Essential Wisdom: Inspiring Future Female Physicians

Traci Marquis-Eydman, MD - Family Medicine

January 28, 2020 Carrie Dubeau Season 1 Episode 11
Essential Wisdom: Inspiring Future Female Physicians
Traci Marquis-Eydman, MD - Family Medicine
Show Notes Transcript

Help me welcome Dr. Traci Marquis-Eydman! Dr. Marquis is a Family Physician currently practicing in the urgent care setting, as well as a faculty member at the Frank H. Netter MD School of Medicine at Quinnipiac University. She serves as Director of the Medical Student Home program, Director of the Longitudinal Integrated Clerkship, and Director of Fourth Year electives in Rural Emergency Medicine, Rural Primary Care (Maine), and Healthcare for Individuals with Developmental Disabilities. She attended medical school at Dartmouth Medical School and completed her training in Family Medicine in St Louis, MO. She then went on to practice as a full-time family-practice physician in ambulatory care. She is accomplished in leadership and promotion of patient-centered communication with a passion for improving patient experience. Her current roles at the Frank H. Netter MD School of Medicine develop her interest in compassionate and patient-centered education. Dr. Marquis, thank you for joining us on Essential Wisdom, welcome to the show!

spk_0:   0:05
welcome to essential wisdom. Inspiring future female physicians. A podcast for engaging and informing the next generation of women in medicine. My name is carried a bow. I'm 1/4 year medical student at the Frank H. Netter, MD. School of Medicine at Quinnipiac University. Essential Wisdom is a podcast for discussing the joys and the challenges off being a woman in medicine through the sharing of stories and advice by women who mentor us. Take a seat with me at the desk of the mentors. Come along, tow, walk the holes of the hospitals to experience residency and life as a physician personally, as we get to know these phenomenal physicians and scientists. Hello, everyone. And welcome back to essential wisdom inspiring future female physicians. My name is Carrie, and I'm so excited that you have joined us on the show this week. Help me Welcome Dr Tracy Marquis I demon doctor Marky is a family physician currently practicing in the urgent care setting as well as a faculty member at the Frank H. Netter, MD. School of Medicine at Quinnipiac University. She serves as the director of the Medical student home Program director of the longitudinal integrated clerkship and director of fourth year electives in rural emergency medicine, rural primary care and health care for individuals with developmental disabilities. She attended medical school at Dartmouth Medical School and completed her trading in family medicine in ST Louis, Missouri. She then went on to practice as a full time family practice physician and ambulatory care She has accomplished in leadership and promotion of patient centered communication with a passion for improving patient experience. Her current roles at the Frank H. Netter, MD. School of Medicine, developer Interest in Compassionate and Patient Centered Education. Dr Markey, Thank you for joining us on essential wisdom. Welcome to the show. I like to start off every episode by having you tell us a bit about your path to becoming a female physician.

spk_1:   2:10
Had a picture in my mind when I graduated. Actually, a picture in my mind from sixth grade on off of me being a being a town physician and because when I grew up, that's what we tried. We had, um, at any one time, maybe two. They used to call them GPS back then, and to general surgeons in town. Between the four of them, they and their people that had been there for years. And so between the four of them, they took care of almost every need. We had a podium, emergency room positions that would come up to the emergency room man woman that, um but but that. But that image of the town physician was what I grew up with. So I imagine when I graduate from residency, go back to mainland, maybe even my hometown and town dock. And then when I met my husband, he's a city guide and zero desired anyone anywhere east of ST Louis that I could missed him to get us far as Connecticut's. This is rated in. It all worked out amazingly well, very happy here, but I just full time ambulatory care practice was just what I imagined myself. Definitely. I'm grateful that I, for obstacles as well speed bumps that looked like obstacles at the time, just steered me in a different direction and encourage me open my mind to other opportunities. And I'm so in hindsight, are grateful for those at the time. They felt like frustrations, and they were. But having in that open mind, maybe there's something else better suited for me and Then we moved to the Norge area. Where did my job was? Inpatient outpatient in urgent care in one practice. So allow me to still keep that full scope piece. And then when I have my daughter with a two year old, also two year old one had been a new newborn on the other hip. You know, I did have to make some adjustments in my in my schedule. So impatient fell off the plate and went to just

spk_0:   4:27
ambulatory, and I joined the practice

spk_1:   4:29
in Middle and Madison. It was there for 13 years to ingest ambulatory care, handsome and some leadership stuff leadership can. Early on, leadership became a big part of my life of being part of my professional life. And then I went from there in 2013 to North East Medical Group as an urgent care physician on, then became quickly their medical director for patient experience and then their chief experience officer, and was training positions how to be good communicators and be patient centric. Did you ever consider or do like part time work during that trajectory, or were you always So Yeah, so, um, what's interesting, I notice is that people's lifestyle rises to their income. So when I was in residency, I lived happily on my residency salary. Of course, I was single and didn't have a whole lot of mouse to be was just me and cats. So it wasn't easy, you know, So it But it was a very self contained and hi, say, every meager income. And then So when I first got paid, paid as a physician, you think, Well, never spend on this. This is crazy. I should save all of this and then you buy a house and then they have kids when you have a car and then you just wanna live to that. What I'm telling you that is because when I had my second child, like, briefly contemplated part time, but a couple things made a little bit difficult was one we had acquired a lifestyle that part time may have made that challenging to as a primary care physician going part time. I witnessed friends and colleagues try to do that, and it they basically did a full time job in a part time schedule, so they still had to produce a certain amount of income over. Are they have a dramatic reduction, so they didn't produce the volume. It was a pretty big hit on their incumbent, so that would have affected our budget. So there was concern about income in salary and then also watching my colleagues basically just get paid for part time pay part time but full time work. You know, there are situations I've seen or I think, and I think it works well where two people do part time together in the job share and then job sharing. I think as the one time I have seen that work, at least in primary care, should not work really well. When one person is there, the other person's not bias versa. And there's complete coverage of each other's in baskets, man sick patients and questions. So when you're when you're really when you're when you're off, you are truly not expected to check your email or check your in basket the questions or labs because that person is taking care of you. That's true part time. And I think if there were more of that, I could see more people doing that, Yeah, but that I think those are my two main main concerns And it's funny because, you know, of course, whenever someone asks, I'd like to go part time. There's a tremendous pushback from administration at you. I'm explaining the groups of hospitals because the overhead for them is the same and they know it. So there's a lot of frowning people even bring up the P word. Yeah, that's why I ask. And it also is different between every single specialty brochure. So it's just an interesting things. Yeah, you're seeing you are seeing more and more. I think, what's also helping that become less of an issue? Our worry is the rising use of injured professional teams know there's more of a team based approach to care, and I think that's probably gonna be really helpful. Yeah, I think, uh, if it's done well and maybe in consideration with job share plan that maybe we'll see less of our Seymour part time folks without it being a big two.

spk_0:   8:52
D'oh! Is there any

spk_1:   8:55
challenge that you face specifically being a female in

spk_0:   8:59
the career that you've had lack of

spk_1:   9:02
transparency on equity of compensation and conversations are just dollars? I mean, it could be, you know, being willing to comedy a flexible schedule mean that to me would be worth a lot of money. But the transparency and inequity and income is a challenge for women

spk_0:   9:20
on and asking for it

spk_1:   9:22
without looking. So, of course, as you know, when men ask for things that started when we ask for things were being aggressive,

spk_0:   9:29
or maybe or demanding or whatever the term. Maybe that maybe

spk_1:   9:32
it's different cultures, different or different cultures, different work environments in different places to different degrees. I think, you know, in a hospital environment where more and more women leaders are rising and still have enough, but for more. And then there's more women physician presence. I think maybe it's less onerous than other cultures, but it's still a big issue. You're basically doing two full time jobs, and when your homework's almost kind in the background pulling and then when you're at work, there's a nagging home thing, maybe pulling you two. So

spk_0:   10:10
what I've been trying to do is more on the mindfulness thing. Um, and that's been helpful for me. I used to multi task like you would

spk_1:   10:17
not believe. I mean, I would have 45 things happening at the same

spk_0:   10:21
time on a conference call. Um, put it on you answer an email answer Question, kid, because I'm working from home. A muted answer, their question muted again. And then there are

spk_1:   10:34
a lot of Washington, the laundry. And then it's another question from my assistant on email and get back to this so painful And honestly, sometimes I would answer that person's question in the conference colic. Clearly, you weren't paying attention or

spk_0:   10:50
they asked me what

spk_1:   10:51
I didn't like. Look, what what What was that? You know? Oh, I put you know, darks on hot or I would, you know, give my kid peanut butter on it rather than peanut butter on toast. I give them peanut butter on other manners the wrong thing. So So I've learned that, um, and it would make my head hurt, so I would just I have learned dial it down to what I'm doing in the moment. Something else that I have learned to do is to schedule things, and I used to laugh when people would say, Schedule your exercise like, seriously, if you have to schedule

spk_0:   11:30
a shower or schedule your exercise, u h, yeah, yeah,

spk_1:   11:36
it's true. Doing You have to be okay with saying it's okay. My my hair is not done now today. Who cares? You know, and so I just don't care. And then, um, but I do schedule me time. So on Friday mornings, except for this morning, which is ironic, schedule a hike in the woods with my dog from 7 15 until 9 30 That's our Friday morning and then have a hiker

spk_0:   12:07
Saturday morning and I have a

spk_1:   12:08
hike Sunday morning. Nice. So Monday through Thursday is a little sad, but, like for this week, I knew I had to do a lecture Friday morning. So I blocked out Thursday morning

spk_0:   12:18
for Bella Night to go for our hike in the woods. That yeah,

spk_1:   12:22
so it sometimes there's some. There's some ships of that time. By three mornings a week, I'm doing my shin ring yoku in the woods and I'm chilling out. Listen to nature. I don't And I used to check my email and I was walking in the woods. I found myself saying, What's the point of me being? Why am I here right now? I'm here to relax. I'm here, too. Be in the moment with my dog and just quiet my brain happened. Quite my brain when I'm trying not to trip is, um So

spk_0:   12:52

spk_1:   12:52
scheduled that time. And then, you know, Sundays are secret for us. A ce faras just family time. Um, that's sacred. And then my husband and I scheduled Friday night date nights because we found ourselves saying I don't think I've talked to you

spk_0:   13:11
in a couple of weeks. I mean,

spk_1:   13:13
like, talk talk, you know, it gets harder with kids, and that's that's the reality is not a bad thing and not a complaint. But we felt like we needed Thio to book. And we take turns who gets to choose the restaurant. But we book that time and then we know. Okay, make a mental note to talk to him about this. Yes, it's like those kinds of things. And then I try to make the evening from 9 to 10 o'clock is when I read my book Has nothing to do with Medicine is not a journal. It's not purely mind brain fluff. Is there something about being a female practitioner you really enjoy separate from all of the crazy? People tell you stuff. I love that I think there's a level of trust. Um, people see a woman's face, whether it's a male patient, female patient, transitioning patient, anything in between. They see your face and the they assume. And I think most times rightly so that you will listen to them and you will not judge them. And you will hear them. And you will feel for them. And you will. You may have an answer, a solution. Um, but But they know that you're safe, safe person to talk to and that you'll really be in the moment with people. Oh, my gosh, patients tell me things. Unbelievable. I mean, what they share its any constable places trust. That's a unique opportunity for women. There's that. They think we as women tend to be, um, very thoughtful, their approach to things. So we don't like to leave tease uncrossed, and I's not dotted, which you put that together with the really good dusting skips. I think you know, women are uniquely extremely qualified to do this job because we're not gonna miss much. We're not gonna forget to do much. Yeah, so I perceived quality reasons as well as patients, but it's a win for us, too, Because to be the recipient of that trust and that level of appreciation people, Actually, I did a house call an old patient this week. So her I know I haven't had these patients, um, under my direct care since 2013 And this and there's still see me stopping shop and ask what? I'm going back to practice. But, um, but this one patient's husband called a couple weeks ago to say that my old patient waas failing or failure to thrive. So she's late eighties down to £74 but still a spitfire. But just not listening to what she's being told to do, which is to walk into T. So So he said, you know, it would be amazing if you came to visit her. Okay, so

