This episode’s guest is Dr. Mark Earnest, Division Head of Internal Medicine at the University of Colorado Anschutz Medical School. The conversation centers on the concepts of psychological size and psychological safety in medicine. Psychological size is described as a relational dynamic involving power and status within professional interactions. Psychological safety refers to creating an environment where people feel comfortable having open, honest conversations. Dr. Earnest shares stories that illustrate these concepts in the healthcare setting and emphasizes how leaders must be proactive in recognizing and managing power dynamics. In addition, he highlights the benefits of early education, how ongoing modeling of positive behaviors are essential, and that organizational culture set by leadership has measurable impacts on outcomes, satisfaction, and risk.