Workplace Bullies Characteristics – Recognizing The Traits Of A Workplace Bully

Video Transcript

welcome to intrinsic motivation from a homies perspective podcast where we meet experts from all walks of life to learn their intrinsic motivation so that they can share it with the world what do we have in store today stay tuned to find out more good morning good evening good afternoon everybody out there in podcast land you are in tune to another episode of intrinsic motivation from a homies perspective this is Hamza and I am David and I must say last year I was really in tuned every week to Fox TV show watching the TV show called the resident and haven’t watched a lot of medical shows but some of it seemed like it was over the top until I reached out to the guest that we have today she’s going to talk about what happens behind the scenes in the hospital in the medical environment and some of the things that we would only think happens on television is it real or not we’re going to talk about medical bullying how it is rampant and how it affects patient safety without further ado I like to welcome Sharon Barrett’s to the podcast welcome Sharon thank you very much hello everyone thanks for being here yes thanks for being here and didn’t mention in your in your intro but I used to hang out and not hang out but I said work in your year part of town as far as your training you you were a physician’s assistant at Baylor College of Medicine and we used to my old firm used to work in the Medical Center so we worked at MD Anderson we did some animal labs at Baylor College of Medicine as well and so I’m really interested in talking to you about the medical bullying because as a civilian on the outside I know that as a researcher was going to get a lot of money and we were designing a new building for them they could pretty much do anything they want and they could you know be a king or they could you know just wield a lot of power and but you were behind the scenes so just really again happy that you were able to make the podcast today well I appreciate the invite and so you you were this is assistant at Baylor did you know you got your master’s in public health from the University of Texas School of Public Health so you right after grad school you stayed in the area public health how did that come about I actually got my physician assistant degree from Baylor College of Medicine so that’s where my bachelor’s degree comes from then I stayed in the Houston area and I actually went across the street to work at MD Anderson and I worked in oncology there for three years and then I decided at that point in time to go back and get my master’s degree at UT School of Public Health which is just immediately across the street from MD Anderson so I was able to work at st. Luke’s which is across the street a different way from MD Anderson fifty mmediately west of MD Anderson and UT School of Public Health is immediately south of MD Anderson so I was able to walk to them from school and work at st. Luke’s while I was doing the infectious disease working in that kind of a practice as a PA and once I faced with that degree I decided to also did some work up in Livingston was getting my master’s thesis collected up there at the little health clinic but once I was totally done with my degree then I came back into Houston and I started working in Pediatrics and got back into oncology for a while got into primary care for a while really got into clinical research and doing all kinds of drug research and study drug research and I did that for 16 18 years total being the study drug coordinator to being all the way up to being a COPI ion a National Institutes of Health clinical grants that we submitted to them for 1.3 million dollars and they came back to me and said publish your data and we’ll give you the money so I started publishing my data at which point time I went back to school back down to UT back down to Houston to the School of Public Health and started working on my doctorate in clinical trials epidemiology so I wasn’t able to finish that degree I ended up having to come back to Denver and help take care of my mother who was ailing at that point I’m and had had open-heart surgery so then I had to quit the degree and just returned back to being a PA so that’s where I’m at at present time god I thought David was jumping in I do want to say that I remember the art I worked with an architecture architectural engineering firm and so we designed research labs around the world and specifically in the country I work with a lot of university work and a lot of universities were vying for rail systems so that the collaborations could happen with you know top institutions across the state and chetan was one of the first places to get that rail system just so that there can be greater collaboration with the medical center so it was just really interesting to be a part of that from the outside and you were you know you with your advanced degrees you were able to see a lot of different environments and since we’re talking about medical bullying I was just wondering before we dive into all of it were you able to see similarities in the different environments or were they totally different as far as medical bullying when bullying is bullied you know the scenarios are a little bit different in regards to who’s doing it and why but most of the bullying occurred from a senior superior like a senior attending to either a junior attending or to the residents for the most part it also occurred with some of the older nurses on the floor to the younger nurses on the floor who then turned around and bullied the student IRS’s on the floor it just it’s it has a lot to do with the sense of power and the fact that you’re going to do this because I tell you you’re going to do this and I’m not going to hear any backlash about it do you feel that with bullying I like to know especially from a medical environment can you talk about when you first saw it happening because on the outside we always imagine you know everything’s kind of more so focused on patient care and so everyone kind of puts their differences aside and make everything happen to the greatest good but that may not be the case you know that’s not always the case I wish it was the case 100% of the time but it’s not because I know of several scenarios myself where patient