The “MED-life Crisis” of a Dermatologist

Physician Wellness Scott Paviol

Guest Blog By: Scott Paviol, MD

Wanting More In Medicine

Sometime in 2013 was the start of what I call my “MED-life crisis”. I came to the realization that I wanted more in medicine.  I found that I was not happy with the “pills for ills” approach to medicine nor trying to see as many patients per day as possible. I realized that method creates hollow care. I realized that instead of being a small part of the medical problem (and when I say problem, I mean epidemic medical crisis of poor-quality, antiquated, dehumanized, and expensive medical care) I wanted to be a part of the physician wellness solution.

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In 2013, I reached my lifelong goal of being a physician part of a thriving medical practice providing care to a great family of patients. I was blessed with a loving wife, nice house, paid off my abundant student loans, and attained a steady income.  Everything that I had worked for since I was 10 years old was now in my grasp. But I wasn’t happy in the depths of myself. In a way, I was living someone else’s picture and I sensed that I had other things to work on in addition seeing patients daily (which I enjoy very very much). I created a mental prison for myself in the way I visualized my role in medicine. 

Even though I still enjoyed that piece of medicine that includes diagnosis and treatment, I always knew I wanted my impact to be bigger than that, I just wanted more.

A turning point occurred when I started meditating. I found that it allowed my brain to slow down and create space to see other opportunities for positive change.  I was able to listen to myself for the first time.  I could be a part of that change within medicine.  It was so refreshing.

Since that moment, along with my wife and numerous others support (THANK YOU), I started to take small steps towards instilling an attitude of service, innovation, creativity, presence, and compassion in my work and myself.   I created a blog with a dear friend and colleague, Marc Carruth, as a tool to get ideas out into the world.  The hope was to stimulate discussion to better our care for those in need. My goal in medicine is to be a part of physician-led change in healthcare. 

Shifting Priorities & Valuing Help

I started listening to myself. I began slowing down enough to see the big picture and see opportunities for innovation and transformation in healthcare.  It was then my world started to open up and expand. I put a six foundational elements in my life and hope to promote physician wellness for my colleagues.

6 Elements for Physician Wellness

(1) I defined a list trusted people in my life whom I can count on for honesty. I call them my “lighthouses” because they remind me of my direction when I seem lost. I count on them to tell me if I am acting out of my commitments to myself, my friends and family and my profession.  Outside of that circle, I don’t place much value in the options and judgement of others. 

(2) I committed to creating the family that I want to be a part of through thought, word and action.

(3) At my wife’s recommendation, I paid for a coach to talk with weekly.  At first, I was very against this, because I thought I had things all figured out.  But I soon realized my thought patterns that got me to where I was (treading water in my career and life), wouldn’t get me to where I want to be (a transformational agent of change in medicine and a great friend and family member). I loved coaching so much that I completed a year-long executive coach training program in Washington, DC in an effort to bring this practice to medicine. I cannot quantify the enormity of positive change that coaching and being coached has brought to my life.  My epiphany came when I realized that most of the people I look up to have coaches in their lives (i.e. athletes, CEOs, TED talkers) who allow them to see things from different perspectives. I realized I was victimizing myself in several areas of my life and I can choose to play big and be my best self in all aspects. 

(4) I asked someone to be my mentor.  She equips me with advice and guidance as I am navigating my medical career.  She has been instrumental in my interpersonal relationships with others, revealing new opportunities, and acts as a sounding board for new ideas.  I truly believe everyone who is interested in growth and changing their lives story needs a mentor AND a coach. 

(5) I committed to deepening my understanding of activities that give me energy so I am my best at every moment possible. I meditate, do something physically active, and eat well daily so I can feel confident in my health, be an example of healthy living for my patients and staff, and do my best to minimize the chance that my health will hinder what I want to do in this life. I started writing because it allowed me to be creative and record my thoughts rather than having anxiety about remembering them.

(6) Finally, I committed to being physician-led change in healthcare. 

