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A movement founded by doctors, for doctors, dedicated to empowering medical professionals to reclaim control over healthcare decisions and advocating for their fair share of the industry's resources.
00:00:04:00 - 00:00:27:19
Justin Nabity
This is the Doc Nation podcast. We are a movement founded by doctors for doctors dedicated to empowering medical professional to reclaim control over health care decisions and advocating for their fair share of the industry's resources. Please note the views expressed are those of Doc Nation and not necessarily those of our Guest or Reference Health centers.
00:00:27:21 - 00:00:49:08
Justin Nabity
We are excited to announce Doctor Kelly Cawcutt on with us to talk about her experience in health care. She has been in many parts of the country with her practice, and has a lot to say about what it's been like to go through multiple different avenues. And so we're going to dive into that shortly. But before we do, we you want to give a little some soundbites to our audience.
00:00:49:10 - 00:01:11:16
Reid Lancaster
Yeah, I just like to to let everybody know as we switch from our, our Tuesday night at, at 8:00, 830 to, what'd you say? Yep. The webinar. Thank you. To the podcast. Our goal here is to keep them to 15 to 20 minutes. We want you to be able to jump in the car and listen to us on the on the way to work and, and, jump back in the car on the way home and listen to another short one.
00:01:11:17 - 00:01:19:06
Reid Lancaster
So our goal is 15 to 20 minutes of high quality content. And we thank you for joining. So here we go.
00:01:19:08 - 00:01:24:20
Justin Nabity
So Kelly, tell us about you. How'd you get into healthcare and what are you doing today. What's your role.
00:01:24:22 - 00:01:48:22
Dr. Kelly Cawcutt
How I got into healthcare. So I'm a first gen college grad, actually, in my family, and probably got into healthcare predominantly because I was a sick kid and had a ton of exposure to healthcare and loved science and eventually really liked talking to all of my doctors and ultimately kind of chose that path, in undergrad.
00:01:48:22 - 00:02:16:03
Dr. Kelly Cawcutt
So I did not I was not a early on decision of going into healthcare or medicine, but decided kind of going in through undergrad that I really did love the biosciences and was going to apply to medical school. Entered medical school and went to medical school at University of Minnesota in the Twin Cities, not the Duluth campus, and did my internal medicine ... medical school there, then internal medicine residency, also at University of Minnesota.
00:02:16:04 - 00:02:48:08
Dr. Kelly Cawcutt
I then decided to be a little less typical in pathways after residency, and looked for an opportunity to proceed to do both infectious diseases and critical care medicine training. I talked to many organizations around the country at that time. It was not a common, nor easily found dual specialty training that you could find, and I ended up being offered an opportunity at Mayo Clinic in Rochester to train there and do both fellowships.
00:02:48:08 - 00:03:14:18
Dr. Kelly Cawcutt
And my Masters of Clinical and Translational Science, across those fellowships while I was there. So I went there and spent four years at Mayo, completing both fellowships and my masters, and then got recruited to Nebraska Medicine UMC during the Ebola pandemic. To come on and join faculty here with some of the faculty that were transitioning out of the infectious disease division, and out of the infection control world there.
00:03:14:20 - 00:03:45:07
Dr. Kelly Cawcutt
So I've been in Nebraska medicine now, since January of 2016. I currently serve as the medical director of Infection Control and Hospital Epidemiology, and the medical director of Acute Care quality for Nebraska Medicine. As a as a full entity. And today I am here doing this interview and doing other administrative roles and communication, spending a lot of time prepping for flu season, vaccine season, M-pox.
00:03:45:09 - 00:03:50:13
Dr. Kelly Cawcutt
All the viruses that are hitting the news and all the aspects right now.
00:03:50:15 - 00:03:51:11
Justin Nabity
Was there something in.
00:03:51:13 - 00:03:52:16
Dr. Kelly Cawcutt
That’s a bio of me.
00:03:52:18 - 00:04:07:21
Reid Lancaster
Yeah, that was well done. Well done. And and and congratulations and thank you for your service to get there. That's not an easy path. And, many lives will be not only saved, but, impacted in a positive manner because of the work that you've put in. So thank you.
00:04:07:23 - 00:04:09:06
Dr. Kelly Cawcutt
Thank you.
