Physicians are the first ones who care for other people’s health. However, they have difficulty taking care of themselves and their wellness.
The medical profession is under immense pressure to perform more and more while sustaining the same level of quality, which can create a desire to place work above all as they care for patients and others around them. Yet, physicians need to prioritize their self-care, provide for themselves, and find time for rest.
Join the conversation with Dr. Alicia Shelly as we discuss running from burnout to wellness with mindset and margin. She enjoys running, traveling, and spending time with family in her free time, and by making some changes in her charting, she has been able to create the margin to continue her outside pursuits as she trains for an Ironman triathlon.
If you are a physician who feels like you can’t be fully present at home because in the back of your mind, you are thinking about your remaining charts, join me for a free webinar “Reclaim your purpose while charting”. Get encouraged and challenged about how you can live in alignment with your priorities, not wondering if you can go out to dinner or have family movie night.
“Reclaim your purpose while charting will be happening on August 3 and August 4”, please sign up to join me atmededwell.com/purpose
During this episode, you will learn about;
[00:00] Introduction to the show
[01:44] A bit about our guest today, Dr. Alicia Shelly
[02:55] Dr. Shelly’s journey in medicine and what she has learned over time
[04:55] Shelly’s story of running from burnout to wellness with the right mindset
[09:43] We fail to share our stories of vulnerability due to shame
[12:14] How exercising supported her pursuit of wellness
[14:26] Burnout can be depicted by your body’s failure to recharge after resting
[16:00] How the burnouts opened her doors into the sports space
[20:00] How the experiences in the marathon training complement the medical space
[21:42] Advice she gives to other physicians that she wishes to have known earlier
[25:20] Ending the show and call to action
- It’s rewarding and comforting to help someone.
- You can get carried in the busyness of life and forget to prioritize your mental and physical health.
- Burnout could mean a lack of the ability to recharge during your off times or whenever you are not working.
- Don’t always be a perfectionist. Strive for progress rather than perfection.
Do you want to get home sooner from the clinic or hospital? With all your notes and charting done, too? Get your FREE PDF guide with 10 tips to maximize your clinical efficiency! https://www.mededwell.com/efficiencyguide/
Connect with Us
Dr. Ryan Stegink
Get Coaching with Dr. Stegink: https://www.mededwell.com/coaching
Dr. Alicia Shelly
Back on Track Podcast: Overcoming Weight regain: https://podcasts.apple.com/us/podcast/back-on-track-overcoming-weight-regain/id1573676523
Above are the episode show notes and below is the transcript via www.temi.com. Some episode transcripts have been edited more than others, but they are up in the meantime to help those who would rather read and for searchability on the web. Extensive editing has not been prioritized as I seek to both produce regular content and maintain my own wellness. See the website disclaimer if you have questions, since this is all for your education and entertainment only. Enjoy!
Dr. Ryan Stegink (00:01):
Does charting in medicine seem overwhelming the queue of messages, labs, patient calls that never seems to get smaller. The pile of preauthorizations awaiting your input, the tens or hundreds of charts that you still have to finish and sign it’s exhausting, right? And still all you want is to be able to go home with your work done, to be able to spend time with family, hang out with friends, practice, self care. I want to invite you to join me for a six week long coaching program, charting mastery, where you will get equipped with the skills and approach that you need to get home sooner and leave that work at work, to check out more info and to join the wait list, head over to charting mastery.net. You will be among the first to hear when the door is open so that you can join me on this journey.
Dr. Ryan Stegink (01:12):
There will be opportunities to reflect and earn CME after the different sessions as well. And now onto today’s show. Welcome to the MedEd well podcast, empowering physicians to get work done at work, and then be able to reflect and choose what is important for both their life and medical practice. I’m your host, Dr. Ryan Stegen general pediatrician and life coach for physicians. Hello everyone. And welcome to another episode of the MedEd well podcast, where physicians come to be encouraged and equipped to take the next step in their own wellness journey. Thank you so much for subscribing in sharing these episodes and for engaging with these concepts to advance wellness for yourself, your patients and your colleagues today, I’m excited to be joined by Dr. Alicia, Shelly, who is a board certified internal medicine and obesity medicine physician with WellStar medical group in Douglasville, Georgia, just outside of Atlanta. She is the host of back on track, overcoming weight regain podcast, and YouTube channel. She is a fitness enthusiast and has completed six marathons in an Ironman 70.3 or half Ironman. She is currently training for her first full Ironman. Dr. Shelley, thank you so much for being here. Welcome to the podcast.
Dr. Alicia Shelly (02:42):
Thank you so much for having me. It’s such an honor to be able to talk to you today and detect your audience as well.
Dr. Ryan Stegink (02:49):
Thanks Dr. Shelley, why don’t you tell us a little bit more about yourself and your journey to medicine?
Dr. Alicia Shelly (02:55):
Ah, so my journey medicine, so it’s kind of funny. I’ve always, I think, you know, when you were a kid, you’re like, I wanna be an actress or I wanna be a school teacher. I think for me, I’ve kind of always wanted to go into healthcare. My mom tells me stories of how she would sit. She was sick and I would like make soup for her. I’d have my little pretend stethoscope listening to her heart. So I think either they brainwashed me at an early age or it’s just something I naturally kind of grew into. And even though I changed my mind, like I really wanted to be an actress and then they were like, so, you know, a majority of the time you start off, you’re waiting tables until you get that big break. And I was like, what?
Dr. Alicia Shelly (03:37):
Oh no, I need some job security. So, and I really did enjoy just help the, not only just helping people, but the, the mental, I guess, rigor of medicine, because it’s not just, you’re helping people, but you’re doing it a totally different way. You’re really thinking through the disease process, you’re taking people’s symptoms and saying, okay, it’s this. So you’re, you’re doing a lot of mental work gymnastics to kind of help people feel better. And so I have to admit it. It’s been very rewarding for me to be able to not only it’s an honor to be able to be in this position to, to see a service, but then also it’s rewarding to be able to help others and to just be a part of people’s lives. Like they allow you to come in, like in the good, the bad, the ugly, and you’re seeing people at so many different stages of life and it’s, and it’s, it’s truly an honor.
Dr. Ryan Stegink (04:28):
Yeah, really well said. I think just that, that honor and that service and, but also that intellectual rigor that really can just be so fulfilling when you really get to bring that all to bear as a physician.
Dr. Alicia Shelly (04:43):
Dr. Ryan Stegink (04:45):
So tell me a little bit more about how you got into practice and then how your wellness was threatened and what ultimately led you to burnout.
Dr. Alicia Shelly (04:55):
Yeah. So I entered into practice in 2014, beginning of January, 2014. And I actually, my first, the, the first boss the first practice I I started with was just excellent. He really mentored me. He allowed me to grow and as I was just building up my practice, I have to admit when I look back at it, now I realize that I was a perfectionist instead of delegating more. I was like doing things myself, because I thought I was the only one could do this. You know, I had to, I mean, I’m not saying you shouldn’t look through all your labs, but I had to look through the labs. I had to write a detailed, you know, detailed message on what each and every lab is. So this, this, this notion to be perfect notion to be able to like explain everything to the T you know, I would get behind in clinic.
Dr. Alicia Shelly (05:44):
Not, not that it’s okay to get behind. I’m not saying you shouldn’t, but I would get behind just with the, you know, regular follow ups, you know, trying to just give my all, and what I found was that I started to get burned out. Not only was I behind on my notes, I was behind on my labs, I behind on my messages. I mean, let’s not even talk about doing prior authorizations. It was like a big stack on my desk. and I was the only one that could do prior authorizations. Like I, I didn’t delegate to people. And so it got to the point where I was just, I was just dissatisfied. I wasn’t happy where I was. I’m like, can I be in primary care forever? I, I didn’t mention I’m a primary care and obesity doc. So in my primary care practice, I work three, three and a half days of primary care.
Dr. Alicia Shelly (06:32):
And then one day of obesity medicine. And so I’m like, I don’t know how I’m gonna be able to last, like, I’m only, it’s only been a couple years and I’m still wondering to, you know, thinking maybe I should jump ship. And so I have to, you know, so I think those certain characteristics that I had kind of caused me to lead to burnout. And so I thought that, Hey, let me change jobs. Maybe it’ll be better. On the other side, you know, the grass is always greener on the other side. And so I, I, I left my first practice, went to a different practice that had more people, more staff, more help. And I found no granted it was during COVID, but I did find that I started to get after the first year I started get burnt out again. I started to get behind in my nose behind in my labs.
