Episode 41: 
Self-Care Starts with No for Doctor Moms: with guest Dr. Maria Colon-Gonzalez

“Don’t betray yourself. Because if you betray yourself, eventually there’s something inside of you that will start cooking.”

Spot on insight from my guest, Dr. Maria Colon-Gonzalez.

Sometimes, saying “no” is easier said than done, right?

In theory, I know what to do, but sometimes I just feel guilty or obligated to say yes.

And not standing firm with boundaries is a blow to self-care too.

Listen in as I sit down to discuss boundaries and self-care in today’s episode.

Discover key insights about:

• how being a woman changes your approach to boundaries.
• how to manage guilt over saying “no” to a patient.
• negotiating with colleagues who want more from you.
• defining self-care on your own terms, not what society dictates.

I promise you, Dr. Maria dives deep into these topics.

Meet Doctor Maria Colon-Gonzalez

Dr. Maria Colon Gonzalez is my guest today. Before I roll tape on our discussion, here is some background.

Dr. María founded SaludRevisited, an Integrative and Lifestyle Medicine practice in Houston, Texas.

While in residency, Dr. María realized the many missing links in the care she provided to her patients.

She noticed patients would visit the office for medication refills but not necessarily live healthier.

After four years in practice, she completed her training in Lifestyle Medicine; then she retrained as a yoga instructor.

She is also trained in culinary medicine and plant-based nutrition.

In 2021, she started her Integrative Medicine fellowship since she believes patients deserve holistic care.

She is a trauma-informed physician, recognizing that the events of harm to one’s life have affected the body, mind, and spirit. Her approach to care is your body tells a story, and you can rewrite the narrative.”

Insights for Physician Moms with Doctor Maria

Dr. Cindy

Hi everyone and thank you for joining us today. I have a very special guest. Her name is Dr Maria Colon Gonzalez, and she is out of Texas. I got to meet her. She’s in my hometown.

She is an integrative and lifestyle medicine physician, and I just read some information about her in my intro. But another thing that I find fascinating is that she has a podcast just like this. It’s called Beyond Medicine, Humanized Care for Women of Influence.

She has a book called Healing the Wounds of Medicine: Stories and Journaling for Physicians.

And she has her own practice, which is a functional integrative medicine practice for women and teenage girls. So, to get started, tell us a little more about yourself, your passion for medicine and your focus on women and teenage girls.

Dr. Maria  

Yes, thank you, and thank you for having me here. Cindy. So, my passion for medicine, I think that started very early on, a combination of different things.

I do have family members that are physicians, and they’re not mom and dad, so I didn’t grow up with them specifically in my home, yet, especially my maternal grandfather, I had heard a lot of stories, from my mom, of him attending to his own patients at his home.

Actually, before dying, he tried to build the hospital for like, this little small town in Puerto Rico. So, he has a legacy, and maybe not now, but growing up, when I would go to the town, which is called “Latice”, everybody would be like, “Oh, you are the granddaughter of” and they would say his name.

So, there was something of the stories of hearing him serve people, and not only serve people, but the relationship was very different because it was it was more relatable.

I think that sometimes perhaps when you are in a bigger city or in a bigger like health system, the relationship becomes more transactional than the personal type of relationship where, hey, my patients know where I live, and that is okay.

And if they want to bring me some chicken for Christmas or whatever it is, that is okay. I mean, even to the point where now we even have regulations in terms of, can we accept gifts and what we can and cannot accept.

The relationship that I heard was very, very different, and I think that as I’m establishing my practice, even that my patients do not know necessarily where I live and come to my home to give me chicken, I am trying to establish and trying to foster a more personal way of relating to my patients – because I really believe that we have lost that.

And why my passion for women and why my passion for like teenage girls?

Well, at home, we’re three girls. And I think that growing up with women in a family of all girls by itself, has made an impact, but also the reality that women itself, we have perhaps suffered from, I’m not going to use the word discrimination, but just challenges.

Challenges that we have to overcome as we have to enter the career world, as we have transitioned into what some people say, like the more masculine roles. Which again, that has been given by culture.

And then finally, when I was in academic medicine, I was actually in charge of the module that was related with hormones and female health. And the reality is that, in a way, women’s hormones are much more complex, and sometimes in that complexity, there is a lot that can be misguided or even dismissed by health professionals. And that is why I’m passionate about helping women and empowering women, and the earlier, the better.

