Solving For Joy

Mel (00:00)
We forget that we're doing it for ourselves. We have to do it for ourselves first. have to create the thing and put it out in the world for us. If we're doing it for others, that's not creation, that's consumerism.

Chrissie Ott (00:13)
I feel like it took me into my 40s to realize that I didn't have to somebody else to decide thoughts were worth To be discovered, right? I actually my own value

Mel (00:29)
I'm all done with that now. I'll close that chapter and now I have this other desire and I don't have to feel like I'm stuck. And so I can light a match to that part of my life if I choose to and I can go do this other thing.

Chrissie Ott (00:42)
You're listening to Solving for Joy. I'm your host, Dr. Chrissie Ott, a multi-boarded integrative physician and professional certified life and career coach.

Chrissie Ott (00:51)
podcast is about joy, what it means, how we find it, and the creative ways people are solving for it in their

Chrissie Ott (00:58)
own lives.

I'm so glad you're here.

Chrissie Ott (01:02)
Hello friends and welcome back I am here with my friend, Dr. Mel Thacker today. Dr. Thacker's signature podcast, Surgeons with where she helps surgeons navigate dissatisfaction, burnout, imposter syndrome, and reclaim purpose in their careers. She is a two-time TEDx speaker.

a coach as she is working on a book and she's a co-founder of the Hippocratic Collective. I know that I am missing many amazing accomplishments in that introduction, but I'm so grateful that you are here with me today. Mel, welcome.

Mel (01:42)
Thank you so much for having me.

Chrissie Ott (01:44)
I ask everybody, almost everybody at the topfor

A little joy check in. What is something that has brought you joy recently? And bonus points if it something surprising.

Mel (01:55)
Yeah, I mean, that's such an easy question to answer because we just had our first summit for the Hippocratic Collective in Nashville. And all I wanted to do was play. And that's what we did. And it's not often that I laugh until I cry. Neither is it often that Francis May does that. And we both did. there was a lot of ideating and collaborating and playing and talking and being in each other's energy with some powerhouse human beings.

that all bring some unique element to the table. And I think that's how innovation happens. And so it's really fun for some very intelligent brains and some really powerful energy to all get together. And we're all very different. And sit in a room and chat and talk and laugh and play and ideate together. And so that was very joyful.

Chrissie Ott (02:45)
That is wonderful. I feel like that is kind of the nectar of the human experience when you get to ideate and connect and play all at the same time.

Mel (02:56)
Yep, that's exactly what it was. It was like the nectar. And the thought that kept popping into my head was, this is so much better than rounding in the hospital.

Chrissie Ott (03:05)
side to side comparison, real clear.

And also we appreciate all of the people who are out there rounding in the hospital today. Thank you. We cannot ideate and play every single day, maybe we can, but it's tricky.

Mel (03:16)
Yes, we need you.

Yeah, and it's funny because I think back to my first career, the first 12 years of my life as a surgeon, and I would never give that up. Like, this just feels like a very natural evolution, moving from the fluid intelligence curve into the crystallized intelligence curve, like Arthur C. Brooks talks about in the book, From Strength to Strength. And it's like leaving classic intelligence and a lot of energy.

Chrissie Ott (03:42)
Mmm.

Mel (03:48)
know, it's just

hard to burn out when you're young

and a willingness and a desire to go in on a Saturday and help and see patients and you want to do surgeries and you want to do all the things to, I'm all done with that now. I'll close that chapter and now I have this other desire and I don't have to feel like I'm stuck. And so I can light a match to that part of my life if I choose to and I can go do this other thing.

Chrissie Ott (04:09)
Yes, that's such a good lead For those who are meeting you for the first time, would love for you to share a little background about your journey from being an ENT surgeon to the coaching and leading work that you're doing today.

Mel (04:27)
do we start? I I come from a little bit of an unusual background in that I from very meager beginnings. I grew up in Wisconsin outside of Milwaukee with a single mother and in poverty, on food stamps, all of the things. I had never gone to see a doctor, not because my mother had

any sort of thoughts about Western medicine, but just because she was neglectful. And so I don't ever remember seeing a pediatrician. I wasn't vaccinated until I got to college. I remember getting all of my childhood vaccines and then having to take exams. And I just decided at the age of 13, I'm going to be a doctor. And I think that came from a desire to matter and to have a

purpose and an impact. And physician just seemed to fit that even though I didn't quite know what that meant.

I just knew that you got to help people and you could save people and that felt very important to me. And so I decided that and I held onto that and that was my one plan A, there was no plan B. And that was what I put my future focus on and it was the one goal that I wanted to achieve and I was really smart and precocious. And so they moved me into all of the advanced classes. So I knew I was intelligent enough and got into college and then...

medical school. And then once you're in medical school, it's like, okay, I'm going to graduate the top of my class. What are what is available to me? What's the panoply of options? You can have orthopedics, dermatology, urology. And I loved ENT. I just felt very comfortable with the people. They're very quirky and weird. And you get to use your hands and work in little tight spaces. And I played a lot of video games when I was a kid. So I thought like the the endoscopic equipment was really cool. And I was pretty good at it.

And so I chose ENT, but I also didn't really know what that meant. You it's like you spend a rotation with a couple of people, you see a tonsillectomy and you're like, I think this sounds good. You just have to go by feel. And I felt right. And so I trusted that I've always been somebody who follows my intuition. And I went into ENT. My first job out of training, well, residency was hard as it is for everybody. I did residency in Houston, Texas at Baylor. It was... ⁓

Chrissie Ott (06:33)
Yeah, that was the

other thing we had in common. forgot,

Mel (06:34)
Yeah.

Yes, yes. ⁓ It was it was pretty, I don't want to say toxic. It was just hard. But there were moments where the vertical hierarchy was very confusing to me. And I was told, you know, pretty plainly that I was a piece of shit when I was an intern and a less worthy human being. And it was very confusing. I was like, what's going on here? So I never subscribed to it. I was a troublemaker. I'm surprised they didn't kick me out. But

I took really good care of patients and I'm a really good doctor and really good surgeon. I think they're like, you know what, she'll probably be okay. We'll pass her. Whereas other people were being kicked out in my program. graduated and then I did a fellowship in rhinology and my first job out of training was in academics or like a pseudo academic. It's actually perpetual employment at the University of Florida in Jacksonville, Florida. I realized very quickly, I don't like...

not having any autonomy. I wasn't understanding. was like, why do I have all of these secretaries that I have to go to? I can't close a clinic without giving 30 days notice. Who do I talk to for my clinic schedule and my clinic scheduler and my surgery scheduler? We're trying to sabotage each other. Yeah. So I was like, OK, I have no control over anything in my professional life. I don't like this. Get me out of here.

Chrissie Ott (07:37)
You're like, I'm out of school. Where's my agency?

Mel (07:50)
So two years passed and my contract ended and I was like, okay, private practice, that's where I'll go. I had also met my husband in New England and we wanted to go back and be near his family and we had a baby and another one on the way. So we moved back to New England and I love the Northeast, coming from the Midwest and living in the South and now living in the Northeast, I realize the Northeast is the place for me and I wanna raise my family here and I definitely don't wanna live in Florida.

And so we found a great private practice. I joined them. I quickly became partner within two years. And I was there for a total of 10 years, partner for eight. And it was amazing. It was great. But no one ever taught me the fact that life is cyclical and that once you take away your goal, you're on this conveyor belt up and up and up and up to kind of achieve this thing. And then you just become an adult with a job. It's not like you sit there and you're like enjoying the fruits of your labor and you're just

Chrissie Ott (08:38)
Yeah.

Mel (08:42)
elated all day, every day and just happy. You've reached perpetual joy. That never happens. So I had to kind of stop and look back at all of the trauma that I went through throughout my life that I compartmentalized and kind of shoved into a little corner in my body. And that started to kind of scream for my attention. And so that's when I went through probably the most emotionally distressing time of my life while I had the perfect family, the perfect job.

The autonomy of private practice, I was serving a community, loved my patients, loved my staff. have staff who have been there for 30 years. They've been there for almost about as old as I was when I was working there. 30 plus years, they started in the 80s. I was born in 1980. And I'm like, wow, the retention, clearly there says something about this culture of this place. I love the culture of my private practice. I love my partners. I love my employees.

Chrissie Ott (09:24)
you

Mel (09:38)
There's a lot to be said about the hospital system and like the call schedule stuff and not being paid for a call. Obviously, that's really awful. But I can't really complain living in this beautiful house and having a beautiful family and finding the guy of my dreams, the person who I want to spend the rest of my life with. But I was at like the very bottom of the barrel in terms of my mental health. It's fascinating how that happens.

Chrissie Ott (10:03)
It really is. And it's just such a reminder that no matter who you're looking at, what you see is not the whole story.

Yeah, thanks for sharing how that was for you.

Mel (10:10)
Yeah, exactly.

Chrissie Ott (10:14)
It must have been really disorienting.

Mel (10:17)
Yes, really disorienting. And it started to threaten my identity when I was having panic attacks at work. And that's when I got really bad. And I was like, what's happening? Because I'm the sole breadwinner. If I can't do surgery, doing a little tiny procedure in the office, which I could do with my eyes closed, I've done it thousands of times, it seems like nothing. wouldn't even have thought about it. An older version of me wouldn't have thought about it. It's just something you just do.

And now I'm crying and dreading doing a biopsy in an office. It was wild, like cutting off a little papilloma on a uvula. That's something I could do within minutes and just move on. And now I'm having a panic attack every single time something like that comes up when I have to stop a nosebleed. It was really wild. And I was like, can't, this isn't sustainable.

Chrissie Ott (11:06)
Yeah.

Yeah, something really was out of balance. It's like the things that were your bread and butter. You didn't even want to face them.

Mel (11:11)
Yeah.

Yeah. And it was kind of like the being exposed, the vulnerability, because when you have panic attack, at least for me, it manifested as shaking. My hands would shake uncontrollably. And the last thing is surge. And I hate hurting people. And so I think like, I'm overly empathetic. And so the thought like, one, what's wrong with me? Now I look very exposed and they have heard all of these wonderful things about me.

Chrissie Ott (11:27)
and convenient if you're doing surgery.

Mel (11:42)
And here I am. And I'm like shaking uncontrollably. You know, it's just

like the disconnect, how incongruent that is from their version of me. You know how patients tend to hero you? And I didn't know the drama triangle then. And so I bought into it. And I was like, yeah, yeah, I am the hero. Yeah, thanks for noticing.

Chrissie Ott (12:00)
Thanks for noticing. ⁓ Real

quick, we've talked about Drama Triangle on this podcast at some point in the past, but just since we mentioned it, go ahead and give us a little breakdown.

Mel (12:15)
Yeah, so the drama triangle is a psychological concept that was created, I believe, by Steven Cartman in 1968 or somewhere around there. And there are three roles. And if you are invited to play one role, then you are simultaneously accepting the invitation to play all of the other roles. And everybody always ends up as a victim. So the three roles are hero, we love playing the hero, and ⁓ victim and villain. Or you can think...

⁓ Instead of a hero, it's rescuer. Instead of villain, it's persecutor and then victim. And so whenever you have that patient who's just love bombing on you and telling you how amazing you are and all of the things they read about you and your reputation precedes you and blah, blah, blah, blah, and your ego is just like inflating, that is a sign that you are being invited into the drama triangle and you do not want to accept that invitation. But I used to, and I used to buy into it.

I'm sure a lot of people who are listening know that feeling. It's almost like when you're dating someone and they're like, everybody else is crazy, but you're different. And you're like, something seems wrong about that. Like my spidey sense is going off. so, yeah, and if you are invited into the drama triangle as the hero, then very quickly, they can flip on you and now you can become the villain. And it's so fascinating villains, if you look in their brain.

Chrissie Ott (13:22)
If

Mel (13:38)
they always are saying, I'm the victim. So if, for example, a patient comes in and says, this doctor screwed me up. I have had first, second, third, fourth, fifth opinions. I've heard about you. I'm coming to see you. I believe you. You're the best. That person operated on me and I hate them. And they destroyed my life. They are a villain. And you say, yep, they are a hack. They screwed you up. They're awful. They're horrible human beings. And you buy into that story. The patient is a f-

is the victim. They think, poor me. You are the hero. You're like, poor you. I will save you. I'm the best. And if we looked at that physician that we're vilifying, if we looked in their brain, they would be thinking, poor me. That patient is actually the villain. They're the ones who are vilifying me. I've done nothing wrong. They're crazy town. And so it's just like this nonstop spinning around in a triangle problem. So instead, there was a man named

David Emerald, who came up with the empowerment dynamic, where the victim can now become the creator, the villain becomes the challenger, and the hero becomes the coach. And so when I learned about this amazing reframe of the drama triangle, I stopped buying into the drama triangle everywhere, not only with myself, but in my personal life and in my professional life. I just refused to get into the triangle. And instead, I stepped into the the reframed role. So when a patient says,

You're the best. You're amazing. Will you be my hero? Instead of saying, absolutely, you say, OK, I see that you had surgery. And now you have this new problem. You had a problem and somebody tried to help you with it. Now you have a new problem. And you had a really awful experience. And I'm really sorry for that. I wasn't there. And I can't speak to it. But I'm here for you. And I feel for you. And I'm so sorry. And now that you have this problem, this is what I can offer. What would you like to do? And so now you're.

putting them back in their power, you're re-empowering them. Victims are always disempowered. And by re-empowering them, you are taking a huge amount of weight off your shoulder because no victim can ever be rescued enough. And so you have to give people their power back. That's kind of our job, honestly, as physicians, is giving people their power instead of disempowering them by stepping into the healthcare hero. And I know there's a lot of cultural messages.

telling us we should, but it's actually very bad for everybody.

Chrissie Ott (15:57)
That is why I am one of the super many people who cringed every single time I saw heroes work here outside the hospital. can't, yeah, I remember all the way back to training as a medical student when patients would try to put me in the hero, they would actually say, no, you're different than other people.

Mel (16:05)
Yes.

Chrissie Ott (16:21)
you're different than regular people. Doctors are different. And for a time in the late 90s, early 2000s, I was actually going to retreats called Physicians and Allies that was talking about this as a form of unintentional oppression. Oppression might be writ large, like we can interpret if that's the exact right word.

But it diminishes the fullness of our identity when we are asked to play a role, even one that is.

apparently a desirable one, right? It's still a label. It's still a limitation. And you're right, it gets flipped.

Mel (17:04)
Yeah, I love that. It is unintentional oppression. And I think that's why we feel it. We feel the energy. And then we say, OK, well, I guess culture wants me to be that, so I will be that. But there's another way that we can do this. We can say, no, I'm not going to. Thank you, but no, thank you.

Chrissie Ott (17:18)
Yes.

Thank you. No, thank you. I have vision that sees beyond the apparently enticing invitation that's really a bait and switch. Yes. I love that you're teaching that to surgeons. I do think that once you're inoculated thoroughly enough with this information, it shows up across different domains of life, just as you said.

Mel (17:27)
Mm-hmm.

Chrissie Ott (17:44)
So even when I have a very strong desire to vilify, I have nearly an equally strong insight about how is this person challenging the status quo. This is a challenger situation. Like how can I actually transition myself or my child into creator or coach when faced with a challenging?

person or situation.

Mel (18:10)
Yeah, I love that. I always go back to Viktor Frankl. And if he can create something like man search for meaning and find meaning in a Nazi death camp, I'm sorry, but we can find meaning in anything. Is there any other example? Like if that man can find meaning in that he became a creator or Nelson Mandela is another example of a great creator. But we know that you can create something from a shitty healthcare system.

like finding villain compassion for United Healthcare executives, not easy, but we can do it and it will lead to a solution, a much better solution than if we otherize them and vilify them.

Chrissie Ott (18:50)
I feel like I've personally experienced that in so many different octaves and situations. And I think I share this with many healthcare leaders who are trying to lead and find difficulty or opposition or obstacles in the administrative layer of the system.

And it's very easy, especially for frontline healthcare workers to vilify those in the administrative layer. But when you meet one-on-one with many of them, are really required to remember that they are complex humans just like you, just like me, and vice versa, hopefully, when we are actually listening to our better angels.

Mel (19:30)
Yeah, and a lot of my clients always tell me they have so much shame over how they've behaved. They look at how the system has morphed them into kind of this villain version of themselves, like an egotistical, mean, burnt out at capacity, poorly resourced version of themselves. And they look at how they've behaved and they're like, I feel so much shame. That's not me. It's like not their baseline, but you...

Chrissie Ott (19:40)
so painful.

you

Mel (19:59)
it makes you realize it's not the humans in the system, it's the actual system that wants to dehumanize the people within it.

Chrissie Ott (20:05)
Yes.

So when you found yourself there, having panic attacks facing normal routine procedures, what was the conclusion for you?

Mel (20:15)
that time.

Chrissie Ott (20:16)
at that time and the time after.

Mel (20:19)
Okay.

I thought that I was broken and something was horribly wrong with me. And I remember crossing the street in a, I had a bout of insomnia of about three months and I was just anxious all the time. I was terrified. I was scared all the time. And I was crossing the street from my, from my, hospital where I was doing surgery and I was still doing surgery throughout all of this and seeing patients and about to go to my office and I was not paying attention. I almost got hit by a car and my brain offered up.

if only I would have been hit, things would be so much easier, which is one of those desperation escapism thoughts. And it was really scary when that came up. And that moment is very much burned into my brain. And then a moment when my daughter was saying something and I had fear on my face, because I always did. That was my baseline, just fear. And my son said to my daughter,

Chrissie Ott (20:54)
Yeah, I'm so sorry.

Mel (21:12)
Nora, stop that. You're scaring mama. And I was like, my gosh. Like, my kids think they can manage my emotions. And so I had to do something. And I started to desperately try to find help. And I was searching everywhere. So psychiatry, therapy. was looking for somebody overseas who could help with insomnia. I was like, I'll go to England. I don't care. Just trying to figure out whatever. light, like an infrared.

Chrissie Ott (21:39)
Why overseas?

Mel (21:40)
I've tried all of the meds that are available here and I found some insomnia clinic in England that I was like, maybe they have some new med. And I was like, okay, I'll try that. Yeah. Yes. Give me an answer. I read all of the books. I was listening to all these anti-anxiety podcasts. I was just trying to figure out myself and I would go into psychiatry. I saw a psychiatrist and he misdiagnosed me and tried me on like...

Chrissie Ott (21:50)
a new answer for me. I'll find it.

Mel (22:08)
Gabapentin and I don't know, all these weird meds that were not at all effective. And he didn't seem to know at all what was going on with me whatsoever. And so I lost a lot of faith in that. I met with a therapist who I didn't connect with. It was just like a lot of like misses and then, And so my friend was like, well, she had lost her father and she worked with a grief coach who was actually a high school friend of hers. And that

Chrissie Ott (22:25)
Let it miss us.

Mel (22:34)
coach had lost her mother suddenly. So she went through her own death and rebirth and all of that grieving process and came out of it the other side, a better person and like all of these tools. And so my friend was like, Hey, you got to talk to her. And I was pushing back and pushing back. And then finally, I talked to her and then coaching was introduced to me. And that was what ultimately helped me arrive. I realize now like trauma is very healable. If you're in a space where you can tell your story and

really give like your authentic take on it without fear of being seen without fear of being judged. And you have a compassionate witness. And I think that was probably like the most healing part was just being in the space of somebody who's really truly compassionate and not judgmental at all. Not to say that therapists or psychiatrists are but they have an agenda. It seems I don't know I think a lot of them do and that

as humans as highly sensitive social creatures, we can tell when somebody has an agenda and I could tell that the people who are treating me did and I found a psychiatrist ultimately who didn't have an agenda and who has been really wonderful.

Chrissie Ott (23:40)
Yes, your neuroception was informing you of the perception that, you know, it's probably somewhere accurate, even if unintentional. You're really describing, you know, post-traumatic growth. And yes, burnout can absolutely be labeled I wonder if you would agree now.

that your insomnia derived primarily from your sympathetic nervous system just being completely dysregulated in that phase of burnout.

Mel (24:13)
100%. Yeah. A very dysregulated nervous system. was like my human animal was grabbing me and saying like, you cannot ignore this and compartmentalize this anymore. I will not allow you to. You're not going to sleep and you're not going to be able to do your job.

Chrissie Ott (24:28)
Yeah, it's an extreme version of a tale as old as time in this corner of the universe. Your particular lived version of it. Thank you for sharing what that was like. And I'm so glad that your friend pestered you and that you found a coach that helped you tell your story in a safe space.

Mel, I'm aware that one of the adventures that you're on right now is a collaboration called the Hippocratic Collective. And I would love to just share with our listeners a little bit about what's going on and what you and Frances and your collaborators want it to become.

Mel (25:06)
Yes, the Hippocratic Collective is antithetical to the current culture of medicine, which is very comparative. And it believes that you cannot have a voice until you produce so much so that you are now considered important until you have so many research papers or you are now a professor or you are now considered an authority or a giant in your field. And

At the Hippocratic Collective, we believe everybody has a voice and we celebrate all physicians and all not yet physicians, medical students, medical students, residents. You have all of these people along this journey at all these different levels and we can celebrate everyone no matter what level they're at and they all have a voice. And so that is what the mission is, is to give every single physician a voice. You don't have to wait till you grow up into an old crusty, highly published professor to...

Chrissie Ott (25:58)
Yes.

Mel (25:58)
Let

your voice be heard.

Chrissie Ott (26:00)
Yes, not only give them a voice, but give them a voice now. Yes, the book that somebody writes at 21 is different than the book they write at 41, but that doesn't mean it doesn't have value.

Mel (26:03)
now because you have a very important piece.

Yes.

It's it's not vertical.

Chrissie Ott (26:13)
I mean, what if somebody told

Mel (26:15)
So I hear stories all the time about this compare and pretend model, which seems to poison all of academia, where you have all of these human beings and they're all supposed to be working together and working beside one another and elevating each other and helping each other and sharing ideas and innovating collaborating. But what they're really trying to do is climb some imaginary ladder and be the person who wins. I don't know what you win, but

They are more likely to throw people under the bus. Even reporting systems, there's a lot of weaponization of the reporting system among each other and try to stomp over one another to get the next chair, for example, and try to get more cases. There's a lot of looking at the schedule and cherry picking the types of patients you get. That's a big problem, both in private practice and in academia.

it's a lot of like me, me, me, what can I get? Whatever your desire is, choose your flavor, power, status, wealth. You're like, I need to win the power, the status and the wealth. And if I win it, then then I'm at the top. And like, I'm like, yurtle the turtle from Dr. Seuss. But if somebody else wins it, there's not gonna be enough for me. It's like the zero sum game mindset where you think it's a limited resource. It's not a limitless resource. And so you can't share.

Chrissie Ott (27:23)
you

Mel (27:34)
And that makes you show up, a lot of people show up to their job, not as their true self, because they have this agenda, this ego-based agenda, that they're trying to get their power, wealth, whatever motivates them, and they just show up like creepy weirdos, and they don't talk to each other like actual humans. the normal.

Chrissie Ott (27:52)
weirdos. love that so succinct and accurate.

be creepy weirdo at good. This is so good. I mean, and I want to say it's not just academia. I mean, the power, status, pursuit, know, overflows into whatever humans are doing and believing is a ultimately competitive problem that is a zero sum game.

Mel (28:13)
Yes.

Chrissie Ott (28:14)
So I think about it in entrepreneuria as well. I just made that word up and I like it. ⁓ It is the same for many people who are trying to create a business out of coaching or consulting or doing other creative service work. And you you and I have been in some of the same spaces learning from, you know, marketing teachers like Stacey Bayman, who talks about

Mel (28:17)
Yes!

I like it too.

Chrissie Ott (28:43)
Getting yourself out of get energy where you're trying to solve this me, me, me problem and remembering that actually this is a great honor. It is a great honor to be of service. Being of service is what's beautiful about this work and everything else actually will take care of itself when you put that at the center of your

Mel (29:03)
Yes, that is exactly the message that every physician needs to hear and tell themselves over and over again, is if I show up in service, whatever the thing that I'm trying to get after, whatever the power, the status or the wealth is, it will follow. It has to be the second thing.

Chrissie Ott (29:09)
Mm-hmm.

It's so, so true. You can feel the energy shift when you lean into that. I will not get into details, but I will just share real briefly that, our family has been involved with a clinician who accidentally has shown how immersed they are in get energy that

they stepped out of centering what the patient needed because they were going to profit less enthusiastically. And it is really disappointing. It's actually in our business unethical because we have a fiduciary obligation to patients, whether we are in traditional payment models or direct payment models, the fiduciary

consideration in my opinion does not waver. It does get complicated.

Mel (30:20)
That's so funny that you say that because that's not what people follow. Do they not know about the fiduciary responsibility? Can people be told about that? Or do they even care? I don't know. I guess I can say I get it because again, this is like a systematic thing. And as a human in a system and as someone who is in private practice and I'm doing a very lucrative procedure and I'm sitting with a patient and I know how much I'm getting compensated and I can either...

Chrissie Ott (30:27)
you

Maybe.

Mel (30:49)
offer them the ⁓ procedure in the hospital or in the surgery center that pay me maybe $3,000, $4,000, or I could offer them an office-based procedure where they could have the same exact results and I could get compensated $15,000. Now, subconsciously, if you're not aware of that, you're going to push for the more lucrative procedure. And what happens is that

Chrissie Ott (31:05)
Hmm.

Mel (31:15)
this is a common thing in ENT and it's called balloon sinuplasty. So we say like, you balloon anybody who has a pulse. Suddenly you start seeing sinus disease where there is no sinus disease and you start offering it to everyone. And what's motivating you, it's that compensation that is so common. And it's really unfortunate because it's that kind of mindset that poisons the water. But I was, I felt it, I felt it. And I had to stop and say,

Excuse me, Mel, what's happening here? Like you will not be doing that. You will not be convincing patients to have a procedure because you get paid well. That is the most disgusting, icky, gross thing. And so I had to be very cognizant of myself and like very aware that I was always asking myself, what is the right thing for this patient? Take all of the other information and throw it out. And what does the patient need? And I stopped caring what I was being compensated. I just trusted it would all come.

Chrissie Ott (31:51)
Yes.

I mean, it's a surprising moment for me of thinking like this is actually one of the potential arguments for having, you know, a traditional payment model of some kind that distances professional service providers and clinicians from.

the payment directly from their patients. I think that we can easily dilute ourselves into thinking that we are on the up and up. We're not good self-reporters when we've been swayed, which is why big pharma isn't allowed in a lot of places anymore because we would prescribe based on influence, even though we reported to ourselves and others that we were not influenced by these things. In other businesses,

there is actually some transparency required, right? Like the FCC requires you to say, hey, I got this ⁓ can of bubbly water for free, and I'm telling you it's delicious, but I need to tell you that it was actually a promo gift, and this is an advertisement of some kind. In medicine, there's so little transparency, as you and I both know.

Mel (33:06)
Yes

Chrissie Ott (33:16)
It's almost like, well, I need you to know that you could have it at the hospital or the thing. I get paid differently. I get paid more in this situation. And I want you to know that so that all of us have information together so that you can choose the thing that works for you and know that I am not wanting to unduly influence you. But that's a lot of words and time and awkward communication to say.

I'm happy to do your balloon sinuplasty in any place. It makes sense for you.

Mel (33:47)
Yeah.

And it's not to say that balloon sinulasty is a bad procedure. I did it all the time, you know, but I was very choosy in who it was right for. And I made sure that they understood difference and it was completely in their court to decide. But this requires us to stop living unconsciously.

Chrissie Ott (33:51)
Thank

Say it again, girl.

Mel (34:09)
Yeah. And so that's

the first step. Like, I don't care how many words that I would love to sit there and say, this is how much I'd be compensated if I did it here. This is how much I compensated there. I don't want to make this decision based on that. I want you to know that in full transparency. But nobody can arrive at having that conversation until they live consciously. And most, think, surgeons, I'm realizing most physicians are living unconsciously.

Chrissie Ott (34:32)
I mean, most humans, we're not set up in a era of super high consciousness, although we have more access to the tools of consciousness raising than ever before. They are sitting right next to Instagram and other distracting items.

Mel (34:52)
Yeah. And I was living unconsciously and then I started suffering and that's why suffering is so wonderful because it makes you pay attention to it.

Chrissie Ott (35:00)
I like that reframe. That's why suffering is so wonderful. I have a premise that I live by that I was inspired by my own teacher, you know, with this thought, but it's basically made no suffering go untransformed. Now, if we are to suffer, and PS, we are to suffer.

Mel (35:04)
It's the best.

Chrissie Ott (35:23)
May we at least find the gems within that suffering and offer them to others. May they be of service.

Mel (35:32)
Yes. And I think Stacey Bayman said something similar, something along the lines of saying life happens for you is just so coachy and not true and doesn't feel true. But life just happens, whether it's for you or to you, it doesn't matter. And really shitty things happen in the world all the time. We can resist it. We can rail against reality or we can say, okay, that shitty thing is happening. And then that space after the shitty thing is for us.

That's also very Viktor Franklid. I think he has a quote about the space between the stimulus and the response.

Chrissie Ott (36:11)
and resonates deeply. All of this came out of people having a voice at different stages of training in Hippocratic Collective. So I loved that whole, Tangea, thank you. When I started the physician group coaching program, ROAR, last year, the ROAR acronym was about reclaiming our brains, which is also to say living consciously.

owning our power, so finding empowerment, accessing our joy, and raising our vibes and voices. Which is like just, it was just like a full body yes, like I must create this program, I must hold space for these pillars, this is what it's about, this is what I want to give physicians access to long term. And having a voice is so

Mel (36:47)
Love it. Full chills.

Chrissie Ott (37:06)
amazing. I feel like it took me well into my 40s to realize that I didn't have to wait for somebody else to decide that my thoughts were worth sharing. To be discovered, right? Like, no, I actually discovered my own value and I am happy to share it because it delights me and sometimes it's of service to others.

Mel (37:34)
And that's like, you're touching on the intention behind the sharing. We forget that we're doing it for ourselves. We have to do it for ourselves first. have to create the thing and put it out in the world for us. If we're doing it for others, that's not creation, that's consumerism.

And by others, I mean like, so others will buy or so that we will be famous so that people will...

Chrissie Ott (37:54)
Yes!

Mel (37:59)
look at us and like us and we will have a million followers. And yes, yeah. So that don't mean like in service of others, but for the popularity and for the eyeballs.

Chrissie Ott (38:02)
get energy.

Yeah, it erodes the authentic energy of the offering from the Yeah. I'm aware that Hippocratic Collective also has a performing artist fellowship. I might get some words wrong. Please tell me about that. Because when I saw that in whatever, you know, feed reel it came through, part of me just started jumping up and down as a former performing artist. I was just like, my gosh, what? So please share.

Mel (38:15)
Mm-hmm.

So good. Wait, what kind of performing artist were you?

Chrissie Ott (38:43)
I was a dancer.

Mel (38:45)
What kind of dance?

Chrissie Ott (38:46)
⁓ many kinds. I was a pre-professional ballet dancer. And then after enough time with anorexia, and the infantilization of young adults in ballet, I decided to be a modern dancer, which was much healthier, but still eventually not aligned with my long-term values. How, what about you?

Mel (39:03)
Okay, wow.

Well, my performing arts, I have none. ⁓ I can't sing. I don't dance well. I am not the artist in residence. They did not select me at the Hippocratic Collective. I would be doing like the running man from like the 80s. And I have like the fists. don't know. I dance like I'm not a good dancer. But.

Chrissie Ott (39:08)
you

you

my gosh, so funny.

Mel (39:29)
So yeah, the Artisan Residence, we have that. We have this fellowship. we choose someone who wants to take the money that we offer them, this grant that we offer, and to do something that will impact the profession of medicine. And so currently, our Artisan Resident is Mahitha, who is a urology resident out in the, she's out near you. She's out in the West Coast. And she is also a dancer.

a very talented dancer. And she has the vision of translating a patient's experience and translating what it's like to go through a diagnosis and treatment in dance. And so she has a video, you can look it up on YouTube of a woman being diagnosed with lung cancer that is displayed in traditional Indian dance is the form that she does it. But she does the traditional Indian dance and she also

does modern hip hop and all of these kinds of things. So it's really fun to see the two worlds come together.

Chrissie Ott (40:31)
That's wild. I can't wait to do that. What are the other spokes of the Hippocratic Collective wheel? I know there's also a publishing arm.

Mel (40:39)
Yes, we have a publishing arm where you can edit and proofread. offer editing, proofreading, design and layout, publishing and distribution, marketing and promotion. We have a course creation arm, a podcasting arm, digital marketing, video production. We have an editor that is very busy currently, videographer. So if somebody decided, ⁓ I have a story to tell, they want to tell it either in writing or...

with their own voice, they can do that. They can contact the Hippocratic Collective and decide to publish a book through the Hippocratic Press, or they can start a podcast if they so wish. But as we start to grow, because we are the only physician-owned company that offers this, there are seven physician co-founders, one non-physician co-founder, so there's eight total, and we all bring different things. So it's really fun. We have a pediatrician, OB-GYN, I'm ENT.

Frances May is the primary co-founder. She's ENT. We have a family practice doctor out in Canada. We have another actually ENT who's facial plastics. And she is so amazing because she finished her, partially finished her fellowship. That's a whole story, but left it for very good reason. And then started her own plastic surgery business. She didn't go into academics or.

perpetual employment or private practice. She just went straight into pay me money for the services that I offer. And she did it. And her mission is to create a business where she supports her employees like no other. She gives people time off. She's so thoughtful in how she takes care of her employees. She wants her employees to be really happy human beings. And so that's what moves her. And she's created this business after three years. She's very successful. And then we have pediatrician.

and a pediatric GI doctor. And then our artist in resident who was before Mahitha is Tyler Beauchamp, who is a young adult author and wrote the book Freeze Frame. And he's also creating this other medical type fiction world that he's going to, I'm hoping, I think he's going to try and get it made into a movie where the idea is...

there's these kids who are trying to fight these monsters that look like this imaginary world in this imaginary town that kind of resemble the actual disease. So there's like a rhino virus that is like a big old rhinoceros. And the way that you fight the disease has something to do with like how you treat the disease. So it's again, the marrying of the left and the right hemisphere where you have medicine with all the knowledge and all of the facts that you incorporate and then you regurgitate just, you know, black and white thinking. And then you have

the creative brain where it's like, okay, what can I create from this? What has never been done before?

Chrissie Ott (43:21)
I love that.

I am so happy that there's an artist in residence opportunity for clinicians. There are so many of us who have some, you know, creative skills, some artistic skill that needs to be highlighted and just to have a venue for that is so exciting to me. In order to follow along with

what's happening with Hippocratic Collective? Do you guys do a newsletter or is the best way to follow on Instagram or what do you think?

Mel (43:52)
Yes.

Follow Instagram. We do have a newsletter. We publish progress notes. And so we have people write little things that are in the zeitgeist. And that will be shared with on Instagram and in our newsletter. And so definitely go to Hippocratic-Collective.com, sign up for the newsletter, follow us on Instagram. Like I said, there's nothing else like this. We want to be the barstool sports of medicine eventually.

And we're hoping to eventually have some sort of live events where we have speakers and all of the things, maybe dances, who knows?

Chrissie Ott (44:27)
Barstool sports of medicine. need an interpretation. What is a barstool?

Mel (44:33)
Okay, I'll try. It's

from my understanding. mean, I know who David Portnoy is. Maybe your listeners don't know who this is, but he's he basically revolutionized and changed how you do sports reporting. A lot of people know who Bars Tool Sports is, what the company is, even if you don't follow sports. I don't follow sports, but they're very popular. They're funny. It's a group of people who are like, we're going to report on sports in this new way. And so it's kind of like journal.

a journalizing or journalifying medicine, medical culture in a new way like they did for sports.

Chrissie Ott (45:09)
Okay, thanks for explaining that to Cool, I can't wait to follow along. And also, I know you speak primarily to surgeons. So if there is a surgeon who listens today and is like, could use some of what she's got, how do they find and follow you?

Mel (45:24)
You can follow me on Instagram at the underscore surgeon underscore coach, or you can go to my website, melthackercoaching.com. And I do have a course that is enrolling empowered surgeons group we meet every Wednesday, it's so healing. 4pm Eastern Time. It's very important that you make time for it. But if you can't, can listen to the recordings. We have some live events coming up. I'll be in Chicago October six for a free event at the London house during

the American College of Surgeons and American Women Surgeons are all in Chicago for their annual meeting. It's ticketed and it's as though it's free, we need RSVP. So it will be capped at about 35 people. I don't know if this will be out by then. And then we'll be doing an actual live event in Cabo in January for women surgeons only.

Chrissie Ott (46:08)
Fun,

Mel (46:09)
So good.

Chrissie Ott (46:10)
what a delight. Always. I cannot wait till our paths are crossing more frequently. I'm so excited by the many things that you are doing with your insights and intentions.

Mel (46:24)
Yeah, thank you. And I'm so excited to meet you, like to finally connect with you and really sit down with you for a long period of time and have this conversation. So thank you.

Chrissie Ott (46:33)
Yeah, absolutely.

Chrissie Ott (46:36)
Thank you so much for spending this time with us today. It is truly an honor and a privilege to have you with us. We release a new episode of Solving for Joy every Tuesday. So if you enjoyed this time, we'd love to have you back. Please hit subscribe, follow along, and leave us a review if you feel so inclined. We read and celebrate every single one. If you're curious about ways we could work together, my services include coaching with individuals,

Consulting with families navigating the complex US healthcare system, and specialized obesity medicine care for children and adults in Oregon and California. You can learn more about all of these at chrissieottmd.com.

Chrissie Ott (47:22)
Thank you again to Dr. Mel Thacker for your candor, courage, and service. Your story and the way you turn suffering into fuel offers so much help for the rest of us. Next week, I'm joined by Dr. Sheeta Shafi, emergency physician, performance coach extraordinaire, and co-host of the Physician Coaching Summit. If you're a busy clinician craving more energy alignment and doable rituals that lift your baseline, this one's for you.

We talk high vibe Sundays, three minute dance resets and designing a life that supports the work you are here to do. And if you're a physician coach or coaching curious, the Physician Coaching Summit is coming up. We would love to see you there. Details are at the physiciancoachingsummit.com. As always, a quick note before we go, I'm a doctor, but not your doctor. This podcast is for education and connection only and is not to be construed as medical advice. Please speak with your own clinician about your specific situation.

Deep thanks as always to our fabulous producer, Kelsey Vaughn, to Sue, my partner in all the adventures, and to you. I'm so glad you're here. You're the reason we make this show. Thank you for spending this part of your day with us. May we move when the day feels heavy, make simple rituals that raise our baseline, and remember, we're allowed to choose joy on purpose. I'll see you next Tuesday.