The Practice of Medicine

In this episode of Writing Therapy, SMA Education Committee Vice Chair Dr. Richard Leggett sits down with Dr. Carey Robinson, a retired ophthalmologist whose creative journey has taken him well beyond the exam room. Known by his pen name “Dr. Crawdaddy,” a nod to his Louisiana roots and LSU background, Dr. Robinson shares how writing has become a meaningful outlet in retirement. From a children's book (Yes! That's What I Do Best!) and a collection of life lessons (The Last Sip of Coffee) to an Advent devotional and two upcoming works-in-progress, his projects illustrate his passion for storytelling. Tune in as he discusses the therapeutic power of writing and the inspiration behind his body of work.

In this episode, Randy Glick, BSB/PM, MCP, speaks with Erica D., MSN, FNP-BC, a full-time nurse practitioner and founder of The Nurse Practitioner Charting School. Erica's mission is to help clinicians reduce charting time and reclaim their personal lives, offering practical tips to combat burnout and improve work-life balance. She'll share insights on the impact of charting at home, three time-saving strategies for busy providers, and the potential role of AI medical scribes.

In this episode, Tatiana Havryliuk, MD, and Randy Glick, BSB/PM, MCP, examine how point-of-care ultrasound (POCUS) can help primary care providers differentiate between congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD) exacerbations in real-time. They discuss a compelling case that highlights how POCUS led to rapid diagnosis and appropriate treatment, avoiding unnecessary delays and hospitalizations. Dr. Tatiana Havryliuk is an emergency physician and founder of Hello Sono. With 15 years of experience using POCUS in diverse settings, from urban EDs to Everest Base Camp, she is dedicated to extending its benefits to more patients. With Hello Sono, she and her team support practices in building compliant, high-quality, and profitable POCUS programs through tailored education and implementation.

The Vertically Integrated Trainee Program (VITP), now rebranded as MedConnect, at the University of South Carolina School of Medicine - Columbia, is transforming the pathway for premedical students by fostering mentorship, reducing disparities, and creating sustainable opportunities for those without traditional connections to the field.    This episode of SMA's Physicians-in-Training Podcast explores the program's mission, vision, and guiding principles, as well as the unique aspects that set it apart. Moderated by Donald DiPette, MD, FACP, FAHA, Logan Hitchcock, BS; Greyson Fox Tran, BS; Buckley McCall, BS, MD; and Jaron Pettis, MD, share insights on the origins of VITP, the role of mentorship in preventing burnout, and the evolving direction of MedConnect as it expands into new academic and clinical spaces. Listen as they discuss the challenges facing today's premedical students, the program's long-term sustainability, and the impact it has had on aspiring physicians.   About the GuestsLogan Hitchcock, BS MD Candidate/Class of 2027 University of South Carolina School of Medicine - Columbia Greyson Fox Tran, BS MD Candidate/Class of 2026 University of South Carolina School of Medicine - Columbia Buckley McCall, BS, MD PRISMA Health - Upstate Chair, SMA's Physicians-in-Training Committee Jaron Pettis, MD Northwest Health General Surgery Donald DiPette, MD, FACP, FAHA University Of South Carolina School of Medicine - Columbia SMA President, 2017-2018

During SMA's 2023 Annual Scientific Assembly, Donald DiPette, MD, FACP, FAHA, discussed the current unsatisfactory hypertension control rates and the need for a new management and treatment approach, as well as barriers to achieving hypertension control with a particular focus on patient-related barriers. He also detailed the the importance of including the patient as part of the management and treatment “team” and presented approaches to include the patient in their hypertension treatment plan.

Point-of-care ultrasound (POCUS) is a transformative tool for diagnosing deep vein thrombosis (DVT) in primary care. After this podcast, during which Tatiana Havryliuk, MD, and Randy Glick, BSB/PM, MCP discuss this important element of care, you will understand the benefits of POCUS for DVT rule-out, basic techniques, and strategies to mitigate liability. Dr. Tatiana Havryliuk is an emergency physician and founder of Hello Sono. With 15 years of experience using POCUS in diverse settings, from urban EDs to Everest Base Camp, she is dedicated to extending its benefits to more patients. With Hello Sono, she and her team support practices in building compliant, high-quality, and profitable POCUS programs through tailored education and implementation.

In this episode, Tatiana Havryliuk, MD, and Randy Glick, BSB/PM, MCP, dive into a real-life case where a primary care doctor used POCUS to diagnose pneumonia in a patient with a cough, leading to quick and effective treatment. They discuss the evidence behind lung ultrasound, what the ultrasound revealed in this case, and how it made a difference for the patient. Join them to explore how POCUS is making primary care more efficient, accurate, and patient-focused. Dr. Tatiana Havryliuk is an emergency physician and founder of Hello Sono. With 15 years of experience using POCUS in diverse settings, from urban EDs to Everest Base Camp, she is dedicated to extending its benefits to more patients. With Hello Sono, she and her team support practices in building compliant, high-quality, and profitable POCUS programs through tailored education and implementation.  This topic is important because it shows how POCUS can help primary care providers make quicker, more accurate diagnoses, like catching pneumonia right at the bedside. It's a game-changer for patients, reducing delays, avoiding unnecessary tests, and ensuring they get the right treatment faster.

Dr. Pragna Patel, MD, MPH, Chief Medical Officer at the U.S. Department of Health and Human Services/Centers for Disease Control and Prevention (CDC), provided an overview of  COVID-19 testing and treatment during her presentation at SMA's 2023 Annual Scientific Assembly. Her discussion covered the epidemiology of COVID-19, including current circulating variants; SARS-CoV-2 testing recommendations, and COVID-19 treatment guidance. She also addressed approaches to patients with influenza-like illness.

Presented by David Netscher, MD, this session details common sports injuries affecting the hand and upper extremity. Dr. Netscher discusses evidence-based diagnostic techniques and management strategies and reviews the latest advancements and rehabilitation protocols in treating hand and upper extremity injuries. 

During this presentation, Donald DiPette, MD, FACP, FAHA, on behalf Robert M. Carey, MD, reviews the role of the RAAS in normal blood pressure and salt and water homeostasis. In addition, Dr. DiPette discusses the role of the RAAS in the pathophysiology of cardiovascular disease, diabetes mellitus, and kidney disease, and he also details the pharmacologic inhibition/blockade of the RAAS.

Closed tendon injuries, dislocations and fractures are among the more common sports related hand injuries. Due to initial swelling and pain, these injuries may sometimes be deceptively difficult to diagnose. Often effective treatment is relatively simple and nonoperative but must be instituted in a timely manner in order to minimize complications. It is also important to recognize when surgical referral is required. Dr. David Netscher discusses several topics, including:  -- Phalangeal and metacarpal fractures -- MP and PIP joint dislocations -- Closed tendon injuries -- Tendinopathies

During this presentation, Robert Baillieu, MD, MPH, FAAFP, describes the current state of the overdose crisis and details SAMHSA/CSAT's role and associated strategies for addressing the overdose crisis.

This podcast explores the growing role of point-of-care ultrasound (POCUS) in primary care. We discuss practical applications, challenges in implementation, and tips for providers looking to adopt POCUS in their practice. Learn more about the Southern Medical Association at sma.org.

This case-based session, presented by Dr. Christopher D. Jackson, MD, FACP, FSSCI, will use the Curbsiders podcast to help develop a systematic approach to the diagnosis, workup, and initial management of patients with dementia. CME is available: https://sma.org/courses/demystifying-dementia-2/

In this podcast, Dr. Eugene Lambert reviews the current state of alcohol use disorders, its healthcare system impact and utilization. He also describes the increasing prevalence of the dual pathology of alcohol use disorders and associated liver disease, including the advanced liver disease entity of AUD-cirrhosis. Additionally, Dr. Lambert reviews the current state of AUD-cirrhosis management and discusses an addiction-focused and multidisciplinary approach to the effective treatment and management of AUD-cirrhosis.

In this episode of Southern Medicine, Dr. Ankur Patel highlights the potential consequences of polypharmacy, such as drug interactions, decreased adherence, and increased likelihood of adverse events. He also emphasize the rising prevalence of ADEs, underscoring their impact on patient outcomes, healthcare costs, and the burden on healthcare providers. 

In this episode of Southern Medicine, Dr. Sadie Elisseou, an internationally recognized subject matter expert in trauma-informed care (TIC), will highlight specific examples of how healthcare professionals can apply the Substance Abuse and Mental Health Service (SAMHSA)'s “4 Rs” and “6 principles” of TIC to clinical care and their own well-being. Listeners will leave with simple, actionable steps to ensure that care provided is safe, collaborative, and avoids retraumatizing patients.

Trauma is highly prevalent in the general population in various forms--adverse childhood experiences (ACEs), natural disasters, medical illness, and community violence are several examples. U.S. Military Veterans have unique exposures to trauma in the course of their service. The aftereffects of trauma can impact Veterans' health as well as their experience with health care. In this podcast, VHA healthcare professionals discuss how to practice person-centered, trauma-informed care with Veterans.  

Sara Paul, DNP, FNP, FAHA, CHFN, FHFSA, discusses the association between sudden death and heart failure with reduced ejection fraction, and actions for aggressive treatment and management of heart failure will be presented. In addition, she describes device therapy for the prevention of sudden death.

Healthcare planning predicts a shortage of 135,000 or more physicians in the next 10 years, coupled with existing shortages of all healthcare workers including nurses and other allied health professionals. Organized medical leaders must address the current and future gap in delivering health care to America's patients. Gerald Harmon, MD, FAAFP, presents data outlining the scope of the situation and current and potential approaches to addressing it.

Desiree Burroughs-Ray, MD, MPH, FAAP, FACP, and Christopher Jackson, MD, FACP, FSSCI, discuss contributing factors to physician burnout, barriers to physician wellness, organizational and individual practices to reduce the impact of burnout, and interventions that can promote physician wellness.

This presentation will explore the principles of collective intelligence and teaming, emphasizing their importance in healthcare. SMA Education Committee member Daniel Matthew Sherrer, MD, MBA, FASA, FAACD, will discuss principles of collective intelligence and teaming as well as strategies to minimize conflicts and enhance collaboration.

In this episode, Richard Leggett, MD, discusses writing as a form of physician wellness with Jeffery K. Smith, MD, a modern day "Sir Arthur Conan Doyle", who has published three novels as well as 20 non-fiction books on various historical figures. Together, they address the process of getting started in writing and publishing fiction and non-fiction works. 

SMA Education Committee member Rodney W. Overstreet, BSN, CRNA, MNA, discusses compassion fatigue, burnout, PTSD; explains depersonalization and derealization; and details the process of interoception. He also highlights healing tools and modalities that can be utilized to target the pain, release it, and allow space for healing.

Herpes zoster is a public health concern for the public, especially in subjects who are immunocompromised. The CDC–recommended recombinant zoster vaccine (RZV) is an effective way to reduce the incidence of herpes zoster, but because of the increased immunogenicity of the vaccine adjuvant, there is a concern about flares of underlying autoimmune diseases in rheumatology patients. Join Drs. Syed Raza Saurav Acharya, and Gabrielle Howard, as they discuss the safety of RZV in this patient population, a topic they, and their coauthor Debendra Pattanaik, addressed in their February 2022 Southern Medical Journal article. In this podcast, they talk about why patients with rheumatic diseases are found to be at higher risk of herpes zoster and what led them to conduct their study. Additionally, they provide evidence of the safety of  RZV in subjects with rheumatologic diseases.

In this podcast, Drs. William Ventres and Erick Messias discuss adverse shared historical experiences and the influence historical trauma has on current health outcomes, a topic addressed in their article appearing in the November 2021 issue of the Southern Medical Journal.