Dr. Cindy   

Amen to that. Yes, I agree, discrimination is not quite the right word, but yes, we have an extra tall mountain to climb as women. I agree.

And as a woman who helps other people like you and other women physicians there’s definitely a rewarding aspect to that, right?

I think that women naturally give more to their patients, and some studies have shown that, and I’m not saying women are better physicians, but they have a different type of interaction with their patients, and it’s possible they may give more.

And that leads me into our first topic of today. Actually, I didn’t introduce that, but we’re going to talk about boundaries and self-care. The first topic of boundaries, I think, is particularly relevant to women physicians.

In your opinion, what are some common challenges that women in these helping profession, like health care and as a physician, face?

Dr. Maria

Yes, one, the time. Because we want to provide excellent care. Because we want to give more. Because we tend to be better at communicating, at listening. That by itself, might put us in a position where that you might be running behind and seeing patients or putting your notes in doing your work.

And it’s not because you’re less effective. It’s just because, females tend to have different communication strengths. I’m not saying that we are superior or better, but just that by itself, can put a set in this position of like, how do I manage my time, and where do I get it?

I also feel, and this goes a little bit into the difference of how we can be perceived. And at least that has been my experience as a woman physician. I do have to, with male patients, a lot of the times present myself as much more authoritative, much more of a distance.

Because, for whatever reason, I can be seen more as a nurse, because that’s more of a female role, the nurse rather than physician. They can use words as like honey, sweetie, daughter, all these other things that they probably would not be using if it was another male physician.

I think that there is an area where there has to be this boundary, at least for me. I have put where not only do I try to interact in a more authoritative way, but if they say those words so use those words – one, I’m not going to laugh at it, right?

I don’t try to say that it’s okay, and if it’s very uncomfortable, I remember one time that I told my office manager, you need to talk to this patient, because this is like, not this is a boundary that it’s starting to get cut.

I think that that’s also very important, and I might be wrong, but I think that those in terms of interacting in a way that we are perceived with the same knowledge and authority as a male colleague doing the same work.

Then definitely our own time management. And not because we want to be more efficient, but I think that we should protect our time, because also the majority of the female physicians have a life after work, whether that is kids, family, partner, whatever your social life is, whatever your life is, it can look different.  I think that you want to protect it because of that, because you want to be able to have life outside the clinic.

Dr. Cindy    

Right.  I’m hearing that you’re saying women have a different communication style, and because of that, some women need to alter their approach to talking specifically to male patients to fight the perception that you know as a female they don’t know it well enough, or they’re not of the same status. It’s almost like, I don’t know, would you say compensation is a word? Are you compensating for how women are perceived?

Dr. Maria

Yes, I think that definitely. And I think that in my case, I’m very petite, that by itself, right? I mean, there is a difference even in your physical persona, that when you enter the room, versus if you’re tall, big, that, by itself, speaks so I think that, in my case, is specifically yes, and not only compensating, but also keeping this distance.

Because for me respect is very important. And if I have a patient, whether it is male or female, that the interaction is not one of respect, that I do not feel respected by them. I know that that is not a physician/patient relationship that is going to continue long term. It’s also so that there is the respect that I think that I deserve.

Dr. Cindy

You do deserve that absolutely, and it sounds like you are nipping it in the bud. You’re catching it early. When you first notice signs of disrespect or reply with of course, it’s obvious to hear a “honey,” you jump on it and draw that boundary right then and there. It’s like time spring into action.

Dr. Maria

Red flag.

Dr. Cindy   

What about something that’s not so obvious? What about just maybe time you spend with patients, or if someone wants to call you after hours? And what about that feeling of that gray area and that feeling of guilt that some not saying you do, but some physicians have about not being available for their patients.

How do they handle that fear of rejection or that  guilt that they have over drawing boundaries  and those softer situations that aren’t so obvious?

Dr. Maria 

So, I think that the first thing that you should do is examine – is this guilt because you’re being negligent to the patient?

Or is this coming, maybe from what culture has told you that you should be at the position, medical school, residency training where you do not sleep, because the patient comes first, for example.

Or is it coming from a place of shame?

Because, if you know, depending on where it comes from, I think that you need to deal with it in very different ways.

And I think that it becomes, it comes from what culture has told you that you should be as a physician. It is starting to retell a different story. It’s starting to you know, change that thought process.

