Dr Andrew Greenland: 0:08

Dr. Sharon Winters is a board certified psychiatrist and the founder of Winter's Family Psychiatry, where she works with individuals and families to navigate complex emotional and mental health needs. Her practice stands out for a deeply personal relational approach, a rare find in today's fast-paced healthcare landscape. So, Sharon, welcome to the show and thank you very much for your time this afternoon.

Dr Sharon Winters: 0:36

Well, thank you for inviting me, and I hope I can do some value to the topic.

Dr Andrew Greenland: 0:41

I'm sure you can. Maybe you could start a little bit at the top. Could you share a little bit about your role and the kind of work that you're doing at um Winters Family Psychiatry?

Dr Sharon Winters: 0:50

Well, okay. Um I was asked to uh discuss this topic on um what I guess is uh high achieving clinicians. And so I guess I fit that role, and maybe it's because I have a lot of initials behind my name, but uh I am uh, like you said, uh board certified psychiatrist, and uh that is in the area of medicine. So I am a medical doctor, and my specialty is psychiatry, which is about the um chemistry and wiring of the brain. That's what I tell my patients. So I'm not a psychologist. I think I tell them psychology is the study of the mind, whereas psychiatry is the healing of the brain. I also have a fellowship in child psychiatry, which is an additional two years in addition to my psychiatric residency. And I'm a clinical faculty at Florida State University School of Medicine and adjunct professor. So I have uh third-year medical students that occasionally rotate in my office. Uh, I also have a JD, jurisprudence doctorate degree, but I haven't practiced law. I just did that to kind of enhance my uh ability to kind of um get through some of the dilemmas that people have, uh, particularly with certain types of mental illnesses, uh, when they face legal issues. And then I also have a uh master's certification in Christian apologetics. So I am a Christian Bible believing Christian. So those are my accolades, I guess, um of my professional life.

Dr Andrew Greenland: 2:38

Amazing. What a collection of very valuable tools and qualifications and credentials. Just um would you mind telling us a little bit about your practice and what you're what you're doing there for people, how you're helping people?

Dr Sharon Winters: 2:50

Well, I've been a uh practicing psychiatrist. I don't like that word practicing, but I guess I've been a practicing psychiatrist for about 40 years. Um, and so I've been in all areas of psychiatric medicine, ranging from inpatient uh to outpatient to uh my husband and I own some partial hospital programs. And right now, currently, over the last probably maybe 10, 15 years, I am in my own private practice. My husband also is a psychiatrist, so um he and I are in this practice together. Uh, we don't have any ancillary staff. We used to have nurse practitioners and clinicians that did counseling, psychology, things like that. But right now it's just me and him, and um we do medical psychiatric uh health care, which is about I I always tell people it's there's two aspects of medicine as a medical doctor, you're either uh prescribing medications or you're uh cutting people in surgery. So we are medical, and so my practice is about diagnosing and treating what are called mental illnesses.

Dr Andrew Greenland: 4:19

Cool. And with um all the things that you do, what does a typical day look for for you like? What does a typical day look like at the moment? And I I appreciate that there probably is no typical day, but with all the things that you balance and juggle, just kind of talk us through how it all fits together.

Dr Sharon Winters: 4:34

Well, actually, my typical day is rather ordered. Um, I get to my office and I have my patients scheduled and I have my office staff, I have my charts, and I generally see patients for 30-minute appointments versus the typical when I was in the community mental health system, um, hospital-based, it was like this 15-minute med check. But I have had some of my patients for years. Uh, I do see new patients. I probably get maybe four or five new patients a month, but I generally have a half an hour for follow-ups, and then we go over their medication issues, and generally, um, I have to say, they're doing well uh as far as their illness. And so we do spend some time talking about uh how they can apply some um, I guess, techniques of uh I give them advice and we talk about um a lot of things that go on in their lives, uh ranging all the way from uh birth of a new baby to um elderly parents with dementia. Uh so uh I in that role, I guess I do participate in some aspects of counseling. So that's a typical day.

