The Great ReExamination — Interview with Wheel’s Head of Clinical Operations, Pooja Aysola, MD, MBA

I have a lot of empathy for the millions of people taking part in the “Great Resignation.” I know what it’s like to feel stuck and discouraged in your career, as well as what it’s like when you find a path that’s rewarding and motivating. And for many of us, the pandemic has been a healthy forcing function to take a step back and reassess what we want from a job.

There have been a lot of headlines about how the Great Resignation has impacted the healthcare industry. But I don’t think these stories have gone deep enough to understand how the pandemic has truly disrupted the clinician career path — nor have they helped healthcare organizations stop the growing pile of pink slips.

That’s why I’m turning to Wheel’s Senior Director of Clinical Operations, Pooja Aysola, MD, MBA to help explain the new normal for doctors and nurses. In addition to leading our clinical operations team at Wheel, Dr. Aysola is a practicing emergency medicine physician and recent graduate of MIT’s Sloan School of Management.

In our conversation, Pooja explains the long-term side effects of working on the front lines of the pandemic, including struggling with “empathy fatigue” and the growing uphill battle with misinformation. She draws from her personal experience and from a new study conducted by the Wheel team, which found the majority of doctors and nurses are rethinking their career and struggling to rekindle their passion for patient care.

In what we’ve dubbed “the Great ReExamination,” our study also finds a silver lining: clinicians are eager for change and see an opportunity with virtual-first care. Pooja explains what ultimately turned her from a skeptic into an advocate.

What initially inspired you to work in healthcare?

I’ve known I wanted to be a doctor from a very young age. Several of my family members work in medicine, so it was always top of mind for me. My first job was filing patient charts at a local physician’s office. Then I put myself on the med school track my first day of college. It’s always something that I’ve been marching towards.

You went to medical school in Canada. How did that shape your perspective on the healthcare system?

In Canada, there’s a bigger focus on whole-person care. It’s not always about the treatment or medication. It’s about talking to the patient and listening to their story. Understanding whether they have a place to sleep or a support system at home.

Coming back to practice medicine in the US was eye-opening. Sometimes it can feel like the incentives are misaligned. There’s a bigger focus here on ordering more tests, giving more medication. In the ER, I don’t always have the time I’d like to spend with each patient, but I try to keep in mind that it’s not necessarily medicine that helps — it’s about talking to the patient and listening to their stories.

Our team recently released a study examining how the pandemic has disrupted the clinician career path. What were some of the findings that stood out to you?

The study speaks to many of the realities facing clinicians today, including this idea of “empathy fatigue.” The pandemic has put doctors and nurses in the impossible position of upholding our promise to provide judgment-free care. All the while addressing mistrust and misinformation on a weekly or even daily basis.

I have plenty of my own stories over the last few years, telling patients who refuse to believe that COVID is real that they tested positive and need to stay in the hospital or be put on a ventilator. It’s hard, but I’ve found my own ways to manage empathy fatigue. Something that I’ve found helpful is to take a deep breath before knocking and entering the exam room. It gives me a physical signal to leave any judgment or bias at the door.

Were you surprised to learn that the majority of clinicians have lost their passion for patient care and are thinking about quitting their jobs?

I can’t say that I was surprised. Early on we were celebrated as heroes, and now we’re dealing with patients who refuse to wear masks or get vaccinated. We’re feeling overworked and undervalued, just like millions of other people have felt during the pandemic.

I also don’t think clinicians will suddenly regain their passion for patient care once COVID rates start declining. There are plenty of other factors that make our jobs challenging, including administrative burden and staffing shortages. These were massive problems well before the pandemic.

But it’s not all bad news! Clinicians may be eager for a change, but they’re also optimistic for what the future could hold.

Tell us more about what clinicians are looking for moving forward.

Working in virtual care was a less-than-traditional career path before the pandemic. Now it’s widely embraced by the majority of clinicians, myself included! I hadn’t ever considered a career in virtual care until a few months into the pandemic. Overwhelmed with COVID patients, my hospital paused elective procedures and cut back on shifts. I started working in telemedicine as a temporary solution but ended up loving the flexibility to see patients at home and on my own schedule.

Although virtual care wasn’t taught or addressed in medical school, I did have some exposure before the pandemic. When we had a stroke patient with a more complicated case, we would wheel in a monitor and connect with a neurologist across the country. I loved the ability to bring a specialist into the exam room, but I had never considered working in virtual care myself. As a recent convert, I’m excited others are just as optimistic about virtual care.

What do you hope our readers take away from the study?

Clinicians are past the point of burnout. It’s a term that’s been used over and over again, but it stops having meaning after a while. What we’re experiencing goes further than feeling stressed or overwhelmed — it’s impacting our ability to provide great care to patients.

I also hope that healthcare organizations recognize adopting virtual care can be just as beneficial for their workforce as it is for their patients. If you had told me when I graduated from medical school that I would be working in virtual care, I would have thought you were crazy. But I’ve been able to shape a career that not only fits my lifestyle but also keeps me motivated and engaged in practicing medicine.

You recently got your MBA from MIT Sloan School of Management. What inspired you to go back to school?

I was working at a hospital on a very traditional career path. As the director of quality, I had a lot of ideas for how to improve our program. But I quickly learned that I needed to better understand the business of healthcare in order to drive true change and innovation. Working at Wheel has been a great opportunity to combine all of my interests and skillsets.

In medical school, we’re taught there’s only one track you can follow: in-person clinical practice. But that’s not the case anymore. I want every doctor and nurse to feel empowered to follow the career path that works best for them.

What’s the best or most impactful thing you’ve read lately?

I recently finished White Fragility. It was an incredible read on how we perpetuate stereotypes in society without even thinking about it.

Name something that you can’t live without and tell us why.

My running shoes! I run every day if I can. Even if it’s just for a few miles.

Thank you, Pooja for sharing your story with us. We are lucky to have you on the Wheel team!