213 episodes

Supercharge your learning and enhance your practice with this Internal Medicine Podcast featuring board certified Internists as they interview the experts to bring you clinical pearls, practice changing knowledge and bad puns. Doctors Matthew Watto, Stuart Brigham, Paul Williams and friends (a national network of students, residents and clinician educators) deliver a little knowledge food for your brain hole. Yummy! No boring lectures here, just high value content and a healthy dose of humor. Fantastic for Internal Medicine, Family Medicine, Primary Care, and Hospital Medicine.

The Curbsiders Internal Medicine Podcast Matthew Watto MD, Stuart Brigham MD, Paul Williams MD

    • Medicine

Supercharge your learning and enhance your practice with this Internal Medicine Podcast featuring board certified Internists as they interview the experts to bring you clinical pearls, practice changing knowledge and bad puns. Doctors Matthew Watto, Stuart Brigham, Paul Williams and friends (a national network of students, residents and clinician educators) deliver a little knowledge food for your brain hole. Yummy! No boring lectures here, just high value content and a healthy dose of humor. Fantastic for Internal Medicine, Family Medicine, Primary Care, and Hospital Medicine.

    #195 TWDFNR 3: Potassium, Oxygen, and antipsychotics

    #195 TWDFNR 3: Potassium, Oxygen, and antipsychotics

    Discover common practices that persist in the hospital wards despite no proven benefit! We review how potassium replacement goals should not drive you bananas, extra oxygen should not give you comfort, and how you should maybe calm down with antipsychotics for delirium. Join returning guests: high-value care specialist Dr. Lenny Feldman (@DocLennyF, Johns Hopkins) and tweetorialist Dr. Tony Breu (@tony_breu, Harvard) as they walk us through round 3 of “Things We Do for No ReasonTM.
    SHM members can claim CME-MOC credit at https://www.shmlearningportal.org/curbsiders (CME goes live at 0900 ET on the episode’s release date). Note: The planners and faculty for this activity have no relevant relationships or conflicts to disclose.
    Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com
    Credits Written and Produced by: Burton H. Shen MD, Justin Berk, MD MPH MBA Infographic: Cover Art: Hosts: Justin Berk MD MPH MBA; Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FaCP Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of Nodderly.com (audio) Guest: Lenny Feldman MD, Tony Breu MD Sponsors The Society of Hospital Medicine Hospital Medicine 2020 (HM20) is the Society of Hospital Medicine’s Annual Conference April 15th through the 18th in sunny San Diego. Don’t miss the largest hospital medicine meeting. Register now at https://shmannualconference.org/ and use the code CURBSIDERS to receive a $50 discount.
    Primary Care Internal Medicine of Ithaca Join a well established practice in beautiful upstate New York near the finger lakes and wine country! You'll have flexible hours and the ability to take the time you need with patients! Contact Dr. Ann Costello arcostello@gmail.com to find out more about this incredible opportunity to join the team at Primary Care Internal Medicine of Ithaca https://www.primarycareinternalmedicineofithaca.com/. 
    Time Stamps 00:00 Sponsors -SHM’s Annual Conference, HM20 (use code CURBSIDERS) and Primary Care Internal Medicine of Ithaca (email: arcostello@gmail.com) 00:38 Intro, disclaimer, guest bio 02:10 Guest one-liners 03:35 Picks of the Week*: Knives Out (film), Priced Out by Uwe E. Reinhardt; Crisis in the Red Zone by Richard Preston; CardioNerds podcast; Outbreak (film); Teaching Physiology on the Fly (faculty development course) 07:55 Sponsors -SHM’s Annual Conference, HM20 (use code CURBSIDERS) and Primary Care Internal Medicine of Ithaca (email: arcostello@gmail.com) 09:30 Case of Eric Lokay; Repleting potassium. Is it necessary to “buff the lytes” 20:30 Pathophysiology of hypokalemia; Final recommendations on potassium repletion 24:30 Supplemental oxygen; pO2 vs total oxygen content; Oxygen, vasoconstriction and potential harms 30:33 Evidence of harm from supplemental O2 35:00 Tony’s recommendations for use of supplemental O2 41:55 Case of delirium; Definition and diagnosis 46:20 Can we prevent delirium? Melatonin and ramelteon 50:33 Should we use antipsychotics? Benzodiazepines?; What should we do instead? 58:25 Take home points, Outro and a terrible pun *The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.
    Disclosures Dr. Feldman and Dr. Breu report no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. 
    Citation Feldman L, Breu T, Shen BH, Berk JL, Williams PN, Brigham SK, Watto MF. “#195 TWDFNRTM 3: Potassium, Oxygen, and antipsychotics”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. February 17, 2020.

    • 1 hr 1 min
    #194 Treatment of Alcohol Use Disorder with Dr. Marlene Martin MD

    #194 Treatment of Alcohol Use Disorder with Dr. Marlene Martin MD

    Dismantle alcohol use disorder with some evidence based tools for your toolbelt! We cover everything from ways to screen patients for risky drinking, to all the different treatment options with our guest expert Dr. Marlene Martin, @MarleneMartinMD, Director of the Addiction Care Team and Assistant Professor of Clinical Medicine at the UCSF. We learn how to initiate medications such as naltrexone and acamprosate for the treatment of alcohol use disorder, how to define treatment success, if psychosocial interventions such as Alcoholics Anonymous are effective, and what’s the deal with baclofen and gabapentin? After listening to this episode, listeners will feel ready to start prescribing medications such naltrexone to treat alcohol use disorder.  Your patients need you!
    ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date). 
    Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com
    Credits Written and Produced by: Carolyn Chan, MD Cover Art and Infographic: Carolyn Chan, MD Hosts: Carolyn Chan, MD; Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Matthew Watto MD, FACP (written materials); Clair Morgan of Nodderly.com (audio) Guest: Marlene Martin, MD Sponsor ACP’s Medical Knowledge Self Assessment Program, MKSAP 18. MKSAP provides the latest and most comprehensive educational content needed by internists today. It’s THE internal medicine go-to resource for continuous learning and Board preparation. Visit http://www.acponline.org/mksapcurbsiders to place your order!
    Time Stamps 00:00 Sponsor -ACP’s MKSAP 18 http://www.acponline.org/mksapcurbsiders  00:45 Intro, guest bio 01:30 Guest one-liner, book recommendation, favorite failure, career advice Picks of the week*: Project Runway (TV show); The Quiet Place (film); Tattoos on the Heart: The Power of Boundless Compassion (book) by: Gregory Boyle; Cats (film) 08:20 Sponsor -ACP’s MKSAP 18 http://www.acponline.org/mksapcurbsiders  09:05 Case of Mr Hops; Defining unhealthy alcohol use 13:37 Screening and diagnosis; assessing for tolerance; stratifying severity of AUD 16:56 Spiel and first steps after diagnosing a patient with unhealthy alcohol use; Motivational interviewing; Exploring motivation to change 22:12 Pharmacologic treatment options: Naltrexone, acamprosate, disulfiram 26:40 How effective are medications for alcohol use disorder; Defining success 29:41 Naltrexone prescribing, dose titration 34:25 Acamprosate prescribing; Naltrexone in advanced liver disease 38:05 Off label use of baclofen, gabapentin and topiramate 43:39 Risk stratifying for inpatient versus outpatient treatment; Non-pharmacologic interventions 49:26 Deciding duration of therapy 52:24 Take home points; Plug for AMERSA conference 53:57 Outro *The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.
    Disclosures Dr Marlene Martin reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. 
    Citation Martin M, Chan, C, Williams PN, Brigham SK, Watto MF. “194 Treatment of Alcohol Use Disorder”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. February 10, 2020.

    • 55 min
    #193 LIVE! The Struggling learner with Dr. Melissa McNeil

    #193 LIVE! The Struggling learner with Dr. Melissa McNeil

    Join us as we discuss how to approach “The Struggling Learner” with Dr. Melissa McNeil (@missydoc0128), Professor Medicine and Associate Chief of General Internal Medicine at the University of Pittsburgh Medical Center (UPMC), recorded LIVE in Pittsburgh, PA!  In this episode, we discuss how to approach the struggling learner, highlighting the 5-Step process discussed in a recent article co-written by Dr. McNeil (Merriam 2019).  This episode is not intended to give educators a roadmap for how to develop and implement a corrective action plan, but was put together to provide a common toolset on how to approach a struggling learner.  As such, the topics discussed can be applied to all kinds of learners that struggle, not just in medicine. However, the techniques discussed involve a common framework routinely taught in medical education (assessment, diagnosis, and referral) and, therefore, is communicated using this shared language.
    Show Notes | Subscribe | Spotify | Schwag! | Top Picks | Mailing List | thecurbsiders@gmail.com
    Credits Written and Produced by: Stuart Brigham MD Infographic: Matthew Watto MD, FACP Cover Art: Stuart Brigham MD Hosts:  Matthew Watto MD, FACP; Paul Williams MD, FACP; Stuart Brigham, MD Editor: Stuart Brigham MD (written materials); Clair Morgan at Nodderly.com Guest: Melissa McNeil MD, MACP Special thanks to Dr. William Kelly, FACP, FCCP Sponsor ACP’s Medical Knowledge Self Assessment Program, MKSAP 18. MKSAP provides the latest and most comprehensive educational content needed by internists today. It’s THE internal medicine go-to resource for continuous learning and Board preparation. Visit http://www.acponline.org/mksapcurbsiders to place your order!
    Time Stamps 00:00 Sponsor - ACP’s MKSAP 18! 00:15 Intro, disclaimer, guest bio 05:50 Guest one-liner, favorite failure 10:30 Picks of the Weeks*: Book: Radical Candor; Movie: Clue (1985); Book: Awareness by Anthony De Mello; TV Series:  The Expanse (Season 4) on Amazon Prime 13:28 Sponsor - ACP’s MKSAP 18! 14:14 Case of a struggling learner; defining terms 20:24 Gathering data; Clarifying questions; Timing and feedback 28:30 Develop a differential diagnosis; Naming the behavior 37:42 SRL tool to evaluate deficits 42:55 Case of an overconfident learner 48:40 Concern for substance use in a struggling learner 52:02 Educational handoffs 54:53 Identifying learners who struggle with empathy 56:36 Outro *The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.
    Goal Listeners will identify practical tools, tips, and techniques using skills developed for patient care and appreciate what they can do when a learner is struggling.
    Learning objectives After listening to this episode listeners will…  
    Develop an appreciation for how to approach the struggling learner  Recognize how to “diagnose” learners using clinical reasoning skills Appreciate the importance that timely, specific feedback plays in identifying why a learner struggles Identify why lack of insight can make addressing these struggles more difficult Disclosures Dr. McNeil reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. 
    Citation McNeil M, Brigham SK, Williams PN, Watto MF. “#193 The Struggling Learner with Dr Melissa McNeil”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. February 3, 2020.

    • 58 min
    #192 Dialysis for the Internist with Joel Topf MD

    #192 Dialysis for the Internist with Joel Topf MD

    Kidney Boy Returns! Compare the types of dialysis, learn how nephrologists approach medication management in ESRD, and avoid the most common mistakes non-nephrologists make in patients on dialysis! Kashlak Chief of Nephrology Dr. Joel Topf, @kidney_boy, walks us through what you need to know to take care of a patient on dialysis and gives us an idea of how nephrologists think through mineral bone disease (calcium, phosphorus and vitamin D), anemia, iron repletion, and hypertension. We answer all your questions about co-managing patients on dialysis!
    Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com
    Credits Producer: Hannah R. Abrams Written and produced by: Hannah R. Abrams Cover Art and Infographic by: Hannah R. Abrams Hosts: Hannah R. Abrams, Matthew Watto MD, FACP; Paul Williams MD, FACP    Editor: Matthew Watto MD, FACP (written materials), Clair Morgan of Nodderly.com (audio) Guest: Joel Topf MD Sponsor ACP's Internal Medicine Meeting 2020 April 23-25th in Los Angeles, CA at the LA Convention Center. Early bird rates are available through January 31, 2020. Don’t forget to use the code: IMCURB20
    Time Stamps 00:00 Sponsor -ACP’s Internal Medicine Meeting 2020 00:15 Intro, disclaimer, guest bio 01:45 Guest one-liner, Picks of the Week*: KidneyCon, CATS (film) 06:00 Sponsor -ACP’s Internal Medicine Meeting 2020 06:50 Case of Anne Yuric; Assessing risk of progression to dialysis; Candidacy for dialysis and renal transplant 12:20 Why is mortality so high on dialysis 15:47 When to initiate dialysis 19:40 Types of dialysis; the importance of residual renal function 25:45 Why is peritoneal dialysis underutilized 28:10 Dialysis access 34:25 Return to our case: Mineral bone disease, and phos binders; Calcyphylaxis 44:40 Which problems are under the domain of the nephrologist and the dialysis unit?; Hypertension management in ESRD; Midodrine; 48:18 ACEI/ARB, spironolactone 51:55 Anemia and iron in ESRD; Screening in Primary Care for patients on dialysis; Statins in patients on dialysis 57:42 Medications to avoid 61:50 Renal diet; Warfarin and DOACs on dialysis 66:48 Common inpatient mistakes: Labs, PICC lines 69:36 Takes Home Points; Plug: NephMadness 2020 is coming! 72:19 Outro Disclosures Dr Topf lists the following disclosures on his website: “I have an ownership stake in a few Davita run dialysis clinics and a vascular access center. Takeda Oncology made a donation to MM4MM the program that is taking me to Mount Everest in 2018”. The Curbsiders report no relevant financial disclosures. 
    Citation Topf, J, Abrams, HR, Williams PN, Watto MF. “#192 Dialysis for the Internist with Joel Topf MD”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. January 27, 2020.

    • 1 hr 13 min
    Season 9 Trailer and KIDNEYcon 2020 Announcement!

    Season 9 Trailer and KIDNEYcon 2020 Announcement!

    Trailer for season 9 of The Curbsiders! Plus, our friends from NephJC and the Freely Filtered Podcast will be at KIDNEYcon 2020! It features 6 amazing hands on workshops and lots of celebrities from #NephTwitter. The deadline for travel grants is approaching (See below).
    What: KIDNEYcon 2020 (www.kidneycon.org)
    When: April 16-19, 2020

    Where: Little Rock, Arkansas
    Who Should Attend: Internal Medicine Residents, Pediatric Residents, Adult and Pediatric Nephrology Fellows, Attending Nephrologists
    Travel Grants: Available for Adult and Pediatric Residents and Nephrology Fellows (Deadline to apply: February 1st )
    Click HERE to Register in January 2020

    • 2 min
    #191 Lipids Update with Erin Michos MD

    #191 Lipids Update with Erin Michos MD

    Lipids Update! Get up close and personal with ASCVD prevention and lipid management guidelines, including changes in the 2018 update, with our discussion with Dr. Erin Michos @erinmichos, preventive cardiologist and associate professor of medicine at the Johns Hopkins University Hospital! We review the background on the ASCVD risk calculator, basics of primary and secondary prevention, statins benefits and misconceptions, appropriate follow up, cool things to look out for in the future, the deal with medications like aspirin and icosapent ethyl, among many other things! If that wasn’t enough, Dr. Michos also goes over great ways to counsel patients on healthy living and when that darn statin is giving you the “muscle aches”! 
    ACP members can claim CME-MOC credit at https://www.acponline.org/curbsiders (CME goes live at 0900 ET on the episode’s release date). 
    Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com
    Rate our infographics! Tell us what you think in this brief survey.
    Credits Producers: Christopher Chiu MD FACP FAAP; Jasneet Devgun DO; Justin Berk MD MPH MBA; Beth Garbitelli  Writers: Jasneet Devgun DO; Justin Berk MD MPH MBA Infographic: Beth “Garbs” Garbitelli Cover Art: Kate Grant MBChB DipGUMed Hosts: Christopher Chiu MD FACP FAAP; Matthew Watto MD FACP; Paul Williams MD FACP    Editors: Emi Okamoto MD (written materials); Clair Morgan of Nodderly.com (audio) Guest: Erin Michos MD MHS Sponsor ACP's Internal Medicine Meeting 2020 April 23-25th in Los Angeles, CA at the LA Convention Center. Early bird rates are available through January 31, 2020. Don’t forget to use the code: IMCURB20
    Time Stamps 00:00:00 Intro 00:01:52 Getting to know Dr. Erin Michos 00:O6:50 Picks of the Week*: Sparking Joy- concept for Marie Kondo (book and show), The Life-Changing Magic of Tidying Up by Marie Kondo; Shadowland, book by Peter Straub; The Crown, Netflix series; Catch and Kill, book by Ronan Farrow; Trick Mirror, essay collection by Jia Tolentino; Make it Stick, book by Brown, Roediger, and McDaniel 00:11:50 Digging into ASCVD Risk Calculator 00:16:12 Who should get 10 year ASCVD Risk assessment and what are the categories? 00:18:13 How Dr. Michos discusses healthy lifestyle and “Primordial Prevention” 00:19:42 What are “Risk Enhancing Factors”? 00:22:36 Who should get biomarker testing vs CAC scoring? 00:29:35 How Dr. Michos discusses statin therapy with her patients 00:32:18 How to address risks of side effects 00:37:57 Primary vs Secondary Prevention 00:39:40 “What should my cholesterol be?” 00:42:03 How often to follow-up labs? 00:46:00 Differences between stain intensity 00:47:57 How to manage side effects 00:52:05 PCSK9 inhibitor discussion 00:55:06 Aspirin, Fibrates and Icosapent Ethyl 01:02:13 High Risk vs Stable ASCVD 01:06:50 Take home points and the future 01:10:50 Outtro *The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra.
    Goal Listeners will feel comfortable managing both primary and secondary prevention for ASCVD among different patient scenarios. 
    Learning objectives After listening to this episode listeners will…  
    Recognize the different risk levels and further ways to hone risk-stratification. Describe primary prevention management including how to discuss lifestyle changes, statins, and managing common statin-related complaints. Recognize the importance of lipid reduction for secondary prevention and different medications to achieve this. Disclosures Dr Erin Michos reports no relevant financial disclosures. The Curbsiders report no relevan

    • 1 hr 12 min

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