Select Page

Above are the episode show notes and below is the transcript via 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 Dott 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 positions 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 and sharing these episodes and for engaging with these concepts today, I am joined by Dr. Melissa Barbosa. Dr. Barbosa is a triple board certified family physician and addiction medicine specialist as an osteopathic physician, Dr. Melissa’s training at the Philadelphia college of osteopathic medicine instilled the principles that the body is a unit comprised of mind, body, and spirit. With this knowledge Dr. Melissa’s approach to medicine addresses whole person care to facilitate the process of true healing. Dr. Melissa’s method of care involves her patients finding a common ground upon which treatment can commence by working with patients through their fears and insecurities as an empathic and conscientious physician. Dr. Melissa is an advocate for both colleagues and patients, Dr. Melissa, welcome to the show.

Dr. Malissa Barbosa (02:59):
Thank you for having me, Ryan. I am so excited to be able to have this opportunity to sit down and speak with you tonight.

Dr. Ryan Stegink (03:06):
Thanks. Well, tell me a little bit about yourself and your journey to medicine.

Dr. Malissa Barbosa (03:11):
Well, as you stated, I’m triple board certified, which, um, the three disciplines are family medicine, addiction and obesity medicine. And for me, medicine was not a direct path. I actually jokingly tell myself I had a whole life before I came to medicine and, and then medicine just popped up on the trajectory. But I initially thought I was supposed to been a researcher. My plan was biochemistry and genetics when I was going through undergrad. And my goal was to find the next great cure to the thing to help heal the world. But along my road of graduate school was when I deter, when I discovered that the terminal PhD was not the doctorate that I was supposed to be pursuing. And, um, it was during that timeframe that basically my whole life was disrupted. And I went on my new journey to pursue medicine after that, but it was a couple of segues to get me there. I went and did research at the NIH for two years. I taught at the university level biology coursework and then ended up in medical school as a non-traditional student in my thirties. So yeah, it was wonderful. I had a whole life before I came to medicine

Dr. Ryan Stegink (04:34):
And just really brings some perspective as to how to deal with life and students, and just were really richness that I think really has the potential to serve your patients and your community.

Dr. Malissa Barbosa (04:51):
Yes, it, it did because earnestly, when I started medical school, I discovered that I was in classes with colleagues that were my brother’s ages, my brother and I are eight years apart. So it was, it was definitely, I could tell the difference and it was that cusp generation, cuz they weren’t at cusp of being millennials versus being my gen Xers. But I could tell that they were truly, truly millennials. So work ethic was a little bit different. I was the old school person out of the bunch. So we still had the ways of like the boomer generation. So it just made it interesting that interplay between how I saw things and how my colleagues saw things, but it was a great synergy all the same because I was able to learn how to adapt. And um, I, I believe that’s what make us as gen Xers a little bit more unique because we have to, we had to adapt between the two generations going forward. So it, it was, it did give me perspective and a uniqueness to how I approached not only my coursework, but then ultimately how I practiced.

Dr. Ryan Stegink (06:06):
Hmm. Well, and just speaking of perspective and some of this intentionality and transitions, could you share about how you started intern year and how you survived the stress of intern year while being pregnant?

Dr. Malissa Barbosa (06:21):
Oh my goodness. Well , I would have to say intern year was, was very eyeopening for me. I started in internal medicine. I was that I called myself the internal medicine chick all through, uh, all through medical school because I felt that, um, that was where I was supposed to be. I was uniquely nerdy. My background in undergrad was engineering and uh, and finished with two degrees in chemistry. So I’m very analytical and I was just like, yeah, internal medicine, that’s where I’m going. And then I started intern and it was, it was a unique experience that as I traverse through my time there, I realized I wasn’t, as in love with it, as I thought I was going to be. And then about three months into internship, I discovered I was pregnant. And so it was interesting because it wasn’t that me, I was one of, I was one of two female interns in the internal medicine class at that time.

Dr. Malissa Barbosa (07:30):
And I was the only African American female in the intern class. So, you know, it was almost like I had a target on my back already. And then to end up being a pregnant intern on top of it, it was just like, great. Did I really need this right now? But it was an interesting time because, you know, um, when you didn’t, when you didn’t have a lot of individuals that were supporting you, as far as senior residents was concerned, it made it a little bit more of a tenuous situation where I saw some of my other internal colleagues getting all the support and all the help that wasn’t the case for me. So I had to do a lot of things on my own. And for me, my, because I had a particular work ethic and I was dealing with colleagues that were younger than me by years.