spk_0:   16:33
I did. And it was

spk_1:   16:35
It was really nice to be chatted for about 1/2 an hour. I gave her the, gave her a hug and I gave her the what for And I said, Listen, do you mean it's your intended here? This is your body. This is your life. This is all about what you feel is your quality of life. But if you fell in love the end of the nursing home. Probably cause I don't think your husband would take care of you. What would you like to do? And that's not an option. I said, Well, that's not really an option. Then this little things you could do, like protein and, um, a walk. And so use your walker when she was over there in the corner somewhere. So, yeah, when you phrase it like, what do you want? You know what? What would be your vision of quality of life right now? What would be your worst case scenario then? A light bulb go off. Well, in that case, so I was like, tears in the eyes. I was so grateful as well. Listen, I'm not saying to go tomorrow. Should never wake up tomorrow and say But, you know, they have my cell phone number ass and call me, But I know her family. So her nephew was my patient. Her grand nephew was my patient or other nephew. Wife was my thought. There is this family connection that was pretty special. So we'll tell someone. Someone, someone, someone. So so Hello. And I hope they're doing Well, so it was. Yeah, it was nice, but it's those kinds of connections. I think that maybe we haven't easier time to make. So, on the flip side of that, I guess those connections can

spk_0:   18:13
be both And bickering and sometimes draining. Draining. Uh, So do you

spk_1:   18:17
have a thing that you d'oh thio leave some of it at the door or what do you do? How do you mean it? Which is probably partly why I have to put a little extra break. No,

spk_0:   18:28
that's true. I am. I

spk_1:   18:32
would probably still be in practice today. So the hot, So yeah, so take me back to 2013 for a minute. So only Doc, in a practice with two, um, midlevel providers used to call them a Macy's now and the only dog. And so in a town, that lovely town, beautiful people, but a little bit of entitlement sensed in general. So when they call, they would only wish to speak with me. And so what I had done as I set myself up when I first started practice, because I was just starting when I first started, I had half full schedule, and I would call every patient with every test result, good or bad. I was sometimes call for myself. So I was pretty sick. I would call them a couple of days later to see how you were doing. So nowadays is air all things and a nurse for anybody. And as my practice moved along, a busy, busy, busy, busy er I did not pull back on that piece of me because it became my signature. People were like, Why? I need to go see this position because she calls you back. She never has the nurse call you back. Um, it's, you know, she calls you with your would be with your test results and she calls to check on that became my calling card or my signature. And so I had a hard time. Plus, I like doing it. It was nice. Just give some good news. And it was I felt the time saver to be the one to give the not good news because or the off test results, because I could explain it much more efficiently myself, than go back and forth in a phone exchange with minors. But patients because of the connections that we're building over time it a two minute phone call could be a 10 minute phone call. It could be a 20 minute phone call to do that for 50 lab results. Then you go home and do your documentation. So hindsight, I probably would have set myself up. Thio, huh? And I still would do this is give the abnormal test result phone calls myself were Have the nurse say, Please come in So we could talk about your test results and maybe have them give out the normals. This was before the my chart and the accessibility have access to your record. Yeah, so but many patients find that onerous, and they just want a person. I didn't want a computer. They want a person. So I would have my nurse probably call with normals. And then me either call the abnormals or just happened committed them. So I think, and then my patients would very reluctant to see one of my AP sees for sick visit. So I didn't have double booking and then So I think that you have and I could never say no to a new patient because I figure someone's coming to see you. There's a reason why they chose you so

spk_0:   21:42
that I

spk_1:   21:42
have all these innovations like 4000 patient panel, the average patient panels about 2500 with no other covered with me to cover. And I was primary care. It wasn't like any anti or I'll see you in two years if you hurt. Oh, no. 1000. Yeah, so that's when I said. And Plus, I was doing charting, and I was on electronic record eventually, and it was midnight going to bed and then getting up run, doing charts of a Saturday morning for four hours. So I think if I had another physician in the group, if I could, I could have convinced my leadership plant another position in that group, or convince them that a patient every 15 minutes was just what it didn't fit my style. I had a big geriatric practice, which also was interesting in a big on the flip side. I was seeing a lot of little babies, and then I had home hospice patients, and then I was sort of the go to person for Vista and the adults with disabilities patients because no one else will take, so yeah, yeah, so that I So it got to a point where I said, You know, again, if I'd had that other person off load for people that I had to see a physician, I could have updated my patients of my new policy for normal lab results but without that other physician. And so I just said, Look, if if you can't get that for me, I'm losing my joy medicine and I'm getting to the point room, dreading going into work. Yeah, time for a change. So I intended to go to this other group to do. Would you care for two years to live out my non compete clause and go back in a different environment with and reset my patient's expectations? And then we said, Expectations on patient volume? Yeah, I was gonna be 1/2 hour per person position period carefully. It's never just or hospital follow up. No, Um, and then I actually liked her to care. And then I got more in the leadership and the leadership piece. I knew I couldn't do primary care justice and doing 30 hours of good leadership, so but it's all good, good, But

