Dr. Sarah Smith [00:00:04]:
Welcome to the sustainable clinical medicine podcast. I am your host, Sarah Smith. I am a practicing rural family physician and the charting coach. This is the podcast for physicians and advanced practice providers who are ready to step back from the busyness of their clinical day to share ideas, question everything, and redesign their clinical day. We are redesigning clinical medicine to create sustainable clinical days and create time for our lives outside of medicine. Join us for discussions with world experts who are helping design sustainable models of clinical medicine and the physicians or clinicians who have discovered or designed sustainable models of clinical medicine for themselves.
Dr. Sarah Smith [00:00:49]:
Hello everybody. And welcome back. We're so delighted to have you here today. And today we have with us doctor, Fabienne Moore, who is going to introduce herself to us.
Dr. Fabienne Moore [00:01:02]:
Thank you so much, Sarah, for having me and for the chance to introduce myself. I am a physician by training, and I am currently a physician and physician executive coach. I work with leaders 1 on 1, and I also offer group coaching. And, I'm based in Atlanta.
Dr. Sarah Smith [00:01:19]:
Perfect. Alright. So let's go back to your beginnings in maybe beginnings in medicine or beginnings somewhere in your story, about your journey as you started this, career and the things that happened.
Dr. Fabienne Moore [00:01:36]:
Origin stories. So important. Right? Probably different from many of the guests on your podcast. Certainly, the folks who I've had a chance to listen to. My origin story actually goes back to when I was in residency. I was a categorical general surgery resident at a level 1 trauma center. And I was a few years in when I had the realization, like, wow, this is this is not my work.
Dr. Sarah Smith [00:02:02]:
Mhmm.
Dr. Fabienne Moore [00:02:03]:
Which sounds so simple to say with the benefit of 20 years of hindsight, but you can imagine how completely earth shattering that kind of insight was in the moment. And, you know, this was long enough ago that there really weren't nontraditional paths for folks with clinical degrees. So I remember reaching out to mentors, reaching out to deans at my medical school and no one could offer me any guidance. So I I wound up just having to say, even not knowing what can be next for me. I know that this is not for me. And and I could feel how the demands and the stresses of the work, like, you know, your focus on sustainability and burnout. I was becoming a person who I didn't wanna spend the rest of my life being in response to those pressures. And so I left.
Dr. Fabienne Moore [00:02:55]:
Three simple words, a lot in them.
Dr. Sarah Smith [00:02:58]:
Absolutely. Tell us, why did general surgery pique your interest? And then what was it about general surgery that was not your work? So kinda how did you come to that revelation? So why did you wanna be there to start with?
Dr. Fabienne Moore [00:03:15]:
New things about general surgery. Apparently, when I was about 5 years old, I made the declaration that I was going to be a surgeon and a prima ballerina. Prima ballerina fell by the wayside, surgeon did not. And then I have a vivid memory of the first case I scrubbed in on as a 3rd year. And that moment when we broke through the peritoneum and the bowel kind of it was an obstructive case. Right? So the bowel kind of ballooned up, and I was like, this is amazing. Just amazing.
Dr. Sarah Smith [00:03:51]:
Love it. So good. So good.
Dr. Fabienne Moore [00:03:53]:
And then, you know, there was the reality of the intensity of the work. And and when you catch yourself more,
Dr. Sarah Smith [00:04:01]:
I I
Dr. Fabienne Moore [00:04:01]:
have a very vivid memory, and I'm guessing at least some of your listeners will identify with this of rounding in the ICU one day and thinking, got it. Sure. Would be nice to lay down like that. And I was like, oh, okay. That's that's a that's a red flag.
Dr. Sarah Smith [00:04:19]:
Okay. So there's the general surgery and then trauma surgery. Now they're not the same thing. Had you explored different types of surgery to because something pulled you towards this trauma center.
Dr. Fabienne Moore [00:04:32]:
Yeah. Tell us about Well, so I had intended to go on through to a fellowship. So I want it was important to me that I match it at, you know, a high level academic center where I'd have a broad range of exposure as a trainee. And because it was a level 1 trauma center, most of what we did our 1st few years of training was trauma. We did other things, but it's a lot of trauma based work.
Dr. Sarah Smith [00:04:57]:
And what did on call, what was the demand like when when you were a resident? So what sort of kinda hours were you pulling? What did it look like to be you in that that time?
Dr. Fabienne Moore [00:05:09]:
I'm gonna date myself for at least those in the in the those who are listening in the US. This was long before the 80 hour work week. So I was in the days of q 2 on call for 36 hours.
Dr. Sarah Smith [00:05:22]:
K. Yeah. Routine. And I'm guessing there's not a lot of sleeping time in those 36 hours?
Dr. Fabienne Moore [00:05:30]:
No. No. No. No. I we learned I learned very quickly the order of operations was eat when you can eat, void when you can void, and then if you're lucky, take a 20 minute nap.
Dr. Sarah Smith [00:05:44]:
Yeah. Yeah. And that is exhausting on a human physiology.
Dr. Fabienne Moore [00:05:50]:
Absolutely.
Dr. Sarah Smith [00:05:51]:
And how long were you in that kind of busyness when you kinda had the realization that no way. I'm not doing this. This is not my work.
Dr. Fabienne Moore [00:06:02]:
Yeah. For me, it was a couple years in. I was about 2 and a half years in. And there's a another interesting well, I'll say relevant aspect of my story that I I now know about myself is that I do there's a a particular neurotype called the highly sensitive person. And it turns out, I have one of those highly sensitive nervous systems. And we are particularly vulnerable to sleeplessness, low blood sugar, high stimulation, high input environments, and unrelenting paces. So it was just really it's actually really healing to over, like, a decade and a half later. I realized like, oh, wow.
Dr. Fabienne Moore [00:06:42]:
Like, there was just something as as important as that work is. There was maybe just a fundamental lack of fit
Dr. Sarah Smith [00:06:51]:
Mhmm.
Dr. Fabienne Moore [00:06:51]:
Right between my wiring and what the what that environment demanded of folks.
Dr. Sarah Smith [00:06:57]:
Yeah. What was the feedback you were getting about your performance and things? Was there anything on that level that was suffering, or is it really an it was an internal journey?
Dr. Fabienne Moore [00:07:10]:
You know, it was primarily internal, and it's one of the things that I'm committed to. And my work with leaders now is supporting them in developing their ability to communicate effectively with their teams and give feedback. Because I honestly I don't remember that any of the it's hard to say the grown ups. Any of the attendings around me were actually able to to give me skillful feedback or, you know, offer support that might help me redirect. And I that's not a judgment. Right? That's just a recognizing that it their experience hadn't necessarily equipped them to to, right, to be present to their trainees in that way.
Dr. Sarah Smith [00:07:55]:
Wow. Interesting. And did you tell anyone that you were suffering before you went off to the dean and the the the, program director about what what you were experiencing and did any like, I don't know. I'm guessing the other residents were having a similar awful experience, but I don't know what you guys talked about. Was that a thing that you would talk about?
Dr. Fabienne Moore [00:08:22]:
You know, it was just the thing. Right? That's how it was. That was the work. That was the pace of the work. That was the lifestyle. That was the expectation. And so we all, you know, we would get together and blow off steam about it, but there was certainly never any sense that it should or even could change. Right? It's just the nature of the beast.
Dr. Sarah Smith [00:08:51]:
Okay. So you're all suffering together. Everybody's feeling miserable.
Dr. Fabienne Moore [00:08:55]:
Yeah. And you're like, this is not for me. One of my co interns, you know, like, one of the games we would play is where and how many times did you fall asleep while driving home? Oh, wow. Right? That was
Dr. Sarah Smith [00:09:08]:
that was
Dr. Fabienne Moore [00:09:09]:
kind of one of the themes of our stories that we shared, which Wow. Again, like, in hindsight is just horrifying.
Dr. Sarah Smith [00:09:17]:
Is there breaks? Is there annual leave? Like, is there any end to the relentlessness of residency or as it had been?
Dr. Fabienne Moore [00:09:30]:
No. That's such a good question, Sarah. I'm gonna say I'm sure we were given vacations. I remember it feeling unrelenting, but I'm using that language very deliberately.
Dr. Sarah Smith [00:09:42]:
Mhmm. Yeah. Yeah. No. That's okay. It's okay. So then you were like, okay. This is not for me.
Dr. Sarah Smith [00:09:47]:
I need an alternative, and you then go and seek advice. Who did you go and see?
Dr. Fabienne Moore [00:09:54]:
I spoke with the dean of students for at my medical school.
Dr. Sarah Smith [00:09:59]:
Mhmm.
Dr. Fabienne Moore [00:10:00]:
And I reached out to, actually, a dear family friend who she's now retired. She was an internist, so she had been something of a mentor to me along my journey. And those those were really the only resources I could think of. And, you know, of course, talk to friends, but they didn't know any more about the situation than I did. So it was very much a leap deep into the unknown.
Dr. Sarah Smith [00:10:26]:
Mhmm. Yeah. And did they say there's no way you can switch residency or different pathway? Like, what was what were you looking for? What did you ask for?
Dr. Fabienne Moore [00:10:36]:
I think I was just probably saying help. I don't know what to do. I'm not even sure that I had high quality questions. And I did actually I wound up doing some clinical research at the institution where I was a trainee. So that was a that was a transition out of the full on residency role. But, yeah, just help. What should I do? That's a good question. We have no idea, and we wish you the best.
Dr. Sarah Smith [00:11:08]:
Wow. Okay. Okay. Alright. So some clinical research. Was that fun? Exciting? Did you enjoy that one?
Dr. Fabienne Moore [00:11:15]:
Yeah. It was definitely better, and it was it was really nice to, like, be with the team in the lab. I very much enjoyed that.
Dr. Sarah Smith [00:11:23]:
Excellent. Okay. So there's a little bit of segue into something different, but then, you did make it plan to do something different. How did that come about?
Dr. Fabienne Moore [00:11:33]:
So I would love to say that I drew up a 10 year plan for how I would gracefully transition out of a clinical career, pay off my loans from a private medical school and still contribute beautifully to society, probably more accurately, a bit of creative bumbling and divine intervention. I also have my master's in public health. And so, I wound up doing some work in public health. I got a job working on a CDC contract in health communications. And I did that for a few years. And then, I was also on the side doing some tutoring and that led to some teaching and I learned, oh, wow. Like, I really love I have a skill for and a real I find a real joy in teaching, facilitating, leading courses, which I hadn't done much of before. So that combination of health care, public health communications led to me submitting my resume to a health care research and consulting firm based in DC called the advisory board company.
Dr. Fabienne Moore [00:12:35]:
And I wound up working for them for about 12 years. And I was one of the spokespeople for the organization. So presenting at conferences, working with hospital boards, present you know, walking them through our research on strategy and operational best practice. And then I moved over into leadership development, and that was really where it all came together for me because it was an opportunity to combine my interest in people, what I know about medicine, my time as an insider, also the perspective I have gained as a a front row outsider, and then and then presentation. So I did that for many, many years, and that then led to me. I was recruited to serve as the vice president of physician development for a nationwide multispecialty practice. And then from there, I stepped out of my own, and I now run my executive coaching and leadership development consultancy.
Dr. Sarah Smith [00:13:37]:
Wow. Okay. Very good. So what was it about the nonclinical things that helped you stay there? So you've got now this new job. You're there for 12 years, and that's is that's is that's more sustainable? Like, how how come that was fun? Well, how come you stayed there for 12 years?
Dr. Fabienne Moore [00:13:59]:
Yeah. So it's interesting, and this is something that I see a lot of my clients. So I'm guessing it will resonate. That work was differently not so sustainable from clinical work. So it was consulting. It was travel 3 to 4 cities a week for, like, 8 straight years. And part of it was just my nervous system was accustomed to functioning at that pace and at that rate. And that's what felt normal to me.
Dr. Fabienne Moore [00:14:32]:
Right? And also to be fair, like the 1st few years, it was exciting, like traveling, seeing parts of the country I've never been to before. How many people can say, unless they're from there, like I've been to Paducah, Kentucky 3 times, or, you know, I've been to just parts of the country I never would have seen on my own. Right? And meeting people and hearing the things that are universal and evergreen in health care. And also, what are the unique things in this community, in this medical staff, in this hospital?
Dr. Sarah Smith [00:15:05]:
Interesting. Okay. So it was sustainable and unsustainable. I'm presuming you're for a point,
Dr. Fabienne Moore [00:15:10]:
and then it became unsustainable.
Dr. Sarah Smith [00:15:14]:
What about, like, you outside of this job? So what was happening kind of on your personal level while you're doing all these? Like, that's a lot of travel.
Dr. Fabienne Moore [00:15:23]:
Yeah. It was. It was. It's funny. Like, I like to say that that work for the advisory board was like me kind of earning my MHA. They paid me to write to to for me to earn my unofficial MHA. And then for me, there was this parallel journey of personal development work and exploration. So I, I got into I started practicing yoga.
Dr. Fabienne Moore [00:15:48]:
I started practicing meditation. I ultimately I have, technically, it's 4 different yoga teacher training certificates, a variety of lineages that I wanted to bring in. I started riding horses and also doing groundwork with horses and, like, equine facilitated experiential work. And so there was this as I was kind of, you know, busy and traveling and being very, like, corporate, there was also this, this deeper vein emerging of really exploring, like, who am I, who do I want to be? And even, you know, just some of the philosophical, like, how do I want to move for the world? What is the world? What are we all doing here?
Dr. Sarah Smith [00:16:32]:
You had mentioned, before we started talking about, as you transitioned out of residency, you were doing some work with WASSES. Where did that come from? Tell us about that.
Dr. Fabienne Moore [00:16:42]:
Yeah. So I first started riding horses when I was a little girl, like 5 years old and I rode for a few years, and then we moved. And I think I was young enough that it didn't occur to me that there might also be horses in this new place, so I just never asked. And then when I was transitioning out of residency, I started writing again. And it was and this is another thing that I, you know, I I work with my coaching clients on, and I offer this to anyone. The importance of following even the tiniest glimmer and to find a place that can nourish you.
Dr. Sarah Smith [00:17:18]:
Mhmm.
Dr. Fabienne Moore [00:17:19]:
That can write like a place that can feel safe, where you can relax. And for me, that happy place became the barn. Even when I wasn't riding, I would just put a 5 pound bag of carrots in my car, drive out to the barn with a folding chair and just post up in the pasture and spend, you know, an hour or 2 just being with the horses. Right? Like, come home post call Saturday, sleep for 2 hours, go sit in the pasture. And having having that place, whether it's a pasture, the park, your bathtub. But creating that place for yourself where you can start to Mhmm. Just a little bit. Yeah.
Dr. Fabienne Moore [00:18:04]:
Horses are being horses are that place and those partners for me.
Dr. Sarah Smith [00:18:10]:
Very nice. Very nice. And what about the yoga? Why did that come in? Where did where did that come from?
Dr. Fabienne Moore [00:18:17]:
Some of it just fitness. Mhmm. And, you know, I'm of that archetype where if I try something and I like it, well, then I must master it. And so it was really important to me to continue to develop and grow and and really understand, like, not just the often a practice that we see in our heads. And when we think of when we hear the word yoga, but what are the roots of this and yoga philosophy and really getting into the energetics and even the spiritual aspects that are expressed through the physicality of the practice?
Dr. Sarah Smith [00:18:58]:
Mhmm. Mhmm. I'm guessing that it's also transportable when you're traveling 3 different cities in a week.
Dr. Fabienne Moore [00:19:05]:
100%. I found myself a 2 millimeter thick travel yoga mat. So like and I still have it to this day. I fold it up. It's it's right on top of my 22 inch suitcase, and you just roll it out. And, yeah, I could practice anywhere.
Dr. Sarah Smith [00:19:22]:
Perfect. Okay. So nice and easy to do. Goes with you, travels easily. It's just important because even if we're in the hospital system or we're doing clinical work, having something that's able to be done easily. So I'm thinking of finding a barn won't be so easy if you're in a different city, but but having your yoga mat is easy.
Dr. Fabienne Moore [00:19:43]:
And and you don't even need a yoga mat. Right? Like, asana, the postures that we think of is just one aspect of yoga. Right? There are things that you can do. And in fact, there are I'm I'm hoping we'll have the opportunity that you and I might even explore some exercises. There are things we can do anywhere that are part of the yogic tradition that give us this opportunity to pause and shift ourselves downshift from that sympathetic mode and more towards our parasympathetic, which, you know, that's neurologically. That's what's going on right at the core of this move towards sustainability.
Dr. Sarah Smith [00:20:19]:
Mhmm. Yeah. Okay. Well, then let's let's do that then. So we can give people something that they can do to kind of practice this. Let let's have it.
Dr. Fabienne Moore [00:20:29]:
Perfect. Let's do it. And this is something even if folks are listening in their car, they can do this. You can do this in meetings, and no one has to know that you're doing it because you keep your eyes open. Perfect.
Dr. Sarah Smith [00:20:40]:
Sounds good.
Dr. Fabienne Moore [00:20:41]:
And it's something called the 5 senses, and it's a noticing exercise. So what we'll do is I'll offer the instruction. We'll do it together. You'll notice silently and then just give me an okay when you're ready to move on. So we may be a little bit out of sync with folks who are listening later, but that's fine. We're still all gonna get the feel of the exercise.
Dr. Sarah Smith [00:21:00]:
Perfect.
Dr. Fabienne Moore [00:21:02]:
Okay. So the first thing we're gonna do is we're gonna start with our sense of sight. And the invitation is to look around you, and that includes up, down, maybe even behind you. And find 5 objects, And rest your eyes on each of them in turn, just letting your eyes take in as much visual information, shape, size, color, movement, shadow. And when you've looked at those five things, just give me an okay.
Dr. Sarah Smith [00:21:41]:
Okay.
Dr. Fabienne Moore [00:21:43]:
K. Next is texture. So if anyone is driving, let's keep one hand on the wheel, and we'll take one hand off. And we're gonna in turn 4 textures. Just gently rub your fingers and feel. You could do your sleeve. You might choose your hair. Just experience and notice 4 textures.
Dr. Fabienne Moore [00:22:06]:
Okay. And now 3 sounds. Notice the volume, the pitch, the rhythm.
Dr. Sarah Smith [00:22:23]:
Mhmm. Okay.
Dr. Fabienne Moore [00:22:25]:
K. 2 smells. Bonus if they're pleasant. They don't have to be.
Dr. Sarah Smith [00:22:34]:
You're all smelling your armpits, aren't you? It's not myself.
Dr. Fabienne Moore [00:22:41]:
You have a cup of something that works.
Dr. Sarah Smith [00:22:43]:
It does. It does. Yep. Okay. Yep.
Dr. Fabienne Moore [00:22:48]:
And then no judgment. We're gonna notice the taste that's in our mouth.
Dr. Sarah Smith [00:22:56]:
Mhmm. Got it. Yeah.
Dr. Fabienne Moore [00:22:59]:
So curious, how do you feel after doing all of that noticing?
Dr. Sarah Smith [00:23:06]:
I think it it reorientates yourself to where you are right now, and I think that, experience in itself is helpful. Right? Otherwise, you can feel like you've been carried along by the day. Whereas if you pause and do these, I agree, you could do that in a meeting or while you're on the phone to someone in the busyness of your day. It can just bring you back to you Mhmm.
Dr. Fabienne Moore [00:23:34]:
That you 1.
Dr. Sarah Smith [00:23:35]:
And even the, oh, I noticed I probably need to find some water. Right? Interesting. Yeah. 100%. Just a a feedback. Yeah. It's a good feedback to ourselves. Love it.
Dr. Fabienne Moore [00:23:47]:
Yeah. And that's what it is. It's an exercise in presencing and coming into what's actually happening in this moment. We're moving so quickly. You're pulled in so many different directions in the course of a clinical day. Taking a moment to like, I sometimes think of, you know, like, in the time travel movies where you're kinda, like, split across time to bring all of yourself back together. And people also will frequently say that that they find it very calming. Mhmm.
Dr. Fabienne Moore [00:24:18]:
That's not the point. That that is a consequence of coming into the present moment.
Dr. Sarah Smith [00:24:23]:
Mhmm. Yeah. Calming is important. I think when we're in the frustration, overwhelm, anxiety of the day, calming is great. Just having a moment of
Dr. Fabienne Moore [00:24:36]:
Yeah. And what I what I love about exercises like the 5 senses and some of the other things I do with clients is, you know, breath work is beautiful. And and that, you know, the sort of the common wisdom of, oh, when you catch yourself feeling overwhelmed or overstimulated, stop and take 3 deep breaths. Couple of challenges with that. Number 1, taking a big deep inhale actually puts you more into your sympathetic according to polyvagal theory. So it can kind of backfire. Number 2, that may not be that may actually be too abrupt of an override of where your nervous system is in that moment. Where something like a, oh, I'm just gonna softly place my attention.
Dr. Fabienne Moore [00:25:27]:
That's more of a a gentle invitation to pause and settle in. And it can be yeah. There's just there's something I find that it's maybe more consistently nourishing regardless of where you are at baseline.
Dr. Sarah Smith [00:25:42]:
Got it. Yeah. Yeah. That makes sense. Yeah. Makes sense.
Dr. Fabienne Moore [00:25:44]:
Yeah. Perfect.
Dr. Sarah Smith [00:25:45]:
Love it. So tell
Dr. Fabienne Moore [00:25:47]:
me deep breaths to be clear, but there's just one True.
Dr. Sarah Smith [00:25:53]:
Tell us about your work now. So what do you do, in your executive coaching practice, and who do you work with, and what sort of things are coming up in those spaces?
Dr. Fabienne Moore [00:26:03]:
Yeah. So I work primarily with physician leaders and physician physician executives and helping them to get unstuck, reconnecting to their purpose, their energy, even like that vitality, right, of life force. So it's very much about finding sustainability on that leadership journey. And I think of my work as having 3 pillars. The first is what we just did. Presencing self awareness, learning to notice myself, becoming present again to my experience. Because particularly in surgery, although I I would imagine it's not that different in the medicine, you know, in medicine and the medical subspecialties. So much of our training numbs us to, like, what's happening in our body and what we need.
Dr. Fabienne Moore [00:26:53]:
So learning to reconnect and reattune to that. And then the second pillar is finding clarity. Another phenomenon I see, and I work with a number of, like, mid career female physicians over the past couple of years is, you know, we reach this tipping point where there's the opportunity to shift from I call it from applicant to author. So, so much of our early career is spent knocking on a set of doors, hoping one of them will open to let us in, and then trying to find our place in that room. And then we reached a moment where we maybe look around and we start to ask, well, do I wanna be in this room? What kind of room do I wanna be in? Do I wanna be in a room at all? And those questions are beautiful, and they're potent, and they are so deeply disorienting for people. Right? So being there to help someone start to figure out, like, gosh, what do I wanna do? And maybe it stay in practice. I've coached plenty of people who stay in practice with a different with a different set of purpose. Right? Animated more deeply and who they are now as an adult.
Dr. Fabienne Moore [00:28:06]:
And then there are other people who say, gosh, like, there are other ways that I can serve and still honor the things that brought me into medicine.
Dr. Sarah Smith [00:28:16]:
Thanks. And
Dr. Fabienne Moore [00:28:16]:
then the 3rd pillar of my work is maybe not a pillar at all. There's everyone who I work with. There's some other factor that's unique to them and their journey. And so teasing that out, holding a space for them where they can explore and figure out what's there's something kind of archetypal about this journey. And then what's my unique flavor of that archetype? Am I rainbow sprinkles or my raspberry swirl? And how does that unfold for me?
Dr. Sarah Smith [00:28:47]:
Yeah. Okay. So that helps us with regards to kind of understanding what type of leader are you and what is interesting and important to you and, what rooms do you wanna put yourself in and what he's saying yes to, why, what are your priorities. Yeah. Got it. Okay. Exactly. This is, interesting work.
Dr. Sarah Smith [00:29:08]:
I know that adding another role to a clinical situation is a lot of, additional time
Dr. Fabienne Moore [00:29:17]:
and
Dr. Sarah Smith [00:29:17]:
skills, and sometimes people don't feel supported in having the skills to move into that role. It's just simply the person who was in it left and so somebody else needs to step up.
Dr. Fabienne Moore [00:29:31]:
Yeah. Yeah. And that's you know, I used to not at all I used to unjokingly joke. Like, the reason that I had a career in physician leadership development is you're either tapped because you're maybe you're well liked. Right? You're kind of universally liked and respected. Oh, okay. So every everybody likes Sarah. Everyone can talk to her.
Dr. Fabienne Moore [00:29:55]:
So we're gonna tap her to lead the group. Or you were on vacation the day that we met and voted, and so you kinda dominated in absentia. But either way, you know, so frequently as as clinicians. And to be fair, this isn't unique to health care. I've I've now seen it happen across industries, but it definitely happens with us. It's, you know, we're we're thrown into these leadership positions without a lot of specific support and investment in developing our leadership skill. I have seen that start to change over the past 15 years after all. Right? Like, I've I've had a nearly 2 decade career in position leader development.
Dr. Fabienne Moore [00:30:36]:
And I still see lots of room for opportunity and lots of room for individuals who are considering a move like this to advocate for themselves and to be comfortable saying, like, I'm interested in adding this to my portfolio and stepping into this role. And I'm aware that it's it's totally different from what I've been doing as a clinician. What sorts of skill development and support are you gonna offer me so that I can be successful for the sake of the patients, the organization, and also my personal satisfaction?
Dr. Sarah Smith [00:31:08]:
Do you find people will, or physicians will start to look for opportunities to learn these leadership skills before applying for a position, or they tend to start looking for them once they are in the position?
Dr. Fabienne Moore [00:31:22]:
Both.
Dr. Sarah Smith [00:31:23]:
Mhmm. Yeah.
Dr. Fabienne Moore [00:31:25]:
There's actually there's a a program that I work with through AMWA, American Medical Women's Association. We have an elevate program, which is a we take a cohort of female physicians through a group and 1 on 1 coaching experience. And most of our participants in that program are proactive. They're like, I know I want to move into leadership, and I wanna have some preparation. I wanna just have a little bit more ground beneath me before I apply for that that thing that I have my eye on. And then I also know plenty of people who say yes. They jump in, and then they realize, oh, this water's a little bit deeper than was portrayed. And it would I could use I could use some floaties or some flippers.
Dr. Sarah Smith [00:32:09]:
Good. Got it. Yeah. We also hear, in the research, just given that you're talking about women physicians, that many of them are often overqualified for the positions that they are applying for, that that they've held themselves back thinking they didn't have a skill set or enough skill. Tell us more about what if if that's something you've encountered in your, clients.
Dr. Fabienne Moore [00:32:37]:
Absolutely. You know, we've all heard that. What is it? You know, like, men will apply for a role if they have 70% of the qualifications. Women feel like they have to have 120%. So I 100% see that pattern. I will tell you though, more frequently, I see the pattern with my female physician leader clients of over committing. So one of my favorite things that I like to do with folks is something that I call a role audit. We get on a Zoom together.
Dr. Fabienne Moore [00:33:06]:
I open a word document and we say, okay. What are all of that just at work? Right? Just within the hospital or the clinic setting. What are all of the hats that you're wearing? And then let's list. What are all of the things that that each of these hats requires of you. And it's I've never not had it be an moment of, oh, that's that's why I feel the way I do. Yes. You know, from a beautiful place. Right? From a desire to serve, a desire to contribute.
Dr. Sarah Smith [00:33:42]:
Yeah.
Dr. Fabienne Moore [00:33:42]:
I just keep saying yes.
Dr. Sarah Smith [00:33:46]:
Mhmm. Mhmm. I think that's such a great exercise to do is write down all the things you're doing and what they require of you. I mean, just that pause to say, oh, no wonder I have so many things in my calendar, and why don't I have any time for myself or whatever else that you're saying to yourself on the regular. This sounds like a really good exercise.
Dr. Fabienne Moore [00:34:13]:
Yeah. Yeah. And then, you know, what we do with that is typically, I've already done some values clarification work, which is another thing that fascinates me how few of us in the course of our our education and professional journey have ever identified what are my values. We've been told what's important. We've been given expectations to meet. And Yeah. By golly, we are good at doing that. Right? But getting clear on what's my why.
Dr. Fabienne Moore [00:34:42]:
So we can then take those values and use them as a filter for reviewing what we've captured in that audit. And then, typically, that tees up some uncomfortable, important, really powerful conversations about what they will continue to say yes to and what they will start to say no thank you to.
Dr. Sarah Smith [00:35:04]:
Give us an example of a values exercise. Like, what are we just saying kind of are we saying, like, family and exercise? Are we trying to get a little deeper than that? What what do you think is the
Dr. Fabienne Moore [00:35:20]:
Deeper than that. So I will I'll share with you the framework I use is actually one that was given to me by one of my coaches, Danielle Danielle Cohen. She oh, god. I just I still think it's so beautiful. I'd love to talk about it. She invites folks to think of their values as a set of advisors. And so when you reach a key fork in the road, a key inflection point in your life, Who do you want sitting around the table with you being your partners and making that decision? I find that with many, Not all. Maybe not even most of my clients.
Dr. Fabienne Moore [00:36:08]:
We frequently go through that exercise twice. The first round is, you know, family, honesty, service. Lovely lovely concepts, And they can be a little bit like world peace, apple pie. Right? Things that we've inherited more global things. And then as we start to get in and, like, wrestle with and, like, dance with these things. For many of us, there is a deeper layer of, like, oh, but, like, what's what's really alive for me? What's what's really the spirit in which I wanna live my life? Show up to my family. Whatever my family looks like. Right? Be they biologically related or chosen.
Dr. Fabienne Moore [00:36:50]:
Show up to my colleagues, show up to my patients. Right? What are those energies I wanna bring?
Dr. Sarah Smith [00:36:56]:
Love it. Yeah. I think that's really helpful because sometimes we we prosecute ourselves for not keeping our values forefront, and we're not necessarily understanding when we say family, we may not even understand what about family is creating importance for us. So it's just nice to have your, your perspective of what that means.
Dr. Fabienne Moore [00:37:23]:
Right. I actually I love, Sarah, that you use the verb persecute because I have more than once seen people use their values that way. Right? Like, the values then become yet another standard that I'm measuring myself to versus allies and supports in my journey.
Dr. Sarah Smith [00:37:42]:
Yeah. Yeah. Super important. Excellent.
Dr. Fabienne Moore [00:37:45]:
Alright. You feel bad about yourself, it's not about you.
Dr. Sarah Smith [00:37:50]:
Good one. There we go.
Dr. Fabienne Moore [00:37:52]:
Yeah. Takeaway number 1.
Dr. Sarah Smith [00:37:56]:
Alright. Perfect. So we can remove people from the the table who love it. Okay. Where do people find you if they're interested to learn more about what you do?
Dr. Fabienne Moore [00:38:08]:
Oh, thank you for that question. My website is simply my name, www.fa bienmoore.comfab ienmem0ore. And so there's information there about a little bit more about me, about my coaching practice, and there's also an opportunity to book a 20 minute meet and greet so we could meet each other and get to know each other a little bit better.
Dr. Sarah Smith [00:38:30]:
Excellent. Is there anything we didn't talk about that you wanted to bring forward today?
Dr. Fabienne Moore [00:38:39]:
One more thing that I wanna share that frequently comes up in my work with with the physician leaders who I coach. You know, we we we tend to think of memory as a purely cognitive process. And our memories being something that, right, that live in in our in our brains. There's a memory as a super tentorial phenomenon. The reality though is that our memories are actually encoded in our entire nervous system. You know, they live in our bodies, and they shape how we behave. And so I just I wanna offer for any of our listeners who are feeling burnt out, who are feeling stuck in an unsustainable situation, and who, you know, when it starts to feel like it's sort of a vicious cycle, those cycles can be broken, and it may not necessarily be something that we can truly talk ourselves out of. Sometimes frequently, we also have to feel our way out of it.
Dr. Fabienne Moore [00:39:42]:
And also recognizing that what we do, the process we go through in our training as physicians, it is very demanding, and it imprints itself on our nervous system. And so learning to recognize and work with those patterns, I believe is really core on our individual and collective journey towards sustainability.
Dr. Sarah Smith [00:40:04]:
Love that. So interesting. Thank you for that. We we've talked before with some other guests about how, like, trauma imprints and how our body will often respond before our brain even knows what's going on. And I think that you're right. The the training that we, given in medicine to, you know, put away the human demands, the the bladder is full. I'm hungry, but there's a patient in front of me, so it's all gonna be, like, put aside. You're right that that is so imprinted and has a physical manifestation in you, not just a mental one.
Dr. Sarah Smith [00:40:42]:
So interesting. Thank you for your time here today with us.
Dr. Fabienne Moore [00:40:49]:
Thank you for inviting me. It's been such a pleasure to get to know you and to talk.
Dr. Sarah Smith [00:40:54]:
Yeah. And, thank you for your work with leaders because I think Pat, you're right. We don't necessarily have the skillsets or training before we endeavor into a new role, or we, we want to learn before we move into a new role. So love it. All right. Have a great week, everybody. We'll see you next time. Bye.
Dr. Sarah Smith [00:41:16]:
Thank you for being part of the sustainable clinical medicine podcast. If you'd like to learn more or join us to help you get home with today's work done, go to chartingcoach.ca. There you'll find all the information on the premier lifetime access charting champions program that is helping physicians get home with today's work done with all the proven tools, support, and community you need to create time for your life outside of medicine. We would love to see you there. Until next time. Thanks for listening.
