Featuring Articles for HEALTH CARE PROVIDERS, EDUCATORS, AND PARENTS 

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Hello friends,

I’m sitting here on this wintery day, slowing down my pace a bit between busy holidays. It is a welcome time of year for reflection, gratitude, and outlook on the new year. As I type and watch the snowfall, I am filled with immense gratitude that so many of you invite me into your lives, both personally and professionally. Your strength, vulnerability, and professionalism are noticed and appreciated.

Reflection

As I reflect on 2021, my eyes fill with tears. My goal in moving my work to a training and consultation model was to touch more lives, hear more stories, and have a broader impact on children, families, and patients. Here are some milestones my small, mighty team and I accomplished this year:

  • Dozens of consults to healthcare organizations, large and small. Mainly around managing uncertainty and acknowledging that “It’s OK to NOT be OK.”
  • 4 trainings for hundreds of early childhood educators about the impact of trauma on children and ways to build resilience
  • 2 large trainings and 4 parenting classes aimed at decreasing child abuse in Oregon.
  • Supervision for DHS managers and supervisors as they navigate overwhelming circumstances to protect children.
  • 2 ECHO Trainings for integrated behavioral health care & child psychiatry.
  • 2 INCREDIBLE conferences at the farm inviting over 50 providers to our property to address trauma and build resilience for patients and their families.
  • The launch of The Provider Lounge – a community to build resilience for medical providers. AH-mazing group of individuals.
  • The launch of THRIVE – an organizational consultation group for clinics committed to organizational wellness.

 

Wow. Just wow. Thank you for trusting my advice, allowing me to be your guide and inspiration as we navigate rough waters. More so, I want to reflect on the gratitude I feel from each of these opportunities.

Gratitude

It’s easy to tick off boxes of accomplishments as I review my 2021 calendar. But here’s what emerged during these encounters, for which I am truly grateful. This was the most important work I did this year:

  • Sitting with providers in tears as they express overwhelm, disappointment, confusion and fear.
  • Supporting parents who feel uncertain, lack confidence, attempt to break cycles of intergenerational trauma or learn new skills.
  • Laugh with early childhood educators about how little people show up and model resilience, forgiveness and the magic of early childhood with adults who believe in them and love them.
  • Reach out to supervisors as they attempt to support case workers navigating unspeakable truths about how children are maltreated. Encouraging words, wise guidance, and authenticity were present in all of them.
  • Providing insight for providers around mental health, behavioral health, and collaboration on medical teams. Expert group understanding provided insight and strength to all of us!
  • On the farm – sitting with awareness, tears, support, and epiphanies as providers navigated ways to continue to support their patients, address trauma and become resilience-building heroes in their practices.
  • Creating a safe space in The Provider Lounge where providers feel like they can show up, bring hard questions, ponder ways to mitigate trauma and ask curious questions.
  • And, working with new colleagues and healthcare systems to transform primary care and creating thriving organizations.

 

Thank you so much for trusting me, asking the hard questions, sitting with tough answers, supporting each other, holding each other’s truths and continuing to forge on through the hard work that needs to be done. I see you, I’m amazed by you, and I am humbled by your humanity and brilliance.

Outlook

What do we do with all of this collective learning, support, pain, curiosity, and insight? We create more space for it to grow! You know what else we continue to do? Be in community where we show up as brave and honest as we can be – full hearts, open minds, and curious questions.

The common theme in ALL of the work that I committed to this year and ALL of the work that you LOVED was…connection. Connecting stories, with each other, with me, with other providers, and in groups. Whether those groups were in-person or virtually, being together matters. Connection creates triumph during hard times. Connection, story-telling, sharing hard truths and sitting with each other’s pain was what created meaning, a village, and a space for growth. This is what I know changed me and changed you.

It’s truly the most important medicine. 

So, will you do me a favor? Will you make a list of your achievements, large and small? Then go back through and take inventory of what truly made those accomplishments feel meaningful. My guess is that you, too, will find a common thread.

Then let me know what themes you find because I love hearing from you.

With gratitude and hope in the new year,

Dr. Amy

Hey friends,

Have you heard of the term “pacesetter?” If you’ve entered running races, swimming events, biking races, or the like, you’ve probably heard about pacesetters in that context. A pacesetter is a person who does exactly that: sets the pace for others. In a moment, I’m going to make the argument that I can be your pacesetter for navigating stress and decreasing burnout, but more on that later. In a large race, you’ll find a person holding a sign or leading a group with a paced time on it. Before high-tech gear, a pacesetter would have one of those sandwich board that said “10 min mile” and would encourage others who aspired to run a 10-minute mile to run with them, assuring a finishing time that met their goals. See where I’m going here? And, by the way, don’t judge me for running a 10-minute mile as a reference point. 10 minute miles get the job done! But I digress…

What we’re all going through as helpers during the middle of the pandemic is nothing short of an ultra-marathon. Not a 5K or 10K as we initially thought. Heck, this pandemic isn’t even a marathon…but an ultra-marathon. We’re going to need more than good sneakers, Gu and some inspirational beats to get through all of this. We need a pacesetter. May I be your pacesetter?

You see, as medical providers, you’re trained to put on a brave face and help others, even during the most trying times. But the last year and a half have been exhausting. Am I right? And it’s difficult to find respite, purpose, and sift through all of the messages of self-care. How are you supposed to do that while running a clinic, seeing patients, taking care of your staff, and rolling out vaccines? I’m here to help.

I am hosting a workshop this week– to give you practical tools to feel less burned out so you can practice meaningful medicine. As soon as the pandemic hit, I began reaching out to medical providers, clinics, and hospitals about how I might help. I spoke with medical directors in tears, providers in panic, and distraught colleagues. I knew we had to focus on practical tools to mitigate the effects of the pandemic and see this as an ultra-marathon if we were going to make it through intact.

Earlier in this newsletter series, we began with acknowledgment. Acknowledgment begins a healing process. Then we moved into support and resources. And now, as we begin to reconcile with what we’ve been through (and still have curveballs thrown at us) and what we continue to go through, we need ways to navigate the uncertainty of primary care. We need practical tools and actionable next steps to make sense of what’s happening and clear the way for a meaningful path forward.

Here’s exactly what we’ll be covering in the webinar if you join me:

  • Recognizing the signs of burnout
  • Understanding compounding stress and its effect on us
  • Practical tools to address overwhelm
  • Actionable tools to deal with uncertainty
  • Ways to find purpose
  • Moving into community

 

The workshop will take place this Wednesday, November 10th at 6:00 pm PST. Register at https://doctoramyllc.mykajabi.com/registration-page

Come and run a 10-minute mile with me! Or just come, drink wine and listen. It’s better in company!

With compassion,

Dr. Amy

Hello Friends,

Holy smokes, do I have news for you! TWO opportunities to get some support during this time of uncertainty. I know you’re all overwhelmed. I know burnout is real and fatiguing. The only way to address burnout is through connection, support, and practical tools. When we come together as a community and acknowledge how challenging the last 20 months have been, then some healing and reconciling can begin. So, with that being said, here are two opportunities for support. FREE and FREE!!

“Amy, no one had told me that ‘it’s ok to not be okay’ until you did. Thank you for reminding me that we’re human.”
Chief Medical Officer (after Summer Wellness Workshop)

Mark your calendars! The first bit of support is through a free workshop on November 10 at 6pm. Beyond Burnout: Navigating your way through trying times as a provider. In this workshop, we’ll discuss symptoms of burnout, what’s contributing to burnout and how to address what we’re going through. I promise you, I’m not going to give out nuggets that focus on eating better, getting sleep and taking a vacation. I mean, that’s all-important, but I’m going to give you tangible things you can do to address overwhelm. Let’s be honest, we need to focus on what’s possible and practical. And more importantly, when we only focus on a few parts of self-care, we miss the big picture! We’re going to walk through actionable steps you can take to address overwhelm and find more purpose in your work.

Register for this free workshop here.

Join us! Many of you have joined us for Refresh – our monthly meetings for providers to gather as a community, gain tools around resilience-building and gather resources to support your patients. Well, Refresh will now be known as The Provider Lounge: A Community to Build Resilience. The Provider Lounge is a community of like-minded medical providers that want to focus on building resilience in their patients and themselves. If you’re looking for a place to find purpose, create meaning, and respond with practical tools that build buffering forces for whatever our patients face, this is the community for you!

The Provider Lounge is also an online portal for providers. In it, you can access tons of content that build resilience for your patients including scripts, videos, resilience interventions, and cards for connection.

For now, The Provider Lounge is free! Come to a meeting and check out the portal. If you want access right away to see what’s going on inside, just reply to this email and I’ll send you a login so you can join us. Our next community gathering in The Provider Lounge will be Thursday, November 4 at 12:30 pm. And yes, all meetings are taped so that, even if you miss us, you won’t miss the gems!

Join us via Zoom on November 4th at 12:30 pm for The Provider Lounge.

OK friends, I hope you feel like help is on the way. I’m working hard to make myself available, provide resources and free support as much as possible.

See you November 4 and November 10th! Mark your calendars now!

Speaking of free and easy…. did you know that 90 seconds of deep belly breathing has been shown to decrease cortisol by 30%??? Yep – breathing is straightforward and simple – but we don’t always take time to do it.

So, deep breaths friends, help is coming!

With compassion,

Dr. Amy

Hello Colleagues,

Wow. The past few weeks have been exhausting. Or, shall we say, even more exhausting? Between returning to school, vaccine mandates and staffing shortages, not to mention increased hospitalizations due to COVID, I know so many of you feel like you’re drowning.

You’re not alone.

Because you’re short on time and a lengthy email is the LAST thing you have time for right now, might I offer you a few reminders to address overwhelm?

