Dr Nina Su is a paediatric and emergency junior doctor in Aotearoa, New Zealand. Working within healthcare systems which increasingly felt "like a revolving door" inspired Nina to create her podcast "Revolving Door Syndrome"

"We make patients a bit better, only to send them back to the environment that made them sick in the first place," explained Nina.

"Healthcare, education and justice systems are intricately connected and it's only by breaking down these silos that we can begin to form more effective policies and positive change."

Revolving Door Syndrome podcast brings you engaging dialogue from people who work in or have experienced these systems focussing on systemic issues and potential solutions to inequities for vulnerable groups.

We caught up with Nina to find out a bit more about what inspired her podcast and the ground she has managed to break so far.

From a young age Nina knew that she wanted to follow a career path where she could help people.

"I remember in high school when a past student became a nurse on the Mercy Ships and I thought 'wow, I could really help someone through healthcare like that one day."

It was this driving force that led her into a career in medicine. "It's very cliche, I know, but I have always wanted to help people. Striving for equity and bringing up the most vulnerable people has always been a core driver for my work."

Now, she has found her passion in paediatrics. "I love working with children because I love seeing how they see the world with such wonder. Admittedly I also have a strong affection for emergency care because I enjoy the wide spectrum of patients and types of illness I get to see and treat."

The Revolving Door Syndrome podcast:

Working in emergency medicine, Nina sees patients "at their most vulnerable." "It becomes so easy to see the issues people have in accessing health and the impact of poor social supports has on their health outcomes, explained Nina.

Nina would go home and express her frustration at the issues she was seeing, both in healthcare and wider society, to her partner. He suggested the she harness this energy into a podcast to "drive these difficult conversations and make some change."

Revolving Door Syndrome is named for Nina's feeling of futility of treating patients' illnesses only for them to become sick again due to our unhealthy environments.

"The podcast allows us to try and address issues at the root cause. If we are able to show people what the issues are straight from the people who need the help, perhaps we can come up with some better understanding and more effective solutions," Nina explained.

One of the most meaningful interviews for Nina was with Cherie Kurarangi. Cherie is a wahine from Hawke's Bay and is a member of a women-only chapter of the Mongrel Mob.

"I saw a short interview with her on the news a few months ago talking about the work she is doing to help vulnerable gang-affiliated families and I thought, I have to talk to this woman. Cherie is a bridge between the gang-community and health and social services. She works so hard to get better outcomes for gang whanau because we know that gang affiliated whanau have worse health, education and justice outcomes in every measure. She shared some harrowing stories of her own upbringing being shipped around 17 different foster homes before she turned 18, of women who have been sexually assaulted but don't feel safe to access emergency care because they're labelled as gang affiliated. She uses her trauma and experiences to try to break the cycle for others. I learned that the founders of many of the gangs in New Zealand were products of state care and I think we should all really ask ourselves what was it in state care that made people  behave in such destructive ways. At the end of the day, people join gangs for a sense of whanau and belonging when they don't feel accepted in society. If we are concerned with gang-related violence, crime, and incarceration, we all have a role in fixing this. "

Nina's listeners say that as a result of this podcast they feel more inspired to speak out about these wider societal issues.

"A lot of them are already somewhat aware of these issues at a surface level but by hearing about these stories first-hand from people wanting to share their experiences, it becomes easier to see people as more than a statistic."

Nina believes her podcast will be important for the medical industry as well: "A lot of medical training inadvertently dehumanises people and still encourages a paternalistic relationship. My fellow junior doctors are seeing that health is much more than the narrow aspects of treating diseases and it's our duty to look at what we can do to start being the ambulance at the top of the cliff."

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Listen to the podcast:

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Alessandro Demaio, known as Sandro, is a doctor on an unconventional path who’s having a big impact on global public health.

Sandro initially trained as a doctor in Melbourne. He wanted to become a General Practitioner in rural Australia with a white picket fence and a vegetable garden. However, opportunities he took up in Medical School led him to take a different approach to his career as a doctor.

During a clinical care placement in a rural community north of Mt Isa (Queensland, Australia), Sandro saw a mother and a young child walk into the clinic. The young child was holding a Coke bottle almost as large as herself. This sparked an interest in global public health for Sandro, who began to realise that the 20-year difference in life expectancy between rural and urban Australians had more to do with the system we’ve created than individual ignorance.

In 2015, Medworld Institute founder Dr Sam Hazledine talked to Dr Alessandro Demaio, who is on a mission to raise public awareness of non-communicable diseases (NCDs).

Experiences working in Indonesia after the Boxing Day tsunami cemented Sandro’s interest in public health and the systems surrounding it. He was shocked and surprised that so many deaths were the result of treatable illnesses.

After finishing his training as a doctor, Sandro completed a Master’s in Public Health. In 2010, he moved to Denmark to begin a PhD Fellowship in Global Health, focusing on non-communicable diseases (NCDs).

In 2013, Sandro co-founded NCD Free, a global social movement which aims to help curb the rise of NCDs—over 2.5 million people connected with the project in the first 18 months. NCDs encompass a wide range of diseases that result from behavioural or environmental issues. Lung disease, heart disease and diabetes all fall into the category of NCDs, which Sandro says have not been in the public health spotlight in the past. He’s also part of the multi-disciplined team behind Melbourne-based Festival 21, which encourages thousands of young people to celebrate and discuss community, food and our future.

He quotes Margaret Chan and reminds us that “the difference between NCDs and malaria is the mosquito didn’t have a multi-billion-dollar lobby for it.”

Sandro is an outstanding example of the broader role that those with a medical degree can play in working towards a better society.

“When there is a Royal Children’s Hospital in Melbourne with a McDonald’s built in the centre of it, that’s something the medical community should be arguing is not appropriate […] not just for the patients but also the message it sends to young people and the community.”

Sandro holds a Post-Doctorate Fellowship at Harvard and continues a part-time role as an assistant professor at the Copenhagen School of Global Health. He also serves on the advisory board of EAT, a global multi-stakeholder platform for food, health and environmental sustainability.

Usually considered the problem of ‘lazy, fat, white American men’, NCDs are actually affecting a huge proportion of our global society, particularly the poorest and marginalised in our society. Some of these issues surround food and how it is marketed. In conversation with Medworld Institutes’ Dr Sam Hazeldine, Sandro talks about the causes behind many of these diseases and how doctors, particularly General Practitioners and those in primary health care, can make a massive difference.  

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Key thoughts from Dr Alessandro Demaio’s interview:

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1)    You don’t have to follow the beaten path

Though it’s tempting to follow the beaten path we’re taught at Med School, many exceptional doctors don’t follow a traditional career path. Alessandro Demaio’s day-to-day life is very different from what he imagined when he began medical school. He once wanted to be a general practitioner in rural Australia with a picket fence and a vegetable garden. Still, he found himself passionate about making a difference in global public health, managing global movements like NCD Free.

“It’s not been easy,” Alessandro admits.

“I felt a lot of pressure to maintain that path, that conveyor belt style sort of path that is clinical training [but], if more doctors were into a range of different areas, society and the medical community, would be much better.”

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2)    Reach out to your community and ask big questions

NCDs are one of the most significant issues facing the 21st century. It’s perhaps due to a lack of education or miseducation. In part, preventive care is about reaching out to people, dropping the jargon, and communicating in the real world – on social media, blogging, or public speaking- to help spread awareness and understanding of health issues.

“How do we have these big conversations that, quite frankly, not many people want to have?” asks Alessandro.

“We talk about these issues through things that we love […] instead of talking about obesity, let’s talk about food. Food is something we love. It’s something we celebrate.”

How you pose the question and communicate with people is important to success.

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3)    Create balance and meditate!

Doctors are among the groups most at risk of developing NCDs. We all know that overworking and stress contribute to ill health, yet doctors are some of the biggest culprits. Young doctors, in particular, feel pressure and responsibility to undertake unrealistic workloads, whether it’s an effort to create good outcomes for a patient or to get into a competitive training programme. But it’s not good for us.

Alessandro emphasises the importance of creating balance in our lives. He suggests listening to a podcast unrelated to medicine or spending time with friends and family. He also advocates meditation and mindfulness techniques.

“I’m not getting any younger, and I realise that you have to take care of the body that you have because you can’t just swap it out for another when it hits 50,000 miles!” He says.

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4)    Enjoy the journey, and don’t underestimate your ability to make a difference

Don’t ever question the impact you can achieve—aim high! But don’t forget to enjoy the journey either. Like Alessandro, your medical degree may lead you to a path you never expected to follow.

“I know it sounds really cliché, but enjoy the journey and be okay with exploring things, be okay with taking a year off and travelling around Australia and doing locum work, be okay with going and trying a different profession or applying your skills somewhere else,” says Alessandro.

As a doctor, you have many opportunities available to you. Whether locum work across New Zealand and Australia or taking a year out to travel and explore the world, take advantage of the opportunities available to you… you never know what successes they may bring!

Listen to the full podcast here:

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Dr Rolf Gomes is the Queensland nominee for Australian of the Year 2021. He holds a Bachelor of Engineering from the University of Melbourne and is the Founding Father of Heart of Australia.

Heart of Australia delivers monthly specialist medical investigation and treatment clinics to regional, rural, and remote area communities across Queensland. With over 10,000 patients seen and 400 lives saved, it’s no wonder this man is up for such a prestigious award.

Dr Rolf Gomes' parents migrated from Calcutta when he was nine. He grew up in Melbourne's East St Kilda in 1982 when it was still a “relatively rough neighbourhood.”

He remembers loving his new life in Australia: “I was nine years old. I loved television, traffic lights, and BMX Bikes!”

Dr Gomes is acutely aware that his parents left everything in Calcutta to come to a country that offered more opportunities for their children. “I remember my father saying he stepped off the plane with four suitcases, four children, and $200.” 

His gratitude for his life in Australia is unwavering. He praises it as “such a fantastic country,” and he does not miss his parents' sacrifices.  

“I remember catching a rickshaw to school back in Calcutta when I was eight years old and seeing beggars and kids sitting on planks of wood and carpet riddled with polio. You suddenly realise what a different world you are in and how lucky you are to be here!” 

His childhood experiences in a third-world country contributed to his gratitude for his lifestyle, country, and ability to do what he was doing. These early experiences inspired Gomes to make a life around giving back. ‍

Starting Heart of Australia:

“One great benefit of not having much is that you don’t have much to lose - “I  didn’t have a reputation to lose or any money to lose”, Gomes explained when talking about the moment he decided to create the Heart of Australia “Heart Truck.”  

“I was getting to the end of my cardiology training and looking to give back to a country that had given me everything.” The Heart Bus was launched in 2014. To get to this point, he had campaigned for the Federal Government, secured some like-minded sponsors, and remortgaged his family home. 

“Studying engineering previously is instilled in your being. Engineers, they like to make things happen,” Gomes explained.  

The idea came to him while working as a junior doctor in the regional areas. He noticed the lack of services firsthand and wondered how to bring specialists with their equipment to the region. 

“For cardiology, it’s not just a stethoscope; it’s a treadmill and stuff you can’t fit into a suitcase and take on a plane - so why not the back of a truck?” The engineer in him had asked. “In engineering, you look at the problem and try to map out the steps and what options you have in front of you to achieve that.” 

The truck started off servicing five towns with two specialists. Now, they are up to 33 towns and have 23 specialists. They are about to launch a fifth truck complete with a CT Scanner.

Mixing creativity and data: 

Medicine is built on data, studies, trials, and more studies, but Gomes suggests it was mixing medicine with an engineering background that got the truck onto the road. “Stepping out of the traditional mindset into a more innovative mindset can be difficult,” Gomes explained.

In 2011, he saw a paper published by the Australian Bureau of Statistics. It said if you lived outside of major cities, you were 44% more likely to die of heart disease. “I thought in a first-world country, we can probably do a bit better than that.” 

“There have been studies, and blue papers, and white papers, and pillars, and pathway documents talking about making health care more accessible. I was quite happy for people to keep doing the research, but I just wanted to get going and make sure people weren’t dying in the meantime.” 

Gomes explained that medicine is a very traditional profession, and you can understand why. You are dealing with human lives, so you want to ensure you are not pushing the boundaries too far. However, Gomes suggests that when you take the logistical aspects of a trade like engineering and mix them with medicine, innovation happens.

“People, I think, have an over-reliance on data. Data has a role and is very useful, so don’t get me wrong! But you hear very profound sayings, like “without the data, all you have is an opinion”, and the truth is data has no relevance to the imagination.” 

Data tells you the facts, which is very important, especially in medicine. Still, it takes imagination to dream new ways of doing things, innovate, and chase aspirational goals.

“Having a good imagination and creativity has very little to do with data. It’s something that I don't think people appreciate. Data can tell you where you’ve been and provide some guidance of where to go, but having the imagination and the courage to follow it is also very beneficial.”‍

How finding your ‘why’ can help you lead a burnout-free career: ‍

Dr Rolf Gomes works tirelessly; he started the Heart Truck in 2014 and still works in it today. He tucks his children into bed at night and then goes off to the hospital for a nine-hour shift, and yet, he has never experienced burnout. Gomes attributes this to staying clear on his “why.” 

“The interest in what I was doing was the sustaining factor. You believe in the benefits, and that causes the lines between work and fun to blur. I feel very fortunate to be living in this world, and I enjoy doing my job so much that it’s not a chore to do it.” 

Gomes explains that he has never felt at risk of burnout. His parents brought him to this country with nothing and instilled in him gratitude for the country, his job, and an incredible work ethic.

Dr Hazledine explained that he had done extensive research and interviewed many doctors who had experienced burnout. The one thing all the doctors who were not burnt out and thriving had in common was “purpose.”

The one thing the burnt-out doctors had in common was that they had become disconnected from their purpose, causing exhaustion, increased mental distance, and/or feelings of cynicism. 

To avoid burnout, don’t just go through the motions, take the time to reflect on the impact that you’ve had. “My purpose protected me the most, focusing on my why. I go out there on the weekend, see 20 patients, and I come back, and I think they are so lucky they turned up for an appointment on the truck - it’s very rewarding,” Gomes explained. 

“Around Christmas time, I get sentimental. I often find myself closing my eyes and just thinking about all the faces and conversations I've met on the truck and how very lucky they are to be with their families that time of year.” ‍

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Some tips from Dr Rolf Gomes on combating burnout include: ‍

1. Try to recapture that feeling you had while waiting to be called in for your medical school interview. Where was your mind? Where was your heart? You were so excited! Saving people’s lives and easing suffering—this will be great.

2. Try to find social significance and community-oriented work - this creates a healthy existence

3. Accept sometimes you are too busy, and it’s OK to say no. 

4. When you spend time with your family, make sure you have quality time with them and are present. You have to make a little sacrifice when you have a family.

‍‍Dr Sam Hazledine to Dr Rolf Gomes, “If you could return to your 18-year-old self, what are the three most important things you have learned?”

1. Always maintain honesty and integrity.

2. Do not dismiss your ideas as easily; nurture them and give them a sanctuary. Don’t wait until you’re older to do things. Take action to make them happen. 

3. Listen to yourself; what you know as a person, what you enjoy doing. Don’t be pressured into something you are not innately accustomed to. ‍‍

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‍Dr Sam Hazledine to Dr Rolf Gomes, “How would you like to be remembered?” ‍

“I’d like to be remembered as someone who had the courage to try their best. Someone who tried to follow a moral compass and was mindful that it was pointing in the right direction. A man who stuck to his word and maintained his integrity. Always maintain your integrity. In all your dealings, that is the currency you are trading, and once you have lost that, you have pretty much lost everything.”  

Medworld Founder Dr Sam Hazledine caught up with Dr Gomes on his This Generation podcast to discover what drives him, what prompted this innovation, and how he takes care of himself while doing so much. 

This article included highlights from the show. Dr Gomes has such a fascinating and inspiring story, so we suggest you also take the time to listen to the whole thing.

Dr Danielle Jones, known online as @mamadoctorjones, is a multi-channel social influencer with a couple of million followers. She’s an American (OB/GYN) living and working in Southland, New Zealand. When she spoke out about abortion rights on her public platforms, she received hate messages and lost followers, but that didn’t stop her advocacy. 

Danielle uses her platform to address the challenging areas of medicine in a very engaging way. She also uses her platform for advocacy. 

When the decision to overturn Roe v. Wade was announced in the US, we thought that a former US doctor who practised in the state of Texas and a gynaecologist could shed more light on the situation. 

It was essential to get Dr Jones back onto the This Generation podcast with Dr Sam Hazledine to discuss this decision, what it means for women in the US, and what those outside of the US can do to help. 

‍Roe V. Wade:

On the 24th of June 2022, the US Supreme Court ended constitutional protections for abortion that had been in place for almost 50 years in a decision by its conservative majority to overturn Roe v. Wade. At the time of writing this, the decision has led to abortion bans in nine of the 50 states, with a prediction of more to follow. 

“It’s obviously concerning for a lot of reasons, but the primary reason is that it's going to lead to worse outcomes,” explained Danielle. 

The decision, which seemed unthinkable to many Kiwis, was the culmination of decades of campaigns by abortion opponents, made possible by an emboldened right side of the court that has been supported by three appointees of former US President Donald Trump.

Danielle and other doctors took to social media to share their outrage when the decision broke. 

“We know that banning abortion does not make anyone safer. It only increases the riskiness of procedures that people seek, and delays care to a point where abortions are happening later and later because of inability to access care earlier in the pregnancy.” 

Dr Danielle Jones grew up in a very conservative area of Texas (one of the states that supports the ban).

“I didn't come to a conclusion about things like this on my own...I felt like I was given my ideas and opinions about it as I was growing up.” 

Now Danielle has a platform and a voice. "It became more and more important to me as I got to a place online where I had a voice and where I was in a space where it was safe…It took a long time to really unlearn and re-establish my feelings on this topic….I've been given a platform and hope to use it for the right purposes.” 

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Advocacy and abortion rights:

Regarding advocacy, Dr Danielle Jones says that using her voice for education is her number one priority.

“I work in a field where many things we do are very taboo. People aren't often taught about sex-ed about their own body, about abortion, about seeking abortion in times of dire stress.” 

Danielle wants to be an Internet educator and someone who can reliably convey scientific and evidence-based information in a way that people actually want to consume. 

“I think to really get your point across, you have to be able to explain things in a way that doesn't bore people in the process.” 

Since Danielle started speaking out on the Roe v. Wade decision, her fans have commented, “I really like your content, but you're too political now.”

She explains, “I will stop talking about politics when politics is not in my exam room with my patient.” 

“I didn't choose for politics to come in and start messing with how I can take care of my patients. They forced us into that, and I won't be silent because somebody else has made it my problem. So I will continue to talk about anything, including politics, as long as it affects my patients.” 

Danielle admits that because of her platform, she often feels pressure to speak out about these things. “A voice says, it's your duty. You need to be speaking about this to other people who are silent.” 

Living in New Zealand, it’s easier for Danielle to have a voice on these issues, but she also remembers what it was like for her in Texas.

“I can put myself back in a position where I had a private practice in Texas. My literal safety and my patient population were threatened by me being open about how I felt or advocating for topics like this that were not acceptable in that environment.”

So, she thinks that where doctor advocacy is concerned, "we have to deal with the issue of whether you are safe speaking about it.”

“I think that part of the problem that the United States has right now is these stringent boxes because I will often hear people say, I'm pro-life, I vote pro-life, but if you want to have an abortion, that's not my business...So I don't like the labels. I'm not here to tell anybody what the ethical choice would be or what I would do because it doesn't matter what I would do at the very end of the day. I have a lot of money. I have a lot of social support." 

Dr Sam Hazledine agrees that these “labels are problematic.” “Let's call one pro-life because it feels hard not to be pro-life, doesn't it?” It suggests that if you're not pro-life, you’re pro-death. I mean, what are you?”

Danielle says that Sam has “hit the nail on the head.” “It was an intentional politicisation of this topic during the Reagan administration. It was intentionally made to be something that was clung to by religious people. Before that, most churches were not either stringently opposed or in support of termination in general. It was thought to be an individual's decision that had no place in day-to-day conversation. And it intentionally was made into a political pond to win votes after the Reagan administration.” 

Danielle opens up about how tough it has been. Since speaking up about abortion rights, she has had to ignore comments calling her a murderer (among other things).

What gets her through all the negativity is telling herself it is nothing compared to her patients and what they must go through.

“I had a patient when I was working in Texas who had a lethal fetal anomaly that wasn't diagnosed until 20 plus weeks, and it was cheaper for her to fly to Colorado, have her termination done there, stay in a hotel and fly back, then it would've been to get care in Texas. So that pales in comparison to me having to listen to a bunch of nameless facial city idiots call me names on the internet.” 

Danielle feels that these new laws won’t affect privileged Americans in the same way they will affect the lower-socio.

“I don't think these things will ever affect the people who put them into place, the politicians, their wives, their mistresses, their daughters. They can always access a termination if needed because they can just fly to another state.” 

She explains that some low socio-mothers living in a state like Texas may not have these options. 

“It would've been a 10-hour drive to get to another state, and that state may also not be offering abortion, not to mention they may be completely overloaded in their ability to care for people. So you can expect people to be able to take a week off work when they're already at a socioeconomic disadvantage, they're living in a place where they can't tell anyone why they're taking off work because they will be labelled as a murderer and just ostracised from their community. This is impractical. Of course, this isn't an option for most people.” 

She goes on to express her concerns about "the LGBTQ community and the ability of transgender people to access care and the ability of gender dysphoric children to access puberty blockers, which is a very evidence-based and safe intervention that has a lot of science behind it.”

“And now, you have political leanings coming in and trying to dictate how people get their medical care; it's absolutely insane!”

"I can't even hardly talk about it without getting frustrated because the amount of science we have on these topics and the importance of the ability to access care for both of these things is so evident in the literature – that it just boggles my mind!”

‍How can doctors help advocate:

"I think from the standpoint of having been there, that things that I could have done better when I was working in a place like Texas where my patients can get access to care were making sure that everybody who walked through my door knew that they were in a no-judgment zone and that they could talk to me about whatever they wanted."

Danielle stresses the importance of making your practice a safe place. “I had the experience of working in Texas and then moving to Hawaii to work there for a little while. Hawaii is much more liberal than Texas, and seeing how freely people came in and expected me to be a safe place.” 

Suppose you are a doctor in America, practising in one of the states where a ban is in place. She suggests “educating yourself on options and how to direct your patients to your front desk staff because people will get phone calls about, can I come there for help? And obviously, the answer is not now, but you need to be able to give them well…Here are your resources; here's what you can do.”

She urges New Zealanders and New Zealand doctors not to be complacent. “64% of the more conservative group of politicians (National) here voted against the legalisation of abortion rights.” 

“New Zealand is not safe. Don't get complacent. You have to get out there and use your voice.”

Other than that, Danielle suggests that “just continuing to speak out” is the best option. “Unfortunately, probably what it is going to take is somebody who is white enough and rich enough having a bad outcome (or losing their life) for people to realise that this was such a bad idea.”

“And unfortunately, before we get to that point, I think it will take a lot of people who don't look like that to suffer even worse outcomes before we end up having changed.” 

Danielle describes herself as "a relatively positive person,” but since the decision, “it feels a little bit hopeless…It feels like something really terrible’s going to have to happen before we make actual revisions.” 

Despite this, she remains focused on the difference she can make daily as a doctor. “Taking care of patients and being in the clinic make me feel like it is still worth it to be in this field despite so much contention.” 

Listen to the podcast:

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Dr MeiLan Han is a very busy doctor. She is a professor of medicine in the pulmonary and critical care division at the University of Michigan. She is an accomplished physician, researcher, and academic. She's taken a prominent public advocacy position and, as part of that, serves as a Spokesperson for the American Lung Association. She is an Associate Editor for the American Journal of Respiratory and Critical Care Medicine. She serves on the editorial boards of Thorax, Lancet Respiratory Medicine, and the Journal of the COPD Foundation. She is also a member of the Global Obstructive Lung Disease Scientific Committee, responsible for internationally developing a recognised consensus statement on COPD diagnosis and management. 

Despite all this, she found the time to impart wisdom to Medworld Insitute founder Dr Sam Hazledine on his This Generation podcast.

Dr MeiLan Han grew up in rural Idaho and volunteered as a Candy Striper at the local hospital. “Because of the rural location, it wasn’t very heavily regulated. And I got to do pretty much everything. Assist in the emergency room. I was there for codes and procedures, and I thought it was one of the most exciting and thrilling things I'd ever done.” 

After this experience, MeiLan was hooked. “One of the things that I still value most about medicine, I think that there is so much value in the work, and you can feel good about, you know, doing something interesting, exciting, and at the same time, you're helping people.” 

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Variety in career for combatting burnout:

Michigan, where MeiLan now lives, was in the middle of its fourth stage of COVID-19 when writing this. “I took over as chief of the division here at the University of Michigan in January. And so, I like to think of myself as sort of like, the shepherd in chief.” 

MeiLan explains how the effects of COVID-19 on staff burnout have been “brutal.” “Many of my faculty, particularly; unfortunately, female physicians, I think, have really had it the worst because of childcare impacting them even more so and not being able to get their work done and things like that. 

She feels fortunate that she has been afforded a lot of flexibility in academics, in particular, and that’s one of the things she likes about her career path. 

MeiLan says she has been lucky enough to find a variety of career avenues on which to focus her energy, which has protected her, in a way, from experiencing burnout. 

‍“I had the opportunity to get a master’s degree in clinical research and that led to me then starting to get more involved with research and doing papers. I now have the opportunity to get into advocacy and am trying to push for change at a national and international level.” 

The secret, she says, is to keep reinventing yourself. 

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The importance of finding joy:

"I guess maybe I'm an optimist, but I'm always excited about what that next bend around the corner is going to be."

For MeiLan, it’s about finding joy in every aspect of medicine - which comes down to perspective. For example, when she writes an academic paper, she looks at it as a creative process, “even being in something that seems sort of as cut and dry as research…It's how you present the data, get that message out, and help it have an impact.” 

She explains that it is about finding places where your passions align. For her, this is between medicine and helping other people. 

She says it is about having a philosophy or core values around what’s important to you in place and then keeping yourself open to the universe. 

“I don't know whether you create those opportunities or attract them; I’m not sure which it is.” 

“Have I always gotten every job I've wanted or whatever grant I’ve applied for? Is every paper I've submitted not accepted? Of course not - But ultimately, yes, I have very much learned to enjoy the journey.” 

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Advocacy and her book Breathing Lessons:

MeiLan’s first foray into lung health advocacy was ten years ago when the American Lung Association approached her as their spokesperson. 

“There is a part of me that every time I hear someone say she's an advocate…or social media this…I cringe. Because that's so anti-my usual nature.”

Despite this stigma, MeiLan believes her cause is worth pushing aside these feelings and fighting for.

“One of the things that drove me to enter pulmonary medicine in the first place is that, at least in the US, many of the patients who have chronic lung disease tend to be socioeconomically disadvantaged; they live in rural areas. And I'd always sort of had a heart for that patient population.” 

MeiLan found herself with a group of patients who were struggling. “They weren’t getting funding, we didn't have cures, and somebody needed to help be a voice for them. And so, I think that ultimately got me to just sort of my frustration around the issue.”

She explains that in the United States, pulmonary disease doesn’t receive much attention or public health funding. 

“We don't screen for the disease. We don't create drugs for diseases. And even now with the COVID-19 pandemic, despite that, little has gone into understanding lung disease.”

When COVID-19 struck, the lack of public health funding and research on respiratory diseases contributed to the excess deaths from the pandemic, which spurred MeiLan on. 

“Everything that we saw played out in millions of people across the world during the pandemic. I think we could have done better. So, I think the pandemic sort of helped to confirm my resolve on the importance of this issue, but at the same time, there is part of me that still cringes a bit. “ 

Helping patients is MeiLan’s “true north,” and this inspired her to impart the gift of information to her patients in the form of a book she wrote during the pandemic called Breathing Lessons. 

"It explains to patients how their lungs work, but also, the whole last chapter is all about the crisis of lung health, where we're at right now, and what we need to do to move forward.”

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Ideas as gifts:

Medworld believes that harnessing the collective intelligence of the medical profession could be the answer to healing from within, and MeiLan thinks that everyone has a zone of genius that we can share with others. She explains that imparting that wisdom to others is like giving them a gift—the gift of an idea.

“You can craft your message into a story. Everybody wants to hear a story, right? And the more you craft your message into a story, the more interested people will be in it. And also, to just kind of when you're talking about a concept, to have, I guess, the idea in your mind that you're presenting, you’re framing something for someone in a new way and kind of offering that up as a gift.”

MeiLan says to think about the way you frame the information that you are passing on as if it's a gift. When Sam tells her of Medworld's mission, she agrees: "I love this idea of doctors being able to share their own, you know, sort of nuggets of wisdom on a central site so we can all learn from each other."

She goes on to explain the importance of sharing information within the profession. "You can only learn so much in medical school, but I think 99% of what we learn about being a doctor and how you diagnose and just that art of medicine comes from just doing it and being with patients one-on-one."

‍In conclusion:

Dr Sam Hazldine asks, "If you could go back in time and speak to your 18-year-old self, what are the three most important pieces of advice you would give, whether it’s medical or life advice? What advice would you give to yourself to help yourself live a great life?"

"I think the main message to my younger self would be not to stress out quite so much, not to be quite so anxious and to realise that there's so much room in medicine for so many people to make different kinds of contributions. And everyone will ultimately kind of figure out their own path."

Then, to conclude, he asks, "How do you want to be remembered?"

"You know, it's funny. Someone asked me recently if I thought I was successful. And in many ways, I don't feel particularly successful; I measure my success in terms of winning hearts and minds. And I don't always win my patients' hearts and minds by convincing them to adopt healthier behaviours or take their medications. But you don’t want to on a more, you know, health system-wide or health policy level. There is still so much work to be done. So, I don't know what dent I'll be maybe able to make, but I'm hopeful that I will be remembered as having made some dent in something. 

And make me something permanently better. And so, I don't know which of my multiple swings at the plate will ultimately have an impact, but I pray that one of them does. "

Listen to the podcast:

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Globally, 1 in 3 women have experienced domestic violence, and lockdown has seen cases escalate. This means, sadly, doctors may likely experience patients who have suffered abuse at the hands of their intimate parters, or be experiencing it themselves. 

We caught up with Dr DonDiego, who experienced domestic abuse whilst working the long hours of a doctor.

In 2016, Dr Danielle DonDiego was burnt out. She was working 80-hour weeks, dealing with stressful experiences on the frontline, and at home, she was in an abusive relationship. Now, she has the career and life of her dreams.

Her book Self-Care Rx: A Doctor's Guide to Transformation After Trauma provides advice on the road to recovery after suffering abuse.

"Death by internal self-destruction only begins to show mercy when we have left that abusive relationship or job, stopped turning to food, drugs, and shopping carts to soothe us, and stared the culprit in the face with the determination to fully overcome. And start over," said Dr DonDiego.

In the book, she reminds us domestic abuse is as common in white-collar-wearing couples as it is in the blue-collar world. She wants to ensure that every reader can spot the earliest signs of an abusive predator-partner, leave before their sanity is disrupted, and live a rich life that is sealed from entering another toxic relationship pattern.

What was it like for you, working as a doctor but also dealing with an abusive partner at home? ‍

It was very stressful, but I am not sure I fully realised how much I was dealing with. I dove into my work and training but only reflected a little on what else was happening. I didn't have the time or bandwidth to acknowledge what was going on at home fully, so I ignored it longer than I may have in less stressful work circumstances. I knew my medical training was the top priority, so I ignored everything else.

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Jealousy is often a trait of an abusive relationship. Did you experience this when you had long night shifts? How did it affect your mental health? 

Definitely! I am typically a very outgoing and friendly person with everyone, but I found that if I became this way towards any male, I was met with insults or manipulation to keep me from being friendly. I became much more reserved over time, always being careful not to upset my partner for my own sake more than anything else. But this ultimately wasn't who I am. Not every interaction a female has with a male is at all based on attraction, and I've had to remind myself those thoughts were placed in me by someone else and not by my intentions. 

Could you talk with your colleagues about what was going on at home?

Not at the time. Everyone was just as busy as I was, and I wasn't sure how to communicate it. A few times I tried, I could just feel people didn't know how to respond or help. I think I knew it was bad, but speaking it out loud made it more real, and I wasn't quite ready to face leaving yet. When things were absolutely awful at the end, I eventually confided in a few close friends at work who helped keep me safe from stalking and threats that ensued afterwards. I ended up getting multiple protective orders while trying to start a brand-new job as a new doctor. It was a chaotic time, and I couldn't have functioned without that support.

How did you get out of the relationship, and how did it feel when you finally left him? 

I felt really liberated internally, but I lived in fear for several years.

I had a lot of help leaving. The most dangerous time in an abusive relationship is when you take action to leave. I had to get multiple protective orders and was almost run off the road on my way to work after being stalked. The security team at my apartment was aware of the situation, so I moved several times and got a different car to make it less noticeable. I moved a lot differently. The court system helped to an extent, but not to the place that I really needed at the time. I also started therapy, which was the best thing I ever did.

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Can you tell me a bit about your healing process? Is this what your book Self-Care RX is about? 

Yes! Self-Care Rx discusses my process of healing. The book really isn't about the relationship so much as it is about my journey of taking action in my own life. I discuss some details of events that occurred for context and to bring awareness to narcissistic abuse. Still, I wanted to be completely transparent about how resilience can work against us. I was too strong, too numb, too busy, too unaware until everything came to a halt. I remember thinking I wouldn't survive the relationship, and that lightbulb made me leave. It just took me a while to acknowledge it. Therapy was the best thing I ever started. I still see my therapist weekly; I'm still evolving. They say those in therapy are because of those who aren't, which sums up my journey. I also regularly have a spiritual and yoga practice I nurture. I have invested in a lot of personal and business development groups, and being able to speak about my experience to help others has also been healing. I've actually been able to help several other women out of their own abusive relationships, and that has been pretty cool. Self-Care Rx also has stories of similar situations for other women. The psychological patterns are very recognisable. 

Do you have any advice for other women in the industry who could be suffering domestic abuse at home? 

Find a therapist that specialises in narcissistic abuse. I've met several over the last few years, and there is more awareness of how intricate and manipulative that rabbit hole can go. You need a professional to be objective, walk you through your situation and help you assess your risk and psychology. Friends are great support, but it isn't the same as a professional therapist. Second, invest in yourself and take care of yourself. Healing is a full-time job. You have to give it the energy and merit that you would any other life-changing long-term goal. Third, find other survivors you can relate to. Unless someone has experienced what you have/are going through, they won't fully understand. It's an isolating time, so finding a tribe of other survivors can really help the healing process.

‍You can buy Dr Danielle DonDiego's book Self-Care Rx: A Doctor's Guide to Transformation After Trauma on Amazon here.

Instagram: @drdondiego

‍Main photograph by Alessio Filippelli @ale_ssiofilippelli and Manuel Pergugini @manuel_perugini

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Dr Tahnee Bridson was recently awarded the 2022 Queensland Young Australian of the Year for her work as the founder of Hand-n-Hand Peer Support, a free and confidential peer support network for health workers in Australia and New Zealand.

This is something that the profession needs more than ever during and after a pandemic. It fosters a culture in the medical profession in which mental health is valued and can be sought without fear or shame. Tahnee is a psychiatry registrar and is passionate about improving the well-being of doctors and medical students. 

Dr Tahnee Bridson grew up in a small country town in far north Queensland. Her parents came from backgrounds where they didn't get to finish school; her dad grew up on a cattle station, and her mum was an immigrant from Italy. 

“My Mum came to Australia, not speaking a word of English, and then went to an all-English speaking school, and there was a lot of racism towards the Italians and the Greeks and the Spanish back in the sixties and seventies when they came over. And so she never finished high school, my dad never finished high school, but obviously, they would've liked to have done that kind of thing.” 

Tahnee attended the same high school as her parents, and in a small town (where everyone knew everyone), she felt that she was looked upon as someone who would not excel academically.

“I really wanted to prove that I could do something and fight that stigma my parents had gone through.” 

Tahnee applied herself and finished high school with top grades.

“I guess there's this kind of thing that if you do well at school, people think you'll be a doctor or a lawyer or something along those lines.” 

When Tahnee started studying medicine at university, the same feeling of unworthiness and self-pressure began to build.

“My parents weren't doctors. I always felt that I wasn't good enough; I was an imposter. So, I always strived to do my best and do well. “ 

Tahnee had a supervisor who was quite harsh and “the typical medicine doctor that you see in the movies (Like Dr Cox off Scrubs)” 

“And I think because of my upbringing and where I'd come from, I had this idea that I had to prove people wrong, and I wouldn't give up.” 

Tahnee pushed herself to achieve more and take on extracurricular work until she reached her own breaking point—and then pushed through it. 

“One day, I was at uni, and I ended up collapsing and getting sent to ED…The doctors came around, and they told me that they were diagnosing me with anorexia nervosa. I hadn't even thought about mental illness or psychiatry or anything; it just didn't cross my mind.” 

After going through this, Tahnee started to realise the importance of mental health, and then, when she found a really good mentor who was a psychiatrist, she found joy within the profession.

“They showed me that you could do all these extracurricular things without having a consultant or a supervisor around you who wanted to make you cry daily." 

Tahnee was inspired: “There was still so much unknown about mental illness and why things happened or how to fix them.”

‍Dr Sam Hazledine interviewed her on his This Generation podcast to learn more about her Hand-n-Hand Peer Support journey and what needs to change within the profession.

Dr Bridson's "brainchild" Hand-n-Hand Peer Support:

Tahnee had never spoken about her own experiences with mental illness with her patients or at work. It wasn’t until the Australian of the Year award that she spoke openly about her journey for the first time. 

“I was always really conscious because a lot of people would tell you that as a doctor, you can't have an illness, and you can't let people know that you've been unwell because you'll be stigmatised and that people would say, especially in psychiatry, if you are somebody who has an illness, you definitely shouldn't tell your colleagues because they'll judge you.” 

It took becoming an Australian of the Year for Tahnee to feel confident enough to share that story, which shows how difficult it is for health professionals to admit any form of vulnerability. 

“I just thought, I'm doing all this work to support doctors and healthcare workers, and I'm advocating that we should get help, and I've now been given this platform. I also need to show people that it's okay to speak up.” 

When Tahnee was mentally unwell, she remembers feeling incredibly alone.  "I was (maybe intentionally, maybe not) made to feel like I was the only person who could be going through something like this in medicine as a med student or a doctor."

When she finished her medicine and was out of that situation, she realised she was not the only doctor suffering.

"That same year, one of the doctors in my hometown ended their life by suicide. I think that was also a big light bulb moment where I started to realise it wasn't that we were alone in this fight; it's just that people didn't talk about it, and there wasn't any sort of support available for those of us who were going through it."

When COVID came along, and Tahnee started seeing what was happening overseas, healthcare workers who were sleeping in the hallways, and increased doctor suicides, she realised that she wanted to do something to help.

"I reached out to a few of my colleagues and mentors and asked if we should be doing something. Shouldn't we be doing something to support our colleagues out there so that we don't end up with the same things happening?"

Tahnee posted the idea on social media and had about 400 people respond within 24 hours, saying it was needed. "It just took off from there and has had a life of its own since then."

Hand-n-Hand Peer Support is now a thriving not-for-profit organisation offering free, confidential peer support for health professionals in Australia and New Zealand.

"We've been really lucky that we've got an amazing group of volunteers, a lot of whom have been with us from the beginning in 2020; they've volunteered to help build Hand-n-Hand and get it to where it is now and build the organisation."

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Changing the profession from within:

Through Hand-n-Hand Peer Support, Tahnee has created a movement within the profession. Dr Hazledine explains that the "profession is struggling", but what he finds heartening from his experiences and Tahnee's story "is that there's a real feeling that people want to help, that people want this to change."

"I feel like our generation and the generation of med students that are coming through, it is more now than just us talking about it," Tahnee explained. "I think we are all looking for ways to actually make the change happen because we are sick of seeing this same thing repeated over and over and over again. The Dr. Cox culture, we have all encountered at least one of them."

Tahnee explains that she thinks it is important to help doctors before they "fall off a cliff," and that's what Hand-n-Hand Peer Support does.

"But then there's also the kind of systemic issues, like how do we get rid of bullying and discrimination, and how do we start to actually address those things in the workplace that chip away at you day in, day out."

She believes that it starts with the little things that should be a given, like allowing doctors to take lunch breaks.

"And getting paid for overtime, how many people don't get paid for overtime or, work weekend shifts and don't get paid or work the on-call the night before and then."

She explains how staff shortages affect the mental health of the profession.

"There's not enough staff, and we are trying to do the best job, but we know we're not doing the best (and it's not really our fault). It's more of a systemic issue, but often we take it on as well. And then that also contributes to the whole not taking breaks, not looking after ourselves."

She describes these as "moral injuries." "We are a caring profession, and we want to be able to help all of the people who come to us for help."

‍To conclude the interview, Dr Sam Hazledine asks Dr Tahnee Bridson some questions.

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Advice you'd give your younger self:

"I think 18-year-old me was, well, similar to me, but was just a lot more unconfident and a lot more self-doubting and probably felt like she didn't really belong in the university or medicine world. 

I would tell her to have more confidence in herself and to stop thinking that she has to get a hundred per cent in an exam to be worthy; you don't have to.

Everyone always used to tell me, "P's get degrees", and I didn't even believe that. I know you have to do your best, but you don't have to kill yourself over it. 

I think I would also tell her to have a bit more fun. I think it's really important for us, especially as doctors.

I thought university was the be-all and end-all, and med school was like make-or-break, and I had to do well or it was the end of the world. I definitely would've told myself to make the most of those years because now, a few years down the track from finishing university, I feel like I didn't make the most of my kind of university life.

One of the other things I would say is to hang out with your family and people who aren't in medicine because I think sometimes we get caught up in the bubble of medicine. All you're doing is talking medicine, exams, and studying, and you just get sucked into this world that is only medicine.  

I think sometimes it's so important to have people outside of this world to be like, oh yes, actually medicine is strange, and there are other things out there, and there is a whole world out there that other people live in that we seem to forget about that."

"I don't know. I always think that I like to be ready to help other people, whether they're friends, colleagues, or even people I might not know. So, I think it's important to be a helpful, caring person. So that's probably how I'd like to be remembered. Just probably very like medicine."

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How to contact Hand-n-Hand Peer Support?

"We have a website. You can just Google us, Hand-n-Hand Peer Support, and sign up to get peer support there. 

You don't have to put in full details if you don't want to, but just like a name, what area of practice you're in and what you're looking for, and then the same goes for people who want to volunteer, they can fill in the "I want to be a facilitator" form, and they can also just email us. 

We're always keen to get more volunteers. I love the culture that we have in Hand-n-Hand at the moment because we all work so well together, we all look after each other, and we all are really grateful for the work that everyone does."

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2020 Australian of the Year, Dr James Muecke, has dedicated his life to treating and preventing blindness.

Originally from Adelaide, he’d always wanted to become a doctor despite having no medical role models.

“There was nothing specific. I didn’t have a parent who was a doctor, and I didn’t really have any exposure to medicine,” he explains in this podcast with Medworld’s Dr Sam Hazledine.

But he vividly recalls enjoying creating things with his hands, putting together aeroplane models, and doing the delicate, detailed parts of the models. When he was eight, his parents bought him a ‘Visible Man’ model for his birthday. Carefully painting and putting together the organs, skin, and all the different parts of the model man was a hint that James’ future would involve microsurgery.

James studied hard—perhaps a bit too hard, he concedes. Working 34-hour shifts as an intern left him feeling burnt out, too, and he felt he needed a break. Many of the patients he was seeing had chronic diseases, often self-inflicted through poor diet and smoking. Drawn to the idea of ‘fixing’ people and curing them, he decided to take a year out to work in Africa. It was this experience that transformed the direction of his career.

“I loved that now that I could deal with patients, I could cure patients [...] There are mainly infectious diseases, diseases such as malaria, TB, etcetera. And so, this re-inspired me. It reinvigorated my love for medicine and created a desire to pursue a career in public health. And so this, combined with the idea of using microsurgery to cure blindness in people in poor parts of the world, really fueled this desire to head down the pathway of ophthalmology.”

Teaching others to cure blindness:

Dr James says one of the defining experiences of his life occurred when he was conducting research in Myanmar, Southeast Asia. The team was looking at causes of blindness among children in schools for the blind across the country.

“What we found was absolutely staggering. We found that nearly half the kids have blindness that could have been prevented or treated […] but the thing that really had a powerful impact on myself and on the entire team actually were quite devastated to find that measles was the leading cause of blindness in the country.”

Inspired to do something about it, Dr James talked to officials and ended up training Myanmar’s first pediatric ophthalmologist. This ophthalmologist went on to train others, who have collectively helped thousands of children.

“In 2015, he finished training a second pediatric ophthalmologist in the country. He now trains at least two every single year. It shows you the sustainability of what we do, the scalability of what we do, and just the experience, from the research through to educating and equipping a colleague, which really captures the essence of what we do with Sight For All.”

Through the Sight For All charity, Dr James and his colleagues aim to positively impact the 85 million people in the world who are vision impaired or blind. Ninety per cent of blindness or vision impairment is preventable or treatable, and the charity can have a huge impact by training others and educating the public.

Dr James says it has been “One of the most important things in my life and one of the critical things to continue my love of medicine and my passion of medicine […] If I was just in Adelaide being an ophthalmologist, working, I think I would have long time burned out by now.”

From curing blindness through surgery to raging a war on sugar and, more recently, managing a neurological condition that’s forced him to quit surgery, Dr James’ story is a fascinating one.

Listen to his story, as told to Dr Sam Hazledine, below:

https://open.spotify.com/episode/5lbPdv9hzHrmaXFAGNDcHs?si=8mq_aPTnQV-u2RxJ-9MiSQ

Dr James Muecke, ophthalmologist, teacher, and 2020 Australian of the Year, has led a fascinating life and career.

He founded Vision Myanmar and Sight For All and has also been awarded a Queen’s Birthday Honour. A growing concern with public health and the proliferation of sugar in the modern diet is his latest mission. Since becoming Australian of the Year, Dr James has used this public platform to share information about diet and preventable diseases – he says public health initiatives are one of the reasons we’re all living longer.

“Critical prevention is in our profession,” he says.

“I've been campaigning about the ravages of sugar and type two diabetes in our society these days because I was seeing patients every year, seeing normal patients who were losing vision, going blind due to their diabetes (in particular type two diabetes, which makes up 90% of all the cases) […] This is a disease that shouldn't be happening at all.”

Don’t have time to listen to the full podcast? Here are some of Dr James’ key ideas about evolving your own life and the world through medicine.

When you feel burnt out, don’t be afraid to make a change:

During his internship, Dr James felt disillusioned with medicine. The long hours and dealing with chronic illnesses where alleviation rather than curing was the order of the day left him feeling burnt-out. He decided to take time off to travel and work and this led to him working in Africa where humanitarian work reignited his passion for medicine and public health.

“For the first time, I was really able to cure people and it was so inspiring. I did my morning ward rounds and just immediately knew which patients were better, were ready for discharge. Actually be getting brought back to life in their beds and have a big smile on their faces. And you just knew that they were ready to go home. They wanted to go home. And it was something that was so much more appealing to me than the medicine that I'd experienced in that first year as an intern.”

Share your skills:

Dr James has found sharing his skills a rewarding way to ensure that the work continues – even when he can’t operate any more. He saw a need for a trained pediatric ophthalmologist in Myanmar and convinced authorities to let a young ophthalmologist train with him and his colleagues in Australia. A children’s eye unit was set up in Myanmar and that doctor now provides close to 30,000 treatments every year.

“What's even more impressive is that he then used his expertise and competence to train his own colleagues. In 2015, he finished training a second pediatric ophthalmologist in the country. He now trains at least two every single year. So, it shows you the sustainability of what we do, the scalability of what we do [at Sight for All].”

Keep a day free:

“The money will come. You will have more than enough money to survive, and have a very enjoyable life. But the thing which will be the icing on the cake of your life is the opportunity to give back.”

Dr James reminds us that doctors have the opportunity to earn good money. But to keep your passion alive for medicine you should do something that fuels your life in a different way. He recommends keeping off one day per week to commit to “other things”, whether that’s research, training, humanitarian work or something different altogether.

It’s up to us to educate patients about sugar:

Dr James talks about the ‘Five A’s of Sugar Toxicity’;

• Addiction – it activates the reward center in our brains
• Alleviation – we use it to alleviate stress and to make us feel better  
• Accessibility – sugar is cheap, and it is everywhere
• Addition – around 75% of food and drinks have added sugar
• Advertising – the world is flooded with ads for sugary products “often in the most insidious and predatory way.”

It’s a big thing and something that governments aren’t overly keen to tackle because sugar generates revenue. But doctors can make a difference. Dr James says he’d like to “shout from the rooftops” that type two diabetes IS reversible in many patients.

“It's not all doom and gloom. There are some important positive messages here as well […] Type two diabetes is preventable, but also really critical. And this is something that many doctors are not aware of. […] There are over a hundred controlled clinical trials to support that, through a low-carb diet, you can reverse type two diabetes, and one a very good paper showed a 56% reversal in a 10-week period using a very low-carb diet.”

Keep your interests broad in case you can’t do the thing you love one day…

Dr James Muecke has a neurological condition called Focal Dystonia, which means he is no longer able to perform surgeries. His right-hand function has diminished, and he’s only able to use his left hand for most tasks.

“It was pretty, pretty hard-hitting, particularly when I've spent so much time and effort preparing to get into medicine, into surgery, and into ophthalmology training,” he says. But he stays positive and reminds us to engage in lots of different activities and interests:

“Have other interests in your life and keep time off in your week for other interests. I've always done that because you don't know what's ahead of you. I enjoy doing all sorts of other things. I'm a keen photographer. I've actually been a music producer. I’ve created a number of albums. I've written some books. I've done all sorts of things to keep myself amused and interested.

“[…] I didn't do it with the thought that one day, if I have to give up medicine, I can pull back on these other things. But now that I am faced with my career and I've done all these other interesting things, I can continue my humanitarian work. I have all these other interests […] I've started to stitch together a career after medicine, which draws on all of these things I've been doing for the last 20 years.”

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Listen to the episode:

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Dr Sam Prince’s interest in medicine was partly inspired by his mother.

Sam’s mother grew up in Sri Lanka in a poor rural village with few opportunities for young people. Her brother and sister died because the family could not afford health care. However, Sam’s mother managed to overcome poverty and other limitations—she was the only child to pass the U10 and went on to become the first person in her village to attend university. She eventually gained five degrees and a PhD and was an Australian Bureau of Statistics economist.

“She is the cycle breaker. I’ve been really obsessed with people who break cycles. It's not too hard to find an accountant who has a father who is an accountant who has a mother who is an accountant. These cycles continue; they are good cycles to perpetuate. I am really fascinated with people who are able to break bad cycles,” says Sam.

He adds that his mother’s ability to set her sights on doing something different and breaking that bad cycle has inspired him (and his sister) to do more with his life.

“I idolise her. She’s a very easy person to look up to; calm, intelligent, kind, and a lovely, lovely spirit. So that's why she's been our rock.”

While studying medicine, Sam worked at a Mexican restaurant to help pay the bills. It was here that an idea to do something more struck him. At just 21, he opened his Mexican restaurant called Zambreros. It quickly grew into a franchise of almost 200 restaurants with a plate-for-plate initiative that has seen more than 14 million meals donated to people in developing countries. He says skillsets used in business and medicine have a surprising number of similarities:  

“It is a great place to learn more about skills taught in medical schools, like how to lead a team in the right direction, and people management, strategies… all these things you learn in entrepreneurship […] I think that doctors are uniquely skilled; I think they are almost selected for those kinds of entrepreneurial skills. My definition of entrepreneurship is having an idea, breathing life into it, making it real, and having it adopted by others. And I think a systematic way of approaching problems is well suited for that, so I have to indulge here.”

When Dr Sam Prince was 32, he developed a cough and became very sick. Chest X-rays revealed a mass in his lungs, which was, at first, thought to be cancer. He was eventually diagnosed with sarcoidosis, “It was a soul-searching period,” says Sam, “it was also a place where I got up close and personal in the medical system.”  

His experience as a patient led him to believe that the whole world needed to be changed and that the healthcare industry needed a new way of melding medicine and technology to create a better system for patients and doctors. It inspired Sam to found Next Practice – a combination of technology (including an app) and clinics that strip away what doctors don’t like about the traditional system. These things often prevent them from practising medicine, like back-breaking paperwork and restricted patient time.

“[T]he thing that inspired us was, we can just obsess about making the best general practice experience on planet earth, not only for patients but also noting that doctors are exquisitely skilled at advocating for patients.”

Next Practice aims to use technology to assist rather than replace doctors. It brings together innovative technology and doctors who are passionate about healthcare. It’s healthcare “re-imagined.”

“I am not interested in best practices anymore. I'm interested in the next practice and what happens next because I think we can elevate ourselves to something beyond that.”

Sam is positive about the future of healthcare and is passionate about ensuring the industry is driven towards a forward-thinking future. He illustrates this importance with an anecdote from his time in Sri Lanka, where he often does charity work. He was thrilled to be able to give a scholarship to a little girl who’d passed her U10 and had grown up in a village similar to the town where his mother had grown up. Sam and his mother asked the girl:

“We are greatly honoured to be able to offer you a scholarship in school. You can do whatever you want… so what do you want to do?”

The girl replied that she wanted to be a bus ticket collector, and at first, they were surprised that this was what the girl saw as the pinnacle, the thing she wanted to do most.

“But if you stood from her vantage point and looked out from the slum at all you could see, there was this bus that would pass by every once in a while. The bus driver was a man, so she thought she could not do that, but everyone on that bus wore suits (and things like that), and there was this young girl in this beautiful white dress who collected bus tickets. And so [the little girl] thought: ‘That is the absolute pinnacle of what I can attain’.”  

Sam says that although aspiring to pinnacles beyond what you can see is difficult, it’s important to think bigger and better for the future of the medical industry.

Listen to the full podcast here: