This week on Inside Reproductive Health, Griffin Jones and Dr. Kutluk Oktay go down the rabbit hole on the meaning of work-life balance. They discuss Dr. Oktay’s approach to limiting his patient load to spend more time on research and how that affects his motivation and quality of life. This conversation culminates in tips on how to be more productive and comments on developing leaders in your organization so you can get the balance you deserve.
Listen to the full episode to hear our perspective on:
How to fill your schedule
What makes good leadership
How does social media fit into ‘self-care’
How to approach work-life balance
Dr. Kutluk’s Information:
Linkedin: https://www.linkedin.com/in/kutluk-oktay-md-phd-909b656a
Website: https://www.fertilitypreservation.org/
Sponsored by:
Inside Reproductive Health is sponsored by EngagedMD. For technology that educates your patients with true informed consent, visit engagedmd.com/IRH for 25% off your implementation fee.
Mentioned in the Episode:
Profit First by Mike Michalowicz: https://profitfirstbook.com/
Need help attracting the right people to make your practice great? Connect with us at fertilitybridge.com
Transcript
[00:00:00] Dr. Kutluk Oktay: I always think that our colleagues thought they were doing the best 25 years ago, but we look at what they've done.
We kind of roll our eyes, right, if we thought that it was today. So I always imagined myself looking at myself 20 years from now.
[00:01:01] Griffin Jones: The episode, I just recorded one a little bit differently than I thought it was going to go. I thought it was going to be about pursuing a career track in academic medicine. And it's a bit of that, but it talk more about what it means to have a meaningful and well-balanced career. My guest for today was Dr. Kutluk Oktay. He's at Yale. He's a professor of OB GYN and reproductive sciences. There is the director of the laboratory of fertility. The preservation and molecular reproduction there, he has published over 200 manuscripts and book chapters. His research has been funded by the NIH for almost 20 years.
And we talk about what it means to have a meaningful career for someone. Not that there's one path for anyone, but giving the listener an idea of what it's like to balance this and how you incorporate different interests, not just in the work part, but all of the things that happen when you're not working, you know, like your family, your health, your fitness, your hobbies, if you have those.
And that's what this episode explores in a way that's a bit more meaningful than just talking about self-care as a platitude, which I can't stand. And then talk a little bit about that in the conversation, but I'll let you decide. So I hope you enjoy.
Dr. Kutluk Oktay, welcome to Inside Reproductive Health.
[00:02:22] Dr. Kutluk Oktay: Thank you. Thanks for having me.
[00:02:25] Griffin Jones: I'm interested in the topic that you and I were snowballing, the idea that you had about the ability to have it all as an REI practitioner and specifically with regard to working in an academic setting.
And so before we go into how one is able to have it all, I believe that that the topic you had phrased as was having your cake and eating it too. So let's start before we talk about how to eat the cake, tell us what the cake looks like.
[00:02:59] Dr. Kutluk Oktay: I'm not sure if there's a cake in this instance, but well, cake is I think hobby, the first trick is that, you know, you need to love what you're doing and if you're doing what you're doing as a job, you know, it's not a cake, right? So it's a cake because it tastes good, then you enjoy it. But even having too much of your favorite food would not be good for you even eventually get sick and tired of it.
So I think to me, cake is what you love doing. And the cake is one that's made with balanced ingredients and not one flavor's overpowering the others and a healthy cake a healthy cake. So you have to bake your own cake. You have to come up with your own recipe. If you have the wrong recipe for your cake you know, you may so soon throw up everything you had eaten so the speak.
[00:03:55] Griffin Jones: We talked about a balance of ingredients. What are some of those ingredients look like?
[00:04:00] Dr. Kutluk Oktay: Well, you know, a little bit of flour and I'm just getting.
[00:04:03] Griffin Jones: That's a different show. That's Inside Reproductive cooking.
[00:04:07] Dr. Kutluk Oktay: I know I just want to make stuff, you know. During the time of COVID we are always disoriented and the wrong show. Okay. Because I do some cooking and that's part of the ingredients, right.
You need to balance your life as much as your work life. And you, we cannot be a single channel or a single ingredient cake. You know, if you just made it the flour, no sugar who's going to eat that cake. Number one is to have their idea of ingredients and not to build on one ingredients.
So maybe if you want to start diverging from the cooking analogy right. In my case, I'm curious, right, because I'm both a scientist and clinician, and I always question, I always question and say, there must be a better way of doing this. And I always think that our colleagues thought they were doing the best 25 years ago, but we look at what they've done.
We kind of roll our eyes, right, if we thought that it was today. So I always imagined myself looking at myself 20 years from now. And first of all, try to always improve things. And so that kind of makes it fun because to me, nothing is routine. Everything is a challenge, the challenge to do better, do better for your patients and do better for the field.
Never stagnate. And so the ingredients for that reason is of course it's a good patient care, but innovation and always asking, you know, what can I do? What question can I ask? And how do I study that to take this current approach to the next level?
[00:05:59] Griffin Jones: When you talk about a balance in work life, do you mean balancing life within work with life outside of work, you know, family and hobby balance?
Or do you mean balancing what you do within work?
[00:06:14] Dr. Kutluk Oktay: Right. So in your life different index funds. One is the work index funds that you want to track the optimum rate of increase in your quality with balancing components of your work. And then you have your family life. Then you have your hobbies and then you have, you know, another balancing there.
And then together you balance all of these together. So you have balancing the compartments, but then you are so the life balance. So when I say work life, not work life, but your life at work. I'm talking about, I personally, if I just saw patients seven days a week, I would probably burn out in two weeks.
And because that's not how my brain functions. Right. And as I said, that, pausing and asking questions, how can I do better? And if you just constantly see patients, you cannot pause and ask that question. So for me action versus introspection in our case, introspection is we could say research because research is introspection to me, you know, asking questions about what you're doing, whether it's right or not.
And how can I just like, how can I be a better person? So for me, there has to be a balance between actually seeing patients doing surgery, administration research teaching, and doing yoga and during your breaks, whatever. If you're doing that to work you have to find the right balance for yourself.
You might be a warrior you know you see patients, seven days a week, I admire you. But I don't have that skill. I personally my approach is I focus on one patient at a time and I put a lot of energy and time in one case. And I probably can do, I don't know, certain number of cases like that in a given time.
And then I turned my energy to more academic questions who would, which would, I answered correctly, benefit those patients or the patients in the next generation. So I have to balance the work like that. And then, and then leave time for things that make you relax outside of the work and that's going to be different for everybody.
But to me family is important. Hobbies are very important, exercise, you know, well, if I don't exercise properly, I could be staring at my screen for five hours and producing nothing. But sometimes you take part in a health to hit that, you know, hard tennis session. And when you come back in three hours, you do work that you would normally do in three days in two to three hours.
So, I mean, time is a very expandable thing. Reality, we think five hours equals five hours. Now, you know, five hours could be 72 hours, or it could be three minutes depending on your mindset productivity energy level. So you have to do things to expand those three hours. Again, to buy your times for other things.
[00:09:22] Griffin Jones: So let's see how many different metaphors we can use on today's episode. I like the index fund. Let's stick with that because you have your total resource allocation in your portfolio. In this case portfolio is the total amount of time and you have a number of different index funds within that portfolio and then with in at specific index fund, you have allocations of shares to different different companies in one index under, or perhaps even across different fields. So let's stick with the work index fund and then we'll, and then we'll move on to the rest of the portfolio. You talked about saying, you know, seeing patients every day, you would burn out within two weeks.
So research helps you be introspective at all. Teaching helps you to improve. Why do you feel that the academic route has been best for you in, in, in serving those different areas?
[00:10:23] Dr. Kutluk Oktay: Right? I think I have to think about, you know, an artist. Right. You know, why did being a you know, impressionist help me kind of why, you know it's just, I think part of it is you have certain tendencies,
[00:10:35] Griffin Jones: Let me rephrase that because rather you have your tendencies, why do you feel that working at Yale was more accommodating to your tendencies than maybe if you had gone and worked for a private practice or a network, or maybe if you'd gone somewhere else in the country, why do you feel that working at an academic division suited your tendency better?
[00:10:56] Dr. Kutluk Oktay: I'm not necessarily advocating for or against any company or any setup or private practice and all that. I think you could have a private setting but you could affiliate yourself with an academic Institute and you could still follow by the same index fund so for me.
[00:11:13] Griffin Jones: Would it be the exact same index fund though?
Or would it be like Fidelity's version of what Vanguard did? Well, you know, it's pretty much the same thing, but the expense ratio is different and there might be some fees that I don't know about. And can you do it the same way?
[00:11:30] Dr. Kutluk Oktay: I dunno. Yeah, you're right. Their management fees could be different.
And so I, maybe there are different, you know, they may not be as broad based. But I think the key is to think creatively. I think we see examples of these major private enterprises. You know, turning starting fellowships doing you know, academic investments with their private money, et cetera.
