EP 35: Letting Go of Perfectionism

Episode Description:
This week, the Hope4Med podcast features Dr. Vanessa Klugman. She is an endocrinologist who stopped practicing medicine in 2015 and currently is an ICF-certified life and recovery coach. Dr. Klugman shares her journey into the field of medicine and the events that led her to leave medicine. We discuss perfectionism in medicine and how setting these unattainable standards affect mental health. We further explore how mental health and substance use disorders affect healthcare professionals and the barriers to seeking the care they need.

Connect with our guest:
Website: https://resiliencerecoverycoaching.com/

Transcript:
[00:00:00] Dr. JB: Welcome to Hope4Med.

[00:00:04] Welcome to the Hope4Med podcast with me, Dr. JB as your host. Today’s featured guest is Dr. Vanessa Klugman, she is an endocrinologist who stopped practicing medicine in 2015 and currently is an ICF certified life and recovery coach. Welcome, Dr. Klugman.

[00:00:22] Dr. Klugman: Thanks so much for having me today. I’m really looking forward to sharing with you.

[00:00:27] Dr. JB: Let’s start from the beginning. What is your origin story?

[00:00:33] Dr. Klugman: Okay, so I will go back to the very beginning of my story. I was born in South Africa and I was born really into a family that valued academic achievement and service to others. So my grandfather was a cardiologist, my father was a pathologist, my mom was a social worker, my grandmother was a nurse, so a lot of service to others, and I think I just, I really, at a very young age, I would say when I was maybe seven or eight years old, I decided that I wanted to be a physician myself. And looking back, I think the reasons I decided to become a physician were really two fold. One, my father was a very strong role model for me. I really looked up to him and admired him and I wanted to impress him, and I just thought he was just this incredible person in my life. And the other reason was that I myself have always being fascinated from a very early age about what makes others suffer and about really alleviating suffering. So one of my greatest values, my top value really is compassion, being able to help and alleviate suffering, and so medicine gave me that capacity or the idea of practicing medicine, idea of being able to alleviate the suffering physically of others in my presence. And so I decided to become a physician and I never really veered from that path once I made that decision. That was, it was a done deal. I was going to be a physician. I immigrated to– my family immigrated to the United States when I was 15 years old, which was really for me a very traumatic event in my life.

[00:02:19] I didn’t really understand at that time how traumatic it was because I was just really trying to get through it. I come from a very close community, my family was very close, I had a lot of friends that lived close to me, and then I came to America and there was this huge sprawling high school. I felt like I didn’t fit in, I had the wrong accents, I had the wrong clothing. And 15 is not a good age to move in anywhere. So that really was the first time in my life, when looking back on it, that I felt like there was something different about me, and that perhaps I didn’t really fit in. It was just a very challenging time in my life.

[00:02:59] So then I went to the University of Chicago as an undergrad and I met my husband there, he was also pre-med. We were both pre-med, we worked incredibly hard. It’s not a university where people party, there was no drinking, no nothing, we just studied, studied, studied. Our lives are pretty much getting together and studying, there was not a lot of– we socialized a bit, but we were very serious students. And that was something I knew I could do, that I could really achieve, was I could get good grades, so I really associated my worth with how much I accomplished and how well I did in school. And after the University of Chicago, we both went to medical school together at the University of Illinois. We worked really hard during medical school. You know, the call was really intense. I myself had struggled with insomnia from a young age, and once I started on my rotations and being on call, I started getting very anxious about sleeping and about sleeping the night before I was on call, and what would happen if I couldn’t sleep? And how would I show up for my patients if I couldn’t sleep? So that was the first time that I actually started going to my parents’ medicine cabinet and taking their sleeping pills and using them, not really telling anyone that I was doing that.

[00:04:25] So we went through medical school, we did our residencies in internal medicine, and then I went back to the University of Chicago and did my fellowship in endocrinology, and started my family at that time. I have three children, they’re 28, 26 and 20. And then after that, my fellowship, I was hired into a practice of endocrinologists. We were all female, all had trained at the University of Chicago and it was a really wonderful practice, super supportive partners, but we worked, we worked really hard. Initially we were both internal medicine and endocrinology, we covered both so our calls were really intense, we were very busy, but for me, medicine, I viewed medicine as a privilege and a calling. I loved practicing medicine. I truly took care of my patients, spent tremendous time with them, and went overboard in terms of giving people my phone number and access to myself and not setting good boundaries at all.

[00:05:33] And definitely as I practiced medicine, it changed. The medicine I entered and the medicine I left was very different. And the anxiety, I started developing so much more anxiety towards the end of my practice around, well, initially with the introduction of electronic medical records, which for us older physicians was really challenging and we were kind of thrown into it and told to just sort of make sense of it. We had some support, but in my mind, not enough support to help me figure out how to do the recording fast enough, I wasn’t good at keyboarding, it was really challenging. And then, the pressures around seeing patients fast enough, being productive, and doing so many things that I hadn’t initially signed on for, like ordering tests and putting in MRI orders and all of that. And I started feeling a lot of like I wasn’t in integrity.

[00:06:30] Then, around the age of 39, I had a panic attack. I was diagnosed with general anxiety, and I do think that my panic, at that time, looking back, I think it was really due to the pressure I put on myself. I was just a perfectionist. I was pushing, I was proving, I was protecting myself. I had to be the perfect mom, the perfect wife, the perfect daughter, and I kind of lost myself in there. I didn’t take care of myself. I didn’t put myself anywhere near first. I didn’t even know that there was such a thing as self care. I just was constantly pushing, and so I developed anxiety, was put on an anxiety medication, and I was given a number of different medications. I was given the SSRI, a selective serotonin inhibitor, and then I was also given Ambien for sleep, and my psychiatrist gave me a long acting benzodiazepine also to help me with sleep. I think I was prescribed at that point too much medication. But I did okay, I would go through periods of getting more anxiety and they would switch my medications and I kind of muddled along with some anxiety, getting better, getting worse and just really pushing, pushing, pushing. Then about, I don’t know, it’s about 10 years ago, I ended up– probably more than that– going on a vacation with my husband and I was riding a bicycle and I flipped, hit the front brakes and fell, threw myself forward, fell over, broke my arm, and ended up being prescribed Vicodin, a narcotic, and I had a, truly for me, it was like a magical connection. As soon as I took Vicodin, instead of feeling tired and groggy, I felt energized. I felt like, wow, this is how I’m supposed to feel. I felt calm. I felt energized and calm, and my anxiety was completely alleviated.

[00:08:22] I had a frozen shoulder, so I was in therapy for a long time, and I got a lot of Vicodin prescription prescribed for me with many refills, because that was before we were docked, physicians were being careful around how much they were prescribing, and I became addicted. I noticed that I was taking the Vicodin, I was taking too much of it. I was taking it for anxiety and to help me cope and to help me get through the days. And I went to my husband and told him that I thought I was addicted and I threw the pills away. I went through a horrible withdrawal, feeling kind of achy, and just vowed to myself. I will never allow myself to take that much Vicodin, which was maybe six pills a day, ever in my life again. Then about a couple of years later, my anxiety started to really increase and became almost paralyzing. I think when thinking back on it as to why that occurred, there were a number of reasons. First of all was the anxiety around my work, the pressures and the distress I was feeling about medicine in general. It was the decision I made to come off and wean myself off my long acting benzodiazepine as I was really concerned, I had heard reports that it could cause dementia and I really wanted to come off it. My psychiatrist had told me that once no harm in staying on it forever, and I really didn’t want to. So as I weaned the medication, my anxiety went through the roof and I could barely function. And I was also trying to balance aging parents who were struggling with their health and my two daughters were at college. Exactly at that time, I ended up needing to have dental implants done and I was represcribed Vicodin, and of course it wasn’t a lot, at that point it was just like 10 tablets of Vicodin, but as soon as I took it, I felt such a relief in my anxiety.

