Surgeons with Purpose

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.

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)1-800-635-1196Sham Peer Review Hotline: 719-627-7759AAPS 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 — AAPSDr. 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 SignsCenter for Peer Review JusticeA 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 2024The 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 AssetYou 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 PatientsStaying 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 IdentityThis 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.

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

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 DiscussWhy identity in medicine can become limiting and how to expand beyond itThe concept of “golden handcuffs” and why so many physicians feel stuckLearning to tolerate failure (and why it’s essential for fulfillment)Building A Tribe Called V and what entrepreneurship revealed about her strengths and blind spotsThe emotional toll of OB/GYN, including moral injury and high-risk deliveriesThe psychological pressure physicians face in moments like shoulder dystociaHer personal journey through endometriosis, infertility, and ovarian cancerWhat illness taught her about resilience, perspective, and life beyond medicineThe importance of playfulness in the OR and how it shifts performanceA powerful daily mindset practice that shapes how she shows upWhy resentment is not useful in surgery—and what to do insteadCommunication, emotional intelligence, and how to navigate patient retaliation🧭 Why This Conversation MattersYou 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 GhofranyDr. 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.

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.

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-understandingThe power of acceptance and letting go of control over outcomesThe moment Karen realized even “good doctors” get suedHow 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 yourselfThe reality of inequity: women physicians being undervalued and underpaidLessons from Women Don’t Ask on why women avoid negotiationThe mindset shifts needed to negotiate powerfully:Your value is yours—even if others don’t recognize itHearing “no” is part of the process, not the endDiscomfort is the price of increasing your impact and incomePractical negotiation strategies:Research compensation (e.g., Medical Group Management Association data)Communicate your value from the institution’s perspectiveHave the conversation in person and set expectations ahead of timeAnticipate objections and stay in the conversationKey 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.

Join Empowered Surgeons Group here.Learn more about what's inside ESG here.In the perfectionist surgeon's mind, either we get a perfect outcome or we fail. But in the realm of humans, perfection is impossible. And we don't always have full control over the final surgical result.Instead of thinking in terms of surgical "success" and surgical "failure", what would it look like to categorize circumstances into mistakes, complications, and missed expectations? That's what I explore inside this episode.

What do physicians actually need when they find themselves on the receiving end of a malpractice lawsuit?In this episode, I have a conversation with emergency physician, educator, speaker, coach, advocate and legal expert Dr. Gita Pensa about the reality of medical malpractice from the physician defendant’s perspective. We explore why getting sued can feel like being dropped onto another planet. Also why shame, fear, and avoidance often keep doctors from learning how the system actually works.Gita explains how the malpractice landscape has shifted dramatically in recent years. Public trust in medicine has eroded since COVID, nuclear verdicts are increasing, and third-party investors are now funding lawsuits in pursuit of massive payouts. Meanwhile, physicians often stay silent, leaving the narrative about medicine to be shaped by media outlets, documentaries, and plaintiff attorneys who are highly organized and strategic about influencing public perception.We also unpack a crucial misconception: a verdict or settlement does not necessarily mean bad care. Medicine operates in a world of uncertainty, yet the public expectation of perfection has never been higher. Complications, missed expectations, and true mistakes are very different things, but in courtrooms and headlines, they’re often treated as the same.Gita shares practical insights into the litigation process, including why the deposition is one of the most important moments for a physician defendant. She also discusses the work she does helping physicians prepare for these high-stakes conversations so they can show up with clarity instead of fear.Finally, we zoom out to the bigger picture. From legislative advocacy to improving how medicine talks publicly about risk and error, physicians need to become more informed, more strategic, and more willing to speak openly about malpractice and its consequences.Because the truth is: if we want the system to change, we have to be willing to understand it and talk about it out loud.Learn more about Dr. Pensa's LEAP course here.Listen to Doctors and Litigation: The L Word podcast here. Season 3 episode 4 features Dr. Nirav Patel, the radiologist who is an example of what is possible.Join Empowered Surgeons Group here.

Surgeon-writer, Dr. Cornelia Griggs joins me this week.Check out her article with Dr. Andrea Merrill, The Hidden Reason Women are Leaving Surgery: They're Being Pushed Out here.Check out her book, The Sky Was Falling here.The first physician in a family of writers, artists, and communicators, she grew up surrounded by people willing to speak openly about medicine’s vulnerabilities. A former theater kid, she found early inspiration in Atul Gawande’s Complications and the patient safety movement—so much so that she wrote her senior honors thesis on its history. After college at Harvard and medical school at Columbia, she developed a deep interest in health policy and the cultural forces shaping modern medicine. She reflects on how differently she writes when her “research hat” is on—passive voice, sterile, stripped of self—compared to the personal writing she uses to metabolize the hardest moments of her career.We talk about what it was like to be a young surgeon in New York City when COVID hit—what was meant to be the crown jewel of her training. Following intensivists on early medical Twitter, she became convinced by February that disaster was coming. What frightened her most wasn’t ventilator shortages but the prediction that hospitals would run out of staff as clinicians fell ill. She felt dismissed, even gaslit, when others minimized the threat. Yet she knew—capital B Bad was coming. When the surge hit, it felt dystopian: inadequate PPE, mounting loss, the emotional toll of watching a system strain and fracture. That experience deepened her commitment to nurturing the softer, intuitive, vulnerable parts of herself—and to helping others do the same.Cornelia also speaks candidly about women’s attrition from medicine, including her co-authored work with Dr. Andrea Merrill examining why so many are leaving. From differential treatment in the OR to referral streams quietly diverted to younger male partners, from pay disparities to the subtle “thousand paper cuts” of heightened expectations, she describes the cumulative mental load women surgeons carry. She has a unique vantage point watching how OR staff treat her husband compared to how they treat her and her female colleagues. Meanwhile, medicine offers few of the perks seen in tech and other industries—despite the time, sacrifice, and invisible labor the profession demands.We explore the erosion of public trust, the ways academic medicine has ceded ground to the wellness industry, and how rebuilding credibility will require more than data—it will require humanity. For Cornelia, the path forward means reinjecting compassion into the profession, setting boundaries, and redefining what it means to be a powerful physician in today’s world.Follow Dr. Griggs on TikTok here.Check out Dr. Frances Mei Hardin's book, Surgeon on the Edge here.Sign up for "When you Can Cut the Tension with a #10 Blade: Anxiety, Performance, and the Surgical Nervous System" here.Join us inside Empowered Surgeons Group here.

Join us inside Empowered Surgeons Group here.”It makes you feel crazy as a patient,” Tiphany Kane.As physicians, we have more influence than we realize over how patients feel and how they perceive us (and the profession in general). Whether or not we diagnose them or operate on them, patients want—and deserve—to be treated humanely.At its core, our job is simple: serve the patient.But that becomes profoundly challenging inside a dehumanizing healthcare system rife with moral injury and burnout. I get it. It’s easy for physicians to slip into a transactional mindset when the system itself is transactional.And still, both things can be true.We can humanize ourselves, humanize every patient we see, and work to change the system at the same time. In fact, I believe everyone wins when we choose this path.In this episode, you’ll hear one patient’s journey. Tiphany Kane is an entrepreneur and a medical mystery. She shares what it was like to be gaslit for years by her primary care physician, cardiologists, nephrologists, and endocrinologists. It wasn’t until she independently enrolled herself in a clinical trial that she finally received the care she had been searching for.And it wasn’t easy. Despite surgical complications and unexpected setbacks, Tiphany speaks with gratitude and deep respect for the surgical team who cared for her.Her story is a powerful example of what becomes possible when physicians make compassionate, patient-centered, service-based care their highest priority.Follow Tiphany and her medical journey on instagram here.

The Pain to Power Workshop is the foundation upon which your self-concept is built. You can't step into the next version of yourself until you heal old wounds and rewrite your past. We start this work Feb 2nd, 2026. You have access to the content until March 2nd, 2026. Sign up here.If you are catching this episode outside the window, no worries! You can still join us inside Empowered Surgeons group here.

Have you ever felt like you were on a moving sidewalk toward retirement, as if you had committed to a life path long ago and now you’re simply being carried along it? If so, you’re not alone, and you won’t want to miss this episode.This week I speak with Mark Shrime, MD, PhD - Head and Neck surgeon, researcher, and former Chief of the Harvard Program in Global Surgery - about discernment, vocation, risk, and the search for meaning in medicine. Mark talks candidly about disliking medical school, nearly quitting, and ultimately choosing ENT after spending time with a surgeon who modeled what it means to balance work and play - a theme that never stopped mattering.We explore how physicians make consequential decisions under uncertainty, how intuition can be trained, and why medicine treats vocation almost like the clergy: you choose young, never leave, and give your whole life to it. Along the way, we discuss administrative bloat, the profit motives of healthcare, the indoctrination of not listening to our inner voice, and the question of whether doctors are truly risk-averse or simply trained to be.A turning point comes with Mark’s service work on Mercy Ships, where he performed head and neck surgery in a purely service mindset. An epiphany in Monrovia - punctuated by a near-fatal car accident - clarified his path in a way that finally felt aligned rather than obligatory. Conversations in Madagascar later informed his paper Trading Bankruptcy for Health (Value Health, 2018), a study I referenced in my TEDx talk Seeing Beyond the Red Swans.We talk black swans, white swans, and red swans, and the privilege of being present with people in their deepest truths. Ultimately, we circle back to what humans crave most: to be seen, accepted, safe, and unjudged, even though safety is not incentivized in modern healthcare.We close with positive psychology, the inner judge and its saboteurs, and the uncomfortable but necessary skill of falling in love with failure, especially in surgery, where complications become harder emotionally even as skill peaks.Watch Mark's TEDx talk, Putting Purpose Over Path.Work with him and buy his book here.Follow him on instagram here.

Are you a woman surgeon who wants to retreat with us in Norway in August? Get on my calendar for an interview here.Join Empowered Surgeons Group here.In this episode, Dr. Lauren Umstattd shares her journey through otolaryngology training, a painful facial plastics fellowship experience, and the difficult decision to leave a path that no longer aligned with her values. First drawn to ENT as a medical student by its breadth and clinical complexity, Lauren enjoyed the precision of endoscopic and microscopic surgery during residency but found herself emotionally weighed down by head and neck cancer care. A rotation in facial plastic surgery changed everything, offering her clarity, creativity, and a sense of elective choice that resonated deeply.Fellowship, however, became one of the most difficult chapters of her training. Despite being a strong student, Lauren felt profoundly out of alignment with her fellowship director and increasingly isolated, questioning herself in ways she never had before. As the experience deteriorated, she began simultaneously building her future practice, ultimately making the terrifying decision to resign just ten months in, despite fears about certification and professional identity. Ultimately, she chose her hard.Lauren goes on to describe building a facial plastic surgery practice rooted in trust, transparency, and psychological safety. She discusses leveraging social media, thinking like an entrepreneur, and learning to separate the certainty required in surgery from the experimentation required in business. Central to her work is reframing perfectionism and failure, setting honest expectations with patients, and acknowledging that neither surgeons nor outcomes are ever perfect.This conversation explores what it means to design a life and practice on your own terms, build culture intentionally, and fall in love with the hard parts of the work. It’s a powerful reminder that sometimes the bravest move in surgery and life is choosing alignment over approval.Dr. Lauren Umstattd is a facial plastic surgeon and entrepreneur known for her commitment to autonomy, ethical patient communication, and psychologically safe practice culture. She is passionate about building systems that support excellence without sacrificing humanity. Follow her on instagram here and TikTok here.