So within that, somebody who's interested in boats can also find home. So it's not necessarily, you know, Yale versus some major and right for the private practice, but I think the formula, so in the end, yes, you are right. That not every enterprise would be accommodating right. To somebody who wants to spend time on research.
So first of all, you have to find that study for yourself. But second thing is you may have to create that same for yourself. And you know, if you're attracting research funding one more or the other, or you have some you know, you have some charity or something that's you can attract money and other different ways than you can set up your lab, even in a major commercial enterprise nevertheless in academics it's easier, but it used to be easier. Let's say because academic centers are also facing a lot of financial pressures. So I don't think there's one perfect solution in that sense.
[00:12:53] Griffin Jones: Why do you say used to be easier?
[00:12:56] Dr. Kutluk Oktay: Well, I think if you listen to people for before us and when NIH funding rate was something like 50%, every other grant submitted would be funded and the universities received a lot more government funding, state funding, they had more money to throw around for research and free up there faculty. So those resources have been over time restricted. So with the managed care managed care squeeze as well. So a lot of academic centers you know, they're pushing their faculty to work, you know, similar hours to sometimes, you know, privates centers. And I think in our field it has become a problem and a lot of good any centers have lost their REI divisions and because financially it didn't make sense to a lot of them.
Must create it Yale in one sense that Yale department of OB GYN and reproductive sciences as always being a pro translational research always support it clinicians with scientific interests and always created time as much as possible or supported them so that they can get funding.
So there's still departments like that somehow, but not as mad as many of those. So I'm lucky to be where I am right now.
[00:14:16] Griffin Jones: Yeah. Well that changes things for the people that go into work for those places. Don't they, if what they wanted out of an REI division was to spend perhaps less clinical office hours, more research hours if they are starting to see more of the push that, well, we need you at this clinical capacity, no matter what do they lose some of their recruiting edge?
[00:14:45] Dr. Kutluk Oktay: I think so. I think academic centers especially at the more advanced level you know, junior colleagues, they still, I think are attracted academic centers because they need to pass their boards. Maybe build a little bit of name for themselves, but I think there's a difficulty in recruiting, more senior people and and losing a junior people when eventually they have acquired, you know, certain credentials and skills.
So yes, I think there's a brain drain in academia, especially in our specialty. You know, there are still mechanisms of supporting these like your productive scientist development program wore her, like Yale has this. So we have number of faculty who are on these tracks with protected time.
And then we see that there are some, you know, rising stars because of that. You had one of our colleagues on your show and there is still opportunities, but you know, if you compare, academia in terms of salaries to a private practice you know, we are all aware of the differences but, you know, I think the medicine, or especially our subspecialty is not something that you want to pursue because you're only interested in the financial aspects.
I think in that case risk benefit ratio is not that great. You really have to love that the path you have chosen. So as I say, somebody who's likes to do a lot of introspection through research will not be happy in that continuous flow of academic clinical practice.
[00:16:16] Griffin Jones: What advice would you give?
Because a lot of the people that listen to this show are fellows, and some of them might even want to come work for you. So the advice you give could be used against you, you got to remember that, but people are listening across the country. And in other places too, for that matter. And so what, what advice would you give them to investigate if the program they're interested in potentially working for really does meet. What they want in terms of research in terms of protected faculty time, or if it's just kind of a smoke screen, for lack of a better word though. I'd certainly don't mean to say it's so sinister for you're just going to be a workhorse clinician, like you would anywhere else.
What advice would you give fellows for sniffing that out as they determine what program they want to work for?
[00:17:11] Dr. Kutluk Oktay: So going back to financial and knowledge, I would say invest early, you know, start putting in your 401k. Well, they were early, right? I think that should start when your residents, because if you are number one, you think you are interested in research.
I usually don't like to use term research to speak on cliche whether what it means, I mean so that's why I used introspection analogy, but you're more introspective, inquisitive. You want to approach more creative side of what we do. I mean, clinical creation is also important.
I think I have to start as a resident, maybe even a medical student building that those research skills. And so that, you know, when you hit fellowship, you are maybe a few steps ahead and you can do things and enduring fellowship that could prepare you to be more competitive for an academic job, which would enable you to, you know, get funding early.
And once you secure some funding, then you have more support from these institutions to have more time. So it's a self-fulfilling prophecy, you know, like you start with know to write, to propose, to think eventually you're not going to produce anything. So you have to preempt, I would say, you know, just decide on your career path, not first year of fellowship book.
Oh boy. Maybe when medical school or first year of residency and build those skills and portfolio. If you're interested in clinical research, start working with somebody to build have publications and understand the skills. If you're interested in basic research, same thing and hit the ground running.
And so that's number one. Number two is, you know, there may not be a lot of academic jobs that you can negotiate necessarily about. If the other alternative is working for an academic center and like working for a private practice, but every reduced salary, you may. If they give me this I'll work for academics.
If they don't, then I'll just stick with private practice. I think they need to have a good negotiation. Maybe allow them themselves three years of maybe protected research time in which time they can apply for various mechanisms for junior faculties. As I said, there's a productive scientist development program.
There's the Warhol from NIH and there could be other mechanisms. Most likely they get that on board and then they can build on that. Then start getting, you know, bigger grants, et cetera, if that's what they're interested in. So that would be my general guidance.
[00:19:51] Griffin Jones: So that negotiation happens for the employment agreement.
This is the amount of protected time. You have this when you're negotiating the employment agreement?
[00:20:01] Dr. Kutluk Oktay: Right, I mean, you know, some institutions are like, Very rigid, right. And say, okay, you're coming as an assistant professor, unless you get a grant, we'll give you, or, you know, .5 FTE for you to do whatever you want with that time.
Some institutions are more rigid. Some institutions maybe looking for they're missing that we've been talking about portfolios, et cetera. Maybe now let's go more towards smaller. I mean, building a department is like building a national soccer team, you know, like you have to put the people with different skills in different positions to lead, and maybe they have a lot of strong clinicians, but they need somebody who's promising who's going to move the field.
So if you can show them the portfolio like you've done in your residency, you published three key papers. It shows that you are a promising person. Okay. Going back to the investment. So this is a low risk investment for us looks like, but he or she has done during residency. Imagine if you give her time during as an attending faculty, what she could do.
I mean, it's going to depend on the job, but if you have already built some portfolio, it will be easier for you to negotiate.
[00:21:13] Griffin Jones: Okay. So let's move on to a couple of the other index funds in our portfolio. We've talked about what would the actual work-life the allocation of work.
Let's talk about the rest of the allocation of life. You could family as its own index fund. Hobbies would be its own index fund. Health and fitness would probably be its own index fund. And so of those other three things, which, which do you find sharpens the saw most for you? And by that, I mean, gets you back.
You mentioned if you play around a tennis that you can be exceptionally productive afterwards. So which do you find reenergizes you the most quickly?
[00:21:59] Dr. Kutluk Oktay: I don't think anyone matters individually because in the end this is the total amount of assets you retire with. Right. So I don't care which one built that fund.
I think it, again, it's balanced and it's also depends on the day. Right. But you know, I can have the same pleasure as going, picking up my daughter from school, let's say, during the lunchtime and bring her home and chatting whatever, as a you know playing a tennis match and kicking the rear end of a right.
You know, long-time rival in tennis or something like that. I think it also depends on your chemistry that day, too. Right. So so I don't think that there's a formula for one person, but whatever keeps you balanced. But I tried to keep these things going. I agree with you that exercise a regular exercise is important.
I also personally do yoga regularly. I've discovered this maybe three, four years ago. And it's a really, it balances you in some things. Some days you have 10 minutes, you do 10 minutes, some days you have more, you do more. So not only exercising of body at the same time, you're exercising your mind in a different way than when you're reading or doing experiments or seeing patients trying to solve a clinical dilemma.
I think your mind, your brain also needs stretching. So if you only stretch it in one direction, it's deformed. So you know, like seeing patients at stretch stretches this way, we will research stretches this way, but if I do yoga this way, you know, exercise this way, family that way. So you're going to have more space.
So for me, you know, it depending on how things are one may do better on day am. I may do better the other way.
[00:23:43] Griffin Jones: I didn't think that I would do an Engaged MD sponsorship read for an episode on work-life balance. And then I got to the end of the episode and I'm like, no, this is the meat and potatoes of what you want from someone like Engaged MD. One of my guests and I are talking about the junk bonds of work that go into the work life allocation, the junk bonds are those things that are monotonous tasks that should be done at scale, should be done with software, should be done ahead of time, should be done at the convenience of the user, but aren't. Things like repeating the same information to patients to teach them things that are coming in their protocol.
The same legal forms, except you're tracking down one for this patient. And your staff is basically law clerks because they're tracking it down for another patient. All of these things that should be done at scale, that should be organized in a platform. And that's Engaged MD. That way you're spending your time with the most valuable minutes possible tailoring the experience to the patient's needs.
They know what you're talking about because they're well-educated and you're not acting like a darn paralegal go to engagedmd.com/irh, but only if you want 25% off the implementation fee, if you do, if you go to engagemd.com/irh and you select. You heard them on the show or you heard them from me, you'll get a few bucks off of your implementation fee and it helps us to create more content and give you more resources like this, but you'll also be getting time back to make life better for you, for your staff, for your patients, because that allocation is not infinite.
The junk bonds have to go. And the meaningful work and the meaningful things that we get out of life have to stay, go to engagedmd.com/irh and get some of your time back.
When you said at the end of the day, it's the fund that helped get you rich was the most important. And in this context where we're talking about rich in life, as opposed to material wealth, but that can be a part of it.
And I think that the question people need to get to this allocation answer is what does it look like at the end of your life? And what, what do you think you'll regret? And I do believe that there are people like Jeff Bezos and like Elon Musk that I don't think they're going to regret, not spending time with their loved ones that much.
I really believe that those are people that will regret if they haven't gotten to the absolute limit of their pursuit. So I do think that is possible for most of us though. I don't think we're going to look back and say, I wish I worked one more day. I wished that I had taken that meeting.
I wished that I had done that for most of us. I believe that we're going to either regret not having pursued something else that was meaningful or spending more time with our loved ones. But what we will regret if we just sit on the couch and do nothing and we don't, and we don't become better at our craft.
And so now you have more things competing for time. Potentially what I think has to go is the things that don't lead to any one of those things that have been decided as meaningful, meaning candy crush, video games and not to say that all of those things can never be meaningful, but I I'm talking about the things that don't fulfill our, our biggest interest in the form of hobbies that don't make us closer to our family.
That don't make us better at our craft. You know, the YouTube videos that I think those things are the things that have to go and if you want to have a balanced life, you really have to, you have to protect even more. Don't you, in terms of your time allocation.
[00:27:44] Dr. Kutluk Oktay: Absolutely. You've got to get rid of the junk bonds, you know so penny stocks, whatever exactly.
I mean, I'm not saying I have an ideal situation here. Yeah. As you said, you know, watching TV, you know, Fantastic movies that you can watch and great sports events you can watch. But if you can, if you're consuming a TV three, four hours a day, the social media Instagrams and things like that you know, you're already, what is that time coming from a lot of those other components, right?
As you said if you think that you fulfilled everything else and you still have free time, congratulations to you and you must be in a different dimension, but go ahead and invest your time into other things. Perhaps one of the things that I do is, yeah, I rarely watch TV, for example, I'm never on social media.
I'm very selective. For example, I mainly use LinkedIn, but that's select, maybe I will post once a month. Maybe we'll our operation we'll do an Instagram post once a month. As you said that the social media could be poisonous in that sense. You know, obviously if you have a professional operation, I think this is more for private practices.
They do all that stuff for you that can spare you, right. In terms of business marketing.
[00:29:11] Griffin Jones: Well, a lot of people think that I am just ubiquitously pro social media and I approach life as a consumer and a business owner. Not always through the same exact lens. It's important to look through both lenses, but sometimes they are different as a business owner.
I can't get romantic about where my client's attention is. My perspective client's attention, or in the case of providers where their patient's attention is, I have to go where that attention is, and I have to speak to people where they are. But as a consumer, I don't need to be watching what my friends are having for breakfast or some political debate between two people that have no business commenting on policy one way or the other. And I think that has to do with the junk bonds that you were referencing. It's not for me to say this. This is exactly a junk bonds. Although I think generally I could speak to it and generally be right, but it's going to be different for people's allocation, but people do need to get rid of that first, because there's never going to be enough time for all of the other.
[00:30:19] Dr. Kutluk Oktay: Right, I mean a social media. You're right. There's a business function of it. As I said, you know, you can use that, but otherwise it's designed to be addictive. I mean, it's a drug, so we just, the more we take it, the more you'll be evicted and it's a war text. You'll be socked in there. So, you know I was always scared of that.
[00:30:38] Griffin Jones: Did you think in these terms, when you were building your career outlook, what did you think as you took your first real job? Or did you think, well, this is how I want to build my life. Or did you start thinking about terms like work-life balance after, after your kids started growing up after millennials started talking about it all over the place?
Is this something that a focus that came to you later on? Or did youset out to build your career in a certain way?
[00:31:08] Dr. Kutluk Oktay: I think cliche, right, that's what they say life is what happens to you when you're busy planning. And so obviously, no, but I mean, my goal was always to have fun and that if something is not giving me fun, I'm not saying, you know, fun, meaning you know, I'm going to be playing cards all day or something, but there has to be fun.
