Podcast Episode 41 | Practicing Self-Care as a Physician Isn’t Selfish, It Is Self-Preservation

With Dr. Jillian Bybee

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The Prosperous Doc® podcast by Spaugh Dameron Tenny highlights real-life stories from doctors and dentist to encourage and inspire listeners through discussions of professional successes and failures in addition to personal stories and financial wellness advice.

Shane Tenny, CFP® is our podcast host and Partner at SDT. He has lectured numerous times for hospitals and physician groups and, most importantly, helped hundreds of clients develop strategies to navigate through turbulent times toward their financial goals.

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Dr. Jillian Byb...:  00:00   I do this work that is really trying to make outcomes for the healthcare system better and outcomes for the people I work with better.
Intro:                       00:11   From Spaugh Dameron Tenny, it's the Prosperous Doc Podcast. Real stories, real inspiration, real growth. A show for doctors who are ready to improve their overall wellness in every aspect of life. Now here's your host, Shane Tenny.
Shane Tenny:     00:28   Welcome back to the Prosperous Doc ® Podcast. I'm Shane Tenny and glad to have you with us today for another episode on a super important topic we've covered on the show quite a bit over the years. And that is physician burnout. All of us are familiar with at least the phrase. We know that over the last year with COVID, it's been exacerbated. I know last year's annual Medscape survey that was released in September really just showed the statistical impact of COVID on the burnout factor for physicians. And we know that doctors that experience and are struggling with burnout, depression, anxiety tend to leave their practice, which of course impacts patients access to care and continuity of care.
Shane Tenny:       01:15   Today, I'm grateful to be speaking with Dr. Jillian Bybee who began her practice of self care and self compassion to deal with her own burnout and struggles as well as provide support for the fellows, the residents, the nurses, the other physicians that she works with closely as a pediatric critical care physician in Grand Rapids, Michigan. For those of you not familiar with the Midwest, if you look at your right hand, Grand Rapids is down there underneath your ring finger. So if you're from the Midwest, I hope you'll appreciate my geographical reference.
Shane Tenny:       01:50   So Jillian, thanks so much. Welcome to the Prosperous Doc Podcast.
Dr. Jillian Byb...:  01:54   Thank you so much Shane, for having me. It's definitely an important topic. And since I'm now an honorary Michigander, I really do appreciate the geographical reference.
Shane Tenny:       02:03   That's right, yeah. I think you're originally from Washington state. So I think everybody knows that's just out there in the corner. So Michigan needs a little bit more direction. So I guess maybe start with a little bit of your journey of self care.
Dr. Jillian Byb...:  02:15   So prior to my fellowship in pediatric critical care medicine, I didn't really have a practice of self care. And like so many other people, it came to me by necessity. So I was born and raised in a really hardworking family, a lot of perfectionism tendencies, some mental health issues like anxiety that probably were undiagnosed. And I just achieved my way through school, through med school, through training. Kept going and didn't really pay attention to self care. I would work out, I would do some things for fun, but as I went through training, I started to lose more of my hobbies. And you combo all of that with pediatric critical care medicine fellowship itself, which has a lot of trauma, a lot of stress, a lot of sleep deprivation. It finally came to a head my second year when I had a patient who ended up dying and that derailed me.
Dr. Jillian Byb...:  03:05   It took a few weeks for me to realize what was happening. I was able to show up to work, do my job, but not really able to do my research or be social with my family. And it finally dawned on me, oh hey, your probably burned out and you might be depressed. So I told that to my program director, who was very supportive of me seeking therapy. From there, started doing therapy, finally started meditating, working out, getting my hobbies back and really took a few years to put that back together. But it was so liberating to finally say that out loud and to have people be so receptive.
Shane Tenny:       03:38   You just packed the whole life story into about 90 seconds there. Well, let's unpack it a little bit because one of the things from talking with docs over the years on the topic is, I think we can all agree, that at least to generalize people attracted to the field of medicine tend to be pretty high achieving. Pretty driven people, that they've learned the behavior of being really focused to accomplish things. And then at some point for docs that get to this crossroads of whatever, sleep deprivation, diet fatigue, just life-changing patient encounters. I'm thinking as you describe it, and maybe just asking if you can elaborate a little bit on maybe the emotional confusion and internal struggle of wait, I don't deal with these things. I press on. That's how I got here, but I'm now up against a wall that I can't deny is real. I don't know if I'm describing that right. But can you just talk about that part of your experience and fellowship there?
