August is here. Usually, it's the time for vacations and recharging. But not in 2020. It's a different time now and finding the balance between work and life is trickier than ever.
On this episode of Inside Reproductive Health, Dr. Stephanie Gustin of Heartland Center for Reproductive Medicine, PC in Omaha, Nebraska. Between seeing patients, running her independent practice with her partner, teaching OB/GYN residents, raising a family of her own, and making time for herself, it’s safe to say that Dr. Gustin has a pretty full plate. Despite it all, however, she has found a work-life fit that works for her. So what is her secret?
Learn more about Dr. Stephanie Gustin at heartlandfertility.com
To get started on a marketing plan for your company, complete the Goal and Competitive Diagnostic at FertilityBridge.com.
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Welcome to Inside Reproductive Health, the shoptalk of the fertility field. Here, you'll hear authentic and unscripted conversations about practice management, patient relations, and business development from the most forward-thinking experts in our field.
Wall Street and Silicon Valley both want your patients, but there is a plan if you're willing to take action. Visit fertilitybridge.com to learn about the first piece of building a Fertility Marketing System--The Goal and Competitive Diagnostic. Now, here's the founder of Fertility Bridge and the host of Inside Reproductive Health, Griffin Jones.
GRIFFIN JONES 1:02
Today on Inside Reproductive Health, I'm joined by Dr. Stephanie Gustin. Dr. Gustin is a Nebraska native but she spent time on both of the coasts, Georgetown for med school, Stanford for residency and her REI fellowship prior to returning back to her roots in Nebraska. Now she's commencing her fifth year in private practice. She believes she truly has the best job on the planet because it's a hybrid of private practice and academic medicine, and that she fulfills her love of education research by mentoring and teaching the University of Nebraska and OB/GYN residents there while maintaining the freedom and flexibility of private practice. As such, she and her partners have been able to consistently manage to both support and promote work/life fit. That's what we're going to talk about today. Dr. Gustin, Stephanie. Welcome to Inside Reproductive Health.
DR. STEPHANIE GUSTIN 1:53
Thank you for having me.
JONES 1:55
I think you're being choice in your words with work/life fit, and not work/life balance. Is there a reason?
GUSTIN 2:01
You know, I think that the notion that you can have it all at once is something that we're constantly questioning, right? Like, how do you make it all work? And I think that the new term of work/life fit means that you can make what you want fit into the confines of your life if you make the right choices.
JONES 2:25
So when did the notion of having it all come to play do you think? Because I think like why in God's name, with any of us expect to have it all? Like I just think maybe that's just the way I think because I think the natural human condition is one of poverty and toil and just thinking of evolution from primates, to being in the caves and how we managed to get 7 billion of us on this planet to me is a complete mystery, but I think of the idea of having it all as a 20th century, if not a 21st century luxury, and still one that's probably not achievable. How do you look at it?
GUSTIN 3:14
It's definitely perspective. What having it all to me could be very different to having it all to you, right? I think that as physicians, for the most part, you know, we enter into medical school, for example, and all of a sudden, everything that was important to us up until that point, sort of gets pushed to the side because now the most important thing, the thing that we've been aspiring to achieve is at our fingertips, and now we have to work incessantly to continue to prove ourselves, right? So then in medical school, when really we're just students, but we're learning to be doctors, we’re missing really important things like weddings like funerals, we’re not taking care of ourselves, we're not eating well, we're not exercising. And we're in this trajectory of, you know, 80 plus hours a week of work that precludes us from doing other things that make us who we are and make us happy. And it's taught to us from the minute we walk into the system. And so, I think a lot of that is the altruism that is inherent to people who go into medicine, right? We are servants. That's why we choose to do what we do. I mean, certainly, there's probably some handful of people who choose to go into medicine for different reasons that don't include that. But for the most part, I think most people who practice medicine do it because they want to help others. And inevitably, that desire to help others often supersedes the desire to help yourself or your family or, you know, your close friend. And I think that it dawned on me, definitely in medical school, but certainly in residency that in order for me to be the best physician I can be, I have to take care of myself. I have to do things like exercise, I have to eat well, I need to find the me that's not defined by just medicine so that I can do this for the long haul.
JONES 5:19
Is that what having it all is to you? Is it some family time, some time to devote to fitness? Like I don't want the whole overarching answer, I just want like, what does it mean for Stephanie Gustin?
GUSTIN 5:36
Yeah. So for me, it's being the best doctor I can be, the best parent I can be to my children, the best wife that I can be, to be healthy for myself, so to get exercise and to take care of myself and be present for my family and friends, essentially.
JONES 5:54
Does one have to prioritize those things?
GUSTIN 5:57
Yeah. I think if we don’t, they don't happen.
JONES 6:04
And by that I mean against each other, as in this one's one, this one's two, this one's three, this one's four.
GUSTIN 6:12
You know, I think that they all take different places in your life, right? Like there may be certain times where one element or one pull that you have supersedes the other depending on its urgency, right? But I think that if exercise or taking care of your body is constantly your lowest priority, it's not going to happen, or it will happen infrequently, or at an unsatisfactory level for you.
JONES 6:44
I think that the idea that we have to choose between things is what really messes people up in us and that's why I really have a problem with the idea of having it all because the idea of having it all means that one doesn't have to choose. And I just think of like, how could that possibly be the case? Like I don't think Jeff Bezos has a great family life, I could be wrong. I don't know the guy but I read the same things in the headlines that everyone else does. And maybe that's fine for him because he has 100% put building this empire at the top of his list and I think that I can't make that decision for anybody else. But it was clearly a choice that he made. This comes before this and I think for myself, you know, I really am putting so much into building this company, but I do not get it twisted. My company comes second, my career comes second. My family comes first. And there's boundaries for both. But if you know it came down to somebody's wedding or a funeral or if I have an engagement with somebody--a family member or a friend--and then a client tries to reschedule something that was in there, it was in the work boundary, and then they try to put it--most people, I think, take that call because, well, this, it's just one call or one meeting. And that's the example I'm trying to get to of “I'm choosing that this boundary is protected. I'm putting my family first.” And that's a choice that I've made. But I think that my problem with having it all just comes from thinking that we don't have to make choices, but if we don't, they inevitably sort themselves out by default.
GUSTIN 8:46
Now, I think that's why I like the word fit, right? Because you can succeed in multiple aspects. You can prioritize different things as they need to, and you can make it fit without feeling like you're letting one thing or another slide or have any less importance, if that makes sense.
JONES 9:11
Do you have those types of boundaries? Are you strict? Or do you tend to do family stuff during a certain time? My boundaries just happened to be time and particular windows and I understand people might manifest them in different ways. But do you, yourself, say this is family time, this is work time? And are you generally good at keeping them very compartmentalized? Or do they tend to blend more?
GUSTIN 9:39
I think you'd be hard pressed to find a lot of physicians that can be that clear cut. Truthfully, you know, for you, it's like a meeting that perhaps would be more respectable than for me when it's a patient who needs urgent surgery and it's at an inopportune time for me socially, right? The choice then, probably more often than not, is to take care of the patient, right? It's just a little bit different in that aspect not to say that it's fair to draw a hard line and to have, you know, someone else take care of that patient. But sometimes that doesn't always feel like it's going to lead to the best outcome for both the patient and the provider that's taking care of and know that patient well. For me specifically, answering your question, I take call, I work on the weekends, so to say that I have like, set aside finite family versus work time would be a bit like it would be incorrect, but I do try to when I'm home with my kids be present, to the best of my ability and then when I'm at work, be present at work. You know, my husband and I are both physicians. So we have very similarly demanding jobs. And we also both realize that in order to be healthy, happy, same people, we both need to exercise pretty much seven days a week, and so we have just built our schedule such that we can do that every day. So we have a rule in our house that if one person wants to go exercise, the answer can never be no, it has to be yes and how can we make it happen? And so we've changed our work schedule. So I start early in the morning, because that's when REIs start seeing patients is early, and he starts later, and I finish earlier, and he ends later. And we make conscious decisions to allow us to get those pieces of the puzzle fit together. Whereas, you know, I see a lot of dual physicians or other, you know, alpha/alpha families or even non-alpha/alpha families where, like, it never seems like that can work out. And oftentimes, I think that that's more of just needing to sit back with your partner to figure out how to make it work rather than just assuming there's not enough time in the day.
JONES 11:51
So that is an example of something that is an immutable priority, fitness.
GUSTIN 11:53
Right.
JONES 11:54
And I'm not sure if you've ever heard of Core Four but there's a lot of schools of thought, Core Four being one of them, that say that it's one's physical fitness that comes first. Core Four is, I believe, body, being, balanced, business. Body being your physical health, that if that's not in check, that one's being, their spiritual, mental, emotional health won't be in check. And if their being isn't in check, their balance, which is their balance of relationships with their loved ones won't be in check. And then lastly, their business, their career won't be in check. And I'm not sure if it's always that linear. When I read Core Four, I'm not sure that I buy it to that degree of being so linear, but I do certainly get the premise that you know, try advancing your business or try having a really good work day when you're fighting with your spouse, right? Or when you have disagreement with your significant other in the back of your head and it just grinds on you. But that is an example that you gave, you know, if someone wants to work out the answer is always yes, that's the priority being fitness in that order. You also brought up the reality that physicians face that sometimes there are emergencies. And I wonder, Stephanie, if that sometimes allows physicians to cheat a little bit on the protection of their priorities, because sometimes there are real emergencies. In the case of an REI, somebody might have an ectopic pregnancy. That's a real emergency. And I wonder if that habit though, says, Well, now this is an emergency. And now example B is also in an emergency, when in reality, we may have slid down the spectrum to operational deficiencies.
GUSTIN 13:58
Right. I'm sure you're right. I think it depends on how strongly someone feels about what they're not doing because of that emergency, right, quote, unquote. You know, like, I have this--exercise for me, sort of how you portrayed it, you know, when you read that hierarchy is a form of therapy, it keeps both my husband and I even keel. So, if that doesn't do it for you, like if you don't have that bug in you that says, if I don't do this, I'm not going to feel like a good human. And it's easier to say, Oh, you know, I don't mind coming in to scan that patient, it’d make them feel a lot better, even though it's not an emergency. Right?
JONES 14:44
So how do you make those types of decisions like in the exact example that you just used?
GUSTIN 14:48
So in terms of my life, like our schedule?
JONES 14:52
Yeah, like saying no to patients, maybe or building processes so that you don't necessarily have to say no to patients, but that you're just not finding yourself in in a situation where your calendar could potentially always be intruded, for lack of a better word, by someone who might be able to have their needs met in a more efficient way that also doesn't just have you in this constant state of having to interrupt other things that might be really important.
GUSTIN 15:25
Right? Well, that's where my partners in my practice, you know, kind of falls in line with supporting this vision as well. We are a group practice. So we have a doc of the day that covers IVF and procedures and whether it's, you know, technically my patient or someone else's, if I'm the doctor of the day, then I'm the one doing those things. And there are pros and cons to that. You know, certainly, probably most patients would prefer that their physician do all of their procedures for continuity sake, but I would argue that having three, or you know, five, depending on the size of practice, having that many sets of eyes on you and your process, it's like three to five second opinions essentially because to be doing a procedure on a patient I don't know, you better believe that I'm reading in their chart and making sure I have know about them and getting any questions that I have. So I think that there are a lot of benefits. And in terms of lifestyle wise, certainly, if I'm not on call, I'm not on call. So one of my partners is doing the ectopic at night even if it's not their patient, because it's our patient as a group and similarly for the weekend, which really creates those boundaries, which is helpful.
JONES 16:44
We could have come into this conversation from a different way, but where we came in from work/life balance, I was thinking we would come in the other way and end up at work/life fit which is your particular work scenario because you, Stephanie, are a unicorn in terms of REI practice partners. You are what all of my clients are telling me they're looking for, in other words--or many of my clients--which is someone that came to an independent practice, and especially in your case in a small market, not on the coast and not in a big city, and had the entrepreneurial drive to take up partnership and really buy-in and grow it. And so many independent practice owners say that that's what's lacking from the younger class of REIs. And when I talk to many people who are still in fellowship, what I find that they're selecting is they're selecting based on compensation and based on city and as long as they're making the money they want and living in the city that they want to live in, those are the two biggest priorities. And many of them say they don't want to do the track that you have because they perceive it as not a great work/life fit. Like, Oh, I'm gonna take over a practice and I'm gonna be on my own and I'm gonna have all the challenges of running a business. So I was thinking we would come to work/life fit from how could you possibly have it in that scenario? How do you reconcile it? Like if this is something that is clearly important to you? Wouldn't it be so much frickin easier to have an employee role in a much larger organization?
GUSTIN 18:43
That's not what I found. So, you know, Zack and I--my husband--when we were looking for job opportunities, the job that you're describing didn't allow the fit that I needed, you know, it was like in a big city with an hour commute one way and the hours were long and the pay was lower. And it wasn't--I didn't see it all fitting together. I didn't see that I would have time with my kids, I didn't see that I'd have time with him and I certainly didn't see where exercise was going to fit into that. Whereas this private practice gig really does allow me to do that, you know, we have a really great cadence within the practice of how we see patients. We're not here all day from beginning in the morning till the end of the evening kind of a practice. We do most of our monitoring in the morning, which is not what most practices do, but we have physician extenders to help with that moderating. I don't have to be here at 6:30 or six in the morning to start scanning but our clinic is operational then, right? And then I'm done in the late afternoon such that if I needed to run to get to my kids or wanted to get my workout in, I would have time to do all those things. So I can either work out at 5:45 in the morning or 4:30 in the afternoon, no big deal, which for me is a deal breaker. For those other opportunities that didn't allow me that cushion for my “me time” and the time that I would need to sort of do other things if it wasn't going to be decided that, for example. So, you know, the other part that we haven't really talked about either is that when I finished, I actually wanted to stay in academics. I wanted to stay at Stanford because I love teaching, it's like one of my favorite things to do. And they didn't have a spot open. So we looked at some private practices, and that's where I sort of really got more interested in private practice. And then that notion and kind of what we talked about, about owning your business, you know, being able to bet on yourself, and being able to make choices and drive change was to me very enticing. It’s like that saying, if you're gonna bet that on yourself, because that's something that you actually can control is how hard you work, how well you perform, things like that. So, this to me just sort of a no brainer because I get the residents that come to see me, so I teach them every day, which I love and that fulfills me in that aspect. But I don't have a lot of bureaucracy from above telling me that I can't do X, Y, or Z. The sky is sort of the limit, which is really pretty incredible in this field where there's so much change all the time.
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JONES 23:31
I think one definitely has to have a certain personality type for that. I mean, just the fact that you're saying you want to bet on myself. I think that's how many entrepreneurial people think. If people are sort of on the spectrum where they could go the entrepreneurial way, but maybe they're not 100 on the scale, but they could possibly open their practice, I think one thing that they look at work/life fit is Well, yeah, but I can so I can do these I can structure around the day and the operations and and I have some autonomy to make the calls based on how hard I work. But I'm also on the hook for a whole lot like what if this company decides to change reimbursements? And what if we have trouble making payroll one month? And what if there are these HR issues? How do you feel like that impacts work/life fit because I think that's what's keeping a lot of people that are coming out of fellowship, especially from pursuing a similar track to the one you did.
GUSTIN 24:38
Well, I think it's important to do your due diligence, right? Like you should get a pretty informed history of practices, performance to date, or the best information that's available, they're willing to share with you. So that you'll know if they're consistently in the red or had a few really bad years, it then requires some explanation. But if you're joining and the practice is established has been there for, you know, 5, 10, 15 years, it's got good referral patterns and doesn't have any significant credit or history or concerns, I don't--I think it should be pretty fair to say that it's gonna be okay. You know, you have to bet on yourself and nothing's a guarantee, right? But I didn't want to be one of those statistics of the vast majority of people out of fellowship, have a job for two years and they leave. That's just not me. I'm like a pathological loyalist, like to a fault. I'm so loyal. And I knew that I wanted to be in a place from the get go that I would want to stay indefinitely and not find myself in a situation where I was somewhere where it wasn't the right fit, because it didn't allow me the capacity to do everything that I need to do for myself. Does that make sense?