[00:10:12] And I was in such a bad space in my life at that point, I tried to figure out how I was going to be able to get that Vicodin and have it available to help me cope with days where I just felt I could not get through the day. And I went so completely out of alignment with my own value system and I started visiting an elderly patient of mine in her home, I had prescribed her Vicodin and then I went to her bathroom where she kept her Vicodin and I took pills out of her pill bottle. I did this a number of times over a period of a year, I don’t really recall how many times, and it turns out that her son was a DEA agent, so kind of crazy confluence of events. They suspected that something was going on and they set up a sting with a plan to have me come to her home, she called for a prescription on June 11th, 2015 and I told her to come and pick it up, she called back and said she couldn’t. I went over to her home to take it to her, and they had the pills out on the kitchen table and she said that she needed to go to the bathroom. I took some pills out of the bottle and there was a video filming me and I went downstairs and the DEA surrounded me and arrested me.

[00:11:30] Dr. JB: Wow.

[00:11:31] Dr. Klugman: And I truly was devastated. I felt like my life, I could not believe that things have come to this, that pedestal of perfection that I had placed myself on was shattered that day. No one knew that I was doing this, the husband had no idea, my family had no idea, my friends had no idea. To everyone else, other than my husband and my close family who knew I was struggling and knew I was really struggling with anxiety, this was such a shock, and yet in some ways I think a relief that I was finally going to have to face this addiction, this stuckness that I felt in my life, the feeling of being trapped and not knowing where to go. So I relinquished my DEA license that night, my medical license was suspended, I went into a treatment program for professionals, and I really went in thinking that I was not an addict. I thought, I’m not physically dependent on this medication and I’m only taking it once in a while. But when I met with the psychiatrist, then he explained to me that addiction is continued use despite adverse consequences, I realized that I really was an addict. I was taken off all the medications that I’d been struggling, especially the one I’ve been struggling to get off, and it was remarkable how much better I felt once I got off that medication, all the other medications. Just almost as if my anxiety lifted and I felt such tremendous release.

[00:13:02] I really decided at that point that I really needed to learn the causes and conditions that have got me here, to change my life, to grow from this, to transform, and I threw myself into recovery. During my journey, I was, so many things fell away from me in terms of medicine. Every day, something would arrive in the mail. My malpractice insurance was going to be, I decided not to renew that because they were going to take it away from me. My boards were removed from me. My Medicare/Medicaid was removed. And eventually when it came time for me to go before the licensing board and decide whether I was going to practice medicine again, I realized that honestly, I would have license, but I would really not be able to practice. I didn’t have a DEA license, getting that back was going to require tremendous hurdles. I couldn’t take Medicare. I couldn’t take Medicaid. Didn’t have my boards. And I sort of saw this as a sign that it was time for me to give up medicine and to move on to something else, and I became passionate about supporting other people who are seeking recovery or who are in recovery. I certified as a life and recovery coach and started by coaching practice, Resilience Recovery Coaching, and so that’s what I do today. I support others who are seeking recovery or who are in recovery to build a life that is balanced and meaningful and brings them joy.

[00:14:31] Dr. JB: Thank you so much for, for sharing that.

[00:14:34] Dr. Klugman: You’re welcome.

[00:14:36] Dr. JB: I’m sure it was very, very hard.

[00:14:39] Dr. Klugman: Yeah. Well, I’m used to telling my story. I’ve told it many times. The first few times were really hard, but it’s so important to me to reduce stigma around addiction, particularly in the medical community. And I think that the only way we can do that is by telling our stories and not hiding.

[00:15:01] Dr. JB: So there’s a couple of things that you highlighted throughout your story that I just wanted to try to revisit these concepts and dig into them a little bit more. The first one being the perfection, think you said you were on a perfection pedestal. Can we talk a little bit more about perfectionism in medicine?

[00:15:24] Dr. Klugman: Yeah, I think that many physicians, probably the majority, have an element of perfectionism and for sure, the ones that I have worked with struggle with perfectionism. I think to become a physician requires, in many ways, this kind of perfectionistic standard for ourselves, and so I think that for me, perfectionism was this feeling that nothing less than perfect was good enough. And these extremely high and almost unattainable standards, right? So it resulted in this feeling of tremendous anxiety and tremendous striving, this kind of unhealthy striving to always do the best. And it wasn’t, for me, just in medicine. For me, it was in my family life. It was needing to be everything to everybody and that isn’t possible. We set these such high standards for ourselves that we set ourselves up for failure. I think that when these things occur, when you lose a patient, and you are a perfectionist, it’s incredibly hard when you set– it’s so painful. And when you set yourself up to do sort of perfect record keeping, it can take forever to get your notes done, and that also is really challenging. It’s just a recipe for disaster. So I think that that is one of the underlying factors that really causes physicians to, and I’m not going to say burn out, but you have a challenge with the practice of medicine, that really puts such high demands on us and unrealistic demands.

[00:17:13] Dr. JB: And where are those demands coming from? Is it internal or is it external or is it a combination of both?

[00:17:21] Dr. Klugman: That’s a great question. I think that for me, I think probably it’s a combination of both. For me, if I think back on it, I set a lot of pressure on myself to achieve well academically, but there was also a lot of pressure in my family. My parents really highly valued academic success, and so definitely I got a lot of praise when I did well and not so much praise if I got a B or didn’t do so well, so I internalized that as only an A is really acceptable. So it was both internal and external. In terms of medicine in general, I mean, there is a pressure, like we have to keep people alive. We have their lives at stake, right? There is that feeling of like, if I make a mistake, something really tragic can happen. So I think it’s both internal and external.

[00:18:17] Dr. JB: That’s true. And that is true that mistakes by healthcare professionals can have devastating results. That’s why the focus shouldn’t be on individuals, but on groups and teams and systems, because individuals are not perfect.

[00:18:33] Dr. Klugman: Absolutely. That’s a great point. It should definitely be. I think that a lot of the time physicians feel alone. They don’t feel supported. There’s not– I recall, and maybe things have changed somewhat, but I recall a lot of times when we were medical students, where you would go in these groups and have to discuss medical mortality rounds, things that had gone wrong, and there wasn’t this feeling of support. It was more this feeling of like, why did you make that mistake? And that wasn’t a supportive process at all. And you came away from that feeling really bad, like you’ve done something wrong and that you did not have the support of people around you. Now, I think this may have changed and I think that there is some desire now to support physicians more. Maybe, I don’t know because I’m not practicing anymore, but my husband is, and I definitely do see more emphasis on physician wellbeing and more programs on coaching and more awareness of the importance of physician wellness, which gives me hope. It makes me feel like maybe we are seeing that it is super important for us to support physicians and to put programs into place that do support physicians.

[00:19:49] Dr. JB: Hmm. Which is what Hope4Med is all about, is to really be able to provide that support for the healthcare team itself.

[00:19:58] Dr. Klugman: Yeah. That’s essential, absolutely essential to the future of medicine.

[00:20:04] Dr. JB: And another thing that you had mentioned was that you determined your worth based off of how much you had accomplished.

[00:20:14] Dr. Klugman: Yeah. I believed that I believed really until I came into recovery, I believed that my worth was equated with how much I accomplished and how much I did for other people. So there were those two elements of how I believed I was worthwhile. And if I wasn’t accomplishing, if I wasn’t really succeeding in medicine, doing the best I could for my patients, getting really great Press Ganey reports, doing really well on the Press Ganey scores, and I wasn’t giving a rec to everyone around me, then who was I? And I wasn’t really worth, I didn’t have worth. And when I came into recovery, suddenly I wasn’t working, so I didn’t have that to give me a sense of worth. My children were mostly grown, I was able to give to them, but I really had this huge shift in my identity. Like, who am I and what is my worth now that I’m not doing these things? That was one of the hardest things in recovery, was trying to figure out what is my identity and who am I? And I really, a lot of my recovery was around understanding that my worth, that I am worthy just because I’m here. And that I’m worthy, that we are all worthy, just because we are here and that we all have our unique gifts that we can share with others, and that it had nothing to do with how much I was accomplishing or how much I gave to anyone else it had to do with more, how I was showing up in the world and what qualities I was bringing to each day.

