Scalpel and Sword: Conflict and Negotiation in Modern Medicine

What happens when the fear of medical malpractice becomes powerful enough to change how physicians see themselves and practice medicine?In Part 1 of a 2-Part episode, Dr. Gita Pensa shares her experience as a physician defendant in a multimillion-dollar malpractice case that lasted 12 years, including two jury trials. She explains how litigation affected her identity, confidence, and relationship with medicine, and how education helped her reclaim control.The conversation explores why malpractice remains surrounded by shame and silence, despite being an occupational reality for many physicians. Gita discusses preparing doctors to navigate litigation, the importance of peer support, and why medical schools and residency programs should teach these skills. The episode also examines physician attrition, high-risk specialties, nuclear verdicts, and the broader consequences of litigation fear.Three Actionable Takeaways:Learn the Process Before You Need It: Don't let malpractice become a mysterious boogeyman. Learn how litigation actually works, understand your role as a defendant, and develop the skills to communicate effectively. Preparation can replace fear with confidence when an unexpected legal challenge arises.Talk About Litigation Without Shame: Create a culture where physicians can acknowledge lawsuits without feeling judged or isolated. Peer support matters. Remind colleagues of their competence, value, and contributions, while respecting legal boundaries around case details. No physician should have to carry litigation stress alone.Prepare for High-Risk Practice Intentionally: Physicians in specialties facing greater litigation exposure should understand their professional risks, insurance considerations, and local legal environment. Preparation does not mean practicing defensively or abandoning a specialty. It means knowing your value, understanding the system, and building resilience.About the Show: Behind every procedure, every patient encounter, lies an untold story of conflict and negotiation. Scalpel and Sword, hosted by Dr. Lee Sharma—physician, mediator, and guide—invites listeners into the unseen battles and breakthroughs of modern medicine. With real conversations, human stories, and practical tools, this podcast empowers physicians to reclaim their voices, sharpen their skills, and wield their healing power with both precision and purpose.About the Guest:Dr. Gita Pensa is an emergency physician, educator, nationally recognized speaker, and leading voice on the impact of medical malpractice litigation on physicians. After spending 12 years as the sole physician defendant in a multimillion-dollar malpractice case involving two jury trials, she transformed her experience into physician education, litigation coaching, consulting, and advocacy. She created Doctors and Litigation: The L Word and has also consulted on Season 2 of The Pitt.Website: https://doctorsandlitigation.com Podcast:  Doctors and Litigation: the L Word PodcastAbout the Host:Dr. Lee Sharma is a gynecologist based in Auburn, AL, with over 30 years of clinical experience. She holds a Master’s in Conflict Resolution and is passionate about helping colleagues navigate workplace challenges and thrive through open conversations and practical tools.Connect with Dr. Lee Sharma: 📧 Email: [email protected] 🌐 Website: East Alabama Health - Dr. Sharma  The Scalpel and Sword Podcast is for informational purposes only and does not constitute medical, legal, or professional advice. Always consult a qualified professional regarding your specific situation. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

We practice knot-tying, codes, and difficult deliveries until the skills become automatic. Why do we still fly blind when it comes to conflict? In this warm, practical conversation, Dr. Lee Sharma sits down with Kimberly Bes to examine exactly that question. Kim shares how decades in emergency and critical care nursing revealed the damage caused when fear, time pressure, and competing priorities collide without shared language or tools. She explains why she designed a 50-card deck (20 story cards and 30 skill-and-practice cards) that lets individuals and teams build conflict competence one manageable skill at a time. Listeners will hear how the cards function as both a reflective practice after a hard interaction and a proactive way to prepare teams for better conversations. Kim and Lee walk through high-impact skills such as “the story I’m telling myself,” separating the person from the problem, and the powerful reminder that disagreement does not equal opposition. They also explore why more than half of healthcare professionals identify as conflict-avoidant, how the system has normalized unhealthy patterns, and why learning to be both honest and kind is a professional and personal necessity. This episode offers an accessible, hopeful path for anyone who wants to stop carrying unresolved conflict home and start building the communication skills that make teams stronger and healers healthier. Three Actionable Takeaways: Treat conflict skills like clinical skills, practice them deliberately: One focused tool at a time (whether a single conversation card or a short reflective exercise) builds a sustainable toolbox far more effectively than absorbing an entire seminar and then forgetting it under pressure. Use “the story I’m telling myself” to lower the temperature and open curiosity: Naming your internal narrative invites clarification instead of defensiveness, reveals your own assumptions, and often transforms a stuck interaction into a collaborative one. Disagreement is not opposition, and conflict itself is not the enemy: Healthy systems need honest difference. Skills that help us stay connected while we disagree protect relationships, improve patient care, and reduce the isolation and burnout that flourish when we avoid hard conversations. About the Show:  Behind every procedure, every patient encounter, lies an untold story of conflict and negotiation. Scalpel and Sword, hosted by Dr. Lee Sharma—physician, mediator, and guide—invites listeners into the unseen battles and breakthroughs of modern medicine. With real conversations, human stories, and practical tools, this podcast empowers physicians to reclaim their voices, sharpen their skills, and wield their healing power with both precision and purpose. About the Guest: Kimberly Best is a nurse, mediator, conflict consultant, speaker, and trainer, and the founder of Best Conflict Solutions. After decades in emergency and critical care nursing, she earned a master’s degree in conflict management from Lipscomb University and pursued advanced training in mediation, negotiation, restorative practice, and conflict systems design. She is a court-listed mediator, FINRA arbitrator, adjunct professor at Lipscomb University’s Institute for Conflict Management, and past president of the Tennessee Association of Professional Mediators. She is also the creator of Best Conflict Conversation Cards, Workplace Edition, a practical 50-card deck designed to help individuals and teams build conflict competence one skill at a time. Website: https://www.bestconflictsolutions.com/ LinkedIn: https://www.linkedin.com/in/kimberlybestmediator About the Host: Dr. Lee Sharma is a gynecologist based in Auburn, AL, with over 30 years of clinical experience. She holds a Master’s in Conflict Resolution and is passionate about helping colleagues navigate workplace challenges and thrive through open conversations and practical tools. Connect with Dr. Lee Sharma: 📧 Email: [email protected] 🌐 Website: East Alabama Health - Dr. Sharma The Scalpel and Sword Podcast is for informational purposes only and does not constitute medical, legal, or professional advice. Always consult a qualified professional regarding your specific situation. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

What if the most powerful form of advocacy for physicians wasn’t on Capitol Hill, but in the doctor’s lounge, the county medical society, and a quiet self-referral to a Physician Health Program? In this deeply personal and practical conversation, Dr. Lee Sharma welcomes Dr. Damian McHugh to unpack what advocacy really means. Damian shares how a career spanning two countries and two specialties taught him that advocating for healthy doctors is inseparable from advocating for healthy patients. He reflects on mentors who lifted him up, the often-misunderstood role of state medical boards, the quiet sacrifices of physicians who serve on them, and the growing problem of boundary violations under extreme stress. Together they examine how relentless productivity pressure and the electronic medical record have siloed physicians, eroded face-to-face relationships, and drained the joy and teamwork that once defined excellent care. Damian offers a clear path forward: start local with county and state medical societies, intentionally rebuild collegial relationships, come to problems with solutions, and when burnout hits, have the courage to reach out to a Physician Health Program. He closes with a powerful reminder that these programs exist to restore careers, protect patients, and help physicians reclaim joy in medicine. This episode is both a call to action and a hand extended to every physician who has ever felt helpless in a system that seems to be crumbling around them. Three Actionable Takeaways: Advocacy for physicians and patients is not either/or, it is the same work: Healthy doctors deliver better care. Supporting colleagues through organized medicine, medical boards, and peer networks ultimately protects patients and strengthens the entire system. Relationships are the soil in which both good care and effective advocacy grow: The EMR and relentless busyness have siloed physicians. Intentionally rebuilding face-to-face connections, whether in the doctor’s lounge, at a county medical society, or through a simple phone call, restores teamwork, reduces isolation, and creates the unified voice needed for change. When you feel burned out, reach out early and privately: Physician Health Programs in most states offer confidential, supportive pathways for physicians who are struggling. Self-referral can protect your career, your license, your relationships, and your patients, long before a crisis reaches the medical board. About the Show:  Behind every procedure, every patient encounter, lies an untold story of conflict and negotiation. Scalpel and Sword, hosted by Dr. Lee Sharma—physician, mediator, and guide—invites listeners into the unseen battles and breakthroughs of modern medicine. With real conversations, human stories, and practical tools, this podcast empowers physicians to reclaim their voices, sharpen their skills, and wield their healing power with both precision and purpose. About the Guest: Dr. Damian McHugh is a retired emergency physician based in Raleigh, North Carolina. He completed his medical education at the University of Manchester in the UK and built a clinical and administrative career in the United States. A former member of the North Carolina Medical Board, he is an active advocate through the Clinician Burnout Foundation and a strong voice for organized medicine, peer support, and Physician Health Programs. Connect with Dr. Damian:  Visit the Clinician Burnout Foundation website and use the contact form: https://clinicianburnoutfoundation.org About the Host: Dr. Lee Sharma is a gynecologist based in Auburn, AL, with over 30 years of clinical experience. She holds a Master’s in Conflict Resolution and is passionate about helping colleagues navigate workplace challenges and thrive through open conversations and practical tools. Connect with Dr. Lee Sharma: 📧 Email: [email protected] 🌐 Website: East Alabama Health - Dr. Sharma The Scalpel and Sword Podcast is for informational purposes only and does not constitute medical, legal, or professional advice. Always consult a qualified professional regarding your specific situation. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

What happens when a patient’s request collides with medical reality? In this thoughtful solo episode, Dr. Lee Sharma opens with a recent Instagram post from a primary care physician that struck a nerve across healthcare. The scenario, a patient who declined a physical, refused an appointment, then demanded same-day FMLA paperwork, sparked dozens of comments from clinicians saying, “Do you work in my office?” The episode uses that moment as a launch point to examine a topic many experience but few discuss openly: patient entitlement. Dr. Sharma draws a careful distinction. Patients deserve dignity, respect, excellent communication, informed consent, and shared decision-making, those are rights. Entitlement, by contrast, appears when expectations become disconnected from medical reality and every request is expected to be fulfilled simply because it was made. Using the SPARK framework and concrete phrasing examples, she shows how clinicians can set realistic expectations early, validate emotion without agreeing to every request, and maintain professional judgment without becoming cynical. She emphasizes that compassion is not the same as compliance, that boundaries function as guardrails rather than barriers, and that service is not servitude. The healthiest physician-patient relationships, she concludes, require both kindness and clear limits because together they build the trust that remains medicine’s most powerful tool. Three Actionable Takeaways: Distinguish rights from entitlement: Patients are entitled to dignity, respect, and compassionate care. They are not entitled to every requested test, medication, or timeline. Naming this difference protects both clinical judgment and compassion. Set expectations early and explicitly: A few clear sentences at the start of a visit, before surgery, or around communication policies prevent many conflicts before they begin. Ambiguity fuels resentment; clarity builds trust. Validate the emotion, then address the request: Naming the underlying feeling (“I understand why you’re asking for this…”) lowers intensity and opens space for evidence-based reasoning. Compassion means helping people feel heard, not automatically saying yes. About the Show:  Behind every procedure, every patient encounter, lies an untold story of conflict and negotiation. Scalpel and Sword, hosted by Dr. Lee Sharma—physician, mediator, and guide—invites listeners into the unseen battles and breakthroughs of modern medicine. With real conversations, human stories, and practical tools, this podcast empowers physicians to reclaim their voices, sharpen their skills, and wield their healing power with both precision and purpose. About the Host: Dr. Lee Sharma is a gynecologist based in Auburn, AL, with over 30 years of clinical experience. She holds a Master’s in Conflict Resolution and is passionate about helping colleagues navigate workplace challenges and thrive through open conversations and practical tools. Connect with Dr. Lee Sharma: 📧 Email: [email protected] 🌐 Website: East Alabama Health - Dr. Sharma The Scalpel and Sword Podcast is for informational purposes only and does not constitute medical, legal, or professional advice. Always consult a qualified professional regarding your specific situation. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

What if the key to resolving conflict wasn’t winning, but learning how to hold the calm? In this engaging conversation, Dr. Lee Sharma welcomes Hesha Abrams, a master mediator who has resolved thousands of high-stakes disputes, from corporate battles involving Google, Amazon, and Apple to the secret recipe for Pepsi. Drawing on decades of experience and her book Holding the Calm, Hesha shares why most of us in healthcare tend to avoid or accommodate conflict, how the amygdala hijacks even the smartest professionals, and why so many conflicts boil down to a simple dynamic: people trying not to lose rather than trying to win. Together they unpack practical, immediately usable tools: the power of asking questions instead of making statements, the four-step VUCS method (Validate, Understand, Clarify, Summarize), the surprisingly effective technique of simply naming an emotion, and the disarming sentence stems that can shift even the most difficult people. Hesha also explores how holding the calm is contagious, why a few seconds of genuine curiosity can prevent years of fallout, and how laughter, awe, and a little “bacitracin on the railroad tracks of life” make the whole process sustainable. This episode offers clinicians concrete skills they can use on their next shift, whether with a frustrated patient, a stressed colleague, or a high-ego administrator, and a powerful reminder that becoming better at conflict is one of the most practical acts of self-preservation and leadership available. Three Actionable Takeaways: Shift from “winning” to “not losing”: Most conflict is driven by fear of looking bad, making a mistake, or being forced into something. Recognizing that the other person is primarily trying not to lose lowers the temperature and opens new options for resolution. Ask questions and name the emotion: When the amygdala is triggered, statements escalate; questions and simple emotion-naming (“You seem really frustrated”) calm it. These two moves take seconds and often change the entire dynamic. Practice holding the calm as a skill, not a personality trait: Like flossing or putting bacitracin on a wound, small consistent practices like curiosity, validation, looking for the miraculous, compound. The result is fewer conflicts, stronger relationships, and less emotional residue at the end of the day. About the Show:  Behind every procedure, every patient encounter, lies an untold story of conflict and negotiation. Scalpel and Sword, hosted by Dr. Lee Sharma—physician, mediator, and guide—invites listeners into the unseen battles and breakthroughs of modern medicine. With real conversations, human stories, and practical tools, this podcast empowers physicians to reclaim their voices, sharpen their skills, and wield their healing power with both precision and purpose. About the Guest: Hesha Abrams is a master mediator renowned for turning high-conflict situations into amicable resolutions. She has mediated thousands of complex matters for major corporations and high-stakes parties, including the dispute over the secret recipe for Pepsi. She is the principal of Hesha Abrams Mediation and the author of Holding the Calm.  Learn more at holdingthecalm.com and heshaabramsmediation.com. About the Host: Dr. Lee Sharma is a gynecologist based in Auburn, AL, with over 30 years of clinical experience. She holds a Master’s in Conflict Resolution and is passionate about helping colleagues navigate workplace challenges and thrive through open conversations and practical tools. Connect with Dr. Lee Sharma: 📧 Email: [email protected] 🌐 Website: East Alabama Health - Dr. Sharma The Scalpel and Sword Podcast is for informational purposes only and does not constitute medical, legal, or professional advice. Always consult a qualified professional regarding your specific situation. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.