EP 63: What I Didn’t Learn in Medical School

Episode Description:

In episode 63 of the Hope4Med podcast, we feature Dr. Carolyn Flynn, a board-certified family practice physician practicing hospital medicine for the past 17 years. She enjoys sharing her passion for wellness, including the power of a primarily plant-based diet, yoga, and meditation. Despite a love for learning and passion for education, Dr. Flynn talks about the realities she faced as a new attending physician, a wake-up call many of us can relate to. She shares how she overcame the challenges and found balance in her life. We discuss the valuable skills and lifestyle habits we often don’t learn in medical school but can benefit students and new physicians in achieving longevity in their careers.

Transcript:

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

[00:00:04] Hi, everyone. Welcome back to the Hope4Med podcast. I am your host, Dr. JB and today’s featured guest is Dr. Carolyn Flynn. She is board-certified in family practice and completed her residency in 2005 and has been practicing hospital medicine for the past 17 years. She enjoys sharing her passion for wellness, including the power of a primarily plant-based diet, and yoga, and meditation. Welcome to the show.

[00:00:36] Dr. Flynn: Thank you, Dr. JB. I’m so happy to be here.

[00:00:40] Dr. JB: So Dr. Flynn, please, let’s start from the beginning. Share with my audience your origin story.

[00:00:47] Dr. Flynn: Sure, I’m happy too. So like so many other physicians, I grew up in a home where education was very much encouraged and supported. And my father had two master’s degrees. My mother was a teacher. And so, I just really, I think you hear the story often where I just really focused on my education and, and really did not struggle much through school. And that was, something that I just got a lot of enjoyment out of and I just was very focused on my education and all the way up through college.

[00:01:20] And I went to, I was, I grew up in New Jersey and I went to university in Maryland for undergrad. And I was a psychology major in undergrad, but around my sophomore year, I realized that I started to have interest in medicine. And basically, by my junior year, I decided that I did want to go to medical school. So, I spent the last few years of college catching up on classes I needed to take. So, I was a year out of college before I actually got into medical school. So, I had a year off in between and I was a counselor during that year.

[00:01:52] And I really was very motivated to go to medical school. I really wanted to, by the time I got there, I really wanted to be there. And I went to the Philadelphia College of Osteopathic Medicine and I, again, really enjoyed medical school. I had the same experience I had in college where I really just really loved studying and I loved the whole learning about medicine and the human body. And really had a great experience and did my residency in Florida, a family practice residency, and by the time it came out my residency in 2005, I was really enjoying life.

[00:02:24] I started practice, both office and hospital-based practice, traditional practice in 2005. And then the next three years were on the rough side, so like reality hit of what it is like to actually be a doctor versus studying to be a doctor and being a resident. And really those first three years out of residency were hard. And I really looked back in time and I can see how hard they were for me and I really quickly felt disillusioned with the career choice I made all of a sudden. I worked, was working full-time and I had a traditional type of practice where I joined with another a few physicians, it was a very small practice, and I worked Monday through Friday and I worked every other weekend and I just had very little time off and had really long, hard days. And about three years in, I just had had it with the whole, the whole career and really came to a crossroads about how do I want to go forward? And at that time, hospitalist medicine was just emerging as a possibility for a career around that time. And so I decided to, to make the leap and just become a hospitalist.

[00:03:25] Just feeling like I couldn’t do office and hospital well, I just felt like I was never in the right place at the right time. And my days were so long and I’m just working so many, I only had like four, four or five days off a month. And so, I made that change. And at the time I was living in Florida and my husband and I then moved to Colorado when I made that change in my career and it really alleviated, for me, a lot of the stress that I was feeling as far as being unhappy, because I had a lot more days off as a hospitalist. There were long days and hard days, but I had more time off. Did seven on, seven off, and that really did make a big difference for me. So, so really I, found my groove as being a hospitalist and I’ve been happy ever since.

[00:04:09] I also, after about four years of being a full-time hospitalist, I actually went more part-time and now I work about six to ten shifts a month, depending upon the month and I love that. So I have a really nice work-life balance that I’ve found over the years. And I’m really, I’m fortunate that I, that I’ve been able to do that and have really found that balance in my life. And then we moved to Virginia, so that’s where I live now. And we have a little girl, our little beautiful daughter, Grace, she’s five now. So being a mom has been an amazing journey and obviously filled my life with a whole different type of joy and really it’s also been wonderful that I can work part-time and still enjoy my career and, and enjoy motherhood.

