Transforming Healthcare Coaching

Episode 109  ·  Wellbeing

Physician Career Change and Neurodiversity in Medicine:
The Gifts That Were Hiding in Plain Sight

With Krystal Revai Sodaitis, MD, MPH
Pediatrician, Health Plan Medical Director & Coach for Neurodivergent Physicians  ·  Hosted by Lillian Liang Emlet, MD MS CHSE CPC ELI-MP
Krystal Revai Sodaitis, MD, MPH — board-certified pediatrician, health plan medical director, and coach for neurodivergent physicians

What Healthcare Leaders Will Take Away

“There are other things outside of medicine that are more important that define you.” — Krystal Sodaitis

This episode is for physicians, APPs, and clinical leaders who are either quietly considering a different chapter or trying to lead someone whose mind works differently from theirs. Host Lillian Liang Emlet, MD MS CHSE CPC ELI-MP talks with Krystal Revai Sodaitis, MD, MPH, a board-certified pediatrician who spent years in academic general pediatrics, left for a utilization management medical director role she did not know existed, and now coaches physicians with neurodivergent brains.

The conversation covers two things that turn out to be the same thing. The first is what a career change out of clinical practice actually takes: not a leap, but roughly 15 months of conversations, courses, and certifications. The second is what she found once the mental load of daily patient care lifted — a way of thinking she had been treating as a problem rather than a strength.

By the end of this episode you will be able to:

  • Name the trap — recognize “fail in advance” goal-setting in yourself and in the people you lead.
  • Hear the noise — describe the invisible cognitive load clinical work runs in the background, and what returns when it stops.
  • Use the language — explain neurodiversity, twice exceptionality, and masking in plain terms.
  • Act sooner — offer practical support to a struggling clinician without waiting for a diagnosis.

What Does a Physician Career Change Outside Clinical Medicine Actually Look Like?

It usually starts with a search you make while frustrated, and it takes longer than the story usually suggests. Krystal Sodaitis typed her own title, medical director, into a job board, found a utilization management medical director posting, and knew immediately it fit — and that she was “not anywhere close to qualified.”

What followed was roughly 15 months of preparation: “I began about a 15 month process of talking to people, taking courses, adding certifications.” She was already a medical director of a mother baby unit and specialized in breastfeeding and lactation, and she had been folding managed care into resident rotations because she thought it was missing from academic training. The narrowness was the problem she names most plainly about that era: she knew “academic medicine and pediatrics” and, as someone who had finished medical school, believed those were the only two choices.

Her practical encouragement to anyone in the same place: “medicine does give you other skills” — teamwork, leadership, decision-making, running quality projects — and “you do have skills that will transfer into other industries.” Where there are real gaps, “that doesn’t mean you need to go out and get a degree.” Lillian’s framing of the same point: “our growth isn’t going to be a straight ladder or straight line the entire time.”

Why Do So Many Physicians Never Set the Goal at All?

Because failure has been made unthinkable. “we only set goals that we are reasonably certain that we are going to attain,” Krystal Sodaitis says, and “Very few physicians are willing to go out on a limb, set a goal, take a chance” knowing it might not work.

She has a name for the result: “fail in advance.” The venture you never start, the idea you never say out loud. “we’re just failing beforehand. We’re not even allowing ourselves the chance to grow.” Lillian names her own version of it — “self throttling” — and describes it as “deciding for yourself ahead of time that your voice doesn’t matter.”

The antidote in the episode is not courage on demand. It is a word Krystal borrows from kids: “nervcited.” “You’re nervous and you’re excited.” The people who treat the nerves as a stop sign are the ones who stay stuck; the people who move anyway tend to find, as she did, that “it couldn’t happen fast enough” once the decision was made. Her own verdict on the role she took: “I feel like I found the golden ticket,” because “the job is so well suited for me and for my interests and my personality.”

What Happens When the Background Noise of Patient Care Finally Stops?

You notice it only once it is gone. Krystal Sodaitis describes “the constant background noise in my head about work” — the charts, the bilirubin, the baby, the discharges — and how it kept her from being present in her own life.

In the new role the day ended when the computer closed. She was not thinking about work in the evenings or across the weekends. What returned was capacity: “my brain started to open up” and had room to consider what else might be possible. She took walks in the middle of the day and listened to podcasts without an agenda — not to extract a lesson, but because something would eventually arrive.

Lillian’s read on why this matters clinically: the daily work is a sustained sensory and cognitive load — data, people, emotions, competing projects — that clinicians manage invisibly and are never taught to calibrate. Naming that load is the first step to protecting against the depletion it produces.

What Does Neurodiversity Mean in Medicine, and What Is Twice Exceptionality?

Neurodiversity is broader than the diagnoses most people picture. “neurodiversity is just a term that reflects all spectrums of the way a brain works,” Krystal Sodaitis says, and giftedness sits inside it. Her comparison: “neurodiversity is no less important to our earth than like biodiversity.”

Twice exceptionality is the second half of the vocabulary: “twice exceptionality, which is usually more like multiple exceptionality” — being gifted and also having a disability, whether neurological, such as ADHD or dyslexia, or another kind entirely. That combination is common in medicine, she argues, because getting through training generally requires giftedness of some kind in the first place.

The expectation that does the damage is uniformity. Ability profiles are uneven: a full neuropsychological assessment tends to show some domains in “the far superior range” alongside others where the same person struggles. Lillian raises the term spiky profile; Krystal’s answer widens the frame to neurodiversity rather than narrowing to a definition. Later in the conversation she is blunt about the expectation itself — gifted people are not supposed to be good at everything. “that’s not how giftedness works.” Lillian’s own summary lands in the same place: “Everyone’s a little bit neurodivergent.”

Krystal came to this work sideways. She trained as a coach expecting to use the tools for leadership, fell in love with one-to-one coaching — “a similar way of caring for people” — started with gifted adolescents and young adults, and found that the residents in that age band, and then the neurodivergent physicians who disclosed to her, were the people she wanted to work with.

What Does Masking Cost a Clinician?

Krystal Sodaitis defines it plainly: “Masking is basically hiding your traits or the things that you need to do in order to be able to function in the world.” And it is not free: “masking takes an emotional and cognitive toll” that lands on top of the demands of patient care.

The examples are ordinary and easy to miss. Someone who needs to move, or fidget, or stand instead of sit, or who braces before every new patient encounter because of social anxiety, spends the day suppressing what regulates them. Krystal is honest that this cannot always be avoided: “sometimes there are places where it’s not safe to” disclose or act on those traits. The point is not to demand disclosure. It is to stop treating the trait as a defect: “I’m not bad because I can’t stand and sort of rock between my feet.” The colleague who rocks or paces? “They’re probably just regulating their nervous system.”

The environment is the variable a leader controls. Offer the option to chart standing. Keep a standing-room spot at the back of grand rounds for the person who listens better while walking. Ask what someone needs rather than assuming. As Krystal puts it, the aim is “so everybody can show up at work and do their best work.”

What Can a Leader Do Without Waiting for a Diagnosis?

Act on the difficulty, not the label. Krystal Sodaitis says it plainly: “don’t require a diagnosis in order to put in an intervention.”

The first signal is almost always the same. “It’s usually the people who can’t get their charts done. That’s your first clue.” But the reason underneath varies, which is why one fix does not work for everyone:

  • Condensing. The clinician is not sure how to distill information into a succinct note.
  • Completeness. “Is it that you’re worried that you’re going to miss something and you need to put every single thing in your note?”
  • Starting. “There’s so much that they want to put in. They can’t figure out what are the important points and that causes paralysis.”

Standard advice — here is a template, finish the note in the room — addresses only the first case. Krystal’s suggestion for institutions with the capacity is to find someone willing “to almost become a charting coach,” who can sort out which pattern a person is in and match the strategy to it. Some of that is straight tactics; some of it is coaching. Lillian’s honest note from the program-director side is that leaders wait too long, hoping a different rotation or mentor will resolve it, while the clinician keeps trying and the gap stays open.

Krystal’s script for the leader is short and non-clinical: ask what is going on, and ask whether there is another way. If the pen-twirling is distracting in that setting, “is there another fidget” that works instead. The question “how can you address that? How can you make that situation easier” does more than a referral.

Will AI Ambient Scribes Help or Hurt Neurodivergent Clinicians?

Both, depending on the brain. “It’s not a panacea.” For someone with mild dysgraphia — “something called dysgraphia and it’s the inability to put your thoughts on paper” — removing the blank page is a real gain.

For a clinician with dyslexia, the same tool can shift the work rather than remove it: instead of composing, they now have to read a generated note closely enough to catch errors. Someone who had been dictating and watching the words appear in real time may find the change adds a step rather than saving one. In Krystal’s words, for some people it may “introduce new hurdles that they didn’t even know they were there.”

The leadership implication is Lillian’s, and it is about who is in the room when these tools are chosen: bring the range of users into the design and rollout conversation so “we don’t accidentally create one size fit all solutions,” which is also a fair explanation for some of the adoption friction organizations are already seeing.

Key Takeaways for Healthcare Leaders

A career change is sequenced, not sudden — roughly “a 15 month process of talking to people, taking courses, adding certifications.”
Physicians “only set goals that we are reasonably certain that we are going to attain” — and then call it prudence. That is failing in advance.
The mental load of patient care is invisible until it lifts. In her words, “my brain started to open up.”
“neurodiversity is just a term that reflects all spectrums of the way a brain works” — giftedness included.
Masking is a tax: it “takes an emotional and cognitive toll” on top of clinical demands.
Unfinished charts are the first clue — and “don’t require a diagnosis in order to put in an intervention.”
There is no deadline on the decision: “There are no false starts.”

