Speaker 1: You’re listening to Your Practice Made Perfect; support, protection, and advice for practicing medical professionals brought to you by SVMIC. J. Baugh: Hello, everyone, and welcome to today's episode of Your Practice Made Perfect. My name is J. Baugh, and I will be your host for today's podcast. I'm really looking forward to the subject that we'll be talking about today, which is the Renaissance woman, and helping us with this subject today is Dr. Nancy Shipley. Dr Shipley, welcome. Dr. Shipley: Hi. Thank you so much for having me. J. Baugh: Before we get into the topic itself, maybe you could give us a little bit of background about yourself and how you got into the practice of medicine and how you started talking about this type of a subject. Just to give us a little bit about your background, your history. Dr. Shipley: Sure thing. I'm currently an orthopedic surgeon. I'm board-certified, and I have a subspecialty in sports medicine. I took a little bit of a nontraditional route into medicine in that it took me a couple of years after college before I decided I wanted to go into medicine, and as it was, it then led to me having to take post-baccalaureate classes to satisfy the requirements, take the MCAT. I entered medical school in my late 20s, as opposed to many of my peers in medicine who goes straight through and start medical school at, say, age 21 or 22. A little bit of a nontraditional path into medicine. I became interested in orthopedics somewhat halfway through my medical school career. I actually came into medicine thinking I would be an internist or a generalist, and as you find out in medical school pretty quickly, you're either a surgical type or a nonsurgical type. It became apparent that I was more of a surgical type, and after a really great positive shadowing experience, it kind of opened up my world to orthopedics and a series of events led to me going into orthopedics. As a woman, at the time, it was very unusual, and I got a lot of funny looks, but I kind of disregarded them and ended up an orthopedic surgeon anyway. I practice now in Portland, Oregon. I'm in private practice. I'm a member of a three-partner group. I'm also a wife and a mom, and I enjoy doing lots of things outdoors here in Portland. J. Baugh: I know that you participate in different speaking engagements in various settings on a variety of topics, some directly related to your practicing as an orthopedic surgeon and some related to what we'll be diving into more today. Some of those topics would be tackling fear, achieving balance, and being a Renaissance woman. Before we get started with the questions, I would like to mention to our listeners that they will be able to find on our show notes references to your website and any other materials that we may be talking about today. As we get started here today, what is the meaning behind the idea of Renaissance woman to you? What does that mean? Dr. Shipley: I came upon this term and maybe coined it a while back when I thought about what makes me tick and maybe what sets me apart sometimes. A lot of times in medicine, we end up being one-trick ponies. Sure, people have their families and their friends, but career-wise, we tend to get pigeonholed in our respective fields. Even though it takes years and years and years of training to get there, a lot of us end up being, and I say this with air quotes, just a doctor. I started thinking about how I wanted to be not just a doctor. Even though that is a huge part of my career and my identity I obviously love, love, love what I do in orthopedics, I wanted to dive deeper into the concept of being a Renaissance woman and just sharing my path and discovering that with others who hope to do the same. What does being a Renaissance woman mean to me? I think it means being a little bit of a Jacqueline of all trades. I like to say Jacqueline, because I'm a woman—a female corollary of being a Jack of all trades. I also recently came across an article describing that as being a polymath, so just somebody who has varied interests, somebody who is multidimensional. In addition to being an orthopedic surgeon, I like to make sure that the values that I've identified that are important to me in life across not just career, but across all different areas, I think what it means being a Jacqueline of all trades is identifying all the values that are important to oneself and making sure that everything that one does fits into those values. Part of what my values include, one is the idea of fun. In anything that one tackles, whether it is work, whether it is personal, there's got to be an element of fun to it. As adults, we get into the grind of everyday life, and we lose the fun. That may sound trivial and superficial, but when you think about it, like for me as an orthopedic surgeon, yes, I am helping people regain function, yes, I'm helping people regain form, it's important, but at the end of the day, what I do at work still has to be fun to me. It is fun to me to scope a shoulder. It is fun to me to fix a broken bone. I think there needs to be a little bit of an element of fun and everything you do; otherwise, it's not going to be worth going through all of that training for and the long hours at work and spending time away from family, which is also very important to me. If your work doesn't feed into that sense of fun or that sense of passion that you have, then you're missing something. Another piece of that I think is learning how to identify your joys and your passions in life. One of the things that I talk about in my blogs and in my writing is the concept of ikigai. There are actually a lot of different names for that, and that's just one way to describe it. It's basically figuring out where the intersection of your passion and your mission, your profession and your vocation all come together. When those things meet, then that's where you have your ikigai, which in other words is your reason for getting out of bed in the morning. I know that's a lot to kind of wrap one's head around, but I paraphrase that in my own way and in my own style. To me, what that means is do what you love with the skills that pay the bills and fill a void in the world. That's kind of my more fun spin on it. J. Baugh: Well, that's a great concept for someone who is starting their career to be thinking about the fact that they should be looking for a career that, one, they enjoy, two, that pays the bills, and three, has some sort of meaning to it, like you say it, to be able to serve other people in what it is that you're doing, so if you have meaning and adequate compensation for being able to pay the bills, and it's also something that you enjoy, I think that makes a lot of sense that we're looking for a career that can fulfill all three of those ideas. Dr. Shipley: Right. J. Baugh: You mentioned earlier about having sort of a nontraditional path to the career that you have now. I can identify with that a little bit myself because I'm one of the attorneys here at SVMIC, and I did not start law school right out of undergraduate school. I worked as an accountant for about three years before I started law school, so I identify a little bit with this idea of nontraditional paths, and I think that's becoming more and more common to have people that find themselves in their career in a way that some might describe as nontraditional. How was your path to being an orthopedic surgeon nontraditional, and what kind of challenges might you have had by approaching your career in a nontraditional way? Dr. Shipley: I went to undergraduate at UCLA. I started college thinking, "Hey, maybe I should go into medicine," and it was not for the right reasons. I think I probably chose the premed path because it was something maybe my parents expected me to do, it seems like a respectable thing to do. I very, very quickly in my very first class got weeded out of premed. I walked into BIO 101 or whatever we called it back then into a room of an auditorium of about 550 people. Everyone wanted to be in that pre med path, and I got weeded out. I find myself in college now without a major, and I ended up just choosing something that was interesting to me, and so at the end of the day, it was either sociology or psychology. I ended up a psychology major. I had a wonderful time in college. I found me, and I think that's what college should serve a role as a place for young adults to figure out who they are- J. Baugh: Absolutely. Dr. Shipley: - but I had a great time, and I graduated with a 2.999999, which I round up to a three. J. Baugh: Yes. I would too. Dr. Shipley: So clearly, with the 3.0 rounded up, that's not med school material, but at the time, I wasn't really focused on going into medicine at that point, and so I did a variety of different jobs after college as I was trying to figure out what I wanted to do for the long term. My first job after college, I worked for a snowboarding company. I did marketing and sales, and I traveled around. It was a great experience, but it was working for a minimum wage and clearly was a short-term thing. Then I worked in somewhat of an event planning position. I worked with a family member helping to run a small business. I learned a little bit about Chinese medicine and complementary medicine at the time. I even took a couple of acupuncture classes and learned a little bit about running a small business. But again, not something that I thought at the time was going to be my long term career, so as I was exploring all of that, I had the good fortune of encountering some physicians who, and oddly enough, ironically, were also interested in Chinese and complementary medicine. As I was studying acupuncture, I said, "That is one piece of the pie, that I actually think that I do want to come full circle and that I do actually want to study medicine." It was at that point a couple of years out of college that I started to look into medical school and take my post-baccalaureate classes. I started to study for the MCAT. Probably as you can relate, it was a little bit of a different experience already being somebody who is working full time while trying to take classes while trying to study for a test. You end up with a little bit of a different focus and a different level of seriousness in that situation compared to when your only job is to study, right? J. Baugh: Right. Dr. Shipley: I was successful, fortunately, the first time around getting into medical school. I ended up going to Drexel University in Philadelphia for medical school. I was, at that point, I believe, six or seven years out of college already. That was my nontraditional path into medicine, and with orthopedics being 6% women, that was, again, somewhat of a nontraditional choice for me as well. J. Baugh: The next step from there would be once you got into medical school, you mentioned earlier that you had thought about being an internist, and yet you ended up going into orthopedic surgery. I'm curious what happened during medical school that caused you to focus on orthopedics instead of being an internist? Dr. Shipley: As I got into medical school thinking that I was going to be a generalist, I had some exposure to orthopedics between the first and second years of med school during our only summer break. I had the opportunity to shadow an orthopedic surgeon who did total joint arthroplasty, so joint replacements of the hip and knees. At that point, I really had very little idea of what orthopedics even was all about, but I had that opportunity to not just shadow in the operating room, but to see the patients in clinic before and after surgery. I think that was the key. I was, first of all, blown away by this massive incision that the surgeon was putting onto this person's hip, and exposing the hip joint, replacing the native hip with metal and plastic, and then closing this person back up. It was this big, big surgery, and because I stuck around to shadow for more than just a day or two, I got to see that very same patient walk back into clinic a week later, which is amazing. It was amazing to me the invasiveness of the surgery and the amount of impact it had and that this person could be upright and walking just a week afterwards. The restoration of function really blew me away, and that piqued my interest. I kept my mind open. This was pretty early in medical school. It was only between the first and second years, and so the first two years being all the classes and the lectures, and the second two years being more clinical exposure and being in the hospital. I had a little bit of time to think about my specialty choices, but it stayed there in the back of my mind so that when I started my third year clinical rotations, I requested orthopedics to rotate through, and that ended up sealing the deal. I think that I realized that I was somebody who, to remain engaged in what I do, I need to work with my hands, and I would have less of that as an internist, less of that as a generalist. It was clear to me that being a surgeon and using my hands as part of my craft in medicine was something that was going to keep me going and as I mentioned before something that was fun to me. As I rotated through orthopedics as a third year medical student, and that's what sealed the deal. The whole idea of fracture fixation and the biomechanics behind it just made sense to me. It made sense in my head, and so I said, "Well, looks like this is what I'm going to do." From that point on, everything I did was geared towards getting into a career in orthopedics. J. Baugh: That's a great story to hear about your path through medical school, how you came to being an orthopedic surgeon, and the fact that you are able to find a specialty that you really enjoy doing and that you could become very passionate about and really help your patients with a specialty that you enjoy doing. I think that's great. We've talked about your path into medical school, your path through medical school, and now you've become an orthopedic surgeon. We've been talking a little bit about this idea of being a Renaissance woman, about tackling fear, achieving balance, some of those types of issues. I recently read an article about something called imposter syndrome. I think that term was first used in an article about high-achieving women, and so that may be something that you have heard about, that you're familiar with. I'm wondering what your experience has been with this idea of imposter syndrome. Dr. Shipley: Yes, I definitely have had experience with imposter syndrome firsthand. To me, one of the things that help me feel better about it was reading about it and knowing that it actually existed and had a name. Putting a name to it, first of all, was incredibly helpful to me. Imposter syndrome, as you described, was first discussed in the '70s in a psychotherapy journal. Clance and Imes in psychotherapy looked at 150 high-achieving women in this cohort. These women had amazing CVs. They were CEO. They were leaders in the community. They were leaders of businesses. But so many of these women suffered from this imposter syndrome. Despite their amazing accolades and their amazing achievements, they had difficulty internally validating their success, so basically internally feeling inferior or that they weren't good enough. From the outside, when you're looking at these women, you're like, "How could that be? Why would you not feel good about what you do? Why do you not feel like you're worth it?" It's this incredible phenomenon called imposter syndrome. These women would internalize criticism. Males and females both experience it, but females I think tend to experience it maybe a little bit more because we tend to internalize that criticism and we externalize success, whereas sometimes, and broadly speaking, of course, males are more likely to externalize criticism and internalize the success, but no one's really immune to imposter syndrome, it happens in men and women, but it was interesting to me that women in particular, and high-achieving women were vulnerable of this. My own experience with imposter syndrome, it's happened multiple times along the way. I would say that when I got into medical school, I looked around at all these just Uber intelligent people, and one of my first thoughts was like, "What am I doing here? I don't belong here. They're going to find me out." I think that's a common theme when you talk to people who have experienced imposter syndrome. They go, "Someone's going to find me out." Even though they have all of the achievements and all of the hard work that they've put in to be able to earn their spot there, there is that fear. Like I said, one of the things that helps combat it is putting a name to it. J. Baugh: That's interesting that you're describing imposter syndrome in this way because the article I read mentioned Maya Angelou who said that she wrote 11 books, and every time she wrote one, she thought, "Okay, this is it. This is when everyone's going to find out that I'm a fraud because of this book that I've written," and yet she was one of the most successful authors that we have in our culture. Everyone knows who she is, and yet she always questioned that about herself, that "this is the one in which people are going to find out who I really am." I just find that fascinating that there are those people who are so successful in what they do, and yet internally, they're questioning whether or not people are going to accept or believe that they can really do what it is they're trying to do. Dr. Shipley: Right. That's an excellent example. I think that as one progresses through their career, if you're kind of prone to this imposter syndrome, it'll come up time and time again. I think it's one of those things that's hard to do away with. At least I've found that because at every step of my career, I'll have it rear its ugly head again. What has helped me is number one, writing about it, so I've written about it on KevinMD, and number two, knowing that other people have it, hearing other people's stories. That kind of goes full circle in why I write about it because maybe I'll be able to help somebody else who knows that they're not alone. I think acknowledging it and recognizing it in others, showing others that you have it, normalizes it and destigmatized it to an extent. J. Baugh: Yeah, I think that's excellent advice for people who are dealing with this type of syndrome. You bring up another good point, and that's the fact that it can be recurring, that there might be a point in your life when you feel like you've kind of tackled it, you've taken care of that issue, and you move on to something else, and yet it's going to come back potentially at different times in your career in your life, so that's very helpful to know. There are different people in different professions who from time to time experience some type of fear, whether it's in their work or in their family or community service that they might provide, whatever aspect it is in their life, they might find that they have episodes of being fearful of something, so what advice would you give to someone who is trying to tackle the fear that they're facing? Dr. Shipley: I think a lot about the idea of fear and how fear holds us back. I really like Mel Robbins' is five, four, three, two, one concept where she thinks about a rocket taking off and springing up out of her chair to go do something and using that as a way to overcome fear. I think there's a lot of value in thinking about it in that way. I think it's great to come up with your own personal analogy. My personal analogy is thinking about standing on a diving board over a cool pool. Maybe it's warm outside, but you know that water is going to be really cold when you jump in, and it's always a little bit of a shock. You're standing there at the edge of the pool, your toes are hanging over, and there's that little bit of fear. That's my analogy for how one can tackle fear in everyday life, whether it's career or personal issues. You kind of have to tip yourself forward until the gravity just pulls you in. You just fall right in. Once you kind of get past that threshold, there's no turning back. That's one of my approaches to tackling fear. One good example is my fear of speaking. I've had a lifelong fear of speaking, speaking in front of crowds, speaking like this. You would never guess this because like I will talk your ear off now. J. Baugh: You're doing a job. I would not have predicted that at all. Dr. Shipley: Yeah, but it's been a lifelong fear, and I think that came to a head in high school when I was running for some student council position. I had to speak in front of the whole class, and I flubbed my speech so bad, but I realized when I was asked to give a talk to high school students who were interested in going into medicine that they actually wanted to hear what I had to say. When I looked into the crowd and they were interested, that helped me get over my fear because it made me realize that my experiences and what I have to say about how I got from point A to point B actually is of value and it is of interest to somebody. That helped me get over the fear a little bit. It's not to say that I don't get nervous in those situations. A little bit of nerves is good. But what I did to tackle that fear thereafter was I just dove into it head-on. That was something that I was asked to do, but then I realized there was something of value that I could provide to that group of individuals, and so I turned it around and it's now actually pretty joyful for me to get into speaking situations. I actually really, really enjoy speaking. It's funny to look back at how afraid I was of public speaking and how it just took a little bit of a nudge, it