Microskills for Healthcare Leaders
with Dr. Resa E. Lewiss

Transforming Healthcare Coaching Podcast — Episode 76: Microskills for Leadership with Dr. Resa E. Lewiss. Host: Lillian Liang Emlet, MD MS CHSE CPC ELI-MP. Guest: Resa E. Lewiss, MD.

Lillian Liang Emlet: Welcome to the Transforming Healthcare Coaching Podcast, and we are excited this week because we're featuring Dr. Resa Lewiss and her book Micro Skills. And so it was a really an honor and a pleasure to be able to interview her here on our Transforming Healthcare Coaching Podcast. And I'll let Resa introduce herself.

Resa E Lewiss MD : Well first thank you so much for the invitation to join you on the podcast. Hello to the audience. My name is Resa Lewiss. Sometimes I call myself Dr. Resa e Lewiss. I am by training in emergency medicine and a lifestyle medicine physician, and I'll just keep it short and say that within medicine I have many interests.

Highlights would include healthcare design. Workplace productivity. Mm. And I'll stop there.

Lillian Liang Emlet: Sounds good. And so I'm curious what drew you to this idea of microscopes? I love the book that you, the, this whole entire book that you and Adaira have put

Resa E Lewiss MD : together.

Lillian Liang Emlet: And how did this book come to be and how did this emerge from your own leadership journey?

Resa E Lewiss MD : Yeah. You know, I neglected to say just now that one of my interests is writing and communication because I knew that's what we were gonna focus on. So I would say, first of all. It is critical no matter what we do, no matter what our profession, specifically as physicians, that we are able to communicate.

And so we actually have a chapter in this book on polished communication. Well, you know, what the heck does that mean? And to your question, the polished communication piece that this spoke to, this book is writing. Now to be clear, I had never identified as a writer. I mean, I wrote the requisite essay to get into college, med school residency, but I was by no means a comfortable or confident writer, and I didn't think that I was a writer.

And I had a key moment in my early career that I think illustrates when I first sort of. Recognized and was developing this concept of the micro skills framework. Now, to be clear, I did not do this alone, but this was an aha moment for me of when I really had this overwhelming task that had paralyzed me and I thought, I need to break this down.

I need to figure this out. And it was writing. So about seven years into my career as a faculty member, I was looking to change institutions. And when I called up the institution where it was actually where I had trained, they had offered me a job outta training and I really wanted to change geographies, change locations, and grow.

And they had sort of said, let us know when you wanna come back. So I called them up when I thought I was ready to come back and. You know, we learn about different currencies throughout life. I'm not talking about money, but Sure. Money is a currency. In the book, we actually talk about time as a currency.

Time can only be spent. We can't put it into a savings account. We spend, spend, spend it. So we want people to be thoughtful about how they spend their time, where they spend their time with whom they spend their time. The currency I'm talking about though is writing. When I called up my old institution and said, I'm ready, they said, you know, we don't see that you have any PubMed publications and what they were highlighting there and then was something I knew was in within academic medicine, no matter the specialty writing publishing is a currency. So that was a time in my professional career where I thought, I'm gonna figure this out, and I really broke it down into small.

Actionable steps and behaviors and you know, I've, I've given talks about this, about this micro skills framework of like, okay, how do I figure out how to write? And I started reading, specifically reading about how to write. 'cause there are books on writing. Editing like for journals, because then you get a sneak peek about how other people write.

You get ideas. You look at grammar, you learn about words, you learn about structure, and then ultimately writing like you have to write to become a writer. So I started writing with people, and this ties into the work you do, Lily of coaching, and I was often writing beside someone that was much more experienced or someone that could give me feedback on my writing.

You know, initially I would join projects where they needed someone to take something over the finish line or where I could. You know, add a little bit and then slowly I built up to like putting forth an idea with a first draft and adding someone with more experience to join me and really make their participation and their lift light.

But still, I knew that I was working with someone that had more experience and more competence in writing. So over time I became very. Accomplished at publishing academically, but writing this book and writing for non-academic outlets is a different kind of writing. And I started gaining confidence that I could do something like that when I was a founding member of something called Times Up Healthcare.

And it was a group of mostly physicians, mostly women. And they were doing this, they were publishing, op-eds in newspapers, they were writing in mainstream outlets like Fast Company or Slate Magazine. I was like, wait a minute, we can do that. Well, of course we can do that. And arguably, you know physicians are really good people to put their voice forward in that way and those outlets.

And so I started with those small articles and then slowly those small articles that I wrote with my co-author were the proof of concept to say, we're onto something here. It's resonating with a lot of audiences in all industries. She approached me and said, I wanna write a book. Will you join? I didn't have to take long at all to, to say yes 'cause I, I love learning.

Growth mindset, and this was something that I was ready for, and all the steps up to this moment seemed to have led up to writing this book.

Lillian Liang Emlet: It is such a beautiful story. I, you know, I think it's interesting because a lot of time when people listen to our podcast or they think about leadership, they think it has to be a title or has to be this. Climb up a ladder you have to make. And what you really demonstrate is the self-leadership required to own, grow, and develop the identity of being a writer, an author, a speaker, an advocate, and a leader in a space that I think for most healthcare physicians, I. Most people in healthcare and in physicians, we're, we're often afraid to do that, and we're not obviously taught how to do that. Some of those opportunities do come somewhere along the way for, for a very small percentage for our organizations in terms of media pitching or writing opportunities. But what you demonstrate through this book through the process, the labor of love that it is with, with you and Dr. Landry is the fact that. You can learn, you can find your board of directors, advisors, coaches, people to get you there. And many years. And it's a, it's a, it's a whole process. So it's a beautiful story.

Resa E Lewiss MD : 100%. And something you just alluded to, which is an important part of that writing process, that journey that I just shared is one of the. Even steps before the steps was, I talked to a lot of people, like I knew who was well published in emergency medicine and within emergency medicine my subspecialty is point of care ultrasound, the use of ultrasound at the bedside.

So I was really up on that literature or as I like to say, literature and I knew who was well published. So I actually went to some of those people. I asked them for meetings and they were like, why does Lisa wanna meet with me? And often I was like, listen, I see a case report. Almost every emergency medicine journal, almost every month.

How do you do it? What is your process? Or you know, and then, you know, people broke down their process and what I thought, thought took weeks. Some people were like, oh no, we turn it around in like 30 minutes. I was like, 30 minutes. But you know, in other words, things build up in your mind and take up. Just like we think every single meeting needs to be an hour, whereas in reality, a lot of meetings can be 30 minutes.

Same thing with writing. If you're not comfortable, if you're not confident, if you're thinking, Ugh, alright, I gotta really sit down. I'm gonna, I'm gonna put time for this in three weeks. You know, and you realize if you make it a big deal, it's a big deal. But if you sit down and just do it, it's amazing what you can get done.

But it, it, it. It means learning how the steps and that ties into micro skills. Micro skills is literally the book I wish I'd been given when I was starting out in my professional journey. You know, we do think when there is something that we wanna do, that somehow we're supposed to know it. And you know this, asking for help or asking for input or building your board, the people that can help you because they hold expertise that you don't.

You know, I think we're all coming around to it, but early on residency and as early career faculty, I thought somehow I was just supposed to know how to do this because. Everybody around me seemed to know how to do it. So we put down in writing a toolbox, a book that, sure, you can read it cover to cover, but you can just dive into specific areas, micro skills chapters to sort of upskill yourself on the areas that maybe you didn't get the 4 1 1, you didn't get the information.

And we really wanted to make that information accessible to everybody.

Lillian Liang Emlet: Yeah. What I love about this is like in some ways I've read through this all the advice I think I probably have given out. Some point in the last 20 years of my academic career in mentoring and also experience myself in my own entrepreneurial writing and, and journey now. And so it's interesting to, to see all of that.

And so I guess my question for you is. For really busy healthcare leaders 'cause we get this a lot that I'm too busy. How do these micro skills support sustainable self leadership and leadership for your team so that you can really prevent the overwhelm? I really feel that a lot of the things you cover in the book can actually nip a lot of our own problems.

