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Racial Disparities in COVID-19 Outcomes with Dr. Jasmine Marcelin

November 2020
24min

This year we’ve launched two special audio series to help clinicians practice the best medicine possible: one on the Covid-19 pandemic, and the other on dismantling systemic racism in medicine. In this special conversation, these two audio series come together for an in-depth view of racial disparities in Covid-19 outcomes and how we can do better by our patients. Our usual hosts, Drs. Jay-Sheree Allen and Neda Frayha, interview Infectious Diseases specialist and Diversity and Inclusion expert Dr. Jasmine Marcelin for a rich discussion that sits right in the center of the Covid-19/Race and Medicine Venn diagram. 

CMS Changes Due to COVID

November 2020
8min

Kris and Adrian discuss AAPAs efforts to make some Covid-era CMS changes permanent instead of temporary. These permanent changes will help reduce unnecessary regulatory and administrative burdens to improve access to high quality care and ensure a sufficient healthcare workforce.

Paper Chase #1 - Preventing Serious Fall Injuries

November 2020
6min

There was no significantly lower rate of serious fall injury.

Constipation

November 2020
22min

Constipation can be a tricky thing to both diagnose and treat. In this month’s intro segment, Neda and Aisha discuss the work up and management of this common complaint. 

Approach to Joint Complaints

November 2020
19min

Do you have a super amazing approach to patients with joint complaints? If not, you will after listening to this practical conversation between Neda and Dr. Uzma Haque, a rheumatologist and arthritis expert at Johns Hopkins.

Paper Chase #2 - Compression Therapy to Prevent Recurrent Cellulitis

November 2020
6min

Compression therapy resulted in lower incidence of recurrent cellulitis 

COPD Updates

November 2020
21min

COPD can be a big, unwieldy topic in primary care. Thank goodness we have pulmonologist Dr. Kathryn Robinett to walk us through a practical, real world approach to the evaluation, classification, and management of COPD in our primary care practices. Spoiler alert: it’s not always about the Gold criteria.

The Big Picture: Elderhood Part 1

November 2020
22min

For most of us, people over the age of 65 make up a huge portion of the patients we see and the energy we pour into clinical care. And yet most of us receive woefully inadequate training to provide the best care for these patients and to overcome structural, systemic biases against the elderly. In this special conversation, Neda sits down with Dr. Louise Aronson, geriatrician and Professor of Medicine at UCSF and author of the fantastic book Elderhood to learn more about how we can take better care of our over-65 patients.

Paper Chase #3 - Antimicrobial Stewardship for Cystitis in Nursing Homes

November 2020
5min

A low-intensity, multifaceted intervention was associated with improved antibiotic prescribing for uncomplicated cystitis without adverse outcomes

The Big Picture: Elderhood Part 2

November 2020
19min

For most of us, people over the age of 65 make up a huge portion of the patients we see and the energy we pour into clinical care. And yet most of us receive woefully inadequate training to provide the best care for these patients and to overcome structural, systemic biases against the elderly. In this special conversation, Neda sits down with Dr. Louise Aronson, geriatrician and Professor of Medicine at UCSF and author of the fantastic book Elderhood to learn more about how we can take better care of our over-65 patients.    For most of us, people over the age of 65 make up a huge portion of the patients we see and the energy we pour into clinical care. And yet most of us receive woefully inadequate training to provide the best care for these patients and to overcome structural, systemic biases against the elderly. In this special conversation, Neda sits down with Dr. Louise Aronson, geriatrician and Professor of Medicine at UCSF and author of the fantastic book Elderhood to learn more about how we can take better care of our over-65 patients.

What's that Lab? Monocytosis

November 2020
8min

Monocytosis is a fairly common finding that is often of undetermined significance. In this “What’s that Lab?” segment, Paul presents an approach to this abnormality we can use in our practice.

Paper Chase #4 - CLUSTER-HF Study

November 2020
9min

Incorporation of lung US significantly reduced the risk of urgent visits for worsening CHF

Oncofertility Options

November 2020
24min

Our cancer patients need to consider lots of different factors when it comes to preserving their fertility. Reproductive endocrinologist Dr. Lauren Roth walks us through the options available to our oncofertility patients.

Dog & Cat Bites

November 2020
29min

Paul and Matt go over the ins and outs of dog and cat bites. This discussion includes appropriate wound management, use of prophylactic antibiotics,and post-exposure rabies prophylaxis.

Paper Chase #5 - Workplace Wellness Program Effects

November 2020
8min

Among employees of a large US warehouse retail company, a workplace wellness program resulted in greater rates of positive self-reported behaviors but no significant differences in clinical measures of health, healthcare spending and utilization, and employment outcomes

Mailbag

November 2020
23min

Racism as a Public Health Crisis with AAFP President Dr. Ada Stewart

October 2020
17min

In this Hippo Education bonus conversation, Drs. Jay-Sheree Allen and Neda Frayha sit down with American Academy of Family Physicians President Dr. Ada Stewart. They discuss the AAFP’s recent policy statement that racism is a public health crisis; what the AAFP is doing as an organization to dismantle systemic racism; and resources that all practicing clinicians can use to help us in our own daily practice.

PAs in Telemedicine

October 2020
8min

Adrian and Kris discuss 7 things every PA should know about telemedicine and the newest expanded medicare coverage for these services. They explore options for PAs in telemedicine and describe recent changes to rules and regulations regarding care via telemedicine. 

The Lone Node

October 2020
16min

When you discover an enlarged lymph node in someone who otherwise feels well, what do you do? Aisha and Neda tackle this exact issue in the Introduction to the October 2020 Primary Care RAP episode.

Paper Chase #1 - Statin Use and Mortality in Vets Over 75

October 2020
7min

New statin use was significantly associated with a lower risk of mortality in US veterans > 75 years of age.

Neonatal Hyperbilirubinemia

October 2020
22min

Neonatal hyperbilirubinemia affects almost 84% of term newborns! If you’re a little rusty on the subject, listen in as Drs. Lekecia Pitts and Matthew Zeitler discuss the evaluation and management of this important (and common) diagnosis. 

Cancer Survivorship

October 2020
18min

With the number of cancer survivors growing and the longer lasting effects of newer treatments, how well equipped are primary care clinicians to care for cancer survivors over the long haul? Dr. Cathy Handy Marshall, an oncologist at Johns Hopkins, joins Neda for a conversation about cancer survivorship in primary care.

Paper Chase #2 - Triple Inhaler Therapy for Mod to Severe COPD

October 2020
6min

Triple therapy at either dose resulted in lower rate of COPD exacerbations.

TIDBSI: Low-Dose CT Screening

October 2020
21min

Screening for lung cancer is a controversial topic among medical professionals and patients. In this segment, our intrepid Things I Do But Should I duo Paul and Justin dig deep into the guidelines so we can guide our patients through this decision.

Carbon Monoxide Toxicity

October 2020
23min

Toxicology aficionado Cyrus Rangan sits down with Parul and Ilene to take us through the prevention, diagnosis, and management of carbon monoxide toxicity.

Paper Chase #3 - Oral Steroid Bursts and Severe Adverse Events

October 2020
6min

Serious adverse events are associated with short bursts of steroids and are most common within the first month.

Delirium: Part 1

October 2020
19min

Delirium affects up to ⅓ of older patients in the hospital and is associated with significant morbidity and even mortality. How do we recognize it? Treat it? Better yet, prevent it? Geriatrician Dr. Jenny Litrivis sits down with Neda to help us provide better care to our patients at risk for delirium.

The COVID-19 Vaccine with Dr. Paul Offit

October 2020
25min

In this Hippo Education bonus, world-renowned vaccine expert and Pediatric Infectious Diseases specialist Dr. Paul Offit sits down with Peds RAP host Dr. Sol Behar and Primary Care RAP host Dr. Neda Frayha for a candid conversation on where we stand with the development of a COVID-19 vaccine, challenges ahead, and how clinicians can best focus our efforts in education and advocacy when it comes to a future COVID-19 vaccine. 

Paper Chase #4 - L-thyroxine for Subclinical Hypothyroidism

October 2020
6min

In older adults with subclinical hypothyroidism and high symptom burden at baseline, levothyroxine did not improve hypothyroid symptoms or tiredness compared with placebo

Warts

October 2020
29min

Viral warts are common in children and most resolve spontaneously without treatment. Salicylic acid with regular paring and occlusion is the preferred treatment for cutaneous viral warts. Cryotherapy in combination with salicylic acid is recommended as a second line treatment.

Delirium: Part 2

October 2020
15min

Delirium affects up to ⅓ of older patients in the hospital and is associated with significant morbidity and even mortality. How do we recognize it? Treat it? Better yet, prevent it? Geriatrician Dr. Jenny Litrivis sits down with Neda to help us provide better care to our patients at risk for delirium.

Paper Chase #5 - Distal DVTs

October 2020
8min

Anticoagulation prevents recurrent VTE in patients with distal DVT

MAILBAG: SMORGASBORD

October 2020
21min

Maternal and Child Health Disparities

September 2020
19min

In this Hippo Education bonus conversation, Drs. Jay-Sheree Allen and Neda Frayha sit down with Dr. Joia Crear Perry, thought leader and researcher on racism as a root cause of health inequities, obstetrician-gynecologist, and Founder and President of the National Birth Equity Collaborative. They explore reasons for disparities in maternal and child health and close with three concrete steps we all can take to improve our clinical practice.

COVID and The Social Needs Response Team

September 2020
22min

In this Hippo Education bonus, Dr. Lisa Patel from the Peds RAP team sits down with Dr. Jaya Aysola, Assistant Professor of Medicine and Pediatrics and Assistant Dean of Inclusion and Diversity at the Perelman School of Medicine at the University of Pennsylvania. The COVID-19 pandemic has strained community resources and exacerbated health disparities. They discuss crisis intervention theory and how Penn Medicine’s Social Needs Response Team addresses these critical issues.

Telemedicine Do’s & Don’ts

September 2020
29min

In this Hippo Education bonus, Dr. Mizuho Morrison from the Urgent Care RAP team sits down with Dr. Ajsa Nikolic, family medicine physician and medical director for Ochsner Health’s Virtual Care Provider Network. They discuss practical do’s and don’ts for those starting out in telemedicine, as an introduction to Hippo Education’s newest video course, Telemedicine: Common Conditions. Check out the course at hippoed.com/telemed!

Steps for Legislative Advocacy

September 2020
18min

How do you get what you want? You advocate for yourself? How does that happen in the PA world and especially in a pandemic? It’s still advocacy and as a PA, you’re part of it! Joining Adrian and Kris as they guide you through a quick overview of how to engage with policy makers and legislative movers and shakers to advocate for yourself, your profession and your patients, in a time when we need your voice more than ever

Clonidine or Clonidon't?

September 2020
15min

What is the deal with clonidine? In this introduction to the September PC RAP episode, Neda and Paul answer some listener questions about this controversial medication.

Paper Chase #1 - P2Y12 Inhibitor or Aspirin for Secondary Prevention

September 2020
7min

P2Y12 was associated with a very slight risk reduction for myocardial infarction compared to aspirin. There were comparable risks of stroke.

TIDBSI: Cryotherapy

September 2020
19min

To freeze or not to freeze, that is the question that Drs. Paul Simmons and Justin McCarthy will attempt to answer in this Things I Do But Should I? conversation on cryotherapy. 

SGLT2 Inhibitors and GLP1 Agonists

September 2020
26min

The world of diabetes management has changed dramatically in the past several years. Given the new ADA guidelines and all the new literature on SGLT2 inhibitors and GLP1 receptor antagonists, endocrinologist Dr. Beth Lamos is back to help us understand how to use these drugs in practice. 

Paper Chase #2 - Antibiotics Don't Reduce LOS for Uncomplicated Diverticulitis

September 2020
6min

Antibiotics did NOT reduce length of stay, adverse events, or readmission rates

Proceed With Confidence: LARCs: Part 1

September 2020
20min

How comfortable are you with placement of LARCs (implants and IUDs)? If you could use a refresher, Drs. Paul Simmons and Karlynn Sievers walk through the procedures as part of our “Proceed with Confidence” series.

Chronic Cough

September 2020
23min

A cough lasting longer than 8 weeks can be a major frustration for our patients (and everyone around them). In this segment, pulmonologist and cough expert Dr. Kathryn Robinett walks Neda and Paul through a real-world approach to chronic cough and drops tons of beautiful, shimmery knowledge pearls along the way.

Paper Chase #3 - Security Risks of Patient Portals

September 2020
8min

Almost half of hospital personnel recommended password sharing and that few hospitals enabled patients to limit the types of information seen by those with proxy access.

Proceed With Confidence: LARCs: Part 2

September 2020
15min

How comfortable are you with placement of LARCs (implants and IUDs)? If you could use a refresher, Drs. Paul Simmons and Karlynn Sievers walk through the procedures as part of our “Proceed with Confidence” series.

Perinatal Mental Health

September 2020
12min

Postpartum depression has gained a lot of national attention in recent years, but what about depression during pregnancy? Neda discusses the important topic of perinatal mental health with Ob/Gyn Dr. Sara Mazzoni. 

Paper Chase #4 - Distracted Driving Laws and Motor Vehicle Crash Fatalities

September 2020
6min

Distracted driving laws were associated with significant reduction in fatal MVCs for teenage drivers.

