How Medicine Is Failing Women Doctors, And What We Can Do to Fight Back with Dr. Tiffany Moon

Dr. Tiffany Moon is a board-certified anesthesiologist, entrepreneur, mother of twins, and — yes — a former cast member of The Real Housewives of Dallas. She is a deeply thoughtful physician who’s spent the last several years reckoning with burnout, unlearning perfectionism, and redefining what success means inside and outside of the operating room.

On this episode of How I Doctor, Dr. Graham Walker talks with Tiffany about the challenges of practicing medicine, particularly as a woman, how becoming a mother changed the way she works, and why she believes more physicians need to reclaim joy as a clinical priority. They cover everything from gender bias and burnout to parenting advice and how to build a personal brand on TikTok. And they do it with honesty, vulnerability, and laughter.

We’re also incredibly grateful to Tiffany for her early support of Offcall – After we put out the call to help a rural anesthesia group with their salary negotiation, Tiffany’s public support for the campaign led to hundreds of anesthesiologists who have contributed to Offcall’s growing dataset and working toward our movement for fair compensation across medicine.

We’re thrilled to celebrate the release of Tiffany’s new book Joy Prescriptions coming May 6. Part memoir, part survival guide, this book it’s a must-read for any doctor who’s ever felt stuck in the pressure cooker of achievement and wondered, “Is this really it?” You can buy the book here or wherever you buy your books.

Here are four of the biggest takeaways from this refreshingly candid episode with Tiffany and Graham:

Why Perfectionism Is a Physician’s Hidden Enemy

“The things that make me a damn good anesthesiologist also shoot myself in the foot at home.”

Tiffany opens up about the internal and cultural forces that drive many doctors—especially women—to relentlessly pursue achievement at the expense of joy. She traces her own perfectionism back to childhood, immigrant family expectations, and the relentless roadmap of medical training. For years, she delayed joy in the hope that it would arrive at the next milestone. Only later did she realize that joy wasn’t a destination at all—it had to be intentionally cultivated every day. From redefining success to setting better boundaries, this conversation is a powerful reminder that the pressure to be perfect can quietly destroy the very joy that brought many physicians to medicine in the first place.

The Gender Gap That Won’t Go Away

“Women get paid less than men for doing the same work—even when you adjust for everything.”

The data is undeniable, and Tiffany isn’t afraid to say it: gender bias in medicine is real, persistent, and often invisible to those not affected by it. She shares personal stories of being mistaken for a nurse, being denied promotions after going part-time, and how institutions subtly punish women for choosing balance over burnout. Despite women now making up the majority of medical students, nearly 30% leave medicine or reduce hours within six years of completing residency. “It’s not the women,” she says. “The problem is the system.”

How Parenthood Changed Her Approach to Practicing Medicine

“Being a mom makes me a better doctor. It humanizes the patient again.”

Motherhood forced Tiffany to confront just how dehumanizing the medical system can be—for patients and physicians alike. She talks about how becoming a parent helped her reconnect emotionally with her patients, seeing them as someone’s child, partner, or parent. But she also acknowledges the cost: the system makes it brutally difficult to be both a good parent and a good doctor. There’s no time for empathy, she says, when hospital administrators are tracking your turnover times. And yet, it’s that human connection—the part you can’t chart—that patients remember most.

Redefining Success After Burnout

“If you became a doctor, you can do anything.”

After stepping back from full-time clinical work, Tiffany built an entirely new version of herself—author, speaker, social media creator, and founder of the LeadHer women’s leadership summit. But getting there required letting go of the rigid identity she’d clung to for years. For physicians who fear that stepping away from medicine means losing themselves, Tiffany offers a liberating counterpoint: sometimes, you have to lose who you were to find who you’re meant to be. And sometimes, the thing you’re best at isn’t what you trained for—it’s what comes after.

Connect further with Tiffany on her website here. Buy her book Joy Prescriptions here.

To make sure you don’t miss an episode of How I Doctor, subscribe to the show wherever you listen to podcasts. You can also read the full transcript of the episode below.

Offcall exists to help restore balance in medicine and improve the wealth and wellbeing of physicians. Sign up for Offcall here to bring about more physician compensation transparency and join our physician movement.

Transcipt

Tiffany Moon:
Almost 30% of female physicians leave medicine entirely or significantly cut their hours within six years of graduating from residency. And I'm just thinking, "Something's not right." Like a third of women, after they've gone to pre-med, university, medical school, racked up hundreds of thousands of dollars of debt, went through a rigorous residency training program and now they just tap out. I don't think these women are the tap-out kind of people.

Graham Walker:

Welcome to How I Doctor, where we're bringing joy back to medicine. Today I'm talking with Dr. Tiffany Moon and if you only know her from the Real Housewives of Dallas, you might not realize she's a board-certified anesthesiologist, a mom of twins, an entrepreneur, and has a new book out called Joy Prescriptions. It's part memoir, it's part guide, and honestly it's pretty relatable for any type A physician, myself included, whoever has felt the weight of perfectionism on our lives and the burnout that can follow. Joy Prescriptions comes out May 6th, 2025, so we're dropping this episode a little bit early. Please check it out. You can pre-order it at joyprescriptions.com. She wrote, "I used to think that joy was a destination and that kind of hit me like a ton of bricks. I think it was a lesson that I actually learned during COVID, but I think it's a really important lesson for physicians to learn today more than ever." Dr. Tiffany Moon, thank you. Welcome to the show.

TM::
Thank you for having me. I'm so excited to talk to you.

GW:
Tiffany, before we get started, I just want to say a big thank you to you. The way we met was Offcall, put out a request for help to support a rural anesthesia group of fellow anesthesiologist and you helped us promote that, so the response has really been amazing. We've had hundreds of anesthesiologists show up and contribute information thanks to your post. Thank you for helping support salary transparency and equality in medicine.

TM:
You're so welcome. I'm happy to contribute to the cause because that's very important to me.

Gender Pay Gap in Healthcare and Physician Compensation Inequity

GW:
Thanks. If you're listening, you can still go to offcall.com and sign up. It's anonymous and free and it's trying to help us advocate for change. Something you said in your Instagram post really stuck with me and it's the importance of having access of that data for all physicians, but particularly women. If you look through your comments, a huge number of people were talking about the challenges of being a female physician, so maybe we can start there.

TM:
I still think that there is a gender gap for pay. Some people will say that pay is equal and I will respectfully disagree. The data shows that it is not. Even when adjusted for level of expertise, number of years worked, RVU's, number of calls taken, adjust for whatever you want to adjust for, but the fact remains that women get paid less than men for doing the same work. I've seen big research projects, I've seen departmental data, I've seen AAMC data and it remains that that is true.

GW:
The majority of med students are women?

TM:
It's close, it's about 51, 49, thereabout.

GW:
Yeah. But for years it was an entirely male dominated profession and still we are seeing a lot of women get out of medical practice maybe five or 10 years afterwards. So it is hard, I think, to argue that the practice of medicine is serving female doctors extremely well if they're deciding to leave and find something else to do or cut back their hours substantially. It seems like the profession is not serving our biggest group of users almost anymore.

TM:
There is a statistic that is put out by the American Women's Medical Association, AMWA, and they said something like almost 30% of female physicians leave medicine entirely or significantly cut their hours within six years of graduating from residency, and I'm just thinking, "Something's not right." A third of women after they've gone to pre-med, university, medical school, racked up hundreds of thousands of dollars of debt, went through a rigorous residency training program, and now they just tap out. I don't think these women are the tap out kind of people.

GW:
Thank you. Yeah.

TM:
Let's examine the system within which they work, which sometimes, depending on institution and department and leader and things like that, makes it very untenable for women physicians to work and have this elusive work-life balance and raise a family and be sane. It's like too...

GW:
You wanted sanity with it, Tiffany?

TM:
I mean not every day, Graham. Every day would be a lot, but just most days than not, I would like to be sane and not feel like a crazy person, which is how I felt sometimes.

Patient Bias Toward Female Physicians in Clinical Settings

GW:
The most common thing that I run across with my colleagues all the time is the patient complains, "Oh, I never saw a doctor," and it's like, "Nope, you literally saw three doctors. They were just all female." I mean, to the point that I think it is way more common that female emergency physicians feel that they have to wear a white coat to play the role and wear the costume of doctor because many patients still will not recognize them as the physician in the room and the same stereotype of male nurses. They will assume that the man is the doctor, not the nurse. Tiffany, what other challenges come to mind when you think about just the stresses and the struggles of being a female physician?

TM:
It's not just being mistaken for a nurse, and this happened to me not long ago. I had a male medical student who was doing research with me and they literally thought that he was the doctor and I was the nurse.

GW:
Oh my gosh, yeah.

TM:
Never mind that I'm a decade older than him, but he's indeed a male and I am indeed a female and the patient is not trying to be rude or whatever, it's just unconscious biases and we all have them. I used to always try to be very serious face because I basically have five minutes to acquire the trust of my patient and their family members at the bedside before I take them back for surgery. It's not a very long time. I don't see them before the morning of surgery, so I need to walk in and be able to look them in the eyes and say, "I'm going to be your anesthesiologist. I will be taking care of you. These are the risk benefits," all these kind of things, but sometimes I do that. I'm literally consenting the patient, have done their PMH, gone over the risk benefit alternatives of different anesthetic techniques, whatever. They're signed the consent and then they're like, "Do you know when the doctor's coming in?" I'm like, "What do you think just happened?" You know what I mean?

GW:
You're doing all the doctor things.

TM:

Career Consequences of Part-Time Work for Women Doctors

It's wild. It's wild. I think it doesn't help to be Asian. I think it doesn't help to be of short stature. I have multiple things going against me and those are just the patient things. Then there's the colleague and the things that come from the tower. After going part-time, I felt that I was no longer considered to be a "serious" academic anesthesiologist and my administrative leadership roles were taken away from me. I was refused promotion from associate to full professor because I was part-time. Sometimes they make it so untenable for women to have both, meaning work and life or family, that people go part-time or leave. I mean you have to ask why the system is not retaining its talent and these women are leaving because you simply don't make that kind of investment in your career and education to just be like, "Oh no, I'll just stay at home instead," or, "I'll start my own knitting business and sell sweaters on Etsy." I'm telling you. The problem is not the women, the problem is the system. I stand by that.

GW:
I will stand right there with you. Anesthesia services are in such high demand right now especially, you would think if the system was logical, it would be trying to find ways to make it work so that a part-time... "You want part-time? Great. If I can get you for any hours, the system, the patients need this service," but the system continues to choose otherwise.

TM:
Yeah, I mean there's so much wrong with the American healthcare system or the American sick care system as I like to call it that this is just really the tip of the iceberg. I mean, we could go on with the insurance companies and the pre-auths and there's other doctors on social media who are much better versed. I always say I'm a little bit blessed in anesthesia 'cause I never have to get pre-auths for my patients. By the time your pre-authed for surgery, guess what? You need an anesthetic too, and I work at a level one trauma hospital, so when they come through the ED and they've been shot and stabbed and I'm on my 40th unit of blood, I don't have to get a pre-auth for that, so I don't deal with insurance companies at all, and I think that is one of the reasons that I continue to do my job and my friends in primary care are about to pull their hair out. I think that's a big element of physician burnout.
And then the other for me is patient compliance. I'm like, "Oh, 100% of my patients are compliant. They do whatever I want when they're on my table." Now after I drop them off in the PACU, that's none of my business, but I think there's a lot of factors contributing to the broken healthcare system and really the system not making it easy, or not even easy, but tolerable for women to work and still have family is one of the main problems.

Perfectionism and Cultural Pressure in Physician Upbringing

GW:
Reflect on your book a little bit. A lot of the book is about pressure and expectations, and I'm curious how much of that is self-driven, like it's just an internal engine of your own doing. How much of that is family? How much of that is culture, whether it's American culture or Chinese American culture or medical culture? How do you break down how much of the challenges come from those different parts of your life?

TM:
That is an excellent question, Graham, and I'm not sure the answer, but if I had to break it down, I would say somewhere on the order of one third internal, one third society and medical culture and one third coming from my parents and my Chinese background. If someone offered to pay the therapy bills, those are how I would divide the therapy bills to be sent out equally and I would, myself, pay a third of them. There's no randomized double-blinded controlled trial version of me that grew up differently and see how she turned out. You know, they do those identical twin studies where they got separated at birth and one went to Germany and one went to Switzerland and now their favorite color is both purple and they hate chocolate. What are the odds? You know what I mean?
But unfortunately, as far as I know, I do not have an identical twin sister that grew up differently and we don't know how she turned out, so I can only say that as a child, as I wrote in the book, I had an immense amount of pressure put on me, but I don't think that's a unique experience. I think a lot of people who are immigrants to this country or maybe not even immigrants, had an enormous amount put on their shoulders as well because the people who come here for the opportunity at the American Dream sort of expect their children to attain that American dream, so a lot of immigrants in this country, they placed enormous emphasis on their children to succeed, which, in their eyes, generally meant education and financial security and joy was nowhere in the equation. My father never said, "Did you have joy today? Tell me the funnest thing that happened to you today. Tell me something that made you laugh." These are the questions I asked my kids at the dinner table. My father did not ever ask me any of those questions.

GW:
I really liked in your book, trying to navigate one version of you and then realizing that that version of you doesn't understand joy and how do you find that when you maybe haven't had it or it hasn't really been emphasized or prioritized in the past? You wrote, "I realized that someone else's opinion to me is none of my business," which I loved When you wrote about joy, I reinterpreted that word as meaning for me because I think that's really... Sometimes I struggle to think, "Well, what is meaningful in my life," and that's a similar sense of joy, of a sense of happiness and purpose and enjoyment and fulfillment, I think as well, is maybe another word too.

TM:
Yes. Joy is all of those things that you just said, so to me, my definition of joy supersedes happiness. My friend, Judith, says that, "Happiness is an idea and joy is the experience," and a lot of people think of happiness as a state or a finish line, a destination of some sort. Like, "If I do this, then I'll be happy," which kind of means that, "Oh, so without that, which you don't have right now, are you not happy?" And I don't want to play that game. Joy, to me, is the experience like having a delicious meal and savoring it, watching something on TV or having an inside joke with your family and everyone's just having belly laughs. That, to me, is joy, which transcends happiness.

GW:
I remember talking with my therapist when I was a brand new attending and I think I just had passed my oral boards in emergency medicine and I was done with everything and I remember thinking like, "Well, what am I supposed to do with my free time now? Should I be reading journal articles or I need to be writing something or what am I supposed to do?" And it really took me, and I counsel younger attendings, it took me six months to accept I'm allowed to just do whatever I want. I'm allowed to spend my money how I want because from high school until I was 31 or 32, everything was planned out for me and I had milestones I had to meet to get to this level of attending.
Tiffany, you also talk a lot in the book about just being a parent and the challenges of being a good parent and being a good doctor as well. If there's anybody out there listening, what are some of the lessons that you learned or took away from how to do those roles and find joy and meaning in being a mother and also being a physician as well?

Balancing Motherhood and Medical Practice

TM:
Having kids and the process of getting pregnant, which for me was not easy, taught me a lot about patience and control. If I didn't have kids, I think I would be a completely different person. I think being a mom actually makes me a better physician. I'm definitely more caring. I think whoever I have on the table or whatever I'm doing, I'm like, "This is someone's child," and it humanizes the patient because sometimes when you get burned out, you start to dehumanize patient and you call it the case or the room number. Like, "My case in OR eight. And it's like, "Wait a second. Your case in OR eight just got run over by a car and is someone's son." You know what I mean? Not that I wouldn't do anesthesia well, but I think having practiced medicine for now 13 years post-residency, you do get a little bit dehumanized from everything.
And some of it is protective, like if I cried over every patient that I've lost on the table, I'd be a sloppy mess, but sometimes I've got to pull up my big girl panties and go on with the next case. Is that the right thing? I don't know, but that's what we do.

GW:
It seems like we go through this weird cycle where when you're starting out as a med student, you've got all this very positive emotion and you want to do medicine for the right reasons, and patients really touch you in a very deep, emotional way, and then as you maybe get in toward residency internship, you realize you cannot be emotional about every single patient. I think you lose some of that humanity and then as an attending, you're trying to find that balance of gaining it back and being able to see patients as a father or a son or a daughter or an aunt or anything like that, but still at the same time recognizing that you have to find that balance and that it was protective, but I always want to let a little bit more in.

TM:

Loss of Empathy and Human Connection in Modern Medicine

Me too, but it seems that the medical system wants to beat the empathy out of us, and often there's no time for empathy. Often that's what it boils down to. I want to spend a little extra time and talk with the patient and answer their questions or just sit with them or pray with them and there's no time 'cause I got to get back into the OR lest I have a 30-minute turnover time and there's a ding and I get a mean email that was, "Your turnover time's too long." You know what I mean?

GW:
Yeah.

TM:
It's like I didn't have time to have empathy today, which I realize sounds ridiculous.

GW:
That's insane. I know. Yeah.

TM:
Yeah, yeah.

GW:
And the funny thing is patients want that too. I think a patient would love for you to spend an extra five minutes with them just sitting, holding their hand answering, "Hey, any additional questions about the medicines?" This is when I do my verbal consent for the patients. I say, "I just told you so much information and I know I speak really quickly. You have to have questions for me." Even the person that trusts me implicitly, "Give me some questions. Show me that you were listening." I think patients would love it too, but again, the system doesn't want that.

TM:
Well, the system is incredibly broken and honestly, I didn't even see that until about maybe just five years ago. When you're going through it as a med student, you don't know anything. Resident, you're just trying to survive. As an early attending, you're also just trying to survive and build up your patient list and things like that, and then mid-career, you see how the sausage is made so to speak, and you're like, "Oh, I don't know about billing. I don't know about RVUs. It's none of my business. I'm here to take care of patients." But when you're out in practice and private practice, especially, if you're in a group, you have to know those things and they don't teach you any of that stuff in medical school. So you're going through mini business school as an early attending. That's what you do in all your free time as an attending. Now you got to figure out how to run your business.

GW:
Part of it to me seems like there's a lot to learn in med school and residency, and so there's plenty on our plates already, and part of it's like, "God, I think if we told the med students this is how the sausage is made, they'd be like, 'I don't want the sausage anymore.'"

TM:
They would, and people don't want the sausage anymore. I mean a lot of people do. Don't get me wrong. Medical school admissions are still very competitive, but if we continue to treat physicians the way we do, and Gen Z is wising up because they're more about self-care and wellness than our generation, my parent's generation was like. You know, "Keep your head down and deal with it more," the top talent will be recruited away from medicine because they see how unhappy the people before them are and how broken the system is, and there will be a few people who really want to do it and think they can change and will be the change makers, I hope, for my sake, 'cause I'm going to get old and I need someone to take care.

GW:
I know we're going to need medical care too.

TM:
I know. I look at some of the young people and I'm like, "If these are the future doctors, we're really screwed." My medical student asked me if they could leave at 2:00 P.M. and I was like, "When I was a medical student, I never asked."

GW:
Yeah. I would never, yeah.

TM:
I would never. At 2:00 P.M. they were like, "So is this the last case?," and I was like, "Yeah." And they were like, "I'll probably just leave then if there's no more incubations after this." And I was like, "Oh, my God. Oh, my God. I can't imagine."

Building Joy and Meaning Beyond the White Coat

GW:
Tiffany, in your book, you have a joy prescription at the end of each chapter, and I'm wondering if you can share some of those mindset shifts that you think might help other physicians who are practicing as well to be either happier, more mindful, have more joy, more meaning in their lives.

TM:
The whole thing about joy is that it's the small moments that add up to be the big thing and to stop anticipating joy, which is really the antithesis of medical education, is like we are on this roadmap that's clearly delineated, which I like, which soothes my anxiety to kind of know what's next, what step, like, "This is how you go." But also it rids you of the creativity and spontaneity to detour off this path that you think you need to be on. Some of the best and brightest doctors I know did something else before medical school. They didn't just go straight through. They worked in engineering, they were a teacher, they did Doctors Without Borders. I'm like, "That's so cool." If I didn't have kids, I would want to do something like that, but it's very difficult.
I used to actually do medical mission trips to South America and to Mexico. We had one through the school, but it's so hard now with... Well, first of all, my employment place is very stingy on our vacation. In the months of June, July and August, there's a lottery system and you get two weeks in the full months of June, July and August, which is when everyone needs [inaudible 00:23:08]

GW:
Everyone wants to take time off, yeah.

TM:
Kids are out of school. I can take a maximum of two weeks, and so it's just very hard. So I'm not going to, not waste, but use one of those weeks on a medical mission when I could spend time with my children. It's just they make it very untenable, again, for people who want to do good things to actually do them. I'm actually taking PTO to go examine for oral boards because that's how the schedule worked out. I don't want the people who are listening to this to feel despondent because this was supposed to be an episode about joy, but I do want people to know that you can't wait for the joy to happen to you. You need to have an active effort in cultivating your joy. You need to be finding what brings you joy. This is the other question. Sometimes people are like, "Dr. Moon," I do coaching for women physicians and executives, and they'll be like, "I don't really know what brings me joy." And I'm like, "Oh, girlfriend, we got so much work to do."
I think you end up serving so many people, your patients, the walls on your study for diplomas and gold stars, your parents, society, your spouse, your children, your patients. You end up serving so many other people that at the end of the day you actually forgot what brings you joy. We have to take a whole step back and find, "Well, what used to bring you joy when you were a little girl? Do you like arts and crafts? Do you like running? Did you used to play basketball?" You know what I mean? And so many times with some of my coaching clients, we're going all the way back to even find what gives them joy, and then we cultivate it and we get rid of toxic things. We set healthy boundaries.

GW:
I was talking with Dr. Elisabeth Potter, who's a plastic micro-

TM:
Oh my God, I love her.

GW:
She's incredible.

TM:
She's in Austin, Texas. I've never met her.

GW:
Yeah, she's in Austin. I was talking with her a few weeks ago and we were just-

TM:
I follow her. I love her.

GW:
She's great, and she's so driven and dedicated to her patients. She and I were just talking about how the Hippocratic Oath, we're taught from day one of med school, the values of medicine of non-maleficence and beneficence and first do no harm. And I think really the Hippocratic Oath has been used against us and waged in an evil way where because the patient is always supposed to come first, it automatically means that the doctor has to come last. That no longer seems like a sustainable model 'cause there's always going to be another patient as well.

TM:
Yeah. My problem isn't even with the patients by and large, it's with the intermediaries and the insurance companies. Patients by and large are quite understanding if you just talk to them and they feel listened to and cared for. I had a guy who was supposed to have a hip surgery the other day that was in new onset AFib with RVR, and I was like, "Maybe the hip can wait a little minute. I got to see what's going on with your heart." And he went and they were like, "Why did nobody tell us this yesterday?" And I was like, "I'm so sorry. I don't know. It slipped through the cracks. If you were my father, what I would recommend, is being seen by cardiology before you come downstairs for an anesthetic." And I sat with the patient and his wife and we talked it all out and they were upset, but after I talked to them, they were fine. And I think the vast majority of the problem is not the patients at all.

GW:
Oh, yeah. Yeah. I think the patients are unfortunately, ironically, the least powerful, the most powerless in all of these other arrangements that are impacting the patient in the first place. It's supposed to all be about the patient, but all of these other factors come and get involved as well.

TM:
I think we keep people unhealthy and chronically ill so that industry can benefit off of them. I think we don't give enough money education to keeping people healthy, nutrition, lifestyle, patient education, and we eat crap in this country. I was at the airport and I was trying to find something healthy to eat.

GW:
Something.

TM:
We don't make it easy to make healthy choices, and then we benefit off of chronically sick people. I think it's terrible.

GW:
Sometimes when you dive in, it is hard to think the system is not rigged. I mean, every single doctor and nurse I work with, literally is working nights, weekends, and holidays to try to make people better. But then when you look at the rest of the machinery above us, it does feel like, "Well, I can see why people believe a lot of the conspiracies or worry that doctors are trying to keep people sick because then we can keep them on a bunch of medicines," or something like that.

TM:
It's not the doctors. I guarantee you. I don't know a single doctor that would withhold a medication or prescribe something extra and be happy that you stayed chronically sick. The problem is not the doctors and the problem is not the patients. So smart people do the math, figure out what the problem is.

GW:
Tiffany, let me ask you a few more things about your book. You talk about the trap of dress rehearsing tragedy, and I mean, I didn't know that anesthesiologists do this 'cause this is literally all ER doctors do all day long, is think about, "What's the..." I mean, we literally do this in residency. The attending will ask you, "Okay, what's the worst thing this person could have?" I mean, that's our job is to rule out an emergency. They teach us how to think one step ahead, be on that algorithm so we're prepared that you've got your stick of NEO drawn up in case the patient gets hypotensive or something. That's as much anesthesiology as I do.

TM:
Very good.

GW:
Thank you. Thank you. But how do you untrain that mindset when you go home to actually enjoy your life? Have you figured it out? Because I'm personally asking just for me at this point.

TM:
No, you can't. The fact of the matter is that that is who I'm. The quality-

GW:
I know it's baked into our brains.

TM:
Yes. And the qualities that make me a good anesthesiologist also shoot myself in the foot at home. I can never be fully present. Okay. Do you want to know? My kids call me no fun mom, because I will tell you why. Because they're not allowed to have a trampoline because I work at a level one trauma hospital.

GW:
You've seen it all. Yeah.

TM:
I've seen it all and I've seen a quadriplegic who landed off a trampoline in just the right way and broke his spine. He was like 14 years old. You know what I mean? So they're not allowed to have trampoline. They're not allowed to zip line. They're not allowed to ride in a helicopter, which is weird because when my husband and I got engaged, he surprised me with the helicopter thing over Maui to look at the other islands, and it was very romantic. And I'm like, "I'm never doing that again." They're not allowed to go in a hot air balloon. They cannot ride ATVs.

GW:
Oh, never, never?

TM:
This is a thing in Texas, maybe not in San Francisco, but in Texas, everyone like rides ATVs. Golf carts, unless they're on a golf course. Yeah. There's a huge long list of things that my children... They're not allowed to play with fireworks, for sure. I mean, how many hands have we seen blown off on 4th of July? You know what I mean? And so my kids are just like, "Mommy, you never let us do anything." And I'm like, "It's for your own good. I am your mother. My primary job in this life is to keep you safe." We've seen too much. What about you? I mean, how do you feel about all this?

GW:
I think it is a challenge, and I think I have to tell my brain, "Oh, thanks for that warning." You know what I try to do actually, is I try to tell myself, "What if a patient came into the ER saying what you're thinking in your head?" And I would be like, "That guy's crazy." And it tries to deactivate that part of my brain and say, "Okay, yeah, that's actually not that reasonable thing to be concerned about." Well, Tiffany, in our last few minutes, let me ask you just some kind of rapid fire questions about-

TM:
I love rapid fire.

GW:
Okay. What is one myth about success in medicine that we should kill, we should get rid of from the culture of medicine

TM:
That being tired is a badge of honor.

GW:
Yes. For people that are listening that aren't in medicine. That's the thing you brag about in residency is how little sleep you're on.

TM:
Oh, yeah.

GW:
You're constantly comparing to the consultant. "Oh, oh yeah, I didn't get any sleep last night." "Oh, you? I haven't slept in three days." It's like a-

TM:
Well, can I tell you, in that realm, until I was pregnant with twins at six months, I would take one 24-hour trauma call once a month, which was Saturday, seven A until Sunday 7 A. 'cause that's when all the madness happened, and it was a badge of honor, and I'd be like, "Oh, my God, I did six cases. We did MTV. There was a rollover MBC." You know what I mean? And it was such a thing. And I did that until I was six months pregnant with twins. So basically until I couldn't.

GW:
Wow. Well, again, that seems so bad because a lot of the trauma's going to come in on the Saturday night, so you've already been working doing probably elective cases, seven A to seven P and then seven P to seven A, the hardest, the next 12 hours you're doing all the critical stuff too, probably. What's something medicine taught you that you had to unlearn in real life?

TM:
Oh, that your superior is not always correct. Question authority.

GW:
Tiffany, what's one thing every doctor should say no to more often?

TM:
Sacrificing personal time to work more.

GW:
There will always be plenty of work to do. And I almost think that discovering your joy earlier or your meaning or being fulfilled, may actually make you be able to practice medicine for longer.

TM:
That's exactly right, Graham, because now you've built a buffer and you're not going to burn out because you've been redlining your engine. You discover what your joy is, you put in healthy boundaries, you enforce those boundaries, and now all of a sudden practicing medicine becomes more joyful.

Physician Identity, Entrepreneurship, and Career Reinvention

GW:
Tiffany, you wear a lot of hats, you've had and continue to have a lot of different roles in your life. We have talked with a lot of physicians who have stepped back from clinical practice or from the bedside or that they're doing that part-time, and they said that they've lost part of their identity, that things are so entangled with being a doctor as their number one identity. How does being a doctor rank for you, and have you found ways to untangle that a little bit going back to part-time practice?

TM:
I completely understand that sentiment. Look, when you've given up your entire adolescence and early adulthood to achieve this dream of adding two letters after your last name, it is a part of your identity. So if you pull back a little bit, you do lose a part of your identity. It's like being married for however many years then you get a divorce. You do lose part of your identity. For me, I was full-time for eight years post residency, then I went back to four days a week for a year, and now I'm currently at three days a week. So FTE 0.6. And I love that I went part-time because if I didn't, I would've never become an entrepreneur. I wouldn't have had the time to write Joy Prescriptions. I wouldn't have had the time or energy to create LeadHer Summit, which is my women's conference that's in Dallas in November. Going part-time and losing a little bit of my doctor identity opened up the world in so many ways so that I could do other things outside of medicine.

GW:
When you said that people dedicating their teens and twenties and thirties to medicine, that's going to be part of our identity, that's true probably of all humans, right? If you are a violinist or a skateboarder or a lawyer and you spent 20 years of your life dedicated to something, that's just human nature, that that's always going to be a part of your identity because half of your life is dedicated to it. You really believe in it and it's part of you.

TM:
Yes. But you can do other things. You can always do other things outside of your stated profession. You can switch professions. I don't know who, listening to this, needs some sort of permission or sign or whatever, but if it's not bringing you joy, seriously, find something else. I give a talk about building your personal brand on social media. I talk about how I started posting on social media and it really took off. And now that's actually a major stream of income for me that supplements my not being full-time at the hospital. And one of the audience members, and this was a physician conference, was like, "I don't know. It's just too hard. These sounds. And then you got to edit and you got to know it's trending and how do you know which hashtags?" And I was like, "Ma'am, did you go to medical school?" And she's like, "Uh-huh." And I'm like, "And did you go to residency?" She's like, "Uh-huh." And I'm like, "And you have a private practice that's pretty popular. You have a waiting list of pa..."
She's like, "Uh-huh." And I'm like, "And you think TikTok is hard?" I'm like, "Sit down with me. Buy me a drink. I will teach you how to TikTok." If you can become a doctor, trust me, you can do anything. There are much less skilled people out there in the world doing way more, so the skills of being a physician are transferable, but also if you became a physician, you have whatever it takes to become something else too.

GW:
I love it, Tiffany. You just gave me chills. Tiffany-

TM:
We're all quitting our job. No, I'm just kidding.

GW:
Leave. Dr. Tiffany Moon, I just want to say thank you. This has been an absolute pleasure to get to talk with you and just reflect on medicine and practicing and learning how to find joy and meaning in life.

TM:
Yes. Please, everyone, find your joy, cultivate joy because life is short. We all know that. And joy is the word of 2025.

GW:
Love it. Tiffany, where can listeners find you and your book?

TM:
The book can be found at joyprescriptions.com or anywhere books are sold. My website for speaking or social media or mentoring is tiffanymoonmd.com, and if you want to follow me on social media, I'm across all the platforms at tiffanymoonmd.

GW:
Dr. Moon, thank you again so much. It's been a real pleasure.

TM:
Thanks for having me.

GW:
Thanks for joining me today. For interviews with physicians creating meaningful change, check out offcall.com/podcast. Make an account on Offcall to confidentially share your details about your work, and sign up for our newsletter, where you can hear more about the latest trends we're seeing in physician pay. You can find How I Doctor on Apple, Spotify, or wherever you listen to podcasts. We'll have new episodes weekly. This has been and continues to be Dr. Graham Walker. Stay well, stay inspired and practice with purpose.