care was compromised just having a relationship with the patient can be compromised because physicians are into their ego and their pride and you don’t do it this way because this is the way it’s always been done and we’re going to do it this way in the future and you just broke the you know the what we expect and what we accept from people just as if for instance I used to when I went back into oncology and I was working in I I was working in bone marrow transplant up in Milwaukee and this is many many many years ago I had a senior attending who was at that point time we were four days apart in age she was very insecure she did not have any self-confidence other senior attendings demeaned her so she turns around and demeaned us who were in lower authority from her and there was a scenario where I had a patient that I had been taking care of for a whole month she had done her transplant because she had a key leukemia she had completely finished the whole transplant she had done very well she bit was discharged back home and within three days she was back in the hospital she was had a major grand mal seizure we ended up working her up and found out that it was not because of her leukemia coming back into her meninges which is a part of your brain her type of leukemia could invade immonen G’s and she was just deathly afraid that that’s what had happened so when we finally got her worked up got the MRI done and everything else the attending told us that she would be up there and you know couple hours and go and talk to the patient and tell her that this was a medication side effect to the anti-rejection medication she was on and I thought okay that’s fine well we waited around for four hours for the attending to show up on the floor to go in and talk to her and in the meantime she and her mom were just an absolute tears they could not quit crying in the room because they truly believed that her leukemia was back and subsequently if it had come back she would have been given a death sentence because there was nothing else to do for her and so I walked in just trying to calm her down and she looked at me and she begged me and begged me and begged me to tell her the truth because she couldn’t handle it anymore four hours of being you know in high stress high anxiety just totally wiped out emotionally she just begged me to tell her the truth so I sat down with her and I said here’s what’s going on it’s not leukemia it’s a side effect of the medication we’re going to switch you to something else and we’re waiting for the attending to come up and tell you that but I can I can guarantee that’s what’s going on and the relief on her face and her mother’s face is just like immediately and instantaneously they hugged me and they said thank you thank you for telling us the truth nobody would even talk to us nobody would even you know come back and tell us anything and we’ve just been seen there for four hours in tears and I said I understand I’ve been waiting for the attending to show back up also and she hasn’t showed back up and she told us she would and finally an hour later she showed up she went in she talked to the patient she came out she just about unloaded on me of that how dare you do that how dare you you know or CERP my authority I’m the attending on the floor and you’re just a mere PA and you shoulda said that I said she was my patient and this is what happened and you took five hours when you told me you were gonna be for four hours and you still didn’t show up I says it’s not fair to that patient what you did to her and she still wouldn’t agree with me and I eventually had to leave but I mean you know just common courtesy keep going and you explain things to patients and you don’t keep them waiting for hours on end but other things similar to that also happened and patients don’t always get the best of care because physicians are too wrapped up in their culture of being a bully to others to even think about it so Sharon let me ask you this and in all your years in their expense have you noticed in regards to males and females that do the women tend to get bullied more or men or the kind of you know equal I’m the resident side now resident is a medical student who’s graduated from med school and is now doing their postgraduate training and the residency training programs can take anywhere between three to five years based on which program you go into whether it’s like internal medicine or surgery which is five years and so when you’re doing your residency I don’t think it really matters whether you know you’re a female or a male you’re still just going to get demeaned and you’re still going to get you know beat up on and you know sleep deprivation going on and you know the seniors senior attendings just beat the beat up on you because they were beat up on when they were going through their residency so they think it’s only fair to beat up on the younger residents and so when when you’re doing your residency I don’t think it really makes a lot of difference when you’re a senior attending I think there’s more bullying that goes on between men attendings to female junior attendings I would also say it makes me think of high school because that’s always in the news now with the shootings and such where they’re usually under classmen and or they’ve been picked on since they were underclassmen and it’s always been a rite of passage for the seniors to kind of pick on the junior so power kind of rolls down the hill and it also made me think of with the Greek life so with fraternities and sororities can’t really speak on sorority side but when I speak with the older gentleman that were in paternity Xand like the 60s or 70s they were like you guys got it easy and it’s kind of like we didn’t get the the rite of passage that they did because they had to go through so much bullying it’s a nice way to play it and so the feel that it’s kind of like you’re earning your stripes or that that’s where it’s not I mean it’s accepted it seems on some level well I mean what you’re talking about with the fraternities is what’s called hazing which is unfortunate because there’s been several deaths of freshmen college you know males who have come into a fraternity and they’ve been hazed and they’ve died so that’s the unfortunate end result of some of those activities as far as medical bullying goes and you know the culture of medicine I think some of it is just you you go to med school and you and you’re out there in the clinics and you’re joining your clinical work as a medical student and you see that the culture is one that demeans you because you don’t know enough and you see the residents who are sleep-deprived you see the residents are depressed they’re inked they have anxiety dr. pamela Wimble who’s who’s now doing a phenomenal amount of work in regards to physician suicide and you have to remember that one physician or more sometimes it’s more per day are committing suicide and killing themselves because they are depressed they have anxiety there being a whistleblower to bring the light to hear something that’s really going wrong and this needs to be changed there are several different things that lead into suicide but dr. rumble is really doing an incredible job in following up and being accessible to the medical students and the residents and the physicians who are all thinking of suicide and she’s got a hotline and she will answer it 24 hours a day to help these physicians and these student doctors find their way again because they need to be able to find their way and they need to have somebody who can support them so it’s if medical bullying runs the ramped it up from bullying to you know adding depression and anxiety which 75% of all medical students and residents and attendings have a problem with according to dr. woman’s research you add that in on top of you know you have to be perfect you can’t make a mistake and if you make a mistake where are you going to find relief where are you going to find somebody you can show you some grace or show you some understanding or show you you know this is okay I made that mistake too when I was the resident there’s there’s not a lot of camaraderie between physicians and especially when a physician makes a mistake it’s like oh my goodness I just made a mistake and then they go into this self-condemnation attitude which doesn’t help anybody at all bring up the whole hazing and what-have-you because you know once upon a time it was unknown and then it was brought to the light and as an institution I mean fraternity a nation and international in some respects and so like a larger institution it takes a lot longer for change to happen and so I was just wondering if you could talk about some of the small changes or you know any any level of change for example the time that was required to work in the 70s 80s and 90s versus now it seems like they still may be sleep-deprived but compared to the 70s and they have it a little bit better well in regards to the sleep deprivation the American lanolin commune sweet deprivation prior to 1984 was horrible it was residents were expected to work 120 hours per week and when you think that there’s only one hundred six hundred and eighty seven hours in a week I mean they’re not even able to sleep anywhere close to where they need to be able to sleep to be able to function the next day so in 1984 is when Lemmy Zion died in New York State due to a sleep-deprived president who saw her in the ER and because of that case took five years for her family to take that case through the civil courts and sue the hospital and and they won their case and so in 1989 is when the New York State Health Commission finally came down on all of the hospitals in New York State and said from here on out you will no longer be allowed to have the residents scheduled for 120 hours plus or more a week they can only be scheduled for 80 hours per week now 80 hours is still an awful lot of time but at least it’s not as bad as the 120 hours but yet it took another 14 years after that it took until 2003 for the Accreditation Council for Graduate Medical Education which is a nationwide group that meets in Chicago to finally agree that all the other 49 states had to comply with the 80 our resident work week and with that it is definitely helped with the residents who are there still sleep deprived but they’re not as sleep deprived there’s Slevin some promise but it’s not as bad so that’s been one cultural shift which has been absolutely necessary and I remember when that occurred here in Denver because I was working at Denver Health and the chairman of our Department of Medicine was trying to figure out how to get the residence schedule with an 80 hour work week and this guy stuff and boy those senior attendings in the Department of Medicine were like wow they’ve got it really easy you know I used to have to work I earn 20 plus hours a week and I made it why can’t they make it so it’s like hey wait a minute you know you worked on in 20 hours plus per week yes you survived but did you really survive that well how where’s your emotional you know connection with people what happened to your marriage a lot of them ended up being divorced what happened to your kids your kids even know you I don’t think so so they kind of to have this fantasy world that well I survived you know this resident can survive or you know this fellow can survive and I’m like you’ve lost touch with the reality of how hard it was when you were going through and now the changes are being made so the better you’re saying they’re going well they shouldn’t have they shouldn’t have it so easy and I’m like they’re not having it easy they’re just having a little easier yeah yeah what cost so why do you think we’re so the people I could administrators and the hair departments are so reluctant to you know weed out the people that are doing the bullying well because at this point I’m if you weeded out the people who are doing the bullying you’d be leading out probably everyone who’s over the age of 25 because it’s so rampant in the medical world it’s just it’s everywhere I mean I have come across numerous scenarios where medical bullying has occurred and yes the culture is is slowly beginning to change such as what happened with the Libby Zion case it’s slowly beginning to change such as with sorze rounds which is a an hour-long time period for all of the staff nurses social workers residents fellow you know whoever wants to go taking to go to Swartz rounds once a month and presented case it’s really hard freeze in a case where they’re having problems presented case of a patient who has died and they received the support in the encouragement and the physical hugs and the affirmation that they did everything that they could possibly have done yes they there can be situations within those patient cases where learning can occur but it’s it’s given to the person who’s presenting the case in a way that they can accept it they realize you know this could have been better but hey these people they they’ve told me they’ve had similar situations that have similar cases they handle it this way they handle it that way and it it’s done you know in an environment of acceptance of everyone in this room can improve including the presenter and we’re all going to walk out better for having attended this last hour so that is helping a lot with the personnel nursing staff social worker staff residents PA staff physicians staff everyone it’s helping everyone across the board to see that hey I have a colleague here I have someone who is you know really upset about this particular patient and they learn how to be encouraging they learn how to get physical uggs they learned that there’s an emotional connection that is needed between the team members and so Schwartz rounds has really helped out Wow now I was thinking when you were talking about the seventies and eighties you know you had the baby boomers that were working in that environment and then you had the Generation Xers and now you have you know Millennials and soon you’ll have the Generation Z have you found that that some of the changes are because you have this collab or just the interaction with all the different generations working together and we’re realizing that what used to drive one generation doesn’t drive the other I’m finding that the culture and it doesn’t matter whether it’s Gen Xers Millennials baby boomers and whoever they are it just takes a really long time to change the culture it takes a really long time for everyone across the board to realize that this activity that you just did is a bullying activity and you need to stop doing that here is how to be your be a team leader here is how you can learn to respect the resident here is how you can encourage the resident to continue to learn here’s so if there’s a lot of behavioral changes that have to occur I know one of the changes that has occurred here at the medical school at the hospital here in Denver that I’ve been real pleased with is the fact that they now have a Ethics Committee and if you have a problem with someone at the hospital within all the various training programs who is being bullied they can go to the Ethics Committee and it’s a elderly professor emeritus who really understands work environment bullying that kind of stuff and they can go and talk to him totally behind closed doors he never says to anybody who you are and he and his staff go about changing the work environment where this particular occurrence has happened and they have made some pretty substantial changes in regards to the work environment in regards to the positions in regards to retraining the physicians there’s a whole area over there right now that just talks about and addresses retracting of the physicians training them in regards to leadership skills in judgment skills working with others being a team leader and there’s the whole arena there’s one health center that just does that so these things are changing there the culture is changing but it’s taking a really long time yeah is it just as prevalent sharing in private practice because you would think well someone’s private practice they’re going to have to treat people good or you know they have options they can go somewhere else as opposed to like a big Hospital or something well unfortunately in some of the private practices it is still happening I can recall just like a year ago when I was working for a private practice and it was a solo practice and the physician she didn’t even bother her to walk into our shared mutual office and just started yelling at the top of her voice at me because she was mad about the fact that I had contacted the patient’s specialists because this is the primary care office I had contacted the patient’s pelvis specialist and asked him on the phone how do you want me to deal with this particular problem regarding this particular patient of course it’s trying to be seen in two weeks and how do you want me to change his medicine can you know in between now and when you see them and the cardiologist told me he says I want you to change this man to this change this man to this and make sure he keeps his appointment with me I was like great I hung up the phone and she walked in and started yelling at me because she said you’re not to contact the specialists on to contact them and I already knew that answer anyway I says no you did not because you don’t even know what he told me and you’re telling me something totally contradictory to what he just told me so you would have given me wrong information and she just about blew her lid so yes it still does happened even in private practices unfortunately and how that is going to be changed I don’t know but I do know at the hospitals and at the medical schools and the training facilities they are slowly coming around and slowly changing and addressing the work environment that so desperately needs to be changed mmm it’s interesting because I mean obviously we’re in this day and age us you know the you know can get online and this digital age and so I happen to know if someone who has extras is a physician so I think someone years ago a few years ago and they were getting a lot of bad reviews and so how does that well I guess what were the bullying can be amongst you know physicians and nurses and stuff but she was you know just particularly dr. she was being bullying some of her you know her the people that worked for her but ultimately there was some of the reviews how is she was getting that kind of made her get her act together and I just know kind of thought that was interesting does that affect things how you know the reviews physicians and get know what not like on health grades and Yelp and some of the other ones unless they read them you know it’s not going to affect them because they don’t even know what the reviews say and sometimes students can walk out of the physician office and you know they can be upset at the position because the physician has given them disappointing news so you have to know what happened within the visit that has created this quote bad review on the part of the patient some of the some of the bad reviews are legitimate and they have every right to say you know what they say but sometimes the bad reviews are not legitimate because the patient is just you know mouthing off and that kind of stuff and just saying I’ll get that I’ll get that position and I’ll put a bad review on for them I’m so it goes both ways well phrase yeah yeah on the other side of it it made me think of the tech industry that I know of and I know the attorney industry that the older that we get we realize how small the world is and before we had the internet people would kind of talk amongst each other but now you have some of these online you know closed communities where it’s like oh you’re going to work there you might this is what you should prepare for which would dissuade people from working for certain people just because of that work environment are you seeing how technology is playing a point to to maybe curb some of this workplace bullying as well um I’ve not personally seen that I mean I certainly wish I could have seen it when I’m thinking about a particular scenario that I was involved in just about ten years ago where one of the hospital administrators tried to kill me she physically assaulted me and yet the hospital did absolutely nothing about it and I just about went to the police and files you know a police report on her and pursued it through the criminal court system but until the hospitals from the higher-ups take responsibility for what’s going on on the day-to-day environment on the floors day to day in regards to how the residents are being talked how they’re being treated fact that they need respect they need to be validated they need to be encouraged that whole environment needs to be changed and until that environment is changed it’s just going to continue and whether technology has anything to do with that I can’t tell you whether it will or not because we’re talking about a relationship between people you know human to human and technology doesn’t have a lot to do with a emotional connectedness between two people and that’s where the bullying occurs and I was also wondering you know decades ago we weren’t so from a technology standpoint we weren’t used to all of the cameras and things that we have outside now and you know now it’s commonplace and in many cases you have cameras inside of the buildings in your workplace so I was just wondering is there a continued encouragement to you know not only improve your working place environment but also have those cameras of teaching lessons I mean in many cases if you don’t have some type of physical evidence beforehand it’s one word against another and baseball for you’ve been saying it if you have a higher standing you may have more weight in getting a decision going your way well I can see where cameras would help out I know with dr. Reynolds research she just recently came back from New York City where there have been an awful lot of physician suicides at Mount Sinai Hospital and there was cameras outside of Mount Sinai Hospital and with them I think it was I remember right it was one physician a week for like four weeks that decided to end their life and they went on top of a hospital and plunge from the 11th floor down you know they died when they got to the bottom and there was cameras all over that hospital and the cameras caught the physicians joined this and yet the hospital said oh well it’s not our fault we don’t know anything about that it’s not our fault just keep working and they completely ignored the residents and the fellows who said we need to recognize this is going on we need to recognize this person and what they brought to the table and how wonderful they were and yes they were depressed and yes they had anxiety but they did some wonderful things and it was a way for the people left behind to start healing their heart and the hospital wouldn’t even allow them to do that until dr. rumble showed up and they had a p.m. roll service and then a March for the position so it basically killed himself that way and that’s I was happy because here you’re behind the scenes you actually get to see the day-to-day and as a civilian we’re looking at television where they solve all the answers and sixty or thirty minutes and as you’re talking I was thinking about that there was an episode on the residence I don’t know if you ever watched that show over the resident on Fox but there they had addressed a suicide aspect and so you know the next episode they were able to put up a wall so people couldn’t climb over it you know cuz they were using it as an example of I’m going up to the top of the building to smoke and that’s what people were actually jumping they were catching them on camera but then when they put that barrier out there and they were also as a result also they were able to kind of go back because people are starting to leave signs and so when when from a bullying standpoint from high school if there’s a shooting or something and may after in the aftermath they asked well were there any signs in many cases there are and I was wondering in some of the research dealing with suicide or just improving the environment or are we seeing some indicators or a new person that’s coming into this practice are there indicators that they can kind of identify and then kind of cut it off at the past instead of oh this is something I’m gonna have to deal with my whole career um there are some indicators dr. bumble has come up in her research with various different indicators but many times those indicators nobody else knows about it except for maybe the wife if it’s the husband is a physician or the husband if it’s a wife who is a physician so a lot of times those indicators are within the family they’re not out there for you know their fellow med students to know about or their fellow residents or that kind of stuff to know about so it’s just a matter of we who are involved in medicine need to be encouraging we need to be supportive one of the things that I have done a couple of times with physicians that I know and I can tell you how totally appreciated they have been of my doing this is to give the physicians of an emotional affirmation validation of what they have done give them positive strokes I have actually written poems for new for several of them