Improving outcomes by helping physicians avoid burnout
: [00:00:01] Welcome to the outcomes rocket podcast where we inspire collaborative thinking improved outcomes and business success with today’s most successful and inspiring healthcare leaders and influencers. And now your host Saul Marquez
Saul Marquez: [00:00:19] Rocket listeners welcome back once again to the outcomes Rocket really appreciate you tuning in.
Saul Marquez: [00:00:24] This is where we chat with today’s most inspiring and successful healthcare leaders. And you’re tuning into yet another awesome show. If you like what you’re hearing in the previous episodes or what you’re about to hear now with my awesome guest go to outcomes rocket.com/reviews where you could go and then I’ll send you straight to our Apple podcasts reviews where you could subscribe. Leave a rating leave a review. This is how we grow the show. This is how we get feedback to make it better so that it serves you the listener. So without further ado. I want to welcome our guests. Her name is Dr. Stephanie Hartselle.
Saul Marquez: [00:00:59] She is the owner and founder of Hartselle and associates as well as a clinical assistant professor of psychiatry at Brown University. Dr. Hartselle welcome to the show.
Stephanie Hartselle: [00:01:11] Thank you for having me.
Saul Marquez: [00:01:13] Absolutely. And so one of the things that I really wanted to do Dr. Hartzel is dive into this topic of health as well as sort of mental health as being part of it because a lot of times it gets left out of the equation or separated. Exactly yeah. And it’s just like this different thing but yet it’s part of the whole and so you I want to dive into that in today’s show but I wanted to ask you first and foremost what got you into medicine.
Stephanie Hartselle: [00:01:40] That’s a great question. I wanted to be a doctor ever since I was little and throughout school I actually just kind of messed around wasn’t very serious and was always sort of those that are writing and speaking. And I was at math science and I never knew a doctors and so I figured being a doctor was completely out and so wonder my way through high school, wonder my way through college really graduated poorly and was working as an orderly and emergency departments and I love that even though it was you know just really scrappy work but I still love that and all of a sudden realize oh no I want to I want to be a doctor and then have to go back and so I was working nights and then it actually and for a while taking medical classes that took me about four years and that actually got to do it in university.
Stephanie Hartselle: [00:02:29] So I was thrilled. I actually thought I wanted to be an emergency doctor. That’s why I knew then I figured out that what I loved about emergency was both psych and the trauma and I didn’t want to be a trauma surgeon. And everyone said I’ll talk to psychiatry and so I went ahead and become a psychiatrist.
Saul Marquez: [00:02:46] That’s amazing. And it’s so cool that you had this thought that you wanted to do it kind of hold the away and then all of a sudden here you are in the E.R. and it’s just calling you and calling you and you just had to answer.
Stephanie Hartselle: [00:02:57] It did. It was it was funny because I gotten home from night shift and called my parents at 7:00 in the morning and said I’m going to go to medical school.
Stephanie Hartselle: [00:03:04] And you know my parents agreed that they had them right there. I said OK sure. Four years later you know that change is funny.
Saul Marquez: [00:03:15] And Dr. Odzala it’s one of those things where it’s like sometimes we don’t choose medicine it chooses us right.
Stephanie Hartselle: [00:03:22] I think it’s also a great way for me to connect with some of my patients. I’m anxious.
Stephanie Hartselle: [00:03:27] It is and our goal is to make this as any kind of piano or anything else. I’ve made our way through and I.
Stephanie Hartselle: [00:03:35] Well actually yeah you know I had a really difficult to do anything backtrack and work hard for it you get there.
Saul Marquez: [00:03:47] That’s pretty awesome. Yeah. What would you say Doctor Hartselle is a hot topic that should be every medical leaders agenda today. And what are you guys at your practice focused on in approaching.
Stephanie Hartselle: [00:03:59] So I definitely think it’s positioned right now. That is something that’s all over. I think the general news is all over the medical news. We have an incredibly high suicide rate and physicians mostly because we don’t miss almost everything she knows. Yes. Yes quotes But I think the most effective way to die.