Discrimination is often experienced among medical students in clinical settings, especially those who belong to ethnic or gender minority groups, and it can occur in the form of “microaggressions”. In this podcast, Ms. Allison Kumnick and Dr. Julia Belkowitz discuss a simulation-based approach to improve medical students' resilience and communication, as well as educate faculty members on unintentional discriminatory practices. They also detail what led them to develop their project, the findings of which they and their coauthors present in their upcoming Southern Medical Journal article, “Developing Awareness and Allies: Simulating Difficult Conversations about Microaggressions for Faculty and Students”.

Food insecurity is a problem for people across the lifespan, and it has been exacerbated by COVID-19. Adults facing food insecurity often reduce the variety of their diet and tend to consume a few low-cost, energy-dense, and nutritionally poor foods to maintain caloric intake, and this puts them at an increased risk for a variety of adverse health outcomes, including diabetes, pulmonary diseases, cardiovascular diseases, and obesity. In this podcast Jennifer Mandelbaum discusses identifying and addressing food insecurity in older adults, a topic she addresses in an upcoming editorial in the Southern Medical Journal.

Mentoring is important for both professional and personal development in medical education. In this podcast, Drs. Andrew Sephien, Danielle Gulick, and Ambuj Kumar discuss why mentoring is necessary, as well as provide insight into common qualities and barriers that medical students believe are associated with successful mentors and mentoring relationships. They also detail what led them to conduct a study focusing on mentoring, the findings of which appear in their Southern Medical Journal article, “Prevalence of, Qualities, and Barriers Associated with Mentoring Relationships from Medical Students' Perspective: A Multi-Institutional Cross-Sectional Study” hat they coauthored with Drs. Leigh Hatch, Jordan Karsch, and Karim Hanna.

In this podcast, Dr. Lauris Kaldjian explains the need for ‘shared decision making' between patients and physicians, why it is important and details steps physicians can take to make that happen. He also offers insight to help physicians avoid slipping into manipulation or coercion when faced with certain situations. 

In the conclusion of this multipart podcast series, Dr. Benjamin Broome, a nephrologist with Nephrology Associates in Birmingham, Alabama, is joined by Drs. Elizabeth Edwards and Donald DiPette, both of whom are on faculty in the department of internal medicine at the University of South Carolina in Columbia to discuss proteinuria. They will review causes and symptoms, as well as provide information related to the association between proteinuria and later progression of chronic kidney failure. In addition, they will detail treatment options, as well as offer healthcare providers insight into when a nephrology referral may be warranted. 

In part five of this multipart podcast series, Dr. Benjamin Broome, a nephrologist with Nephrology Associates in Birmingham, Alabama, is joined by Drs. Elizabeth Edwards and Donald DiPette, both of whom are on faculty in the department of internal medicine at the University of South Carolina in Columbia to discuss hyponatremia, which occurs when the sodium level in the blood is below normal. They will provide information on common causes of both acute and chronic hyponatremia, as well as their similarities and differences. In addition, they will review the management of, and treatment modalities for, hyponatremia.

Hypertension is a leading cause of kidney disease and in part four of this multipart podcast series, Dr. Benjamin Broome, a nephrologist with Nephrology Associates in Birmingham, Alabama, is joined by Dr. Donald DiPette, who serves on faculty in the department of internal medicine at the University of South Carolina in Columbia to discuss the clinical implications of hypertension as a significant cardiovascular risk factor. They will also review the clinical care implications of the recent hypertension management and treatment guidelines.

The occurrence of Autism Spectrum Disorder (ASD) is on the rise and during this podcast, Drs. Anuja Mehta, Shirin Hasan, Lisa Spector, and Christopher Morris detail what ASD is, as well as some of the myths and misconceptions of ASD. In addition, they will provide information regarding the transition of care from adolescence into adulthood, and offer insight into treatment for ASD, including occupational and speech language therapies, as well as applied behavioral analysis.

In a special podcast, past SMA President Dr. Donald DiPette is joined by Dr. Don Powell, Professor Emeritus in the Department of Internal Medicine/Gastroenterology at the University of Texas Medical Branch in Galveston. Dr. Powell is the 2021 recipient of the Dr. Robert D. and Alma W. Moreton Research Award and Commemorative Lectureship, which will be presented at SMA's 112th Annual Scientific Assembly in Lake Buena Vista, Florida. During the conversation, Dr. Powell discusses innovations in medicine that have changed the care of patients with gastrointestinal disease and shares insight into how medicine has changed for the better (and perhaps not so better). He also reflects on defining moments in his career and offers guidance to medical students, physicians in training, and young physicians who are the future of medicine.

Every year, there are more than 13 million cases of acute kidney injury (AKI) worldwide, and this disease burden is on the increase in emerging countries where the annual incidence is estimated to be 11.3 million. In part three of this multipart podcast series, Dr. Benjamin Broome, a nephrologist with Nephrology Associates in Birmingham, Alabama, is joined by Drs. Elizabeth Edwards and Donald DiPette, both of whom are on faculty in the department of internal medicine at the University of South Carolina in Columbia. They will discuss what AKI is, as well as some of its most common causes. In addition, they will offer healthcare providers insight into the diagnosis and management of AKI, including the understanding of the long-term consequences of AKI and appropriate patient follow-up.

Pain is often referred to as the fifth vital sign and in this podcast, Drs. Philip Hartman and Christopher Morris use an evidence-based approach to discuss different modalities of acute and chronic pain management. They also provide insight into the changing approach to opioid prescribing as well as touch upon the preliminary data and the need for additional research surrounding cannabinoid-based products.

Patient care pathways exist as a method to create safe entry and exit strategies for patients undergoing surgery. Good perioperative care should improve the patient's experience, including quality of, and satisfaction with care. We invite you to join Dr. Christopher Morris and Dr. Christopher Jackson as they discuss the perioperative management of surgical patients, focusing on best practices from a medical management perspective. The discussion will briefly highlight three areas of successful surgical outcomes, including preoperative evaluation, intraoperative management, and postoperative care.

It is estimated that 37 million American adults have chronic kidney disease, or CKD, and millions of others are at increased risk. In part two of this multipart podcast series, Dr. Benjamin Broom, a nephrologist with Nephrology Associates in Birmingham, Alabama, is joined by Drs. Elizabeth Edwards and Donald DiPette, both of whom are on faculty in the department of internal medicine at the University of South Carolina in Columbia. They will detail what CKD is, as well as some of the causes and conditions that can lead to it. Additionally, they will offer healthcare providers information related to the scope of care for the diagnosis and management of CKD, including possible scenarios that could warrant collaboration with, or a referral to, a nephrologist.

Prior to the COVID-19 (SARS-CoV2) pandemic, vaping-related illness was the prevailing public health concern. The incidence of vaping related illnesses mainly e-cigarette, or vaping, product use–associated lung injury (EVALI) declined with the arrival of COVID 19 but EVALI should still be considered as a differential diagnosis for people with COVID-19 for reasons outlined in this review.  This narrative review describes vaping devices, summarizes the adverse health effects of vaping on the lungs and other systems, considers the potential interplay between vaping and COVID-19, and highlights gaps in knowledge about vaping that warrant further research.

Renal disease affects 15% of the US adult population and is considered an under-recognized health crisis with significant morbidity and mortality. In this introduction to a multipart podcast series, Dr. Benjamin Broom, a nephrologist with Nephrology Associates in Birmingham, Alabama, is joined by Drs. Elizabeth Edwards and Donald DiPette, both of whom are on faculty in the department of internal medicine at the University of South Carolina in Columbia. They will offer healthcare providers an overview of conditions that can warrant a nephrology referral as well as provide insight into collaboration among providers when referring a patient. 

During the COVID-19 pandemic, clinical care of patients and undergraduate medical education faced substantive challenges.  Many traditional patient-physician and family-physician interactions were no longer possible, and alternative, often virtual, methods of communications were required to be devised.  The existing challenges of transition of care from inpatient to outpatient treatment for many patients were exacerbated with the physical and communication restraints. The authors of this article analyzed this vital “transition of care” and identified an opportunity to improve medical student education with a special elective that addressed enhanced methods for improving the transition of care of patients within the restrictions of the pandemic.  A joint clinical faculty/medical student team developed a student elective wherein the students actively participated in its design and implementation, thus filling an identified gap in the undergraduate curriculum, which adds value to the educational effort through an innovative process in an on-going manner.  The authors describe their elective in this podcast.  The targeted audiences include medical students, resident physicians, academic faculty, clinical faculty, and institutional medical educators.

Surveys are commonly used in medical education, yet educators and researchers often fail to follow best practices for survey design, administration, and reporting in manuscripts. In this podcast, Drs. Tanya Nikiforova and Emmanuelle Yecies discuss the evidence and expert-supported best practices for designing and reporting on surveys in medical education research, a topic they and coauthors Drs. Andrea Carter and Carla L. Spagnoletti address in an upcoming article in the Southern Medical Journal.

In this podcast, Dr. Christopher Jackson shares an inside view on the residency match and recent changes to the application process in response to the COVID-19 pandemic. He additionally discusses his role as a clinician educator in shaping the training experience for internal medicine residents at UTHSC.

This podcast explores the motivating factors for a physician experiencing “Joy in Practice”, a topic that will also be addressed in an upcoming issue of the Southern Medical Journal.  Join Matthew Du, a third-year medical student at the University of Chicago Pritzker School of Medicine as he details how this study used a bit different approach to the topic of satisfaction with one's practice; instead of addressing the commonly studied concept of “burn-out,” he and his coauthors, Drs. Zhoy Jung Tak and John Yoon, utilized the novel concept of why physicians experience joy in practice.  The authors' study utilized validated physician well-being measures, and tested the concept of joy in practice with certain intrinsic and extrinsic factors. The authors believe that there is promise in addressing joy in practice as a marker of physician well-being, and offer primary and secondary outcomes from the study as insightful into the perspectives from a national physician survey.

Join Dr. Doris Lin as she discusses the readiness of hospitalists to assess and evaluate resident progress, a topic on which she has written an article for the April 2021 issue of the Southern Medical Journal. In this  podcast, she also explores the role of faculty development in the evaluative process, as well as provides strategies to help hospitalists assess and evaluate trainee progress. In addition, she offers insight regarding the current state of evaluation of learners and where it could be headed in the near future.

Join Drs. Tracey Dabal and Christopher Jackson as they discuss the safety of baricitinib for the treatment of rheumatoid arthritis, a topic they address in their article that will appear in the May 2021 issue of the Southern Medical Journal. In this  podcast, they talk about why they chose to perform their safety-focused meta-analysis and what results were the most surprising to them. They also provide insight into how the findings could impact practice. Additionally, the two of them share their perspective on submitting and having published a research article, as well as touch on the various aspects involved with the publication process.

In this podcast, we are joined once again by Dr. Philip Hartman. He is also a past president of the Southern Medical Association. The podcast will cover the COVID-19 vaccine which Dr. Hartman has received and he will discuss his opinions on the vaccine, as well as what his thoughts are for the vaccine and the community at large. Lastly he will offer insight into possible vaccination strategies as the vaccine is made available to the public.

In this podcast, Dr. Everett Magann discusses prophylactic transfusion during pregnancy for women with sickle cell disease. Dr. Magann is the corresponding author of an article appearing in the April 2021 issue of the Southern Medical Journal that addresses this topic.

In Part 2 of this podcast, Drs. Jason Wagner and Richard Holt join us again to  look back on the past year and discuss the effects of the COVID-19 pandemic. They will discuss how clinical outpatient care has been affected and offer insight into how physicians have been coping. They will also share their thoughts regarding the medical profession's response to the pandemic and ethical issues in patient care that may have arisen as a result of COVID-19. 

In this podcast, Drs. Jason Wagner and Richard Holt join us again to  look back on the past year and discuss the effects of the COVID-19 pandemic. They will discuss how clinical outpatient care has been affected and offer insight into how physicians have been coping. They will also share their thoughts regarding the medical profession's response to the pandemic and ethical issues in patient care that may have arisen as a result of COVID-19.