Amanda: Hey guys, welcome back to the podcast. I am Amanda.
Laura: I'm Laura.
Kendra: And I'm Kendra.
Amanda: And today we are honored because we have a special guest, Dr. Kristine Goins. She is an integrative adult and pediatric psychiatrist and also digital nomad. She empowers doctors to achieve a balanced and fulfilling life where they can work less from anywhere in the world.
Yes, please. I cannot wait to hear what you have to say. So thank you so much for joining us today, Dr. Goins.
Kristine: Thank you so much for having
me.
Kendra: Kristine, tell us a little bit about you, your medical training, and how everything came to be.
Kristine: So, I am, as you said, an integrative child and adolescent and adult psychiatrist. And in terms of my training, I grew up in Jersey, so that's kind of where I started. At Rutgers, that's where I did college.
It's also where I did med school. I was in a combined program called access med, which allows you to start medical school while you're still in your senior year of college. So I had known since third grade that I wanted to be a doctor. So it was a long time coming by that point. And I had always wanted to leave New Jersey since I was a teenager.
I have been reading books about travel. I never had the means or the opportunity, but through the books I would read, I would travel extensively in my imagination and I just couldn't wait to get the chance to do it in real life. so in college was my first. You know, true like opportunity to study abroad and got to this point where I had paid, I scrapped up all my, work, study savings and paid for a semester to go to Spain because I was a Spanish minor.
And the week before I got into this early program where I would start med school. So it was the first time that I had to give up my passion for travel for medicine. And that's kind of where this battle began between, medicine, you know, many of us. as doctors that it requires so much of our time, our energy, our focus, and a lot of times to the exclusion of everything else that or a lot of the other things that we really love or might be passionate about pursuing.
And so, that's kind of where my journey began in residency. I was also, trying to make it happen in med school, actually, before I got to residency and med school,, we had that little summer right after the first year. That was my first time leaving the country. I made it happen that time.
I went to live in in Costa Rica with the family. And then, you I went on some vacays, but didn't get like a big chance to travel. But in fellowship, I specifically picked that program because they had an international month away where I went to Nepal and. studied mindfulness in the Tibetan Buddhism monastery.
And so that was life changing for me. And it began to kind of open my eyes to the necessary aspects of, of travel for me, but even more important than that of pursuing different aspects of my life and my passion outside of medicine and being able to integrate all the things that I love, which eventually led me to where I am now.
Kendra: that's amazing. How inspiring. So tell us what a digital nomad is and what led you to become one.
Kristine: Yeah. So a digital nomad is someone who is able to work online. So that's the digital part and they're able to travel to different places. So, you know, the way that you kind of live your life as a digital nomad is different for everyone, for someone, you know, they might be moving to different countries or cities every week for someone else's every couple of months or several months.
The way that I do it is I live in a different city typically every month in a different country, every three months. Unless I'm kind of slowing down a little bit, which I am doing right now in the islands and it's like my home away from home. So I'm going to just stay put on the islands here on Bocas for a few months and recalibrate.
But it's basically your ability to, work from anywhere because you, you kind of digitized your income streams. And so, for me, what brought me to this juncture, including like, you know, that early history of just like always wanting to do it, you know, I have been reading books. It's an author called Eric Jerome Dickey.
I have been reading his books. Since I was a kid, I only found out like literally in the last few months Cause he died some years ago that the way that I'm living now was the way he was living when he was writing his books. But I didn't know that I was just reading them until I ended up kind of absorbing, absorbing some of that, that passion and that lifestyle.
So, in terms of, you know, finishing training, you know, all the, the ups and downs that I had during training, because I was always. Feeling as though I was giving up part of what I really wanted, which was to travel and pursue other things. I thought like a lot of people think, okay, well, training's done.
So that means I'm going to get the chance to do whatever I want as an attending. And when I got to that life, I realized it had even more responsibilities. It had, you know, I was in a leadership it was teaching and training and I felt there was pressure to perform so much more than I was even in training.
And so really it, it seemed more restricting than less. I was still saying yes to a lot of things and hadn't learned how to say no yet or how to delegate. you know, trying to take on every opportunity that you can, cause you feel like, you know, you're an early career physician trying to make your way.
So that was part of that process and it really led me to. extreme burnout to the point that I would have chest pains in the middle of my day. I was going to six different schools a week, four different clinics all over DC. So I was constantly running and in between like one school and another traveling in the middle of traffic in DC, I would just have, I feel like I was having a heart attack literally.
And I started to, like, notice every organ system being impacted. My neurological system started to go haywire. I started having abnormal tremors all over my body. I ended up in a neurologist's office. And I got there within five minutes. I'm like, yeah, I'm so stressed out. I don't know what to do with this job.
Like, he was just like, "stop, stop, stop. I'm just going to prescribe you Lexapro. Why don't we just do that?" And I was like Were you not listening about this job? Like I don't understand what the point of that is. He's like, "yeah, but you're not gonna quit are you? You know, so this is your way of just coping with this." And so for me, especially as a psychiatrist, I would just like I did not know that this is what doctors were doing.
And, and it just, it really shocked me. And so I was like, you know, it's only up to me, you know. It's, it's up to me to create this life and this balance that I want. It's up to me to decide what I want my career to look like. If my career is going to be everything on the most important thing, or I'm going to have this more.
Fulfilling and balanced aspect that even if no one else is doing it, it's up to me to create that space that no one else is. That really motivated me. During the same time, both of my grandmothers died. And that really it helped me to prioritize time as a commodity that we can't get back. You know, we think we have all this time.
I was like, Oh, I have a five year plan. I'm going to figure it out. I'm going to work it out. And after that, I was like, you don't know how much time you have. You think you have this time, but We don't know. And so, I changed my five year plan to a five month plan. I booked a one way ticket to Columbia and put a meeting on the books to quit my academic job.
Kendra: Wow. That's amazing. It, it does help when you have someone. Something in your life that occurs that just kind of stops you in your tracks and makes you reflect. And unfortunately, in that time, I'm sure you were grieving and that was a hard time. But look what came out of that. The perspective shifted. You took back control over your life. And you've
the most amazing thing that you could come up with and now you get to live it. So that's amazing. So tell us how it works exactly. Like we want some details here.
Kristine: You need to think about how You're going to digitize your expertise. We all have medical knowledge, skills, talents, life experience, and no matter what type of medicine we do, we have aspects of our knowledge and the work that we do that we can do online. All of us have. I mean, this is, of course, was all possible before the pandemic, but all of us have been through the pandemic.
And we know there's certain aspects of our work that we can do online because we've done it. And so it's really about taking that in creating something that brings you joy, even if you, you still want to do, let's say, procedural work, or maybe you still want to do surgery. You know, I have docs who do a hybrid.
But that means they have a big chunk of their life where they are fully remote. So it really just depends on. On the person, but it's really thinking about that aspect and being able to do work. You know, I encourage that is flexible in terms of like working with insurance companies. A lot of insurance companies do have restrictions about where a physician can be.
When they are billing and in practicing, but those restrictions are not there when you're not dealing with insurance. So if you're doing something that's cash based, or if you're doing, a DPC or DSC or some other type of model that is not insurance based that gives you that kind of freedom.
So you definitely want to think about, you know, licensing and malpractice and all of those implications, which are things that, right now, even if it's, it's not common knowledge, I want to make it common knowledge that are all accessible and you're able to, to be able to, to connect with attorneys. I talk to them all the time with attorneys and with your malpractice insurance to kind of talk about what that would be like for, for your particular specialty and situation.
