Amanda: Hey guys. Welcome back to the podcast. This is Amanda.
Laura: I'm Laura.
Kendra: And I'm Kendra.
Amanda: And today we're excited because it's part two of our interview with Dr. Kristin Yates. She is going to join us today to talk about Five Ways Your Medical Training Has Failed You. This is basically the second of two interviews that are just straight from her Instagram account, which everyone needs to go follow right away. It's @KristinYatesDO. I love her content, but this one really did impress me whenever I read it. And I couldn't have worded it any better myself, so I was happy when she agreed to come on and tell you directly about this topic. Dr. Yates is an OB/Gyn in Georgia. She's an author, speaker, and self-described rebel.
She has her own podcast called Rebel Physician, whose aim is to help create a path for physicians to break free of the toxic medical system and create an enjoyable and sustainable career in medicine. Thank you again for joining us, Kristin.
Kristin: You're welcome. And thank you for having me.
Laura: So, Kristin, thanks so much for coming back. And you guys, you cannot see her, but she has the most beautiful- it's a purple highlight, isn't it?
Kristin: I just love that purple.
Laura: I just love it. So on Instagram, you mentioned five ways our training has failed us. We're gonna go one by one and you tell us more about these. So the first one is hustle culture.
Kristin: Oh yes. So hustle culture is- the way I like to describe it is this idea that if you're not constantly doing or creating something or busy 100% of the time, then there's something wrong with you.
You're not worthy, you're lazy, those kinds of things. And I don't think I really, truly understood what hustle culture was until I started to build a business and like go into the entrepreneur world. Because I took the hustle culture with me, which is interesting because that's definitely one of the reasons that we get burned out is because we're just working too dang much. And then I, when I was starting to build my business, I had the same exact thoughts. Because our thoughts go wherever we go. So I realized that I really thought I had to be doing something all the time. It was always about producing something. Rest really wasn't, didn't serve a purpose in my job or my business or in my life at all.
And that's when I realized that this is something that is ingrained in me, and what's going on? And then through my work with other physicians, I realized that it wasn't just me, like everything, it's, it was a universal. We all think that we can't take a break. We have to be constantly working, and we learned that from day one of medical school.
I tell a story often that it's really stuck with me. My first day of medical school. I think it was the dean of our medical school actually sat there and said, you know, look to your left and look to your right. One of you won't be here at the end of this, basically saying like, a third of you won't make it.
And the purpose really was, it wasn't like support each other. It was like, let's hope it's you, you know, like don't mess it up. And right from there it was like, okay, like I have to be constantly- if I'm not constantly studying or telling people that I'm studying then I'm not gonna make it. It was this belief that our uniqueness and individuality isn't enough to provide a job or life. That we always had to be doing more and more to prove that we are enough. And that is 100% what the medical system wants us to continue to believe as attendings, which is why we have the patient volume that we have, which is why we can't spend more than 10 or 15 minutes with a patient.
It's why vacation- sometimes if we take too long off or we don't wanna, we don't wanna take a day off cuz we're sick because of hustle culture.
Laura: Yeah. And again, that situation you described on your first day of medical school. Yet another example of the system of narcissistic abuse where you are made to feel afraid for your very life and existence because of like, nothing, like no good reason. So, anyway, I'm so glad that you're bringing awareness to all this. So the second one is lack of emphasis on mental health.
Kristin: Yeah, I mean, I think that we all can feel this, especially going through the pandemic that we went through. There's still so many physicians right now who either feel immense shame to admit that they have sort of a mental health diagnosis, whether it be anxiety, depression, bipolar disorder, suicidal thoughts. Or they have tried to advocate for themselves and have been told by their employer that they can't do that or they're not given the support.
Or even worse, they reported to the medical board or something ridiculous like that. We are human beings first, and that is basically ignored. I mean, when I was in, in medical school or training, it wasn't like anyone was ever asking me if I'm getting support for my mental health or after a bad outcome or something traumatic happens.
It was like, how are you doing one time 24 hours later? Right? And it was never this, you know, how can we help you? Like do you need a therapist? And of course these are things that are personal. But I think that if we openly talk about these things, then there will be less stigma.
And if we're not immediately taught from medical school that we can take care of our own mental health, then we just never do it. So this is, this is a huge one. Especially right now. I'm on like this, I dunno, like this war or this- I just have so much anger about how many physicians die by suicide. And I think this is why.
It's because we constantly are internalizing everything. Like, I, I'm so overwhelmed, but that's because I'm not strong enough. I'm so tired, but it's because I'm not strong enough. I have anxiety, but I can't get help for it because then I wouldn't be a good doctor. We are internalizing everything instead of realizing that this is a systemic issue, that we are being placed through.
This is being done around us and to us. This is not a failure on your human being self. This is something that you have been failed to being supported through. And I just think we, we cannot have that system in place anymore because actually truly what's happening is that physicians are dying. Physician are dying because of it. So I just am very passionate about this topic because it's not okay.
Laura: Yeah, well, we couldn't agree more. We are so incredibly passionate about this as well. And why is it that these amazing, incredibly intelligent, empathetic, wonderful human beings get driven to this point?
It's completely senseless and it has to stop. We totally agree. So thanks for bringing that up. Okay, so the third is no individualization.
Kristin: Yeah. This has to do with I think it's obvious, like when you're a resident you just have to kind of, you put your head down, you have to do what you have to do. Obviously it's hard to feel unique when you just have to kind of, meet a checkbox, right? And then very few of us have a good transition from residency to attending hood when we realize, okay, like I have a little bit more ability to decide how I show up in life. And we're just so used to just having our head down and doing our work that we forget that we're a whole person outside of medicine. And that whole person might not wanna work the way that all their partners work. That whole person might want to have hobbies outside of medicine or have purple hair or spend weeks skiing or something like that. And so little of that is recognized or valued in medicine. It's always like, this is what a doctor should look like. This is what a doctor should do on their time at work and time at at home.
And if you're not doing that, then you're not, you're not meeting the standards of what a physician should look like. So we see this in our contracts. Like, this doesn't really work for me. I wanna work this schedule and being told we can't. Or being told that you can, but you have to lose all of these extra things like you're not gonna get loan repayment or maybe you don't get health insurance or whatever else.
Or I need a little bit of extra support in my office. I need a scribe in order to do my job. You can't have that cuz no one else does and it's not fair. Okay, like this isn't kindergarten. I'm a different person than that person, and that doesn't make me any less. Mm-hmm. It just means that I have different needs, and I think that we are just not encouraged or mentored to own our uniqueness, which I think is very sad.
Laura: I, I love that you mentioned kindergarten, because I saw a TikTok recently of a kindergarten teacher who had her kids, like all her little students. And she asked, you know, who has ever skinned their knee? Who has ever hurt their elbow? Who has ever hurt their head? And then she has these bandaids, and she goes and puts a bandaid on each kid's head. I'm sorry you hurt your knee. And she puts the bandaid on their head. And she says, you know, it's not about the same treatment for everyone. It's taking care of each individual's needs to help them be their very best. And the same applies to us as adult doctors. We all have different needs and situations, and we're just gonna be better and take better care of our patients if our own needs are addressed.
Kendra: Yeah, that's really good point. And I think one of the things too about bringing the human back to humanity, and humanizing instead of dehumanizing what we do as physicians. Because one of the reasons that brings meaning to our work as physicians is that humanity piece- is the fact that we reach out and our empathy and compassion for our patients. And turning it inward. That's not fostered in our training. And there's no space for that in our training. So then, just like you said too, Kristin, the conditioning over years and years. It's time to unwind that a little bit. It's time to challenge that. Let's look at the facts here.
Kendra: So fourth is denial of play time. And I know how you alluded to this in our last podcast, so this is my favorite.
Kristin: Yeah, this is a big one for me. I realized maybe about three or four years ago that I don't know how to play. Like I was literally like, how do adults play? I didn't know. It didn't make sense to me. At that point I think I had two or three kids, and I was like, playing with my kids is not fun. That's not something I wanna do really that much. No offense to my young kids, but Barbies for hours on end is just not for me. And that's when I sat back and realized, like I used to play. I used to have a lot more fun. And I used to be more playful.
It wasn't just, I spent time playing. My personality was more playful and silly. And I was taught that that wasn't professional, number one, through medical school and residency. And I also was internalizing that in order to be professional, I had to be serious all of the time, whether I was at work or out at home or out in the world, because what if a patient saw me?
So what that meant is that I got so serious. And it, my life was just, it felt bland and dull and depressing. And, I realized that I thought that play was futile. There was no purpose for it, and it was actually a waste of my time. And that goes back to hustle culture as well, because if we believe that we have to be working all the time, playing is not work or so we believe.
So I went to this whole rabbit hole about play and the neuroscience of play. And come to find out, which is why I stand so strongly about playtime. Play is a really good way to exercise the right hemisphere of your brain, the right brain. And we need the right hemisphere of our brain because that's where human connection is. That's where our love is. That's where we feel most connected to the world around us and to ourselves and our intuition. And it's basically where like all the good stuff is that we lose in medical school. Because we're such left brain people. You have to be because that's where memorization is and policies and procedures.
But the problem is that left brain is where also the self-doubt and the judgment and the comparison is. So we get really, really good at using our left brain, and our right brain kind of is forgotten. And what I realized through practicing on my own and changing how I view the world and through my own spiritual practice is- I really perform better as a physician, and I feel better as a human when I'm a right brain dominant person, and I use my left brain for when I need it. So if I can sit in a patient's room and be present with her and listen to her without my ego, without the self-doubt, I'm a better doctor. And meditation for me was a little bit harder way to do a workout for the right hemisphere. So that's when I started playing instead.
And playing sometimes looked like coloring. It looked like jumping on the trampoline with my kids or zip lining or going on go-karts, bike riding. It doesn't matter what I was doing. What matters is how I felt. And what I know now is that play increases the neurochemicals in your brain that actually make the prefrontal cortex, which is the part of our brain that is the critical thinking part, function better.
So in reality, 30 minutes a week is all you really need of play, and it makes you think better. It makes you smarter, makes you more efficient and productive. Like there's only benefit to that actually. And adults don't think that they need it when in reality- there's a really good quote in a book called "Play" by Dr. Stuart Brown. And he says, the opposite of play isn't work. It's depression. And that's really true, when we don't play enough, it's under homeostasis. Like we need it. We can have too much or too little of it. Like food.
We need food and sleep. Right? There's a balance. Play is the same. So all of the doctors who are neglecting playtime because you think you need to be productive or be working, it's actually hurting you because it's making you feel more depressed. You're not connecting with your body or whatever spiritual thing you believe in, if you have that. And you're not connecting with your patients either because you're constantly in the left brain.
So if we realized and truly understood the importance of play, that would be something that we're taught from the beginning. Like in order to be the best doctor you can be, play is a requirement, which I truly believe.
Kendra: Yeah. That's fantastic. Thanks for giving us many excuses to play. And backed by science, which all of us nerds, we need our science and our data, right? Mm-hmm. Yes. Okay. So lastly, the fifth one is forced reliance on external validation. This one's a big one.
Kristin: Yeah. And I don't wanna take too much time, but this is a huge thing. So essentially what happens is external validation, meaning someone is giving me feedback about if I'm good enough. Obviously in medical school and residency, we need that to get to the next level. Like we need the test score, we need the evaluation. We need someone telling us that we passed this procedure in order to become an attending. So what happens is that repetition. We believe that, okay, in order for me to know that I'm competent, I need to be validated by someone else.
I can't just make that decision on my own. And then that's coupled with the fact that we're doctors. And we have human lives in our hands, and sometimes that means life and death, which is terrifying for us, right? Because we care about our patients. So if we couple this experience of someone could die if I'm not good enough at my job. And in order to be good enough at my job, someone has to tell me I'm good enough at my job.
That is not a great combination when you're an attending because what happens is that you don't have tests every month and you don't have evaluations every month. And no one's looking after you really, when you're an attending. But your brain needs it cuz you've just been taught for at least seven years that you could kill someone unless someone's constantly telling you that you're okay, and then it's gone. The validation is gone. So then we unfortunately, have to rely on patient feedback. Which if we're gonna get it, it's probably gonna be bad. Or if it's good, then it's not quite exactly what we need to hear because we're used to hearing feedback from our attendings. And maybe our employers are giving us feedback, but it's probably constructive criticism at best.
So then all we're left to do is believe that we're not quite good enough because no one ever told us how to internally validate ourselves. Which is essentially positive self-talk. And then needing it becomes an addiction. Because if we think that we need it to be good enough, and we're scared of not getting it because we could hurt someone, that's an addiction because it also releases dopamine in our brain.
So then we do things to try to get more of it, like people pleasing or working more, or doing really long notes, or being a perfectionist. Because we think if we can just do a little bit more, prove ourselves, then I'll get more validation and it'll be okay, for a second. And it's never enough.
None of us were ever gonna have enough external validation to feel good enough. And you can prove that to yourself by asking, how much validation have I already had? And I bet it's a lot cuz you're a doctor. And then ask yourself, how much more do I need? How many more good patient evaluations do I need to feel like I really am good enough?
Your brain will not put a number on that cause it's infinite. It's never gonna be enough. So the only way you can survive and feel like truly a confident and competent physician is to just decide that you are one. And I don't mean ignoring things. Like some things you're gonna be better at than others, and that's because you're a human, and that's okay.
But it's being in a place of I know what I'm good at. I know when I need to call for help. And I know I need to outsource, and that's all okay. And I'm just gonna decide at the end of every single day to tell myself that I did a good enough job today. Or I did the best I could today, and let that be enough.
Because the reality is that the same hormones are being released when you tell yourself a good thing. And this is again, proven by science. We know this happens. If I tell myself I did a good enough job today, I'm still getting dopamine and serotonin. It just feels weird because you haven't done it.
And because you've been taught that it's not enough. But if you keep it up, then eventually it will be.
Amanda: You guys see why I'm screaming at my phone? Yes! Over and over and over with her, with her content.
Laura: Well, this is, so Amanda, this is what I've been saying with the narcissistic system of abuse. She just described completely codependent behavior, and that's what we all do. Is we seek that external validation, and it's never enough. And that's why we become so miserable. So that was just brilliant.
Amanda: It was. First of all, go listen to the previous podcast, but if they did not, will you remind us the programs that you do? And last time you didn't tell us about the adventure retreats that you've done in the past, and I'm sure people would be curious, especially now that we know how important fun is. Mm-hmm. And how do they get in touch with you? Tell us of things.
Kristin: Yes. Yeah, so the best way to find me- I'm most active on Instagram, and that's @KristinYatesDO. And from there you can find my Rebel Physician community, or you can just go to rebelphysician.com. And that's a free community where I'm inviting every physician who is a rebel, wants to be rebel, doesn't know what a rebel is but is curious, to come and join. Because we're, I'm collecting people who are ready to love medicine on their own terms basically, again. And then you can, whatever that means for you. And along with that, if you join that community, I have a bunch of workshops in there, all about confidence, imposter syndrome, medical complications. There's just a bunch of goodies in there that all come with the community.
I have done adventure retreats in the past, and it's one of the things that I really like to do. I will probably be starting that up again in 2024. And if you're in that community, it'll be released to the community first. And those adventure retreats are essentially, you come and I'll give you some empowering thoughts about how to get over all the junk that you're taught at work. And then we're gonna do something fun like race each other on go-karts or bumper cars or zip line, which is my favorite, or something like that.
Amanda: That's so awesome. So before we close out, did anything pop up that we needed to cover?
Kristin: I don't think so. I think that we covered all of the points, and I tried to talk fast and get all the things I wanted to say out.
Amanda: It was amazing.
Kendra: Thank you Kristin, so much. This was a great second time together. And also things that she put forth today, let it just be a seed that you could just consider it. If you could put it on repeat, listen to a couple of times. I think you'll find your values aligning with a lot of what she put forth today and in the last podcast. So thank you so much, Kristin, for sharing your wisdom today.
So if you're interested in working with us, go to our website, www.thewholephysician.com to find out more information, and follow us on the socials for more great content. So until next time, you are whole. You are a gift to medicine, and the work you do matters.