Cydoc & Dr. Rigert
The Cydoc team is pleased to welcome Jillian Rigert, DMD, MD, for an interview on our blog this week.
Dr. Rigert has formal training in dentistry, medicine, and oral medicine, and is currently a postdoctoral researcher in Radiation Oncology. She is an Air Force veteran, Certified Life and Professional Leadership Coach, and Certified Chief Wellness Officer on a mission to bring the humans back into the healing. Her passion is fueled by her experience risking her military career to save her life, deeply knowing the devastating impacts that healthcare is having on the health and wellbeing of all trying to navigate the dysfunctional system. She is passionate about serving physicians and other healthcare professionals to help them gain back ownership of their lives at the individual level while targeting solutions to improve healthcare at the systemic level.
Disclaimer: Dr. Rigert’s responses reflect her opinion and are independent of her current institution. She is not affiliated with Cydoc and has no financial conflicts of interest.
Thank you so much for joining us, Dr. Rigert!
What motivated you to become a certified coach, and what services do you offer physicians?
After I transferred out of surgery and was medically discharged from the military following treatment for mental health related conditions in 2017, I was lost and buried myself in guilt and shame. I had spent my adult life thinking that I needed to become a surgeon to prove my worth, and without that identity, who was I? To answer that question, I dove into coaching for my own healing. Coaching provided me the pathway to get back into the driver’s seat of my life, see where my beliefs and societal values had been leading me astray, and develop the tools to create a life of meaning and purpose grounded in my own core values. Experiencing the transformational benefits of coaching in my own life, I value the opportunity to coach other physicians and healthcare professionals so that they, too, may reclaim their lives and free themselves from all the thoughts, external pressures, and obstacles that are currently inhibiting them from living a fulfilling life in alignment with their true desires. As a coach, I support individuals in discovering or rediscovering who they are after they have spent years being who they thought others needed them to be at the expense of their own wellbeing.
What are the biggest challenges you see physicians facing today?
Many of the challenges that arise for physicians stem from values conflicts experienced from trying to be a healer in a system that is not created for human healing, and worse - a system that contributes to the suffering of the physicians and other healthcare professionals who have dedicated their lives to serving patients. While we know the weight of working in the system contributes to “burnout,” I believe many are experiencing “moral injury” due to the values and morals conflicts that arise in the face of systemic barriers.
Some of the heaviest weights burdening physicians can come from feeling trapped in the system, not seeing alternative options, and losing our sense of agency - these stressors contributed to my own experience of suicidal ideation, and I share my story in hopes that it may save others from this despair. It’s important for physicians to know that there are many options, and that nothing in their career is more important than their life - nothing. Working in a dysfunctional system without observing improvements while having financial needs (i.e., loans to pay off, families to care for, etc.), can increase distress and risk for developing a learned helplessness. Holding on to hope, knowing you have options, and reclaiming agency over your life can be critical in saving your life… and then your career… and keeping your life as the top priority is essential. Check in to see what comes up if you feel resistance to putting yourself as your top priority, which is common as individuals in a serving profession. Trust that we cannot sustainably serve others if we are not taking care of ourselves first. Leveraging the lesson taught when flying to “put your oxygen mask on first,” I recommend physicians ask themselves what it may take to commit to that action daily?
Many physicians feel resistance to getting mental health support due to stigma and risks to their career. It’s unfortunate that physicians do not feel safe to put their own wellbeing first. As a person who lost their military career after seeking treatment for my mental health, I know the biases and outcomes may not always be what we imagine even when we are encouraged to get the support we need by our employers. I do know that no matter what happens, I’d recommend you get the help every time. We need to change the culture and see physicians as humans. We need to bring the humans back into the healing for all. If you are a healthcare professional, you are a human who has been trained to ignore your own needs in service to others...which comes with personal consequences. Setting boundaries and putting your needs first may feel unnatural and requires unlearning to relearn. The benefits will be a much happier, healthier you.
While much feels outside of our control in healthcare and it feels near impossible to stay well while working for a system that is dysfunctional, we do have agency over our lives. Learning how to reclaim a sense of control and focus on what you can change is empowering, and taking action to create a life that aligns more with your values and desires can help to reduce burnout and improve personal and professional fulfillment, including finding ways to practice medicine on your own terms and in a way that better allows you to take care of yourself and patients with less negative impact from systemic barriers.
Recognizing that burnout is foundationally a structural problem with the healthcare system, what are your favorite strategies for reducing burnout?
If you are in a deep stage of burnout, you may need to take time off to step out of the grind and to be able to think more clearly. Many of us are in survival mode, and our brains cannot get into a creative mindset to explore options. Depending on the severity of symptoms, I would make sure to prioritize rest and potentially time off work first with a support plan in place. While we often think we can’t afford to take time off, I’d argue that many of us can’t afford NOT to take time off. That was my biggest mistake after I transferred residencies without giving myself time to recharge, and it led to prolonged suffering with a deeper level of burnout a few years later. Additionally, when we take time off, our nervous systems may remain wired. Having a plan in place for how to utilize the time to reset will be important as “time off” isn’t typically restful when stuck in old thoughts and behaviors.
Whether you choose to take time off or not, examine your circumstances, thoughts, beliefs, and behaviors. Where are the true stressors coming from? There will be a combination of external and internal factors. For the circumstances and systemic barriers, which aspects do you have agency to change? For the thoughts, beliefs, and behaviors, it is often challenging to fully examine our own thoughts as we have blindspots and deeply rooted beliefs. Work with a therapist, coach, and/or trusted friend who may provide an outside perspective to help you identify where your thoughts, beliefs and behaviors may be contributing to the stress.
Once you create space to breathe and reset the nervous system, identify your core values and audit how your life is currently in alignment with those values and where you are not - including ways that the system may be pushing you to be out of alignment. To reduce burnout and moral injury, key goals that I recommend to improve symptoms include creating a life that aligns with your core values, increasing autonomy, reducing thoughts and behaviors (i.e., people pleasing, poor boundaries) that are contributing to suffering, increasing positive thoughts and behaviors (i.e., self-compassion, strong boundaries) and developing a life where you feel a sense of meaning and purpose. Determine how you’d like to practice medicine, and take small, continuous steps over time to create that vision - this may or may not necessitate a move from your current role and practice.
I encourage you to find a community of individuals with shared values and missions to support you in your journey if you have not already. Social media has made this very efficient for physicians seeking to be part of the positive change in healthcare, and you will find many on platforms such as LinkedIn.
Are there any resources you’d recommend to physicians for optimizing the efficiency of their practices?
Before considering solutions, first identify the specific issues that are impacting the workflow of your practice and yourself. Get clear and concrete with the problems that you’d like to target for solutions, and then identify measurable outcomes to assess your current state and develop goals for desired states. Once you are clear on the problems, you may then brainstorm potential solutions to implement. Make sure to have a plan to measure and assess progress as well as any unintended consequences following implemented changes. Solicit feedback from your team throughout the process and support them with learning the skills that they need to adapt when making changes which can be temporarily destabilizing.
As the factors impacting the flow of practice will be variable, the resources recommended will differ based on identified needs. For an example - Individually, timely chart completion is a common problem. Some of this may be internal (i.e, procrastinating, desire to write a “perfect note,” not feeling like writing the note, being overwhelmed, feeling bogged down by administrative work, etc.) warranting work on mindset and personal efficiency. Some factors contributing to delays in chart completion may be flow of practice - is the workflow leading to redundant work? Are there missed opportunities for delegation of tasks? Is the computer behind the patient, and you aren’t able to get the chart started during the visit? Identify where the problems are originating, and then develop your action plan. There are coaches available to support with charting efficiency as well as technology/dictation applications that may expedite your note completion.
(Editor's featured tech: the Cydoc Smart Patient Intake Form interviews patients and automatically drafts notes before a visit, saving 10 minutes of charting per patient. It is compatible with any EMR.)
I highly recommend working with a coach and/or consultant to help you identify and work through the hurdles individually and systemically if you are feeling stuck. Having an outside perspective can help with identifying blind spots, support you in creating solutions you may not have considered, and provide a method of accountability. Once you localize areas for improvement, you will have a better idea of which resources, including technology, you may utilize that meet your needs.
What are your future plans for your coaching practice?
I currently coach within a large academic institution, individually, and as a contractor to support physicians sponsored by their institution. I am evolving my practice to include more group opportunities as I find it very valuable for physicians to hear their own obstacles being said by someone else to support them in knowing that they are far from alone. I value the opportunity to create communities as a coach to empower all on a mission to bring the healing back in healthcare, starting with their own lives.
I recently became a Certified Chief Wellness Officer, and I am working to be a change agent at the system level. I am eager to work with all change agents, and meet them where they are at whether they want to stay focused on their own individual level improvements and/or are seeking to tackle systemic barriers.
What “words of wisdom” would you want every physician to have the chance to hear?
Nothing in your career is more important than your life - nothing. You always have options, even when you feel trapped and hopeless. When in the depths of emotional exhaustion, the best next step is rest. While many of us don’t think we can afford to rest, the reality is that we often cannot afford not to rest. We must break free from the pressures of healthcare and society that are leading us away from prioritizing our lives and wellness. Make sure that you are in the driver’s seat of your life - and invite a friend, therapist, loved one, or coach alongside to help you navigate… we were not meant to be alone in this world. There is always someone who understands, even when you think it’s “just you.” Hold on to hope and find a community to support you in your journey. We are strong, and much stronger together.
How can our readers reach out to you or follow you on social media?
YouTube Community: https://www.youtube.com/@JillianRigertDMDMD
LinkedIn: https://www.linkedin.com/in/jillian-rigert/
Coaching: https://www.jillianrigertcoaching.com/
Thank you very much for joining us today to share this important message, Dr. Rigert.
