Have you ever found yourself deep in “The Pit” where the mere thought of going back to work triggers an existential crisis? You wonder if your current job is the right choice. Sometimes, all it takes are a few adjustments to the current job and you'll feel fully refreshed and stoked to tackle that next shift. It may also, however, be time for The Trade.In this episode, we delve into the critical juncture many professionals, particularly physicians, find themselves in when their once-aspired career paths no longer bring fulfillment. We tackle:Whether to deepen commitments to your current role or brave the uncertainty of switching careersWhat it means to tolerate another yesterdayThe silent tax paid by grinding it outThe emotional and practical implications of making significant life changesHow a well-cultivated professional identity can become an albatrossA step-by-step guide on how to transition towards a more satisfying careerSo, whether you're a physician on the brink, a professional in a pickle, or just someone who enjoys a good existential quandary with their morning coffee, tune in. Let's laugh in the face of the status quo and ponder if the grass is greener, or if it's just astroturf.Guest bio: Lon Stroschein is the purveyor of the Normal 40 podcast and author of The Trade. In past career interactions, he was an aide to a US senator and brokered billion-dollar deals in the aerospace industry. He now guides professionals in finding their second-half stories. The Flameproof CourseCohorts 1 and 2 sold out. Cohort 3 begins Sept 10, 2024. This is the hidden anti-burnout curriculum we all should have learned in training. Get the deets Coming soon: Out on TimeStay out of chart debt. Document like a legend. Get home on time! Love medicine, but the job itself leaves a lot to be desired?I work with many docs in your shoes. To learn more about 1-on-1 coaching, start here.For full show notes of this episode and all sorts of other goodies, visit our podcast websiteWe Discuss: Do I double down on what I'm doing right now or consider making a career change?Tolerating another yesterdayThe Pit: A Signal for ChangeRecognizing and Overcoming the Tax of DiscontentWorking yourself into The Box | We strive for years to get into it, but then it can feel like a trap. The two things that keep high-level professionals stuck in a career or positionWork identity takes a long time to build. It gives amazing opportunities but also takes some awayThe Trade: Step by StepThe mindset to thwart inertia #JFDSHas this job given me all it has to give and have I gotten all I have to get?A lifetime is a long time, but it doesn't take long to live itMentioned in this episode:Awake and AwareOur Live Event. May 1-3, 2024 | Bend, OR

Awake and Aware An in-person live workshop to help you put into practice the tools you hear...

Making the trade | How to know when it's time to change careers

The interplay between the Default Mode Network (DMN) and the Task Positive Network (TPN) is crucial for our cognitive and emotional health. The DMN, active during restful states and wandering mind, facilitates introspection, memory recall, and creativity, serving as a foundational element in our mental processes. On the other hand, the TPN takes charge during focused, goal-oriented tasks, enabling attention, decision-making, and problem-solving. They operate in balance - when one is active, the other quiescent and this dynamic is essential for optimal mental functioning.However, imbalances in these networks can lead to mental health challenges. For instance, excessive DMN activity is linked to conditions like depression and anxiety, where rumination and negative self-referential thoughts prevail. In contrast, overreliance on the TPN without adequate rest can lead to burnout and stress.Mindfulness meditation offers a practical approach to equilibrating the DMN and TPN, promoting mental well-being by fostering a state of alert relaxation and enhancing self-awareness. Moreover, incorporating regular breaks into the workday, particularly those that allow for mental disengagement from task-focused activities, is vital for sustaining cognitive performance and preventing decision fatigue. Engaging in activities that stimulate the DMN, such as spending time in nature or practicing mindfulness, during these breaks can further enhance cognitive restoration and emotional balance.﻿Awake and Aware | Our 2024 Live EventJoin us at Awake and Aware 2024, a transformative 3-day workshop from May 1st to 3rd in Bend, Oregon. Mitigate stress and stay cool under pressure. Create the mindset you want and lock it in. Limited slots.Website: Awakeandawarebend.com16.25 Hours Category 1 AMA CMELove medicine, but the job itself leaves a lot to be desired?I work with many docs in your shoes. To learn more about 1-on-1 coaching, start here.For full show notes of this episode and all sorts of other goodies, visit our podcast websiteWe DiscussWhat is the Default Mode Network?What is the Task Positive Network?Interplay of the TPN and DMNDefault Mode Network out of Balance | Mental IllnessThe Neurophysiology Behind How Taking a Small Step of Action Can Decrease Rumination and AnxietyThe Default Mode Network and InsomniaWhat Happens with the DMN in Meditation?The Task Positive Network&#39;s Role in MeditationWhy Your Task Positive Network is Begging You to Take a Break in the WorkdayHow to Take a Break That Effectively Recharges Your Task Positive NetworkMentioned in this episode:Our Live Event.  May 1-3, 2024 | Bend, ORAwake and Aware

An in-person live workshop to help you put into practice the tools you hear on this show.

Learn to keep cool under pressure, better manage stress, and thrive in what&#39;s an incredibly challenging line of work. 

CME? Yes! This is a CME event.

Unplug, slow down, and dig in.Awake and Aware4 Free Resources specifically designed to address pain p

Default Mode Network vs. Task Positive Network | How our brains balance mind wandering and focused attention

Moral injury, a term initially used in the military context during the Vietnam War to describe the psychological trauma soldiers experienced, has become increasingly relevant in medicine. In this episode, we discuss how moral injury manifests as psychological distress when healthcare professionals' actions, or inactions, contradict their moral or ethical codes, leading to feelings of guilt, inadequacy, and a sense of betrayal.Our conversation will navigate through the history of this term, its definition, relationship with burnout, PTSD, and moral distress. We'll examine real-life scenarios where healthcare workers face moral dilemmas, feeling trapped in a system that often works contrary to their values. Moreover, we’ll explore individual and systemic actions that may help mitigate the impact of moral injury.Guest Bio: Kim Baumbach, MD  is an Assistant Professor of Emergency Medicine at The Ohio State University and Assistant Director of the Kiehl Resident Wellness Endowment ﻿Awake and Aware | Our 2024 Live EventJoin us at Awake and Aware 2024, a transformative 3-day workshop from May 1st to 3rd in Bend, Oregon. Mitigate stress and stay cool under pressure. Create the mindset you want and lock it in. Limited slots.Website: Awakeandawarebend.com16.25 Hours Category 1 AMA CMELove medicine, but the job itself leaves a lot to be desired?I work with many docs in your shoes. To learn more about 1-on-1 coaching, start here.For full show notes of this episode and all sorts of other goodies, visit our podcast websiteMentioned in this episode:Our Live Event.  May 1-3, 2024 | Bend, ORAwake and Aware

An in-person live workshop to help you put into practice the tools you hear on this show.

Learn to keep cool under pressure, better manage stress, and thrive in what's an incredibly challenging line of work. 

CME? Yes! This is a CME event.

Unplug, slow down, and dig in.Awake and AwareThe Driveway DebriefA free resource to help you transition from work to home life. 

Developed from extensive experience with one-on-one physician clients, The Driveway Debrief is a structured exercise for decompression and processing the day's events. 

*Release work tension
*Establish a boundary between professional and personal life
*Be more present with your loved ones after a day's workThe Driveway Debrief

Moral Injury | The crossroads of conscience

There’s no getting around the surges and potential chaos of an emergency department. The good news is that these events are predictable, you know they’re going to happen, just not when. So how do you prepare and then navigate the storm once you’re in the thick of it?In today’s episode, we start with a discussion with Thom Mayer, MD exploring strategies to steel yourself for the inevitable chaos, underscoring the importance of maintaining a positive, agentic, proactive mindset. Drawing parallels to General Theodore Roosevelt Jr.&#39;s decisive leadership on D-Day, the discussion highlights the critical need for quick, confident decision-making. A key focus is on the concept of &quot;energy packets,&quot; a methodical approach to managing the cognitive overload in the ED by strategically allocating mental resources to specific tasks. We also delve into understanding individual stress thresholds and how to manage stress without succumbing to a sense of helplessness. In the second half of the episode, Chris Hicks, MD gives his approach to managing high patient volumes, communication while managing critical patients, and how to address a direct challenge in the resus bay. Guest Bios:Chris Hicks, MDChris is an emergency physician and trauma team leader at St. Michael&#39;s Hospital in Toronto.  He has innovated in several areas of resuscitation and psychological skills, including mental practice, stress inoculation training.  These days he enjoys a quieter life, free from the problematic corporate jib-jab of academic deliverables.  In 2018, as a partial rebuke of the status quo, Chris co-created and chaired resusTO, an inter-professional simulation-based resuscitation conference in Toronto with international acclaim.  In 2020, he co-founded Advanced Performance Healthcare Design, consulting with hospitals and industry using simulation to inform the design of systems, spaces and teams.  Chris is an avid speaker and lecturer, staunch #FOAMed supporter, occasional runner and cyclist, fledgling boxer, semi-retired pianist, and proud father of three lunatic boys.Thom Mayer, MDDr. Mayer is the Medical Director for the NFL Players Association, Clinical Professor of Emergency Medicine at George Washington University and a Senior Lecturing Fellow at Duke University. Dr. Mayer was named the ACEP Outstanding Speaker of the Year in the second year the award was given and has twice been named ACEP’s “Over-the-Top” award winner. On September 11, 2001 Dr. Mayer served as one of the Command Physicians at the Pentagon Rescue Operation, coordinating medical assets at the site.  Dr. Mayer has served on the Department of Defense on Defense Science Board Task Forces on Bioterrorism, Homeland Security and Consequences of Weapons of Mass Destruction. Dr. Mayer also serves as a Medical Director for the Studer Group.﻿Awake and Aware | Our 2024 Live EventJoin us at Awake and Aware 2024, a transformative 3-day workshop from May 1st to 3rd in Bend, Orego

117. From Chaos to Control | Taming the tempest of task saturation

We all have an internal drive that propels us forward, inspiring us to achieve and create. Yet, there's also an innate anti-drive, a subtle yet powerful force that holds us back. This episode delves deeply into the nature of this anti-drive. We explore the foundations of resistance, drawing insights from Stephen Pressfield's 'The War of Art' and linking it to entropy and the Second Law of Thermodynamics. We'll examine why resistance occurs, how it manifests in both our personal and professional lives, and the various ways it can be hidden, even under the guise of positivity. We'll discuss practical strategies to overcome this resistance, ranging from the psychological tools developed by Phil Stutz to Stephen Pressfield’s adopting a professional mindset.﻿Awake and Aware | Our 2024 Live EventJoin us at Awake and Aware 2024, a transformative 3-day workshop from May 1st to 3rd in Bend, Oregon. Mitigate stress and stay cool under pressure. Create the mindset you want and lock it in. Limited slots.Website: Awakeandawarebend.com16.25 Hours Category 1 AMA CMEThe Flameproof CourseCohorts 1 and 2 sold out. Cohort 3 begins Sept 10, 2024. This is the hidden anti-burnout curriculum we all should have learned in training. Get the deets Coming soon: Out on TimeStay out of chart debt. Document like a legend. Get home on time! Love medicine, but the job itself leaves a lot to be desired?I work with many docs in your shoes. To learn more about 1-on-1 coaching, start here.For full show notes of this episode and all sorts of other goodies, visit our podcast websiteWe Discuss:What is Resistance?The link between resistance and entropy Resistance is always on patrol and ready to thwart creativityWhere does resistance come from, and how does it work? The pain of leaving the comfort zoneResistance can be hidden in positive actionHow to overcome resistance. Strategy 1 – Phil Stutz’s The ToolsEven the best feel fear, it can rarely be overcome How to overcome resistance. Strategy 2 – Going ProWhy being process vs goal-oriented is a key to overcoming resistance but nearly impossible to execute fully How criticism can be a manifestation of resistanceOvercoming resistance in documentation habitsMaking your bed and small acts that squeeze resistance out of the pictureMentioned in this episode:Our Live Event.  May 1-3, 2024 | Bend, ORAwake and Aware

An in-person live workshop to help you put into practice the tools you hear on this show.

Learn to keep cool under pressure, better manage stress, and thrive in what's an incredibly challenging line of work. 

CME? Yes! This is a CME event.

Unplug, slow down, and dig in.Awake and Aware

116. Resistance | How to crack inertia

When a critical patient lands on your department&#39;s doorstep without prior notice, even the most seasoned professionals can find themselves momentarily at a loss — wondering what steps to take first and how to prioritize actions in those crucial initial seconds. What do I do first, what do I do next? What’s REALLY important in the first few seconds? In this episode, emergency intensivist and physician coach Scott Weingart breaks down how to get your mind unstuck and move into action. Guest Bio: Scott Weingart, MD is a physician coach and emergency department intensivist from New York. He did fellowships in Trauma, Surgical Critical Care, and ECMO. He is best known for talking about Resuscitation and Critical Care on the EMCRIT podcast , which has been downloaded &gt; 40 million times.﻿Awake and Aware | Our 2024 Live EventJoin us at Awake and Aware 2024, a transformative 3-day workshop from May 1st to 3rd in Bend, Oregon. Mitigate stress and stay cool under pressure. Create the mindset you want and lock it in. Limited slots.Website: Awakeandawarebend.com16.25 Hours Category 1 AMA CMEThe Flameproof CourseCohorts 1 and 2 sold out. Cohort 3 begins Sept 10, 2024. This is the hidden anti-burnout curriculum we all should have learned in training. Get the deets Coming soon: Out on TimeStay out of chart debt. Document like a legend. Get home on time! Love medicine, but the job itself leaves a lot to be desired?I work with many docs in your shoes. To learn more about 1-on-1 coaching, start here.For full show notes of this episode and all sorts of other goodies, visit our podcast website We Discuss: Temporizing vs. Stabilizing: Why Seconds Count but Don&#39;t Really CountThe Emergency Action DrillGet Off the Spot: Taking Action to Get Out of the White NoiseBeat The Stress Fool: Breathe, Self Talk, See (Mental Rehearsal), Focus with a Trigger WordUsing Operant Conditioning to Train a De-escalating Trigger WordYou Don&#39;t Need to Be Everything, Everywhere, All at Once: The Critical Steps to Start UnfreezingThe transition from temporizing to definitive care in a trauma arrestWhy ACLS Fails as an Emergency Action Drill: Strategy vs LogisticsThe Reason Why Cognitive Freeze Happens in a Zero Warning Critical SituationHow to Craft Your Own Emergency Action Drills: The Difference Between Thinky Time and Pure ActionBuilding an Emergency Action Drill from the Ground Up for a New DiseaseA Hospital&#39;s Resuscitation Readiness Contributes to an Individual Clinician Freezing in a Zero Warning SituationMaking an Emergency Department Resuscitation Ready on an Individual LevelEmergency Department Resuscitation Readiness on a Systems Level: The Four Steps to Become a Resus World ChampionPotential Objections to Becoming Resuscitation ReadyHow to Communicate Uncertainty in a Critical SituationMentioned in this episode:The Driveway DebriefA free resource to help you transition from work to home life. 

Developed from extensive experience with one-on-one phy

115. Zero Warning | Scott Weingart on frameworks for no-notice critical patients

The specter of medical malpractice lawsuits looms large for many clinicians, but according to Mark Brown, MD, JD, this anxiety may be disproportionate to the actual risk. In this discussion, we explore the contrasting nature of law and medicine, the unpredictable and capricious nature of legal proceedings, the systemic elements that fuel the high number of medical malpractice lawsuits in the United States, and several practices to reduce the risk of lawsuits.Guest Bio: Mark W. Brown, M.D., J.D., holds a JD from Harvard Law School (1970), and an MD from Dartmouth Medical School (1982). His career includes roles in the Los Angeles District Attorney's Office, criminal defense practice, and teaching law at Southwestern School of Law. In medicine, he completed his internship and residency in Emergency Medicine at Presbyterian Hospital, San Francisco, and UCLA and is currently an emergency physician at Antelope Valley Medical Center and clinical faculty member at UCLA School of Medicine. ﻿Awake and Aware | Our 2024 Live EventJoin us at Awake and Aware 2024, a transformative 3-day workshop from May 1st to 3rd in Bend, Oregon. Mitigate stress and stay cool under pressure. Create the mindset you want and lock it in. Limited slots.Website: Awakeandawarebend.com16.25 Hours Category 1 AMA CMEThe Flameproof CourseCohorts 1 and 2 sold out. Cohort 3 begins Sept 10, 2024. This is the hidden anti-burnout curriculum we all should have learned in training. Get the deets Coming soon: Out on TimeStay out of chart debt. Document like a legend. Get home on time! Love medicine, but the job itself leaves a lot to be desired?I work with many docs in your shoes. To learn more about 1-on-1 coaching, start here.For full show notes of this episode and all sorts of other goodies, visit our podcast websiteWe Discuss: The Fundamental Difference Between Law and MedicineShould you be worried about the National Practitioner Data Bank?Can Getting Sued Lead to Getting Sanctioned by the Medical Board?The Odds of Getting SuedThree Reasons Why The US Has So Many Malpractice SuitsShould You Push For Settling a Lawsuit?The Plaintiff's Attorney Is Not Your Friend, Even If They Act Like ItWhen the Doctor's Med Mal Fear Supersedes the Patient's Risk ToleranceWhat's Really Happening in a DepositionHigh Yield and Low-Cost Ways to Reduce Med Mal Risk and AnxietyThere's a Big Ticket Item That Your Documentation Doesn't CaptureWhat to do About Hindsight Bias

114. An Insider’s Guide to Medical Malpractice | Why the US system is so peculiar and how to navigate the morass

None of us are born with the skills to build and sustain healthy relationships. These things are learned. In this episode, our guest is Ryan Cheney, an experienced psychotherapist and behavioral leadership coach, guiding us through the intricacies of healthy and unhealthy relationship dynamics. Our conversation will explore the importance of interdependence, the negative impacts of codependency, and the nuanced practice of attunement, including how to rectify misattunements. Further, we will delve into the role of healthy boundaries in building resilience and trust, how resistance and perfectionism can hinder growth, acceptance and self-awareness, and the difference between appeasement and compromiseGuest Bio: Ryan Cheney MS, LPC, is a licensed professional counselor, wellness specialist, certified behavioral leadership coach, breath work specialist, and certified XPT (extreme performance training) coach. He received his Master of Science in clinical mental health from Oregon State University and has dedicated himself to learning how to help others through continued research, education, and practice for over 15 years. He has worked in many settings, including community mental health crisis work, clinical outpatient work within medical settings, and as a clinical supervisor for Deschutes County Behavioral Health. He works in his private practice as a clinical mental health therapist specializing in trauma work and as a performance coach, helping others gain self-mastery and thrive.Connect with Ryan Here﻿Awake and Aware | Our 2024 Live EventJoin us at Awake and Aware 2024, a transformative 3-day workshop from May 1st to 3rd in Bend, Oregon. Mitigate stress and stay cool under pressure. Create the mindset you want and lock it in. Limited slots.Website: Awakeandawarebend.com16.25 Hours Category 1 AMA CMEThe Flameproof CourseCohorts 1 and 2 sold out. Cohort 3 begins Sept 10, 2024. This is the hidden anti-burnout curriculum we all should have learned in training. Get the deets Coming soon: Out on TimeStay out of chart debt. Document like a legend. Get home on time! Love medicine, but the job itself leaves a lot to be desired?I work with many docs in your shoes. To learn more about 1-on-1 coaching, start here.For full show notes of this episode and all sorts of other goodies, visit our podcast website We Discuss: The Campfire Metaphor for RelationshipsInteracting with Others' CampfiresThe Difference Between Healthy Interdependence and Codependency The Dynamics of Healthy RelationshipsIdentifying Healthy vs. Unhealthy RelationshipsBlaming Never Helps, But It Sure Happens A LotUnderstanding Resistance in Personal Growth and RelationshipsResistance is a Struggle Against AcceptanceConfronting and Recovering from PerfectionismThe Impact of Attunement on Personal and Professional InteractionsThe Importance of Boundaries in Healthy RelationshipsThe Distinction Between Appeasement and Compromise

113. Understanding Healthy (and Unhealthy) Relationship Dynamics

What: Awake and Aware. Our 3-day live eventWhen: May 1-3 2024Where: Bend, Oregon. USAWebsite: Awakeandawarebend.comEarly bird discount code: FULLYAWAKE24. $100 off registration. Expires Jan 31, 2024CME: Yes! Category 1 AMA continuing medical education credit

Our 2024 Live Event | May 1-3. Bend, OR

Burnout is not a foregone conclusion. While individual efforts play a pivotal role, continually battling systemic challenges can be exhausting. In this episode, we delve into a simple and cost-effective systemic intervention that not only mitigates burnout but also enhances job satisfaction. We then discuss how you can recognize when your colleagues might be in distress, what to do about it, what to say, what not to say, and how to break through the stigma of seeking help. Guest Bio:  Dr. Tricia James is an internist and the Director of Wellness at Providence Portland Medical Center. A champion of local and regional clinician wellness, she is the first author of the groundbreaking HOSP-CPR study﻿Awake and Aware | Our 2024 Live EventJoin us at Awake and Aware 2024, a transformative 3-day workshop from May 1st to 3rd in Bend, Oregon. Mitigate stress and stay cool under pressure. Create the mindset you want and lock it in. Limited slots.Website: Awakeandawarebend.com16.25 Hours Category 1 AMA CMEThe Flameproof CourseCohorts 1 and 2 sold out. Cohort 3 begins Sept 10, 2024. This is the hidden anti-burnout curriculum we all should have learned in training. Get the deets Coming soon: Out on TimeStay out of chart debt. Document like a legend. Get home on time! Love medicine, but the job itself leaves a lot to be desired?I work with many docs in your shoes. To learn more about 1-on-1 coaching, start here.For full show notes of this episode and all sorts of other goodies, visit our podcast website  We Discuss A study of two hospitalist groups. One struggled. One thrived.The intervention group’s mandate was threefold: Listen, identify the pain points, find agencyThe Role of regular debriefing, sharing experiences, and addressing uncertaintyEngagement levels were highThe Intervention Group continued meeting after the study, and it helped. A lotIt’s not just talking about medicine and logistics. There’s a sense of cohesion and mutual support:Outcome of the Non-Intervention GroupChallenges in wellness fundingThe value of funding and compensation for wellness initiativesApproach to securing grantsData and stories are great for persuasion. But it&#39;s empathy and curiosity that will win the day. Most start by approaching administration for grantsThe first step when creating an in-house clinician-run program to build agency and thwart hopelessnessStaffing is a significant stress for many and can seem insurmountable. What can you as an individual do about it?Emotional suppression in healthcare professionals Our tendency to conceal weaknessHow to identify when one of your colleagues is in distressApproaching a distressed colleagueWhat to do if you ask a distressed colleague how they&#39;re doing and they repeatedly say, &quot;I&#39;m fine,&quot; but it&#39;s clear they are notIt&#39;s not our job to fix our colleagues that we&#39;re worried about. But we can step in and offer an invitation.The hardest part about reaching out to offer support is tryin

112. Pizza doesn’t work | An evidence-based intervention that reduced physician burnout and increased job satisfaction

What’s the impact of private equity’s increasingly large footprint in medicine? The results so far have not been promising. We dissect: what is private equity, the recent bankruptcy of the largest emergency medicine staffer in the US and how that impacts clinicians, can corporations practice medicine,  the American Academy of Emergency Medicine has jumped into the fray, does profit-driven medicine ever serve patient care, HCA has been accused of naughty deeds, performance metrics versus the one metric that really matters, the No Surprises Act, and  physician unions.Guest Bio: Leon Adelman, MD, MBA, FACEP, FAAEM is an emergency physician and co-founder of Ivy Clinicians, a software company that simplifies the emergency medicine job search through transparency. Dr. Adelman is the author and publisher of the Emergency Medicine Workforce Newsletter, which explores the business of emergency medicine. As medical director at Tennova Healthcare Clarksville and Johnston Health UNC (large rural EDs in Tennessee and North Carolina), Leon led emergency department teams to exceptional patient-centered outcomes. Leon is a graduate of Brown University, the University of North Carolina School of Medicine, the Harvard-Affiliated Emergency Medicine Residency at Beth Israel Deaconess Medical Center, and the University of Tennessee Haslam College of Business. Leon is married to an emergency nurse and has two adorable dogs.﻿Awake and Aware | Our 2024 Live EventJoin us at Awake and Aware 2024, a transformative 3-day workshop from May 1st to 3rd in Bend, Oregon. Mitigate stress and stay cool under pressure. Create the mindset you want and lock it in. Limited slots.Website: Awakeandawarebend.com16.25 Hours Category 1 AMA CME The Flameproof CourseCohorts 1 and 2 sold out. Cohort 3 begins Sept 10, 2024. This is the hidden anti-burnout curriculum we all should have learned in training. Get the deets Coming soon: Out on TimeStay out of chart debt. Document like a legend. Get home on time! Love medicine, but the job itself leaves a lot to be desired?I work with many docs in your shoes. To learn more about 1-on-1 coaching, start here.For full show notes of this episode and all sorts of other goodies, visit our podcast websiteWe Discuss:  What does &#39;venture capital/private equity&#39; in medicine really mean?The largest emergency medicine staffer in the US, Envision, recently went bankrupt.What happens with all of those clinicians and hospitals when the staffing company implodes?A corporation cannot practice medicine in most states in the US (but can in some!).The American Academy of Emergency Medicine is suing Envision and their corporate entity for the illegal corporate practice of medicineIs there a functional difference between the old-school CMG (contract management groups) and modern-day private equity-owning medical groups?Does profit-driven medicine ever serve patient care?HCA has been accused of funneling patients into end-of-life care to improve hospi

111. Does Private Equity Belong in Medicine?

In this real-life coaching session, we walk Dr. Brit Long through building a framework to help navigate being overwhelmed during the middle part of an emergency department shift. Since this session, he has become more efficient, gotten home earlier on a consistent basis, lowered his stress level, felt less burnout, and experienced more joy in his career. Guest BioBrit Long is an assistant professor of emergency medicine in San Antonio, Texa, and Editor-in-Chief of Clinical Content at emcdocs.net. He is one of the most published authors in the field of emergency medicine. In addition to that, he is a father of two and works in both academic and community settings.﻿Awake and Aware | Our 2024 Live EventJoin us at Awake and Aware 2024, a transformative 3-day workshop from May 1st to 3rd in Bend, Oregon. Mitigate stress and stay cool under pressure. Create the mindset you want and lock it in. Limited slots.Website: Awakeandawarebend.com16.25 Hours Category 1 AMA CME The Flameproof CourseCohorts 1 and 2 sold out. Cohort 3 begins Sept 10, 2024. This is the hidden anti-burnout curriculum we all should have learned in training. Get the deets Coming soon: Out on TimeStay out of chart debt. Document like a legend. Get home on time! Love medicine, but the job itself leaves a lot to be desired?I work with many docs in your shoes. To learn more about 1-on-1 coaching, start here.For full show notes of this episode and all sorts of other goodies, visit our podcast websiteWe Discuss: The fundamental differences between the beginning, midpoint, and end of the shiftWhy mid-shift is so fraughtWhat we usually do when feeling overwhelmedWhy willpower will almost always fail as a sole strategy for keeping up with documentationThe specific steps for navigating mid-shift overwhelmEarly detection of overwhelmA mid-shift action planHow to keep up with documentationThe real reason timely documentation is importantBreaking through your comfort zoneBrit’s plan for triaging tasks Why deferring charts is so seductive and a slippery slope 

110. A Strategy Mid-Shift Overwhelm | Conquer the deluge and get home on time

We wear many hats in life, and one of them can become disproportionately large: our professional identity. Don’t get me wrong, being a physician is amazing and the associated identity is imbued with meaning and purpose. The challenge comes when identity becomes calcified and too narrowly defined. When that happens, it can limit us. In this episode, we delve into the diverse and often unforeseen roles of a physician, the constraints placed on one's identity due to deeply entrenched beliefs about our own capacities, strategies to overcome limiting beliefs,  how the term "just" can undermine one's potential, the significance of embracing alternate identities, and the common thread between Ted Lasso and Deion Sanders. Guest Bio:Pranay Parikh is a principal of Ascent Equity Group, a real estate, private equity company, predominantly for physicians with over 310 million in assets. Pranay is also the purveyor of the Passive Real Estate Income Academy course, which teaches doctors to be able to find vet and invest in real estate syndications; part of the Passive Income MD podcast, and most recently  The Effective Living Formula Course - doing more of what matters. (here's his free webinar) On the side, he is a hospitalist, nocturnist, husband, and father of two young sons.﻿Awake and Aware | Our 2024 Live EventJoin us at Awake and Aware 2024, a transformative 3-day workshop from May 1st to 3rd in Bend, Oregon. Mitigate stress and stay cool under pressure. Create the mindset you want and lock it in. Limited slots.Website: Awakeandawarebend.com16.25 Hours Category 1 AMA CMEThe Flameproof CourseCohorts 1 and 2 sold out. Cohort 3 begins Sept 10, 2024. This is the hidden anti-burnout curriculum we all should have learned in training. Get the deets Coming soon: Out on TimeStay out of chart debt. Document like a legend. Get home on time! Love medicine, but the job itself leaves a lot to be desired?I work with many docs in your shoes. To learn more about 1-on-1 coaching, start here.For full show notes of this episode and all sorts of other goodies, visit our podcast websiteWe Discuss: You are more than ‘just’ a doctorPranay’s system for how he approaches lifeAn over-the-top identity exerciseWhat assumptions do you make about yourself?Unpacking the word 'Just' Exercises to Overcome ‘Just’ The Power of Alter EgosBelief impacts outcome

109. Is Your Identity Holding You Back?

It’s tempting to think of accepting the reality of the moment as acquiescence or giving up, but the opposite is true. Awareness and acceptance of what’s going on inside of you and around you is a recipe for equanimity. With this equanimity, you are able to operate at a higher level as well as be an effective agent for change in the system. Sounds like a paradox!In this episode, we look at mindfulness as a tool for addressing and mitigating burnout, fostering self-compassion, promoting a sense of well-being, squashing imposter syndrome, restoring autonomy, working through our ‘specialness’, getting out of a scarcity mindset, doubting self-doubt, and getting charts done so you can get home on time (yes, it’s true!) Guest Bio Gail Gazelle, MD, MCC is an assistant professor at Harvard Medical School and Master Certified Coach for physicians. She is the author of Everyday Resilience. A Practical Guide to Build Inner Strength and Weather Life’s Challenges, and most recently Mindful MD. 6 Ways Mindfulness Restores Your Autonomy and Cures Healthcare Burnout. To hear more of Gail, she’s the featured guest on Stimulus Episode 27. ﻿Awake and Aware | Our 2024 Live EventJoin us at Awake and Aware 2024, a transformative 3-day workshop from May 1st to 3rd in Bend, Oregon. Mitigate stress and stay cool under pressure. Create the mindset you want and lock it in. Limited slots.Website: Awakeandawarebend.com16.25 Hours Category 1 AMA CME The Flameproof CourseCohorts 1 and 2 sold out. Cohort 3 begins Sept 10, 2024. This is the hidden anti-burnout curriculum we all should have learned in training. Get the deets Coming soon: Out on TimeStay out of chart debt. Document like a legend. Get home on time! Love medicine, but the job itself leaves a lot to be desired?I work with many docs in your shoes. To learn more about 1-on-1 coaching, start here.For full show notes of this episode and all sorts of other goodies, visit our podcast website We Discuss What is mindfulness?  The thinking mind can be overwhelming.  Mindfulness training helps us gain autonomy.   Apps and other methods to assist with meditation and mindfulness.Mindfulness helps in gaining awareness and insight into one's inner dialogue.Recognizing that we are not our thoughts helps restore autonomy and cure burnout. Imposter beliefs contribute to burnout and prevent recognition of our own accomplishments.  Steps that can be taken to challenge and overcome imposter beliefs. Combatting the "special syndrome" experienced by many physicians? The role self-compassion plays in reducing burnout and improving motivation.Shifting from inner criticism to inner ally.  How does the focus on comparison affect healthcare professionals' well-being?  Practicing gratitude and abundance mindset shifts physiology and wellbeing Emotional reactivity and resistance to accepting reality impact...

108. How To Not Argue With Reality | The paradox of accepting the present moment, even when seems really sh*tty

Investigative journalist Scott Carney is our guest as we dive into: Why you might want to consider getting in cold water, the technique for staying in cold water for more than a few seconds, how to take your first step into the freeze, brown fat, the power of lightly held beliefs, how people are dying with the Wim Hof method, and the law of speedy gains. Guest Bio: Scott Carney is an anthropologist, investigative journalist, author, and a seeker of both the fringes of human experience and the core of what makes us human. Scott has written four books to date, including The Vortex, The Enlightenment Trap, The Red Market,  What Doesn’t Kill Us, and The Wedge, and produced the recent film  The Rise and Fall of the Wim Hof Empire.Scott’s work has been featured in many magazines — Wired, Mother Jones, Playboy, Foreign Policy, Men’s Journal, and National Public Radio. He has won the Payne Award for Ethics in Journalism and is a multi-finalist for the Livingston Award for International Journalism. You can find all his goodies on his website.  ﻿Awake and Aware | Our 2024 Live EventJoin us at Awake and Aware 2024, a transformative 3-day workshop from May 1st to 3rd in Bend, Oregon. Mitigate stress and stay cool under pressure. Create the mindset you want and lock it in. Limited slots.Website: Awakeandawarebend.com16.25 Hours Category 1 AMA CMEThe Flameproof CourseCohorts 1 and 2 sold out. Cohort 3 begins Sept 10, 2024. This is the hidden anti-burnout curriculum we all should have learned in training. Get the deets Coming soon: Out on TimeStay out of chart debt. Document like a legend. Get home on time! Love medicine, but the job itself leaves a lot to be desired?I work with many docs in your shoes. To learn more about 1-on-1 coaching, start here.For full show notes of this episode and all sorts of other goodies, visit our podcast websiteWe Discuss: The mindset method for staying in cold waterDetailed steps for entering cold waterThe benefit of breaking through walls and physiologic control using ice water exposureThe power of lightly held beliefsCold exposure as a lightly-held beliefPeople are dying using the Wim Hof methodThe Bitcoin EnemaDoes Brown Fat matter?The law of speedy gains

107. The Power of Lightly Held Beliefs | Bitcoin enemas, cold exposure, and the law of speedy gains

The Drama Triangle identifies our roles in dysfunctional interpersonal dynamics. It can be a potent tool for understanding conflict and miscommunication within personal and professional relationships. In this episode, we break down the core components of the Drama Triangle, strategies to disentangle ourselves from ‘drama’, and explore practical tools to identify and navigate the dynamics of our own interactions.Conceived by Stephen Karpman, the Drama Triangle highlights a particular type of destructive interaction that can occur between individuals in a conflict.The model delineates three distinct roles: the Victim, who experiences a sense of oppression, incapacity, and externalizes responsibility for their predicament; the Hero, who embodies an overly helpful persona and frequently fosters dependency, thus indirectly sustaining the Victim’s sense of helplessness; and the Villain, characterized by blaming, controlling, and authoritative behavior, fostering a power dynamic that aggravates the Victim’s sense of oppression.These roles are not fixed, and participants in the drama often rotate through them, perpetuating a cycle of destructive, non-productive interactions. Understanding this model provides insight into dysfunctional communication patterns, offering a starting point for transformation and healthier relationship dynamics﻿Awake and Aware | Our 2024 Live EventJoin us at Awake and Aware 2024, a transformative 3-day workshop from May 1st to 3rd in Bend, Oregon. Mitigate stress and stay cool under pressure. Create the mindset you want and lock it in. Limited slots.Website: Awakeandawarebend.com16.25 Hours Category 1 AMA CMEThe Flameproof CourseCohorts 1 and 2 sold out. Cohort 3 begins Sept 10, 2024. This is the hidden anti-burnout curriculum we all should have learned in training. Get the deets Coming soon: Out on TimeStay out of chart debt. Document like a legend. Get home on time! Love medicine, but the job itself leaves a lot to be desired?I work with many docs in your shoes. To learn more about 1-on-1 coaching, start here.For full show notes of this episode and all sorts of other goodies, visit our podcast websiteWe discuss: What is the Drama Triangle?The Empowerment DynamicRecalibrating from drama to neutrality

106. The Drama Triangle | Rewriting the script for conflict and broken communication

How do you make important decisions? Do you go by your gut, some sort of defined process, or perhaps a combination of the two? When we're offered an opportunity to participate in something that seems amazing, it’s almost always associated with a cost. That cost is time. Every ‘yes’ is accompanied by even more ‘no’s’.In today’s episode, we take a look inside a real coaching session that addresses just this scenario. Our client is a physician who wants to develop a decision-making process so that he can derive meaning from his professional life and not take on projects or jobs that on the surface sound intriguing but may end up draining rather than fueling him. Client Bio: Josh Russell MD is the editor-in-chief of the Journal of Urgent Care Medicine and is double board-certified in Palliative Care and Emergency Medicine. Apart from his clinical practice, he is a writer, educator, entrepreneur, and trivia enthusiast.﻿Awake and Aware | Our 2024 Live EventJoin us at Awake and Aware 2024, a transformative 3-day workshop from May 1st to 3rd in Bend, Oregon. Mitigate stress and stay cool under pressure. Create the mindset you want and lock it in. Limited slots.Website: Awakeandawarebend.com16.25 Hours Category 1 AMA CMEThe Flameproof CourseCohorts 1 and 2 sold out. Cohort 3 begins Sept 10, 2024. This is the hidden anti-burnout curriculum we all should have learned in training. Get the deets Coming soon: Out on TimeStay out of chart debt. Document like a legend. Get home on time! Love medicine, but the job itself leaves a lot to be desired?I work with many docs in your shoes. To learn more about 1-on-1 coaching, start here.For full show notes of this episode and all sorts of other goodies, visit our podcast website

105. How Do You Decide When to Say Yes or No | Steps to develop a heuristic for decision making

Are you often quick to give advice? You're not alone, but sometimes our advice may not be as helpful as we think. In this podcast episode, we explore the concepts of the advice trap and humble inquiry, which shift communication from telling to asking and encourage us to stay curious a little longer.Guest Bio: The late Edgar Schein, PhD. was a renowned figure in the field of organizational psychology, with significant contributions to the understanding of organizational culture and leadership. As a Professor Emeritus at the Massachusetts Institute of Technology's Sloan School of Management, his academic work spanned several decades, educating countless leaders and thinkers. Holding a Ph.D. in Social Psychology from Harvard University, Dr. Schein was widely recognized for his groundbreaking theories on corporate culture and process consultation. His seminal works, including “Humble Inquiry”, "Organizational Culture and Leadership" and "The Corporate Culture Survival Guide", continue to be pillars of study in the field. Dr. Schein’s dedication and influence earned him prestigious accolades, including the Lifetime Achievement Award in Workplace Learning and Performance from the American Society for Training and Development. His insights continue to shape modern approaches to organizational development and leadership.The Advice Trap  LinkHumble Inquiry  Link﻿Awake and Aware | Our 2024 Live EventJoin us at Awake and Aware 2024, a transformative 3-day workshop from May 1st to 3rd in Bend, Oregon. Mitigate stress and stay cool under pressure. Create the mindset you want and lock it in. Limited slots.Website: Awakeandawarebend.com16.25 Hours Category 1 AMA CMEThe Flameproof CourseCohorts 1 and 2 sold out. Cohort 3 begins Sept 10, 2024. This is the hidden anti-burnout curriculum we all should have learned in training. Get the deets Coming soon: Out on TimeStay out of chart debt. Document like a legend. Get home on time! Love medicine, but the job itself leaves a lot to be desired?I work with many docs in your shoes. To learn more about 1-on-1 coaching, start here.For full show notes of this episode and all sorts of other goodies, visit our podcast websiteWe Discuss:We love to solve problems, and that can be a problemThe Advice TrapWhy even good advice can be badThe paradoxical pitfall of how we see our valueThe demotivatorWhere this comes up in coachingYou are in the coffee shop with your best friendHearing yourself think Humble inquiryIt’s not just to fill the awkward silenceAsking questions is not straightforward Critical skills for implementing humble inquiryTake-home challenge: The next time you engage in a conversation, particularly in a setting where you’re accustomed to ‘telling’, try implementing the principles of Humble Inquiry and notice if there is an advice trap. See how just noticing, not even doing, influences the dynamics of the conversation and the outcomes that unfold. 

104. Trapped in a World of Bad Advice | The tightrope between asking and telling with Edgar Schein, PhD

How often do you walk into work hoping it will be a good day or at least not a bad one? What if it didn’t matter what happened and the good/bad was entirely in your control? In today’s episode, Christina Shenvi MD, MBA, PhD gives insight and specific strategies for a nearly perfect shift. Guest Bio: Christina Shenvi MD, MBA, PhD is an emergency physician at the University of North Carolina, Chapel Hill.  She is president of the Association of Professional Women and Medical Sciences, director of the UNC Office of Academic Excellence, and a world-class time management coach www.timeforyourlife.org. A selection of her previous Stimulus episodes includes Procrastination,   Habits, and ‘Too Much on My Plate.’Mentioned in this episode:  Zen DrivingBe Water documentary﻿Awake and Aware | Our 2024 Live EventJoin us at Awake and Aware 2024, a transformative 3-day workshop from May 1st to 3rd in Bend, Oregon. Mitigate stress and stay cool under pressure. Create the mindset you want and lock it in. Limited slots.Website: Awakeandawarebend.com16.25 Hours Category 1 AMA CMEThe Flameproof CourseCohorts 1 and 2 sold out. Cohort 3 begins Sept 10, 2024. This is the hidden anti-burnout curriculum we all should have learned in training. Get the deets Coming soon: Out on TimeStay out of chart debt. Document like a legend. Get home on time! Love medicine, but the job itself leaves a lot to be desired?I work with many docs in your shoes. To learn more about 1-on-1 coaching, start here.For full show notes of this episode and all sorts of other goodies, visit our podcast website We Discuss:How do you define a nearly perfect shift?What to do when you can’t get something done or things don’t go your way?Why do we experience frustration?The irony of power and powerlessnessPoint of care frustration reversalEven out your standard deviation and raise your meanMental contrasting with implementation intentionsWhat Bruce Lee can teach you about adaptabilityIdentify the opposite outcomeChange your own mindMinimaize vs maximize 

103. How to Have a Nearly Perfect Shift | Reversing frustration and identifying the opposite outcome

In this episode, we explore the 10% rule - the idea that in disagreement, the other person is at least 10% right. This is a tool for conflict abatement and resolution. It’s easy to get caught up in the rightness of our own opinions and ideas – whether it’s in medicine, business, leadership, relationships, or any time we interact with others. However, this can be detrimental to collaboration and creativity.The basics of the 10% rule are simple. When presented with an idea that your gut reaction is to reject, find the 10% value.For example, someone says to you, “I’m thinking of buying one of the decommissioned space shuttles so I can get to work faster.” On the surface, you might think that’s moronic. But what’s the 10% in there? Maybe it’s that they’re thinking of a way to improve the commute to work. So instead of completely rejecting the idea, you could say, “What I like about that idea is less commuting stress and getting to work faster. Let’s build on that and see what other ideas we can come up with.”The 10% rule is different than saying you like the idea itself because that might be a lie. You might not like the idea in total, but there’s almost certainly 10% in there that you do like. By finding that 10%, you can build on it and create a more collaborative interaction.﻿Awake and Aware | Our 2024 Live EventJoin us at Awake and Aware 2024, a transformative 3-day workshop from May 1st to 3rd in Bend, Oregon. Mitigate stress and stay cool under pressure. Create the mindset you want and lock it in. Limited slots.Website: Awakeandawarebend.com16.25 Hours Category 1 AMA CMEThe Flameproof CourseCohorts 1 and 2 sold out. Cohort 3 begins Sept 10, 2024. This is the hidden anti-burnout curriculum we all should have learned in training. Get the deets Coming soon: Out on TimeStay out of chart debt. Document like a legend. Get home on time! Love medicine, but the job itself leaves a lot to be desired?I work with many docs in your shoes. To learn more about 1-on-1 coaching, start here.For full show notes of this episode and all sorts of other goodies, visit our podcast website We discussThe sublime feeling of basking in our own rightnessHow to operationalize the 10% ruleDon't lie and try to appeaseYes vs No. And vs But.All the buts in your dayThe 10% Rule in real-time

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