Unscripted | Episode 9

Mentorship and Medicine: Dr. John Scott’s Guide for Success

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Doctor John Scott talks about residency and private practice on Unscripted

Addisyn Uehling: Welcome to Unscripted. I’m your host, Addisyn Uehling. In this series, we have candid one on one conversations with physicians about common struggles that doctors face in today’s world. On today’s episode, we will be sitting down with Doctor John Scott to talk about residency and private practice on this episode of Unscripted. Thank you so much for joining us today, Doctor Scott, can you please start by introducing yourself and sharing a little bit about your background?

Dr. John Scott: I’d be glad to. Thank you for having me. First off, it’s a great honor to be here. I’ve got a lot. Long story, just like everybody else does. I’m from a small town, Beaumont, Texas. My parents were very poor growing up, and so I was a first generation to go to college, let alone medical school. So I went, when I was getting ready to go to college, my dad said I was too down to be a doctor. So I said, well, I’ll show you. And, because I really had never studied ever. My thing in high school was sports, so I was always playing sports. And they just give you the grades. I didn’t enjoy a couple of the things, history and science, I really enjoyed. So when I got to, college, I went pre med. And what is that? And then from then on, you had to learn how to study. So I spent a lot of time in the library, and it’s kind of like you have to indent the wheel. And so I spent a lot of time as well in the professor’s office. So when I took a test, I could hear their voice. I knew what the questions they were coming from. I could feel it. So, one of my favorite classes was embryology, because you could see in your mind the development of how it had to be. For example, one of the questions was, why are the lungs on each side of the heart? The answer is, because the cavity was formed 1st. 2nd was the heart. It came in twisted set itself so the lung buds had no other way around but go on each side of the heart. And that’s the way things are. So I really enjoyed that. And then I had a friend of mine. I met him at the end of my first semester. Ah, in college, we both said the same thing to each other, said, why are you here? And I said, because I’m pre med. He goes, what are you doing here? So? Well, I’m mechanical engineering. I said, I thought you went off to be a pipe fitter. And so we kind of got in a little argument. We grew up together. We went to elementary school together, played sports in different high schools against each other. And then, he said, well, if you can be pre med, I can be pre med, too. Long story short, it made a competition between each of us. And the brainiacs in the class couldn’t handle it, because we’d go into class and got to, a point where we talk to each other and say, did you study for the test? I didn’t know there was a test. So it was always messing with their minds. And, he went off to be a heart surgeon. He’s now a heart surgeon in Beaumont, Texas. A great friend, good guy. And so just very enjoyable person. And so, getting through college, it’s all about, I use the sports analogy, fourth quarter, two minutes. Because when you’re tired, you don’t want to study. Gotta, gotta get it going. Gotta get it get together. It’s all about the grades. It’s all about the Medcat. It’s all about your interviews. It’s everything. So I was doing everything I could. first off, want to see if I can handle it. So I got a job in the local hospital for all four years in physical therapy. And that allowed me to go everywhere, because we could do everywhere, because we might have patients in the ICU, CCU, different places. So it was a great experience for me to see that I could handle everything. So went to medical school in Fort Worth, Texas, College of Osteopathic Medicine. And it was really neat, because not only do you learn the same things American Medical association, we learn manipulation, chiropractic stuff. So for two years of that, in association with the other classes, in addition, we did the manipulation. So I got very good at it. I thoroughly enjoy it, use it today. And it’s a very, nice thing to have in your, as your armamentarium then. Anyway, after medical school, I wasn’t sure what I want to do. I did a transitional internship, which is six months of medicine, six months of surgery. And the only thing I really didn’t like was pediatrics. but I liked everything else. So later on, when I finished my m internship, I wasn’t sure what I want to do. So I worked in a local, one of these urgent care centers. I was the youngest medical director they ever had and had a really good time. I moonlight ers and the small ers, because back then, in the state of Texas, you could work with a one year internship. Now you can, but back then, you could. So, anyway, a friend of mine, went to med school. He called me, said, john, you got to come check this out. So I flew out to Lubbock. They have an international, famous pain program. And I met the chairman, spent the day with the chairman. He said, john, you need to come. So, hence, I was in

Dr. John Scott: Lubbock doing an anesthesia residency and then a pain fellowship. I thoroughly enjoyed myself, and then at the time, there weren’t very many jobs available for anesthesiologists. It’s kind of switched now. But then I went and did a cardiac anesthesia fellowship in New Orleans at Oxner, and it was extremely impressive in the sense that they did everything. Transplants, thoraco, abdominal aneurysms, you name it. Liver transplants was very, very neat, very enjoyable. Then I always wanted to live in Dallas. I went back, and at the time, like I said, not many jobs.

