Podcasts about assistant medical director

Send us a textKeilani interviews Dr. Amanda Downey, the Assistant Medical Director of UCSF's Eating Disorder and Translational Psychedelic Research Programs, as well as an Assistant Professor of Pediatrics and Psychiatry. Dr. Downey shares her expert insights on the evolving role of psychedelic therapy in mental health, discussing groundbreaking research, clinical applications, and her personal journey into the world of transformative healing. This candid conversation dives into how innovative approaches are reshaping treatment paradigms for eating disorders and psychiatric care, offering a compelling look at the intersection of science, medicine, and the art of self-discovery. Buy Us a Coffee: https://buymeacoffee.com/delightfuly Schedule a FREE Discovery Call with Keilani: www.coachkeilani.comFREE Guided Meditation: https://coachkeilani.com/audio-journey/FREE Journaling Prompts: coachkeilani.com (scroll to bottom of page)Instagram: @keilani_evolve All social platforms: @delightfulpod

Parvez and Omar are truly honored to host Dr. Mohammad Subeh who just returned from a five week medical mission to the Gaza Strip, specifically the Rafah Crossing to the south. Dr. Subeh shares his background born to a Palestinian refugee family living in Kuwait and then forced to flee overnight at the start of the First Persian Gulf War and invasion of Kuwait. Dr. Subeh shares in harrowing detail what he witnessed first-hand during his recent five week medical mission to the Gaza Strip in February and March 2024. It is a sobering listen as he recounts first hand the unprecedented devastation and humanitarian crisis unfolding before our very eyes as Israel continues its brutal military incursion into Gaza. In the midst of the brutality and horror he also beautifully details the unyielding faith and resilience of the Palestinian people. It is an absolute must listen for anyone dismayed by what is occurring in Palestine. Please give it a listen, share widely, and above all pray for an end to the suffering and the ultimate liberation of Palestine.          About Dr. Muhammad Subeh Dr. Mohammad Subeh is an emergency physician and traumatologist with a deep passion for innovation and discovery, both inside and outside of medicine. After completing his undergraduate degree (BA Human Biology) and graduate work (MA Sociology, MS Epidemiology/Biostatistics) at Stanford University, Mohammad took his first major dive into entrepreneurship. He founded HireLabs, an outcomes analytics company aimed at deciphering organizational data to reshape and guide how people are managed within these organizations. Since then, he has founded and advised several companies in the health tech space. More recently, his love for science and coffee led him to launch Kenz Coffee Roasters, a bay area-based specialty coffee roastery that sources high quality coffee microlots worldwide and featuring these unique coffees to coffee lovers across the globe. Dr Subeh received his MD from Oregon Health and Science University, and completed Emergency Medicine residency training at the University of Chicago and Ultrasound Fellowship at UC Irvine. Currently, he serves as Partner of Vituity and Assistant Medical Director of the El Camino Hospital Emergency Department in Mountain View, CA. Additionally, he practices emergency medicine at UC Irvine, Catalina Island Medical Center, Good Samaritan Hospital in San Jose, CA. He enjoys spending time with his family of four, deep sea fishing, and traveling to different countries to provide free medical care to underserved communities.     

How do you know that your teaching is effective?  We asked Tom Grawey, D.O., who is  Assistant Professor of Emergency Medicine at Medical College of Wisconsin, EMS Medical Director for Gateway Technical College, and Assistant Medical Director,  Milwaukee County OEM.  He said, "I thought what I was teaching would actually change behavior.  I was later surprised to see it wasn't happening." Hosts Maia Dorsett, Rob Lawrence and Hilary Gates discuss with Tom how to solve education problems with education, teach to your learner's values and teach to change, not to disseminate knowledge. Mentioned in this episode: Tom Grawey, DO https://twitter.com/EMtgDO Nancy Duarte: Resonate How to Write Learning Objectives The Affective Domain of Education The EMS Educator will publish on the first Friday of every month! Be sure to turn on your notifications so you can listen as soon as the episode drops! This podcast is sponsored by EMS Gives Life.  Would you consider becoming a living organ donor? For more info visit www.emsgiveslife.org Check out the Prodigy EMS Bounty Program! Earn $1000 for your best talks! Get your CE at www.prodigyems.com  Follow @ProdigyEMS on Twitter, FB, YouTube & IG.

The BBANYS Podcast Lecture series presents short lectures on core topics in blood banking, transfusion medicine or cellular therapy for both trainees and seasoned professionals. In this episode, Dr. Victoria Costa, the Assistant Medical Director of the blood bank at NYU Langone Health, Tisch Hospital discusses transfusion-transmitted babesiosis. This case of transfusion-transmitted babesiosis is also linked here, recently published in Transfusion: https://onlinelibrary.wiley.com/doi/10.1111/trf.17244.

DR Suzanne Kelly talks about taking on the role of Assistant Medical Director of the Irish College of General Practitioners, following a successful few years as Clinical Lead for Diabetes. Ballincollig-based, and Dublin born and bred, Dr Kelly talks about why she chose general practice, the influence of her GP parents, and the importance of encouraging women to becoming leaders in general practice. This podcast is produced by Aileen O'Meara for the Irish College of General Practitioners. Contact us at media@icgp.ie

On episode 450 of The Nurse Keith Show nursing and healthcare career podcast, Keith interviews Dr. Kissinger Goldman, DP, MBA, a highly experienced emergency physician and sought-after patient experience consultant. In the course of their conversation, Keith and Dr. Goldman discuss the critical importance of communication and connection in order for the provider-patient relationship to lead to satisfying outcomes for all concerned. His new book, Dr. Goldman's Guide to Effective Patient Communication, is a powerful resource for healthcare providers and organizations seeking to exponentially improve the patient experience. Dr. Kissinger Goldman is a board certified Emergency Room physician, Director of Patient Experience for the Memorial Healthcare System Emergency Departments, and Assistant Medical Director of Memorial Hospital West ED, with over a decade of experience in leadership and direct patient care. Soon after completing his training, Dr Goldman was tapped to work with other physicians at his hospital to improve patient experience, and developed a training program that is now used throughout the EDs at his healthcare system, resulting in improved patient experience scores to top decile. He subsequently began working as a patient experience consultant. In this role, he has helped healthcare organizations develop patient-centered care plans, improve patient-provider communication, and implement strategies to improve patient satisfaction. Dr. Goldman is committed to working with healthcare organizations to create positive change. He believes that by focusing on the needs of patients and healthcare providers we can improve outcomes and deliver better care to those in need. In addition to his clinical work, Dr. Goldman serves as Assistant Clinical Professor at Florida Atlantic University Medical School, Florida International University department of Emergency Medicine and Critical care, and Founding Clinical Faculty Member at Orlando College of Osteopathic Medicine. He is co-founder and Chief Strategy Officer of Primary Care Haiti, a non-profit dedicated to providing emergency response training to Haitian medical professionals. Fluent in French and Haitian creole, conversational in Spanish, Dr. Goldman is currently learning Mandarin. Outside of medicine, he enjoys gardening, exploring the mountains, reading, exercising, and spending time with his family. He lives in Florida with his wife and three boys. Connect with Dr. Kissinger Goldman: KissingerGoldman.com Dr. Goldman's Guide to Effective Patient Communication on Amazon Facebook Instagram X LinkedIn Primary Care Haiti Primary Care Haiti on Facebook ----------- Nurse Keith is a holistic career coach for nurses, professional podcaster, published author, award-winning blogger, inspiring keynote speaker, and successful nurse entrepreneur. Connect with Nurse Keith at NurseKeith.com, and on Twitter, Facebook, LinkedIn, and Instagram. Nurse Keith lives in beautiful Santa Fe, New Mexico with his lovely fiancée, Shada McKenzie, a highly gifted traditional astrologer and reader of the tarot. You can find Shada at The Circle and the Dot. The Nurse Keith Show is a proud member of The Health Podcast Network, one of the largest and fastest-growing collections of authoritative, high-quality podcasts taking on the tough topics in health and care with empathy, expertise, and a commitment to excellence. The podcast is adroitly produced by Rob Johnston of 520R Podcasting, and Mark Capispisan is our stalwart social media ringmaster and newsletter wrangler.

Problems and misunderstandings with physician supervision of PAs, NPs and other APPs are perennial issues in North Carolina Medical Board (NCMB) enforcement cases. In this episode of MedBoard Matters, Host, Jean Fisher Brinkley talks with John Goldfield, PA-C, who is an Assistant Medical Director with the NCMB about his experiences building successful relationships with supervising physicians.Host: Jean Fisher BrinkleyGuest: John Goldfield, PA-CProducer: Sylvia French-HodgesFollow the North Carolina Medical Board on X (formally Twitter), Facebook, and LinkedIn.Email your questions to: podcast@ncmedboard.org.

We would love to hear from you! Please consider giving us your feedback about the Leadership Podcast by going to this link so we can deliver meaningful content. In this episode Dr. Jeremy Brywczynski and Dr. Jared McKinney, both highly accomplished and respected leaders in the field of emergency medicine, generously share their secrets to success. Dr. Brywczynski emphasizes the importance of effective communication and building solid relationships within the team. He believes that fostering a culture of open dialogue and collaboration allows for the best outcomes. Additionally, Dr. McKinney highlights the significance of continuous learning and personal growth. He encourages aspiring leaders to stay updated on their field's latest advancements and never shy away from seeking new challenges. Both leaders stress the value of leading by example, displaying integrity, and being compassionate towards patients and colleagues. Their shared wisdom serves as a guiding light for aspiring leaders in the field of emergency medicine, inspiring them to lead with excellence and humility.Jeremy Brywczynski, M.D. completed his residency in emergency medicine, as well as a fellowship in emergency medical services at a Vanderbilt University Medical Center. He currently serves as the medical Director of LifeFlight air medical EMS, in addition to Associate Medical Director of the Nashville Fire department.Jared McKinney, M.D. earned an undergraduate degree from Purdue University in Engineering. He graduated from Vanderbilt University School of Medicine and then completed a residency in Emergency Medicine at Vanderbilt. During his residency he was presented with the Ian D. Jones Chief Resident's Award. Following his residency, he did an EMS Fellowship at Vanderbilt Medical Center. Jared has been an Assistant Professor of Emergency Medicine at Vanderbilt since 2007. He is also Assistant Medical Director for Metro Nashville Fire Department and also serves as Medical Director of Life Flight Event Medicine as well as Chairman of the Resuscitation Committee.

One of the biggest questions in ECPR right now is how do we organize our system to provide ECPR in an effective and streamlined approach?  Nichole Bosson and her army of ECPR enthusiasts have successfully implemented a multi-hospital ECPR receiving center program in Los Angeles.  In this episode, Zack talks with Dr. Bosson about how they started, what they learned, and where they are going. A little about Dr. Bosson She is the Assistant Medical Director at the Los Angeles County EMS Agency. She is an Associate Clinical Professor at David Geffen School of Medicine at UCLA and faculty and EMS fellowship director in the Department of Emergency Medicine at Harbor-UCLA. Here is the link to her paper Bosson N, Kazan C, Sanko S, Abramson T, Eckstein M, Eisner D, Geiderman J, Ghurabi W, Gudzenko V, Mehra A, Torbati S, Uner A, Gausche-Hill M, Shavelle D. Implementation of a regional extracorporeal membrane oxygenation program for refractory ventricular fibrillation out-of-hospital cardiac arrest. Resuscitation. 2023 Jun;187:109711. doi: 10.1016/j.resuscitation.2023.109711. Epub 2023 Jan 30. PMID: 36720300. And here is Jason Bartos' editorial Bartos JA, Yannopoulos D. Starting an Extracorporeal cardiopulmonary resuscitation Program: Success is in the details. Resuscitation. 2023 Jun;187:109792. doi: 10.1016/j.resuscitation.2023.109792. Epub 2023 Apr 10. PMID: 37044354.

The Alert Medic 1 crew sit down with Dr. Jeff Nusbaum to discuss his view on various topics in Emergency Medicine and EMS from the perspective of a Medical Director. Dr. Jeff Nusbaum is an Emergency Medicine Physician who currently practices in the University of Maryland system. He is formerly the Assistant Medical Director of the Baltimore City Fire Department. In the very near future, he will be taking the reigns of Medical Direction of the Baltimore County Fire Department. He comes into the position with a wealth of experience and the AM1 Team looks forward to his work in the future.

This episode of Menninger Clinic's Mind Dive Podcast explores burnout and emotional labor experienced by physicians and mental health professionals, particularly in women clinicians. Driven by their observations of burnout within their own psychiatry department at Harvard Medical School, Ashwini Nadkarni, MD, and Jhilam Biswas, MD, take a dive into their quest to understand the factors influencing women who are leaving the field or contemplating career changes. Join hosts Dr. Kerry Horrell and Dr. Bob Boland for this discussion of issues commonly faced by women physicians, such as an increased likelihood of depression due to the strain of balancing work and family life and the emotionally charged experience of discarding professional aspirations for conflicting needs. Dr. Biswas and Dr. Nadkarni are both instructors of psychiatry at Harvard Medical School Department of Psychiatry. Dr. Biswas serves as the Director of Psychiatry, Law and Society program at Brigham and Women's Hospital and the Co-director of Harvard Mass General Brigham Forensic Psychiatry Fellowship. Dr. Nadkarni also serves as Assistant Medical Director of Brigham Psychiatric Specialties and Associate Vice Chair of Wellness in the Department of Psychiatry. Follow The Menninger Clinic on Twitter, Facebook, Instagram and LinkedIn to never miss an episode of Mind Dive. To submit a topic for discussion, email podcast@menninger.edu. Visit www.menningerclinic.org to learn more about The Menninger Clinic's research and leadership role in mental health. Listen to Episode 31: Neuropsychiatry, Connecting the Brain to Behavior with Dr. Julia Ridgeway-DiazResources:“Gender Disparity in Cognitive Load and Emotional Labor—Threats to Women Physician Burnout” “When Compromised Professional Fulfillment Compromises Professionalism” “Primary Care Physician Gender and Electronic Health Record Workload”“Experiences of Work-Family Conflict and Mental Health Symptoms by Gender Among Physician Parents During the COVID-19 Pandemic” “'I Cry but No One Cares': Physician Burnout & Depression Report 2023”David Silbersweig, MD 

This episode of Spinal Cast features the extraordinary world of emergency services and two heroes who save lives every day. Dr. Gregg Jones and Dr. Aaron Robinson are EMS Physicians with Hennepin County Emergency Medical Services. They share valuable insights into their challenging field of work and discuss the causes of many critical calls, including those that result in spinal cord injury. Learn some life-savings tips and discover how you can be a hero too in those critical moments when experts are not immediately available.Gregg A. Jones, MDDr. Gregg Jones currently serves as Medical Director of Public Safety and Special Operations at Hennepin EMS, EMS Fellowship Program Director, Assistant Medical Director, Hennepin Emergency Medical Services, and Medical Director for Minneapolis Fire Department. Dr. Jones also serves as Medical Director for MN Task Force 1 Urban Search and Rescue Team. He completed medical School at Oregon Health and Science University and Emergency Medicine Residency training at Hennepin County Medical Center in 2018 and EMS fellowship in 2019. Prior to going to school, Dr. Jones served in the US Army, which included two combat tours to Afghanistan. His current medical interests include medical directing for large-scale events, mass casualty incident planning, paramedic education, provider wellness and the interface between prehospital medicine and law enforcement.Aaron Robinson, MD, MPHDr. Aaron Robinson is an Emergency Medicine and EMS Physician at Hennepin County Medical Center and Hennepin EMS in Minneapolis, Minnesota. He is indigenous and from the Menominee Tribe of Wisconsin. He attended undergrad at the University of Wisconsin Oshkosh before earning his MD at University of Wisconsin. He also earned an MPH from the University of Minnesota. Dr. Robinson completed his residency in Emergency Medicine at Hennepin County Medical Center and stayed to complete a fellowship in Prehospital (EMS) Medicine. His professional interests include out of hospital cardiac arrest, critical care, and health disparities. Thank you again to both Gregg and Aaron for joining us on today's podcast! This production is a collaborative effort of volunteers working to create a quality audio and visual experience around the subject of spinal cord injury. A special shout out of appreciation to Clientek for providing studio space and top-notch recording equipment. Most importantly, thank YOU for being part of the Spinal Cast audience!Interested in watching these episodes?! Check out our YouTube playlist! https://youtube.com/playlist?list=PL40rLlxGS4VzgAjW8P6Pz1mVWiN0Jou3vIf you'd like to learn more about the MCPF you can visit our website - https://mcpf.org/Donations are always welcomed - https://mcpf.org/you-can-help/

The fingers on my hands are not enough to enumerate the number of television shows and films I have watched since childhood where cancer is made to be the death sentence and the divider of the families of either the main or supporting character. The protagonist feels a certain pain, is shown inside the doctor's office, and the physician somberly states, "You have cancer" or "You have six months to live." There is something so draconian about cancer that a book about the disease was titled "The Emperor of All Maladies." But is cancer truly a death sentence? What is the actual definition of cancer? What makes it different from a tumor? What do the infamous four stages mean? Is there a way that we can now track cancer's origins and hopefully evade the ultimatums that most shows have set? How toxic is chemotherapy, and what other treatments do we have available in the current age?We are joined today by Dr. Sanjay Juneja (aka TheOncDoc), a board-certified hematologist and oncologist, to tackle all things about the emperor of afflictions. He received his BS in Biology, Chemistry, and Philosophy from Louisiana State University in 2009, MD from LSU School of Medicine in Shreveport in 2013, Internal Medicine Residency at LSU Health Sciences Center in 2016, and Chief Hematology & Oncology Fellowship at Feist-Weiller Cancer Center in 2019. Dr. Suneja currently stands as an attending cancer specialist at the American Oncology Network in Louisiana, the Chief of Oncology Service Line at the Baton Rouge General Medical Center, and the Assistant Medical Director of Hospice at The Carpenter Health Network. Online, he provides education on cancer and the importance of screening as the host of the Target: Cancer Podcast and has been seen in The Washington Post, Thrive Global, WebMD, and the PBS Louisiana Public Broadcasting Special.Livestream Air Date: September 7, 2022Dr. Sanjay Juneja: IG @theoncdoc, YT @TheOncDoc, TikTok @theoncdocFriends of Franz: IG @friendsoffranzpod & FB @friendsoffranzpodChristian Franz (Host): IG @chrsfranz & YT Christian FranzThankful to the season's brand partners: Clove, BETR Remedies, Eko, Lumify, RescueMD, Medical School for Kids, Your Skincare Expert, Twrl Milk Tea

One of my favorite conversations - and one of yours as well - we are replaying some of our favorites from seasons past - and you don't want to miss this one.Menopause is a challenging time for women.  Expanding waistlines, loss of sleep, forgetfulness….we need to find some peace of mind.  Wouldn't it be nice to say Good Bye to menopause symptoms and Hello to a new found confidence?In this episode Jackie Giannelli shares her knowledge and insight around all those things, and shares strategies that work.Elektra Health is on a mission to smash the menopause taboo by empowering women with evidence-based education, care & community.Jackie Giannelli is a women's health expert, board-certified nurse practitioner, and certified menopause provider. She's a medical provider at Elektra Health and serves as Assistant Medical Director at Maze Health. Jackie specializes in peri menopause and menopause, urology, sexual medicine, and general gynecology.You can find Elektra Health here:  and get started on finding resources and answers to your menopause questions.And specials savings for our listeners! 50% off an Annual Elektra membership with the code FEARLESSLYELEKTRA--------------When it comes to your dream, just go for it and CANNONBALL with CONFIDENCE!Make sure to listen to the entire episode to receive inspo and tips!Thank you for listening!If you enjoyed this episode, take a screenshot of the episode to post in your stories and tag me on Instagram. And don't forget to subscribe, rate and review the podcast and tell me your key takeaways!If you liked this episode and you're feeling generous, don't forget to leave a review on iTunes And be sure to Connect With Amy!Follow Fearlessly Facing Fifty on Instagram for updates and tips.Follow the podcast on your favorite player and tell your friends!Peruse the Fearlessly Facing Fifty Website, which has many product discounts discussed on the podcast, blog posts and more.And SPECIAL SAVINGS ALERT  - go to BOSSABARS and use theCODE: FEARLESS10 for special savings!-------------------Mind and Body Confidence - double your confidence in just 14 days! Here's the link to get started. Click here May contain affiliate links

Making a decision that leads to a major life change is the topic explored in today's Faculty Factory episode with Rachel Salas, MD, MEd. Dr. Salas is Assistant Medical Director with Johns Hopkins Center for Sleep and Wellness and serves as Professor of Neurology with Johns Hopkins Medicine. She joins our podcast to share the story of her carefully planned major life-changing decision on today's episode. Make sure to tune in for the full story! Dr. Salas first visited with us here on the Faculty Factory in October 2020 for Episode No. 92. The interview was called The Practical Use of Strength-Based Psychology. Last year she came back for a “reunion” episode called Coaching and Strength-Based Approaches to Keep us Progressing. When you are done listening to today's show, you can listen to her other two episodes here: The Practical Use of Strength-Based Psychology Coaching and Strength-Based Approaches to Keep us Progressing Learn More You can reach Dr. Salas here: rsalas3@jhmi.edu Find Dr. Salas on Twitter: https://twitter.com/RachelSalasMD

Dr. Allison Eberly, PhD, describes her Clinical Microbiology Fellowship at the Mayo Clinic as well as her current role as an Assistant Professor at Washington University School of Medicine and the Assistant Medical Director at Barnes Jewish Hospital.

Data is fundamental to the modern world. From education to healthcare to economic development and public policy, we rely on data to allocate resources and make decisions. In Caroline Criado Perez's groundbreaking book, Invisible Women: Exposing Data Bias in a World Designed for Men, she contends that there's a gender data gap. And because the bulk of the world's data is based on male bodies and behaviors, we live in a world that caters to men and disadvantages women. How does this gender data gap impact women in pathology and laboratory medicine? And what can we do to make the profession more inclusive? On this episode of Inside the Lab, Host Kelly Swails, MT(ASCP), is joined by Dr. Alison Krywanczyk, MD, FASCP, Deputy Medical Examiner at the Cuyahoga County Medical Examiner's Office in Cleveland, Ohio, Dr. Letycia Catalina Nunez-Argote, PhD, MPH, MLS(ASCP)CM, Assistant Professor of Clinical Laboratory Sciences at the University of Kansas Medical Center in Kansas City, Kansas, and Dr. Catherine M. Stefaniuk, DO, MBA, FASCP, Assistant Medical Director of Clinical Pathology at the University of Cincinnati Medical Center, for an ASCP Leadership Institute Book Club discussion of Invisible Women.Dr. Krywanczyk, Dr. Nunez-Argote, and Dr. Stefaniuk discuss the unpaid work many women do and share their experiences with the changing roles of breadwinner and homemaker between the genders. They explore the negative perceptions of women in positions of authority and explain how the myth of meritocracy has impacted their careers in pathology and laboratory medicine. Listen in for insight on designing laboratory spaces for women and learn to leverage your knowledge as a medical professional to advocate for women in the healthcare system.Topics Covered· How the gender data gap in healthcare caters to men and actively disadvantages women· The unpaid work most women do and the changing roles of breadwinner and homemaker between the genders· Why so many women trade flexibility for advancement and how working part-time disadvantages women in terms of healthcare and retirement benefits·  How the gender data gap impacts pathology and laboratory medicine and what we can do to make the laboratory more amenable to women· The negative perceptions of women in positions of authority and how that impacts the way we work·  Situations where our knowledge as medical professionals can help us advocate for women whose symptoms are not understood or believed· How insights gained from Invisible Women will influence decision-making moving forward Connect with ASCPASCPASCP on FacebookASCP on InstagramASCP on TwitterConnect with Dr. KrywanczykDr. Krywanczyk on Twitter Connect with Dr.Nunez-ArgoteDr. Nunez-Argote on TwitterConnect with Dr. Stefaniuk Dr. Stefaniuk on LinkedInResources ASCP Leadership InstituteInvisible Women: Exposing Data Bias in a World Designed for Men by Caroline Criado PerezInside the Lab in the ASCP Store 

Visiting the Faculty Factory podcast this week is our friend Rachel Salas, MD, MEd. Dr. Salas has plenty of pearls of wisdom for us when it comes to coaching, strength-based approaches for growth, and mentorship. “I am on the coaching bandwagon and I think it's much needed in academia, not just for faculty, but for residents, fellows, nursing students, medical students, everything,” she said. Dr. Salas is Assistant Medical Director with Johns Hopkins Center for Sleep and Wellness and serves as Professor of Neurology with Johns Hopkins Medicine in Baltimore. Today's chat is a reunion episode where we visit with past guests and friends of the Faculty Factory community. You may remember Dr. Salas from her first appearance with us here on the Faculty Factory. She last joined us in October 2020 for Faculty Factory Podcast No. 92. The interview was called The Practical Use of Strength-Based Psychology and you can check it out here. “Next week I'll be a different person because I'm constantly thinking about who I am, how can I be better, and I'm really in a growth mindset,” she said. Learn More You can reach Dr. Salas here: rsalas3@jhmi.ed Find Dr. Salas on Twitter: https://twitter.com/RachelSalasMD More on Faculty Factory Coaching: https://facultyfactory.org/coaching/  Visit us on the Faculty Factory website: https://facultyfactory.org/ Visit the Faculty Factory on Twitter: https://twitter.com/faculty_factory

Have you ever thought about finding a naturopath to support you on your health journey or even becoming one yourself?Today on the podcast we interview Dr. O'Connell and get a behind-the-scenes glimpse into her life as a naturopath, her own journey with healing, and how she helps her patients in her practice at Thrive Integrative Medicine. Dr. Cameron O'Connell is a Naturopathic primary care doctor whose interests include longevity, endocrinology, and sexual health. Dr. O'Connell hails from Alaska and spent much of her childhood improving her microbiome by playing in the forest and foraging for snacks among the edible flora. Having had variable life experiences – from working at a ski resort in Montana to acting as the Assistant Medical Director for the Engine2 Immersion Programs in 2016 - she loves meeting and helping people with a variety of backgrounds and concerns.Episode Links:To learn more about Dr. O'Connell and the work she does visit Thrive Integrative MedicineFollow the Snowpeas Podcast on InstagramConnect with Zaneta on InstagramConntent with Dr. Mandanas

In this episode, we kick off a month-long focus on breast cancer awareness. Melissa Wolf, MS, NP-C, AOCNP, joins us. As an Assistant Medical Director for PinnacleCare, she brings her expertise to provide an introduction to breast cancer: what do we mean when we say cancer, risk factors, early detection and prevention, treatment options, and when and how to get a second opinions. Melissa also will be our guest for AFSPA Live on October 27 at 11am ET. 

From shopping for school supplies to scheduling doctor's appointments, women carry a disproportionate amount of the mental task list, both in their roles in the workplace and at home. This can contribute to burnout, which is occurring in high numbers among health care workers, especially women physicians.Join Dr. Jennifer Reid as she speaks with Harvard psychiatrists, Dr. Ash Nadkarni and Dr. Jhilam Biswas about their recent article on this topic. We cover:*What is cognitive load, and how does it differ from emotional load?*What data supports the belief that women carry a far heavier cognitive load?*What changes could improve this for women, especially in health care? Dr. Ash Nadkarni is an Instructor of Psychiatry at Harvard Medical School, the Assistant Medical Director of Brigham Psychiatric Specialties and Associate Vice Chair of Wellness in the Department of Psychiatry at Brigham and Women's Hospital. Dr. Nadkarni was featured as an expert commentator in the documentary film “The Observed Life,” and is regularly quoted in media outlets including the Wall Street Journal, Washington Post, and US News and World Report. Dr. Jhilam Biswas is a board-certified Adult and Forensic Psychiatrist and is the Director of the Psychiatry, Law, and Society Program at Brigham and Women's Hospital and the Co-Director of the Harvard Mass General Brigham Forensic Psychiatry Fellowship. She has been a featured commentator in the Boston Globe, ProPublica, and CBS This Morning.Jennifer Reid, MD on Instagram: @TheReflectiveDocLooking for more from The Reflective Doc? Subscribe today so you don't miss out!Also check out Dr. Reid's regular contributions to Psychology Today: Think Like a Shrink**********************Seeking a mental health provider? Try Psychology TodayNational Suicide Prevention Lifeline: 1-800-273-8255SAMHSA's National Helpline - 1-800-662-HELP (4357)Dial 988 for Mental Health EmergencyThank you to Brendan Callahan for the original music featured on the podcast.Disclaimer:The information and other content provided on this podcast or in any linked materials, are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment. All content, including text, graphics, images and information, contained on or available through this website is for general information purposes only.If you or any other person has a medical concern, you should consult with your health care provider or seek other professional medical treatment. Never disregard professional medical advice or delay in seeking it because of something that have read on this website, blog or in any linked materials. If you think you may have a medical emergency, call your doctor or emergency services (911) immediately. You can also access the National Suicide Help Line at 1-800-273-8255

(Lander, WY) – Mental Health Monday, the new weekly segment on KOVE 1330 AM / 107.7 FM's Coffee Time, hosted by Vince Tropea, continued today with guest Dr. David Martorano, MD, Assistant Medical Director, Director of Adult Psychiatric Services at the Wyoming Behavioral Institute (WBI) in Casper. The last time we spoke with Dr. Martorano, we looked at mental health from a broad perspective and touched on some local and state issues, but for today's show we chatted about a new undertaking for WBI, which will be somewhat of an exclusive announcement from Mental Health Monday. WBI is about to officially launch Transcranial Magnetic Stimulation (TMS) treatments, a non-invasive treatment for depression, beginning in October. (In the interview, it is stated that the treatments will begin in August, but it will in fact be in October, with a full press release from WBI forthcoming.) Dr. Martorano discussed the TMS process, how folks can tell if this form of treatment is right for them, and why he felt the need to bring the treatment to Wyoming (he was the first to do so). One of the key points brought up in today's conversation was the concept of hope in the world of mental health, which issues like depression and anxiety rob most people of. While TMS treatment may not be for everyone, it might provide hope to those who have not had successful medicinal or psychiatric treatments. To learn more about TMS and what the folks at WBI are doing for treatment, check out the full Mental Health Monday interview below. The main goal of Mental Health Monday is to start an open dialogue about a number of mental health topics, and how folks are being affected on local, state and national levels. Guests range from psychiatrists, psychologists, school/drug/grief counselors, and any other professionals in the field, as well as testimonials from those affected by mental health issues, such as students, veterans, first responders, and many more. Be sure to check out Mental Health Monday on Coffee Time every Monday, and tune in to Coffee Time every morning at 8:00 AM on KOVE 1330 AM / 107.7 FM, or stream it live right here. If you would like to be a guest on Mental Health Monday, please reach out to vince@county10.com.

  The overuse of pain medications and narcotics, like opioids, in health care over the last two decades has had devastating effects. The use of this long-lasting regional anesthetic has revolutionized the field of anesthesia and is part of an important and necessary shift in the conversation about how we manage pain. Not only championing its use in the surgical setting, Joseph Marino, MD, Northwell's senior vice president for anesthesia, is now expanding its use to emergency departments in Staten Island, Westchester and Long Island.  The team responsible for implementing this approach at Staten Island University Hospital share their experiences using the femoral nerve block for certain painful ailments, like hip fractures. They include:  Joshua Greenstein, MD, Assistant Medical Director, Department of Emergency Medicine Maria Tama, MD, co-director, division of emergency ultrasound in the hospital's Department of Emergency Medicine Simone Rudnin, DO, co-director, division of emergency ultrasound, Department of Emergency Medicine and director, emergency medicine clerkship

Dr Eva Carneiro, Consultant in sports and exercise medicine and clinical advisor for TRR nutrition talks with Angela about collage peptides and how they work to enhance recovery and repair tissue building structurally stronger tissue There is a fine balance and a sweet spot to be found to optimise collagen and Dr Eva shares great information and advice on how to take collagen effectively and achieve the best results in the journey to anti-ging, tissue repair and enhanced recovery   KEY TAKEAWAYS Around the cell is an amazing structure and collagen is the major protein in this matrix The building of tissue is very sport specific Loading is a positive thing for the body and makes it structurally stronger, it's how you load that makes the difference We don't absorb the collagen molecule itself we absorb the collagen peptide Take it as naturally as you can and stay away from tea and coffee around the time of taking You can increase collagen production by taking collagen peptides When cartilage cells are surrounded by collagen peptides they absorb it and also produce the right type of collagen Collagen peptide can be taken at any point throughout the day, the most important thing is that it's taken regularly Research indicates cartilage is affected by a lack of sleep but once it's in your body it's used as needed and there are no side effects It's a nutritional supplement so it's important to take it every day Taking  in protein first thing in the day makes a huge difference to cognitive function   BEST MOMENTS ‘It's about measuring where the sweet spot is and this can be dependent on genetics and previous injury ‘How we load is the real art in sports' ‘It's not only clever in absorbing the collagen it's also clever in producing the type of collagen you need to produce'   RESOURCES FOR THIS EPISODE https://www.trrnutrition.com/ TRR NUTRITION OFFER – 20% DISCOUNT AVAILABLE WITH CODE – ANGELA20   http://bit.ly/younggoose YOUNG GOOSE OFFER – 20% DISCOUNT WITH CODE - ANGELA FOSTER   TRRNutrition.com Clinic for appointments: www.thesportsmedicalgroup.com  info@thesportsmedicalgroup.com Twitter @evacarneiro, Facebook. insta.   VALUABLE RESOURCES High Performance Health Podcast Series -https://angelafosterperformance.com/podcasts/   Free Fasting Guide -https://angelafosterperformance.com/fasting/   Free Health Check & Personalised Report -https://www.yourtotalhealthcheck.com/   Join Angela's Female Biohacker Community -https://www.facebook.com/groups/femalebiohacker    Biohack Your Way to Your Best Self - Join My Exclusive Female Biohacker Collective -  www.angelafosteracademy.com/female-Biohacker-collective   Get a free health check and personalised report atwww.yourtotalhealthcheck.com   Watch my Free Masterclass on how to master your metabolism -www.angelafosteracademy.com/master-your-metabolism   Download my free Guide to Harmonising Your Hormones -www.angelafosterperformance.com/hormones   Download my  free Fasting Guide -www.angelafosterperformance.com/fasting/   Download my free Guide to Sleep Like a Boss -www.angelafosterperformance.com/sleep   Join my free Facebook Community -www.facebook.com/groups/femalebiohacker   Get my bestselling book Rethink Health -https://amzn.to/3vbzYOV     ABOUT THE GUEST Dr Eva Carneiro is a Consultant in Sports and Exercise Medicine working at The Sports Medical Group London. She was one of the first eight pioneering doctors recruited nationally to the UK Sports and Exercise Medicine Specialist Training Programme. She worked in the New South Wales Institute of Sport in Sydney and at the Olympic Medical Institute, London in the build-up to the Beijing Olympics. She completed her research in Football Hydration for her master's degree in Sports Medicine at West Ham United. She worked at Chelsea Football Club from 2009-2015. During her four seasons as First Team doctor, the team was successful in winning the Champions League, Premier League, Europa League, FA Cup and League Cup titles. During her six and half years with the team she worked with a total of seven elite international football managers. She is the first woman to sit on a team bench pitch-side in Champions League, Premier League, and Europa League competitions and the only woman to become Assistant Medical Director in a football club in the UK.  She is a mentor for The True Athlete Project and a clinical advisor for TRR Nutrition.   CONTACT DETAILS TRRNutrition.com Clinic for appointments: www.thesportsmedicalgroup.com  info@thesportsmedicalgroup.com Twitter @evacarneiro, Facebook. insta.   ABOUT THE HOST Angela Foster Angela is a Nutritionist, Health, and Performance Coach. She is also the Founder and CEO of My DNA Edge, an Exclusive Private Membership Site giving individuals the tools and bio hacks needed to optimise their genetic expression for optimal health and performance. After recovering from a serious illness in 2014, Angela left the world of Corporate Law with a single mission in mind: To inspire and educate others to live an energetic, healthful, and limitless life. Angela believes that we can truly have it all and has spent the last 5 years researching the habits and routines of high performers, uncovering age-old secrets, time-honoured holistic practices, and modern science to create a blueprint for Optimal Human Performance.   CONTACT DETAILS Instagram Facebook LinkedIn                       See omnystudio.com/listener for privacy information.

In this episode, Dr. Mark Piehl and Dr. Peter Antevy discuss why EMS must adopt a more thoughtful approach to fluid resuscitation for critically ill or injured patients.  Specifically, patients in shock. It turns out that EMS needs to take a more of a proactive approach to recognizing the need for and administering fluids for certain patients. Dr. Piehl, and Dr. Antevy are here to put a spotlight on the value of fluid resuscitation in the pre-hospital setting, walk us through the data, and discuss the how EMS can provide the right amount of fluid in the right amount of time to make a big impact for our patients.  Dr. Peter Antevy is a Pediatric Emergency Medicine Physician, as well as an EMS Medical Director for several fire-based EMS agencies in South Florida.  Dr. Mark Piehl is a Pediatric Intensivist at WakeMed Health & Hospitals.  He is also the Assistant Medical Director for WakeMed Mobile Critical Care, and an Associate Professor of Pediatrics at the University of North Carolina School of Medicine. On top of all that Dr. Piehl is the Chief Medical Officer and Co-Founder of 410 Medical, Inc. as well as the inventor of LifeFlow. LifeFlow is a device used to deliver rapid fluid boluses or blood transfusion for patients with signs of shock.  Visit 410medical.com for more information about LifeFlow.  Click here for access studies and information that support the information expressed in this episode:  https://drive.google.com/drive/folders/152po79RnJcXI53-AlxRsoUKbH_ODnqDh?usp=sharingPlease keep emailing your questions, comments, feedback, and episode ideas to the EMS on AIR Podcast team by email at Geoff@EMSonAIR.com Visit EMSonAIR.com for the latest information, podcast episodes and other details. Follow us on Instagram @EMSOnAIR.Geoff Lassers, Paramedic I/C, AAS.  Host/Producer, EMS on AIR PodcastFirefighter/Paramedic, West Bloomfield Fire DepartmentEMS System Manager, Oakland County Medical Control AuthorityDirector of Sponsorships, GuardianCME.comGeoff@EMSonAIR.com      Support the show

(Lander, WY) – Just in time for the closing of Mental Health Awareness Month, 1330 KOVE AM / 107.7 FM and Coffee Time aired the first episode of Mental Health Monday, hosted by Vince Tropea. The goal of Mental Health Monday is to start an open dialogue about a number of mental health topics, and how folks are being affected on local, state and national levels. Guests will range from psychiatrists, psychologists, school/drug/grief counselors, and any other professionals in the field, as well as testimonials from those affected by mental health issues, such as students, veterans, first responders, and many more. Tropea recently spoke with David Martorano, MD, Assistant Medical Director, Director of Adult Psychiatric Services at the Wyoming Behavioral Institute (WBI). Dr. Martorano, a second-generation psychiatrist, obtained his medical degree from the Columbia University College of Physicians and Surgeons in New York, and completed his residency in psychiatry at the University of California Neuropsychiatric Institute. He specializes in addictions and is affiliated with the American Society of Addiction Medicine and the California Society of Addiction Medicine. Tropea and Martorano discussed a variety of topics, including: the worryingly high rate of suicides in Wyoming, the shortage of mental health professionals in our state, the lack of funds to keep said professionals here, the roles of both in and out patient care, how drug dependency affects mental health, the pandemic's affect on mental health, and the importance of having open dialogues about mental health, especially with the youth. Check out the full, first official Mental Health Monday interview with Dr. Martorano below. Be sure to tune in to Coffee Time every morning at 8:00 AM on 1330 KOVE AM / 107.7 FM, or stream it live right here. If you would like to be a guest on Mental Health Monday, please reach out to vince@county10.com.

In keeping with the theme of helping you to refuel and recover better, today we're joined by Sports Medicine specialist Dr. Eva Carneiro. Dr. Carneiro has extensive experience working with elite athletes. She worked for Chelsea FC from 2009 to 2015 where she was the first female doctor to sit pitch-side in Champions League, Premier League, and Europa League competitions and the only woman to become Assistant Medical Director in a football club internationally. She now works as a Specialist Consultant in The Sports Medical Group. Today we disappear down a lot of rabbit holes but the key topics covered include: The best way to measure recovery, and the best recovery promoting approaches The benefits of listening to your body Sensible approaches to nutrition Why we should all consider Zinc, Vitamin D, and Vitamin C supplements The benefits of collagen supplementation You can find out more about Dr. Eva Carneiro and her sports medicine consultancy by visiting her website: http://www.thesportsmedicalgroup.com  To find out more about TRR nutrition and especially their range of collagen supplements please use these links: Instagram - trr_nutrition  Facebook - @trrnutrition    Dr. Carneiro recommended this book: 'Becoming a True Athlete' by Lawrence Halsted Join our SWAT/High Performance Human tribe now, with a happiness guarantee! Join SWAT/High Performance Human tribe here Purchase a copy of my High Performance Human e-book featuring more than 30 top tips on how to upgrade your life. If you would like to help offset the cost of our podcast production, we would be so grateful.  Please click here to support the HPH podcast.  Thank you! Visit Simon's website for more information about his coaching programmes.  Links to all of Simon's social media channels can be found here.  For any questions please email Beth@TheTriathlonCoach.com.

Turning on TV, opening a magazine, or going on our phones these days, kids are overwhelmed with images showing us what we should look like. Even on “reality” TV, none of the people look like your average person. With all of these images circulating in our everyday lives, it is easy for any of us to get caught up and judge our own bodies, but especially young people who soak these images in and can internalize these “ideals”.Today, Gene and Khadijah are joined by special guest Dr. Holly Peek, Assistant Medical Director of the Klarman Eating Disorders Center at McLean Hospital, and former Miss New Orleans, to talk about body image and the ways in which it can affect self-esteem. They also touch on how boys are often left out of this conversation, how media and Hollywood impacts body image, the importance of nutrition, and how parents can help young people cultivate a positive body image for themselves.Tune in for this timely episode. We hope that our conversation will help you to have yours. Media List:· Dr. Holly Peek, MD, MPH (McLean Hospital) · Paw House Inn (Paw House Inn) · National Love Your Pet Day (Instagram)· How To Talk To Children About the Russian Invasion of Ukraine (AP News)· Digital Media and Body Image (MGH Clay Center)· Relationship Woes: Helping Your Child Break Up With Junk Food Without Harming Their Mental Health (MGH Clay Center)· The Impact of Reality TV On Our Teens: What Can Parents Do? (MGH Clay Center)· Super Bowl Halftime Show 2022 (YouTube)· Media and Eating Disorders in Fiji: Interview with Anne E. Becker, MD (WebsEdgeMedicine – YouTube) (MGH Clay Center) - https://www.mghclaycenter.org/parenting-concerns/digital-media-eating-disorders/· How to Make a Vision Board That Works in 9 Simple Steps (Artful Parent) See acast.com/privacy for privacy and opt-out information.

Dr. Ashley Ellis, the Assistant Medical Director at Bloodworks Northwest could never figure out why Black History Month was only confined to February. Here at Bloodworks, she's deeply involved in the "All of Us," a research program that aims to level the playing field when it comes to health care. She's also been at the forefront of our response to the recent national blood emergency and its impact on Transfusion Services. That's why her pager is always going off. What drives a committed professional like this? As Bloodworks 101 producer John Yeager tells us, it all started with Ashley's big sister, Sonya.  

In this podcast, Andrea Donsky, co-founder of Morphus for Menopause, interviews Debbie Rice a Naturopathic doctor and the Assistant Medical Director of the Dutch Hormone Test.Debbie explains what the Dutch Hormone Test is, what it can reveal about your hormones, and how it can help women in menopause.  Interested in getting a Dutch Test? Email us at info@wearemorphus.com00:00 Introduction and what is the Dutch Hormone Test2:27 The difference between other tests and the Dutch Hormone Test7:07 What are metabolites8:40 Can the dutch test help us know if we are in perimenopause and menopause12:37 When should we get the Dutch Hormone Test. 14:51 Cortisol, what is it and how does it relate to perimenopause and menopause18:16 Sleep and cortisol levels, what can we do20:31 The role of melatonin in menopause 22:47 Estrogen and what happens to our hormones as we head towards the path of menopause28:10 Metabolites E2, E4, E16 and why they're important 32:20 Can we guide our metabolites from the 4-OH to the 2-OH34:24 Why liver support is crucial35:03 Final thoughts about the Dutch Hormone Test38:32 Can you change the results of your dutch test with food and supplementationAre you in perimenopause or menopause? Join our Wearemorphus PRIVATE group here: https://bit.ly/2MsxBBf ======

Justin Bright MD, CPXP is an attending physician and the Assistant Medical Director for Patient Experience in the Department of Emergency Medicine at Henry Ford Hospital in Detroit. He is fascinated by the intersection of patient experience, interpersonal communication, customer service, and employee engagement. Check out his ideas at www.ptexpmd.com or on The Patient Experience podcast on Spotify, Apple Music, or any other listening platform you enjoy. In this episode, we learn that patient satisfaction and the patient experience are different things. We can improve the patient experience by asking open-ended questions, recognizing nonverbal cues, validating emotion, and pausing to listen. We discuss: A patient satisfaction survey rant [02:45]; The “patient experience” and how it is influenced by every conceivable touchpoint, perception and logistical thing that may happen to a patient  [11:10]; How making a purposeful choice to care helps ensure that our patients have a positive experience [16:15]; The power of the pause [19:35]; Avoiding the “doorknob complaint” by asking open-ended rather than direct questions [22:00]; Efficiently handling the situation when a patient has extra questions after you thought you had already completed the encounter [24:50]; The best way to acknowledge a patient's long wait [26:40]; How to respond to the disgruntled patient who voices complaints about other people involved in their care or their prolonged wait [29:30] Deescalating the unhappy patient whose expectations of care were not met [33:10]; Salvaging the situation when a patient threatens to call the nurse administrator or an attorney [39:10]; And more. For previous episodes, detailed show notes, or to sign up for our newsletter: https://www.stimuluspodcast.com/. This podcast streams free on iTunes, Spotify, and Stitcher. Interested in one-on-one coaching? https://www.stimuluspodcast.com/coaching Follow Rob:  Twitter, Facebook, and Youtube.

Justin Bright MD, CPXP is an attending physician and the Assistant Medical Director for Patient Experience in the Department of Emergency Medicine at Henry Ford Hospital in Detroit. He is fascinated by the intersection of patient experience, interpersonal communication, customer service, and employee engagement. Check out his ideas at www.ptexpmd.com or on The Patient Experience podcast on Spotify, Apple Music, or any other listening platform you enjoy. In this episode, we learn that patient satisfaction and the patient experience are different things. We can improve the patient experience by asking open-ended questions, recognizing nonverbal cues, validating emotion, and pausing to listen. We discuss: A patient satisfaction survey rant [02:45]; The “patient experience” and how it is influenced by every conceivable touchpoint, perception and logistical thing that may happen to a patient  [11:10]; How making a purposeful choice to care helps ensure that our patients have a positive experience [16:15]; The power of the pause [19:35]; Avoiding the “doorknob complaint” by asking open-ended rather than direct questions [22:00]; Efficiently handling the situation when a patient has extra questions after you thought you had already completed the encounter [24:50]; The best way to acknowledge a patient's long wait [26:40]; How to respond to the disgruntled patient who voices complaints about other people involved in their care or their prolonged wait [29:30] Deescalating the unhappy patient whose expectations of care were not met [33:10]; Salvaging the situation when a patient threatens to call the nurse administrator or an attorney [39:10]; And more. For previous episodes, detailed show notes, or to sign up for our newsletter: https://www.stimuluspodcast.com/. This podcast streams free on iTunes, Spotify, and Stitcher. Interested in one-on-one coaching? https://www.stimuluspodcast.com/coaching Follow Rob:  Twitter, Facebook, and Youtube.

Following an early winter storm producing record rainfall, we discuss the bigger picture trends regarding home insurance and how to have the right coverage. A UCSF-led study about three teens with mild to asymptomatic COVID-19 who developed sudden, severe psychiatric symptoms. What it's like to meet patients' needs during a pandemic while experiencing a nursing shortage. CapRadio Music picks for your Halloween playlist. Today's Guests Following an early winter storm producing record rainfall, Janet Ruiz, Director of Strategic Communication at the Insurance Information Institute, talks about the bigger picture trends of how people in our area are insuring themselves and how to have the right coverage for your home and belongings.  Dr. Sam Pleasure, Professor of Neurology at UCSF, discusses the findings in a UCSF-led study published Monday regarding three teens with mild to asymptomatic COVID-19 who developed sudden, severe psychiatric symptoms.  Dr. Adam Dougherty, Assistant Medical Director at Sutter Medical Center Sacramento, as well as Joanne Spetz, Director of the Philip R. Lee Institute for Health Policy Studies at UCSF, explain what it's like to meet patients' needs during a pandemic while experiencing a nursing shortage. Weekend and Fill-in Host for News and Modern Music at CapRadio, Andrew Garcia, gives us his picks for Halloween music.

Dr. Rasean Hodge and Nick Mccauley – Making Sense Of The Cannabis DebateAir Date Live Streaming on OMTimes TV 2 September at 12:00 PM ET/9:00 AM PT Watch the Livestream on OMTimes Radio & TV Facebook or OMTimesTV Youtube Air Date OMTimes Radio 9 September at 12:00 ET/9:00 PTWith statistics showing that stress, depression, anxiety and fear are fast becoming a major global problem, more and more people are turning to medical marijuana to help lift their low moods, calm chronic tension, ameliorate withdrawal symptoms, and ease their physical, mental, and emotional pain.But how effective is medical marijuana really? And, perhaps more importantly, how safe?While marijuana is the most commonly used drug of abuse in the USA, 26 states and the District of Columbia have now enacted laws that have legalized its use in some form, and three additional states have passed measures permitting the use of medical marijuana. With the cannabis debate being such a hot topic of late, Rebecca and Sandie have invited experts Dr. Rasean Hodge and Nick McCauley on to Cracked! The Podcast this week to unravel some of the many myths and misconceptions about cannabis in general, and the question of medical marijuana being a safer alternative to opiates and NSAIDs in treating PTS, depression, anxiety, addiction, mental health issues, and pain.Dr. Rasean Hodge received his Bachelor of Arts in Psychology from Morehouse College and earned his medical degree, cum laude, from the Robert Wood Johnson Medical School. Dr. Hodge completed his internship and residency in Family Medicine from the Morehouse School of Medicine in 2005.Upon completion of his education, Hodge matriculated into Family Medicine and served as Investigator on numerous clinical research studies aimed at making the human condition better for those who are suffering. His compassion for those in need continued to be evident as he has led several Hospice Programs throughout Georgia as both Medical Director and Assistant Medical Director.Nick McCauley is an expert on marijuana.Visit the CRACKED! The Podcast show page https://omtimes.com/iom/shows/cracked-the-podcast/Connect with Sandie Sedgbeer at https://www.sedgbeer.comConnect with Rebecca Schaper at https://www.rebeccaschaper.com/#DrRaseanHodge #NickMccauley #RebeccaSchaper #SandieSedgbeer #CrackedThePodcast

On Health Suites, in view of World Lymphoma Awareness Day on September 15, Claressa Monteiro speaks with Dr Francesca Lorraine Lim, Consultant with the Department of Haematology, Singapore General Hospital (SGH), Assistant Medical Director at the Cell Therapy Facility, Health Science Authority (HSA) and Deputy Head of the SingHealth Duke NUS Cell Therapy Centre, to find out more about lymphoma and where does Singapore stand in its fight against this cancer. See omnystudio.com/listener for privacy information.

Presenters: Travis Neill PA-C, Assistant Medical Director with Vivage Senior Living Clay Watson MD, Infectious Disease Physician and Regional Medical Director with Optum Greg Gahm MD, Chief Medical Officer and multi-facility medical director with Vivage Senior Living Colorado Journal Club this month will be conducted by Dr. Clay Watson presenting an update on treatment of Covid followed by Travis Neill updating us in regard to the recently approved Alzheimers Drug, Aducanumab. Aducanumab Statement Aducanumab Word document MONOCLONAL ANTIBODY UPDATE 7/23/21 Word document No More Bam Bam Abs 6/21 Word document Omnicare Monoclonal Antibody Update Word document Rx Mgmt of Nonhosp Adults w COVID Word document   Recorded: August 5, 2021 Available Credit 0.25 CMD-Clinical

Today's guest, Dr. Amy Rohlfing, Assistant Medical Director for Hospice of Southern Illinois and CMO for Red Bud Regional Hospital, shares personal stories and professional advice and education about dementia and dementia related diagnoses, like Alzheimer's Disease. We cover specific scenarios families and caregivers may experience during a journey with dementia. We also debunk common misconceptions related to these illnesses. Finally, we touch on some medication questions and deprescribing in hospice care.

Dr. Jenice Baker, Assistant Medical Director of the Emergency Department and Attending Physician at Our Lady of Lourdes Hospital in Camden NJ, discusses the "No Time to Wait" campaign and educates viewers about deep vein thrombosis (DVT) and pulmonary embolism (PE) symptoms and why it's critical for those experiencing symptoms that could be due to DVT or PE to consult a healthcare provider. Dr. Jenice Baker is the director and Chair of Emergency Medicine at Chestnut Hill Hospital in Philadelphia. She has practiced community emergency medicine for over a decade providing compassionate clinical care and was named Top Doc in 2018 and Top Emergency Medicine Specialist in 2020. In addition to practicing clinically, Dr. Baker advocates for New Jersey Emergency Physicians. She is a fellow of the American College of Emergency Physicians (FACEP), and in 2015, was elected to the Board of Directors of the New Jersey ACEP Chapter and is currently the president elect. Alongside advocacy, she is passionate about education and has given many presentations on various topics including women leadership and violence in the emergency department. Dr. Baker is also a national speaker on provider bias and medical racism. Dr. Jenice Baker M.D., received her bachelors and medical degrees from Cornell University, and Weill Cornell Medical College. Thereafter, she successfully completed a four-year Emergency Residency program at Cornell and Columbia's New York-Presbyterian Teaching hospitals. Dr. Jenice Baker was born in Trinidad & Tobago and immigrated to Brooklyn, N.Y. as a young child. She is married to Rafiq Baker and resides in Voorhees, N.J. with their daughters. Dr. Baker is a proud member of Delta Sigma Theta Sorority Incorporated, New Jersey Garden City Alumnae Chapter and Jack and Jill Incorporated, South Jersey Chapter. #NoTimeToWait #DeepVeinThrombosis

Host: Peter Buch, MD, FACG, AGAF, FACP Guest: Colin T. Swales, MD How can we help the two to four million Americans who are living with hepatitis C? Joining Dr. Peter Buch to answer this question and share treatment strategies for various case scenarios is hepatologist Dr. Colin Swales, Assistant Medical Director of Transplant Services at Harvard Hospital.

Host: Peter Buch, MD, FACG, AGAF, FACP Guest: Colin T. Swales, MD From cirrhosis to liver cancer, there are many dangers associated with non-alcoholic fatty liver disease. So what are some best practices for managing this condition? Dr. Peter Buch sits down with Dr. Colin Swales, Assistant Medical Director of Transplant Services at Harvard Hospital, to discuss the management of non-alcoholic fatty liver disease.

Host: Peter Buch, MD, FACG, AGAF, FACP Guest: Colin T. Swales, MD Should sobriety and drug abstinence be required for hepatitis C therapy? Dr. Peter Buch dives into this dilemma with Dr. Colin Swales, Assistant Medical Director of Transplant Services at Harvard Hospital, as he walks us through both sides of this controversial issue.

Host: Peter Buch, MD, FACG, AGAF, FACP Guest: Colin T. Swales, MD Should sobriety and drug abstinence be required for hepatitis C therapy? Dr. Peter Buch dives into this dilemma with Dr. Colin Swales, Assistant Medical Director of Transplant Services at Harvard Hospital, as he walks us through both sides of this controversial issue.

Host: Peter Buch, MD, FACG, AGAF, FACP Guest: Colin T. Swales, MD From cirrhosis to liver cancer, there are many dangers associated with non-alcoholic fatty liver disease. So what are some best practices for managing this condition? Dr. Peter Buch sits down with Dr. Colin Swales, Assistant Medical Director of Transplant Services at Harvard Hospital, to discuss the management of non-alcoholic fatty liver disease.

Host: Peter Buch, MD, FACG, AGAF, FACP Guest: Colin T. Swales, MD How can we help the two to four million Americans who are living with hepatitis C? Joining Dr. Peter Buch to answer this question and share treatment strategies for various case scenarios is hepatologist Dr. Colin Swales, Assistant Medical Director of Transplant Services at Harvard Hospital.

Today's episode is dedicated to PICU applications of lipid emulsion therapy. Join us as we discuss the patient case, symptoms, and treatment.  Joining us is Dr. Ziad N. Kazzi, Associate Professor of Emergency Medicine at Emory University School of Medicine, Director of the International Toxicology Fellowship Program at Emory, and Assistant Medical Director of the Georgia Poison Center. Dr. Kazzi is also a board member of the American College of Medical Toxicology and current president of the Middle East North Africa Toxicology Association.  https://www.dropbox.com/s/htbyhre5zictxke/Lipid%20Emulsion%20Therapy.jpg?dl=1 (>>Click here to download the PICU card for this episode

Dr. Safiya Lyn-Lassiter M.D. earned her medical degree at Meharry Medical College in 2010 and completed her Emergency Medicine residency at Morristown Medical Center in New Jersey. She currently serves as Assistant Medical Director at Mount Sinai Medical Center freestanding emergency department. Dr. Lyn also serves as a faculty member at Nova Southeastern University College of Osteopathic Medicine. Dr. Lyn founded her own medical marijuana company serving South Florida residents: for more information, visit AskDoctorLyn.com. -- Hosts: Daniel Epstein & Raj Kavadi Producer: Timothy Crowe Social Media Director: Anja Von Der Osten Music: Foximusic.com

Jacqueline Giannelli MSN, RN, FNP-BC, NCMP Jacqueline Giannelli is a board-certified family nurse practitioner specializing in women’s health with a focus in menopause, urogynecology, and sexual health. Jacqueline is a North American Menopause Society certified practitioner with Elektra Health, a women’s health company on a mission to smash the menopause taboo. She is also the Assistant Medical Director at Maze Women’s Health in New York. She earned her nursing degrees at NYU and San Francisco State University, and BA from Georgetown University. When not at work, Jacqueline enjoys tennis, hiking, cooking for her family and hunting for treasures in New York City. Website: www.Elektrahealth.com Instagram: @elektrahealth

David McNeill, Medical Director for Westdoc, and Dr Brian Osborne, Assistant Medical Director of the Irish College of General Practitioners and a GP in Galway, discusses rising rates of Covid-19 in the West of Ireland.

Created by: Mari Feher,  Hosted by: Ania WiktorowiczWhat is Psychological First Aid?  Whether you are affected by the pandemic, you've suffered an accident in the outdoors and it limits you from doing the things you love, many of us are having extra stress in our lives nowadays. When the level of stress exceeds what that person can cope with is when one develops a stress injury. Learn how to notice the symptoms, how to diffuse it and how to recover from it so you can get back to the life you love, return to climbing and get back on that mountain trail. Pearce Beissinger is Portland Mountain Rescues  leader of PFA as well as our Assistant Medical Director. He is here to help you get back to that summit. Follow these links for additional information: https://www.responderalliance.com/https://mazamas.org/https://americanalpineclub.org/

Oftentimes, the terms wellness and well-being are used interchangeably.  Is there a significant difference especially in the context of physician burnout?   This is expounded by Dr. Harjot Singh, a physician wellness and burnout prevention coach.  He is Assistant Medical Director in Kingsview Tele-Psychiatry services in California, a Fellow of American Psychiatric Association, and one of our coaches at TheHappyMD.com.  He shares with us his four-level system of wellbeing, namely succumbing, surviving, existing, and thriving.  Tune in on today's episode to learn more.   “Well-being is not just this weird positive thing all the time, take for example a busy life of a physician.  Every day we have a chance to do good. It's almost like we have to travel to any place else, to have that sense I did good today.” - Dr. Harjot Singh   Highlights: (01:28)  The difference between wellness and well-being (02:12)  The science of well-being (04:00) Two types of well-being (04:47) The four-part scale (06:35) The jangle effect (12:23) Flow as a psychological concept (16:05) The role of vision on well-being   Resources: WHO article on mental health:  https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response University of Rochester articles on Burnout: https://www.urmc.rochester.edu/people/23096820-michael-r-privitera/publications The Jangle Fallacy: https://journals.sagepub.com/doi/abs/10.1177/001316445401400214?journalCode=epma   Connect with Dr. Harjot Singh: TheHappyMD.com Linkedin  HarjotSinghMD.com   Watch this episode: Youtube:  https://youtu.be/rDcJCNPnvOc   Get to know more about Dr. Dike Drummond and The Happy MD: https://linktr.ee/dikedrummond   We would love to hear your feedback.  Send us your review on Apple Podcasts/Itunes, or in other directories through this link: https://www.podchaser.com/podcasts/physicians-on-purpose-1546320

Medicine, like it seems everything else, is undergoing an experiential transformation. The movement toward redefining healthcare in terms of patient experiences is not necessarily new. While it might not ebe new, it still is evolving. Not only our understanding of patient experiences, but the broadening out of that into provider experiences as well. As we have turned our attention to frontline heroes in healthcare, the question arises of to what extent does an emphasis on patient experience potentially negatively impact provider experience. To explore the question of healthcare experience, we welcome Dr. Justin Bright to the ExD studios. Dr. Bright is a real doctor, unlike Adam and me. He is an ER doctor at Henry Ford Health Systems in Detroit, my hometown. I heard Justin speak at a Patient Experience online conference, and knew he had to be on ExD. He also is the Assistant Medical Director for Patient Experience at Henry Ford Emergency Medicine, and Co-Chair of the Physicians Council at the Beryl Institute. We talk about understanding provider perspectives in delivering patient experiences, comparing famous television doctors like Doc Martin versus Doc McStuffins, how to innovate in regulated spaces, whether patients are customers, and ER medicine in a pandemic. 

Menopause is a challenging time for women. Expanding waistlines, loss of sleep, forgetfulness....we need to find some peace of mind. Wouldn't it be nice to say Good Bye to menopause symptoms and Hello to a new found confidence?In this episode Jackie Giannelli shares her knowledge and insight around all those things, and shares strategies that work.Elektra Health is on a mission to smash the menopause taboo by empowering women with evidence-based education, care & community. Jackie Giannelli is a women’s health expert, board-certified nurse practitioner, and certified menopause provider. She's a medical provider at Elektra Health and serves as Assistant Medical Director at Maze Health. Jackie specializes in peri menopause and menopause, urology, sexual medicine, and general gynecology.You can find Elektra Health here: and get started on finding resources and answers to your menopause questions. Listen to Amy's TEDx talk: What does it mean to cannonball with confidence?Subscribe to the Fearlessly Facing Fifty PodcastFor all of your holiday shopping needs. Save 25%. Faherty is fueled by purpose and optimism. Check out the Faherty brand. Use the CODE: FEARLESSLYFACINGFIFTY at checkout for 25% savings on your order.

In 2018, the NRA tweeted, “Someone should tell self-important anti-gun doctors to stay in their lane,” in response to a paper released by the American College of Physicians (ACP) about Reducing Firearm Injuries and Death in the United States. Soon after, medical professionals from around the country responded with their stories using the hashtag #ThisIsOurLane. Episode 4 of (Re)Search for Solutions reflects on the crucial role emergency medicine physicians, who are on the front lines of responding to firearm injuries, play in developing solutions. We spoke with Dr. Megan Ranney, an emergency physician and faculty at Brown University and co-founder of the AFFIRM Research collective. She tells us how AFFIRM includes the perspectives of more than 40,000 healthcare professionals, public health experts, and researchers to find ways to reduce gun violence. Additionally, Dr. Ameera Haamid, an emergency medicine physician at Cook County Hospital in Chicago and the Assistant Medical Director of the Chicago West EMS System, as well as Dr. Garth Walker,  an emergency medicine physician at Jesse Brown Veteran Affairs Medical Hospital in Chicago and a health equity fellow with the Northwestern Emergency Department and Northwestern Buehler Center for health economics and policy, share their experiences treating gun violence victims. Talk to us on Twitter using the hashtag #R4S!Learn more about AFFIRM and find additional resources on the webpage for this episode: https://researchforsolutions.com/episode-4Production Team: Azsaneé Truss, Joe Riina-Ferrie, Sonali Rajan, and Lalitha VasudevanEditing: Azsaneé Truss with the help of the (Re)Search for Solutions teamMusic: “Research Area” by Poitr PacynaWebsite: ResearchforSolutions.comThe views expressed in this episode are solely those of the speaker to whom they are attributed. They do not necessarily reflect the views of the faculty, administration, staff or Trustees either of Teachers College or of Columbia University.

For our first episode of Season 3, we are sharing an insightful conversation with a Burns Boss, Dr. Juvonda Hodge. She is currently the Assistant Medical Director at the Grady Memorial Hospital Burn Center. Dr. Hodge sat down with us to discuss her unexpected path to becoming a burn surgeon, the continued need for mentorship […]

Welcome to this week's Light Warrior Session, "Immune Boosting" with Dr. Cameron O'Connell!Dr. Cameron O'Connell is a Naturopathic primary care doctor with interests in longevity, cardiology, fertility, and sexual health. She is a provider with Thrive Integrative Medicine in Anchorage, AK. Dr. O'Connell has been a speaker at various plant-based events, such as the, 2020 Climate Healers Health Conference, and is currently the scientific advisor for Switch For Good. In today's episode, we discuss natural ways to boost our immune systems. Sometimes we forget how empowered we are with how our own bodies function. I hope today's episode provides tips, reminders, and wake-up calls to take back control of your immunity.Dr. O'Connell hails from Alaska and spent much of her childhood improving her microbiome by playing in the forest and foraging for snacks among the edible flora. Having had variable life experiences – from working at a ski resort in Montana to acting as the Assistant Medical Director for the Engine2 Immersion Programs in 2016 and 2017 - she loves meeting and helping people with a variety of backgrounds and concerns.Dr. O'Connell graduated with a Doctorate of Naturopathic Medicine from the National University of Natural Medicine in 2015 and completed her subsequent residency with TrueNorth Health Center. She is certified in water-fasting through the International Association of Hygienic Physicians. She served 2 years as the Assistant Medical Director at the Engine2 Immersion Experiences. Her undergraduate degree is a B.A. obtained from George Fox University in Writing/Literature with a Biology Minor. Dr. O'Connell is confident that these two degrees sum her up well as an individual.One of Dr. O'Connell's objectives is to meet the patient where they are at and help them to further their own health goals. She believes that the patient is an active partner in determining future wellness and it is Dr. O'Connell's job to help them cultivate and create both patient-driven preventative medicine and client-motivated treatment for chronic conditions. She believes that a quote from William Osler underlines her clinical approach: “The good physician treats the disease; the great physician treats the patient who has the disease.”Learn more here: https://www.drcameronoconnell.com/ https://www.plantbaseddoctors.org/cameron-oconnellToday's episode is brought to you by Dance Driven. Dance Driven was created to provide more opportunities to the local dance community and youth that previously weren't there.  With an aim to make opportunities to learn from professional dancers, teachers, and choreographers an affordable option for any dancer that wants to have that opportunity.  Dance Driven is constantly trying to bring new ways to help not just the dance community but the general Alaskan community as well. Learn more about their upcoming dance events here:https://dance-driven.com/ https://www.instagram.com/dance_driven/

David P. Deutsch, MD, FACS, ABHRS, Assistant Medical Director for Bosley Inc: World renowned Dr. Deutsch has completed over 7000 Hair Transplant procedures. These procedures include: FUT (strip harvest), FUE (Follicular Unit Excision), eyebrow transplants, and facial hair transplants. Patients travel from all over the world to have Dr. Deutsch perform their Hair Restoration. Among his many patients are members of royalty, movie and TV actors, musicians, athletes, and corporate CEOs.

Faizan H. Arshad, MD, is the EMS Medical Director for Vassar Brothers Medical Center, part of NuVance Health. With an undergraduate background in Sociology and Psychology, he graduated from Northwestern's Feinberg School of Medicine – Honors Program in Medical Education – and pursued specialty training in Emergency Medicine at Yale-New Haven Hospital. Dr. Arshad completed his EMS fellowship with the Fire Department of New York City while serving as Assistant Medical Director of Manhattan. He then served as the Associate EMS Fellowship Director at Newark Beth Israel Hospital and Deputy System Medical Director for MONOC EMS in New Jersey. His interests include endurance training, cardiac arrest outcomes research, and tactical medicine, having also served with law enforcement as a TEMS physician. He is the EMS Nation podcast and blog founder and is an editorial board member of the Journal of EMS (JEMS). He has recently elected to serve his country as a critical care retrievalist physician in the United States Air Force Reserves. What You Will Learn: Dr. Arshad's background in medicine, and how he ended up in the USAF How Dr. Arshad turned a backyard shed into a multi-use home office Different ways business owners can leverage the TCJA of 2017 How Dr. Arshad took advantage of Sec.179 deductions, 100% bonus depreciation, and QIP Bonus depreciation vs. Sec.179 How Sec.179 creates a substantial financial planning opportunity How to contact Dr. Faizan Arshad: Facebook: //www.facebook.com/PrehospitalNation Twitter: @emscritcare @EMS_Nation

In 2018, the NRA tweeted, “Someone should tell self-important anti-gun doctors to stay in their lane,” in response to a paper released by the American College of Physicians (ACP) about Reducing Firearm Injuries and Death in the United States. Soon after, medical professionals from around the country responded with their stories using the hashtag #ThisIsOurLane. Episode 4 of (Re)Search for Solutions reflects on the crucial role emergency medicine physicians, who are on the front lines of responding to firearm injuries, play in developing solutions. We spoke with Dr. Megan Ranney, an emergency physician and faculty at Brown University and co-founder of the AFFIRM Research collective. She tells us how AFFIRM includes the perspectives of more than 40,000 healthcare professionals, public health experts, and researchers to find ways to reduce gun violence. Additionally, Dr. Ameera Haamid, an emergency medicine physician at Cook County Hospital in Chicago and the Assistant Medical Director of the Chicago West EMS System, as well as Dr. Garth Walker, an emergency medicine physician at Jesse Brown Veteran Affairs Medical Hospital in Chicago and a health equity fellow with the Northwestern Emergency Department and Northwestern Buehler Center for health economics and policy, share their experiences treating gun violence victims. Talk to us on Twitter using the hashtag #R4S! Learn more about AFFIRM and find additional resources on the webpage for this episode: researchforsolutions.com/episode-4 Production Team: Azsanee Truss, Joe Riina-Ferrie, Sonali Rajan, and Lalitha Vasudevan Editing: Azsanee Truss with the help of the (Re)Search for Solutions team Music: “Research Area” by Poitr Pacyna Website: ResearchforSolutions.com The views expressed in this episode are solely those of the speaker to whom they are attributed. They do not necessarily reflect the views of the faculty, administration, staff or Trustees either of Teachers College or of Columbia University.

In 2018, the NRA tweeted, “Someone should tell self-important anti-gun doctors to stay in their lane,” in response to a paper released by the American College of Physicians (ACP) about Reducing Firearm Injuries and Death in the United States. Soon after, medical professionals from around the country responded with their stories using the hashtag #ThisIsOurLane. Episode 4 of (Re)Search for Solutions reflects on the crucial role emergency medicine physicians, who are on the front lines of responding to firearm injuries, play in developing solutions. We spoke with Dr. Megan Ranney, an emergency physician and faculty at Brown University and co-founder of the AFFIRM Research collective. She tells us how AFFIRM includes the perspectives of more than 40,000 healthcare professionals, public health experts, and researchers to find ways to reduce gun violence. Additionally, Dr. Ameera Haamid, an emergency medicine physician at Cook County Hospital in Chicago and the Assistant Medical Director of the Chicago West EMS System, as well as Dr. Garth Walker, an emergency medicine physician at Jesse Brown Veteran Affairs Medical Hospital in Chicago and a health equity fellow with the Northwestern Emergency Department and Northwestern Buehler Center for health economics and policy, share their experiences treating gun violence victims. Talk to us on Twitter using the hashtag #R4S! Learn more about AFFIRM and find additional resources on the webpage for this episode: https://researchforsolutions.com/episode-4 Production Team: Azsanee Truss, Joe Riina-Ferrie, Sonali Rajan, and Lalitha Vasudevan Editing: Azsanee Truss with the help of the (Re)Search for Solutions team Music: “Research Area” by Poitr Pacyna Website: ResearchforSolutions.com The views expressed in this episode are solely those of the speaker to whom they are attributed. They do not necessarily reflect the views of the faculty, administration, staff or Trustees either of Teachers College or of Columbia University.

(Running time: 19:09) Dr. McKinley Glover pays us a visit to discuss how value-based reimbursement can incentivize PHM initiatives. Dr. Glover is Assistant Medical Director of the Massachusetts General Physicians Organization and a neuroradiologist at Massachusetts General Hospital in Boston. Dr. Glover is also Vice Chair of the Population Health Management Committee of ACR's Commission on Patient- and Family-Centered Care.  

In this episode, we discuss airways with Dr. Rachel Ely, who is doing a rotation with CCEMS as an Assistant Medical Director as part of the military's EMS and Disaster Medicine Fellowship based at Brooke Army Medical Center in San Antonio. Dr. Ely has a background in EMS and actively worked as a paramedic for a few years before and during medical school. Passionate about all things "airway", Dr. Ely outlines some of her "must-dos" for a successful advanced airway while providing insight from her years of experience. Before the call: Visualization and mental rehearsal Physical rehearsal: have a plan, and a backup, and a backup, and practice all of them Location of equipment is key Airway preparation During the call: Pre-oxygenate early. Once you decide they need an advanced airway, give all the oxygen. Resuscitate before you intubate, Laryngoscope as a Murder Weapon (Scott Weingart) Hypotension O2/Hypoxemia pH/acidosis. The apneic period can be deadly in certain patients. Recognizing this is trickier in EMS because you don't have all the data (like blood gases). Fear this in the DKA patient, the septic shock patient, any metabolic acidosis Position the patient: it is worth your time to try do this right. The donut works, sometimes towels/pillows are needed, but just having a FF lift the head off of the floor will give you a 100% better view. Head off stretcher works for some, but may actually make things worse as the angle of oropharynx to glottis becomes more steep (glottis more anterior). Neck flexed, head extended gives optimal alignment

Alex Bittner is a certified Physician’s Assistant and the President & Assistant Medical Director of AM~PM DOC. He has worked with clients from all over the world in numerous hotels as an on-call house doctor. They have been offering five star medical service for years, working with the top hotels as well as high-profile patients.As the pandemic started and travel restrictions started falling into place, it was pretty clear that the United States was going to be hit pretty hard. Hindsight is always 20/20. Could we have locked down earlier? Sure? But we have never been in this situation before. Instead of focusing on what we could have done better or faster, it is important to focus what we can do now.Businesses being closed and travel restrictions are not an over-reaction. It is appropriate. Again, this is a situation that we have never been in before, so it is paramount that we are cautious and following the guidelines of the WHO, CDC, and the government. How long it will take to “flatten the curve” depends on so many factors, but it is important to follow Stay At Home orders to help alleviate the medical system, minimize exposure, and ultimately passing on the virus.Interestingly enough, when we think about the medical industry, many of us assume it is insanely busy everywhere. But that is not the case. ER volume is down in smaller markets, like in Cleveland. People are scared to seek medical attention for things that are not coronavirus-related. So the medical system is in an interesting place right now. It is operating at max capacity in hotspots like New York City, but in other cities, not as much.Ultimately, there is no vaccine yet, and that is where we stand. Or course, there has been talk about different medications, such as the famed Malaria drug. But it is always important to remember that with every medication, there are side effects. Prescribing any sort of medication must be carefully weighed. Currently this Malaria drug is not a sure thing, as testing is still underway.There have been so many misconceptions regarding the virus. From age to chronic health conditions, there hasn’t been one factor that guarantees you will be sick. As our understanding of this disease has changed, and continues to change, we have to remember that no one is immune to it. On the other side of things, we have to remember that is not an automatic death sentence if you get it. We have to keep things in perspective.Alex left us with some great advice:Remember, the best thing is to avoid contact with other people. Be aware of what you are touching, from items to your face. Wash your hands often. And use common sense. It is OK (even encouraged) to be outside to get fresh air and to work out, just be mindful of being around others.For more info on Alex and his company, check out:888 AM~PM DOC ~ Toll Free Emergency Hotlinewww.ampmdoc.comhttps://www.instagram.com/dabittnah/.

Dr. Stephen Olvey is on the short list of true experts in trauma medicine especially as it relates to motor racing. He was the Assistant Medical Director at Indianapolis Motor Speedway, and developed the first U.S. traveling motorsports medical team for USAC and the CART series. His primary interests are traumatic brain injury and concussion. He has also authored two books, including Rapid Response, an autobiography of his career in motor sport medicine and, yes, the Amazon Prime documentary Rapid Response comes from Dr. Olvey's story. The Freaks talked with Olvey about a number of issues from Coronavirus to protecting drivers from themselves. Listen...

Dr. Stephen Olvey is on the short list of true experts in trauma medicine especially as it relates to motor racing. He was the Assistant Medical Director at Indianapolis Motor Speedway, and developed the first U.S. traveling motorsports medical team for USAC and the CART series. His primary interests are traumatic brain injury and concussion. He has also authored two books, including Rapid Response, an autobiography of his career in motor sport medicine and, yes, the Amazon Prime documentary Rapid Response comes from Dr. Olvey's story. The Freaks talked with Olvey about a number of issues from Coronavirus to protecting drivers from themselves. Listen...

Welcome to Episode #57 –Improving your reputation- Fiona Birch Who is Fiona? Fiona spent 9 years as a trainer / exercise physiologist. Mostly in men's sports (rugby union, rugby league and aussie rules). In fact, she was one of the only female athletic trainers in Australia in men's sports at the time. She was the Sports Medical Director at Griffith University for the 1994 World University Games and Assistant Medical Director for the 1994 ITU World Cup Triatlon. She was a competitive athlete from age 6 to 18, then a professional lifeguard, and has spent the last 9 years competing in triathlons. So nothing shocks her. She's seen and heard it all. She understands it from the athlete's perspective, the team's perspective and the association's perspective. And just as important – the fan's perspective. This show you'll learn: How to build your brand withstanding a crisis Crisis management Reputation How to use data, analysis and content strategy If you would like to find out more about Pro Athlete: https://proathleteonline.com/ fbirch@proathleteonline.com Follow Pro Athlete: https://www.facebook.com/proathleteonline/ https://www.instagram.com/proathleteonline/ https://twitter.com/fi_birch https://www.youtube.com/channel/UCqZG4Y_a9MVo2NAK6ZvRNog Join our Motorsport Sponsorship Group: http://bit.ly/Motiv8Sp Learn more about MotiV8 Training: Motiv8training.com.au Reviews: Have some feedback on the show? I would love to hear it! Please leave a review on itunes or stitcher and I will read them out on next week's show, good or bad! Every review will go in the draw to win a prize. Thank you again for taking the time to listen to the podcast!

Welcome to Episode #57 –Improving your reputation- Fiona Birch   Who is Fiona? Fiona spent 9 years as a trainer / exercise physiologist. Mostly in men’s sports (rugby union, rugby league and aussie rules). In fact, she was one of the only female athletic trainers in Australia in men’s sports at the time. She was the Sports Medical Director at Griffith University for the 1994 World University Games and Assistant Medical Director for the 1994 ITU World Cup Triatlon. She was a competitive athlete from age 6 to 18, then a professional lifeguard, and has spent the last 9 years competing in triathlons. So nothing shocks her. She’s seen and heard it all. She understands it from the athlete’s perspective, the team’s perspective and the association’s perspective. And just as important – the fan’s perspective.     This show you’ll learn: How to build your brand withstanding a crisis Crisis management Reputation How to use data, analysis and content strategy     If you would like to find out more about Pro Athlete: https://proathleteonline.com/ fbirch@proathleteonline.com   Follow Pro Athlete: https://www.facebook.com/proathleteonline/ https://www.instagram.com/proathleteonline/ https://twitter.com/fi_birch https://www.youtube.com/channel/UCqZG4Y_a9MVo2NAK6ZvRNog     Join our Motorsport Sponsorship Group: http://bit.ly/Motiv8Sp   Learn more about MotiV8 Training: Motiv8training.com.au   Reviews: Have some feedback on the show? I would love to hear it! Please leave a review on itunes or stitcher and I will read them out on next week’s show, good or bad! Every review will go in the draw to win a prize.   Thank you again for taking the time to listen to the podcast!

With Dr. Clay Watson, an infectious disease specialist in Denver, CO.and Travis Neill, Assistant Medical Director at VIVAGE    References: Daniella Meeker, PhD, et. al., "Effect of Behavioral Interventions on Inappropriate Antibiotic Prescribing Among Primary Care Practices:", JAMA, 2016. Pranita D. Tamma, et. al., "What Is the More Effective Antibiotic Stewardship Intervention: Preprescription Authorization or Postprescription Review With Feedback?", IDSA, 2017.

Dr. Marco Mavromaras sits down with us to talk about both his Professional and Personal upbringing. Originally from Johannesburg, South Africa "Dr. Marco" offers a truly unique view on life and how easily it can all be taken for granted. Dr. Marco is a Tactical Physician with The Center for Tactical Medicine as well as serving as Assistant Medical Director for Airmed. This episode is one not to be missed. Sit back, Relax, and Enjoy. 

On PopHealth Week, our special guest is Emeritus Assistant Medical Director and former Chief Medical Informatics Officer for Kaiser Permanente of Southern CaliforniaJohn Mattison MD. John's Dr. Mattison's focus and passion is the transformation of health care delivery via information technology, through convergence of exponential technologies and data liquidity. He led the design and implementation of the largest integrated electronic health record in the US, and leads various national programs including virtual care. He has sponsored or led numerous digital innovations, and mentors many digital health startups. He chairs the eHealth Workgroup of the Global Alliance for Genomics and Health (GA4GH), and is a board member of Open mHealth, advisory board member of the NIH funded Policy and Ethics in Precision Medicine, teaches at multiple Universities including Singularity University, and has published widely on privacy, policy, security, IOT, global genomics collaboration, interoperability, mobile health, and healthcare transformation. He has published in Nature, JAMIA, JAMA, WSJ, Forbes, and has authored chapters for various books. He has keynoted or hosted many national and international healthcare conferences and has consulted in many countries. He is the founder of the international XML standard for health record interoperability known as CDA, CCD and CCDA, and is an active participant on several global initiatives to bring internet services to underserved communities providing access to both jobs and healthcare. Join us!   ==##==  

Robin is a GP, born and trained in Toronto. He has been working in the NHS since 2007, largely in clinical governance. He is currently working as an Assistant Medical Director for the South East Coast Ambulance NHS Trust, a Clinical Advisor with NHS England, South-East team and as GP Lead for Primary Care Streaming in the A&E of East Sussex Healthcare NHS Trust (Hastings and Eastbourne Hospitals). He has always been interested in medical error. Now his professional and personal lives have converged, in trying to make sense of the death of his son Julien, a third year Registrar in Anaesthesia.

"Hospital in the Home" is emerging as a frequently discussed concept in the medical community. Programs that allow patients to receive hospital-level of care in their homes have shown to be safer, less costly, and result in better patient outcomes. As a result, Hospital in the Home programs are gaining traction as an alternative option to acute inpatient stays. To better understand the opportunities, benefits, and challenges of Hospital in the Home programs, we invited two of the nation's pioneers and leading experts on the matter to join us on the Change Healthcare podcast: Dr. Bruce Leff, Director for The Center of Transformative Geriatric Research at Johns Hopkins University School of Medicine; and Dr. Allyson Kreshak, emergency medicine physician and Assistant Medical Director at UC San Diego Emergency Department. Both helped innovate and steer Hospital in the Home programs for their respective hospital systems,and are optimistic that in-home hospital care can become the new standard of care for some patients. On today's show, we dive deep into the Hospital in the Home trend and discuss: The genesis of Hospital in the Home programs and today's modern home-based care movement (5:50) The quantifiable (and non-quantifiable) benefits of Hospital in the Home for patient outcomes (11:07) What contributes to a successful Hospital in the Home program? (16:41) The adoption challenges some Hospital in the Home programs have faced and the role of technology in the future of more streamlined home-based care (20:18) Which patients are appropriate for Hospital in the Home programs? (26:18) Top considerations to win buy-in to establish a Hospital in the Home program and common pitfalls to avoid (33:50) Steps to create internal infrastructure for a successful Hospital in the Home program (33:50) The practicalities of reimbursement models (44:00) The future of Hospital in the Home (46:12) Episode Resources Bio: Laura Coughlin RN Bio: Dr. Leff Bio: Dr. Kreshak Change Healthcare introduces InterQual 2019 InterQual evidence-based clinical decision support web InterQual 2019 brochure Contact us Show Resources SUBSCRIBE to the podcast using any podcatcher or RSS reader Download the audio and listen offline Get the iOS app Get the Android app Suggest or become a guest

Episode 180 is ESO Metrics with Drs Brent Myers and Remle Crowe. An interesting podcast this week as my guests discuss the ESO Metrics Project. Performance metrics are becoming increasingly valuable in the healthcare industry as well as in EMS. Brent and Remle will take us through the project and discuss what metrics are improving, declining, and staying the same. Do you wonder how the item list in the drop-down menus in the ESO PCR program is the way they are? The answer is provided in the podcast. Dr. Brent Myers is an internationally recognized expert in the areas of EMS System Design, Performance Improvement, and Population Management. He is the Immediate Past President of NAEMSP and currently serves as the Chief Medical Officer of ESO and Assistant Medical Director of the Wake County EMS System. Dr. Remle Crowe began her career in EMS as a volunteer EMT and instructor with the Mexican Red Cross in Mexico City. She completed the EMS Research Fellowship at the National Registry of EMTs, earning her Ph.D. in Public Health from The Ohio State University. Currently, Remle serves as a research scientist and performance improvement manager with ESO.

Disclaimer: This is the unedited transcript of the podcast. Please excuse any typos. Jeff:  Welcome back to Emplify, the podcast corollary to EB Medicine's Emergency Medicine Practice. I'm Jeff Nusbaum, and I'm back with my co-host, Nachi Gupta. This month, we'll be talking Updates and Controversies in the Early Management of Sepsis and Septic Shock. We have a special  episode for you this month… We've brought Dr. Jeremy Rose, one of the peer reviewers, and a sepsis expert, on with us to talk through the content this month. Jeremy: Dr. Jeremy Rose here. Thanks for having me in on this conversation.  I'm always happy to talk about this topic because it's clearly important.  There's a great deal of confusion around sepsis and I hope that in the next couple minutes we can clarify things in a way that really help your average front line doc trying to get it right. Nachi: So Dr. Rose, before we get started, tell us a bit about your background and your interest in sepsis… Jeremy: I'm the Assistant Medical Director and Sepsis Chair at Mount Sinai Beth Israel in Manhattan.  For those listening, my hospital probably looks a little bit like yours.  We're busy, interesting, and just a little rough around the edges.  We like it that way.  More importantly, though, we mirror the national averages regarding sepsis.  Roughly half of in-hospital mortality is associated with septic  in some fashion.  Pretty incredible when you think about it.  Half. Jeff:  Sepsis chair... clearly this is an important topic if it warrants it's own chair at a major hospital in NYC. But getting back to the article this month. This month's issue was authored by Faheem Guirgis, Laurent Page Black, and Elizabeth DeVos of the University of Florida, Department of Emergency Medicine. Nachi: And it was peer reviewed by Michael Allison, Assistant Director of the Adult ICU at Saint Agnes Hospital, and Jeremy Rose and Eric Steinberg of Mount Sinai Beth Israel. Jeff: So as well all know Sepsis is bread and butter emergency medicine, but, what is sepsis?  It seems that every month or so we have a new guideline, bundle, definition, or whatever… I think it's best to start with the basics -  At its core, sepsis is a dysregulated response to infection that can be life-threatening. Nachi: Right and it's the combined inflammatory with immunosuppressive features of sepsis that lead to the devastating organ dysfunction and even death. Optimal management of septic patients has been a source of intense research, stemming from the landmark study by Rivers in 2001. Jeremy, can you give us a little historical context there? Jeremy: Rivers was a real pioneer.  He found a 16% mortality reduction with randomization to an early aggressive care bundle.  Amazing work.  That being said, many components of that bundle have since been disregarded.  For example, Manny Rivers would measure CVP in all of his patients, something we rarely do. Nachi: Not to cut you off and steal your thunder there, but we'll get to the most recent updates in management shortly. Let's first talk definitions and terminology, and specifically, diagnosis, which is definitely a big elephant in the room. As Jeff mentioned a few minutes ago, diagnostic criteria have undergone so so so many changes. Jeff: Yes it has! 1991 marked the first standardized definition.  Then in 2001, sepsis-2 was introduced.  In 2014, the Society of Critical Care Medicine and the European Society of Intensive Care Medicine started a task force, and by 2016, updated definitions were out again! Sepsis-3!! A lot of this came after the realization that SIRS was just too broad and was overly sensitive and non-specific. Jeremy, why don't you take us through Sepsis 3. Jeremy: So just to back up a little and frame this: Here's the fundamental problem:  As we likes to say, “there's no troponin for sepsis.”  And if you look at our patients, we tend not to miss the hypotensive, tachycardic, febrile patient.  We know they're septic.

Disclaimer: This is the unedited transcript of the podcast. Please excuse any typos. Jeff:  Welcome back to Emplify, the podcast corollary to EB Medicine’s Emergency Medicine Practice. I’m Jeff Nusbaum, and I’m back with my co-host, Nachi Gupta. This month, we’ll be talking Updates and Controversies in the Early Management of Sepsis and Septic Shock. We have a special  episode for you this month… We’ve brought Dr. Jeremy Rose, one of the peer reviewers, and a sepsis expert, on with us to talk through the content this month. Jeremy: Dr. Jeremy Rose here. Thanks for having me in on this conversation.  I’m always happy to talk about this topic because it’s clearly important.  There’s a great deal of confusion around sepsis and I hope that in the next couple minutes we can clarify things in a way that really help your average front line doc trying to get it right. Nachi: So Dr. Rose, before we get started, tell us a bit about your background and your interest in sepsis… Jeremy: I’m the Assistant Medical Director and Sepsis Chair at Mount Sinai Beth Israel in Manhattan.  For those listening, my hospital probably looks a little bit like yours.  We’re busy, interesting, and just a little rough around the edges.  We like it that way.  More importantly, though, we mirror the national averages regarding sepsis.  Roughly half of in-hospital mortality is associated with septic  in some fashion.  Pretty incredible when you think about it.  Half. Jeff:  Sepsis chair... clearly this is an important topic if it warrants it’s own chair at a major hospital in NYC. But getting back to the article this month. This month’s issue was authored by Faheem Guirgis, Laurent Page Black, and Elizabeth DeVos of the University of Florida, Department of Emergency Medicine. Nachi: And it was peer reviewed by Michael Allison, Assistant Director of the Adult ICU at Saint Agnes Hospital, and Jeremy Rose and Eric Steinberg of Mount Sinai Beth Israel. Jeff: So as well all know Sepsis is bread and butter emergency medicine, but, what is sepsis?  It seems that every month or so we have a new guideline, bundle, definition, or whatever… I think it’s best to start with the basics -  At its core, sepsis is a dysregulated response to infection that can be life-threatening. Nachi: Right and it’s the combined inflammatory with immunosuppressive features of sepsis that lead to the devastating organ dysfunction and even death. Optimal management of septic patients has been a source of intense research, stemming from the landmark study by Rivers in 2001. Jeremy, can you give us a little historical context there? Jeremy: Rivers was a real pioneer.  He found a 16% mortality reduction with randomization to an early aggressive care bundle.  Amazing work.  That being said, many components of that bundle have since been disregarded.  For example, Manny Rivers would measure CVP in all of his patients, something we rarely do. Nachi: Not to cut you off and steal your thunder there, but we’ll get to the most recent updates in management shortly. Let’s first talk definitions and terminology, and specifically, diagnosis, which is definitely a big elephant in the room. As Jeff mentioned a few minutes ago, diagnostic criteria have undergone so so so many changes. Jeff: Yes it has! 1991 marked the first standardized definition.  Then in 2001, sepsis-2 was introduced.  In 2014, the Society of Critical Care Medicine and the European Society of Intensive Care Medicine started a task force, and by 2016, updated definitions were out again! Sepsis-3!! A lot of this came after the realization that SIRS was just too broad and was overly sensitive and non-specific. Jeremy, why don’t you take us through Sepsis 3. Jeremy: So just to back up a little and frame this: Here’s the fundamental problem:  As we likes to say, “there’s no troponin for sepsis.”  And if you look at our patients, we tend not to miss the hypotensive, tachycardic, febrile patient.  We know they’re septic.  But how do we find the ones who don’t look as sick.  Frequently elderly, possibly with normal-ish vitals and no fever.  Those can be a lot harder to spot, but they may indeed be septic.  Also, for research purposes we have to have a common definition, so Sepsis 3 came up with something called the SOFA score. The problem with the SOFA score is that its difficult to perform in the ED.  It has parameters like bilirubin that often aren’t available when we want to screen out very sick patients.  Fortunately there is the abridged version qSOFA, which identifies non-icu patients who are at high risk of inpatient mortality. So here it is, and if you get one thing from this episode, this is it: There are ONLY 3 criteria to the qSOFA.  3 Criteria. RR > 22; AMS; SBP 2. So quite a few changes! Jeff: And Jeremy, sticky topic coming up here. Center for Medicare and Medicaid Services (or CMS) quality measures - They haven’t really caught on to and adapted to Sepsis-3 yet, have they? Jeremy:  The CMS mandate is based on the presence of SIRS criteria. Sepsis 3 is based on SOFA.  This is definitely confusing.  Part of the challenge in discussing this topic is separating out the QI guidelines from what is actually relevant to patient care based on the latest evidence-based medicine. Nachi: That seems fair.  We’re really going to put you in an uncomfortable spot for a second and push you here Jeremy. Do you have any insight into why CMS isn’t interested in following the mountains of research that have led to sepsis-3? Is there a reason they are sticking to their current criteria? Jeremy:  I think some of it is the slow pace of bureaucracy and the time that it takes to develop a consensus on management.  Even if we can agree on who is septic, it’s really hard, if not impossible to link the care to a pay-for-performance metric which is what CMS ultimately would like to see.  That’s not how Sepsis-3, or for that matter, SIRS, was designed to be used.  You’re trying to take a tool which was originally designed for research and mold them into a tool used for pay for performance. Nachi: What a struggle. The CMS metrics are slightly different from the 2001 sepsis guidelines also. Take a look at Table 2 of the article for a quick comparison of sepsis-3, 2001 sepsis, and cms side-by-side. And for those on twitter, we’ll be sure to tweet this table out too for your review. Jeff: With so many different scores and definitions, I think that adequately sets the stage for the challenge this month’s authors faced coming up with real evidenced based guidelines. Nachi: Oh absolutely.  And to make matters worse - this is a HUGE problem. We’re talking up to 850,000 ED visits annually in the US, and 19 million cases worldwide. Compounding this, sepsis results in death in approximately 1 out of 4 cases. Not only is it lethal, it is also very costly -- 17 billion dollars per year in the US alone! Jeff: And don’t forget importantly the 30-day hospital readmission rate. Sepsis is coming in at a higher readmission rate and cost per admission than acute MI, CHF, COPD, and PNA. Nachi: Let’s speak briefly on the etiology and pathophysiology of sepsis: we all know that sepsis is due to local infections that then become systemic. Previously, it was believed that the bacterial infection itself was the cause of the clinical syndrome of sepsis. However, we now know now that the syndrome of sepsis is due to the inflammatory and immunosuppressive mediators that were triggered by the infection. Normal immune regulatory safeguards fail and this leads to the syndrome. And interestingly, several studies have shown that critically ill septic patients experience reactivations of specific viruses that were previously limited to patients with severe immunosuppression. Jeff: Definitely something to look out for in your critically ill septic patients.  We should talk  briefly about the most common inciting infections that lead to sepsis. In order, these are: pneumonia, intra-abdominal infections, and urinary tract infections. No surprises there! Nachi: Yeah, that basically parallels my own experience, so that’s reassuring!  That takes us to our next potentially controversial topic - blood cultures.  Jeremy - we’re going to punt this one back to you Jeremy: This is another interesting topic that has received plenty of attention.   CMS loves blood cultures.  It’s an easy metric to track.  That doesn’t mean they’re always helpful.  We looked at our patients with lactates between 2.1 and 4.0 which had “severe sepsis.”  These patients were normotensive though, In other words, the ones that aren’t that sick.  We found that blood cultures are useful about 20% of the time.  That’s not bad.  So what do we do? We draw cultures before pushing antibiotics.  Is that helpful? Sometimes yes, does it waste money?  Debatable.  Does it help us meet our metrics, yes. Jeff: And I think that gets at the crux of the problem here: we don’t want to delay antibiotics on anybody, but we must balance this with the potential harm of further increasing the drug resistant bacterial population via sound antibiotic stewardship.  Remember also that there is a broad differential for sepsis, with several “sepsis mimics”. To name a few, we have PE, MI, CHF, acute pulmonary edema, DKA, thyroid storm, GI bleeds, drug intoxications, and withdrawal syndromes, just to name a few.  In case that wasn’t enough check out Table 3 of the article. Nachi:  And we already mentioned the leading causes of sepsis, that’s pneumonia, intra abdominal infections, and uti’s. But remember the source can be anywhere. Be sure to also think of pyelonephritis, central line associated bloodstream infections, prosthetics, endocarditis, necrotizing fasciitis, and meningitis. Jeff:  I don’t think we need to dwell on this much longer - basically the differential is huge.  Let’s move on to my favorite section - prehospital care. Jeremy: 20 pages of evidenced based recommendations and your favorite is the prehospital section, what’s up with that? Jeff: I’m an EMS fellow, what can I say… Anyway, on to my favorite section -- prehospital care.  This is always a hot topic because the prehospital period is a special opportunity to get early interventions in for septic patients  as 40 - 70% of all severe sepsis hospitalizations arrive via EMS. Nachi: And in one study taking place in a large metropolitan area, prehospital care time was over 45 minutes, and less than  37% arrived with IV access. Of course, these numbers would vary significantly based on where you practice. Jeff: So get this -- one study showed that out-of-hospital shock index and respiratory rate were highly predictive of ICU admission. So clearly early recognition and therapy may play a role here. Another study, however, showed knowledge gaps by advanced EMS providers in diagnosis and management of sepsis. And yet another study showed that only 18 to 21% of confirmed septic patients were suspected of having sepsis by EMS. Out of hospital fluids were started in only half of patients with severe sepsis. In essence, there is likely a strong role here for pre hospital protocols for identifying and treating sepsis. Nachi: In terms of pre hospital treatments though, prehospital IV fluids haven’t been shown to improve mortality, but have been associated with shorter hospital stays. Prehospital sepsis protocols have been described, but in general more research is needed in this area. Jeff: While prehospital care hasn’t yet been shown to improve the prognosis of septic patients, those presenting via EMS do have shorter delays to initiation of antibiotics, IV fluids, and early care bundles. EMS should focus primarily on stabilizing vital signs and providing efficient transport. If it’s possible to establish an IV and initiate fluids without delaying transport, EMS should do that as well. Nachi: And of course, oxygen for the hypoxic patients! Moving on to history and physical for your presumed septic patient. Jeremy, what are the big hitting things here that you always ask and check for, and that you make sure your residents are doing? Jeremy:  After ABC’s and glucose, AMS is really important, it’s in the QSOFA SCORE.  Unfortunately, this can be hard in many septic patients where they’re baseline mental status is less than perfect.  The other thing is to try and find the source.  Finding the source lets you make wise choices about therapy. Jeff:  Great point about the mental status - so many of our older population have an altered baseline, but recognizing changes from that baseline is key. Nachi:  Absolutely, with that in mind, let’s talk diagnostic studies, especially lactate.  Where I trained, basically everybody was getting a lactate, even tired looking residents seemed to be having their lactates checked, and trust me, they weren’t looking that good... Jeremy:  Brace yourself: lactate is really important in septic patients.  That being said, not every cause of elevated lactate is sepsis.  There is this animal called Type B lactic acidosis can come from numerous drugs like albuterol. Just because you see elevated lactate doesn’t mean you can forget about the other causes.  That being said, we know that patients with sepsis do better when they clear lactate. Jeff: Seems like the evidence is definitely in favor of serial lactate testing… Jeremy: For sure.  At least until you have a reasonable trend towards improvement.  We know lactate clearers do better.  We’ve looked at our own lactate numbers.  Interestingly, the takeoff point for sepsis seems to be around 2.5.  Meaning that patients with altered vitals and lactates above 2.5 tend to do worse.  But, there is a broad ddx to elevated lactate.   What is true, though, is that lactate is a marker for badness.  If your patient’s lactate is rising, yours should be too. Nachi: I bet I’m a “lactate clearer”. I may add “lactate clearer to my CV,” sounds impressive.  But I digress…  Next up we have Procalcitonin.   Since procalcitonin becomes elevated in those with bacterial infections, intuitively, this should be a valuable marker to assess in potentially septic patients.  Unfortunately procalcitonin lacks negative predictive value so most literature supports its use in diagnosing pulmonary infections and for antibiotic de-escalation. Jeff: Good to know, I’ve seen it being used a lot more recently and wondered how evidence based this test was. Jeremy:  Honestly, I don’t see Procalcitonin changing ED management at the moment.  If you’re   waiting for Procalcitonin to start antibiotics or fluids, you’re waiting too long. Nachi: Moving on, let’s talk imaging.  Based on current studies, the authors recommend focused imaging only.  In addition, they also note that our good friend, the point of care ultrasound, likely plays a role, as in one study, POCUS demonstrated a 25% improvement in sensitivity from clinical impression alone. Jeremy:  I think there are two ways POCUS comes in.  One, lung ultrasound can be really useful to find that occult pneumonia or differentiating pneumonia from CHF.   Two, your ultrasound is your best tool for assessing volume status.  I try to look at the IVC of all my septic patients and echo them when possible. Nachi: Right.  So now we’ve examined, drawn labs and cultures, checked a lactate, may be obtained imaging… next up we should probably start treating the patient. Whether you like it or not, we have to discuss CMS. Jeremy: Just to clarify before we start.  CMS defines “severe sepsis” as SIRS + infection with a lactate of 2.1-4.0. Septic shock is SIRS + infection with hypotension or a lactate > 4.0. That’s where we’re at. Jeff:  Good point.  Back to treatment: within the first 3 hours, for any patient with sepsis and septic shock, you must measure a lactate, obtain 2 sets of blood cultures, administer antibiotics, and give an isotonic fluid challenge with 30 cc/kg to patients with hypotension or a lactate greater than 4.   Then, within the first 6 hours, you must apply vasopressors to achieve a MAP of at least 65, re-assess volume status and perfusion, and remeasure a lactate. Nachi: This begs the question - are these recommendations evidenced based? Jeremy…. Jeremy: I’m so glad you asked that . Let’s start with fluids. Patient’s need adequate fluid resuscitation.  Interestingly there are 3 large RCT’s, PROMISE, PROCESS and ARISE,  that compared a Rivers type bundle to usual care.  Surprisingly, they showed no difference.  But when your drill down into these 3 trials, you see that “the usual care,” now generally includes at least 2 liters of fluid. Jeff: Ok, so it seems that there is some pretty good data to support a rapid fluid challenge of at least 30 cc/kg.  But how do we determine who needs more fluids and how much more they need.  There must be an endpoint to all of this? Jeremy: Another million dollar question. 30cc/kg is probably a good place to start.  How much is too much?  I think we need to be smart about our fluids.  Some patients will need less and some will need much more.  So, I remind my resident’s to be smart about fluids.  Sono an IVC, trend a lactate, follow a urine output, do a passive leg raise, even check JVP.  I mean just because you haven’t seen a unicorn doesns’t mean they’re not real.  Do something to monitor volume status. Nachi: Very important. Put your ultrasound skills to work here. They’ll only improve as you practice more.  Jeff, let’s get started on the ever important topic of antibiotics. Jeff: Sounds good.  Current guidelines recommend that broad spectrum antibiotics be administered within the first hour of presentation for those with sepsis or septic shock, ideally with blood cultures being drawn beforehand. In one study, every hour of delayed abx administration was associated with an 8% increase in mortality.  Since this 2006 study, other studies have had mixed results - with studies showing increased odds of death with delays in abx administration and others showing only a benefit in those with septic shock with or without hypotension with no benefit to those without shock. Nachi:  In terms of antibiotic coverage - you need to consider the site of infection, local resistance patterns, the presence of immunosuppression, and the patient’s age and comorbidities.  Table 5 of the article is very thorough and should be kept as a quick reference. Jeremy do you have any specific recommendations for our listeners on how we should approach antibiotic usage in the septic patient? Jeremy: I like to think about antibiotics a little more simply than referencing a table.  I ask a couple questions.  Does my patient need MRSA coverage ?  Does my patient need Pseudomonal coverage?  If the answer is no and no, then narrow your coverage.  You don’t necessarily have to use a bunch of Vanco, or a big gun antipseudomonal like Pip/tazo.  Also, have a look at your local antibiogram.  I can’t tell you how many times this changes prescribing habits for even things like simple UTIs.  I’m going to stray into some controversial territory here. The benefits of sepsis protocols are measured one patient at a time, but the harms are only measured in the aggregate.  What does that mean?  CMS metrics have caused us to  use to use more broad spectrum antibiotics.  As a result, we’re seeing more resistance.  My resident’s tell me to make it easy, give em VZ (that’s vanco/zosyn) and it kills me.   Every time you put a Z-pack into the world a pneumococcus gets it’s wings. So think more about your antibiotics, and know your local biograms. Jeff: That’s a great way to think about it, I fear I’ve given a lot of pneumococci wings during my training…  Next we’re on to vasopressors.  The data is pretty clear on this one - norepinephrine is the recommended first line vasopressor for septic shock.  In numerous trials comparing Norepi to dopamine, NE was far superior, with dopamine increasing arrhythmias in one trial and associated with an increased risk of death as compared to NE in another trial. Jeremy:  So here’s a question I get all the time: How can I give Norepi without a central line.  Let’s use Dopamine, its safe peripherally.  Ok, so follow that through.  We’re going to give a drug to increase blood pressure by constricting blood vessels, but don’t worry, it’s safe peripherally.  What does that mean?  It means it doesn’t work!!  It doesn’t give much blood pressaure.  Dopamine is a lousy pressor.  It causes a lot of tachycardia, which is not what you want in failing septic hearts.  So what do we do if we don’t have a central line?   We start norepi peripherally into a large bore IV for the time it takes us to get a central line.  That’s where the evidence is.  There’s a mortality benefit to NE over dopaine in septic shock. Jeff:  Right, this month’s authors note peripheral pressors may be safe for brief periods in settings with close monitoring.  While this is commonplace in some hospitals, others haven’t yet jumped on that bandwagon. I think it’s important to mention that this is becoming more and more commonplace, even in the prehospital realm.  With the service I fly for, we routinely start peripheral vasopressors without hesitation.  But this isn’t limited to the air.  Many ground 911 services have also adopted peripheral vasopressors in a variety of settings. Nachi: I’m sure there are many trials to come in the future documenting their safety profile, but moving on to the next pressor to discuss... vasopressin. This should be your second line vasopressor for septic shock.  In the VASST trial, low-dose vasopressin was found to be noninferior to NE.  In other trials, vasopressin also appeared to show a potential benefit in those with AKI and sepsis, although the subsequent VANISH trial (perhaps the best name for a clinical trial so far) failed to demonstrate a benefit to vasopressin titration with regard to renal outcomes in septic shock. Vasopressin has also been shown to reduce NE dosing when administered at a fixed dose of 0.03-0.04 units/min. Jeff: Next we have epinephrine.  In one study epinephrine and NE were equivalent in achieving MAP goals in ICU patients with shock, however several of those receiving epi developed marked tachycardia, lactic acidosis, or an increased insulin requirement.  The increasing lactic acidosis could confound the trending of lactates, so in those requiring inotropy in addition to some peripheral squeeze - the authors recommend adding dobutamine to norepinephrine instead of starting epinephrine. Although, keep in mind, this can lead to some hypotension so remember to start at low doses. Nachi: Phenylephrine, a pure alpha adrenergic agent, is next and should be considered neither first nor second line, but it may have a role as a push dose agent while preparing other vasoactive agents. Jeff: And lastly, we have angiotensin 2.  One recent 2017 study examining the role of angiotensin 2 in those with septic shock already on 0.2 mcg/kg/min of NE found that those receiving AT2 had significant improvements in MAPs as well as cardiovascular SOFA score at 48h with no difference in mortality.  Unfortunately, these benefits do not come without risk as AT2 may increase risk of arterial and venous thrombosis and potentially thromboembolism.  Clearly, one study isn’t enough to change practice, but it’s certainly food for thought. Nachi: So that wraps up vasopressors. Jeremy, we’re on to corticosteroids -- another hotly debated topic. When do you give steroids in sepsis? Jeremy:  Hmmm steroids, this is an age old question.  No study has clearly supported the blanket use of steroids in septic shock. Several like CORTICUS and ADRENAL showed no difference.  I will use hydrocortisone for pressor refractory shock. Meaning, you’ve tried everything else, so you might as well try.  Also, I do tend to avoid Etomidate, given the possibility of adrenal suppression and that there are several other induction agents, notably Ketamine  that don’t have this problem. Jeff: Those trials are certainly important, thanks for bringing them up - Especially with all the FOAM content out there, it’s incredibly important to look back at the data to understand where certain recommendations are coming from.   Anyway… one quick note on blood transfusions before we move on to special populations - Although part of the original early goal directed therapy, thanks to data from the TRISS trial which showed no difference in outcomes with a transfusion goal of 7 vs 9, transfusions are reserved for those with a hbg of less than 7. Jeremy:  One population we should make sure to mention and be careful with is end stage liver disease.  In the ER, we tend to miss SBP alot.  Mostly because these patients have lots of reasons to be sick and they already have elevated lactate because of their deceased clearance.  My practice is to give a dose of Ceftriaxone and sent a diagnostic tap to patients who are sick and have ascites. Nachi: Alright Jeremy, let’s talk controversies in sepsis. We’re giving you all the big questions this month! Jeremy:  We’ve already talked about fluids and how much to give.  Just a reminder that a history of CHF doesn’t preclude proper fluid resuscitation.  I think broad spectrum antibiotics for relatively well patients is a big controversy.  Our national rates of antibiotic resistance are terrible, and yet we’re using more antibiotics all the time.  There are very few if any antibiotics coming down the pharma pipeline and we’re going to have to face the music eventually.  Finally, we need national metrics that mirror clinical evidnece.  Protocols should be a tool and not a crutch.  You know what’s best for the patient in front of you, so don’t let metrics or protocols make you do things you think are not in your patient’s best interest. Nachi: So how do you escape the hospital protocols and CMS and do what’s best for your patient without “getting in trouble”? Jeremy: Here’s how I deal with it as the one who reads and QI’s all of our sepsis charts. I tell my colleagues to do what’s right, and if you need to deviate from the protocol tell me why.  As long as you can explain your decision, I’ll support it.  Explaining your thinking is good clinical practice and is good medico-legal practice. CMS has been unable to link these metric  to payment, simply because no hospital can meet them with any regularity.  It’s important that we advocate for our patients or nothing will change. Make them respect you for the highly educated professional that you are, and your patients will ultimately benefit. Jeff: Preach!! And before we close out with disposition, there are a few new therapies and trials on the horizon to keep a lookout for. The RACE trail examined the role of L-carinitine.  The VICTAS trial is looking at vitamin C, thiamine, and steroids in sepsis.  The CLOVERS trial is looking at early vasopressors vs a crystalloid liberal strategy.  And lastly, IL-7 is also being investigated.  All really cool stuff that could change how we manage sepsis in the future.. Nachi  A few quick notes on disposition before we close this episode out.  Certainly not all patients meeting SIRS require admission, but many do.  Those with qSOFA of 2 or higher represent a sick population and an ICU admission should be considered.   Even for those with a qSOFA of 1 but a lacate over 2 -- they have a mortality approaching that of patients with a qSOFA of 2.  Be careful just sending a patient who is on the fence to the floor because several studies have demonstrated that patients who are later upgraded have worse outcomes. Jeff: That’s in line with the general themes we’ve laid out today - definitely better to start early with aggressive care rather than play catch up later.  Jeremy - in 30 seconds or less, what are the most salient points in the management of sepsis that you would like our listeners to take with them from this episode. Jeremy:  Here are my take aways: qSOFA, RR, AMS SBP < 100 Norepi, not Dopamine - it doesn’t work! Be smart about fluids!! Be smarter about antibiotic use! You are the best advocate for your patient, despite what anyone else says! Jeff: Excellent, so that wraps up the October 2018 episode of Emplify. A big thanks to Jeremy Rose for joining us. Jeremy: Thank you for having me!!! It was great talking with you. Nachi: For our listeners -- additional materials are available on our website for Emergency Medicine Practice subscribers. If you’re not a subscriber, consider joining today. You can find out more at www.ebmedicine.net/subscribe. Subscribers get in-depth articles on hundreds of emergency medicine topics, concise summaries of the articles, calculators and risk scores, and CME credits. You’ll also get enhanced access to the podcast, including the images and tables mentioned. You can find everything you need to know at ebmedicine.net/subscribe. Jeff: And the address for this month’s credit is ebmedicine.net/E1018, so head over there to get your CME credit.  As always, the ding sound  you heard throughout the episode corresponds to the answers to the CME questions. Nachi: Lastly, be sure to find us on iTunes and rate us or leave comments there. You can also email us directly at emplify@ebmedicine.net with any comments or suggestions. Talk to you next month!

For Episode 408 of The Paleo Solution Podcast we have guest Dr. Emory Liscord. Dr. Liscord is an Emergency Medical Physician and Assistant Medical Director at the Deptartment of Emergency Medicine Maine General Medical Center. Show Notes 00:46 – Summary/Pre-Intro 1:57 – Intro and Dr. Liscord’s background 4:26 – Why Dr. Liscord chose emergency medicine 6:30 – Medications, and “less is more” 8:43 – Pre-diabetes while marathon training 13:49 – Seasonal eating 14:30 – Grand Rounds about the ketogenic diet at the hospital 15:44 – Where are the current problems in healthcare 19:01 – Conflicts of interest in medicine and subsidies in the food industry 23:10 – Where to initiate change 24:43 – Problematic features of the insurance system 31:18 – History of healthcare in the USA and changes from WWII 34:50 – Experimenting to find better healthcare systems 37:02 – Calling representatives really matters 38:44 – Work with the Chickasaw Nation 40:28 – Conversations in your community and strategies for patients 44:30 – Hospital changing snack foods story 48:30 – Food addiction, social pressure, and psychology 51:21 – Incentives and subsidies 54:28 – Future of Dr. Liscord’s outreach in the community 56:43 – Dietary dogma 59:30 – Where to find Dr. Liscord Website: SimplyHealthME.com Podcast: SimplyHealthME podcast Facebook: SimplyHealthME Facebook page

Date: October 5, 2011​ Featuring: Arthur Kleinman, MD, Esther and Sidney Rabb Professor of Anthropology, Professor of Medical Anthropology, Professor of Psychiatry, William Fung Director: Harvard University, Harvard Medical School, Harvard University Asia Center Jeremy Boal, MD, Chief Medical Officer, North Shore–LIJ Health System; Professor of Medicine, Hofstra North Shore–LIJ School of Medicine Dana R. Lustbader MD, FCCM, FCCP, FAAHPM, Section Head, Palliative Medicine, North Shore–Long Island Jewish Medical Center; Program Director, Palliative Medicine Fellowship, North Shore–LIJ; founding Director, Palliative Care Unit, North Shore University Hospital; Assistant Medical Director, New York Organ Donor Network   Andrea Kabcenell, RN, MPH, Vice President, Institute for Healthcare Improvement When we talk about caring for loved ones with serious illness, we usually focus on the problems and challenges most of all. And that makes sense. There is nothing easy or simple about family caregiving, and when it’s required of spouses and grown children the burdens can be especially high. Still, when you hear Arthur Kleinman describe what it was like to take care of his wife before she died, the words that jump out are honor, respect, and love ― even in the midst of grief, fatigue, and loneliness.Kleinman, a psychiatrist and medical anthropologist, discovered that caregiving could be transformative, especially the further away he got from the fast-paced, high-tech world of cure and intervention that characterize so much of health care today. But there doesn’t have to be such a divide ― not if health care providers can become more comfortable talking with patients and families about serious illness, more familiar with the benefits of palliative and end-of-life care, and more capable of appreciating the power of compassion.This WIHI discusses the very human “call to action” that family caregiving poses for all of health care today. WIHI host Madge Kaplan talks with Arthur Kleinman, two physicians from North Shore-Long Island Jewish (NSLIJ) Health System ― Chief Medical Officer Jeremy Boal and Intensivist and Palliative Care program director Dana Lustbader ― and IHI Vice President Andrea Kabcenell. In partnership with the Institute for Healthcare Improvement, NSLIJ is on the cusp of bringing a great deal more expertise and knowledge to bear on how their 15 hospitals, long-term care facilities, and home health agencies can better respond to and support patients and families facing serious illness. This is a perfect moment and opportunity to engage with this team in shared learning.As Arthur Kleinman told The New York Times: “There is a moral task of caregiving, and that involves just being there, being with that person and being committed. When there is nothing that can be done, we have to be able to say, ‘Look, I’m with you in this experience. Right through to the end of it.’ ”  

The annual 'fall classic' aka the Health 2.0 Fall Conference convened at the Santa Clara Convention Center for it's 10th Annual gathering from September 25th - 28th, 2016. In this session Douglas Goldstein debriefs with John Mattison MD, Assistant Medical Director and Chief Medical Information Officer, Kaiser Permanente, Southern California. Dr. Mattison discusses the applications of Blockchain technology in healthcare operations separating the hype from the hope. Segment filmed and produced for Health Innovation Media by Gregg Masters, MPH. Enjoy! 

Dr. Arthur Ollendorff with MAHEC discusses the C Section Care Process Model at Mission Health. Dr. Calvin Tomkins, Assistant Medical Director at Mission Health Partners, leads the discussion

Where can you find pregnant 12-year-olds, women pregnant again and again just months after giving birth, and teens with high blood pressure, diabetes, HIV, and multiple pregnancies? A third world country perhaps? Maybe. But you really don't have to look that far. Right here inthe USA we have areas where there are no local access to maternal health care, where extreme poverty prevents women from getting medicine or from transportation to doctors. So how rampant is this problem, who is affected and what are we doing about it?  Dr. Keisha Renee Callins is a women's health professional at Mirian Worthy Women's Health Center, and Assistant Medical Director for Albany Area Primary Health Care. She has earned numerous awards for resident teaching and research, presents at local and national conferences and is an expert in teenage pregnanacy prevention, obesity prevention, and physician workforce issues . She works every day in one of the most poverty stricken areas of the US and she sees the catastrophe that is maternal health care in poor, rural communities. Join us as we talk about poor women's health care, the reality and the tragedy.

  Happy holidays from the PEC podcast crew!  We hope you had a fantastic Thanksgiving and are busy planning for the upcoming festivities!       Welcome to episode VIII of the PEC Podcast!   Prehospital ECGs.  Do they make a difference? Can they speed up time to definitive treatment?  This months podcast delves into these questions with Dr. Nichole Bosson and our newest correspondent Dr. Joelle Donofrio.                                           ALSO!  As a result of questions concerning education for LA and ECG roll out, per Dr. Bosson:   "We had a countywide training for the paramedics and MICNs.  It is both online and train-the-trainer format.  The nurse educators and prehospital care coordinators come to the EMS Agency for a live training so that they can answer questions at their agency etc.  We created a separate short on-line training video for physicians to introduce them to the protocol.  We are reaching out to individual SRCs as there are issues and educating them on the protocol."   Also special thanks to Mat Goebel for helping Dr. Donofrio with her podcast!   Dr. Nichole Bosson (Below) is the Assistant Medical Director for Los Angeles County  EMS Agency, the Medical Director for the J Michael Criley Paramedic Training  Institute, and the Associate EMS Fellowship Director for Harbor-UCLA Medical  Center.  She was recently the Director of EMS and Disaster Preparedness for  Harbor-UCLA Medical Center.                                               Dr. Joelle Donofrio (Below) is currently an EMS fellow at UCSD and a Pediatric Emergency Medicine attending at Rady Children’s Hospital of San Diego.  She is  also a fellow of the California EMSC Technical Advising Committee and sits on  the advisory counsel for the EMSC National Resource Center.     Once again thanks for listening and have a safe and happy holidays!   Right click here to download.   Phil Moy MD

Hi all,  Get ready for an awesome episode to be published soon starring Dr. Ricky Kue, Assistant Medical Director of Boston EMS, reviewing his manuscript "Tourniquet Use in a Civilian Emergency Medical Services Setting: A Descriptive Analysis of the Boston EMS Experience" Right click here to download.   Thanks for listening and feel free to contact us at pecpodcast@gmail.com or twitter us @pecpodcast for any suggestions for future podcast episodes or any comments you have.  Who knows?  You may be the next star on Prehospital Emergency Care Podcast!   Stay tuned for the next Episode! Cheers, Phil Moy MD Scott Goldberg MD Jeremiah Escajeda MD Prehospital Emergency Care National Association of EMS Physicians, NAEMSP

                                Hi everyone!   This month's Prehospital Emergency Care podcast will be an interview with Dr. John Holcomb's article, Prehospital Transfusion of Plasma and Red Blood Cells in Trauma Patients in this month's Journal of Prehospital Emergency Care.    This podcast includes Dr. Holcomb's career arc from his humble beginnings in Arkansas to his time as a United States Army Surgeon in the Black Hawk Down incident to his current research on prehospital transfusion.  It is a truly fascinating story and conversation.  Enjoy!   Feel free to leave your comments or thoughts about this podcast!  I'll see you in New Orleans at the NAEMSP Conference.  Feel free to find me and let me know what you think about the podcast.   Cheers,  Hawnwan Philip Moy MD Assistant Medical Director, Saint Louis Fire Department Division of Emergency Medicine Washington University in Saint Louis

Welcome to Alzheimer's Speaks Radio where we listen to all voices on dementia. Today we will have talk with some of the foundering members of Dementia Mentors: Gary Joseph LeBlanc, Richard Taylor, Michael Neuvirth  and Harry Urban. Demetia Mentors was built to help those newly diagnosed understand their life is not over, by connecting them with a mentor who has been living with the disease himself.  This is a fantastic program and resourceful  website which will help people around the world. Call in and join the conversation. Our second guest will be Dr. Koffler who is located in Miami Beach, Florida.  She is the Assistant Medical Director for Alzheimer's Research and Prevention Foundation, known as ARPF.  We will be talking about nutrition and why it's important to all of us!  Email    1-888-908-5766 Check out Alzheimer's Speaks Website for more resources and information - Blog, Free Webinars, Tools, Resource Directory and more.Support this Show: https://alzheimersspeaks.com/donate-now/See omnystudio.com/listener for privacy information.

Dr. Anthony Shih is a physician executive who has held a number of leadership positions across the healthcare industry.  He started his medical career as Assistant Medical Director for a community-based mental health organization serving immigrant and refugee populations in Oakland, California.  In 2001, Dr. Shih joined IPRO, one of the nation's leading independent, non-profit, health care quality improvement organizations. At IPRO, he held a variety of senior management positions, including Vice President of the Health Care Quality Improvement Program, Medical Director of Managed Care, Chief Quality Officer and Vice President of Strategy.  In addition, he also led IPRO's Health Care Transparency Group, a Web and technology team that was an early leader in public reporting of health care performance information. Dr. Shih most recently served as the Executive Vice President for Programs at the Commonwealth Fund, a national health services research and philanthropic organization dedicated to promoting a high performance health system in the United States.Dr. Shih is board-certified in Public Health and General Preventive Medicine.  He earned his B.A. in economics from Amherst College, an M.D. from the New York University School of Medicine, and an M.P.H. from the Columbia University Mailman School of Public Health.In this interview, Dr. Shih discusses payment reform, access, quality, and the cost of care, as well as many other critical topics in health today.

On the Thursday, February 28th 2013 broadcast at 3:30PM Pacific/6:30PM Eastern our concluding special guest in the HiMSS13 Coundown series isJohn Mattison MD, aka @JohneMattison, CMIO of Kaiser Permanente, Southern California. Dr Mattison began his medical career at UC San Diego and Scripps Clinic, where he practiced in many clinical settings including primary care, critical care, preventive medicine, hyperbaric medicine, trauma and helicopter medicine, and held several directorships while at Scripps Clinic, including Quality, Utilization, and Critical Care.   He joined Kaiser Permanente in 1989, and was appointed as Assistant Medical Director and Chief Medical Information Officer in 1992.   John's interest in systems design began as a marine biologist when he created several software applications to model population behavior.  He wrote his first electronic health record in 1984 and used fully automated medical records in his practice until the time he began a fulltime commitment to healthcare informatics.  He has built, designed, or implemented seven different EHR systems, most recently KP HealthConnect.  His team helped build and deploy the first highly scalable version of this system, which today stands as the largest private sector implementation of an EHR in the US.     John was director of the first and largest regional deployment, encompassing 5,000 physicians, 140 clinics, 13 hospitals, and 2.3million members, but he is quick to identify his many colleagues within KP who have provided the support, the resources and the skills necessary for such a monumental achievement. John is also the founder of CDA and CCD international standards for HIE.   Join us!