Within Normal Limits: Navigating Medical Risks

This episode is part of a special series that focuses on organizations that received grant funding from the COPIC Medical Foundation for initiatives that address the issue of reducing fragmentation across care settings. Dr. Zacharias welcomes Arturo Brito, MD, MPH, the President and CEO of Children’s Health Fund. Dr. Brito highlights how the grant was used to support the review, update, and dissemination of the successful Referral Management Initiative to incorporate new technologies that enhance care coordination procedures for pediatric populations living in under-resourced communities. They talk about health equity, innovation with mobile clinic programs, concern over COVID-19’s long-term impact on pediatric patients, addressing the challenges of navigating a complex health care system, and how “continuous improvement” serves as a guide for the organization’s efforts.

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Disclaimer: Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition.

This episode is part of a special series that focuses on organizations that received grant funding from the COPIC Medical Foundation for initiatives that address the issue of reducing fragmentation across care settings. Dr. Zacharias welcomes two guests from the Children’s Hospital Colorado: Jennifer Disabato, a pediatric nurse practitioner, and William Anderson, MD, an Associate Program Director. Ms. Disabati and Dr. Anderson highlight how the grant was used to support the ImPACT Navigation Hub—a centralized resource hub to coordinate the transition of young adult patients with pediatric onset conditions to adult care. They talk about some of the key challenges this patient segment faces in navigating health care systems, the importance of educating providers about this issue, and the broader application of their program and what they have learned from it.

Feedback or episode ideas email the show at [email protected]

Disclaimer: Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition.

This episode is part of a special series that focuses on organizations that received grant funding from the COPIC Medical Foundation for initiatives that address the issue of reducing fragmentation across care settings. Dr. Zacharias welcomes two guests from the Mile High Health Alliance: Dede de Percin, Executive Director, and Vicente Cardona, Program Manager. Dede and Vicente highlight how the grant was used to support the “Orange Flag” Project—an initiative that uses historic, predictive, and real-time data to inform emergency department personnel of a patient’s high utilization of emergency services to aid in care coordination. They talk about approaching the issue from a grassroots and systems level, the importance of collaboration with other organizations, what data tells us about high utilizers of ERs, and how they are working with medical providers to initiate protocols to improve outcomes.

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For more information on the guest in our show please visit : http://milehighhealthalliance.org/

Feedback or episode ideas email the show at [email protected]

Disclaimer: Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition.

This episode is part of a special series that focuses on organizations that received grant funding from the COPIC Medical Foundation for initiatives that address the issue of reducing fragmentation across care settings. Dr. Zacharias welcomes Olivia Soutullo, a psychologist and Director of Parent-Child Interaction Therapy Services at Children’s National (Washington, D.C.). Olivia highlights how grant funding from the Foundation was used to support a program aimed at improving coordination of pediatric mental care after psychiatric hospitalization. She talks about some of the key challenges faced in these situations, the importance of connecting with the families involved and helping them navigate mental health resources, and how they are evaluating outcomes to determine success as well as gathering insight to guide long-term efforts in this area.

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About | Children’s National Hospital Foundation (childrensnational.org)

Feedback or episode ideas email the show at [email protected]

Disclaimer: Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition.

Dr. Dennis Boyle, a COPIC physician consultant and rheumatologist, is the guest on this episode which looks at the issue of treating friends, family, and staff as patients. The discussion looks at the ethical, legal, and other considerations in these types of situations using some case studies and highlighting the American Medical Association’s guidance. In particular, there is the issue of how your professional judgement may be impacted when you have a close, personal relationship with a patient. Dr. Boyle also highlights other concerns that include confidentiality, sensitive examinations, and dealing with the urge to provide medical advice to people you care about. 

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Feedback or episode ideas email the show at [email protected]

Disclaimer: Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition.

This episode examines patients who present with chest pain and how this can run the full spectrum of being a minor irritation to a more serious condition that requires immediate attention. Dr. Zacharias draws upon his experience in internal medicine to talk about using clinical judgment to work through an assessment. He delves into using a differential diagnosis approach, addressing emergency situations, and evaluating considerations based on a patient’s medical history. In addition, Dr. Zacharias looks at how mental health conditions can influence chest pain and tests to rule in (and rule out) certain conditions.

Show email [email protected]

Feedback or episode ideas email the show at [email protected]

Disclaimer: Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition.

Due to recent active shooter situations and a renewed focus on the safety of health care providers, COPIC is re-releasing this past episode. Some providers may draw a strict boundary about discussing guns with their patients (or not think about it). But research has shown there are situations when access to firearms is a potential risk factor and raising this issue can be not only appropriate but necessary. Dr. Michael Victoroff, who is a firearms safety expert, addresses some scenarios associated with guns that can arise in the clinical setting. These range from imminent danger (e.g., suicide risk) to general considerations that vary from household to household (e.g., storage methods). Dr. Victoroff offers guidance on how to approach this topic with non-confrontational questions and suggestions for credible resources for healthcare providers.

Feedback or episode ideas email the show at [email protected]

Disclaimer: Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition.

This episode’s guest is Jody Thomas, PhD, Founder/Chief Executive Officer of The Meg Foundation, a nonprofit whose mission is to empower families with the pain management strategies, skills, and support they need to prevent and reduce pain. The discussion examines how “fear of needles” and health care avoidance can develop in early childhood, and what strategies can be implemented—by parents and medical providers—to prevent negative associations with medical care. Thomas highlights some best practices for pain management with children, such as over-the-counter numbing creams and comforting techniques, and talks about resources they have developed in partnership with health care organizations to support physicians. In addition, she talks about how her organization has used its experience to address vaccine hesitancy, the role anxiety plays in this, and how they have shared insight to help overcome these barriers. 

Feedback or episode ideas email the show at [email protected]

Disclaimer: Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition.

Our guest for this episode is Dr. Dan Rosenquist, a family medicine physician in Nebraska and risk manager for COPIC. The focus is on Stevens-Johnson syndrome and toxic epidermal necrolysis, which are commonly caused by medications or infections and typically present as skin reactions. Dr. Rosenquist walks through the causes and symptoms to be aware of, the role of certain medications in this condition, and discussing the issue with patients. The conversation also touches on having a high index of suspicion, particularly early in its presentation, as the findings may be subtle or confused with more common conditions.

Email the show at [email protected]

Feedback or episode ideas email the show at [email protected]

Disclaimer: Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition.

Dr. Zacharias reexamines the issues that lead to spinal epidural abscess, a rare condition that can result in severe adverse outcomes and allegations of negligent care. We start with a clear definition of spinal epidural abscess, why it occurs, and some notable contributing factors. From there, Dr. Zacharias examines risk factors with patients and some suggestions on being highly vigilant about certain signs that should increase your index of suspicion. He also walks through some examples of symptoms that patients commonly present with as well as key considerations when evaluating and treating patients with these symptoms.

Show email for feedback or topics you want to hear: [email protected]

Feedback or episode ideas email the show at [email protected]

Disclaimer: Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition.