Core IM | Internal Medicine Podcast

Latest Episodes:

#67 Salt Restriction in Heart Failure: Mind the Gap Segment May 20, 2020

Show notes

Let's dive deeper into the dogma of salt restriction in heart failure! Show notes, transcript and references: https://www.coreimpodcast.com/2020/05/20/salt-restriction-in-heart-failure-mind-the-gap-segment/ Get CME-MOC credit with ACP! Time Stamp

01:37 Sodium restriction guidelines
07:13 Current data in outpatient data
11:32 Do inpatient studies show signal?
13:44 Physiology behind sodium balance
16:27 Take away and clinical applicability

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#66 Outpatient Advance Care Planning with COVID19 May 06, 2020

Show notes

How do you navigate new challenges with goals of care with your patients in clinics?

Show Notes, Transcript, References: https://www.coreimpodcast.com/2020/05/06/outpatient-advanced-care-planning-during-covid-19/

Time Stamps

01:32 COVID Crisis as an Outpatient and Advance Care Planning (ACP)
08:06 The virtual visit
12:44 Vital Talk Mnemonic: “CALMER”
22:03 Challenges to Outpatient COVID Care
26:03 Parting Thoughts

#65 COVID Reflections- Disconnections and Connections: At the Bedside Segment Apr 29, 2020

Show notes

Episode Outline

Disconnection/connection: Patients
Disconnection/connection: Family/friends
Disconnection: Security, Certainty
Connection: Other clinicians

Sharing fears, supporting each other)
Shared ethos in healthcare (one workforce, no division of specialty or hierarchy)

Conclusion: Post-traumatic growth / Peri-Traumatic Growth

Thank you to everyone we interviewed, particularly to the voices you heard:

Dr. Kimberly Manning (@gradydoctor)

Dr. John Hwang (Hoofbeats segment)

Dr. Steve Liu (Mind the Gap segment)

Dr Katherine Arthur

Dr. Maria Garcia-Jimenez

Dr. Kelsey Luoma

Hosts:

Dr. Margot Hedlin (@MargotHedlin) - Introduction and Ending

Dr. Tamar Schiff

Dr. Michael Shen (also audio editing)

Dr. Jafar Al-Mondhiry (@mondhiry)

tags: COVID19, COVID-19, CoreIM, coronavirus, narrative medicine

#64 Inpatient Goals of Care with COVID-19 Apr 22, 2020

Show notes

What is your approach to goals of care conversations, particularly during COVID-19? How do you navigate some of the new challenges with COVID19?

Show notes, transcript and references: https://www.coreimpodcast.com/2020/04/22/goc-on-inpatient-service-during-covid-19/

Time stamps:

05:54 Laying the groundwork
08:56 Asking permission, eliciting values and making a recommendation
15:55 When a patient is dying
16:42 Sharing the prognosis first
20:28 Functional status post-CPR
21:52 Headline statement
23:40 Virtual and PPE Communication Challenges
25:28 Separate process from outcome

Tag: coronavirus, COVID, CoreIM, Sars-cov-2, medicine floors, wards, advanced care planning

#63 Practical Tips for COVID-19 Floors Apr 12, 2020

Show notes

How do you organize your day? How do you minimize exposure of yourself and your colleagues? What are the new things to keep in mind with discharging patients?

Show notes, transcripts and references:

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

Time Stamps

02:37 Entrance and Exit strategy
04:25 Prioritizing patient acuity
08:14 PPE uses
11:11 Respiratory concerns in COVID-19 patients
16:35 Patient examination
18:49 Family updates
20:56 Oxygen requirements
23:12 Medications
24:08 Discharging patients
31:00 What we mean by isolation

tag: coronavirus, COVID, CoreIM, sars-cov-2, medicine wards

#62 Transgender Health, Hormone Therapy and Preventive Screening: 5 Pearls Segment Apr 01, 2020

Show notes

Practical tips on starting estrogen or testosterone on patients who are transgender and approach to primary care with cancer screening.

CME Credit with ACP; https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im

Show notes, transcripts, and references: https://www.coreimpodcast.com/2020/04/01/5-pearls-on-transgender-health-hormone-therapy-and-preventive-screening/

Time Stamps:

02:54 Hormone therapy contraindications
07:09 Time course for hormone changes
10:21 Hormone risks
19:09 Hormone treatment options
25:22 Preventative Care Screening

Tags: CoreIM, gender affirming care

#61 Transgender Health, Gender Affirming Care: 5 Pearls Segment Mar 18, 2020

Show notes

Practical tips on Gender Affirming Care!

Show notes, transcript and references

Time Stamps:

02:43 The Gender Unicorn and how it helps us better understand gender identity, expression, and sex assigned at birth
11:15 Gender dysphoria
14:16 The organ or anatomical inventory
16:46 The inevitability of mistakes
18:39 Ways to ensure gender-affirming care in clinic

#60 Capacity Part 1: At the Bedside Segment Mar 04, 2020

Show notes

What goes into a capacity assessments? Is it just reciting risks, benefits and alternatives? Explore this and more on this At the Bedside Episode!

Show notes, Transcript and References: https://www.coreimpodcast.com/?p=22310

Time Stamps:

2:04 Introduction to decision making
4:12 Choice
8:24 Understanding
11:22 Appreciation
13:58 Reasoning
21:55 Common myths and misconceptions
25:11 When and how to call a psychiatry consult for capacity assessment
27:47 Conclusion

Tags: CoreIM, AMA Discharges, Psych, Competency, medical ethics, medical humanties

#59 Flu Diagnosis and Treatment: Mind the Gap Series Feb 19, 2020

Show notes

What are the new guidelines for influenza treatment? What are the diagnostic ratios of flu symptoms and tests? Time Stamps03:10 The art of diagnosing the flu
05:17 Bayesian statistics and the diagnostic odds ratio
07:09 The ins and outs of diagnostic testing for the flu
08:44 Changes in influenza guidelines - testing and treatment
11:17 The not-so-rosy origin story of neuraminidase inhibitors (NAIs)
13:47 Neuraminidase inhibitors (NAIs), mortality benefit and limitations of studies
15:49Take aways

#58 Case Managers and Social Workers: Interprofessional Education Series Feb 06, 2020

Show notes

What is the difference between a case manager and social worker? What are the limitations that social workers and case managers face? How do you create a safe space for the interdisciplinary team?

Show Notes and References

Get CME-MOC credit with ACP!

Time Stamps:

03:54 What are the various roles within a multidisciplinary teams?
10:42 Understanding limitations of social workers and case managers
15:55 The “behind the scenes” paperwork
18:42 Insurance and medications
22:17 Insurance and disposition options
25:08 The importance of creating a safe space for better communication

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