When Work Overwhelms: Lessons from a Physician’s Journey Through Burnout – interview with Dr John Cummins – The Entrepreneurial Clinician Podcast

This week on The Entrepreneurial Podcast, Jo is joined by Dr John Cummins to discuss the importance of stress management in managing and preventing burnout at work and the unfortunate health consequences that can follow from exposure to chronic stress levels.

In this conversation, Jo and John discuss: 

• John’s experience with burnout and times in his life when he’s had to make significant changes in his life,
• The impact that chronic stress can have on your long term health and longevity,
• The importance of interpersonal relationships at work and home in managing stress, and 
• The health advice John would give an allied health practitioner starting their career.

About John: Dr John Cummins MBBS, FRACP, MPH graduated from Sydney University in 1984 and was accepted as a fellow of the Royal Australian College of Physicians in 1992 as a Consultant Specialist Physician in General Medicine. He obtained a Masters Degree in Public Health at the University of Minnesota in 1996. John has had extensive clinical experience in a variety of both public and private hospitals as a senior doctor, in addition to running his own private practices. In addition to being the director of Executive Medicine, John is also the Chief Medical Officer for a number of life insurance companies (NEOS, PPS Mutual and Clearview), and the Treasurer of ALUCA (Australian Life And Underwriting Claims Association) Subcommittee of Medicine.

You can connect with John via LinkedIn or via the Executive Medicine website.

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:

Welcome back to another episode of the Entrepreneurial Clinician Podcast. We have another guest with us today, and this guest comes all the way from LinkedIn. So my guest today is Dr. John Cummins, who I’ve known across my career. But this is the first time we’ve really spent some time together to learn who we are, what we do, and our commitment to helping high performing health professionals stay the course. 

Before we get stuck into the podcast interview today, I’d like to acknowledge the Darug people who are the traditional custodians of the land that I come to you from here in the Blue Mountains in the greater West of Sydney. I welcome and pay my respects to any Aboriginal Torres Strait Islander or First Nations people who are listening to this podcast today or watching it over on YouTube. Thank you for everything you have done to create a wonderful country that I get to call home.

Now, John Cummins is a doctor. He graduated from the University of Sydney in 1984, which is really cool because I graduated in 1994, so we can talk to each other. And he was accepted as a fellow of the Royal Australian College of Physicians in 1992 as a consultant specialist physician in general medicine. He obtained a Master’s degree in Public Health at the University of Minnesota in 1996. And John has had extensive clinical experience in both a variety of public and private hospitals as a senior doctor, in addition to running his own private practices. Now, in addition to being the director of Executive Medicine, John is also the Chief Medical Officer for a number of life insurance companies, which is kind of how we got connected and is the treasurer of the Australian Life and Underwriting Claims Association Subcommittee of Medicine. So it is no accident that I asked John to be on this podcast today. John, welcome. And thank you so much for giving us your time and your expertise. Welcome.

John:

Always a pleasure, Jo. Thanks for inviting me.

Jo:

This is really cool. So tell me a little bit about the practice that you currently have in Sydney right now. What do you do on a day-to-day basis?

John:

Oh, look, the focus of the practice was when people come in, brand new people, and I saw a guy just this morning, I said, look, our ultimate aims that you never get sick. I mean, that’s a tall order, right? But as I explained to him and I got to here through a little bit of burnout, which I can tell you about. But I said to this guy that 6 in 10 deaths, so let’s say it’s 50%, you’re sitting in a movie theatre, every second person’s death is preventable. Which is very tragic. And it’s preventable because we first of all don’t need to get a lot of the sickness that we do.

It’s due to our nutrition, stress, exercise habits. It’s due our what I call stress management. But in there I also lump alcohol and smoking as stress coping mechanisms. And one of the things that I’ve found out when I started it’s called Executive Medicine, but it’s a preventative medicine practice, is this absolute wealth of really good evidence to show the power of prevention. So what we do is we coach people, we sort of see what are you doing with your diet and your exercise habits and things. Most people do some things, but they don’t do enough. And so we try and balance that out. And so the wings of a bird are a good example. People may do aerobic [activity], they go for a run, but they won’t do strength. People may eat a Mediterranean diet, but they won’t limit their calories. They’re still eating too much. People are highly engaged and work with their minds, but they won’t do recovery. And you’ve gotta do both. But then we also do sensible screening on people because the models built on, I guess the blue zones, which are villages, towns throughout the world where people live to an enormous age. By the time someone comes to me, like this guy, today’s 47, he is already had 47 years of a Western culture. So we do cardiovascular testing. We image arteries, and you really have to, because 70% of men, 50% of women don’t get a warning before their heart attack. And 40% of us die from a heart attack with stroke. And even like I did a talk, I was a physician at the hospital for a while and did a talk for them. It was really interesting on what do we know about doctors’ mortality? Guess what, it’s no better than the rest of the population, which I think is awful. And in some groups, and I think at that time, it may may be different now, but I think it was female anaesthetists were at a much higher mortality rate because they had suicide and they knew how to do it. So doctors aren’t very good at looking at you know, after themselves. And we also do sensible cancer screening. Like if you smoke, we image the lungs. I think the Australian guidelines now are saying image the lungs if you’ve got a chronic smoker. But we do bowel cancer screening, breast cancer screening, anywhere where there’s good evidence or good enough evidence we basically do it.

And so we find that people get healthier and healthier often. We find things on people like prostate cancers, melanomas, occasional breast cancer things. And we want to get it really super early because I don’t think doctors would say this, but the general public says, I know I don’t have bowel cancer. ’cause I would know if I had it. And I say, rubbish <laugh>, by the time you’ve got them, if you’re waiting for symptoms it’s raced off. It’s gone and you’re in serious trouble. So that’s what the practice does. People come in annually for an hour and a half, two hours. They get to know our exercise physiologist, who’s very good at the nutrition as well as exercise. So he’s sort of our health coach. And I would reinforce what he does and do the own health coaching. So I say to people, it’s no different from getting a car in once a year for service. You pay $1500 bucks, the mechanic’s got it for half the day or whatever it is. They pop the bonnet. You know, you can’t just look at a car and say, it’s fantastic. You’ve gotta do some diagnostics. And people treat their cars better than treat themselves. It’s that simple. And there’s a lot of good evidence for what we do and how we do it.

Jo:

And I really appreciate that you saying that it is that simple ’cause my rhetoric and my discussion in the early stages of this podcast was, we need to drink more water. We need to, as health professionals who were stuck behind screens for two years, we need to move our bodies more. And we actually need to watch our diet and we need to sleep and we need to sleep better. And with all this biohacking that’s around in the world, we just gotta get those four things right before we start thinking of anything else.

John:

Yeah. You can’t hack good health. People try it all the time. They micro-dose with the ozemspic and stuff. You can’t hack it. You have to do the basics and then if you wanna try and hack it, (a) good luck, but (b) make sure you do it on a good foundation of lifestyle ’cause that’s what I mean. You look at these cluster of people. These people live a long time. It’s not genetic ’cause If you move them to another culture within their lifestyle, they’ve got the western diseases within their lifestyle. It’s not that everyone lives to 120, But a lot of them do. It’d been probably six times the rate of anywhere else in the world. And if you look at their blood work, it’s like they’re 20 years younger. And the reason I’m saying this is they get it from eating unprocessed food, lots of incidental physical activity, and they’re not that stressed. So you don’t have to hack it.

Jo:

We don’t have to hack it. We’ve actually got the foundations there and they’ve been there since Jo was a little girl and John was a little boy. And we are trying to get smart with medications and wearables. And I’m like, can we just get these basics down? Like, I’d really like to see health professionals drink more water. And you know what one of the reasons is they don’t do it is because they’re so back to back to back to back with clients. They don’t have time for a bathroom break.

John:

Yeah.