Dr. Alicia Shelly (07:22):
Like the same thing was continuing. And, you know, I asked myself something has to give, this is not the work because the work is the same, whether in my first practice or in my second practice, there’s something internally that’s going wrong. And that’s when I fell in with well, I had started exercising before, so lemme get wrong. I started exercising before and it helped with kind of managing the burnout because it was a stress reliever. But in may of 2021, I realized that I needed coaching life coaching. And so there was a, a burnout coach. And by working with her, I was able to see kind of internally why, you know, I’m burning out. Why is it that I have to be so perfectionist? And then that is so funny, cuz sometimes one coach, it also led me to another coach where they helped with kind of honing in on the framework of like of your, of your, not just the frame of your notes, but just as a framework of how you can improve and be faster.
Dr. Alicia Shelly (08:29):
And you have like, you know, you have people you’re delegating more to people. You know, now I’m the thing that caused my burnout. The fact that I had, you know, so many outstanding notes. I mean, at one point I had 400 labs. Okay. 400 so, you know, if anybody who’s out there that understands, it was really bad. So, you know, I’ve gotten to the point where each time I’m in clinic, I have to finish my nose. I can’t leave without finishing my nose. So I’m finishing after every patient and it, it really helped me to be more efficient in the clinic so that I can be able to recover outside of clinic. Like I can use my, my off time as my off time, not just, oh, let me help, let me catch up time. So it really, it really made a difference. So I think that the 2021 is when I really realized how being in balance, not just with your emotional, but physical health is important as well.
Dr. Ryan Stegink (09:24):
Thanks so much for your vulnerability and sharing. I think this is so common and yet it’s, sometimes it’s easy to feel feelings of shame and like, oh, I bring things home or this pile of prior authorizations or the backlog of notes or labs. And it just, it feels overwhelming.
Dr. Alicia Shelly (09:43):
You’re absolutely right. And I would sometimes think of myself, oh, you’re a bad doctor. You know, you’re a bad doctor because you didn’t respond to this message within two hours or you’re a bad doctor because you know, the labs are still outstanding. No mind you, I had 400 labs, so yeah, I may have been a little bit of a bad doctor, but you know, but still it was like you said, the shame, the guilt that you feel, you know, and, and what I found was because I felt so guilty, I, it developed anxiety. I didn’t wanna even touch the labs because I’m like, oh gosh, what did this mean? If I touch, you know, like I just felt like so bad that, oh, you’re such a bad doctor that I didn’t even wanna just touch it. I was just, it just caused so much anxiety and stress.
Dr. Ryan Stegink (10:27):
Well, and I think it’s the things that got us into medical school, got us through medical school, those hardworking I can do it. Tendencies are real easy to bring into the never ending what seems never ending stream of labs and notes and the next 15 minutes. And so I think that’s really helpful just whether it’s getting coaching or just examining your thoughts and the stories that we tell ourselves around. It’s like, okay, I can actually take an extra two minutes in the room after I’ve signed the orders. The staff is getting things ready. And I just can tell them, Hey, I’m working on my notes. And especially as I see teenagers and I’m like, you wouldn’t wanna bring extra homework home with you, neither do the doctors.
Dr. Alicia Shelly (11:17):
No, that’s so true. And it, and you’re right, that we do tell ourselves these stories. And we do tell ourselves like these negative thoughts that be, you know, we’re thinking that, Hey, I’m a victim here. Cause I, you know, I have so much and I don’t have a life outside because of the fact that I’m having to take my work home. And so I, I found that to be the case myself or I was, I mean, we, it was so sad. I was talking to one of my friends from medical school and all of our conversations were, how are your notes? Like, , wasn’t like, oh, what are you doing? That’s fun this weekend. It was like, so are you catching up on your notes this weekend? Like what, like, it was really like, this was a way of life and, and it doesn’t have to be, it doesn’t have to be.
