Episode 81: What Does the Data Say About Burnout? With Dr. Ellie Kazemi

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Transcript

Jonathan: 0:29

My guest today is Dr. Ellie Kazemi. Dr. Kazemi merges behavioral science, advanced technology and database decision making with many years of experience working with leadership to promote strong organizational cultures, practical and efficient training, and transparent messaging and communication. She's a tenure track professor at CSUN, where she founded the MS in Applied Behavior Analysis program in 2010, and teaches undergraduate and graduate coursework in organizational management and behavioral analysis. She's also served as the chief science officer at the Behavioral Health Center of Excellence, BHCOE, an accrediting organization where she oversaw standard development, evaluation methodology, measurement science, and thought leadership. Ellie, welcome to the pod.

Dr. Ellie Kazemi: 1:12

Thank you. It's nice to be here.

Jonathan: 1:14

Alright, this is so topical. We're recording this, not only on today. April 27th is a day without hate, but it's, um, almost exactly one week after I got to see you at the Autism Investor Summit. And I was sitting in the front row and just like grinning ear to ear on all of the data you were sharing, about burnout and what makes people stay and retention and turnover and all kinds of stuff. And so, it's an honor to have you here, Ellie, and let's start with what got you so interested in learning more about provider burnout and retention.

Dr. Ellie Kazemi: 1:43

Well, um, I've been interested in that for some time. I think when we put out the turnover paper, it was like 2010, we were beginning to realize that there is such a, incredible amount of turnover in that behavior technician level. Um, and I think that, In any profession, what you're interested in is why are people leaving? because you want to do something about that. And you know the people that are leaving for good reasons. You want to encourage'em on and be happy about that and, get them to a better place. But if people are leaving because you're not doing something right or you just need to change your messaging or you need to change the culture of what you're doing. Those things I think are doable and good feedback for us as a community. So I've been interested in this topic, at many different levels, and I think more interesting is probably post covid, how everyone else has gained so much interest in the area. So I feel like I've kind of been watching this rise in turnover and likelihood to quit, but, I think that Covid sort of made us all very aware that we have a problem.

Jonathan: 2:48

Yeah. Let's go deeper on that.'cause one of the things I totally didn't appreciate until I saw it in your presentation, and there's a Harvard Business Review article you highlighted, called The Great Resignation Didn't start with Covid. Tell me more.

Dr. Ellie Kazemi: 3:03

Yeah. You know, I thought Harvard Business Review did such an awesome job with this, where they showed that this progressive graph showed very clearly that what we're seeing is a rise in, voluntary turnover and silent quitting from individuals, but that because of job insecurities or people worrying about furloughs and whatnot during Covid, there was actually a period of time when people were keeping their jobs, so right afterwards we experienced what we would've typically experienced as the next rise, but it just feels like so much more. And I think that that is exactly why I've been interested in, turnover and burnout for some time because we're seeing it and we're seeing it progressively, but it's only human. When something happens just slightly a little bit more every time there's a shaping process, we don't feel it's happening. Um, and so I think it's really giving us some time to think about this, uh, which is important.

Jonathan: 3:59

Yeah, and it shows, I, I think just a fundamentally different sort of nature of contract between employee and employer than we've experienced in the past. And that we, we may or may not, right, as organizations or specifically as ABA providers have tools that we're equipped to address that. But of the many things that were so powerful about your presentation is you shared some of the data with your conversations with, I think it was like, 250 RBT and BCBAs in which you listened and you had direct conversations with them about what they love feeling and seeing in their jobs, what keeps them coming to work, and also what burns them out. Tell me more about your findings.

Dr. Ellie Kazemi: 4:37

Yeah, I love that because I think what happened for me was, when everyone started to recognize this as an issue, and you know, our turnover paper had been there. People had looked at it before. But then more than ever, I'm getting notifications from ResearchGate that people are actually looking that paper up now, post Covid. I really wanted to shift the focus'cause it's important if we see Covid as the cause or the major explanation, if something happened during Covid, we're likely to look at different things than what is it progressively that we're doing as corporations, as organizations, as employers that may potentially be resulting in a higher and higher level of individuals leaving. And I think it, that shifting that focus is really important, uh, from my perspective. so I put out a call and I've been hearing from a lot of individuals, that we've graduated over the years, we've graduated over 400 BCBAs from the Cal State Northridge program. And I can't even say how many behavior technicians'cause each semester alone I teach 300 students or so. So we absolutely have our own base of individuals who were contacting me, talking to me about changing jobs, leaving the profession as a whole, and I didn't want the sample to just be the individuals that we had graduated or that came to CSUN. So I posted on social media, believe it or not, just, Hey, if you wanna talk about, your profession, if this is not what you envisioned. gimme a call, text me or send me something. And the number of individuals who wanted to speak just blew me away. They, reached out, they would send me such personal informations, they would write out what felt like just these events in their lives that they had sat down and thought about the vulnerability was pretty incredible. And the other part of what was incredible was that I had not said, you know, hey supervisors, I assumed who I was speaking to was supervisors. but actually I received calls and requests to speak from CEOs, from, uh, academicians, from behavior technicians. So it was definitely across, positions where they wanted to talk about what they thought the profession would be, why they came to it, what they loved and what was changing for them, or why they were seeking something else. so I was able to synthesize across those stories and what became very clear to me when you speak to over 250 people, is the similarities, the universal truths come up. Right? so I think that that's been very, uh, very cool. In my history, I've not done that much qualitative research, but I can definitely see the value in having spoken to people, cause what I didn't wanna do, Jonathan, is to put out a call and say, Hey, are you burned out? Tell me more about your feelings of burnout, because we know that that's been done to teacher education, and all it does is it burns people out. so I wanted folks to, to connect back to why they're here, and tell me how we could get there.

Jonathan: 7:45

So I'm, I'm like on the edge of my seat. You gotta share some of the universal truths that you were hearing. Uh, I remember in particular, like stories about a behavior technician, for example, who was like expected to go into this really challenging situation with a kiddo in bed and yeah. Tell me more about the universal truths.

Dr. Ellie Kazemi: 8:03

Yeah. so, I don't think we have enough time for me to share with you the personal stories at those levels. I selected stories of individuals that I felt really were echoed across the technician and the supervisor, and then of course the CEOs. Um, and I wanted the similarities to emerge and I think for the most part it's very clear that people came to the clinical portion of our field from a desire to change things, to be able to be an effective agent of change, I want to be able to help families. many individuals shared those exact moments where they fell in love and it was typically fell in love with a client or fell in love with, um, like our CEOs, would talk more about these moments of feeling like they could make a difference in the lives of their employees when they watch them blossom. And so there were clearly these moments of, I want to help and when I see that change, when I get to access being effective, that feels great. Uh, and that was definitely universal. Um, the other was, Feeling appreciated. Which was interesting because the technicians spoke about appreciation more from the perspective of when the families want me around, when they are thankful when their child speaks, when we first get that potty training right, and they cry or they share with me, they went to the movie theater together and finally were able to watch the movies and engage in family outings and they take the time to give me a call and tell me how important my work has been and. On the other level, a lot of times they shared how important it is for them to feel like a part of the team, that the supervisor makes them feel like they're collaborating. They have something to say about what's going on in the home, that they're good at what they do. A lot of times technicians would say, I liked it when I felt like I'm good at it. and that was also echoed by the supervisors and the CEOs, this sense of feeling appreciated for their efforts. A lot of the supervisors would share, same thing back about their technicians. When technicians look at them and are feel like I really wanna do what you do. How can I learn more? So supervisors would get very excited about families appreciating them, but also their technicians appreciating their efforts. And then of course, their employers. A lot of supervisors shared with me that when their clinical recommendations are honored or when they're called in and they're asked a little bit more about their decisions, not from a probe and correct perspective, but rather, what led to this decision making and why are you making some of these decisions? And those are honored as a part of what they provide. So in a sense of, I'm good at what I do, I am heard and I'm appreciated, was absolutely things that were shared about what brought people to the field and eventually, I think, a lot of them came to this point of, and I wanna make change in the lives of the families we serve, you know, and all of that to the same path. and the, flip side of that, uh, was really this very clear message that sometimes they felt like pencil pushers, like when I'm asked to collect data or when I'm asked to stay certain hours the family's home, or when I'm asked to carry out certain procedures with the child, it doesn't feel like this is for the client or it's making change, but I'm being asked to do these things for some, uh, you know, pencil pushing reason, and I, don't appreciate it or supervisors shared that their efforts could really be minimized over, you know, dotting the T on some paperwork and all of that clinical effort could completely go out the window and in turn, a lot of times then the CEOs also shared that they, got into their positions they were excited about recruiting talent, growing talent, but that they too felt like they were just pencil pushing, trying to deal with insurance. And then dealing with all the errors in paperwork that trickle up from their clinicians, because they don't quite understand the importance of that in billing and being able to keep the organization, moving forward without, constant having back pay and billing issues. So I think that that portion of the, I don't feel good about this job is very clear. I don't wanna be a pencil pusher. And the other that I think to myself, these are the times I'm called in during conflicts and which makes perfect sense to me was really this sense of I don't seem to matter, I'm a number. Um, I am just, Replaceable and, I don't feel connected because what I do and who I am is not necessarily anything other than just a, a service to provide for some end game for someone else. And that I think, absolutely was something that I can see us addressing a lot better also as a field because I think it's an issue of communication and how we create our cultures so

Jonathan: 13:04

Ellie, I confess, I melted when you said early on in your presentation, you told the audience behavior is a function of its circumstances, and you quoted from Dr. Friman like another hero of mine, that widespread adoption of this view would make the world a better place. I think that's from 2014 to get Dr. Friman It's so cool. But like this idea of the behavior is a function of its circumstances certainly applies to burnout and turnover. and it's something that I think, that ABA practitioners recognize, like seeing their day-to-day work with clients. But why has it been so hard for organizations to recognize this vis-a-vis burnout?

Dr. Ellie Kazemi: 13:40

You know, why has it been so hard for organizations to recognize it? I think it's because they are also victims of the context. it's a vicious cycle. So organizations, employers, Get caught up in the billing issues, billing difficulties, the constant changes that are coming their way from the payers. And the payers are dealing with some of those things as well with regards to policies and changes that are happening. and I think under those conditions, things are hasty. You're trying to survive as an organization. Everyone's moving to survival and being able to do well. So I don't think in any way, anyone has mal intent. I have yet to meet anyone in the field from investors who come to the field, they're selecting to do good for the individuals. They could have put their money anywhere. They often come to the field because they really want it to be somewhere that could be meaningful. So I have yet to really meet anyone that I'm like, you know, you have some bad intent. it really is that they're a victim of those circumstances and have not had the opportunities to evaluate it. They've gotten into there over over time and don't even recognize where they've gotten to. And so the context is for a lot of employers that they are just in this constant moving, I need to survive. I need to change things, and I need my people to understand and move with me, help me, you know, move. And the staff are not necessarily getting that communication the same way. So they feel nothing but rushed changes and things that are being trickled down and they're being asked to do things that they don't quite feel is in line with their values or what they joined the organization for. So I really think that the context is, Occurring at different levels and it's just become of a cycle that is not well communicated. That's resulting in a lot of this conflict I think

Jonathan: 15:34

ellie, that feels deeply insightful'cause it's almost, uh, I mean the Maslow's hierarchy of needs that pyramid comes to my mind. If an organization is fighting for just pure financial survival and there's some studies out there. Bixby for example, just did a huge survey of over 60 ABA providers, it's the second annual one, and I think they estimated that like 50% of ABA providers are either breakeven or losing money. Like this stuff can't sustain. So if organizations are in this fight for survival, it's hard to get to higher levels of understanding and compassion and wanting to make sure to address these kinds of burnout issues like you're describing. But I mean, what do you think? Help me, read the Dr. Ellie Kazemi, like crystal ball here. Like what's our field gonna look like in three to five years when it comes to clinical services and different clinical services models? Just knowing that, this idea of burnout, is not just a short term trend. This is a secular trend here to stay. how do these changes get addressed by providers? And can we get back to retention rates we saw maybe five, 10 years ago? Or is this truly a big shift in staffing and our field has to move away from maybe reliance on just frontline RBTs or maybe focusing more on BCBA parent training only models. I don't know. Help me like piece all this together. I

Dr. Ellie Kazemi: 16:44

love it. I absolutely love it. And, that is also the entrepreneur in me. You know, I'm constantly looking for new models, and, it's interesting because as a scientist, I move to solving the problem from a science perspective. But as an entrepreneur, I move to the problem and think to myself, how do I change a create and get out of the box? So I actually think it's, it's gonna sound odd, but I think it's exciting times because I think that when we don't recognize there's a problem, when there is just this shape up process and we're losing people, we have these explanations of, ah, people come and go. But now I think we're in this time when clearly individuals want change and conflict to me sets the occasion for some really good conversations. Conflict is not a bad thing. It means that people are recognizing something is wrong at every level. Our supervisors came to the field invested time to go to school, invested time to get those clinical rotations and internships and supervision. They don't want to leave. They want to stay, but they're at this place of, I'm frustrated and our CEOs are in the same position. So if you think about it, I think that we have to pivot and we're about to, as a field, I don't think we can continue being where we've been and getting creative about, well, uh, should we put someone in someone's home for 30 hours if we're burning them out when there's these elongated hours? And potentially clients are not providing, any reinforcing events because they're exhausted and everybody's just gotten used to this person being around. So those changes that are occurring don't seem as cool. We can revisit those models and say, could we really actually do this in a more efficient way so that we can have a better system for our technicians as well as the family. I think getting out of the box with regard to some of the things that you're talking about, like, can we think about some of these models and groups? Can we think about these things a little differently with regards to how we're providing hours and where our clinicians are? Is absolutely upon us, and I think we can, and we should. our model should be pushed. We have been doing it the same way, and I think we should be thinking a little bit more about our current model. I also think that there's some exciting times with, artificial intelligence here. Like, you know, it could hear that you're already having conversations with Mandy and everybody else about some of these things. And I think that we will absolutely be able to remove some of that pencil pushing things when we begin to automate and create systems that lift some of the work from clinicians, so they're not going in there retyping date of birth. Here's, you know, the date of my visit. Some of this is populated because there's clear records and information that can just populate itself. I think that we're gonna begin to see, some of that lifted, and that's gonna be better. And then of course, I think that, the fact that we're having these conversations and, you know, a lot of organizational leaders stayed afterwards and had conversations with me. I'm getting lots of calls from individuals to have these conversations. They are realizing that they need to be more transparent with their employees regarding, you know, this is a vicious cycle. here's the state I'm in, but you, the labor force, you the clinical, supervisors, you are my lifeline and together we can turn this or not. I think that the conversations shifting and more transparent conversations about how can we create systems that create better communication and message better to each other, will be very helpful in the time to come. So I think we're gonna have to pivot and I don't think we're alone, Jonathan. I think we see this in healthcare. We see this in veterinary care. I was, Just, talking to a colleague, you know, my nearby Ralphs has had to close down a bunch of sections because they don't have enough people. So we're definitely not alone. And so I think we are, as a society, beginning to think a little bit more about where's our youth? What do they want in their positions? How can we make them feel less like numbers and more connected? and I think, behavior analysis is going to make the necessary shifts. We have the tools.

Jonathan: 20:54

we absolutely have the tools. I mean, that's what gets me excited even in these challenging times. But, if we were to zoom up a bit and we look at this like golden triumvirate of, um, you know, the three critical stakeholders and services we've been talking about one part, the ABA providers and, team members. Another critical stakeholder are payers, and then a third critical stakeholder obviously are families. so maybe this is a duh kind of question, but are families experiencing some of the impacts that all the turnover, retention and other things, are causing and what are you hearing, if anything at all from families?

Dr. Ellie Kazemi: 21:26

Yeah, that's an excellent question. And when I was, working at BHCOE, one of my favorite things actually was our stakeholder engagement groups with parents and, individuals on the spectrum themselves, telling us what they were looking for in the services that they received, telling us what were some of the outcomes they had hoped that were not achieved. and. always, it wouldn't fail the first thing they would talk about is turnover. Making sure that the individual that they're getting is someone that is dependable and, and is showing up and they saw the turnover as directly an organizational problem. it was a very clear message of, uh, when I'm working with an organization that the individual is not staying. They put someone in my home that's not staying. I see it as an organizational problem.

Jonathan: 22:16

Well, I gotta share, you know, um, when we started Ascend, gosh, almost six years ago now, in the first couple years I would randomly go to family, not random. I'd give heads up, but I wanted to check in with our rbt'cause we are entirely home-based. So, you know, I talked to rbt, is, I'd hear lots of feedback from families. You know, one of the, IM most important things I heard was, as an RBT and you're in the homes, 10, 20, 30, 40 hours a week. A family knows you as the RBT. Mm-hmm. Not necessarily the organization. Exactly. And you know what a common question or feedback I got from RBT is families will ask them, how is your employer taking care of you? And I think it's really important not to underestimate like how powerful that relationship is between RBT and family directly, not necessarily between family and organization.

Dr. Ellie Kazemi: 23:04

Right. I think you made an excellent point and I've, I've gotten this question before actually from, um, organizational leaders, they'll say, I don't understand. So when you go to your dentist, you've got the dental hygienists. These individuals are not saying that, you know, I know a lot of things to do. They're working with a team of individuals. I don't understand why our behavior technicians feel like they have such a large role. There are. Part of a bigger system, they're a part of a bigger role, and I don't understand why they feel so independent and we have to keep wheeling'em in and it cracks me up because I can absolutely understand that from a system perspective, there's an entire system that supports the behavior technician, right? There is somebody who dispatches on someone who's doing the billing, someone who's providing the supervision. But if we take a moment to take perspective of what the technician experiences, it's not in an office. You're not a dental hygienist. They're not surrounded by the tools and the training and the material provided to them by the organization. They're holding their phone quite often, their personal phone that they're using for a lot of information, and they are not walking in there in a, sterilized system. They're walking in someone's home and how they interact, who they are, their previous experiences that brings them to that moment absolutely matter. And so they, in many ways are the frontline and they are the ones that make all impressions about us. So it makes sense that they feel completely like everything rests on them. And the flip side of that is that if we are not providing them with enough reminders of the support and really making them feel supported when they're out there, some if they feel great at the job and they feel great on the case, that's fine. They feel a sense of like, this is mine, this is what I'm doing. But in other times, they feel completely alone and worried that they're going to be scapegoated or things will fall on them. So I do think the nature of the job is such that being in people's private space, in people's homes, day in and day out, seeing how they eat dinner, how they interact with each other. How many times can couples or family members keep family fights from a technician overseeing it. I couldn't fake it that good. Jonathan, I don't know about you, but I can fake it for a week. But, you're gonna see some of those interactions and, and we kind of have to realize that's the context they're in providing care.

Jonathan: 25:32

It's so true. there's no place to hide, right? you have become as an RBT, like a, effectively, like a therapeutic member of the family while this family's home has become a therapeutic place right. It's, um, it's extraordinary. Well, let's look at the third group of critical stakeholders here, the payers, right? Insurance companies or Medicaid, who's actually paying for services. What are you hearing from payers about all of this?

Dr. Ellie Kazemi: 25:57

Well, I've been very fortunate to work with wonderful payers and individuals who equally care about the families and, have, really a lot of care about organizations doing well. And I think, uh, what they're interested in and what they really wanna see more of is, recommendations from the provider and recommendations from the supervisors that really, seem to make sense. Seem to be socially valid for the families and outcomes that are achieved, that they can speak to. So as the payer, they wanna be able to say, something changed. I agreed to this, I paid for this. I can tangibly hold and say, here's what happened for this family. Um, you know, I, I think they're highly influenced by, rightfully so, by parent reports of outcomes. So how caregivers feel about the organization, how caregivers feel about how much they're gaining, some of the stories that they share. it's incredible because the growth of a child, they're not sharing. I saw in this report the most remarkable growth. Instead, it's the stories that caregivers have shared with them. Like, here's what occurred for me. So I think that they're highly influenced by those and want to see organizations have, better standards, better predictions, be able to really speak to what they're able to achieve better. I would say we're they're at,

Jonathan: 27:24

do you think this, to this idea, Ellie, of better standards, better organization, better operating systems that accreditation, whether it's through behavioral health center of excellence, where you worked or the Autism Commission on Quality and CASP, like, is, is accreditation part of the solution here?

Dr. Ellie Kazemi: 27:40

Well, um, you ask a question of a very biased person. I just actually submitted a paper on accreditation and I've worked, a very long time. Uh, you know, Eric Dubuque is a great colleague of mine and so when Sarah Litvak came to me and asked if I was, joined BHCOE, it just made sense for me because of really, uh, I think that quality control at every level helps. Because if we are nothing but victims of our circumstances, and if circumstance explains our behavior, we have to sort of think about, well, the supervisor behaviors can be shaped by what the organization requests as well as the board, right. The BACB sets guidelines for ethical conduct. The technicians can also have guidelines and things that their behaviors are actually under certain guidance by the organization as well as by, organizations that oversee them, who oversees the organization's behavior. If the payer is the only contingency, then the payer requests are always going to be superseding clinical quality issues, right? Because the organization's gonna move toward billing and the things that hurt their vitality. So I see accreditation as necessary because I can only see a third objective party being a, a place that provides those contingencies for an organization to say, yes, I realize this is the best standard in the profession that I adhere to it.

Jonathan: 29:09

Well, we are in such violent agreement there and as I've said many times in the show, I and Ascend are huge fans of accreditation. We've been through I think, six or seven voluntary, BHCOE accreditation and re-accreditation rounds. And, with the, I don't know, recent estimates are six to 7000 ABA providers across the country. there have to be certain minimum standards and that also feels important when you think about, yes, there are many, BCBAs who have started and own practices and there are a lot of practices that don't have BCBA owners, right? So therefore, potentially are not bound by the BACB code of ethics and exactly all that comes with that. And so that's where it feels particularly important that, we have this like minimum standard and objective set of things that we've agreed on, lead to a higher likelihood of the kinds of outcomes for clients of outcomes for our team members of outcomes, for our payers, for funders. that's where it feels really important to me. Ellie, who are your heroes in the field, and what's the most important thing you've learned from them?

Dr. Ellie Kazemi: 30:13

Oh, uh, We're probably gonna be here for a bit, uh, on, on that note. But, probably can begin with Pat Friman and one of the reasons that I, say that, and I have no idea how I came to this man's attention, but early in my career, he, uh, would really be proud of some of the things that I'm doing. and that's how our mentorship relationship begun is he would take time to attend to some of the things that I was doing in my students and he's one of my heroes because what he does, uh, with regards to youth and his clinical practice is absolutely, a great showcasing. Boystown is a fantastic example of what we could do for our society. the other thing is that he has such a deep respect for our profession, such a deep respect for the helping profession, and, The way that he sees the world from, behavior's a function of its circumstances, he means it, he applies that to every circumstance. And, for all of those reasons, he's one of my heroes. And no matter how famous he is, and no matter how much you know he's got on his plates, he'll take time to let individuals know, I've witnessed him do this at conferences where he's seen a young person present somewhere and he'll take the time to individually send them a note, look'em up and say, keep that up. So I really appreciate that and that has influenced me a lot in my career. Um, I. I also am deeply influenced by Shahla Rosales, and her, social activism in the field and her desire to make change at such a bigger level. I had the pleasure of seeing a lot of her students work and you know, that application of behavior analysis at such a larger level to solve major problems with regards to, what family's need and just the social activist in her I think is something I aspire to and really have a lot of respect for. And, I think that obviously, outside of that, I could, also go into talking about Alice Dickinson and other, individuals I have a lot of respect for because of my organizational management, side and the fact that there is a very clear business organizational mindset that those individuals bring to the profession. I could sit here for many hours, so that's a very bad question for Ellie.

Jonathan: 32:38

Well, you know, I, no, I appreciate you sharing some of your heroes. I also think it reflects just a deep humility on your part, and this is What I commonly see across extraordinary leaders is there, there's a humbleness, right, of knowing, the, homage to, your mentors and heroes and knowing that even as a leader, There's so much still to continue to learn. Right. and passing that forward just kind of feels important.

Dr. Ellie Kazemi: 33:00

100%. Yeah. and then of course, you know, the mentorship trait, the reason that question is so tough is because you have colleagues that you respect a lot. They continue to influence your work. And then I have students that Jonathan, they have absolutely shifted my career with, great input with great, Feedback on their part. They have absolutely changed a lot of my efforts in, DEI and being able to really bring that to BHCOE and also my continued efforts there were, because I had brilliant, wonderful students who were kind to have real conversations with me. So it goes all the way.

Jonathan: 33:39

What an amazing shout out. Yes. It goes absolutely both ways. Well, Ellie, what's one thing ABA business owners should start doing and one thing to stop doing?

Dr. Ellie Kazemi: 33:48

I think that, one thing that they could do, if they're not already, is to begin to really message what's happening for the organization. I am, absolutely shocked to hear from a lot of clinicians or behavior technicians when I share their numbers of what an organization has to do or what happens when they budget. They are absolutely shocked. they have no idea what it costs to have human resources and billing. So I absolutely think that learning to message more about the activities of an organization so that the individual realizes that there is an entire system of support and what it takes to make its work together is important. One thing that they should not do? I would say I'm deeply influenced by what individuals are sharing with me, and that is to never make anyone feel like they're just a number. We are at work for more hours than we are with our families. We're at work for more hours than we sleep, to join a place or be a, at a place where you don't feel you matter. I don't think anybody would give us their best under those conditions. None of us said, I wanna grow up to be a number somewhere. You know, I don't, I don't think anyone aspires to that, and I do think that we make those mistakes. So taking time to think, how can I make my people not feel like just another number is gonna be really important?

Jonathan: 35:10

Amen to that. I mean, what you just said, like taking time, right, is just pause in the moment and be present as you have conversations, and don't think about those interactions as, you know, checking off the latest meeting and, checking off the boxes, but truly being deeply present. Well, Ellie, where can people find you online?

Dr. Ellie Kazemi: 35:28

Well, um, I am excited in my new journey. I'm actually, looking really into self-reflective practice and I've developed some tools for some time that I've been working with organizations doing consulting. And, I'm going to move all of that into my new, uh, work. And so you can find me at elliekazemi.com and I'm just building those out. so if you go there, you'll find bunch of pages that are just new. I've done a lot of consultations for organizations over the years, but I've never actually, matriculated them into formalized assessment procedures for individuals to be able to access. My goal is to formalize and, and make everything accessible in the, upcoming year.

Jonathan: 36:09

I love it, Ellie, just another way you are paying it forward in our field. Well, are you ready for the hot take questions?

Dr. Ellie Kazemi: 36:16

I sure am.

Jonathan: 36:18

All right, Ellie, you're on your deathbed. What's the one thing you wanna be remembered for,

Dr. Ellie Kazemi: 36:22

uh, being a strong family member?

Jonathan: 36:26

What's your most important self-care practice?

Dr. Ellie Kazemi: 36:29

Turning it on and off.

Jonathan: 36:32

Woo. Say more about that. I love that.

Dr. Ellie Kazemi: 36:35

Uh, learning to be present, you know, this is, this is work. I love my job very much. It's also a passion, but learning to turn it off when I'm spending time with my nieces or with my son and turning the pressures or the stressors of what's happening there off when I'm elsewhere, so that it's not leaking over. So, mindful practice to learn, to continue to turn it on and off is, yeah.

Jonathan: 37:00

So powerful. Please include that in this set of organizational tools. Leaders can like develop better repertoires around. That feels really important. What's your favorite song and or music genre?

Dr. Ellie Kazemi: 37:14

You know, this is gonna sound really corny. So I grew up listening to Led Zeppelin'cause my dad loved that era. And, you know, I absolutely am a Queen fan. And, so I, I actually like a lot of the pop, um, Sort of, heavy metal like Metallica. Um, so those are,

Jonathan: 37:35

we are kindred spirits on that. Metallica just came out with a new album, 72 seasons. I do not believe they are still doing it. Wow. I wish I had a 10th of their energy. Right. What's one thing you'd tell your 18 year old self Ellie?

Dr. Ellie Kazemi: 37:48

I would say know that you know nothing and that you'll change your mind all the time, and that change is cool and awesome and that you'll need to ride unchanged. Don't be so fixed.

Jonathan: 38:06

Well, if you could only wear one style of footwear, what would it be?

Dr. Ellie Kazemi: 38:09

Oh, oh my God. I wish I had prepared for this question. I can't even, I can't even think of what that would be. It would be cool and weird with really weird heels, but I can't think of the name I like, I like things that are retro.

Jonathan: 38:26

I love it. Cool and weird with really weird heels. Boom. There. Well, Ellie, thank you so much for taking time to catch up and for sharing your wisdom with our field. I appreciate you.

Dr. Ellie Kazemi: 38:38

I appreciate you back. Thank you.