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Unstable Vitals

Dr. Adam Brown and Dr. Lara Zibners

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Welcome to Unstable Vitals, where healthcare experts Dr. Adam Brown and Dr. Lara Zibners navigate the ever-evolving healthcare landscape. Adam, an emergency physician, professor, and founder of ABIG Health, brings a wealth of leadership experience and expertise in healthcare strategy and DEI. Lara, a nationally recognized educator and co-founder of Calla Lily Clinical Care, combines clinical insights with business expertise to address the industry's most pressing challenges. In each episode, ...
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Take a deeper dive into our peer-reviewed emergency medicine content with the EMplify podcast. Join hosts Sam Ashoo, MD and T.R. Eckler, MD for educational, conversational reviews of current evidence guaranteed to help you make your best clinical decisions. Each high-yield episode gives you practical, time-tested guidance from practicing emergency medicine clinicians and subject-matter experts. Listen and learn!
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In this episode, Sam Ashoo, MD and Lara Zibners, MD discuss the August 2025 Pediatric Emergency Medicine Practice article, Diphtheria, Pertussis, and Tetanus: An Update of Evidence-Based Management of Pediatric Patients in the Emergency Department Introduction and guest background Host welcome, show context Dr. Lara Zibners’ credentials EB Medicine…
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In this episode of Unstable Vitals, we sit down with Mac Deford, former local government attorney, community advocate, and congressional candidate from South Carolina. From his time in the Coast Guard to his work in behavioral health and affordable housing, Mac has seen firsthand how policy decisions ripple through people’s lives. We talk about wha…
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In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the October 2025 Emergency Medicine Practice article, Emergency Department Evaluation and Management of Patients With Adrenal Insufficiency Introduction Welcome and host introductions Brief overview of the episode’s topic Resources and CME reminder Article Overview Source: Emergency Medicin…
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In this episode of Unstable Vitals, hosts Dr. Adam Brown and Dr. Lara Zibners sit down with orthopedic surgeon, researcher, and author Dr. Jocelyn Wittstein. Together, they dig into an often-overlooked area of medicine: bone and joint health as the foundation for long-term wellness. Dr. Wittstein shares insights from her new book, The Complete Bone…
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In this episode of Unstable Vitals, Dr. Adam Brown and Dr. Lara Zibners welcome Dr. Steven Farmer, former senior leader at the Center for Medicare and Medicaid Innovation (and Adam’s husband). Between playful banter and sharp commentary, the trio dives into the serious business of healthcare regulation: why the U.S. system remains unaffordable, how…
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In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the September 2025 Emergency Medicine Practice article, Emergency Department Management of Patients With Status Epilepticus Topic Introduction Focus: Status Epilepticus in Adults Reference to recent pediatric episode Article authors: Dr. Marquez, Dr. Kaur, Dr. Lay Why Status Epilepticus Mat…
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Trigger warning: This episode contains discussion of physician mental health and suicide. If this topic is distressing, please consider listening with support nearby or using local mental health resources. In this episode of Unstable Vitals, hosts Dr. Adam Brown and Dr. Lara Zibners sit down with Dr. Stefanie Simmons, Chief Medical Officer of the D…
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In this episode, Sam Ashoo, MD interviews Ali Chaudhary, MD about the benefits of working Locum Tenens in Emergency Medicine. 00:00 Introduction and Welcome 00:54 Meet Dr. Ali Chaudhary 01:41 The State of Emergency Medicine 03:29 Understanding Locum Tenens 05:45 Financial Benefits of Locum Work 08:40 Balancing Family Life with Locum Work 12:54 Locu…
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In this episode of Unstable Vitals, Dr. Adam Brown and Dr. Lara Zibners dive into one of the biggest challenges in healthcare today: misaligned incentives. Should our system prioritize profit or patients? How do payment models, public policy, and personal responsibility collide to shape health outcomes? From fee-for-service vs. value-based care to …
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Why is the U.S. healthcare system so expensive, yet so ineffective? In this episode of Unstable Vitals, Dr. Adam Brown and Dr. Lara Zibners dive deep into the tangled web of patients, profits, and misaligned incentives driving instability in American healthcare. From skyrocketing medical school debt and low primary care reimbursements to insurance …