I got a job at Ut southwestern. It was a level one trauma center

So I got a job at Ut southwestern. Had a great time, great experience. It was a level one trauma center, and I thoroughly, thoroughly enjoyed myself. They sent me everywhere. I did everything. I just had a really good time. I got to work with the residents of. And see, I took over the neuro department since, the neuro guy left. So I ran it, and they always gave me a junior residence. And the other room I had was usually a beginner. So you’re kind of running back and forth. But like I said, I had a great time then. I always wanted to live out in a place called grapevine, Texas. I kept driving out there. I talked to the chief of the anesthesia department, and I was able to get a job out there. I took over the pain program, did pain for 15 years, and then, just kind of got razor burned out on it because I really felt like it could help one in ten. The rest was narcotics and other kind of medication, and. But I really was, you know, I just, when people would come to you, you could feel them give your, their pain to you, and I just have to give it back and say, listen, I’ll do everything I can, but I didn’t have any permanent cures, so I did try everything I could. So over time, it just kind of got burned down and went strictly to the operating room, and then, at the same time, got heavily, heavily involved in the society, Texas Society of Anesthesiology, American Society of Anesthesiology, and the Texas Medical association. So I, first off, I just went to the meetings, and then after a while, I said, well, I’d like to do something. So I got, eventually got on every single committee there was in the TSA, and their annual meetings or once a year. And so you have intermittent meetings and then the American Society of anesthesiologists, real great pleasure to go to where they have the national meetings. That’s 50,000 people coming to those things. And so, I’ve had a really good time, both in the leadership aspect, in the didactic aspect, the clinical aspect, the private practice aspect. So I’ve got a wide array of experience and knowledge, and I really enjoy trying to share that knowledge. It’s your society or our society, and it’s either you get involved or you’re going to lose it. There’s always going to be competition out there.

You worked in a university and then in private practice

Addisyn Uehling: So you mentioned that you worked in a university, and you also worked, like, private practice. what did you prefer, and kind of why did you choose to go with either of them?

Dr. John Scott: All right. When I first got finished, I went to a university, and I thoroughly, thoroughly enjoyed myself. It was kind of the wild, wild west. It’s a level one trauma center. What that means is everything comes in there that’s major. Gunshots, car wrecks, all of it. And they have a 95% success rate. If you come in there at all alive, you’re gonna leave, you’re gonna live. And so it was a great opportunity to see a wide array of man’s inhumanity to man, man’s inhumanity to self, you know, those kind of things, and see all the different dynamics, because it was a huge place. All the different dynamics of the different, residents, staff, faculty, you name it. I thoroughly, thoroughly enjoyed myself, so I could see myself staying there, a whole career, and I really wanted to be like a chairman. I’ve done two fellowships, so that was kind of one of my goals. But the lure of private practice kept calling me, that is, it pays a lot more. I hate to say it that way, but that’s honest truth. It just pays so much more than at the university. And then, also, where I was living, I was living in an apartment. I was able to buy a house where I wanted to live, and it was just a great, great opportunity to move out there. And I turned it down the first time, and they said, either you take this one or we’re not calling you back. So I had to take it. And this is where I’ve been from the past 25 years. I’ve thoroughly enjoyed it. It’s, what it is. In private practice, you did your own cases. So I did my own cases for 25 years. And then in a residency program, you’re overseeing the residents, and you’re either from beginners all the way to seniors. You know, you’re trying not to get in the way. If it’s a senior and if it’s a first year, you have to do, practically do the case yourself.

Dr. John Scott: So then you, in the private practice world, you have to learn to get along with the staff and the surgeons. You know, surgeons can be very, word for it is very,

Dr. John Scott: demanding. That’s the word I’m going to stay with today, demanding. And so you got to try and figure out their personalities and try and make everybody happy. And anesthesiologists, we’re kind of, we’re the ones there that do all the cases no matter what. And our job is trying to make sure the patients are safe and ready for surgery. And so, there’s both an art and science, and anesthesiology definitely does that. Science is the drugs, the medicine we use, monitoring a patient and the artist, dealing with your faculty, other colleagues, your staff, and just trying to get along. It’s very interesting.

What tips and tricks did you use when going through your residency fellowship and attending

Addisyn Uehling: what tips and tricks did you kind of use when you were going through your residency fellowship and newly attending that really helped you and that you would want to share with the audience today?