Dr Andrew Greenland: 5:57

Got it. So you've been in the field a long time. Um what would you say has changed in the last few years, especially in terms of how clinicians are expected to show up, both in their professional and personal lives?

Dr Sharon Winters: 6:09

Well, I think my my true uh view of it is that uh probably in the last maybe five to ten years, and maybe in part related to COVID, um, there are a lot more uh, I guess what we would call paraprofessionals in medicine. So not speaking for myself, but just medical doctors in general, I think they probably are uh under the gun a little bit more as to uh production, seeing patients, supervising uh or relegating their medical skills to paraprofessionals. Anyway, that's here in the United States, particularly in Florida, we see a lot more nurse practitioners and PAs. Uh Florida is the third largest populated state in the nation. So we and we also kind of are a retirement state, so I think there's a lot more elderly people here. So we have a population that maybe has more illness. And uh so I think physicians um are kind of more under the gun. But in addition to that, I think you know, healthcare has uh, if I don't want to misuse the word evolved, uh, with newer medications, newer treatments, even um attempts at educating the population on preventative care. So that what we see here, interestingly enough, is a lot of the family practitioners have separated uh parts of their business into um more what I call sort of aesthetic medicine. So I guess it's all part of wellness. I mean, people, you know, want to they strive for wellness and happiness and they want to look good and feel good. So um I think that's what we see now in the hospital environment. Uh, we get more um, well, we we have a lot of um maybe elective surgeries. Um, so that again, that's more in this area. I'm sure there's some large city populations where you know you got more of the very ill and the trauma. So I can't really speak to those physicians other than to my own personal experiences, but uh in general, um there's been some lessening of stressors for clinicians, but also some enhancement of stressors, which is kind of what that topic was about, you know, balancing your um sort of clinical time, your work with what was termed life. So I think that's more prevalent now, even.

Dr Andrew Greenland: 9:09

And in terms of the way that um clients are showing up, have you noticed any shift in recent years in the way they show up and maybe what what COVID did to change that, or anything else that you've noticed that has been an influence on the way that clients pitch up? I'm sorry, I didn't hear the first part of your Yeah, I was just asking whether you've noticed any shift in the way that clients um pitch up and present themselves to you and if that's evolved in recent years and to what extent COVID had anything.

Dr Sharon Winters: 9:36

Um I'm not sure related to COVID, uh people are much more educated in their health. So I find, and maybe this isn't typical, but I really enjoyed my patients. They they share very interesting information, they seem to have uh decent insight and uh about their illness. Um and uh they we have sort of a uh collegial working approach where they respect my knowledge and expertise, and I respect them because who knows what's really going on in anyone's mind but the person themselves, and um that can be influenced by other things like culture and traditions and uh underlying beliefs. So I make it a point to not, and I suppose that's easier said than done, or but not be judgmental uh on persons when they come in with particular disorders. And uh I think that that's one of the things that has been maybe more beneficial with not just COVID, but the whole aspect of uh uh this digital information generation. So people do have more information. Sometimes it's not good. I have a cup on my desk that says, uh, please do not confuse your Google search with my medical degree.

Dr Andrew Greenland: 11:12

But you've got the mark, have you?

Dr Sharon Winters: 11:17

Yes.

Dr Andrew Greenland: 11:18

Okay. And um in terms of, I mean, as again, you've you've been in the field for a while, and I guess treatments and um therapeutics have evolved in the last few years or so. What are you seeing that's really moving the needle to help patients forward in terms of what you can offer them?

