Join host Dr. Leo Damasco as he welcomes Dr. Peter Crane, to discuss the role of telemedicine in serving underserved communities and the importance of physician wellness. Dr. Crane shares insights from his practice, lessons learned from telemedicine’s limitations, and strategies for balancing professional demands with personal well-being. A must-listen for physicians navigating telemedicine and seeking a fulfilling career.
How can telemedicine enhance care in rural communities, and why is physician wellness critical to effective practice? In this episode, Dr. Leo Damasco sits down with Dr. Peter Crane, as he explores the evolution of telemedicine in his practice, from supporting snowbirds to managing follow-up care for patients with transportation challenges. He candidly shares a lesson from a missed appendicitis diagnosis during COVID, highlighting telemedicine’s limitations and the importance of physical exams for certain conditions. Dr. Crane also discusses the benefits and challenges of direct-to-consumer telemedicine, emphasizing the need for better EMR integration and communication to avoid disrupting primary care plans. Additionally, he reflects on physician wellness, urging doctors to prioritize self-care and live in the present to avoid burnout. Drawing from his podcast, Doctors Making a Difference, Dr. Crane offers actionable advice for physicians to reclaim their time, financial autonomy, and purpose, ensuring they can serve patients as rested, engaged healers.
Three Actionable Takeaways:
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. Peter Crane is a board-certified family physician practicing in rural Ohio since 2011, serving the community where he was born. A graduate of a family medicine residency, he replaced the doctor who delivered him, reflecting his deep commitment to his roots. Host of the Doctors Making a Difference podcast on the Dr. Podcast Network, Dr. Crane shares stories of physicians finding purpose and balance, with a focus on wellness and community care. His practice integrates telemedicine to serve patients with limited access, while his experiences in medical missions to Uganda highlight his dedication to global health equity.
LinkedIn: https://www.linkedin.com/in/petermcranemd
Podcast: Doctors Making a Difference
About the Hosts:
[00:00:00] Welcome back everybody to telemedicine talks. I am very honored to have our guest today. this is Dr. Peter Crane. So Dr. Peter Crane is a board certified fp physician practicing in rural Ohio since 2011. And funny story though, he returned to the place where he replaced. The doctor that actually delivered him.
So super small world. also, I first met him when I was able to get on his podcast. So we have a sister podcast on the same Dr. podcast network called Doctors Making a Difference. If you haven't checked it out, check it out. It's right up your alley. Right up our alley in terms of telemedicine and mindset.
But Dr. Peter Crane, welcome. Thank you so much for being on our podcast. It's an honor to have you. Thank you so much. I appreciate the intro. like I told you, it's kind of a funny story when I tell people Yeah, the doctor that delivered me retired and they needed another doctor. So I came and I think as physicians, I know you could pick a job anywhere.
And this, like, this whole arc [00:01:00] because my wife is from southern Arizona and so Hey, maybe you should go back and live in Idaho where we have lots of winter and it's cold. And it was just like this long process. And finally when it came down. To being offered this job. We both kind of felt like, that's a place that we need to be.
And so we came and have been here almost 15 years still serving the same community where I grew up. So all the good, the bad, and the ugly as far as that goes. That's amazing. And talk about a calling, right? this is your community. You were. Born in this community? Raised, I'm assuming in this community.
Yeah. And you came back to serve this community in that capacity. That is huge. Not a lot of people, you know, sign up to do that, especially in rural Haida, and actually this kind of rural community you're calling. When I was talking on your podcast, you mentioned a couple things, regarding telemedicine and how, you saw Telemedicine's role in kind of the type of practice that you have.
In terms of telemedicine, you know, this is telemedicine talks. What have you [00:02:00] seen work well in your practice work? Not so well. Hopefully you could change, and any lessons that you give the telemedicine doctors out there that are practicing and possibly taking care of your patients. Yeah, so I guess I'll go on with my thoughts about it.
You know, telemedicine, just like for all of us, became really much more prominent during the COVID era because we were trying to figure out a way to care for people, even without having them physically present. Before that we used it a little bit for, snowbirds. Like I say, I live in a place yeah, where it's cold in the winter.
So we had a fair number of my adult patients that will travel to warmer climates in the winter. So I would use it as long as I had a state license in the place where they would travel, then I could do it. But it came a lot more prominent during that time,
So the way I found telemedicine to be super useful is for follow-up care. Like I have a patient just this last week I was talking to you know, we live in a p. A rural area, there's not a good mass transit system.
A lot of people kind of [00:03:00] struggle with transportation and a elderly patient, and it's very hard for this person to come in and see me and, and we have this conversation that, hey, I need to see you sometimes if I need to listen to your heart or I need to look at something or, do the, palpation part of the exam.
But if I'm refilling your medications or. Reviewing labs or something that the Home health service or somebody went out and did for you, I probably don't need to have you come in because it was this major taxing effort for this patient to come in. And that was what we decided that was a awesome tool, even in our own community.
And I could go to her home and I certainly would if there was something necessary, but a lot of times it really is just kind of reviewing medications, reviewing chronic diseases. Yeah.
One of the challenging things, and this was because I think I was sort of a rookie at it during the COVID time, is the inability to touch people. And I remember one specific one. It was during COVID, everybody was nervous to go anywhere.
they weren't taking people to the emergency room. And I had a little 11-year-old, I think, [00:04:00] girl that presented via telemedicine with just kind of an upset stomach is all it was. Yeah. And I thought, well, let's see. You know, no fever had her push on her own stomach or have her mom push on her stomach, and she didn't seem to have any rebound tenderness and no guarding that I could appreciate.
And, you know, she's not throwing up and it's kind of vague. Abdominal tenderness you know, and then 12 hour, and I, so I, I decided it probably wasn't anything too big. Let's check back. Let's check back with you tomorrow, see how you're doing. 12 hours later, she had her appendix out, uh, ended up in the emergency room.
And so it was one of those, like, had I been able to lay eyes on her and realize. How much guarding there actually is. Yeah. And what's going on? Just, you know, the idea of the physical exam and so that's one I've always felt really bad about it. The patient got the care she needed. Her parents were really wise and took her to the emergency room.
Yeah. When it seemed like she wasn't resolving, but that was, especially at that time, like, oh dear we, uh, missed that one. It was a bad deal. No, and you definitely bring up kind of the limitations, right? This is a tough one, right? I agree with you. You know, [00:05:00] telemedicine is not the end all, be all gonna take over telemedicine altogether.
It just can't. There's definitely situations that, yes, you still need brick and mortar. You still need to touch and examine a patient, right? Like primary care, annual visits, I think. Definitely have to go to brick and mortar, but you're right. You know, there's definitely roles where, you know, refills just to talk.
You know, you don't want somebody to go two hours, three hours, you know, I don't know how long your patients transit, you know, especially in your community, but sometimes it's long just to, have a 20 minute conversation. It says, Hey, good labs. You know, let's refill your meds, so forth and so on.
But you know, this definitely displays one of the limitations, right. You know, like, abdominal exams. Definitely. when I practice, I have a very low threshold to say, Hey, I'm probably gonna waste your time. I can't examine you. Can you press on your belly and if they're not still smiling, even if they have like a little twinge, I'm like, okay, go.
Go to the er. I'm not gonna risk it because, well, yeah, the appendicitis [00:06:00] case, and, you know, just like in the er, there's always good follow-up. You know, another one is like ear exams. Ear exams always. I can't look in your ear, you know, and I'm probably to waste your time, but no, that's, it's a good rule and you have to develop, you know, your left and right measures, right.
You're left and right limits on where you feel comfortable in practicing. But so what lessons, have you had your patients. There's a lot of telemedicine practices out there that, the patients could jump on, get on, you know, direct to consumer care. Have you seen any of your patients do that?
Have you had any thoughts? has that augmented your care provided? Or been detrimental to what you wanted to do? You know, I've, whenever I'm doing kind of direct to consumer stuff, always in the back of my mind is like, Hey, how would the primary care, you know, am I actually providing additional care or am I really doing, what?
A primary care would not want me to do. do you get what I'm saying? Oh yeah. when I think in balance, most of it's positive. 'cause if you give people [00:07:00] care in the time and setting where they can receive it, that's the best. I always tell my patients, the best care you'll get is the care that you'll do.
And that's true. A lot of times people, go to the university and you do this big test, and you that's ideal, but. They're not gonna do it. So I have to say, well, what will you do? Or, yeah, sometimes people they, you know, whatever test or whatever thing they'll do, you have to kind of meet them where they're at.
