Podcast 914: Healthcare Anonymous: Put Yourself First to Avoid Anxiety, Addiction and Burnout with Dr. Simon Maltais

Our guest for this podcast is Dr. Simon Maltais.  He is an active cardiac surgeon in one of the world’s largest provider of healthcare services and the author of a new book entitled, “Healthcare Anonymous: Put Yourself First to Avoid Anxiety, Addiction and Burnout.”

Simon’s book is designed to allow us to understand using his real-life inspiring stories the real source of anxiety, addiction, and burnout.

In my interview with Simon, we speak about the healthcare system and the works that needs to be done to prevent, stop, and heal from healthcare disease and breakthrough a better life.

If you want to know more about Dr. Simon Maltais and his new book , please click here to visit his website.

Join me and Dr. Simon Maltais as we talk about his new book entitled “Healthcare Anonymous: Put Yourself First to Avoid Anxiety, Addiction and Burnout.”

Thanks for listening and enjoy this interview!

THE BOOK

Perfection is endemic in the healthcare environment. The system that we have dedicated our life to is gradually eating our life away. In Healthcare Anonymous, Dr. Simon Maltais allows us to understand using real-life inspiring stories that training, misguided references, maladapted interactions with the system, and increasingly demanding hours have created a perfect nidus to manifest healthcare disease.

In this eye-opening, core shattering, and inspiring book, Maltais lays bare the real source of anxiety, addiction, and burnout. He explains how our healthcare system and the way we interface with it can create a vicious cycle that directly impacts our entire system. Healthcare Anonymous describes:

• HealthCare Disease: how the system getting you well is creating sick workers.

• How high-intensity environments impact the delivery of care and the performance of our nation’s finest    medical minds.

• The symptoms of maladapted healthcare workers.

• Findings of an in-depth compassionate case study on healthcare workers.

THE AUTHOR

Dr. Simon Maltais is an active cardiac surgeon in one of the world’s largest provider of healthcare services. Born in Quebec Canada, he is French Canadian and board-certified from Canada in cardiac surgery. He further has a doctorate degree in biomedical engineering and heart regeneration. He is an internationally recognized leader in the field of heart transplantation, mechanical heart devices, and alternative cardiac interventions.

Before 40, Maltais has raised to lead two world-renowned programs in his specialty and has among the youngest promoted associated professor at a nationally recognized institution. He is a frequent keynote speaker, has published more than 160 articles and has contributed to numerous books. As he worked in two different countries and health systems, Maltais has a unique perspective on the delivery of care and its inherent challenges for healthcare workers.

You may also refer to the transcripts below for the full transciption (not edited) of the interview.

Greg Voisen
Welcome back to Inside Personal Growth. This is Greg Voisen and the host of Inside Personal Growth And joining me… Where are you joining me from Simon?

Simon Maltais
I’m actually in Montana now

Greg Voisen
Montana whereabouts in Montana, Whitefish?

Simon Maltais
No Billings. Yep, absolutely. Yellowstone Medical Center.

Greg Voisen
Okay, Yellowstone Medical Center, and we're going to be speaking with Simon about his new book called Healthcare Anonymous: Put Yourself First to Avoid Anxiety, Addiction and Burnout. And is it Maltais? Did I say it right. Is that French?

Simon Maltais
Yes, sir.

Greg Voisen
Okay, my last name is French too, but no one ever says was on so I am okay. All right. So this is this is a book that for all of my listeners, you can go to the website, it's pretty easy if you want to learn more, but it's healthcare anonymous.com. We'll have a link to that website as well. But it's really about the critical issue of what he calls health care disease. And we'll get into that, during the interview. I'm going to tell my listeners a bit about you. Simon is an active cardiac surgeon, and one of the world's largest provider of health care services. Born in Quebec, Canada, is a French Canadian, and board certified from Canada and cardiac surgery. He further has a doctorate degree in Biomedical Engineering and heart regeneration. He is an internationally recognized leader in the field of heart transplantation, medical art devices and alternative cardiac interventions. Before 40, he was raised to lead to world renowned programs and especially, and has among the youngest promoted associate professors at the nationally recognized institution. He's a frequent keynote speaker, he's published more 160 articles is contributed to numerous books, he also has worked on two different countries, in health care systems, so he's uniquely qualified to speak about this, considering his schedule is not only super busy and packed and filled with, as he says, in the book, anxiety, addiction and burnout and stress. We're going to be talking about that, you know, Simon, in the introduction to your book, you tell a story about yourself. And you paint a picture of a physician who was you know, basically burnout stress and on the brink of, you know, you just couldn't do it anymore. It was it was a really interesting intro involve my listeners, definitely you state that you almost gave up your life to save hours, meaning the people that were that you're treating, can you tell a story and what pushed you to this brink? You know, there are a lot of physicians out there. And I'm sure a lot of them get to this point, but they don't want to talk about it. And I think what you're doing is breaking open the yolk in the egg and saying, Hey, community, let's talk about it.

Simon Maltais
Right? No, it's been. Well, thank you for the invitation, Greg, I really appreciate it. And it's been an it's certainly been a journey. And I was, I was just talking with a friend recently about the book and more of a less in an informal way, and how this all came together. And I guess it really started really early where med school was a rat race residency was a rat race. Meaning a race to always be the best. Always be Always in a reach the heights publish being meanings be the center of attention. Exactly like you see it in those shows on TV, right, so. And so it felt like a sprint. Until, until I'd say about five years ago, I'd say that I was I was a pretty good contender of Olympic sprinting, you know, say I was very good at it was publishing a lot. And then all of a sudden, all of a sudden, but progressively, there was a little bit of things that I've noticed that were happening. I got, I got frequent visits, HR was angry. I was heavier, physically. Getting the work was a bit harder. And it was all not all together, but sort of progressively. A big part of that process was empathy. I started less caring about patients, issues or complications. It always was their fault that they had a complication they were too sick or they were and so there was things I noticed were changing. I didn't like operating anymore more of a job. And so I was tired of being on planes I was getting through divorce. And so there was just a lot of things happening. And, and, and we couldn't just find a common denominator, I. And I started to write and that I mean writing meaning for myself. So one of the things I've learned during the time therapy was that you need to write when it goes well. And when it doesn't go well. And so it wasn't going well. So I started right. And then, and then that's how the book really came along. That was the two years ago, that was the initiation. That was the that was the start of a process where I started to think about where what environment I was in, and how I was conditioned to always do more. And then that's how I learned it. That's how I was functioning into it. I couldn't say no. And, and I thought that was the only way to do it. I mean, I was at the Mayo Clinic, I was the vice chair of the department. I was not even 40 Then and I was more published and people that have 65 years of no years old, and I've been in practice for 30 years.

Greg Voisen
But when did you sleep Simon? I mean, you obviously didn't get much sleep. And did you meditate, and did you keep a gratitude

Simon Maltais
for that stuff? No, I knew that stuff. I was drinking to go to sleep I was a lot of times tired in the morning getting up. I talked about it in the book. I'm for many years, I just I just fell asleep. I mean, that fell asleep. I just crashed asleep. And just fell and woke up in the morning at 4am and continued to work and got up to work and just fell normal. Until it didn't. Right.

Greg Voisen
Right. Right. It caught up with you caught up with Yeah,

Simon Maltais
I couldn't function anymore. I was drinking asleep and drinking quite a bit. And you're right when you talked about it in the introduction, it it's not something especially as a male. I mean, I know this male female conversation is always difficult. But I mean, charged with a lot of things socially, I guess. But being a male in heart surgery and medicine and going through depression, because that's what I had addiction with alcohol and having the willingness and or the need to talk about it wasn't that easy? Because

Greg Voisen
well, I mean, look in the community, you face a lot of repercussions when you come public like you have and I want to give you credit, the community of support around you, other doctors, nurses, hospital administrators, whatever, they all need to be supporting someone like yourself. And there is a stigma attached to a young male like yourself, kind of coming out about burnout, stress, whatever, right? And I'm sure you saw this in many of your colleagues as well. But they want as bold as you are, and I want to give you credit. And so let's talk about this a little bit, you know, in your estimation, why does health care disease that you call it exist? You mentioned many of the things like being a resident and how things happen in the hospitals and all the rest of it. And you state that the true landscape is that we are ill equipped to take care of the stain strangers at the expense of our own personal deficit. And we practice in a culture that Shane's weakness. So that's one big clue right there. What needs to change in your estimation, to eliminate health care disease?

Simon Maltais
Well, I mean, it's a complex definition, right? So you pointed out a few things I described in the book, some path to understanding the disease. And, and the way I describe it is it's usually a combination of things when you get sick. It's not only one thing, usually it's the it's when you're let's say you catch an infection, it's the infection being in a susceptible host. And that has an in within a special environment either hot or cold, cold and so when you have this disease, the burnout, the depression the addiction, that's the acute moment where it manifests itself but there's a there's a process for wish over many years you yourself, they've loved characteristics traits that are sometimes imposed too early. You know, you spend your 20s 2015 years studying and you're faced with death you're faced with mortality, you're faced with heavy scheduled not sleeping, and you're only like 22 years old. And so these character traits are really forced into you Where were you really not mature enough to really understand them. So that's one. And so there's that there's this, this medical notion that you always have to perform the perfectionism and that an ego becomes a big part of who you are. So that's the host, there's things related to yourself that are important, then there's the environment. And so there's things about the system like, you know, the work hours, the demand, the number of cases, the changes over the years that have happened in the system to force on us changes to meaning, you know, we need to reach a certain quota for surgery, we need to generate a certain amount of money, and that's all tracked, and so that the movement towards administrative management of medicine or monetizing medicine, from the last, let's say, 20 years has really had an impact on the provider. And so the environment is also it's exactly at times how you see it in the, in the end the movies again, right,

Greg Voisen
right.

Simon Maltais
You know, and then, and then there's the way you start interacting with them. And so when those three, so that means your ability to say no, your ability to manage your schedule, your ability to cope with death and things. And so that becomes your, your sort of interaction with it. And so when the host has a problem when the environment is tough, and then your ability to cope with it is over many years, wrongly equipped. That's where you sort of have these moments where then the depression, and so when people say burnout, in high intensity, environment, or healthcare, it's the end result, in my opinion, and that's what the book is all about the showing that burnout, and in depression, and in addictions are the end result of this complex interact, those complex interactions over many years that have been imposed, or learned, you know,

Greg Voisen
almost like, you know, it's the perfect Firestorm, you know, what you just talked about yet, on the other hand, you know, he's like this quote from the Buddha, there's suffering, and then there's the end of suffering, but we create our own suffering. You know, this is a, this is a podcast on personal growth, right. So all these listeners out there are, they're not judging, they're saying, it's a unique position that Simon got into assignment is the only one that can get out of it. And no one else. And this isn't a judgment, either, no one else is kind of to blame for where we go, you know, and that's, that's called self-responsibility. In other words, I take responsibility for it, I get that when you go in the healthcare field, you got, you got to make money for the hospitals and the and the system, you got a schedule to keep you got people that basically when your phone goes off, or you get a text and you got to go to emergency, you've got to do that. But you also as you found out, have to kind of slow down and take care of yourself. Because if you don't take care of you, number one, you're going to be no good to nobody else up 00 Good, the drinking this, that everything that happened to you. You're a perfect poster child for probably what's happening in many cases. And you stated that healthcare Anonymous is an open hearted book carrying visit via section of the illness that is real and worth talking about. How difficult has it been for you to express your own feelings about this epidemic in the healthcare community? And I would presume that it is but it's kind of a quiet one. It's like a under wrestling one, you know.

Simon Maltais
Not easy. Because it's admitting I mean, especially for a guy like me, you His ego was bigger than everybody else. I think it's it takes a certain utility and difference between you know, trying to be humble, and try to explain things that have happened to you. So true humility is when you decide to speak for the greater good and that and that when that switch when that switch has happened for me to say, Listen, I'm not so if I sell zero book, I don't really care about it. That means to me it's a message that is bigger and actually extends to more than healthcare. Because a lot of people are suffering out there in environments like this. I mean, we're hearing I have a friend who I was just talking to as a formal athlete. With a former athlete, I mean, any high intensity environment where you're sort of forced into a lot of those things that you have to perform, where you have to be perfectionist, we have to exert exercise and perfectionism are to some extent that have the common theme. And so starting to speak up about it, like you hear for, you know, I think it's Simone Biles, you know, during the Olympic, or some of that, sort of real true vulnerability is, is not easy. And, and, and, and, you know, I'm a better doctor than I am, and I am now and I was doing 400 cases a year, you know, trying to just crank to be the betters the best, you know, that the world has ever seen. People now I know, I know, I know, my patients, I, you know, I have plan A, plan B, plan C, it's not just the factory, it's so in some ways, you know, it is it is sort of a way to for it was very difficult. But then as the growth process or cures through self-cares, through self-responsibility, throughout the journey, then you realize after a while, that you really transform into something different. And, and, and my interaction the way I work now, I would I wished I would have known that, you know, 10 years ago, and some part of my training and some part of my, of me evolving within the system. And that's the same thing with a company or within the, within sports or within it, you know, part of me would have liked to know what I know now. And so that was the intent of the book to try to describe something that was bigger than myself. And as I sort of, did that, and it became easier to, to, to express, I know what I went through.

Greg Voisen
Well, you know, this is your own healing journey. Let's face it, and you do want to sell books, because you want people to hear the message yet. On the other hand, what's most important is Simon's journey. Right? And I and I question for you, and I'm sure through all of your therapy that you've gone through, this has been brought up. But hey, look, this is a podcast show, I have hundreds of 1000s of people that go through never being enough. You know, I don't know when that occurred for you. But for the most part, somewhere, parents school, something, usually people like you that are that driven. I know, because I had the same disease, okay. But I had to learn how to repair it to be able to live with myself. Because the ego was big, the issues were big, the pain, the anxiety attacks, I was having real in elevators, couldn't go see clients, because these anxiety attacks would think, and I was thinking I was having a heart attack. And, you know, look I've been I've been through all of it. But the one thing that did calm me was I went to scripts in Ohio, and they put all these electrodes on my head, and they put my hands and fingers and they, they, I could see the attack. I saw it on the screen. It was real, you know, like, this is what's going on and heart rates going up your blood pressures gone and all that. And I started meditating way back. And I never stopped. And I never had another anxiety attack after that. Yeah. So my question to you is, have you identified at what point in your life you weren't enough, because you had to excel and be better and always, you know, write 160 articles versus, you know, 25 articles? So what was that you identified? Because you must know now?

Simon Maltais
Yeah, I think I hit the, I mean, it was progressive. Again, I, you know, I talk I try to really, almost, I was going to bring up that concept. We become, in these high intensity environment where you have to study you have to practice a lot where you have to go and engage yourself fully into your work. You get you have this thing called AI in the book I talked about, but delayed gratification becomes a really big factor. And let me explain what that means. But you always that's a bit what you were saying you always you become expert at saying, I'll be happy when I publish,

Greg Voisen
right? 100 when I sell a million books, I'll be happy when I find the perfect wife. I'll be happy with whatever is going

Simon Maltais
on with this model or I'm going to be happy without these three cars. And so but that I mean, just in healthcare In general, that's how you, you learned in med school how to function. That's how your brain functions because they tell you even in med school, like you, and then I'm sure it's a lot of that for nurses and other profession just talking to people is that they tell you, this is an investment, you study 100 hours a week, because in four years, you'll be done, you'll have the MD, and then all the doors are opening up. And they don't

Greg Voisen
really started, you just started,

Simon Maltais
it just stopped. And you finished a residency, and then you'll, you'll make tons of money, and you'll pay all these debts back. And so you become, and that translates into your life again, in a lot of other areas, you're like, Well, you know, I'll be happy when I go on vacation in three weeks, I'll be happy when my wife gets this, whatever. So, so you become expert at doing that. And so when I realized that, that's where that's where the healing process started for me. And then yeah, and then your question more specifically. And then what this when I realized that understanding that allow me to become more in the present, so it comes back to your meditation, this sort of mindfulness, ability to sort of come back to the present, I do now, you know, realize, realizing that when I was angry at work, it wasn't normal. Like, you know, it was a anger, anger is not normal. It's a reflection of, it's an emotion that you can't contain, right? So. So it's same thing as crying, are they? So if you're at work, angry all the time? You know, it's because as a deeper thing, so once I realized that there was this deep regret issue, that I was an expert, and delayed gratification that some of the things, I mean, were upon me to correct and that sort of feeling. And it took, I mean, I hit the point where I just said, the cliff, I mean, I can do the work. And that's about two, three years ago, where I got divorced, I was 60 pounds heavier. I mean, I had all these responsibilities. I was a chair, this president of that, you know, on paper every two weeks student teaching, no teacher that you I just had so much stuff going on. And, and yet, I had the feeling that I wasn't accomplishing enough, you know,

Greg Voisen
well, and you know, Simon, that, you know, because you've studied this, the anger does nothing to help your own heart. So, I mean, you've seen plenty of people come in, that you've done surgeries on. And if you were to probably profile, and you would find there was lots of anger somewhere along the way. I and I, I interviewed rom Das, so I throw this up, be here. Now, this sits on my desk, and I have a now clock on my wall that you can't see. But there's actually no time on it. It basically just says now, right? And I always remember what, you know, ROM das would say about that in, and it is so important. God bless him, he's now deceased. But that the journey he went on, to actually explore and define that, and it isn't for everybody, but what is for everybody is a middle path. You know, if you're going to go down this road, there's, you know, the body as you know, you've studied in it, and if it seeks homeostasis, it's like, okay, I want to come back to the middle ground, great. I can go exert myself and ride my bike 100 miles, or I can climb Mount Everest. I'm doing a book right now with another author on Everest, it's climbed it three times. The reality is, is to live. Sometimes you have to face death. I know that's a conundrum. But to really live life, you faced death. I know you've had plenty of patients that have faced death. They've come back. And the question is, are they living their life? And my next question is, is you were told by a friend and a mentor, John Byrne, that there's a very few fine line between confidence over time overconfidence and arrogance, you state that you recognize that these traits would become the source of your most significant personal and professional failures. Can you explain the challenges you have had as a heart surgeon and trying to balance your life and understanding how important those traits are?

