What a 1990s SNL character got right about coaching, and what he got right about getting it wrong. During the early 90s, Stuart Smalley would sit in front of a mirror in a pastel cardigan and repeat his catchphrase. “I’m good enough. I’m smart enoug...

This is a hard post to write. It is also important. I have escorted trainees to the emergency room for urgent evaluations. A colleague has stayed at my house so they did not have to be alone. And I have helped absorb schedule changes so a peer could...

At some point you typed is medicine right for me into a search bar. Then somebody told you to go shadow a doctor. Maybe you already have — a morning in a clinic, a badge that said OBSERVER, a physician who was generous with you and let you stand nea...

There are two monitors on my desk. One has Epic open. The other holds my calendar, and most days a partially read echo sits behind it. My phone rests next to the keyboard with email open. That is the setup in my office. The setup in clinic, on my co...

I work with a lot of high-earning physicians who still feel trapped in a job or specialty they’ve clearly outgrown. It’s very common for physicians who spent years as W-2 employees to keep operating that way once they own a practice. They work 50- o...

I’m standing in the shower wiping soap out of my eyes, and I’m three exchanges deep into an argument that I’m losing. I can feel my blood pressure rise. As I grit my teeth and prepare for another witty comeback, my partner yells from the other room,...

It is faculty annual review time, and if I am being honest, I dread it. The reasons are not clear. I have been full professor for a while now, so the review carries less weight than it once did. I believe in the intent behind it. The process was bui...

You just pitched an idea that was weeks in the making. The pushback starts, and some of it is hard and pointed. All eyes are on you. Each comment lands somewhere behind your sternum, like a blow from a heavyweight boxing champion. The room is expect...

The academic year is four weeks old. Maybe you are assembling a promotion dossier. Maybe your annual review is on the calendar and you are already rehearsing the conversation. Or maybe the promotion came through in July, and you have spent the past...

Showing up has never been your problem. You put your head down. You gut it out. The strength that built your career is the one you reach for when the work gets hard. So you reach for it again. And again. Until showing up becomes second nature, even...