[00:04:53] Dr. JB: So going back a couple steps in your story. There was a drastic transition, ’cause it seems like everything was great. “I love medicine. I love medicine, yes! Medical school, ra-ra-ra! Residency, woo-hoo!” And then after residency, it was whoa. So what was, what was different between real life now you’re the attending versus when you were a resident?

[00:05:19] Dr. Flynn: Yeah, I think so many people feel this way. You just don’t expect it, even though you’re a resident and you’re seeing the work of attendings and you’re with them by their side, it’s just, it’s just the weight’s just not on your shoulders, it’s just not on your shoulders in the same way. And then the reality that, nobody’s there to help you with like, as far as the workload goes. So when the workload gets large, you as an attending, you have to manage that workload. And I think a lot of people got that experience right out of residency where they’re, they’re a little unsure of themselves because they’re a new physician, and then on top of that, the workload feels very overwhelming. And you’re often searching for your place that feels most comfortable for you in the career itself. I think a lot of people end up either changing to a different specialty or going back to fellowship or just finding a job that fits them better. You hear the story a lot. And that’s what happened to me, I just ended up finding a job that fit me better.

[00:06:12] But yeah, I think the stress of just everything, of the, um, responsibility, the workload. Also not necessarily feeling supported in my early career, I wasn’t– the, the jobs that I had in the beginning, I didn’t feel as supported as I feel today. I found a company that I feel really supported by and that wasn’t something I felt in my early career either. So, the combination of those things, I think weren’t made those first three years really hard.

[00:06:40] Dr. JB: It is such a steep learning curve. It’s basically intern year is tough– and intern year is tough, right? But–

[00:06:47] Dr. Flynn: Yeah, right.

[00:06:48] Dr. JB: You know, the first year of being an attending, just like you said, it is so steep because now it’s all me. I can’t say, “right, attending? You could do this, right?” It’s like, I need to make the last and final decision and stand by whatever I decide and whatever consequences arise, it’s all on me.

[00:07:10] Dr. Flynn: Yes. And I think you’re still at a point in your career where your confidence isn’t that great yet, and I think that’s normal and healthy for your confidence not to be that great because you don’t have that much experience yet. And I think physicians can be, or are often excellent right out of residency. They have great knowledge base and they have great work ethic and they are compassionate, and it’s just, it’s just a learning curve of confidence and experience, and also just figuring out your work-life balance that I think so many of us struggle with. And the way I see it, especially as I’m mid-career now, is that when I look back in time, I’m much happier today than I was in my early to mid-thirties. Lots of reasons for that, obviously being a mom is a huge factor in that for me, but also just my work-life balance is so much better.

[00:07:57] I see it as like, as like, three legs on a stool that we all have to balance to keep that stool steady so that we feel happy, that we feel like life is good for us, and I feel like one of the legs is our education, how we got there, and then our social responsibility and our satisfaction with work in general. So, our career. And I think there’s so much, so many factors in there, obviously to keep that leg going in well. But I do think in addition to our own personal journey in our careers, the job we have, the company that we work for, how we feel about all those factors, there’s also a drive that’s why we went into medicine to help society, right? Where we did this for a reason, so that’s a super important leg to that stool, but at the same time, the other two legs have to be okay. They have to have the same length or otherwise you feel like you’re lopsided.

[00:08:49] And for me, the second leg in that as our personal finances, we have to grapple with that as we go along to figure out what’s the most important. How am I going to go forward in time so that I have control over my life and how am I going to do that with my personal finances? Because in the end, so much of what’s driving us is both our desire to practice medicine, but also the finances of our lives. And so over time I got better at grappling with that, with deciding what was most important to me when it comes to personal finance and really reigning in some things that I realized, okay, we’re making my life more difficult and not be giving me a lot more happiness when it came to finances. So there’s that component that I think is a huge learning curve as we get into it, become an attending and deal, deal with real life with our attending salaries and then what we do with it, what we create from that.

[00:09:39] And then the third is just as important, obviously, which is our personal happiness. So our relationships and our family or hobbies and our travel and all the things, whether our lifestyle and what we’re doing that exercise and our diet, all those things that really fill us up as human beings. And often, in our careers there’s times where that is so such a small part of what’s going on in our lives and I remember those first three years and I worked so much, I just felt like all the time, like, what is the time for me? Like what, like, and I think that was one of the things that, I think a lot of us that have so much education is that so much of that time in education, there was a lot of time for you. It wasn’t like, you know, I mean you had time to have fun. You had time to, to go out to eat. You had time where it wasn’t, it was stressful, yes, but it also, there was time for you.

[00:10:32] And you come out as an attending and if you’re working a lot as an attending, I just remember having this thought all the time, like, did I work all these years for this? Like where’s the “me” time? And I think carving that out for ourselves in whatever way we do that is so crucial. And setting up boundaries within our work environment and in our home environment and our even extended families about what we can and can’t do and really making sure that we’re giving ourselves self-care and all the things that really matter for long term happiness, and that takes time to figure that out too, I think. And I’m much better about all this now than I was even 10 years ago, so I do think that there’s for most of us that journey takes time to figure all this out. But for me, when I looked back in time, why I’m happier today is because I think I got that stool a little more even, I feel balanced.

[00:11:22] Dr. JB: I wonder if, if there is a way before leaving training that we could better understand, our values and, and what was, most important to us to help guide us in terms of making these types of decisions. So that even though that first year out is still going to have this insanely steep learning curve, but if someone, other things were in place. How that would help in terms of easing that, early career experience?

[00:12:00] Dr. Flynn: I think more discussions about this in residency would be really helpful. I don’t remember having discussions about this with the attendings. I don’t remember this really being a topic much about our, the realities of. Of what life is going to look like, even though we were watching our attendings, it’s not like we didn’t see their lives.

[00:12:20] Dr. JB: We worked right side-by-side though.

[00:12:21] Dr. Flynn: Right, right. But I just don’t remember there being much focus on, and I, and I’m hoping today there is more focus in residency programs on this. I think talking about personal finance, I think talking about self-care and all that entails for all of our sake so that we all can have longevity in this career and, find that balance. I think more discussions around that topic, these topics would be great in residency because I don’t recall ever having them.

[00:12:49] Dr. JB: No. I remember, I don’t recall ever having these conversations in residency. I remember there was like some capstone course in medical school and they talked about how much debt I was in.

[00:13:00] Dr. Flynn: I recall that too. There were though there was a lot of debt. My husband is also a physician, so  we came out with lots of debt between the two of us, yes. Yes. And that, that is a struggle, on so many of us are just have just mountains of debt, coming out of residency and it’s tough, it’s not easy. But I think the personal finance part of this, discussing more about that would be helpful earlier on in our careers. Cause most of that’s just figure it out as we go, when we do eventually in our kind of, I forgot like 36 to 38 range, in that range of our ages. Do you get a financial advisor? And that financial advisor helped us tremendously, but you know, I mean, that would be nice to have had more just kind of formal education about that while we were in training. I think it would greatly to many people, not just us.

[00:13:52] Dr. JB: That’s right. Especially with that second leg of the stool that you mentioned.

[00:13:56] Dr. Flynn: I was just going to say, so. Our freedom as physicians and what we can and can’t do, and we can afford to not do and do all those decisions and factors are so dependent on our personal finance. Right. And what decisions we have made regarding that. So, there’s a lot of connect connectivity between, our control of our career and our personal finances.

[00:14:17] Dr. JB: Interesting. You brought up an interesting word. You said our freedom as physicians. Can we explore that a little bit? And what do you mean exactly by that?

[00:14:26] Dr. Flynn: So I can’t, and I, I’m outspoken about this to people that know me, because I do feel like there’s a little bit of shame sometimes that goes along with working part-time in medicine as well. Like shouldn’t you be working full time? Like, I know it’s not that many. I don’t, I haven’t come across that many physicians doing what I’m doing. And I understand the reasons why, but the truth of the matter is, and I, I have more of these conversations as I get older with other physicians about the choice of working part time and figuring out how to do that if somebody really has made that decision. And I did a kind of early, I did it after, after working full-time for seven years. But to me, that’s freedom. Freedom is saying, I love this career. I want to help people. I, I’ve spent years training and I’m good at this job, but I also want the freedom to decide that I am going to have more time for myself, for my family, for pleasure, travel that’s important to you for just self-care for lifestyle. Because there’s, there’s so much joy that comes from that honestly, and also empowerment as a person that I’m not only a doctor, I, that’s not my whole identity. And I think when we can, have that more equal feeling about our lives and freedom comes from being able to make more decisions about what we really want to do and with our life and our career it’s empowering for us.

[00:15:50] And so I didn’t really, when I was in residency and the first part of my career. I don’t remember coming across anyone else that was working part-time as a hospitalist or any other field. I mean, I was really just, in the hospital. So that’s who I was seeing. Other physicians, I see it more now than I, than I did before. And I don’t know if that’s just because of my age and I’m starting to, more people are starting to do that because I’m in an age group of people or it just becoming more of an acceptable path. Because you hear so much burnout and a lot of people ended up just leaving medicine in general because it’s so stressful. And so for me, it’s the path forward. And then I will continue on, like, I enjoy what I do now. I, when I looked back in time, I am an all. And what I used to do, like having the energy for it.

[00:16:40] Dr. JB: In terms of the four days off a month?

[00:16:42] Dr. Flynn: Yeah, I don’t even know how I did it, I couldn’t do it today. Like I literally couldn’t do today. And so I look at other physicians and I’m in awe of them, and I’m in awe of nurses, and I’m in awe of so many people that are working so unbelievably hard and, it is such a double-edged sword because it, it is a wonderful thing that people can put that much of their heart and soul into a career, but at the same time, at what expense to them?

[00:17:09] Right? And I think that’s what so many healthcare professionals feel, especially through the pandemic, it’s like, boy, it’s like, this is our lives too. And I also want to share with you that our daughter has Down syndrome and when she was born, we had a birth diagnosis and for, for both of us, it was, a life-altering time. And it’s, she is the biggest joy of our lives. She’s an amazing little person. And it really changed my view, her having Down syndrome has changed my view so much of what’s important in life and really solidified for me, my feelings about focusing on the joy in life and not getting weighed down by things that I can try and diminish as far as stresses. And then, as far as work and just in general and really focusing on the things that matter the most. And also, I learned so much from her with joy and actually I think people with Down syndrome especially have so much to teach us about joy. And so being a mother has been so joyful.

[00:18:12] Her little personality so joyful and, and the truth is it’s really shifted my views about what do you think is most important in life? And that’s really solidified this feeling I have that things need to be balanced and that I don’t, I don’t focus so much anymore about on the negative about the career. I just try to focus on the positive things and also put it, put that part of my life in its place. And I think that’s something that we all have to figure out how to do for ourselves over time in medicine. Because when I talked to colleagues, I often hear this just really tough stuff that’s coming up for them. And I feel it too at times, but I, I think that through focusing on self-care, and also putting some limits to our work, we can better that for ourselves,

[00:18:58] Dr. JB: So, how did you get to the point where you focus mostly on the positive things?

[00:19:04] Dr. Flynn: I, I, it was such a fast shift for me too, cause I, I think my journey made it an easy shift for me because I was and after seven years of working full time, like, as I said, I’m so burnt out. And I went part-time before I had our daughter, but I had actually lost two pregnancies before having her, so I was in a, such a sad place in life. But to be honest with you, I was just, just wanting to be a mom so bad. And so a lot of the things that work that were upsetting– and still today can be upsetting about our jobs are stressful–at that point in my life, even before I had her, kind of diminished in their importance in my life, because I could see that the most important thing for me was family and that those things I had just kind of just not focused on so much.

[00:19:52] And then after we had her, the joy in my life was like, just so. And so, I naturally just after having her, I just naturally did not focus on those things. And I, and when I go to work, I really just try to, every time I go do a shift, I just try to do the best I can. I just try to, really practice the best medicine I can, counsel patients the best I can, give as much caring as I can, but I’ve gotten much better and not taking it home. And that’s, a big factor. I think in a big factor in that is, is being, having a happy home life and focusing on, being a mother, but also learning to do that. I think there is something about, us being very intentional in that way, where we decide, I’m, I’m going to leave this there. I’m not going to take it into my house. I took me years to figure that out for myself, because I used to bring a lot home with me emotionally in my head.

[00:20:53] Dr. JB: So we’re not just talking about charting, we’re talking about–

[00:20:55] Dr. Flynn: No, we’re talking about thinking. Yeah. Yeah. I mean, and I, I have so much, like for office physicians because I used to be one and I know how hard that is when it comes to the actual physical work of charting and all that to keep on top of. As a hospitalist, that’s one of the beauties of being a hospitalist is you, when you’re, when you leave the shift, you leave the shift, you’re done with your charting and you’re done with it, it was that day, that day’s work has done.

[00:21:19] But for years as a hospitalist, emotionally, bring things home that that I can much more easily let go today. And I do think that was a skill I honed over time, that’s a self-protective skill. I think that a lot of us do figure out how to do over time. And I, and again, I don’t remember ever really having this conversation in residency, either with attendings about their feelings about that, but that’s another really good topic to talk about. I think because it is something that I think we do learn as attendings, how to do, and it is an important part of our longevity in a career.

[00:21:55] Dr. JB: And that’s interesting how you’re able to do that because you are in a two physician household.

