Dr. Leo Damasco sits down with Dr. Michael Hersh, as they explore why many physicians remain burned out even after switching to telemedicine, the deep-rooted “physician personality,” the myth of work-life balance, and how coaching helps doctors redefine success and build a more fulfilling life.
In this episode of Telemedicine Talks, Dr. Leo Damasco welcomes Dr. Michael Hersh to discuss the challenges physicians face when transitioning careers, particularly into telemedicine. Dr. Hersh explains how the “physician personality”, marked by achievement addiction, poor boundaries, and tying self-worth to productivity often travels with doctors into new practice models, leading to the same burnout they were trying to escape.
The conversation dives into the myth of work-life balance, the importance of self-awareness, identity shifts, and the power of physician coaching. Dr. Hersh shares practical insights on noticing unhelpful patterns, clarifying what you truly want, setting boundaries, and building a life where medicine is part of the “chocolate milk” rather than something to be extracted.
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About the Show
Telemedicine Talks explores the evolving world of digital health, helping physicians navigate new opportunities, regulatory challenges, and career transitions in telemedicine.
About the Guest
Dr. Michael Hersh is a full-time practicing gastroenterologist, husband, father, podcaster, and physician coach at Better Physician Life Coaching. He helps doctors create better work-life integration, set meaningful goals, reduce overwhelm, manage stress, and feel more present at home. He is the creator and host of the Better Physician Life podcast, focused on helping physicians who feel stuck in their medical careers.
Connect with Michael Hersh:
Website: betterphysicianlife.com
Podcast: Better physician life
About the Hosts:
Leo: [00:00:00] Hey, welcome back everybody, to Telemedicine Talks. this is your host, Leo Damasco, and we have a great guest today. Super excited. we had the opportunity to be on his podcast, a while back, but now, we are lucky to have him. This is Dr. Michael Hirsch. Dr. Michael Hirsch is a full-time practicing gastroenterologist, husband, father, podcaster, and a physician coach at Better Physician Life Coaching.
he helps doctors create work-life balance, set meaningful goals, manage stress, reduce overwhelm, and feel more present at home and less annoyed at work. Now, his goal is to help doctors
stop
Leo: feeling trapped in medicine so they can finally enjoy the life they've worked so hard to build. He's also the creator and host of Better Physician Life: How to Get Unstuck in Your Medical Career.
This is a podcast for doctors who feel stuck and
out of sync
Leo: featuring honest conversations about work, identity, and redefining what success can look like in medicine. Dr. Hirsch, thank you so much for joining us. it's our pleasure to have you. It's our honor. Thank you. I'm
Hirsh: so grateful to be here.
Thank you so much for having me.
Leo: Yeah,I was, perusing [00:01:00] your podcast and, looking at, what you do for coaching and, one thing, came to mind, and a lot of these doctors that look into telemedicine, right? They wanna transition. They're burnt out.
They're tired. They want something new, and they're trying to find a change in their life. But,not everybody's successful in that, and a lot of them, are hitting the same roadblocks, hitting the same bumps that they were doing in, their traditional telemedicine career. And,what do you think about that?
what's going on, and what are your thoughts on how to kinda get over that and kinda just move along?
Hirsh: Yeah. , This really Does get to the core of doctors, right? I think you're hitting- ... on something that I like to refer to as the physician personality. So we, as physicians tend to hit the ground running.
there is this path in front of us, and we- Yep ... just go, and, sometimes without fully thinking through what all of this means. I certainly didn't know [00:02:00] at 18 years old what it meant to be a full-time practicing gastroenterologist. And we follow the path, and we do the things, and, there are things about our careers that we love, and certainly other aspects of our career that we struggle more with.
And as is human nature, we tend to focus on the things that we don't like way more than the things that we do- Yep ... And so I have found a lot of times with- when we don't really stop and really get a good idea of the things that we like and the things that we don't like, we tend to just start running in a different direction.