We often get in our own way.

Resa E Lewiss MD : Yeah, it's a great question. And the book is so dense that some people are like, you know what, Resa, this is a lot. Which goes back to why you don't have to read it, cover to cover. You can just jump in and out, you know? My. Place in academic medicine has been as an educator, and there's a technique called just in time learning.

You know, a lot of times in the emergency department you may take care of a patient and you, there's a procedure that you haven't done in a while. So it used to be we'd run to the back of the emergency department, flip through the textbook. Then we started looking the apps on our phone. Now we can probably, you know, through the EHR.

Ask AI to generate sort of the, the reminder of how to do the procedure. But that's called just in time learning, where you read and then you apply that knowledge pretty much real time. And this book is one of those books that you can apply real time. In fact, one of my dear friends from college is in a leadership position and it was one of her first times leading a team, running a meeting.

So she flipped to the how to run a meeting. And so you can just. Access it. When you need. So to your question about, you know, the overwhelm, I don't have time. It doesn't have to be all or nothing. It can be in small, digestible pieces. I'm a podcaster and I love listening to podcasts and many of us do not have time to listen to a one hour or 1.5 hour podcast, but there are.

Many podcasts that give you your daily dose in 10 minutes, in 15 minutes. I intentionally, when I drop episodes, try to make them under 30 minutes and I've gotten feedback that people like that because they don't feel like it's that too much of an intrusion of time. The other thing I'll say is, and you know, one of my favorite questions regarding podcasts, I say to people, what speed do you listen?

People are like, what are you talking about? What, what speed do I listen? Because I listen 1.5 to two times. Now a lot of people say then they miss out on emotion or they miss out on details, but there are ways to sort of condense some time and get the nuggets and not feel like you are doing a big time expense.

Lillian Liang Emlet: Feel like I should out myself. I'm a 1.25 to 1.5 gal too. Yes.

Resa E Lewiss MD : I love that.

Lillian Liang Emlet: Yeah. It. Yeah.

Resa E Lewiss MD : It depends on the type of podcast and, and you know, you know, are you in learning mode or are you in meditation mode? Are you in walking mode? Are you in driving mode? It's all you know.

Lillian Liang Emlet: right. Well, so I guess we probably should ask our audience, what are you listening to us as both on YouTube and also on Apple? Feel free to leave a comment below on how fast you're listening to us. I have to admit, I've always been told I'm a relatively fast speaker, and so I, I probably like to listen the way I like to talk to you probably.

Resa E Lewiss MD : Yeah. One small comment is, you know, when you listen to podcasts at 1.5 to two times, when I listen at regular speed, I'm like, oh my goodness, why are they speaking so slowly?

Lillian Liang Emlet: Right, exactly. Right. Exactly. So I do love the fact that we can modify all those things to help everyone to adjust to, to where you are. So I do love that how in your book you can. Just use the points and the chapters as you need it, as they come up and help you find. And there's an entire section just on the time blocking and the time management.

And so for those of you who are worried about time and productivity especially as leaders, 'cause you have a lot more on your plate that's definitely a great book to check out. I did wanna transition a little bit because there is another topic that healthcare leaders often come to us as coaches because like you said, you know, you are often not given a manual life to be able to handle things, but, and that's really regarding conflict.

And so I'm curious, you know, what, you know, you talked a bit about the communication, but what micro skills are most important when we're leading through conflict in our team? Uncertainty and team transitions. 'cause I feel in healthcare there's always a transit transition. Every single year there's a transition.

Resa E Lewiss MD : Yeah. You know, I think people listening and watching probably have a sense of the culture of healthcare and the way healthcare was built. And quite honestly, it's not so different than many, many industries. There is a lot of vertical leadership. There is not a culture often of transparency. And we can just take one example of like salary for example.

There's not salary transparency in, in medicine. I think it's increasingly becoming requested by people in the industry, but it's just not traditionally like that. And hierarchy and leadership, as I said, is vertical. So I think that setup has also. Affected communication, and in this case related to conflict.

So to be clear, conflict is inevitable. It is a part of every single workplace. And, you know toxic conflict, maladaptive conflict can actually take up hours of time per week. As well as, you know, if you are someone involved in the conflict, you bring it home with you and then it can occupy nights, weekends, holidays none of these.

Sort of scenarios are healthy and what we would like to have, you know, sort of to be thriving in the workplace. Conflict is something that when you see it, you know And I have had many examples that I've witnessed directly or indirectly, and one of the. Big summaries I'll say is what I notice most is that leaders avoid conflict.

They try to not have the difficult conversation. They hope the conflict goes away. They hope the person goes away. They hope that people just sort of work it out amongst themselves, or if they start deprioritizing talking about it and start prioritizing something else, again, everybody will forget about it.

But we all know, then it just festers and then it shows its head up in whatever period of time. Often much, much, much worse. So I think one of the biggest summaries that I would say is that a lot of leaders avoid conflict. And I would say that that is not leadership. I think as uncomfortable as it is, how our default perhaps as humans is to avoid it.

That's not leadership. And I do think we have to figure out ways to navigate conflict and to even model how to navigate that conflict. And you mentioned the personal board of directors, and this is a group of people on whom I rely when I'm navigating conflict. And part of it is these are your go-to people.

The personal board of directors for people not familiar. It's similar to like a board of directors of a company, except this is sort of not an official board. There are no term limits. You're not signing on to be a member of the board, but it's this concept of the people that are your go-to people. When you have questions, when you need to fill in some of your gaps.

Now someone can be your finance person, someone can be your person that you talk about challenges in your personal life. Someone could be the person that you go to when you're negotiating a contract or a new position. You know, people have different skills and so. There's a graphic in the book of this being a round table, always with an open chair.

So growth mindset. There are always more people that can come onto your board, and some people are with you for one event in time, and some people are with you for a lifetime. And sometimes you can predict, sometimes you can't predict. And by the way, roles change and emerge. Someone, sometimes someone's a friend, then they become a member of your board.

Sometimes someone is a coach or a mentor or a sponsor, and they take different hats, different times. Sometimes it's flipped and you become that for them. These are relationships. That you invest in. They're not transactional. You really care about them. They intentionally and really care about you and want you to succeed in your professional journey.

So back to the personal board and conflict. I often call upon board members to either run scenarios by them. To get their input. And if I know that I'm entering in what is called a difficult conversation, and I think at the crux of conflict in the workplace is avoiding difficult conversations or not knowing how.

To have it being fearful that we're not gonna do it well, and again, avoiding it. And so the personal board of directors is key because you can actually talk to them about your fear, about your stress and role play. I love the role play and I'll say, you know, can we role play this conversation that I need to have tomorrow?

And again, these are board members that are like, as long as they have time, you know, then they'll say yes. And I have found that the more I practice and role play those conversations. The better they end up happening and rolling out and everybody feels better and it's because we all want them to go well, and we fear them going poorly.

What I think as I've al already shared, is avoiding them is not a great idea and, well, one tactic that I ha I worked for a leader who basically handed off a difficult conversation to me kind of. Framed it as this is gonna be a really good leadership opportunity for you to practice this conversation.

And I was like, oh, that sounds great. And then literally as I was conducting this difficult conversation, both the person and I realized real time what had happened, that this had been handed off to me. It really didn't involve me. And at the end of the day, it negatively reflected on that leader. Because it was exposed.

So I don't think handing off these conversations is a good tactic by any means.

Lillian Liang Emlet: Yeah, it's one

Resa E Lewiss MD : Yeah.

Lillian Liang Emlet: where I think conflict avoidant personalities and conflict avoidant leaders are the least effective because. The people below you feel that you have that, that you won't advocate for them when times get tough and be able to do the right thing by them. So you really have no political capital and also emotional capital.

And then the other thing, there's so reason that can just be fixed really quickly with a quick little, just, Hey, what's going on? You know? And like then nothing ever festers you. You can actually diagnose problems within your own person. And it's really interesting that. Conflict is always, to some degree a perception problem too. There's always so many more layers of truth underneath from both perspectives. And often there's fantasy things that we've told ourselves and perpetuate and, and fester inside a group or a team rather than just talking about it frankly, together as two adults trying to work together, have a cordial relationship and how can we make this, how can we make this work?

Resa E Lewiss MD : Yeah

Lillian Liang Emlet: it is fascinating to me how often we are conflict avoided.

Resa E Lewiss MD : we have a chapter on polished communication and what you just shared. All of which I agree with reminded me of sometimes figuring out the best medium for communication. And a lot of times people will be like, well, I emailed them and I emailed them. I emailed them well. I'm like, well, you know, sometimes it's a time for an in-person conversation or why don't you call them?

And, you know, sometimes I feel very generational that I talk about phone calls. You know, also that's, you don't always have to schedule the phone call. You can just kind of. Call someone, even though again that over time and generationally, some people are like, wait a minute, you just call people without like setting it up.

I'm like, you know, you can do that. You know, they know you can. But my point is that sometimes we get stuck on a medium and a mode of communication and sometimes stepping back the power of the pause. And we talk about this a lot in the book, pausing. Pausing before reacting. Pausing if something is not working, and trying to figure out why.

And so in this example that I, I'm sharing now is if email is not working, well try another means of communication. And to your point, you could pick up the phone and solve whatever you've decided as a major conflict in a minute, and you're done. It's, you know, a lot of times things don't have to be a big deal.

Lillian Liang Emlet: Yeah, it is, it is pretty fascinating that we're all often so, so afraid to just ask. And so I'm, I'm wondering, you know, in your personal board of directors, do you see a role of how coaching can help leaders notice and strengthen their micro skills, especially around this self-awareness communication piece?

How does, how do you see that, aside from the role playing, do you think coaching can have any kind of role? I.

Resa E Lewiss MD : 100%. Yes. No question. And I think, you know, there are formal coaching relationships and informal coaching relationships, and I mentioned the example of writing. You know, in a way, any friend or colleague who agrees to read a draft of something I've written, I've written. Is a writing coach. They're giving me feedback.

They're offering edits. They're posing questions. You know, it's another set of eyes from a person that has a different perspective. So that's an example of coaching. You can get writing coaching. One of my first exposures to something that I think is exquisitely powerful. Speaker coaching came when I gave a Ted Med talk in 2014.

They assigned me a speaker, coach. I didn't even know there were people called speaker coaches. But then after TED Med, I was a part of smack the conferences that were based

Lillian Liang Emlet: Yep.

Resa E Lewiss MD : out of Australia. Again, I was assigned a speaker coach. I, I thought it was such a brilliant concept that with a group of people, we started creating a speaker coaching program at some of the other groups I've been a part of most recently Scoff, which is the Society for Clinical Ultrasound Fellowships.

We actually wrote a piece about it in an online blog for medical educators about how to create a speaker coaching program. And the reason I wanna highlight is. It is so powerful. Like you don't even, you didn't, you don't even realize you needed it until you get it and you're like, oh my gosh, my talk is so much better.

Even for people that think they're amazing speakers, every, every speech, every talk could be better with a speaker coach, and I bring it up because this is not for just early career people. Often it's senior. Career keynotes or mid-career plenary speakers, they too are assigned a speaker coach and they're like, wow, I never thought, I thought I was just giving this talk for free and I wasn't gonna get any sort of quote benefits.

And next thing you know, they have someone who's working with them to give a better talk and the learning points from that experience, they can take forward to all the talks they give in the future. So I mean, that's a very literal. Coach, writing coach, I gave the example of speaker coach, you know, in the work that you do in terms of professional development and leadership coaching.

I think again, if you are working with someone who you respect and who respects you, you know, who is really there to help you on whatever professional. Skill, habit, you know, overwhelming task you're working on. You know, they say you can get maybe there faster alone, but better together. And that's true in terms of even whatever you're working on for yourself, because none of us are working alone.

None of us accomplish things alone. Healthcare has been slower on the uptake or late to the party of coaching. I first heard about executive coaching and professional coaching from friends who are in business and in business consulting. In fact, at one point when I was sort of in a fork in the road of my professional journey, one of my friends said, you know, why don't you work with a coach?

And I remember saying to, and she's one of my best friends. I was like, you know what? I don't know of any physicians that have ever worked with a coach. Now, granted this is over a decade ago, and again, the culture in healthcare has changed, but I started asking around and sure enough, again, in the business world, many people were working with coaches and changing positions and all this other stuff.

I actually asked some of my healthcare, my doctor, physician mentors, have you ever worked with a coach? Have you ever hired a coach? And they were like, no, no, no, no. And I think a little bit it, it was this rugged individualism, but I think what I realized is they get it from each other on their personal board of directors, but they just hadn't highlighted that that was where they were getting their source of help and input.

Lillian Liang Emlet: Right. That's a really, that's a really insightful summary of, I think the challenges we've had in general in healthcare that is still reserved for the executive and the highest levels of leadership as investments for an external coach to come work with someone's career in their professional development as you, you know, navigate the different positions.

I think some women leadership. and some MBA programs do have them embedded as specific opportunities. So different from the business world where all throughout the life cycle of your career, you have access points to career coaching, life coaching, leadership, coaching, like all different types of niches in the business world.

And you're right. For me, the reason I even knew that this was potentially a viable career fortunately in some women in medicine circles that I was, you know, you know, just mentoring circles. They mentioned, like, I was like, well, how did you get to where you are now? I mean, he's obviously C-suite at this point. She said, I had, I have a executive coach. I'm like, oh, there's a thing. and then every single higher level. You know, on national circles, national panels. How did you get to where you are? Their answer. Oh. Started to become, oh, my business friend told me about executive coaching, and so I'm like, huh, the next thing you know, here I am many, many years later, realizing it's a magical place that we as educators. To have this as one of our core skills. We just never really named it as such. And now fortunately, there is so much more development and so much work being done from the Institute of Coaching and other physician coaches in the different ways that we can help people in academic coaching versus leadership versus executive. So there's all these different opportunities.

Resa E Lewiss MD : I'd like to add that when I have friends say to me, you know, I'm negotiating a new position

Lillian Liang Emlet: Mm-hmm.

Resa E Lewiss MD : a new job, you know, what are some of the things that I can ask for, I should think about in terms of negotiating? Because just like you know, navigating the workplace, what you can ask for or what is negotiable, you often.

Don't know because it's not always shared with you. But I always say to friends that ask for my input, remember to ask for negotiate a coach, an executive coach, a leadership coach for 12 months, 24 months, and you know, it's not always available. And you're not gonna always get it. And ultimately when you are negotiating, you end up prioritizing what is most important to you and what is sort of a, you know, I can leave that if it doesn't happen, but most people don't realize that that is something that you can negotiate and ask for.

And I would say also you should make sure that you have a say in who that coach is. Sometimes they'll say, oh yeah, we have an institutional coaching program. We can assign someone you internally, but you want someone with whom there is psychological safety. With whom there's some organic comfort and ability to build that professional relationship, but also to make sure that there's a confidentiality.

But remember whoever's listening, whoever's watching you can negotiate and ask for a coach for your professional journey and to be better.

Lillian Liang Emlet: How bad I do. We do find that the internal,

Resa E Lewiss MD : internal

Lillian Liang Emlet: programs are wonderful and I don't want to I mean, I think the amount of work that's been put in to make internal programs, internal relationships really great, is really important. I think those are all necessary. And also we have found that external. Coaches are really important as soon as you hit a some moderate level of leadership position because of the trust and ability just to lay it all on the line because, you know, we all have to acknowledge that leadership is talent. And so that talent could potentially does require external. Development that to make it even better for the organization to bring an additional non insular sort of perspective to that organization. So organizations that are smart do invest in external coaching, and so people do have more negotiated power than they realize. And you're right, I personally have never negotiated that.

I personally never recognize all the things that you're, you're mentioning as possibilities. And so I. You're, you know, talking with you is really a breath of fresh air. And that hopefully we can take this to all of our different fellowships and residency training programs to have medical educators recognize that there are so many ways that you can help and that people can be helped through their career. You know, between mid and senior positions especially, you start to, you know, the room starts to get smaller. You don't know where else you're going to get your information, right. When you're, when you're younger, there's lots of people you could ask for guidance. Give me your opinion, help me think through something.

But then as you get higher and higher, the room gets a little smaller. There's, there's less and less people, which means diversification of where you get your information is really important.

Resa E Lewiss MD : In one caveat, you know, I end up speaking with a lot of friends. I'm at the age and stage that people are getting interim leadership positions, like interim chair positions, and just a reminder that even for those interim positions, you can negotiate, you can negotiate salary, you can negoti, negotiate a start time, and you can negotiate.

A coach because you're stepping into a new leadership position, and often you're gonna be straddling the old leader and whoever's being hired for the new leader. So people inherit sometimes a mess. And so to set yourself up for success, if you're negotiating an interim position, ask for a coach, ask for a coach.

Lillian Liang Emlet: I love that. So I'm also wondering, you know, how do micro skills intersect with wellbeing and preventing burnout, especially for leaders that are beginning, you know, when you're junior. You do a lot, you do a lot of the work, and it just seems like a, and you're not sure exactly how you can say yes or no to certain things.

And even if you have great boundaries and you're pretty efficient and very organized how do, how do the micro skills help with the wellbeing portion of things.

Resa E Lewiss MD : It's almost as if you're an audience plant. Oh, wait a minute. You are an audience plant. Are you? Meaning, you know, you're asking like you've read the book. You know the book. So intentionally our chapter one is Micro Skills for Self-Care because Industries Healthcare Prime Example, does not teach us how to take care of ourselves.

It does not model it. It does not laud it. It does not reward it. So. At the end of the day, these institutions are bigger than we are, but, and this book reminds the reader that you have agency and that if you don't take care of yourself, nobody else will. And emergency medicine, you probably know, has some of the highest rates of burnout and the lifestyle does not set itself up.

For one, to be able to take care of oneself. And, you know we have actually written about ways that you can start taking care of yourself. Emergency medicine, for example, I have worked at places where there's no time for a break to eat. And in the book I write a story about you know, I saw my colleagues be able to go a full shift with an aunt without eating or drinking anything.

And I tried it. I thought, oh, I can do this too. It's strong. And then I literally realized it, like the six hour mark. I started getting a little sweaty and a little like shorter tempered with myself. I wouldn't, you know, I'd keep it in check when with my conversations, I was like, Resa, what's, I'd have these, these dialogues, Resa, what's going on?

And then I was like, you're hungry, you haven't eaten. So I would speed, walk to the coffee shop, get a bagel. Get a small coffee. By the time I sped walked back, the bagel was inhaled and I had the coffee for the rest of the shift, but I realized I could not go without eating 8, 10, 12 hours. And so, but that's just to say that many of, of the emergency department workplaces are not set up to eat sleep.

You know, it's sort of, back in the day it was considered strong to not have to sleep and to, you know, stay up. All night, overnight, do a full day of clinics and then drive home. And I've also shared that like I have done many an overnight shift where I have hoped when driving that I didn't hit any stop signs or any red lights, not hit them, but like they didn't come on my driving path so that I wouldn't have to stop because if I stopped, I may not off or it's like funny, not funny.

When I lived in New York City if I sat down on the subway, it was just. Bad outcome. I often would wake up in Queens and miss my stop in Manhattan. And so, you know, sleeping and sleep health you know, I have a very broad definition of health. I of health. I consider financial health, social health, emotional health, you know, all these different kinds of health.

And so, no one is coming to save us if we don't take care of ourselves. Nobody will, but those people listening who are in leadership, you can model it. You know, you can model when emails come in and out of the inbox, you can model whether or not you ask for things in off hours, meaning after work hours, weekends, holidays you know, we have choices that we can make.

