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

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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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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

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Episode Outline

1. Disconnection/connection: Patients
2. Disconnection/connection: Family/friends
3. Disconnection: Security, Certainty
4. Connection: Other clinicians

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

1. 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

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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

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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

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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

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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

 

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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

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• 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

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