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Residency: the rite of passage every doctor must survive before practicing on their own. But is the system built to train (or to break) young physicians? In this episode of Unstable Vitals, Dr. Laura Zibners and Dr. Adam Brown sit down with Dr. Jared Dashevsky, a resident physician at Mount Sinai and founder of Healthcare Huddle, to unpack the real…
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In this episode, Sam Ashoo, MD interviews Lauren Black, MD about the August 2025 Emergency Medicine Practice article, Updates and Controversies in the Early Management of Sepsis and Septic Shock 00:00 Introduction and Welcome 01:09 Meet Dr. Lauren Page Black: Sepsis Expert 01:56 Sepsis Statistics and Impact 04:16 Understanding Sepsis Definitions 09…
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In this episode of Unstable Vitals, we dive into a staggering truth: women make 80% of healthcare decisions, yet only 4% of R&D dollars focus on women’s health. Dr. Marina Gerner, award-winning journalist, author of The Vagina Business, and professional myth-buster, joins Dr. Lara Zibners and Dr. Adam Brown to unpack why the system is built on male…
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In this episode, Sam Ashoo, MD interviews Christina Shenvi, MD, PhD, MBA about ways to manage your day and keep distraction at bay. Introduction to Dr. Christina Shenvi Why Focus and Time Management Matter Experiences coaching medical students and professionals The importance of managing mind, time, and attention Applicability to both career and pe…
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Can we really Make America Healthy Again? In this dynamic and slightly unconventional episode, our hosts Dr. Adam Brown and Dr. Lara Zibners combine a spin class with a candid conversation on the fragility of the American public health system. As they pedal through pop hits and resistance levels, they dig into the recent political shifts shaking up…
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In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the July 2025 Emergency Medicine Practice article, Emergency Department Management of Status Epilepticus in Pediatric Patients Introduction Welcome and brief overview of the episode Promotion of EB Medicine’s $1 for 7-day trial offer Why Pediatric Status Epilepticus Matters Seizures make up…
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In this episode of Unstable Vitals, ER docs-turned-entrepreneurs Dr. Adam Brown and Dr. Lara Zibners sit down with Dr. Owais Durrani — emergency physician, media personality, STEM advocate, and Coldplay superfan — for an unfiltered conversation that flies from fighter jets to frontline care. A first-generation college student, Dr. Durrani shares ho…
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In this episode of Unstable Vitals, hosts Dr. Adam Brown and Dr. Lara Zibners sit down with Dr. Melissa Parsons, a former top pediatrician turned life coach, to unpack the emotional cost of surviving in the healthcare system. Melissa shares her deeply personal journey from burnout and perfectionism to finding healing through coaching, vulnerability…
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In this special episode of Unstable Vitals, your hosts Dr. Adam Brown and Dr. Lara Zibners dive into their experience at the HLTH Europe conference in Amsterdam — a dynamic, innovation-driven gathering for health tech startups, investors, and industry leaders. They share what made the event stand out, from the high-energy networking and startup pit…
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Special Offer - EB Medicine is 26 years old! Get 26% off all purchases at ebmedicine.net! In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the June 2025 Emergency Medicine Practice article, Emergency Department Management of Patients With Thyroid Emergencies Introduction to Thyroid Emergencies Understanding Decompensated Hypothyroidism Th…
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Episode 2 of Unstable Vitals features hosts Dr. Lara Zibners and Dr. Adam Brown, as they offer an unfiltered and often humorous look into the realities of emergency medicine. They delve into why people are so fascinated by ER stories, particularly the more bizarre and gruesome ones, a common question they face at social gatherings. The hosts share …
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In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the May 2025 Emergency Medicine Practice article, Emergency Department Management of Patients With Complications of Chronic Neurologic Disease: Parkinson Disease, Myasthenia Gravis, and Multiple Sclerosis Parkinson's Disease Importance of maintaining medication schedule for Parkinson's pati…
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In this episode, Sam Ashoo, MD interviews Rob Orman, MD about ways to manage the trauma inflicted by the ER. Discussing Trauma in Emergency Medicine Personal Experiences with Trauma The Impact of Suppression Defining Trauma and Its Effects Integration vs. Disintegration Debriefing and Coping Mechanisms The Driveway Debrief Nurse and Physician Dynam…
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In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the April 2025 Emergency Medicine Practice article, Sodium Disorders in the Emergency Department: A Review of Hypernatremia and Hyponatremia Hypernatremia (High Sodium Levels) Definition: Sodium level greater than 145 mEq/L Breakdown into three categories based on total body water status Hy…
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In our debut episode, meet your hosts—two ER doctors turned health policy nerds—who are fed up with pretending everything’s fine in healthcare when it’s clearly… not. From government chaos to moral injury in medicine, we kick off with a candid (and sometimes hilarious) look at why the system feels broken and what inspired us to start this podcast. …
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In this episode, Sam Ashoo, MD interviews Patrick O'Malley MD about his career in emergency medicine, The Laceration Course, and the power of connection with our patients. Dr. Patrick O'Malley's Journey in Emergency Medicine The Laceration Course: Origins and Evolution The EM Docs Side Hustle Facebook Group The Patient That Changed My Life For More…
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In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the March 2025 Emergency Medicine Practice article, Emergency Department Management of Knee Pain Common Etiologies of Knee Pain Risk Factors and Statistics Infectious Causes of Knee Pain Pre-Hospital Care and EMS History and Physical Exam Imaging Guidelines Ottawa Knee Rule and X-Ray Necess…
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In this episode, Sam Ashoo, MD interviews Ashley Weisman, MD about her career in rural emergency medicine, and the February 2025 Emergency Medicine Practice article, Management of Traumatic Intracranial Hemorrhage in the Emergency Department Interview with Dr. Ashley Wiseman Introduction of Dr. Wiseman: Emergency physician specializing in rural ER.…
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In this episode, Sam Ashoo, MD interviews Erin D'Agostino, MD about the February 2025 Emergency Medicine Practice article, Management of Traumatic Intracranial Hemorrhage in the Emergency Department Pathophysiology Types of Traumatic Brain Injuries Pre-Hospital Care Critical History and Physical Examination Neurological Assessment and Monitoring La…
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In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the January 2025 Emergency Medicine Practice article, Alkali Exposure: An Evidence-Based Approach to Diagnosis and Treatment Patient Demographics and Case Scenarios: Types of patients prone to alkali exposure Causes and scenarios leading to alkali exposure (e.g., accidental, intentional, so…
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In this episode, Sam Ashoo, MD interviews Nicholas Stark, MD, MBA & Zaid Altawil, MD about the Emergency Medicine Innovation Collaborative 1. Discussion on EMIC - Overview of the collaborative - Background and formation during the pandemic in late 2021 2. Growth of EMIC - Expansion from three members to over 500 - Focus areas: Education, mentorship…
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In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the December 2024 Emergency Medicine Practice article, Diagnosis and Management of Acute Mesenteric Ischemia in the Emergency Department Introduction to Acute Mesenteric Ischemia Statistics on prevalence and mortality Pathophysiology and EtiologyMesenteric artery embolism Mesenteric artery …
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In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the November 2024 Emergency Medicine Practice article, Emergency Department Management of Patients With Low Back Pain: A Review of Current Evidence Prevalence and Importance of Back Pain in the ED Differential Diagnosis and Serious Pathologies Patient Expectations and Management Strategies …
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In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the October 2024 Pediatric Emergency Medicine Practice article, Emergency Department Management of Acute Scrotal Pain in Pediatric Patients 00:00 Welcome and Introduction 00:13 Free Subscription for Emergency Medicine Residents 01:05 Introduction to Pediatric Emergency Medicine Practice 01:…
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In this special episode Sam Ashoo, MD interviews Ryan Johnson, Pharm. D. who shares strategies to address the recent IV fluid shortage caused by Hurricane Helene. 00:00 Introduction and Episode Overview 01:10 Meet Ryan Johnson: Clinical Pharmacist 02:06 Role of Clinical Pharmacists in Emergency Medicine 05:03 IV Fluid Shortage: Causes and Impact 05…
