Difficult Conversations Podcast
Lessons I Learned as an ICU Physician
Episode 110 | September 22, 2020
Dr. Dike Drummond
Coach, Trainer, Consultant and CEO
Welcome to Difficult Conversations – Lessons I Learned as an ICU Physician with Dr. Anthony Orsini. Our special guest today is Dr. Dike Drummond, a Mayo trained family doctor, professional coach, author, speaker, and trainer, whose sole focus is addressing the modern epidemic in physicians and that is professional burnout. He is the Founder and CEO of TheHappyMD.com, which receives over 25,000 visits per month and hosts an online community of over 18,000 physicians from 63 countries around the world. He is the “go to” man and leading expert on physician burnout. His book, Stop Physician Burnout, has sold over 40,000 copies worldwide. Dr. Orsini keeps his promise about two things, that you will be inspired, and you will learn communication techniques that will help you in your professional and personal life.
Dr. Drummond tells us about the mission of his new Podcast called, “Physicians on Purpose.” He shares his story of how he experienced burnout after ten years of practicing medicine and why he made a major switch in his life. He launched TheHappyMD.com when the interest and prevalence of physician burnout peaked over time. Dr. Orsini asks “How do physicians who may feel symptoms of burnout have that first conversation with themselves and accept that they need help?” Dr. Drummond tells us it’s a conversation between your heart, your soul, your actual self, and the conditioned automaton that the medical education system spits out the far side. He explains the different personality traits that all physician have: workaholic, perfectionist, and lone ranger. What does this look like for the next generation of millennials? Dr. Drummond lets us know if the next generation of physicians are going to have less physician burnout or if it’s going to get worse.
The number one determinant of the patient’s experience is the doctor’s experience, so he explains what he teaches people on how to be awake in your workday. He reveals his simple single breath technique called the “SqueeGee Breath.” Dr. Orsini discusses his It’s All in the Delivery program that he developed and tells us the story about how he proved his hypothesis that patient experience scores can be improved by doing absolutely nothing but training the entire staff on how to communicate and to understand how human beings connect. If you are a physician or a nurse and have symptoms of burnout, find out how you can go from being afraid to tell anybody to asking for help. Reach out to Dr. Drummond. He shares some great advice he gives doctors and the keyword to think about is “satisfaction.” If you loved this episode, please hit the subscribe button to find out more about what we do and how we teach communication. Go ahead and download this episode now!
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Dr. Dike Drummond (1s):
When a doctor or nurse or anybody who works in healthcare, walks into their practice, they walk into the
middle of a small whirlwind. And the thing about the whirlwind is from the inside of the whirlwind, all you
could see is the inside walls at the whirlwind and most of what you see sucks. So the question is, how do
you step out of your whirlwind set the whirlwind off to the side. It will be there when you come back. So have
you step out of that is the points were you need to, but point’s do you need to number one, when you are
going to go into a room or into an encounter with the patient or a patient’s family, number two, when you’re
interacting with your team.
Welcome to Difficult Conversations Lessons I Learned as an ICU Physician with Dr. Anthony Orsini. Dr
Orsini is a practicing physician and the president and CEO of the Orsini way as a frequent keynote speaker
and author, Dr. Orsini has been training healthcare professionals and business leaders, how to navigate
through the most difficult dialogues each week, you will hear inspiring interviews with experts in their fields
who tell their story and provide practical advice on how to effectively communicate whether you are a doctor
faced with getting a patient bad news, a business leader who wants to get the most out of his or her team
members’ or someone who just wants to learn to communicate better.
Announcer (1m 23s):
This is the podcast for you.
Dr. Anthony Orsini (1m 26s):
All right. Welcome everyone. To another episode of Difficult Conversations the lessons I’ve learned as an
ICU physician today, we are very, very fortunate to have a very awesome guest today. Dr. Dike Drummond.
Dr. Drummond is a Mayo trained family doctor, a professional coach, author, speaker, and trainer. Who’s
sold professional focus since 2011 has been addressing the modern epidemic and Physicians, and that is
professional burnout. He is a graduate of the Mayo clinic medical school in Rochester, New York.
Dr. Anthony Orsini (1m 59s):
He then went onto the completed residency in family medicine in Redding, California, and practice full
spectrum family medicine in Washington state for over 11 years. Dr. Drummond is currently the CEO and
founder of the HappyMd.com, where he receives over 25,000 website visits per month, and hosts an online
community of over 18,000. Physicians from 63 countries around the world. He is the go to man and leading
expert, as I say on Physician Burnout.
Dr. Anthony Orsini (2m 28s):
Dr Drummond has logged over a 3000 hours of one-on-one Physician coaching and has trained over 40,000
doctors are on behalf of 175 corporate clients in 2014, his book Stop Physician Burnout, which I just finished
reading. And I’ve also actually quoted during some of my teachings and my presentations, his book Stop
Physician Burnout what to do when working harder. Isn’t working has sold over 40,000 copies worldwide.
Well, thank you. Dike for agreeing to be a guest on my podcast as a, you know, I launched this podcast just
a few months ago, and I’m really happy to say that in 48 hours, the Podcast went to Apple at 200 and we
actually went as high as number seven and medicine in the first week.
Dr. Anthony Orsini (3m 13s):
So, wow. I’m very happy with that. I’m really honored with the number of people who subscribe and the
reviews that we’ve gotten. So I’m really excited. I know that your just about, or you just have launched your
podcast and I believe that’s called Physicians on Purpose. Yes, it is. Physicians on Purpose. Yes. Tell us a
little bit about that first we’re on the topic of Podcast. So what’s the mission to that podcast. And where do
you see that going?
Dr. Dike Drummond (3m 40s):
One of the things that I know about physicians who are burned out, having experienced it myself, and
worked with hundreds of doctors is that it’s a experience of waking up, right? You’re trying to comply with
somebody else’s job description and it’s painful when you try to see color inside their lines and do what they
expect of you, because you didn’t play any role in developing the job description. It’s not your ideal job
description. And so what you do is you wake up through Burnout, it gets so painfully you can keep going
down that same path. Then you wake up to take control of your practice.
Dr. Dike Drummond (4m 13s):
Instead of being a physician on somebody else’s path, you become your own physician on purpose. It’s an
act of waking up then. So what we are going to do on the Physician on purpose podcast is talk about
Burnout stories, how you made the turn, what difference it made in your life, because it’s almost always a
very positive transition, as long as you survive it, it has a crisis point that you have to turn towards the light
that as long as you survive it, it’s usually a positive thing in your life. So Burnout stories, we’re not
prevention, tips and wellness leadership strategies as well.
Dr. Dike Drummond (4m 47s):
That’s what we’re going to talk about.
Dr. Anthony Orsini (4m 48s):
Well, I’m looking forward to it and it, soon as you have all the information about that, please let me know. I
will share it through all of our social media’s and will help you push that. And I’m certainly gonna subscribe.
So I’m looking forward to that. You know, every episode I review my promise with the audience, my promise
is two fold. One is that there’ll be inspired by the end of this episode and two that their going to leave with
some good communication techniques and some good sound based evidence on what to do the next time
they’re involved at a Difficult Conversations.
Dr. Anthony Orsini (5m 20s):
And I have no doubt that I’m going to fulfill my promise today, I guess you and I spoke about a month ago,
and you told them your story, and we all have a story, right? I have a story of how I started getting into
communication and medicine, how I started teaching, breaking bad news. People ask me all the time, how
did I get here from a young altruistic physician who just wanted to cure cancer? And, and then something
happens along the way that changes you and the universe kind of pushes you into a different way.
Dr. Anthony Orsini (5m 51s):
Now I’m still practicing medicine. I know your not, but do me a favor and just share your story about what to
you, you were practicing
Dr. Dike Drummond (5m 59s):
And then something happened. He decided I’m going to make the switch. I think in 2011, correct? Actually I
always practicing medicine and until the year of 2000, and that is my first episode of Burnout. And by the
way, I would argue with you that I still practice medicine. I just don’t see patients for insurance money.
Excellent. All my patients are doctors. So just shoe on that for a second. I like that. So when I grew up, my
doctor was named Dr. Schmitt, and he was a classic old guy with a button up vest, and he looked like a
captain kangaroo. We had the silver beard.
Dr. Dike Drummond (6m 30s):
Then, you know, the Norman Rockwell, a picture of the kid, looking at the doctor’s qualifications, all while his
pants are down. He is going to get the injection. I I think most physicians do. His office looked like that and
when I went to medical school, when I thought about what it would be like to be a doctor, there was only one
choice. I was going to be a GP, a small town GP. So ultimately I ended up practicing for 10 years. I counted it
up once about 35,000 patient visits, 500 babies delivered all of that kind of stuff. Been there done that got to
the T shirt. And then one of the things that hit me was my mom and my grandma.
Dr. Dike Drummond (7m 2s):
really wanted me to be a doctor. They were both dead at that point in time when I was 40. And I had gotten
to that point in a primary care practice, where part of what I enjoy is new stuff, right? So the thrill of not
knowing what was behind the next door and seeing new things every week was part of what I really enjoyed
about being a doctor. And that’s true about a lot of primary care people. And that starts to peak and fade
when your about 10 years into a practice. So what ended up happening to me was over the course of a
couple of weeks, when I would come in to work, it felt like somebody was putting me in a choke, hold it a
Dr. Dike Drummond (7m 37s):
I didn’t understand. In the UFC, they call it a rear naked choke. And it had been going on for a couple of
weeks. And I said, wow, this is really strange. And I took a sabbatical, it took a month off, shaved my head
did a bunch of yoga, prayed that I would come back and I would be better. But the feeling returned the
minute I came back into seeing patients and I didn’t have a lot of coping skills at the time, it was very
disorienting. So I basically walked into the CEO’s office, sign my resignation and walked away from my
medical career, which I don’t recommend is a transition strategy because it just burns too many bridges.
Dr. Dike Drummond (8m 11s):
And so if anybody’s listening to this, if you’re listening to this and you’re saying, yeah, yeah, I want to chuck it
to don’t don’t you keep listening here and will give you some tactics, some conversations to have so that you
don’t have to burn all those bridges cause you work hard to get here. So I put food on the table. I was
walking clinic doc for a couple of years. Then my now ex wife’s business took off. We were trainers of
teaching business and leadership, facilitation skills. So meeting facilitation skills as a training business.
Dr. Dike Drummond (8m 43s):
And we grew that to be a pretty successful endeavor. And then in 2010, that marriage in that business went
away. I was burnt to the ground that the second time, and I’ve had been at a coach for a decade and he got
certified as a coach back in 2000. And I decided I would try to see if there was a way for me to make a living
as coach, to burned out doctors like I had been. And I launched a little website called the Happy md.com.
And fortunately or otherwise its not fortunate for the professional, but it was fortunate for me, but the interest
in Burnout and the prevalence of Burnout have peeked over the last decade or so.
Dr. Dike Drummond (9m 21s):
And so I’d been basically riding a wave of learning from my client’s all the different ways burn out, can get
ya, learning all at different things that work and taking that body of knowledge and turning it into training’s
and consulting in taking it out into the real world.
Dr. Anthony Orsini (9m 39s):
It is extremely common, both in Physicians Well first of all, do you also counsel nurses because we know
that nursing burnout is also very high. How prevalent is physician burnout and nursing burnout for those
non-medical people that are out there? Well, I will say that if you’ve use them as a back burner, right
Dr. Dike Drummond (9m 59s):
used Maslach Burnout Inventory which is the gold standard for burnout prevention for you, is there a
standard cutoffs for the last six or eight years in Physicians 40 to 50%, have doctors are burned out on any
given office state suffering from at least one symptom of burnout is the way it’s usually stated that most
common symptom has basically exhaustion. And that that’s a prevalence that is right now today snapshot 40
to 50% of your doctors are burned out right now. I don’t know the nursing literature, by heart, right? I’ve
trained lots of nurses in mixed audiences with doctors inside healthcare organizations got to try to train all
the employee’s when I can cause the lessons we learned with doctors apply to anyone who draws a
Dr. Dike Drummond (10m 39s):
So anybody is in a situation where you’re organization sees patients. The mantra that a patient comes first is
in play. You got the same risks as a doctor. It’s just not the same level of responsibilities. So the prevalence
of Burnout we’ll be lower or the farther down the responsibility chain you go.
Dr. Anthony Orsini (10m 56s):
And I know that physicians have a very high suicide rate, which is I’m sure related to other things as well, but
I’m sure if a physician burnout plays a major role in that, all right,
Dr. Dike Drummond (11m 5s):
You have double the risk. So I always explain it like this. Everybody who is now a doctor at one point in time,
was that a fork in the road? I call it the Lightworkers fork in the road. When you were trying to decide
whether to go to medical school or do anything else. And this is where all your stone are. Friends said, heck
with that. And they went and did anything else while you went on the path to medical school and you had no
idea what you were getting into, but what you did when you took that path and chose to be a doctor, was you
doubled your suicide rate man or woman or the rate is double.
Dr. Dike Drummond (11m 36s):
And I just wanna say really clearly I just ask Pam, why will this question? We believe that Physician suicide’s
are dramatically under reported, right?
Dr. Anthony Orsini (11m 45s):
Hm. So it was much higher than we even think
Dr. Dike Drummond (11m 49s):
People say 400 doctors a year. I’m sure it’s more than that. And we have,
Dr. Anthony Orsini (11m 54s):
I work for very large hospital system in, we here every now and then about another physician who took his or
her life in, you know, we don’t know what was going on in the background, but it’s certainly something that
we need the help with. So I’m going to guess, and you are going to tell me more about this, that for every
doctor that is starting to realize that he’s got signs of burnout or she has signs of burnout, there’s a bunch of
doctors who wonder if they do right. And I guess they can call you or they can take some tests and find out
that you haven’t really feeling burned out.
Dr. Anthony Orsini (12m 30s):
And the name of this podcast has Difficult Conversations. So I always say that every critical moment in our
lives, there is a difficult conversation. The first conversation that one has to have then is I’m burnt out or I
feel burned out. Do I ignore this and push through because I have a family to Thiede and I have
responsibilities and it’s embarrassing to say, cause that physician’s right, we’re supposed to B we know
everything. That’s the way we’re trained. Like we’re the leader we’re in there.
Dr. Anthony Orsini (13m 2s):
And I would think that physicians have a hard time asking for help. How does the first conversation happen?
Or what do you, for someone out there who’s listening? How do you have that first conversation with yourself
to say, am I burned out and how can I go to the next step to get help?
Dr. Dike Drummond (13m 18s):
Yeah. Great question. To realize that it’s a conversation with yourself. It’s actually a conversation between
your heart, your soul, your actual self, and the conditioned automaton that the medical education systems
spits out the far side. So lets just talk about this a little bit. And it’s something that is not taught in medical
school or residency and the 40,000 doctors that I’ve trained in. This is one of the lessons we have to share
every single time. And that’s the conditioning of your medical education. So at that light workers fork in the
road where you decided to go to medical school, just so you know, you did that because you were different
than your stoner friends, right?
Dr. Dike Drummond (13m 57s):
You are a help. You are a healer, I’d call it a Lightworker in that choice, you’ve chose to be a helper. A healer
specifically chose to ally your professional career. From this point forward to the forces of light in the
universe. As we battled the forces of darkness, illness, suffering, death, dying, and family members, crazed
attempts to deal with it. And you chose as an NICU, doctor to put yourself in a crucible wear, that kind of
stuff happens all the time. Nobody’s baby’s in the NICU for a good reason, right?
Dr. Dike Drummond (14m 31s):
You’re going to have those conversations. It’s a disaster in the family. Any time you meet these people. So
your a Lightworker impulse and in the forces of darkness are right in your face all the time at work. But what
happens is you don’t start a practice. When you decide to be a doctor, you go to four years of medical
school, do you go to a minimum of three years of residency. I’ve seen people who spent 16 years in the
medical education system. The reason you went is because you wanted to be a light worker, but you also
had certain characteristics because remember you weren’t one of the stoners you are getting straight A’s
Dr. Dike Drummond (15m 6s):
So we have these personality traits, workaholic, perfectionist, lone ranger, right? All of these things are well
developed in us. They are supposed to be tools, but you take out and use for a particular purpose and then
put away. But the instant you enter medical school for anywhere from seven to 16 years are gonna be using
these tools every single day. So workaholic, lone ranger, emotion, freight perfectionist is a peace of who we
are and we come out dramatically conditioned.
Dr. Dike Drummond (15m 37s):
And in addition to those character traits there’s to prime directives, everybody knows the first one that patient
comes first. The second one is never show weakness. Yes. And that’s the one that’s an underground, right?
And remember too medical school and residency have really nothing to do with the medical practice. They’re
a survival contest. And you’re going to be put to the test. I say medical school and residency is the energetic
equivalent of water-boarding. So I’m going to be held under water to see if you can take it any falter, any
hesitation you’re out.
Dr. Dike Drummond (16m 11s):
Okay. It was much more severe in the years when we had no work hour restrictions, but even with the work
hour restrictions, it’s still like waterboarding. And so when you pop out the other side, you’re programmed to
work you’re programmed to keep pushing your programmed, to see things like fatigue, hunger, having to use
the bathroom as things you have to hide from other people because someone might consider it a sign of
weakness. And then there’s always a generous dollop of bullying and all sorts of other things that happen in
medical school too.
Dr. Dike Drummond (16m 45s):
So often times as you come out of your education process and you get your first job, you’ve completely
forgotten. You have free will because until now you’ve just been doing what everybody wanted you to do. All
you have to do is make it to the end of these tracks because honestly what do they call the person who
graduates last in their medical school class Doctor. Yeah, exactly. So all I’ve got to do is make it to the other
end. And then when I go to get my first job, I’ve completely forgotten””
Dr. Dike Drummond (17m 18s):
I have free will. Doctors are terrible at job search, right? All I’m looking for is somebody else to tell me what
to do. And in your first job, there are more than happy to do that. They call it the way we do things around
here. And you say, awesome. All you got to do is the way we do things. And this is going to be great. And
you start doing it just like a resident working real hard to what everybody expects. If you have to color inside
the lines until it gets so uncomfortable, you can’t take anymore. He goes, what are the odds that this job
description is actually your ideal job description.
Dr. Dike Drummond (17m 51s):
It starts with the Z is zero, right? If you had no role in designing this job description. So what I like to do when
people are waking up and in the agony of Burnout, they can not continue to go any longer. They’re physically
incapable of going back into the office, their dying on the inside, in a battle with their programing. What I like
to do is actually work to open back up what you were thinking at the fork in the road, way back in the day,
what were you thinking?
Dr. Dike Drummond (18m 27s):
This choice to be a doctor would provide for you and your family in terms of your profession and in terms of
enabling an extraordinary life, it’s an extraordinary choice. How can it, it enable in an extraordinary life and
how’s it going so far? And then all I have to do is start talking a little bit about Einstein’s insanity trap is even
a doctor who understands that.
Dr. Anthony Orsini (18m 54s):
This brings up so many questions just with what you said. It was just so great. I remember if it was just
yesterday, I was sitting on a deck with, my an adult children. And one of my adult children’s best friends is
finishing medical school and he’s starting residency. He was talking about relationships with his girlfriend and
how he studying all the time. And the girlfriend kind of understands, but doesn’t understand. And I said to
him as advice, I just said, listen, when you are under that kind of pressure in medical school, that most
people don’t understand that you and I would wake up at eight o’clock on a Saturday to study, at least I did
Dr. Anthony Orsini (19m 36s):
Maybe you were brighter than I was, but I’d wake up at 8:00 AM medical school study until 12, eat lunch
study til six, eat dinner or a study to 11. And I go to bed and that was my life. And I said to my son’s friend’s,
girlfriend and said, this is his life. And you know, if you tried to stop that he is going to end up resenting you
because we’re so driven. Right? And then when I went to did my residency, there’s a lot of stories that you
and I could talk about forever or what they made us do, right? It was actually the first year that they have the
laws that you weren’t allowed to work more than 80 hours a week.
Dr. Anthony Orsini (20m 12s):
Dr. Dike Drummond (20m 12s):
Right. So you’re a little younger than me.
Dr. Anthony Orsini (20m 15s):
And this was in New York. I’m 56. And in New York they would say to us, listen to the law, says you’re
supposed to clock out at midnight because we can’t have any more than 80 hours a week. But after you
clock out, you still have seven history and physicals to do all night, but we’re not going to tell anybody. So I
was still working 36 hour shifts. And then it, from my point of view, now things have gotten a little bit easier
now, but I thought this was what was supposed to happen. You’re supposed to be abused, almost kinda like
you’re joining a fraternity and their going to haze you.
Dr. Anthony Orsini (20m 48s):
And I personally thought that when I got out of my training and I did that internship, I did a residency. I did a
fellowship. So it was seven years after a medical school. I thought that I was going to have what my family
doctor, it sounds like the same is your family doctor. And all of the guys have a family practice. He delivered
babies. He had his own practice. And when he walked in, he did whatever he wanted to do. And then I get to
Neonatology I join a hospital and they were saying, here’s your hours. This is when you’re going to sleep.
Dr. Anthony Orsini (21m 18s):
This is where you’re not gonna sleep. And so, so there’s a question. And this long statement, I just want him
to let you know, like, as you were speaking, thinking about all this kind of stuff, the millennials or the people
that are coming out of medical school now into residency one yesterday, I interviewed someone from human
resources and they said the millennial’s, they don’t have that kind of hazing. They don’t tolerate it as much
as you and I do that. Millennials are working a little bit less. Do you think that we’re going to have less
physician burnout because of the millennials haven’t been through that or you think it’s just going to keep
getting worse and worse?
Dr. Anthony Orsini (21m 51s):
It, it has nothing to do with it.
Dr. Dike Drummond (21m 53s):
I would say only time will tell because there’s many, many forces at work here. And let me just say two that
this statistic I hear most frequently is that the difference between a non work hour restricted residency and a
work hour restricted residency is about one third. Meaning if you were in a work hour restricted residency
compared to boomers like me, who were not, you have one third, less hours of experience when you come
on shift in your first job.
Dr. Dike Drummond (22m 24s):
And as a matter of fact, I hear CMOs all over the country, say, yes, we actually have extended on boarding
and we don’t let these people see patients unsupervised when they first come on, because they’re not ready
to join a group of mature baby boomers style doctors, they’re graduated with an incomplete education. They
also what you’ll see. And again, we’re into a generational issue here. The CMOs will also tell me that these
young links, if they don’t know how to work hard and they just don’t care. And the reason is this, okay?
Dr. Dike Drummond (22m 56s):
Imagine the water-boarding analogy than I said. Imagine you come out with a third more experience and
having been waterboarded twice, as much as somebody who comes out without that kind of basic abuse of
your physiology and your ability to tolerate that, It’s a different person. They have different loyalties. They
feel different levels of guilt when they don’t complete a task. And it’s a much easier for them to draw
boundaries. Then us where we would have somebody would ask us to do something and we would do it out
of a feeling of obligation, or you wouldn’t want somebody.
Dr. Dike Drummond (23m 30s):
You think we couldn’t handle, it’s a sign of weakness. So these are fundamentally different animals. Yes,
we’re practicing medicine, but I’ll work hour restricted graduate and a non work hour restricted graduates
have gone through a different conditioning process. So time will tell the other thing that millennials are as
typically digitally native. So they don’t struggle so much with EMR like us older doctors to, you know, there’s
a lot of different moving parts here. I think it’d be really interesting. The thing that I’m most distressed about
as being a patient, right?
Dr. Dike Drummond (24m 2s):
So my experience of being a patient has dramatically deteriorated over time and what’s gone away is not
anything to do with millennial or a baby boomer. It’s people’s, they’ve completely let go of the physical exam.
I mean, they click boxes and’ talk to me and maybe put an automatic blood pressure cuff on my wrist. And
it’s like, hang on a second. Aren’t you going to examine me? But it just doesn’t happen in the way it used to.
Dr. Anthony Orsini (24m 28s):
All right. And patient experience is the hottest topic and medicine right now. And we are pushing a lot to
improve that patient experience. It’s an uphill battle at the Orsini Way when I do, you know, I have a program
called its all in the Delivery and that’s the name of my recently published book two. And that book and this
program, the address is exactly what you said is that what’s missing in the patient experience right now is
that one on one connection with your physician that you had with your family doctor and I had with my family
Dr. Anthony Orsini (24m 59s):
And now we have a whole bunch of physicians who are feeling task oriented. They have to get their work
done. They are feeling maybe a little bit burnt out at the hospital is telling them that they have to see more
and more patients and there’s no relationship building. And we know that when a physician has a
relationship with their patient, even if that relationship is a short term, I mean an emergency room visit five
minutes that that patient is more likely to follow their medication treatment. They’re more likely to follow up
with a subspecialist and they have better outcomes and they’re happier.
Dr. Anthony Orsini (25m 33s):
And what I teach in that it’s all in the Delivery is that you can form these relationships and very quickly by
using a certain communication techniques, difficult conversations and not to take that long, have a period of
time. And I think in the programs that we’ve done and I can tell you from personally that I go home about the
same time every day, but I go home with a smile on my face because I had that human connection. And so I
think you’re exactly right. Pick your head up from the iPad that your typing on or to the laptop and as a
patient, something that opened the question, talk about the Yankee’s or I guess in, in your area to Seattle,
let’s talk about some baseball and we’ll spend a minute doing that and what I leave here, they’ll go.
Dr. Anthony Orsini (26m 18s):
Well, that was a great doctor. He’s a really nice, she’s really nice and I’ll leave here going “I know that
patient” to me that helps me with my Burnout symptoms when I’m feeling really bad because I left there just
rushing around to see patients. I find I go home, I’m a little more sad. You know, we would, do you agree with
that? Made it this way. We crave that relationship so that our patients, right.
Dr. Dike Drummond (26m 40s):
He just built a case that it’s actually even more connected than people realize. When I say this, you’re going
to agree with me. Everybody always does. Right? The number one determinant of the patients experience is
the doctors experience, how can I ask a patient to give me a top score on their satisfaction? If the doctor is
going to give the organization a three out of five and what I’ll also say is all of the techniques and all of the
dialogue that you teach has a predecessor.
Dr. Dike Drummond (27m 10s):
And so let me teach you what I teach people in terms of how to, how to be awake in your workday. So when
you look at patient satisfaction, it’s all linked to one thing, the doctor’s attention, the doctors focus. And I
actually have a drawing behind me hear that you were asking about earlier. I have a stick figure with a
stethoscope on and it’s in a whirlwind and then a scribble whirlwind all around them. In my experience is this.
It doesn’t matter when you graduated from your training program, when a doctor or nurse or anybody who
works in healthcare, walks into their practice, they walk into the middle of a small whirlwind.
Dr. Dike Drummond (27m 50s):
Things are coming at you from all different directions. Patients only bring complaints. Your staff only bring
prompts, questions, decisions, responsibility, busy work, charting, all that kind of stuff. It’s like being in a
whirlwind. And the thing about the whirlwind is from the inside of the whirlwind, all you could see is the inside
walls of the whirlwind and most of what you see sucks. So the question is, how do you step out of your
whirlwind? Set the whirlwind off to the side. It will be there when you come back.
Dr. Dike Drummond (28m 20s):
So you step out of that in the points where you need to, what points do you need? Two number one, when
your going to go into a room or into an encounter with the patient or a patient’s family, number two when
you’re interacting with your team.
Dr. Anthony Orsini (28m 34s):
Yes. That’s so important. Yes.
Dr. Dike Drummond (28m 34s):
So how do you do that? And what I’ll tell you is They would have to do this in order to use your
communication techniques to cause ideally they com communication techniques, phrases, things that work
in terms of speaking to a patient are building on your undivided attention with that patient. And so what I
teach is a simple single breath technique called a SqueeGee Breath. So you take a big breath to the top of
your head, hold it in two, three, and then exhale to your toes for and hold it out two or three, imagine a giant
squeegee, has wiped you completely clean when you turn that knob?
Dr. Dike Drummond (29m 13s):
When you go into the room, right?
Dr. Anthony Orsini (29m 15s):
I think that’s great advice. We talk about that all the time. We joke around, we say, take a deep breath in and
take your own polls, you know, calm down. Right,
Dr. Dike Drummond (29m 22s):
Right. We already know this as a habit. Cause the what is the first step? What is the first step in an
emergency? You take your own Ples so we already know this as a mantra. It’s just a question of it. Doesn’t
have to be an emergency to center yourself. Right? So what I teach is a BJ Fogg technique for, for it to have
a, so what is going to be your trigger to take a big deep breath and recenter yourself multiple times in your
day. And it’s easy to find triggers in doctors because we all have lots of work habits between patients.
Dr. Anthony Orsini (29m 52s):
We have our “it’s all in the delivery” training, I took a major unit and we tested the hypothesis that we can
improve patient experience scores by doing absolutely nothing but training the entire staff on how to
communicate, not telling them what to say, but to understand how human beings connect and they
communicate. And so we trained the doctors, the nurses, the chairman of the department, we train the
receptionist, et cetera. And the patient satisfaction scores went up 60% in the rankings and have stayed
there for two years.
Dr. Anthony Orsini (30m 24s):
And our trigger is we have to understand that even if we’re really good at this, we understand this, that
there’s going to be a point during the day, during the week, maybe several points. Then you can comment on
this where you forget about it. Okay. I’m feeling rushed, I’m feeling hurried. And so here you go to the
whirlwind. And so what we teach is maybe an offensive for a nurse to come up with me and say, Dr Orsini,
you know, that was a bad interaction that you had when a patient that’s not going to happen or your head
spinning you’re in a whirlwind.
Dr. Anthony Orsini (30m 54s):
So what we have as a code is everybody gives permission to positively and negatively reinforce this. And
that means the receptionist can go up to the chairman of the department and say, Dr Orsini, it’s all in the
delivery. And that means I can see it in your eyes. You’re there speaking. Yeah. I saw it. And the response
that we all make and what we promise it will always be, thank you, Nancy. I needed that. You know, I needed
that because I got caught in it. And so what your saying is just, is just amazing.
Dr. Anthony Orsini (31m 26s):
So, but before we finish up, I have a couple more questions for you. So Now, there’s a bunch of healthcare
providers out there. A bunch of Physicians are going, Oh my, God, I’m so glad I listened to this because I got
the symptoms. I’m feeling burned out besides going to the HappyMD.com, which was going to be a big step.
What do they do to get from? I’m afraid to tell anybody I’m afraid to admit it. To I have to reach out Dr.
Drummond How do they go from that point to that point?
Dr. Dike Drummond (31m 55s):
Oh, there’s a whole bunch of intermediary steps. So let’s just talk about this for a second at the act of waking
up. So here’s what I know from inside the whirlwind. I can see it as the inside the walls of the whirlwind are
and all you see any of the things that don’t work. Then when I meet somebody whose burned out exhausted,
by the way, the symptoms of burnout or exhaustion, cynical, sarcastic venting about your patient and feeling
like what’s the use to inner voice phrases. You’ll hear when you’re around, when you’re flirting with burnout
are number one. I’m not sure how much longer I can keep going like this number two.
Dr. Dike Drummond (32m 29s):
And this is a huge red flag. Maybe if I’m lucky, I’ll get hit by a car on the way to work today and I won’t have
to see patients. So be on the lookout for those. But here’s what I’ll tell you when you’re stuck in this trap of all
the stuff that sucks about your practice, you really know what you hate, but you know what? This is a word to
live by. You can avoid everything you don’t want and you still won’t get what you want. Cause the only way to
get what you want it’s to decide what that is and go get it.
Dr. Dike Drummond (33m 0s):
And these are almost opposites of each other. You can figure out what you want, starting with what you don’t
want, but their not the same thing. So what I try to get doctors to do is to wake up a way of looking at life that
was beat out of them in their education. And that’s the word satisfaction. So if you want to do the exercise
with me, it’s very easy. You take a big deep breath and let your mind and your energy just wander back
through the last couple of weeks of your practice on a scale of zero to 10, what’s your level of satisfaction
with your practice, whatever your practice is.
Dr. Dike Drummond (33m 36s):
What’s your level of satisfaction are over the last couple weeks or so the zero to 10. What’s your number
two. The second question is, OK, what’s your number or how do you feel that that’s your satisfaction number
with your practice? Are you okay with it or is it a distressing to you? What I find is anything less than about a
six or a seven is felt as some level of distress. If your down to three For you’re hurting, right? And if things
don’t change your days are probably numbered in that particular position. OK.
Dr. Dike Drummond (34m 7s):
So to start with satisfaction, okay. Not am I burned out? How satisfied am I? Then what I want people to do
is to start, and this is a process. It takes a while to wake up. Cause it’s been asleep for a very long time to
write the down on a piece of paper, my ideal practice description. And then just start to write down over the
next couple of weeks, the pieces of your practice you would like to see in an ideal world, if you were the
boss, if you were the King of the forest, if you had a magic wand, what are the things that you would run
toward, not run away from one of the things that you would run towards if they are available to you.
Dr. Dike Drummond (34m 45s):
And what you’ll end up with is a list of the kind of things you have in your dream practice. This list might’ve
come from as far back as the light worker’s fork on the road, where are you imagined what it was like to be a
doctor. And at that point, what you can do is you can actually create a Venn diagram in your head. If I know
what my ideal job description is, and I imagine what that would feel like, and I know what this practice feels
like. I can create a two circle Venn diagram compare my ideal practice to this practice of that’s a Venn
diagram, how much overlap is there between those two circles right now.
Dr. Dike Drummond (35m 20s):
And it tends to correlate in percent. It tends to correlate with your satisfaction score. So as soon as it says,
my satisfaction is a two, this overlap and the Venn diagram is gonna be about 20%. It’s just an association
I’m seeing if you’re satisfaction, seven is going to be about 70%. And then the question is okay, if I we’re
going to make this practice a better match with my ideal practice, what’s one little tiny thing I could change
Dr. Dike Drummond (35m 50s):
Because the reason that you Burnout is because your satisfaction and your overlap is low and you have no
sense that you can change it. This is that term loss of autonomy that people talk about, right? But you
always have the ability to get new results. If you take new actions, Einstein’s insanity trap. It’s easy to bust
out it, but if you know what direction you’re headed and in that direction, that target that bulls-eye is your
ideal practice description.
Dr. Anthony Orsini (36m 19s):
And that is perfect advice from the conversation that you need to have with yourself. Cause you gotta get
there right. And then once you’re there to say, I’m going to make some changes. Then if they need help, then
they can contact you. I was on your website. You have so many programs for Physicians. I mean, there were
so many choices. It’s for physicians who are feeling burned out or educational things. I was really very
impressed you’ve been at this for so long. And as I said, you are the go to man for this.
Dr. Dike Drummond (36m 46s):
You say that I’ve never seen anybody who said their practice satisfaction was at 10. So you can approach us
from two different perspectives. I need to work on this because I’m burning out. I’m a two or three or a four,
right? And I’m not feeling well. And I need to make a change because I’m exhausted. Or you could say, look,
I’m an eight. I’d like to be a nine and a half. This is like the Olympic athletes have more than one coach. It’s
not because they suck. Okay. Its because they want to be the best. So there’s all sorts of different reasons to
get support. And remember that Burnout is not a mental illness, depression and other things like that are
complications of burnout.
Dr. Dike Drummond (37m 21s):
And then they are not frequent, but they’re more frequent than in the general population. We’ve got all sorts
of self study and books and all sorts of things. That’ll help you turn this around by identifying what you really
want and heading in that direction.
Dr. Anthony Orsini (37m 34s):
And that’s fantastic. I just want to say thank you. I mean you’ve fulfilled both my promises and so I’m really
happy. I think there are people out there that are inspired right now that they can do something. If they’re
feeling down, if their feeling burned out, they now know what to do. And I think you’ve helped them to have
that conversation with themselves and how to get there. And I think it’s so needed right now. We talked
about the physician suicide rate. We need to make medicine a better place. We need to bring it back to
where physicians and nurses are happy to be, where they are.
Dr. Anthony Orsini (38m 5s):
We need to bring, I know nobody’s ever said a 10, but it’s a great goal, right? That’s what your here for it.
Let’s push that. Every doctor says that my practice has a 10. I want to thank you so much for being on here.
If anyone wants to get in touch with Dr. Drummond, please don’t hesitate. He’s a very easy to speak to as
you can see. And that’s the best way to contact you is through the HappyMD.com, right?
Dr. Dike Drummond (38m 27s):
HappyMd.com and there’s the contact form there. Just blast me a contact request or just look at all the
different self study courses that we there, and your welcome to
Dr. Anthony Orsini (38m 36s):
Join us at any one of those experiences and look for his podcast Physicians on Purpose get ready to dive to
that is coming up. I can tell you its a blast to have once I highly recommend and I love it has a warning. It’s a
lot of work, there’s preparation and there’s audio and there’s the whole thing, but it’s definitely worth that. I’ve
met some great people on a very short period of time, including you so, I want to say thank you again.
Thanks for being here. If you loved this podcast, you like this episode, please go ahead and hit the subscribe
and download and tell your friends about it.
Dr. Anthony Orsini (39m 7s):
Share it on social media. If you want more information about the Orsini way, you can reach us out the Orsini
way.com. It could also email me for that, but again, go ahead and hit subscribe and we’re going to be
dropping a new episode every single Tuesday. I will let you know Dike when this will air, it will probably be in
about a month or so. And then you talked about that picture behind you. So when we’re done and we signed
off, I’m going to take a screenshot of you in that picture. We’ll go ahead and put that on social media
because I think everybody’s going, I really would love to see this picture.
Dr. Anthony Orsini (39m 37s):
You’re quite the artist there.
Dr. Dike Drummond (39m 37s):
Let me say, let me say to that, this basic understanding of the difference between what you don’t want in
what you want. We built on top of that. We have 235 different tools that can help. So there’s plenty more
conversation to be had here on passing what we love to have you on it again.
Dr. Anthony Orsini (39m 54s):
So, but in the meantime, thank you so much again, thank you for being on this podcast and I hope we’ll
speak soon. Thanks.
Announcer (40m 0s):
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Orsini and his team or to suggest guests for a future podcast, Visit us at the Orsini Way
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