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:

115. Zero Warning | Scott Weingart on frameworks for no-notice critical patients Dec 11, 2023

Show notes

When a critical patient lands on your department'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 > 40 million times.

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:

Temporizing vs. Stabilizing: Why Seconds Count but Don't Really Count
The Emergency Action Drill
Get Off the Spot: Taking Action to Get Out of the White Noise
Beat The Stress Fool: Breathe, Self Talk, See (Mental Rehearsal), Focus with a Trigger Word
Using Operant Conditioning to Train a De-escalating Trigger Word
You Don't Need to Be Everything, Everywhere, All at Once: The Critical Steps to Start Unfreezing
The transition from temporizing to definitive care in a trauma arrest
Why ACLS Fails as an Emergency Action Drill: Strategy vs Logistics
The Reason Why Cognitive Freeze Happens in a Zero Warning Critical Situation
How to Craft Your Own Emergency Action Drills: The Difference Between Thinky Time and Pure Action
Building an Emergency Action Drill from the Ground Up for a New Disease
A Hospital's Resuscitation Readiness Contributes to an Individual Clinician Freezing in a Zero Warning Situation
Making an Emergency Department Resuscitation Ready on an Individual Level
Emergency Department Resuscitation Readiness on a Systems Level: The Four Steps to Become a Resus World Champion
Potential Objections to Becoming Resuscitation Ready
How to Communicate Uncertainty in a Critical Situation

Mentioned in this episode:

The Driveway Debrief

A 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 work

The Driveway Debrief

1 on 1 Physician Coaching

I work with physicians to help them flourish in medical practice. If you're feeling stuck, burned out, or in trouble at work because of communication or conflict, check out our FAQ page for more info. Ready for real change? Book a discovery call. It’s free, low-pressure, and will give you clarity on your next steps.

Physician Coaching FAQ

114. An Insider’s Guide to Medical Malpractice | Why the US system is so peculiar and how to navigate the morass Nov 27, 2023

Show notes

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 + 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:

The Fundamental Difference Between Law and Medicine
Should you be worried about the National Practitioner Data Bank?
Can Getting Sued Lead to Getting Sanctioned by the Medical Board?
The Odds of Getting Sued
Three Reasons Why The US Has So Many Malpractice Suits
Should You Push For Settling a Lawsuit?
The Plaintiff's Attorney Is Not Your Friend, Even If They Act Like It
When the Doctor's Med Mal Fear Supersedes the Patient's Risk Tolerance
What's Really Happening in a Deposition
High Yield and Low-Cost Ways to Reduce Med Mal Risk and Anxiety
There's a Big Ticket Item That Your Documentation Doesn't Capture
What to do About Hindsight Bias

113. Understanding Healthy (and Unhealthy) Relationship Dynamics Nov 13, 2023

Show notes

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 compromise

Guest 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 Here

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 Campfire Metaphor for Relationships
Interacting with Others' Campfires
The Difference Between Healthy Interdependence and Codependency
The Dynamics of Healthy Relationships
Identifying Healthy vs. Unhealthy Relationships
Blaming Never Helps, But It Sure Happens A Lot
Understanding Resistance in Personal Growth and Relationships
Resistance is a Struggle Against Acceptance
Confronting and Recovering from Perfectionism
The Impact of Attunement on Personal and Professional Interactions
The Importance of Boundaries in Healthy Relationships
The Distinction Between Appeasement and Compromise

112. Pizza doesn’t work | An evidence-based intervention that reduced physician burnout and increased job satisfaction Oct 30, 2023

Show notes

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 study

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 study of two hospitalist groups. One struggled. One thrived.
The intervention group’s mandate was threefold: Listen, identify the pain points, find agency
The Role of regular debriefing, sharing experiences, and addressing uncertainty
Engagement levels were high
The Intervention Group continued meeting after the study, and it helped. A lot
It’s not just talking about medicine and logistics. There’s a sense of cohesion and mutual support:
Outcome of the Non-Intervention Group
Challenges in wellness funding
The value of funding and compensation for wellness initiatives
Approach to securing grants
Data and stories are great for persuasion. But it's empathy and curiosity that will win the day.
Most start by approaching administration for grants
The first step when creating an in-house clinician-run program to build agency and thwart hopelessness
Staffing 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 weakness
How to identify when one of your colleagues is in distress
Approaching a distressed colleague
What to do if you ask a distressed colleague how they're doing and they repeatedly say, "I'm fine," but it's clear they are not
It's not our job to fix our colleagues that we're worried about. But we can step in and offer an invitation.
The hardest part about reaching out to offer support is trying not to fix it
Importance of asking hard questions
The internal and external barriers to seeking help when we're struggling | Tricia paid for counseling out of pocket, so no one would know about it
Dr. James’ vision for medicine

111. Does Private Equity Belong in Medicine? Oct 16, 2023

Show notes

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 + 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 does 'venture capital/private equity' 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 medicine
Is 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 hospital mortality metrics.
Has private equity made universal healthcare impossible in the US?
The group you want to work for sees physicians as the business rather than an expense to minimize
Quality of shift is a metric you rarely see on your monthly performance stats, but it should be at the top of the list
Would you ever wash your rental car? The downstream of not having ownership in a group
The No Surprises Act was set up to protect patients. It’s kind of a mess.
Physician unions. Can doctors go on strike?
Leon’s guess outlook for the emergency medicine job market in the coming years

110. A Strategy Mid-Shift Overwhelm | Conquer the deluge and get home on time Oct 02, 2023

Show notes

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 Bio

Brit 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 + 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 fundamental differences between the beginning, midpoint, and end of the shift
Why mid-shift is so fraught
What we usually do when feeling overwhelmed
Why willpower will almost always fail as a sole strategy for keeping up with documentation
The specific steps for navigating mid-shift overwhelm
Early detection of overwhelm
A mid-shift action plan
How to keep up with documentation
The real reason timely documentation is important
Breaking through your comfort zone
Brit’s plan for triaging tasks
Why deferring charts is so seductive and a slippery slope

109. Is Your Identity Holding You Back? Sep 19, 2023

Show notes

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 + 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:

You are more than ‘just’ a doctor
Pranay’s system for how he approaches life
An over-the-top identity exercise
What assumptions do you make about yourself?
Unpacking the word 'Just'
Exercises to Overcome ‘Just’
The Power of Alter Egos
Belief impacts outcome

108. How To Not Argue With Reality | The paradox of accepting the present moment, even when seems really sh*tty Sep 04, 2023

Show notes

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 + 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 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 healthcare providers.
Mindfulness helps healthcare providers appreciate the present and avoid a "milestone mindset"
There's often confusion between acceptance of the moment and acquiescence to an external issue that you want to change

107. The Power of Lightly Held Beliefs | Bitcoin enemas, cold exposure, and the law of speedy gains Aug 14, 2023

Show notes

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 + 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 mindset method for staying in cold water
Detailed steps for entering cold water
The benefit of breaking through walls and physiologic control using ice water exposure
The power of lightly held beliefs
Cold exposure as a lightly-held belief
People are dying using the Wim Hof method
The Bitcoin Enema
Does Brown Fat matter?
The law of speedy gains

106. The Drama Triangle | Rewriting the script for conflict and broken communication Jul 24, 2023

Show notes

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 dynamics

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.