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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 Phildelphia 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, PhD 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