The Inspiration for Writing a Book for Women Physicians Suffering Burnout
Simon: I thoroughly enjoyed reading your book, Boundaries for Women Physicians: Love Your Life and Career in Medicine. What inspired you to write a book for women physicians suffering from burnout, starting with your own experience?
Tammie: This book and everything I do in my life today has come out of the darkest time in my own life and career three years ago as a pediatric hematologist/oncologist, when I was so severely burned out that I considered suicide as my only way out. Last January, nearly one year into the pandemic, I was inspired to write this book after writing the op-ed article Boundaries as a Woman Physician for KevinMD, our most widely read physician blog. When the article went viral and struck a chord with many other women physicians, I decided I needed to write more. I felt a deep desire to share a message of hope more broadly for all of us struggling with the often guilt-ridden and visceral emotions we experience when we try to set personal boundaries—When we try to prioritize ourselves and our own well-being, as women physicians. Little could I have guessed that our pandemic would be raging on for yet another year. And this message of hope is needed now more than ever.
Simon: I have heard that physician burnout can be so bad that it can lead to suicidal thoughts or even suicide. I am so glad you found a path and are now offering guidance for other burned out women physicians.
Writing for a Niche Market (Women Physicians)
Simon: You write to women physicians specifically, although both men and women suffer from burnout. Why specifically did you focus on the smaller, more niche market and how did that affect your tone, word choices and other decisions?
Tammie: All physicians need help with our boundaries, without question. I felt most deeply passionate about writing and speaking to women physicians as our struggle with personal boundaries is unique. There is a reason why women physicians experience significantly higher rates of burnout and exhaustion than male physicians, and why 40% of women physicians are either cutting back or quitting medicine altogether within 6 years of finishing residency training.
Empowered women physicians recognize our own agency and choice in how we create and set healthy boundaries—so that we don’t continue to burn out and quit medicine—is paramount if we want to continue to retain women physicians in our healthcare workforce.
Simon: Do you have any advice for aspiring authors struggling with deciding on their audience?
Tammie: I feel like I am one of those aspiring authors…! Go with your gut. Where do you have a passion and a fire in your belly? What gets you going and gives you energy? Who are you most passionate about helping? Who needs your message or story most?
Embodying Courageous Integrity When Sharing Personal Stories
Simon: In the introduction, you share your own personal story in which you struggled with having boundaries. What are some lessons you learned that might help authors who are looking to share personal stories in their book?
Tammie: I began by putting my own personal, vulnerable story of struggle and suicidal ideation out there from the very beginning. One of my core values is courageous integrity, and I knew that I wanted to be brave in sharing my own story. I know my story is the story of countless silent women physicians. In sharing my own vulnerable story, in contrast to the culture of silence that permeates the practice of medicine, I wanted to model the courage that I admire in others. And so it was not so much about sharing my story, as sharing so that others could realize that they are not alone. Once I realized this, it wasn’t scary to share my personal story at all. I hope that a woman reading these pages will resonate with what I’ve shared, and realize that she is not alone, too.
The Most Impactful Chapter
Simon: What is your favorite chapter in Boundaries for Women Physicians and why?
Tammie: Hmm… great question Simon! I would have to say the chapter on setting boundaries around our Electronic Medical Record (EMR) and Charting! Oh I’m so passionate about this one as the EMR is the bane of pretty much every physician’s existence. I was once 300 patient charts behind (p.s. this is VERY BAD). For any physicians reading this they are likely cringing in horror as they read these words! And yes this was my reality not all that long ago!
I share my all-time favorite phrase: C=MD/DO. Yes, I advocate C level work! (only for charting) The vast majority of women physicians are extreme perfectionists, and I find time and time again that the women who struggle to complete their charting apply their A+ attention to detail to their notes. I love this message of not necessarily “aiming low” but more giving ourselves the grace to not have to do A+ work all the time. This is incredibly liberating once we recognize this, and my goal is to give women physicians this freedom.
Crafting Reflection Questions for Women Physicians
Simon: In Boundaries for Women Physicians, you incorporate reflection questions for the reader. I think you ask some powerful questions that help your readers to reflect on their boundaries. What was your process for coming up with these reflection questions?
Tammie: These are the questions I ask when I’m coaching. My main goal is to get the reader actively thinking, and to occasionally even stop her in her tracks to evoke transformation.
Simon: It’s great advice for any writer to start with what they already find themselves sharing with patients, clients or friends.
Setting the Structure
Simon: You divide your book into five main parts. How did you decide the order for the five parts?
Tammie: I knew the first part needed to be about the WHY of why boundaries are so necessary for women physicians, and to present the background data to make this case. Next I focused on boundaries with self, as I deeply believe that boundaries must come from the inside out. Without a strong sense of self, who we are at our core, what we stand for and what our non-negotiables are, it’s very difficult to set effective boundaries in any facet of our lives. This then lays the groundwork for parts three (boundaries at work) and four (boundaries at home). Part five brings everything together.
Simon: What is the most important lesson you learned from writing Boundaries for Women Physicians that you would apply to any future books or writing activities?
Tammie: Have an incredible editor! I was so lucky to work with Lynne Heinzmann, who has also worked with Lisa Tener (Lisa referred me to Lynne)! I owe so much to Lynne…!!
The Decision to Self-Publish
Simon: You published this book with your own imprint, Visionary Women Publishing. How and why did you decide to self publish? What has been fulfilling about that choice?
Tammie: This question was actually why I first reached out to Lisa Tener for guidance! To me, my priority was getting this book out to women physicians as quickly as possible. With all we have struggled with during the pandemic, I deeply wanted to be able to give a message of hope through this book as quickly as possible. Self-publishing therefore made the most sense.
Working with a Team for Publishing and Promotion
Simon: Lisa Tener mentioned to me that you’ve worked with several colleagues that she recommended (and who worked with her in publishing and promoting The Joy of Writing Journal: Spark Your Creativity in 8 Minutes a Day), including her publisher, Tamara Monosoff, publicist Zilker Media and editor, Lynne Heinzmann. Can you share a bit about what it was like to work with these folks?
Tammie: Yes, I’m working with all of them and they are all incredible!! Knowing what I know now, I wouldn’t consider publishing another book without the guidance of all of these incredible people. Writing and publishing a book takes a village, and the finished product is that much better when we have a team helping us. Boundaries for Women Physicians: Love Your Life and Career in Medicine is my second book. I didn’t have this team with my first book and I wish I had…!
Simon: What challenges did you face in writing and publishing this work and how did you overcome those challenges?
Tammie: The largest challenge for me was time and bandwidth. I had the book proposal written in February 2021, but then took on a new role as medical director of provider wellness for my large health system, which took all my energy for several months. I returned to the book in August 2021. The one silver lining of the Delta surge was that we had to cancel our family vacation, and that I was able to complete the first draft of the book by Labor Day.
The Process for Obtaining Positive Reviews
Simon: You just published this book, and it already has five stars on Amazon. How early in the process did you set your book review strategy and how did you go about it? What tips do you have for authors who are hoping to receive positive reviews of their book?
Tammie: I started this process when I began reaching out to colleagues, friends and connections to endorse my book once the manuscript was completed approximately 3 months prior to launch date- I also asked each to consider leaving me a review. And I’ve had over 60 friends and connections helping me as book ambassadors, all of whom agreed to help me also leave a review and ask their communities to help leave me a review. The main tip I have is to start out early, and to reach out and share your Why behind what you’ve written. I’ve been so touched by how many people have wanted to help, especially once they understood the Why behind why I wrote this book.
Using the Book to Support Businesses
Simon: You have two businesses, coaching services for female physicians and Pink Coat, MD, a community that offers leadership training, and personal and professional support to women physicians to help them thrive, despite the current burnout environment of medicine. How will you use the book to support these businesses? In particular, as you wrote the book, are there ways you featured the work of these businesses in the stories you shared? Do you have any advice on weaving your professional offerings into your book in an organic way, without sounding overly promotional?
Tamara: Oh absolutely. To me, the book is another way to share a message, and another piece in the greater purpose of all the work I do. The book may be how a woman physician first hears of either me or Pink Coat, MD, and is a way to get her a greater range of needed support and resources.
In Boundaries for Women Physicians, I featured the stories of three hypothetical women physicians, who are an amalgamation of the hundreds of women physicians I’ve worked with. My intent with everything within in the book, through my coaching business and Pink Coat, MD, is to support women physicians so that we can thrive. I’ve woven additional workbooks, videos, and exercises into the book to give women more depth into the resources we offer on both platforms. Not really in a promotional way, but out of wanting to help and be of greatest service.
Simon: What marketing activities have you planned to help promote Boundaries for Women Physicians and what have you learned from this process?
Tamara: I’ve had a lot of help in this area, thank goodness! I’ve learned a lot about online marketing and launches through building Pink Coat, MD over the last two years, so many of the concepts applied to the launch of the book and the many offerings I have lined up following the book launch. I first held a teaser-paid, 5 day ‘setting boundaries’ challenge with live workshops two weeks prior to the book launch, then a free 5 day ‘setting boundaries‘ challenge with a pop-up Facebook group for anyone who purchases the book 2 weeks after the book launch.
My live Boundaries for Women Physicians 12 week group coaching program launches 1 week later which I will then plan to market as an on-demand digital course afterward, which then leads into my year-long mastermind program for women physicians. The audiobook and hardback versions of the book will be released in mid-April and will provide an additional chance to market and re-launch the book through the spring.
Simon: What advice would you have for authors who are working to come up with a marketing strategy for their book?
Tamara: I would recommend working with a coach or consultant who is an expert! Tamara Monosoff is brilliant when it comes to launches and helping authors to build a business around their book.
Dreams for the Book
Simon: When you think of the potential impact of Boundaries for Women Physicians, what is your dream vision for what you can accomplish with this book? What results would make you feel “I’ve done what I sought out to do”?
Tamara: I would love to get Boundaries for Women Physicians into the hands of as many women physicians out there as possible. My dream would be for it to become a book that women give to their women physician friends, colleagues, trainees and students, because the lessons and messages are valuable and timeless—and what we most need to hear. Even more importantly, I’d love for a book like Boundaries for Women Physicians to not even need to exist someday! This would be the ultimate success, even if not during my own lifetime.
Dr. Tammie Chang is a pediatric hematologist/oncologist, certified leadership coach for women physicians, the co-founder of Pink Coat, MD, a platform dedicated to the personal and professional success and well-being of all women physicians, and the medical director of provider wellness for her healthcare system based in Tacoma, WA. She is a speaker and the bestselling author of Boundaries for Women Physicians: Love Your Life and Career in Medicine, and co-author of the bestselling How to Thrive as a Woman Physicians, together with her Pink Coat, MD co-founder, Dr. Luisa Duran.