[00:22:00] Dr. Flynn: Right, right. Yeah. So, we will occasionally talk about a case, and it has to be a pretty interesting one for us to bring it up at each other at this point, because we’ve… so my husband is hospice and palliative care physician and we used to talk more about patients than we do at this point in our lives So it has to be pretty interesting case for us to bring it up with each other. But I think he’s gotten very, he’s gotten better at it over the years, too. He’s struggled with the same as I have, about bringing, bringing emotional, feelings about case specific patients and specific situations home. I think we’ve both kind of equally struggled with that and I think we’ve both kind of grown in a way that we’re, we’re individually better at that. And I think that helps each other. Yeah.

[00:22:42] Dr. JB: Did you guys explicitly have a conversation about this stays at the door, it does not enter it to her house, we leave the baggage there and we pick it up on our way to work the next day?

[00:22:54] Dr. Flynn: You know, over the years, there were times in our lives where we were talking about. I mean, it, I can’t say it was a one or two conversation discussion, but yeah, there were times where I think we agreed with each other that we should talk less about work and focus more on our home life and just not focus so much on it. I think we did have that conversation, several times over the years.

[00:23:16] And I think we just naturally each got better at that too as time went on. But yeah, I think that there’s beauty and understanding each other’s careers. I mean, there’s something very helpful about that and a relationship, but there’s also something that, with that understanding of each other, there can also be too much sharing where you just it’s like, you’re talking too much about what happened at work because the other one, understands. And so it’s, it’s that balance. And I mean, I think there’s sometimes, we still struggle with a little bit, but I know I don’t feel the same that we both bring it home as much as we used to, you know?

[00:23:49] Dr. JB: And so if we go to the third side of the stool, we talk about happiness and wellness. I know that that is an area that is very dear to you, and we’ve highlighted some of those aspects already, but we haven’t talked about the nutritional part.

[00:24:11] Dr. Flynn: And I’d love to talk about that. It’s actually one of my biggest passions now is nutrition and focusing on my own nutrition and also how I can help best counsel, I’m sorry, help counsel patients best about nutrition. And one of the things that I had discovered which many physicians and healthcare providers know about before me was last year I joined the American College of Lifestyle Medicine. And I’m not sure how many how many people have explored or discovered that yet, but it is a great website.

[00:24:41] They have so much information there. I joined as a member of last year and I’ve been doing their CMEs for about a year now and I’m, I’m working towards my certification with them. And they’re doing the really important work. And they, I think they started about a decade ago. I think that it was developed about decade ago and they’re sharing data about lifestyle, specifically plant-based, the power of plant-based diet and exercise and mental health and all those things that, you know, as individually we have we can really focus on in our own lives and then also our society for us to really help society in general see that there’s changes we can be making as a society that are going to really do a world of good for the future. For our current health and our future health and the health of the planet. And it’s really a powerful realization that I just didn’t even know existed until last year. So, I’d love to talk about it because I think it’s really awesome. And so I, lately I have been sharing with my physician colleagues this information, because a lot of those that I’m friends with haven’t heard of this yet, or haven’t experienced the website or looked at any of it yet.

[00:25:53] And they really, I have to say 20 years ago in medical school, I don’t recall being taught any of this stuff about diet. I think many physicians will say the same. I hope things are changing for the better in medical schools today, but I realized, I just don’t know what’s happening when it comes to the the diet education that’s occurring in medical schools. But if I could, I’d like to share a little bit of facts today because there’s, there’s things that that just a few facts really, I think, going to go a long way when it comes to changing people’s minds about, about lifestyle things. There is a NIH study that– sorry, NIH paper that came out in 2013, so it’s not new, but it really highlighted with the American College of Lifestyle Medicine, when it comes to what nutrition is highlighting today. And it did it in a really concise manner that I think is really helpful where you don’t really have to spend that much time to understand the basic data, but it may change some people’s mind about the power of a plant-based diet. So, I actually wrote down a few to share if that’s okay. Because I find this so fascinating and again, I find it fascinating because I don’t recall learning this in medical school.

[00:27:06] Dr. JB: That’s a theme for our conversation today, all these things we didn’t learn in medical school or residency.

[00:27:13] Dr. Flynn: I know, I don’t remember learning this in residency. And I, and I do want to premise this conversation by saying I have, for years really, since my early twenties been pescatarian, I really haven’t eaten a lot of meat myself, but I wasn’t doing it for, for health reasons really. And I wasn’t doing it for environmental reasons. I just didn’t like meat. So I really wasn’t doing for the reasons of that I’m learning now about. But the power that I understand now as a doctor is, it makes me more vocal about it. And I’ve really made some recent changes in my own diet towards the veganism. I’m not vegan, but I’m in that direction way more than I used to be when it comes to eliminating my dairy. So, but I want to share just a couple of these facts because I think, the more people hear this, the more they may change how they counsel their own patients, how they’re eating themselves. And so, basically this article really talks about the data from the late nineties until about 2011. So in that, that decade period, and they concluded that in 2008, they did a study where they found that non-vegetarians were 74% more likely to develop diabetes in a 12-year period than vegetarians. 74% enormous, right? That’s an enormous percentage.

