Dr. Sara Tamarin, a pediatrician at the Everett Clinic, shares her impetus for pioneering a peer coaching program among physicians and other clinicians to address internalized self-concepts such as imposter syndrome, self-judgement, comparison, and perfectionism. Although peer coaching is relatively new in the health care industry, preliminary data from participants suggests a reduction in burnout, an increase in feeling and thoughts of self-compassion, and improved connection to others. Dr. Tamarin’s novel efforts to ‘heal the healers,’ is broadly contributing to a fundamental shift in the culture of medicine for current and future healthcare professionals.
“Finding Joy: The Health Care Professional’s Journey to Well-being" is a podcast resource developed by a team of interprofessional education researchers from Washington State University Health Sciences Spokane. They’re promoting well-being among students, faculty, and healthcare professionals during challenging times. Funding is provided by the Health Resources and Services Administration.
The Interprofessional Education Research team wishes to thank the following individuals for their invaluable contributions to this project:
• Dr. Barb Richardson, nurse, educator, and interprofessional champion;
• Cameron Cupp, creator of the “Finding Joy” musical score and current enrollee at WSU Elson S. Floyd College of Medicine;
• Washington State University staff from Marketing and Communications, Financial Services, and the Collaboration for Interprofessional Health Education Research and Scholarship; and
• Claire Martin-Tellis, Executive Producer, and Solen Aref, student intern, who developed the first five episodes of the “Finding Joy” podcast.
This episode of “Finding Joy” was produced by Doug Nadvornick, Program Director, Spokane Public Radio.
If you would like to reach out, please contact our team by sending an email to: medicine.ipoc@wsu.edu We also encourage you to visit our podcast blog as well as our team's website at: https://opioideducation.wsu.edu/about/.
This is “Finding Joy: The Health Care Professional’s Journey to Wellness and Resiliency.” It’s a podcast resource developed by a team of interprofessional education researchers from Washington State University Health Sciences Spokane. They’re promoting wellness among students, faculty, and healthcare professionals during challenging times. Funding is provided by the Health Resources and Services Administration.
[theme music]
I’m Doug Nadvornick. We think of doctors as strong, invulnerable people who help solve our problems and yet have none of their own. But they’re human beings like the rest of us. Where do they go when they need to talk about their experiences? Sara Tamarin believes, who better to guide a doctor than another doctor.
Sara Tamarin: “I like to think of coaching as this space in which physicians can be fully human and share this experience with another physician as a witness, not only as a witness, but also, in this case, as a trained, certified coach who can reflect back what their thoughts and feelings are and also help them to explore new perspectives.”
We talk about coaching physicians, today on Finding Joy.
[fade music]
Sara Tamarin: “My name is Sara Tamarin and I am a physician, an M.D., with the Everett Clinic and I have been practicing medicine as a pediatrician since 2005.”
For 17 years, Sara Tamarin has cared for children, but now she also sees a second set of patients. Tamarin coaches physicians through situations that hold them back in their own lives.
Sara Tamarin: “An example of these kinds of things might be impostor syndrome, perfectionism, a sense of never being enough, a sense of constant overwhelm, a fear of making a mistake or maybe perseverating on mistakes made in the past with patients, even if they didn’t have, quote, unquote, ‘a bad outcome.’ Self judgment, comparison, all these things that physicians tend to experience quite a lot of and, at the same time, we are very much conditioned not to talk about and to not even really admit, in a sense, to ourselves.”
Doug: “There’s a particular poignancy, given the time that we’re in right now, when there’s a lot being made about health care workers being burned out, being mistreated at work by the people that they care for. Do you think that doctors are more sensitive to this and are, therefore, more willing to open up and talk about those things that they’re experiencing?”
Sara Tamarin: “Yes, I do think that the experience that physicians have on through with the pandemic has, in some ways, accelerated the willingness to talk about these things and open up about these things. But the experience of burnout, which is a lot of what we’re talking about here, has been around for a long time for physicians, with already a major challenge before the pandemic, but then with the pandemic, it has just skyrocketed.”
Peer coaching for physicians is still a new phenomenon in the health care industry.
Sara Tamarin: “That could be something coming down the road and I know that there are some clinics in the country that have employed that model, but right now I am the coach and I am coaching many, many different health care providers at our clinic.”
Doug: “If this is a pretty new thing, then who did you learn from?”
Sara Tamarin: “It was a couple of years back, even before the pandemic hit. I had been grappling with a sense of wanting to change the trajectory of my career. I’ve loved practicing pediatrics, but there is also part of me that was just really yearning for some change. Even that, in and of itself, is something that physicians tend to not really talk about. It’s almost like if you become a physician you’re expected to just want to keep doing that until the end of your career. Even just grappling with ideas of do I maybe want to take my career in a different direction is itself something that physicians often get coached about. I wasn’t necessarily looking to completely give up practicing, but I knew that I wanted to explore other possibilities. So, through a combination of factors, it was in the fall of 2020, I decided to enroll in a life coach certification program. A week after I enrolled in that, one of the leaders of the Everett Clinic reached out to me, via email, to let me know about a program he thought I might be interested in, which is the University of Washington’s Women in Entrepreneurial Leadership certification course. So I ended up deciding to do that as well. In the fall of 2020 I started both of those certification programs and, in the course of that entrepreneurial leadership course, I decided to create, essentially, a pitch, a proposal, to my clinic that, once I certified as a coach, that I would help initiate this in-house coaching program to help address issues around burnout for our physicians and other providers.”
Doug: “So you’re 17 years out from your residency, so you’re kind of a mid-career doctor right now. So you’ve had a chance to see the doctors in the generation before you and you’re probably getting a chance to see how medical education has changed. Give me an idea of the evolution there, of how doctors have been, of how this has been treated over a period of years.”
Sara Tamarin: “Certainly I think the generations before me, it largely was about nose down, hard work, never question…”
Doug: “Suck it up, buttercup.”
Sara Tamarin: “Yes, thank you. Exactly. And in my generation of training, I think there is still quite a bit of that, but things were starting to evolve. My generation or half a generation before mine, the concepts of some degree of work-life balance for physicians started to become a little bit more in focus. I couldn’t tell you the details, but certain regulations started being changed around how many hours in a row could a resident physician be allowed to work. Even when I was a resident in training, a law passed in the middle of my residency that cut back on how many hours in a row a resident could be working. That shift definitely has been coming and evolving over this past generation. The new cohorts of physicians out of training now, they know that the way we used to practice medicine is not sustainable, not just on a system basis, but personally for physicians. There’s much more openness and more of a sense of I can ask for and say what I’m willing and not willing to do in order to be able to have a full balanced life. I think there’s still a lot of room to improve on that but I do see that shift happening.”
Doug: “So, back to the peer coaching. If you’re going to get doctors to talk about this it’s a lot better if doctors are talking with each other because they’re not going to open up to somebody who doesn’t really understand what they’re going through. Is that an accurate assessment?”
Sara Tamarin: “I think, to a large degree, yes. It’s not that I think doctors would just refuse to talk about these things with a non-doctor coach, but, first of all, there’s just so many things that are unique to the experience of going through medical school and going through residency and the responsibilities of being a doctor that just only another doctor can understand at a certain level. There’s so much that just doesn’t hav e to be explained. Like, from the get-go, that first session, I’m sitting down with another physician and I am coaching them. You don’t have to explain to me what medical school is like. They don’t have to explain the many traumas that they’ve experienced about medical school or residency or what it’s like to be an intern on the ward for the first time alone at night. There’s just this understanding, this foundation that’s already there, that’s allows us to just get right into it. And, as a physician, being able to really relate to all the internalized self concepts and the conditioning that we’ve experienced, I think does allow for more of an openness and a connection than there might be with a non-physician coach.”
Doug: “So then, you as a trained peer coach, how do you steer them through this in order to be able to get, as quickly as you can, to get to the nub of what they need to deal with so they can experience it and they can get through it?”
Sara Tamarin: “I do have a structured curriculum that I walk my clients through. I have readings and different topics by unit where I introduce certain concepts and walk them through those and I listen. I just ask questions. Tell me what is challenging for you right now. Just from there, usually, that just opens up the dialogue and I can help identify where the areas are that I can be helpful. Often people who come to me already have specific things they want to be working on, like I’ve had physicians, they know they want to talk to me about their impostor syndrome and how much that is getting in the way for them. Or another doctor might talk about how their perfectionism is getting in the way of finishing their notes at the end of every day and they’re spending hours at home after the kids go to bed, working on their charting and they recognize that some of that is coming from this perfectionism. Often they’ve been able to identify certain areas that they want to address and at other times not so much and I can ask questions that help illuminate what some of those things are.”
Doug: “Given that this is still a pretty new concept, of peer coaching, what are the early returns? Is it working?”
Sara Tamarin: “It is. I’ve used, at least with the initial pilot cohort of providers that I coached last summer and the pre- and post-questionnaires before and after, the 12-week coaching program showed significant reduction in burnout, significant increase in feelings and thoughts of self-compassion and of connectedness to others and, from just the comments that physicians and providers have shared, it is making a difference. They feel heard and seen in a way that they may not have before and they are learning how to employ tools to help them, ways of changing their perspective, ways of becoming more patient and self compassionate and in ways that make a real difference in their day-to-day experience of their jobs and of their lives overall.”
Doug: “Well, if that’s true, you’re probably going to get to talk at conferences and medical meetings. Do you anticipate that this is the wave of the future then for the medical industry?”
Sara Tamarin: “I do. Absolutely. I really do feel that I’m part of a movement. There are physician coaches popping up all over the country that are all on this similar mission and are changing the culture of medicine, physician-by-physician, in clinic-by-clinic, hospital system-by-hospital system, and I do think that this is going to become something that physicians are going to expect will be part of the services that our clinics and hospitals provide.”
Doug: “I have one more question that is not related to peer coaching. The name of this podcast is called Finding Joy and so we’ve been asking everybody we’ve interviewed where do you find joy? Bring it back down to your own practice, your own what you do at the Everett Clinic. Where is it that you find joy professionally and personally?”
Sara Tamarin: “Helping my colleagues in this way fills me up and brings me so much joy. I feel like I spent many years providing care to children and the families of those children that I served and now I am helping heal the healers, is the term that’s often used in this field. For me, I feel like that is where my true talents and abilities lie and I feel like I am giving back in this new and different way and I just love that this work that I’m doing so much.”
Sara Tamarin is a pediatrician and life coach for physicians at the Everett Clinic, north of Seattle. We thank her for talking with us for this podcast.
[theme music]
The Interprofessional Opioid Curriculum team also wishes to thank these people for their contributions:
- Dr. Barb Richardson, nurse, educator, and interprofessional champion;
- Cameron Cupp, creator of the “Finding Joy” musical score and current enrollee at WSU Elson S. Floyd College of Medicine
- Washington State University staff from Marketing and Communications, Financial Services, and the Collaboration for Interprofessional Health Education Research and Scholarship; and
- Claire Martin-Tellis, Executive Producer, and Solen Aref [so-LEN uh-REF], student intern, who developed the first five episodes of the “Finding Joy” podcast.
This episode of “Finding Joy” was produced by Doug Nadvornick from Spokane Public Radio.
If you are interested in sharing your perspective about wellness and resiliency as a healthcare professional or would like to reach out, please contact our team by sending an email to: medicine.ipoc@wsu.edu We also encourage you to visit our website at: https://opioideducation.wsu.edu/about/.