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Christopher H. Loo, MD-PhD: Welcome to this week's episode for the financial freedom for physicians podcast. And as you know, we promote four types of freedom. First is financial. Second is location. Third is time. And fourth is emotional freedom. So our aim is to bring on guests that are doing cutting edge innovative work, doing things against the grain and changing the world.
Today we have a very special guest, Dr. Sogol Pahlavan and I. We actually have some of the same roots. We went to the same medical school, we went to Baylor, went to the same undergrad, Texas A&M, and she did her pediatric residency at Texas Children's Hospital. And she is a managing partner and founder of ABC Pediatric Clinic established in 2008, which is an independent pediatric private practice. And she grew the practice from a physician clinic to a provider serving 10,000 patients in an underserved Hispanic community in East Houston. She has also served on a number of boards in administrative roles for the Texas Pediatric Society, the Texas Medical Association, also for the Texas Children’s Health Plan, as well as the Memorial Hermann Physician Network.
And her passion is to serve the low income community where she created a pediatric medical home that focuses on providing evidence based medicine and quality care for the underserved. And she's a strong advocate. So now she's actually transitioning, and she's been an advocate for all physicians to take the leap in embracing autonomy, and independence and be free from all of these regulatory and administrative hassles. So she's also focused on mindful living. And today we're going to be talking about the role of finances and she has a really unique message and the importance of mindful living. So without ado, welcome, Dr. Pahlavan. Welcome.
Dr. Sogol Pahlavan, MD: Thank you so much for having me. Thank you. I'm honored to be on this podcast. Okay, you have to state your four freedoms again, financial,
Christopher H. Loo, MD-PhD: financial, location, time, emotional
Dr. Sogol Pahlavan, MD: I love how you added that emotional component because I have in 13 years of private practice going on 14 years, I have hit every single goal, time and financial and personal. But I think at the end of the day, the component that was missing for me was that emotional and it took me five years to try to figure out why I felt the way I did. And so I love the fact that this space is coming more into its being more highlighted, especially by us physicians because I think it's the root, one of the root causes of burnout. In a sense, and so fabulous, I'm so excited.
Christopher H. Loo, MD-PhD: I'm always interested in just, I'm using this platform as a platform and stepping stone as a form of aggregate seeing for physicians and for people suffering from chronic stress, fatigue, burnout, looking for options. And so we're so pleased to have you. So tell us, I'm always interested in the backstory. I'm always interested in how people came to be for inspiration, motivation. So tell us your story, and where it led you to what you're doing today.
Dr. Sogol Pahlavan, MD: Yeah, so I am, I feel like physicians fit this typical description, we're driven, we're intelligent, we're hard working, we're type A, we're organized. So we can say across the realm that every one of us is like that. So when we step into, into medicine, we come with those characteristics.
And so I did, and I was super gung ho. But kind of beyond my bandwidth, I started emigrating to the US at the age of 10. So lots of challenges with communication, cultural, social, family finances, and my entire family, my dad moved here, and he has five brothers, and they're all in, they're all entrepreneurs, they all kind of created whatever field that they're in from the, from kind of the baseline and then moved up and, and have their own companies in whatever field they're in. And so that's what I grew up around. Right.
So that said, those were my mentors. And those were kind of my that's just the way you do it. It's the American dream. Immigrants come over, and the American Dream is just like to own whatever that you can have. Because that's what America allows you. And that's what's so beautiful about America.
So I went through, undergrad and med school and residency, and I am actually in residency because. So, hands on, I think I have undiagnosed ADHD but I have so much energy that I wanted to do a fellowship, and it was between ER and PICU. And so I chose PICU, because it was so much more intense. That was like, Oh, I loved intensity. This is great. And it was very procedure based, and I love procedures. And so I applied, I wanted to move to California. I had been married by then. And I was a couple of months pregnant when I was interviewing, and I got into the UCLA program. And then I had my daughter in August of when we graduated, we graduated in July. And then I had her in August. And then reality kind of hits like, Oh, I'm moving away from my family. My husband's not in medicine. He's an attorney, he took the bar, he passed it, but salaries for lawyers there are less and then cost of living is more. And so I backed out. I backed out in October, and it was horrible. And I felt really bad backing out. But it was the best thing that I had done for my family.
And so I came and then I stayed home a couple of months. And then I was like, Well, I guess I need a job. Right? I've liked it so much. So much training. So I need a job. So we got a part time job at a wonderful outpatient pediatric clinic with my sister. She was in the same class as me as well. And then we worked for her for two years. And clinically we were a good fit. But administratively just like any other physicians that goes into this space they love their patients, but they can't. There's a lot of the fit that comes from the administrative component. And so my dad owns a Dairy Queen in East Houston. And he's owned it for like 30 years. And he kept saying, Come, come, come. There's so many kids. And then we were like, we don't even know what opened up a bit. I don't know anything. I don't know I finally got through with school, I don't know anything. And he said come and then my cousin had a building
Plaza there and he's like, I'll give you the space and he gave us a space. He's like, I'll give you six months off. We'd like free, whatever comes in, build it out. If it works great, if it doesn't, it doesn't. And so we went, we built it out and we opened the doors and the patients have not stopped coming with zero marketing. It's all word of mouth.
And so I for the past for the next decade. And for those that are physicians that work with the Medicaid community, most of us work in FQHCs these nonprofits that are funded by money from the federal government. We're not just private practice and we get 50% less than our private counterparts for peds in Texas. So you have to run a really lean clinic and you can't have, and you have to have like everybody working at the top of their scope of care. And you and so it takes a lot. And so those are in the past decade I just worked, I worked crazy, insane hours, because when you have a practice of yourself, it's like having a fourth, I have three kids. So I'm like, This is my fourth child because the phone calls, don't stop the bills don't stop there's something 24 hours a day coming your way. Right.
And so I think what happened is at the age of 40, I hit a wall, is what I call it, and I was completely exhausted, beyond anything like I call it post-call fatigue. When you've done 48 or 36 hours at the hospital in the PICU, you come home and you're completely delirious and you don't want to get out of bed. That's how I felt from 40 to like, 44, I'm 45 now, and I couldn't figure it out. And there were no resources out there. burnout wasn't a big thing. it wasn't, was a thing, but nobody knew about it back then. So I was like, Maybe I'm dying, maybe cancer, maybe rheumatological disease or chronic fatigue. Like, okay, this is how you're supposed to, maybe it's midlife.
And it wasn't until I started just kind of reading, I started reading like self help books and about like, what is the bigger picture? Right? Because at that point, I was financially right where I needed to be. I had checked off all the things on my to do list. I had a family, I had a career, I owned my own business, I was financially in a place where I didn't have to worry about things. And I'm not a person that spends a lot of money on like lucrative things like so it wasn't like there was a lot of expenses going out, I was still living kind of the same way. and so I was like, okay, but like, I am the American dream, but why do I feel like poop? Right? Why do I feel like this? And that's what was so mind boggling to me.
And so the message that I want to have for the earlier physicians early career physicians, is like, you have to put yourself into this checklist that you have, right like you, yourself, your well being your health, your mental, because I feel like some of us are very good about like, I'm going to go exercise and I'm going to feel I'm going to eat well, which is a part of well being but your emotional well being is something that we don't talk about often. And so if you are giving and giving, there's a point where you're going to go, there's not going to be any gas, it's like, you're driving a car across cross country, you have to fill it up. So that is the message that I want.
And and and you have to do it now. And I know the excuse is like I don't have as much time to do it. There's no time in the day, I need 48 hours in a day. Make time. There's always time, if you even start with like five minutes, make time for that five minutes, or one minute or two minutes, start with something. Because yes, you'll hit financial freedom, and you'll hit personal freedom and you'll hit time freedom. But if you haven't really focused on your mind, and your thoughts and your feelings and process, so many emotions, so many emotions that we keep suppressing, and we're trying to suppress during residency, if you have not processed those emotions, that financial freedom is not it's going to give you freedom in your bank account, but it's not going to give you self fulfillment in yourself.
