Melinda Thacker, MD

Melinda Thacker, MD Surgeon, Coach, Speaker, Writer

12/23/2025

Gotta get my work out in and take my Pepcid this time of year.

How do you manage holiday stress?

12/23/2025

The United States spends more on healthcare than any other country, yet ranks last in health outcomes among high-income nations.

Why?

I believe one reason for this is what I call “red swan mindset”.

Red swan mindset directs clinicians to order unnecessary tests just to cover our asses.

Red swan mindset convinces hospital leaders to enact reactive policies in the name of “patient safety”.

Red swan mindset takes action in service to self-protection, not in service to helping a patient.

Fear and reactivity have shaped US healthcare, resulting in an inefficient system that dehumanizes every player at every level.

One solution to red swan mindset is what I think of as black swan mindset, and it has worked incredibly well in my surgical practice.

Black swan mindset requires presence and curiosity.

Black swan mindset is showing up undistracted and meeting patients where they are.

Black swan mindset is connecting with patients on a deeply human level.

Black swan mindset is creating psychologically safety in the OR and having the observational awareness to catch a near miss.

When I am in black swan mindset, essential policies like surgical time-outs become formalities. Because, of course, I know the patient’s name and the surgery I’m performing on her. I also know her husband’s name, what she does for work, where her kids go to school, and the temperament of her pet Maine C**n.

The black swans are the unknown unknowns; they matter most when it comes to decision making. But we cannot see black swans unless we are well-resourced, curious, and present. We cannot see black swans unless we look for them.

There is a world where we hold the white swans (known knowns) loosely, keep the red swans (known unknowns) right-sized, and make it a priority to uncover the black swans (unknown unknowns).

I believe that if we all do this, we can create a courageously human, more efficient, and safer system.

What are your thoughts? Comment below ⬇️

12/23/2025

For centuries, there was no such thing as a black swan. That was, until in 1697, when Dutch sailors spotted a black swan off the coast of Australia.

This is something I like to call “Swan Theory”. White swans are the “known knowns”, black swans the “unknown unknowns”, and red swans the “known unknowns”.

Nassim Nicholas Taleb defines a black swan as an event with three traits:
1. An outlier, or beyond normal expectations
2. Has extreme impact
3. Discovered as predictable in hindsight, meaning clues that pointed to the event are typically only found retrospectively

Events like the 2008 housing market crash, or perhaps the COVID19 global pandemic.

Christopher Voss defines a black swan as a crucial, game-changing piece of information or a hidden truth that, once uncovered, drastically shifts a negotiation’s direction, leading to a much better outcome. Finding black swans, or unknown unknowns, is so crucial to Voss’ teachings that he named his company “The Black Swan Group”.

Black swans are seemingly insignificant pieces of information, but thy have the power to change the outcome of a negotiation…and the treatment plan for a patient.

In my TEDx talk, I apply the concept of white and black swans to healthcare. I’ve learned that the most important job of a clinician is to uncover the black swans—patient-specific truths that guide decision making.

The problem is the red swan—the known unknown. These are the fears we that drive defensive medicine. Red swans create double blindness, preventing us from seeing not only the white swans we’ve accumulated over the years, but also those all-important black swans.

The solution is to recognize what’s happening, name it (“this is red swan fear”), and ground into our mission: to serve the patient—the human—in front of us.

12/22/2025

A good physician doesn’t hide behind red swans and white swans. They find the black swans.

Use link in bio to watch the whole talk.

12/22/2025

I learned about the metaphor of the “identity house” from author, Brad Stulberg, and it was a major aha moment for me. Diversification of identity is one of the core concepts I teach inside my coaching program for surgeons, Empowered Surgeons Group. Listen to my conversation with Brad using the link or wherever you get your podcasts.
surgeonsofinstagram

12/18/2025

Really, the only true statement we can make is: “I don’t know”. Everything we think we know could change on a dime.

What are your thoughts on absolute certainty? Comment below ⬇️

12/17/2025

I thought I was special. Because I graduated top of my med school class. Because I entered a competitive specialty. Because I’ve been told I have “good hands”.

Well, I’m not special. I’m no different than anyone else. And acknowledging that truth has been one of the most freeing realizations I’ve ever had.

Say it louder for the surgeons in the back 📣

Instead of making up stories, we can have brave conversations. Here’s how:1. Turn the spotlight: shift attention from th...
12/17/2025

Instead of making up stories, we can have brave conversations. Here’s how:

1. Turn the spotlight: shift attention from the story in your brain to the lived experience (yours, mine, & ours), so we can see what’s actually happening right now. “I’m noticing ______.” Or “I’m hearing_______.”

2. Loop for understanding: “Is that what you meant?” The goal of this is to arrive internally at a place where you are following the other person (“Ok, now I follow.”)

3. Don’t insert your ego’s story until you verify the intentions of the other human. Curiosity is the key.

This doesn’t take long. In fact, it saves a TON of time and sham incident reporting AND allows for safer surgeries for patients.

What are your thoughts? Comment below ⬇️

JCAHO and OSHA miss the mark on this. Surgeons who are empowered feel safe, and surgeons who feel safe perform safe surg...
12/16/2025

JCAHO and OSHA miss the mark on this. Surgeons who are empowered feel safe, and surgeons who feel safe perform safe surgery.

Your institution will not empower you. That’s your job. And it’s exactly why I created Empowered Surgeons Group.

✨Investing in this course is investing in your own sense of safety.

Comment “empowered” to join a growing group of surgeons of all specialties.

12/16/2025

We don’t request exactly what we want because we’ve been conditioned to fawn. Fawning is a trauma response - our nervous system’s unconscious attempt to keep us safe by maintaining connections with others.

I’ve been a master fawner in my career. I know how enticing it is to make decisions in service to OR staff, just to be perceived as “easy to work with” and “not high maintenance”.

✨You know where you must be rigid and where you can be flexible.
✨You can stand firm in your request from a clean, compassionate place.
✨You can cancel cases without having thoughts about it.

We just had a discussion about this inside Empowered Surgeons Group. You don’t have to go it alone. Comment “empowered” to learn how to join us.

Dr. Taleb’s concept of “anti-fragility” is an important one to understand in surgery. You can start becoming anti-fragil...
12/11/2025

Dr. Taleb’s concept of “anti-fragility” is an important one to understand in surgery. You can start becoming anti-fragile by learning how to alchemize failure into value. Join me Dec 14th at 10 am EST for “5 Ways Surgeons Fail at Failure”. Show up LIVE and get the workbook that accompanies the class. Comment “failure” to register.

“See one, do one, teach one” is cheeky and oversimplifies the skill acquisition process, but there’s a reason it’s not: ...
12/09/2025

“See one, do one, teach one” is cheeky and oversimplifies the skill acquisition process, but there’s a reason it’s not: “See one, memorize the steps, do one, teach one”. Understanding the nuance of achieving excellence is essential. You can get there faster by pre-ordering “The Way of Excellence” by today.

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Shifting paradigms, educating and motivating people, seeking truths

I am a truth seeking physician who passionately endeavors to educate my fellow humans on the science supporting consumption of nutrient dense, fiber rich, whole plant foods to promote optimum health and wellness. Inherent in this mission are components of paradigm shattering and myth busting. This does not include selling diet plans, books, supplements, or service for profit. Pure data-driven, evidence-based information sharing. Feel free to follow and geek out over the nutritional science with me.

****Please do not contact me asking for medical advice or personal health questions. For ethical and legal reasons, I cannot provide any form of personal medical advice via social media. If you would like an appointment with me, contact my office at 508-757-0330 or click the “learn more” button. Information shared on this page is not meant to be a substitute for the recommendations of your doctor.***