Resa Lewiss MD
Appearances
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
And you're there's a critical care physician in Canada who have first introduced me to the term called a failure friend, the friend that you can call up, not necessarily because you've failed, but there's been a failure, like, for example, a death. And sometimes it feels like a failure. Sometimes it's actually not a failure. It's just a sad because you witnessed it and helped with that transition.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
And you just need these people sometimes to be able to call and just get it off your chest and speak about no judgment, no problem solving, no, oh, here's what you can do next time. But literally, I just need to talk about this.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
And there are things that I think are coming to the surface in terms of important, not just for physicians, for many people in health care and in other fields, but I'll say in the case specifically of physicians, what happens in the emergency department and on an emergency department shift, you just can't really explain it completely.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
And certainly people get a view into that when they watch the doctor TV shows.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
So I made the decision to stay in what they call academic medicine, which means that when you, if you go out into a private practice or in a community hospital, often there are no other expectations except going in and working your shift. When you stay and work in an academic center, in a teaching hospital, there are doctors in training.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
and other healthcare team members where you end up teaching them. In my case, I would teach them about emergency medicine, but within emergency medicine, my specialization became the use of ultrasound at the bedside. And when I really completed my training in ultrasound and then started teaching, it was a new technology for the emergency department.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
It was very common in radiology, but not for the emergency department. So it became very, let's see, there was a large demand to teach ultrasound. So that's really a lot of my teaching and education has been in the use of ultrasound at the bedside. And within the training programs, there was a demand across the country, but also
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
Across the world, I have traveled to teach ultrasound in many other countries, both to physicians as well as to nurses, as well as to midwives, as well as because ultrasound happens to be a very relatively affordable service.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
technology to help make patient care decisions and the technology has evolved to be even more affordable even smaller and the motivation what I've really loved about the teaching and specifically teaching ultrasound is you're helping people deliver safer care and make better decisions for patients and it just that it's a really good feeling
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
I truly believe that fields and people have more in common than not in common. And the way the U.S. education system works, you go to four years of university before then you do specialization commonly. And so many colleges and universities, you get what they call a liberal arts education. And I have always enjoyed learning many different subject areas, studying many different languages.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
And part of it is I've always felt that the more you know about all different areas, the better it actually makes you as a physician and as a professional. And one example I'll give is in university, I actually concentrated my studies in sociology and in ethno-racial studies. And simultaneously, I was completing my pre-medical courses.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
And I knew that would make me an even better, more understanding, more empathetic person. physician to knowing that people come to the emergency department at the end of the day sick is sick everybody wants food shelter clothing education and to feel good and healthy to function in society and in their lives and if i have a sense of someone whose first language is not english
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
Someone who lives in a city versus someone who lives rural. Someone who is elderly versus an elementary school child. Like having that sense of groups and even the way people came to the U.S. and how people have moved in terms of socioeconomic status within the U.S. Those types of factors help me provide value.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
better patient-centered care because I'll have an understanding, never assuming that I completely ever understand someone else's experience or have had that experience myself. I've always felt the responsibility is me to educate myself. So educating oneself also takes the form of reading books, all kinds of books, fiction, nonfiction, and also writing.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
I've always believed in the power of communication. And I always thought that Verbal speaking was more my strong suit in terms of communication. However, when you're at a teaching hospital, there's an expectation that you write. So my first ventures into writing were writing scientific and medical papers.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
So I have a whole sort of period where I was only writing for medical and scientific journals. This concept of writing for non-medical, non-science audiences came as I started being exposed to other mostly physicians who were doing the same.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
Realizing that our opinion matters, our voice matters, and if we're coming from an informed, educated place to talk about science, to talk about medicine, healthcare, etc., that it is helpful for us to speak up in this way, and speaking can mean writing.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
I was very into reading, for example, leadership books, people management books, communication books, and like the articles that are published in, for example, Harvard Business Review or Fast Company. Because I think people don't realize healthcare is an industry. It's a company. These are organizations just like all the others. We think they're different, but they're not.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
And so I found many of those articles relevant to my own experience. And flipping it 180, I realized that what I was seeing in healthcare and in medicine and my own experience of navigating the workplace, it can be...
