Sustainable Clinical Medicine with The Charting Coach copertina

Sustainable Clinical Medicine with The Charting Coach

Sustainable Clinical Medicine with The Charting Coach

Di: 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 Disturbo fisico e malattia Economia Igiene e vita sana Psicologia Psicologia e salute mentale Ricerca del lavoro Successo personale
Episodi
  • Malpractice, Audits, and Where to Put It All | Episode 195

    Malpractice, Audits, and Where to Put It All | Episode 195
    Oct 26 2026

    Nobody told you what to do when the letter arrived. Not in med school. Not in residency. And now you’re trying to hold it together through a malpractice case, a licensing board investigation, or a billing audit that feels like it came out of nowhere.

    Dr. Erin Pemberton has spent 20 years defending doctors and healthcare providers in exactly those moments. Now she’s also a certified coach, and she works with providers who are in the middle of the hard stuff: not after, not in recovery, but right now, while it’s happening. In this episode, she and Dr. Sarah talk about what that kind of support actually looks like, and why it matters.

    Dr. Erin Pemberton is a partner at Baylor, Evnen, Wolf & Danele law firm in Lincoln, Nebraska and the founder of Pemberton Professional Coaching. She is a certified coach credentialed through the International Coaching Federation and trained at the Physician Coaching Institute. She works with doctors, nurses, pharmacists, and other healthcare providers navigating licensure, discipline, malpractice, and audits. Find her at pembertonprocoaching.com.

    Timestamped Highlights

    [00:00] Dr. Erin Pemberton’s path from OR tech to nurse to nursing administrator to law school to coaching

    [07:00] What 20 years of malpractice defense taught her about what doctors actually go through

    [13:00] Why coaching is a safe space legally: no notes, no evidence, no diagnosing

    [19:00] The risk behaviors that show up when doctors are under sustained pressure

    [24:00] Billing audits, Medicaid letters, and the legal layer of medicine no one prepared you for

    [28:00] What coaching looks like when someone is facing discipline, not just career transition

    [31:00] How to find Dr. Pemberton and what working with her looks like

    Three Key Takeaways

    1. Coaching is legally distinct from therapy, and that distinction matters when you’re in trouble.

    Dr. Pemberton is clear: coaching doesn’t generate notes, doesn’t create evidence, and doesn’t involve diagnosing. For a doctor in the middle of a malpractice case or licensing investigation, that makes it a genuinely safe place to process what’s happening. You can talk about how you’re feeling without creating anything that could be used against you later.

    2. The emotional toll of a malpractice case or audit doesn’t wait for the case to resolve.

    These cases can take years. Licensing board investigations move slowly. And the pressure doesn’t pause while your life keeps going. Dr. Pemberton talks about the risk behaviors that show up when doctors are carrying that weight with nowhere to put it, and why having a place to let the relief valve open can change how someone shows up in every other part of their life.

    3. You’re not the first. You’re not the worst. And there are people who specialize in the hard part.

    Most coaching focuses on career transitions or growth. Dr. Pemberton deliberately works with people who are in crisis right now, not on the other side of it. Knowing that someone has walked alongside dozens of doctors through this, and has seen them come out, is its own kind of grounding.

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

    Charting Champions is a premiere, lifetime access program for doctors that is helping them 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 @thechartingcoach 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 min
  • 10% of Doctors May Have ADHD. Here’s What That Actually Means | Episode 194

    10% of Doctors May Have ADHD. Here’s What That Actually Means | Episode 194
    Oct 19 2026

    Dr. Jennie Byrne is a psychiatrist, neuroscientist, and author of three books on brain performance, moral injury, and ADHD in professionals. In this episode, she and Dr. Sarah dig into what ADHD actually looks like in high-performing clinicians and why so many go undiagnosed for decades. If you’ve ever wondered why the administrative side of medicine feels exponentially harder than the clinical side, this conversation is going to feel uncomfortably familiar.

    Dr. Jennie Byrne is a board-certified psychiatrist and neuroscientist. She’s the founder of Constellation, a mental health practice, and the author of Work Smart: Use Your Brain and Behavior to Master the Future of Work, Moral Injury: Healing the Healers, and ADHD in Professionals: Embracing Your Brain. Connect with her at constellationpllc.com.

    Timestamped Highlights

    [00:00] Why ADHD shows up differently in high-achieving doctors, and why the traditional picture doesn’t fit

    [07:00] The “brain variant” framing: why Dr. Byrne doesn’t see ADHD as a disorder

    [14:00] Up to 10% of doctors may have ADHD, and the adrenaline-driven specialties are where you’ll find the most of them

    [21:00] Task-shifting and cognitive load: why switching from clinical to admin work costs ADHD brains up to 60% capacity

    [28:00] The inbox problem: how to stop letting email run your day (scheduling send, time blocking, making it a game)

    [35:00] Portal messages as moral injury: when the system is asking more than it was ever designed to give

    [42:00] Why doctors avoid psychiatry and how coaching offers a lower-barrier path to support

    [49:00] The three books, what they cover, and how to find Dr. Byrne

    Three Key Takeaways

    1. ADHD brains aren’t broken. They’re built for a different environment.

    Dr. Byrne reframes ADHD as a brain variant, not a deficit. The skills that make ADHD brains exceptional in high-stakes clinical environments (hyperfocus, fast pattern recognition, comfort with chaos) are the same skills that make the administrative side of medicine feel like it’s grinding gears. The mismatch isn’t in the brain; it’s in the job design.

    2. The cognitive cost of switching from clinical to admin work is real and measurable.

    For doctors with ADHD brains, task-shifting between clinical and administrative work doesn’t just feel hard. Research suggests it can consume up to 60% of working capacity. That’s not a motivation problem or a time management problem. It’s a neuroscience problem, and it reframes why charting after hours feels so disproportionately exhausting.

    3. The barrier to mental health support for doctors is partly structural, and coaching can help bridge it.

    Doctors are less likely to seek psychiatric support due to stigma, licensing concerns, and the particular awkwardness of being a clinician and a patient in the same system. Dr. Byrne talks about why coaching offers a lower-stakes, more accessible entry point and why that matters for sustainable careers in medicine.

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

    Charting Champions is a premiere, lifetime access program for doctors that is helping them 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 @thechartingcoach 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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    44 min
  • She Moved Countries. The Charting Problem Followed | Episode 193

    She Moved Countries. The Charting Problem Followed | Episode 193
    Oct 12 2026
    Dr. Sarah Smith recently joined Dr. Andrea Austin on Heartline: Changemaking in Healthcare to talk about something that hits close to home for a lot of doctors: the charting problem that follows you no matter where you work, what system you're in, or what country you move to. In this conversation, Dr. Smith shares practical emergency department charting strategies, her honest take on perfectionism and training trauma, and why the administrative burden is an "us problem, not a you problem." This episode originally aired on Heartline: Changemaking in Healthcare, hosted by Dr. Andrea Austin, board-certified emergency doctor and doctor development coach. Visit andreaaustinmd.com to learn more. Timestamped Highlights [02:00]: Dr. Smith traces how she became interested in helping other doctors, starting with 15 years of working evenings and weekends before she finally figured out how to get home with the work done, and what it took to get there. [07:00]: The emergency department gets specific attention here. Dr. Smith explains why doctors staying six hours after their shift is not a personal failing, and what it is actually costing the department. [09:00]: A quick shift huddle at the start of every shift, done right, can reduce interruptions, improve teamwork, and set up the whole team to leave closer to on time. The logistics are simpler than you might think. [11:00]: Real-time charting in a busy ED sounds impossible. Dr. Smith makes the case for why doing it imperfectly in the moment beats doing it perfectly at midnight. [14:00]: C-minus. That is the charting standard Dr. Smith recommends when you are under pressure, and the reasoning behind it will resonate with anyone who has ever held their notes accountable to a voice from residency they do not even respect anymore. [19:00]: Training trauma is real, and it shows up in documentation. Dr. Smith and Dr. Austin talk about the attendings, the fear of courtrooms, and the invisible audience doctors are still writing for years later. [25:00]: What can a CMO or hospital leader actually do? Dr. Smith gives concrete, practical answers including one idea for how a department could restructure a shift to give doctors a protected hour to get caught up. [31:00]: Dr. Smith lived and worked in both Australia and Canada, saw up to 40 patients a day across multiple practice settings, and was still working evenings and weekends in both countries. The problems followed her. What finally changed things was not the system; it was the skill set. [39:00]: What does a sustainable clinical career actually look like? Dr. Smith closes with her own definition, and why the goal of leaving 10 minutes after the last patient once felt completely impossible. Three Key Takeaways 1. The end-of-shift backlog is a system problem, not a personal one. When doctors are staying six hours past their last patient to finish documentation, that is not a sign that those doctors are slow or disorganized. The electronic medical record was not designed for speed or ease, the click burden is heavy, and nobody hands clinicians the specific strategies to work differently inside it. Dr. Smith frames it plainly: this is an us problem, not a you problem, and that reframe matters because it puts the conversation where it belongs, at the level of the team and the department, not the individual. 2. Perfectionism around charting is often training trauma wearing a professional mask. C-minus charting is not a shortcut. It is the right standard for a doctor who has not eaten in three hours, has a full waiting room, and knows something is coming through the door in five seconds. The reason so many doctors cannot let themselves chart to that standard is that they are still writing for an attending who intimidated them in residency, or bracing for a courtroom that is unlikely to ever materialize. Naming who you are imagining looking at your notes is one of the most practically useful things in this episode. 3. Moving countries does not fix the problem; changing your skill set does. Dr. Smith left Australia for Canada and kept working evenings and weekends. Different system, different EMR, different patient volume structure, same problem. What changed things was not geography. It was learning a different way to interact with the system she was already in. For any doctor who is convinced their burnout is entirely environmental, this is worth sitting with: the system is broken, and it is also true that there is a skill set available that can make where you are right now more sustainable. Would you like to view a transcript of this episode? Click Here Charting Champions is a premiere, lifetime access program helping doctors 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 chartingcoach.ca/charting-champions Enjoying this podcast? Please share it with someone who would benefit. Also, don't forget to hit "...
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    47 min
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