Core IM | Internal Medicine Podcast

Latest Episodes:

#48 AMA Discharges: At the Bedside Segment Sep 04, 2019

Show notes

Do we have to sign the AMA form? Do insurances deny payment for patients who leave AMA? What is your approach to AMA discharges? Core IM At the Bedside speaks to ethics researcher, Dr. David Alfandre, author of Things We Do For No Reason: Against Medical Advice Discharges

Show Notes, Full Transcript and References

Time Stamps

3:03 Demographics of AMA discharges
5:59 Clinician/System related factors of AMA discharges
10:30 Strategies for mitigating AMA Discharges
15:59 Do we have to make patients sign the AMA form?
18:27 Do insurances deny payment for patients who leave AMA?
23:09 Take Away Points

Tags: shared-decision making, harm reduction

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#47 Stories of Women in Medicine Aug 21, 2019

Show notes

We hope these stories can make us more introspective and open minded on how these concepts can affect each one of us differently.

Let's continue the discussion on the Women in Medicine Twitter chat on 8/25 at 9pm EST !

Full Transcript and Show Notes

Time Stamps

2:07 Introduction to one woman’s journey
3:00 Stereotype Threat
6:15 Not all Anger is Created Equal
10:17 Asking and Writing Your Own Job Description
13:08 Imposter Syndrome
15:50 Breaking Points to Self Care
18:50 Work Life Integration
21:40 Support Networks

#46 A 45F with Persistent Bleeding: Hoofbeats Segment Aug 07, 2019

Show notes

20 Qs with Core IM Team vs. Expert Discussant !

Full Transcript and Show notes

Get CME-MOC Credit for listening to this episode (live at 09:00 am EST on 8/7)

Time Stamps

00:20 The game of medical Twenty Questions
04:37 Case introduction
05:50 The CoreIM team attempts to solve the case
15:36 The discussant’s diagnostic schema for abnormal bleeding
23:37 Primary versus secondary hemostasis
30:33 The pathology report !
37:38 Criteria for the final diagnosis
38:46 Dissecting a diagnostic coup
49:42 Conclusion

Do you have a good case or an expert you would like to suggest for an episode? Send it our way at hello@coreimpodcast.com

Tags: Coagulopathy, Bleeding Disorder, Diagnostic Schema, Von Willebrand's Disease, Clinical Reasoning

#45 Statins: Prescribing Meds Day vs. Night Part 2 Mind the Gap Segment Jul 24, 2019

Show notes

Night and Day… join us for part II of our exploration into why we prescribe medications in the morning vs. at night, featuring statins!

03:28 How do statins and cholesterol synthesis work again, anyway?

04:00 Power in numbers - what do the meta-analyses say about timing of statins?

04:40 The long and short of it - how half-life may dictate when to take your statin.

07:35 Effect magnitude - does medication timing actually really impact patient outcomes?

10:30 Practical matters - so what should we tell patients?

11:05 Review of teaching points

Show notes, transcripts and references

#44 Coronary Calcium Score and CTAs: 5 Pearls Segment Jul 10, 2019

Show notes

Solidify your knowledge on Coronary calcium scores and Coronary CTAs!

ACP members can claimCME-MOC Credit !

Quiz yourself on the 5 pearls we will be covering below:

3:10 What are the big picture differences of functional stress tests and anatomical cardiac tests?
7:48 What is the role of coronary artery calcium scores in managing coronary artery disease (CAD)?
16:20 How do coronary CTAs compare to stress tests?
24:28 When should we avoid CTA?
29:33 How do we communicate coronary CTA results with patients?
36:02 Recap

Full transcript, infographics and show notes !

#43 "Difficult" Patients: At the Bedside Segment Jun 26, 2019

Show notes

In ‘At The Bedside’, our newest podcast segment, we tackle important topics that *aren’t* easily indexable in guidelines and UpToDate article – topics that are better discussed…well…at the bedside. Our first episode examines the all-too-common trope of the ‘difficult’ patient.

01:13 Introduction
05:27 Question 1: What makes a patient difficult for you?
13:22 Question 2: What is a “good outcome” when working with difficult patients?
23:05 Question 3: What have you learned from your difficult patients?
31:56 Conclusion

Show notes, Transcript, Further Reading

#42 July Stories Jun 12, 2019

Show notes

Transitions can be hard. Laugh, commiserate and be inspired by these July stories in medicine!

Very big thank you to everyone who told their stories !

Let's help each other feel a little less alone in the struggle, be more understanding and compassionate or laugh at ourselves. Please share this episode with colleagues. Do you have a July story? Email us at hello@coreimpodcast.com.

Lets continue conversation over social media. Which stories moved you? Which July stories can you relate to? Tweet us, find us on instagram at coreimpodcast or Facebook. Good luck this coming July !

#41 A 23M with AMS and Fever: Hoofbeats Segment May 22, 2019

Show notes

Dissect clinical reasoning and dive deeper into an interesting case!

02:04 Initial Presentation
03:03 The Core IM team tackles the case
09:30 Social History
16:05 Physical Exam
22:47 An exercise in Bayesian inference
36:35 Pre-mortem
43:37 Revealing the diagnosis
48:57 How do we define diagnostic success?

Full transcript with references and show notes

#40 Prescribing Meds Day vs. Night Part 1: Mind the Gap Segment May 08, 2019

Show notes

Dive deeper into why we prescribe medications in the morning vs. at night !

Why do we dose warfarin at night? (2:45)
Back to the basics - what are the pharmacodynamics of warfarin and how does vitamin K intake matter? (4:28)
Practical matters - so what should we tell patients (6:14)
Dippers and non-dippers - what happens to blood pressure (BP) at night? (9:32)
The surprising link between dipping and cardiovascular outcomes (11:15)
Timing is everything… or is it? The evidence behind taking BP meds at night (11:58)
Review of teaching points (15:58)

What is your prescribing practice with blood pressure medications? Leave a comment, tweet us or share with us on instagram or facebook on how you dose BP meds?

Transcript with references and show notes

#39 Stress Testing: 5 Pearls Segment Apr 24, 2019

Show notes

Solidify your knowledge on stress tests! Quiz yourself on the 5 pearls we will be covering:

What are the indications for a stress test? (2:18)
How to choose stress protocol in a stress test? (8:29)
How to choose diagnostic modality in a stress test? (14:46)
How do we interpret results from stress tests, and how should this be communicated to patients? (24:08)
Pearl Recap (31:13)
Risk of contrast induced nephropathy between arterial and venous contrast load (36:02)

For full transcript, infographic and show notes: https://www.coreimpodcast.com/2019/04/24/stress-testing/

Tags: Internal Medicine, Internist, Primary Care Physician, Hospitalists, Emergency Medicine, Nurse Practitioner, Physician Assistant, Family Physician, Cardiology

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