Jo:

That starts to tell us that there’s a problem with the way we’re working. Right?

John:

Exactly.

Jo:

So we wanna bring this conversation back to stressors and burnout. So I’m gonna ask you the same thing I’ve asked most people who’ve been on this podcast for this season. Have you experienced a time when work was overwhelming or you felt burnt out? Or have you got a story that you can share with us about that?

John:

Look, it was a good question ’cause I’d remembered some stories I hadn’t thought of for a while. So there’ve been a few periods in my life where I’ve had to make changes. So, and I actually just remembered this this morning, Jo, when I was 17, I did my HSC and I actually got burnt out then. I didn’t get into medicine first time. I went back to do the HSC again, which was very embarrassing. But it worked. But what happened was I got the Dux of the school. And so the school was the Marist Brothers at Eastwood and I got a medal. And the Dux was because I came first in the trials. And so I was totally expected I would get into medicine then. And I dropped the ball and I think I got burnt out.

And that’s what I used to tell myself as 17, 18, 19-year-old, I realised I got burned out. I’d lost the drive ’cause I think I tried so hard for the trials. And in those days, I think the trials were 50% of your mark or something. So that was probably the first episode. The second time was I dunno if you’d call it burnout, but I had a significant problem with my boss. I was in Minneapolis. And the reason I talk about it is because the most stressed I ever see my clients, my patients, are in interpersonal relationships at work. It’s actually not through divorce and illness. I think it’s ’cause people feel trapped. Anyway, my boss calls me and he says, John, there’s been a complaint about you. I said, oh what was the complaint? And he said, well, I’m not gonna tell you. I can’t tell you. I said, oh, who made it? He says, well, I’m not gonna tell you. I can’t tell you. I said, ah it’s never happened to me before. So I said, well, what are we gonna do? He said, well, I’m just going to keep a really close eye on you from now on. So I was angry. I was felt trapped. I was really angry. But I’ll tell you what saved my bacon was that I was thinking of going back to Australia I was halfway through the fellowship. And just for your audience, the fellowship was actually in adolescent medicine ’cause I was always interested in behaviour and emotions and people’s health. And so I was an adolescent physician for a while because I thought I’d get to them early. And that career didn’t pan out. But back to the story with the boss. So I was feeling pretty not happy. And this guy comes over who I didn’t know very well. His name is Glen Bose. I mean, it’s made me think I really wanna chase him up and thank him. So Glen was a respiratory physician that got into adolescent medicine, came to Minneapolis ’cause it was the best place in the world at the time to train in adolescent medicine, which is why I was there. And he had a beer with me. And he sort of said, what’s going on? I told him about this thing. And I was having a bit of cultural adjustment to the US anyway. And he said to me and it’s really important to that if we mentor people to sort of remember this sort of stuff. He said, John, you’ve gotta remember that you are an Australian physician. You’re an F-R-A-C-P. Said you’re one of the most highly trained people in the world. And he said that when you compare your level of expertise or or training with the Americans, he said, you’re far superior and despite what this guy’s trying to do or doing you’ve just gotta back yourself and be confident.

And it made all the difference, Jo. It was a shot in the arm. He was right. I don’t know about now. But certainly the training was much more in depth then. And it just gave me that boost of confidence to keep going. I dunno what happened with this guy. He was just very not a good manager. Obviously very passive aggressive. But that really helped me stay the course. Now, there were two other times and I’ve forgotten this one until this morning. It’s kind of burnout. When I got to about age 40, I was working in hospitals. I had a practice at the Mater Hospital as a hospitalist, I was just getting quite disillusioned with my lot because I felt that I was by default becoming a pill pusher ‘cause a lot of medicine is based on interventions and they work. And I do do pills now, but I just wasn’t feeling soulfully satisfied. So, and it’s funny, we actually have our medical school 40 year reunion coming up in two Saturdays. And one guy that I can think of at the moment got out of medicine and into business. And so I was interested in business. So I spoke to some doctors that had done MBAs and got out of medicine and I didn’t do that because I had three kids. I had a mortgage, I was kind of handcuffed to the financials.

And then I think if you put things out there, this practice, I fell across because there was a Doctor Adrian Burden had the practice. And a patient told me, I met Adrian, who’s a GP, and two years later he wasn’t ready to retire, butI was very inspired because I thought, aha, you can do this style of work. Because it’s very time intensive. You have to naturally charge a lot to make it worth your time as well. And if you get the right client group who are interested then, then it does work. And that what got me into this practice. It’s actually 20 years ago this year. And it’s been really successful since then.

So then the final one, as I think about my life with work is I had a a really good position at the Mater Hospital in Sydney. But I was back on call. It was a private hospital. And so it’s this 24/7 on-call. I tried to get other physicians in to join the practice. I did swap some of the weekend on call with another physician. There’s very few general physicians, you know and I’m sort of mid forties I’m thinking, oh, Jesus do I wanna do this for another 20 years? And I tell you the key for me was my gut. I was getting resentful of the phone calls about the diary. Just simple stuff, 247. So my gut was telling me I was getting irritable and resentful. And when I projected myself 20 years in the future, thinking, oh, I just don’t wanna do this with my life. So I made the decision to leave. And there relief. Now I knew I needed the money, so I had to boost the life insurance. And then found this practice. So it took me a couple of years. But It was sad. I had a couple of guys come up to me, both men, but that’s irrelevant, at the hospital, one was a spinal surgeon and the other one was a general surgeon. And when they heard I was leaving, they walked up to me and said, John, I wish I had the courage to do what you are doing. I’m thinking it’s not that hard. You can leave, and they’re still doing what they do. Hopefully they’re not resentful. But I felt sad that they wouldn’t look outside the square and I guess follow their passions more or their dreams, whatever they were. 

Jo:

Wow. Thank you so much for providing like a historical context ’cause I think for us in this day and age it’s very easy to get caught up in just what’s in front of us. You know, the next thing, since we’ve had the pandemic, we’ve kind of been shoved into this way of operating, which is ‘when’s the next bad thing happening?’ And I know there’s a lot of anxiety still in the community around, like, we’re still quite hypervigilant as a society around when the next bad thing’s happening. Which doesn’t really help us manage our stress, does it?

So there’s three things I wanted to come back to there. Well, one of the things that you said in the beginning was, and you talked about your experience in Minneapolis is a lot of the people who are coming to you as patients. So you’re working with high performing people, like you’ve got a practice called Executive Medicine, right? These are people who have finally worked out, they need to take their health seriously. Who probably know the rhetoric, but they’ve never found the time. So if these are the people who are coming in and they’re talking about the stressors being with interpersonal relationships at work, how is that turning up for them physically as a stress response?

John:

Great question. So first of all, in the 20 years, and this could be a cohort effect, we’re attracting certain people, but I think I’ve suggested strongly to two or three people that they leave, right? And I don’t wanna do that, but one woman she called me back or emailed or whatever, this is quite a while ago. But she was so stressed at work and I said, look, I think you should quit. And she did. And she was so grateful for the push. So it doesn’t happen a lot. I see a lot of you know, there’s a change in leadership and the dynamics change ’cause every new CEO wants to put their own stamp in it. And often that sort of plays out where people will then drift. They’ll work for another company or whatever. In my view is that when you get an interpersonal problem, the only solution to that ever is that one person leaves. And it’s often not the victim, but the person that’s suffering more. Because I don’t I’ve never seen or heard of sort of mediation, things like that work. It’s generally someone has to go and disrupt it. So physically by far the most important question I ask someone about how they’re coping with life, other stress, how they’re burned out is, do you sleep? Because if someone can fall asleep and stay asleep they’re coping with life. And it’s always the same thing, right? Yes, you are asking me about booze and we don’t get many smokers, but it’ll manifest physically with sleep.

