Doug Nielson – Physician Burnout

Watch in video below!

Today’s podcast is going to be a little different than normal, instead of focusing on financial success, we’re going to talk about personal success and specifically the topic of physician burnout.


Josh M.:                              Hello and welcome to the “Physician Financial Success Podcast.” My name is Josh Mettle and this is the podcast dedicated to advising physicians how to avoid financial landmines. Today we’ll be talking with Doug Nelson, a clinical psycho therapist, leadership expert, and public speaker. I had the great pleasure to hear Doug address the Utah Medical Associations, Young Professional Group, a few months ago and found his message to be so profound that I wanted to share it with our listeners.

Today’s podcast is going to be a little different than normal. Instead of focusing on financial success, we’re going to talk about personal success and specifically the topic of physician burnout. So Doug with that, I am excited to chat with you today. How are you doing this morning?

Doug:                                  Hey, I’m doing great Josh. It’s so good to be here with you, see you again.

Josh M.:                              Likewise my friend. And as I mentioned previously, I really was moved by your presentation and I came up to you afterwards and said, “Doctors aren’t the only ones who suffer from burnout.” A lot of what you were saying was striking a chord within me internally.

Doug:                                  Absolutely.

Josh M.:                              I felt if it was helping me, it would help our listeners and I wanted to bring your message to our listeners that are usually tuned in for financial success but I guess it doesn’t matter if your financially successfully and personally miserable right?

Doug:                                  That’s a good point right? That’s a good point because very often we lose sight of that.

Josh M.:                              Well I’m glad to take the left fork in the road today and have a totally different conversation. So let’s just start with, tell our listeners just a little bit about your background. How you got started down the path with working physicians and on this topic of physician burnout.

Doug:                                  It goes way back. I’ve been doing this a little over 20 years and it’s a fascinating world. By education, I’m a psychotherapist. I also started then with physician coaching. I think of the time where I really became interested in it because the opposite of burnout really is engagement at work and in life, with family, with health, with spirituality and all those kinds of things. I was running a company and I was experiencing that myself.

I remember working with my first physician that came in back in the 90’s, and that’s when things began to change a little bit for me. Because I was going through the journey myself, running and building this company, employee assistance and wellness company, and I was also now seeing folks in private practice and started coaching. And at that point I decided, “You know what, something’s got to change. Something’s got to give because the path that I’m on is not good.”

Very often when we get into burnout, we don’t get out of it alone. I was able to get some help and then start to establish, started working with docs and helping them. I had friend who were docs. I started talking to them and really starting to understand that it’s a different world, docs, and understanding that if you look at statistically speaking, back in 2013, 40% would say that they were entering into the realm of burnout. Fast forward, five years, 2017, the same study showed that over 50% were now saying I’m actively in burnout. That’s quite alarming.

Josh M.:                              I was at a conference. A business and entrepreneurial conference in Arizona, a couple months ago, and one of the attendees is the lead trauma doc in, and I’m not going to remember the name of the hospital, but it’s I believe, it’s the largest hospital in Chicago.

Doug:                                  Okay.

Josh M.:                              Do you think they see some trauma? They see some trauma.

Doug:                                  I would imagine there’s a little trauma going on in Chi town.

Josh M.:                              Little trauma in Chi town. She was telling a story, she was giving a 10 minute presentation. She was telling the story of having a presentation, this presentation that she was giving to this group due, and in her day, she walked us through her day. She came in at 6:00 in the morning, there had been someone how had lost their life on the table. By noon there were several other very serious, near death, off to the emergency surgery type situations by the end of her shift and then at the end of her shift she had to be mom, and then she had to write her speech, and she had to get on an airplane to come join this group. I’m just thinking, “Wowzers!”

Doug:                                  How do you shift gears?

Josh M.:                              How do you shift gears? What you just said was, and maybe this is all we need to say, we could probably just close this thing down right here, you said the opposite of burnout equals engagement. I’m thinking to myself of this story of this doc and how does she come home and engage with her two children and then leave there and reengage in the writing of this speech she’s going to give, fly overnight and give the speech like man you could just get numb and just push away.

Doug:                                  Kind of almost like post traumatic type of a job, very much like your first responders. Clearly the trauma docs and the ER, that is a high level … they’ve really got to watch themselves, the burnout areas. There are different areas of the medical profession that have different levels but that is a high level burnout. How do you shift the gears? I think that is a great question because all of us face that. How do I then shift gears because often times, particularly with docs, when you see overlapping roles that you feel are co congruent, are important to you, when you see these roles that are conflicting with each other. For instance, I’ve got a job I’ve got to go perform, but I’m also a mom, and I’ve got to go home and you see the scarcity of resources and energy. That’s when we start to head for burnout. Research will show us that docs, usually we start to see that start to creep in, burnout, in about the second year of medical school.

There’s a good 30% chance that my significant other, or my spouse will also be affected by the burnout. It’s not just me as the doc but also my family, it’s going to go downhill and hit them as well. I think as we look at this, it’s a constant navigation to check in with our heart. This is a little while back, my dad passed away. I was in my office, I was in coaching session with the doc, and I just reach back to grab my pen, and I looked at my phone and it said, “Call me, 911.” I don’t know if you’ve had one of those texts lately but my heart just stopped.

Josh M.:                              Yeah man.

Doug:                                  I excused myself from the coaching session, went out and I called my sister back and she said, “Dad’s dead.” That was the first response she had and again that shock just went through my system. I just froze there. Unfortunately the first thing that rushed through my veins and through my thoughts were, “Regret.” And I thought had I allowed my business, my busyness of life to push aside the things that were most important. That’s unfortunate, it was the first thing that just slapped me upside the head. The crazy thing is, this podcast and what I do as a burnout coach for physicians, to help them thrive, move from surviving life to thriving in life and have a thriving practice and culture, but my goal for every physician that can hear this podcast today is for them to get to the end of their day, look back over that day and say, “I’m glad that I lived the life I did today.”

The scary thing is, burnout will kill that. Burnout will take that and rob that from every single one of us if we’re not aware of it. The starting point of where do we start, we’ve got to realize that we are slowly like that proverbial frog, that’s put on the pot that slowly doesn’t even realize … I mean the second year of medical school and I can’t even see this. But I often ask folks, “Can you think of a friend who was in medical school with you, that you knew them and you knew them when they were most alive?” Then you fast forward three, four five years, six years, they’re not even the same person. They’re a hollow shell of what you once knew them to be. And it really sneaks up.

I think number one we’ve got to really pause and have, if you will, a self interview with ourselves fairly regularly, kind of a heart check and looking at ultimately, “Am I happy? Am I thriving? Am I growing?”

Josh M.:                              I love that. You said, “Constant navigation to check in with your heart.” Maybe we can get into some more tactical ways to remind ourselves to do that. I know personally when I start to feel overwhelmed and insufficient in different dynamics or areas of my life, I’ve got a six year old girl, Aria and an eight year old son, Xander. I try to go home and immediately and grab a ball and grab a kid or try to go home immediately and get on my knees, where they’re taller than me. That kind of connection is soothing and calming and puts you back into a place where you can go back into your work day tomorrow, ready for the work day tomorrow instead of never really leaving the work day yesterday.

I was so moved by your presentation that you did with Utah Medical Association that I want to just set this up for you to run however you want to run it. And [crosstalk 00:10:26] differently than normal. I’m not just going to pester you with questions but I also failed to mention, I mentioned you were an author, but your book is titled, “Take Life by the Helm.” I would hope from here that you would just guide us through the highlights of that book and cover some of the key elements of the message that you gave to the Utah Medical Association and what I’d love as a end result is for just how I live that presentation that you did at the Utah Medical Association, with three or four things I could actively employ tomorrow. I’d love to share that message, because I thought that was powerful and I know that that will help people, this weekend.

Doug:                                  You got it. Absolutely. You mentioned that it just so happens that I … Here’s what the book looks like and it really is this idea that in our world today, and I think professionally with docs, personally with docs, is I have a sense that I am out of control of my life. There was a study that shows that 82% in this particular survey, of docs saying, “Yeah, with the bureaucracy, with regulations, with documentation, I feel really out of control of my life.” Really as we look at what are some nuggets that I can take away?

