Do No Harm: Rethinking Burnout and Rediscovering Purpose in Allied Health – Interview with Kayur Kotecha – The Entrepreneurial Clinician Podcast

As allied health professionals, we are trained to consider the psychosocial hazards that our clients face. But what about the psychosocial risks in our own work? How often do you take the time to acknowledge, assess and manage those risks in your practice or for your staff?

That’s the topic of discussion in this episode when Jo is joined by Kayur Kotacha. Kayur is a Physiotherapist and Mindful Yoga Teacher who brings a unique blend of medical knowledge, holistic practices, and heart-centred approach into healthcare.

In this conversation, Jo and Kayur discuss: 

• Kayur’s unique perspective on burnout
• The role and insights that yoga and Eastern philosophy played in helping Kayur overcome burnout
• The importance of understanding your personal ethics and values
• The broad interpretation of ‘do no harm’ that Kayur adopts in his life and practice
• The psychosocial risks Kayur has seen as an allied health professional and practice owner, and
• The need to identify situations in which you (and your staff) are feeling conflicted which can contribute to feeling burnout.

About Kayur: As a Human Biology graduate and a dual-qualified Physiotherapist and Mindful Yoga Teacher, Kayur Kotacha brings a unique blend of medical knowledge, holistic practices, and heart-centred approach into the field of healthcare and rehabilitation.

Founder & CEO of Transcend Rehabilitation in the UK, a boutique provider of Immediate Needs Assessments and Case Management solutions to the personal injury sector, and amidst the broader responsibilities as the company visionary, Kayur continues to manage a small caseload, because it is his belief that hands-on experience fuels innovative leadership and keeps the heart of the business’ practices closely aligned with the evolving needs of those we serve.

 Kayur’s expertise also extends to Australia, where he provides Health, Recovery, and Rehabilitation Consultancy, primarily focusing on occupational rehabilitation & return to work across various insurance schemes including Workers Compensation (nationally), Life Insurance, and CTP.

Kayur, and Transcend Rehabilitation, promote a rehabilitation case management practice that is holistic, person-focused, outcome-orientated, and results-driven; aiming to settle for nothing less than the best possible healthcare delivery, as well as enabling rapid functional recoveries & return to work for those who have sustained traumatic personal injuries

Apart from his professional and business pursuits, Kayur is passionate about lifestyle medicine, natural wellness practices, teaching yoga, meditation, ancient wisdom, philosophy, travelling and photography. These interests not only enrich his personal life but also enhance his professional practice as well as approach to business, allowing the provision of well-rounded and compassionate services to his customers and clients.

You can connect with Kayur via LinkedIn at linkedin.com/in/kayurkotecha.

Special thanks to our podcast sponsor, Practice Conquest!

Resources mentioned in this episode:

• Future Proofing Health Professional Facebook group 

 If you know you need more support, please visit my website at https://jomuirhead.com

Finally, if you loved this episode, please make sure you subscribe and leave us a review.

Transcript

Jo:

And welcome back to the Entrepreneurial Clinician Podcast, season four. Today’s episode is going to be for anyone who has anything to do with health. I’m going to be quite broad about that because if you are an allied health professional, you are going to need to know about the information contained in this podcast. If you manage allied health professionals, you’re gonna need to know about the information contained in this podcast. If you are a allied health business owner, you have legal reasons to know what’s going on in this podcast today. No pressure at all Kayur  <laugh>

Kayur:

<Laugh>.

Jo:

So how this has come about for me in Australia over the last couple of years, we’ve had some legislation come through, which talks about the psychosocial risk assessment in workplaces and allied health professionals, for some reason, as supposed to be the experts in being able to go and assess these psychosocial risk in workplaces. What we haven’t been doing is actually acknowledging, assessing, and managing the risks in our own work. So I’ve asked Kayur to come on today to talk about this very specific, but very important way of exploring our work. So, before we get on, I’m going to acknowledge the Darug people of the land in which I find myself coming to you from today in the greater out west of Sydney. I pay my respects to their elders past, present, and emerging. And I just wanna say a really big thank you for the care that you have taken for this land that I get to live on and for allowing me to be here and call it my home. So, welcome, Kayur. Can you please explain who you are? Give me a pronunciation lesson on your name, <laugh>

Kayur:

<Laugh> Thank you. Thank you for the warm welcome, Jo. And that’s a beautiful way to acknowledge the country in which you reside in, and the lands you operate on. And it’s a very purposeful way of introducing yourself in a very respectful way. So, thank you. My name is Kayur.

It’s interesting, actually, the name won’t go into it too much, but being born and raised in the United Kingdom, my mom and dad actually spelled my name in a way that would be easily pronounced in the UK. And I guess over the years, I’ve had my name pronounced in multiple ways up up until very recently, I have been saying my name in the way my parents say it prior to that, very accepting of how the name had been. So it’s Kayur which is a bit of a bit of a challenging one because we have to roll the r at the end. 

Jo:

<Laugh>. Yeah. And I’ve got no rolling of the r capabilities at all. I tried to learn Danish for a while, and that was just horrendous for the Danes. Well, welcome to the podcast. Now, you are not talking to us from the United Kingdom today, though, are you? Where are you talking to me from?

Kayur:

I’m currently based on the Sunshine Coast.

Jo:

Yeah. So all the Australians just went, oh, course you are. So what’s your background? I mean, you’re an allied health professional, but what’s your background?

Kayur:

Are, are you speaking culturally?

Jo:

Oh, okay. No, I was speaking in terms of discipline, but we can go into culture, if you like.

Kayur:

No. So I mean, I’m off Indian heritage. My parents were born and raised in Southeast Africa and migrated to India and then across the pond to the United Kingdom in the eighties. I’m a human biology by graduate. That was the the discipline. I went down first partly because I didn’t get the grades to study physiotherapy, <laugh>. I was told I didn’t have the grades to study physiotherapy at university at graduate level. And then I went on to do a postgraduate Master’s degree in physiotherapy at the University of Birmingham in the United Kingdom. And I have a heap of other hats and egos, <laugh> alter egos. I’m also a mindful yoga teacher also love a bit of photography and yeah, so multidisciplinary, I would say in its truest sense.

Jo:

Nice. I hadn’t made the Africa, India, Great Britain, Australia connection before. Like, that’s the joy of being in Australia is that we have so many people who have come from quite diverse parts of the world. My cultural background in case nobody’s heard this story before is my family came out with the convicts. So some people find that story hilarious. I was ashamed of it for a very long time, but you know what? It’s a part of the land in which I live <laugh> yeah, great big melting pot.

Kayur:

An interesting label. <Laugh>.

Jo:

Yes. Very interesting label. Yes. We didn’t decide to go back to Great Britain. So here we are. Many generations.

Kayur:

Not a bad choice.

Jo:

No, not at all. Not at all. So we’re gonna be talking about psycho social demands today, but in the context of our work. So it’s kind of a really big discussion, but it’s a really important discussion. But before we get into some of that, I’d like to ask you the question. Have you ever gone through a period of your work life where you thought you were burning out or you had burnt out? Can you give us a little bit of insight into what that was like for you, and maybe how you pulled yourself out of it or recovered from it?

Kayur:

I’ve been contemplating on that question,  <laugh> the word burnout I’m not sure if that word resonates with me. And something I’ve probably particularly experienced. I have certainly felt periods of my life, work life, where I’ve experienced an inner conflict, this dis-ease, this discomfort, this feeling of this doesn’t feel right. Why am I feeling this way? Is it work? Is it my family life? Is it the things I’m pursuing outside of the workplace as what’s causing me to feel this dis-ease, this discomfort, this inner conflict, which which may be considered as the term burnout at this present time, it’s a bit of a buzzword, I think <laugh>.

Jo:

Good point. Good point.

Kayur:

So I wonder whether what we mean by burnout is this inner conflict, and yeah, absolutely I have periods of of times where I do experience this inner a conflict, this discomfort, this feeling of being eaten up inside. And I think over the years, I’ve got better and better and more self-aware at recognising when that’s happening. But I first experienced that feeling of being burnt out inside in my late twenties and I recognised, ah, this is not how I life should feel like. And what steps did I take? Something occurred where I realised I had to take a long look at myself inside. And I think the first opportunity I got to kind of experience, it was at the end of a yoga class, where I felt this serene state of bliss. I felt this silencing of the mind, the quietening of the mind, which I think contributed to that inner conflict. The fluctuating mind, the battles, the conversations with myself, the conversations with my personal systems, the values, the conversations with I had with myself. You know, what are my ethics? What are my morals? I think burnout, in a sense, is a conflict or a way of operating against those systems of values that we have, those core ethics we have that are often brought onto us by the external world. But it was at the end of a yoga class where I truly realised what I valued in life, what my ethics were. And from that point onwards, the kind of the powerful experience I had the end of a yoga class, at the end of an vigorous kind of session of moving the body with the breath.

