Couverture de Sustainable Clinical Medicine with The Charting Coach

Sustainable Clinical Medicine with The Charting Coach

Sustainable Clinical Medicine with The Charting Coach

De : Dr. Sarah Smith
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 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 Economie Hygiène et vie saine Maladie et pathologies physiques Psychologie Psychologie et psychiatrie Réussite personnelle
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    • 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
      Feb 23 2026
      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 min
    • Burnout in healthcare isn't just about being tired. It's feeling numb, checked out, and ready to walk away from the career you worked years to build. Dr. Nikia Smith Ep 159

      Burnout in healthcare isn't just about being tired. It's feeling numb, checked out, and ready to walk away from the career you worked years to build. Dr. Nikia Smith Ep 159
      Feb 16 2026
      Welcome to another episode of the Sustainable Clinical Medicine Podcast! In this interview, Dr. Nakia Smith, a board-certified anesthesiologist, wellness coach, and retreat curator, shares how she experienced burnout twice during her attending career and nearly left medicine. She describes early warning signs (persistent fatigue despite rest, increasing irritability, and eventual emotional numbness and autopilot), and links her initial burnout to chronic understaffing after colleagues left and a lack of administrative support, including being told the team was “handling it so well” that additional hires were unnecessary. After a near-20-hour call shift, she set boundaries by refusing further call, began educating herself on burnout, compassion fatigue, and self-compassion (including reading Kristin Neff), and rebuilt recovery through small, joy-based habits, movement (starting with Pilates), and reconnecting with community. She ultimately left a job that would not put agreed terms into a contract, moved to a no-call role to regain nights and weekends, and later negotiated for a part-time contract; she now works in Las Vegas under a contract requiring eight days per month, aligned with her goal of working 10 days or less. Dr. Smith explains how her personal retreat became an annual four-day wellness retreat for physicians (expanding to other clinicians) that includes CME and group learning on moral injury, perfectionism, invisible labor/“third shift,” and practical strategies such as boundary-setting, negotiating schedules, and mutual support (including helping participants craft emails). She advises clinicians to talk to others to learn what’s possible, keep asking for what they need (e.g., administrative time for committee work), and recognize that burnout recovery is not a quick fix but a process of re-engaging with self and community. Here are 3 key takeaways from this episode: Burnout Recovery Takes Time and Intentional Action: Burnout develops gradually over years, and recovery requires more than just rest. Dr. Smith emphasizes reconnecting with activities that bring joy and energy (like movement, hobbies, and community), even when exhausted. Small, consistent steps—like 5-minute walks or puzzles—can help rebuild your capacity to recharge. Advocate for Your Non-Negotiables: Healthcare systems often claim certain accommodations are "impossible" until you're ready to leave. Dr. Smith successfully negotiated no-call schedules and eventually part-time work (8-10 days/month) by persistently asking and being willing to walk away. She encourages clinicians to keep asking for what they need and get terms in writing. Systemic Issues Require Personal Boundaries: While healthcare systems prioritize profits over provider wellbeing, waiting for institutional change isn't sustainable. Dr. Smith learned to set firm boundaries—like refusing additional committee work without administrative time, and leaving jobs that wouldn't honor her needs. The solution involves both advocating for systemic change and taking personal responsibility for protecting your wellbeing. Meet Dr. Nikia Smith: Dr. Nikia Smith is a practicing board-certified anesthesiologist, wellness coach, and retreat facilitator. She’s also the founder of She Is Fire Forged, a transformative wellness brand that helps high-achieving women of color reclaim their peace, power, and purpose. With over a decade (and counting!) of experience in the high-stress world of medicine, Nikia brings a deeply informed lens to conversations around burnout, boundaries, and emotional restoration. Nikia specializes in guiding women—especially Black women in leadership and healthcare—through the exhaustion that comes from constantly being everything for everyone. She equips her clients with the tools to say no without guilt, build lives rooted in their own definitions of success, and live in softness over survival mode. Through retreats, coaching, and community care, Nikia curates spaces where women are invited to pause, reset, and reimagine what thriving truly looks like. Her work blends evidence-based wellness tools with embodied spiritual practice, creating a holistic path forward rooted in softness, sustainability, and self-trust. She’s also been featured as a guest on the Docs Get Money and Free to Be Mindful podcasts. Outside of her work, Nikia prioritizes rest, joy, and connection. You’ll find her reading, recharging with loved ones, and spending time with her niece, modeling what’s truly possible for a strong and powerful woman in this world. Connect with Dr. Nikia Smith: 🌐 Website https://sheisfireforged.com/ Instagram https://www.instagram.com/nikiasmithmd/ -------------- 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 ...
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      33 min
    • Achieving Work-Life Balance: A Doctor's Journey Through Locum Tenens with Dr. Andrew Wilner - Episode 158

      Achieving Work-Life Balance: A Doctor's Journey Through Locum Tenens with Dr. Andrew Wilner - Episode 158
      Feb 9 2026

      Welcome to another episode of the Sustainable Clinical Medicine Podcast!

      In this episode, our host welcomes Dr. Andrew Wilner to discuss his extensive career in medicine, detailing his certifications in internal medicine, neurology, and epilepsy. Dr. Wilner shares his multifaceted journey, from starting as an ER doctor without formal training to becoming a professor of neurology. He delves into the evolution of the internship model and offers advice for medical students in career decision-making.

      Dr. Wilner also elaborates on the locum tenens lifestyle, discussing the challenges and benefits, including the necessary preparation and mindset for success. Additionally, he highlights his experiences in academic roles, private practice, and as a medical journalist. The conversation concludes with insights into Dr. Wilner's book, 'The Locum Life: A Physician's Guide to Locum Tenens,' and his podcast, 'The Art of Medicine,' featuring stories of physicians pursuing unique medical careers.

      Here are 3 key takeaways from this episode:

      1. Flexibility is Essential for Locums Success: Locums work requires adaptability in every aspect - assignments can be canceled last minute, you'll work in unfamiliar systems, and conditions are often less than ideal. The ability to be flexible and resourceful is more important than clinical skills alone.
      2. Prepare Thoroughly Before Each Assignment: Arrive 2 days early to handle logistics: learn the EMR system (demand paid training), scout parking and accommodations, get credentialing done, and eliminate uncertainties. This preparation reduces stress and lets you focus on patient care when the assignment starts.
      3. Locums Prevents Burnout and Maintains Career Options: Working locums (even part-time) keeps you clinically active, resets credentialing clocks, and provides control over your schedule. Many burned-out physicians rediscover their love of medicine through locums by working on their own terms (7-9 months/year) rather than leaving clinical practice entirely.

      Meet Dr. Andrew Wilner:

      Dr. Wilner has worked locum tenens on and off since 1982 and is the author of "The Locum Life: A Physician's Guide to Locum Tenens." Dr. Wilner is Professor of Neurology at the University of Tennessee Health Science Center in Memphis, Tennessee, and host and producer of the Art of Medicine with Dr. Andrew Wilner podcast since 2020. Dr. Wilner is a PADI Divemaster and passionate underwater photographer.

      Connect with Dr. Andrew Wilner:

      🌐 Website http://www.andrewwilner.com

      Twitter/X http://www.twitter.com/drwilner

      Instagram http://www.instagram.com/seaphoto2025

      YouTube http://www.youtube.com/c/andrewwilnermdauthor

      YouTube Underwater http://www.youtube.com/c/andrewwilner

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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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      51 min
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