handed, no babies, no crying. And he said I'm sorry, I just couldn't do it. I they were crying. They were hungry. I just had to and then he put them to bed. He fed them put them to bed and I just broke down crying. And I said I don't want to do this anymore. And he said you don't have to. And so the very next day I turned in my resignation, I left that job. And I found this great new clinical job. And in this job. I was I was working so much less. I was still an inpatient hospitalis.t I had so many less patients, I had much better work hours, I wasn't on overnight call. And then I was like having never complained about this job. And I would hear some of my colleagues complaining about theirs or complaining about that. I'm like you're crazy, they have no idea how bad it is out there. And so then fast forward, three years later, I'm crashing and burning all over again, all over again. And I remember thinking, What am I going to do? This job was so much easier than my last job. And now I'm burnt out again, I can't do this, I can't keep going. And mind you a lot happen. I introduced a third baby into the game, right. And that changes everything. So long story short, I had went to a Tony Robbins conference. And in the conference, he teaches you, you need to take massive action. And so I was like, I'm going to take massive action, just like I did last time. I don't know what I'm going to do. But I'm not going to do this job anymore. Well, the sad part is I only heard part of the message, I didn't hear him really talk about the mindset stuff, because I wasn't there yet. I wasn't in the right mental space to accept that mindset talk. I heard parts of it, I agreed with parts of it, but not all of it, I had selective hearing. And so I went back and I resigned from my clinical position. And I was already working part time in a non clinical position. And I just stayed in that non clinical position.

Dr. Aguirre, Guest  06:40

And so to make a long story short, I got burned out in my non clinical position all over again. And that's when I realized I have got to do something different. I just have to and so now what I've realized is my thoughts have followed me from one job to the next. I never did the thought work. I never worked on my mind on how my thoughts were contributing to my feelings, and what I was experiencing. And so I learned that it doesn't matter what job you're in. That's why when we see the studies, and they look at burnout amongst physicians, that's why we see that the dermatologist is just as burned out as the pathologist is just as burned out as the hospitalist is just as burned down as the intensivist. And you're like, well, wait a minute, how is the pathologist as burnt out as an intensivist. the jobs are very, very different. And it's because of our mind and our thoughts, and what we think about our circumstances, and only through coaching was I able to come full circle and really understand that to the fullest and fast forward the job that I was burnt out in, my non clinical job, is beautiful all over again. I'm not burnt out at all. I'm not feeling overwhelmed. I'm not feeling like I have too much on my plate. And nothing has changed. The circumstances of the job have not changed at all, what has changed just how I think about the job. And so people ask, Well, how do you know how do you know when you should leave? And versus when you should stay and do the thought work because there is a line, right? And when you talk to people, you can find evidence for both, you can find the evidence or you should say because if you make these little tweaks, if you focus on yourself, when you give yourself permission to take a break and do those things, you can recover and get some energy and overcome a little bit of that burnout. But there's also look, there's a firm line here, and I should not accept this and I should move on. So how do you know? How do you know which one you should be following? And the answer is that I was given and I couldn't believe this was true for me. But it was his you find happiness in your current job. You find the happiness. And then if you still want to leave after you have found happiness, then you leave is the right decision. And to me, I couldn't get that at the time. But now I can see that the circumstances in my current job they didn't change at all. What changed is the way I was thinking about it and I'm happy all over again. So do I want to leave my job now? No, I don't. So I'm in the right place for myself right now. Am I pursuing other things? Yes, I am. I'm doing things that fill my cup outside of my job. And I wasn't doing that before. Speaking, I love speaking, I love helping people. I love connecting with people. And once I started doing that for myself because it was a passion. I was filling my cup, and I was doing things that made me happy that I wasn't down and sad and feeling stressed about. And that's how I found happiness again in my job without changing my job without changing the circumstances of my job.

