HRV, Doctoring, and Entrepreneurship

Guest post by Josh Emdur. Josh is a board-certified Family Medicine physician (practicing for over 10 years) and 2:53 marathoner with a passion for providing personal, high value medical care that embraces the use of technology.

​It was April 12, 2017, 5 days out from the 2017 Boston Marathon when my coach (Adam St. Pierre Carmichael Training Systems) first introduced me to HRV4Training.

As a physician, runner, and gadget geek I was immediately intrigued by this quantitative metric of stress. Both personally and professionally my stress over the past ten years of life has been both manageable and predictable. My professional time was spent working shifts at my local hospital. While my shifts were often stressful, I was able to leave my stress where it belonged (at work). When I was off I was off, and could sleep well knowing that my partners would provide great care for the patients I had handed off to them. After a tough shift, I would intuitively know that my body and mind needed rest. Easy runs after hard shifts were the norm.

As life would have it, one month after learning about HRV4Training my career took a dramatic change. I was laying awake at 3AM at the hospital when I came across a posting on my Facebook feed asking if I would be interested in founding an online primary care practice especially for runners called SteadyMD. I was immediately hooked and found myself on a plane bound for St. Louis to meet with the founders of the company. The day after my meeting in St. Louis I embraced entrepreneurship and began monitoring my HRV.

My life of predictable stress as a physician, parent, and athlete quickly morphed into a life of unpredictable stress by adding the additional role of startup entrepreneur. Many of my friends are founders of companies. For years they have shared their stresses with me, but it wasn’t until recently that I could relate to what they had been going through.

Challenge has always been my main motivator in life. Easy tasks don’t engage me. Medical school, mountaineering, big wall climbing, backcountry skiing, marathons, and raising a family have all been my objectives. Starting a business is hands down the hardest thing I have done to date.

As an entrepreneur my work is no longer confined to the walls of the hospital. My sleep has become more erratic with late nights responding to emails followed by early mornings waking with epiphanies and excitement. Despite my increased workload, balance is of paramount importance to me. Falling into the trap of neglecting family, career, and workouts is not an option. HRV tracking has been a useful tool to achieve this balance.

Metrics aside, spending 60 seconds every morning checking HRV provides a valuable opportunity to build self-awareness. Learning to listen to your body is an invaluable skill. I use the HRV testing interval as a daily ritual to check in with myself and simply be mindful of my situation.

My HRV consistently drops after busy hospital shits, nights of restless sleep, and periods of consistent hard training. As a runner I train with heart rate and power. Many argue that these metrics are inferior to pacing based on perceived exertion. I agree that self-awareness is the ultimate measure, but for most people objective quantitative metrics are a means to help better understand ones body.

Since partnering with SteadyMD I have found utility in using HRV4Training as a means to coach my patients to a healthy stress/rest balance. In the recent book Peak Performance by Magness and Stulberg the authors present a growth equation that is defined as growth=stress+rest. HRV is a great way to quantify the rest portion of the equation. HRV provides me as a physician a window into my patients’ progress towards growth.

For years I have seen athletes over train and suffer the consequences of deteriorating performances, injuries, and even development of chronic medical conditions.

My goal at SteadyMD is to keep my patients healthy and performing to their potential. To learn more about my innovative primary care practice for runners that provides you access to me from the convenience of your Smartphone go my website www.steadymd.com/hrv or follow me on Facebook, Instagram, or Twitter @steadymdrunning