Podcasts about Family medicine

Episode 194: Acute low back pain.  Future Dr. Ibrahim presents a clinical case to explain the essential points in the evaluation of back pain.  Future Dr. Redden adds information about differentiating between a back strain and more serious diseases such as cancer, and Dr. Arreaza shares information about returning to work after back strain.Written by Michael Ibrahim, MSIV. Editing and comments by Jordan Redden, MSIV, and Hector Arreaza, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Dr. Arreaza:Welcome back, everyone. Today's topic is one that every primary care provider, emergency doctor, and even specialist sees routinely: low back pain. It's so common that studies estimate up to 80% of adults will experience it at some point in their lives. But despite how frequent it is, the challenge is to identify which cases are benign and which demand urgent attention.Jordan:Exactly. Low back pain is usually self-limiting and mechanical in nature, but we always need to keep an eye out for the rare but serious causes: things like infection, malignancy, or neurological compromise. That's why a good history and physical exam are our best tools right out of the gate.Michael:And to ground this in a real example, let me introduce a patient we saw recently. John is a 45-year-old warehouse worker who came in with two weeks of lower back pain that started after lifting a 50-lb box. He describes it as a dull, aching pain that radiates from his lower back down the posterior left thigh into the calf. He says it gets worse with bending or coughing, but he feels better when lying flat. He also mentioned some numbness in his left foot, but he denies any bowel or bladder issues. His vitals are completely normal. On exam, he had lumbar paraspinal tenderness, a positive straight leg-raise at 40 degrees on the left and decreased sensation in the L5 dermatome, though reflexes were still intact.Dr. Arreaza:That's a great case. Let's take a minute and talk about the straight leg raise test. This is a bedside tool we use to assess for lumbar nerve root irritation often caused by a herniated disc. ***Here's how it works: the patient lies supine, and you slowly raise their straight leg. If pain radiates below the knee between 30° and 70°, that suggests radiculopathy, especially involving the L5 or S1 nerve roots. Pain at higher angles is more likely due to hamstring tightness or mechanical strain.Michael:Right. So, stepping back: what do we mean by "low back pain"? Broadly, it's any pain localized to the lumbar spine, but it's often classified by type or cause:Mechanical (like muscle strain or degenerative disc disease), Radicular (nerve root involvement), Referred pain (like from pelvic or abdominal organs), Inflammatory (AS), and Systemic or serious causes like infection or malignancy. Jordan:In John's case, we're thinking radicular pain, most likely from a herniated disc compressing the L5 nerve root. That's supported by the dermatomal numbness, the leg pain, and that positive straight leg test.Dr. Arreaza:Good reasoning. Now, anytime we see back pain, our brains should run a checklist for red flags. These help us pick up more serious causes that require urgent attention. Let's run through the red flags.Michael:Sure. For fracture, we think about major trauma or even minor trauma in the elderly, especially those with osteoporosis or on chronic steroids. Also, anyone over 70 years old.Jordan:Then we have infections, which could include things like discitis, vertebral osteomyelitis, or epidural abscess. Red flags include fever, IV drug use, recent surgery, or immunosuppression.Michael:Malignancy is another critical one, especially if there's a history of breast, prostate, lung, kidney, or thyroid cancer. Clues include unexplained weight loss, night pain, or constant pain not relieved by rest.Jordan:And don't forget about inflammatory back pain, like ankylosing spondylitis, which is often seen in younger patients with morning stiffness that lasts more than 30 minutes and improves with activity.Dr. Arreaza:And of course, we always rule out cauda equina syndrome: a surgical emergency. That's urinary retention or incontinence, saddle anesthesia, bilateral leg weakness, or fecal incontinence. Missing this diagnosis can be catastrophic.Michael:Thankfully, in John's case, we don't see any red flags. His presentation is classic for uncomplicated lumbar radiculopathy. But we must stay vigilant, because sometimes patients don't offer up key symptoms unless we ask directly.Jordan:And that's where associated symptoms help guide us. For example:Radicular symptoms like numbness or weakness follow dermatomal patterns. Constitutional symptoms like fever or weight loss raise red flags. Bladder/bowel changes or saddle anesthesia raise alarms for cauda equina. Pain that wakes patients up at night might point to malignancy. Dr. Arreaza:So when do we order labs or imaging?Michael:Not right away. For most patients with acute low back pain, imaging is not needed unless they have red flags. If infection is suspected, we'd get CBC, ESR, and CRP. For cancer, maybe PSA or serum protein electrophoresis. And if inflammatory back disease is suspected, HLA-B27 can be helpful.Jordan:Yes, imaging should be delayed for at least six weeks unless red flags or significant neurologic deficits are present. When we do image, MRI is our go-to especially for suspected radiculopathy or cauda equina. X-rays can help if we're thinking about fractures, but they won't show soft tissue or nerve root issues.Michael:In the example from our case, since the patient doesn't have red flags, we'd go with conservative management: start NSAIDs and recommend activity modification. As this is the acute setting, physical therapy would not be recommended.Jordan:For the acute phase, research shows no serious difference between those with PT and those without in the long term. However, physical therapy is really the cornerstone of management for chronic back pain. It's not just movement: it's education, body mechanics, and teaching patients how to move safely. And PT can actually reduce opioid use, imaging, and injections down the line for patient struggling with long term back pain.Dr. Arreaza:Yes, and PT is not one-size-fits-all. PT might include McKenzie exercises, manual therapy, postural retraining, or even neuromuscular re-education. The goal is always to build core stability, promote healthy movement patterns, and reduce fear of motion.Jordan:Let's take a minute to talk about the McKenzie Method, a physical therapy approach used to treat lumbar disc herniation by identifying a specific movement, (often spinal extension) that reduces or centralizes pain. A common exercise is the prone press-up, (cobra pose for yoga fans) where the patient lies face down and pushes the upper body upward while keeping the hips on the floor to relieve pressure on the disc. These exercises should be done carefully, ideally under professional guidance, and discontinued if symptoms worsen.Michael:For our case patient, our working diagnosis is mechanical low back pain with L5 radiculopathy. No imaging needed now, no red flags. We'll treat conservatively and educate him about proper lifting, staying active, and recovery expectations.Jordan:We also emphasized to him that bed rest isn't helpful. In fact, bed rest can make things worse. Keeping active while avoiding heavy lifting for now is key.Dr. Arreaza:Return-to-work recommendations should be individualized. For example, an office worker, positioning while working, or work hours may be able to return to work promptly. However, those with physically demanding jobs may need light duty or be off work.Ice: no evidence of benefit. Heat: may reduce pain and disability in pain of less than 3 months, although the benefit was small and short.And we should always teach safe lifting techniques: bend at the knees, keep the load close, avoid twisting. It's basic knowledge, but it is very effective in preventing recurrence.Jordan:Now, if a patient fails to improve after 6 weeks of conservative therapy, or if they develop new neurologic deficits, that's when we think about referral to spine specialists or surgical consultation.Michael:And as previously mentioned: in cases where back pain becomes chronic (lasting more than 12 weeks) a multidisciplinary approach works best. That can include:Physical therapy, Cognitive behavioral therapy (CBT) And sometimes pain management interventions. Jordan:We can't forget the psychological toll either. Chronic back pain is associated with depression, anxiety, and opioid dependence. Increased risk factors include obesity, smoking, sedentary lifestyle, and previous back injuries.Dr. Arreaza:Well said. So, let's summarize. Michael?Michael:Sure! Low back pain is common, and most cases are benign. But we have to know the red flags that point to serious pathology. A focused history and physical exam are more powerful than many people realize. And the first step in treatment is almost always conservative, with a strong emphasis on maintaining physical activity.Jordan:And don't underestimate the value of patient education. Helping patients understand their pain, set realistic expectations, and stay active is often just as important as the medications or therapies we offer.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:Chou, R., Qaseem, A., Snow, V., Casey, D., Cross, J. T., Shekelle, P., & Owens, D. K. (2007). Diagnosis and treatment of low back pain: A joint clinical practice guideline from the American College of Physicians and the American Pain Society. Annals of Internal Medicine, 147(7), 478–491. https://doi.org/10.7326/0003-4819-147-7-200710020-00006Deyo, R. A., Mirza, S. K., Turner, J. A., & Martin, B. I. (2009). Overtreating chronic back pain: Time to back off? Journal of the American Board of Family Medicine, 22(1), 62–68. https://doi.org/10.3122/jabfm.2009.01.080102National Institute for Health and Care Excellence. (2020). Low back pain and sciatica in over 16s: Assessment and management (NICE Guideline No. NG59). https://www.nice.org.uk/guidance/ng59Qaseem, A., Wilt, T. J., McLean, R. M., & Forciea, M. A. (2017). Noninvasive treatments for acute, subacute, and chronic low back pain: A clinical practice guideline from the American College of Physicians. Annals of Internal Medicine, 166(7), 514–530. https://doi.org/10.7326/M16-2367UpToDate. (n.d.). Evaluation and treatment of low back pain in adults. Wolters Kluwer. https://www.uptodate.com (Access requires subscription)Theme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/. 

Have you been googling “burnout” at 2 a.m., or debating going back to school for a doctorate because, hey, maybe that'll at least give you more career options?In today's conversation, I speak with Renee Hamler, a seasoned family medicine PA-C and doctoral student who knows burnout inside and out. Renee opens up about her personal journey—what it felt like to hit a wall in a career she loves, what helped her climb out, and how going back to school gave her a fresh perspective on her identity as a clinician.We explore the power of taking small, consistent steps: setting boundaries, building a circle of support, finding joy outside of work, and giving yourself permission to rest. Renee and I talk about how mindfulness and gratitude can rewire your daily outlook, and why it's so important to separate your self-worth from your job title.This is not just a burnout episode—Renee is actually working on the issue of burnout as part of her doctoral project. She'll share ideas for getting unstuck, reigniting your purpose, and remembering who you are without your white coat.Whether you're feeling crispy around the edges or flat-out fried, tune in for practical encouragement, permission to slow down, and a reminder that you are not alone.CONNECT WITH RENEE: Facebook, LinkedInHOPE'S BOOK:⁠⁠⁠⁠⁠⁠⁠Healing Clinician Burnout, How to Revive Your Life and Career ⁠⁠⁠⁠⁠⁠⁠(available in ebook and paperback)CONNECT AND SIGN UP FOR COACHING:⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Hope's Website: www.coachhopecook.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Hope's IG @coachhopecook⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Hope's FB @hopeallencook⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Hope's LinkedIn: hope-cook-56041283/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Hope's YouTube @coachhopecook⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Email: hope.cook@gmail.comLove y'all, and remember: There's always hope!

Dr. Sarah Weinstein is a triple board-certified physician in Family Medicine, Lifestyle Medicine, and Sports Medicine. Fellowship-trained in Sports Medicine, she combines advanced sports medicine techniques with a holistic approach rooted in lifestyle medicine. With an emphasis on movement and food as medicine, she helps patients heal from injury, prevent future issues, and optimize their health using individualized exercise prescriptions, nutrition, and sustainable lifestyle changes.  Her ultimate objective is to empower her patients to prioritize these aspects of wellness to achieve optimal health, one step at a time. During her fellowship at the University of Colorado, Dr. Weinstein served as a team physician for NCAA Division I and professional athletes and now brings that same level of care to her community. When she's not in the office, she loves staying active, volunteering locally, teaching a group fitness class and spending time outdoors with her husband and two kids. Some of the topics we discussed were: How Dr. Weinstein's practice combines her skills in primary care, sports medicine, and lifestyle medicine How Dr. Weinstein incorporates lifestyle medicine into her patient visits Dr. Weinstein's practice model The most important factors of treating sports injuries The free health clinic that Dr. Weinstein volunteers at Practical tips for physicians who would like to open a practice involving sports medicine or lifestyle medicine How lifestyle medicine and sports medicine enhance each other by being so closely related What helped Dr. Weinstein actually move forward and take the leap on building her own practice How long it took Dr. Weinstein to actually open her practice after deciding to do it How Dr. Weinstein found the right medical malpractice insurance company and policy for her The most helpful thing that helped Dr. Weinstein on her path to building her practice And more! Learn more about me or schedule a FREE coaching call:https://www.joyfulsuccessliving.com/ Join the Voices of Women Physicians Facebook Group:https://www.facebook.com/groups/190596326343825/ Connect with Dr. Weinstein:Website:https://coresportsmedicine.com/ Email: info@coresportsmedicine.com Instagram:@drsassyweinstein Facebook:https://www.facebook.com/profile.php?id=61567208010632 Resources Mentioned: Direct Specialty Care Alliance The American College of Lifestyle Medicine Lifestyle Medicine for DPC Docs American Medical Society for Sports Medicine American Osteopathic Academy of Sports Medicine Private Practice 101 Webinar 

Send us a textSupport Roots' Current Fundraising Campaign!LCMD will be away for the summer. Will Dr Khan post anything in the meantime?? Find out by following her: On the newsletter at longcovidmd.comOn TikTok @LongCovidMDOn Instagram @LongCovidMDIn this episode of Long COVID MD, Dr. Zeest Khan highlights a healthcare system that effectively mitigated the pandemic and maintained community trust, while facing numerous structural obstacles. Should we follow this model of medicine more broadly? She interviews Dr. Noha Aboelata, Family Medicine physician and CEO of Roots Community Health, who shares insights on Root's holistic approach to healthcare, the importance of community trust, and the need for accessible and equitable health services. Roots played a tremendous role in the beginning of the COVID-19 pandemic. The organization offered testing, recognized patterns of viral spread, and shared critical information with the public before, and sometimes in place of, government agencies. Roots' model of rebuilding community trust allowed them to respond quickly and effectively against the COVID-19 pandemic, and continues to serve the community well. The conversation highlights the role of community health in addressing systemic inequities and the significance of empowering patients to advocate for their own health.People's Health BriefingHow Roots Pushed Medtronic to Improve Pulse OximetrySupport the showSubscribe for more at LongCovidMD.substack.com, and follow Dr Khan on X @doctor_zeest

Listen in as Joseph Kim, MD, MPH, MBA, interviews Natalie, Orbach, PA-C, to learn about how she implemented patient-centered and individualized treatment plans to improve obesity care at her practice, includingDiscussing weight and how nutrition, physical activity, mental health, and pharmacotherapy strategies can helpMeeting patients where they are at and offering slow, incremental changes that support long-term outcomesReferring patients to community resources and other professionals as needSharing lessons learned for those interested in implementing similar strategies in their practice PresenterJoseph Kim, MD, MPH, MBAPresidentQ Synthesis, LLCNewtown, PennsylvaniaNatalie Orbach, PA-CPhysician AssistantFeirtag & Ramos, PALutherville, Maryland Link to full program: https://bit.ly/45P0v8z

On tonight's show, I have Dr. Janet Nwaukoni to share about the importance of Gen Z when it comes to a shortage of those working in the field of family medicine. Listen & share.

Dr. Sarah Weinstein is a triple board-certified physician in Family Medicine, Lifestyle Medicine, and Sports Medicine. Fellowship-trained in Sports Medicine, she combines advanced sports medicine techniques with a holistic approach rooted in lifestyle medicine. With an emphasis on movement and food as medicine, she helps patients heal from injury, prevent future issues, and optimize their health using individualized exercise prescriptions, nutrition, and sustainable lifestyle changes.  Her ultimate objective is to empower her patients to prioritize these aspects of wellness to achieve optimal health, one step at a time. During her fellowship at the University of Colorado, Dr. Weinstein served as a team physician for NCAA Division I and professional athletes and now brings that same level of care to her community. When she's not in the office, she loves staying active, volunteering locally, teaching a group fitness class and spending time outdoors with her husband and two kids. Some of the topics we discussed were:Dr. Weinstein's first steps after deciding to open her private practiceResources that helped Dr. Weinstein when she was starting her practice Logistical steps Dr. Weinstein took to launch her practice How Dr. Weinstein found an office spaceHow Dr. Weinstein markets and finds her clients Dr. Weinstein teaching a group fitness class at a local gymPractical tips for physicians who want to open their own private practice And more!Learn more about me or schedule a FREE coaching call Join the Voices of Women Physicians Facebook GroupConnect with Dr. Weinstein:  WebsiteEmailInstagramFacebookResources Mentioned: Private Practice 101 WebinarDirect Specialty Care AllianceThe Private Medical Practice Academy Podcast with Dr. Sandra WeitzApple PodcastsSpotifyMy DPC Story Podcast with Dr. Maryal ConcepcionApple PodcastsSpotifyPodcast Episodes Mentioned: Ep 89 & 90: Building and Expanding a DPC Practice with Dr. Maryal ConcepcionPart 1 on Apple PodcastsPart 1 on SpotifyPart 2 on Apple PodcastsPart 2 on SpotifyEp 97: How to Build Your Online Brand with Dr. Dana CorrielApple PodcastsSpotify

What happens when you are a "general practitioner" but are passionate about Emergency Medicine or PEM. Listen to Dr. Allen Herman's story on practicing Emergency Medicine despite completing his training in Family Medicine. 

Lauren and Julia DaSilva are graduating Medical School at Western are are going into Family Medicine. They talk about what made them want to be family doctors.

This episode covers:In this episode, we discuss foundational lifestyle changes that are essential for healing, the connection between Lyme disease and autoimmune disorders, redefining stress in modern life, and so much more.Since the beginning of her medical career, Dr. Casey Kelley, M.D. continually asked questions about health, longevity, and healing that conventional medicine didn't answer. Seeking those answers, she began studying Functional Medicine to complement her traditional medical studies. Utilizing this multi-disciplinary approach, Dr. Kelley has been at the forefront of Integrative Medicine, devoting her career to treating patients in a highly personalized manner that focuses as much on overall health and wellness as it does on specific issues and diagnoses.Board Certified in Family Medicine, Dr. Kelley was among the first physicians to add a board certification in Integrative Medicine as well. She has studied the causes, effects, and treatments of Lyme Disease extensively, and lectures nationally on this and other topics. Dr. Kelley graduated from The Ohio State University College of Medicine and completed her residency in Family Medicine at St. Joseph Hospital in Chicago.  She is a ten-year member of the Institute of Functional Medicine (IFM), a Treasurer of The International Lyme and Associated Disease Society (ILADS), and is a Founding Member of the Academy of Integrative Health and Medicine (AIHM).  Dr. Kelley is on the faculty at the Feinberg School of Medicine at Northwestern University. Links mentioned during this episode:Dr. Kelley's Course: https://www.healwithcase.com/courses/Groundwork-for-healingDr. Kelley's Instagram: https://www.instagram.com/caseintegrativehealth/Free Initial Consultation with Dr. Megan: https://p.bttr.to/3a9lfYkLyons' Share Instagram: www.instagram.com/thelyonsshareJoin Megan's Newsletter: www.thelyonsshare.org/newsletter

Diabetes Core Update is a monthly podcast that presents and discusses the latest clinically relevant articles from the American Diabetes Association's four science and medical journals – Diabetes, Diabetes Care, Clinical Diabetes, and Diabetes Spectrum. Each episode is approximately 25 minutes long and presents 5-6 recently published articles from ADA journals. Intended for practicing physicians and health care professionals, Diabetes Core Update   discusses how the latest research and information published in journals of the American Diabetes Association are relevant to clinical practice and can be applied in a treatment setting. Welcome to diabetes core update where every month we go over the most important articles to come out in the field of diabetes. Articles that are important for practicing clinicians to understand to stay up with the rapid changes in the field.  This issue will review: 1.    Intensive Blood-Pressure Control in Patients with Type 2 Diabetes 2.    Cardioprotective Glucose-Lowering Agents and Dementia Risk A Systematic Review and Meta-Analysis 3.    A Randomized Trial of Automated Insulin Delivery in Type 2 Diabetes 4.    Screening for Metabolic Dysfunction–Associated Steatotic Liver Disease–Related Advanced Fibrosis 5.    Risk of Urogenital Infections in People With Type 2 Diabetes Initiating SGLT2i Versus GLP-1RA in Routine Clinical Care   For more information about each of ADA's science and medical journals, please visit Diabetesjournals.org. Hosts: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health John J. Russell, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Chair-Department of Family Medicine, Abington Jefferson Health

Many chronic health conditions—such as IBS, asthma, and autoimmune disorders—can be traced back to imbalances in the gut. Disruptions to the microbiome caused by antibiotics, poor diet, food sensitivities, and environmental exposures can lead to inflammation, malabsorption, and increased intestinal permeability (leaky gut). Addressing gut health through a structured Functional Medicine approach called the 5R's of gut repair—removing harmful triggers, replacing missing digestive factors, reinoculating with beneficial bacteria, repairing the gut lining, and rebalancing lifestyle factors—can restore balance and improve systemic health.  In this episode, I discuss, along with Dr. Elizabeth Boham and Raja Dhir, the Functional Medicine approach to healing the gut and why the gut is at the center of imbalances in the body, including many health conditions. Dr. Elizabeth Boham is Board Certified in Family Medicine from Albany Medical School, and she is an Institute for Functional Medicine Certified Practitioner and the Medical Director of The UltraWellness Center. Dr. Boham lectures on a variety of topics, including Women's Health and Breast Cancer Prevention, insulin resistance, heart health, weight control and allergies. She is on the faculty for the Institute for Functional Medicine. Raja Dhir is the co-founder and co-CEO of Seed Health, a microbiome science company developing innovative probiotics and living medicines to advance human and planetary health. He specializes in translating cutting-edge microbial research into impactful products and leads Seed Health's academic collaborations with institutions such as MIT, Harvard, Stanford, Caltech, and the NIH. Raja co-chairs Seed's Scientific Board alongside Dr. Jacques Ravel, guiding research across microbiology, immunology, genetics, and ecology. He also directs LUCA Biologics, a company focused on the vaginal microbiome and women's health, and oversees SeedLabs, which drives environmental initiatives. Through this work, Raja plays a key role in accelerating microbiome-based solutions from discovery to market. This episode is brought to you by BIOptimizers. Head to bioptimizers.com/hyman and use code HYMAN10 to save 10%. Full-length episodes can be found here: What Is Leaky Gut And How Can You Treat It?How to Select a Probiotic and the Future of the MicrobiomeHow To Do The 10-Day Detox

Effective leadership is about more than decision-making—it's about advocacy, collaboration, and advancing a shared mission. In partnership with the Association of Departments of Family Medicine (ADFM), STFM kicks off a three-part series on The STFM Podcast exploring the lifecycle of leadership in academic family medicine. In this first episode, Grant Greenberg, MD, and Wanda Cruz-Knight, MD, MBA, CPE, FAAFP, discuss how to lead within the complex ecosystems of academic medical centers and health systems. From advocating for departments to building coalitions and managing institutional change, they share insights on what it takes to lead with impact.Hosted by Omari A. Hodge, MD, FAAFP and Jay-Sheree Allen Akambase, MDCopyright © Society of Teachers of Family Medicine, 2025Resources:STFM Understanding Health Systems CoursesSTFM Leading Change CourseSTFM Emerging Leaders FellowshipSTFM Quick Consult - Connecting STFM members for professional development, coaching, and mentorshipADFM Leader Development Committee -  Resources from the Leader Development Committee for New & Interim ChairsADFM LEADS FellowshipGuest Bios:Grant Greenberg, MDDr. Greenberg is the Chief Medical Executive for Primary Care with oversight of Family Medicine, General Internal Medicine, and ExpressCARE operations.  Since joining Lehigh Valley Health Network in October 2016, Dr. Greenberg has also served as the Leonard Parker Pool Endowed Chair of Family Medicine and is a Professor of Medical Education and Family Medicine for the University of South Florida Morsani College of Medicine. Dr. Greenberg received his undergraduate degree in Biology and English from the University of Michigan.  Before medical school, he received a master's degree in Ecology and Evolutionary Biology at Indiana University in Bloomington, IN.  He received his medical degree from the University of Michigan Medical School in Ann Arbor, MI.  He completed his residency training in Family Medicine at the University of Michigan and completed a master's degree in health services administration from the University of Michigan School of Public Health.  He has also completed the Health Management Academy's GE Scholars Fellowship. Dr. Greenberg is active with the Association of Departments of Family Medicine, serving as the Chair of the Membership Committee, participating on the Leadership Development Committee, contributes to the steering committee for the “LEADS” fellowship, and is on the Board of Directors.  Dr. Greenberg is a contributor to the MP3 collaborative “Making Primary Care and Population Health Primary” sponsored by  the ABFM.  Dr. Greenberg has been a member of the American Cancer Society National Lung Cancer Round Table since its inception, serving on the Screening and Implementation Work Group, the Early Detection Strategies Work Group,  and the Fiscal Health Work Group.  He has 4 children (mostly adult, but still “on the payroll”).Wanda Cruz-Knight, MD, MBA, CPE, FAAFPDr. Cruz-Knight is the Owen L. Coon Endowed Chair for the Department of Family Medicine at Endeavor Health and Clinical Professor at University of Chicago Pritzker School of Medicine. She is a graduate of Case Western Reserve School of Medicine and completed her residency training in Family Medicine a

Building Equity into Health Care AI: From Promise to PracticePresented by Irene Dankwa-Mullan, MD, MPH, Dartmouth CollegeSTFM Annual Spring Conference 2025 Blanchard Lecture | Wednesday, May 7, 2025As the integration of artificial intelligence (AI) in health care accelerates, the promise of improved patient outcomes and operational efficiencies is accompanied by critical concerns about the impact on health equity. Family medicine, with its commitment to holistic, patient-centered care, plays a vital role in ensuring that AI solutions contribute to more equitable health care delivery rather than perpetuating existing disparities.In this keynote presentation, the presenter will explore how health care AI can be harnessed to advance equity while also addressing the significant risks posed by biased data and flawed algorithms. Drawing on her work in AI ethics and health equity, Irene will provide a practical framework for the intentional design and deployment of AI tools that promote fairness in patient care. She will discuss key strategies for mitigating biases in clinical algorithms, ensuring diverse patient representation in AI training data, and advocating for policies and practices that uphold equity at every stage of AI development.This session will empower health care professionals and educators to actively engage in shaping AI's future—transforming concerns into action by advocating for responsible AI use, inclusive design processes, and equitable outcomes for all patient populations.Learning ObjectivesAt the end of the session each participant should:Identify potential sources of bias in health care AI systems and understand their impact on health equityUnderstand the principles of equitable AI design and deployment in clinical settingsExplore strategies for family medicine educators to advocate for the intentional development and use of AI technologies that promote health equityDevelop actionable steps to ensure diverse representation and fairness in data used for health care AI algorithmsRecognize the role of health care professionals in shaping the future of AI to achieve more equitable patient outcomesCopyright © Society of Teachers of Family Medicine, 2025Irene Dankwa-Mullan, MD, MPHIrene Dankwa-Mullan, MD, MPH, is a leading expert at the intersection of artificial intelligence, health equity, and clinical care, with over a decade of experience driving innovation in the health care industry. She has worked extensively with academic institutions, nonprofit organizations, and health care systems to develop equitable AI frameworks that ensure the fair and inclusive deployment of technology in medicine. Her expertise lies in integrating AI and machine learning tools into clinical workflows while advocating for policies that prioritize diverse patient populations and mitigate systemic biases in data and algorithms.Dr Dankwa-Mullan currently advises on how to evaluate health care delivery systems' readiness to procure, evaluate, and deploy AI solutions that adhere to the highest ethical and technical standards. She also works with early-stage health technology start-up companies, where she leverages her industry experience and expertise to build fair and inclusive AI solutions. She has published widely on the ethical implications of AI in health care and frequently speaks at national and international conferences on the role of AI in advancing health equity. She is passionate about educating the next generation of health care leaders to be advocates for responsible, patient-centered AI. She is committed to ensuring that AI serves as a tool for reducing health disparities, not exacerbating them.

Welcome to NCFM Today! Today, we're reviewing the Best News in North Carolina Family Medicine: The Care First Act (and its progress through the NC House!), the 2025 Family Medicine Match results, the Collaborative Care Management Capacity Building Fund, and other key topics!Learn more about the Academy at www.ncafp.com!

Listen as Michael S. Blaiss, MD provides case-based perspectives on chronic cough recognition, burden, management, and pathophysiology and describes the evolving treatment landscape for refractory chronic cough.PresenterMichael S. Blaiss, MDClinical Professor of PediatricsDivision of Allergy-ImmunologyMedical College of Georgia at Augusta UniversityAugusta, GeorgiaLink to full program: https://bit.ly/4kweynG

Listen in as Evette Whaley and Katie Smiley PA-C talk about innovative strategies for NPs and PAs to improve treatment for pediatric patients with atopic dermatitis. They discuss how to assess the whole patient and their family to better understand the impact of the disease on their quality of life. They also discuss newer treatments and how they can be incorporated into a comprehensive management plan for pediatric patients and their caregivers. Presenters:Evette WhaleyCaregiverBaltimore, Maryland Katie Smiley PA-CGrants & Clinical DirectorProgram Coordinator, Multidisciplinary Atopic Dermatitis ProgramAllergy & Asthma Medical GroupRady Children's HospitalSan Diego, CaliforniaLink to full program:https://bit.ly/43svVyJ

What Does It Meant To Be A (Family) PhysicianPresented by Thomas L. Schwenk, MD, University of NevadaSTFM Annual Spring Conference 2025 General Session | Monday, May 5, 2025The enduring values of family medicine center on the compassionate, comprehensive care of patients over time. That care has defined family medicine and motivated family physicians for decades. Today, simply providing excellent care for patients may not be enough in the face of an extraordinarily perverse and dysfunctional health care system that often does everything in its power to make caring for patients difficult, stressful and discouraging. The regenerative power of the physician-patient relationship is often compromised and thwarted by a health care system that ranks as the worst in the world among developed countries. The health care system rides on the backs of family and other primary care physicians, and those backs are bending painfully under the system's weight.The solution lies in using the power of the physician-patient relationship as the source of motivation and energy to fight for the very soul of our profession, fight for the core of what it means to be a family physician, fight for operational changes that are designed for quality instead of efficiency, fight for informational and technological solutions that promote continuity, and fight for model operations that show our learners how attractive family medicine can be. This fight will require leadership at all levels of the discipline of family medicine. Through stories and personal anecdotes from his career, the presenter will illustrate the regenerative power of the physician-patient relationship and the power of the family physician's role as an agent for change.Learning ObjectivesAt the end of the session each participant should:Be exposed to the core importance and regenerative power of the physician-patient relationshipHave the opportunity to reflect on their own commitment to the core attributes of the physician-patient relationship as the motivation to fight for operational changes in the health care systemHave the opportunity to consider their role as a leader in preserving and supporting the physician-patient relationshipCopyright © Society of Teachers of Family Medicine, 2025Thomas L. Schwenk, MDThomas L. Schwenk, MD, holds an appointment as dean emeritus at the University of Nevada, Reno, having served as dean of the School of Medicine and Vice-President of Health Sciences from 2011–2021.Dr. Schwenk earned his B.S. degree in chemical engineering and M.D. from the University of Michigan. He trained at the University of Utah and practiced in Park City, Utah, before returning to the University of Michigan where he served as chair of the Department of Family Medicine from 1986–2011. He has served on the Board of Directors of the American Board of Family Medicine and was elected to the National Academy of Medicine in 2002. He also served for four years on the Administrative Board of the Council of Deans of the Association of American Medical Colleges. Dr Schwenk's research has focused most recently on mental health and wellness in medical students, residents and physicians. He has co-authored over 160 publications, and has consulted to over 50 medical schools and teaching hospitals in various capacities. All Episodes

Skin issues like acne, eczema, and rosacea are deeply connected to internal imbalances, especially those originating in the gut. It is important to explore diet—particularly sugar, refined carbs, and dairy—because it can drive inflammation, insulin resistance, and hormonal disruption, all of which contribute to poor skin health. Topical treatments and antibiotics may provide short-term relief, but they often disrupt the skin and gut microbiome, worsening conditions over time. A Functional Medicine approach focuses on restoring gut balance, identifying food sensitivities, and supporting detoxification pathways with nutrient-dense foods, supplements, and lifestyle practices. Addressing the root causes not only improves skin but also promotes systemic healing and resilience. In this episode, I speak with three of our doctors at The UltraWellness Center—Dr. Elizabeth Boham, Dr. Cindy Geyer, and Dr. Todd LePine—about why, when it comes to skin care, we need to look inside the body first. Dr. Elizabeth Boham is Board Certified in Family Medicine from Albany Medical School, and she is an Institute for Functional Medicine Certified Practitioner and the Medical Director of The UltraWellness Center. Dr. Boham lectures on a variety of topics, including Women's Health and Breast Cancer Prevention, insulin resistance, heart health, weight control and allergies. She is on the faculty for the Institute for Functional Medicine. Dr. Cindy Geyer received her bachelor of science and her doctor of medicine degrees, with honors, from the Ohio State University. She completed residency in internal medicine at Strong Memorial Hospital in Rochester, N.Y. and is triple board certified in internal medicine, integrative medicine and lifestyle medicine. Dr. Todd LePine graduated from Dartmouth Medical School and is Board Certified in Internal Medicine, specializing in Integrative Functional Medicine. He is an Institute for Functional Medicine Certified Practitioner. Prior to joining The UltraWellness Center, he worked as a physician at Canyon Ranch in Lenox, MA, for 10 years. Dr. LePine's focus at The UltraWellness Center is to help his patients achieve optimal health and vitality by restoring the natural balance to both the mind and the body. His areas of interest include optimal aging, bio-detoxification, functional gastrointestinal health, systemic inflammation, autoimmune disorders, and the neurobiology of mood and cognitive disorders. Dr. LePine enjoys skiing, kayaking, hiking, camping, and golfing in the beautiful Berkshires, and is a fitness enthusiast. This episode is brought to you by BIOptimizers. Head to bioptimizers.com/hyman and use code HYMAN10 to save 10%. Full-length episodes can be found here: Treating Acne From The Inside OutChoosing Skin Care Products that Won't Make You SickTreating Adult Acne & Rosacea From The Inside Out

Welcome to the Sustainable Clinical Medicine Podcast! In this episode, Dr. Sarah Smith sits down with Dr. AJ (Amjed) Kadhim-Saleh, a dynamic family physician and entrepreneur from Toronto. Dr. AJ shares his inspiring journey from dreaming about building his own clinic during residency to actually opening the doors of his practice—starting with just a concrete slab and a vision of long-term sustainability in medicine. The conversation dives into the nuts and bolts of setting up a clinic from scratch, the importance of efficient systems, and the sometimes-overwhelming administrative burden that comes with being both a physician and practice owner. Dr. AJ openly discusses the challenges he faced with paperwork, how it began to impact his family life, and the pivotal moment that led him to co-found Pippin AI, an innovative AI scribe designed to support family doctors. Along the way, Dr. AJ and Dr. Smith explore the often overlooked business side of medical practice, the need for practical education in practice management, and how embracing change (with a little entrepreneurial grit and a supportive team) can help create a more sustainable clinical day—and a life outside of medicine. Whether you're a new resident thinking about your future, a physician looking for inspiration to build a more efficient practice, or just curious about how technology is shaping the future of primary care, this episode is packed with insights, practical tips, and plenty of encouragement to pursue your vision. Here are 3 key takeaways from this episode: Build with Vision & Community: Starting a clinic from the ground up is about more than architectural plans—it's about designing systems, choosing supportive partners, and cultivating a team invested in sustainable change. Embrace Technology for Sustainability: Efficient tools—like secure patient portals and AI-powered documentation—can relieve the paperwork burden, free up precious hours, and allow us to focus on quality patient care (and our lives outside the clinic!). Change is a Team Sport: Successful practice transformation hinges on bringing your people along for the ride. Clearly communicate the “why” behind changes, tailor solutions to their needs, and foster an environment of ongoing collaboration and support. Meet Dr. AJ (Amjed) Kadhim-Saleh: Dr. Amjed Kadhim-Saleh (AJ for short) is a community family physician, clinic owner, and health technology entrepreneur in Toronto. AJ graduated medical school from the University of Ottawa, and completed his family medicine residency at the University of Toronto. Serving a diverse population of over 1700 patients, AJ is passionate about comprehensive family medicine and building efficient practice. AJ developed an AI-powered Physician Assistant called Pippen, which aims to alleviate administrative burden among physicians and encourage better doctor-patient interactions. AJ is also a Clinical Lecturer at the University of Toronto. -------------- Would you like to view a transcript of this episode? Click here **** Charting Champions is a premiere, lifetime access Physician only program that is helping Physicians get home with today's work done. All the proven tools, support and community you need to create time for your life outside of medicine. Learn more at https://www.chartingcoach.ca **** Enjoying this podcast? Please share it with someone who would benefit. Also, don't forget to hit “follow” so you get all the new episodes as soon as they are released. **** Come hang out with me on Facebook or Instagram. Follow me @chartingcoach to get more practical tools to help you create sustainable clinical medicine in your life. **** Questions? Comments? Want to share how this podcast has helped you? Shoot me an email at admin@reachcareercoaching.ca. I would love to hear from you.

Some relationships stand the test of time—others unravel. In this week's episode, both of our storytellers explore what it means to heal, let go, and move forward. Part 1: Stuck in a monsoon on Kauai, Belinda Fu unintentionally ruins a friendship with a classmate. Part 2: Matt Storrs blames a dinosaur scientist's theory for the end of his marriage. Belinda Fu, MD, (“theImprovDoc”) is a physician, educator, and performing artist based in Seattle. She travels the country teaching about medical improv, using the principles of improvisational theater to improve wellbeing, health, communication, and patient care. (medicalimprov.org) She is also a Clinical Associate Professor of Family Medicine at the University of Washington. Belinda performs and directs improv theatre, studies jazz voice, makes really good popcorn, takes naps in the sun, and would like to say hi to your dog. belindafu.com Matt Storrs is a comedian and storyteller based out of NYC and originally from Phoenix, AZ. Matt created a solo show based upon the story in the episode entitled "Jurassic Heartbreak." It will next be performed at the Harrisburg Fringe Festival in July (https://www.hbgfringe.com/). He has also been featured on NPR and PBS. Matt is known for sharp stories and his esoteric comedy. Matt Storrs is a humor person. He can be found online at @mtstorrs   Learn more about your ad choices. Visit megaphone.fm/adchoices

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In this episode, Drs. Shruti Javali and Adnaan Edun speak with Drs. Maryal Concepcion and Jeannine Rodems live from the CAFP All Member Advocacy Meeting to talk about Direct Primary Care (DPC), what DPC is, how it works with the patient relationship, and resources available for any family physician look at DPC as a potential career. Guests: Maryal Concepcion, MD, FAAFP is a board-certified rural family physician dedicated to serving patients in Northern California since 2012 and Calaveras County since 2015. Passionate about community-focused medicine, she provides comprehensive care for patients of all ages, from infants and expectant mothers to children and adults, including in-office procedures. Jeannine Rodems, MD, FAAFP is a board-certified family medicine physician who brings more than 25 years of experience to Santa Cruz Direct Primary Care. She is a graduate of UC Santa Cruz (go Slugs!), and completed her medical degree at the UCLA School of Medicine with her residency through the UCLA Family Medicine Residency program. She has been an active member of the local physician community in Santa Cruz County for several years. She has been the past president of the Santa Cruz County Medical Society. She has been very active with the California Academy of Family Physicians, having been a previous member of their board of directors, and served as a past president of the Santa Cruz – Monterey — San Benito CAFP Chapter. Shruti Javali, MD is family medicine physician who sees patients of all ages with a specific focus on obstetrics and women's health. In addition to each patient's medical condition, her approach also incorporates whole-person care, considering factors such as nutrition, exercise and work/life balance. Dr. Javali earned her medical degree from Saba University School of Medicine in the Dutch Caribbean and undergraduate degree from McMaster University in Hamilton, Canada. She completed her family medicine residency through Michigan State University at Mercy Health Grand Rapids in Michigan. Adnaan Edun, MD is a board-certified family medicine physician who provides preventive care, such as wellness checks, physicals, health counseling and more, he treats patients with chronic and complex conditions, including obesity, hypertension and depression. Growing up, Dr. Edun became interested in pursuing a career in healthcare as he watched his mother continue to increase her nursing knowledge by studying at home. That interest was solidified when he had open heart surgery, after which he saw healthcare through a different lens. The experience shaped his desire to study medicine and impacts how he provides care with compassion. Dr. Edun also is interested in global and rural medicine and learning about how medicine is practiced around the world. He has participated in medical trips to Peru, Guatemala and Kenya and hopes to continue to share his healthcare knowledge with other underserved communities in the future. Rob Assibey, MD, FAAFP (he/him) identifies as Ghanaian American. Dr. Assibey is the Associate Program Director at San Joaquin General Hospital Family Medicine Residency Program. He practices full spectrum family medicine with an emphasis on street medicine, addiction medicine, SNF. Dr. Assibey is the District 8 Director on the CAFP Board, and a member of the JEDI Committee. Resources: CAFP Direct Primary Care information - www.familydocs.org/dpc  CAFP's New Physician Toolkit - www.familydocs.org/nptoolkit  AAFP Direct Primary Care - https://www.aafp.org/family-physician/practice-and-career/delivery-payment-models/direct-primary-care.html  DPC Summit (July 24-27, 2025) - https://www.dpcsummit.org/home.html  CaliDPC - www.calidpc.com  Inaugural CaliDPC Docs Summit (June 7-8, 2025) - https://www.calidpc.com/resources  The Family Docs Podcast is hosted by Rob Assibey, MD, FAAFP.   The Family Docs podcast is developed, produced, and recorded by the California Academy of Family Physicians. The views and opinions expressed in this program are those of the speakers and do not necessarily reflect the views or positions of any entities they represent or the California Academy of Family Physicians. More information at www.familydocs.org/podcast. Visit the California Academy of Family Physicians online at www.familydocs.org. Follow us on social media: Twitter - https://twitter.com/cafp_familydocs  Instagram - https://www.instagram.com/cafp_familydocs  Facebook - https://www.facebook.com/familydocs 

The Environment We Live In and Health: A Complex RelationshipDeploy: Code: WOLVEFDescription:Join us on "The Environment We Live In and Health: A Complex Relationship," where we delve into the intricate dynamics between our environment and human health. This episode explores how environmental factors shape our well-being, examining the complex interplay between health outcomes and the world around us. We'll unpack the latest research, highlight innovative solutions, and tackle pressing challenges at the intersection of environmental science and public health. Whether you're a healthcare provider, an environmental advocate, or simply curious about the world we live in, this podcast will equip you with insights to foster a healthier future for both people and the planet. Tune in and discover how together we can create a sustainable, thriving environment for generations to come!Objectives: Discuss the intricate dynamics between environmental factors and human health and wellness. Explain the impact of the environment on health and well-being and the complex interplay between health outcomes and the surrounding world. Identify and appraise the latest information, innovative solutions, and pressing challenges at the intersection of environmental science and public health. Guests: Gina Alexander, PhD, MPH, MSN, RN, Texas Christian UniversityGina Hill: https://cse.tcu.edu/faculty-staff/view/gina-hill Brendan Lavy: https://cse.tcu.edu/faculty-staff/view/lavy-brendanBios: Gina Alexander, PhD, MPH, MSN, RNDr. Gina Alexander, Professor in the Harris College of Nursing and Health Sciences at Texas Christian University, champions interprofessional collaboration through education, research, and practice. She teaches public health nursing and coordinates interprofessional education initiatives with colleagues on campus and throughout the community.Dr. Alexander leads interprofessional, participatory action research focused on promoting equitable access to nature and food, improving social determinants of health in the local community and beyond. As the project lead of RxPLORE™: Prescribing Life Outdoors and Real Exploration, she develops community-academic-practice partnerships to advance nature-based health promotion and environmental stewardship.With a public health nursing practice grounded in collective action and advocacy, Dr. Alexander co-leads the Fort Worth Climate Safe Neighborhood Coalition and serves on the Immunization Collaboration of Tarrant County. Within the Association of Community Health Nursing Educators, she serves as Policy Committee Chair.Gina Jarman Hill, PhD, RD, LDDr. Gina Jarman Hill is a Professor in and the Chair of the Department of Nutritional Sciences at Texas Christian University (TCU). She joined the faculty of the Department of Nutritional Sciences in 2003. Dr. Hill earned her PhD in Nutrition from Texas Tech University in Lubbock, TX. Hill is a Registered and Licensed Dietitian and a member of the Hunger and Environmental Nutrition (HEN) dietetic practice group and the Dietitians in Integrative and Functional Medicine dietetic practice group. Her current research interests include hunger and food security, sustainability, urban agriculture, and community nutrition education and health. Hill is a Texas Master Gardener, is trained in Permaculture Design, and is an active community volunteer. In her spare time she enjoys gardening, spending time with her family, cooking, traveling and reading.Brendan Lavy, PhDDr. Brendan Lavy is an Assistant Professor at Texas Christian University. As a Professor in the Environmental and Sustainability Sciences, his teaching and research interests include sustainability metrics, business sustainability, urban environmental management, disaster recovery and resilience, watershed resilience, and geographic information systems. Dr. Lavy's research projects include how businesses' sustainability practices align with principles of the circular economy and the UN Sustainable Development Goals, how municipal environmental ordinances and their outcomes support urban sustainability initiatives, and how the recovery of parks and protected places influences the recovery of communities impacted by disasters. References:American Nurses Association. (2023, September 14). Nurses' role in addressing global climate change, Climate Justice, and health. ANA. https://www.nursingworld.org/practice-policy/nursing-excellence/official-position-statements/id/climate-change/ Haq, C., Iroku-Malize, T., Edgoose, J., Prunuske, J., Perkins, A., Altman, W., & Elwood, S. (2023). Climate change as a threat to health: Family medicine call to action and response. The Annals of Family Medicine, 21(2), 195–197. https://doi.org/10.1370/afm.29...

Garrett Butler, MD. Husband, father, son, friend, and family doc in rural WV. Undergraduate in Physics from Johns Hopkins University. Undergraduate in Molecular and Cell Biology from Towson University. MD from West Virginia University School of Medicine. Family Medicine residency at WVU SOM. Hospitalist at Vandalia Health Davis Medical Center. Outpatient family physician at Vandalia Health Broaddus Family Care. Hospitalist at Vandalia Health Broaddus Hospital. Medical director of Mansfield Place nursing home. Work With Us: Arétē by RAPID Health Optimization Links: Dr. Garrett Butler - Old Fellow Manor Anders Varner on Instagram Doug Larson on Instagram Coach Travis Mash on Instagram

Listen in as Paula Henao, MD; Rohit Loomba, MD, MHSc; Cheryl Pirozzi, MD, MS; and Corinne Young, NP, FCCP, discuss their screening and monitoring strategies for patients with alpha-1 antitrypsin deficiency, including:Why early detection is key for improving patient outcomesHow to monitor through use of noninvasive imaging and biopsy per guideline recommendationsHow to coordinate patient care to provide much-needed multidisciplinary careWhat therapies in the pipeline could transform the treatment landscape for this genetic disease PresentersPaula Henao, MDAssistant Professor of MedicineDivision of Pulmonary, Allergy and Critical Care MedicinePenn State Hershey Medical CenterHershey, PennsylvaniaRohit Loomba, MD, MHScProfessor of MedicineChief, Division of Gastroenterology and HepatologyDirector, MASLD Research CenterUniversity of California, San DiegoSan Diego, CaliforniaCheryl Pirozzi, MD, MSAssociate Professor of Internal MedicineDivision of Pulmonary and Critical Care MedicineUniversity of UtahSalt Lake City, UtahCorinne Young, NP, FCCPPresident/FounderAssociation of Pulmonary Advanced Practice ProvidersColorado Springs, ColoradoLink to full program: https://bit.ly/4dgCRnq

Have you ever struggled to support a close friend or family member dealing with a mental health condition? How do you know when you're truly helping rather than enabling? When should you push, simply show up, or even step away? If these questions resonate with you, you're not alone—at least 20% and possibly up to 40% of people will face this reality at some point in their lives. On this week's podcast, you'll meet a psychologist who shares her research and clinical experiences. Listen and learn: How to differentiate between supporting and enabling a loved one Key questions to ask yourself if you're in a caregiving role The impact of online support groups and AI on mental health care Strategies for handling difficult or unpleasant caregiving situations How to find affordable mental health resources locally and nationally Common challenges of caring for aging family members and how to cope Links www.SeedsofHopeBooks.com ABOUT OUR GUEST Dr. Michelle D. Sherman is a licensed clinical psychologist with over 25 years of experience, specializing in individual and couples therapy. She is a professor in the Department of Family Medicine and Community Health at the University of Minnesota Medical School and a board-certified expert in couples and family psychology. Her work focuses on supporting families dealing with mental illness, PTSD, and trauma. She is the author of Loving Someone with a Mental Illness or Trauma History. Like the Show? Leave us a review Check out our YouTube channel

Listen in as Joseph Kim, MD, MPH, MBA, interviews Sejal Desai, MD, DABOM, to learn about how she implemented virtual support groups to improve obesity care at her practice, including:Dedicating 5 support groups with chat features to obesity-specific topics (eg, sleep, nonscale wins)Moderating these chats to ensure no misinformation is shared and a positive, safe space is maintainedExpanding to include other virtual options that allow patients to engage more in their careUtilizing free and subscription-based services to aid in marketing effortsSharing lessons learned for those interested in implementing similar virtual options for their patients PresentersJoseph Kim, MD, MPH, MBAPresidentQ Synthesis, LLCNewtown, PennsylvaniaSejal Desai, MD, DABOMBoard-Certified Obesity Medicine PhysicianOwner & Medical DirectorTula Medical Weight Loss & WellnessKaty, TexasLink to full program: https://clinicaloptions.com/content/qi-resource-hub

Picture a hospital room late at night, the soft hum of machines in the background. A family gathers quietly around their loved one, unsure how to navigate the complexities of end-of-life care. It's a scene playing out every day across the country, highlighting a crucial yet often neglected part of healthcare—the way we care for people as their lives near an end. Joining me today is Ira Byock, a renowned physician, author, and passionate advocate for palliative care, whose groundbreaking work has transformed how we think about living—and dying—well. As the Emeritus Professor of Medicine and Community & Family Medicine, Dartmouth Geisel School of Medicine, Ira has dedicated his career to ensuring that end-of-life care is compassionate, comprehensive, and patient-centered. From developing the influential Missoula Demonstration Project to leading the Robert Wood Johnson Foundation's initiatives on end-of-life care, Ira's pioneering efforts have touched millions of lives. Drawing deeply from his early experiences in rural family medicine, Ira witnessed firsthand the profound gaps in care for dying patients, sparking a lifelong mission to humanize healthcare. His belief that moments of crisis can also be opportunities for growth and wellbeing and reshaped our understanding of what it means to care for the whole person. In this episode, we explore Ira's remarkable journey—from a young physician confronting ethical dilemmas, to a visionary leader reshaping the landscape of hospice and palliative care. We'll discuss the challenges of balancing compassionate care with a profit-driven healthcare system, the transformative power of treating patients as whole people, and Ira's innovative vision for a more humane and effective healthcare future. Do you have thoughts on this episode or ideas for future guests? We'd love to hear from you. Email us at hello@rosenmaninstitute.org.  

Doctor's Farmacy with Mark Hyman, MD: Read the notes at at podcastnotes.org. Don't forget to subscribe for free to our newsletter, the top 10 ideas of the week, every Monday --------- Many people struggle with mysterious symptoms like fatigue, brain fog, food sensitivities, and skin issues—only to be misdiagnosed or dismissed altogether. This conversation highlights how histamine intolerance and mast cell activation syndrome can be the hidden drivers behind a wide range of chronic conditions, and why they're often overlooked in conventional medicine. From the role of gut health, food triggers, and environmental toxins to deeper root causes like Lyme disease or mold exposure, it's clear that personalized, Functional Medicine is key to uncovering real answers. Understanding the immune system's role in histamine reactions—and how even “healthy” foods can be inflammatory for some—is a critical step toward healing. In this episode, I talk with Dr. Todd LePine, Dr. Elizabeth Boham, and Dr. Mark Pimentel about what histamine intolerance is, how it can be related to gut health, and why it's important to address it. Dr. Todd LePine graduated from Dartmouth Medical School and is Board Certified in Internal Medicine, specializing in Integrative Functional Medicine. He is an Institute for Functional Medicine Certified Practitioner. Prior to joining The UltraWellness Center, he worked as a physician at Canyon Ranch in Lenox, MA, for 10 years. Dr. LePine's focus at The UltraWellness Center is to help his patients achieve optimal health and vitality by restoring the natural balance to both the mind and the body. His areas of interest include optimal aging, bio-detoxification, functional gastrointestinal health, systemic inflammation, autoimmune disorders, and the neurobiology of mood and cognitive disorders. Dr. LePine enjoys skiing, kayaking, hiking, camping, and golfing in the beautiful Berkshires, and is a fitness enthusiast. Dr. Elizabeth Boham is Board Certified in Family Medicine from Albany Medical School, and she is an Institute for Functional Medicine Certified Practitioner and the Medical Director of The UltraWellness Center. Dr. Boham lectures on a variety of topics, including Women's Health and Breast Cancer Prevention, insulin resistance, heart health, weight control and allergies. She is on the faculty for the Institute for Functional Medicine. Dr. Mark Pimentel is a Professor of Medicine and Gastroenterology through the Geffen School of Medicine and an Associate Professor of Medicine at Cedars-Sinai. Dr. Pimentel is also the Executive Director of the Medically Associated Science and Technology (MAST) program at Cedars-Sinai, an enterprise of physicians and researchers dedicated to the study of the gut microbiome in order to develop effective diagnostic tools and therapies to improve patient care.  Dr. Pimentel has over 150 publications in many high-profile journals, and he is the author of the book, The Microbiome Connection: Your Guide to IBS, SIBO, and low fermentation eating. This episode is brought to you by BIOptimizers. Head to bioptimizers.com/hyman and use code HYMAN10 to save 10%. Full-length episodes can be found here: Is Histamine Intolerance The Cause Of Your Mysterious Symptoms? What is Histamine Intolerance? Surprising Symptoms You Need to Know IBS: It's Not In Your Head—Advances In Diagnosing And Treating, Bloating And Tummy Troubles

Doctor's Farmacy with Mark Hyman, MD Key Takeaways  Histamine intolerance and mast cell activation syndrome (MCAS) can be the hidden drivers behind a wide range of chronic conditions, such as fatigue, brain fog, food sensitivities, and skin issues – yet, histamine intolerance is often overlooked by conventional medicineMCAS is a condition where certain immune cells – called mast cells – release too many chemicals (like histamine) at the wrong timesUsing diet as a short-term therapeutic tool: A low-histamine diet or Low-FODMAP Dietis not a lifelong diet because tons of healthy foods have histamine in them Consume the freshest foods possible and avoid leftovers, as histamine levels in food rise over time after preparationFoods that are traditionally categorized as “healthy” may be contributing to your histamine issues; these include: aged meats, cheeses, fermented foods, and dairy Even though they are generally healthy, consuming them is like throwing gas on your histamine fire Implementing a low-histamine diet in three phases Phase 1 – remove alcohol, especially beer, wine, and champagne Phase 2 – remove canned and smoke fish (examples: anchovies), processed and fermented meats, aged cheese, pickled and fermented foods (sauerkraut, kimchi, yogurts, kefir, mustard, ketchups, vinegar, soy sauce)   Phase 3 – remove plant foods such as spinach, avocado, tomatoes, pineapples, citrus foods Treat IBS with a low-FODMAP diet, which is specifically designed to reduce the fermentable carbohydrates that gut bacteria feed on; this helps reduce: gas production, bloating, bacterial Foods to avoid: Garlic, onions, wheat, legumes, milk, soft cheeses, apples, honey, sorbitol, xylitol, stone fruits, artificial sweetenersFoods to consume: Carrots, spinach, bananas, chicken, rice, cheddar cheese, eggsSupplement to support healthy histamine levels:Quercetin – a natural plant compound that helps people with mast cell issues, histamine intolerance, and allergies (with additional benefits to metabolic function) Read the full notes @ podcastnotes.orgMany people struggle with mysterious symptoms like fatigue, brain fog, food sensitivities, and skin issues—only to be misdiagnosed or dismissed altogether. This conversation highlights how histamine intolerance and mast cell activation syndrome can be the hidden drivers behind a wide range of chronic conditions, and why they're often overlooked in conventional medicine. From the role of gut health, food triggers, and environmental toxins to deeper root causes like Lyme disease or mold exposure, it's clear that personalized, Functional Medicine is key to uncovering real answers. Understanding the immune system's role in histamine reactions—and how even “healthy” foods can be inflammatory for some—is a critical step toward healing. In this episode, I talk with Dr. Todd LePine, Dr. Elizabeth Boham, and Dr. Mark Pimentel about what histamine intolerance is, how it can be related to gut health, and why it's important to address it. Dr. Todd LePine graduated from Dartmouth Medical School and is Board Certified in Internal Medicine, specializing in Integrative Functional Medicine. He is an Institute for Functional Medicine Certified Practitioner. Prior to joining The UltraWellness Center, he worked as a physician at Canyon Ranch in Lenox, MA, for 10 years. Dr. LePine's focus at The UltraWellness Center is to help his patients achieve optimal health and vitality by restoring the natural balance to both the mind and the body. His areas of interest include optimal aging, bio-detoxification, functional gastrointestinal health, systemic inflammation, autoimmune disorders, and the neurobiology of mood and cognitive disorders. Dr. LePine enjoys skiing, kayaking, hiking, camping, and golfing in the beautiful Berkshires, and is a fitness enthusiast. Dr. Elizabeth Boham is Board Certified in Family Medicine from Albany Medical School, and she is an Institute for Functional Medicine Certified Practitioner and the Medical Director of The UltraWellness Center. Dr. Boham lectures on a variety of topics, including Women's Health and Breast Cancer Prevention, insulin resistance, heart health, weight control and allergies. She is on the faculty for the Institute for Functional Medicine. Dr. Mark Pimentel is a Professor of Medicine and Gastroenterology through the Geffen School of Medicine and an Associate Professor of Medicine at Cedars-Sinai. Dr. Pimentel is also the Executive Director of the Medically Associated Science and Technology (MAST) program at Cedars-Sinai, an enterprise of physicians and researchers dedicated to the study of the gut microbiome in order to develop effective diagnostic tools and therapies to improve patient care.  Dr. Pimentel has over 150 publications in many high-profile journals, and he is the author of the book, The Microbiome Connection: Your Guide to IBS, SIBO, and low fermentation eating. This episode is brought to you by BIOptimizers. Head to bioptimizers.com/hyman and use code HYMAN10 to save 10%. Full-length episodes can be found here: Is Histamine Intolerance The Cause Of Your Mysterious Symptoms? What is Histamine Intolerance? Surprising Symptoms You Need to Know IBS: It's Not In Your Head—Advances In Diagnosing And Treating, Bloating And Tummy Troubles

Listen in as our expert panel discusses medications for management of opioid use disorder. They'll review strategies to optimize buprenorphine use and clarify the role of methadone and naltrexone.Special guest:Tyler J. Varisco, PharmD, PhDUniversity of Houston College of Pharmacy Assistant Professor, Department of Pharmaceutical Health Outcomes and PolicyAssistant Director, The PREMIER CenterYou'll also hear practical advice from panelists on TRC's Editorial Advisory Board:Stephen Carek, MD, CAQSM, DipABLM, Clinical Associate Professor of Family Medicine for the Prisma Health/USC School of Medicine Greenville Family Medicine Residency Program at the University of South Carolina School of Medicine, GreenvilleCraig D. Williams, PharmD, FNLA, BCPS, Clinical Professor of Pharmacy Practice at the Oregon Health and Science UniversityFor the purposes of disclosure, Dr. Varisco reports a financial relationship [cardiology, inflammatory bowel disease] with HEALIX Infusion Therapy (research consultant).The other speakers have nothing to disclose.  All relevant financial relationships have been mitigated.This podcast is an excerpt from one of TRC's monthly live CE webinars, the full webinar originally aired in March 2025.TRC Healthcare offers CE credit for this podcast. Log in to your Pharmacist's Letter, Pharmacy Technician's Letter,or Prescriber Insights account and look for the title of this podcast in the list of available CE courses.Claim CreditThe clinical resources mentioned during the podcast are part of a subscription to Pharmacist's Letter, Pharmacy Technician's Letter, and Prescriber Insights: FAQ: Management of Opioid Use DisorderChart: Treatment of Opioid WithdrawalFAQ: Treatment of Acute Pain in Opioid Use DisorderFAQ: Meds for Opioid OverdoseSend us a textIf you're not yet a subscriber, find out more about our product offerings at trchealthcare.com. Follow, rate, and review this show in your favorite podcast app. Find the show on YouTube by searching for ‘TRC Healthcare' or clicking here. You can also reach out to provide feedback or make suggestions by emailing us at ContactUs@trchealthcare.com.

James L. Ali, PA-C, DMSc, MBA, DFAAPA is the president of the Society of PAs in Family Medicine, SPAFM. In Part 2, Jim discusses considerations for opening your own practice, the various models for reimbursement, and the future role of PAs in primary and specialty care. Read his article in the recent AAPA here to learn more about Jim and his journey in PA practice: https://www.aapa.org/news-central/2024/11/the-interconnected-journey-of-a-pa-from-rejection-to-innovation-in-primary-care/

Okay, so I made one comment about Kristin's coffee-making skills and instantly became the villain. And then she replaced me—with Family Medicine. Like, actually replaced me. For an entire segment. This episode, we talk about the real heartbreak behind Medicare's decision not to cover GLP-1 medications for weight loss and diabetes, and the wider implications for access, affordability, and the ongoing “just exercise more” narrative that's exhausting all of us. Spoiler: we're not fans of weaponized personal responsibility. Then Family Medicine makes his podcast debut, and wow—he has some things to get off his chest. Like being overworked, underappreciated, and constantly asked to “clear” patients for cataract surgery. (Which isn't a thing. Please stop saying it's a thing.) We close things out with a conversation about burnout, respect, weighted blankets, and fermented Texaco antibiotics. You know, just a normal Tuesday. Takeaways: I mentioned Kristin's coffee grounds and now I'm banned from caffeine commentary. GLP-1 meds aren't being covered by Medicare anymore, and it's as infuriating as you'd expect. Family Medicine is here. He's tired. And he's not “clearing” anyone for anything. If you don't think all doctors are burned out, you're not paying attention. We might've created a new mascot: Emotional Support Drape™. — To Get Tickets to Wife & Death: You can visit Glaucomflecken.com/live  We want to hear YOUR stories (and medical puns)! Shoot us an email and say hi! knockknockhi@human-content.com Can't get enough of us? Shucks. You can support the show on Patreon for early episode access, exclusive bonus shows, livestream hangouts, and much more! –⁠ http://www.patreon.com/glaucomflecken⁠  Also, be sure to check out the newsletter: https://glaucomflecken.com/glauc-to-me/ If you are interested in buying a book from one of our guests, check them all out here: https://www.amazon.com/shop/dr.glaucomflecken If you want more information on models I use: Anatomy Warehouse provides for the best, crafting custom anatomical products, medical simulation kits and presentation models that create a lasting educational impact.  For more information go to Anatomy Warehouse DOT com. Link: https://anatomywarehouse.com/?aff=14 Plus for 15% off use code: Glaucomflecken15 -- A friendly reminder from the G's and Tarsus: If you want to learn more about Demodex Blepharitis, making an appointment with your eye doctor for an eyelid exam can help you know for sure. Visit ⁠http://www.EyelidCheck.com⁠ for more information.  Today's episode is brought to you by DAX Copilot from Microsoft. DAX Copilot is your AI assistant for automating clinical documentation and workflows helping you be more efficient and reduce the administrative burdens that cause us to feel overwhelmed and burnt out. To learn more about how DAX Copilot can help improve healthcare experiences for both you and your patients visit ⁠aka.ms/knockknockhi⁠. Produced by⁠ Human Content Learn more about your ad choices. Visit megaphone.fm/adchoices

Do you feel like you're doing everything right—eating healthy, exercising—but still not seeing the results you want, especially with bone health? In this episode, I interview Dr. Melissa Mondala, a lifestyle medicine expert, to explore how mindset and stress management can impact osteoporosis and overall wellness. Dr. Melissa is a triple specialist in Family Medicine, Lifestyle Medicine, and Integrative Psychiatry, and is double-boarded in Family Medicine and Lifestyle Medicine. She is one of the first nationally recognized Lifestyle Medicine Intensivists and serves as Core Faculty at Loma Linda University's Preventive and Lifestyle Medicine Department, which is one of the Blue Zones for longevity.   She prioritizes lifestyle modifications to optimize health, brings evidence-based methods to combat chronic disease, and uplifts potential barriers through self-empowerment and self-compassion Dr. Melissa shares her multidisciplinary approach to bone health, combining nutrition, exercise, and the often-overlooked element of mental well-being. Learn about practical tools and strategies you can implement today to reduce stress, improve your mindset, and protect your bones for the long term. Tune in and discover how lifestyle medicine can revolutionize your health! “Every day, we all have a new beginning. We can choose to live the life we want." ~ Dr. Melissa Mondala   In this episode: - [01:18] - Meet Dr. Melissa Mondala, lifestyle medicine expert - [07:50] - Practical tips for improving our health - [18:52] - Affirmations for reducing stress  - [21:21] - The connection between mental and physical health - [24:53] - The importance of proper nutrition for overall well-being - [29:10] - Glutathione and its role in the body - [31:20] - Tips for preparing healthy meals  - [37:53] - Details about the Plant-Powered Mind Masterclass - [41:48] - Book recommendation: Embody Lifestyle Medicine   Resources mentioned - Embody Lifestyle Medicine: How to Build a Successful Direct Care Startup by Dr. Melissa Mondala - https://www.amazon.com/dp/B0DXRCX8RC - Margie's Favorites (products I personally use and love) - https://margiebissinger.com/margies-favorites/ -    More about Margie - Website - https://margiebissinger.com/  - Facebook - https://www.facebook.com/p/Margie-Bissinger-MS-PT-CHC-100063542905332/  - Instagram - https://www.instagram.com/margiebissinger/?hl=en    DISCLAIMER – The information presented on this podcast should not be construed as medical advice. It is not intended to replace consultation with your physician or healthcare provider. The ideas shared on this podcast are the expressed opinions of the guests and do not always reflect those of Margie Bissinger and Happy Bones, Happy Life Podcast.   *In compliance with the FTC guidelines, please assume the following about links on this site: Some of the links going to products are affiliate links of which I receive a small commission from sales of certain items, but the price is the same for you (sometimes, I even get to share a unique discount with you). If I post an affiliate link to a product, it is something that I personally use, support, and would recommend. I personally vet each and every product. My first priority is providing valuable information and resources to help you create positive changes in your health and bring more happiness into your life. I will only ever link to products or resources (affiliate or otherwise) that fit within this purpose.

Diabetes Core Update is a monthly podcast that presents and discusses the latest clinically relevant articles from the American Diabetes Association's four science and medical journals – Diabetes, Diabetes Care, Clinical Diabetes, and Diabetes Spectrum. Each episode is approximately 25 minutes long and presents 5-6 recently published articles from ADA journals. Intended for practicing physicians and health care professionals, Diabetes Core Update   discusses how the latest research and information published in journals of the American Diabetes Association are relevant to clinical practice and can be applied in a treatment setting. Welcome to diabetes core update where every month we go over the most important articles to come out in the field of diabetes. Articles that are important for practicing clinicians to understand to stay up with the rapid changes in the field.  This issue will review: 1.     Lepodisiran — A Long-Duration Small Interfering RNA Targeting Lipoprotein(a) - NEJM 2.     Diabetes and Anemia – Diabetes Care 3.     Efficacy and Safety of Finerenone in Type 2 Diabetes: A Pooled Analysis of Trials – Diabetes Care 4.     Cardiovascular and Kidney Outcomes and Mortality With Long- Acting Injectable and Oral Glucagon-Like Peptide 1 Receptor Agonists in Individuals With Type 2 Diabetes: A Systematic Review and Meta-analysis of Randomized Trials – Diabetes Care 5.     Oral Semaglutide and Cardiovascular Outcomes in High-Risk Type 2 Diabetes - NEJM   For more information about each of ADA's science and medical journals, please visit Diabetesjournals.org. Hosts: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health John J. Russell, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Chair-Department of Family Medicine, Abington Jefferson Health

Infectious diseases fellow Sam Peterson, MD, shares her unique journey to ID with Buddy Creech, MD, MPH, FPIDS. The two explore the power of mentorship, the value of storytelling, and what it takes to inspire the next generation of ID specialists. 

Dr. Butt is a retired Clinical Associate Professor in the Department of Family Medicine at the University of Saskatchewan. He served for 24 years as a consultant in Addiction Medicine in the Saskatchewan Health Authority.

James L. Ali, PA-C, DMSc, MBA, DFAAPA is the president of the Society of PAs in Family Medicine, SPAFM. He shares his experience running an APP practice in an underserved community in part 1 of his interview with Sam. Read his article in the recent AAPA here to learn more about Jim and his journey in PA practice: https://www.aapa.org/news-central/2024/11/the-interconnected-journey-of-a-pa-from-rejection-to-innovation-in-primary-care/

In episode #368 of The Hormone Puzzle Podcast, our guest Dr. Miranda Naylor, talks about Explaining Unexplained Infertility. More about Dr. Miranda: Dr. Miranda Naylor is a board-certified Family Medicine and Functional Medicine Doctor specializing in women's hormonal health and fertility. She uses a root-cause approach to help women get to the bottom of symptoms and optimize their health from the ground up. Thank you for listening! This episode is made possible by Puzzle Brew's Fertility Tea: https://hormonepuzzlesociety.com/fertility-tea Follow Dr. Miranda on Instagram: @‌drmirandanaylor Follow Dr. Kela on Instagram: @‌kela_healthcoach Get your FREE Fertility Meal Plan: https://hormonepuzzlesociety.com FTC Affiliate Disclaimer: The disclosure that follows is intended to fully comply with the Federal Trade Commission's policy of the United States that requires to be transparent about any and all affiliate relations the Company may have on this show. You should assume that some of the product mentions and discount codes given are "affiliate links", a link with a special tracking code This means that if you use one of these codes and purchase the item, the Company may receive an affiliate commission. This is a legitimate way to monetize and pay for the operation of the Website, podcast, and operations and the Company gladly reveals its affiliate relationships to you. The price of the item is the same whether it is an affiliate link or not. Regardless, the Company only recommends products or services the Company believes will add value to its users. The Hormone Puzzle Society and Dr. Kela will receive up to 30% affiliate commission depending on the product that is sponsored on the show. For sponsorship opportunities, email HPS Media at media@hormonepuzzlesociety.com

The NACE Journal Club with Dr. Neil Skolnik, provides review and analysis of recently published journal articles important to the practice of primary care medicine. In this episode Dr. Skolnik and guests review the following publications:1. Adverse Outcomes Associated With Inhaled Corticosteroid Use in Individuals With Chronic Obstructive Pulmonary Disease. Annals of Family Medicine 2025. Discussion by:Guest:Barbara Yawn, MD, MSc, MPHAdjunct Professor, Department of Family and Community HealthUniversity of Minnesota Former Chief Scientific Officer at the COPD Foundation2. Optimal dietary patterns for healthy aging. Nature Medicine. Discussion by:Guest:Jessica Stieritz, MD Resident– Family Medicine Residency Program Jefferson Health – Abington3. Amount and intensity of daily total physical activity, step count and risk of incident cancer. British Journal of Sports Medicine. Discussion by:Guest:William Callahan, D.O. Associate Director – Family Medicine Residency ProgramJefferson Health – AbingtonMedical Director and Host, Neil Skolnik, MD, is an academic family physician who sees patients and teaches residents and medical students as professor of Family and Community Medicine at the Sidney Kimmel Medical College, Thomas Jefferson University and Associate Director, Family Medicine Residency Program at Abington Jefferson Health in Pennsylvania. Dr. Skolnik graduated from Emory University School of Medicine in Atlanta, Georgia, and did his residency training at Thomas Jefferson University Hospital in Philadelphia, PA. This Podcast Episode does not offer CME/CE Credit. Please visit http://naceonline.com to engage in more live and on demand CME/CE content.

Many people struggle with mysterious symptoms like fatigue, brain fog, food sensitivities, and skin issues—only to be misdiagnosed or dismissed altogether. This conversation highlights how histamine intolerance and mast cell activation syndrome can be the hidden drivers behind a wide range of chronic conditions, and why they're often overlooked in conventional medicine. From the role of gut health, food triggers, and environmental toxins to deeper root causes like Lyme disease or mold exposure, it's clear that personalized, Functional Medicine is key to uncovering real answers. Understanding the immune system's role in histamine reactions—and how even “healthy” foods can be inflammatory for some—is a critical step toward healing. In this episode, I talk with Dr. Todd LePine, Dr. Elizabeth Boham, and Dr. Mark Pimentel about what histamine intolerance is, how it can be related to gut health, and why it's important to address it. Dr. Todd LePine graduated from Dartmouth Medical School and is Board Certified in Internal Medicine, specializing in Integrative Functional Medicine. He is an Institute for Functional Medicine Certified Practitioner. Prior to joining The UltraWellness Center, he worked as a physician at Canyon Ranch in Lenox, MA, for 10 years. Dr. LePine's focus at The UltraWellness Center is to help his patients achieve optimal health and vitality by restoring the natural balance to both the mind and the body. His areas of interest include optimal aging, bio-detoxification, functional gastrointestinal health, systemic inflammation, autoimmune disorders, and the neurobiology of mood and cognitive disorders. Dr. LePine enjoys skiing, kayaking, hiking, camping, and golfing in the beautiful Berkshires, and is a fitness enthusiast. Dr. Elizabeth Boham is Board Certified in Family Medicine from Albany Medical School, and she is an Institute for Functional Medicine Certified Practitioner and the Medical Director of The UltraWellness Center. Dr. Boham lectures on a variety of topics, including Women's Health and Breast Cancer Prevention, insulin resistance, heart health, weight control and allergies. She is on the faculty for the Institute for Functional Medicine. Dr. Mark Pimentel is a Professor of Medicine and Gastroenterology through the Geffen School of Medicine and an Associate Professor of Medicine at Cedars-Sinai. Dr. Pimentel is also the Executive Director of the Medically Associated Science and Technology (MAST) program at Cedars-Sinai, an enterprise of physicians and researchers dedicated to the study of the gut microbiome in order to develop effective diagnostic tools and therapies to improve patient care.  Dr. Pimentel has over 150 publications in many high-profile journals, and he is the author of the book, The Microbiome Connection: Your Guide to IBS, SIBO, and low fermentation eating. This episode is brought to you by BIOptimizers. Head to bioptimizers.com/hyman and use code HYMAN10 to save 10%. Full-length episodes can be found here: Is Histamine Intolerance The Cause Of Your Mysterious Symptoms? What is Histamine Intolerance? Surprising Symptoms You Need to Know IBS: It's Not In Your Head—Advances In Diagnosing And Treating, Bloating And Tummy Troubles

"10 Key Questions Facing Medicare Advantage" is the subject for our Medicare Advantage Minute. More trouble ahead? This is the reason we spend time in every episode warning listeners of MA plan dangers! In "Your Medicare Benefits 2024" we learn about how Emergency Department Services are reimbursed by Medicare. As usual they ignore the fact that my clients, and all responsible Medicare participants, will have acquired a Medicare supplement plan to enhance the Medicare reimbursement amount. Average earnings of Medical Doctors by specialty in an interesting way to decide whether you could have chosen a more lucrative path in life! The lowest earning specialties are: Public Health & Preventive Medicine (lowest at $257K per year) Pediatrics and Family Medicine. Highest earners are: Orthopedic & Ortho Surgery ($543K per year) followed by Radiology, Plastic Surgery and Cardiology out of a total of 29 different branches of medicine.   Contact me at: DBJ@MLMMailbag.com (Most severe critic: A+)                   Visit us on: BabyBoomer.ORG Inspired by: "MEDICARE FOR THE LAZY MAN 2025; Simplest & Easiest Guide Ever!" on Amazon.com. Return to leave a short customer review & help future readers. Official website: https://www.MedicareForTheLazyMan.com.

Episode 189: Intermittent Fasting (Religious and Sports)Future Doctors Carlisle and Kim give recommendations about patients who are fasting for religious reasons, such as Ramadan. They also explain the benefits and risks of fasting for athletes and also debunked some myths about fasting. Dr. Arreaza add input about the side effects of fasting and ways to address them.    Written by Cameron Carlisle, MSIV (RUSM) and Kyung Kim, MSIV (AUC). Editing by Hector Arreaza, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Introduction: In the last episode on fasting (#179), we explored how intermittent fasting (IF) can help manage type 2 diabetes by improving insulin sensitivity, promoting weight loss, and lowering inflammation. We discussed the benefits of methods like 16:8 time-restricted eating and the 5:2 meal plan, and even compared IF to medications like metformin. Today, we're bringing that science into real life. We'll talk about how people fast for religious reasons, like during Ramadan, how athletes use IF to stay in shape, and how we can use IF as a tool in family medicine to support community health and A1c control.Intermittent Fasting in Religious PracticeRamadan just ended on 3/30/25, but this is a great time to talk about the broader role of fasting in religion and health. Many faiths incorporate fasting into spiritual practice and understanding this can help us better support our patients.Islam (Ramadan): Ramadan is a month where Muslims fast from dawn to sunset, focusing on spiritual reflection and self-control. No food or drink is consumed during daylight hours. Despite this, studies have shown that with good planning, fasting during Ramadan does not significantly impair physical performance or metabolic health.Key health tips for patients observing Ramadan:Hydrate well between iftar (sunset) and suhoor (pre-dawn).Break the fast with dates and water to gently replenish energy and electrolytes.Eat balanced meals with complex carbs, protein, and healthy fatsAvoid greasy, heavy foods right after fastingLight exercise (such as a walk) after iftar is beneficialReview medications with a healthcare provider, especially for those on insulin or sulfonylureas.For example: Metformin should be taken when you break your fast and then again before dawn. If its an extended-release metformin, take it at night. Metformin does not cause significant hypoglycemia and can be continued during Ramadan. Basal insulin is advised to be given at Iftar, and the dose should be reduced by 25-35% if the patient is not well managed. And regarding the fast-acting insulin, it requires a little more reading, so you can look it up and learn about it. Judaism: In Judaism, fasting is practiced on days like Yom Kippur and Tisha B'Av, typically lasting 25 hours without food or water. These fasts are spiritual and reflective, and patients with medical conditions may seek guidance on how to participate safely.Christianity: Many Christians fast during Lent, either by abstaining from certain foods or limiting meal frequency. Some practice partial-day fasts or water-only fasts for spiritual renewal.A branch of Christianity known as The Church of Jesus Christ of Latter-day Saintsoften observe a 24-hour fast on the first Sunday of each month, known as Fast Sunday, where they abstain from food and drink and donate the cost of meals to charity. This practice is both spiritual and communal.Cameron: Fasting for religious reasons, when done safely, can align with IF protocols and be culturally sensitive for diverse patients in family medicine.IF in Athletes and PerformanceIntermittent fasting is gaining popularity in the sports world. Athletes are using IF to improve body composition, increase fat oxidation, and enhance metabolic flexibility. A recent study, known as the DRIFT trial and published in Annals of Internal Medicine, found that fasting three non-consecutive days a week led to more weight loss than daily calorie restriction. Participants lost an average of 6.37 pounds more over 12 months.Why? Better adherence. People found the 3-day fasting schedule easier to stick to than counting calories every day.Benefits of IF for athletes:Encourages fat burning (via AMPK activation and GLUT4 upregulation, listen to ep. 179).Helps maintain lean muscle while reducing fat.No major drop in performance when meals and workouts are timed properly.What are some practical tips?Schedule workouts during or just before eating windows.Eat protein-rich meals post-workout.Avoid intense training during long fasts unless adapted.Stay hydrated, especially in hot environments or endurance sports.Broader Applications and Myths Around IFHormonal Effects of IF: In addition to improving insulin sensitivity, IF also affects hormones such as ghrelin (which stimulates hunger, remember it as growling) and leptin (which signals fullness). Over time, IF may help the body regulate appetite better and reduce cravings. IF can also decrease morning cortisol levels, the stress hormone. That's why it's important to monitor sleep, hydration, and stress levels when recommending IF.Circadian Rhythm Alignment: Emerging research shows that aligning eating times with natural light/dark cycles—eating during the day and fasting at night—can improve metabolic outcomes. This practice, known as early time-restricted eating (eTRE), has been shown to lower blood glucose, reduce insulin levels, and improve energy use. Patients who eat earlier in the day tend to have better results than those who eat late at night.Myths and Clarifications on IF:-“Fasting slows metabolism” In fact, short-term fasting may boost metabolism slightly due to increased norepinephrine. -“You can't exercise while fasting.” Many people can safely train during fasted states, especially for moderate cardio or strength training. -“Skipping breakfast is bad.” For some, skipping breakfast is a useful IF strategy—as long as total nutrition is maintained. You can break your fast at 2:00 pm, it does have to be at 7:00 AM.What to Eat When Breaking a FastBreaking a fast properly is just as important as fasting itself. Whether it's after a Ramadan fast or a 16-hour fast, the goal is to replenish energy gently and restore nutrients.Ideal foods to break a fast:Dates and water: provide quick energy, potassium, and fiberSoups: lentil or broth-based soups are gentle on digestionComplex carbs: whole grains like brown rice or oatsLean proteins: chicken, fish, eggs, legumesFruits and vegetables: hydrate and provide fiberHealthy fats: nuts, avocado, olive oilProbiotics: yogurt or kefir for gut supportBalanced meals with carbs, protein, and healthy fats help the body transition smoothly back to a fed state.Using IF in Family Medicine and Community HealthIntermittent fasting can be a practical, cost-effective strategy in family medicine. In areas with high rates of obesity and diabetes, like Kern County, IF offers a lifestyle-based tool to improve metabolic health, especially in underserved populations. IF is free!How IF can help in family medicine:Lower A1c levels: improves insulin sensitivity and glucose controlPromote weight loss: decreases insulin resistance and inflammationReduce medication dependence: fewer meds needed over time for some patientsEncourage patient engagement: flexible and easier to follow than strict calorie countingFit diverse lifestyles: aligns with religious and cultural practicesAddress food insecurity: structured eating windows can help patients stretch limited food resourcesHow to apply IF in clinic:Start the conversation by asking if the patient has heard of IFRecommend simple starting points: 12:12 or 14:10Emphasize hydration and nutrient-dense mealsMonitor labs and symptoms, especially in diabetic patientsAdjust medications to avoid hypoglycemiaProvide follow-up and patient education handouts if possibleWhat if a patient isn't ready to try fasting?For those not ready to commit to intermittent fasting, one effective alternative is walking after meals. A simple 10–20 minute walk post-meal can help stimulate GLUT4 receptors in skeletal muscle, promoting glucose uptake independent of insulin. This reduces the demand on pancreatic beta cells and may help improve blood sugar control over time. This strategy is particularly useful for patients with insulin resistance or early-stage type 2 diabetes.Conclusion: Intermittent fasting is not one-size-fits-all, but it can be a powerful tool for both individual and community health. From Ramadan to race day, IF has a place in family medicine when used thoughtfully. Encourage patients to work with their healthcare providers to find an approach that fits their lifestyle, medical needs, and personal values. IF is a cost-effective toolEven without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:American Academy of Family Physicians. (2022). "Intermittent Fasting: A Promising Treatment for Diabetes." AAFP Community Blog. https://www.aafp.org/pubs/afp/afp-community-blog/entry/intermittent-fasting-a-promising-treatment-for-diabetes.htmlHealthline. (2023). "What Breaks a Fast? Foods, Drinks, and Supplements." https://www.healthline.com/nutrition/what-breaks-a-fast.Sarri KO, Tzanakis NE, Linardakis MK, Mamalakis GD, Kafatos AG. Effects of Greek Orthodox Christian Church fasting on serum lipids and obesity. BMC Public Health. 2003 May 16;3:16. doi: 10.1186/1471-2458-3-16. PMID: 12753698; PMCID: PMC156653. https://pmc.ncbi.nlm.nih.gov/articles/PMC156653/.Shang, Y., et al. (2024). "Effects of Intermittent Fasting on Obesity-Related Health Outcomes: An Umbrella Review." eClinicalMedicine.https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(24)00098-1.Abaïdia AE, Daab W, Bouzid MA. Effects of Ramadan Fasting on Physical Performance: A Systematic Review with Meta-analysis. Sports Med. 2020 May;50(5):1009-1026. doi: 10.1007/s40279-020-01257-0. PMID: 31960369. https://pubmed.ncbi.nlm.nih.gov/31960369/.Theme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/.

Steve Bierman, MD is the Director of the Noetic Medicine Institute at the Andrew Weil Center for Integrative Medicine (University of Arizona, College of Medicine). He is also the author of two award-winning books on Noetic Medicine: HEALING (2020) and The END of WORRY (2023). Dr. Bierman is a graduate of Northwestern University's School of Medicine and was board certified in and practiced Emergency and Family Medicine. He is also a diplomate of the American Board of Medical Hypnosis. Dr. Bierman teaches noetic medicine (“mind medicine”) around the world, reminding caregivers that MIND MATTERS – that “the words of a caregiver can harm or heal.” You can connect with Dr. Bierman via YouTube @SteveBierman and the website www.healingbeyondpills.com View his recently published paper, Placebo and the law of identification, here. Related Episodes: Ep 299 - Dr. Wayne Jonas on  Whole Person Care for Cancer and Healing Ep 262 - Upgrade your Language with Mark England If you like this episode, please subscribe to Pursuing Health on iTunes and give it a rating or share your feedback on social media using the hashtag #PursuingHealth. I look forward to bringing you future episodes with inspiring individuals and ideas about health. Disclaimer: This podcast is for general information only, and does not provide medical advice.  I recommend that you seek assistance from your personal physician for any health conditions or concerns.

Listen in as Joseph Kim, MD, MPH, MBA, interviews Sophia Kwon, MD, to learn about how she implemented a documentation shortcut at her institution to improve obesity care, including:Creating an obesity checklist within the electronic health recordTraining staff to correctly use this checklist and broach obesity topics with patientsGarnering feedback to ensure this checklist did not add to note fatigue or burnout among staffSharing lessons learned for others interested in implementing a similar documentation shortcutPresenterJoseph Kim, MD, MPH, MBAPresidentQ Synthesis, LLCNewtown, Pennsylvania Sophia Kwon, MDInternal Medicine AttendingRiverside University Health System AttendingLoma Linda University Health Associate FacultyLoma Linda, California

The typical patient/doctor experience is changing as younger generations demand holistic, convenient, and personalized care. To address these expectations, a new medical model is sweeping the nation that includes ample appointment availability, lengthier patient/physician visits, and enhanced continuity of care. In many ways, this model of care is a return to the days of personalized medicine rather than typical medical management as we know it today.Dr. Nicole Dorotik joins us today to acquaint us with the concept of direct primary care. This medical model provides care to all ages, independent of insurance carriers, Medicare, and Medicaid. Direct primary care is a patient-centered model prioritizing personalized care, accessibility, and affordability. Unlike traditional healthcare systems, Dr. Dorotik's practice does not rely on insurance reimbursement. Instead, she and her team establish a direct relationship with their patients, offering comprehensive primary care services for a flat monthly fee. Dr. Dorotik's goal is to ensure that each patient feels comfortable, heard, and empowered - the perfect prescription for patient satisfaction. Show Notes:Dr. Dorotik, earned her medical degree from the University of Arizona College of Medicine and completed her residency at Long Beach Memorial Hospital in Long Beach, California. She is board certified in Family Medicine and has over 20 years of clinical experience. Driven by a passion for providing comprehensive care, Dr. Dorotik is dedicated to staying up to date with the latest medical advancements, and patients can trust her expertise and compassionate approach to healthcare. When she's not working, Dr. Dorotik loves all things outdoors, hiking, biking, and skiing with her three kiddos.To find a direct primary care physician in your area, go to: https://mapper.dpcfrontier.com/To learn more about Dr. Dorotik's practice, visit her website at: https://arvadadpc.com/To vote for our podcast for Best Local Podcast in the 2025 Best of Columbia, go to:https://best-of-columbia-2025-voting--inside_columbia_magazine.contest.vote/local-favorites/best-local-podcastWill the doctor see you now? Maybe not amid the changing health care landscape in the US: https://www.usatoday.com/story/news/nation/2023/06/27/primary-care-doctor-shortages-on-the-rise-in-the-us-as-wait-times-grow/70352744007/#.   How Gen Z are reshaping the healthcare industryhttps://www.weforum.org/stories/2023/09/how-gen-z-are-reshaping-the-healthcare-industry/.

What if your fatigue, weight gain, hormone imbalances, and brain fog all traced back to a silent disease that affects 1 in 3 people—and you didn't even know you had it? In today's episode, I'm joined by Dr. Elizabeth Boham and Dr. Yousef Elyaman to talk about a condition that's quietly becoming one of the biggest threats to our health: fatty liver disease—now renamed Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD). It's not just a liver issue. It's deeply connected to heart disease, cancer, infertility, type 2 diabetes, dementia, and even hormone dysfunction. The most alarming part is it's often missed in traditional medicine because there's no easy drug to prescribe. We break down: The real root causes—from sugar and starch overload to gut imbalances, toxins, alcohol, and chronic inflammation The surprising early warning signs your body might be giving you Why standard labs often miss it, and the tests you actually need The step-by-step functional medicine approach to reverse fatty liver naturally—using targeted nutrition, lifestyle upgrades, and proven supplements I also share the latest science on inflammation, why it's the common thread between fatty liver and nearly every chronic disease, and how to calm it down at the root. This is the episode I wish every patient (and doctor) could hear—because fatty liver is reversible when you catch it early, and the ripple effects of healing it are massive. If you care about your energy, hormones, brain health, or longevity… this one's for you. Dr. Elizabeth Boham is Board Certified in Family Medicine from Albany Medical School, and she is an Institute for Functional Medicine Certified Practitioner and the Medical Director of The UltraWellness Center. Dr. Boham lectures on a variety of topics, including Women's Health and Breast Cancer Prevention, insulin resistance, heart health, weight control and allergies. She is on the faculty for the Institute for Functional Medicine. Dr. Yousef Elyaman is the founder and Medical Director of Absolute Health, a primary care functional medicine practice in Ocala, Florida. He is the 100th President of the Marion County Medical Society and the Functional Medicine Director at The Guest House Ocala, a trauma and substance abuse center. Dr. Elyaman also serves as the Medical Director for HumanN, a leading nutraceutical company, and is a Consultant for Quest Diagnostics Laboratory in their Wellness Division. He is teaching Faculty for the Institute for Functional Medicine on their Cardiometabolic module. Dr. Elyaman belongs to the first graduating class of the Institute for Functional Medicine. He is Board-certified in Internal Medicine and holds certifications in functional and integrative medicine as well. His leadership and expertise are reflected in his diverse roles, demonstrating his commitment to advancing medical knowledge and improving patient care. When not at work, Dr. Elyaman loves spending time with his wife and seven children where they live on a cattle and horse ranch. This episode is brought to you by BIOptimizers. Head to bioptimizers.com/hyman and use code HYMAN10 to save 10%. Full-length episodes can be found here: How To Prevent And Reverse Fatty Liver Disease with Functional Medicine The Best Diet to Reverse Fatty Liver Disease with Dr. Yousef Elyaman Why Fatty Liver Is So Common And How To Heal It

Thank you for joining us for another episode of the Low Carb MD Podcast. Dr. Laura Buchanan is board certified in Family Medicine and is on the board of the Society of Metabolic Health Practitioners. She graduated summa cum laude with a Bachelor of Science in Biomedical Sciences from the University of South Florida and was a valedictorian of her class at the University of Florida College of Medicine. She is on staff at Dr. Tro's Medical Weight Loss & Direct Primary Care. In this episode, Dr. Tro and Dr. Laura talk about… (00:00) Intro (03:19) When and how Dr. Laura knew she wanted to go into some form of medical practice and become a doctor (07:25) Dr. Laura's experience working at a small rural hospital in Peru (09:15) The story of how Dr. Laura met her husband, Dr. Matt Calkins (10:31) Some of the most prominent issues with Western medical education and standard nutritional information (14:39) Issues with the medical insurance system in the United States (21:50) Dr. Tro's Employee Wellness Program (26:15) The initial 6 month data results of Dr. Tro and Dr. Laura's employee wellness program study (see links below) (28:59) The incredible effectiveness of DPC and remote monitoring and remote patient care (33:51) The most important findings presented in the Toward Health paper  (36:30) The GLP-1 medications' benefits and downsides for weight loss and metabolic health (43:35) The highlight findings of the Toward Health study (49:52) Outro For more information, please see the links below. Thank you for listening! Links: Please consider supporting us on Patreon: https://www.lowcarbmd.com/ Resources Mentioned in this Episode: The Toward Health Study: https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2025.1548609/full Dr. Laura Buchanan: Twitter The Society of Metabolic Health Practitioners Website Instagram Dr. Brian Lenzkes:  Website: https://arizonametabolichealth.com/ Twitter: https://twitter.com/BrianLenzkes?ref_src=twsrc^google|twcamp^serp|twgr^author Dr. Tro Kalayjian:  Website: https://www.doctortro.com/ Twitter: https://twitter.com/DoctorTro Instagram: https://www.instagram.com/doctortro/ Toward Health App Join a growing community of individuals who are improving their metabolic health; together.  Get started at your own pace with a self-guided curriculum developed by Dr. Tro and his care team, community chat, weekly meetings, courses, challenges, message boards and more.  Apple: https://apps.apple.com/us/app/doctor-tro/id1588693888  Google: https://play.google.com/store/apps/details?id=uk.co.disciplemedia.doctortro&hl=en_US&gl=US Learn more: https://doctortro.com/community/ 

Garrett Butler, MD, is a devoted family man and physician serving rural West Virginia as a husband, father, son, and friend. With a strong academic foundation, he earned undergraduate degrees in Physics from Johns Hopkins University and Molecular and Cell Biology from Towson University, followed by an MD and Family Medicine residency from West Virginia University School of Medicine. He's a busy healthcare professional, working as a hospitalist at Vandalia Health Davis Medical Center and Broaddus Hospital, while also caring for patients as an outpatient family physician at Broaddus Family Care. On top of that, he serves as the medical director of Mansfield Place Nursing Home, showcasing his commitment to his community. Please check out the Mansfield Place nursing home YouTube page Work With Us: Arétē by RAPID Health Optimization Links: Anders Varner on Instagram Doug Larson on Instagram Coach Travis Mash on Instagram