Stimulus - Learn Tools to Crush It in Your Medical Career

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 MedicineNot All Interruptions Are UrgentThe Cognitive Cost of Task SwitchingBecoming a Non-Interruptible ClinicianDeferring Without Alienating Your TeamProtecting Focus at the End of the ShiftFixing the EKG Interruption ProblemAsynchronous Communication That Actually Works

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 podcastJosh’s WebsiteWe Discuss:Mimetic Desire: Chasing What Others WantThe Trap of “Should”: Internalized ShameThe Concentric Circles of StressorsFinding What You Really WantThe Ladder Against the Wrong WallActionable Reflection PracticesMentioned in this episode:The Out-On-Time CourseBuilt 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 CourseDoctoring Done Well | Bite-Sized WinsEvery 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 ActionWhat We Control (And What We Don’t)Action Over EmotionThe Three Rules of Wise LivingThe Power of Present Moment AwarenessMastery Through Deliberate PracticePurpose as a Practical ToolGrowth Without PerfectionWorking Within Broken SystemsPracticing LifeMentioned in this episode:Free Tools To Make Medical Practice EasierNo fluff. Just good stuff.Free Resources LinkThe Out-On-Time CourseBuilt 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 CourseDoctoring Done Well | Bite-Sized WinsEvery 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 RetreatJoin 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 LoadHarvesting Free RollsApplying Dominance and Cutting Through Decisional NoiseHow to Stop Fretting Over Equivalent DecisionsNavigating EquipoiseMaking Big Life DecisionsMentioned in this episode:5 Free Tools To Make Medical Practice EasierScripts 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 LinkDoctoring Done Well | Bite-Sized WinsEvery 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 NewsletterThe Out-On-Time CourseBuilt 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. SabotageThe Myth of the Perfect ApplicantWhy Checklists Aren't Really ChecklistsWhat Shadowing Really Tells YouWhat's the Deal With Volunteering Hours?Service for the Right ReasonsWhy Pre-Med Doesn't Mean Pre-DoctorUsing AI When Writing Med School EssaysCompressing Preclinical EducationThe Price of Applying and the Sneaky SecondariesWhy Don't Schools Post MCAT Cutoffs?How to Write a Good Letter of Recommendation and When to Say NoThank You NotesLetters of IntentShould Premeds Attend Non-Interview Info Sessions?Why Clinical Hours Are Non-NegotiableMentioned in this episode:Free Tools To Make Medical Practice EasierNo fluff. Just good stuff.Free Resources LinkThe Out-On-Time CourseBuilt 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 CourseDoctoring Done Well | Bite-Sized WinsEvery 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 episodeWhat My Bones Know by Stephanie FooWe Discuss:The Case for a New Residency ProgramWhat It Means to Be a Change MakerWorking Within the Domains of ChangeOvercoming Social Loafing in MedicineRethinking Suicide Risk in Emergency MedicineThe Call for Psychiatric Fellowships in EMReclaiming Wellness Through the “Heart Line”The Inner Work is the System WorkBuilding a Portfolio CareerMentioned in this episode:Coming Soon! The Out On Time CourseIf you are on our mailing list, you will have early access and a few other surprises as well.Sign up for our NewsletterThe Out-On-Time CourseBuilt 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 CourseNever 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 TermsDefining Medical Decision-Making CapacityReal-Life Dilemmas in Emergency MedicineThe Right Terminology in DocumentationWhat Physicians Get Wrong in CourtHow to Testify Like a ProHow to Handle Yes/No Cross-ExaminationsOne Legal Nugget You Should Never ForgetMentioned in this episode:The Out-On-Time CourseBuilt 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 CourseDecision Making Capacity Free TemplateNeed 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 LinkNever 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 medicineThe toll of moral injury and why staying closed and rigid nearly broke himSmall rituals that help shed the emotional residue of a shiftUsing gratitude and stillness as tools for resilienceHow changing clothes, music, and even snacks can protect emotional healthTurning frustration into advocacy for immigrant health and systemic changeAdvice for new attendings on protecting the threshold between work and homeMentioned in this episode:5 Free Tools To Make Medical Practice EasierScripts 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 LinkDistilled Kickassery Every Other SaturdaySign 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 EverythingPhonetic Clarifications: Stop the “Norman” ProblemNumbers: Say the DigitsWhiteboards: The Cheapest Safety Tool in the RoomChecklists: Mastering the BasicsCheaper Than Dirt, More Precious Than GoldMentioned in this episode:The Out-On-Time CourseBuilt 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 CourseDoctoring Done Well | Bite-Sized WinsEvery 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

Stressful events can hijack cognition, cloud judgment, and leave emotional residue that can fuel long-term burnout. For acute care clinicians, those moments of emotional overwhelm, when heart rate spikes and the thinking brain goes offline, can have consequences that last far beyond the shift. While long-term resilience is essential, it’s often the just-in-time strategies that determine whether we break down or rise to the moment. In this episode, we explore the physiology and psychology of real-time emotional regulation with Scott Weingart, MD, co-creator of the Beat the Stress Fool protocol. Finally, we uncover how practices like gratitude flooding and negative visualization can inoculate against burnout and offer emotional integrity in the most harrowing moments of care.💡 Check out our Free Resources specifically designed to address pain points in medical practice💡Scott Weingart, MD, is an emergency department intensivist and physician coach based in New York. He completed fellowships in Trauma, Surgical Critical Care, and ECMO, and is internationally recognized for his expertise in resuscitation and critical care. As the creator of the EMCrit podcast, with over 40 million downloads, he has shaped how clinicians think and perform under pressure. Together, Scott and I co-founded Guidewire Coaching, where we create and teach tailored courses to address the real-world pain points of acute care medicine.We Discuss:Rapid stress reset with “Beat the Stress Fool”Breathing techniques that calm the nervous systemSelf-talk under pressureMental rehearsal that ends in successTrigger words for fast de-escalationGratitudinal flooding as a shield during emotional overloadReal-time tools for grief resilienceThe quiet strength of negative visualizationTeaching stress tools to trainees without pushbackMentioned in this episode: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 NewsletterThe Out-On-Time CourseBuilt 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 Course5 Free Tools To Make Medical Practice EasierScripts 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

No one enters medicine expecting to land on a performance improvement plan, yet for many physicians, it becomes a disorienting reality. A PIP can feel like both a warning and a test, raising existential fears about career, reputation, and future. Behind the formal language is often a complex mix of organizational risk management and legitimate behavioral concerns. In this episode, we explore what it really means to be placed on a PIP, how to navigate the process effectively, and why resistance is rarely a successful strategy. Finally, we share a structured approach to coaching through a PIP that can turn even the most fraught situation into meaningful professional growth.💡 Check out our Free Resources specifically designed to address pain points in medical practice💡We Discuss:Understanding the Purpose and Structure of a Performance Improvement Plan (PIP)Variability and Pitfalls in PIPsWhy Coaching Matters During a PIPCommon Reactions and Emotional TollStructural Flaws That Undermine PIPsNegotiating and Responding to a PIPThe Myth of Performance ImmunityA Coaching Framework for Navigating PIPsCollaborating With LeadershipSuccess and Long-Term ImpactMentioned in this episode:Distilled Kickassery Every Other SaturdaySign up for our Newsletter5 Free Tools To Make Medical Practice EasierScripts 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

What if addiction isn’t about drugs, but about pain? Beneath compulsive behaviors often lie histories of trauma, anxiety, and unmet emotional needs, hidden behind layers of stigma and misunderstanding. In medicine, addiction is still often mischaracterized as a moral failing rather than a treatable illness with deep psychological roots. In this episode, we explore the personal and professional evolution of Dr. Casey Grover, an addiction medicine physician who reframed both his own struggles and the way he cares for patients. Finally, we uncover how shifting mindset and language can transform both clinical outcomes and clinician well-being.💡 Check out our Free Resources specifically designed to address pain points in medical practice💡Guest bio:  Dr. Casey Grover is a board-certified physician in Addiction Medicine and Emergency Medicine at Montage Health, where he also serves as Chief of Staff. He is the Physician Champion for the Monterey County Prescribe Safe Initiative, a program focused on reducing opioid misuse through education, safe prescribing, and improved treatment access. In addition to his clinical and leadership roles, Dr. Grover hosts the podcast Addiction Medicine Made Easy, where he breaks down complex topics to make addiction care more approachable for both providers and the public.We Discuss:What is Addiction?When Food Becomes a Coping MechanismThe Stigma of AddictionThe Neurology of AddictionDivided Views on SobrietyWhy Some People Recover and Others RelapseThe Reason Some Brains Get HookedAddiction vs. Dependence — and Why Stigma Makes It WorseBuilding Trust with PatientsFrom Frustration to Compassion: Reframing Patient EncountersTrauma, PTSD, and Personal ReckoningThe Practice of Addiction MedicineMentioned in this episode:The Out-On-Time CourseBuilt 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 CourseNever 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 Newsletter5 Free Tools To Make Medical Practice EasierScripts 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

What is it about your work that still lights you up inside? At the center of every profession is a core - the reason we chose it in the first place, the part that feels meaningful no matter the chaos around it. When we reconnect with that core, even amid challenge, fulfillment often follows. Sometimes, though, that spark fades. Sometimes the core of what we love evolves, shifts direction, or gets buried under layers of stress and routine. In this episode, we explore how to evaluate your relationship with the essence of your work and how small (or big) recalibrations can realign your day-to-day with what matters most. Finally, we share strategies to clear out the noise, fuel the flame, and shape a career that energizes rather than drains.🧭 UnBurnable | Our Cohort-Based Burnout Prevention and Cure CourseAs physician coaches, my partner, Scott Weingart, and I have noticed a clear pattern: some doctors are thoroughly burned out, and many others are on the path toward it. Almost all were shortchanged in their medical training, having been molded into excellent clinicians but given virtually no tools for retaining joy and equanimity throughout their careers.This course will teach you the hidden anti-burnout curriculum.Learn more at unburnablecourse.com 🚀We Discuss:Starting with the central question: How do you feel about the core of your work?Using the stories you tell about your job as diagnostic tools. What tone are you bringing to those tales?What is a micro recalibration, and how can it reshape your workday from within your current job?How do you recognize when overwhelm is a sign of a broken approach, not a broken you?Exploring macro recalibrations. What if you love the work, but the environment is eating you alive?Running the “look-around test” to evaluate other institutions.Identifying “gravity problems.” Which issues can't be solved within your current system?Considering a mega recalibration. What does it mean to step away from the work entirely?How identity and sunk costs keep us rooted in roles we may have outgrown.Visualizing the flame and smoke of your career. What’s burning bright, and what’s clouding the view?Defining what a fulfilling day looks like. Is that kind of day even possible where you are now?Use a five-year future vision to clarify whether your current job fits into your ideal life.Why walking away doesn’t have to mean burning it down. What might rediscovery look like instead?You don’t have to burn it all down to rediscover what lights you up.💡 Check out our Free Resources specifically designed to address pain points in medical practice💡

Burnout isn’t just emotional, it’s financial. Many doctors put off financial planning until they’re deep in debt, stuck in lifestyle inflation, and too burned out to pivot. In this episode, The White Coat Investor Jim Dahle lays out how to build a burnout-resistant career by making smart, intentional money decisions, whether you’re a student or a seasoned physician.We delve into frugality (the useful and the absurd), how burnout can quietly become your biggest financial threat, what makes a solid investment plan, the waterfall method of managing your money, and why many doctors end up wealthy on paper but broke in practice. Plus: when hiring a financial advisor is the smartest move you can make—and when it’s the worst.Guest bio:  Jim Dahle, MD, FACEP is a practicing emergency physician and the founder of The White Coat Investor. After early experiences with predatory financial advisors, he taught himself personal finance and saw firsthand how financial literacy transformed his life. Motivated to help colleagues avoid similar pitfalls, he launched The White Coat Investor—then the only unbiased financial education resource for physicians. More than a decade later, Dr. Dahle continues to lead the organization as CEO, columnist, and podcast host, staying true to its mission: “help those who wear the white coat get a fair shake on Wall Street.”We Discuss:Financial goals as the “game,” not competition with othersEmbracing frugality (and where it can go too far)Burnout as a major financial riskStrategies to reduce burnout, including working less and managing spendingUnderstanding your financial “basement” (minimum monthly needs)Lifestyle creep and how to monitor itThe “live like a resident” strategy post-trainingNet worth versus income, and why physicians sometimes retire brokeThe financial “waterfall” (how to prioritize where your money goes)Why trying to beat the market usually backfiresWhole life insurance: the hype versus realityCreating an Investment Policy Statement (IPS)Real estate investing: REITs versus hands-on ownershipDesigning your life and shifts as a financially independent physicianThe "night shift marketplace" modelWhen to work with, or fire, a financial advisorCase study: mid-career physician financial planningMentioned in this episode:5 Free Tools To Make Medical Practice EasierScripts 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 LinkRecalibrate Your CareerI work with physicians to help them flourish in medical practice. If you're feeling stuck, burned out, or in trouble at work because of communication or conflict, check out our FAQ page for more info. Ready for real change? Book a discovery call. It’s free, low-pressure, and will give you clarity on your next steps.Learn more about 1-on-1 coachingThe Out-On-Time CourseBuilt 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

Making a major career shift is never easy, especially when you've dedicated decades to a profession that has become part of your identity. The decision to leave clinical medicine can be fraught with self-doubt, financial considerations, and the lingering question - what comes next? But at some point, the balance shifts, and the cost of staying outweighs the fear of leaving. In this episode, we explore what it takes to walk away from a stable medical career, redefine success, and craft a life that aligns with evolving priorities. Finally, we dig into strategies for managing stress, investing in personal growth, and finding fulfillment beyond the bedside.💡 Check out our Free Resources specifically designed to address pain points in medical practice💡Guest bio:  Dr. Patrick O’Malley is an emergency physician with nearly two decades of experience in community emergency departments and high-acuity urgent care. Based in Columbia, South Carolina, he has recently expanded into entrepreneurial ventures, including The Laceration Course, in partnership with EB Medicine. He helps moderate the EM Docs Side Hustle Facebook group, a community of over 3,000 emergency physicians exploring side gigs and alternative careers. Dr. O’Malley is dedicated to helping physicians explore new opportunities beyond the walls of the emergency department.We discuss:The Decision to ResignFinancial Readiness and the Role of Family SupportLooking Back on a Career in Emergency MedicineRedefining Work-Life BalanceTransitioning to a New IdentityInvesting in YourselfBurnout, Coaching, and the Road to ChangeFinding Joy in Medicine: Small Moments, Big ImpactLiving Another YesterdayCrafting Your Own Path: Empowering CliniciansNewman and John Marks: Managing Stress and CalmMentioned in this episode:🔥 New Free Resource! 🔥Just dropped: a brand-new video + PDF on how to recalibrate your career based on our sold-out webinar, now re-recorded with the best audience questions and tactical takeaways. You’ll get strategies for micro, macro, and mega career shifts, rules for adding anything to your plate, and real stories of how others made it work. Plus: explore our full collection of free resources for getting unstuck, unburnt, and back in the driver’s seat.Free Resources LinkRecalibrate Your CareerI work with physicians to help them flourish in medical practice. If you're feeling stuck, burned out, or in trouble at work because of communication or conflict, check out our FAQ page for more info. Ready for real change? Book a discovery call. It’s free, low-pressure, and will give you clarity on your next steps.Learn more about 1-on-1 coachingThe Out-On-Time CourseBuilt 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

Delivering the news of death is one of the hardest yet most overlooked skills in emergency medicine. Many learn by watching others or through trial and error rather than structured training (or just make it up as they go). This lack of preparation can lead to discomfort, stress, avoidance, and even systemic failures in how death notifications are handled. In this episode, we explore the critical components of death communication, how to navigate these difficult conversations with clarity and compassion, and why avoiding or mishandling these moments can have lasting consequences for both providers and families. Finally, we discuss the emotional toll of secondhand grief and the importance of proactive mental health care for those on the front lines of healthcare.💡 Check out our Free Resources specifically designed to address pain points in medical practice💡Guest bio: Alexandra Jabr, PhD, EMT-P, is the founder of Emergency Resilience and a leading voice in the overlooked aspects of first responder training. With nearly 15 years of experience as an EMT, paramedic, cardiac tech, EMS coordinator, and educator, she saw firsthand the emotional toll of the job—especially when it came to death communication. She went on to earn a Master’s in Death, Grief, and Bereavement, followed by a Ph.D. in Depth Psychology, focusing on how first responders can maintain their mental health while supporting grieving families and colleagues. Through her work, she’s redefining continuing education, ensuring first responders get the training they truly need—not just another CPR recert.We discuss:Why On-Scene Death Notifications Are So DifficultChallenges in Death Communication TrainingPractical Steps for Delivering the News of DeathA Structured and Compassionate FrameworkHandling Determination of DeathCommon MistakesSecondhand Grief and Provider Well-beingProactive Mental Health for ProvidersMentioned in this episode: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 NewsletterThe Out-On-Time CourseBuilt 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

Leadership impacts everyone—whether you're steering an entire organization or simply navigating team dynamics. It’s an essential skill, yet it often feels elusive, even for experienced professionals. While every leadership challenge is unique, the core principles remain universal.In this episode, we break down eight critical leadership principles drawn from years of experience, hard lessons, conversations with seasoned experts, research, and coaching leaders at all levels. Plus, we share actionable strategies to help you refine your leadership, whether you're guiding thousands or leading a small team.Want more? Subscribe to our free newsletter, Doctoring Done Well. Every other Saturday, straight to your inbox—strategies to work smarter, lead better, and build a career that lasts.We Discuss:Don’t Worry About Leading, Worry About ListeningThis is Not Your Dumpster FireSlow Your RollYou Will Have to Be a Judge, Even When You Don’t Want to BeModel the ValuesWith Behavioral Issues, Build the Pathway, Not Just the ExpectationYou Don’t Know What You’re Doing—And That’s OKPeople Do Things for Their Reasons, Not YoursMentioned in this episode:The Out-On-Time CourseBuilt 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

Violence has a cadence, a rhythm that disrupts the normal flow of life. When an act of violence erupts, the first sign is often a sudden, unexplainable shift in the environment—an eerie silence, a heightened energy, or a gut feeling that something is wrong. But when does that uneasy feeling cross the threshold into immediate danger? In this episode, we explore the critical decision points in an active violence situation in the healthcare/hospital setting, the moral and ethical dilemmas of medical providers staying versus escaping, and tactical strategies for survival. Finally, we break down the "run, hide, fight" approach and how to act decisively when every second counts.Guest bio: Mike Shertz, MD is an emergency physician who spent 13 years as a Green Beret and a Special Forces medic. He is the founder and purveyor of Crisis Medicine, which teaches tactical casualty care to medical professionals. Check out this video that we did together in 2019 on how to place and remove a tourniquet and this one on how to pack a gunshot wound with combat gauze. Want more? Subscribe to our free newsletter, Doctoring Done Well. Every other Saturday, straight to your inbox—strategies to work smarter, lead better, and build a career that lasts.We Discuss:Recognizing an Active Violence SituationMoral Dilemmas: Stay or Escape?Perspectives on Risk and ResponseTactical Survival: Run, Hide, FightPost-Shooting Medical Response

Dealing with an angry, upset patient can feel like walking into an emotional storm. The frustration in the room is palpable, and even the most experienced clinicians can feel thrown off balance. While medical training equips us to handle complex diagnoses and emergencies, it often falls short when it comes to managing interpersonal conflict. That’s where the Universal Upset Patient Protocol comes in—a straightforward, highly effective framework designed to de-escalate tense situations, restore trust, and protect your own emotional bandwidth. In this episode, we explore Dr. Dike Drummond’s original protocol, breaking down each step with specific language to use in the heat of the moment. Finally, we’ll add a few practical tweaks to help make these conversations even more natural and effective in real-world practice.💡 Check out our Free Resources specifically designed to address pain points in medical practice💡Guest Bio: Dike Drummond, MD, is a physician coach, burnout prevention expert, and creator of the Universal Upset Patient Protocol—a step-by-step framework for managing challenging interactions with upset patients. A former family physician, he transitioned to coaching to address the emotional toll of healthcare on providers. As founder of TheHappyMD.com, he’s helped thousands of physicians improve communication, manage stress, and build healthier professional relationships.We Discuss:The Universal Upset Patient Protocol: A Framework for Diffusing ConflictKey Principle: Acknowledgment Over FixingStep 1: Acknowledge the Vibe and Name the EmotionStep 2: Open the Door for Them to SpeakStep 3: Apologize and Show CompassionStep 4: Identify Their NeedStep 5: Clarifying Reflection (Rob O Addition)Step 6: Set Boundaries and ExpectationsStep 7: Express GratitudeBeyond the Protocol: The Magic of Conflict FrameworkMentioned in this episode:5 Free Tools To Make Medical Practice EasierScripts 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 LinkThe Out-On-Time CourseBuilt 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 CourseDoctoring Done Well | Bite-Sized WinsEvery 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