The Day Shift

Pick up where we left off in Part 1 (Season 4, Episode 3) by applying the pediatric-to-adult transitions strategies we learned in that episode to a specific patient population: those with Intellectual and Developmental Disabilities (IDD), like Autism Spectrum Disorder (ASD). Transitions can be one of the most trying and health-destabilizing things a young person and their caregivers experience. In this episode, we learn from the experience and wisdom of Dr. Susan Hingle and Dr. Mai Pham, who have not only navigated this process with their patients, but with their own children as well. Their personal experiences have informed and fueled their wonderful professional work in this space as they demonstrate how we can provide and advocate for equitable care for this patient population.

Learning Objectives:
1. Define Intellectual and Developmental Disabilities (IDD), and the specific example of Autism Spectrum Disorder (ASD). Describe how these are diagnosed.
2. Describe key issues that healthcare teams should keep in mind for patients with IDD, including ASD, as they transition from childhood to adolescence to adulthood.
     a. In the clinic
     b. In the ER/hospital
3. Give examples of advocacy efforts for healthcare for members of this community.
4. Strategize how one can create inclusive healthcare environments, spaces, and culture for people with IDD, including ASD.

Credits:
Guest: Dr. Susan Hingle, Dr. Mai Pham
Co-hosts/Co-Executive Producers: Dr. Pooja Jaeel, Dr. Maggie Kozman
Executive Producer: Dr. Tammy Lin
Associate Producer: Dr. Candace Sprott
Senior Producer: Dr. DJ Gaines
Editor/Assistant Producer: Clara Baek
Production Assistants: Nilgoun Farhadi, Likitha Aradhyula
Website/Art Design: Ann Truong
Music: Chris Dingman https://www.chrisdingman.com

Continuing Medical Education/Maintenance of Certification (CME/MOC) credits are available through the American College of Physicians for both members and non-members. To submit for CME/MOC credit for this episode, visit: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/the-dei-shift

Connect with us on Instagram at @thedayshift.pod and via email at [email protected]

Join us in learning from our wonderful guests, Dr. Denise Connor (hospitalist and groundbreaking leader in curriculum development for diagnostic reasoning and anti-oppression) and Dr. Cristina Gonzalez (hospitalist and internationally renowned expert in the development of skills-based curricular interventions in implicit bias recognition and management). Dr. Connor and Dr. Gonzalez teach us how to define, identify, and mitigate disparities in diagnostic decision-making and reasoning in order to attain greater diagnostic equity for all patients.

Learning Objectives
1. Define disparities in diagnosis and diagnostic reasoning.
2. Review contributing factors to disparities in clinical diagnosis.
3. Outline steps individuals can take to reduce disparities in diagnostic reasoning.
4. Discuss organizational strategies to mitigate diagnostic disparities to achieve diagnostic equity.

Credits:
Course Directors/Co-Hosts: Dr. Ricardo Correa, Dr. Elisa Choi                                 
Guests: Dr. Denise Connor, Dr. Cristina M. Gonzalez                                           
Executive Producer: Dr. Tammy Lin                                                                                               
Co-Executive Producers: Dr. Pooja Jaeel, Dr. Maggie Kozman                                     
Senior Producer: Dr. DJ Gaines                                                                                         
Associate Producer: Dr. Candace Sprott                                                                               
Production Assistants: Erynn Beeson, Nikhil Thope                                       
Website/Art Design: Ann Truong                                                                                           
Music: Chris Dingman

Continuing Medical Education/Maintenance of Certification (CME/MOC) credits are available through the American College of Physicians for both members and non-members. To submit for CME/MOC credit for this episode, visit: https://online2.snapsurveys.com/26b3mt 

Connect with us on Instagram at @thedayshift.pod and via email at [email protected]

Join us for Part 2 of our discussion on Climate Change! Climate change is shifting how we live across the globe, impacting some communities far more than others, and forcing us to continue working to mitigate the damage and adapt to a new and changing environment. Nowhere is this need more important than in healthcare. Listen in on the rest of our conversation with Dr. Robert McLean (rheumatologist, advocate for climate justice, former ACP President) and Dr. Erika Moseson  (pulmonary and critical care physician, founder of Air Health Our Health) about the impact of climate on health and the ways we can work toward climate justice.

Learning Objectives:

1. Explore the intersection between health, healthcare disparities, and climate change.
2. Describe the breadth of the impact of climate change on historically marginalized and disinvested communities and individuals.
3. Understand the various strategies to respond to climate change being adopted at the community level, frontline, and systems level in two different areas in the United States.
4. Explore advocacy around slowing, mitigating effects of, and planning/adapting to climate change and climate change emergencies.

Credits:
Guests: Dr. Robert McLean, Dr. Erika Moseson
Co-Hosts: Dr. Marianne Parshley, Dr. Elisa Choi
Executive Producer: Dr. Tammy Lin
Co-Executive Producers: Dr. Pooja Jaeel, Dr. Maggie Kozman
Associate Producer: Dr. Candace Sprott
Senior Producer: Dr. DJ Gaines
Editor/Assistant Producer: Joanna Jain, Sanika Walimbe
Production Assistants: Leyna Nguyen, Dr. Erynn Beeson
Website/Art Design: Ann Truong
Music: Chris Dingman https://www.chrisdingman.com

Continuing Medical Education/Maintenance of Certification (CME/MOC) credits are available through the American College of Physicians for both members and non-members. To submit for CME/MOC credit for this episode, visit: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/the-dei-shift

Connect with us on Instagram at @thedayshift.pod and via email at [email protected]

Climate change is shifting how we live across the globe, impacting some communities far more than others, and forcing us to continue working to mitigate the damage and adapt to a new and changing environment. Nowhere is this need more important than in healthcare. Join us as we learn from Dr. Robert McLean (rheumatologist, advocate for climate justice, former ACP President) and Dr. Erika Moseson  (pulmonary and critical care physician, founder of Air Health Our Health) about the impact of climate on health and the ways we can work toward climate justice.

Learning Objectives:

1. Explore the intersection between health, healthcare disparities, and climate change.
2. Describe the breadth of the impact of climate change on historically marginalized and disinvested communities and individuals.
3. Understand the various strategies to respond to climate change being adopted at the community level, frontline, and systems level in two different areas in the United States.

Episode Credits:
Guests: Dr. Robert McLean, Dr. Erika Moseson
Co-Hosts: Dr. Marianne Parshley, Dr. Elisa Choi
Executive Producer: Dr. Tammy Lin
Co-Executive Producers: Dr. Pooja Jaeel, Dr. Maggie Kozman
Associate Producer: Dr. Candace Sprott
Senior Producer: Dr. DJ Gaines
Editor/Assistant Producer: Joanna Jain, Sanika Walimbe
Production Assistants: Leyna Nguyen, Dr. Erynn Beeson
Website/Art Design: Ann Truong
Music: Chris Dingman https://www.chrisdingman.com

Continuing Medical Education/Maintenance of Certification (CME/MOC) credits are available through the American College of Physicians for both members and non-members. To submit for CME/MOC credit for this episode, visit: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/the-dei-shift

Connect with us on Instagram at @thedayshift.pod and via email at [email protected]

Join us for Part 2 of the powerful discussion we started at the end of last season (Season 4, Episode 6), with our 2 experts on caring for people experiencing houselessness, James O’Connell, MD, MACP (Boston Healthcare for the Homeless) and Rachel Solotaroff, MD, FACP (Central City Concern- Portland, Oregon).
 
From the HIV epidemic to the rise of multi-drug resistant TB and the opioid crisis, those caring for people experiencing houselessness and housing insecurity saw the rise of each of these epidemics in their patient populations long before the rest of us.  The devastating impact of the COVID-19 pandemic was particularly harsh for those in shelters or unhoused. Some say that caring for those experiencing houselessness reveals the fractures in our healthcare system earlier and more clearly than healthcare in other settings.  In our discussion, Drs. O’Connell and Solotaroff describe some of the obstacles faced by these patients and their healthcare providers in obtaining/delivering healthcare, and some of the opportunities to learn from and address these challenges.

Learning Objectives:

1. Identify challenges and lessons for both clinical teams and people experiencing houselessness in providing and accessing healthcare.
2. Describe different models of housing support and healthcare delivery for which clinicians can advocate in order to support those experiencing and emerging out of houselessness, and to ultimately reach the goal of ending houselessness.
3. Discuss some of the challenges facing houseless individuals who are seriously ill and/or at end-of-life, and facing those who are providing their end-of-life healthcare.

Episode Credits:
Guests: Dr. James O’Connell, Dr. Rachel Solotaroff
Co-Hosts: Dr. Marianne Parshley, Dr. Elisa Choi
Executive Producer: Dr. Tammy Lin
Co-Executive Producers: Dr. Pooja Jaeel, Dr. Tiffany Leung
Senior Producers: Dr. Maggie Kozman, Dr. DJ Gaines
Editor/Assistant Producer: Clara Baek
Production Assistants: Nilgoun Farhadi, Leyna Nguyen
Website/Art Design: Ann Truong
Music: Chris Dingman https://www.chrisdingman.com

Continuing Medical Education/Maintenance of Certification (CME/MOC) credits are available as an American College of Physicians national member benefit. To submit for CME/MOC credit for this episode, visit: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/the-dei-shift

Connect with us on Instagram at @thedayshift.pod and via email at [email protected]

From the HIV epidemic to the rise of multi-drug resistant TB and the opioid crisis, those caring for people experiencing houselessness and housing insecurity saw the rise of each of these epidemics in their patient populations long before the rest of us.  The devastating impact of the COVID-19 pandemic was particularly harsh for those in shelters or unhoused. Some say that caring for those experiencing houselessness reveals the fractures in our healthcare system earlier and more clearly than healthcare in other settings.  Join us for the first of 2 episodes with 2 experts on caring for this population, Dr. James O’Connell, MD, MACP (Boston Healthcare for the Homeless) and Rachel Solotaroff, MD, FACP (Central City Concern- Portland, Oregon). In our discussion of the obstacles faced by these patients and the opportunities to learn from them, Drs. O’Connell and Solotaroff describe the root causes of houselessness, the best terms to use when addressing people experiencing houselessness, and some of the challenges in delivering healthcare to these patients.

Learning Objectives:

1. Define houselessness/homelessness and housing insecurity.
2. Explore and define root causes of the crisis of houselessness in the U.S.
3. Understand the challenges to access and provision of healthcare to houseless folks.

Episode Credits:
Guests: Dr. James O’Connell, Dr. Rachel Solotaroff
Co-Hosts: Dr. Marianne Parshley, Dr. Elisa Choi
Executive Producer: Dr. Tammy Lin
Co-Executive Producers: Dr. Pooja Jaeel, Dr. Tiffany Leung
Senior Producers: Dr. Maggie Kozman, Dr. DJ Gaines
Editor/Assistant Producer: Clara Baek
Production Assistants: Nilgoun Farhadi, Leyna Nguyen
Website/Art Design: Ann Truong
Music: Chris Dingman https://www.chrisdingman.com

Continuing Medical Education/Maintenance of Certification (CME/MOC) credits are available as an American College of Physicians national member benefit. To submit for CME/MOC credit for this episode, visit: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/the-dei-shift

Connect with us on Instagram at @thedayshift.pod and via email at [email protected]

As the COVID-19 pandemic abates, migration across the globe has increased. Health care professionals are likely to encounter immigrant populations who have unique needs. Join us in learning with Dr. Lorena Bonilla (Internal Medicine Hospitalist and Assistant Professor at Florida University/Herbert Wertheim College of Medicine) about factors that influence the health care of immigrants, how to approach patients with cultural sensitivity, and ways physicians can incorporate advocacy into their practice to help support migrants.

Definition of Terms:

In this podcast, we use the terms migrants, immigrants, refugees and asylum. Here we wanted to define these terms. A migrant is an individual who migrates from one location to another usually seeking employment or education. An immigrant is an individual who seeks to live in another country permanently. A refugee is an individual who is forced to flee their home because of violence or persecution. Additionally, someone who applies for asylum is seeking protection from dangers in their home country and is awaiting their claim for refugee status to be legally determined. For further reference, rescue.org has an article outlining these terms. https://www.rescue.org/article/migrants-asylum-seekers-refugees-and-immigrants-whats-difference.

Learning objectives:

1. Identify key social determinants of health that affect immigrant populations.
2. Recognize factors that influence the health care of migrants and refugees.
3. Summarize a situation from your own clinical experience in which understanding the culture of a patient enhanced your ability to care for them. Identify how you can be consistent in ensuring that you consider the role that culture plays in the lives of your patients.

 
Credits:

Guest: Dr. Lorena Bonilla
Co-hosts/Producers:  Dr. Brittäne Valles, Dr. Ricardo Correa
Executive Producer: Dr. Tammy Lin 
Co-Executive Producers: Dr. Pooja Jaeel, Dr. Tiffany Leung
Senior Producers: Dr. Maggie Kozman, Dr. DJ Gaines
Editor/Assistant Producer: Clara Baek
Production Assistants: Ann Truong
Website/Art Design: Ann Truong
Music: Chris Dingman

Connect with us on Instagram at @thedayshift.pod and via email at [email protected]

The advent of the COVID-19 pandemic highlighted the negative effects medical misinformation and disinformation can have on our communities. Despite these not being new phenomena, health professionals have seen first-hand during the pandemic how difficult it is to combat these pervasive problems. Join us in learning with Dr. Tracey Henry (General Internist and Associate Professor of Medicine at Emory University) about what constitutes medical misinformation and disinformation, the psychological factors that drive their spread, and ways we can combat them.

Learning Objectives

1. Define the terms misinformation, disinformation and malinformation. 
2. Describe the 3 psychological factors that drive the spread of misinformation and disinformation. 
3. Identify strategies physicians can use to combat misinformation and disinformation, such as psychological inoculation or “pre-bunking”.

Credits:

Co-Hosts/Producers: Dr. DJ Gaines and Branden Barger
Executive Producer: Dr. Tammy Lin
Co-Executive Producers: Dr. Pooja Jaeel, Dr. Tiffany Leung
Senior Producers: Dr. DJ Gaines, Dr. Maggie Kozman
Editor/Assistant Producer: Emily Han
Production Assistants: Alexandra Babakanian, Leyna Nguyen
Website/Art Design: Ann Truong
Music: Chris Dingman

Connect with us on Instagram at @thedayshift.pod and via email at [email protected]

Transitions between pediatric and adult healthcare models can be one of the most trying and health-destabilizing things a young person and their caregivers experience. Healthcare professionals on both the sending and receiving ends of this transition need training in how to facilitate successful transitions. Resources like medical society recommendations and GotTransition.org can help, but there are many challenges to successful transition of which healthcare teams must be aware in order to assist their patients through the process.

Learning Objectives:

1. Define Healthcare Transitions. 
2. Describe two barriers that patients and families face in transitioning to an adult-centered model of care.
3. Describe two barriers that healthcare professionals face in comprehensive transition. 
4. Identify specific challenges that patients with complex medical needs face during the transition process. 

Credits:
Guest: Dr. Shirin Alonzo  
Co-hosts/Producers: Dr. Pooja Jaeel, Dr. Maggie Kozman
Executive Producer: Dr. Tammy Lin 
Co-Executive Producers: Dr. Pooja Jaeel, Dr. Tiffany Leung
Senior Producers: Dr. Maggie Kozman, Dr. DJ Gaines
Editor/Assistant Producer: Joanna Jain, Clara Baek
Production Assistants: Alexandra Babakanian, Leyna Nguyen
Website/Art Design: Ann Truong
Music: Chris Dingman

Connect with us on Instagram at @thedayshift.pod and via email at [email protected]

Trauma has an undeniable impact on our patients' health and illness, and resilience is vital to their ability to buffer that trauma. Join us in learning from Dr. Moira Szilagyi (President of the American Academy of Pediatrics) and Dr. Edward Machtinger (Internal Medicine physician and director of UC San Francisco's Center to Advance Trauma-Informed Healthcare) about the key elements of resilience, symptoms that develop when resilience factors are challenged, reframing trauma-informed care as resilience-informed care, secondary traumatic stress, and the fundamental role of trauma in creating/exacerbating health disparities.

Learning Objectives:

1. Define the term resilience in the context of trauma-informed care.
2. List 3 key individual resilience factors, and identify the symptoms of trauma that may result from impairment in those resilience factors.
3. Define secondary traumatic stress, and distinguish it from burnout.
4. Consider how health disparities are caused and exacerbated by trauma, and therefore necessitate a trauma-informed approach to address disparities.

Credits:
Guests: Dr. Moira Szilagyi, Dr. Edward Machtinger
Co-hosts/Producers: Dr. Maggie Kozman, Dr. DJ Gaines
Executive Producer: Dr. Tammy Lin 
Co-Executive Producers: Dr. Pooja Jaeel, Dr. Tiffany Leung
Senior Producers: Dr. Maggie Kozman, Dr. DJ Gaines
Editor/Assistant Producer: Joanna Jain
Production Assistants: Nilgoun Farhadi, Sanika Walimbe
Website/Art Design: Ann Truong
Music: Chris Dingman

Connect with us on Instagram at @thedayshift.pod and via email at [email protected]