Should we use oral diabetes agents in our hospitalized patients? Do you hold metformin for fear of lactic acidosis? Do you typically order an insulin sliding scale? When can you comfortably restart PTA meds?Time Stamps:02:25 Can we give metformin in the hospital?10:50 Incretin-based therapies14:49 Sodium Glucose Cotransporter-2 Inhibitors16:27 Sulfonylurea & Thiazolidinediones18:00 Basal Insulin inpatientShow notes, Transcript and References: https://www.coreimpodcast.com/2021/10/13/oral-diabetes-medications-in-hospitalization-mind-the-gap-segment/ACP CME: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im Tags: Core IM, IM Core, glucose, insulin, hospitalized patients, oral medications, sliding scale, DPP-4, GLP-1

Core IM | Internal Medicine Podcast

#91 Oral Diabetes Medications Inpatient: Mind the Gap Segment

What are practical phrases can you incorporate to help patients who use drugs? What changes can you make to ensure person-first language? What safe drug practices can you advise? What is MOUD?Show notes, Transcript and References: https://www.coreimpodcast.com/2021/09/29/5-pearls-on-stig…oid-use-disorder/ACP CME: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im Time Stamps:04:24 Starting the Conversation 10:43 The Shared Agenda14:46 Exploring patient goals18:54 Reducing drug use24:09 Reducing harm in opioid use29:06 RecapTags: Core IM, IM Core, MOUD, buprenorphine, patient centeredness, motivational interviewing, safe practices

#90 Stigma in Opioid Use Disorder: 5 Pearls Segment

A very practical episode around nuanced code status conversations with many examples!Time Stamps:00:08 Introduction04:01 Information Gathering20:41 Informed Consent29:47 Giving Recommendations36:47 Mistakes48:22 Wrap Up Show notes, Transcript and References: https://www.coreimpodcast.com/2021/09/12/code-statusTags: Core IM, IM Core, DNR/DNI, CPR, intubation, goals of care, shared decision making, documentation, conversations, recommendations

#89 Code Status: At the Bedside Segment

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

"Best of" | SNF, SAR, NH, ALF and More Discharge Options

What are the indications for a stress test?  How to choose stress protocol in a stress test?  How to choose diagnostic imaging in a stress test?  How do we interpret results from stress tests, and how should this be communicated to patients? For full transcript, infographic and show notes: https://www.coreimpodcast.com/2019/04/24/stress-testing/ Tags: Internal Medicine, Internist, Primary Care Physician, Hospitalists, Emergency Medicine, Nurse Practitioner, Physician Assistant, Family Physician, Cardiology, angina, ischemia

"Best of" | Stress Testing 5 Pearls

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   Tags: CoreIM, AMA Discharges, Psych, Competency, medical ethics, medical humanties

"Best of" | Capacity Part 1 At the Bedside

20 Qs game with Core IM Team vs. Expert Discussant ! Full Transcript and Show notes Get CME-MOC Credit for listening to this episode 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 

"Best of" | 20Qs Hoofbeats

Transitions can be hard. Laugh, commiserate, and be inspired by these July stories in medicine! Very big thank you to everyone who told their stories ! Let's help each other feel a little less alone in the struggle, be more understanding and compassionate or laugh at ourselves. Please share this episode with colleagues.  Do you have a July story? Email us at hello@coreimpodcast.com. Tags: Narrative Medicine, CoreIM, IMcore, imposter syndrome

"Best of" | July Stories

 How can we help colleagues that we think are struggling with substance use disorder? What options are available for physicians? Are these different state to state? What deterrents do physicians face when seeking help? Time Stamps: 00:21 Introduction 13:50 Barriers to care 28:44 Physician Health System Show notes, Transcript and References: https://www.coreimpodcast.com/2021/06/09/physician-clinician-impairment/ Tags: Core IM, IM Core, impairment, substance use disorder, mental health, stigma, treatment, cost

#88 Physician Impairment: At the Bedside Segment

Debunk common myths of penicillin allergies! What's the best way to ask about allergies? How can you challenge patients to determine if they have a true allergy? Organic chemistry buffs, what mediates cross-reactivity? What medications can you safely give your patients? Show note, Transcript and References: https://www.coreimpodcast.com/2021/06/02/5-pearls-on-penicillin-allergy/ Time Stamps: 02:49 Penicillin Myths 07:20 Penicillin Allergy 11:21 Allergic Reactions 19:01 Managing allergic reactions 26:53 Alternative medications 33:28 Recap Tags: CORE IM, IM Core, history taking, rash, skin testing, hypersensitivity, medications, over labeling, antibiotics, management

#87 Penicillin Allergy: 5 Pearls Segment

What are good habits in QI? What are the areas of expertise needed to have a successful career in QI? How can you get involved in quality improvement? What projects can you get involved with, and how do you work outside of your own interests? How can you partner with your healthcare system to make changes? Show notes, Transcript and References: https://www.coreimpodcast.com/2021/05/08/quality-improvement-careers-series/ Time Stamps: 01:36 Getting started 05:01 Formal training 08:27 What are areas of expertise to get good at? 16:27 Typical Day 19:27 Challenges 23:56 Metrics Tags: CORE IM, IM Core, fellowships, jobs, leadership, metrics, training, patient safety

#86 Quality Improvement: Careers Series

 How does cost, potency, and bleeding risk affect which antiplatelet you choose P2Y12 inhibitors? How long after starting, do you feel comfortable stopping DAPT on a patient? How do you manage DAPT in patients who need anticoagulation? Show notes, Transcript and References: https://www.coreimpodcast.com/2021/04/07/5-pearls-on-dual…platelet-therapy/ Join Our Team Time stamps 02:35 Indications 08:52 Medications 17:37 Duration 28:23 De-escalation 30:55 Anticoagulation Tags: IM Core, CoreIM, anticoagulation, DAPT, acute coronary syndrome, stents, thrombosis, bleeding risk, cardiology, hospitalist, primary care

#85 Dual Antiplatelet Therapy: 5 Pearls Segment

Hear perspectives that don't get as much spotlight! What is it like to be a surrogate? How can we be better listeners for our patients and for their surrogates? Show notes, Transcript and References: https://www.coreimpodcast.com/2021/03/17/supporting-surrogates/ Time Stamps: 01:09 Background Information 03:54 Surrogate Challenges 16:04 Clinician Challenges 36:10 Conclusion Tags: CORE IM, IM Core, decisions, prognosis, goals of care, clinicians, patients, family medicine, palliative care, end-of-life

#84 Supporting Surrogates: At the Bedside Segment

How can we better serve the public's health? What does the landscape of public health look like? What opportunities are available to better hone your skills? What are common challenges professionals face? Show notes, Transcript and References: https://www.coreimpodcast.com/2021/02/24/public-health-ca…rs-in-gim-series/ Time Stamps: 01:00 Introduction 05:07 Defining Public Health 11:17 Pursuing a Public Health Career 20:12 Politicization of Health Tags: CORE IM, IM Core, fellowships, advocacy, healthcare, jobs, leadership, population health

#83 Public Health: Careers Series

What does each diagnostic test tell you? How do you interpret urine osmolality, urine sodium, or urine urea? What studies can be used to better assess response to treatment? How can uric acid be utilized as a diagnostic tool? What is the interplay between ADH and UOsm? Time Stamps: 04:50 General Diagnostic Approach 12:26 Serum Osmolality 19:34 Urine Osmolality 32:09 Urine Sodium 45:23 Uric Acid Show notes, Transcript and References: https://www.coreimpodcast.com/2021/02/10/5-pearls-on-hyponatremia-episode-1/ ACP CME: https://www.acponline.org/cme-moc/cme/internal-medicine-podcasts/core-im Tags: urine studies, SIADH, Core IM, IMCore, antidiuretic hormone, hospital medicine, family medicine, nephrology

#82 Hyponatremia Diagnostics: 5 Pearls Segment

Core Internal Medicine via following segments: 5 Pearls || Clinically relevant pearls on IM topics! Mind the Gap || Why do we do what we do? Hoofbeats || Dissecting clinical reasoning!

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Core IM | Internal Medicine Podcast

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