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
relevant generalizable and helpful to others in other fields as well i started writing articles some were with other authors some were alone some were with my co-author with whom i wrote the book and these articles really did well people are like wow i'm really glad you wrote that article i'm going to share it with my mentees or there would be these secrets of the workplace that they weren't really secrets but no one talked about and one example is
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
writing a letter of recommendation. It's very common in many workplaces that you are asked to draft your own letter of reference. And the first time my supervisor asked me to draft my own letter, I thought he was asking me to do something illegal or that he was being lazy. And I was just so confused. It came out of nowhere. I did it. And then I found out actually it's exquisitely common
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
Good morning. It is wonderful to be with you. And what an honor that I am the first medical doctor to join the show.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
And my co-author and I flipped it and actually wrote an article about why we are actually the best people to write our own letter of recommendation. Unless the rules say you cannot and it's illegal. We know ourselves. We remember our relationship to this person. Often these supervisors don't remember when they met us or how we're related.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
And also, if we're applying for a position, we know the details of the position, and we're best able to say why we're good for that position. And we very much emphasized in this article that it's a draft. You hand it to the supervisor. They make it their own. They can add superlatives like, she's the most competent, most da-da-da. But basically... It really makes sense.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
And in terms of helping them help you, you've actually lightened their load because you've created a draft for them.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
The true motivation behind not only those articles, but then what became the book was to make it easier for other people, to give them a copy of what I call like the workplace playbook. If we were to make a sports reference, teams will get a playbook. And I certainly felt along the way that I did not get a copy of that playbook.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
And I thought, all these, what I just, the example I just gave about letters of reference, if someone had just told me that, I would have, it would have made, it would have saved me a few years of learning and being less efficient. and allow me to be more efficient because I was less efficient until I learned that pearl, that lesson, that this is the way the workplace works.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
And so the motivation was to create a book that would help people in their careers and not just doctors and not just women, but truly everybody. And You have highlighted that we started the book with three truths. Number one, we want the reader to think of time as a currency. Time can only be spent. You can't put it in a savings account for later and you cannot get a refund.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
And that even ties back to the story I shared about the patient that died right at the beginning of the shift in front of me. Time was going. I had seven more hours. I had to keep going. And in the emergency department, we do a lot of task switching. When one thing's done, one patient gets discharged, one cut is sewn, next, next, next. We're always pivoting. And so time is always being spent.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
And so we want the reader to be very intentional about how they're spending their time and with whom they're spending their time. And the how is also what motivated the book to be a very efficient book. practical, useful read. So sure, you can read it cover to cover and you're right, it is chock full of content, but also it can be a toolkit that you can jump in and jump out of.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
And so that's why we wrote a very granular table of contents. So people would be like, I need to learn about running a meeting. Oh, okay, page 258, running a meeting. And we specifically wanted it to be readable And when you're publishing a book and to make it publishable, you have to somehow make the argument that it's different from all the other books.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
Someone that interviewed us on a podcast was like, I have a lot of these books on my shelf and I've read a lot of them. Why should I read your book? Why is your book different? And it's a fair question because if all of us or any of us that have traveled in airports or train stations, when we go to the bookshop, there's always that table of business self-help books. And this is different in that.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
If you've ever had the experience of picking up a book and it's put out there as a book for everybody, but you read it and you're like, this doesn't relate to me or my experience or this author's not speaking to me. We wanted to write a book that made no assumptions about where someone is coming from. their upbringing, their financial resources, their network, their pedigree. No assumptions.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
We want to tell you these secrets, these tips, the plays in the playbook. Time is currency. It can only be spent. Number two, the world is not equal. We all have different start lines and start at different places. But by learning these micro skills, we can fill in gaps. So hopefully we all get to the same end point in terms of navigating and being successful in the workplace.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
And number three, we truly believe learning is limitless. If only it is accessible. And that speaking to accessibility means, do people have time to learn, to read a book, to watch an online video, to have a conversation with a subject matter expert? Do people have the money to pay for this education, these resources?
