A father and son on being doctors and avoiding burnout

It only happened once, but it left a memorable impression.

Dr. Ridgley Salter, a family physician at WellSpan Health in Pennsylvania, had been growing increasingly frustrated with his work. His son, Nick, then in his teens, was expressing interest in a career as a doctor and following in his father’s footsteps.

But after a particularly rough stretch, Ridgley told his son not to pursue medicine as a career.

“I'm thinking, ‘My son wants to get into this. I'm pretty miserable right now. I don't want him to be miserable,’ Ridgley recalls. “And that was really what it was all about.”

Now, Ridgley is in a better place, working as a doctor and also as the co-leader of WellSpan’s well-being efforts to help other clinicians stay healthy.

And his son did go to medical school and is now Dr. Nick Salter.

Now, both are working in the WellSpan health system in central Pennsylvania. They talk about their journey in medicine, Ridgley’s work to help other caregivers, and Nick’s passion for medicine and his desire to have a life outside of work as well.

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‘Make life better’

Even at his busiest, Ridgley Salter found time to be there for his family. He coached Nick and his brother Alex in basketball, and his daughter Emily in softball.

But he was also working long nights, and he was growing increasingly unhappy.

“As an overachiever, a former ‘A’ student, you want to be good at everything you do, right? And I felt like I wasn't good at all that,” Ridgley says.

“I'd come home and I'd finish up tasks while I'm falling asleep on the couch, and then I wouldn't get enough sleep, and I'd wake up and do it all over again,” he adds. “And so what I realized was that I was, things would easily frustrate me because of all that. And then I realized that I was emotionally exhausted, and I was becoming cynical, and I realized I've had this reduced sense of professional efficacy. These are all the manifestations of burnout.”

Eventually, he was given an opportunity to move into a leadership role. And now, Ridgley is a leader of WellSpan’s efforts to help keep people healthy. He’s been leading WellSpan’s efforts to improve physician and advanced practice provider wellbeing since 2018.

“That's where it really started to find my purpose,” Ridgley says. “I think this is what I was called to do. I was called to make life better for our future, for our current and future physicians and APPs. If I can make this better, maybe Nick and his colleagues that want to enter medicine won't be miserable. Maybe they'll actually be able to find professional fulfillment.”

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Finding balance

Nick Salter, a family medicine doctor at WellSpan, seems anything but miserable. He also spends part of his time teaching family medicine residents.

Nick says he has always emulated his father. Like his father, he played basketball and the drums when he was young. And he says he was moved by his father’s stories of caring for patients, including taking care of generations of families and having family members thank him for being the doctor of a loved one who had passed away.

“There are very few, I think, professions where we get to see people's most vulnerable and be in that space, and to have an example of someone who stewarded that was really cool,” Nick says.

Nick, who is now the father of a baby girl, says it’s important for hospitals and health systems to recognize the need to keep staff healthy.

“I will work hard when I'm on the clock, but I want to be able to unplug,” he says. “I want to be able to do things outside of medicine, be with my family, be with my baby. And I think if you're not offering those opportunities, then honestly, it's going to be hard to recruit and it's going to be hard to retain.”

Nick says after he completed his residency, he would ask people if they enjoyed their job, if they felt like their feedback was heard, and if the system is taking care of them.

“I think it's just kind of the way things are shifting, and in a positive way,” Nick says.

Younger physicians are more focused on having a work-life balance, and Ridgley says it’s important for organizations to recognize that fact. And he says younger staff are offering an important lesson.

“We probably will have a better, richer and more fulfilling career if we realize that working 70 hours a week and taking call every third night is really not the best way forward,” Ridgley says. “It's not best for us, and frankly, it's probably not best for our patients.”

Ridgley says he’s grateful that his son realized that he likes teaching and now is able to do that as part of his work. He says that’s an important facet in avoiding burnout.

“If you're doing something you really enjoy and passionate about, only 20% of your work week, you're going to have less burnout, and you're going to have more professional fulfillment,” Ridgley says.

He also says that it’s important for health systems to devote some staff resources to maintain the well-being of caregivers. The American Medical Association recognized WellSpan as a “Joy in Medicine” organization for its efforts to maintain the health of its staff.

“I think the biggest thing is, if you can as much as possible, is to sit down and listen to your people and understand what their needs are,” Ridgley says. “And have conversations with your physicians, your APPs, your nurses, your leaders, your other care team members, and say, ‘Hey, what is it that makes your work fulfilling? Let's do more of that.’”