Ep. 53 | Elizabeth Flail, DO, Emergency Medicine, SGMC Health

Transcript

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- Chest pain, shortness of breath, or just not feeling right. How do you know when it's an emergency? Welcome to What Brings You In Today?, a podcast from SGMC Health. I'm Kara Hope Rockwell, and I'm Erika Bennett, and today we have Elizabeth Flail, DO, an emergency medicine physician with SGMC Health. So Dr. Flail, what brings you in today?

- I'm here to talk about emergency medicine and the reasons that we should be coming to the ER the urgent care, and just kind of overall the health system from the standpoint of being chief of staff. So excited to be here.

- Thank you. All right. Well, let's start off with your background. Kind of tell us what led you to even become a physician.

- So my dad was an emergency medicine physician and he practiced right here at South Georgia Medical Center for 25 years. So I remember as a child thinking what my dad did was pretty cool. I remember being stopped as a kid and people being like, "Oh, you took care of me in the ER. Thank you. " staff and the nurses just always being so, you know, warm and welcoming. So at a, at, at a young age, I remember being very fond of his career. But it was really my mom that told me when I was entering high school, I was 15. She was like, "I want you to shadow your dad." I was thinking about being a physical therapist, maybe a vet, medicine. I knew I wanted to do something in sciences, but I didn't know what. And so I shadowed him and I was hooked on patient number one. We had a VTAC arrest and he we, he was shocked, he came back to life, he had a STEMI, he went to the cath lab, he, he lived. And you know, that does not happen every day in the ER, but it happened on my first patient encounter with him, and I was like, wow. I mean, what purpose in life to be able to save someone's life, right? You know, you're there in a time of need, in a true emergency, you make a difference. And I was like, this no doubt, I was 15, that's what I was doing. So the rest of my whole life really has been a mission and a purpose of, you know, becoming a physician and on that career path. And my mom actually really set me up with mentors to get me there. She I sat out, I shadowed Kim McGow, a pediatrician here in town. She was my pediatrician.

- Me too.

- And she's, she has no idea how much of an influence she's made all my life. And then Dr. Korsen, the OB/GYN huge impact on me and Bridget Moore. So I got, you know, put up with just strong women that really let me know I could go into medicine and I could do this. So that's kind of how I got here.

- I think it's so powerful to be able to see other women doing that- Yes. ... whether it's in your specialty or not and just know that like, oh, oh, I can achieve

- That because they have. Yes. All moms, you know, two of them having four kids you know, and very involved, you know, parents, they they live for their kids. So they, they had a huge influence on me.

- Yeah. And what, so you were hooked on emergency medicine from, you, did you ever consider any other-

- Yes. ... specialty? I actually, I love peds. I still love peds, but I get to see kids, but I, but it was actually Dr. McGow that said, "Don't do peds." She was like, running a business and an office is challenging. You get to see plenty of peds in emergency medicine. I think you're gonna like that career path. So I, you know, I remember gra- getting into medical school and really loving peds and I called her and she was like, "Don't do it. " And so I, you know what, I didn't even question it. I was like, "I'm gonna take her advice." So here I am.

- And you, do you, did you know you were gonna serve in Valdosta or did you think you were gonna do something-

- You know, I'm gonna be honest with you, I did not immediately ... When I, when I left UF, I did have this picture of going to the big city and having this career and I took a job up in Atlanta, like on a partnership track and I was gonna have this amazing life in the city and then, you know, life has this way of sometimes just kind of, you know, hitting you in the face. And so my son Weston was two at the time and I actually unfortunately diagnosed him with cancer. He was sitting on the couch with me and he rolled over to my hand and I palpated a mass and I was like, "Oh my gosh." And I was like palpating it around. I was like, "It doesn't cross the midline. He doesn't have any symptoms." And I just remember Tony was sitting right there in that chair and I just look up at him, I said, "I have really bad news and I have really good news." I was like, "Weston has cancer." I was like, "The good news is it's really treatable." And he was like, "What are you talking about? " I'm like, "I, I can feel it. It's what, it's what it is. " And he was like, "It's not, he's constipated." I was like, "That's not what it is. " So he actually went up to my place of work and we got the ultrasound and of course was Wilm's tumor, that's what I told him he had. And we got transferred to CHOA and he had a nephrectomy and chemo and very intense 10 months of my first coming out into practice and this dream job I thought I was gonna have. And it was Valdosta that reached out to me. My friends were in Valdosta, I don't wanna cry. And they were so good to me. And I just thought, life's too short not to come back home. So I came back home and I wanted to make a difference here and that has been my mission to make the healthcare at SGMC be as good as Atlanta. Yeah. And you know, us have that same caliber of physicians here. So that's how I'm back.

- Wow. Very powerful.

- I know. God, you make me want to cry. Yeah.

- Well

- ... So let's, we'll take it back to more simple things- Yes. ... for a little bit. Let's talk about when someone should go to an ER- Yeah. ... or when maybe an urgent care, because y'all also run operate, your physicians are in our urgent cares.

- Yes. - And that's kind of relatively new. I mean- Yes. ... it's been around for several years, but becoming more popular. Yes. So how do patients decide when they should use an urgent care? Primary care, urgent care or ER?

- Yes. Okay. I will say, I just want to give kudos to the community. They have done a really good job of choosing lately from all the publicity of y'all done. But, you know, the Smith ER, Maine and the two urgent care. So let's say, let's say, like your son had a cut on his face, you know, depending on, you know, the time of day, that probably could have gone to an urgent care if it happened. It was right at the time urgent care clinic right before. Of course it did. And I was like- Yes. But if it's smaller and you're, you don't think you're, it's one, a one year old that's in a need sedation that can't stay still, that's perfect for an urgent care. Or your child is at football practice, they roll their ankle, is it broken or is it just a sprain? We have x-ray capability, perfect for an urgent care. And of course, your coughs, runny nose, congestion, you need to get in somewhere quick because, you know, you're in the public school system, you need that school excuse right then. So you gotta get in and get a school excuse. Yeah. So, and for those acute, you know, treatments, things like that, the urgent care's wonderful for that. And then the Smith ER is great. Let's say you're, you're 35 with chest pain, you don't really have any risk factors, but you're worried, "I'm having chest pain." Smith's perfect for that, you know, and you're, you know, nausea, vomiting, gastroenteritis and all the ... And we can do most things, but if you are a transplant patient, on dialysis, if you think you are having a heart attack, if you have stroke-like symptoms where you cannot move, you know, one side of your body, that is what main campus, we have all the specialists and all the service lines, and that's when you go to SGMC in the main campus.

- And let's talk a little bit about, like, triage. I don't, and, you know, we use that word frequently because we know what it means, but most, the public doesn't understand that and kind of how when someone does arrive in the emergency room- Yes. ... kind of how that process works, what does that look like from what's happening in the background that they see?

- Right, right. When you're coming in that front door and you're coming into our lobby, let's say the main campus, and you're initially putting in your chief complaint, then you get pulled into a room for usually a nurse, and sometimes there is a provider out there too and you're taking your initial complaint, vital signs, and they're giving you an acuity level, and it's, it's one through four. One, you're coming right back, we think that you are truly having a life emergency, and four being, this is simple, this doesn't require a lot of additional testing, that's a four. And a lot of that's based off your vital signs. You know, someone whose, you know, heart rate's real elevated and blood pressure's real low, of course they're gonna go immediately to the back. But if all your vital signs are fine, we initially put in those initial labs. So from there, we have lab techs that are up front, x-ray that's up front, so you get all that initial kind of workup, and then based as your results are coming back in, we triage that next acuity and moving you forward. Now, if, if we are, you know, the ambulances aren't coming through the back, we move those directly to the room. But what people don't see, especially at the main campus, is we are a regional referral system, and we are taking care of Lowndes County and the communities, and that ambulances, we're at grounds air, which means every truck is out almost the whole day. And so a lot of times you're waiting thinking, you know, why am I not getting back? But it's because those ambulances are coming in with the sickest of the sick and they're going straight to rooms. And so that's how they kind of determine the acuity.

- Yeah. And as our main campus is kind of advanced in capabilities- Yes. ... brought on more specialists and formalized our trauma program, protocols, I mean, we are seeing more and more patients come from across the region. Yes. So more from that 15 county, even 25 counties surrounding area for those high acuity and those things that they can't access- Exactly. ... closely in their region. Exactly. So they're having to come here.

- And just Lowndes County's growing. Yes. You know what I mean? And with that, and, you know, our population is aging and just the complexity that patients come in with, you know, there's a lot of complexity. I mean, I think this week we have, you know, I'm just thinking in one day, I think we put in four chest tubes that day. It was just like, it was just, you know, the acuity is just high here.

- Yeah. And talk about a little bit, like, why is choosing that right level of care important for us as a health system- Yes. ... but also for the patient themselves?

- Yeah. I mean, because when you are choosing the right area to go, let's say, you, you show up at the ER, it's something that could have gone to the urgent care, y- you're having it with, and it's your time, right? You know, and, and you need to make sure that you're getting to where you need. But also for the healthcare system, not to lack of a better word, bogged down, but when we have a whole bunch of people checking in that might not need to be at the ER and we're trying to triage all them, do all their labs, it does put a s- a strain on, you know, some degree of the ER of trying to get through all those patients.

- Yeah. And I think that's why, I mean, as a health system, open it, reopen in Smith Northview- Yeah, it's been great. ... ER was wonderful. Yes. But obviously that filled up just as fast as it opened. Yes. But another good advancement that's taking place right now is the new construction- Yes. ... for the new emergency room and trauma center. And definitely something that's been, what, like, I don't know, five or six years- Yes. ... in the planning stages, but we're so close to that opening and tell us about what the functionality that will offer just being bigger with capacity.

- Yes. It's definitely gonna help with capacity and it's definitely gonna help with those, when you're coming in from the lobby standpoint, our ability to be able to see you quicker, do more. We, we've designed it that way. But what's really, I don't think, and everyone realizes that mental health is a real problem in Lou- in, in Georgia, just really anywhere in the nation. And so right now, if you come in with those type of complaints, you're, they're holding in ER beds. But in this new unit, we will have its own section that will be staffed kind of differently, held differently. So we have, we'll have so much more bed space on top of that with that design. And more trauma rooms and, and better flow. And, and the flow's kind of designed for more, kind of what you see more upstairs with the, with the nurse and the patient rooms, more almost like a cubby with being designated closer to the patients just to kind of facilitate quicker care, you know, more bedside electronics right there in the room. You know, the x-ray capability is going to be right there in trauma. I'm going to have to call for an x-ray and when after I intubate someone, I'm going to pull it down from the, the top and, and take a picture. I mean, everything's going to be just so excited about it. But I definitely think the community is going to feel improved flow, you know, when they come in for an emergency and then I think it's going to also alleviate probably some of Smith's burden. You know, they, they see over 100 patients a day. Right. Because sometimes it's hard to get in with us...

- Yeah, that's gonna be huge. I can't wait to see how that once that's opened- Yes. ... and utilized as it's built to be with the difference that that's gonna make- And we're still on

- Track to be completed at the end of

- 2026. I mean, it looks amazing. Yeah. I mean, the, the, when I'm driving in, like, you know, it's dark when I come into work in the morning and I'm always like, and they're just, they're all the construction people- Yeah. ... walking by and I'm just like, "Don't hit anybody." You have my eyes out on the road, but they do a great job. Yeah. They've kept it looking beautiful. The whole site and the area that we walk by and they are right on track. They might even be early. Yeah. I've been impressed. They're

- Doing a really good job- Yeah. ... to like keeping things moving along and because it matters because the quicker we can get into that facility, the quicker we can start operating- Agreed. ... at a higher capacity. Yeah. And obviously, like you said, Lowndes County growing, I mean, the, the demand is just there. Yeah, it is there.

- Yeah. Well, just switching gears a little bit, you currently serve as the chief of our medical staff. So what does that mean? You know, what, what, what impact does that have on patient care across the health system?

- So, you know, there's a medical executive committee that's made up of physicians here. We have, you know, you have your chief of surgery and the, and we have ER and medicine and a board. And essentially being head of that, you get involved with more of, I say day to day operations. I think I'm kind of the liaison of the medical staffs and administration. So when we're trying to grow and we're talking about, you know, what we're doing next and what's, what, you know, what type of physicians do we recruit and what service lines do we need I get to take a place in a lot of that, which I've, I've really enjoyed. And I think Mr. Dean and I have a, a pretty great relationship. He's easy to talk to. We can talk about growth and vision and where we want to go as a health organization. And then it's really nice being able to go to the board meetings. I've learned so much going to those, you know, I, that's how I realized five years ago the growth of all this was happening and going to the strategic meetings just learning about also just how much the health system is an economic impact on Lowndes County. I don't think I realized that, that to have a functioning economic fiscal important, you know, community, you have to have a, a great hospital system... Yeah. We are so responsible for the strength of the community fiscally too, right? Yeah. You know what I mean? That brings businesses in and we're taking care of everyone, right?.. So I don't think I realized that until I got into this position.

- Yeah, the not- for-profit status of the health system and how we truly are an organization that is built to serve the community regardless of their ability to pay. Yes. A lot of that come, but if we did not operate like that, where would those patients go? Exactly. I mean and the fact that you have to make sure that you're sustainable and still growing and still ma- you know, elevating your level of care, but in a fiscally responsible way so you can still be here- Yes. ... because last thing you ever want is for the health system to just go away because someone wasn't-

- I know.

- ... managing it appropriately and the responsibility. But I think we have a good team that leadership team that comes and really rallies around that and understands that and the medical staff is just phenomenal. So what's been the most surprising to you serving in that role that you've learned about the health system?

- I mean, I, I'm, right now I'm, I'm the only female sitting on that. And usually there's another one which, so I'm, but it's been I, I, I appreciate that, that has been a respected role for me, right? I don't feel like when I sit down at the table, I'm being judged as the only female at the table like a peer and, and I think that they listen to me with my leadership ideas which is, it's, it's been refreshing. I sat, I sat on med exec for five or six years as treasurer, and then I think it was Dr. Ziegler that told me it's time to put on my big girl pants and step into the next phase of the world that I was a little hesitant to do. He's like, "But, you know, if you, if you sit here and you're gonna be a leader and you're gonna be trained, you have to be willing to step up that ladder." So, and it's a six year commitment, right? Yeah. Two years chief of staff elect, two years chief of staff, two years chief of staff pass. So but, you know, you have to have people that are willing to fill those roles. And so he kind of nudged me but I've enjoyed it.

- Yeah. I wanted to talk about that too, like just being a woman in medicine, like, what kind of progress have you seen over your career of, you know-

- Well, for me personally, it's pr- pretty drastic, right? When I came back here 11 years ago, most everyone that was practicing s- knew me as a child, right? Sure. So I mean, I remember, like, coming in and the Millers would be like, "Hey, Liz," you know, like, they knew me as a, as a, as a kid. So that was a little bit challenging, right to have to prove my almost worth, right, like that I, you know, when I called them with something that I, I'm competent, that I know what I'm doing and you know, I'm a physician too and to be taken as a peer. So that has been you know, an over decade process. But if you know me, I love a challenge. So I kind of took it to even work harder strive a little harder to, to prove my worth a little bit more because, you know it's, it's hard when you grow up in a town- Yeah. ... and you're from here and then m- move into a leadership position for make sure that people understand, you know, where you're coming from. But, you know, I think I learned also doors open when doors are supposed to open to not push on that door. So when I first started here, I was 30 and young and I was eager and I had to learn to also take a bit of a step back and, and learn from others and be mentored and develop my practice as a physician before I developed anything in leadership because, you know, you have to have a foundation of, it's a lot different in residency than getting out and working. Yeah. It's a, it's a big learning curve. So I'm thankful for the time I had when I first got back here and to really just hone in as a physician and then progress more in leadership and o- operations. I, I really like operations. I don't know if anyone else is like, "Oh, I love operations." I like, I just find it fascinating.

- Yeah. I like-

- Cause

- It's so dynamic. I mean- It's so dynamic. Healthcare is so complicated. It's so helpful. Everything about it. So try to remove whatever barriers you can- Yes. ... to make it better for the staff and for the patients.

- Agreed. That's really what's led me to, I don't, to be in school right now, I'm getting my MBA in healthcare and it's because I've enjoyed operation so much and I was, I wanted to get more, you know, business degree with that and kind of develop it more and I've enjoyed that. I graduate in May, two years. Awesome. Nothing like going back to school in your 40s. No. I remember how to write a paper. I was like, "How do you write a paper?" And, you know, when we wrote a paper, it's completely different, you know, they have this APA format and everything's done differently. And I just remember sitting down for my first assignment, I think it took me 10 full days to write my first paper. Like

- Let me remember how

- To do this. And I was like, let me, let me try, but you know, now I can write a paper. There you go. Come back to the basics. Yeah, that's right.

- Is it interesting to you to see all the new female physicians coming now? I mean, now I feel like that's almost transitioned to where it's more female-

- Yes. ...

- Dominated

- Than male. Our residency classes have been basically split fifty fifty, male, female. Yeah.

- Yeah. I, I think that I don't want to say women can do it all, but I do feel like women's brains are tasked very efficiently for multitasking, right? And so I think that works really well in, in medicine. And I think that that's what makes them excellent providers. And I think that nurturing side that's just kind of naturally in a, in a female makes a really good physician- Yeah. ... because you, you have that empathy, and of course men have it too, but you know, it's just, it's just a little different of an aspect in healthcare. And I think this what attracts females to it. I think that you want to help people...

- Is there any particular like story that stands out to you, experience as a physician that you like just that really stood out and you're like, "I'm doing the right thing." Like ...

- I think COVID, just the whole thing of COVID, I think that I realized that I definitely, that was my calling was to go into medicine and you know, we were the health of the county. Everything shut down, even doctor's offices did. So the ER really was the hub of health for Valdosta and and it was interesting to see just how physicians in my group really stepped into this role of not knowing were we gonna be harmed, you know, what- Yeah. And, and no one even thought about that. I mean, healthcare's just such a calling being, and we were like, you know, we put our mask on and we got out there and like we took an oath to serve and, and to take care of others before ourselves. And it's kind of a little bit, I always tell people residency's a little bit militant, right? Like you're working 80 hours a week and you're working for a purpose and you have this group, you know, camaraderie and you're, you're almost like fighting for something. And when you, when COVID hit, I was like, you know, this is what we're training for. This is why we're here. And I got to really take care of a lot of people in my community you know, when they were at their sickest. Yeah. And, and it was scary. Yeah. You know, I, I think everybody has a little bit of almost PTSD when you think of COVID, you know, you don't really want to even talk about it, but I think that that really was a, a turning point. Also in my career, it's where it kind of launched me into leadership-.. ... because, you know, I was here.

- Yeah.

- Right? So ...

- Yeah. That was a very challenging time for everyone. Yes. But I do think a lot of strength was shown- Agreed. ... in display through that, that you could never see and recognize fully- Right. ... without something like that happening.

- Yeah, agreed.

- Any misconceptions out there about ERs or anything you hear like maybe just something that you hear that, any rumors that you

- Want to

- Dispel or like-

- I think it just in general, I think people ... I think the wait time is the main thing that, I think we all hear like, you know, why am I not getting back? And I do think the larger building will help that, but I do want people to know that even though you're out there, stuff is being done and what's going on in the back is sometimes, I mean, it's just, it's, it's life and death. And it's not really sometimes until you get into the back, you know, that you realize, oh my goodness, this is what was going on. And also I think that, I don't know if people realize just the caliber of ER physicians that we have here, I mean I'm probably the least qualified. I have done everything to recruit above and beyond me. I mean, everyone that's at the main campus is board certified they all come from, you know, UF and MCG and Emory and they are so well trained and, you know, I, we take our group against any of these major hospital systems and they're, they're more educated with more experience. And also they're just great people. I mean, I think everyone makes sure they take a tour through the ER when they're trying to recruit someone because the, the, the, the vibe is, is great, you know? And that's like with the staff, my nurses are wonderful, my techs are wonderful, you know, they take great care of me. The physicians are amazing. It's a very cohesive group that you might not realize. You think the ER is chaotic, but the few times my friends have had a BER patients, they always talk about how people are working together and genuinely happy together and how kind the physicians are. So, you know, we worked really hard to recruit just that. I don't want to be at work all day with someone that I'm not enjoying being around who might take care of my son or my daughter- Yeah, absolutely. ... and isn't well trained. So if you get- It's a culture. It's a culture, you know? If you get in an ATV accident or you're having a stroke, you know, I, I want to make sure you're in the best hands.

- Absolutely. Yeah. It gives you some peace of mind

- To know. It does. And it gives me great peace of mind. I mean, like my mom was hospitalized here for a very long time with COVID and I rem- you know, the ER doctors run the codes and go upstairs and I just remember every night just knowing I didn't, I could rest easy. You know what I mean? I just knew that she was in good hands, that whoever was down there that night would be taking great care of her. And that, I mean, it just, it matters. Yeah. It matters. I really do treat who we recruit as would I want them taking care of my family. And I can say there's not a single person that works with us, mid-level physician, I'd let any of them take care of my family.- Yeah.

- And that's important for like emergency services in particular- Yes. ... because while you can shop around for specialty care for certain things when you're in an emergency, you don't have that luxury- Exactly.

- ...

- To feel comfortable and know that you have that right here so that should it happen.

- And that's probably what sets our urgent care apart from other urgent cares, right? I mean, you might see other ones in town that don't have the SGMC name, but when we, we train for the urgent care providers, like the APPs, they only intensive like, you know like three months at minimum where they're training with us and we're making sure they have all the skill sets and then we're doing boot camps with them and, you know, we're making ... I don't put anyone out in these facilities that, you know, I, I want them to know what to know and whatnot, like, don't miss anything, know when to refer to the ER. So I really train them a lot in the ER so they see the sickest of the sick, so they can recognize what sick is and get them to where they need to be. And then, you know, you can take care of the cough and cold, but you don't want to mix someone who's septic. Right.

- Absolutely. Right?

- You have to be able to recognize those signs. And I know some of the other practices in town, they've never worked anywhere but an urgent care. Right. They didn't get any training. They went straight from school into a place where they don't have any oversight. And so I take that very seriously, the oversight of those facilities and training.

- And the continuity of care it brings to- Yes. ... just knowing them being familiar and well versed in both arenas. I think that's-

- Yeah. ...

- Unique. It is unique. And a benefit to the patient. Yes.

- And it's so nice to have multiple urgent care options- It's so nice. ... as well. We have two urgent cares right now and you can, you know, check the wait times on your phone before you go and see maybe which one's closer or which one is a shorter wait. I

- Know. I, I did just that. My kids had the flu over January and I was like, and I lo- I logged in and I was like, "Okay, take them here, Tony." I was at work. I was like, "We need to get swab." I didn't know if it was strep or flu or what, but it was, we had flu A and B lucky us.

- Oh, fun. Yeah. Yeah, I think we got that too. Yeah. Well, I actually didn't take them anywhere though because I was like, I just knew it was the flu probably. Yeah. I was like, we're gonna just medicate. But that function was put together because we were like, we know as busy moms- Yes. ... you don't have time often to wait and, and you, if you're working and you're trying to get for things like that, that's what makes urgent care so great is that you can get in and out very quickly

- Every day and after hours after work open until 7:45 at night, so-

- And their door to dispo is under 60 minutes consistently always. I mean, that is so impressive. It was amazing. And I, I mean, we were 25 minutes. I mean, from the time, you know, it wasn't any special treatment that, I mean, it just flows that well. They immediately get you in, they get you swabbed, you get your results, you're out the door. It's you know, the, you know, Mandy and Lynn, they, they have a well oiled machine at those facilities- Yeah. ... and the staff there, that's why providers like working there so much too. They love the staff.

- The staff, yeah.

- They, they're such a great group. Well,

- And for the patients too, just to have an access to MyChart to like be put in that system you'll probably get your results before you actually- You do. ... you're still sitting there before they come and tell you what they are. Yes. But- I love it. Again, adding that benefit of putting all the provider information and stuff together into one system so then you have it all there and can look

- Up- And I like, because when I walk in to update the patient, I like when they have their stuff up because they're seeing these reds and it's scary to them and I want to be like, that is just literally the size of your red blood cell and that does not mean anything about being anemic that doesn't mean that you're in bed health. I was like, that is just literally under like a microscope. I was like, "Do not worry about that. " But they would go home and worry about it and then they're Googling what's an MCV and I'm like, don't Google that. Like it's okay. Like you know, so I like that they can get on their phone because I would never in a million years think to communicate that result to them- Right. ... that that would give them fear, but when they see Reddit, they're, they're scared. They don't know what that means. So I, I like, and often now, because I have the little, the DAX, you know, I use the AI where I can go in there and I can record my conversation and so I can see the labs in the room. So I pull up my phone and I can show them in real time, "Hey, this is what we're getting back, this is what I'm thinking and, and it's nice for the patient."

- Well, I think it just also helps that patients are educated- Yes. ... and it helps them become more intimate with their own healthcare- Yes. ... and understand it more. I ask those questions that they have and it facilitates that conversation with y'all. So I think that's ... I feel like we're gonna continue to move in that direction-

- Yes.

- ... as patients evolve and have access to more of that, but I think that's important to their career because I feel like kind of in the past, you know, it was all a big mystery- And people

- Wouldn't ask questions, right? Yeah. They're almost, it was almost intimidating, like they were afraid to ask as if it was rude or they ... I'm like, I'm like, "Ask away." Yeah. You know, like, I want to answer your questions and give you some me and so I think that having that interface allows just an easier communication because they're like, "Hey, I saw this lab." And it's not just like, "Well, what's wrong with me? " So-

- Yeah.

- I think it, that helps.

- And then everybody being in the connected network, you can go back to your primary care doctor and they can see your labs and, you know, maybe-

- I just love that. Yeah. I mean, it's so nice and epic. I can just click on and I can see everything they did in a doctor's office, the cardiology office. And it just makes, it makes things so nice.. I mean, I, I literally called, you know, Dr. Or Dr. Marino routinely to be like, "Hey, I saw that you're doing this. I found this today. Can you follow this up for me? ".. Absolutely. And they're so good about getting their patients in for quick ER return, like turnarounds... All the doctors are. They come to the ER and I'm like, I really would like to them to get seen soon... They get them in soon, which is really nice.

- That's cool.

- Yeah. All

- Right. Well, any kind of advice you want to give to maybe anybody just thinking about becoming a physician. We know that they're rare around here and we're trying to build that workforce or just even getting in the medical field in general, maybe in a different specialty. Any advice you would give?