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
Do they go home and do they have what is called the second shift where they take care of children or elderly parents or pets? Trying to make no assumptions. So we wanted to write an efficient read that would give people access to that learning.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
why medicine what drew you to that path in the first place thanks for this question and i've thought about this like how do we put together our narrative like how do we become we become and I believe I'm one of those people that it's always been in me. It's a calling. Medicine has been a calling.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
And the reason I share that is some people, they're told you should become a doctor or they have a parent who's a doctor. And in my case, nobody in my family is a physician. And I grew up in a small town in the smallest state in the United States, so in Rhode Island. And
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
I went to the public high school and I would say that my parents, when they decided their parenting style with my brother, my sister and myself, they had very traditional values and roles and expectations. They definitely had this line of boys do this and boys are expected to do that when they grow up. And in contrast, girls do this. Girls look like this.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
And girls have different societal expectations and what they may do professionally. And those sort of divisions and those expectations really rubbed me the wrong way. And I think from childhood, from early childhood, I saw the differences and I didn't like it. And so I think I've been on a journey to prove that I want to do and become the individual that I want to become.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
And it has nothing to do with gender roles. And there's one story that I tell that I didn't even know why it rubbed me the wrong way, but every night we would sit down as a family for dinner at 6 p.m. Dinner would finish, and my father would say, Okay, girls, help your mother clear the table. And I would always say, Why do you say girls? Like, why do we have to help mom clear the table?
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
How about everybody clears their own dish? And then he would look at me and say, Risa, help your mother clear the table. And then I would say, what about him? What does he do? Meaning my brother. And he said, he takes out the garbage. And I actually said, I prefer to take out the garbage. I'll take out the garbage and he can do the dishes. And it sounds like so bizarre, but...
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
I ended up reading a book during my early career that completely explained why this bothered me so much. And it was called Women Don't Ask, Negotiation and the Gender Divide. And they actually used almost that exact example about, again, this is the household I grew up in, these, quote, traditional values. I realized everybody's household was different.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
They put out the explanation that girls are given these chores, these roles in the house that promote dependence rather than independence. Also, they're often like the monotonous everyday things that need to get done in the household. They're not these isolated events or once a week events. There's two or three times a day events.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
And they're much less likely to get, for example, monetarily rewarded. You might not get an allowance, but say you take all the garbage or say you actually mow lawns and you can go to the different neighbors in the street and ask them, if you can mow their lawn and get paid. Same thing with shoveling snow.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
And I literally always wanted to do those types of activities as opposed to the ones in the house. One sort of final little piece to this story, at the American Thanksgiving, again, it was just in me. The meals would end, the main meal, and there was a break between the main meal and then coffee dessert. And all the women would get up and clear. And all the men would sit and relax and talk.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
And I would sit. And intentionally, purposely. And my father would look at me and he'd say, Risa. And I'd say, Dad. And he'd say, Risa. And I'd say, Dad. And he said, are you going to get up and help clear? And I said, no, I want to sit here and relax and let my meal digest and enjoy just the way you are. And again, I just didn't like this division. And it was really because I really wanted...
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
equal access, equal opportunity, and equal support and encouragement to be and pursue the things that I wanted to pursue and be as an adult, as a professional, and in my personal life as well.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
Great question. And I'll more directly address the why the doctor. As I said, it was always in me. Like, I really loved when I had the opportunity to learn the bones of the body. I really was fascinated when we brought in our baby teeth and we left it overnight in the classroom in a glass of soda and we saw the disintegration of the teeth. Like, I really loved understanding...