Right? So when I followed my own principal, it just naturally happens. I try to do my allocation based on that, but of course, you know, the the more you live and see the more wrong steps and missteps you take, you realize that, oh, you know, I shouldn't have gotten that waste your next time. You're better trained the mouse.
You don't get into that trap. Yeah, I don't think that you can do that allocation at birth.
[00:31:58] Griffin Jones: Well, maybe that's what we're starting to see more of maybe not at birth, but starting to see it younger and younger. And I wonder if that's the difference when we talk about millennials wanting work-life balance, one of the responses has been, well, all the generations have wanted work-life balance.
It would have been great to have, and surely millennials are not exceptional as humans in the sense that they are the only ones that want balance between their work and their hobbies and their health and their fitness.
[00:32:28] Dr. Kutluk Oktay: Well, I think there expectional, I admire millennials you know, like they're the homodeus.
[00:32:33] Griffin Jones: What's exceptional about them?
[00:32:36] Dr. Kutluk Oktay: They've got all the skills, you know, like we didn't grow up with a giant life pop med, you know, the internet, right. We came into that. So they have this huge life, bob mitt on internet. They can, they can get their answers to everything. I mean, one question is now, how necessary is the classical schooling system?
And you know, you can get all the information. Of course, the skill we need to teach them is to objectively analyze what they see on the internet to scrutinize it. But my 15 year old has more wisdom than I had when I was at 35, because of all the giant global library that they have at their disposal.
So they figure it out. When I figured it out at 35, they figured out that 15, of course they don't, you know, like, why am I going to be a doctor? I want something that offers me more balanced. I'm going to plan something so I can work from home or, you know I'm going to boost start-up I don't want to work for anybody else.
So I think that's where I'm saying that they have that kind of long view. They don't have the classic on the standing of her going to working for somebody it's still the right. Of course that's going to create some kind of anxiety in that generation because you know, there's so much competition for the independent space.
So it's an interesting experiment and I'm waiting to see how it's going to end. You know, like I lived there 15, 20 years, we'll figure it out.
[00:33:57] Griffin Jones: So I think that's what makes them accept. It's not the desire to, because you yourself have talked about that desire, but it is exceptional that they are coming into the work force with a picture in mind of what work-life balance looks like.
And they are willing to prioritize it in terms of walking away from offers or quitting jobs or who they go to work for. And your point is interesting about how the accelerated learning from the digital age has been a part of the accelerated expectations, right. You hit on the accelerated learning what you knew at 35, your 15 year old knows.
I think that's all also true for expectations of, oh, if this is what a 35 year-old drives and what a 35 year old makes in salary. And this is what I want coming out of college too.
[00:34:53] Dr. Kutluk Oktay: You know, I don't know if it's some kind of enumeration issue, but definitely they have I think you know, more global view on things and the priorities.
And so, you know, maybe you know, maybe they don't think that you need to sacrifice your life because life is the most, you know, most valuable commodity. To you know, have a luxury car, right. And I think they're so globally connected. They experienced the word globally and you know, they have other ways of enjoying life rather than traveling on a private jet.
So you know, it's not a hippie generation, right. But I look at it as you know, differently, less militaristic male generation. I don't know how I put it, but that they're less regimented to me more broad minded. And they don't want to be you know, put into cubicles to achieve what they want to achieve.
And I don't think there's any amount of money that can force them into the lifestyle that they detests. They think they have options, let's say.
[00:35:54] Griffin Jones: Well, I think one wrench in the works is that having junk bonds in the portfolio, I think they want the yield of the portfolio. And that is, it is possible to get a high yield from portfolio.
But I think that there's a lot of junk bonds in there. And that's one of the concerns that I have when I hear the word self-care and I hear it's, I am more than open to the idea of self-care it is necessary for being productive. If it's something that, that actually helps rejuvenate you, that if it actually helps you pursue a larger goal, but if it's just increasing media consumption or if it's just an excuse to differ from an obligation, then I don't see how we get to a place where we have 30 hour productive work weeks. If there are marbled with escapism.
[00:36:54] Dr. Kutluk Oktay: Right. Escapism it's the right word. I mean, that's why it's a drug, right, alcohol, drugs, social media. You're constantly escaping from what you have to do or what you should really be thinking.
That's kind of what the quick send for the next generation. So that's going to engulf some, some talents and bog them down but others will learn how to dance around it and hopefully do great things. And I think also being aware of what we are doing to environment is also very a lot of young generations are aware of that. And a lot of them are more worried about that then you know, filling up their coffers because you know what good it does if you don't have a good healthy planet to live with, what are you going to do with all that money? So I think that's the other reason, I think this generation will have a long view because they need to think about the entire planet with what they do.
[00:37:54] Griffin Jones: Well, \ they do have a lot more to think about in terms of, you know, having to have a response for other things that are, that are happening. And so let's pretend that we, we have solved for the junk bond issue for the moment that we've gotten all the junk bonds out of our allocation.
We are left with high yield, low cost index funds that lead us to a good outcome. At the end of all this. But then there is this pestering concept that I hear from, and about physicians who look and I don't know that it's erroneous. It could very well be valid, but the, but the idea is that, well, physicians can never really be off.
They can never be totally unplugged because what if our patients need something from us.
[00:38:45] Dr. Kutluk Oktay: Well, I have to take a break now, so I'll see you in five minutes just getting right. I get to a point physicians can be off on the paper, but they can never be off here. Because I mean, at least personally, but I know a lot of other people, you know, and if we wouldn't, if I go away.
I think about my patients. What happened to this? What happened to that? What happened to that? That's the nature of it. That's why you don't pick this field. If you're really not, you know, you don't like to have that kind of lifestyle. Right. But not necessarily your uncle, every movement of today, but when we are caring for people's future it's hard to completely detach yourself from that.
But if you're working in a good team situation and you have colleagues that you can trust maybe you can disconnect nicely when you're off, when you're doing your yoga, when you're like a week away with you know, doing the things you like. But if you're a one man show, yeah, that's very hard.
Maybe one of the advantages of being an academic sort of larger practice is that you can have other people take the burden off of you sometimes.
[00:39:53] Griffin Jones: Can you do that if you're taking a two week vacation with your family and you just want to be alone with your family and a cabin in Europe, can you say I'm not taking any calls?
I trust my partners to be able to handle the case. Can a physician do that?
[00:40:12] Dr. Kutluk Oktay: I can imagine a physician can do that. So I'm I can imagine that it happens in other practices. All I could say that, you know, academics and other places, I've been to several places and I've seen that happen. I don't necessarily see anything wrong.
That's an individual personality issue, I think And you can also set limits. I mean, I don't need to know these, but if something like this happened, yes, you can contact me. You know, we have patients that we make very personal personal relationships in terms of patient doctor relationships and that sometimes they just want to hear from you.
And so yeah, there will be situations, well you could be in on vacation, but there's some emergency, we'll have to answer that. But the key to that is to be able to switch on and switch off you make a phone call, you know, give instructions, and now you're back to as if it's never happened so it's matter of a.
[00:41:05] Griffin Jones: What about the doctors that say, I trust my partners, they're perfectly qualified, but my patients expect me and they have to be able to reach me. And I can never have a window where I'm unreachable.
[00:41:20] Dr. Kutluk Oktay: Right. If you're complaining about that, that means that you need to change it. So you cannot say that I don't trust my colleagues.
I need to be reachable, but I'm never off. So that's like trying to have the cake and eat it right. Going back to that. But when it comes to patient care and when you're trying to be personal with your patient, provide personal, there's no formula for that other than cloning yourself. So either you trust your team or be available.
So I don't know if there's a formula for that. So I, for me, I set sort of criteria. Okay. You know, XYZ happens. Perfect. Good. Go ahead and map. But it hits, I dunno, let me cry. Then you have to call me and you know, that way, if you get a call, you know, that it was absolutely necessary or, you know, you clone yourself, there's exactly a personal like you and a fine great, go away to Mars on a mission or whatever.
Nobody can reach you.
[00:42:21] Griffin Jones: I have somewhat of a formula. It doesn't totally address the limits that you would set in terms of, of what you can use of what people can contact you for or not. But it does give a formula for how much time one might want to protect. Have you ever heard of the book profit first?
[00:42:41] Dr. Kutluk Oktay: Maybe I'm not sure.
[00:42:42] Griffin Jones: Well, link to it in the show notes. The author's last name. I can't pronounce, even if I remembered it, but it's the concept is a bit contrary to gap, generally accepted accounting principles, where revenue minus operating expenses equals profit and profit. First, it simply is revenue minus profit equals operating expenses.
So you're always allocating for profit, even from the infancy of a business. And if you're an infant business, you, you have almost nothing to allocate anyway. So, but you start with that current allocation percentage, and then you have a target allocation percentage. And so in the beginning, you might be saving a dollar, but the point is that you reserve profit from the very beginning and learn to manage operating expenses accordingly, as opposed to the reverse. And when I think of the needs that we have to have loving relationships with our families to have mental health and clarity breaks, there has to be some time and I'm not going to tell people how much time it is.
But when I'm with my loved ones, that there's nothing that's going to interrupt that unless it is a grave emergency. And so I'm going to write this book someday, Kutluk called time first, where it, you start off with a current allocation percentage and maybe it's just, you know what, every Sunday evening, I'm gonna I'm tucking my daughter in, and I'm going to read her a book and nothing will threaten that.
And then a year from now, I want to be able to do this and five years from now, I want to be able to take three weeks in Europe. I believe that that has to happen. People have to have some allocation of percentage of uninterruptible time and then based on how that goes and how much they want, then they can have a different target to augment for the future.
[00:44:32] Dr. Kutluk Oktay: Right, I mean, you know, the vacation break, whatever is break, but I also think about you may have that time, but there is a situation. If you didn't respond that would create consequences that cost you more time in the future, which would come out of your family time. So even when you're on your off time, you have to be able to recognize the situation.
If you didn't respond at that time. That will cost you a lot more time in the future. So you can think about scenarios of, you know, the complication happens and you, you don't give the right instructions or whatever that, you know, them medications may take more time. So it's a bit tricky. We say that, but you know, as a physician as I said, you need to be able to have some kind of artificial intelligence in your system that will read that out.
Do that calculation for you before you're interrupted. It doesn't happen a lot if you have a good team. So that comes to building good teams. You good leaders are the ones who develop other leaders. Your leadership is measured by the index. Of how many leaders you can develop or how many people who would lead others.
But when you're building your team, you need to build people who can also independently think and function with you. Again, if you don't have a good team it's hard to have time off.
[00:45:57] Griffin Jones: Well, in order to have an independent team, though, you also have to take some time off because how do you know if they're really independent or not?
If you're constantly there, they will ask you and you will stick your finger in the pudding jar. If, if that temptation is offered, I took two weeks last year in 2021. And my team didn't make every decision that I would have agreed with. It revealed to me. Oh, there's, there's one to three things here that are clearly missing from our core processes that I need to fix.
And I only knew that because I went away and they made a different decision that I wouldn't have made. and because of that, it's like, okay, well, I was gone for two weeks that the farm isn't going to burn down the practice, isn't going to burn down during a two-week period. But then I can make the, it could, I guess it could.
Well, that's a good, that is a good point though, because I couldn't have done that six years ago, so that is a good point.
But that's why you start with a day and then maybe it's a couple of days and then it's two weeks. And eventually I'd like to be able to go for big blocks at a time. So we've talked a lot about the different balances of work, not just what goes into work, but also the things that accompany it like health and fitness, family and hobby.
We're going to conclude the show and a lot of private practice owners listen, but there are a lot of division chiefs that listen to this show. And one of our biggest segments is fellows and it's younger associates that are thinking about what the next move next move is. So how would you want to conclude with them, Dr. Oktay?
[00:47:34] Dr. Kutluk Oktay: Well, to fellows are the biggest, you know, very important part of the team, whether they're clinical fellows, research fellows, you know, observers, whatnot. And in my career, I always worked with fellows of again, either clinical fellows or fellows from various parts of the world.
And their contributions are tremendous. So they are important part of the. And that's, you know, by working with a mentor prepares them well for the future. So my advice to them again, I said, you're a fellow now, but if you are planning to be a fellow, you're going to start early bit, but also find yourself a good mentor and which could help you with whatever you want to accomplish in your career and work with them.
[00:48:18] Griffin Jones: And you said that you are active on LinkedIn, so that may have been a little subliminal nod if somebody can people reach out to you on LinkedIn, if they're interested in it..
[00:48:27] Dr. Kutluk Oktay: Oh yeah, absolutely.
All the time. So, you know, I decided to focus on one social media gadget. And I think LinkedIn works well because it's nicely filtered and more focused on professional topics and I think it's pretty efficient.
You know, I have through LinkedIn may have formed many alliances, solved many issues reached out to executives of insurance companies when we had problems with the patients, reimbursements, things like that. So I think LinkedIn is a really a good way to expand your network.
[00:49:02] Griffin Jones: Well, before I let you go, I know that everybody listening to the audio and not watching the video is picturing you as a millennial with your artists in coffee and your beanie and a flannel, but Dr. Oktay is in a suit and tie today, and it's been a pleasure having you on Inside Reproductive Health. Thank you Dr. Kutluk Oktay for coming to IRH.
[00:49:22] Dr. Kutluk Oktay: Thank you. Thank you. Next time, I'll put that digital outfit on.
[00:49:27] Griffin Jones: Sounds great.