JONES 25:54
It does, and I think the betting on yourself is really the trait that comes out because what you're describing still seems like a risk to many people. Like even if you're looking at a place with great referral patterns, good financial history, the team is pretty well put together and can last for a while, even with all of those things, just given how fast business, society, the field is changing, there's still so much to update. I still think even with those metrics, being as sound from doing due diligence, as you mentioned, that's still a risk for a lot of people. One thing that I've noticed about you is you just have that little bit of a vision to see now we could be doing things this way. And I'm thinking of you and I have talked about referral patterns before and how many people think that referral patterns are immutable, that they're unchangeable and you and I just don't buy that and I think that that just has to do with one’s entrepreneurial spirit. And maybe that's why it's a better fit for you. Is that possible?
GUSTIN 27:05
I mean, I think you're probably spot on with that. I just--I think referral patterns aren't easy to change, but I think that they have to be changeable, right? I just can't imagine them not being just sort of like what you just said, truthfully. But I think you just have to prove yourself, right? It's not going to be me just asking for a referral, it's going to be me showing that I am a good physician, that the patients come back to that provider pregnant saying, “Wow. It's such a great experience,” and then feeling more confident about sending a patient my way.
JONES 27:39
For that reason, I feel like there's more opportunity to be an entrepreneurial doc than there ever has been. Because frankly, I think that there's just a lot of people doing the same things. And I think that's why we are seeing a few groups ascend pretty quickly because they're willing to do things a bit differently and believe differently and maintain different cultures. And so to me, it seems like there's more opportunity for the profile that I think you resemble of somebody being entrepreneurial. How do you think one assesses that? For the person that's in fellowship right now listening, what opportunities would you have them consider to see if it excites them to know if that's even their profile?
GUSTIN 28:34
I mean, I think you have to know your personality, right? I think you also--joining a practice of any kind, be it a private practice where you have the potential to become an owner versus joining a big group practice that's owned by a, you know, larger medical group, it's a marriage, right? When you join those groups, and you're there long term, the people that you work with, sort of help to define who you are, to some degree, as a physician and where your dreams can go. And so I think for me, looking at what the field had available for me at the time and looking at the relationships that I would gain at different places and looking at things that way, not just what is the dollar risk versus reward, it just became very apparent to me that taking a position that would allow me to grow as a physician, but also business-minded, was probably going to long term suit me better than just being a cog in the wheel, which it sounds terrible to say cog in the wheel, I don't mean it that way. But plenty of people just don't want that responsibility. And for me, you know, I don't know if you know this about me, Griffin, but when I was in residency, I also taught an exercise class. So on night float, I did this almost 10 months training on how to be a called the Barre Method instructor and I would work at night as a resident full-time and then during the day when I supposed to be sleeping and do the training to become the fitness instructor because it just gave me a balance, right? Which was sort of ridiculous, I think, to most of the people that I work with, but it was just--I just needed my own piece of me, I need to do something that wasn't necessarily medicine, I could talk to other people about other things other than medicine, and it was probably arguably one of the most rewarding experiences I had. I did it in residency and fellowship, and I loved it. I taught for five years. And I would go straight from the hospital in my scrubs to teach this exercise class. But it taught me that in order for me to feel fully satisfied, my brain kind of has to be doing different stuff. And so what I like about being a private practice doctor and being on the business side is I don't know anything about business--well, I now know more, but starting out, I don't have a business degree. I didn't have any training on accounting or contracts or HR. I mean, like all of this is new, but it's requiring me to use my brain in a way that is actually invigorating for me and not overwhelming. But that's just because I think I like to have that variety. So I think there are people out there who sort of feel like they need a side gig, right, which there's a lot of talk about that in the community. What is your side gig? Becoming a business owner is kind of a side gig for me because it's very different than just being a physician.
JONES 31:28
That's a really interesting--we’ll probably go down a rabbit hole about that-but listening to you talk, I can see that the work/life fit frame making a bit more sense because I think you are just somebody that needs to have so much in different areas. And for you, that being a partner in a practice is what allows you to fit it all in, is that a fair assessment?
GUSTIN 31:59
Yeah. Absolutely.
JONES 32:01
Whereas for others, it might be like, Are you kidding? Learning about business is not exciting at all! I sure as hell don't want to teach a workout class, maybe I want to, you know, run a couple miles a few times a week. And I'm good on that. Whereas I feel like the profile you're describing is one where you want to expand your business knowledge, you want to have the involvement in academics that you talked about, you still want to be a clinician. Fitness is super important. And that it sounds like the track that you've taken of becoming a partner in an independent practice is what allows you to fit all of that in. Do you think that someone can be successful doing that today if they don't have that personality profile?
GUSTIN 32:58
Yeah. I mean, you have to be willing to have balls in the air and figure out a way to juggle them. Right? Because it is putting more hats on your head at once. And that sort of level of trying to quote unquote, work/life fit you have got to be comfortable with that. But I think there are ways you know, certainly I think some people were really smart when they went into medicine, they got like an MD on the side or you know, things like that, that would make it easier. But I think most physicians, also went into medicine, because it's a continuous learning curve. We are required to continue to learn all the time. And I think that when you go to seminars about physician burnout one of the things that come up a lot is like, what else can you do to make you happy, right? Like, can you have a side gig? Can you do something that's outside of medicine? Can you, you know, if they’re like living near wine country, plenty of physicians that own wineries for example, or you know, this, that or the other. And for me, at least at this point at this point, because the business side of things is so new, it's very similar to that. And I think if people acknowledge where they need help, right, like it's not, I think it takes courage to ask for help. So it's not something--I am very forward that I don't know a lot about what I'm doing, and I'm willing to learn and then I'm willing to rely upon the people that we have set in place to help us navigate it. I think acknowledging that there is a learning curve that is quite possible for many people to succeed, but you’ve got to trust that you are worth it and you’ve got to believe in yourself.
JONES 34:38
And with you, I think that you the way you just described yourself as 100% true, and I think that's why you're such a quick learner, because there's no charade about I don't know this--and I think you know, a lot more than you give yourself credit for sometimes. But I've been in meetings with you, where you're like, I know this, I'm not so sure about this and then your notes and you're not wasting any time. I'm trying to dance around and protect your ego, you're just getting as much information, then you can see how quickly that you're learning. And so do you think that this conversation, the one that we're having now about work/life fit is sometimes--I guess kind of shooed away as something fluffy or some sort of, you know, millennial entitlement or something like that, in that, you know, the idea of having a work/life fit or a burnout is--people don't want to talk about it that much because it makes them seem like they're not as hard working or as resilient or as Type A as the standard?
GUSTIN 35:47
I think that's a really great question. I think you're right in terms of it's not well received by everybody, but what my answer would be is that I'm so happy. And I don't see a moment where I could--I would stop this train. Like I don't see, wanting to retire when I'm 70. The cadence that I'm at right now does not feel oppressive. I do not feel like I am sacrificing my family, or my body or, you know, my happiness for my job. Like it's all fitting together the way that I envisioned it would and I think a large part of that is because of the choice that I made and the job that I took. I really did soul searching with my partner, my husband, to figure out what is it, what do we want, what would it look like? And then let's find the right gig for us. And so I think that for people who think it's fluff, or who don't prioritize it, you know, I'm curious what percentage of those people are, you know, raising their hand at that meeting who are burnt out or who, you know, don't aren't feeling like they have the best job on the world or, you know, feel dissatisfied or maybe not thrilled about their current place in life. Whereas, you know, me by being very specific about what I know I need to be successful, I'm able to do that and do it really enjoyably.
JONES 37:25
Do you ever think of it in terms of, maybe I'm going morbid here, but do you ever think of it in terms of what you'll regret at the end of your life?