Christopher H. Loo, MD-PhD: That's a very poignant point. So you reached the top and you had everything and then you have this sudden aha moment, just looking around and you're like, why do I feel this way? a lot of comments and a lot of feelings when you reach the top and are like, is this what I worked for? This is not what I dreamed of. So, that's very, very common.
So, you mentioned a lot of good points about refueling and really, as physicians we are really going in to the field to give ,but the system just takes and takes from us so we have to learn how to replenish ourselves and refuel ourselves so that we we can continue to serve and give the community so I love that. And so please continue.
Dr. Sogol Pahlavan, MD: Yeah. And so what I say is, you just mentioned, we give, but instead of giving, because when you give, it empties you out. But instead of giving, why don't we change the conversation to sharing, when you share you are full. If full of knowledge or full of energy, or whatever that is what that container is. And so you're able to make a connection with whatever that you have, that piece of knowledge that you have, or a piece of energy that you have, you're able to make that connection on a more balanced scale versus like, I'm just gonna keep taking a pieces of myself and giving it to you at the expense of myself, which is what we've been doing.
So it's time that we start sharing, and how do you share? First, you have to fill yourself up. And, and then, and then you don't even completely share, it's a completely passive process. Giving us like, Okay, I have to expend energy to give something to you. Sharing is literally like I am in this space. And just by my presence, there's a ripple effect. And people can feel that energy of love, or, or whatever that energy that you want that you're sitting at. So it's like you're vibrating at a higher energy, those energies of happiness and joy and contentment, ease and patience, which is so against what we've been conditioned to be trained in medicine.
I've been reading a lot about the nervous system. Because I'm trying to when you were so when I started on my mindfulness journey, right there were like, I would read books, and it was very esoteric, it was very woowoo, they'd be like, sit in the present moment. And I'd be like, I'd be like, Okay, I dropped off my kids, I'm only working three days a week. So I have these two days off. So I'm gonna be in the present moment. And I would sit on the couch, and I'd be like, I am present. I am physically present on this couch.
But what I didn't realize is that I needed to acknowledge what was up here in my brain, what were those thoughts that were ruminating right in my brain. So physically, I was present. And I had the time freedom, like freedom of time, to like, sit here, but emotionally and mentally I was so preoccupied, because even though I sat on the couch, strapped in the couch looking at the walls. It was like, Oh, this employee and this physician and this kids activity, and what, all those crazy thoughts that go through our mind.
That there was one. And then the other component is, recognizing your feelings straight, we must. And then that's what's called the mind body connection is your brain and your body or your feelings, your mind is all your thoughts that you keep thinking, and that's why you have insomnia. And that's why you have, you're not sleeping and you're anxious. And those thoughts have a connection, those thoughts actually create your feelings. And that feeling, you feel your feelings in your body. It's the energy that's in your body.
So once I connected and brought awareness to like, what am I thinking? Right? Like, I have all this money, I have all this time. I have all these degrees. And I have all these titles and status and whatever, all these committee things, but like, what do I actually think about myself? And it wasn't until I dove into that deep, and I was like, really open to where I was like, Oh, that's not very nice. You know? And it was thoughts like, what more can I do? Is there more to do? This isn't enough, oh, this person's doing this. And I feel like I'm not worthy enough to do that. Or they're ahead. All these insane thoughts about competition and jealousy. Which, at the beginning, is great. Physicians are very competitive. And we probably got into med school because of our competitive nature. We always wanted to be top of our class, whatever president of this, save the world, all that kind of stuff, which is great. I'm not saying competition is bad.
I'm just saying at whatever point you have in your life. Recognize where you are. And then ask yourself like, does this thing that I embody like this competitive behavior? How is it serving me now? Where I am? And at that point when I paused and I asked myself that I said, Okay, I can see like, it served me great. Like, I've gotten financial freedom because of it. I've gotten time freedom because of it. But now, do I want to move forward with that same mindset?
And then some people might say, Yes, I do. Because I don't know they might. But for me at that point, I was like, I don't, because I'm exhausted. Right? I'm in like, an internal competition with myself. Right? Because everyone that looks at you from the outside world was like, Oh, you've got everything that you want it like, Please stop most people would be like, Please stop. Like, what else would you do? Why do you like my husband used to tell me that all the time Oh, my God, another project? Are we doing another project? you need to stop your projects.
It's very much about the internal dialogue that you have with yourself, and asking questions like, Where do I stand? What are my values and your values can be, they can change. They're dynamic, they're not static, and what and then the other component is, okay, all these thoughts in my head that was all like, competitive, go, let's go, let's conquer the world, whatever, more more more, and then dipping that like falling down into your body and going down and asking like, Okay, if I do want to go forward with this competitive like, thoughts, how is my body feeling?
And that’s where I was just blown away? Because to start out with, I'm MBTI, Myers Briggs, what's the TI part of it? Anyways, the Myers Briggs is certified. And so there's a portion in the Myers Briggs, which is essentially like, the way that you'd like to make decisions and the way that you operate in the world. It's like, Are you a thinker or a feeler? Okay. And most of us physicians are thinkers. And so, feelings were so foreign to me. I was like, I can't feel because like, when you feel that's all like that stuff. And then you don't like it getting in the way. Right. So feelings in my thoughts, my beliefs about feelings where feelings are weak. Right. And so I was completely disconnected from my body.
And it got to the point where I had the psychosomatic symptoms. I had chronic fatigue, which I didn't even think was a feeling I thought was a disease, right? And then I had palpitations. And then I was like, oh, my palpitations could be, my arrhythmia. I've got a family history of coronary artery disease. So I kept linking it to like all these, if putting on my like, Doctor brain, and looking into all these family history stuff. But it wasn't until I was like, Okay, let's try to figure out what it's like when I get palpitations, and I started linking it to like, where I was in my day, or what was happening during that week or during that day. And it all went back to like the stresses that I brought on to myself, because of the way that I was trying to control the world. We're very, physicians are very I have a plan. And it's got to go this way. It can't go any other way. And when it does, it's like, oh, we get all stressed out about it.
So I started journaling, I started writing my thoughts down. And then once I started writing my thoughts down, I was like, What is this? Is this what I thought about today? How does this make me feel? And then literally at the beginning of my feelings, I was like, good or bad. that. That was I couldn't even identify with feelings. What's the difference between content and joy and bliss and like, different spectrums of happiness? I don't even know what happiness is literally, I was like, when I started on this journey a year ago, I was like, I want to feel joy, because I don't, but I don't even know what that is like I was in that space.
And the other part that I think is so hard for physicians is that because we are looked upon as like our careers are very, it's a public service. And so, you're healing the world. And you're making a lot of money. All those perceptions of the world, there was a lot of shame for me to come out and be like, I feel like poop. Because people would be like, what we mean, you feel like poop like you have, this house and this car in this family and your business and like, How dare you say, you don't even have the permission to feel like poop. Right? So I think a lot of us are in that space where like, okay I'm so blessed. I'm so thankful. But there's still something missing. And I can't, there's no resources out there to talk about this number one. And there's a lot of shame. Because if I, God forbid, if I complain, and this happens in like, corporate the big hospitals, I've never worked in a big hospital, but I've heard like people, it's like, oh, the doctor is complaining again, you've got it. So great. Stop complaining.
And so to have these conversations and bring light to this and say what I want to tell the audience out there is if you are hurting, if you feel void, if you feel nothing, but you just know that if you feel off, but you can't point out what it is. I completely understand. I want to attune and I want to validate that feeling.