Dr. Malissa Barbosa (08:22):
And working with that hierarchy, they couldn’t identify how I would draw my boundaries. And at we had pagers, they wanted my cell phone. I’m like, why do you need my cell phone? When we have pagers, you don’t need to call my personal cell phone. You know? So things of that nature. And even when I was button heads with, with my attendings, because my attendings, we were the same age, but they were very demeaning in their conversation towards me, just very, it was just a very hostile environment. So to be the pregnant intern during that time, it was, um, it was very stressful. I would go to my OB appointments, crying and begging for them to figure out a way to pull me out. And they were just like, well, you’re healthy. There’s no gestational diabetes. You’re not preeclamptic. We don’t have anything me medical to pull you out for.

Dr. Malissa Barbosa (09:21):
And I was like, okay. Yes, I understand. And I had to pretty much suck it up. And every morning when I would go in before morning report, before rounds, I would go into the chapel and would have my good cry before I started rounds. I would have my good cry before I started my on call. And I would have my good cry before I left to go home. And so I was like, this is, this is not what I thought this was going to look like. And, and my husband as supportive as he was at that time, he was a protector still is. And he, he was like, I don’t care who they are. They’re not gonna treat my wife this way. I’m gonna come up to that hospital. And I said, no, no, no, I don’t need for you to do that. Cuz we’ll only make matters worse but there was a situation that did occur while I was on call where I, um, I started feeling abnormal pain and um, that necessitated that I had to be removed from the hospital.

Dr. Malissa Barbosa (10:33):
And um, they called my OB and my OB told me to told them to have me sent by way of ambulance to a tertiary, to another hospital that had a NICU, cuz they weren’t certain at the time that if the baby was gonna come prematurely or not. And so I was still being a good intern, trying to call individuals to see if they can come in and cover the call for me, even though I was in this distress and I couldn’t identify any other intern to take my spot. So I was just like, well, this, you know, they forced me put me on the ambulance, sent me over to the other hospital and I was there on monitors for the rest of the, the day. And then once they released me, they said, no, you go straight home. Do not return to the hospital, do not return to on call.

Dr. Malissa Barbosa (11:26):
And I was like, okay. So I went home. Well when I returned to, and it was a Saturday call. So you know, that just, that just didn’t rub people the right way. And so when I returned on Monday morning, basically I got hit with an onslaught of, well, this is what you should have done before you left the hospital. I’m like, what? And it’s like, well it’s not your fault or anything, but it just messed up everything. And a senior had to take your call for you and nobody. And because you can’t reciprocate, then you know, it just wasn’t fair. Okay. And then I received an email from the, from the chief resident at the time, that was just like, oh, I hope everything is okay between you and a baby. But according to policies and procedures, you were supposed to find a replacement before you left the hospital.

Dr. Malissa Barbosa (12:20):
They sent me out in an ambulance. What was I supposed to do? And so that it was very eyeopening and because of everything that had gone on leading up to that point, the GME director was they called me into the office and they were just like, we’re gonna allow you to go out on your maternity, leave early if you like, because they were afraid that, um, cuz they were afraid that I was going to bring a complaint because of everything that had taken place during that time. And I had been documenting instances and things that was trans, that was going on and they were afraid that I was going to formally bring a complaint and what the chief resident did was the straw that broke the camels back, so to speak. And they were just like, if you need to go out early, you can, we’ll give you four months of maternity leave as opposed to the three.

Dr. Malissa Barbosa (13:18):
And this is that and the other and blah, blah, blah. And I was like, that’s fine. I’ll take it. Cuz by that point I needed out for my mental health. I needed out for the stress that I was under. I needed out and I was home for four months and thank God my daughter was born. Perfect, no issues. And the only, the only thing that we’re still dealing with now is that the poor child doesn’t sleep through the night. Cuz I never slept during intern year. I never slept on call. So we still have issues with her sleeping through the night. But that was the experience. And through that, I learned that a lot of my faith had to carry me through because that chapel became more important to me than anything else. That was my place of solitude. It was my place where I could get myself, get my mind. Right. That’s what I would say. I would, I could go there and get my mind. Right. And I knew no one would look for me there cuz no one ever went to the chapel. And so that was just my place to be able to say, you know, unleash all of the burdens that I had, get all the good cries out and then get my courage up to face, whatever I was gonna face that day.

