The Certainty of Uncertainty
Welcome to the July 2020 episode of Primary Care RAP! This month, we make a plan to embrace uncertainly, see right through some X-Ray lies, dive deep into Ferritin on 'What's That Lab', and much more. Let's hop to it!
Bonus: Race and Medicine - An Introduction
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.
Bonus Short - Laceration Repair in the Time of COVID
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.
Bonus Short - Facing Death in the Time of COVID-19 with Dr. BJ Miller
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.
Cause of Death?
Welcome to the June 2020 edition of Primary Care RAP! This month, we process info on Acute Gastroenteritis, take some deep breaths while reviewing new Asthma guidelines, open our eyes to some great information about Flashes and Floaters, and much more. Let's jump in!
Bonus Short - COVID Antibodies and Immunity
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.
*UPDATED*Bonus Short - The Saga Continues with Remdesivir and Hydroxychloroquine
*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.
Bonus Short - COVID CARDIOLOGY
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.
Bonus Short - Indirect Impact of COVID-19 on Children
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.
Bonus Short - COVID Findings in Kids
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: IDSA Treatment Guidelines, Remdesivir, and a Look Back
In this Hippo Education update, Primary Care RAP host Dr. Neda Frayha interviews regular guest and Infectious Diseases expert Dr. Devang Patel for a discussion of where the IDSA stands on all the potential treatments for COVID-19, a review of the remdesivir paper that is all the rage lately, and a look back on whether or not their very first conversations on the novel coronavirus have stood the test of time.
Bonus Short - Primary Care in the Time of Covid
Sol Behar interviews Oakland, CA based primary care pediatricians Celine Sparrow and Katie D’Harlingue about the impact of Covid-19 on primary care practices. They discuss practical details of how to safely continue caring for their patients, selves and staff members. They also share strategies and resources on how to keep financially afloat during these challenging times.
Bonus Short - COVID-19: The Long Game
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.
Pain in the You-Know-Where
Welcome to the May 2020 Edition of Primary Care RAP! This month, we look deep inside the world of knee x-rays, learn all about telling pain syndromes apart, discuss alcohol use in pregnancy, and much more. Let's go!
Bonus Short - Clinician Mental Health in the COVID-19 Pandemic
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
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
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
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
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.
Bonus Short - COVID-19: UC/Primary Care Triage
Covid-19 is a rapidly spreading pandemic that is having worldwide ramifications. As Emergency Rooms and Hospitals quickly get overwhelmed by ill patients, the Urgent Care and Primary Care settings are playing critical roles in identifying who can go home vs. those that need to be transferred to the Emergency Department for further evaluation and treatment. This ability to act as levies, to the large number of patients during this pandemic, is helping to preserve the ED and Hospital “resources” for those critically ill patients that need it most.
Bonus Short - COVID 19: Hot Topics and Lit Review
There are so many active threads, subthreads, and sub-sub-threads of conversation in the medical community surrounding the COVID-19 pandemic. In this Hippo Education Short, Drs. Tom Robertson and Steve Biederman of Primary Care RAP’s Paper Chase take 4 hot topics in COVID-19 and examine the literature behind them. They look into the epidemiology of the outbreak in the U.S. and lessons learned, the sensitivity and specificity of SARS-CoV-2 testing, the rates of co-infection with other respiratory viruses, and convalescent plasma as a potential therapy.
More Listener Love
Welcome to the April 2020 Edition of Primary Care RAP! This month, you'll react well to info on food allergies, get a healthy dose of tramadol content, and take a serious look at efforts to destigmatize therapy. Let's hop in!
Bonus Short - Covid-19: Pregnancy and Newborns
Sol interviews Children’s Hospital of Philadelphia NICU doc Joanna Parga-Belinkie to discuss Covid-19 and 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
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.
Bonus Short - Telemedicine in the Time of COVID-19
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?
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
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
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.
Mailbag March Madness
Welcome to the March 2020 Edition of Primary Care RAP! This month, we go into the trenches with Measles, take a close look at Family Centered Care, review new A-Fib guidelines, and much more. Let's listen in!
Don't Go Breaking My Heart
Welcome to the February 2020 Edition of Primary Care RAP! This month, we break down broken heart syndrome, gulp down some info on swallowing disorders, explain the birds & the bees, and much more. Let’s take a listen!
Bonus Short - Novel Coronavirus
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.
Weird and Wacky Wounds
Welcome to the January 2020 Edition of Primary Care RAP! This month, we discuss beginning breast cancer screening, do an adjustment to our knowledge of chiropractors, discuss the relationship between marijuana and lung disease, and a whole lot more. Let's get to it!