Core IM | Internal Medicine Podcast

Latest Episodes:

#120 Safety Net Hospitals, A Disproportionate Share Health Affairs Pathways Podcast Mar 02, 2023

Show notes

Why are safety net hospitals barely surviving? What makes a hospital a safety net hospital? How essential are safety net hospitals in caring for low income Americans? How do we pay for that care?

Show notes, Transcript and References:

https://www.coreimpodcast.com/2023/03/02/safety-net-hospitals/

Timestamps:

0:00 Hahnemann University Hospital

4:36 What is a Safety Net Hospital?

11:11 The Origins and Paradox of the Safety Net Hospital

Links to other episodes:

A Complex Patchwork of Supplemental Payments:

https://www.healthaffairs.org/do/10.1377/hp20221223.651856/full/

The Future of Safety Net Hospitals & Payment Policies:

https://www.healthaffairs.org/do/10.1377/hp20221223.105519/full/

Tags: IM Core, CoreIM, health policy, health disparities, insurance, medicare and medicaid

Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840
Our Sponsors:
* Check out ElevenReader and use my code PODCAST for a great deal: https://elevenreader.io
Advertising Inquiries: https://redcircle.com/brands
Privacy & Opt-Out: https://redcircle.com/privacy

#119 A 80F with Melena and AKI also with an Unresolved Pneumonia: Hoofbeats Episode Feb 15, 2023

Show notes

How does your problem representation change as we get more history in this episode? How can we use Oxaam's razor & Hickman's dictum as powerful diagnostic tools IF used properly?

Show notes, Transcript and References: https://www.coreimpodcast.com/2023/02/15/25438/

Use promo code COREIM for 1 month of free access to Glass Pro at https://glass.health/coreim

Time stamps

01:51 Intro
07:57 Case
13:09 Differential
16:15 Diagnosis
22:20 Problem Representation

Tags: IM Core, CoreIM, diagnostic tools, Occam's razor, Hickam's dictum, data collection, mental model, clinical reasoning, rheumatology

#118 "Futility": At the Bedside Segment Feb 01, 2023

Show notes

How do you approach requests for 'futile' care? What do we mean by futility? What kind of recovery do we think is meaningful? How do we evaluate potentially inappropriate care? Where can we go for guidance on this?

Show notes, Transcript and References: https://www.coreimpodcast.com/2023/02/01/futility-at-the-bedside-segment/

Time stamps

04:45 What do we mean by “futility”?
11:20 Definitions
20:23 Ethical Analysis
39:13 Recommendations

Tags: IM Core, CoreIM, ATS, autonomy, justice, values, emotions, communication, medical humanities, ethics

#117 Atrial Fibrillation: Gray Matters Segment Jan 18, 2023

Show notes

Check out original interviews on our Youtube channel!

What does the duration of afib tell you about the thromboembolic risk? When do you start anticoagulation for post-op afib? What do the most recent guidelines recommend for perioperative anticoagulation management? How many devices do you know that can be useful in post-discharge cardiac monitoring in new atrial fibrillation? How can we improve our communication regarding afib management?

Behind The Scenes videos

Get CME-MOC credit with ACP

Show notes, Transcript and References

Time stamps

01:12 Intro
03:51 Deep Dive 1
08:16 Deep Dive 2
15:25 Deep Dive 3
21:05 Deep Dive 4
27:07 Deep Dive 5

Tags: IM Core, CoreIM, Devices, cardiac, risk, perioperative, stroke, surgery, anticoagulation

#116 The Lipid Panel Reimagined: Mind the Gap Segment Dec 15, 2022

Show notes

Is it enough to look at LDL-C? What is Apo-B? How do you use TG/HDL ratio to understand your patients cardiovascular risk? Do you need to get a fasting lipid panel? How does it affect the triglycerides and LDL?

Show notes, Transcript and References: https://www.coreimpodcast.com/2022/12/15/reimagining-the-…-the-gap-segment/

Use the code “COREIM-AMBOSS” to get a free month of access on https://go.amboss.com/CoreIM-E8

Time stamps

01:24 Intro
03:37 Fasting vs. Nonfasting Lipid Panel
05:11 Current guidelines
07:43 Pathophysiology Overview
09:04 Pathophysiology of Apo-B vs. LDL-C with traffic analogy
11:23 Apo-B
15:40 TG-to-HDL ratio
17:06 Takeaways

Tags: IM Core, CoreIM, risk, USPSTF, ACC/AHH, family medicine, cardiology, primary care

#115 Hope: At the Bedside Segment Nov 23, 2022

Show notes

What are some ways you address unrealistic hopes with your patients? How can you build a portfolio of hope with your patients? Can you learn to guide your patients hope?

