『Sustainable Clinical Medicine with The Charting Coach』のカバーアート

Sustainable Clinical Medicine with The Charting Coach

Sustainable Clinical Medicine with The Charting Coach

著者： Dr. Sarah Smith
無料で聴く

概要

 On the Sustainable Clinical Medicine Podcast we are capturing the stories of physicians who have made clinical medicine sustainable in their own lives, including their before and after stories. I will also interview coaches who are helping Physicians create sustainable clinical medicine for themselves.© 2026 2024 出世 就職活動 心理学 心理学・心の健康 経済学 衛生・健康的な生活 身体的病い・疾患
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  • Bite-Sized Wellbeing for Burned-Out Healthcare Workers with Brian Sexton on Burnout Metrics & Micro-Interventions Episode 162

    Bite-Sized Wellbeing for Burned-Out Healthcare Workers with Brian Sexton on Burnout Metrics & Micro-Interventions Episode 162
    2026/03/09

    Welcome to another episode of the Sustainable Clinical Medicine Podcast!

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

    Here are 3 key takeaways from this episode:

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

    Meet Dr. Bryan Sexton:

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

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

    Don’t miss this enlightening conversation! 🎙️

    Connect with Dr. Bryan Sexton:

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

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

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

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

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

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

    **** Questions? Comments? Want to share how this podcast has helped you? Shoot me an email at admin@reachcareercoaching.ca. I would love to hear from you.
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    46 分
  • The Doctor's Path: Transformations and Triumphs of Medicine, Identity, and Resilience: Insights from Dr. Dhaval Desai Episode 161

    The Doctor's Path: Transformations and Triumphs of Medicine, Identity, and Resilience: Insights from Dr. Dhaval Desai Episode 161
    2026/03/02

    Welcome to another episode of the Sustainable Clinical Medicine Podcast!

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

    Here are 3 key takeaways from this episode:

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

    Meet Dr. Dhaval Desai:

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

    Connect with Dr. Dhaval Densai:

    🌐 Website https://dhavaldesaimd.com/

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

    --------------

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

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

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

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

    **** Questions? Comments? Want to share how this podcast has helped you? Shoot me an email at admin@reachcareercoaching.ca. I would love to hear from you.
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    35 分
  • Empowering Teams, Redesigning Care & Improving Health Outcomes with Amanda Laramie & Adrienne Mann - Episode 160

    Empowering Teams, Redesigning Care & Improving Health Outcomes with Amanda Laramie & Adrienne Mann - Episode 160
    2026/02/23
    Welcome to another episode of the Sustainable Clinical Medicine Podcast! Our host Dr. Sarah Smith interviews Coleman Associates staff Amanda Laramie and Chief Innovation Officer Adrienne Mann about how Coleman Associates helps healthcare clinics—especially community health centers—redesign care delivery through their Dramatic Performance Improvement (DPI) methodology. Adrienne describes how Coleman’s work in her Chicago community health center targeted goals such as cycle time under 30 minutes (from patient arrival to departure), no-show rate under 5%, and 100% real-time charting completion, leading to improved patient and staff satisfaction and reduced burnout. They explain cycle time as a measure of organized care and patient experience, and discuss how patient visit tracking reveals bottlenecks, handoffs, and physical-layout issues that slow flow. They cover strategies to reduce no-shows, framing them as a sign of a broken relationship and an access problem; examples include mystery shopper calls to identify barriers like long hold times, easier cancellation processes, and proactive visit confirmation and preparation. They discuss role realignment and preparing for visits through team-based workflows, including the “sheep-shepherd model” where MAs or nurses shepherd clinic flow to protect clinician time, reduce interruptions, and support “today’s work done today.” Specific tactics include team “dance steps,” robust intake and concise handoffs, the “midway knock” check-in (physical or virtual), and having staff “bodyguard” clinicians while charting to prevent interruptions and avoid getting behind on notes. They also discuss inbox/worklist overload, aiming for net-zero inbox at day’s end through better routing/oversight, team support for tasks, and a “red carpet exit” to reduce follow-up calls by addressing questions and ensuring orders/referrals are completed before the patient leaves. The conversation addresses individual needs and disabilities (including neurodiversity), emphasizing that frontline staff should design and adapt solutions; examples include noise-canceling headphones for charting and using space creatively (e.g., an exam room as a quiet charting space). They discuss shifting visit prep from clinicians to teams so multiple “brains” are aware of patient needs (e.g., hospital follow-ups, missing labs, forms), including pre-visit calls asking about ED visits, specialists, and concerns. They argue checkbox-heavy requirements (e.g., Medicare-related items) should be handled by nurses or staff through pre-visit “concierge” workflows, and note EHR limitations can be addressed through optimization and interdisciplinary decisions about filing and access. They conclude by encouraging curiosity and questioning existing systems (“why” thinking), noting that everything is changeable except load-bearing walls, and provide ways to find Coleman Associates online. They state they primarily work across the U.S. but are open to working anywhere, including Canada and Australia. Here are 3 key takeaways from this episode: Cycle Time Under 30 Minutes Indicates Organized Care: Cycle time (patient arrival to departure) isn't about rushing—it's about eliminating confusion, handoffs, and mishaps. Shorter cycle times mean better-organized care that respects patients' time, especially those without PTO or childcare access. The goal is efficiency through coordination, not speed through corners cut. No-Shows Signal Broken Relationships, Not Patient Irresponsibility: When no-show rates exceed 10-15%, it reveals systemic issues: long hold times making cancellations difficult, appointments booked months in advance, or lack of relationship-building. The solution involves confirmation calls, easier cancellation processes, and recognizing that patients who no-show often need care the most—they're the ones appearing in emergency departments instead. The Shepherd-Sheep Model Empowers Teams and Protects Clinician Focus: Medical assistants and nurses should "shepherd" the clinician's flow—staying slightly ahead, looping back to check needs, and bodyguarding charting time from interruptions. This allows clinicians to focus on what only they can do while the care team handles preparation, coordination, and protection of workflow. The result: 100% real-time charting completion becomes achievable. Meet Amanda Laramie & Adrienne Mann: Amanda is experienced in process design, training, and leadership development. Before working with Coleman, Amanda worked for a women’s health center in Providence, Rhode Island. She was a Medical Assistant and later, a Health Center Manager. Amanda has been working with Coleman Associates since 2011 and has coached hundreds of health center teams. She is a team leader and current COO of Coleman Associates. Adrienne Mann is a dynamic coach, trainer, healthcare leader, speaker, and podcast host passionate about driving positive change. She ...
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    50 分
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