Dr. Gray, Host  10:14

So you're saying that the speaking was an additional to your job you started pursuing speaking, while also working this non clinical job that gave you some flexibility in pursuing speaking as a passion,

Dr. Aguirre, Guest  10:26

Right. Absolutely. And there's a lot of work that comes with that. Because a lot of physicians are like, well, I want to do this, but my hospital doesn't let me and I actually had someone told me that no, our hospitals not going to let you do that. And I was like, oh, man, they're not? And she's like, No, they didn't let me do it. That's why I ended up deciding to leave. And I was like, okay, but then I talked to somebody else who said, well, I've asked for permission, and I got permission. So I decided, Okay, that was a no for that person, not for me there, what's going on with them doesn't apply to me, I need to research and find out myself. And come full circle, I had to get approval from my institution, I had to have a contract with my compliance department, the things that I would not do that I would clearly indicate that I'm not representing my hospital when I'm out there as a speaker, but they allowed me to do it, and I was able to find the path to make that happen. But we again, will get stuck in those limiting beliefs, oh, that person couldn't do it, o I can't either, or we can find the evidence for the opposite. They could do it so I can too. So, we really, really have to be careful again, surrounding yourself with the right people who are going to allow you to see the possibilitie. 

Dr. Gray, Host  11:44

The part where you talked about how whatever job you're in, where you feel burnt out, or unhappy, or wanna leave, the secret is trying to find happiness in that job.

Dr. Aguirre, Guest  11:55

Right. People are gonna ask, how do you do that? And again, it goes back to giving yourself permission to prioritize yourself. You cannot function on an empty gas tank, you cannot. This is why the airline industry says put a mask on yourself. If the oxygen mask deploy, put a mask on yourself before you put it on your kids. or whoever's with you, I had this talk with my mom, too, because I have a little brother, little brother, he's an adult now. But he has cerebral palsy. And he doesn't walk or talk, he can't take care of himself. He's wheelchair bound, he fed with a PEG tube, and my mom takes care of him. And she has our whole life. And my mom has always done such a great job taking care of him. But it's at the expense of herself. And so as she's getting older, she has the backaches and the neck pain, and the this and the that, that I told my mom who is 67 ish, you cannot continue to take care of Eric, if you don't take care of yourself first. And so you have to give yourself permission. I give myself permission to exercise, to have time away from my kids, to have a date night with my husband, to have meditation time to myself. All of these things are new within the last couple of years. When I was going through my burnout, it's because I was not giving myself permission to recharge and do the things that I needed for myself. You have to ask yourself, what is it that I need for myself to be able to continue to do this job, and then create the space for them? How do you create space, you have to say no to some things that are less important to be able to say yes to the things that are important for you. Sorry, my kids do not get to go to all of the birthday parties that they're invited to. And you know what, I always thought that my kids were going to be in all the sports just like I was, buy they're not. Because I have to say no to certain things to be able to say yes to the things that are going to keep me going and allow me to be good at my job, allow me to be a great mom, allow me to be a good wife. And guess what those words are really, really, really subjective. What is a good mom? What is it a great wife, you know, it changes from time to time, and we have to be careful how we're talking to ourselves. But in answer to your question, and for this audience, how can you find happiness in your job by allowing yourself to do the things that make you happy. And it's not working nonstop? It's not putting everybody else first. It's not saying yes to every committee. You have to be able to say no to some of those things to allow yourself the opportunity to do things you need to do to recharge.

Dr. Gray, Host  15:04

Hmm, so good. That's so wise. And I'll say that probably the first thought that comes up for physicians when they say, Okay, I'm going to prioritize my happiness. And what I need is the fear that, well, once I do that, then I'm going to do a horrible job of taking care of patients, I'm going to be the bad colleague, where I'm not picking up the shifts that I need to pick up. And so is that true? I mean, how did they wrap their head around that,

