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Jan. 19, 2024

People-Pleasing, Perfectionism, and Boundaries with Dr. Megan Melo

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Clinician Researcher

Dr Megan Melo is a dual-board certified Family and Obesity Medicine Physician as well as a Certified Physician Life Coach and Certified Daring Way™ Facilitator based on the work of Brenè Brown, PhD, LMSW. After years of struggling with burnout, she now coaches fellow physicians on how the learned habits of perfectionism, people-pleasing and a lack of boundaries contribute to burnout, particularly as we work within a broken healthcare system.

In this episode, Dr. Melo addresses people-pleasing, perfectionism, and boundary challenges in the context of burnout. This episode is particularly relevant for clinicians transitioning into research.

Key Points Discussed:

  1. Understanding the roots of people-pleasing behavior in high-achieving clinicians.
  2. Strategies for setting boundaries.
  3. Addressing perfectionism.
  4. The significance of self-compassion in a culture that lacks it.

Links and Resources Mentioned:

Call to Action:

Explore Dr. Mello's resources, website, and podcast. Seek safe spaces and support systems to navigate the challenges of burnout, perfectionism, and people-pleasing.

Sponsor/Advertising/Monetization Information:

This episode is sponsored by Coag Coach LLC, a leading provider of coaching resources for clinicians transitioning to become research leaders. Coag Coach LLC is committed to supporting clinicians in their academic and research endeavors.

Looking for a coach?

Sign up for a coaching discovery call today: https://www.coagcoach.com/service-page/consultation-call-1

Transcript

1 00:00:00,000 --> 00:00:05,860 Welcome to the Clinician Researcher podcast, where academic clinicians learn the skills 2 00:00:05,860 --> 00:00:11,260 to build their own research program, whether or not they have a mentor. 3 00:00:11,260 --> 00:00:17,340 As clinicians, we spend a decade or more as trainees learning to take care of patients. 4 00:00:17,340 --> 00:00:22,380 When we finally start our careers, we want to build research programs, but then we find 5 00:00:22,380 --> 00:00:27,780 that our years of clinical training did not adequately prepare us to lead our research 6 00:00:27,780 --> 00:00:29,200 program. 7 00:00:29,200 --> 00:00:35,480 Through no fault of our own, we struggle to find mentors, and when we can't, we quit. 8 00:00:35,480 --> 00:00:40,580 However, clinicians hold the keys to the greatest research breakthroughs. 9 00:00:40,580 --> 00:00:46,200 For this reason, the Clinician Researcher podcast exists to give academic clinicians 10 00:00:46,200 --> 00:00:51,800 the tools to build their own research program, whether or not they have a mentor. 11 00:00:51,800 --> 00:01:01,100 Now introducing your host, Toyosi Onwuemene. 12 00:01:01,100 --> 00:01:03,340 Welcome to the Clinician Researcher podcast. 13 00:01:03,340 --> 00:01:07,780 I'm your host, Toyosi Onwuemene, and it is such a pleasure to be here talking with you 14 00:01:07,780 --> 00:01:15,260 today because I have a special guest, an absolutely super awesome physician coach who specializes 15 00:01:15,260 --> 00:01:21,620 in how people-pleasing perfectionism, lack of boundaries intersects with burnout. 16 00:01:21,620 --> 00:01:25,100 It is none other than Dr. Megan Melo. 17 00:01:25,100 --> 00:01:27,700 Megan, welcome to the show. 18 00:01:27,700 --> 00:01:28,700 Thank you so much for having me. 19 00:01:28,700 --> 00:01:33,500 I'm really pleased to be here and chat with you because that's always a good time for 20 00:01:33,500 --> 00:01:34,500 us. 21 00:01:34,500 --> 00:01:35,500 Absolutely. 22 00:01:35,500 --> 00:01:36,500 Okay. 23 00:01:36,500 --> 00:01:40,820 So, Megan, clearly you're a physician and you're a coach. 24 00:01:40,820 --> 00:01:42,460 Tell me about that journey. 25 00:01:42,460 --> 00:01:43,460 Yeah. 26 00:01:43,460 --> 00:01:47,060 How much time do we have? 27 00:01:47,060 --> 00:01:54,000 So I'm a family and obesity medicine physician in Seattle, Washington, and was in practice 28 00:01:54,000 --> 00:01:59,940 for about 10 years before I started really sort of jumping into sort of more coaching 29 00:01:59,940 --> 00:02:00,940 frameworks. 30 00:02:00,940 --> 00:02:06,900 Initially, I became certified in Brene Brown's work through the Certified Daring Way program, 31 00:02:06,900 --> 00:02:14,220 being able to facilitate some of her programs, and then also added on a life coaching certification 32 00:02:14,220 --> 00:02:18,900 when I was trying to do more work with my patients struggling with obesity. 33 00:02:18,900 --> 00:02:25,060 So I wanted to add coaching tools and be able to blend sort of both coaching and medical 34 00:02:25,060 --> 00:02:26,060 care. 35 00:02:26,060 --> 00:02:31,940 But what that led me to was becoming familiar with the literature on coaching and physician 36 00:02:31,940 --> 00:02:32,940 burnout. 37 00:02:32,940 --> 00:02:38,780 We had statistically significant benefits to using coaching tools to help relieve physician 38 00:02:38,780 --> 00:02:39,780 burnout. 39 00:02:39,780 --> 00:02:44,420 I had been involved in physician wellness for a long time without having a lot of tools 40 00:02:44,420 --> 00:02:45,420 or skills. 41 00:02:45,420 --> 00:02:47,940 It's just something that I was passionate about. 42 00:02:47,940 --> 00:02:53,420 But being able to get trained as a coach and use these tools now with physicians has just 43 00:02:53,420 --> 00:02:57,900 made a tremendous difference for my life and the people that I serve. 44 00:02:57,900 --> 00:02:59,860 It's about relieving the stress. 45 00:02:59,860 --> 00:03:03,620 That same thing applies to my obesity medicine patients, right? 46 00:03:03,620 --> 00:03:08,140 We're relieving distress and bias and all the things that people struggle with. 47 00:03:08,140 --> 00:03:12,740 So it's really been quite a gift to the work that I already do. 48 00:03:12,740 --> 00:03:14,220 That is really beautiful. 49 00:03:14,220 --> 00:03:17,100 And your work is a gift to my audience. 50 00:03:17,100 --> 00:03:22,380 And so I have clinicians who are trying to make this transition to becoming researchers 51 00:03:22,380 --> 00:03:29,740 and a lot of people pleasing, a lot of perfectionism, and definitely a struggle with boundaries. 52 00:03:29,740 --> 00:03:33,500 And so I feel like you're the perfect person to come on the show. 53 00:03:33,500 --> 00:03:36,540 Let's start with people pleasing. 54 00:03:36,540 --> 00:03:38,020 How do you help us with people pleasing? 55 00:03:38,020 --> 00:03:40,140 I feel like it's just in our DNA. 56 00:03:40,140 --> 00:03:41,140 What are we going to do about it? 57 00:03:41,140 --> 00:03:42,140 How can we win? 58 00:03:42,140 --> 00:03:43,140 Yeah. 59 00:03:43,140 --> 00:03:49,220 And it really kind of is in our DNA because for so many of us who have been on the path 60 00:03:49,220 --> 00:03:55,340 to becoming physicians, clinicians, we have been high achievers for a very long time. 61 00:03:55,340 --> 00:03:59,660 And the road to high achieving is filled with external validation. 