Stephanie Hartselle: [00:04:19] And I think they’re a combination of factors that are going on but I think that the fact that these issues are dying and they’re doing it by their own hand is something that needs attention. And I think it has so much to do with psychiatric health, mental health and physical wellness.
Saul Marquez: [00:04:34] So what do you think is a good way to deal with it. Yeah.
Stephanie Hartselle: [00:04:39] Good question. So there’s a combination of factors going on medical screening.
Stephanie Hartselle: [00:04:45] So you know it’s four years of college if you do it once or twice then you do it once it’s four years of college four years of medical school at least three years of residency although most of us I did five most people do between five and after I have people from 11 years.
Stephanie Hartselle: [00:05:02] And they get out and suddenly they’re in these situations where they aren’t in charge of patient care. And I think that can be really devastating. And so the person in charge of patient care is a system that will charge of patient care has changed into this kind of big box medicine. Now hospitals are having a private practice those are becoming big conglomerations becoming corporations. And if I want a giant box of cereal that will last me three months. I want to go to a big box store if I want my child to be treated really well for something that’s happened to him. I want to go to physicians not burn them out and who’s not being ruled and dictated by. I think that this is and it’s medicine and I think that
Stephanie Hartselle: [00:05:39] As I think that’s the real bait and switch for a lot of medical graduates and people who are mid career those the people who are killing and some of the highest rates.
Saul Marquez: [00:05:47] Now that’s really interesting. And so you get through medical school you get through residency which could be very long and then you start practice and you realize oh my gosh I am not in control right.
Stephanie Hartselle: [00:06:00] I’m not in control and I’m not able to actually do what I want to do which was treat patients well and actual care for them in a way that I think is useful to us.
Stephanie Hartselle: [00:06:09] Instead you’re often in clinic you’re mandated to see 46 patients or more an hour. So you’re running from the room.
Stephanie Hartselle: [00:06:16] I don’t know. This is more and more complex I wonder you are able to make any kind of sessions like during the 2000 – 4000 patients there or more. And there’s just no way to treat human beings and their medical complexities. Well that way I think doctors become just hired and burned out. And it was worth it.
Saul Marquez: [00:06:36] Yeah it’s definitely an issue. You know I mean you see it in their physician bloggers out there there’s people just expressing their frustrations. And I do feel like there is this undertone of just I’ve had enough.
Stephanie Hartselle: [00:06:49] Yes very much very exasperated a lot of people retiring early. And so to answer your question about how to how do we fix it.
Stephanie Hartselle: [00:06:56] I think one really important ways to make room for potential leadership so is hospitals and the corporations to not just have a board of MBA.
Stephanie Hartselle: [00:07:06] We’re running a hospital series. The solution at any time is up to the leader. Yes gonna be carved out. One of the reasons I have now practice your own practice is you know how to treat patients.
Stephanie Hartselle: [00:07:21] We’re learning how to run the business end of things. You know that’s a learning experience every single day. But I’d rather learn that than I have people who understand how to run business help me how to treat patients. And so I think that’s one of the ways that we improve.
Stephanie Hartselle: [00:07:34] I think they always start early and that’s for training physicians to have them care cells how to stand up for themselves and how to make sure they’re not psycho and feel like they have an ounce lot are trapped.
Saul Marquez: [00:07:46] Now that’s a really good point and I do agree and just having spoken to many physicians physician leaders to you know just like this is a hot topic. Yes.
Saul Marquez: [00:07:55] This is a really hot topic and.
Stephanie Hartselle: [00:07:57] Then it doesn’t just affect doctors it affects it you know if you think about it’s a tragedy to lose a human being suicide but one physician dying and he’s lost.
Stephanie Hartselle: [00:08:06] Now that doctor for thousands of physicians and even a family of her or him that’s the connection that’s so important and they’ve lost it. So this impacts not just the physicians and that impacts all of our patients.
Saul Marquez: [00:08:23] It sure does. Yeah the domino effect is without a doubt very serious. Can you give an example to the listeners. Dr. Hartselle of of how you and your practice or any other things that you may be involved with have created some results by doing things differently.
Stephanie Hartselle: [00:08:40] Sure.
Stephanie Hartselle: [00:08:41] And I can even tell you about how I was stuck in a box and after graduation I took a job as a medical director of one of the pediatric sites are here. It’s one of the highest volumes surprisingly there are children in psychiatric crisis. And it was just it was a set up and it’s like a hall and many many psych yards where the system has suddenly began yearly a patient or has increased and so
Stephanie Hartselle: [00:09:07] Hospitals do try their best. They try to cobble together teams to handle this but it’s therapists and couples together. And I think you know I was stuck in a position where I wanted to be a physician leader I wanted to change decision but they’re outside the resources at the time.
Stephanie Hartselle: [00:09:23] And in some cases because it’s mental health not the interest because mental health hurt certain areas of medicine so scary. And so I had to leave that area and open my own practice.
Stephanie Hartselle: [00:09:33] And there were two things that had stuck with me and are in residency you know one was or thought that I would be able to care for patients in the way that I thought it could. And I learned later that that was not only possible in the system which it was working. The second was physicians come in and told us about how it was really important that after all these years of training as a psychic and just because there are so few of us in the country that we had a real charge to not only treat our individual nations but to also figure out a way to reach people across the country that after seven years of training and this much investment that we had to figure out a way to provide care to more people. So I think what you’re doing with the show is really critical. So you are doing so well. Is it mandated that we do which is reach people everywhere and it’s another thing that I’ve also tried to work on and so in addition to the private practice where I can or kind of rich people one to one I’m hoping to be able to bring videos about how to do some software for physicians and patients and be able to reach more people that way because there just aren’t enough of us and be able to figure out a way to reach more people.
Saul Marquez: [00:10:35] That’s outstanding and kudos to you Dr. Hartselle for saying you know what I want to make a bigger impact and I’m going to find a way to multiply myself and give these people that are looking for solutions for answers those answers and solutions.
Stephanie Hartselle: [00:10:51] I’m hoping so.
Stephanie Hartselle: [00:10:52] I really am because it’s hard anyway to get in with a doctor regardless of where you are in the country to get in with a psychiatrist or child psychiatrist. It’s almost impossible.
Stephanie Hartselle: [00:11:02] And I want to make that mark.
Saul Marquez: [00:11:05] That’s amazing. And so I really admire you for making that effort outside of all the things that you already have going on to say you know what I want to do something because this is my calling. Without a doubt it is your calling and I’m excited to see what you put out there.
Stephanie Hartselle: [00:11:20] Thank you.
Stephanie Hartselle: [00:11:20] I’m hoping it will be great. Really I’m working on both. First of all how to get physicians can and maybe step away from the larger big box medicine and produce their own practice that’s driven by themselves and think those practices like Pamela Weible as someone who is a real leader in this area I don’t know her personally. I have exchanged e-mails with her but she talks about general medicine and how to scape a general physician and open up your own practice for very little money and be able to treat patients the way you want to. I think she’s another wonderful physician into but I think that it’s really important and then secondly some of the videos and I’d like to share on sleep insomnia I think that affects so many people and so for patients to be able to work on their own sleep and work on our own anxieties.
Stephanie Hartselle: [00:12:02] And that’s where I’m aiming.
Saul Marquez: [00:12:04] We’ll see how plastic. This is a truly exciting and it’s so interesting because we went from an environment where physicians did you know they got out of medicine they hung their shingle and they practiced medicine and made to care of their patients.
Stephanie Hartselle: [00:12:18] Stayed at home visits which I get to do. But yeah we’re traditional old old world authors.
Saul Marquez: [00:12:24] And there’s no reason why if that’s what you want to do you can’t.
Stephanie Hartselle: [00:12:27] It’s true. I think we’re very indoctrinated funny word.
Stephanie Hartselle: [00:12:31] But yeah we have these huge hospital systems and I think you know in certain industries first orthopedic cases that you have to have an OR you have large systems.
Stephanie Hartselle: [00:12:43] But I think the general medicine is I think the NBN is fordable for patients and that helps you live a life worthwhile and helps your patients live better that that’s absolutely rewarding thing that have seen the last few years was watching people get better and actually be able to not have to do therapy.
Stephanie Hartselle: [00:13:08] Right.
