Physician Burnout


Dr. Relly Nadler: Today we are really excited to talk about physician burnout. We have Dr. Naim El-Aswad with us. He is American Board Certified in internal medicine. He specializes in internal medicine and emergency medicine for over the last 15 years. He practices both disciplines in Houston, Texas and he has been involved in the care and wellness of patients, but also has been very active in teaching and training other healthcare workers including physicians, paramedic personnel, and nurses.

He is the cofounder of Vital Signs Vital Skills, where he is a Chief Medical Officer. This is a company that he is involved in with his wife, Zeina Ghossoub El-Aswad, who is a PhD in counseling and behavioral science, and also myself. We’ve done a fair amount of work together and it’s really great to be able to share some of this work with the world in regards to really the epidemic of burnout with physicians.

He is currently developing programs that target physician’s well-being. He’s focused much of his experience in the medical field on the science of medicine. But perhaps more importantly, the art of medicine. He has lectured throughout the United States to students, residents and attending.

His passion, and you’ll hear it, and his mission is to help develop the best possible physician / patient relationships which he believes are still and always will be the basis and the nature and the driving force of the medical field.

He’s a very dedicated physician. You’ll hear the passion but really to address this epidemic that we have about the people who care for us being able to be at their best.

Dr. Cathy Greenberg: Naim, welcome to the show.

Dr. Naim El-Aswad: Thank you both. With all that lovely introduction you set the bar way to high. It’s an honor and a privilege to be here. I want to thank you both for the opportunity. I have learned so much from both of you. You are very, very dear friends to me and you have provided me with opportunities and a different outlook on life that I have cherished and I use in the care of my patients and in the delivery of our message, if you will. So, thank you so much for this opportunity. I’m privileged and humbled.

Dr. Relly Nadler: Well, we are really happy to have you Naim, as Zeina your lovely wife would say, she kind of pulled your arm and compelled you to take the EQi.

You are such an advocate for physicians around having emotional intelligence. We have a series of questions that we want to ask you. It will be a lively conversation today. Who are some of the people who have influenced you most in your life. Maybe one as who you are as a leader, but then also as a physician?

Dr. Naim El-Aswad: I would say that in college we studied a lot of civilizations, so the first person that really struck me was Socrates. He was a great philosopher, but he struck me time and time again because of his two words, “Know Thyself.” I figured everything starts with knowing who we truly are and that revelation came from that point, but I didn’t even know how strong that would be until 10-15 years later when I was introduced to EQ and we talked about this. This was one person who had affected me. The other reason why he affected me is because he was doubting and questioning everything and really trying to understand the source of information and where it comes.

My faith has also helped me navigate a lot of the issues as a physician and as a human being.

Then in my med school in the last year, we had a physician who was 87 years old and he was still teaching with the passion of a 22 year old. So we had to be very, very careful when presenting cases to him about difficult patients. We bring this chart that is about 3,000 pages and we start to talk about it. He’ll stop us and say, okay, so tell me about the patient. As we are reading the chart he says, “no, no,” tell me about the patient.

For quite some time we didn’t understand what he meant until he finally explained that you are dealing with human beings, you’re not dealing with charts and cases.

During my training, again, that was reinforced by another physician, he is an infectious disease specialist. He would not matter how much the patient was upset or afraid or anxious, when he walks in and then he leaves, the patient is in a totally space.

So, I would say that these three folks and my faith have influenced me the most.

Dr. Relly Nadler: Give us a little background about where you are from and where you did your training, and then what you do now.

Dr. Naim El-Aswad: I grew up in war-torn Beirut from 1973 when the war started up until 1990. So for 17 years there was a lot of civil war. That taught us a lot about life and the value of it. Then I finished my medical school at the American University of Beirut in 1997, and I came into Philadelphia an ended my residency training in internal medicine and then later on as Chief Medical Resident at Graduate Hospital which is part of the MCB Drexel University.

Then in 2002 I came to Texas where I started practicing internal medicine and emergency medicine, and have been in the Houston area since 2009 and working with several facilities and working in emergency rooms in different hospitals.

That has given me a unique perspective in seeing—at one time I was working in 14 -15 different hospitals and it was fascinating that no matter where I worked, the response of the healthcare professionals was the same. It doesn’t matter the institute, it was just the same. That’s what got me started to think about burnout and the issues that are driving us as healthcare providers; angry or not being effective, and I was guilty of that myself on several occasions.

That pretty much led me to ask a few questions. When I met Cathy through Zeina and then I met you, I started to learn more about coaching and learned more about emotional intelligence; one thing led to the other and here we are.

Dr. Cathy Greenberg: Naim, when you talk about what you are doing and how you do what you do, it’s important for me to have the audience understand that you have also a very strong entrepreneurial mind. I know right now you are into physician burnout and well-being and the whole coaching aspect, but could you just provide us with a thumbnail sketch of some of the innovative teaching techniques that you have used in the past. Because, you know that burnout and well-being are so important, having hands-on experiences are also very important. Can you talk a little bit about that entrepreneurial mindset that you’ve used for training other physicians?

Dr. Naim El-Aswad: Well, the issue was with me; as physicians or healthcare providers, we are taught to be data-driven and then to come up with a diagnosis and then come up with a solution. But it all starts with identifying the problems. So by first trying to understand what was going on with me, and then realizing that this was, like Relly said, and epidemic, because everywhere you see, and we’ll state a few data and statistics.

Listen to the complete interview above!


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