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Stressful events can hijack cognition, cloud judgment, and leave emotional residue that can fuel long-term burnout. For acute care clinicians, those moments of emotional overwhelm, when heart rate spikes and the thinking brain goes offline, can have consequences that last far beyond the shift. While long-term resilience is essential, it’s often the just-in-time strategies that determine whether we break down or rise to the moment. In this episode, we explore the physiology and psychology of real-time emotional regulation with Scott Weingart, MD, co-creator of the Beat the Stress Fool protocol. Finally, we uncover how practices like gratitude flooding and negative visualization can inoculate against burnout and offer emotional integrity in the most harrowing moments of care.

💡 Check out our Free Resources specifically designed to address pain points in medical practice💡

Scott Weingart, MD, is an emergency department intensivist and physician coach based in New York. He completed fellowships in Trauma, Surgical Critical Care, and ECMO, and is internationally recognized for his expertise in resuscitation and critical care. As the creator of the EMCrit podcast, with over 40 million downloads, he has shaped how clinicians think and perform under pressure. Together, Scott and I co-founded Guidewire Coaching, where we create and teach tailored courses to address the real-world pain points of acute care medicine.

• Rapid stress reset with “Beat the Stress Fool”
• Breathing techniques that calm the nervous system
• Self-talk under pressure
• Mental rehearsal that ends in success
• Trigger words for fast de-escalation
• Gratitudinal flooding as a shield during emotional overload
• Real-time tools for grief resilience
• The quiet strength of negative visualization
• Teaching stress tools to trainees without pushback

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The Out-On-Time Course

Built for emergency clinicians who are tired of chart debt and getting derailed by interruptions and overwhelm. Learn practical, real-time documentation and shift-efficiency strategies to finish your shift and actually leave on time.

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5 Free Tools To Make Medical Practice Easier

Scripts for your least favorite conversations.

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No one enters medicine expecting to land on a performance improvement plan, yet for many physicians, it becomes a disorienting reality. A PIP can feel like both a warning and a test, raising existential fears about career, reputation, and future. Behind the formal language is often a complex mix of organizational risk management and legitimate behavioral concerns. In this episode, we explore what it really means to be placed on a PIP, how to navigate the process effectively, and why resistance is rarely a successful strategy. Finally, we share a structured approach to coaching through a PIP that can turn even the most fraught situation into meaningful professional growth.

💡 Check out our Free Resources specifically designed to address pain points in medical practice💡

We Discuss:

• Understanding the Purpose and Structure of a Performance Improvement Plan (PIP)
• Variability and Pitfalls in PIPs
• Why Coaching Matters During a PIP
• Common Reactions and Emotional Toll
• Structural Flaws That Undermine PIPs
• Negotiating and Responding to a PIP
• The Myth of Performance Immunity
• A Coaching Framework for Navigating PIPs
• Collaborating With Leadership
• Success and Long-Term Impact

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What if addiction isn’t about drugs, but about pain? Beneath compulsive behaviors often lie histories of trauma, anxiety, and unmet emotional needs, hidden behind layers of stigma and misunderstanding. In medicine, addiction is still often mischaracterized as a moral failing rather than a treatable illness with deep psychological roots. In this episode, we explore the personal and professional evolution of Dr. Casey Grover, an addiction medicine physician who reframed both his own struggles and the way he cares for patients. Finally, we uncover how shifting mindset and language can transform both clinical outcomes and clinician well-being.

💡 Check out our Free Resources specifically designed to address pain points in medical practice💡

Guest bio:  Dr. Casey Grover is a board-certified physician in Addiction Medicine and Emergency Medicine at Montage Health, where he also serves as Chief of Staff. He is the Physician Champion for the Monterey County Prescribe Safe Initiative, a program focused on reducing opioid misuse through education, safe prescribing, and improved treatment access. In addition to his clinical and leadership roles, Dr. Grover hosts the podcast Addiction Medicine Made Easy, where he breaks down complex topics to make addiction care more approachable for both providers and the public.

We Discuss:

• What is Addiction?
• When Food Becomes a Coping Mechanism
• The Stigma of Addiction
• The Neurology of Addiction
• Divided Views on Sobriety
• Why Some People Recover and Others Relapse
• The Reason Some Brains Get Hooked
• Addiction vs. Dependence — and Why Stigma Makes It Worse
• Building Trust with Patients
• From Frustration to Compassion: Reframing Patient Encounters
• Trauma, PTSD, and Personal Reckoning
• The Practice of Addiction Medicine

Mentioned in this episode:

The Out-On-Time Course

Built for emergency clinicians who are tired of chart debt and getting derailed by interruptions and overwhelm. Learn practical, real-time documentation and shift-efficiency strategies to finish your shift and actually leave on time.

Learn More About The Out-On-Time Course

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5 Free Tools To Make Medical Practice Easier

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What is it about your work that still lights you up inside? At the center of every profession is a core - the reason we chose it in the first place, the part that feels meaningful no matter the chaos around it. When we reconnect with that core, even amid challenge, fulfillment often follows. Sometimes, though, that spark fades. Sometimes the core of what we love evolves, shifts direction, or gets buried under layers of stress and routine. In this episode, we explore how to evaluate your relationship with the essence of your work and how small (or big) recalibrations can realign your day-to-day with what matters most. Finally, we share strategies to clear out the noise, fuel the flame, and shape a career that energizes rather than drains.

🧭 UnBurnable | Our Cohort-Based Burnout Prevention and Cure Course

As physician coaches, my partner, Scott Weingart, and I have noticed a clear pattern: some doctors are thoroughly burned out, and many others are on the path toward it. Almost all were shortchanged in their medical training, having been molded into excellent clinicians but given virtually no tools for retaining joy and equanimity throughout their careers.

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• Starting with the central question: How do you feel about the core of your work?
• Using the stories you tell about your job as diagnostic tools. What tone are you bringing to those tales?
• What is a micro recalibration, and how can it reshape your workday from within your current job?
• How do you recognize when overwhelm is a sign of a broken approach, not a broken you?
• Exploring macro recalibrations. What if you love the work, but the environment is eating you alive?
• Running the “look-around test” to evaluate other institutions.
• Identifying “gravity problems.” Which issues can't be solved within your current system?
• Considering a mega recalibration. What does it mean to step away from the work entirely?
• How identity and sunk costs keep us rooted in roles we may have outgrown.
• Visualizing the flame and smoke of your career. What’s burning bright, and what’s clouding the view?
• Defining what a fulfilling day looks like. Is that kind of day even possible where you are now?
• Use a five-year future vision to clarify whether your current job fits into your ideal life.
• Why walking away doesn’t have to mean burning it down. What might rediscovery look like instead?
• You don’t have to burn it all down to rediscover what lights you up.

💡 Check out our Free Resources specifically designed to address pain points in medical practice💡

Burnout isn’t just emotional, it’s financial. Many doctors put off financial planning until they’re deep in debt, stuck in lifestyle inflation, and too burned out to pivot. In this episode, The White Coat Investor Jim Dahle lays out how to build a burnout-resistant career by making smart, intentional money decisions, whether you’re a student or a seasoned physician.

We delve into frugality (the useful and the absurd), how burnout can quietly become your biggest financial threat, what makes a solid investment plan, the waterfall method of managing your money, and why many doctors end up wealthy on paper but broke in practice. Plus: when hiring a financial advisor is the smartest move you can make—and when it’s the worst.

Guest bio:  Jim Dahle, MD, FACEP is a practicing emergency physician and the founder of The White Coat Investor. After early experiences with predatory financial advisors, he taught himself personal finance and saw firsthand how financial literacy transformed his life. Motivated to help colleagues avoid similar pitfalls, he launched The White Coat Investor—then the only unbiased financial education resource for physicians. More than a decade later, Dr. Dahle continues to lead the organization as CEO, columnist, and podcast host, staying true to its mission: “help those who wear the white coat get a fair shake on Wall Street.”

• Financial goals as the “game,” not competition with others
• Embracing frugality (and where it can go too far)
• Burnout as a major financial risk
• Strategies to reduce burnout, including working less and managing spending
• Understanding your financial “basement” (minimum monthly needs)
• Lifestyle creep and how to monitor it
• The “live like a resident” strategy post-training
• Net worth versus income, and why physicians sometimes retire broke
• The financial “waterfall” (how to prioritize where your money goes)
• Why trying to beat the market usually backfires
• Whole life insurance: the hype versus reality
• Creating an Investment Policy Statement (IPS)
• Real estate investing: REITs versus hands-on ownership
• Designing your life and shifts as a financially independent physician
• The "night shift marketplace" model
• When to work with, or fire, a financial advisor
• Case study: mid-career physician financial planning

Mentioned in this episode:

5 Free Tools To Make Medical Practice Easier

Scripts for your least favorite conversations.

Free Resources Link

Recalibrate Your Career

I work with physicians to help them flourish in medical practice. If you're feeling stuck, burned out, or in trouble at work because of communication or conflict, check out our FAQ page for more info.

Learn more about 1-on-1 coaching

The Out-On-Time Course

Built for emergency clinicians who are tired of chart debt and getting derailed by interruptions and overwhelm. Learn practical, real-time documentation and shift-efficiency strategies to finish your shift and actually leave on time.

Learn More About The Out-On-Time Course

Making a major career shift is never easy, especially when you've dedicated decades to a profession that has become part of your identity. The decision to leave clinical medicine can be fraught with self-doubt, financial considerations, and the lingering question - what comes next? But at some point, the balance shifts, and the cost of staying outweighs the fear of leaving. In this episode, we explore what it takes to walk away from a stable medical career, redefine success, and craft a life that aligns with evolving priorities. Finally, we dig into strategies for managing stress, investing in personal growth, and finding fulfillment beyond the bedside.

💡 Check out our Free Resources specifically designed to address pain points in medical practice💡

Guest bio:  Dr. Patrick O’Malley is an emergency physician with nearly two decades of experience in community emergency departments and high-acuity urgent care. Based in Columbia, South Carolina, he has recently expanded into entrepreneurial ventures, including The Laceration Course, in partnership with EB Medicine. He helps moderate the EM Docs Side Hustle Facebook group, a community of over 3,000 emergency physicians exploring side gigs and alternative careers. Dr. O’Malley is dedicated to helping physicians explore new opportunities beyond the walls of the emergency department.

We discuss:

• The Decision to Resign
• Financial Readiness and the Role of Family Support
• Looking Back on a Career in Emergency Medicine
• Redefining Work-Life Balance
• Transitioning to a New Identity
• Investing in Yourself
• Burnout, Coaching, and the Road to Change
• Finding Joy in Medicine: Small Moments, Big Impact
• Living Another Yesterday
• Crafting Your Own Path: Empowering Clinicians
• Newman and John Marks: Managing Stress and Calm

Mentioned in this episode:

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Just dropped: a brand-new video + PDF on how to recalibrate your career based on our sold-out webinar, now re-recorded with the best audience questions and tactical takeaways.

Free Resources Link

Recalibrate Your Career

I work with physicians to help them flourish in medical practice. If you're feeling stuck, burned out, or in trouble at work because of communication or conflict, check out our FAQ page for more info.

Learn more about 1-on-1 coaching

The Out-On-Time Course

Built for emergency clinicians who are tired of chart debt and getting derailed by interruptions and overwhelm. Learn practical, real-time documentation and shift-efficiency strategies to finish your shift and actually leave on time.

Learn More About The Out-On-Time Course

Delivering the news of death is one of the hardest yet most overlooked skills in emergency medicine. Many learn by watching others or through trial and error rather than structured training (or just make it up as they go). This lack of preparation can lead to discomfort, stress, avoidance, and even systemic failures in how death notifications are handled. In this episode, we explore the critical components of death communication, how to navigate these difficult conversations with clarity and compassion, and why avoiding or mishandling these moments can have lasting consequences for both providers and families. Finally, we discuss the emotional toll of secondhand grief and the importance of proactive mental health care for those on the front lines of healthcare.

💡 Check out our Free Resources specifically designed to address pain points in medical practice💡

Guest bio: Alexandra Jabr, PhD, EMT-P, is the founder of Emergency Resilience and a leading voice in the overlooked aspects of first responder training. With nearly 15 years of experience as an EMT, paramedic, cardiac tech, EMS coordinator, and educator, she saw firsthand the emotional toll of the job—especially when it came to death communication. She went on to earn a Master’s in Death, Grief, and Bereavement, followed by a Ph.D. in Depth Psychology, focusing on how first responders can maintain their mental health while supporting grieving families and colleagues. Through her work, she’s redefining continuing education, ensuring first responders get the training they truly need—not just another CPR recert.

We discuss:

1. Why On-Scene Death Notifications Are So Difficult
2. Challenges in Death Communication Training
3. Practical Steps for Delivering the News of Death
4. A Structured and Compassionate Framework
5. Handling Determination of Death
6. Common Mistakes
7. Secondhand Grief and Provider Well-being
8. Proactive Mental Health for Providers

Mentioned in this episode:

Never Lame. Never Spammy. Always Fresh.

If you’d like a few minutes of career-elevating curated kickassery delivered to your inbox, sign up for our newsletter.

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The Out-On-Time Course

Built for emergency clinicians who are tired of chart debt and getting derailed by interruptions and overwhelm. Learn practical, real-time documentation and shift-efficiency strategies to finish your shift and actually leave on time.

Learn More About The Out-On-Time Course

Leadership impacts everyone—whether you're steering an entire organization or simply navigating team dynamics. It’s an essential skill, yet it often feels elusive, even for experienced professionals. While every leadership challenge is unique, the core principles remain universal.

In this episode, we break down eight critical leadership principles drawn from years of experience, hard lessons, conversations with seasoned experts, research, and coaching leaders at all levels. Plus, we share actionable strategies to help you refine your leadership, whether you're guiding thousands or leading a small team.

Want more? Subscribe to our free newsletter, Doctoring Done Well. Every other Saturday, straight to your inbox—strategies to work smarter, lead better, and build a career that lasts.

1. Don’t Worry About Leading, Worry About Listening
2. This is Not Your Dumpster Fire
3. Slow Your Roll
4. You Will Have to Be a Judge, Even When You Don’t Want to Be
5. Model the Values
6. With Behavioral Issues, Build the Pathway, Not Just the Expectation
7. You Don’t Know What You’re Doing—And That’s OK
8. People Do Things for Their Reasons, Not Yours

Mentioned in this episode:

The Out-On-Time Course

Built for emergency clinicians who are tired of chart debt and getting derailed by interruptions and overwhelm. Learn practical, real-time documentation and shift-efficiency strategies to finish your shift and actually leave on time.

Learn More About The Out-On-Time Course

Violence has a cadence, a rhythm that disrupts the normal flow of life. When an act of violence erupts, the first sign is often a sudden, unexplainable shift in the environment—an eerie silence, a heightened energy, or a gut feeling that something is wrong. But when does that uneasy feeling cross the threshold into immediate danger? In this episode, we explore the critical decision points in an active violence situation in the healthcare/hospital setting, the moral and ethical dilemmas of medical providers staying versus escaping, and tactical strategies for survival. Finally, we break down the "run, hide, fight" approach and how to act decisively when every second counts.

Guest bio: Mike Shertz, MD is an emergency physician who spent 13 years as a Green Beret and a Special Forces medic. He is the founder and purveyor of Crisis Medicine, which teaches tactical casualty care to medical professionals. Check out this video that we did together in 2019 on how to place and remove a tourniquet and this one on how to pack a gunshot wound with combat gauze. 

Want more? Subscribe to our free newsletter, Doctoring Done Well. Every other Saturday, straight to your inbox—strategies to work smarter, lead better, and build a career that lasts.

We Discuss:

• Recognizing an Active Violence Situation
• Moral Dilemmas: Stay or Escape?
• Perspectives on Risk and Response
• Tactical Survival: Run, Hide, Fight
• Post-Shooting Medical Response

Dealing with an angry, upset patient can feel like walking into an emotional storm. The frustration in the room is palpable, and even the most experienced clinicians can feel thrown off balance. While medical training equips us to handle complex diagnoses and emergencies, it often falls short when it comes to managing interpersonal conflict. That’s where the Universal Upset Patient Protocol comes in—a straightforward, highly effective framework designed to de-escalate tense situations, restore trust, and protect your own emotional bandwidth. In this episode, we explore Dr. Dike Drummond’s original protocol, breaking down each step with specific language to use in the heat of the moment. Finally, we’ll add a few practical tweaks to help make these conversations even more natural and effective in real-world practice.

💡 Check out our Free Resources specifically designed to address pain points in medical practice💡

Guest Bio: Dike Drummond, MD, is a physician coach, burnout prevention expert, and creator of the Universal Upset Patient Protocol—a step-by-step framework for managing challenging interactions with upset patients. A former family physician, he transitioned to coaching to address the emotional toll of healthcare on providers. As founder of TheHappyMD.com, he’s helped thousands of physicians improve communication, manage stress, and build healthier professional relationships.

• The Universal Upset Patient Protocol: A Framework for Diffusing Conflict
• Key Principle: Acknowledgment Over Fixing
• Step 1: Acknowledge the Vibe and Name the Emotion
• Step 2: Open the Door for Them to Speak
• Step 3: Apologize and Show Compassion
• Step 4: Identify Their Need
• Step 5: Clarifying Reflection (Rob O Addition)
• Step 6: Set Boundaries and Expectations
• Step 7: Express Gratitude
• Beyond the Protocol: The Magic of Conflict Framework

Mentioned in this episode:

5 Free Tools To Make Medical Practice Easier

Scripts for your least favorite conversations.

Free Resources Link

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