00:04:09:08 - 00:04:21:04
Justin Nabity
So you were talking about your life growing up. Was there something that captured your interest about infectious disease specifically, or is it more so just learning about it through medical school and residency?
00:04:21:06 - 00:04:42:22
Dr. Kelly Cawcutt
A little bit of both. I would say my initial first love was actually critical care medicine. But I did not love pulmonary medicine. It was not an area that I could see myself practicing in long term. I loved infectious diseases when I spent some time with it because much like critical care, you never know what you're going to see next.
00:04:42:22 - 00:05:11:08
Dr. Kelly Cawcutt
It's any organ system, any time. All of human pathophysiology could be impacted as you're seeing patients. But I did have an event when I was in medical school that probably tipped me a little bit towards it, too, which was having, my grandfather die of septic shock in an ICU that I was rotating in, and so had a very close to home impact that I don't think initially led me down that road.
00:05:11:08 - 00:05:16:12
Dr. Kelly Cawcutt
But ultimately, I think he was kind of a thread across that critical care and ID side of my world.
00:05:16:14 - 00:05:17:04
Justin Nabity
00:05:17:06 - 00:05:26:05
Dr. Kelly Cawcutt
Knowing that they were so heavily tied and that was under-recognized at the time. I was doing the training that I chose to do.
00:05:26:07 - 00:05:40:03
Justin Nabity
Gotcha. That makes sense. Tell us about what you see today is why is it difficult to be a physician, to be a doctor in health care with the direction that things have been going? What are some of the things you're encountering?
00:05:40:05 - 00:06:14:01
Dr. Kelly Cawcutt
I think there's a lot of things in healthcare that make it difficult currently to be a physician. I know one thing that you and I had the opportunity to talk about offline was women physicians have a harder time in many aspects, from training through promotion, pay structure, and ultimately even moving into leadership positions. And that has been a continued data driven disparity in the medical world, which is a hard, hard thing to overcome.
00:06:14:03 - 00:06:41:03
Dr. Kelly Cawcutt
And when we kind of look at Women in Medicine Month and, you know, some of these initiatives that get some press with that, it really is because of that disparity and that struggle that it will be a harder road, especially for women in male dominated fields. But even in non male dominated fields, those disparities still very clearly exist.
00:06:41:05 - 00:06:49:14
Dr. Kelly Cawcutt
So that's a very close to home piece for me. But there's a lot of other things related to the critical care, the infectious disease side that are always top of mind also.
00:06:51:06 - 00:07:10:17
Dr. Anthony Giuffrida
I'd love to have a followup question on that because I agree with you 100%. And I think on a previous podcast a few weeks ago, we talked about how starting a family is just easier for a male than a female, right? If you're going to have the baby, you have to carry it for nine months. And in the mean time that you're in residency and you you did a lot of training.
00:07:10:19 - 00:07:23:23
Dr. Anthony Giuffrida
Right. And kudos to you. Like that's impressive. It's hard to start a family during residency during fellowship. I'm not saying it's shunned upon, but when I trained, it was not optimal. Is that a good way to put it? I mean, that's.
00:07:24:00 - 00:07:37:18
Dr. Kelly Cawcutt
Absolutely I mean, I was like, told to take off my wedding rings when I was interviewing for certain places and told to not talk about whether or not I would ever have children. I mean, I went down that road very clearly.
00:07:37:20 - 00:07:58:03
Dr. Anthony Giuffrida
I mean, that's just not it's out of control. I remember one of my co-residents, I was physical medicine rehab, and our first year was internal medicine, and she was pregnant, had a baby, and they wanted her back in two weeks. And we're like, we'll cover it. Like, what are you talking about? Two weeks. Like, she just had a baby and like, oh, if she, you know, she could take more time, but she could do this.
00:07:58:03 - 00:08:11:19
Dr. Anthony Giuffrida
But. And it was just so disheartening for all of us that we're all excited for one of our residents to have a baby. And you're like, how do I. And she came back in two weeks and I was blown away at my how, how I can barely take care of myself right now. And that.
00:08:11:21 - 00:08:15:09
Justin Nabity
Was that male leadership or a female leadership that were pushing.
00:08:15:11 - 00:08:24:16
Dr. Anthony Giuffrida
It was it was male leadership at that time. And honestly, that there were some other issues with.
00:08:24:18 - 00:08:49:06
Dr. Kelly Cawcutt
There were issues related to that, even from overarching national training policies that that really did not allow significant parental leave for women. And you had to use all of your vacation at all for maternity leave, even that you might not get. And you have to make up all of that time, which pushes you off cycle. Then if you're going into getting hired for a job, if you're trying to enter a fellowship.
00:08:49:08 - 00:09:20:17
Dr. Kelly Cawcutt
To me, I ended up going through things off cycle based on when my son was born. And you know, you're not on track with everybody else. It makes it much more difficult and an extraordinary amount of negotiation. And and without strong advocacy, either from yourself and others or someone in a program who's going to advocate for you. It can be extremely physically traumatic, but also just emotionally traumatic because you don't have that time to recover.
00:09:20:23 - 00:09:34:13
Dr. Kelly Cawcutt
And I actually remember after my son was born, I was able to come back. I came back right at six weeks, but I went right into a senior ICU night float at a level one trauma center, where I was the only trainee on call.
00:09:34:15 - 00:09:54:01
Dr. Anthony Giuffrida
Yeah, it's just unjust right now. What happened in going off cycle, for those of you that aren't physician is a big deal. I mean, you're you're applying for fellowships against everyone else, everyone else to getting their fellowship in July. You're trying to get it in August or September. Most fellowships won't take someone off cycle because it throws their whole, their whole curriculum off cycle.
00:09:54:01 - 00:09:54:10
Dr. Anthony Giuffrida
So you have.
00:09:54:10 - 00:10:18:09
Dr. Kelly Cawcutt
To defer a whole year event potentially, or not or choose not to or again, have a, you know, I was able to do some weird negotiating kinds of things with mine. And, but yeah, I was very off cycle, both with timing, a fellowship start and with timing of starting my faculty career. I mean, I started in January, you know, we everybody starts in July.
00:10:18:11 - 00:10:25:23
Dr. Kelly Cawcutt
So even trying to find a position sometimes can be difficult. If you don't have something outlined in advance.
00:10:26:00 - 00:10:44:15
Dr. Anthony Giuffrida
Yeah. And just because you wanted to start a family, that's just unfair. At the time that normal people start a family. Not that doesn't normally start earlier or later, but the majority of the country starts a family at that time. It's not like you were doing something extraordinary, right? And to me, it's just it's not right. We have to fix that problem.
00:10:44:20 - 00:11:05:14
Dr. Anthony Giuffrida
And this is the kind of stuff that leaves leads to physician burnout, too, because you have to sit there and think about your kid and then sometimes there's resentment towards the kids either. I'm not saying you had that, but, you know, all that threw me off cycle. That's why I didn't get to my fellowship is because you had a child like, that's not okay if you got in trouble and it threw you off cycle, or if you know other reasons, I get that.
00:11:05:14 - 00:11:10:05
Dr. Anthony Giuffrida
But because you have a child, I just don't. I don't agree with that at all.
00:11:10:05 - 00:11:36:14
Dr. Kelly Cawcutt
Yeah. And I think a lot of the resentment, resentment truly goes to the system now because people recognize that as a problem. But there's another gap after that. So you're off cycle. And so you have a delayed start to your fellowship. You know, the downstream impact, though, of that reality is that there are several missed opportunities. That and you see an attrition of women at mid career at what would be academically that associate level professor 5 to 7 years.
00:11:36:16 - 00:12:02:18
Dr. Kelly Cawcutt
Because, you know, for the women who whether you choose or choose not to have a family, this gap exists. But particularly amongst so among the data with women who have families, you know, you still tend to do more of the home, additional non professional life work compared to if you have a male partner in your home. But that means that those are the hours that you don't spend doing the research, writing the papers and fellowship.
00:12:02:20 - 00:12:28:22
Dr. Kelly Cawcutt
They delay your capacity to move forward. And there's multiple examples of being, you know, over mentored and under sponsored for opportunities. Because people frequently when you look at literature and experiences personally, you have this gap of saying, well, you have a young family, so, you know, we're not even going to offer you that opportunity because you're busy. And I've had that exact thing told to me, well, we didn't even ask you if you were interested because you have small kids.
00:12:28:22 - 00:12:30:21
Dr. Kelly Cawcutt
I'm like, that's not your decision. That's my decision.
00:12:30:21 - 00:12:32:10
Dr. Anthony Giuffrida
Like they're doing you a favor too. That's
00:12:32:10 - 00:12:32:24
Dr. Kelly Cawcutt
Right.
00:12:33:01 - 00:12:35:10
Dr. Anthony Giuffrida
how it’s brought up. Oh, I didn't want to. I don't want to bother you with that.
00:12:35:13 - 00:12:36:05
Dr. Kelly Cawcutt
Right.
00:12:36:07 - 00:12:36:12
Dr. Anthony Giuffrida
Yeah.
00:12:36:13 - 00:12:41:21
Dr. Kelly Cawcutt
Right. And I think similarly the bias is very different between men who have children and women.
00:12:41:23 - 00:12:43:04
Dr. Anthony Giuffrida
100%.
00:12:43:06 - 00:12:54:00
Dr. Kelly Cawcutt
You know, one of the kind of most memorable moments for me was having a male physician tell me I could either choose to be a good mom or a good academic doctor, but I can't do both.
00:12:54:00 - 00:12:54:10
Reid Lancaster
Geesh.
00:12:54:12 - 00:12:55:12
Dr. Kelly Cawcutt
00:12:55:14 - 00:13:05:24
Dr. Kelly Cawcutt
And, you know, unfortunately, I don't have a lot of reserve for that commentary. And so, you know, at that point it's kind of like, well, did you choose to be a terrible father, too?
00:13:06:02 - 00:13:32:01
Dr. Kelly Cawcutt
I mean, you were a successful academic physician, like, are we not the same? But, you know, that's not the perspective that seen. It's not an equitable perspective on men versus women in any aspect of from training, parenting, whether you choose to have kids or not. And the impact of that bias, that kind of is pervasive because if you don't have kids, everyone's going to ask you why you're not
00:13:32:03 - 00:13:32:16
Reid Lancaster
Right.
00:13:32:18 - 00:13:36:02
Dr. Kelly Cawcutt
Downside to you will be perpetually asked why you don’t have children.
00:13:36:04 - 00:13:40:08
Reid Lancaster
By everybody, not just in medicine, by every friends, family, particularly.
00:13:40:08 - 00:13:41:07
Dr. Kelly Cawcutt
Right.
00:13:41:09 - 00:13:42:19
Dr. Kelly Cawcutt
Right.
00:13:42:21 - 00:13:51:20
Justin Nabity
So when we were talking about this today, Kelly, you were saying that scratching inclined to get your way, it's like ten times the effort.
00:13:51:22 - 00:13:52:07
Dr. Kelly Cawcutt
Yes.
00:13:52:13 - 00:14:04:18
Justin Nabity
Do you have any examples or like, things you would share. Because normally we're talking about the problems in healthcare on the scale of like the system. And this is very much attributes to the system.
00:14:04:20 - 00:14:29:12
Justin Nabity
How can how can other women, from your experience, can they learn from what you've done? Or have you found some successes? Have you overcome any of these obstacles that you've encountered because you're very confident, it sounds like, in how you're dealing with these things nowadays. And maybe before, what did you always have that level of confidence, or was it something you developed along the way?
00:14:29:14 - 00:14:52:19
Dr. Kelly Cawcutt
I think I had some of it and I think some of it developed and I think because there is like truly published literature that is related to this, which I participated in some of those publications, and I've spoken at different conferences about this, you know, and I've been part of some of those research projects. You know, there's the lived experience, there's the learned experience, and then there's the research driven.
00:14:52:19 - 00:15:12:07
Dr. Kelly Cawcutt
How do you train from that experience? And I think all three of those have been very important to me. I think that one of the most dangerous things, though, is actually to ask a women how they should fix it. This is a systemic problem. So if men are not driving part of the solution, you are actively part of the problem.
00:15:12:09 - 00:15:36:15
Dr. Kelly Cawcutt
And I think that's really important. And that is true not for gender disparities, but racial disparities, transactional intersectional disparities. If you put the burden of the disparity on the disparaged to fix it, you are only actually driving the systemic problem to be worse. Why should those who have been suffering more from that be the ones to solve it?
00:15:36:21 - 00:16:01:08
Dr. Kelly Cawcutt
And when you look at health care disparities and you look at your expertise and the people driving those change, it is still very heavily driven by the people who have actually struggled the most. So I think one, there's a lot of ways to move through that process. But two, this is a collective problem that needs to be addressed in the system, and you need to have active engagement on all sides to fix it.
00:16:01:10 - 00:16:01:16
Justin Nabity
Yeah.
00:16:01:17 - 00:16:24:04
Dr. Kelly Cawcutt
Just like you do regarding maternal mortality. Right? You can't just ask women. And OBs purely to fix the issues on maternal mortality, in which African American women, you know, black women have a higher mortality. That is something that has to be built into the system, not just in those populations or those specialties.
00:16:24:06 - 00:16:46:12
Justin Nabity
Definitely needs a collaborative approach, no question. So is there anything else that you would suggest as as DocNation, as the people who want to see change and are pushing change? What what are some things that, that, we can do or that ideas you may have that would help us be able to do more in this area?
00:16:46:14 - 00:17:11:20
Dr. Kelly Cawcutt
I think things that are really important are one, be aware that this exists and acknowledge that it exists. You know, you can't do anything if you're not acknowledging the issue and the problems that are gender, other disparities in health care in general, right. And two, when you are looking at something where there's implicit and explicit bias, like gender in medicine.
00:17:11:22 - 00:17:37:02
Dr. Kelly Cawcutt
There's really that simple opportunity to choose to be an upstander where when you see it, you say something versus a bystander who observes it happening and doesn't take that chance in the moment to do something different. So, you know, if you're sitting in a committee looking at candidates for a new role, how many women are in that pile of candidates?
00:17:37:04 - 00:17:54:04
Dr. Kelly Cawcutt
Is it equal proportionality wise to your population of women and men in that specialty? If not, is it because there's no qualified women or because somehow they got weeded out because of concerns for bias? Is it truly that they're not qualified.
00:17:54:06 - 00:17:56:12
Reid Lancaster
Because they were wearing a wedding ring.
00:17:56:14 - 00:18:17:05
Dr. Kelly Cawcutt
Right. Because they were wearing a wedding ring? Because someone assumed that they didn't have time or they weren't interested because they may not have been as verbally aggressive. I think also, similarly, when you look at some of the data, when men apply for a role, if they have 50 to 60% of the attributes or training, they're considered competitive for the role.
00:18:17:07 - 00:18:47:08
Dr. Kelly Cawcutt
That is not necessarily true for women. You really have to be higher than that. You really have to almost out credential men to be considered equitable in that capacity. And so being aware when you're looking at applications, if you're writing a letter of recommendation, when you're looking at someone who's going to get promoted, are you looking at that group equitably and frankly from all lenses, gender, race, all of these pieces, because representation in healthcare in this country matters.
00:18:47:10 - 00:19:11:23
Dr. Kelly Cawcutt
It's hugely important to so many of the systemic issues impacting healthcare across the country. And I think for women who are struggling, finding other women and mentors outside of your geographic constraints, if you can't, there's is really important. There is a phenomenal number of fantastic women in medicine conferences that can help provide education and coaching for women.
00:19:12:00 - 00:19:16:11
Dr. Kelly Cawcutt
They're also open to men, and men do what you need to also learn similarly, which is.
00:19:16:13 - 00:19:32:24
Dr. Anthony Giuffrida
I was just about to say that I go to the Women in medicine, conference in the pain field. The pain field is dominated by men. And we have some amazing women in our field. And kudos to them. They rise to the top. I mean, they stick their heads right in there and get it done, and that's because that's their personality.
00:19:33:01 - 00:19:46:11
Dr. Anthony Giuffrida
But I love talking to them and collaborating with them. And I love that you say representation. But even more than Rep, it's not about representation. There's actually data that's come out about women surgeons are better than men surgeons. Like that data came out and normally...
00:19:46:13 - 00:19:48:09
Dr. Kelly Cawcutt
There’s data about internal medicine too.
00:19:48:11 - 00:20:14:12
Dr. Anthony Giuffrida
Yeah, it just came out. I saw the surgery side like six months ago, and everybody's kind of stared at it. And it was a real, you know, that it was. They looked at it and everything like that so this isn't just representation anymore. Maybe we're they're better or we're better, I, I don't want to call it just representing because I the thought of a woman getting put in a position just because she's a woman too, like, she's good at that and really good and deserves that spot.