and had that printed up I’ve had pictures put on one of them as a photo collage because he loved birds so I wrote a poem about what he was doing as a pediatrician I tied it into his bird loving and how he was going to fly off and do this research for the kids that he was wanting to work with and I had all sorts of birds that he loves as a part of that collage he just had more tears in his eyes than you could imagine because he finally realized somebody finally understood what he was doing and they finally got him and he was just he couldn’t he was overwhelmed I have given it to a cardiologist that I know yeah I knew he wanted to have a certain biography of a cardiology mentor that he really had worked spent a lot of time with and this biography came out of this particular cardiologist at Harvard so I got the book I wrote him upon him about everything that he did in his work in cardiology and the next time I saw him he said that he had taken the poem he had gotten a friend and he had to put it up in his office and several of his colleagues in cardiology came in read the poem and turned around to him and said why can’t that happen to me where’s the person in my life to give me this validation like you received and he told me later on he says he will forever remember the day that I gave him that poem in that book because he finally received the validation he had been waiting for for 40-plus years Wow so Sam you had mentioned earlier you have experienced Co whether you said ten years ago and you were attacked at you the job the job place correct yes so when you reported that to your superiors I mean what exactly did they tell you when I actually after it happened I went back into my office and I tried to call my supervising physician and tell him and he was at a dinner so he wasn’t around a stager the next morning I waited for him to come in to the main administrative office with Department of Medicine and the person who had attacked me was waiting for him down on the first floor our offices were on the fourth floor she was waiting for him down the first floor and she caught him in the elevator and she said I did such-and-such to Sharon I’m sorry and I won’t do it again and then she got off the elevator and he came in he saw me and he says that this particular administrator would come in and you know apologize to me for what she had done and he said that she promised that she would never do it again and I was like aha all right I don’t believe you so she never came in to apologize to me she didn’t want to be around me I sent her an email and I says I’m giving you the white flag of truce are you willing to have a truce with me she’s completely ignored my email and in fact for blowing up at me later on I’m getting really angry again and I was just kind of like okay I should have gone across the street to the ER and had them take pictures of my neck because her finger marks were on my neck that night but I didn’t do it I didn’t think about that because I was just I was so upset I was just crying for an hour at the fact that she actually tried to fix EA me oh yeah I think it’s a sessional environment how could this even happen but as you’re explaining and living fear that it made me think of IQ versus EQ and in many cases you there are instances where someone is really intelligent from a book standpoint they don’t have that emotional maturity and I was wondering if there’s even in the outreach because they can identify somebody that’s really good in there at the top of their field but they’re a person a person or they’re their bedside man or maybe lacking but the fact that they’re so successful in another area is just never addressed well I mean you’re talking about emotional quota or quotient and yes there are you know physicians and there are administrators that they don’t have that emotional connection with others and they don’t know how to be a leader because they’re still dealing with their self-assurance they don’t have self-confidence they don’t have respect they’re dealing with their own depression they’ve got all this other stuff going on in their emotional KAG if you want to say that’s what it is and so they don’t know how to reach out to somebody else and they don’t know how to connect with somebody else and they don’t know how to lead they’ve never been taught how to lead and be the leader and garnish to the respect and garnish the honor that is deserved for that title and it’s unfortunate you know there are a lot of people who yes they have their masters in health administration they have their masters in you know Business Administration or whatever and they should know how to do this but they’re not necessarily taught that during their MBA or their MHA program that needs to be taught but I think it’s much more innate at times that you’re born with it and you’re given the correct environment in which it can grow and become better and better and you become you know more of a servant and you learn how to help others and you learn how to lead others so when you go to get your master’s in Business Administration or your masters in health administration it’s already there and it’s kind of innate and so now you’re learning the skills you’re learning how to do the paperwork you’re learning the skills you’re learning how to you know do the finances and do the accounting and that kind of thing and you come out with your degree and you’re very very good at it and there are others who come out with their degree but they didn’t have the innate ability to reach out to others and to really see the need for that emotional connectedness if that makes sense no it makes a lot of sense and it makes me think of summat like we were talking like you were saying some of the changes and some of the positive changes and over the past 10 15 20 years you traditionally people would go straight through so you know undergrad and an advanced degrees and then universities were finding out that they didn’t have any world world experience and so they really couldn’t negotiate you know better salaries and let they have real world experience so you couldn’t even get into the advanced degrees until you had a couple of years world world experience and then I think that’s where you would see some of the shortcomings and how you can overcome some of those shortcomings and become a better person once you graduate and