Explore every episode of the podcast Surgeons with Purpose

*************SENSITIVE CONTENT WARNING*******************

This episode discusses a recent suicide. Please listen carefully, or if this is particularly triggering for you, forgo listening completely.

On July 23, 2025, Vaibhav Duggal turned 24. He spent the morning of his birthday in a women's health clinic in El Paso, on his OB/GYN rotation as a third-year medical student at Texas Tech University Health Sciences Center. Six days later he was dead.

In this episode, I share more details that have come to light about this case, including the processes the institution followed to address the complaint against Vaibhav, what the culture was like inside the institution, and the conversation between the Dean of the school and Vaibhav's parents.

Please go back and listen to the first episode #111, Vaibhav's Story, before listening to this one.

If you or someone you know is struggling, the 988 Suicide & Crisis Lifeline is available 24/7 by call or text in the U.S. Medical students and physicians can also reach the Physician Support Line at 1-888-409-0141, staffed by volunteer psychiatrists.

Join us inside Empowered Surgeons Group here.

Join us inside Empowered Surgeons Group here.

Interested in the Women Surgeons' Cabo retreat Jan 6-10, 2027? Get on my calendar here.

Dr. Erik Pearson grew up the son of an X-ray tech, trained in Dublin, and matched in Utah, where watching the pediatric surgeons at work made the decision for him. It wasn't only the operations. It was the weight of being trusted with someone's child.

After fetal intervention research at Children's Hospital of Philadelphia and pediatric surgery training at Emory, he found a growing practice in Las Vegas looking to build out its ECMO program. Ten years later, he joins us to talk about what that work actually asks of a person.

We get into the parts of pediatric surgery that don't make it into the training curriculum: the driveway moments after a hard case and learning to compartmentalize without going numb. Erik describes the mental shift that let him keep doing this work: I get to be there to help. Not so much be the hero.

The second half of the conversation turns to October 1, 2017. Erik was on call at Sunrise Hospital when victims of the Las Vegas mass shooting began arriving. He walks us through the organized chaos of the ER, the improvised triage bay in the ambulance parking lot, the color category the team invented on the spot because the standard system didn't fit, and the five hours he spent with a single gunshot patient alongside a scrub tech he had never met. He also describes the leadership he saw that night: a CEO in a purple polo whose entire job became removing barriers so clinicians could work.

It's a conversation about competence, grief, transparency with families, and what every hospital and every physician should be asking themselves before the worst night of their career arrives.

• 124 patients with gunshot wounds requiring treatment
• 129 patients admitted that night
• 16 mortalities, 14 of them dead on arrival
• 58 surgeries in the first 24 hours
• 516 blood products used

A model first identified in the response to the Boston Marathon bombing (observed in flocking birds) that Erik saw play out in real time:

1. Unity of mission
2. Generosity of spirit in action
3. Staying in your lane
4. No ego, no blame
5. Trust-based relationships

Dr. Erik Pearson is a pediatric surgeon in Las Vegas, where he has practiced for the past ten years as part of a physician-owned group. He is known as Citizen Surgeon on Instagram. Follow him here. Check out his website here.

Interested in the Cabo retreat? Click here to schedule a 15-min interview.

Learn more about the powerful coaching community & mindset course, Empowered Surgeons Group, here.

Decades of research point to the same conclusion: social support is one of the strongest protective factors in the face of trauma. But what happens when the way we've learned to relate to others gets in the way of that connection, especially in a profession where repeated trauma exposure is routine?

In this episode, Dr. Sacha McBain joins me to talk about the intersection of attachment, community, and trauma-informed care in medical settings. We start with the research: Australian psychologist Richard Bryant's work following the Black Saturday bushfires showed that it wasn't just individual relationships that predicted recovery; it was the shape of a person's whole social network. People who were diversely connected, and whose connections were also connected to each other, fared better. The overlapping network itself served as a buffer.

From there we turn to what happens inside hospitals. Sacha describes sitting in on resident onboarding and hearing the scare tactics used to keep new physicians in line: it's not if you'll be sued, it's when. Patients will find you in parking garages. Never admit you were wrong. The message underneath is essentially "be perfect, or a patient could destroy you.” And it makes co-regulation almost impossible with the very person you've been taught to fear.

What shifts when you see a distressed patient as a frightened, vulnerable human rather than a threat to your livelihood? What do you do when you can't find any empathy left and you're already overwhelmed? Sacha shares a piece of advice from a mentor that reframes curiosity as the thing you reach for when compassion isn't available. And we close on trauma-informed care as something fundamentally pragmatic, not a soft add-on, but a working set of practices around safety, transparency, power, collaboration, and cultural humility.

Sacha McBain, PhD, is a clinical psychologist and associate professor at Rush University System for Health in Chicago. A national leader in medical traumatic stress, she has published peer-reviewed research on the conceptualization and treatment of medical trauma, led national clinical trainings, and helped shape best practices for mental health screening and intervention after traumatic injury.

Previously at the University of Arkansas for Medical Sciences, she developed and led the Trauma Surgery Psychology Consult Service at Arkansas's only Level 1 Trauma Center and served as associate director of the Center for Trauma Prevention, Recovery, and Innovation. She contributed to the American College of Surgeons Mental Health and Substance Use Disorder Best Practice Guidelines Work Group and is an active member of the International Society for Traumatic Stress Studies.

Learn more about Sacha here.

Interested in the ESG Cabo Women Surgeons' Retreat in January 2027? Get on my calendar here.

Join us inside Empowered Surgeons Group here.

In today's episode, you will learn the three success tenets to create success and sustainability in surgery:

1. Protect the asset
2. Serve the patient
3. Diversify your professional identity

When we master these three things, life as a surgeon becomes easy and fulfilling. Even in the face of moral injury, decreasing reimbursement, litigation fear, complication fear, and the public's mistrust of the medical profession in general. I know because I'm living proof.

*************SENSITIVE CONTENT WARNING*******************

This episode discusses a recent suicide. Please listen carefully, or if this is particularly triggering for you, forgo listening completely.

”If we could save one student, one kid, one life, we are spreading his shine,” Neeru Duggal.

On July 23, 2025, Vaibhav Duggal turned 24. He spent the morning of his birthday in a women's health clinic in El Paso, on his OB/GYN rotation as a third-year medical student at Texas Tech University Health Sciences Center. Six days later he was dead.

In this episode, I sit down with Vaibhav's parents, Vivek and Neeru Duggal, who are passionate about spreading the truth about what happened to Vaibhav with hopes to prevent this from happening to anyone else.

We talk about who Vaibhav was, why he became a physician, his dreams for the future, and the events that ultimately crushed those dreams.

We also reconstruct those six days, hour by hour, email by email. Vivek and Neeru hope to turn this needless tragedy into a campaign for reform.

The burning question: when a university opens a disciplinary process against a student, what does it owe that student while the process is underway?

As Vivek puts it: nothing can bring their son back, but if another family is spared this, they will be able to look themselves in the mirror.

Neeru and Vivek describe a son who had wanted one thing since childhood: to be a doctor. By every measure available before that week, he was on his way. He graduated summa cum laude from Texas A&M with a 4.0 in biology, finished a semester early, volunteered at a medical center through COVID, and came to Texas Tech El Paso on a scholarship. He had no prior professionalism concerns anywhere on his record.

The clinical encounter at the center of this story lasted a few minutes. The nurse practitioner conducting the exam and asked whether the patient was comfortable having a student present; the patient consented. On her way out, according to Vaibhav's account, the patient invited him to follow her on Instagram. At 10:34 a.m. he did. About an hour later he unfollowed and blocked her, telling the dean days afterward that he'd realized it crossed a professional line. That afternoon, the patient filed a complaint.

The same day, the nurse practitioner who had been in the room the entire time completed Vaibhav's clerkship evaluation. She marked him as exceeding expectations in every single domain, including medical knowledge, patient care, communication, professionalism, all of it. Under "opportunities for improvement," she wrote nothing.

Two days later, a faculty physician emailed the clinic director and the dean describing the incident as an egregious breach of professionalism. The clerkship director wrote that she believed Vaibhav should be pulled from clinical duties. On July 28, at 10:26 a.m., she submitted a formal referral to the Grading and Promotions Committee, and in that same referral, wrote that she had not yet had the opportunity to speak with the student because of clinical obligations. Vaibhav was, at that hour, sitting for his OB/GYN shelf exam, which he passed.

That afternoon he met with the dean. He gave his account and was told he was removed from all patient contact, placed on a temporary leave of absence, and would appear before the GPC on August 15, eighteen days out. The family's account notes that the instruction not to contact patients was repeated eight separate times in that meeting. He was referred to counseling. He went to the counseling office at 3:30 p.m. that same day; the director spoke with him briefly, did not see him for a session, and directed him to intake paperwork. Vaibhav emailed that evening asking for the paperwork. The reply came back at 6:01 p.m.: the intake forms were only accessible weekdays between 8:15 a.m. and 3:45 p.m. He would have to try again tomorrow.

He spent that evening with his girlfriend, called his parents, and made weekend plans. At 11 p.m. they went to bed. At 11:36 p.m. his phone lit up with an email from the dean's office. Attached were the meeting notes and the GPC presentation instructions: the document telling him to prepare a PowerPoint, explain to the committee why he was there, be convincing that he was sorry, and humbly request permission to resume clinical work. Attached beneath that was the policy excerpt listing what the committee could recommend: individual remediation, delayed progression to Year 4, repeat of Year 3, delay of graduation, or dismissal. A second provision noted the committee could place a permanent professionalism notation on his MSPE (the dean's letter that follows a physician into every residency application).

He died the next day, July 29. He was 24 years old.

Three days later, the family says the president of the university called them and made a claim about physical contact that appears nowhere in the complaint, the evaluation, or the referral. The Duggals dispute it, and it is one of the central grievances in the litigation they have since filed.

If parts of that timeline sound familiar, it is because a version of it happened three years earlier and 1,200 miles away.

Katie Meyer was a Stanford goalkeeper (the one who captained the team to the 2019 NCAA championship), a resident advisor, and an aspiring lawyer awaiting word on her Stanford Law application. In late February 2022, four months before graduation, she received a lengthy email informing her she faced disciplinary action that put her degree at risk. She had thrown coffee on a football player who had allegedly assaulted a teammate. Her parents did not know the process was happening. She died by suicide on March 1, 2022.

Gina and Steve Meyer built the rest of their lives around a single, narrow, achievable reform: no student should have to navigate a disciplinary process alone. Their advocacy produced California Assembly Bill 1575 — Katie Meyer's Law — authored by Assemblymember Jacqui Irwin, passed unanimously through both chambers, and signed by Governor Newsom on September 28, 2024. The law gives students at UC, CSU, and community college campuses the right to select an adviser of their choosing — a parent, a coach, a professor, a peer — to accompany them through a disciplinary proceeding. Critically, the institution must train that adviser on its own procedures. The adviser is looped in from day one and, with the student's permission, receives regular updates. The Meyers call it a front-end safety net: someone in the room who knows how the machine works, so the student isn't facing career-ending stakes alone against a panel of professionals.

