In this episode of the Take Good Care podcast, Drs. Williams, Guthrie, and Greene continue their discussion on how to find the calm within the chaos, specifically in the workplace.
Transcript
Dr. Mironda Williams:
Welcome to Take Good Care podcast. An endeavor that grew out of our love for obstetrics and gynecology. Our aim and mission is to serve as a source of vital information for women of all races, ages, and walks in life. I am Dr. Mironda Williams.
Dr. Deanna Guthrie:
I am Dr. Deanna Guthrie.
Dr. Karen Greene:
And I am Dr. Karen Greene.
Dr. Mironda Williams:
[inaudible 00:00:27]. Welcome to this episode of Take Good Care podcast. I’m Dr. Mironda Williams.
Dr. Deanna Guthrie:
I’m Dr. Deanna Guthrie.
Dr. Karen Greene:
And I am Dr. Karen Greene.
Dr. Mironda Williams:
And for those of you who are checking us out, either on our website or on our YouTube channel, you also know it gives me great joy when I can say that we are live and on the air. Give me my joy wagon. So today we are going to continue delving into a topic that we started as we were preparing for our time with Portia Bruner for the Portia Show. And we put together some thoughts that we use the tagline, going from chaos to calm. And we broke it down into three different categories, looking at making the transition in our home life, making that transition in our workplace, and also trying to make that transition in our social life.
So on this episode where we’re taking a further look into that whole issue of how do you create calm in your environment, we’re going to talk a little bit more about our work environment and look into and talk about some of the things that we have done and are still attempting to do as we continue in our workplaces. Anything else y’all want to add before I give the people a little background into where we’ve come from and where we are now in terms of our workplace?
Dr. Karen Greene:
Yeah, I think that we spend so much time at work that you don’t realize how important it is to really get that organization and calm, especially for us going into a situation that was already established, you accept this is how it always is. And as physicians you accept, this is what we do. We push, we push, we push, we push. But if I’m going to be here eight hours a day, there must be a better way. And I think, you know what Dr. Williams is going to go into. I think we found that better way.
Dr. Deanna Guthrie:
Yeah, I was going to say that a lot of people just accept their work situations as is. I just go in, do my work and go home. But it’s important to look at it to see if there are any changes that you can make. Some people, depending on your employer, if you’re self-employed, you don’t have much control. But for any little thing that you can control, it’s good to look at it and see if you can make things better.
Dr. Mironda Williams:
Absolutely. I think those are both great. And where we were, we all joined the practice that we are currently owners of in two-year intervals. So I joined in 1992, Dr. Guthrie in 94, and Dr. Greene in 1996. And we joined a practice under the mentorship and the guidance of Dr. Rosemary Schultz, who founded this practice in 1984. But then in 2000, Dr. Schultz decided that she was going to semi-retire. And so we took the reins of this enterprise at that point. And at the time we were still doing obstetrics and to what my partners have mentioned, and I think all of us do this, you just stick with the familiar, so we came into a practice, medical practice has certain organization, we were doing obstetrics at the time, and we were doing OB as we thought we knew or should do ob.
And you just get into your routine, but that doesn’t always mean that it’s good or that you don’t need to pivot. And so what happened is that through some work that we had been doing at the time with the hospital, the different meetings and things, we were really starting to see how the business of medicine was starting to shift. So the clinical aspects of medicine are always being improved. And there’s innovation that comes with how you do things clinically to take care of patients. But what none of us got in our era of residency training is how do you run a business? How do you make business decisions and what information do you get? And even where do you get that information to make good business decisions? And so because of the information that I was getting, and we were getting in other meetings related to the healthcare as a whole, the healthcare system that we were affiliated with and still remain affiliated with.
And so as a result of that, we sat down back in 2015 and came up with a whole strategy, a marketing strategy for how we wanted to make sure people knew about our practice, who we were as practitioners, as people, what our practice offered, because the world was changing, social media was coming into play, all of the technology advances that were coming into play, we used to put up ads in the paper. We were just doing things that that’s what you did. And so we came up with this whole 10 year plan of a strategy of the different things that we wanted to try to see our practice accomplish and some of the changes we thought we needed to make so that we could remain viable as a business, not just as physicians taking care of patients. Do you remember much else in terms of were thinking way back in 2015 as business owners? Mainly?
Dr. Karen Greene:
I remember just in terms of getting more protocol-oriented and setting things that this is how you do it and this is why you do it. Not just we do it because that’s always the way we did it. So it allowed us to improve on how we did things and how we manage things. And then just looking over some of the things that we did made me think about how we did it. And it some days really did feel like chaos. And I can’t honestly say consciously, I was aware that that’s what we were doing, but having protocols and procedures and a plan of action and an action plan really does get you out of that chaos because it’s like, “Okay, we’re not just doing this because this is what everyone else does. We’re doing this because this is what’s best for us.”
Dr. Deanna Guthrie:
And what we learned 10 years ago,
Dr. Karen Greene:
Right.
Dr. Mironda Williams:
15, 20.
Dr. Deanna Guthrie:
Well, yeah. And so it’s more of as opposed to, this is the way we’ve always done it, this is the way we keep doing it now we’re going to do this for a reason and that’s going to help us to be better business owners. And I think that our mentor also taught us how to care for patients. So that part was the easier part. The business part was a little more difficult.
Dr. Mironda Williams:
And Dr. Guthrie, do you remember, I know that’s when the whole concept of best practice medicine, can you talk a little bit about that?
Dr. Deanna Guthrie:
So there’s an old saying that medicine is an art and there is an art to medicine that it’s not cookie cutter per se, that you do have to look at the patient individually. But there were a lot of processes that could have 15 different choices. An example would be antibiotics prior to surgery. One of the big outlooks that came out was that now we have set antibiotics to use before surgery. And it’s not that that’s the only one that can be used, but they using scientific evidence and studies, looking at which one is best and why it’s best. And then you also have alternatives, again, looking at individual patients because that patient may be allergic to it or have a sensitivity to it, but instead of having 15 different sets of orders for each doctor that was coming into the hospital.
Dr. Karen Greene:
For every patient.
Dr. Deanna Guthrie:
For every patient that was coming into the hospital, which could lend to a lot of errors also because, “Oh, is this Dr. so-and-so’s?” And then there’d be a delay. Somebody pulled Dr. so-and-so’s orders instead of Dr so-and-so’s orders. And so one of the title is Best practices so that most physicians will agree that this is the best antibiotic to use. So it just simplifies things. It makes for less errors and better patient care.
Dr. Mironda Williams:
Absolutely. And in that, that’s a great example because again, it’s based on science. Because we know now we have this huge wealth of information from history to know what bacteria are the most likely bacteria in certain circumstances and in certain situations. And not just the kind of bacteria in which antibiotic is the most appropriate, but the timing as well of when antibiotics are given. That’s another thing, again, because physicians, we’re very, we have our own individual likes and preferences, and it’s not that any of them are wrong, but if you’ve got a hundred plus physicians operating on patients and everyone has their own specific list of what they want, it just becomes chaotic in the OR suite in terms of what is given, when it’s given, how it’s given, and all those things. So best practice medicine was a way that from a clinical standpoint, we started to Dr. Greene’s point, “Okay, let’s see what’s the best thing to do?” So that way we know which avenue to go down to cut down on some of that chaotic thinking with patient care.
And so we took that same thinking with our business model in terms of what we wanted to do. Also, about that same time, we were deciding, again, because life was chaotic, that we needed to try to restructure our practice. And it was at that time that we really decided, just because of a number of variables that we’ve talked about on different shows, that we were going to retire from the obstetric part of our practice and really focus on the GYN care of patients. And that was being done for a number of reasons. Again, we were looking at the demographic data of what was going on in our current area of where we practice medicine. We were looking at the fact that women, all of us, not just women, but our population is aging. And so women are living longer. And as a result of living longer, becoming very active and very vibrant, even as we age, that there are other types of issues that can become more prevalent for the older woman and women who are remaining active.
And so we really wanted to try to hone how we wanted to take care of the GYN patient using the demographic data, the population growth data, the fact that fertility rates were decreasing and all these things to say, “Okay, well this is where we may be in 2015. Where do we want to be 10 years from now?” We really started, not just as we did that personally, to look at our personal life goals, vision statements and things like that, but as a practice, where do we want to be at that time, 10 years into the future? And what do we therefore need to do to really put ourselves in a position as a business to remain viable, even as the environment around us was changing, we hit a, I don’t know, did they call it recession when everything tanked 20 years ago? Whatever it was.
Dr. Karen Greene:
That was a Dot-Com. What was it? The Dot-Com? You’re talking about the cars?
Dr. Deanna Guthrie:
No, no, no. When we had that economy drop in 2005, 2006. It’s about 20 years ago, yeah.
Dr. Mironda Williams:
And they’re phasing. We were just… And as a business, you feel all of that because your patients are going through economic changes and financial challenges, which then makes us go through economic changes, financial challenges. So how do we structure ourselves? And that’s one of the things that I’ve really pushed to the providers as well as to our leadership team, is that the problem isn’t a person, the problem is a process. So what process do we need to put or series of processes that we need to put in place in our practice, in our business, so that we know how to weather these storms that we can just go along with it without losing our minds and saying, “What the hell?” Which we can still do that, but still, it still happens. So we really looked at how we wanted to become more viable and visible in the social media realm. And it was 10 years ago that we decided to start a Facebook page. And it was just like at the time we were like, “How do we do it? What are we doing?”
Dr. Karen Greene:
Slap the reg on it?
Dr. Mironda Williams:
I don’t know. You know? And so we were really trying to figure that out. We started bringing people into our space who had the expertise in that. And I think that’s one of the things when we talk about how do we try to go from a chaotic situation to a more calm environment, is realizing that we don’t know everything. I’m not trying to know everything.
Dr. Karen Greene:
That’s not my area of expertise.
Dr. Deanna Guthrie:
You can’t do it.
Dr. Mironda Williams:
Can’t do everything. So why don’t we just reach out there and see who’s got the knowledge and just partner with them in our business model to help us get to where we need to be.
Dr. Karen Greene:
You know? Because I think that realizing that we were now going to be taking care of women for just GYN as a population age, and how are people getting their information? One of the reasons we went to this whole podcast mode is how do people get their information? We knew that putting ads in the paper was no longer viable. So clearly people aren’t reading, they’re not reading newspapers, they’re logging on. And if they’re logging on, they need to see us.So that was a whole new avenue and was well in line with just doing GYN because thinking back and trying to do what we do now and OB, it would not have been a good plan.
Dr. Mironda Williams:
Yeah, we probably would’ve figured it out but-
Dr. Deanna Guthrie:
It’s so much harder.
Dr. Mironda Williams:
It is so much more to try to manage and to do well. I think that’s the other thing. We’re overachievers and you don’t like to not do things well.
Dr. Deanna Guthrie:
Also in GYN, GYN, it was like, I don’t want to say the steps. It kind of got a second place to OB when you do both in the practice.
Dr. Karen Greene:
Yes, it does.
Dr. Deanna Guthrie:
So I have a lot of patients who come in and say, “Oh, I love coming here because the doctor’s not going to run and leave to go deliver a baby or cancel or whatever.” So we could focus more on that population of patients.
Dr. Mironda Williams:
Because it’s true. I mean, you can’t decide when a baby’s coming. So there were times where you would have to just say, “I’m so sorry.” But either you couldn’t see them for a certain period of time because you were getting your OB patients in. So it put our GYN patients.
Dr. Deanna Guthrie:
On the back burner.
Dr. Mironda Williams:
On the back burner. So one of the things that happened, and then we’re going to pivot in a minute, and again for you just joining in, you’re listening to Take Good Care podcast with Dr. Mironda Williams
Dr. Deanna Guthrie:
Dr. Deanna Guthrie.
Dr. Karen Greene:
And Dr. Karen Greene.
Dr. Mironda Williams:
And we’re just having a further conversation about some of the things we did over the last 10 years for reshaping our personal lives, our home life, and our work life. And so we’re talking about some of the things specifically in the workplace that we did over the previous 10 years. And this past year, 2024, at the time of this recording was a pivotal year for the practice. We celebrated 40 years of business being in business practice. We’ve had some great new partnerships that have come on board, our podcast production team, our marketing team, we rebranded, we changed our name. So we did a lot. And all of that was done really with an eye to the future. But as we started looking at what we wanted to do for the next 10, 15 years, it gave us an opportunity to look back and say, “Yeah, we pretty much hit every mark that we set in 2015.” We wanted to be more relevant in social media. We wanted to be in that whole social media space.
So we went from not knowing how to post on Facebook, much less what to post to podcasting, Instagram pages, newsletters, blogs. I mean, we’re like doing all the things. And as a consequence of that, one of the goals of the way that we structured from a business standpoint that we wanted to create was value-based gynecological care. Because we wanted to make sure that patients coming through our doors got value for their time spent coming to our office to make an appointment, to be seen. And also that we are able to attend to them without interruption for other things, to really make sure that patient felt cared for by the time they left our office, that they were seen and they were heard. And I think that’s been an amazing thing. Also over the last 10 years, Dr. Guthrie and Dr. Greene in particular, you can talk about how we really looked at changing how we do surgery, minimally invasive procedures and the kinds of things that we’re able to do. Can you briefly talk about that? Robotics and all that good stuff?
Dr. Karen Greene:
When we were talking about the whole chaos, we’ve tapped our feet in a lot of different areas, having surgery in the office, which pre-COVID kind of worked, but added to the chaos. But then we also continue with our training in doing minimally invasive type procedures. And for those of us that like to operate a lot, that’s very helpful in terms of the longer cases, because sometimes we’re sitting down the entire case. So for those of us who are older, not standing for three hours is nice to sit for three hours. And so having to figure out how those surgeries are going to work into our office space and how we’re going to schedule our time so that we can give time to the surgical patients as well as the patients that are just coming in for the routine exams or the problem visits.
And so being, I guess up to date with the latest procedures and then deciding which procedures we’re just not going to do, because it may not serve us in terms of our time, and we can always make referrals to other physicians that might be better. So figuring out what is our wheelhouse, what we want to do well as to being as a doctor of all, master of none. So, and I think that that has served us well, just in terms of figuring out how many surgeries do we really need to do, what surgeries are going to be for our patients and what time? And most of the time they’re not emergencies. So things can be planned. And having that mindset, which is very different from the obstetrical mindset where everything’s an emergency and urgent.
Dr. Mironda Williams:
And urgent and has to happen right now.
Dr. Karen Greene:
And for GYN, that’s not always the case.
Dr. Deanna Guthrie:
And also with the advances in surgery, things are now outpatient. So that helps with the patient.
Dr. Mironda Williams:
Work with the benefits.
Dr. Deanna Guthrie:
Number one, of course, patient benefit, less blood loss, no hospital stay up and around right away, back to work and life very quickly. But also for the doc, like you said, Dr. Greene mentioned one of the advantages that you don’t have to stand, and it’s not backbreaking work any more like it used to be.
Dr. Karen Greene:
For longer career.
Dr. Deanna Guthrie:
But then also even for our schedules, there’s less rounding in the hospital, which then interrupts with your office schedule. So it’s just a win-win all round.
Dr. Karen Greene:
Absolutely.
Dr. Mironda Williams:
And the last thing I really wanted to touch on in terms of how we’ve tried to create a more of a calm atmosphere in our workplace is that we really, really, really did work very hard and very intentionally over the last seven years in particular, of creating a collaborative model in our office for leadership. And that most practices have an office manager, and the office manager is the individual who tries to handle all of the administrative things, billing things, all things that are not clinical. And that’s great in certain environments.
And when you have a great individual that’s good at that, but we all get older and things happen. And so what we found that was happening prior to our change in our model is that we would have one great individual that was with us for 15, 20 years. But then when that individual either decided to retire or to leave, then that wealth of information went out the door with that individual. And so then we were left trying to recreate things that we shouldn’t have. And so that to the process, procedures, manuals, making sure that the information is housed in an area electronically, digitally that’s easily accessible so that you don’t have to recreate the wheel every time. And by making sure that instead of having that one key person that manages all the things, we’ve really tried to decentralize that and how we’ve organized the leadership of our office both clinically and administratively.
So the A, again, just like we can’t know everything and do all things from an, excuse me, administrative standpoint, there’s no one individual that can know everything there is to know about billing, collecting, ordering, taking care of equipment. I mean, it’s just too much. It’s just too much. And so we took, I think, the pressure off our people and thinking, “Well, I don’t know that.” “Well, that’s okay. Talk to your colleagues, see if they know. If they don’t know, then we’ll call, we’ll find the answers.” So it’s not about having to know everything and do everything, but it’s knowing how to get the information that’s needed and realizing that you can rely on your teammates to help you with that. You don’t have to be in this alone. And there’s no judgment.
Dr. Karen Greene:
And it’s funny, because clinically we have always done that. So there was never a time-
Dr. Mironda Williams:
We.
Dr. Karen Greene:
Yes, we as the-
Dr. Mironda Williams:
We as in Rosa Gynecology [inaudible 00:22:23]. It’s Still not always the case in other practices.
Dr. Karen Greene:
Well, that is true, but I was about to say that I think Dr. Schultz, I remember getting here in 96 and there was never a time that I couldn’t ask her a question. And so setting that example so that we know you can talk to the doctor, you can talk to another doctor. If I’ve got a question, I just go on the other side of the office and see who’s available. If Dr. Williams is not available, I call on the phone and get Dr. Guthrie because she’s in the other office. And so setting that type of example allows our team leads to understand, you don’t have to know everything. We don’t always know everything. And we’re going to ask, there’s no shame in asking. That does set us apart. I realize that and I should brag on that.
Dr. Deanna Guthrie:
Collaboration brings more ideas too. It’s not the one person trying to figure everything out. If there’s an issue or something that we’re going to do or a new project or whatever, just the leadership model that we have, we have more than one eye.
Dr. Mironda Williams:
Yes. And more than one brain, which is great. So that’s just a little bit more of an in-depth conversation as we’ve looked back, like I said, during this previous year, 2024, we’re looking back at our accomplishments, looking back at how far we’ve come. And I do think, and especially as women, I think we don’t always celebrate our wins. We don’t always celebrate what we’ve done well. Women nitpick ourselves and we nitpick each other and sometimes we need to say, “No. We’ve done a hell of a good job for the last 25 years taking care of this business and making sure that this business continues.” And in that light, knowing that we need to retool and to reset and to refocus. We’re planning something we’ve never done, which is we’re having a retreat, we’re having a professional retreat.
We’re investing in ourselves, we’re making the time to go apart, away from the office, away from our leadership team who is great, but sometimes you still need to go to the mountain and have a little talk with Jesus and just try to see, okay, what are we doing for the next 10 years? We’ve done it great for the last 40 years as a business, the last 25 years as we have been in charge and owners of this business and the 30 plus years of clinical practice. But we intend to continue going, we don’t intend to go forever, but we don’t intend to stop anytime soon. And so we don’t want to make the assumption that what we’re doing now and has worked for the last 10, 15 years is going to continue to work for the next 10 or 15 years. So we’re investing in ourselves, we’re getting experts, and we’re going to take some time away to say, “Okay, what course do we need to set moving forward?”
And I think that as we are sharing thoughts in terms of what we think are some nuggets that we’ve been able to gain and learn over these last 20 plus years is take the time to celebrate your wins, evaluate where you could have done things differently. Don’t be afraid to pivot. Just because it’s the way you’ve always done it doesn’t mean you need to always continue doing it that way because you’ve got to look at the environment around you. We get so busy doing what we’re doing, we get blinders on our heads down and we just do what we do. But sometimes we need to take a step back, look around, see what’s happening in the world with your constituents, patients, whoever they may be, and say, “Now what do we need to do?” Any other closing thoughts before we end this episode?
Dr. Karen Greene:
And I think along the lines of, take the time to look into yourself as well and what’s going to work for you. And I think when we talk about professionally, going from chaos to calm, it’s intertwined with our personal, because we just said that okay, we like to be able to do the surgeries that are sitting down because it makes us live longer, really. I mean, it’s not backbreaking and we’re able to do what we enjoy and that’s part of our personal. So you have to think that, “Okay, not only is this good for the patient, it’s also good for the doctor doing it.”
Dr. Mironda Williams:
No, of course.
Dr. Deanna Guthrie:
It’s like they say the doctor should take your own pulse or the same thing with oxygen mask, you need to put your oxygen mask first, and that’s self-care. You want to look at things that work for you, not at the sacrifice of you want to do good for your patients. You always want to be there for your patients, but you also have to look at what’s good for you too.
Dr. Mironda Williams:
We’re human too. And I think that’s a struggle because-
Dr. Deanna Guthrie:
In the old days it was like you stay up all night.
Dr. Mironda Williams:
You got to do what you got to do.
Dr. Deanna Guthrie:
You don’t eat, you don’t sleep, you don’t do anything.
Dr. Mironda Williams:
No, no, no. [inaudible 00:27:20].
Dr. Deanna Guthrie:
We’re not doing that.
Dr. Mironda Williams:
I’m not doing that.
Dr. Deanna Guthrie:
And they found out it’s not good for the patient. It sounds noble.
Dr. Mironda Williams:
It sounds very noble.
Dr. Deanna Guthrie:
I was up three days in a row.
Dr. Mironda Williams:
But was it safe?
Dr. Deanna Guthrie:
Thank you. When you’re up three days in a row. Are you really doing any good?
Dr. Mironda Williams:
We’re doing the best thing you can do.
Dr. Karen Greene:
I saw 30 patients today, but did I take care of those 30 patients?
Dr. Mironda Williams:
You cannot take care of 30 patients.
Dr. Karen Greene:
Or did I worry about the stuff I might have missed?
Dr. Mironda Williams:
That’s right. And that’s the thing.
Dr. Karen Greene:
And yeah, that’s a big deal.
Dr. Mironda Williams:
And so that’s the lesson I think we’ve all learned in terms of going from chaos to calm is it’s okay when you’re not okay to say I’m not okay. And it’s okay to do things differently. One last thing again, society, your professional standards may say, “You should do this.” Well, as an individual I can say, “Well, you know what? I don’t want to do it that way anymore. And I find more joy and fulfillment doing it this way.” And it’s okay for me to make a change in how I perform professionally because that impacts me personally and it impacts my own health. And then in essence, it impacts how I really can show up for my patients. And so that’s the thing that we really want to do. So for whatever you’re doing in your life, whether it’s working outside the home, within the home, you want to be present.
You want to be able to show up as your authentic selves in whatever arena that you happen to be and to try to make it a little bit more of a calmer environment. It’s never completely calm. We don’t want to give that impression that we think it’s always calm, but we’re trying to make it a more calm and sustainable environment for you to live and work and to enjoy your life, all of it professionally and personally. So we want to thank you all for listening to us once again. We never take your time for granted. We don’t take your viewership or your listenership for granted. We appreciate when you log on. We appreciate when you check us out on all of our social media channels.
So please continue to share us with your friends and family. Look for us wherever you get your podcasts. Take good care. Also, check out our website at rosagynecology.com. Rosagynecology.com. All of our previous episodes are housed there, as well as on our YouTube channel. And you can always refer to us on our website and send us messages on our email, either through the office or through takegoodcare.com info, excuse me, [email protected] to send us any questions. So until we meet again, thank you for listening. I’m Dr. Mironda Williams.
Dr. Deanna Guthrie:
I’m Dr. Deanna Guthrie.
Dr. Karen Greene:
And I’m Dr. Karen Greene. Take good care.