Mark Kovacs, PhD in Physiology and Human Performance Strategist, presents a framework for treating healthcare professionals as elite performers, drawing from work with professional athletes, NASCAR drivers, and executives.

Background

• Collegiate tennis champion turned performance scientist after a misdiagnosed shoulder injury redirected him into physiology and biomechanics.
• Career focused on prevention, making individuals more resilient rather than rehabilitating the injured.

Hydration as a Performance Foundation

• Even 2% dehydration reduces cognitive performance; 80% of clinicians experience dehydration within six hours of operating.
• Generic recommendations are counterproductive; personalized protocols require testing sweat rate and composition, identical to methods used with US Open athletes.
• Competitive stress elevates core temperature, cortisol, and sweat rate while suppressing bladder function, placing OR clinicians under demands comparable to those of NASCAR drivers.

Recovery Strategies

• Caffeine Nap Protocol: Espresso followed by a 20-minute nap produces cumulative benefits greater than either alone. Stay in Stage 1 sleep, avoid REM.
• Neuromuscular Stimulation: Passive muscle contractions drive blood flow to overworked muscles, reducing soreness 20–30% per treatment with compounding benefits.
• Contrast & Compression Therapy: Heat/cold and pneumatic compression modalities, originally for DVT, are now standard athletic recovery tools applicable to clinical work.

Key Metrics for Clinicians

• VO2 Max: Enables faster recovery from on-shift physical demands.
• Strength: Unloads joint pressure, reducing soreness for professionals on their feet all day.
• Sleep: Clinicians rank among the lowest-sleeping professions; strategic napping is essential.

Mental Performance & Culture

• Mental and physical stress are physiologically inseparable. Breathwork and vagus nerve stimulation offer accessible tools for activating the parasympathetic nervous system.
• A "win journal" counters negativity bias; great culture requires top-down leadership alignment.

Building a Hospital Performance Program

• Baseline test across aerobic capacity, strength, recovery, sleep, and nutrition.
• Design simple interventions with positive incentives; "Show me the incentive, and I'll show you the behavior."
• Leadership must drive the standard; healthier employees produce better outcomes.

Bottom Line: Clinicians face physiological demands equivalent to elite athletes, yet receive none of the performance infrastructure. The same personalized, science-backed protocols used at the US Open should be standard in every hospital system.

Got thoughts, questions, or big ideas? Reach out to the team at Arena Labs.

Carrie Taylor, Vice President of Soccer Operations at USL Spokane and a pioneering female coach in men's professional soccer, presents frameworks from elite athletics that are relevant to healthcare.

Key Career Insights

• Transitioned from University of Michigan soccer and a pre-medical academic track to a pioneering coaching career.
• Determined that effective coaching prioritizes understanding individual team members rather than focusing solely on technical strategies.
• Identified a critical distinction between high performers and meta performers, noting that both groups require coaching.

Core Principles from Elite Sports

• Support Infrastructure: Professional athletes benefit from access to sports psychologists, nutritionists, sleep tracking, and real-time performance metrics. These resources are often unavailable to healthcare professionals.
• Feedback Resistance: High performers frequently resist coaching, creating particular risks in medicine where patient outcomes are at stake
• Preparation Over Correction: Effective practice preparation reduces the need for corrective intervention during performance
• Core Values: Accountability, trust, courage, and joy must drive decisions, not remain superficial statements

Practical Applications

• Monitor team members' daily motivation, preferred learning styles, and cognitive capacity.
• Implement immediate feedback mechanisms analogous to real-time performance tracking in athletics.
• Observe nonverbal communication to detect early signs of cultural dysfunction.
• Prioritize recovery as a performance strategy, as demonstrated by the extended elite careers of Christine Lilly and Tom Brady.
• Establish clear role definitions to mitigate the risk of burnout.

Central Paradox: Healthcare providers prioritize others' health while neglecting their own, sometimes to the point of hospitalization. Taylor advocates rigorously monitoring burnout alongside performance metrics and investing in personal well-being alongside professional development.

Bottom Line: Sustainable high performance requires systematic support structures, a standard in professional sports that healthcare desperately needs to adopt.

Got thoughts, questions, or big ideas? Reach out to the team at Arena Labs.

In this episode, we sit down with Diane Malaspina, Performance Coach Manager at Arena Labs, psychologist, and yoga and mindfulness teacher, who spent years working directly with healthcare providers navigating unprecedented stress during COVID-19. Her unique integration of psychology, mind-body practices, and frontline coaching experience reveals the hidden patterns that lead talented clinicians to struggle and what actually works to help them recover.

Diane walks us through the window of tolerance framework, explaining how healthcare providers cycle between hyperarousal (the inability to sleep, anxious rumination, digestive issues, and irritability) and hypoarousal (the exhaustion phase where motivation disappears and the body shuts down). While working with a University Department of Psychiatry during the pandemic, she witnessed compassion fatigue firsthand as practitioners carried patients' struggles home, unable to separate work from personal life, what she calls "the gray zone."

This isn't abstract theory. It's about what happens when brilliant problem-solvers ignore their own symptoms, believing time management will solve what's actually an energy management crisis. Diane explains how high achievers in high-demand environments develop a distorted relationship with time, constantly pushing through strain without pausing to regenerate their nervous systems.

We explore:

• The physiological markers that signal burnout before it becomes severe—and why coaches can't let clinicians skip past symptoms
• Why that "break" spent scrolling your phone in the cafeteria isn't actually a break, and what qualifies as genuine nervous system recovery
• How a surgeon working 12-hour procedures manages energy through team structure, strategic mini-breaks, and sleep optimization
• The shift from "I can't" to "what's the minimal doable step?"—and why starting with five deep breaths outside matters more than elaborate wellness programs
• How one couple reclaimed 30 minutes of sleep by co-creating bedtime goals, leading to measurable improvements in workplace focus
• Why leaders need to hear that "putting in more hours when people are depleted" doesn't produce quality outcomes—and what the alternative looks like

Diane makes the case that investing in clinician well-being isn't soft science—it's directly connected to patient outcomes, turnover, and whether healthcare providers can stay connected to their purpose. She challenges us to get curious about quality of life metrics, not just quantitative dollar analysis, and to recognize that the system can only push for so long before it hits exhaustion.

Whether you're experiencing the early signs of burnout, managing teams under relentless pressure, or trying to build a culture where breaks actually restore energy, this conversation offers evidence-based frameworks and practical tools from someone who's guided hundreds of healthcare providers back from the edge.

Have thoughts or ideas sparked by this episode? Reach out to the team at Arena Labs.

Got thoughts, questions, or big ideas? Reach out to the team at Arena Labs.

Got thoughts, questions, or big ideas? Reach out to the team at Arena Labs.