Show notes, Transcript and References: https://www.coreimpodcast.com/2022/11/23/hope/

Sponsor: Use the code “COREIM-AMBOSS” to get a free month of access on https://go.amboss.com/CoreIM-E7

Time stamps

01:20 Intro
04:37 What are some definitions of hope?
09:57 How can we address unrealistic hope?
21:39 Addressing hope in clinical practice
32:10 Conclusion

Tags: IM Core, CoreIM, care, communication, goal setting, support, strategies , medical humanities

#114 Alcohol-Associated Hepatitis: 5 Pearls Segment Nov 09, 2022

Show notes

What tests and history points help with the diagnosis of alcohol-associated hepatitis? What other etiologies should be ruled out? To steroid or not to steroid? What are the medications for alcohol use disorder? Do you make sure your patients have a late night snack? How do you prognosticate?

Show notes, Transcript and References: https://www.coreimpodcast.com/2022/11/09/alcoholic-hepati…5-pearls-segment/

Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im

Time stamps

01:42 Intro
04:37 Pearl 1: Diagnosis
13:20 Pearl 2: Differential & Treatment
20:48 Pearl 3: Nutrition & Alcohol Cessation
27:45 Pearl 4: To steroids or to not steroids?!
35:34 Pearl 5: Throwback

Tags: IM Core, CoreIM, ALT, AST, liver abnormalities, gastroenterology, alcohol use disorder, nutrition, MELD, Lille, Steroids, Alcoholic Hepatitis

#113 Aspirin for Primary Prevention: Mind the Gap Segment Oct 19, 2022

Show notes

How do you educate your patients on aspirin use? For what reasons do you start, continue or stop aspirin? What does trial data tell us? How does aspirin exerts its effect?

Sponsor: Use the code “COREIM-AMBOSS” to get a free month of access on https://go.amboss.com/CoreIM-E6

ACP CME: http://bit.ly/CIMCME

Show notes, Transcript and References: https://www.coreimpodcast.com/2022/10/19/mind-the-gap-asp…imary-prevention/

Time stamps

03:03 Guideline recommendations
07:00 How does Aspirin work?
09:11 Trial Data
13:00 ASCVD Risk Calculator
18:07 Starting vs. Stopping Aspirin
22:11 Summary

Tags: IM Core, CoreIM, guidelines, atherosclerosis, ASCVD, plaque, bleeding, shared decision-making

#112 ANA (Antinuclear Antibody) Test: 5 Pearls Segment Oct 05, 2022

Show notes

Is a positive ANA always significant? What does the titer mean? Is the pattern of the ANA helpful? What patient histories should you not get an ANA for and which aspects of the history would raise suspicion for autoimmunity? How can you use the physical exam to assess likelihood of autoimmune disease? What is the ddx for a positive ANA?

Whiteboard animation video on YouTube

Show notes, Transcript and References

Get CME-MOC credit with ACP

Sponsor: Visit www.medmastery.com/coreim for 15% off on all subscriptions. Discount code: “COREIM”

Timestamps:

01:37 Pearl 1
03:54 Pearl 2
13:53 Pearl 3
18:07 Pearl 4
29:30 Pearl 5

Tags: IM Core, CoreIM, autoimmune, joint disease, titers, Raynaud's, lupus, Rheumatology

#111 Discharges with Incidental Findings: Gray Matters Segment Sep 21, 2022

Show notes

How do you decide which lung nodules should be worked up inpatient or outpatient? How common are incidental lung nodules? What considerations are there for patients that could potentially get lost to follow up? What risk adopted approach can be implement in our practice? Do you know what fast forward rounds are?

Sponsor: Use the code “COREIM-AMBOSS” to get a free month of access on https://go.amboss.com/CoreIM-E5

Show notes, Transcript and References: https://www.coreimpodcast.com/2022/09/21/discharge-with-i…atters-segment-2/

Time stamps