I Went from Burned Out Pediatrician to AAP President | Dr. Sue Kressly

Sue Daniels: [00:00:00] Hey, everybody. Welcome back to another episode of Still Practicing. Today, I am super excited to get to talk to Dr. Sue Cressey, the immediate past president of the American Academy of Pediatrics and a fierce advocate for kids and pediatricians, too. She navigated 2025 with great skill and an optimistic outlook, and it was wonderful to get to talk to her about her personal experiences as a practicing pediatrician over 30 years and see how she is continually working to include herself in the circle of compassion that she extends so freely to others.

I think you will really enjoy hearing what she has to say. [00:01:00] 

Dr. Sue Kressly: Oh my gosh, Dr. Kressly, it is such a pleasure to have you here. I'm 

Sue Daniels: so excited that you were able to make the time. I'm so inspired by you, and really this project came out of the NCE from last fall. So, um, it is a real treat to have you here.

Thank you. 

Dr. Sue Kressly: And what an honor and a privilege it is to join you in this important conversation. Thanks for having 

Sue Daniels: me. Mm-hmm. Thank you. Um, uh, just to, to warm us up a little bit and get us settled in, I thought I would ask you when in your life you knew you were going to or wanted to be a pediatrician. 

Dr. Sue Kressly: Um, I was four This is an interesting story.

Um, I didn't actually have a pediatrician. I had a family practitioner who, uh, his pra- his office was at the end of the block where I lived. And so when you're, um, a kid, and you're allowed to go out on your scooter [00:02:00] and do things and ride your bike, but only to the end of the block or around the block, um, you end up visiting people, um, on your block.

And so I went into his office a lot because he had lollipops. Um- ... but I also found it very interesting because he had all these cool tools, and there were all these people, and he always made me feel bad- better when I was sick. I had recurrent strep throat when I was a little kid. Um- Mm-hmm ... and, um, one day he said to me, he said, "You should become a doctor when you get older."

And I said, "No, there's too many smelly old people in your office. I don't, I don't wanna take care of smelly old people." Now I am one, right? But, um, he said, "No, actually, you can be a doctor and only take care of kids. It's called a pediatrician." He's like... And I was, like, blown away, and I'm like, "That- Wow

that's, that's what I wanna do. I'll do that." 

Sue Daniels: Amazing. That is a fantastic story. Um, yeah, the, the difference lollipops can make in one's life, [00:03:00] right? Or stickers. That's such a nice m- I know. Yeah. It's excellent. I, too, uh, knew I was gonna be a doctor when I was v- very young, six years old maybe. Um, I didn't know I was gonna be a pediatrician for a long time after that, though, so that's a, that's a really sweet story.

Um, I, I wanna, um, just by way of introducing you more formally, um, make sure everyone's aware, I feel like everyone is aware, but you are the immediate past president of the American Academy of Pediatrics, and you led that, uh, largest professional organization for pediatricians in this year of 2025, a very singular moment in history, uh, where the federal government was removing scientists from the CDC and particularly from the Advisory Committee on Immunization Practices.

And those changes led [00:04:00] to, uh, a big revision in the immunization schedule that, uh, until then had been, uh, evidence-based and necessitated the AAP suing the Department of Health and Human Services. And I just, uh, am curious what that experience was like for you. I imagine when you got elected, um, we didn't really know that that was gonna happen.

Dr. Sue Kressly: No, um, as you know, there's a year that you spend as incoming president, and you actually run the year before and are elected. So there was no way that, um, anyone knew what we were up against. Mm-hmm. Um, and it's very interesting, as many times in, in medicine we do, I had sort of in my head had a plan for how I was going to manage, um, this difficult, um, position before the administration changed, and, and I had a whole [00:05:00] six weeks plan on how I'm gonna learn to drink from the fire hose.

Well, two weeks in, um, I'm like, "Okay, that's not gonna work." I am-- This-- We are in new territory, uncharted territory. What I'm committing to do is show up every day, be mindfully present in every moment, give myself and others grace, and do whatever is necessary to benefit children and our profession. And so, um, I got rid of my rear view mirror because otherwise I would have been in my own head all year long- Mm-hmm

and it was changing too rapidly. Um, and I finally decided if I lead with my heart and I do what I can, um, then that will be enough, and that is how I defined success in the moment. So, um, it was a challenging year, um, but I was honored to have the microphone and able to speak up on behalf of the country's kids and, and our profession.

Sue Daniels: Well, [00:06:00] you did so, so artfully, uh, and professionally and calmly, and I think a, a lot of us were out here, you know, in the fields, um, uh, you know, feeling like our hair was on fire, and it was really nice to be able to look to you and see such competence in such a challenging moment that obviously, um, medical school and pediatric residency training, uh, does not prepare us for.

So- 

Dr. Sue Kressly: Thank 

Sue Daniels: you for those words- So well done ... those kind words And we're- Thank you ... we're all, many of us out here so inspired. You and I don't know each other personally at all, uh, although I feel like I know you. Uh, and I don't know if you have ever been through an experience that you would characterize as burnout per se, but of course I know you've had a long career that included founding your own general pediatric practice in Pennsylvania and being very involved in the [00:07:00] health IT space and making sure that, uh, kids and pediatrics are represented well in that space.

And so I have no doubt that you have come up upon significant challenges along the way. Um, did you ever feel or characterize any of those challenges as being burned out? 

Dr. Sue Kressly: In retrospect, I, I, I do. Um, and that was probably 10 years into my career. Um, and what happened was I, as many of us, you finish residency and my whole plan was to go be part of a community and be a pediatrician and really make the, the community a better place for kids and families.

Um, and so I joined an independent practice, um, uh, back in the, the '89, '90 age range. Now I'm gonna show my age. But, um, in, in that timeframe, went outside of Philadelphia, um, it was not a very favorable c- [00:08:00] insurance n- um, environment to, to be living in independent practice. Um, but I did it anyway because I'm a fiercely independent human um, and um, like to have agency.

And so I joined this practice and, um, over the course of 10 years, the environmental pressures started to be felt by that independent practice, and they sold to an organization. And I watched my love of being integrated and part of the community, um, be constrained by people who really didn't understand what, um, care we were providing and how integral we were to the, to the community.

Um, and I came home several days and said to my husband, "I have to quit my job." And he said, "So quit your job." And I said, "I can't. Uh, like what am I gonna do? I don't know what else to do. This is the only thing I'm trained to do, and I [00:09:00] still have medical school debt," like 10 years in, right? I'm, I felt trapped, and I was going to work and going through the motions.

And I finally said, "You know, um, I can, um, just- Get along and go along for the next 30 years of my career, um, or I can reimagine something different. And that's when I went out on my own and started an independent practice, um, in 2004 because, um, I really in my head had a vision of how we had been delivering care to families in our community and how I wanted to.

And I wanted to innovate, and I wanted to use technology to add access and efficiency, but people where they mattered, and care about my patients, not just provide care for them. Mm-hmm. Um, and so I took a huge risk and a leap of faith, and then I led with my [00:10:00] curiosity, 'cause there's so much about running the business side that I thought I knew and I didn't.

Mm-hmm. Um, and so I asked a lot of questions to a lot of people and, and just, um, learned about, um, thinking in, in a systems mindset and a business mindset, not just in a health ca- care delivery mindset. And, and at that point, it was like, "Okay, who thought this was a good idea, and who do I talk to to fix it?"

Um, and so it, it sparked my, um, my need for continuous growth and change. 

Sue Daniels: Yeah. Yeah. Did you have support from anybody in making that decision, uh, or in executing that? Was there, you know, was there a practice management consultant who helped you on that path, or you just were really inventing it as you went?

Dr. Sue Kressly: It helps to have practiced for over 10 years. It was probably 14 by the time I finally did it. Yeah. And realizing [00:11:00] all the things that I thought were done wrong, and if I could do it myself, I would do differently. Um, I had a young son at the time. My parents were, um, both died in their 50s, so I had lost that support.

Um, I was newly remarried, um, so I had this, um, this really supportive husband who was just sort of thought, "Okay, she's, she's crazy. I'm gonna ride along." Um, and, um, I, to me, the risk... So it's interesting. This actually tags to what happened th- last year as president. To me, it wasn't only deciding what is the risk of taking this action, but what is the risk of not taking the action?

And, um, and the risk of not taking the action was I was afraid that I was going to not like my job and not be there for my patients and families and [00:12:00] community the way I wanted to be. And if I failed, I was gonna fail big and then regroup. But I gave myself permission to ask a lot of questions. Um, so my husband was, um, emotionally supportive.

He had started a business, so he understood some business dynamics. He had not, no, no idea what anything happened in healthcare. Yeah. And as he dug in with me, as I dug in, I'd come home and say like, "Can you believe this?" He'd be like, "That's crazy." And I'd be like, "Mm-hmm. It is." 

Sue Daniels: Uh-huh. Yeah. Yeah. And I'm thinking about, um, your early career before that, um, difficulty emerged 10 years in.

Did you know anybody, witness anybody else ever get burned out? Did you have any, uh, even passing thought about that, whether, or any regard for that person's experience, or worry that that could happen to you? 

Dr. Sue Kressly: Um, yes and no. So I had [00:13:00] seen it. There were a couple of people who didn't make it through our med school year at Temple.

Mm-hmm. Um, there was someone who was an intern with me who really just was, um, oppressed by the stress of internship, and she, I mean, I, uh, I'd had many conversations with her just crying and feeling, like, numb and not being able to go on and imag- and felt like she was on a rollercoaster ride and couldn't get out.

Wow. I have watched other people who had, um, been in practice who, um, left the practice of medicine all because they felt like, um, the environment was, um, making it impossible for them to be the humans that they wanted to be. 

Sue Daniels: Mm-hmm. 

Dr. Sue Kressly: And so, um, I had seen it. I had, uh, beared witness to the pain in colleagues along my whole [00:14:00] journey.

Um, I didn't, in the first probably eight years, allow myself to think that I, that could happen to me because I was $196,000 in debt in 1989. Wow. And so it was not a luxury that I could afford. I had no choice. Mm-hmm. And so, um, as I started to dig out and get involved, then I started to say, "Oh, my. Um, the environment of the practice of medicine is not what I th- thought it was gonna be."

And it really is the, the people, the practice, it was the environment and the external forces that were s- making it impossible for us, I think, to practice to the top of our ability as humans and caregivers and caretakers. Um, and [00:15:00] then, um, so the question is, so I toyed with, like, you know, what do I... M- I'm gonna quit my job.

What else do I do, right? Um, but, but when you're, when you decide at four you wanna be a pediatrician and you spend your entire career justifying that to people who ask you, "Why did you wanna be a pediatrician?" Trying to define yourself outside that scope is very, very challenging. I, I gave myself the space to do it.

And said, "What do I really love about practicing, uh, um, pediatrics? Why does this matter to me? D- do I still care about the kids and the care delivery? 'Cause if not, then, then I'm not doing anybody a favor." Um, and so I, I have, and maybe you have this experience too, the older I get, the more I realize that there are many chapters to your, your book of life.

And sometimes it's a short chapter, and you pivot, and sometimes you close a book and open a new [00:16:00] one. And sometimes... And, and I used to feel like that in itself, and it's interesting because medicine doesn't really paint that picture. Like- Yeah ... you go to undergrad, you go to m- medical school, you do a residency, maybe you do f- like y- you're, you're set up for life in these increments.

Mm-hmm. And there's not a whole lot of visible weaving and pivoting in what you imagine that journey to be. Um, but I decided at some point, and probably around the time when my parents both got ill, that, um, it is that rich fabric of the pivoting and changing and reprioritizing- Yeah ... um, that really is, um, makes us human and, and, and can help us connect to our passion, um, and where we want to have impact.

Sue Daniels: Yeah, so important. And you're right. It isn't something that at least my generation of [00:17:00] trainees had a lot of exposure to or encouragement toward, and maybe it is different now. Um, but I, I hope, uh, one of the things we can do in these types of discussion is encourage people earlier in their career to recognize what is, um, not working for them, um, before they get deeply into burnout, uh, where it's really hard to see your way out, right?

It's really hard to see what changes can I even make. Um, certainly my experience was one of knowing I needed to make change and kind of like you 10 years into your career saying, "I'm gonna have to quit this profession that in many ways I love, but I can't thrive in these conditions." And I couldn't even imagine that I could change the conditions very easily.

Um, and, uh, it [00:18:00] took, it took some good help with a therapist to, to really question my assumptions that I couldn't still be a, a great pediatrician if I wasn't always available, if I wasn't doing, you know, inpatient medicine, if I wasn't, you know, intubating and putting in chest tubes and, um, everything soup to nuts that, um, I had done previously in my career.

So, um, yeah, I think you're right that at this point in my career, I think that fabric, that weaving is, um, yeah, a gift to the profession and to our patients, um, and often to our families too Uh, and, uh, is something that would be good to discuss more early on. Although I know, you know, I know a lot of trainees, and I know they're just immersed in what they're immersed in, so they're not really thinking, uh, 5 and 10 years and 15 years out.

Dr. Sue Kressly: Yeah, but I think we have an [00:19:00] opportunity and, and the environment is changing because more people like us are being honest and not pretending that we're okay- Yeah ... and that we're ducks and we're, everything's okay on the surface and underneath, it's- 

Sue Daniels: Mm-hmm ... 

Dr. Sue Kressly: it's okay to be human. It's okay to cry. Yeah. It's okay to, to be, to, to feel the feelings that you feel- Mm-hmm

in your professional life and understand how that also impacts your personal life. And so I, just like when, y- y- you know, mental health is not a taboo subject anymore, I think the more we expose our trainees and we give them space to express some of those emotions and understand there's nothing wrong with them early on when you're starting to have those questionings, that's the place where you can really reimagine, set boundaries.

Um, there is no one-size-fits-all in medicine. There is [00:20:00] no one way to be a pediatrician. And showing people multiple flavors and helping them discover what it is about the experience and what they want to gain, um, all through from, um, early on, I think will leave us all in a better place. Um, then the other thing we need to do is get into positions of power so we can change it- Yeah

um, uh, as much as we can. But, um, um, but, but it's, it's a yes and to me. 

Sue Daniels: I'm, uh, thinking back on the time before you made the big change, and, um, obviously, you articulated it was a big risk. What was the thing you were most afraid to change, leaving the security of your old practice, taking a new financial risk?

Dr. Sue Kressly: Two, one of which was financial. I was afraid that I was, you know, I still have student debt. I was managing a house and a [00:21:00] son as a single mom for a while, and when you are in charge of all of those things, there is a weight to that. Actually, maybe three things. So there's the financial weight. There's the weight of I knew it would consume a lot of my energy, and my son would pay a price for that.