Number one, I mentioned just awareness. And if I were to ask those listening to the podcast today, on a scale from one to 10, where would you rate your level of happiness? And that we can interpret as a sense of fulfillment. A sense of contribution. A sense of enthusiasm. A sense that I’m really connected. I’m not depersonalized. The opposite of that is the burnout. On a scale from one to ten the average American would rate about a seven.

If you look at somebody who’d been through a traumatic event that’s left them say paralyzed or something, obviously they’re going to bottom out for six to nine months, but usually they’ll come right back and settle in about 6.5. The average lotto winner on the other hand, is going to spike as high as you can go but then they’ll come in an settle about a 7.5. One of the first questions really is to assess, “Where am I at? What is my level of fulfillment in my life?” Because we see it’s easy to allow the cynicism to creep in.

There are two types of docs. There’s one doc that brightens the room when he or she walks into it and then there’s the other doc that brightens it when they leave.

Josh M.:                              Man haven’t we seen both of those? That is so very true. That is so true.

Doug:                                  Well and you look at that, 50% of docs too would say, “I wouldn’t go back into this field.” And yet there’s another 50% of the docs who are doing something different. That they are alive, they are engaged, and their nailing it, and that’s really what I focus on, is helping folks get to that place where they’re saying, “I am resilient and I’m bouncing back. Were I’m not stuck,” and these are indicators, “Stuck in the cynicism. Where I’ve lost enthusiasm. Nothing really excites me. My hobbies, my self care, it’s not there. I have no sense of contribution and I really kind of feel isolated and overwhelmed at the end of the day running back and forth.”

When you talk to a doc they’re some of the most passionate, creative, and caring people on the planet. They went into this field to make a difference and then they run up against all these barriers to doing that very thing. Another question that I love to ask docs is, “ho are you becoming? Right as of this moment, who are you becoming as a person? To your kids, like you just mentioned. To your patients, to your staff that you work with. To your family, to your wife, to yourself. And I think that’s an important thing to really take a peak at.

Very often they’re saying, “I don’t really know. I’ve lost,” if you will, “My identity of what I went into this field to become. The scary thing is when you lose your identity, when you forget who you are, you become who you aren’t. When we’re not reminding ourselves daily of the person that I would like to become, how I’d like to approach the day, then by default we start to go into coast mode. That coast mode is going to head us ripe for burnout.

Really when I start to work with burnout I really focus in on two key relationships. That first relationship is the relationship that you have with yourself and that idea of the importance of … and I’m just going to title it, resiliency. The importance psychologically speaking, if you will, a burned out physician is going to have a one to one ratio. They will have one positive heartfelt event for every one negative heartfelt event. That’s going to lead me into depression or burnout so to speak. An average performing doc will have a two to one ration. Two positive heartfelt events for one negative heartfelt event. Now when we start to move into the realm of thriving, we see a three to one and ultimately we love to see a five to one ratio, where I’m going to have more uplifts in my day, the resiliency to bounce back quickly, then I will be to the downdrafts. Meaning, one of the questions you look at as a doc is what’s my ratio right now? If on my scale of one to ten if I’m down at a four or a five I need to really pay key attention to my uplifts in life, my bounce back, my resiliency in order to thrive not just to survive.

So what does that look like? Excuse me. A resilient idea can be something as simple as enjoying a sunrise and I don’t have to take an hour to do that. That can be literally pausing as I’m going out to my car this morning, as I was coming into the office, I paused, I look at the beautiful sun coming up, how it was illuminated the sky and just took a mental picture and went, “Ah it’s beautiful.” And it filled my soul. It might be listening to a piece of music. It might be reaching out to a friend. You have that intuitive nudge that says, “Hey reach out and say hi to Sheri today. Last time you talked with her, she was struggling with this.” It might be praying. It might be reading some poetry. It doesn’t really matter what it is. It might just be a walk in nature and take some slow deep breaths or do some yoga.

Find your uplifts. What are five key uplifts that will help you in your life, that you can formally put in but also informally, along the way. Putting a smile on the checker at Wal-mart’s face. Whatever that is just to find the uplifts. That relationship with yourself is really critical. I think another piece is the renewal time. When it comes to myself I need to look at my thinking and my thoughts. That’s number one the resilient uplifts. If I’ve experienced the heartfelt negative even, that tells me that I need to go on a hunt to find at least three to five uplifts. Make a list of what brings fulfillment in your life. Make a list of what stirs your soul.

On that same idea then, schedule renewal time. What are you doing to allow yourself just to be with yourself? ‘Cause constantly doctors are giving, giving, giving, giving, giving . If you don’t make yourself a priority it’s gonna catch up to you, and burnout as we know, it’s really important again, usually get some help. Get a friend, a fellow doc. Do something. Get a coach to help pull you out of this. Because it can have impact on your heart, your disease, anxiety, depression. We have suicide rates of docs is relatively high. More than one a day are taking their lives, and that’s tragic, and it doesn’t have to be this way. Self care is critical. Schedule you into your life. Schedule your renewal time and hold true to that renewal time.

Josh M.:                              If I could just interject there. I think, and I have found myself at times, especially at times of overwhelm, feeling guilty about doing me time. THere’s only 100% of me and my energy and my ability, but the world at this moment, or at least in order for me to feel like I’m doing a good job, I would need 125%.

In that moment when I’m coming up 25% short, you want me to go take a walk? You really have to handle that mental hurdle where you have to give yourself permission and say, “Look the only way to make yourself 125%, which is what the world is asking of you right now, is for you to bring yourself up 25%. You gotta bring up your energy and your game and every interaction 25% and the only way to do that is to invest in yourself.” You almost have to change the way you look at that and say, “No this isn’t Josh being selfish and needing to go waste time. This is really recharge time to get myself to a place where I can give 125% or a little more. We only need a couple more positive interactions or a couple more correct decisions each day to live a drastically different life. If you don’t do what your saying, you’re just missing it by a couple degrees. Those couple degrees add up.

Doug:                                  That’s right.

Josh M.:                              Can I say one more thing?

Doug:                                  Absolutely.

Josh M.:                              One thing that has worked well for me on that, is I try to stack those. So you talk about the uplifts. For me I’ll give you three examples. A hike, listening to a podcast, time with my wife. That’s just three of many but what I’ve found is, if I take a hike and my wife and decide to listen to the same podcast on the hike? And my wife goes with me? Then I nail three of those in an hour or two hours because I got an hour up on the podcast, an hour of conversation back, and I got my fitness in. If you can stack ’em-

Doug:                                  There you have it.

Josh M.:                              If you can make that list of what gives you your uplifts and you can try and stack them in the same period of time. You can get really efficient that way. I’ll turn it back over to you. I just wanted to add that in.

Doug:                                  Absolutely Josh and not only are you a brilliant financial person, the person of choice when it comes to financial, getting the mortgage and what not, loans, but you also are brilliant. I love the stacking idea.

Josh M.:                              Oh thank you.

Doug:                                  I think along with that it’s really important to understand that that is more of a formal, but also take advantage of the informal. Telling a joke to somebody in the office. Taking the time just to sit down and breathe, literally for 30 seconds and slow down. Take advantage to hear a song you like. There’s the formal, schedule yourself into your schedule. Then be aware of the informal. Be the person that you have always been and not allowing burnout to take and rob you of that personality that you once were.

Josh M.:                              Doug I think we should send our clients whoopee cushions. Like, “hey we just need to laugh more, and I’m sending you a couple of whoopee cushions. Fill ’em up and put ’em around the hospital.

Doug:                                  We do need to laugh more. And you know you mentioned another thing though that’s really important in relationship to taking care of myself, and that is learning. It’s critical because either we’re agreeing and we’re growing, or we’re ripe and we’re rotting. And that’s not just educationally but also in humor, also in life, daily our relationships, it’s really critical to keep … the only sign of life is growth.

Josh M.:                              No doubt.

Doug:                                  [crosstalk 00:23:20] we stop learning and we get stuck and we stop growing and we’re not laughing. You look at this, a study will show that the average child will laugh out loud, positive expressions of exuberance 200-300 times. What is the average adult? 10 to 15 and usually that’s in cynicism. We need to laugh more. You are absolutely right. That is an uplift. When we can find the humor. Allow your personality to shine through. Do not allow burnout to kill that beauty that’s within you, that awe, that wonder, that ability to be vulnerable and real, and authentic, and connected to our work. It’s critical. We want to help as docs to help save other people. We’ve got to help ourself first. You can’t lift another person to a place that you’re not. You’ll be so much more effective being alive.

