38. Janeeka Benoit, DO: Creating HABITs & Transforming Lives with Exercise

Hello everyone, I'm Dr. Darsha, and I'm Dr. Altamash Raja, and welcome to Medicine Redefined. A podcast where we will explore the often overlooked but necessary components of health, what we consider to be the fundamentals. We will investigate topics and practices that can give you and your patients the best chance to optimize a healthy lifestyle. It's time to move the needle forward and put the health back in healthcare. Alright guys, welcome back to the show. Darsha and I are joined today by Dr. Janika Benoit, who is better known as Dr. J on social media. She is a board certified internal medicine physician and sports medicine specialist. She is also the founder of MedFitDO. Dr. J is a runner, exercise enthusiast, and former A certified personal trainer, and not only does she enjoy caring for athletes, she also has a passion for preventing chronic disease through exercise so people can live holistically healthier lives, both mentally and physically. As an osteopathic physician, Dr. J is focused on treating the whole body so people can live more fully and have life transformation from the inside out. Some of the things that we touch on this episode, of course include her journey into medicine, why she is so passionate about the topic of exercise, and something that she routinely talks about on many of these platforms as well as her social media platform. But the bulk of the conversation is going to be around habit formation. We know it's important to implement changes in our lives, but how do we do that? And I think the easiest way and the most successful way for us to stay is instill good habits into our daily lives. It also may mean to get rid of some of the bad habits, through what's been a great deal of time, diving into how we found it successful, and apply some of the knowledge that we routinely learn both in school and some of the knowledge that you might have learned on this show or some of the other discussions that you might have heard elsewhere. So we hope that you find this to be a bit more of an actionable rather than a mechanistic scientific based discussion. Without further delay, please enjoy our conversation with Dr. J. Janika, welcome to the show. Hi, thank you for having me. So excited to have you here. We're going to talk about one of my favorite things to do. Historically, I used to say it's my favorite thing to do in the past, but then when you're sleep deprived for long enough, sleep becomes your favorite thing to do. As you know, being a trainee, before we get into all that, Janika, I'm going to ask you a question that every single doctor prepares for, but something that we don't rehearse as often the further we get away from training. Why medicine? Wow, honestly, I don't have like this, I have to like, I have to bring you down my story because this is, it's not like, it's not a, just a, you know, a sentence. So I've been a nerd for most of my life, as old doctors are, and initially, I wanted to go into medicine because I was like, really, the only thing that I'm good at is studying. Like, that's the only thing that I know how to do well. And I can, I can study and yeah, I could definitely do that. And I enjoyed studying. So it's like, okay, I will, I can go into, I can do medicine. And then when I was in the sixth grade, my English teacher, she nominated me to go to a medical forum for high school students who are interested in medicine. So I stayed about two weeks at UCLA and I shadowed physicians and I also shadowed medical students at the cadaver lab and we collaborated in medically oriented projects. And I was like, oh, this is just so exciting. Like, I'm definitely going into medicine. But you know, I've always been shy. So I remember like, during my third year, I was just like, oh my gosh, I don't have to speak to a patient. Like, I'm not ready for this. And I remember my very first patient encounter, my, on my third year of medical school. And it was actually a couple. And I believe the, the, the, the husband was the patient and the wife, you know, came along for the visit. And I just remember just like this intimate connection that I had with this couple. And we were like, they even like brought out their wedding picture, which was black and white. He was the Navy. So he had his like Navy costume on and she was so beautiful. And he had vintage wedding dress. And I just like intimately connected to them. And I was very surprised how quickly I was able to develop that connection. And it was just amazing because I remember putting my handle on that metal door knob being so nervous, right? To going out of that, that room, I was like, oh, yeah, this is what I was born to do. So it's, that's, that's, that's really how I got into it. Now, I love that. And I think that that's an important thing for us to remember. As I mentioned, when you're in training, Darshan, I both are in, you know, I'm really almost at the end of that tunnel. But, you know, that's day to day. That's something that's challenging to kind of keep at the forefront of your mind. And it seems like you had a pretty awesome story and some people to thank for to kind of remind you that. You mentioned, where are you originally from? Are you from something, California? No, I'm originally from New York City, Brooklyn, Born and Bread. Love that. North East person. And so where are you now when you're practicing? So right now I'm doing low coms. I am currently in San Diego, California. It's amazing. If you're considering something chill after training, I definitely encourage low coms. So yeah, right now though, I'm doing, I'm doing primary care low coms, but I did secure a sports medicine local assignment. I'm super proud of myself because those are very fine. So yeah, that's what I'm just, you know, just enjoying life and traveling right now and just seeing what else life has to offer. I love that. And so, I mean, I think what may be worthwhile is just taking a step back and kind of explaining the scope of what a sports medicine physician is, right? I mean, people have heard, I mean, it's pretty self-explanatory. But I think that today's sports medicine physician, that the tools that we have in our tool belt are extremely, oh, it's a word I'm looking for. They're much wider, right? Then we can do the scope is much wider than we could do in the past. And so what's your day to day like, like when you say sports medicine, what's your practice look like? You come to your team, team physician, you know what I mean? Like are you doing more clinic type safe? I think that might be worth explaining a little bit. Yeah, well, you know, so just coming out of sports medicine fellowship and so in fellowship, you know, I would cover teams and go to training rooms and go to the games on the weekend. So now I'm actually doing primary care at a VA. And I mean, there's a lot of sports sports medicine that is involved there, you know, dealing with military veterans and all their, you know, musculoskeletal conditions that they've experienced during their service. So but what you said sports medicine is completely if so wide and so vast. So although I'm not, I'm not treating, you know, the typical athlete, but in this sense, they are, you know, they are athletes, right? Just, you know, older athletes, a lot of them are, you know, are still maintaining a physical team. Others have not. Others have, you know, old injuries that, you know, I'm there to treat and diagnose. So it's different now. It's different from when I was a sports medicine fellow. So I'm not going to games on the weekends anymore. But