Saul Marquez: [00:13:09] Now that’s really interesting and I agree. And if you’re a physician listening to this interview and you’re just thinking to yourself wow she’s so right. Why don’t you think a little bit more about what you want to do and collaborate. Definitely the people that come on the show like Dr. Hartselle are looking to collaborate with other like minded individuals. You were dealing with big issues here and the more common minded people that we can get together to deal with them the better wouldn’t you agree. Dr Hartselle
Stephanie Hartselle: [00:13:37] I absolutely agree and I’m happy to talk to anybody who has great ideas about this because I think it’s so important.
Saul Marquez: [00:13:43] Absolutely so. You shared with us some some really cool things. Now let’s take a look at the other side of the coin here. Can you share a time with the listeners when you’ve had a setback and something that you learned from that setback.
Stephanie Hartselle: [00:13:55] Sure. So when I came straight out and was I just graduated from residency and was hired as the medical director I think I came into that system kind of guns blazing and had been trained for adult reasons yet all the hospital for those who are not in New York and I grew up in California didn’t know what the hospital was and a lot of people who are older do. But it’s one of the biggest psychiatric hospitals in the country is the oldest psychiatric hospital in the country and has hundreds of psychiatric beds and basically treats I think the most ill patients in the country if not the world. So it’s why I chose to train. It’s self-selecting.
Stephanie Hartselle: [00:14:28] I love that place still and it is a place where you kind of have to fight to get what you need. And I came I think into the bound system. So with that attitude. And I think that coming into a medical director position it is still middle management and I think I came into meetings and systems and blazing.
Stephanie Hartselle: [00:14:48] Why can’t we change this. What’s going on. I think now I would have tried to work with us live a little more even though it would have really been frustrating for me. So slowly but I think I could have made better change had them or patients in the system. And so if I continued in that position or if I may some day consults in that position again I think I’ll be watching carefully and see how I approach the system and being more empathetic and listening more.
Stephanie Hartselle: [00:15:13] I think talking less I think I really came out knowing what I wanted to do and not were to anybody else I think that’s a that’s a real problem.
Saul Marquez: [00:15:21] They learn that that is really interesting you know because across the country I mean it’s not one size fits all right. Every system is going to be different. So what advice would you give to somebody leaving one system and going to another on how to make big impact and get what they need.
Stephanie Hartselle: [00:15:40] I think for the first year that you leave the system then you go into another system.
Stephanie Hartselle: [00:15:44] I think the first year and head down and listen.
Stephanie Hartselle: [00:15:48] And also picture put your oxygen mask on yourself first. That’s always a message to everyone is can’t help anybody else.
Stephanie Hartselle: [00:15:55] You are burned out tired to let yourself down listen and just go with the flow for the first year and then start.
Stephanie Hartselle: [00:16:03] And certainly make a connection you see are moving in middle and then start to have the conversations and listen more than your like you. Now this is the. First. Time yourself when you figure out how to survive. This is something unsearchable.
Saul Marquez: [00:16:20] I love it that listeners put your oxygen mask on first because if your tank is empty there’s no way you’re going to be able to give. There’s just no way you can’t.
Stephanie Hartselle: [00:16:29] It’s the last thing that goes with most people is work. And for physicians especially if less so everything else their lives will fall apart.
Stephanie Hartselle: [00:16:35] Families, their health the work will go last. So notice that because they will stop caring about what’s going on a little more Brosnan’s more every day.
Saul Marquez: [00:16:44] Yeah that’s such a great message. Really great message. And so what would you say. Dr. Herd sell is one of your proudest medical leadership experiences to date.
Stephanie Hartselle: [00:16:54] So in June I was awarded the Dean’s excellency award for teaching and that of us.
Saul Marquez: [00:17:00] And congratulations.
Stephanie Hartselle: [00:17:02] That was amazing just because it’s an amazing award to get.
Stephanie Hartselle: [00:17:04] But also my mother was a teacher and I remember watching her in the classroom and thinking Oh my goodness she works hard.
Stephanie Hartselle: [00:17:12] I’m not doing our job. It’s hard. I’m becoming a Doctor. I’m not kidding about that I really.