62 00:03:59,660 --> 00:04:02,980 We have been seeking prizes. 63 00:04:02,980 --> 00:04:05,580 We have been trying to be the tops in our class. 64 00:04:05,580 --> 00:04:09,020 We have been trying to be amenable and polite. 65 00:04:09,020 --> 00:04:14,060 And if you think about medical school and the rotations that we go through, yes, you 66 00:04:14,060 --> 00:04:15,900 needed to know medical information, right? 67 00:04:15,900 --> 00:04:19,540 You needed to be able to do sort of medical skills and do that. 68 00:04:19,540 --> 00:04:25,500 But you also had to be the good one, the nice one, the smart one. 69 00:04:25,500 --> 00:04:29,940 And you had to restart that every four to six weeks, depending on how long your rotation 70 00:04:29,940 --> 00:04:30,940 was, right? 71 00:04:30,940 --> 00:04:36,500 And so, we've always got very good at being able to show up and be polite and pleasant 72 00:04:36,500 --> 00:04:39,500 and do whatever was necessary of us, right? 73 00:04:39,500 --> 00:04:43,140 We've built that habit over many, many years. 74 00:04:43,140 --> 00:04:47,620 And when we transition into our attending roles or if we're trying to do anything else 75 00:04:47,620 --> 00:04:52,100 professionally, no one tells us that we could turn that off. 76 00:04:52,100 --> 00:04:57,580 No one tells us that we no longer have to go seeking the gold stars. 77 00:04:57,580 --> 00:05:02,180 We still want to do high quality work, but the higher achiever we are, right, the higher 78 00:05:02,180 --> 00:05:07,780 we are on the ladder, the less of the little stuff that we have bandwidth for, right? 79 00:05:07,780 --> 00:05:10,300 We need to be much more focused. 80 00:05:10,300 --> 00:05:15,860 And so, when I'm working with someone, it's really about recognizing the discomfort that 81 00:05:15,860 --> 00:05:18,620 happens when you consider saying no, right? 82 00:05:18,620 --> 00:05:24,460 When you consider setting boundaries, when you are trying to advocate for what you need 83 00:05:24,460 --> 00:05:29,220 and want and getting all this pushback, because that's very real. 84 00:05:29,220 --> 00:05:31,140 So how do we turn it off? 85 00:05:31,140 --> 00:05:36,820 Because when you start to talk about not being that person anymore, are you saying we should 86 00:05:36,820 --> 00:05:40,060 no longer be team players? 87 00:05:40,060 --> 00:05:45,500 That is often the language that is used against us and often the language that keeps us stuck. 88 00:05:45,500 --> 00:05:52,820 So me saying to someone in a kind of polite way, I'm not going to be able to help you 89 00:05:52,820 --> 00:06:00,180 with that, or being able to say, well, you know, if I'm going to take on that project, 90 00:06:00,180 --> 00:06:03,060 then what is coming off my plate, right? 91 00:06:03,060 --> 00:06:07,820 Being able to sort of negotiate and advocate for yourself, making it clear that you're 92 00:06:07,820 --> 00:06:14,260 not trying to be mean or rude, but there's only so much bandwidth we have, right? 93 00:06:14,260 --> 00:06:19,580 We have to wrestle, though, with our own discomfort of saying no, because we have been trained, 94 00:06:19,580 --> 00:06:20,580 right? 95 00:06:20,580 --> 00:06:26,860 Being a team player means you always say yes, but you're not going to be effective in any 96 00:06:26,860 --> 00:06:30,540 place that you are, really, if you're always saying yes, right? 97 00:06:30,540 --> 00:06:35,580 Even if you are working at, I don't know, a clothing store, right? 98 00:06:35,580 --> 00:06:38,500 If you're always saying yes and always being interrupted, you're never going to complete 99 00:06:38,500 --> 00:06:41,500 any projects, right? 100 00:06:41,500 --> 00:06:44,300 We have to be somewhat focused. 101 00:06:44,300 --> 00:06:50,700 And in order to do that, we have to, you know, kind of tolerate that discomfort of saying 102 00:06:50,700 --> 00:06:51,700 no. 103 00:06:51,700 --> 00:06:52,700 We have to sit with it. 104 00:06:52,700 --> 00:06:53,700 We have to practice it. 105 00:06:53,700 --> 00:06:55,740 It's as silly as that sounds. 106 00:06:55,740 --> 00:07:01,940 Yeah, I'm, as you're speaking, already feeling uncomfortable sitting with that discomfort. 107 00:07:01,940 --> 00:07:06,340 So tell me, how do you help physicians to sit with the discomfort? 108 00:07:06,340 --> 00:07:10,580 I mean, okay, so from my audience, your mentor tells you to do something. 109 00:07:10,580 --> 00:07:15,700 You're depending on your mentor to be, you know, to sign your letters of recommendation, 110 00:07:15,700 --> 00:07:19,020 to support you in your projects. 111 00:07:19,020 --> 00:07:23,860 And when you say, hey, sit with the discomfort of saying no, I'm thinking my career is about 112 00:07:23,860 --> 00:07:24,940 to be over. 113 00:07:24,940 --> 00:07:26,580 I'm about to say no to my mentor. 114 00:07:26,580 --> 00:07:31,940 So help me talk to my audience about how do they handle this with mentors who have actual 115 00:07:31,940 --> 00:07:35,660 hierarchy over them in this journey? 116 00:07:35,660 --> 00:07:38,060 Yeah. 117 00:07:38,060 --> 00:07:44,860 How do we feel now when we're being asked to do too much? 118 00:07:44,860 --> 00:07:49,300 Frustration, resentment, overwhelm. 119 00:07:49,300 --> 00:07:50,940 How am I ever going to get this done? 120 00:07:50,940 --> 00:07:51,940 Right? 121 00:07:51,940 --> 00:07:55,980 We have a lot of negative emotions and they aren't pleasant to feel, right? 122 00:07:55,980 --> 00:08:00,660 Obviously we don't like feeling them, but they are familiar. 123 00:08:00,660 --> 00:08:03,680 They're sort of comfortable in their own way, right? 124 00:08:03,680 --> 00:08:05,700 This is just the way it is, right? 125 00:08:05,700 --> 00:08:07,460 Everybody has to go through this. 126 00:08:07,460 --> 00:08:10,260 You know, this is the cost of having this career, right? 127 00:08:10,260 --> 00:08:16,420 We have all these ideas that we just have to suck it up and deal with it. 128 00:08:16,420 --> 00:08:22,780 If we want to move forward though, we're going to need to tolerate the discomfort of a different 129 00:08:22,780 --> 00:08:28,620 feeling, the discomfort of saying no, the discomfort of being able to advocate for yourself, 130 00:08:28,620 --> 00:08:31,220 you know, in order to be successful with the other thing. 131 00:08:31,220 --> 00:08:37,900 So in the instance of a mentor or a boss of some kind coming to you and wanting you to 132 00:08:37,900 --> 00:08:44,180 take on a project, if you know that you're already too busy, you probably already have 133 00:08:44,180 --> 00:08:50,060 too many things on your plate, you might need to ask for their help to decide which is the 134 00:08:50,060 --> 00:08:52,420 most important. 135 00:08:52,420 --> 00:08:58,580 Because sometimes they are simply looking for another human to take over whatever that 136 00:08:58,580 --> 00:09:01,500 task is that they probably don't want to do, right? 137 00:09:01,500 --> 00:09:06,340 Because they're probably also overburdened with things to do. 138 00:09:06,340 --> 00:09:08,820 But that doesn't mean that it's a good fit for you. 139 00:09:08,820 --> 00:09:12,940 It doesn't mean that it's in alignment with your interests. 140 00:09:12,940 --> 00:09:14,420 We're going to have to say no to things. 141 00:09:14,420 --> 00:09:19,020 And again, you know, kind of the higher on the ladder we climb, the more skills and expertise 142 00:09:19,020 --> 00:09:22,220 that we have, the more opportunities we get offered. 143 00:09:22,220 --> 00:09:25,700 But again, to do good work, there's only 24 hours in a day. 144 00:09:25,700 --> 00:09:29,420 We're going to have to be focused on what's important to us, what helps us move forward. 145 00:09:29,420 --> 00:09:35,220 You know, where can we use our gifts and talents, but do that in a bounded way. 146 00:09:35,220 --> 00:09:36,220 I love it. 147 00:09:36,220 --> 00:09:38,660 I love two things that came out of what you said. 148 00:09:38,660 --> 00:09:41,040 One is that, wow, this is a skill. 149 00:09:41,040 --> 00:09:44,980 And that means you can practice it, you can develop it and get strong in it. 150 00:09:44,980 --> 00:09:46,220 And that is real. 151 00:09:46,220 --> 00:09:50,380 It's like you may not be good at it now, but you're going to practice and get better. 152 00:09:50,380 --> 00:09:54,940 The second thing is I love the way you talk about sharing with your mentor. 153 00:09:54,940 --> 00:09:55,940 Oh, great. 154 00:09:55,940 --> 00:09:57,620 This is a great opportunity. 155 00:09:57,620 --> 00:10:02,820 And what of these other things on my plate do you recommend I take to take on this work? 156 00:10:02,820 --> 00:10:05,820 Which is awesome, because what you're doing is putting yourself on the same side of the 157 00:10:05,820 --> 00:10:10,100 table and saying, I know you care about me and I know you want me to succeed. 158 00:10:10,100 --> 00:10:12,060 And how can we move forward together? 159 00:10:12,060 --> 00:10:16,340 And so I think it's a really great way to do it without being confrontational or feeling 160 00:10:16,340 --> 00:10:21,200 like you're being mean or being rude in some way. 161 00:10:21,200 --> 00:10:25,900 And when we're feeling overwhelmed and taxed and burned out, we often fall into black and 162 00:10:25,900 --> 00:10:26,900 white thinking. 163 00:10:26,900 --> 00:10:32,780 So we think either I say yes and just go along with it, or I slam my hands down on the table 164 00:10:32,780 --> 00:10:35,500 and say, hell no, and I leave. 165 00:10:35,500 --> 00:10:37,420 There is in between. 166 00:10:37,420 --> 00:10:40,580 There is a lot of middle ground there. 167 00:10:40,580 --> 00:10:48,980 And practicing and learning the skills of being able to say sort of no, but or yes and 168 00:10:48,980 --> 00:10:53,860 I'm going to need some help in deciding which of these things are priorities. 169 00:10:53,860 --> 00:10:57,660 Using those tools really helps us to be able to keep it collaborative. 170 00:10:57,660 --> 00:11:01,340 Yeah, to sit on the same side of the table, as you say. 171 00:11:01,340 --> 00:11:02,340 I love it. 172 00:11:02,340 --> 00:11:03,340 I love it. 173 00:11:03,340 --> 00:11:04,340 Okay. 174 00:11:04,340 --> 00:11:05,340 You also touched on boundaries. 175 00:11:05,340 --> 00:11:06,820 I think this is a good segue into boundaries. 176 00:11:06,820 --> 00:11:07,820 Okay. 177 00:11:07,820 --> 00:11:11,660 Tell me about boundaries and should clinicians who are trying to succeed as researchers have 178 00:11:11,660 --> 00:11:12,660 any boundaries? 