But I think it's really about taking that, whatever it is, it could be telemedicine, it could be consulting, it could be medical education. It could be it's such a bad, it's over a hundred different things, honestly, that you. And I always tell my clients, like, if you're looking at the list of 100 plus things and you're like, I don't really like any of them, then you can create whatever it is that you want to, that that possibility is also there.
So it's just in that process of thinking through what is it that I want to be doing? What is it that I want to create? And then how do I begin to take those steps towards doing that?
Laura: So what would you say are the biggest obstacles in starting a nontraditional practice like yours?
Kristine: Fear. Fear I think is the biggest obstacle because it's something different.
You know, when, when we're in medical school, they're like, either you're going to do private practice or you're going to be in academia. If you don't do one of those, you're like, well, what the hell am I doing with my life? Um, You know, I think right now there's, there is a slight broadening of what's possible for physicians.
You know, all of you who are here as such wonderful models for all of us, you know, in your coaching and the work that you do. You know, there's some physicians who are doing locums and that's kind of breaking the mold that, you know, people could be practicing medicine in different ways. I remember when I was in fellowship, I mentioned like international locums to you know, a really famous attending and they just looked at me like I had three heads.
They were like, why would you do that? Waste your education doing something, you know, so it's, it's basically breaking these these limiting thoughts that we have around what our lives as physicians can look like. And you know, when I work with my clients, fear is, is the biggest thing. What are other people going to think?
What, what are my colleagues going to say? My family, my friends what if it doesn't work out? What about the money? That was my biggest. like fear, like, Oh my gosh, what if, you know, somehow my finances are not stable or like, worst case scenario situations with health. And, and I basically took all of these limiting thoughts and I just flipped them all on their heads.
You know, I took my biggest one that was like what if I end up with no money, like under a bridge? You know, in the middle of Columbia with no one that's like the fear and I was, and I flipped that and I said, what if traveling the world and living this life that I want to live as a doctor is my way to fast track my financial independence?
What if this is the key instead of the thing that's going to stop me? And that really opened up my mind to like, well, these are the opportunities. Oh, these are the things that are possible. Oh, wow. This really can be done. I wish more people knew about this.
Laura: Oh, that's awesome. You're such a great example.
You hear that? You could just flip all those negative beliefs and make them something that inspires you to do something different. That's awesome. So if somebody's considering leaving their traditional practice or a journey like yours, what are some things to consider before they do that?
Kristine: I mean, you definitely want to consider thinking about, let's say, from the financial aspect, like, what does your financial health look like right now?
Do you have some type of emergency fund? Or do you have a way of circulating your resources that are in, You know, that's an alignment with your values, because if that's not already stabilized, it's going to be really difficult to jump into something brand new, unless you already have something that is virtual and digital, and it's not going to be very difficult for you to kind of make that shift.
But if you're in a completely traditional, let's say, brick and mortar practice, or you're working for someone else, You know, in a hospital and then you're making that shift, I think it's just you do want to make sure you have a solid foundation financially in terms of like how you want to move about that.
And if you don't, then you just, you begin, you just begin the process of kind of building your financial literacy and thinking about how you want to circulate your money so that you can kind of focus in on what's most important to you. So I think that's a big part of it. But when I was leaving, because I have been practicing essentialism for probably like seven years at that point, you know, the way that I was circulating my money and living my life, I had a cushion.
I didn't want to use it and I never had to use it, but I knew it was there. That if anything did happen, though in my mind, I said I'd be under a bridge. I wasn't going to probably be under a bridge because I had that, you know, bucket. So I think it, if anything, it's really just like a psychological safety of having that.
And I think another piece is really having the commitment towards what you want to do because everything isn't always perfect, you know, and it, you might come to a step and you're like, I don't, I don't exactly know how to navigate that. I don't know anyone else who has navigated this, the exact path that I'm going.
And so you do have to have, a commitment to what it is that you you want to do and the commitment will likely come before the competence of fully figuring out every little aspect of it and so you have to have some faith in your ability to figure things out and you have to be able to look back at what you've already accomplished.
If you're a doctor, you've already, you've been through a lot, a lot of things already. so you have a lot of evidence, you know, previous evidence of, you know, Things are figure-out-able and just being committed to what you want, knowing that you can figure out each step as you go. You just need to figure out the next step and take action towards that.
Laura: Yeah, so. You mentioned the phrase you use circulating your resources and alignment with your values. I would love for you to speak more to that because I think what happens to a lot of us and gets us stuck in burnout is we get trapped in this accumulation and just the feeling that we need to just accumulate more and more and more and more and maybe not reflecting on how that aligns with our values.
tell us what you mean by that.
Kristine: Yeah, and it really is in connection with, you know, what you're, you're talking about, Laura. It's thinking about the flow of money. And my use of circulation has to do with the idea of money being energy. You know, it is something that you give, it is something that you receive.
You want to be giving towards those things that you value most. So you can receive. You want to create if there are things in your life that don't really serve you, you want to remove them so that you can create a vacuum. That will allow you to bring in more of what you actually do want. You know, I stopped using the word spend many years ago because I think it's a limiting word and it makes us kind of move into the scarcity mindset around money.
Like it doesn't go away. It's just, it's just moving. It's just circulating. And so if you recognize that, you know that there might be A certain moment or a certain season where maybe you're giving more, but it's always coming back. It's always coming back. And if you kind of, depending on, you know, what your, your thoughts are around money and how you you know, use money and, and utilize that in your life, you see the flow.
And I, and I am of the belief that. When I'm doing things that I really care about and I'm bringing value to a lot of people that's when I also begin to receive more in terms of that flow. So I think that as physicians, The way that we're taught almost it's almost like inbedded and that's like that If we're making a lot of money, then that means we probably are doing something that is like really hard.
We're burning out. There's so many hours, like it's connected to our time. You know, necessarily it, it, it pushes us in a different direction. Oh, but if I'm really enjoying myself, then I guess I'm not going to make any money. Then I guess I have to give up the other things that I really, really want. And it was, Helping me to see that there's this alignment where they come together where I'm doing what I love and I'm doing what I want, and I'm bringing value, but I'm also receiving value, not only in the enjoyment of what I do, but in money also, because it's part of that.
Laura: That's awesome. I love that. So how can physicians use travel as a therapeutic approach to overcome burnout?
Kristine: So there's so many ways to do this, but you know, some of, some of my favorite aspects is in that travel really gives you the opportunity to practice moment to moment awareness. You know, when you go to a different place, you're outside of your normal routine and your normal environment, you are aware. You have to be more present because you don't know where you're going.
You don't know where the grocery store is yet. Or you might not, you know, if you're in a country where that's not even your first language. Like you have to be more attuned to your surroundings, to the people that you're connecting with. You recognize even more so, especially if you're a solo traveler, traveler like I am.
How important it is to connect with other people. Because I'm an introvert, but no one would ever know when I travel because I'm talking to everyone. I want to know everyone. I'm curious. I'm, you know, become almost even more friendly because the connection is so important. And. And through that, I think you're able to see different aspects of yourself that you may not see when you're in a place where, one, you feel very comfortable or you're very used to, and two, there's a lot of people around you that are used to you being a certain way.
So you don't, might not show up, you know, quite the same. You go to somewhere and no one knows you, you might see yourself doing a few different things because you, you, in your mind, you might think, Think that you have more freedom to just be yourself. There's no one that remembers, you know, Oh, Kristine only stays in the house.
So, I think it's that freedom. It's a lot of cognitive flexibility, I think, because you, you learn to be very comfortable with the uncomfortable. You learn to be okay with, with the unexpected. Have you ever been to an island and the water shuts off? Or, you know, the lights go out. I remember being somewhere, maybe like two years into my traveling journey, the light shut off.
I think it wasn't even a beat. I like started lighting a candle and I continued doing whatever it was that I was doing. That would have never happened if I was in the US. I'd be like, Oh my God, what's going on? Like, what's wrong with it? Like, just, you know, it's just like being able to move and flow at what's happening and being okay with it.
For me, it's all, it's also given me such time freedom because I never wanted to be living my dream life traveling to be strapped to a computer all day, you know, so for me, as soon as I left the U. S. three years ago I automatically said, I'm going to work two days a week. And once I started doing it, I was like, I'm going to work two days a week for the rest of my, I mean, yeah, for the rest of my life.
Because. It's just easier and it's more fun. You know, so for me, it was also the time freedom that, that travel allowed for me because of the way that I was able to work, do the work that I really love. It meant I was able to, even though I was working, you know, went from working over 60 hours to working less than 20, I was making about the same compensation because I had just changed the type of work that I was doing.
So it freed up all of this time. For me to be more introspective, for me to think about what I really want, for me to really get into my values and be able to easily make decisions. Every decision in alignment with those values. So if it's outside of my, my greatest values are freedom and peace of mind.
If it doesn't connect with that, I'm not doing it, you know? And so it makes it easier to, to decide what to say yes to and what to say no to. It's given, I think it really gives docs the opportunity to be more innovative. To use their imagination more, you know, when you're talking to other people, you're engaged in different cultures, you see that there is different ways to do things.
There's different approaches. There are different ways of thinking and being, and it really just opens you up to knowing that you can step outside of the box. So for me, all of those aspects really have, allowed me to become a better physician, a more present listener, a more present healer. You know, I think a big aspect of being a doctor, which I don't know if we've always practiced so much, is also being healed ourselves, also taking care of ourselves.
You know, I think that's a big part that we miss, but it's really hard to show up for someone else when you're not. Fully present and being present if you haven't done that work for yourself and if you haven't made that space for yourself. So for me, I think I became so much better, you know, at at the work that I
do and what I'm able to provide and give. And I think one of the biggest aspects of travel is that it really gives you an opportunity to trust yourself when you're moving in faith towards something that you're trying to create. And you have to, you know, really lean in on your instincts. It tells you when to go.
It tells you when to stay. It tells you, I gotta, I gotta get out of this alleyway and move somewhere else. You know, if you listen, you have to become more in tune with yourself, I think, in travel. And I think that becomes a really important skill set to have in every decision that you make and in all the moves that you make in life as well.
Amanda: That's awesome. So I'm going to put a plug in for your website, thenomadmd.com because you have a bunch of really beautiful blogs on the website. One of which is titled how to recognize the surprising benefits of burnout. So please tell us more because that does sound very surprising. Yeah.
Kristine: Yeah. I mean, I started thinking about that, you know, just reflecting because I definitely had times of burnout through my, throughout my entire journey and I started thinking one day, you know, just chilling in my apartment in Argentina.
Like what if I never was burnt out? Like what if it wasn't that bad? I would still be there. Like I would have never made this decision. And so I started thinking about how burnout really gives us this opportunity to redesign our lives. You know, there, there is a a period, a point where we begin to prioritize what is our non negotiable self care, where we find like, this is where I draw the line and we begin to firmly establish like, this is my boundary, where we have the experience of being able to uncover like new personal dreams that we have aspirations that we have, you know, where we begin to redefine what we want our role in medicine to be, what we want it to look like.
Maybe we want to uncover some skills that we already have, or maybe we want to learn something new. So it really gives us the opportunity to be more imaginative, more innovative and thinking through what we want, what we want to create and what our solutions will be to the desperation that we feel in that particular moment.
So I think it's it can be this really cool opportunity to, like, redefine our lives and the life that we want both in medicine and outside of medicine.
Amanda: I love that.
Kendra: Yeah. That's a true testimony to us too. I mean, I think all of us can speak to that. I mean, if, if Amanda hadn't got plagues and Laura and I hadn't just walked out, I mean, we would have just done the thing until that pain pushed us right out the door.
You know what I mean? Like, and sometimes, You put it so well that it can teach us something. It can make us stop dead in our tracks and just redefine what we consider, our priorities or how we want our life to be. So I love that. I think that'll speak volumes for all you listen out there for knowing that pain motivates us more than peace and why it's, it's, it's our humanity.
It's
a
crazy thing, but it's so true.
Amanda: So along those lines, too, there was another I think it's another blog on your website, but tell us this is such a big. If you listen to any question, any answer, please listen to this because so many of us have our value tied in our job or like, can, cannot even imagine ourselves outside of medicine.
What is the importance of reclaiming our value outside of medicine?
Kristine: I think that's everything. You know, I think that unless we tap into who we truly are, like outside of this role I don't think that we'll find true joy and true peace, There are so many physicians who are really struggling with being part of different aspects of the healthcare system and what they're finding that their role is in that system, how they're looking at that system to think about their value.
And feeling very devalued and, and demoralized in, in some of these situations. And so, you know, when we think about who we are. What we have to offer. Who loves and cares about us. Who we love and care about .What value we can bring to the world outside of even just this, this particular sphere, I think that it really Allows us to open up and really broaden our horizons and our ideas.
And thoughts about who we are and what we're able to give. And so for me, it was really about stepping outside of, of medicine and that aspect of how limiting it can be in terms of like our scope and what we could do and who we are. like engaging with the idea that were more, that were more than the people ever taught us thought of us how does have conversations about what we could be in this field.
And so I really love the idea and what the three of you bring, which is having the role as Doctor and physician, because many of us, you know, love medicine. I really, really love medicine. But also recognizing that there's so many transferable skills that we have learned through this journey and that we can utilize them in a myriad of ways that can serve not only patients, but other causes, other communities, other industries and folks that really allow us to touch people all over the world in ways that we never really thought of.
Amanda: So good. I love that. So my, and some of us may choose to leave medicine and that's perfectly fine. You still have value for sure. It's always fascinating to me when people are like, well, I don't know who I am outside of medicine or anything like that. Like you live two decades on this earth before you were a doc.
Like, what did you not exist? Like that cognitively it doesn't. But it's wild. A lot of us do that. And you can also work within a system that's broken, and that doesn't take away the good that you're doing. It's not defining you that the system is broken, and I think that's a big distinction that we have to make a lot of times.
But if someone were to want to choose and want to become a digital nomad like you are, my understanding is that you help people sometimes on this journey, and if that's true, where do they go to find out more how to work with you?
Kristine: Yeah. So, what I do right now and how I love to serve docs is in helping them to work less and live anywhere and how that looks for different docs.
It's very different for each one. For some people, it's, you know, I want to travel six months a year with my kiddos but have a home base in the U. S. For other people. It's like, I want to travel ongoing and, or I just want to leave and move to Spain, you know? So for everyone, it's different.
And so I have clients that are in all different stages, and if they want to know more, or they are really passionate about moving along in this journey, they can find me at thenomadmd.com and on instagram
at thenomadmd
these and on Facebook at thenomadmd.
Kendra: Awesome. Thank you so much, Kristine. What a pleasure having you on. Your journey has been a true testimony. So thank you so much. We honor you for just your time joining us today, but also your experience in sharing it.
So many of our listeners are probably going to finish listening to this podcast and start to. Think about some things. So you have been a true inspiration. So we thank you for joining us today.
Kristine: Thank you so much for having me. It's been such a pleasure and honor to meet all of you.
Kendra: And thank you guys for listening today.
We recently launched a new version of our course. So go to our website. www.thewholephysician.com and check it out. We take demoralized doctors from fried to fantastic with our easy and evidence based wellness 911 program.
So until next time you are whole, you are a gift to medicine and the work you do matters.