1.     Get connected – on any level – in person, online, in a group, with your body, with an incredible friend. Connection is the NUMBER ONE factor that will address burnout.

2.     Breathe – it’s simple but effective. Research has shown that just 90 seconds of deep, belly breathing can reduce your cortisol levels. Take off your mask, find a space, and breathe deeply.

3.     Tap out – take a break, even if it’s for short periods of time. In 90 seconds you can breathe. In 5 minutes you can stretch. In 15 minutes you can eat a meal and try not to rush. In 30 minutes you can watch a sitcom and belly laugh. In an hour you dive into a creative task like knitting, singing, or drawing. In a half-day, you can go for a hike or visit a friend. In a day you can get out of town and disconnect from work. You get the picture…

4.     Feel your feelings – I know, you’ve stopped reading… “If I feel my feelings, I’ll go into a black hole and never come out.” It’s not true. Acknowledging feelings actually help them subside because they’re recognized. Once a feeling is recognized, you can decide what to do with it – cry? Set it aside for now? Write it down? Talk to someone? Run? Share it? That feeling needs to be felt all the way through, or it will pile up and come out in other spaces.

5.     Focus on what you can do now. You can’t solve the problem of yesterday and you cannot predict tomorrow (or even later today). But you can be present in the next moment with your patient, your colleague, your MA, or your partner. That’s the only moment we can control.

Gentle reminders friends. This is not an assignment, nor a task to achieve. It is how you will survive through this mess. Simply take an inventory of the ideas and choose one to be more intentional about during your day. Just one small action.

With compassion,

Dr. Amy


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First of all, thank you so much to ALL OF YOU who responded to the last blog post– I felt the love! I’m going to incorporate all of your questions throughout this series but especially during Week Five – Reader Spotlights and Questions. So keep your comments and emails coming!!
 
Second, I promised you some great content; and today we’re covering How to Reframe Discipline.
 
Define It.
When we think of the word “discipline,” what’s the first word or thought that comes to mind? If you’re like most people, we think of the word “punishment.” We ask ourselves questions like, “How do I make this punishment SO BAD that my child will never engage in this behavior again?” Or, we think “How do I bribe, create incentive, or manage changes in this behavior so that it stops happening?”

Discipline, by definition, means: To train or develop in instruction and exercise, especially in self-control.”

 
WAIT, WHAT??? Yes, discipline is actually a practice of instruction and exercise. This means, you’re the teacher of behavior! If I tell you, I’m disciplined in the area of psychology – you would know I’ve been a student of psychology and I’ve been trained in that area. If I tell you, I’m a disciple of X – you know I’m a student or follower of something.
 
So, that means that when it comes to defining discipline, I’m referring to HOW you train and develop self-control and HOW you train and teach your child (the student) about self-control and behavior.
 
Wow…..now we’re talking about something entirely different.
 
Name It.
Now, I want you to take a moment and write down the TOP THREE behaviors you most often feel frustrated or overwhelmed by. What are three behaviors that, if your child or student stopped engaging in, your life would get easier. Write them down. Better yet, leave them in the comments below so we can showcase in week five – we’ll problem-solve together!
1.
2.
3.
 
Reframe It.
Great, now I want you to think about the behavior in an entirely different way. Suppose you said, “hitting” or “yelling” as the most concerning behavior you see in your child. And if you’re on the same page as me regarding our new, shared definition of discipline, then you know, that instead of STOPPING, BRIBING, CORRECTING OR SCARING YOUR CHILD OUT OF THIS BEHAVIOR, you must, instead, focus on a different way of training or exercising self-control.
 
So, ask yourself this… If my child is engaging in X behavior (hitting or yelling), what SKILL does it show that he/she has not yet learned? What behavior must still be learned so that my child will stop doing X behavior. For instance, if I don’t want my child to hit, yell or engage in aggressive behavior, what skill must they learn? Or what have they NOT learned yet that they need to acquire?
 
Revisit It.
Here are some possible answers. If my child is hitting, hurting or yelling at others, the SKILL they’ve not yet developed is…..

  • Self-control

  • Problem solving

  • Non-violent ways to express anger

  • Verbal ways of identifying feelings

  • Non-verbal ways of expressing frustration that are safe

  • Who to find when I’m upset

  • Models of positive behavior

 
Revisit your top three concerning behaviors and write down the skill your child must still learn.
 
Now that you see this behavior as a “skill set yet to be learned” aka, a “new discipline to follow,” you can revisit the behavior.
 
Find ways to teach the new skills such as problem solving by using words, walking away to avoid hurt feelings or finding an adult who can help him/her. Play games, take turns, model problem solving during play – all of these activities teach the new behavior or discipline. Then, reinforce that behavior with words of praise and encouragement.
 
To close, this isn’t easy. It’s a new way of thinking about behavior and discipline. But we can all get better with greater intention. And when we’re more purposeful about our approach to children’s behavior, we gain more meaningful connection.
 
That’s a wrap folks! Thanks for learning together.

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