GUSTIN 37:34
You know, I lost my mom when I was 19, actually, so she was 46. And I think that changed me. So I think that's part of the reason why I'm more of a unicorn to you is that I already know what it feels like to lose everything. So I don't live my daily or yearly life with regret. I'm very forward to the people that I care a lot about how much I care about them. And I try to leave nothing on the table so that if tomorrow I weren't here, no one would question what my intentions were or what my feelings were for them. So no, I don't feel like I leave anything or I worry about living in regret. But that's just because I, you know, have had life sort of teach me that early, I guess.
JONES 38:19
To me, it almost sounds like you've just automatically made that calculation. I use that framework to think of it and I'm totally speculating about Jeff Bezos, I have no idea what's in the guy's head. And I do want to emphasize that we can never know what's in somebody's head. But if I'm just using him as a persona, he may very well not give a damn at the end of his life of other things that happened in his personal life weren't, weren't that great because he built what he wanted to build and that was his greatest priority. And I think wherever anybody is on that scale, no one can make that decision for them. I just encourage them to think about it like that. Like I think in terms of, you know, if I had one last day with my grandma, I would regret that. I would not regret taking one more sales call. And so I just build those boundaries in that way. If I didn't have--if I wasn't able to be 100% present with my family on our winter camping trip, then I would regret that. Now, I also would regret if I didn't push myself as a business owner and executive, a leader, and an entrepreneur at the end of my life, I would regret that. So that is what comes second. So the days where I'm not with my girlfriend, or with my family, or those types of occasions where I've blocked out that time, I'm probably gonna work 14 hours today. And it's because what I will regret, I just know I will regret--or I would say that I won't regret. I won't regret not watching that Netflix episode. I won't regret not messing around on social media, which is why, as a consumer, I'm on social media almost never for my business, I use it to network like crazy. But as a consumer, I'm not watching cat videos, I'm not scrolling through people's feeds, because that is what I won't regret if I cut out at the end of my life. So I know that there's select moments of family that gets protected. And then there's work, which is living up to my potential. And then third is just all of the other stuff that could fill your time: Candy Crush, social media, politics, then even the news--I don't even watch the news anymore. And I don't know that you prioritize in the same way, but I think that you, maybe because of your experience, make those calculations just more second nature.
GUSTIN 41:06
Yeah, I think I mean to a degree, I think you're right. It's just--so it definitely changed my perspective. I love very intensely, like, you know, you say, your family is your number one priority and equally that is mine as well. We've just made it so that it doesn't--like, family never needs to get put to the side by, you know, strategic planning between my husband and I and our childcare. So I think you can live your life in a way that suits you and that fulfills you, right? As as soon as you identify what those needs are, like you realize what your hard lines are for you, what my hardlines are for me, and then you figure out a way to make it work and to make a plan. And then certainly, like we talked about in terms of my job taking care of others. Sometimes there's going to be some interweaving or percolation, but I'm never gonna regret taking care of a patient. I'm not--I'm also never going to regret not taking care of a patient because I needed to be there for my kid, for example, and I'm not going to do that. I'm not going to allow myself to do it. Someone told me once--and it is a really harsh statement, but it really opened my eyes--they said guilt is a wasted emotion. It's just not worth it. And I think we have a lot of guilt-driven things that happen in our society. And it's stuff that, you know, for the most part they’re about things we can’t change or choices that were made. So rather than that, I try to learn from the choices that I make and decide if that's a repeatable choice or not, and then, you know, strive to be better thereafter, by learning for myself, I would say.
JONES 42:55
So, I think that point that you made of just not Kicking oneself is a huge part of what we used to say balance that we're talking about fit but I think the balance just comes from Well, if you're spending too much time at work, start spending more time with your family. If you're not spending up to work start working some more and, and guilt as you say being the wasted emotion of kicking oneself. We've stayed on topic, mostly of work life fit in the context of independent practice and I don't want to digress but you did touch on something that's important to me that I'd like to explore a little bit because I'd like other people to consider it. And you just talked about, you know, I don't have an hour commute where where you live in Nebraska and at the places you were looking at, that would have been the case and I've talked a bit about it on the show with with Alex cos and I don't think he and I disagree on the value. I think he and I just disagree on how much we each value it but I think small markets are Really the upside in a I think there's so much upside in, in small markets. And so I wonder, just your perspective on if you're as bullish on small cities as I am and why or why not?
GUSTIN 44:16
Yeah, I mean, I, I think it's not just the new, right, the patients are different in it in a very endearing wonderful way. I feel like my relationship that I have with my patients in this market is very different than relationships. I have a patient in the Bay Area, for example. And not to say that, you know, that like to qualify one is good or bad. It's just, for me, it's a better fit here in the Midwest and the smaller market, I feel like I'm able to provide better whole person care here. And maybe that's because I am more whole as a person, like I have that balance that I need or that fit that we've talked about. So I have that a bit To connect more, not, you know, stores to see patients every 10 minutes or you know, in a cadence that is unsatisfying to both me and my patient, right? And I don't have them this glaringly long commute that I have to deal with once I'm done seeing all my patients before I get home to unwind, like that's not my life, like my life is, I get to take as much time as I need with my patients for the most part, you know, arguably, I probably finished my patient visits faster than what's allotted. So probably, you know, business of mind of me is like, wow, I should make these patient visits shorter, but I think they're, I think you're totally right, people. If they're willing to move to markets like the one I'm in, it's a great place to be, you know, also in a smaller market. The priority of the community often is different. There is more of a focus for work life fit for the whole community at large, though that permeates to your home life as well as your natural work life.
JONES 46:05
Yeah, I just would like people to consider because I think we're starting to see an imbalance where so many people are ending up in the largest of cities and it's harder for people in smaller markets to recruit and therefore, access to care is more difficult to come by in some areas, and I just believe that the life of a busy professional is the same anywhere like if you like playing in San Francisco, your your your, your top 5% wager you can go there whenever the heck you want. But for the most part, you're gonna be busy with work, you're gonna be busy with your family, you want some time to work out. I think that the small markets provide the work life fit that people are actually looking for, in a lot of ways if they can make the rest of it work so well. Steph, you've given us so much to think about how would you want to conclude with our audience About work life fit, especially for those that are considering their career path that are either just in their first gig in their employees, and they're thinking of what the next move is or they're still in fellowship. What would you conclude about work life set, particularly within the context of the possibility of independent practice?
GUSTIN 47:25
I think people just need to be honest with themselves. So for people in training, or people who've been trying to decide what field of medicine you want to go into, or for people who are trying to find the right job, you need a gut check, like what is important to you? What are your hard line items? Yes or nos. And then how willing are you to, you know, open up your geographical search to find a job that really fits that but may not be in initially in the place that you had thought it would be. I think that if you're someone unlike me, who wants really one job for the foreseeable future, and wants it to be the right fit from the get go, and you really have to do your homework in terms of what job options you're looking at, and how that job and that group of professionals are going to join you is going to allow you to meet your needs. And if you're getting red flags, it's good that you're not going to get those needs met, you're probably not going to. And so rather than taking the job, I think it's probably more worthwhile to either expand your horizon as to where you're looking or rethink your needs. But I think the expanding your horizon is probably a better option because honestly, your needs probably aren't going to change, at least not for the next couple of years. And if you're someone like me, who's planning from--you know, I'm looking at like, tomorrow, five years, 10 years like I'm constantly figuring out where I need to be. So that's helped me so much because I got the job that I wanted. I got my dream job because I knew what I wanted. And I think that's going to be the key to your success outright is knowing what you want. Go after it. Be unapologetic about it, and it's available to you. You've got to look for it.
JONES 49:22
And I'd love to bring you back on in the future to talk about how that has been as you grow as a business owner and a practice partner, Dr. Gustin, thanks so much for coming on Inside Reproductive Health.
GUSTIN 49:36
Thanks for having me.
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You’ve been listening to the Inside Reproductive Health Podcast with Griffin Jones. If you're ready to take action to make sure that your practice drives beyond the revolutionary changes that are happening in our field and in society, visit fertiltybridge.com to begin the first piece of the Fertility Marketing System, the Goal and Competitive Diagnostic. Thank you for listening to Inside Reproductive Health.