And, when we do that, when we just decide, I want a different job, I wanna move to a different city, I wanna change, what my practice model looks like, we tend to bring all of the aspects of our personality and the things that we were doing that we didn't really like about the last job [00:03:00] along with us.
So the surroundings start to look different, but all of our, the way that we show up in life, comes with us. So again, that can be look like, that can look like being addicted to achievement, to- Yeah ... not knowing when to slow down and rest, to, not knowing how to take a break, set boundaries, all of these things.
And so I think that speaks to why sometimes physicians will pivot and try telemedicine and then realize they're not getting what they thought they were going to from the switch.
Leo: Yeah, and it's a very common story in the people that I see that make the switch they reach this point, and they go maybe even just full-on telemedicine, but they're like , "Hey, Leo, I'm working just as hard.
I'm working just as many hours. I'm just as frustrated. What am I doing wrong? what's going on? What can I do different?"
Hirsh: Yeah. that's fascinating too, because people also, and physicians in particular, they mix up this [00:04:00] idea of hard work and burnout. So a lot of times when we are feeling burned out or frustrated or feeling like our careers aren't really what we want or we're just exhausted, we are used to hard work, and most of us love working hard, right?
When I think about, how hard it can be sometimes for me to just sit around and do nothing, I was really sick last weekend- ... and I had to, I couldn't do anything. I was exhausted. And I did, I rested and I relaxed, and I just kept thinking about all the things that needed to get done. So when I think about hard work, I actually really enjoy it.
The problem comes when the hard work doesn't really align with how we wanna be showing up, right? And so as those physicians are coming to you and saying, "Oh, I switched to telemedicine and I'm still feeling just as burned out as before," it really comes down to not just how hard they're working, but also how does that hard work align with the [00:05:00] life that they actually wanna be living?
And again, most of us don't stop and take inventory to figure out where do I wanna be putting the work and effort and time into, and where do I want a boundary that says this is where this work ends and the rest of my life starts?
Leo: it, it's funny 'cause I've mentioned it before 'cause, a lot of our identity as doctors, is how hard you've worked, and nobody's really,asked ourselves or really posed that question to us is it what are you working for or what do you want, right?
I remember, in intern residency year, you get lined up and, along the pimp line, and, you ask your,attending , "Hey, what could I do better?" Work harder, read more, this and that, right? But they don't really... that, that's it. That's it. they equate work harder, read more, do more hours, stay awake more to success, but nobody really defined what that meant.
and if you didn't, then you were a failure, right? Or if there was some other goal other than that. So how do we do that ourselves? How do we, when we're stuck in this loop, [00:06:00] what's, what's step one to kick ourselves out of there and get onto the right kind of linear or the right pathway?
Hirsh: Yeah. I think what you were just mentioning is noticing it because I think- It has become such a part of who we are. you named it for what it is, which is it becomes a part of our identity.
Leo: Yeah.
Hirsh: And how hard is it, I don't know if you've ever seen that, commencement speech called, This Is Water, where, it starts with the story of two goldfish swimming past a third goldfish, and the third goldfish says to the other two, "How's the water?"
Or, "Nice water today," or whatever. And the other two goldfish keep swimming by and they're like, "What's water?" Because when you're so immersed in it, you don't even recognize that's how you're showing up. And so you named the identity piece. It's just how we grew up. This is how we grew up in medicine, is tying our worth to our achievement.
And so- untangling it starts with noticing how it's showing up in [00:07:00] our day-to-day lives, and then deciding if you want it to be different. And, this is hard. This is,an unbecoming, if you will, for a lack of a better way of saying it. And so untangling who you have always been with who you wanna be, it does take some work, but it always begins with first noticing that, that's where you're showing up from.
Leo: and so with the people that you've seen, what are other goals that people have strived to? good examples that are like, "Hey, instead of work, this is what I'm striving for." what are kinda successful examples that you've seen?
Hirsh: Yeah. it does come back to, what is the goal, right?
