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A Huge PA Advocacy Win

March 2021
6min

The PA profession had a huge win at the beginning of this year when one of the AAPAs top legislative priorities was signed into law. PAs can now bill and be paid directly by Medicare, something that was previously afforded to other health professions, but not PAs. Adrian and Kris summarize AAPAs news briefing and discuss what this means for PAs. Does it change how you bill?

Health Literacy

March 2021
15min

When our own Dr. Aisha Lofters realized she should have used the word “poop” instead of “stool” when discussing colon cancer screening with her patient, it was a major light bulb moment for her. Join her and Neda as they explore what health literacy means, how low health literacy can affect patient care, and how we can promote happy and healthy outcomes in our lower health literacy patients.

Paper Chase #1: High Blood Pressure and Long-Term CV Events in Young Adults

March 2021
6min

Higher BPs were associated with more CV risk but data on the included studies is limited

Unexpected Killers in Primary Care

March 2021
31min

How are your anxiety levels? Because we’re about to ratchet them up to an 11. In this segment, EM/IM physician Dr. Joe Martinez teaches Paul about 4 patients with deadly diagnoses who presented with seemingly benign findings. Let’s heighten our awareness of do-not-miss pathology that can masquerade as run-of-the-mill disease processes.

Gabapentinoids

March 2021
17min

It seems like gabapentin is prescribed for everything from hot flashes to dementia. Are we prescribing it appropriately? In this segment, Dr. Molly Heublein takes a deep dive into the use (and misuse) of gabapentinoids.

Paper Chase #2: Effect of CBD and THC on Driving

March 2021
8min

Unsafe driving behaviors were higher in the THC and equal THC/CBD groups 40-100 minutes after vaporization. There was no significant difference between CBD only and placebo

Hospitalist Lightning Round: Heme/GI

March 2021
20min

Hospitalist Corner Lightning Round is back! This time Dr. Maj Cina drops knowledge on a few common inpatient scenarios, focusing on apixaban and colonoscopy prep.

Recurrent Pregnancy Loss

March 2021
23min

Recurrent pregnancy loss can be difficult for our patients to live with. Reproductive endocrinologist Dr. Lauren Roth joins us for a conversation on the causes, evaluation, and management of recurrent pregnancy loss

Paper Chase #3: Effect of Omega-3 in Elderly Patients After MI

March 2021
6min

There was no difference between omega-fatty acid supplements and placebo on CV outcomes in eldelrly pts with recent MI

Virtues and Sins of Medicine: Part 1

March 2021
21min

Dr Richard Alan John Asher was an eminent British hematologist and endocrinologist who died in April 1969. During his career, he wrote an essay titled, “Seven Sins of Medicine.” Drs. Paul Simmons and Keith Dickerson ruminate on this essay and how it still applies to the practice of medicine today.

Virtues and Sins of Medicine: Part 2

March 2021
14min

Dr Richard Alan John Asher was an eminent British hematologist and endocrinologist who died in April 1969. During his career, he wrote an essay titled, “Seven Sins of Medicine.” Drs. Paul Simmons and Keith Dickerson ruminate on this essay and how it still applies to the practice of medicine today.

Paper Chase #4: Once-Weekly Insulin for DM2

March 2021
6min

Once-weekly treatment with insulin icodec had glucose-lowering efficacy and safety profile similar to those of once daily insulin glargine U100 in patients with type 2 diabetes

The Game Bag

March 2021
20min

There is a lot of variability in terms of practice patterns when it comes to providing medical care for an out of hospital event. Keys to preparation include having a good understanding of the particular event logistics and anticipating potential injuries and medical complications.

Paper Chase #5: LP and Spinal Hematoma

March 2021
7min

There was not an increased risk of spinal hematoma complications in pts with coagulopathy

Mailbag: Smorgasbord

March 2021
9min

PA Perspectives

March 2021
23min

Remember when you learned the phrase “If you hear hoofbeats, think horses” to explain that usually the things we see are usual? What happens when those unusual things sneak in though? In this segment, Kris and Adrian review the Unexpected Killers segment and highlight their PA perspectives on thinking about these important “Do Not Miss” diagnoses! Like the diagnoses themselves, a do-not-miss segment.

COVID-19 and Intimate Partner Violence

February 2021
18min

In this Hippo Education bonus, Dr. Lisa Patel and Dr. Maya Ragavan discuss intimate partner violence (IPV) in the context of COVID-19. While data has focused on prevalence, they dive into how the pandemic has changed survivors’ experiences, access to resources, approach to safety planning, privacy concerns, and survivor resilience. They also discuss alternative means of counseling families for IPV in the setting of increased telehealth, where survivors may not be in a private place to disclose an abusive relationship.

Race and Medical Education

February 2021
28min

In this installment of Hippo Education’s Race and Medicine series, Jay and Neda dive into some of the unique challenges facing Black medical students and residents. They also discuss solutions in both undergraduate and medical education with two experts in the field: Dr. Millard Collins, Chair of the Department of Family & Community Medicine at Meharry Medical College and Dr. Renee Crichlow, former Director of Advocacy and Policy in the Department of Family Medicine and Community Health at the University of Minnesota School of Medicine. She is currently the Chief Medical Officer of Codman Square Community Health Center and incoming Vice Chair of Health Equity at Boston University Department of Family Medicine.

More helpful POEMs for 2021

February 2021
9min

Kris and Adrian continue their review of patient-oriented evidence to help you provide great care by doing less from the article called, “ Top POEMs of 2019 Consistent with the Principles of the Choosing Wisely Campaign from an online article from the American Academy of Family Practice, October 30, 2020.

All About Amitriptyline

February 2021
16min

What is the deal with amitriptyline? Is it a panacea? Or a pariah? PC RAP’s own Dr. Jay-Sheree Allen and Dr. Neda Frayha break it all down for us in this medication deep dive.

Paper Chase #1: Antibiotics vs Appendectomy for Appendicitis

February 2021
7min

Antibiotics were not inferior to appendectomy at 90 days. 30% of the antibiotic group ended up having an appendectomy by 90 days.

Proceed With Confidence: Onychocryptosis

February 2021
22min

How’s your toenail-removing game? If it needs a little practice, listen to this segment about onychocryptosis to help you proceed with confidence in the why and how of removing a toenail.

Paper Chase #2: Memory Training for Children

February 2021
5min

Computer games did not improve children's working memory at six months.

Keeping Up with the Literature with Dr. Alan Ehrlich

February 2021
25min

On average, 5,000 new medical articles are published every day. In this segment, Dr. Alan Ehrlich, Executive Editor of DynaMed, and Paul Simmons discuss some practical tips in staying current with the literature and applying it to our everyday practice.

Light Chains, SPEPs, and MGUS

February 2021
23min

Kappa? Lambda? SPEPs? MGUS? WTH? Hematologist Dr. Victoria Giffi walks us through a clear, helpful primer on this alphabet soup of immunoglobulins.

Paper Chase #3: Palliative Care and Chronic Illness

February 2021
6min

Use of palliative care was associated with less acute healthcare use and modestly lower symptom burden, but there was no significant difference in quality of life.

Primary Care of Gay, Bisexual and Other Men Who Have Sex With Men: Part 1

February 2021
19min

There are significant health disparities for men who have sex with men. In this enlightening segment, Drs. Matt Zeitler and Hayden Shafer discuss these disparities and how we can address them in our primary care practice.

Primary Care of Gay, Bisexual and Other Men Who Have Sex With Men: Part 2

February 2021
8min

There are significant health disparities for men who have sex with men. In this enlightening segment, Drs. Matt Zeitler and Hayden Shafer discuss these disparities and how we can address them in our primary care practice.

Paper Chase #4: Patient-Reported Errors in EHR Notes

February 2021
6min

Patients reported errors in medical documentation almost a quarter of the time, and half of those errors were deemed serious.

Group Prenatal Care

February 2021
18min

Can you picture attending a routine prenatal visit in a visit with other pregnant women? What does the literature say about this? Neda discusses group prenatal care with Ob/Gyn Dr. Sara Mazzoni.

Tips for Getting Paid!

February 2021
29min

When you are deciding to bill a level 99213 vs 99214, how comfortable are you with your documentation? How about billing for procedures? Paul dives deep into coding with Dr. Kim Yu in this segment, including the 2021 Medicare coding changes.

Paper Chase #5: Smoking Cessation in New Cancer Diagnoses

February 2021
6min

Among smokers recently diagnosed with cancer, sustained counseling and provision of free cessation medication resulted in higher six month quit rates.

Mailbag: Intuitive Eating

February 2021
14min

PA Perspectives

February 2021
13min

Kris and Adrian review, reflect and share their takes on this month’s 2 part segment about the unique components of care for men who have sex with men.

Are you a POEt and don’t know it?

January 2021
13min

We made it to 2021!!!! 2020 is behind us, but you can look forward to a great discussion with Adrian and Kris around using quality patient-oriented evidence that matters (POEMs) to change common practice patterns in primary care.

Paper Chase #1 - CV and Renal Outcomes with Empagliflozin in Heart Failure

January 2021
7min

Among patients with heart failure, SGLT inhibitors improved rate of hospitalizations and decline in renal function regardless of diabetes status

Less is More

January 2021
16min

Less is more! We were thrilled to learn about the JAMA Internal Medicine series highlighting which primary care services we can scale back on or do away with completely. In this month’s Primary Care RAP introduction, Neda and Paul begin breaking down some of these recommendations and how they’ll put them into practice. Happy new year!

The Big Picture: Facing Death with Dr. BJ Miller

January 2021
25min

Why are we so afraid of death? What is the vicarious death bed test, and what role does love play? How can we help our patients face death on their own terms, and how can we all live our best lives beforehand? We ask these questions and more of Dr. BJ Miller, a palliative care specialist with Mettle Health and co-author of A Beginner’s Guide to the End: Practical Advice for Living Life and Facing Death. 

Paper Chase #2 - Early Rhythm-Control Therapy in Patients with A-Fib

January 2021
7min

Early rhythm control therapy was associated with a lower risk of adverse cardiovascular outcomes than usual care among patients with early atrial fibrillation and cardiovascular conditions

PFTs for the PCP: Part 1

January 2021
19min

PFTs? Easy as ABC! Pulmonologist Dr. Nirav Shah is back, this time walking Neda and Paul through pulmonary function tests in a super clear, straightforward way.

PFTs for the PCP: Part 2

January 2021
16min

PFTs? Easy as ABC! Pulmonologist Dr. Nirav Shah is back, this time walking Neda and Paul through pulmonary function tests in a super clear, straightforward way.

Paper Chase #3 - Time Restricted Eating on Weight Loss

January 2021
5min

Time-restricted eating on its own is not more effective in weight loss than eating throughout the day.

What's That Lab: Bilirubin

January 2021
13min

It’s time for another installment of our fan-favorite “What’s That Lab?” series! This time, our own Paul Simmons answers a listener question about bilirubin. 

Tattoo Complications

January 2021
19min

Tattoos have become more and more common over the past decade. Besides regret, there are other cutaneous complications that clinicians should be aware of. Having a broad differential beyond simple bacterial infections can assist in making decisions on appropriate treatment and prompt referral to specialists when indicated.

Paper Chase #4 - Physician EKG Interpretation Accuracy

January 2021
5min

Physicians at all training levels had deficiencies in EKG interpretation, even after education interventions.

PCOS

January 2021
27min

Endocrinologist Dr. Rana Malek is back on Primary Care RAP, this time teaching Neda and Paul about the in’s and out’s of polycystic ovarian syndrome in her usual, chock-full-of-clinical-pearls way. 

Navajo Health and COVID-19

January 2021
22min

The COVID-19 pandemic has struck minority populations and populations of color most severely. One population hit particularly hard, but to little public notice, has been the Native American population in North America. Our own Paul Simmons and Dr. Matt Nelson, a family physician providing full-spectrum care to the Navajo population in Page, Arizona, discuss not only what Dr. Nelson has seen through the COVID-19 pandemic, but his perspective on the unique challenges and benefits of working with the Navajo population.

Paper Chase #5 - Fecal Microbiota Transplantation

January 2021
6min

Among patients with recurrent CDI treatment with FMT, cure rates were high with minimal adverse effects.

Mailbag: Long Covid Syndrome

January 2021
30min

Just when we all get accustomed to treating COVID-19, along comes Long Covid Syndrome to keep us on our toes. Some patients take months to recover and experience debilitating fatigue, dyspnea, and joint pains that have a huge impact on their quality of life. Neda and Paul answer a few listener questions about Long Covid Syndrome and what we know about it so far.