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Do fertility doctors deserve happiness?
It sounds like a strange question, but for many REIs it’s not abstract.
We step back from operations, technology, and finance to ask a more fundamental question with Inception’s National Medical Director, Dr. Jason Yeh:
What does a good life actually look like for a fertility specialist?
In this conversation, we explore:
Moral injury vs. burnout
The X–Y axis of time and money in a physician’s career
Happiness vs. meaning
Why fertility doctors often benchmark happiness against the status and performance of peers
Living in the moment as an REI
The different kinds of regret fertility doctors describe at the end of their careers
Conversations like this are rare. If you find value in it, please tell us. Because if the field wants more conversations like this…
we need to prove they’re worth having.
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Dr. Jason Yeh (00:00)
Burnout is really the exhaustion, but a moral injury is like a betrayal of values, so to speak. if you care a lot about patients, at risk, it's not a weakness. It's really a sign that your conscience is working. Hopefully we went into medicine for all these great reasons and the days can be long and the work can be beautiful. But sometimes that misalignment of value systems creates this friction in the conscience. That's what I would call it.
Griffin Jones (00:34)
Do REIs deserve happiness? It's a luxury to even be able to wax philosophical about this, it? My guest, Dr. Jason Yeh names three people by name who he says work like it's their life's calling to make life easier for his network's fertility doctors. Is that not beautiful? I want to talk to all three of those people about what they're doing to make fertility doctors' better, particularly at an inception, but I had to have this conversation first
justify all that investment, we have to know what a better life means for a fertility specialist. Dr. Ye doesn't pretend to be an expert, but he has thought about this question a lot. An interview I did with him last year about burnout broke the REI internet for a couple of weeks. In this conversation, we talk about moral injury versus burnout, the XY axis of time and money, happiness versus meaning, why REIs may be even more likely to use their comparison
of the performance and status of their peers as their benchmark for happiness, living in the moment as a fertility specialist, and regrets that many fertility doctors have at the end of their careers and why that can look very different from physician to physician.
There are so many similar topics that you all have asked me to cover, but sponsors are sometimes really restrictive with what they're willing to sponsor. So please, if you like this conversation, please, you gotta tell someone on Inception's leadership team. If you like this conversation, you have to tell them. They did not have editorial control over it, but I personally think it says a lot about how they treat their doctors and their team if they just let Jason and I space out in existentialism for an hour.
and I don't want them to regret it. So if and only if you like it, please mention it to them and to us, seriously. If not, I don't know how much more we'll be talking about this kind of topic. We would love to hear from
Dr. Jason Yeh (03:36)
all of us that got here who are blessed and lucky enough to get here have put through immense amount of work to get here and that there's inevitably some unhappiness and tension that has happened in our lives. But burnout, I think many of us are familiar with. That is this idea that it is just like a physical
and mental exhaustion, right? Essentially overwork. think about, you know, long rotations in residency where every two to three weeks I would just go home, fall asleep at 5 p.m. and sleep until the next morning, skipping dinner, skipping breakfast. That is burnout. I'd like to hope that I think a lot of our jobs as outpatient daylight specialists, we're not working, you know, 3 a.m. hours, hopefully most of the time. But I would define, you know, moral injury as more of like an
asymmetry, when we have essentially some psychological suffering, when we're not acting in accordance to maybe certain values that we had, or there's some sort of external constraints.
I'll give you some examples, right? So, you know, maybe as a physician, we care a lot about success rates and how we care for our patients. Those are in some ways, easy things to measure. But I think for a lot of networks and physicians, even within mine and others, what we get
our feedback scores for like how many consults did we see and how many cycles did we do? And that is an incongruity or an asymmetry there that takes a little bit of adjusting to get used to, but we all do. Or another common one would be like, ⁓ we get this a lot with new hires and new physicians. They say, I love surgery. I did so much laparoscopic surgery. And a very common reply is, well, you know, that's great. You can do as much as you want, but I think you'll find in three to six months that it's going to be not
your time financially, right? And so I think burnout is really the exhaustion, but a moral injury is like a call it like a betrayal of values, so to speak. I mean, I think I would say that if you care a lot about patients, ⁓ you're at risk, it's not a weakness. It's really a sign that your conscience is working. But, you know, there's that line about grief, you know, if someone loses somebody they love, grief is just this outpouring of love.
And there's nowhere for the love to go and moral injury is like, hopefully we went into medicine for all these great reasons and the days can be long and the work can be beautiful. But sometimes that misalignment of value systems creates this friction in the conscience. That's what I would call it.
Griffin Jones (06:03)
What's the appropriate amount of moral injury to tolerate in your view versus when is it really going to lead to burnout?
