Healing Burnout Requires Unlearning the Habits of People-Pleasing, Perfectionism and Lack of Boundaries

Cydoc & Dr. Melo

Today the Cydoc team is pleased to introduce Dr. Megan Melo, a board-certified Family and Obesity Medicine Physician and Certified Life Coach for Physicians. She practices medicine part-time, and runs her own coaching business, Healthier For Good, where she coaches female physicians on overcoming people-pleasing, perfectionism and a lack of boundaries to reduce burnout in medicine. Dr. Melo graduated from The University of Washington School of Medicine and completed residency training at Group Health Family Medicine Residency (now known as Kaiser Health Plan of Washington Family Medicine Residency). Dr. Melo lives in Seattle, Washington, with her husband and 2 sons.

Dr. Megan Melo

Thank you so much for joining us, Dr. Melo! What motivated you to start Healthier For Good, and what services do you offer physicians?

Since early in training, I’ve been a keen observer of the wellbeing, or lack thereof, of physicians. Early in my career I had the opportunity to engage in Physician Wellness work at my previous employer, but it was not at all connected to Operations, and to be honest our impact was not meaningful. When I left that organization, I had a strong desire to do better by my colleagues, having wrestled off and on with burnout, and I started in a coaching certification program, originally with the aim to use these tools with patients. But as I went through the certification program, I became more familiar with the literature showing that coaching has the power to decrease burnout in physicians; I knew the impact it had had on my life, so I decided to open my own business, serving physicians and other healthcare providers.

My coaching practice, Healthier For Good, offers 1:1 and group coaching programs, specifically designed to help physicians see where their learned habits of perfectionism, people-pleasing and lack of boundaries come from and more importantly how they can be changed. Many of us love the practice of medicine, but we’re drowning in the volume of work and a belief that boundaries are selfish or not available to us. It’s my belief that to be able to show up and work in a broken healthcare system it’s necessary to acquire skills around boundaries, to let go of the habits of people-pleasing and perfectionism, and take great care of ourselves.  Most of the physicians I coach show up wanting to leave medicine; and most end up staying once they learn skills around this critical piece of self-care.

What are the biggest challenges you see physicians facing today?

The goals of caring professionals, including physicians, is to have a meaningful impact on the health and wellbeing of our patients. Our healthcare systems however, are structured to profit off us seeing more patients than we can reasonably manage, with increasingly less help from support staff, and are incentivized around us not having boundaries or autonomy. Some of these systems are well-intentioned; some are not.

My work with physicians is highly focused around seeing the broken healthcare system for what it is, and making decisions for themselves that are centered in what they want and need in order to continue this work. We unlearn people-pleasing, and get a better understanding of how our thoughts and emotions interact.

And if they don’t want to stay in medicine, if they plan to move into non-clinical roles, I also help them unlearn these areas, because these habits follow us. We can overwork, overagonize, and undervalue ourselves in other settings as well. Once we get clear on our value being innate, and not tied to our productivity, our sacrifice, our ability to always prioritize others, we can start to heal and live happier, healthier lives.

What are your favorite strategies for reducing burnout?

For me, it’s about helping physicians see that they are not broken, not lazy, not inefficient. They are operating in a system that constantly asks more of them, and often belittled or judged for trying to set boundaries. A lot of the work that we do is around normalizing the discomfort that occurs with saying “no,” and being willing to practice that. Once this starts to happen, more space opens up for the things that we need and want; sleep, physical activity, more time for ourselves, more time for family and friends. 

We often know what we want to spend more time on; but until we learn to set boundaries, it tends to stay off-limits. It’s really a game-changer once this clicks in.

Are there any resources you’d recommend to physicians for optimizing the efficiency of their practices?

Great question!I don’t want to help people optimize their efficiency, which is the speed with which they get tasks done. I do want to help people optimize their effectiveness, which is their ability to get more important things done. In employed settings, physicians and other professionals are often pressured to go faster, become more robot-like. That isn’t what we really want. What really helps is when the right people are doing the right work at the right time. It takes the thoughtful creation of high-functioning teams, and it seems rare right now.

I don’t know how we solve the problem of creating high-functioning teams. But in the meantime, I teach physicians how to identify where the priorities are so that they get the right work done, with appropriate boundaries based on their resources. If they don’t have an MA, and they are rooming their own patients and cleaning the room in between patients due to staffing issues, there is less time to address patient concerns, less time for physician work. No one will tell them to do less. They have to give themselves permission to adjust to the circumstances, in order to take care of themselves.

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What “words of wisdom” would you want every physician to have the chance to hear?

If you are struggling to keep your head above water, it’s not you. It’s the water. Severe staffing shortages and poor access have made a tough healthcare landscape worse. But none of us created this mess, and we can’t continue to sacrifice ourselves to save it. I believe that each of us needs to figure out what we need for self-care, given the circumstances in our lives, and decide how we are going to get it. It necessarily involves boundaries, but more importantly changing some of the thoughts and beliefs we have about our work. I always want to provide high-quality care to my patients; but my notes don’t need to be polished essays, and I can’t address all 17 concerns on their list safely or adequately. We can change the way we do things, learn to take care of ourselves and find the balance and sustainability that we crave; no one will hand that too us, we need to find it for ourselves.

How can our readers reach out to you or follow you on social media?

Thanks for asking! My podcast is “Ending Physician Overwhelm,” available on all major players, and my website is www.healthierforgood.com. The best way to follow me is on Instagram at @MeganMeloMD

Thank you for joining us, Dr. Melo!

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