Rob Orman MD | Physician Coach

📍 Hey X friends! If things have been quiet here, it’s because I’m now active on YouTube & Instagram. YouTube is where I’m having deeper conversations - youtube.com/c/emergencypdx Instagram for quick, practical anti-burnout tips - instagram.com/emergencypdx/ See you there!

Do No Harm. Take No Shit.

@JMCWJ @EM_RESUS @DrGolfShirt @ZDoggMD @ALiEMteam @EmergencyDocs @Emeril Of all the perceived slights from the C-suite, that may cut the deepest. I also prefer the bagel. It highlights the delight of creamy PB texture with the semi-sweetness of grahams. The sando is too much cracker all at once

@emergencypdx @EM_RESUS @DrGolfShirt @ZDoggMD @ALiEMteam @EmergencyDocs @Emeril I can tell by your questions you are quite the connoisseur of fine ED fare and are a seasoned EM Physician. I’m more of the bagel type. One hospital tried to replace PB with sunflower seed butter!! I nearly walked out mid-shift!

20+ years working the ER and another great meal. Lost count yrs ago how often this is a meal. All out of turkey sandwiches, the gold mine of ER cuisine! 👊🏼to my fellow EM colleagues eating the same @EM_RESUS @DrGolfShirt @ZDoggMD @ALiEMteam @EmergencyDocs @emergencypdx @Emeril

We're explicitly taught (at least from our med mal colleagues) to not say a word. Keeping it inside — letting it ruminate and swirl around ad infinitum is 100% the wrong move. Awareness and acknowledging that the trauma is happening is the first step.

I still think about cases where I harmed patients. Three of them died. I didn't want that to happen, but it did. Processing that trauma is a skill almost none of us are taught. Processing that trauma is something that may never happen if not approached with intention.

Sometimes we harm patients. Medical education, particularly audio, does a massive disservice to doctors. I've been guilty of it dozens of times. It's subtle, but multiple clients have brought it up. A case is discussed on a podcast where something went wrong.

On chance and regression to the mean: "Deviations are not "corrected" as a chance process unfolds; they are merely diluted."

On the paucity of Socratic ignorance: "It's frightening to think that you might not know something, but more frightening to think that, by and large, the world is run by people who have faith that they know exactly what is going on."

Amos Tversky was a psychologist instrumental in the understanding of cognitive bias and handling of risk. On Experts: "Whenever there is a simple error that most laymen fall for, there is always a slightly more sophisticated version of the same problem that experts fall for."

You can't take med mal risk to zero; there's a certain capriciousness to it. You can, however, reduce the risk with a few light lifts. From Mark Brown MD, JD, where to focus your energy: *Stay up to date and practice solid medicine *Be Nice *Follow-up/callbacks

For my buddy @emergencypdx

@GikuhiJotham I have not heard it but it's now in the queue!

⁦⁦@emergencypdx⁩ Did you listen to this episode. Has words like equanimity and stimulus as I was listening to this episode I thought of stimulus podcast too great content podcasts.apple.com/us/podcast/the…

@First10EM @EMSwami @emcrit @EMManchester @_NMay @TheSGEM Blessing of a skinned knee.

@EMSwami @emcrit @emergencypdx @EMManchester @_NMay @TheSGEM Thanks!

Suggestions on books that changed your philosophy or approach to parenting? Not necessarily parenting books, but books on broader topics, like grit, or growth mindset, or the like? @emcrit @emergencypdx @EMManchester @_NMay @TheSGEM @EMSwami

@vasisht Is it a matter of templates and preprogrammed dragon phrases or do you have another secret sauce?

@emergencypdx I mean. There’s a certain degree of work from shift that ends up getting done post shift. Fortunately I’ve got epic programmed to the point my notes take 1-2 mins on average

On average, how long after the official end time of your shift do you leave the hospital?

@vasisht well then, hit me up with the rest of the story!

@emergencypdx On time. Now if you were to ask how many hours do I spend not at work finishing up charts? That’s a different answer……..