Podcast appearances and mentions of rob orman

In this episode, Sam Ashoo, MD interviews Rob Orman, MD about ways to manage the trauma inflicted by the ER.Discussing Trauma in Emergency MedicinePersonal Experiences with TraumaThe Impact of SuppressionDefining Trauma and Its EffectsIntegration vs. DisintegrationDebriefing and Coping MechanismsThe Driveway DebriefNurse and Physician DynamicsReflective Solitude vs. IsolationCreating Narratives During TraumaDropping Anchor TechniqueBody-Oriented ResetsPost-Incident RitualsAddressing Lowercase t TraumasTherapy and Trauma PathwaysFor more about Rob Orman and physician coaching: https://roborman.com/

In this insightful conversation, I speak with Dr. Rob Orman, emergency physician turned physician coach, about the urgent challenges many clinicians face—including burnout, incivility, and a lack of sustainability in traditional healthcare roles. Rob is the creator and host of The Stimulus Podcast and leads Orman Physician Coaching. He holds extensive expertise as a medical educator, is a multiple award-winning speaker with a deep background in communication. He served as chief editor of EM:RAP, created the Stimulus and ERcast podcasts, and for nearly a decade hosted Essentials of Emergency Medicine, the largest single-track emergency medicine conference in the world.  The discussion touches on the structure of physician jobs, how coaching can shift individual mindsets and institutional culture, and how moving from rumination to action can be transformative. Recommended readings and tangible strategies round out this thoughtful episode for anyone rethinking their path in medicine. Key takeaways: —Recalibration is essential for physicians confronting burnout and stress. —Incivility in healthcare environments undermines physician well-being. —Coaching offers sustainable solutions for personal and professional growth. —Coaching can improve not just individual outcomes but also hospital culture. —The traditional structure of medical roles often overlooks clinician health. For further reading: —What Got You Here Won't Get you There Marshall Goldsmith —A Guide to the Good Life William Irvine —The Advice Trap Robert Bungay Stanier Book a  Coaching Discovery Session with Rob If you enjoy the show, please leave a ⭐⭐⭐⭐⭐ rating on Apple or a

Today we are talking with Dr. Rob Orman. Dr. Orman is a writer, podcaster and coach. He is an emergency medicine doc who now works with physicians to build resilience, overcome burnout, and reconnect with meaning and purpose in their work. In this conversation we discuss side gigs and the impact they can have, we talk about the incredible power of mindset, we talk about burnout and so much more. Financial Waterfalls for New Residents and Attendings: https://www.whitecoatinvestor.com/financial-waterfalls-for-new-residents-and-attendings/  Today's episode is brought to us by SoFi, the folks who help you get your money right. Paying off student debt quickly and getting your finances back on track isn't easy, but that's where SoFi can help — they have exclusive, low rates designed to help medical residents refinance student loans—and that could end up saving you thousands of dollars, helping you get out of student debt sooner. SoFi also offers the ability to lower your payments to just $100 a month* while you're still in residency. And if you're already out of residency, SoFi's got you covered there too. For more information, go to https://www.whitecoatinvestor.com/Sofi SoFi Student Loans are originated by SoFi Bank, N.A. Member FDIC. Additional terms and conditions apply. NMLS 696891. The White Coat Investor has been helping doctors with their money since 2011. Our free financial planning resource covers a variety of topics from doctor mortgage loans and refinancing medical school loans to physician disability insurance and malpractice insurance. Learn about loan refinancing or consolidation, explore new investment strategies, and discover loan programs specifically aimed at helping doctors. If you're a high-income professional and ready to get a "fair shake" on Wall Street, The White Coat Investor is for you! Main Website: https://www.whitecoatinvestor.com  YouTube: https://www.whitecoatinvestor.com/youtube  Student Loan Advice: https://studentloanadvice.com  Facebook: https://www.facebook.com/thewhitecoatinvestor  Twitter: https://twitter.com/WCInvestor  Instagram: https://www.instagram.com/thewhitecoatinvestor  Subreddit: https://www.reddit.com/r/whitecoatinvestor  Online Courses: https://whitecoatinvestor.teachable.com  Newsletter: https://www.whitecoatinvestor.com/free-monthly-newsletter 

Every physician has those patient conversations they'd rather avoid, the ones that drain energy and feel like a constant struggle. But what if there was a way to make them easier and more effective? In this episode, Dr. Rob Orman shares how scripting your least favorite conversations can help you stay in control, set boundaries with compassion, and reduce emotional fatigue.Dr. Bradley Block and Dr. Rob Orman dive into key frameworks that can help you approach difficult conversations with confidence, including the “Yes, No, Yes” method—affirming concerns, setting boundaries, and providing alternatives, how to identify the conversations that exhaust you the most (and how to script them), the mindset shift from “I have knowledge to give” to “the patient has knowledge I need to understand”, why physicians often speak in logic, while patients respond to emotion—and how to bridge the gap and techniques from hostage negotiation that can help physicians communicate more effectivelyIf you've ever found yourself dreading certain discussions, whether it's refusing antibiotics for a viral infection or setting expectations for pain management this episode gives you a roadmap to navigate them with ease and confidence.Three Actionable Takeaways:Yes, No, Yes Framework – Start with an internal ‘yes' to your values, set clear boundaries with a ‘no,' and end with a constructive ‘yes' offering alternatives that align with good medicine.Shift from Logic to Emotion – Patients often respond more to emotional validation than pure facts. Acknowledge concerns before explaining the medical reasoning.Unearth the Real Concern – Patients don't always verbalize their true fears. Use open-ended questions to uncover the question behind the question, building trust and addressing the root issue.About the Show: The Physician Guide to Doctoring covers patient interactions, burnout, career growth, personal finance, and more. If you're tired of dull medical lectures, tune in for the real-world lessons we should have learned in med school!About the Guest:Dr. Rob Orman is an emergency medicine physician, performance coach, and the producer of the Stimulus Podcast. He specializes in helping physicians navigate high-stakes environments, overcome burnout, and improve their careers. With years of experience in emergency medicine, he focuses on practical strategies for difficult patient conversations and resilience in medical practice. He co-runs his podcast and coaching business with his wife, Melissa, and offers various free resources on communication, mindset, and professional growth. Socials and Website:https://www.linkedin.com/in/rob-orman-md-78518238https://roborman.com/about/106-2/https://www.instagram.com/emergencypdx/?hl=enhttps://x.com/emergencypdxhttps://www.youtube.com/channel/UC5yWVgldIp7TFVQXAc1CltwAbout Host  – Dr. Bradley Block is a board-certified otolaryngologist at ENT and Allergy Associates in Garden City, NY. He earned his medical degree from SUNY Buffalo in 2006 and completed his residency at Georgetown University Hospital in 2011. Dr. Block specializes in adult and pediatric ENT, with interests in sinusitis and obstructive sleep apnea. He also hosts the "Physician's Guide to Doctoring" podcast, focusing on personal and professional development for physicians.Did you know…You can also be a guest on our show? Please email me at brad@physiciansguidetodoctoring.com to connect or visit www.physiciansguidetodoctoring.com to learn more about the show!Socials:@physiciansguidetodoctoring on FB@physicianguidetodoctoring on YouTube@physiciansguide on Instagram and Twitter Visit www.physiciansguidetodoctoring.com to connect, dive deeper, and keep the conversation going. Let's grow! Disclaimer:This podcast is for informational purposes only and is not a substitute for professional medical, financial, or legal advice. Always consult a qualified professional for personalized guidance.

In this special episode, Sam Ashoo MD and Rob Orman MD discuss the concept of Maladaptive Perfectionism and its application to emergency medicine.Understanding Maladaptive PerfectionismCase Example and DiscussionAdaptive vs Maladaptive PerfectionismPersonal Experiences and Legal ChallengesDealing with Negative OutcomesStrategies for Managing Perfectionism in the EDHandling Overwhelming ShiftsManaging Expectations in the EDA Soul-Crushing Day in the EDFinding Meaning in Moments of CrisisThe Importance of Meaningful WorkOperationalizing Meaning in Your ShiftThe Driveway Debrief: Transitioning from Work to HomePreparing for the Next ShiftConclusion and Next Episode TeaserFor more from Rob Orman, MD check out Orman Physician Coaching

What would you do if your job ended tomorrow? Even though you might want to say, “Take this job and shove it,” that won't help build stepping stones to your next job.In this episode, we discuss: what it's like for physician coaches who regularly work with docs in this situation, getting fired, dealing with unexpected events that shake up professional stability, planning for career disruption, the importance of networking, and finding your clinical practice N plus one.

Many of us have ideas that could make a great business. Most of the ideas, however, never see the light of day. It can feel like a big leap from physician to entrepreneur. So how do you do it? We speak with Dr. Jason Hine, the founder of SimKit, and see how he went from community emergency medicine doctor to successful business owner. In this episode, we cover how Jason started his business, accounting for the knowledge gap between clinician and entrepreneur, setting boundaries, why saying hell yes has a critical proviso, the inevitable oscillation between passion and money, and a marketing exercise that's critical to walk through before you even consider jumping in on a new product or business.

Success and happiness are often determined by where we place our focus: within ourselves or on external factors. Mastery lies in asking the right questions, and understanding the locus of control is a key part of this. Those who focus on what they can influence are generally happier and more successful. In this episode, we explore the philosophy behind the locus of control, its impact on burnout, the importance of small bets in making significant changes, and state vs. trait gratitude. Finally, we delve into practical strategies to cultivate a more resilient mindset

Non-compete clauses have plagued contracts for decades. It's been analogous to asymmetric warfare, with employers holding the upper hand. All of that may soon be a thing of the past.In this episode, we explore the Federal Trade Commission's recent ruling to ban these clauses and its implications for doctors and the healthcare industry. We'll also discuss the unexpected ways non-competes can protect smaller groups, the rise of independent contractor models, and the critical staffing issues in emergency medicine. A highlight of our discussion includes the lure and the trap of signing bonuses—what seems like a generous offer can sometimes come with subtle strings attached. Finally, we'll touch on the U.S. Senate's investigation into major staffing companies and the innovative emergence of empath units for mental health patients.

Welcome to Episode 71 of the Sustainable Clinical Medicine Podcast! In this episode, we are joined by Dr. Rob Orman, a seasoned emergency physician turned medical educator and coach. Diving into the crucial topic of burnout in the medical field and exploring the navigation of stress, overwhelm, and ultimately finding fulfillment. Join us as we uncover practical strategies for creating sustainable models of clinical medicine and prioritizing well-being in the demanding world of healthcare. Here are 3 key takeaways from this episode: Reflection & Resilience: Dr. Orman highlights the significance of slowing down to reflect on decision-making processes, documentation practices, and interactions with colleagues. Building resilience and patience in clinical practice can combat burnout and enhance overall well-being. Small Changes, Big Impact: Instead of seeking immediate and drastic changes, Dr. Orman emphasizes the power of making small, manageable adjustments and building upon them. Taking micro steps towards sustainable habits can lead to lasting improvements in work-life balance. Personal & Professional Alignment: Dr. Orman's journey showcases the importance of aligning personal passions with professional pursuits. Finding joy in your career and addressing stress through self-reflection and mindset shifts can transform your approach to clinical medicine and enhance job satisfaction. Dr. Rob Orman Bio: Rob Orman, MD spent 21 years as a community emergency physician and is a certified executive coach who works with doctors to build resilience within their medical practices, deconstructing ideas and strategies to live and work with intent. He specializes in helping doctors reverse maladaptive behaviors that might threaten their jobs and relationships. -------------- Would you like to view a transcript of this episode? Click here **** Charting Champions is a premiere, lifetime access Physician only program that is helping Physicians get home with today's work done. All the proven tools, support and community you need to create time for your life outside of medicine. Learn more at https://www.chartingcoach.ca **** Enjoying this podcast? Please share it with someone who would benefit. Also, don't forget to hit “follow” so you get all the new episodes as soon as they are released. **** Come hang out with me on Facebook or Instagram. Follow me @chartingcoach to get more practical tools to help you create sustainable clinical medicine in your life. **** Questions? Comments? Want to share how this podcast has helped you? Shoot me an email at admin@reachcareercoaching.ca. I would love to hear from you.

In this episode, Sam Ashoo, MD interviews Rob Orman, MD, founder of Orman Physician Coaching, about routine examination of our careers in emergency medicine.Understanding Career Cycles and Embracing Change The Importance of Career Reflection and Making Trades Navigating Career Satisfaction and Preventing Burnout Proactive Career Management and Reflection Strategies Exploring Career Alternatives and Rediscovering Joy in Medicine Balancing Work, Love, Play, and Health for a Satisfying Life When to Seek Coaching for Career Guidance Practical Tools for Self-Reflection and Taking Action Closing Thoughts and Resources for Emergency Physicians

Will you have enough money to retire? What does that even mean? In this pod, our guest physician financial coach, Elisa Chiang, M.D. Ph.D. breaks down Trading time for money and money for timeWorking harder vs creating valueThe FIRE (Financial Independence Retire Early) movement and why it doesn't always mean living by austerity rulesThe risk of relying solely on retirement accounts to fund your post-career lifeHer biggest financial mistakeHow identity influences spending habitsIncorporating real estate into an investment portfolioGuest Bio: Elizabeth ‘Elisa' Chiang, M.D. Ph.D. is a board-certified ophthalmologist and fellowship-trained oculoplastic surgeon who found her way into personal finance and real estate investing during her MSTP program, aspiring for FIRE long before it became mainstream. Battling burnout from her work in a hospital system, she turned to real estate as her avenue to financial independence, complemented by her newfound passion for life coaching. With active involvement in rental properties and passive investments in syndications and real estate funds, Elisa now helps others achieve financial independence while embracing life's journey. Learn more at https://www.growyourwealthymindset.com/Love medicine, but the job itself leaves a lot to be desired?I work with many docs in your shoes. To learn more about 1-on-1 coaching, start here.For full show notes of this episode and all sorts of other goodies, visit our podcast websiteWe discuss:Why a high income does not equate to wealthWorking harder vs creating valueOnce debt is gone, attention to money can dwindle Finding a place to start investing can be overwhelming and lead to inertiaHow to navigate a scarcity mindsetHow identity influences spending habitsMoney can buy time, but there's a catchElisa's biggest financial mistakesHow to decide if a real estate investment is a good (or bad) dealElisa's big-picture financial strategyReal estate investing for positive cash flowIf you only think about maxing out your retirement account, you probably won't retain the same lifestyle when you stop workingBeyond real estate investing, what are other areas for investment to produce cash flow?F.I.R.E Financial Independence Retire Early | Survival, Regular, and Fat FIREHow to figure out how much FIRE money you'll need to stop workingWill my retirement funds actually last? Rate of withdrawal and sequence of returns risk Fat FIRE | Spending more in retirement than you did while workingMentioned in this episode:4 Free Resources specifically designed to address pain points in medical practiceScripting your least favorite conversations The Driveway Debrief My 4 favorite documentation templates The quick and dirty guide to calling consultsFree Resources LinkThe Flameproof Course. Sept 10, 2024Real-time instruction with Rob Orman, MD, and Scott Weingart, MD. Specific tools and strategies for anti-burnout, career longevity, and self-mastery. From a recent Flameproof graduate, "I went from constantly dreading work and thinking of quitting to being able to enjoy shifts on a regular basis."Flameproof Course

In this episode of the Wild Health Podcast, Dr. Mike Mallin is joined by Dr. Rob Orman, an emergency physician and educator, to explore the intricacies of stress management through the lens of acceptance, awareness, recalibration, and the mindset required to effectively manage stress. Dr. Orman shares his insights into the different types of stress, the physiological and cognitive responses to stress, and introduces a multifaceted approach to coping with stress. This conversation is not only a deep dive into the science of stress but also a practical guide on how to apply these concepts in everyday life, especially for high-performing individuals. Whether discussing the impact of stress on healthcare professionals or offering techniques for recalibrating our response to stress, this episode provides valuable tools for anyone looking to manage stress more effectively. Learn more about Rob's upcoming conference at awakeandawarebend.com 

Welcome to the emDOCs.net podcast! Join us as we review our high-yield posts from our website emDOCs.net.Today on the emDOCs cast we have back Rob Orman, MD (@emergencypdx).Emergency Physician and founder of Orman Physician Coaching Host of the Stimulus PodcastLearn more at  roborman.comRob and several other amazing clinicians and educators are putting on Awake and Aware, a 3 day conference May 1-3 in Bend Oregon. A 3-day interactive workshop focusing on skills to thrive in your incredibly demanding job (and life). Taught by the leaders of emergency medicine coaching. This will be an awesome experience to let you reset that inner thermostat.To continue to make this a worthwhile podcast for you to listen to, we appreciate any feedback and comments you may have for us. Please let us know!Subscribe to the podcast on one of the many platforms below:Apple iTunesSpotifyGoogle Play

The one question that Emergency Room Doctors get more than any other is "what sorts of objects have you pilled out of people's rectums." I've known Dr. Rob Orman for several years now and he has stories galore: from the proper technique to remove rectal foreign bodies without damaging his patients, to how to keep up his bedside manner when operating on a known criminal with a horrible record. You don't want to miss this show. Listen to Rob Orman's Stimulus Podcast: https://roborman.com/stimulus-podcast/

Welcome to the emDOCs.net podcast! Join us as we review our high-yield posts from our website emDOCs.net.Today on the emDOCs cast, we have a guest piece by Rob Orman, MD.Emergency Physician and founder of Orman Physician Coaching Host of the Stimulus PodcastLearn more at  roborman.comIf you want to hear the coaching session where Brit and Rob deconstructed his shift and came up with this strategy, it's here.To continue to make this a worthwhile podcast for you to listen to, we appreciate any feedback and comments you may have for us. Please let us know!Subscribe to the podcast on one of the many platforms below:Apple iTunesSpotifyGoogle Play

Imposter syndrome robs you of confidence - and it can imperil your team, especially in a moment of crisis. Learn how to down-regulate yourself and the whole team, with host Will Smith, MD, and physician/coach Rob Orman, MD. (Pro tip: Tune in to Part 1 first to learn how to recognize that inner critic.) 

In this 2-part series, physician and coach Rob Orman, MD, explains how to deal with our inner critic so that we can be at our clinical best. He also touches on imposter syndrome and shares tips for dealing with the anxiety that sometimes comes with the territory for emergency physicians. Join host Will Smith, MD, to gain valuable insight from Dr. Orman.

Today's topic is something that applies to everyone: silencing your inner critic. While the original talk was given to an audience of medical professionals, the advice and content is applicable to all walks of life. We all have that little voice in our head that tells us we're not good enough, that we could have done better, or that we're just not measuring up. It can be exhausting and discouraging, especially in high-stress situations.   In this episode, we're joined by three experts: Scott Weingert, a performance coach for medical professionals; Ryan Cheney, a psychologist with experience working with high performers; and Rob Orman, an emergency physician and host of the popular medical podcast "ER Cast." Together, they share practical methods for coping with self-criticism.    They discuss the importance of recognizing and acknowledging your inner critic, as well as specific techniques for reframing your mindset.   Whether you're a medical professional struggling to manage the intense pressure of your job, or simply someone who wants to learn how to silence that nagging voice in your head, this episode has something for everyone. 

In this episode, Sam Ashoo, MD, talks with Rob Orman, MD, founder of Orman Physician Coaching, about longevity in emergency medicine.Personal foundation Regular check-insBecoming an expert in… Job stressLiving beneath your meansRecharging and shift workBad outcomesPhysician loungeLearning to say noSet a reminderMore at Orman Physician Coaching 

ER doc, coach, and educator Rob Orman, MD, on the process of working with and leaning into hard things.

Dr. Orman spent 21 years working in clinical community emergency medicine. In the first 10 years of his practice, he experienced three severe burnouts. Without much guidance, he thought the solution was to work harder - grit it out. Soon after his third major bout of burnout, Dr. Orman realized that his current way of life wasn't sustainable. So, he switched gears to work in medical education, and that became a salvation for him, giving him a new purpose. This led him to start his podcast, Stimulus, and spend a year getting his certification from a coaching academy. Dr. Orman is now a certified executive coach, and he dedicates his time to helping physicians develop strategies to live and work with intent, creatively solve problems, and practice self-compassion.Tune in to this episode of the Prosperous Doc® to hear our host Shane Tenny, CFP®, chat with Dr. Orman about the true meaning of grit and how physicians can still have it while being gentler with themselves.

In this episode of EMplify: Conversation, Sam Ashoo, MD talks with Rob Orman, MD, founder of Orman Physician Coaching, about career disillusionment.Career Disillusionment: What is it? How do we combat it? Should we combat it? A frog in boiling water... BurnoutTwo questions to ask yourselfHow coaching can helpThe advice trapA framework to explore your career and life goalsMore at Orman Physician Coaching. 

The pandemic hasn’t just changed how we live — it’s changed how we work, and how we feel about our jobs. One of the major ripple effects: burnout. Over the past couple years, people in all different jobs — from doctors to teachers, students to hospital workers — have found themselves exhausted and struggling, questioning if it's them or their workplaces, and if they belong in their jobs at all. Burnout can lead to serious problems — depression and insomnia, the feeling that your work, or even your life, has no meaning. It can affect job performance too, leading to mistakes that, in some cases, could cost lives. But burnout can also mark a fresh start — a breaking point that leads you onto a new path. On this episode, we look at what's fueling widespread burnout, why so many people report feeling pushed to their absolute limits, and what can be done to stop it. We talk with a psychologist about the signs of burnout and how to avoid it, a teacher who was forced to choose between his health and his profession, and a former ER doctor who coaches physicians on how to avoid that sinking feeling. Also heard on this week's episode: We talk with psychologist and burnout expert Brad Johnson about the signs of burnout, how it begins, why it's more common among women and people of color, and how to deal with it. Johnson is a clinical psychologist and a professor of psychology at the U.S. Naval Academy in Annapolis, Maryland. Teachers have always had a high burnout rate — but according to a survey from the National Education Association, that rate has reached crisis proportions. Reporter Jad Sleiman tells the story of how one Philadelphia teacher reached his limit, and was forced to choose between his career and his health. A version of this story was featured on the WHYY podcast series “Schooled.”  We hear from teenagers about what's stressing them out and how adults sometimes don't take them seriously. This piece was produced by student reporters at WHYY's Pathways to Media Careers Youth Employment project. Rob Orman spent years working as an ER doctor before burnout sent him looking for new opportunities. Now he coaches other physicians on how to avoid the same fate. He tells us about the systemic problems fueling doctors' high burnout rates, and the compromises that are needed to save America's stressed-out health care workers. We talk with Amelia Nogoski about how her PhD program drove her to the edge, and how she walked herself back. Nogoski is an associate professor and music coordinator at Western New England University. Her book is called “Burnout: The Secret to Unlocking the Stress Cycle.”

I speak with Dr. Rob Orman, emergency physician, about our shared experiences working together in the ER, processing failure, expectations of perfection and the imperative of moving towards self forgiveness.

In this episode of EMplify: Conversation, Sam Ashoo, MD and Rob Orman, MD discuss cognitive reframing.What is cognitive reframing you ask? It is a tool for dealing with a particularly difficult event. In our case, we discuss the “near miss” medical case and how it impacted a physician. Then we discuss how the use of cognitive reframing can help improve our perception of these “near miss” events in medicine. We also discuss what this tool can do for our longevity in medicine, regardless of our career choices. So take a listen. You may be surprised how this tool can be used in all aspects of your life.Rob Orman refers to a videos he created for a client for the post-shift power-down. You can find it and other helpful videos on his YouTube channel.Also, if you would like to learn more about Dr Rob Orman's coaching services, visit his home page .As always, we value your feedback. Please take our listener survey.See the episode page for more details.

In this episode of EMplify: Conversation, Sam Ashoo, MD and Rob Orman, MD discuss cognitive reframing. What is cognitive reframing you ask? It is a tool for dealing with a particularly difficult event. In our case, we discuss the “near miss” medical case and how it impacted a physician. Then we discuss how the use of cognitive reframing can help improve our perception of these “near miss” events in medicine. We also discuss what this tool can do for our longevity in medicine, regardless of our career choices. So take a listen. You may be surprised how this tool can be used in all aspects of your life. Rob Orman refers to a videos he created for a client for the post-shift power-down. You can find it and other helpful videos on his YouTube channel. Also, if you would like to learn more about Dr Rob Orman's coaching services, visit his home page . As always, we value your feedback. Please take our listener survey.

I was fortunate enough to record a podcast on Rob Orman's, Stimulus podcast on Oct 14th, 2021.  We both felt it was an important enough topic that we should post it on both his and my site.  The treatment of non-hospitalized patients suffering from COVID-19 is a hot topic and constantly changing.  In this podcast ... Read more The post REBEL Cast Ep103: Outpatient COVID-19 Therapy appeared first on REBEL EM - Emergency Medicine Blog.

We need to carry fear, but we do not need to be afraid...

 As emergency physicians, we experience a great deal of success, and failure, in our journeys. What can failure and success teach us, and how can we best use these to grow? Today on the emDocs podcast, Brit Long, MD (@long_brit) interviews Rob Orman (@emergencypdx), host of ERCast, the Stimulus Podcast, and Essentials of Emergency Medicine. The first part looked at Rob's perspectives on failure and how to learn from it. Today we look at success in EM and life. To continue to make this a worthwhile podcast for you to listen to, we appreciate any feedback and comments you may have for us. Please let us know!Subscribe to the podcast on one of the many platforms below:Apple iTunesSpotifyGoogle Play

As emergency physicians, we experience a great deal of success, and failure, in our journeys. What can failure and success teach us, and how can we best use these to grow? Today on the emDocs podcast, Brit Long, MD (@long_brit) interviews Rob Orman (@emergencypdx), host of ERCast, the Stimulus Podcast, and Essentials of Emergency Medicine. This first part will look at Rob's perspectives on failure and how to learn from it. In the second part, we will cover success in EM and life. To continue to make this a worthwhile podcast for you to listen to, we appreciate any feedback and comments you may have for us. Please let us know!Subscribe to the podcast on one of the many platforms below:Apple iTunesSpotifyGoogle Play

This is a guest podcast from Rob Orman of the Stimulus Podcast with some amazing content on breathing.

COVID-19:  Troponin, Abx, Chloroquine, X-rays, Rationing Tests, Public Health Responsibilities Rob Orman MD and Rick Pescatore DO   In this episode I speak with Dr. Rick Pescatore, Chief Physician for Preparedness for the state of Delaware and a front-line emergency physician.  While the general topic is the COVID-19 pandemic, specific issues discussed include: triage decisions, X-rays, troponin, what to do when there’s limited testing ability, antibiotics, chloroquine, viable strategies for managing homeless populations, and more.  Let’s go.   We’re in this strange time of limited testing capacity (due to insufficient swabs, testing kits, universal transport media, lab equipment, etc.)  with an exploding infection. If you are working in an area where COVID is rampant and you can only test a select population, what is the highest yield?    When you have a dearth of tests, they need to be rationed.   Patients who come in in respiratory distress and with obvious upper and lower respiratory illness need to be assumed to have COVID until proven otherwise. The decision has to move away from identifying who is at risk for deterioration or for having the disease and needs to move toward identifying who is at risk for infecting others. This is a constantly evolving process and recommendations will change.  But FOR NOW, when tests are limited, Rick recommends we use those tests to mitigate disease spread.  DO NOT TEST:  the asymptomatic or the mildly symptomatic. DO TEST:  hospitalized patients with respiratory illness, symptomatic people who are likely to put others at risk (health care workers, mass transit drivers, law enforcement officers, firefighters, EMS providers.  As emergency physicians, it’s incumbent upon us to not forget about our differential diagnosis.  We don’t want to focus so much on COVID that we miss pulmonary emboli and other life-threatening causes of respiratory distress.   Are there specific symptoms that can identify who is more likely to deteriorate?  The only sign or symptom that seems to have any discriminatory capability for severe disease is a patient complaint of shortness of breath.   Other risk possible factors:  males, elderly, diabetics.   Tent management Who should get a chest x-ray?    Have a low threshold for CXR in those with chest pain, SOB, severe cough, rhonchi, and/or rales.  We must remember, however, that the Chinese data showed that the overwhelming majority of patients had radiographic findings whether or not they had severe disease.   When should we send patients to the ED for further testing (CBC, ECG, troponin, other labs) and advanced treatment?   Lacking evidence to guide us, we rely on our gestalt to separate the sick from the not sick. If there’s any concern about myocarditis, ED evaluation is mandatory. Pneumonia severity scoring tools can be helpful to guide disposition.   Should we give antibiotics to the “not so sick” patient with infiltrate(s) on x-ray?   Yes. Azithromycin is the antibiotic of choice due to its antibacterial and immunomodulatory properties.   What about hydroxychloroquine or chloroquine?   There is limited but justifiable data showing that implementation of one of these agents may be effective at stopping viral replication. Dosing recommendations are all over the map, but many suggest a 400 mg loading dose followed by 2oo mg bid for the duration of the illness. Studies in California are looking at hydroxychloroquine for prophylaxis for providers.  These drugs have few side effects and are not at this time a limited resource.  Both azithro and chloroquine are QTc prolonging   Once a patient is triaged from the tent to the ED, what is the inflection point for admission to the hospital and what work-up should be initiated?   Many who are identified to be sick enough to come into the ED are going to require hospitalization. Labs should include:  CBC, BMP, troponin, CRP, and procalcitonin.  Troponin elevation has been found more common in non-survivors and those with critical illness CRP is one of several inflammatory markers that, when elevated, can indicate cytokine storm. This subset of patients has a prognosis of severe disease with different avenues of treatment. Procalcitonin has been used in China to help determine when antibiotics can be stopped.   What should be the disposition for homeless patients with suspected COVID who do not meet admission criteria based on their clinical severity?   These patients are going to need assistance from the public health infrastructure of the state or region. There will need to be structures (tents, buildings, etc.) dedicated to house these patients. The general public will soon recognize what we have known for ages:  the social safety net of the ED and of the hospital cannot continue to weather the strain of the social service failures that are prevalent throughout the nation.   Troponin in COVID ACC Update on Troponin and BNP March 18 Link ACC Cardiologist’s Perspective Treating COVID in China Link   Chen C, Chen C, Yan JT, Zhou N, Zhao JP, Wang DW. Analysis of myocardial injury in patients with COVID-19 and association between concomitant cardiovascular diseases and severity of COVID-19.  Zhonghua Xin Xue Guan Bing Za  Zhi. 2020 Mar 6;48(0)PMID: 32141280. Full text link (Google with translate to english)   Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, Xiang J, Wang Y, Song B, Gu X, Guan L, Wei Y, Li H, Wu X, Xu J, Tu S, Zhang Y, Chen H, Cao B. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020 Mar 11. PMID: 32171076. Full Text Link   Azithro plus Chloroquine  Gautret et al. (2020) Hydroxychloroquine and azithromycin as a treatment of  COVID‐19: results of an open‐label non‐randomized clinical trial. International Journal of  Antimicrobial Agents – In Press 17 March 2020 Full Text Link   Editor-in-Chief:  Rob Orman, MD Associate Editor: Melissa Orman, MD

The question is: how do we best mentally and physically prepare for an ED shift? Dr. Rob Orman, master educator and fellow podcaster joins Anton to discuss a few options... The post Ep 134 Shift Preparation: Pre-gaming with Rob Orman appeared first on Emergency Medicine Cases.

Listen as Drew and Andy sit down with the voice of ER Cast, Rob Orman. They discuss how Rob got into podcasting, how it has transformed his career and his favorite SuperHero. #MoreThanMedicine #Podcasting in #MedEd

A consensus summit with world experts and primary researchers focused on the question, “After a negative ED evaluation for ACS, is an expedited outpatient evaluation a safe alternative to admission?” Featuring Colin Kaide, MD, Mike Palacci, MD, Barbara Backus, MD, Erik Hess, MD, Ezra Amsterdam, MD, Douglas Van Fossen, MD, Rob Orman, MD, Mike Weinstock, MD, and Cam Berg, MD

Britt Long, MD and Rob Orman, MD discuss emergency department management of patients with complications of cirrhosis.

In this corner, former editor of EM:RAP, coproducer of EM Essentials, creator/editor in chief of ERcast, and… the coolest dude you’ve ever known! Dr. Rob Orman! (Applause, Cheering, Etc.) In the opposing corner boring, old, and tired… Your current pre/post shift routine and some of your beliefs about your first year as an attending! Welcome to a sold-out podcast that only VIP’s like you with the link have access to! You’re welcome! Listen as Rob “The Doc” Orman strikes like lightning against what you thought you knew! He masterfully dissects some of the most difficult mental obstacles to your first year as an attending! Believe the hype! Let’s get ready to rumbleeeeeee! Hangout host: Dr. Liang Liu Podcast editor: Dr. Aron Slear

In this episode, the fabulous Liz Crowe (@LizCrowe2) discusses how to approach debriefing after critical (and non critical) incidents in healthcare. We focus on the debriefing that takes place 5-7 days after an incident. For more on a "hot" debrief listen to this podcast by Ashley Liebig and Rob Orman 

The tables are turned when ERCast host and emergency medicine physician Rob Orman hijacks the show! Video and comments here: https://www.facebook.com/ZDoggMD/videos/10156013476917095/

Rob Orman is back again for another fun week where we continue his "grab bag" interview.  I need to make a quick warning that there is some language in this podcast so if you are easily offended please be warned now.  However, language is very brief and minimal at best.  This interview was done in a lot of fun and we hope you find it entertaining, too.

We just came back from SEMPA 360 and it was a blast!  But today, we have a two part interview with Rob Orman.  The first half, today's discussion, is all about patient satisfaction.  Next week, we will further our "grab bag" discussion with some other interesting questions that others wanted to hear from Rob about, but all I can say is you do not want to miss the pearls from the interview so make sure to listen to both!

In this podcast, we discussion burnout. With emergency medicine having one of the highest burnout specialties in medicine, it is crucial that we bring these conversations to the forefront. This episode features Dr. Rob Orman and Dr. Anand Swaminathan talking on the ever elusive work-life balancing act. These podcasts are a lead-up to the Essentials of Emergency Medicine preday event (May 15, 2017) co-hosted with ALiEM and EMRA: Resident Wellness Consensus Summit

Rob Orman joins the show to talk about Tamiflu. Yes, we have talked about Tamiflu in the past but that was at the beginning (episode 1 and 2) and "not the quality you now subscribe" (wait till you hear how Rob described it). While on the show Andrew and him talk about the name to their new rap group. Rob admits he use to collect smurfs as a child. They break down the study that came out after the Cochrane review saying, 'Tamiflu is good'. Finally, if this podcast doesn't get you, 'hot blooded' you might want to grab a rectal thermometer.

Rob Orman drills down on what suicidal ideation really means and how you can tell if your patient really has it.

You’re just now coming down from your nerve block high off of SCP and Tibial block goodness, but we’ve got another for you!  It’s a block that isn’t super common, but it’s got some really nice potential in the right patient. Obviously we’ve got the nerve block man, Mike Stone, on to talk about this one.  Who else would, right?!?  At the end stay tuned to hear a special announcement about an incredible course with Scott Weingart, Haney Mallemat, Rich Levitan, Andy Sloas, Anand Swaminathan, and Rob Orman. And see you next time when we talk about DVT ultrasound and whether what we’ve been teaching for several years is total crap…… Follow us:  @ultrasoundpod Learn with us:  www.ultrasoundleadershipacademy.com Register:  Yellowstone Course, DevelopingEM Cuba Course, Atlantis CME Bahamas Course FREE Introduction to Bedside Ultrasound eBook: Volume 1 Volume 2 One Minute Ultrasound Smartphone App for iOS One Minute Ultrasound Smartphone App for Android