Default Mode Network vs. Task Positive Network | How our brains balance mind wandering and focused attention
ERCAST
by Rob Orman, MD
2w ago
The interplay between the Default Mode Network (DMN) and the Task Positive Network (TPN) is crucial for our cognitive and emotional health. The DMN, active during restful states and wandering mind, facilitates introspection, memory recall, and creativity, serving as a foundational element in our mental processes. On the other hand, the TPN takes charge during focused, goal-oriented tasks, enabling attention, decision-making, and problem-solving. They operate in balance - when one is active, the other quiescent and this dynamic is essential for optimal mental functioning. However, imbalances in ..read more
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Moral Injury | The crossroads of conscience
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by Rob Orman, MD
1M ago
Moral injury, a term initially used in the military context during the Vietnam War to describe the psychological trauma soldiers experienced, has become increasingly relevant in medicine. In this episode, we discuss how moral injury manifests as psychological distress when healthcare professionals' actions, or inactions, contradict their moral or ethical codes, leading to feelings of guilt, inadequacy, and a sense of betrayal. Our conversation will navigate through the history of this term, its definition, relationship with burnout, PTSD, and moral distress. We'll examine real-life scenarios w ..read more
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117. From Chaos to Control | Taming the tempest of task saturation
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by Rob Orman, MD
1M ago
There’s no getting around the surges and potential chaos of an emergency department. The good news is that these events are predictable, you know they’re going to happen, just not when. So how do you prepare and then navigate the storm once you’re in the thick of it? In today’s episode, we start with a discussion with Thom Mayer, MD exploring strategies to steel yourself for the inevitable chaos, underscoring the importance of maintaining a positive, agentic, proactive mindset. Drawing parallels to General Theodore Roosevelt Jr.'s decisive leadership on D-Day, the discussion highlights the cri ..read more
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116. Resistance | How to crack inertia
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by Rob Orman, MD
1M ago
We all have an internal drive that propels us forward, inspiring us to achieve and create. Yet, there's also an innate anti-drive, a subtle yet powerful force that holds us back. This episode delves deeply into the nature of this anti-drive. We explore the foundations of resistance, drawing insights from Stephen Pressfield's 'The War of Art' and linking it to entropy and the Second Law of Thermodynamics. We'll examine why resistance occurs, how it manifests in both our personal and professional lives, and the various ways it can be hidden, even under the guise of positivity. We'll discuss prac ..read more
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115. Zero Warning | Scott Weingart on frameworks for no-notice critical patients
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by Rob Orman, MD
1M ago
When a critical patient lands on your department's doorstep without prior notice, even the most seasoned professionals can find themselves momentarily at a loss — wondering what steps to take first and how to prioritize actions in those crucial initial seconds. What do I do first, what do I do next? What’s REALLY important in the first few seconds? In this episode, emergency intensivist and physician coach Scott Weingart breaks down how to get your mind unstuck and move into action.  Guest Bio: Scott Weingart, MD is a physician coach and emergency department intensivist from New York ..read more
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114. An Insider’s Guide to Medical Malpractice | Why the US system is so peculiar and how to navigate the morass
ERCAST
by Rob Orman, MD
1M ago
The specter of medical malpractice lawsuits looms large for many clinicians, but according to Mark Brown, MD, JD, this anxiety may be disproportionate to the actual risk. In this discussion, we explore the contrasting nature of law and medicine, the unpredictable and capricious nature of legal proceedings, the systemic elements that fuel the high number of medical malpractice lawsuits in the United States, and several practices to reduce the risk of lawsuits. Guest Bio: Mark W. Brown, M.D., J.D., holds a JD from Harvard Law School (1970), and an MD from Dartmouth Medical School (1982). His car ..read more
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113. Understanding Healthy (and Unhealthy) Relationship Dynamics
ERCAST
by Rob Orman, MD
1M ago
None of us are born with the skills to build and sustain healthy relationships. These things are learned. In this episode, our guest is Ryan Cheney, an experienced psychotherapist and behavioral leadership coach, guiding us through the intricacies of healthy and unhealthy relationship dynamics. Our conversation will explore the importance of interdependence, the negative impacts of codependency, and the nuanced practice of attunement, including how to rectify misattunements. Further, we will delve into the role of healthy boundaries in building resilience and trust, how resistance and perfecti ..read more
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Our 2024 Live Event | May 1-3. Bend, OR
ERCAST
by Rob Orman, MD
1M ago
What: Awake and Aware. Our 3-day live event When: May 1-3 2024 Where: Bend, Oregon. USA Website: Awakeandawarebend.com Early bird discount code: FULLYAWAKE24. $100 off registration. Expires Jan 31, 2024 CME: Yes! Category 1 AMA continuing medical education credit ..read more
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112. Pizza doesn’t work | An evidence-based intervention that reduced physician burnout and increased job satisfaction
ERCAST
by Rob Orman, MD
1M ago
Burnout is not a foregone conclusion. While individual efforts play a pivotal role, continually battling systemic challenges can be exhausting. In this episode, we delve into a simple and cost-effective systemic intervention that not only mitigates burnout but also enhances job satisfaction. We then discuss how you can recognize when your colleagues might be in distress, what to do about it, what to say, what not to say, and how to break through the stigma of seeking help.  Guest Bio:  Dr. Tricia James is an internist and the Director of Wellness at Providence Portland Medical Center ..read more
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110. A Strategy Mid-Shift Overwhelm | Conquer the deluge and get home on time
ERCAST
by Rob Orman, MD
1M ago
In this real-life coaching session, we walk Dr. Brit Long through building a framework to help navigate being overwhelmed during the middle part of an emergency department shift. Since this session, he has become more efficient, gotten home earlier on a consistent basis, lowered his stress level, felt less burnout, and experienced more joy in his career.  Guest Bio Brit Long is an assistant professor of emergency medicine in San Antonio, Texa, and Editor-in-Chief of Clinical Content at emcdocs.net. He is one of the most published authors in the field of emergency medicine. In addition to ..read more
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