Heartline: Changemaking in Healthcare

What does it take to break through leadership barriers in medicine without sacrificing your authenticity?

In this inspiring episode, Dr. Andrea Austin welcomes Dr. Shannon Udovic-Constant, as she shares her journey into executive leadership, the lessons she learned navigating spaces where women remain significantly underrepresented, and why visibility, not just hard work, is essential for career advancement.

Together, Andrea and Shannon unpack the realities women physicians continue to face, from being mistaken for non-physician staff to balancing invisible labor at home while pursuing leadership opportunities. Rather than accepting these challenges as personal failures, they encourage...

What happens when a dedicated family physician hits burnout after 22 years in practice?

Dr. Rashmi Schramm opens up about her path from residency activism (securing a 15% raise for her program) through deep burnout, physical symptoms, and eventual transition to coaching, retreats, and teaching meditation and laughter yoga. The conversation covers arrival fallacy, the power of mindfulness practices rooted in her Indian heritage and Ayurveda, laughter yoga’s origins, Duke’s integrative health coaching program, and creating safe spaces for women physicians through retreats.

You’ll hear how they:

What happens when we stop treating hospitals like factories and start recognizing them as complex systems filled with uncertainty, competing priorities, and deeply human experiences?

In this thought-provoking episode, Dr. Andrea Austin sits down with John D'Alesandro to discuss the realities of improving healthcare from an operational perspective. Drawing from decades of experience in manufacturing and healthcare systems, John shares why traditional dashboards often fail to predict problems, how organizations can learn to identify early warning signals, and why building a culture of action matters more than simply completing improvement projects.

Together, they tackle some...

In Part 2 of a two-part episode, Dr. Rob Orman joins Dr. Andrea Austin to discuss the profound changes in emergency medicine, the importance of intentional joy, and powerful coaching frameworks that help physicians navigate reactivity and complexity. Rob shares a powerful passage from his book Supernormal about the Drama Triangle, discusses career ownership versus renting, and offers insights on redesigning medical education with mindfulness and awareness at the center.

This episode is filled with immediately applicable tools for clinicians, leaders, and anyone seeking to create space in high-stakes moments.

They discussed:

What happens when a lifelong emergency physician steps back from clinical practice and dedicates himself to helping other doctors navigate the impossible job of medicine?

 In Part 1 of a two-part episode, Dr. Rob Orman joins Dr. Andrea Austin to share his remarkable path, from documenting mass casualty events to becoming a technical advisor for the hit HBO series The Pit, and ultimately building a coaching practice that helps physicians create meaningful change in their behavior and careers.

Together they discuss the importance of awareness, the space between stimulus and response, cognitive empathy, and why art a...

Healthcare is filled with great ideas, promising technologies, and passionate clinicians, but why do so many innovation efforts fail?

In this episode, Dale Ellicott joins Dr. Andrea Austin to explore what it really takes to create sustainable change in healthcare. From his early experiences introducing groundbreaking rehabilitation technologies to his current work at Rely Health, Dale shares lessons about resistance to change, organizational alignment, and the importance of putting patients first.

Together, they discuss the realities of value-based care, the challenges clinicians face when navigating fragmented healthcare systems, and the growing role of AI in...

What does it take to drive meaningful change in healthcare when systems feel broken and institutional betrayal runs deep?

Dr. Jessica Bunin, a retired Army Colonel with deployments to Iraq and Afghanistan, joins Dr. Andrea Austin to discuss her remarkable journey from psychiatrist to critical care physician and senior academic leader. Through compelling stories; including dramatically reducing ICU central line infections by empowering unexpected team members, Jessica reveals how shifting from “extreme ownership” to true team-building, practicing moral courage, and mastering civil discourse can rebuild trust and create healthier healthcare cultures.

The conversation explores self-awareness as t...

What if the biggest threat to healthcare isn’t just burnout, but the belief that suffering is simply part of the job?

In this deeply validating and practical conversation, Dr. Andrea Austin welcomes Dr. Sarah Smith, to unpack the hidden habits and systemic pressures that keep clinicians trapped in unsustainable work patterns. Dr. Smith shares her personal journey of spending years staying late after clinic, working evenings and weekends, and feeling crushed by the endless demands of medicine. What began as frustration with change initiatives eventually became a transformative realization: sustainability in medicine required changing not just th...

What happens when excellence makes others uncomfortable?