Dr. Jillian Byb...:  04:38   Yeah. This experience and fellowship with this particular patient was not new. I had had as a resident, several patient deaths, difficult situations, a lot of traumatic experiences just as the result of the work that we do. And either we debrief them or we didn't, we all just moved on. And I think that is the key is that we all just moved on from it, not really knowing that you bring that stuff with you unless you actively deal with recovering from it. And so with this patient, I did the same thing. Just moved on, kept working. And it wasn't until I noticed that I didn't want to do my research. I couldn't really focus on anything and that didn't come with a light bulb that said, "Oh, you must be depressed. You should get help". It said like most people with perfectionist tendencies, "You're not doing a good enough job. You're not strong enough for this". And that internal voice was really critical for a couple of weeks until I thought, "Oh, it's not just me and my inability to move on. I've moved on plenty of times before. This must be something different".
Dr. Jillian Byb...:  05:49   And so fortunately I have a really supportive partner in my husband now who I said, "I think I'm depressed. I want to see somebody". And I was so worried about telling him that just because of the shame that it comes with, at least for me. And he, because he's great said, "Okay, you should do that". And that was so liberating. And so with that I was finally able to say it to my program director and get the help that I really needed.
Shane Tenny:       06:13   You mentioned the shame and the stigma, burnout is a lot more ubiquitous, at least in terms of vocabulary than it used to be. But there is still some stigma around it. Talk about that. Why is that the case? What's happening in that element of the topic?
Dr. Jillian Byb...:  06:28   So that is so true. There was actually just an article published, I think a couple of days ago or a little bit ago in the Chicago Tribune talking about this topic. But it's really a combo of things. So some of it just comes from the culture of medicine. And like you mentioned, the types of people who choose to go into medicine are usually high achieving, don't necessarily have a lot of grace for themselves. And the culture of medicine is really built on this foundation of viewing doctors and other healthcare professionals as superheroes. I think we've really seen that this year, as people called health care workers, "Superheroes". And that can be really flattering, but the problem is, is that superheroes don't have flaws and they're also not real. And so when you set out to be a superhero who doesn't have failures, doesn't have flaws and is not an actual human being, that creates a toxic culture within the hospital. And I think sets people up to not be willing to talk about it, but also other people to judge the people that do need help.
Dr. Jillian Byb...:  07:30   The other part is really the systemic issue of credentialing. So whether it's the hospital credentialing or medical licensing. Asking questions, "Have you ever had a mental health disorder?" I think those sorts of questions have really made people worry, will I lose my job? Will people judge me? Will I be able to take patients or have any restrictions on my license? And that has really forced people not to speak up. Fortunately, a lot of people are doing work to combat that and some of the things are changing, but it's pretty slow.
Shane Tenny:       08:04   Within your department as a pediatric critical care physician, I guess in some ways I hope I phrase this right, the pediatric side of COVID hasn't quite been the same epicenter as like an ICU. But still it hasn't been a year without stress. What have you seen within your department or your hospital system to try to attend to and attune to the well-being and the mental wellbeing of the providers?
Dr. Jillian Byb...:  08:30   That's a great question. So I work at a hospital that is a pediatric freestanding hospital within an adult system. So I've been able to see what a large health system has responded to during the pandemic. And they had already started pre pandemic to work on their wellbeing. They had done a pilot program for physician wellness prior to the pandemic that I was part of that was really great. And I think the pandemic just accelerated the need for this.
Dr. Jillian Byb...:  08:58   So it's been nice to see messaging from our hospital leadership, from the office of physician and advanced practice provider fulfillment of a lot of programming. So they've been doing structured debriefs, putting out a bunch of messaging related to this, having free apps. And I think that's been good, but the response I've seen from a lot of people is, "I don't have time for that. That doesn't apply to me. I'm not able to take care of that". And I used to have the same discussions either with people or in my own head also. But I think what people are seeing now is that if you don't actually take the time to utilize those services, that things catch up with you.
Shane Tenny:       09:40   So culturally, did you see your colleagues more making excuses of why they didn't need these things or is there a culture of participating or attending or making time in your schedule to avail yourself of the resources that the system is trying to provide?
Dr. Jillian Byb...:  09:59   And so it really depends on the person like so many things do. And also the venue. So what I have seen is though there are more resources offered, some of the same hesitations are there. Some of the debriefs by the system had mental health professionals from our employee assistance program. So outside people. And the things that I heard privately about that is that people were nervous to go to those. They were worried it might be on the record or that maybe wasn't a psychologically safe place to go. But the need and desire for other avenues has increased.
Dr. Jillian Byb...:  10:34   So I sit as one of the co-chairs of our children's hospital fulfillment committee. And I also lead debriefs for our residents after their ICU months. And I've seen a lot more people want to do those sorts of things. So for some reason there's more of a feeling of psychological safety, either with a colleague or someone who is not labeled a mental health professional. Like a psychiatrist or a therapist or a counselor, or even a chaplain. And people are taking advantage of those resources, but it takes a little bit of nudging. Usually those people approach me in private, "Hey, what resources do we have? What could we do?". We have a chat about it, point them in the direction that makes sense to them.
Shane Tenny:       11:16   Yeah, that's really great. It strikes me as I'm thinking in my own family, when my grandmother died. And people expressed their concern and then some friends will say, "Oh, let me know if there's anything I can do to help". And then other friends just show up with a meal and how meaningful that is. I'm just struck with that type of comparison within your hospital system. There's a big difference I think that is so important between an administrator, a CEO, a hospital system saying, "Oh yeah, burnout's a thing. Let us know if you need any help" and saying, "We know you need some help. Here are some resources" or at least attempting to provide. And it's much easier to eat the meal that's delivered to you than to raise your hand and say, "I could really use some help".
Dr. Jillian Byb...:  12:02   Yeah, I think that's such an important thing. It's so common to say exactly what you said, which is, "Let me know what I can do. Seek help, find me". But it's really hard to do those things. And so, especially with the trainees, I think regular check-ins with them just scheduling them or when they don't seem like they're their regular self. And I do this with my colleagues too. If you don't seem like yourself and something seems off, either I'll send you a little email or a text if I have your number. Or approach you in person and say, "Hey, something seems like it's happening. Did you want to talk about that at all?" or, "Can I help you with that?".
Dr. Jillian Byb...:  12:42   I prefer the email or the text way. It really gives people space if they do want to talk, but it also gives them space if they don't want to talk about something, because obviously you shouldn't force people to talk about stuff. And I think that's really why some of these mandatory wellness sessions are really the joke on Twitter and other medical sites. Because mandatory sessions where they force you to show up and talk about your feelings or talk about something, really haven't been shown to be helpful. It's those spontaneous things are the things that you seek out that are really the thing that does it.
Shane Tenny:       13:16   Your experience around burnout or depression, which I think surfaced in your story back in fellowship. Is that something that you see now as something that's part of your past, or is that something that continues to surface within you in your field, your specialty and your own physiological makeup?
Dr. Jillian Byb...:  13:38   You referenced the Medscape report. That was really, I think what we saw this year in the most recent one is that critical care has a 50% rate of burnout, which is not surprising given the conditions of the pandemic. And it's really a high burnout specialty. It always has been. And so the conditions are always there to burn out. I think the other things that can happen, especially when you're a junior faculty member like I am, is that there's this expectation that you'll show up, say, "Yes" to things, take on projects and really establish your career in whatever you're doing. And that really doesn't lend itself to having good boundaries. And so boundary setting and figuring out how that works navigating that is really important.
Dr. Jillian Byb...:  14:22   A lot of people in the first one to three years of their career report higher rates of burnout, especially young women in medicine. And that is certainly something that I was feeling. The difference this time though, is that through the therapy I've done, the podcasts I've read, the information that I gather to give to other people. I'm really able to recognize that that's creeping up for me when I wasn't before. And so it's always something that's there in the background, but it's usually something that can be managed. Or at least I have the tools to manage it better than I did before.
Shane Tenny:       15:01   Gotcha. Yeah. You've been on this ride before. I know it's upcoming. I'm not looking forward to it, but I can recognize it and begin to make the adjustments that are going to be constructive for me in the midst of the ride.
Dr. Jillian Byb...:  15:15   Exactly. And there's also some degree of knowing when it might crop up. So we do shifts for seven days in a row, and sometimes there's just some really hard patients. And I know when I'm on those weeks, that it's nice if after I'm done with the week, I can block my calendar on the Monday following and do some things that really restore me. And ever since I started doing that, A, people were jealous and wanted to know how I was doing that for myself. So we've been working on that with some people I coach. But also I've noticed that it feels so much better. Once you're able to clear all of that out, you can really move on with the rest of your projects if you're intentional about it.
Shane Tenny:       15:55   That's a great point. I want to take a quick break, but when we come back, I want to talk a little bit about some of the outlets that you have found to highlight, the importance of the journey you've been on. So we'll be back right after this break.
Shane Tenny:       16:11   Do you have a financial junk drawer? Even before I describe it, you probably know what I'm talking about. Just like that proverbial drawer in your kitchen or laundry room. You know, the one filled with pens and pencils, screws and duct tape. Matches, chopsticks, maybe even an old sock. The drawer filled with things that you didn't know where else they belong. Well, many of us as we go through life accumulate a financial junk drawer filled with an insurance policy we bought from a college roommate after graduation. An old 401k that we never moved from an early job or bank accounts that we opened to get a car loan or mortgage, even though we don't bank with that institution. The more products, accounts and policies you have, the harder it is to create a centralized vision and progress towards the goals that you have, whether you're working with a professional financial planner or trying to tackle these things by yourself. The more organized you can be, the more effective you'll be at making the changes and monitoring the results towards the goals that you have.
Shane Tenny:       17:20   If you need help in this regard, click on the show notes below and download our free guide, Five Steps to Organize Your Finances. I can't say it's a fun way to spend a weekend, but you'll be amazed at the progress you can make if you'll just start cleaning out your financial junk drawer.
Shane Tenny:       17:40   Dr. Jillian Bybee, thanks for your time today just to talk about your story and burnout and depression. But more than that, the flip side of that coin is just the beauty and the value of self care, which so often physicians don't prioritize. Maybe people in general don't prioritize, but at least within the medical profession because of the drive and the type A personality that is so often attracts. You have become outspoken in the last whatever couple of months, couple of years, to Twitter, to teach, to speak, to write on the topic of self care. What do you get out of that? How does that help you?
Dr. Jillian Byb...:  18:19   Well, as I heard Daniel Goldman, one of the leaders of emotional intelligence say the other day on his podcast, "You write about the things you need to learn". And for me, that's really been true with the things I write, the things I teach, what I counsel people on. Those are all skills I had to learn for myself. And as I teach others, I learn a lot from me. So obviously I get a benefit. But really it comes down to the purpose that I feel after recovering from this and the post traumatic growth I've had. That part of what I do in the hospital is quality improvement work and trying to make outcomes for patients better. But also I do this work that is really trying to make outcomes for the healthcare system better and outcomes for the people I work with better. So I really just try to be the person that I think I could have benefited from while I was in training.
Shane Tenny:       19:04   You mentioned right before the break, just the importance of setting boundaries, at the very least in terms of your own schedule. Certainly boundaries show up in relationships in a variety of other areas and applications of life. Why is self-care so difficult for physicians?
Dr. Jillian Byb...:  19:22   [inaudible 00:19:22] question. Obviously it is, or more of us would do a better job at it. But I think it gets back to that superhero thing that we were talking about earlier. If you're a superhero you're not supposed to need to sustain yourself, you're just supposed to keep going. And that's really the culture of medicine is this grin and bear it. Or just move on, bury your feelings approach. There's also this feeling that somehow it's selfish. I think that's still a really prevalent viewpoint in society. Unfortunately, that's especially true for women. They're supposed to be everything to everyone except for something to themselves. And if you put yourself on your own priority list, somehow you're less than, or people look at you funny.
Dr. Jillian Byb...:  20:05   That being said, self-care is not selfish, first of all. And also it's really self preservation. I think all it is, is the things that help you put yourself back together so you can keep doing what you need to do. And if you're not able to take care of yourself, you certainly can't take care of other people as effectively as you could.
Shane Tenny:       20:24   It strikes me as we use that phrase in this conversation and others, self care, which definitely has like this overtone of, "Oh no, no, no, no. I'm okay. I don't want to be selfish. I can [give 00:20:35]". And I'm reminded of a business school book, one of the most famous by Stephen Covey's Seven Habits of Highly Effective People. And number one habit is sharpen the saw. Take care of yourself. And sharpen the saw doesn't that just so much more inspiring than self-care, but it's really the same thing. If you're burning the wick at both ends. If you're the lumberjack and never sharpen the saw, you are going to be just exhausted and working way harder than you should when you should be caring for yourself and your tools. And I guess I'm stretching the analogy too far now, but you get the point. I just was struck by the difference and the similarity in those two phrases.
Dr. Jillian Byb...:  21:10   Yeah. I think like you're saying words really do matter. And certainly depending on who your audience is, the words that you choose to use about the same topic really can affect people. And so when I talk to a group of women, I might use different words. When I talk to a broader audience in my hospital, I might use different words than when I go talk to my pediatric critical care group of people. Only because I know what the attitudes and opinions are of that group. And so tailoring the message to really say the same thing, but using different language, I think is important.