[00:28:27] And in 2006, they did a randomized clinical trial comparing low fat vegan diet to the typical ADA diet, which is basically what most people are counseled on, when they’re, when they’re new to diagnose the diabetes or pre-diabetic to help. And they found that the low-fat vegan diet actually had a bigger reduction in their A1C than people that were on the ADA diet. So that’s a powerful information to have because we’re using, for most of us, we’re using the ADA diet as the gold standard for educating people. And we’re not really talking so much about their animal product intake. And they concluded in that same study– I think this is really fascinating– that 40, that of the people that followed the low-fat vegan diet, 43% of them that were that were diabetic, were able to decrease their medication need for the diabetes versus only 20%, 26% of the ADA diet followers. So double the amount of people were able– doubled the amount of medication decrease occurred with a vegan diet. Again, it just, it just emphasizes the power of a plant-based diet for. All the things we’re trying to help patients do, and ourselves do, which is live healthier, live, happier, take less medication.

[00:29:47] It also talked about in this article about mortality risks, I’m sorry, mortality decrease and decrease risk of heart disease. And most of us have heard of Dr. Ornish. We, we all recognize his name, but and again, I don’t recall learning this in medical school, but in 1990 in The Lancet, he published the lifestyle heart trial. And basically in that study, he found 82% of participants were diagnosed with, that were diagnosed with heart disease had a regression of their atherosclerosis when they were putting on, or followed a plant-based diet. And that was a groundbreaking study at the time.

[00:30:32] And yet I went to medical school a decade later, and don’t remember, don’t have that in my head as something that really I was taught and that we talked a lot about. And so. What I do today in, in how I counsel patients is different than what I did most of my career. And it’s because of this information that now I really feel very sure that I should be saying to patients that they should decrease their animal product intake, and, and I don’t think that’s something that in general most patients hear from physician. Or, really the physicians themselves are really focusing on for their own life and their own diet. And so, it’s really been a powerful change for me that I love talking about because I think that the more of us talk about it, the healthier world will be as individuals and society. And there’s great data to show that people that eat less animal products are also helping the planet more with less, less carbon footprint. So it’s really been a important thing for, a kind of pivot in how I see medicine and how I’m trying to change the way I interact with people.

[00:31:43] Dr. JB: No. I agree with you, but I too did not learn this in medical school or in residency. And if we’re not taught this and we don’t take the initiative to teach it to ourselves, it’s hard for us to teach it to patients, right? So of course, I see lots of patients in the emergency department and we diagnose them with new onset high blood pressure, possible diabetes. You follow up with your doctor and they have a conversation with them about it. Medicine is not the initial treatment. The initial treatment is lifestyle changes and that’s why I was like, eat right, diet, like–

[00:32:24] Dr. Flynn: Avoid the sugar. We’re good at telling people about the sugar, I mean I’ve focused on the avoid the sugar conversation for years, the sugar conversation.

[00:32:36] Dr. JB: Right, and okay, now go to your primary care doctor, but we don’t, if we don’t know the tools to share with our patients–

[00:32:45] Dr. Flynn: It’s hard to know exactly what to say.

[00:32:47] So I want to share with, with you all what I specifically say now, because I learned this through the American College of Lifestyle Medicine. They really do a great job at helping people figure out, the physicians especially figuring out like, what exactly should you be saying at this point what’s evidence-based and what you should be saying that’s evidenced-based, that is simple and effective because I think that that’s the key for all of us practicing medicine. We have to do something that’s effective and yet is not super time consuming because we are very busy. Right? So I, when I go into a room now, If the patient brings it up with me, or I bring it up with them about diet, whatever, they’re there in the hospital for, I say I have great advice for you and it’s only three things and they’re, they’re simple things. They’re a little hard to do. You have to take, you have to put some effort into them, but if you do them, you will be healthier. And I say, number one, eat five cups of fruits and vegetables a day. If you actually do that, and you will feel healthier, you will be healthier. You’ll have, whatever they’re there in the hospital for, say that you’ll have less, a better control of your diabetes. You’ll have less risk of heart disease. You’ll have less risk of cancer if you, if you do this this every day or try to do it every day.

[00:33:56] And I say, and I say to think about how much food that is, ‘cause, it’s a positive thing to say about diet instead of something negative. Like you have to take something away. It’s saying eat more of this, and fruits and vegetables are delicious and whatever you like and so I have that little discussion. And then I say, number two, whatever you’re eating animal product-wise, you know, dairy, eggs, decrease it by half. And I’m not telling people to be vegan. I don’t ever use the word vegan. I don’t ever use the word vegetarian because it’s off putting to most people, and so I’m also not telling people, okay, never eat meat again and never eat, never drink milk again. So I just say whatever you’re doing now, decrease it by half because you’ll have better health if you eat less animal products. And then I say, number three, you have to replace that protein with plant protein. So I say, eat some nuts in a week, eat beans eat some lentils, I use those three examples as pro-plant proteins. So they understand what I’m saying to them is More plants, less animals, like, and that’s a drastically, different than what I used to say about diet. And it’s evidence-based and, and every once in a while, since I’ve been doing this about a year now, I’ll have a patient say to me, oh, my cardiologist said the same thing and it’d be like, oh, that’s so great.

[00:35:13] So that’s my best advice from being part of the American College of Lifestyle Medicine, and really doing a lot of hours that they’re seeing these and how I’ve been able to process that information for myself and really work on my own counseling skills. And then if the patient talks to me more about specific things about diet, then I go into more details about good carbs versus bad carbs and lowering sugary drinks. And I’d have that conversation if I get engagement. But if I don’t get as much engagement, at least I said the things that have the best chance of helping their health, is fill your belly up with fruits and vegetables, eat less, eat less animal products because the data really shows.

[00:35:52] Dr. JB: The other thing that you mentioned is if you do these things, then you will slowly be able to, to be remove or stop taking some of these other medications.

[00:36:04] Dr. Flynn: It’s such a good thing to say to patients. I know you’re absolutely right. And I’m trying to get better about remembering to add that, but you’re absolutely right, because there’s a powerful message and it’s a true message that states have shown us that people that follow this diet do have a bigger reduction in medicine use the people that don’t, and that’s, they’re a powerful. And that’s it. And again, something that I’m working on to adding that. Yeah. I mean, that’s my, my counseling discussion because it is, it’s, it’s, evidence-based, it is an evidence-based statement, so, so diet, I find, a huge part I’ve made changes in my own diet. I eat a lot less dairy than I used to. But you know, I’m not an all or nothing person. I mean, I think that’s the message too, not all or nothing to make good change. And then the other component for me, and I think a lot of us do this too in our own personal life is just figuring out whatever exercise works for us, and I’m just a huge fan of yoga. And I do a lot of meditation too, but I, I think that the. They go back, going back to the stool analogy, that important self-care part. It’s just so great to really focus on for ourselves. We just feel so much better, whatever we choose to do whatever the exercise is or whatever the, the self-care is, and so I, I think carving that out for assessment time that it takes for us to have for our own physical activity and whatever brings us happiness and joy and makes her bodies healthier.

[00:37:26] Dr. JB: And when did you get into yoga and meditation?

[00:37:29] Dr. Flynn: In medical school actually. I was seeking relief from, some of the stresses I was feeling a medical school and I remember taking a, I took a medication, I’m sorry, meditation class for a year where we met once a week. And it was, it was a very impactful year for me and it was happening through medical school. So I really learned how to, you know, how to breathe through my anxiety, if I’m feeling anxious and really learned kind of meditation techniques through that. And just the routineness of it was great because it is a hard thing to, to make routine in your life. And then at the same time, I started doing yoga just on my own and took classes over the years. And so, which has been something that has helped me with the stress level of my career and whatever I was going through in life.

[00:38:14] And I think a lot of us find that whatever that avenue is that physical exercise that, that release that we need. And also, the, the cardio for our, for our hearts, but also, breathing techniques and stretching and all the things that really just make our bodies feel better. Whatever we find, whatever path we find there is great, for me, yoga was just so natural because I enjoyed it, but also it’s something I could do at the end of a busy day for 10 minutes. Yeah.

[00:38:42] Dr. JB: Incorporated that since medical school throughout.

[00:38:46] Dr. Flynn: Yeah. I’ve got to show, you know, most days of the week for most of my adult life it’s something I’ve just done very, very routinely over time. And it is something actually down the road, I’d like to become a yoga instructor, do some classes. I just love it so much, but I just haven’t focused on that part of my life enough to do that. But yeah, I, I mean, that, I’ve made that a routine in my life for years.