Dr. Ryan Stegink (14:37):
Thanks for your vulnerability and willingness to share. I mean that’s so hard and just thinking about okay, the going through a medical emergency and then still not having that support from your colleagues, from your program, where did you find support throughout intern year, whether pregnancy or throughout your training? Like what other things were good supports for you?

Dr. Malissa Barbosa (15:06):
Well, I had one attending that looked out for me. He was wonderful and, and I appreciated him fully. He was a Christian in a faith as well. And I elected to do my clinic with him. So I would go to his clinic. He would sit me down. We would have nice long conversations just about life in general. And he would give me Sage words of advice to help me navigate through the remaining of my year. He even gave me heads up when they weren’t gonna renew my contract, even though they never formally told me that they weren’t gonna renew my contract and, and I, because of, because of the maternity leave, I had to come back and finish off cycle. And so there was no mention of anything and it wasn’t. And the only person I would hear from was from that particular attending and he made it clear.

Dr. Malissa Barbosa (16:07):
I was supposed to finish in October. He told me in September, he’s like, yes, it’s clear. They’re not going to renew you. And he said, and they’re not going to tell you either. He says, so I figured I would let you know, so you can make your arrangements because I was trying to figure out how to get in midyear someplace else. But because they never said anything, it kind of blocked my chances to get in midyear. So it afforded me the opportunity to spend six months at home with my daughter that was priceless at that time and go through the match again in a traditional context to find a new program. But between, you know, having that one faculty member working with, um, my family tremendously was of support to me. And even surprisingly my GYN, they could see how much stress I was under and they would talk me off the ledge too, cuz they knew I was a resident and they would just keep encouraging me like, look, you’re going to make it through, just keep doing what you’re doing. It’s okay. And it was just nice to hear it from people on the other side to let me know that I could make it because I wasn’t getting it from the individuals that were in my program.

Dr. Ryan Stegink (17:25):
Well, it’s just so encouraging to know that even if you don’t have supportive whatever group of people, whether it’s colleagues or family, it’s like that intentionally seeking out others and surrounding yourself with people you can find and build that supportive team. So I’m glad you found that.

Dr. Malissa Barbosa (17:45):
Yeah, that’s, it’s very true. I, I had, I had had good friends of mine that were in residency as well, but they were a year ahead of me. So we would have those, um, commiserating sessions together as well. And um, and we would spend a lot of time outside of when they weren’t on call. I wasn’t on call being able to hang out at each other’s homes and just have that community as well. That was also important because, um, you know, once, once you graduate from, from medical school to, if you’re not going into residency with friends, you’re pretty much isolated. You’re alone. You, you lose that community and if you don’t really formulate those communities amongst your program, then it can be very lonely and um, and can be very difficult to get through. And you feel like you’re enduring situations as opposed to enjoying the process.

Dr. Malissa Barbosa (18:45):
And so I was grateful that I did have at least like my good friends from college that lived in the area, good friends, that I went to high school with that I kept in contact with, you know? So these were like long standing friendships that they knew me and I could share and unburdened myself to a certain degree. They may not have understood everything I was going through, but at least if they gave me a listening ear, it was a good enough for me to be able to feel like I could release and be safe in those communities.

Dr. Ryan Stegink (19:18):
So some of those things I think lend themselves to transitioning into discussion of resilience and how you build that and the importance of mindset. How would you characterize your perspective on resilience and how this was shaped by your experience as an intern?

Dr. Malissa Barbosa (19:38):
You know, it’s interesting cuz when I was looking at recently, I was looking at the definition of resilience and it was just, it was speaking to that capacity to recover quickly from difficulties. And so when I thought about that and thought about reflecting on my intern year, I was like, you know what? It wasn’t the best of times, it definitely was the worst of times in my opinion at that point, but I didn’t allow it to take me out. And that was what was important because I had already, prior to intern year, I had already went through a medical setback during medical school. And actually the medical setback was, was grievous enough where if I did not make it to the emergency room when I did, I wouldn’t be sitting here right now. And so going through that scenario, that hospital stay, having those, those weeks in a hospital, under treatment and surgery and everything that had transpired during that time, I had a lot of moments to have introspection to try to figure out like, okay, how did you get here?

Dr. Malissa Barbosa (20:56):
And a lot of it came down to, in that time, just really figuring out what was making me tick and understanding that, that there was a lot of things that I had allowed to happen in my life that was building the stress. And it was all under the guise of I work well under pressure and realizing how that was becoming a detriment to me physically. And recognizing that I was, that I had cycles of the behavior that followed me all throughout my schooling, that when I recognized that, wow, I had been bullying myself into these stressful situations because I wanted to prove to myself how well I could pro I could perform underneath high stress. What sense does that make? I was like, I was really a fall intent of purposes. I was an, a very sadistic person and torturing myself in those situations. And I had to learn that if I didn’t take the time to take care of me, no one else would cuz I have to care for me first.

Dr. Malissa Barbosa (22:06):
So fast forward when I got into residency and during the intern year, it circled back in that instance and I, and when I was off for those four months, being a mother and enjoying that new season of my life, I was like, you know, if I were to, if something had happened to me on that faithful day, during that on call, that led to me no longer being present on this earth, what would’ve been the reaction of the hospital, the team at that time, they would’ve said pleasantries such as oh, Dr. Barbosa was a good intern. Oh she was a pleasant person to be around, but they would hire someone else to replace me and they would keep it moving and would not miss a beat. So because of that, I had to then take ownership of me being my own VA advocate and valuing me enough to know that there were situations that I just don’t need to be a part of and in doing so I had to find a healthier solution for me because I did not want to put myself back in a place where I was just a few years before in the hospital.

Dr. Malissa Barbosa (23:22):
And so I had to learn how to really take ownership of, of being a good person to myself and being a good caretaker of myself and realizing that if I was to drop dead today, the world would not stop moving. They would think and comment on me for a moment and it will continue on. And so understanding that it was just like, yeah, no, it’s time for you to really take care of you because if you don’t know, one else will,

Dr. Ryan Stegink (23:52):
That’s such great advice because we need to hear that when so much of medical education, whether in medical school and residency, or even after it’s about, okay, what’s your output? What’s your achievement? What are you able to do? What shift are you able to cover? What procedures are you able to perform? And if you can’t do it, they’ll find somebody else and yet advocating for yourself. And that intentionality of saying, this is what I need and I’m gonna figure out how I’m going to make that happen. It’s so important. So I really appreciate you sharing that.

Dr. Malissa Barbosa (24:30):
Yes, because it’s often frowned upon. Unfortunately. I mean even when the rule changes started coming down a pike during my time in residency, I graduated from medical school in 2009. So that was that era where things were changing, where residents could take naps. Ooh, we were restricting hours, no longer working 180 hours a week. You know, those types of things and folk were giving the lip service to having better working conditions for residents. But then it was tongue in cheek because it’s like, well, if you really wanna get the most outta this program, you need to work the way we worked. And so it was a winking, a nod and still encouraging individuals to not comply with the new rules. And so that was an eye-opening season because I was already unique cuz I was an older resident and I already came into this awakening to myself of, you know, what I need to take care of me. But then when I started setting boundaries, I got pushed back because I wasn’t the team player cuz I wasn’t willing to sacrifice myself to the same extent. And I’m like, no, no I don’t need to. And even after I changed residency programs, the second program that I attended was very much so supportive, more laid back. But I think that’s because it was in Miami, everyone’s laid back in Miami .

Dr. Malissa Barbosa (26:10):
I was in a, I was in a Cuban hospital. So you know, it was, it very laid back environment. But um, but it was just, it was a different vibe from what I had before and I had to learn how to decompress. I could be more intentional and slow down. I was still working, running at a breakneck pace of being from the Northeast and coming to south Florida. It was no, just as long as you get your work done, it’s good. And it took me a moment to accept that. And I was like, really? I was like, as long as you get your work done, it’s good. And I was like, oh, okay. And um, and then I could get the balance because, um, cuz when we first moved here, it was a transition. I transitioned first, I got a late acceptance into the program.

Dr. Malissa Barbosa (27:07):
So I had a week to prepare before everything started. Didn’t have housing lived in a hotel for two months before I found housing in Miami. My daughter transitioned six months after and it was just the two of us. And then my husband was able to follow a year later. So I had to learn how to be a single mom for like six months. And they were very amenable to, okay, let’s work out your hours so that you don’t have any problems. I could, even though I was still, I was somewhere in our program was in south Miami and I had to travel to deer Delray beach and depending on traffic, it could take me three hours to get back home and they would say, okay, no, that’s fine. Look just to make sure you can make it home. You’re done in a clinic at three.

Dr. Malissa Barbosa (28:00):
So you can make it back down to Miami by six. Because if you weren’t picking up that kid by six o’clock, you know, DCF would be sitting there out on a stoop with your kid and so we didn’t want that to happen. So bet I would break my neck to get back down, to pick her up and I could be mommy, take her home, read bedtime stories, fix dinner, do all these things. And I was, and that was my chief resident year. And so it was, it was a very interesting dynamic where I learned how to start putting more things in perspective. And it was very helpful to say the least.

Dr. Ryan Stegink (28:38):
Hmm. And I could see that really shaping your vision of like being a whole person. You’re a mom, you’re a wife, you’re a woman, you’re a doctor. It’s not just, oh, it’s like, you are a resident. And that is your only identity. It’s like you are a whole person. How has that shaped? How you think about your practice of medicine now?

Dr. Malissa Barbosa (29:03):
Well, how it shapes my practice is, is simple. It’s just that I see, I see people in totality and a, a portion of that. I credit towards my osteopathic training as well because that’s how we’re taught. And that’s a part of our philosophy, the home mind, body spirit aspect of things, but really having that, understanding that there’s a whole lot to a person that’s going on beyond the symptoms that they’re presenting with. And if you don’t take that vested interest to really get to know what’s going on with your patient, then you will miss a whole lot. And it’s particularly interesting, especially in the field of addiction where I’ve been working for the past couple of years because they, this particular population has been not so much in touch with the medical field as much. And if they have been, it’s been from a very jaded perspective.

Dr. Malissa Barbosa (29:57):
And so it’s been, for me, it’s been a mission of mine to make them feel included back into the family of medicine because they feel that if they come into the ER, they already been stigmatized, oh, they’re the frequent fire or they’re drug seeking or they’re the, that, and the other, all the lovely names. We like the nicknames we use, we usually call our patients, which, you know, I’m glad that we’re working towards the patient centered conversations as opposed to labeling them by their conditions. But understanding that dynamic when they would come to see me, I would take that vested interest. I start getting to know them, start talking about, oh, how’s, you know, if do they have contact with the family? How’s that dynamic going? What are their options or what did they foresee in life? Because I’m pretty sure when they were a little kid, they didn’t raise their hand and say, oh, when I grow up, I wanna be an addict.

Dr. Malissa Barbosa (31:02):
I wanna be addicted to something that was not their dream. So helping them find, get back in touch with who they are. As we walk their process together, we spend a lot of time talking and oftentimes at the end of the visit, they feel like they’ve been through therapy. And I tell them my disclaimer, as like, I’m not a therapist, I just have therapeutic tendencies. So no, you will not be billed for this hour as therapy. this was your follow up. But I allow them space because I’m afforded that opportunity to give them the space. And if, if we were allowed to be that way in other areas of medicine, particularly in primary care, we could get to the heart of the matter a whole lot sooner. Then the 2.3 minutes, we spend in a room with them after the nurse has done all the triage information and we come in for a hot second, maybe put hands on them and then type everything up in the electronic medical record, you’ll be able to have those tangible conversations to be able to learn more.

Dr. Malissa Barbosa (32:17):
And, um, that’s, that’s why it didn’t last too long as a family doctor because my clinic would blow up every day with someone that would have some issue. And for the life of my practice manager, they couldn’t understand why my clinic was always running behind. And I was like, yeah, because you put a person on my schedule that said they had a cough. And when they actually, when I came into the room, they said that they were having suicidal ideation. And because I worked in a Mennonite Amish community, which was very closed and didn’t wanna discuss things in the general public, they waited until I come into the room to talk with their doctor. So you had, ’em slated for 15 minutes and it ended up being an hour visit cuz we had a contract for safety, get them in with the social worker, making sure everything was okay mm-hmm and those would be the patients that I would see. And yeah, they didn’t like me too much there.