Dr Sharon Winters: 11:34

Well, from a medical psychiatric point of view, I think it is the improvement of medications to reduce side effects. And also the research that's gone into looking at the neurobiological basis of medications, which actually, even though people think, oh, patients aren't interested in that, they really are. And so I try and uh put the science behind the medications so people just don't think, oh, that's for schizophrenia, I'm not schizophrenic, or oh, that's bipolar disorder, and relate it to maybe someone they know or a family member that has really not been well medically treated because maybe the medications were available. So I do a lot of talk in regards to that, and I think the newer medicines are much more tolerable. I mean, people still relate to this movie that was called One Flu over the Cuckoo's Nest. I don't know if you ever saw that, but totally uh not accurate as far as treatment there. So uh, but it's still kind of um, you know, Hollywood plays a big role in how people perceive things. So I think that you know, the newer medications and stuff have helped people see that, you know, you don't have to walk around with some major uh side effects or adverse effects or sedations or uh no expression on your face, uh, this what we call affected blunting. Uh so that that's really been a positive in psychiatry.

Dr Andrew Greenland: 13:13

Thank you. Um we hear a lot about burnout, um, but I'm curious to know how do you personally define balance and has that evolved for you over time?

Dr Sharon Winters: 13:23

Yes. Well, I think that I kind of look at balance as well, let me put it this way. I sort of look at life as a timeline. And that timeline changes in our perspective of it based on where we're at developmentally. So whether you're a child or a teenager, an adult, an elderly adult, it also depends on our circumstances and what I kind of call our gifts and talents. And so when I look at this timeline, I mean this kind of yeah, timeline, I sort of put this um fulcrum on it, almost like a teeter-totter. And I think of time as sort of the point of the fulcrum. So I don't really look at uh, I don't separate work meaning career with life meaning non-career. I have them all kind of together as my 24-hour day. And maybe that's just my personality or my way of looking at things, uh, because I've kind of always done that. Um, I've never really thought, oh my gosh, I gotta finish doing this work and finish doing this paperwork and everything. Uh, you know, if I have some other event to do, I guess maybe that's because I've been able to be more flexible with my time. I haven't um, you know, worked for um like an environment other than in residency where you know you had to be somewhere and you were committed to a time and you had to be on call at night and you had to answer the pager. So, in that way, um I've kind of balanced my work in life by what I call prioritizing and relationships come first, and this becomes a little jumbled in the field of medicine because you're dealing with people, so you're dealing with relationships, uh, and so uh, but I have to separate that because I know that I'm simply an individual and I only have 24 hours in the day, just like everybody else. And I think this is sometimes where um maybe some physicians, when they get this burnout, they don't step back and really look at their whole 24-hour day, their week, their months, their years as part of their wholeness of life. And maybe they're gravitating more to uh, I don't know, because I I I don't want to again be overly opinionated, but to the dollar, like uh, you know, I gotta do this, this, and this to make money. But I um I just feel like in my case that that balance, I'm not saying it's always easy. I mean, I got traumas in my life and and uh you know major events that happen that I gotta address. And you know, sometimes I've had to cancel a whole week of patience because of something, right? And I feel, you know, like, oh wow, what are they gonna do? Because in psychiatry, unfortunately, if people run out of medications or have an issue, a lot of times they end up in the emergency room, and that could be the worst place for them because they don't really get treated like they're ill and and need, you know, maybe a boost in their medication or whatever. They are always afraid they're gonna get locked up or something. So anyway, I I I think about that in the back of my mind, but um, but I'm pretty able to balance my my life.

Dr Andrew Greenland: 17:21

So, I mean, you mentioned I think prioritization and of focusing on the relationships. I was just gonna try and get to the nub of why other highly successful clinicians, even the ones who are mission driven and successful, struggle with this balance. Is is there anything any other factors other than the things that you've managed to prioritize, which kind of get in the way of other people retaining this balance?