In this deeply personal solo episode, Dr. Andrea Austin introduces the concept of Tall Poppy Syndrome, the tendency for high achievers to be criticized, diminished, or excluded simply because they stand out. Drawing from her own experiences and the stories of coaching clients, she explores how this dynamic often shows up in healthcare organizations, leadership structures, and academic medicine.

Dr. Austin unpacks the connection between tall poppy syndrome and gaslighting, the emotional impact of professional rejection, and the difficult process of discerning when to fight for accountability versus...

What happens when the medications and supplies clinicians rely on simply aren’t there, or worse, aren’t what they claim to be?

In this eye-opening episode, Dr. Andrea Austin sits down with Tony Paquin as he shares his journey from technology entrepreneur to healthcare supply chain disruptor, revealing the complex and fragile systems behind the delivery of drugs and medical supplies. From saline shortages caused by hurricanes to the global dependence on manufacturing in China and India, Tony explains why the current system is more vulnerable than most clinicians realize.

Dr. Austin and Tony expl...

What happens when big business runs healthcare and clinicians are pushed out of decision-making? In this powerful conversation, Dr. Harry Severance shares decades of clinical and educational experience to diagnose the root causes of our workforce crisis: moral injury, profit-over-patient priorities, and the exodus of burned-out physicians and nurses.

Dr. Severance and Dr. Austin explore multi-tiered healthcare solutions, the unsustainability of the current U.S. system, barriers like the Stark Law, the growing unionization movement, and practical paths for clinicians to reclaim agency, both top-down (seats at the C-suite table) and bottom-up (advocacy and collective action).

What if medicine's ancient rituals could evolve to heal the modern physician's soul, turning burnout into a blueprint for resilient leadership?

In this episode, Dr. Andrea Austin speaks with Dr. Venktesh Ramnath about his journey from ICU conflicts and existential doubt to pioneering the Health Architect model. Venktesh recounts early career frictions like coding audits and rigid communication clashing with rural teams, that led to his 2015 rock bottom, and how embracing cognitive science, myths, and practical rituals helped him redesign his path. The conversation unpacks leadership as a learnable skill, the need to embed financial literacy and...

What does it actually mean to partner well, especially as a woman in medicine?

In this Valentine’s Day episode of Heartline: Changemaking in Healthcare, Dr. Andrea Austin shares a short chapter from her book on partnering well after divorce. She reflects on boundaries, money, self-worth, and building a healthy, lasting relationship as a woman in medicine.

Drawing from personal experience, Andrea explores how insecurity and self-sabotage can show up in relationships, why liking your partner matters as much as loving them, and how true partnership supports growth without self-erasure. 

This episode offers pra...

What happens when medical training, perfectionism, and codependency collide with marriage at a young age?

In this solo episode, Dr. Andrea Austin reads from her book and reflects on her early marriage and divorce during medical school. With honesty and vulnerability, she explores how caretaking tendencies, cultural expectations, and the “achievement treadmill” contributed to a codependent relationship, and how choosing herself became a turning point toward healing.

Andrea shares how compartmentalization and grit can keep physicians stuck in unhealthy situations, why vulnerability and trusted friendships matter, and how resilience is built not by enduring harm, but...

How can healthcare professionals transform burnout and trauma into a revitalized life and practice?

In this special episode of Heartline: Changemaking in Healthcare, Dr. Andrea Austin reads from her book Revitalized, focusing on the chapter "The Revitalization." She reflects on her own soul-level burnout at the end of the pandemic, sharing a formula for change: inflection point + inner work + clarity = revitalization. Drawing from personal experiences and expert insights, she emphasizes embracing the past's pain as part of growth, avoiding trauma loops, and intentionally "doing the work" for self-improvement.

You'll hear how to:

Why do so many healthcare providers still view obesity as a lifestyle choice rather than a complex chronic disease—and how can we change that?

In this Echo Episode, Dr. Andrea Austin interviews Dr. Katherine Saunders about her journey from pre-med influences to pioneering obesity medicine at Weill Cornell and co-founding FlyteHealth. They explore obesity's scientific underpinnings, the impact of weight bias, practical advice for EM physicians in brief encounters, common weight-promoting medications, the value of bariatric surgery, and emerging tools like genetic testing and AI-driven algorithms. Katherine emphasizes empathy, permission-based discussions, and multidisciplinary approaches to treat ob...

What happens when the adrenaline of emergency medicine meets the high personal cost of shift work and family demands?

In this Echo Episode, Dr. Andrea Austin talks with Dr. Miranda Phillips about her transition from full-time trauma center EM to a life of financial freedom and wellness. Inspired by a mission trip to Guatemala at age 16, Miranda pursued medicine to make a profound impact. She reflects on loving EM's wide scope but leaving due to burnout, single parenthood challenges, and value misalignments. Discover how she built passive income surpassing her salary, healed through lifestyle medicine, and now...

What draws someone with a big heart and endless curiosity into the narrowing path of medicine, and how do they reclaim their multifaceted self amid burnout and systemic challenges?

In this Echo Episode, Dr. Andrea Austin talks with Dr. Amanda River about her unconventional journey in emergency medicine, from medical school friendships to leading a cannabis clinic and pursuing lifestyle medicine. Amanda reflects on her sister's Ewing sarcoma diagnosis that sparked her interest in medicine, the sacrifices of medical training, and the pride and frustrations of EM practice. They discuss the pathology of long hours, sleep deprivation...

In Part 2 of this two-part Echo Episode, Dr. Andrea Austin and Dr. Mehrdad Soleimani picks up right where they  left off: two emergency physicians who actually like coming to work, unpacking the systemic forces that are burning everyone else out.

 Dr. Mehrdad explains why he co-founded NeoMd Spa.  It started with one vial of Botox and a refusal to be a 60-year-old shift-worker, how physicians surrendered control of their profession to corporations, and why financial wellness is the missing pillar no one talks about. Dr. Andrea and  Dr. Mehrdad wrestle with the death of the democratic group, the...

What does a man raised in a country where women are legally second-class citizens become one of the strongest male allies in American medicine?

In Part 1 of this two-part Echo Episode, Dr. Mehrdad  Soleimani pulls back the curtain on his improbable journey: fleeing Iran at 16, putting himself through nursing school as a first-generation immigrant, defending his female nursing colleagues from an abusive surgeon and then deciding that very night to become a doctor, switching specialties mid-residency, and ultimately landing in emergency medicine, where he now champions wellness, debriefing, and the “human factor.”

Mehrdad and Andrea explo...

What happens when your childhood calling collides with a system that limits your capacity to live it out?

In this Echo Episode, Dr. Maria Sturchler shares her extraordinary journey from first-generation college student to educator to medical student, years after being told she “wouldn’t make it” in medicine. Now double board-certified in Emergency Medicine and Palliative Care, Maria reveals how serendipity, mentorship, and resilience brought her back to her original dream on her own terms.

She and Andrea unpack the realities pushing talented clinicians out of traditional EM practice: night shifts, moral injury, violence in the...

What happens when you combine a lifetime of service, leadership, and a deep desire to uplift others?
In this inspiring episode, Dr. Andrea Austin welcomes Paula Drivas, as she shares how her changemaking story started at age 13 as a candy striper in Queens and how a simple request to transfer to the emergency department shaped her life’s purpose. She walks listeners through an expansive 33-year career spanning emergency medicine, internal medicine, orthopedics, urgent care, academia, and leadership, culminating in her transition into coaching and medical administration.

This conversation honors the evolution of medicine over three de...

What happens when compassion, strength, and military medicine collide?

In this Echo Episode, Dr. Andrea Austin speaks with Dr. Kat Landa, a Navy emergency physician whose career has taken her from a nontraditional path in medical school to a groundbreaking role as the first female battalion doctor assigned to a Marine Corps artillery unit.

Kat recounts her childhood working in nursing homes, discovering medicine through geriatrics, and initially matching into family medicine before realizing her passion for emergency medicine. Her story takes a dramatic turn when she is unexpectedly assigned to 29 Palms as the first...

How do we solve one of healthcare’s biggest crises—the workforce shortage—while making opportunity more equitable?

In this enlightening episode, Dr. Andrea Austin interviews Van Ton-Quinlivan, founder and CEO of Futuro Health and a key voice in reimagining workforce development. Van shares her powerful personal story—from refugee beginnings to shaping California’s healthcare education strategy—and the values that fuel her changemaking leadership: courage, equity, and collaboration.

Together, Andrea and Van explore:

What happens when a simple act of initiative in the OR sparks a lifelong pursuit of conflict resolution and systemic change in medicine?

In this inspiring episode, Dr. Andrea Austin chats with Dr. Lee Sharma about her path from private practice frustrations to earning a master's in conflict resolution amid burnout doubts. Lee recounts her "aha" moment assisting in a delayed C-section, realizing small actions foster teamwork and belonging. She discusses overcoming conflict avoidance, the emotional "bank account" in healthcare relationships, and scripting responses to personal attacks. Now in her 24-year solo practice and a health policy...

How can podcasting transform the way we deliver health information to patients and providers?

In this episode, Dr. Andrea Austin speaks with Dan Kendall, as he recounts his path from a sales career at Siemens to launching Digital Health Today in 2016, inspired by his family’s experience with multiple sclerosis and his daughter’s type 1 diabetes diagnosis. He discusses the power of podcasting to fill gaps in patient education, combat misinformation, and create human-centered content. From launching the Health Podcast Summit to developing Health Unmuted miniseries, Dan emphasizes serving niche audiences with authentic, trustworthy stories. The conversation expl...

Can any physician pivot to open a ketamine clinic, and what does it take to do it safely?

In this Echo Episode, Dr. Andrea Austin continues her conversation with Dr. Kim Chan Ko, about common questions on ketamine infusions for mood disorders and chronic pain. As an ophthalmologist turned creative director for her emergency physician husband's clinic, Kim shares insights on transitioning careers, required training, and ethical considerations. She discusses building a patient-centered practice, managing risks like emergencies and addiction, and navigating business challenges while prioritizing family and values.

You’ll hear how they:

What happens when burnout pushes physicians toward innovative, autonomous careers?

In this Echo Episode, Dr. Andrea Austin continues her conversation with Dr. Kim Chan Co,  to speak about her journey from ophthalmology to launching Reset Ketamine in Palm Springs. Kim discusses supporting her husband Sam's shift from ER medicine to ketamine infusions, the clinic's focus on treatment-resistant depression, PTSD, anxiety, and chronic pain, and the business challenges of starting a private practice. She emphasizes intentional use of ketamine, collaborative care, and the importance of "set and setting" to minimize risks like emergence phenomena or addiction.

Y...

What happens when the “perfect” medical specialty no longer fits, and you dare to forge a new path?

In this Echo Episode, Dr. Andrea Austin sits down with Dr. Kim Chan Ko, a former academic ophthalmologist and co-founder of Ketamine Startup, to explore her transition from repairing eyes to building a ketamine infusion clinic and teaching other physicians to do the same. Kim opens up about the challenges of practicing at a high-pressure Level 1 trauma center, the emotional weight of patient care, and the struggle to reconcile her identity as an ophthalmologist with her need for crea...

How can emergency physicians thrive in a broken system while staying true to themselves? 

In part two of this Echo Episode, Dr. Andrea Austin and Dr. Leslie Crawford explores sustainable solutions for physician well-being and systemic change in healthcare. Leslie shares insights from her journey as an emergency physician, reflecting on the toll of circadian rhythm disruptions, the limitations of quick-fix administrative solutions, and the power of personal practices like meditation and fitness. From navigating burnout to embracing compassion over judgment, this episode offers practical strategies for physicians and system leaders alike.

You’ll hear how...

How can emergency physicians thrive amidst chaos and stress?

 In this Echo Episode, Dr. Andrea Austin reconnects with Dr. Leslie Crawford, a fellow residency alum, board-certified emergency physician, and creator of the Stress Relief Survival Guide. Dr.  Koenig shares her story of navigating COVID exposure, military service, and the demands of emergency medicine while raising a family. She discusses her transition to mindfulness, the power of heart rate variability (HRV) as a vital sign, and her journey to becoming a meditation teacher. From her "battery technique" for grounding thoughts to embracing meditation as a tool for neuroplasticity, Dr...

What happens when insurance companies and emergency physicians clash over fair payment, leaving patients caught in the middle? 

In this Echo Episode, part two of a two-part series, Dr. Andrea Austin talks with Dr. Jillian Schmitz about the pressing challenges in emergency medicine today.

Dr. Schmitz explains the intricacies of surprise billing, where out-of-network emergency care leads to unexpected patient costs, and the No Surprises Act’s intent to protect patients by removing them from billing disputes. She highlights the implementation challenges, including insurance companies’ failure to follow regulations, skyrocketing arbitration fees, and delays in payme...

What does it take to lead emergency medicine through unprecedented challenges like workforce shortages and systemic burnout?

In this Heartline Echo Episode, Dr. Andrea Austin sits down with Dr. Gillian Schmitz to explore her career trajectory, from civilian roles in military medicine to becoming ACEP's past president. Gillian reflects on her path, inspired by her father's military service, and how she balanced family life with a demanding career. They discuss the hidden opportunities in government jobs like those at the VA or Uniformed Services University, the resilience of EM physicians, and the impact of events like the...

What happens when the demands of academic emergency medicine collide with personal health and family priorities? 

In this Heartline Echo Episode, Dr. Andrea Austin speaks with Dr. Shannon McNamara about her transition from simulation director and ED physician to urgent care provider amid burnout, moral injury, and the pandemic.

Shannon recounts her nomadic upbringing, love for emergency medicine's complexity, and challenges in dysfunctional systems—including chronic illness, night shifts, and institutional politics. She discusses stepping away from academics, embracing urgent care for autonomy and balance, and applying simulation principles like huddles and debriefs to real-world tea...

What does it take to break free from financial stress and become a changemaker in healthcare? 

In this episode, Dr. Andrea Austin connects with Michael Swartz, a fee-only financial planner and coach who specializes in guiding physicians from residency to retirement. Drawing from his work at Schwartz Financial Planning, and his Health and Wealthness podcast, Michael offers a roadmap for physicians to navigate financial challenges and align their careers with their purpose.

They explore how the psychological weight of student loan debt can drive overwork and burnout, with Michael sharing strategies to reframe debt as a...

What does it take to lead change in healthcare’s most challenging environments? In this episode, Dr. Andrea Austin connects with Stephen Berkeley, a healthcare administrator turned change facilitator, and Anne Boland, a coaching psychologist, to explore how leadership, self-awareness, and curiosity can reshape healthcare systems.

Stephen shares his 35-year journey in healthcare administration, from Australia to India, and how a shift from self-focused to service-oriented leadership transformed his approach. Anne reflects on her privilege of coaching leaders who turn dysfunctional teams into thriving ones, emphasizing the power of listening and collaboration. 

Together, they...

Ever wonder why healthcare policy feels like a maze? Or how one doctor can spark systemic change? In this episode of Heartline: Changemaking in Healthcare, Dr. Andrea Austin talks with Dr. Scott Pasichow, an assistant professor of emergency medicine at Rutgers New Jersey Medical School and a passionate advocate for equity and reform.

Scott’s advocacy journey began with a personal realization: the inequities in family leave policies for residents. His push for fairer policies led to incremental changes at the ACGME and ABEM, ensuring better support for new parents. From testifying on EMS bills to...

Healthcare’s broken system hurts patients and physicians, but collective action can heal it. In this episode of Heartline: Changemaking in Healthcare, I sit down with Kim Downey, a physical therapist, three-time cancer survivor, and Community Ambassador for Medicine Forward and the Dr. Lorna Breen Heroes Foundation. Kim shares her transformative journey—facing thyroid and breast cancer, multiple surgeries, and the loss of her radiation oncologist to suicide—which sparked her mission to found Stand Up for Doctors. She discusses how gratitude, like thank-you notes, fosters connection, and how patients can advocate for physicians to improve care. Kim highlights the ne...

Burnout and trauma can feel like dead ends, but what if they’re inflection points for growth? In this episode of Heartline: Changemaking in Healthcare, I, Dr. Andrea Austin, share a deeply personal chapter from my book Revitalized, reflecting on my recovery from soul-level burnout during the pandemic. Drawing on lessons from therapy, coaching, and vulnerability, I explore the power of “and”—embracing pain while finding joy. I discuss top-down (e.g., CBT) and bottom-up (e.g., EMDR, somatic) therapies, along with the role of coaching for future-focused growth. Inspired by Dr. Lorna Breen’s story, I advocate for stigma-fre...

Burnout doesn’t have to be the only option in medicine. 

In this conversation, Dr. Diane Shannon shares her personal journey through burnout and how she found her way through. 

We explore the small, yet impactful changes that can completely transform a physician’s career—whether it’s learning to set boundaries or recognizing the trauma and moral injury that so often go unspoken in our profession.

I’m excited to dive into how Dr. Shannon has been coaching and empowering other physicians, especially women physicians, to overcome the pressures of perfectionism, manage their emotio...