Deborah L. Benzil, MD

Podcast Transcript

Dr. Cara King:

Hello, everyone. I hope you all are having a great week. We are excited to have Dr. Deborah Benzil on today. Dr. Benzil is the Vice-Chair of neurosurgery and is well known for her excellence in patient care, as well as innovation and education. Dr. Benzil is widely published with an incredible white paper from 2008 titled “The future of neurosurgery: a white paper on the recruitment and retention of women in neurosurgery” which has since been adapted across specialties. On today's episode, she discusses how she founded WINS, the Women in Neurosurgery subspecialty group, her most memorable hike, and the current advocacy work she's engaged in with trainees. We hope you enjoy.

Dr. Cara King:

So today on Inspirations and Insights, we are extremely excited to have Dr. Deborah Benzil, who is the Vice-Chair of neurosurgery. So welcome, Deb. We're so happy to have you today.

Dr. Deborah Benzil:

Thrilled to be here.

Dr. Cara King:

You just are flying out of the operating room coming right in with your blueberries, we're so excited that you made it.

Dr. Deborah Benzil:

As a surgeon, you have to have a well-orchestrated life and you can't go into the operating room unless you're well fed and well rested. And so I've learned a lot of key habits so that I can always grab nutritional and delicious and healthy food to get me through the day.

Dr. Cara King:

I hear you. I'm also a gynecologic surgeon and there's a few crucial things that I need and that's my food and the bathroom. As long as I have those two things, everything else will fall into place. So, I want to start out by talking a little bit about your childhood and your upbringing. So I heard you say that when you were growing up, you wanted to be a football player. I need more information about this.

Dr. Deborah Benzil:

I grew up in this really small town in rural Maryland, real close to the Pennsylvania border. And it happened to be the town that this old fashioned football team called the Baltimore Colts trained in. So unlike today, where they had these fancy training camps that are all guarded and nobody's allowed in, and whatever else, this was just a local college. And the team came up every summer and they trained there. So I could bike across town on my own and just stand next to the coaches and the football players and watch them play. And it was pretty inspirational. There was a really famous quarterback in those days... I don't know if anybody listening is a football fan, but his name was Johnny Unitas, and he had this patented thing that he did with one of his receivers, Raymond Berry, who flew into the end zone and caught the ball out of bounds. And I would literally watch them practice this.

Dr. Deborah Benzil:

And as it got darker and darker, and everybody else had left, and Raymond Berry would say, "Johnny, we've done this a 100 times, do we have to do it again?" He's like, "Yes, we haven't perfected it yet." And Unitas would throw the ball further and further away from him and make him reach further and further while still keeping his feet in bounds. So it was just a fascinating thing to watch as a kid, but I think many of the lessons really taught me about stretching yourself about the importance of practice, the importance of teamwork. It was just inspiring. And they were so friendly and welcoming to me. Here I was this six, seven, eight year old girl, and at that time it was very unusual, but they just really embraced me being there and my enthusiasm and helped me correct my arm position when I was throwing the ball and that sort of thing. That was sort of my first real love in my life.

Dr. Cara King:

Oh my goodness, the story's even better than I could have played out in my head. That is a fantastic story. So when you were a little girl, did you have a favorite position?

Dr. Deborah Benzil:

Yeah, I was a quarterback, of course.

Dr. Mary Rensel:

Obviously.

Dr. Deborah Benzil:

I liked being the team leader. I liked controlling things and directing things and being able to make things happen. I wasn't really very fast, but I was reasonably strong and I could throw the ball really well. So I had good aim and I had good arm skills and hand skills at that point. So it was really my love of sports.

And then as part of the Baltimore Colts enterprise, I actually worked with their athletic trainer who had no medical background. His name was Fern. He was like one of these old curmudgeon guys. And he ruled their locker room, like he told everybody when they could get their ankles taped, and their knees taped. And he had learned it kind of on the fly. To me, as a six or... I mean, I took my courses with him. When I was 12, he seemed like he was 80. He probably was 50 or 60.