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I was approached by the CEO of our multispecialty group to improve the cohesivity of our new physicians that we bring in. I decided to call it the PHIRE group (PHysician Innovation and REsiliency).   My peer, Betsy Simon, and I asked around and formed a small group of doctors who were interested in driving Piedmont Healthcare to be a better place for physicians, staff and patients. We meet monthly to create initiatives and present them to our board. Right now, we are working on a wellness initiative which will include wearable devices that all employees can wear and get rewarded for positive lifestyle habit creation such as steps in a day, mindfulness practices, financial literacy. etc. We are also working on creating a peer mentoring program for new employees to help them as they transition to their new jobs. We also created a system where docs shadow other clinics to see how the EMR is being used there and where they can improve their process.

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Our PHIRE group meetings are invigorating, which is much different than normal doctor get-togethers where things often spiral down to complaints and victimization.  We keep the conversation forward driven and focus on physician wellness. Eventually, we also aim to bring a coaching program to Piedmont as well. My view is that if we can spin off enough doctors who are empowered and innovative, then positive growth and improved patient care is inevitable. I really believe that physicians and providers in general are the best hope to change healthcare for the better, because they are the ones who can create what is needed for true caring of patients.  That-s what its all really about– the doctor patient relationship. Its why we are all here and people lose sight of that way too often.

Physician Wellness: The Importance of Finances

Finances are one of those things that if you get them taken care of, then you can be your best. One of the first things my wife and I did was get a financial advisor. I’m not just talking about someone who makes investments for us. I’m talking about someone who coaches us to make value based decisions of how we manage our finances. If you are not making limiting decisions about finances, then you are free to use your money to support change in the world.  

I was pretty aggressive paying off my loans out of medical school and residency.  I had $270k in loans from medical school alone. I was lucky enough to have my parents pay for my college.   When we met with our financial advisor, we shared that we wanted to pay that off as soon as possible. It was a conscious decision.  There are other paths that may make more sense for other people, but for us, I just didn’t want that hanging over me. I wanted to be done with debt and move on.  We had our advisor siphon off the money above what our current budget every month. We kept living like I was in residency. That was easy, we were already doing it. 

I think one trap a lot of doctors get into is they think that because they are “smart” in medicine, they are smart in all other fields.   I just knew I should let someone who specializes in finance do the thing they do best, the same as getting a mechanic to work on my car.   You have to know when it makes sense for you to pay for services that allow you to delegate tasks. Working with a financial advisor educated myself in finance for sure. I read several finance books so I could be literate in investing and finance, but I knew I didn’t have time to manage finance all the time. I made the decision to pay someone for my peace of mind. 

The other trap doctors fall into is the idea that we worked so hard and deprive ourselves of nice things for so long, we need to make big purchases.  You can get into trouble with this really quickly if you aren’t intentional. My wife and I picked a few things we could reward ourselves with responsibly, (one nice car for example) but we rented a cheap apartment for two years and I still drive the car I drove in residency.  Again, we had all of these discussions with our financial advisor, based on our life goals in the present and for the future.

Final Thoughts

Hopefully my personal story of a “Med-life crisis” will help fellow colleagues in medicine to pursue happiness professionally and personally. Physician wellness needs to be at the forefront of our community so we can be at our best to serve our patients. Many factors come into play with overall wellness and the six elements I brought into my life may not work for everyone who is looking to make a change. A sound financial plan allowed me to focus on creating space in my mind when I was feeling trapped in a mental prison visualizing my career in medicine. Once I was able to change my life, I was in a position to create the PHIRE group and lead physician wellness, as well as, organizational change.

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Scott Paviol

Scott Paviol Dr. Scott Paviol is Dermatologist at Mooresville Dermatology Center. He is focused on restoring humanity to the field of medicine. Dr. Paviol is also the Co-author at Practicehealthrx.com, an MD coach driving physician empowerment, and speaks on physician-led change in healthcare.