From Crisis to Calling:
A 2025 Year in Review for Healthcare Leaders

Transforming Healthcare Coaching Podcast — Episode 88: 2025 Year in Review. Host and narrator: Lillian Liang Emlet, MD MS CHSE CPC ELI-MP, with archival clips from seven 2025 episodes.

Cold Open

Kim Downey: Just tell one person, don't keep it all inside.

Lillian Liang Emlet: That's the quote from Kim Downey. Cancer survivor, physical therapist and the woman who started an entire movement after her doctor died by suicide.

Resa E. Lewiss, MD: Healthcare has been slower on the uptake or late to the party of coaching.

Lillian Liang Emlet: That's a quote from

Dr. Resa Lewiss, emergency physician, author,

one of the most thoughtful leaders I know.

Peter Kim: If I talk about this at work, people are like,

"What are you talking about? You're crazy."

Lillian Liang Emlet: That's Dr. Peter Kim, who built a community of over 700 physicians because he knew we weren't meant to do this alone.

We have seven conversations, seven different voices. One message that kept echoing throughout every single one was that we don't have to do this alone.

This is the Transforming Healthcare Coaching Podcast 2025

year in review.

Episode Introduction

Lillian Liang Emlet: Hi everyone. I'm Lillian Emlet, and today we're doing something a little different. Instead of a new interview, we're taking you on a journey through the seven conversations that we felt were the most impactful in our podcast has shaped our year seven moments through this arc of learning and development that we did together this past year.

Seven voices that said something that we all needed to hear. And when I sat down to plan this episode, I thought I'd just pick my favorite clips. But as I listened back, I realized these conversations weren't random. They tell a story and a story I think a lot of us are living right now. And really it has to do with crisis, with the reality of what's broken in healthcare and what is costing all of us.

And it moves to rebuilding, figuring out how are we going to show up differently even when the system isn't changing at the pace that we would like. And so from there we find connection. We talk about community, we find the people who actually get it, get us and will be agents of change because the next step is action, growth and thinking about our legacy.

And finally, a charge. A call to stop doing this alone. And so that's where we're going to go today from Crisis to Calling Seven Conversations.

Dr. Lorna Breen Heroes Foundation

Lillian Liang Emlet: And let's start at back at the beginning. So this is one of my favorites, and we're deeply grateful for the opportunity to have featured the Dr. Lorna Breen Heroes Foundation is our first ever Podcasthon Charity podcast episode back in March 2025.

If you've ever been in healthcare for any length of time, you know the name, Dr. Lorna Breen. She was an emergency physician in New York City. She was the medical director of her emergency department, and by all accounts, she was exceptional, dedicated, driven, well respected, deeply committed to her patients, to her department, and then in April, 2020, at the height of the pandemic, she died by suicide.

What makes her story even more heartbreaking is what came out afterward. Lorna was afraid to seek help. She was worried that getting mental health treatment would end her career, and they would show up somehow on her licensing application and that she be seen somehow as weak or unfit.

The tragic part is that in New York state where she was licensed, doesn't ask about mental health history on the applications. She didn't know, and the stigma was so deep and so ingrained in healthcare that she never found out that she was already protected After her death, her family started the Dr.

Lorna Breen Heroes Foundation to make sure no one else has to carry that fear. I had the honor of speaking with Dr. Stephanie Simmons, the foundation's Chief Medical Officer in March 2025, and what she said about the individual agency about what we can actually control. It really stuck with me. In this clip, Stephanie talks about putting on your own oxygen mask first, about the difference between what we can control, what we can influence, and what we have to let go.

So listen to the clip.

SEGMENT 1: THE CRISIS / Episode 48 — Dr. Stefanie Simmons

Stefanie Simmons: So this year we have our second summit and we're looking forward to the conversation, the gathering of colleagues who are all committed to and interested in this area and the learning that comes out of that.

Lillian Liang Emlet: That's awesome. it's funny. I just even I just think about the well being groups that I'm in locally. And really does take a village, a huge village, maybe a city to really be able to try to change the culture in general. And so when we think about all of us little individuals who just have interest in how do the individuals inside a system help contribute to the cause?

I guess, if you had advice to give to the regular individual.

Stefanie Simmons: Yeah, so the first thing I would say is, "Put your own oxygen on first." Make sure that you are taking care of yourself your department, the people around you. And then out of the things that you learn in doing that, think about ways to expand within your sphere of influence that change.

And so think about looking at your hospital or health systems credentialing application. What could be changed? We'll talk to your med staff services, submit the application for review at the foundation and ultimately work towards the badge. We also have an ambassador program for leaders in healthcare workforce Well being people who are passionate about this, have made this their career. We put those folks into community with each other and they help to promote the goals of the foundation and of healthcare workforce well being nationally. You can also talk right to your state board if you are a health care worker.

If you're a physician, a nurse, a pharmacist, a dentist, to your state board. We have a tool on our website and a link in the comments on how to do that. And get involved in advocacy. Every professional organization in healthcare, is involved in advocacy in some ways and helps to make change at the state level and at the federal level for their organization.

And for many of those organizations, professional well being is part of that advocacy work. And so think about getting involved, learning what your organization is doing and lending your voice and your story to those efforts, because we need to share inside our profession. What's happened to human beings that are doing this work. But we also need to educate and inform people outside of medicine and outside of health care about what our colleagues are going through as well.

Lillian Liang Emlet: Yeah, I love that. I think also, you just start to realize, you're one person after your oxygen mask is on. If you can glow and sort of make your group a little more healthy, and then from there, your division, your department, and then most of us work inter- professionally. So then you accidentally, "Oh. It's you're pharmacist, you're nurses..."

Also kind of come along for the ride and really whatever program you put together or whatever ideas can be shared freely because information is free. And positive energy and attitude is free. And the desire to make the workplace a better place is often as little as one person's attitude can make such a big difference.

Stefanie Simmons: It can make such a big difference. And we control a lot less than we like. There's actually very little we control other than our own reactions to events, But we have much more influence than we think we do on the people around us, but also on the policies of our organization, on our state politics and the ability to have conversations about how things are done in health care And then there are things that are out of our control that we also need to learn to accept and just focus on what we can control in our day. And then what we can influence in our day. And so that learning of controlling what you can influencing and impacting where you can, and then also not being so distracted and scattered by the things you can't influence and control that you don't get anything done in those other areas. It's important for people to focus on where they can make an impact.

Lillian Liang Emlet: "Put your oxygen mask on first."

I know we've all heard that phrase, but hearing Stephanie say in the context of Lorna's story hits differently. And here's what I've learned, both as a physician, as a coach, we cannot pour from an empty cup. We cannot show up for our patients, our teams, our families, if we're running on fumes.

And yet that's exactly what so many of us are doing day in, day out. Stephanie says something that stuck with me. We control a lot less than we like to think we do, but we have much more influence than we realize. And that really capitalizes on much of how I feel about our work at Transforming, the tension between what's broken in the system and what we can actually do about it.

That's where coaching lives. When I work with healthcare leaders one-on-one, this is often where we start: not fixing the whole system, but in getting clear on you, what can you control? Where is your energy going? What if you could change what you stopped waiting for? What could change if when you stopped waiting for that permission to take care for yourself?

What would happen? What new ideas and what bravery? What projects? What new policies would you implement so that things could be different? If you've been feeling like you've been swimming against the current, maybe the first step isn't swimming harder. Maybe it's putting on your own oxygen mask first.

Here's the thing about oxygen masks. They help you breathe. They don't teach you how to have the hard conversations. They don't rebuild the trust that's been broken between us, our patients, our colleagues, our systems, our teams, our supervisors. And for that you need some different skills.

SEGMENT 2: REBUILDING TRUST - Truth, Trust & Talking Science: Communicating in a Skeptical World with Dr. Varun Shetty

Lillian Liang Emlet: Which brings me to our next conversation in episode 54 with Dr. Varun Shetty, we talk a bit about, something else that shifted during the healthcare and after the pandemic. That shift is not burnout, although that's very real. I'm talking about 'trust'. Patients and society seem to stop trusting us, or maybe they stop trusting the systems we represent. There's a lot of vaccine hesitancy.

There's so much misinformation. There are conspiracy theories. It feels like overnight the ground shifts underneath our feet. And I talked to a lot of physicians who are frustrated, angry, even. How can they not believe science? How can they not trust us? I mean, after all, we've dedicated a good solid 10 or 20 years of training, to get here.

And then I had this conversation with Dr. Varun Shetty. Varun is a critical care physician, a pediatrician in Ohio. And yes, practicing during the pandemic means having a lot of difficult conversations about vaccines, masks, and trust. And Varun didn't get defensive, he got curious, and what he discovered really surprised me.

In this clip, Varun talks about checking your own emotions first before walking into a difficult conversation; about building trust through listening about what happens when we lead with curiosity instead of judgment. And this applies well way beyond vaccine conversations. This is about every hard conversations we have with patients, colleagues, administrators, with family.

Let's take a listen to what Varun has to share with us

Lillian Liang Emlet: The question is, do we even just believe the robot without,

Varun Shetty:

Lillian Liang Emlet: Actually checking it ourselves? So I guess I'm wondering, how is in that communication piece that we might be able to think where some of the missteps of communication might have been between the patients, their families, and ourselves as the clinical team?

Varun Shetty: Oh my God. Where do I begin? So I think... I think, one, I always like to look at myself first, keep my emotions in check. Make sure that I am not in the wrong. Make sure that I am listening to my patient in front of me. When it comes to a vaccine hesitant patient, be it for their child or for themselves.

I think what's important to recognize is that both me as the clinician or you as a clinician and the patient have the same goal. Is the child's health and the child's or the person's health and prevention from disease, right? So I think I would begin there: "That I am so glad that you're here in the office today or that you're here to see us and that you're so engaged in making sure that your child is safe and healthy."

And what I then try to do is, what are the points of skepticism and where are they coming from? And I'm trying to figure out where on that spectrum they are. Are they complete deniers, are they advocates, are they on the pro-vaccine, but skeptical about this? So I'm trying to figure that out because that put shape our conversation.

Then I'm asking a lot of questions. I wanna know where they got that information from. And if I am not familiar with that source of information, be it a blog, be it a research paper, be it a journal article then I would ask for that information. I would ask them to share that with me, and I want to go over that information.

So depending on how that visit goes. And these are AAP guidelines also, is that if somebody's really skeptical about vaccines, you keep that conversation going. And because your idea is to build trust and if they don't trust you, if they're not feeling heard, why would they trust you?

So it is important to listen to them what their source of information is, and then go from there. And we'd be surprised how much we would learn and how far we can get just with that. That's one part of it. But once we are past that, once we have a trusting relationship, there are certain communication guidelines that come up in literature over and over again that are helpful. One of the most common things is presumptive language. So when children come to clinic, when patients parents come to bring children to clinic you don't ask. "Do you want the vaccine?"

You say, "They are due for these vaccines. So they're gonna get these do you have any questions?" And they have the right to ask whatever questions they want, whatever misgivings they have. But this way we are normalizing the fact vaccines are safe, which is an established scientific fact. We are normalizing the fact that multiple physicians, scientists across the world have vetted the safety of the vaccines, the timing of the vaccines and are constantly looking at the evidence to determine if any changes need to be made to the vaccination schedule.

And that's where this communication is happening. We have that context behind us. So talk about it in presumptive language and make sure they understand, make sure we are speaking the same language. Also, for example, stroke might mean different things to different people.

So making sure we have the same vocabulary and we are understanding what they are saying. So I think that those are some of the other strategies we can use. Some of the other things that come up in literature was also that I did not know this in the beginning was numerical versus verbal quantifies of risk.

For example, saying number needed to treat. For example, you need like 33 people need to be given this medication. For one person to get benefit does not work nearly as well as a relative risk. This brings, this is a 50% reduction talking about and more than that, talking in terms of expressing probabilities out of a hundred or one.

So one in 100 people will get this, or one in 50 people will benefit from this. So framing those numbers are more effective than some other statistical indicators. So some of those little tools that we can use to better improve patient understanding of what we are talking about and better understanding of patient risk.

And Lily, I wanna tell the viewers that you are one of the crucial people who taught me how to talk to patients when it comes to end of life goals. And this is what we do also is this shared decision making where we are trying to understand people's views and we are trying to come to them with our medical knowledge and trying to translate that medical knowledge so that they know what's in store, what's ahead, and they make an informed decision that way.

Lillian Liang Emlet: I just wanna highlight, "I always like to look at myself first. Keep my emotions in check, make sure that I am not in the wrong, make sure that I am listening." I was nodding the whole time when Varun was talking because this is sometimes the foundational things that we cover in coaching.

This is literally what we work on with our clients on how to keep our emotions in check, especially as a leader. I've learned that the conversations that feel the hardest usually aren't about the other person. They're about what's happening inside of us.

When we are triggered, we can't listen. And when we are defensive, we can't connect. When we're certain we're right, we stop being curious. Varun's secret isn't a script or a technique. It's self-awareness. Checking his own emotions first, getting curious before getting defensive. This is the inner work that makes the outer results possible.

And it's exactly what happens in coaching. You get a mirror, someone who helps you see patterns, your triggers, your blind spots before you walk into that difficult conversation and begin to practice skills to help you in that moment. As you're in those difficult conversations. So we've talked about individual agency, we've talked about self-awareness and trust, but here's what I kept bumping also into this year.

You, you can do all the inner work in the world and still feel completely alone because sometimes the problem isn't inside you. The problem is that you look around and think who would even understand? And that's where our next guest comes in with, episode 58, with Dr. Peter Kim.

SEGMENT 3: FINDING YOUR PEOPLE - Episode 58 : Why Community is Everything with Dr. Peter Kim

Lillian Liang Emlet: I remember looking back and was so grateful when he accepted our invitation to be on our podcast, because I remember the first time I heard about Dr. Kim, during the pandemic online, inside Facebook. Peter's an anesthesiologist. He's also Founder of Passive Income MD and the creator of something called The Leverage and Growth Accelerator. A community of over 700 physicians interested in physician entrepreneurship. And when I talked to Peter, he talked mostly about loneliness.

About having ideas and dreams that people around him didn't understand about feeling crazy for wanting something more than just clinical medicine practice. And he talked about what happened when he finally found his people. In this clip, Peter shares about what it was like to feel isolated, to have ambitions that his colleagues didn't get, and then what changed when he surrounded himself with people who were on the same journey.

If you've ever felt like you're the only one who wants more, you should listen to this next clip,

Peter Kim: I made that mistake, which is why I'm telling you this.

And this has been a constant work in progress. Schedule the things that you love and want to do first, then fit everything else in, and it'll start to really work out for you.

Lillian Liang Emlet: I love that. Those are really amazing tips for everyone who's listening. And I think, we often work with people and say, just do a time audit. And people are like, what the heck do you mean by a time audit? When you look at your color coded beautiful Google, either digital or paper calendar, and you have like all color coded by family sports. Work all your different businesses, color code them. You can see the rainbow if you can. It's like you eat the rainbow. you also see the rainbow on your calendar, and if you have the things and the balance that you want, then you're doing something right with the most important things first.

Peter Kim: Yeah, I agree with you on that for sure.

Lillian Liang Emlet: I love that. So going back to why community networking, accountability and coaching is so important for ongoing growth and wealth for healthcare professionals, I don't know that people were taught that, that well, even in our professional development during training. why do you feel that that growth idea is one of the more important foundational pieces no matter what it is you want to end up doing?

Peter Kim: I mean, that's a great question. For all of us. we go back and you talk to people and maybe they've been in years since, seven, 10 years of practice. And you always ask them like, how's it feel? And they're like, I feel kind of stuck. I feel like I've hit a wall.

I feel kind of bored. I don't know what to do. And it's not the whole seven to 10 year itch or whatever you might hear. And I think what it is, and when I've talked to enough people about it. It's the fact that when you were in or even before that college medical school, residency, there's this path that you're on and you're always striving for something new.

Like there's a new goal to hit a new target. You're constantly learning new things, you're being challenged. And yes, it can be hard at times and difficult, and sometimes you're like, why am I doing this? But you're striving and you're pushing yourself in every three to four years. There's a new transition or new goal and you overcome that and you go to the next stage.

But then once you become an attending, you think everything's set and everything's good. And maybe for the first couple years you're excited 'cause now you're establishing your life. You're able to buy a home, start to get out of debt, feel like you have some income. And then after some time, usually it's around year five, year seven, year 10, whatever it is, you start to realize what else is there.

And so a lot of people hit that stage and they feel like, okay, I don't know what's going on with me. And usually what it is they've stopped growing. Meaning that they haven't really pushed themselves to something new. There's nothing in front of them dangling that they can look forward to, except the only thing they look forward to is like 20 years down the road when they retire, and that's the next carrot. And so something that's helped me is having people around me who are not okay with just kind of saying, "All right, now this is my life for the next 30 years." For the community that I've been fortunate to surround myself with, I think it's really, really important. You get to pick and choose that. And you do that intentionally. I've chosen to surround myself, people who are striving for all these cool things. You know, they have one year goals. They have three year goals. They have five year goals it's not just about income, but whether it's about growing portfolios, growing a new business, being a better husband, father, whatever it is, they've got different outcomes that they're shooting for, and they're constantly moving towards those, they're learning more, and they're bringing in resources and they're doing all this.

And so you still feel like you're always progressing. I've heard this saying that, change is inevitable. Meaning that, our bodies are changing, life changes, but that doesn't make us happy. it's feeling like we're progressing towards a certain goal that really helps us kind of feel fulfilled.

And I think all of that like whenever you take on a new challenge and something actually gets through with it and you see your kids do it, you do it like there's a little spark inside of you. There's a little energy that comes about. And so surrounding yourself with the right people. To help you see that that's possible.

See that that's important. help you along that path has been really important. And that's, of course that helps in the form of community. It can be a coach, it can be a mentor. It can be any of these things which can help you get there. And I think it's so important for everyone to do that.

Again, it hasn't been part of what we've been taught to do. That's not part of our normal path. All along the way though, in medicine, we've had those mentors,

Lillian Liang Emlet: Right.

Peter Kim: Senior residents, we've had those attendings who we said, Hey, I wanna be like that. But then once we kind of get into practice, a lot of times it's just, you're just focusing on yourself and trying to build your own life.

And , as we've been missing some of that, and so if people can reconnect to that I find that it really kind of fills out their life and makes it feel a lot more full.

Lillian Liang Emlet: Yeah, it is really funny because, as an educator in medical education, like learning and growing is so important, fundamental to me, which is now a fundamental part of my company, Transforming Healthcare Coaching® .

And I completely agree. when we stop growing, stop being curious and we don't know where we're going and when we stagnate. that's almost worth getting too comfortable and not being excited to try something new, to do something different.

"If I talk about this at work, people are like, what are you talking about? You're crazy. Just keep doing what you're doing."

How many of you have felt that you have an idea, a dream, a frustration, something you want to change?

And you look around your colleagues, your friends, maybe even your family, and you think, who would even understand? So you stay quiet, you keep to yourself, and slowly that spark starts to dim. Peter's story is a reminder that the problem isn't you. The problem is that you just haven't found your people yet, or you, in evolution, are becoming the next version of you.

And this is exactly why we created medTHRIVE.

medTHRIVE is our community for healthcare professionals who are ready to stop just surviving. And start thriving. It includes a little bit of self-paced learning along with monthly group coaching, but most importantly, it's a community, people who get it, people who won't look at you like you're crazy when you say you want something more, who can see something different for the future because Peter's right surrounding yourself with the right people, changes everything.

You don't have to figure this out alone, and you were never meant to. So now we've gotten our oxygen mask on. We've done some inner work. We've found our people. So what do we do with that? We act.

SEGMENT 4: STANDING BESIDE OTHERS - 74. Patient Advocacy with Dr. Angie Ingraham

Lillian Liang Emlet: So my friend Dr. Angie Ingraham, was a trauma surgeon. She had the career, the training, the skills in academia, and then her dad got sick.

Her father was diagnosed with brain cancer and suddenly Angie wasn't the doctor anymore. She was the family member sitting in the waiting rooms, navigating insurance, trying to understand what the specialists were saying. And here's what she discovered. Even as a surgeon, even with all her training, it's overwhelming to experience the brokenness of our healthcare system.

The system was impossible to navigate. She kept thinking, if this is this hard for me, how about everybody else? What about the families who don't have a doctor in their corner? And that question changed the trajectory of her career. Angie left surgery and became a patient advocate. She started True North Patient Advocates to be that person in the room for families who don't have anyone else. In this clip, Angie describes what she actually does, and as I was listening, I realized she's basically a support coach for the entire healthcare experience, A human, extra person so that you're not alone.

Someone to help families synthesize all the noise and to find clarity, throughout the process. Let's listen to how she describes what patient advocacy really is.​

You know how you chose the name and what is the philosophy of your particular organization in terms of how you deliver patient advocacy and whether, can anyone work with you across the country or just, how do they even begin to investigate what True North is all about?

Angie Ingraham, MD BCPA: Sure. So my philosophy on this is that like I really want to be that person for other clients and families that I needed for that my dad needed. That's like the whole kind of like mission behind all of this. In like the name, it's twofold. One is, it's like, it's my own true north.

So like I had my own career path where I, the combination of burnout and my my experience with my dad. I was like, I don't know if I wanted, being clinical in medicine anymore. I definitely, I had been on the RO one train and I was like, I don't wanna do that anymore. So it was also finding my own true north and what is for me professionally and from a career standpoint. And then it is, helping my clients and their families find their own true north. What are we working towards? What's right for you? How do we encourage you to voice that, to identify it first, to know what you want, and then to voice that as far as your healthcare. And then, really for me, it's all about I try to strive for service.

Like I want my clients and families. you have to build trust, really quickly. And it also is setting expectations, like to do advocacy work. There's a lot that goes into the upfront work of thing. There's a lot of time and effort that goes in and they don't always see what I'm doing right away. But I always tell people, you can always call me because, there are some advocates that limit their working hours. At least for right now, if you're in the ER at two o'clock in the morning I want you to call me, right? Because that's when you need me. I've been on Q3 trauma call.

I can handle being woken up in the middle of the night, to go back to sleep pretty easily. But it's also easier for me to then to be there and with you real time than it is to try to catch up after the fact. And I can be a better advocate for you if I know what's going on as it's happening.

Lillian Liang Emlet: That's really incredible because I have to admit, I've never I personally have not experienced having a patient advocate with our family meetings or the care are that, you know so far, but I can only imagine how reassuring it is 'cause it's scary to go to the ER and it's scary to have an unplanned visit and it is really overwhelming.

And so just the idea that you have someone on speed dial, it's like really providing VIP concierge services for it's almost like having a healthcare professional in your pocket, right? To be able to just know that you're not alone navigating all of this insanity that is healthcare and

a healthcare scare is often usually the wake up call for all of us, right? So I think it's not surprising that for most people through the pandemic that were touched by the COVID pandemic, or that had their own health challenges or have battled health things in their family have caused people to want to enter into the healthcare field to try to make a difference, help other people and continue to be in this caring profession.

And so it doesn't surprise me that, with your talent and your skill that you would find a different way to be able to help make things better. 'cause you're really trying to bring the whole team to function and just to be a neutral, it's almost like you're a coach for the experience. A coach for the experience of being a healthcare user end- user and deliver in this crazy US healthcare system.

Angie Ingraham, MD BCPA: Yeah. Yeah. Several reactions to that. One is like I'm gonna meet, potentially sign on another client tomorrow, and she's a widow. She doesn't have any children nearby. Her closest relative and her POA is a niece who's in Arizona and she has Parkinson's and some early dementia.

And so one of my main roles is gonna be to go with her to her doctor's appointments so that I can then, write a summary, communicate back to the needs. Help them prepare for these doctor's appointments. 'cause we all know that, they're, the appointments are getting shorter and shorter just because there's so many more patients to see. And I do think that also I definitely see my role and I experienced this with my dad of we always, as much as we try, and this is me speaking from having been on the provider side of things. As much as we try and we think that we're delivering coordinated care, it's not always as coordinated as it can be.

And we faced that with my dad. So my dad went into surgery. He was induced with his anesthesia. I don't know exactly what happened. I think he went into some RVR. He had one round of chest compressions. They aborted a surgery, he got admitted to the ICU. Then it literally was, and so he had the worst delirium I've ever seen. We were in that ICU for a week and it was cardiology and neurosurgery debating on how long he had to be on heparin and when they could take him off and redo the surgery. And it was like we had no plan. So I forced Cardiology and Neurosurgery to be in the room together and like we are figuring something out because we were just in this limbo.

And it's not because 'cause people have ill intent or anything. We just, it's, we do healthcare providers. Now that I've seen it on the other side as a patient and I've had this experience in talking with other physicians or health providers who've had their family members, have a healthcare issue.

We don't see our own blind spots. And part of what patient advocate can do can be to help to shed some light on those.

Lillian Liang Emlet: Yeah, and it's really, interesting. So much of, I think primary hospitalist care and primary critical care is trying to harmonize all of the voices in many ways. And so sometimes palliative care gets involved to do the similar thing on the team side and at the same time, it's still, from the patient's perspective, it's still not good enough.

Because it's just not clear. And you'd like to see all the stakeholders actually say something rather than all being hidden behind one person, one poor, resident physician who's delivering the message on behalf of like 15 other team members.

" A human extra brain and a coach for the experience of healthcare." As Angie was talking, I really kept thinking about this is what our coaching clients tell us.

It feels like to work with a coach when you're in the middle of it - leadership challenges, career transitions, burnout, conflict - it's overwhelming. You can't see the whole picture when you're inside the frame. A coach is that person in your corner not to tell you what to do, but to help you slow down, see clearly, and trust yourself to make the next right decision.

Angie does that for patients and families navigating healthcare. Our team does that for healthcare leaders navigating their careers and their lives. The principle's the same. You don't have to figure it out alone. Sometimes you need someone to stand beside you and say, "I'm not going to let you be by yourself."

A guide on the side. So we've talked about standing beside other people, finding your people, putting your oxygen mask on first. But how do you actually build the skills to do all of this? How do you grow as a leader when no one ever taught you how? And that's what our next guest is all about.

SEGMENT 5: THE POWER OF COACHING Episode 76 - Microskills for Leadership with Dr. Resa E. Lewiss

Dr. Resa Lewiss is someone I deeply admire. She's an emergency physician, a professor, an ultrasound expert, and the author of a book called "Micro Skills", which she wrote with Dr. Adaira Landry. The premise of Micro Skills is a simple but powerful, the things that make you successful in your career, whether it's writing or networking, managing up negotiating aren't taught in medical school.

They're not taught in residency. They're just supposed to figure it out, and most of us don't, or we figure it out the hard way, years later after making preventable mistakes. Resa's book is the guidebook she wished she'd had when she was starting out. When we talked, I wanted to ask her directly about something that's still controversial in healthcare - coaching.

In the business world, executives have had coaches for decades. Athletes have coaches. Performers have coaches. But in healthcare, we're still catching up. There's this idea that needing a coach means something's wrong with you. So I asked Resa point blank, does coaching make a difference? So let's hear what she says.

Resa E. Lewiss, MD: I'm sharing now is if email is not working, well try another means of communication. And to your point, you could pick up the phone and solve whatever you've decided as a major conflict in a minute, and you're done. A lot of times things don't have to be a big deal.

Lillian Liang Emlet: Yeah, it is, it is pretty fascinating that we're all often so, so afraid to just ask. I'm wondering, you know, in your personal board of directors, do you see a role of how coaching can help leaders notice and strengthen their micro skills, especially around this self-awareness communication piece?

How do you see that, aside from the role playing, do you think coaching can have any kind of role?

Resa E. Lewiss, MD: 100%. Yes. No question. And I think, you know, there are formal coaching relationships and informal coaching relationships, and I mentioned the example of writing. You know, in a way, any friend or colleague who agrees to read a draft of something I've written, is a writing coach. They're giving me feedback.

They're offering edits. They're posing questions. You know, it's another set of eyes from a person that has a different perspective. So that's an example of coaching. You can get writing coaching. One of my first exposures to something that I think is exquisitely powerful. Speaker coaching came when I gave a TED Med talk in 2014.

They assigned me a speaker coach. I didn't even know there were people called speaker coaches. But then after TED Med, I was a part of SMACC the conferences that were based originally out of Australia. Again, I was assigned a speaker coach. I thought it was such a brilliant concept that with a group of people, we started creating a speaker coaching program at some of the other groups I've been a part of most recently SCUF, which is the Society for Clinical Ultrasound Fellowships.

We actually wrote a piece about it in an online blog for medical educators about how to create a speaker coaching program. And the reason I wanna highlight is. It is so powerful. Like you don't even, you didn't, you don't even realize you needed it until you get it and you're like, "Oh my gosh, my talk is so much better."

Even for people that think they're amazing speakers, every speech, every talk could be better with a speaker coach, and I bring it up because this is not for just early career people. Often it's senior. Career keynotes or mid-career plenary speakers, they too are assigned a speaker coach and they're like, "Wow, I thought I was just giving this talk for free and I wasn't gonna get any sort of quote benefits."

And next thing you know, they have someone who's working with them to give a better talk and the learning points from that experience, they can take forward to all the talks they give in the future. So I mean, that's a very literal coach, writing coach, I gave the example of speaker coach, you know, in the work that you do in terms of professional development and leadership coaching.

I think again, if you are working with someone who you respect and who respects you, you know, who is really there to help you on whatever professional. Skill, habit, you know, overwhelming task you're working on. They say you can get maybe there faster alone, but better together. And that's true in terms of even whatever you're working on for yourself, because none of us are working alone.

None of us accomplish things alone. Healthcare has been slower on the uptake or late to the party of coaching. I first heard about executive coaching and professional coaching from friends who are in business and in business consulting. In fact, at one point when I was sort of in a fork in the road of my professional journey, one of my friends said, you know, why don't you work with a coach?

And I remember saying to, and she's one of my best friends. I was like, you know what? I don't know of any physicians that have ever worked with a coach. Now, granted this is over a decade ago, and again, the culture in healthcare has changed, but I started asking around and sure enough, again, in the business world, many people were working with coaches and changing positions and all this other stuff.

I actually asked some of my healthcare, my doctor, physician mentors, have you ever worked with a coach? Have you ever hired a coach? And they were like, "no, no, no, no." And I think a little bit it, it was this rugged individualism, but I think what I realized is they get it from each other on their personal board of directors, but they just hadn't highlighted that that was where they were getting their source of help and input.

Lillian Liang Emlet: Right. That's a really, that's a really insightful summary of, I think the challenges we've had in general in healthcare that is still reserved for the executive and the highest levels of leadership as investments for an external coach to come work with someone's career in their professional development as you, you know, navigate the different positions.

I think some women leadership. and some MBA programs do have them embedded as specific opportunities. So different from the business world where all throughout the life cycle of your career, you have access points to career coaching, life coaching, leadership coaching, like all different types of niches in the business world.

And you're right. For me, the reason I even knew that this was potentially a viable career was because fortunately in some women in medicine mentoring circles. They mentioned, I was like, well, how did you get to where you are now? I mean, he's obviously C-suite at this point. She said, "I have a executive coach." I'm like, "Oh, there's a thing." And then every single higher level. You know, on national circles, national panels. How did you get to where you are? Their answer. " Oh. my business friend told me about executive coaching." And so I'm like, "Huh," the next thing you know, here I am many, many years later, realizing it's a magical place that we as educators. To have this as one of our core skills. We just never really named it as such. And now fortunately, there is so much more development and so much work being done from the Institute of Coaching and other physician coaches in the different ways that we can help people in academic coaching versus leadership versus executive. So there's all these different opportunities.

Resa E. Lewiss, MD:

Healthcare has been slower on the uptake, late to the party of coaching. "I've been with a coach for six years now and it's completely changed my life." I love how direct Resa is about this because she's right. Healthcare is late to the party. I personally have had a coach for five years ever since I started this journey, and I say the same thing, Resa does.

It changed everything. Here's what I want you to hear. You don't have to wait until you're struggling to work with a coach. You don't have to be broken to want a Sherpa. Some of the highest performers in the world have coaches, not because it's something wrong, but it's because they're committed to growth, because they know that having someone in their corner, someone who can see what they can't, accelerates everything.

If you've been curious about coaching but haven't taken the leap, maybe this is your sign. We still talked about micro skills, the very small daily actions that compound into big results. But what about the people who are just starting out? What about our students, the residents, the fellows, the trainees who don't even know what they don't know yet?

And that's what Klaus and I talked about in the next episode.

SEGMENT 6: SUPPORTING THE NEXT GENERATION Episode 80 — Wellbeing for Students & Trainees

In episode 80 for Wellbeing for students and trainees, Klaus Grim, Podcast Director of Transforming Healthcare Coaching podcast, we decided to go ahead and address the question we got from a listener this past year. "

Lillian Liang Emlet: How do you maintain wellbeing when you're the student, when you're the one with the least power in the room?"

It is such an important question because let's be honest, training in healthcare is brutal. The hours, the hierarchy, the pressure to never show weakness, the unspoken rule that you should just be grateful to be there. Klaus and I talked about this and we kept coming back to one skill that almost no one ever teaches.

Managing up. Managing up means advocating for yourself professionally within the hierarchy, and not against it. It means asking for what you need in a way that works within the system and almost no one teaches this. We assume trainees will just figure it out or worse: we assume that suffering is part of the process.

In this clip, Klaus and I talk about what it actually looks like to manage up Klaus model, something really powerful, how to ask for what you need in a way that works, and I share why I think this skill is so critical and so rarely taught.

And we also know that movement helps with neuro processing, and so you do actually need to get up and move. And so we all probably should have a 90 minute timer on all of our watches to get up, move and breathe, because that will help us become more efficient at the tasks that we have.

That's pretty much what we know from brain science, and yet most of us don't really adapt to that unfortunately.

Klaus Grim: Yeah, I like that.

Lillian Liang Emlet: And so speaking of learning and thinking how to optimize it, I guess, if, what do you wish you had known about advocating for your own personal learning needs during your clinical rotations?

Klaus Grim: That's a good question because it brings me a little bit of anxiety about myself during rotations. Because when I was in rotations you're already so nervous about constantly switching to new locations, meeting new people who are grading you, who are pass or fail, and you say something wrong.

Is it gonna lead to a distasteful rest of the four or five weeks that you're there? But I guess, one thing that comes to mind is, just speaking up about maybe more what you need. Like, I've had students. And I like to think that as a preceptor, I listen a lot to my students and, and create a very comfortable, warm, inviting environment for them to learn, but also, feel like they are owning their patients and being an active member of the team just as I would want a coworker who's stepping into this environment to feel and or even just my patients, right, just to feel like they're in a very warm, inviting space where they can talk without judgment and they can get better.

And so I think one thing I would, do is if you don't have a preceptor that is invested in that thinking back to rotation. So I think I would've asked and said, "Hey, I'd appreciate to have that 30 minutes of lunch, for instance, and being able to go for a walk. Is that okay?" "Do I have to come back and eat my lunch right at the desk where we have to go right back to patient care?" I think finding ways to speak your needs in a very professional manner, I think would be really helpful. And, and say, this is what's gonna keep me well and keep me refreshed for the day and keep it so that I can get the best learning experience.

How does that work for you and your team? I think it's just advocating for yourself in a, in a way that reads the vibes of the room as well.

Lillian Liang Emlet: Yeah, that is really so important. I do think almost every single trainee does not feel like they have agency, and managing up is a skill that we often don't teach. But what you just sort of role model is the fact that. You are a member of this team, and also you have some opportunities to ask for, "Is this okay by you?"

And to explain what is happening because, just going off and doing your own thing is not helpful. You do have to, you are part of a team. And so being clear with what you need, what you're curious about, what you're working on so that people can help support you and actually offering them the opportunity.

"Would you be able to support me?" Or "Do you think there's another resource that I should be looking at?" Because like, "Oh, I should go look In the shared drive we actually have all of our protocols right there." Maybe there's just something you were unaware of, like allowing them to participate and then, they often feel really great that they can help you in your learning journey.

Everyone in healthcare, loves to help other people, but when you ask for it, which I know again, in healthcare for some reason we find a hard way to ask. But when you ask correctly, you're managing up, you're managing laterally. You're offering them the opportunity to help me help you.

In some ways

Klaus Grim: And see things

differently,

because a lot of our senior healthcare professionals don't just see it as, "Okay, you're a student. You gotta do what we say you gotta do. And this is the way it is. I had to go through this. You have to go through this." But that's the one thing I love about the newer generations is that they're speaking up and saying that, "I need to be well and focus on my wellness in the same time." And something that we here at Transforming Healthcare Coaching promote because in order to have a thriving healthcare environment, you need to be well in the first place. And so, just like you had mentioned speaking up, asking, and it may be a no, for instance, right, if you're in surgical rotation and they're like no.

You can't get a 30 minute break at 12 o'clock exactly. Because you may be scrubbed in a case, but at least you asked and you didn't know what you didn't know, and you can still find ways to find wellbeing for yourself amidst the chaos of that rotation. Just now need to explore other options. Like, is it okay after that case if I go take a quick walk just to kind of recenter myself, refresh on the case, and then come back with renewed energy or something like that, something that would benefit you during that time.

Lillian Liang Emlet: That's so true. I think we often don't make our work visible. And so I think for me, the advice I often give , that I teach now for our, our fellows, is trying to set that learning goal at the beginning of each week into how can you find a micro habit that you're going to try to change or tweak upon.

You can't fix everything about yourself in one shift, or one week being on service or being part of a clinical team. And so what's the one little thing per day that you are want to try to really narrow over? So for some people it's really the teaching part. For some people it's just gathering the data accurately.

For some people, it's making a decision and related to moving care forward day to day for a particular case, for example, and just making sure that you advocate for making time to debrief. A lot of times we just allow experience to sort of happen and we never really reflect on it. At the end of the day, I think one of my other colleagues, always points out, "What did you learn today?"

Because we all learned something that day. Every one of us who's on any particular shift, whether it be a communication, a clarity a fact, a protocol, a drug dose, we learn something each day. Otherwise, I think it'd probably be, we all wouldn't be doing this anymore. 'cause I think most of us in healthcare really love to learn.

Klaus Grim: I love that. That's actually a pearl that I think I could be more intentional about is, is asking the students actually that I work with a little bit more follow through awareness, questions like that. 'Cause you're right. Unless we pause and think about it too. We may be losing a learning opportunity for ourselves. 'Cause we're doing so much all the time. It's like you're just experiencing, experiencing it and you're just trying to get to the point where you take your exam and you pass your boards and actually out there and practicing. But it's gotta enjoy the process and see the little things that we're learning every day that are leading to that bigger picture of ourselves. I think we're speaking to is very challenging. I mean, I've been practicing for almost seven years now and implementing things for my wellbeing while at work is extremely difficult. Because I'm also too, like if I have a minute, I wanna make sure my note is written and it's details, so the next clinician, whoever stumbles upon it can read it and gets a good picture.

Almost every single trainee does not feel like they have agency.

And honestly, I'll tell you, a lot of attendings feel the same way. I'll even argue that some of our leaders feel the same way. Managing up, asking for what you need, advocating for yourself professionally. These are all skills, and skills can be learned. This is what we work on in coaching, helping you find your voice, communicate your needs, and stop waiting for someone else to give you permission to take care of yourself and to do the next right thing.

And if you're earlier in your career as a student, a resident, a fellow, an early career attending, this is exactly why medTHRIVE exists. It's a community where we can practice these skills with peers who understand. We can ask questions you're afraid to ask at work where someone's got your back, because whether it's one-on-one coaching or the supportive community, you deserve to have people in your corner as you navigate the journey of a career in healthcare.

You know, so we've talked so far through this year about individual agency, self-awareness, community, action, micro skills, and supporting the next generation. And I want to end our year with something a little bit deeper, something that gets to the heart of why we do this work.

SEGMENT 7: THE CHARGE Episode 87 — Kim Downey

And this is one of our very most recent episodes, episode 87 with Kim Downey of Standing Up for Doctors.

Kim Downey isn't a physician, she's a physical therapist, cancer survivor, a patient who went through hell and came out the other side with a mission. During her cancer treatment, Kim was cared for by incredible physicians, doctors who showed up for her during the worst time of her life. And then one of them, one of the doctors who really had been there for her, who she really cared for.

Suddenly died by suicide. And Kim was devastated and she was angry, not the doctor, but at the system that made it impossible for him to ask for help at the stigma, at the silence. So she did something about it. Kim founded non-profit Stand UP for Doctors. She wrote a book called "White Coats Courageous Hearts".

She has a YouTube channel, a podcast. She's become an advocate for physician mental health. From the outside, looking in. From the grassroots. Meeting many of us where we're at to be able to let us tell our stories so that we all feel more represented and less alone. I think sometimes the outside perspective is exactly what we need to hear at the end of a conversation.

I ask Kim, if a physician is quietly struggling right now, maybe listening to this episode, what's one thing they can do? So listen to her answer,

​

Kim Downey: So it's standing up for, what you believe in and just taking one small step. Is it writing an email? Is it prioritizing exercise over doom scrolling on social media? What do you need? What do you want in taking one small step? And also again, just to question any limiting beliefs that you have, is to, because again, I've learned this from Dr. Michael Hirsch, he does like a thought download. So if you write down just all the things you're thinking today, right at or at the end of the day. Or I had no control, or I'm going to get in trouble for this. Just whatever it is. And then go back and look at the list. And you could make two lists from that.

Like the things that are, actual facts that are true, right? It was a long, hard day, or I did 25 cases, but then circle the things that are just thoughts about that, that, "Oh I was the worst doctor in the universe, right?" Then he goes, "Is that true? Is that really true? What if the opposite is also true?"

So just starting to realize what are facts and what are your limiting beliefs, and starting to question them.

Lillian Emlet: Thank you for sharing so many pearls. And so I'll just reiterate for everyone, I mean the very small things, it just takes really tiny advocacy for yourself. That little things are enough. And I often tell people, you get five minutes in the car you can just spend an extra 10 minutes in the bathroom.

You can choose a small little moment for yourself. And to not start big because when you just, when you start to do small little things for yourself, it's like radical braveness for yourself. You feel a little more courageous to do the next big thing. And you know what? It doesn't change anything.

I still remember, when I was pumping back, when I had my daughter and I was like, I guess I need to figure this out. So I would go off into the call room and do that, and I accidentally became more efficient because I would do all my notes at the same time and I'm like, "Oh, this is really great. I have an unintended side effects. I have to biologically care for myself. I am sorry." It's like just eating, or peeing. These are biological facts of being a human. And there's still a way that you'll still win out in the end. It's not wrong to advocate for just normal biological things.

An extra five minutes in the bathroom. Take a couple deep breaths and just have a moment to yourself so you can notice what's real; opinions and that's not real. And just notice what's okay, what's actually going okay in the day. So thank you so much for sharing those great pearls of wisdom.

Kim Downey: You're welcome.

Lillian Emlet: And so finally, the last question I have for you is, if a physician listening today is quietly struggling or really any healthcare provider is, quietly struggling, keeping it all inside and really is too afraid to become vulnerable and doesn't have a safe group to go to, or if a leader really wants to find a way to make sure that they can create an environment of psychological safety to support their group, their colleagues better, what's one practical step that a leader or an individual can take right now if there's suffering going on in the group.

Kim Downey: Sure. So for the physician themself, for an individual Dr. Amna Shabbir shared, and because we collaborated on a KevinMD article, and she was saying, "When you're feeling really low, even asking for help feels like too much work or too

much struggle.

But you have to take that step. Don't wait till you feel like doing it, and even if it feels monumental or you're a little bit scared. There is a safe person. And for you, who is that? You just tell one person, whether it's a pastor there's list of coaches. You're a coach. I know a ton of amazing physician coaches. There's so many, psychologist, a psychiatrist, a mentor, a friend, a spouse, a partner. Just tell one person, don't keep it all inside. to know that you're not alone and in asking for help, is a strength. That's not a weakness, and that is the most brave, courageous thing you can do is ask for help."

So I would say that from the physician standpoint and for the leader, I think it goes back to what we were just talking about a little while ago, is to create that culture of caring and and just supportive environment. So make sure physicians and other healthcare workers are aware of the resources, but that they also aren't sham resources. Or that they act like it's okay if you do this or take the time to have an appointment, but then if you try to do it, they give you a hard time. That should not happen.

Like it needs to be truly supportive, they need to talk the talk and walk the walk. That we support the mental health of our healthcare workers because they need to know even if it affects their bottom line. Every time a another statistic would be, every time a physician leaves a healthcare system, it costs the organization 500,000 to a million dollars. even if they just care about the bottom line, they should care about retaining physicians. And it also impacts the reviews because if the physicians are burnt out, they're going to be more clinical errors. The patients aren't going to be as satisfied. So even if they approach it from a selfish aspect, which you hope they don't. need to care. So making sure that they know that and that they offer like real resources that are confidential and that they do support people when they actually reach out.

Lillian Emlet: So those are really great lessons. Just say something to someone, anyone, someone that you can trust and that is just be able to mention it to someone because then the burden becomes lighter and surprisingly, people will have other great ideas to maybe think, help you think through, and maybe start to brainstorm or start to search for resources and for leaders.

Caring first because when you care for the people, when you care for the person first, everything else will follow. Compliance, adherence, money, retention, all those things because it is, people leave because you were not a good leader.

"Just tell one person, don't keep it all inside. Asking for help is a strength, not a weakness," and so I want to end our year with this because I think it's the most important message of all.

You don't have to carry it alone. You are never supposed to. Sometimes that one person you tell is a friend, a colleague, a family member. Sometimes that one person's a coach, someone confidential, trained completely in your corner. Sometimes what you need isn't one person. It's a community of many people, peers that understand what you're going through without you having to explain.

At Transforming Healthcare Coaching, we offer three ways to help individual and executive coaching for deep work. medTHRIVE, our community for the ongoing support, belonging, and wellbeing work that every healthcare professional deserves, and we serve the interconnected teams and organizations through systemic team coaching.

If something in these episodes resonated for you today, if you've been quietly struggling, if you're ready for something different, please reach out to us, to someone, because you don't have to do this alone. If you've listened this far, we are- I am- so deeply grateful for you being here on this journey with us.

Please like, follow and share our YouTube and podcast and all your different channels, Apple, Spotify with a friend, colleague, and leaders in healthcare. Together, we can change healthcare, one person at a time. We'll see you in 2026. Here's to a peaceful, restful, loving, calm holiday season for all of you healthcare workers out there.

We see you and we support you.