Stephanie Hartselle: [00:17:17] To this day I watched teachers and I have two patients and I work so hard and in residency I had a wonderful resident mentor her name is Grace Henessy from an MBA degree in Tennessee she made me lead a group from the SBA with a group of men.
Stephanie Hartselle: [00:17:36] It was incredibly squirrelly group and it was difficult. I remember trying to do it and coming to Dr. Henessy.
Stephanie Hartselle: [00:17:42] I felt like that went horribly ignorant. So the fact is the Brownstein had a word.
Stephanie Hartselle: [00:17:49] They were the ones who voted for has been in award with. Actually the proudest moment I’ve had in medical career
Stephanie Hartselle: [00:17:55] Besides getting getting into medical school, that was amazing. I was just I was just so proud of and so so happy about.
Saul Marquez: [00:18:02] Yeah you know and congratulations on that.
Saul Marquez: [00:18:04] And you know many of us in leadership positions in medicine oftentimes forget that hey we didn’t get here alone we had teachers and we’re standing on the shoulders of those that got us here. And so I think you bring up such a great point and thank a teacher today if you haven’t thank your professor from 10 years ago or 20 years ago. If you’re listening to this episode just send an e-mail to one of your previous teachers that made a difference today.
Stephanie Hartselle: [00:18:31] I so agree I think about the fact that I took some of my classes at the community college and then orders for my finance classes and two of the best teachers I had and professor and I are getting there and they were amazing and I had so many mentor for me. I read it.
Saul Marquez: [00:18:49] Yeah. And what happens is it takes you back and it puts your roots back down and it makes you understand what your DNA is. It does. yYu’re here because of that. So thank them and Dr. Hartselle, thank you for that because I’m going to do it as well as soon as our interviews over.
Stephanie Hartselle: [00:19:05] I am, too. I am going to go right.
Stephanie Hartselle: [00:19:08] Dr. Ruth Emerson and tell him thank you again.
Saul Marquez: [00:19:14] I love it. I think that’s great. So listeners. Be sure to do that as well. You know great things and really great outcomes can often start with gratitude. And so it’s an awesome thing. Let’s all do it. So Dr. Hartselle, tell us a little bit more about an exciting project or focus that you’re working on today.
Stephanie Hartselle: [00:19:32] Sure.
Stephanie Hartselle: [00:19:33] I have a great friend now and Yuri Tomikawa who know me a few years ago and had said that she was putting together some Web sites out there. And of course I was there as well as some recommended.
Stephanie Hartselle: [00:19:47] And I said Hey I have a conversation. I realized what she was doing was. So needed because it was decided that it was all recommendations that it’s. For
Stephanie Hartselle: [00:20:02] Psychiatrist. And she created the Zencare. So lucky to be a part of it. Now about her visor on it do it because I believe on it..
Stephanie Hartselle: [00:20:14] You see she interviews therapists she has this great job a head shots and videos of therapists
Stephanie Hartselle: [00:20:23] We interview couples the therapists and physicians and we make sure that we’re creating a space for people to reliably find someone and make it so hard to reach out for help. And so I think it’s a video of someone who has been vetted by several people and at least makes a certain level of excellence. And if anybody thinks that’s most helpful thing therapy and then she has some amazing things. Every time I forget people I talk about it in different cities and good at it.
Stephanie Hartselle: [00:21:03] And everyone says well when is this coming to D.C. when they are Vermont or when’s it coming in Chicago. Yeah.
Saul Marquez: [00:21:10] Doctor it’s so I had the chance to meet with Yuri here on the show as well and it was just a wonderful person to speak with and has a strong vision that we said you know what you have the not that Uber put the lift of mental health does you really really does I think anything.
Stephanie Hartselle: [00:21:27] She has a concept like really the Stenzel areas in medicine and generally but you really this is such an important thing and her own personal during her honesty and that is why she likes this project they really think and are so proud of her. I’m so proud to be a part of that.