Sue Daniels: Mm-hmm. 

Dr. Sue Kressly: Um, and, um, how I was going to preserve the fact that he still, when push came to shove, was more important to me than anything. Mm-hmm. Um, and then the third thing was I wanted to make sure that I could honor the families who entrusted their children to me- In a way that really, um, was what th- they wanted and needed, and I did not want to fail them either.

Mm-hmm. I probably was less worried about failing myself, um, than I was about failing my, my son and my patients. You know, [00:22:00] 'cause what if, like, I did this grand experiment and all these people followed me, and then it, like, went bust and two years later, like, I left these families who... You know, there's a weight to the trust on both sides.

As a parent, it's a very weighty decision to decide that you're entrusting your child- Mm ... to a physician when you're vulnerable and don't have all the answers. Yeah. And it is something that we feel the weight of when we take that trust. And, um, and I wanted to make sure that I really was in a position to honor that, which is one of the reasons that I decided if I was gonna do this, I was gonna do this all from a family-centered lens.

Mm-hmm. And if I couldn't make the business work, um, I at least as a human, um, uh, connected with them, um, as, uh, a- and really honored that trust. 

Sue Daniels: And when you got into your new [00:23:00] practice, uh, it sounds like that really addressed the burned-out feeling. It sounds like you were able to successfully navigate that.

Dr. Sue Kressly: Um, yes, but it, I mean, it had challenges. I was solo for the first two years. So how do you, how do you put boundaries around, you know, 'cause you can't, when you only have... Yeah, and families followed me, which was really humbling, because I was the person at the practice who got all the complex kids, which is one of the reasons that I had to l- leave, because they wanted me to do it in 10 and 15 increment- ments.

I, yeah, I can't do a, a teen, new teen struggling with an eating disorder followed by a child who's neurodiverse followed by someone who's there depressed. And, and my colleagues were seeing pink eye and ear infections, and I had the former preemies and the d- and the, and I'm like, "I can't do this safely. I can't do it safely."

And so I, [00:24:00] I made myself promise that I was gonna give people the time that it needed to do it well, um, although that's hard to do sometimes from a financial standpoint, but also set boundaries. So it turns out that if you say to families, "I am gonna empower you to make really great parental decisions about your child's health, and when you reach out to me, I will be there for you," they did not abuse that, that privilege.

Everybody said to me, "Sue," they were all like, "I'm sorry to bother you. I'm sorry." I'm like, "You're not bothering me. This is my privilege." Like, "Sorry, hang on a second, I'm on the soccer field. Can I call you back in five minutes?" Right? Um, and I found three other solo pediatricians in my geographic location, where we cross-covered for weekends, because we need, you, you, you have to have space.

And I always said to them, "If you get one of my complex patients and, um, there's, like, something that's not making sense, like, call me. I don't care." But you, you have to set [00:25:00] boundaries around that or, um, or, or you, you, you burn... I, I tried to put boundaries around it so it would fill my cup but not burn me out.

And h- you, you, you f- you have to flex... You, you think you know what that is up he- ahead, but then something else happens, and, um, and, and you, you, uh, you, you pivot, and you change, and that's sort of the pivot and weave and, and all of those things. And then I became an accidental informaticist. Um- 

Sue Daniels: Yeah, how did that happen?

Dr. Sue Kressly: Well, I, uh, you know, because, like, there felt like there was huge injustice to kids in the technology, and I was like, "Well, who, whose thought this was gonna work for kids," right? And- Yeah ... I just kept being that Well, you know, I sort of in elementary school created a strike on the playground, so it shouldn't be s-

surprising to anyone that, that I'm like, "Wait a minute, like, who's making the rules here, and do they really understand this from somebody [00:26:00] else's perspective?" Yeah. Um, I have learned to think about this from other people's perspective. Uh, and last year that helped a lot. Like, okay, what does this look like from someone else's lens?

Mm-hmm. I have my bias. Right. But what does this look like? And if I'm going to move hearts and minds, I have to appeal from it from their angle, not mine. Um- Right ... but f- for the informatics piece, when I went out on my own, I said, "Okay, I'm not building a chart room. It's 2004." Mm-hmm. "I'm gonna buy an electronic health record."

My husband had a tech company for business software investment for, like, all of the big banks, so he knew tech, and I'm like, "I- I got no... I, I only know what I, like, looks like a pediatric functionality." And then, um, we got, uh, we, I bought something as a end user, um, and I'm like, "Why doesn't it do this? Why doesn't it do this?

Who do I talk to?" Called the guy who started the software, right? Like- Yeah ... I, I just, I, I just kept bringing my folding chair to tables where I wasn't invited. Uh-huh. Um, [00:27:00] and quickly then realized that, um, if I was gonna change this for me, I might as well bring my whole colleagues with me. And I had to figure out how to talk to the, the tech people in language that m- made our cli- clinical needs un- better understood, and I had to go back to my colleagues and say, "Hey, you don't want the move the button here.