Research shows that doctors who are put in a positive mood, who are going to laugh and that helps recalibrate the brain, a happy brain, a happy doctor, will outperform other doctors. They’ll be three times, intense research shows, three times more intelligent and creative than those who were in a neutral state. But can you imagine a doc in a depressed state? Depression’s never been a good motivator. It doesn’t help us. They were more accurate, 19% faster and more accurate in their diagnosis. Powerful idea.

Josh M.:                              I totally believe that. I’ve gotten myself in situations where we run into a challenge on a mortgage loan for a client and for the life of me, with all the pressure on you at that moment, I can’t figure it out, and I can’t make the right decisions. Then I go, “I’m not going to solve this today. I’m putting it aside. I’m going to go get a run tomorrow morning at sunrise, and by the time I come into the office and I look at it again, and I go, “Oh my gosh, man this is like the easiest …. this is so …” Anybody would have been able to see this solution but in my space, at the moment I didn’t have the intelligence to overcome it. I have been in the stat that you just described.

Doug:                                  And that’s research based. We’ve got decades now proving this, that in all walks of life, a happy brain, we just perform better. We’ve got to make that an important part of our world.

Number one we’ve talked about taking care of yourself and I give you the invitation, the challenge, the 30 day challenge to apply these things. Make your uplifts. Number two, schedule yourself into your schedule. Make that a priority. Number two, connection with others. This is another huge secret. When I can no longer empathize with others, it’s time for me to recalibrate because I’m headed for disaster. When I’m not connecting with my patients. I’m not talking about overdoing it, but when I’m not present and my mind is always somewhere else and I always feel like I’m running behind, where I can’t be with my patients or my staff, or my family. When I go home and my mind just continues to race, we gotta slow it down. And that’s again, that self care but can I be there, and this is called three L’s and a T, with key relationships or even with patients, it stands for, “Look, laugh, listen, and touch.” The best doctors know this. Three L’s and a T. Look, laugh, listen and touch.

They’re going to take the time to be fully present with that other person. That other person will feel this presence and you want to see doctors who thrive, they connect with their patients. They connect with staff. They enjoy and look forward to, now I’m not saying … there’s always a challenge to any job. But I’ll tell you what, those docs who are thriving, they get this. They’re going to be present and look that person in the eye, they’ll smile with them. They’ll laugh with them. And they’re going to listen to them and it creates a completely different experience.

You think about in your personal life as a doc. What key relationships do I need right now to go out and look, laugh, listen and touch? Be there present with them. And you will notice immediately, you’ll feel it in your gut. There will be a sense of connection. We are neurologically, it’s not a choice, we are neurologically wired to connect with other people. That is a huge indicator. If I am not connecting with others, I’m disconnecting from myself, I’m heading for burnout. It’s just not an option.

I will numb out. I will find substance, I’ll go into anxiety, I’ll do whatever it is because I’m starting to, if you will, die inside. Years before a tree dies inside, before it shows on the outside, same can hold true for us and sometimes it’s a little late for us to wake up. Number two, make sure that you’re also scheduling key relationships into your life. Get those key people. And what I mean with yourself renewal and also with your key relationships, get it on your calendar. Don’t leave it to chance. If you don’t schedule those and hold those boundaries as best you can, again so you can get to the end of your day, look back over that day and say, I am glad that I lived the life that I did today. Yeah go ahead Josh.

Josh M.:                              You’re speaking gospel to me right now. I just wanna park here and go a little deeper. The two things that I wrote down was, schedule your self time, those uplifting … You mentioned, a sunrise, a sunset, a laugh, a whoopee cushion, a flower, all those things are spontaneous uplifts.

Doug:                                  Sunrise, sunset.

Josh M.:                              Yes. But also schedule the self time uplifts that we know that these are the staples that are going to recharge us, and then schedule the key relationships that we need to have connection on into our schedule. I’m someone that would commit suicide if I didn’t have my Outlook calendar. I just cannot function without. Maybe I can figure something out but I have a hard time figuring out-

Doug:                                  That’s a little extreme but okay.

Josh M.:                              I’m close. Walk me through what it looks like, or what you would recommend it looks like to schedule self time. I know this sounds basic, but lets get granular. How does one take that next step to schedule self time and to schedule key relationship time and what might that look like?

Doug:                                  Excellent question. Because if I leave it to chance, it’s not going to happen. My intentions are good. You know they say the road to hell is paved with good intentions but then so is the road to heaven. We’ve got to work with that desire and continue to be on that … be easy on ourselves. The idea is to take, and what I recommend is either the night before or that morning, connect with your core. Connect with that sense of awe, that wonder.

If it’s with God, you now that spirituality, keep that spirituality alive in your life. But take the time to really connect with your heart and kind of do that self assessment that we’re talking about. That one to 10, how are things going? Like I mentioned in the evening be able to look back over your day, this is one of the simplest, quick, immediately applied tools we can have. Are you glad you lived the life you did today? Yes or no? And if more often then not the answer is no, then I need to pause and say, what’s one small micro step I can take today to bring my heart to life? So that I live, and I know this might sound crazy, but I live in a place of love.

Doctors went into this field to love and to heal and yet burnout, like we mentioned before, will rob that from them. Self love in a sense is being able to pause and look at my life and I would say every morning ideally that’s exactly where we wanna be. To pause and look at the key roles in my life and evaluate and plan them into my life. Take that morning time. I’d recommend a little bit of meditation, prayer, what not, that helps and then from that place, establish clarity. Because we’ll find in a world of distraction, you take some time to plan your priorities in your life, that would include work and don’t overdo it. You take your to do list and everyday most people would say hey, cut that in half, then cut that in half again. Only to identify, two, three, four major things, otherwise you’re going to set yourself up for failure.

Bottom line, what I’m trying to say is, take the time to check in with your heart, and then take the time to schedule in the morning, what’s most important for that day.

Josh M.:                              For me, and I could not agree with you more. You’ve almost described, “The Miracle Morning” by Hal Elrod. If anybody hasn’t read that, that’s a great one. Another one about morning routines, is “The Compound Effect,” by Darren Hardy. That’s another great book. You can get those on audio and listen to them while you’re out hiking with your spouse.

Doug:                                  And wait, that’s not all if you order right now …

Josh M.:                              Yeah right. We should have a link down below with some sort of a override. Two great books that helped me a lot and speak to what you just said. The thing that really also helped me wast to get those things literally in my Outlook calendar. And the power of a reoccurring appointment. For example, with my wife, we do three date nights a month, that it’s us and the new do one date night with the kids. And we swap kids. So I get Aria, one month, she gets Aria the next month. And that is a reoccurring appointment that always goes off and three days before that appointment, there’s a reminder that goes off to me and my wife to come back in and say, “Okay this is your weekend with Aria, what are you going to do? I dunno, let’s go see if there’s a cool musical in town.” And we start researching stuff.

Then what we try to do, is we try to outdo each other. Because if one parent comes up with something cooler than the other parent then your kid wants to leave to go with mom.

Doug:                                  I get the trophy.

Josh M.:                              I gotta do something cool. But if we wouldn’t have put it in the calendar as a reminder and made a commitment to it, we would have forgot about it. It would have just been a good idea, you know what I mean. The other thing that has helped me a ton in terms of scheduling, in terms of exercise stuff is classes. If you go to group classes where you have a time you have to be there and you have accountability and there’s a group that’s going to be there or even a group mountain bike ride, a group anything. What happens is, when you get overwhelmed and you get into the burnout all the sudden, sometimes going on that hike doesn’t sound as fun because you’re just over your head, but if I’m supposed to meet Doug and Collin, and we’re going hiking, I’m not dogging you guys. I’m going to show up.

Doug:                                  That’s right.

Josh M.:                              So reoccurring appointments in your Outlook calendar, that are shared and agreed upon with your significant other, and group activities have been something for me that even when I get in my, feeling over my head, pull me back out and keep me on track. So I just wanted to give some real tangible examples to what you had said about scheduling yourself and your key relationships.

Doug:                                  Even along that same line is if you buy say season tickets to plays or to the opera or whatever it is, music in the mountains or whatever that case might be, when you buy the season tickets, you’ve already prepaid for it, so it’s a lot more painful to say we’re going going to go to that play tonight. We’re just throwing money away. So another great idea to back up what you’re saying there is saying, “Yeah, buy this.” Get a workout buddy. Something along that line that really, and again so your stacking like you said, that I’m also getting the social, but also I need to show up for myself because the reality is, what comes first, action or motivation? And everyone says well clearly motivation. Guess what? That’s not the case. It is action. Action comes first and then the motivation will follow?

Do I feel like exercising? Have I ever felt like exercising? Not really. Some people do and I think we need to drug test them. But I never feel like exercising. It’s “Oh my word I’ve scheduled exercise,” I’m not motivated to do it and if I sit there and wait for the motivation, it’s like when I have a paper route when I was a kid. If I waited to be motivated to get up early in the morning on a snowy day, it’s never gonna happen. But once I started folding the papers, once I started loading them up on a bike and started going then the motivation will follow. [inaudible 00:36:48].

Don’t think about it. Just go do it and go make that happen. Don’t think just do and then the action will bring the motivation and typically the payoff comes after I’m done and I look back over and I say, “Wow, okay that wasn’t as bad as I thought. I feel better because I allowed my spirit, if you will, to conquer the body.” That’s where we find that happiness is at. That’s what gets us out of our comfort zone. There’s no growth in our comfort zone but getting out of that and understanding take the action. Don’t sit there and wait to be motivated. Take small incremental actions, schedule it like you said, make it happen.

Josh M.:                              And just to your point if you get your butt out of bed when it’s cold and you don’t want to and you make yourself do it and then you feel great afterwards and you have the endorphin release, aren’t you ready to take on the day?

Doug:                                  Yeah, absolutely.

Josh M.:                              Now you’re ready to reengage.

Doug:                                  You know along that same line, I think it’s real important, and I believe we lose our identity, we lose that sense inside of us, that intuitive self that is about potential and it’s replaced with a cynicism, and that takes no effort. It’s cowardice to allow that ultimately, we’re saying, “Don’t allow burnout to dictate who you are.” Get connected to that core, that sense of yourself and take the time to remind yourself of who you really are at your core. That this is your life and it’s passing, what are you waiting for? Take the helm of that. One suggestion I would have for all of our listeners here today, is to really take the time and say, “Who do I want to become in the next 30 days?” And write that down. What characteristics do I want? What would I like to do in the next 30 days in my relationships, with my family, my office, with myself. Who do I want to become? How do I want to contribute and make my work environment or this world a better place?

In essence what I’m asking a few questions there, I find that stress more comes from a lack of clarity. When we get the clarity, we know what’s most important. We make better choices. I run my choices through that core. Where I’m core congruent. I’ll tell you what, that’s one of the biggest ways we can reduce stress in our lives is identifying what’s most important. And sometimes it’s hard when we have conflicting roles. But understanding our core sure helps us make better choices down the road. That we don’t look back with regret. Again, regret is one of the most difficult things that we will live with as humans so we want to reduce regret as best we can.

Josh M.:                              You said something that reminded me of a quote by Jim Carrey, the actor and comedian of all people.

Doug:                                  Oh yeah, love him.

Josh M.:                              He’s actually a brilliant dude. He was giving a speech, I believe it was a college graduation speech. It went something along the lines of, “So many of us live our lives in fear, but we call it practicality.” I butchered that quote, he said it much better than I but it speaks to what you just said. That … you now that’s not practical, that’s not realistic, that’s not going to happen. There’s no way I could fit in yoga, three times a week with my buddies. There’s no way I could fit in a date with my kids every other weekend, it’s not realistic. How much of that is a fear that you just need to get in, get clarity on what’s important to you, start making adjustments, maybe you need hire somebody to do a few things and take it off your list so you create more space in your life.

Doug:                                  Absolutely.

Josh M.:                              And then see where life expands from there. But anyway I thought that was great point that you made, I didn’t want to skip over it.

Doug:                                  Well and I think, see, we’ve talked about some tactical things that people can do immediately to help them gain control, to get back at the helm of their life. To gain a sense of control. That’s critical. To gain a sense of purpose, that I’m making a difference and to gain a sense of connection with others. We’re really hitting burnout right at it’s core. I don’t think we need research to tell us what that is. We know it intuitively, but we numb ourselves out and we disconnect from that. To truly be alive, why we’re alive, one of the saddest things, there’s a quote, can’t remember who said it, “What a tragedy to be dead while you’re yet alive,” and boy isn’t that burnout? And then we start to feel guilt and we start to feel shame.

