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How can I best answer my families medical questions? How can I give my loved ones the best care without providing it directly for them? What boundaries should I have in place? Show notes, Transcript and References:   https://www.coreimpodcast.com/2021/01/13/treating-friends-family/ Time Stamps: 02:45 The tension, the push and pull 05:45 Prevalence 06:32 Stances of societies/professional organizations 08:18 Concerns 10:35 How to respond 17:52 Favors for physician/trainee colleagues, self-doctoring 22:26 Formal vs informal, documentation 23:55 Long-term care Tags: patient care, advocate, advice, healthcare, Core IM, IM Core, medical ethics, medical humanities

How do you form an educational mission statement? What role do coaches and mentors play? Do you need formal training for a MedEd career? What are the challenges with careers in medical education? Digital Education conference (virtual) on Jan 22, 2021: cmeregistration.hms.harvard.edu/digitaleducation Show notes, Transcript and References: https://www.coreimpodcast.com/2020/12/27/medical-educatio…s-careers-series/ Time Stamps: 00:00 Introductions 05:44 General Tips 18:00 Challenges in Med Ed 24:54 Conclusion Tags: CoreIM, IM Core, mission statement, clinician educator, mentors, coaching, training, feedback

Can you identify where along the clinical reasoning pathway the learner is struggling? What coaching exercises can be helpful? What feedback do you fall back on when working with learners? What are common challenges? Show notes, Transcript and References: https://www.coreimpodcast.com/2020/12/09/hoofbeats-strugg…inical-reasoning/ ACP CME: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im Time Stamps: 00:00 Introduction 03:33 Mental Health & Wellbeing 06:43 Case 1 11:48 Exercise 1 12:53 Exercise 2 14:35 Case 2 19:15 Exercise 3 21:22 Exercise 4 23:24 Case 3 27:29 Exercise 5 28:07 Exercise 6 29:24 Conclusion Tags: CoreIM, IM Core, problem representation, coaching exercises, data gathering, hypothesis generation, clinical reasoning, faculty development

What is the difference between mnemonics and schemata? What does the mnemonic NAACP bring to mind? How do repeat interviews bring you closer to or further away from the diagnosis? Show notes, transcript and references: https://www.coreimpodcast.com/2020/11/25/a-29m-with-cough…oofbeats-segment/ ACP CME: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im Time Stamps: 00:43 Case presentation Part 1 04:55 Case presentation Part 2 06:50 Expert discussant 28:52 Framing bias 33:38 Concluding thoughts Tags:  IM Core, CoreIM, schemata, mnemonics, eosinophilia, framing bias

What leads patients to search for alternative treatments than those offered in Western Medicine? How can we provide patients with safer complimentary interventions? How do we prioritize what is important in our patients health? Show notes, Transcript and References: https://www.coreimpodcast.com/2020/10/15/approach-to-patients-with-cam-beliefs/ Time stamps: 01:49 Intro 04:54 What is CAM 06:29 Prevalence of CAM 08:01 Holistic approach to patient care 11:09 Patient empowerment 14:38 Integrating CAM 18:34 Risks and Benefits 19:50 Caution patients 22:29 Indirect Risk 23:45 Big Picture 26:04 Therapeutic Alliance 27:27 Conclusion Tags: IM Core, CoreIM, supplements, homeopathic, naturopathic, Ayurvedic medicine, mind-body interventions, massage, acupuncture, and chiropractic manipulation, qi gong and Reiki

How can we feel more comfortable in treating these patients? What treatment options do we now have in our toolbox to fight COVID-19? How has the landscape changed in what we can offer patients? Show notes, Transcript and References: https://www.coreimpodcast.com/2020/09/30/covid-management/ Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im Time stamps 04:16 Supportive Care 07:48 Step-up approach to oxygenation 13:44 Data Points 15:30 Clots 19:13 Steroid use Tags: IM Core, CoreIM, oxygenation, proning, anticoagulation

How do we respond to challenging times? Are you a driver of change? How can we forge ahead during times of adversity? What lessons can we learn from the stories of our peers and colleagues? Show notes, Transcript and References: https://www.coreimpodcast.com/2020/09/16/transitions-episode/ Time Stamps: 02:48 Minneapolis 2020 with Dr. Uloko 06:44 Early HIV/AIDS with Dr. Kalet 12:07 Hurricane Sandy with Dr. Hwang 17:20 Aftermath of the Syrian Civil War 20:23 Transitions with Dr. Arora Tags: Core IM, IM Core, change, inspiration, narrative medicine