And when we're in the leadership positions, we can actually model. What is acceptable and respectful cultural practices and you know, it's more than just eating and sleeping. But it's some of those other things I mentioned. The final thing I'll say is calling in sick. When sick.

As physicians, we do have sick days.

We do have a sick benefit, but. It was considered not cool, not strong. You don't do that. And all of us care about our team members, right? So we don't wanna put extra workload on our team members. But at the end of the day, if we're sick, we're not our best selves and we probably should not be working and taking care of patients.

And in a way, COVD really changed the culture around that practice because, you know, guidelines. Required that if we were infected, you really did have to stay home and you couldn't go to shift. So just opportunities for the workplaces to get better.

Lillian Liang Emlet: Love that. So I guess I'm wondering if you had to pick one, one outta those, like there's like a thousand in here for the leader to really take home. There's one for the leader to start with. would you, what would you recommend?

Resa E Lewiss MD : Yeah, you know, I give talks about this book and about navigating the workplace in many places and at the end of the talk I have a QR code and I ask audience members to, you know, what's one thing, what's one thing that you really liked about the talk Or one positive? And the reason I ask this is so I know what to make sure I carry forward and make sure I talk about, you know, in subsequent talks and the one that comes up a lot.

Is psychological safety and. Kind of like what I, what I said, you know, you know it if you've experienced it. If you've ever worked in a workplace, in an environment where you don't feel safe, where you feel like you can't speak up, that a new idea is gonna be met with negative consequences, if you've actually been the object of retaliation, you know, then you know what it's like to not feel psychologically safe.

Those of you listening, watching, if you have no idea what we're talking about, then you know, number one, read the definition about psychological safety, but know that you know, if you look at Harvard Business Review or Fast Company, you know that if you are in a leadership position and you have the ability to create psychological safety for members of your team, then you should do that because you'll get higher morale better.

Product, workplace, product, whatever that is, and you will less likely have people leave. But if you're not intentional and active in creating a workplace environment that's psychologically safe for people who are working, then people will leave. And people won't tell you honestly how they're doing, and they'll avoid conflict and they'll avoid difficult conversations.

And you may never know what you can do to actually create a safer, better, more equitable, more respectful workplace.

Lillian Liang Emlet: I love psychological safety. All of us in the sim world, we try to do that as much as we can, and so that's a

Resa E Lewiss MD : another episode

Lillian Liang Emlet: That we can get into another time. But thank you Dr. Lewiss so much for coming on the podcast. And again, everyone please go out, get your copy of micro skills no matter what industry you're in, but especially for healthcare professionals, this book is like a love letter to your leadership journey for all the little things you're gonna need for the next couple decades.

And I think both of us, you know, a lot of the reason why I started transforming is because I want people not to leave healthcare. This narrative of people leaving. Was heartbreaking to me because there are so many people doing great work and there are moments of joy. You just might not be able to see it sometimes when you're burned out.

There's so, such a different way that we could live and these micro skills help you get there through the practical, tangible advice to get you there in coaching, we're the sherpa on the side to also help you get there faster. So thank you so much Dr. Lewiss. Is there anything else you'd like to share with our audience for how to work with you things you're promoting right now or ways that they that someone could help amplify the message of micro skills?

Resa E Lewiss MD : Thanks for that question. Super generous. First of all, thank you for the invitation. I've loved our conversation. I welcome people to reach out, whether it's LinkedIn or I have a website and it's all versions of my first name, my last name with or without an md. So Resa Lewiss md.com, and you know. Reach out.

I'd love to hear from you. I'd love to work with you. I'd love to collaborate with you and figure out just how to get you to a better place and you know, figure out how to create healthier, better healthcare workplaces.

Lillian Liang Emlet: Awesome. Thank you so much. And everyone, please feel free to link it. Leave us some comments in below in the Apple Show notes or on the YouTube channel. We'd love to sort of hear again. Dr. Lewiss has mentioned, what's the one thing that resonated for you from this? Podcast because that way we know.

So just leave your comment below. Thanks everyone.