Dr. Deborah Benzil:

But at the time he just seemed like this really, really, really old man who had this wealth of knowledge of having been with the Baltimore Colts for 20 or 25 years. So I actually stayed with the Colts kind of enterprise for a long time. And when he offered this course in the summer, I took it and I became a certified athletic trainer. And that was actually kind of my launch into the medical arena because I really wanted to be an athletic trainer, but knew that as a woman and given how sports was changing, I was probably going to have to get to that through a medical career rather than the way he had done it, which was to show up one day and carry the water bottles and eventually move into being the head trainer.

Dr. Cara King:

What an inspiring story. And did that trainer have any idea what an impact that he had on you? Have you kept in touch at all or how'd that all unfold in the future?

Dr. Deborah Benzil:

No. I mean, I know he's passed away and there is some history written about him in the Colts history, and I looked it up at one point to get his name and to confirm his name. But I don't think he did, but it's funny because people who I've trained and I've worked with over the years... Like when Johnny Unitas died, I got lots and lots and lots of messages from across the world because people knew that he was one of those mobilizing forces for me.

Dr. Cara King:

Wow, that's really inspiring.

And then another question just for outside of medicine chat, so I know having passions outside of medicine can be extremely important for us. Especially as surgeons, I feel like our time in the operating room in the hospital can be all consuming. And you and I share, I think, a similar passion in being outside in the sun and hiking and being active. And I'm just curious, what is your favorite hike? What hike have you done that has left the biggest impact on you?

Dr. Deborah Benzil:

Well, picking one is pretty hard, but I think the one that I enjoyed most, and it was a sort of culmination of where we went, the hikes we took, but I was also finally in good shape. People who've known me all my life have known I've really struggled with being healthy and with being obese. And so some of the hikes I took, I was actually fairly obese and not in very good shape, and so it was very difficult.

Dr. Deborah Benzil:

But we did about a 100 miles in Southern Patagonia over a course of two weeks. We didn't have to do much backpacking because we were with a group where they carried most of our stuff, but the hikes were... They were hard enough and we did them day in and day out. And the scenery was just breathtaking and there were many times we would come across a glacial lake and only the 15 people in our group were the only people there. And so it was serene, incredible skies and mountains and glacier lakes that were so blue that it almost hurts your eyes. And then you'd come back and there's really good wine and really good food.

Dr. Deborah Benzil:

And we had a really, really great group on that trip as well. When we left, I found out that there was going to be another neurosurgeon and two other doctors on the trip and I almost canceled because I go away on these things to get away from all of that. But it actually worked out really well. And that's another story, but I'll tell you some other time offline because that won't fit so well into the podcast theme.

Dr. Cara King:

Oh, that sounds amazing. But I hear you, I feel like the thing that really draws, at least me, and I feel a sense of this in you too, into the woods is that like there is no technology. The medicine thing is completely out of our minds, and seeing the blues and smelling the air, it puts our head space in just a different place. Do you agree?

Dr. Deborah Benzil:

Yeah. I mean it really is great to completely unplug to be away from that technology. I'll tell you a real quick funny story about Patagonia. So, the day we took the longest walk, it was about 15 miles altogether. And we took the extension, about half of the group went back and then half of us went on and saw these other two lakes. And you came down into this small little town that literally had two blocks that had WiFi and cellular service, it was because the ice cream shop had their own little WiFi. So if you were within one block in either direction of this place... So we'd done this walk and at this point, I got to admit, my legs were fine, but my feet were really killing me. And I just wanted to get back to my room and take a bath or a shower.

Dr. Deborah Benzil:

And my cell phone rings. I was like... And I couldn't really answer because there wasn't good enough reception. But I saw that it was my aunt who would never in all the world call me unless it was something important. And through sending some texts, which I could send, I found out that one of my family members had been diagnosed with a spinal tumor, or so they said. And they thought it was metastatic disease. And they wanted me to be able to look at his images and talk to his doctors and all the residents. And here I am like, okay, I've just walked one of the hardest hikes of my life. It was breathtaking. It was rejuvenating, and all the rest of it. And bam, I was hit with this.

Dr. Deborah Benzil:

But the good thing was, is I actually knew that we had a family history of neurofibromatosis. And so right away, I knew that they had given him the wrong diagnosis.