CBD

September 2020
11min

In recent years, CBD has become increasingly popular as a “cure” for ailments ranging from pain to anxiety. How much evidence is there to back up these claims? Drs. Michael Baca-Atlas and Hayden Shafer do a literature deep-dive. 

SPIKES: Breaking Bad News

September 2020
24min

Throughout our career, we will inevitably have to give some bad news to our patients, and many of us feel unprepared. Neda discusses an evidence-based model for breaking bad news with geriatrician and palliative care expert Dr. Jenny Litrivis. We even include an example role-play for your listening pleasure. 

Paper Chase #5 - OPTIMIS Trial for BP Control in Older Adults

September 2020
8min

Among older patients treated with multiple antihypertensive medications, a strategy of medication reduction, compared with usual care was NON-INFERIOR with regard to systolic blood pressure control at 12 weeks.

Mailbag: Staying Up To Date With New Therapies

September 2020
25min

Kids, School and COVID

August 2020
27min

In this Hippo Education bonus, Dr. Lisa Patel from our Peds RAP team sits down with Dr. Ryan Padrez, Medical Director at The Primary School, Assistant Clinical Professor in Pediatrics at Stanford University and Executive Committee member on the Council of School Health at the American Academy of Pediatrics (AAP). They discuss the most recent AAP guidance published on COVID-19 planning considerations for school re-entry and suggested protocols on suspected COVID-19 and contacts.

Health Disparities with Dr. Utibe Essien

August 2020
24min

In this Hippo Education bonus conversation, Drs. Jay-Sheree Allen and Neda Frayha sit down with noted health disparities researcher Dr. Utibe Essien, an Assistant Professor of Medicine at the University of Pittsburgh School of Medicine and Core Investigator for the Center for Health Equity Research and Promotion at the VA Pittsburgh Healthcare System. They explore reasons for disparities in the health care outcomes of our patients, disparities in the diversity of our medical profession, and the crucial bridge that connects these two. They close with three concrete steps we all can take to improve our clinical practice and reduce health disparities in our patient communities.

Pediatric COVID-19: Lit Review

August 2020
16min

Pediatricians Roy Benaroch and Geoff Simon break down the latest literature on Pediatric COVID-19.

Intro: Clinical Decision Making

August 2020
12min

Have you ever wondered how you make decisions?  Ever been completely lost in a patient’s presentation, or stayed two steps ahead of their clinical management?  This month, Kris and Adrian talk about heuristics, cognitive biases, and dual process theory as it relates to clinical decision making.  Then they discuss the segment on strategies to improve clinical efficiency and time management.

Temporal Arteritis

August 2020
13min

In August’s introduction segment, Neda and Dr. Jay-Sheree Allen discuss a case of giant cell arteritis and summarize the diagnosis and treatment of the condition.

Paper Chase #1 - Gabapentin to Treat AUD in Alcohol Withdrawal

August 2020
6min

To examine whether gabapentin would be useful in the treatment of AUD, including alcohol withdrawal.

Eosinophilic Esophagitis

August 2020
18min

When a patient presents with a subacute cough, is eosinophilic esophagitis in your differential? It will be after you listen to this deep dive on EoE with Drs. Micaela Robb Bowers and Neda Frayha.

Patellar Injuries

August 2020
12min

Andy, Drew, and Miz discuss common presentations of patella fractures and review appropriate stabilization, treatment and follow-up recommendations.

Paper Chase #2 - Readmission Diagnoses after COPD Exacerbations

August 2020
6min

To investigate readmission characteristics following hospitalizations for COPD exacerbations.

Iron Deficiency

August 2020
23min

Iron deficiency is incredibly common and yet also difficult to both manage and treat. Dr. Victoria Giffi, hematologist extraordinaire, drops tons of knowledge bombs on Paul in this helpful and clear primer on iron deficiency.

Efficiency & Time Management in Clinic

August 2020
21min

Got time? A lot of our resident listeners have been asking for tips and tools for time management in the clinic. Dr. Nikki Southall joins Paul and Neda for a conversation about typical time sinks, some great time management tips, and strategies for becoming more efficient at work.

Paper Chase #3 - Liraglutide for Adolescents with Obesity

August 2020
5min

To assess the efficacy of liraglutide as a weight loss medication in adolescents.

HELLP Syndrome

August 2020
17min

HELLP syndrome is a scary diagnosis, especially for primary care clinicians. Listen in as Neda and Aisha discuss HELLP syndrome from H to P. We hope it HELLPs your practice.

Medicare Annual Wellness Visit

August 2020
28min

G codes and split billing and abbreviations, oh my! If the Medicare Annual Wellness Visit boils your brain, listen in as Neda and Dr. Jay-Sheree Allen break it down into a simplified checklist.

Paper Chase #4 - Apixaban for Treatment of VTE in Cancer

August 2020
4min

To evaluate the safety and efficacy of apixaban for the treatment of cancer-associated venous thromboembolism.

Breast Cancer Chemoprophylaxis

August 2020
18min

As we continue our series on breast health, Dr. Molly Heublein takes us through all we need to know about breast cancer chemoprophylaxis.

Paper Chase #5 - ED Validation of Canadian Syncope Risk Score

August 2020
7min

To validate the CSRS and determine its ability to predict 30-day serious outcomes.

Mailbag

August 2020
24min

Racism and Child Health

July 2020
28min

Race and health are inextricably linked to each other. Pediatricians Nathan Chomilo and Michael Cosimini break down the AAP Policy Statement on the health effects of racism on children.

Uncertainty and Ambiguity in Medicine

July 2020
10min

Kris and Adrian discuss different principles clinicians use when faced with the uncertainty and ambiguity of medicine and how these can help with clinical decision making. It all gets wrapped up with a good review on mumps and its vaccination recommendations.   

Embracing Uncertainty

July 2020
15min

How comfortable are you with uncertainty? Super comfortable? Great! Then there’s absolutely no reason to listen to this month’s intro conversation, in which Neda and Paul talk about how they’ve coped with all the uncertainty of the covid-19 pandemic and dive into the literature to find some solutions.

Paper Chase #1 - Aspirin Association with HCC

July 2020
7min

Use of low-dose aspirin was associated with significantly lower risk of hepatocellular carcinoma and lower liver-related mortality in patients with chronic viral hepatitis.

The Ol' Cup of Noodles and Pediatric Burns

July 2020
26min

Ilene Claudius reviews for us the classification of burns in pediatric patients and how this affects management. Criteria and referral to a burn center is discussed as well as the treatment of burns for outpatient vs. inpatient management.

Paper Chase #2 - Rhythm Monitors and A-Fib Screening

July 2020
8min

Compared with implantable loop recorders, the diagnostic yield  of detecting Afib improved with increased number of screenings and duration of screenings.

Nephrogenic Systemic Fibrosis

July 2020
20min

We’ve talked about IV contrast and the kidneys, but what about the gadolinium-based contrast agents we use for MRIs? Are they safe in kidney disease? Neda and Paul break down nephrogenic systemic fibrosis and how we should think about the GBCAs.

Proceed with Confidence: Vasectomies

July 2020
19min

Do you automatically refer to a urologist when a patient asks about a vasectomy? Have you ever considered that this procedure can actually be done in the primary care office? Our own Paul Simmons discusses this with Dr. Lyrad Riley in the first installment of a new series on procedural tips and tricks called: “Proceed with Confidence.”

Paper Chase #3 - POLSTs and ICU Admissions

July 2020
7min

Treatment-limiting POLSTs were significantly associated with lower rates of ICU admission compared with full-treatment POLSTs. However, 38% of patients with treatment-limiting POLSTs received intensive care that was potentially discordant with their POLST.

Neonatal Abstinence Syndrome

July 2020
18min

How much do you know about Neonatal Abstinence Syndrome? Whether you work in hospital medicine or in the clinic, it’s important to be aware of the risks of substances on neonates and understand what happens after they’re born. In this segment, Dr. Michael Baca-Atlas and Dr. Matt Zeitler take a deep dive into NAS while they work through a case together. 

What's That Lab: Ferritin

July 2020
8min

Have you ever ordered a lab and then been baffled by the results? Paul Simmons starts a new series called, “What’s That Lab” in which he teaches us what we need to know about common laboratory tests. First up: Ferritin.

Paper Chase #4 - PCN Allergy Clinical Decision Rule

July 2020
6min

A score of <3 on the PEN-FAST clinical decision rule was associated with a high NPV and could be used to identify low risk PCN allergies.

Mumps

July 2020
20min

We all learned about mumps in school, but how often is it on your differential? In this segment, Dr. Micaela Robb Bowers takes Neda through a crash course on mumps, including complications and fertility concerns.

Colon Cancer Screening for the PCP

July 2020
20min

Colon cancer screening guidelines seem to be changing constantly. For the newest updates, tune in to Paul and Neda’s conversation with GI guru, Dr. Sandra Quezada. 

Paper Chase #5 - Decline in PC Use in Commercially Insured Adults

July 2020
7min

Insured adults have been visiting PCPs less often and nearly one half had no PCP visits in a given year by 2016.

When X-Rays Lie

July 2020
11min

Medical tests can lie. X-rays are simply a test. The purpose of any test is to affect our pre-test probability - it is not to make a diagnosis. Any test result (positive or negative) must be placed in the clinical context it is being used. We should have an expectation of any test before we order it. Neda and Matt sit down with Orthopedic expert Dr.Arun Sayal to discuss best use of radiographic films in our workup. 

Mailbag

July 2020
18min

Race and Medicine - An Introduction

June 2020
20min

In recent weeks, many of our medical organizations have released official statements declaring racism to be a public health crisis. In this introduction to Hippo Education’s new Race and Medicine audio series, Dr. Jay-Sheree Allen sits down with Primary Care RAP host Dr. Neda Frayha for a candid conversation exploring the definition and types of racism, the historical and present-day manifestations of racism in medicine, and potential strategies we all can incorporate into our daily practices to go beyond the hashtag and become true allies.   

Laceration Repair in the Time of COVID

June 2020
15min

Drs. Brian Lin and Mike Weinstock discuss alterations to our usual practice patterns of laceration repair in the setting of the COVID pandemic, which include increasing patient throughput through faster closure techniques, reducing total points of contact with the healthcare system by using techniques to obviate the need for a return visit, and habit changes during closure to minimize exposure risk during face-to-face contact.

Facing Death in the Time of COVID-19 with Dr. BJ Miller

June 2020
22min

How are you coping with all of the death around us these days? In this Hippo Education update, Primary Care RAP host Dr. Neda Frayha interviews Dr. BJ Miller, a hospice and palliative care specialist at the University of California, San Francisco whose TED talk on what really matters at the end of life has been viewed over 10 million times. Along with Shoshana Berger, Dr. Miller is the co-author of the book, A Beginner’s Guide to the End: Practical Advice for Living Life and Facing Death and founder of the Center for Dying and Living. In this conversation, he helps us come to terms with our own mortality and provide better support to our patients at the end of life. 

New Kid on the Block

June 2020
13min

 Oh oh, ohohoh, oh oh oh oh, oh oh, ohohoh, the RIGHT STUFF! Remember New Kids on the Block? Everyone’s the new person sometimes! A snappy 90s pop song might help, but in case you need more, Kris and Adrian examine a few of the important things to keep in mind when it’s your turn to be the new kid on the block. They also dive into what organizations can do well when onboarding. It all gets wrapped up with their take on the continuous glucose monitoring segment. This is one you can’t miss! 

Death Certificates

June 2020
15min

Does the thought of completing a death certificate scare you half to death? In this month’s intro segment, Neda and Aisha get into the nitty gritty of how to accomplish this (sometimes) daunting task.   

TIDBSI: Knee Injections

June 2020
15min

An elderly patient with knee pain limps into your clinic asking for a “cortisone shot”. Do you reach for the needle? Paul Simmons and Justin McCarthy dive in to the real evidence behind intra-articular knee injections in this TIDBSI segment.   

Paper Chase #1 - Naproxen vs Colchicine for Gout Flares

June 2020
6min

 Open-label randomised pragmatic trial (CONTACT) comparing naproxen and low-dose colchicine for the treatment of gout flares in primary care.  

Acute Gastroenteritis, Part 1 - UPDATED AUDIO

June 2020
18min

Most cases of AGE in children are self-limited illness that can be managed with supportive care. Antiemetics facilitate oral rehydration. Treat more severe cases with IV fluid rehydration. Do not empirically treat suspected bacterial diarrhea with antibiotics given risk of HUS with certain strains of E Coli.

Continuous Glucose Monitors

June 2020
24min

Are you an expert in continuous glucose monitors and how to use them? Great! Then you can teach us! If not, endocrinologist and friend of the podcast Dr. Beth Lamos is back to walk us through the indications for CGMs and practical ways to use them in our patients.

Paper Chase #2 - CT Screening and Lung Cancer Mortality

June 2020
7min

Reduced Lung-Cancer Mortality with Volume CT Screening in a Randomized Trial.  

Acute Gastroenteritis, Part 2

June 2020
18min

Most cases of AGE in children are self-limited illness that can be managed with supportive care. Antiemetics facilitate oral rehydration. Treat more severe cases with IV fluid rehydration. Do not empirically treat suspected bacterial diarrhea with antibiotics given risk of HUS with certain strains of E Coli (O157:H7).

Flashes and Floaters with Dr. Glaucomflecken

June 2020
19min

Ever wondered what to do when a patient has flashers or floaters? None other than Dr. Glaucomflecken is here to teach Mike and Neda about how to tell these presentations apart, how to manage them, and when to call your friendly local ophthalmologist. 

COVID Antibodies and Immunity

June 2020
17min

Dr. Mizuho Morrison & Dr.Jenny Beck Esmay both having had covid themselves, briefly discuss the clinical course and what presence of IgM vs. IgG signifies. They discuss what we currently know about antibody testing (national availability, reliability, sensitivity) as well as convalescent plasma transfusion (CPT) and criteria for donation vs. recipient.

Paper Chase #3 - Post Contrast AKI in Children

June 2020
7min

Risk of Acute Kidney Injury Following Contrast-enhanced CT in Hospitalized Pediatric Patients.  

New GINA Guidelines for Asthma

June 2020
11min

Asthma treatment guidelines have been evolving since the last published guidelines in 2007. Take a deep breath with Paul Simmons as he dives into the 2019 recommendations from GINA.  

Paper Chase #4 - Plasma Concentration of Sunscreen Ingredients

June 2020
8min

Effect of Sunscreen Application on Plasma Concentration of Sunscreen Active Ingredients.

Medications in Breastfeeding

June 2020
17min

Are you stumped by prescribing medications to nursing mothers? Do you know about pumping and dumping? Neda sits down with Dr. Elizabeth Lavery to discuss the use of medications in breastfeeding women so we can feel empowered to prescribe in this population.  

Prior Authorization

June 2020
18min

Few things can ruin our mood more quickly than a request for a prior authorization or a peer-to-peer. In this segment, Neda and Dr. Ashish Patel tackle the beast that is the dreaded prior authorization.   

Paper Chase #5 - USPSTF on Hepatitis C Screening

June 2020
6min

Screening for Hepatitis C Virus Infection in Adolescents and Adults USPSTF recommendation statement.

Mailbag

June 2020
23min

*UPDATED*The Saga Continues with Remdesivir and Hydroxychloroquine

May 2020
9min

*Editor's note: As of June 4, 2020, The Lancet article by Mehra MR et al has been retracted. (https://www.thelancet.com/lancet/article/s0140673620313246) In this Hippo Education short, Dr.Salim Rezaie from REBEL EM and Lit Matters critically appraises two papers published on Friday May 22nd, 2020.  He discusses what the evidence shows for both remdesivir & hydroxychloroquine/chloroquine as effective treatment or prophylaxis for COVID-19.

COVID CARDIOLOGY

May 2020
27min

COVID-19 causes STEMI’s, arrhythmias and myocarditis?!? Emergency medicine and cardiology guru Amal Mattu, MD chats with Mizuho Morrison, DO on the cardiovascular effects of COVID-19. They discuss: the known pathophysiology of how viral infections affect the heart; Review the new consensus statement from the Society of Cardiovascular Angiography and interventions (SCAI), American College of Cardiology (ACC), and the American College of Emergency Physicians (ACEP) on how to manage STEMIs; and lastly discuss how cardiac arrest management differs in this COVID era.   

Indirect Impact of COVID-19 on Children

May 2020
17min

Children seem to be less affected than adults by the direct effects of COVID-19 infection, but the pandemic has brought forth other health risks to the pediatric population. Sol Behar interviews Oakland, CA based primary care pediatricians Celine Sparrow and Katie D’Harlingue about the indirect  impact of COVID-19 on children. Topics covered include home school and academic achievement, mental health issues, and nutrition/food insecurity. 

COVID Findings in Kids

May 2020
25min

Sol Behar interviews New York City pediatric emergency doctor Dr. Ee Tay, highlighting the features of pediatric COVID disease, including an emerging illness that is being compared to Kawasaki Shock Syndrome called “pediatric inflammatory multisystem disease” (PIMS).

Bonus Short - COVID-19: The Long Game

May 2020
27min

Dr. Matthieu DeClerck talks to Dr. Manie Beheshti on how the healthcare system should approach the “re-opening” of society as we plan the lifting of social restrictions. What safety implementations need to be in place in order to protect our most vulnerable patients. What changes can we anticipate in the healthcare system moving forward.

POEM’s

May 2020
16min

 Do you like POEMs?  Kris and Adrian review some of the top 20 Patient Oriented Evidence that Matters from 2019 and give their take on how to best apply these potentially practice changing recommendations.    

Proctalgia Fugax

May 2020
13min

Isn’t primary care full of diagnoses you’d never heard of before? In the intro to our May 2020 episode, Neda and Aisha go through the basics of proctalgia fugax, a condition that affects 20% of patients (or more!). 

Paper Chase #1 - Oseltamivir vs Usual Care in ILI

May 2020
6min

To determine whether adding antiviral treatment for patients with an influenza like illness reduces time to recovery.

Knee X-Rays

May 2020
15min

Hippo Education’s EM/Ortho expert, Dr. Arun Sayal, joins Matt DeClerck and Neda Frayha for a high-yield conversation about knee pain, the knee exam, and knee X-rays.

Peritoneal Dialysis, Part 1

May 2020
16min

Have you ever had a patient who is on peritoneal dialysis? What does this even mean? How does it work? Neda and Paul answer these questions and more in this 2 part-segment about peritoneal dialysis

Paper Chase #2 - Unnecessary Pelvic Exams and Pap Smears

May 2020
7min

To identify prevalence and risk factors associated with unnecessary bimanual pelvic exams and pap smears in young women less than 21 y/o. 

Telling Pain Syndromes Apart

May 2020
14min

When a listener wrote that many different chronic pain syndromes felt a little confusing to her, we were relieved that it wasn’t just us! Join us as our regular contributor Dr. Molly Heublein breaks down different pain syndromes that we see all the time in primary care.

Peritoneal Dialysis, Part 2

May 2020
18min

Have you ever had a patient who is on peritoneal dialysis? What does this even mean? How does it work? Neda and Paul answer these questions and more in this 2 part-segment about peritoneal dialysis.

Paper Chase #3 - Alcohol Abstinence in Drinkers with Atrial Fibrillation

May 2020
5min

To investigate the effect of abstinence from alcohol on secondary prevention of atrial fibrillation. 

Alcohol Use in Pregnancy

May 2020
9min

When PC RAP listener David wrote to us that he has seen more of his patients using alcohol in pregnancy, our own Michael Baca-Atlas put on his addiction medicine hat to review research and recommendations regarding alcohol use in pregnancy.

Ode to the Node: Pediatric Lymphadenopathy

May 2020
27min

Sol and Matthieu discuss the differential diagnosis, evaluation and management of pediatric lymphadenopathy, including when to pursue imaging and specialist referral.

Paper Chase #4 - Effectiveness of Different Treatments for Opioid Use Disorder

May 2020
7min

To examine different OUD treatment pathways and associations with overdose or opioid-related acute care. 

Scribes in Health Care

May 2020
20min

The use of scribes in medical practices has been around for decades. They have been utilized in emergency departments, primary care practices, inpatient medical teams, and specialty practices. The use of scribes in the urgent care can be a big improvement to the practice if the implementation is correct. Sam Ashoo discusses with our team his thoughts on this implementation.

The Breast Exam

May 2020
21min

We’ve been discussing breast health and breast cancer screening recently on PC RAP, but haven’t touched on the physical exam yet. In this segment, Dr. Rebecca Zendel Berliner walks us through how to perform a complete history and physical exam for a breast complaint. 

Paper Chase #5 - Vit D and Calcium for Fracture Prevention

May 2020
8min

To assess the risks of fracture associated with differences in concentrations of 25-hydroxyvitamin D in observational studies and the risks of fracture associated with supplementation with vitamin D alone or in combination with calcium.

Mailbag

May 2020
25min

Bonus Short - Clinician Mental Health in the COVID-19 Pandemic

April 2020
23min

In this Hippo Education Short, psychiatrist Dr. Melissa Shepard sits down with Primary Care RAP host Dr. Neda Frayha for some real talk on the mental health challenges facing health care workers in the COVID-19 pandemic, and some concrete, tangible tools to help us get through this period. Spoiler alert: it’s more than yoga. 

Bonus Short - Pandemic Malpractice Issues

April 2020
22min

Dr. Matthew DeLaney and Dr. Michael Weinstock sit down to discuss the threat of lawsuits in the midst of the COVID pandemic. The last thing anyone wants to think about is the risk of a lawsuit. Unfortunately, despite the extra challenges posed by our current pandemic, the threat of medicolegal consequences remains. In this segment, we evaluate the unique medicolegal risks that can occur during disaster situations and look at potential sources of medicolegal protection.

Bonus Short - COVID CXR Study and Findings in Ambulatory Patients

April 2020
16min

Drs. Mike Weinstock and Josh Russell, from Urgent Care RAP, just published a landmark COVID study: CXRs obtained from confirmed and symptomatic COVID-19 patients presenting to the UC were normal in 58.3% of cases, and normal or only mildly abnormal in 89% of patients.

“What if I Get Called In”...COVID Airway Management for the Non-Intensivist

April 2020
1hr 7min

COVID airway management creates a lot of anxiety for those of us non-intensivists. Dr. Mizuho Morrison interviews Dr. Scott Weingart (founder of EMCrit.org and Chief of the Division of Emergency Critical Care at Stony Brook University Hospital, NY) on the basics of COVID airway management.

Bonus Short - COVID-19 Lessons From NYC

April 2020
22min

Patients with COVID-19 present in a variety of ways, and clinicians need to have a low index of suspicion for diagnosis. Management involves emergency referral for patients with a low oxygen saturation. Every patient should be treated as if they could have COVID-19.

Introduction: Common Reimbursement Questions

April 2020
8min

We all like to get paid, right?  Do you know all the “ins and outs” of reimbursement?  If not, you are in luck! Adrian and Kris talk about the five most common questions regarding reimbursement for PAs in 2019.  After that, stick around to hear how to help destigmatize therapy for our patients and make it more universally accepted.    

More Listener Love

April 2020
21min

Neda and Paul are back at it, answering your questions. Here they cover: TMJ dysfunction, the new Nordic diet, and hypopigmentation

Paper Chase #1 - Metoprolol to Prevent Acute COPD Flare

April 2020
6min

To evaluate beta blockers efficacy in preventing COPD exacerbations.

Transgender Care

April 2020
23min

It’s estimated that at least 1.4 million Americans identify as transgender. In this segment, Neda and endocrinologist Dr. Elizabeth Lamos discuss how we, as primary care clinicians, can best serve our transgender patients at any point before, during, or after their gender transition.

Diabetic Neuropathy

April 2020
20min

When a patient with poorly controlled diabetes presents with numbness and tingling in their feet, how well do we really know what to do next? To help us understand diabetic neuropathy a bit better, Dr. Harpreet Tsui joins Neda to discuss screening, diagnosis, and treatment pearls.

Paper Chase #2 - Dapagliflozin in Patients with Heart Failure and Reduced EF

April 2020
6min

To assess effect of Dapagliflozin vs placebo in patients with HFrEF.

Food Allergies, Part 1

April 2020
25min

Sometimes it can seem like every other child we see has a food allergy. How prevalent are food allergies in the general population, and how can we best diagnose and manage them? To shed light on these questions, as well as recent guideline changes in the allergy community and novel therapies on the horizon, PC RAP welcomes back Dr. Torie Grant, a Med/Peds allergist and immunologist at Johns Hopkins. She sits down with Neda to share the full scoop on food allergies.

TIDBSI: Tramadol

April 2020
16min

Tramadol - good or bad? This age-old question has been burning for decades. Today, Paul Simmons and Justin McCarthy will attempt to settle the matter once and for all in our latest Things I Do But Should I conversation.

Paper Chase #3 - HOPE Trial for Prednisolone in Hand Arthritis

April 2020
8min

To evaluate the safety and efficacy of 10 mg prednisolone in treatment of patients with osteoarthritis and signs of inflammation.

Food Allergies, Part 2

April 2020
10min

Sometimes it can seem like every other child we see has a food allergy. How prevalent are food allergies in the general population, and how can we best diagnose and manage them? To shed light on these questions, as well as recent guideline changes in the allergy community and novel therapies on the horizon, PC RAP welcomes back Dr. Torie Grant, a Med/Peds allergist and immunologist at Johns Hopkins. She sits down with Neda to share the full scoop on food allergies.

Bonus Short - COVID-19: Pregnancy and Newborns

April 2020
15min

 Sol interviews Children’s Hospital of Philadelphia NICU doc Joanna Parga-Belinkie to discuss COVID-19 and the some of the peripartum issues that come up during the novel coronavirus pandemic for both pregnant moms and their newborns. 

Bonus Short - COVID-19 Pharmacology

April 2020
17min

Mizuho sits down with emergency medicine pharmacist/toxicologist Bryan Hayes, PharmD to answer some pertinent questions and myth-bust clarifications about pharmaceutical options in COIVD-19 treatment.

Destigmatizing Therapy

April 2020
20min

If your car broke down on the side of the road, wouldn’t you ask for help? New PC RAP contributor Dr. Jay-Sheree Allen brings this analogy to how we can help our patients seek the appropriate mental health care they need, focusing on the indications for and benefits of therapy.

Paper Chase #4 - Postdischarge Visits with PCPs

April 2020
6min

To assess the effect of post-discharge scheduling assistance on PCP followup or readmissions. 

Precharting

April 2020
10min

Pre-charting  can be a controversial topic in the medical community. Should we do it? Should we not? Aisha shares her thoughts on the advantages and disadvantages of pre-charting, as well as some tips and tricks she uses in her own practice.

Pre/Post Menopausal Vaginal Bleeding

April 2020
18min

Vaginal bleeding - an Ob/Gyn concern, right? Not so fast. Turns out, we can handle quite a bit of this in primary care. Neda and Dr. Megan Jones dive into diagnosis and management of bleeding in both the pre and post-menopausal woman. 

Paper Chase #5 - Periop Management of A-Fib on DOACs

April 2020
6min

To investigate the safety of a standardized perioperative DOAC management strategy.

Mailbag

April 2020
32min

Bonus Short - Telemedicine in the Time of COVID-19

March 2020
21min

Has your clinical practice shifted to telemedicine yet? In the era of COVID-19, clinicians everywhere are being thrown into telemedicine, often without any experience or background knowledge. To help us all get up to speed with this patient care technology, Hippo Education’s Dr. Neda Frayha sits down with Dr. Edward Kaftarian, the Vice Chair of Mental Health at the American Telemedicine Association and CEO of Orbit Health Telepsychiatry. Together they explore the benefits and potential pitfalls of telemedicine, the equipment required, billing and coding considerations, appropriate etiquette, and much more.

COVID: What If I Get Called In?

March 2020
30min

Many healthcare workers are worried if we get called in to help with COVID patients because this may be outside our scope of practice. Aaron Bright, MD sits down with Salim Rezaie, MD to simplify critical frontline lessons to keep you and your patients safe if you get called in. Topics include pearls and pitfalls regarding: PPE, management of stable suspected COVID patients, respiratory interventions, diagnostic and radiology patterns, and provider self-care tips.

Bonus Short - Impact of COVID-19 on Healthcare Workers

March 2020
19min

Our panel of podcast hosts from a variety of practice settings discuss the logistical and psychological impact of the COVID-19 pandemic on healthcare workers and discuss strategies to mitigate the stress associated with the pandemic.

Bonus Short - COVID-19 Update

March 2020
23min

In this Hippo Education Short, Infectious Diseases specialist Dr. Devang Patel and our own Dr. Neda Frayha discuss the latest, clinician-focused updates on the COVID-19 coronavirus outbreak.

AAPA and PAEA Initiative for MAT Training

March 2020
10min

Adrian and Kris talk PAs and Medically Assisted Treatment- that’s MAT for our patients struggling with opioid dependency. Tune is to learn more about the PAs role and opportunities in fighting this crisis.   

Listener Question Potpourri

March 2020
17min

When the PC RAP mailbag is overflowing, Neda and Paul get to work and tackle a few of your questions at once.

COPD vs CHF Crossover

March 2020
21min

When a patient with COPD and CHF presents with shortness of breath, how do we know what’s causing it? The heart? The lungs? Both? Neda discusses the best approach for this diagnostic conundrum with Dr. Sam Ashoo, ED physician and dyspnea expert.

Paper Chase #1 - Smartwatch to Identify A-Fib

March 2020
7min

To assess the ability of a smartwatch to identify individuals with new afib.

Hyperprolactinemia

March 2020
18min

Hyperprolactinemia is a common endocrine condition that can be treated in the primary care setting if our patients aren’t able to see an endocrinologist. Aisha and Neda run through the complete diagnosis and management of hyperprolactinemia in this segment.

Paper Chase #2 - Comparison of First-Line Antihypertensive Drug Classes

March 2020
8min

To assess if there is a superior first-line antihypertensive.

New A-Fib Guidelines: NOACs Over Warfarin

March 2020
19min

 It is now recommended that NOACs are chosen over warfarin, in patients with atrial fibrillation, except in patients with moderate to severe mitral valve stenosis or a mechanical heart valve.

Paper Chase #3 - Metabolic Surgery and MACE

March 2020
7min

To investigate the relationship between metabolic surgery and incident major adverse cardiovascular events in patients with type 2 diabetes and obesity. 

Family Centered Care

March 2020
21min

When we treat patients, whether in the hospital or outpatient setting, involving their family members can lead to improved outcomes. Tom and Miz discuss the engagement of family members with Dr. Giora Netzer, who literally wrote the book on family centered care. 

Paper Chase #4 - Neurodegenerative Disease Mortality among Former Soccer Players

March 2020
7min

To assess incidence compare mortality from neurodegenerative disease morbidity and mortality among soccer players.

Measles: In the Trenches

March 2020
27min

Sol Behar interviews Portland, OR doctors Holly Tse (urgent care) and Paul Lewis (infectious disease and public health) to chat about the real world experience of responding to the measles outbreak in their community. 

Ophtho Basics with Dr. Glaucomflecken

March 2020
26min

While eye complaints are common, true eye related emergencies are fortunately rare. Any patient with sudden painful vision loss, binocular diplopia or possible penetrating globe injury should be seen emergently by an ophthalmologist.

Paper Chase #5 - Off-Label Gabapentinoid Prescriptions in Hospitalized Patients

March 2020
8min

To describe prescribing trends of gabapentinoids in hospitalized patients.

Introduction to LGB Health

March 2020
15min

Approximately 8.2% of the population engages in same-sex behaviors. This population is considered in the sexual minority, and has a different set of health needs from the sexual majority. Neda, Tom, and Dr. Helen Hedian dive into the details of these needs so we can better serve our LGB patients.

Mailbag

March 2020
26min

PA Regulation in the UK and Dysphagia

February 2020
6min

PA’s in the UK have finally won their fight to gain licensure regulation! This is a big win for the profession across the pond specifically, and a big win or the profession globally. Then Adrian and Kris will help you “swallow” the segment on dysphagia and give you some of the highlights for your clinical PA practice.

Takotsubo Cardiomyopathy

February 2020
17min

Broken hearts? Octopus traps? What’s the deal with Takotsubo cardiomyopathy? Matt DeClerck and Neda Frayha dive into the details of this interesting condition in this introduction segment.

Paper Chase #1 - Hypertension Treatment at Bedtime

February 2020
6min

Bedtime hypertension treatment improves cardiovascular risk reduction: the Hygia Chronotherapy Trial.

Oxygen Supplementation Part 1

February 2020
24min

We provide supplemental oxygen all the time. But how often do we really understand the physiology behind what we’re doing, or the different modalities we have available to us? Dr. Avir Mitra, Clerkship Director of Emergency Medicine at the Icahn School of Medicine at Mount Sinai Beth Israel in New York, joins Neda for a conversation about O2 supplementation, mechanical airway support, and the tools we have to oxygenate and ventilate our patients.

Paper Chase #2 - Physician and Nurse Time at Bedside

February 2020
7min

How Much Time are Physicians and Nurses Spending Together at the Patient Bedside.

Community Acquired Pneumonia - Guideline Update

February 2020
27min

We have been waiting and waiting and waiting for the new community acquired guidelines. And here they are! Infectious Diseases expert Dr. Devang Patel joins Matt DeLaney and Neda Frayha for a conversation on CAP in general and the new guidelines in specific.

Oxygen Supplementation Part 2

February 2020
22min

We provide supplemental oxygen all the time. But how often do we really understand the physiology behind what we’re doing, or the different modalities we have available to us? Dr. Avir Mitra, Clerkship Director of Emergency Medicine at the Icahn School of Medicine at Mount Sinai Beth Israel in New York, joins Neda for a conversation about O2 supplementation, mechanical airway support, and the tools we have to oxygenate and ventilate our patients.

Paper Chase #3 - N95 vs Medical Mask for Preventing Flu

February 2020
6min

N95 Respirators vs Medical Masks for Preventing Influenza Among Health Care Personnel. 

Common Sprains

February 2020
18min

Management of sprains can be divided into the acute and functional phase. In the acute phase early range of motion exercises and techniques to manage pain and swelling are key aspects of treatment. In the functional phase the focus shifts more to emphasize strength, stability, and a return to pre-injury activity.

Paper Chase #4 - Total vs Partial Knee Replacement

February 2020
6min

The clinical and cost-effectiveness of total vs partial knee replacement I patients with medial compartment osteoarthritis (TOPKAT): 5-year outcomes of a randomized controlled trial.

Swallowing Disorders

February 2020
19min

Dysphagia? Sounds like a hard-to-swallow diagnosis. ENT expert, Dr. Elizabeth Guardini, helps us navigate phases of swallowing, diagnostic testing, and deciding when to refer to a specialist.

Paper Chase #5 - Medical vs Surgical Treatment for Heartburn

February 2020
7min

Randomized Trial of Medical versus Surgical Treatment for Refractory Heartburn.

Let's Talk About Sex

February 2020
17min

Talking about sex with our patients can feel uncomfortable, but is an important part of primary care practice. Dr. Helene Hedian walks us through how to have this conversation in a sensitive and inclusive manner.

Mailbag

February 2020
26min

Bonus Short - Novel Coronavirus

January 2020
18min

In this Hippo Education Short, Infectious Diseases specialist Dr. Devang Patel sits down with our own Dr. Neda Frayha to discuss what we know so far about the new 2019-n-CoV coronavirus outbreak and what front-line clinicians can do if we suspect a patient of ours might have this viral illness.

Challenge Bowl and Cholestasis of Pregnancy

January 2020
11min

How about a little spaced repetition? Lets break in the New Year with a little friendly competition between Adrian and Kris…challenge bowl style!  Listen while they recap some of the important topics over the last few months of Primary Care RAP. Got an itch for more? Then “stay put” around as they discuss intrahepatic cholestasis of pregnancy.

Wound Dressings

January 2020
12min

Wet to dry dressings? Nope! Our Urgent Care RAP cousin Matt DeLaney schools Neda and Paul on a better way to do wound care. Such as: Foam dressings address the important elements of wound healing; they absorb exponentially more than gauze, keep wound somewhat moist, and can stay on for 3-7 days. Downsides are that they may not help all wounds (little benefit for arterial ulcers).

Paper Chase #1 - Apixaban in ESRD and A-Fib

January 2020
7min

To determine patterns of apixaban use and its outcomes in dialysis-dependent patients with ESRD and atrial fibrillation.

Respiratory Failure: Pre- and Post-ICU

January 2020
23min

Respiratory failure in primary care? Not an oxymoron! Our own Drs. Mizuho Morrison and Tom Robertson interview returning pulmonologist extraordinaire, Dr. Nirav Shah, about how we approach and manage respiratory failure, both before our patients need the ICU and after they come out of intensive care.

Cholestasis of Pregnancy

January 2020
20min

Itching is a common complaint in pregnancy. When do we need to worry about cholestasis of pregnancy when a pregnant woman complains of itching? Neda sits down with our newest PC Rap contributor, Dr. Matthew Zeitler, to scratch the surface of the most common pregnancy-specific liver disease. 

Paper Chase #2 - Finasteride vs Minoxidil in Male Alopecia

January 2020
4min

To compare the efficacy of oral finasteride and topical minoxidil for males with androgenetic alopecia.

Breast Cancer Screening: When to Begin?

January 2020
26min

PC RAP has covered the start-screening-mammos-at-age-50 perspective in the past. Today, we’ll explore the other side of the coin: why women’s health focused organizations recommend beginning annual screening mammography at age 40. Neda sat down with Dr. Alison Chetlen, breast imaging expert and Associate Professor and Vice Chair of Education in the Department of Radiology at Penn State Health and Hershey Medical Center, for a deeper dive into the evidence we don’t always hear about in primary care. 

Marijuana and Lung Disease

January 2020
13min

As marijuana becomes legal in more states, it’s important for us to be able to advise our patients on the risk of inhaled marijuana causing lung disease. Neda discusses the current literature with Dr. Kathryn Robinett, pulmonologist extraordinaire.s

Paper Chase #3 - Polypill for CV Disease Prevention in Underserved

January 2020
6min

To evaluate the efficacy of a polypill containing atorvastatin amlodipine losartan and hydrochlorothiazide for lowering blood pressure and LDL.

Anaphylaxis

January 2020
22min

Even in the primary care setting, we all need to be prepared to deal with emergencies, including anaphylaxis. Dr. Jason Liebzeit, EM physician, arms us with the knowledge and power to recognize and treat anaphylaxis in the primary care setting.

Medical Assistants, Please

January 2020
15min

The medical assistant workforce is the largest in US ambulatory clinics. As nurses shift to inpatient roles, we use medical assistants more and more in the outpatient setting. Neda and Dr. Michael Baca-Atlas chat about how to best utilize this group of allied health professionals as well as share some ideas for expanding their roles in the clinic. 

Paper Chase #4 - CLEAN Meds RCT

January 2020
6min

To determine whether providing essential medicines at no charge to outpatients who reported not being able to afford medicines improves adherence.

Management of Sexual Assault

January 2020
16min

Kari Sampsel MD reviews how to recognize and manage sexual assault from a medical perspective and also social support that patients warrant. 

Chiropractors

January 2020
23min

Back pain is one of the most common complaints that we see in primary care. Many of our patients have either already seen a chiropractor for their pain, or ask our opinion about seeing one. Neda and Tom Robertson talk with Dr. John Allen about the literature regarding chiropractic care. 

Paper Chase #5 - Frequently Hospitalized Patients' Perceptions

January 2020
6min

To obtain patients’ perspectives of factors associated with the onset and continuation of high hospital use.

Mailbag

January 2020
19min