And what that culminated at the end got me on that journey of, ah, if I can bring my mind to this state of peace and silence just through this exercise, maybe I will be in a better space to learn and listen to myself and understand what’s making me feel uneasy. And you need an environment in which you can contemplate that state of dis-ease, that state of inner conflict you need. You need moments of silence and tranquility when you’re feeling burnt out and restless. And when you’re feeling you need to escape the world. That was the first accidental step I took to o overcome it. And then naturally my interest in philosophy grew from there. So I initially became very interested in yoga philosophy and what yoga and what yoga explains about inner conflict and suffering. And I became interested in Buddhism and what what Buddhism says about pain and suffering and an inner conflict, and how we go about resolving that in this kind of a kind of almost a structured or in a path. It sets out pathways and approaches to contemplate and work on. You do inner work within, within yourself.

Jo:

Absolutely. Yeah.

Kayur:

So they were my initial steps is to become interested in faith-based philosophies, hope-based philosophies that looked at perhaps burnout or in a conflict, this dis-ease in a different way than what we do in the West. And exercising and moving the body and connecting with myself in a different way as opposed to say, going to the gym. So that was the basis of how I started to work towards overcoming that inner conflict. And I would say that that framework has over the years softened that feeling of burnout over time. And as I mentioned, I think there’s a number of factors that contribute towards the feeling of burnout. And it’s not just the workplace, it’s what goes on around that. 

Jo:

Yeah. We’re gonna get into some of that in a moment, but before we do, I just wanna help us understand a bit of your process. So number one, you, you kind of noticed that something wasn’t right with yourself. You’ve used the word dis-ease, like dis-ease rather than disease, which as soon as you said that, I went, oh, that’s so right. Like, if you keep the people that I’ve worked with and the people I go back to and I try and track when they start to feel a sense of dis-ease, it’s usually a couple of years before their great big ‘come to Jesus’ moment if we’re going to use faith-based philosophies today, <laugh>, and you know, they go, I wish I hadn’t ignored that. I wish I hadn’t ignored that. I, Jo Muirhead right now goes, I wish I hadn’t ignored that. And I think we get this sense of something’s not right. And then you talk about this internal conflict, which is not necessarily a conflict within ourselves, but it’s usually we are conflicted with the external environment. So quite often, I’m just gonna call it what it is that’s working inside insurance companies or any type of system where someone else who is not a health professional is guiding the way we have to do our work. You know, I often talk about that in my own work, going, great, your high school education is now limiting my <laugh> higher education degree, stopping this person from getting the treatment they need because you have a box you need to tick, like that level of conflict as well going, why am I doing this? Why am I doing it in this way? Sometimes we find ourselves conflicted because the people who manage or support us, they have different KPIs to what we do. But I love the way you turned around and you said in this yoga class where you said, I found out what my ethics were ’cause every allied health professional has a board of ethics or a code of conduct that they have to abide by. And I don’t think any of us really take the time, number one, to learn what those are. But number two, are they meaningful for me? What are the ethical considerations for me? Like I know broadly speaking as health professionals, we’re not supposed to do harm, do no harm, do no harm. But I could do no harm over here and not harm this person, but in not harming this person, these people over here might end up being really harmed. How do I navigate that conflict and what responsibility do I have in that? Can you talk a little bit about, I don’t know if you’ve ever explored this, but what are some of your personal ethics that help you navigate this? The onflicts that we find ourselves in a day-to-day basis,

Kayur:

‘Do no harm’ is a central pillar of yoga philosophy. Like we will suffer less, the mind will be at more peace and will be at more harmony when we practice our himsa, which is translated to nonviolence, do no harm. Whether that’s in thought, whether that’s in a way we project ourselves and the way we act and do our work. If the goal and the aim is to do no harm to the insurer, ie. overspending on their money, is that considered a non-harmful healthcare practice to deliver healthcare in a cost efficient way that delivers functional recoveries in a timely way? My practice is embedded in doing no harm for stakeholders. How do I navigate that when it comes to working with treatment providers or healthcare providers to deliver treatment services?

You know, it’s supporting them to govern themselves, supporting them to become accountable professionals so that their healthcare practice and their delivery is not going to harm that person in front of them. That the patient, the injured worker, the claimant, whatever you want to call them, if a MRI scan is ordered, is it potentially gonna do them harm? And does that healthcare professional, are they aware and conscious that it could potentially do harm? Because there’s research out there. That routine scanning, for example, of a musculoskeletal condition [even if] there are no clinical red flags or kind of nothing sinister kind of being highlighted in the history taken, [you know fully well] that a report will come back with an array of medical terms, which can be quite overwhelming and quite overpowering and cause quite a lot of inner conflict in that human being that’s reading it, is that harmful?