It’s starting to play with, okay, well, what if I just closed, just to give you an example, I closed my computer at 7pm and whatever comes after that, comes after that. Is that going to start to give me anxiety and not let me sleep at night? So let me try that. Let me see how that works. Let me see how the patients react, right?

I think that also communicating it to the patients. Like yesterday, I had a patient that messaged me when I told them I start seeing my patients at 11:30 in the morning. And I was like, you know, you can message me whenever it is convenient for you, yet I don’t start seeing patients until 11:30 in the morning.

You know, they can message me at the time that is convenient for them, and sometimes that is after midnight. Yet, I have an automated response. It tells you what are the hours that I will respond to you.

So again, I’m saying those expectations. I think that sometimes, if we do not communicate that, then that’s where the relationship starts to get gray. And especially if you have some say and control in what is going to be those expectations, as in any relationship.

If it’s coming from this place of “I’m feeling guilty,” I think that then it’s going deeper.

Feeling guilty, because then to say something that you’re not a good doctor. So then, how do you define being a good physician? And are you going to define it as maybe how society does again, your RVUs use, your scores, all of those things. Or do you want to define it in your own terms?

And you have to start to like wave with the mind, right? And then the other thing is, really look at so are you being negligent? And what I mean by that is I remember a patient that she messaged me.

It was not that late, maybe 8pm and she was afraid that she had was having very, very low blood sugar levels. And when I saw the message that it was because I did see what the message was at that time evening, to her, in particular, because of what it was, I told her, you know, for something like this, I prefer that. yeah, I’m going to answer to you. And I want you to tell me, if you check your blood sugar level and it’s beyond this. So, I messaged her, and I told her, if your blood sugar level is lower than this, please give me a call.

I think that, also knowing that boundaries do not have to be rigid, they can be flexible. And then you decide how you move between them, and that’s the beauty of it.

And finally, you know, if it comes from a place of shame, I think that then there you really need, whether it is a coach, mental health provider, this is not that you’re crazy. This is not that there’s a problem, but shame is a very strong emotion, and when there is shame, you meet somebody else that can start to attune and mirror you. Or a really, really, good friend, safe friend, but you need, you need somebody else if there is shame.

It’s not only your mind. There’s also something about the feeling and the emotion and the WHO that needs seen and attuning.

Dr. Cindy    

I love how you broke down your answer into three or four categories. Guilt is a big is a big topic.

So essentially, just to mirror back to you so you can ask yourself, is it, am I feeling guilty out of some kind of neglect, or am I doing something that’s not right for my patient?

You can view it from the lens of and do I feel guilty just because society told me that I should be doing this?

Or do I feel guilty, finally, because I feel shame, and that involves some deeper work, of course.

And I also loved that you talked about communication, communicating your boundaries with your patients, and that it can be fluid, and that you can allow they don’t have to be so rigid. You can allow, for example, your patient, you don’t want them to get hypoglycemic because you’re like, well, I refuse to see anybody. I mean, you’re not, you know, being irresponsible. That sounds so reasonable.

One more aspect of boundaries I wanted to ask you about is that in a different taking you out of those situations, let’s say it’s a work situation, maybe it’s with administration or with some coworkers, or maybe have a partner in your practice, and they’re asking you to do something doesn’t sit right, because you just have a hard time saying no.

When it’s just hard to say no. It’s hard to let  people down. What advice would you give to someone who has that issue?

Dr. Maria   

Wow, that’s a good question, and I’m going to be very honest, depending on what it is, I don’t have a hard time saying no, I’ll be honest.

On the contrary, I think that, because sometimes I have said no in situations where the person asking is somebody in a position of authority like my residency program director.  So, the situation was, I was asked to use a diagnosis code that the patient just didn’t have that diagnosis code. Let’s just, let’s leave it at that.

And you know when, if it’s somebody in a position of authority, and even if you say no, what has been my experience is that you need to be ready for retaliation, unfortunately. So, I think that one ask yourself, what is it that you know —what is the situation? Right? I think that sometimes you do have to keep your no, even though that might cost you something, because you want to put your values first.  And that is going to be in the long term more important.

Let’s say that it’s something more simple. For example, a colleague that was placed to be on a call for Christmas. Last minute they realized, like, oh my God, I got put on call, and I already was going, I don’t know, to Europe with my family members.

And they ask you, “Hey, can you cover for me?” And it’s the last minute. I think that in that situation, what I would look at is okay. So, what is this going to cost me? If I think, is that a cost that I’m willing to, like, live for? And then, so if this is going to cost me something, can we negotiate, something that I can get in return? I think that those are very, very easy.

Again, putting your values first, because maybe for you, it is a big you know value that I don’t know. In Christmas morning you want to open the gifts with your kids. Maybe for you, that’s really, really important. And if that’s more important than saying yes to a colleague, then don’t betray yourself. Because if you betray yourself, eventually there’s something inside of you that will start cooking. So we never want to betray ourselves and who we are.

Dr. Cindy   

Oh, that’s fabulous, because, you know, my first instinct for some situations would be, I don’t like conflict. It’s so much easier just to say yes and just go with it and just deal with it. But I, too, fully, like my whole body, gets this energy. Of course, your values come first.

And I like the fact that you’re reinforcing what’s so true, what’s hard to follow. You can know it. You know that you should follow your values first, but it doesn’t mean your body is going to feel that way at the moment. Your body may be, oh, I just, I just don’t want conflict. But yes, you’re right. You need to step out and negotiate your values first, and you can negotiate. If you say yes, it doesn’t mean that they can’t give
you something back in return.

Dr. Maria 

Yes. And I think that also, you know, taking into consideration, I mean, look at the big picture. Is this somebody that is known to do this over and over and over, right?

The other thing is thinking of, well, if I’m, it’s also you need to think, if I’m all the time saying no to all my colleagues, eventually I might need something, right? That flexibility is very important.

And then finally, also this can play into, again, your value system. Let’s say that the person asking “Hey, can you cover for me?” They just have, like a family emergency. For example, you know, my parents are in Puerto Rico, and something happens, I always have to, like, turn the world around to go, to go there. I think that also makes a difference, because in my value system, helping the other is also very important.

I just want to add you also want to look at the entire picture and the entire story, putting your values first without self-betraying.

Dr. Cindy   

Do not betray yourself, like you said.

So, I’d like to transition a little bit to a second area to discuss, which is self-care. But it’s actually kind of the same thing, because self-care is also setting boundaries, in my opinion.

Just the term self-care, I think has this stigma. Gosh, when people say self-care, they think, oh, you want to go get a manicure. It means so many different things to different people, some of them very positive, like for me, some of them very, very negative and very stigmatized.

How would you define self-care, and why is it so important for healthcare professionals?  Physician moms?

Dr. Maria

Yes. So, without going necessarily into a big discussion on religion, I’m just going to say you have to love yourself first before being able to love others. And I think that that applies to self-care, and that’s one of the reasons why I start seeing patients like later in the day. Because it’s not that I’m sleeping in until 10 in the morning. It’s because in the morning I’m taking care again, along with my values my dog, cooking my breakfast. I’m exercising. I’m looking at my schedule, I’m doing my journaling, I’m doing my Reiki. 

I’m doing all these other things that, in a way, are going to position me to be a better physician, to be in a better mindset when I sit down and then start seeing the patients.

So for me, self-care can look like, yes, I take some time of rest where I have somebody else serve me, whether that is I go to a restaurant or I take a massage or, you know, a facial, but not because the self-care is the massage, but rather because that is a space where then I can disconnect. I’m not with my computer and not with my laptop. I am  resting and I am allowing somebody else to serve me.

It’s very important that you serve but that you allow others to serve you.

Also, for me, self-care can look like doing something that I enjoy, reading, hyping, exercising, cooking. Those are other things that feed my soul.

What are the things that you are doing to feed your soul, that you like, that you enjoy?

Most of all for me, also self-care I have learned a lot is having some space and time where I can do some journaling, awareness, introspection, self-examination.

And that self-examination is not because you need to perfect yourself. Because I think that sometimes when we talk about self-examination, people are thinking, well, something is wrong with you. You’re not good enough. You’re trying to perfect yourself.

I think that this self-examination can even be How are you doing today? Oh, I’m okay. Well, how are you truly doing today? That, for me, is what self-care can look like.

Dr. Cindy   

So, you are putting your values and yourself first at the beginning of the day, positioning yourself to be a better doctor for the rest of the day.

And, wow, I really love how you say that we spend, we as physicians, spend so much time serving other people, or as moms, as sisters, as daughters, like you said, serving all people in our lives.