Versus being able to say, “Hey you know what? A big key really is to be present in this moment.” We find that anxiety it resides in the future and the majority of folks that I talk to, they’re going to spending 80-90% of their life in the future with fear. They’re having their amygdala the flight flight response is going off. I’m in the future and then I go to the past with depression, despair and we really forget that in this moment, like Victor Frankle, one of my heroes … had a conversation with him in 1997, forever changed my life. This idea that between stimulus and response, is choice. We need to be able to understand that it’s choice in this moment. The next decision that I make is gonna lead me to resilience and an uplift or by default to a downdraft. The idea is we really want to be in this moment. If you are feeling out of control of your life right now, pause breathe. Get into some mindfulness ideas. Get on the apps of your phone, slow down. So that again that you’re living your life. You feel fully alive.

Now we’re going to have our normal ebbs and flows in our life. I’m not talking about perfection. But I’m saying, life is way to short and sometimes it slaps upside the head like with my dad. It was one of those recalibration going, “Doug, you know this stuff you hypocrite. You know that relationship with dad is key.” We want to savor life and we want to become alive. And ultimately one of the biggest driving forces again, it is we want to make sure that we’re infusing love into our lives. Every aspect that we possibly can. Because in the end what else is there?

Josh M.:                              If there was a message for us to end on that might be it. Other than love what else are we living for right? We’ve covered a lot of really good stuff, we’re over a time which always tells me this is a great podcast when we blow past the time and I’m just … could go another hour. Here’s what I want to do. I’d like if you would, feel free to give us any closing thoughts here in a moment. I’d love you to give us a place where we can get your book. A place where people can connect with you if the want you to come speak to their group. I will tell our listeners, the presentation you gave at the Utah Medical Association, there wasn’t a person in that room that didn’t connect, doctor, non doctor, it was powerful. Anybody who might want to have you come speak to their group and anybody who might want to talk to you about coaching or read your publications.

First any closing thoughts you want to leave with us as we part ways here?

Doug:                                  I think as far as the book is concerned you can go to Amazon, you can go to Itunes, you can get the download, you can buy a hardback if you’re more into that. If you want the audible you can get that as well. One key thing I would say is keep learning. Keep learning. Everyday try to learn something new and share it with somebody within 24 hours. Learn something new and share it so you can keep it. That’s one key.

Hey if you’d like to read my book, I’d love you to read it and also if you’re interested, I would, like you mentioned, this is what I do for a living, I speak to groups. It’s my passion. It’s what I love. It’s what brings me to life and it’s important for me to be true to that. If I can help you with your group I’d love to talk to you about that. Also if you’re interested in coaching I do have packages and an initial free 20 minute coaching to start things off, see where you’re at, help you identify and then see if coaching is a fit for you. There’s no pressure. That’s a freebie that I throw out there to the entire group.

My last parting Josh is, just number one, I love your energy. You’re making a difference in this world. And you haven’t allowed life or the financial terrain that we find ourselves in to kill that hope inside of you. And I want to say that same thing to the podcast listeners, to every person hearing this, don’t allow life to kill that inside of you. Keep that love, that hope, making a difference, alive. Your contribution. Life again, as we mentioned, is so short, enjoy, savor the moment.

Bottom line is I want you to get to the end of your day and here’s the indicator, look back over that day, take that self assessment, were you glad you lived the life you did today or not? What do I need to do different so I can continue to be alive and making a difference. To be a force for good in a world that often is so dark. We need heroes in our world where today we see that this cynicism and the sarcasm, and whatnot, just pushing that aside. Don’t allow life to kill that inside you. Keep that hero alive, rescuing other people, in the process, rescuing yourself.

Josh M.:                              Awesome. This has been one of the most fun conversations I’ve had in a long time. I appreciate you sharing with our group and my suspicion is this will be one of our most popular listened to podcasts and I would like to just make sure that we decide at some point in the future, that we do this conversation 2.0-

Doug:                                  You got it.

Josh M.:                              Appreciate what you are doing for the world my friend. Thank you for joining us today.

Doug:                                  Alright, thank you Josh, take care.


Find out more about Doug at