Dr. Ryan Stegink (12:00):
So by examining your thoughts and getting coaching, but then you said exercise really helped you as you worked through this and fought through burnout and supported your wellness. So tell me more about that.
Dr. Alicia Shelly (12:14):
Yeah. So what I find is that, like I mentioned, with the burnout, I also experience some anxiety. And so a lot of times, you know, with most people understand that when you have that anxiety, it could just build up if you don’t release it. And you’re just kind of sitting there just shaking because you’re just that anxious. And so by exercising it at first, I started off with just running. I would run maybe three days a week, you know, have a long run on the weekends. And then two days throughout the, throughout the week do a short run. And I found that it gave me an outlet. I wasn’t always like worried about my labs or worried about my notes. I was actually doing something else that kind of took my mind off of it. So it helped me to maintain, I think I probably wasn’t burnout for like several years.
Dr. Alicia Shelly (13:00):
Like it, it wasn’t like, oh, all of a sudden I decided this, no, this was something that I had been suffering with probably in silence for several, several years. And it took me some time to, to figure out what’s the next step to not, let’s say feel guilty or shameful that, oh, I’m the only, and in my mind telling myself, I’m the only doctor that’s, you know, that that’s going through this and it took some time, but I had started exci or, or running in 2016. And it just kind of helped it, you know, it gave me an opportunity, not only with being healthy and, and feeling better, but it, it was a really big stress reliever and allowed me some, some self-care time self-care time, which is also important when you’re trying to battle burnout.
Dr. Ryan Stegink (13:44):
Absolutely. And that’s really a good reminder that just prioritizing that self-care time and whether it’s going on that longer run or playing music, I play piano. And it’s just sometimes fun to have some totally different outlet. And whether it’s a hobby or spending time with people, friends, family, it’s just slowing down and saying, what are my priorities? And cuz it’s so easy to get caught up. And I think one of the big things for burnout with in my experience was just that lack of ability to really recharge during that off time, whether it’s a weekend or whenever you’re not on shift,
Dr. Alicia Shelly (14:26):
It makes a difference to be able to recover because you find that you’re waiting for the weekend, the weekend gets here and then you’re like, oh my gosh, I need another day. You know and so having that recharge, it makes you a lot. It makes you happier. It makes you, you know, ready to go. I was talking to a colleague today actually. And we were like, I wonder if I’m a better doctor on Monday than I am the better doctor on Friday, because on Friday you’re kind of drained from the week. You’re just trying to get to the weekend. And then the weekend comes, you’re like, oh yeah, the weekend’s here. And then Monday you’re like, well, I’m, you know, I’m refreshed, you know, or the opposite. I’m just drained from the weekend. And so it just kind of makes a difference. And it also, it makes a difference in how you practice too, because when you’re burnt out, you’re just kind of trying to phone it in. You’re trying to make it to the next patient. And, and people can see through that when you’re maybe not as interested or you, you have something on your mind, they can tell, they can tell. Mm
Dr. Ryan Stegink (15:24):
Yeah. They can see that you’re rushed or you’re not listening as well. Or when they bring up that one thing as you’re about to walk out the door.
Dr. Alicia Shelly (15:31):
No, that happens all the time. mm-hmm
Dr. Ryan Stegink (15:34):
and then it’s yeah. It’s like, how do you choose to manage your own mind and how you respond to that? Cause those thoughts can be challenging.
Dr. Alicia Shelly (15:43):
Yes. Yes. They can be mm-hmm
Dr. Ryan Stegink (15:45):
So you found exercise and running, but then you got into marathons and are now training for a full Ironman. Tell me more about that process and how you got interested in that.
Dr. Alicia Shelly (16:00):
Oh yeah. So the funny thing is I was never athletic at all, never athletic. And in fact, I only got into running, like I said, in 2016, cuz my friend was like, Hey, let’s do a 5k. So we did the couch to 5k app and then every year in Atlanta they have this six mile or 10 K on 4th of July called the Peachtree road race. And my friend was like, Hey, let’s, let’s train for that. So we did the couch, just 10 K app. And then I, after, you know, just putting like with those apps, you’re exercising maybe three days out the week and I just realized this was such another way, how to exercise and I enjoyed it. And so I was like, okay, let me try the half marathon. The half marathon kicked my butt. And I, because there was no, well maybe there was a couch to half, half marathon, but I did not use that app so I wish I had, cause that half marathon kicked my butt, but I finished it.