now you’re at an elevated position well and I also think people need to when they’re in the work environment they need to have an attitude of continual and constant learning they need to have an attitude I don’t know everything and this person or that person or maybe that person down the hall has something that they can teach me and I need to be willing to learn what they know so should become a better person and it’s it’s a matter it’s just it’s an attitude it’s what it is yeah I agree but and I also think that’s why I want to get your opinion on the inside because every industry is dealing with with mentoring and it’s fallout from me too so you have some people that won’t even look at mentoring the next group be it from a gender standpoint or what have you do to any fallout or association because you’re saying you’re spending 80 hours and in many cases 80 plus hours with a person and you’re starting to learn a lot about that person there in many cases I mean to be honest the human element comes in and there’s relationships and then that relationship burns out and now there’s litigation involved so I just wanted to know about the environment for mentoring and and how it could be a better scenario to grow beyond the medical bullying there are and I have come across and I had thoroughly adored them in regards to their dream a lot of the senior attendings are incredible mentors they love to teach they love to mentor they love to show the junior staff how to do things how to improve upon things and when you come across a physician like that everyone just like wants to attach themself with superglue to that person because they are so wonderful but unfortunately at this point I’m those kinds of physicians are still somewhat on the rare side their thirst they are not as common as they need to be yeah I would think and that’s where if you could have a perfect work environment where I know there’s a lot of demands for hospitals to bringing revenue and so some of these high flyers are bringing in a lot of revenue so people can turn their head of any misdeeds what would be an ideal scenario where there the hospitals or the business are still getting the revenue targets that they need and still produce a healthy environment I think a perfect environment would be where the medical students and the residents and the fellows are taught by the senior attendings with respect they are honored for what they know they are encouraged to learn more they are never ever demeaned they are never ever bullied and subsequently the physician sees within the junior staff this is strength of yours you need to pursue that strength where they see within another person a junior staff member a particular strength and they encourage them to go after that particular strength whether that be you have a really strong line detailed mind regarding research going to a research field or you have a really strong line detailed mind in regards to connectedness to patients so you need to be an internist because you’re really good with your connection with the patient and able to talk to the patient so a perfect environment would be the senior attending recognizing with in his junior attendings his team members their particular strengths not demeaning in at all not bullying them at all but helping them encouraging them allowing them to learn showing them opportunities to learn and really being that incredible mentor that I’ve been around a couple of different times and like I said I wanted to super glue myself to them I’m so sure and I was thinking many people and their lives are not really linear and even in your home life as you’re saying you know there are some to go back for something something happening in the family and then I was able to regain and go back to my dish my traditional trajectory and what happens is when you take some of those detours some of your mentors or other people will see other strengths that you have and I’m bringing that up because I was looking at Kevin MD comm and you have written an article there and I was just wondering if there’s an environment where there’s some some it could be junior people senior people were there that may be a way for them to promote their expertise and other things as far as getting out of the day-to-day and if there’s a social media site so other people are seeing what you’re writing about and they may identify areas of strength that you never knew about which could actually take your your your business experience and your ear work ethic to another level well I mean I if I remember right I have like 12 articles on Kevin MD some of it in regards to you know patients that are taken care of or particular scenarios that I’ve been involved in cannot enjoyed writing on that being a guest blogger I also have I believe it’s now 80 patients stories on my blog which is PAP one medicine dot blogspot so I also have another website which I’m just now beginning to get up and running but one of the things that I love to do is I love to teach and patients always love being around me learning from me being taught by me being seen by me so one of the things that I’m I’m currently doing is I’m doing an outreach on Pinterest and I have if you know anything about Pinterest it you create little pins and each basically like a poster board and I’ve been doing quite a bit of post ability on medicine and how patients can take care of themselves at home or when do they need to go see the physician based on things that I will list on my post online on the various boards that I put on Pinterest and I’m now getting quite a bit of feedback from that so there are lots of different ways to reach out to patients and to encourage them in to help them out and to make their lives better and I’ve had to basically kind of back away from some of the stuff that’s going on in medicine to be able to do some of these other things and here in the very near future I am planning on buying a medical practice in fact I’m in the process of buying one right now and then I will start seeing patients I will be my own boss and you know hopefully that won’t happen again and I know how to treat employees and treat patients because I’ve been through the wringer myself and I know what’s I know what’s wrong and I think that’s the intrinsic motivation and itself because you have an upcoming tedtalks i like for you to talk about