When you watch LeBron James practice with his team, you can see that he constantly works on his skills, just like you do.

He shoots 3-pointers from half-court; you stay current on transfusion strategies in trauma. You both keep the sword sharp.

Most of LeBron’s time is spent doing this.

Most of LeBron’s time, however, is spent off the court, where he invests heavily—by some reports, around $1.5 million annually—in physical conditioning, recovery, and nutrition.

Here’s a sample of what he does, by no means exhaustive:

• Sleep: Prioritizes 8-10 hours per night, supplementing with power naps
• Nutrition: Low-sugar, high-protein diet with whole foods, lean proteins, healthy fats, plenty of water; avoids processed foods
• Training: Weightlifting, cardio, plyometrics, yoga
• Recovery: Cryotherapy, massages, cupping, compression, hyperbaric oxygen therapy, foam rolling
• Mental Conditioning: Meditation, game analysis, mental focus techniques

Being an NBA starter is taxing, just as working in medicine is.

Emergency medicine, in particular, has one of the shortest average career spans among specialties due to the physical, emotional, and psychological toll it takes.

Concrete vs abstract

Clinicians frequently devote significant time and money to refining their clinical skills, yet often de-prioritize nurturing their emotional and physical health.

And it makes sense. What you face each day at work are proximate, concrete stressors. If you don't know how to handle a medical issue, the patient will suffer, and you’ll feel inadequate in your role.

Career endurance, however, is more remote and abstract. It's not in your face every day.

It’s not that stress isn’t felt. It’s that many clinicians believe they already have the skills to handle it.

The wrong tool

The primary tool we tend to reach for in times of stress is to put our heads down and grind through—pushing, muscling, and relying on grit to get us by. I'm not even talking about burnout, just the regular demands of a workday.

We feel like we can tap into our grit indefinitely because we’re so adept at it. But the capacity to suck it up is not an infinite resource.

The short stack of medical fitness

Your job has a unique recipe: high cognitive load and physical demands.

How do you ensure that you stay game-ready in both areas?

Keep the sword sharp. Ongoing clinical education is the cornerstone of cognitive fitness. It isn't just about knowing the latest; it’s about deepening your critical thinking (1, 2)

Be uncompromising in how you invest in sleep. Many of you work jobs where sleep is suboptimal for long stretches. When you're tired, bandwidth and resilience drop and the long-term toll is real. In every house in which Melissa and I have lived, our first investment has been heavy-duty blackout blinds. They cost a few grand and stung a bit when we were fresh out of training, but they're essential in my mind. Add in the best mattress, eye masks, and perfect temperature control. If noise has ever disturbed your pre- or post-shift sleep, use earplugs. (3,4)

Maintain a baseline level of physical fitness specific to your role. Every position in medicine has unique physical demands. For example, in an emergency department shift, you may walk up to 7,000 steps, perform awkward squats while reducing a hip, and stand for long periods during resuscitations. (5, 6)

Hydrate and feed like you're in a marathon. If you think you don’t have time to eat or drink, you’re wrong. It’s a matter of pre-committing to that action and protecting it like you’d protect the time to perform a fecal disimpaction. (7,8,9)

Meditate. What is this doing in the big 5? It’s one of the most robust evidence-based tools for handling stress, staying in control at work, and reducing burnout. If you think you are bad at meditation, you will be convinced otherwise in an upcoming podcast episode. (10, 11, 12)

These are just the basics, not the full picture. So, what am I overlooking? And from this list, what are you missing? Where can you double down and crush it?

Keep on rocking,

Robbie O

P.S. I'd love to hear your thoughts on this article—just hit reply, and your message will go straight to my inbox.

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