And so telemedicine really does have the ability to meet that 'cause somebody's in their home or they're at a place, you know, they're visiting family or whatever it may be. And they can access the care right then and there. And so I like it, especially, I love it for our specialist follow-up care, like the patient's already got a known chronic disease.
We live in an area where it's an hour and a half drive each direction to go to the specialist center. Like if you want to go see any of, any larger center hospital for something, it's that kind of a drive. And so it's a major undertaking for people to go there. So telemedicine is served very well in that capacity.
When I think about, uh, you know, your question about those who receive [00:08:00] direct care from a telemedicine doctor when they're not seeing me 'cause they're not in my clinic. When I think back when I first started my practice or like when I first started seeing that come around and I wasn't quite as busy in my practice, I thought like, oh, what do these guys do?
Raining on my parade. I have to work so hard to build this practice. Why are they taking my patient encounters? From, as I've gotten farther into it, I've realized. Primary care isn't a shortage. Almost everybody, no matter where you are, if you're rural or urban, there's a lengthy weight to get into medicine, into a doctor's appointment, and that's detrimental in most cases.
So even just having a practice set of eyes and ears to listen to somebody say, is this serious? Do I need to take this to a higher level quicker? Or am I okay to wait till my appointment in two or three weeks? That is actually pretty valuable to patients. And so the only thing where I run into a hangup.
I've had it happen before where somebody gets a chronic medication changed by somebody. Yes. And they're kind of messing with their blood pressure medicine. Or for example, amlodipine causes swelling for a lot of people. And [00:09:00] so the patient will come in and they've been swapped to a different antihypertensive, which may be exactly the appropriate thing to do.
I don't know. And sometimes patients are not real savvy. They'll come in and they'll say, I don't know. The doctor told me to take this other medicine. And it's this big workaround. 'cause you don't get a note, uh, necessarily. And the patient, if they're really medically in touch with things, they'll know.
But some people are like, I don't know, they told me to take something else so that it becomes this big circus to try to find out. Where they got it and what pharmacy and what dose and what are we doing and has anybody checked labs? So I, like you said there's some huge benefits, but all of us have to learn to navigate these waters so that at the end of the experience, the patient gets the best outcome.
That's what it has to be about, is the patients. No, absolutely. And, so before I was an ER doc, I was a primary care pediatrician and it was one of the most challenging things. You're right. You know, I had a plan and this was a plan, and then the patient comes in and the plan is changed. And we don't know why.
Right? We don't know what the circumstances were. a lot of times there's not a lot of chart sharing, right? So it's [00:10:00] hard to actually delve into that. So, in my practice now when I do telemedicine I absolutely avoid changing chronic medications is, even if the patient comes in and says, Hey, I really don't like this medication.
My primary put me on this, you know, unless there is some severe acute reaction or a, an acute indication to change it. No, I definitely tell the patient, Hey, you need to go back and discuss this plan with your primary care because, I don't know the plan. I don't know the plan involved, so forth and so on.
You know, and actually this came up too, is what's your thoughts on telemedicine, doctors, potentially ordering kind of chronic therapies, physical therapy, speech therapy, things like that for your patients? And when they're seen in an acute setting in telemedicine and then sending it back to you and saying, Hey, please continue this therapy, or in that kind of, uh, line of thinking.
I don't have a problem with that. I think the majority of people who I've encountered who work in telemedicine [00:11:00] are like you. They've worked in primary care or they've worked in an ER setting. They know both sides of that fence. And the reason I say I think it's actually beneficial is because.
When we're all done, when everything boils down, the thing that has to matter the most is what was right for the patient. And if the shortest path between the patient having a problem and getting a solution is for the telemedicine doc to initiate that re referral to therapy or whatever it may be, then that's great.
Some patients are so good at following up and double checking and, you know, doing all the steps. And those folks almost never get lost in the cracks. But there's so many people who don't really have a big medical fund of knowledge, and when we tell 'em to, okay, follow up with your doctor and make this appointment in three weeks, and remember to tell 'em that you need to do yada, yada, yada.
I just find that a lot of times that doesn't work that well and so I'm on board with just initiating whatever therapy. The biggest thing I hope that future electronic medical record systems or future AI associated systems will facilitate is some [00:12:00] of the note sharing so that it just automatically pops into my EMR and I can say, oh, this person saw Dr.
So-and-so, and they recommended this. And you just have to trust that your colleague made a good recommendation based on the information at that time. And then you can either support or refute what they're saying based on, uh, what's presenting in front of you. No, absolutely. And, you know, that's, a big need.
Right? And, not just telemedicine too, just across services. Across systems. Right.I know, when I work in brick and mortar in the er, sometimes I can't see evena hospital system across the island. I live in Hawaii, right across the island, 20 miles away. I'm blind. Right. I don't even know.
No, that's super challenging and you just kind of have to guess and you have to take the patient's word for it. And you're right. A lot of times the patients aren't necessarily that educated in their plan of care, so. No, that's another one I was just thinking about, Leo, is we do rural obstetrics care and it's great when the person's there in the hospital or they live close by [00:13:00] they get excellent care.
'cause they come in all the time. They receive, evaluations, they get ultrasounds just like they would anywhere. But, I live in Idaho, but I'm very close to the border of Wyoming and there's a large part of Wyoming that's kind of a OB desert, if you wanna say it that way. There just aren't that many hospitals or physicians who do obstetrics.
And so I found that it's a little bit of a challenge for that population because they need to come in. Most thing, obstetrics need to have your blood pressure checked and you need to have a urine test to see if there's protein. And there's just so many things, but we are often sending patients to perinatologists at the university or one of these large referral centers and.
They can do some of it over telemedicine, but it's one of those challenges, like I want it to solve that need. But until you have something where there's better exam tools on site, the patient still has to make that trek. And that's when I come up across pretty often. 'cause people are in childbearing years, often are kind of trying to work to make ends meet and they're working jobs.
Or maybe [00:14:00] the patient and her spouse are both working jobs and taking time off to, to go out of town and receive this care. Sometimes it just doesn't happen. And so my hope is that in the future time we have better system coordination, you know, across these, systems that talk to each other and a little bit better exam tools or point of care testing things so that we can do some, a little bit more detailed testing than we're able to at this point.
do you think it'd work if ideally you could train a tech or somebody that's actually pretty mobile to do that in your stead you know, what kind of technology ideally would you want to see to help that?
Because it's funny 'cause OB is a, big thing, right? especially with the new rules and what you can and can't do. you know, some doctors can't do things in different states and the OB care shrinking, you're getting.
Bigger and bigger OB deserts. So how can you know, ideally, what do you want to see in, you know, what kind of advancements can we make? Or, you know, what are you hoping to see to help us? Well, I don't know what, you know, I don't know what the future will hold. I would like to see a [00:15:00] day where our.
Nurse midwives are sort of used in that manner where you say, look we've got a team of excellent people. We can do point of care ultrasound, and you can make decisions as part of a care team instead of having patients say, okay, am I gonna go to a midwife or a doctor? Am I gonna go to a university system?
Or I gonna go deliver at a delivery center and have it be a little bit more of a team approach? 'cause you could see something like that where you say, okay, the hospital and the physician. Are in close communication with a team of nurse practitioners, for example, or nurse midwives who mobilize a little bit, and that we provide a little bit seamless care where some of those care encounters are at the person's home or they're near where the person lives.
And instead of having it be an either or a competition. You could say, Hey, this is something where we're just trying to provide obstetrics care. Uh, you know, one other comment on this, Leo, this is just like sidebar tangent. We, just got back from a medical service trip to Uganda a couple weeks ago.
Mm-hmm. And I've had the privilege of [00:16:00] going there off and on for the last 10 years and really enjoy it. You talk about a place with very limited medical care and just the folks that are so sincere and their healthcare team is, they're just really patient focused and great, but wouldn't it be great if they had access to the information and knowledge in their capital city or specialists from.
Other countries to access those resources and say, this is a person that really does have something, legit. And like we go there and try to find the people who are really seriously ill, and we tie in with this foundation and we get help for whatever things they need, but. It's still intermittent at best.
And so you, wish that you had ability to use telemedicine to help our rural areas and that eventually, maybe kind of on a global scale to say, Hey, we can bring the expertise to you without flying the doctor and their team to your village, in order for you to be able to actually see a doctor.
Absolutely. And that's not a big reach. It's not a big ask. I don't think, you know, once you develop the technology and the processes to do [00:17:00] so, other than just kind of the local logistics, what bigger difference is there ? You know. 200 miles away versus, 10,000 miles away across, other than time zone.