that but it also shows that we don’t have to accept what our current circumstance is if we realize there’s something that needs to be changed we could try to change that within and if that doesn’t work there’s other tangents that we may not have thought of but we have especially in 2018 with with all these social media sites and and sharing and Pinterest and TED talks and all that there’s outreach where you can actually find yourself in another stratosphere that you hadn’t imagined well during a TED talk is an honor and there’s a lot of people who have done them but in regards to how many people who actually apply to do them it’s like 1 in 10 get accepted so the acceptance rate is not very high right now which is good because then they get the best a talks but that’s the best Ted presenters I’m going to be planning on doing two TED Talks one is going to be on medical bullying which you’re just been discussing and the other one will be on health care fraud where I have come across numerous scenarios of physicians to have done at least two and a half million dollars worth of healthcare fraud a year for 10 20 25 years so far and I’ve been working with the FBI to get these cases closed down and addressed by the FBI and criminal charges filed Wow I guess that’s speaking of what we were just talking about your health care advocate and didn’t start your career thinking that way but here you are no I never thought I would come across healthcare fraud ever ever and I’ve come across several scenarios of it unfortunately and then in regards to medical bullying I never thought that medical bullying would affect me I never thought I would be involved in a physical assault case and be the victim of one but that’s not the only time where I’ve been involved you know been the victim of a medical bullying from a senior attending to me so it’s just way too rampant and it really does need to change thankfully it is she to some degree I’m very grateful for what Pamela Wimble is doing regarding physician suicides and really trying to stop the position suicide she’s reached out I can’t tell you how many people and stop the suicide from occurring she now has a movie called do no harm it’s a documentary that’s out and it’s being presented in front of medical schools and at various hospitals and that kind of thing and it’s bringing up the whole issue of bullying suicides all of these negative things that are going on in medicine and all of this is needed and more to bring about the positive change within the medical culture that it has so direly desperately needed for decades upon decades Wow yeah I think that’s the comfortable comforting thing that with you bringing this to the to the masses and letting them know and your colleagues it can only get better so you know keep up the good fight I’m definitely motivated and glad that you took the time to speak with us about that until your TED talk happens if you would be a perfect time to talk about how people can get in touch with you read some of your blogs and your Pinterest pages as well that’d be fantastic on Pinterest all they have to do is just look me up on my name and they can get on my Pinterest pages as far as my patient blog which is I believe almost 80 patients tours patients that I have taken care of it’s a educational I will basically to like a paragraph of peers this patient came in they had these symptoms here’s the questions that we asked and then I’ll break in and I’ll say here’s why we ask those questions here’s what we were going after and then I’ll go back to the patient and here’s the additional sentence that they had here’s the answers that they gave us here’s the diagnostic work we did and then I break back in and they say here’s what we did this this is what we were looking for this is why we are doing it and then I’ll come back and I’ll say here’s what happened with and here’s how we treated the patient here’s the end result of what happened with the patient and here’s how they did so much better so that’s how my PA view on medicine dr. Logue spot.com is all set up which is I’ve had lots of positive reviews from people who have come onto that page onto that website and really enjoyed reading the stories and learning a lot in regards to how can they take care of themselves better I’ve had PA students from Australia so we’re trying to get the Australian law set up for them and they had the physician attendings read my blog realize what a PA could do and that has helped them set up their laws in Australia for the PAS just within the last five years so that’s a very positive for that particular blog I and as far as my other blog I’m trying to my other website I’m trying to reach moms wise kids with my other website because it’s an author’s website where I have published a book for Christian women and I’m going to very shortly put on my juvenile mystery novel on that website for the kids because I’ve had numerous kids tell me they love my juvenile history that I wrote so and there’s all kinds of blog entries on that website as far as how do you be a better person how do you be a leader how do you address your depression how do you address you know your anxiety all of that sort of thing that’s on the authors website which is strengthening your faith calm if they want to get a home you they can get a hold of me via my email at Colorado – peas and Paul is an apple at msn.com and I’d be happy to converse with them awesome awesome and you have just been in tune to another episode of intrinsic motivation from a homies perspective this is Hamza and I am daily Sharon it was definitely a pleasure and you are definitely in the trenches making change happen we’d love to follow up with you in the future well thanks for the phone call Hamza and nice to meet you David yes nice to meet you thanks for being with us all right bye-bye [Music] thanks again for checking out another episode of intrinsic motivation from a homeless perspective podcast please check us out on our website at intrinsic motivation dot life where you can click on the speak pipe button and leave any suggestions for a future podcast that you like us to cover also check us out on our social media sites we have a YouTube channel Facebook page iTunes podcast in addition to stitcher and Google Play all under intrinsic motivation from a homeys perspective check you out next time have a great day