Dr. Aguirre, Guest  15:30

Yeah, that it's remembering that those are just thoughts. So I had such a hard time, I would hold that G on my chest, and I would call it the big G. That's guilt. That's guilt. And that guilt is based on your thoughts. If I don't do that, they're gonna think I'm terrible. They're gonna think that I'm not willing to help. They're going to think that I don't care. What if they don't think that? What if instead, they think, okay, she's always willing to help, and if she says no, that's really because she doesn't have the capacity. Or what if they're thinking I wish I could say no. And they just haven't had the courage to say no. The people that I encounter that are really still happy in medicine is because they're saying, no. They're saying, no, I'm not going to do all those things. There is a certain part of practice, we do need to do as physicians, we need to serve patients, we need to write good notes that are going to allow our hospital to be reimbursed, we need to make sure that we are following guidelines and regulations that come out, we need to do those things. But it's all the little things that creep up on us that we feel we have to do, don't make same no mean anything, It doesn't have to mean you're terrible. It doesn't have to mean you're bad. And you don't have to say no all the time. You just have to say no to the things that you need to say no to to create the space to allow you to take care of yourself. And this is what I want people to understand a lot of people right now feel that it's the leadership against us, I promise you, your leadership does not want you to keep working yourself to the ground at the expense of your own well being. And that is something that a lot of us, myself included, have thoughts, they don't care, they don't understand they only care about the bottom line about the money about this about that the B bean counters don't care. But I promise you there are people too. And they're feeling stress and burnout at their level too. Everybody is just trying to figure out how to overcome these challenges, right? But from you personally, you do not need to worry about what everybody else thinks. And the sooner you stop worrying about what other people think the sooner you can focus on what your needs are. And meeting those needs to allow you to remain in the physician workforce for much longer, because what happens, you'll leave clinical medicine just like I did. And now I can see that absolutely was not the answer. So I even asked myself, do I want to go back into clinical medicine now knowing this, and for a moment, I thought I absolutely should. But then I realized if I use my voice, if I start speaking about this, if I'm brave and vulnerable about what I did, what I've overcome, and what I now see, and I share that with other physicians, and I help them get there, I can have way more impact for our patients having good physicians in the workforce than I can if I go back as a clinical physician and just see patients because the reality is so many physicians are struggling right now, because they haven't figured it out yet. And figuring out that you'd have to say no. And that's okay is so so important. So very important.

Dr. Gray, Host  19:17

Oh, I love it.

Dr. Aguirre, Guest  19:18

Don't make it mean anything. It does not mean you're bad. It doesn't mean you're selfish. It means that you're taking care of yourself to allow you to be able to continue to give.

Dr. Gray, Host  19:29

Hmmm, such an important message. And I love the part where you said it's easy to feel like we're the victims. And I'm not saying that we're not victims. Sometimes that could be the case. But it's also, you know, be careful of the stories we tell ourselves the assumptions that we have. And in some ways it doesn't even matter what other people think right? Whether the the hospital leaders want to work us to the ground or just want to maximize the bottom line or whatever it is it doesn't really matter because if we really start valuing our well being in ourselves and our ability to show up to work and be a good physician in a way that's sustainable, then it doesn't even matter what they think it just matters for us to know ourselves to know what we need in order to show up that way. And then the next step would be to start asking for it right to start pursuing that.

Dr. Aguirre, Guest  20:23

And I think you made a very important point because for the record, do I think healthcare is broken? Absolutely. Do I think that there are so many things that are fundamentally wrong? Too much time spent in EMR, too many hours at the office, too many patients put on our caseload? Do I think all of that? Absolutely. I think all of that. Do I think those things need to change. Absolutely. But guess what, if we don't take care of ourselves, if we don't become empowered, to feel like we can say no, and put ourself in our health and our well being at a level of priority for ourselves, there is no way that we as physicians can create change. We can create change, when our thoughts are clear, when we're rested, when we're feeling empowered, when we're feeling like, Hey, I can do this. And I know there's a way to do this differently. Let's do this. Let's create this change. We can do that when we're in a good place ourselves. But when we're in a really bad place, when we're hurting, when we're struggling, when we're depressed when we're overworked, when we don't have enough sleep, we don't have the capacity to fight that fight. We don't. So does medicine need to change? Yes. The only way we're going to create change, I believe, as physicians is for us to start taking care of ourselves, prioritizing ourselves, and then working directly together to create that change that absolutely needs to happen. But we need to change our thoughts, we need to believe that we deserve to put ourselves first, you have to believe that you are worth it, and you deserve it. And no matter what anybody else thinks that you can do it, because you deserve it. If you don't believe you deserve to put yourself first and make yourself a priority, you're not going to do it. But you need to believe that. You need to believe that you deserve it, and that you're here for so much more than just running yourself to the ground.

Dr. Gray, Host  22:39

Yes, yes, I love it. And I love that, I think a lot of the discontent that's out there is we as physicians are waiting for the hospital leaders to solve the problem that we have. And the reality is they're not walking in our shoes. So they don't know what the problem is necessarily. And so by us really starting to know ourselves and to start thinking of solutions. That's how we're going to get better, right? Because we can't expect somebody else to just come in and say, Oh, yeah, let me let me fix this. The problem is, there are just so many different moving parts that need to be fixed. And so we can advocate for the part that we know best, which is ourselves and what we do.

Dr. Aguirre, Guest  23:24

The beauty of that is we do have the power, we do. We have the power to put ourselves first. We're too afraid we're too worried about what other people think. getting over that obstacle, I think is one of the very, very first things we need to do. Because we have the power to create the change we want to see. And we can't sit back and expect as you said, somebody else to create that change. But it starts with us. It starts with us in the individual decisions that we make for ourselves. 

Dr. Gray, Host  24:03

Hmm, well, I love it. 

Dr. Aguirre, Guest  24:05

My husband used to tell me that he used to say babe, everything that we need to be happy we have here right now. And in my mind, I would always think that's easy for him to say. But as a physician with all the pressures I have, what's going on, no, what I need is I need more time I need more space, I need to be able to do this, I need to be able to do that. But what I didn't realize until now is Yeah, I did have everything. I just didn't use it because I didn't, I didn't believe I deserve that. I didn't believe that I could just say no. What would they think I have so many of these other worries. But the reality is we do have the power, we just have to use our power. And that's the beauty of it. We have the power right now to make very small changes that can have huge impact. And it's not, it's not making a drastic change right now. I've heard Tony Robbins say that we way, overestimate what we can do in a year, and way underestimate what we can do in five years. So I'm talking about the very small changes every day, that is gonna change the trajectory of your life.

Dr. Gray, Host  25:23

Oh, I love that I am so just ecstatic that you came on the podcast. And I just wish you the very best. Keep speaking, keep growing your audience because you're making an impact and what you do. And please tell our listeners, how do we find you?

Dr. Aguirre, Guest  25:44

Yeah, so I actually love to hear from my audiences, I do have a fair amount of people who look for me on social media. So I made my accounts public. So you can find me on Instagram and Facebook and LinkedIn. And I do have a speaker's website. So if anybody is looking for speakers at your institution, you can go to LizAguirreMD.com And you can find me and reach out to me that way.

Dr. Gray, Host  26:14

Fantastic. I'll put all of that in the show notes. And I hope you consider inviting Dr. Aguirre to your institution for grand rounds or any sort of talk. The message that she's giving needs to be heard by more and more physicians. And thank you so much for listening to the podcast. And remember that if this episode made an impact on your thoughts, on your life, please share it with another physician who needs to hear it too. 

Dr. Gray, Host  26:45

Thanks for listening. Make sure you hit subscribe so you don't miss another episode. If you liked this episode, please share it with a friend and give us a five star review so we can help more physicians dare to dream and create their most abundant lives. There's also exciting news at the dare to dream physician. For those of you who wish to get clarity on your own why and get energized as you explore, envision and create your dream life. I'm so excited to announce that I'm taking on a limited number of one on one clients for life planning. To get the complete details and sign up for an exploration meeting. Go to my website, daretodreamphysician.com. I really look forward to working with you. And it would be such an honor and privilege for me to be able to help you create your life plan. I truly believe that life planning will transform your life and will give you that energy to pursue your dream life sooner than you ever imagined. See you next week.

SUMMARY KEYWORDS

physicians, burnout, job, people, thoughts, life, patients, clinical medicine, feeling, burnt, hear, care, hospital, episode, non clinical, hospitalist, create, absolutely, permission, institution