BOSS Business of Surgery Series

Dr. Stacey Ishman is a pediatric ENT surgeon, a sleep physician, a chief medical officer, an author, and a coach, and she wants every physician to know a secret: you can actually do whatever you want. Her book, The Physician's Guide to Owning Your Time, grew out of a stretch in her own career when she felt overwhelmed, lost, and spending her days on things she did not want to do.

More than 20 years into an academic career, Dr. Ishman was laid off from an administrative role. It had never occurred to her that a surgeon could be laid off. It turned out to be the best thing that ever happened to her, though the hit to her identity was significant. With time to think, she asked what she loved most about academic medicine, and the answer was teaching, coaching, and mentoring. She built a coaching practice, then wrote the book by speaking it aloud in her car, answering 99 prompts with stories from her own career.

In this conversation with Dr. Amy Vertrees, she explains why you cannot find time but can align your calendar with your values, how to build a yes/no filter, why busyness became a currency of perceived competence, and how to set boundaries that stick, from turning off EMR notifications to letting your system and your leaders hold the line. Along the way, the two compare notes on deep work, on the roles surgeons play, and on the pauses in a career (deployments, maternity leaves, COVID) that reveal what really matters.

Part 1: Who She Is and Why She Wrote the Book

Part 2: The Layoff and the Book

Part 3: What the Book Promises and Where to Start

Part 4: Busyness and What It Hides

Part 5: Rebuilding the Life You Want

Part 6: Boundaries in Practice

Part 7: Deep Work

Part 8: Coaching, Vision, and Community

For Overwhelmed Surgeons and Physicians

•       You can't find time. You can only align your calendar with your values.

•       Pick your top three or four values and use them as a yes/no filter so the decisions are made in advance.

•       Turn off EMR notifications after hours and batch your messages during the day.

•       Start with one boundary. Nothing bad will probably happen.

For Leaders and Program Directors

•       Help your team protect their time: ask schedulers and office managers to hold boundaries so physicians don't have to renegotiate daily.

•       Don't fix system problems by asking people to give away admin time and peace of mind.

•       System-level fixes, including ambient AI, reinforce boundaries.

For Early-Career and Academic Physicians

•       Build a promotion plan from day one so your work is intentional and counts toward where you want to end up.

•       Protect deep work, even 30 to 60 minutes at your best energy time.

•       Remember that a layoff, a pause, or a leave can be the moment that shows you what you actually want.

Book (Amazon): https://a.co/d/0ha3GUtP
Podcast: Academic Medicine Strategy Podcast, https://podcasts.apple.com/us/podcast/id1744860399
Blog: http://amedsg.com/blog
LinkedIn: http://linkedin.com/in/stacey-ishman-md-mph
Instagram: @sishmancoach
Website: http://amedsg.com

For the BOSS career clarity audit, head to https://www.bosssurgery.com/

What if your exhaustion and constant "I'm fine" are not a personal failing, but numbness you were trained into?

In this episode of BOSS: Business of Surgery, host Dr. Amy Vertrees sits down with Dr. Stephanie Byerly, an anesthesiologist, coach, and keynote speaker, to talk about the program she created for high-achieving women physicians who have done it all and still feel disconnected from themselves and everyone around them. Her mission: help women go from numb to unnumb, unapologetically themselves and fully alive, without blowing up their lives.

Dr. Byerly spent 25 years in academic medicine as a professor and leader, including national work advocating for women in anesthesiology. Then, after stepping back from leadership roles that she realized she was filling out of habit and external validation, and after a salary discovery that crossed a boundary, she moved to private practice within days and has never looked back.

In this conversation:
- Why so many women physicians perform for safety and validation, and how patriarchal conditioning and imposter syndrome show up in the exam room and the conference room
- Why shame becomes identity for women, and how to stop making every setback about who you are
- Radical self-compassion, and how Dr. Kristin Neff's three parts (mindfulness, common humanity, self-kindness) map onto becoming unnumb
- Nervous system tools from an anesthesiologist: 4-7-8 breathing, grounding, the five-senses reset, and movement
- Why gratitude has been weaponized against women, and what real gratitude looks like
- How safe communities of women accelerate healing, and why rituals matter
- Her daily mirror practice and nighttime clearing ritual

Whether you're burned out, over-functioning, or quietly wondering who you are beneath the roles, this episode is for you.

🎁 Free guide: Numb to Unnumb: Coming Home to Yourself 🌐 stephaniebirley.com (book a breakthrough call) | @stephaniebirleymd on LinkedIn, Facebook, and Instagram

Website:  www.stephaniebyerly.com

LI:          https://www.linkedin.com/in/stephaniebyerlymd/

IG:         https://www.instagram.com/stephaniebyerlymd/

FB:        https://www.facebook.com/stephaniebyerlymd/

🎙️ Host: Dr. Amy Vertrees | bosssurgery.com ⭐
Website: https://www.bosssurgery.com/
IG:https://www.instagram.com/thebosssurgeon

If this episode helped you, please leave a review on Apple Podcasts.

What do you do when you've achieved everything you set out to — and still feel empty? Dr. Mel Thacker did what most surgeons never do: she wrote it all down.

Scrubbing In: A Surgeon's Journey from Self-Doubt to Wholeness is Dr. Thacker's memoir about moral injury, imposter syndrome, panic attacks in the OR, physician devaluation, and the coaching tools that changed everything. In this episode of BOSS: Business of Surgery, Dr. Mel Thacker and host Dr. Amy Vertrees dig into the stories behind the book — and the deeper question underneath all of them: who are you when surgery is no longer the whole answer?

Dr. Thacker is an ENT surgeon, master coach, host of the Surgeons with Purpose podcast, and founder of the Empowered Surgeons Group. She left her private practice partnership in 2024, went to zero for six months, then found a one-week-per-month locums gig in Western Massachusetts — and discovered she had joy again. She now lives what she calls a mosaic career: surgery, coaching, keynote speaking, expert witness work, and writing.

In this episode: what moral injury actually looks like (fighting insurance companies for Budesonide approval is moral injury too, not just the catastrophic cases); why she was paid $254 for a six-hour life-saving airway on a Saturday; how Byron Katie's The Work dismantled the thought "they're gonna find me out"; why she no longer believes in villains — only lessons; and what it means to run toward the storm instead of away from it.

She also explains her three-pillar coaching framework: protect the asset, serve the patient, diversify your professional identity.

🎙️ Book: Scrubbing In (available on Amazon and melthackercoaching.com)
🎙️ Podcast: Surgeons with Purpose | Coaching: Empowered Surgeons Group
🌐 melthackercoaching.com | Host: Dr. Amy Vertrees | bosssurgery.com
⭐ If this episode helped you, please leave a review on Apple Podcasts.

What do you do when someone has a negative opinion of you—and you know they’re wrong?

For high-achieving people, especially surgeons and leaders, it can be incredibly uncomfortable to be misunderstood. We want to explain. We want to correct the record. We want people to understand our intentions.

But spending your time trying to change someone’s opinion can pull you into a cycle of defending, explaining, convincing, and people-pleasing.

In this episode, Amy Vertrees, MD, explores what it really means to let people be wrong about you without ignoring useful feedback or abandoning your responsibility to yourself.

You’ll learn how to:

• Decide whose opinions actually deserve your attention
• Separate useful feedback from someone else’s story about you
• Stop defending yourself and shifting into “convincing energy”
• Use criticism as an opportunity to become more effective and authentic
• Know when to speak up and defend yourself
• Recognize when it’s time to leave a relationship, job, or environment
• Avoid becoming consumed by workplace conflict and other people’s opinions
• Build greater self-trust and stop making someone else’s opinion your identity

The goal isn't to become someone who never cares what other people think. The goal is to become better at deciding whose opinions deserve your attention—and what you want to do with them.

Sometimes you learn from the criticism. Sometimes you stand up for yourself. Sometimes you leave.

And sometimes the most powerful thing you can do is stop trying to win a game you no longer want to play.

For women surgeons navigating difficult colleagues, leadership challenges, workplace conflict, and the pressure to be liked, this is a reminder that you don't have to spend your life convincing everyone to understand you.

You can let them be wrong about you—and keep becoming more of yourself.

The late surgical case is one of the fastest ways for a surgeon to go from having a perfectly planned day to feeling completely trapped, frustrated, and angry.

Cases get delayed. Emergencies happen. Staffing changes. Patients aren't ready. Equipment isn't available. And sometimes, despite everyone's best efforts, the OR schedule simply doesn't work.

But what happens next is where the real coaching work begins.

In this episode, Amy talks about her own experience with a very late case and explores why these situations can trigger so much anger and resentment. Beneath the anger, she argues, is often something deeper: powerlessness.

You'll learn how to:

• Handle the emotional frustration of a late surgical case
• Use waiting time intentionally instead of allowing resentment to build
• Recognize the difference between advocating for change and emotionally discharging
• Avoid taking frustration out on the people around you
• Think differently about the thought, “This shouldn't be happening”
• Decide what you're willing—and no longer willing—to sacrifice for your patients
• Set boundaries without abandoning your commitment to patient care
• Prevent one late case from consuming your evening, weekend, relationships, and peace of mind

There will always be late cases. There will always be things in surgery that are outside your control.

The goal isn't to become the surgeon who never gets frustrated. It's to become the surgeon who can experience frustration without allowing it to consume the rest of the day—or the people around you.

What does Dolly Parton's career teach surgeons about authenticity, ownership, and building a legacy? Listen to hear the 9 lessons I took away from her life and her career. 

FULL DESCRIPTION:

In the days following Dolly Parton's passing, Dr. Amy Vertrees reflects on the business lessons behind one of the most beloved careers in American entertainment, and why they matter so much for surgeons, especially women surgeons.

From refusing to change her signature look to fit anyone else's idea of "professional," to keeping the publishing rights to "I Will Always Love You" even when it meant walking away from a deal with Elvis Presley, Dolly Parton built decades of durable, compounding assets rather than trading her time for a paycheck. Amy walks through nine lessons from Dolly's life and career: authenticity as a business strategy, owning your intellectual property, building teams that compound your strengths, scaling your impact through systems instead of personal bandwidth, and leading from values without becoming divisive.

This episode is a call to shift from the traditional physician question — how much am I being paid — to the boss question: what am I building? Whether it's expertise, reputation, relationships, intellectual property, or a team, Amy makes the case that surgeons, like Dolly, can build something that continues creating value long after they leave the room.

Topics covered: personal branding for physicians, owning your intellectual property, visionary leadership, scaling impact and mentorship, values-based leadership, financial confidence for women in medicine, and building a legacy beyond clinical work.

KEYWORDS

Primary: personal branding for physicians, women in surgery, physician entrepreneur, Dolly Parton business lessons, surgeon leadership, Boss Surgeons, Business of Surgery podcast

Secondary: authenticity in leadership, owning intellectual property, legacy building, scaling impact, values-based leadership, financial confidence for women physicians

CHAPTER MARKERS

00:00 Introduction
01:00 Authenticity as a business strategy
04:00 "Coat of Many Colors"
08:00 Building a brand bigger than your product
10:00 The Elvis Presley story and owning your IP
12:00 Nice is not the opposite of powerful
13:00 Visionary leadership and Dollywood
15:30 Scaling impact: the Imagination Library
19:00 Thinking long term
20:00 Don't be afraid to make money
21:00 Values without division
23:00 Make people feel good
24:00 Closing thoughts

EPISODE TAGS
Dolly Parton, personal branding, women in surgery, physician entrepreneur, intellectual property, visionary leadership, legacy building, values-based leadership, financial confidence, surgeon coaching

Amy shares the origin story behind Columbia Surgical Partners — the practice she now runs with three additional partners across three locations. After 17 years in the Army and a stint as an employed surgeon in a Tennessee community hospital, Amy hit a breaking point: she wanted to make decisions, choose her team, and build the patient experience she believed in, and the employed model wouldn't let her. She walks through the exact moment she quit without a backup plan, how she bought and renovated a building in six weeks right as the pandemic hit, and the financial formula and mindset shifts that took her from a paper planner and a phone app to a thriving four-surgeon group six years later.

Amy's 17 years in the Army gave her early exposure to leadership and committee work, plus a broad-based general surgery skill set (thoracotomies, neck explorations, abdominal cases) and strong breast cancer training from Walter Reed. When she got out, she took the path 'everyone said you're supposed to do' — an employed job at a Tennessee community hospital that seemed to check every box on paper. But the fit wasn't right: decisions felt illogical (the clinic famously had no voicemail because leadership 'didn't want to give them the impression that we'd be checking messages'), and Amy felt she couldn't shape the environment or the patient experience the way she wanted to.

Around 2019–2020, at the end of her three-year contract, Amy started working with coaching for the first time and began asking for changes at the practice. When she hit a wall with administration, she found herself in a meeting with the medical group's CEO. He told her, 'that's just the way it is.' She responded, 'I don't think that I want to do this anymore' — and when he asked if she was quitting, she said yes, on the spot, without a plan. She describes the moment not as fear but as relief: 'it felt like someone was clipping the tethers... I felt free.'

Amy didn't have a financial safety net waiting for her — she built one herself. No student debt from her military years, strong financial habits, and the confidence that she could always find another job if the practice failed. That self-trust, more than any external backup plan, was what let her take the risk.

After quitting, Amy drove around her neighborhood the same day, found available buildings through a patient who happened to be a real estate agent, and closed on one within weeks. She gave her contractor six weeks to renovate — right as COVID-19 began. A fortunate decision to buy all renovation materials and supplies upfront (funded partly by the sale of her mother's house) meant she avoided the supply shortages that hit shortly after. She ran the entire early operation on a paper planner and the Spruce app, personally booking the first appointments before the doors even opened.

Amy's former group initially wanted her to stop seeing new patients six weeks before her departure. Using a negotiation lesson from Chris Voss — treating a 'no' as the start of a negotiation, not the end — she asked the hospital CEO, 'What would make it a yes?' The answer: proof she could follow up with new patients after the move. She provided it, and the restriction was lifted.

Amy is candid that the early days were consumed by decision fatigue — design decisions, financial decisions, hiring decisions, all at once. What helped was a technique she credits to Brooke Castillo of The Life Coach School: Monday Hour One. Instead of an endless task list, Amy took an hour each week to convert her list into things that would actually get done — put on the calendar, not just written down. 'If it's on the list, good luck. If it's on the calendar, you have a chance.'

Amy built her practice around a simple formula: income minus expenses minus tax burden. Owning her building (rather than renting) helped control both expenses and tax exposure. She deliberately kept a 'micro clinic' model to minimize overhead, was profitable from month one, and has watched reimbursement percentages shrink industry-wide since — which is part of why she now teaches that physicians who only get paid for clinical work are, in effect, capped hourly workers. Diversifying income and thinking like an entrepreneur, not just a clinician, is what changes the math.

Six years later, what started as a 'cute little solo practice' has grown into Columbia Surgical Partners: four surgeons, two nurse practitioners, and three locations. Amy never set out with that scale in mind — she credits following instinct, building systems as she needed them, and getting better at delegation (an area she admits she still struggles with) for the growth.

Amy closes with a reminder that private practice isn't the only path to autonomy — many of the mindset and business lessons she describes can be applied inside an employed job too. Her core message: you don't need someone else to be your safety net. Everything you've built up to this point already is one.

It felt like someone was clipping the tethers that I had, and I felt free.

You don't need someone else to be your safety net. Everything you've done for yourself to this day is what has created your safety net.

If it's on the list, good luck. If it's on the calendar, you have a chance.

It's not how much money you make, it's who you become in your career.