Key Takeaways
- Setting professional boundaries—especially learning to say “no”—is essential for preventing burnout and maintaining long-term sustainability in wound care.
- Mentorship, coaching, and leadership roles help clinicians build resilience, reduce isolation, and navigate career challenges more effectively.
- Balancing compassion with emotional awareness allows clinicians to form meaningful patient relationships without experiencing emotional depletion.
Transcript
Please note: This content is a direct transcript, capturing the authentic conversation without edits. Some language may reflect the flow of live discussion rather than polished text.
Jayesh Shah, MD:
Welcome back to Wound Conversations. I am Dr. Jay Shah, and today we are following up on the previous discussion on caring for the caregiver. The last time we met with Dr. Desmond Bell, a respected clinician, speaker, and a leader in wound care, we defined burnout and discussed recognizing early warning signs. Today, we are focusing on solutions, specifically how to set professional boundaries while staying compassionate and how to build resilience through mentorship, leadership, and community. Dr. Bell works as an executive physician coach, and aligns with this topic perfectly. So we are thrilled to add his perspective to this conversation. Welcome back, Dr. Bell.
Desmond Bell, DPM:
Thank you, Dr. Shah. Once again, it's really a great pleasure and privilege to spend some time with you.
Jayesh Shah, MD:
Dr. Bell, when you look back at your own career, what was the one boundary you wish you had learned to set earlier?
Desmond Bell, DPM:
This is a great one. I think the simple answer here is it's okay to say no. Learning how to say no. I think we as caregivers, a lot of times, we're so anxious to try and please and to help. And the word no is almost not in our vocabulary. We don't like to think that we can't do anything. It's kind of like that old saying, if you want something done, you find the busiest person in the room. And you can go to SAWC and look around the room, and there's a whole bunch of guilty as charged right there. And whether it's a fear of missing out, as one of my colleagues will say, but it's also, I think, Jay, if I had felt comfortable in knowing how to say no earlier on, that probably would have maybe helped me maintain some of that balance we have previously talked about in our earlier discussion.
It's when you keep giving and giving and giving, and now you're not taking care of yourself the way you should, whether it's by accepting an extra speaking engagement, you're traveling, or you're seeing another patient, or you're doing another consult that day, whatever it is.
I like to do that test where, and as my age was starting to become a factor in my life and I could hear that clock ticking, it hit me. I said, "You know what? One day I'm not going to get out of bed and the world's still going to go on without me. And what would happen if I, for some unfortunate reason, I didn't show up in my clinic today? What would happen?" And you know what? The answer that I came up with is life's going to go on. People are still going to keep living their lives. They're going to move this all forward. Somebody will pick up the slack and everything will work out the way it's supposed to. So it's almost like, in a sense, we're sort of foolhardy to think we can control everything. When you say no sometimes, it's really empowering.
Not that you say no just to be obstinate, but just say no when you feel like, "Hey, if you're on the fence, I think I'd rather be doing something with my family. I think I'd rather be doing something for myself." Take a little break and say no. And guess what? You're probably going to be more in demand than you realize for doing so. So it's kind of like that little crazy dichotomy, if you want to describe it that way. That would be the tip earlier in my career I wish I had been able to do.
Jayesh Shah, MD:
Wonderful. What a powerful statement. I think if we had learned to say no, I think that would be so awesome for all of us. I think you are right. We are all culprit of doing more than what we can handle and we end up in the same situation, but absolutely important message. Thank you for saying that. In wound care, Dr. Bell, we often develop long-term relationship with patients. And how do we stay compassionate without becoming emotionally depleted? I think this is kind of very important for most wound care clinicians.
Desmond Bell, DPM:
Oh my gosh, absolutely. I mean, it's like in the oncology world, especially when you're dealing with, let's say, pediatrics. I know years ago I witnessed firsthand nurses at Stanford University with the pediatric oncology patients, it would only allow them to stay on a rotation for two weeks at a time. Then they'd rotate off to prevent that emotional attachment that would inevitably come about between the nurses and the patients. Then they'd be carrying that with them. So I see the same parallel in wound care, but we don't get the opportunity for the most part to take a time out after two weeks and have somebody cover for us. We're in for the long haul with these patients. So we do develop strong minds with many of them. This is real. And Jay, to be frank too, I still have correspondence with some of my patients. I haven't been in clinical practice now since the end of 2019, and I still have some old patients reaching out to me, contacting me, or family members.
And it's really quite gratifying. And why it's so kind of sweet in a way too, is because it validates that I always treated my patients like family members. When you do that, you let that be your guide. But it also means in a family, you don't always see eye to eye on everything either. So you can have honest discussions with each other. It's funny, I would see my patients actually, a lot of times, being concerned about me. That's another one of those little things. How do you know maybe you're feeling a little tired or burnout or just feeling like you need a little break? Sometimes your patients will let you know. So it's kind of fascinating phenomenon. So the relationship we have with our patients, obviously it's sacred. It's a wonderful thing. To me, it's probably been the most rewarding part of my career. It's the people that you meet along the way, whether it's our colleagues, but really it's our patients.
They're just like family members, a big dysfunctional family at times, but really a beautiful, beautiful family.