On September 23, 2025 — almost a year to the day after the California signing — Representative Julia Brownley introduced a federal version in the U.S. House. It would extend the adviser right to students at any institution receiving federal funds, and would additionally require colleges to disclose student suicides in their Annual Security Report, a transparency measure with no current federal analogue. The Meyers have said plainly that they believe this law could have saved Katie's life. They also founded Katie's Save, a nonprofit focused on student mental health and suicide prevention.

The overlap with Vaibhav's case is hard to miss. A student with no disciplinary history. A serious allegation. A process that moved before anyone had spoken with him. A high-stakes hearing scheduled weeks out. A counseling door that was closed by the time he reached it. And an eighteen-day wait to be alone with.

In February 2026, the Duggal family filed suit in El Paso County District Court against TTUHSC and several administrators, seeking more than $30 million and alleging gross negligence, wrongful death, and denial of due process. Since going public, Vivek Duggal says other students from the same institution have come forward with their own accounts.

Texas State Representative Cody Vasut, who has been working directly with Vivek and Neeru, has committed to introducing legislation when the Texas House reconvenes in January 2027 that would require universities to provide advocates to students in disciplinary proceedings: the Texas answer to what California has already passed.

We close the interview by asking the Duggals what they want listeners in medical education to do differently. Their answer is not complicated, and it does not require a bill to pass: treat students like the human beings they are.

• Justice for Vaibhav — memorial and advocacy:
• Katie's Save — katiessave.org
• California AB 1575 (Katie Meyer's Law), signed September 28, 2024
• Katie Meyer's Law (federal), introduced in the U.S. House, September 23, 2025

If you or someone you know is struggling, the 988 Suicide & Crisis Lifeline is available 24/7 by call or text in the U.S. Medical students and physicians can also reach the Physician Support Line at 1-888-409-0141, staffed by volunteer psychiatrists.

Sheikh C. Ali dreamed of becoming a private practice surgeon from age seven. Then, when COVID hit between his third and fourth year of medical school, he noticed the landscape shifting. The pathway he'd spent his life walking toward no longer seemed viable, so he built a new path. He became the strategist healthcare leaders now hire to turn their expertise into visibility, authority, and opportunity on LinkedIn.

This conversation is the playbook.

Sheikh makes the case for why LinkedIn beats every other platform for clinicians. It is the one platform where you have direct access to 1.3 billion users and key decision-makers.

He defines personal branding as what people say about you when you are not in the room, built from three components: core values, applicable expertise, and personality. Then he walks you through his 4 P's framework (Position, Polish, Publish, Pursue), reveals the gold mine hiding in plain sight, and gets tactical about writing a headline that works ("I help X do Y in Z").

You'll learn about the two audiences your content must speak to, why commenting is a superpower, what it takes to move someone from "I know you" to "I want to work with you."

Underneath it all runs the mindset that makes the tactics work: network from abundance, choose done over perfect, and let confidence compound through action.

Sheikh C. Ali helps clinical leaders and healthcare executives become the leading voice in their niche. Connect with him (where else??) on LinkedIn or his website here.

Join us inside Empowered Surgeons Group here.

For 19 years, Dr. Adrienne Towsen practiced in the kind of orthopedic group most surgeons dream of: five partners, employees who'd been there forever, a 30-year reputation, a family feel.

Then came the supergroup. Then came private equity.

The pitch: liquidity events, surgery centers, top-dog status. The math: one year's salary upfront, paid back over five years through a 25% management "scrape." The reality: 12-to-14-hour days, a salary cut in half, a practice that couldn't pay for gauze pads, and a call center in another location that didn't even know she was a doctor there.

Her breaking point came after a weekend of hip fracture call, when she did the math and realized she'd essentially volunteered her time. She sent her resignation the next morning. With no plan. Just the certainty that there had to be another way.

Five months ago, she opened The Towsen Clinic: a concierge direct-care practice built entirely on her own terms, where visits last 60 to 90 minutes and patients finally get what they're starved for: a human partner in their health.

In this episode:

• The seductive pitch PE makes to physician groups and the math hiding underneath it
• What "we're employed now. This is no longer our practice" feels like from the inside
• The moment a 20-year patient left because he couldn't get through the phone tree
• Why she resigned without a plan, and what the sadness-plus-relief told her
• Walking away from the OR after 21 years and making peace with it
• The surprising bridge from hip fractures to hormone health and women's medicine
• Her advice if work is murdering your soul: don't stay stuck

"I couldn't have been more miserable." -Dr. Towsen then.

"This is the beginning of my next chapter." -Dr. Towsen now.

Dr. Adrienne Towsen is an orthopedic surgeon and founder of The Towsen Clinic, a concierge preventive-care practice in West Chester, PA. Check out her clinic here. Follow her on LinkedIn here.

🎧 If this episode resonated, share it with a colleague weighing their own next chapter, and leave a review so more surgeons find the show.

Join us inside Empowered Surgeons Group here.

Take the Trainee to Attending Masterclass here.

Join us inside Empowered Surgeons Group here.

Most of us got less than 20 hours of communication training in four years of medical school. Then we were thrown into the real world.

Dr. Anthony Orsini has spent his career fixing that. A practicing neonatologist and founder of The Orsini Way, he's trained thousands of clinicians to navigate medicine's hardest conversations: breaking bad news, disclosing medical errors, and rebuilding trust when everything's gone wrong. His methods have helped hospitals boost patient satisfaction scores by as much as 60% and reduce malpractice risk.

Learn more here.

Follow Dr. Orsini on LinkedIn here.

Take the quiz: What kind of surgeon are you becoming? here.

Join us inside Empowered Surgeons group here.

One of the most surprising truths about medical malpractice is this: the work that prepares you to become a strong defendant is the very same work that helps prevent lawsuits in the first place. It's the work that strengthens your relationships with patients, your spouse, your children, your colleagues, and your friends. At the heart of all of it are two skills: compassion and communication.

In today's episode, I sit down with Heather Hansen, a medical malpractice defense attorney and expert in effective communication. As surgeons, most of us will face a lawsuit at some point in our careers. Yet no one teaches us how to navigate that experience, or how to become the kind of defendant a jury can trust.

The research is clear: patients are less likely to sue physicians who communicate with empathy, authenticity, and compassion. Heather has spent decades defending physicians in the courtroom, and she shares a fascinating perspective from the other side of medical malpractice. The defense attorney's job is to humanize the physician and tell the story of a compassionate, thoughtful surgeon who genuinely cared for their patient. The good news is that is a skill set that can be developed long before you're ever named in a lawsuit.

In this conversation, you'll learn how to better understand the game of medical malpractice, see the key players through a different lens, communicate more effectively under pressure, and cultivate the qualities that not only make you a stronger defendant but a better surgeon and leader.

For more than 20 years, Heather Hansen defended physicians, healthcare providers, and hospitals in medical malpractice litigation. During that time, she mastered the art of communicating with compassion, credibility, and charisma when the stakes couldn't have been higher. Today, she teaches those same communication strategies to leaders, teams, and healthcare professionals around the world. You can learn more about her on her website here. Follow her on LinkedIn here.

Take the quiz, What Kind of Surgeon Are You Becoming here.

Join us inside Empowered Surgeons Group here.

We often believe we have to create villains in the world in order to effect change. But what if that were not true?

In this episode, I teach villain compassion, the difference between helping, fixing, and serving, and the power of intentionally choosing our thoughts before we make decisions. Because when we change our mindset, we open up a portal to new ideas and solutions. That's the heart of coaching.

Join us in Empowered Surgeons Group here.

Why are so many talented women surgeons questioning whether they belong in surgery, and what does that reveal about the culture of surgery as a whole?

In this episode of Surgeons with Purpose, I talk to pediatric surgeons Dr. Cornelia Griggs and Dr. Jose Greenspon about the relational challenges of practice, imposter syndrome, the hidden emotional labor women carry in surgery, and why leaving is often a self-preservation response rather than a personal failure.

We discuss the toxic conversation around resilience, the narrow line women are expected to walk between being likable and authoritative, the concept of "status leveling," and the exhaustion of constantly managing others' perceptions. We also explore why women are often the first to challenge the status quo, what gives Dr. Griggs hope for the future of academic surgery, and why creating a more equitable culture will require a critical mass of men who are willing to help level the playing field. This is a conversation about identity, belonging, leadership, and what it will take to build a surgical culture where everyone can thrive.

Read Dr. Cornelia Griggs' and Dr. Adrea Merrill's article here.

Read Dr. Arghavan Salles' piece on the status leveling burden here.

Join us inside Empowered Surgeons Group here.

Join Dr. Gita Pensa’s Litigation Education And Preparedness course here.

Dr. Stephen Cohen is a board-certified general and colorectal surgeon, Section Chief of Surgery at the VA, and an experienced medical expert witness with nearly 30 years in the medicolegal field. We explore what it really means to build a sustainable career in surgery: one that allows surgery to enhance your life rather than consume it.

Dr. Cohen shares why he left more than 20 years in private practice for academic medicine, how financial conflict influenced that decision, and why he believes every physician should consider developing multiple streams of income. We discuss the many career opportunities available outside of direct patient care, including medical expert witness work, utilization review, consulting for medical device and pharmaceutical companies, research, and other non-clinical physician roles. He also offers practical advice on how physicians can get started, how to value their expertise, and why it's important to understand both plaintiff and defense work as a medical expert.

We also talk about medical malpractice lawsuits and the emotional toll they take on physicians. Dr. Cohen openly shares his experience of being sued five times, what it was like to be served, how those cases were resolved, and why being named in the National Practitioner Data Bank (NPDB) does not define your career. He explains why malpractice litigation is fundamentally adversarial, why the legal system doesn't always reward the truth in the way physicians expect, and what every doctor should know before ever stepping into a deposition or courtroom.

Along the way, we discuss one of the biggest lessons he learned as an expert witness: knowing the medical record better than anyone else. He explains why carefully reviewing the chart, understanding every detail, and studying depositions can make all the difference in litigation. We also explore why a poor outcome does not necessarily mean poor medical care and the single question from a plaintiff attorney that changed the outcome of a malpractice trial despite excellent surgical care.

Our conversation turns to risk management and the everyday habits that protect both patients and physicians. Dr. Cohen shares why thoughtful documentation is so important, why physicians should never argue with colleagues in the medical record, when to involve risk management after complications, and why communication remains one of the most powerful ways to reduce malpractice risk. He also discusses the surprising benefits of giving patients your cell phone number, approaching every patient with a beginner's mind, and asking yourself how you would care for the patient if they were your own parent.

Finally, we reflect on what changes after residency and fellowship, when technical excellence alone is no longer enough and physicians begin redefining success on their own terms. Dr. Cohen shares what he still loves about colorectal surgery, how the specialty has evolved throughout his career, his thoughts on the rising incidence of colorectal cancer, and why every surgeon should build a career that creates freedom, purpose, and longevity, not just more time in the operating room.

Whether you're interested in medical malpractice, becoming a medical expert witness, physician consulting, utilization review, physician burnout, career diversification, or building multiple streams of income as a doctor, this conversation is filled with practical advice and hard-earned wisdom from someone who has successfully navigated every stage of a surgical career.

Follow Dr. Stephen Cohen on linkedin here.

Take the quiz "What Kind of Surgeon Are You Becoming?" here.

Join Empowered Surgeons Group here.

Dr. Racheal Peterson joins me to share her journey into neurosurgery, a path she set her sights on before medical school and ultimately made a reality. We talk about her first experiences in the operating room as a medical student and the sense of wonder that comes with being able to truly change a patient's life with surgery.

Our conversation explores what made her residency genuinely formative rather than simply something to survive, the unique "bro nerd" culture of neurosurgery, and the common trap of believing the next milestone will finally make you feel like you've arrived. We also discuss how she discovered an unexpected creative outlet through social media, her experience becoming a mother during training and as a young attending, and how her aspirations, priorities, and communication style have evolved throughout her career.

This is a thoughtful conversation about identity, ambition, growth, and what it means to build a life in surgery that continues to evolve alongside you.

Follow Dr. Peterson on instagram here.

What kind of surgeon are you becoming? Take the quiz here.

Join us inside Empowered Surgeons Group here.

Check out Behind the Sports Medicine Podcast here and follow them on instagram here.

Dr. Cameron Roth is a fellowship-trained orthopedic doctor specializing in hand, wrist, and upper extremity surgery and co-host of the podcast, Behind the Sports Medicine Podcast.

In this episode we talk about what it actually feels like to finish training and go out into the world as an attending for the first time when the buck stops with you.

We talk about imposter syndrome and the real divide between how men and women experience the culture of surgery, particularly orthopedic surgeons.

We touch on the fallacy of certainty. You train under one attending who tells you there is one right way to do things. Then you rotate to another attending who tells you the same thing about a completely different technique. Both are certain. Both are wrong about their certainty.

We also get into the first complication after training, and how it hits differently than anything you experienced as a resident.

We consider whether being a woman in surgery might be a superpower, or, perhaps, that surgery selects for badass women. The extra scrutiny, the bias, the being underestimated, done consciously, can produce antifragility. Not just toughness. The capacity to grow stronger under pressure. I think every surgeon, regardless of gender, needs to hear this reframe.

We also cover what genuine availability to patients looks like versus the kind that breeds resentment, and what it means to show up for patients from service energy rather than fear.

This one is for every surgeon who has ever stood at the scrub sink before a hard case and wondered why their career doesn't feel like they thought it should.

Join us inside Empowered Surgeons Group here.

Sham peer review can be one of the most devastating threats facing surgeons today. But it doesn’t have to.

Physician, educator, and coach, Dr. Tracey O'Connell, pulls back the curtain on a reality most surgeons don't see coming until they're already inside it. This conversation is sobering. It is necessary. And it ends with a message of genuine hope: that the surgeon who protects herself, serves her patients, and diversifies her professional identity is also the surgeon who is hardest to destroy.

What Is Peer Review, and What Is Sham Peer Review?

Legitimate peer review is a quality assurance process initiated when a patient, fellow physician, or staff member reports that a physician failed to meet the standard of care or acted improperly. A hospital committee reviews the case, the physician may testify and present evidence, and a determination is made.

Sham peer review is something else entirely. It is the weaponization of that same process for personal, competitive, or political reasons, not to protect patients, but to target a physician. It is used to intimidate, silence, retaliate, and in some cases, end careers.

Sham peer review is defined as “the abuse of a medical peer review process to attack a doctor for personal or other non-medical reasons." Physicians most at risk are those employed by large hospital systems.

How Often Does This Happen?

The honest answer is that precise data is hard to come by, and that itself is part of the problem. Many cases are buried under non-disclosure agreements or never reported because physicians are too isolated, too afraid, or too ashamed to speak.

What we do know

- 56% of U.S. physicians surveyed by Medscape report higher concern that peer review could be misused to punish them for reasons unrelated to the case being reviewed.

- At least 10% of peer review investigations are estimated to be sham peer reviews used to weaponize the process rather than ensure quality care.

- 15% of physicians surveyed in a 2007 AMA investigation indicated awareness of peer review misuse or abuse.

- Hospital disciplinary actions, including suspected sham peer reviews, average 2.5 per year per hospital, according to National Practitioner Data Bank (NPDB) records.

- In Texas alone, 68% of adversely peer-reviewed physicians in 2004 were later adjudicated by the Texas Licensing Board, meaning the reviews were found to be without merit, yet their NPDB reports remain.

The pattern is hard to see because it happens in the confidential, protected setting of hospital committees. But the incidence and severity are increasing.

What You Must Know about the NPDB:

The NPDB was originally created to prevent physicians who had committed dangerous acts from crossing state lines and practicing without consequence. A legitimate and necessary tool, in theory.

In practice, it has become one of the most powerful weapons in a sham peer review.

Key facts Dr. O'Connell wants every surgeon to understand:

- Do not resign while a review is underway. Resignation during an active peer review or Performance Improvement Plan (PIP) can trigger an adverse report to the NPDB and, critically, waives your right to challenge the review. This is one of the most common and devastating mistakes physicians make.

- The only person who can remove an NPDB report is the person or institution that created it. Once reported, removal requires cooperation from the very party that filed it.

- An NPDB report does not have to end your career. This is important. While it can be weaponized as an indicator of incompetence, it is not an automatic career death sentence. Many physicians navigate NPDB reports and continue to practice successfully.

- Get legal representation early. Do not wait. Find an attorney with specific experience in sham peer review and NPDB reporting requirements before the process accelerates.

The Psychological Weight of This Reality:

Dr. O'Connell is direct. This is depressing to know about. It is genuinely sad that the systems designed to protect patients are being turned against the physicians who serve them.

The isolation is real. Physicians under review are often told not to discuss the matter with colleagues. This is a deliberate strategy, and it works. Physicians blame themselves. They question their competence. They feel shame. They feel alone.

Dr. O'Connell's core message: a sham peer review is not a reflection of your worth as a physician or as a person. It is, in many cases, a reflection of institutional politics, competition, and the absence of adequate legal protections for doctors.

We must be able to survive this psychologically and emotionally.

Resources:

Physician Just Equity (PJE)

Founded by Dr. Pringl Miller, MD, FACS, PJE is a 501(c)3 organization of 50 physicians, all of whom have experienced workplace injustice and are dedicated to preserving justice in medicine. PJE offers free, confidential peer support teams for physicians navigating conflicts. They are also collecting data on the nature of workplace conflicts and the career trajectories of physicians after workplace injustice.

Association of American Physicians and Surgeons (AAPS)

1-800-635-1196

Sham Peer Review Hotline: 719-627-7759

AAPS is the only national medical association actively helping physicians fight sham peer review. Their general counsel, Andy Schlafly, has stated plainly: "The biggest misconception about sham peer reviews is a denial of how pervasive they are." AAPS offers free legal consultation for physicians facing a sham peer review.

Dr. Lawrence Huntoon, MD, PhD — AAPS

Dr. Huntoon has run the AAPS sham peer review hotline for over 20 years and is one of the foremost experts on recognizing and combating sham peer review. His resources include:

- Sham Peer Review: Resources for Physicians

- Sham Peer Review: Recognizing Possible Early Warning Signs

Center for Peer Review Justice

A resource for physicians who want to get back to work and avoid expensive legal battles.

Dr. Tracey O'Connell's Writing

- The Sham Peer Review: A Hidden Contributor to the Doctor Shortage — KevinMD, July 2024

- Sham Peer Review: Strategies for Saving Your Career and Soul — KevinMD, October 2024

The surgeon who is most vulnerable to sham peer review is the surgeon whose entire identity, livelihood, and sense of self is housed in one institution, role, and set of privileges. When that is taken away or threatened, everything collapses.

The surgeon who is hardest to destroy is the one who has built differently.

This brings us back to the three essentials of a resilient surgical career:

1. Protect Yourself as the Asset

You are the most valuable instrument in the operating room and in your career. That means investing in your psychological health, your self-concept, and your ability to weather attacks that are not about your competence. Sham peer review is designed to make you question your worth. The surgeon who has done identity work, who knows who she is separate from her title, her privileges, and her outcomes, is the surgeon who survives.

2. Serve the Patients

Staying anchored in your purpose is both a psychological and a strategic act. The surgeon who takes actions genuinely in service to patients, not to institutional approval, compensation, politics, or accolades, is the surgeon who makes clean decisions, communicates clearly, and builds a reputation that outlasts any investigation.

3. Diversify Your Professional Identity

This is the structural protection. A surgeon whose identity and income are entirely dependent on one skillset has no leverage and no safety net. Diversifying through speaking, writing, coaching, consulting, or building an independent practice creates not only financial resilience but psychological resilience. You cannot be completely silenced if you have a platform that doesn't belong to the institution.

The medicolegal, interpersonal, and politically-motivated landmines of a surgical career are real. Sham peer review is one of the most dangerous. The best protection is not legal; it is architectural. Build yourself in a way that no single institution can dismantle.

Dr. O'Connell is a resource for you! Learn more about how she can help you here.

Join us inside Empowered Surgeons here.

Every surgeon enters the profession knowing the clinical risks. Complications happen. Patients are unhappy. Outcomes fall short. That is part of the contract.

But what about the other risks? The systemic and structural ones that have nothing to do with how compassionate of a human you are, how good of a diagnostician you are, or how slick of a technician you are? You got into this to take care of people. But the system was designed to protect patients from bad actors, and those protections can be weaponized against good doctors for nefarious reasons.

In this 100th episode, neurosurgeon Dr. Christian Bowers joins me for an unfiltered convo about the systems governing physician careers and the gap between what those systems were designed to do and how they actually function. Dr. Bowers draws on years of watching colleagues' careers upended to illuminate what no one teaches in training.

"The thing that could totally derail someone's career overnight, with no fault of their own, is never discussed," — Dr. Christian Bowers

THE KANGAROO COURTS

• Academic medical centers operate as large corporations with financial incentives that diverge from physician protection.
• The house always holds the cards, and that matters for surgeons who find themselves in its crosshairs.
• A predetermined outcome can be built through paper trails before a physician ever knows they are being targeted.

SHAM PEER REVIEW

• The "disruptive physician" label is legally vague, subjectively applied, and the starting point for building a paper trail.
• Things that were never a problem before all of a sudden become problems when an institution has decided to move on from you.
• HCQIA (1986): designed to protect peer reviewers from retaliation, with the unintended consequence of making bad-faith reviews difficult to challenge.
• A small group of aligned physicians often leads the charge, which makes this harder to see coming.

DARVO

• Deny, Attack, Reverse Victim and Offender: the pattern coined by psychologist Jennifer Freyd that Dr. Bowers has seen play out repeatedly in institutional settings.
• Physicians who have never heard of this concept are the most vulnerable to it.
• DARVO typically shows up alongside sham peer review.

THE ROLE OF PIPS, THE MEDICAL BOARD, AND THE NPDB

• Performance improvement plans and professionalism reviews are tools institutions use alongside sham peer review when they have decided to move on from a physician.
• Medical board complaints and NPDB reporting are downstream consequences that can encumber a physician's ability to find their next position.
• The damage is typically done upfront.
• The goal of legal counsel is protecting you for the next job, not saving the current one.

THE ACGME & STRUCTURAL ACCOUNTABILITY

• The ACGME is a private organization, not a government agency. It is accountable to its interests, not to trainees.
• The Glass-Steagall parallel: the same perverse incentive structure between regulators and the institutions they regulate contributed to the 2008 financial crisis Medicine now has a version of exactly that.
• Resident unionization may be one of the few structural checks on this dynamic.

PRACTICAL ADVICE FROM DR. BOWERS

• Going into academic medicine as a highly sub-specialized surgeon may be the highest-risk career setup.
• The two-hospital model: having multiple institutions competing for your cases fundamentally changes your negotiating position and safety.
• When to consult an attorney, why you do NOT need to tell the hospital you have one, and what an attorney can and cannot do for you.
• The controlled retreat strategy: protect yourself for the next job even when the current one is already lost.
• Non-competes, NPDB, contracts, and what to investigate before signing anything.

Closing Reflection: The 100th Episode

Every system discussed in this episode was built with a legitimate purpose. The Board of Registration in Medicine protects the public. HCQIA was designed to encourage good-faith quality review. The ACGME exists to ensure training standards. Each one began with a just cause.

Over time, changes in how medicine is organized and how physicians are employed have created dynamics the original frameworks were not written for. The physician who simply showed up and did excellent work inside a broken system did not cause that drift. But they are the ones absorbing its cost.

The majority of physicians are not the bad actors these systems were designed to catch. They are doing their best inside systems that apply the same rules to the rare bad actor and to the exhausted surgeon who had a difficult patient or staff interaction after a long night of call.

Knowing that is clarity of environment, and clarity is the first form of protection.

Key Terms Referenced

• Sham Peer Review: The use of the peer review process to target a physician for non-clinical reasons, typically when an institution has decided to remove someone and needs a documented justification.
• HCQIA: Healthcare Quality Improvement Act (1986). Grants qualified immunity to hospitals and peer reviewers. Designed to encourage good-faith review; the unintended consequence is that bad-faith reviews are difficult to challenge.
• NPDB: National Practitioner Data Bank. A federal repository of adverse actions against clinicians. An adverse report follows a physician across state lines and employers permanently.
• PIP: Performance Improvement Plan. Can be a legitimate corrective process or a documented pathway toward termination, depending on the institutional context.
• DARVO: Deny, Attack, Reverse Victim and Offender. Coined by psychologist Jennifer Freyd. A pattern that can arise when individuals or institutions face accountability, with or without conscious intent.
• ACGME: Accreditation Council for Graduate Medical Education. A private, non-government organization that accredits residency and fellowship programs.

Join Empowered Surgeons Group here.

Dr. Won Kim is a brain and tumor neurosurgeon at UCLA Health, where he trained, completed a fellowship in stereotactic and functional neurosurgery, and built a practice around treating tumors that were once considered inoperable. He is also the kind of surgeon who will tell you he is hard to work for, that M&M should be about quality improvement not blame, and that the last five percent of a perfect resection isn't worth the cost of your patient's quality of life.

Won's path to neurosurgery started with a childhood friend who had clinical depression. He wanted to understand how a brain could work so well and suffer so much at the same time. That question took him from a fascination with psychology to watching his first awake craniotomy, and it never really let him go. He ultimately chose neurosurgery over psychiatry. But the question of what makes one person able to thrive while another person can't escape the darkness has followed him throughout his career.

In this conversation, we talk about what it actually means to treat the patient and not the scan and why the pursuit of perfection can be its own form of hubris. He talks about what it means to go to sleep without shame or guilt, as long as you prepared to give your best.

We also get into his AI startup, why AI will paradoxically create more demand for radiologists rather than less, and what he has learned about becoming a better teacher and mentor.

Follow Dr. Kim on instagram here.

Are you a surgeon with a story to tell? Yes you are! Email me at mel@melthackercoaching.com

Join Empowered Surgeons Group here.

Dr. Red Hoffman has spent her career sitting with people at the hardest moments of their lives. As a physician who combines trauma care and palliative medicine, she has built a practice around something most of us spend our whole lives avoiding: death. But what makes Red's perspective so singular is that she isn't just a professional witness to loss. She has lived it, repeatedly and violently. Her grandparents died in a car accident when she was 12. Her father was killed in a terrorist attack in Egypt when she was 19. Her partner sustained a traumatic brain injury and later died by suicide when she was 49. This is a woman who knows grief from the inside out, and she has chosen to meet it with love rather than distance.

In this conversation, we talk about what it actually means to have a good death, and what it means for the people left behind. Red explains why violent deaths carry a unique burden — not just the loss itself, but the law enforcement, the media, the legal system, all the unknown layers that pile on top of an already impossible experience. She shares what to say to someone who is grieving when you don't know what to say, and why the most important thing is not to assign meaning to someone else's loss. That work belongs to the bereaved.

We also get into what it looks like to build a life on your own terms inside a system that wasn't designed for you. Red talks about navigating a corporate hospital buyout, watching her community get hit by Hurricane Helene, and finding genuine love for a corporation she once might have resisted. She talks about long COVID, what it is like to go from healthy to chronically ill, and how she has learned to ask for what she needs inside a system that makes that incredibly hard.

And we talk about twriting the book she wishes she had when her father was killed: a guide to surviving violent death for the people left behind.

Red carries a lot of loss and a lot of love, and somehow in her hands those two things are not opposites. I think you are going to feel that.

Learn more about Dr. Red Hoffman here.

Follow her on instagram here.

Join us inside Empowered Surgeons Group here.

What happens when being a doctor is no longer enough to sustain you?

Dr. Shieva Ghofrany, OB/GYN and founder of A Tribe Called V joins me to explore identity, autonomy, and the hidden pressures of practicing medicine.

Dr. Ghofrany didn’t follow a traditional path into medicine, and she doesn’t practice it traditionally either. From switching majors multiple times to building a parallel business, she shares what it looks like to question expectations, tolerate failure, and expand beyond the narrow identity many physicians inherit.

We talk about the emotional and psychological realities of OB/GYN, the weight of responsibility in high-stakes situations, and the courage it takes to step outside the “golden handcuffs” of medicine.

This episode is about more than career decisions.

It’s about how you relate to yourself, especially when things don’t go as planned.

• Why identity in medicine can become limiting and how to expand beyond it
• The concept of “golden handcuffs” and why so many physicians feel stuck
• Learning to tolerate failure (and why it’s essential for fulfillment)
• Building A Tribe Called V and what entrepreneurship revealed about her strengths and blind spots
• The emotional toll of OB/GYN, including moral injury and high-risk deliveries
• The psychological pressure physicians face in moments like shoulder dystocia
• Her personal journey through endometriosis, infertility, and ovarian cancer
• What illness taught her about resilience, perspective, and life beyond medicine
• The importance of playfulness in the OR and how it shifts performance
• A powerful daily mindset practice that shapes how she shows up
• Why resentment is not useful in surgery—and what to do instead
• Communication, emotional intelligence, and how to navigate patient retaliation

You can follow every rule, do everything “right,” and still feel constrained by your career.

This episode challenges the idea that medicine alone should define you—and offers a different way to think about autonomy, fulfillment, and what it means to build a life that actually works.

Dr. Shieva Ghofrany is an OB/GYN in private practice and the founder of A Tribe Called V, a platform dedicated to increasing knowledge and reducing anxiety around women’s health.

Her work sits at the intersection of medicine, education, and empowerment—helping women better understand their bodies while encouraging physicians to think more broadly about identity and impact.

Learn more about Dr. Ghofrani here.

Join us inside Empowered Surgeons Group here.

Dr. Jake Goodman is a psychiatrist who works with healthcare professionals and has built a following of over 2 million people by saying the things most physicians are thinking but not saying out loud.

His practice started in a telling way: his first patient was a surgeon, then a dentist, then a veterinarian, then an OB/GYN. That pattern wasn’t random; it revealed something much bigger. There is a massive, unmet need for mental health support in healthcare, and most of us are silently struggling more than we admit.

Jake shares his own story of depression during intern year, when he thought he was “burned out,” but was actually depressed. Low energy. Numb. Going through the motions. And here’s the part that hits: he was a psychiatry resident and still couldn’t see it in himself. That’s how deep the stigma runs in our profession.

We talk about what it actually takes to come out of that place and why “working harder” is not the answer. At some point, the armor has to come off. And for physicians, that’s often the hardest move.

If you’ve ever felt like your life used to work—and now it doesn—you’ll recognize what he describes. The career, the family, the workouts, the expectations… at some point, something gives. His question is simple: Is what you’re doing sustainable for the next 20 years?

We also get into the stuff no one taught us:

– what to do with the stress your body is carrying after a case

– why you can’t just compartmentalize forever

– how to recognize your own “check engine lights” before things spiral

And one of the most practical tools he shares is how to separate “hot thoughts” from reality. The ones that sound like: I’m a bad doctor. I’m an imposter. I’m going to be found out. Instead of fighting them, he teaches you how to create space from them so they stop running the show.

We also talk about emotions: what they are, what they’re not, and why making permanent decisions in temporary emotional states is one of the biggest mistakes physicians make.

This conversation is real, practical, and long overdue.

If you’ve been telling yourself you’re just “burned out”… you may want to listen to this one.

Learn more about Jake's practice here.

Follow him on instagram here.

Join us inside Empowered Surgeons Group here.

What if your relationship with food had nothing to do with discipline and everything to do with your nervous system?

In this conversation with Luis Mojica, we explore the connection between developmental trauma, chronic stress, and the way we relate to food. Luis shares his own story of using an eating disorder to cope with undiagnosed PTSD, and how that led him to question the traditional psychology model that focuses on behavior without getting curious about environment, physiology, or nutrition.

His work in nutrition counseling revealed a pattern: people with unresolved trauma and chronic stress often struggle to stabilize their health in ways that have nothing to do with discipline and everything to do with their nervous system.

We talk about food as a relationship. Not just something we consume, but something that becomes us. Our tissues, our skin, our blood. Food can stimulate, suppress, or balance the body, much like our relationships with people. Caffeine, sugar, and refined carbohydrates can activate the system. Rich, comforting foods can initially settle us but create downstream effects that dysregulate. Whole foods tend to support balance. This shifts the conversation away from good and bad foods and toward how different foods impact our internal state.

We also unpack trauma as a physiological response rather than an event. The body mobilizes for fight or flight, and when that is not possible, it moves into freeze, collapse, or fawn. Many high achievers learn early how to override their own needs in order to belong. That override becomes a strength professionally, but it comes at a cost. Hunger signals, boundaries, and emotional cues all get muted, and over time there is a growing disconnection from the body. The same stress pathways that are activated in trauma can also be activated by the foods we eat.

A big part of this conversation is reframing cravings. Instead of something to control, they can be understood as a signal. A compass pointing toward an unmet need. Luis shares examples from his work with patients, including how removing a coping mechanism too quickly can create more distress if we do not first understand what role it is playing. We talk about what it looks like to pause, get curious, and actually listen to what the body is communicating.

We also go into practical tools. Tracking where tension or pressure lives in the body. Creating a sense of safety with simple physical cues. Working with numbness and understanding what is underneath it. For those of us in high intensity environments like surgery, this matters. The constant activation, sleep deprivation, and vicarious trauma create a baseline level of stress that most people never experience. In that context, food becomes more than fuel. It becomes a way to regulate. Meals and snacks can either amplify that stress or help bring it down.

We close by talking about capacity versus desire. Many physicians love what they do, but their capacity to metabolize the constant input is maxed out. Without space to process, the system stays activated. Practices like pendulation, moving between states of activation and regulation, help rebuild that capacity. This is ultimately about returning to a more sovereign relationship with the body, supporting the microbiome, and understanding that even something as simple as fiber can play a meaningful role in restoring balance.

Get Luis's book Food Therapy here.

Follow Luis on instagram here.

Learn more about Love and Science Fertility here.

Join Empowerd Surgeons here.

Infertility is shaping the lives of female physicians, and we need to talk about it.

Dr. Erica Bove, creator of Love and Science, shares the startling fact that 1 in 4 female physicians and 1 in 3 female surgeons experience infertility. Interestingly, the very mindset that makes us successful in surgery can work against us when it comes to building a family.

We explore the hidden role of stress, trauma, and nervous system dysregulation, and the trap so many physicians fall into: trying to solve infertility by working harder, researching more, and disconnecting from their own bodies.

Dr. Bove offers a radically different approach, one that begins with humanity.

We talk about:

• Why going on a certainty frenzy doesn't solve the problem
• How trauma states impact fertility physiology
• The courage it takes to receive care, not just give and give
• Reconnecting with your deepest “why”
• Boundaries, community, and learning to say: I deserve to be a patient

This is not just a conversation about fertility, it’s about reclaiming your humanity in a system that taught you to override it.

Erica Bove, MD, is a double board certified OB-GYN and Reproductive Endocrinologist (REI) physician at the University of Vermont, She is also the CEO and founder of Love and Science: Thriving Through Infertility. She has a keen interest in marrying an evidence-based approach with intuitive knowing in the context of a trusting relationship. She empowers women physicians to build their families with confidence, self compassion and community. Her mission is to heal and support the healers and to create a legacy she is proud of.

In her free time, she enjoys running, yoga, kayaking, skiing, reading, writing, and spending time with her inner circle.

Follow her on Linkedin here, IG here, FB here, and check out her podcast, Love and Science Fertility here.

Surgeons, join us inside Empowered Surgeons Group today.

In this episode, Dr. Karen Leitner and I explore the hidden thought patterns that keep women physicians stuck. And how to break free!

We cover:

• Why charting paralysis happens (and the thought loops that drive it)
• Being diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD) later in life and the shift from self-judgment to self-understanding
• The power of acceptance and letting go of control over outcomes
• The moment Karen realized even “good doctors” get sued
• How medical training builds a hypercritical inner voice (and how to replace it with self-compassion)
• Moving from walking a tightrope → to feeling solid and safe within yourself
• The reality of inequity: women physicians being undervalued and underpaid
• Lessons from Women Don’t Ask on why women avoid negotiation
• The mindset shifts needed to negotiate powerfully:
• Your value is yours—even if others don’t recognize it
• Hearing “no” is part of the process, not the end
• Discomfort is the price of increasing your impact and income
• Practical negotiation strategies:
• Research compensation (e.g., Medical Group Management Association data)
• Communicate your value from the institution’s perspective
• Have the conversation in person and set expectations ahead of time
• Anticipate objections and stay in the conversation

Key takeaway:

Money = impact. When you are compensated appropriately, you expand your ability to create change.

Ready to go deeper?

If you’re a woman physician looking to feel better, think clearer, and show up more powerfully in your life and career, check out Dr. Karen Leitner's coaching program here. Make sure to follow her on Instagram here.

And if you’re a surgeon ready to step out of burnout and lead your career from a place of confidence and ownership, join Empowered Surgeons. You don’t have to keep doing this alone.

Interested in our retreat to Norway? Get on my calendar for an interview here.

What does it really take to survive and succeed in a system that wasn’t built with you in mind?

In this episode, I explore that question with orthopedic surgeon Dr. Sonya Sloan. We talk about the hidden curriculum of medicine: the unspoken rules, the power dynamics, and the strategies required to navigate surgical training, especially as a Black woman in a historically white, male-dominated field.

From early inspiration in the operating room to enduring microaggressions, bullying, and even physical assault during training, Dr. Sloan shares what she learned, how she protected herself, and why resilience alone is not enough.

This episode is not just about survival; it’s about strategy, leadership, and rewriting the rules for the next generation.

We talk about:

• How her early experiences sparked a career in orthopedics
• What it was like being one of the only Black trainees in a surgical program
• The reality of bias, microaggressions, and exclusion in medicine
• The difference between mentors and true advocates
• A moment of physical assault in the OR, and how she handled it
• Why documentation and strategy are essential for protecting your career
• The hidden “rules” of medicine no one teaches you
• How surgical culture impacts women
• The critical importance of leadership and communication skills
• Why “soft skills” are not optional but essential
• How humor and tone-setting can transform the OR environment
• The emotional toll of training, and the importance of narrative processing
• Why so many trainees feel isolated, targeted, or unsupported
• What needs to change in surgical education right now

Takeaways:

• Resilience isn’t enough. You need strategy, awareness, and support
• Documentation is power in environments where bias exists
• Mentors advise. Advocates act. You need both.
• Microaggressions shape careers, even when they seem subtle
• Leadership skills are not taught, but they are critical to survival
• You don’t have to silently tolerate inappropriate behavior
• Processing your story is part of healing and reclaiming your voice

Learn more about Dr. Sonya Sloan and get her book, The Rules of Medicine here.

Follow Dr. Sloan on instagram here.

Check out Hardball for Women here.

Check out White Fragility here.

Join us inside Empowered Surgeons Group here.

Join Empowered Surgeons Group here.

Learn more about what's inside ESG here.

In the perfectionist surgeon's mind, either we get a perfect outcome or we fail. But in the realm of humans, perfection is impossible. And we don't always have full control over the final surgical result.

Instead of thinking in terms of surgical "success" and surgical "failure", what would it look like to categorize circumstances into mistakes, complications, and missed expectations? That's what I explore inside this episode.

What does it mean to stay grounded in your identity and your humanity inside a system that often asks you to override both?

In this episode, orthopedic surgeon, Dr. Brian Nwannunu, shares his journey from being the son of Nigerian immigrants to building a career in surgery rooted in purpose, faith, and service. Brian knew from a young age that he was called to medicine, but his path wasn’t linear. After not getting into medical school on his first attempt, he pursued a master’s in physiology, eventually gaining admission and thriving - reinforcing a powerful truth: test scores don’t define clinical excellence or future success.

We talk about the realities of surgical training, where Brian faced criticism, microaggressions, and the pressure of being one of the only Black residents in his program. Despite external narratives that questioned his performance, he had objective evidence of his excellence and mentors who helped him stay grounded. His story highlights the disconnect that can exist between perception and reality in training environments, and the lasting impact of bias, labeling, and unequal protection among trainees.

Brian shares how these experiences shaped the way he practices today. As an attending, he’s intentional about bringing humanity back into orthopedic surgery: slowing down, listening deeply, and recognizing that every surgery affects not just a patient, but an entire life system. We also explore the difference between operating from service versus ego, and how that distinction changes both outcomes and fulfillment.

The conversation expands into the broader realities of modern medicine: insurance barriers, loss of autonomy, and the growing influence of private equity. Brian explains why he chose private practice, why physicians need an exit strategy, and how models like direct care may shape the future of certain specialties.

Finally, we talk about identity beyond medicine. Brian shares how he’s diversified his life through teaching, speaking, and financial literacy, which all creates a sense of purpose and stability that extends beyond the OR.

This is a conversation about resilience, integrity, and choosing how you want to practice, both as a surgeon and as a human being.

Follow Dr. Brian Nwannunu on instagram here.

Join us inside Empowered Surgeons Group here.

What do physicians actually need when they find themselves on the receiving end of a malpractice lawsuit?

In this episode, I have a conversation with emergency physician, educator, speaker, coach, advocate and legal expert Dr. Gita Pensa about the reality of medical malpractice from the physician defendant’s perspective. We explore why getting sued can feel like being dropped onto another planet. Also why shame, fear, and avoidance often keep doctors from learning how the system actually works.

Gita explains how the malpractice landscape has shifted dramatically in recent years. Public trust in medicine has eroded since COVID, nuclear verdicts are increasing, and third-party investors are now funding lawsuits in pursuit of massive payouts. Meanwhile, physicians often stay silent, leaving the narrative about medicine to be shaped by media outlets, documentaries, and plaintiff attorneys who are highly organized and strategic about influencing public perception.

We also unpack a crucial misconception: a verdict or settlement does not necessarily mean bad care. Medicine operates in a world of uncertainty, yet the public expectation of perfection has never been higher. Complications, missed expectations, and true mistakes are very different things, but in courtrooms and headlines, they’re often treated as the same.

Gita shares practical insights into the litigation process, including why the deposition is one of the most important moments for a physician defendant. She also discusses the work she does helping physicians prepare for these high-stakes conversations so they can show up with clarity instead of fear.

Finally, we zoom out to the bigger picture. From legislative advocacy to improving how medicine talks publicly about risk and error, physicians need to become more informed, more strategic, and more willing to speak openly about malpractice and its consequences.

Because the truth is: if we want the system to change, we have to be willing to understand it and talk about it out loud.

Learn more about Dr. Pensa's LEAP course here.

Listen to Doctors and Litigation: The L Word podcast here. Season 3 episode 4 features Dr. Nirav Patel, the radiologist who is an example of what is possible.

Join Empowered Surgeons Group here.

In 2019, two patients complained to the Board of Registration in Medicine about me.

At the time, it felt deeply unfair. I felt hate. I felt indignation. I felt like a victim. I even fantasized about horrible things happening to the people who complained about me. They were my villains.

But, through my own coaching journey, I began to understand that pain is not individual; it is inherited, relational, generational, and cultural. These two complaints were sources of clean pain, but they were not the source of my suffering; my decision to indulge in drama was the real cause of my suffering.

In this episode, I'll teach you the important lessons I learned from that year.

I now feel immense gratitude for experiencing what it's like to be investigated by the Board, and I'm so happy I can bring these lessons to all of you.

If you want to take this work deeper and master the lessons I now teach, you're going to want to join us inside Empowered Surgeons Group here.

Not ready yet? Definitely get on my email list here so as not to miss any free or paid offerings.

Sign up for the webinar, "Mistakes, Complications and Missed Expectations" on March 26th at 5 pm EST here.

Surgeon-writer, Dr. Cornelia Griggs joins me this week.

Check out her article with Dr. Andrea Merrill, The Hidden Reason Women are Leaving Surgery: They're Being Pushed Out here.

Check out her book, The Sky Was Falling here.

The first physician in a family of writers, artists, and communicators, she grew up surrounded by people willing to speak openly about medicine’s vulnerabilities. A former theater kid, she found early inspiration in Atul Gawande’s Complications and the patient safety movement—so much so that she wrote her senior honors thesis on its history. After college at Harvard and medical school at Columbia, she developed a deep interest in health policy and the cultural forces shaping modern medicine. She reflects on how differently she writes when her “research hat” is on—passive voice, sterile, stripped of self—compared to the personal writing she uses to metabolize the hardest moments of her career.

We talk about what it was like to be a young surgeon in New York City when COVID hit—what was meant to be the crown jewel of her training. Following intensivists on early medical Twitter, she became convinced by February that disaster was coming. What frightened her most wasn’t ventilator shortages but the prediction that hospitals would run out of staff as clinicians fell ill. She felt dismissed, even gaslit, when others minimized the threat. Yet she knew—capital B Bad was coming. When the surge hit, it felt dystopian: inadequate PPE, mounting loss, the emotional toll of watching a system strain and fracture. That experience deepened her commitment to nurturing the softer, intuitive, vulnerable parts of herself—and to helping others do the same.

Cornelia also speaks candidly about women’s attrition from medicine, including her co-authored work with Dr. Andrea Merrill examining why so many are leaving. From differential treatment in the OR to referral streams quietly diverted to younger male partners, from pay disparities to the subtle “thousand paper cuts” of heightened expectations, she describes the cumulative mental load women surgeons carry. She has a unique vantage point watching how OR staff treat her husband compared to how they treat her and her female colleagues. Meanwhile, medicine offers few of the perks seen in tech and other industries—despite the time, sacrifice, and invisible labor the profession demands.

We explore the erosion of public trust, the ways academic medicine has ceded ground to the wellness industry, and how rebuilding credibility will require more than data—it will require humanity. For Cornelia, the path forward means reinjecting compassion into the profession, setting boundaries, and redefining what it means to be a powerful physician in today’s world.

Follow Dr. Griggs on TikTok here.

Check out Dr. Frances Mei Hardin's book, Surgeon on the Edge here.

Sign up for "When you Can Cut the Tension with a #10 Blade: Anxiety, Performance, and the Surgical Nervous System" here.

Join us inside Empowered Surgeons Group here.

Join us inside Empowered Surgeons Group here.

Life is more fun when your career path isn’t linear. Dr. Raymund King knows this well. From performing magic to practicing medicine, from the courtroom to the screen, Raymund’s life reflects a deep willingness to evolve and follow his inner knowing.

We talk about witnessing tragedy, bucking the norm, the mindset of a doctor vs lawyer vs creative, reinvention of self, becoming a good steward of service, and the importance of trust, even when things are scary and uncertain.

For physicians navigating burnout, or identity shifts, Raymund’s story is a reminder that your path does not have to be singular to be coherent. Reinvention is not failure. And sometimes the most powerful next step is the one that makes the least sense on paper.

Find Dr. Raymund King on IMDB here and Linkedin here.

Join us inside Empowered Surgeons Group here.

”It makes you feel crazy as a patient,” Tiphany Kane.

As physicians, we have more influence than we realize over how patients feel and how they perceive us (and the profession in general). Whether or not we diagnose them or operate on them, patients want—and deserve—to be treated humanely.

At its core, our job is simple: serve the patient.

But that becomes profoundly challenging inside a dehumanizing healthcare system rife with moral injury and burnout. I get it. It’s easy for physicians to slip into a transactional mindset when the system itself is transactional.

And still, both things can be true.

We can humanize ourselves, humanize every patient we see, and work to change the system at the same time. In fact, I believe everyone wins when we choose this path.

In this episode, you’ll hear one patient’s journey. Tiphany Kane is an entrepreneur and a medical mystery. She shares what it was like to be gaslit for years by her primary care physician, cardiologists, nephrologists, and endocrinologists. It wasn’t until she independently enrolled herself in a clinical trial that she finally received the care she had been searching for.

And it wasn’t easy. Despite surgical complications and unexpected setbacks, Tiphany speaks with gratitude and deep respect for the surgical team who cared for her.

Her story is a powerful example of what becomes possible when physicians make compassionate, patient-centered, service-based care their highest priority.

Follow Tiphany and her medical journey on instagram here.

Join us inside Empowered Surgeons here. Subscribe to Stitches here.

What happens when the skills that make you a great surgeon begin pulling you toward a different kind of impact?

In this episode, I sit down with Dr. Ivan Capobianco, who trained as a hepatobiliary and transplant surgeon and whose career journey spans Italy, Germany, global health work in Angola, academic research, AI, entrepreneurship, and medical publishing.

Ivan shares a deeply honest account of how he moved from the operating room into startup life and research, not because he couldn’t handle surgery, but because he began asking a bigger question:

How else can I serve?

We talk about:

-Growing up in Italy in a creative family, and why medicine wasn’t always the obvious path

-Training at the University of Padua, one of the oldest medical faculties in the world

-Key differences between European and U.S. surgical training systems

-How a year “off” before residency led him to Angola and permanently changed how he saw medicine

-Why pediatric surgery culture felt different, and what that revealed about surgical identity

-Burnout that didn’t announce itself until it did

-A pivotal moment during parental leave that forced a reckoning between career, family, and self

-Attrition in surgery, particularly for women

-The unfortunate truth that productivity and profit override patient-centered values in modern surgical systems

-The realization that helping healthcare workers may help more patients than operating alone

Ivan also shares how his love of research, data, and prevention led him to:

-Learn coding and machine learning

-Found the healthcare documentation startup Briefly

-Create STITCHES, a daily newsletter that curates and summarizes the most relevant surgical literature from hundreds of papers published each day

We explore:

-Why most “AI in surgery” papers miss the mark

-The value of small case reports and practical technique papers

-Why knowing open surgery still matters in a robotic era

-The loss of discussion and collaboration in modern academic medicine

-The myth of “I don’t have time”

-How essentialism can reduce cognitive and bureaucratic burden for surgeons

This is a conversation about agency, courage, and redefining service and usefulness in a system that often narrows our sense of who we’re allowed to be.

Dr. Ivan Capobianco leads the Surgical AI anda Digital Phenotyping Group at the Department of General Surgery, University of Tübingen. His research focuses on machine learning and artifical intelligence, Big Data in medicine, with a a particular emphasis on natural language processing methods applied to clinical data. He is the founder of the healthcare startup Breeflee, and creator of the surgical research newsletter STITCHES, which reaches over 5,000 readers daily. His work focuses on improving working conditions for surgeons and other healthcare professionals through better data, automation, and access to meaningful research.

The Pain to Power Workshop is the foundation upon which your self-concept is built. You can't step into the next version of yourself until you heal old wounds and rewrite your past. We start this work Feb 2nd, 2026. You have access to the content until March 2nd, 2026. Sign up here.

If you are catching this episode outside the window, no worries! You can still join us inside Empowered Surgeons group here.

LIMITED OFFER: The Pain to Power 5-day Coaching Program starts Feb 2nd. Sign up here.

In this episode I speak with Dr. Mandy Rice, a dual board–certified General Surgeon and Surgical Intensivist whose path to surgery was anything but traditional. She began her career as a pediatric ICU nurse at 22, carrying the belief that she “wasn’t smart enough to be a doctor” - until a physician challenged that narrative, and she chose to believe him.

Mandy loved medical school: the chaos, the autonomy, and the sense of purpose. Only later did she realize that the chaos she gravitated toward mirrored the chaos of her childhood, and that comfort and disorder had long been paired in her nervous system. After graduating medical school at 36, she entered residency and discovered stark differences between nursing and medicine, mentorship and hierarchy. A strong female role model in medical school contrasted sharply with a toxic training environment in residency, where lack of support - particularly from women in leadership - left her asking, “Why would people who are paid to train me treat me this way?”

We talk openly about the pain and disorientation of being fired from a training program, and the rude awakening that truth, logic, and “first, do no harm” do not always govern surgical culture. From there, Mandy navigated her first job out of training, reimagined the life she wanted, and ultimately designed a practice on her own terms, including direct-care surgery and later, community-based women’s health and hormone therapy.

Along the way we examine burnout, depersonalization, and the subtle spectrum between over-empathizing and dehumanizing patients. The middle ground, we learn, is compassion and skillful empathy. We also explore the gifts of palliative medicine and how it reshaped her ability to have difficult conversations, confront uncertainty, and meet suffering without collapsing into it.

Today, Mandy practices community surgery through a circuitous and self-authored route - proof that there are many ways to practice surgery, many ways to serve, and many ways to live a life in healthcare that is meaningful, humane, and your own.

Learn more about Dr. Mandy Rice here.

Join us inside Empowered Surgeons Group here.

Have you ever felt like you were on a moving sidewalk toward retirement, as if you had committed to a life path long ago and now you’re simply being carried along it? If so, you’re not alone, and you won’t want to miss this episode.

This week I speak with Mark Shrime, MD, PhD - Head and Neck surgeon, researcher, and former Chief of the Harvard Program in Global Surgery - about discernment, vocation, risk, and the search for meaning in medicine. Mark talks candidly about disliking medical school, nearly quitting, and ultimately choosing ENT after spending time with a surgeon who modeled what it means to balance work and play - a theme that never stopped mattering.

We explore how physicians make consequential decisions under uncertainty, how intuition can be trained, and why medicine treats vocation almost like the clergy: you choose young, never leave, and give your whole life to it. Along the way, we discuss administrative bloat, the profit motives of healthcare, the indoctrination of not listening to our inner voice, and the question of whether doctors are truly risk-averse or simply trained to be.

A turning point comes with Mark’s service work on Mercy Ships, where he performed head and neck surgery in a purely service mindset. An epiphany in Monrovia - punctuated by a near-fatal car accident - clarified his path in a way that finally felt aligned rather than obligatory. Conversations in Madagascar later informed his paper Trading Bankruptcy for Health (Value Health, 2018), a study I referenced in my TEDx talk Seeing Beyond the Red Swans.

We talk black swans, white swans, and red swans, and the privilege of being present with people in their deepest truths. Ultimately, we circle back to what humans crave most: to be seen, accepted, safe, and unjudged, even though safety is not incentivized in modern healthcare.

We close with positive psychology, the inner judge and its saboteurs, and the uncomfortable but necessary skill of falling in love with failure, especially in surgery, where complications become harder emotionally even as skill peaks.

Watch Mark's TEDx talk, Putting Purpose Over Path.

Work with him and buy his book here.

Follow him on instagram here.

After returning from our inaugural women surgeon's retreat in Cabo, Steph Sheldon and I debrief about the lessons we learned.

Please enjoy this special episode of Surgeons with Purpose.

The "Pain to Power Workshop" will launch on Jan 18th. Get on my email list here to get all the updates about the program.

And if you are ready to join us in Empowered Surgeons Group, click here.

Steph Sheldon is a creative entrepreneur, business coach, website designer, and brand strategist who works primarily with women founders and coaches to help them clarify their voice, build intentional digital spaces, and grow sustainable, aligned businesses. She blends her background in architecture with business strategy and creativity to support her clients in creating meaningful, effective online presences and offerings.

Steph frames business not just as technical work but as creative and personal expression, rooted in clarity, intention, and connection between the founder and their audience. Her content and coaching often explore how inner beliefs, creativity, and somatic experience inform business success.

Follow her on instagram here.

Are you a woman surgeon who wants to retreat with us in Norway in August? Get on my calendar for an interview here.

Join Empowered Surgeons Group here.

In this episode, Dr. Lauren Umstattd shares her journey through otolaryngology training, a painful facial plastics fellowship experience, and the difficult decision to leave a path that no longer aligned with her values. First drawn to ENT as a medical student by its breadth and clinical complexity, Lauren enjoyed the precision of endoscopic and microscopic surgery during residency but found herself emotionally weighed down by head and neck cancer care. A rotation in facial plastic surgery changed everything, offering her clarity, creativity, and a sense of elective choice that resonated deeply.

Fellowship, however, became one of the most difficult chapters of her training. Despite being a strong student, Lauren felt profoundly out of alignment with her fellowship director and increasingly isolated, questioning herself in ways she never had before. As the experience deteriorated, she began simultaneously building her future practice, ultimately making the terrifying decision to resign just ten months in, despite fears about certification and professional identity. Ultimately, she chose her hard.

Lauren goes on to describe building a facial plastic surgery practice rooted in trust, transparency, and psychological safety. She discusses leveraging social media, thinking like an entrepreneur, and learning to separate the certainty required in surgery from the experimentation required in business. Central to her work is reframing perfectionism and failure, setting honest expectations with patients, and acknowledging that neither surgeons nor outcomes are ever perfect.

This conversation explores what it means to design a life and practice on your own terms, build culture intentionally, and fall in love with the hard parts of the work. It’s a powerful reminder that sometimes the bravest move in surgery and life is choosing alignment over approval.

Dr. Lauren Umstattd is a facial plastic surgeon and entrepreneur known for her commitment to autonomy, ethical patient communication, and psychologically safe practice culture. She is passionate about building systems that support excellence without sacrificing humanity. Follow her on instagram here and TikTok here.

Dr. Kat Hudon shares her journey from enthusiastic learner to an employed physician slowly beaten down by a system designed to keep doctors exhausted, constrained, and disconnected from their creativity.

In this convo, we explore how medicine places an impossible mantle of perfection on physicians, why resilience is a finite resource, and how the system punishes anything that falls outside the narrow definition of “excellence.” Dr. Hudon reflects on moral injury, middle management challenges, the growing administrative bloat in healthcare, and how she realized she always had a choice.

This episode is about reclaiming agency through values, connection, collaboration, and the courage to design a life and practice that actually aligns with who you are.

1. Kat describes the arc many physicians experience: entering medicine as a high-achieving, enthusiastic learner and slowly realizing, “I thought this was going to be better.”
2. Residency forges some of her most meaningful, lifelong relationships—even as the system itself begins to erode joy and creativity.
3. As leadership changes in employed medicine, conditions often worsen rather than improve.

1. Medicine demands perfection while punishing anything less.
2. Resilience is not endless—it’s a bucket that must be actively filled and resourced.
3. The dream of post-training life rarely matches reality; the clinical work is often the easiest part of the job.

1. Five years ago, Kat witnessed a dramatic rise in loneliness and anxiety among children without adequate training, resources, or systems to support them.
2. The moral injury of feeling like she was causing harm simply by working within a broken system shook her willingness to participate in it.
3. Healthcare has become an industry of industries, bloated by layers of administration and confusion designed to perpetuate itself.

1. Insurance companies dictate care decisions, limiting physician autonomy and patient-centered care.
2. If given a magic wand, Kat would eliminate the outsized power insurance holds over medical decision-making
3. The growing number—and salaries—of administrators contrasts sharply with the lived experience of clinicians.

1. Disillusionment with healthcare helped catalyze Kat’s move toward building a direct care clinic focused on longevity and age management.
2. Starting a business required clarity around core values and identity.
3. Physicians have highly transferable skills and more freedom than they are often led to believe.

1. One of medicine’s most powerful skills: building trust within minutes.
2. Relating well to patients—rather than using fear or authority—creates better outcomes.
3. Kat shares how relationship-centered conversations led to a 95% success rate with vitamin K acceptance, compared to 10% when scare tactics were used.

1. Kat describes her current practice model, including hour-long initial consultations followed by a membership structure.
2. Diversifying income streams and designing life intentionally creates capacity for empathy, connection, and meaningful discourse, even in challenging conversations.

1. Drawing on David Brooks’ concept of The Second Mountain, Kat reflects on moving from achievement-driven success to purpose, service, and community.

Kat offers practical first steps for physicians who feel trapped:

1. Pause and reflect: Identify what’s working and what isn’t. This isn’t quitting; it’s pruning.
2. Assess probability: What are the chances you’ll be happy if you stay? What are the chances you’d be happy doing something else?
3. Remember: You always have a choice.

Dr. Kat Hudon isn’t just another voice in the crowd; she’s a dedicated advocate for a new era of medicine–one that values integrity over profit, compassion over convention, and authenticity over everything.

Her voice rises above the noise, guiding both practitioners and patients toward a more holistic, honest approach to healthcare. Because real medicine isn’t just about treatment; it’s about trust, and Dr. Hudon is here to redefine what it means to truly care. Dr. Hudon is on a mission to educate, inspire, and advocate for a system where patients and practitioners are empowered to pursue health and healing with more humanity.

Follow her on instagram here.

Join Empowered Surgeons Group here.

See you all in 2026!

Click here to join us in Empowered Surgeons group.

Check out my latest TEDx talk, "Seeing Beyond the Red Swans", here.

In this conversation, I’m joined by author and human performance expert Brad Stulberg to explore identity diversity, mastery, and what it really means to build a sustainable, meaningful career. We discuss the concept of the identity house, what it means to feel one's way to skill attunement, core values, process vs product, and how presence and flow are at the heart of mastery.

This episode is especially relevant for surgeons and high-achievers who have poured everything into one role and are wondering how to prevent burnout without giving up ambition.

1. The idea that we all live in an identity house with multiple rooms (e.g., surgeon, parent, artist, athlete, writer)
2. Why having multiple rooms matters: if one room floods or burns down, the entire house doesn’t collapse
3. Not all identity rooms are the same size, and we don’t need to spend equal time in each
4. You can spend most of your day in one “room”—the key is not letting the others get moldy
5. The concept of minimum effective dosing for neglected parts of identity
6. Why it’s never too late to renovate your identity home, even if you’ve lived only in the “surgeon room” for years

1. Why defining core values is the first step in preventing burnout and moral injury
2. Research-backed values associated with long-term well-being: Autonomy, mastery, belonging
3. Two distinct types of burnout:

1. The danger of optimizing for a “successful week” instead of a successful career
2. How ego convinces us we’re more indispensable than we are
3. The liberating truth: the world keeps turning without us

1. “Feeling our way to excellence” and how it intersects with see one, do one, teach one
2. The universal mastery trajectory:
3. Simple → Complex → Simple
4. Why what looks “simple” is actually hundreds of unconscious micro-steps
5. The four stages of competence:: unconscious incompetence, conscious incompetence, conscious competence, unconscious competence (the apex of excellence)
6. Why many high-achievers get stuck in conscious competence (or try to skip steps)
7. Presence, intimacy with craft, and why the best moments (like a first kiss) are thoughtless

1. Seeing your work as a craft, not just a job
2. Identifying the right goals without obsessing over them
3. The danger of outcome fixation
4. Why process is what sustains excellence over time

1. The nuance of “going all in” without “going all the time”
2. Stimulus + rest = recovery
3. How intensity and joy are not opposites, but partners

Join Empowered Surgeons Group here.

Find Brad Stulberg and his incredible books here.

Trauma is more common than we think, especially in high-stakes professions like surgery. In this episode, I define trauma, PTSD, and post-traumatic growth and explore how these experiences can show up in the body, the nervous system, and everyday life.

Drawing from my own experience with complex PTSD and panic attacks, I walk you through a practical, humane process for moving through trauma rather than around it. This isn’t about fixing yourself or returning to who you were before. It’s about learning how to metabolize difficult experiences and create something meaningful from them.

If you need support, you can get on my calendar for a free consult here.

Join us in Empowered Surgeons Group here.

Join Empowered Surgeons here.

Book a free consult with me here.

And if you're here for the free content, amazing! My next masterclass + open coaching is on December 14th at 10 am EST. Sign up for "5 Ways Surgeons Fail" here.

In this episode, I break down what coaching is. Not the corporate wellness version, but the real, practical, life-changing version that surgeons and high-stakes professionals actually need.

Coaching, as I define it, is choosing thoughts that generate feelings that empower you to create results you truly desire. It's the antidote to the soul-crushing grind of modern healthcare, moral injury, the day-to-day depletion, and the feeling that you’re running out of capacity while the system demands more.

It’s also the only part of this profession that you can truly control.

We start by identifying what you yearn for (your will), then reconnecting with your power, the internal clarity, agency, and authority that have been buried under years of training, cultural conditioning, and systemic pressure. Then we learn how to wield that power with intention and compassion. In this way, one moment at a time - little by little - your impact and your world expands. Instead of stagnating and staying small, you show up big. You create big things.

I know it works because I've done it.

If you’ve ever wondered what coaching actually is (and isn’t), why it works, or whether it’s worth your time, this episode is your starting point.

⚠️ SENSITIVE CONTENT WARNING

This episode discusses suicide, which may be distressing for some listeners. If this subject is triggering for you, please consider skipping this episode. If you choose to listen, do so gently and take good care of yourself. If you’re feeling hopeless or suicidal, please reach out for support. You can call the Suicide & Crisis Lifeline at 988 or click here for additional resources.

Dr. Michelle Chestovich is a family medicine physician, physician coach, and the host of the Remind Yourself podcast—soon to be renamed Stress Rx. She is also the sister of Dr. Gretchen Butler, a brilliant, beloved human and radiologist who died by suicide on March 5, 2021.

Michelle’s story mirrors the quiet struggle many physicians face. She found herself living a life she didn’t quite sign up for, balancing the demands of medicine with a shifting sense of identity after becoming a mother. Coaching became her pathway back to clarity, alignment, and truth.

Her sister, Gretchen, faced the impossible convergence of pressures, expectations, and circumstances that contribute to the staggering statistic of 300–400 physician suicides each year.

This episode is a tender, honest conversation about grief, the hidden burdens physicians carry, the systemic failures that harm our colleagues, and the transformative power of recognizing our own humanness.

Get a lifetime of support in Empowered Surgeons Group here.

Learn more about Dr. Michelle Chestovich and how she can help you here.

*********SENSITIVE TOPIC WARNING*******************

This episode discusses substance abuse and suicide. Please listen carefully.

In this powerful and deeply honest conversation, Dr. Courtney McKeown shares the story she was once told would be “career suicide”—a story of mental health crisis, addiction, recovery, and the hard-won journey back to her authentic self.

She reflects on the research-year psychotic break that led to hospitalization, the healing support of an extraordinary program director, and her rise into a prestigious hepatobiliary fellowship at the Cleveland Clinic. But even at the top, her body kept signaling what she now sees clearly: her life was misaligned, fueled by external validation and hidden coping mechanisms.

When routine monitoring uncovered her secret drinking, she was thrust into the harsh reality of how the medical system treats physicians in distress—often punitively, fearfully, and without nuance. She describes how the state of Ohio’s approach pushed her to rock bottom, how a trusted psychiatrist saved her life, and how the state of Massachusetts’ more compassionate physician health program ultimately helped her rebuild it.

Courtney has been sober since March 2021. She chose to share her story publicly, despite warnings it would end her career. Instead, the opposite happened. A closed credentialing door redirected her to a new opportunity—now serving as Chief of Surgery in a community where she is supported, aligned, and deeply fulfilled.

Her journey highlights both truths: yes, institutions can weaponize oversight against physicians who don’t “fit,” and our ultimate success cannot be dictated by anything outside of us. Alignment, authenticity, and courage are powerful forces.

Today, she is living her best life: thriving in private practice, leading a department, and connecting with her patients more meaningfully than ever.

• The research-year crisis: stimulants, psychosis, and hospitalization
• The power of a supportive program director and the road back to residency
• The dream fellowship that wasn’t aligned, and how her body told the truth
• Addiction, secrecy, and the moment she was “caught”
• How states differ dramatically in supporting (or punishing) physicians in distress
• The paradox of safety expectations: punished for depression, allowed to operate without sleep
• The credentialing roadblock that redirected her to the role she was meant for
• Two truths: systemic weaponization and internal sovereignty
• Sobriety since March 2021 and what real recovery looks like
• Living in alignment: joy, leadership, community practice, connection with patients

Find Courtney on instagram here.

Watch her story on CBS morning news here.

Join Empowered Surgeons here.

Trauma surgeon and healthcare leader Dr. Scott Ellner joins me to talk about the moments that reshaped his life and career, from witnessing a beachside intubation at age 21 to navigating one of the lowest points of his surgical practice. We explore complications, shame, psychological safety in the OR, and why compassion and emotional intelligence are essential (not optional) in surgery.

Scott shares the retained foreign body case that transformed his approach to leadership, the danger of tense OR energy, and the difference between title-based authority and referent power. We also discuss the failure of punitive peer review, the legacy of Ernest Codman, and what it really takes for surgeons to regain confidence after early-career mistakes.

We each open up about panic attacks—mine recently in the OR, his in medical school—and talk about vulnerability, preparation, and staying ahead of fear. Scott also previews his upcoming book, Wipe Out Rise Up, a blend of surgical stories and lessons from surfing on resilience, perseverance, and facing storms head-on.

Find Scott and his book here.

Listen to his TEDx talk "Lessons from Surgery and Grey's Anatomy" here.

Join Empowered Surgeons Group here.

Get the pre-or mindset checklist here.

Join us in Empowered Surgeons Group here.

Anxiety can be transformed into resilience and courage, but only when we move toward it, not away from it.

Anxiety is the life-saving fear response misapplied to the imagination.

By definition, anxiety is a lie.

What we fear—killing the patient, facing a lawsuit, losing our reputation, losing everything—is not actually happening in real time.

Fear is intuitive, primitive, and immediately actionable. It comes in a wave, then recedes.

Anxiety, on the other hand, never relents.

• Fight
• Flight
• Freeze
• Fawn
• Flop

When we close a loop with fight or flight, our brain registers safety and completion.

But when we respond with freeze, fawn, or flop, the event can encode as trauma.

That’s why exercising healthy fight—asserting boundaries instead of people-pleasing—is essential.

In the hierarchical culture of surgical training, this can be especially hard to do.

Notice the thoughts your brain offers, often disguised as innocent questions:

Instead of accepting that thought as truth, offer the opposite:

Then, shift into a mental state that serves you. I like to remind myself:

Finally, create a short ritual, like visualizing the entire case from start to finish at the scrub sink.

When anxiety hits—bleeding, getting lost in a dissection, uncertainty—let the physiologic surge pass through your system for 90 seconds.

Do not believe the story your brain tells you during those 90 seconds.

Once the wave subsides, find certainty:

Then move from known to unknown with curiosity and creativity.

Download your thoughts.

Speak them into a voice memo or write them down unedited, unfiltered, stream-of-consciousness.

Getting it out of your head helps you process, release, and reset for the next case.

Key takeaway:

Anxiety isn’t the enemy; it’s an invitation.

When you learn to meet it directly, you transform it into the fuel for courage, clarity, and growth.

In this episode, digital marketer Colin Royal—husband to ENT surgeon and fellow Hippocratic Collective co-founder Dr. Frances Mei Hardin—joins the show to discuss everything we didn’t learn about how industries outside of surgery work.

In surgical culture, we often carry false notions, like the idea that we should give our time, energy, and value away for free (see Episode #4: Toxic Martyrdom).

The truth is: we aren't exempt from the rules of business. Businesses need money for sustainability, and money comes from value.

As surgeons, we have a lot of value to give the world.

We give value to our patients when we hold space for them in clinic and offer our expertise. We give value in the operating room when we use our skills to help fix their problems. We give value to our communities by taking call. We give value every time we answer phone calls and messages.

These are all value points, and we’re not wrong or bad for monetizing them. Every other industry does. That’s how a profession becomes sustainable: the more value you offer, the more people want to pay to receive it. The more resourced and protected you are as the ASSET, the more capacity you have to give your value for free…when you want to. Giving value away for free isn’t bad in and of itself, but when a system or culture forces us to martyr ourselves against our will, that’s a recipe for burnout and implosion.

When we begin to understand how the world outside of surgery works, we open the door to diversifying our identity. We start to feel comfortable with the idea of multiple income streams. We stop telling ourselves that we’re special snowflakes with no discernible skills beyond surgery. We can learn marketing, selling, and social media just as well as the next person.

The sooner you learn these lessons, the sooner you release yourself from your self-appointed shackles and the sooner you create freedom to evolve with your career. You deserve to be compensated for the immense value you offer the world. And you get to give value away for free on your terms.

If this resonates, you are going to want to follow The Hippocratic Collective here. If you have an idea you want to share with the world, HC can bring that idea to life. If you are a woman surgeon interested in the Cabo retreat, get on my calendar here. You can learn more about Empowered Surgeons Group here.

******SENSITIVE CONTENT WARNING*********

This episode discusses child abuse, religious trauma, depression, moral injury, and pediatric violent trauma. Please listen carefully.

Pediatric surgeon Dr. Jose Greenspon shares an unflinching account of practicing at one of the busiest trauma centers in the country, shouldering all of the work after his partners resigned, all while his own faith, family, and mental health unraveled. He speaks candidly about stigma in surgery, moral injury, being labeled “disruptive” when asking for help, and the moment a sensory trigger in the OR surfaced a childhood assault by a rabbi. This conversation is about the cost of carrying more than one human can hold, and the courage to put the burden down.

If this episode resonates with you, and you'd like to reach out to Dr. Greenspon, email him at jgreenspon76@gmail.com

In this episode we discuss:

• Dealing with life-and-death without a vent partner: Pediatric penetrating trauma is difficult enough; facing it without support is punishing. Dr. Greenspon recognized the essential need for a trusted peer or space to unburden the experiences surgeons carry.
• Faith in crisis: As an Orthodox Jewish man, he struggled to find God in the chaos—then a flashback to childhood molestation shattered what remained of his religious safety net and contributed to the end of his marriage.
• The breaking point: A child his daughter’s age died from a gunshot wound to the chest. A smell in the OR triggered a panic attack and a vivid flashback. He finished the case, then self-reported to the CMO.
• Stigma and moral injury: Seeking help led to being labeled rather than supported. “You martyr yourself, and it gets weaponized against you.”
• Choosing to leave: Why leaving a toxic job and facing his demons was the best decision, and how outstanding residents became close friends.
• “Parent whisperer”: How he builds trust with families, honors the gravity of every operation, and treats residents with radical humility: “The only difference between me and you is that I happen to come first.”
• Work as a vice: How unprocessed trauma can morph into work addiction, guilt, and a compulsion to protect children—plus what recovery looks like now with a therapist who understands religious abuse.
• System reflections: On toxic competitiveness in pediatric surgery, administrative incentives, and what true appreciation and backup should look like.

RAINN (U.S.) — National Sexual Assault Hotline: 800-656-HOPE (4673) | rainn.org

988 Suicide & Crisis Lifeline (U.S.) — Call or text 988 | 988lifeline.org

Physician Support Line (U.S.) — 1-888-409-0141 | physiciansupportline.com

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• Subscribe to Surgeons With Purpose and leave a review to help other surgeons find the show.
• For coaching and community: Empowered Surgeons Group—tools, calls, and connection for surgeons navigating moral injury, complications, and career inflection points.

Thank you, Dr. Greenspon, for the honesty and heart you brought to this episode.

Click here to join Empowered Surgeons Group.

On today's episode, enjoy the replay of the webinar, "From Imposter to Integrated: Reclaiming Humanity and Authenticity in Surgery".

You can access all webinar replays inside the Empowered Surgeons Group member portal. Looking forward to seeing you inside the group!

Click here to get on my calendar for a 15 min interview for the Cabo retreat. Women surgeons only.

Click here to learn more about Empowered Surgeons Group.

It's back-to-back Chrissy(ie) episodes! Dr. Chrissy Guidry is a trauma and critical care surgeon and founder of Whole Body Optimism, a program designed to empower busy healthcare professionals find integrity of mind, physical body, and soul by implementing practical intentional practices into their everyday lives.

In this conversation, we explore Dr. Chrissy's journey through academic medicine, infertility, and institutional betrayal, and how it all led to a deeper integration of mind, body, heart, and soul.

After seven and a half years at Tulane, she found herself at a crossroads. While navigating marriage and fertility treatments, she faced the harsh reality of how academia often punishes physicians for being human. What began as an ultrasound appointment became a weapon used against her and a defining moment in reclaiming her integrity and purpose.

• Surgeon Purpose Check: Who are we really doing this for: ourselves or the patients?
• Coaching as Catalyst: How hiring a coach for the department transformed the culture for everyone.
• Fertility and Academia: The tension between starting a family and the unspoken expectations of academic productivity.
• Integrity in Healing: How her fertility journey sparked a whole-self integration of mind, body, heart, and soul.
• Becoming the Medical Education Wellness Director at Tulane
• Creating wellness champions across departments
• Using GME funding to host interdisciplinary networking events
• Developing an app to centralize well-being resources for residents
• Expanding the Mission Online: How she brought physician wellness work to the digital space, helping clinicians worldwide prioritize their humanity.
• Mindset Over Strategy: Why happiness isn’t a moving target; it’s a mindset shift.

Key Reframes for Resilience:

• We are human beings, not human doings
• Life doesn't just have to happen to you; it can happen for you.

1. How can I take more responsibility for the outcome?
2. How can I grow from this opportunity?
3. What good is already present in this challenge?