Why Am I Not Happier in Medicine? Saying Yes to Yourself with Dr. Lillian Emlet

Episode 92: Why Am I Not Happier in Medicine? Saying Yes to Yourself with Dr. Lillian Emlet

Topics Covered

• When Something Is Shifting in Your Medical Career
• Signs You May Be Outgrowing Your Role</a >
• Stress or Growth? How to Tell the Difference</a >
• Rediscovering Your Core Values in Mid-Career</a >
• What Saying Yes to Yourself Actually Looks Like</a >
• Why High-Achieving Women Physicians Say No to Opportunity</a >
• The Next Generation of Physicians: AI, Critical Thinking, and Clinical Judgment</a >
• What Is Energy Leadership Coaching?</a >
• Leading Healthcare Teams Without Burning Out</a >

“I’ve done all the right things, so why am I not happier?”

If that question has ever crossed your mind, you’re not alone.

So many women physicians reach this moment and immediately question themselves.

Am I just stressed?

Do I need a vacation?

Or is this actually growth asking for my attention?

In this episode, I sit down with Dr. Lillian Emlet, physician educator and certified professional energy
leadership coach, to talk about what these inflection points really mean

This episode is about listening now, before “I’ll deal with that later” turns into years.

We explore how to recognize when you’re outgrowing a role, how to tell the difference between stress and expansion, and what it actually looks like to say yes to yourself without burning everything down.

If something in you has been whispering, “There’s more,” this conversation will help you listen differently.

Find the full transcript and bonus resources for physician moms at inspiredmommds.com/92.

When Something Is Shifting in Your Medical Career

Dr. Cindy: I’m with a special guest today. Her name is Dr. Lillian Emlet She is a physician educator and certified professional energy leadership coach. With over 15 years of experience in academic medicine, she is the founder of transforming Healthcare Coaching and host of a podcast by the same name.

It’s for healthcare professionals and leaders who want to become a better version of themselves at work and in life. Lillian works with healthcare executives and clinical leaders to help them perform at the highest level without sacrificing their wellbeing or their team’s culture in the process.

As a long time educator, simulationist and Vital Talk distinguished faculty member, she brings deep healthcare experience to her coaching. Her mission is to help physicians and leaders tap into their full potential, especially those at critical career inflection points where growth requires courage. I am so excited to explore what it means for physicians to say yes to themselves and how you support their journey.

I welcome you today.

Dr. Emlet: It was so wonderful to be here.

Dr. Cindy: Many women reach a point in their careers, I know I have, where something feels like it’s shifting, not in a bad way, but as maybe an opportunity for growth. And today we’re talking about how to recognize those moments and how to respond intentionally, and what it means for women physicians specifically to say “yes” to themselves. You help leaders perform and grow through these moments.

Signs You May Be Outgrowing Your Role

Dr. Cindy When people come to you, what are they experiencing? What are the signs that they’re noticing that they may be outgrowing a role or being stretched into something new?

Dr. Emlet: Part of it is obviously time, time and energy and capacity and excitement.

I would say probably people notice that the time becomes not aligned in the way they want.

They begin to feel internal friction in terms of how much they have to give to who and when, in terms of what are fixed commitments and what are freer commitments.

I would also say energy in terms of how much energy they actually put into something and whether that really fulfills them.

So, sometimes you do things and the energy is easy and it’s fine and it also doesn’t fulfill you.

Sometimes we really like easy and it’s actually nice to have the stability of easy. So it really depends on how you see that moment.

I would probably say those two things. And I think the third thing is probably just a sort of restlessness, like a weird feeling like I wonder what’s next. I sort of feel like I’ve done what I needed to do here and maybe this chapter needs to change and I don’t know what it is.

Stress or Growth? How to Tell the Difference

Dr. Cindy The word that popped into my head as you were speaking was flow. Sometimes you’re just in the flow and it feels so good and feels so easy until you feel restless. I get that.

How do you help people distinguish between that restlessness, whether it is stress or is it really a moment of growth?

Dr. Emlet: I think I just want to also name that growth is uncomfortable, and so I think people also have to acknowledge that a lot of times we often throttle ourselves and don’t even allow us to see the opportunity. Because at the end of the day when we remember what growth means, it means we actually have to be uncomfortable.

And I think that is often something that people don’t really recognize. When I’ve given the grand round talk about, are you of a growth mindset or are you a fixed mindset? Everyone a
hundred percent raises their hand. I’m the growth one. I’m the growth one. And at the same time, the reality is most of us really have a much more balanced portfolio between what is the
outcome I’m trying to achieve and also how willing am I to be truly uncomfortable?

And there’s really a lot of people who think they want to grow, but they actually just want sort of the end product without really doing the journey to get there.

Probably part of it is thinking through, whether it’s to determine whether it’s stress or whether you do need that shift is the consistency of it. If in every realm of life, especially in the one particular part that you’re not satisfied in, because you know we may be satisfied in our spiritual or relationships, our family, our health.

We may be okay in other things, but there’s just one piece of the pie in life that is this sort of not right feeling. The question may be, you know, usually most people will find a mentor, a sponsor, and learn more things. They do what they can and if it still isn’t working and you are making progress and you’ve hit all of the marks, the most common is, “I’ve done all the right things, so why am I not happier?”

Yeah, it’s probably because you need to grow into something different. And you’re just really not listening to your internal values or internal exploration of things you never even tapped into.

Because in some parts of our journey, you needed to put your nose down, work and do the thing, learn the thing.

But then that means we put aside other values and sometimes those other values need to come back to be able to be fully expressed.

Dr. Cindy Ooh, I love that. They need to come full circle – like for physicians, after putting medicine at the forefront for so many years.

Yes, don’t forget your values.

Rediscovering Your Core Values in Mid-Career

Dr. Emlet: Yeah. I can share my own story to some degree if people are curious. I think I did not realize until I worked with my own coach several years ago through this journey of finding the shift, as you pointed out, of what the values were.

I remember beginning with my coach and realizing, this is really sad. I’m 45 years old and I don’t even know my own values. And it took a year almost of journaling and working through with a coach and really seeing where the patterns lay and going back and reflecting. The ideas and the symbols and the data were already there in my own lived experience. And through that, I realized creativity was an important value.

And I didn’t really realize, this is why I lean so much on my simulation educator journey because I love simulating and recreating what’s real and to make learning and healthcare fun for all people. And I mean, obviously I’m talking about life and death things and like resuscitating and really things that are not considered fun.

But I want to use all that creativity to, you know, either make things, do things, create environments that make it good for people to learn. So my creativity was expressed the entire
way and it was only through that experience of working with my coach and discovering that value I then pivoted into really going back to do things for me.

Like many artists create not because of others, they create because they just need to. And so from there, I obviously then started the podcast and then started writing and I started a Substack and I’ve done other things that fill my cup for the identity that I want to become, which is a writer.

And the rest is sort of history and trying to figure out, like, what are the things that would be in alignment for your values in all the different ways you need to show up, whether that be at work or for yourself.

Dr. Cindy Thank you for sharing that. And I didn’t know that you’re a writer too. That’s so exciting.

Dr. Emlet: Trying.

Dr. Cindy Congratulations.

Dr. Emlet: Aspiring, right?

Dr. Cindy Yeah. Congratulations on embracing your value of creativity. So in a sense, you’re saying yes to yourself and what you value, which is creativity. But so many women in medicine are very well versed in saying yes to other people.

We say yes to our patients, our spouse, our kids, institutions, and colleagues. The list just goes on. But saying yes to yourself can feel really difficult. What does saying yes to yourself, as specifically a physician mom, look like in real life? It’s easy to say in your head, I’ll do it, but what can that look like for our listeners?

What Saying Yes to Yourself Actually Looks Like

Dr. Emlet: In our coaching model we describe this as a particular character of a certain type of energy leadership. The giving professions – the nursing, chaplain, physicians, healthcare – are all giving professions. And the downside of this giving side is that you sometimes give too much and you don’t have anything left for yourself.