- I think that if you're in the, the high school age, I definitely think getting involved with something like that volunteering program. Yeah, your daughter did it last year. I know my daughter did and now I think she wants to be an ER physician. She had a very similar first- Following in her mouth. ... first experience that I did. She had, she had somebody that was in cardiac arrest. And I just looked over at her during it and I was like, "Oh, that's the face I had." Oh nice. And I was like, she's going to love this. And I just remember sitting down afterwards and she was like, "This is amazing." Yeah. And she got to see so much amazing stuff over the summer and learn so much. And I just think that it, it really, you know, took her to the next step and like know, it's, it's nice to have a goal and a drive. Like why are we studying in high school? Like what's your purpose? Yeah. Like I'm just so task oriented and I really just felt like it made her just like hone in like I'm working towards something this is what I want to do. So I think getting involved early is important and then I think especially as a female, what, what do you want to do? Do you want to be a mom later in life? Like what are your goals later in life? And then finding a career that allows you to do that. So I mean, I feel like a lot of physicians that are especially female get there and they're like, well, how am I going to have a family and practice? So it's either choosing a career that's more of a nine to five or like in my case, I just was very blessed with a husband that has taken a, kind of a back roll and, and take gone and cared for my kids so that I could pursue what I wanted to do, right? I mean, it shifts start at six, You know most days are 14 hour days. I can't pick them up. I can't, you know, get them to their after school events. You know, when I'm gone, I'm completely gone. Yeah. So I just think that it's important to realize that choose the right, you know, if you want to go into medicine because it's a lot of work, you know, as we take these medical students on, you know, you're not paid. We do it because, you know, we're here to, we were in their shoes and we want to get good training and we want them to be trained well. So it's a lot from medical student to residency to commit to training someone into their 30s to become a physician, right? Yeah. So it's a big, you know, lifetime commitment. Right.

- It's a commitment. Yeah. No doubt.

- So planning ahead.

- Sorry you might need to go into dermatology if you want. Pick your specialty.

- Yeah. You need to think about it. I, you know, there's a reason that most ER physicians are male. Yeah. It's a, it's a, you know, the shift hours are a little bit harder, but when I'm off, I'm really off and I get to be present and I have such great daughters I work with. Like it was my son's last baseball game for the year yesterday. Yesterday. And it was supposed to be today and so I had taken today off, but not yesterday. And one of the docs came in and worked the last half of my shift. And that's what's so nice about, you know, having so many doctors that live and work here, we have that flexibility, I cover for them, they cover for me. So that's nice. So you can do it, but you gotta plan ahead. Yeah.

- Yeah. All right. Well, one final question. Yeah. You're here a lot in those long shifts. What is your favorite meal to eat here?

- Oh, it's, that's gonna be so boring. You know, I eat a salad every single day. I'm such a big proponent of that salad bar. Yeah, I love that salad. I'm just saying, I, there's something to spinach, right?. I mean, it's such a healthy food and then I love the protein choices that are on there. In particular, I'm a big fan of eggs. When we had that egg shortage, I remember calling Hillary, I'm like, "Hilary, can we get the eggs back on? Can you reach out? " Like, "I know they're expensive, but what can we have them back?" Yeah. So I mean, that's that, but you know, the, the food services here is amazing. Yes. You don't know how many people I discharged from the ER and I'm like, because they haven't, they've been doing all this testing, they haven't eaten, right? They're starving when they leave here and I'm like, can I get you something, what's your plan? Like I don't want you to drive and you haven't eaten for seven hours and they're like, "Oh, I'm gonna go down to the, the spice of the cafeteria.". It's wonderful. I'm like, I know it is. Yeah. You know, that's another recruitment thing for here. They come here and they eat here and the physician's like the food's amazing and we eat so much here.

- Yes. Right. I know because- You don't have time to go.

- You don't have to go eat.

- Yeah.

- You don't. And so the, the, the food quality here is wonderful. And I do think it's nice that we have some really good health choices. I think I was the one that pulled the ice cream machine out of the physician's lounge during COVID. I was like, we need to be healthy and functional. And then they were like, who pulled out? I'm like, "Uh-oh, you might have somebody after you. " I do. They know, they know. They got protein bars instead. They're like, "What's with the protein bars?"

- Somebody's got to, sometimes you just got to make hard, you know, hard

- Sizes. It's better for everyone. Yep,

- Yep. Well, it has been a pleasure talking to you. Thank you so much for all that you do for our health system for our community and for our patients. Phenomenal work and so I was just glad to be able to have you on and be able to talk about that a little bit more.

- So we appreciate the dream team here, so I'm happy to be here.

- Thank you. And thank you all for listening. If you have any questions or any topics you'd like for us to touch on, you can let us know at sgmc.org/podcast and don't forget to like and subscribe.