Stimulus - Learn Tools to Crush It in Your Medical Career

AI has moved into medical practice faster than almost anything in modern medicine. As clinicians lean on it more for documentation and clinical decisions, the pitfalls are getting harder to ignore. AI is a powerful bedside tool. It also has myriad ways to screw you. In this episode, emergency physician and clinical AI trainer Sam Ashoo breaks down how to use AI to help you think, how to frame questions to get answers you can trust, what AI scribes are most likely to leave out of the HPI, why clicking "accept" on an AI tool's business associate agreement can put your license at risk instead of protecting it, and how to keep this technology an adjunct rather than a crutch that harms you and your patients. Guest Bio: Sam Ashoo, MD, is an Emergency Physician and Medical Educator bridging the gap between bedside care and AI. As a clinical informaticist, I explore the future of medicine through a pragmatic, skeptic-first lens to separate clinical signal from hype. He writes at Ashoo Review . We Discuss: What training a medical AI looks like from the physician side Which specialties AI is most likely to reshape, and why procedural fields are safest for now The biggest misconception clinicians have about AI: it won't tell you what it can't do Why omissions, not hallucinations, may now be the bigger risk What AI scribes most often leave out of the HPI, including mental health cues and medication changes Why AI documentation turns you into an editor, and why most of us aren't good ones Treating AI like a smart intern, not the attending, and the rare cases where the reverse makes sense UpToDate vs. OpenEvidence: human-curated knowledge vs. machine-synthesized answers The trap of asking AI a question you can't judge the answer to What "not software as a medical device" means for using OpenEvidence in the ED One case, six LLMs, and how changing the question flipped the answer from "send her home" to "cath lab" A live OpenEvidence test: is a D-dimer reliable five days after symptom onset? Whether to document AI use, and whether your searches are discoverable in court Why "I can just ask AI" doesn't replace a fund of knowledge How med students, new NPs, and experienced attendings should each use AI AI scribe consent: the two steps most clinicians skip, and why all-party consent states matter Why you shouldn't upload ECGs or X-rays for AI interpretation The HIPAA business associate agreement checkbox that can put your license at risk Mentioned in this episode: Doctoring Done Well | Bite-Sized Wins Every other week, a few minutes of career-elevating insight delivered straight to your inbox. The Doctoring Done Well Newsletter is never lame, never spammy, and always fresh. Sign up for our Newsletter 5 Free Tools To Make Medical Practice Easier Scripts for your least favorite conversations. The quick and dirty guide to calling consults. A 10-minute "Driveway Debrief" to switch off from work. My favorite documentation templates. Step-by-step guide for delivering the news of death. Free Resources Link Rob's book now in audio, print, and e-reader versions Rob's book, Supranormal: A Field Guide for the Impossible Job is now available as an audiobook, narrated by Rob. Find the audiobook, print, and ebook versions at the link below. Get Supranormal on Amazon Get Out On Time The Out-On-Time Course gives you the tools to complete your charts on shift, manage overwhelm and interruptions, and create fast, focused, kickass notes, so you can stay out of chart debt and get home on time. Self-paced. 12 hours AMA PRA Category 1 CME. Learn More About The Out-On-Time Course

What do you do before your feet hit the floor? I don't mean coffee or exercise. I mean the minutes before you get out of bed. My guest, Tim Thomas, calls the first five minutes after waking and the last five before sleep the two golden five minutes. Most of us spend them on our phones or let them pass without a second thought. In this episode, we cover how to use breath to change your state, keep worry from hijacking your attention, and build an easy on-ramp so the habit survives a bad morning. We also get into breathing through your thumb and what a pot of coffee taught an Army platoon about ego. Guest Bio: Tim Thomas is a former professional fighter and Special Forces soldier who has spent over a decade working with veterans, professionals, athletes, and everyday people to improve sleep, resilience, and nervous system health. He is also a survivor of PTSD, pharmaceutical addiction, alcohol addiction, and family breakdown. Along the way, he has raised over 1.3 million dollars for charities close to his heart and founded his company Breathwork in Bed . A platform focused on natural and immediate sleep improvement. We Discuss: The Golden Five Minutes Using Breath to Change Our State Making a Morning Routine Easier to Do Why Starting the Day With Connection Matters How to Make Gratitude Something You Actually Feel How Ego is a Wall but When We Let it Down, It Becomes a Bridge Why We Keep Looking Outside Ourselves for Stability and Satisfaction How Preparing Coffee for Tim’s Special Forces Unit Had an Unexpected Effect Worry Steals Processing Capacity Turning the Phone Against the Phone Sleep Is the Soil Mentioned in this episode: Rob's book now in audio, print, and e-reader versions Rob's book, Supranormal: A Field Guide for the Impossible Job is now available as an audiobook, narrated by Rob. Find the audiobook, print, and ebook versions at the link below. Get Supranormal on Amazon 5 Free Tools To Make Medical Practice Easier Scripts for your least favorite conversations. The quick and dirty guide to calling consults. A 10-minute "Driveway Debrief" to switch off from work. My favorite documentation templates. Step-by-step guide for delivering the news of death. Free Resources Link

Interruptions are, in a way, the currency of emergency medicine. But many of them may be making patient care worse rather than safer. EKGs are a perfect example: physicians may be interrupted thousands of times each year so that every tracing receives immediate attention, even when the overwhelming majority do not represent an emergency. Protecting physician attention doesn’t have to come at the expense of quickly identifying patients who need immediate intervention. In this episode, we explore how one emergency department dramatically reduced unnecessary EKG interruptions, why a 10-minute interpretation window may be safer than reflexively interrupting physicians, and how local data helped turn a counterintuitive idea into departmental practice. We also examine how asynchronous communication, protected workspaces, nursing partnerships, and a different way of thinking about attention can create a safer and more intentional emergency department. Guest Bio: Dr. Jake Zadra is a board-certified Emergency Physician and the current Chair of the Department of Emergency Medicine and Diagnostics at St. Mary's Hospital in Janesville, WI, where he also serves as Vice Chief of Staff. He completed medical school (’18) and EM residency (’21) at the University of Wisconsin, where he served as chief resident. Outside of medicine, he’s a live music enthusiast, enjoys slipping Lord of the Rings references into everyday conversation, and spends as much time outdoors as possible. He remains one of the few Emergency Physicians with no interest in ultramarathons or BASE jumping. We Discuss: Why Every EKG Doesn’t Need to Be an Emergency The Cost of 7,000 Interruptions to Find Two Unflagged STEMIs What Happens When the EKG Machine Misses a STEMI Why Fewer Interruptions May Lead to Better EKG Interpretation How the Workflow Handles Gray-Zone EKGs Rethinking the 10-Minute EKG Rule Using Local Data to Build a Safer Workflow How an EKG Drop Zone Keeps Deferred Reviews From Getting Lost How a Quieter Workspace Reduces Drive-By Interruptions Why Not Every Interruption Deserves the Same Response How Secure Chat Can Become an Asynchronous Inbox Why Nurses Need Protection From Interruptions Too How Making Interruptions Visible Creates Buy-In Mentioned in this episode: Rob’s Book: Supranormal Supranormal: A Field Guide for the Impossible Job, tackles the parts of being a doctor that medical training leaves out, with practical tools for navigating conflict, overwhelm, burnout, and the sustained complexity of medicine, so you can build a career that is both sustainable and fulfilling. Get Supranormal Get Out On Time The Out-On-Time Course gives you the tools to complete your charts on shift, manage overwhelm and interruptions, and create fast, focused, kickass notes, so you can stay out of chart debt and get home on time. Self-paced. 12 hours AMA PRA Category 1 CME. Learn More About The Out-On-Time Course Rob's book now in audio, print, and e-reader versions Rob's book, Supranormal: A Field Guide for the Impossible Job is now available as an audiobook, narrated by Rob. Find the audiobook, print, and ebook versions at the link below. Get Supranormal on Amazon

Getting sued, or even just the fear of it, is one of the greatest hidden drivers of physician stress, burnout, and career dissatisfaction, yet almost no one teaches doctors how to survive it. A malpractice lawsuit can shake your confidence, challenge your identity, and strain your relationships long before you ever step into a deposition. The good news is that preparation, practice, and the right mindset can transform litigation from an overwhelming threat into something you can navigate with confidence. In this episode, we explore what every physician should know about medical malpractice lawsuits and malpractice litigation,, how to navigate a deposition, the conversations that can sabotage your defense, and the emotional toll of being sued, along with practical ways to prepare before you're ever named in a lawsuit. Finally, we share the tools, resources, and hard-earned lessons that help doctors protect their careers without losing themselves in the process. Why getting sued changes the way physicians practice medicine long after the case is over. How preparation can take you from feeling like you're on the chopping block to walking into a deposition with confidence. What you should and shouldn't say while a malpractice lawsuit is ongoing. Why understanding plaintiff attorneys' tactics makes you a stronger defendant. The communication mistakes that can undermine your credibility. How to prepare for a deposition. Why shame and isolation can make malpractice harder than the lawsuit itself. Practical ways to protect your confidence, career, and mental health after being sued. Resources Mentioned Books When Good Doctors Get Sued How to Survive a Medical Malpractice Lawsuit - Eileen Brenner Depositions Are Trial Podcasts Doctors and Litigation: The L Word Season 1: Approaching D-Day Season 3: The Educated Defendant Courses & Tools LEAP (Litigation Education and Performance). Use the code STIMULUS100 for $100 off. Guest: Dr. Gita Pensa is an emergency physician, educator, and litigation performance coach who helps clinicians navigate malpractice lawsuits with greater confidence and less emotional distress. Through speaking, coaching, and her LEAP (Litigation Education and Performance) courses, she works with healthcare organizations, insurers, defense attorneys, and physicians to transform how clinicians experience litigation. Mentioned in this episode: Distilled Kickassery Every Other Saturday Sign up for our Newsletter The Out-On-Time Course Built for emergency clinicians who are tired of chart debt and getting derailed by interruptions and overwhelm. Learn practical, real-time documentation and shift-efficiency strategies to finish your shift and actually leave on time. Learn More About The Out-On-Time Course

When another person is upset or angry, our instinct can be to help them lower their emotional temperature by saying something like, "Just calm down," or, "Relax," or, "Take a breath," or, "Look at the facts." However, saying those things when the other person is in the heat of the moment can have the reverse effect from what we were hoping for. The reason is simple: People who do not feel heard are not ready to hear solutions. In this episode, we explore the communication strategy of valence matching, why it works at both a psychological and neurological level, and how it can transform interactions with patients, colleagues, consultants, and loved ones. Finally, we show how a few seconds of emotional attunement can save minutes, or even hours, of unnecessary conflict. 💡 Get Rob's Book Supranormal: A Field Guide for the Impossible Job. Tools, mindsets, and communication techniques so you don't get eaten alive by a job you're good at. Buy it on Amazon We Discuss: Why "Calm Down" Rarely Calms Anyone The Simple Idea Behind Valence Matching Why the Brain Rejects Logic During Conflict Content vs Process in Conversation Why You Should Match First, Then Move Small Words That Create Big Differences How to Effectively Thank Patients for Waiting How Emotional Connection Shapes Clinical Encounters Why an Excellent Clinician Had Consistently Low Patient Satisfaction Scores Mentioned in this episode: 🧭 UnBurnable | Career Longevity, Burnout Prevention, Self Mastery This course will teach you the hidden anti-burnout curriculum. Begins Sept 15, 2026. CME available. The UnBurnable Course Doctoring Done Well | Bite-Sized Wins Every other week, a few minutes of career-elevating insight delivered straight to your inbox. The Doctoring Done Well Newsletter is never lame, never spammy, and always fresh. Sign up for our Newsletter

The quality of our attention shapes every interaction we have, yet listening is often the first skill sacrificed when pressure, technology, and time constraints take over. Most clinicians spend years learning what to say, while spending little time learning how to effectively listen. In a healthcare system dominated by tasks, metrics, and efficiency, the ability to slow down and create genuine presence may be one of the most valuable skills we can cultivate. In this episode, we explore why listening is both a mindset and a practical skill, how to listen more effectively, how small pauses can transform patient care, and why mindfulness extends far beyond meditation. Finally, we examine simple practices that help clinicians stay present, focused, and connected even during the busiest days. 💡 Get Rob's Book Supranormal: A Field Guide for the Impossible Job. Tools, mindsets, and communication techniques so you don't get eaten alive by a job you're good at. Buy it on Amazon Guest Bio: Dr. Ronald Epstein – internationally recognized family physician, palliative care physician, educator, researcher and writer -- has devoted his career to understanding and improving communication and mindfulness in medicine. His scholarly articles have revolutionized doctors’ view of their work, and his 2017 book, Attending: Medicine, Mindfulness and Humanity shows how becoming mindful can transform healthcare, build strong connections between doctors and patients, and help clinicians flourish while providing the best care for patients. You can find Ron at www.ronaldepstein.com and learn about his workshops at www.mindfulpracticeinmedicine.com We Discuss: Why listening may be the most important clinical skill we rarely teach The 90-second habit that changes patient encounters What a near-missed surgical complication reveals about hierarchy The difference between spending time and being present The difference between reacting and responding A simple doorknob practice for transitioning between patients How "Find Your Feet" helps restore presence during stressful encounters Why slowing down often improves performance What mindfulness looks like beyond formal meditation Mentioned in this episode: Doctoring Done Well | Bite-Sized Wins Every other week, a few minutes of career-elevating insight delivered straight to your inbox. The Doctoring Done Well Newsletter is never lame, never spammy, and always fresh. Sign up for our Newsletter The Out-On-Time Course Built for emergency clinicians who are tired of chart debt and getting derailed by interruptions and overwhelm. Learn practical, real-time documentation and shift-efficiency strategies to finish your shift and actually leave on time. Learn More About The Out-On-Time Course UnBurnable Registration is Now Open We took the highest yield tools from our 1:1 coaching and created a community-based course with docs who get it and get you. The UnBurnable Course

Your ability to earn income is your most valuable financial asset. Physicians spend years protecting patients, building careers, and accumulating assets, yet many discover too late that the insurance designed to protect their income is full of loopholes, exclusions, and traps. Disability insurance sounds boring until the moment someone needs it, and then it becomes one of the most emotionally and financially consequential topics in medicine. In this episode, we explore the hidden realities of physician disability insurance, why employer policies often fail when doctors need them most, and how to think strategically about protecting future income before health problems appear. We also walk through what physicians should do when filing a disability claim, and how to avoid sabotaging the process from the very beginning. 💡 Get Rob's Book Supranormal: A Field Guide for the Impossible Job. Tools, mindsets, and communication techniques so you don't get eaten alive by a job you're good at. Buy it on Amazon Guest bio: Matthew Wiggins is the founder of Doc Insure and a leading educator in physician disability insurance. Since 2003, he has helped more than 15,000 doctors understand and secure income protection, while pioneering a faster, online-first way for residents, fellows, and attendings to compare personalized disability policies. Through Doc Insure, Matt makes a confusing and often overlooked topic practical, transparent, and easier to navigate so physicians can make informed decisions about protecting their future earnings. Matt and his crew will give you a quote on disability insurance through this link . Or you can set up a call to chat with them directly here. We Discuss: Why most employer disability policies leave physicians underprotected How true own-occupation coverage protects a physician’s specialty income Why physicians dramatically underestimate their chances of becoming disabled The different disability risks facing procedural and cognitive specialties Why disability claims often become adversarial and difficult to navigate How detailed occupational documentation strengthens disability claims Why income documentation determines the value of a disability payout How understanding a diagnosis improves the strength of a disability claim Why filing timing can affect whether benefits are approved and when payments begin Why buying disability insurance during residency protects future insurability Mentioned in this episode: Get Out On Time The Out-On-Time Course gives you the tools to complete your charts on shift, manage overwhelm and interruptions, and create fast, focused, kickass notes, so you can stay out of chart debt and get home on time. Self-paced. 12 hours AMA PRA Category 1 CME. Learn More About The Out-On-Time Course UnBurnable Registration is Now Open We took the highest yield tools from our 1:1 coaching and created a community-based course with docs who get it and get you. The UnBurnable Course Doctoring Done Well | Bite-Sized Wins Every other week, a few minutes of career-elevating insight delivered straight to your inbox. The Doctoring Done Well Newsletter is never lame, never spammy, and always fresh. Sign up for our Newsletter

Medicine gives you a map. Pre-med, med school, residency, attending. Step by step, no shortcuts. Then one day, the map disappears and you’re there asking, “Now what?” In this episode, Dr. Mizuho Morrison and I dig into what happens after training, when fulfillment, identity, and control are no longer prescribed. We talk about nonlinear careers in medicine, from part-time clinical work and motherhood to podcasting, entrepreneurship, leadership, and walking away from roles that no longer fit. We also get into what happened when Mizuho wore a continuous glucose monitor during emergency department shifts, and what it revealed about stress, cortisol, and the real physiologic cost of the job. This is a conversation about agency, experimentation, and ownership, and how to build a medical career that actually works for your life, not just your training. 💡 Check out our Free Resources specifically designed to address pain points in medical practice💡 Guest Bio: Dr. Mizuho Morrison is a board-certified emergency physician in Southern California and CEO of EM:RAP. A graduate of the Los Angeles County + USC residency program, she has worked in both academic and community emergency medicine and has been a major voice in EM education for more than a decade. Miz was one of the first female EM podcasters, helped launch multiple EM:RAP programs, served as Editor-in-Chief and Senior Medical Director at Hippo Education, and co-hosted Essentials of Emergency Medicine. She is also an entrepreneur and cofounder of 3MD, Three Mommy Doctors, a medical device company that reimagined first-aid kits for kids. She lives in Orange County with her two children. We Discuss: The Train Track Problem in Medical Careers Fulfillment Is Not One Standard Career Shape Seasons, Experiments, and Knowing When to Move On Stress, Cortisol, and the Cost of Shift Work Begin Before You Feel Ready Reclaiming Agency in a System That Keeps Asking for More Mentioned in this episode: Supranormal: A Field Guide for the Impossible Job Rob's book is for anyone doing high-stakes, human-facing work who's ever thought I wasn't trained for this. Built from 20 years in emergency medicine and thousands of hours coaching physicians, Supranormal delivers the tools, mindset shifts, and communication techniques that don't show up on any board exam, but make all the difference in how you perform, connect, and build a career worth keeping. Get Supranormal on Amazon Doctoring Done Well | Bite-Sized Wins Every other week, a few minutes of career-elevating insight delivered straight to your inbox. The Doctoring Done Well Newsletter is never lame, never spammy, and always fresh. Sign up for our Newsletter UnBurnable Registration is Now Open We took the highest yield tools from our 1:1 coaching and created a community-based course with docs who get it and get you. The UnBurnable Course

It’s not uncommon for hospitals to provide clinicians with scorecards. While they may seem like a judgment of your quality of work, scorecards rarely provide data that will lead to flourishing in your career. But what if you made your own scorecard, filled with things that were important to you and fully within your control? If you nailed one of those each day at work, what would your experience be like? In this episode, we explore what happened when Dr. Erin Broderick, a participant in the Unburnable Course, stopped using the hospital’s scorecard as her main definition of success and created a more personal one instead. Erin talks about how she took a new approach to patient satisfaction surveys, one that has eliminated nearly all the stress and distress associated with them. Finally, we look at how intentional practices during and after a shift made Erin’s work feel joyful and sustainable. 💡 Check out our Free Resources specifically designed to address pain points in medical practice💡 We Discuss: Measuring success with a personal scorecard A post-shift routine that closes the day Closing open loops A novel approach to patient satisfaction surveys Letting go of metrics that don’t serve you Scheduling recovery during the shift Extending intentionality beyond the hospital Mentioned in this episode: Doctoring Done Well | Bite-Sized Wins Every other week, a few minutes of career-elevating insight delivered straight to your inbox. The Doctoring Done Well Newsletter is never lame, never spammy, and always fresh. Sign up for our Newsletter Supranormal: A Field Guide for the Impossible Job Rob's book is for anyone doing high-stakes, human-facing work who's ever thought I wasn't trained for this. Built from 20 years in emergency medicine and thousands of hours coaching physicians, Supranormal delivers the tools, mindset shifts, and communication techniques that don't show up on any board exam, but make all the difference in how you perform, connect, and build a career worth keeping. Get Supranormal on Amazon UnBurnable | Our Cohort-Based Burnout Prevention and Cure Course We took the highest yield tools from our 1:1 coaching and created a community-based course with docs who get it and get you. The UnBurnable Course

If you have ever lost it mid-shift, frozen when you should have acted, or spent the next two weeks asking yourself what's wrong with me , you already know what character assassination feels like. In this episode, we break down a simple and effective reframe that interrupts the self-flagellation shame spiral without making excuses or lowering standards. You will learn how to move from why did I to, of course , how to give yourself a legitimate and hard-earned break, and why self-compassion is not softness but one of the most underutilized performance tools in medicine. Topics include physician burnout, self-compassion, cognitive reappraisal, shame and self-criticism, communication under stress, and physician coaching. 💡 Check out our Free Resources specifically designed to address pain points in medical practice💡 We discuss: Why self-criticism after a hard moment often hurts more than the moment itself The difference between first-order distress and second-order distress What the research on rumination and shame actually shows Why your brain treats harsh self-evaluation like a physical threat The biology of performance under load and why grit has a limit The of 'course' reframe and how to use it in real time Four steps to move from character assassination to context assessment Why suppression makes it worse, and reappraisal changes the signal Pre-shift dread and how to take the shame out of it Why self-compassion is a performance tool, not a soft skill What this reframe is not: excuses, lowered standards, or avoiding accountability How to start today with one sentence Mentioned in this episode: Doctoring Done Well | Bite-Sized Wins Every other week, a few minutes of career-elevating insight delivered straight to your inbox. The Doctoring Done Well Newsletter is never lame, never spammy, and always fresh. Sign up for our Newsletter Supranormal: A Field Guide for the Impossible Job Rob's book is for anyone doing high-stakes, human-facing work who's ever thought I wasn't trained for this. Built from 20 years in emergency medicine and thousands of hours coaching physicians, Supranormal delivers the tools, mindset shifts, and communication techniques that don't show up on any board exam, but make all the difference in how you perform, connect, and build a career worth keeping. Get Supranormal on Amazon The Out-On-Time Course Built for emergency clinicians who are tired of chart debt and getting derailed by interruptions and overwhelm. Learn practical, real-time documentation and shift-efficiency strategies to finish your shift and actually leave on time. Learn More About The Out-On-Time Course

Emergency medicine has an interruption-based workflow. There's no getting around some of that, but recurrent interruptions erode quality of care, accuracy of documentation, concentration, and ultimately the ability to leave work on time. While some interruptions are unavoidable, most are predictable and preventable. Reclaiming control over interruptions is more than a way to improve efficiency; it's about patient safety, reducing medical errors, and safeguarding your mental health. Constant task switching creates cognitive load, contributing to emergency physician burnout and compromising clinical decision-making. In this episode, we explore tactical and mindset shifts that emergency clinicians can use to reduce interruptions, enhance documentation efficiency, and avoid the hidden costs of task switching. We'll cover practical strategies for managing EKG interruptions, skillful ways to manage nursing questions, and setting boundaries all while maintaining team dynamics and patient care quality. Whether you're an emergency physician, PA, NP, or resident, these evidence-based strategies will help you work smarter, reduce stress, and reclaim control of your clinical day. Finishing emergency department shifts with a stack of charts to complete gets old fast. This chart debt also contributes to burnout. We will help you break bad habits and equip you with the skills to walk out the door unencumbered. Out-On-Time is a course for emergency physicians and clinicians that teaches shift efficiency and real-time documentation, enabling you to write fast, focused charts that bill well and are medicolegally sound. Learn More About The Out-On-Time Course We Discuss: The Cost of Interruptions in Emergency Medicine Not All Interruptions Are Urgent The Cognitive Cost of Task Switching Becoming a Non-Interruptible Clinician Deferring Without Alienating Your Team Protecting Focus at the End of the Shift Fixing the EKG Interruption Problem Asynchronous Communication That Actually Works Mentioned in this episode: Supranormal: A Field Guide for the Impossible Job Rob's book is for anyone doing high-stakes, human-facing work who's ever thought I wasn't trained for this. Built from 20 years in emergency medicine and thousands of hours coaching physicians, Supranormal delivers the tools, mindset shifts, and communication techniques that don't show up on any board exam, but make all the difference in how you perform, connect, and build a career worth keeping. Get Supranormal on Amazon

So many of our choices are shaped less by desire and more by expectation. We chase prestige, status, or recognition, only to arrive and realize we were climbing the wrong ladder. Beneath burnout and the friction, there’s often the truth that we were never pursuing what we truly wanted. In this episode, we explore the concept of mimetic desire, how it misguides our ambitions, and how to reclaim our decisions. Finally, we examine how fear of judgment and shame shape our careers more than we think, and what it takes to break free. Guest bio: Josh Russell, MD, is double board-certified in Emergency Medicine and Palliative Care. He’s held leadership roles as a Chief Medical Officer in telehealth, artificial intelligence, and urgent care systems. He’s an experienced clinician, writer, educator, and medical editor with a passion for making complex topics accessible. LinkedIn article that spurred this podcast Josh’s Website We Discuss: Mimetic Desire: Chasing What Others Want The Trap of “Should”: Internalized Shame The Concentric Circles of Stressors Finding What You Really Want The Ladder Against the Wrong Wall Actionable Reflection Practices Mentioned in this episode: The Out-On-Time Course Built for emergency clinicians who are tired of chart debt and getting derailed by interruptions and overwhelm. Learn practical, real-time documentation and shift-efficiency strategies to finish your shift and actually leave on time. Learn More About The Out-On-Time Course Doctoring Done Well | Bite-Sized Wins Every other week, a few minutes of career-elevating insight delivered straight to your inbox. The Doctoring Done Well Newsletter is never lame, never spammy, and always fresh. Sign up for our Newsletter

What if the true test of strength is focusing less on what we feel and more on what we do? In this episode, we explore a practical philosophy of action, presence, and personal agency with Dan Millman, author of Way of the Peaceful Warrior. Finally, we dig into how small mindset shifts can transform both high-stakes moments and the quiet struggles of everyday life. Guest bio: Dan Millman is a world champion athlete turned author, educator, and teacher of practical wisdom. With a background that spans competitive sports, university-level coaching, martial arts, and academic instruction, Dan brings a rare blend of physical discipline and philosophical insight to his work. Following two decades of spiritual exploration, he developed what would become known as the Peaceful Warrior’s Way, an action-based approach to living with purpose. Dan is the author of 18 books, including the international bestseller Way of the Peaceful Warrior, which was adapted into a feature film. His writings have reached millions across 29 languages and continue to influence readers around the world. We Discuss: Peaceful Warrior Philosophy in Action What We Control (And What We Don’t) Action Over Emotion The Three Rules of Wise Living The Power of Present Moment Awareness Mastery Through Deliberate Practice Purpose as a Practical Tool Growth Without Perfection Working Within Broken Systems Practicing Life Mentioned in this episode: Free Tools To Make Medical Practice Easier No fluff. Just good stuff. Free Resources Link The Out-On-Time Course Built for emergency clinicians who are tired of chart debt and getting derailed by interruptions and overwhelm. Learn practical, real-time documentation and shift-efficiency strategies to finish your shift and actually leave on time. Learn More About The Out-On-Time Course Supranormal: A Field Guide for the Impossible Job Rob's book is for anyone doing high-stakes, human-facing work who's ever thought I wasn't trained for this. Built from 20 years in emergency medicine and thousands of hours coaching physicians, Supranormal delivers the tools, mindset shifts, and communication techniques that don't show up on any board exam, but make all the difference in how you perform, connect, and build a career worth keeping. Get Supranormal on Amazon Doctoring Done Well | Bite-Sized Wins Every other week, a few minutes of career-elevating insight delivered straight to your inbox. The Doctoring Done Well Newsletter is never lame, never spammy, and always fresh. Sign up for our Newsletter

Your work world is built on endurance, intensity, and mastery. The culture is 'always on,' and you were trained to perform in conditions no one would call normal. The work is supranormal. It sits at the edge of reasonable and regularly exceeds what is sustainable by most standards. High performers like you often find themselves on an above-the-fray pedestal, expected to be tireless and self-sacrificing. Supranormal work can unlock extraordinary performance, but the cost adds up if it goes unchecked. In this episode, we look at where this culture came from, the cortisol spikes that shape your days, the hidden curriculum of self-sacrifice, and the countermeasures that keep you from burning out. It is a straight look at the supranormal experience and what it takes to do this work without losing yourself to it. Awake + Aware | Our 2026 Retreat Join us at Awake and Aware, our 3-day retreat in Scottsdale, AZ. March 1-4, 2026. Space is limited. Learn More Here 🎓 P.S. This is a CME event. We discuss: • Why medical culture expects you to perform inside conditions no one would call normal • What makes supranormal work different from ordinary high-stress work • How the “always on” ethos formed and why it persists • The hidden curriculum of self-sacrifice and the pedestal of being above the fray • Cortisol spikes, sympathetic load, and what chronic activation does to your body • Why self-preservation feels selfish in medicine and why that belief is wrong • The roots of modern training from monastic care to Halsted’s cocaine-fueled stamina • Why emergency medicine is an outlier in burnout, longevity, and physiological strain • The concept of parasympathetic nurturing as a countermeasure • How mindset changes biology and shifts performance • What it takes to last in supranormal work without losing yourself

What if the best decision is to not decide at all? We waste valuable mental energy overthinking simple choices, especially when the outcomes are nearly identical. That kind of cognitive drain reduces our capacity to think clearly when decisions actually matter. In this episode, we explore how to reduce cognitive load, identify low-risk choices that can be automated or ignored, and recognize when deliberation is just noise. Finally, we break down how framing, values, and the right question can make even complex decisions frictionless. Guest bio: Dan Dworkis MD, PhD is an emergency physician who is a clinical professor of emergency medicine at USC Keck School of Medicine. He’s also host of the Emergency Mind podcast that focuses on helping individuals and teams perform better under pressure and the author of The Emergency Mind: Wiring Your Brain for Performance Under Pressure. We Discuss: The Three Types of Cognitive Load Harvesting Free Rolls Applying Dominance and Cutting Through Decisional Noise How to Stop Fretting Over Equivalent Decisions Navigating Equipoise Making Big Life Decisions Mentioned in this episode: 5 Free Tools To Make Medical Practice Easier Scripts for your least favorite conversations. The quick and dirty guide to calling consults. A 10-minute "Driveway Debrief" to switch off from work. My favorite documentation templates. Step-by-step guide for delivering the news of death. Free Resources Link Doctoring Done Well | Bite-Sized Wins Every other week, a few minutes of career-elevating insight delivered straight to your inbox. The Doctoring Done Well Newsletter is never lame, never spammy, and always fresh. Sign up for our Newsletter The Out-On-Time Course Built for emergency clinicians who are tired of chart debt and getting derailed by interruptions and overwhelm. Learn practical, real-time documentation and shift-efficiency strategies to finish your shift and actually leave on time. Learn More About The Out-On-Time Course

As students navigate an increasingly complex, competitive, and costly path to medical school, parents often find themselves uncertain about how to help without hindering growth. Meanwhile, institutions maintain opaque admissions practices, amplifying anxiety for both students and families. In this episode, we explore what parents need to know to truly support, not sabotage, their aspiring doctors. Finally, we pull back the curtain on everything from shadowing to AI in essays, offering a brutally honest look at what really matters in the application process. Guest bio: Dr. Ryan Gray, a former Flight Surgeon in the United States Air Force, is the founder of Medical School Headquarters and Meded Media, where he has become a leading voice in guiding pre-med and medical students toward careers in medicine. He is the author of The Premed Playbook series, including Guide to the Medical School Application Process , Guide to the Medical School Personal Statement , Guide to the Medical School Interview , and Guide to the MCAT . Dr. Gray also hosts several popular podcasts, including The Premed Years , OldPreMeds Podcast , The MCAT Podcast , and Specialist Stories . We Discuss: Support vs. Sabotage The Myth of the Perfect Applicant Why Checklists Aren't Really Checklists What Shadowing Really Tells You What's the Deal With Volunteering Hours? Service for the Right Reasons Why Pre-Med Doesn't Mean Pre-Doctor Using AI When Writing Med School Essays Compressing Preclinical Education The Price of Applying and the Sneaky Secondaries Why Don't Schools Post MCAT Cutoffs? How to Write a Good Letter of Recommendation and When to Say No Thank You Notes Letters of Intent Should Premeds Attend Non-Interview Info Sessions? Why Clinical Hours Are Non-Negotiable Mentioned in this episode: Free Tools To Make Medical Practice Easier No fluff. Just good stuff. Free Resources Link The Out-On-Time Course Built for emergency clinicians who are tired of chart debt and getting derailed by interruptions and overwhelm. Learn practical, real-time documentation and shift-efficiency strategies to finish your shift and actually leave on time. Learn More About The Out-On-Time Course Doctoring Done Well | Bite-Sized Wins Every other week, a few minutes of career-elevating insight delivered straight to your inbox. The Doctoring Done Well Newsletter is never lame, never spammy, and always fresh. Sign up for our Newsletter

A broken system won’t fix itself, and no one is coming to the rescue. Medicine is fraying under the weight of burnout, misaligned incentives, and systemic inertia. Yet, hope isn’t lost. Change is still possible, but it won’t come from the top down. In this episode, we explore how grassroots leadership, inner work, and community involvement can become the antidote to despair in modern medicine. Finally, we dig into the personal cost of service and the tools we need to heal ourselves while fighting for change. Guest bio: Dr. Andrea Austin is the inaugural Emergency Medicine Program Director at Sacred Heart in Pensacola, Florida. As a Navy veteran, her military service taught her how to perform under pressure and lead teams in high-stakes environments. She brings that same focus to her work in medical education, physician well-being, and healthcare systems change. Dr. Austin is the author of Revitalized: A Guidebook to Following Your Healing Heartline and host of the Heartline: Changemaking in Healthcare podcast. Books mentioned in this episode What My Bones Know by Stephanie Foo We Discuss: The Case for a New Residency Program What It Means to Be a Change Maker Working Within the Domains of Change Overcoming Social Loafing in Medicine Rethinking Suicide Risk in Emergency Medicine The Call for Psychiatric Fellowships in EM Reclaiming Wellness Through the “Heart Line” The Inner Work is the System Work Building a Portfolio Career Mentioned in this episode: Coming Soon! The Out On Time Course If you are on our mailing list, you will have early access and a few other surprises as well. Sign up for our Newsletter The Out-On-Time Course Built for emergency clinicians who are tired of chart debt and getting derailed by interruptions and overwhelm. Learn practical, real-time documentation and shift-efficiency strategies to finish your shift and actually leave on time. Learn More About The Out-On-Time Course Never Lame. Never Spammy. Always Fresh. If you’d like a few minutes of career-elevating curated kickassery delivered to your inbox, sign up for our newsletter. Sign up for our Newsletter

How can a person who’s clearly lucid still be deemed incapable of making their own medical decisions? The answer lies in the misunderstood yet critical distinction between competence and decision-making capacity. While these terms are often used interchangeably in clinical settings, they carry vastly different meanings in law and medicine—differences that can determine whether a patient is treated, restrained, or left alone. In this episode, we explore how doctors can (and should) assess capacity, the legal boundaries of competence, and how not to get destroyed on the witness stand. Finally, we unpack a story involving a dog, a scrotum, and a tour of Colorado’s emergency departments. Guest Bio: Rich Orman began his legal career as a public defender before moving into private practice. He soon joined the district attorney’s office, where he spent most of his career and ultimately rose to the position of deputy district attorney. Over three decades in the courtroom, he tried some of the most complex and high-profile cases in the state. After retiring from law, Rich turned to filmmaking. He is the writer and director of the critically acclaimed Boundary Layer. 💡 Check out our Free Resources specifically designed to address pain points in medical practice💡 We Discuss: What Competence Actually Means in Legal Terms Defining Medical Decision-Making Capacity Real-Life Dilemmas in Emergency Medicine The Right Terminology in Documentation What Physicians Get Wrong in Court How to Testify Like a Pro How to Handle Yes/No Cross-Examinations One Legal Nugget You Should Never Forget Mentioned in this episode: The Out-On-Time Course Built for emergency clinicians who are tired of chart debt and getting derailed by interruptions and overwhelm. Learn practical, real-time documentation and shift-efficiency strategies to finish your shift and actually leave on time. Learn More About The Out-On-Time Course Decision Making Capacity Free Template Need to document decision-making capacity quickly and accurately? I created this free resource so you don’t have to waste time looking up the elements each time. It’s an example of how it can be done—use it as a guide and make it your own. Free Resources Link Never Lame. Never Spammy. Always Fresh. If you’d like a few minutes of career-elevating curated kickassery delivered to your inbox, sign up for our newsletter. Sign up for our Newsletter

Ever walk out of a shift and feel like the hospital came home with you? In medicine, the mental residue can cling long after the work day is done. One way to address this is boundary rituals, deliberate actions designed to process the day and allow you to leave work at work, be more present when you get home, and possibly even sleep better. As a bonus, the ability to disengage from work is one of the strongest predictors of reduced burnout. In this episode, Mohamed Hagahmed, MD, shares how he creates this boundary—through small rituals of gratitude, stillness, and reflection. From growing up as a refugee to serving as a sideline physician for the Pittsburgh Steelers, Dr. Hagahmed’s path has been shaped by resilience, culture, and care. He explains how he learned to stop carrying unfixable wounds home, why kindness is clinical armor, and how tiny acts of self-compassion can protect meaning in medicine. Guest Bio: Mohamed Hagahmed, MD a Clinical Assistant Professor of Emergency Medicine at the University of Pittsburgh, Associate Medical Director at the Center for Emergency Medicine, and EMS Medical Director for several systems in Western Pennsylvania. On top of that, he works in high-acuity emergency departments across the region. He’s a graduate of Johns Hopkins Bloomberg School of Public Health, passionate about resuscitation, critical care, and toxicology education. And he’s the creator and host of EMERGE in EM , a podcast focused on emergency medicine education and global health empowerment. We Discuss: Growing up as a refugee and finding purpose in emergency medicine The toll of moral injury and why staying closed and rigid nearly broke him Small rituals that help shed the emotional residue of a shift Using gratitude and stillness as tools for resilience How changing clothes, music, and even snacks can protect emotional health Turning frustration into advocacy for immigrant health and systemic change Advice for new attendings on protecting the threshold between work and home Mentioned in this episode: 5 Free Tools To Make Medical Practice Easier Scripts for your least favorite conversations. The quick and dirty guide to calling consults. A 10-minute "Driveway Debrief" to switch off from work. My favorite documentation templates. Step-by-step guide for delivering the news of death. Free Resources Link Distilled Kickassery Every Other Saturday Sign up for our Newsletter

The best communication in high-stakes environments isn’t complicated. Quite the opposite - it’s structured, clear, and consistent. Small, deliberate shifts in how we transfer information can dramatically improve patient safety, team efficiency, and workplace culture. In this episode, we explore three simple but transformative communication habits that reduce errors and build trust among teams. Finally, we share practical tools you can use today to tighten your communication and improve safety without adding extra workload. We Discuss: The Three-Way Repeat-Back: “That’s Correct” Changes Everything Phonetic Clarifications: Stop the “Norman” Problem Numbers: Say the Digits Whiteboards: The Cheapest Safety Tool in the Room Checklists: Mastering the Basics Cheaper Than Dirt, More Precious Than Gold Mentioned in this episode: The Out-On-Time Course Built for emergency clinicians who are tired of chart debt and getting derailed by interruptions and overwhelm. Learn practical, real-time documentation and shift-efficiency strategies to finish your shift and actually leave on time. Learn More About The Out-On-Time Course Doctoring Done Well | Bite-Sized Wins Every other week, a few minutes of career-elevating insight delivered straight to your inbox. The Doctoring Done Well Newsletter is never lame, never spammy, and always fresh. Sign up for our Newsletter