179 00:11:12,660 --> 00:11:16,460 I mean, maybe when they get to the top, they can have boundaries, but why are boundaries 180 00:11:16,460 --> 00:11:18,100 important and how? 181 00:11:18,100 --> 00:11:19,820 How do we enforce them? 182 00:11:19,820 --> 00:11:20,820 Yeah. 183 00:11:20,820 --> 00:11:21,820 Yeah. 184 00:11:21,820 --> 00:11:24,940 And enforcing them tends to be kind of the biggest challenge, right? 185 00:11:24,940 --> 00:11:27,860 Because it's much easier to say, oh, I need help. 186 00:11:27,860 --> 00:11:28,860 I need to say no. 187 00:11:28,860 --> 00:11:31,180 But when you get that pushback, right? 188 00:11:31,180 --> 00:11:34,980 When you're sitting in that discomfort, when you feel it in a sort of coming on, being 189 00:11:34,980 --> 00:11:37,900 able to hold true to yourself, right? 190 00:11:37,900 --> 00:11:41,300 In that moment, you know, it doesn't all happen at once. 191 00:11:41,300 --> 00:11:45,600 When I think about boundaries, I really love Brene Brown's sort of guidance on that. 192 00:11:45,600 --> 00:11:50,780 She talks about living big, boundaries, integrity, and generosity. 193 00:11:50,780 --> 00:11:56,820 What boundaries do I need to have in place for me to stay within my integrity, making 194 00:11:56,820 --> 00:11:59,300 the most generous assumptions of other people? 195 00:11:59,300 --> 00:12:05,020 So if we think about that in the clinician research or space, right, the integrity piece 196 00:12:05,020 --> 00:12:11,060 is about producing high quality scientific progress, you know, clinical research. 197 00:12:11,060 --> 00:12:17,700 The generosity is assuming that everybody is doing the best that they can and trying 198 00:12:17,700 --> 00:12:22,780 to say with what I've got, with where I am, what am I able to accomplish and what do I 199 00:12:22,780 --> 00:12:24,820 need to say no to, right? 200 00:12:24,820 --> 00:12:30,220 If I've got some kind of a big project that I'm working on, then I'm probably not going 201 00:12:30,220 --> 00:12:35,140 to be able to, you know, take on other little tasks, especially ones that don't require 202 00:12:35,140 --> 00:12:36,140 my expertise. 203 00:12:36,140 --> 00:12:41,820 Maybe when I'm not working on a big project, I would pitch in, but, you know, during that 204 00:12:41,820 --> 00:12:44,140 time, I'm just going to have to say no, right? 205 00:12:44,140 --> 00:12:46,940 And that might be, that might be social engagements, right? 206 00:12:46,940 --> 00:12:53,740 That might be, yeah, I don't bring cupcakes to the birthday party, you know, or I don't 207 00:12:53,740 --> 00:12:57,900 bake, you know, my own, you know, something like, you know, it can be that life stuff 208 00:12:57,900 --> 00:13:03,540 too, that I let myself off the hook with thinking I have to do things in the same way that I 209 00:13:03,540 --> 00:13:08,340 always do them in order to, you know, kind of complete this project the way that I want 210 00:13:08,340 --> 00:13:09,340 to. 211 00:13:09,340 --> 00:13:13,620 Wow, you make it sound so easy. 212 00:13:13,620 --> 00:13:14,620 I don't think it's easy. 213 00:13:14,620 --> 00:13:17,620 Let me, let me, let me just say that I don't think it's easy. 214 00:13:17,620 --> 00:13:21,100 I don't think that I think that's, you know, why a lot of us run into trouble, right? 215 00:13:21,100 --> 00:13:22,820 We might try to set a boundary somewhere. 216 00:13:22,820 --> 00:13:24,380 We might say no to somebody. 217 00:13:24,380 --> 00:13:27,500 And we might feel really good for a moment, right? 218 00:13:27,500 --> 00:13:31,940 After we sort of wrestled with the discoverer, that somebody is going to come and ping again 219 00:13:31,940 --> 00:13:33,700 against that boundary, right? 220 00:13:33,700 --> 00:13:35,580 It's not just going to happen one time. 221 00:13:35,580 --> 00:13:36,580 It's that maintenance, right? 222 00:13:36,580 --> 00:13:43,180 That ability to hold your own values, to know what's important for you and to be able to 223 00:13:43,180 --> 00:13:48,060 kind of keep that, keep that fence around and say, no, I'm protecting my time or my 224 00:13:48,060 --> 00:13:49,940 energy in this way. 225 00:13:49,940 --> 00:13:54,940 And because of that, I'm going to need to say no, or I'm going to need to, you know, 226 00:13:54,940 --> 00:13:55,940 kind of ask for more help. 227 00:13:55,940 --> 00:13:58,940 You know, it can look a lot of different ways. 228 00:13:58,940 --> 00:14:03,020 And it speaks to what you said earlier about black and white thinking, especially when 229 00:14:03,020 --> 00:14:04,300 you are burned out. 230 00:14:04,300 --> 00:14:10,460 And the reality is that there are many ways to present your boundaries and to enforce 231 00:14:10,460 --> 00:14:14,100 them without feeling like you're fighting all the time. 232 00:14:14,100 --> 00:14:15,100 Yeah. 233 00:14:15,100 --> 00:14:16,100 All right. 234 00:14:16,100 --> 00:14:18,940 Well, let's talk about perfectionism. 235 00:14:18,940 --> 00:14:19,940 Okay. 236 00:14:19,940 --> 00:14:25,620 So, sometimes members of my audience will say, well, perfectionism is necessary. 237 00:14:25,620 --> 00:14:27,980 If you're trying to submit a grant, it better be perfect. 238 00:14:27,980 --> 00:14:31,900 I mean, honestly, you've got to be really good. 239 00:14:31,900 --> 00:14:37,780 And so how do you let go of perfectionism when you absolutely need it? 240 00:14:37,780 --> 00:14:38,780 Yeah. 241 00:14:38,780 --> 00:14:39,780 I mean, I don't know. 242 00:14:39,780 --> 00:14:40,780 What do you say? 243 00:14:40,780 --> 00:14:41,780 That's another, that's another big topic. 244 00:14:41,780 --> 00:14:47,500 And again, I sort of lean into Brittany Brown's work on this is that there's a difference 245 00:14:47,500 --> 00:14:52,820 between perfectionism and excellence or healthy striving, right? 246 00:14:52,820 --> 00:14:56,100 Of course we want to provide, you know, high quality work, right? 247 00:14:56,100 --> 00:15:01,060 We want to produce things that matter and, you know, are well done. 248 00:15:01,060 --> 00:15:05,820 But perfectionism is really about a fear of shame, right? 249 00:15:05,820 --> 00:15:08,140 A fear of failure. 250 00:15:08,140 --> 00:15:16,500 So if, if I'm in this mindset where, you know, I can't have a typo or, you know, can't be 251 00:15:16,500 --> 00:15:22,260 wrong about something, I'm going to struggle to put anything out into the world, right? 252 00:15:22,260 --> 00:15:27,020 I'm going to be stopped because it's never going to seem good enough because I'm always 253 00:15:27,020 --> 00:15:31,500 going to be worried that someone's going to find a flaw, right? 254 00:15:31,500 --> 00:15:38,380 We know that, you know, kind of in the medical literature and research world, right, that 255 00:15:38,380 --> 00:15:43,420 we will find answers in some studies and then other studies are going to come along and 256 00:15:43,420 --> 00:15:46,660 they're going to debunk whatever we've seen, right? 257 00:15:46,660 --> 00:15:47,660 We know that, right? 258 00:15:47,660 --> 00:15:54,340 We know that, you know, half of what we learned in medical school is obsolete within five, 259 00:15:54,340 --> 00:15:56,500 you know, five years or something like that, right? 260 00:15:56,500 --> 00:16:01,060 We know that things are always changing and that includes the work that we're, you know, 261 00:16:01,060 --> 00:16:03,180 doing all the time. 262 00:16:03,180 --> 00:16:07,860 We want to produce high quality work and we want to get it out there. 263 00:16:07,860 --> 00:16:12,180 And so we're going to have to let go of this idea that if I don't have it all perfectly 264 00:16:12,180 --> 00:16:15,420 perfect, maybe I'll just add on this little extra piece. 265 00:16:15,420 --> 00:16:18,220 Maybe I'll just revise it again or maybe I'll just do this. 266 00:16:18,220 --> 00:16:20,980 We're never going to get it out there. 267 00:16:20,980 --> 00:16:23,180 Okay, but the struggle is real. 268 00:16:23,180 --> 00:16:28,180 The struggle is real with when you go present your work at a conference and people kind 269 00:16:28,180 --> 00:16:29,660 of are not very nice sometimes. 270 00:16:29,660 --> 00:16:31,140 They tear it down. 271 00:16:31,140 --> 00:16:36,260 And so when you go to publish the manuscript, you are afraid to put it out into the world 272 00:16:36,260 --> 00:16:38,020 because sometimes the criticism is harsh. 273 00:16:38,020 --> 00:16:40,020 How do you deal with that? 274 00:16:40,020 --> 00:16:41,020 Yeah. 275 00:16:41,020 --> 00:16:43,580 And I think that's true elsewhere in medicine, right? 276 00:16:43,580 --> 00:16:49,020 I don't have a perfect answer for that because I don't control, you know, what people will 277 00:16:49,020 --> 00:16:50,020 say. 278 00:16:50,020 --> 00:16:54,100 But even if I produce something that's high quality that, you know, I absolutely stand 279 00:16:54,100 --> 00:16:58,300 behind, somebody may come along and tear it down, right? 280 00:16:58,300 --> 00:16:59,300 That's also true. 281 00:16:59,300 --> 00:17:04,980 I might provide great care to my patient and they're upset about something, right? 282 00:17:04,980 --> 00:17:07,580 And they think it was a terrible visit. 283 00:17:07,580 --> 00:17:09,920 I don't control what other people think. 284 00:17:09,920 --> 00:17:17,380 So what I need to do is to stand behind my own work to know that, you know, I control 285 00:17:17,380 --> 00:17:22,580 how I think about it, that I'm a fallible human, but I work hard and I produce high 286 00:17:22,580 --> 00:17:23,580 quality work. 287 00:17:23,580 --> 00:17:28,980 And I'm going to need to push forward with that, knowing that none of us is infallible. 288 00:17:28,980 --> 00:17:31,420 None of us actually is perfect. 289 00:17:31,420 --> 00:17:36,340 And the people who are being so harsh and so mean have probably been treated that way 290 00:17:36,340 --> 00:17:41,260 themselves and probably would love for it to be different. 291 00:17:41,260 --> 00:17:46,660 But until we start practicing doing things differently, right, if we bring a different 292 00:17:46,660 --> 00:17:51,980 tack to academic medicine, right, to clinical research, until we do that, until we push 293 00:17:51,980 --> 00:17:55,500 for that, the culture won't change, right? 294 00:17:55,500 --> 00:18:00,600 I'm sure that you don't want to be that person who's sitting there tearing down somebody 295 00:18:00,600 --> 00:18:01,600 else's work. 296 00:18:01,600 --> 00:18:02,600 You may need to give them feedback. 297 00:18:02,600 --> 00:18:10,620 You might want to point out if there's a problem, but we don't need to attack the person in 298 00:18:10,620 --> 00:18:14,060 order to do that. 299 00:18:14,060 --> 00:18:22,060 We can be kind, we can be clear, we can be direct and create a different environment. 300 00:18:22,060 --> 00:18:27,220 Yeah, the environment we wish to see. 301 00:18:27,220 --> 00:18:28,220 Yeah. 302 00:18:28,220 --> 00:18:34,340 You know, one of the things that I feel like you allude to is the need for radical self-compassion, 303 00:18:34,340 --> 00:18:38,560 which I think is a prelude to being able to have compassion on others. 304 00:18:38,560 --> 00:18:43,900 And some of that tearing down that we see is people who are struggling with their self-compassion. 305 00:18:43,900 --> 00:18:47,660 And so of course, how can they treat others with gentleness? 306 00:18:47,660 --> 00:18:53,620 Can you speak a little bit to how can our clinicians and our scientists develop more 307 00:18:53,620 --> 00:18:54,620 self-compassion? 308 00:18:54,620 --> 00:18:55,620 Yeah. 309 00:18:55,620 --> 00:19:01,060 And I think often it's very easy for us to have compassion for others, right? 310 00:19:01,060 --> 00:19:05,980 We love our friends, our family, our pets, you know, perhaps our colleagues. 311 00:19:05,980 --> 00:19:09,380 You know, we have a lot of compassion for what other people are going through. 312 00:19:09,380 --> 00:19:14,380 If your friend called you and they told you they were just diagnosed with cancer or they 313 00:19:14,380 --> 00:19:20,740 were really behind on a major project or had a bad outcome, we wouldn't sit there and shame 314 00:19:20,740 --> 00:19:23,680 and blame them, right? 315 00:19:23,680 --> 00:19:24,960 We wouldn't do that. 316 00:19:24,960 --> 00:19:29,260 And yet we might do it to ourselves quite by default, right? 317 00:19:29,260 --> 00:19:32,700 We might, you know, say I missed a deadline, right? 318 00:19:32,700 --> 00:19:35,580 Or made a mistake or had a bad patient outcome. 319 00:19:35,580 --> 00:19:39,220 And I sit there in the energy of I'm a terrible person. 320 00:19:39,220 --> 00:19:40,220 I'm a terrible doctor. 321 00:19:40,220 --> 00:19:45,420 I shouldn't be doing this even though I keep doing it probably, right? 322 00:19:45,420 --> 00:19:49,640 Because now I feel obligated to make up for it. 323 00:19:49,640 --> 00:19:50,940 That doesn't help any of us. 324 00:19:50,940 --> 00:19:51,940 It doesn't help me. 325 00:19:51,940 --> 00:19:53,580 It doesn't help our patients, right? 326 00:19:53,580 --> 00:19:55,940 It's a terrible place to live. 327 00:19:55,940 --> 00:20:01,740 And you would never do that to your friend or your child or even your pet. 328 00:20:01,740 --> 00:20:07,380 So when we're thinking about self-compassion, you know, when we hear those voices in our 329 00:20:07,380 --> 00:20:13,140 head, when we have that energy going on, you know, taking a pause and saying, would I ever 330 00:20:13,140 --> 00:20:15,700 say that out loud to another human? 331 00:20:15,700 --> 00:20:18,500 No, I am a human. 332 00:20:18,500 --> 00:20:23,180 I am, you know, I do make mistakes because we all do. 333 00:20:23,180 --> 00:20:24,980 You know, it's normal for me to feel this way. 334 00:20:24,980 --> 00:20:29,940 It's normal for me to feel bad about something if something bad has happened. 335 00:20:29,940 --> 00:20:31,380 And I can be here with myself. 336 00:20:31,380 --> 00:20:34,100 I can be here with my feelings, right? 337 00:20:34,100 --> 00:20:38,620 So much of the, you know, kind of the major problems with medical culture is we've been 338 00:20:38,620 --> 00:20:40,500 taught that push our feelings down. 339 00:20:40,500 --> 00:20:45,100 Pretend we don't have them, you know, to be just these wonderful, caring, compassionate 340 00:20:45,100 --> 00:20:47,940 human beings who don't have feelings of our own, right? 341 00:20:47,940 --> 00:20:53,300 But so many of us were sitting on top of like years and years of frustration and resentment 342 00:20:53,300 --> 00:20:55,740 and we're just kind of squashing it down. 343 00:20:55,740 --> 00:20:58,740 That is not benign. 344 00:20:58,740 --> 00:21:02,580 And that includes when we think about sort of our compassion for ourselves. 345 00:21:02,580 --> 00:21:07,900 We need to be able to believe that we are valuable human beings, that, you know, that 346 00:21:07,900 --> 00:21:14,060 we will make mistakes, that we can have our own back, even if we're in kind of toxic cultures. 347 00:21:14,060 --> 00:21:15,140 Wow. 348 00:21:15,140 --> 00:21:16,980 Thank you. 349 00:21:16,980 --> 00:21:18,460 Thank you for sharing that. 350 00:21:18,460 --> 00:21:23,940 And I think that's just a perfect segue into my next question, which is that, well, what 351 00:21:23,940 --> 00:21:27,220 you're describing is countercultural, right? 352 00:21:27,220 --> 00:21:31,340 If this is not the prevailing culture of medicine, even though we're compassionate physicians 353 00:21:31,340 --> 00:21:35,500 with our patients, we're not compassionate with ourselves, and to a great extent, not 354 00:21:35,500 --> 00:21:36,820 with each other. 355 00:21:36,820 --> 00:21:43,260 And so for a faculty member who wants to practice radical self-compassion, who wants to start 356 00:21:43,260 --> 00:21:47,420 to change the culture by changing themselves, how can they connect with you? 357 00:21:47,420 --> 00:21:50,020 How can they connect to do this work? 358 00:21:50,020 --> 00:21:51,020 Yeah. 359 00:21:51,020 --> 00:21:52,620 Thank you so much for asking. 360 00:21:52,620 --> 00:21:58,860 I currently work one-on-one and in groups with physicians, and we do this kind of work 361 00:21:58,860 --> 00:22:00,040 exactly. 362 00:22:00,040 --> 00:22:07,780 So we are looking at our situations and trying to untangle and unpack all the layers of things. 