and I'm not, you know, I'm not seeing those acute injuries as much as I did during fellowship, but there's, you know, still a lot of my sports medicine knowledge that I'm using, you know, treating these veterans. Yeah, I think it's important to understand, right? It's athletes active individuals and what we know now is that which is everything social media is fitness is made to come back, right? So people who didn't feel like they were necessarily athletes, maybe even in middle school, high school, college, they have opportunities to get involved. I know that a lot of people will not cross fit for one reason, but something that they've done a phenomenal job is getting people to be more involved, right? They're camaraderie aspect of it as well. And, you know, with the same respect, there are a lot of other classes and stuff. So people do that. And unfortunately, with that, with more active lifestyle, come do some injuries. And so it's typically sports medicine physicians, musculoskeletal physicians, us as well, physiatrist. And we were kind of the first line, you know, the non-surgical stuff, which most of MSK is. You are extremely passionate and vocal about exercise. And, you know, there's this whole idea now that exercises medicine. The three of us have known this for a long time, but people are starting to appreciate it. There's a push in our parent academy, AMSSM, American Medical Society Sports Medicine about exercises medicine and using it in adjunct or in place of a lot of pharmacological treatments. What's that about? Where did the passion come from? Why are you so passionate about that? Yeah. So this started really in my journey prior to going to medical school. I've been involved in just like, you know, being active and fitness for a really a long time. And I think it started when I was in middle school because I was obese and I started exercising and then in high school, one of the teachers, he was a new teacher at the time, he created a new cross country track club. So that's how I got involved in running. And then prior to going to medical school, I became a personal trainer. So I was training prior to going to medical school. So I've been in just the fitness industry for a while. And so going into internal medicine, especially in primary care and even inpatient, you know, there's, I would feel overwhelmed for the patients when I would refill and prescribe medicines. You know, because I would look at that list and I'm like, oh my goodness, how many medicines do you want? And I have to refill all these and just something like, just something within me did not sit right. I'm like, why, like, what am I doing to help curtail this, right? Because then with all these medicines, they're all side effects as well. And then you have to be cautious with the side effects, making sure that, you know, you're not, you know, combining certain medications together and wanting to avoid those interactions so that caused me a lot of distress. Like, I was more, I felt like I was more distressed than some of the patients sometimes. And I noticed that in a lot of my patient encounters, I would talk about fitness. I would actually, like, be in the room performing exercise and showing them, right? And telling them that, like, no, seriously, I used to like demonstrate pushups against the computer desk, like push the keyboard to the side and show them, you know, and, you know, some of them just would look at me like, oh, what are you doing? Like, who is this crazy doctor that I'm seeing? Because just some of them, we're not mentally there, right? Because, you know, because sometimes you, you, I mean, inherently, you want to see your patients do well, right? And as physicians, and I think this gets, this, this kind of gets, you know, trained in us, you know, that you tell your patients what to do. Like, you should exercise. You should eat, right? And that's what I was doing. I'm like, oh, yeah, you should, you should, according to me, you guys like, this is what you should do. And I realized that just me telling the patients that they should exercise doesn't always guarantee that that's what they're going to do, right? And I'm like, well, how, and then I started thinking, well, how can I influence behavior change? Like, how do I get people to actually change, right? And, and I started just, you know, I started reading a lot of books about habits and just, I read, I started reading a lot of books about mindset. And I'm like, well, you know, it, but also that's what their mindset. And then I, I, I delved into the world of coaching. And I realized that this was an actual thing, like, this is what coaches do. They influence behavior, but the way that they do it is that they, they do it through discovery. That means allowing the, the patient or the client to achieve their own self-discovery and eliciting the patient's or client's own motivation instead of using your motivation to try to make them motivated. So that is what I'm really passionate about is just allowing mental fitness to help, you know, facilitate into physical fitness. So. Dr. Day, just like Ultimash was saying, fitness kind of came back and we see that on social media, but the other thing we see on social media as well now is a lot of people talking about how to motivate others and drive an influence change. And one of those people that me and Ultimash look at is Adam Grant, who's actually doing a lot of work on this. So you slowly becoming now an expert in terms of motivating, and like you said, you're now coaching, and you actually created an acronym to help people understand how they can shape their values and identify with being the type of person that they want to be. And that acronym is habit. Can you explain that to us? Yes, yes, yeah, first of all, I'm so proud of this acronym. So habit, age stands for healthy mindset. And age, so that really involves evaluating and just laying out all your limiting beliefs on the table because, you know, as humans, we have so many thoughts that go through our mind every day. A lot of it is negative self-talk that we tell ourselves. And so it's important to actually just lay it all out. And in addition to that is identify what your why is. Why do you want to become this different person? You know, what are the underlying feelings, the emotions that is facilitating that desire? And then A stands for affirming new beliefs. Because after we lay down those limiting beliefs on the table, we then have to change them. We have to change them into a positive affirmation. I do this and I know a lot of people think that it's Google, but this actually does work. But the way that it works is that it has to be happen. You have to make it a regular practice. So the way that this can work is number one, it has to be believable, right? Because if you don't believe it, then that's not going to make you want to change, right? And this goes into the self-efficacy peach, self-efficacy part of the whole public health model because self-efficacy is a person belief in their capacity to change, right? So that is why the affirmation is there. So just to give an example of an affirmation, if you say exercising is hard or I can't exercise, then what do you think your ability to exercise is going to be if you're telling yourself that you can't do it, right? So you can then grab another affirmation that, oh, I can do hard things or I can do difficult things or I'm committed to exercising three days a week at 8 a.m. So creating that affirmation into a positive one can help build your self-efficacy. The other thing is, like I said, make it a regular practice. So something that