spk_0:   24:17
I think before I hated

spk_1:   24:19
medicine. I think that's the thing is that people wait too long. They wait until they're sick. Literally sick from doing something they don't like anymore. Pastor, the substances are or they're just really bad at what they do because they bring that animosity. Distaste to the patient care patients. They're savvy. They're smart. They know united. A colleague. Not really great, Doc. So I didn't want to be that person, so I said, That's okay. You know, life you have again, you have to be open. Thio you passed. Why? It takes you in terms of setting priorities for how you kind of know how you're gonna choose to run your life. Is there a way that you've chosen to set those or they Yeah, changes every day. I mean, obvious, obviously, for me, if push comes to show, always kids first builds a close second tied there with Bella, but, um, like, for example, my my daughter was sick last week. We had more in the earth. So last week, Not great. And then great, um, health care counters. So 1st 1 was no horrible. Nice people. Zero resolution. Second place was really great people resolution. So, anyway, Um, yeah. So, you know, she I felt like after the second e r visit that was whatever your choice of higher powers, name is that was for me. It was God's way of telling me. You know, what the kid needs to rest, just, you know, feeling well. Letter Lilo. She's a very high strong Go get her motivated. Just use the rest, kid. So kept her home from school next day. If there was a meeting, I could do my phone. I did. If I found it, I couldn't do it by phone. Cancel it. And it was like for those days were I felt bad for about 15 seconds because that I had to find a place to be scheduled. Said things. You

spk_0:   26:56
know what that's like? So I

spk_1:   26:59
was like, Yeah, on that day when I can. So I felt bad for 15 seconds on a channel that are any of these things critical for the world's existence? No. Is she critical for my existence? Yes. Okay, so push comes to shove all these kids. Um, but some days I'm all is Well, some days are much more president work. Somebody is a much more present for home. I spent a number of evenings, probably Monday through Thursday, two or three hours a night, because during the day, this time with my kids know on Fridays I picked my daughter from school at 2 15 and that moment until Monday morning, they converse if you know we do things together, are we? If they have plans and they were going somewhere and they're doing something and I have down time at home, I may choose to get caught up. I don't respond to hardly any e mails what I send them out. It's with the understanding I won't hear back from you until Monday. So I changed my just frontload. I probably do a 50 to 60 hour work week, but I do most of it for four. It's taken any relationship. Bill and I are hardly ever 50. 50 were usually 60 40. Just changes. Who's the 60 40? Hey, very day today may very well to be very right now he's coaching basketball for the middle school. So

spk_0:   28:49
cute he's so serious

spk_1:   28:52
about it. He still owes there were 13 set the bar low, but anyway, um but you know, usually when it's not basketball season. He's something. He loads and unloads a dishwasher. He has a grocery shopping. He does all the cooking, which always he does the cooking and then doesn't dishes like that system. And then everything else is mine. But you know what, though? If I don't have to wash a dish, grocery shop or cook, I good. I'll do all the cleaning out to make a three. I'll pay the bills. I'll do that. Appointments problem because that I would be a part. I don't like it. So he hates laundry, and Vicky sabotages him on purpose. He shrugged. 02 casualties, letters on purpose. I know he did. I know he did.

spk_0:   29:48
Fine. Never touch you again.

spk_1:   29:52
Um, but again, we have our strengths and we have our things. We back each other up with kids because they will try to split you. So something happened. So it works. It's just part, Yeah, at this stage, for your career in life, Do you have a piece of advice for a medical student? It's something like when I went to high school, it's very different. And when you guys were now make, we were speaking of not multitasking. We were in class. You were in lecture 8 to 12. 125 Monday through Friday. There was no capstone. There was no scholarship unless you Unless you I was I was And I was on a lecture. I was a lecture hall person. We didn't have recorded lectures in the Stone Age. Our school didn't even have a note service. We just had people who took the class ahead of us would hand down notes, too. Someone like a little sip type of relationship? Sometimes. Sometimes not. Or we would kind of cover for each other. We would share notes of somebody, miss lecture you would kind of share with each other. But I liked to be there. So I was, um, 8 to 12 and then the gym from 12 to 1, and then one defy lecture. And then in winter, like hockey, I there at six. In the morning or 10. So we were very unique. Directional. Yeah. So you you have to multi task or think about multiple balls in the air much more than we do. Single tasking. Um, being easy on yourself, um, opening up to friendships and relationships and not selling yourself and I was a, I think Bruce Captain gives us advice. A swell Friday night and Saturday or yours. I skate every Saturday in med school. Well, when there was snow on the ground, if it was, no snow on the ground was shaking. Saturday was my day, even that. Then Sunday was a library, depending on the forecast. If there was good powder on Sunday, I would do homework on Saturday and on Sunday. But that that weekend day, Unless it was the weekend before exam week, right? I went take a day to myself to just breathe, but I think connections, you know, schedule breathing time. Try the unique. Ask if you can. Um, there's so many really important things. I'm just being being easy on yourself. Obviously, it's a serious thing to tackle. It's huge, right? People get a little okay. Like it's the only Yeah, specifically women any. Don't undervalue yourself. I undervalued myself. I did not negotiate. Well, money is not the only negotiation piece, actually, to a really good conference on women women in leadership in medicine a few weeks ago And amazing talk on negotiating. Um, and I'm gonna ask that person come to better to speak. But now just everybody, not just to the women in that class. I mean everybody. But she was pretty fierce. And she would, you know, just practical ways to approach negotiation. Burbage. But don't undervalue yourself. I can't say that enough. Have women mentors and war just inspiring woman play a role in how you have seen your career change? Fabulous women friends? I shouldn't say I have a G I friend who, if I could be here, she's the perfect. You know, I'm not worthy person. I lost touch with her. I feel like your time. It is a basic so we just reconnected and we're gonna probably go out for a coffee across one in early January. But But we've discussed this. It's because we're all so busy with the jungle that wouldn't end. Medicine schedules tend to be the most onerous schedules. It's difficult for us to, especially to fight time. Yes, it can, because we're all doing the same thing. Like Dr Rafael and I are friends outside of school and for us to try to find a night. One of us doesn't have a child or a family obligation, and we're both free, and it's not a date night, and so does not. All you know, it's hard. It's really hard for us to do that. So we tend to do lunch here a lot together. Just defined that time. But even then, biting lunch. Yeah, it's hard, Mr. So It's not that there are not incredible women role models out there. It's just growing up. Also, much of your time in medicine, there's more women that are visible. Yeah, I did not have many, if any. Visible with him when I was training was a lot of men who were visible and no women in leadership of my medical school at the time. Yeah, so just a different time. But I've had incredible supporters. Too bad along the way and friends who who are women, who have been very supportive. I live in a group of mom's working moms. Most moms who work some don't you know. You know, if I'm hold one of Friday and my neighbors at work, she'll call me and say, Can you let my dog out? I forgot. Or, you know, the school just called. Trevor needs to go home. You sick? Can you pick him up. Well, it's just helped to carry me at times. And I have friends who just, you know, we do that for each other so that we can all maintain our our sanity just a little bit. Yeah, so I think that that network, whether it's a physician that work, not having that women network, I can't imagine doing anything else. You know? I love it. I love. I didn't think I love being in the academic world so much. It's awesome. I mean pros and cons to everything.

spk_0:   36:28
Thank you so much, Dr Marquis, for coming to share your thoughts and your stories here at essential wisdom inspiring future female physicians. It was such a fun time having this episode with you. And I hope our listeners enjoyed it just as much I have to disclose to the listeners out there the doctor, Tracy Marquis Eigeman is the power that helps essential wisdom continue forward. She is my mentor on this project and just a dear mentor in my life. So I'm so excited that we were able to share this conversation with all of you. Thank you for coming back again to listen to essential wisdom. I hope you will choose to tune in again later this week. On Thursday for another episode. We're nearing the end of our season, and it's just really coming to a great fulfillment. So thank you again for tuning in. Please come back next week and have a good week, everyone.