Difficult Conversations Podcast
Lessons I Learned as an ICU Physician
Episode 129 | February 2, 2021
Connect And Be Heard
Dr. Kevin Pho
Physician, Public Speaker and Author
Welcome to Difficult Conversations with Dr. Anthony Orsini. Today, my special guest is Dr. Kevin Pho, a board-certified practicing internal medicine physician, nationwide media commentator and author. If you’re in healthcare, you likely know about his website, KevinMD, which he built from scratch in 2004 and now receives 3 million visits per month. Dr. Pho has been named the web’s “Top Social Media Influencer” in healthcare and medicine. The New York Times called KevinMD “a highly-coveted publishing place for doctors and patients.” Forbes called KevinMD “a must-read health blog.” And CNN named @KevinMD one of its five recommended Twitter health feeds. As a highly sought-after keynote speaker, Kevin shares his story with both clinicians and non-clinicians. His signature keynote, “Connect and Be Heard: Make a Difference in Health care with Social Media,” takes the audience through Kevin’s social media journey since 2004. With video, audio, and an emphasis on storytelling, he inspires audiences to use social media and be healthcare influencers.
Dr. Kevin Pho tells us about himself, his journey, and why he started KevinMD. We learn how the idea of KevinMD came about, which started with his blog. He tells us about the percentage of KevinMD visits from patients and non-clinicians and he makes a point to say there is a tremendous thirst for health knowledge since healthcare is the third most popular use on the web. Dr. Orsini and Dr. Pho discuss how there is a lot of “false information” out there on websites, and how doctors need to guide patients to reputable sources of heath information. We learn about Dr. Pho’s take on the future of social media. One of Dr. Pho’s keynote speaking topics is physician and nurse burnout, he tells us his views and gives advice. Dr. Orsini talks about the lectures he has about burnout and using certain communication techniques can reduce burnout. Dr. Pho shares helpful advice for doctors who want to say they’re passionate about something and they want to get into something else. We end with Kevin telling us the most difficult conversations which he has encountered and shares advice on how to navigate through these difficult conversations. If you enjoyed this podcast, 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. Kevin Pho (0s):
Social media while blogs at that time had really the power for us to extend our influence, extend our voice outside of the exam room, where doctors can, instead of traditionally talking one-to-one to patients in the exam room, we now could talk one to many. And I think that idea has only snowballed over the past few years because we have these really influential platforms for better or for worse. And we’re going to be talking about some of the downsides of that, but I think that that influence is something that I’ve been talking about for the last 15, 16 years and how it’s really important for physicians to really get online and use these platforms to influence patients outside the exam room.
Welcome to Difficult Conversations: Lessons I learned as an ICU physician with Dr. Anthony Orsini. Dr. Orsini is a practicing physician and 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 field who tell their story and provide practical advice on how to effectively communicate. Whether you are a doctor faced with giving 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 this is the podcast for you.
Dr. Anthony Orsini (1m 28s):
Well, I am honored today that The Orsini Way has partnered with the Finley Project to bring you this episode of Difficult Conversations: Lessons I learned as an ICU physician, the Finley Project is a nonprofit organization committed to providing care for mothers who have experienced the unimaginable, the loss of an infant. It was created by their founder, Noelle Moore, whose sweet daughter Finley died in 2013. It was at that time that Noelle realized that there was a large gap between leaving the hospital without your baby and the time when you get home that led her to start the Finley Project. The Finley Project is the nation’s only seven part holistic program that helps mothers after infant loss, by supporting them physically and emotionally.
Dr. Anthony Orsini (2m 11s):
They provide such things as mental health counseling, funeral arrangements, support, grocery gift cards, professional house cleaning, professional massage therapy and support group placement. The Finley Project has helped hundreds of women across the country. And I can tell you that I have seen personally how the Finley Project has literally saved the lives of mothers who lost their infant. If you are interested in learning more or referring a family or donating to this amazing cause please go to the Finley Project.org. The Finley Project believes that no family should walk out of a hospital without support. Well, welcome to another episode of difficult conversations lessons I learned as an ICU physician.
Dr. Anthony Orsini (2m 51s):
This is Dr. Anthony Orsini. You guessed it, I’ll be your host again this week today, we have a very special guest and the audience is really in for a special treat today because my guest today is Dr. Kevin Pho. Dr. Pho is a Practicing board, certified internal medicine physician, a nationwide media commentator, and coauthor Of the book establishing, managing, and protecting your online reputation, a social media guide for physicians and medical practices. He has been a leader in healthcare, social media since 2004. And if you are a healthcare professional, you likely know about the Kevin MD website, Dr. Pho built the Kevin MD platform from scratch in 2004, and now receives over 3 million monthly paid views and exceed 250,000 followers on Facebook and Twitter.
Dr. Anthony Orsini (3m 42s):
Kevin has been named the Web’s top social media influencer in healthcare and medicine. The New York times called Kevin MD, a highly coveted publishing place for doctors
Dr. Kevin Pho (3m 53s):
And patients, Forbes magazine
Dr. Anthony Orsini (3m 54s):
Called Kevin MD, a must read health blog and CNN named @Kevin MD. One of its five recommended Twitter health feeds as a highly sought after keynote speaker. Kevin shares his story nationwide with both clinicians and non-clinicians. His signature keynote connect and be heard, make a difference in healthcare with social media takes the audience through Kevin’s social media journey since 2004, with video audio and an emphasis on storytelling. He inspires audience to use social media and be healthcare influencers. These perspectives define his unique social media journey, and the story has brought audiences to their feet.
Dr. Anthony Orsini (4m 35s):
So welcome, Kevin, I’m excited to have you as a guest this week, and I’m sure my audience is in for a real treat.
Dr. Kevin Pho (4m 40s):
Thank you so much for having me on the show.
Dr. Anthony Orsini (4m 44s):
So one of the things I stress about teaching communication to healthcare professionals and business leaders is that to be a true leader and build a trusting relationship, you must be a genuine person. So what I mean by that is that in order for patients to trust us, they must first think of us as real people and they have to get to know us. And I go through some exercises on how to share personal information with patients so that you you’re a real person. It’s also important for leaders when they’re trying to be good leaders for their employees.. So if you don’t mind, let’s just take a moment to tell my audience who Kevin Pho is. Tell us a little bit about yourself, your journey, and how you got to where you are with the Kevin MD website.
Dr. Kevin Pho (5m 28s):
Sure. I’m an internal medicine physician. I practice in Nashua, New Hampshire. I’ve been here for almost 20 years now. I trained at Boston university, so not too far from here. And I still practice. I see patients two and a half days a week. And as you mentioned, I’m also the founder of Kevin MD, which I founded back in 2004. And what that is, is a platform on Kevin md.com, but also on Facebook, Twitter and LinkedIn, where people across the healthcare spectrum can share their stories. And I often say, it’s, we hear the stories of those that we don’t normally hear from in the healthcare world.
Dr. Kevin Pho (6m 7s):
Because a lot of times when patients think about their doctors, they think about doctors making a lot of money. They don’t think a lot about some of the issues and obstacles that doctors have when we’re treating patients. So I want to have a platform where doctors can really share those stories behind the curtain that they talk about things like physician burnout. We talk about things like student loans. We talk about healthcare reform, and of course over the last year, we talk about the trials and tribulations of the coronavirus and COVID-19, and the effects of the pandemic has on the medical profession. And now we talk about the vaccine and although my audience and my writers are primary clinicians, I also have a lot of non-clinicians as well.
Dr. Kevin Pho (6m 51s):
I have nurses, I have respiratory therapist, physical therapist, and of course I have patients as well, because just as it is important for patients to hear what doctors are going through, I think it’s important for physicians to hear what patients are going through as well. Because a lot of times we’re insulated from a lot of the hardships that patients are going through. So my goal over the last, how many years has it been? It’s been almost 15 years of doing this is really to bridge that gap between doctors and patients and having a platform like Kevin md.com. And of course the various social media platforms that extend out of that, it’s an ideal medium for those conversations to happen.
Dr. Anthony Orsini (7m 31s):
So take me back. The reason why I went into communication training is I really had a profound moment during my training when I witnessed physicians struggle to give bad news. And that kind of sparked way back when I was a neonatal fellow, this interest on how do we teach doctors, how to communicate. So I can point to a moment in time where I said, this is where I’m going to go with my career. Was there something leading up to starting Kevin MD? Or how did the idea of Kevin MD really come into play?
Dr. Kevin Pho (7m 58s):
Well, I could lie and say that I had a plan for the very beginning to be what it is today. But back when I started in 2004, I think very few physicians had blogs. I think blogs were just entering the vernacular and it was something that I started because one of my family members said, Kevin, do you have a lot to say about health care? You know, you should start a blog. So I started one a blog, or I wrote a few articles and I wasn’t really sure where this was going to go. I didn’t really appreciate the applications that might have, but I think there was one time back in the early two thousands, there was that anti-inflammatory Vioxx and it got pulled from the market because of some cardiovascular risk. And at that time we had a lot of patients on Vioxx.
Dr. Kevin Pho (8m 40s):
And I remember writing an article about that, about what patients could ask their doctors about what are some substitutes and what patients should do if they’re on that medication. And I didn’t really think much of it. It was just my commentary and opinion. What happened a few days after I wrote that article, I remember walking into the exam room and I walked in and that’s the first thing that patients said to me. I read your blog post this morning, and I was really comfortable what you had to say. And now I realize I have other options other than vioxx. And I realized that time, that social media, while blogs at that time had really the power for us to extend our influence, extend our voice outside of the exam room, where doctors can, instead of traditionally talking one-to-one to patients in the exam room, we now could talk one to many.
Dr. Kevin Pho (9m 28s):
And I think that idea has only snowballed over the past few years because we have these really influential platforms for better or for worse. And we’re going to be talking about some of the downsides of that, but I think that influence is something that I’ve been talking about for the last 15, 16 years and how it’s really important for physicians to really get online and use these platforms to influence patients outside the exam room. Because as we both know that patients are getting this information anyway, and there’s a whole misinformation pandemic that’s going on. And I think it’s really up to us in healthcare to really get online, use these platforms and connect with these patients and direct them to reputable sources of health information.
Dr. Anthony Orsini (10m 7s):
I’ve been a fan of Kevin MDs for awhile while I had known about it for a long time. I visited frequently. Recently I submitted a contributing article. I was excited when you accepted it. And then I was really honored when you interviewed me for your podcast. So, but I was really excited when you agreed to come on to this podcast because Kevin MD is all about conversations, as you mentioned. And I think that in medicine right now, there are not a lot of ways that physicians can speak to each other and get information, but I’m also really concerned with a lot of websites out there and a lot of the ways that patients get information.
Dr. Anthony Orsini (10m 46s):
And it’s a great way for patients to really go on and see how doctors are thinking, what they’re saying. What percentage do you think of the Kevin MD visits our patients? And non-clinicians,
Dr. Kevin Pho (10m 58s):
I would estimate about a quarter, perhaps are non-clinicians and that’s to expand on the point that you mentioned. I think I read an article just a few weeks ago is that I think one third of people get most of their news from Facebook. And we’re not just talking about health news, but just their news in general, if you look at some of the data from the Q research and they estimated that people going online to look for health care is a third most popular use on a web. So there’s a tremendous thirst for health knowledge. And I think a lot of that is part of our own doing as well. It’s, it’s very difficult sometimes to talk to a physician. And I think the medical profession, we need to do a better job at being more accessible, because if we aren’t assessable, patients are going to go elsewhere for the health information and that’s happened to their own detriment.
Dr. Kevin Pho (11m 46s):
If you look at the whole problem with the false connection between vaccines and autism, for instance, I think a lot of that has been propelled by social media because you have all these anti-vaccine activists, they know how to do search engine optimization. They know how to gain the YouTube and Facebook algorithms. And they’re light years ahead of us in a medical profession. And that lead time has caused a tremendous amount of damage because they can now propagate false information online. And patients are just exposed as information without any interpretation and take it at face value. And I think that we have a lot of catch up to do regarding that.
Dr. Anthony Orsini (12m 25s):
And a lot of physicians I falsely or incorrectly I think will encourage their patients not to go on the internet. I think there’s a problem with that. Twofold. One is it’s not going to happen anyway, no matter how much you tell them not to go on the internet and get their information, but two, this is all about trust. So the main theme I would say that has come through me doing this podcast since August now, and we’ve fed over 10,000 downloads and every week, whether we’re discussing business or healthcare, the word trust comes in over and over again. And during my workshops, that’s exactly the word that I use is that you have to, as a physician and we, as physicians are not taught how to communicate as you know, in medical school.
Dr. Anthony Orsini (13m 8s):
And if we’re taught how to communicate, it’s more about information. This is how you do it, history and physical. This is how you do a review of symptoms, but they don’t say this is how you bond. And so this is all about trust. And so I encourage physicians to say, listen, I know you’re going to go home and you’re going to look this up on Google. Google’s become a verb, right? You’re going to Google this. Here’s some really good websites or whatever website you go to you and I trust each other. We have a great relationship. Let’s actually talk about it afterwards. And one of the techniques we use for communication is I always tell physicians, when you give a diagnosis, many physicians will say you have cardiomyopathy, and this is what it is.
Dr. Anthony Orsini (13m 53s):
And one interesting thing, what happens when you say the word cardiomyopathy, you instantly see the patient on the other side, their eyes go up and what are they’re doing? They’re trying to figure out how to spell it. And they’re trying to remember it because they can’t wait to go home. So one of the techniques we teach doctors is to say, you have a disease of your heart called cardiomyopathy, and I will write that down for you when you’re done. Because by doing that, you’re basically bringing their attention back to you. And so having websites, I guess my point, I mean, websites with such as Kevin MD, that you can say, listen, here’s a list of websites, which I think are really great because you’re exactly right. You look up immunizations or vaccinations. There’s all kinds of false stuff out there.
Dr. Anthony Orsini (14m 35s):
Dr. Kevin Pho (14m 36s):
That’s absolutely true. And if you Google that you get a lot of false information. Although we’ll talk about this later on about how platforms I think are now taking responsibility. They’re starting to realize the power of their platforms, and they’re starting to prioritize reputable health information. They’re starting to de platform false actors or actresses that spread false information, but it’s taken a pandemic really for them to act. This has been going on for 15 years now. And this is something that I’ve been trying to advocate for years, and it doesn’t have to take a pandemic. It doesn’t have to take something as serious as that for them to really take action and take responsibility and take accountability for what’s going on in their platforms.
Dr. Kevin Pho (15m 17s):
And just to expound on what you said about patients researching online. And I think you’re absolutely right. I think rather than trying to be adversarial and telling patients not to go online and don’t trust Dr. Google, you just have to realize that they’re going to do it anyway. And we need to partner with patients and we need to guide them to reputable sources of health information. And if they come to us and say, I read this on this particular website, or is this supplement, okay? We just need to tell them that this may not be reputable information. You tell them that, Hey, you know these supplements, it’s not vetted by the FDA. You don’t know what’s inside them and just partner with them and guide them to something that is reputable. You could tell them that, Hey, this website may not be reputable, but you may want to go to the CDC website.
Dr. Kevin Pho (16m 3s):
You may want to go to these hospital websites. You may want to go to these.gov websites instead. And some of them may not listen to you and that’s fine, but at least there is going to be a proportion of patients who will listen and say, Hey, next time I Google this stuff online, I’m going to remember what my doctor said about whether this is reputable or not. So rather than trying to encourage them not to go online partner with them. And that’s really my philosophy when it comes to doctor patient relationship, I think we do need to be partners and we need to be more guides. And I think that’s certainly a shift from medicine back to yesteryear when there was a more of a paternal relationship right now is I think we’re more guides for our patients.
Dr. Anthony Orsini (16m 42s):
And you discussed being a leader in social media. Let’s talk about, cause we brought it up a couple of times already today. Let’s talk about what’s going on without getting too political with social media. Now, censoring different websites, as you said, it’s a good thing. Sometimes it’s a slippery slope other times. Are you concerned about the future of social media, where you have someone who may not even be a medical clinician, who’s censoring what you’re saying or what someone else is saying?
Dr. Kevin Pho (17m 9s):
So I think the thing with social media is things are evolving so, so quickly. In terms of its ramifications, I can’t predict what’s really going to happen in the next year, let alone six months. I think that the fact that social media platforms and we talked about things like Twitter de platforming, Donald Trump, and you think about Facebook and YouTube, they’re also involved in de platforming. Should they be also D platform purveyors of false information? So I think that’s a question that we need to discuss. I know that whenever there’s false medical information regarding COVID, if you go on Facebook, they specifically say this is false information and go to this website instead.
Dr. Kevin Pho (17m 49s):
I think the issue is that a lot of these platforms they’re trying to do it algorithmically. They’re trying to curate information and they’re trying to find what’s false information, just algorithmically and the robots and machine technology. And sometimes I think with healthcare, I think it’s a little bit more nuanced than that. I do think that there needs to be a human curation component to it. And I know that’s going to take a lot of people power for that to happen. But I think that’s something that we need to do, especially with Facebook. Facebook is certainly so influential. You have billions of people on Facebook. And as I mentioned in that study before a third of people get their information from Facebook. So I do think that needs to be some human curation component rather than outsourcing.
Dr. Kevin Pho (18m 29s):
I know that Facebook, they try to outsource all their curation to these third parties and they try to shift responsibility away from Facebook itself. But I think that more resources need to be done in terms of curation and something that’s obviously harmful, for instance, anything that’s anti vaccine or anything that perpetuates the false connection with anti-vaccine and whether they need to be de-platformed I think that needs to be seriously considered because from a medical standpoint, from a physician point, it really makes our work a lot harder. When you have patients come in and they express doubts about vaccines that are proven to be safe, proven to be effective like MMR vaccines and the vaccines that should be without any scientific question.
Dr. Kevin Pho (19m 12s):
And I think that we need to have a discussion about whether people who spread false information against such a public health good need to be the de-platformed or not.
Dr. Anthony Orsini (19m 21s):
But it really comes back to the word again, trusting relationship. If you have a trusting relationship with your doctor, I get this all the time. I mentioned this in a previous podcast, someone will say to me, I went to my doctor. He was a cardiologist. This is what he told me. But then I read on Google about this, and they’re asking me, I’m in neonatologist, It’s about a cardiology problem, which I’m not qualified to speak about. And my answer is almost always the same. You either trust your doctor or you don’t, and you need to find someone that you trust. And of course, you’re always going to have control of your own healthcare, but if you have a trusting relationship with your doctor, you’re going to trust them. And I do the same thing as a physician. If I’m going to an orthopedic surgeon for a hip replacement, either I’m going to trust them, or I’m not going to second guess them.
Dr. Anthony Orsini (20m 5s):
And you know, as a physician, I get second-guessed all the time. I’d rather do this. I’d rather do that. But it’s also about the relationship with your trusted websites. And so that’s why I think Kevin MD is such a great platform for non-clinicians to visit because everything there is legitimate and you can trust and have a trusting relationship with the website. Let’s move on to your keynote speaking because you do a lot of that. I do that also. I love it. There’s nothing to me, more fun than standing in front of an audience and giving a keynote. But some of the topics that you discuss, we listed one topic I want to discuss today that we’ve discussed in other episodes before is physician burnout.
Dr. Anthony Orsini (20m 52s):
I don’t know if the average patient understands the healthcare crisis that we’re in right now between physician and nursing burnout. And I know you speak about that at your keynote. So tell us what your views about that are and give us some advice about that.
Dr. Kevin Pho (21m 6s):
So I think physician burnout was, has been a phenomenon even before the pandemic. If you look at the studies before COVID-19 hit, almost half of doctors experienced symptoms of burnout. And a lot of it is because that we’re losing control of the profession. You talk to a lot of doctors. I think one of the biggest reasons they feel burned out is that they don’t feel that they have any control in terms of what they do. They’re told by higher powers, corporate powers that they have to see more patients. They have to see more patients in less time. They have these electronic medical records foisted on them. And it just adds time. I think there was a study where for every hour we saw patients, we spent another two hours on a computer doing charts. And I think that we’re just losing a lot of control in our profession.
Dr. Kevin Pho (21m 47s):
And I think to me, that is the biggest driver of burnout. You go into medicine, you want to see patients, you want to develop that trust. As you said, you want to spend time with patients, especially in primary care, you want to sit with them. And I think that’s the only way really to garner trust is really spend time with patients, but really all the forces that medicine over the last five, 10, 15 years really is against that, where we’re based on these metrics, where based on how many patients we see, in fact, a lot of our compensation is based on productivity, right? The more patients to see the more RV use relative value units you earn and that your compensation is based on that.
Dr. Kevin Pho (22m 27s):
So all the incentives is really towards quantity and productivity. And I think that certainly leads to burnout. And now you have COVID-19 in addition to that, and you could only imagine the added stress that’s placed on frontline clinicians. I think early on, back in last March, April, you had doctors speaking out about the lack of personal protective equipment. And for those, you heard news stories about these doctors who spoke out or wrote on social media, they got fired for speaking out. So I think that there’s that added stress. So not only are you on the front lines dealing back then, which was an unknown pandemic, you’re not given the proper protective equipment you get fired for speaking out, and you have all those stresses added to the burnout that was already present before the pandemic.
Dr. Kevin Pho (23m 13s):
So I think that it’s something that I certainly highlight on my site. I don’t think a lot of patients know about physician burnout. They think about doctors. And first of all, let me just say, patients are also going through tremendous hardships as well. It’s very difficult to be a patient in the United States healthcare system. And a lot of patients themselves of course, are going through tremendous hardships during this pandemic as well. But one of the things that I do want to emphasize is that it shouldn’t be an us versus them thing. And that’s one of the things I talk about my keynote is that doctors and patients really should be on the same page because if doctors are burnt out, if they quit medicine, if they go part-time, if they leave medicine, because they’re burnt out, really who’s going to see patients.
Dr. Kevin Pho (23m 53s):
So I try to frame burnout, not only as a physician issue, but a patient issue as well, patients should care about physician burnout, because if there is a doctor to see them, then it’s not going to help patients at all. So that’s one of the ways I try to frame burnout and try to get patients to care about some of the things that we go through. So whenever I have stories on my side about some of the ordeals that physicians are going through, some of the pressures that they’re facing and some of the reasons why they’re burnt out, I don’t hesitate and put that on my site. And, and these stories are very visceral. They’re tremendously powerful. And I get emails from patients all the time saying, I didn’t realize what you guys are going through. And just having that empathy from patients about what physicians are going through.
Dr. Kevin Pho (24m 36s):
I think if we could change a few minds and hopefully get us on the same page together, that’s going to affect some change.
Dr. Anthony Orsini (24m 42s):
And when I give lectures on burnout as well, a lot of it has to do with, you could be in business. It doesn’t have to be physician burnout. When you enjoy what you’re doing and you leave home satisfied. It doesn’t matter how hard you work. I mean, we know entrepreneurs like you and other business leaders, they work 12, 15. My wife’s a realtor. She works 18 hours a day on the computer. But when you enjoy what you’re doing, you’re going to decrease burnout and you hit the nail right on the head as physicians, I had Dike Drummnd on who’s one of the leading experts in physician burnout early on. And he talked about how physicians spend their whole life looking for control. But you’re a lowly college student who can’t go out to party because you have to get straight A’s and then you’re in medical school and you can’t do anything cause you have to get straight A’s and you say, but one day I’m going to have my own practice.
Dr. Anthony Orsini (25m 29s):
I’m going to be in control. And then you go through residency and you’re the low man on the totem pole. And then all of a sudden you get to be a physician and you find out that you’re being told what to do by hospital administrators and by insurance companies. What I try to do is try to remind people why they went into medicine in the first place. And I think that’s where that genuine and that conversation comes into play. And if we can use certain communication techniques to, for you and I as a patient in a, with our patients, if we can come up with certain techniques where we can have a laugh and we can bond real quickly and still be out of there and not too much time, then it’s a win-win situation.
Dr. Anthony Orsini (26m 10s):
But physician burnout is a crisis. And I’m glad that you’re bringing light of that to that, because it’s also a dangerous thing, right? So physicians who are burnt out, don’t perform at the level that they’re supposed to. So we have to bring medicine back to that human to human interaction that is so important and that all starts out with communication. So I think that’s a real topic that we need to really delve into more and more, and I’m glad your website is bringing it into that. So thank you for doing that. What advice do you have? So you’re really an entrepreneur. I just mentioned that. So I’m seeing more and more physicians maybe it’s because of burnout, I’m seeing more and more physicians looking I don’t want to call it a side gig because people like to call that. I don’t think that’s a good thing.
Dr. Anthony Orsini (26m 49s):
I’m doing that with this podcast. And with my workshops, I’m seeing more and more physicians saying, I need an exit strategy. Now, yours wasn’t because of an exit strategy because you’re still young. But what advice do you have for doctors who want to say, I’m passionate about this and I want to get into something else.
Dr. Kevin Pho (27m 4s):
So I wouldn’t call it an exit strategy. I think that it’s so important for physicians to have a passion outside of medicine. Now let me say, if you’re passionate is clinical medicine, then by all means be 100% involved in your profession. But for the majority of doctors, they don’t be defined by medicine because you don’t want to be defined by what you do. You want to be defined by who you are. You want to be remembered as a good husband, father, wife, mother. You want to be defined as the person you are because physicians, no matter how hard you work, you can always be replaced. So he’d been working for 30 years at a hospital and you could put your blood, sweat, and tears into that job.
Dr. Kevin Pho (27m 45s):
And to the hospital, you could just be easily replaced by the new graduates. So I see a lot of doctors who may not be 100% invested or 100% passionate about what they do. And they work 80, 90, a hundred hours per week. They will do this for 30 years and the hospital lays them off because not enough revenues are coming in because of the pandemic. So to the hospital, that’s an easy decision. So I think it’s important to have a passion outside of medicine. So you talk to a lot of physicians who want something outside of medicine. And for me, it, of course happens to be social media has to be speaking during a pandemic. I actually got furloughed because a lot of primary care doctors got furloughed because of decreased revenue. And I wasn’t able to speak, obviously because of the, we weren’t able to travel because of the pandemic.
Dr. Kevin Pho (28m 28s):
So what I do, I started a daily podcast. It was something that I had a time to do. And it’s something that I’ve been wanting to do. I did some research and it does take a lot of time to do a podcast, but it’s tremendously rewarding, but it’s something that I was passionate about. So I do encourage physicians to have that passion outside of medicine. And if you could make some money from it, I think all the more reason why that’s good, because you don’t necessarily want to 100% rely on what we call your W2 job, your job within medicine, because that can go away in an instant. So if you could have another leg on the stool that can support you where you can cut down and it doesn’t have to be social media.
Dr. Kevin Pho (29m 9s):
We have a lot of doctors who are interested in investing in real estate. They write books, they do online courses. There are dozens of ways where physicians can leverage their MD degree to make an income outside of clinical medicine. And if that income allows you to cut down a little bit on your clinical responsibilities and reduce them on a burnout, ironically, that’s going to make you stay in medicine a little longer than you ordinarily would have, because there are so many doctors who don’t have these proverbial side gigs, and there are 100% invested in what they do. And they get burnt out to leave medicine earlier. And you contrast that with a physician who may be only working 75% clinically, they’re happier.
Dr. Kevin Pho (29m 49s):
They have something else outside of medicine that they’re passionate about and they end up staying in medicine longer. So from a patient standpoint, you want the physician who stays in medicine longer. You’ll want the physician who is less burnt out, because as you said, when a physician’s worn out they actually make more medical errors. So I definitely don’t want to shy away from having passions outside of clinical medicine. I think that the days where the physician does medicine and only medicine for 100 hours per week are over, I think for physicians to survive these days, we do need to have an interest, a passion. You could call it entrepreneurial spirit.
Dr. Kevin Pho (30m 30s):
You need to have some way of alleviating some of the burnout that is associated with being in medicine all the time. And if you could make money from that and be less reliant on your W2 job, I think that is definitely helpful going forward.
Dr. Anthony Orsini (30m 42s):
Yeah. I love what you said. I tell my kids that all the time when they were growing up, what you do is not who you are and that’s really important. And physicians get caught up in that many times. It’s you know who you are, I’m a physician. No, you may practice medicine, but you have other skills. The other thing I would say that I totally agree with is for someone who does a lot of workshops, a lot of lecturing and has the podcast and does patient experience stuff. I find that that makes me so happy that when I go to work to see babies and take care of the neonates, I think it makes me a better physician because I’m happier. I have variety in my life, which I’m sure you could agree with.
Dr. Anthony Orsini (31m 25s):
And that when I come back to see those patients and I’m still full-time actually, but I come back and see those patients. I really am in the moment. And I think it just makes me better. And especially when it’s something you’re passionate about, I said on other podcasts, sometimes you feel like you have this thing to teach and you want to stand up on a top of a roof and say, I found the secret. Let me just tell you about it. And so this podcast has been a way of doing that and I couldn’t agree with you more. So, Kevin, as we’re getting to the end, I think I warned you about this. I ask everybody the same question and all my guests tell me that it’s the most difficult question that I’ve asked them, but the title of this podcast is difficult conversations.
Dr. Anthony Orsini (32m 7s):
And so I’m going to ask you what I ask every other one in medicine, in your personal life, what do you think are the most difficult types of conversations that you need to have? And what advice can you give my audience about how to navigate through those really difficult conversations?
Dr. Kevin Pho (32m 24s):
I think of two examples. And I think to me, when people have difficult conversations, what does that really is? People have a fundamental disagreement with what you say and what you believe in. So there are two instances where I think that happened. I think one was after I was giving a keynote and there was a keynote to primarily a patient advocate audience. And I was giving what I said before about how we need to get doctors and patients on the same side. And in order for us to make any changes in healthcare, whether it’s to alleviate burnout, whether it’s to give more time to primary care doctors, physicians, themselves, can’t do it. We need patients on my side. And I think that after that keynote, I remember a group of the audience member came up to me and kind of vehemently disagree with what I said.
Dr. Kevin Pho (33m 8s):
And I think they believe that doctors were in it for the money. And a lot of primary care doctors just churn through more patients and we want to do it to bump up our incomes. And in that instance, no matter what I said, I really couldn’t. All I could say is that that’s not true. I think we were on your side and we would like nothing more to spend more patient, but there are forces above what we can do. It’s not like we can magically conjure up more hours in a day to do do what we do. The second incident was my thing related to, I think what I said before in terms of having a passion outside of medicine. And I think I did talk to a physician who did believe that, you know, medicine should be 100% all in and physicians who are part-time, they’re just wasting their degrees and physicians who go into social media.
Dr. Kevin Pho (33m 56s):
Again, it’s a waste of the degree. They had no use for that. And again, I was sharing my story and really talking about what we talked about today in terms of it’s better to have someone who is part-time clinical medicine, but lasts longer than someone who is a burnt off physician full-time. But again, he would have none of that and basically said, I was like wasting my degree. So I think in both of these disagreements, I think that I always believe that when you have a general audience, I always divide it up into thirds. So I think that there is a third of people who will always agree with you, no matter what you say, I’m really passionate supporters of you.
Dr. Kevin Pho (34m 37s):
And I think there’s a third of people who actually won’t agree with what you’re saying. We see that of course, online, very polarized environment that we live in. It’s very difficult to change some people’s minds, no matter what you say. And of course there’s that middle third, right? Who can kind of be persuaded either way. And I always tell fellow physicians whenever, especially when they’re online, there’s a lot of disagreements, very polarized online is that you don’t necessarily want to speak to your supporters because they already agree with what you say. You don’t necessarily want to speak with people who cannot be convinced because no matter what you say, they’re always going to be entrenched in their beliefs, but it’s that middle persuadable third that I think that you want to speak to.
Dr. Kevin Pho (35m 18s):
So in these two instances, when I was talking to people who disagree with what I said, or I struck a nerve with what I said, I didn’t expect to really convince all of them. My job really isn’t just sway everyone to think the way I do. But if there were like three people there and if I could maybe have one of them, think twice and maybe change their minds, even to me, that’s a success. So I think that’s really the lesson that I want to give is that whenever you’re online or whenever you’re trying to influence someone, when you’re trying to persuade someone, your goal isn’t to persuade 100% of the audience that you’re talking to. I think your goal is to maybe make a third of the people that you’re talking to just think twice about what they believe in going in.
Dr. Kevin Pho (36m 2s):
And if you could make that proportion of people, think twice, I figured my job is a success.
Dr. Anthony Orsini (36m 7s):
Boy, with the political climate that’s going on right now that’s great advice. I mean, I wish our politicians would take that advice and stopped just speaking to the people that like them and against the people that disliked them and started speaking to the middle. Maybe you should be running for Congress someday. So, but that is a great way to end because that’s just fantastic advice. Kevin, I want to thank you for your time. This has been really great. I think the audience is going to be fascinated. We’ll put all your contact information on the show notes, but everyone should just contact you through Kevin MD?
Dr. Kevin Pho (36m 40s):
Yes, that’s correct.
Dr. Anthony Orsini (36m 40s):
Okay, great. So thank you so much. If you enjoyed this podcast episode, please go ahead and hit subscribe. If you want to find out more about The Orsini Way, please go ahead and go to our email@example.com. It has been an absolute pleasure to have you Kevin, thank you so much. And hopefully, and I will continue to visit Kevin MD as I always have. And hopefully my audience will too. So thanks. Thank you so much.
Dr. Kevin Pho (37m 3s):
Thanks for having me on.
Dr. Anthony Orsini (37m 4s):
Well, before we leave, I want to thank you for listening to this episode of difficult conversations lessons I learned as an ICU physician, and I want to thank the Finley project for being such an amazing organization. Please, everyone who’s listening to this episode, go ahead, visit the Finley Project.org. See the amazing things they’re doing. I’ve seen this organization literally saved the lives of mothers who lost infants. So to find out more, go to the Finley Project.org. Thank you. And I will see you again on Tuesday.
Announcer (37m 37s):
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Dr. Anthony Orsini
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