Yeah, you know, that would be amazing. That'd be amazing, to see this tool. It's such a force multiplier if we can use it appropriately and create the systems to do so, We were able to realize that hopefully in our generation too, hope because it'd be fun to do that, right?
It'd be fun to take care of, you know, those that are in critical need. when I was a kid, I was doing medical trips to the Philippines and it'd be fun to reach back to my community where I was born to do that, and be able to share kind of expertise, you know, and gather that across the world so everybody can have, equal care, right?
No, that'd be amazing. That'd be amazing. Well, you know, another thought on that, I don't want to go too far on the sidebar, tangent. No, please. But I think it's really interesting because I think it was a comment, bill Gates made that as we try to incorporate better medical care in all, across the world, some of these things with [00:18:00] ai.
Stuff that can help us interpret x-rays, ultrasounds EKGs, you know, some of that stuff. Instead of having to go have a person do the immediate read, you can get the immediate read like we do from EKGs, you know, the sys, the EKG. automatic reads are pretty good. Yeah. And we use it.
Yeah. I'm a director for our ambulance service in our county, and it's really nice if you get an EKG, the image in my hands before the person's even there. You can say, are we dealing with a STEMI or not? You know, and you've worked in the ER so you know what I'm talking about. But the ability to absolutely integrate that information on onsite.
Have it come to your hands, and then as part of a team, you're making that decision that's best for the patient. There's a lot of technology that has to be developed and a lot of like cooperation among governing entities to make something like that work. But even in our local areas and local states, there's ways to use telemedicine and I think it will just get more and more powerful and more precise and, helpful to our patients as time goes on.
I bet we will see a lot of it in our lifetimes. And I [00:19:00] think we're starting to see at the beginning of it too. 'cause I've seen telemedicine companies, and I actually work for a telemedicine company that's actually partnering with EMS, partnering with ambulances, you know, to one triage to provide care, to get a doctor in the rig without actually having a doctor in the rig.
You know, I, think that's such a powerful tool, especially in your community, right? Or in a community where, You could take a rig out for two hours if you have to transport back and forth, and it's just a very limited resource. We've come across that a number of times the a, a winter storm, somebody has to take a critical patient that can't fly because the weather's too bad.
And so we're doing a transport system and we don't have a paramedic service in our area. It's they just don't have it in our area. So if we send somebody that's in really critical condition. A lot of times the decision is like, the doctor probably needs to go with the patient, but who's gonna run the ER if the doctor goes with the patient?
And so these rural areas, you just don't have a lot of depth to draw from. And so some of these things we're talking about where you can provide. [00:20:00] Really detailed information based on something that's being obtained at the site of care. that can inform a lot, you know, whether it be in the acute emergency setting or chronic disease model.
I am kind of excited to see where it goes. So I'm glad that you are at the forefront and I think telemedicine Talks is a great podcast. I've listened. It's fun to kind of hear all the ideas out there. And some of these are really gonna stick and go forward, I think. it's amazing to see kind of the different ideas that are coming out, right?
And it's just, you know, this agent innovation, right? Let's see what we could do. Let's push the limits. And technology's always ever changing. And it's awesome to see that people are trying to catch up or keep up with the technology and even actually conversely, ask for a need and have technology catch up to them, right?
So it's amazing to see that now, um. Flipping the script a little, a lot of your podcast or, one big focus of your podcast is wellness, right? And, and we talk about this in this podcast too, is Dr. Wellness, one of the things that telemedicine has allowed me to do was [00:21:00] focus on wellness.
Or actually I didn't realize that was a thing before I had the opportunity to actually think about it. And, you know, a lot of your focus is, hey, getting back, getting grounded. Doctors are people finding ourselves, and actually focusing on us, finding freedom, time freedom, financial freedom you know, and just the ability to do what we want.
If you could go back, let's say go back to your intern self, you know, you've graduated, you're starting internship and going back, talk to your intern self and say. Here's the one thing I need you to know before we start. What would you tell your, intern self? As far as wellness I guess one of the things that I've thought about quite a bit is, especially recently, I've shared on my podcast, some health problems that I've, dealt with over the last couple of years, and you just have to realize.
You need to live in the now. You can't put things in the future. And I think I've done a pretty good job. My wife and I have set lots of goals [00:22:00] and we've tried to just do those things as the opportunities have come on. But it's easy to get into. I'll be happy when, or I'll be happy if, or I'll do this when you know that kind of thinking and really.
The best thing to do, I think, in mostly parts of life is to say, well, if there's something I really wanna do, I should just set a goal and just work toward that and do it not someday in the 30 year range, but somewhere in the next six months we're gonna do this. And I think that, whether that be a trip or something with your family, or I'd love to like go backpacking in the Tetons and you know, there's never time to do it, but we're just gonna go, you know, and you'd have to kind of make those choices.
And I wish I had told myself, when I was an intern, You don't have to do it all now. it's good to learn all the medical stuff, but you have to keep learning it and taking care of yourself. And don't put off the happy times 'cause they're here and now and you're living your life right here in this moment.
And if you can't capture the moments, if you're always living for some future time, you might be disappointed. 'cause by the time you get to that future time, [00:23:00] your health or your interests your OR capabilities may have changed. And, you know, that's, strong, right? Because we're not trained to do that as doctors, we are not trained to think of ourselves, to think of our now. You know, it is always the patient, the system. And maybe we could get it done later. You know, I'm working in this hard, you know, I'm gonna work for 20 years and maybe I can join myself later. And that's a mindset, you know, that's a mindset that we've been trained.
when you're telling people this, how do you convince people to get out of that mindset? To convince people that, hey. You are important too. You know, it's like who's the one that dies the most? You know, who's the one that gets sick the most? Who's the one that always ignores themselves as a patient, the most as the doctors.
Right. So how do you convince doctors that are so trained and so used to basically being the martyr for other people to Yes. Think of you. Isn't that selfish? Right. It's like thinking about yourself as selfish if you're taking care of anybody else. Yeah I don't [00:24:00] know if I have a perfect script for it, but I'll tell you what I've found, that I've discovered, and, and I think you have too, most people discover this a little ways into medicine.
The after residency, there's no more protections. Nobody's actually watching out for your time and your family. And you know, it's kind of cliche. You've heard it before, you know they can always hire another doctor, but they can't get a new dad or a new mom or a new family member. And it is so true, and I think that we have to kind of look out for ourselves.
You have to mind the rules and do a good job of taking care of patients and be a, an excellent person in your profession. But I think patients deserve a doctor who's well rested, who wants to be there, who's interested in their care, and speaking on having, you know, been a patient. I think that stuff is so important.
I think about my encounters with doctors when I've been the patient, and everything hinges on that moment. It's not just like theoretical or like, oh, well think about this. My wellbeing, my family's wellbeing. Our future hinges on what those doctors recommend and what they [00:25:00] decide. And I just would be so bummed out if I had someone that was just aloof and disinterested and, hadn't slept for three days, and you're just a number to that person.
I've really been fortunate to have excellent doctors in my own care, and I want to be that doctor. But I would say just to maybe like to use your phrase, flip the script when somebody says It's selfish of me to, think about taking care of myself and my family. I need to give, give, give. Think about it the other way.
That's really selfish of you to not take care of yourself because now you're presenting yourself to your patients as this worn out, fatigued, burned out, frustrated person and you're look, checking your watch and you wanna get outta there 'cause you don't have time. And that's not really fair to them. So I think we have to change that paradigm, that idea that doctors are just like workaholics.
And instead focus on saying, how do I become the best doctor? And the best way I can be a doctor is to get the information I need, but then take care of myself and have a fulfilling life so that when I have someone present in front of me, I can give them my whole self. [00:26:00] And then I can know that there's a time to be a doctor and there's a time when I can not be a doctor.
And, that brings the point, right? I know in my training, and, this is what I was trained, is like to be the best doctor, you just have to focus on being the doctor , right? And, that's it. That's it. But, you bring up a great point that, I. Being a good doctor actually means being a complete person, a good complete person, being rested, taking care of your own life and things away from the hospital.
And that definitely affects and how you are in your clinic, hospital, wherever you are and in patient care. And Anytime I tell myself that it makes me feel uneasy a little because Right. This is the paradigm that we were raising. Right. I remember as a med student, I would ask, Hey, how could I do a better job in this rotation?
And the attendings would be, read more, work more, study more, be here more. Right. And That's it. And it's funny that, I don't know, did, was it COVID that made the difference? Did we all just get burnt out at the same time? But a lot of us are now having this realization that, yeah, you [00:27:00] this is detrimental.
You know, that kind of thinking is detrimental. What's has been, your major roadblock, you the speed bump that you found yourself, trying to get over that kind of thinking, How did you kind of help yourself and get that realization?
You know, I don't know that I have it figured out. I'm definitely a work in progress but I have realized that, like I said before, like nobody else is gonna do it for me And the other part about it, administrators or other people, even if they're well intentioned, they just don't know.
Nobody can really know unless you've been through that experience and you've been the person who's there called upon it, all hours of the day and night to take care of a person. And it's not just the idea that, you know, like you can robotically just have the answer. You're there in this role as a healer and I think maybe as doctors we need to maybe stop seeing ourselves as.
Technicians are looking at our technical prowess and our list of things we've memorized and focus a little bit on being a better healer because I [00:28:00] don't think AI and robots can really ever replace physicians because robots can't be healers. AI can't be a healer, but we can, and when you show up and you say, I'm here to try to help you in whatever way it takes, and that human touch, that human connection.
That has to come from a doctor that is prepared for that moment. And I found myself, if I'm way overtired and fatigued, I get frustrated and burned out and I had a really stressful day the other day at work and I had to come home and I just had to go out and sit on the deck for a while and do something else and you just kind of have to find your center and say,
I'm not doing this to keep the paperwork people happy. I'm not doing this to try to keep the insurance people happy. I'm not even doing this for my boss at work. I am doing this work for the patients and it's a job. I wanna take care of my family and all the rest, but I have to always go back to my core.
What are the motivators I want to make a difference. I want to help patients the best way I can. I need to be. The best kind of doctor that they would need me to be. So I have to take care of myself and I have to go [00:29:00] hiking or I have to go take a run up the canyon or gotta take a bike ride, or I've gotta go on a walk or whatever it may be.
I think all of us have to center ourselves and find the way back to being a healer. 'cause as soon as I stop caring, Or if my eyelid starts twitching 'cause I haven't slept two or three nights, then I know I've got to change. That's totally when I know like, okay, you've got to take a break.
But you know, it's funny 'cause that's definitely not a metric that we measure, right? Right. When you go talk your administrator, your annual review or your peer. That's nowhere, right? It's like, Hey, you know, did you code? Well, what's your patient satisfaction score? There's never a wellness score.
There's never, Hey, how's your family doing? Hey, how are you doing? are you well rested? You know, and you're right. it'd be helpful to have that as a metric, to have that realization. And you're, absolutely right. Nobody's gonna look out, you know, the administrators aren't gonna do that, right?
They, expect you to work as hard as you can and to make those metrics and. Who's the first person [00:30:00] that they know is going to sacrifice their time, their wellbeing for the patients. It's gonna be the doctors and nurses, right? Yeah they know, right? They know, Hey, we're gonna make this change, and the doctors and nurses and all the providers that.
They care for the patients so much that they're gonna sacrifice themselves to do and I've, you know, I just like, I think most physicians who've had administrators who are really tuned into the wellness of a medical team and those who aren't. Yeah. And there's such a stark difference.
we have really good administrators and there's a lot of good that way. But I've been a part of a team before where it was like, wow, we are just focused on All the what? The numbers and the stuff that just doesn't matter really when it comes to healing or patience. And so, you know, some of the stuff on my podcast if people wanna listen in, one of the reasons I focus a little bit on, like wellness and, and part of that is like financial wellbeing. Mm-hmm. Is so that you have the capacity to say no when it doesn't make sense or when a a system is asking of you something that is not for your wellness or your patient's wellness, but keeps some third party interested, you know, somebody else that's interested in [00:31:00] an outcome that really doesn't matter that much to you or to your patients.
You have the capacity to say no, or we're doing this different. And if they. Push and insist because they're in a, a role where they feel like they have to do it. You have the capacity as a doctor at that point to say, no, I, you can't actually push me into this, that's, you don't have power over me, and you can't, you don't have financial power over me.
You don't have any kind of power over me. And so I think enabling us to make those good decisions helps us be better doctors. Absolutely. Oh, absolutely. Right. And having the freedom, right? Having, knowing that, no, I don't need this. you know, you can't threaten my wellbeing becauseI'm pretty self-sufficient.
Right. I think a lot of us are stuck. A lot of us are stuck thinking that, yeah, I need this more than you need me. And flipping that switch, it's actually, feels so refreshing. once you're able to flip that and the realization that. I'm in the driver's seat, right. I'm in the driver's seat, you know, after residency, a lot of us are, are begging for [00:32:00] jobs, are clamoring for jobs.
You know, please hire me. Please hire me. I'm gonna take whatever. Mm-hmm. You know, I'll take it, I'll take it. And a lot of us are stuck in that and, doing things that aren't necessarily the best for us because we want to keep what we think is the job. We could only have. Right. Versus the job that we want.
So like you said earlier, like what would you tell yourself as an intern? That's one of the things is, hey, you have more autonomy, more capacity to choose than you realize. And I wish that I had realized that, but I just didn't, you know, that's, you just made me realize that too. It's, amazing.
that we forgotten our worth. We've gone through all this schooling, all this training, and at the very end, somehow we've forgotten. How much we really are worth. And we, most of us don't know how to stand up for ourselves and say, Hey, I am worth more than you're actually telling me.
you know, when we gave up our administrative duties, so for instance, so on, we've kind of given up that stance as well. We are being told how much we're worth [00:33:00] versus us telling everybody else how much we're worth , right? Yeah. And I think that's whole financial.
Yeah, both financial and your time. You know, I think more and more about time 'cause that's the one thing you can never get more of is time. No, absolutely. we can kind of measure worth with, financial means, but I think it's really important to say, okay, I'm the guardian of my time.
Who is going to inflict in my time? How much am my time? Am I disposable to you as my employer? How much time am I available to you? And you know, we've had instances where the employers have come back and said, well, we just want you to be available for this, and we just want you to be available for this.
And after several things you realize, Hey, you're actually asking me to be available seven days a week, every day. Oh, absolutely. Every minute of every day. And you're not paying me for those additional hours of availability. And so you do have to have the capacity to say. I'm in charge and I would love to be able to do this, but I have to be able to do it well rested, and an administrator who can't understand that is probably not one that's worth working for.[00:34:00]
No, and it's having the mindset to step up, having the where it all step up. And really just having the courage and the knowledge to do so. 'Cause a lot of us are very uncomfortable in doing so. And then talking about your podcast, you know, I was listening to some episodes and yeah, you have many stories of physicians stepping up and doing that.
Right. Finding what they want to do, finding freedom. It's amazing if you guys haven't listened to it. Take a look at it, you know, is this is all talking about mindset, talking about how to break the mold. You know, there's some amazing doctors on, your podcast that share their stories and there's, always nuggets to glean from it.
So, um, absolutely check it out. Yeah, I appreciate that, Leo. No worries, no worries. it's always amazing to see, and Yeah. A lot of things that push me is being able to see people that have done it right. And you see people that are successful in this and it's no longer this pipe dream.
It's a reality. Mm-hmm. And the more and [00:35:00] more that you hear people realizing this it makes it more and more of a reality to you. It makes it more and more attainable. and I have to remind myself a lot, right? Because when things get hard, when you know, things start bearing down, you know, it was like, Hey, there's a bunch of other people that figured it out.
We're all smart people. We wouldn't be here if we aren't all smart people, you know? Right. And we're in it together. We figure. Absolutely. I love that. I love that idea. The more you talk to people in this, you realize we're really all the same. Doctors absolutely. Kind of, there's some differences in specialty, difference in practice location, but we all deal with the same pressures and I think we all have the huge desire and the capacity to do great good, but we have to protect our wellbeing and our finances and our time.
So that you can do that you can realize those things and find a life well lived and not look back on it and just say like, well, I worked a lot and punched the clock a lot and spent a lot of hours, but it meant nothing to me. that's [00:36:00] no good. We have to be able to find the meaning, right?
Otherwise, what's the point? we work this hard to do what, right? And yeah. It's refreshing to see people have figured it out and why can't I. So Awesome. Well, hey it's about that time. Thank you so much again for joining us and sharing your insights and love talking about your mindset.
Love talking about how, your ideas of wellness, and you know where doctors should be. I've mentioned it already. Check out doctors making a difference.com. Check out Dr. Peter k Crane's podcast. Thank you so much for joining and hopefully we could follow up in a few months and see where we're doubt we're at.
No. Yeah. And you know, talk more. I love having you on and talking to you. It's great. Yeah. Thank you. Likewise. it's been a great privilege. Thank you so much. I appreciate you being willing to take me on as a guest. Absolutely. Absolutely. And until next time folks, thank you for joining Telemedicine Talks.
Uh, we'll see you later.