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In this episode, Dr. Julia Draper shares her firsthand account of managing a crisis during a hurricane in Asheville, North Carolina. As the area faced unprecedented flooding, Dr. Draper describes the challenges faced at Mission Hospital, including loss of power and water. She details the innovative solutions the hospital implemented and highlights …
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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 Perfectionism Case Example and Discussion Adaptive vs Maladaptive Perfectionism Personal Experiences and Legal Challenges Dealing with Negative Outcomes Strategies for Managing …
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In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the September 2024 Emergency Medicine Practice article, Elder Abuse and Neglect: Making the Diagnosis and Devising a Treatment Plan in the Emergency Department Introduction and Announcements Elder Abuse and Neglect: An Overview Risk Factors and Reporting Pre-Hospital and Emergency Departmen…
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In this episode, Sam Ashoo, MD interviews social media marketing expert Adam Goodcoff, DO, Founder and CEO of MedFluencers. Meet Dr. Adam Goodcoff The Role of Physicians on Social Media Legal Considerations for Physicians on Social Media Employer Policies and Social Media Creating Engaging Content Balancing Professionalism and Personal Life on Soci…
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In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the August 2024 Emergency Medicine Practice article, Emergency Department Management of Patients With Sickle Cell Disease Epidemiology Common Presentation of Sickle Cell Disease in the ED Screening and Diagnosis Differences Epidemiology: 200,000 ED Visits Annually, 85% for Pain Pathophysiol…
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In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the July 2024 Emergency Medicine Practice article, Emergency Department Management of Patients With Complications of Dialysis Overview of Dialysis Complications Key Dialysis ComplicationsCardiovascular Disease Congestive Heart Failure Pericarditis and Cardiac Tamponade Neurological Sequelae…
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In this episode, Sam Ashoo, MD and T.R. Eckler, MD interview Corey Hazekamp, MD, MS, one of authors of the June 2024 Emergency Medicine Practice article, Managing Emergency Department Patients With Opioid Use Disorder Current State of Opioid Epidemic Overview of overdose deaths and trends. Data and statistics about opioid overdose mortality rates. …
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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 Ref…
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In this episode, Sam Ashoo, MD and T.R. Eckler, MD interview Reuben J. Strayer, MD, author of the May 2024 Emergency Medicine Practice article, Current Concepts in Ketamine Therapy in the Emergency Department Diving Into Ketamine Use in Emergency Medicine Understanding Ketamine: From Origins to Emergency Use Exploring the Ketamine Brain Continuum K…
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In this episode, Sam Ashoo, MD interviews Ashley A. Foster, MD, Bijan Ketabchi, MD, MPH and Jennifer A. Hoffmann, MD, MS on the March 2024 Pediatric Emergency Medicine Practice article, Evaluation and Management of Suicidal Ideation and Self-Harm in Children in the Emergency Department Introduction Understanding Suicidal Ideation and Self Harm in Y…
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In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the April 2024 Pediatric Emergency Medicine Practice article, Brief Resolved Unexplained Events: Practical Evaluation and Management in the Emergency Department Introduction The Evolution of BRUE Understanding BRUE Guidelines The Importance of Pre-Hospital Care in BRUE Cases Investigating t…
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In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the March 2024 Emergency Medicine Practice article, Emergency Department Evaluation and Management of Constipation Prevalence and Impact Understanding the Causes Medications That Can Cause Constipation Dealing with Fecal Impaction Understanding Stercoral Colitis Pre-Hospital Care ED History…
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In this episode, Sam Ashoo, MD interviews Paul Aronson, MD, MHS, one of the authors of the February 2024 Pediatric Emergency Medicine Practice article, Febrile Infants Aged ≤60 Days: Evaluation and Management in the Emergency Department Guideline Changes Pathophysiology Etiology and Definitions Prehospital Care ED History and Physical Diagnostic St…
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