And I think everyone will recognize that analogy of the whole, put your oxygen mask on first before you can help others. And I think the reality is if you really cared about how you’re
performing on all the giving, if you don’t have somewhere on your calendar, that is just for you.

And it can be micro moments. And with moms of very little children, it’s the shower. It literally is. The 20 minutes, even if the toddler’s outside, they’re not in the shower with you, so that is still your time. And so I know of some moms and some coaches for women who really splurge on making that experience as wonderful for themselves.

There’s another coach I know. Her philosophy is bringing joy back in, and she really talked about even going through a divorce and even being a single mom, that the reality is there are some places where it is just for you. Another transition point I always tell people is when to meditate will be in the car, those five minutes to warm up your car and just do what you want.

Put your favorite music on, be in silence, say a prayer. It’s these little tiny things that we ignore, we just sort of just keep on pushing through and there’s no reason to push through because like I can tell you, five minutes is not going to hurt anyone.

It’s sort of the same analogy like we did in COVID, right? There is no emergency in a pandemic If your life is a pandemic and that’s how you’re feeling right now, because everything’s turbulent, you need to put your oxygen mask on first. We put our PPE on first. We are no good to the people in that room with the person dying if we don’t put on our protective equipment first.

So you have to decide what your protective equipment is. And so the question is, is it just an oxygen mask? Is it just a tiny whiff of a perfume or three seconds writing in a journal or just
reading your favorite poetry? You have to decide what it might look like to fill your spiritual cup for yourself before you can enter into that.

And I would argue that a lot of times people try to do these long retreats, go away on big vacations. It’s actually not that, it’s actually frequency of dose. Obviously all of us are clinicians, we understand the dose response and how much the optimal dose changes and if you do it more frequently, as in smaller quantities.

You are sort of proud of yourself, just like drinking water, right? People are very proud of themselves. They keep track of it. They’re like, I drank my water. I did something for myself. I did my little exercise. I hit my steps on my little Fitbit watch. I got my sleep on my Oura ring.

These small things add up.

And once you notice you can do one thing, you’ll keep on adding these habits.

Dr. Cindy I 100% agree, and you mentioned the small moments. So the small moments that fill my cup are silence. That would be when I’m in the car alone. Well maybe not silence. When I get home and I’m listening to music I sit in the car for even just two, three minutes and listen to that really awesome song and crank it up and just let it be. And so I hear you when you’re talking about those moments.

You’re saying to the woman listening, what is it that really gives you a thrill? What really helps you? And just find two or three minutes for that. I love your message.

Why High-Achieving Women Physicians Say No to Opportunity

Dr. Emlet: I also will add on to that, many of you probably have heard about improv and one of the first fundamental lessons of improv is layering to amplify each other. It’s the “Yes. And”.

When you had posed the question like, what do we give to our patients or our families or partners, our kids and where’s the you? Right. And so I think the reality is that means you’re actually not complete. You’re not done if you can’t identify what small thing you can say that you’ve offered yourself each day.

Dr. Cindy Yes.

Dr. Emlet: Yes. Yeah. For me it was yoga this morning.

Dr. Cindy Mm-hmm. You shared that too.

I want to flip the script a little bit. Instead of saying yes, why do they often say no to opportunities that can really expand them or help them? For example, let’s say they have an
opportunity to work on a project that is really kind of thrilling and exciting, but they say no because they don’t have time.

And it’s just so easy to say no when really those opportunities could have brought them great growth. Why is it just so easy to say no to those things?

Dr. Emlet: You know, most women can identify with that. And, I think there’s probably two things. One is they feel like the plate is already very full. And so if I’m going to put something else on it they understand the quality may suffer, and they also understand that they also don’t want to give anything up.

And so I think anytime someone says no, there’s probably two main things that are happening.

One is that you have a very accurate assessment of exactly your capacity, your performance, what you require, your yes, you’re already doing those things. You’re like, I got a perfect balance and I am not ready for growth right now. In fact, I don’t want growth. It’s just not the right time.

And the question will be for those people, do you just put a deadline for yourself? I’m going to revisit this in next quarter. I call this the time-limited trial, if your own life is like a critical care intervention.

You know, let’s just see how this quarter goes, but I will potentially revisit this and actually try this treatment modality in a you know, a couple weeks and see, so that’s one option because your assessment could have been correct.

The other people, it’s much harder to get to. But the other people who say no often internally don’t actually have the belief that they want to go there or they want to do this, or they’re somehow not feeling enough in some way.

And therefore, to me, their mindset is not of an opportunity mindset that they’re currently operating from a place like this is good enough. I’m fine where I am, I’m no longer in danger.

And I’m good with just cruising. In our energy leadership model, it’s like either you’re just cruising and surviving, versus you’re giving. And at this point, when you’re in the giving mode, you’re just giving, you’re not really seeing for new opportunities.

So it makes sense that you wouldn’t choose something new. And then only when you’re really at your next higher level of being is then you actually say like, there’s actually more I can do, even if I might want to suffer quality or maybe just change my direction that there is more out there that I can accomplish or do.

And so I think a part of it is mindset. So to me, those are the two to two big buckets I probably would divide the situation into.

Dr. Cindy And that goes back to the growth mindset, right? I’m really curious about this next topic, about the next generation of physicians. And I know
you teach them.

The Next Generation of Physicians: AI, Critical Thinking, and Clinical Judgment

Dr. Cindy What patterns do you see in early career physicians that concern you? You have your finger on the pulse. I’m curious what you see.

Dr. Emlet: I think the one thing for earlier career physicians is they’ve grown up to some degree, unfortunately, in the pandemic. And so the reality is there is a sort of expectation now that because we pivoted so heavily to a virtual and hybrid state, that much of life will remain in that sort of hybrid or virtual, and that’s acceptable enough.

And they’re not completely wrong. And so I think the question is how do we design workplaces that allow for that? And also I think they’re also much more willing to not know what’s considered okay, truth, reality, best practices.

They’re willing to augment and not really use internal memory and knowledge, and instead are much more willing to be like, well, there’s all kinds of data for this.

There’s an app for this and I should have an external resource and there’s a pharmacist. You can tell me these things. So they’re much more okay. And they, and there isn’t sort of a foundation like when we were trained.

Our professors taught us deep intuitive clinical acumen, making sure that a marker of performance and wisdom was having some degree of judgment and slowing things down so that we actually got the correct data so we can make the right thing and work with patients to be able to make the right decisions.

And now this generation has like 20 million times more data points than we ever had to deal with or even what our professors had to deal with. And so now, it is understandable that they
don’t know what to trust. They don’t know what’s real.

It’s harder to do things in real life versus hybrid and versus virtual. It’s hard to distill what’s really important and it’s not going to get any better necessarily. With AI, I can already begin to see how the practice of healthcare will change.

Even just with having easier ways to process that volume and distill it. The question will be whether we can keep up with emphasizing critical thinking, right? So I think that doesn’t go
away, no matter who you are, what industries that, I think the skepticism is not always a bad thing.

Skepticism means like, well, let’s talk it through. Let’s think it through. Let’s have a conversation and let’s slow down what we’re processing rather than just making a quick judgment and just moving on. Another colleague of mine had actually expressed that some of the learners currently actually didn’t want him to explain physiology or didn’t want him to explain things.

Dr. Cindy That hurts my heart.

Dr. Emlet: There was no dialogue. Dialectical learning is sort of like, where is it going? They just wanted an answer, but I think that’s the question. It’s going to be finding this new balance of do we understand? And I worry, and I wonder, even for me.

While all of these AI things are great shortcuts, they make me produce things faster, but then now we have to change our skills to editing. So even in my writing, I’ve become a master editor because there is so much just jumble of words out there because of all of the outputs these things can make.

And then you start to understand, do I know my fundamentals?

Which is why I really appreciate some of the early childhood educators. The early childhood educators, they still very much are focused on do you understand the process, the structure, the
composition? Because if you don’t know that, then you’re not going to be able to tweak and play.

So same like with artists, right? They’re going to still worry about technique because if you don’t worry about technique first then you can’t really make shortcuts.

Similar to I think expertise development, right? In the beginning it’s slow. It feels a little clunky, then you get a little better, and then you have blind spots once you become an expert,right? We both are in our peak, prime, you know, we’re senior faculty at this point. We actually have blind spots. And so I think that’s the question, is making sure that we all have better critical thinking skills.

Dr. Cindy Hmm. That begs the question, how do we teach that to the next generation?

Dr. Emlet: That’s a question I don’t think I have a full answer yet too. That’s the thing I’ve been sort of pondering on.

So in my Substack, I always like to go back to try to think about what cognitive theories are already out there. And then how that’s applying in real life and what’s changing. So I do wonder how it’s going to end up looking. I do think that we need to return to dialogue and Socratic method and thinking through, and also seeing whether you can explain things.

You know, if AI can make your bullet points faster, can you explain it? Do you understand? I think some of those things won’t totally go away. I think the other question too will be how we measure performance, and then how often do we do the reps?

You know, I think there is a desire that people do want to feel good in the practice of healthcare and having more opportunities to do different things. I think that is a chance for us to refresh, revisit, re-question, have the dialogue, practice again as a team.

And it goes back to the basics.

Dr. Cindy I think that’s an interesting point. If you change how they’re evaluated, they’ll just, they’ll aim for different markers, and if the markers are based on, like you said, the Socratic method, then that’s where they’ll go.

Dr. Emlet: I do wonder whether, I mean a knowledge based fact, I mean, that’s not the correct marker anymore. It’s going to be the process. And so even the question of, oh there’s process outcomes, have we even looked at that? And I don’t think we have. Right?

If you look at most medical schools, they use problem-based learning, case-based learning, team-based learning. There are ways to look at team performance and team contributions and
our people interacting, providing. Core information. And so I think even how we measure teams often are about were the paths applied? Was the medication given? Did you give closed loop communication?

There’s all kinds of things that we’re measuring that are outcomes and not processes. And so I think it will be interesting to have a shift in emphasis of are we more meta aware of those things that are happening?

Dr. Cindy Well, I’m so grateful that you are involved in teaching them and that you’re aware of this.

Dr. Emlet: There’s a lot of people thinking throughout the country about how AI is being used in medical education. But I do worry that we’re all worrying about the wrong thing, which is about shortcuts and faster and productivity and things like that, rather than how we interact as humans with the machine.

I think we all agree that we interact with technology. That’s okay. But the question is when and how and how does it make us better? And some people have already begun. There are some
students at Stanford who have already talked about how they use the AI to be a never ending questioner, like keep asking them questions.

And so in many ways they’ve allowed the bot to help them learn, which is good.

Dr. Cindy Mm, true. I don’t deny that there’s so much value in AI. It’s evolving week by week.

So yes, we’ll see where it takes us. That’s every day.

Dr. Emlet: It’s crazy. A new model.

Dr. Cindy Every hour.

What Is Energy Leadership Coaching?

Dr. Cindy Yes. I’d love to talk about your coaching real quick. I know most of your time is spent teaching, but you do carve out time for coaching. Can you define what energy leadership coaching is? What does that mean?

Dr. Emlet: Yeah. So, energy leadership is a model of how, where I trained at the Institute for Professional Excellence and Coaching. They have a proprietary assessment tool, which looks at the seven levels of energy. And so briefly, sort of how we react in any given moment is a very fluid measure.static and really won’t change principles. You. There’s several personality tests.

One would kind

So unlike the Disc, which is a personality, the Myers-Briggs was also a personality. Those are of argue even like the Clifton Strengths finder is also, tends to be a little more static compared to the energy.

And so the thought is, if you’re at your ideal state and you take this assessment, it categorizes what your ideal state of energy is, sort of like the beginner expression of what your values might be.

It’s how you’re energetically showing up in the areas of life as you’re taking the test as compared to when you’re triggered, not well, traumatized. And it sort of gives you a sense of what your reaction pattern responses are so that you can consciously choose how you want to show up.

I think a lot of people really have a hard time expressing exactly that movement from – I just need to hide. Someone just hurt me. Someone hurt my feelings. I’m attacked.