So what I’ve embedded into my practice, or how do I mitigate potentially harmful healthcare practices, is by collaborating with treatment providers and orchestrating rehab and having certain narratives and discourses that mitigates potential harmful practices or mitigates a harmful pathway that could cause harm. So it’s integrating that knowledge of evidence, integrating what I know, what factors I’m aware could cause harm and supporting healthcare professionals in that way to consider the decisions that they’re making. But doing that in a very diplomatic and professional way, it’s always the challenge, isn’t it? It’s always the challenge when you’ve got healthcare professionals that sit in one camp, and then healthcare professionals that sit in another camp where you’ve got healthcare professionals who truly kind of contemplating and reflect on the next action that they’re about to make.

And healthcare professionals who simply do it because they’re conditioned in that cycle of of, ah, this person’s got neck pain. Because MRIs are easy to order and because they’re undertaken in a timely day, potentially can be done in the same day. It’s easier to go down that, it’s easier to go down that route. So non-violence is a central pillar to the work I do. And I think from that, you have this knock on effect I guess, just one simple action, or one simple way of being can have a ripple effect on the rest of the work work we do.

Jo:

Yeah. Especially for those of us working in environments where it can quite easily become adversarial. Not all treatment professionals are in that type of work environment, but I think it’s really interesting when we look at musculoskeletal, I’m gonna use myself as an example. With cancer diagnosis, you get sent for tests all the time, and then you end up with the scan anxiety, right? I still get anxious about that every time I have to go and have another scan there is this, oh my God, what are we gonna find now? Because it’s rare for me to go to a scan as a woman in her fifties, they’re gonna find something because this body has been on her for 50 years.

What I have had to do in terms of my own self-advocacy now is go, what are some of the things that you are expecting to find in a scan of someone who’s 50 years old? And I think having those conversations with our clients so that they can go, my leg hurts, but I didn’t realise I had five levels of disc protrusion, which might not be contributing to their leg pain at all. Or they go, I’ve just found out I’ve got a tear in my hip, and they’ve never had a problem with their hip before. So again, it’s building this confidence in ourselves not to get caught up in the steam train or the very fast moving vehicle of go get this scan done, then you’ll go again, see the orthopedic surgeon, then we’re gonna do this, and then we’re gonna do that, and then we’re gonna do this, and then we’re gonna do that. And then all of a sudden, you’re gonna be fine. You’re gonna go back to work. And then the client’s going, I’m not fine. I don’t know if I have ever thought about the whole ‘do no harm’ in terms of that very specific practice.

Kayur:

It’s is a big conversation globally. Cause of medical negligence. Is it negligent? It’s a big question. <Laugh>, big debate. But you know, from experience, I’ve experienced so many people go on to live with chronic pain, disability, loss of work, prolonged periods of absence from work because a contributing factor was that a pathway was followed or they were led into a pathway of healthcare that may contributed or attributed towards that harm that ill health. And not every eight and a half billion people on this planet and a very small percentage are medically trained and have no real understanding or awareness of in the large proportion of humanity, have very little understanding of the workings of their body and and the functionings of the body and what it’s capable of in terms of healing and repair and recovery and rehabilitation.

So naturally a lot of people are vulnerable when they experience injury and or illness and there’s an element of vulnerability and you put your entire trust into a system that, I would like to think that if I was ill or injured or unwell, that that I would hope that the people I confide in will help support me recover in the most natural way possible and have a discourse and narrative along the way that reassures me that everything’s gonna be most likely fine <laugh>. And I appreciate that there are people who are living with medical conditions, terminal conditions, and here, I’m talking about cases and circumstances where with that harm is completely preventable.

Jo:

Absolutely. And I think conversely you know, going back to the scans and the diagnostic imaging that we also reliant on, there’s harm we can create with that when it comes back as no abnormality detected. Yet you’ve got a person sitting in front of you who is distressed and all their behaviour suggests that there’s something, there is something very real going on there. But then we get this evidence that says nothing wrong must be in their head. They must be making it up.

Kayur:

Or you get a report that alludes to a number of pathological features when actually those pathological features could genuinely just be normal time related changes. <Laugh>, which sounds completely different to a a herniated protruded disc at L4, 5 & 6 which is impinging on the nerve, which probably was asymptomatic before, or could have been asymptomatic before as opposed to normal anatomical changes expected changes in a male who’s 45 or 55 years old. And then the narrative that comes from that, what I would hope, what I feel should happen is that the discourse and there’s unity in how that person’s prognosis will be, or could be like and just positive being more positive in our language around the people we work with, and the information we’re sharing generally having positivity and reassuring language.

Jo:

And Kayur is not talking about toxic positivity at all here. What he is trying to suggest, or what he is suggesting is that we become very, very well acquainted with how things like diagnostic tests or other medical professionals are languaging things. And we get to see these clients who are their vulnerability is heightened. They could be a lot more hypervigilant. Like I certainly became incredibly hypervigilant around health professionals. So what if we’re going to use this ethic of do no harm? How are we going to interrupt that cycle for that client so that the client can actually start taking back some of their empowerment, some of their agency, and go, I’m a woman in my fifties, I’m gonna see stuff on scans. Right? Or I’m a woman in my fifties, maybe it’s time to go get my hormones checked. 

Kayur:

Absolutely. And that that scan then goes onto a specialist, and it depends again on what camp that specialist is sitting on, and then their lived experience of supporting people who have a diagnostic report that’s been reported in that way. What camp do you sit in? Do you sit in the camp where you’ve seen a thousand people who present with the same image, the same kind of finding, and you’ve seen all thousand people recover completely fully without ever needing to be operated on. Or is your usual practice to recommend a surgical intervention to explore, to see what you can do to fix the problem which then possesses a number of other risks, which then ripples into other experience. We could go and it’s more about let’s reassure people. Let’s just reassure people more. Let’s create less fear and anxiety especially in those cases we know that could be prevented and preventable from a harm perspective long term.

Jo:

And let us become confident in supporting clients to ask the questions that they need answers to and not assume that we know what they’re thinking.

Kayur:

Absolutely. I was recently speaking to a client and I think three or four surgical procedures on the knee arthroscopies multiple over the two, three years. And another surgeon has said they would like to go in again and they think that they can help. And I said to my client, is this what you were hoping for? Is this the pathway you’re hoping to go down given the nature of the three other surgical procedures you had? And given that you’re showing me you are making progress here what are you hoping for? Like, you do have a choice. And he said, but I don’t have a choice. And I said, yes, you do. <Laugh>. You have a choice. What is it you mean by you don’t have a choice? And I said, you absolutely have a choice. You can either see where you can go without having to go for a surgical procedure, or you could absolutely go for a surgical procedure, and after six months post-surgery, you know better, or yeah, there is a choice you can make. It also comes down to the individual’s values as well and ethics around what healthcare is and should look like. And that feeling of having something done to them may sometimes make people feel better. Or it could go the completely opposite way. So yeah, the ripple impact, the karmic seeds that are planted from potential healthcare decisions could go in any direction, couldn’t they?

Jo:

Yeah, absolutely. And I think the powerful part of this conversation, which we will get to very shortly, is helping us understand and explore some of that disquiet, that dis-ease that comes up for us as health professionals and how we navigate that. Because we’re all looking for the simplest neural pathway because we are busy with the work we do is difficult. The work we do, I know you all think it’s common sense and easy, but the work we do is hard. This is why you go to parties with friends and they go, oh my God, I could never do what you do

Kayur:

<Laugh>. True.

Jo:

Absolutely. Yeah. The work we do is difficult, but our brains are wide in such a way that we’re always looking for the simplest way to do something. And when we’re overworked or feeling out a control, or we’ve got kid demands or older parent demands, or we’re about to lose our job, or is the NDIS gonna even fund what we do anymore? Or is this insurance company gonna get hacked by the next Russian cyber attack and we can’t get paid for the next six weeks, like when we’ve got all of that? ’cause they’re real life experiences for my listeners. So we are sitting there and we’re just going, what’s the easiest thing for me to do? We know it’s not even a conscious thought. It’s like, I need to do no harm, which means I don’t stick things in this client. I don’t rush them out the door. I make sure that their next appointment is booked. I make sure that their medication is all up to date. I make sure they’ve got their tools, but do we check to see if they’re practicing using their tools

Kayur:

And even providing advice that I sometimes feel is hopefully gonna do no harm? I often hear clients say I need surgery, or my surgeon says I need X, or This person has said I need y And I said, even trying to challenge that in the most diplomatic and careful way can often be responded with hostility. So it’s a really challenging space to work in healthcare. And there’s just so much conflict in different shapes and forms and so many dynamics to deal with and play with. And to deliver a truly non-harmful healthcare service. It’s the biggest challenge we’re facing in. It’s the biggest challenge we’re facing. Like, we’re all here trying to support people to recover, reach their human potential, most cost effective, the most natural ways possible.

That’s what I feel should be the core of healthcare cost efficient, but in the most natural way possible. And yeah, I think that will do no harm globally to stakeholders, but we need an entire healthcare workforce that believes in a natural recovery, and that has a discourse and narrative around the likelihood of people making full recoveries from from conditions or healthcare issues that are completely recoverable from. So I think if we can help a cohort that cohort of people, I think it’ll alleviate a lot of stress on the system.

Jo:

Oh gosh, yes. Yeah. And then I’m now curious, bringing this back to the topic of this podcast, which is about psychosocial demands of our work. Now, we haven’t labeled them or listed them, but we are talking about them frequently. Like this whole conversation has been about the psychosocial demands of our work as health professionals. So if you were looking for the list so you could go and create your management checklist, have I checked in about vicarious trauma? Have I checked in about slip trips and falls? Have I checked in about road rage? And I think that’s the complexity that managing or assessing for risk really presents us. Now, Kayur, I think you’ve opened up this conversation beautifully. So you’ve got team around you, you’ve got people you refer to, and people that you work with, and people that you care for. What are some of those risks, the psychosocial risks that you are seeing in your colleagues?

Kayur:

I’m not sure what I’m seeing in my colleagues. And there’s perhaps a <laugh> a reason for that, which I probably won’t go into, but what other risks I am seeing in terms of myself?

Jo:

Yep, great.

Kayur:

As in what am I experiencing that impacts my wellbeing?

Jo:

That’s a great way.

Kayur:

What’s causing inner conflict? I’ve expressed that I feel that the large proportion of the people I work with, I’ve worked with people who’ve been involved in major traumatic events and have sustained multiple traumatic injuries multiple orthopedic injuries, multiple fractures. I forgot to mention that I have a rehab provider that I founded in the UK and for the last 10 years, I’ve supported people who have been in intensive care unit for several months to return to work within three or four months. And seeing the speed of recovery that can be achieved and accomplished when everybody’s working in unison. Every stakeholder, every healthcare provider, treatment provider is working in unison towards a unified goal. And every party in that puzzle is aspirational and believes that people can make the best possible recovery, providing we all work together and harmonise and seeing that occurring. Not seeing that occur in the industry generally causes a lot of conflict. And then trying to apply what I know and what I’ve seen and applying the practices that I’ve evolved and implemented over time to enable those outcomes, those results, those functional recoveries in a space that’s so disjointed and that so I’m already on a mission to try help people recover and make full recoveries through lived experience and practices that I’ve adopted over time iand implemented working with people who’ve sustained far more severe injuries than what I’m seeing in this space here. I’m talking poly orthopedic people who’ve multiple fractures, head to toe people who’ve sustained amputations as a result of road traffic collisions, brain injuries etc, go on to accomplish some great things. And consistently and routinely because I’ve been able to deliver rehab and healthcare in a way that the stakeholders value. And so that inner conflict of, okay, I want my clients to experience rehab holistically, I want people to have an integrated healthcare experience. And then it’s more around control. Like, I think that’s the biggest psychosocial risk factor is management or a higher the hierarchies controlling your practice. You need to do X, Y, and Z because that’s what will move the file or the case forward. But that’s not necessarily the best thing for the client. It’s not necessarily the best interest of the client, but it might be in the best interests of a business because by doing X, Y, and Z, it generates revenue. Or have you tried implementing this healthcare program? That controlling of that practice. And as healthcare professional, we all practice in unique and individual ways. We all know how to get to a result and an outcome in our own ways. We just simply need to be trusted. We simply need people to have confidence in us. We need to be empowered to support people in our own unique ways.

Jo:

That’s really powerful ’cause If you think about that from owning a business, when we’ve got team members, I know one of the most empowering things I’ve done for my team members is to go to them and say, I trust you. I trust you. If you can convince me that this is the best thing to do for the client, I will help you get it funded, or I will help you work out a way to step away so that you don’t have that conflict anymore. Because one of the biggest frustrations in our industry, and probably for anyone, is we go, I’ve assessed this client like you asked me to do, and using evidence-based best practice and lived experience. And I have now made these recommendations and then they come back to you and go, awesome recommendations. Do it in half the time, and I’ll give you a third of the money. And then we, as the health professionals who just wanna help our clients go, sure, I can do that. But we end up getting resentful and overburdened, and we have to take on more clients to meet our financial obligations or our KPIs all to keep our bosses happy, to help them meet their KPIs, and then all of a sudden we wonder why we feel like garbage and we’re in it conflicted, and we’re all trying to relocate to Bali so we can become life coaches and cryptocurrency traders, <laugh>. I go to Bali a lot and I see it and I’m like, oh, you used to be an OT and now you’re trying to eat cattle living trading crypto.

So I think that’s a really powerful and quite a simple way for clinicians on the ground to kind of go, where am I feeling conflicted in this work? And then for team leaders to go, where am I noticing this conflict? What are people talking to me about conflict here? And I think if we started to approach the psychosocial demands in terms of this word ‘conflict’ and inner ‘dis-ease’, we are gonna be well on the way to creating a stabilised workforce. An empowered workforce, a workforce that actually wants to do the work, and dare I say it, AI can’t do this bit.

Kayur:

No, absolutely not. And that’s the ongoing conflict I experience is being told what to do, how to do it, when to do it. I think we all do. And healthcare doesn’t work that way.

Jo:

No, it does not.

Kayur:

Healthcare doesn’t work that way. Rehab management doesn’t work that way. It’s a big challenge in this space. And so yeah, it’s an interesting conversation. The psychosocial demand, it’s a very complex subject. I think we in the healthcare space need to trust our people more. The people who work within our organisations who work for us, our team members, more. We’re all in healthcare for a reason. You can’t standardise healthcare as such. You can’t standardise rehab management as such. There are things we can do to standardise measuring success. There’s things we can standardise to measure efficiencies, but you can’t create an entire workforce into robots. You know, you KPIs for example. Well, like, yeah. It’s a big conversation in a big subject that I <laugh> I can get quite emotional about.

It’s really important that we’re not trying to create workforces or rehab consultants or case managers that are robots who, you know get X, Y, Z done in a certain timeframe or write reports or request funding in a cyclical way. In the same way for each client that we work with, we need to ensure we’re not recommending the same types of supports for each client. Every client is unique and has their own values and has their own needs and has their own interests. And it’s ensuring that we mould to that. And yeah, just ensuring that you’re giving your workforce the confidence to go out and just get results and you can’t get results every single time. You can’t get the positive closure and the negative closure. Like it’s just not a metric to really measure your workforce’s success against. I think, yeah, there’s a lot of work to be done in that respect.

Jo:

Yeah. Great conversation. This is we could obviously talk about this a lot and I think it’s a conversation that does need to be opened up. But coming back to the beginning of the conversation, I just wanna remind everybody, go check in with your own personal ethics. I want everybody who listens to this podcast and you can come have the conversation with us in the Future Proofing Health Professionals Facebook group, come and have the conversation. Where are you working out that some of your ethics are being compromised? Not because it’s in your board of ethics or your code of ethics, but it’s like, ethically to me, this feels uncomfortable, right? Ethically, to me, this feels uncomfortable, which means that’s self-inquiry. And if we are going to be health professionals who can meet the demands of the future needs of our client base, we are going to have to take seriously this self-inquiry because we are the people delivering it. We can’t systematise out the human experience.

Kayur:

Absolutely not. Right?

Jo:

That’s what Kayur was trying to explain earlier. We can’t create systems that negate the human experience for both the person needing services, but also the person delivering services.

Kayur:

Absolutely.

Jo:

For the person delivering services. It’s called your clinical reasoning.

Kayur:

<Laugh>.

Jo:

And I’m not trying to be snarky, but I think we get so scared that if I don’t say what they want me to say, I’m not gonna get funding and the client’s gonna be left with nothing. And I can’t have the client left with nothing. I think we need to grow up. We need to grow put on our big girl pants, big boy pants, and or non-binary pants and go, Hey, hang on a minute. You ask me for a professional opinion. I am giving you a professional opinion that is backed up by evidence that is backed up. I’m sorry you don’t like it, but for me to get the outcome and to help the client in the way you want them helped (ie, not needing services anymore), you’re gonna have to pay for these things. And I think once we can adopt a posture that allows us to grow in our confidence of those conversations, we might not be having as many conversations about lack of talent in our workforce burnt out health professionals. And we might actually start seeing people heal.