What are common mistakes with protein on the UA? What questions should you ask while obtaining a history that could clue you into nephrotic syndrome? Are kidney biopsies risky business? Is there an associated clot risk in patients with nephrotic syndrome? Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im Show note, Transcript and References: https://www.coreimpodcast.com/2020/09/02/5-pearls-on-nephrotic-syndrome/ Amboss Article on Nephrotic Syndrome: https://www.amboss.com/us/knowledge/Nephrotic_syndrome?utm_source=affiliate&utm_medium=link&utm_campaign=coreim-01 Time Stamps: 03:22 Evaluating Proteinuria 09:37 Nephrotic Syndrome specifics 22:31 Who to biopsy 31:39 Diuretics 37:16 Thrombosis Risk Tags - CoreIM, IM Core, edema, proteinuria, kidneys, thrombosis, urinalysis, diuresis 

How tough is it to forge your career in clinical research? What struggles do physicians face in finding protected time? Are there setbacks and frequent rejections? How can you follow your passion and find success? Show note, Transcript and References: https://www.coreimpodcast.com/2020/08/19/research-careers…rs-in-gim-series/ Time Stamps: 1:28 Origins 6:57 Mentorship 14:30 Reality, Roadbumps, and Failures 18:17 The path of many fellowships   Tags - CoreIM, IM Core, clinical investigator, general internal medicine

Are fall prevention programs helping our patients? Should patients receive outpatient PT based on clinical diagnosis? How has the landscape changed because of insurance reimbursement? Show note, Transcript and References: https://www.coreimpodcast.com/2020/08/05/physical-therapi…education-series/ Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im Time Stamps: 01:47 Functional Assessment 07:47 Documentation 14:35 Outpatient PT 18:14 Durable Medical Equipment 22:55 Reimbursement Tags: Core IM, IM Core, physical therapy, durable medical equipment, IPE, multidisciplinary team, interdisciplinary

What goes into decision making? What are the invisible tugs that may keep patients from acting in line with their values? Why isn't it part of the formal capacity assessment? Show notes, Transcript and References: https://www.coreimpodcast.com/2020/07/22/capacity-2-0-and-voluntarism/ Get CME-MOC credit with ACP: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im Time Stamps: 2:57 Defining voluntarism 5:36 Four elements that influence voluntarism 10:26 How do you incorporate voluntarism into the capacity assessment? 16:11 Discussions with uncooperative patients 19:14 Protecting unrepresented patients 21:30 Clinician perspective 25:06 Moral distress Tags: medical humanities, ethics, psychiatry, IM Core, CoreIM

Unpack a famous historical legend's medical dilemma on a special "Historical CPC" episode! Show notes, transcript and references: https://www.coreimpodcast.com/2020/07/08/22729/ Time Stamps: 02:55 HPI 07:33 Past Medical History 04:25 Physician Exam findings 24:22 Historical Figure Revealed 26:30 Reflections on top 3 diagnosis Tags: cognitive and neuropsychiatric disturbances, rabies, mercury poisoning, cholera, delirium, COREIM, IMCORE, clinical reasoning case

Packed with so many clinically relevant points taking care of a patient with decompensated heart failure on general medicine floors! Time Stamps: 03:17 What are the key initial clinical variables in evaluating heart failure admissions? 10:09 What are key lab findings for patients with heart failure exacerbation? 17:14 Which guideline-directed medical therapy, and in what circumstances? 22:12 What are diuretics dosing strategies and monitoring tips to help guide initial volume removal? 28:43 What role do thiazides and ultrafiltration play in diuresis, why does diuretic-induced metabolic alkalosis happen and what should you do about it? 38:09 Expert Recap Show notes, transcript and references: https://www.coreimpodcast.com/2020/06/24/5-pearls-on-inpatient-heart-failure/ ACP CME: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im   Tag: Cardiology, BNP, cardiorenal syndrome, beta-blockers, CoreIM, IMCore

SNF vs. NH? SAR vs. SNF? What are the differences in resources, nursing and clinician oversight and who pays for what?! Show notes, transcript and references: https://www.coreimpodcast.com/2020/06/10/snf-sar-nh-alf-and-more-discharge-options-interprofessional-education-series/ ACP CME: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im Time stamps: 04:07 SAR vs SNF 13:35 Long term Nursing Home Care 18:30 Assisted Living Facility 24:40 Acute rehab 26:11 LTACH 27:49 Home Tags: Subacute rehab, skilled nursing facility, long-term acute care hospital, CoreIM, Core_IM, hospital medicine, family medicine, emergency medicine, physician assistant, nurse practitioner, interprofessional education

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

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

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

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

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

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