Frequently Asked Questions

What is Episode 109 of the Transforming Healthcare Coaching Podcast about?
Episode 109 is a conversation between host Lillian Liang Emlet, MD MS CHSE CPC ELI-MP and Krystal Revai Sodaitis, MD, MPH — a board-certified pediatrician who left academic medicine for a utilization management medical director role and now coaches neurodivergent physicians. They cover what a career change outside clinical practice actually looks like, the goal-setting trap Krystal calls failing in advance, what changed when the constant mental load of patient care stopped, giftedness and twice exceptionality in physicians, the cost of masking at work, and what leaders can do before anyone has a diagnosis.
How does a physician move from academic medicine into a non-clinical role?
Krystal Sodaitis found the role by searching her own title, medical director, on a job board and reading a description for a utilization management medical director. She knew the work fit her, and she also knew she was not anywhere close to qualified. What followed was a roughly 15-month build: talking to people, taking courses, and adding certifications until the next posting came. Her framing is that clinical training already gives you transferable skills — teamwork, decision-making, leading projects — and the gaps you still have do not necessarily require another degree.
What does failing in advance mean for physicians?
“Fail in advance” is Krystal Sodaitis’s term for deciding a goal will not work before you attempt it. Physicians, she says, tend to set only the goals they are reasonably certain of reaching, so the riskier idea never gets tested. The cost is not a failure avoided; it is growth forfeited: “we’re just failing beforehand. We’re not even allowing ourselves the chance to grow.” Lillian calls the same pattern self throttling — deciding ahead of time that your voice does not matter.
What is twice exceptionality in physicians?
Twice exceptionality means being gifted and also having a disability — which may be neurological, such as ADHD or dyslexia, or another kind of disability entirely. Krystal Sodaitis notes it is often more accurately multiple exceptionality, because ability profiles are uneven rather than uniformly high. A physician can sit in the far superior range in some domains and struggle in others, and that unevenness is normal. The harmful expectation, she says, is that gifted people should be good at everything.
What is masking at work, and what does it cost clinicians?
“Masking is basically hiding your traits or the things that you need to do in order to be able to function in the world.” In practice that looks like suppressing the pacing, the fidgeting, the movement, or the accommodations a person relies on to self-regulate. Krystal Sodaitis’s point is that “masking takes an emotional and cognitive toll” that stacks on top of the demands of patient care. Sometimes masking is unavoidable, because not every setting is safe for disclosure — which is exactly why the environment matters.
How can healthcare leaders support neurodivergent clinicians without a diagnosis?
By treating the observable difficulty as the trigger for support rather than waiting for a label. Krystal Sodaitis is direct about it: “don’t require a diagnosis in order to put in an intervention.” Unfinished charts are usually the first clue, and the underlying cause varies — difficulty condensing information, fear of leaving something out, or paralysis about where to begin. Ask what is actually happening, offer practical options such as a standing desk or a place to move during conferences, and consider a charting coach who can match the strategy to the person.

Segment 01  ·  00:00 – 02:05

Cold Open and Introduction

The traits she spent a career hiding, and Lillian’s reframe: the map was not wrong, it was unfinished.

Segment 02  ·  02:05 – 04:00

A Tuesday Afternoon, a Decade Apart

What academic general pediatrics looked like, and how narrow the field of view had become.

Segment 03  ·  04:00 – 06:30

The Job She Did Not Know Existed

A frustrated search on a job board, the words medical director, and utilization management.

Segment 04  ·  06:30 – 08:15

Not Qualified Yet

The roughly 15-month build of conversations, courses, and certifications before the next posting.

Segment 05  ·  08:15 – 10:00

What First-Year-Resident Krystal Would Say

Relief that it worked out, and identity that sits underneath the occupation.

Segment 06  ·  10:00 – 13:00

Four Weeks’ Notice and the Golden Ticket

The weight of responsibility on the way out, and the fit she found on the other side.

Segment 07  ·  13:00 – 16:00

Nervcited, and Failing in Advance

Why physicians set only the goals they are sure of, and what that costs them.

Segment 08  ·  16:00 – 19:00

When the Background Noise Stopped

Presence, mid-day walks, and the space that let new ideas arrive.

Segment 09  ·  19:00 – 24:00

Giftedness, Neurodiversity, and Twice Exceptionality

How coaching gifted young adults led her to the neurodivergent physicians she works with now.

Segment 10  ·  24:00 – 28:00

Masking and What It Costs

The emotional and cognitive tax of hiding the things you need in order to function.

Segment 11  ·  28:00 – 34:00

Two Steps: One for You, One for Your Team

Self-acceptance without judgment, and intervening before anyone has a label.

Segment 12  ·  34:00 – 38:30

Will AI Scribes Help?

Dysgraphia, dyslexia, and why an ambient scribe is not a single answer for everyone.

Segment 13  ·  38:30 – 41:55

No Rush, No False Starts

Where to find Krystal, and the closing case for taking the time you need.

Read the full transcript

Transforming Healthcare Coaching Podcast — Episode 109: When the Career Pivots, Gifts Appear with Dr. Krystal Sodaitis. Host Lillian Liang Emlet, MD MS CHSE CPC ELI-MP interviews guest Krystal Revai Sodaitis, MD, MPH, board-certified pediatrician, utilization management medical director, and coach for neurodivergent physicians. Published May 18, 2026.

Krystal Sodaitis: There are other things outside of medicine that are more important that define you. The other thing that many of us face is this mentality that failure is not an option. So we only set goals that we are reasonably certain that we are going to attain. Very few physicians are willing to go out on a limb, set a goal, take a chance with the knowledge that: "I might fail." Masking takes an emotional and cognitive toll that when you're trying to take care of patients, it's going to lead to burnout and depression.

Lillian Emlet: So what if the career you trained for your whole entire life wasn't wrong? It just wasn't finished yet. My guest today spent 15 years in academic pediatrics, fellowship trained faculty position — the entire map. And then one day she stopped and asked a different question, not am I failing? But instead: "What if this was only never meant to be the only chapter, but instead the beginning of many other interesting and exciting things to do with a career in medicine?" What she found on the other side is that pivoting is not a smaller version of a career in healthcare. It's a fuller one, and so she discovered a whole new role she didn't even know existed. She discovered an entire new way to help other physicians in their practice and she's found a way of working that finally fits to fit all of life in there. And so we're really excited to talk about the things that she found hiding in plain sight her entire career, which is the superpower of the way her brain and your brain, and probably many of our brains actually works. These gifts that she's been masking as problems are actually the things that she now helps other clinicians see in themselves. And so if you've ever been telling yourself that you should be happier in this role, or maybe I'm not sure what to do next in my academic career, or maybe it'll be a little quieter about how diverse and rich the way your mind works, this conversation's for you. Stay tuned. I'm so excited today to interview Dr. Krystal Sodaitis, who is a board certified pediatrician who's transitioned from academic medicine to health plan leadership ever since 2013. So that's been a while now. And so Krystal is also a certified life and leadership coach with advanced training certifications and physician coaching. Leadership coaching and also specializes in physicians who also have neurodiversity. And so Krystal, thank you so much for being here on the podcast.

