Episode 57 | Nov 2, 2023

Solving The Physician Burnout Crisis, with Robyn Tiger

Who helps healthcare professionals stay healthy? How can they feel supported in their own self-care? This week Dr. Sandi is joined by Dr. Robyn Tiger, the founder of Stress Free MD. Dr. Tiger’s mission is to help support people with their self-care, specifically in the physician community. Doctors across the medical field are burning out, overworked, and frustrated with the healthcare system, which can affect how they work with their patients. The problem is doctors are taught how to take care of their patients, but not how to take care of themselves. To address this issue, Dr. Tiger works to partner doctors with health coaches. When health coaches help doctors, doctors feel better able to help their patients live healthier lives.

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Episode Transcript

Dr. Sandi: Welcome to Health Coach Talk, and today I am so excited because we have a repeat guest. And her name is Dr. Robyn Tiger, and she is going to talk about her mission, which is very similar to our mission at Functional Medicine Coaching Academy, which is helping people with self-care. And in Robyn’s case, it is specifically looking at the physician community and how physicians can be supported with self-care because I believe there is a crisis, a doctor shortage, doctor burnout we’re hearing so much about, and so that’s why I brought Robyn on, again, to talk about these very, very important issues. So, welcome, Robyn.

Robyn: Thank you. It’s really an honor to be here. I’m really happy to talk with you about this deeply passionate subject of healthcare, and physicians, and overall well-being.

Dr. Sandi: You started out as a radiologist. So, what caused you to pivot and shift to focus on becoming a life coach, focusing on lifestyle medicine? You are very involved with American College of Lifestyle Medicine. So, what was it that created that pivot for you?

Robyn: Well, as the saying goes, make your mess your message, and several years ago, many years ago, maybe 15 or so or more, I was experiencing many symptoms and illnesses both physical, emotional, psychological, that no physician that I went to for help could figure out. And I was taking lots of pills. We say a pill for an ill. Take this, you’ll feel better. Take this, you’ll feel better. And Western medicine is amazing. But in my situation, I wasn’t getting better, and I was only getting worse.

And labs are all normal. Imaging studies are all normal. Radiologists, of course, I’m hopping and getting every imaging study imaginable. And it was then that I just said, “Okay, I got to figure this out because no one else can.” And I was at the point where I started even having dark thoughts like, “I don’t think I want to spend another day feeling this way.”

And it was really, really very scary. I have three physician friends who died from suicide, and I kept seeing their faces. And I saw the faces of my own children, and my husband, and my friends, and even people at work. And I said, “Okay, well, there’s this fork in the road.” You can keep going along the way you are and probably end up like your friends or your colleagues, or you can try and figure this thing out.

And so that was really what drove me to help others was how I figured out how to feel better all by myself and then getting more education and certifications and licensure in what helped me to help others do the same.

Dr. Sandi: Wow, what a journey, but it led you to now pursuing your passion and helping so many others. And what are your thoughts about the help that they need? What is happening in our medical community, our physicians in particular?

Robyn: Well, you know, I frequently hear that our healthcare system is broken, and then there’s a lot of pushback, “Don’t tell me I need to take care of myself. The problem is with the healthcare system. They’re making me work too much too many hours, too many patients in any given hour, really short appointments, all of this electronic medical records and so on, getting paid less for doing more work, right?”

And the thing is it’s true. I say, yes, you’re right. The healthcare system is broken. It’s very different than the healthcare system that I went into many years ago. And every area of medicine has its own unique issues as to what has changed and why it’s so difficult, and harming, and damaging to those who practice in it, whether it be physicians, or nurses, or nurse practitioners, or PAs, or MAs or anyone that is involved in healthcare.

But then there’s the other side, which is the side of the human being. And so I say, yes, you’re right. The healthcare system is broken, but we as humans can still learn how to be the healthiest, happiest versions of ourselves, independent of all that chaos and all that tornado of healthcare system that’s surrounding us. We can actually find some calm in the storm and actually enjoy our lives again and get back our control, get in the driver’s seat of our lives. We just need to learn how.

Dr. Sandi: I love that perspective because, as opposed to just blaming it on external factors and there are many that are problematic in the medical system, but focusing on what can I do on self-care. And I believe that often is really tied to having a support person, a guide, an ally. And I know you’ve trained to become a life coach. There has been great studies showing the value when doctors are paired with a coach, be it a health coach, a life coach, they start to thrive again. They do better. And so I was wondering if you could comment on that.

Robyn: So, I always think of this. It’s really hard to see what’s not there, and I come back to that in radiology. In my first year of residency, we have daily conferences where our attendings would call us up to read cases cold, never seen them before in front of everyone, which is of course stressful. But the reality is all day long, you’re looking at things you’ve never seen before.

And as a first year, my one attending would always show this one film, chest x-ray. Call in the first-year resident, first-year resident standing there and staring. It’ll be like, “Sit down, next one.” Call someone else up. Standing there, standing there. Nothing. “Sit down.” Call the next one up till he got all of the first years.

Of course, by the time you’re second year, you already knew what that film was because you had been in the hot seat the year before. And the finding is actually not something on the film. It’s something that was missing from the film. And the individual who had the chest x-ray didn’t have clavicles, didn’t have collarbones.

And it just goes to show that it’s much easier to see something that’s there than something that’s not there. And I think about that with our education and healthcare. You don’t want to know what you don’t know. And so what’s not there is learning how to take care of ourselves. What is there is a ton of anatomy and physiology and disease processes and what to do with your patients, but no one tells, how can you eat in a healthful way? How can you relieve your stress? How can you get a really nourishing night’s sleep? What exactly should you be doing for exercise? Don’t ditch personal connection, social connection, right? And there are other things you can do besides all those escapes.

And so these key pillars of lifestyle medicine and things that I’m sure in health coaches bring to the table are things that we as physicians and other healthcare professionals can really benefit from learning because what wasn’t there, the clavicles on the chest x-ray is like what wasn’t there in our education, how to take care of ourselves, and how can we as gatekeepers help other people care for themselves when we don’t know how to care for ourselves.

Dr. Sandi: Yes, that is such a good point. And what you just described, those features of lifestyle medicine and functional medicine, those modifiable lifestyle factors, those are areas that the coach can help people address. It is about nutrition and exercise, and sleep, and stress management, and improving interpersonal relationships.

And it’s often ignored or often overlooked because environmentally, it’s challenging. Many years ago, I was on staff at a local hospital and come into the doctor’s lounge. And day after day, what were they having? It was a tray of bagels, and a tray of doughnuts and sweet rolls. Sometimes even stale. They weren’t even sent in fresh sometimes. They’d just be there for days. And boxes of cereals like Rice Krispies. That was it.

And I’d see these doctors, they would just rush in in the morning, grab a donut, grab a bagel. That would be their breakfast or then they come back and maybe have another one. That would be their lunch. And that was it. And now they’re going a full day of work. And where are they being nourished? And one of the things that health coaches has been documented, when they are employed in a practice on a care team, they’re starting to have better snacks in the break room, have different options, because it is very, very challenging. And I know you are committed to lifestyle medicine in your work. What’s the receptivity amongst the doctors that you work with or the nurses, nurse practitioners?

Robyn: It’s overwhelmingly amazing. And I hear all the time, why didn’t we learn this earlier? I feel better now than I’ve ever felt in my life. And those are people in their 60s. I have retired physicians saying that, not because they’re retired but because they finally have energy. They’re retired but busy. Even the busiest of surgeons stopped throwing things across the OR. I have physicians saying, “You saved my marriage. My kids think I’m cool again.” “All in all,” and I’m like, “You saved your marriage. I just was the instrument by which you did that.”

