Welcome to another episode of the Sustainable Clinical Medicine Podcast!

Dr. Sadie Elisseou, a primary care physician in the US VA system in Boston, Harvard and Boston University educator, and trauma-informed care expert, discusses her path into medicine and how working with veterans led her to trauma-informed practice after noticing patients’ discomfort during routine exams. She explains trauma-informed care as creating physical and psychological safety through mindful nonverbal communication, transparent agendas, permission-seeking, and reducing power dynamics, with examples such as thyroid exams and avoiding phrases like “for me.” She highlights VA onboarding on military experience, notes higher ACE rates among volunteer-era veterans, and describes how staff behaviors and clinic environments shape patient stress. The conversation also covers clinician wellbeing and burnout prevention via self-care, team debriefing, boundaries, therapy access, and time-management strategies like scheduled breaks, batching tasks, finishing notes between visits, and structuring varied work roles.

Here are 3 key takeaways from this episode:

1. Trauma-Informed Care Creates Safety Through Small, Intentional Actions: Physical and psychological safety in healthcare settings comes from deliberate practices: positioning yourself at the patient's side (not behind them), asking permission before examinations, explaining what you're doing and why, ensuring clear exits, and avoiding phrases like "for me" that emphasize power dynamics. These don't take extra time but transform the patient experience.
2. Shifting from "What's Wrong With You?" to "What Happened to You?" This mindset shift moves from blaming difficult patient behaviors to approaching them with curiosity and compassion. When patients are agitated or angry, it's often rooted in pain or fear. Co-regulation techniques—modeling calm through your own presence and validating their experience—can help both you and the patient settle into a more productive interaction.
3. Preventing Burnout Requires Structural Self-Care and Intentional Boundaries: Sustainable practice isn't about luxury spa days—it's about taking mindful breaths between patients, batching tasks by day (clinic on Mondays, administrative work on Thursdays), finishing notes immediately after appointments, scheduling regular breaks throughout the month, and setting non-negotiable hard stops. Varied work schedules that incorporate teaching, research, or consulting can also prevent monotony and reignite passion for the work.

Meet Dr. Sadie Elisseou:

Sadie Elisseou, MD is a practicing physician, faculty at Harvard Medical School, and leading subject matter expert in trauma-informed care who teaches clinical healthcare professionals how to provide top-quality care to trauma survivors and consults for organizations that wish to cultivate wellness and help team members engage through stressful times.

Connect with Dr. Sadie Elisseou:

🌐 Website https://www.sadie-elisseou.com/

LinkedIn https://www.linkedin.com/in/sadie-elisseou/

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**** Charting Champions is a premiere, lifetime access Physician only program that is helping Physicians get home with today's work done. All the proven tools, support and community you need to create time for your life outside of medicine.

Learn more at https://www.chartingcoach.ca

**** Enjoying this podcast? Please share it with someone who would benefit. Also, don’t forget to hit “follow” so you get all the new episodes as soon as they are released.
**** Come hang out with me on Facebook or Instagram. Follow me @chartingcoach to get more practical tools to help you create sustainable clinical medicine in your life.

**** Questions? Comments? Want to share how this podcast has helped you? Shoot me an email at admin@reachcareercoaching.ca. I would love to hear from you.

Welcome to another episode of the Sustainable Clinical Medicine Podcast!

The host and physician coach Dr. Karen Leitner discuss why the transition to new attending is often harder than training, marked by impostor feelings, shame about not knowing, and decision paralysis in clinical uncertainty. They compare systems in the US, Canada, and Australia, including practice ownership models, overhead, billing learning curves, and how lack of business training and negotiation skills can affect long-term earnings; they share an example of lost income due to paperwork capacity and not realizing support could be hired. They emphasize that regret is unhelpful, mistakes and bad outcomes can happen despite good intentions, and guilt should be replaced with compassion and connection by talking with trusted colleagues. They address burnout dynamics—skipping food, water, and bathroom breaks—advocating radical responsibility, analyzing the “math” of workload, small workflow fixes, and boundaries, including not relying on external praise. Leitner mentions her eight-week coaching program for women physicians.

Here are 3 key takeaways from this episode:

1. Being a new attending is a normal developmental milestone, not a sign of failure: Feeling overwhelmed, looking everything up, and comparing yourself to colleagues 20 years ahead is universal. The struggle isn't because you're unprepared—it's because no one prepares physicians for this transition. It can take 5-6 years to truly feel confident.
2. Self-compassion beats guilt when outcomes don't go as planned: When bad things happen to patients, guilt is the wrong emotion if you showed up with good intentions and made the best decision with available information. Replace self-punishment with compassion for both the patient and yourself—and reach out to trusted colleagues instead of isolating in shame.
3. Radical responsibility means protecting your time and energy—no one else will: No one is coming to save you from inbox overload, double-booked schedules, or skipping lunch. Taking care of yourself (eating, hydrating, setting boundaries) isn't selfish—it's essential for sustainable patient care. Learn to respect your own time before burnout forces you to leave medicine entirely.

Meet Dr. Karen Leitner:

Dr. Karen Leitner spends the bulk of her time helping women doctors recognize their amazingness and feel better in their lives (in addition to getting paid what they deserve.) She lives outside Boston< MA with her husband, her beloved mini goldendoodle Oscar, and three school-age daughters—and loves to travel, sing karaoke, and fight the patriarchy (preferably in that order).

Connect with Dr. Karen Leitner:

🌐 Website https://www.karenleitnermd.com/

Instagram https://www.instagram.com/karenleitnermd/

🌐 https://go.karenleitnermd.com/masterclass free class for women physicians
looking for more time/less stress

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Would you like to view a transcript of this episode? Click Here

**** Charting Champions is a premiere, lifetime access Physician only program that is helping Physicians get home with today's work done. All the proven tools, support and community you need to create time for your life outside of medicine.

Learn more at https://www.chartingcoach.ca

**** Enjoying this podcast? Please share it with someone who would benefit. Also, don’t forget to hit “follow” so you get all the new episodes as soon as they are released.
**** Come hang out with me on Facebook or Instagram. Follow me @chartingcoach to get more practical tools to help you create sustainable clinical medicine in your life.

**** Questions? Comments? Want to share how this podcast has helped you? Shoot me an email at admin@reachcareercoaching.ca. I would love to hear from you.

Welcome to another episode of the Sustainable Clinical Medicine Podcast!

Psychologist and psychometrician Dr. Bryan Sexton, Chief Wellness Officer at Duke Health Integrated Practice, discusses how his early quality-improvement work in Johns Hopkins ICUs revealed that high staff burnout undermined readiness for interventions like bloodstream infection reduction. He explains measuring burnout—especially emotional exhaustion—and how adding metrics like work-life integration and emotional recovery enables personalized wellbeing “profiles” and targeted interventions. Sexton describes evidence-based, one- to two-minute “bite-sized” tools (e.g., humor, awe, gratitude) designed for busy clinicians, and how Duke embedded these into continuing education with private feedback to boost engagement; a five-hour, eight-day CE program published in JAMA Network Open (Sept 2024) showed improvements, particularly for those struggling most. He outlines a 7-minute gratitude letter exercise, its research roots (Emmons, Seligman), wellbeing-informed leadership practices, and directs listeners to free tools at caws.dukehealth.org.