We all come with our own unique lenses, lived experiences, culture, gender that influence how we see things and we’re going to react a certain way. So we talk about the lower levels of
energy, what we call catabolism, and those higher levels of energy where we’re feeling creative, fulfilled, giving, looking for opportunities.

And then also in touch with our own inner self, a more divine being. At the highest level of energy, we are one with the world and we actually feel like we’re good with nature and other
people and society.

That’s sort of like conceptually, like the two halves of things. And then we begin to look through those seven levels of energy in this assessment. How can we consciously choose to move up a level because almost in every moment, you know, I’m sure you, as you also coach, you know, there’s always a time between the stimulus and the response.

What are you going to do in that gap? What will you choose? How do I want to be? And if we often are just reactive, we’re down in our lower levels of energy, and that’s normal.

Those lower level energies are to protect you.

I’m not saying we should slow down everything, because if you put your hand on a fire stove, you should pull it back very quickly. And that’s actually a good thing.

Dr. Cindy Right.

Leading Healthcare Teams Without Burning Out

Dr. Emlet: But at the same time, most things are not meant to be like that. Society and the way we work in the hospital is not meant to be that triggering. There isn’t always an opportunity in your own self leadership, which then translates into your team leadership, which then changes, translates into your organizational’s leadership.

So we really train leaders to think of themselves. Everyone leaves a group because of their boss.

And so we need leaders that are more human, well, and whole and leading a more well life so that they have the capacity and the energy to care for the people, which is their team, the
clinical team.

And once they, the clinical team is cared for, then they have a fighting chance to actually do patient care. I think in medicine we have often talked so much about the patients. We
understand that the patients are very important. But I think what we forget in the healthcare organizations is that the most important people in those buildings are all the humans who are
running around as employees.

Those people, if they’re cared for and nurtured and given professional development throughout their entire career, they’ll stay, they’ll become loyal. They’ll be cared for. You can prevent things happening. You don’t need as much EAP budget. You can actually, you know, begin to groom and cultivate for people to stay and give them learning opportunities for them to diversify within your organization.

And so those are the things that we talk about with our leaders that come to us for our coaching.

Because first it starts with usually a division chief or a nurse manager or a department chair.

And then from there they’re like, ah, the light bulb goes on. And then they begin to figure out how we can work with their teams to be more strategic for growth rather than people, you
know, the churn rate is not normal.

The fact that departments or healthcare churn, that if an organization has a particular rate of people turning over, that’s not a good thing.

Dr. Cindy Hmm. Thank you for that explanation. That sounds perfect. How can people reach you if they’re interested in that?

Dr. Emlet: My favorite way is actually via LinkedIn.

But if you’re not on LinkedIn and you’re listening to this, I can be reached at hello@transforminghealthcarecoaching.com.

Those are probably the two easiest ways you can just shoot me an email and we can set up a 30 minute call and we can just hear about sort of the things you’re struggling with and what you’re wondering about.

And then depending on the match we have, several coaches in our company have different areas of expertise. So if you’re a nurse, we have physicians, PTs, OTs a PA. We have different
professions. So we actually coach the interprofessional team as well in addition to individuals.

But we always start with the individual because the individual leader is the most important person on that team.

And if they can’t embody and support this energy, leadership growth, then going right to the team isn’t going to be helpful.

Dr. Cindy Right, right. Love that. Lillian, thank you so much for being here. I know we’re out of time and I have so many more questions for you. Maybe if you come back in the future, we can keep going.

I appreciate your time today. Thank you.

Dr. Emlet: Thank you so much for having me. I love talking with like-minded people who are also interested in people’s growth and especially as a mom, as a woman physician as well.

We are the ones at greatest risk for burnout. We carry so much for everyone. And what you’re doing with Inspired Mom MDs is really important in terms of making sure the backbone, over
50% of our medical students are women, and so we need to have a great sustainable career path forward for everyone. So thank you so much for all the work that you do.

Dr. Cindy Thank you for that.

Links:

• Transforming Healthcare Coaching – Coaching for Clinicians
• Lillian Liang Emlet, MD MS CHSE CPC ELI-MP | LinkedIn