Stimulus – Learn Tools to Crush It in Your Medical Career

Do you work in medicine and love patient care but feel like parts of the job don’t measure up? Stimulus equips you with tools, mindset shifts, and strategies they didn’t teach you in training—so you can practice medicine like a boss, flourish in your career, and not let it crush your soul. Emergency physician and executive coach Rob Orman, MD, goes in-depth with thought leaders on how to avoid burnout, improve communication, lead without drama, and stay calm amidst the storm. Don’t just suck it up, think differently.

Latest Episodes:

87. Availability Bias | Skewed risk assessments from a pervasive cognitive distortion Sep 12, 2022

Show notes

We’re all guilty of it, basing decisions on the most recent event. It’s surely part of our wiring. The question is - what do we do about it? In this episode, Justin Morgenstern breaks down availability bias: what it is, how it shows up in life and medical practice, the difference between learning and bias, research showing availability bias happening in real-time, and ways to turn availability bias from a bug into a feature.

Guest Bio: Justin Morgenstern is a community emergency physician with a passion for education, resuscitation, and evidence-based medicine, Purveyor of the amazing First10EM blog, Justin works in the Greater Toronto Area.

On a personal note, Justin and I met years ago at a conference in the Bahamas. He was in the audience and was such an incredible contributor to a group conversation that I had him come up on stage and be a panel member. Since then, I’ve found that he is a rare mix of humility, genius, and kindness.

Awake + Aware | Our 2026 Retreat

Join us at Awake and Aware, our 3-day retreat in Scottsdale, AZ. March 1-4, 2026. Space is limited.

Learn More Here

🎓 P.S. This is a CME event.

The Flameproof Course

The hidden anti-burnout curriculum we all should have learned in training. Cohort 3 begins Sept 10, 2024. Get the deets

For full show notes of this episode and all sorts of other goodies, visit our podcast website

We discuss:

Availability Bias and how it relates to everyday decision-making.
What is availability bias;
Where this shows up in clinical practice;
Learning is not availability bias;
Whether more testing is the right path for subtle presentations of life-threatening diseases;
Testing thresholds;
Tips for avoiding availability bias in our practices;
Real world example of availability bias;
Justin’s tools for addressing bias;
Ways to hack the bias.

86. Mastering Workflow and Overwhelm | Task hierarchy, rate limiting steps, parallel processing, swarming, and the forgotten art of running the board Aug 21, 2022

Show notes

Specific strategies to improve workflow and manage overwhelm during an emergency department shift.

Guest Bio: Landon Mueller, MD is an emergency physician and fellowship trained sports medicine specialist who gave the best talk I’ve ever seen on managing workflow in the emergency department. Now he's our guest on the show.

Awake + Aware | Our 2026 Retreat

Join us at Awake and Aware, our 3-day retreat in Scottsdale, AZ. March 1-4, 2026. Space is limited.

Learn More Here

🎓 P.S. This is a CME event.

The Flameproof Course

The hidden anti-burnout curriculum we all should have learned in training. Cohort 3 begins Sept 10, 2024. Get the deets

For full show notes of this episode and all sorts of other goodies, visit our podcast website

We discuss:

3 phases of an emergency department visit
Why disposition is king, until it isn’
Hierarchy of tasks
Blocking time
Linear vs parallel processing
Swarming
Batching
The quick hit charting nidus
Task switching
Running the board
Managing interruptions

85. The Professional's Mindset | Embracing the pact and extreme ownership Aug 15, 2022

Show notes

What does it mean to act like a true professional? I’m not sure it’s been fully fleshed out in medicine but I’ve met those who are exemplars of it. This pod is a conversation with my partner in hundreds of critical resuscitations, Ben Peery, MD. We talk about wins, losses, lessons learned and, even more than that, I get to introduce you to someone who, for me, was a role model in how to carry oneself as a physician.

Guest Bio: Ben Peery, MD is a 20-year veteran of the emergency department, spending the bulk of that time working in a rural hospital. A former SWAT team member and tactical medicine expert, he is now the host of The Grit Podcast with Ben Peery which you can find on Spotify, iTunes, and all the rest. Ben’s show is conversations “with colleagues in medicine, law enforcement, EMS, and anyone else who has been in the sh*t. By sharing stories and insights we hope to offload mental trauma.”

Awake + Aware | Our 2026 Retreat

Join us at Awake and Aware, our 3-day retreat in Scottsdale, AZ. March 1-4, 2026. Space is limited.

Learn More Here

🎓 P.S. This is a CME event.

The Flameproof Course

The hidden anti-burnout curriculum we all should have learned in training. Cohort 3 begins Sept 10, 2024. Get the deets

For full show notes of this episode and all sorts of other goodies, visit our podcast website

84. A Look Inside Ketamine Clinics (and how to start your own) Aug 08, 2022

Show notes

An inside look at what it takes to launch a ketamine clinic including first steps, navigating hurdles, potential pitfalls, which patients benefit from ketamine, and an exhortation about why you should (and shouldn’t) go into this type of business.

Guest Bio: Dr. Samuel Ko is a Board Certified Emergency Physician and medical director of Reset Ketamine in Palm Springs, California. In addition to his medical practice, Dr. Ko is Co-Creator of an online course - Ketamine StartUp - which teaches other physicians how to start their own ketamine clinic. During his free time, he practices yoga, meditation, reads voraciously, and relaxes with his amazing wife, daughter, and four-legged son. Find Sam on the Insta and Facebook.

Here is the link mentioned in this episode with some ketamine clinic startup SWAG (the ultimate checklist and business plan template) from Sam Ko for Stimulus listeners.

Awake + Aware | Our 2026 Retreat

Join us at Awake and Aware, our 3-day retreat in Scottsdale, AZ. March 1-4, 2026. Space is limited.

Learn More Here

🎓 P.S. This is a CME event.

The Flameproof Course

The hidden anti-burnout curriculum we all should have learned in training. Cohort 3 begins Sept 10, 2024. Get the deets

For full show notes of this episode and all sorts of other goodies, visit our podcast website

We Discuss:

Why Sam started a ketamine clinic [04:45];
What patients report after awakening from a ketamine procedural sedation in the ED [09:30];
What it takes to open a ketamine clinic [11:45];
How ketamine is administered [17:30];
Adverse events during the infusion are rare [20:55];
What happens when the patient enters the clinic [23:05];
Mental preparation prior to the ketamine session [25:50];
The 4 stages of ketamine therapy [28:10];
Monitoring the patient during the experience [28:50];
Liability, price, insurance coverage, and intranasal ketamine [30:10];
Online telemedicine ketamine prescribing and therapy [35:30];
What people get wrong when they start a ketamine clinic [40:40];
Indications for ketamine therapy [43:20];
Ketamine for neuropathic pain [44:50];
Ketamine vs. antidepressants for mood disorders [49:15];

83. Recalibrating when it all falls apart | In real time strategies to reset during a calamity Jul 25, 2022

Show notes

When you are at the lowest of lows after a devastating case, how do you recover in real-time? It’s certainly not easy and it takes a clear plan of action to do it well.

In this episode, pediatric hospitalist Sarangan Uthayalingam walks us through a difficult case where nothing was working. He felt frozen in inaction and the patient, a newborn, did not survive. Immediately afterward, he was in a deep emotional hole, profoundly self-critical, and still had his entire shift in front of him with other patients to care for. What happened next was quite extraordinary - a reset, recalibration, and reframing of intent and mental state so that when the next critical infant came in (which they did in short order) he was not only up to the task but a better clinician. Sarangan breaks down exactly how he did this in granular detail.

Much of the discussion springboards off of Stimulus episode 65

Awake + Aware | Our 2026 Retreat

Join us at Awake and Aware, our 3-day retreat in Scottsdale, AZ. March 1-4, 2026. Space is limited.

Learn More Here

🎓 P.S. This is a CME event.

The Flameproof Course

The hidden anti-burnout curriculum we all should have learned in training. Cohort 3 begins Sept 10, 2024. Get the deets

For full show notes of this episode and all sorts of other goodies, visit our podcast website

82. Letter to My Future Self | Proactively managing self-doubt Jul 11, 2022

Show notes

Have you ever had a situation where afterward you repeatedly questioned the choice you made at the time? You chewed on it, perseverated on it, kept coming back to it? If you are a clinician, there is an amplifier to this because someone else’s life is also involved - the patient’s. You worry about their health, you worry about whether they or their family may sue you - you worry worry worry. I think most of us have been there to varying degrees. In this episode, we will discuss one strategy to manage these fears: the letter to your future self.

Awake + Aware | Our 2026 Retreat

Join us at Awake and Aware, our 3-day retreat in Scottsdale, AZ. March 1-4, 2026. Space is limited.

Learn More Here

🎓 P.S. This is a CME event.

The Flameproof Course

The hidden anti-burnout curriculum we all should have learned in training. Cohort 3 begins Sept 10, 2024. Get the deets

For full show notes of this episode and all sorts of other goodies, visit our podcast website

81. Medical Ethics in the Heat of the Moment | Withdrawing and withholding care, delaying death, over-treatment, and the daughter from California, Jun 27, 2022

Show notes

Medical Ethicist Abbott, MD walks us through her perspectives on myriad ethical quandaries including: How to approach discordance between a patient's written wishes and a family member who says do the opposite, the ethics of operating on demented patients who have an acute life threatening critical illness, a case of a young man with an unsurvivable brain bleed and whether or not to extubate him before the family enters the resus room, strategies to skillfully guide families through withdrawal of life support, and the real consequences of restrictive hospital visitation policies.

Guest Bio: Dr. Jean Abbott is a medical ethicist and faculty at the Center for Bioethics and Humanities and Core Faculty, Master of Science in Palliative Care, University of Colorado Health Sciences Center. She is also Professor Emerita University of Colorado School of Medicine, and 30 year veteran of the emergency department. Not part of her CV but germane to this show...she was my attending when I was a resident in the 1990s and had a profound impact on who I became as a physician. Irreverent, quick witted, and a tireless patient advocate, she is one of the finest physicians I have ever known.

Awake + Aware | Our 2026 Retreat

Join us at Awake and Aware, our 3-day retreat in Scottsdale, AZ. March 1-4, 2026. Space is limited.

Learn More Here

🎓 P.S. This is a CME event.

The Flameproof Course

The hidden anti-burnout curriculum we all should have learned in training. Cohort 3 begins Sept 10, 2024. Get the deets

For full show notes of this episode and all sorts of other goodies, visit our podcast website

We discuss:

Visitor policy– one of the enduring tragedies of the COVID-19 pandemic;
A case of a 45 year old with an unsurvivable brain bleed – Do you remove the endotracheal tube before the family enters the room to say goodbye or do you await their permission to extubate?;
The struggle that society has with brain death;
Withdrawing and withholding care in the emergency department;
One way to approach death disclosure;
Accommodating requests to delay death so family members can arrive to say their goodbyes;
The case of a minimally communicative, demented (but happy) patient with a subdural hemorrhage who was unable to provide consent to surgery and has no POLST;
Reasons why we tend to over treat in the ED;
The scenario where the patient’s POLST form (eg. comfort measures only) and the desires of the power of attorney (do everything) do not align;
Priming families in the ED;
The ethical thing to do when you can’t get informed consent from a patient;
Navigating the “Daughter from California”;
When does the medical Power of Attorney kick in?

80. The False Assumption of Apologizing for Medical Mistakes Jun 13, 2022

Show notes

There’s no denying that mistakes happen in medicine. When they do, what’s the next step? Business as usual is to deny and defend. Not only is this an adversarial and destructive process, it is also a lost opportunity to learn (and for the patient/family to fully understand what happened). In this episode, we explore a novel approach that shifts thinking from ‘risk management’ to ‘patient management’, which some argue is profoundly better for all parties involved in a medical error- clinicians, patients, and systems.

Guest Bio: Peter Smulowitz MD is an expert in health policy and author of Disclosure, apology, and offer programs: stakeholders' views of barriers to and strategies for broad implementation. He currently serves as Chief Medical Officer, Milford Regional Medical Center and is an Associate Professor of emergency medicine, University of Massachusetts Medical School.

Awake + Aware | Our 2026 Retreat

Join us at Awake and Aware, our 3-day retreat in Scottsdale, AZ. March 1-4, 2026. Space is limited.

Learn More Here

🎓 P.S. This is a CME event.

The Flameproof Course

The hidden anti-burnout curriculum we all should have learned in training. Cohort 3 begins Sept 10, 2024. Get the deets

For full show notes of this episode and all sorts of other goodies, visit our podcast website

We Discuss:

The status quo for the way we handle mistakes creates multiple victims, but no winners. [03:30]
It was the aftermath of an unfortunate case that sparked Smulowitz’ interest in this subject. It motivated him to try to make systems better so that others did not have to go through the same trauma. [06:30]
We are taught not to apologize after an adverse event. But is this good advice? [13:50]
Communication, Apology, and Resolution (CARe) programs have been developed to bring providers out of the shadows, encouraging them to talk about adverse events and encouraging a transparent process with the patients and families. [15:55]
How would you apply the CARe process to this hypothetical scenario: a young woman with a viable pregnancy is mistakenly given methotrexate (which was ordered for the patient with an ectopic in the room next to her)?
What is the best way to deliver bad news and apologize effectively? [24:10]
The University of Michigan made the CARe program an institutional process. What happened after they started using it? [22:05]
What are the barriers and strategies for the implementation of CARe programs? [28:45]

79. The Sleep Expert | Get to sleep and stay asleep May 31, 2022

Show notes

Sleep expert Mike Stone, MD joins us for a conversation about how to sleep well (and strategies to do it poorly!) We cover: how sleep cleans your brain, alcohol, caffeine, a pragmatic approach to wearables, light exposure, the villainy of devices before bed, cannabinoids, heat, room temp, and night shifts.

Guest Bio: Dr. Mike Stone has been in medical practice for almost 20 years, and currently serves as the Chief Education Officer at Wild Health. Dr. Stone has held academic appointments at Harvard Medical School and UCSF, and has received multiple national awards for education, innovation, and leadership in medicine. He has spent the bulk of his career focusing on educating students, trainees, and colleagues. Mike is obsessed with optimal health and peak performance, with a deep interest in the effects of lifestyle interventions to improve longevity and cognitive function. He is currently focused on knowledge translation for healthcare practitioners, striving to empower practitioners with practical techniques to competently construct strategies and tactics for their patients' health optimization.

Awake + Aware | Our 2026 Retreat

Join us at Awake and Aware, our 3-day retreat in Scottsdale, AZ. March 1-4, 2026. Space is limited.

Learn More Here

🎓 P.S. This is a CME event.

The Flameproof Course

The hidden anti-burnout curriculum we all should have learned in training. Cohort 3 begins Sept 10, 2024. Get the deets

For full show notes of this episode and all sorts of other goodies, visit our podcast website

We discuss:

What is sleep and why it is important [04:00];
The benefits of exposure to morning sun early in the day and limiting light exposure later in the day [08:00];
A primer on sleep stages [09:30];
How to use wearable sleep trackers smartly [13:45];
Alcohol and sleep [16:40];
Light, blue light and screen time before bed [24:00];
The physiology of caffeine [26:15];
Cannabinoids as a sleep aid [29:30];
Heat – what is the ideal room temperature for optimal sleep? [34:00];
Other sleep hygiene ideas [38:20];
Natural predilection: the early bird vs. the night owl [40:10];l.
Damage control for night shift-associated sleep disturbance [43:45];
Melatonin questions [58:00];

78. I Was Unlucky, But You Frankly Suck | The fundamental attribution error May 16, 2022

Show notes

None of us are immune from the Fundamental Attribution Error - chalking up the behavior of others to their character rather than the situation in which they find themselves. In this episode, we tease out the details of this common bias, its negative effects, and several strategies to address and work through it.

Awake + Aware | Our 2026 Retreat

Join us at Awake and Aware, our 3-day retreat in Scottsdale, AZ. March 1-4, 2026. Space is limited.

Learn More Here

🎓 P.S. This is a CME event.

The Flameproof Course

The hidden anti-burnout curriculum we all should have learned in training. Cohort 3 begins Sept 10, 2024. Get the deets

For full show notes of this episode and all sorts of other goodies, visit our podcast website

We Discuss:

The core tenant of fundamental attribution error;
The fact that nobody sees themselves as the villain of their own story;
Marcus Aurelius’ approach;
Ways to address and manage fundamental attribution error;
Stephen Covey’s simple yet powerful technique: first seek to understand, then be understood;
Empathic listening;
An exercise to understand the other person’s perspective and sort out if you were truly wronged;
“Could malice be misunderstanding?”;
Navigating fundamental attribution error during conflict;
The Most Respectful Interpretation, JFK, and the Cuban Missile Crisis;
How to get 90% of the way with one step;