Arpita: Hi everybody. Welcome to Doctors Living Deliberately. We are excited to have you with us today. Hi Michael. How you doing?

Michael: Hey, Arpita, doing great.

Arpita: Good. So I am excited today to welcome our guest, her name is Dr. Katrina Skinner. She is an independent practice pediatrician and the past president of the Alabama Chapter of the AAP. She's also the founder of Women in Pediatrics, which is an organization that supports the personal and professional needs of female pediatricians. Dr. Skinner is an advocate for women pediatricians on their entrepreneurial journeys and helps them grow advanced level practice management skills. So I have had the pleasure of meeting Dr. Skinner myself attending one of her conferences and actually had the honor of speaking at one of her conferences and doing a couple workshops. And it was really, truly a joy to do it. So much fun. And I just thought that she would be an excellent guest to kind of tell everybody a little bit about how she has created the life she has for herself. So welcome Dr. Skinner.

Katrina: Thank you. Thank you both so much for having me here.

Arpita: Yeah, well, I think I'll have you start by just, I, I gave a little snippet always, but I think you do yourself the best justice with regards to telling people about yourselves. So can you do that? Please tell 'em a little bit about who you are and how you have created what you have for yourself.

Katrina: Sure. Well, I am an Alabama native, which some people can pick up right away with my accent and some people can't, so who knows what you'll think. Born and raised in South Alabama near the beach. I always knew I wanted to practice in my hometown, and so that's what I did after I finished residency. In fact, six weeks after I finished residency, we opened our doors and saw our first patient. So that was a bit crazy during my third year of residency, laying the groundwork for a practice. Actually building a building and doing all of that so that we could be ready to see patients right away. And people think, you know, oh, you must have, you know, had other doctors in your family or you must have had you know, your family had money, but none of those things was true. And so, you know, I had basically just had to keep asking until I found someone who could support me. You know, in other words, a bank who would loan me a lot of money to fulfill my vision. And so that kind of just set the tone for the way I viewed my practice in life, making sure that, you know, if I wanted something, I knew that I had to ask for it and go after it. And so that's one of the things that I weave into women in pediatrics as well, is encouraging women to ask for something that they want. Because if you don't ask the answer as always no. And one of, one of the things that I think is important is, you know, making sure that we do, you know, give ourselves the opportunity to ask for those things so that we can realize our dreams and goals. 

Michael: That's incredible because I think, you know, certainly for women, but I think for all physicians, there's almost an aspect for all of us where we think we need to ask permission and you know, what comes to mind is like, how dare you think that you can just go and start your own practice just right out of residency? And I never imagined that that was ever even a possibility for me. How did you kind of have the vision to just know what you wanted and just go right after it while you were still in residency?

Katrina: Well, like I said, I wanted to practice in my hometown. I really, I wouldn't consider any other option. You know, even a town a few miles away wouldn't be an option for me. I was just very dead set on that and I always thought I was gonna join the practice that was already in town. You know, the practice where I had been a patient when I was a kid. The practice that was well established, well known in the community. And you know, we had kind of talked about it. They had indicated that, you know, that was a possibility that I would join their practice. And then when it came time, the timing just wasn't right for them. They had added a new partner a few years ago. They had grown to the point where they really didn't have any physical space to add someone else. And so it just, to me it was like, well, the only other option is that I have to just do this myself. And so my dad is an entrepreneur. You know, I've, I had always watched him grow his business, run his business. So to me it wasn't scary. It was just what you did. You know, you owned your own business. You called your own shots, you made your own schedule. And so I guess I wasn't as intimidated by it maybe as I should have been. I didn't realize all the different things that could have gone wrong. You know, a lot of it was that I was very young. I was still in my twenties when I went through all of this. So, looking back now, you know, with that wisdom that we have, that comes with time, I realize all the things that could have gone wrong, but I guess you know, I jumped in and, and we just went forward. I had a great team who supported me and helped me get through that initial phase of starting the practice and getting the doors open. So,

Arpita: When you were saying telling, explain your story I was thinking, oh my gosh, my senior year of residency, I was just ready to like, finish. I can't even imagine putting that on the plate and, you know, building a building and starting a practice from scratch so that fear, honestly, you mentioned fear and I'm like, I'm already feeling the fear, like, oh my gosh, how do we do that while we're still actually learning? Right. Because that in and of itself was such a more than a full-time job. So can you think back to that, like you mentioned a little bit of fear, but how did you overcome that adversity? Right? Because all of this was optional to have to do this. You did have the potential to join the practice. They said no. I guess what made you overcome that fear? Was it the fact that I'm gonna do whatever I need to do to stay in my hometown, or was it more something else?

Katrina: I don't know. I guess I saw it as the only option. You know, it was like, okay, well this is just what, what I have to do because I'm going to practice here. The other option isn't an option anymore, so this is it. This is the path. And you know, looking back it was I guess, you know, when we're faced with a challenge like that and we put our mind to it, you know, we just, we power through and residency is not an easy time of life. I mean, you, you both know, you remember what it was like when you're working long hours and long shifts and you're on call. And on top of that, I was driving, I was commuting 50 minutes one way to residency, which is crazy, you know? So I had that added level of stress. And without going into a ton of details about it, I really did not have a very good residency experience. I did not feel like I meshed well with my program. And so I had that added layer of stress where it was to the point where I even considered changing programs my last year. So on top of all that, now I'm building a building. You know, that's in my hometown, which is 50 minutes away from my residency program. So I would go work, you know, a 10 or 12 hour shift, drive home, it's pitch black outside, but I wanna go check on the construction progress. So I'm out there with my flashlight trying to see what they've done that day. And you know, and trying to, you know, I'm at work at residency, having calls from contractors and architects and all of that, trying to manage that while I'm also trying to do my duty as a resident and not have people mad at me because they think I'm trying to work two jobs at once, you know, I mean it was stressful.

Arpita: Yeah, it was stressful. And that also shows the adversity that you were opting into taking on and were able to work through it. Right? That how, I mean, resilience is a plus and minus word here, but how resilient you were despite all the other challenges that you were coming up with or having to face during this time. So, And I, I wonder if that also is what kind of drove you to do what you're doing now. Like talk a little bit about what you've created since then. I mean, it's an amazing practice. You've grown, like you said, you've added physician partners but that wasn't enough, right? So tell us what else you've done.

Katrina: Well, one of the things I came to realize is you know, as physicians we've gone through a lot of short-term goals. We have high school graduation, college graduation, medical school residency, maybe fellowship. So there's a lot of short-term goals that we get to accomplish. And then you get to practice and it's like, okay, well what's the next goal? You know, it's retirement. And when I realized that I had this big sense of just panic and overwhelm, and so I went to a mentor who had a very successful practice and he was on the other end of his career. And I liked the setup of his practice where he owned the practice and he had a lot of employed physicians working for him and that resonated with me because I couldn't imagine sharing what I had built with someone else. You know, I had put all of my hard work into this and I couldn't imagine just like, handing half of that over to someone else. And so I thought, okay, I like this idea of setting it up where I can own it. I can create a space where people want to come and work for me. And so I asked him, I said, you know, like, what's the secret? Tell me the formula. Give me some business principles to guide me. How do I do this? And he said, well, it's really simple. Every year just do more of what you love and less of what you don't. And I was a little perturbed at first. I was like, hold on, no, I called you because I need to know, like a spreadsheet, a formula, some, you know, business principle. And he's like, no, it's simpler than that. Just every year do more of what you love and less of what you don't. And so I took that to heart and that's how I started to run my business and, and my personal life. And so, that has helped me to grow the practice and set goals, continue to set goals like I had in my younger years. So you know, setting a goal for being on call less or working fewer Saturdays, or not attending deliveries in the nursery anymore, or not attending inpatients. So being able to set those goals even though they may not be something like graduating or finishing residency, you can still create those goals for yourself to keep you motivated.

And that was the same thing with women in pediatrics. When I realized that I had gotten my practice to the point where it was very self-sufficient, it was very well run. I realized that I needed something else. I needed another goal. And so that's where women in pediatrics came from because personally, I was looking for education that was tailored to female physician entrepreneurs, and I really wasn't finding it. And so I realized that if I was having to go outside of the traditional medical education space for this content, other women were too. And so I just decided, let's make it easy. Not everyone needs to do all of this legwork. If we could put it all in one place, then other people could come together and share from this information that I've, you know, spent all this time looking for, for myself. 

Michael: yeah, so, you know, I think it's interesting also because you're talking about how we have all of these goals as physicians that are relatively, you know, achievable. Right? So we very frequently said the hardest part about becoming a doctor is kind of getting into medical school. And then once you're in medical school, kind of the path is laid out in front of you and you just get to the next finish line. And you're right. When we finish, kind of the next step is retirement, right? You become a a newly minted physician, and then, okay, now I just have to do the same thing every day until retirement. And that's kind of the next goal that's in front of us, and it's my belief that that is a huge kind of cause of what is going on with with burnout and moral injury is that we are not setting real-time goals for what we want our lives to look like. And when I think back on my own kind of journey and what my life has looked like, I never thought I could be an entrepreneur. Right? I never thought that that was an option for me because I am a doctor and that's all I'll ever be. And when I committed to entrepreneurship, my life became so much more fulfilling. I started kind of filling my cup in ways that had not previously existed, but I first had to believe that that was a possibility for me, that I could do something like that. And so when you are speaking to women physicians, and they may be coming into your sphere with a very similar belief about themselves, like I'm a doctor and this is what my life looks like now. How do you go about kind of letting them see that really the degree kind of opens doors. It doesn't close them.

Katrina: I think the first thing is something that you said a little earlier and that's giving yourself permission. And that's one thing that I've tried to start incorporating into all of our meetings is to actually say it out loud at the beginning of the event that you have permission not to follow whatever the expected standard is that you feel like has been set for you. You have permission, you know, at at a retreat where we just had in Puerto Rico, you have permission not to attend every single session. You have permission to choose to sit on a lounge chair by the beach instead of show up to class. You know, really saying that out loud is the first thing. So I think that that is important. And then the other thing is to understand that having this ability that we have, you know, as physicians that can be used as a tool for us to do other things. Yes, taking care of patients is one way that we can do good things, but it also opens the door for us to do so many other things. 

And one of the ways that I look at it in my practice is that I'm not the only person who can take care of patients in my practice, but I am the only one who can act as the visionary in my practice. You know, because no one else has the, the drive and the desire to do that. And so, I live by the principle that we should all be you know, acting at the top of our license. Well, my license as the owner and the entrepreneur in the practice is to be the visionary. So yes, I may spend some of my time seeing patients, but really that's not at the top of my license. And so I have other people who, for whom that is the top of their license in my organization. And so, you know, I need to make sure that I do have enough time dedicated to doing whatever it is that is the top of my license or, you know, is casting the vision for my business. And so I think that, you know, giving people permission to realize that the top of their license may actually be beyond performing physician duties, that it's okay to have something more than that or bigger than that.

Arpita: Right. One of my favorite quotes is, somebody said to me, you can't be the visionary and the worker bee. Right? You can't do both. And so to be able to recognize what is our visionary level skillset, what are we capable of? And that might be actually more than being a physician, right? Because we put so much weight on the fact that we went to school and we, we earned this degree and were able to take care of other people and save people's lives, and that is very, very impressive. And we can do other things too that builds empires in a sense of what we can offer to others. So I think that's really impactful what you said. And you can't be the visionary and the worker bee so you have to figure out what your skillset is most maximized with. 

Michael: That's an excellent example of yes and right, which I think is so important in this discussion. Yes, you are a physician and there's so many more opportunities for you in this life, right? And all of the skills that we learn as physicians in both clinical practice and also in leadership and in kind of working with others and community. You can take all of those skills and you can parlay them into whatever you want and however you want it.

Arpita: I wanted to touch on one thing, cuz you mentioned that, you know, there were so many things that you had to realize you had to overcome to figure out what you wanted to do and what you wanted to let go of, when you said, pick the thing that you enjoy and then let go of the rest. So if you thought back to your own experience, do you remember what was the most painful thing that you had to let go of and, and how did you accomplish that?

Katrina: So when you say painful to let go of as in like, what did I enjoy the least that I got rid of? Or what was the hardest to let go of?

Arpita: What did you enjoy the least? Yes. 

Katrina: Probably attending deliveries and rounding in the nursery was my least favorite, but it was also really nice when I was able to get some help being on call.

Arpita: Yeah. And then how, like you mentioned, what was the hardest for you to give up? Like, am I gonna be able to do this and still do what I want?

Katrina: Hmm, I don't know that I've had one of those yet.

Arpita: Okay. Even giving away power in your practice.

Katrina: that, maybe that was about to say that. We have worked, we have worked really hard to build our leadership team over the last couple of years and we have incorporated goal setting there as well. So we set quarterly goals. And we roll those out to all the different departments in the practice and our leadership team takes ownership of those to execute those quarterly goals. And we incorporate everybody in the office as part of those projects and it's really has gone really well and I have found that, you know, yes, I am the visionary, but I'm not the project manager of every single project. And if I want to be able to grow leaders within my practice, then I have to be able to delegate things effectively. Because until I can do that, I will not have leaders in my practice who can support me. So that's been one of the things that we've really been working on the last couple of years. And I'm, I'm very pleased with how things have turned out with us focusing on that.

Arpita: Yeah. What would you say to, and I know you probably talk about this at your conferences as well as some of the initiatives that you have coming out, but for somebody for, if you're talking to a female pediatrician or male pediatrician and they are working and really are wanting to make a change, where would you tell them to start? How do they get to a place where they recognize they wanna do something different, but don't know what to do next?

Katrina: So I like to start with just kind of dumping everything out of my brain. I sit down with a pen in a piece of paper or I open a blank doc on my computer and I just start writing and I envision myself, you know, 5, 10, 20 years down the road. And I just write down as many details as I can think of. And then I start working backwards from there. And I start with picking out which things would make me happier. From where I am now, and then you know, I, I see which things do I need to emphasize work on, which things are most important, which would be the next steps to get me toward there. Either for things that I need to do or things that I need to stop doing. And that's kind of a simplified approach, but that's what I do. And in fact, it's something that I, I do personally, not just for my business, which I mentioned are quarterly goals, but I also do it for myself personally, once a quarter.

Michael: And I imagine that that makes it a little bit easier to kind of even let go of some of the things that you enjoy doing as you are building the life that you want to see in 10, 15, 20 years. Because it's hard, right? It's hard when you have spent so much time, effort, and energy building something that you are proud of and that you love, but you also, as we were discussing earlier, want to keep setting bigger goals for yourself, and so when you can lay out the plan in front of you as you're setting up the leadership team for your practice and figuring out, okay, this is my vision and I'm going to allow these other people to help me enact it, it makes it a little bit easier to let those things go even, even though it's hard, right? Even though it's uncomfortable because you are enacting kind of the next step of your vision. Is that right?

Katrina: Yeah, that, that is true. But then of course, as you can imagine, it also, the more people you bring in, the more complicated it can become as well because you're dealing with more personalities. You are there's, I would say more problem solving that can be involved in that. A lot of physicians may have this tendency, they behave like a lone wolf. You know, medical school residency can be a bit competitive. And so we learn, especially as women we learn to you know, rely just on ourselves. You know, we have to take care of ourselves. We have to learn to kind of be a little bit on the defensive. And so a lot of people, a lot of physicians that I've seen tend to, you know, exist in a silo a bit. We tend to be alone, lone wolves where we may not let people in easily. And so it can be difficult to overcome that, to learn to collaborate with others, share a little bit. You know, we work really hard to get to where we are, and so when we start sharing that responsibility with other people, it's like saying, okay, I am sharing all of this hard work. You know, all of these things that I accomplished. I'm sharing that with someone else, and now you are, you know, I'm letting you be somewhat responsible for everything that I did to get to where I am. And so the more people you bring in, the more that you know, you're expanding that liability or that vulnerability, and so that can make it a little bit tricky.

Arpita: That's so on point. When I think back to when I started, honestly, the coaching journey even, it was very much so you're a lone person on an island, trying to make sure that nobody compromises any piece of it, you know, with us, even also with the practice management and ownership and just every area, every aspect of your life, because that's kind of something that's ingrained in us. We don't even realize it while we're in training, right? Having to succeed and be the best, and what I recognize with the coaching is just having this tribe of women, right? We all want the same thing. We all want the support and the camaraderie and just the love of each other to help lift each other up. And part of it is just realizing that we've created this island ourselves, and we don't have to stay on that island, right? We can have this group of individuals who we want to allow in. Some people are gonna be your people, others are not. You get to decide who you wanna bring in, but that requires us to be vulnerable, to say, yeah, you know what? I wanna be your friend. Will you be my friend? Let's see how this works out. But it makes you never want to go back cuz you do realize that you've got this tribe now that will support you no matter what.

Katrina: Yeah, so true.

Arpita: So I think that's a great lead in actually to talk about what you're creating with women in Peds and the practice pediatric, C E O intensive that you're starting. Tell us a little bit about that and what your goals are with that.

Katrina: Sure. So pediatric, CEO Intensive is an event that's coming up in November in Charlotte, North Carolina, and that was something I created just because it was something I wanted. I felt like from all of the practice management conferences that I've attended, that they, you know, they meet the needs of a kind of an introductory or basic level, but it's a lot of repetition if you've been multiple times. And I always would leave feeling like, okay, I need the next level, or I, you know, when, when are the advanced level classes coming for those of us who have, you know, kind of been coming to this for a long time or we've mastered these basic things in our practices. And so I just decided you know, maybe I need to create it. If it doesn't exist, then I could create it. Because again, just like when I started, women in peds, if I'm out here looking for this content, surely other physicians are looking for this content. And so I thought about it for a couple of years and then finally just decided I was gonna go for it. And that's how pediatric CEO intensive was born. We wanted to make it kind of a packed weekend, hence the name intensive. So it's not a retreat like women in pediatrics where we have time to go lay on the beach and have, you know, a lot of relaxation. So this will be jam-packed. We are doing a workshop with a national leader from entrepreneurial operating system, which I'm excited about. I don't know that anyone from that organization has ever interacted with the pediatric community before. We're doing a 90 minute MBA crash course, which I'm excited for. Bonnie Koo who does wealth Money mindset for female physicians is coming. So I'm really excited about the content that we have lined up because I feel like it's different and fresh from other pediatric practice management conferences.

Arpita: That sounds amazing. I'm doing my best. I'm hoping to be able to join there. And is that open, like, is it geared solely for pediatricians or could be, could it be applicable to other specialties?

Katrina: That's a great question. So we're marketing it to pediatricians just because that's who we know, but I truly think that the content could apply to any type of physician. I also think, you know, any CEO level or C-suite level executive would probably benefit from this content. So I think someone who sees themself as the visionary in a business would be the one that it really is targeted to. So some people have been asking, should my practice manager come? And I would say only if you think that person has visionary skills in your practice. Otherwise, I think the physician owner and physician partners are probably the best match.

Arpita: Wonderful. Tell us a little bit about women in Peds. How did this baby start for you and grow now immensely.

Katrina: Yeah, so the idea was born right before the pandemic and then got derailed when the pandemic started. We were able to have a virtual conference that first fall of the pandemic, and since then it has grown into an in-person retreat where we focus on personal development, self-leadership, a little bit of practice management, and really just relationship building. So helping women realize that they do have a tribe and they have other women who will support them, who understand what they're going through, who have got their backs. So, you know, I've seen so many people just make new friends, build relationships. And then also just invest in themselves, because I don't have to tell you all this, but you know, women put themselves last on the list of priorities. And so giving women a space and permission to invest in themselves and take care of themselves for, you know, a long weekend has, has been really meaningful seeing that happen. So we've got an event coming up in March of 2024. It's at the gorgeous Hyatt Regency Grand Reserve in Puerto Rico. And I think we have three full days and then the Wednesday and Sunday bookends will be half day content, so I'm excited. Right now, we are in this stage of looking for speakers, so we have a speaker portal up for people who want to nominate themselves or someone else as a speaker or a topic.

Arpita: And it's an amazing conference having done that, I say conference, but it's really a retreat where we get to bond and meet other women pediatricians and really enjoy each other's company. And I will say that is the first conference I've ever been to where I did a talk or my workshop in my bathing suit. So that's what we're going for there and that's totally acceptable. And it was amazing. So well, awesome. And I, I think we wanna talk about what we're offering together too. We've decided to partner and create a coaching program, a group coaching cohort. Do you wanna speak a little bit about that as well.

Katrina: Sure, sure. Yeah. One of the things that I had always wanted to incorporate in the Women in Pediatrics program is coaching and an online community. And so you and I brainstormed this a few months ago, and we've decided to launch it at the end of the summer. So we are looking for a small group of women to participate in this first cohort where we will have six months of coaching, we will culminate at the Women in Pediatrics retreat in March. Our sessions will be a combination of didactic as well as group coaching, and we're really excited to have that released. And I don't know if you want to share a little bit about the specific topic, since you'll be the one doing most of the coaching and didactics.

Arpita: Yeah, I'm very excited about doing this. I think the goal is to start with some basic foundational concepts for what we can apply to our lives to really start making a change. And it all starts with, again, building awareness first for how we're choosing to see things in our world, and if the way we're choosing to see things is really serving us. So, you know, we'll start with that. And then we build in, or I'll build in other concepts regarding how we can create a life of intention for ourselves, how we pick things that we want to include, and then maybe build boundaries around the things that we don't wanna include. And I think you're gonna do some talks about time management. So again, like you mentioned earlier, how you calendared backwards for what your goals are in, in your life and how you work backwards. So there's a bunch more. I'm super excited about this opportunity. It's a great opportunity for any physician, women pediatricians who are interested. Just I wouldn't pass it up. It's just, I'm really excited about doing this with you. It's gonna be a great, great event or a great couple of months worth of events, so,

Katrina: So many women have asked for a way to stay connected between events, and I think this is gonna be a great answer to that situation. 

Michael: So many great themes here that I just wanna highlight. Number one, the importance of community, right? So the communities of the people that are like immediately around you that you work with, but also building communities outside of your everyday life to connect with other people that have similar or common interests. And then the other theme, which I think ties in very well is if you have a need and you don't see that it exists, just build it. And you have done that in so many different arenas and it's incredibly impressive. And so I want to know can you please tell our audience if they want more information on all of these different offerings, how can they find you? How can they find out more information?

Katrina: Sure. So me personally it's simple, katrina skinner.com for the pediatric CEO intensive. That one is pediatric-ceo.com And then for women in Pediatrics, it's womeninpeds.com.

Arpita: Wonderful, wonderful. And I know you're on the social media platforms as well, and we'll, we'll put some information in the show notes so people can tag you and put some of the links if they're interested in signing up for the meetings or the conferences or any of the events that you have coming up, but I'm just honored to have you, I'm, excited that you agreed to come on and to, to share your knowledge base and your gifts that you're giving the world and, and our colleagues. And I just thank you for being here.

Katrina: Thank you so much for having me. I've loved spending this time with you.

Arpita: Yes, thanks. Yay. And I can't wait to see you soon.

Katrina: Agree.

Michael: All right. Take care.

Katrina: Thank you. You too.

Michael: Bye.

Katrina: Bye.