Okay, good morning to our West Coast attendees and good afternoon to everybody else. My name is Mohamed Agha. I'm the Medical Director for Care Coordination for two hospitals in SSM Health in $8 billion integrated delivery network based here in St. Louis. I am joined by my course co-director, Dr. Greg Worswitz. Dr. Worswitz, would you mind giving a brief introduction on your career? Yeah, thank you, Mohamed. I've worn different hats throughout my career. Leadership-wise, I was the Chair of the Department of PM&R at the University of Missouri for 19 years. I spent one year as President of our AA PM&R. I also was Chair of our 600 Physician Practice Plan for eight years at the University of Missouri-Columbia. And I'm currently a Senior Associate Consultant here at the Mayo Clinic in Jacksonville, Florida. One thing I wanna say is, Mohamed, I wanna thank you for putting this together. My encouragement is listen to these leaders. There's a lot of useful information. They actually taught me a lot of things with your dry run. So thank you. Thank you, Dr. Worswitz. I appreciate that. I'm excited to host this panel discussion with Dr. Worswitz along with three leaders in our field. In our pre-session call, we discussed the order in which we will start our panel discussion. So we'll first hear from Dr. Varghese Kroll, then Dr. Escalon, and then Dr. Powell. We will touch on their journeys in healthcare, the skills and lessons they've learned along the way, key takeaways for our audience, and a question and answer session at the end. But first, a few housekeeping notes. Next slide, please. And next slide. For the best attending experience during this session, please keep your microphone muted, use the Zoom chat feature to share your thoughts and ask questions. As noted, time has been allocated towards the end for Q&A to answer questions submitted. Please keep your camera off and select high non-video participants. This will ensure that speakers are prominent on your screen. CME Claiming will open after this session and to your My Courses page in the Academy's online learning portal, and the link is there. Please complete the session evaluation to claim credit, and your feedback is important so we can put on even better sessions next time. And you're encouraged to continue today's discussion offline by talking with your peers through the Business of Healthcare Physiatrists Community and PHIS Forum, and the link is noted there, right? So now that we're done with the housekeeping notes, let's go ahead and have some fun. So why don't we go ahead and get started with our first panelist introductions, starting with Dr. Barbie Sproul. Thanks, Dr. Agha. It's great to be with you all today, and I'm so glad to see such interest in leadership and modes of leadership, especially for physiatrists. I think we're all excited to share our journeys. So for me personally, again, I'm Dr. Lisa Verghese-Kroll. I'm a physiatrist, longtime member of AAPMNR, and I'm a Senior Physician Advisor for Optum. And when asked to kind of reflect on the various milestones on my path here, I think it really would have to start prior to medical school when I obtained a degree in broadcast journalism. At the time, I was really interested in the intersection of medicine and communication. I still am. It's really a big passion for me. And because that was such an interest, I decided to major in it, focus in it, prior to starting my medical training, which, as you all know, is all-encompassing, and those years of med school and residency and fellowship training kind of leave little time for anything else, or so it feels. So after that, I then went into medical school and residency and started my career in private practice. And at that time, I felt that really what we were taught in medical school and in residency, really regardless of specialty, was that there was really maybe two ways to be a doctor, either academics or private practice, but either way, it was gonna be seeing patients on a regular schedule, taking call until retirement. And it occurred to me that that wasn't actually a very accurate portrayal of medicine in the new millennium. And at that time, one or two years into being in attending in private practice, and prior to that, I had also spent some time as an attending in the VA system, I really was starting to feel that I was missing using some of those communication skills and interests that I had had, and that had been kind of dormant during all of my medical training. And I was looking for an opportunity to use those skills and to dip my feet in those waters while still being a physician. And so it just, that was really the impetus for starting to explore how one could do that. I had no, I'd never heard of anyone really doing anything other than traditional medicine. It was certainly wasn't something I was really exposed to. And in just doing some casual research after a few months, eventually I decided to attend a non-clinical careers conference, which at that time was something I really didn't know much about. Now, I think people are a little more aware of it, but at that time it was definitely a very, very uncharted territory for me. And that conference very much opened my eyes to the possibilities that come with a medical degree. I was really inspired actually to see how so many physicians around the country were using their medical degrees in really creative and innovative ways to either supplement or replace their existing traditional careers. And fast forward, as a result of attending that conference and meeting, networking and meeting certain contacts, I ended up taking a job with Optum. At that time it was called Executive Health Resources, EHR, which was bought by Optum eventually. And I became a physician advisor and I've been a physician advisor for almost a decade since. And so, you know, that experience for me has been incredibly positive. A physician advisor in a nutshell, what they do is they work on utilization review. So ensure medical necessity compliance for their hospital system or for their hospital clients. Physician advisors can work in-house in a freestanding hospital, or they can work remotely for a series of hospitals in a system or for a series of separate hospital clients. But essentially your job is really to manage the appeals process, to ensure that patients are appropriately classified and receiving the appropriate level of care, inpatient, observation, outpatient, and then supporting the appeals process throughout from writing letters to interacting with insurance company medical directors to testifying as expert witnesses before administrative law judges. There are all sorts of other tasks and duties that come along with being a physician advisor. As a physiatrist, I'm also a rehab specialist in physician advising. So our rehab hospital clients, we assist them with CFR guidelines, with CFR compliance, documentation. We meet with their clinical teams to ensure that any issues they're coming across in the utilization review arena that we can assist them with, that we can consult with them and give them our expertise. So that's kind of an overview of what the job is. But having been at this company for almost 10 years, the progressive gaining of experience and saying yes to different skills and opportunities comes with it or brings with it rather the opportunity to be a leader, both in the company and for other people who may be just at the beginning of their journey of exploring how to change their careers to better suit them. So that's kind of how I came to be here. And I'm really happy to have done that and happy to share my experience with others because although what any one person might want to do is not exactly the same as what me or anyone else has done, I think it's always really helpful and encouraging to know that not only your fellow physicians, but your fellow physiatrists may have had some of those same concerns and may have identified some different solutions that you may not have known about or that you may not have known how to execute. So I'm really happy to be here and to answer any questions. Thank you. Two questions right off the bat. So for our audience, what is CFR and what was a conference that helped to change your trajectory? Sure. So the CFR is the Code of Federal Regulations. So that is really the Bible of legislative or legislation that hospitals are required to follow for governmental reimbursement. But third-party payers often use the CFR to delineate their own contracts. So really it's relevant to everyone. And the CFR outlines specific requirements in the case of rehab. They have very specific exacting requirements, which many people on this call will be familiar with. If you're admitting to inpatient rehab, there are certain documents that are required, the pre-admission screen, the individualized plan of care, three physician visits a week, things like that. The CFR also speaks very specifically to other fields such as psychiatry. So hospital facility and other facilities often find it challenging to keep up with CFR requirements because they can technically change once a year or even more often. And as you all know, I mean, we're physicians, our concern is patient care. So we may not really be able to keep up to date with every last thing that changes from a regulatory standpoint, which is the reason that physician advisors are useful, which is the reason that hospitals and physicians choose to contract with a consultant, with a physician advising consultant. It's very similar to getting a renal consult. You're getting your physician advising consult to help you with the UR requirements. And then the conference that I attended was the SEEK Non-Clinical Careers Conference. SEEK is S-E-A-K, and SEEK is the name of the company. And this is one of several conferences that they run for physicians. But this specific conference, the Non-Clinical Careers Conference, it was a great experience. I've been a speaker at that conference since, and I continue to learn from them because they just really highlight excellent and interesting opportunities that you might not have thought of on your own. But they bring physicians who have made that leap themselves so they can talk about their own journeys and their own advice. So yeah, I highly recommend it for anyone who's interested in just exploring. Awesome, thank you, Dr. Varghese-Kroll. Next up will be Dr. Escalon. Do you mind doing an introduction and then sharing your journey into healthcare? Yeah, thank you, everybody. I just want to say thank you for inviting me and for having me here. You know, I think my journey into healthcare generally started with a teenage rebellion. So being the child of immigrants, which is often a story I hear even across different cultures is, you know, you have choices. You can be like a lawyer or a doctor or whatever. So I rebelled against those things naturally and I left home for college. My internet okay? Okay, I thought it froze for a second. And, you know, when I got to college, I thought, you know, maybe I'll do some basic science, but I had some epiphany at some point and I let kind of that teenage rebellion go away. So I thought, you know, for me, what I want to do is go into medicine and I want to affect somebody's life positively. And I want to see that on their face. So I made kind of a quick pivot and I went into medicine and I was really lucky to fall into PM&R because we didn't have much of that where I went to med school. The rotation I did was, and no offense to EMGs because I enjoy them now, but at the time nobody told me what they were. And I showed up at an office and I did like 10 days of EMG where nobody explained anything to me and I almost fell asleep every day. So, but I stuck with it, you know, because what I had read about PM&R online and in books, you know, it's kind of this mixture of orthopedics and neurology and, you know, and musculoskeletal medicine and it seemed to appeal. And actually what solidified PM&R for me was doing residency interviews where I got to talk to people about what they did every day and how they affected lives. And then it clicked. You know, this is why I went into medicine to help people in this kind of way. It's not right or wrong necessarily if you're doing a different kind of medicine, but it's just was what was for me and what I actually had envisioned when I decided to be a doctor and making people smile and doing things that mattered to them in a particular way. So I went to, I did my residency in Houston and I did a spinal cord injury fellowship here at Mount Sinai where I am now. Ultimately I was hired here and I serve at currently as vice chair for the department, residency program director for the residency here. And I've grown into a lot of different roles. I also spend a lot of time in the ICU. So one of the things that's been nice for me in physiatry is because I have a touch of ADHD, I've been able to grow in different ways, which might not have necessarily been the case in another field. So I've been able to dabble in different, you know, in doing some spasticity management, some brain injury, spending time in the ICUs and now doing some administrative stuff. So for me, it just kind of, you know, what I'm envisioning myself doing and what I've learned to do is allow, you know, not to fight myself. So, you know, I ended up doing a spinal cord injury fellowship. It wasn't at that time amongst my co-residents, like the sexiest choice, everybody's going into pain or sports. But when I was honest with myself, I enjoyed it. And in the end, I think it's what I was best at clinically. So if I'm thinking about my patients, it was probably what was best for them too. And so I've been trying to allow that to happen, to kind of like let things flow and listen, really not fight my inner self. So I just imagined myself now as like a leaf, you know, slowly falling to ground, but, you know, just letting that wind take me a bit. And that's what I try to do every day. Now you have progressed to become a residency program director and a vice chair. Could you talk about how you escalated to get to those particular positions? Yeah, you know, people sometimes ask if there's a secret recipe. I think it's a mixture of a couple of things. One is being at the right place at the right time. So I was here at Mount Sinai and I was just doing what I thought was a good job. You know, I was like really dedicated to my patients and really dedicated to teaching. And we had a change in leadership. Our chair retired and the program director became the chair. And it just so happened, if that hadn't happened, I wouldn't be PD now. So part of it is opportunity and setting yourself up in the right way. So when that opportunity comes that you're thought of, or that if you throw your hat in the ring, that people say, oh yeah, you know, I hadn't thought about Miguel in that way, but now that you mentioned it, that could work. So it's not something that I set out planning to do. I mean, if you would ask me, I would have said, oh yeah, that'd be nice. I could aspire to that one day. But it just kind of fell into my lap in that way. And, but I was ready at the time, I think, to take it over. And if I hadn't taken the very basic parts of my job seriously and done them as best as I was able, I wouldn't have been ready, I don't think, to kind of take that next step. In terms of being vice chair, that also happened in kind of a way of right place, right time. Names have been changed to protect the innocent, but as will happen sometimes in your life, you may be looking at another job or someone may come speak to you. So that's something that was happening and I was very happy here. And as part of the process to stay at Mount Sinai, this was brought up as kind of a next step in my evolution. And it was something I was really interested in because I really am interested and continue to be in learning how a program runs and how do you do make business plans and how do you mentor people that might be your senior and how do you keep these bigger picture things in mind? So hopefully I'm answering your question, Mohamed. You definitely are. Oh, you are. Thank you, Dr. Eskalon. Dr. Powell, could you share your journey and how you've ascended to where you are today? Yes. Good afternoon, everyone. I'm Danielle Powell. And so what I want you all to realize is like if you hear the themes of all of our stories, it's all about finding your passion and then also kind of being in the right place at the right time. So my journey started when I was in middle school and got exposed to medicine. We had a dermatologist come to our class and my first thought was, I wanna be a dermatologist and I'll have my own skincare line. But as I learned more about medicine, my thoughts evolved and I started to think about nephrology because that's what I was exposed to. So then fast forward to medical school, go to medical school. And every year we had about two to three people from our class that went into a field called PM&R. And I started exploring, I was like, what is this specialty? What is this? So as I looked, I'm like, okay, you help people quality of life, but it didn't really hit me until I got on my neurology rotation. So on neurology, I got exposed to patients after stroke and it really made me reflect on my own grandmother. So my grandmother has suffered a stroke when I was in high school. And from what I can, I don't remember her receiving any therapy she may have, but I do not think she had a physiatrist that was involved in her care. But what I do remember about my grandmother is that her whole demeanor changed after her stroke. So after her stroke, I felt like she was defeated. You know, her mobility changed and she just changed and she just wasn't the same individual that I had known growing up. And being in high school, that really frustrated me. So when I got to medical school and got exposed to neurology and actually saw that there was a specialty that could help people recover after they've had a stroke, I said, this is what I wanna do with my life. So for me, it was about finding purpose and also finding something that I was passionate about, which was PM&R. So I ended up going on a few away rotations and I picked away rotations based off of where I knew people because I didn't wanna spend a lot of money trying to find housing. So I ended up going to the University of Arkansas for medical sciences, where I met one of my mentors, Kevin Meads. So I met this gentleman who was an African-American chair. So I had never thought about exploring that type of leadership because for me, I just didn't know if that was something that I could attain. But when I saw him, I realized, you know what? This is something I could potentially grow into in the future. Wasn't sure if I wanted to do it, but I said, you know what? If there's something that I want to explore or potentially explore, I need to train underneath him. So I decided to rank them highly. And luckily I ended up at University of Arkansas where I worked with Dr. Meads for four years and still to this day can call on him as a mentor. But that's when I kind of got that foundation for leadership. So then, and so I was chief resident my last year and got exposed more to academic medicine and realized that I wanted to pursue a career in academic medicine. My husband is originally from Alabama. So we decided to move to