Dr. Ryan Stegink (33:16):
And part of it speaks to how you see your role as a physician and saying, this is the care that they need because they’re a whole person it’s not just they’re have a physical symptom of a cough. It’s it’s like, okay, no, it’s like physical, mental, spiritual, all these parts go into the health of an entire whole individual.

Dr. Malissa Barbosa (33:38):
Yes, indeed, indeed. And I used to like from some aspects when I was in primary care, when, um, individuals wouldn’t be fully, they would fully disclose everything that was going on. And you know how you have a little indication that they’re not really telling you everything. So I would borrow lines from who wants to be a millionaire and talk about their lifelines. And it’s like, so I know you didn’t tell me the full truth. So which lifeline do you wanna use phone a friend or just actually tell me what’s going on because I know you weren’t being honest and they, I would catch them off guard. And I was like, yeah, I know you weren’t telling me the truth. So you could phone a friend or you could tell me the truth, you know, which lifeline. And they’re like, okay doc. And so break it up a little bit with the levity, just letting them know that I am on their side.

Dr. Malissa Barbosa (34:31):
And then next thing I can get the fullness of the story that would come out at that point. But you, you, you have to be able to spend that time to understand fully if you’re just about checking the boxes, because you’re on that, you’re on the dag one treadmill that managed care has us on. Then you miss all those subtleties that goes on during the office visit. And it could be that moment that they would be able to really talk about something that has been adversely affecting them, whether it’s a mental health issue, whether it’s a substance issue, whether it’s a chronic pain issue or whether it’s just that, oh, by the way, doc, you know, I’ve been dealing with this cuz if they feel like they’re being rushed out the room, they’re just like, wow, just talk about it next. But for some people next time don’t come

Dr. Ryan Stegink (35:26):
Well. And I think it’s so important to, to have these conversations because if we’re not caring for ourselves as physicians and for our colleagues and checking in on each other, we don’t have the emotional capacity to be able to really be present for some of those harder things that if you’re not showing someone that you’re having the patience and the space creating that space for someone they’re not gonna share.

Dr. Malissa Barbosa (35:54):
Yeah. Yeah. Very true. And it’s um, it’s that emotional intelligence that’s not taught that’s required, especially. I mean, it doesn’t matter what specialty of medicine that you’re in, whether you’re a primary care or otherwise, it’s just really being in tune. And for me, most importantly, when I go and I see my patients, they, I view them as if they’re my family. And um, I’m very intentional about that because I know I wouldn’t want anyone to mistreat my parents, my siblings, you know, any of my loved ones. And so carrying that golden rule concept forward, I’m going to treat them as I would want my family members to be treated, broadening the scope. And so if I want someone to listen to my mother, then I’m gonna sit there. I’m gonna listen to an older individual. If I want somebody to take my younger sister seriously, then I’m going to spend the time to get to know what are their pain points because it’s different for these millennials than what it was for me.

Dr. Malissa Barbosa (37:08):
And so being able to take myself out of the picture, which is like a whole nother dynamic that I talk, talk about with students all the time is that you have to leave your stuff at the door before you walk into the room. Because if you already have your preconceived notions, your bias, your stigma, what have you, you’re not gonna be able to treat the patient. And I don’t want you in my room. I want you, if you can’t handle it, stay on the other side of the door because that’s not what the patient needs. So I would have to remind myself that before I walked into my building every day, whatever my, my issues are, I leave them at the front door. Cuz once I walk through these doors, I have to be about the patient. And I have to see them for who they are, not through the rose color glasses or lenses that I choose to see them by. I have to see them for who they present themselves to be and accept them for that.

Dr. Ryan Stegink (38:09):
Mm-hmm those are great words. As we wrap this up today, what is one piece of advice either for someone who is struggling, just finding community, finding that self care or something else that’s just really stressful in training. And maybe if someone’s not going through that, how they could come alongside someone that’s going through that.