Dr. Jason Yeh (06:14)
Well, moral injury, think, you know, we tolerate a lot of that every day. That's with any job, any profession. I think you'd be naive to assume that medicine is purely just a hundred percent of your time helping people. That's hopefully why a lot of us went into medicine and you'll find that a lot of what we do is 99 % mouse clicks and typing. So there's something congruity there, of course. But I think that's for every person to answer on their own. I think.
would say that the path to cure, maybe that's a better way to frame it is how do we get towards alignment again, right? So this idea that people are talking about it like you and me, this idea that normalizing conversations about disillusionment, whatever that might mean, I think that's super important. I think if you can find a place, hopefully, that supports constant realignment,
constant improvement of workflows, you know, if there's something that's really bothering somebody that we can move the true north towards how do we, you know, find more fulfillment in our day instead of just like crunch out these numbers that is a form of curing the misalignment. But at the end of the day, I think, you know, if you're nitpicky enough, there's moral injury everywhere, accounting, you law, medicine, all of those things. Like those, those jobs are rarely what
You imagine they are when you're actually deep into practice.
Griffin Jones (07:41)
I think an expectation of every part of my job is gonna be something I love is millennial BS. And I'm saying this as someone born in the mid-80s, I fit the demographic, and I don't think it led much of my generation to a great place.
Dr. Jason Yeh (07:51)
Mm-hmm. Mm-hmm.
Griffin Jones (08:00)
setting the expectation that you should always be happy with work. I think that's a privilege that we should all aim for that takes a while for most of us to get to. But the idea that it should be the default, I don't know what people are comparing it to. Like if I'm comparing to any of our ancestors that came from any part of the world prior to the industrial revolution, life sucked. And then before that you had an agrarian society that was
Dr. Jason Yeh (08:12)
Mm-hmm.
Griffin Jones (08:29)
brutal. And then before that, you had a hunter gatherer society that was brutal. So do you think those people were like, you know what, if I have to do something that doesn't lighten me up today, it's just not worth it? Well, there wouldn't be 8 billion of us on the planet if we if we constantly had to face that sort of existential question to get to happiness. So, okay, I'm with you. People might have to determine it for themselves. But where do you land?
Dr. Jason Yeh (08:32)
I could talk. Yes.
Yeah, yeah, yeah.
I'm so glad you asked. You're going to have to make me stop talking at some point because I have feel like I have so much to say about this. But, you know, I think, I think about these questions about happiness a lot. You know, I am very much considered a middle-aged dude. I got young kids, a nine-year-old, a 13 year old, and they take up a lot of my conscious thought wondering about their futures and mine as well. I think instead of what to tolerate,
I think all of us hopefully are chasing happiness in a way that we can sort of hack for ourselves. We have a lot of wisdom through experience and others and philosophy, but you know, there's this, ⁓ quote that's attributed to Confucius, something like I, I complained, I had no shoes until I met a man with no feet. Right. And so, I mean, on one hand, you can see how that could be a powerful idea. I don't think however,
as much as I like your analogies that thinking about how miserable life was immediately makes us happy. I don't think that's how the human mind actually works, right? If you have kids, you know this like blah, blah. My, my life was so hard when I was your age. It doesn't immediately make them full of gratitude and happiness. But I do think if I could share some thoughts about maybe less, let's call it lesson number one about being present, I'll share some personal thoughts about how I sort of started this
post fellowship journey. So I am what I would consider like a fan of student of personal finance. It's something that's always interested in me. I dropped out of the business school a long time ago in college to really pursue other things. But when I graduated fellowship, I was deep into the world of fire. F I R E, right? The financial dependence, retire early movement. And, you know, I would say I'm proud to have brought a lot of my
work colleagues into personal finance and investment. I, you know, stashing away maximum amounts of money. I remember a very poignant conversation with me explaining to a coworker like this coffee is worth so much more in retirement than I would needing it now. So like, why would you buy the coffee now? Like it was, it was pretty extreme, but I would say embarrassingly, it took me two to three years to kind of figure out that was terrible for my work health and mental health. Cause it basically makes you kind of
dread the work hours now like chasing this idea of retirement like of course like I just got to get past this job to like really live my life you know and there's this the risk of sounding you know too philosophical right this is Buddhist monk he passed away a couple years ago I'm not Buddhist but Tick Han he basically said something like there's there's two ways to wash dishes right the first is to
wash dishes in order to have clean dishes. Like you're, you're chasing the clean bowl and the clean plate. And the second is to really wash the dishes to wash the dishes. And if you're chasing that bowl or chasing that plate, we're just rushing through everything. We're not even alive during those times that we're just like getting through to the next thing. And this is such a reminder to be present, right? Like the obvious analogy now I'll call back to our field.
I mean, our ease are, I, know, I'm biased obviously, but we're super human physicians, right? We are trained to the max open surgery, laparoscopic surgery, we're endocrinologists, we're ethicists. You know, we dealt with beginning of life, end of life, G wine oncology. And like we do all this and then somehow we are funneled into these fertility conversations, which I would
you know, generously say 10, 15 conversations on repeat over and over again. It's very easy to get monotony out of that. And if you can sort of zoom out and think in that moment of being present, I think that washes away some of that moral injury. ⁓ you know, I think being with that patient, whatever that means for them, it's, very hackneyed. It's very, you know, stereotypical thing to stereotypical thing to say.
But even this chat, right? This conversation with you and me is an unusual thing for me to do in the week and I'm gonna try to enjoy this as best I can. So that feeling of being present is one way to sort of combat that moral injury that I think we all face.
Griffin Jones (13:19)
people like Zig Ziglar have been saying forever, you need to enjoy the climb up the mountain, you need to learn how to enjoy that. I think some people are more predisposed to do that. And others of us really have to cultivate a mental discipline where you're really associating the outcomes that you've seen and you're establishing a positive feedback loop because I've had
great results with my patients, they've sent me pictures, they've sent me cards, they post on social media how much they like me. And I need to remember that I'm treating every patient as though they deserve the same from me to get to something approximating that even if I can't guarantee that outcome. even if I've seen other negative examples. So for you, that
discipline that you mentioned, was it something that you cultivated or was it something that came a little bit more naturally?
Dr. Jason Yeh (14:14)
Yeah, I forget if we talked about this in episode one. There's another philosopher, Ivan Illich, right? This idea that Western medicine has commoditized healthcare, right? I mean, what has become more commoditized than Western medicine, right? But because we are chasing healing as the outcome,
that has sort of turned into perfect health or a live birth or whatever we're chasing is the only acceptable outcome. But we as the physician should learn to be sort of mediators of coping, right? We are assuaging the positive and negative emotions. Call out to Kenan Omertag if he ever listens to this, but his joke is if you ever look up assuage in a dictionary, you would see an REI doc right next to that definition, because that's basically what we do.
I don't know, probably like you. see me, you strike me as a YouTube guy. I spend a lot of time on YouTube just, you know, trying to absorb wisdom. It's, you know, it's sometimes it's mindless, but sometimes it's deep. And I think it's the comedian, Jimmy Carr, comedian, philosopher, Jimmy Carr, right? He's got this bit. He's like, you know, you and I, there's a very high chance in 30 years that when all is said and done, if we're lucky enough to be alive in 30 years,
that we would probably trade like all the wealth that we have accumulated at that time to be as healthy and lively and not wealthy as we are right now. Right? Like we would just give that up in a heartbeat. Like, yeah, absolutely. Like whatever it is now plus 30 years. And the only logical response to all of that is to just be thankful for today and the moment.
And to be like, cool. I woke up. There's another day. Let's do it. You know, and that brings you back to lesson one, which is like be present. So it actually has to be a skill. I think the trap of fertility docs and all physicians and all high achieving professionals, if it's one of these very laid out paths, right? Like an 18 year old kids is I want to be a fertility doc. Yeah, I got a copy and place, broop copy and paste blueprint. I can give that kid for 15 to 20 years and be like, I know what the next 20 years of your life is going to look like.
And it's going to be a then B then C then D and you're to pass your boards and blah, blah. And it's very easy to lose sight of all of those moments as you're going through it. And yeah, it absolutely has to be a skill that you practice. The bad days are everywhere, right? Good days are everywhere, but you have to be sort of mindful to just kind of accept, that the good and the bad, they don't last forever, but that mindfulness appreciation for the current time now is very important.
And I'll speak personally for myself. My parents are well, they're both 76, but I will probably sadly look back on this 10, 20 years from now. And I'll think of these years as the best years ever. My kids are at home, you know, love my wife, love my family. Parents are nearby. Everyone's happy and healthy as best as we can be. And instead of, you know, reminiscing about the past, scared for the future, just sitting right now is the only logical reaction I can have.
Griffin Jones (17:24)
When you wax philosophical like this with other REIs, how do they respond to you?
Dr. Jason Yeh (17:30)
That's a very good question. I got a couple of work partners that look at me like I'm crazy. I think some of them understand. I think you've got to go through some stuff in life and maybe, you know, heard some stories or just chase this. I probably am an outlier. I think back to a small group learning I had in med school. She'll never listen to this, but it was Dr. Vcio. So at UT Southwestern in Dallas, she ran around the table.
She guessed everyone's medical specialty with pretty good accuracy, turns out. But for the three years that I knew her, she got to me and she's like, I have no idea what you're going to be. So anyway, I probably am a bit of an outlier, but I think we deal with such major topics. We deal with life, family, being a parent, you know, we're all children of somebody. And I just, I just,
This is how I cope. This is how I function in the day. So this is my natural outpouring. I do find that some of my, let's bring it back. Some of my moral injury is resolved by reaching out and connecting to younger physicians to make sure that they don't necessarily feel the weight of the specialty the way I did for the first three to five years.
Griffin Jones (18:41)
Do you have these types of conversations with them? Because I look at you as sort of one of the symbols of Prelude Inception in terms of who would be recruiting talking to younger docs. Like if someone were asking me, hey, I'm thinking about Inception, who should I talk to? I would send them to you and maybe a couple other people. But I see you talking to younger docs when we're at conferences and they seem to know you.
Dr. Jason Yeh (19:01)
Hmm.
Griffin Jones (19:09)
Do you have these conversations with them and how do they respond? Are they just like, okay, thanks Jason, just looking for a starting bonus 500K here or is there a spectrum? Yeah.
Dr. Jason Yeh (19:20)
Yeah. Yeah, rule number one, you gotta know your audience. mean that that is
that is on. Yeah, I mean, I think, you know, this is a I think we talked about this episode one. There is an arc. There's a journey that every already goes through. I think, you know, we're not all the same age when we graduate fellowship. We're not off the same life stage, but a lot of us are, you know, it's you graduate fellowship. Perhaps you're partnered, perhaps.
You're planning a family, perhaps you have young kids and definitely you're studying and trying to pass your boards. So your mind is occupied. Your mind and body are occupied for the first three to five years of training. And then suddenly all respect to a bog and everything you pass your boards. And then you realize that maybe the luster and the academic depth of this field is not really what you expected. And you're like,
Wow, there are unanswerable questions about mosaic embryos and PGTA and all of these things. Why don't transfers work? And you just, I think naturally after your 20,000th console, you're like, okay, there needs to be some other things. So I, I would politely say I do not have these conversations with new fellows, but I do think that seven to 10 year Mark is a, is a pitfall for, think a lot of physicians.
If you are looking for something really deep and meaningful out of the practice of medicine, and maybe you're whatever, chasing the dollars or whatever, this can feel like a very empty field if you kind of let these major insights disappear, in my opinion.
Griffin Jones (20:57)
You're in the YouTube zeitgeist. So you know that within that sphere, the conversations that are happening there is there's a school of thought that says the pursuit of happiness in the way we've come to think of it in our society is frivolous and people should instead be pursuing meaning. And if you get happiness as a nice byproduct, that's a good thing. But pursuing meaning is
Dr. Jason Yeh (21:00)
Absolutely.
Griffin Jones (21:25)
is the proper way to orient oneself through life. How do you think about meaning relative to happiness?
Dr. Jason Yeh (21:31)
Yeah, I would fully agree with this. think, you know, people may not. So I was, I was sort of a student of the liberal arts. Let's say I was sort of a pseudo philosophy major, or you could say a philosophy major in college. And I think, you know,
to
to even go off of what you said, right?
conversation that I hear every couple of months, every couple of years, and maybe you've heard it too, is that it is apparent when you go to ASRM that there are some very wealthy people, very powerful people in our field, right? And I ended fellowship in 2015. I started with residency in 2008. These were some of the sort of major formative years of what we do now.
meaning extended culture, day five transfer, PGT testing, which created immense wealth for some people and practices. And I think a lot of people will say stuff like, man, REIs 20 years ago had it the best and then REIs 10 years ago had it the best, right? And like you said, right? The meaning and the purpose is important because
Are you familiar with this philosopher? ⁓ Renee Girard, does that sound familiar to you? So this is, it's a, it's a French dude. He's, think he's also passed unfortunately, but his idea is that, you know, so much of what we want. So he basically talked about human desire, achievement, competition, all these things that make doctors, doctors, right? You go into ASRM and everybody is puffing up their chest, chasing the next, you know, capitalist exit.
Griffin Jones (22:44)
Not really.
Dr. Jason Yeh (23:08)
multiples here and there. All you hear nonstop is P E this, that and whatever, right? But the idea is that, you know, he had this theory that it's called mimesis or mimetic theory that what we're, what we're wanting, whether it's a title or money or accolades, cars, clothes, watches, whatever. mean, I'm a fan of many of those things I listed, but these aren't things that we want intrinsically. These are things that we're copying what somebody else wants.
And desire is essentially this agreement that you've made with yourself to basically be unhappy until you get what you want, right? That if I get this thing, this product, this clothe, this suit, this watch, this jewelry, whatever, that's when I become happy. But as we all know, that does not work. And it's actually this metaphysical desire of, of what we're chasing that actually causes us to feel.
So it's actually our wants that make us unhappy, right? And so what you said about, I'm not, I grew up staunchly Presbyterian actually. So, you know, it's money, it's stuff, it's time even, right? But what you were saying about hunter gatherers and, you know, a hundred years ago, 5,000 years ago, whatever, like,
Griffin Jones (24:10)
You sure you're not Buddhist?
Dr. Jason Yeh (24:30)
Our quality of life, so here's the equation, right? I had this conversation a couple days ago at the Inception Physician Summit, by the way, which we should talk about. But our quality of life today is objectively good. So the formula for happiness is something like, you know, quality of life, which is good, right? Why is it good? Well, we're all physicians, maybe most of our listeners are, you know, in the specialty, one of the highest paid specialties in all of medicine, if you don't believe me, post your salary on
Facebook group of physicians and watch what happens. You know, for humanity, most of us were dead 200 years ago by the age of 40. I'm reminded of that trip Boris Yeltsin took to a random, I think grocery store Randall's it was in Houston, he just like walked in, looked at an average grocery store unannounced and he couldn't speak for hours, right? Like this was in the 80s. And that is our quality of life today. Like we could all
get delicious food in our mouths in 15 minutes starting right now if we wanted to. And quality of life minus our wants, minus our envy, minus our desires, that is happiness. And that just kind of leaves you thinking that, you know, managing your wants and being grateful for the present can equal happiness. I totally understand. can see.
why this is becoming a very abstract conversation. But I think this is important because, you know, when you start chasing the money, start chasing the stuff, I think we all know at some spiritual level that that's not exactly what we need to become satisfied with our job.
Griffin Jones (26:02)
But
I think it's important because what you're talking about of pursuing those things that other folks want, I think that REIs likely over index for that even more than the average person who already really does that a lot. It's an evolutionarily biological mechanism to want to.
Dr. Jason Yeh (26:08)
Mm-hmm.
Tell me what you mean by that. want to understand that more.
Griffin Jones (26:25)
of being a mechanism of evolutionary biology. If, ⁓ so you all are overachievers. You all are such a slim segment of the population to one, wanna get a good undergraduate degree that weeds out a number of people, then to go through medical school, then to go through four years of residency and say,
Dr. Jason Yeh (26:28)
The overindexing.
Griffin Jones (26:51)
You know what, I haven't had enough of making little money. I don't feel like I have enough either prestige or mastery or something that I just wanna study and get even better at. I need another three years. And by the way, while I'm doing all of this, I'm moving across the country. Maybe I'm not getting matched where my spouse is and I have to do a long distance relationship with someone. And so I...
I think that REIs are even more in the cohort of needing to be the best in their class. And I'd see it all the darn time. get to have private conversations with folks. get to have consulting sessions with folks. very, very often REIs are saying, that's what so-and-so makes, or I heard so-and-so is doing this. And that's...
Dr. Jason Yeh (27:25)
you
Griffin Jones (27:43)
the frame of reference for success for them. And so when we go back to, I 100 % agree with your earlier point that just because hunter gatherers suffered and people are suffering in huge swaths of the world today, that doesn't make one more instantly happy. But comparison is the thief of joy. And I think we constantly need to reset. And I think that many REIs are not
Dr. Jason Yeh (27:44)
Harrison is a thief of joy. absolutely.
Griffin Jones (28:12)
resetting because their whole upbringing, their whole career and academic trajectory has been focused on accomplishing a goal and that goal always raises once they reach it and it's very largely informed by what their peers are accomplishing.
Dr. Jason Yeh (28:30)
Yeah, I was not planning on bringing my wife into this conversation, um, nor am I advertising her services, but she is a clinical psychologist. Okay. And she, uh, essentially has a private practice exclusively of high achieving individuals who may or may not have gotten on the rat race of high achievement. And at the end of 20 years of
CV building are not totally sure what they want out of life anymore. And there's a moral injury there too. And I think she, you know, there's enough of a pattern that she's literally written a book about this. so these, these are topics, you know, to say, when, when are you having these conversations? We, talk about this stuff a lot, but this is a very common thing. You know, I think late thirties, forties, late forties transitioning in the fifties. think a lot of our identities might be wrapped up in our children.
It's very easy when you've got a prescribed 15 year course of REI training that you don't even let these bigger questions into your mind because it's not worth the time or the effort to resolve it.
Griffin Jones (29:37)
And think of how many of your peers went to really good schools growing up. They went to really good colleges, maybe Ivy League or something similar. And it's constantly been about outperforming other people. That's what sets the baseline. And I think trying to get someone to think of a different benchmark
Dr. Jason Yeh (29:56)
Yeah.
Griffin Jones (30:03)
for what success is. You're swimming upstream. Do ever feel that way?
Dr. Jason Yeh (30:09)
Absolutely. You know, I think it's you can zoom in and say, my life is X, Y, Z of a certain situation. And you could see it as objectively good or objectively bad or whatever. But I think that's a lens that you put on a situation. mean, the trap is, you know, I'm I'm capitalist. I believe in all of this. But at the same time, let's not be chasing money that we don't need. It's the expression.
to impress people that we don't care about to do a job that we don't even like, right? So, you know, I'm not here to assume that even my own professional goals will be the same for the next five or 10 years, but for now, this makes a lot of sense. But I think the journey of an RE probably at certain marks, certain time horizons, maybe we transition a little bit more towards leadership or consulting or education or whatever the case may be. There's the job.
The specialty is beautiful and it's endless and there's so many ways to manage this. I, this is tangentially related, but a couple of days ago on YouTube, I saw a short film. I think it was called Retirement or Retirement Plan or something like that, but it's a short film that's up for an Oscar this year. I think it's from the New Yorker or the New Yorker channel or something, but it's basically this cartoon.
illustration short film about this older gentleman and he's just saying stuff like one day I'll learn to play the piano one day. I'll read the books one day. I'll become good at meditation one day. I will become present right and it's like yo what are we waiting for the time is now I mean you have to just I mean we many people would switch places with an REI fellow
as hard as life can be in an instant on this planet. So, yeah.
Griffin Jones (31:59)
I think there is an XY access of time and money, we all need a certain amount of money. And I think we all want a certain amount of time. But I suspect that many people are wired and geared to probably want and feel like they need more money than they actually do, at least in in our field, right? Because our field most REIs by definition are one percenters.
Dr. Jason Yeh (32:05)
Absolutely.
Griffin Jones (32:23)
1 % or I think nowadays is someone at if I'm not mistaken in the United States, a household income of half a million dollars a year. And so most REIs are the people that occupy Wall Street, people were protesting against and and then even for others, almost everyone that works in the fertility space is in the top 20%. And if you are in the top 20 % in the United States of America in the 21st century, you're
Dr. Jason Yeh (32:30)
Mm-hmm. Mm-hmm.
Yeah. Yeah.
Griffin Jones (32:50)
richer than virtually anyone who's ever lived. and so I feel like many of us are still have a higher priority on money because of the roots of evolutionary biology. There wasn't really an evolutionary biology mechanism driving needing more time, right? I need more quality time. That's something that you you
get the luxury of having once you get to a certain place in society. Do you feel like most or many of your colleagues don't prioritize time enough?
Dr. Jason Yeh (33:17)
Mm-hmm, mm-hmm, mm-hmm.
Yeah, this is, mean, I'll be honest, this is a pain point for even myself. think there are, there are temptations to sort of look at your day and just to say like on some days that are hard, like really hard, I do feel like I'm literally just trading time for money. I'm not getting sort of some emotional satisfaction, professional, you know, fulfillment out of this day.
And maybe if you string enough of those days in a row, you're like, Whoa, like, am I really just trading my life minutes for money at this point? I would hope that all of us are in organizations that are receptive to this. Maybe it's a network, maybe it's not, maybe it's physician owned. And I would say that the cure to moral injury or whatever you want to call this is like a realignment of how you can spend your work life balance. Right? So
If there are minutes or if there's drives or whatever, I can say in my own practice, we went from excessive driving consults that were booked inefficiently, a lot of patient dissatisfaction because of certain workflows that would then fall back on the physician, which would create a lot of resentment in me. And the leadership teams were able to sort of help us craft a path that suddenly all of these things suddenly got better within a span of 18 to 24 months.
And even though my job is the same on paper, my day to day is completely different than, and I might be spending the same amount of hours at work, but it's a higher impact hour. It's a, it's a more sort of comfortable burn of my conscious minutes. So it's not like I'm just wanting to my hair out every minute. So yeah, the short answer is, ⁓ there is an XY axis somewhere and everyone's got to figure this out. I think, you know, also as a personal story, I am
child of immigrants and trying to explain to parents that maybe didn't grow up with that much and grew up with, you know, just scarcity mentality that money doesn't make you happy. Like that doesn't register for them. Right. And then I am very successful in explaining. I feel like I will see, but to my children that I'm like, yeah, money does not make you happy. You have to have enough to live all these things. But what if something happened to me or what has happened?
We had to go live in a smaller house. Like, can you find in your brain that space that, you know, the stuff isn't what makes us happy. It's the time together and it's these moments and all of that. So I know this sounds very, very metaphysical and almost a little bit out there, but it's, it's, I do feel like these are skills that you have to practice every day because one trip to ASRM and you're comparing salaries and how nice someone's watches and suits and shoes and
you know, kind of car they just got. And, you know, that is that is interesting. It's a fun game to play if you're a fan of capitalism as I am as well. But it's a dangerous one if you're not really sure what your moral compass is.
Griffin Jones (36:17)
Did you talk about this at the Inception Summit, which we're recording a couple days after? Is this something that you get up on stage and talk about or that you...
Dr. Jason Yeh (36:25)
Yeah.
No, actually.
No, not really. I had a conversation with two colleagues just after the meeting for like an hour about how to find happiness in life. Actually, without naming them, I'll just compare and contrast them. Maybe they'll listen, maybe they won't. But one of them was like.
We, one of them was like, we better not be doing this in 10 years, right? Kind of like a rejection of this work is hard and I gotta be done. And the other one was my idea of retirement is still doing this two to three days a week. So I think this job taxes people differently and that's any jobs, you know, like means to an end versus.
maybe some fulfillment in the here and now. But I can't speak to their personal experiences, but at the end of the day, think these are conversations that start to become real for each mid-career physician.
Griffin Jones (37:24)
Have you ever pitched the topic to TJ or anybody else at Inception and said, hey, here's what I want to do. I want to talk about happiness. I want to have it be the keynote of the Inception Summit. How do you think you go for it?
Dr. Jason Yeh (37:37)
I think he would, well, maybe he listens to this. think he would be receptive to it, but I would absolutely not pose myself as an expert on any of this stuff. just think, you know, we're all just trying to find the culture fit that helps us get through the day in a positive way. I will credit him and the exec team to basically think of this organization as like a, like a living,
Organism with culture and ethos and humans that are real, you know, like we're not just little economic units pumping out X number of cycles per month. I think that is part of the balance sheet. And probably once you move high enough on the, on the management chain, they don't even know me personally. They're just like, Hey, there's this doc in Houston, Texas doing this stuff, but I'll, I'll quote TJ here and at the risk of sounding a little, sappy, but
You know, the good times won't last and neither will the bad. But you know, the time together, however we spend it, you know, can be used towards, I guess I'm putting my words into it, used towards building an organization that can weather the good and the bad times better, right? If the positive time together that we spend, social hour, whatever you want to call it, can help us get through those hard times. And there will inevitably be hard times.
So yeah, I actually, think it's one of the next iterations of physician support. know, I think burnout and moral injury can occur at any output level. Physicians doing a hundred cycles a year being burnt out, physicians doing a thousand cycles a year being burnt out. I mean, there are many physicians at inception doing at or more than a thousand cycles a year, which, I don't know what that feels like, but I'm sure it's pretty intense. And I would hope that
regardless of output that, you know, physicians can have some level of support there. I heard someone quote on stage that like, you know, a turnover on a nursing staff costs us $300,000. I can't even imagine what a physician, you know, turnover would cost, whether it's time off putting changing teams, whatever, you know, very expensive. So, you know, there's a, there's an article that I read every year. There's an author, author books is a
happiness guy from Harvard. He's on YouTube all the time too. but he basically has all this research on happiness and you know, if you're at the worker level, happiness is important integrally to part of your day. But if you're at the C-suite level, guess what? Happy employees generate more profit too. So this is a shared interest that I think all levels should
Griffin Jones (40:12)
I do think that you're not alone with this, Jason, because the last episode that you and I did was really, really popular. And this one is either going to be really popular or people are going to stop listening four minutes in. There's not going to be a middle ground.
Dr. Jason Yeh (40:25)
That's OK.
Yeah. That's fair.
Griffin Jones (40:27)
Jason, like, there's not gonna be a middle ground.
it's either gonna be like this takes off or people are like, what are those two dudes talking about? And so my...
Dr. Jason Yeh (40:33)
Yeah.
It's okay. I'm okay with that. I'm okay with that.
Yeah. I'm used to being a little bit of an odd duck in a lot of the circles that I run in. So that's okay.
Griffin Jones (40:48)
But you're you're just putting words to concepts that people have nagging them whether they think about it or not. And how well do you know Eduardo Harrington? Do you know him from?
Dr. Jason Yeh (41:00)
Yeah, I mean we're
friendly. We always chat. We hang out a little bit when we're next to each other. I've had many one on one conversations with him. I like him a lot. He's always great.
Griffin Jones (41:11)
When I had my first child, sent me a book called, How Will You Measure Your Life? And it was from one of his professors at Harvard that may or may not have been a colleague of Arthur Brooks, I don't remember, and a professor that has since passed away. But he talks about these examples of when people are just pursuing the next thing.
Dr. Jason Yeh (41:22)
Mm.
Griffin Jones (41:33)
it can lead to some serious trouble and to your point about being in the present. I there's a value to being in the present, but there's also a value to being present in the life stage that you are in right now, Jason, because your parents will not be with us in a couple decades time and your kids are not gonna be at home and they're not gonna be as
influenceable to the character that you want them to have. And you will have either done your job as a parent, or, or maybe they will turn into people that we don't want them to be. And the less time we spend with them, the more likely they are to, to, to be influenced by factors that we don't want them to be influenced by. So and that I think it's so critical, because so many REIs are in that stage.
And even if you're a younger REI, like we use the word young REI, it's a relative term, because you're really not an REI if you're less than 33, for the most part. so within a decade of being a fertility specialist, you're middle aged. And so maybe just talk about that. And is that something that your colleagues bring up frequently is just like, because I hear it from docs all the time.
Dr. Jason Yeh (42:32)
Absolutely.
Mm-hmm.
Griffin Jones (42:53)
They say, yeah, but my kids were only little for a short period of time and I missed it or I'm missing it.
Dr. Jason Yeh (42:59)
Yeah, you know, it is, it's, it's the plight of, think, a lot of physicians, unfortunately. think medicine demands a lot from physicians, American physicians, and no one ever posed it this way to me, but I am sort of grateful that randomly, and there was some purpose here, that I ended up in a specialty where I get to go home, sleep in my bed, hang out with my family, basically every night.
Not every physician has that luxury. And whenever I meet a young medical student, sometimes they rotate through a surgery centers. I'm like, okay, I understand there's a lot of different things that you can choose from, but how about you start with, are you willing to work the night shift? How about you start there? If yes, here's your choice list. If no, here's your choice list, right? Because I think at the end of all of this, you know, there's time that you will have. Some people are.
willing and able to give endless amounts of time to the work, to the patients, to the job. A lot of REIs, you know, I think perhaps to be honest with myself and our listeners, like, yeah, a lot of other specialties maybe appealed to me as well, but just because of the life commitment. Yes, there was time commitment in our field, but the life commitment, being on call every other day, being on call for 40 hours straight, 50 hours straight in the hospital, not coming home.
You know, got transplant surgeon friends that really, when they're gone, they're gone for two, three days at a time. That is not in the family ethos that I was raised in. That's not kind of how I want to spend my life. So yeah. So I think every REI has got to figure it out on their own and you know, work life balance, a practice and a network and tech solutions that, that help you live that time at work and at home to the max ability that we can. That's very important.
Griffin Jones (44:46)
you have to have that operational background to it. And so I think maybe we could talk a little bit more about either some things that are on the horizon for inception prelude that either came out of the summit or or just that you're doing because one of our values, one of my company's five core values is forge ahead and recharge.
Dr. Jason Yeh (45:01)
Sure, sure.
Griffin Jones (45:11)
I don't usually contact them in the five o'clock hour. I rarely do in the six or seven o'clock hour and virtually never after eight o'clock, virtually never on the weekends when people go on vacation. They are told take email off your phone, take project management off your phone. But that
Dr. Jason Yeh (45:13)
Mm-hmm
Griffin Jones (45:28)
presumes getting worked on being profitable, all of that sort of thing, because without it, then we, we can't do those sorts of things. So deliberately in our values, forge ahead comes before recharge, don't dawdle, build really good systems, build really good processes, so that we can enjoy this time outside of work and so that we can enjoy the work that we actually enjoy doing more the things that we perceive value adding.
Dr. Jason Yeh (45:31)
Yes.
Griffin Jones (45:57)
but we need to eat our peas and carrots before we can enjoy that meat. It's not about just enjoying the meat, but it is that you have to have that infrastructure built in place. What do you all see you all being able to provide REIs in order to be able to do that?
Dr. Jason Yeh (46:16)
Yeah, I mean what you said there about your organization is amazing. It's also somewhat of a I would say a luxury of our field that we are allowed to do that to some extent. I mean the issues are kind of 24 seven with ectopic pregnancies and OB bleaters, but on a global level like we do kind of wind things down in the evenings. IT energy Houston power goes out. No, those those people are working 24 seven, right? I am grateful to be at.
a national network where I will call out three names and they spent a lot of time on stage these last couple of days, Kat Stillman, Bob Huff, Brian Markworth, where they're almost like their life calling their life mission for us is to weed out just inefficiencies, right? When, you know, I say there's this time in my day where I'm clicking too many buttons and this doesn't make sense. And my gosh, like
literally using an hour and a half of my day doing this and I am not contributing anything to patient care. How do we make that go away? And Kat, her job is to come up with ideas, products, commercial solutions that address that and make that problem go away. There's never gonna be an instantaneous win. All the wins are gonna be small, but if you add them over time, hopefully that stack of solutions can really improve the work-life balance for somebody.
⁓ No, there's lots of stuff. It's different for every organization. AI tools for documentation. There's a lot of internal tools that are on the horizon. I can't really spell too many secrets, cause I were told not to share too much of this, but solutions to help the clinical team members, right? Like make sure that they, cause they're the next target, right? Physicians. Yes, we have burnout, blah, blah.
Griffin Jones (47:35)
What's in that stack of solutions?
Dr. Jason Yeh (48:00)
but also our clinical team members. Like they are deserving of protection as well. There are, you know, obviously telemedicine tools, auto documentation tools. We are big fans of cycle clarity at many of our inception locations where, you know, we have clinical team members, not always sonographers, but clinical team members that have to be trained how to scan. And then after they've been trained how to scan, they realize they have to scan 20, 30, 40, 50 patients a day. And they're like,
I don't like scanning anymore. And then they sometimes leave because they don't want scanning anymore. And then all of a sudden we lose the one year training time that we put into them. So, you know, what if there is this AI tool that helps us scan through ovaries and we can now take a 20 minute or 10 minute or five minute scan and reduce it down to a one minute scan, right? So there's lots of things at every level that we can use, but it requires other people.
team members that are probably not physicians with their own professional work time to solve these solutions because God knows I don't have those hours in the day to chase those down.
Griffin Jones (49:02)
These people are gonna be the people that I interviewed that are like the other side of this conversation. The like, how we get to enjoy the luxury of debating meaning versus happiness. And I wanna talk to each of them. Kat Stillman, Bob Huff, and who was the third person?
Dr. Jason Yeh (49:07)
Mm-hmm ⁓
Mm-hmm.
Brian
Markworth. Yeah, Kat Stillman. I want to say she's president or VP of products at inception. Bob Huff is sort of our tech guru. Sort of deep. you know him. Yes, of course.
Griffin Jones (49:31)
I gotta have Bob back on. I've known Bob for a long time. It's
been a while since he and I have spoken, but when you said that compliment of these are like three people whose calling is to make our lives easier, that is perfectly in line with what I know about Bob. And I know that he's been with you all for a while, but that's such a beautiful compliment, Jason. Have you told them that?
Dr. Jason Yeh (49:37)
Yeah.
Mm-hmm.
Yeah, yeah.
I mean, no. I give them high fives though. No, I mean, I, I, I, I think there is a ambition, but also kind of a humility that they have to carry with them because they're not physicians and you know, they are willing to listen us out and be like, this is a problem. Let me try to fix it. I think if they were
deep into medicine, may have their own biases or preconceived ideas of how a problem should be solved. And I think all of us came from academic institutions where a lot of, you know, overbearing mentors were like, this is my way and this is how it should be done. And that's not everyone's experience, but I think it's cool to have a network that is so agile in this space. you know, thanks for the reminder. will, will thank them for all of their work.
Griffin Jones (50:43)
You should you
should tell them that in those words, because I think it's incredible. I think I think it's what doctors are. They need that. They need people like that.
Dr. Jason Yeh (50:47)
Well...
Yeah, I mean, I,
if you look at my last correspondences with them, I'm usually more sending them requests than me thanking them. But yes, I should, I should even it out with some gratitude. You're totally right.
Griffin Jones (50:56)
Yeah
⁓
all the more reason. Jason, I could have these conversations with you again and again, and we will. Hopefully, people will keep listening to them. They did the last one, so we're gonna find out. We're gonna find out, did we take them off the rails or are they along for the ride? So thanks so much.
Dr. Jason Yeh (51:14)
Right. Yeah, I love it. Fantastic. All right. Have a good evening. Thank you for your time. I enjoyed it immensely.
Dr. Jason Yeh
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