Difficult Conversations -Lessons I learned as an ICU Physician

In this podcast episode, Dr. Anthony Orsini discusses the value of difficult conversations in the medical field, reflecting on how his podcast has allowed him to connect with incredible people over the years. He reintroduces Dr. Robert Pearl, a former CEO of Kaiser Permanente, who first appeared on the podcast in 2021. Dr. Orsini highlights Dr. Pearl’s work and his new book, "ChatGPTMD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine," which explores the role of AI in healthcare. Dr. Pearl emphasizes the broken state of the healthcare system, particularly the inefficiencies and challenges surrounding chronic disease management. He advocates for the integration of AI in medicine, arguing that it can enhance patient care, reduce costs, and ultimately save lives if clinicians are willing to embrace the technology.

Dr. Pearl discusses how generative AI, like ChatGPT, can revolutionize the way healthcare is delivered by providing tools that make the practice more efficient and effective. However, both he and Dr. Orsini acknowledge the importance of maintaining the human element in medicine. They stress that while AI can assist with diagnoses and administrative tasks, the physician's role in building relationships and providing compassionate care remains irreplaceable. The conversation ends with a call for healthcare professionals to actively engage with AI to harness its potential while preserving the critical human touch that defines quality patient care. Please hit the subscribe button now!  

Host:

Dr. Anthony Orsini

Guest:

Robert Pearl, M.D.

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It’s All In The Delivery: Improving Healthcare Starting With A Single Conversation by Dr. Anthony Orsini

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ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine by Robert Pearl, MD

Difficult Conversations Podcast-Episode 153: Uncaring Conversations about Physician Culture with guest Robert Pearl, M.D.

On this episode, Dr. Anthony Orsini and Liz Poret-Christ introduce guest, Laura Diaz-Freeland, whose twin daughters were born at the very limits of viability at just 23 weeks gestation. Laura’s memoir, “Not What I Had in Mind,” is discussed, highlighting the emotional journey and the deep empathy found in motherhood that she experienced following the birth of her extremely premature daughters.  Dr. Orsini was part of the team who cared for her twins and they discuss the bond that Laura forged with the medical staff. Laura  discusses at length the emotional rollercoaster, exhaustion and helplessness that she and her family experienced.  The episode covers the profound advancements in neonatal care and the ethical dilemmas faced by parents and medical professionals in the treatment of such young infants. As a seasoned professional in marketing and creative writing, Laura’s poignant reflections highlight the importance of informed choices in the face of life’s most fragile beginnings, giving voice to the silent struggles and triumphs of preterm birth. 

 Laura advocates for parental choice and informed decision-making in cases of extreme prematurity, sharing insights from her 224-day hospital experience with her twins.  She stresses the need for compassion from healthcare providers and the importance of informed consent.  Dr. Orsini and Laura delve into the delicate conversations that occur in neonatal care, emphasizing the need for a supportive team approach to patient care.  Laura recounts how, despite feeling alone during the initial decision-making process, she later felt part of a team at the Hospital that was committed to her twins’ survival.  Laura also mentions the unique nicknames she has for the medical staff, like ‘The Godfather’ for Dr. Orsini, and ‘Behemoth Hands’ for the surgeon, reflecting their impactful roles in her and her daughters’ lives. For parents navigating this journey, we end with Laura sharing advice to parents to educate themselves, be gracious with themselves, and to not yell at the medical staff.  Please hit the subscribe button now!  

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Hosts:

Dr. Anthony Orsini

Liz Poret-Christ

Guest:

Laura Diaz Freeland

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It’s All In The Delivery: Improving Healthcare Starting With A Single Conversation by Dr. Anthony Orsini

Laura Diaz Freeland Website

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Not What I Had in Mind: A Motherhood Origin Story by Laura Diaz Freeland

COFFEE + CRUMBS-“Delusional Hope” by Laura Diaz Freeland 

In this episode, Dr. Orsini and Liz Poret-Christ are joined by guest, Dr. Samantha Winemaker, an associate clinical professor in the Department of Family Medicine, Division of Palliative Care at McMaster University in Ontario, and co-author of the book, Hope for the Best, Plan for the Rest: 7 keys for navigating a life changing diagnosis. Dr. Winemaker, an advocate for open communication, emphasizes the importance of patients expressing their need for honesty in their healthcare interactions, even when it involves tough conversations. Her work in palliative care, recognized by numerous awards and her co-hosting of “The Waiting Room Revolution” podcast, reflects her dedication to improving the healthcare journey for patients.  She shares her personal path into palliative care, shaped by her medical interests and her desire to move away from internal medicine.  Frustrated by the healthcare system’s delayed engagement with palliative care, she calls for a change, pushing for better public mortality awareness and suggesting that providers integrate palliative skills without necessarily labeling them as such to combat societal discomfort with death.

Dr. Winemaker’s critique of the healthcare system extends to the misconceptions surrounding palliative care and the need for rebranding to reflect its comprehensive role. She argues for mandatory training in communication and palliative care skills in medical and nursing schools to ensure providers are well-equipped to support patients effectively.  She shares a story about a patient with lung cancer, to highlight the importance of informed decision-making and understanding the progression of illness. This episode also features insights into the book, Hope for the Best, Plan for the Rest, which offers 7 keys for navigating life-changing diagnoses, aiming to empower patients in managing their health. Dr. Winemaker aligns with Liz’s experiences with chronic illness, agreeing that patients should feel free to request full disclosure from their physicians to mitigate the fear of the unknown. She expresses her view on dying, considering it a natural chapter of life, and hopes to live her best life until the end without fear. Dr. Winemaker also shares her goal for the podcast and book, which is to educate patients worldwide, empowering them to navigate the healthcare system effectively and to manage their illnesses with confidence and knowledge. 

Hosts:

Dr. Anthony Orsini

Liz Poret-Christ

Guest:

Dr. Samantha Winemaker

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It’s All In The Delivery: Improving Healthcare Starting With A Single Conversation by Dr. Anthony Orsini

Dr. Samantha Winemaker Website

Hope for the Best, Plan for the Rest: 7 Keys for Navigating a Life-Changing Diagnosis by Dr. Sammy Winemaker and Dr. Hsien Seow

The Waiting Room Revolution Podcast

Welcome to another episode of Difficult Conversations-Lessons I Learned as an ICU Physician. In this episode, get ready to explore the journey of Jon Brandt, a remarkable entrepreneur whose journey is not just about business, but about purpose and change, especially in the realm of mental health in educational settings. Liz Poret-Christ and Dr. Anthony Orsini dive into Jon’s recent sale of the Thrive Alliance Group, and his vision for integrating mental wellness into the fabric of our school systems. As we explore Jon’s journey, from the founding of Sage Day Schools to his innovative approach with Thrive Alliance, we’ll uncover the layers of a mission-driven life that has touched many. 

Today, we trace Jon’s path from the loss that ignited his passion for mental health advocacy to the innovative ideas that propelled him into healthcare industry, revolutionizing patient care and worker standards.  Dr. Orsini uncovers the milestones in Jon’s career, highlighting the value of an outsider’s perspective in healthcare innovation. 

The discussion also touches on lessons learned from failures, the power of facing difficult conversations, and how his ventures have had a clear social impact. He also hints at his new venture, an educational program for entrepreneurs incorporating stoic wisdom, which is still in the early stages. Join us as Jon shares his insights on mental health, driving change, and leaving a positive mark on the world. Please hit the subscribe button now!

Hosts:

Liz Poret-Christ

Dr. Anthony Orsini

Guest:

Jon Brandt

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It’s All In The Delivery: Improving Healthcare Starting With A Single Conversation by Dr. Anthony Orsini

Resources Mentioned:

Jon S. Brandt LinkedIn

Jon S. Brandt X/Twitter

Thrive Alliance Group

Difficult Conversations Podcast-Episode 191: Fighting for our Heroes with Corey Feist

National Healthcareer Association

The Road Less Traveled by M. Scott Peck

Welcome to Difficult Conversations. You may have  heard the story of Dr. Lorna Breen, who was an accomplished physician that tragically took her own life during the spring of 2020. Today, Dr. Orsini and Liz Poret-Christ are honored to introduce guest, Corey Feist, who is the co-founder, and President of the Dr. Lorna Breen Heroes’ Foundation. Corey dives into his personal journey, driven by the tragic suicide of his sister-in-law, Dr. Lorna Breen, and his mission to transform the healthcare system to support the well-being of healthcare professionals. The Dr. Lorna Breen Heroes’ Foundation’s work includes awareness efforts to break the stigma surrounding mental health issues, advocating for changes in licensing laws and credentialing questions to protect healthcare workers’ rights, and advancing solutions that aim to improve the overall well-being of the healthcare workforce.

Corey shares insights into the challenges within healthcare, such as electronic medical records and burnout, which prompted him to take action.  He discusses the “All in Wellbeing First for Healthcare” initiative, that includes grants to fund well-being solutions, a starter kit for healthcare systems to kickstart well-being initiatives, and a focus on removing barriers to mental health access. We’ll also hear the significant progress the foundation has made, including the passing of the Dr. Lorna Breen Healthcare Provider Protection Act and the creation of the All In Champions Challenge Badge program,. Corey emphasizes the importance of healthcare professionals reaching out for help and clarifies that the most reliable source for information on the status of physician licensing and mental health concerns is their website because the foundation regularly updates this information. He also discusses the need to remove questions about past mental health issues from peer reference forms, stressing the importance of creating a supportive environment and ensuring confidentiality for healthcare workers seeking help.  If you enjoyed this podcast, please hit the subscribe button on your favorite podcast platform and download this episode to hear more! 

Hosts:

Dr. Anthony Orsini

Liz Poret-Christ

 Guest:

Corey Feist

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It’s All In The Delivery: Improving Healthcare Starting With A Single Conversation by Dr. Anthony Orsini

Resources 

J. Corey Feist LinkedIn

Dr. Lorna Breen Heroes’ Foundation

Dr. Lorna Breen Heroes’ Foundation YouTube

National Physician Suicide Awareness Day

Dr. Lorna Breen Heroes’ Foundation Toolkit

All In: Caring For Caregivers

988 Suicide & Crisis Lifeline

Difficult Conversations with Dr. Anthony Orsini- Episode 88

In this episode, host Liz Poret-Christ along with Dr. Orsini, welcome guest Gina Jacobson, who discusses the Working with Cancer initiative. The initiative, born out of a heartfelt response to the need for better workplace support for employees facing cancer and chronic illnesses, aims to create a safe and positive environment for disclosing health conditions at the workplace. Gina, a survivor of stage four colon cancer, shares her passion for the initiative and her belief in the power of workplace support. The initiative has garnered support from major companies, including Yahoo, Disney, Walmart, SAP, Adobe, as well as The Orsini Way, all dedicated to fostering more inclusive and supportive workplaces, regardless of the company's size. Gina’s own experience surviving Stage 4 colon cancer and her belief in the power of workplace support have driven her commitment to this initiative. 

Gina explains how companies can become involved in the initiative, emphasizing flexibility, and providing a framework with five commitment pillars. The conversation underscores the significance of teaching people how to support colleagues facing cancer and the need for a safe space for difficult conversations at work. The discussion also explores the challenges of sustaining the Working with Cancer initiative and ensuring continuous training. Gina discusses the importance of ongoing training,  teaching people how to speak to and  support their colleagues facing cancer. She  emphasizes the need to provide a safe space for individuals and caregivers to have difficult conversations at work, how personal experiences and emotions play a role in advocating for the initiative’s global change, and its integration into inclusive manager training. Cohort sessions for managers are introduced as a way to offer intensive, real-time support. Gina highlights the initiative as a catalyst for promoting empathetic and compassionate communication in various challenging situations, extending beyond cancer. For more information,  check out the Working with Cancer Pledge website and connect with Gina for more information. Hit the subscribe button now!

Hosts:

Liz Poret-Christ

Dr. Anthony Orsini

Guest:

Gina Jacobson

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It’s All In The Delivery: Improving Healthcare Starting With A Single Conversation by Dr. Anthony Orsini

Resources Mentioned:

Gina Jacobson LinkedIn

Strive for 5 with Gina Jacobson

Publicis Groupe

The Working with Cancer Pledge

Difficult Conversations Podcast-Episode 180: Recognizing Fear with Gina Jacobson

Welcome to Difficult Conversations with Dr. Anthony Orsini. Today, I have the distinct honor  to have another incredible guest and that is Dr. Bruce B.J. Miller, who is a longtime hospice and palliative care medicine physician as well as an author, TEDx presenter, and keynote speaker.  He has given over one hundred talks on the topics of death, dying, palliative care, and the intersection of healthcare with design.  Led by his own experiences as a patient, Dr. Miller advocates for the roles of our senses, community, and presence in designing a better ending.  His career has been dedicated to moving healthcare towards a human-centered approach. His 2015 Ted Talk, “What really matters at the end of life", has been viewed more than eleven million times, and his work has been the subject of multiple interviews and podcasts including Oprah Winfrey, PBS, The New York Times, and the Ted Radio Hour. We will be talking about his book, A Beginner’s Guide to the End,   Dr. Miller currently sees patients and families via Telehealth through Mettle Health, a company he co-founded with the aim to provide personalized holistic consultations for any patient or caregiver who needs help with navigating the practical, emotional, and existential issues that come with serious illness and disability.
 
We start out by hearing BJ Miller’s story, from his childhood experiences, his accident, and what brought him to working in palliative care medicine. BJ tells us a beautiful story about a nurse that locked eyes with him and held his hand upon arrival at the burn unit at St. Barnabas Hospital in New Jersey,. Dr. Orsini talks about the importance of human connection between doctors and patients and how BJ's story is very similar to Marcus Engel’s story who was a previous guest on this podcast.  BJ explains why we struggle with talking about dying which starts with denial. and he shares thoughts on what we need more of in this mission of medicine to help physicians,. Dr. Orsini talks about how training is so limited with physicians which is why he’s dedicated the last ten years of his life  to teach them how to be more comfortable with end of life and tragic diagnosis. If you enjoyed this podcast, please go ahead and hit follow.

Host:

Dr. Anthony Orsini

Guest:

Dr Bruce BJ Miller

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It’s All In The Delivery: Improving Healthcare Starting With A Single Conversation by Dr. Anthony Orsini

Resources :

TED2015: “What really matters at the end of life” - BJ Miller

Mettle Health

A Beginner’s Guide to the End: Practical Advice for Living Life and Facing Death 

I"m Here with Marcus Engel - Difficult Conversations - Lessons I learned as an ICU physician Podcast Episode 102

In this episode of Difficult Conversations, Dr. Orsini is joined by Chris Newlin, Executive Director of the National Children’s Advocacy Center (NCAC) in  Alabama, where he’s responsible for providing leadership and management, as well as participating in national and international training programs for the protection of children. He has more than 25 years of experience working as a Forensic Interviewer, Victim Advocate, Therapist, and other leadership roles in child advocacy.  Today, Dr. Orsini and Chris delve into the complex world of child advocacy. Chris sheds light on the emotional challenges faced by professionals striving to protect vulnerable children. We’ll hear about his background, tracing his journey from being an army kid  to finding his passion for safeguarding children’s well-being. The episode explores the history and evolution of Children’s Advocacy Centers, highlighting their global impact in providing safe spaces for children to share their experiences. 

The conversation shifts towards the vital role of forensic interviewers in child advocacy work.  These professionals who interact with children and faced traumatic events like child sexual abuse, are discussed in detail.  The challenges they encounter in building rapport, extracting accurate information, and creating a supportive environment are examined. Dr. Orsini shares his own experience working with forensic interviewers and child advocates through The Orsini Way and highlights their dedication to improvement.  Chris talks about his TEDx Talk focusing on child abuse, the staggering economic costs of child abuse on a national scale, and he cites research on Adverse Childhood Experiences (ACEs) and their impact on health, productivity, and substance abuse throughout adulthood. Dr. Orsini and Chris Newlin discuss strategies for preventing burnout among child advocates, emphasizing the significance of self-care, staying genuine, and maintaining emotional engagement.  We end with Chris sharing a personal experience of a difficult conversation with a family member facing a serious medical diagnosis and how he navigated through it. He emphasizes the importance of being patient, providing evidence, and allowing time for individuals to process challenging news. 

If you enjoyed this podcast, please hit the subscribe button on your favorite podcast platform and download this episode to hear more! 

Host:

Dr. Anthony Orsini

Guest:

Chris Newlin

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It’s All In The Delivery: Improving Healthcare Starting With A Single Conversation by Dr. Anthony Orsini

Resources Mentioned:

Chris Newlin LinkedIn

National Children’s Advocacy Center

TEDx Talks: Financial Impact of Child Abuse with Chris Newlin (YouTube)

Difficult Conversations Podcast-Conversations About Child Advocacy with Anthony DeVincenzo

Hello and welcome to Difficult Conversations with Dr. Anthony Orsini.  Today, we are excited and honored to have as our guest, Julie McFadden, otherwise known as “Hospice nurse Julie,” on social media, where she has almost a million viewers between TikTok and Instagram. Her warm and insightful ability to normalize and explain the death and dying process has made her a cultural icon. Julie has been a nurse for fifteen years, ten in the ICU, and five taking care of hospice patients. Her gift to the world has been sharing her experiences and discussing topics like death to help others understand the process and alleviate any anxieties they may have about it.  She’s a funny, honest, and natural storyteller and her amazing following has helped expand the conversations about death and dying and change the way people view hospice care. 

Julie tells us more about herself, her journey to becoming an ICU nurse, and what led to her decision to transition into doing hospice. She worked in ICU for ten years and she talks about coming to the realization that there was a missing link to talking about big life goals with what’s going to happen with certain patients. When Julie started speaking up, she realized her voice mattered and it started making an impact with more conversations happening with family members. Julie tells us about two patients she took care of in the ICU who impacted her and made her realize she really wanted to do hospice care. She details the difference between palliative care and hospice, she explains the biggest thing she learned, and why she became so passionate about working in hospice. We learn how “Hospice nurse Julie” started, how topics such as, “The Rally,” “Death with dignity,” and “Myths about morphine,” all came to her, and why she picked TikTok as her platform. Julie explains the process she goes through with families, the conversations she has, and how she navigates through them. Liz and Dr. Orsini talk about the guilt family members feel and the phrase they teach, “Sometimes the more loving thing to do is to not do anything.”  We hear the one question that Julie gets asked the most from people and we learn the most fulfilling thing about her job. If someone is newly diagnosed, scared, and referred to hospice, Julie shares the first conversation she has with this person, and Dr. Orsini shares a sweet story behind his father-in-law last words, “I won!” We end with Julie telling us the most difficult type of conversations she has and how she navigates through them. . If you enjoyed this podcast, please hit subscribe on your favorite podcast platform.

Hosts:

Liz Poret-Christ

Anthony Orsini 

Guest:

Julie McFadden

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It’s All In The Delivery: Improving Healthcare Starting With A Single Conversation by Dr. Anthony Orsini

Resources

Hospice nurse Julie TikTok 

Hospice nurse Julie Instagram

Hospice nurse Julie YouTube

Hospice nurse Julie-End Well (YouTube)

Replay on Demand! Welcome to Difficult Conversations with Dr. Anthony Orsini. Today, my guest is the incredible Cy Wakeman, who is a drama researcher, a global thought leader, and New York Times best-selling author. She has been deemed “the secret weapon to restoring sanity to the workplace” and has helped companies such as Google, Facebook, NBC Universal, Johns Hopkins, and countless others how to navigate our rapidly changing world using good mental processes to harness energy wasted in workplace drama, and reinvent that effort into achieving profound business results. As a highly sought-after conference headliner, she’s a regular contributor on Forbes.com,  The Huffington Post, and has been featured on the Today Show, Ask Gary Vee Show,  and the New York Times Business Insider. Cy has published three books, the latest of which we’ll talk about today called, No Ego: How Leaders Can Cut the Cost of Workplace Drama, End Entitlement, and Drive Big Results. 

Cy tells us about herself and she shares with us her lifelong pursuit. She reveals some statistics about her research  with hardworking, super achieving, professional people and how they spend two and a half hours a day in drama in the workplace. Dr. Orsini shares some advice about how he teaches healthcare professionals to help them prevent burnout and his   concept of  “It’s hard to fire your best friend.” Cy tells us she believes in two things, “you love people up and then you call them up,” and shares a story about an upset nurse and why she said to her, “If you were great, what would great look like?” She also talks about how self-reflection is the ultimate drama diffuser.  Cy explains her concept of toggling up and toggling down. Dr. Orsini talks more about why he loves conflict resolution with a great story and clarifies how great leaders make you self-reflect and how to look at things differently. The topic of leadership and the culture of business comes up in the conversation, and whether or not we need to train the leaders and if there are some leaders that just have to go. Find out why Cy doesn’t believe in working on culture and why she said, “We don’t have to fix the culture, we have to fix the climate.” If you enjoyed this podcast, please hit follow, and download all the previous episodes. 

Host: 

Dr. Anthony Orsini

Guest:

Cy Wakeman

 For More Information:

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It’s All In The Delivery: Improving Healthcare Starting With A Single Conversation by Dr. Anthony Orsini

TEDx Presentation - How the Human Connection Improves Healthcare

Resources Mentioned:

Reality-Based Leadership

Reality-Based Leadership with Cy Wakeman Linkedin

Cy Wakeman-YouTube

No Ego Podcast with Cy Wakeman

No Ego: How Leaders Can Cut the Cost of Workplace Drama, End Entitlement, and Drive Big Results by Cy Wakeman