Sharp Conversations with Eve Bloomgarden, MD

Subha Airan-Javia, MD: Green Room with lots of doors. I have my kitchen with a beautiful lamp.

Eve Bloomgarden, MD: I don't know where I am, but I'm somewhere on planet Earth right now.

Janae Sharp: I'm Janae. I'm the founder of the Sharp Index, and we've been having Sharp Conversations.

Subha Airan-Javia, MD: I'm Subha. I'm the founder and CEO of Carealign. I'm also a practicing hospitalist.

Eve Bloomgarden, MD: I'm Eve Bloomgarden, I am an endocrinologist in the Chicagoland area. I'm the director of thyroid care, and also the director of endocrine education and innovation. I happen to live in the space of Women in Medicine and gender equity as someone really evolved in the nonprofit Women in Medicine. I'm the Chief Development Officer.

Subha Airan-Javia, MD: So I have some questions. We know there's data that shows that women have experienced burnout to a greater degree, especially over the last couple of years. What unique obstacles do you think that women face? What solutions do you think can address these obstacles for burnout?

Eve Bloomgarden, MD: For women, many of us have taken over a lot of caregiving responsibilities. So with children, with elderly family members, with our spouses or with our partners, even our own wellness, or our own medical care has suffered. And so, you know, we know that women tend to take more roles on in the house. When you look at what was happening during the last two years, if you had kids, you had remote school. I used to have patients come in, patients who are moms of young kids, and they would just say, can I just sit here for a couple of hours, because I just need to get out of my house, and this is the only time that I can get my spouse to stay home? Or, the only valid excuse, and I would you know, we just have people, and I wasn't even seeing them, you know, and I just really felt that. Then on top of that was our own fear, our own anxiety, about staying safe, staying well, keeping our family safe and well.

Janae Sharp: How has that changed? How has that impacted people, like the sustained stress, because I remember right before everything shut down, I talked to someone they were saying how physicians are going to do great, they're going to step up to the plate, and that was, what, two years ago. And like sustain levels of stress are devastating, right?

Eve Bloomgarden, MD: Two years ago, we were really, the public at large, really treated doctors and health care workers with a lot of respect. We were very valued. And I will tell you that was appreciated from the frontlines all the way to, you know, those of us who were sitting and doing telemedicine in our kids playrooms with the doors locked, right. And I think over the last two years, we have seen this kind of unraveling of that respect and unraveling of the appreciation and the relationship such that people are showing up angry to the office.

Subha Airan-Javia, MD: I've heard stories of people in you know, being told that they have COVID and just yelling be like, No, I don't have COVID You're lying.

Janae Sharp: You know what, there have been some really interesting things that were said.

Eve Bloomgarden, MD: Just some interesting, completely derailing, emotionally trying, horrible lies that have been said, just going to put it out there. That also has taken a toll on all of us, because I think that is also cost our reputation to the general public and has been an extra layer of insult, you know, where I thought when the vaccines rolled out like we were gonna be done, I was so excited. And then to have 50% of the population opt out because of something they read on Facebook, something they heard on the news, or someone told them, it was just heartbreaking. So when you have that piece of it, and then you add in the fact that patients are coming in a lot sicker than they were two years ago because a lot of people missed their routine medical care and checkup. When you take a system that runs lean, and you take out a lot of support, you lose, nurses, medical assistants, and administrative staff. So the same things still need to get done to take care for patients, but you're doing it without any help.

Subha Airan-Javia, MD: Eve, you are so busy. And you've just described so many ways that everyone is so busy in health care, I have a question, but this analogy will probably resonate with you that it's almost like the healthcare system has type two diabetes because it's just completely burned out - there's like nothing left to give.

Eve Bloomgarden, MD: You were throwing more insulin on it, but we can't get the glucose under control because it's a systems issue, right?

Subha Airan-Javia, MD: Yes, I'm struck by how you've had time, or how you have found the time, to do all of this advocacy work and ally-ship work that you're doing with Women in Medicine and with IMPACT, which I use your infographics all the time for people, so I'd love to hear!

Janae Sharp: We're gonna have to share the infographics.

Subha Airan-Javia, MD: Well, there are tons, so absolutely.

Janae Sharp: See, in the video right now, just imagine.

Subha Airan-Javia, MD: I'd love to hear how does advocacy help you?

Janae Sharp: Or does it?

Eve Bloomgarden, MD: You nailed it. So absolutely I do this because it fills up my bucket. I don't have time for all of this. Of course, nobody has extra time, however, we all have been known to bend or stretch in order to do things that we never would have thought we could do. Things that really ever get me up in the morning are, advocacy, speaking, empowering my friends and colleagues fighting misinformation, pushing for gender equity, and is this a sustainable speed to keep driving on? No. Things suffer, so we cut corners. One way I picked uptime is, that I didn't have to commute for a while when I was doing tele-med. That actually made a really big difference. Doing the advocacy work to help by - a lot of my friends that are in the ICUs, or in the ERs really couldn't keep the same sort of monitoring of what's happening and what's going on in the public and really didn't have the time or the bandwidth to then pivot and translate information between the scientific authorities and the general public. So we did a lot of patient-facing Q&As, and a lot of the infographics for the public. To be perfectly honest, I was getting all of these messages and questions anyway, from my friends in the community and from family all over the country. I was already answering the questions, we kind of, in some ways streamlined it by creating IMPACT which is the Illinois Medical Professional action Collaborative Team. It grew out of that need for us all to feel like we were making some sort of difference think I think that's interesting. We give awards every year, and this year, we had to create a whole new category, because several new nonprofits were created. Huge initiatives, like we had a fund for mother's medicine funds. So it was like a Direct Action Fund and still is for providing for childcare costs. Then there were also whole new nonprofits like emotional PPE, and the Lorna Breen foundation, these giant groups have been organized over the past two years.

Janae Sharp: I think there's something to be said to have kind of heroic efforts and energy when something this massive is happening. Now, I think that's, that's 2020, 2021, and 2022. Obviously, everyone has a little less steam. Why are people resigning now, I think, is really interesting. I've talked to people about that, like how, with death, because my first husband passed away and the initial grief period, you have a lot of things happen. One of my friends sat me down, she's like, You need to know that, like, after a year, it's going to be harder, because people won't realize that it's still hard. That's when it all catches up to you. So just think of it, like when you're pushing against a wall, as soon as that opposite pressure is gone, you kind of collapse.

Eve Bloomgarden, MD: People are that way, for sure, an interesting analogy. Then we come into 2022, that's where we are now. These large kinds of I would say a lot of physicians are employed. And these organizations are trying to figure out how to recoup the cost of the last two years and how to build out their budgets and how to stay in 'the green' financially, not in the red. So to go from: I'm gonna take care of my little kids, take care of my patients, start two nonprofit organizations, but I'm also going to tolerate someone telling me that I have 20 minutes to see a patient in my chart isn't closed. It is a really hard pill - it's a jagged pill to swallow, right as the song goes.

Subha Airan-Javia, MD: So Eve what is the worst thing that you've seen an institution do?

Eve Bloomgarden, MD: How long do we have here again? Just wondering.

Subha Airan-Javia, MD: The worst thing that you've seen a group do in the name of helping burnout?

Eve Bloomgarden, MD: oh interesting and different -I like it. Let me think I will say what breaks my heart, the reason why I am so frustrated right now is that I am seeing a hemorrhage of talent from the healthcare space and I am seeing decisions made by these large institutions and smaller institutions and even just you know, in general decisions are being made that are letting people go. At each step of the way, I also feel like there's an there was an opportunity to pivot and retain and keep the healthcare workforce robust. I'm just seeing mistake, after mistake, after mistake being made.

Subha Airan-Javia, MD: So give us an example of a mistake,

Eve Bloomgarden, MD: Somebody who really benefited from having the flexibility to do telemedicine when their children were at home, was told that they no longer could do telemedicine, and they had to come into the office. That's not a big deal, but for a lot of people, that was a really big deal, because that meant how I have to find childcare, and my kids are still at home, and they are not vaccinated. So now you're going to take away that time that I got back from my commute, you're going to take away what my preference is, and then that person leaves. I feel like we have this big opportunity right now to change things because they weren't working before, but like, right now, they're not working at all.

Janae Sharp: what would you change? So, what does that look like?

Eve Bloomgarden, MD: I would like to be asked, what, how I want my day and my workflow to look like and then to be given the autonomy to go ahead and do that.

Janae Sharp: That sounds so simple, ask me how my day should go, and make it available. Making it possible is harder.

Eve Bloomgarden, MD: I would like someone to say, what do you need to be successful - and then allow me that - so resources. I think there's a lot there. I think, as a society, we need to ask ourselves, what do we want from our medical system? We know what our current medical system is doing, we can see the trends, the writing's on the wall if that's not what we want, and I can tell you what, I think that's what we want.

Janae Sharp: It's not what anybody wants. Every bankruptcy involves health care bills.

Eve Bloomgarden, MD: Our mission is to take care of people, and we can't do it, because of the limitations that are basically self-imposed. Then, we put a man on the moon, why can't we fix this - I feel like we can. I always say, the great resignation is certainly there's nothing great about it, but I do think my hope for what's coming next is not that anything good is going to come out of this, but it's about what we could do together to take advantage of the opportunity, but we have to do it, we have to harness this I can't do this anymore kind of thing and just use our collective brainpower to fix it. We can do it, we can swing forward, as the pandemic kind of, hopefully, closes. I'm working on knowing my own limits. I think it's equally important to know what you can't do and what you can do. Every day I kind of play a game. It's like I wake up, I do a Wordle. Then I'm like, okay, what can I say no to today? So I have my little routine.

Subha Airan-Javia, MD: I feel like that's a good, tactical thing.

Janae Sharp: What can I say no to today and why is it my kids asking to go to McDonald's again?

Eve Bloomgarden, MD: I've also banned the word sorry, from 2022. I've actually liked it, it's, it's gone. It's hard to do, I mess up almost every day. I've said it to like nine people today. I think it's important that we stop apologizing for things that aren't our fault.

Subha Airan-Javia, MD: So our tactical advice is, don't say sorry. Every day, is there something you can take off your plate?

Janae Sharp: Also how to say no, I feel like that's so important.

Subha Airan-Javia, MD: Don't put it on your plate in the first place. Well, Eve, I feel like you have given us some really great, tactical advice and a lot of inspiration, really love how you've used advocacy to address your own wellness and burnout, but also help others and you absolutely impacted my experience and my family's experience through the early days, especially because of COVID. I routinely sent them the IMPACT infographics, it was so helpful. So thank you for the work that you're doing because it makes a difference.

Eve Bloomgarden, MD: I very much appreciate that. And you're welcome, that's why we do it.

Janae Sharp: took close can you tell everyone how to get involved? What is something everyone listening can do?

Eve Bloomgarden, MD: Please check out both of these organizations, Women in Medicine, and IMPACT, and we can send the links and follow us on social media. I'm easy to find, please only find me with your kind words. If you have negative words, don't bother, I don't need to hear it.

Janae Sharp: If you have negative words, just keep that inside your heart.

Eve Bloomgarden, MD: Yeah, hold it, hold it in. If you want to learn more about misinformation or if you want to learn how to design infographics, you can find us at IMPACT. If you want to be part of the gender solution, the solution to gender inequities, you can find us at Women in Medicine. If you have a thyroid problem, you can find me at my job.

Janae Sharp: All right. Well, thank you so much.

Subha Airan-Javia, MD: Thanks, Eve.

Eve Bloomgarden, MD: Thanks for having me, have a good day!


Wanna hear more from Eve? Look no further!

IMPACT: https://www.impact4hc.com/team/project-two-8b68c

Women in Medicine: https://www.womeninmedicinesummit.org/eve-bloomgarden

Twitter: @evebmd

Instagram: @sincerely_dr.eve

LinkedIn: https://www.linkedin.com/in/evebmd/

Article: https://thecurbsiders.com/podcast/228

Article: https://www.onegravesvoice.com/people/eve-d-bloomgarden/

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Sharp Conversations with Paul DeChant, MD, MBA