So often people can fall asleep, but then they wake up. And I think what’s happening is that we have these 90 minute sleep cycles where we lighten up, go deep, lighten up, go deep. And I think what’s happening is when you lighten up, because as you’re going through that cycle, your conscious mind clicks in, then you start the worrying and the and it’s a huge torment for some people. So it manifests physically with sleep. I don’t see it manifesting much with blood pressure or increased heart rate. You know, a great tool is the heart rate variability. And we were looking at it because there’s people say, look, I wanna measure my stress. Well, you can’t really, blood cortisols don’t do it very well. Saliva cortisols don’t do it very well. There’s lots of evidence that stress gives you central adiposity and like big, big tummies, but so does it, so does overeating over drinking. But the hard rate variability literature is robust. Heart rate variability is actually quite good at telling you when you should recover. So it will tell you if you’re under strain. And that can be physical or lifestyle strain. So that’s one thing that I would point to. But generally, physically it’s sleep. You know, it could be weight gain because people say, look, I’m a stress eater, so I’ve just been eating more because of this or that. People don’t tend to take up cigarettes later in life. Some have taken up vaping, funnily enough.

But we don’t get a lot of smokers here, less than 1%. So I’d say sleep and not an awful lot more physically. Now, long term, Imy view is anyone can do stress for a season, but if stress is part of your lifestyle, you wanna be careful ’cause there’s some really good literature on the future risk of heart, like cardiovascular disease, heart attack, stroke. If you ever have a major depression in your life and a major depression, you’ve gotta hit certain criteria through according to the DSM four. But not just, I’m a bit unhappy ’cause I broke up with my girlfriend, but some biological features like sleep and things like that. Let’s say you had a major depression in your twenties, your lifetime risk of heart disease doubles for the rest of your life.

And probably other serious mental health issues that are not just a situational reactive thing do seem to have significant long-term risks to your vascular system. There’s various theories for that. And you would have to wonder whether there’s a cancer risk. I’ve never seen any good data, but you think about it, your immune system basically shields you from the cancer cells that were probably always forming. And when your immune system gets whacked with being stressed, it’s probably good opportunity for those little cancer cells to start propagating and surviving and clustering and growing into a tumour. Not everyone, of course. And the other thing is side issue, but it’s important. Work is always inherently stressful. No matter whether you work yourself or work for other people. For sure, you do not wanna be bouncing from stressful work and stress at home ’cause where’s your respite? Your home should be a refuge. And I worry about people whose relationships at home are under strain and they’re in a workplace stress. So that’s just something for everyone to be mindful of as well, I think.

Jo:

Yeah, I think that’s really important. And as a person who has survived cancer, I’m aware of that research and to me, it has made perfect sense because I’ve gone back over that research and my early childhood adverse childhood experiences right through to my first major depression in my late teenage years, right. Through to all the stressors I had right through it was like, well, this was gonna happen. So, I mean, that’s anecdotal. That’s me. I’m not suggesting that’s for everybody. I’m not blaming myself. But to me, it just made sense. It was actually really helpful in my recovery. Because this whole fatalistic, we dunno where it’s coming from and we can’t prevent it. That freaked me out, <laugh>. I need a bit more control than that in my life, <laugh>. So I appreciate you putting that together. And again, I find it really interesting that the number one, well one of the things that you’re looking for when you’ve got somebody who’s coming into your rooms that you possibly haven’t met before and you’re looking on, they’re pressured in their speech and they’re trying to get through things really fast. And your question’s gonna be, so tell me about your sleep. It’s not tell me about all your relationships. Tell me about your sleep. Great, great indicator.

And I think it’s interesting because allied health professionals, we don’t realise the impact of poor sleep on ourselves. We’ll notice it in everyone else yet. We’ll just joke about it with ourselves. We’ll just talk about the 3:00 AM wake up call or whatever something that’s going on. So the next thing I wanted to come back to was this sense of resentment that you had, particularly going back to Minneapolis, because people don’t realise that burnout, that the burnout comes with some really quite uncomfortable emotions and resentment is one of them. And for me it is the biggest indicator that something’s wrong and something needs to be fixed. Can you just share a little bit about what that sense of resentment was like for you? Was it a feeling in your stomach? Was it ruminating thoughts? Was it, I’m gonna hurt someone? I mean, you’re safe to say that here ’cause we we know you are not going to.

John:

Yeah, yeah. It was actually more somatic like, like a feeling in my tummy that I just knew I wasn’t right. But it was also coming out with it, it didn’t manifest ’cause I managed it, but just being irritable and tired of people calling me at two in the morning for something, well, what I thought was stupid. So having less tolerance, less patience. Of course,’cause these are people that are trying to get on with their lives too. It was my issue. It wasn’t theirs. But there was a an emotional, and it wasn’t strongly physical, but I clearly remember it was a pelvic sort of lower gut. It was a gut feeling, you know? And you know, the gut is so intertwined with your emotions and the amount of serotonin in your gut.

And your body can tell you an awful lot about what’s going on. Which is something I’m exploring at the moment. There’s a guy called Reggie Ray who’s a he’s a theologian that I follow a Tibetan Buddhist path. ’cause I think the Buddhist are a couple of thousand years ahead of Western psychology. And it behooves all of us to take responsibility for our mind because your mind filters everything. And most people don’t realise they’ve got a mind that’s actually separate to them. So Reggie Ray does a lot on somatic descent and and tapping into your body and listening to your body. And I’m starting that sort of journey more so than the cognitive pure meditation. So yes, it had a gut sort of pelvic feel to it.

It’s interesting. I was telling some guy the other day I had a major depression my very early twenties and was put on antidepressants, didn’t want it ’cause I was just a kid. I tell you what, I remember the GP and I wish I could see him again. He impacted on me because he cared. I think I saw him twice. I saw him late one evening. He said, John I want to get you back tomorrow morning ’cause it’s the backend of the day and just wanna listen to you a bit more careful and devote a bit more time to you. And anyway, he convinced me. And I don’t think I may have sent him once more, but that reaching out of caring for me was really important. And and I don’t think as managers we or as or as health professionals, we realise how important that human connection is with healing.

And so what I’m trying to say is I stayed on the Amitriptyline for nine months. I was one of those lucky people with three weeks into it, I woke up and thought, bloody hell, I feel normal. I’d forgotten what normal felt like. Came off it after nine months and haven’t had an episode since. And I think I’ve worked in my mental toughness as well. I would hope. But I haven’t really had a lot of the burnout stuff in my life if I think about it. Some people go through awful stuff with pathological bosses and things. And my advice to them, you just get out what’s only happened twice, but you don’t wanna stay in such life’s too short. It’s not worth it. You’re being an awful situation for a long period of time

Jo:

Especially something that is a little bit preventable. And I think as health professionals, this is not on your questions sheet, so I’m prepared for you to take a moment <laugh>, but I think as health professionals, I mean you obviously had a passion to get into medicine. You went back and did the HSC twice. Nobody wants to do that, but you did that. And we had this heart to serve. Like we didn’t go into marketing or business or banking. It was about, I wanna help people, I wanna help people. And I think because burnout and workplace stress or the stress that we have from the way we do our work is so gradual. Like I often talk about putting a frog in cold water and then gently turning up the heat and you know, we find ourselves in hospital situ, ’cause I worked in hospitals as well, hospital situations where you wake up one day and you go, how the hell did I get here?

Like you taking the 2:00 AM call about trying to stop diarrhea. The questions people were asking me when I started to trip in resentment was why I need to answer that freaking question? Why out of all the people in this 5,000 people hospital, I am the one you’re coming to for that question. <Laugh>. I think it’s quite remarkable that we find ourselves in these systems or these institutional ways of thinking. And you are right, we do feel trapped and you put your hands up and you talked about some colleagues that you felt trapped with. And it’s really hard to see the trap when you’re in it, right? Like sometimes we need perspective.

John:

I think some people do because you think what your situation is as normal and until someone points out to you, maybe it’s not. Like I see people that work an 80 hour week and I say, man, I say the cutoff for me for getting worried about people is usually about 60 hours a week. And the reason being that if you work more than 60 hours a week, you physically lose time for self-care, by which I mean exercise, by which I mean having time for the significant relationships in your life, which are real stress busters if you’ve got good relationships. But they say, well look, I am normal. I said, no, you think you’re normal because you surround yourself with people that are also working 80 hour week. But I can tell you categorically, I said, well we see 800 to a thousand people a year here, done it for 20 years. The Sydney professional, the high flyers working 50 hour week, 55 max. I remember seeing, he is retired now, but CBA boss. I was so impressed with him ’cause he worked about a 45 hour week. He was a very successful CBA boss too. And I asked him about that. I said, how do you handle stress? And he told the story that when he was 35, he had a business mentor, which we don’t get in medicine, right? A lot of your audience are medical. But in business they often will provide formal leadership training and development, which I think is a really good idea.

Anyway, he was told by this mentor that if you’re gonna succeed in business, you have to get good at stress management. So he learned to manage the stress, but the answer that he gave to me is how does he manage your stress now and how does he not work so hard, is that he says he’s got a lot of lever to pull. And so what I mean by that is he’s got a team that he can orchestrate and delegate things and he doesn’t. He’s learnt that he doesn’t have to do every single thing himself. And I don’t know about other doctors, but certainly, look, I’m 64 now and I’m just starting to learn better how to delegate and how to shortcut things and not feel guilty that I’m giving something to my PA to do well I should be able to do this myself.

But it’s just the workload then becomes super onerous. Like Covid sideswiped me in this practice. But I’m sort of back to where I do like three to four days clinical work. We’re usually four because five is just too much, Jo and I do the life insurance as well, and I’m a type A personality, but as I get a bit older, my energy level sags a little bit. And also my desire to do it sags a bit. It’s not that there’s, I love helping people, but I don’t want to run a practice. But I have to adjust my I gotta monitor myself and then make adjustments as I go to reduce my own workload because I want a lot more out of life than just medicine.

Jo:

Yeah, nice. And I think that taking responsibility for our own self-awareness is almost a literacy that we are going to need into the future. And I think it’s gonna apply to everyone, but we’re talking to health professionals or clinicians or medical people here today. If we assume that our bosses or our organisations are always gonna act in our best interests, we’re gonna get disappointed. And if we can then put ourselves in a position where we can become self-aware and know when things aren’t working for us, then we are not waiting for someone else to come and rescue us. We can actually be on the front foot. So we’re not turning up to John’s clinic with heart and arteries going, well, I did have a major depression and I’m still drinking and smoking and not exercising, and John’s going, awesome. Let’s get you some more imaging. Which I know is not, I’m not trying to be trite there.

John:

Can I say two things? The stresses that you go through as an employee, let’s say it’s even the hospital system, are very different to the stresses of being a business owner. And as a business owner, I have a lot of control, but as employee, and this is just gets down to feeling trapped. I mean, one of the biggest, worst things you can do to humans take away their locus of control, they feel they have no control. So therefore, I haven’t worked in a teaching hospital as an employee for a long, long time. But one of the things that really diffuses stress within a workplace, I think is having good friends, having a support a community around you at work.

Jo:

Yeah, I agree. And the research and the literature from a mental health perspective is so strong. A friend and colleague of mine, Cindy Doyle, has written and does a lot of work with first responders, particularly police in the US and her research showing just the role of good quality friendships when you get home good quality relationships, not one of the highest predictors of being a succeed as a first responder is having a good place to go home to.

John:

Huge. Yeah. Nice.

Jo:

So I’m gonna bring this to a close. I’ve got a couple more questions for you, but they’re not all really intense. If you had a younger person who came to your practice, say a person starting out in their career, early twenties, what is one piece of health advice you would like to be able to give them and hope with all hope that they take and listen to?

John:

Good question. So they’re in their early twenties, right? It’s in your twenties, you’re full of hope and optimism and energy. In your thirties you get smashed because you got career stress, children stress, often mortgage stress. And that’s when the anxiety and depression often peaks. And then life tends to get easier after that. Look, I would just instill upon them the importance of looking after your physical body and trying to just inch towards a better diet. Make sure you get the seven to nine hour sleep because you’ve gotta recover. It’s like a stool like your exercise, nutrition and stress management. Most of the work I do with people in their twenties and thirties that I find that come to the practice, is the coaching of the education ’cause they’re not old enough to get sickness yet. So you’re trying to stop all that. And just I also would say, if go through stress, go and pay someone and see them. I think therapists and psychologists are very underutilised there. It may take a two or three goes to get to a good one that works for you, but have a low threshold because they’ll teach you better tools, better skills, they’ll accelerate it.

Jo:

Yeah. Wonderful. What a great way to finish this interview today. Now John, something I do not know about you, do you drink coffee?

John:

Yep. Lots. Tons.

Jo:

Oh, see, I see you’re my people. So the next time I’m in the city, which is very rare, and I find your <laugh> Executive Medicine suite, what type of coffee would you like me to bring you?

John:

To drink there and then? A skinny, a skinny flat white would be awesome.

Jo:

I can definitely do.

John:

Let me know ahead of time. ’cause I’d hate for you to come here and I’m stuck with someone.

Jo:

Yeah, I would definitely let you know ahead of time. Yeah. Because for me to get into the city, I feel like a tourist now. It’s like, woo-hoo, I’m gone to the big smoke. Very cool. So John, if people wanted to find out more about you or connect with, I’m gonna encourage everyone to connect with you on LinkedIn because the way you talk about health, it integrates into your whole life. But are there other ways people might be able to connect with you if they want to come and see you?

John:

Yeah, probably. The easiest is, I can put my email in the chat, can’t I? Or if they just Google John Cummins, I’ll come up pretty quick, but happy to have a chat to anyone if they want some advice or you know what to do, whatever, that’s probably the easiest.

Jo:

Great. So we’ve got John’s direct email address here and his PA no doubt we’ll be filtering that. If not, John will be making that happen from now. We’ll put that in the show notes and make sure that’s available to everybody as well. So,

John:

Well, let me tell you something, Jo. So with four of us physicians, we catch up once a year and I was telling them about my ability to delegate and how it’s really freed up my life. And I actually did, I read this book called 10x is Easier than 2x. So it’s about, it’s easier to make 10 times your revenue than two times because you have to think different, use different systems. So I got Claire to do all of my emails now. I filtered out some, moved them into separate box so she doesn’t seem about personal stuff or financial and whatever. It’s made a huge difference to my life. I would save an hour a day, not trawling through rubbish made a huge difference. So yes, you’re right. Claire will filter it.

Jo:

And if she wasn’t gonna filter it, I was gonna get Claire to speak to Debbie who filters mine, <laugh>.

John:

Didn’t you find that it made a massive difference? 

Jo:

Huge, huge difference. Yeah. And because I had such low impulse control around email, I would just wanna attend to everything all at once and all of a sudden it’s four o’clock in the afternoon and I’m like, oh, no wonder I’m exhausted. And what about that big project that I still haven’t finished>

John:

That’s all got to do with your stress and how do you run your life? How do you run your brain? Where’s your downtime? I mean, not you, but but all of us. 

Jo:

They’re great questions. Very good. Well, John, tthis went on much longer than I anticipated, but I am so grateful for your time and your commitment to me and to this this episode today.

John:

Thank you. Much good on you, Jo. Happy to do it again. We’ll keep in touch we so, and hopefully your audience found something helpful.

Jo:

Oh no, that my audience would’ve found a lot of things helpful here. Thank you so much, John. Cheers. Have a great rest of your week.