Stimulus - Learn Tools to Crush It in Your Medical Career
Rob Orman, MD

Latest episode
163 episodes
- AI has moved into medical practice faster than almost anything in modern medicine. As clinicians lean on it more for documentation and clinical decisions, the pitfalls are getting harder to ignore. AI is a powerful bedside tool. It also has myriad ways to screw you. In this episode, emergency physician and clinical AI trainer Sam Ashoo breaks down how to use AI to help you think, how to frame questions to get answers you can trust, what AI scribes are most likely to leave out of the HPI, why clicking "accept" on an AI tool's business associate agreement can put your license at risk instead of protecting it, and how to keep this technology an adjunct rather than a crutch that harms you and your patients.
Guest Bio: Sam Ashoo, MD, is an Emergency Physician and Medical Educator bridging the gap between bedside care and AI. As a clinical informaticist, I explore the future of medicine through a pragmatic, skeptic-first lens to separate clinical signal from hype. He writes at Ashoo Review.
We Discuss:
What training a medical AI looks like from the physician side
Which specialties AI is most likely to reshape, and why procedural fields are safest for now
The biggest misconception clinicians have about AI: it won't tell you what it can't do
Why omissions, not hallucinations, may now be the bigger risk
What AI scribes most often leave out of the HPI, including mental health cues and medication changes
Why AI documentation turns you into an editor, and why most of us aren't good ones
Treating AI like a smart intern, not the attending, and the rare cases where the reverse makes sense
UpToDate vs. OpenEvidence: human-curated knowledge vs. machine-synthesized answers
The trap of asking AI a question you can't judge the answer to
What "not software as a medical device" means for using OpenEvidence in the ED
One case, six LLMs, and how changing the question flipped the answer from "send her home" to "cath lab"
A live OpenEvidence test: is a D-dimer reliable five days after symptom onset?
Whether to document AI use, and whether your searches are discoverable in court
Why "I can just ask AI" doesn't replace a fund of knowledge
How med students, new NPs, and experienced attendings should each use AI
AI scribe consent: the two steps most clinicians skip, and why all-party consent states matter
Why you shouldn't upload ECGs or X-rays for AI interpretation
The HIPAA business associate agreement checkbox that can put your license at risk
Mentioned in this episode:
Doctoring Done Well | Bite-Sized Wins
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5 Free Tools To Make Medical Practice Easier
Scripts for your least favorite conversations.
The quick and dirty guide to calling consults.
A 10-minute "Driveway Debrief" to switch off from work.
My favorite documentation templates.
Step-by-step guide for delivering the news of death.
Free Resources Link
Rob's book now in audio, print, and e-reader versions
Rob's book, Supranormal: A Field Guide for the Impossible Job is now available as an audiobook, narrated by Rob. Find the audiobook, print, and ebook versions at the link below.
Get Supranormal on Amazon
Get Out On Time
The Out-On-Time Course gives you the tools to complete your charts on shift, manage overwhelm and interruptions, and create fast, focused, kickass notes, so you can stay out of chart debt and get home on time. Self-paced. 12 hours AMA PRA Category 1 CME.
Learn More About The Out-On-Time Course - What do you do before your feet hit the floor? I don't mean coffee or exercise. I mean the minutes before you get out of bed. My guest, Tim Thomas, calls the first five minutes after waking and the last five before sleep the two golden five minutes. Most of us spend them on our phones or let them pass without a second thought. In this episode, we cover how to use breath to change your state, keep worry from hijacking your attention, and build an easy on-ramp so the habit survives a bad morning. We also get into breathing through your thumb and what a pot of coffee taught an Army platoon about ego.
Guest Bio: Tim Thomas is a former professional fighter and Special Forces soldier who has spent over a decade working with veterans, professionals, athletes, and everyday people to improve sleep, resilience, and nervous system health. He is also a survivor of PTSD, pharmaceutical addiction, alcohol addiction, and family breakdown. Along the way, he has raised over 1.3 million dollars for charities close to his heart and founded his company Breathwork in Bed. A platform focused on natural and immediate sleep improvement.
We Discuss:
The Golden Five Minutes
Using Breath to Change Our State
Making a Morning Routine Easier to Do
Why Starting the Day With Connection Matters
How to Make Gratitude Something You Actually Feel
How Ego is a Wall but When We Let it Down, It Becomes a Bridge
Why We Keep Looking Outside Ourselves for Stability and Satisfaction
How Preparing Coffee for Tim’s Special Forces Unit Had an Unexpected Effect
Worry Steals Processing Capacity
Turning the Phone Against the Phone
Sleep Is the Soil
Mentioned in this episode:
Rob's book now in audio, print, and e-reader versions
Rob's book, Supranormal: A Field Guide for the Impossible Job is now available as an audiobook, narrated by Rob. Find the audiobook, print, and ebook versions at the link below.
Get Supranormal on Amazon
5 Free Tools To Make Medical Practice Easier
Scripts for your least favorite conversations.
The quick and dirty guide to calling consults.
A 10-minute "Driveway Debrief" to switch off from work.
My favorite documentation templates.
Step-by-step guide for delivering the news of death.
Free Resources Link - Interruptions are, in a way, the currency of emergency medicine. But many of them may be making patient care worse rather than safer. EKGs are a perfect example: physicians may be interrupted thousands of times each year so that every tracing receives immediate attention, even when the overwhelming majority do not represent an emergency. Protecting physician attention doesn’t have to come at the expense of quickly identifying patients who need immediate intervention.
In this episode, we explore how one emergency department dramatically reduced unnecessary EKG interruptions, why a 10-minute interpretation window may be safer than reflexively interrupting physicians, and how local data helped turn a counterintuitive idea into departmental practice. We also examine how asynchronous communication, protected workspaces, nursing partnerships, and a different way of thinking about attention can create a safer and more intentional emergency department.
Guest Bio: Dr. Jake Zadra is a board-certified Emergency Physician and the current Chair of the Department of Emergency Medicine and Diagnostics at St. Mary's Hospital in Janesville, WI, where he also serves as Vice Chief of Staff. He completed medical school (’18) and EM residency (’21) at the University of Wisconsin, where he served as chief resident. Outside of medicine, he’s a live music enthusiast, enjoys slipping Lord of the Rings references into everyday conversation, and spends as much time outdoors as possible. He remains one of the few Emergency Physicians with no interest in ultramarathons or BASE jumping.
We Discuss:
Why Every EKG Doesn’t Need to Be an Emergency
The Cost of 7,000 Interruptions to Find Two Unflagged STEMIs
What Happens When the EKG Machine Misses a STEMI
Why Fewer Interruptions May Lead to Better EKG Interpretation
How the Workflow Handles Gray-Zone EKGs
Rethinking the 10-Minute EKG Rule
Using Local Data to Build a Safer Workflow
How an EKG Drop Zone Keeps Deferred Reviews From Getting Lost
How a Quieter Workspace Reduces Drive-By Interruptions
Why Not Every Interruption Deserves the Same Response
How Secure Chat Can Become an Asynchronous Inbox
Why Nurses Need Protection From Interruptions Too
How Making Interruptions Visible Creates Buy-In
Mentioned in this episode:
Rob’s Book: Supranormal
Supranormal: A Field Guide for the Impossible Job, tackles the parts of being a doctor that medical training leaves out, with practical tools for navigating conflict, overwhelm, burnout, and the sustained complexity of medicine, so you can build a career that is both sustainable and fulfilling.
Get Supranormal
Get Out On Time
The Out-On-Time Course gives you the tools to complete your charts on shift, manage overwhelm and interruptions, and create fast, focused, kickass notes, so you can stay out of chart debt and get home on time. Self-paced. 12 hours AMA PRA Category 1 CME.
Learn More About The Out-On-Time Course
Rob's book now in audio, print, and e-reader versions
Rob's book, Supranormal: A Field Guide for the Impossible Job is now available as an audiobook, narrated by Rob. Find the audiobook, print, and ebook versions at the link below.
Get Supranormal on Amazon - Getting sued, or even just the fear of it, is one of the greatest hidden drivers of physician stress, burnout, and career dissatisfaction, yet almost no one teaches doctors how to survive it. A malpractice lawsuit can shake your confidence, challenge your identity, and strain your relationships long before you ever step into a deposition. The good news is that preparation, practice, and the right mindset can transform litigation from an overwhelming threat into something you can navigate with confidence. In this episode, we explore what every physician should know about medical malpractice lawsuits and malpractice litigation,, how to navigate a deposition, the conversations that can sabotage your defense, and the emotional toll of being sued, along with practical ways to prepare before you're ever named in a lawsuit. Finally, we share the tools, resources, and hard-earned lessons that help doctors protect their careers without losing themselves in the process.
Why getting sued changes the way physicians practice medicine long after the case is over.
How preparation can take you from feeling like you're on the chopping block to walking into a deposition with confidence.
What you should and shouldn't say while a malpractice lawsuit is ongoing.
Why understanding plaintiff attorneys' tactics makes you a stronger defendant.
The communication mistakes that can undermine your credibility.
How to prepare for a deposition.
Why shame and isolation can make malpractice harder than the lawsuit itself.
Practical ways to protect your confidence, career, and mental health after being sued.
Resources Mentioned
Books
When Good Doctors Get Sued
How to Survive a Medical Malpractice Lawsuit - Eileen Brenner
Depositions Are Trial
Podcasts
Doctors and Litigation: The L Word
Season 1: Approaching D-Day
Season 3: The Educated Defendant
Courses & Tools
LEAP (Litigation Education and Performance).
Use the code STIMULUS100 for $100 off.
Guest: Dr. Gita Pensa is an emergency physician, educator, and litigation performance coach who helps clinicians navigate malpractice lawsuits with greater confidence and less emotional distress. Through speaking, coaching, and her LEAP (Litigation Education and Performance) courses, she works with healthcare organizations, insurers, defense attorneys, and physicians to transform how clinicians experience litigation.
Mentioned in this episode:
Distilled Kickassery Every Other Saturday
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The Out-On-Time Course
Built for emergency clinicians who are tired of chart debt and getting derailed by interruptions and overwhelm. Learn practical, real-time documentation and shift-efficiency strategies to finish your shift and actually leave on time.
Learn More About The Out-On-Time Course - When another person is upset or angry, our instinct can be to help them lower their emotional temperature by saying something like, "Just calm down," or, "Relax," or, "Take a breath," or, "Look at the facts." However, saying those things when the other person is in the heat of the moment can have the reverse effect from what we were hoping for.
The reason is simple: People who do not feel heard are not ready to hear solutions.
In this episode, we explore the communication strategy of valence matching, why it works at both a psychological and neurological level, and how it can transform interactions with patients, colleagues, consultants, and loved ones. Finally, we show how a few seconds of emotional attunement can save minutes, or even hours, of unnecessary conflict.
💡 Get Rob's Book
Supranormal: A Field Guide for the Impossible Job.
Tools, mindsets, and communication techniques so you don't get eaten alive by a job you're good at.
Buy it on Amazon
We Discuss:
Why "Calm Down" Rarely Calms Anyone
The Simple Idea Behind Valence Matching
Why the Brain Rejects Logic During Conflict
Content vs Process in Conversation
Why You Should Match First, Then Move
Small Words That Create Big Differences
How to Effectively Thank Patients for Waiting
How Emotional Connection Shapes Clinical Encounters
Why an Excellent Clinician Had Consistently Low Patient Satisfaction Scores
Mentioned in this episode:
🧭 UnBurnable | Career Longevity, Burnout Prevention, Self Mastery
This course will teach you the hidden anti-burnout curriculum.
Begins Sept 15, 2026. CME available.
The UnBurnable Course
Doctoring Done Well | Bite-Sized Wins
Every other week, a few minutes of career-elevating insight delivered straight to your inbox.
The Doctoring Done Well Newsletter is never lame, never spammy, and always fresh.
Sign up for our Newsletter
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About Stimulus - Learn Tools to Crush It in Your Medical Career
Do you work in medicine and love patient care but feel like parts of the job don’t measure up? Stimulus equips you with tools, mindset shifts, and strategies they didn’t teach you in training—so you can practice medicine like a boss, flourish in your career, and not let it crush your soul. Emergency physician and executive coach Rob Orman, MD, goes in-depth with thought leaders on how to avoid burnout, improve communication, lead without drama, and stay calm amidst the storm. Don’t just suck it up, think differently.
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