Shane Tenny:       21:46   Can you give an example. What's some of the language that you feel like you know you're using synonyms, but designed to tailor to your audience?
Dr. Jillian Byb...:  21:53   We have a joke in my group that none of us really like to talk about feelings. And so though talking about emotions and feelings are important, I think that when you start saying, "Feelings" or "Heart" or things that are perceived as softer, there's a lot of squirming that happens. And so I don't use that language. But I just say, "Self-awareness" or some of the other emotional intelligence principles and really it's all the same thing. It's noticing what's happening in your body but it's just using a little bit, like you said, stronger language that doesn't throw people off.
Shane Tenny:       22:31   Well, I think it's a great point you make,. and I'll ask you one, which is the phrase physician burnout. I think is one that's gained acceptance over the last decade or two among a lot of circles. And I wonder, and I'm curious about your opinion, is it now a phrase that we hide behind because we don't want to say depression or anxiety or that sort of thing?
Dr. Jillian Byb...:  22:55   That's a really good question. I think it is a phrase that has come into the lexicon of our language and we do use it a lot. I think sometimes when people use the word burnout, which actually has a World Health Organization definition, is chronic stress that has not been successfully managed. That is something that covers a lot of bases, but doesn't account for the fact that there are a lot of systems issues that are problems. So people experience compassion fatigue, they experience moral injury, especially this year when people were being asked to care for more patients than they felt like they could take care of safely. There's secondary trauma that happens. And so really sometimes people say, "Burnout", but they mean those other things. And maybe some of the solutions for dealing with them are the same. Maybe they're different.
Dr. Jillian Byb...:  23:49   But I think burnout definitely is distinct from mental health issues, like anxiety, depression, and other things. And sometimes it takes talking to someone. That's why I feel counselors and therapists are so helpful. Really it takes talking to somebody else to piece out which one of those they're going through.
Shane Tenny:       24:09   You mentioned a minute or two ago, just about when you were speaking to a group of female physicians. I think that was the context you referenced that and just the difference. Talk a little bit about that. What's the difference between being a woman physician dealing with burnout or depression or anxiety and your perception of how it affects men?
Dr. Jillian Byb...:  24:31   I think obviously all the parts of burnout can be experienced by both genders equally. All of it is possible to experience, so I don't want to generalize too much. But I think one of the societal expectations for women still is that they give everything they have. And there's this great book that I've been reading called Burnout. It's by Amelia and Emily Nagoski who are also on Bernie Brown's podcast, which is a great intro episode. Really talking about what women go through as human giver syndrome, meaning that they're expected to give everything to other people, but not give anything to themselves. And so when I'm sitting in a group of women talking about this, one of the things that really happens is the guilt that crops up around potentially taking time away from family, whether that's your partner or your children or your parents to give to yourself. I think that is a huge issue that we deal with and perhaps is there for men as well, but there's not such a societal expectation for men to be giving everything of themselves.
Shane Tenny:       25:38   Is it a higher risk for a woman physician to acknowledge or talk to management leader, department head, about these topics than it is for her male counterpart?
Dr. Jillian Byb...:  25:55   Well, that's a good question that I don't have a perfect answer for. I think what I've actually seen in some of my male colleagues is that they might be less likely to seek this out because there's this toxic masculinity that still exists in our culture, where obviously if you're a man you're not supposed to be weak or talk about your feelings. And so it's possible that for them actually, it's harder to seek out help and they might not have the same built up social network that a lot of times women have. I think we're more likely to talk about it with each other, but that's why I'm so grateful that I do have a couple of male colleagues who talk openly about this in my health system. I think they're so important for getting a rounded view of people talking about this.
Shane Tenny:       26:34   Yeah, that's a great point. And I appreciate you spinning my leading question around to highlight a very real thing, which is if you're a guy, the stigmas, you just put your head down and keep going because you don't feel these things and the fact is, we do. And they're there. What resources, you mentioned podcasts, you mentioned books. I'm curious. I think I'll throw out here at two-part question, which is what are the most helpful resources? You alluded to even therapy just a minute ago. Medicine, therapy, books, podcasts, what do people need to be aware of? The second part of that is for somebody listening, who says, "I think I have a colleague who's not themselves". You mentioned texting, emailing, that sort of thing. How do you approach? Do you have a suggestion there based on your story?
