The Curbsiders Internal Medicine Podcast

Latest Episodes:

REBOOT #129 Depression and Physician Suicide with Elisabeth Poorman MD Jan 06, 2020

Show notes

Beth Garbitelli and Nora Taranto MD add a new intro and share their own insights on this Curbsiders classic!

Physician suicide is a problem. There, we said it. We all have that story; Many of us have experienced the symptoms of depression or suicidal ideation ourselves, or have the colleague, mentor, friend, teacher, sibling, parent, or significant other who has experienced these signs and symptoms. Some of us (probably more than you’d think) have lost someone meaningful to suicide. And yet, we don’t talk about suicide and mental health in medicine, or at least, not enough. So, today, we at the Curbsiders are trying to change that.

The problem of depression and suicide is a particularly real one in medicine, a profession that is, by its very nature traumatic and emotionally draining (both in terms of work demands and also the sick and dying patients we treat). In this episode, we talk with expert Dr. Elisabeth Poorman about the natural history of depression in residency and beyond. We share some of our own personal stories, and discuss how we can support one another and reach out for help, how to take care of our mental health in an emotionally demanding career, how to deal with licensing questions and worry about stigma, and what systemic changes may be coming (read: we think need to be coming) down the line.

N.b. This is a sensitive topic. If this is triggering for anyone listening, the national suicide hotline number 1-800-273-8255. Moreover, if anyone needs or wants guidance on available resources, Dr. Elisabeth Poorman has made herself available via email at doctorpoorman@gmail.com, or you may reach out to any of us on Twitter. We are happy to talk and see that you get the support you need.

New episodes return January 20, 2020!

Sponsor

ACP's Internal Medicine Meeting 2020 April 23-25th in Los Angeles, CA at the LA Convention Center. Early bird rates are available through January 31, 2020. Don’t forget to use the code: IMCURB20

Credits

Written and produced by: Nora Taranto MD, Shreya Trivedi MD
Hosts: Stuart Brigham MD, Shreya Trivedi MD, Matthew Watto MD
Edited by: Matthew Watto MD
Guest: Elisabeth Po

#190 Recap Extravaganza 2019 Dec 30, 2019

Show notes

Recap extravaganza 2019 featuring top pearls from our staff’s favorite episodes of 2019 and voicemails from Kashlak faculty, Dr. Avital O’Glasser (@aoglasser), Dr. Kimberly Manning (@gradydoctor), Dr. Renee Dversdal (@DrSonosRD) and The Curbsiders team. Topics include: HFpEF, the PARAGON-HF trial, Buprenorphine, Opioid Use Disorder, Cirrhosis, Coagulopathy, SBP, Hyperkalemia treatment, Multimorbidity, and how to think about NNT. Plus, the team shares a bunch of other favorite moments and random pearls!

Upcoming shows: The next two weeks will feature REBOOT episodes with fresh intros from The Curbsiders team. Season 9 starts January 20, 2020 with a Lipid Update from Cardiologist Dr. Erin Michos (@ErinMichos)

Credits

Produced by: Sarah Phoebe Roberts MPH and Chris Chiu MD, FACP, FAAP
Writer: Sarah Phoebe Roberts MPH
Infographic: Sarah Phoebe Roberts MPH
Cover Art: Kate Grant MBChB DipGUMed
Hosts: Chris Chiu MD, FACP, FAAP; Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Chris Chiu MD, FACP, FAAP (audio), Matthew Watto MD, FACP (show notes)

Time Stamps

00:00 Intro and disclaimer
04:25 Picks of the year*: The Expanse (TV show) -Chiu Man’s pick;

#189 Medical Overuse: Common Cases of Overtesting, Overdiagnosis, Overtreatment Dec 23, 2019

Show notes

Team up with the authors of the JAMA Medicine series on Medical Overuse, Dr. Dan Morgan @dr_dmorgan (University of Maryland) and Dr. Deborah Korenstein @DKorenstein (Memorial Sloan Kettering). We discuss procalcitonin (again!), the dangers of incidentalomas, risks of chest CT for lung cancer screening, the easiest place to get antibiotics for a viral infection, and why not to treat subclinical hypothyroidism despite guidelines. Trying to find ways to shed the fat off of some common medical practices? Look no further.

ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).

Credits

Written and Produced by: Justin Berk, MD MPH MBA
Infographic: Justin Berk, MD MPH MBA
Cover Art: Matthew Watto MD, FACP
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Molly Heublein MD, Matthew Watto MD, FACP, Emi Okamoto MD (written materials); Clair Morgan of Nodderly.com (audio)
Guest: Daniel Morgan MD, Deborah Korenstein MD, FACP

Time Stamps

00:00 Intro, disclaimer, guest bios
04:45 Guest one-liners
Picks of the Week*: The Fifth Season is part of

#188 GERD and Dyspepsia with Dr. Amy Oxentenko MD Dec 16, 2019

Show notes

Delve into the diagnosis and management of GERD and dyspepsia with Dr. Amy Oxentenko (@AmyOxentenkoMD), Gastroenterologist and the Internal Medicine Residency Program Director, Associate Chair for the Department of Internal Medicine, and Professor of Medicine at Mayo Clinic in Rochester, MN. Our discussion features a review of the standard presentations of GERD and dyspepsia, alarm symptoms and who needs referral for endoscopy or other specialized testing (pH, impedance testing, screening for Barrett’s esophagus). Additionally, we comprehensively cover proton pump inhibitor (PPI) therapy including: choice of agent, dose, frequency, how taper, how to counsel patients about risk, what labs should be monitored and the use of adjuvant therapies like H2 blockers, antacids and even carafate. After this episode, you will be flexing on reflux!

ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).

Credits

Written and Produced by: Paul Williams MD, FACP, Beth Garbitelli
CME Questions: Beth Garbitelli, Matthew Watto MD, FACP
Infographic: Beth Garbitelli
Cover Art: Kate Grant MBChB DipGUMed
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD, FACP (written materials); Clair Morgan at Nodderly.com
Guest: Amy Oxentenko MD

Time Stamps

00:00 Intro, disclaimer, guest bio
02:47 Guest one-liner, Picks of the Week*: Reality TV Shows: Survivor and

#187 Buprenorphine Master Class: Managing Opioid Use Disorder for the Generalist Dec 09, 2019

Show notes

How to initiate buprenorphine like a pro. Treating people with Opioid Use Disorder can be the most rewarding part of your practice! Get comfortable with counseling and pharmacotherapy for OUD with tips from Dr. Michael Fingerhood, Associate Professor of Medicine at Public Health at Johns Hopkins. We review building a therapeutic relationship with people with substance use disorders, the differences between the three FDA-approved medications for opioid use disorder (buprenorphine, methadone and extended-release naltrexone), and the nitty-gritty of prescribing buprenorphine.

ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).

Credits

Written and Produced by: Justin Berk, MD MPH MBA, Joseph “Seffy” Muller MD
Infographic: Hannah R Abrams and Justin Berk MD, MPH, MBA
Cover Art: Kate Grant MBChB DipGUMed
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP, Justin Berk, MD MPH MBA
Editor: Matt Watto MD, FACP (written materials), Clair Morgan at Nodderly.com (audio)
Guest: Michael Fingerhood MD

Time Stamps

00:00: Introduction
04:40: Guest introduction & questions (great stories about addiction)
Picks of the Week*: Papillon (film) and Papillon (book) per Dr. Fingerhood;

#186 Sarcopenia: Raising the Bar in Primary Care Dec 02, 2019

Show notes

Make some gains with Drs. Feigenbaum (@Jordan_theCoach) & Baraki (@AustinBaraki) of Barbell Medicine as we delve into the topic of sarcopenia! Together we’ll learn what exactly is sarcopenia, how it is diagnosed, and explore approaches to both management and counseling including: exercise prescriptions, recommendations for protein intake, and even how to treat patients with multiple comorbidities.

Credits

Written and Produced by: Cyrus Askin MD
Infographic: Cyrus Askin MD, Hannah Abrams
Cover Art: Dr. Kate Grant MBChB DipGUMed
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editors: Matthew Watto MD, FACP; Clair Morgan of Nodderly.com
Guests: Jordan Feigenbaum MD; Austin Baraki MD

Check Out our friends at Barbell Medicine!

Learn more about Barbell Medicine through their website at www.barbellmedicine.com or their YouTube channel - Barbell Medicine. They also have their own Podcast, The Barbell Medicine Podcast and can be found on Instagram: @barbell_medicine, Twitter via @BarbellMedicine.
Drs. Feigenbaum and Baraki can

#185 Hotcakes: Updates on CAP, Asthma & Red Meat! Nov 27, 2019

Show notes

“Guidelines” galore! From Community-Acquired Pneumonia to asthma to...red meat? While you may be listening to this around Thanksgiving, we actually recorded on October 30th‒the best and spookiest time of the year. To really set the mood I wanted to include some terrible skeleton puns, but the ones I found weren’t humerus. What we do have for you are some tasty knowledge treats, courtesy of our ghosts‒oops, I mean our HOSTS‒Chris, Matt, Stuart and Paul. Join us as we review the most terrifyingly relevant research findings and creepiest clinical pearls!

Today also marks the debut of our newest Hotcakes team member, the frighteningly talented Dr. Rahul Ganatra. Rahul will now be our resident statistician/study design expert, and will use his research skulls‒no wait, SKILLS‒to provide even more insight into the practice-changing findings we love to highlight for you.

ACP members can claim CME-MOC at CME credit https://www.acponline.org/curbsiders. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits

Written and Produced by: Sarah Phoebe Roberts MPH, Christopher Chiu MD
Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD, and Christopher Chiu MD
Statistics Expert: Rahul Ganatra MD
Editors: Christopher Chiu MD (audio/text), Emi Okamoto MD (text)
Cover-Art: Sarah Phoebe Roberts MPH
Music: Stuart Brigham MD

Time stamps

00:00 Introduction/Disclaimer
03:18 Getting to know Dr. Rahul Gantra
05:35 Community-Acquired Pneumonia Guidelines
15:13 Sarah explains Hotcakes ratings
16:45 A new Asthma Strategy
17:26 Chris forgets what LABA stands for
27:37 Stuart makes a joke
29:00 A lot of meat talk
37:22 Rahul’s Napkin Calculations
51:40 Honorable Mentions
52:42 Take-away Points & Outtro

Meet Rahul:

Rahul Ganatra is a Medical Attending and Director of Continuing Medical Education for the Medical Service at the VA Boston Healthcare System. He fell in love with clinical epidemiology and public health while taking night classes for his MPH during medical school. and we

#184 Update in Sleep Medicine: LIVE from CHEST 2019! Nov 25, 2019

Show notes

Score some great insights and clinical pearls from Dr. Christine Won on the incredibly important topic of sleep medicine during this live recording at CHEST! On this episode we’ll tackle why we sleep, how to treat insomnia, the “Z-drugs” and more! ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date).

Credits

Written and Produced by: Cyrus Askin MD, Matthew Watto MD, FACP
Infographic: Matthew Watto MD, FACP
Cover Art: Kate Grant MBChB DipGUMed
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD, FACP; Emi Okamoto MD
Guest: Christine Won, MD MSc

Sponsor

The American College of Chest Physicians

Time Stamps

00:00 Intro, disclaimer, guest bio
06:10 Guest one-liner
10:15 Picks of the Week*: Become Your Child’s Sleep Coach (book) by Lynelle Schneeberg;
Sleep in Art: How artists portrayed sleep and dreams in the last 7000 years (book) by Meir Kryger; The Toxic Avenger (film);

#183 Longevity, Healthspan and Lifespan with Peter Attia MD Nov 18, 2019

Show notes

We want to live longer… and healthier too! Dr Peter Attia, a physician focusing on the applied science of longevity, walks us through lifespan and healthspan, exploring tactics aimed at extending both. Listeners will challenge the conventional approach to primary care and explore tactics to optimize exercise, nutrition, and health, including counseling on different dietary patterns, fasting, exercise, emotional well-being and how to prepare for the Centenarian Olympics!

Credits

Written and Produced by: Matthew Watto MD, FACP and Elena Gibson MD
Cover Art and Infographic: Elena Gibson MD
Hosts: Elena Gibson MD, Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Emi Okamoto MD
Audio Editor: Clair Morgan of Nodderly
Guest: Peter Attia MD

Time Stamps

00:00 Intro, disclaimer, guest bio
04:22 Guest one-liner, Career Advice, Picks of the Week*
14:30 Case: A couple seeking maximize longevity; Defining longevity, healthspan, lifespan and the 4 types of death
19:30 Lifespan, the longevity curve and the long tail
23:50 Peter’s approach to shepherding patients toward longevity; Exploring motivations
32:06 Back to our couple: What exercises should they perform
42:09 Peter’s advice on nutrition; the standard American diet; Intermittent fasting; Dietary Restriction
51:20 Periodic fasting and water only fasting
54:33 Genetics and longevity
56:40 Metformin;

#182 Becoming a PGY3: Not Just a Repeat of PGY2 Nov 11, 2019

Show notes

This podcast covers several concrete steps that residents can do or program directors can suggest to help residents transition to assuming the role of PGY3. A year is a long time, but requires a strategic approach to ensure that residents get the most out of it. It’s our latest offering from ACP’s IMpower series for residents featuring our friends from Walter Reed IM Residency: Joshua Hartzell MD (@joshuadhartzell); Kim Fabyan MD (@kfabsMD); Jeff Gray MD (@theotherDrGray).

If you are a PGY3 you should: LEAD like someone’s life depends on it!

Credits

Written and Produced by: Joshua Hartzell MD, MS-HPEd, FACP, FIDSA; Kim Fabyan MD; Jeff Gray MD
Infographics: Joshua Hartzell MD, MS-HPEd, FACP, FIDSA; Kim Fabyan MD; Jeff Gray MD
Cover Art: Matthew Watto MD, FACP
Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD, FACP
Guests: Joshua Hartzell MD (@joshuadhartzell); Kim Fabyan MD (@kfabsMD); Jeff Gray MD (@theotherDrGray)

Sponsor - ACP IMpower: Catalyzing your professional future

Each month, ACP IMpower offers non-clinical tools and resources expertly crafted to support residents during their training and catalyze their professional future.

Crafted by ACP leaders, experienced internists, and prominent podcasters, IMpower covers a wide variety of topics valuable to residents at every stage of their training, and beyond. Visit https://www.acponline.org/impower.