Birmingham where I took a job at the University of Alabama, Birmingham and have been here for about 10 years. So while I was here, initially I was on a tenure research track and I thought I was going to be a researcher and devote my career to research. But as I got into it, I realized that that wasn't what I was passionate about. So I had to get back to my roots. What are the things that excite me? And it's seeing patients, educating. So I started going down that path and it's kind of like being in the right place at the right time. And at the time that I wanted to switch tracks, there was a job that became available, a new program that we started called Learning Communities where you had an opportunity to mentor about 80 students in all of the four medical school classes. So when I went to my chair at the time, what I did was I said this is something that so I don't want to pursue this research career anymore but this is what I want to do. So I gave her something that she could say okay Danielle is still going to play a role, you know, and letting people know about our field, and she's still going to have some type something that she focuses on. So I switched my track. So about two years into that job. The assistant dean for students position became available so I applied for that job, didn't get it. But the experience taught me a lot. One, it taught me about multiple interviews. So when you apply for a higher leadership position at a medical school, most of the time you will have like these big interviews so you'll either be in a panel with like 12 people that are asking you questions, and you'll also have multiple interviews so it kind of prepared me for what interviews actually look like when you move into a higher leadership role. So I didn't get the job, but it didn't. So I and I didn't get frustrated by it I said you know what, this is something I want to do, keep moving forward and see if something else becomes available. So, about 18 months after, after I had applied for that job my chair decided that she was going to retire, and the position for interim chair became available. So I didn't initially apply for the job because I felt that I wasn't ready. So I that imposter syndrome kind of set in and made me feel like okay you know you're you've only been here about nine years like you are not ready to be an interim chair. So I spoke to one of my good friends and she said Daniel, apply, just apply put your name in the hat just see what happens. So I applied for the job, and I got it. And I took the job as interim chair, two weeks before COVID-19 hit. So, when you hear the phrase experience is the best teacher. I can tell you that that is the case, experience taught me a lot. And I will tell you for the past since March of 2020. I have learned so much about academic medicine I've learned so much about being a leader, and I truly found kind of my purpose and my calling and what I want to do, which is executive leadership. So that's kind of my, my story on how I got to where I am today so kind of what's next for me so we do have a permanent chair that will be starting in January. But again, like I told you, you can't get frustrated when things don't exactly go the way you want to you keep pushing forward. So what I'm going to do is continue pushing forward because I know I want to be executive leader and try to figure out what my next role may be, you know within my department. So, hopefully you saw from all of our stories kind of that theme of passion determination and just kind of things just falling in at the right time. Wow. That's a great story. I do have one question before we move on to our next session. You said that you were at UAB for nine years. You said that you felt like you weren't qualified if I captured your sentiment right, you were unsure that you were qualified to apply for the interim role. What I've been being there for almost a decade. If I heard somebody was in an institution for almost 10 years I would, I would think that somebody would wouldn't be qualified so what what was it that you that made you feel like you weren't ready initially to apply. I'll be honest with you, I really think it had to do with imposter syndrome so you see others around you. And a lot of times we look at other people and what they've accomplished. And you always wish I wish I had that skill set or I wish I had this and you don't really think about what you bring to the table. So I'll tell you like getting the position really showed me that I can do the job. And that, you know, I am a leader. So I think it was me having to grow up and understand that, yes, you can do this job you are doing the job, and that, you know, if there's you need to just put your name into the hat apply for it and see what happens, because if you don't get the position from the process you will learn. And one of the things that I would advise individuals to do is if you don't get a position that you apply for go get feedback, find out why they didn't pick you for the position so that you can figure out if there's a skill set missing it may not even be that it may just be that they wanted someone else for the role, and it's nothing against you know what you bring to the table, but definitely get that feedback because it'll help you grow as a leader, but then don't get discouraged, just keep, you know, applying for whatever that position that you're interested in. We're going to move on to our next section here and we'll start with one of our speakers. And I'll call one of the speakers and then anybody else just jump in and our, you know, speakers and chime in next. So, the question I have for the three of you. What skills did you develop that helped you get to where you are today, whether that's through courses, organizations, things like that whether it's concrete skills, whether it's the quote soft skills. What skills did you develop that really helped you get to where you are today. And why don't we start with Dr. Powell. So, I spoke on one of them, which is an important skill, which is interview skills. So, I had to learn how to be focused, when a question is posed to you, because if you're kind of scatterbrained, then the committee will not really understand, you know what you're bringing to the table for that position. The other thing that I that I've developed is how to see the big picture. So, when you're applying to be a chair or even a higher level executive leader, you have to be able to see the focus behind your, your own department. So, like what else, what, how does your department fit into the health system, and kind of making decisions that may not always be the benefit of your benefit may benefit your department, but it'll benefit the whole health system as a whole. So, I had to learn how to see that big picture. And then one other thing I had to learn is how to make sure that you always assume positive intent. Developing those relationships with individuals. So, if something happens, say if someone is late, you know, 20% of the time, instead of just thinking that oh they're not trying to make it to work on time, actually explore and see what's going on. They may have children that they're struggling with getting to daycare but really finding out that information and developing those relationships, making sure your team respects you so that they can rally around the vision that you have, so that your plan moves forward. Thank you, Dr. Powell. Who would like to go next? I'll go yeah I would say I think everything Dr. Powell said is excellent I totally agree and I would also say that communication skills have been so key in my career personally and I feel that I didn't really think they were that special I kind of assumed that you know after a certain age everyone has communication skills, written and spoken, but that's really not the case I mean it's kind of surprising there are many people who can't really string a thought together very well. And I think for us to to continue to build those skills helps us to stand out in a field, such as medicine, where communication is so inherently necessary it's something that we're sort of subconsciously or maybe unaware, we're unaware that we're constantly in it because, you know, think of how many people from all sorts of different walks of life that we interact with every day, some of them at their most vulnerable points of their lives so the ability to impart information to develop a relationship with them to develop trust. Those things are very dependent on your ability to communicate, and so I you know I say that developing your communication skills is very important but I also want to give the encouragement that most of us probably have quite a few opportunities for practice. And I would also say then that extrapolating those skills into a non patient environment. So if you're, you know, if your goal is to move into leadership however that looks and whatever niche you're aiming for. Typically, the ability to express yourself in the written word, or one to one, or in front of a group will very much set you apart from other candidates that you know may may have a more traditional path to wherever you are aiming and so sometimes as physicians we think well we're not, we're not really meant to be leaders were meant to just, you know, be in the hospital. But the fact is that your ability to, you know, to interact with other humans and to, to clearly get across your ideas may actually put you ahead of other people that were in business all their lives. Jessica, what do you think. Yeah, well, I think both all everything that's been said has been perfect. I, to add something maybe a little different I think there are two things I would say. First is, I learned to ask a lot of questions. Sometimes people are gonna ask you to do stuff and you're not going to know how to do it or you're just going to try to figure it out. I asked questions all the time. This started my very first like week of intern year I was on call in the neuro ICU. And it was not like a senior in house it was just me and the attending, I could call. And I was like I nobody's dying because I'm an idiot. So I call that attending like every 30 minutes, and I was, and from that point forward I realized like there's nothing wrong with asking questions. And so I do that a lot until I kind of figure it out and that's how, like, Danielle mentioned you know like understanding a big picture I said well what you know if I get asked to do something and I'm just doesn't seem to make sense I'm saying what what's going on why are we doing this, and you get those answers and that that understanding helps you be ready to progress to other positions. The other thing that you hear over and over is understanding how to manage your time, or aka how to say no. And one thing that has helped me the most is saying no by not saying no. So when someone comes to you, and they say say your chair comes to you say hey you know Miguel I need you to leave we're starting a new sub acute way I need you to lead it. I say okay that's fine. Joe, I'd be happy to do that but you know the, the new, you know, Pete's thing we're doing I gotta put on the back burner until this gets done if it's the priority for the department, I'm more than happy to do it. And then, then they'll either say yes please do I'll say oh no no I totally forgot about the pizza thing. Do that I'll ask someone else to do the sub acute thing. So that's gotten me pretty far because then people don't leave that conversation feeling like you said no. And so this goes back to me so I was talking about in terms of understanding communication. But, you know, there are courses and people you can talk to about that. Or you can kind of learn through trial by fire but you should always kind of think back to your interactions and like what came of them and if your intention was like people understood your intention so especially when I'm communicating with the patient or resident. At the end of it, I always say, you know, just, I asked them to kind of parrot back what they're hearing to make sure that what I'm trying to get across is actually hitting the mark. Great points for anybody now for all of the panelists, you know, what books or courses organizations have you joined that have really helped you progress in terms of your leadership development I think that's one of the things our audience members would like to take away is that there's a book that they haven't read, and be very useful a course and organization that they haven't heard of, you know, that'd be a value to them. Which organizations books courses etc articles have you found to be most impactful on you. I guess I'll go first because everyone else has gone first already. Okay, this is this is just you know a few friends just having a nice discussion. That's all. I mean, I think the place that was most accessible to me in the beginning where these organizations like a PMR AP, and, and things like that. Where I started was within my interest also. So, when I as a resident when I started to realize that maybe I wanted to be in academics or maybe I wanted to do spasticity management, I went to people and I asked them, what do you do, when there was maybe like a Texas spasticity society or something when I was doing residence and so I joined that thing. Who else. I would say having worked more closely with a number of legal professionals in my current role, I have become aware that as physicians were not always taught about negotiation. And sometimes we are not. We're not our best advocates. So a couple of books that I found really helpful were never lose again, that's by Steven Babinski and James Mangravidi great book, they're both attorneys, great book about sort of practicing your negotiation skills in in low stakes environments, until you become comfortable with it so that when it really matters, it won't be a new skill for you. Another such book that specific to women is asked for it by, I think, Sarah Lashever and Linda Babcock. Yeah, I mean that you know takes into account the fact that many females we are, you know, have our have our own obstacles to advocating for ourselves so I found that that book specifically was really helpful to maybe undoing some of the cultural conditioning we may have Dr. Powell talked about imposter syndrome, things like that that may be standing in our way, and I really felt like those both both those books gave me some good kind of tools for my toolbox to be ready for whenever such a situation arises. So I'll give you both titles and the authors. The first one was never lose again by Steve Babinski and James Mangravidi. And the next one was asked for it by Linda Babcock and Sarah Lashever. Awesome. Thank you Dr. Farvey. Dr. Powell, what about you. I'll give you two book recommendations I have. One is called what exceptional executives need to know by Elizabeth Jeffries. The other one is an, um, it's an older book but it's but it's a good one good to great by Jim Collins. And then one more is our iceberg is melting by john catchers ko TTR. Some other advice I'll give so I agree with what everyone said. One thing that's helped me tremendously is executive coaching. So if you are able to negotiate with your company to be able to obtain executive coach that experience is something that is priceless. Executive coach has helped me with how to deal with when I've had difficult situations and you're trying to deliver feedback to Miguel talked earlier about, you know, a lot of times you have faculty that may be more senior than you, how do you have those conversations. If you know there may be, you know, something that you have to deliver that it may be difficult for them to receive so they can help you kind of figure out how to get the wording, how to help you be able to have them listen and be able to receive the feedback that you have to give them, but then they can also help with time management, they can help you with dealing with, you know, just the stress of taking a leadership job, and just how to, you know, be the best executive leader you can be so I'm a big proponent of executive coaching. How does that work. I mean, I don't know if any of us have had an executive coach, Dr Worsitz in your role as chair, did you have an executive coach. Muhammad No I didn't, but I've met people that have and they're invaluable. If you think about it, we go to med school for four years we train for four years to learn the science of medicine, but yet we think we're automatically able to be leaders or experts in business world or negotiations. So I think it's hard sometimes you think you're humbling yourself because I need a coach to do this. I need a doctor to help me with my medical prescriptions so no I fully endorse if you have that opportunity to get it. And as you know, I worked with you Muhammad I needed coaching a lot so you gave it to me. No, no, I didn't. No, I didn't. So, great. No, but I think all those everybody mentioned some things the big coaching tip I'd give you is, well never lose that opportunity to keep practice practice practice whether it's never lose again and you're practicing at a low stake margin, or if it's practicing having that difficult conversation. Don't walk in cold have practice, find someone you can relate with and practice. My biggest coach was probably my wife. She all say hey this is a tough one and she's very good. Don't start it that way. Started this way. Ask, how can I help you. So there's techniques and we all tend to quickly react in medicine we want to patch and fix things right away right there give them the medicine get them going. This is a different ballgame, and it takes practice. I would say, some of the best advice I was ever given since we're kind of on this track is as long as somebody's medical care is not at stake. It can wait till the next morning. I can't tell you how many emails I've totally changed, because you you know you might read it the first time one way and then the second time a different way and by the 10th time your view and your thought process is totally different so that's one thing I think that can help you get places if people, you know, like if, if your responses seem thought out, because they are people will notice. Right. Great point. And for our audience members if you have any questions feel free to type in the chat we're going to aggregate the questions then answer them at the end of the session so just as we're going forward. So actually that's a great transition point, Dr. Escon. So, what have been the lessons you've learned that have helped you grow in your journey. So Dr. Escon, why don't you kick us off here. What lessons have you learned as you've progressed in your career that have, you know, helped propel you forward and that you're, you know, that you apply every day. Yeah, I want to mention just kind of in this vein mentioned one thing that Danielle touched on which is imposter syndrome. And I suspect we've all been there. Not sure there are more like comedians that talk about it since they tend to pick up on things that we all experience but you know that's something that I've been through and even recently like I had an article And, you know, you stop and you think well what am I doing like am I as good at this stuff as I thought, and it seeks, you know, it sinks in and that's normal to happen. But happens to all of us, but doesn't mean just because it's normal doesn't mean you can't talk to somebody about it, or you can't reach out for help if you feel like you're not getting over it quickly. There was a period, even before I got hired at Mount Sinai that I had interviewed a lot of places and I wasn't getting any job offers. And actually I got the job at Mount Sinai because another attending left. So I was in the right place at the right time, still finishing up fellowship so, but that was a hard, you know, hard time for me. At that point, and, you know, if you had told myself at that time that I'd be where I am now I would have, you know, laughed It's important to just keep moving forward, as others have said on this. That's one thing I learned. Another thing I learned is one thing I think I wanted to touch on was, as you get more senior in your roles, your words carry more weight. So if you are like an attending, it's like that magic. When you go from resident to attending, the next day, you know, the med students are scared of you. And so it's the same thing, you know, when you go from attending to the residency program director, you say something to a resident or whoever, it's gonna be interpreted a different way. You might say, oh, I can't believe we're still doing that. And then, whatever it is. And instead of just being an attending, like being woke about the system, then all of a sudden it's like, Dr. Escalon doesn't believe in the department or whatever, because he's questioning how it's running. And the more you go up, the more that happens. So I think that's something that I learned as I grew. Executive coach probably would have helped out a few times, but I think that's something that is important to keep in mind. And that's why I've started, when it's something that is an email that can wait, or there's any tension potentially involved in the response, I wait. And I find now that that tends to help me get the resolution that is confrontational while I'm still able to kind of push an agenda. And so hopefully that's helpful to someone, but I think those are a couple of things that I wanted to share. Yeah, I appreciate that. Who would like to go next? I can go. So the question, remind me of the question again. Absolutely. So what were the lessons you've learned that helped you grow in your journey? So I think one of the biggest lessons, and I kind of talked about this before, is knowing your worth. So we talked about negotiation before, and I'll be honest with you, early in my career, I did not negotiate well. And because of that, I didn't feel that I was valued. But the more that I've learned about medicine is that medicine is still a business. So if you don't negotiate well, sometimes it's not that they don't value you, is that if you are willing to work for less, then why should they pay you more? But if you know your worth and you demand, or at least show them your worth and ask for what you want, a lot of the times you'll get that. So I had to learn that I was worthy of what I was worthy of, and I was able to negotiate. So I think that, and for me, because before, like I said, I thought it had to do with my worth, so it affected my self-esteem, and I think some of that imposter syndrome was due to that, because I felt like because I wasn't getting what I thought I deserved, that maybe they don't value me. So I had to kind of learn as I've kind of been here for a while that it's still a business. So I think that's one thing to just remember is that medicine is still a business. Absolutely. Dr. Varghese-Kroll? Yeah, I would say, yeah, probably the most important lesson that I've learned is to always say yes to the opportunity to gain a new skillset. And the caveat I want to add to that is that I totally agree with Dr. Escalon's advice to be comfortable with saying no. I do think it's important to maintain an appropriate work-life balance. I do think it's important to value your time, because if you don't, other people won't. But having said that, if you can take on a new responsibility or learn a new skill without overwhelming your plate, I think it's always optimal to do that, because ultimately these skills accumulate, and two, three, five years down the line, you may be the only one on your team or in your company that has that specific combination of skills, because you happened to be in the right place at the right time, as everyone else has said. You know, when a project came up, you happened to be available, and you said yes. You know, somebody else didn't, or somebody else wasn't offered that. And so when the time comes for a promotion or for you to move into a different position, you can then say that you actually have these skills in your skillset because you had the foresight to say yes, however many years before. And I can see how that has really paid off, I mean, not just for me, but for my colleagues as well. And I think that it's a good lesson because you never know how something could be useful for you in the future. It may seem like whatever you're being asked to do will not be useful at all, but you don't know that to be true. So if it's something that you can do without too much stress or without it being too much of a burden, I think it always behooves you to take that opportunity. I've got one specific follow-up in this section for Dr. Powell, and then that's gonna lead into a second follow-up question for the entire panel. And Dr. Worslitz would love to hear your thoughts too. So Dr. Powell, you mentioned earlier about negotiation. And so I think everybody on this call probably feels like they wish they were a better negotiator. So as you acquired that skill, and obviously it's a skill that you're always gonna keep working on improving, but as you were working on that skill, how did you know that you were making progress aside from the obvious of, oh, I wouldn't have asked for that before, and now I got it? How did you actually build that bridge to get to that point where you were confident enough to start that negotiation and to follow it through to completion to get your worth? Can you talk us through that a little bit? So I think part of it was I got advice. So, and mentorship is key because your mentors can help you with how to word things correctly, how to be able to articulate what you need so that your boss or supervisor understands. So for me, it was a mentorship that I received, me talking with several people to figure out the things that I should be asking for. And then, in a sense, and I almost hate to say this, but almost be willing to know that if it doesn't work out, are you okay with another position somewhere else? And I had to be willing to do that because I was at the point where I just felt like I know what I need, and if I can't get it here, then maybe that I should be somewhere else and explore other opportunities. But I would say mentorship is key with helping you figure out exactly what you need and how to word it. And then, like I said, that advice, that advice is gonna be key with helping you get what you deserve in your employment job. I hope that answers your question. It does, it does, for sure. And then now for the entire panel, we've heard repeatedly imposter syndrome come up and we've all dealt with it. So as you've dealt with it, how did you start to move beyond it? How do you know you're making progress, right? I mean, because I think that we all feel bad at certain stages of our medical training when we're attending, as we're moving through our careers, we feel that, and it doesn't stop, right? You can be a chair, you can be a C-suite executive, people feel that imposter syndrome. So in your journeys, how have you worked through that? What's been helpful for you as you progress to be able to deal with that? And maybe solve it, but even if you haven't solved it, how have you progressed in terms of dealing with it? Maybe Dr. Horswitz, would you be open to kicking us off here? Yeah, I don't know if you ever solve anything, we all have different parts of it forever. And that's the important thing to realize. Everybody on this call has had some of the same feelings and will continue to have it. I think we often do look at people thinking they don't have that, they do. The panel made some great advice on some of that. You just have to learn and ask questions, go, you're gonna fumble, you're gonna stumble, you're gonna bumble. But you just have to get in there and do it. And I realize if I've prepared myself the best I can, I'm gonna make mistakes still, but I'm okay with it. What do we do in medicine? We still make mistakes, but we deal with it and move forward. There's always times, and age does not equal wisdom. So that's an important point to Dr. Powell that brought up. Don't think because you're younger than someone, you can't do it. Dr. Escalon talked about, he still has to talk with people older than him. That doesn't mean anything. We also think that titles equal power and leadership. It might have some influence, but it's not necessary leadership. You lead by your actions and examples. So I don't know if I answered the question. I was looking at some of the comments people made here. And there's like a zillion pearls I've written down from this. I'm happy to sum at the end. Yeah, I appreciate that. Who else would like to, who would like to go next here? I can go. I think this may be unique to my experience, but working in a company where there are physicians, attorneys, and business people, in my experience, I found that imposter syndrome was a little worse for the physicians. And that actually was what helped me kind of step back a little bit from it, because that does not make logical sense that a lawyer or that a business person should be able to do something, but a physician cannot. So that really was what kind of helped me open my eyes and say, I think this is an external projection. This is not real, that I am not capable, but somebody else is. And of course I think humility is very important. I really value that. But I think having an objective view of our skills and our abilities, I mean, it does not make sense that we could make it through four years of pre-medical education, four years of med school, four years of residency, however many years of fellowship, and be less capable than someone in another field. That is, that's really not logical. So for me, that was very helpful. The question of why imposter syndrome might be worse in medicine, if it is, this is just my experience. I don't know, I think it may be, you know, I don't really know the answer to that actually, but I think it helped me to see that it's not real, that that perception that we might not be good enough or capable enough is not actually true. I would say, sorry, I didn't know if you were done. Are you done? Oh yeah, go ahead. So for me, what's helped is getting back on the inpatient unit, seeing some spinal cord patients, getting back to what I started with and reminding myself that I can do the day-to-day. And that's really why I got into this, was to help a person, you know, not like have whatever fancy job or whatever else that I'm looking at. And it helps to reorganize me and kind of like give me perspective. The old chair here used to say, no matter how bad your day is, cause he was a spinal cord doc too, your patients got it worse. So that perspective can be helpful. The other thing I started to do more recently, which I didn't do it with this intention. I did it with a completely different intention, but it's actually helped in this way is I started telling people and giving people compliments a lot. Like, you know what, you do this really well. And I admire that about you. And slowly people say things back. And you're like, oh, wait a second, people care about me. And like, I am good at these couple of things. And so then you can kind of hang your head on that. And I feel like we probably don't do that enough for each other. If people knew how you felt about them and vice versa, there might be a little less of this stuff. So as far as when imposter syndrome starts, I honestly think it starts when we're in medical school. So you take a group of extremely smart individuals and put them into a medical school class. And then you start to basically figure out who's the smartest of the smartest kids and who's the one that is still smart, but maybe kind of in the last tier, but still extremely smart. So I think throughout medical school, you know, at times you can feel a little defeated if you don't get that score that you wanted on a test, or when you took your boards, you may not have gotten the exact score that you wanted. And then we apply for residency. And again, we're trying to, at times, prove ourself. I'm worthy to be in your program. But then you become an attending and everything is just supposed to switch when you become an attending. And you're supposed to, at that point, know that you're smart enough to do this, have all the confidence in the world, where in a sense you've kind of been beaten up along the way. But I think for me, what's kind of helped is one, normalizing it, realizing that it's there and that it will probably never go away, and also talking to people about it. So at times when I may lose my confidence or I'm unsure of something, you know, I have people that I speak to about it and then they reassure me, but then at times it's just not being afraid to make mistakes. And knowing that even if you make a mistake, you're gonna learn from it. But sometimes when you do things, you don't make a mistake and then you build that confidence and then it helps you to be able to continue to grow, you know, as a leader. Great points. Great points from all of our panelists. So now we're gonna move on to key takeaways. From our panelists. So two to three points that our audience can take from this discussion. So why don't we start with Dr. Harvey's role? Sure. The two things I would suggest that everyone take away. The first one is don't undervalue yourself. I think this, again, kind of goes to this idea of a little bit of a lack of self-confidence or imposter syndrome, but we do tend to come out of medical training thinking that we only know how to do one thing and that's how to be a bedside doctor. That's it. But the fact is that there are a myriad of other skills that you have been unknowingly maybe developing during your training and during your career, if you're already in your career. And those skills are valuable. There's a reason that large consulting companies like McKinsey look for doctors to hire because that specific combination of skills is very difficult to replicate in other fields. So if you are looking to be a leader, if you're looking to branch out and do something slightly different with your career, don't think to yourself, all I know how to be is what I am right now, because that's actually not true. You just need to repurpose the skills you already have. So don't undervalue yourself. What you bring to the table is in fact very valuable. And the other thing I would say is not to fall into the trap of thinking that your chance for gaining more knowledge or more training is over. It's not true. You don't have to, you can go back to school. That's always an option, even though that seems daunting, but you don't have to. There are many skills that you can learn on the job. And as I said before, because you bring so many other slightly less tangible skills to the table, there are a lot of places that will give you the opportunity to learn on the job because of these other things that are part of your overall package. And so there are plenty of people that I know and that I know our panelists know that might be later in their careers, in their lives, that were able to do significant pivots because they didn't believe that they were done. And you're not done either. There's never, the opportunity to learn more has never passed. So let that be an encouragement. Thank you. Who would like to go next? I'll go. So my takeaways are some of the points that I stated before. Executive coaching, if you are able, is a priceless resource. Also networking, have career mentors, find individuals that you aspire to become, to be like, and try to reach out, email them. One thing I've noticed about our specialty is that everyone is generally nice. If you go up to them and introduce yourself, they will definitely speak back. And they are willing to give you advice on your career. So find a career mentor, also find peer mentors, find people that are at your level that you can bounce ideas past, that you all can help each other as you kind of are climbing up that leadership pathway. And then also get involved, get involved in your academy. That's how you meet more people. That's how you learn about different opportunities that you may not know are available to you. Great advice. Thank you, Dr. Powell. Dr. Escalon? I would echo everything that's been said. And I'd say something that I mentioned at the beginning, which is be open to your own growth. So a lot of times, we're resistant to our own change because change is hard. So, but for my own story, I'm doing such different things than what I was hired to do. But I was open to that change. And that change may come or may not. You may decide to stay in whatever field you did a fellowship in, and that's what fulfills you. And you may change. Luckily, physiatry is a great field if you have ADHD. So you could change, you can grow in different ways. And I think if you're honest, part of that is just being honest with yourself and taking time to be introspective. I know not a lot of us have time for a lot of things, but I found like the commute or walk to work is a good time to think about those things. So I'd say that. Everyone else is giving great advice. So I think that's what I'd add, to be a little different. It would help if I'm not on mute. Thank you, Dr. Escalon. So now we'll go to the questions that our audience has submitted. Thank you for submitting that. So Dr. Fleming asked, or first question, can the panel comment on the advantages and disadvantages of an MBA or executive MBA? Dr. Worsitz, I know you are a big fan of this question. You wanna chime in? Yeah, I think for me, I actually went on to get an MBA, but this was many years ago. And I had been out in practice for a while and realized, well, as Dr. Powell said, money talks. But the issue is I learned a lot. I gained a lot of skills, but I needed that self-discipline to do it. There are certain CEO spots or things like that, if you're aspiring to, that may require an advanced degree, whether it be an MBA or MHA or whatever. But there are enough courses now and other things that I think you can garner those skillsets. That's just an N of one without having to have that advanced degree, but you need to have some advanced knowledge on how to do it. Now, it does help me when I walk into a room to say, oh, I got an MBA, and it automatically gives you some credibility, but then I have to work and do it. So for that point, it helped me a lot in my career, but I went through at a time not many physicians were getting advanced degrees. So, and I think it comes down to what everybody said. It was a passion of mine. So it wasn't the hard work. So it was a passion. Don't do it if you don't have the passion to do it. You can get the knowledge other ways, but for me, it was a great thing, but I don't think you have to have it to be in a leadership position. If you want to go to a CEO position or certain higher level positions, some places will have that an MBA is preferred, not required. So again, you have to balance what your career goal is and what will it mean to you? And what do you want? I didn't want it just for the letters. I wanted the knowledge, not the letters. And it helped me parlay that into a chairmanship, a practice management leadership program. So long answer made longer. I appreciate it, Dr. Hortz. Does any of our panelists have a comment on this? I would say that any additional degrees are always helpful, but not absolutely necessary. And before you commit to any degree, just be clear that it is actually what you want to do for whatever goal you're aiming towards. In physician advising, I would actually say that a JD is more useful than an MBA. So just be aware before you commit the money and time that it is what you need for wherever you're going and that it's absolutely necessary, or that it's your passion. Excellent. Thank you, Dr. Boyce. Oh, go ahead, sorry. Sorry, I'll just add to that an MBA alone will not get you a leadership position. You still need the experience. So getting the degree, you know, if the jobs just won't open up, you still have to kind of, you know, move up that leadership ladder in order to get the position that you're looking for. Great point. Great point. Our next question comes from Jennifer Adelman, MS1. Awesome. Welcome. I love the book recommendations. What are steps that medical students can take if they plan on pursuing leadership roles in human art in the future? I think if you look at the, you know, AAPMR has a strong physiatrist and training council. I think AAP has a medical student council. So that's one place to start because there are positions there within physiatry. So you can be like the president or chair. I'm not sure what they call it, of that council and their different leadership positions within that. So if you want to practice within the field and get to know people, that's a nice way to start. But there's certainly a lot of ways to learn leadership and leadership translates. So you could be a volleyball coach on the weekends and that leadership is going to translate to your work as a physiatrist. So I also don't think you have to feel pigeonholed in having leadership experiences within physiatry. As a medical student, especially, any leadership experience is going to kind of shine through on your application for residency. I can speak personally from that, given I am reviewing a lot of applications in an interview season. I value that kind of thing. And I use coaching as an example because I look at that in a special way and people that have taught or substitute taught or started a club and led a club, it takes a lot of organization and a lot of communication skills. And so those are things I'm looking for. And so hopefully I'm answering your question that you don't really have to hyper-focus on it being within physiatry, I think at this time, as much as just general leadership. Other responses from our panel? If not, you can shake your hand and then I'll move on to the next question. Okay, all right. Next question, Dr. Fleming again. How can one get practice with more of the business aspects like budgeting, strategic planning and quantifying program development? Ask questions. I had a faculty member who used to say, hey, I wanna learn about it. Can you come and talk to me about it? I went to the CFO of our health system and I asked for his mentorship and said, oh, what does this mean? What do these numbers mean? When you give out these, just do it. Get involved and asked. I think one of the panelists mentioned, it's not just PM&R, people are nice in general and they love to be flattered and they love when someone says, can you teach me something? We're all the same and they will take the time to do it. So that's a good start. And then you'll get information and tidbits and you'll go research it, you'll read about it, you'll do stuff. That person was Muhammad that used to come to me all the time and say, Greg, I need to learn this. I need to learn this. Teach me. Let me know this. That was a pain, but I did learn a lot. So it was good. Other responses from our panelists on this question? I was just gonna say the same thing. If I had to piggyback, I would say, if you know that the department is hiring or something like that, that's a great time to also ask because you can learn as the process is happening. So as opposed to just, you know, sitting down with Dr. Wurstelwitz and him talking extemporaneously about a business plan, you can actually help in the process of making it. And just to add on an addition, my executive administrator in my department has really helped me with learning about budgets. That individual within a department really helps the chair with the budget planning and really the business side of your department. So they're always open to you going to them and asking for tips or learning different aspects of the business side of medicine. Dr. Varghese-Crowe, anything you wanna add here? No, I think everyone else has really covered it very well. I agree with everything. Asking questions is really key. Awesome, thank you. Next question from Dr. Anaswamy. As you say yes to something new, how do you decide what you stop doing? This is an issue of introspection and prioritization within your life. So the first part of that is prioritizing how much of life outside or separate from work you are willing or wanting to give up. And that answer is different depending on the person. I think for myself, if I have an X amount of time, I'm always able to fit more stuff in, but the truth is I think about what is the quality of my work going to be if I add this on? And so if I worry that the quality of my work is going to suffer, then that's when I say, I kind of use that trick I said earlier. In terms of what I choose to let go, usually whatever I'm least passionate about, but if you're equally passionate about everything, then I'll usually go to my mentor, my chair directly, or other mentors I have and say, for my career, if I had to let one of these things go, what would you suggest? And again, if somebody asked me to do something today, I don't have to respond tonight. I kind of can let that marinate until tomorrow or tomorrow afternoon. And that gives me that time to reach out to people. Great response. I agree. I think that's excellent. And I think this is such an individual answer. Everybody's lives and priorities are different, but I find that if you're asked to do something that has a finite endpoint, that's easier to say yes to. So that's what I tend to be more free with my yeses with than something that's sort of a never-ending responsibility. Dr. Powell, anything you want to add here? Yeah, so just to add on, I started to look at some of the roles that I had. Was it a role that was fit for someone at my stage in my career? Or was it a role that should now be passed down to a junior faculty member to allow them to start, you know, rising up that career ladder? So I think as you continue to progress in your career, you have to evaluate that, you know, and make sure that you're sponsoring junior faculty within your own department so that they can also continue to move up that executive ladder as well. Thank you. Dr. Wurst, was there anything you want to add? No, I think everybody hit it. Know yourself. We all have different things. Probably my biggest leadership fault is that I'm too much a people pleaser. And as a result, you want to say yes. Someone is just like your emails. You don't have to say yes on the spot. Give it time, think on it before you come back and analyze your time commitments. But I love the suggestions of the group. I just wrote down, gotta have an end point. Awesome. All right, so our last question in the chat comes from Dr. Fleming. How does one structure their portfolio to show their experience and skillset that the panel has mentioned? Is that through the CV only, or is there a separate document to showcase your success? I'll speak on this. I used a resume service, a resume coach, and I highly recommend it. I think it's money well spent. Again, this is an area where in medicine, we're not necessarily really taught how to craft a resume. We're all used to having a CV. And many positions that aren't solely medical will be expecting a resume. So I feel like that is a very worthy investment. And it sort of depends where you're aiming, but typically most resumes will have at least one paragraph that will highlight your success. And depending on what you're applying to, you may also include a cover letter that might serve as that separate document. I think that's an amazing suggestion because like my CV is in some Mount Sinai format that I have to use to get promoted. And it's like difficult to read and follow, but it's the format that they want. So if I, let's say, you know, somebody wanted to hire me, that's what I'm going to give them. And, you know, maybe it'd be better if I had a separate one for my academic, you know, job here for promotion, and a separate one that I would kind of hand out in a different, you know, for different things. Thank you. Other thoughts or suggestions? So I'll just add on for most jobs that you apply for, be it if it's like an associate dean of your university, they're always going to want either a letter of intent or some type of cover letter where you talk about your skillset. So there will be supporting documents where you can really discuss the roles that you've had and the impact that you've made in more detail. And that's also a good point. And I would always run that, you know, if you're able to by your chair or by a mentor, because folks that are more senior in the profession have spent a lot of time writing letters for people to win awards or to get promoted. So they know what needs to go in there. And it's not a time to kind of be bashful about those kinds of things or like downplay stuff. And oftentimes people have these really cool formats where they're like, spend a whole, like you don't want to leave out research. You don't want to leave out like educational impact and all these things. And they kind of give you some good advice and have maybe some templates you could use. Mohamed, I think the point is know your audience. If I'm Dr. Varghese Crow and I'm going for, you know, X, Y, or Z, I need that resume for sure. Academic buildup, you play the game of your grants and all this. One thing I will say is there's never anything too small that you've done. Be meticulous in keeping records of what you do. If I was Mohamed Agha, I would say I did this for this group and this saved this much money by decreasing length to stay this much each project you do. Because you never know when you're going to flip from private to academic or academic to private or X, Y, or Z to whatever. Because if you're thinking of being a leader, there's going to be interesting opportunities opening up as the field gets more and more muddied in the future. I don't think our lines of delineation for some leadership roles are going to be what they used to be. So keep track of all you do and keep an idea of, wow, I did something. What was the value it brought? Was it publications? Was it savings to the Institute? Was it better patient satisfaction? We don't think of saving that type of info, but in 10 years, you'll forget. And when you're my age, you'll forget what I had for breakfast yesterday. So be meticulous. Great advice for everybody. Any last minute advice for our audience or any last minute questions from our audience before we wrap up? Oh, sorry. Go ahead. I'm sorry. I was going to ask the group, if we tend to learn more from our mistakes, is there one, not mistake, it never is a mistake, a learning opportunity. What opportunity gave you the best learning experience or opportunity? I hate to say mistake, but, or, you know, we're always, I have weaknesses. My biggest weakness is trying to be too much a people pleaser of the rank and file as a leader. And you have to move the ball of whatever you're leading in a certain direction. And you're not going to make everybody happy all the time. And so you've, that's a skillset I have trouble with. So that's probably my, I've over-pleased or I've hired because of what I thought out of need and necessity and not the right person. And people always trump the need filling if they have some of the skills. But I'm curious, Muhammad, do you have one? Mistakes? Or learning or something you've learned from that you've gone, yeah. For you, because we're all individuals and we all have different. Yeah, I think pursuing your growth opportunities in a manner that's conducive to your organization, because we all want to grow. We all want to learn. We all want to develop ourselves, but aligning that growth with what your organization needs, I think is extremely important. Because if your organization is going this way and you want to go that way, it's just not going to happen. It's not going to work. You're going to have to take on all the work yourself. And so finding what your organization is interested in and looking to develop, and then seeing if you can match your career growth and interest with that is extremely important because then you're going to get that career development in your institution. And then you're going to build the relationships that our panelists talked about in your institution. And then more opportunities open up because people have gotten to know you. They've seen who you are as a person and they've seen your good work. So I think that's probably the biggest lesson I've learned as I've progressed. How about our panel? And then we also have another question from our audience. Thank you for submitting that, and we'll get to it. I was just going to answer your question, Mohamed, about what kind of last thoughts I would say. And this panel is a good example, I think, of that, is every chance you get to kind of make new connections and use those. Don't let them pass you by. Meet people, network. I think somebody said that earlier. That's super important for your career, whether private or not. And then in terms of learning, yeah, I kind of, I hinted at this earlier that as you become more senior in your title, what you say is taken a different way. So certainly that came from somewhere, that past experience. So just kind of keep that in mind in terms of, there's a fine line to walk there. You don't want to edit yourself to the point that you don't have opinions. But there's a time and place as you become more senior to voice those in a more open way. And what happens is when you're behind, like say you're the vice chair, and I disagree with something the department is doing, I voice that behind closed doors. And then we come to an agreement, and even if it wasn't my first choice, we come to an agreement for a variety of reasons about what's best for the department. And that might involve the hospital in some way. And then when we leave those closed doors, I agree with everything. So, and that might be different than when I was hired day one. I'm like, well, I don't understand why we don't have three Dr. Pepper, but maybe there's some reason why I don't get. So I think with great power comes great responsibility. Who was that, Superman? Or was that Spider-Man? Spider-Man. Spider-Man. So there's that, yeah. Thank you. Good stuff. I think I would say one of the mistakes that I counsel people to avoid is don't delay taking the leap. So if there's something that, if you're feeling unfulfilled in your current situation and you need to make a change, don't let your own doubts about what might be out there or your own doubts about your abilities delay you from exploring that passion because the alternative is becoming burnt out and then you're no good to anyone. So you could have had, a year from now, you may wish you had started today, right, that saying. So use the time that you have so that a year from now, you can know that you did the best you could. And they might just be baby steps, but don't put off those steps because ultimately your own happiness can make you a less effective physician and worker. Great points, Dr. Powell. I would say be willing to take feedback. Don't beat yourself up too much. I tend to do that when I receive feedback. It takes me a long, I'm getting shorter with the time it takes me to digest the feedback. And then be willing to stretch yourself. This last 18 months has been such a stretch, but I've learned so much and I wouldn't change it for the world. And also be willing to go out of your comfort zone. Be willing to, like I said before, reach out to people if you want advice. A lot of you all have seen us on this panel and may want to talk to us in the future. Be willing to reach out. We're all available to assist. So I would say that's my advice. Appreciate that. Our last question and then we will end this panel. Dr. Anaswamy asks, what are your thoughts of external, so external to your host department or facility mentors versus internal mentors? You need both. Sounds like versus. So what do you think about that? Well, I don't think it should be a versus. I think you should have, you need someone internal because they know your system, but then you also need external mentors because they can help you think of the problem in a different way because they don't know your healthcare system. So I don't think it's a versus. I really think you just need both. That's my thought. I agree. I also think someone that's within your department has a vested interest in having you grow to make the department stronger. Someone that's outside the department is doing it out of the goodness of their heart and they're having you grow to reach your fullest potential which might be somewhere else. And so it's important to have multiple mentors and you might go to different people for different things. And we have both been talking about professional life, but you also need kind of like a personal life coach mentor say like, you know, to work through other problems like with your partner or whatever is mad that you're still taking call or whatever it is to kind of work through those things. So I have people I reach out to all the time for different things. Yeah, I have nothing to add. I think those were perfect. I agree. It's not an option. You gotta have it. You gotta have both. Yeah. Well, thank you to our panelists. Thank you, Dr. Worswitz and thank you to our audience for joining us today. I thought this was a great discussion. So this concludes our panel discussion. Please join me next Wednesday, October 20th, same time slot, 1 to 2.30 PM. We're gonna have a second panel talking about their road to executive leadership. So we'll have Drs. Julie Silver, Dr. Muyano-Park and Dr. Richard Riggs go through their leadership journey and answer the same question that we've been talking about today. So again, that's next Wednesday, October 20th, 1 to 2.30 PM Central. Please also remember to fill out your evaluation for this. You can get credit and also give us feedback. And with that, thank you for attending and have a great rest of your day. Thanks, Mohamed. Thank you. Take care, everyone.

leadership

career growth

medicine

panel discussion

personal experiences

imposter syndrome

negotiation skills

mentorship

networking

relationships

continuous learning

opportunities for growth