Healing Through Trauma-Informed Practices Supporting Doctors and Clinicians with Dr. Sadie Elisseou Episode 164

Welcome to another episode of the Sustainable Clinical Medicine Podcast!

Dr. Sadie Elisseou, a primary care physician in the US VA system in Boston, Harvard and Boston University educator, and trauma-informed care expert, discusses her path into medicine and how working with veterans led her to trauma-informed practice after noticing patients’ discomfort during routine exams. She explains trauma-informed care as creating physical and psychological safety through mindful nonverbal communication, transparent agendas, permission-seeking, and reducing power dynamics, with examples such as thyroid exams and avoiding phrases like “for me.” She highlights VA onboarding on military experience, notes higher ACE rates among volunteer-era veterans, and describes how staff behaviors and clinic environments shape patient stress. The conversation also covers clinician wellbeing and burnout prevention via self-care, team debriefing, boundaries, therapy access, and time-management strategies like scheduled breaks, batching tasks, finishing notes between visits, and structuring varied work roles.

Here are 3 key takeaways from this episode:

1. Trauma-Informed Care Creates Safety Through Small, Intentional Actions: Physical and psychological safety in healthcare settings comes from deliberate practices: positioning yourself at the patient's side (not behind them), asking permission before examinations, explaining what you're doing and why, ensuring clear exits, and avoiding phrases like "for me" that emphasize power dynamics. These don't take extra time but transform the patient experience.
2. Shifting from "What's Wrong With You?" to "What Happened to You?" This mindset shift moves from blaming difficult patient behaviors to approaching them with curiosity and compassion. When patients are agitated or angry, it's often rooted in pain or fear. Co-regulation techniques—modeling calm through your own presence and validating their experience—can help both you and the patient settle into a more productive interaction.
3. Preventing Burnout Requires Structural Self-Care and Intentional Boundaries: Sustainable practice isn't about luxury spa days—it's about taking mindful breaths between patients, batching tasks by day (clinic on Mondays, administrative work on Thursdays), finishing notes immediately after appointments, scheduling regular breaks throughout the month, and setting non-negotiable hard stops. Varied work schedules that incorporate teaching, research, or consulting can also prevent monotony and reignite passion for the work.

Meet Dr. Sadie Elisseou:

Sadie Elisseou, MD is a practicing physician, faculty at Harvard Medical School, and leading subject matter expert in trauma-informed care who teaches clinical healthcare professionals how to provide top-quality care to trauma survivors and consults for organizations that wish to cultivate wellness and help team members engage through stressful times.

Connect with Dr. Sadie Elisseou:

🌐 Website https://www.sadie-elisseou.com/

LinkedIn  https://www.linkedin.com/in/sadie-elisseou/

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