Simon Maltais
Yeah, the, I'd say, again, I'm sorry, I make those comparisons quite a bit in order to make a performance or to achieve a certain level of, of expertise in anything. You do have to have confidence you do have to have I mean, when I do surgery, there's I mean, that's published data. There's hundreds of decisions a minute that I take Take one path, and instead of the other two to heal someone, and during an operation for four and a half hours, that will lead to a favorable outcome. And so if I acetate for every one of those decisions, if someone fibrillated, if someone codes during a surgery or someone have to redo a bypass, or there's a valve that don't work, or there's a problem with the part lung machine, if I esitate in that process, then it will lead to different outcome. And so for me, for heart surgeon, it's a bit of a typical, it's a bit of a harder field understand, because in medicine, I mean, ever, everything has emergencies. And but when things don't go well, for us, it's pretty devastating for patients because the hard don't work and not a whole lot of things work. Right. So you need to, it's just like someone who goes to the Olympics and transfer, I don't know how long to perform, right. So you do have this do have to have this ability to lock it in and make decisions. Now, it's, I call it the god complex in the, in the, in the book, and but this, this ability really is pretty close to some other traits that are not quite as, as favorable for in general, meaning this God Complex, where you feel like you're invincible you feel like you, it's easy to get into those mindset, because your job entails so much decision making, you know, so that you become in your everyday life a bit this sort of automated robot that works in the same way, right. So and that's where the confidence switches to arrogance a little bit where you need to, you need to shove your opinion and your ideas and your and your way of thinking on to everybody, buddy. And then even further, then the perception changes those confidence, overconfidence and an arrogance where then the perceived, you know, way, by the way you're acting is perceived by others to be all for you, or for the all for your own benefits. And that's where I think this, this is a moving line that's very hard to make specifically for people that work in this very high intensity environment. And then for me, for me, it was always about being the best about perfectionism about, you know, there was no way I was going to go at any other specialty than heart surgery, because it was, it was the pinnacle of heart of surgery of medicine, you know, it was like making life or death decision. And, and, and it just, it just fitted my personality, but now retrospectively, it really doesn't. Because I'm not, you know, I'm not like this. And so I wish in med school, there would be a better way to fit in people into what there truly are. Because I mean, I'm a loving individual, I'm someone that has a lot of friends, I'm social I'm, I tend to be a bit soft, you know, when people really know me, like my wife or close friends. And so when I came to work, it was this part of me that just switched into like beast mode, you know that at the you know, and so I needed to accomplish, I needed to like be always on top of things. And so that part to me, was and then so then then what I did, you can leave work, you can change work for me, then I was to find a job. Now that fulfills my interests that fulfills a certain, like level of decision making like this, but that is much less of it high intensity work so that it doesn't bring out this part of me that is just hard to work with, you know,

Greg Voisen
well, you know, you're juggling a lot and I can't hardly even imagine what it must be like, like, but being an actor on the stage of life. You know, you've got a role as a husband, you got a role as a physician, you've got a role as maybe a father, whatever it might be, but you're playing a role in what you're having to do is shift up those roles in the one roll your way at play as a physician, the way you're explaining it was extremely stressful. You had to come in making decisions. And how do you explain away in your own life? As a physician, not You're not going to save every patient? And you're going to have questions as you left. Well, if I had made a right turn, it would have been better or a left turn, I would have done something. How much is it that you your spirituality, fate, whatever you want to bring it up to because you've got to go on to the next case. You've got to tell the wife and the kids that the dad didn't make it or whatever it might be your grandpa didn't make it or grandma or whatever. And I can't imagine that. But how do you reconcile that? In your own mind? Because it's not like Simon did anything wrong? Simon did everything he could. It just didn't work. You know, that happened? I mean, I hate to say it, but you know, like, shit happens. And the reality is, you have to have as a physician, I think some way to explain it, what would you tell our audience? Because that's got to be a very unique position to be in.

Simon Maltais
Yeah, it's weird, because and then and then you're asked to do that too, right? You're sort of face with life or death, commonly in what we do in emergencies and things. And sometimes some of those decisions lead to a bad outcome. And, and, and as long so the way I'll answer this in two full and two folds, the way I've decided to live this for myself, is that if I made the decisions that put the patient first meaning that it's not about the hospital finances, that it's not about the way I feel, it's not about the perceived perception, as long as I'm trying to do what's best for the patient, it includes knowing the literature that includes, you know, doing the pre op assessment correctly, that includes telling them or having them understanding the risk of a certain intervention, I make them on board with the surgery. So as long as I do that, right. And I feel like during the surgery, I've performed the best of my ability, because I'm not stressed because I'm not sleep deprived, because I'm not hanging over. Right. I feel like in that, in my mind, I can live with that. Now, then, to answer your question. Now, how do I deal it? When it happens? When things don't go? Well, the classic behavior is to is to is and that's wherever you failure happens, or every miss content you have at work is to ignore it. That was pretty easy. You know, before I, I didn't sit with it, you know, I've had death. I mean, recently, a couple of patients in a row and very tough cases, and are bad they audit ruptured or died in the operating room, or we have to call in the family, I would typically leave the room. I would I mean, I would be like acting like, Gosh, I really did everything I could you guys deal with that. Now he's not he didn't make it, I'm out, you know. And it really and didn't occur to me that I would learn and the family would appreciate it. If, and I would sort of help me secondarily, if I would sit with it. And sitting with it, it's not trying to explain to people what you did what you did wrong. It's somebody, it's just to be there. And, and just and sit with the emotions sit with the pain sit with the suffering. And, and I realized over the last, and that's been more recent, I'd say the last 24 months where I've really exercised that sort of this, this, this behavior of sitting with things that oftentimes the transition for families as much easier. And because they see the humanity and actually at the end of those of those moments, oftentimes I find that the family is actually consoling me. Yeah, yeah. So and so I have actually grown into this to say to say, You know what, like, I, I and then I stayed in the operating room last, like, I know, I remember one specific event two, three years ago, where a patient on the operating room, it's awful because the family comes, it's sterile, it's cold, you know, they come and see behind the curtains, their family members who just died and swollen and up there a big surgery. And I remember after we all prayed together and things in the room, I used to stay there with them in the corner. And I still receive letters every year from that family of No, thank you. We really had a good transition. It was definitely so I would say and any conflicts like this or any big event, it took me years to understand. I mean, I'm like 20 some years. I mean, I'm 15 years of practice but I've done this now for 20 Some years it took me when you think about it 18 years plus to not just be the passing by a strategist you know that just say, okay, everything's gone now. You know, I've done my job, let's move on, but part of your job is helping family transition to, to comfort and to get over a certain thing too, because you're you didn't really save the person and I'd really helped me getting over that, that those tragic moments.

Greg Voisen
Well, I think, you know, look, I have a like you I don't have as many degrees as you do. But one of the degrees I have is in spiritual psychology. And I have some friends that are chaplains and I understand the importance Have that healing time and what you're doing is healing you as much as it's, as you said, healing them. And it allows you to continue. And pardon me for saying this, but I'll use the word craft. You're like an artist. I used to have plastic surgeon, clients, no. And they would have the pictures of the people that they're going to fix and how they're going to fix them in, you know how they're going to do their artwork, right? How they're going to make this happen. And I think what you do is even more difficult, because of, you know, the intensity of what you're under and keeping someone alive. But what you're doing now is really important, and you speak about, again, this health care system has changed over the years, and how it has contributed to the burnout of residents. You were once a resident, I'm sure you can remember back to that. What are the factors that you believe lead to the burnout? And what can hospitals and the healthcare industry do to change the problems and you listed on page 50? In the book, I even put a p 50. On there. These things, because there's we have many listeners, we're going to have people like Quint Studer listening to this, and we're going to have people that are nurses listening to this or other doctors listening to this, from Simon's percept perspective, what do you think needs to happen?

Simon Maltais
Yeah, you know, I think so a lot of things are already happening. I think there's a movement now for that, that residents and students are burnout. And then I mean, there's 60% of residents and cardiac surgery plus that fitted in this most recent study criteria for depression while in training, right, that's huge, right. And so, now, there's working hours restrictions, you can't be we used when I was training, you can do 100, and some hours a week, plus, there was no restriction on that you could be, you could be on call all night, not sleep, and you couldn't go home. And next, you would never ask to go home in the morning, because that was your time to do surgery. You know,

Greg Voisen
it's like airline pilot. Now, you can't just keep flying.

Simon Maltais
Now. You flying, but it was a it was an unknown. I mean, it was like an unsaid rule before where if you left in the morning at eight after a night call, and you were scheduled to do surgery the next day, you probably your ability to find a job was going to be zero. I mean, you know, because people would sort of put you in a this sort of bucket of people that, you know, are not working hard enough, you know, and so, so that has changed, I think, you know, the their call needs to change as well. You know, those moments where you serve, you know, and you're sort of at the mercy of a color beeper. I mean, by definition, right there call is, is sort of a risk factor for burnout. I mean, you know, you're hot, you're, you're working many hours at night, you're sleep deprived. I mean, the whole the acronym halt, right, you're hungry all the time, you know, finding food is sort of a, so it becomes a challenge, you know, you eat is too much work to do. So, you're hungry all the time, you're angry all the time. Because you get you get to be caught up in the system. You're lonely, because oftentimes, it's like at night, right? And you're tired. So I mean, Hope is what they use in these addicts. The hope is, is an acronym that they use for rehab, right? If you if you get into this whole, you know, system, so realizing that's an important factor for burnout for people that have been, you know, struggling, and then you can act upon those things. You can I mean, you can respectfully and professionally asked for a schedule and, and put certain limits to your to your schedule. I mean, I think hospitals need to hire more people they need, we need to continue forcing on that. They need I mean, sometimes providing lunches is to provide help. I mean, we we've done some changes where I work where we provide some meditation every week, we provide some lunches, healthy stuff, just realizing that the call and the work that we do at times is just not normal. And I think yeah, I think not normal meaning not nine to five, not sort of a time where people need to have a dedicated time to eat and we shouldn't resent as a culture people for wanting to do that and, and teach perhaps in school tricks and tips how to survive, you know, in a call or how to survive on a night shift. And I think it's a complete disaster. My ex-wife is was now is a great friend. These is an accomplishment in itself. But you know that I think about it, but the, you know her schedule still in the nursing, if you're not if you don't have like history at this hospital, if you're a specialized nurse, you just basically start over at night again, right? Like you were 18 years old, whatever, you know, when so. So that doesn't make sense to me, you're trying to attract people with experience, you tell them up front, you know what you got to? You got to do enough for three years, you got to do from the night shift, you know, what, how does this? Like? How does this compatible with life? And so I think the system needs to think differently, you know, the say, well, maybe we rotate everybody does it, you know, and it's not if you haven't been there for 20 years, you can, you can just choose the shift before everybody's you know, during the day, and then, you