Tell me what problem you're trying to solve. I wanna see on one screen the weight and the allergies and the whatever." Right? Like, don't, don't, don't go to the, the fix. We're fixers. We like to diagnose and fix. Mm-hmm. Um, what problem are you trying to solve? And so I got embedded in that. So I'm running my own practice.

At some point I hired a couple other pediatricians, 'cause I got really busy. I'm running my own practice. I'm b- I, I'm a, a medical director of a software company. I'm seeing patients. I'm the school physician, because- Oh, gosh ... I got really mad about a, a no nits policy Yes ... in my kid's [00:28:00] school. And, and, and the school nurse, who I happened to know, 'cause my kid had asthma, so I got to know her, I'm like, "This is ridiculous.

Like, who thought this was a good idea?" She's like, "Would you like to be the school physician and come with me to the school board meeting?" I'm like, "If I can fix this, yes." 

Sue Daniels: Amazing. So I did. Amazing. Wow. That makes me wonder, do you have to keep, uh, some attention on your own tendencies to overextend? 

Dr. Sue Kressly: Oh, yeah.

Sue Daniels: Is it something that you're still attending to now? 

Dr. Sue Kressly: Yes, and I'm giving myself grace because I will never perfect it because, you know, it's interesting, one of the original, um, people who talked about burnout talked about when the, um, qualities of the job mismatch the qualities of the human doing that role, right?

That's, that's... And, and, and I'm a yes and girl, so, but I have come to think of this, you'll [00:29:00] love this, that my life is like my closet. Hmm. Like, a couple times a year, I, like, can't find anything, I don't know where it is, and I get rid of it, and I purge, and I, and I get down to manageable things. Mm-hmm. And then I go shopping and there's another little black dress that I might wear someday, and so I buy it.

Uh-huh. And, and I used to feel guilty, like, why do I keep doing this? And then I realized it's the rhythm of life, and I do that with my calendar. So when I start seeing, like, there's no white space, I- that's my, like, clean out your calendar closet, Sue, it's time to say no. Um, and so then I start saying, "Okay, what still brings me joy, and what- Mm

do I have the unique qualities to do?" And so I have started saying, "Thank you so much for the opportunity." Hmm. Um, "I'm gonna decline, but I'm gonna introduce you to a colleague." Oh, nice. So I've looked at this [00:30:00] as if I step aside, I'm allowing someone else to thrive and shine, and if I take up s- too much space for that, I'm really denying some of my other colleague leaders the opportunity.

Nice. And then I'll introduce them, and if I need to mentor them up a little bit to get there. Yeah. But to me right now, one of the most impactful things that fills my cup is mentoring up the generations- Yeah ... from high school students who seek me out and say, "I think I wanna be a pediatrician," awesome.

Yeah. You can find me in half an hour, let's meet. They're like, "Really?" I'm like, "Yeah, really." Because we can't go too far upstream to really connect with humans who want to join this incredible profession. 

Sue Daniels: Yeah, absolutely. Yeah. Well, uh, you should do a master class on- ... that calendar closet clean-out, 'cause I will attend that for sure.[00:31:00] 

I'm thinking, uh, back to, to your burnout experience of 10 years ago, or actually 10 years into your practice, that was probably 20 years ago maybe. Yeah? 

Dr. Sue Kressly: Yep. 

Sue Daniels: And you've avoided, uh, that experience for most of the rest of your career. 

Dr. Sue Kressly: Intentionally. 

Sue Daniels: Yeah. Yeah. 

Dr. Sue Kressly: Because I have deci- I know what that feels like early on, where I start to dread going to work.

That was the first thing for me. 

Sue Daniels: Mm-hmm. 

Dr. Sue Kressly: Like getting up, like, on a Sunday going, "Ugh." 

Sue Daniels: Yeah. 

Dr. Sue Kressly: And so- ... when I feel that way, I consciously just really sit and take stock of what I'm doing. Mm-hmm. And, and the thing for me, the, the three things that have, that got me through all of that and continue to get me through the, the, the threads of my changes [00:32:00] are- Mm-hmm

curiosity, asking a lot of questions. Why is it I'm feeling this way? Mm-hmm. What is it about going to work that I don't like? What, what is it about... And then asking other people, "How did you make this work?" and, "What did you do?" and, "Does that work for you?" I mean, I, I just, I'm like the perpetual four-year-old who can't stop asking questions like, "Where do fish sleep?"

Right? So that's me, like, asking all kinds of questions always. 

Sue Daniels: Yeah. 

Dr. Sue Kressly: Um, I then tap into compassion for the people I'm working with, the families I'm serving- Mm-hmm ... and self-compassion. I have to be kind and gi- give myself grace. And then what pieces are within my control that I can change? I think that sometimes it's overwhelming, like, "Somebody please just go change the system."

It's like, okay, what's bothering me right now is this. I can probably change that in the [00:33:00] exam room and no one else will notice. Like, I am going to mindfully look at the computer screen before I walk in the room, and then I'm going to sit in front of the family and have, meet them as people. And because I was feeling depersonalized, right?

Like, nope, we're gonna, we're gonna have a conversation about what's your, what's your favorite color, or like, go Birds, 'cause I'm an Eagles fan, right? Like, we're gonna have a human conversation before I engage in the technology. And as a technologist, that's, that's a, that's a, that's a powerful realize, that like technology is a tool, just like our hearts and our minds and our ability to connect with people are.

Mm-hmm. And so, um, how do you balance it? So, um, I really have m- I'm always changing. I feel like I had a contin- I feel like I, there's a PDSA cycle in my, in my heart and my DNA that I didn't even know what it was, but I was always like, "How could we do this better? How [00:34:00] could we h-" And, and, and it's not always, and it's always about the team, right?

'Cause you're only as good as the people around you and the team- Yeah ... that you work with, right? Yeah. Um, and so, and, and I'm sure you learned that, but I learned that during COVID really fast. Like, oh, oh, like I can come in on Monday morning and say, "Okay, we're all doing this," and they're looking at me like, "Yeah, you're crazy."

Sue Daniels: Dread, I have to say, is a little bit of a theme in this podcast. Um, I can relate to that, and it's such a funny, uh, or unfortunate experience when you love the kids and you, and you love the actual work, but you dread the environment or the system. Um, and, and I, like you, own my own practice and developed burnout in that context, where I did feel like I had the ability to change lots of things, uh, but COVID was a particularly gigantic challenge, um, to lots of [00:35:00] pediatric business owners and, and really everyone.

I mean, I, I don't, I don't feel special in that way. COVID was hard for everyone. Um, as I listen to your last comment, I wonder how long you've been tuned into the idea of self-compassion and caring for yourself, 'cause that feels like kind of a new and popular idea. Um, it certainly, um, wasn't something I was doing any of until, you know, fairly, I don't know, five years ago, six years ago, when it, when it became really, really necessary.

Um, so I s- I hear that, and I think it sounds highly evolved, and I... it sounds like you were doing it earlier than many people. 

Dr. Sue Kressly: I, I was aware of it. It doesn't mean that I'm good at it. Mm-hmm. Right? There's a difference, right? 

Sue Daniels: Yeah. 

Dr. Sue Kressly: So, but it's something that it, I, I work on. And, and I will take that back to losing my parents at 53 and fif- when they were 53 and 59.

Mm-hmm. It makes you take pause [00:36:00] about what is really worth living and what are really your priorities, right? Like, what is, you know, if I'm, if I'm gonna not be here tomorrow, did I live today in a way that honored myself and the things I care about? And so there was much awareness before, um, I got to, um, m- maybe being good at it.

And, and I'm, and then, you know what? Again, this is like the closet. It's a journey. People who think they master any part of this, I'm a work in progress. I'll die a work in progress. Um, but I'm curious, and I read, and I listen to other people. How are you managing it? What works for you? I try on lots of things.

Um, lots of, some of them work, some of them don't. I think, and it's interesting, I think pediatricians tend to have a lot of emotional intelligence because we [00:37:00] often-- we have to deal with non-verbal kids, like of all ages, and, and read the emotional dynamics of a room of caregivers and parents when there's a lot that's not said.

But you, like I think we've spidey sense in pediatrics that's pretty highly developed. And then the question about that is, how do you use that? And maybe it's when I started to realize I have to start, if I'm gonna succeed as a business person, I have to see what's, what's in it for them. How do I couch to the insurance company that they should pay me more for X, Y, and Z?

'Cause they don't gonna pay me more just 'cause I tell them. I have to make it a... So in that lens of having to really look at things from other people's perspective, and I learned that in, um, as president last year because, you know, pediatricians are practicing in all across the country in very different [00:38:00] environments.

And I was like, "Tell me what you're seeing. Tell me what you're hearing." I- that's not my lived experience, but I need to understand the broader lens. I consciously chose to look at myself and where I was coming, and check my own biases, and make sure that I was looking at myself obje- as objectively as you can.

Um, and, and again, you know, make it a work in progress. 

Sue Daniels: I think the opening tag for the podcast says something about me being a burnout survivor, and I don't feel always like that. I feel like I'm just a burnout navigator and, you know, I'm, um, I'm a lot more mindful about, uh, all of those things and including myself in that circle of compassion, 'cause I think I'm pretty, pretty good at, um, providing compassion to kids and parents and, and my own kids and family.

And so, uh, yeah, just being a lot more aware of the need for that, for sure. Um, when things get [00:39:00] hard in your professional life, what feels good to you? What's your passion outside of medicine? What fortifies you and, and fills up the white spots on the calendar? 

Dr. Sue Kressly: Um, so a couple of things. I am a, I think I would've been a wildlife biologist if I wasn't a pediatrician.

Sue Daniels: Cool. 

Dr. Sue Kressly: And so, um, anything that gets me close to nature- Mm-hmm ... which I find grounding. Um, I love the beach, so there's nothing like walking along the ocean and looking at the vastness and realizing that we're one speck on this one little day- Mm-hmm ... that's completely, the world's gonna wake up tomorrow with or without whatever I do, is grounding and humbling.

And then just watching, you know, egrets and dolphins and all of the wildlife things. Um, I, uh, when I started to wind down from clinical practice and before I got into this [00:40:00] role at the academy, um, I was volunteering at a wildlife rehab place, which, um, I think is a great thing for people who like me and are pediatricians because wildlife vets, veterinarians generally would rather talk to animals than people- Mm-hmm

and wildlife vets even more so. Uh-huh. So they decided that I had a unique skill, and they put me in triage answering the phone- Ah ... when people would call up and say, "Oh, I, there's an injured pelican, and what do I do?" And they would be panicked- Mm-hmm ... and they're like, "Oh, you talk, you've talked parents off the ledge in the middle of the night who can't have animals that don't know, can't tell them what's wrong.

You can go here." And in the process, I learned so much- 

Sue Daniels: Aw ... 

Dr. Sue Kressly: about wildlife that my curiosity got piqued. I felt like I was adding value to the, to, to the- Mm ... to the work, and so that is sort of my escape, um, of the world. Nice. And then, then my family has to listen to me tell them stories about, "If you [00:41:00] ever rescue a pelican, don't close their pouch.

They're obligate mouth breathers, and they- Oh ... will not be able to breathe." And they're like, "Oh, thank you for that, Grandma." And then my grandkids- That could come 

Sue Daniels: up. You never know. 

Dr. Sue Kressly: My grandkids are like, they're my, the other thing that's my white space, right? Like, I have a 10-year-old and a seven-year-old grand- grandson.

Mm-hmm. And it is so, grandparenting is incredibly fun, um, because you- Mm ... can do things in a way that just honors the kid and not have to worry that you're making a mistake and going to- Yeah ... mess them up. Although their parents think I'm messing them up, which is okay. 

Sue Daniels: Yeah, it is okay. That's y- that's your privilege, I think, at that, at that, uh, role, for sure.

Do you have creative pursuits that you engage in? Do you make art? 

Dr. Sue Kressly: Um, I am not very artistic. Um, I, um, I do jigsaw puzzles. Mm-hmm. I got into, and that's because I feel like I can accomplish something and see it. Mm-hmm, mm-hmm. And it's beautiful. You know, on [00:42:00] days where you feel like I, I am just waving in the sand and nothing is going in the right direction, I can find a couple of pieces, stick them in my jigsaw puzzle.

Oh, yes. Uh-huh. And that- 

Sue Daniels: Yeah ... 

Dr. Sue Kressly: that will, that, that, that will give me, that will give me satisfaction. Um- Yep ... uh, I love listening to music, um, and I like to read historical fiction. Oh. So I have a few escapes too. 

Sue Daniels: Excellent. Oh, yeah. I, I, um, can totally relate to that puzzle thing, just the, um, the feeling of, uh, productivity on something that is, um, less consequential than some other, yeah, arenas where we get to be productive, but- 

Dr. Sue Kressly: Which is, which is important for burnout, right?

If you're feeling like you're not accomplishing anything, go find something small that you can accomplish and feel and see it, and it's tangible. And, and even if it's just in the moment, um, uh, it, it, it makes you feel, uh, like there is hope of moving forward. [00:43:00] It's a step forward. Even a small step forward is a step forward.

Sue Daniels: Absolutely. Absolutely. Um- How do you feel like, uh, addressing burnout relates to the, uh, workforce shortage that's growing in pediatrics? Do you think, um, do you think there's a way to address that through addressing burnout? 

Dr. Sue Kressly: Um, I think it's all interconnected. I think, uh, workforce, um, um, I like to think of it more of healthy wellbeing of our workforce, not necessarily because it, it means we have to invest in it, right?

Um, in, in a lot of things. Um, and we are, we are... I am way past the, you know, you were kind enough to say that I gave myself compass- self-compassion. That's not the answer to this. It's systems change. Yes. Right? It is really systems change that we have to speak up and push back and speak out. And the [00:44:00] first part of it is we've spent a lot of time in medicine talking to each other.

The rest of the world really doesn't have any idea of what that looks like, and so I've spent a lot of time really trying to explain to policymakers and people in the coffee shop and my Uber drivers right, like, what does it take to have a healthy workforce that you are working in lockstep to invest in children?

You know, I spent a lot of time last year talking about kids as 22% of the population, but 100% of our future. What does it mean to invest in kids and those of us who care for them and about them? Mm-hmm. Um, and, and again, back to that, what is the, not only the what does it look like to do that? What is the opportunity loss cost if we don't?

Sue Daniels: Yeah. Yeah. 

Dr. Sue Kressly: Right? That to me, we need to understand that it is very shortsighted if we don't [00:45:00] really holistically look at, um, care delivery models, um, in a different lens. Um, and, um, and I think- From a d- w- as pediatricians, we have a developmental mindset, right? A two-year, two-day-old is not the same as a two-year-old is not the same as a 12-year-old or a 22-year-old, yet we take care of all of them.

Um, if we built systems that they really take in co- in, into context the needs changing developmentally over time, including the care team, the caregivers, everybody wins because really there is no average adult patient, even though technologists and systems try to pretend there is. They would also benefit from really thinking in nuanced, in context of the community and, um, the caregiving team.

Um, and, and so I, we, w- we, I, um, I, I've tried to pivot from talking about the kids 'cause if we keep talking about what kids need, people put us in the kids' [00:46:00] table, and then they ignore us- Mm-hmm ... 'cause kids don't vote. Um- Yeah ... and so if we think about this from a family-centered developmental lens, how the entire population benefits.

Sue Daniels: Yeah. Brilliant. At the end, I like to ask, um, my guests if they could talk to themselves back before their burnout journey started, uh, if there is something they would, uh, want to say to themselves, especially realizing that there might be somebody listening to us who is in a similar situation. 

Dr. Sue Kressly: Um, I would say two things.

Number one, give yourself grace. You're an awesome human who cares about your patients, and the reason that you're struggling is because you care so much. And that doesn't mean you should care less. It means find other people. Find your people. Talk to someone who can acknowledge some of what we [00:47:00] understand is just acknowledging you're not alone.

I f- I, I completely have empathy. I've been where you've been. I feel what you're feeling. Um, together there is a path forward. Um, and remember, a baby step is still a step forward. 

Sue Daniels: Aw. I felt that. I felt that. I just have such admiration for you and feel like I know you before this discussion, and so much, uh, added love is what I feel now for you.

And we share a lot of important things in common, and I feel your positivity and your optimistic outlook, and I just feel further inspired. So I'm so thankful for the time with you. 

Dr. Sue Kressly: Well, we work with kids, right? And so when hope feels like it's impossible, all you gotta do is go to work. 

Sue Daniels: That's right.

Dr. Sue Kressly: That's right. Kids who have incredible challenges [00:48:00] find a way to laugh with you, hug you. Lead with love. Lead with possibility. We, we are p- really in an, in unique and awesome position to be able to bear witness and then take that journey with them to make the world a better place. 

Sue Daniels: Yeah. Oh, thank you so much This next part comes from an individual on Reddit who was sharing their thoughts on what burnout actually is, and I'll read what they had to say.

"Burnout is a repetitive motion injury, doing the same thing over and over at a level of stress that eventually causes harm. The only solution is to not repeat that motion over and over, so finding out exactly what's causing the burnout is the first step. Is it a never-ending pile of homework or due dates at work that you just can't seem to get out of?

Is it long hours day after day with no time to relax? Once you [00:49:00] identify the biggest reason for your burnout, start thinking about how you can change the motion. New job, discussion with your boss, dropping the class. Once you decide on an action, do it. People often talk about finding more time for yourself, but you need to make sure that you aren't just ignoring the problem for a few minutes of air only to walk right back into it.

Recovery from burnout is also very fast, usually less than a week once you know that you're out of the routine that caused it. But you won't recover if you know that the same thing that caused the burnout is still waiting for you to return." I think that's an interesting way to think about burnout as a kind of overuse injury, and I resonate with some of that.

And for me, an even more apt analogy, uh, is the one that comes from aerospace science, uh, where I felt like I had a loss of forward propulsion. Like, all [00:50:00] the fuel and the energy were spent, and there was slowing down that wasn't positive, and then standing still and a bit of a free fall. Definitely agree that time away without deeper reflection and change is a little bit of a Band-Aid, and also appreciate that when you're deep in burnout, it can be really hard to sort out what change is either needed or possible in your setting.

And so for me, and I think for many people, having a good therapist or other supportive person can make all the difference in, uh, sorting that all out and beginning the process of making change Do you have a burnout story? I would love to feature it on the show. Share it with us for a chance to have it read on an [00:51:00] upcoming episode.

You can email us, hello@stillpracticingpod.com, or visit our website, stillpracticingpod.com. You can also check out sudaniels.md on TikTok and Instagram or Facebook to keep up with me and the pod. Check out our Human Content Podcast family on Instagram and TikTok @humancontentpods. Thanks to everyone who listened to the episode.

Please come back and listen again. Send us a message or leave a review on your favorite podcasting app or on YouTube, and I'll give you a shout-out. Speaking of YouTube, check out our full episode videos on YouTube that will be posted every other week at Still Practicing Podcast. Thanks again for listening.

I'm your host, Sue Daniels. Our executive producers are me, Aron Korney, Rob Goldman, and Shahnti Brooke. Our associate producer is Sundus Hassan Nooli. Our editor and engineer is Andrew Sims, and our music is by Omer Ben-Zvi. To learn [00:52:00] more about Still Practicing's program disclaimer and ethics policy, submission verification and licensing terms, and HIPAA release terms, you can go to stillpracticingpod.com and reach out to us at hello@stillpracticingpod.com with any questions, comments, or smart remarks.

Still Practicing is a Human Content production

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