Thoughts: Validating Medical Career Choices Through Impact

First published September 12, 2016

I was catching up with two medical friends yesterday over a traditional Melbourne brunch, and as you do over flat whites and mushroom burgers, we chatted about our careers and our dreams for the rest of the year and beyond.

One friend is launching an app, a new platform that could transform the future of hospital medicine, no hyperbole intended. Looking at the prototype, as a clinician, I was impressed. This person had taken the frustrations of staff across many hospitals, departments, training specialties (eg. Obstetrics and General Medicine junior doctors don’t often interact at work unless there’s a referral or they’re friends), locations, and years of operation, united those frustrations, and summarised them to create this product. I have met several others who have given up months and even years of college training time to devote themselves to their own solutions for higher-quality, high-efficiency healthcare, and the focus and determination they all demonstrate are incredibly inspiring. They don’t realise it, but they rejuvenate me, when I feel worried or anxious about my own work.

The other friend is getting their letters at the end of the year. He’d had startup aspirations for many years, but had shelved those aspirations to complete his training, and despite the long, arduous exams, he’d somehow managed to keep his other interests alive. He is still a fountain of ideas bubbling over today, and will no doubt do something incredible very soon.

Then there’s me. A very keen, slightly travel-weary but ever-inspired writer whose head simmers constantly with ideas on how to energise the medical system in Australia; how to learn from others’ experiences within and overseas; how to inspire students, junior and senior doctors and other healthcare professionals alike; how to connect with others who don’t normally interact day-to-day with our professions in hospital, bar multidisciplinary meetings;  and most of all, how to celebrate the uniqueness and creativity that every single one of us exhibits when we apply ourselves to a self-made project aimed at a greater impact. 

The three of us are happy because we’re each creating impact. The one who’s about to become a specialist, and who was the one who brought up this Impact concept, had to push aside his many ideas and that creative energy whilst knuckling down with training. The other friend and I had waited long enough- it’s an individual decision, and you know when you’re ready to take that leap.

I’m surrounded by inspiration and hope when talking to friends like these. People who can relate to thinking outside the box, and are driven by that internal fire for achieving greater impact than they could one-on-one with a patient, yet still value the sacredness of the clinician-patient interaction. (And when I say “clinician” or “healthcare professional,” I also mean physiotherapists- “physical therapists” in the States; occupational therapists; nurses; dietitians; dentists; and so forth.)

Yet, as I mentioned in my previous editorial, our conversations as healthcare workers are often restricted or self-censored as we fret over whether our projects will be recognised and validated by external medical training colleges; whether we are jeopardising our future careers by deviating from well-worn paths; and whether there will be anything external to show when we’ve given it that shot.

How can we become a more Impact-Driven profession? 

We have to show that education is also about life experience and applying that experience to a greater cause. The trials of forming and running a startup or social impact project are like a real-life, practical exam.

And you fail instantly by not trying. 

To make it easier for people transitioning from stable clinical job to startup or social impact project, the conversation has to start with you. We need to celebrate the individuality of healthcare professionals who value the interactions between clinician and patient (and their loved ones), and nourish that environment of creative thinking in medicine. And by creative, it can mean anything from brainstorming better patient flowcharts between hospital departments on a nursing unit whiteboard, to improvising novel bandages in a resource-poor setting when on a field trip or rescue mission with the Flying Doctors or other emergency services.

Or it can be through sharing stories, like me.

Would love to hear how you gain inspiration to continue your journeys when you feel discouraged, or how you rejuvenated yourself when you felt overwhelmed by opposition. feel free to share your comments below, tag us on Twitter @themedstartup, tag your photos on Instagram at @themedicalstartup, or send me an old-fashioned email via the Contactpage.

Enjoy your working day :) 

Part 3: Interview with Dr Gregory Sam, Psychiatrist and Director of Conduit Health

First published April 29, 2016

 We hope you’ve enjoyed Greg’s series on starting his telepsychiatry business and his journey to success! Here he talks about dealing with the process of failure, and rising from that, along with future plans for Conduit Health.

You can now view Parts 1 and 2 as well.

Dr Gregory Sam, Consultant Psychiatrist, Australia. Image courtesy of Dr Sam.

Can you talk more about your failure process? How did you deal with criticism and get through failure? (Greg had to resit his exams a few times before qualifying as a consultant.)

Firstly, it’s a humbling thing, and there are some good resources. You should find those consultants or colleagues who can give you meaning to your failure.A lot of people will say, “oh, you did this wrong or maybe you did this wrong.” I’m not saying there should be an external locus of blame, I’ve been through that too- “oh, the college is out of its mind failing me because everyone I know is telling me I’m ready to be a consultant, couldn’t really figure that out. But one thing I was told is, “look at this person who’s now a professor, I know during his training he failed 4-5 times,” so I guess there are some comforting things like that. But it’s also about yourself being able to apply that meaning to your failure. Otherwise you go through all this pain, and you can’t get some benefit from it. And that’s pointless, absolutely pointless except to hurt you.

Failure is just an opportunity disguised as pain. 

So I thought, “I won’t let it hurt me or fail me.” With my career, I did think, “should I be doing this?” but I felt resolved that before failing and before I was in that frame of mind, I knew this was what I wanted to do, and this shouldn’t change it. Just because some people failed or I didn’t pass an exam, I will pass eventually.

My reflection of my failure brought about so many positive opportunities.

Medical people tend to become very disillusioned when they fail. We’re not used to failing, we’re high achievers, and when we do fail, it’s a huge fall, and some people don’t recover from that. Those who fail need support, and I know myself because when I did fail, I spent endless nights on YouTube looking up motivational videos and how to get through failing and how to get meaning from that. I felt alone.

I had colleagues who also failed, so we formed a bond and pushed each other through. They’re not entrepreneurial per se, but we had some support in that we failed together.

I think people should apply some meaning about failure. It’s all too painful an experience to do for nothing. Even if you eventually don’t pass, it’s okay, as long as you did something meaningful. Even if I didn’t pass and dropped out of my training, I took meaning from it, and reflected on it.

In fact, Conduit Health is thanks to failing. Had I not failed, I’d have sailed through my training program, with this inside disgruntlement of “this is what I am”.

Conduit Health, Telepsychiatry Service. Photo courtesy of Dr Gregory Sam.

One of my bosses said, “I think this will make you a better psychiatrist, and this is because you now know what it’s like to fail. Previously you had no idea what it was like to fail. You excelled and  succeeded in everything. And now you can see that when your patients fail, you can feel a bit of that.”

The medical field, I think they kind of shun people who fail. And people who do fail, don’t talk about it, because they want to be seen as brilliant, successful, and never a failure. Whereas in business, the more I look, they talk about failure with pride. They go, “I started up ten companies, and all failed before I made Google.” They talk about failure with pride, and those who don’t talk about failure and don’t own it, they’re missing that opportunity to share with people. Everyone fails at something, in one way or another everyone fails at something. And people then tend to hide it and put it in a box and not share it with anyone.

We need to change the culture and say, “it’s okay to fail, lots of people fail, but what will you do with it?”. The famous words from Edison I think were, “It’s not that I’ve found the way to make a lightbulb, I’ve only found ten-thousand ways NOT to make a lightbulb.” 

It’s about mindset change.

It’s like, “ok, I failed four times.” It’s not to say, “I failed and I’m useless,” it’s, “I’ve failed and found four different ways to not pass an exam, and I just need to find that one way to pass it.”

Reflecting on my failures in the exams, what held me back wasn’t anything to do with my knowledge. A lot of people think it’s the knowledge (that makes them fail), not knowing enough. For me, it was the anxiety levels. I went into the exam thinking, “what do the examiners want to hear?” But the time that I passed, I gave that away, I said “I don’t care what the examiners think.”

I think there could be more constructive ways in which our colleges could address failure. One way I think is to talk about it more, and to show that it’s not life or death if we fail, we can get through this, and be more supportive, be able to talk about it. 

By having the courage to say “yes I failed my exams”;  other people find doctors as quite intimidating, they’re seen as being super successful and smart, and when you can bring yourself down a bit and be humble and say “I failed”- everybody fails at something, whether it’s their driving test or something, failure is something everyone has in common, so when I bring it up, a lot of people can suddenly relate to it.

In business, that’s super important, so people are not intimidated by you, they have something to relate to you, and it builds relationships. A lot of my GPs, mental health nurses and staff, they like me for being open about it, rather than hiding it away, rather than bringing across this facade that I’m super brilliant, never failed in my life, top notch.

How do you view competition in business? Doctors have that win mentality, how do you manage that in business?

I welcome competition in business. I feel that if somebody can – if somebody else comes forth, it’s always anxiety related, like, “I must be better than them.” But what I do is look at the competitor, and ask, “did they actually evaluate? Did they actually have new ideas about improving telepsychiatry, did I do that, and if I didn’t do that, why can’t I do that? If there are no competitors, you are at risk of becoming complacent, and competitors bring excitement. So I ask, is there value-add, or do I just have to do my job?It can become about less value, more competing on price point. But I know it’s hard for other companies in this space to compete on price point.

What are your other plans for 2016?

Trying to balance. It’s tempting to focus just on private practice, but Conduit would fall by the wayside. For me, what I’m trying to do is allocate time to Conduit Health and allocate other times for private practice . I’ll try organise more talks for GPs including interstate, hosting events.

I love going out to rural communities and seeing them, they really don’t have much psychiatry services. Same with their GPs, they don’t have much support and can get very isolated without someone coming from the metropolitan areas to offer help.

We’ve received the odd referral from the Great Barrier Reef, the Northern Territory, Tasmania, but I want to increase that. In business I think this is something we do- go back to fundamentals, think “why did I start the company, what did I want to achieve?”

The more isolated rural places, I’d rather focus on them. In the semi-metropolitan places, people travel 1-2 hours, whereas in the NT there’s no psychiatrist for a few hundred k’s.

The other thing will be statistics. Looking at 2015, we’ve been collecting data about how many patients we’re seeing, the outcomes, sending surveys to patients and GPs. Being able to publish them and say “this is where psychiatry services are at, this is what we’ve done.” Entrepreneurship is 24/7. It is on my mind 24/7. Even if you’re not doing something on it, it’s on my mind. My admin staff, everything, it’s on you. It’s like having a baby, it’s 24 hours, no escaping. Something people wanting to get into business need to be aware of. It can be like medicine, it can be all-consuming.

A few years from now, I’d really like to get government involved so that I can provide telepsychiatry services to public hospitals. Public services can be quite stretched, but for a private company like mine, that’s what we can offer.

What are lessons that medical professionals and people from other industries can learn about starting in business?

Guy Kawasaki’s lesson is, it’s not about how are we doing things now and how can we do things better; it’s about, “what is the next curve?” Conduit Health is jumping on the next curve. Not just about how to improve how doctors see patients face-to-face, sure there’s a lot of work to be done there, but if you want to jump on the next curve, (you’ve got to create) innovation.

Not too many doctors by nature are entrepreneurial. A large part of that is because we get comfortable doing our daily job. See patients, make a living. Innovation and startups are a huge risk. It’s out of our comfort zone. We stop seeing patients, and suddenly your startup becomes the neediest patient you’ve ever had. 

It’s important to get this out there. It’s people like you, me, people who dare. And hopefully this will help a lot of people find, “this has been inside me, this has been in the back of my mind, but I’m too scared to do anything about it.

Thankyou for your support of The Medical Startup and Greg’s interview. You can view Parts 1 and 2 of Greg’s interview by clicking here and here. 

If you wish to contact Greg for more enquiries about Conduit Health, or to sign up as a GP or psychiatrist for his service, please emailenquiries@conduithealth.com.au. Conduit Health is also on Facebook. 

Please note: In the medical world, “consultant” refers to a fully-qualified ie. board-certified specialist. “Registrar” is a doctor who’s a member of a training program and preparing to qualify for this certification. “Resident” is pre-registrar; “Intern” or “Houseman” is first-year out of medical training.