Because we’re hurting physicians, we are hurting. A lot of us are buffering. So we hurt and we felt weird discomforts. I'm going to go drink, I'm going to go work, our buffering is working, buffering is doing something that takes the attention away from feeling yucky, feeling discomfort. So we work. So I'm going to work more, and I'm going to be on more committees, and I'm going to leave and have my own private practice. And then when I have one clinic, I'm going to multiply it to 10 Clinics. And then whatever all this crazy stuff. Or I'm going to be working in academics, and then I'm going to be a department, program director and department chair, and then we'll move up and I'm gonna get my MBA.
And that, if that comes from a place of like, ease, comfort, and like, if that comes from that place, great, awesome, do it. I'm not saying, stop, stop and sit at home and just kind of be a yogi and meditate all day. No, I'm not saying that. I'm saying understand what your intentions are, when you're making a decision about your next goal, or next step, because we're so cool, oriented. And then put yourself in that equation, and you should be at the top, you shouldn't be number 2561 on your to do list. Because I was, and this is where I landed.
And all the money in the world all the time in the world. It's actually counterproductive, because you have more time to think. And if you don't clean up your thinking, then that's going to cause a lot of the lower frequency negative emotions of guilt and shame and blame and whatever, whatever they're feeling anxiety, lots of anxiety, lots of anxiety and us.
And so, yeah, so prioritize yourself. There's a lot of talk about self care. One thing I want to point out about self care is if you plan self care hours, let's say once a week great and your self care is, I'm going to do yoga. Or I'm going to exercise. That's like total self care. I'm taking care of my body, with these movements or building burning calories, whatever. But again, you have to look at the intentions behind that self care. Where is it coming from if you go and exercise, is the narrative in your brain. I want to exercise because I've got this, rolls in my stomach, and I've got floppy arms, and I'm overweight and I just need to lose weight to look better. Right? How does that feel?
Versus I need to exercise because I love myself. I value myself. And I want to live a longer life right or more productive life with more energy.
Christopher H. Loo, MD-PhD: You've dropped so many gems. So, thanks so much for sharing that. What resources did you have?
Dr. Sogol Pahlavan, MD: So I started my when five years ago when I hit this wall, and I was like, There's got to be something out there. Let me look. Eckhart Tolle is my favorite author. But I started with it and I didn't have much I didn't have time to read. Right. That's what we tell ourselves. So I did a lot of things like, YouTube's right on my commute to work I just put on his YouTube. and so I watched him a lot. And that YouTubes and then I did audiobooks.
So I would say he's, if you are, if you are interested in kind of pausing and having that introspection and really finding out what's going on in your thought patterns and your beliefs and what's going on in your body and your feelings and how that's playing with another to create your experience. Don't look at changing jobs or changing partners or putting your kids into boarding school or firing an employee, look into here. Look in to see like, what am I thinking about these things? And what are these thoughts creating for me so Eckhart Tolle, he was great. Chopra. Everybody knows Chopra. He was great. Wayne Dyer is another one that I started with. Rahm Das is great as well.
So those are the four that I started with. And then I got certified as a life coach. So the Life Coach School Podcast is a great one to start with, as well. And then I have my own podcast called Mindful Living with Dr. Sogol if you just search Sogol, because there's not that many Sogol’s out there on the podcast on iTunes and other platforms.
I have my own podcast and I talked about it. I literally take you through all these tools, and my podcast is, so those like spiritual teachers are kind of there. If you're starting out healing 101 Listen to my podcasts because I break everything down. And I give a lot of science.
Joe Dispenza, his books are great, too. And he gives a lot of neuroscience. So like, he talks about serotonin and dopamine and cortisol and norepinephrine and the fight and flight. Those things I tried to bring into my podcast, because it's very much a home for us physicians. And so we can, it's not all woowoo out there stuff, which we can't connect with.