Dr. Malissa Barbosa (38:34):
Well, it comes down to, if you see something, say something, even if it’s just going to the individual, that’s struggling and going through, let them know that there’s someone there to support. Even if it’s, Hey, let’s go grab a coffee and a cafeteria. Mm-hmm would you like something? Do you want company right now? Wow. That attending really kind of laid into you. Are you doing okay? It’s just showing the empathy that’s required because a lot of us don’t encounter that. Not as clinicians, not as physicians, not as residents, all of us are keeping our heads down, doing the work. And when everyone is keeping their heads down and doing the work, no one is able to really unleash. And this is why we are seeing the numbers of suicides that we’re seeing amongst residents and medical students, because everyone feels like they’re in silos and in isolation.

Dr. Malissa Barbosa (39:35):
So we have to have those tangible touch points. Doesn’t have to be physical touch. Yes, we are not gonna advocate that. I’m not getting people in trouble, but um, but really touching the spirit of an individual and just really looking out for one another individuals that are going through find an ally because it’s important. You can’t go through difficult situations alone. And instead of feeling like you’re being bullied, seek an ally, that’s gonna help walk you through the process. It may not be in your hospital. It may not be in your program. You may be able to find an ally outside of that. And even an ally. That’s not even in the field just to have a listening ear, to give you advice. Those are things that I would say would be the best recourse. Don’t discount family. Even though family may not fully understand what’s going on.

Dr. Malissa Barbosa (40:32):
They love you first and foremost, and they want to know what’s best for you. So don’t lock them out at a process. They will be the biggest support when all the other chips are down. And even if they don’t understand, you know, they could be like my husband, ready to have your back and roll up into the hospital and work some things out on your behalf. and sometimes it’s just good to know that you have that backup. Not that you have to flex it, but that you absolutely know that you have people that will go to the mat for you. And sometimes that’s, that’s what makes all the difference.

Dr. Ryan Stegink (41:11):
Mm-hmm thank you so much, Dr. Melissa, for, for joining me for, for sharing all these amazing pearls and just your willingness to share from your own experience so that you can help others. And I just think one of the biggest takeaways for me is just the importance of empathy that we are whole people and that you’re not alone.

Dr. Malissa Barbosa (41:32):
Yes, yes, indeed. And, um, that’s um, that’s why I, I named my practice empathic care because that’s what I want people to know that I I’m going to feel your hurt. I’m going to feel your feelings, but just like, I can feel your joy. I can celebrate with you too. We have to learn to be all things to all people. That way the public will understand that we are human as physicians. We’re not on this pedestal and we’re definitely not God’s, but we’re definitely a human and that we, we have the same struggles that they do. It’s just that we have a greater charge of being the caretaker and that we, we have the vested interest in seeing them get better as we ourselves work to make sure that we stay healthy as well.

Dr. Ryan Stegink (42:30):
So great. Thanks so much. If someone wants to learn more about your work or hear more, uh, about your podcast, tell us where they can find you.

Dr. Malissa Barbosa (42:42):
Well, my podcast will be launching in a couple weeks on anchor and it’s, uh, entitled thoughts speak. And basically the podcast is about how thoughts and mindsets structure our lives and the importance of living through not only the triumphs, but understanding some of the setbacks that we experience. So I’m excited because it’s going to be wonderful conversations and insights. And I’m looking forward to having a lot of wonderful individuals speaking on this topic as well. So I’ll be looking forward to hearing from you too, Ryan, so that you’re you’re um, your listening audience will be able to hear you in another venue as well. I’m on social media. I, you can find me on LinkedIn doctor Melissa Barbosa, and I’m on Facebook as Dr. Melissa with the non-traditional spelling of Melissa . I’m not a part of the me click I’m a M a L I S S a girl. So I think I may have encountered maybe seven other women in society that has had Melissa spelled similarly. So we are a part of a unique bunch of women. So yes. So that’s how you can find me.

Dr. Ryan Stegink (44:05):
Sounds great for all of you listening. I want you to consider how you can apply what you’ve learned from Dr. Melissa in today’s discussion. And then please, please share this podcast with another physician in your life who may just really need this today. And if you haven’t already subscribed or left a review, that would be great as well. You can help change the culture of medicine and promote wellness for your patients, for 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 MedEd, 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.