[00:21:47] Dr. JB: It wasn’t that you were worthy because you were a physician.

[00:21:50] Dr. Klugman: Right. Yeah, because I wasn’t a physician, I wasn’t practicing as a physician anymore and I came to see that I was still worthwhile, I still had worth, even when I wasn’t practicing as a physician. I had to go very, I really had to– it took time though. It didn’t happen over night. Initially it was a lot of trying to figure out, well, what is this, why am I here? What is my purpose in the world? And that really came to me from a lot of the different spiritual practices that I developed as a result of my journey in recovery.

[00:22:26] Dr. JB: I think that’s so key to realize that your worth isn’t determined by what you do, your titles, your worth is to determine by who you are and how you present yourself in the world.

[00:22:44] Dr. Klugman: Yeah. Yeah. I think that as physicians, many of us do feel like our worth is defined by what we do. And I think many people go through a huge identity crisis, especially when they come into retirement. I’ve worked with physicians who have retired and really struggled because they’ve suddenly been like, well now what? Who am I? And hopefully we figure that out before you retire.

[00:23:12] Dr. JB: But the thing is if your whole life though revolves around working, you’re a physician whether or not you’re at the hospital or in your clinic or whatnot, it’s hard to separate that identity. But I think that’s extremely important, it’s extremely important for your mental wellness, right? Because if something happens to that identity, if you get tied into some like malpractice or whatever, then you feel like, it hurts even deeper, because it’s not just the clothes that I wear, it is who I am, and there’s something inherently wrong with me which is what caused X, Y, Z to occur.

[00:23:50] Dr. Klugman: So true. So important. And I think the problem with medicine is that it’s a very, it’s a such a demanding career and we’ve become so unbalanced, right? Our lives are not in balance. And it’s so important to try to figure out how to balance our lives and to build other things into our lives, besides just our career. For me, it was career and looking after my family, and other than that, there was very little else in my life. There was no self care. There was no looking after myself or even identifying what was important or, I didn’t even know the words self care existed until I came into recovery, so I never really looked after myself. That was a huge shift, like learning that there was such a thing as like I have needs too and I need to acknowledge my needs and take care of them and not feel guilty for doing that.

[00:24:47] Dr. JB: Because it’s ingrained in us that we are the caregivers and we have to be available and to say “yes,” and if we say no, then somehow we’re being selfish and not being a team player or things like that. And that has to change because if we talk about like burnout and things that contribute to a physician or healthcare professional, experiencing symptoms of burnout, always being available, no boundaries is a big component of burnout. While you were practicing, did you experience any symptoms of burnout during your years of practicing?

[00:25:32] Dr. Klugman: Yes, absolutely. Initially not so much, definitely more as time went on. And I think for me, my issues were that I did not set boundaries. Like you said, I was very poor at setting boundaries with my patients. I would really– once there was My Chart messaging, things got really bad because I had this feeling I kind of needed to answer, those messages within 24 hours. I would spend time lying in bed with my computer on my lap, answering people’s messages at night. So there was very poor boundary setting, and I also gave some patients my phone number so they got a hold of me at home, and I really didn’t do that. So I felt that was probably the biggest contributor to the feeling of burnout, plus the unbelievable workload demands that we had placed on us, the needing to call the insurance companies for prior authorization, the having to put orders in the computer, all of that really led to a sense of disillusionment with the career of medicine in and of itself and a feeling like I wasn’t giving my patients what they really needed. I didn’t have the time to sit down and really spend time with them and really hear their concerns in a way I wanted to and felt like they deserved to be heard. So for me, for sure, towards the end I was, each day I just felt anxious. I just felt an uneasiness. And I also had very challenging patients as time went on because I had had these patients for 20 years and so they had a lot of health issues, and being able to see people like that in 15 or 20 minutes was almost impossible, so I would go into the room with a sense of dread, like, how am I going to do this? How am I going to be able to take care of this person in the way they deserve in the time I’ve been allotted? And I don’t think that’s possible, so I felt a tremendous sense of disillusionment by the end.

[00:27:32] Dr. JB: Yeah. And so, when we talk about these symptoms of feeling disillusioned, anxiety, and other mental health issues many healthcare professionals experience, yet don’t seek help for. What do you think some of those barriers are to seeking the care that they need?

[00:27:55] Dr. Klugman: Yeah, that’s a great question. I think that there are a couple of reasons. Regarding mental health, I think that there’s still a lot of stigma around mental health and substance use disorders in the medical community. I think that there’s some studies, I know in one study, 50% of female physicians didn’t seek treatment, despite feeling that they met the criteria for a mental health disorder, which is terrible. Right? And why aren’t they seeking treatment? I think because of the stigma, and number two, I think because of fear around medical licensing and the state boards and there are questions on those licensing applications, and states differ from state to state, but they are questions around have you ever had a mental health disorder? Have you sought treatment for a mental health disorder? Do you have a substance use disorder? Had you had treatment for a substance use disorder? And there’s tremendous fear around the repercussions of answering yes to that, and that is a barrier then to people seeking the treatment they need. And it’s a huge problem because suicide is at a rate of, I think, 400 physicians a year are committing suicide. So this is something that we really need to address, right? It’s a tremendous issue in the medical community, I think a lot of it is around the licensing issues, but I think also it’s around stigma.

[00:29:25] Dr. JB: And I guess the question is, this licensing issue, is it a unrealistic fear or is this actually legitimate, if you answer a certain way on these forms that it affects your ability to renew your license or even get your license in the first place?

[00:29:44] Dr. Klugman: I think it’s a bit of both. It depends on the state you’re in and that’s the issue, you don’t necessarily know in each state, what state you’re in, whether your particular state is a punitive state or not. In some states, I’ve heard of situations where people will come forward and talk about a mental illness and then will be sent to their professional healthcare providers, their PHP, and required to go to treatment and have all these difficulties and challenges that they have to face, and there have been people who have actually, as a result of that, committed suicide, because of what ended up happening as a result of saying to their PHPs and all the demands that are put on them and the financial issues that then occur as a result of having to do that and be monitored and all of that. So, I have heard that occur in some states. I don’t know around mental health issues as much as I do around substance use; as regards to substance use, there are states where if you come forward and you say that you have an issue with substance use, you may be reported to your board. You’re not going to probably lose your capacity to practice medicine, but there is going to be some financial repercussions and some issues that are going to occur as a result of that. If it is opiate, it is much more punitive. If you’ve used pills or if you’ve diverted medicine, that is a much more punitive and a much more challenging issue. So it varies from state to state, is what I can say. And I hope that in the future, we’re going to have some kind of place where physicians are going to be able to find out what their state is like and what the repercussions are if they seek treatment, what’s going to happen, so that they know in advance what they’re facing.

[00:31:33] Dr. JB: So there was no list of “these are the states that tend to be more punitive than others?” Like a secret list, but shared.

[00:31:44] Dr. Klugman: Not yet.

[00:31:47] Dr. JB: And so, you went through that experience yourself, in terms of standing before the boards. Did you go through PHP also?

[00:31:56] Dr. Klugman: Yes, I went to the Illinois PHP and I did two years of monitoring where I was randomly chosen to go in and give a urine sample, and I went to AA meetings, was required to go to AA meetings, and meet with the person at the board for two years. Then at the end of the two years when I decided to give up my medical license, I relinquished that and I didn’t need to continue with a PHP. And I’m not saying that I have anything against the PHPs at all, I think PHPs can be really helpful, and I think accountability has been shown to be incredibly beneficial in substance use disorders. So having that monitoring and physicians, if they go into a PHP are required to monitor for five years, if you want to keep your license, you need to be monitored for five years, during which time you have a certain amount of time that you required to do therapy, a certain amount of time in which you are required to go to meetings, and you will have random urine samples for five years, and/or breathalyzers. And I do think that it’s been shown that physicians do very well in recovery because they have that accountability, and so that is very important, and I’m definitely not against having that accountability. It does help people stay sober.

[00:33:20] Dr. JB: And in certain circumstances you are able to continue working while you’re going through the PHP?

[00:33:27] Dr. Klugman: Absolutely. Yes. The majority of physicians are continuing to work while they’re going through PHPs, they are just being monitored and being checked and they continue– assuming that their particular job is aware of it and is okay with it– they continue working and there’s no issues with that. So that’s great, but there are certain times where some physicians are challenged. They’ve either been let go of by their work, or in more serious situations like they’ve had DUIs or things like that, then they may be issues with working, but you certainly can work and be part of a PHP.

[00:34:06] Dr. JB: And you said that you end up losing your board certification, also?

[00:34:10] Dr. Klugman: My endocrine boards, they sent me a letter saying that they were taking my board, my endocrine boards away from me. Yes.

[00:34:17] Dr. JB: And why was that?

[00:34:19] Dr. Klugman: I honestly don’t know. I’m just not sure. Apparently the boards do things differently, some boards take your board certification away from you when you have something happen like this and others don’t.

[00:34:31] Dr. JB: And then you relinquish your DEA license, you said that same day?

[00:34:36] Dr. Klugman: Yes. So when they arrested me, they pressured me in that first meeting on the night of my arrest to give up my DEA license. And I honestly had, I was in such shock, honestly I had no idea what was going on. I just was like, I truly was in over my head. I didn’t have a lawyer. I didn’t know what to do. They asked me to relinquish my DEA license. They pushed me to do it, they said I could get it back afterwards, and I just said, sure, I’ll relinquish it. I just wanted to do whatever I could to be a good person, a good girl, like I had always been taught to be, and do the right, do the thing people ask me to do and say yes, and I did it. That was, to me, that kind of began the whole everything falling apart, because once I gave up my DEA license, my medical license was immediately suspended, and so that sort of began everything.

[00:35:30] Dr. JB: Retrospectively, would you have done things differently then with regards to saying yes to giving up the DEA license?

[00:35:36] Dr. Klugman: If I had known, I would never. If I had known the repercussions of giving up my DEA license, I would not have given it up.

[00:35:42] Dr. JB: Yeah, cause I don’t know how many people understand the repercussions if you found yourself, and hopefully you wouldn’t, but if you did find yourself in a situation like that, what does that mean?

[00:35:50] Dr. Klugman: Never give up your DEA license.

[00:35:54] Dr. JB: All right, take home point: never.

[00:35:55] Dr. Klugman: Absolutely do not give up your DEA license because it has devastating consequences. So if anyone is listening and anyone ever comes after you, just don’t ever give up your DEA license, do whatever you can to maintain, to keep it, and deal with the– and that will result in much less harsh repercussions. Because it’s very hard to get a DEA license back, and without a DEA license, it’s very hard to practice medicine.

[00:36:25] Dr. JB: Wow. All right. Well that’s a really good take away point, never give up your DEA license.

[00:36:31] And so, after all of this, you went through your period of recovery, you transitioned to a role of coaching to support resilience in health care professionals. Can you talk to us more about what made you decide to transition into becoming a coach?

[00:36:48] Dr. Klugman: Yeah, so I was really thinking about how can I support others in recovery? And I was trying to, I was, I really looked around to see what kinds of roles people have in the recovery arena. There were therapists, there was therapy, counselors, and then I learned about this whole new area that I did not know about, which was coaching. Someone introduced me, I think it was one of the therapist had told me about this recovery coaching and that it was becoming something that was going to be seen more in treatment and in support of people in recovery, so I really sort of researched coaching in general and I was really attracted to the idea of coaching because coaching really focuses– it’s strength-based, so it focuses on people’s strengths and it guides people. As a coach, what we really do is we help people identify their values, and then we help them set goals according to those values, and then take action in alignment with one’s goals. And as obstacles come up, we troubleshoot those obstacles and we then move forward and implement steps to move forward. And I just think that is such an empowering way of living. It really, the whole concept of coaching was extremely attractive to me, as a person, it’s in alignment with how I view life, and strength-based, which I really enjoy as a practice, so I decided then to go ahead and certify as a life coach with a specialty in recovery.

[00:38:33] During this path, I’ve just spent time– and I’m a lifelong learner, I love learning, I love taking classes, so I just sort of strengthened my own coaching practice by taking a variety of other classes and approaches that just helped my clients and myself in my life and in building resilience. And I think that there’s a lot of emphasis now on coaching and in physicians in general, and it’s been shown that coaching is really emerging as an effective solution for improving physician wellbeing, so that’s very exciting as well. And I think we’re seeing, really seeing a blooming of coaching in physician wellness right now in general.

[00:39:18] Dr. JB: And your population you focus on, is it healthcare professionals or broader?

[00:39:22] Dr. Klugman: It’s broader, so I do both healthcare professionals and professionals in general. I do have a lot of, I do coach a number of physicians, I have some nurses, I’ve had therapists, so people in the allied healthcare professions, nurse practitioner. So I do have, I would say the majority have been healthcare professionals, but I’ve also coached just, I love just coaching people who are seeking recovery, or really, as I say, aiming to release or to let go of self-sabotaging habits. Whether that is over-drinking or binge eating or perfectionism, procrastination, any habit that is self-defeating is something, I just love working with people like that. It’s just such a joy to see people get to the other side and start to live life according to their values and according to what matters to them.

[00:40:19] Dr. JB: And is this just like a short term coaching experience or is this a prolonged coaching experience with you? How, how do you do your coaching?

[00:40:29] Dr. Klugman: Yeah, so I usually have people sign on for three months. And then after those, I ask everyone to commit to at least three months because you can’t really do much in less than three months. Habit change takes at least 90 days to establish, and then after that, I allow them to choose whether they want to continue meeting or not. And I’ve had people choose to continue meeting with me once a month up to a year of sobriety. They want to stay with me, they commit to not drinking for a year and they want to celebrate that one year with me, so we’ve done that. I’ve had people stay on for six months, I’ve had people stay three months, done well after three months and stop, and then come back a little bit later for more coaching. So it’s varied tremendously in terms of how long people stay with me. And I usually meet people once a week for the first month, and then I do every other week for the second couple of months. And I really, as I said, I spend time focusing on establishing your strengths, taking surveys to figure out what your strengths are, getting really clear on your values, and then really taking small action steps forward to what you desire, whether it is quitting drinking, whether it is not binge eating anymore, whether it is getting your charts done and not procrastinating, taking action, troubleshooting what gets in the way.

[00:41:51] Dr. JB: So if my listener wanted to find out more about you or get in touch with you, how could they do so?

[00:41:57] Dr. Klugman: They can go to my website, which is resiliencerecoverycoaching.com, and they can contact me that way or they can shoot me an email, which my email is vanessalifeandrecoverycoach@gmail.com

[00:42:11] Dr. JB: Thank you so much for our time together, I mean, this hour has gone by so quickly. In closing though, I wonder if you have any words of wisdom for my listener?

[00:42:24] Dr. Klugman: I would say first of all, if you’re struggling with mental health issues or with substance use disorders, reach out to somebody, get help. Don’t stay silent, there is help available. There are coaches that are available, there are therapists that are available, and there is a way to get to the other side. And you’re not alone in this, all right? I felt so alone. You’re not alone. There are so many resources out there and it is possible.

[00:42:56] Dr. JB: Yeah, who says a doc can’t rap? D O C T O R J B. The greatest doctor to ever touch the mic. The greatest podcast ever broadcasted or prerecorded. Come learn some. Each one, teach one. I’m done.

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