Breathing New Life Into Patient Care and Provider Wellness - Dr. Michelle Thompson, Medical Director of the Lifestyle Medicine Institute at the University of Pittsburgh Medical Center

Shiv Gaglani: Hi, I'm Shiv Gaglani, welcoming you to Raise the Line with Osmosis from Elsevier, an ongoing exploration about how to improve health and healthcare. We're going to do that today with Dr. Michelle Thompson, medical director of the Lifestyle Medicine Institute at University of Pittsburgh Medical Center. In that role, she is working to place self-care in the center of patient care and employee health and changing the way medical education and residency is taught. 

As a fierce advocate for physician wellness and combating burnout, she's created full-day programs for physicians and nurses to learn tools for resilience and self-care. Dr. Thompson is triple board certified in lifestyle, integrative, and osteopathic family medicine and incorporates culinary medicine and mind-body skills into her patient care. 

Before we get started, I'd like to give a shout out to Dr. Dave Rabin, a mutual friend and colleague who started Apollo Neuroscience and also was at University of Pittsburgh and knows Dr. Thompson well. 

So, Michelle, thanks for taking the time to join us today.

Dr. Michelle Thompson: Yeah, thank you so much for having me. It's exciting to be with you and really get to talk about what's going on on the cutting edge of medicine.

Shiv: Absolutely. I know a lot of our team at Osmosis has followed some of your work because even this year I think at least one or maybe two New York Times articles have featured you and your work both in lifestyle medicine as well as in generative AI so we're going to get into that in just a couple of minutes.

But first, do you mind just giving us a sense of what got you interested in a career in medicine and then ultimately lifestyle medicine as a focus area? 

Dr. Thompson: Yeah. Well, for me, my grandfather passed away at thirty-six years old and I wasn't even born yet. He had diabetes, and essentially, I learned over time that poor diet and lifestyle was what was not beneficial for him and left his family behind without him. When I became a mom myself, I thought I need to take really good care of myself. I'm bringing a child into this world and I want to be there for him. So, I really changed my own diet and lifestyle thirty-two years ago -- my son is thirty-two. I adopted a plant-based diet back then and exercised and worked on mindfulness and all of those things when it wasn't even cool. When I was in medical school, I was also running a massage therapy program. So, I have a background in Eastern medicine, massage therapy, body work, neuromuscular therapy and blended it into osteopathic medicine and it just made sense to go out into family medicine and merge all of these different modalities. 

Lifestyle medicine wasn't a thing back then that I knew of. I became board certified in integrative medicine after family medicine and then went back and got my lifestyle medicine board certification, really realizing that lifestyle medicine was where we were going to create change in our world because we can't argue the six pillars of lifestyle medicine: sleep, exercise, nutrition, stress management, substance use, and connection with others. Integrative medicine can be questionable at times, right? Some people may not agree with it. It may not resonate with them. But those six pillars are not something we can argue about. We know that we all need those things.

Shiv: Yeah, absolutely and it's interesting you started this over thirty years ago because I think in the 90s going plant-based or vegan or whatever it probably made you look weird, whereas now it's very in vogue and there's a lot of research backing it all up. 

What are some of the things that you incorporate now that you find most useful for your own

self-care? I like to ask that question to people who teach others. What has been the biggest game changer for you?

Dr. Thompson: I've practiced yoga for twenty years and that is like mandatory in my life. It just has to be. If I'm not on my mat -- even when I go on vacation for ten days or something -- if I'm not really on my mat, I just don't feel solid. Our yoga mat is a reflection of how we are in our life. When I just came back from Europe and I was off my mat, it was like, wow, my balance is off and my head is not as clear and all of that stuff. So, yoga is mandatory for me in my life. 

I have a very strong mind-body-medicine practice. I got certified in mind-body-medicine.

I started my training with the Center for Mind-Body Medicine in 2018, which is what led to the article in Burnout and the work that I did with physicians and frontline workers during the pandemic. I started breathing with my patients. I teach every single patient a soft belly breathing practice. I do that with them so that they know that they can come back to that and ground themselves on that. 

I started that because I had a physician in my mind-body skills group who said, ‘You know, it's really weird to breathe with our patients. It feels uncomfortable,’ and I thought, wow, we all breathe, right? What is one thing that we all share in common on this planet? We all breathe, so how come that feels weird to us as physicians to breathe together? What I found is when I introduced that and I started breathing with 100% of all my patients, it really grounded us both and got us more mindful and ready to talk about their healthcare and level the playing field and allow us to be part of the same team, right?

Shiv: That's fascinating. So, just to be clear, when you see a patient, you start those interactions with a breathing practice to ground yourself?

Dr. Thompson: Normally what I do with a brand-new patient is I talk to them about the six pillars. I say, these are the six pillars of lifestyle medicine. I'm board certified at this as well as integrative medicine. I name some of them -- sound therapy, art therapy, aroma therapy, yoga, tai chi, supplements, herbs, etc. mind body medicine -- and I ask them, what is a day in the life of Shiv look like? Share with me about those six pillars and how you're doing with those things. And then, do you have a breathing practice? Because we should all have a little breathing practice to ground us. 

I share the story with them that I was on an airplane that caught on fire, and when it caught on fire, I was like, oh my gosh!  I was looking out the window at the wing on fire and I thought, this is something, right?  I looked at my husband, I said, “I love you.” I held his hand. I said a prayer, and I said, “Okay, I can't think about the past and I can't think about the future. I know as long as I have my breath, I'm safe and I'm well, I'm going to tap in. This is my tool. It's all I have in this moment.” I don't have my yoga mat, right? So I think it's so important because even if you're having a moment, you can pause and breathe. 

Like even us right now, if I just said, “Would it be okay if we breathe together?” And we can do that.

Shiv: I would love to do that.

Dr. Thompson: Do you want to do it?

Shiv: I haven't done that yet. I'd love to do that.

Dr. Thompson: Let's do it! Okay. So, if you are in a place that you feel comfortable closing your eyes, if you want to do that, go ahead. If not, just softly gaze at the floor. But begin to come into your breath, breathing slowly and deeply in through your nose all the way to the top of your head, letting it out through your mouth all the way to the bottom of your feet...letting go of any thoughts of the past, anything that no longer serves you, not thinking about the future, anything we need to do when we're done here, but really just being right here right now with our breath...in through our nose, out through our mouth, maybe placing one hand on your chest and one hand on your belly if that feels comfortable and accessible to you and breathing at your own pace and as you breathe in, feeling your chest rise as you breathe in and your belly expand as you breathe out. 

Thinking soft as you breathe in, belly as you breathe out.

And if your mind begins to wander, come back to that mantra of soft belly, knowing that it's in the mind's nature to wander, but we can control our nervous system with our breath, helping us to move from the sympathetic fight or flight nervous system into the parasympathetic

rest. Relax, digest. 

Continuing to breathe slowly and deeply and maybe getting a little more comfortable reminding yourself, we deserve to be comfortable. We deserve to pause and breathe and honor this breath.

And as long as we have this breath, we're safe and we're well. 

We may not have a lot of certainty of what's going on in the world around us, but we have control of our breath and we can use that as our superpower to tap back into our own mind-body connection and make this next breath the most mindful breath you've ever taken in your entire life. Really feeling that quality of the air as it goes in through the nostrils and out past

the lips, and when you feel ready, and only when you feel ready, if your eyes are closed, maybe

softly opening them, maybe smiling, honoring yourself and appreciating yourself, having some kindness and compassion for yourself and knowing that caring for ourselves is caring

for others. This self-care is not selfish. And then coming back to the screen or space, wherever you may be, and reconnecting with whoever is around you.

Shiv: That's incredible. Thank you, Michelle. That's the first time in over 400 episodes we've actually taken time to do a breath practice. We've had AI write a song. We've had people you know well, people like James Nestor who wrote Breath, Scott Carney wrote The Wedge and other books on the podcast. We've had these really awesome people. But actually, we've never actually done a practice, so I'm really glad you did that.

Dr. Thompson: Well, thank you for inviting me to do it. I'll tell you a funny story. I got a new administrator recently and we were in the midst of the meeting and he said, “Dr. Thompson, can I stop you for a moment and just ask you...the old administrator told me that you start all your meetings with breath work and we didn't do that today. Would we be able to do that?” And I was like, yeah. And I didn't do it because he was new to me and I just thought, well, we had a lot to cover and then I remember, you know, it matters. It really centers us and kind of helps us to come into the space and be more mindful and be more connected and more available to each other.

Shiv: Absolutely. That's very cool. One of the reasons we even started Osmosis in the first place was we realized the power of education to influence behavior change and increasingly as Osmosis grew, we went from the mechanics of medicine -- like what drugs to prescribe, when, what the side effects, what tests to run -- into more of the Eastern medicine or concepts like breath work, sleep medicine, lifestyle medicine...these pillars you've talked about.  

Largely we did it because there's evidence that clinicians who practice what they preach are more believable. They're more effective at influencing patients to do behavior change and frankly, you know, if we can give them the tools like you're doing for resilience and combating moral injury and burnout...if you can keep a clinician in viable practice for an extra year, that's hundreds of patients who are benefiting from that. So, that's wonderful. You clearly practice what you preach. I've talked to people who talk about this stuff, but to take the time to actually do it on the podcast is very cool.

Dr. Thompson: Yeah. All my medical students and residents learn to do this with me and then they begin to do it with the patients and I think that that's been one of the things I realized recently: the biggest gift that I can give to the world in however long I'm going to be in practice is to teach and to share this with our medical students and residents and attendings moving forward. I do tons of work on physician burnout in general and with our UPMC Physician Thrive team. If we are caring for ourselves, we are more available to others because we're stopping and pausing and what better way to stop and pause in your day but to breathe with the people around you? I mean, it's just a nice way to utilize the self-care tool and for everybody around you to feel it. 

Last week I had my physician assistants who work with me breathing with each other and then my medical assistants and my heart was so full because I see the ripple of what I have done with our next generation...that they're going to realize that this is important. Because, I mean, especially our medical students and residents who have been training in a pandemic...wow. The lack of connection they experienced. I still have students right now that are quarantined again, and I'm virtual for the majority of my practice. They're able to jump into my schedule, but they otherwise would be home, isolated and quarantined just because they have COVID. They're not sick, but they want to still participate. 

So, we have to just think outside of the box. That's the only way we can truly change healthcare and transform it is to begin with ourselves. 

Shiv: Yeah. 

Dr. Thompson: And that's the way I show up, you know?

Shiv: That's very clear. I've only had you on the podcast for fifteen minutes and it's super clear that you practice what you preach. So, let's talk a bit about the Institute. Maybe you can give us an overview of the Institute and what are some of the programs you're leading because it sounds like you're doing quite a few things across different stages of training -- attending to med student, as well as your own PAs and Mas -- not just physicians, but also nurses and other healthcare professionals.

Dr. Thompson: So, a day in the life of me, of Michelle Thompson, is I wear my Apollo Nero -- shout out to Dave Rabin -- I think that that's really helpful for me for stress management as well as track my own sleep. I wear an Oura ring because I think that's important, that keeps me honest with myself. I am in my office one day a week in person, two days a week virtual. What that day looks like is different all the time. 

I have medical students that join me from Lake Erie College of Osteopathic Medicine, University of Pittsburgh Medical School, School of Medicine, Philadelphia, and then sometimes other schools if they're doing rotations or electives, and they want to be with me virtually. So, I have my medical students with me third and fourth year. Sometimes I have my residents. I oversee the lifestyle medicine residency curriculum for our entire system. So, at UPMC, we have eight family medicine residency programs that have lifestyle medicine curriculum in place so that they can be dually boarded at the end of family medicine and lifestyle medicine. Internal medicine is offering it and most recent physical medicine and rehab. So we have three different specialty tracks for lifestyle medicine along with those and they jump into my schedule. 

That's one of the big reasons why I'm virtual because UPMC has forty-three hospitals and it's big and they're all over the place. My residents...some of them I never meet face to face, but they get to work with me.

In my own practice, I utilize lifestyle medicine every single patient visit because that always really gets me to the answer, right? If you have insomnia, you're not maybe going to take the best care of yourself because you're exhausted. You know, if you're super stressed out, you may grab food that's not good for you because you just don't care, right? If you're not exercising because...there's reasons, right? The six pillars really are what I focus on with everybody. 

Also with the lifestyle medicine program at UPMC, I oversee -- for all of our up to 93,000 employees -- I’m really trying to put self-care and lifestyle medicine in the center of our own employee health as well as patient care. I run group medical visits for patients, for weight management, as well as nutrition, movement, stress management. I run mind body skills groups for patients. That's been something that was recently just added in and hopeful to also enter group medical visits for menopause and kidney disease, hypermobility syndrome, stroke, post-stroke, movement disorders, and more disease specific things like that. So, really at all levels, right? 

In those group medical visits, medical students can jump in, residents can jump in, attendings can jump in because we're virtual. They can learn how to run these groups for themselves. I always call it my training playground. Everything I do is a training playground. The patients love the learners because they know medicine is changing and that we're really teaching this self-care at the center of everything and lifestyle medicine. They watch the learners transform the way they interact with patients and they know that the learners will be the ripple that changes the world.

Shiv: Yeah, absolutely. Absolutely. I agree wholeheartedly with that. That's one reason we've had people like you on the podcast, is to start getting our learners to better understand how to incorporate these habits that eventually will be the foundation for their practice. Because as I've said on this podcast many times before, we're never going to have enough endocrinologists to treat all the diabetes in the world or enough neurologists to treat all the dementia. But if we're able to get third graders incorporating some of these breathing practices or better eating habits, then we can, as we said during COVID, ad nauseum, flatten the curve. It isn't just for COVID, it's for any sort of health issue. 

So how do you measure success of the Institute and the programs you're deploying? I'm bought in on lifestyle medicine. Are you still seeing any pushback from providers, or like Chief Medical Officers? UPMC, I think, is very innovative given you and Shiv Rao from Abridge, who we've had on the podcast, and many others. I think it's a really innovative place. But, you know, how do you measure success and are you seeing this shift happen across different health care systems as well? Or is this Pittsburgh specific?

Dr. Thompson: Oh, no. So it's healthcare across the country. The American College of Lifestyle Medicine has a Health Systems Council that I've been part of since the onset. There were just a few hospitals in the beginning and now we have almost a hundred hospitals that have some form of lifestyle medicine somewhere, whether it's the lifestyle medicine residency curriculum, the lifestyle medicine interest group associated with the medical school, whether they have a lifestyle medicine program, and they're doing group medical visits. 

The Health Systems Council really is where I find my strength because I kind of show up and say -- I just presented them recently -- this is what I'm doing in burnout. I give them a twenty-five-minute overview so that these hundred leaders of hospitals go back and go, “Oh, yeah, Dr. Thompson's doing this out in Pittsburgh, and I'm going to do this at Loma Linda,” which is exactly what happened. I saw Loma Linda's program that had PM&R with lifestyle medicine and I was like, “Well, why don't we do this?” So I reached out to PM&R and said, “Hey, this would be great,” and next thing you know, we have lifestyle medicine residency curriculum in PM&R and the residents are rotating with me and learning.

So I think that that's it's just going to continuously change. We have to. It's hard work and it's not easy. Do I get resistance? Sometimes, yes, absolutely. Why? Because physicians are tough cookies. They don't want to change their own diet and lifestyle. I mean, it's a badge of honor to not sleep, right? Like, that's the way the training was for residency. You're not supposed to sleep for thirty-six hours, you're not supposed to eat when you need to eat, you're not supposed to drink when you need to drink, you're not supposed to manage your stress.

That was the old school training and this new program really is teaching the residents to put that self-care front and center, and when we do that, they own that for themselves and mandate that for themselves. Patients see that, and they also see our human side. We're humans. We're not robots. So, that's how we begin to change the culture of medicine is with ourselves.

Shiv: Yeah, absolutely. I'm glad to hear that. Like the Loma Linda example, if you can expand some of the things that work to other institutions, that's like a ripple effect as you're sharing, because maybe there's a future Dr. Thompson at Loma Linda who will also keep expanding it. 

We recently at Elsevier released the Clinician of the Future Report. It's the second year we've done this, surveying thousands of clinicians around the world. Last year, about 33% said that they were considering leaving their roles within two to three years. This year, it's a little higher at 37%. The pandemic obviously exacerbated things, plus systemic issues like pay, hours, you know, there's nursing strikes at various health systems as well. A lot of people don't actually go to residency or don't finish and become actual providers, or they leave, go to digital health companies. We've had a lot of those kind of physicians, too, on the podcast. 

What's your take on the moment we are in with moral injury and provider burnout? What's actually going to make a dent in it for the next ten years?

Is it scaling up more of these lifestyle medicine programs? Or, I know you were featured in a recent New York Times article about generative AI reducing administrative burden. I'd just love to hear your prognostication for how we're going to turn the tide on moral injury and burnout.

Dr. Thompson: Yeah, I think we just have to keep talking about our lifestyle medicine and mind-body medicine and humanizing who are in healthcare. I think that's really important. AI has been very helpful for me. I love Shiv Rao, who created that. He and I have been friends for the past five years working on this project. I've watched it grow and change in a variety of ways. It has really reduced my charting time from two hours to twenty minutes. I actually just did a demo on it this morning for another hospital to show them how I was using it and answer a lot of questions. I use it as an attending as well. The residents are able to use it with me and the medical students are able to see it being used. So, I think AI has helped a ton. 

I think also really just making the culture of wellness across the institution. It has to be there, right? We need to change all of it. We need to insist that we all take breaks and vacations. We need to make sure that we have options for whole food, plant-based diets and food that is nourishing to our bodies and not garbage. One of the big things at UPMC is we're taking out all the deep fryers, you know, so no more French fries, eventually. As soon as they break, that's it. They're gone. 

We're building a whole new hospital in the city that's going to have a lifestyle village with the first three floors really catering to the lifestyle of the community because it is the community that we are trying to connect to and help. I think also knowing that it's hard. It's not easy to take care of ourselves, right? Like, being human is hard. Post-COVID, it's really hard, you know? And I think that's what always brings me back to starting with myself. How can I best care for me so that I can best care for everybody else around me and then communicating it, right? Like, just having these conversations. 

Thank you for bringing up these conversations because unless the residents and medical students come out knowing that things can be different, they won't want to go into this torturous job where they never sleep and they're charting all night and all of that. They don't get time for their family, they don't get time to exercise, they don't get time to eat dinner together and all of that. Nobody wants to sign up for that. So, I think just knowing that we have to recreate that makes a huge difference.

I see it changing. I really do see it changing. I think physicians in general, like I said before, are a very challenging population and I think when a physician is vulnerable, those around them are more vulnerable. Vulnerability breeds courage and strength -- Brene Brown says that -- and I think that's really important. I'm always very vulnerable about if I need something for me in this moment. And I come back to where am I in this moment.

Shiv: Yeah. Leading by example is really important. My hope is there are more people like you embedded in every health system as well. I know at Hopkins -- as you know, I resumed med school there -- the gym is actually closing at the end of this year so they can build a new massive life science building. So, there's no student gym on campus starting in January. It's like, “What!?” A decade ago when I first started at Hopkins, the only food options within like a one-mile radius if you lived on campus were Popeye's and another mom-and-pop fried chicken shop. In the hospital, there was one of these taco chains. It was like, you can't get a real healthy salad or tofu anywhere within a mile. This was before DoorDash and stuff. So yeah, within three or six months of starting med school, I gained fifteen, twenty pounds due to the stress of med school plus living in a food desert. So, I'm really glad you and the University of Pittsburgh are addressing that as well.

Dr. Thompson: We have whole food, plant-based options in our inpatient setting for our patients who are post MI or who are in there for any reason they're hospitalized, they have the ability to get a whole food plant-based meal. And dietitians are teaching whole food, plant-based consults for the patients at the bedside. I teach a program called Doctors in the Kitchen, Food as Medicine that I created back in, I think, 2016. I just get in the kitchen and cook with my colleagues. I love it. Maybe one day we'll cook together, Shiv. 

Shiv: That would be fantastic. Yeah. 

Dr. Thompson: I've done it virtually and I've done it in person for three years. We were completely virtual, but we're now back in the kitchen. So, we have teaching kitchens and there will be a teaching kitchen in our new hospital that we're building and I think that that's important too...to teach the physicians that are already out there that this food can taste good. It's not just bland tofu and kale that makes you choke. I mean, I love tofu and kale and they're almost always in my programs just because I want to showcase that these foods can taste good. But being able to give this to our patients and to the people working in the hospital and to our community is really important. We're even going to have a grocery store on site that people can get these meals to go and take home to their families in a family style sort of takeout. 

I think we have to just continue to get this message across. This may not be what everybody wants, but this is what the world needs. Because like you said, I mean, chronic disease is because of the lifestyle that people are leading, right? So, we have to teach them different.

Shiv: That's super cool.

Dr. Thompson: It has to be done in a way that is affordable for all and accessible for all. I'm a big proponent of that because I grew up in a very underserved population, so I know that it was difficult for my mom to feed my sister and I when we were young and I have a huge passion for that, just making sure that everybody has access to care, as well as healthy nourishing foods for our bodies and education. To know what's right for themselves and to be that advocate for themselves because they tap into their own inner healer and they are able to communicate and the physicians listen because they're allowing them that space to be seen and heard.

Shiv: Wow. That's really cool about the test kitchen. I didn't actually know that. I knew you were doing culinary medicine, but that that's very cool and hopefully we'll see that at Hopkins soon enough. I'm wanting to be respectful of your time, so I only have two other questions for you. 

The first is my favorite question we ask guests on the podcast, which is, you're speaking to a lot of current and future healthcare professionals. This podcast in particular has already been full of advice, but if you were to wrap up some of your advice that you want to leave our audience with about approaching their careers as healthcare professionals, what type of things would you want to leave them with?

Dr. Thompson: I think knowing that anything is possible. I took a traditional medical practice twenty years ago and I walked in the door and I just said, “This is the way I'm going to practice medicine.” I said to the patients, “This may be something you want, and this may not be. I won't abandon you. I'll make sure that you have a physician that is along your same lines of what you want.” But, you know, I made a commitment that I wasn't going to give a pill for every ill and that I was going to put food first always and lifestyle always. I'm a de-prescribing specialist. I help people get off of medication, not continue to pile it on. 

I think demanding that and being an advocate for yourself -- especially if you're a physician -- you know, not allowing others to judge you and shame you for being different. Being a vegetarian for thirty-two years and being integrative physician, I've heard people whisper behind my back, “Oh, she's the integrative one.” You know, like I wear crazy horns on my head or something, right? But really what I always said is that I want to change healthcare the way it's delivered, and it starts with me. 

So, knowing that that's possible and that you can advocate for yourself about who you want to care for. I tell my residents this all the time: if I choose not to do abortions for a living, I don't have to. Nobody's going to force me. If I choose to not use insulin in my practice with my diabetic patients and put food and lifestyle first, that's my choice, too. Those insulin-needing patients can go to the endocrinologist or to another place to get it. I definitely have resources for everybody. Nobody's not getting what they need, but that's how I built an entire practice that is sustainable, that's lifestyle integrative and mind-body medicine and I'm bringing my physician assistants and nurse practitioners and learners to learn in this space. 

So, you can do anything you want to do. I think integrating this into traditional healthcare and showing that it works...because you asked before, does it work? Yes, it works. I see A1Cs go from fourteen down to six and people go from twenty-seven pills down to zero. I mean, that's what my world is about. You just never know unless you try. So, please just don't give up on yourself as a physician or a healthcare worker. Don't give up on yourself as a human being on this planet, too. First start with you, then it ripples out to your family, to your friends, to all those that you may care for.

Shiv: Yeah, that's wonderful advice. Just being super authentic to your core values and then, you know, that sort of shines and you can build a practice or an organization based on those values. Certainly, it’s something we've done at Osmosis and something I would echo. I think part of moral injury is when clinicians know that there's issues upstream. For example, we had Dr. Michael Mithoefer on the podcast, who you may know from the Multidisciplinary Association for Psychedelic Studies (MAPS). He was an emergency medicine doc and was getting burned out because he realized so many of the patients coming into the ER had mental health issues that were way upstream of them showing up in the ER. And you could replace mental health with cardiovascular or neurological issues or whatever else. 

So, he went back and did a psychiatry residency, became a psychiatrist, and now is the main MD at MAPS helping bring forward the MDMA-assisted psychedelic therapy for changing people's behaviors and preventing them from progressing from PTSD to suicide, for example. So, I think that authenticity is key and I would echo that. I'm glad you gave our audience that advice.

Dr. Thompson: Well, and I'm glad that you had him on. I just got trained in psychedelic-assisted psychotherapy. I'm really known as the anti-drug girl and so I couldn't even understand why I was doing this. I was like, “I just feel like I need to integrate this. I need to learn about it.” What I learned is sometimes we can't get to the spot that we need to get to to implement these lifestyle pillars or integrative or mind-body modalities. But we’re learning the use of ketamine, MDMA, psilocybin helps to be that window to our soul, you know? 

I was in this space with fifteen mental health workers and ten physicians really just seeing that we all needed to go inward and that's what those substances do. They allow us to shine the light in the dark spaces that we may have suppressed for a lot of reasons. I mean, we're all human beings and we put things in the drawer because we don't want to deal with them. So, that's what those substances do and so I'm a huge fan. It's done in a thoughtful way and that's why I wanted to learn it so I can help my patients not just go out to a ketamine

clinic and get it -- because it's a drive-thru -- so we can integrate it into their traditional healthcare.

Shiv: Yeah, it's a tool like any other and it's not supposed to be chronic use, right? I'm not supposed to be taking, you know, MDMA every week or every month.

Dr. Thompson: Then it becomes drug abuse, right?

Shiv: Then it becomes drug abuse, so yeah.

Dr. Thompson: Right, yeah. And yeah, it's just fantastic. There was an article actually done on the use of ketamine in frontline workers and how it showed improvement in physician burnout. That was another big reason why I wanted to explore that and see how we can help those physicians.

Shiv: Yeah, I love that. That's definitely been a theme of our psychedelic coverage on the podcast. My last question for you...is there anything else you want to share with our audience before we let you go? I know there's so many things we could have talked about, but for the sake of your time and our time and our audience's time, we tend to keep these short. So, anything else you want to leave our audience with?

Dr. Thompson: Yeah, I just think that it's important that we never underestimate what is possible in our world. Because being in a healthcare system that is upwards of 100,000 employees often days seems daunting to create change that I'm attempting to create. But I remind myself on a daily basis, nobody's ever taken a hospital system and tried to transform it. The best way to go about everything is to put one foot in front of the other and to follow your heart because our egos often get in the way and I think we need to get out of the way of our ego. Listen, close your eyes, quiet your mind, tap into your heart and just let it go and feel your way down the path. 

I think if every human did that, our world would be a better place.

Shiv: Those are really inspirational words to end on and with that, Michelle, I really appreciate you taking the time to be with us on the podcast, but more importantly, for the authentic way you've built your practice and all the stuff you've done to change the culture of medicine, both locally in your practice, but also obviously nationally and probably globally. I hope our audience really pays attention and reaches out to you based on this conversation.

Dr. Thompson: Yeah, thank you so much for having me. It was so much fun to be with you today.

Shiv: Likewise, and with that, I'm Shiv Gaglani. Thank you to our audience for checking out today's show and remember to do your part to raise the line and strengthen our healthcare system. We're all in this together. Take care.