I was told to take the UCSD Professional Boundaries course by my lawyer. You can read more about my mistakes which brought me here in the first place by reviewing previous posts. The UCSD Professional Boundaries course was suggested by my lawyer because it’s supposedly one of the best in the country which is perhaps why there were people from all over the country who attended course.
The main speaker was Chris and he had 2 other supporting lecturers. The cost was $3,500 to sign up for the course and it was a 3-day long event worth 39.5 CME points. I had to fly to San Diego and arrive the night before since it started bright and early on a Thursday.
Before attending the course we were required to answer incredibly personal questions in a long biography which included if we were ever molested as children.
I learned a lot though I would have never independently paid this amount of money for such a course. It was disheartening, to say the least, to have the doctors share their individual stories and why they ended up there. I have a different view of the practice of medicine and I want to commend the lecturers for not dancing around this fact and instead being quite forthcoming about the state of the medical boards and the medical work culture.
For sure one of the first thoughts I had was that it wasn’t fair for me to end up among doctors who obviously were bad apples. Before attending I assumed that I would be surrounded by a bunch of lowlives.
I assumed that we would get talked down to as to how to be more professional. I expected to be ridiculed or be treated like a criminal.
Not at all.
Chris was very warm but funny. He didn’t make us feel bad. But he didn’t sugarcoat things either. He broached each subject with such grace that he has taken the seat as one of the best speakers I’ve come across.
I wanted so badly to believe that these guys were there lecturing us only for the money – for the life of me I couldn’t find that to be the case.
Though I will say that Kai, though brilliant, seems to get an ego boost from doing the small section which is assigned to him. I don’t think he’s the right person for the job and I think he actually diluted the message slightly.
Yet Kai had one of the more entertaining presentations. The facts he brought up about the science of boundaries and human behavior were very well presented – I don’t want to take that away from him.
I expected there to be as many women as men.
There wasn’t a single female attendee at this UCSD Professional Boundaries course. The only woman was Kristin who came on the second day for just a few hours to talk to us.
There are as many female doctors as male doctors yet 95% of the UCSD Professional Boundaries course attendees are historically men. That doesn’t make any sense.
The course shouldn’t have been coined ‘Professional Boundaries’ but ‘boy-girl boundaries’ because that’s pretty much 98% of what was discussed.
Kristin was incredibly potent, very effective, a fantastic listener. She did a great job with our group of men. But I wish she had a larger role and was there when Chris was lecturing – they would have made a great team.
Both Chris and Kristin have a very warm, loving way about them without coming across as soft or weak. They’ve been doing this for 15 years which shows.
The First Day
The start of the day was epic. I get there at 7:30am for the high-carb continental breakfast and enter the dining room with 4 other dudes already seated and it’s quiet – awkwardly quiet.
I grabbed some fruits which were baking under the sun shining through the window and, just like in high school, had to decide where to sit.
The aura in the room was anger except for 2 dudes whose spirits were obviously broken. I first sat on a table by myself then decided to move – I was curious to get to know these other guys.
I said hello and was greeted back by 2 of the docs – the other stayed quiet.
“Where you from?”
“What’s your specialty?”
We started chit chatting but always looking around to see if any of the course instructors were lurking nearby. I’d laugh at something one guy would say and another guy would signal to us that enemy was nearby.
We’d all hush again like high school kids in detention.
We bonded over this hate. It was sort funny. We got into a rhythm and quicky our table became the lively one until we had to head over to the main conference room.
Breaking The Ice
Chris, the main speaker, dove right in – no wasting time. That actually took me by surprise. We had Chris up front and Kai in the back, sandwiched by these 2 guys whom we didn’t know. I felt cornered and I had one of the mildest reasons for having been sent to the UCSD Professional Boundaries course – can’t imagine how the other dudes were feeling until one guy spoke up.
He wasn’t having this cold start – he opened his mouth and all our jaws dropped.
One of the guys – I love this dude – protested to this course right away. I mean the gonads on this doctor, commendable. He said in a slightly agitated yet vulnerable tone that it wasn’t right for us to have been sent a huge pre-session questionnaire asking us about our childhood and what traumas we’d experienced. Not knowing who these guys were who were going to read our answers and after having gone through the humiliating process of a medical board investigation.
He wasn’t letting up – he kept going and that’s really when his anger gave way to his vulnerability and it was obvious that he didn’t have the kind of childhood you ever want to share with anyone.
