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Surgeons with Purpose

Hippocratic Collective

A podcast for surgeons who feel like they are languishing in a career that didn't turn out to be as fulfilling or as prestigious as they expected. Dr. Mel Thacker, an ENT surgeon and coach, takes you on a journey to help you understand why you are feeling dissatisfied, burnt out, and stuck. With this newfound insight, you'll be able to reframe how you see your experience, rediscover who you are underneath your surgeon identity, and create a life that aligns with your authentic self.

Find more info about Surgeons with Purpose and other shows on the Hippocratic Collective at hippocratic-collective.com

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  • 21 episodes
  • weekly
  • Avg 59 min
  • English
Counted on this page — what you have heard stays on this device, so it is not something the list can be paged by.
  • Monday · 23 min

    #112 The Three Success Tenets in Surgery

    Interested in the ESG Cabo Women Surgeons' Retreat in January 2027? Get on my calendar here. Join us inside Empowered Surgeons Group here. In today's episode, you will learn the three success tenets to create success and sustainability in surgery: Protect the asset Serve the patient Diversify your professional identity When we master these three things, life as a surgeon becomes easy and fulfilling. Even in the face of moral injury, decreasing reimbursement, litigation fear, complication fear, and the public's mistrust of the medical profession in general. I know because I'm living proof.

  • August 17 · 1 hr 7 min

    #111 Vaibhav's Story

    *************SENSITIVE CONTENT WARNING******************* This episode discusses a recent suicide. Please listen carefully, or if this is particularly triggering for you, forgo listening completely. ”If we could save one student, one kid, one life, we are spreading his shine,” Neeru Duggal. On July 23, 2025, Vaibhav Duggal turned 24. He spent the morning of his birthday in a women's health clinic in El Paso, on his OB/GYN rotation as a third-year medical student at Texas Tech University Health Sciences Center. Six days later he was dead. In this episode, I sit down with Vaibhav's parents, Vivek and Neeru Duggal, who are passionate about spreading the truth about what happened to Vaibhav with hopes to prevent this from happening to anyone else. We talk about who Vaibhav was, why he became a physician, his dreams for the future, and the events that ultimately crushed those dreams. We also reconstruct those six days, hour by hour, email by email. Vivek and Neeru hope to turn this needless tragedy into a campaign for reform. The burning question: when a university opens a disciplinary process against a student, what does it owe that student while the process is underway? As Vivek puts it: nothing can bring their son back, but if another family is spared this, they will be able to look themselves in the mirror. Neeru and Vivek describe a son who had wanted one thing since childhood: to be a doctor. By every measure available before that week, he was on his way. He graduated summa cum laude from Texas A&M with a 4.0 in biology, finished a semester early, volunteered at a medical center through COVID, and came to Texas Tech El Paso on a scholarship. He had no prior professionalism concerns anywhere on his record. The clinical encounter at the center of this story lasted a few minutes. The nurse practitioner conducting the exam and asked whether the patient was comfortable having a student present; the patient consented. On her way out, according to Vaibhav's account, the patient invited him to follow her on Instagram. At 10:34 a.m. he did. About an hour later he unfollowed and blocked her, telling the dean days afterward that he'd realized it crossed a professional line. That afternoon, the patient filed a complaint. The same day, the nurse practitioner who had been in the room the entire time completed Vaibhav's clerkship evaluation. She marked him as exceeding expectations in every single domain, including medical knowledge, patient care, communication, professionalism, all of it. Under "opportunities for improvement," she wrote nothing. Two days later, a faculty physician emailed the clinic director and the dean describing the incident as an egregious breach of professionalism. The clerkship director wrote that she believed Vaibhav should be pulled from clinical duties. On July 28, at 10:26 a.m., she submitted a formal referral to the Grading and Promotions Committee, and in that same referral, wrote that she had not yet had the opportunity to speak with the student because of clinical obligations. Vaibhav was, at that hour, sitting for his OB/GYN shelf exam, which he passed. That afternoon he met with the dean. He gave his account and was told he was removed from all patient contact, placed on a temporary leave of absence, and would appear before the GPC on August 15, eighteen days out. The family's account notes that the instruction not to contact patients was repeated eight separate times in that meeting. He was referred to counseling. He went to the counseling office at 3:30 p.m. that same day; the director spoke with him briefly, did not see him for a session, and directed him to intake paperwork. Vaibhav emailed that evening asking for the paperwork. The reply came back at 6:01 p.m.: the intake forms were only accessible weekdays between 8:15 a.m. and 3:45 p.m. He would have to try again tomorrow. He spent that evening with his girlfriend, called his parents, and made weekend plans. At 11 p.m. they went to bed. At 11:36 p.m. his phone lit up with an email from the dean's office. Attached were the meeting notes and the GPC presentation instructions: the document telling him to prepare a PowerPoint, explain to the committee why he was there, be convincing that he was sorry, and humbly request permission to resume clinical work. Attached beneath that was the policy excerpt listing what the committee could recommend: individual remediation, delayed progression to Year 4, repeat of Year 3, delay of graduation, or dismissal. A second provision noted the committee could place a permanent professionalism notation on his MSPE (the dean's letter that follows a physician into every residency application). He died the next day, July 29. He was 24 years old. Three days later, the family says the president of the university called them and made a claim about physical contact that appears nowhere in the complaint, the evaluation, or the referral. The Duggals dispute it, and it is one of the central grievances in the litigation they have since filed. If parts of that timeline sound familiar, it is because a version of it happened three years earlier and 1,200 miles away. Katie Meyer was a Stanford goalkeeper (the one who captained the team to the 2019 NCAA championship), a resident advisor, and an aspiring lawyer awaiting word on her Stanford Law application. In late February 2022, four months before graduation, she received a lengthy email informing her she faced disciplinary action that put her degree at risk. She had thrown coffee on a football player who had allegedly assaulted a teammate. Her parents did not know the process was happening. She died by suicide on March 1, 2022. Gina and Steve Meyer built the rest of their lives around a single, narrow, achievable reform: no student should have to navigate a disciplinary process alone. Their advocacy produced California Assembly Bill 1575 — Katie Meyer's Law — authored by Assemblymember Jacqui Irwin, passed unanimously through both chambers, and signed by Governor Newsom on September 28, 2024. The law gives students at UC, CSU, and community college campuses the right to select an adviser of their choosing — a parent, a coach, a professor, a peer — to accompany them through a disciplinary proceeding. Critically, the institution must train that adviser on its own procedures. The adviser is looped in from day one and, with the student's permission, receives regular updates. The Meyers call it a front-end safety net: someone in the room who knows how the machine works, so the student isn't facing career-ending stakes alone against a panel of professionals. On September 23, 2025 — almost a year to the day after the California signing — Representative Julia Brownley introduced a federal version in the U.S. House. It would extend the adviser right to students at any institution receiving federal funds, and would additionally require colleges to disclose student suicides in their Annual Security Report, a transparency measure with no current federal analogue. The Meyers have said plainly that they believe this law could have saved Katie's life. They also founded Katie's Save, a nonprofit focused on student mental health and suicide prevention. The overlap with Vaibhav's case is hard to miss. A student with no disciplinary history. A serious allegation. A process that moved before anyone had spoken with him. A high-stakes hearing scheduled weeks out. A counseling door that was closed by the time he reached it. And an eighteen-day wait to be alone with. In February 2026, the Duggal family filed suit in El Paso County District Court against TTUHSC and several administrators, seeking more than $30 million and alleging gross negligence, wrongful death, and denial of due process. Since going public, Vivek Duggal says other students from the same institution have come forward with their own accounts. Texas State Representative Cody Vasut, who has been working directly with Vivek and Neeru, has committed to introducing legislation when the Texas House reconvenes in January 2027 that would require universities to provide advocates to students in disciplinary proceedings: the Texas answer to what California has already passed. We close the interview by asking the Duggals what they want listeners in medical education to do differently. Their answer is not complicated, and it does not require a bill to pass: treat students like the human beings they are. Links & Resources Justice for Vaibhav — memorial and advocacy: Katie's Save — katiessave.org California AB 1575 (Katie Meyer's Law), signed September 28, 2024 Katie Meyer's Law (federal), introduced in the U.S. House, September 23, 2025 If you or someone you know is struggling, the 988 Suicide & Crisis Lifeline is available 24/7 by call or text in the U.S. Medical students and physicians can also reach the Physician Support Line at 1-888-409-0141, staffed by volunteer psychiatrists.

  • August 10 · 1 hr 2 min

    #110 From Hiding to Highly Visible on LinkedIn with Sheikh C. Ali

    Sheikh C. Ali dreamed of becoming a private practice surgeon from age seven. Then, when COVID hit between his third and fourth year of medical school, he noticed the landscape shifting. The pathway he'd spent his life walking toward no longer seemed viable, so he built a new path. He became the strategist healthcare leaders now hire to turn their expertise into visibility, authority, and opportunity on LinkedIn. This conversation is the playbook. Sheikh makes the case for why LinkedIn beats every other platform for clinicians. It is the one platform where you have direct access to 1.3 billion users and key decision-makers. He defines personal branding as what people say about you when you are not in the room, built from three components: core values, applicable expertise, and personality. Then he walks you through his 4 P's framework (Position, Polish, Publish, Pursue), reveals the gold mine hiding in plain sight, and gets tactical about writing a headline that works ("I help X do Y in Z"). You'll learn about the two audiences your content must speak to, why commenting is a superpower, what it takes to move someone from "I know you" to "I want to work with you." Underneath it all runs the mindset that makes the tactics work: network from abundance, choose done over perfect, and let confidence compound through action. Sheikh C. Ali helps clinical leaders and healthcare executives become the leading voice in their niche. Connect with him (where else??) on LinkedIn or his website here. Join us inside Empowered Surgeons Group here.

  • August 3 · 1 hr

    #109 PE Sharks in the Water with Dr. Adrienne Towsen

    For 19 years, Dr. Adrienne Towsen practiced in the kind of orthopedic group most surgeons dream of: five partners, employees who'd been there forever, a 30-year reputation, a family feel. Then came the supergroup. Then came private equity. The pitch: liquidity events, surgery centers, top-dog status. The math: one year's salary upfront, paid back over five years through a 25% management "scrape." The reality: 12-to-14-hour days, a salary cut in half, a practice that couldn't pay for gauze pads, and a call center in another location that didn't even know she was a doctor there. Her breaking point came after a weekend of hip fracture call, when she did the math and realized she'd essentially volunteered her time. She sent her resignation the next morning. With no plan. Just the certainty that there had to be another way. Five months ago, she opened The Towsen Clinic: a concierge direct-care practice built entirely on her own terms, where visits last 60 to 90 minutes and patients finally get what they're starved for: a human partner in their health. In this episode: The seductive pitch PE makes to physician groups and the math hiding underneath it What "we're employed now. This is no longer our practice" feels like from the inside The moment a 20-year patient left because he couldn't get through the phone tree Why she resigned without a plan, and what the sadness-plus-relief told her Walking away from the OR after 21 years and making peace with it The surprising bridge from hip fractures to hormone health and women's medicine Her advice if work is murdering your soul: don't stay stuck "I couldn't have been more miserable." -Dr. Towsen then. "This is the beginning of my next chapter." -Dr. Towsen now. Dr. Adrienne Towsen is an orthopedic surgeon and founder of The Towsen Clinic, a concierge preventive-care practice in West Chester, PA. Check out her clinic here. Follow her on LinkedIn here. 🎧 If this episode resonated, share it with a colleague weighing their own next chapter, and leave a review so more surgeons find the show. Join us inside Empowered Surgeons Group here. Take the Trainee to Attending Masterclass here.