Dr. Jillian Byb...:  27:17   The first thing I would say is that, if you're somebody who thinks you might be struggling or have a question about this, that you don't need to suffer in silence. You can get the help that you deserve and it actually isn't just that you need help. It's really that you're a human being and you deserve it. And I think if you're really suffering with burnout or a mental health condition, that's where a therapist and a counselor is really important. That's what I sought out first, before I sought out these other resources. Peer support is a resource that happens in a lot of health systems if you have the luxury of being in one of those. Obviously there are a lot of people who are either rural or in their own offices who don't have those luxuries. And so I think trying to reach out to a friend is important, that really getting that mental health professional is important.
Dr. Jillian Byb...:  28:06   If you're not struggling, but you think, "Oh, maybe I need some resources. I need to boost myself care game" or something. I think there are a ton out there. I love Brené Brown. I think she's been great. Her Unlocking Us podcast has a ton of resources as I mentioned on burnout, but also she has an episode on secondary trauma and some other things that overlap between the general public and also physicians. Also, meditation has been really important for me. I think it's allowed me to become more self-aware. There are a ton of apps out there. My favorite is the Ten Percent Happier app. It also has a podcast that tackles a lot of these issues. Also, this is a great podcast to listen to for those sorts of things.
Shane Tenny:       28:49   Thanks for the shout out.
Dr. Jillian Byb...:  28:51   Shameless plug. The other question is harder obviously, as I mentioned, everybody's different. And so I think if you know the person that you think is struggling, either through casual encounters at work, or they might be your friend. I think like you talked about with your experience with your grandmother, just showing up whether that is in a text, an email, in person. And saying, "I'm here, it seems like you're struggling. Do you want to talk about how you're doing?". And if they do, I think the really important thing is to pay attention to what they're saying. To hold space for what they're saying. So often we show up for people in order to fix things, or we don't show up for people because we know we can't fix things. But most of the time people don't need to be fixed. They just need somebody to listen. And that is probably the number one thing I can say for people.
Dr. Jillian Byb...:  29:45   And that's really something I teach my trainees in the ICU is when you have a terrible situation, you can't fix it. There are a lot of times things are inevitable, but you can show up as a human and give space for another human.
Shane Tenny:       30:02   Yeah. I think that's really important. And I'll just add my own 2 cents on there on this topic, which is I think that the ability to identify and then cry out for help is a pretty high emotional calling. And for people who are struggling to simply say, "Let me know if you need some help" is putting the obligation onto the needing person to exercise a skill that they're not in a place to do. And so if you're identifying that, to step into that and offer help or offer that ear or whatever. Because what, at least my feeling is, and you can either add to it or dispute it, but is that in some ways the deepest threat in these and in much of our emotional wellbeing is the threat of loneliness. And shouldering that stress or that anxiety or that depression, that fear alone is what magnifies it a hundred fold.
Shane Tenny:       30:55   But if you can journey it with a spouse that you can speak genuinely with, or a colleague or a friend or a therapist, just puts light on it and allows that healing and that healthiness to take root.
Dr. Jillian Byb...:  31:10   Yeah. I think that was so well said. And I would agree with that. One of the things about burnout and depression is that it makes you want to isolate. And so obviously as a person approaching someone like that, you want to be respectful of boundaries and not push too hard. But sometimes just the showing up is the important part. Like you said, they're not going to seek you out.
Shane Tenny:       31:34   Jillian, thanks so much for your time today. I'll wrap us up here. I really appreciate your tone and the authenticity that you bring to the topic, because it's an important one. I love your reference to Brené Brown's podcasts, which are great books. We'll put a link to those in the show notes below. And thanks for being here today.
Dr. Jillian Byb...:  31:53   Thanks so much for having me and also for this podcast that spotlights such important things for physicians.
Shane Tenny:       31:59   Thank you. And thank you for giving us some of your time today. I appreciate you listening to the Prosperous Doc Podcast. You can find us on a lot of social media channels. If you have any suggestions for guests, friends that would like to be on here, topics you'd like us to tackle. Feel free to email me directly at shane@whitecoatwell.com. Thanks so much. We'll see you back here next time.
Outro:                     32:21   This episode of the Prosperous Doc Podcast is over, but you're not alone on your journey. Spaugh Dameron Tenny has been helping physicians and dentists prosper through financial planning for over 60 years. To connect with us, visit sdtplanning.com today and take your financial wellness to new levels. Join us on the next episode of the Prosperous Doc Podcast.