Dr. Alicia Shelly (16:56):
And then I had a couple other races, half marathon and 10 mile already paid for. So I’m like, well let me try to train for it cuz I don’t want to lose my money. And actually I ended up enjoy loving it, loving it. And then they of course with the different, you know, different, it was Atlanta track club with these different run clubs, they have different promotions. And so they said, Hey, if you did the Peachtree roadway, if you did the 10 miler and you did the half marathon, you can do the marathon, which would be the ultimate peach and you get something special. And so of course they didn’t tell you what that something special was and I was like, let me train. I’ve always wanted to do it. So knowing that I need to train, I joined a training program at the Atlanta track club and the rest is history.
Dr. Alicia Shelly (17:44):
I fell in love with marathon running. I loved just the, the person you have to become in order to finish that race, which is somebody who’s consistent, somebody who is continuing to go, making sure you have your nutrition together. And so even eventually I was able to do over the years, six marathons and then I realized I need a challenge. I need more of a challenge. And so for the last year I’ve been training for an Ironman, which is in September. So I have a few weeks to go until this Ironman, but it’s been a great challenge. It actually, it’s more than, I mean, of course with anybody who’s, if you’re not familiar with an Ironman, it’s basically a triathlon where you have 2.4 miles of swimming, 116 miles of riding your bike and 26.2 miles of running all on the same day within 16 hours, my goal is 16 hours.
Dr. Alicia Shelly (18:39):
I think it’s 16 hours and 30 minutes is the time cutoff. So that’s what my goal is. 16 hours and 29 minutes so that I can finish. But it is a challenge and the discipline that you have to have. And that’s when I realized I had to do something more than what I was doing because I was spending a lot of time working outside of work and I needed to focus on the Ironman. I needed to be able to do my my activities, my exercises, because usually with the Ironman, you’re exercising twice a day in the morning and at night. And so it makes it somewhat difficult to have to have like this burden of burden of notes to do or labs. And so that’s when I sought out my second coach who kind of helped me with conquering that conquering the notes and the labs.
Dr. Ryan Stegink (19:28):
That’s amazing. Well, and just to see that the confluence of the working out the going for goals, the, the mind work that you needed and then just realizing, okay, in order to have that space to use that discipline, you were then in getting that second coach able to apply those same disciplines to your charting and your workflows and it all kind of has come together. And here you are just weeks away from finishing your first Ironman.
Dr. Alicia Shelly (20:01):
Yes. Yes. And, and you’re right. The funny thing, the different tools and the different mindset that you actually develop while training for the Ironman you use in, in regular medicine life, you know, cause there’s some days when I don’t, you know, I’m tired, I don’t wanna go to work and I use that, Hey, you can do hard things. Just keep going, just show up. You know, so different affirmations that I use in the Ironman I use too with my work. And it helps me to kind kind of avoiding burnout because I realize that when those negative thoughts start to come, I can be able to change them to more positive thoughts to kind of help me get through that moment.
Dr. Ryan Stegink (20:41):
Yeah. Thanks. That’s so huge. And just looking at it’s like, even if others listening, aren’t training for an iron man as I am not, it’s like, you can still realize it’s like, you’ve done hard things. You’ve graduated medical school, you might be in residency or in your first attending job. These are all things that looking back, you can say, all right, I’ve done this and I can apply it here. So things you’ve done in going for a marathon and then a half Ironman. It’s like those all come together and just your life and your medical practice.
Dr. Alicia Shelly (21:20):
Oh definitely. You’re absolutely right. It all comes together and you can all use it. You can all use it. and it’s been very helpful for me too as well.
Dr. Ryan Stegink (21:28):
That’s so cool. So what advice would you have for other physicians out there right now? Something that maybe you wish you knew earlier in your career, maybe even when you were still in training that might help them in their journey right now.