How many times can you count on one hand how many times someone has served you? And I know you can, because you prioritize that, and I think that’s a beautiful takeaway. However, that looks for you, right, and whatever time of day, not that they have to do that first thing in the day.

What you’re doing is you are prioritizing yourself.

How can we inspire other people to do the same thing? Kind of get towards where you are, not that they’re trying to model you, but just try to get to that state that you’re in.

How can we inspire the listeners to prioritize  themselves? What are some small steps that they can do?

Dr. Maria 

Yeah, so I think that again, starting with introspection and awareness.

So why is it that you need to prioritize yourself? Why is it that you need self-care, or how you want to word it, because I think that, like Simon Sinek says, if you start with the why you have a greater hold as to why you’re doing this right the purpose, let’s start there.

And then I would say, examine, know what your values are, and then know what type of life you want to try to create.

For me, a lot of what I create is counter cultural. Think about it. A lot of people wake up to have coffee while they’re checking their email. I am a little bit counter cultural. And this is not necessarily something that everybody – one, wants to do or two, that being countercultural also comes with a price.

This is something that maybe you don’t even want to do because you don’t want to pay that price. But again, independently of how you choose that this is going to look for you. Can you align it with your values? Can you align it with the type of life that you’re going to create?

So are the decisions that you’re making today taking you closer to where you want to be. For example, in my stage, I’m making decisions so that I can build my practice. And those are decisions in a lot of other areas, but it is because of where I want to be.

Rather if you’re making your decisions just based on the on the present and on the rush and the reacting rather than the responding, then that’s when you can start to get into like problems. I think, starting with this awareness introspection, who you are, what are your values? Where do you want to go in life? What are the decisions that you want to make so that you can get there?

And then knowing yourself. You might not be a morning person. You might not like to exercise in the morning. You might prefer to do like after do everything, because then you take that off of your mind, so know yourself and honor who you are without culture and the noise of social media telling you who you need to be.

Dr. Cindy    

It’s not, it’s not a quick you know, here’s three tips, here’s three tricks, and then you’re going to be you’re gonna arrive at self-care. It’s about self-reflection and values.

Very well said.

In the last few minutes. I just want you to give you a chance to just kind of explain how people can reach out to you. How can they work with you? What if they’re interested in, you know, coming to you as a physician and telling us more about how they can reach you, what you offer. Go for it.

Dr. Maria 

I love working, as I said, with women as well as with teenage girls, whether I’m working with both of you, so if you have like a daughter, or maybe you are coming by yourself that is completely okay.

My area of passion is to help women really heal their metabolic health and hormonal health that go together.

I am very passionate also about mental wellness. My approach to care is optimizing everything, that is lifestyle which goes beyond diet and exercise. Then I might use some supplements, nutraceuticals. I do medical acupuncture as well. So if you are somebody that is looking for a way to optimize your health and help your body heal from the inside out. You are a perfect fit for me.

I see patients in the state of Texas, virtually, of course, not for acupuncture, and then in person in Houston, in the Houston Heights area.

And then I also use regular medications, for multiple reasons. Perhaps you need them or two. You are in a stage where you are like, I don’t know about the needles and I don’t know about the supplements, and I completely respect that, as long as we can always optimize that lifestyle, which, again, is the foundation of health.

Dr. Cindy    

Yeah, beautiful. And of course, I will list the link to your website in the show notes today, and I’d like to just throw in, if it’s okay, link to your podcast and where they can find your book, which is on journaling and looks fascinating.

Anything else you throw my way; I will put it there so people can find it later.

Dr. Maria  

I was just going to say the book can be found in Amazon. And then the podcast. Or ever you listen to podcasts, I do it biweekly. And if you are a female position, and anything that we spoke about also is in your like your areas of like topics, and you want to reach out to me just to be in the podcast, you can also do that.

Dr. Cindy    

Wonderful. Thank you so much for being my guest today. It was such a pleasure.

Dr. Maria 

Yes, until next time bye.

It’s Time to Take Control and Thrive!

Show notes:

Dr. Maria is the author of
Healing the Wounds of Medicine: Stories and Journaling for Physicians.

She hosts the Beyond medicine, humanized care for woman of influence,
podcast.

Find her writings at shineMD:
www.shineMD.net

Follow FB and IG: @MDwrite2heal and @saludRevisited