Dr. Deborah Benzil:

And I was able to convey that to my family and just said, "You know what? I'll clear all this up when I get back in 10 days. But just tell him not to worry about it, I'm 100% sure that, that's what it was." And it was, and he's fine. It's been more than five years and that's all he's got. And that's all they'll ever have, and they're not a problem for him. So it's great.

Dr. Cara King:

Oh my gosh. Thank goodness for the ice cream shop, you got a little buzz in your pocket.

Dr. Deborah Benzil:

Really. In more ways than one.

Dr. Cara King:

Yeah. I'll take the hot fudge Sunday and a text message. Thank you.

Dr. Deborah Benzil:

Yes. And a beer, or a glass of wine, or something at the end of one of those days.

Dr. Cara King:

God, you're so right. When you finish up a hike though, there's nothing better than that cold beer for me. You're tired, you're hungry, your feet hurt. There's nothing better, I agree.

Dr. Deborah Benzil:

Yeah, it's great.

Dr. Mary Rensel:

So impactful all this beautiful nature in your life, but let's get back to medicine, ladies.

Dr. Deborah Benzil:

Do I have to? No, I'm just kidding.

Dr. Mary Rensel:

No, we don't have to.

Dr. Mary Rensel:

All right. So neurosurgery, when you came into neurosurgery, was it like less than 2% women in neurosurgery? And tell me about some of those early meetings and how WINS (Women in Neurosurgery) started, which is one of your babies, right?

Dr. Deborah Benzil:

Right, so WINS is my baby. So I can't determine, I was somewhere between number 52 and number 60 of female neurosurgeons ever trained.

Dr. Mary Rensel:

Oh, gosh.

Dr. Deborah Benzil:

So, they don't do it. I mean, there were a couple of us that trained in this that got board certified in the same year. So I know the year before I became board certified, there were only 52. And then the year that I was certified, we got up to 60 that year. So I don't think that ranks as 2%, especially if you consider historically there. At that time, there were about 3,200 neurosurgeons in the country that were actively practicing, but that doesn't account for the ones that were practicing in the '30s, and '40s, and '50s, and '60s, and '70s. So, that's sort of where my ranking is.

Dr. Deborah Benzil:

The year I applied, I think there were 30 out of 300 applicants, but only two got into neurosurgery that year. So we were less than 2% of the entering resident class when I first embarked on neurosurgery. We were pretty small and we were pretty isolated. At that time, there was maybe one program that had two female residents or who had trained two female residents, and there were three faculty in the whole country that were women. So, one of the issues was that you just never, ever, ever saw another woman. I saw very few women general surgeons in even fields like OB/GYN, to be honest. I think there was one female staff at that time. The residency was about 25% female, which was a big deal. So I didn't know women surgeons, I didn't know women neurosurgeons, I didn't know any women that were even in that operating realm through other mechanisms.

Dr. Deborah Benzil:

I was at a national meeting and I was fairly fortunate because I did research early on and I was able to get some papers accepted to present. And I went to a resident lunch and normally what I did was I just sat at one of the remoter tables because I didn't know anybody. I was in a small program, I didn't know any other residents. None of my fellow residents ever went to national meetings. So I didn't know anybody. And of course, there were no women. So I would just kind of sit down, and for some reason it just was the easier thing to do.

Dr. Deborah Benzil:

So I went into this one resident luncheon, so it was no nurses, or no PAs, or anything like that, which were the only other women that were generally at these meetings, or spouses. And this other woman came and sat down with me, and I knew that she had to be a resident because it was a resident only luncheon. And because the two of us were there, a third woman came and sat down next to us. And so here we were at this table with three women. And the speaker there was a gentleman named Dr. Thor Sundt (Mayo Clinic), who's just really a fabulous guy and he did a lot for neurosurgery, and he was also good for women, and that sort of thing. But I couldn't wait till he stopped talking because here I had this opportunity to speak to these other two women.

Dr. Deborah Benzil:

So after that, about three other women at the end of the luncheon came up to see us, because it's like they'd all seen these three women sitting at a table. So we decided we would go out for a drink that night and invite any other women that we knew or that we ran into that day. And it was at that meeting that we decided that we had enough. There were, I think, 10 of us. We decided that we'd reached a critical number to start a small organization and try to support each other, and network, and do that sort of thing.

Dr. Deborah Benzil:

They agreed that I was the best person to lead it, I don't quite know why. But anyway, it was probably because I was pregnant and I was on research. And so I wasn't actively on clinical responsibility at that point. And I knew that I was going to get my four weeks of vacation as maternity leave, so I was going to have a little bit of extra time. Not really. But anyhow, so you have to understand these are the days before cell phones. This was the day before the internet. So the start of WINS was me sending out postcards to every addressee that I could find to ask them if they wanted to be part of WINS and to send me their address, and that sort of thing. So I still have all those postcards, it was 25 postcards I got. And I started a database and then we had our first official meeting in the spring of 1990. And I brought my daughter along who had been born a couple of months earlier, and I brought my son along because I was already pregnant with my next one.

Dr. Mary Rensel:

I love it. Oh my gosh. Amazing. So three of you started, put your heads together, and then it was 25. Oh my gosh, amazing.

Dr. Mary Rensel:

How big is it today? Do we know how many members?

Dr. Deborah Benzil:

We have I think 250 members or more now.

Dr. Mary Rensel:

Amazing, look at you. Wow.

Dr. Deborah Benzil:

But we just reached about 20% of every entering class. We've crossed that 16% threshold, which is the really critical one for being a minority and no longer really being isolated individuals. We're still less than 5% of all practicing neurosurgeons. Every year it goes up.

Dr. Mary Rensel:

And you've been publishing on these topics related to gender and medicine, but also traumatic brain injury in the military, spinal cord tumors, sexual harassment. I mean wide ranging publications, Deb. What makes you spend your time and energy on creating these collaborations and these publications? What do you hope to gain from this? Or, why do you do it?

Dr. Deborah Benzil:

Well, I'm going to digress because, Mary, you probably brought about one of the shining moments of my career, which was when you had me as that sort of dinner guest the night before a WPSA event.

Dr. Deborah Benzil:

And I had been instrumental in getting the white paper... I call it the white paper... the white paper on the recruitment and retention of women in neurosurgery. And you may or may not remember, but at that meeting, Susan Rehm (MD) asked me what had been the motivation and how I had come about that. And she said... because at the Cleveland Clinic, we read that paper and we used it as one of our roadmaps for how to accomplish change for women at the Cleveland Clinic. And then there was another woman, who I don't remember, she was an anesthesiologist and she said, "The anesthesia group also read that paper, and we used a lot of those things."

Dr. Deborah Benzil:

And it was at that moment that I realized that this thing that I had been a big part of years and years before, had really had an enormous impact on the lives of many, many people. And it's not just the women physicians, but I think it's all of healthcare, and by extension it's our patients because I think women bring something to healthcare that enhances the quality of care and the outcomes for our patients. I went into it thinking I was going to be a brain tumor scientist, and I published in molecular biology and I thought I was going to help find advances in that, and you'd impact in that way. And that career didn't work out for a variety of reasons. But I found these other niches.

Dr. Deborah Benzil:

And to be able to impact how we practice medicine and the satisfaction and outcomes for our patients or the engagement of other staff... I mean, to be able to help move that needle from one place to a better place, I mean there is no greater gift that you can give a human being than to be a part of those sorts of things. And so that's why I've always found the time to do it and that's why I've almost always said yes to anybody who's approached me and said, "We'd really like to study this. We'd really like to understand this. Will you mentor me? Will you join with me? Will you add your expertise?" And then sometimes I've driven it because they were things that I felt passionate about.

Dr. Mary Rensel:

Amazing. See, I think you were a quarterback, you were like the neurosurgery quarterback and gender equity quarterback. You were making things happen as you wanted to as a quarterback when you were the six to 12 year old watching those teams, you knew what you wanted and you made it happen. So I'm glad I could show you that you had impact far and wide. I already knew that, but I'm glad you saw it.

Dr. Deborah Benzil:

I shared that story at our 30th anniversary of WINS, which we just celebrated and literally it was a Zoom with, whatever, 50 people on it and stuff. And the number of people who had participated in that project had started crying when I shared that story, was really amazing because they had all been in the same position. We had all struggled. We'd all done this work. We're never sure whether we'd made an impact with the kind of things we stuck our necks out to do. And to understand years later and many, many miles away from where you were when you started that, that it really did have an impact was really very touching.

Dr. Cara King:

It's absolutely remarkable. And I love how you said women bring a very unique aspect to medicine. And I feel like in the past, women have always, at least historically... I've interviewed a lot of other people on this podcast... women feel like they had to be more like men, right? Speak more like men, and dress more like men, and act more like men at the workplace to have an impact. And I keep thinking about Dr. Linda Bradley (Episode 4), who we interviewed a couple months ago, how she was telling me how she was trying to dress like a man at her interview. She's like, "I'm going to wear a suit and I want to put a tie on. I want to blend in." I just cannot thank you enough for your work in saying, "You know what, we're women and we have unique characteristics, and they're powerful, and they're meaningful, and we have a place at the table." So thank you.

Dr. Deborah Benzil:

Well, I'm going to tell you and be honest that it took years for me to get to this point. I dress in gray and blue, and even black was considered too extreme. It's like, it had to be really, really neutral. And the shoes had to be feminine, but not too high. The number of things that I would pour over my suitcase for hours before going to a national meeting, especially if I was presenting. And it was even worse when I was pregnant, because I didn't have any money. It's not like I could go out like wealthy business people and buy the perfect pregnant suit. So I was trying to buy these $10.99 dresses that would fit me, but would look professional enough when I gave my presentations when I was seven months pregnant.

Dr. Mary Rensel:

Stretch them out.

Dr. Deborah Benzil:

So it's been an interesting journey. Now, I will tell you that I wear what I want to, I wear the earrings I want to, and I say the things I want to, but that's because they can't touch me anymore. And I realize that the vast majority of my colleagues are not in that position.

Dr. Cara King:

I love that, they can't touch her anymore. I cannot wait to be in that position. That's amazing. That feels good.

Dr. Cara King:

You were saying that when you were pregnant and having to wear, obviously, clothes that were presentable, I've heard of stories about how people couldn't even talk about their pregnancies and how like male colleagues would come in and be so proud that their wife is pregnant and then the female physicians weren't even allowed to talk about it, or express joy when inside they were feeling proud and excited. Did you experience anything like that during your pregnancies?

Dr. Deborah Benzil:

Well, I was one of the first women neurosurgeons to ever have babies let alone during residency and my husband and I decided the first person we were going to tell was going to be my Chair, because even though his family was in England and my family was hundreds of miles away, it was like this thing, like the Chair can't find out from anybody else, but from me. And so we made this decision that we, of course, were going to tell him first, but we weren't going to tell him until I got through the first trimester, knowing all the things that when you're in medicine, and particularly if you're a resident and you're working 110 hours a week. So I called him one Friday just as I was reaching the end of my first trimester and his secretary said, "Oh, he's decided to go away on a three week vacation. And he just walked out the door and he has no time to talk to you."

Dr. Deborah Benzil:

So I went from being 14 weeks pregnant to being 17 week weeks pregnant, and I was starting to get a lot of comments from people about that I should stop eating so much at breakfast, especially all the potatoes and sausages and whatever else. And of course, I had hidden all my terrible morning sickness. I would get up a half an hour before rounds so that I could get sick, and eat crackers, and drink tomato juice, and then eat some more crackers, and then get sick again, and then be ready at 6:00 AM for rounds and not have anybody know that this was going on. So I finally told my Chair at about 17 weeks, and then after that we told our families, and I announced it to my other residents.

Dr. Deborah Benzil:

And one of the other residents had told us his wife was pregnant and had been blabbing it all over, and this, and that, and the other. And I told him what my due date was. And he says, "Well, that's not possible because our due date is in March. Yours can't be in February." And I said, "Well, it is in February. I just didn't tell anybody." And he's like, "Well, it's impossible." He says, "If you've known and you were pregnant, then why didn't you tell." It was this incredible conversation. It literally took months for this gentleman to believe that my due date was before his wife because how could you not blurt it out to the world the day you found out?

Dr. Deborah Benzil:

And I hid the second one until after the first trimester as well, which was a little bit more difficult because having two back to back, they had the same due dates one year apart. I showed-

Dr. Deborah Benzil:

I showed a lot earlier. And so then people... I could see the looks of people, it's like, "Weren't you just pregnant? I thought you were supposed to give birth, and you kind of look pregnant again." And nobody wanted to say anything.

Dr. Cara King:

But I can't say anything.

Dr. Deborah Benzil:

That was another kind of humorous period of time. You take care of women all the time. There's never a perfect time to have kids, right?

Dr. Cara King:

Never.

Dr. Deborah Benzil:

So you just make the choices. And I was very fortunate because I had two years of research where I only had to take every fourth night on call instead of every second or third, and so I thought that it would make it a little bit easier. Plus, I didn't have to be in the hospital at 6:00 AM every day because I could get to my lab by seven or eight o'clock. That was when we decided we would try to fit two kids in. Of course, it never occurred to me that I wouldn't succeed.

Dr. Cara King:

You're the quarterback, you do what you want. Yeah, you call the shots.

Dr. Deborah Benzil:

But we threw two complete passes for touchdown, so the timing all worked out great.

Dr. Cara King:

That's called deliberate practice. Yeah, deliberate practice.

Dr. Deborah Benzil:

Yeah, deliberate practice for sure.

Dr. Cara King:

But isn't that fascinating that your male colleague couldn't even understand the lens of not being able to express joy, like he couldn't even comprehend that the internal strife that you guys, the women who led the way for us, I just can't imagine the pressure that was on you guys.

Dr. Deborah Benzil:

It was challenging, but it all worked out and I'm now a grandma, and case that is in the parent, but I have three grandkids already, so.

Dr. Cara King:

Oh my gosh, I love it. That's so fun. Is it the funnest job being a grandparent?

Dr. Deborah Benzil:

No. I mean it's fun, it's great, but the funnest job is, I don't know, being a wife to my fabulous husband.

Dr. Deborah Benzil:

And maybe neurosurgery comes second, but-

Dr. Cara King:

Close second. Yeah, that's right.

Dr. Deborah Benzil:

I mean I love being a grandma, my grandkids are great and they cuddle up with me, and they FaceTime with me, and I swim with them, and do all kinds of things, and they are great fun. And it is nice to not have all the responsibilities for them.

Dr. Cara King:

And it's really nice to love your husband. I have a husband I actually really love too. And it's just really nice to have that so I can value that too.

Dr. Deborah Benzil:

It is invaluable.

Dr. Cara King:

We have a few more minutes. To close off our conversation, I can't talk with you without diving in a little bit about your advocacy work, because this is such a cool pivot where I feel like you've really embraced a lot of this advocacy work and not only for patients, but for fellow physicians, right? Like really teaching about these critical business principles and really filling a gap, at least for me in my education, I think a lot of us in our education. Can you talk to me a little bit about that work that you're doing, and how you dove into the business aspect of medicine?

Dr. Deborah Benzil:

Yeah. So I launched a formal socioeconomic curriculum at Columbia when I was on faculty there. It's probably the better part of 10 years ago now. We actually published on it. And my work in socioeconomics, as a lot of things came through serendipity, so when I started off doing brain tumor research and I had a brain tumor lab for a couple of years and I had grants in that. And then my academic department kind of fell apart and I ended up in private practice. But I had this passion for teaching residents and teaching other people. So I was always looking for some way to stay active in that and this opportunity came up for me to be appointed to this socioeconomic organization in neurosurgery. And I said yes, and one thing led to another. A colleague of mine and I had pushed to start teaching negotiations in communications and other leadership skills courses maybe 20 years ago before where that stuff was really fashionable.

Dr. Deborah Benzil:

It actually took us maybe four or five years to get them to approve the first course, because they kept saying, "Ah, neurosurgeons don't need to know that kind of thing. We need to know how to clip aneurysms and put pedicle screws in and put brain stimulators in. And I said that stuff's important, but if you can't run your business and can't get your hospitals to buy you the equipment and that sort of thing, then you're not going to be able to do any of those things. So we started pushing for that. And one thing led to another and I sort of got the mantle of being the socioeconomic queen type thing. So I don't know the most about all aspects of socioeconomics. And there're people who are better billers and better coders and know more about medical malpractice, but I have gained this knowledge and comprehension and expertise in a lot of those areas. And the courses continue to grow mainly through the residents because they will ask me to add topics in.

Dr. Deborah Benzil:

So like last year, two of the residents said, "Can you do a more in-depth talks on personal finance?" And so I put together a three part talk on personal finance so that they could understand better how to take on those challenges and develop really good lifelong skills in terms of managing their own finances and understanding about retirement, and all the different types of retirement funds, and that sort of thing. So it keeps growing as people want more and more, and want more in depth. So it's become a real integral part of the teaching that I do, and I brought it from Columbia to the Cleveland Clinic when I came here. And this year in fact I'm actually going to be teaching some of it in one of the orthopedic departments as well because the residents got a taste of it when they rotated through my service here at Hillcrest. And they just said, "We really need to have more." So I'm going to be doing some orthopedics this year as well.

Dr. Cara King:

You took the words right out of my mouth in that I want you in WHI (Women’s Health Institute), I mean, that's exactly what I was going to ask about is, do you have a curriculum?" Like if there's other institutes, or other listeners, or at different academic institutions, do you have any type of curriculum that you could share or can people turn to you to know how to implement this into our own institution?

Dr. Deborah Benzil:

Yeah. So, I mean, I have a three year curriculum actually, so it is pretty comprehensive and then I have added on to it and I'm happy to share that. And a lot of departments, you can find the expertise in individuals. You may not have somebody who could give all, whatever it is, 40 of the lectures, but you probably can find individuals who can give one, or two, or three, or four of them. It's also good to have the residents give them with you as a mentor because they learn a certain amount, and you sometimes learn something that they're interested in about a topic that you're doing.

Dr. Deborah Benzil:

I'd actually pitched to somebody that we somehow put this on my learning and do it through... So that it was available to all the residents across the enterprise. And maybe I wouldn't give all the lectures, but that we put together an organized thing to teach these skills because I think it's really invaluable. I mean, it is socioeconomic, but it's even things like just communication, preparing people for bad news, so the special communication around death and dying, and that sort of thing. And I know we touch on a lot of these things in a lot of different ways, but somehow putting it all together I think is really impactful.

Dr. Cara King:

I couldn't agree more. And I feel like a lot of times we call these "soft skills", which I personally hate that name because they're so important to what we do every single day, and sometimes we don't even know what we don't know. So I think actually having a structured curriculum, that's tremendous. I would love to see that on my learning. I would make all my residents and fellows do it. So please, with your extra time, if you wouldn't mind just whipping that up, that'd be really great.

Dr. Deborah Benzil:

Yeah, I'll set it out. So many people that work at the Cleveland Clinic are not really aware of billing and coding things. And how that translates is actually into the bottom line because if you don't really understand how the system works, then you're not always getting the most out of your operative reports. There's a special way to do operative reports to get credit for all the work that you're doing. And if you don't understand that system, you're leaving money on the table. It's kind of like selling yourself short when you're negotiating for a house, or for a car, or selling your house. I mean, we wouldn't think about doing that, but we practice medicine and we don't think about getting everything that we deserve. And that's both for us, but also for the enterprise that we work for.

Dr. Cara King:

Perfectly put. And I've only been here at the clinic for two years. I came from the University of Wisconsin in Madison where we are very RVU focused, and so I feel like I've been trained very much looking at billing. And then here, I'm salary, right? And so I feel like some people, when you're salary, you don't have that lens that, just like you said, you're just billing for the things that you're already doing. It's really important.

Dr. Deborah Benzil:

It is. We could definitely make progress across the enterprise in that area.

Dr. Cara King:

All right. Well, I think that's all we have time for today. Deb, thank you so much for your time, and for running from the OR to come sit with us. It's been great, and we hope to have you back sometime soon.

Dr. Deborah Benzil:

Thanks, it's been real fun.