Dr. Alicia Shelly (21:42):
So definitely. And, and you may not suffer with how I did with my notes in my labs, but you know, I, the one key thing that really made it difficult for me was my perfectionism having to be perfect. And so I would tell you it’s more about progress, not perfection, you know, make sure that you’re showing up every day, but you know, you don’t have to do it perfectly. You know, when you are in medical school, they teach you how to write your soap note. And then, you know, you go on your rotations and they’re like, critiquing your soap note, soap note. So in your mind, you’re like, it has to be perfect or they’re gonna critique me. They’re gonna read this note and blah, blah, blah. But when you become an attending, you realize literally what people care about are the assessment and plan .
Dr. Alicia Shelly (22:24):
They said, they’re like, what did you do? What’s next? Where do we go from here? You know, like that’s what people care about. I mean, you know, rarely they kinda look through the HPI. So, you know, you spending like hours trying to have that craft, that perfect note. You don’t have to, you don’t have to be perfect. You definitely it’s okay to do your notes anyway, to let that be not as perfect or be work, shall we say? And sometimes you have to give yourself grace, cuz that was where I, that’s where I stopped, where I wasn’t allowing myself grace. I was just beating myself up for not being the perfect doctor that I thought I was in my mind or that the perfect doctor that I wanted to be or strive to be because, oh, I didn’t answer this message, you know, within the 24 hours.
Dr. Alicia Shelly (23:13):
And as long as it’s not urgent, I think you’re fine. So I would say my advice to you all coming up is, you know, you don’t have to be perfect. You don’t have to craft that same note, but you definitely wanna be able to finish your notes that in that day, like, you know, don’t take stuff home, like finish it after each patient. Even like you said, even if it’s half, you know, a minute or two, what I found is like one of my frameworks is that I use a little timer in the room because I tend to talk and just chat, chat, chat, chat, chat. And before you know it, we’re 30 minutes over and now I’m behind a whole, you know, so I use a little timer. And the one thing I realized is that I tie myself in between the patients.
Dr. Alicia Shelly (23:52):
So where I finish their notes and it may take me like one to two minutes to finish the note and close it. But if I were to take this same note and sit down, like after work, it takes me 30 minutes, 15 minutes to close this note. Why? Because I’m like, I’m trying to remember what happened. I’m like, what was I thinking? What did they say? So it is better just to, I would say for those that are coming up, finish your note. After every patient, people will wait, they’ll just be on their phones while you’re finishing your note. It’s just one to two minutes. They won’t notice, they won’t notice Uhhuh, but you know, just make sure that you’re also taking your time for yourself to recover and have that self-care time.
Dr. Ryan Stegink (24:35):
Hmm. Those are such great insights. I think I’ll have to go back and listen myself cuz just those things that it’s really helpful to remind yourself those positive thoughts, because it’s so easy to yeah. Talk negatively to ourselves like to those feelings of shame and guilt, that can be so isolating and even just acknowledging that it’s like so many of us face them and just reminding ourselves of these things I think can be really helpful in supporting one another. So thanks so much for sharing those.
Dr. Alicia Shelly (25:08):
Oh, you’re welcome. And thank you so much for having me.
Dr. Ryan Stegink (25:11):
It was an honor to have you join us and I wish you all the best with your iron man coming up.
Dr. Alicia Shelly (25:18):
Dr. Ryan Stegink (25:19):
Thank you so much, Dr. Shelley for joining me on the MedEd well podcast and sharing such amazing insights to help other physicians in pursuing their own wellness and to prioritize that self-care and caring for your own health and wellness for all of you listening. I want you to consider how you can apply what you’ve learned from Dr. Shelly in today’s discussion. And then please share this podcast with another doctor in your life and subscribe to the podcast. You can help change the culture of medicine and promote wellness for your patients, your colleagues and yourself. Thank you so much for all that you do and have a great day. And now for our important disclaimer, Dr. Ryan Stegen is a practicing general pediatrician, but the meed well podcast does not reflective views opinions or belief of his employer nor his affiliated university. Additionally, the MedEd well podcast is for educational and entertainment purposes only and should not be considered advice regarding financial legal student loan, medical, or any other specific topic. In such a case you should see consultation with certified professional in that particular area. Again, thanks for joining us on the MedEd well podcast and have a great day.