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:

77. Tiny Habits | Anchors, micro moves, and upward scaling May 02, 2022

Show notes

Habit change doesn’t have to be grand, spectacular, or a massive shift all at once. In fact, it may be better to start small, tiny, you might say. In this episode, Scott Weingart and I break down the methodology from BJ Fogg’s Tiny Habits and give real world examples as to how it works (and might not work).

Tiny Habits was the selection for our most recent book club. We host these every few months and (free) tickets are available only to those on the mailing list. As you’ll hear us talk about in this pod episode, the discussion amongst the community is by far the best part of the book clubs. Our next book will be The Art of Learning by Josh Watizkin.

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.

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🎓 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:

A Tiny Habits success story [04:55];
Why it may be better for habits to start tiny [07:10];
The three step process of Tiny Habits begins with an ANCHOR MOMENT [08:05];
The second step is the NEW TINY BEHAVIOR [10:25];
The third step and most often neglected: INSTANT CELEBRATION [12:45];
Celebrations that are intrinsically rewarding resonate better from some people than those that are extrinsic [14:50];
Behavior swarm refers to using multiple specific behaviors that can help you achieve a big aspiration [18:50];
Why temptation linking can be remarkably effective [23:10];
The two things that make an action more likely to happen: motivation and the ease of doing it [26:00];
Scaling tiny habits to larger habits [30:00];
Atomic Habits by James Clear may be even more applicable to large behavioral change [32:35];
Willpower and behavioral change [35:20];
The psychological concept of streak perception [38:30];
Using a negative emotion as a prompt for behavioral change [40:00];
And more.

76. Inner Criticism | How to keep a negative inner voice from taking over Apr 18, 2022

Show notes

Chances are that you have a robust inner critic. You might even believe that self-criticism and castigation are the only ways to excel. As a high-level performer, you are not alone. In this episode, we break down the nature of inner criticism and several ways to manage 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.

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🎓 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 objectives in the training of ski jumpers which can be applied to any moment or high stakes situation [02:30];
The importance of self talk [03:45];
What IS your inner critic? [05:40];
The first step to thwarting the inner critic is to be aware that it exists [08:00];
Judgment vs. discernment [09:10];
Dialogue of “the Judge” compared with “the Sage” in a complex resuscitation scenario [11:00];
Switching from “What if” to “What’s next” [13:15];
The second step to quieting the inner critic: coming back to center [15:15];
Activating the voice of the Sage, that motivates through curiosity, empathy, and purpose [17:22];
One way to shift out of self judgment and into discernment is to speak (think) about yourself in the third person [21:20];

75. Hot Debriefing | Processing events while you're still in the arena Apr 03, 2022

Show notes

Finding time to debrief challenging cases can feel nearly impossible amidst the tumult and task saturation of medical practice. The reality, however, is that it’s a necessity, not a nicety. In this episode, emergency physician Stuart Rose and rescue specialist Ashley Liebig discuss two different approaches to immediate debriefs: INFO and the hot offload.

Guest Bios:

Stuart Rose is an emergency physician practicing in Calgary, Canada and lead author of the seminal debriefing paper, Charge nurse facilitated clinical debriefing in the emergency department.

Ashley Liebig is a HEMS Flight Nurse and Helicopter Rescue Specialist with Austin Travis County STAR Flight. Prior to her flight and rescue career, Ashley served in the US Army as a combat medic with the 101st Airborne Division. She is known around the world as a teacher of managing the stress response

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

A particularly stressful resuscitation that was taxing, emotionally and physically, and an approach to the “hot offload” [03:30];
Debriefing core concept #1: The ED charge nurse is optimally suited to organize the debriefing and to lead the conversation [07:25];
A structured approach to debriefing using the mnemonic INFO [12:40];
Sample debrief scripting [13:30];
Handling conflict or criticism that may arise during a debrief [18:35];
The importance of establishing psychological safety [21:00];
Principles of a hot offload [28:15];
Hot offload steps [32:25];
Ashley’s Credo: work hard, be respectful, be kind [36:40];
And more.

74. Flipping the Narrative on Performance Metrics | Why we're bad at self assessment, crafting meaningful metrics, balancing data Mar 21, 2022

Show notes

It doesn’t look like performance metrics are going away any time soon. So why not make them a feature instead of a bug? We discuss: reframing audits so they help elevate and don't feel punitive, why we're not good at self-assessment, creating clinician-relevant (and friendly) metrics, the best way to present metrics to providers, 3 high-yield metrics that make a difference.

Guest Bio: Shawn Dowling MD is the medical director of The Physician Learning Program at the University of Calgary and Clinical Content Lead at the Calgary Zone Emergency Department.

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 metrics are important and how reframing the process can make them feel less punitive
How providing metrics can be an impactful tool to get physicians to identify improvement opportunities and implement changes in their practice
The goal: to improve the quality of care provided by making individual-level as well as system-level changes
Audits are meant to be self-reflective, not punitive.
The fact that current metrics cannot identify the secret sauce for making the best ED provider. They are interrelated and need to be “balanced”.

73. The Value and Pitfalls of Signout Culture with Mike Weinstock, MD Mar 06, 2022

Show notes

There is no doubt that handing over care of a patient to another clinician is potentially fraught with peril. After all, it’s in the transitional moments when error is most likely to occur. But there’s a balance to strike here because there are also myriad upsides to signouts for both the patient and clinician. In this episode, Mike Weinstock, MD breaks down the arguments in favor of signouts, how to do them well, the big fat hairy signout pitfall, and why signouts might just be a key ingredient to career longevity and patient safety.

Guest Bio: Mike Weinstock, MD is Professor of Emergency Medicine, adjunct in the Department of Emergency Medicine of The Ohio State University’s College of Medicine, and director of research and CME at the Adena Hospital.

He has lectured nationally and internationally on medical topics and patient safety issues and is the executive editor for UC RAP, contributed to ERcast and Risk Management Monthly, and has published original research in JAMA IM and Annals of Emergency Medicine. He is the author of the Bouncebacks! series of books,and How’d it Go?. Mike has practiced medicine nationally and internationally including volunteer work in Papua New Guinea, Nepal, and the West Indies.

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:

How the key to protecting yourself medico-legally is having your primary concern be about patient safety and then documenting such that the chart reflects good medical care [01:50];
Principles of medically defensible charting [05:00];
Rob’s chest pain template medical decision-making (MDM) [08:30];
The importance of remembering that one-directional rules (like PERC for PE) do not obligate you to do a workup if a patient fails the rule [12:00];
Why handing off a patient to the incoming doctor when your shift is over may contribute to a successful career as an emergency physician [13:00];
Whether your level of busy-ness during an ED shift is seen as an extenuating circumstance by a defense or plaintiff’s attorney [18:45];
An argument for always reviewing nursing/paramedic notes (and documenting that you did it) and trying to greet EMS when they arrive with a new patient [24:45];
Mike’s opinion of the ideal sign-out culture [32:00];
Some doctors are not comfortable signing out patients, but they take a risk in their career longevity by not doing so [35:30];
Why sign-outs need to have constraints [39:25];
More.

72. Navigating Uncertainty and Powering Down at the End of the Day with Dan Dworkis MD, PhD Feb 21, 2022

Show notes

It can be hard enough managing critical tasks in the best of times, but when things start to go awry, you need to focus even more to keep moving in a positive direction. Back by popular demand, Dan Dworkis (our guest on episode 57) walks us through: navigating uncertainty when under situational pressure, powering down at the end of the day, managing the physiologic response to stress, the most thoughtful procedural time out we’ve ever heard, and transparent team communication.

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.

This episode brought to you by Wild Health! Wild Health provides personalized medicine that takes into account DNA, biometrics, microbiome, and lifestyle factors to come up with your ideal diet, supplements, and lifestyle to optimize health and maximize healthspan. I have been through the Wild Health program and found it a game changer as far as optimizing diet and exercise. Use the code GET30 for 30% off the monthly subscription. Learn more at wildhealth.com.

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:

How Dan’s approach to resuscitation or stressful situations has changed since he started The Emergency Mind project [02:30];
Applying the core principles of prepare, perform, recover, and evolve to the scenario of a difficult intubation [05:20];
Breathing techniques to manage the physiologic response to stress [07:40];
Being cognizant of the other people in the systems around you and communicating what you think you might need next [09:00];
How to build a high-functioning culture [10:55];
Leave no trace emergency medicine and tale of the squeaky door [15:30];
The drama triangle: victim, villain, and hero [17:15];
Altering the principles of behavioral economics when doing a timeout in the ED [19:15]
David Marquet’s fist to five [24:15];
Cognitive load theory and how it helps us guide trainees who struggle when it comes to knowledge under pressure [27:40];
Managing task saturation with systems and structure [31:30];
Powering down after a shift [32:45];
The fact that some days a win is simply not “throwing gas on the fire” [40:12];
Algorithmic vs creative thinking and the shape of uncertainty [42:20];
Dan’s recommendations for new listeners of his show [50:47]

Follow Rob: Twitter, Facebook, and Youtube.

71. Designing Your Life | How an engineer recommends evaluating your work, health, love, and play Feb 07, 2022

Show notes

A book I recommend to many coaching clients is “Designing Your Life” by Bill Burnett and Dave Evans. I’ve even had a client use a several month coaching engagement specifically to focus on the exercises in the book. What makes it such a potent tool? Design thinking.

What happens if we take the same principles that are used to create the fastest road bike or most efficient electric vehicle and apply them to help us live our best life? The concept was not only intriguing, it blew me away. In today’s episode we break down one tool from Designing Your Life: gauging how full/empty we are in 4 buckets of life (health, love, work, play), determining if these buckets are in balance, and introducing the process for rebalancing.

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:

“Designing Your Life” thinking is about approaching life from the perspective of engineering and design, building prototypes to see what does/doesn’t work and using that information to create your next iteration.
When thinking about the quality of your life, Bill Burnett and Dave Evans suggest that you assess your life in terms of these 4 distinct yet overlapping areas: health, work, love, and play.
Start with health, since it is the foundation of all of the other gauges or buckets (pick your metaphor).
While it is often imbalance the work gauge/bucket that brings people to seek the help of a physician coach, work is just another bucket in the totality of what goes into making your life.
The love bucket takes into consideration both the love you give and the love you receive.
The final gauge is play. Play is vital because it allows you to massively recharge.
Once you have determined where your gauges fall or the fullness of your 4 buckets, the next step is to determine whether there is an imbalance and how to correct it. Only you can answer that.

70. Real World Applications of Nonviolent Communication Dec 27, 2021

Show notes

Case studies using Nonviolent Communication in real world situations including: how to give a proper compliment, perils of bringing up past issues, emergency empathy when speaking to a consultant, receiving gratitude, point of care compassion, and the limitations of NVC in the resus bay.

Guest bio: Scott Weingart is an emergency physician who went on to complete fellowships in Trauma, Surgical Critical Care, and ECMO at the Shock Trauma Center in Baltimore. He is best known for his EMCrit Podcast which focuses on resuscitation and ED critical care, and most recently, On Deeper Reflection, an exploration of academic productivity, philosophy, and wellness. He is the author of two books: Emergency Medicine Decision Making and the Resuscitation Crisis Manual.

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 violence in communication that NVC is seeking to remedy [ 03:40];
Why you should avoid discussing the past in heated conversations [06:00];
How to give a compliment NVC-style [11:00];
Receiving gratitude [17:25];
Emergency empathy [18:45];
4 levels of response evolution [22:30];
Limitations of using NVC in the emergency department [24:45]
Point of care compassion [27:00];
The last 3 words mirroring technique [28:50];
Using NVC when the person you’re talking with has a personality disorder [30:40];
What happens when you use NVC to “manipulate” someone who is astute and quickly realizes they’re being managed [35:00];
The fallacy of attribution [38:30];
And more.

69. A Primer on Nonviolent Communication Dec 21, 2021

Show notes

Nonviolent Communication is one of the most powerful ways of speaking with people that I have ever come across. It eliminates useless strategies like judgment and proving yourself right and instead gives you absolutely tactical techniques to get the things you need for happiness for yourself and your interlocutor.

NVC is not a new, gimmicky set of dictum. It boils down the philosophies of Stoicism, the psychological approaches of cognitive behavioral therapy (CBT), and cognitive psychology.

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

68. Take the Suck out of Documentation | Making the most of scribes, documenting in the room (and in front of the patient), efficient workflows Dec 13, 2021

Show notes

Nobody goes into medicine hoping they can have a long career in data entry, but that’s how many feel when looking at computer screens more than patients during a work day. Documentation and the electronic medical record (EMR) are nearly ubiquitous sources of frustration in medical practice. In this episode we cover two solutions to make medical documentation, charting, and the EMR less onerous: a very specific way to interact with scribes and using technology that’s already in your pocket to chart at the bedside. These might seem like ‘tech hacks’ but they are really tools to get away from the computer and back to patient care.

Guest bios: Alan Sielaff is an emergency physician in Ann Arbor, Michigan. Lon Setnik is a community emergency physician in New Hampshire.

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:

Challenges that scribes have when documenting critical parts of the medical record [08:25];
Setting ground rules with your scribe [09:30];
The provider-scribe workflow [11:20];
Lon Setnik’s tips for successful utilization of scribes [19:45];
The importance of doing as much of your documentation as possible in the room with the patient [24:35]
The strategy of dictating the chart in the patient’s room requires several enabling technologies [26:00];
The primary advantages of documenting in front of the patient [33:05];
Habits for good workflow discipline and documentation [37:15];
A primary goal in caregiving: building trust with the patient [42:00];
And more.