What Defines You? A Q&A with Helane Fronek

What defines you? A physician. A parent. A philanthropist. I’m sure many reading this would consider themselves these things. But are they what define you?

It’s a question that most people will ask themselves at least once during their lifetime. Whether we pose the question to ourselves—or it is posed by someone who we respect and who wants to help us find the answer through thoughtful introspection—how we choose to answer it defines us as much as the conclusions we make as we travel the path toward answering it, assuming we are bold enough to accept the challenge of answering it at all.

In this issue, we are fortunate to highlight one of our own, Helane Fronek, MD, FACP, FACPh.

Professionally, Dr. Fronek sees patients at La Jolla Vein Care, educates medical students as an assistant clinical professor at the UC San Diego School of Medicine, is the author of The Fundamentals of Phlebology, is a past President of the American College of Phlebology (ACP), is the first recipient of the ACP’s Leadership Award and is recognized as an Honorary Member of the organization.

In addition to her accomplished career in phlebology, Dr. Fronek writes for multiple titles, including this magazine, and most recently as a blogger on The Huffington Post, and has recently added Life Coach to her distinguished resume, specializing in physician development and helping doctors find fulfillment in all aspects of their lives.

On a personal level, she rides horses, enjoys scuba diving, paddle boarding, cooking, hikes with the family dog, and spending time with her immediate and extended family. She is the vice president of the San Dieguito Chapter of the National Charity League, and also has managed duties as Cub Scout leader and manager of a girls’ softball team.

In the course of conversation, we found a resounding theme in her character and spirit that, as you read on, we believe you will recognize. And if you read carefully, it is a case study in answering the question of “what defines you?”

Q&A with Helane Fronek MD, FACP, FACPh.

VM: Tell us how it all began. What made you decide to choose medicine in the first place? What was your path?

I chose medicine for the same reasons as most people; I loved science, I wanted to help people, and I found the clinical environment fun, stimulating, and gratifying. After college, I worked as a microbiologist for a corneal surgeon. It was a great job. He was very busy and we were always doing so many things, from research on rabbit corneas to planning hands-on courses for ophthalmology residents, to culturing the eye of a horse with a corneal ulcer. And that’s not to mention helping with his patients several times a week.

After that I was a research assistant in the murine leukemia section at Sloan-Kettering in NYC. I had the great fortune of working for a fantastic scientist, but the research world wasn’t where I wanted to spend my life.

VM: What are your current pursuits and positions in the medical field?

I teach first and second year medical students in a variety of courses at the UCSD School of Medicine. Some of the courses are clinical, such as Problem Based Learning, which includes walking a small group of students through a case, step by step, to teach them how to think about the various presenting symptoms, lab results, etc. It’s so much fun to watch first year medical students actually put their newly-acquired knowledge to use so they arrive at the correct diagnosis; everything from Celiac disease to sepsis to aortic stenosis.

Most of what I teach, though, involves the less tangible aspects of medicine like communication, ethics, professionalism, and healthcare systems. I also teach in a course designed by the amazing Rachel Remen, MD, a physician at UCSF who has had Crohn’s disease for 60 years. It gives the students a chance to explore their own thoughts and issues around things like grief and loss, appreciating the mysteries in medicine and exploring service as a way of life.

I love seeing patients one or two days a week in a wonderful office in La Jolla, where I work with a kind, innovative and dedicated colleague, and a terrific staff.

In the ACP, as a member of the leadership committee we are planning an extremely exciting program: the ACP’s Leadership Academy. It will debut this fall and will offer a year-long experience, providing the participants with new skills and insights that will truly change their lives, their work and their relationships. The ACP’s Leadership Academy will give the ACP effective leaders who can develop a vision, then inspire and motivate others to commit to that vision, communicate and advocate in ways that will help the ACP enhance its role in the continued development of phlebology, and advance the care of venous disease in the medical community at large.

I continue to work with individual clients on a variety of issues including work-life balance, communication, office strategy, determining personnel needs, strategizing around next steps in life and career and anything else they want to work on! I have also held workshops for local physicians on work-life balance, delegation, and communication.

I write for both VEIN Magazine and San Diego Physician, the journal of the San Diego County Medical Society. Both publications request articles on coaching topics, so I try to bring in life and work issues that present some difficulty, and then offer alternative perspectives that may help the reader see a more helpful or powerful way to view the situation. When we can open our minds to other perspectives, it gives us choices. When we feel stuck, it’s usually because we insist on seeing an issue-from a narrow viewpoint.

I started my own blog a couple of years ago after I gave the ACPs first presentation on communication. Many people came up after the talk to say they were interested in learning more on the subject, so my earliest posts focused on that. Over time, the topics have included more coaching issues, such as becoming more mindful during the day and more aware of our own behavior and attitudes, and using this increased awareness to make decisions that create a happier and more fulfilling life.

VM: Tell us a little about your personal life.

My husband and I will celebrate our 29th anniversary this year and are enjoying living near the ocean, taking walks on the beach, and watching the sea life on our stand up paddle boards. Our kids are thriving as they engage in new pursuits and struggle to find their own place in the world. Our son is enjoying the hard work and team approach in the private equity-real estate company he works for, but isn’t sure what he eventually wants to do. That’s okay though— he is learning and growing and will definitely figure it out! Our daughter will be starting medical school this summer.

People asked if my husband, an orthopedic surgeon, and I tried to talk her out of going to medical school. We did try to suggest other paths that might not require such extensive training, but she was pretty set on becoming a physician. We both agree that being a doctor has been a wonderful part of our lives, so we understand her desire to do that and support her fully. She will be an exceptional physician!

VM: What made you decide to become a life coach for professionals in the medical field?

As I looked around and saw the unhappiness and frustration of my colleagues, who I know have spent so much time and effort getting where they are and yet feel so frustrated and unfulfilled, I knew I wanted to use my skills to help them specifically. I decided to become a coach once I realized how powerful coaching can be in helping a person become clear about what s/he wants, planning the steps to get there, and holding him/her accountable so that those goals are reached.

VM: Looking at the medical field overall, what do you think is missing in the curriculum that would better prepare students for the demands on personal lives of those who pursue medicine?

The game has changed since those of us who were trained decades ago signed up. My generation of physicians might benefit from learning how to adapt to change, to be clear about what we will and won’t do, and to think creatively about how to use our skills in other ways. Understanding what our core values are will help those of us who feel estranged from our lives, as that will allow us to reorient to what is truly important.

Although they still work hard, current medical students are already different in that they realize that work is only part of their life. Many medical students come to me wondering how they will fit all of their interests into a busy medical life. That was the furthest thing from our minds when I was in medical school and residency!

Just recently I was asked to speak to the student representatives of the Association of American Medical Colleges about “Balancing Your Interests Inside and Outside of Medicine.” First, I asked them what they had already given up but would like to reclaim in their lives. The answers were varied, from dancing to playing the saxophone to reading. This speaks to the fact that each of us is an individual, and one life structure definitely won’t satisfy all of us. Then I asked them to imagine their perfect lives. There were many surprises, as some students emphasized a strong family life while others focused on having a busy research career. We then brainstormed what other medically-related activities they might want to include. Media involvement, research, teaching, medical service trips, etc.—all of which can offer variety that maintains the stimulation in a lifelong medical career. Lastly, we mined for their individual core values so they could be cognizant of whether those values were showing up in their lives or not. When we feel as if we’re living someone else’s life, it’s usually because we’ve lost sight of our own values.

VM: What would your best advice be for those entering the current medical workforce?

A medical life is going to be a busy and demanding one. There’s a lot to learn, a lot to keep up on and change i a certainty. The stresses are considerable. Becoming a physician is a huge investment of both time and finances, by both physicians and society. If we want to take full advantage of that investment and not have the attrition we are seeing today, it’s important for each person to take some time to discover what s/he really wants and needs to feel fulfilled. I would suggest that they consider not only what area of medicine they are interested in, but what specialty will allow them to live the life they want to live. Periodically looking at our life and making sure that we are finding time for the things that matter most to us is essential.

Thinking outside the box is even more important nowadays and there are always more options than the establishment offers us. A medical career can also be quite fluid. We can change our specialty (within some boundaries), our focus, our practice location, or add a related activity (such as adding a research component) and still continue to practice clinical medicine. Physicians are very valuable commodities and they should treat themselves as such, in order to nurture and maintain their passion for their work for the duration of their career.

VM: How did blogging for the Huffington Post come into play?

How do you see using your voice in this widely recognized media venue? While I was attending the annual meeting of the American Medical Women’s Association, I heard Arianna Huffington speak. She was promoting her new book, Thrive. During the talk, she invited anyone who wanted to write for her site to contact her, so I did. I sent a few of my own blog posts and her assistant sent a note welcoming me as a blogger. Voilà!

What I hope to do is establish a platform on the Huffington Post that will be a voice for physicians. I don’t believe that our patients realize how unhappy many of us are with the direction our healthcare system is going, and I am hoping that we can engage them as advocates for more sensible change in our system.

I also believe that if we band together, we can become a force for more effective change. Recently, a coaching client shared with me how anxious she becomes each time she has to work in clinic. A hospitalist on labor and delivery, she sees other physicians’ clinic patients two days a month. When I asked what her expectations were, it became clear why this was such a source of stress for her. She expected herself to develop rapport with each patient, determine and solve the problem that each patient came with, get the patient to trust her so they would follow her recommendations, and communicate those recommendations effectively. All of this in 15 minutes, with 30 patients per day who she was seeing for the first time. This is clearly an unreasonable expectation for anyone.

Our current scheduling has taken the “care” out of healthcare. Patients are dissatisfied, we are frustrated, and no one wins. I am sure there is a better solution for all of us.

VM: Given all that you are involved with, what’s next for you?

I don’t know! I’m involved in so many things and don’t really have a good sense of what direction it will take me. I love everything I do right now, including treating patients, although my passion has definitely shifted from clinical interests to supporting medical students and physicians. I’ve always lived my life by following my passion, and that has been an effective strategy. But right now, I don’t have a good sense where it is leading.

There’s a quote attributed to John Lennon that goes: “When I was 5 years old, my mother always told me that happiness was the key to life. When I went to school, they asked me what I wanted to be when I grew up. I wrote down ‘happy.’ They told me I didn’t understand the assignment, and I told them they didn’t understand life.”

What defines you is what matters most, and what matters most is finding happiness. Dr. Fronek’s perspectives personify this, and she has proven to lead by example. Given her focus on furthering the field of phlebology, helping doctors attain fulfillment through work-life balance and following one’s passion, we are confident that whatever is next, she will embrace it with the same zest and positive attitude as she has everything else. We look forward to seeing what that is.