Here are 3 key takeaways from this episode:

1. Assess Wellbeing Before Adding New Tasks: Healthcare workers experiencing burnout lack the capacity to take on new initiatives. Organizations should measure emotional exhaustion and wellbeing readiness before implementing quality improvement programs or system changes. About one-third of ICUs weren't ready for innovation due to burnout - addressing wellbeing first is essential.
2. Bite-Sized Interventions Have Lasting Impact: Simple 7-10 minute wellbeing exercises (like writing a gratitude letter) can produce measurable improvements lasting 6-12 months. These micro-interventions are designed for busy healthcare workers who want something that takes minimal time, provides immediate relief, and creates long-term benefits. The effects actually continue improving over time rather than fading.
3. Wellbeing is Contagious - Both Ways: When 60% of a team engages in wellbeing interventions, even those who haven't participated show improvement through contagion effects. However, this works both ways - negativity and burnout also spread. Getting "enough" people engaged (not everyone) can create positive cultural shifts that lift the entire team.

Meet Dr. Bryan Sexton:

Bryan is the Chief Wellness Officer of Duke Health Integrated Practice and Director of the Duke Center for the Advancement of Well-being Science. After 30 years as a psychologist, psychometrician and investigator, he now works with leaders to assess and improve culture and work-force well-being. Bryan has conducted and published large studies and randomized controlled trials showing how to cause enduring improvements in the well-being of our workforce. He has authored over 100 peer reviewed publications, and his research instruments and well-being interventions have been translated and used in over 30 countries.

A perpetually recovering father of four, he enjoys running, using hand tools on wood, pickleball with friends, and hearing particularly good explanations of extremely complicated topics.

Don’t miss this enlightening conversation! 🎙️

Connect with Dr. Bryan Sexton:

🌐 Website https://caws.dukehealth.org/

LinkedIn https://www.linkedin.com/in/wellb/

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Would you like to view a transcript of this episode? Click Here

**** Charting Champions is a premiere, lifetime access Physician only program that is helping Physicians get home with today's work done. All the proven tools, support and community you need to create time for your life outside of medicine.

Learn more at https://www.chartingcoach.ca

**** Enjoying this podcast? Please share it with someone who would benefit. Also, don’t forget to hit “follow” so you get all the new episodes as soon as they are released.
**** Come hang out with me on Facebook or Instagram. Follow me @chartingcoach to get more practical tools to help you create sustainable clinical medicine in your life.

**** Questions? Comments? Want to share how this podcast has helped you? Shoot me an email at admin@reachcareercoaching.ca. I would love to hear from you.

Welcome to another episode of the Sustainable Clinical Medicine Podcast!

Dr. Dhaval Desai, an Atlanta-based internal medicine–pediatrics physician and former hospitalist director, shares his path from studying economics and Spanish and teaching high school to training abroad and leading a 30-physician hospitalist group at Emory St. Joseph’s with a split clinical/administrative role. He describes how COVID-era pressures and a new baby contributed to burnout, sleep and mood issues, and seeking therapy and medication, later deepening his advocacy through a memoir and work with the Dr. Lorna Breen Heroes Foundation, noting about 400 U.S. physicians die by suicide annually. After being rejected for a chief wellbeing officer role and facing institutional limits on speaking publicly, he hired an executive coach and resigned, concluding loyalty can hold physicians back. He pivoted to direct primary care by purchasing a retiring physician’s practice, citing autonomy, fewer patients, and reduced bureaucracy as key to preventing burnout.

Here are 3 key takeaways from this episode:

1. Physician Loyalty Can Become a Career Trap: Dr. Desai learned that his loyalty to his institution, patients, and colleagues was actually holding him back from making necessary career changes. His executive coach's blunt advice - "Nobody is going to give a shit if you leave tomorrow" - proved true when he resigned. Healthcare systems will move on, regardless of individual contributions, and physicians need to recognize when loyalty is preventing them from pursuing fulfillment.
2. Institutional Control Compromises Professional Integrity: Large healthcare systems often restrict physicians' ability to speak freely and advocate for what they believe in, even on humanitarian issues. Dr. Desai's experience being called in after writing an op-ed about ICE raids in hospitals showed how "the firm" can force physicians to compromise their values. This institutional pressure, combined with being passed over for the Chief Wellbeing Officer position, revealed that systems may pigeonhole physicians regardless of their capabilities.
3. Direct Primary Care Offers Control and Prevents Burnout: Transitioning to a Direct Primary Care (DPC) model allowed Dr. Desai to reclaim control over his schedule, patient panel size, and work-life balance. By eliminating insurance billing bureaucracy and middle management, he now spends 30-60 minutes per patient visit instead of documenting for 6 hours daily. This autonomy - combined with ongoing therapy and medication - has eliminated the "dread of going to work" and allows him to pursue advocacy, media, and other passions without institutional gatekeeping.

Meet Dr. Dhaval Desai:

Dr. Dhaval Desai is a dual board-certified Internal Medicine and Pediatrics physician who transitioned from hospital leadership into Direct Primary Care to practice medicine with deeper connection and purpose. He is the author of "Burning Out on the COVID Front Lines..." and host of the podcast SEEN IN FULL, where he explores burnout, identity, advocacy, and the human experience in modern work and life.

Connect with Dr. Dhaval Densai:

🌐 Website https://dhavaldesaimd.com/

Instagram https://www.instagram.com/doctordesaimd/

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Would you like to view a transcript of this episode? Click Here

**** Charting Champions is a premiere, lifetime access Physician only program that is helping Physicians get home with today's work done. All the proven tools, support and community you need to create time for your life outside of medicine.

Learn more at https://www.chartingcoach.ca

**** Enjoying this podcast? Please share it with someone who would benefit. Also, don’t forget to hit “follow” so you get all the new episodes as soon as they are released.
**** Come hang out with me on Facebook or Instagram. Follow me @chartingcoach to get more practical tools to help you create sustainable clinical medicine in your life.

**** Questions? Comments? Want to share how this podcast has helped you? Shoot me an email at admin@reachcareercoaching.ca. I would love to hear from you.

Welcome to another episode of the Sustainable Clinical Medicine Podcast!

In this episode, our host welcomes Dr. Andrew Wilner to discuss his extensive career in medicine, detailing his certifications in internal medicine, neurology, and epilepsy. Dr. Wilner shares his multifaceted journey, from starting as an ER doctor without formal training to becoming a professor of neurology. He delves into the evolution of the internship model and offers advice for medical students in career decision-making.

Dr. Wilner also elaborates on the locum tenens lifestyle, discussing the challenges and benefits, including the necessary preparation and mindset for success. Additionally, he highlights his experiences in academic roles, private practice, and as a medical journalist. The conversation concludes with insights into Dr. Wilner's book, 'The Locum Life: A Physician's Guide to Locum Tenens,' and his podcast, 'The Art of Medicine,' featuring stories of physicians pursuing unique medical careers.

Here are 3 key takeaways from this episode:

1. Flexibility is Essential for Locums Success: Locums work requires adaptability in every aspect - assignments can be canceled last minute, you'll work in unfamiliar systems, and conditions are often less than ideal. The ability to be flexible and resourceful is more important than clinical skills alone.
2. Prepare Thoroughly Before Each Assignment: Arrive 2 days early to handle logistics: learn the EMR system (demand paid training), scout parking and accommodations, get credentialing done, and eliminate uncertainties. This preparation reduces stress and lets you focus on patient care when the assignment starts.
3. Locums Prevents Burnout and Maintains Career Options: Working locums (even part-time) keeps you clinically active, resets credentialing clocks, and provides control over your schedule. Many burned-out physicians rediscover their love of medicine through locums by working on their own terms (7-9 months/year) rather than leaving clinical practice entirely.

Meet Dr. Andrew Wilner:

Dr. Wilner has worked locum tenens on and off since 1982 and is the author of "The Locum Life: A Physician's Guide to Locum Tenens." Dr. Wilner is Professor of Neurology at the University of Tennessee Health Science Center in Memphis, Tennessee, and host and producer of the Art of Medicine with Dr. Andrew Wilner podcast since 2020. Dr. Wilner is a PADI Divemaster and passionate underwater photographer.

Connect with Dr. Andrew Wilner:

🌐 Website http://www.andrewwilner.com

Twitter/X http://www.twitter.com/drwilner

Instagram http://www.instagram.com/seaphoto2025

YouTube http://www.youtube.com/c/andrewwilnermdauthor

YouTube Underwater http://www.youtube.com/c/andrewwilner

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Would you like to view a transcript of this episode? Click Here

**** Charting Champions is a premiere, lifetime access Physician only program that is helping Physicians get home with today's work done. All the proven tools, support and community you need to create time for your life outside of medicine.

Learn more at https://www.chartingcoach.ca

**** Enjoying this podcast? Please share it with someone who would benefit. Also, don’t forget to hit “follow” so you get all the new episodes as soon as they are released.

**** Come hang out with me on Facebook or Instagram. Follow me @chartingcoach to get more practical tools to help you create sustainable clinical medicine in your life.

**** Questions? Comments? Want to share how this podcast has helped you? Shoot me an email at admin@reachcareercoaching.ca. I would love to hear from you.

Welcome to another episode of the Sustainable Clinical Medicine Podcast!

Happy Women Physician Day! In this special episode, Dr. Sarah Smith sits down with Dr. Sunny Smith, founder of Empowering Women Physicians, to discuss the unique challenges facing women physicians and the coaching tools that are helping hundreds break free from burnout—without quitting medicine.

If you've ever felt trapped, exhausted, or wondered "when does it get better?"—this conversation is for you.

Here are 3 key takeaways from this episode:

1. The Arrival Fallacy - Happiness Won't Come Later: The belief that you'll be happy "once you become an attending" or "once the kids are in school" is a fallacy. Happiness isn't found at some future milestone—it requires intentional choices now. The system won't change on its own, and no one is coming to save you.
2. Agency Over Learned Helplessness: Medicine systematically exposes physicians to situations beyond their control, leading to learned helplessness. The antidote is recognizing you have agency and choice—even small 1% changes compound over time. Start with one closed chart, one boundary, one small decision that shows you can impact your outcome.
3. Connection Breaks Isolation: You can't understand the mental load of being a physician unless you've been one. Being in community with other women physicians who normalize your struggles and model different choices is therapeutic. When you see others advocating for themselves—taking leave, setting boundaries, pursuing passion projects—it gives you permission to do the same.

Bonus insight: It's not your job's job to make you happy—that's your job. And 77% of physicians entering coaching programs meet burnout criteria, but only 33% do after just 8 weeks, without changing jobs.

Meet Dr. Sunny Smith:

Sunny Smith MD is the Founder and CEO of Empowering Women Physicians.

Dr Smith brings her background as an awarded Medical Educator, and Clinical Professor of Family Medicine and Public Health into the coaching space.

She advocates for physician wellness through her comprehensive and collaborative coaching program, podcast, retreats and Facebook group that seek to change the culture of medicine through normalizing and humanizing the experience of being a physician.

Connect with Dr. Sunny Smith:

🌐 Website: https://empoweringwomenphysicians.com/

Facebook: https://www.facebook.com/groups/empoweringwomenphysicians

Instagram: https://www.instagram.com/sunnysmithmd/

LinkedIn: https://www.linkedin.com/in/sunnysmithmd/

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Would you like to view a transcript of this episode? Click Here

**** Charting Champions is a premiere, lifetime access Physician only program that is helping Physicians get home with today's work done. All the proven tools, support and community you need to create time for your life outside of medicine.

Learn more at https://www.chartingcoach.ca

**** Enjoying this podcast? Please share it with someone who would benefit. Also, don’t forget to hit “follow” so you get all the new episodes as soon as they are released.

**** Come hang out with me on Facebook or Instagram. Follow me @chartingcoach to get more practical tools to help you create sustainable clinical medicine in your life.

**** Questions? Comments? Want to share how this podcast has helped you? Shoot me an email at admin@reachcareercoaching.ca. I would love to hear from you.