Krystal Sodaitis: It's great to be here. I'm excited. That intro was amazing and I realized like all true. I didn't even see it myself.

Lillian Emlet: Yeah. So before we dive in, we need to go all the way back. So paint us a picture a long time ago, which is probably really hard to remember now, because this is, over a decade ago, a picture of a Tuesday afternoon Krystal, back now compared to when you were in academic pediatrics. I mean, it's night and day I'm sure. So I'm just curious what you've noticed, a decade in this transition.

Krystal Sodaitis: Yeah, I mean so academic, general pediatric Krystal, was definitely much more narrow in her focus and in her view of the possibilities of life. I only knew, two things — academic medicine and pediatrics. And I felt for someone who had graduated from medical school, those were the only two choices. I was looking for ways. I was in an academic practice and in an academic setting where I was not happy. I had some leadership, but my leadership was not really supportive and so I was looking for ways in how to create a pediatric practice that was, was best for me, that made me the happiest.

Lillian Emlet: And so, what was the way you got there? how did you even begin to explore? Because I won't say like 10 years ago, I have to admit, I mean, we at least talk about these things a little bit more frankly, on social media and in other platforms, but these platforms didn't exist over a decade ago.

Krystal Sodaitis: Yeah. Oh no. So really we're talking 15 years ago. like I said, I was in an academic practice. I was the medical director of our mother baby unit. I specialized in breastfeeding and lactation. I was looking at ways to increase the amount of breastfeeding and lactation clinical time I could have within the academic practice I was teaching about it. I was also incorporating other things, one of which was managed care into our rotations because I felt that this was also something that was generally lacking in academic medicine. But as I said, the practice was not ideal for me. The leadership were not people who I wanted to be leading me. And as one does when they get really frustrated, I started a search I probably came up with Indeed back then. I think, I don't know if LinkedIn probably existed, but it's not what it is today. And so I just searched for my title, which is "medical director" into Indeed, and the search provided a UnitedHealthcare medical director, utilization management, medical director which I know for many people is sort of like the devil, the dark side, but for me it's an incredibly interesting part of medicine. And when I saw the job description. I knew immediately that this was the perfect job for me. And that stems all the way back to fellowship. And that's an even longer story. But basically I had had this interest in managed care that was sparked in fellowship, never knowing a job like a utilization management medical director even existed. And once I saw it, I applied but I was not anywhere close to qualified. I began about a 15 month process of talking to people, taking courses, adding certifications so that the next time, and again, there wasn't LinkedIn, so it wasn't, I was, I was looking daily, but I was also talking to people. I was networking even back then, and someone sent me the job description of the job that I applied to and eventually got as my first utilization management medical director.

Lillian Emlet: Yeah. so you really bring up some really important points in just your story. The fact that we often are very uneducated as frontline clinicians through our training because we're so focused on the clinical process of skill development that we don't understand about population-based health, value-based care, innovation, business of healthcare, managed care. We know nothing about these things and there's just not enough time for program directors to put them in. And yet, as a clinician, after what, 15 years, you're like: "I'm a director of something. I've been managing people projects and things for a while, and what do you mean I'm not qualified?" And yet, it's a process. You're like: "fine, let me think about what it is I need. How do I get there? What do I not know? And I think that's the one thing we often forget about is as clinicians, is that our growth isn't going to be a straight ladder or straight line the entire time." That ended basically as soon as you graduated. And then from there, it really is about the projects, the people, and diversity of the experiences you have. And so I think. You know that story alone is really important for people to hear that, to go out and look for these things.

Krystal Sodaitis: Yeah, absolutely. And know that medicine does give you other skills, working as a team, being a leader, having to make decisions working on projects, especially if there are quality projects, you do have skills that will transfer into other industries and you may also have to develop other skills and learn other things. And that doesn't mean you need to go out and get a degree. But you can continue your education in other ways.

Lillian Emlet: Yeah. so now, so many years later, you can say, "I'm a pediatrician. I'm you're a health plan executive. You are a life coach, you're a TEDx speaker, you're a mom a daughter." And if you're first year resident, Krystal could see you now. What do you think she would say?

Krystal Sodaitis: Yeah. So I have two daughters. Both of whose brains work very, very differently. And I think first year resident Krystal would just be really relieved that it all worked out. I think she had a lot of doubt that life was going to work out. And it did. It did. It doesn't look anything like she expected, but it definitely worked out.

Lillian Emlet: Yeah. Did you have your kids in residency

Krystal Sodaitis: No. In post-residency, far past, beyond residency?

Lillian Emlet: the story that you described really is, this fear that is it going to work out? how is the life going? How's the path going to unfold? You know what, because many of our trainees now have full families as an intern-trainees. And that's a whole another stressor and also gift in order to, in some ways being distracted away from, the thing that is the behemoth of our medical career.

Krystal Sodaitis: Yeah, realizing that there are other things outside of medicine that are more important that define you because as physicians so often, our occupation defines us. But when you are first a mother or wife or a caretaker, that becomes your foundational identity and physician is just laying on top of that.

Lillian Emlet: Right. so it's, well, I'm also hearing you in your story is that there is some overlap time. you overlapped that growth time. You were still working as a clinician. You're also getting the other experiences. I'm curious, before the actual move to leave an employed academic position, else was happening in your life and what were you noticing in yourself? Like how did you know this is now Okay, after 18 months? Not only am I qualified and I got position, but also this is it now.

Krystal Sodaitis: Yeah, well, interestingly. I knew, I wasn't a hundred percent sure. It was definitely a leap of faith. it was interesting that around the same time I got two job offers. One was, I had applied for a leadership position at an an FQHC, but it was an FQHC it's a large network of clinics within the city. But I was turned down for the leadership, but they still wanted me to come and work as a clinician. Which I was not interested in, just moving from one clinical job to another.

Krystal Sodaitis: And then when I got offered my first position I still remember I was talking to the, my boss in a clinic room. I was so excited. And, you know, I was thinking about like all, everything that had been scheduled and the call and this and the that, and I said, well, I, I need like six weeks. And she said, you have two.

Krystal Sodaitis: So I kind of negotiated for four weeks. But still I was thinking, and even beyond that, I was like, we have such a weight of responsibility, like we take responsibility so heavily. Where I was like, how are they going to do call? I probably still worked many weekends. I was on call on Sunday and on Monday I reported to my new job because I didn't want to be that person that just walked away. and I will say this though, when I first gave my letter of resignation and I told them, "yeah, I'm going to be gone in four weeks. I felt like, "oh my gosh, it's so fast. How is this all going to happen?" As each day progressed? it couldn't happen fast enough. I realized, I'm like, "no, this is really what I want. I want to move on." And just to take the story one step further is that when I did walk in that first day and that first week, and I still say to myself sometimes, I feel like I found the golden ticket because the job is so well suited for me and for my interests and my personality.

Lillian Emlet: That's so wonderful. and you've obviously changed positions and institutions even in the utilization management sphere, and you've learned and grown, and direct more things now. And at the same time, the reality is — it's that, it's just that transition point can be so scary for so many of us. It's really hard to pull the trigger. And I think the more people that I interview and talk to that at some point there eventually just becomes the, you just step out into the exciting unknown and you get carried. Like, it just works out. And I think it's one thing to be on one side of that step forward and to know that it will, that you can do it, that you can trust yourself enough.

Krystal Sodaitis: I don't think, I know I didn't coin this term. I know I have heard it from multiple people, especially kids, but kids call it "nervcited." You're nervous and you're excited. And I think one of the differences, the people who are nervous and scared, and you choose that as an opportunity not to move forward, those are the ones that risk a lot of burnout and job and life satisfaction. But if you're willing to embrace the nervcitedness and know, like I am, like even my most recent job change, I was very nervous to take this job, but as the day got closer, I got more and more excited about the opportunity.

Lillian Emlet: it's really funny how I think definitely also as we become faculty, we become more entrenched in our security. When we push faculty to be brave and truly experiment and truly have a growth mindset, people actually start to pull back. They actually don't want to know the data. They don't want to know the assessments. They don't want to necessarily be courageous and playful like we ask all of our trainees to, because when we think about like when we were in training and every four weeks we change the location. We had capacity, we grew. It was exciting as hard as it was. When we all look back, when we think about — people would argue is trauma bonding. But the reality is, in our training programs and in those special times, there's also something magical about that ability to learn. I mean, learning at a relatively rapid pace so many things. It is hard to imagine that at some point you stagnate and part, and I agree with you completely. Part of burnout that people don't talk about is that. You hit into like almost a mindset rut where you can't imagine this nervcitis, you can't imagine. What it was like and you've done it before. That's what's even more crazy. I often point out to my clients, when else in your life have you been able to fill in the blank. all point back to some of their hardest times with, a patient bad experience or an encounter or a death or like something in training. And you're like, "yeah, and how did you get through it? And what skills did you learn along the way? And they realize, "Oh yeah, I could, I actually might be able to handle this."

Krystal Sodaitis: Yes. And I think the other thing that many of us face is this mentality that failure is not an option. So we only set goals that we are reasonably certain that we are going to attain. Very few physicians are willing to go out on a limb, set a goal, take a chance with the knowledge that: "I might fail." Like this startup, it could fold and they take that as a reflection of themselves that: "I made a mistake, I should have known better." And it's like, no, but it may not be the case. So we sort of fail in advance a term called "fail in advance." I'm not going to bother to do that because I'm worried I might fail, but then we're just failing beforehand. We're not even allowing ourselves the chance to grow.

Lillian Emlet: Right. Absolutely. And I call it a self throttling, like you're not allowing your voice to be out there as a, even an opportunity to even say something about whatever business or passion or contribution you want to make. You're just deciding for yourself ahead of time that your voice doesn't matter that you don't go out there.

Krystal Sodaitis: Yeah, exactly.

Lillian Emlet: so we've covered about how you've discovered this whole new career path you didn't know existed and what this reinvention process looked like, that it wasn't overnight. It did take courage, it did take mindset change, and it did take time. And then finally when you re rebuild this new career, you discover other things along the way. What did you begin to notice about yourself that had been hiding in plain sight this whole entire time?

Krystal Sodaitis: So one of the things that I realized was when it was gone. The enormous weight of patient care that my ability to be present in my own life was really hampered by the constant background noise in my head about work: where are the charts? Or the charts done? Did the residents do the chart? Did that baby go to the hospital? Did she drink? What's the bilirubin? Is the bilirubin back in? How many kids are waiting to be discharged? There was always this background noise. So when that was gone, and I'm sure it took me some time to sort of like recalibrate. I started to realize that and I worked basically eight to five. When the day was done, the computer was done. I wasn't thinking about work. I was not thinking about work really on the weekends. I had some minor call and my brain started to open up and have the ability to think about what else. I took a lot of walks. I had the time to take walks in the middle of the day. And listen. I listened to a lot of podcasts. Not with the idea of like, you should do that, you should do this, you should do that. Just listening, knowing that something would come, but I didn't know what that was and so I was just listening.

Lillian Emlet: It's really beautiful. I can almost see the spaciousness in general to be able to be receptive and to realize how much the day-to-day normal work is such a sensory overload. the reality is we're juggling so much data, so many people, so many emotions, so many intangibles, so many projects that is constant data stream that we are invisibly managing as our brain in general, that it is incredible that we never learned how to calibrate that kind of intensity for that long. Right..

Krystal Sodaitis: Exactly right.

Lillian Emlet: And so, I think you've talked about this maybe in like other other venues. What exactly is a spiky profile in plain language and like what kinds of things, for people who might identify as gifted or maybe people who were never tested for neuro diversion. Because so many more adults are now being tested and I've also counseled and talked with many other clinicians that, if you're struggling with board exams, it's most likely you probably should also get assessed. Because it's hard to concentrate and be able to complete just, the normal test that we have to take. I'm curious, how you discover that part of yourself along this journey.

Krystal Sodaitis: So first I want to point out — I don't know if you intentionally did it, but you looped giftedness under neurodivergence, which is totally correct. Because most people, when we think about people who are neurodivergent, I'm using air quotes for people who aren't watching the video. We think about like Autism, and ADHD, and Dyslexia. Really, neurodiversity is just a term that reflects all spectrums of the way a brain works. And we need all different types of brains and brains that work in different ways for a functioning society. So neurodiversity is no less important to our earth than like biodiversity. And so how I discovered it was really when I got certified as a life coach, I did not expect to become a one-on-one coach. I got certified as a life coach because I recognized the tools that the Life coach school, where I got certified. I recognize them as leadership tools. And so I really intended to get certified so that it would help me to be promoted, which it did. And also then to be able to coach and lead my team, which it did. But along the way I really fell in love with one-on-one coaching. And I think part of the reason is because I was no longer in clinical practice, I missed that sort of caretaker physician role. And you know, not that coaching is practicing medicine in any way, but it is a similar way of caring for people and caretaking for people. So, I loved one-on-one coaching. And then for many physicians, I think in order to be a physician you have to be gifted in some way in order to be able to get through the rigors of medical training. And anyone who is gifted, many of us have biological children who are also gifted. And you can, if you search, do an internet search of like how to raise my gifted child, how to help my gifted child. You get a billion hits. What many people don't see is that when those children become young adults and become adolescents and young adults, there is are huge rates of depression, anxiety, failure, drug abuse. It felt like a population that really needed help that wasn't there. So I started coaching gifted young adults — adolescents, and young adults. And in that young adult age group was residents. And then I started contract coaching for another physician coaching group. And I found myself really, really drawn to, there's a lot of neurodiverse people, not just gifted, but with other diagnoses in my family. And I just found myself drawn to those physicians who just self-disclosed. I had begun to listen more and learn more about twice exceptionality, which is usually more like multiple exceptionality, which means that you're gifted and you have some kind of disability. It can be, a neurological disability, like ADHD or Dyslexia. But it can also be technically twice exceptional people. It can also be people who have other disabilities, non-ambulatory, you know whatever it is. So, I took some time, as I realize is now my sort of the way I work. I took some time and I made and some discernment if I wanted to give up my, sort of my kids you know, my young adults and my adolescents. I moved to focus on neurodiversity, you know, physicians who are neurodiverse. And then after some time I decided that yes, that that was going to be my focus. That's what I really felt called to. Also along the way as I was learning and reading about, executive functioning, I recognize that I happen to have very high levels of executive functioning and can really help those neurological disorders or have difficulties in executive functioning. So I could use those skills to help those clients and it just seems like a perfect match.

Lillian Emlet: That's so wonderful. And so, what do you think happens to a gifted or a twice exceptional clinician when nobody ever names or acknowledges what they are? Because I have to admit, even as a program director, we do not get any additional training in this. And we often are just told to refer to the EAP who has moderate if any sometimes resources to be able to assist with that. And as getting in to see specialists can often be very long, the reality is, I do think that in the culture of neuro typicality and just in general the culture of medicine, it sometimes can be perceived potentially as a weakness and people don't know what to do with it. So what happens to people who either undiagnosed or don't want to disclose or aren't sure where to even get the supports that they need.

Krystal Sodaitis: Yeah, I mean, from what I said there I think it contributes a lot to burnout — Depression, anxiety — people who feel that there's a term called "masking." So especially if you, for example, if you are autistic, if you have social anxiety you feel like, and even people who need to, what we call "stim" you know, people who use fidgets or need something to sort of help regulate their nervous system. If they're not able to do that, they just mask all day. They hide. Masking is basically hiding your traits or the things that you need to do in order to be able to function in the world. And so masking takes an emotional and cognitive toll that when you're trying to take care of patients, it's going to lead to burnout and depression. And sometimes it's even just acknowledging, you know, that. do you need a standing desk? would it be easier for you if you had the opportunity to do your charts standing rather than forcing you to sit? is it easier for you to pace in the back of the room during grand rounds? It's okay if you do, it's okay. Right? We can have a standing room only spot where you can, so that you can keep. Listening while you walk

Lillian Emlet: Right. It's funny because I, I actually do think most of us in general have some range of neurodiversity in general. And it is funny because, as you become a parent, you start to wonder, because so I was tested as gifted when I was in kindergarten, so I always thought, this is a normal thing and it's fine. And so it's great to be gifted, but then when it came to your own daughter, you're like, you want to be gifted? aren't you as well? And then when she missed it, by one point, her two points are like, "ah." But then, it's hard because, she even points out now that it's like, "well, but if I go with a gifted kids, then I really won't be s spectacular compared to all the average Because right now life is kind of boring and easy right now and it's hard because the reality is boring and easy is okay maybe for a little while, but what a shame to like not actually be in an environment that actually makes everyone to be the human potential that you need to be. And then also to be able to have a place where all of us can have acknowledgement that the way you're thinking, the way you're presenting and the way the learning can be, can just be broader and bigger for everybody. So like to bring, to merge to some degree that that spectrum.

Krystal Sodaitis: Yeah, absolutely. But you know, we all have the places that where we want to drive. Like I think that that's your example though of your daughter is, so perfect because I mean, it's probably the whatever test assessment they were doing, she missed by one point. there are areas if you were to do, if someone were to do like a full neuropsychological evaluation on her, not that I would recommend anybody going through it unless they really need to. There are probably places that she's in the far superior range and then there are going to be places that are in that she struggles. And it's this sort of this idea that gifted people and gifted children should be good at everything

Lillian Emlet: right.

Krystal Sodaitis: They should be able to be, you know, reading Harry Potter in kindergarten and doing long division by first grade, and also want to be the superstars on the soccer team. Like that's not how giftedness works. are there people like that? Sure. But the vast majority are not.

Lillian Emlet: Right. I think you know, what you also highlight too is that all of us. We'll have parts that come a little easier and other parts that come a little more challenging, and that's also totally okay. Whether you test into these categories or not. I really honestly do agree with you. Everyone's a little bit neurodivergent. And we all have different ways of processing and what's most important is that we can actually hold space for each other to, to make sure that everyone's coming along together in the learning process. And it's okay to ask the questions. It's okay to to modify and that it's normal. So I think the best facilitators, like you said, really are just asking, is there anything that anyone needs? And just to be aware that people may need different things. Video on, video off. Physically walking, not walking, that you can't just confine people to the same standard expectations in general to have some flexibility so that people can all get out of the experience together.

Krystal Sodaitis: Yeah, absolutely. Absolutely. So everybody can show up at work and do their best work.

Lillian Emlet: Yeah. And it's really hard. I actually think it's kind of challenging in healthcare. Because I think there's a lot of norms, especially with our 360 and our evaluations and our clinical evaluations where we kind of stereotype and put people into, like it has to be sort of this way. And so, if you had to give our listeners one thing that they can try this week, because I know a lot of people out there identifying with what you're talking about. If someone suspects, they might be twice exceptional, maybe never even got tested. but now it can really resonate with what you're talking about, what could be some concrete steps that they could take. And then on the flip side, if it's a leader that's listening, how can they be more welcoming, psychologically safe, neurodiversity affirming to create these environments?

Krystal Sodaitis: So I'll start with what people can do themselves. So the first thing is — accept yourself for who you are and not judge yourself. if you are tend to be an introvert and you prefer to spend time on your own, you know, maybe listening to music, maybe just reading that's okay. If that's how you need to regain your energy, that's okay. if there are certain things that, if you need a fidget, right, if you always want to be clicking your pen or twirling your pen that's okay. And accept yourself for who you are. Don't try to be somebody else. Now, sometimes we do have to mask. Sometimes there are places where it's not safe to, divulge and fully act on all of your neurodiverse traits. And while that is a shame, that is our reality. So knowing that, hey, I'm, I'm not bad because I can't stand and sort of rock between my feet. We all know that doctor or that person that stands and rocks back and forth, right? They're probably just regulating their nervous system. And just because you can't do it at that moment doesn't mean anything's gone wrong. And for the leader who sees somebody struggling and this is really hard. I want to acknowledge that it can be hard. if something's not clear, you can't figure it out, then yes. you know, neuropsychological evaluation to figure out what are the nuances. Is it a short-term? Is it an issue with short-term memory? Is it just an organizational issue? Is it just general, you know, is it just some social anxiety and they need some tools to help them even start a new patient encounter? Right? Just imagine you have social anxiety, you're a physician, and every new patient encounter is a struggle, so, so sometimes it's easy to, how can you address that? How can you make that situation easier? Sometimes, i'm just going to say sometimes it's not easy to know, but sometimes it is and somebody, if you see somebody who's always, you know, twirling their pen, find a way to ask them, like, "is there something like the twirling, your pen is a little bit distracting in this setting, maybe. Is there another way that we can, is there another fidget? Is there something else that I can do for you?" If they come to you, if someone comes to you and says, "I can't get the..." It's usually the people who can't get their charts done. That's your first clue, right? They don't need a diagnosis. They don't need an OCD diagnosis or an ADHD diagnosis. Just say, "okay, what's going on? Is it that you're not sure how to distill down? Information into a succinct note. Is it that you're worried that you're going to miss something and you need to put every single thing in your note? Or is it that you yourself, I've heard this from many people with ADHD, they can't. They can't. There's so much that they want to put in. They can't figure out what are the important points and that causes paralysis. They can't start because they're not sure where to start. So all that is a very long-winded way of saying like, don't require a diagnosis in order to put in an intervention.

Lillian Emlet: So both of those were really so, so powerful because I think, especially the very first one, like just accepting yourself and that knowing that you can't always be who you are a hundred percent all the time, but still know that you are totally. Whole and beautiful just the way you are. And at the same time, on the flip side, I know many people with all of the things that you have described. and, I do feel bad as a leader, in terms of we wait too long. We wait too long for interventions. We wait until half, six months in hoping that maybe it'll go away. Maybe a different faculty member can get through, maybe a different mentor can teach them differently. maybe this environment will help them be different. and because, there is incremental progress, right? There is small ways where the person does try. Like I can try to fit in, I can learn a new skill, I can make this work. But ultimately, at the end of the day, after so many months. It still isn't. And the chart completion thing and just the, it is paralyzing. I think when, because the amount of data, obviously in the ICU, we have a lot of data and so just make the plan, you can communicate the plan. You're great with families. you are very safe for care. But it's the note writing where it's it's a little bit of an Achilles heel.

Krystal Sodaitis: Yeah, for so many people, and it's hard to know why. That's why if you have the ability in your institution, to have somebody, I think it's well worth it to find someone that is interested enough in these conditions to almost become a charting coach that takes all of that into consideration. Like a lot of charting coaches start with like, here's your template and here's how you build a template. And, finish your notes while you're in the room. Yes, for neurotypical people, that's fine, because that's part of their issue is they don't have good templates. They're writing too much, whatever. But for someone whose brain thinks differently, the issues might be varied. And so having a resource in your institution that they can go to and say, "okay, let's figure it out, which category do you fit into? And how can we find different strategies that might help you?" Some of it might be coach, some of it might be just a straight on strategy, some of it might be coaching.

Lillian Emlet: so I think I'm curious too, what how do you think AI and ambient scribing will help or hurt some of these executive functioning in different ways that we are showing up together in the clinical workspace?

Krystal Sodaitis: Yeah, I think that for some people it will be very helpful. It's definitely going to help the people. So there's something called dysgraphia and it's the inability to put your thoughts on paper. And so someone who has some mild dysgraphia, it's going to be great because they don't have to get the process. Started for someone however, who has dyslexia, who now has to read through a note and be able to pick through where the errors are, then it might take them, it might take them longer, it might not. If they were using Dragon Speak before, so they knew pretty much exactly what was going into the note and could watch it in real time. Moving to an AI ambient scribe might be might be a little bit of a challenge for them. So it all depends on, for some people it may introduce new hurdles that they didn't even know they were there. I mean, by and large, I think for the neurotypical physician, like the AI ambience, we had them when I was in practice because I think it's fantastic. But I know that just, and that's something to be aware of too. It's not a panacea. It's not like, "oh, just give them an AI scribe. They'll be fine."

Lillian Emlet: Right. And so that's a really great point that you highlight. and so there are so many nuances and layers because even as we work with a machine, we have to work with the machine. And so as we, our brains work with this sort of fixed way of responding, we're going to have to learn a new way. And so I think, for those people who are listening, making sure all of your, the correct voices are at the table for the user interface, and get involved with the people who are implementing AI across the system. It's really important that everyone is represented and that we don't accidentally create one size fit all solutions, which won't make any sense for the long term. And it's no wonder that there's some adoptability issues in general given what you're talking about, considering everyone's brain is neurodiverse. So what have I missed? as we come to a close. Well, is there anything that I've missed that you would just like to share with our audience in terms of anything from career changes to neurodiversity to what you hope for them to take away after our chat today?

Krystal Sodaitis: Yeah, I think that if I were going to sort of sum it up all up it would be two things. The first is that, all spectrums of brain function are normal. we need neurodiversity for a functioning society. So no one's particular skill is worth more or less than the other person's particular skill. For people out there who are thinking about a change, there's no rush. you don't have to decide on your next career today, you can allow yourself to take time and space and think about it and maybe do some research. Maybe take some classes. There are no false starts. Just have confidence that when the right opportunity comes along, you'll know it, you'll feel it. And you'll have to just take my word for it.

Lillian Emlet: That's so beautiful and so Krystal, how can other people work with you? Where can they find you? How do you work with people? where can they contact you?

Krystal Sodaitis: Yeah, thanks. So my website is neurodiversedocs.com. I'll definitely send you a link. People can sign up for a "what now call." It's a 20 minute call. We can just talk and see if, you know, they want to coach with me, I can. I have you know, some packages that I offer. If they just want to sort of chat about neurodiversity and raising Neurodiverse kids, that's totally fine too. You can find me on LinkedIn. That's mostly where I hang out. and then, you can listen to my podcast, which is not about neurodiversity at all. It's luxury cruising passion project.

Lillian Emlet: Yeah, so tell us about your podcast.

Krystal Sodaitis: Yeah. So again, very similar story, but a passion project that I started a little bit over a year ago because I love cruising and I love talking about luxury. And so I started a podcast called Luxury Cruising. And it's just super fun. It's a completely different skillset that I have embraced and I love. And yeah, check it out if you're interested, if you're at all interested in cruising.

Lillian Emlet: Obviously if you've made it to this far in the episode, You like podcasts and so we hope that this has been a great episode for you. And thank you all so much for listening to the Transforming Healthcare Coaching Podcast. Thank you so much, Krystal, being on our show. And for all of you listening still here to the very bitter end, please like, subscribe and share with a friend and tell us what you want us to listen to what questions we can answer for you. Just email us at podcast@transforminghealthcarecoaching.com. Thanks so much.

Connect with Krystal Sodaitis

neurodiversedocs.com — her coaching practice for gifted, twice exceptional, and neurodivergent physicians
Krystal Sodaitis on LinkedIn — where she says she mostly spends her time
Luxury Cruising Podcast — her passion-project podcast, and, as she notes, not about neurodiversity at all

Your Host

Dr. Lillian Liang Emlet

Physician · Executive Coach · Founder, Transforming Healthcare Coaching®

Lillian is a practicing physician, certified executive coach, and the voice behind the Transforming Healthcare Coaching® podcast. She works with clinicians, clinical leaders, and healthcare executives leading through role transitions, seasons at capacity, and culture change — helping them lead with clarity, intention, and sustainability.

Learn more about Lillian →

Browse by Pillar

Every episode of the Transforming Healthcare Coaching Podcast, organized by the three collections.