  • July 27 · 55 min

    #108 Difficult Conversations with Dr. Anthony Orsini

    Join us inside Empowered Surgeons Group here. Most of us got less than 20 hours of communication training in four years of medical school. Then we were thrown into the real world. Dr. Anthony Orsini has spent his career fixing that. A practicing neonatologist and founder of The Orsini Way, he's trained thousands of clinicians to navigate medicine's hardest conversations: breaking bad news, disclosing medical errors, and rebuilding trust when everything's gone wrong. His methods have helped hospitals boost patient satisfaction scores by as much as 60% and reduce malpractice risk. Learn more here. Follow Dr. Orsini on LinkedIn here.

  • July 20 · 1 hr 8 min

    #107 Becoming a Great Defendant with Heather Hansen

    Take the quiz: What kind of surgeon are you becoming? here. Join us inside Empowered Surgeons group here. One of the most surprising truths about medical malpractice is this: the work that prepares you to become a strong defendant is the very same work that helps prevent lawsuits in the first place. It's the work that strengthens your relationships with patients, your spouse, your children, your colleagues, and your friends. At the heart of all of it are two skills: compassion and communication. In today's episode, I sit down with Heather Hansen, a medical malpractice defense attorney and expert in effective communication. As surgeons, most of us will face a lawsuit at some point in our careers. Yet no one teaches us how to navigate that experience, or how to become the kind of defendant a jury can trust. The research is clear: patients are less likely to sue physicians who communicate with empathy, authenticity, and compassion. Heather has spent decades defending physicians in the courtroom, and she shares a fascinating perspective from the other side of medical malpractice. The defense attorney's job is to humanize the physician and tell the story of a compassionate, thoughtful surgeon who genuinely cared for their patient. The good news is that is a skill set that can be developed long before you're ever named in a lawsuit. In this conversation, you'll learn how to better understand the game of medical malpractice, see the key players through a different lens, communicate more effectively under pressure, and cultivate the qualities that not only make you a stronger defendant but a better surgeon and leader. For more than 20 years, Heather Hansen defended physicians, healthcare providers, and hospitals in medical malpractice litigation. During that time, she mastered the art of communicating with compassion, credibility, and charisma when the stakes couldn't have been higher. Today, she teaches those same communication strategies to leaders, teams, and healthcare professionals around the world. You can learn more about her on her website here. Follow her on LinkedIn here.

  • July 13 · 54 min

    #106 Villains in Surgery

    Take the quiz, What Kind of Surgeon Are You Becoming here. Join us inside Empowered Surgeons Group here. We often believe we have to create villains in the world in order to effect change. But what if that were not true? In this episode, I teach villain compassion, the difference between helping, fixing, and serving, and the power of intentionally choosing our thoughts before we make decisions. Because when we change our mindset, we open up a portal to new ideas and solutions. That's the heart of coaching.

  • July 6 · 52 min

    #105 Why Women are Leaving with Dr. Cornelia Griggs and Dr. Jose Greenspon

    Join us in Empowered Surgeons Group here. Why are so many talented women surgeons questioning whether they belong in surgery, and what does that reveal about the culture of surgery as a whole? In this episode of Surgeons with Purpose, I talk to pediatric surgeons Dr. Cornelia Griggs and Dr. Jose Greenspon about the relational challenges of practice, imposter syndrome, the hidden emotional labor women carry in surgery, and why leaving is often a self-preservation response rather than a personal failure. We discuss the toxic conversation around resilience, the narrow line women are expected to walk between being likable and authoritative, the concept of "status leveling," and the exhaustion of constantly managing others' perceptions. We also explore why women are often the first to challenge the status quo, what gives Dr. Griggs hope for the future of academic surgery, and why creating a more equitable culture will require a critical mass of men who are willing to help level the playing field. This is a conversation about identity, belonging, leadership, and what it will take to build a surgical culture where everyone can thrive. Read Dr. Cornelia Griggs' and Dr. Adrea Merrill's article here. Read Dr. Arghavan Salles' piece on the status leveling burden here.

  • June 29 · 1 hr

    #104 Multiple Streams of Income with Dr. Stephen Cohen

    Join us inside Empowered Surgeons Group here. Join Dr. Gita Pensa’s Litigation Education And Preparedness course here. Dr. Stephen Cohen is a board-certified general and colorectal surgeon, Section Chief of Surgery at the VA, and an experienced medical expert witness with nearly 30 years in the medicolegal field. We explore what it really means to build a sustainable career in surgery: one that allows surgery to enhance your life rather than consume it. Dr. Cohen shares why he left more than 20 years in private practice for academic medicine, how financial conflict influenced that decision, and why he believes every physician should consider developing multiple streams of income. We discuss the many career opportunities available outside of direct patient care, including medical expert witness work, utilization review, consulting for medical device and pharmaceutical companies, research, and other non-clinical physician roles. He also offers practical advice on how physicians can get started, how to value their expertise, and why it's important to understand both plaintiff and defense work as a medical expert. We also talk about medical malpractice lawsuits and the emotional toll they take on physicians. Dr. Cohen openly shares his experience of being sued five times, what it was like to be served, how those cases were resolved, and why being named in the National Practitioner Data Bank (NPDB) does not define your career. He explains why malpractice litigation is fundamentally adversarial, why the legal system doesn't always reward the truth in the way physicians expect, and what every doctor should know before ever stepping into a deposition or courtroom. Along the way, we discuss one of the biggest lessons he learned as an expert witness: knowing the medical record better than anyone else. He explains why carefully reviewing the chart, understanding every detail, and studying depositions can make all the difference in litigation. We also explore why a poor outcome does not necessarily mean poor medical care and the single question from a plaintiff attorney that changed the outcome of a malpractice trial despite excellent surgical care. Our conversation turns to risk management and the everyday habits that protect both patients and physicians. Dr. Cohen shares why thoughtful documentation is so important, why physicians should never argue with colleagues in the medical record, when to involve risk management after complications, and why communication remains one of the most powerful ways to reduce malpractice risk. He also discusses the surprising benefits of giving patients your cell phone number, approaching every patient with a beginner's mind, and asking yourself how you would care for the patient if they were your own parent. Finally, we reflect on what changes after residency and fellowship, when technical excellence alone is no longer enough and physicians begin redefining success on their own terms. Dr. Cohen shares what he still loves about colorectal surgery, how the specialty has evolved throughout his career, his thoughts on the rising incidence of colorectal cancer, and why every surgeon should build a career that creates freedom, purpose, and longevity, not just more time in the operating room. Whether you're interested in medical malpractice, becoming a medical expert witness, physician consulting, utilization review, physician burnout, career diversification, or building multiple streams of income as a doctor, this conversation is filled with practical advice and hard-earned wisdom from someone who has successfully navigated every stage of a surgical career. Follow Dr. Stephen Cohen on linkedin here.

  • June 22 · 58 min

    #103 Right Place Right Time with Dr. Racheal Peterson

    Take the quiz "What Kind of Surgeon Are You Becoming?" here. Join Empowered Surgeons Group here. Dr. Racheal Peterson joins me to share her journey into neurosurgery, a path she set her sights on before medical school and ultimately made a reality. We talk about her first experiences in the operating room as a medical student and the sense of wonder that comes with being able to truly change a patient's life with surgery. Our conversation explores what made her residency genuinely formative rather than simply something to survive, the unique "bro nerd" culture of neurosurgery, and the common trap of believing the next milestone will finally make you feel like you've arrived. We also discuss how she discovered an unexpected creative outlet through social media, her experience becoming a mother during training and as a young attending, and how her aspirations, priorities, and communication style have evolved throughout her career. This is a thoughtful conversation about identity, ambition, growth, and what it means to build a life in surgery that continues to evolve alongside you. Follow Dr. Peterson on instagram here.

  • June 15 · 1 hr 6 min

    #102 Becoming a Surgeon with Purpose with Dr. Cameron Roth

    What kind of surgeon are you becoming? Take the quiz here. Join us inside Empowered Surgeons Group here. Check out Behind the Sports Medicine Podcast here and follow them on instagram here. Dr. Cameron Roth is a fellowship-trained orthopedic doctor specializing in hand, wrist, and upper extremity surgery and co-host of the podcast, Behind the Sports Medicine Podcast. In this episode we talk about what it actually feels like to finish training and go out into the world as an attending for the first time when the buck stops with you. We talk about imposter syndrome and the real divide between how men and women experience the culture of surgery, particularly orthopedic surgeons. We touch on the fallacy of certainty. You train under one attending who tells you there is one right way to do things. Then you rotate to another attending who tells you the same thing about a completely different technique. Both are certain. Both are wrong about their certainty. We also get into the first complication after training, and how it hits differently than anything you experienced as a resident. We consider whether being a woman in surgery might be a superpower, or, perhaps, that surgery selects for badass women. The extra scrutiny, the bias, the being underestimated, done consciously, can produce antifragility. Not just toughness. The capacity to grow stronger under pressure. I think every surgeon, regardless of gender, needs to hear this reframe. We also cover what genuine availability to patients looks like versus the kind that breeds resentment, and what it means to show up for patients from service energy rather than fear. This one is for every surgeon who has ever stood at the scrub sink before a hard case and wondered why their career doesn't feel like they thought it should.

  • June 8 · 1 hr 12 min

    #101 Finding Opportunities in Sham Peer Review with Dr. Tracey O'Connell

    Join us inside Empowered Surgeons Group here. Sham peer review can be one of the most devastating threats facing surgeons today. But it doesn’t have to. Physician, educator, and coach, Dr. Tracey O'Connell, pulls back the curtain on a reality most surgeons don't see coming until they're already inside it. This conversation is sobering. It is necessary. And it ends with a message of genuine hope: that the surgeon who protects herself, serves her patients, and diversifies her professional identity is also the surgeon who is hardest to destroy. What Is Peer Review, and What Is Sham Peer Review? Legitimate peer review is a quality assurance process initiated when a patient, fellow physician, or staff member reports that a physician failed to meet the standard of care or acted improperly. A hospital committee reviews the case, the physician may testify and present evidence, and a determination is made. Sham peer review is something else entirely. It is the weaponization of that same process for personal, competitive, or political reasons, not to protect patients, but to target a physician. It is used to intimidate, silence, retaliate, and in some cases, end careers. Sham peer review is defined as “the abuse of a medical peer review process to attack a doctor for personal or other non-medical reasons." Physicians most at risk are those employed by large hospital systems. How Often Does This Happen? The honest answer is that precise data is hard to come by, and that itself is part of the problem. Many cases are buried under non-disclosure agreements or never reported because physicians are too isolated, too afraid, or too ashamed to speak. What we do know - 56% of U.S. physicians surveyed by Medscape report higher concern that peer review could be misused to punish them for reasons unrelated to the case being reviewed. - At least 10% of peer review investigations are estimated to be sham peer reviews used to weaponize the process rather than ensure quality care. - 15% of physicians surveyed in a 2007 AMA investigation indicated awareness of peer review misuse or abuse. - Hospital disciplinary actions, including suspected sham peer reviews, average 2.5 per year per hospital, according to National Practitioner Data Bank (NPDB) records. - In Texas alone, 68% of adversely peer-reviewed physicians in 2004 were later adjudicated by the Texas Licensing Board, meaning the reviews were found to be without merit, yet their NPDB reports remain. The pattern is hard to see because it happens in the confidential, protected setting of hospital committees. But the incidence and severity are increasing. What You Must Know about the NPDB: The NPDB was originally created to prevent physicians who had committed dangerous acts from crossing state lines and practicing without consequence. A legitimate and necessary tool, in theory. In practice, it has become one of the most powerful weapons in a sham peer review. Key facts Dr. O'Connell wants every surgeon to understand: - Do not resign while a review is underway. Resignation during an active peer review or Performance Improvement Plan (PIP) can trigger an adverse report to the NPDB and, critically, waives your right to challenge the review. This is one of the most common and devastating mistakes physicians make. - The only person who can remove an NPDB report is the person or institution that created it. Once reported, removal requires cooperation from the very party that filed it. - An NPDB report does not have to end your career. This is important. While it can be weaponized as an indicator of incompetence, it is not an automatic career death sentence. Many physicians navigate NPDB reports and continue to practice successfully. - Get legal representation early. Do not wait. Find an attorney with specific experience in sham peer review and NPDB reporting requirements before the process accelerates. The Psychological Weight of This Reality: Dr. O'Connell is direct. This is depressing to know about. It is genuinely sad that the systems designed to protect patients are being turned against the physicians who serve them. The isolation is real. Physicians under review are often told not to discuss the matter with colleagues. This is a deliberate strategy, and it works. Physicians blame themselves. They question their competence. They feel shame. They feel alone. Dr. O'Connell's core message: a sham peer review is not a reflection of your worth as a physician or as a person. It is, in many cases, a reflection of institutional politics, competition, and the absence of adequate legal protections for doctors. We must be able to survive this psychologically and emotionally. Resources: Physician Just Equity (PJE) Founded by Dr. Pringl Miller, MD, FACS, PJE is a 501(c)3 organization of 50 physicians, all of whom have experienced workplace injustice and are dedicated to preserving justice in medicine. PJE offers free, confidential peer support teams for physicians navigating conflicts. They are also collecting data on the nature of workplace conflicts and the career trajectories of physicians after workplace injustice. Association of American Physicians and Surgeons (AAPS) 1-800-635-1196 Sham Peer Review Hotline: 719-627-7759 AAPS is the only national medical association actively helping physicians fight sham peer review. Their general counsel, Andy Schlafly, has stated plainly: "The biggest misconception about sham peer reviews is a denial of how pervasive they are." AAPS offers free legal consultation for physicians facing a sham peer review. Dr. Lawrence Huntoon, MD, PhD — AAPS Dr. Huntoon has run the AAPS sham peer review hotline for over 20 years and is one of the foremost experts on recognizing and combating sham peer review. His resources include: - Sham Peer Review: Resources for Physicians - Sham Peer Review: Recognizing Possible Early Warning Signs Center for Peer Review Justice A resource for physicians who want to get back to work and avoid expensive legal battles. Dr. Tracey O'Connell's Writing - The Sham Peer Review: A Hidden Contributor to the Doctor Shortage — KevinMD, July 2024 - Sham Peer Review: Strategies for Saving Your Career and Soul — KevinMD, October 2024 The surgeon who is most vulnerable to sham peer review is the surgeon whose entire identity, livelihood, and sense of self is housed in one institution, role, and set of privileges. When that is taken away or threatened, everything collapses. The surgeon who is hardest to destroy is the one who has built differently. This brings us back to the three essentials of a resilient surgical career: 1. Protect Yourself as the Asset You are the most valuable instrument in the operating room and in your career. That means investing in your psychological health, your self-concept, and your ability to weather attacks that are not about your competence. Sham peer review is designed to make you question your worth. The surgeon who has done identity work, who knows who she is separate from her title, her privileges, and her outcomes, is the surgeon who survives. 2. Serve the Patients Staying anchored in your purpose is both a psychological and a strategic act. The surgeon who takes actions genuinely in service to patients, not to institutional approval, compensation, politics, or accolades, is the surgeon who makes clean decisions, communicates clearly, and builds a reputation that outlasts any investigation. 3. Diversify Your Professional Identity This is the structural protection. A surgeon whose identity and income are entirely dependent on one skillset has no leverage and no safety net. Diversifying through speaking, writing, coaching, consulting, or building an independent practice creates not only financial resilience but psychological resilience. You cannot be completely silenced if you have a platform that doesn't belong to the institution. The medicolegal, interpersonal, and politically-motivated landmines of a surgical career are real. Sham peer review is one of the most dangerous. The best protection is not legal; it is architectural. Build yourself in a way that no single institution can dismantle. Dr. O'Connell is a resource for you! Learn more about how she can help you here.

  • June 1 · 1 hr 8 min

    #100 Surgery's Kangaroo Courts with Dr. Christian Bowers

    Join us inside Empowered Surgeons here. Every surgeon enters the profession knowing the clinical risks. Complications happen. Patients are unhappy. Outcomes fall short. That is part of the contract. But what about the other risks? The systemic and structural ones that have nothing to do with how compassionate of a human you are, how good of a diagnostician you are, or how slick of a technician you are? You got into this to take care of people. But the system was designed to protect patients from bad actors, and those protections can be weaponized against good doctors for nefarious reasons. In this 100th episode, neurosurgeon Dr. Christian Bowers joins me for an unfiltered convo about the systems governing physician careers and the gap between what those systems were designed to do and how they actually function. Dr. Bowers draws on years of watching colleagues' careers upended to illuminate what no one teaches in training. "The thing that could totally derail someone's career overnight, with no fault of their own, is never discussed," — Dr. Christian Bowers THE KANGAROO COURTS Academic medical centers operate as large corporations with financial incentives that diverge from physician protection. The house always holds the cards, and that matters for surgeons who find themselves in its crosshairs. A predetermined outcome can be built through paper trails before a physician ever knows they are being targeted. SHAM PEER REVIEW The "disruptive physician" label is legally vague, subjectively applied, and the starting point for building a paper trail. Things that were never a problem before all of a sudden become problems when an institution has decided to move on from you. HCQIA (1986): designed to protect peer reviewers from retaliation, with the unintended consequence of making bad-faith reviews difficult to challenge. A small group of aligned physicians often leads the charge, which makes this harder to see coming. DARVO Deny, Attack, Reverse Victim and Offender: the pattern coined by psychologist Jennifer Freyd that Dr. Bowers has seen play out repeatedly in institutional settings. Physicians who have never heard of this concept are the most vulnerable to it. DARVO typically shows up alongside sham peer review. THE ROLE OF PIPS, THE MEDICAL BOARD, AND THE NPDB Performance improvement plans and professionalism reviews are tools institutions use alongside sham peer review when they have decided to move on from a physician. Medical board complaints and NPDB reporting are downstream consequences that can encumber a physician's ability to find their next position. The damage is typically done upfront. The goal of legal counsel is protecting you for the next job, not saving the current one. THE ACGME & STRUCTURAL ACCOUNTABILITY The ACGME is a private organization, not a government agency. It is accountable to its interests, not to trainees. The Glass-Steagall parallel: the same perverse incentive structure between regulators and the institutions they regulate contributed to the 2008 financial crisis Medicine now has a version of exactly that. Resident unionization may be one of the few structural checks on this dynamic. PRACTICAL ADVICE FROM DR. BOWERS Going into academic medicine as a highly sub-specialized surgeon may be the highest-risk career setup. The two-hospital model: having multiple institutions competing for your cases fundamentally changes your negotiating position and safety. When to consult an attorney, why you do NOT need to tell the hospital you have one, and what an attorney can and cannot do for you. The controlled retreat strategy: protect yourself for the next job even when the current one is already lost. Non-competes, NPDB, contracts, and what to investigate before signing anything. Closing Reflection: The 100th Episode Every system discussed in this episode was built with a legitimate purpose. The Board of Registration in Medicine protects the public. HCQIA was designed to encourage good-faith quality review. The ACGME exists to ensure training standards. Each one began with a just cause. Over time, changes in how medicine is organized and how physicians are employed have created dynamics the original frameworks were not written for. The physician who simply showed up and did excellent work inside a broken system did not cause that drift. But they are the ones absorbing its cost. The majority of physicians are not the bad actors these systems were designed to catch. They are doing their best inside systems that apply the same rules to the rare bad actor and to the exhausted surgeon who had a difficult patient or staff interaction after a long night of call. Knowing that is clarity of environment, and clarity is the first form of protection. Key Terms Referenced Sham Peer Review: The use of the peer review process to target a physician for non-clinical reasons, typically when an institution has decided to remove someone and needs a documented justification. HCQIA: Healthcare Quality Improvement Act (1986). Grants qualified immunity to hospitals and peer reviewers. Designed to encourage good-faith review; the unintended consequence is that bad-faith reviews are difficult to challenge. NPDB: National Practitioner Data Bank. A federal repository of adverse actions against clinicians. An adverse report follows a physician across state lines and employers permanently. PIP: Performance Improvement Plan. Can be a legitimate corrective process or a documented pathway toward termination, depending on the institutional context. DARVO: Deny, Attack, Reverse Victim and Offender. Coined by psychologist Jennifer Freyd. A pattern that can arise when individuals or institutions face accountability, with or without conscious intent. ACGME: Accreditation Council for Graduate Medical Education. A private, non-government organization that accredits residency and fellowship programs.

  • May 25 · 58 min

    #99 Not Getting Greedy with the Last 5% with Dr. Won Kim

    Join Empowered Surgeons Group here. Dr. Won Kim is a brain and tumor neurosurgeon at UCLA Health, where he trained, completed a fellowship in stereotactic and functional neurosurgery, and built a practice around treating tumors that were once considered inoperable. He is also the kind of surgeon who will tell you he is hard to work for, that M&M should be about quality improvement not blame, and that the last five percent of a perfect resection isn't worth the cost of your patient's quality of life. Won's path to neurosurgery started with a childhood friend who had clinical depression. He wanted to understand how a brain could work so well and suffer so much at the same time. That question took him from a fascination with psychology to watching his first awake craniotomy, and it never really let him go. He ultimately chose neurosurgery over psychiatry. But the question of what makes one person able to thrive while another person can't escape the darkness has followed him throughout his career. In this conversation, we talk about what it actually means to treat the patient and not the scan and why the pursuit of perfection can be its own form of hubris. He talks about what it means to go to sleep without shame or guilt, as long as you prepared to give your best. We also get into his AI startup, why AI will paradoxically create more demand for radiologists rather than less, and what he has learned about becoming a better teacher and mentor. Follow Dr. Kim on instagram here. Are you a surgeon with a story to tell? Yes you are! Email me at mel@melthackercoaching.com

  • May 18 · 1 hr 1 min

    #98 You're Not Stuck with Dr. Red Hoffman

    Join Empowered Surgeons Group here. Dr. Red Hoffman has spent her career sitting with people at the hardest moments of their lives. As a physician who combines trauma care and palliative medicine, she has built a practice around something most of us spend our whole lives avoiding: death. But what makes Red's perspective so singular is that she isn't just a professional witness to loss. She has lived it, repeatedly and violently. Her grandparents died in a car accident when she was 12. Her father was killed in a terrorist attack in Egypt when she was 19. Her partner sustained a traumatic brain injury and later died by suicide when she was 49. This is a woman who knows grief from the inside out, and she has chosen to meet it with love rather than distance. In this conversation, we talk about what it actually means to have a good death, and what it means for the people left behind. Red explains why violent deaths carry a unique burden — not just the loss itself, but the law enforcement, the media, the legal system, all the unknown layers that pile on top of an already impossible experience. She shares what to say to someone who is grieving when you don't know what to say, and why the most important thing is not to assign meaning to someone else's loss. That work belongs to the bereaved. We also get into what it looks like to build a life on your own terms inside a system that wasn't designed for you. Red talks about navigating a corporate hospital buyout, watching her community get hit by Hurricane Helene, and finding genuine love for a corporation she once might have resisted. She talks about long COVID, what it is like to go from healthy to chronically ill, and how she has learned to ask for what she needs inside a system that makes that incredibly hard. And we talk about twriting the book she wishes she had when her father was killed: a guide to surviving violent death for the people left behind. Red carries a lot of loss and a lot of love, and somehow in her hands those two things are not opposites. I think you are going to feel that. Learn more about Dr. Red Hoffman here. Follow her on instagram here.

  • May 11 · 1 hr 5 min

    #97 Break Free from the Golden Handcuffs with Dr. Shieva Ghofrany

    Join us inside Empowered Surgeons Group here. What happens when being a doctor is no longer enough to sustain you? Dr. Shieva Ghofrany, OB/GYN and founder of A Tribe Called V joins me to explore identity, autonomy, and the hidden pressures of practicing medicine. Dr. Ghofrany didn’t follow a traditional path into medicine, and she doesn’t practice it traditionally either. From switching majors multiple times to building a parallel business, she shares what it looks like to question expectations, tolerate failure, and expand beyond the narrow identity many physicians inherit. We talk about the emotional and psychological realities of OB/GYN, the weight of responsibility in high-stakes situations, and the courage it takes to step outside the “golden handcuffs” of medicine. This episode is about more than career decisions. It’s about how you relate to yourself, especially when things don’t go as planned. 🔍 In This Episode, We Discuss Why identity in medicine can become limiting and how to expand beyond it The concept of “golden handcuffs” and why so many physicians feel stuck Learning to tolerate failure (and why it’s essential for fulfillment) Building A Tribe Called V and what entrepreneurship revealed about her strengths and blind spots The emotional toll of OB/GYN, including moral injury and high-risk deliveries The psychological pressure physicians face in moments like shoulder dystocia Her personal journey through endometriosis, infertility, and ovarian cancer What illness taught her about resilience, perspective, and life beyond medicine The importance of playfulness in the OR and how it shifts performance A powerful daily mindset practice that shapes how she shows up Why resentment is not useful in surgery—and what to do instead Communication, emotional intelligence, and how to navigate patient retaliation 🧭 Why This Conversation Matters You can follow every rule, do everything “right,” and still feel constrained by your career. This episode challenges the idea that medicine alone should define you—and offers a different way to think about autonomy, fulfillment, and what it means to build a life that actually works. 👤 About Dr. Shieva Ghofrany Dr. Shieva Ghofrany is an OB/GYN in private practice and the founder of A Tribe Called V, a platform dedicated to increasing knowledge and reducing anxiety around women’s health. Her work sits at the intersection of medicine, education, and empowerment—helping women better understand their bodies while encouraging physicians to think more broadly about identity and impact. Learn more about Dr. Ghofrani here.

  • May 4 · 1 hr

    #96 F*ck the Stigma: The Truth About Physician Mental Health with Dr. Jake Goodman

    Join us inside Empowered Surgeons Group here. Dr. Jake Goodman is a psychiatrist who works with healthcare professionals and has built a following of over 2 million people by saying the things most physicians are thinking but not saying out loud. His practice started in a telling way: his first patient was a surgeon, then a dentist, then a veterinarian, then an OB/GYN. That pattern wasn’t random; it revealed something much bigger. There is a massive, unmet need for mental health support in healthcare, and most of us are silently struggling more than we admit. Jake shares his own story of depression during intern year, when he thought he was “burned out,” but was actually depressed. Low energy. Numb. Going through the motions. And here’s the part that hits: he was a psychiatry resident and still couldn’t see it in himself. That’s how deep the stigma runs in our profession. We talk about what it actually takes to come out of that place and why “working harder” is not the answer. At some point, the armor has to come off. And for physicians, that’s often the hardest move. If you’ve ever felt like your life used to work—and now it doesn—you’ll recognize what he describes. The career, the family, the workouts, the expectations… at some point, something gives. His question is simple: Is what you’re doing sustainable for the next 20 years? We also get into the stuff no one taught us: – what to do with the stress your body is carrying after a case – why you can’t just compartmentalize forever – how to recognize your own “check engine lights” before things spiral And one of the most practical tools he shares is how to separate “hot thoughts” from reality. The ones that sound like: I’m a bad doctor. I’m an imposter. I’m going to be found out. Instead of fighting them, he teaches you how to create space from them so they stop running the show. We also talk about emotions: what they are, what they’re not, and why making permanent decisions in temporary emotional states is one of the biggest mistakes physicians make. This conversation is real, practical, and long overdue. If you’ve been telling yourself you’re just “burned out”… you may want to listen to this one. Learn more about Jake's practice here. Follow him on instagram here.

  • April 27 · 59 min

    #95 Food, Trauma, and the Nervous System with Luis Mojica

    Join us inside Empowered Surgeons Group here. What if your relationship with food had nothing to do with discipline and everything to do with your nervous system? In this conversation with Luis Mojica, we explore the connection between developmental trauma, chronic stress, and the way we relate to food. Luis shares his own story of using an eating disorder to cope with undiagnosed PTSD, and how that led him to question the traditional psychology model that focuses on behavior without getting curious about environment, physiology, or nutrition. His work in nutrition counseling revealed a pattern: people with unresolved trauma and chronic stress often struggle to stabilize their health in ways that have nothing to do with discipline and everything to do with their nervous system. We talk about food as a relationship. Not just something we consume, but something that becomes us. Our tissues, our skin, our blood. Food can stimulate, suppress, or balance the body, much like our relationships with people. Caffeine, sugar, and refined carbohydrates can activate the system. Rich, comforting foods can initially settle us but create downstream effects that dysregulate. Whole foods tend to support balance. This shifts the conversation away from good and bad foods and toward how different foods impact our internal state. We also unpack trauma as a physiological response rather than an event. The body mobilizes for fight or flight, and when that is not possible, it moves into freeze, collapse, or fawn. Many high achievers learn early how to override their own needs in order to belong. That override becomes a strength professionally, but it comes at a cost. Hunger signals, boundaries, and emotional cues all get muted, and over time there is a growing disconnection from the body. The same stress pathways that are activated in trauma can also be activated by the foods we eat. A big part of this conversation is reframing cravings. Instead of something to control, they can be understood as a signal. A compass pointing toward an unmet need. Luis shares examples from his work with patients, including how removing a coping mechanism too quickly can create more distress if we do not first understand what role it is playing. We talk about what it looks like to pause, get curious, and actually listen to what the body is communicating. We also go into practical tools. Tracking where tension or pressure lives in the body. Creating a sense of safety with simple physical cues. Working with numbness and understanding what is underneath it. For those of us in high intensity environments like surgery, this matters. The constant activation, sleep deprivation, and vicarious trauma create a baseline level of stress that most people never experience. In that context, food becomes more than fuel. It becomes a way to regulate. Meals and snacks can either amplify that stress or help bring it down. We close by talking about capacity versus desire. Many physicians love what they do, but their capacity to metabolize the constant input is maxed out. Without space to process, the system stays activated. Practices like pendulation, moving between states of activation and regulation, help rebuild that capacity. This is ultimately about returning to a more sovereign relationship with the body, supporting the microbiome, and understanding that even something as simple as fiber can play a meaningful role in restoring balance. Get Luis's book Food Therapy here. Follow Luis on instagram here.

  • April 20 · 48 min

    #94 Solving for the Infertility Crisis in Surgery with Dr. Erica Bove

    Learn more about Love and Science Fertility here. Join Empowerd Surgeons here. Infertility is shaping the lives of female physicians, and we need to talk about it. Dr. Erica Bove, creator of Love and Science, shares the startling fact that 1 in 4 female physicians and 1 in 3 female surgeons experience infertility. Interestingly, the very mindset that makes us successful in surgery can work against us when it comes to building a family. We explore the hidden role of stress, trauma, and nervous system dysregulation, and the trap so many physicians fall into: trying to solve infertility by working harder, researching more, and disconnecting from their own bodies. Dr. Bove offers a radically different approach, one that begins with humanity. We talk about: Why going on a certainty frenzy doesn't solve the problem How trauma states impact fertility physiology The courage it takes to receive care, not just give and give Reconnecting with your deepest “why” Boundaries, community, and learning to say: I deserve to be a patient This is not just a conversation about fertility, it’s about reclaiming your humanity in a system that taught you to override it. Erica Bove, MD, is a double board certified OB-GYN and Reproductive Endocrinologist (REI) physician at the University of Vermont, She is also the CEO and founder of Love and Science: Thriving Through Infertility. She has a keen interest in marrying an evidence-based approach with intuitive knowing in the context of a trusting relationship. She empowers women physicians to build their families with confidence, self compassion and community. Her mission is to heal and support the healers and to create a legacy she is proud of. In her free time, she enjoys running, yoga, kayaking, skiing, reading, writing, and spending time with her inner circle. Follow her on Linkedin here, IG here, FB here, and check out her podcast, Love and Science Fertility here.

  • April 13 · 44 min

    #93 Negotiating Our Worth with Dr. Karen Leitner

    Surgeons, join us inside Empowered Surgeons Group today. In this episode, Dr. Karen Leitner and I explore the hidden thought patterns that keep women physicians stuck. And how to break free! We cover: Why charting paralysis happens (and the thought loops that drive it) Being diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD) later in life and the shift from self-judgment to self-understanding The power of acceptance and letting go of control over outcomes The moment Karen realized even “good doctors” get sued How medical training builds a hypercritical inner voice (and how to replace it with self-compassion) Moving from walking a tightrope → to feeling solid and safe within yourself The reality of inequity: women physicians being undervalued and underpaid Lessons from Women Don’t Ask on why women avoid negotiation The mindset shifts needed to negotiate powerfully: Your value is yours—even if others don’t recognize it Hearing “no” is part of the process, not the end Discomfort is the price of increasing your impact and income Practical negotiation strategies: Research compensation (e.g., Medical Group Management Association data) Communicate your value from the institution’s perspective Have the conversation in person and set expectations ahead of time Anticipate objections and stay in the conversation Key takeaway: Money = impact. When you are compensated appropriately, you expand your ability to create change. Ready to go deeper? If you’re a woman physician looking to feel better, think clearer, and show up more powerfully in your life and career, check out Dr. Karen Leitner's coaching program here. Make sure to follow her on Instagram here. And if you’re a surgeon ready to step out of burnout and lead your career from a place of confidence and ownership, join Empowered Surgeons. You don’t have to keep doing this alone.

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