Dr Sharon Winters: 17:42

Uh-huh. Well, I do think it's partly related to how one sees oneself. Um there are um, I I think you know, physicians highly intelligent, overachievers, high achievers. That's just part of being a doctor. I mean, you can't get into medical school and residency and all that without being competitive and a high achiever. And so I think sometimes um there becomes this belief that you are the all in all. And that becomes a struggle in this whole work life. What you're defining as work life, I believe, on the topic is this separation of career versus uh non-career time. And so I think sometimes people think they're all the all or none, and maybe that's sometimes true because we are the expert in what we do, but we also need to realize that there is um a community of others that can be helpful and beneficial, even the patient themselves, they have a say in their life, and you have to be able to assist them with that. So to be able to say, you know, like, well, what should you do about this situation? Or gee, how come you're not like taking your medicine? Or, you know, how did you end up here when we started there? And so the again, I think the emergency room is a little different, but they're supposed to be dealing with emergent things. Not necessarily are they, but but yeah, I think that that is what causes burnout because people start looking at like, oh, I'm getting older, and you know, I've spent my whole life devoted to my career, and I've done a lot of good, and I have a lot of knowledge, but I should retire. I want to go do something fun instead of looking at some things within our shorter lifespan as being enjoying, enjoyable or fun. So I I think that's where some uh physicians get into this battle. I also think that and again, uh I I really hold firm to this, I I do believe that we need to really think about the purpose and meaning of life in general and maybe who we are working for. And it's really not to accumulate things, not even credentials by your name. It's really um, you know, uh well, I know it sounds hokey, but I really do think uh it's about doing your best and serving others. And there's this little um movie, I think, and it was uh Miss Congeniality, and it's kind of like to make the world a better place, and so uh I also think that I maybe I look at it from a different perspective because I'm female, and I think men look at you know, work and occupation and obligation sort of as what they need to do to provide, and that's somewhat changed, you know, in the last uh maybe 30, 40 years, really. But uh I see some people coming back to that, even, you know, because everybody's working eight to five, nine to five, and then they got kids and they drop them off of the daycare, and that's all um really. I think you're it is becoming kind of like a a battle, but to me, battle sort of implies war. I think it's more of a conflict, or maybe uh maybe it's more of a um a way that we need to sort of um handle again and prioritize our life, not necessarily as a war or a conflict. So thank you.

Dr Andrew Greenland: 21:55

And do you think this is um industry-wide in in the patient-facing world? Or have you noticed there are any particular pockets of people that really struggle with work-life balance? And I don't know whether you've sort of treated any clinicians or providers in different um specialities or niches, and you get a sense that you know some particular things are worse than others or more challenging than others.

Dr Sharon Winters: 22:17

Well, again, uh as a psychiatrist and having been a psychiatrist for four years, yes, I do have. I have physicians, I have attorneys, um, accountants, MBAs, uh, all the way down to kids and teenagers with drug problems, to people who are worried about dementia, all um kind of walks of life, even in my private practice. Um, and so I um I kind of sense that physicians, the ones that maybe struggle more, uh, do have some problems with um mood. Mood and also maybe um attention and concentration issues. Um they're very intelligent and but they sometimes have difficulty prioritizing. And uh for in general, you know, I think most physicians go into medicine because they are compassionate about people's wellness, but that's something else I think has changed uh with uh this whole competition and uh sort of the aspect of money-driven medicine that um I know my youngest son just uh finished at Florida State University, and uh he is, I have to say, very insightful young man. And he uh and my other kids as well always said, you know, mom, people seem to want to go into the biological sciences to be a doctor because they think they're gonna make a lot of money, and I'm going like ah, and and then they sometimes um don't make it, or they do, but they're not really driven for the core reason of being a doctor, which is to heal people, and so that I mean I see that a lot really. Uh, the physicians that don't seem to struggle as much are the ones that um have really looked at that balance and that aspect of this is my whole life, and you know, try and devote appropriate time to outside of career obligations. Uh, and I think the hospital systems and stuff like that are really working towards that. I mean, even residency programs now, it's not like this super grilling, you know, you got to be up for like 72 hours and no sleep because you got to be on call, or uh emergency room doctors, a lot of them work like three days on and then they have four days off, things like that. So I think maybe that um that voice of balance is kind of uh starting to permeate and may change some of that um attitude and that whole concept of uh burnout, so to speak.

Dr Andrew Greenland: 25:32

I hear you. Um is there anything um in terms of simple tips that you could perhaps mention that you use for maintaining some personal sustainability that you know people might um find helpful listening to this call?

Dr Sharon Winters: 25:47

Well, I have to say that I am a very firm believer in God, and um I start my mornings um with prayer and giving thanks, and I always read one proverb a day, and I always read several psalms a day, and I have a little devotion that I listen to, a little podcast that's very it's not all you know, holy roller stuff like that. It's kind of practical applications, and I tell you, it just sets my day up so nicely when I know that it's not all about me and what I'm in control of. Um and it it does give me um this aspect, I think, of peace. And that's not to say I don't like have freak out moments or whatever, but I try and um you know regroup in my conscious mind.

Dr Andrew Greenland: 27:05

So some some element of spirituality.

Dr Sharon Winters: 27:11

Yes.

Dr Andrew Greenland: 27:12

Interesting. Um so what's working well for you right now in the clinic in terms of things that are going well, things that you do that get the outcomes that you're looking for and the patients are seeking? Anything in particular that you can nail down?

Dr Sharon Winters: 27:28

Well, I think being an experienced clinician, um, I have my paperwork down. So I have my intake form that addresses um different mental disorders. Um, I've used the same, I devised it myself. I used uh inputs from other sources and stuff like that, but I've had this compilation of uh documents that people fill out before their appointment that allows me to sort of hone in on the issue because I mean you can get overwhelmed with people's issues of thoughts and anxieties and you know, circumstances and stuff. So it helps me to stay uh sort of grounded in what in medicine is called the chief complaint, and um that's one of the things I do. Um, the other thing I did have the same office staff for 15 years, which was great because they knew the patients, they knew me, they knew my husband, but they left the year after COVID. Uh, one of them retired, and the other one kind of retired because her husband moved and she moved with him. So I have new office staff, which has been interesting because neither one of them are clinical, but they're both um office manager types, but not medical in their experiences, right? So that's been kind of a teaching thing for me, but I guess one of my other high achieving gifts is that I do have a lot of uh um leadership and administrative uh skills. So I don't a lot of uh physicians get overwhelmed by that, you know, and they really rely a lot on their office staff um to get everything organized for them. But I've been able to do that a lot myself, so that's kept my um my documentation and my, I guess if you want to say patient interview very similar. And uh because I have been doing this for so long, I really can uh kind of hone in on areas that are uh depicted in some of these documents and forms, some of the answers people have, and like really be like, this is definitely bipolar disorder, or this is generalized anxiety, or something. So that's made it easier for me to do. Um, so that's I think the other thing is I don't use electronic medical records, and I there's good and bad to those. Um, I mean, I would like to access more information about patients' medications and stuff. I rely on them to tell me. Uh, but one reason I don't use electronic medical records is because they kind of force one to revert to check the box. And I don't really check the box, I um I put down little notes, uh, little reminders that maybe like like I might put something down like the patient's dog's name and that the dog was uh recently ill. So when they come back, I am able to, you know, look back and say, like, oh, how's your dog? Because to me, that relates to how they handle life situations in regards to things like if they have a mood disorder, uh, whether they've lost their job, how did they handle that? Whether they have attention and concentration disorders, uh, ADHD kind of things. Um, I can go back on those more um bullet point notes and hone in on it from a medical point of view. So that that's one of the things that uh I find is simpler in my practice. Plus, I get to choose my patients better now, which is really helpful too. I get to I have an intake form, and again, I've honed it down so that I can kind of tell by how they fill out this simple one-page form, uh, what the situation's gonna be. Which I know that sounds like, whoa, okay, but um I I know when the medical students come in, I'll I'll point that out to them and they'll be going like, oh, and I'll say, well, let's interview the patient and see. And I I would say most of the time I'm correct. So anyway, sometimes somebody will surprise me, but it's not too often. Um, so yeah, that's that's kind of what I've done to you know maybe smooth out my practice. So yeah.