I do is I actually put this on my schedule and I keep a list of affirmations in my Google Drive. I have a document labeled affirmations and I read the ad to myself every morning before I go to work and you will be so amazed, so amazed what that does because the regular practice of making it a habit, those affirmations then become part of your subconscious, right? So because you're telling yourself, okay, I can do hard things, meaning I can exercise and that's hard and I can do that, you've improved your self-efficacy, you're improving your belief to do that and making your regular practice improves it even further, okay? Next is B, which is stands for believing greater because once you've created your affirmation, so for example, let's say you create an affirmation, I'm committed to walking 30 minutes daily at 8 a.m. and you do that, let's say you do that for two weeks, okay? And then you reach a point like, okay, well, what else can I do, right? Because it's important to create those small, those microhabits because those microhabits are quick victories, right? And why do those quick victories do to the human brain? I'm like, oh, I can do this, I can do 30 minutes, all right? So let me try to do 45 minutes or maybe an hour, right? So that's believing greater. I is incorporating change and this is actually just a summation of what I've stated previously is you're creating affirmations, thinking about affirmations that you believe, right? You actually want to believe them in order for it to work. You're creating your schedule of exercises that you will do, right? Then you have to do something different in order to be somebody different, right? So that's I. And T is transforming lives because this is the whole mission that I'm behind is really creating transformational change. I felt before when I was residency, I felt like I wasn't changing anyone's life. And I'm like, I want more. Like I, I did not go through all of this cooling to not be able to make someone's life better. And, you know, my whole, my goal, what I tell myself, when I see a patient, I want that patient to leave differently than how they came in, right? And honestly, going through this practice, using it in my own life, right, has allowed me to become such a better doctor. I'm happier. I listen to my patients more. I'm able to meet them where they're at. I'm able to approach them from a sense of non-judgment, which can be, you know, pretty prevalent in the physician community. I know I, I definitely handle some patients with a lot of judgment, but it takes process, right? It takes process. So I'm super, super, super excited to, you know, teach my patients how to do this so that they can, you know, just live better lives, live transformational lives, which is my mission. You know, Dr., I love that last letter T when you talk about transforming lives. And a lot of it you just spoke about how you wanted to do that. But I think people need to realize that when they start exercising, when they start changing their own life, they're also going to be this spark of change for others, right? Like I can, like I go to the gym and sometimes I'll see no bees or super obese person just lifting and I'm like, you know, it's just like, wow, like good for you. You know what? I want to do something that challenges me today as well. You know, so I just, I love that last letter and I think that's huge for people to understand their why. And I kind of want to go back to that letter H because you talk about how people need to develop their why. And oftentimes as a pre-med coach, it's exactly what I do for people to write a better personal statement, right, rather than keep it on that superficial level. How do you get to the deeper why with your patients when you start to talk about these things? Yeah. So honestly, it's just allowing them to talk. It's more listening than anything because they will tell you what is on their mind, right? And it's listening to their feelings, right? And it's listening to their needs both met and unmet. They will tell you what they're feeling. And so I've learned to do less talking and more listening, which is sometimes really hard as a doctor because you want to tell your patients what to do and when you want to give them your recommendation, but it's just really not saying much and allowing them to give you the information and then what you do with the information, you ask open-ended questions that ignite reflection, right? So that is really how I'm doing. It is really hard to not talk, especially when you're trying to be a coach or transform lives, right? Because you're like, listen to me, I'm the one creating value here. I'm the one that can spark this change in you. And a lot of the times, like you said in the very beginning of that habit acronym is you want to make that horse thirsty as kind of Altima says. And that comes from them hearing themselves and saying, you know, this is within me the whole time, right? This is this is kind of why I want to do these things. So that's that's awesome. I did want to ask you though, you did touch on books earlier in this in this episode. What books, if any, do you think people should read to learn about habits or affirmations or growth? Oh my gosh, I'm such a book nerd. Okay. Let me tell you. So the how I got started with affirmations was from how Elrod, Miracle Morning, that's what, so him, I have, I have so many people to contribute to during residency because during residency, I was, I was trying to find out like the essence of who I was, honestly, I was so unhappy. I was so unhappy. And I'm like, there has to be a better way. I know that I'm designed to be a physician. Like, I know that with that, I doubt. When I came out of that room as a third year medical student, I'm like, this is what I was born to do, right? And I know, and I know I have this higher calling on my life to transform lives. I really, I really do believe that and feel that. So I went on a search. So how Elrod, Miracle Morning, he helped me develop a morning routine. And so I established my morning routine and that's why affirmations is part of my morning routine because he actually has his whole acronym. It's called Savers, S is for scribing, so he journals, and I do that as well. C is, oh, I'm sorry, it's called Savers, A is for affirmations, B is for visioning, E is for, okay, I'm forgetting, R is for reading and S is for, okay, I may not remember all, but basically, basically, you know, he creates a morning routine, but what I love about that is that you, I sit from reading that book, I was able to find out what worked for me. So I don't, I don't follow his to the tee. I do incorporate a lot of what he taught in the book as my own, right? So I do journal in the morning, I read affirmations, I exercise in the morning, I meditate, so I read the Bible in the morning. So those are all the things that allow me to become mentally sharp, or I leave my door because I need to be mentally sharp, really for, for my patients too, right? Because a lot of them are coming to me with their problems, and I'm like, I need to be mentally robust, so I can handle it. So Miracle Morning, the other one, this is also a Hal Elrod book, it is called Miracle Equation. It's like a sequel to Miracle Morning. So Miracle Morning is like the what, and Miracle Equation is like the house. Another one is Atomic House, I forget the, yeah, yeah, really good book. I also listened to, besides books, I love love Jim Rohn, he's a mode of Jim Rohn. There's one statement that he said changed my life, really, and it says he said, work harder on yourself than you do on your job. That has stuck with me forever, work harder on yourself than you do on your job. So yes, even though residency was tough, I still, you know, established that morning routine and that exercise routine, even on nights, people like my co-residents were like, oh, you're crazy, I'm like, no, I have to work harder on myself than I do on my job. So regardless of what I'm going through at work, I still have to establish this routine for myself. I still have to make this a habit, no matter what I'm going through, because this is who I am, this is my identity, right? And another quote that I love from Aristotle, he says, we are what we repeatedly do, excellence is not an act but a habit. So what are you doing on a regular basis that affirms who you are, right? Because that's when it is a habit, right? Because you are what you repeatedly do. So who else, man, I know I've read so many books. I can also throw some in there for some of you guys to go for it, yeah, if you want to go. Yeah, right, right now I'm reading the one thing. And that is one of my top five books of all time, Gary Caller, love it. Yes, yes, yes, I'm reading the one thing and it just talks about the power of focus. And I love any talks about identity, right? Because also in the book, he talks about, right, in order for you to, you know, be someone different, you have to do something different, right? And all the challenges that I'm going through, even, you know, being on podcast, that has been a challenge for me. But when I think about the bigger vision, right, the big why, you know, he talks about the big why and that the smaller why, my big why is to be this person who can transform lives, right? And in order to do that, I have to, you know, put myself on social media and put myself on podcasts. So, and network and connect with people and be a part of communities with people who think like me and can challenge me and who have much bigger dreams than I do, right? So, but I had to do that, but I know my big why, right? I know that, that big one thing, that's a big one thing that I'm after. So, yeah, but I'm pretty sure there's so much more books, but I can't think of them at the moment. What books do you have? I'm curious. I'll add to it, just to your point about building the community, it's just, we're talking about building a tribe, right? I think, you know, a super hot topic, people like to talk about culture. And I keep coming back to this Adam, Adam Grant's book, I think again, it's, I just finished it and so it's fresh in my mind and in it, he talks about sometimes changing the culture i.e. medicine, it's not very easy for a few trainees, for a few physicians, it's just a big ship that it's going to hard turn that around sometimes, right? It's going to take a lot of time. What you can do is you can affect the subculture and part of that is kind of finding your tribe, like minded folks like that we've been talking about. I want to go back to the concept of listening that you're talking about. A lot of the, the, the skills that you've mentioned today is just this thing is called motivational interviewing, right? My cofello and I, we talk a lot about therapeutic listening. But then there's also this concept again, Adam, Grant talks about persuasive listening is finding people or helping people find their own motives, especially when your motives don't align, right? If individuals, individuals coming in offline, we talked about somebody coming in with osteoarthritis and they just want to get out of pain, but you know that maybe 20, 30 pounds is not going to help them take the load off the knee, but it's going to pay dividends when we're talking about cardiovascular disease, type 2 diabetes, right? Atherosclerosis, that kind of stuff. And so in it, I mean, look, the old saying is you have two years, you know, one mouth for a reason, right? And how we can all be better. But he really talks about listening without a clear agenda and attempting to respond, which is what most folks do, particularly us, right? We've done 10 years of training and I've got all this knowledge on my back pocket. You got to hear me out. But listening so intently that you can help the other person find clarity in their own ideas, right? So you can, and you only ask questions to get that person to crystallize their thinking, really, really teased into why that's so important. So for you, Dr. Jay, two other books that, you know, for that, of course, think again, you mentioned atomic habits, love that. I think that that a prequel to that one is the power of habit by Charles Duhig. I think that as much as James Clear is his book is more about the actual tips of habit. Charles Duhig explores why habits even matter or, you know, why are they so impactful? Changemaker by Dr. John Barardi, absolutely phenomenal for, you know, my colleagues in the health and fitness industry to really, again, try to explore that bigger why and try to identify this gap between folks like us having this conversation and people who maybe aren't there yet. So something to think about. I think Darsh has a few. For, let's say, for habits, overall, BJ fog, tiny habits is also a great one in conjunction with James Clear. And I know you already mentioned kind of why you need the small wins and the tiny habits. Healthy mindset, growth mindset by Carol Duhig, I think, is a must for anyone trying to really just get into that personal belief of being better than who they are. And affirmations, I really love Napoleon Hill's thinking grow rich, although it's more focused on money, I think it's still about, you know, having that vision and convincing yourself that you can do something bigger, like the secret. I think it's the original secret is thinking grow rich. I would say those are the three. And then any of the Ryan Holiday books, honestly, I just finished the trilogy, I just recently posted it. So any of his books I think will give anyone a deeper perspective just on identity and living, I think, a more clear life with purpose. Mm-hmm. Yeah. I love that. Yeah, with purpose, because that's what I was searching for for a long time. Here's a quick message from our sponsor, Comp Health. There are a lot of podcasts out there, murder mysteries, breaking news. There's even a podcast about garden notes. But instead, you're here learning how to be the best version of yourself, smart move. Do you know what else is a smart move? Learning a Locom tenant assignment with Comp Health. Now I know what you're thinking. If you are a physician, you already have a job. That's the best part. You can work flexible, local assignments on the side for extra income, or you can work Locom's full time too. And to top it all off, Locom's almost always pays more on average. Just head to financialresidency.com for slash Comp Health and see what Locom's can do for you financially. And now back to the show. That's where it starts, right? Yeah. So you mentioned a couple of your daily, almost non-negotiable practice, right? You mentioned affirmations, meditation you threw in there, you talked about journaling. What are other daily, non-negotiable practices that you have? Yeah. So for me, so the first thing that I do, I actually study the Bible when I, the first thing I do is that I spend about maybe about 45 minutes to an hour. So I have to get up really early to do all this stuff. One more time do you get up? What time do you get up? What time do you get up? 305. It's the time I get up. I'm sorry. Did you say 305? Yeah. Yeah. As in, okay. Yeah, you're right. That's early. All right. Sorry. Go ahead. Yes. So, and I actually got a faith coach. So I really went really far with this because I, and like I said, that's what I was searching for. I was searching for like my purpose and trying to figure out like what am I supposed to do on this earth, right? What is, you know, what are my, my God-given gifts? You know, what are the things that make me unique? What are the things that people tell me that they compliment me on, right? So, so I started to just take inventory of things that people will tell me that it was good at. And a lot of things that people told me that I was good at was like, people told me that I was a coach. Like, oh, you should be a coach or you sound like a coach. And I'm like, oh, no, maybe I should be a coach. But reading the Bible has allowed me to just find so much wisdom, so much truth, so much of purpose. The Bible is a whole bunch of stories, right? And in the Bible, there are so many people who have gone through different challenges, right? And it's, you know, the belief in something greater than themselves that allows them to endure those challenges, right? The belief that, no matter what I'm going through, I know that this bigger, you know, thing that's above me already has ordained my steps, right? All I have to do is take the next best step and keep on going. So, that is what I'm committed to doing, and it's just showing up. Just show up consistently, habitually, because I know that my steps were already ordained. You know, reading the Bible, it really motivates me and places me in, like, in such a position of grace, it allows me to be even just more compassionate to myself, to other people. It's really, it's really, it really has changed my life. I've seen just looking back on this year alone, because I've never really been into reading the Bible. I actually, like, used to fall asleep when, like, my parents would tell me to read it in my mom specifically. But I knew that I had to do something different. Like, I knew that I was called for something more, something that I couldn't describe, and I just had to figure out for myself. So, I actually got a faith coach, and I have a faith coach now, and she's teaching me how to read and study the Bible for myself, and it's paid dividends, dividends. I can see the coaching thing. You're just having this conversation with you for the last 30 minutes or so. I've been so fired up, and I should be considering it's almost bedtime for all of us. At least, we're a little further ahead. So, finding the purpose, I mean, that's, that's really super important, right? I mean, again, going back to the beginning of the conversation, that's, that's, that's how it starts. And you've got to have that why, like you already mentioned. Darshare has written about, I know that, you know, the, the consistency is the most important thing. We've talked about James Cleare quite a bit. I think in order to recent interview with Peter Atilla, he talked about, I forget, I don't think this was in his book. I think he just gave an anecdote of an individual, basically, who is trying to incorporate exercise into his life. And this person would go to the gym, set a five minute timer, five minute workout. Honestly, and he wouldn't do anything more than that. He would go in, work out five minutes. And even if he wanted to do more, he wouldn't, he would go home and stop. And he did that for a year consistently. And one might say, well, that sounds kind of ridiculous. If you're already in there, why not just do it? And the idea behind this was that he was just getting into the creating that habit of showing up consistently without excuses, right? So now that most difficult barrier of that friction has been reduced, hey, I'm good at showing up, I will make it to the gym. And then you can start adding more complexity, right? You can make it 10 minutes, you can add more access to whatever you might have. And I think this, the second part to this for James Cleare is, you know, his book is called Atomic Habits, because he's talking about how tiny changes make, you know, big splashes, right? And I think that the example he gives is, if you get on a plane from Southern California, and we all sit in the back of the plane, if it makes a five degree turn, something that we won't be able to appreciate. But over those couple of thousand miles, instead of being in New York City, where we're initially destined to go, that plane ends up in Washington, DC. So the idea that he's saying is that showing up like a tiny little change that you make after years and years and years, you can have drastically different results. So I think that's just a super important concept that I really want people to understand and take away from this. Yeah, yeah. No, I'm definitely, and this is, and you know, when I was thinking about how do I help people influence behavior change? I think about my own life and things that I've learned, right? You know, things like In Atomic Habits, and, you know, creating those quick wins, those quick victories are so instrumental to our, you know, success in creating those lifestyle changes. Because, you know, we can see, you know, that person with the six pack abs and, you know, the nice bum, right? And think that, oh, I'll never get there. It seems so far, right? But creating those just small shifts on a regular basis does, I mean, does wonders, does absolutely wonders. But, you know, it's the part with sticking with it, right? It's making it a habit, putting it on a schedule, creating reminders to yourself, like, this is what I'm doing. And what I'm doing is firms who I am, right? This is who I'm becoming, right? And it's like, okay, like, who are you becoming? Who are you developing to be? Because you have to do something different to become that different person, right? And it goes back to what Aristotle says, we are what we repeatedly do. So, yeah, I love those. I love those Michael. You know what, this made me think of. I was reading Dr. Shafali who's actually like a parent coach, and she says, you know, when you want your kids to clean up the toys that they've kind of put all over the carpet, rather than asking them and say, hey, do you mind cleaning up or let's sing a song about cleanup? Ask them if they're a cleaner, right? Are you a cleaner? And most of the time they say, yeah, and, right? It's that identity they form and said, I'm a cleaner. This is my job. So what I do, right? And it just, it just made me think of that and talk about identity and becoming that version of ourselves that we always want to be. Yes, yes, another example. This is actually from the atomic habits where he talks about two people who are trying to quit smoking, right? And let's say smoke or a someone offers smoke or a cigarette. And smoke or a says, no, thank you. I'm trying to quit smoking. And smoke or be says, no, thank you. I'm not a smoker, right? And it's, you know, it's, you know, creating that different person, creating that new identity for yourself. So yeah, I love that. I love any talk about identity. Yeah, I mean, what's really important about that, that example that you just gave is both of those people achieve the same thing, right? Both of them passed up the cigarette. But one person in a different circumstance, maybe under different cognitive circumstances as well. Smoke or a it might not make that same decision, just because they haven't, you know, they haven't foreclosed that part of the identity like you said. So yeah, I just want to emphasize that one as well. I think that James clear again, talked about the Peter T and interview will link that, but of course he talks about it in the book, as you mentioned as well. Dr. Jay, I wanted to switch gears here a little bit in terms of talking about how you actually practice now, right? So we kind of just went through the acronym, we talked about identity purpose. Now, when you're trying to influence change in your patients, how much does the data matter? Personally, I'm a big data guy, right? Like I would love to know the guidelines for exercise. How much of that are you talking, talking about the guidelines with your patients? I definitely do mention the guidelines, however, so like according to the physical activity guidelines, they recommend at least, you know, 150 minutes of moderate intensity and 75 minutes of vigorous. Um, what I tell them, I, I extrapolate information from that. So a lot of patients that I, that I see right now, they're most of them are elderly. So I tell them, I give them a quick thing, I say 30 for three, can you use 30 for three? And they're like, what's the three? And I'm like, can you walk for 30 minutes for three days a week? They're like, yeah, I think we can do that. And you know, because then I say 150 minutes a week, 150 minutes a week. Right? Who like it from, from not, you know, walking at all to 150 minutes a week, that's a lot for someone to take in, right? So I give them that, can you do that? That's, can I, I allow them to get that quick victory, that quick win. 30 minutes a week, that's all I asked. And then I follow up with them, I'm like, okay, so did you do your 30 for three? Oh, yeah, that was easy. Nope, no problem. Actually, I did 45 minutes the other day. I'm like, okay, you did nice. So, so that's so, so I use the guidelines, but I, you know, also think about the person as well, right? Because sometimes the guidelines, I mean, it could be overwhelming. So I use it, I shop on information in a way that is more palatable for the patient. Awesome. And then go ahead, too. Sorry, I was going to transition into kind of weightlifting all, but if you have another question, go for it in regards to this. Now, I was going to say, if we can specify it even a little bit further, right? So again, going back to both Charles, do it and James here, they talk about how habits, the habit loop, right? It's a four step process. Basically, you have a queue, you have a craving to do something. And then you have either a routine or a response. And then you have the reward, right? And so you talked about the reward towards the end. And so what is the queue that you'll tell them? Like, how will they incorporate that 30 minutes? Right? Is it going to be first thing in the morning? Like, how detailed is that conversation that you're having? I think if we kind of lay it out for people, that might be, it might be a bit more clear. Yeah, yeah. No, for sure. So I always tell my patients, if it's not scheduled, then it's not going to be. And it's not going to happen. So I tell them, I'm like, well, when is the optimal time of day for you to do any type of physical activity? I know for me, it's in the morning. So I, you know, I'll ask them, I'm like, okay, well, give me a rundown of your day. And we'll discuss, you know, okay, well, do you think you can exercise during this time or this time or, you know, not this time because take the kids to work or not this time because I have the, you know, pick up my grandparents or grandchildren. So I have them go through a rundown of their day. And I actually help them come up with a plan before they leave. So they know, okay, this is what I'm going to do at this time on, on, on these days. And it's not something, you know, intent. Like I said, it's either 30 for three or, okay, okay, 30 for three. But, okay, at 8 a.m. on Monday, because I know I have time been in my, my wife will take my grandchildren to school, for example. And then on Wednesday, I'll do it at noon. So I actually help them come up with a time, a day, and what they're going to do before they leave. Do you, I don't want to say do you hold them accountable, but we know that accountability with a partner is one of the most effective ways to make sure that we follow through with our commitments, right? We know that when they schedule an encounter, is that something that's shared with you? Do you suggest they kind of find a partner to do that with? Yeah, so I mean, it kind of, it depends. So some, some, some of the, I'm currently working at the VA. So some of the beds that I, that I, that I see some of them do a lot of the stuff with their, with their significant other, right? So, and they, and I, and they usually tell me this information, because I'm always acting about exercise and habits already. So that information just kind of unravels itself. So sometimes I don't even have to act about accountability, because they already told me, oh, yeah, I'm like, I'm doing juicy with my wife and me and my wife are doing this and my family does this. I'm like, okay, that's perfect. That's your accountability right there. So sometimes I don't have even have to say it. Other times it's not, it's not that simple, because sometimes they, they don't have that accountability. And that's actually a great idea to like have a shared schedule with, with them to help them be accountable. But I, you know, I don't have any specific way to hold them accountable. I just kind of listen and, and, and just see like what their day to day affairs are in terms of lifestyle changes. And I'll know or not whether, you know, they already have accountability or this is a person that I'm going to like hold closer so that I can make sure that, you know, they're doing all those lifestyle changes that we've spoken about. I can see that one going two ways, right? I think that the, the, the accountability part, I think is really important. I think that maybe Chaldini talks about this, the concept of social proofing. I hope I'm getting this right and I'm not mislabelling it. But, you know, the classic example is if, if Darshan, I aren't exercising or if Darshan exercising, and I'm not, and I tell Dars, hey, like, I will meet you tomorrow morning yet. I don't know, 60 in the morning, definitely not three o'clock, like, like, thank you, Dr. Jay. But, but I'll meet you in the gym at six in the morning. Or let's say I don't tell him that, right? Let's say I set a goal in New Year's resolution that I'm going to start working out and I'm going to go in before work at six in the morning. Well, when six around six o'clock rolls around and that alarm goes off for whatever time, 530, I'm much more likely to hit snooze because at that time, it's going to be way more challenging, right? We're going to have a tremendous amount of willpower that we have to execute and really call upon to do that. However, if I've made this pact with Darshan, and I know that Darshan is waiting for me at the gym at six o'clock. Now, it's much more challenging because I don't want to let him down. So from that standpoint, I think it's an extremely powerful thing where I can see it back firing is I think that, you know, despite the fact that physicians now, it's, you know, it's kind of looking at your, like you said, coach. Patients sometimes don't want to let your physician down, right? And so from that standpoint, I wonder if that's something back right I haven't personally used it. But I'm curious to get your thoughts. I mean, maybe you can try it and give us some feedback and let me know what you think. I don't know if anybody has any thoughts on that actually. But, you know, okay, so this, this, this also went into the coaching realm as well, because I feel that, you know, being a doctor and being coaches, they're almost like complete opposites, right? So with, you know, doctoring, you know, we provide those recommendations, we, I mean, it's almost, I don't want to say coercion, but, I mean, but it comes from, you know, inherent, inherent desire to see our patients well, right? So that's where it comes from. So, but to the patient, it's like, oh, like I need to comply with what my doctor says or else, I'll succumb to all these diseases and all these illnesses and may potentially die, right? And we know the science, we know the evidence, so that's where it comes from, but it also comes from, you know, as physicians and inherent need to see our patients well. And coaching is actually, you know, they call it rolling with the resistance, right? So even though the resistance to change, it's approaching them from a self, from a sense of non-judgment and curiosity, because when you do that, you are setting the field, you're creating the atmosphere, right? And with creating that atmosphere, you're allowing them to be more open, more vulnerable with you to find out what those underlying feelings and emotions of why they're resistant to change. And by delving into those underlying feelings, you're, they're also discovering themselves and they're discovering their own autonomous motivation. And that's where it should come from, it should come from themselves, right? Because if I motivated to change myself, then they're going to want to change because they're inherently motivated. And nothing that I'm extremely doing to motivate them, it's coming from themselves, I'm just serving as a guide, I'm facilitating that self-discovery, but ultimately it comes from them. Absolutely, I think intrinsic motivation. Which is complete opposite from being adopted. I think you nailed it there, right? Like the paternalism that we feel as physicians, right? Yeah. And it's funny because I was just reading this recent stat, right? Like I don't even, probably more than 20% of people actually don't even get their prescriptions filled or, you know, what not, don't actually take their full course antibiotics or skip pills, etc. Because that intrinsic motivation is lacking from them. So it also begs the question, do you, when you, do you prescribe exercise, like do you actually write it on a pad? Because you think they'll adhere better to it? Yeah, so it depends, so it depends, yeah, so it depends on the patient. So it really depends, it depends what level that they're on. I will prescribe them, you know, different exercises to do. Like I said in residency, I wouldn't even demonstrate it. Right. In the claim for them. So it depends on their, on their level, it depends on their capacity, it depends on their mental capacity, like where they are mentally to like even want to exercise. So it's, it's a variable, but more often than not in this population, I don't. I usually start out with very, very simple exercises, like for example walking and then I'll tell them different ways to make it more challenging, such as like adding ankle weeks or carrying a gallon of water or carrying a book back. So things like that very, very simple. Absolutely. So, you know, we talked about how walking is an awesome place to start. And we know cardio has obviously amazing benefits. But we also know that weightlifting and muscle building and muscle strength provide their own set of benefits. How do you incorporate that with your patients when I know most of the population who, who can't even fathom exercise, you're now telling them to squat or bicep curls and technique and form, right? It's a whole other world that they're being introduced, introduced to. How do you approach that? Yeah, so I make it super, super simple. I don't even talk about exercise equipment because most of my patients don't even have exercise equipment at home. So I don't even, I don't even mention that. So I'll mention like, you know, getting a water bottle because I mean, you know, having a water bottle or a gallon and using that as weight. And I'll perform bicep curls in the office to show them or doing shoulder presses. And I'll mimic them and I'll talk about form. I'll talk about if you're going walking to, you know, get ankle weights or carrying a book bag and putting stuff in the book bag. So, or like sometimes grabbing a bag of vegetables and using that as shoulder presses. So very, very simple exercises depending on their interest also as well. I have the gauge that as well. I have to gauge like, they're ready Mr. Change. So I'll mention some things versus not mention anything based on my assessment of the ready Mr. Change. I'll mention, okay, you know, resistance bands. That's really easy way to incorporate exercising. I know this one patient he traveled for work. I'm like, oh, that's a great way. You can put the resistance bands in your bag and you can have that with you on the go. Also TRX. That's super easy. That's you can use to incorporate weight training at home. You just put it over the door and then there's so many. Oh my gosh, I love TRX. So many exercises that you could do with a TRX. So those are the various ways. So I gave you a readiness to change and based on my assessment of the readiness to change, I'll make it simple versus complex, just depends on the patient. For those who don't know TRX is. TRX is actually so resistance. Actually, I don't think I know what TRX stands for, but it's just it's a suspension trainer. It's a suspension trainer, right? So it's super easy. You can I have one in my own apartment. You just you put it over your door. You close your door and there are so many things you can do. You can do first. Oh my gosh, so many things. Pikes. Rose. So many things. I do one like it lunges with them. Oh, so it's so much fun. I love my TRX. Dr. Say, you are clearly the exception when it comes to. As you mentioned, helping transform lives this way, right? Doing it through exercise, lifestyle change, coaching. It's funny that you talk about physicians being coaches. That's exactly what my personal statement for a sports fellowship was about. Do you see a future in medicine? As you know, the name of the show is medicine redefined. Do you see a future of where this is the norm and it's the rule, not the exception. And if so, do you have any thoughts on how we get there? For sure, for sure, for sure, and for sure. Part of me embarking on this journey is to help inspire other physicians. Because I know that I'm not the only one who wants something more, right? A lot of people who entered into this medical journey, we all have like an inherent need to help, right? Just like at any position that you talk to. The thing is that medicine has almost dated us, right? And you have to find your way, right? But you don't have to do it by yourself, right? It's the community to thrive, like I spoke about earlier. It's finding people who think like you, who want more like you, getting into community with those types of people. It's also about bringing up people behind you on the journey, right? I know for a difference, and I know for a fact that there are medical students following me on social media, and the residents following it on social media, and they're like, how is she doing this? I think about the impact that I'm leaving behind, right? This is for the medical community, but someone has to fear off-path, right? You know, you have to do something different to be someone different, right? And I feel like, you know, I'm one of those people to fear off a different path. And I know that I'm inspiring others behind me, right? I know that because I get people in my DM saying, how do you do this and how do you do that? Or like, you know, medical students and residents will DM me. So I think this requires a collective effort of leveraging all the power, all the knowledge, all the intellect, all the bright minds that we have in medicine, and using it to push medicine forward. And the thing is, it's not, you know, relying on someone else to do it for us. We're not waiting for anybody to do it for us. We have to do it for ourselves. We have to do this for our patients. We have to do this for our families, okay? Because otherwise, you know, physician burnout is real. More injury is real. All of that is real. We all have an inherent need to serve our patients the best of our abilities. And it's there. The inherent need is there. But if physicians don't see other physicians doing that, they won't think that they're capable, right? So it's things like this platforms that you've created like this, right? This is what motivates us. This is what gives us together, brings us together. This is what creates community. It creates inspiration. It creates legacy. It creates all of this stuff. But we have to view off a different path in order to be something different, to create something different for ourselves, for our patients, and for our families. Absolutely. I mean, Dr. J, your passion and purpose shine through the screen, right? Ultimately, I stand with you 100% on that. And this is why we brought you on here to collaborate and really talk about the changes that we can make. And you know, there's a quote by Confucius who says every person has two lives in the second begins when they realize they have one. And I like to change that up a little bit to say every physician has two lives in the second begins when they truly figure out why they want to do medicine. Because I know as premeds, we have this idealistic idea. We get into medicine and we say, whoa, what the hell just happened here? Like this is not what I was expecting. Exactly. And then it's up to us. Like you said, right? Like it's up to us because nobody's going to come to save us and tell us what to do. So I absolutely love that. But Dr. J, what is next for you? So you're currently in San Diego, you're doing loco, but what's your what's your future looking like? Yeah, so my future is looking at becoming a mindset and fitness coach. So I am doing, you know, various things to try to leverage my own community of people who are interested in mental and also physical fitness. I just finished a virtual fitness masterclass, which was awesome. That was on Saturday and I'll be doing more things like that. So yeah, that's the realm that I'm that I'm going into right now and I think I'm still going to be doing loco because it allows me to be very flexible. And it also allows me to to give time to this other passion that I love, right? I love being a physician, but like this like keeps my soul, you know, there's only so much. I'm feeding up my slow sometimes that I can do in the clinic room, but, you know, being a mindset and fitness coach, this is like really, really truly what I'm so passionate about. I feel like it's definitely a calling and something that I love to just alter or just want to alter provide an alternative focus to the fitness interest industry. In terms of, you know, preventing chronic disease through, you know, mental, both mental and physical fitness. So, you know, being an eternal medicine resident and seeing, like I said, the huge list of medicines, they would, it would just like give me publications. And, you know, I really want more, I really want so much more, I know that there's so much more, so much more healing that needs to be done, you know, in this world. And I know that I'm just one contributor to the healing you guys are definitely too. So, I just want to, you know, be as much of a healer as I can. And my goal is also, I always tell myself that I want to leave this world better than I found it. Okay, so that is, you know, my contribution to the world is providing healing in the unique way that I've been gifted and designed to do. As one of our previous guests quoted, I think Muhammad Ali is, you know, service for others is the rent that you pay in this world, right? We're looking forward to a day where you don't have to pick and choose between doing the daytime physician shop and also doing this thing on the side that's feeding your soul. Hopefully all the things that you mentioned in a near future will come to fruition and it'll all be one, right? And it'll be one and that's where I'll hope and for. I want to thank you, Dr. J, for all the awesome things that you're doing, for inspiring us, for inspiring our listeners and continuing doing the badass things that you're doing. Excited to continue working with you and collaborating like you mentioned. I'm excited that you're part of our tribe or part of each other's tribe now, so we continue doing this. Lay out the places where people can find you at social media, where else, if they want to get in touch with you, if they want to learn about you, you know, maybe you want to pick your brain on things. Where can they, where can they come at you? Yeah, so the easiest way to find me is on Instagram, if you go to MedFit.do, that's M-E-D-F-I-T-D-O, and you could click on my link tree and I have all my social media links there. I want you to, so there's a link there. I also have a link to set up a discovery call with me. If you're interested in a mindset and fitness coaching or just want to learn more of these really happy to get on jump of phone calls and find out what your goals are and see how we can be a fit together. And I also have a freebie as well on the link tree. It's five tips to increase your motivations to exercise with type 2 diabetes and high blood pressure. So those are just like mindset hacks that I, you know, some of them that I spoke about on the call today, that's there for you as well. Awesome, and we will post all those links in the show notes. Now, Dr. Jay, last question we have for you, you kind of already answered a lot of it. So, you know, I'll change it up here a little bit for you. So the question is, how do we add the health back in health care? But if you can just give me three words, let's say, because I know we had a lot of buzz words today that you were describing. I'll make it a little challenging for you. Yeah. Okay, okay. Oh, I love challenges. Okay, so the first word that comes to mind is impact. Right. So impact. The second word that comes to mind is community. And the third word that comes to mind is lead, right? Because in order to change the face of health care, we have to lead. We have to show up and show out as leaders of this space. This is our space. It's our space. And we have to lead it like it is our. All right. Love it. Impact community. I love that. I love that. Thanks. I appreciate that. Thank you. No problem. Thank you guys so much for having me. This was so much fun. Well, guys, I hope you enjoyed that inspirational and informative conversation with Dr. Jay. I know I left that truly fired up. She's a special person, and I'm glad we had her on the show. If you found that to be valuable as well, please be sure to subscribe, review, and share with anyone who you think will gain value from this. Now, before you sign off, please remember this important disclaimer that everything in this podcast is for educational purposes only. It does not cost you the practice of medicine, nor should be construed in medical advice. No physician-patient relationship is formed and anything discussed in this podcast does not represent the views of our employers. We recommend that you seek the guidance of your physician regarding any specific health related issues. And until next time, thank you for listening.