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“Conquering Charting & Life” – Interview with Dads Before Doctors

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I was recently interviewed by one of my classmates from my life coaching training small group! Dr. Adam Broussard is a pediatric anesthesiologist and physician coach who recently launched his podcast, Dads Before Doctors.

He was gracious enough to invite me onto his podcast to share a little about my coaching journey. What follows is the transcript of our discussion.

You can listen to the podcast episode by searching for his podcast in your favorite podcast app or below (embedded in the post).

The Man Under the Mask

Adam

Alright guys, welcome back to Dads Before Doctors podcast. Today, we’re joined by Dr. Junaid Niazi. He’s a pediatrician and internal medicine physician, and a life coach, and he has a specific niche of helping us chart a little bit quicker so we can get back to our families and do things a little bit more enjoyable than charting.

I’ve gotten to know Junaid over the past 10 months or so. We actually did our life coach training together and we coach together in some other programs. And he is a good example of what we’re trying to achieve here with Dads Before Doctors. Welcome. Junaid! Can you tell everybody a little bit more about yourself?

Junaid

Yeah, well, hi, Adam. First of all, thanks for inviting me out to your podcast, and thanks for creating a space for male physicians. It’s much needed. So yeah, like you said, my name is Junaid Niazi. I’m a father, husband, physician, life coach and entrepreneur.

I’m dual boarded in internal medicine and pediatrics, and I practice as a primary care physician in the Twin Cities in Minnesota. I met my wife in residency; she does pediatric primary care. And then we have two pretty spirited young kiddos, a three-year-old son and a one-year-old daughter. And I’m sure Adam recalls hearing a lot about my kids throughout our coach training….

Junaid

I did undergrad in Houston, Texas, at Rice University. I studied history there and completed my pre-med reqs. I stayed in Houston for medical school at Baylor College of Medicine, and I did public health school there at the University of Texas as well. And then after about a decade in Texas, I decided to venture north and do something completely different for my med peds residency at the University of Minnesota.

After residency, I started working at my current job where I see patients of all ages for all their primary care needs. And part of my FTE is carved out as what’s called an Information Services Medical Director. So I’m basically part of a team tasked with helping optimize the medical record for physician use and for patient care.

Seduced to the Dark Coaching Side

Adam

That’s awesome. So what got you into physician coaching?

Junaid

Yeah, so really, this all started–well, the impetus started years ago. Basically, there were parts of my life that just didn’t feel like they were working the way I thought they should. And on paper, it felt like I was doing all the right things and you know, crossing my T’s and dotting my I’s, but things just still seem like they weren’t working right. So like, especially in medicine, you know, I was burning out mostly just from disillusionment with the system and sort of the pressures and how it often felt like we had to function a certain way within the system that butted heads with providing good care at times.

And I had subscribed to the FIRE mentality–financial independence, retire early–where basically, you know, you work hard for a few years, earn a lot of money and then you try to pull the cord and, you know, have a low spending rate so you can go do whatever you want. But that just didn’t quite feel right. Like even as I was trying to do that, I still sort of felt like I was missing something.

Sort of like riding a motorcycle won’t make you feel younger. At least they are wearing a helmet!

Junaid

I follow a lot of physicians on the physician blogosphere and podcast-sphere. And yeah, you know, I noticed several of them were becoming coaches and a lot of them were talking about getting coached, and that sort of piqued my interest. So much so that I did some digging and I stumbled across the Life Coach School podcast with Brooke Castillo.

I really, really took to what she was saying, kind of binged a lot of her content. And, you know, prior to this, I’d always thought coaching was kind of, you know, woowoo. But she was presenting it in a very sensical fashion. And, you know, incorporated psychology and neuroscience. And I think there’s a sort of a sense of familiarity there that was appealing.

Cue the Rocky Training Montage

Junaid

And so I started just self-coaching, just by myself, and I started to see some changes, which were pretty impressive. So especially relating to work, and sort of that FIRE mentality, you know. I realized while FIRE may be sort of a goal to aspire to, if my underlying reasons for it are not in line with how I’m living my life right now, I’ll still be unhappy when I get there. You know, in the group coaching program you and I are both a part of, we talk a lot about the arrival fallacy, and that’s sort of what I was setting myself up for.

So I started to really see that the results in my life were really the result of my thinking. And that the nidus of control for my life really resided with me, and not all these circumstances around me, related to work and family and such. So really, the next step was I joined a physician group coaching program, because I wanted to see what being coached was like.

This just really accelerated all my transformations. I mean, when I was actually coached by other physicians who were trained in coaching, you know, this greatly outpaced my own self-coaching at the time. And it was through that program, I really learned like, hey, this is really important for myself and for other physicians. And I knew at that point that I, you know, I had to become a life coach. So that’s why I joined the very next cohort at the Life Coach School with you.

I went all hyperspace on my transformation.

Arrival Fallacies

Adam

Yeah, I think a lot of our fellow physician dads will, I think that will resonate a lot that, you know, we go through undergrad, and things are gonna get better and in med school. And then go through med school and things are gonna get better, and residency. And then finally, you’re that big, bad attending and you’re gonna get the big paycheck.

And, you know, it still isn’t quite what you’re expecting, or, you know, what you, as you kind of mentioned, the arrival fallacy, that just that next step is just going to make everything better, and doesn’t always happen. And it has a lot to do with your thoughts. And especially even with the financial independence, retire early, you know, if you–that’s just your next point of arrival–and when you when you get there, it might not be you know, unicorns and rainbows.

Junaid

Yeah, you can’t keep running from things, which is what a lot of us keep doing, even if it doesn’t seem that way on the surface. You really have to be running towards things. I think a lot of people only associate that maybe with actual retirement. Like, if you don’t have something to retire to, you’re not going to be very happy. But I think it happens actually in a lot of phases in our lives. Even if you change a job, if you haven’t really done the mindset work ahead of time, before you leave that job, you’re probably going to sort of recreate everything that was what you were trying to get away from in the new job.

Figuring It All Out

Adam

Yeah, I know, we we’ve seen some pretty remarkable transformations in the Alpha Coaching Experience that we’re we’re both working in. What kind of changes do you feel that you’ve made along the way between your self-coaching and once you started actually getting coaching yourself?

Junaid

It was really that, you know, I think coaching really helped show me that when I’m not getting the results in life that I want, that I really have some introspection to do. I think prior to that, I would sort of blame the system or blame other people, blame our circumstances. And that just wasn’t the right way, right?

So the thought model to which you and I subscribe that we were trained in shows us that the results in our lives come from the actions we take. The actions we take are driven by our feelings, and our feelings come from our thoughts.

So, when you do any kind of thought work, you find that you have thoughts or beliefs–which are just ingrained thoughts–you find that those are just sort of automatic. And you never question them because they’re so automatic, that they happen so quickly. You don’t even sort of realize that they’re occurring necessarily. But suddenly, when you put them under the microscope, you start to see that they maybe don’t work for you.

So, you know, coaching really sort of gave me a framework for dealing with any issues that that come up, right, and it’s constant work. People sometimes think that coaches have everything figured out. And you and I both know that that’s not the case. We’re still human.

Junaid

But it’s sort of that ongoing effort at chipping away at reframing our thoughts and working to develop new thoughts that better serve all of us. So I think for me, the key difference from coaching is I can now, you know, really be intentional about things and not simply reactive. So coaching gave me the agency to kind of craft how I show up in any role in my life, be it, you know, a father, a husband, or a physician.

The Stigma Around Failing

Adam

Yeah, absolutely. And I think it also, you know, has helped me with, you know, as physicians, we all, kind of expect to be perfect, and a lot of issues that, you know, we’re trying to, you know, chart every last detail so that we don’t get sued or so that the next provider knows exactly what we thought and everything we did.

I know you and I’ve been in different, you know, entrepreneurial kind of circles and stuff like that, and it’s amazing, the different, you know, mindset that a lot of those people have, and that, you know, every, “failure” is just a learning opportunity. It’s you know, what to do now and how to get better. But that’s just a thought. Just a simple change in your thought of, you know, I’m a failure, I’m a horrible doctor, I’m a horrible dad, whatever. And versus, you know, okay, what can I learn from this? And now I’m going to be even better physician because of this, or better dad because of this.

Junaid

Yeah, I mean, I think medicine especially, is not a welcoming place for failure. And, you know, to a certain degree it makes sense, right, we’re dealing with people’s lives, and their well being. But, you know, we all failed at things constantly as med students and residents. It was the only way that we could learn.

Unfortunately, I think a lot of us, myself included, always carried a lot of shame about that. And that shame just sort of builds and builds and builds, and we try to sort of, you know, push it under, it’s like this beach ball of shame that we tried to kind of push underwater and a lot of physicians, you know, suffer then from perfectionism that you were discussing and imposterism as well. Oh, I maybe don’t even notice when other people make mistakes, because I’m so focused on my own, then I’m constantly worried that others will discover that I shouldn’t be here, and I’m not good enough. And I think that just makes your day to day grind of medicine just much harder to deal with, because you’re constantly questioning if you even belong, which is challenging.

Whereas in these other realms, like–you’re getting big into real estate and such–people just try things, right? And what’s the worst that could happen? So it doesn’t go well, you’re like, okay, well, like you said, “now I know what not to do next time.” It’s like you put out a hypothesis, if it didn’t work, you’re using the scientific method, and you’ll now test the new hypothesis. So, you know, I think coaching goes a long way in overcoming a lot of the negative thought patterns that we as physicians have sort of ingrained in ourselves and what’s actually been sort of put upon us by those that came before us.

Is It "Neesh" or "Nitch?"

Adam

Absolutely. So now you have both coaching program and then helping with charting efficiency. How do you get into that?

Junaid

Yeah, so becoming a charting coach was definitely not intentional initially. So as you referenced earlier, we both coach physicians within Dr. Jimmy Turner’s Alpha Coaching Experience. I noticed on a lot of those group coaching calls, whenever issues around clinic workflows or charting were being discussed, I was always piping up in the comment section and, you know, Jimmy’s clients noticed that and started bringing those issues to one-on-one coaching calls with me.

Jimmy noticed that as well and actually asked me to lead a focus call on charting optimization and shortly after I did that call, that’s when I realized I had a niche and I was like, oh, okay!

Now I like many others used to struggle with charting, right? So my wife and I, like I mentioned, are both primary care docs and we used to sit at opposite ends of a couch, you know, on weekday evenings and many a weekend night just typing away at our laptops, trying to close our charts and clear out our inboxes and I knew that that was unsustainable for us. And this is before we even had kids. And this was long before I discovered coaching, actually.

But it was actually intentional thinking, I just didn’t know what I was doing at the time, that I’d said, “Okay, I, there’s this result I need to create, and that’s not bringing my work home.” I need to finish that work before I come home. And then I actually just found solutions and built efficiencies to get me there.

And as you can probably tell, I’m a primary care doc, I did med peds for goodness sake, so I clearly struggle with choosing a niche. So becoming a charting coach wasn’t actually easy for me. It was one of my struggles within business, but it actually it feels right for me now. Charting is the leading cause of physician burnout. And, as you know, I’ve been able to help several dozen physicians turn their lives around by getting a handle on their charting.

You know, the best feedback that I get from clients is when they’ll tell me on a call or when they’ll email me and tell me that, you know, their child or partner is excited to have them back again. Or one even told me that their child thanks me, because now, you know, now mom is back in the evenings to eat dinner with them and to play with them.

Adam

That’s amazing!

Junaid

Yeah, right! So you know, through this niche, I can really help physicians, their families, and even the patients they serve, if mastering charting can extend their careers in medicine.

Anesthesiologists Have It Easy...

Adam

That sounds like some remarkable transformations. Yeah, I’ve had some, some clients come to me talk about it. And unfortunately, or fortunately, I guess, either way, I don’t have a whole lot of charting to do. Certainly not at home. So got it, got to just send them your way.

Just Kiddin'

Junaid

Certainly, by all means. You know, we all we all have our different struggles in medicine.

Should I Chart or Should I Go?

Adam

So what are some, you know, high level tips that that some of the listeners might be able to take, take to work or take to home to avoid having to take it home?

Junaid

Yeah, yeah. So, the most important thing that I love to tell people and teach people is you really have to chart as you go. A lot of docs will sort of hop room to room before they’ve finished their prior encounters. And they leave things undone: they’re not finishing the notes, they haven’t put orders in, and they go and see the next patient. Because there’s a lot, most of them will say, there’s a lot of pressure, they feel this, internal drive to get to the next room if a patient is waiting.

And that is a huge hindrance for a variety of reasons. So you are carrying a mental load with you every time you don’t close an encounter, because maybe there’re orders you haven’t put in and you’re trying to keep that in the back of your mind. You’re using sort of your mental bandwidth for that. You’re trying to remember which patient had that murmur that you really wanted to put in the exam. And you’re carrying all that with you into the next room. So you’re not actually fully present for any subsequent patient if you’re not closing your charts as you go.

Furthermore, if you just send a patient to a lab and you haven’t put lab orders in, guess who’s going to knock on your door and interrupt you while you’re with your next patient?

Junaid

If a patient’s waiting at the pharmacy for a medication you haven’t sent in yet, guess who’s getting a phone call saying, “Hey, where’s that refill you said you were going to send in?” So it’s really incumbent upon us to really find systems that work for each of us. And it’s pretty individual in terms of solutions, but just challenging yourself on, “How can I close my encounter before I go see the next patient?”

In the Zone

Junaid

We also tend to work a lot faster actually in the moment, when you’ve dealt with all the information about the patient. So right there in your mind, you have all the facts you need finish the note. Doing it then might take you two or three minutes. If you leave it for the end of the day, it’s going to take you five or 10 minutes, and sort of pile up.

One way that I facilitated charting as you go was I learned to type as I talk. And specifically, I learned to ask something different than what I’m typing and that took me like a year to master! But it’s super helpful because I’m asking the next question while I’m writing down the response to the last one. So those are some sort of high level tips for helping physicians get their work done.

Constrain Yourself!

Junaid

I did want to just mention, there’s one principle that’s called Parkinson’s Law, which basically states, you know, work will expand to fill the time available to it. And if you decide you’re going to finish your work at work, you’ve put a constraint around the time that’s available to get your work done and you will find a way to get it done.

Junaid

If you just say I will get it done when I get home. You’ve just expanded the time to get that work done to all the hours that you’re not at work as well. And that’s why when you go home, it’s so much harder to work. Because subconsciously, you know, “I can just stay up an extra hour or two. Yeah, that’s not fun, and I’ll be grouchy tomorrow, but I have this extra time.”

Junaid

So you’ll actually work less efficiently unless you constrain yourself timewise. Physicians who struggle with charting at home will tell me, “Yeah, that happens to me all the time. I’ll have an hour of work, and it’ll take me three hours if I take it home.” You know, the goal is really, if you can constrain it to shortly after you see your last patient, all your work is done! You’ve just freed up your evenings and your weekends! And you know, that’ll make you even enjoy medicine more moving forward!

Time Is Everything

Adam

I mean, it’s just amazing to think about all the things you can do with that free time.

Junaid

Yeah, you can become a coach!

Adam

Exactly. But you know, being able to enjoy your family more, and be around for your kids more, like you said, you know, that that client, that child, thanked you. But it’s amazing how you fill your time up, you know, if you don’t have some type of guidelines, or some type of, you know, guardrails of how you’re going to spend your time. I know I suffer from that, absolutely. That, you know, if you come in to work on one thing, and three hours later, you haven’t even gotten to it.

Junaid

Right. Yeah.

Adam

And the charting in the moment, I think that’s an excellent, you know, excellent point. When you have to carry that along with you, and you’re still thinking about putting that that order in, and you’re not really listening to, you know, the patient that’s in front of you that you end up missing something they say, that may have been, you know, some big clue to their diagnosis. And in the end, you order, you know, five more tests than you probably need than you may need to, and they come back three more times before you figure out what’s going on. Just because you were preoccupied with something else. I mean, it benefits you, the patients, and family, community, everything!

Junaid

Yeah, I mean I think there’s been some studies on how many things can you carry in your mind at the same time, and I feel like physicians are always pushing that to an extreme. You know, some people will say it’s six different things you can actually juggle in your head at the same time. And think of all the information you’re getting and having to process real time to serve the patient in front of you, let alone all the things you’re trying to keep from your prior encounters in your head so you don’t forget them. So, you know, I’ve described it as a mental tax on your brain. I’ve described it as barnacles attaching to your ship and slowing you down.

Adam

That’s one good thing about anesthesia is that there’s one patient in front of you. And when you do something to it, it happens immediately.

Take. Back. Your. Time!

Adam

So how can listeners get in touch with you if they want to learn more about, you know, charting or coaching?

Junaid

Yeah, so I run an online course with group coaching called Charting Conquered. I’ll next offer it later this summer, early fall. So you know, I’ll help you finish your work at work so that you can reclaim your time at home. Essentially, we can make medicine work around your life instead of the other way around.

To learn more about this program, and to get updates when doors open next, listeners should go to www.chartingconquered.com, and then click on the green button that says “Get on the waitlist!”

Adam

Awesome. Yeah, I think that will help everyone become better dads before doctors, and be able to have more time with their family. More personal time to exercise, eat right, and take care of their own mental health, and maybe go out and become coaches or start their own business. And hopefully join medicine again and help their patients, their community, leave a legacy.

Junaid

Absolutely.

Adam

I enjoyed chatting with you today. And I appreciate you for joining us on the podcast. And I hope the listeners can take some value from learning how they can get their charts completed at work and not take them home.

Junaid

Likewise, it’s been a pleasure, Adam. I appreciate it.

I hope you enjoyed the listen or read! Let me know in the comments below what you thought!

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