Career Growth Advice from Dr. Nancy Salisbury, Healthcare Leader | Career Tips for Women in Healthcare

2B Bolder Podcast – Episode 5
Featuring Dr. Nancy Salisbury

Episode Title: #5 Career Podcast Featuring Dr. Nancy Salisbury, a Global Renowned Doctor Who has Dedicated her Life to Serving Women

Host: Mary Killelea
Guest: Dr. Nancy Salisbury



Mary Killelea (Host): Hi there. My name is Mary Killelea. Welcome to the To Be Bolder podcast, providing career insights for the next generation of women in business and tech. To Be Bolder was created out of my love for technology and marketing, my desire to bring together like-minded women, and my hope to be a great role model and source of inspiration for my two girls and other young women like you. Encouraging you guys to show up and to be bolder and to know that anything you guys dream of, it's totally possible. On To Be Bolder, you're going to hear inspiring stories of how successful women, some I know, some I just want to bring to you guys, and they're going to talk about their careers in business and tech, and they're going to tell us their stories about their passion and their journey and their challenges, and we're going to learn some of their advice along the way too. So, sit back, relax, and enjoy the conversation.

My guest today is Dr. Nancy Salisbury. Nancy is a very caring and brilliant woman who is often referred to as Dr. N. She is a board certified gynecologist who has been in practice since 1987. Dr. N is a surgeon skilled in minimally invasive procedures and vaginal surgery, often referred to many in her field as the vagina expert. Her special interests in female sexuality and interpersonal development make her a leader in female care services. Over the years, I have had the pleasure of working with her as well as being one of her patients. Dr. N has many great qualities and skills, but the one thing that makes her exceptional in my eyes is her genuine caring and nurturing spirit that she shares with each of her patients. Nancy, it is so wonderful to have you on the show. Thank you for joining me.

Dr. Nancy Salisbury (Guest): It's great to be here, Mary. Thanks for inviting me.

Mary Killelea: Alright. So I'm super anxious for everyone to learn about your work. Can you tell us what you do and how you got started?

Dr. Nancy Salisbury: I'm a doctor. My specialty is in gynecology and I have a private practice in Lake Oswego, Oregon where I and another associate take care of patients. We also do surgery for women and I'm board certified in my field of both obstetrics and gynecology.

Mary Killelea: And how did you get started? I mean, like when you were in high school, did you always dream and know that you were going to be a doctor or was it something that like in college, how did you get started to go down this path?

Dr. Nancy Salisbury: Well, I tell you, I often ponder that question because it's been such a great career trajectory for me and in our family anyway, there were no physicians. They didn't have any doctors in my family where I said, I want to do that. So to my mother's credit, she exposed us to a lot of different things. She exposed us to music, to dance, to sports and she exposed me to a volunteer position in a hospital in high school. I was a volunteer and most of the girls in that, you know, we were candy stripers back then. We were all women. Most of the young women that were candy stripers went on to nursing school. And I remember I was working in the hospital as a candy striper, I looked at all the positions. I loved doing it. I did it every Friday night and it ignited something in me that nothing else ever had. And yet when I looked at the difference between what the nurses did, the pharmacists and the doctors, I told my mother, I said, I want to be a doctor. And that's where it all started.

Mary Killelea: That's fantastic. And I know you've been a role model obviously to your daughter as well. So tell me about the women who come to your practice. What kind of services are they looking for?

Dr. Nancy Salisbury: I think in healthcare, women in general, we start young women start with usually family planning or contraceptive services, but just general wellness exams of just saying, I want to stay healthy, be healthy and have a strong body, mind and spirit. And they come to us to try to get help mostly with their health. And it usually starts somewhere around teens to twenties, and we take care of women through all seasons of life. I do not do obstetrics, but I used to. So, we take care of women all the way into their late eighties and nineties.

Mary Killelea: How did you hone in on this specialty?

Dr. Nancy Salisbury: To be an OBGYN doctor obstetrics and gynecology is to sort of comprehensively take care of women through childbirth and all health and surgical specialties. And going through med school, I think one of the most daunting decisions you make as a young doctor is what am I going to do? What kind of doctor am I going to be? And in medical school, I really didn't know what I wanted to do, but I knew once I did surgery in medical school and I was gifted surgery that I said I want to be a surgeon. And as a sidebar, when I tried to be an orthopedic surgeon, I remember asking them if I could do that. Back when I did it in the eighties, they said I was too small, too petite, too feminine to be an orthopedic surgeon. And women weren't going into general surgery much. So, it was really the main surgical field I could go into at the time that I was being educated. In hindsight, it was a privilege because after I saw the birth of the first baby, I went that's something I want to do. So the beauty of birth, the combination of surgery and being able to empower and take good care of women. I also had a formative experience as a patient. I remember as a 16-year-old, I had a physical exam once done by a gentleman much my father's age and he probably had eight different sheets all over my body. I felt very self-conscious. And I remember at the end of that exam thinking I could have done better than that to put me at ease. So, there were a few things where I thought I think I could take better care of women than that. And then the combination of surgery and birth and putting it all together made it a specialty that I was attracted to.

Mary Killelea: What's the biggest misconception women have about themselves and their own bodies?

Dr. Nancy Salisbury: If I think about that question, I do have the privilege of visiting with women every day. You know, I see 15 to 20 women a day and I have for almost 30 years, so I get to listen to women. And I think what strikes me the most about women is that as a whole, women don't feel like they're enough. I initially thought we're all worried about our weight, but even women that are beautifully made and wonderful figures find a way not to feel good enough in another area of their life. So, I think striving for perfection is an illusion and that I think I hear it from women all the time that in one or the other area in their lives, they just don't feel like they're enough for somebody or themselves. That's what strikes me. That's what I like to help teach women that we can feel like we're enough, just the way we are.

Mary Killelea: As you know, talking about vaginas has been taboo in the past and I think the way that you educate women about their bodies and their options for health and aesthetics is so empowering. What do you wish for women that comes to their bodies?

Dr. Nancy Salisbury: This has taken a while through my career to realize that this part of the female body has a certain stigma to it that isn't necessary. I think genitals in general, people kind of shy away from and are to talk about it and yet it's just another part of our anatomy. We don't have a problem talking to a doctor about ears and noses and faces and mouths, but when we start talking about our vagina or a bladder or something is it or bowels or any of that, people feel ashamed and shut down. And my goal for women is to be able to talk openly about whatever is on their mind about their bodies without apology and not to be embarrassed. And if I can put them at ease with their own body, maybe they can feel at ease with their body with somebody else.

Mary Killelea: Now, I know your website does a great job of explaining the different services that you provide and you're big on YouTube and you've got YouTube videos on all sorts of different services, but can you talk to a vaginal rejuvenation and the different services around that just for the audience that might not be familiar with these type of services?

Dr. Nancy Salisbury: Sure. And this topic of vaginal rejuvenation is always a bit controversial because people say it isn't necessary or they trivialize it or they think it's pop culture. When in reality, to rejuvenate someone, I just gave a lecture on this the other day, is to just make it new, to make it feel new again. And vaginal rejuvenation is descriptive. It's just to say, hey, I want something to feel better that has been affected by aging or childbirth. And unapologetically, I think women are allowed to say something doesn't feel right and I'd like it to feel better. So, I think for the women in the audience out there, I'm sure you've all seen the bumper sticker that says, well, behaved women don't make history. I think sometimes you have to have an idea that goes just a little bit against the grain if you're going to make an impact in life or a splash. I have a strong belief that women's voices around this particular subject deserve to be heard. And yet, it's still somewhat minimized. And yet, I was willing to step out and say, no, that is not true. This should not be minimized. It's relevant. And women need help in this area. But I can tell the audience that it has not been an easy march or is it popular to be that woman trying to go a little bit against the grain of the general medical community. And I still feel that way some, but it's changing ever so slowly. But to rejuvenate the vagina is to say, my vagina's changed because of some event, whether it be a traumatic event. I mean, it could be something as egregious as a rape. It could be childbirth. It could be a relationship that didn't go well and you want to start over in your life. There's a lot of reasons to want to make something new again, just like turning the page. And I think if our anatomy has been affected by whatever we've been through, we're allowed to get a do-over.

Mary Killelea: And also in your clinic, you offer services around hormones and balancing and just women's health care in general. What are some of the services within that segment that I want to make sure the audience knows that you offer?

Dr. Nancy Salisbury: Yeah, I think hormones are mysterious to women and men. I think it's one of those things in our life that affects us, how we feel, our personality. And in a woman's life, there's so many passages we go through where hormones fluctuate. One is puberty, obviously. One is childbirth, pregnancy. One is menopause. And so, through each of these passages, the hormones are fluctuating. And sometimes women and people need help with how to handle them when they're a little too extreme. So, whether it be PMS in adolescence, whether it be postpartum depression, whether it be the hormonal fluctuations of pregnancy, could be menopause where women don't know if they need hormones or not. I don't think it's real clear cut to all of us when we know whether we need something. So, to have a sideline coach around what's normal, what isn't normal? Is there help? Should I take help? All those things. That's one of the areas we help women navigate their lives.

Mary Killelea: Well, that's awesome. So being a doctor requires you to have enormous responsibilities. And of course, being a business owner has its own set of responsibilities and challenges. What made you decide to take on the additional challenges of opening up your own practice?

Dr. Nancy Salisbury: Well, Mary, that was not an easy decision for a physician, because in general, as physicians were not trained to run businesses. That's not part of our training. We're trained to care for people. But I had been in practice for over 20 years, where I wasn't in charge of my own business and finances and profit and loss statements and employee management. And I felt that the care that I was delivering was somewhat impacted by the people managing me. And so, some of the choices I had to make or wanted to make were affected by the fact that I was under a broader management system. And I decided that for me to take off and do certain aspects of my career that I felt passionate about, I had to be in charge of it, because somebody else might tell me I couldn't do it. So, I wanted to, if you will, I wanted to drive the bus so I could go any direction I wanted to.

Mary Killelea: Is there a way to say you have a typical day? I mean, I imagine that you never have two days that look the same. But what are some of the roles and responsibilities that you do from day to day?

Dr. Nancy Salisbury: I would say since I've owned my own business, and since I've given up at Structrix, my typical day is a little bit different. But today, in my day to day walk, I try to keep my work to four days a week. I try to not work three days a week. So, I have a reasonable work life balance, and I have time for health care. My work day starts somewhere, depending on whether it's a surgery day, between 7:30 and nine in the morning. I get home between six and 6:30 at night, four days a week. And then I have all responsibilities. So, I'm always available to patients after hours by phone. But that isn't too laborious. It's a privilege, actually. It doesn't affect my quality of life. I don't hear from people that often. But as a physician, our responsibility is to be available to our patients, which is some of the stress that doctors feel for the other industries where you can actually turn your phone off. We can't do that.

Mary Killelea: So that might fall in one of the cons. I mean, I guess you look at it as a pro, because you feel it's part of the service or responsibility that you have as a doctor. But what are some of the pros and cons of being a doctor or business owner?

Dr. Nancy Salisbury: I think a positive, being a physician is, like I said, what a privilege it is to be such an important person in people's lives. And they give us their personal information so freely and so trustingly that it's an honor. It really is being an honor. And I get to do amazing things. I've learned how the entire human body works. The first day I got into med school, I thought I'd won the lottery because I got to find out every part of the human body and diseases and treatments. So just having access to that knowledge to me, someone who loves to learn was such a privilege. I got taught surgery, which is in everybody that gets to go into the human body and work in it, take things out, sew things up. And it's just an amazing craft, if you will, that not everybody gets to do. The con side is, and it's an enormous stress to carry that kind of responsibility. After someone does an operation, when I do surgery, I think of those people for weeks. I don't stop thinking about them until I know they're okay. I carry them with me all the time. Or if there's a surgical complication, we take it very hard. They happen. We get through them. But it takes its toll. In childbirth, when we lost babies or there was a birth defect, that takes its toll emotionally on a physician terribly. It's a terrible burden sometimes to see tragedy that people don't touch. And yet watching a birth is the opposite side of that, the exhilaration of birth. So, there's a cost to how many years of training it takes. If I'm ever playing Trivial Pursuit, people go, gosh, you don't know much about anything but medicine. That's right. Because all I ever did, I lost a decade of my life studying. I never had a television. I never read a newspaper. So there's a certain part of my life that I gave up to become a doctor. So there's some sacrifice.

Mary Killelea: Technology has evolved so greatly over the last decade, two decades. It's constantly evolving. What has technology done or enabled you to do for your patients today that you couldn't have done in the past?

Dr. Nancy Salisbury: Well, first of all, the access to information. In med school, we realized that first we had to memorize everything. If we couldn't remember what branch or what artery was in what order, we had a problem. We had to go find a book. And now, if for any reason we're lacking information, the computer is not very far away. We can look up medications. We can look up differential diagnoses. There are all sorts of things at our fingertips that need to be available. If I can't remember the side effects of a medication, I can look it up immediately. So, I think the tremendous surge of access to information so quickly has made practicing medicine in a way less stressful. It used to be you had to remember everything. Now it's just right there at our fingertips. On the other hand, there's so much more information, it would almost be impossible to know everything. So, I think it's been a good thing.

The other is electronic medical records. I watched that change. We went from paper to computers. In some ways, it's been positive that you have access to information quickly if you need to, if you can get into a patient's chart that was at the hospital from your office. On the other hand, we used to be able to dictate and not even worry about a chart. We never saw the charts. We just sort of talked into a machine and ended up in the chart. We used to be able to give verbal orders to a nurse. We were able to give them verbal orders to a nurse. Now we're not allowed to do that. Everything has to be inputted in the computer. Then surgical technology has gone through the roof since I've started practice. We used to open every woman's abdomen to do a hysterectomy. Now we're operating through five-millimeter ports and using robots. Very few women have a big incision on their abdomen anymore. It's been a privilege to watch that too, the boon of technology and how it's impacted surgery.

Mary Killelea: Isn't there something that you can do where you sit on a machine for incontinence or kegels?

Dr. Nancy Salisbury: We have a chair now. Again, it used to be, two, thirty years ago, women barely knew what a kegel was and we could tell them to squeeze a muscle. That was about it. I now have a chair in my office that will do 11,000 kegels in 28 minutes, just sitting on a chair fully clothed with a magnetic coil that when it moves, it creates an electromagnetic field that makes muscles contract. The innovation is astounding. Things are moving very quickly. If we see a problem, the innovators get on it and solutions appear very quickly.

Mary Killelea: That's what I love about technology is real-life improving tools like that that change people's lives. Unfortunately, there are so many women out there that still don't even know these exist or are available to them. That's, again, one of the reasons I'm so happy that you're on here as a guest because part of this show is empowering women and educating women. Have you had mentors that have helped you along the way and how did you go about building those relationships?

Dr. Nancy Salisbury: When I think of a mentor, it's an interesting term because I make it an effort now to try to mentor young women. I have a few women that have reached out to me to say, hey, I think I want to be a doctor. I spend time with them, talking to them and trying to help them just think through things when they're making decisions and seeing if they're on the right path. I didn't have a lot of that growing up. As a matter of fact, in my family, like I said, there were no doctors. When I told my parents I want to be a doctor, they tried to steer me towards nursing because it was the 60s and 70s. I would say people that stand out for me as a mentor are the chairmen of my department that believed in me. When I felt affirmed by other doctors where they would give me the nod like, you're doing a good job, they were little. The mentor relationship for me was more about just being affirmed for what I was doing and that I was doing a good job. I was starving for that. When I got it, I picked it up and I ran with it, especially from people that I respected. There was a chairman at OHSU that's nationally recognized and he said there's something special in you. I would keep doing it. Those little words I would carry with me. Another chairman in Kansas did the same thing. He said keep doing what you're doing. You're going to change the world. I remember he said that to me. I hung on to it. Sometimes it isn't just side-by-side mentoring but it's somebody believing in you and giving you a gift that you carry with you.

Mary Killelea: Do you think those gentlemen know that you kept those nuggets with you?

Dr. Nancy Salisbury: Absolutely not. I don't think they have any idea how much they impacted me. They probably thought they were just one of many. I think young people need other people to believe in them and to encourage them. I think words of encouragement are hugely important when we feel kind of lost in what direction to go. If someone sees something special in you and they tell it to you that I see that in you and you want to run with that, that's a wonderful thing to do for a young person. I hope to do that for people. When I see it, when I see talent, I try to let women know I see it in them because sometimes we don't see it in ourselves.

Mary Killelea: Yeah, absolutely. What have been some of the biggest challenges that you've faced in your career?

Dr. Nancy Salisbury: I think in medicine the first greatest challenge I had to deal with was learning how to deal with death when no one prepared me for it. When a patient dies, when a baby dies. Medicine is not a specialty where people sit down and ask you how you're doing. How did you handle that? How do you feel? It's a very lonely profession when somebody dies or a baby dies. That's a lot of resiliency to be able to understand that that's just part of the job. But it wasn't easy when I was first in early in my career as a very deeply feeling woman. I wish there had been more resources for that. If I could make a difference, I'd probably want to help medical students learn. Because when you're young, you don't usually deal with tragedy like that until you get older. But it was difficult in training. I also was a single parent for while I was going through my career. I would say it was probably one of the most difficult parts of my career was struggling being a good mother and being a good doctor at the same time.

Mary Killelea: Yeah, that's hard for any career. I can't even imagine the additional constraints and pressures you must feel as being a surgeon as well as a mother.

Dr. Nancy Salisbury: Yeah, that was very difficult. I hope there are some support systems along the way for women in business that need help and support to know how to get through it. Because mothering is its own career. But to challenge two careers, both mothering and being a physician or a business owner or whatever women want to do, it requires some incredible balance and knowing to give enough to both, but you can never give everything to both. So that was difficult.

Mary Killelea: So I think we just kind of touched on it. But is there specific advice that you would give someone looking to become a doctor or a business owner? I mean, what would you want to say, hey, first think about these three tips or these three things?

Dr. Nancy Salisbury: I think no one ever said to me when I was young was what do you want your day to look like? What does a typical workday look like for you? Or if you're thinking about a certain career, ask what your day looks like and what your career looks like and what it looks like day in and day out. I mean, I think it's way more than income. It's about job satisfaction and being able to maintain a family life if you want to, or be happily married if you want to, or if you want to be a chairman of a department, do you want to have children? Is that doable? I would sort of ask the questions about their life as much as their profession to make sure they all fit together.

Mary Killelea: What are some of the key qualities that someone must have to be successful in your business?

Dr. Nancy Salisbury: As a physician?

Mary Killelea: As a physician, yeah, and also a business owner. I mean, organization responsibilities, those are obviously obvious, but there's got to be a deeper quality that makes you a unique candidate to do your field.

Dr. Nancy Salisbury: To be a physician, you have to really be a high achieving human. You want to have to get A's. Learning has to be something that you thrive on. I think you have to be competitive. You have to want to win at the game of being a doctor. Like I want to get A's. I want to get a good grade on that test. I want to get there early. There's a certain drive that you need to get into medical school and to get through medical school because it's intense. It's very intense and yet very rewarding. But I think there's a certain ingredient you have to have or you just don't think you would make it. And simple things like showing up on time, being accountable, not cancelling on things. All of those things really matter when it comes to going to professional school.

Owning your own business, I think it's accountability to self. You have to pay taxes. You have to get your bills in on time. If you ask your employees to have a certain standard, you have to live by that standard. To be a boss means you have to live by the standards you expect from your employees. So, I think there's a great responsibility in being a boss. I enjoy it. Sometimes, frankly, I'd rather be in the lunch room chatting about recipes with everybody else. But when you're the boss, I think you have to leave them alone and let them have their fun time and kind of distance yourself and be the boss to oversee to make sure everybody's doing what they need to do. So, it is somewhat of a lonely walk being the owner of a business because you're in charge. You have to be the boss and not be one of the, you know, workers who gets to complain about the boss, you know.

Mary Killelea: Right. The buck stops with you. Yep. So, what drives your success or what is your big why in life?

Dr. Nancy Salisbury: That's a really tough question, Mary. I think it's, someone once told me that you have to have a fire in your belly for this kind of thing. I don't think motivation and passion is something someone gives you. I think it's inside of you. I think our challenge is to notice it and to believe in yourself. I think a lot of us have desire, passion, but to follow through with that has to do with a certain inner strength that you go, I think I can do this. I think I can succeed. And where that came from, I'm really not certain. I have, I don't think I was, it was really from within. Something inside of me really wanted to make a difference for women and I had the courage to do it. Maybe courage is the key.

Mary Killelea: So, what would you tell people who or women who have self-doubt? I mean, everyone has it in different degrees. So, when you're feeling challenged, but yet you know you should be at the end of success, but someone either some, you feel some external force is trying to knock you down or it's just going outside your comfort zone more than you're ever used to. What words of encouragement would you tell those people?

Dr. Nancy Salisbury: I think you have to be willing to take chances in life that may not succeed and not look at failure as the end, but just looking at if you take a chance and it doesn't work, get up and try again at something different. I mean, I think, I think we all have had times where we've tried something, it didn't work. I didn't get into medical school the first time I tried and if that had been, I always think about, I tried again the next year and it's mostly because I didn't have good mentors to explain to me what the process was like. I didn't handle it right the first time, but the second time around I gave it everything I had and had I not done that, I wouldn't be where I am today. So, I think you have to be willing to fall down a few times along the way, but if you have that inner conviction to keep going. And I also think, I don't know if it's unique to women, I listen to women more than that all day, there's this inner voice that wants to take you down and that self-doubt, that self-critic, I think we have to quiet that voice. I mean, everybody has it, but I think we have to convert that voice into an I can, I will, and get some key friends that feed that voice and I think we have to be around people that feed the side of us that loves ourselves, that can grow and flourish and if we're around people that don't feed that side of ourselves, try to surround yourself with people that empower you so when you don't feel empowered, you can lean on them.

Mary Killelea: Great advice. What are you most proud of?

Dr. Nancy Salisbury: My children. It's pretty easy to look at them and just go, wow, how did I do that? Also, I mean, they're just amazing humans and I'm just really proud to be their mother. The other thing is my surgical abilities is something I take great pride in, where I can transform someone's body with my hands and do surgery and stitch them up and put a bandage on it and say, wow, look, I did that, you know, it was great satisfaction to me.

Mary Killelea: Okay, just a couple more questions left as we turn the corner here. If you could tell your 20-year-old self one thing, what would it be?

Dr. Nancy Salisbury: I'd probably say don't worry what you look like in a bathing suit. I wouldn't I love to go to a beach in my 20-year-old body.

Mary Killelea: I know, right.

Dr. Nancy Salisbury: You know, I think dare to be bold and be kind to yourself and forgive yourself mistakes, but I think that, you know, we have so much doubt, self-doubt in our 20s that it really isn't necessary. So I think probably embrace yourself, you know, celebrate yourself. Probably what I tell my 20-year-old self.

Mary Killelea: That's a perfect place to end. Thank you so much for being my guest today. Where can women find out about you, connect with you?

Dr. Nancy Salisbury: I have a website, drngyn.com, drngyn.com. I have a clinic in Lake Oswego, Oregon, phone number 503-908-1646. It's Dr. Nancy Salisbury, better known as Dr. Angie Williams.

Mary Killelea: Wonderful. Thank you, Nancy.

Dr. Nancy Salisbury: Thank you, Mary.

Mary Killelea: Thanks for listening to the episode today. It was really fun chatting with my guests. If you liked our show, please like it and share it with your friends. If you want to learn what we're up to, please go check out our website at 2bbolder.com. That's the number two, little b, bolder.com.