Dr Andrew Greenland: 32:23

And in contrast, if you had a magic wand and could fix one thing in your business or clinic tomorrow, what would that be?

Dr Sharon Winters: 32:31

Oh, I have to say I would want to put the magic wand on the pharmacist's head and say, listen, I know what I'm doing, just fill the medication. I get so much problems with pharmacists, it just inundates my everyday, you know. Well, I'm just not comfortable with that. That's outside the FDA package insert. Uh, what are you trying? I've even had them say, what are you trying to do? Kill your patient? Or well, that's an upper and a downer. So that has become a big struggle. So if I had a magic wand, that would be what I would like you to sit on.

Dr Andrew Greenland: 33:14

It wouldn't be a magic wand, it'll be a gag for the pharmacist by the time to it.

Dr Sharon Winters: 33:19

Yes.

Dr Andrew Greenland: 33:20

And finally, so you've really built something special with your practice. What's um on the vision, what's on your plan for the next six to twelve months, either professionally or personally?

Dr Sharon Winters: 33:31

Well, I am getting old, and my husband wants to retire. Uh, so we've kind of pared down our office hours a little, but I really enjoy what I'm doing. I would like to, actually, I would like to be more involved in the uh academic arena. Um, I had looked at maybe uh there was a child psychiatric uh fellowship that had begun last year at Florida State University, and so I had talked with the the dean of that program about maybe doing some of that, but uh it's difficult for us to kind of move out of what we have, you know, because we have our private practice, we have patients, uh, we have been here uh where we are living in our house for 30 some years. And so um that was a little difficult, but again, with this um internet technology and Zooms and all this stuff, uh, you know, it was said, well, maybe you could be a supervisor of some of the fellows by uh just communicating, you know, maybe once a week in a treatment team fashion, you know, using Zoom or whatever forum there like that. So I I would be interested in doing that. Um I I have a really good friend of mine who um was one of the uh top people at Mutual of Omaha, retired, and he's uh into business administration and stuff, and he keeps telling me, you know, I ought to do a podcast. I'm like, I I really don't uh that that just seems like a lot of intense time. I don't know how you do it really, but um anyway, um, and I have several books I've sort of begun writing. Uh like one I called Pass with Care, um, which is about life experiences and how we move through those. And then another one I started, which is called Face to Face. Because people say, Oh, you ought to write down about your patients and all your interesting anecdotes about patient lives and stuff. Um, so I I did start doing that, and and I think it would be interesting, but I have to look at who my audience would be and um you know, be careful as far as not not revealing anybody's information because I I know I could get past that, but just uh like what am I really trying to accomplish by writing that? You know, I mean there's so many books and things out now, and I I don't know. I I have I that's another thing though that I've been thought thinking to do is maybe uh write. As you can tell, I'm kind of a nerd. I love hiking and I love nature, and uh but to me, you know, living out there and doing that, like I have a friend who has an RV and they go out west for like four months at a time, right? And I'm like, oh as long as I have the internet and some area of research and I can get involved still, I would be okay with that. But I'm not really one to get away like that. So I haven't really decided what I'm gonna do.

Dr Andrew Greenland: 36:58

Sounds like the world's gonna be oyster. Sharon, thank you so much for your time this afternoon. It's been really interesting hearing about you and your practice, what you've done at uh Winters Family Psychiatry and your insights into burnout and maintaining balance. So thank you so much for the conversation. I'm sure other people are gonna resonate with what you say. Obviously, we'll put your details on the bio page so anybody can look you up and um get in touch if they would like to from the contact details on the bio page. But thank you so much, Sharon.

Dr Sharon Winters: 37:26

Okay, well, thank you again for inviting me. I've I've enjoyed it. It was an experience to work through the talk.

Dr Andrew Greenland: 37:34

Hopefully a good one.

Dr Sharon Winters: 37:35

Okay, yes, it was.

Dr Andrew Greenland: 37:38

Thank you.