Chief Change Officer - #417 Resa Lewiss MD: Building a Career with Both Hands — Part One
Episode Date: July 5, 2025In Part One, Dr. Resa Lewiss reflects on the experiences that led her to emergency medicine, from early memories of gender inequity at the dinner table to the interdisciplinary studies that s...haped her worldview. She shares why she chose a career in high-pressure medicine, how a love of procedures led her to ultrasound, and why teaching globally changed how she practices and leads.Key Highlights of Our Interview:Medicine Was a Calling, Not a Family Trade“I didn’t grow up around doctors. But from early on, medicine was in my bones.”Resa explains how her internal pull toward healthcare was stronger than any external influence.The First Fight for Fairness“My dad said, ‘Girls, clear the table.’ I said, ‘What about the boys?’”She recalls early moments that sparked her refusal to accept unequal expectations.Finding Her Fit in Emergency Medicine“Once I rotated in emergency, I thought—this is it. This is where I belong.”Resa describes the moment she discovered the dynamic, procedure-driven specialty she’d been looking for.The Power of a Liberal Arts Education“My literature and sociology classes made me a better doctor. They taught me empathy.”She shares how studying beyond science helped her connect more deeply with patients.Teaching Around the World“When I went to India, Rwanda, Jordan—these were not lectures. These were collaborations.”Why global teaching in ultrasound expanded her understanding of medicine and leadership._____________________Connect with us:Host: Vince Chan | Guest: Resa Lewiss MD --Chief Change Officer--Change Ambitiously. Outgrow Yourself.Open a World of Expansive Human Intelligencefor Transformation Gurus, Black Sheep,Unsung Visionaries & Bold Hearts.EdTech Leadership Awards 2025 Finalist.20 Million+ All-Time Downloads.80+ Countries Reached Daily.Global Top 1% Podcast.Top 5 US Business.Top 1 US Careers.>>>200,000+ are outgrowing. Act Today.<<<See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
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Listen now on Audible. Hi, everyone.
Welcome to our show, Chief Change Officer.
I'm Vince Chen, your ambitious human host. Oshul is a modernist community for change progressives in organizational and human transformation from around the world.
Today's guest is Dr. Riza Lewis, emergency medicine physician, educator, and co-author of the book titled Micro Skills.
She's also our first guest in medicine.
Dr. Lewis knew early on she didn't want to be boxed in by gender roles. She chose
a specialty where she could sing fast, move freely, and lead in real time. Over the past 25 years. She's worked in trauma base, taught ultrasound across the world,
and trained others to stay calm
when the room is anything but.
In this two-part series,
we talk about what drew her to emergency medicine,
how confidence is built through pivoting and preparation,
and how small practice behaviors, i.e. micro skills,
can shift how we show up under pressure in life and in career.
Let's get into it.
Good morning, Dr. Lewis. Welcome to my show. Welcome to Chief Change Officer. You are the
first medical doctor I host on my show. Thanks for joining me.
Good morning. It is wonderful to be with you and what
an honor that I am the first medical doctor to join the show. I told you before, becoming a doctor
was my childhood dream. I didn't pursue it in the end, but I've always had deep respect for medical professionals. Growing up, I had
health issues and spent time in a hospital, so doctors really made a
difference in my life. That's why it's such an honor to have you here today.
And a big thank you to Chris Hare for connecting us. Now you've got this fantastic
book called Micro Skills, which I know isn't written just for doctors. We'll get into that
soon. But first, let's start with your personal story. Give us an overview of your journey and then I'll dive into some key turning points
in your life and career. Why medicine? What drew you to that path in the first place?
Thanks for this question. And I've thought about this, like, how do we put together our
narrative? Like, how do we become who we become?
I believe I'm one of those people that it's always been in me. It's a calling. Medicine
has been a calling. And the reason I share that is some people, they're told you should
become a doctor or they have a parent who's a doctor. And in my case, nobody in my family
is a physician. And I grew up in a small town in the
smallest state in the United States, so in Rhode Island. And I went to the public
high school. And I would say that my parents, when they decided their
parenting style with my brother, my sister, and myself, they had very
traditional values and roles and expectations.
They definitely had this line of boys do this
and boys are expected to do that when they grow up.
And in contrast, girls do this, girls look like this,
and girls have different societal expectations
and what they may do professionally.
And those sort of divisions and those expectations
really rubbed me the wrong way.
And I think from childhood, from early childhood,
I saw the differences and I didn't like it.
And so I think I've been on a journey to prove
that I wanna do and become the individual
that I wanna become and it has nothing to do with gender roles.
And there's one story that I tell that kind of,
I didn't even know why it rubbed me the wrong way,
but every night we would sit down as a family
for dinner at 6 p.m. Dinner would finish,
and my father would say,
okay, girls, help your mother clear the table.
And I would always say, why do you say girls?
Like, why do we have to help mom clear the table?
How about everybody clears their own dish?
And then he would look at me and say,
Risa, help your mother clear the table.
And then I would say, what about him?
What does he do?
Meaning my brother.
And he said, he takes out the garbage.
And I actually said, I prefer to take out the garbage.
I'll take out the garbage and he can do the garbage. And I actually said, I prefer to take out the garbage.
I'll take out the garbage and he can do the dishes.
And it sounds like so bizarre,
but I ended up reading a book during my early career
that completely explained why this bothered me so much.
And it was called, Women Don't Ask,
Negotiation and the Gender Divide.
And they actually used almost that exact example about,
again, this is the household I grew up in, these quote traditional values, I realized
everybody's household was different. They put out the explanation that girls are
given these chores, these roles in the house that promote dependence rather
than independence. Also, they're often like the monotonous everyday things
that need to get done in the household.
They're not these isolated events or once a week events.
There's two or three times a day events.
And they're much less likely to get, for example,
monetarily rewarded.
You might not get an allowance,
but say you take all the garbage
or say you actually mow lawns
and you can go to the different neighbors in the street
and ask them if you can mow their lawn
and get paid. Same thing with shoveling snow. And I literally
always wanted to do those types of activities as opposed to the
ones in the house. One sort of final little piece to the story
at the American Thanksgiving. Again, it was just in me. The
meals would end the main meal and there was a break between
the main meal and then
coffee dessert.
And all the women would get up and clear.
And all the men would sit and relax and talk.
And I would sit intentionally, purposely.
And my father would look at me and he'd say, Risa?
And I'd say, Dad?
And he'd say, Risa?
And I'd say, Dad?
And he'd say, are you. I'd say, dad. And he said, gee, you're going to get up and help
clear? And I said, no, I want to sit here and relax and let my meal digest and enjoy
just the way you are. And again, I just didn't like this division. And it was really because
I really wanted equal access, equal opportunity and equal support and encouragement to be and pursue
the things that I wanted to pursue and be as an adult, as a professional, and in my
personal life as well.
So you chose science, and not just any science, but medical science, which, let's be honest, still isn't the most common path for girls.
But you went for it. And then, within medicine, you chose to specialize in emergency medicine.
Why ER? What pulled you towards that particular field?
Great question. And I'll more directly address the why the doctor.
As I said, it was always in me.
Like, I really loved when I had the opportunity
to learn the bones of the body.
I really was fascinated when we brought in our baby teeth
and we left it overnight in the classroom in a glass of soda
and we saw the disintegration of the teeth.
Like, I really loved understanding
the functioning of the human body, learning the names. Like I really loved understanding the functioning
of the human body, learning the names.
I'm a big word person.
I loved words and I studied Latin even in high school.
And I just loved that a physician had a knowledge base,
was decisive and it was a very practical field.
And it just, I really, I always liked blood and guts
and I liked watching scary films that were gory.
So I just told myself, like, this seems right.
And then when I went to university,
I told myself if I do well in these classes,
then that's a message.
And I did well in my pre-medical studies classes.
And then when it actually became time to spend time
in a hospital to get that exposure,
I was surprised with how comfortable I felt in a hospital,
in a medical environment. And I felt in a hospital, in a
medical environment, and I thought it was interesting the patients that came in,
their questions, their cases, their problems, and to have that knowledge to
help people was very attractive. To your question regarding emergency medicine,
when I went to medical school, I was very attracted to surgery and the general surgery
specialties.
And one of the reasons was because there was an actual doing things with your hands and
that action-oriented part of the practice that I really liked.
However, I knew I didn't love surgery.
I liked it.
And I really felt that to pursue that path, you have to love it.
And you have to always want to be in the operating room.
And as much as I was very comfortable in the operating, depending on what you call it,
the theater or the operating room, I was comfortable. I liked it, but I didn't love it.
And when I looked around, the surgeons I met loved it. So I did a year of research in my third year
of medical school. And when I returned from my final year of medical school and when I returned for my final year of medical school, to get right back into the mindset of clinical medicine, I did an emergency medicine rotation.
And immediately I was like, oh my goodness, where have I been?
This is it.
I see men and women and children and elderly.
I take care of patients presenting with heart attacks and strokes and cuts and fractures
and abdominal pain and
pregnancy related. I just loved the variety, the practicality, and also I got
that fix of doing procedures that you would do in an operating room but you
don't have to go to the operating room. So again, like if someone has a cut or if
someone has broken a bone and you can create the splint. So I was using my
hands and doing those quote
procedures, but it wasn't something that took the same intensity, both time-wise, resource-wise,
and intention as going to the operating room. So you really enjoyed the action. The unpredictability,
The unpredictability, like you said, no two cases are ever the same. With 25 years of experience under your belt, both teaching and practicing, I can't even
imagine how many cases you've seen and treated.
But that variety, that constant challenge, is that what keeps you going?
So you're on to something.
I definitely like the variety.
I like that there's always going to be, every day, every shift is going to be different.
And I think you and I have touched a little bit, I know we'll probably get more on sleep.
I identified as someone that didn't need a lot of sleep. I identified as someone that didn't need a lot of sleep.
I actually hadn't gotten fully on board that sleep was
necessary for health and I really there's so much that I
wanted to learn and do in life personally and professionally
that I thought I don't need a lot of sleep I can sleep when
when I'm old or when it's time to sleep then I'll sleep but
now there's so much I want to do and emergency medicine is shift work. And so
you work days, you work nights, you work weekends, you work holidays. Weekend doesn't mean, and I
liked that variety of even, I might have a Wednesday where I can get all of my errands done while the
rest of the world is working their eight to six, nine to five, Monday to Friday work week. So I
liked the variety both of the schedule of yes, the actual shift work. And also you end
up identifying with your cohort. And what I found with other people that pursued emergency medicine
is they tended to be very down to earth, rounded. And also it was okay to say that you have other
interests and pursuits outside of medicine, because you know very much when you're on and when you're off,
and you do have time to create and develop other interests.
You specialize in ER.
You solve urgent problems, and often, you save lives.
But in your line of work,
there are cases where despite everything,
the outcome isn't what you hoped for.
Literally, it's life and death.
I'm curious, when you were just starting out,
still learning and gaining experience,
how did you handle those moments,
especially when you did everything you could
and it still wasn't enough?
And looking back now,
how did you learn to navigate that emotional weight?
Staying professional, staying grounded,
so you could keep showing up case after case, shift after shift.
It's a very insightful question because I do think that if emergency medicine is attractive to you, there's a reason.
If you're not able to have that sense
of professional detachment or necessary detachment
to make decisions to take care of patients
in like emergent situations,
like sometimes you have plenty of time
and the patient is not that ill.
Sometimes they're very ill and you need to act quite quickly.
So I think it is something that is modeled. So you see ill and you need to act quite quickly. So I think it is
something that is modeled so you see it when you're working with your teachers, your faculty members.
It's something that over time you develop your ways to do that compartmentalization.
That being said, I actually don't think it's modeled or taught as well as it could be. Like, I think it's a work in progress in terms of realizing the importance of helping doctors
in training take care of themselves mentally and emotionally, decompress.
And also, there are aspects that are just very devastating, as you would imagine.
And I think the pivoting, because I do remember the first time I had a patient
die in front of me when I was a first year doctor in training. It was right at the beginning
of the shift. The patient died. I spoke with my faculty member, my attending, and we spoke
about it. And he said to me, okay, just fill out what they call the death packet. When
a patient dies, there's paperwork that you have to complete.
You, for example, contact the organ bank,
you make sure the family's aware, all these things.
And so there's a checklist and it's a packet,
and at the time it was a paper packet.
Now, hopefully it's digitized.
It's mostly digitized, but medicine is slow to change,
even though things have become accepted in other fields.
It's slow, but it was a paper packet.
Now it's a digitized,
mostly digitized packet.
So it was right at the beginning of the shift.
And he said, all right, finish the death packet
and then start picking up more patients.
And I remember like, Risa, you gotta take care of this
and like, you've got seven more hours
because it was an eight hour shift.
And so you realize, real time, you learn on the job
and even that pivoting and that needing to compartmentalize
happens even if it's not taught and talked about, you end up learning it on the job,
so to speak.
And what I'll say, one more thing that becomes important, and we talk about this in the book,
is this concept of a personal board of directors.
And there's a critical care physician in Canada who first introduced me to the term called a failure friend,
a friend that you can call up, not necessarily because you've failed,
but there's been a failure, like for example a death,
and sometimes it feels like a failure, sometimes it's actually not a failure,
it's just a sad because you witnessed it and helped with that transition.
And you just need these people sometimes to be able to call
and just get it off your chest and speak about no judgment, no problem solving, no oh here's what you can do next time,
but literally I just need to talk about this. And there are things that I think are coming to the
surface in terms of important, not just for physicians, for many people in healthcare and
in other fields, but I'll say in the case specifically of physicians, what happens in
the emergency department and on an emergency department shift,
you just can't really explain it completely.
And certainly people get a view into that
when they watch the doctor TV shows.
You not only practice medicine, but you also teach it.
How do you feel about the teaching side of your work?
Do you enjoy it just as much as being in the ER? Or is there one part you find more
fulfilling than the other? So I made the decision to stay in what they call
academic medicine, which means that when you, if you go out into a private
practice or in a community hospital, often there are no other expectations except going in and
working your shift. When you stay and work in an academic center in a
teaching hospital, there are doctors in training and other health care team
members where you end up teaching them. In my case, I would teach them about
emergency medicine, but within emergency medicine my specialization became the use of ultrasound at the bedside. And when I
really completed my training in ultrasound and then started teaching, it
was a new technology for the emergency department. It was very common in
radiology but not for the emergency department. So it became very, let's see,
there was a large demand
to teach ultrasound.
So that's really a lot of my teaching and education
has been in the use of ultrasound at the bedside.
And within the training programs,
there was a demand across the country,
but also across the world.
I have traveled to teach ultrasound
in many other countries, both to
physicians as well as to nurses as well as to midwives as well as because ultrasound
happens to be a very relatively affordable technology to help make patient care decisions.
And the technology has evolved to be even more affordable, even smaller.
And the motivation, what I've really loved about the teaching
and specifically teaching ultrasound,
is you're helping people deliver safer care
and make better decisions for patients.
And it's a really good feeling.
Earlier, you mentioned that working in the ER gives you both the excitement and the space
to explore interests beyond medicine.
Is that what led you to write this book called Microskills?
Clearly, it's not a medical textbook.
It feels more like a business or self-development book. What
made you decide to take on this project? What was the thinking behind it?
I truly believe that fields and people have more in common than not in common.
And the way the US education system works, you go to four years of university
before then you do specialization commonly. And so many colleges and universities, you get
what they call a liberal arts education. And I have always enjoyed learning
many different subject areas, studying many different languages. And part of
it is, I've always felt that the more you know about all different areas, the
better it actually makes you as a physician and as a professional.
And one example I'll give is in university, I actually concentrated my studies in sociology
and in ethno-racial studies.
And simultaneously, I was completing my pre-medical courses.
And I knew that would make me an even better, more understanding, more empathetic physician
to knowing that people come to the emergency department at the end of the day sick is sick.
Everybody wants food, shelter, clothing, education, and to feel good and healthy
to function in society and in their lives. And if I have a sense of someone who's first language is not English, someone who lives in a city versus someone
who lives rural, someone who is elderly versus an elementary school child. Like, oh, having that sense
of groups and even the way people came to the U.S. and how people have moved in terms of
socioeconomic status within the U.S., those types of factors help
me provide better patient-centered care because I'll have an understanding.
Never assuming that I completely ever understand someone else's experience or have had that
experience myself, I've always felt the responsibility is me to educate myself.
So educating oneself also takes the form of reading books, all kinds of books, fiction, nonfiction, and also writing.
I've always believed in the power of communication.
And I always thought that verbal speaking
was more my strong suit in terms of communication.
However, when you're at a teaching hospital,
there's an expectation that you write.
So my first ventures into writing
were writing scientific and medical papers. So my first ventures into writing were writing
scientific and medical papers. So I have a whole sort of period where I was only
writing for medical and scientific journals. This concept of writing for
non-medical, non-science audiences came as I started being exposed to other
mostly physicians who were doing the same,izing that our opinion matters, our voice matters, and if we're coming
from an informed, educated place to talk about science, to talk about medicine, healthcare,
etc., that it is helpful for us to speak up in this way, and speaking can mean writing.
So I was very into reading, for example, leadership books,
people management books, communication books,
and the articles that are published in, for example,
Harvard Business Review or Fast Company,
because I think people don't realize
that healthcare is an industry.
It's a company.
These are organizations just like all the others.
We think they're different, but they're not.
And so I found many of those articles
relevant to my own experience. We think they're different, but they're not. And so I found many of those articles relevant
to my own experience.
And flipping it 180, I realized that what I was seeing
in healthcare and in medicine and my own experience
of navigating the workplace, it can be relevant,
generalizable and helpful to others
in other fields as well.
I started writing articles.
Some were with other authors, some were alone,
some were with my co-author with whom I wrote the book. And these articles really
did well. People are like, wow, I'm really glad you wrote that article. I'm gonna
share it with my mentees. Or they would be these secrets of the workplace that
they weren't really secrets but no one talked about. One example is writing a
letter of recommendation. Like it's very common in many workplaces
that you are asked to draft your own letter of reference.
And the first time my supervisor
asked me to draft my own letter,
I thought he was asking me to do something illegal
or that he was being lazy.
And like, I was just so confused.
It came out of nowhere.
I did it.
And then I found out actually it's exquisitely common.
And my co-author and I flipped it and actually wrote an article about why we are actually the best people to write our own letter of recommendation.
Unless the rules say you cannot and it's illegal.
We know ourselves. We remember our relationship to this person.
Often these supervisors don't remember when they met us or how we're related.
And also if we're applying for a position, we know the details of the position and we're
best able to say why we're good for that position.
And we very much emphasized in this article that it's a draft, you hand it to the supervisor,
they make it their own, they can add superlatives like, she's the most competent, most da-da-da,
but basically it really makes sense. And in terms of helping them help you, you've actually
lightened their load because you've created a draft for them.
Clearly, you love learning. And writing seems to be your way of learning out loud, not just for yourselves, but for others too.
Now, when I first skimmed through the book,
my immediate reaction was, ambitious.
And I mean that in a good way.
This show is all about making change ambitiously.
I've been dying to ask you this.
Why combine so many different scenarios and skills into one book?
You covered communication, networking, managing up, everything and anything.
Each of those could easily be his own short book.
But you decided to go comprehensive.
What was your thinking behind it?
The true motivation behind not only those articles,
but then what became the book,
was to make it easier for other people.
To give them a copy of what I call
the workplace playbook.
If we were to make a sports reference,
teams will get a playbook.
And I certainly felt along the way
that I did not get a copy of that playbook.
And I thought, all these, the example I just gave
about letters of reference, if someone had just told me that, I would have, it would have made, it would have saved me a few years of learning and being less
efficient and allow me to be more efficient because I was less efficient until I learned that pearl,
that lesson that this is the way the workplace works. And so the motivation was to create a book
that would help people in their careers and not just doctors and not just women, but truly everybody.
And you have highlighted that we started the book
with three truths.
Number one, we want the reader to think of time as a currency.
Time can only be spent.
You can't put it in a savings account for later
and you cannot get a refund.
And that even ties back to the story I shared
about the patient that died
right at the beginning of the shift in front of me.
Time was going. I had seven more hours. I had to keep going.
And in the emergency department, we do a lot of task switching.
When one thing's done, one patient gets discharged,
one cut is sewn, next, next, next, we're always pivoting.
And so time is always being spent.
And so we want the reader to be very intentional
about how they're spending their time
and with whom they're spending their time.
And the how is also what motivated the book
to be a very efficient, practical, useful read.
So sure, you can read it cover to cover,
and you're right, it is chock full of content,
but also it can be a toolkit that you can jump in and jump out of. And so that's why we wrote a
very granular table of content. So people will be like, I need to learn about running
a meeting. Oh, okay. Page 258, running a meeting. And we specifically wanted it to be readable.
And when you're publishing a book, and to make it publishable, you have to somehow make the argument that it's different from all the other books.
Someone that interviewed us on a podcast was like, I have a lot of these books on my shelf and I've read a lot of them.
Why should I read your book? Why is your book different?
And it's a fair question because if all of us, any of us that have traveled in airports or train stations, when we go to the bookshop, there's always that table of business self help books and this is different in that.
If you've ever had the experience of picking up a book
and it's put out there as a book for everybody, but you read
it you're like this doesn't relate to me or my experience
or this author is not speaking to me. We wanted to write a
book that made no assumptions about where someone is coming
from their upbringing their financial resources,
their network, their pedigree.
No assumptions.
We want to tell you these secrets, these tips,
the plays in the playbook.
Time is currency.
It can only be spent.
Number two, the world is not equal.
We all have different start lines
and start at different places.
But by learning these micro skills, we can fill in gaps, so hopefully we all get
to the same endpoint in terms of navigating
and being successful in the workplace.
And number three, we truly believe learning is limitless.
If only it is accessible.
And that speaking to accessibility means
do people have time to learn, to read a book,
to watch an online video, to read a book, to watch an online
video, to have a conversation with a subject matter expert?
Do people have the money to pay for this education, these resources?
Do they go home and do they have what is called the second shift where they take care of children
or elderly parents or pets?
Trying to make no assumptions. So we wanted to write an efficient read that would give people access to that learning.
That's all for part one.
Risa shared how emergency medicine found her, why literature and sociology still shape her world, and how she builds her way into teaching
ultrasound around the world. In part two, we'll talk more about micro skills,
the repeatable habits that help you stay grounded when everything around you is spinning. See you there. Thank you so much
for joining us today.
If you like what you heard,
don't forget, subscribe
to our show, leave us
top-rated reviews,
check out our website,
and follow me on
social media.
I'm Vince Chen, your ambitious
human host. Until next time, take care.