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
the functioning of the human body, learning the names. I'm a big word person. I loved words and I studied Latin even in high school. And I just loved that a physician had a knowledge base, was decisive, and it was a very practical field. And it just, I really, I always liked blood and guts and I liked watching scary films that were gory. So I just told myself like, this seems right.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
And then when I went to university, I told myself, if I do well in these classes, then that's a message. And I did well in my pre-medical studies classes. And then when it actually became time to spend time in a hospital to get that exposure, I was surprised with how comfortable I felt in a hospital, in a medical environment.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
And I thought it was interesting, the patients that came in, their questions, their cases, their problems, and to have that knowledge to help people was very attractive. To your question regarding emergency medicine, when I went to medical school, I was very attracted to surgery and the general surgery specialties.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
And one of the reasons was because there was an actual doing things with your hands and that action-oriented part of the practice that I really liked. However, I knew I didn't love surgery. I liked it. And I really felt that to pursue that path, you have to love it and you have to always want to be in the operating room. depending on what you call it, the theater or the operating room.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
I was comfortable. I liked it, but I didn't love it. And when I looked around, the surgeons I met loved it. So I did a year of research in my third year of medical school. And when I returned for my final year of medical school to get right back into the mindset of clinical medicine, I did an emergency medicine rotation. And immediately I was like, oh my goodness, where have I been? This is it.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
I see men and women and children and elderly. I take care of patients presenting with heart attacks and strokes and cuts and fractures and abdominal pain and pregnancy related. I just loved it. The variety, the practicality, and also I got that fix of doing procedures that you would do in an operating room, but you don't have to go to the operating room.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
So again, like if someone has a cut or if someone has broken a bone and you can create the splint. So I was using my hands and doing those quote procedures, but it wasn't something that took the same intensity, both time-wise, resource-wise, and intention as going to the operating room.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
Is that what keeps you going? So you're onto something. I definitely like the variety. I like that there's always going to be every day, every shift is going to be different. And I think you and I have touched a little bit. I know we'll probably get more on sleep. I identified as someone that didn't need a lot of sleep. I actually hadn't gotten fully on board that sleep was necessary for health.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
And I really... There's so much that I wanted to learn and do in life, personally and professionally, that I thought, I don't need a lot of sleep. I can sleep when I'm old or when it's time to sleep, then I'll sleep. But now there's so much I want to do and... Emergency medicine is shift work. And so you work days, you work nights, you work weekends, you work holidays. Weekend doesn't mean.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
And I liked that variety of even I might have a Wednesday where I can get all of my errands done while the rest of the world is working their 8 to 6, 9 to 5, Monday to Friday work week. So I liked the variety both of the schedule. of, yes, the actual shift work. And also you end up identifying with your cohort.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
And what I found with other people that pursued emergency medicine is they tended to be very down to earth, rounded. And also it was okay to say that you have other interests and pursuits outside of medicine because you know very much when you're on and when you're off and you do have time to create and develop other interests.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
It's a very insightful question because I do think that if emergency medicine is attractive to you, there's a reason. If you're not able to have that sense of professional detachment or necessary detachment to make decisions to take care of patients in like emergent situations, like sometimes you have plenty of time and the patient is not that ill.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
Sometimes they're very ill and you need to act quite quickly. So I think it is something that is modeled. So you see it when you're working with your teachers, your faculty members. It's something that over time you develop your ways to do that compartmentalization. That being said, I actually don't think it's modeled or taught as well as it could be.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
I think it's a work in progress in terms of realizing the importance of helping doctors in training take care of themselves mentally and emotionally, decompress. And also, there are aspects that are just very devastating, as you would imagine. And I think the pivoting, because I do remember the first time I had a patient die in front of me when I was
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
a first-year doctor in training, it was right at the beginning of the shift. The patient died. I spoke with my faculty member, my attending, and we spoke about it. And he said to me, OK, just fill out what they call the death packet. When a patient dies, there's paperwork that you have to complete.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
you for example contact the oregon bank you make sure the family's aware all these things and so there's almost a there's a checklist and it's a packet and at the time it was a paper packet now hopefully it's digitized it's mostly digitized but medicine is slow to change even though things have become accepted in other fields it's slow but it was a paper packet now it's a digitized mostly digitized packet so it was right at the beginning of the shift
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
And he said, all right, finish the death packet and then start picking up more patients. And I remember like, Risa, you got to take care of this. And like, you've got seven more hours because it was an eight hour shift. And so you realize real time you learn on the job. And even that pivoting and that needing to compartmentalize happens.
Chief Change Officer
#319 Resa Lewiss MD: Micro Skills for Moments That Actually Matter – Part One
Even if it's not taught and talked about, you end up learning it on the job, so to speak. And what I'll say one more one more thing that becomes important. And we talk about this in the book is this concept of a personal board of directors.