Cheryl Martin (Host): Welcome to The Obstetrics Podcast, where we dive into the stories behind the scrubs, one inspiring healthcare journey at a time. I'm your host, Cheryl Martin. Today we're joined by an incredible OBGYN, who is not only delivering babies, but also delivering powerful insights on physician wellness and the future of women in medicine.

Dr. Christina Adams has built a career rooted in compassion, clinical excellence and advocacy. After making the transition to the OB Hospitalist model, she found a new rhythm in her practice and a new mission; addressing burnout among female physicians. In this episode, we'll hear about her path into obstetrics, why hospitalist work has been a game changer, and what she believes needs to change to better support women in medicine.

So whether you're a med student, a fellow clinician, or just curious about the real lives behind the lab coats, you will want to stay engaged. Welcome, Dr. Adams. Great to have you on.

Christina Adams, MD: Thank you for having me. I'm happy to be here.

Host: First, let's talk a little about your background and career path, your journey to become an OBGYN. What originally inspired you to pursue medicine?

Christina Adams, MD: So when I first started going to college, I thought that I wanted to go to law school and then wanted to change schools, transfer from one college to the other and had to take a science class in order to have the appropriate number of credits to transfer. And so I took anatomy and I loved it and changed majors after that point.

 And then in medical school, originally I thought I wanted to do family medicine. So I put my OBGYN rotation toward the end of my third year of medical school, and then fell in love with it, doing deliveries and procedures, and still having the opportunity to have those longitudinal relationships with patients, were all parts of the reasons that I chose to become an OBGYN.

Cheryl Martin (Host): So what influenced you to move from private practice to OB Hospitalist medicine?

Christina Adams, MD: So I had been in general private practice for 18 years or so when I made the decision to change. And I'd been thinking about it for about five years prior to deciding to change. I was planning to wait until my youngest son was out of high school because I didn't want to have to travel to work and my non-compete would've restricted me where I would've had to travel to work.

And then OBHG opened a program that was within a reasonable driving distance of home for me. And so I took the opportunity then to go ahead and make the switch. Really, what I was looking for to become a hospitalist, was because I had accepted a new leadership role within Florida's ACOG district and wanted more time to pursue advocacy and also more time to pursue my newfound love of coaching physicians.

 And so being a hospitalist and having those extra days in between shifts allows me to do other things that I'm interested in.

Host: Let's talk about a topic you're passionate about, female physician burnout. I understand that in addition to your role as an OB hospitalist, you're also a burnout and career coach for female clinicians. So what inspired this passion for addressing burnout and why the focus on female clinicians?

Christina Adams, MD: So what inspired me to focus on burnout, I was going through it myself and seeing friends and colleagues go through burnout. I got involved in being coached first as a modality to help mitigate my own burnout around the time of the pandemic. I started with listening to podcasts and then joined a program called Self-Coaching Scholars Run by the School where I ultimately certified to become a coach.

I did a couple of group coaching programs and retreats, and finally decided I wanted to train to become a coach because I had seen the power of it, to give me peace and provide me with empowerment. And, that made me want to do the same thing to help other women physicians. So women in particular, are socialized as young girls to be people pleasers.

We're rewarded often for being the good girl and getting the gold star in elementary school, and that carries through our training and education and right into practice where it no longer serves us. It basically makes us afraid to set boundaries and afraid to upset someone to the point where we're stuck often in chronic fight or flight mode, and that is what leads to burnout. The definition of burnout is it's a syndrome of chronic unprocessed stress, that has three components. Exhaustion, depersonalization, and decreased sense of personal efficacy. And it absolutely happens to men as well, but women are more likely to experience it for various reasons.

Host: Go deeper now into how burnout manifests differently for female physicians compared to their male counterparts. You've talked about how women are taught how we should be. What are some common challenges you see female physicians facing today in OBGYN?

Christina Adams, MD: So there are definitely different expectations of women in medicine compared to men, both from a societal standpoint as well as from an institutional standpoint that increase their risk of burnout. First off, we're expected, when we're parents to work as if we don't have kids and to parent as if we don't have jobs, which is not possible.

 We absolutely can do everything we want to do in our lives and careers. We just can't necessarily do it all at the same time. Many of us are carrying more of the mental and physical load of parenting than our partners, despite working long physician hours, and there can be a huge amount of guilt around outsourcing tasks. Often because we want to be perceived as a good mother.

Again, we're those gold star strivers. We want to be the good girl, the good mother, and that creates a values conflict that can lead to a lot of distress for women physicians. There are also different expectations on the part of patients and staff and offices and hospitals toward female physicians.

There are data that we get a higher number of inbox messages from both staff and patients, about 25% more messages than male physicians. And so that leads us spending more time in our EMRs. And then as we progress in our careers into leadership roles, there's the leadership double-bind that's common outside of medicine as well as within medicine where, women leaders walk a tightrope between being perceived as assertive enough to be a good leader, but not being negatively perceived as being too bossy or aggressive.

Host: So what are some practical strategies that have worked for you or others to reduce or prevent burnout?

Christina Adams, MD: So first of all, you have to take some time alone with yourself to figure out what it is you want from your career and your life. Most of us as physicians are so busy that we don't have time to sit alone with our thoughts. Or the thought of sitting alone with our thoughts is terrifying because we're so used to our ego being tied up in our accomplishments and we're afraid of what will come up if we take the time to sit alone and figure out what it is that we want to do.

So there are various tools that can help with that. Journaling, meditation and coaching. And then you have to learn how to set boundaries. Many of us aren't good boundary setters. And we have to protect our time, not only with people at work, but also with other people in our lives. We have to learn to give up being that, that people pleaser, that good girl stereotype, and be comfortable with saying no to things we don't want to do, obviously within reason. There's always going to be things in your job that you don't want to do that you still have to do. But, but there are a lot of opportunities for people to reclaim some of their time to spend it doing things other than the constant churn of medicine.

Host: Can you give just a practical example regarding that as a physician, let's say she is, given the thought time, what would that look like? What would be an area where she would set a specific boundary? Would it be lowering her, less hours? Give me an example of that.

Christina Adams, MD: I think there are a lot of people who are told early in their careers to say yes to every opportunity that comes along. So things like volunteering to be your hospital's department chair where you're not compensated for any of that time and it takes billable time away from your practice if you're in a private practice.

Being on sort of housekeeping committees within different organizations, practices, hospitals, things that don't actually help you advance your career. They're just sort of mundane tasks that somebody has to do. And women are often the ones who are asked to do those.

Host: In your opinion, how can healthcare institutions better support physicians?

Christina Adams, MD: I think our institutions need to realize that physician wellbeing and satisfaction is just as important as patient satisfaction. And it actually helps to achieve better patient satisfaction to have physicians who are working in alignment with their values and goals and patients get better care when doctors aren't burned out.

We know what we need to do. We just need our institutions and organizations to listen to us and try to enact some of those things so that we burn out less frequently.

Host: Talk about the importance of mentorship or peer support in helping physicians cope with burnout.

Christina Adams, MD: It's extremely important. Community is very important for pulling yourself out of burnout. Medicine can feel very isolating. And ultimately when doctors get in community, they just get each other. We face the same challenges and issues and, we know how to support each other when we take the opportunity to do so.

 There are two things that I can think of that mentors or partners told me when I had a challenging patient interaction or a bad outcome, that I try to carry forward and pay it forward by saying the same thing to colleagues. Number one is, I would've done exactly the same thing you did there.

 It validates your thought process. It validates your actions. Especially when things don't go perfectly in care. And the other is the patient was lucky to have you. That one really has been very helpful to me when I've heard it, particularly when I'm feeling like I didn't do a good job because something happened that was outside of my control.

And that peer support is key when you have someone who's burned out or who's dealing with a bad outcome. We have to be there for each other in medicine.

Host: What advice would you give to young women entering medicine to help them protect their wellbeing and thrive in demanding specialties like OBGYN?

Christina Adams, MD: First of all, you have to develop a plan to deal with chronic stress or else it just continues to get on top of you. Don't give up everything that brings you joy in your life. If you like drawing or you like playing music or you enjoy art, you can't just completely carve that out of your life because your life gets so full with medicine.

You have to make time for the things that make you happy. Your wellbeing matters enough to carve out time for yourself to do the things that bring you joy.

Host: You talked about the importance of mentorship or peer support. So for a person just starting out in the career, should the physician seek out a mentor and look for that person as soon as they are in their career?

Christina Adams, MD: I think sometimes it's better for those things to evolve organically. I mean, obviously you can try to find someone who you look up to and say, tell me your secrets. Like, how are you staying balanced? But oftentimes those mentorship relationships evolve without necessarily trying to have some formal mentorship program or going to them saying, would you be my mentor?

Like, it's just a matter of developing relationships with people who you admire, and then using those people to help you delineate your values and priorities and live in alignment with yourself.

Host: What's the one message you want every clinician listening to this podcast to walk away with?

Christina Adams, MD: No one will care more about your wellbeing than you. You have to be intentional about living the life you want to live. You have to be intentional about working on your mindset. Coaching is one of these things that in other industries has been around for years. And oftentimes executives that work at the level in which physicians work within medical organizations have that as part of their contracts.

It's a benefit that they ask for in their contracts, and it's still not really looked at as a normal thing for physicians to do, but it's evidence-based. There are studies out there that show that it, it improves physician wellbeing that are done by physicians who are working in the coaching space.

There are a lot of us out there. And you can find someone who can help you to prioritize yourself and your wellbeing while still staying in medicine. I don't want people to run away from medicine, but there are ways to continue to be involved clinically and not just completely burn the candle at both ends and burn yourself out.

Host: Thank you so much for sharing your story and your passion.

Christina Adams, MD: You're very welcome. I was happy to be here.

Host: That's Dr. Christina Adams. For more information about the benefits of OB Hospitalist careers, go to obhg.com. And if you found this podcast to be helpful, please share it on your social channels. Make sure to check out the entire podcast library for additional topics of interest. Thanks for listening to this episode of The Obstetrics Podcast from OB Hospitalist Group.