Greg Voisen
know, the thing, Simon that that we know, there's a health care shortage of health care workers, right, it's just, and then the pandemic just exasperated it, and it exasperated your heart surgery even more because they were postponed. And that kind of leads me to this next question. You speak in the book about the overall decline of cardiac surgery in the US and the increase of the mortality after cardiac or artery bypass surgery during pandemic were? And they because of the postponement Look, people weren't going in for, quote, voluntary surgeries. I can't imagine that the coronary bypass surgery is voluntary. But to some degree, it is, I'm sure how did the pandemic exacerbate the problem? And what has the fallout been to physicians like yourself, because of the pandemic, and we can speak about it in general terms, but you can speak about it also, specifically as it relates to your profession as a heart or cardiac surgeon.

Simon Maltais
Yeah, I mean, we're seeing we're seeing delayed presentations, people wait longer, you know, when they have chest pain to show up. And, you know, time is, is money, you know, for the heart that so if you have chest pain and have a heart attack, I mean, if you show up later, there's, it limits your our ability, often patients are sicker, the heart has had damage. And so that's for sure, one factor, when people get short of breath, they oftentimes I mean, what we see is now the go to reflex is to sell that's COVID You know, I'm sort of coughing, I'm short of breath. That's COVID. And we now see that, I mean, that's the main symptoms for us, right, people have valve problem, they have a heart attack they have. And so shortness of breath, oftentimes is Miss people have been in hospital somewhere, being treated for you know, COVID, you know, quote, unquote, pneumonia. And, and, and then we realize that hearts the problem two weeks later, and they've been in the ICU and things and so, so that's, and then COVID has brought up a lot of weird stuff too. For us, like the blood is more thick. We we've had some patients have stroke, and we have had some patients have early occlusion of bypasses. And so that's been a problem, too. So, I mean, it's changed a practice a little bit. But yet, you know, the community doesn't support us, you know, because we I do the same thing day in day out, you know, but people are dying more, you know, so it's, you know, it's tough to live through that. And we don't really talk about that much. Because in the book, what you're referring to I talked about this article, they say, Well, you know, it's being more difficult. People are dying more the, from COVID. And from heart surgery after COVID More than you would expect. But yet, you know, nobody talks about what impact is has on teams, and then the surgeon. I mean, I remember that week, a couple weeks ago, a couple months ago, when I lost two patients same day of weird stuff, like, you know, all the bypasses occluded, and we find out patient had COVID A month ago, and then that's probably what the cause is. And then and then another one having another complication. And yet I was sitting in my office and like God, I went up what am I doing here? Like what happened and I was like, lost, I had lost confidence. I was sad. In this article, they talked about the impact on residents on the system, and nobody talks about what it has on your mental health and especially when it's been going on for two years, you know, so and now we're seeing we're seeing a lot of people, nurses and doctors saying To hell with it, I'm just going to go and do temporary assignments because doing this day in day out is just not I just can't do it anymore.

Greg Voisen
Well, it obviously the pandemic has had a huge impact on the healthcare system and it's, you know, it's just, it's crazy in kind of wrapping up our Interview though, I want to ask you kind of a twofold Question one, you speak about the psychological manifestations from the healthcare disease. And you tell stories about fellow physicians who are faced with it as well. And your estimations as a two part question, how can the healthcare system reinvent itself so that it's more compassionate understanding and as a community, community of support for the brave doctors and surgeons and nurses and other workers in the field? And the second part of that question is, you created a roadmap, a step by step poor growth program toward recovery? What is that plan? And how can other health care professionals avail themselves of your step by step program? I know they can go to the website, healthcare anonymous.com is so two point question. First part and the second part

Simon Maltais
was in regards to that first part, I think there's a lot of work within the system, to change the culture to change the perception to open up the conversation, create a community of support, not just about heart surgeon, but nursing, you know, to favor the sort of long haul not to make any relation with COVID. But right Hall treatment of the problem. As opposed to this to treating the acute moment, I think a system is pretty good about recognizing when people drink too much when people can't get up, go to work, recognizing the acute moment, but the prevention of it, whether it's facilitating some time helping people with their kids, you know, at work and, and is not very good about recognizing early problems, and so fostering this. And I think some companies and some tech companies are even, are probably better about doing that or preventing or, you know, fostering that environment of, you know, having a gym or having good food or having a fight a jeans or having mean healthcare in that way is a bit it healthcare systems in that way, lagging old school, you know, that with belly wavering. I mean, I was just reading this business, Harvard Business Review on hybrid work and how most of the tech companies and some 90% of them won't go back to the usual sort of getting the work and with your lunch every day and driving through traffic. I mean, they've realized that it's more profitable for someone to be on site, you know, when and when they have to, and then meetings, telemedicine, tele communication and things have really taken over satisfaction has improved turnover, turnover as the word complaining about turnover in medicine, a lot people change job the nurses go, do they go to other jobs? I mean, versus the pay and reward the experience, but also it's the favoring some of that hybrid models, right? So I have my kids on Friday, you know, I can I can do the work from home from telemedicine. And that way, in that way, the medicine is hard to adapt those cultures. So that's the first.

Greg Voisen
Yeah. Yeah, no, no, no, I agree with you. I've worked in the healthcare field. So I understand it is it's old fashion. It is. It is reinventing itself. I think the culture that pervades is the biggest factor. And it's I'm not just the culture with healthcare administrators. But truly, when I say this hospital administrators, I should say, it's truly pervasive in the whole culture, the cultures have to shift for everything else to shift. And I think they've had a very difficult time trying to do that.

Simon Maltais
Right. And it's, and it's coming back now, when other people were forced out of the system. Now they're asking to come back. I mean, I'm very fortunate. And that's part of the reason why I took the work here. But I have three partners who think the same, are very tech savvy are very sort of forward and there's a hybrid work. And so we among us have proposed to the hospital, they were having trouble with keeping people within the system within the system, because people are, you know, changing after three or four years and things leading to other places. Yeah, listen, we're going to commit the stay here. But here's what we want, you know, we want this time off, we want telemedicine to work, when I'll be here, I'm going to operate, I want my time to be optimized, and we're all three, you know, the same and focus on so that I'm very fortunate. So people need to propose to their system, some more hybrid work like that. And in regards to your second point, I mean, I propose in the book a step program, right, it's basically summarizing the things that have helped me you know, in in five general steps and then plus one, and so i i Actually, you know, I you know, taking a pause, reassessing values, sort of, you know, virus checking yourself on a daily basis, you know, forgiving and not being resentful. So there's a couple of things in there to help people get through a stage of they have these acute moments. And I do open up the conversation, I do give the book room, I actually invited people to give stories about their, their experience, which I think helped a lot of people. It's not just doctors, it's nursing. It's administrators, it's technicians. And so we have family, doctors, specialists, and so very helpful. We have a wife that talks about her husband who died. You know, remember that story? Yeah. So I think that is a lot of powerful stuff, but people will recognize themselves. And then what we're trying to do further, I've created a working group called you can go to breakthrough points calm. It's basically a coaching system or a group of people that gotten together to help people get through and work in a better and better homeostasis within these high intensity environment, whether it's health care, whether it's business, whether it's, and it's, the program has a lot of steps, but we follow people six months, we propose sort of one on one coaching, we have teaching sessions. And because I think a lot of the a lot of growing comes from understanding the environment and how it works, and then how this people work and what it leads to. So we have we are recreating you're trying to create a movement to try to open up a forum. And certainly that that is a that is going to be I think the book is one thing, but it's a stepping stone to creating a movement to help people.

Greg Voisen
Well, I think you've done a great job of summarizing it for all my listeners out there that are in the healthcare field that want to learn more, go get a copy of this, he gave two websites, we'll put links to both of them. The first one is healthcare anonymous.com. You can learn more about Simon there, he has bonus packages, with bundles. So if you want to, like distribute this to people in the hospital, you know, get 100 copies circulated around,

Simon Maltais
and I can come at you I offer a program where we come to we do like a SWOT approach visit to your hospitals. So we come in and do like an N 360 analysis suggest some things that we can do to improve, you know, in the environment and help people and things like that. We do breath work and things like that. So there's, there's information on there to help.

Greg Voisen
Well, the breakthrough points is the other website that we'll put a link to. And you know, when you talked about breath work, I think I spoke with him. My son just got certified in somatic breathing. He's doing the what is it Meinhof? Him Hoff, the guy that goes into cold water? Yeah. So it does work because this? Yeah, it works tremendously. Well. Simon, just a pleasure having you on speaking about your book, your own personal journey. And usually the stories that people tell are really what they actually bring up in people. The best parts meaning, Hey, these are things that Oh, I relate to Simon, I was going through the same thing, or I had a problem with this as well. So for all of you who could relate to Simon story, you then need to go get the book. You need to go to breakthrough points. You need to go to HealthCare anonymous. Pleasure having you on. Thank you so much. And as we said, Be Here Now take a big deep breath.

Simon Maltais
No, our on it. Love it. Let's go.

Greg Voisen
Oh, I can I can show it to you. Here. Here. I'll show it this. This part won't go in the recording. How's that? How's that? Yo, if I if these were still being made, I would send you one.

Simon Maltais
Now with no I love it. You see it? I love it. This is great, I'm sure.

Greg Voisen
And this thing goes back and forth, like this. And it's an homesick signal, which is what I wear around my neck. Yeah, that's I love it, isn't it? Amazon or you know the guy that has them all? Try and find it. You won't find them. He actually is here in my town in Encinitas. Let me stop the recording and I will get you one

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