00:20:14:13 - 00:20:18:21
Dr. Anthony Giuffrida
Not because people like, oh, she's a woman. That's why she's on the board. We need one more. I hear that all the time, too.
00:20:18:21 - 00:20:19:14
Dr. Kelly Cawcutt
Right.
00:20:19:16 - 00:20:19:21
Dr. Anthony Giuffrida
I hate that.
00:20:19:21 - 00:20:33:03
Dr. Kelly Cawcutt
And that's very much an example. I mean, again, whichever group it is, that's a very much the example of tokenism, which happens for women and other represented people. Right. We're like, oh, we have a board and there's 12 members. But as long as you have one woman, we're okay.
00:20:33:06 - 00:20:34:05
Dr. Anthony Giuffrida
Yeah. Exactly.
00:20:34:08 - 00:20:34:22
Reid Lancaster
The token female.
00:20:34:24 - 00:20:36:09
Dr. Kelly Cawcutt
That’s not, that's not equity.
00:20:36:09 - 00:20:47:07
Dr. Anthony Giuffrida
One woman one person of race. Like it's like it's like you check the boxes. I'm like, is that really. That's not what we did here. Like, this isn't. We're not. We shouldn't pat ourselves on the back for doing that. And it's easy for me to say, obviously.
00:20:47:10 - 00:20:54:05
Dr. Kelly Cawcutt
There's definitely a progression in that of moving from tokenism to truly finding, you know, equity in...
00:20:54:07 - 00:20:54:16
Dr. Anthony Giuffrida
Yeah.
00:20:54:19 - 00:21:27:17
Dr. Kelly Cawcutt
Board membership, leadership positions. I mean, that's true in authorship, right? And, you know, but our medical society component, I actually suspect I know some of the people you're referring to in your pain field. And so, you know, there is that need to think about the difference between, you know, fair and just equality and equity and avoiding having people be a token to, you know, click a box and say, oh, well, we have someone here, but because unfortunately, when that happens, oftentimes too, they're there.
00:21:27:17 - 00:21:37:18
Dr. Kelly Cawcutt
And that is exactly the mentality. We check the box, but we don't value them the same way. Like they belong here. We just check the box that someone's at the table.
00:21:37:20 - 00:21:39:13
Dr. Anthony Giuffrida
Yeah. Yep.
00:21:39:15 - 00:21:40:09
Justin Nabity
So we think
00:21:40:10 - 00:22:09:13
Reid Lancaster
This makes a this this makes me think, about physician burnout and think about the road that Kelly has had to take to get where she is right now. Like that's at least times ten, I would say times ten in the burnout field. It makes me think about a podcast, guest that we had Doctor Allison Cotton, who founded a physician hotline where, physicians have actively taken their own life on the phone with this physician hotline.
00:22:09:15 - 00:22:29:17
Reid Lancaster
And I just get a lot of the passion coming from Kelly that we got from Doctor Allison Cotton. And, it's just it's really this podcast. Got to be honest. It's opened my eyes. We talk to doctors all day long, and, I'd say a good portion of them are male and they're burnt out. And I'm just thinking about Kelly, and I'm thinking, you got to be burnt out.
00:22:29:22 - 00:22:33:10
Reid Lancaster
And I'm just hoping that today you're wearing your wedding ring. That's. That's all I can think of
00:22:34:00 - 00:22:34:14
Dr. Kelly Cawcutt
I am.
00:22:34:17 - 00:22:57:14
Dr. Kelly Cawcutt
I, you know, it was a very short lived run of things. But there are there are, there are those moments of interviewing and doing different things over the course of my years of, things that I would never do again, that I, I certainly regret doing to fit in the box of what I was supposed to look or act like or be like trying to become a physician.
00:22:57:16 - 00:23:13:24
Dr. Kelly Cawcutt
And yeah, you learn from those, but you don't forget them. And, you know, we still see these moments, you know, even now, you know, patients, some patients do not want a woman physician. They don't think we belong there, or they always assume I'm the nurse.
00:23:14:01 - 00:23:14:14
Dr. Anthony Giuffrida
Yep. Yep.
00:23:14:16 - 00:23:36:07
Dr. Kelly Cawcutt
Or if my internist, taller than me, looks older than me. You know, he's clearly the one in charge. And, you know, you still see all of that. And so I think, you know, there is there's data for burnout related to this. You know, that’s grown obviously that's a massive issue in health care in general and certainly escalated profoundly with the pandemic and post pandemic states.
00:23:36:09 - 00:24:10:14
Dr. Kelly Cawcutt
There is data, you know, you speak about surgical data. It's there. It's there across the board, too, that when you have a group of of health care workers who, again, are in some way suffering from a bias disparity or underrepresentation, that burnout tends to fuel further and often does appear related to imposter phenomenon mixed in with that because of the, you know, kind of silent messages that you're just not enough as you are that cycle through that and that just fuels that fire.
00:24:10:14 - 00:24:39:07
Dr. Kelly Cawcutt
And it's really hard. And that is part of why you see the attrition of that mid-career age group leaving medicine because of those issues. And trying to kind of navigate through that is complicated. And that's I mean, it's very, very true in academic medicine, but it's true in private practice. It's true in hybrid practices. It's just different professional experiences sometimes in those different arenas of healthcare.
00:24:39:09 - 00:25:05:06
Justin Nabity
Professionally, having to wait ten years to start making decent income, then being told you have to wait to build a family when that's not the right time of life, necessarily to wait all that together. We talked about representation. I think about how this, this, this study or whatever you said, Anthony, about the results of this, that, women are doing better.
00:25:05:08 - 00:25:06:18
Reid Lancaster
They're better female surgeons.
00:25:06:20 - 00:25:07:13
Justin Nabity
Better female surgeons.
00:25:07:13 - 00:25:08:13
Dr. Anthony Giuffrida
Better outcomes, better outcomes.
00:25:08:13 - 00:25:09:13
Justin Nabity
Better outcomes.
00:25:09:15 - 00:25:10:13
Dr. Anthony Giuffrida
For female surgeons than male surgeons. - the same surgery, the same surgery.
00:25:10:22 - 00:25:33:20
Justin Nabity
I think you're you're aware... Yeah, I think I think Kelly your awareness piece, the awareness factor like women make health care better is kind of what the common denominator that I'm hearing is. And so like let's actually view them that way rather than viewing them in the opposite. And this representation piece with Christiana Care in Delaware, the largest health system there has a union.
00:25:33:20 - 00:25:58:03
Justin Nabity
Now they just formed a union. They voted the doctor voted for a union. There's the residents striking in Buffalo in New York, like, we're probably going to need to think more about what women can do in terms of by supporting them here in this topic. From an organization perspective, because they make health care better and we we need them.
00:25:58:05 - 00:26:43:08
Dr. Kelly Cawcutt
Well, I think too, you know, you think back to, times of training, right. Like, I mean, I, I knew what it was to work more than, you know, a 24 to 30 hour shift in training. I worked more than 120 hours a week. Those things don't necessarily happen anymore, or they're not supposed to, but the issues just systemically of inhumane treatment to some ways of healthcare workers, of assuming that you can work ridiculous hours in perpetuity, right, that the standard working hours should always be profoundly more than 40 to 80 hours a week, and you should be able to be on call, you know, so much more.
00:26:43:13 - 00:27:09:19
Dr. Kelly Cawcutt
I mean, and yes, there's a professionalism, there's a calling there. There is some capacity that, you know, of choosing this. Right. And then the flip side of that is at what point when you have burnout and you have trainees struggling and you're struggling to maintain your future health care workforce, do you start from the beginning and say, maybe we actually revisit medicine and how we've structured how people live professionally, functionally in this?
00:27:09:21 - 00:27:15:07
Dr. Kelly Cawcutt
And a great example was the loss of nursing through the pandemic. I mean, you know, heavily abused.
00:27:15:12 - 00:27:15:19
Justin Nabity
Yeah.
00:27:15:19 - 00:27:47:06
Dr. Kelly Cawcutt
You know, in a pandemic in many areas, it's not all overworked, multitudes of physicians, profoundly overworked. The attrition was phenomenal. That happened with, you know, what some dubbed the Great resignation in general. Right. And that's a systemic problem of being understaffed, not having redundancy in systems and not being able to have people have time off, time away when you're sick, you know, the ability to take maternity leave or paternity leave, right?
00:27:47:06 - 00:28:08:13
Dr. Kelly Cawcutt
Like these are all critical pieces that need to be addressed like the rest of the business world, in ways to say, you have to be able to treat people in a way that they want to continue to do their job. If you don't, they will burnout and they will leave because they can't have any component of non professional life.
00:28:08:15 - 00:28:16:00
Dr. Kelly Cawcutt
And that's a struggle that's made some improvement over the last 10 to 20 years, but probably nowhere near enough.
00:28:16:02 - 00:28:33:02
Dr. Anthony Giuffrida
And and honestly, in the end it'll benefit the patient. If your physicians are happier and not burning out, patient will do better. And that's, that's where it has to come from, isn’t it? It's not. Everyone thinks it's physicians complaining at this point. But it's not that we just can't take care of patients the way we'd like to.
00:28:33:04 - 00:28:52:14
Dr. Kelly Cawcutt
Right. And there is a clear data behind that. You know, burnout and infection control. If you are burnt out, you are less likely to do all of the things you need to do to prevent your patient from getting a healthcare acquired infection. That's a known entity, you know. So how do you avoid burnout? It's not by adding more tasks to a burnt out physician.
00:28:52:18 - 00:29:15:09
Dr. Kelly Cawcutt
It's not by asking people to do yoga or to find, yeah, additional resiliency classes. That doesn't actually help. By nature, anybody who made it that far is already really resilient because they lived through medical training. You know, it's it's understanding it and really looking at it from the organization and systemic standpoint more then putting the blame again on the people who are suffering.
00:29:15:11 - 00:29:15:18
Dr. Anthony Giuffrida
Yeah.
00:29:15:22 - 00:29:18:01
Justin Nabity
And you have insurance companies posting record profits.
00:29:18:01 - 00:29:22:07
Dr. Kelly Cawcutt
Um-hmm.
00:29:22:09 - 00:29:22:22
Dr. Anthony Giuffrida
Yeah.
00:29:22:24 - 00:29:37:14
Justin Nabity
That's clearly a sign that the cash flow running through all this demanding more from doctors to see more patients, to have less time per patient. And the solution is physicians and doctors need to do more. Well, actually...
00:29:37:18 - 00:30:01:12
Dr. Kelly Cawcutt
Increase reimbursement for everything you do or you have to do more to even, you know, meet kind of that same income requirement. Whether you're physician based that way or whether you're, you know, a hospital organization looking at your income. If we continually have cuts back on those efforts, you just can't maintain the same level of patient care in the setting of those financial constraints.
00:30:01:14 - 00:30:21:01
Justin Nabity
So I think that's interesting. With regard to our last episode, we had talking about, again, how the insurance companies have have gotten in the way. I think about how this says perpetuated our problems with the gender gap here by forcing pressure. All of this, when there's a the dollars are not there. They're they're continuing to be taken away.
00:30:21:03 - 00:30:27:10
Reid Lancaster
Cash flow is fine in the health care system. It's more than fine. It's where is the cash flowing to that is the problem
00:30:27:16 - 00:30:32:01
Justin Nabity
Right. So Kelly I appreciate you being on
00:30:32:06 - 00:30:33:14
Reid Lancaster
Well done. Well done.
00:30:33:18 - 00:30:49:00
Justin Nabity
I love your input here. And look forward to visiting with you more, we have a large platform, and I hope that freed up some of our physician clients to maybe reach out to us female physician clients to maybe reach out to us, and maybe if we could put them in contact with you, just maybe for a word of encouragement or something like that.
00:30:49:00 - 00:31:02:14
Justin Nabity
I think that would be really, really cool. We will be respectful of your time, but, I'm inspired and I think, someone on the drive home today or next week whenever we get this posted, will be inspired as well. So thank you so much. Very impressive.
00:31:02:16 - 00:31:04:15
Dr. Kelly Cawcutt
Well thank you. I appreciate the opportunity.
00:31:04:17 - 00:31:06:17
Reid Lancaster
Have a wonderful day.
00:31:06:21 - 00:31:08:02
Dr. Anthony Giuffrida
Thank you Kelly. Very nice meeting you.
00:31:08:04 - 00:31:11:05
Dr. Kelly Cawcutt
Nice to meet you, also.
00:31:11:07 - 00:31:28:02
Justin Nabity
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00:31:28:08 - 00:31:35:17
Justin Nabity
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