363 00:22:07,780 --> 00:22:14,020 People can find me at my website, which is www.healthierforgood.com. 364 00:22:14,020 --> 00:22:18,220 And I am a fellow podcaster, and my podcast is all about these topics. 365 00:22:18,220 --> 00:22:21,300 So that is Ending Physician Overwhelm. 366 00:22:21,300 --> 00:22:25,700 And so for anybody who's out there listening to us on their favorite podcast player, they 367 00:22:25,700 --> 00:22:28,740 can certainly find my podcast there as well. 368 00:22:28,740 --> 00:22:29,740 Awesome. 369 00:22:29,740 --> 00:22:30,740 Okay. 370 00:22:30,740 --> 00:22:33,900 And I will put that information in the show notes as well. 371 00:22:33,900 --> 00:22:39,340 Megan, it's been a pleasure to talk with you, and you shared so many incredible insights 372 00:22:39,340 --> 00:22:41,500 and I know I can be helpful to so many. 373 00:22:41,500 --> 00:22:45,860 I wonder if you have any closing comments, anything that we haven't talked about that 374 00:22:45,860 --> 00:22:48,300 is important for you to mention? 375 00:22:48,300 --> 00:22:49,300 Yeah. 376 00:22:49,300 --> 00:22:55,700 I think I'd just like to circle back to that counterculture because that really comes up 377 00:22:55,700 --> 00:22:56,700 a lot. 378 00:22:56,700 --> 00:23:01,940 And I think that, you know, I especially see that in the women physicians that I coach 379 00:23:01,940 --> 00:23:10,860 who are working so hard to often fit into these sort of patriarchal, hierarchical systems. 380 00:23:10,860 --> 00:23:16,780 And there's an extra layer there, right, of trying to be countercultural when you are 381 00:23:16,780 --> 00:23:20,820 already others. 382 00:23:20,820 --> 00:23:26,700 Finding safe spaces for you to feel cared for and nurtured, whether that's in a coaching, 383 00:23:26,700 --> 00:23:32,620 a therapy, a group, your family, your friends, right, having safe spaces where you can feel 384 00:23:32,620 --> 00:23:35,660 really nurtured and taken care of is really important. 385 00:23:35,660 --> 00:23:38,100 That isn't weakness. 386 00:23:38,100 --> 00:23:42,100 We as humans need compassion and connection for ourselves. 387 00:23:42,100 --> 00:23:49,180 And so even if the dominant culture where you are is not supportive and not, you know, 388 00:23:49,180 --> 00:23:53,140 kind of conducive to that, please find your space, find your safe space, get the help 389 00:23:53,140 --> 00:23:54,140 that you need. 390 00:23:54,140 --> 00:23:57,820 We all deserve that. 391 00:23:57,820 --> 00:23:59,100 That is beautiful. 392 00:23:59,100 --> 00:24:00,100 And thank you. 393 00:24:00,100 --> 00:24:04,620 I feel like that's a perfect way to end today's show. 394 00:24:04,620 --> 00:24:06,700 Everyone you heard Dr. Megan Mello. 395 00:24:06,700 --> 00:24:09,060 Wow, it is countercultural. 396 00:24:09,060 --> 00:24:13,500 And especially if you are underrepresented in the academy in any way, it becomes even 397 00:24:13,500 --> 00:24:15,180 more challenging. 398 00:24:15,180 --> 00:24:20,260 Definitely seek help, seek community that will support you and reach out to Dr. Mello 399 00:24:20,260 --> 00:24:25,780 if you are struggling with perfectionism, burnout and people pleasing, which I think 400 00:24:25,780 --> 00:24:27,180 is most of us. 401 00:24:27,180 --> 00:24:29,220 So definitely check her out. 402 00:24:29,220 --> 00:24:30,940 Megan, thanks again for being on the show. 403 00:24:30,940 --> 00:24:32,940 Thank you so much for having me. 404 00:24:32,940 --> 00:24:34,940 It's been a pleasure. 405 00:24:34,940 --> 00:24:39,380 All right, everyone, we'll see you again on the next episode of the clinician researcher 406 00:24:39,380 --> 00:24:40,380 podcast. 407 00:24:40,380 --> 00:24:43,220 Please share this episode with someone else. 408 00:24:43,220 --> 00:24:50,900 Thank you. 409 00:24:50,900 --> 00:24:56,260 Thanks for listening to this episode of the clinician researcher podcast, where academic 410 00:24:56,260 --> 00:25:01,980 clinicians learn the skills to build their own research program, whether or not they 411 00:25:01,980 --> 00:25:03,060 have a mentor. 412 00:25:03,060 --> 00:25:09,180 If you found the information in this episode to be helpful, don't keep it all to yourself. 413 00:25:09,180 --> 00:25:10,900 Someone else needs to hear it. 414 00:25:10,900 --> 00:25:14,960 So take a minute right now and share it. 415 00:25:14,960 --> 00:25:20,420 As you share this episode, you become part of our mission to help launch a new generation 416 00:25:20,420 --> 00:25:26,100 of clinician researchers who make transformative discoveries that change the way we do health 417 00:25:26,100 --> 00:25:41,540 care.

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Megan Melo

MD/Certified Physician Life Coach/Mom/Wife

Dr Megan Melo is a dual-board certified Family and Obesity Medicine Physician as well as a Certified Physician Life Coach and Certified Daring Way™ Facilitator based on the work of Brenè Brown, PhD, LMSW. After years of struggling with burnout, she now coaches fellow physicians on how the learned habits of perfectionism, people-pleasing and a lack of boundaries contribute to burnout, particularly as we work within a broken healthcare system. Dr Melo also hosts the podcast, "Ending Physician Overwhelm," which discusses these learned habits and how to change them, as well as the stories of other Physicians overcoming burnout.