Jayesh Shah, MD:
Very rightly said. I have had so many experiences like that. And sometimes my patients themselves told me, "Doc, you need to take a vacation." And I'm sure a lot of our patients will have said that because they also care for how we live and how we can provide the best service. So you rightly said that.
Desmond Bell, DPM:
At some point, there's that trust. When they see that you're going doing the best you can for them and providing results and you have real discussion with them too. I mean, communication's so important. They're part of the team as well. It's not just providers. The patients have to be part of it, but you include them. They appreciate that too. I will say from experience, they truly do, but it's golden rule 101. It's just like treat people the way you want to be treated yourself. And I would always imagine myself, if I were in that chair, how would I want my doc to treat me or a family member? So that's all. It's really simple. It's really quite simple.
Jayesh Shah, MD:
I know, Dr. Bell, that you are quite involved in mentorship and coaching. How does mentorship help to protect against burnout?
Desmond Bell, DPM:
This is a great question, Jay. As I was winding down my career, and again, through our network within the wound care community, I was introduced to a wonderful person, Rhonda Crowe. And Rhonda is a nurse by profession, worked for Healogics for years, but then went off and started this organization called MD Coaches. And it was really the initial idea was to address some of the concerns we've been talking about, physician burnout, suicide, all these terrible things that could often be preventable. And I knew nothing about coaching. It's like, what is coaching? You'd hear about life coaches and all this stuff. What is it? Psychiatry? Is it therapy? What exactly is coaching? And from my time spent working with MD coaches and the colleagues there, and I've also learned that it's really, it goes back to that simple concept of personal accountability, looking in the mirror, but then not expecting a solution right away.
Coaching and mentoring teaches you how to navigate and address things that inevitably are going to come up in your life and really how to make you better equipped to address these things. Again, that feeling of helplessness that we described, which can lead to anxiety and all these other bad things. If you just get it out there and you have somebody that can help you navigate, and hearing the words come out of your own mouth a lot of times is extremely powerful too. So it's not expecting just a quick fix or a solution right then and there, but it's learning skills that you're going to be able to continue to apply as you go through life. And part of that is knowing how to ask for help, how to seek a mentor. And like we've talked about and not being embarrassed by it or feeling it's a sign of weakness.
So that's my take on coaching what I've gained from it too. It's really fascinating.
Jayesh Shah, MD:
All right. And Dr. Bell, you've been on multiple leadership role. How does stepping into leadership even informally change the burnout equation?
Desmond Bell, DPM:
So again, Jay, great question. I think if you look at so many physicians, they're natural-born leaders and they've also a lot of times have learned how to function independently. A lot of us, you start out, you're identified as a gifted student or they put you in different classes. And so much of then your focus is on how do I get accepted to med school, then how do I get my residency? All these things. It's all about you, you, you. But leadership comes from recognizing what you can give to others too by being able to listen, to apply what you learn from others too. I see leadership taking on a leadership role, how it starts. You may be asked to serve on a committee or you may be asked to function as a volunteer or some other type of thing where it's a natural extension of what we do, you're giving in a sense.
Leadership is certainly part of our makeup, I believe, by and large. I do say though, again, going back to the, it's okay to say no to, you can get overwhelmed with too many things coming at you, especially all at once. They never seem to just come naturally. But I think that if you take the opportunity, you have an opportunity to serve in some type of a leadership capacity, in some type of a society or an organization, you get so much in return from that that you never imagine. I will say, speaking from my own experiences, some of the committees and organizations that I've served with, I'm still friends with these people. Ultimately, you have a lot of fun too in the process. You really get a chance to get to know people beyond that professional veneer in a sense.
Jayesh Shah, MD:
Someone rightly told me that you don't look for Rolodex when you are in trouble or when you need help. You get that ready for you so that it's available for you when you need some help. And that's what I think leadership roles and the networking and all these things does is now you are equipped to handle any kind of situation that comes across your arena, which could not be clinical, which may be administrative, which could be billing, but now you have the whole community with you. And that's what I think is so important to prevent burnout. You so rightly said ... So now we are at the end of the program. And for our wound to the wise today, if you could give one habit that early career wound clinician should start now to build a sustainable and fulfilling career, what will it be?
Desmond Bell, DPM:
Be grateful. Approach each day with a certain amount of gratitude and humility. Know that you've been given gifts and use them to your best, but make sure you have fun. Make sure that it's like the law of attraction. Throw out the good energy to the universe and you will get that back tenfold easily. And we all have our weak moments. We all have times where maybe you feel down, but you just keep going. Just always look for the positive in each day. Always look for the positive in each situation and get from breakfast to lunch, get from lunch to dinner. You don't have to do all at once, but stepwise, be grateful. Have that gratitude along the way, and you'll be fine. I truly believe that's one of the secrets to having a much more fulfilling life.
Jayesh Shah, MD:
Dr. Bell, thank you for helping us explore not just how to take care of wounds, but how to care for people treating them. A sustainable career in wound care doesn't happen by accident. It requires awareness, intention, and community. For more episodes, visit woundcon.com and explore educational resources at woundsource.com and Woundcon. Thank you for joining us. Please listen today and apply tomorrow.