House of God author, Samuel Shem and Prof Katharine Watson share thought-provoking takes on Gallows Humor. Laugh and listen to this captivating take on the different shades of humor in the day-to-day of medicine. Time Stamps

• 02:33 Episode preview and Guest Introductions
• 04:20 Definition of Gallows Humor
• 07:25 Gallows Humor by Comedians vs Patients vs Physicians

The Good

• 08:15 Benefits/Functions of Humor in General
• 11:10 Connection
• 13:07 Coping/Catharsis
• 16:22 Resistance Against Oppression
• 19:03 Humor as our Authenticity/Humanity

The Bad, The Ugly

• 21:01 Unintended Audiences (e.g., patients, families)
• 25:30 “Corporeal” Joking
• 28:00 Toxic Role Modeling
• 31:10 Desensitization/Losing Empathy
• Tips, Takeaways & Conclusion33:48 Challenging Inappropriate Jokes
• 35:45 Excessive Gallows Humor: Signal of Distress?
• 37:17 Using Gallows Humor: Questions to Ask Yourself
• 38:40 Keeping the Faith!

• 41:11 Excerpt from Man’s 4th Best Hospital by Samuel Shem

Transcript and References

Tag: medical humanities, medical ethics, CoreIM, IMCore

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1st outpatient clinical reasoning case on Core IM Hoofbeats!

Get CME-MOC Credit (live at 9AM EST on 10/16)

Time Stamps

• 01:18 Case introduction
• 11:40 The Casablanca strategy
• 23:17 The diagnosis revealed
• 25:30 Logical fallacy: Denying the antecedent
• 33:22 Components of illness scripts
• 41:37 Conclusion

Show notes, transcripts and references!

Do you have a good case or an expert you would like to suggest for an episode? Send it our way at [email protected]

Tag: normocytic anemia, splenomegaly, CoreIM, endocarditis, clinic case

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Go deeper into the world of blood cultures!

Time stamps

• 04:10 Review of Choosing Wisely Guidelines
• 05:55 What are estimated incidences of positive blood cultures?
• 06:17 Which clinical signs or patient history is more likely to have positive blood cultures?
• 09:48 What is the estimated incidence of false positive blood cultures?
• 11:01 What infections more likely to have bacteremia?
• 13:50 How do positive blood cultures impact patient outcomes and the use of resources?

Show notes, transcript, and references

 

Tags: Infectious disease, CoreIM, pyelonephritis, cellulitis, community acquired pneumonia

 

 

 

 

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Practical tips on smoking cessation! Get CME Credit with ACP!

Full Transcript with References and Show Notes

Time Stamps

• 04:50 What questions are important to ask after a patient who contemplative about quitting tobacco?
• 07:00 Is quitting abruptly on a quit date or gradual cessation to a quit date better?
• 08:10 How can technology help support patients who are trying to quit?
• 08:49 How should we prepare patients who quit smoking and are worried about weight gain?
• 11:06 How can we try to convince patients to use medication as assistance to quit smoking?
• 11:50 What is the most effective nicotine replacement approach?
• 13:54 What are the potential side effects of the nicotine patch?
• 15:00 What should we prescribe for patients who smoke <5 cigarettes a day?
• 16:28 How can we determine how severe a patient’s nicotine dependence is?
• 18:26 When is the ideal frequency of nicotine gum or lozenge?
• 21:45 How does varenicline work?
• 25:05 Can you start varenicline in patients who have had psychiatric history?
• 27:15 What major side effect is seen in patients taking bupropion?
• 29:15 How do e-cigarettes work?
• 31:18 How should we approach adding e-cigarettes into a patient’s plan for quitting?
• 31:42 How should we discuss e-cigarette use with our patients?
• 33:47 Recap
• 39:54 Screening for Barrett’s Esophagus

 

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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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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

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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 [email protected]

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

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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

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Solidify your knowledge on Coronary calcium scores and Coronary CTAs!

ACP members can claim CME-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 !

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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

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