Ercast

What does it mean to act like a true professional? I’m not sure it’s been fully fleshed out in medicine but I’ve met those who are exemplars of it. This pod is a conversation with my partner in hundreds of critical resuscitations, Ben Peery, MD. We talk about wins, losses, lessons learned and, even more than that, I get to introduce you to someone who, for me, was a role model in how to carry oneself as a physician. Guest Bio: Ben Peery, MD is a 20-year veteran of the emergency department, spending the bulk of that time working in a rural hospital. A former SWAT team member and tactical medicine expert, he is now the host of The Grit Podcast with Ben Peery which you can find on Spotify, iTunes, and all the rest. Ben’s show is conversations “with colleagues in medicine, law enforcement, EMS, and anyone else who has been in the sh*t. By sharing stories and insights we hope to offload mental trauma.”ººººººººººººººººººººººººººººººººººAwake and Aware | Our 2024 Live EventJoin us at Awake and Aware 2024, a

An inside look at what it takes to launch a ketamine clinic including first steps, navigating hurdles, potential pitfalls, which patients benefit from ketamine, and an exhortation about why you should (and shouldn’t) go into this type of business. Guest Bio: Dr. Samuel Ko is a Board Certified Emergency Physician and medical director of Reset Ketamine in Palm Springs, California. In addition to his medical practice, Dr. Ko is Co-Creator of an online course - Ketamine StartUp - which teaches other physicians how to start their own ketamine clinic.  During his free time, he practices yoga, meditation, reads voraciously, and relaxes with his amazing wife, daughter, and four-legged son. Find Sam on the Insta and Facebook.Here is the link mentioned in this episode with some ketamine clinic startup SWAG (the ultimate checklist and business plan template) from Sam Ko for Stimulus listeners. ººººººººººººººººººººººººººººººººººAwake and Aware | Our 2024 Live EventJoin us at Awake and Aware 2024, a transf

When you are at the lowest of lows after a devastating case, how do you recover in real-time? It’s certainly not easy and it takes a clear plan of action to do it well. In this episode, pediatric hospitalist Sarangan Uthayalingam walks us through a difficult case where nothing was working. He felt frozen in inaction and the patient, a newborn, did not survive. Immediately afterward, he was in a deep emotional hole, profoundly self-critical, and still had his entire shift in front of him with other patients to care for. What happened next was quite extraordinary - a reset, recalibration, and reframing of intent and mental state so that when the next critical infant came in (which they did in short order) he was not only up to the task but a better clinician. Sarangan breaks down exactly how he did this in granular detail.Much of the discussion springboards off of Stimulus episode 65ººººººººººººººººººººººººººººººººººAwake and Aware | Our 2024 Live EventJoin us at Awake and Aware 2024, a transformative 3-

Have you ever had a situation where afterward you repeatedly questioned the choice you made at the time? You chewed on it, perseverated on it, kept coming back to it? If you are a clinician, there is an amplifier to this because someone else’s life is also involved - the patient’s. You worry about their health, you worry about whether they or their family may sue you - you worry worry worry. I think most of us have been there to varying degrees. In this episode, we will discuss one strategy to manage these fears:  the letter to your future self.ººººººººººººººººººººººººººººººººººAwake and Aware | Our 2024 Live EventJoin us at Awake and Aware 2024, a transformative 3-day workshop from May 1st to 3rd in Bend, Oregon. Focusing on interactive experiences, this event offers a unique opportunity to reset, reflect, and connect with like-minded individuals. Limited slots.Website: Awakeandawarebend.comEarly bird discount code: FULLYAWAKE24. $100 off registration. Expires Jan 31, 2024CME? Yes! This is a CME event

Medical Ethicist Abbott, MD walks us through her perspectives on myriad ethical quandaries including:  How to approach discordance between a patient's written wishes and a family member who says do the opposite, the ethics of operating on demented patients who have an acute life threatening critical illness, a case of a young man with an unsurvivable brain bleed and whether or not to extubate him before the family enters the resus room, strategies to skillfully guide families through withdrawal of life support, and the real consequences of restrictive hospital visitation policies.Guest Bio: Dr. Jean Abbott is a medical ethicist and faculty at the Center for Bioethics and Humanities and Core Faculty, Master of Science in Palliative Care, University of Colorado Health Sciences Center. She is also Professor Emerita University of Colorado School of Medicine, and 30 year veteran of the emergency department.  Not part of her CV but germane to this show...she was my attending when I was a resident in the 1

There’s no denying that mistakes happen in medicine. When they do, what’s the next step? Business as usual is to deny and defend. Not only is this an adversarial and destructive process, it is also a lost opportunity to learn (and for the patient/family to fully understand what happened). In this episode, we explore a novel approach that shifts thinking from ‘risk management’ to ‘patient management’, which some argue is profoundly better for all parties involved in a medical error- clinicians, patients, and systems. Guest Bio: Peter Smulowitz MD is an expert in health policy and author of Disclosure, apology, and offer programs: stakeholders' views of barriers to and strategies for broad implementation.  He currently serves as Chief Medical Officer, Milford Regional Medical Center and is an Associate Professor of emergency medicine, University of Massachusetts Medical School.ººººººººººººººººººººººººººººººººººAwake and Aware | Our 2024 Live EventJoin us at Awake and Aware 2024, a transformative 3-d

Sleep expert Mike Stone, MD joins us for a conversation about how to sleep well (and strategies to do it poorly!)  We cover: how sleep cleans your brain, alcohol, caffeine, a pragmatic approach to wearables, light exposure, the villainy of devices before bed, cannabinoids, heat, room temp, and night shifts. Guest Bio: Dr. Mike Stone has been in medical practice for almost 20 years, and currently serves as the Chief Education Officer at Wild Health. Dr. Stone has held academic appointments at Harvard Medical School and UCSF, and has received multiple national awards for education, innovation, and leadership in medicine. He has spent the bulk of his career focusing on educating students, trainees, and colleagues. Mike is obsessed with optimal health and peak performance, with a deep interest in the effects of lifestyle interventions to improve longevity and cognitive function. He is currently focused on knowledge translation for healthcare practitioners, striving to empower practitioners with practica

None of us are immune from the Fundamental Attribution Error - chalking up the behavior of others to their character rather than the situation in which they find themselves. In this episode, we tease out the details of this common bias, its negative effects, and several strategies to address and work through it. ººººººººººººººººººººººººººººººººººAwake and Aware | Our 2024 Live EventJoin us at Awake and Aware 2024, a transformative 3-day workshop from May 1st to 3rd in Bend, Oregon. Focusing on interactive experiences, this event offers a unique opportunity to reset, reflect, and connect with like-minded individuals. Limited slots.Website: Awakeandawarebend.comEarly bird discount code: FULLYAWAKE24. $100 off registration. Expires Jan 31, 2024CME? Yes! This is a CME event ººººººººººººººººººººººººººººººººººThe Flameproof Course | Self-mastery and anti-burnoutThis 6 month, bi-weekly course will make you so burnout-resistant that when they tell you to see 5 patients an hour with only a rusty spoon in your po

Habit change doesn’t have to be grand, spectacular, or a massive shift all at once. In fact, it may be better to start small, tiny, you might say. In this episode, Scott Weingart and I break down the methodology from BJ Fogg’s Tiny Habits and give real world examples as to how it works (and might not work). Tiny Habits was the selection for our most recent book club. We host these every few months and (free) tickets are available only to those on the mailing list.   As you’ll hear us talk about in this pod episode, the discussion amongst the community is by far the best part of the book clubs. Our next book will be The Art of Learning by Josh Watizkin. ººººººººººººººººººººººººººººººººººAwake and Aware | Our 2024 Live EventJoin us at Awake and Aware 2024, a transformative 3-day workshop from May 1st to 3rd in Bend, Oregon. Focusing on interactive experiences, this event offers a unique opportunity to reset, reflect, and connect with like-minded individuals. Limited slots.Website: Awakeandawareb

Chances are that you have a robust inner critic. You might even believe that self-criticism and castigation are the only ways to excel. As a high-level performer, you are not alone. In this episode, we break down the nature of inner criticism and several ways to manage it.ººººººººººººººººººººººººººººººººººAwake and Aware | Our 2024 Live EventJoin us at Awake and Aware 2024, a transformative 3-day workshop from May 1st to 3rd in Bend, Oregon. Focusing on interactive experiences, this event offers a unique opportunity to reset, reflect, and connect with like-minded individuals. Limited slots.Website: Awakeandawarebend.comEarly bird discount code: FULLYAWAKE24. $100 off registration. Expires Jan 31, 2024CME? Yes! This is a CME event ººººººººººººººººººººººººººººººººººThe Flameproof Course | Self-mastery and anti-burnoutThis 6 month, bi-weekly course will make you so burnout-resistant that when they tell you to see 5 patients an hour with only a rusty spoon in your pocket and a unit clerk at your side, you will j

Finding time to debrief challenging cases can feel nearly impossible amidst the tumult and task saturation of medical practice. The reality, however, is that it’s a necessity, not a nicety.  In this episode, emergency physician Stuart Rose and rescue specialist Ashley Liebig discuss two different approaches to immediate debriefs: INFO and the hot offload.  Guest Bios: Stuart Rose is an emergency physician practicing in Calgary, Canada and lead author of the seminal debriefing paper, Charge nurse facilitated clinical debriefing in the emergency department. Ashley Liebig is a HEMS Flight Nurse and Helicopter Rescue Specialist with Austin Travis County STAR Flight. Prior to her flight and rescue career, Ashley served in the US Army as a combat medic with the 101st Airborne Division. She is known around the world as a teacher of managing the stress responseººººººººººººººººººººººººººººººººººAwake and Aware | Our 2024 Live EventJoin us at Awake and Aware 2024, a transformative 3-day worksh

It doesn’t look like performance metrics are going away any time soon. So why not make them a feature instead of a bug? We discuss: reframing audits so they help elevate and don't feel punitive, why we're not good at self-assessment, creating clinician-relevant (and friendly) metrics, the best way to present metrics to providers, 3 high-yield metrics that make a difference. Guest Bio: Shawn Dowling MD is the medical director of The Physician Learning Program at the University of Calgary and Clinical Content Lead at the Calgary Zone Emergency Department.   ººººººººººººººººººººººººººººººººººAwake and Aware | Our 2024 Live EventJoin us at Awake and Aware 2024, a transformative 3-day workshop from May 1st to 3rd in Bend, Oregon. Focusing on interactive experiences, this event offers a unique opportunity to reset, reflect, and connect with like-minded individuals. Limited slots.Website: Awakeandawarebend.comEarly bird discount code: FULLYAWAKE24. $100 off registration. Expires Jan 31, 2024CME? Yes

There is no doubt that handing over care of a patient to another clinician is potentially fraught with peril. After all, it’s in the transitional moments when error is most likely to occur. But there’s a balance to strike here because there are also myriad upsides to signouts for both the patient and clinician. In this episode, Mike Weinstock, MD breaks down the arguments in favor of signouts, how to do them well, the big fat hairy signout pitfall,  and why signouts might just be a key ingredient to career longevity and patient safety.Guest Bio: Mike Weinstock, MD  is Professor of Emergency Medicine, adjunct in the Department of Emergency Medicine of The Ohio State University’s College of Medicine, and director of research and CME at the Adena Hospital.He has lectured nationally and internationally on medical topics and patient safety issues and is the executive editor for UC RAP, contributed to ERcast and Risk Management Monthly, and has published original research in JAMA IM and Annals of Emergenc

It can be hard enough managing critical tasks in the best of times, but when things start to go awry, you need to focus even more to keep moving in a positive direction. Back by popular demand, Dan Dworkis (our guest on episode 57) walks us through: navigating uncertainty when under situational pressure, powering down at the end of the day, managing the physiologic response to stress, the most thoughtful procedural time out we’ve ever heard, and transparent team communication. Guest Bio: Dan Dworkis MD, PhD is an emergency physician who is a clinical professor of emergency medicine at USC Keck School of Medicine. He’s also host of the Emergency Mind podcast that focuses on helping individuals and teams perform better under pressure and the author of The Emergency Mind: Wiring Your Brain for Performance Under Pressure. This episode brought to you by Wild Health!  Wild Health provides personalized medicine that takes into account DNA, biometrics, microbiome, and lifestyle factors to come up with

A book I recommend to many coaching clients is “Designing Your Life” by Bill Burnett and Dave Evans. I’ve even had a client use a several month coaching engagement specifically to focus on the exercises in the book. What makes it such a potent tool? Design thinking. What happens if we take the same principles that are used to create the fastest road bike or most efficient electric vehicle and apply them to help us live our best life? The concept was not only intriguing, it blew me away.  In today’s episode we break down one tool from Designing Your Life:  gauging how full/empty we are in 4 buckets of life (health, love, work, play), determining if these buckets are in balance, and introducing the process for rebalancing. ººººººººººººººººººººººººººººººººººAwake and Aware | Our 2024 Live EventJoin us at Awake and Aware 2024, a transformative 3-day workshop from May 1st to 3rd in Bend, Oregon. Focusing on interactive experiences, this event offers a unique opportunity to reset, reflect, and conne

Case studies using Nonviolent Communication in real world situations including:  how to give a proper compliment, perils of bringing up past issues, emergency empathy when speaking to a consultant, receiving gratitude, point of care compassion, and the limitations of NVC in the resus bay. Guest bio:  Scott Weingart is an emergency physician who went on to complete fellowships in Trauma, Surgical Critical Care, and ECMO at the Shock Trauma Center in Baltimore. He is best known for his EMCrit Podcast which focuses on resuscitation and ED critical care, and most recently, On Deeper Reflection, an exploration of academic productivity, philosophy, and wellness. He is the author of two books:  Emergency Medicine Decision Making and the Resuscitation Crisis Manual.ººººººººººººººººººººººººººººººººººAwake and Aware | Our 2024 Live EventJoin us at Awake and Aware 2024, a transformative 3-day workshop from May 1st to 3rd in Bend, Oregon. Focusing on interactive experiences, this event offers a uniqu

Nonviolent Communication is one of the most powerful ways of speaking with people that I have ever come across. It eliminates useless strategies like judgment and proving yourself right and instead gives you absolutely tactical techniques to get the things you need for happiness for yourself and your interlocutor.NVC is not a new, gimmicky set of dictum. It boils down the philosophies of Stoicism, the psychological approaches of cognitive behavioral therapy (CBT), and cognitive psychology.ººººººººººººººººººººººººººººººººººAwake and Aware | Our 2024 Live EventJoin us at Awake and Aware 2024, a transformative 3-day workshop from May 1st to 3rd in Bend, Oregon. Focusing on interactive experiences, this event offers a unique opportunity to reset, reflect, and connect with like-minded individuals. Limited slots.Website: Awakeandawarebend.comEarly bird discount code: FULLYAWAKE24. $100 off registration. Expires Jan 31, 2024CME? Yes! This is a CME event ººººººººººººººººººººººººººººººººººThe Flameproof Course | Self

Nobody goes into medicine hoping they can have a long career in data entry, but that’s how many feel when looking at computer screens more than patients during a work day. Documentation and the electronic medical record (EMR) are nearly ubiquitous sources of frustration in medical practice. In this episode we cover two solutions to make medical documentation, charting, and the EMR less onerous:  a very specific way to interact with scribes and using technology that’s already in your pocket to chart at the bedside. These might seem like ‘tech hacks’ but they are really tools to get away from the computer and back to patient care.  Guest bios:  Alan Sielaff is an emergency physician in Ann Arbor, Michigan. Lon Setnik is a community emergency physician in New Hampshire.ººººººººººººººººººººººººººººººººººAwake and Aware | Our 2024 Live EventJoin us at Awake and Aware 2024, a transformative 3-day workshop from May 1st to 3rd in Bend, Oregon. Focusing on interactive experiences, this event offers a u

We share two conversations about navigating the waters of interacting with unvaccinated COVID patients. Brit Long, MD and Jose Pacheco, RN are thoughtful healthcare providers with somewhat different approaches. The common thread is that both are intentional and compassionate.Guest bios: Brit Long is an assistant professor of emergency medicine in San Antonio, Texas and Editor-in-Chief of Clinical Content at emcdocs.net. He is one of the most published authors in the field of emergency medicine. Brit is working in a unique environment where he's running what is in effect a COVID emergency department in an underserved area with an incredibly high unvaccinated rate. Jose Pacheco is an emergency department nurse who is a local legend for his kind personality and fully engaged approach to caring for patients. He is not just a legend among healthcare providers, but frankly, among the community.ººººººººººººººººººººººººººººººººººAwake and Aware | Our 2024 Live EventJoin us at Awake and Aware 2024, a transf

How do you decide whether to say yes or no to something? In this 5 minute episode, we break down a simple yet incredibly effective heuristic taken from the book Hell Yeah or No by Derek Sivers.ººººººººººººººººººººººººººººººººººAwake and Aware | Our 2024 Live EventJoin us at Awake and Aware 2024, a transformative 3-day workshop from May 1st to 3rd in Bend, Oregon. Focusing on interactive experiences, this event offers a unique opportunity to reset, reflect, and connect with like-minded individuals. Limited slots.Website: Awakeandawarebend.comEarly bird discount code: FULLYAWAKE24. $100 off registration. Expires Jan 31, 2024CME? Yes! This is a CME event ººººººººººººººººººººººººººººººººººThe Flameproof Course | Self-mastery and anti-burnoutThis 6 month, bi-weekly course will make you so burnout-resistant that when they tell you to see 5 patients an hour with only a rusty spoon in your pocket and a unit clerk at your side, you will just smile (results not guaranteed).The next cohort begins Feb 1, 2024. Learn mor