Core IM | Internal Medicine Podcast

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 Stamps02:33 Episode preview and Guest Introductions04:20 Definition of Gallows Humor07:25 Gallows Humor by Comedians vs Patients vs PhysiciansThe Good08:15 Benefits/Functions of Humor in General11:10 Connection13:07 Coping/Catharsis16:22 Resistance Against Oppression19:03 Humor as our Authenticity/HumanityThe Bad, The Ugly21:01 Unintended Audiences (e.g., patients, families)25:30 “Corporeal” Joking28:00 Toxic Role Modeling31:10 Desensitization/Losing EmpathyTips, Takeaways & Conclusion33:48 Challenging Inappropriate Jokes35:45 Excessive Gallows Humor: Signal of Distress?37:17 Using Gallows Humor: Questions to Ask Yourself38:40 Keeping the Faith!41:11 Excerpt from Man’s 4th Best Hospital by Samuel ShemTranscript and ReferencesTag: medical humanities, medical ethics, CoreIM, IMCoreFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out Quince: https://quince.com/coreim* Use code FIGSRX for a great deal: https://wearfigs.comAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

A 65-year-old man's mysterious fatigue unfolds as hosts dive into outpatient diagnostics. They discuss the challenges of patient communication and the need for personalized approaches beyond standard tests. The spotlight turns to a complex case of anemia that leads to a life-changing diagnosis of endocarditis. Listeners learn the significance of logical reasoning in medicine and the development of illness scripts. The case concludes with a successful treatment story, urging engagement and reflection on clinical practices.

Dive into the fascinating world of blood cultures! Discover the guidelines for accurate testing and the surprising rates of false positives. Explore which clinical signs suggest positive blood cultures and their association with infections like bacteremia. Learn about the impact of blood cultures on patient outcomes and resource utilization. The discussion balances humor with critical insights into effective fever management and the complexities of diagnosing serious infections, highlighting the need for judicious testing practices.

Dr. Michael Fury, a tobacco use expert, and Dr. Scott Sherman, a primary care psychiatrist, share valuable insights on smoking cessation strategies. They discuss the best questions to ask patients contemplating quitting and whether to quit cold turkey or gradually. Technology’s role in supporting quitting efforts is explored, along with concerns about weight gain and effective nicotine replacement therapies. They also dive into contemporary approaches like e-cigarettes and the significance of tailoring cessation methods to individual patient needs.

Dr. David Alfandre, an ethics researcher and author, dives into the complex world of discharges Against Medical Advice (AMA). He discusses the demographics and factors influencing these decisions, emphasizing the critical role of clinician communication. The conversation reveals the challenges health professionals face when patients leave despite risks. Alfandre also explores the ethical dilemmas involved and shares strategies for improving shared decision-making, ensuring patient autonomy while enhancing care outcomes.

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 NotesTime Stamps2:07 Introduction to one woman’s journey3:00 Stereotype Threat6:15 Not all Anger is Created Equal10:17 Asking and Writing Your Own Job Description13:08 Imposter Syndrome15:50 Breaking Points to Self Care18:50 Work Life Integration21:40 Support NetworksFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out Quince: https://quince.com/coreim* Use code FIGSRX for a great deal: https://wearfigs.comAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

20 Qs with Core IM Team vs. Expert Discussant !Full Transcript and Show notesGet CME-MOC Credit for listening to this episode (live at 09:00 am EST on 8/7)Time Stamps00:20 The game of medical Twenty Questions04:37 Case introduction05:50 The CoreIM team attempts to solve the case15:36 The discussant’s diagnostic schema for abnormal bleeding23:37 Primary versus secondary hemostasis30:33 The pathology report !37:38 Criteria for the final diagnosis38:46 Dissecting a diagnostic coup49:42 ConclusionDo you have a good case or an expert you would like to suggest for an episode? Send it our way at hello@coreimpodcast.comTags: Coagulopathy, Bleeding Disorder, Diagnostic Schema, Von Willebrand's Disease, Clinical ReasoningFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out Quince: https://quince.com/coreim* Use code FIGSRX for a great deal: https://wearfigs.comAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Explore the debate on whether statins should be taken at night or during the day, considering the physiology of cholesterol synthesis and evidence supporting nighttime use. Discuss the impact of nighttime statin dosing on cholesterol levels and patient outcomes, highlighting the importance of individualized treatment plans and patient adherence.

Explore the crucial differences between functional stress tests and anatomical cardiac tests. Delve into the role of coronary artery calcium scores in managing coronary artery disease and their implications for risk stratification. Learn how coronary CT angiography compares with traditional stress tests and when to avoid using CTA. The discussion also highlights effective communication strategies for conveying CTA results to patients, ensuring clarity in their treatment options.

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   Introduction05:27   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   ConclusionShow notes, Transcript, Further ReadingFind the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840Our Sponsors:* Check out Quince: https://quince.com/coreim* Use code FIGSRX for a great deal: https://wearfigs.comAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy