Success Stories

Q and A with MD

Like many young OB/GYNs, she felt that she couldn't take of her patients or herself , she faced adverse and difficult circumstances daily in he work: the unpredictability of her hours, dwindling satisfactions of patient care, the repetitive demands and stress of emergencies and disasters, and the lack of balance between her professional life and her personal life.

Yet is was precisely these problems that became opportunities, once she realized through the counseling process she undertook with Dr.Stephen Rosen at Celia Paul Associates -- that she had a bushel basket full of specific, enjoyable, transferable skills—advocacy and passion for womens’ health-care issues, leadership, quick problem-solving abilities, dependability, steady energy, seeing important tasks to completetion and follow-through, and strong motivation to deal effectively wioth emergency situations.

Once identified, these signature strengths became her assets in transforming herself (with the help of career counseling) from an overwhelmed surgeon beset by emergencies, into a hospital administrator whose responsibility it is to take apart minute-by-minute the most adverse unexpected events with horrendous outcomes that happen in a hospital, Now she analyzes and deconstructs the details of what went wrong in  order to help the hospital become and remain a high-reliability organization. She coordinates lines of communications among staffs and teams when patients transfer from one unit to another, simulation drills on the Labor floor, analysing ‘close calls’ and ‘near misses’ and how to recognize them. The systems approach to airplane and ship disasters, and how experts deconstruct the incidents, provides revealing similarities. She has made lemons into lemonade.

SR: When did you first want to be a doctor and why?

MD: When I was 14. I had taken a test at school at that time which said I should be a lawyer. I had no interest in becoming a lawyer but knew I liked science. I enjoyed my science classes and was fairly certain I wanted to do something that involved service. I also wanted something that could potentially challenge me in a lot of different ways and I thought that being a physician could do that.

SR: Did you talk to anyone at the time who was a physician who helped advise you?

MD: The role model I had was my own pediatrician who was a leader in our community, and somebody that people looked up to in a lot of different ways. I didn’t pursue medicine in high school…although I tried to do my best in school and get involved in a lot of different things with people…since... it seemed as though to get into medical school, you had to be a really strong student and have a wide breadth of extra-curricular activities. So I really just focused on that.

SR: What kind of work did your parents do?

MD: My father was a mechanical engineer and my mother was a high school math teacher and she also taught computers and was very involved in student leadership.  My mother has a lot of energy. She’s so driven. There’s a part of me that very much identifies with my mother. But there’s a part of me that’s very much like my dad. My dad likes to sit back and take it all in and listen and fix everything. He’s persistent. There’s a part of me that wants to sit back and relax and learn and listen.

SR: So when you finished your undergraduate studies, what was going on in your head?

MD: I had planned to go to medical school and applied my last year there and got into a highly-ranked ivy league medical school--my first choice.

I was so happy in medical school. I chose the school because of its diversity. There were people with different talents and different backgrounds. I really bonded with the people there and some of my best friends today are from medical school. I felt ready for medical school. I was a biochem major as an undergraduate so the classes in medical school were a little easier than they had been for me as an undergraduate. There was less pressure on me.

SR: So then comes your residency with patients?

MD: I think the more telling part was at the end of medical school when you have to choose what direction you go. I certainly felt at home with the people in medical school, as I had finally found a place where there were other people like me--people who did a lot of different things and who were talented in a lot of respects but also great students and were very driven and disciplined. When it came time to choose which specialty to go into I didn’t really know what I wanted to do. The only clerkships I went through in medical school that piqued my interest in a career were OB/GYN and Psychiatry which really surprised me.

When it came down to choosing, I had a month to decide, which isn’t a lot of time. It’s a big decision in your life. I was really undecided and with OB/GYN I felt that it would be difficult. I was wondering if the lifestyle would bother me.

Even so, there was something about the field of OB/GYN that grabbed me. I had set up a rotation early in my 4th year with an OB/GYN and he asked me to read a specific book about the field. I read it over 3 or 4 weeks and it totally grabbed me. And I really enjoyed working with the attending physician I was assigned to for one month. And when somebody in my family made a derogatory comment about psychiatry, that was it. I chose OB GYN!  But I knew I had hesitations about the field even then.

SR: Please tell us about that period of residency.

MD: The internship was particularly painful although there was a lot of growth during those years. I was pushed very hard. It was physically demanding (you are literally up and running for 36 hours in a row). It was emotionally demanding. It was intellectually demanding. It pulled me more than I had ever wanted to be pulled. Internship was one year and residency for OB/GYN was a total of four years including the internship.

SR: So, for your first job, how did you pick that?

MD: I picked it based on the geographical location, the organization, and the specific opportunity.  I left after one and a half years to join another practice with a different set-up that met my needs better.

SR: How long were you there, and how was it?

I was there for 3.5 years. Initially it was good. I loved my partners. I learned a lot from them. Our practice was a nice mix of patients from all ethnicities and many different socio-economic groups, which I enjoyed a lot. We did some teaching with the residents. We were on a labor floor, in the operating rooms, and in the clinics with them. I enjoyed working with the residents and teaching them, since it allowed me to grow more as a physician.

The practice became very busy—overbusy and I became unhappy and burned out. It got to a point where patients weren’t able to get in for appointments, patients who had abnormal pap smears who needed biopsies and follow-up and couldn’t get in for those appointments. I felt that it was very dangerous and made me feel that it was very unsafe practicing like that. Many of my colleagues felt the same. I left when six other people decided to leave.

So feeling that things were unsafe led to me taking some time to sit back and reflect about what I liked about my job and what I didn’t like.  I needed to ensure I didn’t put myself in the same position again, and to make sure I keyed in to what I did like and the skills I had gained over my first few years of working. And I didn’t want to just trash those.

SR: Can you identify those skills?

FG: I became a much better communicator with my patients--helping and listening to people. I became a better decision-maker. I became a better manager of time and of staff.

SR: So, in recognizing these skills, how did that take you forward?

FG: I don’t even know if it was my skills or that I wanted to look at my interests and what it was that really got me going in my job. What motivated me?

SR: So what got you up in the morning?

FG: I liked talking with my colleagues, and I’m also driven by the organizational structure leading to improved care for patients. The disorganization inherent in a busy practice and the lack of control over being able to lead improvements was something I felt passionate about. I liked seeing patients one-on-one in the office; in fact my practice was popular and busy, but I wanted to impact things on a broader scale also.
 
SR: So where did this all lead?

MD: It led to me to becoming more interested in the quality of care that was provided to women…what I was always interested in. ‘Patient safety’ is something that has evolved in medicine in the last decade and hadn’t really touched OB/GYN when I started looking at this. I realized it needed to. I did it at the right time. Now I feel like I’m doing some really intersting and important things.

SR: Tell us about them.

MD: I’m working on some of the most adverse events that happen in a hospital. The most unexpected things that should not have happened--errors. I look at those cases, and take them apart minute-by-minute, and look at the errors. I try to identify what the system problems are. How can we create systems to prevent this from happening again? Do we need to improve the IT systems or create better lines of communication? How do we do it? That is what I work on.

Medicine really is so complicated and so complex today. It really needs to be a high-reliability organization.
I work with a great team of people tht are forward-thinking and supportive.

SR: What did career counseling did for you?

MD: The career counseling really helped me to focus on what my interests were, and really put those together into something meaningful. On my own, I felt I was limited to either being a doctor, going into industry, or doing something completely different. I didn’t understand that physicians can do a lot of different things -- creating positions and naming what it is you want to do and then going after it. It’s easy to go after what you want to do when it’s going to medical school, or something where the path is so clearly laid out. But for most jobs in the world, it’s not clearly laid out. So it was especially difficult for me because that’s how I was programmed and how most pre-meds are programmed -- to do what they tell you to do.  The most important part of the counseling process was having counselors who were objective…having objective individuals to bounce ideas off of, and to help point me in the right direction, and to help motivate me was very helpful.

SR: Please talk about your experience with the informational gathering interviews.

MD: I had to be pushed at the time because I didn’t really know what I wanted, or what I wanted to talk to these contacts about. I was resistant to the process. I’m an introvert and shy. That’s part of why I found the clinical stuff to be so draining.

SR: So tell us more about how you felt about the process.

MD: The assessments were okay. I’m not sure how much I learned from them although doing the exercises and writing things out were helpful. You have to start there. You can’t skip over that.

SR: Please talk about the networking phase.
MD: The networking was hard because I was still working at the time. So, I really did have to set aside time that I didn’t necessarily have.

SR: Did you believe the career counseling process would help you?

MD: I believed it would help me if I took the time but at that slow pace I was doing it at the beginning was not very helpful. I knew that you needed some flow to get it moving -- to get the process going. Part of the career counseling process early on was trying to figure out if I could make my job work out. So counseling did facilitate starting to talk to my boss and my team leader about setting up my position in a different way. I needed encouragement and direction. I didn’t want to leave what I was doing -- but I wanted to become more involved in teaching or administration.

Through the networking, I was offered a fellowship at high-ranked ivy league school with research, writing, and more public health. That was very interesting and really made me think. At that point, I was nine months into the career counseling process. That really forced me to think about a huge pay drop which I wasn’t really up for. I knew it to some degree before -- but having the offer in front of me is what really pushed me to think. That’s what you need to do when you look for a job. You need to go out and get offers. Because it’s only when you get offers and are that close to getting a job that you really consider whether or not you want to do this. I had originally thought about leaving the job but was nervous about doing that because I had no fallback. I didn’t know what else I wanted to do. There were other things going on in my life that were financially prohibitive. And six months later, when things had gotten worse, I spoke to you [Dr. Stephen Rosen] and Celia [Paul] on the phone. You listened and advised that I should quit -- even though it was something that you said you hardly ever advise clients to do.

SR: How long did it take after that conversation for you to quit?

MD: Within a few weeks. My practice did offer me another position -- which I was not interested in.

SR: So would you say having people tell you that you could do something else was helpful?

MD: Very. I felt that you and Celia were very inspiring in helping me to see the different shades of gray in career opportunities, and that my job is what I make it. More often than people realize, you can create a job that’s who you are and what you want. But it takes pushing you beyond your usual boundaries.  Like, those first steps when I first spoke to my boss about trying to re-create my position, trying to shift it a little bit to my needs --which I had never done before, and I had left it up to somebody else to do the negotiating for me. So that was very helpful and a big start. It was our conversations led me to do this.

SR: So do you think you could do this all over again if you have to?

MD: I could. I wouldn’t want to for a while. It was a difficult process, as I left my job and was out of a job for nine months. Part of it was good. I needed a break and some time for myself, my family and my hobbies.   I wanted to figure something out. But, it was very hard to be structured about it, and the counseling was very helpful in that respect. The assessment exercises got me to sit down and think a little bit. Those inklings of ideas that come through when you sit and do the structured exercises--all of a sudden something seeps in a little bit differently. You make that extra phone call, or that phone interview goes a little bit better than expected, and that spurs you on to the next thing. It’s that whole building process that took a while to get into the flow during those nine months. ####