So I would start with that. I am more than happy if you want to take this further, if you've listened to my podcast, and you're like, Oh, these tools totally make sense. I want to take this further. Then I have coaching. I have one-on-one coaching and it's specifically for physicians. And it's for physicians that have literally checked off their financial goals, personal goals, professional goals, and feel like poop, or don't feel or something feels weird off, they don't feel good.
My mission is to heal the physician community. And that healing starts with healing yourself, because we are so conditioned to healing others and so conditioned to giving and so for us to be able to share that compassion and that connection and that energy that we have. We've got to start with healing ourselves.
Christopher H. Loo, MD-PhD: That's a wonderful note and if listeners want to get in contact with you. Is there a website or email or social media?
Dr. Sogol Pahlavan, MD: Yeah, so I'm on Instagram and Facebook, I don't know why I have two different names just because that's how weird my brain is. So it's Mindful Living with Sogol is on Facebook, and then my Instagram is drsogol_mindfulliving.
My email if you go to message me. I check my messages through Facebook and Instagram all the time. And then if you go to my podcast, then in my show notes at the bottom is my email, it's super long, it's Pahlavansogol[at]gmail.com.
But you could just click on it, I do not have a website, just because one of my beliefs is that I hate technology. And so I haven't been able to grasp that part. I wanted to get my message out, before getting bogged down into the details of things like, perfect website, whatever. And I love to talk. So I was like podcast it is, because I can just talk into a microphone. And that's super easy for me. So a website will be coming on. But most of my material is on my podcast, Instagram, and Facebook. And if you follow me I have daily posts.
In my posts I try to heal myself by sharing and telling my story. So it's very much what I feel for the day or, aha moment I had for the day or, or something that I did wrong that I wanted to share, but not beat myself up for it, since they're all very authentic stories. And that's actually how I started because I kept looking at social media and I was like, We are not fine. We're not happy. We're not what all of these pictures show us as, and I got tired of it. I got tired of having these conversations with people that were just like, oh, yeah, my job is good. My family. It was like, No, we’re so much more than that. I wanted deeper conversations. I wanted things that really came from the heart from the soul and your true essence. And, and so I think that's what my social media is about. It's not like a perfect picture filter, blah, blah, blah. It's about like, even if I go on vacation, because I took what my brain was telling me during this awesome vacation at the beach, and brought that to light and said that it's normal, that we're all humans, and we're not supposed to be happy all the time.
Christopher H. Loo, MD-PhD: We've really enjoyed your time on the show and any last parting words before we conclude?
Dr. Sogol Pahlavan, MD: Oh, gosh, last parting words for me is that please take the time. Whether that's one minute, two minute, three minutes, please take the time to yourself. For those busy moms. I recommend that time to be in the bathroom when you're peeing. Because that's what I used to do. When my kids were toddlers, the only alone time I had was in the bathroom, in the shower. In my drive to work those were my like sanctuaries where when the kids were younger. And journaling is so important and just writing down what you're feeling. And so you can bring it into your awareness instead of keep pushing it and avoiding it and buffering it.
Christopher H. Loo, MD-PhD: Awesome. That's so wonderful. You've dropped so many gems and we look forward to having you on the podcast again.
Dr. Sogol Pahlavan, MD: Awesome. Thank you so much for the opportunity. This has been so much fun, I’m honored.
Christopher H. Loo, MD-PhD: Many thanks again for being here. If you’re new, you can find me online at Christopher H. Loo, MD-PhD, where I have links to other episodes or links to online resources that will support you on your financial literacy journey. I’ll see you there in on next week’s show. While I bring you thoroughly vetted information on this show regarding a variety of financial topics, I cannot promise you a one size fits all solution. This is why I caution you to continue to learn. Educate yourself and seek professional advice unique to your situation. If you want to talk to me, I welcome it. Please reach out via my website or email at email@example.com I read and personally respond to all of my emails. Talk soon!
Editor's note: This transcript has been edited for brevity and clarity.