LETTING GO OF THE TRAUMA OF CORPORATE MEDICINE AND FINDING FREEDOM IN DPC!

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It has been a little over a year since I opened my Direct Primary Care Practice, Love and Light Integrative Medicine (LALIM Health) and the steady clearing of my mind has been astounding. With the new spaciousness, I have been able to shed inflammation from my body and light on my previous experience. Healing myself from the oppressions of corporate medicine has required an honest look at both the ways in which I grew and the ways in which I was constrained. Two truths can exist simultaneously. I was taken for granted and sometimes treated with cruel comments, anger, colonization, corporate greed and manipulation. While also, the extra efforts and gifts I offered my organization, patients, colleagues, trainees and staff helped me grow and refine my skills. I needed to take a cold, hard look at how my beliefs impacted my people pleasing and approval seeking. I also have needed to take accountability for my part in the abuse I continued to allow to survive and try to “make things better.”  And now that I am over a year removed from this, I am opening my eyes to the different layers to the gaslighting I received and entertained. 

I now realize that there was no incentive for the organization to provide me with different opportunities for growth and development because I kept producing at a high level and did so with a smile. A mentor of mine recalled a moment where she was told by a superior that “women are not to be advanced because they are needed to work and see patients.” Both relief and anger washed over my body when I heard her say this because it confirmed what I had felt for a long time. Validation is a wonderful thing! In addition to this, I have long felt that being a Latina physician meant that the administration assumed that I need to work harder than some of my counterparts. When the chief of Family Medicine describes junior attendings, it became clear many of the physicians are “smart”, but the Latina physicians are “sweet.”

Having to fight to prove that I am as good as my male and dominant group colleagues has exhausted me but the worst part of is that I adopted and internalized so many of those isms and beliefs. I am now releasing these and decolonizing my mind and body!

 According to the recent a CNN Health report in 2023, Only 5.7% of US doctors are Black, and experts warn the shortage harms public health

https://www.cnn.com/2023/02/21/health/black-doctors-shortage-us/index.html

I could never understand why high producing physicians of color who carried a high volume of complex patients of color were pushed so hard and few allowed to move up.  After reflecting on these truths, I felt like things made sense and I needed to leave if I wanted to heal. That choice was been mine and I took it! My colleagues have often told me, “Soto, I would feel afraid to do what you did.” And I would find myself saying “Oh I feel fear, I am just not letting it stop me. I may fail but I will be happy because I know I tried. And If I succeed, WOW!”

I worked in both Family Medicine and Infectious Disease for 11 years and transitioned to Infectious Disease for the last 2 years of my time at that organization. Caring for people living with HIV/AIDS is both challenging and fulfilling. I had a wonderful Chief of ID who was as supportive as he could be within the required structure. One January morning I slowly made my way up the hallway to his office, sat down and told him “You are great and have been good to me, but this is stupid so I gotta go.” He nodded and said he understood and asked if there was anything he could do to change my mind. I affirmed my decision was set and he stood up and gave me a hug. He remarked how sad it was to lose a member of his dream team, but he was still supportive. I would often ask if he wanted to come with me, but he would always respond that he soon “wants to be done with medicine all together.” This saddened me because he is a wonderful clinician, but I also respect his choices. It is my hope that my success will demonstrate to others that they can do this too! 

Then one afternoon, an administrator, who I had barely known came to my office and sat down. Not only did he speak at length about how great that organization is, but he also proceeded to tell me how great he was. And then he felt the need to inform me that there might be something wrong with how I was working if I felt strained from the work. All the other doctors he worked with “found the work easy” and he just didn’t understand why I found it difficult. When I clarified that I was fatigued and I needed to go, he then gave me the blessing of “I hope you find yourself” as if I did not know myself well enough and that is why I needed to leave.  Again, the implication being that something is wrong with me. 

One of my colleagues reflected to me “who is going to care for your very difficult patients?” And then he proceeded to tell me that Los Angeles is a big pond, and I would not likely make it here with a practice that offers Ketamine. Thankfully I was able to laugh with the nurses about that “pep talk”, but it still stung, as there was no need for that cutting remark. 

Now that I have been out of that scenario for over a year, I am able to reflect on these conversations. How better to get a physician to get in line than playing upon their racial and gender trauma, gaslighting them into believe they are just not as good as their counterparts and need to work harder. Add a pinch of humiliation with a healthy dose of fear and they will be more likely to comply! This use to work on me in the past but no longer does. I have had too much therapy and psychedelic treatments to believe this nonsense anymore! I will share more on the psychedelic treatments I have had and offer in a future post-so stay tuned!

Caring for complex and ill patients is a job that requires effort and dedication. Doing that job while being gaslit and overworked required me to be dissociated. I now understand that the term “resilience” in corporate medicine really means dissociated. And the funny thing is that it is a dissociative anesthetic coupled with integrative therapy that helped me reconnect with myself in authenticity and understanding.  We are all beautiful just as we are and valuable because we exist!  And now I have a growing medical practice based on love, listening, understanding with healthy boundaries. My patients often refer to me as a unicorn and I am honored by that. We are all special with our own signature and this is the beauty of humanity. And we can all heal together! I am eternally grateful for those who forged a path of Direct Primary Care and paved a road that is becoming more traveled every day! 

About April Soto, MD

April Soto was born and raised in Guatemala to Puerto Rican Missionaries. She came to the US to attend university and medical school at University of California San Francisco. She completed her residency in Family Medicine at White Memorial Hospital in Los Angeles, Ca , a 1-year Fellowship in HIV Medicine at Los Angeles County-University of California, 2-year fellowship in Integrative Medicine through Academy of Integrative Health and Medicine in San Diego, Ca. She worked at Kaiser Permanent for 13.5 years in Family Medicine, Infectious Diseases, Family Medicine Surgical Services and served as the Wellness Champion for the Family Medicine Residents. Dr Soto is also trained in psychedelic services and offers Ketamine, Breathwork and Biofield Medicine/Energy Healing services for patients with mental health concerns. She enjoys complementing western medicine along with addressing the physical, mental, spiritual, and emotional needs of her patients as well. She meditates daily and enjoys time in nature. Boogie boarding alongside the surfers brings her great joy! She lives in Los Angeles, Ca with her beloved husband Chris.