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:

105. How Do You Decide When to Say Yes or No | Steps to develop a heuristic for decision making Jul 10, 2023

Show notes

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 + 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

104. Trapped in a World of Bad Advice | The tightrope between asking and telling with Edgar Schein, PhD Jun 26, 2023

Show notes

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 Link

Humble Inquiry Link

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:

We love to solve problems, and that can be a problem
The Advice Trap
Why even good advice can be bad
The paradoxical pitfall of how we see our value
The demotivator
Where this comes up in coaching
You are in the coffee shop with your best friend
Hearing yourself think
Humble inquiry
It’s not just to fill the awkward silence
Asking questions is not straightforward
Critical skills for implementing humble inquiry
Take-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.

103. How to Have a Nearly Perfect Shift | Reversing frustration and identifying the opposite outcome Jun 05, 2023

Show notes

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 Driving

Be Water documentary

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 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 powerlessness
Point of care frustration reversal
Even out your standard deviation and raise your mean
Mental contrasting with implementation intentions
What Bruce Lee can teach you about adaptability
Identify the opposite outcome
Change your own mind
Minimaize vs maximize

102. Ten Percent of a Bad Idea | Why your gut reaction may lead you astray May 15, 2023

Show notes

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 + 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 sublime feeling of basking in our own rightness
How to operationalize the 10% rule
Don't lie and try to appease
Yes vs No. And vs But.
All the buts in your day
The 10% Rule in real-time

101. Being In-Between | How to navigate big and small transitions May 01, 2023

Show notes

Transitions, by their nature, involve ambiguity and disorientation. It's important to recognize that this zone is a natural part of the process of growth and change. In this episode we break down the nature of the being in a transitional/liminal space, embracing it as an identity, and navigating it through small and tectonic changes.

The liminal space is a transitional or in-between state where you’re in a place of vagueness or uncertainty. It’s a place of being ‘in-between’. In architecture, it’s often a passageway. What a perfect metaphor. You’re neither in the room you were before nor arrived at the one where you’re heading.

You’re neither here nor there. You are becoming. You have not yet become.”

We often don’t like it as it feels unsettling and disorienting because we don’t know what to expect.

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 a liminal space?
Situational awareness and the big picture
Embracing a transitional identity
Essential tools and strategies for navigating uncertainty

100. Listening to Understand versus Listening to Win | Strategies for quality listening and how to know when you've got it right Apr 09, 2023

Show notes

Hidden in plain sight is the most important procedure we do. Listening. And not just listening, but listening to understand. Measurable, improvable, and, when done well, can have an incredibly positive impact. Intention is key with listening: are we doing it to understand or to win? In this episode, we break down specific strategies for quality listening, potential pitfalls, and how to know when you've got it right.

Guest bio: Lon Setnik MD is an Emergency Physician and Associate Director of Clinical Programs at the Center for Medical Simulation with expertise in communication

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 concept of listening as a procedure
Two modes of listening: listening to understand and listening to win
Specific tools for listening to understand
Separating the problem from the person
The external marker of quality listening
Finding the optimized solution in patient interactions
Negotiation strategies for success
Active vs empathic listening
How to stay present during conversation

99. Unlocking the Secrets of Learning | Mental models of expertise, threaded cognition, and tactics for information retention Mar 27, 2023

Show notes

Have you ever wondered what it takes to reach the highest level of mastery?Are you a medical student looking for ways to achieve excellence in medical school or a physician wanting to become an expert in your field? If so, you’re in luck! Join us as we explore a fascinating conversation with Dr. Jeff Riddell, a leading expert in medical education as he talks about strategies to develop any skill, how medical school curriculum is adapting, the importance of context and relationships for comprehension, and so much more.

Guest bio: Dr. Jeff Riddell is an Assistant Professor of Clinical Emergency Medicine at the Keck School of Medicine of the University of Southern California. His research on digital technology in medical education has made him a sought-after teacher, speaker, and researcher. He has won numerous accolades and awards for his work in both teaching and research, including the 2019 CORD/EMF Emergency Medicine Education Research Grant and the 2019 Academy Scholar Award in the category of Education Research from the CORD Academy for Scholarship in Education in Emergency 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.

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:

Mastering Learning
Mental Models of Expertise
Evolving Medical Education
Learning Retention from Podcasts
Threaded Cognition - A Theory of Concurrent Multitasking
Is There Gender Bias in Medical Education?
Resident Burnout

98. How to recover from a horrible, rotten, no-good shift Mar 13, 2023

Show notes

Have you ever had a day at work that was so difficult and draining, it felt like it took a toll on your entire being? You're not alone. Meet Dr. Sara Gray, an expert in wellness, resilience, and resuscitation team performance. In this episode, Dr. Gray dives deep into her special framework for coping with difficult days and how to recover and even come out of them a little stronger. She has outlined a process to help you identify and acknowledge the struggles, practice self-care, and ultimately, learn from the experience. This framework will provide you with a roadmap for navigating the complex emotions that come with these difficult moments.

Guest Bio:

Dr. Sara Gray is an Emergency Medicine & Critical Care Physician, Associate Professor at the University of Toronto, and Chief Medical Director with Advisory Services by Cleveland Clinic Canada. Dr. Gray was once named Toronto’s best ER doctor by Toronto Life Magazine. She is also a professional coach and a public speaker.

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 it's important for medical professionals to prepare for a bad shift or traumatic event.
The framework steps in coping with bad shifts and difficult cases.
What is a failure friend and what are their characteristics?

Quote of the pod

"We train to manage all sorts of disasters, to manage the worst cases, but nobody teaches you how to recover when it goes badly...If you have a plan, you can make your recovery so much easier." - Dr. Sara Gray

97. The Spock Retreat | Using logic to solve emotional situations (and how to stop it) Feb 21, 2023

Show notes

Part of practicing medicine is telling patients 'no'. It’s never fun to do so and it can be a draining daily task. It doesn’t have to be that way! In this episode, we break down pitfalls and pearls in these situations as well as specific scripting to help the medicine go down, The Spock Retreat - falling back on logic to solve an emotional situation, what happens when we get pushback on our logical responses, when embracing logic is the right and wrong move, how to approach frustrating and illogical interactions, and saying 'no' in a positive way.

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 the Spock Retreat?
The scenario: a patient pushes for something that they think will help but will actually harm.
A common response when we get pushback on our logic.
You can’t please all the people all of the time.
When embracing our inner Spock is the right move.
When embracing our inner Spock could be the wrong move.
Introducing Bones McCoy.
Why scripting is important.
How to approach a situation that is frustrating and illogical.
What do you want to avoid?
How to say “no” in a positive way: The Yes, No, Yes framework, compliments of the Harvard Program on Negotiation.
What does Yes, No, Yes sound like in real-time?
A script for pushback.

96.5 The curious case of Zithromax and viral respiratory infections Feb 06, 2023

Show notes

When you have a patient who requests a Z-pack for what is almost certainly an acute viral respiratory infection, you probably respond internally or externally (possibly both) that antibiotics do not treat viruses. But could there be some effect on their symptoms, or the viral infection itself, that is not part of the common discussion when it comes to such things? We know that azithromycin is an antibiotic, but it turns out that azithromycin actually has some activity in the viral arena. This absolutely shocked me. The question is, does it matter?

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:

In vitro studies show azithromycin reduces rhinovirus replication and release.
Another in vitro study on respiratory cells from lung transplant patients found azithromycin reduces rhinovirus-associated cellular inflammation.
Kids with coronavirus (the pre-COVID, old-school coronavirus) had reduced viral load with azithromycin.
In enterovirus-infected mice, azithromycin improved survival.
Patients infected with influenza a who were given azithromycin had reduced interleukins 6, 8, 17, tumor necrosis factor, and CRP, indicating anti-inflammatory properties in flu patients.
This study, however, did not show improved clinical outcomes with azithromycin.
Another study using a similar methodology did not see any change in inflammatory markers but had a slight improvement in sore throat and fever resolution in the azithromycin group.
A 2009 paper found that azithromycin did not improve disease course in hospitalized infants with a respiratory synovial virus. There has been signal of clarithromycin decreasing hospitalization in patients with severe RSV, but the preponderance of data are fairly consistent that there is no benefit in hospital stay, length of illness, or oxygen utilization.