So for some people, we're just talking about career goals. Yeah. and the career goal may look like how much time every week do I wanna spend doing this thing? it may also very much include something that is very foreign to doctors, which is boundaries. Because we are- taught that there [00:08:00] is, work is life and life is work, and we try to create this work-life balance, and we always feel like we're so inept at it, and we can never quite get to it.
I personally don't believe that work-life balance exists. I think it's a myth. and we- ... can certainly talk about that if you want.
Leo: Yeah.
Hirsh: Really.
but, but yeah, I think, it's also figuring out, what do I want the other parts of my life to look like? What do I want exercise to look like? What do I want family time to look like?
What do I want my activities outside of work to look like?
Leo: Yeah, I was just looking at an Instagram Reel by,a doctor influencer. and she was talking about,her recent post talking about how even the public, has put no boundaries on us, right?
they expect us to sacrifice ourselves. They expect us to work over hours. They expect us to give that up, and it's hard to, to find that balance when all the expectations on you are, no, you have to give up yourself." Now, it's [00:09:00] interesting that this work-life balance, idea that you brought up.
So you don't believe that there's such a thing as work-life balance. Tell me more about that.
Hirsh: Yeah. so think about it. I like to use the analogy of chocolate milk. So we- ... start off in our medical training as a glass of milk, and then we spend 10 years of our lives of chocolate syrup being poured into the glass and it all getting mixed up, right?
Yeah. And then we get to the end of our training, and we go out into the world and we say, "This is great. Now I want my milk back." And you can in theory extract the chocolate syrup back out of the milk, but it's gonna take a lot of effort and it's probably not worth it, right? And so we have basically made medicine a part of our lives.
It's what our training is. And so the question is not how do I extract the milk from the chocolate syrup, but how do I figure out how to pour the [00:10:00] chocolate milk into the different aspects of my life and show up in the ways that I want to in the places that I want to? And this is why I was saying it's really important to figure out, what do I even want in my life?
Because when you know what you want, then you can create the guardrails, the boundaries if you will, that then allow you to show up in those different aspects of your life.
Leo: No, that's interesting. That's interesting, that whole idea of the... I've never heard of that.
you're right. It's instilled in us. It's now us. and you can't separate it out. But I think that's where a lot of frustrations are. so how do you do that? this is a revelation for me, to be honest, right?
And I think indirectly and unconsciously it's kinda doing that now with the whole telemedicine thing, right? I put life first, I put my schedule first, and I fit telemedicine everywhere around it. I'm not like, I'm not shunning medicine altogether. It is still part of my life.
But it's not the main part of my life , right? it's now, a part of [00:11:00] this kind of environment where now I'm a lot happier. But how do people do that? that's so hard, right? we're so binary sometimes . One and zero, Work is work. play is play when we ever had time to do that, right?
So Can you tell us how we do that and how to get there?
Hirsh: So yeah. So I love what you're saying, eh, very much. It gets back to the first, thing that we were talking about, which is the physician personality, which is very binary. And the world is filled with grays, right? And so it really, as you're thinking about- How do you do this?
this for me is where physician coaching really fit into the picture, because I also did not know how to do it, and there is no guidebook that helps you, right? Like, there's Nothing where you just sit down and you figure out, what do I want my life to look like? . It does Take some time and figuring out truly, because so many things get in the way of us figuring out what we truly want for [00:12:00] ourselves.
Talking about physicians and the ways that we show up in the world, many of us are people pleasers, right? We, grew up in an environment where it was all about making somebody else happy. It's how we got into medical school, and residency, and the fellowship- ... that we wanted. And so if we build our lives around making the people around us happy, we may build a life that we don't necessarily want.
another piece that shows up all of the time for doctors is, building the goal with the purpose of achievement Because our achievement becomes how we value ourselves.
Leo: Exactly. Exactly,
Hirsh: And so l- really being onto ourselves, taking a step back,
this may be a good place for the listeners to start. Here's a list of the things that I want. Now, why do I want them? And being onto yourself about why you want the things that you want, right? So if you want, [00:13:00] a huge house in the suburbs, like, why do you want that?
And just following the trail there to figure out, again, to be onto yourself and be like, "Do I really want that, or is that just what I think I'm supposed to want?" Because I think that shows up all the time for doctors also.
Leo: You're right. It's all about expectations, too, 'cause that's how we're trained, right?
that was it, that's especially hard for us, because we were so one-track minded. We were I just talked to a guest too, and it mentioned it. we were trained to be a one-trick pony, right? And to think one way, and to get unstuck from that.
Now, you're like, "Hey, coaching could do this," right? But we're doctors, right? we're not supposed to be coached. We're the ones supposed to be coaching, right? and a lot of doctors are resistant to that, you know? one, it shows a kink in their armor, right?
Shows their vulnerability. And we're all Type A some way or another. And how do you convince people [00:14:00] that, hey, maybe you should be talking to another person. Maybe you should have a support system or, somebody you can talk to or a lot of people you lean on. A lot of us, are lone wolves going out there.
And, even as we grew in college and whatnot, we were all pitted against ourselves. So how do we find people to help support that?
Hirsh: Yeah. the first thing I'll point out is, it's an invitation, right? There's no convincing people. This work, it actually is work to figure out what you want.
And, I spent a really long time trying to figure it out. I thought I had figured it out. I thought my path was not being a doctor anymore. Yeah. And it was, And I had it figured out, and I found physician coaching for myself because I was, like, frustrated, and it was COVID, and I was just trying to sort through some things, and I wasn't gonna do it.
And the coach said to me the thing that probably changed my entire perspective, and probably my life, which was, "If you don't do this, what [00:15:00] changes?" Because the truth was I had been sitting with myself for my entire life, and I hadn't been able to figure it out for myself yet.
Leo: Yeah.
Hirsh: And that is the magical thing, at least it has been for me with coaching, has been you can't read the label from inside the jar.
It's very hard to figure out what is going on for you from inside you. And what helpful coaching does is it holds up a mirror and helps you see you. And the benefit of coaching for me and for the physicians that I work with is really asking those hard questions that we don't even know to ask ourselves so that we can parse out, "Okay, this is why I actually want these things."
'cause it's so much easier to go for the thing that you want once you know why you want it. and for me, The only thing I ever wanted to do was practice medicine. There was no part of me that wanted a podcast. There was no part of me that wanted to be an [00:16:00] entrepreneur or have a business, and it's transformed my life.
I love these things, but I didn't even know that they existed or that they were something I wanted.
Leo: Yeah. No, that's,a similar pathway for myself, to be honest. I think- The time, how it unlocked my journey, to moving forward was being part of this community, right? To be able to lean on people and to have people tell you and make you accountable for your actions, your thoughts, so forth and so on, and share ideas with.
So no, totally agree, and it's right. I was in the ER and I was gonna die an ER doctor, right? I was gonna probably die, coding somebody or have a heart attack like some of my colleagues had in the ER. I had one colleague diagnose his own PE in the ER. And,that was a path.
But, finding this you know, the answer is always evolving, for me, is what I want, right? initially it was like, "Hey, I'm gonna go full, telemedicine, just do clinical work, just run this," and then found the entrepreneurial track, [00:17:00] now found helping people build businesses, so forth and so on, and I actually went back to the ER as well.
Hirsh: I was out of the ER for almost a year, right? And I was like, "I'm never going back And I was like, "Oh, I miss my team." And it just gave me fulfillment going back and doing that, and it was interesting how, the answer was evolving and changing as, I grew and as my pathway grew, Yeah. And it gets to evolve and change. I think this is the other thing I love talking about, like, how we all are, because we're all so similar, is that we think that once we set a goal, we have to, latch onto it and see it-all the way through to the end .
Leo: absolutely. Because if you don't, you're a failure, right? that's how we were trained. And even from the very beginning, it takes a certain personality. And this is a generalization, but it takes a certain personality to get to become a doctor, so forth and so on. But that has been ingrained, right? Like, oh, you need high SAT scores.
If you don't do that's it, right? you need your MCAT super high. If you don't do that's it, right? And it's giving up, right? You can't give up. you're a failure if you do, you're a failure if you [00:18:00] pivot, so forth and so on. And, it's funny 'cause a lot of the telemedicine doctors that I've helped move along, that was another big roadblock is, "Hey, I'm forsaking what I've trained.
how do I reconcile this thought with myself that I'm doing something else? And this is different. This is not me. How do I convince myself? How do I convince my colleagues?" And like, why are you trying to convince your colleagues anyways, right? But, how do I do that? do you see a lot of that and, how do you move forward with that?
Hirsh: Yeah, a huge identity piece here, right? and then you just asked a great question, like, why are you trying to convince
Leo: anybody?
Hirsh: It really is all about following the things that you want. And if you are chasing an Instagram version of your life or somebody else's life, it's really hard to find happiness from those places.
Yeah. So if you are looking for other people to accept you and the things that you're doing or what your life looks like, you're gonna be chasing that for a very long time. And so it's about [00:19:00] finding ways to be at peace with "This is what I want, so it's just what I'm gonna do." And it's easier said than done.
There's no switch that flips. and sometimes it involves just taking incremental steps. Like I mentioned, there was no part of me that ever wanted to put my words on the internet or put my face, or my voice in podcast land. and that didn't happen overnight, and I did it in these different ways of dipping my toe in the water of being seen because medicine had taught me it was better to go unseen, right?
I'd just- Absolutely ... lie under the radar. Absolutely. Yeah. And being out in the world is fun, too.
Leo: Yeah. Be the silent martyr, right? You are serving everybody else, right? no, this is great insight. the one last question I ask for every guest, too, is as we're wrapping up,if you go back to your intern self, day one intern year, what, July 1st, right?
It's always July 1st . What would you tell your intern self? any piece of advice really. Open book. What would [00:20:00] you tell this person?
Hirsh: Enjoy it. Enjoy all of it. intern year was so hard.
Leo: Oh, it sucked.
Hirsh: And when I look back at it now, there are so many parts of it that were so fun, and I made some of the best friends I've ever had in my entire life that year.
And it doesn't mean all of it was easy, and we went through it together. Yeah. and the path from that point has not all been easy. it's so easy to focus on the bad stuff. It's so much harder to see all of the good and all of the positive that came out from all of that. And, finding ways to enjoy even the littlest parts of the day, it makes a huge difference.
So I would tell him, "Just enjoy it."
Leo: Oh, man. good luck convincing that July 1st, right?
Hirsh: Oh, I know.
Leo: Yeah. Yeah. as you get everything, and y- you're staring at this, you're like, "I have to do what?" No, but I agree. No, that- that is great advice. Dr. Hirsch, thank you so much for joining us. great [00:21:00] insight.
Incredible insight, really. Just, how do they get in contact with you if they're interested in your physician coaching or really just getting to know more about you?
Hirsh: we are, I'll call them brother podcasts on the Doctor Podcast Network. we are, yeah. So if you, if you wanna hear more, I talk about these things that we've talked about here, every week on the Better Physician Life podcast.
and then, you can also head over to my website, betterphysicianlife.com, where I've got a ton of free resources. on the site I have this five-minute commute reset for physicians, teaching doctors how to transition from work to home so that your families don't just get what's left over at the end of the day.
and there's all information about my coaching services as well.
Leo: Super useful. I'm gonna plug that. I checked that out too, and I was like, "Oh, my gosh, this is great. This is..." If I had a commute now, So- Tell them ... but no, this is- ... this is amazing. check him out. Dr. Hirsch, thank you so much for your time, your insight.
Always a pleasure [00:22:00] talking to you. to the listeners out there, I'll see you again next time. Thank y'all.