The Conscious Clinician Podcast

Episode 18: Impostor Syndrome in Healthcare Providers

In this episode, we shed light on impostor syndrome in healthcare. This all too common phenomenon is an isolating experience. Providers who feel like impostors are constantly striving to earn the acceptance they cannot give to themselves. This is most common in marginalized groups including people of color, first-generation college students, and women in male-dominated fields. If not addressed it worsens as people attain more prestige/higher positions and is associated with burnout. 
We share our experiences with impostor syndrome and how this has affected us in the clinic. Feeling inadequate or like a fraud definitely influences how a provider interacts with patients. Impostor syndrome is shaped by our thoughts and beliefs, which thankfully we can change. We end by discussing strategies that help us face impostor syndrome. 
Highlights from our conversation in Episode 18
(0:34) Introduction
(1:58) Defining Impostor Syndrome (IS)
(2:30) Who is most likely to experience IS 
(5:15) The link between IS and mental health 
(5:45) Monika’s experience with IS 
(7:45) How IS can show up in clinical practice 
(12:24) Sammy’s experience with IS
(19:55) Self-compassion as an antidote 
(22:35) Affirmations to develop compassion
(23:49) Connecting with others 
(25:36) Seeking feedback to retrain your brain 
(29:33) Adjusting your expectations of yourself 
(30:04) Improving your self-awareness 
(31:45) Cognitive Behavioral Therapy 
Thank you for listening to The Conscious Clinician. If you enjoyed this episode, please subscribe and write a review for the podcast to grow our community. Keep the conversation going by following The Conscious Clinician on Instagram and Facebook. 
Resources from Episode 18
(20:51) Self-Compassion: The Proven Power of Being Kind to Yourself by Kristen Neff
What is self-compassion?
Test your level of self-compassion
(30:04) Impostor Syndrome test
(31:45) Finding a CBT therapist
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Episode 17: Providing Patient-Centered Education

Have you ever had a moment where you realize that a patient did not understand what you thought you educated them on? We have!
In this episode, we share our strategies for providing patient-centered education rather than lecturing. We’ve developed a checklist to follow:
Assess their current understanding
Ask permission to share your knowledge or perspective 
Identify their skepticism and response 
Break it down into chunks
Check their interpretation  
We explain each step, how we do it, and why we do so. We’ve learned that patient-centered education is an ongoing process, especially when we're working to change a limiting belief. This strategy helps us meet people where they are and provide tailored education that’s meaningful to the individual we're working with. 
Highlights from our conversation in Episode 17
(1:12) Monika’s case example of patient “education” that went awry
(5:17) Lecturing versus educating/counseling 
(7:18) #1 Assess their current understanding
(9:45) Sammy’s case example of skipping step #1
(11:07) #2 Ask permission to share your knowledge
(13:38) #3 Identify their skepticism and response  
(19:08) #4 Break it down into chunks
(21:18) #5 Check their interpretation 
(23:46) The snowball of patient-centered education 
Thank you for listening to The Conscious Clinician. If you enjoyed this episode, please subscribe and write a review for the podcast to grow our community. Keep the conversation going by following The Conscious Clinician on Instagram and Facebook. 
Resources from Episode 17
(23:06) Episode 11: Authentic Evidence-Based Practice with Annemarie Everett, DPT, WCS
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Episode 16: Defining Patient-Provider Relationship Boundaries

In this episode, we explore how to establish healthy patient-provider boundaries around discussing personal matters. Sammy describes a patient experience that started as a discussion of pain-related stress and evolved into the patient sharing personal conflicts, relational issues, and more. 
Sammy felt uncomfortable and realized that the patient was seeking emotional support that exceeded her scope of practice. After multiple attempts to redirect and focus on PT, she had a direct conversation with the patient. 
These types of situations can challenge our personal and professional boundaries. Each of our definitions of “oversharing” varies, however, practicing with emotional intelligence does not mean you have to do the emotional work for your patients.
We share techniques for redirecting people, what’s worked and what hasn’t for us. We hope that this episode helps you maintain your integrity in your relationship with patients.
Highlights from our conversation in Episode 16
(0:55) We discuss Sammy’s experience with a patient oversharing 
(11:32) Responding to and redirecting emotional dumping
(16:07) Identifying the difference between disclosure and venting 
(18:34) Does the patient need a new therapist?
(20:38) How your emotional intelligence can help you navigate this situation 
Thank you for listening to The Conscious Clinician. If you enjoyed this episode, please subscribe and write a review for the podcast to grow our community. Keep the conversation going by following The Conscious Clinician on Instagram and Facebook. 
Resources from Episode 16
(6:23) The Mountain Metaphor
(6:33, 21:48) Emotional Intelligence for Healthcare Providers 
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Episode 15: The Power of Understanding Patient Beliefs with Dr. Mike Nelson, DPT

In this episode, we have the pleasure of interviewing Mike Nelson, DPT about patient-centered care. We’ve both worked with Mike and admire his dedication to building a relationship with patients that helps facilitate change. After reflecting on moments of tough interactions, he began a quest to create more structure in his communication and found motivational interviewing. Since then he’s been passionate about connecting closely, integrating evidence, and sharing a message of hope with his patients. 
Together we unpack buzzwords like: shared decision making, patient-centered care, motivational interviewing, and program adherence. What do these terms mean and how does that sound when we talk with patients?
Mike shares practical answers to burning questions like “How do we respond to high pain catastrophizing” and “How can we help patients change their unhelpful beliefs?” We also debunk the myth of compliance in favor of empathetic listening and replace “I’ve got to fix them” with shared decision-making. You’ll enjoy this episode if you’re interested in understanding your patients on a deeper level! 
--
Mike is a clinical director at Agile Physical Therapy and a part-time professor of orthopedics at the UCSF/SFSU DPT program. He is also an adjunct faculty member in the Agile Orthopedic Residency and helps with research and education for PhysioTree. He is passionate about helping bridge the gap between evidence-based medicine and clinical practice. 
Highlights from our conversation with Mike Nelson, DPT
(0:34) Introducing Mike Nelson, DPT
(4:09) How & why we need to stratify patients’ risk for disability 
(9:56) Mike’s entry into motivational interviewing 
(13:37) Training communication skills and EQ
(17:28) What is patient-centered communication?
(21:39) How can we respond better to pain catastrophizing? 
(25:34) Understanding your patient’s pain belief system 
(32:59) Improving patient buy-in and adherence
(40:08) Additional tips for catastrophizing, patient education, & empathy 
(43:41) Mike’s lightning round
Thank you for listening to The Conscious Clinician. If you enjoyed this episode, please subscribe and write a review for the podcast to grow our community. Keep the conversation going by following The Conscious Clinician on Instagram and Facebook. 
Resources from Episode 15
(2:10) Mike's app in progress: Physiotree 
(5:47, 21:44-24:42) Episode 5: Pain Catastrophizing
(16:39) Nonviolent Communication
(25:56) The Common-Sense Model of Self-Regulation (CSM): a dynamic framework for understanding illness self-management (2016)
Let’s Connect!
Email Mike at mikenelsonpt@gmail.com 
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Episode 14: Enhancing Your Emotional Intelligence

In this episode, we are so excited to bring you part 2 of emotional intelligence (EQ). First, check out Part 1: EQ for Healthcare Providers (Episode 13).
Emotional intelligence affects both patient and provider outcomes. A staggering 80% of medical errors are due to miscommunication (2014). Logically, improving our EQ will help us connect with people of different backgrounds, communicate clearly, and thus improve patient outcomes. However, we were surprised to find that there is relatively little research exploring EQ and patient outcomes.
The link between EQ, burnout, and resilience has received more empirical attention. Emotional intelligence is inversely correlated with burnout because EQ increases resilience. When we consider the key components of EQ (self-awareness, self-regulation, motivation, empathy, and social skills) this relationship makes sense! The higher your EQ, the more coping skills you will have, and the more stress you can tolerate in a healthy sense, like the emotional version of overload. 
Both of us have experienced burnout and looking back we see how our EQ was a factor in both the issue and the solution. We hope that by sharing our experience we can help you feel like you are not alone and offer insights into what we can do to reduce burnout. We’ve worked to develop EQ and share practical strategies for how to cultivate it. 
Highlights from our conversation in Episode 14
(0:39) - Intro 
(2:03) - EQ and patient outcomes 
(3:59) - EQ and burnout 
(7:09) - Sammy’s burnout & EQ reflection
(10:19) - Monika’s burnout & EQ reflection
(13:14) - Identifying your energizers and depleters 
(22:50) - Charting your daily energy levels
(26:53) - Structuring your day to optimize your energy 
(30:06) - Prioritizing your personal needs 
Thank you for listening to The Conscious Clinician. If you enjoyed this episode, please subscribe and write a review for the podcast to grow our community. Keep the conversation going by following The Conscious Clinician on Instagram and Facebook. 
Resources from Episode 14
(2:03) The Relationship of Bedside Nurses’ Emotional Intelligence with Quality of Care 2014 
(2:03) The Importance of Emotional Intelligence in Delivering Patient Centered Care 
(7:02) A Conceptual Model of Medical Student Well-Being; Promoting Resilience and Reducing Burnout 2008 
(22:54, 26:53) Dr. Shahid Medical Education 
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Episode 13: Emotional Intelligence for Healthcare Providers

In part 1 of a two-part series, we break down emotional intelligence (EQ), what it is, and how it shows up in clinical practice. We have discussed several of the skills of EQ in our previous episodes, so it’s about time we focus specifically on this skill! 
Emotional intelligence is the ability to monitor your own and others' feelings, to discriminate amongst them, and use this information to guide your thinking and action. EQ is a skill that can be developed, the cornerstone of those elusive yet important “soft skills.” We discuss the skills which make up EQ, based on the works of Daniel Goleman and Salovey & Mayer. 
Although “being emotional” carries a negative connotation in the workplace, the truth is that we all feel. We feel joy, gratitude, anger, sadness, compassion, even pain when working with patients. The more nuanced we can be when naming emotions and the quicker we pay attention to an emotion,  the easier it will be to diffuse. 
Our EQ helps or hinders our ability to cultivate healthy relationships with patients and peers. The emotions we acknowledge in others build trust and safety. The emotions we miss lead to miscommunication, lack of motivation, and frustration for both parties. EQ is an essential component for developing healthy patient-provider relationships.
Tune in next week for Part 2: Strategies to Improve Your EQ! 
Highlights from our conversation in Episode 13 
(0:40)  Welcome back to The Conscious Clinician, this week we discuss emotional intelligence 
(2:42)  Defining emotional intelligence 
(4:25)  Skill 1: Self Awareness 
(6:30)  Building our emotional vocabulary 
(14:45)  Skill 2: Self Regulation
(20:09)  Skill 3: Motivation 
(21:13)  Skill 4: Empathy 
(24:03)  Emotional blind spots
(30:58)  Monika & Sammy’s EQ difficulties 
(36:24)  Skill 5: Social Skills 
(37:10) 4 skills from Salovey and Mayer model 
Thank you for listening to The Conscious Clinician. If you enjoyed this episode, please subscribe and write a review for the podcast to grow our community. Keep the conversation going by following The Conscious Clinician on Instagram and Facebook. 
Links
HBR’s 10 Must Read on Emotional Intelligence (1:27; 4:25; 14:45, 20:09; 21:13; 36:24)
Salovey and Mayer 1990 (2:16; 2:42; 37:10)
Feelings Inventory (7:55)
Emotion Wheel (8:00)
Test Your Emotional Intelligence (12:58)
The Language of Emotions by Karla McLaren (25:30; 27:21)
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Episode 12: Our Words Have the Power to Heal and Harm

In this episode, we focus on the power of language in clinical practice. We’ve all seen patients who are hypervigilant or scared of movement because they’ve heard their pelvis is unstable, their pelvic floor muscles are too weak, they have disc degeneration, etc. 
These biomechanical and kinesiopathological explanations of pain paint an image that their body is broken and they must rely on our help to fix it. So we have to consider every statement that we're making and have an intent behind it. 
How does this sound to someone who doesn’t know much about anatomy and treatment? Are we empowering or creating dependency? What are we conveying to people with our marketing? Let’s change our words to reflect our message of empowerment, from “common not normal” to “common and treatable.” 
Expectations are the key to unlocking the power of language because we're constantly setting people up for something. Our words shape patient expectations which produce chemical changes within their brain that may affect outcomes. When positive, we call this the placebo effect, and when negative it’s the nocebo effect. There are specific strategies that emphasize the negative which we may not even realize we're using. We dive into each of these and offer suggestions for reframing how we speak to people. 
Highlights from our conversation in Episode 12
Introduction and patient examples (0:40)
Placebo definition and effects (5:13)
Nocebo definition and effects (7:11)
How patients may hear our “explanations” of their pain (11:26)
Pelvic floor marketing using nocebo language (16:59)
Strategies to improve your communication with patients (22:33)
#1 Reduce uncertainty / Build confidence (23:36)
#2 Limit jargon / use layman’s terms (27:50)
#3 Avoid ambiguity / Be clear (29:16)
#4 De-emphasize the negative / Embrace the positive (31:47)
#5 Focus attention on / outside of pain (32:51) 
#6 Stop trivializing / start empathizing (37:33)
Practice with a PT friend before you see the patient (41:25)
Thank you for listening to The Conscious Clinician. If you enjoyed this episode, please subscribe and write a review for the podcast to grow our community. Keep the conversation going by following The Conscious Clinician on Instagram and Facebook. 
Resources from Episode 12
Episode 11: Authentic Evidence-Based Practice with Annemarie Everett, DPT, WCS (3:16)
Placebo effect research Bendetti et al 2007 (5:41)
Nocebo effect research from Bendetti et al 2007 (7:30)
Quote from Bendetti et al 2007 “expecting a painful stimulus…” (8:11) 
Nocebo effect on erectile function (9:15)
Epidural pain based on provider language from Häuser et al 2012 (9:54)
Unintended negative suggestion in everyday clinical practice from Häuser et al 2012 (22:50; 23:36; 27:50; 29:16; 31:47; 32:51; 37:33)
Risk factors for pelvic girdle pain development and persistence from Clinton et al 2017 (26:05) 
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Episode 11: Authentic Evidence Based Practice with Dr. Annemarie Everett, DPT, WCS

In this episode, we dive deep into PT practice, what it is and what it could be, with Annemarie Everett, DPT, WCS. She shares how she co-founded POPUp and the humbling lessons she learned to approach patients who have prolapse with dignity, honesty, and autonomy. 
This patient-centered approach to practice was shaped by her personal growth. At a low point, Annemarie realized that she had to stop assuming responsibility for other people’s happiness, fulfillment, and ability to achieve their goals. Something had to give. She started asking “what can I create for people and what can I see in people that I maybe didn't recognize before? And how can I feel okay?” She focused on authenticity, dropping facades that she “knew it all” and had all the answers. Now her focus “is making sure that I can show up as myself and practice in a way that sits well with my conscience.” 
No one warned us in PT school that we can’t fix how people feel and carry their burdens. So we discuss how PT schools and practitioners can do better by focusing on soft skills, the power of language, and the importance of mentorship. This is a thought-provoking and encouraging episode! 
Bio: 
Dr. Annemarie Everett is a Board Certified Women’s Health Specialist since 2017. She is passionate about making evidence-based and comprehensive care accessible and routine for pelvic health concerns, particularly in the pre-and post-partum populations. She is a co-founder and co-writer of POPUp, an online educational and community platform for people with pelvic organ prolapse and the providers who serve them. 
Highlights from our conversation in Episode 11
Annemarie’s intro, current projects, and POPUp (0:34)
Practicing with authenticity and focusing on patient autonomy (8:26)
Annemarie’s backstory and dropping the ego from practice (13:23)
PT education: how can it prepare us for the real world? (23:32)
Soft skills and the power of language (29:26)
How PT failed Annemarie when she was a patient (35:25)
Reshaping PT practice: what we can do better (38:59)
Creating a cognitive buffer for our patients (44:52)
Mentorship to help challenge your clinical assumptions (54:30)
Lightning Round (58:02)
Thank you for listening to The Conscious Clinician. If you enjoyed this episode, please subscribe and write a review for the podcast to grow our community. Keep the conversation going by following The Conscious Clinician on Instagram and Facebook. 
Resources from Episode 11
To get in contact with Annemarie visit her website annemarieeverett.com
Check out POPUp and follow on IG @popuplift
Annemarie’s margarita recipe: Equal parts, lime, tequila, and cointreau, shaken and strained over some ice. Note: it’s strong!
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Episode 10: Grounding Techniques for Patients and Providers

In this episode, we explore the concept of grounding in pelvic health. Grounding is “directing attention toward what is happening in the present moment.” It has many benefits for patients AND providers including improved bodily awareness, improved focus, and better problem-solving. 
In our experience, grounding can also reduce sympathetic nervous system activation and help regulate emotional reactions. Oftentimes people in pelvic PT feel betrayed by their body or try to avoid bodily signals as a way of adapting to pain. When people are disconnected from their bodies it can affect their progress. Helping people feel safe is a prerequisite to many treatments, such as dilator training and pelvic floor muscle training. Grounding through breathwork, movement, and cognitive exercises can help patients re-orient to the present moment. 
Providers may also need to practice this skill throughout sessions for many of the same reasons as patients. When providers are grounded we can hold space for patients and better teach this essential skill. We end by sharing our favorite techniques to use for ourselves and with patients. 
Highlights from our conversation in Episode 10
Introduction to Grounding (0:38)
Benefits of grounding practices (4:23)
Grounding and bodily awareness in PT practice (6:59)
Grounding for emotional awareness/regulation (13:44)
It starts with us as the provider (18:29)
Our favorite techniques (26:57)
Focusing on experience rather than the outcome (35:56)
Thank you for listening to The Conscious Clinician. If you enjoyed this episode, please subscribe and write a review for the podcast to grow our community. Keep the conversation going by following The Conscious Clinician on Instagram and Facebook. 
Resources from Episode 10
The Language of Emotions by Karla McLaren (2:03)
Episode 8: Dr. Krystyna Holland on Trauma-Informed Pelvic Health Practice (14:03)
Additional handouts of Grounding Techniques 
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Episode 9: Vicarious Trauma in Healthcare with Dr. Brie Robertori, PsyD

Episode Summary
Our special guest in this episode is Dr. Brie Robertori, PsyD, a clinical psychologist who specializes in family therapy, trauma-informed care, and multicultural practice. After experiencing vicarious traumatization through her training, she developed a passion for trauma-informed practice. This passion led her to complete her dissertation as a program evaluation for a trauma recovery clinic, with a goal of ensuring that clients were receiving trauma-informed care and that treating clinicians were receiving support for vicarious trauma exposure.
Brie shares best practices when screening for abuse and trauma, including how we can respond with compassion and strength when someone says yes. On the flip side, trauma exposure carries a risk for healthcare providers.
“The definition of vicarious trauma is that we're impacted by our clients or our patients and the things that they've gone through, the pain that they've gone through because we care. It's because we care that we get vicariously traumatized. Not because we're not good enough.” She shares how we can create space for ourselves to process our natural responses.
We also explore how healthcare systems propagate trauma and what changes would support providers instead. She goes on to say that “We need to pull on every single way that we can articulate and metabolize these experiences and not just alone but in the company of others, which is sharing this with our supervisors and directors and making sure that we have advocates internally because we can't just expect to do this alone. In fact, expecting that it's just something we need to take care of alone is a further perpetuation of this kind of trauma-organized system.”
Ultimately, the most courageous thing we can do as providers is care for ourselves, because that will change the system.
--
Dr. Robertori has worked with children, families, and adults across the life span who have been impacted by psychological trauma related to domestic violence, child abuse, sexual abuse/assault, community violence, racial marginalization, and immigration ruptures. She is collecting hours for licensure as a Bilingual Family Clinician (Spanish-English) at Through the Looking Glass, a non-profit that serves Medi-Cal clients with intellectual, developmental, or health-related disabilities.  Her therapeutic style is systems-focused, strengths-based, intimate, and warm.  Dr. Robertori completed her B.A. at the University of CA, Berkeley and her Doctorate in Psychology at the Wright Institute in Berkeley.
Highlights from our conversation with Dr. Brie Robertori, PsyD
Brie’s intro and how she got into psychology (0:33)
Screening for trauma/abuse history (5:06)
The power in owning your trauma (11:16)
Supporting our patients and using our power wisely (14:16)
Screening for the different types of trauma (18:32)
Vicarious trauma experiences (24:47)
A call for systemic change (36:09)
The definition of vicarious trauma and changing out expectations (41:45)
Redefining what it means to be a “strong” clinician (46:43)
Burnout, vicarious trauma, and moral injury (49:27)
Brie’s Lightning Round (62:43) 
Thank you for listening to The Conscious Clinician. If you enjoyed this episode, please subscribe and write a review for the podcast to grow our community. Keep the conversation going by following The Conscious Clinician on Instagram and Facebook. 
Resources from Episode 9: Dr. Brie Robertori, PsyD
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