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:

The Emergency Mindset: What Med School Got Wrong Jan 27, 2025

Show notes

What defines the unique mindset of an emergency clinician? It’s not just the fast pace or the chaotic environment—it’s the deliberate, top-down thinking that prioritizes patient safety over diagnostic certainty. This approach, though deceptively simple, often flies in the face of traditional medical training, which emphasizes comprehensive differentials and exhaustive workups. In emergency medicine, knowing what the patient needs often matters more than knowing exactly what they have. In this episode, we explore the emergency medicine mindset, the pitfalls of the bottom-up approach, and why experienced clinicians focus on acute interventions and dangerous conditions. Finally, we discuss how humility and strategic communication with patients can make all the difference in mitigating risk and building trust.

💡 Check out our Free Resources specifically designed to address pain points in medical practice💡

Guest bio: Reuben Strayer is an emergency physician based in Brooklyn, at Maimonides Medical Center. He tweets @emupdates and blogs at EMupdates.com on a variety of emergency medicine topics. His clinical areas of interest include airway management, analgesia, opioid misuse, procedural sedation, agitation, decision-making, and error. His extra-clinical areas of interest include sweeping generalizations and jalapeño peppers.

We Discuss:

A Critique of Medical School Training and the Bottom-Up Approach
Top-Down Approach and Ophthalmology Insights
The 8 Responsibilities of Emergency Physicians
The Wheel of Dangerous Conditions
Top-Down Thinking in Practice
Humility and Communication in Emergency Medicine

Mentioned in this episode:

5 Free Tools To Make Medical Practice Easier

Scripts for your least favorite conversations. The quick and dirty guide to calling consults. A 10-minute "Driveway Debrief" to switch off from work. My favorite documentation templates. Step-by-step guide for delivering the news of death.

Free Resources Link

The Out-On-Time Course

Built for emergency clinicians who are tired of chart debt and getting derailed by interruptions and overwhelm. Learn practical, real-time documentation and shift-efficiency strategies to finish your shift and actually leave on time.

Learn More About The Out-On-Time Course

Doctoring Done Well | Bite-Sized Wins

Every other week, a few minutes of career-elevating insight delivered straight to your inbox. The Doctoring Done Well Newsletter is never lame, never spammy, and always fresh.

Nonverbal Communication | From facial expressions to tonal authority Jan 13, 2025

Show notes

Mastering nonverbal communication can be an elusive task, but the fact remains: what’s unsaid leaves a significant footprint in any interaction. Nowhere is this more palpable than in the medical exam room, where trust and connection between physicians and patients often hinge on subtle, nonverbal cues.

So, how can one build trust through facial expressions and tone of voice alone?

In this episode, we break down how to silently establish rapport, effective use of pauses, the curious role of your eyebrows, impact of end-of-sentence inflection, how to convey uncertainty with confidence, and why learning a patient’s eye color can pay dividends.

💡 Check out our Free Resources specifically designed to address pain points in medical practice💡

Guest bio: Bradley Block, MD, is a private practice otolaryngologist on Long Island, New York, where he lives with his wife and three young sons. He is a partner at ENT and Allergy Associates and creator of the Physician’s Guide to Doctoring Podcast. He realized that rapport was the key to gaining trust, seeing patients efficiently, enjoying his practice, and building his reputation. He tried to find a podcast that would help him improve at doctor-patient communication, but there was none, so he created Physician’s Guide to Doctoring! The topics quickly expanded to “everything we should have been learning while we were memorizing Kreb’s Cycle.”

We Discuss:

The "Interest and Authority" Framework for Nonverbal Communication
Facial Expressions: Conveying Interest
Humor and Likability in Patient Interaction
Making Eye Contact and Noticing Eye Color
Attitude and Authority in Patient Care
Effective Communication Techniques
Addressing Patient Concerns and Fears

Mentioned in this episode:

The Out-On-Time Course

Learn More About The Out-On-Time Course

5 Free Tools To Make Medical Practice Easier

Free Resources Link

Doctoring Done Well | Bite-Sized Wins

Every other week, a few minutes of career-elevating insight delivered straight to your inbox. The Doctoring Done Well Newsletter is never lame, never spammy, and always fresh.

Why You Can't Be Bad at Meditation Dec 30, 2024

Show notes

What’s the biggest mistake people make about meditation? Thinking they’re bad at it. Why do they think this? Because they’ve tried meditating, and their mind just won’t shut up!

It’s a common misconception that meditation means clearing your mind of all thoughts. But in reality, meditation has little—or nothing—to do with that. If your mind wanders or feels like a crowded room full of shouting voices when you close your eyes, you’re not alone. That’s exactly what’s supposed to happen!

A wandering mind isn’t failure—it’s expected, even for seasoned meditators.

In this episode, we break down the exact steps of how to meditate, what to do with a wandering mind, and why a flurry of thoughts—popping up like popcorn—doesn’t mean you’re bad at meditation. In fact, it means your mind is working exactly as it should. Ultimately, meditation isn’t about thinking less; it’s about changing how you engage with your thoughts, making it a skill you simply can’t fail.

💡 Check out our Free Resources specifically designed to address pain points in medical practice💡

Mentioned in this episode:

Doctoring Done Well | Bite-Sized Wins

Every other week, a few minutes of career-elevating insight delivered straight to your inbox. The Doctoring Done Well Newsletter is never lame, never spammy, and always fresh.

What's It Like To Be A Transgender Physician? Dec 16, 2024

Show notes

It started in medical school, when I witnessed the stark reality of the hidden curriculum: a transgender patient referred to as "it" by an attending physician. Over the years, I saw more subtle but no less harmful behaviors—snickers, misused pronouns, quiet biases. I often felt lost in how to respond.

Today, transgender identity feels more politically charged than ever. But beyond the politics, what’s it like simply to be transgender? What challenges do transgender patients face—physically, medically, socially, and emotionally? And how do you navigate a world that sees you differently after transitioning?

In this episode, Dr. Jailyn Avila shares her story. We cover the deeply personal aspects of transition, from conversations with her wife and kids to navigating professional dynamics as an internationally recognized expert. Dr. Avila offers candid insights into her experience as a physician presenting as both male and female, practical advice for providing better care for transgender patients, and strategies for addressing pronouns and mistakes with grace.

💡 Check out our Free Resources specifically designed to address pain points in medical practice💡

Guest bio: Jailyn Avila is a board-certified emergency medicine physician, transgender woman, wife, and mother of three. She has been heavily involved in medical education with an emphasis on bedside ultrasound and runs Core Ultrasound, delivering online educational content. In 2021, Jailyn began her gender transition and “completed” said transition in 2023. Jailyn is currently Core Faculty for the UHS SoCal MEC Emergency Medicine Residency in Temecula, California where she also functions as the Associate Ultrasound Director and the Director of Faculty Development.

Coming Out to Her Wife
Navigating External Frictions and Gender Identity
Balancing Personal and Professional Identity
The Gradual Process of Transition
Work and Social Dynamics
Experiences as Both a Male and Female Physician
Managing Emotions: The RAIN Method
Caring for Transgender Patients in the Emergency Department
Impact of Jailyn's Transition on Her Family and Children
Understanding Gender and Biological Variations

Mentioned in this episode:

The Out-On-Time Course

Learn More About The Out-On-Time Course

Never Lame. Never Spammy. Always Fresh.

If you’d like a few minutes of career-elevating curated kickassery delivered to your inbox, sign up for our newsletter.

5 Free Tools To Make Medical Practice Easier

Free Resources Link

Regression to the Mean Isn’t as Boring as it Sounds Dec 02, 2024

Show notes

Why do our minds seek explanations for everyday patterns, even attributing a cause where none may exist? "Regression to the mean" offers a statistical lens on why extreme experiences naturally revert to the norm. In medicine, this concept reveals why critical observations and repeated assessments are essential to avoid overreactions to abnormal results.

In this episode, we explore the nuances of regression to the mean, breaking down its impact on medical decision-making, patient assessments, and even how we view high-stakes scenarios in healthcare. Finally, we delve into how understanding this principle can enhance clinical judgment and reduce unnecessary interventions.

💡 Check out our Free Resources specifically designed to address pain points in medical practice💡

Guest bio: Josh Russel, 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.

We Discuss:

Superstitions in the Emergency Department
Understanding Regression to the Mean
Is It a Good Idea to Chastise Fighter Pilots?
Blood Pressure Lives on a Bell Curve
The Importance of Control Groups
Pediatric Visits For Fever
Natural History of Disease Processes: Some Are Outliers
The Test of Time
Balancing Urgency with Thoughtful Testing Thresholds

Mentioned in this episode:

5 Free Tools To Make Medical Practice Easier

Free Resources Link

Never Lame. Never Spammy. Always Fresh.

If you’d like a few minutes of career-elevating curated kickassery delivered to your inbox, sign up for our newsletter.

The Out-On-Time Course

Learn More About The Out-On-Time Course

Five Ways to Connect With Patients Nov 18, 2024

Show notes

Being a patient can feel like a lonely experience, especially when you sense your doctor is disconnected. A rushed or disengaged interaction can leave patients feeling unheard and uncared for, no matter how clinically skilled the physician is. At the same time, doctors struggle with overwhelming workloads, which can lead to unintentional detachment from those they treat.

In this episode, we explore five ways to build connection in the exam room quickly, why small gestures matter, and how intentional preparation can change the entire dynamic. Finally, we dive into the emotional complexities of patient care and the essential role of listening and presence in preventing burnout. Our conversation centers around the ‘Presence 5 Practices’ from this article.

💡 Check out our Free Resources specifically designed to address pain points in medical practice💡

Guest Bio: Clay Smith, MD, is an Associate Professor of Emergency Medicine at Vanderbilt University. He is triple board-certified in Internal Medicine, Emergency Medicine, and Pediatrics and the founder of JournalFeed, which provides concise, daily summaries of top medical journal articles.

We Discuss:

The Disconnect Between Patients and Physicians
Why Genuine Doctor-Patient Connections Matter More Than You Think
Easing Patient Anxiety and Shame
The Impact of Preparation and Focus on Patient Care
Listening Intently and Completely
Aligning Care with Patient Priorities
Building Trust by Connecting with the Patient's Story
Understanding Emotional Cues
The Delicate Balance of Antibiotic Stewardship
Understanding Fear Behind Patient Anger

Mentioned in this episode:

The Out-On-Time Course

Learn More About The Out-On-Time Course

5 Free Tools To Make Medical Practice Easier

Free Resources Link

Never Lame. Never Spammy. Always Fresh.

If you’d like a few minutes of career-elevating curated kickassery delivered to your inbox, sign up for our newsletter.

Mel Herbert on Mediocrity, Forgiveness, and the Cost of Holding Grudges Nov 04, 2024

Show notes

Holding onto a grudge can feel strangely delicious, but that sense of righteousness often comes at a steep cost. In this episode, EMRAP founder Mel Herbert joins Rob to unpack a rift that’s lingered for over half a decade—and explore the way forward to healing.

We also break down why achievement does not demand extraordinary genius or talent but a shift in how we view our perceived mediocrity. Why the idea that we need to be exceptional to succeed fuels imposter syndrome and keeps us from valuing the potential in our "average" qualities. We examine the pressing challenges of modern medicine, where corporate pressures often clash with the need for human connection, and how clinicians can reclaim compassion and autonomy. Finally, we address the role of forgiveness and communication in personal and professional growth, revealing how setting boundaries and letting go of resentments can transform relationships and renew purpose.

💡 Check out our Free Resources specifically designed to address pain points in medical practice💡

Guest Bio: Dr. Mel Herbert is an acclaimed emergency medicine educator, entrepreneur, and speaker renowned for his innovative approach to accessible medical education. An Australian-born, U.S.-trained physician, Mel founded EM:RAP, a leading platform providing engaging, high-quality education for emergency care providers globally. His dedication to equitable access led to EM:RAP GO, a nonprofit extending emergency medical training to underserved communities worldwide. Mel’s philosophy, captured in his debut book The Extraordinary Power of Being Average, champions the idea that anyone can achieve remarkable things through dedication and resilience. Currently a Professor of Emergency Medicine at UCLA, Mel also serves as a consultant on the upcoming TV series The Pitt on MAX.

We Discuss:

The Power of Embracing Mediocrity
The Myth of Extraordinary and Why Determination Outshines Talent
Turning Weaknesses into Strengths
The Evolution of Medical Education
The Squeeze of Modern Medicine
Emotional Intelligence in Medical Practice
Forgiveness and Personal Growth
A Dust-Up and Its Aftermath
The Weight of Sadness and Forgiveness
The Power of Communication
Boundaries and Forgiveness – Healing Without Compromising Safety
Entrepreneurial Challenges and Lessons: Balancing Vision and Collaboration

Mentioned in this episode:

Never Lame. Never Spammy. Always Fresh.

If you’d like a few minutes of career-elevating curated kickassery delivered to your inbox, sign up for our newsletter.

Awake + Aware Bend May 5-7, 2025 | Our in person live event

Ready to reset, recharge, and level up? Awake + Aware is a game-changing 3-day workshop where you will learn how to stay cool when the pressure’s on and lock in the mindset you need to flourish. Space is limited. 🎓 P.S. Yes, this is a CME event!

Awake + Aware Bend 2025

5 Free Tools To Make Medical Practice Easier

Free Resources Link

The Fine Print of Crushing It | Small actions for big impact Oct 21, 2024

Show notes

It's often not the big power moves that change our lives; it's the small, intentional actions. By focusing on micro-skills, even the most ambitious goals become achievable.

In this episode, we talk with Drs. Adaira Landry and Resa E. Lewiss about their new book, MicroSkills: Small Actions, Big Impact. We explore how financial literacy, self-presentation, concise communication, and allyship can be developed as essential micro-skills for a successful career. We also navigate workplace dynamics, including recognizing and addressing issues like mansplaining and bropropriating. Finally, we discuss the nuances of learning when to say “yes” or “no,” and the art of timely, respectful communication.

💡 Check out our Free Resources specifically designed to address pain points in medical practice💡

Guest Bios: ADAIRA LANDRY, MD, MEd, is an assistant professor at Harvard Medical School who studied and trained at University of California, Berkeley; University of California, Los Angeles; New York University; and Harvard with almost a decade of experience mentoring students and early-career professionals. She is an entrepreneur, keynote speaker, and award winning mentor. She co-founded Writing in Color, a nonprofit that teaches the craft of writing.

RESA E LEWISS MD is a professor of emergency medicine, TEDMED speaker, TimesUp Healthcare founder, designer, entrepreneur, and award winning educator, mentor, and point-of-care ultrasound specialist. She studied at Brown University, the University of Pennsylvania School of Medicine, the NIH Howard Hughes Research Scholars Program, Harvard Emergency Medicine, and Mount Sinai St. Luke’s Roosevelt. She hosts the Visible Voices Podcast, amplifying content in the healthcare, equity, and current trends spaces.

They have written for CNBC, Fast Company, Forbes, Harvard Business Review, Nature, the Philadelphia Inquirer, Science, Slate, STAT News, Teen Vogue, VOGUE, and USA Today.

We Discuss:

The Concept of Micro-Skills
Financial Literacy and Debt Management
Performing a Debt Inventory to Understand the Landscape of Your Debt
Appearance Matters and Personal Hygiene is a Skill That Doesn't Always Come Naturally
Timing and Context are Critical When Checking In or Providing Feedback
We’re Trained to be Cumbersome in Communication When What We Need is to be Succinct
Don't Bury The Lead
Role-Playing to Improve Communication
Learning from Experience and Modeling. Do we Leave Too Much Up to Chance?
Micro-Skills for Self-Care and Burnout Prevention: The Art of Saying No
Responding to Emails Promptly and Respecting Deadlines are Force Multipliers
Addressing Mansplaining and Bropropriating
The Power of Allyship
Recommended Books

Mentioned in this episode:

5 Free Tools To Make Medical Practice Easier

Free Resources Link

The Out-On-Time Course

Learn More About The Out-On-Time Course

Never Lame. Never Spammy. Always Fresh.

If you’d like a few minutes of career-elevating curated kickassery delivered to your inbox, sign up for our newsletter.

Registration for Awake + Aware 2025 is Now Open! Oct 18, 2024

Show notes

Ready to reset, recharge, and level up?

Join us at our live event - Awake + Aware, a game-changing 3-day workshop from May 5-7 in Bend, Oregon.

Learn how to stay cool when the pressure’s on and lock in the mindset you need to flourish. Space is limited.

🖱️ Website: Awakeandawarebend.com

🎓 P.S. Yes, this is a CME event!

The Lowest Common Denominator of Communication Oct 14, 2024

Show notes

How do you handle your authority being challenged under stress? Even minor communication missteps in high-pressure environments like medicine can create lasting rifts and missed details. While the instinct to push back is strong, it's rarely the best response.

We share a story of miscommunication between a resident and a nurse, highlighting the importance of humility and inquiry in clinical settings. We examine why leading with curiosity instead of ego can save time, build trust, and improve patient care.

💡 Check out our Free Resources specifically designed to address pain points in medical practice💡

We Discuss: