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Home » Christi Hay: A Doctor’s Standard Career Path – And The Path I Chose (Transcript)

Christi Hay: A Doctor’s Standard Career Path – And The Path I Chose (Transcript)

Christi Hay

Here is the full transcript of pediatrician Christi Hay’s TEDx Talk: A Doctor’s Standard Career Path – And The Path I Chose at TEDxFoggyBottom conference. 

Listen to the MP3 Audio: A doctor’s standard career path – and the path I chose by Christi Hay at TEDxFoggyBottom

Christi Hay – Pediatrician

I’m a doctor. We doctors are not typically considered risk takers.

Our path is pretty safe. We go to college, take pre-med school courses, some would go to graduate school and get a master’s degree, and then complete four years of medical school. After medical school, there is residency fellowship for three to seven years. Once all that training is done, most of us go and work in a hospital for a provider, like Kaiser, or in private practice.

Like I said, pretty safe path. But I left this path for something different. And I would like to share that journey with you today.

I followed this blueprint with every intention on being a lifelong employee of a hospital. I love to teach. I have a master’s in public health, in health behavior, health education. I love my specialty – pediatrics.

So, I thought the best fit for me would be a physician in a pediatric teaching hospital. But after eight years, something was missing. So I made the switch to private practice. In private practice, I love the families, but the business of medicine, not so much.

Honestly, medical school and residency did not prepare me for the business of medicine. I can diagnose and treat diseases; no problem. Give me a sick kid coughing, difficulty breathing, the parents in the corner about to faint because they don’t know what to do, I’m all over that.

My brain clicks on, I’m diagnosing the problem, determining the best course of action, but private practice was more than that. There were office policies and procedures that just didn’t make sense to me.

Insurance policies with different formularies and benefits, office personnel that just didn’t know what they were doing. It ultimately made my workday a nightmare. Imagine waking up everyday to start a nightmare. Who does that? I did for three years. To make matters worse, I was always getting in trouble.

And I have to say, I am not a troublemaker. But, I became that person over the years that was asking questions about things that just didn’t make sense to me. Like, why did it take four weeks to return a school form when I can complete it in four minutes during the visit? Or why did it take 20 minutes to bring a family back to an empty exam room when I could do it in two?

Or why did a mother, calling to find out what food to feed her child with diarrhea, need to come into the office for a visit? And why was a medical assistant who could not properly count respiratory rate and heart rate not fired? And why was the schedule done in a way that I must enter every room and say, “I’m so sorry for your wait.” Trouble I stayed in it and it just added to my nightmare experience at work.

Then one of my girlfriends gave me my aha moment. We were chatting on the phone about work when she simply said: “You were not listening to the voice in your head. The voice is telling you to pick up and move, but you are comfortable where you are, but miserable, so you need to make a choice. No one is making you stay there but yourself.”

And with that, I knew I needed to start my own pediatrics practice. I was choosing to stay in the nightmare. Who does that? Most of us. My husband had been encouraging me to start my own practice since medical school, but that wasn’t my intention at first.

But now, I believed that I could create a pediatrics practice that was a pleasant experience for the child, the family, and me. The process of creating Palisades Pediatrics forced me to think about what is medicine to me? How can I fully express myself as a physician and a health educator? How could I be my authentic self at work? I had never asked myself these questions before.

So in 2011, I started my own pediatrics practice. I made it small and intimate. My families have direct access to me. They call, text, email me when they need me. I visit my families at their home.

I focused on comprehensive and preventive care I’m in. I’m the doctor, the nurse, the lab tech, and the receptionist. Some call it old-fashion, I just call it different.

To me, medicine is more than diagnosing and treating illness. For me, a doctor, a good doctor, is about three things: relationships, accountability,and passion. Medicine is about doctor-patient relationships. And in the case of pediatrics, the doctor-family relationship. Listening to and communicating with the patient builds that relationship.

I believe that it is important for my families to know who I am, where I was raised, where I was educated, what my interests are, and what my treatment philosophy looks like. Does my personality and medical philosophy fit for this family? Communication is the foundation of the doctor-patient relationship and ultimately, the care of the child.

Parents bring a lot to the medical decision-making table. Doctors need to know the family’s health beliefs and preferences. When I’m creating a treatment plan I need to know: Is this a family that can take a medication three times a day versus twice or once a day? I need to understand the child’s tolerance.

Is this a kid that can sit for a nebulizer treatment? Or should I use an inhaler? Relationships matter when creating plans for the family to execute, so the child will thrive.

Accountability. Families want one person, an easily accessible person, to be accountable for the well-being of their child. One of my favorite cases was an 11-year-old boy with abdominal pain. Abdominal pain is a very common pediatric complaint. The mom called me in the morning and said her son had a stomachache and was lethargic. She thought he was coming down with a cold and was just giving me a heads up, but this didn’t sit right with me.

I went to the home, evaluated the patient, and diagnose him with appendicitis. He was taken to the hospital, the diagnosis was confirmed, he had surgery that evening, and was back home within 24 hours. Appendicitis is a medical emergency and can be fatal, so the early diagnosis and appropriate treatment made this a sweet case.

It’s easy to be accountable when there is good outcome. It’s more challenging for doctors to admit to a mistake. In my practice, I do not have a receptionist. My families call me directly, and I answer the phone. So if I do not return a voicemail, it is my fault.

If I forget to call a prescription to the pharmacy, it is my fault. If I do not complete a school form, or I do not follow up the family about a lab result, it is my fault. These are all tasks that most doctors delegate to staff, but I wanted to be responsible for the entire healthcare process of my families. The “but” starts and stops here, and I like it that way. I believe it is a privilege to take care of children and their families, and that families expect and deserve their doctors to be attentive, accessible, and responsive to their needs.

An intimate practice like mine requires the doctor to come from behind the curtain, stand alone on the stage, and say, “How may I help you?” Passion. I love being a pediatrician. When I was a resident, I remember having a conversation with one of the nurses about how us residents, we have this awesome responsibility to take care of the children of our city, and she looked at me, and said she had never heard anyone say that before. I love the health issues that span from birth to adolescence. I believe one of the greatest gifts that I have been given is the care of children.

I think about my families all the time. I worry about my sick patients until they are well, and I celebrate the successes of my well patients by attending birthday parties, graduations, and plays. It is never a chore to go to a medical conference, read the medical literature, or remain current on medical topics. When I am at work, I am happy. My families expect me to be the expert, which is a constant process of learning and teaching.

Pediatrics is my passion. Once I was able to identify these three core values, I was able to write a business plan rather quickly. I knew I needed to step outside the traditional model in order to be my authentic self at work. I needed a small practice, not a lot of support staff, a lot of time to engage the family and the child in the office or at home. Time for professional development and time to create health education materials for my families.

And when I think about it, these three core values, relationships, accountability, and passion, can apply to any new business venture you may be undertaking. Along the way, support is helpful, doesn’t matter how big or small. When taking a risk, it may be really hard to find external validation. I was really fortunate to have a small group that encouraged me to make my dream practice a reality. Honestly, I thought my ideas were too out there.

Home visits? Those are things of the past. The families really want that in the 21st century? The families really want their doctor in their kitchen? Were there enough families in the area to make my startup a viable business? Ultimately, you have to believe in yourself and in your ideas. I had to realize that I was getting in trouble, not because I was a bad employee, but it was a bad fit. I had to reconcile my core values with work. I had to believe in my idea and in my ability to execute on that idea.

I had to take a risk, I had to in order to create an authentic workspace for myself. And today, I am so grateful and happy. I did. Thank you.

 

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