Kayur:

Absolutely. Absolutely. <Laugh>,

Jo:

Thank you. So you write amazing things on LinkedIn. That’s how we connected by the way we did. So I wanna encourage everybody now to open up the LinkedIn app that they’ve probably got dormant on their phone. Go find Kayur, it’s K-A-Y-U-R-K-O-T-E-C-H-A. Go find him or find me. And then just scroll through my contacts and you’ll find him and watch what he writes about, get involved, get engaged. ’cause these are thought provoking discussions, which is why we’ve connected so well.

Kayur:

We have indeed, Jo, and you know, one of my biggest vulnerabilities is to have discussions like this. It’s something I find challenging. Sharing your truth and sharing your experiences and sharing the way you want to change the world is a real challenge without being judged or without being fearful of how it impact will impact you, your personal brand, your livelihood, your career, and your business. And I use my LinkedIn and words to express the chaotic mind. Sometimes all the thoughts and the emotions and inner conflict I have about the day-to-day experiences. And sometimes using words just helps in a different way to communicate the messages and highly encourage healthcare professionals to utilise platforms like LinkedIn to just share the story and share changes they are embedding in their healthcare practices, what what little things they’re doing to evolve and transcend the status quo.

Healthcare is an exciting space to work in. And I can’t wait to see the evolution of what happens in the personal injury space. I can’t wait to see stakeholders evolve. I can’t wait to see how healthcare professionals and treatment providers and evolve. I can’t wait to see it being a more seamless process. I can’t wait to see the majority of people who find themselves rehabilitating as a result of a personal injury. I can’t wait to see more people have an enhanced rehab experience. And it’s a great space to be in and a great journey to be a part of. And within those challenges and experiences, those challenges give me the purpose to drive change, to drive evolution in my own little way. And I encourage other others to step out or come out of their shells. And because there’s plenty of us out here who want to support people like that.

Jo:

Yeah. We do. And I love the way you say like, you’ve just taken us from a place of could have been despairing, but, we have the same philosophy here is if we don’t drive change, change will not occur.

Kayur:

Absolutely. I read a quote once I dunno who it was by. It might have been an unknown. The system will never change. We are the system, we are the change. And that’s resonated with me when I mean the system, it’s just the day-to-day operation of the capital world, capitalistic world. But there are people within these worlds that are working towards progressing things. And I’m seeing progress and I’m seeing that in myself, seeing that in my clients, seeing that in the people I work with and collaborate with and partner with and connected with that there is a community out there. And just reaching out is all you need to do, and don’t feel you don’t have a voice. Because I love that through LinkedIn I have connected with so many people who don’t feel that they have a voice. And it’s really important to connect with people who feel that way because they’re the game changers.

Jo:

Yes,

Kayur:

They’re the game changers. They just need someone to put their hand around and say, I’ll support you. I’ll back everything you’re gonna say because we’re having these conversations behind closed doors. And I agree with that. Now. It’s just putting it into a realm where the masses can read it, see it, believe it.

Jo:

Wow. I really encourage everybody to just be thoughtful. Don’t race off to your next thing after this podcast, after you’ve listened or watched this episode today. Just take some time to let it settle and things will come up for you. Good things will come up for you, but it will also guide you to know what you individually and personally need to do next. So before I close out this conversation, when we get to meet each other in real life, and we’re going to go to a cafe, what am I ordering for you?

Kayur:

Ooh, that will depend on how I’m feeling on the day. <Laugh>.

Jo:

Okay. So if it was today <laugh>,

Kayur:

I am unfortunately a bit of a coffee fiend, <laugh>.

Jo:

Oh, you are my person.

Kayur:

<Laugh>

I love a good coffee. I also love a green tea. I also love an Indian chai. So <laugh>, I would say surprise me, Jo, and take your pick. I’m not fussy <laugh>, and I’m not fussy about the milk either. <Laugh>. 

Jo:

Namaste. <Laugh>. My coffee questions have gone from what type of coffee, right through to coffee milk sizes, milk types <Laugh>. Hey, thank you so much for being so generous with your time and your thoughtfulness today. Thank you. I am looking forward to pursuing and pursuing these conversations greater. 

Kayur:

Absolutely. And hope this conversation doesn’t get me chatised <laugh>.

Jo:

It really won’t. <Laugh>, I think what you and I will find will happen, and I’m gonna leave this in the podcast ’cause I know is that we will find others who will go, I wanna learn to do that. I agree with you. How do I know this? Because you’ve given me confidence to start posting on LinkedIn in a way I never would have two or three years ago.

Jo:

Alright, I think we’re done. I look forward to introducing to you to our next guest on the next episode of the Entrepreneurial Clinician Podcast.