Saul Marquez: [00:21:45] That’s pretty awesome. Yeah it’s super exciting and for the listeners who haven’t taken a listen to that podcast go to outcomesrocket.com/yuri that’s y-u-r-i. I know you’ll be able to hear our conversation with her and the cool things that Dr. heart cell and Yuri are working on through zencare. So, Dr. Hartselle, let’s pretend that you and I are building a medical leadership course on what it takes to be successful in medicine today. It’s the 101 course or the ABC of Dr. Stephanie Hartselle. We’re going to build a syllabus here for questions lightning round. We’re going to finish with a book that you recommend to the listeners you ready. I’m ready. All right. So what would you say the best way to improve healthcare outcomes is.
Stephanie Hartselle: [00:22:26] I think take care of your providers first for making sure that they know how to figure out what is the biggest mistake or pitfall to avoid.
Stephanie Hartselle: [00:22:35] I think branding medicine as glamorous medicine is not a cause in any kind of machine. We’re not a treadmill. Make sure that you are not since you need any other kind of operation that has priority number one all the time for employees and also they also have
Saul Marquez: [00:22:58] A strong message. How do you stay relevant as an organization.
Saul Marquez: [00:23:01] Despite constant change.
Stephanie Hartselle: [00:23:03] I think you really do need to keep up with what’s going on.
Stephanie Hartselle: [00:23:05] I think there’s a certain amount of social media and news that well over in terms of putting your own oxygen mask on.
Stephanie Hartselle: [00:23:12] I think there’s with that small steps you need to make sure you have your finger on the pulse.
Stephanie Hartselle: [00:23:16] But for things to take way that I think you in half an hour understand what the trends are right now.
Saul Marquez: [00:23:25] What is one area of focus that should drive all else in your organization.
Stephanie Hartselle: [00:23:30] Always always always patients first always.
Stephanie Hartselle: [00:23:33] That is of course the caveat that you are in yourself are healthy and it is making sure that whatever you are doing, have the patient in mind and that’s the bottom line and things will fall into place.
Saul Marquez: [00:23:44] Love it. What book would you recommend to our listeners.
Saul Marquez: [00:23:47] Dr. Hartselle.
Stephanie Hartselle: [00:23:48] This year I read getting things done by David Allen and I really enjoyed it and really talked about prioritizing and I think it’s a stand for everything else static.
Saul Marquez: [00:23:56] That’s wonderful.
Saul Marquez: [00:23:56] And so to the listeners everything that we’ve talked about here all of the pearls of wisdom that Dr. Hartselle has shared the book her website the things that she’s up to the show notes you could find those at outcomesrocket.com/hartselle.
Saul Marquez: [00:24:12] That’s H A R T S E L L E.
Saul Marquez: [00:24:16] So don’t worry about writing them down. You could just go ahead and check it out on line. So before we conclude Dr. Hartselle I like to just ask you to share one closing thought and then the best place for the listeners to get ahold of you.
Stephanie Hartselle: [00:24:28] Sure.
Stephanie Hartselle: [00:24:28] So I think my closing thought would be for medical providers so that anybody in medicine physicians or nurses anybody providing healthcare to others.
Stephanie Hartselle: [00:24:38] If you are burned out if you are struggling and feel like you have no work is.
Stephanie Hartselle: [00:24:44] More than anything else.
Stephanie Hartselle: [00:24:46] What we do as all the rules and there are places where if you are not going right and you have nowhere to go. My cell phone is on my Web site. I’m not kidding.
Stephanie Hartselle: [00:24:58] It’s all on there all the time and it’s with me all the time and we will try to figure something out. We’ve got nowhere else.
Saul Marquez: [00:25:08] Such a wonderful message Dr. Hartselle and the listeners just know you know you’re definitely not alone and if you do find yourself in that place and you can’t reach your oxygen mask. You just can’t do it on your own. Go to outcomesrocket.com/hartselle and you’ll find the best way to get ahold of Dr. Hartselle there if you need her answer. Doctor thank you so much for spending time today. It’s been so much fun. And really looking forward to seeing the awesome things that you do with the videos.
Stephanie Hartselle: [00:25:39] I was really excited to be here.
Stephanie Hartselle: [00:25:40] I really appreciate you for having me.
Outro: [00:25:46] Thanks for listening to the outcomes rocket podcast. Be sure to visit us on the web at www.outcomesrocket.com dot for the show notes, resources, inspiration, and so much more.
The Best Way To Contact Stephanie: