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. 3 free resources specifically designed to address pain points in emergency medicine practice Scripting your least favorite conversations The quick and dirty guide to calling consults My 4 favorite documentation templates Registration for the Flameproof course is now open The next cohort begins Feb 1, 2024. Learn more here. Love medicine but the job itself leaves a lot to be desired? I work with many docs in your shoes. To learn more about 1 on 1 coaching, start here   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.   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  

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.  Stay Connected Sign up for our newsletter here. Never spammy, always fresh. Our best stuff delivered to your inbox.  Elevate Your Career To learn more about 1 on 1 coaching, start here Registration for The Flameproof Course is Now Open The second cohort begins Feb 1, 2024. Learn more here.  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. 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  

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.  Stay Connected Sign up for our newsletter here Read our last newsletter “The Kids Who Hated Math Have Something to Teach Us” here Elevate Your Career To learn more about 1 on 1 coaching, start here 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. 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  

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!)  For complete show notes, click here.    Stay Connected Sign up for our newsletter here Read our last newsletter “The Kids Who Hated Math Have Something to Teach Us” here Elevate Your Career To learn more about 1 on 1 coaching, start here   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.    We Discuss What the heck is mindfulness anyway? 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  

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.    Shield yourself from bullsh*t Want to re-spark the joy in your practice, get home on time, unstick what’s feeling stuck, or even just build a shied for all the BS you face in a workday? Start here to learn more about 1 on 1 coaching. You’ll be glad you did.   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.   Check out our new (free!) Mini Book Scripting Your Least Favorite Conversations   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  

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. Check out our new (free!) Mini Book on Scripting Your Least Favorite Conversations   Kickassery Want to re-spark the joy in your practice, get home on time, or just unstick what’s feeling stuck? Start here to learn more about 1 on 1 coaching. You’ll be glad you did.   In this podcast, we discuss: What is the Drama Triangle? The Empowerment Dynamic Recalibrating from drama to neutrality

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.   For full show notes visit our podcast page Interested in one-on-one coaching? Learn more at roborman.com Subscribe to our kickass newsletter here

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.   For complete show notes with way more detail than you see on this podcatcher summary, click here. If you’re not into that kind of detail, have an aversion to websites, don’t really care about show notes, or are contrarian in nature, by all means, do not click here.    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. Kickassery: Want to re-spark the joy in your practice, get home on time, or just unstick what’s feeling stuck? Start here to learn more about 1 on 1 coaching.    Mentioned in this episode:  Our recent newsletter on communicating with patients  Newsletter Signup Here Freebies with documentation phrases and tips on calling consults Here The Advice Trap Link Humble Inquiry Link   Registration is open for the FlameProof Course This is a small cohort six-month course specifically for emergency and acute care clinicians that will build and strengthen tools for career longevity, strategies for well-being, life balance, and so much more. Learn more here.    In this pod, 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 The take-home challenge Ed Schein quotes from this episode  

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.    For complete and detailed show notes, visit our website  If you’re interested in 1 on 1 coaching, start here    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.’   Registration is now open for the Flameproof Course.  Scott Weingart and I are launching the FlameProof Course starting September 2023. This is a small cohort six-month course specifically for emergency and acute care clinicians that will build and strengthen tools for career longevity, strategies for well-being, life balance, and so much more. Learn more on the brand-spanking new website.   Mentioned in this episode:  The Quick and Dirty Guide to Calling Consults and My 4 Favorite Documentation Templates Zen Driving Be Water documentary   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 

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 as well as resolution.  Registration is now open for the Flameproof Course The big kahuna! After a year in the making, Scott Weingart and I are launching the FlameProof Course starting September 2023. This is a small cohort six-month course specifically for emergency and acute care clinicians that will build and strengthen tools for career longevity, strategies for well-being, life balance, and so much more. Learn more on the brand-spanking new website. Half day in person. Flameproof: Shift KickAssery workshop on May 29, 2023, at the Cosmopolitan Hotel, Las Vegas. 9a-1p. Limited space (intentionally). This is a PreCon for Essentials of Emergency Medicine. Register Here.   Interested in one-on-one coaching? Learn more at roborman.com For full show notes visit our podcast page 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