[00:39:09] Dr. JB: And so, some people do different exercise, activities, yoga, pilates, running, and then, as their career continues, they put that on the back burner and say, oh, I’ll do that later, maybe tomorrow or whatnot. So how did, what did you do to ensure that you are able to do it frequently?

[00:39:30] Dr. Flynn: I think what was the driver for me was I noticed, especially in medical school and residency, that if I did not do yoga at least 10 minutes a day, most days of the week, I had bad neck. Um, It was, so it was so such a clear connection for me that I would have all the stress on my shoulders and my neck. And if I did not release that through yoga, I suffered. So for me, it was such a direct connection that I carried through. That once I got into that routine of life, it became a habit which you hear this all the time about, about good habits in life. It’s just become something you do. And because I associated it with pain, if I didn’t do it, it was the driver for me to keep going. And I think we all have something that drives us, to do something either we’re, we’re working on either weight loss or health in general or something, that’s driving us to put the effort into, the exercise that we’re choosing. And for me, my driver was, I was trying to make sure I didn’t have neck pain the next week. Yeah. And it just works. I mean, I really don’t have any neck pain today, but I think if I hadn’t been one of those people who focused on that part of my life, I would probably be one of those people that had a lot of chronic pain.

[00:40:43] Dr. JB: And do you do it like a certain time of the day everyday, or?

[00:40:47] Dr. Flynn: Yeah. Yeah. I’m a nighttime yoga person. So, I do it before bed, most days. And my daughter does it with me. It’s adorable. So she’s, she’s become a yogi. Yeah, she’s adorable. She asks to do it nowm she’s signed–she does sign language, our daughter’s quite fluent at this point in sign language, and so she asks in sign language to do yoga with me.

[00:41:10] Dr. JB: That’s so awesome.

[00:41:10] Dr. Flynn: Yeah. I started a TikTok actually because it’s so fun and cute to do videos with her and she loves to do the videos. So I started a TikTok called a yoga medicine just because it’s fun and it’s some fun to share. And she loves to do these little videos with me.

[00:41:27] Dr. JB: Wonderful. And then along with what you just said, you associate, or you combine yoga with bedtime. And so that’s how it’s able to be a routine, right? ‘Cause we all sleep at some point. We’re going to sleep at some point, and so I’ll doing some kind of wellness activity. If you’re a morning person, first thing in the morning, when you wake up. If you’re a night person, then maybe pairing it up with before you go to bed, this is the thing I’ll do right before, do my yoga. And then the other thing that you highlighted it doesn’t have to, it doesn’t have to take that long.

[00:42:00] Dr. Flynn: Right. It’s amazing. It’s really, for me personally, like that 10 minute window of time, or maybe 15 at the most I do, is so powerful for my body. Like, I feel it when I don’t do it and I don’t, and there’s not many days I don’t do it, but I mean, I know the difference, but you’re right. It doesn’t have to be that time consuming. And I think the point you’re making about pairing it with something that you routinely do anyway, which is getting ready for bed, brushing your teeth, getting your contacts out, whatever you’re doing, is such a great part of making a habit. And I think that’s why I’ve been able to continue with for many years, because it’s just part of my nighttime habit and, and my daughter’s nighttime habit now, nighttime routine, so she’s, she’s like it’s yoga time! And that’s wonderful. That’s great.

[00:42:44] Dr. JB: So, in closing do you have any pearls of wisdom that you would like to leave my audience?

[00:42:52] Dr. Flynn: Just like to say that, that. I think that one of the things that I have really tried to do in my life, especially the last five, six years, it’s just focused on the joy of life. And appreciate that that often the that are upsetting on us, if we put them, in a place in our, in our minds, that’s not as significant and we look for those joys that we all have in our lives and push that up in our minds, that our life balance, no matter what’s happening in our life, we’ll feel better.

[00:43:25] And I think sometimes in medicine, especially we are surrounded by a lot of really hard things. We’re, our work is hard. We’re seeing a lot of sad things. We’re seeing a lot of people’s suffering and we’re trying to help them, obviously that’s why we’re there, but from a mental health standpoint, it is hard not to get into a negative mindset. And I would just say that one of the most powerful things we can do as healers ourselves is really work on our own positivity because we bring that with us. We, we carry that with us and how we interact with people. And so whatever brings us positivity whenever that is whatever, whatever self-care, whatever lifestyle, whatever it is that fills us up and gives us joy, focus on that more in your life because you will, you will be happier and you’re bringing that to work better. And that’s something that I, I’ve definitely improved for myself over time. And I like to share that because I feel like it’s something we all can do for ourselves and for our communities.

[00:44:24] 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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