Welcome to another episode of the Sustainable Clinical Medicine Podcast!

This week, Dr. Sarah Smith sits down with Dr. Diane Sliwka, Chief Physician Experience Officer at UCSF, to explore what it really takes to create a sustainable and fulfilling career in medicine.

Dr. Sliwka shares her personal journey through hospital medicine, the challenges of burnout, and how systemic change and leadership can make a real difference for clinicians. Together, they discuss practical strategies for improving work-life balance, the power of advocacy, and the importance of open communication in healthcare organizations.

Whether you’re a physician, healthcare leader, or anyone interested in the future of clinical practice, this episode is packed with insights and inspiration to help you thrive in your career and support a healthier medical community.

Here are 3 key takeaways from this episode:

1. Systemic Change Is Essential for Combating Burnout: Dr. Sliwka’s experience highlights that physician burnout is often rooted in systemic issues—such as long hours, inflexible schedules, and excessive documentation. Addressing these challenges requires organizational change, not just individual resilience.
2. Leadership and Advocacy Make a Difference: Taking on leadership roles and advocating for change within the system can lead to meaningful improvements. Dr. Sliwka’s journey shows that when clinicians step into leadership and use data to drive decisions, they can influence policies that support well-being, such as improved scheduling, documentation support, and wellness initiatives.
3. Continuous Improvement and Open Communication Are Key: Sustainable clinical practice depends on ongoing feedback, open communication between frontline staff and leadership, and a willingness to adapt. Initiatives like anonymous surveys, regular check-ins, and a culture that values listening to clinicians’ needs are crucial for creating a healthier, more supportive work environment.

Meet Dr. Diane Sliwka:

Diane Sliwka, MD is a Hospitalist and Clinical Professor of Medicine in the Division of Hospital Medicine at the University of California San Francisco Medical Center. In her role as Chief Physician Experience Officer at UCSF Health, she has led provider experience efforts organizationally since 2014. Diane co-designed and facilitated UCSF’s well-being centered leadership development program for physicians. She also leads UCSF Health’s Center for Enhancement of Communication in Healthcare which provides relationship centered communication skills training for providers. She hosts “The Expansive Life Project” on Instagram, providing personal well-being resources and tips focused on mid-career working professionals.

You can find Dr. Sliwka on:

• Instagram: https://www.instagram.com/theexpansivelifeproject/
• Linked In: linkedin.com/in/diane-sliwka-md-59122413b
• UCSF Web Bio: https://hospitalmedicine.ucsf.edu/people/diane-sliwka

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**** 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.

Welcome to the Sustainable Clinical Medicine Podcast!

In this episode, Dr. Sarah Smith sits down with Dr. Paul DeChant, a family physician and former CEO with decades of experience transforming healthcare organizations. Dr. DeChant shares his journey from a frontline family doctor to leading a 300-physician medical group through transformative change using the principles of Lean management—with a core focus on respecting people and restoring joy to the practice of medicine. Together, they explore the root causes of physician burnout, how aligning values and empowering local autonomy can revolutionize clinical workplaces, and the practical strategies—like daily huddles and "getting rid of stupid stuff"—that make care more efficient and sustainable for healthcare teams. If you're looking for real-world insights into creating healthier clinical environments and reclaiming work-life balance, this conversation is packed with ideas, inspiration, and actionable advice. Tune in for expert wisdom on building a medical career—and a life—worth sustaining.

Here are 3 key takeaways from this episode:

1. Respect for People Drives Results: Dr. DeChant’s leadership at Sutter Gould Medical Foundation focused on Lean principles—especially respect for people and empowering clinicians to solve problems at the local level. This shift led to dramatic improvements in physician satisfaction and organizational performance.
2. Addressing Burnout Means Redesigning Work, Not Just Building Resilience: Burnout is mostly a SYSTEM issue, not an individual failing. By analyzing and redesigning workflows (from front desk processes to the physical design of clinics), Dr. DeChant’s team reduced unnecessary burdens, improved efficiency, and helped clinicians reconnect with joy in their work.
3. Daily Huddles for Continuous Improvement: Instituting short, focused daily team huddles had a profound impact—building appreciation, improving communication, and addressing small problems before they snowball. These micro-adjustments collectively created a more supportive environment and drastically reduced staff turnover.

Meet Dr. Paul DeChant:

Dr. Paul F. DeChant, MD, MBA, FAAFP Principal and Co-Founder, Organizational Wellbeing Solutions, LLC Dr. Paul DeChant is a thought leader on leading organizational transformation and creating healthy workplaces. Paul advises C-level healthcare executives on managing critical problems such as financial and staffing challenges by transforming management systems and cultures to reduce the root causes of clinician burnout, improve KPI performance, and reduce burnout. He supports the AMA’s Professional Satisfaction and Practice Sustainment team and teaches at the University of Colorado – Denver’s Graduate School of Business. Following 25 years practicing family medicine, Dr. DeChant became CEO of the Sutter Gould Medical Foundation, where he led a transformation based on the theme of “Returning Joy to Patient Care.” After four years the group achieved recognition as the highest performing among 170 medical groups across the State of California two years in a row, while improving physician satisfaction from the 45th to 87th percentile on AMGA’s Provider Satisfaction Survey. He received his MD from the Oregon Health Sciences University and his MBA from the University of Colorado-Denver. Co-author of the book, “Preventing Physician Burnout: Curing the Chaos and Returning Joy to the Practice of Medicine”, Paul speaks internationally, and blogs regularly at www.pauldechantmd.com

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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.

Welcome to the Sustainable Clinical Medicine Podcast!

In this episode, Dr. Sarah Smith welcomes Dr. Tracey O’Connell, a radiologist whose career journey took a transformative turn when she left a toxic private practice after 16 years. Together, they dive into Dr. O’Connell’s path from aspiring psychiatrist to radiologist and ultimately to her work focusing on vulnerability, shame resilience, and expressive writing—especially among physicians and marginalized groups.

Dr. O’Connell opens up about her early influences, the emotional challenges of medical training, and how technological shifts in radiology contributed to feelings of isolation. She shares her personal experience of grappling with shame and the toll that unsustainable work practices can take on mental health. Dr. O’Connell also discusses how discovering expressive writing and the work of Brene Brown helped her reconnect with herself and build resilience—insights she now brings to her coaching and writing workshops.

If you’re a clinician looking for ways to create a more sustainable career and life, or interested in how vulnerability and self-reflection can transform your wellbeing, this candid conversation offers inspiration, tools, and hope. Let’s dive in!

Here are 3 key takeaways from this episode:

1. Vulnerability is Key to Physician Well-being: Dr. O’Connell highlights that being vulnerable with ourselves is a crucial first step. This can be made more accessible through expressive writing, providing a safe space for self-reflection before sharing with others.
2. Redefining Career “Success” in Medicine: Her story challenges the idea that conforming to traditional work patterns is the only path forward. Doing things differently to protect personal well-being sometimes feels isolating, but it’s a vital part of creating a sustainable career.
3. Expressive Writing as a Healing Tool: She describes how non-judgmental self-reflection through writing can unlock growth and be a gateway to real change—especially for those struggling with burnout, shame, or isolation in clinical settings.

Meet Dr. Tracey O’Connell:

Tracey O’Connell, MD is a radiologist, professional certified coach, consultant, educator, and facilitator of expressive writing and Brene Brown's shame resilience programs. She provides tools for good people having a hard time, tired of feeling lonely, negative, or out of place. After many years of feeling "not enough" as a person, a physician, a parent, or partner, her work fosters positive self-worth, psychological safety, and shame resilience for others. She is currently adjusting to life as an "empty nester" and is curious about what's next for her.

Physician Coach | Traceyoconnellmd.com

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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.

Welcome to the Sustainable Clinical Medicine Podcast!

In this episode, Dr. Sarah Smith is joined by Dr. Heather Signorelli—pathologist, business leader, and founder of a medical billing company—to dive into the practical side of billing, optimizing clinical workflows, and turning inefficiency into sustainability.

Together, they tackle one of medicine’s most vexing issues: how to make sure you’re getting paid for the important work you do—all while reducing frustration and freeing up more time for life outside medicine. Dr. Signorelli shares her journey from clinical pathology to the business end of healthcare, drawing on years of experience in workflow optimization and billing stewardship across the U.S. and Canada.

Tune in as they break down key points about revenue cycles, documentation, avoiding common billing mistakes, tackling administrative burdens, and leveraging teamwork for better compliance and less personal stress. Whether you’re struggling to keep up with billing, navigating complex healthcare systems, or just looking for actionable tips to make your practice more efficient and financially sustainable, this conversation is packed with real-world insights and resources.

Here are 3 key takeaways from this episode:

1. Understand the "Language" of Billing: Mastering billing is about learning a new language that isn’t taught in medical school, but is essential for ensuring you’re paid appropriately for your work—whether salaried or fee-for-service.
2. Optimize Workflow and Delegate: Sustainable and efficient practices rely on setting clear priorities, leveraging team members’ strengths, and building strong processes—especially for things like data collection, documentation, and patient billing.
3. Audit and Education Matter: Regular internal audits and ongoing education around coding, compliance, and payer rules can save you from costly errors, denials, or paybacks—and reduce the administrative overwhelm over time.

Meet Dr. Heather Signorelli:

Dr. Heather Signorelli is a board-certified pathologist and physician executive with over a decade of experience leading healthcare teams. She co-founded NatRevMD, a physician-led medical billing company that's been in business for 3 years, now supporting 26 practices with a team of over 65 billing and coding experts. NatRevMD helps private practices increase revenue by 25–30% through smart, data-driven billing, coding, and operations support.

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*** Learn more about Dr. Signorelli at https://natrevmd.com/

**** 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.

Welcome to the Sustainable Clinical Medicine Podcast!

In this episode, Dr. Sarah Smith sits down with Dr. Michele Knox, an accomplished ophthalmologist, physician leader, and passionate physician development coach. Dr. Knox shares insights from her nearly 30-year career, reflecting on what made her journey in medicine sustainable and fulfilling. Together, they explore the importance of building strong medical teams, cultivating community within healthcare, and finding purpose both inside and outside of clinical practice.

Dr. Knox opens up about the challenges and rewards of working in a large group practice, her transition into coaching and leadership roles, and the lessons she’s learned supporting early-career physicians. You'll hear practical strategies on how to delegate effectively, set personal boundaries, and prioritize wellness—both for yourself and your patients. Plus, Dr. Knox offers thoughtful advice on navigating patient satisfaction, self-compassion, and seeking support when burnout strikes.

If you're a clinician looking for realistic and actionable ways to create a more sustainable, joyful, and balanced practice, you won't want to miss this episode. Get ready for an inspiring conversation about resilience, mentorship, and the power of community in medicine.

Here are 3 key takeaways from this episode:

1. Community Matters: Building and maintaining a supportive professional network—friends, mentors, and coaches—is essential for resilience and long-term sustainability in medicine. You’re never alone, and sharing experiences can make all the difference through the ups and downs.
2. Delegate & Elevate: Practicing at the top of your training means focusing on work only you can do, while entrusting support staff with the rest. Streamlining workflow not only benefits physicians but also improves patient care and reduces burnout.
3. Life Beyond Medicine: Cultivating interests and relationships outside of clinical practice is vital. Hobbies, leadership roles, and simply giving yourself permission to rest can replenish your energy and passion for your work.

Meet Dr. Michele Knox:

Michele Knox, MD, Certified Physician Development Coach. Canadian Medical School & Ophthalmology residency, fellowship in US, stayed in SF Bay Area. Career in ophthalmology and physician leadership at very large group practice, recently retired and now giving back as Physician Development Coach, coaching through University Alumni Association & non profits.

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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.

Welcome to the Sustainable Clinical Medicine Podcast!

In this episode, Dr. Sarah Smith sits down with Dr. Peter Baum, a family medicine physician, medical director, and physician coach with a special focus on negotiation for early career doctors. Dr. Baum opens up about his personal journey through burnout—sharing his struggles with long hours, the pressures of perfectionism, and the impact these challenges had on his well-being and family life. He discusses how coaching helped him reclaim his time, shift his mindset, and develop practical strategies for more sustainable charting and patient care.

Together, Dr. Smith and Dr. Baum also explore the often-overlooked world of physician contract negotiation. Dr. Baum shares his mission to empower doctors—especially new grads—to advocate for both their worth and their time, and provides insight into the evolving landscape of physician employment in the U.S., including pay models, wage gaps, parental leave, and the importance of setting healthy boundaries. Whether you're feeling overwhelmed by your clinical workload, wondering how to approach your next contract negotiation, or simply searching for ways to make your medical career more sustainable, this episode is packed with real-life stories, practical advice, and hope for a better balance inside and outside of medicine.

Here are 3 key takeaways from this episode:

1. Perfectionism in Charting Can Lead to Burnout Baum described how striving for "perfect" documentation and internalizing imposter syndrome left him stuck—late nights, missed family time, and growing dissatisfaction. He emphasized the importance of mindset shifts, letting go of perfection, and embracing efficient workflows. Sometimes, “good enough” really is best for our own wellbeing.
2. Setting Boundaries Is Essential for Sustainable Care Learning to set healthy boundaries with patients—through strong agenda-setting and recognizing what truly requires immediate attention—was a game-changer. Dr. Baum shared practical scripts and reframes, allowing for quality care, but not at the expense of personal wellbeing or family life.
3. Negotiate Your Worth Early (and Don’t Forget About Non-Salary Benefits) Baum now coaches physicians in contract negotiation, with a special focus on early-career docs who often accept lowball offers out of fear or lack of information. He reminds us to ask about salary, workload, parental leave, and compensation for inbox management—ALL aspects that affect career sustainability and satisfaction.

Meet Dr. Peter Baum:

Peter Baum, DO is a physician coach, family medicine physician, and clinic medical director at a rural FQHC. He is passionate about physician wellness, leadership, contract negotiation and easing career transitions. He empowers physicians to create work-life balance and a sustainable career path. Always happy to help!

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

Learn more about Dr. Peter Baum www.sustainablephysicians.com and www.physiciancontractnegotiation.com

**** 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.