Dr. John Scott: Oh, very good. I get it. Now. Go back over. What are the things that helped me get through residency and then in private practice? It’s all about mentors. Finding someone that believes in you when you don’t believe in yourself because you know, you’re thrown into something you’ve never done before. As you know, I’m a physician. I did an internship. You know, I’ve gone to medical school, passed the, med exam, so I’m a physician. But now you’re starting something that’s brand new. It’s a residency, and it’s hard to gain that experience without ever being in it. So the people that make you help you get through it are your mentors, the people that come in the room and are supportive in one of the things you learn in life. And I really want everybody to understand this. There are going to be detractors, people that don’t want you to succeed. They don’t like the way you look or the talk or whatever. And it’s your job to work through it, because in life is competition. In life, they’re going to people, no matter what, don’t like you. So it’s your job to read motivational books, pray, get involved, you know, talk it out, have someone that you can lean on. And I had that. I had a real good friend of mine went to elementary, school through medical school, residencies and things like that. He was always there to kind of vent and to talk things over. So one of the most important things is to have mentors, have friends that understand what you’re going through. They don’t have to be an anesthesiology resident or an Ob GYN resident. Whatever you’re going through, it’s just someone that is in the medical field that can understand how difficult at times it is, because it is a lot of hours, it’s a lot of pressure. But the reason why it’s there is there’s lives at hand. You got to be able to handle things. One, that. One of our famous quotes we use is when seconds count, everything’s great, when everything is normal and there’s not any problems, but when there is an event or a, problem that occurs, you got seconds to figure it out. If not, it can cause irreversible harm to a patient. So it’s, you got to be on your best game at all times. And there’s demands. You know, we put in 8100 hours, weeks. So to get through these things, you have to have a faith. You have to have a belief in yourself. And what I really want to emphasize, knowledge is power. Keep reading, keep studying, keep asking questions. Go and find someone to talk things over with. I sought out the mentor later on in my career, the mentor sought me out, and I was lucky to have that. I got involved with the tech side of anesthesiology, and two mentors of mine, Doctor Tillman Hine, and then doctor David Gloim. They believed in me, and they said, john, you want to give your chance? And they did. And I’ve been able to rise up the leadership of the society and all the societies because of that. So if I can’t leave you with anything, is to read motivational books. Two, stay in contact with close friends, and when you’re having a bad day, talk about it. Three, is mentors in your department someone that you can tell things to and I’ll never go anywhere else?

Addisyn Uehling: Yeah, absolutely. community is such an important aspect in, every part of your life. And just having that person who is. Is in that same position or who has been recently and who can connect really on that level, to be able to help you through whatever, you’re going through is incredibly important. So thank you for sharing that. how do you feel like you kept community besides mentors? you mentioned that club that you were in, or that society. Kind of share more about that.

Dr. John Scott: Oh, I’d love to. Thank you. Thank you for bringing that up. I have been so involved. I put on 114 receptions in my career and 15 year career doing this. So I’ve given receptions for us senators, congressmen, congresswomen, Texas, governor, lieutenant governor, attorney general, representative senators, and, local city councilmen and mayor. So I’ve been involved heavily, and through that, you know, you. One of the famous sayings is

Dr. John Scott: act globally. No, I’m sorry. Let me think. Think globally, but act locally. And that’s very true. So I got involved in the campaigns. There’s six city council members. I helped all six get elected. It’s in your backyard. So through this thing, I’ve been appointed to Texas medical board district review committee. I was on it for seven years. Governor appointed. Then I was appointed by the governor to the, physician assistant board. I was on it for two years, but at the same time, I got appointed to the University of North Texas Board of Regents. And I’m the second physician that’s ever been on the board of regents. So that’s a big, accomplishment in my career. One of the things that really is one of my highlights is because you went to medical school, and then you get to serve on the board, overseeing everything. You see them all. University of North Texas has four campuses, one in Denton, one in Dallas, one in Frisco. And the health science center is. That’s where I went to medical school. So it’s a very big honor to oversee all of it, especially. There’s nine of us on the board. Eight are business people. One is a physician. So when they bring up the physician questions, that’s where I’m all about it.

Working with residents from the beginning to the seniors, fellows, all of it

Addisyn Uehling: Kind of going back to the, your newly attending position, kind of what were some of the biggest challenges you faced during that time?

Dr. John Scott: All right, let’s start with ut southwestern. So you go there, and from day one, you kind of look odd. Okay, who is this guy? What’s he doing? Does he know what he’s talking about? Is he trained? Is he not trained? So, in a very short period of time, they either put you as good or bad, and it’s just how you handle yourself. You got to stay cool and calm at all times. you got to try and be polite to everyone, try not to make anyone mad. And it is. It was a zoo. I mean, it’s just. It’s. It was a very dysfunctional place to work, but the dysfunction makes it, made it function. I thoroughly enjoyed it all. So, in a short period of time, I got the title, of a superstar because I had a license that’s unrestricted. I could go anywhere. And I enjoyed it. I thoroughly enjoyed it. Seeing the variety of cases, the variety of things, working with residents from the beginning to the seniors, the fellows, all of it. they, put me over in the pain clinic, and I started running the pain clinic and over at Zelda street, which is another hospital, and I had three fellows under me. Okay? So I got us involved in the anatomy lab. We started doing anatomy again just to kind of go over where the nerves are all what we’re doing, and then come back another day. You’re working with a freshman? First year resident. So it was a wide ride. I took over the neurodepartment. So you’re working on brain tumors and all the different things. And then there was a guy, a very famous surgeon that was there at the time, became good friends with him because it was just so different. So different. And, we had, monthly, what is known as m and m morbidity, mortality. You know, you had lectures, you had, different things. I would get with residents. They would come to me. I would. I was on this Osler oral board, company, and we would go around and teach oral boards, help student, residents get ready for that. And so I would do practical oral boards for people all the time. So. And when I went into an or on a daily basis, depending on your level, if you’re a first year, I’m lecturing to you. If you’re a senior, you’re lecturing to me. And if you’re not lecturing, I’m asking questions. And so it’s, when you saw me coming, it’s either one way or the other. You’re going to get, you’re giving me a lecture, I’m asking questions, and I would get down to m biomechanical, biomolecular level, like me out the pathway, for making, tommenate or something like some crazy like that. But I really enjoyed that. And so one of the things that I’ve learned over the years is I’m kind of segueing into that is burnout, suicide, depression. It happens in all specialties. But I really took a deep dive and started giving lectures on this throughout the country, and I did it in colleges, med school residents, and in private practice as well. So I’ve thoroughly enjoyed that aspect of it. Yeah.

You gave a lecture on stress, depression and suicide among medical students

Addisyn Uehling: so can you give us just like a short intro into those speeches that you gave on that burnout, that depression, suicide, because that is so high and that’s such a big problem for, medical students.

Dr. John Scott: Well, thank you. Yes. The number one thing to know is you’re not alone. You’re not the only one that’s going to have problems. You’re not the only one that’s going to have issues. And in our atmosphere, environment, there’s a lot of finger pointing and a lot of things like, I would have never done that.

Dr. John Scott: You know, it’s trying to. If I can step on you, then you can’t be looking at me. And you have to learn, you got to grow a tougher outer skin, number one. But number two is you’ve got to know that there’s help out there. And the medical society has gotten better on that. when events occur, they look at it, and the first thing they try and determine is start, is they start with, it wasn’t your fault. And then they work backwards, and then they determine what happened and why. You know, we’re working. We’re doing cases that weren’t ever done before 50 years ago on, sicker and sicker and sicker patients. The population’s getting older, and the young are getting younger with more and more pathology. So it’s a risk is gonna happen. Doing anesthesia on somebody like you should be a walk in the park unless you have some problem we didn’t know about. But really, overall, that would be it. So then it started delving into it. Okay, alcohol and drugs, you know, you kind of. And it starts in college, it starts in medical school, you know, the pressure of school, and you kind of turn to alcohol and drugs. You don’t feel like you have somebody backing you, and you start delving together. You get depressed because you didn’t do well on this test, and you start getting in what’s known as quicksand. You delve on the past more than what you do on the present and the future. You’re going to have things happen your whole career. Where do you do with it? There’s no famous saying that it’s not how hard you can hit, it’s how hard you can take a hit and keep on going. That was Sylvester Stallone is rocking one of his movies, but it’s words to live by. And then suicide is not alone. The important thing is to recognize your colleagues and get help. Texas medical board now does not suspend you or do a, reprimand if you self report saying, hey, I’m depressed, I need help. They’re not allowed to do that anymore. And so what can make or break you in your career is if you get reported to medical board or you get a suspension or you get a reprimand from the national databank or any of those things. So now they’ve taken that out. They do understand now that medicine is demanding. It can cause you to have problems, and we have to take care of our best. We have to be always on our a game. We’re not always there. You know, life gets in the way. Marriage, divorces, sick kids, six family, whatever, and it’s gotta have some help doing that. And I gave a lecture, just sidebar. I gave a lecture on stress, burnout, suicide to all the police chiefs in Dallas Fort Worth. And so I did a deep dive into what the police do. They’re way, way above, medicine because their patients, their people shoot back at them. Well, my patients don’t shoot back at me. So they have so much more than what we have. They have apps on their phone. They can get ahold of somebody 24/7 they have so many different things. So when I gave the lecture, I first started by apologizing, saying I thought I came here to teach you, but instead you’re teaching me. So it was very enjoyable. But, when I finished the lecture, they started asking each other questions, and I felt like, well, maybe I should sit down. But it was kind of interesting. But,

Dr. John Scott: Getting back to our thing is, no matter what profession you’re in, you’re always going to have issues and problems. And when you’re in private practice, you could work 8100 hours, weeks. You’re doing cases when you’re tired. And things happen. Things happen to good people as well as bad people. And we got to be able to take care of it, and we got to be believing in ourselves. And that’s why I really recommend counseling. having a mentor, having friends. So I have all of it. I really think it’s very important. Most important thing. I want you to remember, you’re not alone. Two is, you’re going to have detractors. And three, get help your whole career. You’re entitled. You’re taking care of patients. Why can’t you be taken care of? Get a psychologist, get a counselor.

Addisyn Uehling: Yeah. Such good advice that you just shared.

Anesthesiologist says patient care should be your number one focus in medicine

Do you have one last, like, great story that you kind of want to leave us with?

Dr. John Scott: yeah, I gotta have a lot. What I felt like is going back is I’ve thoroughly, thoroughly enjoyed taking care of m patients over the years, both in the pain clinic as well as anesthesia. That’s. That’s what it’s all about, is taking care of these people.

Dr. John Scott: And they’re so grateful, you know, as an anesthesiologist, you only meet for a minute or two, and you have to go report. You have to make them feel safe. You have to make them feel that you’re going to do a good job. And this is where the art and science come in. I go in there and I shake, hands and sit down by that. just sitting down lets people know that you’re not in a hurry. They want to know. They count. So

Dr. John Scott: stop for a second and sit down. Hold hands, look them in the eye. When I go into a room, I shake hands with everybody in that room. Who are you? How do I, you know, so and so, all those kind of things. So I recommend that have a personal touch to your career. And two is, you know, I’ve been doing this a long time and being involved politically. Really, it’s your specialty to lose. Advocacy should be your number one thing. Get involved. If not, you can be replaced. everybody’s going to want to do your job. Finally, practitioners. You got nurse practitioners, anesthesiologist. We got certified registered nurse, necessitator, and surgeon. Someday could be a physician assistant doing the case. So we’re always going to have competition. It’s what you do about it. So that’s why you got to get involved. And a long time ago, it wasn’t, didn’t, it didn’t mean as much. Just doing a good case. Quality is given m. It is expected. It’s no longer assumed. It is expected of you. So when you walk into it, you’re supposed to be doing your best. So that’s why I always want to say, patient care is number one focus. Whenever you’re getting someone administration or someone’s coming on you and you have something, patient care. Patient care should be your number one focus. And sometimes it’s the money, the cost. The case was too long or too slow or getting turned over. And if your answer is the patient wasn’t ready or patient care, whose issues they can’t get you for that. The other thing is, you always want to keep reading, keep studying, keep going to conferences, talk things over with colleagues. If something bad happens, which inevitably, it does in medicine, you got to have somebody to talk to. That’s why you got to have mentors and friends to get through things with. And the thing I want to leave you with is stay involved. I’m, heavily involved. But it doesn’t mean any longer. Just do a good job and go home, because the competition is going to try and take your place, your job. It took me 14 years to get here. Don’t give it away.

Addisyn Uehling: Yeah, absolutely. Thank m you so much for joining us today and for sharing all about your career and your background.

Dr. John Scott: Oh, I’ve enjoyed it. You have? It’s been enjoyable. I look forward to doing more.

Unscripted takes a deeper look into what it is to be a resident

Addisyn Uehling: I’d like to thank Doctor John Scott for joining us today as we took a deeper look into what it is to be a resident and to work in private practice. I hope our conversation has shed some light on advice on the medical field and has given you tools to utilize in your medical career. Stay tuned for more discussions on important topics in the medical field. And one way to do that is to like and subscribe so you’ll never miss an episode. I’m your host, Addisyn Uehling, and we’ll see you next time on unscripted.