So, it’s really just providing the education and we as healthcare professionals love learning, right? So, we’re lifelong learners. We just have to be fed the information. And lots of times, I hear, “I just love how you teach because you make it simple. You spoon feed us, but it’s actually incredibly important evidence-based real stuff. It’s not woo-woo Molly Moonbeam. It’s actual real information that you can’t possibly know if you were never taught. You can’t see what’s not there. The clavicles are missing, right? The self-care education is missing.

Dr. Sandi: Absolutely. And I think that, through your teaching, what they have now learned and assimilated, that is going to help them pass that along to their patients. And so they’ll be looking at a more comprehensive picture of a whole human being, not just a diagnosis and what pill should we give them or what treatment, but perhaps looking at somebody’s lifestyle and even then bringing in a health coach who will be then supporting that individual with those often very difficult lifestyle changes.

Robyn: Yeah, that team approach is so key, really getting all of these important key players on your team to help you. It’s interesting because I have a lot of board-certified lifestyle medicine physicians as clients because they go through the training and they study everything to help their patients and then they develop this amazing team for their patients, but they themselves still don’t feel grounded in how to care for themselves. Their patients are doing great, but they’re still not doing great.

And to hear, “Wow, I haven’t slept in decades. I’m finally sleeping,” “I’m not drinking anymore,” or, “I can control it. I just have one glass of wine because I enjoy it, not because I need to finish off the bottle.” Netflix becomes a, “Maybe tonight I’ll watch an episode, not hours and hours of drowning and television to just avoid whatever you’re feeling.” And it just goes on and on, energy. Weight loss finally happens. They can’t figure out why they can’t lose weight. Well, I know why you’re not losing weight. I mean, stress is a huge factor in that and also not knowing the right prescription for exercise, and sleep, and what you should be eating, and all the things.

So, it’s very exciting. It’s exciting. I’m sure you see a lot of exciting changes in who you work with as well. It’s so exciting to be able to, as they tell me, spoon feed the information. Make it accessible. Make it digestible. Make it simple.

Dr. Sandi: That reminds me that we recently did a randomized controlled trial with IFM, Institute for Functional Medicine, where their new trainees, these are doctors entering into their program, they’re coming from a hospital system they’ve never had this focus on themselves. But going through this intro course, they have the option of being paired with one of our health coach graduates to coach them through the elimination diet, which is one of the optional activities that suggest, if you’re going to be focusing on this with your patients, having them put on an elimination diet, you could go through it yourself and see what it’s like. Well, it’s very challenging. Giving up your coffee, for example, that’s hard. And so they’re paired with a health coach. And for the first time, they’re coming out saying things like, “Wow, I never knew that… I feel transformed. This has changed my life. I’m really focusing on me for the first time off.” So, it’s really important.

I’d like to switch topics because I’m hearing and I’m sure you are as well about solutions and healthcare AI. I’m going to be going to a conference and every email I’m getting about a conference, a sponsor, a participant has to do with tech. We’ll just have a better tech system and then the system won’t be broken anymore in terms of healthcare.

And I just love your thoughts on AI and what you’re hearing and your perspective in its applicability in healthcare. Will it replace health coaches or life coaches?

Robyn: I don’t think so. Someone actually just sent me x-ray images. AI read them, and a radiologist read them, and the AI reading was not nearly as accurate, so if you’re out there, don’t worry. You’re not being replaced, at least right now.

But I think like anything, we love new technology, and there’s a place for it always. But I don’t think that it’s going to replace the human to human connection. There are studies that have been more recently coming out. Nothing against male doctors here, but the studies have been showing that female physicians have a much lower morbidity and mortality with respect to their patients and a much quicker and outcome turnaround than their male counterparts.

And a big study came out evaluating male versus female surgeons, and it showed that there are a lot less mistakes made and a lot better outcomes with patients who are seeing female surgeons than male surgeons. And the reason I’m bringing this up is because they believe that a huge piece of that is that social connection is that personal touch, even if it’s only 30 seconds of an eye contact or a quick comment or whatever. That social connection piece cannot be replaced completely by AI.

So, I’d like to believe that AI is going to help us in doing tasks that we don’t need our own eyes, our own voice, our own body or mind for. But it’s not going to replace, we cannot replace, the human being, we cannot replace that energy that’s exchanged between two people who are working together, healthcare professional and patient. I don’t believe in my own heart that that can be replaced.

Dr. Sandi: I agree 100%. And speaking of heart, it is a heart-centered communication when you are communicating with somebody, and you are showing empathy, and you’re building rapport, and that connection, it’s a heart-to-heart connection. And no matter how refined AI gets, that can’t be replaced.

So, health coaching or lifestyle medicine just can’t be getting text messages about whether you’re meeting your goals. It is that personal connection. And I believe it’s bedside manner, and I’ve been reading about the lost art of bedside manner. And I was wondering if you would comment on that. Is that something that you are seeing and could that possibly be tied into the frustration that doctors and other healthcare professionals are experiencing? Because they don’t have that connection. They’re just have to document everything in the EMR and they’ve lost the…there’s so many requirements for them, that they don’t have the time or the ability in some cases to have that kind of bedside manner, what we used to refer to that connection.

Robyn: Well, I am personally experiencing it over and over again. And it’s so interesting because one of the first things I was taught, as a medical student, is to look your patient in the eye when you’re speaking to them, address them by their name, address them and tell them your name and what you do. You know, Medical School 101. Who are you? What do you do? Address the patient by the name, look them in the eyes, right? That’s incredibly respectful.

And I can’t tell you how many doctor’s offices I have gone into in the last several years, and I’ve seen a shift over this last decade, I would have to say where somebody comes to get you in the waiting room. They don’t look at you, they don’t tell you their name, they don’t tell you who they are, they put you in a room, they put their back to you, they start typing into a computer. I stop them, and I say, “Hey, can you just tell me your name?” And, wait, can you just turn around for a second? Can you just tell me your name and what you do here?

And I do it gently. And every time I do it, I just hope that they’re like taking that, “Oh, wait, I forgot to do that.” I’m hoping that my doing that over and over again is going to change and help that incredible healthcare profession that went through all of those years of study and deserves to be there to not forget the why behind their being there, which is to serve the human in front of them and to remember that it doesn’t take a lot of time to look someone in the eye to tell them your name, to tell them what you do , and to address them by name.

It’s less than, I don’t know, 10 seconds. I mean, it’s super easy. And I’ve gone so far as having my own surgery and being terrified because someone I don’t even know, while I already had my beginning anesthesia, taking it over, and I was getting a little groggy, starts wheeling me down the hallway, and I don’t know who this person is, and I don’t know what they’re doing. I don’t know if I’m even supposed to be with that person. I was really being afraid because I was kind of out of it but sort of awake. I’m like, “Am I going in the right OR? Am I going to end up in the right place?

So, taking that moment to say, “Hi, I’m Dr. Robyn Tiger. I am your radiologist today. I’ll be doing your breast biopsy. Mrs. Jones, look her in the eye, “Do you have any questions for me? Anything?” But that means everything and no AI is going to replace that. So, I do think AI is super important though. I think it’s amazing, and I’ve seen amazing things, but we need that. We need that piece, and it’s missing.

Dr. Sandi: Yeah. And what you have just described is the essence of the coach approach. And I think that’s why we’re getting an increasing number of practitioners who are wanting to be health coaches. They’re enrolling. They want to learn health coaching skills, techniques, strategies, the art of communication, so that they will be able to create therapeutic alliances and get back to why they went to medical school, why they chose this profession to be true healers because we’re just losing that.

Robyn: Yeah, we really, really are. And I talk to my husband a lot—he’s also a physician—about my experiences. And we even compare, “Oh, when you went to that office, what did you notice? Did they look you in the eye? Did they say hello? Did they tell you their name, tell you what they did?” I think it’s respectful. Otherwise, that fear, that white coat syndrome that you already have sitting in the waiting room just escalates because you don’t feel safe. Our job is to make people feel safe, and secure, and that we’re authentic and trustworthy. And you lose that.

Dr. Sandi: Absolutely, and that’s why we’re training health coaches to be that bridge of communication, to be the advocates, to greet people by their names, to listen to them, and then to be that support for the practice for the physicians and the nurses as well.

So, you do retreats. Anything else that you have coming up? And I’d love for you to share what your retreat is about, and you’re doing that with someone who I absolutely adore, Dr. Jonathan Fisher. And it was just how I actually learned about your work. It was through Jonathan.

Robyn: Yeah. So, I love to educate in any way people like to learn. So, whether it’s online programming, whether it’s group or one on one coaching, whether it’s in-person retreats, which are so fun, really gathering people together for that social connection piece. So, let’s see, coming up. The retreat that’s coming up is in two weeks, and that is an Art of Living Retreat Center with the amazing Dr. Jonathan Fisher, who is incredible. As you mentioned, he is top doc cardiologist in Charlotte. He is the founder of the ending clinician burnout community. And he has a very important job as a wellness professional in his hospital where he oversees like 30,000 healthcare professionals and their well-being. And so I am honored and incredibly fortunate to be teaming up with him, and we’ve created a really nourishing weekend for healthcare professionals at the Art of Living Retreat Center in Boone, North Carolina. That’s October 13th to 15th. I’m not sure when we’re airing, but that is coming up. In a weeks, there are incredible healthcare professionals coming from all over the county. Physicians, yes, all the way to we have a chaplain from the hospital that supports healthcare professionals who reached out and said, “I’m really depleted. Can I attend?” I said, “Absolutely.” There’s 20 CME, and we just can’t wait to team up and share our passion, which is to heal the healers and to teach the healers how to heal themselves.

Dr. Sandi: I just love that. So, one final question that I typically ask. Any thoughts about what you see is the future of health coaching?

Robyn: I just hope it continues to skyrocket. As you said, I’m seeing more and more physicians going to study to be health coaches to improve their own communication skills with their patients. For me, I’ve been in this essentially coaching area of work for over a decade, being a certified yoga therapist and a meditation teacher and life coach and then certifying in lifestyle medicine. Not to say that I couldn’t learn more from health coaching, but I understand the importance of the skills that a health coach has. And I think that it really should be incorporated into every medical professional’s education, no matter where you are on this journey, because it only helps you understand how to communicate and how to be on a team with your patient.

You know, I always think about the talk show host, and there’s somebody up here that’s asking the questions and somebody sitting down lower. And I just love sitting at the same level as my clients, as my patients, and I think of coaching whatever coaching hat you’re wearing really brings you to that same level. And that’s’ where the magic happens.

Dr. Sandi: Totally. Well, this has been such a wonderful conversation, Robyn. Where can listeners find you?

Robyn: Yes. So, my website is stressfreemd.net. You’ll find all the information about offerings from my podcast, which is called the StressFreeMD podcast, to online programs. If you’re someone that likes to do self-paced learning, to group and one-on-one coaching, to the retreats, the retreat that I just described with Dr. Jonathan Fisher. I have a lifestyle medicine symposium coming up this weeks, Saturday, the 30th. I’m not sure if we’re going to be airing after that in Ashville. I’ve got a retreat in Africa in January of 2025.

So, if you’re someone that has always had that on your bucket list to go to Africa and to track primates and to integrate lifestyle medicine skills while you are there, then we warmly welcome you. Dr. Melissa Sundermann and I warmly welcome you to that retreat. So, it’s really a place where you can find lots of ways to learn to see how you can elevate your health and well-being. And if you’re on social media, check me out on LinkedIn, Facebook, Instagram, Twitter. I haven’t really played with TikTok, but I’m on those platforms as well.

Dr. Sandi: I love it. Well, thank you so much for being with us today, Robyn.

Robyn: Thank you so much for all you do as well.