took a little bit of gravity to pull me off of that diving board, and then after that, I said, "I'm going to turn this around. I'm just going to... If I'm afraid of it, I should tackle it with even more gusto," and that's how I turned that around. J. Baugh: You talked a little bit earlier about wanting to find a career in some other activities in your life that you feel are fun, and I think that's important because if you enjoy what you're doing, then you're going to want to do a better job at it, spend more time at it, to become better at it, and those sorts of things. What would you consider some areas in your life that you're passionate about? Dr. Shipley: Well, being a Renaissance woman, I have more than one, of course. I'm definitely passionate about orthopedics, and in particular, within orthopedics, I love the shoulder. I am a subspecialist in sports medicine, which means I do arthroscopic and open surgeries of the shoulders and knees, among other parts, but one of my true loves is the shoulder. I feel like it’s one of the most challenging joints to work on, and I find it fascinating. It just is a very rewarding part of the body to work on. Within my work within orthopedics, that is one area that I'm passionate about, but going beyond the doctor concept, but beyond that, my passion for connecting with people and finding creative ways to do it is something else that keeps me going. Over the last couple of years as I have started to blog and get on social media and start to make educational videos, I've found that doing that via multimedia speaking and sharing my story is a great way to make an impact on more than that one-on-one relationship that you have as physician and patient, and so I'm really passionate about being out there, sharing my story, inspiring young women to explore their full potential, and finding creative ways to do it. I'll visit that whole imposter syndrome thing again. I initially actually had a discomfort with that role model title. I've been told that, "Oh, you're a great role model," and I felt like I didn't deserve it. I'm like, "Who am I to be a role model? It's just me," and that's imposter syndrome kind of rearing its head, right? J. Baugh: Right. Dr. Shipley: But what was helpful for me there was realizing that no matter where you are and where your perception of that place is, there's always somebody out there that is one or more steps behind you that wants to be where you are. That's why anybody can be a role model, and anybody can inspire the next generation of surgeons, of physicians or whatever, because there's someone out there that is going to benefit from your voice, and so it's important to have your voice out there. J. Baugh: I like the idea of whatever it is that you find that you're doing that it be something that's meaningful for other people. I think we're seeing that more and more, that people are trying to find careers that are meaningful, community service that's meaningful, spending time with their family because it's meaningful, and trying to find areas in your life in which you're able to help other people because that is so rewarding to be able to help someone with whatever career you have, whatever role in life you have that really motivates people to do more and more for other people. I think that's great that you're mentioning that several times in what you're doing as a Renaissance woman. As we begin to wrap up, are there any last-minute tips or advice that you would like to leave with our listeners today? Dr. Shipley: I think that the biggest piece of advice that I could offer, and whether you're a male or female listening to this, I think is make it a point to find your inner Renaissance man or woman. As we discussed before, by that, I mean find your passion, figure out your mission, figure out what you want to do so that when it's your last day on this earth, you've looked back at your life, and you said, "Okay, I did a pretty good job with that one." Be proud of what you've done. I think being in medicine, and fortunately, in orthopedics, and especially in sports medicine, I don't often deal anymore with life-or-death situations, but being in medicine, you see that. You see that things can change in an instant for somebody, whether it is functionally or whether it is the extreme end of the spectrum, such as the end of life, things can change in an instant. I think the take-home point that hopefully I can leave with your listeners is just be proud of what you've done. Take advantage of your time here on earth. J. Baugh: Well, Dr. Shipley, I certainly have found today's discussion to be very fascinating and very interesting. I want to remind our listeners to check our show notes where they can find a reference to your website and other references that we've talked about today. I want to thank you for spending time today to talk about your path and where it's led you and how you can help other people. Thank you, Dr. Shipley. Dr. Shipley: Thank you. Speaker 1: Thank you for listening to this episode of Your Practice Made Perfect with your host J. Baugh. Listen to more episodes, subscribe to the podcast and find show notes at svmic.com/podcast. The contents of this podcast are intended for informational purposes only and do not constitute legal advice. Policyholders are urged to consult with their personal attorney for legal advice as specific legal requirements may vary from state to state and change over time.