Why Relationships Are the Real Foundation of
Physician Wellbeing

Transforming Healthcare Coaching Podcast — Episode 82: Relationships as the Real Foundation of Physician Wellbeing. Host: Lillian Liang Emlet, MD MS CHSE CPC ELI-MP. Guest: Lisa Muehlenbein, PhD, NBC-HWC (Founder, The MedLife Matrix).

82. Relationships as the REAL Foundation for Healthcare with Dr. Lisa Muehlenbein

Lisa Muehlenbein, PhD: So when I started my PhD, I noticed that there was

a mountain of information

on how burnout affects physicians, but almost nothing for the people who share their lives. So that's why I focused my dissertation on the spouse perspective. I wanted to understand not just what burnout looks like for the physician, but what it feels like to live with someone who's burning out

from the perspective of those people who are really deep in the trenches with them and you know, everybody studies the fire, but I wanted to study the smoke and you know, that's really where the human story lives in this scenario

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Lillian Liang Emlet: So we are super excited to have Lisa on. Dr. Muehlenbein, she is of "The the Medlife Matrix," and we're gonna talk a bit today about

'why relationships are the real foundation for healthcare.'

And, Lisa, let's get started. I'm wondering what moment or pattern first convince you that relationships are foundational to the physician wellbeing? That's the actual problem is the, is the relationships.

Lisa Muehlenbein, PhD: Right, Right. So I've been with my husband Steve, who's a radiologist for 28 years, but I've literally been married to medicine for 26 of those years. So I've lived the long hours, the emotional exhaustion, the missed birthdays, and the milestones. And I've had an opportunity to see how burnout can quietly erode the connection at home.

So when I started my PhD, I noticed that there was a mountain of information on how burnout affects physicians, but almost nothing for the people who share their lives. So that's why I focused my dissertation on the spouse perspective. I wanted to understand not just what burnout looks like for the physician, but what it feels like to live with someone who's burning out.

From the perspective of those people who are really deep in the trenches with them and you know, everybody studies the fire, but I wanted to study the smoke and you know, that's really where the human story lives in this scenario.

Lillian Liang Emlet: And so often invisible, you know, as a program director and a director of the wellbeing curriculum for my own trainees, I know that theoretically we need to surround with community, have friends, have social connections. I try to get the partners involved or the spouses involved. And yes, sometimes it's hard, right?

A lot of times you're transplanted, you have little babies at home and it's hard to make new friends. And so I'm curious , you know, from your vantage point as a longtime medical spouse, what were some of those inflection points or those you know, challenging moments, like now the way you look back as a, as a PhD and you're like, those were the places where we might be able to have you know, something different moving forward.

Lisa Muehlenbein, PhD: So I really wanted to focus on the spouses of physicians because these are the people who, until now they were invisible in this 'burnout research'. So using "Bulger's Crossover Theory" as my framework I explored how these stressors transferred between the partners, between the physician and their spouse, and how the relationships that they have can either amplify or buffer that strain.

So during the process I did semi structured interviews with female spouses of male physicians across various specialties and at different stages in their career, but they were all attendings for the last five years, so I get asked all the time, "Why this specific demographic?" And there's actually several reasons.

So the first reason that I went with female spouses of male physicians was because during the study that I did, which was in 2024, we have had an increase of females in residencies in medical schools. But when we look at attending physicians. The male physician with a female spouse was still the greatest population for generalizability.

And so I wanted to interview these spouses of these physicians who had been practicing at least five years at that time to encompass the pre, during, and semi-post COVID years and specifically attendings because when you're an attending the entire weight of everything is on your shoulders, whereas when you're a resident or a medical student, you still have that safety net of your attending.

And those demographics, the medical students and the residents, they have additional complex stressor, stressors of their own and a high burnout rate among them. So they really need their own study too. But then I looked at layering and multiple coding cycles when I was analyzing the data so that I could ensure rigor in this study.

But really one of the biggest things that it kind of came out of it was that burnout is contagious, but so is compassion. And understanding that dynamic was really key to showing how couples can either spiral together

or they can heal together. So their connection that they had when burnout was high was really almost like a predictor of how they would kind of fare long term.

Lillian Liang Emlet: That's super fascinating and I would say that probably, I mean, when I burned out was also the first five years

of becoming

an attending, and so you are right. That's also when you're supposed to be the most productive and

you're supposed to

be doing all of the things and you're supposed to say yes to all the committee work. And so I can see how to keep things homogenous and have the most numbers of potential people to

interview.

Only that would make sense for you to, to choose that that, that time. And so they seem more similar

Lisa Muehlenbein, PhD: Yeah.

Lillian Liang Emlet: Compared to what you said, there's just so much more variability in the diversity and the lived experiences in, in training.

That's something you can't control for, you can't control

Lisa Muehlenbein, PhD: Right?

Lillian Liang Emlet: the way the program gives out the rules. There are probably more homogenous rules as an attending.

Lisa Muehlenbein, PhD: Yes, exactly.

Lillian Liang Emlet: I'm curious if it's okay to dive a little bit deeper into more like the, the sort of negative ways things filtered in.

I'm curious

what were the ways that the spouses describe burnout leaking into the marriage? Like what kinds of things related to either communication or maybe emotional availability?

Lisa Muehlenbein, PhD: Yeah, so that was that was really kind of one of the highlights of this whole process for me, was actually being able to conduct these interviews and sit down with these women who were being really vulnerable and sharing their story with me. They were amazing. But these spouses described burnout really as a slow leak and that it kind of seeps into their communication.

It affects their intimacy.

And you know, some of them reported physical health symptoms and many said that they felt like single parents, but with a married title because they were doing everything for the family, all the domestic responsibilities fell on their shoulders. And when something went wrong, it was always their fault.

And you know, there was a lot of emotional distance, irritability, and resentment. These things became common undercurrents in what I was hearing because, you know, burnout doesn't knock on the door. It just kind of like moves in quietly

Lillian Liang Emlet: Yeah, it does.

Lisa Muehlenbein, PhD: Yeah, it does. And then the next thing you know, it's like, it's there.

Lillian Liang Emlet: Right.

Lisa Muehlenbein, PhD: But, you know, one of the, the positive things was that there was also a lot of hope in the voices of these women and when these couples recognize what was happening, they could shift from a "me versus you" to the fact that they recognize that they were on the same team and the narrative kind of shift to it's now "us versus the problem."

And that awareness was really a turning point for them and really having that awareness is the first antidote. So you know, once the couple names it, they can navigate it together.

Lillian Liang Emlet: So amazing. Because it's often what the same things we say with our individual clients, right?

Lisa Muehlenbein, PhD: Mm-hmm.

Lillian Liang Emlet: what awareness then allows you to be able to figure out what to do next. And then

if you can name it, you can tame that emotion. And so it

really interesting

how, you're saying that happens even in the diadic relationship of being a healthcare spouse.

Lisa Muehlenbein, PhD: Yeah. Absolutely.

Lillian Liang Emlet: You know, it's

Lisa Muehlenbein, PhD: It's funny because

Lillian Liang Emlet: wonder whether they, you know, partners in healthcare really don't get a crash course in any of this, right?

Lisa Muehlenbein, PhD: no.

Lillian Liang Emlet: from, from our perspective, we get to teach and tell the, you know, physicians, physicians in training, there's all kinds of you know, anti burnout or burnout help or wellbeing help for your career and professional development. There are no programs that invite the spouse in to the healthcare sector or allow them to really be the first line of defense. And yet they may be the little canary that helps right. Helps the minor get out. And so I'm curious, you know, if we had to leverage this counterintuitive, the spouse is probably the most important aspect, what kinds of things do you think could be helpful for, for spouses?

Lisa Muehlenbein, PhD: Yeah, so I'm really glad that you asked that because the data suggests that the spouse is really the physician's greatest tool against burnout. So when we're talking about burnout, mitigation strategies. The home, the family, the spouse is really the foundation. But for couples who practice connection in what I like to call micro moments, these little tiny intentional acts that say that we as a couple are relationship matters.

They fared the best. And so when I talk about micro moments that matter, I'm talking about things like sharing a cup of coffee together, taking a brief walk, and even setting boundaries around post call decompression and knowing that okay, you know, physician gets some time before you know, entering into family life, they need that transition.

And I was just reading Brene Brown's new book of Strong Ground and she talks about locks in like the river systems in London and talks about how it takes so many hours for the lock to get at the right level to open and let a boat through. And she talks about how this is the same for

families and for this, for like a partner coming home from a stressful day, you know, hopefully it's not gonna take hours like a lock does, but that transitional time period, we need time to kind of shift those gears. And so kind of putting some boundaries around that and knowing that this person has just come in from a stressful day, not that the spouse at home hasn't had a stressful day, but that we each kind of need time to decompress and to assimilate into, into that transition into the new space.

And so you know, one of my favorite strategies, for these little different connections is called what I call a "10-minute Touchpoint." So just 10 minutes a day of undistracted connection where there's no phones, there's no charting. So what the AMA refers to as 'pajama time' when the physician is working at home after hours.

Nope. No charting, no pajama time, no problem solving. Where we're you know, talking about how we're going to solve our marriage's biggest problems, but just connecting. Just 10 minutes to listen to each other. To, To really hear what the other person is saying without trying to fix it. Because a lot of spouses said, you know, the physician is experiencing this and "I wanna fix it for them.

I wanna help them, and I can't."

So there's no problem solving happening here. You're just listening. You're just connecting. And you know, like you mentioned earlier about, you know, name it. So remembering that we can't fix what we don't face. So you can't face what you don't name, right. And so connection is so important and it doesn't require hours.

I mean, yes, lovely vacations where you can get away with no kids and just the two of you. Those are wonderful. My husband and I, we, we love those. We didn't get them in the early years, but now that our kids are older, it's great. But connection doesn't require those hours. It just requires intention. So when couples can commit to that, even just a few minutes can start to shift everything.

It's just a little micro shift.

Lillian Liang Emlet: Love that, you know, so I obviously only teach the physician side of things, and so I

Lisa Muehlenbein, PhD: I.

Lillian Liang Emlet: combination could really be great. The micro moment that you have at home with intentional partnering with your partner. Also, I always tell our physicians that as you transition out. When you should do your gratitude practice your breathing, your meditation is in the car in transition.

No one's gonna fault you for 10 minutes in the car by yourself. Just take a moment, journal, reflect, breathe, appreciate, just decompress for a second. Like you're allowed to have 10 minutes to yourself. And what you're saying is you're giving permission and prescription to couples where then you also, as you transition in, you both 10 minutes get used to just being with each other again.

'cause you're now taking on a new role and new identity, right?

Now you're in a partnership,

Lisa Muehlenbein, PhD: Yep.

Lillian Liang Emlet: you're in at home, you're with your kids, you know, whatever. Use those transition times really intentionally. So that's 20 minutes of really fully trying to get out of your own head from what you were doing and now being with what you need to be.

Lisa Muehlenbein, PhD: Right. And you know, for couples who have small children and other demands, you might only have 10 minutes total. And it's like you each get five, but you still get that time and you start to look forward to it. And I think that people, when they start to look forward to something and they make it more intentional, then they'll start to notice that, you know, these little habits start stacking.

We all know, you know, habit stacking is a great thing for you know, making progress, but. They'll notice that they're able to get 10 minutes in the morning and then 10 minutes at night or 10 minutes after bath time. Or maybe there's 10 minutes between cases that you can send, you know, your loved one, a text at home to, just to let them know you're thinking about them. And you, you know, just these little micro habits add up.

Lillian Liang Emlet: I love that. You know, so I also can see like this is probably the reason why people love having a dog that could grieve to them at home because, you know, you sort of distract. They, they, they, you know, they need to be walked. They need to get, you know, get some fresh air, some exercise,

Lisa Muehlenbein, PhD: Yep.

Lillian Liang Emlet: tail wagging.

And so if we all could be the better puppy for each other,

Lisa Muehlenbein, PhD: Yeah.

Lillian Liang Emlet: we're able to just bring a little bit of joy and just make that transition a little bit easier. And to be there for each other because we we're just being present, right? If we think

Lisa Muehlenbein, PhD: Yes.

Lillian Liang Emlet: brings us so much joy, aside from walking outside and being in nature, it's also just being, just being.

Lisa Muehlenbein, PhD: Yes. Yes. Mine is laying under my desk right here.

Lillian Liang Emlet: That's amazing. That's amazing. know, so I guess I'm also curious if we move it to the leadership side of

things

A lot of times we don't bring, even the fact that we have a partner uh, or a spouse into our work negotiations, our work conversations, you know, so for leaders, if relationships are so foundational to the health of your team, of your individuals, the people that work for you of.

What's the most practical change that you think for chiefs and bosses, chief wellness officers to be able to normalize a very spouse, inclusive education or be able to provide more supports, for people who are married.

Lisa Muehlenbein, PhD: So the first thing is awareness that there's a problem.

80% of the factors that contribute to physician burnout are attributed to organizational issues, so we need to keep that in mind. But if medicine truly wants to address the issue of physician and practitioner burnout, it has to treat the physician family. It has to treat that family unit as one system.

And what that means is spouse inclusive education, partner coaching and a schedule that's designed to actually allow for recovery and connection. So we know physicians work on average you know, more than the general population, 60 hours a week plus. You know, and, And I know my husband will, he works a nine hour day, but he also gets up and he works before he works after if I have something going on.

It's just who he is. And I think sometimes these physicians, they can't get it they can't, they have a trouble kind of turning off their brain.

But you know, I talked earlier about like the the not 'me versus you,' but 'us versus the problem.' And thinking of it as we're all on the same team. So if we think of medicine as a team sport, the home is part of that team.

So when organizations recognize that everybody wins, burnout decreases retention, improves, family satisfaction rises, and you know, when burnout decreases, there's less medical errors and more patient satisfaction and less lawsuits. So it's like winning all over. So I think it's important for organizations to be aware that healthy families don't just support healthy physicians, but they help to sustain healthy organizations.

Lillian Liang Emlet: That's like, I need to take that and just make a quote out of that because, so I do think, I agree that leaders, and this is why

we're transforming.

We really are see ourselves as a leadership plus wellbeing coaching company because if we don't think about wellbeing first, and so for you with medlife Matrix is really about making the family unit

Well and healthy,

that's so foundational to be able to have clinicians to be able to perform and do their job and be healthy and happy and whole when they show up at work. What we're saying is leaders need to be measured. By how well they support the family unit, which means actually having conversations and not being afraid

Lisa Muehlenbein, PhD: Yeah.

Lillian Liang Emlet: asking the really scary questions or how are things at home.

Lisa Muehlenbein, PhD: Right.

Lillian Liang Emlet: always very pretty at home actually,

Lisa Muehlenbein, PhD: No.

Lillian Liang Emlet: people are really afraid to talk about it, and it's really to find a good friend to be able to talk about these things. there's, we don't even know where the resources are. And then

Lisa Muehlenbein, PhD: Right.

Lillian Liang Emlet: you get pushed off to EAP only when you need therapy or counseling. But, there are

so many things that can be done proactively as a cultural standard in our

Lisa Muehlenbein, PhD: Our teams and

Lillian Liang Emlet: with team building is to get

our get to know our family. Right? Do you even know your colleagues, number of children, major life events they're happen, you know, they're happening. All those types of things do impact, you know,

Lisa Muehlenbein, PhD: Desire to work, ability to work,

Lillian Liang Emlet: and you know, honestly, also how

Lisa Muehlenbein, PhD: how much you really could step up,

Lillian Liang Emlet: Step up

Lisa Muehlenbein, PhD: step up and do more projects.

Lillian Liang Emlet: Because if you're going through a huge transition and you're about to launch your kid and graduate right from high school, it's a busy time of the

Of the year. You're not

able to do another huge heavy lift in the group.

And so as the group knows, then they can all help each other grow

Lisa Muehlenbein, PhD: together

Yeah. Yes, yes. And so when you think about the team dynamic, you know, if you, my husband loves sports, right? And so when you think about like a football team, right? We're we're right in the midst of football season. So you've got the offense, you've got the defense. Each of those has a coach, right? And then there's the head coach, but they're not working against each other.

They are working together to make sure that that team functions like a well-oiled machine. And so when we talk about leaders in the C-suite and in organizations, we need to look at them, or they need to look at themselves as the head coach, and they need to make sure that all members of their team are getting what they need to function properly for the same goal.

Lillian Liang Emlet: I think this is where, you know, if we don't invest in people first, we don't invest in families first. It's no wonder that we often are left with problems later. And so it's, you know, someone was asking me like, what do I think and predict what really needs to happen. I think this whole paradigm shift of people first and the quality of the, of what we're experiencing. Because then we can stop this cycle, right, of what we're talking about.

You and I are talking about that the 80% is the organizations that a lot of this is, we've falsely constructed and told ourselves we shouldn't talk about these things when let's, why don't we have a conversation? Why don't we have team building and have leaders that want to make our our teams more?

Well, because I mean, nobody enjoys recruiting and firing and hiring and all of that. No one likes staff turnover when you have a really stable group. That's what actually everyone wants.

Lisa Muehlenbein, PhD: Yes, that is more attractive to an incoming or potential hire. Like to know that they're coming into a culture that supports wellness or wellbeing and is going to support them. Hands down. Yeah.

Lillian Liang Emlet: right. And it's funny because it's, it's a easy, it's a, it's a easy recruitment, right? Like they can

see it. They

can feel it. All it takes

one meeting and then it's like, and then it's done. And so you

Lisa Muehlenbein, PhD: Yep.

Lillian Liang Emlet: that those who are doing really

Lisa Muehlenbein, PhD: Mm-hmm.

Lillian Liang Emlet: to do really well. And those of us who are just putting the financial metrics ahead and like doing the contractual and the industry standard it's, it's just causing more of the same and which is causing more of the the leaks in the system as well. I do wanna sort of transition a little bit about like along these lines, like if we had to paint a picture then for health systems, if they designed that the family physician unit was more core, the leaders were trained in all of these things and we have more resources, we have more coaching. What do you think the culture could look like? Because I also feel like sometimes people can't go there until they can see it and dream it. And so I'm wondering, are there research gaps that you were thinking about? Are there places that you think that can be easy fixes right now that we could do?

Lisa Muehlenbein, PhD: Yeah, so my vision would be that health systems start seeing families. As stakeholders in physician wellness, so imagine orientation programs that include spouses, leadership training that teaches relational awareness, and benefits that truly support the family ecosystem. For example, there is a local business here that is in the biotech industry, and they are

one of the largest corporations in the world, but their head, their headquarters is here where I live in Naples, Florida. And they have childcare for their, their staff. I know some hospitals do have that, but really thinking about how can we support our physicians better because they are the ones that are supporting the

organization and they are the ones that are treating our patients. And so really that's what the MEDLIFE Matrix is all about. When we look at the physician, their spouse, the organization, the patient, it's about helping physicians, their spouses in these organizations rebuild the connection, helping them restore balance so that they can thrive together.

Again, that team mentality of we're working together towards a common goal and thriving together really isn't just a slogan, but really can be a systems strategy. So when we strengthen the family, we strengthen the family of medicine.

Lillian Liang Emlet: Such a beautiful vision. So, which actually leads us into something that we wanted to talk about

together,

which is about our Med Thriving Virtual Summit. Lisa, you're one of our guest speakers at the Med Thriving Summit, which we will put a link in the show notes below for how you can buy a ticket, you know, if you wanna be part of the change Maker Society in healthcare, and begin to think about leading your own life, leading how your relationships can be better, how you can strengthen your foundations so that you can show up better as a healthcare professional.

That's what our Med Thriving virtual conference is about. And so, would you like to give our audience a little bit of a taste or a, a pearl or a tidbit about what you want, what you're gonna be speaking about at the conference?

Lisa Muehlenbein, PhD: Sure, sure. So I'm really happy to be part of this conference and really supporting the work that Med Thriving is trying to do because it's so intricate in supporting our physicians and their families. And so for me, I'm happy to be there talking about how we can support physicians and their families together to strengthen this healthcare system because it really is what we're all here for, but different, different tactics that we can employ to, to really address that, that need address.

How do we address burnout? How do we support the family? What are additional ways that we can support the physicians? What are you know practical skills and applicable techniques that we can use to really make this matrix work, not just part of it, because if it all isn't working, then we're on a three-legged stool.

Lillian Liang Emlet: And so we're really excited that, you know, we, you can fo if, so, if you're listening to this episode and you're like, "Oh, my friend is married to a doctor," or "I have a colleague that she's in my mom group and you know, she's with a pa or she was with a doctor or a nurse."

You can check out our virtual summit because we include everyone who is adjacent and touching because it is with everyone together, but with the organization, the patients society, the physicians, the clinicians themselves, and also the partners, the spouses, those who support all of us in this family. So we'll put all the

links and descriptions

down below when this episode airs. This will be in December, 2025. And so it's a great gift to give someone that you know, and we're super excited to have Dr. William Beam here with us. So any, my last question for you, sort of a fun and quirky one, just what kinds of books or things are you listening to?

What podcasts, what books? You already mentioned one by di dr. Dr.. Brene

Lisa Muehlenbein, PhD: Hi, Brene Brown. Yes, it's right here.

Lillian Liang Emlet: gotten it yet, so

Lisa Muehlenbein, PhD: Yes. Yeah, she's amazing. She's, I've read every one of her books and every single time I find such amazing pearls of wisdom that I just, I just love her so much because she does so much great work for organizations as well. So it, that's, that's really, really important.

And I gotta say I know, I turned 50 this year, and so I've, I've actually become a "Swiftie" at 50 and I am, I'm very much listening to some Taylor Swift - Life of a Showgirl on my on my playlist. And it's really interesting to hear some of the things that I'm like, "Oh wow, that's like medical life."

There's a lot of crossovers. So, you know, the show never ends. You're always keeps going. And finding those little moments away and and getting to like what is on your wishlist and what's really important, and some of the things that you would give up just really to have quality time with your partner and have that connection.

So there's a lot of parallels there. So tho those, that's my book and that's my playlist for, for the moment.

Lillian Liang Emlet: Awesome. Thank you so much for coming on our Transforming Healthcare Coaching podcast, and we're looking forward to seeing you at the Virtual Summit in December. So everyone, feel free to please share this episode with your friends and colleagues. Subscribe to us. It means a lot to us. And feel free if you have things you want us to address for 2026. Email us at podcast@transforminghealthcarecoaching.com and we'll see you next time.

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