Stimulus - Learn Tools to Crush It in Your Medical Career

What defines the unique mindset of an emergency clinician? It’s not just the fast pace or the chaotic environment—it’s the deliberate, top-down thinking that prioritizes patient safety over diagnostic certainty. This approach, though deceptively simple, often flies in the face of traditional medical training, which emphasizes comprehensive differentials and exhaustive workups. In emergency medicine, knowing what the patient needs often matters more than knowing exactly what they have. In this episode, we explore the emergency medicine mindset, the pitfalls of the bottom-up approach, and why experienced clinicians focus on acute interventions and dangerous conditions. Finally, we discuss how humility and strategic communication with patients can make all the difference in mitigating risk and building trust.

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

Guest bio: Reuben Strayer is an emergency physician based in Brooklyn, at Maimonides Medical Center. He tweets @emupdates and blogs at EMupdates.com on a variety of emergency medicine topics. His clinical areas of interest include airway management, analgesia, opioid misuse, procedural sedation, agitation, decision-making, and error. His extra-clinical areas of interest include sweeping generalizations and jalapeño peppers.

We Discuss:

1. A Critique of Medical School Training and the Bottom-Up Approach
2. Top-Down Approach and Ophthalmology Insights
3. The 8 Responsibilities of Emergency Physicians
4. The Wheel of Dangerous Conditions
5. Top-Down Thinking in Practice
6. Humility and Communication in Emergency Medicine

Mentioned in this episode:

5 Free Tools To Make Medical Practice Easier

Scripts for your least favorite conversations.

Free Resources Link

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

Doctoring Done Well | Bite-Sized Wins

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Mastering nonverbal communication can be an elusive task, but the fact remains: what’s unsaid leaves a significant footprint in any interaction. Nowhere is this more palpable than in the medical exam room, where trust and connection between physicians and patients often hinge on subtle, nonverbal cues.

So, how can one build trust through facial expressions and tone of voice alone?

In this episode, we break down how to silently establish rapport, effective use of pauses, the curious role of your eyebrows, impact of end-of-sentence inflection, how to convey uncertainty with confidence, and why learning a patient’s eye color can pay dividends.

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

Guest bio: Bradley Block, MD, is a private practice otolaryngologist on Long Island, New York, where he lives with his wife and three young sons. He is a partner at ENT and Allergy Associates and creator of the Physician’s Guide to Doctoring Podcast. He realized that rapport was the key to gaining trust, seeing patients efficiently, enjoying his practice, and building his reputation. He tried to find a podcast that would help him improve at doctor-patient communication, but there was none, so he created Physician’s Guide to Doctoring! The topics quickly expanded to “everything we should have been learning while we were memorizing Kreb’s Cycle.”

We Discuss:

1. The "Interest and Authority" Framework for Nonverbal Communication
2. Facial Expressions: Conveying Interest
3. Humor and Likability in Patient Interaction
4. Making Eye Contact and Noticing Eye Color
5. Attitude and Authority in Patient Care
6. Effective Communication Techniques
7. Addressing Patient Concerns and Fears

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

5 Free Tools To Make Medical Practice Easier

Scripts for your least favorite conversations.

Free Resources Link

Doctoring Done Well | Bite-Sized Wins

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What’s the biggest mistake people make about meditation? Thinking they’re bad at it. Why do they think this? Because they’ve tried meditating, and their mind just won’t shut up!

It’s a common misconception that meditation means clearing your mind of all thoughts. But in reality, meditation has little—or nothing—to do with that. If your mind wanders or feels like a crowded room full of shouting voices when you close your eyes, you’re not alone. That’s exactly what’s supposed to happen!

A wandering mind isn’t failure—it’s expected, even for seasoned meditators.

In this episode, we break down the exact steps of how to meditate, what to do with a wandering mind, and why a flurry of thoughts—popping up like popcorn—doesn’t mean you’re bad at meditation. In fact, it means your mind is working exactly as it should. Ultimately, meditation isn’t about thinking less; it’s about changing how you engage with your thoughts, making it a skill you simply can’t fail.

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

Mentioned in this episode:

Doctoring Done Well | Bite-Sized Wins

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It started in medical school, when I witnessed the stark reality of the hidden curriculum: a transgender patient referred to as "it" by an attending physician. Over the years, I saw more subtle but no less harmful behaviors—snickers, misused pronouns, quiet biases. I often felt lost in how to respond.

Today, transgender identity feels more politically charged than ever. But beyond the politics, what’s it like simply to be transgender? What challenges do transgender patients face—physically, medically, socially, and emotionally? And how do you navigate a world that sees you differently after transitioning?

In this episode, Dr. Jailyn Avila shares her story. We cover the deeply personal aspects of transition, from conversations with her wife and kids to navigating professional dynamics as an internationally recognized expert. Dr. Avila offers candid insights into her experience as a physician presenting as both male and female, practical advice for providing better care for transgender patients, and strategies for addressing pronouns and mistakes with grace.

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

Guest bio: Jailyn Avila is a board-certified emergency medicine physician, transgender woman, wife, and mother of three. She has been heavily involved in medical education with an emphasis on bedside ultrasound and runs Core Ultrasound, delivering online educational content. In 2021, Jailyn began her gender transition and “completed” said transition in 2023. Jailyn is currently Core Faculty for the UHS SoCal MEC Emergency Medicine Residency in Temecula, California where she also functions as the Associate Ultrasound Director and the Director of Faculty Development.

1. Coming Out to Her Wife
2. Navigating External Frictions and Gender Identity
3. Balancing Personal and Professional Identity
4. The Gradual Process of Transition
5. Work and Social Dynamics
6. Experiences as Both a Male and Female Physician
7. Managing Emotions: The RAIN Method
8. Caring for Transgender Patients in the Emergency Department
9. Impact of Jailyn's Transition on Her Family and Children
10. Understanding Gender and Biological Variations

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

Never Lame. Never Spammy. Always Fresh.

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5 Free Tools To Make Medical Practice Easier

Scripts for your least favorite conversations.

Free Resources Link

Why do our minds seek explanations for everyday patterns, even attributing a cause where none may exist? "Regression to the mean" offers a statistical lens on why extreme experiences naturally revert to the norm. In medicine, this concept reveals why critical observations and repeated assessments are essential to avoid overreactions to abnormal results.

In this episode, we explore the nuances of regression to the mean, breaking down its impact on medical decision-making, patient assessments, and even how we view high-stakes scenarios in healthcare. Finally, we delve into how understanding this principle can enhance clinical judgment and reduce unnecessary interventions.

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

Guest bio: Josh Russel, 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.

1. Superstitions in the Emergency Department
2. Understanding Regression to the Mean
3. Is It a Good Idea to Chastise Fighter Pilots?
4. Blood Pressure Lives on a Bell Curve
5. The Importance of Control Groups
6. Pediatric Visits For Fever
7. Natural History of Disease Processes: Some Are Outliers
8. The Test of Time
9. Balancing Urgency with Thoughtful Testing Thresholds

Mentioned in this episode:

5 Free Tools To Make Medical Practice Easier

Scripts for your least favorite conversations.

Free Resources Link

Never Lame. Never Spammy. Always Fresh.

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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

Being a patient can feel like a lonely experience, especially when you sense your doctor is disconnected. A rushed or disengaged interaction can leave patients feeling unheard and uncared for, no matter how clinically skilled the physician is. At the same time, doctors struggle with overwhelming workloads, which can lead to unintentional detachment from those they treat.

In this episode, we explore five ways to build connection in the exam room quickly, why small gestures matter, and how intentional preparation can change the entire dynamic. Finally, we dive into the emotional complexities of patient care and the essential role of listening and presence in preventing burnout. Our conversation centers around the ‘Presence 5 Practices’ from this article.

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

Guest Bio: Clay Smith, MD, is an Associate Professor of Emergency Medicine at Vanderbilt University. He is triple board-certified in Internal Medicine, Emergency Medicine, and Pediatrics and the founder of JournalFeed, which provides concise, daily summaries of top medical journal articles.

1. The Disconnect Between Patients and Physicians
2. Why Genuine Doctor-Patient Connections Matter More Than You Think
3. Easing Patient Anxiety and Shame
4. The Impact of Preparation and Focus on Patient Care
5. Listening Intently and Completely
6. Aligning Care with Patient Priorities
7. Building Trust by Connecting with the Patient's Story
8. Understanding Emotional Cues
9. The Delicate Balance of Antibiotic Stewardship
10. Understanding Fear Behind Patient Anger

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

5 Free Tools To Make Medical Practice Easier

Scripts for your least favorite conversations.

Free Resources Link

Never Lame. Never Spammy. Always Fresh.

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Holding onto a grudge can feel strangely delicious, but that sense of righteousness often comes at a steep cost. In this episode, EMRAP founder Mel Herbert joins Rob to unpack a rift that’s lingered for over half a decade—and explore the way forward to healing. 

We also break down why achievement does not demand extraordinary genius or talent but a shift in how we view our perceived mediocrity. Why the idea that we need to be exceptional to succeed fuels imposter syndrome and keeps us from valuing the potential in our "average" qualities. We examine the pressing challenges of modern medicine, where corporate pressures often clash with the need for human connection, and how clinicians can reclaim compassion and autonomy. Finally, we address the role of forgiveness and communication in personal and professional growth, revealing how setting boundaries and letting go of resentments can transform relationships and renew purpose.

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

Guest Bio:  Dr. Mel Herbert is an acclaimed emergency medicine educator, entrepreneur, and speaker renowned for his innovative approach to accessible medical education. An Australian-born, U.S.-trained physician, Mel founded EM:RAP, a leading platform providing engaging, high-quality education for emergency care providers globally. His dedication to equitable access led to EM:RAP GO, a nonprofit extending emergency medical training to underserved communities worldwide. Mel’s philosophy, captured in his debut book The Extraordinary Power of Being Average, champions the idea that anyone can achieve remarkable things through dedication and resilience. Currently a Professor of Emergency Medicine at UCLA, Mel also serves as a consultant on the upcoming TV series The Pitt on MAX.

We Discuss:

• The Power of Embracing Mediocrity
• The Myth of Extraordinary and Why Determination Outshines Talent
• Turning Weaknesses into Strengths
• The Evolution of Medical Education
• The Squeeze of Modern Medicine
• Emotional Intelligence in Medical Practice
• Forgiveness and Personal Growth
• A Dust-Up and Its Aftermath
• The Weight of Sadness and Forgiveness
• The Power of Communication
• Boundaries and Forgiveness – Healing Without Compromising Safety
• Entrepreneurial Challenges and Lessons: Balancing Vision and Collaboration

Mentioned in this episode:

Never Lame. Never Spammy. Always Fresh.

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Awake + Aware Bend May 5-7, 2025 | Our in person live event

Ready to reset, recharge, and level up?

Awake + Aware Bend 2025

5 Free Tools To Make Medical Practice Easier

Scripts for your least favorite conversations.

Free Resources Link

It's often not the big power moves that change our lives; it's the small, intentional actions. By focusing on micro-skills, even the most ambitious goals become achievable.

In this episode, we talk with Drs. Adaira Landry and Resa E. Lewiss about their new book, MicroSkills: Small Actions, Big Impact. We explore how financial literacy, self-presentation, concise communication, and allyship can be developed as essential micro-skills for a successful career. We also navigate workplace dynamics, including recognizing and addressing issues like mansplaining and bropropriating. Finally, we discuss the nuances of learning when to say “yes” or “no,” and the art of timely, respectful communication.

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

Guest Bios: ADAIRA LANDRY, MD, MEd, is an assistant professor at Harvard Medical School who studied and trained at University of California, Berkeley; University of California, Los Angeles; New York University; and Harvard with almost a decade of experience mentoring students and early-career professionals. She is an entrepreneur, keynote speaker, and award winning mentor. She co-founded Writing in Color, a nonprofit that teaches the craft of writing.

RESA E LEWISS MD is a professor of emergency medicine, TEDMED speaker, TimesUp Healthcare founder, designer, entrepreneur, and award winning educator, mentor, and point-of-care ultrasound specialist. She studied at Brown University, the University of Pennsylvania School of Medicine, the NIH Howard Hughes Research Scholars Program, Harvard Emergency Medicine, and Mount Sinai St. Luke’s Roosevelt. She hosts the Visible Voices Podcast, amplifying content in the healthcare, equity, and current trends spaces.

They have written for CNBC, Fast Company, Forbes, Harvard Business Review, Nature, the Philadelphia Inquirer, Science, Slate, STAT News, Teen Vogue, VOGUE, and USA Today.

We Discuss:

1. The Concept of Micro-Skills
2. Financial Literacy and Debt Management
3. Performing a Debt Inventory to Understand the Landscape of Your Debt
4. Appearance Matters and Personal Hygiene is a Skill That Doesn't Always Come Naturally
5. Timing and Context are Critical When Checking In or Providing Feedback
6. We’re Trained to be Cumbersome in Communication When What We Need is to be Succinct
7. Don't Bury The Lead
8. Role-Playing to Improve Communication
9. Learning from Experience and Modeling. Do we Leave Too Much Up to Chance?
10. Micro-Skills for Self-Care and Burnout Prevention: The Art of Saying No
11. Responding to Emails Promptly and Respecting Deadlines are Force Multipliers
12. Addressing Mansplaining and Bropropriating
13. The Power of Allyship
14. Recommended Books

Mentioned in this episode:

5 Free Tools To Make Medical Practice Easier

Scripts for your least favorite conversations.

Free Resources Link

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

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.

Sign up for our Newsletter

Ready to reset, recharge, and level up?

Join us at our live event - Awake + Aware, a game-changing 3-day workshop from May 5-7 in Bend, Oregon.

Learn how to stay cool when the pressure’s on and lock in the mindset you need to flourish. Space is limited.

🖱️ Website: Awakeandawarebend.com

🎓 P.S. Yes, this is a CME event!

How do you handle your authority being challenged under stress? Even minor communication missteps in high-pressure environments like medicine can create lasting rifts and missed details. While the instinct to push back is strong, it's rarely the best response.

We share a story of miscommunication between a resident and a nurse, highlighting the importance of humility and inquiry in clinical settings. We examine why leading with curiosity instead of ego can save time, build trust, and improve patient care.

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

We Discuss:

• Because I Said So
• Cherubic Buddha vs Grumpy Gravel
• You May Feel Frustrated, That's OK
• Pushing vs Pulling
• Tell Me What You're Thinking
• The Three Reasons Why a Nurse Might Question a Doctor's Order
• Why Inquiry Saves Time and Improves Care
• The Other Person's Special Knowledge