The Well-Being Connector
The Coalition for Physician & APP Well-Being presents conversations with healthcare professionals who support wholeness within their organizations. Our guests understand that in the pursuit of wholeness we must encompass the physical, mental, social, and spiritual health care of each individual, in order to reinvigorate their purpose and meaning. Hosted by: Roy Reid, APR, CPRC
The Well-Being Connector
Dhaval Desai, MD • Live at the Summit
This episode was recorded live at the 2025 Joy & Wholeness Summit in Asheville, North Carolina.
Dhaval Desai was raised in Atlanta, Georgia, and completed his undergraduate studies at Emory University. He completed medical school at American University of the Caribbean School of Medicine in St. Maarten, performed his clinical years of medical school in New York City, and had the opportunity to rotate through various different community hospitals. He completed his residency at Wright State University School of Medicine in Dayton, Ohio in combined internal medicine & pediatrics and became board certified in internal medicine & pediatrics in 2012. After briefly working in Ohio, he joined Emory Saint Joseph’s Hospital in 2012 as a hospitalist and serves currently as the director of hospital medicine. Desai also works at CHOA several times per year as a pediatric hospitalist. Over the past several years, he has developed a passion for the patient and human experience in medicine, focusing on patient-centered care.
Thanks for tuning in! Check out more episodes of The Well-Being Connector at www.bethejoy.org/podcast.
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Speaker 00:Welcome to another episode of the Well-Being Connector podcast hosted by Roy Reid and sponsored by the Coalition for Physician and APP Well-Being. This episode is one of a multi-part series recorded live at the 2025 Joy and Wholeness Summit. Thank you for listening.
Speaker 02:Welcome to our next episode
Speaker 01:Clinically practicing as an attending for the past almost 15 years. I've been a leader, a director of our hospital medicine group for over 10. And if you asked me 15 years ago, would I be involved in this type of work? The answer would be probably not. But, you know, late 20 teens and right around COVID and after COVID, I initially became very excited about the human experience in medicine and more so the patient side of things, because I knew we were doing things that are not the best. optimal communication experiences for patients. 2020 COVID, all of the crises that followed, I also realized at that point that I was at rock bottom from a burnout and mental health standpoint. Our second child was born two weeks before the country shut down. And my wife, also a physician, her maternity leave turned into caring for a four-year-old and a newborn. And I was back on the front lines in the fire, so to speak. All to be said, not for sympathy, but really it was a very climactic critical point where i knew i the adrenaline had waned and i was struggling um and to make a long story short it was really about me one recognizing that i was struggling number two what am i going to do about it um and number three actually do that all still while working being a father being a husband all of that and um i did it you know i got through it i'm still a work in progress um i am let's see a therapist i have been through some medications and medications And a year and a half into that journey when I realized, okay, you know, this idea of struggling as a physician who is struggling, mental health, the frontline, what we're all dealing with, I'm not alone. And it was time to share my journey.
Speaker 02:First of all, thank you for not just sharing your story, but the vulnerability of sharing some of those details. A lot of times it is a reluctance to share your story. to get help thinking that we don't need it. And for you to share that, I think it's important for the listener in terms of both understanding how you got where you are, but also where we're going to go in the conversation. So thank you. Having shared all of that, tell us a little bit about what you're doing now, what you talked about in your speech and perhaps a little bit of the results you're seeing from the work.
Speaker 01:Yeah. You know, right now, my idea, what I talked about today was psychological safety of the frontline. And there's so much about keeping our frontline feeling safe at work, from feeling like they can trust and feel physically safe from violence, that they feel like their environment is inclusive and accepting and keeping them safe, whatever their background is. And the reason I came to talk about that was I have seen workplace violence events that are suboptimally or not responded to. I have seen racial tensions in the hospital after 2020, you know, with the twin pandemic of racism, with the murder of a Mm-hmm. Physician mental health, physician suicide, all of that kind of ties into the same piece. But today, the focus was on psychological safety and really, you know, critically appraising what the current environment looks like with that, what's not being done or what systems think they're doing but aren't doing and how we passionate about this topic and the 200 people that were there. I think we all have a lot in common on that is things we can take back. And importantly, you know, as leaders be vulnerable. challenge the system, and make sure our teams know it's okay to not be okay and call out what's not being done.
Speaker 02:That's outstanding. Tell me a little bit about how do you measure or what are the markers that you're looking for that either say there is psychological safety within a unit or within an organization or not? I
Speaker 01:think the biggest things you can look for, obviously, there are those metrics and the workplace engagement surveys that say And I don't know the exact question. Each survey is a little different, but do you feel like you belong at this institution? Do you feel trust and support by your leaders? Those are the things we want to look for. There are specific safety questions, and those are obviously ones we can look for. And a lot of times what we're seeing is physicians, nurses, the frontline, they simply don't feel like the work environment is as safe. And you're not going to get maybe a zero out of five, with five being the best, but you're going to get maybe a three out of five. But how is it three out of five okay. How is that okay when we work in a profession that demands so much of us, but we still don't feel safe? I just don't see how that's an acceptable way for us to be, and we have to work towards getting that better.
Speaker 02:Outstanding. Tell us a little bit about what you're doing. What's your program look like? What are some of
Speaker 01:the activities? Yeah, so, you know, things within Emory Healthcare where I work, we've worked on is workplace violence response, really organizing a unified approach for workplace violence. The other things that I'm passionate about doing is helping physicians, nurses, frontline feel empowered to say something, to help be a solution, and also be vulnerable. I think a lot of times we go in with this front and face trying to be the tough person and just kind of, it's what we signed up for, we have to do. But there is more power in vulnerability and knowing where we have pitfalls, knowing I think acknowledging those openly, not only as a leader, but as a team member helps build those relationships. And that's what we need to, we really need to focus on because I think we have to be real with each other. And that's so important, especially in the work that we do, which is getting harder and harder to do.
Speaker 02:Yeah. Unpack the training a little bit or the programs that help people get to that place of vulnerability that opens the door to.
Speaker 01:I think it's modeling. I think a big part is leaders have to model vulnerability. There are structured things that can be done, whether there's listening sessions, talking about second victim syndrome, creating safe spaces to talk about that. Those are all things. But I think fundamentally at the bottom of the pyramid, it starts with trust in a leader that's going to be vulnerable and model that behavior. I am saying this about what I'm struggling with. I'm openly expressing emotionally with my team. Now they are, I'm broke that I said, they can feel comfortable that it's okay to do that. And I know it sounds simple, but it's, it's something that's very easy for lack of better words to be done because people will follow their leader, especially a good leader.
Speaker 02:Yeah. We find in exit surveys that most people don't leave a job. They leave a manager.
Speaker 01:Isn't that the truth? That is the truth.
Speaker 02:Tell me. So if modeling is that foundational idea that, Talk about the journey to get leadership buy-in for the things that you're advocating for within Emory.
Speaker 01:It's a journey. I think that's a good way of putting it. It's a journey. I think we keep have to tell the stories of the human experience from the front line and the journey will happen. And sometimes there'll be a catalyst on the journey when there is a sensational event that causes people to feel less safe or feel in danger, whether that's a physical physical violence, gun violence in the hospital, or severe verbal assault. It's sort of those things where we cycle along, cycle along, have a big event, and that's the event that you have to respond to and either change and pivot behavior from a leadership standpoint or continue to let it ride it out. And I argue at those events, which all of us face, these events at our respective institutions, that a suboptimal response will lead to that, you know, what you're describing, that it's the management that you're not satisfied with. And that's when we have to pour in all the resources, all the, you know, all the communication transparently about what system doesn't know, what we can do, what we're going to try to do at that moment to make things better. And that's what I'm encouraging and I'm pushing for. You know, I'm not the executive CEO, but I'm a middle manager of a team of 30 plus physicians. Even when I don't know the answer, I'll tell them at this time, this is what we know. I agree. This is bad. Here's what we're doing locally for our team. What I want to do, I'll update more as soon as I can. And that says more to somebody than not saying anything.
Speaker 02:Talk about some of the results you're seeing from the work you've done.
Speaker 01:I think we're seeing increased retention, physicians feeling more satisfied in their work that they do, feeling trust with leadership. As you said, people leave not the job, they leave their leader. And we're not seeing I'm not seeing my physicians, my physician, I don't like to call be territorial like that. But the physicians that work with me, I'm not seeing them leave. And on my engagement survey, you know, yes, there's systematic issues, things that come up. But when it comes to a leadership evaluation, I'm seeing that there's trust there. I'm seeing that we are doing what's right. And I find that other leaders who follow that also are seeing that. So it turns out to workplace engagement, trust, and all that leads to then joy and practicing and joy and satisfying and satisfaction being where you're at.
Speaker 02:And so how does that role to the staff as well? Are you able to track, measure, or see an impact on the staff that the physicians are working with?
Speaker 01:That's a really good question. You know, whether there's a metric I can track on that off the hand, I can't share, but there's anecdotal feedback. These are our doctors. This is who we like working with. I will share this. When our program first started, you know, we're the new guys on the block as hospital medicine physicians, and it's hard to develop those trust and relationships with staff. But the more cohesive and stronger our culture internally began to do, you know, became, so to speak, we saw the translation, what seeing on the floors and how we're interacting with staff and becoming ingrained in the culture of being, you know, where the physicians, yes, but still being part of them. So we see less complaints, we see more satisfaction, we see, you know, like hospital medicine, that's our group, we love our physicians. And that's, those are the big things I think we can look for. And
Speaker 02:so as you've gone down this road and rolled this out, what do you see a year from now? What's an emerging issue that you feel is going to take front and center or perhaps a new approach that you've introduced that you are excited about that may produce some results?
Speaker 01:You know, I think the biggest thing we need to know is in our country and society, we're going to keep being divided. And I think that division is going to continue to grow given where we're at. And I always say hospitals and healthcare systems are micro societies of what's going on outside of the hospital. So instead of keep driving more, maybe innovation, it if we can sustain the way we are treating each other as teams, unit-based leadership, sort of those cohorts, small group leadership, if we can sustain that, those strong relationships, that camaraderie, and most importantly, that trust, all that will lead to the more psychological safety at work. And that's what we're going to need when things are so divided. Is
Speaker 02:there a correlation that you're finding with the outcomes that you're getting as people feel safer to outcomes in terms of the delivery of care and the quality of care?
Speaker 01:Hypothetically, yes. Whether I've had a correlation when I'm seeing what we are doing resulting in that, and I can say A to B equals C, probably not. But I will say this, the metrics that we watch, which are unfortunately, fortunately, however you look at it, the business metrics of hospitals, length of stay, readmissions, hospital acquired infections, things that make hospital administrators freak out, right? We're seeing even either... improvement or sustaining where we're at on those results. So I would say, you know, talking out loud with you right now, as I think through that, that's where we want to be because sustaining is very hard to do in healthcare. Absolutely. Change management, right? So sustainability is the hardest thing. You can do a project, but then it'll fizzle out.
Speaker 02:Those are all important. And so as you work with the leadership of the hospital, the organization, do you have people that are taking a role as being a champion for your work and really advocating for you as the advocate? Good
Speaker 01:question. The short answer is yes. There is a separate wellness group for the system called Mwell. And I think each organization has something like that. And are they advocating? Yes. Is there still opportunity for more advocacy and more resources? Bigger yes on that. So I think it goes to show you, me, we're all here because, you know, I think your chairman CEO presented this yesterday that the number of the burnout scores are better but we can't run with that no the work continues
Speaker 02:yeah yeah it's hard work no that's right that's like your your your observation that why would we ever settle for three why on safety that's just not acceptable not at all not at all so our listeners are all people and working with organizations trying to improve the condition and well-being of folks as they think as you think about what you've done particularly in this psychological safety what tips would you give someone who may just be having those first few steps in trying to start a program?
Speaker 01:Very good question. First and foremost, be vulnerable, be transparent with communication, and it's okay to not know everything. So what that means is you may not have a solution to the problem, but you're being open, you're being vulnerable, you're being real, you're being transparent. If we can have those qualities, and I say that intentionally because for better or worse, not every leader can do that, especially when you're first time taking on a leadership position, you feel like you have to have it all together. But if we can, especially in healthcare, accept that you don't have to, and the way to get a team successfully managed is to have those qualities. I think that would be the first important step. If somebody had told me that 10 years ago, when I took my leadership position, my first year and a half probably would have been better because I'll be honest, my first year and a half as a leader, I was trying to fix everything, trying to keep perfect, trying to keep a happy face. And keep that borderline toxic positivity. And I rapidly realized that's not the way it's not going to sustain like that. And yeah, that's one way to lead, but it's not realistic. And the problem with that is people on the front line who are very smart clinicians, mind you, they're scientists in their own way. They figure that out. Like, no,
Speaker 02:it's not. And we have to listen to that. Absolutely. What's next for you?
Speaker 01:Yeah, I'm in it. So I'm also an author. I wrote a memoir burning out on the COVID front lines. And I donate all of my proceeds in my story to the Dr. Lorna Breen Heroes Foundation. I'm going continuing to use writing as a tool for advocacy and social media. And I'm hoping to start a podcast myself on mental health, burnout, vulnerability that can not only apply to healthcare workers, but other professions too. I have two school age kids in public school, and I will say this, teachers are just as much a frontline in a very complex system as healthcare workers.
Speaker 02:No doubt about
Speaker 01:that. So
Speaker 02:that's the plan. Where can people find your book?
Speaker 01:Thank you. On any major book platform, they can find my book, Burning out on the COVID front lines. And I also have a website, devaldisimd.com.
Speaker 02:And I'm assuming you're available for speeches.
Speaker 01:Absolutely. Always open to anything, a collaboration. I think, as I told this morning, as a platform in a place like this, you find like-minded people and we continue to need these like-minded people to grow. So always open to it.
Speaker 02:Well, with the time we have left, what haven't we talked about that's on your heart?
Speaker 01:Yeah, good question. The biggest thing on my heart is I saw health care in a different eye when my dad passed away last year 15 months ago when i was on the sidelines with him and it's the grief journey is very complex but what i see is i had the most respected doctors at the bedside who were i could tell were burnt out with the way they were communicating and what worries me for all of us who are going to be utilizers of the health care system how are we going to have the best health care system it's we have the healthiest and best health care workers and we need to really focus on that and the work you're doing with advent health and this coalition and the work we're all doing together, I'm hopeful and optimistic that's what's going to help get us there.
Speaker 02:I'm going to ask one more question. I'm going to pivot off of your personal experience. Grief is a big deal. How have you struggled through that?
Speaker 01:I'm struggling as we speak. I really want to know the truth. I will say this. I was trained as a doctor that the first year of grief is the hardest because you have all the firsts from birthdays, holidays. I will say this. We hit the the first year mark and months 13 through 16 have almost been harder because it feels very real now. Like this is very permanent and there's good days and bad days. And yes, grief is not a linear journey. You've heard that, but it's so true. So I wish I could have a conversation with you and said, I figured out the grief and it's fine, but I have not. And it's a struggle in a good and bad way. I will say that, you know, we like to honor my dad the way the best way with my kids they got to know him but we talk about him often but it's tough grief is very tough and it's I will say this he passed away at the hospital where I work and there are days when I walk by one of the rooms he was in and I just pause and kind of jolt myself like whoa that feels a little yucky
Speaker 02:well I appreciate you sharing that and knowing what my wife lost her mom within the last couple of years and we see it every day and one of the things that she did and she at Licensed Mental Health Counselor was find a group, get engaged with a group that... A grief
Speaker 01:support group. Yeah. You know, that's so important. My mom, who's here on this trip in Nashville with us, we brought her with us just to get her out a little bit. And she's very active and helps my kids, but the grief is a major... In that month, 13 through 16, really feeling it. So it's almost like a sign for you to say that because we're getting her connected as we speak with the grief support group because it's such a lonely journey. And, you know, David... I'm not sure if you've heard of him. I learned, you know him, the grief, he's a grief expert. And I'm going to use one of his quotes as we talk about this, that we all come into this world in the middle of someone's movie and we leave the world in the middle of someone's movie and the movie never finishes. Isn't that wild? I know. Doesn't that get you?
Speaker 02:If you have one before we wrap up, is there an anecdote, a conversation, an experience that you've had over the last couple of years? if you've done this, that stands out as a marker for you to the value of the work that you've been doing with your physicians and even the people impacted by the work you do with the physicians.
Speaker 01:I think it's been a series of things. I think it's kind of individual events when I hear from that nurse or that physician individually come to me and somehow get connected with me and openly talk about what the issue is and nobody's backing them up and they feel very isolated. And I'm not there necessarily to say, yeah, you're right. What you did didn't happen. Or yes, it was an adverse outcome, but let me back you up. And this is what you need to do. And this is how I'm going to, I went through this. This is what happens. And I a hundred percent validate what you're feeling because the bigger system, not Emory or wherever this, the system's not designed to take care of us. And when I have those conversations and it's some with somebody, let's just put it this way. Somebody who I always felt is somebody I would never be able to relate to as a friend. Or I always felt they're superior because they're a specialist of a specialist and the brightest mind. And it's like, what do they want to do with me? And I have that bond. And to your point, 15 years ago, what I've ever thought I would have some connection with them. That's when I feel like, okay, you know what, this work is worth it. And somebody's listening. So
Speaker 02:yeah, the human connection
Speaker 01:is, it is in this, this area. It's one of those things that people are so scared sometimes to even talk like a fire. But once you open up the floodgates, and that's why I chose to be open with with my story. Once you open that floodgate, it's like, okay,
Speaker 02:it's time. It is. This has been a pleasure.
Speaker 01:Likewise. I mean, you're so easy to talk to. Thank you. Well,
Speaker 02:so are you. And I know that our listeners are going to benefit from everything you've talked about and the work that you've done. Thank you for committing to it and spending this time with us today. Thank you. Thank you. Absolutely. Yeah, absolutely.
Speaker 00:Thank you for tuning in to the Well-Being Connector podcast, brought to you by the Coalition for Physician and APP Well-Being. The Well-Being Connector offers insightful conversations with healthcare professionals devoted to fostering wholeness within their organizations. Each episode delves deep into the holistic approach to well-being, underscoring the importance of physical, mental, social, and spiritual health. For more episodes, visit our website at www.bethejoy.org podcast.
