How do you build a team in the critical first moments of a crisis? The balance between rapid response and thoughtful planning is delicate, especially when understanding what defines a crisis and acknowledging when you're in the midst of one. This conversation delves into the complexity of emergency team dynamics, emphasizing that the composition and organization of these teams are deeply influenced by their members' specific skills and contexts, with lasting implications long after the crisis has passed.We introduce 'Name, Claim, Aim'—a straightforward, three-step framework designed to streamline team organization under pressure. It's about rapid situational assessment, clear role delegation, and setting concise objectives. The discussion extends to effective leadership in high-stakes situations, including establishing command, ensuring effective communication from the start, and striking the right balance to encourage team input without compromising decisiveness.Exploring the subtleties of crisis leadership, we'll discuss the strategic balance needed for effective oversight and the practicality of 'Name, Claim, Aim' as a distilled version of more complex crisis management theories tailored for the immediacy of emergency care. The conversation will also cover the practical implementation of this framework, from team huddles to understanding the profound impact of the first few seconds on the trajectory of team success.This episode builds on episode 115 - Zero Warning | Frameworks for no notice critical patientsGuest Bio:Lon Setnik, MD, is an emergency physician practicing in New Hampshire and the associate director of clinical programs at the Center for Medical Simulation. Lon is a Stimulus fan favorite. Here are some of his most popular episodes:Listening to Understand versus Listening to WinFeedback can be hard to give and harder to receive. Here are techniques to do both betterTake the Suck out of Documentation | Making the most of scribes, documenting in the room (and in front of the patient), efficient workflowsLove 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.For full show notes of this episode and all sorts of other goodies, visit our podcast websiteWe discuss:The tension between planning and actionWhat defines a crisis?How do you know when you're in a crisis?Teams are contextual in their skill setsHow you organize a team in a crisis has ripples after the event has endedThe three steps to organizing teams in a crisis: Name, Claim, AimHow to declare yourself as a team leaderModeling closed-loop communication from the first moments of team formationThe balance between being a tyrant vs an effective leader and how to avoid suppressing speaking-up behaviorsThe two pillars of Aiming what we want to achieve and who is going to do what to get us thereName, Claim, Aim needs to be fast and efficient; otherwise,...

Will you have enough money to retire? What does that even mean? In this pod, our guest physician financial coach, Elisa Chiang, M.D. Ph.D. breaks down Trading time for money and money for timeWorking harder vs creating valueThe FIRE (Financial Independence Retire Early) movement and why it doesn't always mean living by austerity rulesThe risk of relying solely on retirement accounts to fund your post-career lifeHer biggest financial mistakeHow identity influences spending habitsIncorporating real estate into an investment portfolioGuest Bio: Elizabeth ‘Elisa’ Chiang, M.D. Ph.D. is a board-certified ophthalmologist and fellowship-trained oculoplastic surgeon who found her way into personal finance and real estate investing during her MSTP program, aspiring for FIRE long before it became mainstream. Battling burnout from her work in a hospital system, she turned to real estate as her avenue to financial independence, complemented by her newfound passion for life coaching. With active involvement in rental properties and passive investments in syndications and real estate funds, Elisa now helps others achieve financial independence while embracing life's journey. Learn more at https://www.growyourwealthymindset.com/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.For full show notes of this episode and all sorts of other goodies, visit our podcast websiteWe discuss:Why a high income does not equate to wealthWorking harder vs creating valueOnce debt is gone, attention to money can dwindle Finding a place to start investing can be overwhelming and lead to inertiaHow to navigate a scarcity mindsetHow identity influences spending habitsMoney can buy time, but there's a catchElisa's biggest financial mistakesHow to decide if a real estate investment is a good (or bad) dealElisa’s big-picture financial strategyReal estate investing for positive cash flowIf you only think about maxing out your retirement account, you probably won't retain the same lifestyle when you stop workingBeyond real estate investing, what are other areas for investment to produce cash flow?F.I.R.E Financial Independence Retire Early | Survival, Regular, and Fat FIREHow to figure out how much FIRE money you'll need to stop workingWill my retirement funds actually last? Rate of withdrawal and sequence of returns risk Fat FIRE | Spending more in retirement than you did while workingMentioned in this episode:4 Free Resources specifically designed to address pain points in medical practiceScripting your least favorite conversations The Driveway Debrief My 4 favorite documentation templates The quick and dirty guide to calling consultsFree Resources LinkThe Flameproof Course. Sept 10, 2024Real-time instruction with Rob Orman, MD, and Scott Weingart, MD. Specific tools and strategies for anti-burnout, career longevity, and self-mastery. From a recent Flameproof graduate, "I went from constantly dreading work and thinking of quitting to being able to enjoy shifts on a regular basis."Flameproof Course

Phantasia Kataleptike, a lesser-known gem from Stoic philosophy, offers a transformative approach to life's challenges. This practice of 'objective representation' strips away the layers of subjective judgment that often cloud our perceptions. Imagine the power of viewing a setback not as a disaster but simply as a fact of life, a moment ripe with potential for growth. How does this shift affect our inner turmoil? The Stoics had insights that might surprise you, blending ancient wisdom with actionable strategies for modern living. In this pod, we break down the essence of Phantasia Kataleptike and multiple methods for employing it as a tool for equanimity and de-catastrophization. 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.For full show notes of this episode and all sorts of other goodies, visit our podcast websiteThe Flameproof CourseCohorts 1 and 2 sold out. Cohort 3 begins Sept 10, 2024. This is the hidden anti-burnout curriculum we all should have learned in training. Get the deets Coming soon: Out on TimeStay out of chart debt. Document like a legend. Get home on time! We Discuss:Defining Phantasia KataptikeAcceptance of what isA dog and a cart | Epictetus’ classic simileWhy the words we use impact us as much as (or more than) they impact othersThe lost shipThe A-hole in a JaguarOperationalziing Phantasia KataleptikeValence | Awareness of emotion and narrative The Dichotomy of ControlHow to Think Like a Roman EmperorActively de-catastrophizing Shifting from ‘what if’ to ‘why did’ to ‘so what?’ to ‘what’s next’The threat-challenge seesawWhat to do when the emperor banishes youThe counterarguments to Phantasia KataleptikeMentioned in this episode:4 Free Resources specifically designed to address pain points in medical practiceScripting your least favorite conversations The Driveway Debrief My 4 favorite documentation templates The quick and dirty guide to calling consultsFree Resources LinkOur Live Event. May 1-3, 2024 | Bend, ORAwake and Aware An in-person live workshop to help you put into practice the tools you hear on this show. Learn to keep cool under pressure, better manage stress, and thrive in what's an incredibly challenging line of work. CME? Yes! This is a CME event. Unplug, slow down, and dig in.Awake and Aware

Have you ever found yourself deep in “The Pit” where the mere thought of going back to work triggers an existential crisis? You wonder if your current job is the right choice. Sometimes, all it takes are a few adjustments to the current job and you'll feel fully refreshed and stoked to tackle that next shift. It may also, however, be time for The Trade.In this episode, we delve into the critical juncture many professionals, particularly physicians, find themselves in when their once-aspired career paths no longer bring fulfillment. We tackle:Whether to deepen commitments to your current role or brave the uncertainty of switching careersWhat it means to tolerate another yesterdayThe silent tax paid by grinding it outThe emotional and practical implications of making significant life changesHow a well-cultivated professional identity can become an albatrossA step-by-step guide on how to transition towards a more satisfying careerSo, whether you're a physician on the brink, a professional in a pickle, or just someone who enjoys a good existential quandary with their morning coffee, tune in. Let's laugh in the face of the status quo and ponder if the grass is greener, or if it's just astroturf.Guest bio: Lon Stroschein is the purveyor of the Normal 40 podcast and author of The Trade. In past career interactions, he was an aide to a US senator and brokered billion-dollar deals in the aerospace industry. He now guides professionals in finding their second-half stories. The Flameproof CourseCohorts 1 and 2 sold out. Cohort 3 begins Sept 10, 2024. This is the hidden anti-burnout curriculum we all should have learned in training. Get the deets Coming soon: Out on TimeStay out of chart debt. Document like a legend. Get home on time! 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.For full show notes of this episode and all sorts of other goodies, visit our podcast websiteWe Discuss: Do I double down on what I'm doing right now or consider making a career change?Tolerating another yesterdayThe Pit: A Signal for ChangeRecognizing and Overcoming the Tax of DiscontentWorking yourself into The Box | We strive for years to get into it, but then it can feel like a trap. The two things that keep high-level professionals stuck in a career or positionWork identity takes a long time to build. It gives amazing opportunities but also takes some awayThe Trade: Step by StepThe mindset to thwart inertia #JFDSHas this job given me all it has to give and have I gotten all I have to get?A lifetime is a long time, but it doesn't take long to live itMentioned in this episode:Awake and AwareOur Live Event. May 1-3, 2024 | Bend, OR Awake and Aware An in-person live workshop to help you put into practice the tools you hear...

The interplay between the Default Mode Network (DMN) and the Task Positive Network (TPN) is crucial for our cognitive and emotional health. The DMN, active during restful states and wandering mind, facilitates introspection, memory recall, and creativity, serving as a foundational element in our mental processes. On the other hand, the TPN takes charge during focused, goal-oriented tasks, enabling attention, decision-making, and problem-solving. They operate in balance - when one is active, the other quiescent and this dynamic is essential for optimal mental functioning.However, imbalances in these networks can lead to mental health challenges. For instance, excessive DMN activity is linked to conditions like depression and anxiety, where rumination and negative self-referential thoughts prevail. In contrast, overreliance on the TPN without adequate rest can lead to burnout and stress.Mindfulness meditation offers a practical approach to equilibrating the DMN and TPN, promoting mental well-being by fostering a state of alert relaxation and enhancing self-awareness. Moreover, incorporating regular breaks into the workday, particularly those that allow for mental disengagement from task-focused activities, is vital for sustaining cognitive performance and preventing decision fatigue. Engaging in activities that stimulate the DMN, such as spending time in nature or practicing mindfulness, during these breaks can further enhance cognitive restoration and emotional balance.Awake and Aware | Our 2024 Live EventJoin us at Awake and Aware 2024, a transformative 3-day workshop from May 1st to 3rd in Bend, Oregon. Mitigate stress and stay cool under pressure. Create the mindset you want and lock it in. Limited slots.Website: Awakeandawarebend.com16.25 Hours Category 1 AMA CMELove 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.For full show notes of this episode and all sorts of other goodies, visit our podcast websiteWe DiscussWhat is the Default Mode Network?What is the Task Positive Network?Interplay of the TPN and DMNDefault Mode Network out of Balance | Mental IllnessThe Neurophysiology Behind How Taking a Small Step of Action Can Decrease Rumination and AnxietyThe Default Mode Network and InsomniaWhat Happens with the DMN in Meditation?The Task Positive Network's Role in MeditationWhy Your Task Positive Network is Begging You to Take a Break in the WorkdayHow to Take a Break That Effectively Recharges Your Task Positive NetworkMentioned in this episode:Our Live Event. May 1-3, 2024 | Bend, ORAwake and Aware An in-person live workshop to help you put into practice the tools you hear on this show. Learn to keep cool under pressure, better manage stress, and thrive in what's an incredibly challenging line of work. CME? Yes! This is a CME event. Unplug, slow down, and dig in.Awake and Aware4 Free Resources specifically designed to address pain points in medical practiceScripting your least favorite conversations The Driveway Debrief My 4 favorite documentation templates The quick and dirty guide to calling consultsFree Resources Link

Moral injury, a term initially used in the military context during the Vietnam War to describe the psychological trauma soldiers experienced, has become increasingly relevant in medicine. In this episode, we discuss how moral injury manifests as psychological distress when healthcare professionals' actions, or inactions, contradict their moral or ethical codes, leading to feelings of guilt, inadequacy, and a sense of betrayal.Our conversation will navigate through the history of this term, its definition, relationship with burnout, PTSD, and moral distress. We'll examine real-life scenarios where healthcare workers face moral dilemmas, feeling trapped in a system that often works contrary to their values. Moreover, we’ll explore individual and systemic actions that may help mitigate the impact of moral injury.Guest Bio: Kim Baumbach, MD  is an Assistant Professor of Emergency Medicine at The Ohio State University and Assistant Director of the Kiehl Resident Wellness Endowment Awake and Aware | Our 2024 Live EventJoin us at Awake and Aware 2024, a transformative 3-day workshop from May 1st to 3rd in Bend, Oregon. Mitigate stress and stay cool under pressure. Create the mindset you want and lock it in. Limited slots.Website: Awakeandawarebend.com16.25 Hours Category 1 AMA CMELove 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.For full show notes of this episode and all sorts of other goodies, visit our podcast websiteMentioned in this episode:Our Live Event. May 1-3, 2024 | Bend, ORAwake and Aware An in-person live workshop to help you put into practice the tools you hear on this show. Learn to keep cool under pressure, better manage stress, and thrive in what's an incredibly challenging line of work. CME? Yes! This is a CME event. Unplug, slow down, and dig in.Awake and AwareThe Driveway DebriefA 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 workThe Driveway Debrief

There’s no getting around the surges and potential chaos of an emergency department. The good news is that these events are predictable, you know they’re going to happen, just not when. So how do you prepare and then navigate the storm once you’re in the thick of it?In today’s episode, we start with a discussion with Thom Mayer, MD exploring strategies to steel yourself for the inevitable chaos, underscoring the importance of maintaining a positive, agentic, proactive mindset. Drawing parallels to General Theodore Roosevelt Jr.'s decisive leadership on D-Day, the discussion highlights the critical need for quick, confident decision-making. A key focus is on the concept of "energy packets," a methodical approach to managing the cognitive overload in the ED by strategically allocating mental resources to specific tasks. We also delve into understanding individual stress thresholds and how to manage stress without succumbing to a sense of helplessness. In the second half of the episode, Chris Hicks, MD gives his approach to managing high patient volumes, communication while managing critical patients, and how to address a direct challenge in the resus bay. Guest Bios:Chris Hicks, MDChris is an emergency physician and trauma team leader at St. Michael's Hospital in Toronto.  He has innovated in several areas of resuscitation and psychological skills, including mental practice, stress inoculation training.  These days he enjoys a quieter life, free from the problematic corporate jib-jab of academic deliverables.  In 2018, as a partial rebuke of the status quo, Chris co-created and chaired resusTO, an inter-professional simulation-based resuscitation conference in Toronto with international acclaim.  In 2020, he co-founded Advanced Performance Healthcare Design, consulting with hospitals and industry using simulation to inform the design of systems, spaces and teams.  Chris is an avid speaker and lecturer, staunch #FOAMed supporter, occasional runner and cyclist, fledgling boxer, semi-retired pianist, and proud father of three lunatic boys.Thom Mayer, MDDr. Mayer is the Medical Director for the NFL Players Association, Clinical Professor of Emergency Medicine at George Washington University and a Senior Lecturing Fellow at Duke University. Dr. Mayer was named the ACEP Outstanding Speaker of the Year in the second year the award was given and has twice been named ACEP’s “Over-the-Top” award winner. On September 11, 2001 Dr. Mayer served as one of the Command Physicians at the Pentagon Rescue Operation, coordinating medical assets at the site.  Dr. Mayer has served on the Department of Defense on Defense Science Board Task Forces on Bioterrorism, Homeland Security and Consequences of Weapons of Mass Destruction. Dr. Mayer also serves as a Medical Director for the Studer Group.Awake and Aware | Our 2024 Live EventJoin us at Awake and Aware 2024, a transformative 3-day workshop from May 1st to 3rd in Bend, Oregon. Mitigate stress and stay cool under pressure. Create the mindset you want and lock it in. Limited slots.Website: Awakeandawarebend.com16.25 Hours Category 1 AMA CMELove 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.For full show notes of this episode and all sorts of other goodies, visit our podcast websiteWe Discuss:Setting Yourself Up for Success at the...

We all have an internal drive that propels us forward, inspiring us to achieve and create. Yet, there's also an innate anti-drive, a subtle yet powerful force that holds us back. This episode delves deeply into the nature of this anti-drive. We explore the foundations of resistance, drawing insights from Stephen Pressfield's 'The War of Art' and linking it to entropy and the Second Law of Thermodynamics. We'll examine why resistance occurs, how it manifests in both our personal and professional lives, and the various ways it can be hidden, even under the guise of positivity. We'll discuss practical strategies to overcome this resistance, ranging from the psychological tools developed by Phil Stutz to Stephen Pressfield’s adopting a professional mindset.Awake and Aware | Our 2024 Live EventJoin us at Awake and Aware 2024, a transformative 3-day workshop from May 1st to 3rd in Bend, Oregon. Mitigate stress and stay cool under pressure. Create the mindset you want and lock it in. Limited slots.Website: Awakeandawarebend.com16.25 Hours Category 1 AMA CMEThe Flameproof CourseCohorts 1 and 2 sold out. Cohort 3 begins Sept 10, 2024. This is the hidden anti-burnout curriculum we all should have learned in training. Get the deets Coming soon: Out on TimeStay out of chart debt. Document like a legend. Get home on time! 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.For full show notes of this episode and all sorts of other goodies, visit our podcast websiteWe Discuss:What is Resistance?The link between resistance and entropy Resistance is always on patrol and ready to thwart creativityWhere does resistance come from, and how does it work? The pain of leaving the comfort zoneResistance can be hidden in positive actionHow to overcome resistance. Strategy 1 – Phil Stutz’s The ToolsEven the best feel fear, it can rarely be overcome How to overcome resistance. Strategy 2 – Going ProWhy being process vs goal-oriented is a key to overcoming resistance but nearly impossible to execute fully How criticism can be a manifestation of resistanceOvercoming resistance in documentation habitsMaking your bed and small acts that squeeze resistance out of the pictureMentioned in this episode:Our Live Event. May 1-3, 2024 | Bend, ORAwake and Aware An in-person live workshop to help you put into practice the tools you hear on this show. Learn to keep cool under pressure, better manage stress, and thrive in what's an incredibly challenging line of work. CME? Yes! This is a CME event. Unplug, slow down, and dig in.Awake and Aware

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.Awake and Aware | Our 2024 Live EventJoin us at Awake and Aware 2024, a transformative 3-day workshop from May 1st to 3rd in Bend, Oregon. Mitigate stress and stay cool under pressure. Create the mindset you want and lock it in. Limited slots.Website: Awakeandawarebend.com16.25 Hours Category 1 AMA CMEThe Flameproof CourseCohorts 1 and 2 sold out. Cohort 3 begins Sept 10, 2024. This is the hidden anti-burnout curriculum we all should have learned in training. Get the deets Coming soon: Out on TimeStay out of chart debt. Document like a legend. Get home on time! 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.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 CountThe Emergency Action DrillGet Off the Spot: Taking Action to Get Out of the White NoiseBeat The Stress Fool: Breathe, Self Talk, See (Mental Rehearsal), Focus with a Trigger WordUsing Operant Conditioning to Train a De-escalating Trigger WordYou Don't Need to Be Everything, Everywhere, All at Once: The Critical Steps to Start UnfreezingThe transition from temporizing to definitive care in a trauma arrestWhy ACLS Fails as an Emergency Action Drill: Strategy vs LogisticsThe Reason Why Cognitive Freeze Happens in a Zero Warning Critical SituationHow to Craft Your Own Emergency Action Drills: The Difference Between Thinky Time and Pure ActionBuilding an Emergency Action Drill from the Ground Up for a New DiseaseA Hospital's Resuscitation Readiness Contributes to an Individual Clinician Freezing in a Zero Warning SituationMaking an Emergency Department Resuscitation Ready on an Individual LevelEmergency Department Resuscitation Readiness on a Systems Level: The Four Steps to Become a Resus World ChampionPotential Objections to Becoming Resuscitation ReadyHow to Communicate Uncertainty in a Critical SituationMentioned in this episode:The Driveway DebriefA 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....

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 and Aware | Our 2024 Live EventJoin us at Awake and Aware 2024, a transformative 3-day workshop from May 1st to 3rd in Bend, Oregon. Mitigate stress and stay cool under pressure. Create the mindset you want and lock it in. Limited slots.Website: Awakeandawarebend.com16.25 Hours Category 1 AMA CMEThe Flameproof CourseCohorts 1 and 2 sold out. Cohort 3 begins Sept 10, 2024. This is the hidden anti-burnout curriculum we all should have learned in training. Get the deets Coming soon: Out on TimeStay out of chart debt. Document like a legend. Get home on time! 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.For full show notes of this episode and all sorts of other goodies, visit our podcast websiteWe Discuss: The Fundamental Difference Between Law and MedicineShould you be worried about the National Practitioner Data Bank?Can Getting Sued Lead to Getting Sanctioned by the Medical Board?The Odds of Getting SuedThree Reasons Why The US Has So Many Malpractice SuitsShould You Push For Settling a Lawsuit?The Plaintiff's Attorney Is Not Your Friend, Even If They Act Like ItWhen the Doctor's Med Mal Fear Supersedes the Patient's Risk ToleranceWhat's Really Happening in a DepositionHigh Yield and Low-Cost Ways to Reduce Med Mal Risk and AnxietyThere's a Big Ticket Item That Your Documentation Doesn't CaptureWhat to do About Hindsight Bias