Interruptions are, in a way, the currency of emergency medicine. But many of them may be making patient care worse rather than safer. EKGs are a perfect example: physicians may be interrupted thousands of times each year so that every tracing receives immediate attention, even when the overwhelming majority do not represent an emergency. Protecting physician attention doesn’t have to come at the expense of quickly identifying patients who need immediate intervention.

In this episode, we explore how one emergency department dramatically reduced unnecessary EKG interruptions, why a 10-minute interpretation window may be safer than reflexively interrupting physicians, and how local data helped turn a counterintuitive idea into departmental practice. We also examine how asynchronous communication, protected workspaces, nursing partnerships, and a different way of thinking about attention can create a safer and more intentional emergency department.

Guest Bio: Dr. Jake Zadra is a board-certified Emergency Physician and the current Chair of the Department of Emergency Medicine and Diagnostics at St. Mary's Hospital in Janesville, WI, where he also serves as Vice Chief of Staff. He completed medical school (’18) and EM residency (’21) at the University of Wisconsin, where he served as chief resident. Outside of medicine, he’s a live music enthusiast, enjoys slipping Lord of the Rings references into everyday conversation, and spends as much time outdoors as possible. He remains one of the few Emergency Physicians with no interest in ultramarathons or BASE jumping.

We Discuss:

• Why Every EKG Doesn’t Need to Be an Emergency
• The Cost of 7,000 Interruptions to Find Two Unflagged STEMIs
• What Happens When the EKG Machine Misses a STEMI
• Why Fewer Interruptions May Lead to Better EKG Interpretation
• How the Workflow Handles Gray-Zone EKGs
• Rethinking the 10-Minute EKG Rule
• Using Local Data to Build a Safer Workflow
• How an EKG Drop Zone Keeps Deferred Reviews From Getting Lost
• How a Quieter Workspace Reduces Drive-By Interruptions
• Why Not Every Interruption Deserves the Same Response
• How Secure Chat Can Become an Asynchronous Inbox
• Why Nurses Need Protection From Interruptions Too
• How Making Interruptions Visible Creates Buy-In

Mentioned in this episode:

Rob’s Book: Supranormal

Supranormal: A Field Guide for the Impossible Job, tackles the parts of being a doctor that medical training leaves out, with practical tools for navigating conflict, overwhelm, burnout, and the sustained complexity of medicine, so you can build a career that is both sustainable and fulfilling.

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Get Out On Time

The Out-On-Time Course gives you the tools to complete your charts on shift, manage overwhelm and interruptions, and create fast, focused, kickass notes, so you can stay out of chart debt and get home on time. Self-paced. 12 hours AMA PRA Category 1 CME.

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Six Sessions to Recalibrate Your Career

Still like the doctoring, but all the stuff around it is taking a toll? Career Longevity Coaching is six one-on-one sessions over five months to identify what’s making your work harder than it needs to be and start making changes. If you’re wondering, "How long can I keep doing it like this?" Don’t wait until the answer is "I can’t."

Career Longevity and Burnout Coaching

Getting sued, or even just the fear of it, is one of the greatest hidden drivers of physician stress, burnout, and career dissatisfaction, yet almost no one teaches doctors how to survive it. A malpractice lawsuit can shake your confidence, challenge your identity, and strain your relationships long before you ever step into a deposition. The good news is that preparation, practice, and the right mindset can transform litigation from an overwhelming threat into something you can navigate with confidence. In this episode, we explore what every physician should know about medical malpractice lawsuits and malpractice litigation,, how to navigate a deposition, the conversations that can sabotage your defense, and the emotional toll of being sued, along with practical ways to prepare before you're ever named in a lawsuit. Finally, we share the tools, resources, and hard-earned lessons that help doctors protect their careers without losing themselves in the process.

• Why getting sued changes the way physicians practice medicine long after the case is over.
• How preparation can take you from feeling like you're on the chopping block to walking into a deposition with confidence.
• What you should and shouldn't say while a malpractice lawsuit is ongoing.
• Why understanding plaintiff attorneys' tactics makes you a stronger defendant.
• The communication mistakes that can undermine your credibility.
• How to prepare for a deposition.
• Why shame and isolation can make malpractice harder than the lawsuit itself.
• Practical ways to protect your confidence, career, and mental health after being sued.

Books

• When Good Doctors Get Sued
• How to Survive a Medical Malpractice Lawsuit - Eileen Brenner
• Depositions Are Trial

Podcasts

Doctors and Litigation: The L Word

• Season 1: Approaching D-Day
• Season 3: The Educated Defendant

Courses & Tools

• LEAP (Litigation Education and Performance).
• Use the code STIMULUS100 for $100 off.

Guest: Dr. Gita Pensa is an emergency physician, educator, and litigation performance coach who helps clinicians navigate malpractice lawsuits with greater confidence and less emotional distress. Through speaking, coaching, and her LEAP (Litigation Education and Performance) courses, she works with healthcare organizations, insurers, defense attorneys, and physicians to transform how clinicians experience litigation.

Mentioned in this episode:

Distilled Kickassery Every Other Saturday

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The Out-On-Time Course

Built for emergency clinicians who are tired of chart debt and getting derailed by interruptions and overwhelm. Learn practical, real-time documentation and shift-efficiency strategies to finish your shift and actually leave on time.

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When another person is upset or angry, our instinct can be to help them lower their emotional temperature by saying something like, "Just calm down," or, "Relax," or, "Take a breath," or, "Look at the facts." However, saying those things when the other person is in the heat of the moment can have the reverse effect from what we were hoping for.

The reason is simple: People who do not feel heard are not ready to hear solutions.

In this episode, we explore the communication strategy of valence matching, why it works at both a psychological and neurological level, and how it can transform interactions with patients, colleagues, consultants, and loved ones. Finally, we show how a few seconds of emotional attunement can save minutes, or even hours, of unnecessary conflict.

💡 Get Rob's Book

Supranormal: A Field Guide for the Impossible Job.

Tools, mindsets, and communication techniques so you don't get eaten alive by a job you're good at.

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We Discuss:

• Why "Calm Down" Rarely Calms Anyone
• The Simple Idea Behind Valence Matching
• Why the Brain Rejects Logic During Conflict
• Content vs Process in Conversation
• Why You Should Match First, Then Move
• Small Words That Create Big Differences
• How to Effectively Thank Patients for Waiting
• How Emotional Connection Shapes Clinical Encounters
• Why an Excellent Clinician Had Consistently Low Patient Satisfaction Scores

Mentioned in this episode:

🧭 UnBurnable | Career Longevity, Burnout Prevention, Self Mastery

This course will teach you the hidden anti-burnout curriculum. Begins Sept 15, 2026. CME available.

The UnBurnable Course

Doctoring Done Well | Bite-Sized Wins

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