I later found out how tough this guy’s childhood was – breaks my heart thinking about it even now. I came from the most loving family you can imagine and this guy had the polar opposite.
Anyway, he was trying to get across to Chris and Kai that after dealing with the medical board for 3 years and feeling beat down, he was getting exposed to even more intrusive questions and that he had no reason to trust the lecturers.
I can’t imagine a more hurt person in a more timely manner saying the most timely thing to the most appropriate people – it was poetry – the perfect tiramisu with a double espresso and a small club soda to rinse your palette.
One of the surgeons jumped in and said that he’d sue if any of the information he provided got out. This was a very intelligent individual and he was asking how our information was being kept safe. Poor Chris and Kai did their best to address it but what can you do?
I expected child molesters, narcissists, criminals, and anti-social doctors. Instead I met warm, caring, passionate, and interesting physicians – human beings – who were vulnerable, realized what they had done wrong, and genuine about wanting to figure out how to prevent this in the future.
I won’t delve into each case again since I did that in this previous post but I can think of only one person who truly needed to be there because he repeatedly asked and commended on topics which were fairly obvious to the rest of us.
Landing At The Professional Boundaries Program
Men land here.
95% who are sent here are men. The women are referred for things like prescribing to their same-sex partners how report them to the medical board later.
In everyone’s case it was a woman who reported the men even if they weren’t involved in the matter.
I want to give credit to Chris for helping us men understand that it wasn’t an evil gesture on the part of the women for reporting the men, rather, it was the way that women felt that they could have a voice – a way to retaliate.
Most doctors there met the definition of burnout and then some. The very last module of the 3-day marathon was to discuss burnout and it was quite clear that most of us were burnt out and some of our actions were the result of this state of being.
Infidelity and ex-wife or ex-girlfriend problems were a dominant theme.
Another interesting observation was that most of the men who attended were alphas. These men were in positions of power and not just worker bees.
Kai is brilliant so it hurts me to say this but that dude doesn’t strike me as someone who likes women. But who am I to say that? The past few years I have been searching hard to redefine my relationship and understand of women.
I just don’t want to be told that women have different brains than men – oh, and the way we know that is because we did some MRI study which showed xyz. Please! People are raised in a society, how the shit did you factor for societal influences?
No doubt that the absolute biggest risk to women’s safety in the world are men – no doubt. Women have a way tougher battle when it comes to making it because we as men hold women hostage in most societies. Men are the perpetrators of pretty much all crimes against women.
It doesn’t help that men are usually in the position of power. I don’t mean just being a physician, but being the medical directors, being the section chief or the vascular surgeon. And women are the nurses, MA’s, and patients of these men.
There were 3 speakers, Chris, Kai, and Kristin.
Chris is the main person and on the first day you’re going to go around and share your stories and all 3 of them will be there but Chris will lead it.
Chris was the main speaker on the first day and had to deal with my already good buddy who shredded these guys for sending us those intrusive questionnaires.
Chris hit it out of the park. No judgement, no confrontation, no babying, no side-taking – just honest and genuine answers to our concerns. I can’t think of any better response to such emotionally charged protests.
I talked to this doctor afterwards over drinks and he really respected Chris for how he handled this. And this guy was no easy customer to please.
Favorite Chris quote: “Doctors are like moths to a flame – we want to help and that will get us in trouble.”
Kai injected a lot of brilliant scientific facts but he had a hard time being interrupted by our questions and he couldn’t connect with anyone in the room. It almost felt like he was doing this because it was a job or perhaps he got an ego boost from it.
He seems quite intelligent and there was a lot of passion in his talk so maybe he was just having an off-day. However, a few of us didn’t get a good vibe from him.
My favorite Kai quote: “I will only hug women if they are over 90.”
You got mostly dudes who get into trouble and you have a Kristin who is a female doctor with superb skills as a speaker, who is confident, whom we can trust, and someone whom we could ask the real questions to. But they only used her for half a day, what are these guys thinking!
I’ll add that a few of us alpha’s had already bonded pretty well and had become the disruptive punch in the group which must have made it pretty tough at this point to handle. Yet Kristin injected incredible insight into the topics she covered and managed us skillfully.
My favorite Kristin quote: “Dr. Mo, I put an asterixis by your case because it was the perfect example of what a physician could do that would end them up here.”
Sharing My Story
I shared my story on the first day and a few people gave me inquisitive looks trying to figure out exactly what I did wrong to end up here. However Chris broke it down beautifully by saying that I had violated the patient-doctor boundary by ordering a test for a person with whom I hadn’t developed a legitimate patient-doctor relationship.
“Once you do something for a person that only a physician can do then you violate the boundary of friendship and take on the role as their doctor. You now own that patient… forever. Make sure you really want that responsibility because it could end you up here.”
It’s so nice hearing the feedback of your colleagues because even though I thought I had come to terms with this event, a couple of doctors commented that I seemed still butt-hurt over this matter and that I should give myself some times to come to terms with it.
We like to think that we got shit figured out until well-meaning colleagues give us a reality check.
Men & Women
This whole course was about men and women. I thought of another title for this course instead of the UCSD Professional Boundaries course, “How to Navigate Women at Work”.
Except for the very last part of the presentation which focused on burnout, everything else was about women and touch and sexual abuse and all the other shit you can imagine if you have a penis.
The message which was presented to us was: stay away from women at work. Minimize contact. Don’t comment on their hair or attire. Don’t touch them, avoid hugging them, avoid jokes because you don’t know how will be offended by what.
One final interesting message was that boundaries exist whether you think they should or shouldn’t. Nor are the borders clear. The only person who doesn’t get to determine the violation of a boundary is you – everyone but you gets to decide so you have to be cautious.
The Vibe In The Room
The vibe in the room was collegiate! Not the first few hours of the first day. But after the first doctor put the speakers on blast and the rest of us got a few inappropriate comments out-of-the-way, it was fun place to be.
These doctors were genuine, vulnerable, caring, inquisitive, introspective, and curious about their fellow doctors.
When you share insanely intimate shit with strangers then you connect on a deep level. And we shared a lot – a lot more than I thought us men would be comfortable sharing.
The very last part of the course was about burnout and Chris shared some really good data on physician burnout. It’s likely not anything that you haven’t heard.
What surprised me is how burned out a lot of the doctors were who were in the UCSD Professional Boundaries course. One after another shared their story of how they were burnt out.
Once Chris mentioned how the majority of doctors are burnt out then I suppose it didn’t make much sense to bring up the topic of burnout sooner or place more emphasis on it – when something is the norm as opposed to a tiny signal on the radar then everyone should be familiar with it.
The Gist of the Professional Boundaries Course
You are constantly walking a fine line when interacting with colleagues, particularly those with breasts and vaginas. I am not trying to sound crass, such terms were used quite a bit to perhaps drive the point home that we are here because we are men and don’t know how to properly interact with women.
There are “boundary events”, “boundary crossings”, and “boundary violations” and I won’t break these down here because I wouldn’t do them justice in this post.
Ending up in front of the medical board is terrible. I learned a lot about what others went through and are still going through as I’m writing this post. It’s inhumane.
If you don’t want to be in this situation then this is the course you should take ahead of time. If you have a penis and are attracted to women and are at even the slightest risk of boundary issues with patients or coworkers then you should be taking this course.
My Impression of Medicine
My impression of the medical profession changed after hearing the stories which my medical colleagues shared. It changed after I learned how careful I need to be.
I realized that neither HR nor the medical board will protect me – rightfully so. “Everyone but you gets to decide whether you violated a boundary so all you can do is be as aware as possible and even then it’s out of your hands.”
I am not saying that medicine shouldn’t be practiced but it’s no longer a field which would bring me any joy to practice in. Perhaps I went into medicine for all the wrong reasons but this isn’t what I signed up for and there are much easier ways to earn a buck.
There has never been a pathologist who has had to attend the UCSD Professional Boundaries course. There have been very few radiologists and as I mentioned, very few women.
It’s the classic question of “What would you do if you had $50,000,000 deposited in your account today? Would you keep practicing?” I asked this question of everyone and only 1 person said that they would continue practicing because they didn’t know what else they would do.
I’m trying to keep my review of this course as unbiased as possible. I think the information presented here is 100% necessary for every single doctor. What’s the point of sharing it with a professional after they have already gotten in trouble?
I don’t think that my lawyer gets any money for referring me to these guys but Chris mentioned that he goes before the medical boards and gives talks there regarding professional boundaries.
This is a UCSD affiliated program so it’s not like the $35,000 which was earned that day all went into the speaker’s pockets. Nevertheless, it would go against self-preservation instincts to appear before the medical board as a speaker for a course and rally against the need for such a course.
I wonder if it creates a bit of advertisement and puts such programs on the radar of the medical board members. That’s how I would market it, at least.