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Episode 96: Autonomy via Locums & Independent Pain Practice In Hawaii w. Dr. Dawn Sparks

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Episode 96: Autonomy via Locums & Independent Pain Practice In Hawaii w. Dr. Dawn Sparks

This Episode

Interview w/ Dr. Dawn Sparks

You Will Learn

– Dr. Sparks’ independent pain practice in Hawaii
– Why she decided to apply to NASA to be an astronaut
– Dr. Sparks realization that an ivy-league academic center was not where she wanted to spend her career
– How Dr. Sparks used locums to travel and work part time in between roles, and
– How a terrible car accident, and the resultant medical care, shaped the way Dr. Sparks approaches empathetic patient care.

Resources & Links

This week, I’m talking with Dr. Dawn sparks. Dr. Sparks runs a pain practice on the Island of Hawaii, where she’s one of only two pain physicians on the whole Island. She shares her career journey, which encompasses a brief stint in academics doing some locums work and other medical entrepreneurship before finally launching her own practice a few years ago, she also shares a story of a really bad car accident she had when she was a teenager and how that experience that she had as a patient undergoing and recovering from that treatment continues to this day to shape her deeply held conviction around empathetic care.

Justin (00:25):
This week, I’m talking with Dr. Dawn sparks, Dr. Sparks runs a pain practice on the Island of Hawaii, where she’s one of only two pain physicians on the whole Island. She shares her career journey, which encompasses a brief stint in academics doing some locums work and other medical entrepreneurship before finally launching her own practice a few years ago, she also shares a story of a really bad car accident she had when she was a teenager and how that experience that she had as a patient undergoing and recovering from that treatment continues to this day to shape her deeply held conviction around empathetic care as always. Thanks for tuning in this week. Hello, and welcome to episode 96 of APM success. I’m very pleased to be joined today by a special guest. Dr. Dawn sparks. Dr. Sparks is an anesthesia trained interventional pain physician out in Hawaii. So it’s 3:00 PM here on the East coast then I guess she’s probably drinking her morning coffee, Dr. Sparks. Thanks for joining us today. Hey, there it is.
Dr. Dawn Sparks (01:26):
Hi, how’s it doing? How are you? Thanks for having me on,
Justin (01:28):
Yeah, I’m I’m so pleased to be speaking with you. There’s a lot of interesting stuff I want to cover. And when we spoke the other day in preparation for this conversation, a lot of little nuggets popped up a lot of good things to discuss. And the one that really peaked my interest was talking about NASA eligibility for you. So tell me, tell me a little bit about that.
Dr. Dawn Sparks (01:52):
So this was like pre pandemic actually before the world had actually shut down, but I guess there was things going on that we were hearing about Corona virus and that there was this stuff going on and, you know, Italy and China and so on and so forth. So it was definitely started, but it was like the beginning of March and I just was kind of pondering, like I wonder I’ve wanted to be a doctor since I was four. So I wonder what else would I do if I wasn’t a doctor and what was the thing that I wanted as a child? And so it kind of took me back to, I went to space camp as a young adult and and my parents said that that was too expensive. I couldn’t go. And I used my artistic skills and entered a local art project of drawing the downtown square that had been recently redone.
Dr. Dawn Sparks (02:46):
And I won $350, which got sweat back at 1989. That was enough to go to space camp and, and so, so on what my space expedition of studying for exam and on the plane all the way to Huntsville, Alabama, and then the night before taking the test. So I tested high enough to become the commander of the discovery mission back then. And so I think that was just kind of my part with NASA and wanting to go to outer space and wanting to do something else. And so I always wanted to be a doctor, but like the other thing I was interested in was definitely space exploration and the whole entire space shuttle program and everything about it. And like much like a lot of anesthesiologists who learned how to become pilots or get really into photography. We are definitely into gadgets.
Dr. Dawn Sparks (03:41):
So that was just kind of a natural thing of learning all of the physics and the mechanics and stuff like that related to the space shuttle, even at that young age. So I was laying in bed pre pandemic and I thought, huh, I wonder what it takes to be an astronaut. And I Googled now that that’s really a verb in the dictionary. Now I Googled and said what does it take to apply to be an astronaut? And up popped first hit was like USA jobs.gov. And I clicked on it and I started reading the qualifications. I’m apparently being a doctor who is willing to learn a different language and scuba dives and has all these other like prerequisites is the ability to apply to be an astronaut was there. So I just decided, well, I might as well try it. I mean, my daughter’s grown. I’ve kind of done all kinds of different things and had different jobs than medicine. And I thought, well, he missed a thousand percent of the chances you don’t take. So I’m going to throw my hat in the ring. And as you know, it was like pretty much two weeks later, the entire world shut down which was like, well, you know, this could be like my whole quarantine getting me ready to be in the space station, being alone, you know,
Dr. Dawn Sparks (05:10):
It’s kind of seemed natural. So
Justin (05:12):
What is the process like from here?
Dr. Dawn Sparks (05:16):
So there was a couple of different processes of, of online applications and then an online psychiatric evaluation, which I passed. So, so now I believe the next step would be an in-person interview and Houston, and we’re just been waiting for there to be safe, the, and vaccinations and all that other stuff. So, you know, I’ve gotten a few emails that they’re, you know, they’re sorry about the delay. The astronaut program was supposed to begin in July of 2021. And now they’re thinking more like sometime in 2022, which was the most recent email I received. So it’s just kind of been delayed.
Justin (05:59):
Do you have a favorite space movie?
Dr. Dawn Sparks (06:02):
Well I love the movie space camp. Like I used to say that all the time sitting in my backyard, looking up at the sky at the stars and I would say, I’m going up. I am,
Justin (06:13):
I’ll have to put that one on my list. My wife really interstellar is one of our favorite.
Dr. Dawn Sparks (06:18):
Oh, that’s really good. One to contacts, another pretty full ones. Yeah, there’s a lot of good movies.
Justin (06:24):
So tell us what your current clinical practice looks like there in Hawaii.
Dr. Dawn Sparks (06:28):
So my current clinical pain practice I actually also just pivoted and started a lab as well. So I have both the pain practice in the lab here in Hawaii, and that was more of just keeping our bubble safe. We’ve really had low numbers of coronavirus here in Hawaii. And so I wanted there to be testing and access to testing and the County and the tourism department had decided that they wanted to allow there to be an incentive for tourists who would come here with a negative test, even if they were vaccinated to be able to get another test three days after arrival in order to further their negative status and get an incentive card for discounts all over the place for clothes and, you know tourist activities and eating out and doing things like that. So I actually have that in my office as well for patients that want to get the COVID testing.
Dr. Dawn Sparks (07:25):
And my pain practice is pretty much like a lot of people’s pain practices. I see patients in the office, new patients, followups, med refills, things of that nature. And then of course I do interventional pain management is the forte, and I’m getting more and more excited about all the different opportunities we have because pain is pretty much a new field still. I mean, since 1990, 1991 we kind of became our own little niche and have been furthering ourselves with the amount of things that we can do. And I think that’s super exciting. I think it’s an exciting time to be a pain doctor and the ability to learn how to do minimally invasive lumbar decompressions, or really advanced spinal cord stimulation. So neuromodulation is super duper exciting to me and how, how that, who knows that may fit in with like, you know, the Elan Musk Neurolink program, or it might fit in with space X, I mean, AI, like who knows where this could end up. I think it’s really exciting.
Justin (08:33):
Yeah, absolutely. Elon Musk, gosh, she’s doing so many interesting things. So you might have a better chance of being a private astronaut as a space X employee than a NASA one who knows
Dr. Dawn Sparks (08:44):
Either way. I mean, Elan and I already share a birthday, so I’m go June 28th. And who knows? I mean, I, I’m not opposed to getting up to space and anyway, Richard Branson, I mean, you know, whatever
Justin (08:59):
That’s right. That’s right. Jeff bees. I mean, there’s a lot of options now. I feel like if, you know, there’s probably most of the physicians listening to this podcast are here on the mainland with me. So take a minute and describe what kind of, you know, what’s unique about practicing in Hawaii or Kauai and are there like cultural differences or anything that makes like clinical differences or patient population payer mix? Like, how’s it different where you practice?
Dr. Dawn Sparks (09:27):
Well, definitely cultural differences and payer mix is different too. I think that overall Hawaii and Hawaii have way out here in the Pacific ocean. We didn’t have a lot of access to a lot of things of that nature. And so when I first moved here in 2015, I was working for someone else and then I subsequently start my own practice. And prior to that they weren’t doing any Nevro in Hawaii at all, or HF 10 high-frequency. And so I was hearing, and, and of course my mentor from way back at the Cleveland clinic, Leo capital had written a bunch of stuff and, and I’d been talking to him about it and like the data looked good and I really wanted, I was like, I want to try this Nevro. I want to try this high-frequency I want to give it a shot.
Dr. Dawn Sparks (10:20):
Especially for it’s it’s data to low back pain. And as you know, that’s the most frequent visit that a patient makes to any doctor. So I started looking at that information and why isn’t it in Hawaii? Why isn’t it here? Why haven’t we brought it here? And I really kind of just started networking at my local meetings and trying to figure out how to get it to Hawaii, Hawaii specifically. And I ended up subsequently doing the first trial and implant for a high-frequency system here. And that opened a lot of doors, I think because then people who had thought that opiates or physical therapy were their only option now knew of this new technology. And then the more I did, the more I saw how life-changing it could be for, for patients now, mind you, I was already using other companies that were here on Hawaii. So it just, it just gave another opportunity. Right. And the same thing as we start to see all these sacral spacers, or you know, others, lumbar middle decompression, you know, to be able to do that to the population, who’s never had it as an opportunity or an option is really fantastic because they’re super thankful and they’re super grateful to have their pain relieved.
Justin (11:51):
Sure. Are there, is there a difference in like physicians per capita or pain management docs per capita in a place like Hawaii? Just cause it’s a little more insulated.
Dr. Dawn Sparks (12:02):
Actually there’s quite a few pain management doctors on Oahu, which is the Island with the most population, which is where, how to Lulu is. I was the only pain physician here for quite a while until I left and opened my other practice. And now there’s two of us. And there’s some islands that don’t have like a designated pain physician. And a lot of the inner Island flights have pretty much opened back up and we’re getting back to being able to kind of move around more. But I do know from a private practice standpoint, that Hawaii is one of the States that has the highest percentage of, of physicians who are solo practice physicians or, you know, dual practice physicians. Why is that? I don’t know. I, I would think because it gives them autonomy. That makes sense to me. And, and where else, where else would you want autonomy except someplace where you could go surf or go fish or, you know,
Justin (13:11):
So you’re currently in private practice, it sounds like you were working with another physician a few years ago. Maybe give us like a 30,000 foot view of training and Cleveland clinic and then a couple of the, what bring us to present with regards to your career.
Dr. Dawn Sparks (13:26):
So I’ve like I’ve had a couple jobs, like a lot of physicians do, and I, it was interesting. I wish someone would have told me in the very beginning that like less than 7% of physicians stay at their first job because I’ve always been that kind of all in sort of person like implement, I do it, I’m going to go all in and do it. And so when I got my first job, which was like Ivy league, I went all in, bought the house, moved, the kids, moved the family, this is my retirement job. First job out of fellowship. I found it, you know, I was in all the way, but then it kind of became clear that like, as much as I loved teaching and I really, really did enjoy all of that. And I’m still in contact with a lot of my fellows that I taught over the years that I was there, which is really nice.
Dr. Dawn Sparks (14:14):
The academic political, like the true academic political scene was probably not my scene. And that’s okay. I mean, I’m okay with that. I learned a lot of great things there. I took baking classes at King Arthur flour, you know, I learned how to cross country ski. I mean, I had a lot of fun. But I feel like each little point is something you have to look into. Like, you can either let it make you better or you can let it make you better. And I am always like, make it better, like whatever the point is, whatever you’re going to do, allow take the good things were with that, leave the rest behind and go onto the next thing and become better because of it and all of the positions and places I’ve been, and the things I’ve done, I feel have led me to this point and made me who I am today made me better because of it not only a better physician, but like more compassionate and caring to other doctors as well.
Justin (15:19):
Totally. I love that idea. Better. Not bitter. It’s amazing. The difference of Al Minx. Yeah. Where did you pick that up?
Dr. Dawn Sparks (15:31):
I just, I just thought of it one day that, that, that I just, I just woke up one day and I decided that that’s how I needed to be for like the rest of my life.
Justin (15:40):
Yeah. Yeah. So after that experience in academia, where did you go then?
Dr. Dawn Sparks (15:45):
Actually, I thought I was just going to do a locums job and the us Virgin islands and a weekend or two weeks into being there, which was supposed to be a month stint covering for somebody for vacation. And that was a government hospital. And I was mostly just doing anesthesia and this guy was acting weird, like super weird while I was giving him a break and he was like tying a scrub pants and he kept walking back in and out of the room and I was like, so take a break. Like, I’m good. I got it. He’s like, did I tell you? And I was like, he told me, go take a break. And then he came back in about five minutes later. He’s like, do you know my locker combination? I was like, no, I do not know your locker combination. And I was like, are you okay?
Dr. Dawn Sparks (16:32):
Do you, do you need some help? Do you want me to get help for you? And I’m good. I’m good. So after he came back from his lunch, I was kind of like, do I leave him here? Like what’s going on? I knew something was happening and he was older, but I don’t know how much older, but like definitely older. And as you can imagine, I’m, you know, 32, maybe at this point 33 and I walked the next, Oh, our room after I left him there. And I said I don’t know if it’s his heart or his head, but something’s wrong with ed and the senior guy who I’m still friends with to this day went over and to kind of assess the situation. And they immediately took them actually out of the room and took him down and went to the ER and he got a head scan and huge glioblastoma multiforme and he was dead four months later. So that night they were like, would you like to stay here?
Dr. Dawn Sparks (17:32):
And I had a lot of choices to make. And I thought, well, here we go. So I stayed. And that was kind of that part of that journey. I started my first medical business. I started in Croix, which was so much red tape. Everything has to have a rubber stamp. You know, you have to go through all these like things because it’s more complicated because it’s on an Island, but it’s also more complicated because it’s like considered out of the country, even though it’s one of our territories, there’s so many different things. So I did a little bit of office-based anesthesia and pain management. It’s like an independent kind of contractor for the business that I created there. And that kind of gave me the taste or the entrepreneurial spirit that I know I have hidden in me. I mean, I started a video store when I was like 19. So I’ve, you know, the VHS kind where you like had to go get the little plastic thing with like the Ms dos computer, where you had to like on the blue screen type in which number it was to calculate the late fees and everything. It was pretty, it was pretty special.
Justin (18:50):
Okay. So you’re an entrepreneur in the Virgin islands as a 30 something physician after having a, it’s gotta be like a, I mean, that being on the job for a week, having an experience like that with one of your colleagues that must have been, I mean, I don’t know. What, how did you process that?
Dr. Dawn Sparks (19:07):
I think it was super sad for him. Of course, I had all of the empathy, compassion and grief around the fact that this was happening and happening quickly. But I think it just showed me like life’s short life is really short and you like, never know when your time is going to be up. And I think because I had kind of a near death experience when I was like 18, that I’ve always kind of had that in there, but medicine made me kind of like push that down just to put the blinders on and get through. But it’s there, like it’s, it’s omnipresent in my life. I can’t deny it.
Justin (19:52):
Well, I’ve got to ask what was the near death experience?
Dr. Dawn Sparks (19:56):
So I was driving to finals, I’d come home over the weekend and it was finals week and I was driving. I had been on the turnpike for like four miles and I had a dog in the car with me and it had doggy seatbelt on and it must’ve been barking or it wanted something because on the police report, which I later went back and read and I read the microfish and all of the medical records later, once I was further along in medicine I must’ve like grabbed the wheel as I reached for something and just being 18 and not cognizant of that kind of stuff. When you drive, I ramped 70 miles an hour up, one of those guardrails that go down into the ground, the car flipped, I was blown thrown from the car. I broke all the bones in the left side of my face, both my wrists, a lot of my fingers.
Dr. Dawn Sparks (20:50):
I was life-flighted to Metro where I was in a coma for four days. And yeah, so I know the patient perspective pretty well. And it’s like being a prisoner and and, and the people that take care of you and save your lives are awesome, but like, there’s, there’s this confining feeling. So I think from the very onset of, of my medical training, I always had that feeling of understanding, like what it feels like to be in an ICU to have a endotracheal tube taken out or a NG tube taken out, tastes kind of nasty, or, you know, just going through the process of feeling not heard and not listened to as an 18 year old, I decided when I was on the head trauma rehabilitation floor, that I was going to sign myself out AMA because I didn’t like my roommate who was clearly brain damaged and like wedding and, you know smelling during the night from her, you know, not under her control, but at the time as an 18 year old, I was like, this is ridiculous.
Dr. Dawn Sparks (22:04):
I just have casts on my hands. I want outta here. I’m not staying here. I’m signing myself out AMA. So I had like the whole conglomerate of the group that was like rounding on me. And I met with them at this big long table. And I just remember telling him, I’m leaving, I’m leaving tomorrow. Like, you do not have a choice I’m out of here. And because what they knew, they knew that that meant like all my insurances wouldn’t pay and like all this other stuff, because of course, as an 18 year old, I just wanted out, they talked me into staying through the weekend until Monday so that they could discharge me appropriately.
Dr. Dawn Sparks (22:44):
So I was discharged on April fool’s day, and this is 1995. And I went home in, within 24 hours of being home. I was internally suffocating and I had developed tracheal stenosis and Malaysia, and it had been undiagnosed while I was in the hospital. Although my mom did tell several doctors that it sounded like my voice was changing and that she felt like I was whistling when I talked, but they would always listen to my lungs. So clearly it was up here. And lo and behold, I ended up having to be flown to mass general hospital and had a tracheal resection and my chin sewn into my chest for 10 days. And Dr. Mattison was kind enough to save my life in that fashion. So I’ve got many lifesavers out there. Yeah.

Speaker 4 (23:39):
Was that the time that you decided you wanted to be a physician or was it before then?
Dr. Dawn Sparks (23:42):
I wanted to be a doctor since I was like four. So each little thing along my path, I think just kind of further cemented that.
Justin (23:52):
Yeah. A word that I’ve heard, you mentioned a lot is empathy. And it’s clear from your experiences that you have some, you have a bank from which to draw and to empathize with patients in pain and experiencing other medical situations. So how has your, how would you say your clinical practice or just your mindset is distinct or has been informed by some of these things you’ve been through?
Dr. Dawn Sparks (24:22):
I think I just really try to listen and hear what the patients are saying and, and what they need and what they want. So trying to get the same game plan with them. What are their goals? Make sure their goals are realistic. I, I’m fortunate enough here in Hawaii that the guy down the hall is an acupuncturist and he’s called pain-free quiet so I can tell my patients, listen, here’s the goals. We’re going to try to reduce your pain by 50%. We’re going to do whatever we can do on the quality of life to be better. And there’s ultimately, there’s some people that will say, but I want you to take care of all my pain. I want to be pain-free. And I say, I’m sorry, the pain-free clinics down the hall. So this is about restoring function. This is about treating the source of your pain, because I think a lot of people there just have so much gratitude about having someone who wants to find the source of their pain. Cause everybody else up until this point has just wanted to cover it up.
Justin (25:25):
Yeah. I had a, I D I distinctly remember I had a back issue that I’ve actually talked about before on the show. I had a slightly compressed disc. And I went to my primary care doc. He was busy all day, couldn’t get into, but there was like one slot for one of the other physicians in the practice. And I distinctly remember sitting down and having a conversation with this physician whom I had never met. And she was just so like intentional. And like, I would say like, Oh, my back hurts, yada, yada. She’s like, no, wait, like, stop back up, explain like this what happened when did? And I just felt through the thoroughness and through her, it was, it was I think empathy and her D her diligence. And then she explained the whole, like, you’re gonna need to get MRI. You’re going to need to get an x-ray first.
Justin (26:08):
Even though we both know you need the MRI, like it’s how they do it. Like, this is what, and I just remember coming away from that thinking like, wow, that’s I was, you know, for a physician who might have never met to experience in that moment. For me, it was a very, it was a time of real vulnerability. And I was about to be leaving the state for like a month. We were flying out West to visit my wife’s family. It was right after my son was born. She was on maternity leave and all these factors made it like time crunch. I gotta like get an MRI the next two days. And I got to get the prior auth first. And it was, it was a mess. And they, she really was an advocate for me, a stranger in a way that I still like really remember and appreciate. So
Dr. Dawn Sparks (26:49):
That’s awesome. That’s amazing. Yeah.
Justin (26:52):
And out there, like Dr. Bell from a Radnor family practice, she probably has no reason to listen to this podcast, but I might send it to her and say you,
Dr. Dawn Sparks (27:01):
Yeah, that’s great. Well, shout out to Dr. Bell for helping you out. Right. And I think that that’s pretty much what we do. As payment physicians is we are a patient advocates. We coordinate a lot of care between other physicians. We try to help them along the kind of crazy pathways that they have to deal with with just insurance programming and on getting the prior auths and like helping them navigate it because it’s not really clear to a lot of people. And I mean, as a, as a solo practitioner, having people come in and be angry about their copays or angry about what they’re, I’m like, I am not, I didn’t take your insurance plan. Like, I don’t know what to tell you, you know what I mean? But instead of like talking to them in that way, I explained to him like, listen, I can’t possibly remember that HMS has like 80 different plans and which each plan does.
Dr. Dawn Sparks (27:56):
Like, that’s really kind of where your, you have to take some accountability, that to look at your plan and try to understand what they’re willing to reimburse. And if they’re willing to reimburse more, we’ll we’ll work with them. No problem. But a lot of that stuff gets really complicated. And I think the older, the patients are having to go online and having to do all of that. I mean, it’s really hard to convert the telemedicine during the close down because so many people here you know, if they live in [inaudible] and they don’t have good internet service and they’re like, I’m just going to drive on my car and talk to you on FaceTime. I’m like, don’t, don’t call me on FaceTime while you’re driving stops. So, I mean, it was really interesting converting to telemedicine over here.
Justin (28:43):
Yeah. what was your ex, so at what point did you leave the Virgin islands? How long were you there?
Dr. Dawn Sparks (28:50):
Two years. Yeah.
Justin (28:54):
I also, there’s one experience that you mentioned earlier on the, the travel and the bucket list. And I think this was during residency. Can you talk a little bit about how you became like a world traveler? Kind of,
Dr. Dawn Sparks (29:08):
Okay, so I’m going to just like throw it out there. Like Dr. Christiane, Oakland Teenie, like told me, like I needed to travel. Like you, he came to the Cleveland clinic from Italy and like joined the liver transplant team as a fellow, I believe maybe he went to Miami first and then came to the Cleveland clinic, but there was like something like, he just left Italy to be like a liver transplant fellow and restart his life in a new country and all this other stuff. So just having worked with him throughout residency, he couldn’t believe that I had never been to Europe and I got a journal, a Smithsonian journal, and it was like the 28 places to see before you die, which seemed way more doable than like 1,001 or whatever that book’s called. So I was looking through the 28 and I only been to one and I was like, Oh no.
Dr. Dawn Sparks (30:01):
And this was like 2008. So I’m like a CA three. I’m like at the end of the residency. And one of the 20 places what’s falling water, which is in Pennsylvania. So of course I was at Cleveland area, not far from there. I was like, that’s it, we’re going this weekend. I have a golden weekend. We’re packing up the family. We’re going to Fallingwater I got to start knocking off these 28. And and then I planned a trip with the family and we went to like five countries in Europe and did like a European family cruise. It was a little bit like European family vacation, but when you take three teenagers to Europe, all that stuff can happen. So no, but like it did it definitely once I got out and saw more cultures got around to seeing different countries and stuff.
Dr. Dawn Sparks (30:46):
I mean, it really does open your worldview so much so that after visiting like 38 countries, now I would consider myself more of a citizen of the world than anything else, because I’m, I’m very compassionate to the cultural differences and the things that go on in different countries that we’re quite blessed in the United States of America to have all of the things we have at our disposal and, and often probably taken for granted. So maybe it was in me and Mara when the little kid was running behind me with like different countries, dollar bills and like a monsoon. And like I had read something before I went there that they really like it if you give them like us dollars. So I gave them like a couple, $1 bills and he was like super excited. So it’s just, it’s like a whole different feel when you’re exposed to many different cultures and, and like the things that they went through, the perseverance for these different subsets around the world, because they’ve had to have a lot of perseverance and kind of stamina to do the things that they’ve done.
Justin (31:55):
Yeah. Perseverance is another word. I know that you have mentioned a few times and you know, through that crazy experience when you almost died too, you know, making it through training with kids, like during med school and then getting through residency and fellowship and just the demands of a physician career. And I know you mentioned when we spoke recently, just a couple of times in your, like, you know, you’re in the, or, and you’re just like so frustrated or whatever, and you’re talking to one of your mentors about just trying to like, please talk me into still being a doctor, because I’m about to lose it kind of thing. Tell me about what it means to you to like, have that grit or the perseverance or the, the idea that you’re going to see something through. How has that played out for you?
Dr. Dawn Sparks (32:37):
I think there’s been a lot of naysayers as well, too. Like kind of like fueled some of my fire. Like, Oh, you can’t do that. Like, there was some physician when I was in clinicals in med school. I remember her saying something to the effect of your, you should be barefoot and pregnant in a trailer park. And I was like, I can’t believe, first of all, I couldn’t believe she just said that to me. I was already in medical school and I was just kind of like floored. Right. And I think I thought to myself, no, that’s not my, that’s not my path, like, but good for you for thinking that way. And everybody’s entitled to their opinion, but it doesn’t mean I have to go along with her opinion.
Justin (33:23):
Did that motivate you? Oh yeah. I would be so amped if somebody said something like that, to me.
Dr. Dawn Sparks (33:29):
Yeah. Like currently the child status is one and done. But I’ve had step-kids, but yeah, I only have the one biological daughter and never lived in a trailer park, so, and I’m not always barefoot in Hawaii. I wear slippers, you know, the let’s flip flops, whatever.
Justin (33:55):
Tell us a little bit about, to extent that you’re comfortable talking about it, cause I’m sure it’s a small Island you know, the prior experience you had. I know there’s a lot of physicians who are trying to find a clinical opportunity where perhaps there’s a partnership opportunity, a place where they can express their own, you know, clinical and personal selves in the way they care for patients and the way that they build out their professional lives. And I’m sure that that’s what you are looking to do and expecting when you joined the last practice and at some point you decided it was better to move on. So can you tell us a little bit about that?
Dr. Dawn Sparks (34:27):
Yeah, for sure. I I really do think that like the big motivator, not just being told that I couldn’t start a practice and then like having to do it, but like the motivator was more about transparency honesty, clarity, and showing that physicians that you can do this, you can have a life that you’ve always dreamed of and you can have success that may not to some physicians be like the super duper high and a flute, monetary success that you really thought you should have, perhaps I don’t know, but like success can be defined by everybody in a different way. And and having a successful pain practice and having the freedom and the autonomy to make your schedule to run the practice the way you want to and have, you know, of course you have all of the compliance and stuff that you have to follow, but in general, you’re given a lot of freedom to make those decisions.
Dr. Dawn Sparks (35:35):
And, you know, if you’ve read rich dad, poor dad, he says, you pay twice. Once is for security. And the second time is for freedom. So if I paid twice, once was med school and residency to be at the physician for security. And then the second part was for the freedom with being an entrepreneur. And most of all of my friends who have now ventured out into having their own practices as well, I be like, kind of speak the same story. Is it that they don’t think that they could manage having to work for somebody again, because now they’ve gotten so used to being able to design things the way that they want to do them, what works best for them, how, how they can kind of just make medicine better. And so for me, starting to practice my vision, I guess, was that not only to make medicine better, but like show people that they can do it and they can have that clarity and not have to feel like they’re going to somehow be duped or not given the reality of the situation. And really kind of be excited about being entrepreneurial and, and that this becomes like their baby to now, whether that means like a partnership or, you know bringing other people in to show them that they can do it. I’m not sure exactly what that means right now, but that was my vision.
Justin (37:02):
Awesome. Are there, have there been people for you and I’m sure there have anyone who has, you know, maybe the opposite effect, if that other physician, you just mentioned people who have empowered, you lifted you up and equipped you to say like, yes, I can, even though I don’t even know the way to get there from here, I have what it takes to be able to be an independent pain practitioner one day.
Dr. Dawn Sparks (37:22):
Yeah. I, and I do think that there’s a lot of people that have inspired that and, and kind of helps me to remember who I am if you will. And so one of my greatest, like we were talking about earlier, I think mentorship versus sponsorship. And so like mentorship is somebody who helps you along. And then sponsorship is like somebody who can actually help you get somewhere that you might not have otherwise been able to get to. And so this person throughout 18 years may have changed from being like more of a mentor to a sponsor, whatever, but he’s always been in my corner, have my back rooting for me. And so just a shout out to Dr. Mark Popovich, who I met at the Cleveland clinic when he was the head of the ICU, and now is the chair at university hospitals in Cleveland, Ohio. So he has always kind of like said, you can do it, you can do it. And even if as long was no, I God.
Justin (38:21):
Hm.
Dr. Dawn Sparks (38:23):
You know? Yes, you can. Oh, that sounds good.
Justin (38:27):
It’s so critical. And being surrounded by that right person, I’ve experienced that so many times. And it’s invaluable. And being, being surrounded by people like that or putting yourself in the way of people like that, it’s so important. And then it’s also really fun to have the opportunity to, you know, be that person for others as you gain experience and can open doors.
Dr. Dawn Sparks (38:52):
That’s like part of like the growing up in medicine, or like a lot of people say like, Oh, you’re married to medicine. Well, I mean, if that’s how you want to look at it, maybe, but I think it also gives you the opportunity to learn how others, you know, manifest what they want and, and, and also support them like where it can now be like a joint venture where it’s like, Oh, you’ve been supporting me, but let me support you because of this, you’ve got this, like, you know, keep doing what you’re doing. And other people just kind of like coming along into your path and saying, you know, you should really be a pain doctor. And you’re like, really? Yeah, you should apply. And you know, that’s kind of how Dr. Nagy McKayla was when I was rotating through the pain department.
Dr. Dawn Sparks (39:39):
And I wasn’t really sure, I knew I wanted to do a fellowship, but I was kind of thinking, I see you. So those guys were really smart. And I thought, you know, I should probably learned more about electrolytes and like, stuff like that. It seemed like it would be a valuable year, you know? And then he just kind of approached me and said, I should apply for pain that I had good surgical hands and I, you know, I was good at procedures and it seemed like something that he thought I would do really well in. And that year was pretty competitive. So I remember just kind of thinking, nah, I don’t like competition. I don’t like rejection. I’m good. I, I already got this ICU spot. I’ll just stay over there where it’s comfy. And he was like, no, no, you should apply.
Dr. Dawn Sparks (40:24):
You should apply. And so I did. And the rest was kinda history from there, but I think that’s the beauty of pain management being such a new field and like having all these cool new things that we’re learning and we’re able to do. And we’re able to like really kind of like keep our wheelhouse open and, and do more. So like do a podcast with you or create another venture, or like, you know, maybe write a book or, you know, just the ability to be able to do other things. It’s part of that freedom and I’ve actually really enjoyed it. Awesome.
Justin (41:07):
Yeah. I want to wrap it up here and I thank you for your time today, Dr. Sparks you are somebody who’s, you know, not only very professionally accomplished, but you’ve had these experiences that have left a significant impact. And I think have changed the way that you see the world in the way that you treat patients. So in closing, I’d love to just have you reflect on a time of professional actualization where the, and the grit and the empathy and the seeing, perhaps it could have been worth a patient, or it could have been something else that you’ve been working towards for a long time, a moment where you said, you know what, like thanks to the haters. Like in this moment I did it I’ve achieved the goal I’ve, I’ve reached that success that I was striving for. And you were able to enjoy that. Can you think of anything like that?
Dr. Dawn Sparks (41:57):
I think that there’s been a ton of those experiences sprinkled, like throughout all of my training. And I think I was just talking to someone in relation to like, do you miss anesthesia? I’m like, sometimes like, yeah, I kinda missed doing anesthesia. So one of the things was being in like a big liver transplant, like having all these things going on and the, like the attending calling as he’s like walking out, you know, at the hospital, I would assume, you know, like the cases over we’re taking him to the ICU, he’s like, you did a great job, blah, blah, blah. And so it was one of those moments, I think in residency, like, Oh, I can do this. Like, I’m doing this, this is me. And when you’re about to finish residency and you have kind of that imposter syndrome and you’re like, ah, I don’t know, like that’s, that was really cool.
Dr. Dawn Sparks (42:48):
And there’s a lot of things like that. Like walking across the stage when graduating med school and hearing them call you doctor for the first time, you know, even though you had been working hard to get there, that was pretty cool. You know, in residency for our residency slideshow, I made a really cool like slide show to music, which they played during the graduation at residency was, let’s just kind of reminiscent of all of the things we’d all been through together. And how kind of like tight knit, your band of brothers kind of becomes when you’re going through residency. So all these people along the way, you know, have sprinkled all of these things. The first time I opened my practice here, just like thinking like I’m doing it, like it’s happening. Like, I don’t know how it really happened, but like, I’ve got like this EHR and I’ve got like employees and I got this like, you know, logo on the wall and, you know, people are showing up, so,
Justin (43:48):
Oh, that’s that’s amazing. And it’s been really fun. Dr. Sparks hearing your story. Thank you for joining us today on APM success.
Dr. Dawn Sparks (43:55):
Thanks so much. I really appreciate it. Just some have a great day. Aloha.
Justin (44:01):
If you liked what you heard this week, head on over to APM success.com, where you can find more content and free resources to help you build a successful career in anesthesia and pain management. If you wanted to leave a review in iTunes, that also really appreciate it. Thanks for using some of your valuable time to join me today on APM success.

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Episode 96: Autonomy via Locums & Independent Pain Practice In Hawaii w. Dr. Dawn Sparks

This Episode

Interview w/ Dr. Dawn Sparks

You Will Learn

– Dr. Sparks’ independent pain practice in Hawaii
– Why she decided to apply to NASA to be an astronaut
– Dr. Sparks realization that an ivy-league academic center was not where she wanted to spend her career
– How Dr. Sparks used locums to travel and work part time in between roles, and
– How a terrible car accident, and the resultant medical care, shaped the way Dr. Sparks approaches empathetic patient care.

Resources & Links

This week, I’m talking with Dr. Dawn sparks. Dr. Sparks runs a pain practice on the Island of Hawaii, where she’s one of only two pain physicians on the whole Island. She shares her career journey, which encompasses a brief stint in academics doing some locums work and other medical entrepreneurship before finally launching her own practice a few years ago, she also shares a story of a really bad car accident she had when she was a teenager and how that experience that she had as a patient undergoing and recovering from that treatment continues to this day to shape her deeply held conviction around empathetic care.

Justin (00:25):
This week, I’m talking with Dr. Dawn sparks, Dr. Sparks runs a pain practice on the Island of Hawaii, where she’s one of only two pain physicians on the whole Island. She shares her career journey, which encompasses a brief stint in academics doing some locums work and other medical entrepreneurship before finally launching her own practice a few years ago, she also shares a story of a really bad car accident she had when she was a teenager and how that experience that she had as a patient undergoing and recovering from that treatment continues to this day to shape her deeply held conviction around empathetic care as always. Thanks for tuning in this week. Hello, and welcome to episode 96 of APM success. I’m very pleased to be joined today by a special guest. Dr. Dawn sparks. Dr. Sparks is an anesthesia trained interventional pain physician out in Hawaii. So it’s 3:00 PM here on the East coast then I guess she’s probably drinking her morning coffee, Dr. Sparks. Thanks for joining us today. Hey, there it is.
Dr. Dawn Sparks (01:26):
Hi, how’s it doing? How are you? Thanks for having me on,
Justin (01:28):
Yeah, I’m I’m so pleased to be speaking with you. There’s a lot of interesting stuff I want to cover. And when we spoke the other day in preparation for this conversation, a lot of little nuggets popped up a lot of good things to discuss. And the one that really peaked my interest was talking about NASA eligibility for you. So tell me, tell me a little bit about that.
Dr. Dawn Sparks (01:52):
So this was like pre pandemic actually before the world had actually shut down, but I guess there was things going on that we were hearing about Corona virus and that there was this stuff going on and, you know, Italy and China and so on and so forth. So it was definitely started, but it was like the beginning of March and I just was kind of pondering, like I wonder I’ve wanted to be a doctor since I was four. So I wonder what else would I do if I wasn’t a doctor and what was the thing that I wanted as a child? And so it kind of took me back to, I went to space camp as a young adult and and my parents said that that was too expensive. I couldn’t go. And I used my artistic skills and entered a local art project of drawing the downtown square that had been recently redone.
Dr. Dawn Sparks (02:46):
And I won $350, which got sweat back at 1989. That was enough to go to space camp and, and so, so on what my space expedition of studying for exam and on the plane all the way to Huntsville, Alabama, and then the night before taking the test. So I tested high enough to become the commander of the discovery mission back then. And so I think that was just kind of my part with NASA and wanting to go to outer space and wanting to do something else. And so I always wanted to be a doctor, but like the other thing I was interested in was definitely space exploration and the whole entire space shuttle program and everything about it. And like much like a lot of anesthesiologists who learned how to become pilots or get really into photography. We are definitely into gadgets.
Dr. Dawn Sparks (03:41):
So that was just kind of a natural thing of learning all of the physics and the mechanics and stuff like that related to the space shuttle, even at that young age. So I was laying in bed pre pandemic and I thought, huh, I wonder what it takes to be an astronaut. And I Googled now that that’s really a verb in the dictionary. Now I Googled and said what does it take to apply to be an astronaut? And up popped first hit was like USA jobs.gov. And I clicked on it and I started reading the qualifications. I’m apparently being a doctor who is willing to learn a different language and scuba dives and has all these other like prerequisites is the ability to apply to be an astronaut was there. So I just decided, well, I might as well try it. I mean, my daughter’s grown. I’ve kind of done all kinds of different things and had different jobs than medicine. And I thought, well, he missed a thousand percent of the chances you don’t take. So I’m going to throw my hat in the ring. And as you know, it was like pretty much two weeks later, the entire world shut down which was like, well, you know, this could be like my whole quarantine getting me ready to be in the space station, being alone, you know,
Dr. Dawn Sparks (05:10):
It’s kind of seemed natural. So
Justin (05:12):
What is the process like from here?
Dr. Dawn Sparks (05:16):
So there was a couple of different processes of, of online applications and then an online psychiatric evaluation, which I passed. So, so now I believe the next step would be an in-person interview and Houston, and we’re just been waiting for there to be safe, the, and vaccinations and all that other stuff. So, you know, I’ve gotten a few emails that they’re, you know, they’re sorry about the delay. The astronaut program was supposed to begin in July of 2021. And now they’re thinking more like sometime in 2022, which was the most recent email I received. So it’s just kind of been delayed.
Justin (05:59):
Do you have a favorite space movie?
Dr. Dawn Sparks (06:02):
Well I love the movie space camp. Like I used to say that all the time sitting in my backyard, looking up at the sky at the stars and I would say, I’m going up. I am,
Justin (06:13):
I’ll have to put that one on my list. My wife really interstellar is one of our favorite.
Dr. Dawn Sparks (06:18):
Oh, that’s really good. One to contacts, another pretty full ones. Yeah, there’s a lot of good movies.
Justin (06:24):
So tell us what your current clinical practice looks like there in Hawaii.
Dr. Dawn Sparks (06:28):
So my current clinical pain practice I actually also just pivoted and started a lab as well. So I have both the pain practice in the lab here in Hawaii, and that was more of just keeping our bubble safe. We’ve really had low numbers of coronavirus here in Hawaii. And so I wanted there to be testing and access to testing and the County and the tourism department had decided that they wanted to allow there to be an incentive for tourists who would come here with a negative test, even if they were vaccinated to be able to get another test three days after arrival in order to further their negative status and get an incentive card for discounts all over the place for clothes and, you know tourist activities and eating out and doing things like that. So I actually have that in my office as well for patients that want to get the COVID testing.
Dr. Dawn Sparks (07:25):
And my pain practice is pretty much like a lot of people’s pain practices. I see patients in the office, new patients, followups, med refills, things of that nature. And then of course I do interventional pain management is the forte, and I’m getting more and more excited about all the different opportunities we have because pain is pretty much a new field still. I mean, since 1990, 1991 we kind of became our own little niche and have been furthering ourselves with the amount of things that we can do. And I think that’s super exciting. I think it’s an exciting time to be a pain doctor and the ability to learn how to do minimally invasive lumbar decompressions, or really advanced spinal cord stimulation. So neuromodulation is super duper exciting to me and how, how that, who knows that may fit in with like, you know, the Elan Musk Neurolink program, or it might fit in with space X, I mean, AI, like who knows where this could end up. I think it’s really exciting.
Justin (08:33):
Yeah, absolutely. Elon Musk, gosh, she’s doing so many interesting things. So you might have a better chance of being a private astronaut as a space X employee than a NASA one who knows
Dr. Dawn Sparks (08:44):
Either way. I mean, Elan and I already share a birthday, so I’m go June 28th. And who knows? I mean, I, I’m not opposed to getting up to space and anyway, Richard Branson, I mean, you know, whatever
Justin (08:59):
That’s right. That’s right. Jeff bees. I mean, there’s a lot of options now. I feel like if, you know, there’s probably most of the physicians listening to this podcast are here on the mainland with me. So take a minute and describe what kind of, you know, what’s unique about practicing in Hawaii or Kauai and are there like cultural differences or anything that makes like clinical differences or patient population payer mix? Like, how’s it different where you practice?
Dr. Dawn Sparks (09:27):
Well, definitely cultural differences and payer mix is different too. I think that overall Hawaii and Hawaii have way out here in the Pacific ocean. We didn’t have a lot of access to a lot of things of that nature. And so when I first moved here in 2015, I was working for someone else and then I subsequently start my own practice. And prior to that they weren’t doing any Nevro in Hawaii at all, or HF 10 high-frequency. And so I was hearing, and, and of course my mentor from way back at the Cleveland clinic, Leo capital had written a bunch of stuff and, and I’d been talking to him about it and like the data looked good and I really wanted, I was like, I want to try this Nevro. I want to try this high-frequency I want to give it a shot.
Dr. Dawn Sparks (10:20):
Especially for it’s it’s data to low back pain. And as you know, that’s the most frequent visit that a patient makes to any doctor. So I started looking at that information and why isn’t it in Hawaii? Why isn’t it here? Why haven’t we brought it here? And I really kind of just started networking at my local meetings and trying to figure out how to get it to Hawaii, Hawaii specifically. And I ended up subsequently doing the first trial and implant for a high-frequency system here. And that opened a lot of doors, I think because then people who had thought that opiates or physical therapy were their only option now knew of this new technology. And then the more I did, the more I saw how life-changing it could be for, for patients now, mind you, I was already using other companies that were here on Hawaii. So it just, it just gave another opportunity. Right. And the same thing as we start to see all these sacral spacers, or you know, others, lumbar middle decompression, you know, to be able to do that to the population, who’s never had it as an opportunity or an option is really fantastic because they’re super thankful and they’re super grateful to have their pain relieved.
Justin (11:51):
Sure. Are there, is there a difference in like physicians per capita or pain management docs per capita in a place like Hawaii? Just cause it’s a little more insulated.
Dr. Dawn Sparks (12:02):
Actually there’s quite a few pain management doctors on Oahu, which is the Island with the most population, which is where, how to Lulu is. I was the only pain physician here for quite a while until I left and opened my other practice. And now there’s two of us. And there’s some islands that don’t have like a designated pain physician. And a lot of the inner Island flights have pretty much opened back up and we’re getting back to being able to kind of move around more. But I do know from a private practice standpoint, that Hawaii is one of the States that has the highest percentage of, of physicians who are solo practice physicians or, you know, dual practice physicians. Why is that? I don’t know. I, I would think because it gives them autonomy. That makes sense to me. And, and where else, where else would you want autonomy except someplace where you could go surf or go fish or, you know,
Justin (13:11):
So you’re currently in private practice, it sounds like you were working with another physician a few years ago. Maybe give us like a 30,000 foot view of training and Cleveland clinic and then a couple of the, what bring us to present with regards to your career.
Dr. Dawn Sparks (13:26):
So I’ve like I’ve had a couple jobs, like a lot of physicians do, and I, it was interesting. I wish someone would have told me in the very beginning that like less than 7% of physicians stay at their first job because I’ve always been that kind of all in sort of person like implement, I do it, I’m going to go all in and do it. And so when I got my first job, which was like Ivy league, I went all in, bought the house, moved, the kids, moved the family, this is my retirement job. First job out of fellowship. I found it, you know, I was in all the way, but then it kind of became clear that like, as much as I loved teaching and I really, really did enjoy all of that. And I’m still in contact with a lot of my fellows that I taught over the years that I was there, which is really nice.
Dr. Dawn Sparks (14:14):
The academic political, like the true academic political scene was probably not my scene. And that’s okay. I mean, I’m okay with that. I learned a lot of great things there. I took baking classes at King Arthur flour, you know, I learned how to cross country ski. I mean, I had a lot of fun. But I feel like each little point is something you have to look into. Like, you can either let it make you better or you can let it make you better. And I am always like, make it better, like whatever the point is, whatever you’re going to do, allow take the good things were with that, leave the rest behind and go onto the next thing and become better because of it and all of the positions and places I’ve been, and the things I’ve done, I feel have led me to this point and made me who I am today made me better because of it not only a better physician, but like more compassionate and caring to other doctors as well.
Justin (15:19):
Totally. I love that idea. Better. Not bitter. It’s amazing. The difference of Al Minx. Yeah. Where did you pick that up?
Dr. Dawn Sparks (15:31):
I just, I just thought of it one day that, that, that I just, I just woke up one day and I decided that that’s how I needed to be for like the rest of my life.
Justin (15:40):
Yeah. Yeah. So after that experience in academia, where did you go then?
Dr. Dawn Sparks (15:45):
Actually, I thought I was just going to do a locums job and the us Virgin islands and a weekend or two weeks into being there, which was supposed to be a month stint covering for somebody for vacation. And that was a government hospital. And I was mostly just doing anesthesia and this guy was acting weird, like super weird while I was giving him a break and he was like tying a scrub pants and he kept walking back in and out of the room and I was like, so take a break. Like, I’m good. I got it. He’s like, did I tell you? And I was like, he told me, go take a break. And then he came back in about five minutes later. He’s like, do you know my locker combination? I was like, no, I do not know your locker combination. And I was like, are you okay?
Dr. Dawn Sparks (16:32):
Do you, do you need some help? Do you want me to get help for you? And I’m good. I’m good. So after he came back from his lunch, I was kind of like, do I leave him here? Like what’s going on? I knew something was happening and he was older, but I don’t know how much older, but like definitely older. And as you can imagine, I’m, you know, 32, maybe at this point 33 and I walked the next, Oh, our room after I left him there. And I said I don’t know if it’s his heart or his head, but something’s wrong with ed and the senior guy who I’m still friends with to this day went over and to kind of assess the situation. And they immediately took them actually out of the room and took him down and went to the ER and he got a head scan and huge glioblastoma multiforme and he was dead four months later. So that night they were like, would you like to stay here?
Dr. Dawn Sparks (17:32):
And I had a lot of choices to make. And I thought, well, here we go. So I stayed. And that was kind of that part of that journey. I started my first medical business. I started in Croix, which was so much red tape. Everything has to have a rubber stamp. You know, you have to go through all these like things because it’s more complicated because it’s on an Island, but it’s also more complicated because it’s like considered out of the country, even though it’s one of our territories, there’s so many different things. So I did a little bit of office-based anesthesia and pain management. It’s like an independent kind of contractor for the business that I created there. And that kind of gave me the taste or the entrepreneurial spirit that I know I have hidden in me. I mean, I started a video store when I was like 19. So I’ve, you know, the VHS kind where you like had to go get the little plastic thing with like the Ms dos computer, where you had to like on the blue screen type in which number it was to calculate the late fees and everything. It was pretty, it was pretty special.
Justin (18:50):
Okay. So you’re an entrepreneur in the Virgin islands as a 30 something physician after having a, it’s gotta be like a, I mean, that being on the job for a week, having an experience like that with one of your colleagues that must have been, I mean, I don’t know. What, how did you process that?
Dr. Dawn Sparks (19:07):
I think it was super sad for him. Of course, I had all of the empathy, compassion and grief around the fact that this was happening and happening quickly. But I think it just showed me like life’s short life is really short and you like, never know when your time is going to be up. And I think because I had kind of a near death experience when I was like 18, that I’ve always kind of had that in there, but medicine made me kind of like push that down just to put the blinders on and get through. But it’s there, like it’s, it’s omnipresent in my life. I can’t deny it.
Justin (19:52):
Well, I’ve got to ask what was the near death experience?
Dr. Dawn Sparks (19:56):
So I was driving to finals, I’d come home over the weekend and it was finals week and I was driving. I had been on the turnpike for like four miles and I had a dog in the car with me and it had doggy seatbelt on and it must’ve been barking or it wanted something because on the police report, which I later went back and read and I read the microfish and all of the medical records later, once I was further along in medicine I must’ve like grabbed the wheel as I reached for something and just being 18 and not cognizant of that kind of stuff. When you drive, I ramped 70 miles an hour up, one of those guardrails that go down into the ground, the car flipped, I was blown thrown from the car. I broke all the bones in the left side of my face, both my wrists, a lot of my fingers.
Dr. Dawn Sparks (20:50):
I was life-flighted to Metro where I was in a coma for four days. And yeah, so I know the patient perspective pretty well. And it’s like being a prisoner and and, and the people that take care of you and save your lives are awesome, but like, there’s, there’s this confining feeling. So I think from the very onset of, of my medical training, I always had that feeling of understanding, like what it feels like to be in an ICU to have a endotracheal tube taken out or a NG tube taken out, tastes kind of nasty, or, you know, just going through the process of feeling not heard and not listened to as an 18 year old, I decided when I was on the head trauma rehabilitation floor, that I was going to sign myself out AMA because I didn’t like my roommate who was clearly brain damaged and like wedding and, you know smelling during the night from her, you know, not under her control, but at the time as an 18 year old, I was like, this is ridiculous.
Dr. Dawn Sparks (22:04):
I just have casts on my hands. I want outta here. I’m not staying here. I’m signing myself out AMA. So I had like the whole conglomerate of the group that was like rounding on me. And I met with them at this big long table. And I just remember telling him, I’m leaving, I’m leaving tomorrow. Like, you do not have a choice I’m out of here. And because what they knew, they knew that that meant like all my insurances wouldn’t pay and like all this other stuff, because of course, as an 18 year old, I just wanted out, they talked me into staying through the weekend until Monday so that they could discharge me appropriately.
Dr. Dawn Sparks (22:44):
So I was discharged on April fool’s day, and this is 1995. And I went home in, within 24 hours of being home. I was internally suffocating and I had developed tracheal stenosis and Malaysia, and it had been undiagnosed while I was in the hospital. Although my mom did tell several doctors that it sounded like my voice was changing and that she felt like I was whistling when I talked, but they would always listen to my lungs. So clearly it was up here. And lo and behold, I ended up having to be flown to mass general hospital and had a tracheal resection and my chin sewn into my chest for 10 days. And Dr. Mattison was kind enough to save my life in that fashion. So I’ve got many lifesavers out there. Yeah.

Speaker 4 (23:39):
Was that the time that you decided you wanted to be a physician or was it before then?
Dr. Dawn Sparks (23:42):
I wanted to be a doctor since I was like four. So each little thing along my path, I think just kind of further cemented that.
Justin (23:52):
Yeah. A word that I’ve heard, you mentioned a lot is empathy. And it’s clear from your experiences that you have some, you have a bank from which to draw and to empathize with patients in pain and experiencing other medical situations. So how has your, how would you say your clinical practice or just your mindset is distinct or has been informed by some of these things you’ve been through?
Dr. Dawn Sparks (24:22):
I think I just really try to listen and hear what the patients are saying and, and what they need and what they want. So trying to get the same game plan with them. What are their goals? Make sure their goals are realistic. I, I’m fortunate enough here in Hawaii that the guy down the hall is an acupuncturist and he’s called pain-free quiet so I can tell my patients, listen, here’s the goals. We’re going to try to reduce your pain by 50%. We’re going to do whatever we can do on the quality of life to be better. And there’s ultimately, there’s some people that will say, but I want you to take care of all my pain. I want to be pain-free. And I say, I’m sorry, the pain-free clinics down the hall. So this is about restoring function. This is about treating the source of your pain, because I think a lot of people there just have so much gratitude about having someone who wants to find the source of their pain. Cause everybody else up until this point has just wanted to cover it up.
Justin (25:25):
Yeah. I had a, I D I distinctly remember I had a back issue that I’ve actually talked about before on the show. I had a slightly compressed disc. And I went to my primary care doc. He was busy all day, couldn’t get into, but there was like one slot for one of the other physicians in the practice. And I distinctly remember sitting down and having a conversation with this physician whom I had never met. And she was just so like intentional. And like, I would say like, Oh, my back hurts, yada, yada. She’s like, no, wait, like, stop back up, explain like this what happened when did? And I just felt through the thoroughness and through her, it was, it was I think empathy and her D her diligence. And then she explained the whole, like, you’re gonna need to get MRI. You’re going to need to get an x-ray first.
Justin (26:08):
Even though we both know you need the MRI, like it’s how they do it. Like, this is what, and I just remember coming away from that thinking like, wow, that’s I was, you know, for a physician who might have never met to experience in that moment. For me, it was a very, it was a time of real vulnerability. And I was about to be leaving the state for like a month. We were flying out West to visit my wife’s family. It was right after my son was born. She was on maternity leave and all these factors made it like time crunch. I gotta like get an MRI the next two days. And I got to get the prior auth first. And it was, it was a mess. And they, she really was an advocate for me, a stranger in a way that I still like really remember and appreciate. So
Dr. Dawn Sparks (26:49):
That’s awesome. That’s amazing. Yeah.
Justin (26:52):
And out there, like Dr. Bell from a Radnor family practice, she probably has no reason to listen to this podcast, but I might send it to her and say you,
Dr. Dawn Sparks (27:01):
Yeah, that’s great. Well, shout out to Dr. Bell for helping you out. Right. And I think that that’s pretty much what we do. As payment physicians is we are a patient advocates. We coordinate a lot of care between other physicians. We try to help them along the kind of crazy pathways that they have to deal with with just insurance programming and on getting the prior auths and like helping them navigate it because it’s not really clear to a lot of people. And I mean, as a, as a solo practitioner, having people come in and be angry about their copays or angry about what they’re, I’m like, I am not, I didn’t take your insurance plan. Like, I don’t know what to tell you, you know what I mean? But instead of like talking to them in that way, I explained to him like, listen, I can’t possibly remember that HMS has like 80 different plans and which each plan does.
Dr. Dawn Sparks (27:56):
Like, that’s really kind of where your, you have to take some accountability, that to look at your plan and try to understand what they’re willing to reimburse. And if they’re willing to reimburse more, we’ll we’ll work with them. No problem. But a lot of that stuff gets really complicated. And I think the older, the patients are having to go online and having to do all of that. I mean, it’s really hard to convert the telemedicine during the close down because so many people here you know, if they live in [inaudible] and they don’t have good internet service and they’re like, I’m just going to drive on my car and talk to you on FaceTime. I’m like, don’t, don’t call me on FaceTime while you’re driving stops. So, I mean, it was really interesting converting to telemedicine over here.
Justin (28:43):
Yeah. what was your ex, so at what point did you leave the Virgin islands? How long were you there?
Dr. Dawn Sparks (28:50):
Two years. Yeah.
Justin (28:54):
I also, there’s one experience that you mentioned earlier on the, the travel and the bucket list. And I think this was during residency. Can you talk a little bit about how you became like a world traveler? Kind of,
Dr. Dawn Sparks (29:08):
Okay, so I’m going to just like throw it out there. Like Dr. Christiane, Oakland Teenie, like told me, like I needed to travel. Like you, he came to the Cleveland clinic from Italy and like joined the liver transplant team as a fellow, I believe maybe he went to Miami first and then came to the Cleveland clinic, but there was like something like, he just left Italy to be like a liver transplant fellow and restart his life in a new country and all this other stuff. So just having worked with him throughout residency, he couldn’t believe that I had never been to Europe and I got a journal, a Smithsonian journal, and it was like the 28 places to see before you die, which seemed way more doable than like 1,001 or whatever that book’s called. So I was looking through the 28 and I only been to one and I was like, Oh no.
Dr. Dawn Sparks (30:01):
And this was like 2008. So I’m like a CA three. I’m like at the end of the residency. And one of the 20 places what’s falling water, which is in Pennsylvania. So of course I was at Cleveland area, not far from there. I was like, that’s it, we’re going this weekend. I have a golden weekend. We’re packing up the family. We’re going to Fallingwater I got to start knocking off these 28. And and then I planned a trip with the family and we went to like five countries in Europe and did like a European family cruise. It was a little bit like European family vacation, but when you take three teenagers to Europe, all that stuff can happen. So no, but like it did it definitely once I got out and saw more cultures got around to seeing different countries and stuff.
Dr. Dawn Sparks (30:46):
I mean, it really does open your worldview so much so that after visiting like 38 countries, now I would consider myself more of a citizen of the world than anything else, because I’m, I’m very compassionate to the cultural differences and the things that go on in different countries that we’re quite blessed in the United States of America to have all of the things we have at our disposal and, and often probably taken for granted. So maybe it was in me and Mara when the little kid was running behind me with like different countries, dollar bills and like a monsoon. And like I had read something before I went there that they really like it if you give them like us dollars. So I gave them like a couple, $1 bills and he was like super excited. So it’s just, it’s like a whole different feel when you’re exposed to many different cultures and, and like the things that they went through, the perseverance for these different subsets around the world, because they’ve had to have a lot of perseverance and kind of stamina to do the things that they’ve done.
Justin (31:55):
Yeah. Perseverance is another word. I know that you have mentioned a few times and you know, through that crazy experience when you almost died too, you know, making it through training with kids, like during med school and then getting through residency and fellowship and just the demands of a physician career. And I know you mentioned when we spoke recently, just a couple of times in your, like, you know, you’re in the, or, and you’re just like so frustrated or whatever, and you’re talking to one of your mentors about just trying to like, please talk me into still being a doctor, because I’m about to lose it kind of thing. Tell me about what it means to you to like, have that grit or the perseverance or the, the idea that you’re going to see something through. How has that played out for you?
Dr. Dawn Sparks (32:37):
I think there’s been a lot of naysayers as well, too. Like kind of like fueled some of my fire. Like, Oh, you can’t do that. Like, there was some physician when I was in clinicals in med school. I remember her saying something to the effect of your, you should be barefoot and pregnant in a trailer park. And I was like, I can’t believe, first of all, I couldn’t believe she just said that to me. I was already in medical school and I was just kind of like floored. Right. And I think I thought to myself, no, that’s not my, that’s not my path, like, but good for you for thinking that way. And everybody’s entitled to their opinion, but it doesn’t mean I have to go along with her opinion.
Justin (33:23):
Did that motivate you? Oh yeah. I would be so amped if somebody said something like that, to me.
Dr. Dawn Sparks (33:29):
Yeah. Like currently the child status is one and done. But I’ve had step-kids, but yeah, I only have the one biological daughter and never lived in a trailer park, so, and I’m not always barefoot in Hawaii. I wear slippers, you know, the let’s flip flops, whatever.
Justin (33:55):
Tell us a little bit about, to extent that you’re comfortable talking about it, cause I’m sure it’s a small Island you know, the prior experience you had. I know there’s a lot of physicians who are trying to find a clinical opportunity where perhaps there’s a partnership opportunity, a place where they can express their own, you know, clinical and personal selves in the way they care for patients and the way that they build out their professional lives. And I’m sure that that’s what you are looking to do and expecting when you joined the last practice and at some point you decided it was better to move on. So can you tell us a little bit about that?
Dr. Dawn Sparks (34:27):
Yeah, for sure. I I really do think that like the big motivator, not just being told that I couldn’t start a practice and then like having to do it, but like the motivator was more about transparency honesty, clarity, and showing that physicians that you can do this, you can have a life that you’ve always dreamed of and you can have success that may not to some physicians be like the super duper high and a flute, monetary success that you really thought you should have, perhaps I don’t know, but like success can be defined by everybody in a different way. And and having a successful pain practice and having the freedom and the autonomy to make your schedule to run the practice the way you want to and have, you know, of course you have all of the compliance and stuff that you have to follow, but in general, you’re given a lot of freedom to make those decisions.
Dr. Dawn Sparks (35:35):
And, you know, if you’ve read rich dad, poor dad, he says, you pay twice. Once is for security. And the second time is for freedom. So if I paid twice, once was med school and residency to be at the physician for security. And then the second part was for the freedom with being an entrepreneur. And most of all of my friends who have now ventured out into having their own practices as well, I be like, kind of speak the same story. Is it that they don’t think that they could manage having to work for somebody again, because now they’ve gotten so used to being able to design things the way that they want to do them, what works best for them, how, how they can kind of just make medicine better. And so for me, starting to practice my vision, I guess, was that not only to make medicine better, but like show people that they can do it and they can have that clarity and not have to feel like they’re going to somehow be duped or not given the reality of the situation. And really kind of be excited about being entrepreneurial and, and that this becomes like their baby to now, whether that means like a partnership or, you know bringing other people in to show them that they can do it. I’m not sure exactly what that means right now, but that was my vision.
Justin (37:02):
Awesome. Are there, have there been people for you and I’m sure there have anyone who has, you know, maybe the opposite effect, if that other physician, you just mentioned people who have empowered, you lifted you up and equipped you to say like, yes, I can, even though I don’t even know the way to get there from here, I have what it takes to be able to be an independent pain practitioner one day.
Dr. Dawn Sparks (37:22):
Yeah. I, and I do think that there’s a lot of people that have inspired that and, and kind of helps me to remember who I am if you will. And so one of my greatest, like we were talking about earlier, I think mentorship versus sponsorship. And so like mentorship is somebody who helps you along. And then sponsorship is like somebody who can actually help you get somewhere that you might not have otherwise been able to get to. And so this person throughout 18 years may have changed from being like more of a mentor to a sponsor, whatever, but he’s always been in my corner, have my back rooting for me. And so just a shout out to Dr. Mark Popovich, who I met at the Cleveland clinic when he was the head of the ICU, and now is the chair at university hospitals in Cleveland, Ohio. So he has always kind of like said, you can do it, you can do it. And even if as long was no, I God.
Justin (38:21):
Hm.
Dr. Dawn Sparks (38:23):
You know? Yes, you can. Oh, that sounds good.
Justin (38:27):
It’s so critical. And being surrounded by that right person, I’ve experienced that so many times. And it’s invaluable. And being, being surrounded by people like that or putting yourself in the way of people like that, it’s so important. And then it’s also really fun to have the opportunity to, you know, be that person for others as you gain experience and can open doors.
Dr. Dawn Sparks (38:52):
That’s like part of like the growing up in medicine, or like a lot of people say like, Oh, you’re married to medicine. Well, I mean, if that’s how you want to look at it, maybe, but I think it also gives you the opportunity to learn how others, you know, manifest what they want and, and, and also support them like where it can now be like a joint venture where it’s like, Oh, you’ve been supporting me, but let me support you because of this, you’ve got this, like, you know, keep doing what you’re doing. And other people just kind of like coming along into your path and saying, you know, you should really be a pain doctor. And you’re like, really? Yeah, you should apply. And you know, that’s kind of how Dr. Nagy McKayla was when I was rotating through the pain department.
Dr. Dawn Sparks (39:39):
And I wasn’t really sure, I knew I wanted to do a fellowship, but I was kind of thinking, I see you. So those guys were really smart. And I thought, you know, I should probably learned more about electrolytes and like, stuff like that. It seemed like it would be a valuable year, you know? And then he just kind of approached me and said, I should apply for pain that I had good surgical hands and I, you know, I was good at procedures and it seemed like something that he thought I would do really well in. And that year was pretty competitive. So I remember just kind of thinking, nah, I don’t like competition. I don’t like rejection. I’m good. I, I already got this ICU spot. I’ll just stay over there where it’s comfy. And he was like, no, no, you should apply.
Dr. Dawn Sparks (40:24):
You should apply. And so I did. And the rest was kinda history from there, but I think that’s the beauty of pain management being such a new field and like having all these cool new things that we’re learning and we’re able to do. And we’re able to like really kind of like keep our wheelhouse open and, and do more. So like do a podcast with you or create another venture, or like, you know, maybe write a book or, you know, just the ability to be able to do other things. It’s part of that freedom and I’ve actually really enjoyed it. Awesome.
Justin (41:07):
Yeah. I want to wrap it up here and I thank you for your time today, Dr. Sparks you are somebody who’s, you know, not only very professionally accomplished, but you’ve had these experiences that have left a significant impact. And I think have changed the way that you see the world in the way that you treat patients. So in closing, I’d love to just have you reflect on a time of professional actualization where the, and the grit and the empathy and the seeing, perhaps it could have been worth a patient, or it could have been something else that you’ve been working towards for a long time, a moment where you said, you know what, like thanks to the haters. Like in this moment I did it I’ve achieved the goal I’ve, I’ve reached that success that I was striving for. And you were able to enjoy that. Can you think of anything like that?
Dr. Dawn Sparks (41:57):
I think that there’s been a ton of those experiences sprinkled, like throughout all of my training. And I think I was just talking to someone in relation to like, do you miss anesthesia? I’m like, sometimes like, yeah, I kinda missed doing anesthesia. So one of the things was being in like a big liver transplant, like having all these things going on and the, like the attending calling as he’s like walking out, you know, at the hospital, I would assume, you know, like the cases over we’re taking him to the ICU, he’s like, you did a great job, blah, blah, blah. And so it was one of those moments, I think in residency, like, Oh, I can do this. Like, I’m doing this, this is me. And when you’re about to finish residency and you have kind of that imposter syndrome and you’re like, ah, I don’t know, like that’s, that was really cool.
Dr. Dawn Sparks (42:48):
And there’s a lot of things like that. Like walking across the stage when graduating med school and hearing them call you doctor for the first time, you know, even though you had been working hard to get there, that was pretty cool. You know, in residency for our residency slideshow, I made a really cool like slide show to music, which they played during the graduation at residency was, let’s just kind of reminiscent of all of the things we’d all been through together. And how kind of like tight knit, your band of brothers kind of becomes when you’re going through residency. So all these people along the way, you know, have sprinkled all of these things. The first time I opened my practice here, just like thinking like I’m doing it, like it’s happening. Like, I don’t know how it really happened, but like, I’ve got like this EHR and I’ve got like employees and I got this like, you know, logo on the wall and, you know, people are showing up, so,
Justin (43:48):
Oh, that’s that’s amazing. And it’s been really fun. Dr. Sparks hearing your story. Thank you for joining us today on APM success.
Dr. Dawn Sparks (43:55):
Thanks so much. I really appreciate it. Just some have a great day. Aloha.
Justin (44:01):
If you liked what you heard this week, head on over to APM success.com, where you can find more content and free resources to help you build a successful career in anesthesia and pain management. If you wanted to leave a review in iTunes, that also really appreciate it. Thanks for using some of your valuable time to join me today on APM success.

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