Podcast appearances and mentions of gurpreet dhaliwal

This episode is an audio version of "Ted Talks: Learning the Lasso Way" by Irina Kryzhanovskaya, MD, and Gurpreet Dhaliwal, MD from the June 2024 issue of the Journal of Graduate Medical Education. The article shows how educators used clips from the show Ted Lasso to teach interpersonal competencies to their residents. The authors show how lessons from the show, such as “Be Curious, not Judgmental,” Woman Up,” “Be A Goldfish,” and “You're Just One of Eleven” can teach trainees how to look beyond biases, value diversity, learn from mistakes, and seek support from a team.  

Dr. Centor discusses strategies for improving diagnostic skills with Dr. Gurpreet Dhaliwal.

Bapu tries to stump master clinician Dr. Gurpreet Dhaliwal with a medical mystery. 

How do doctors actually think? And if we can answer that, can we train a computer to do a better job? In the post-WW2 period, a group of iconoclastic physicians set about to redefine the nature and structure of clinical reasoning and tried to build a diagnostic machine. Though they would ultimately fail, their failure set the stage for the birth of the electronic health records, formalized the review of systems, and set up a metacognitive conflict that remains unresolved to this day. This episode, entitled “The Database,” is the second part of this on the history of diagnosis with Gurpreet Dhaliwal.

Internal medicine physicians like to pride ourselves on our clinical reasoning – the ability to talk to any patient, pluck out seemingly random bits of information, and make a mystery diagnosis. But how does this actually work? In this episode, called The History, I'll be joined by Gurpreet Dhaliwal as we explore the beginnings of our understanding on how clinical reasoning works – starting in the middle of the 19th century with polar tensions between two ways of approaching our patients that are still felt today. Along the way, we'll talk about the American Civil War, Car Talk, Sherlock Holmes, and whether the practice of medicine can ever be considered a science. Sign up for Digital Education 2022 here: https://cmecatalog.hms.harvard.edu/digital-education Sources: Fitzgerald F, Curiosity. https://www.acpjournals.org/doi/full/10.7326/0003-4819-130-1-199901050-00015 Montgomery K, How Doctors Thinks (amazon link: https://www.amazon.com/How-Doctors-Think-Clinical-Judgment/dp/0195187121) Da Costa J, Medical Diagnosis, 1864. https://openlibrary.org/books/OL23402241M/Medical_diagnosis  

Diagnosis is a complex categorisation task driven by mental models that reside in long term memory. Through education and experience, clinicians form scripts that encapsulate their knowledge of specific conditions and develop diagnostic schemas that structure their approach to a specific health problem. This cognitive process also intersects with systems, teamwork, and social factors that can enhance or reduce diagnostic accuracy. In this podcast, we hear about five techniques that can help with the accuracy of those mental models, and mitigate against some of the external factors which may reduce diagnostic accuracy. Our guests; Hardeep Singh trained as a GP before moving to becoming a general internist and professor of patient safety research at Michael E DeBakey Veterans Affairs Medical Center and Baylor College of Medicine Houston. Denise Connor is an associate professor of medicine at University of California San Francisco and a practicing internist at San Francisco Veterans Affairs Medical Center. Gurpreet Dhaliwal is a general internist at the San Francisco Veterans Affairs Medical Center, and a clinician educator.

Listen as our esteemed guests Dr. Emily Abdoler (@EmilyAbdoler,) and Dr. Gurpreet Dhaliwal (@Gurpreet2015) introduce us to the entity of management reasoning and its subset, therapeutic reasoning! Turns out our learners probably have a lot more to learn about therapeutic reasoning (what we spend most of our time doing in primary care) than the better known cousin, diagnostic reasoning. Learn easy to implement techniques like the Management Pause- four simple questions that make your learner show their thinking- to help push training to the next level. We hope you'll integrate the Equity Check into your daily practice from here on out!

Hear diagnostician Gurpreet Dhaliwal try to solve the case of a patient who came to the emergency room with an unusual combination of symptoms. Plus, we discuss how difficult it is to separate the signal from the noise when treating patients, and how cognitive biases factor into doctors' decision-making.

A woman comes to the emergency room with back pain. She'll leave with an unexpected diagnosis. How does her doctor figure out what's wrong? Listen as host Bapu Jena puts master clinician Dr. Gurpreet Dhaliwal on the spot to solve a real medical mystery. Along the way, you'll learn how doctors think and the most important questions they ask.

"The future is limitless...I think we're going to take over the world" To celebrate National Hospitalist Day 2021, Explore The Space & Society of Hospital Medicine collaborated on a roundtable discussion concept. This episode is that roundtable: Dr. Ndidi Unaka, Dr. Anika Kumar, Dr. Gurpreet Dhaliwal, & Dr. Maylyn Martinez joined me for a discussion on "The Pluripotent Hospitalist." This is just extraordinary Representing the fastest growing specialty in modern healthcare, the Society of Hospital Medicine (SHM) is the leading medical society for hospitalists and their patients. SHM is dedicated to promoting the highest quality care for all hospitalized patients and overall excellence in the practice of hospital medicine through quality improvement, education, advocacy, and research. To learn more, visit hospitalmedicine.org. Please subscribe to and rate Explore The Space on Apple Podcasts or wherever you download podcasts. Email feedback or ideas to mark@explorethespaceshow.com Check out the archive of Explore The Space Podcast as well as our Position Papers and much more! Follow on Twitter @ETSshow, Instagram @explorethespaceshow Sponsor: Elevate your expertise with Creighton University’s Healthcare Executive Educational programming. Learn more about Creighton’s Executive MBA and Executive Fellowship programs at www.creighton.edu/CHEE. Sponsor: Have you been looking for a better way to manage your tasks and collaborate with colleagues? Check out CareAlign - a HIPAA Compliant, digital workspace built to make the EHR work better for clinicians. Manage your tasks, build dynamic care plans, view vitals and labs and generate your progress note in less than 3 clicks. CareAlign has everything you need for patient care, at your fingertips. Visit www.carealign.ai/explore to learn more. Sponsor: The Clinician Experience Project by Practicing Excellence uses coaching and development to help clinicians become their best and improve patient and organizational outcomes, while amplifying purpose and contentment. Learn more at https://practicingexcellence.com/. Key Learnings 1. Welcome and the most wonderful introductions of our panelists for "The Pluripotent Hospitalist" 2. Pluripotency and diverse skill sets as a mindset for a Hospitalist and as a whole person 3. Orchestration as an aspirational skill and the value of being a Generalist 4. Thinking beyond the walls of the hospital 5. Seeking autonomy, mastery, and purpose so we can continue to enjoy our careers 6. How much do we share our whole selves with our teammates and with patients 7. What skill did each panelist have to develop to move through the Covid-19 pandemic? 8. Maintaining mental health and uplifting it within the profession 9. Unique challenges faced by medical students, residents, and fellows 10. Answering questions from the audience Links Twitter @Gurpreet2015, @freckledpedidoc, @MS_Martinez_MD, @NdidiUnaka, @SocietyHospMed #Hospitalist #NHD2021, #HowIHospitalist, #mentalhealth, #Covid19, #pluripotent, #roundtable #podcast, #podcasting, #healthcare, #digitalhealth, #health, #leadership, #mentorship, #coaching, #FOAmed, #doctor, #nurse, #meded, #education, #hospital, #hospitalist, #innovation, #innovate, #medicalstudent, #medicalschool, #resident, #physician

Gurpreet Dhaliwal MD is a Professor of Medicine at the University of California, San Francisco and site director of the internal medicine clerkship at the San Francisco VA Medical Center. Dr Dhaliwal completed his medical school from Northwestern University and residency in internal medicine from University of California, San Francisco, where he stayed on as chief resident. He is best known as a medical educator with a specific emphasis on diagnostic reasoning and clinical problem solving and has been lauded by The New York Times as “one of the most skillful clinical diagnosticians in practice today.” From being nominated for a medical student teaching award while still a resident, Dr. Dhaliwal has received multiple Excellence in Teaching awards including the Osler Distinguished Teacher Award at UCSF and has been inducted into the UCSF Department of Medicine Council of Master Clinicians. Think a goal is impossible to achieve? Think again. Today, Dr. Gurpreet Dhaliwal shares a powerful technique that he uses to achieve his goals: set regular habits. Determined to achieve his goal of becoming an expert diagnostician, Dr. Dhaliwal set a habit of reading the New England Journal of Medicine's Clinicopathological Conferences series as a medical student. Now, more than 20 years later, he shares not having missed reading a single weekly case report and the marked impact this has had on moving him closer to his goal. Join us as Dr. Dhaliwal explains how to incorporate regular habits into our routine to achieve our goals and realize our maximum potential. Pearls of Wisdom: 1. The key to achieving seemingly “impossible” goals is setting daily habits. 2. To go from experience to expertise, be deliberate about continuing to challenge and push yourself. 3. Practice the framework of relationship-task-relationship with the patient. It not only improves the relationship with the patient, but acts as a memory hook for recall at a later timer. 4. Students really stand out when they show enthusiasm for the 'extra' work in medicine. Click here to listen to Dr. Dhaliwal's inspiring Commencement Address to the 2014 UCSF School of Medicine graduating class.

Episode description Drs. Kimberly Manning and Gurpreet Dhaliwal discuss an unknown case as part of the 50th CPSolvers Virtual Morning Report. Virtual Morning Report Click here to learn more about joining VMR and learn together, live. Dr. Kimberly Manning Kimberly D. Manning, MD is a general internist/hospitalist who serves as Associate Vice Chair of Diversity,… Read More »Episode – 89 – Virtual Morning Report #50 with Drs. Kimberly Manning and Gurpreet Dhaliwal – Foot Drop

Episode Description Dr. Andrew Olson presents a clinical unknown case to Reza & Rabih at DEM, with an introduction by Dr. Gurpreet Dhaliwal. Download CPSolvers App here Schema #1 Schema #2 Show notes Patreon website Dr. Andrew Olson Andrew Olson is an Associate Professor of Medicine and Pediatrics at the University of Minnesota Medical School.… Read More »Episode 62: Clinical unknown w/ Rabih & Reza at DEM – bloating and abdominal distension

A special edition of STC!  This time our good friend of the podcast Gurpreet Dhaliwal, master diagnostician, works through a case with Nic.  The case was originally presented to Art at morning report by one of our registrars Luke Sutherland.

Dr. Kelly Arps presents a clinical unknown to Dr. Gurpreet Dhaliwal.

In our final episode of 2018, we have a proper A-list MD, Dr. Gurpreet Dhaliwal, joining us. He is a master diagnostician who never fails to dazzle an audience with his process for evaluating and solving the most challenging cases. We discuss how he learns and trains, the need to look for "desirable difficulty" and how his mistakes are his most valuable tool. This is our first Grand Slam episode! All 4 Pillars of Explore The Space are fully engaged in this conversation! Key Learnings 1. Why Dr. Dhaliwal should be an A-list celebrity in medicine 2. Is Sherlock Holmes the right popular culture comparison for Dr. Dhaliwal? 3. What Dr. Dhaliwal does that gets such a response from an audience 4. How practice and his training program allow him to reach his maximal potential 5. Shifting information from short term memory to long term memory and how to extract it when needed 8. What is the number #1 enemy of learning... 8. The importance of tempo in optimizing his process to provide patient care in a busy environment 9. Extrapolating the skills Dr. Dhaliwal uses into any profession where someone wants to do their work better 10. Diagnostic error and why Dr. Dhaliwal keeps track of each case where he got the diagnosis wrong 11. The value of discussing mistakes and the opportunity we miss in medicine when we don't do this. 12. Anchoring bias and how it plays into error creation 13. Does he make diagnoses while walking around with the public? Links New York Times article by Katie Hafner The Mechanics of Reasoning Diagnostic Excellence Tags #hospitalist, #medicine, #podcast, #UCSF, #teaching, #education, #FOAMed, #reasoning, #heuristics, #podcast, #learning, #error, #mistakes, #diagnosis, #clinicalreasoning, #internalmedicine, #memory, #celebrity, #sherlockholmes

Expert diagnostician, Dr. Gurpreet Dhaliwal, again joins The Curbsiders to dive deeper into the topic of clinical expertise.  Topics include, and are mainly focused on, Dr. Dhaliwal’s “training regimen:” feedback, simulation, quizzing, learning from consultants, and how to read the medical literature as a clinician.  While we found this episode to be incredibly useful (and entertaining to record), don’t let our bias sway your opinion! In fact, just listen to the episode and listen for practical advise on how to improve your own clinical acumen.   Dr Brigham’s comment:  Be forewarned, much of what we talk about is seemingly common sense, but, upon listening to the episode many times, I realize that we have, over time, overly complicated the fundamentals of expertise.  I’m just as guilty as the next physician. Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Credits Written and produced by:  Stuart Brigham MD Hosts: Stuart Brigham MD, Paul Williams MD, Matthew Watto MD Guest: Gurpreet Dhaliwal MD Images by: Beth Garbitelli Edited by:  Matthew Watto MD Time Stamps 00:00 Disclaimer, Intro 02:25 Guest Bio 03:57 Pun 04:25 Dr. Dhaliwal 05:57 Pick of the Week - Move, “Jiro Dreams of Sushi” 08:00 Pick of the Week - Podcast, “Unspooled” 09:06 Pick of the Week - Water Putty, “Durham’s Rock Hard Water Putty” 10:20 “Clinical Case” Introduction 12:00 Developing expertise, introduction 15:50 Developing a patient log 21:30 Asking the wrong question leads to the wrong answer 23:35 Telling a colleague they were wrong 26:00 Five to one ratio 28:58 Understanding the why 33:57 Simulation in practice 37:35 Quote on learning… Just listen. 41:00 Quizzing and consolidating memory 44:24 Reading the literature as a clinician 50:10 Bottom line 57:10 Outro Tags: clinical, reasoning, diagnosis, diagnostician, accuracy, Osler, misdiagnosis, train, brain, care, test, self, Dhaliwal, Gurpreet, Curbsiders, podcast, patients, cats, funny, educational, inspirational, educator, school, free, doctor, education, family, foam, foamed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, physician assistant, resident, student

We chat once again with Gurpreet Dhaliwal, this time about what it takes to become a master diagnostician.  We discuss the main strategies; seeing many cases, deliberate training, getting feedback, closing the loop, and others.

Dr. Gurpreet Dhaliwal is a Professor of Medicine at UCSF and is generally considered one of the most skillful diagnosticians in the United States. He teaches medical students and residents in the ER, inpatient wards and outpatient clinic at the San Francisco VA Medical Center. He studies how doctors think, how they diagnose, how they make treatment decisions and how they develop expertise. He has published over ninety articles in leading medical journals including the New England Journal of Medicine and JAMA. Dr. Dhaliwal writes for The Wall Street Journal’s “The Experts” series, and, in 2012, he was profiled in The New York Times. Series: "A Life in Medicine: People Shaping Healthcare Today" [Health and Medicine] [Science] [Business] [Show ID: 32876]

Dr. Gurpreet Dhaliwal is a Professor of Medicine at UCSF and is generally considered one of the most skillful diagnosticians in the United States. He teaches medical students and residents in the ER, inpatient wards and outpatient clinic at the San Francisco VA Medical Center. He studies how doctors think, how they diagnose, how they make treatment decisions and how they develop expertise. He has published over ninety articles in leading medical journals including the New England Journal of Medicine and JAMA. Dr. Dhaliwal writes for The Wall Street Journal’s “The Experts” series, and, in 2012, he was profiled in The New York Times. Series: "A Life in Medicine: People Shaping Healthcare Today" [Health and Medicine] [Science] [Business] [Show ID: 32876]

Dr. Gurpreet Dhaliwal is a Professor of Medicine at UCSF and is generally considered one of the most skillful diagnosticians in the United States. He teaches medical students and residents in the ER, inpatient wards and outpatient clinic at the San Francisco VA Medical Center. He studies how doctors think, how they diagnose, how they make treatment decisions and how they develop expertise. He has published over ninety articles in leading medical journals including the New England Journal of Medicine and JAMA. Dr. Dhaliwal writes for The Wall Street Journal’s “The Experts” series, and, in 2012, he was profiled in The New York Times. Series: "A Life in Medicine: People Shaping Healthcare Today" [Health and Medicine] [Science] [Business] [Show ID: 32876]

Dr. Gurpreet Dhaliwal is a Professor of Medicine at UCSF and is generally considered one of the most skillful diagnosticians in the United States. He teaches medical students and residents in the ER, inpatient wards and outpatient clinic at the San Francisco VA Medical Center. He studies how doctors think, how they diagnose, how they make treatment decisions and how they develop expertise. He has published over ninety articles in leading medical journals including the New England Journal of Medicine and JAMA. Dr. Dhaliwal writes for The Wall Street Journal’s “The Experts” series, and, in 2012, he was profiled in The New York Times. Series: "A Life in Medicine: People Shaping Healthcare Today" [Health and Medicine] [Science] [Business] [Show ID: 32876]

Become an expert diagnostician like Dr Gurpreet Dhaliwal, Professor of Medicine at UCSF. Join us for this deep dive into clinical reasoning and how doctors think! Topics include: how to improve your own clinical reasoning and diagnostic skills, how to teach these skills, and the initial steps to building your own expertise/mastery in clinical medicine! Dr. Osler once admonished his students to build experiential wisdom and follow-up with their clinical cases (clear cases, doubtful cases, and mistakes), but to do so, one must “...learn to play the game fair, no self-deception, no shrinking from the truth; mercy and consideration for the other man, but none for yourself, upon whom you have to keep an incessant watch.” Test yo’ self: Take our quiz here Written and produced by:  Stuart Brigham, MD; Images by Hannah Abrams; Edited by:  Matthew Watto, MD Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Goal: Listeners will gain an appreciation for the Clinical Reasoning process and the difficulties that underpin building expertise in medicine. Learning objectives: After listening to this episode listeners will… Develop an appreciation for clinical reasoning. Recall the importance that the educator plays in role modeling. Learn how to improve diagnostic accuracy by keeping a patient log. Identify the common nomenclature used in clinical reasoning and how teaching this common verbiage could serve to improve diagnostic accuracy Recognize that misdiagnosis is common in clinical practice and every clinician could benefit from deliberate practice. Explain the difference between experience and expertise. Time Stamps 00:00 Disclaimer, Intro 02:30 Guest Bio 04:50 Dr. Dhaliwal 06:45 Book recommendation 09:14 App recommendation 11:34 Advice for learners and teachers (Pearl #1) 12:40 Can a computer out-think a human? 15:49 Defining Clinical Reasoning 18:38 “Train the Brain” introduced 20:30 Knowledge is a precondition 21:46 A learner who lacks synthesis 24:23 How to provide learner feedback 27:04 Defining problem representation, illness scripts, etc. 29:20 How to start teaching clinical reasoning 31:00 Focus on the “why” and not the “what” 32:11 Teaching the nomenclature of clinical reasoning 36:07 “You can’t get the right answer if the brain is solving the wrong problem” 36:34 Osler and his “Incessant Watch” 40:40 Being wrong feels exactly the same as being right 42:00 Patient tracking (Dr. Dhaliwal’s recommendation) 45:30 Why keeping a patient log is so important 47:00 Are heuristics beneficial? 48:55 Can you debias yourself? 50:00 “Going slow just makes you slow.” 52:00 All evidence has flaws, but knowledge is still king. 55:13 Clinical reasoning on multi-disciplinary teams 59:27 Take-home points Tags: clinical, reasoning, diagnosis, diagnostician, accuracy, Osler, misdiagnosis, train, brain, care, test, self, Dhaliwal, Gurpreet, Curbsiders, podcast, patients, cats, funny, educational, inspirational, educator, school, free, doctor, education, family, foam, foamed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, physician assistant, resident, student

Dr. Gurpreet Dhaliwal is professor of clinical medicine at UCSF and has written many articles in the realm of clinical reasoning.  Although you have already heard snippets of our conversation on prior episodes, we thought we would share the entire interview with all of you.  Gurpreet has an enlightening way of explaining how we think, and how we move from good clinicians to expert clinicians, through extended problem-solving and feedback.

We continue laying the foundations of type 1 and type 2 thinking with a discussion about biases.  Once again we hear from Prof. Gurpreet Dhaliwal and some of his thoughts on the utility of studying metacognition.

Howdy - This Scott Selinger and welcome to the podcast on behalf of the Northern California's chapter of the American College of Physicians Council of Early Career Physicians.  I should note that I'm thinking about calling the podcast ABCs for ECPs, ECP's being early career physicians.  It seemed a little more legit than the original working title, modeled after my favorite phrase to hear from a patient, "Can I be real with you?"  One of my biggest concerns starting off my medical career, is staying up to date.  Through medical school and residency, it seemed like so much time was devoted to learning about new practice altering information because I was always trying to catch up with and impress my attendings with things they hadn't heard of.  At the end of residency, I think I was subscribed to at least 10 different journals and newsletters, on top of the e-newsletters and listservs, and trying to peruse through all of them is just something I felt I had to do every week.  I was always searching for that one little nugget of information that would make life better and easier for my patients and for myself.  But now I'm out, and I'm practicing in a busy setting and having trouble to find the time to do as much reading and research.  But I still feel that need, that pressure, to stay up to date on all the breaking evidence.  Now of course we're required to have our continuing medical education and doing things to fulfill our ABIM maintenance of certification requirements, but that's not my real driving force.  I'm sure we've all seen patients either coming into the hospital or transferring to a new clinic on a bizarre outdated medication regimen.  And my fear is ultimately becoming one of those physicians.  While there's not a fantastic amount of high quality data out there, a systematic review published in the Annals of Internal Medicine about 10 years ago, looked at 62 studies regarding various outcomes relative to physicians years of practice.  Almost 75 percent of these studies showed decreasing guideline adherence in a variety of performance and outcome measures with increasing years of experience, and that scares me a little bit.  Now I'm sure like all studies there's geographic and practice setting variance, but overall it makes sense that the more entrenched you get into the everyday world of patient care, the harder it is to be able to step back and access your own practice and the advancing practices of those around you.  To put it more simply I feel like I'm Rocky in Rocky III.  I've come from being a little nothing to an attending physician.  I've knocked out Apollo Creed twice, med school and then again in residency and know I'm riding high and taking pictures and even doing pod casts.  But I know somewhere out there it's Clubber Lang, some new kid on the block or some new piece of data that's hungry, and slowly working its way up the chain, and if I don't do enough to stay on top of my game I'm gonna get knocked out.  So what is an early career physician to do?  Well to help get some guidance I spoke with Dr.  Gurpreet Dhaliwal, a clinician educator and associate professor in clinical medicine at UCSF who has particular interest in medical education and clinical and diagnostic performance and improvement.  Me:  Doctor Dhaliwal thanks so much for joining me today.  So I guess to dive right in, what mistakes do you feel physicians make starting out; as far as what they try to do with staying up to date with all the recent advances, and new papers and things like that.GD:  I'm thinking it's hard to make a mistake in terms of trying to stay up to date.  But just doing that itself is a good effort.  It's a commitment to lifelong learning.  I think one of the mistakes that might be made is that thinking the best way you're gonna do service to yourself and your patient is keeping up with all the new studies that are coming out.  A lot of the new studies are alluring and interesting, but a lot of the research doesn't change our day to day practice.  They're more news than they are information you can use.  So I wouldn't, heavily prioritize reading research articles.  Me:  I know now there's now tons of different ways that everything is being published.  What do you feel are becoming the most common ways that people are using to stay up to date with the changing practices?  GD:  I think one of the best ways to stay up to date is to recognize that you sort of choose three different streams of learning from the literature that come to you.  On one level are things where you just literally get them as a headline.  These may be scanning the table of contents that come by email or maybe seeing even I'll get a news alerts about, big research.  Then there is another layer of things where you get a more in-depth but still relatively brief report on something, like a podcast or a summary of the article that, that comes from Journal Watch or ACP journal club or something along those lines, and then finally is those moments where you sit down and actually read something in-depth, and by that I mean you're starting to commit more than ...  Fifteen to twenty minutes of reading.  And when you do that I think that those episodes are few and far between.  But, that's when you have to choose whether you're going to read a research article in depth, a review article in depth or maybe read a case in depth.  But there's different ways the information is streaming to us and part of that is how much time we have to commit to each one of them.  I think a good strategy is that on a daily basis you're getting that headline steam, through your inbox, and on your phone and then within some period you just need to give yourself a little more help with facts in the literature, like reading general watch, and at least once a week you commit to more structured reading, either based on stuff that you have for your patients, or your own general reading.  Me:  What do you feel are the most efficient things that you do in those areas as far as which services you use?  GD:  I would describe what I do as sort of cross training.  I give myself the same messages multiple different ways so I know that the information exists, even though I haven't necessarily read it in depth, so, for instance, I will get the key table of contents for a lot of the medical journals that I subscribe to and that means I get to see at least what's out there even if I never clicked on any of those articles.  Then I'll listen to the podcasts on a weekly basis of some of the major internal medicine journals.  So I hear the data the second time there.  Sometimes it's a little more nuanced or a little different.  Usually that's all I need to be aware of that research, to have heard the message One or two, or maybe three times.  If I ever actually need that research to take care of a patient and make a decision, that's when I'll find myself actually looking at the article in more depth, and saying, does it apply or not?  Me: And I guess as far as knowing how often to cross train how often in a given year do you think you hear something, or read something that's truly practice changing versus a lot of very small, well this is, this maybe interesting down the line.  GD:  Yeah, I would say I bet for a, a general hospital or general internist that probably 90% of what I read or hear about is interesting, intellectually but potentially for patients in the future it may be 10  percent.  It's news that I can use or I'm gonna change what I do today.  But a lot of times, I'm saying I'll change what I'm doing today because I have heard about the same topic for a number of months or a number of years in other places.  So, there is a value of being aware of the literature or feel of moving in some direction, like there is a change coming up.  I remember the article last year now I'm hearing it again, and this third time, it seems like it's really getting enough time to achieve by practice.  So sometimes, opinions are changing but there's benefit from having been aware of the topic for the past year or two.  Me:  So I guess finally, since we are, you know, coming to people on a podcast, right now, what, what do you think of the podcast as a way to help you keep up to date?  And what are some of your favorite ones?  GD:  I think the podcast has been one of the best ways I keep up to date.  I, listen to the, the podcast for the big five journals, The American Journal of Medicine, NEJM, JAMA, Annals, BMJ and there are other ones that have weekly podcasts as well.  But what I really like is each one of them is different.  Some of them, like the Annals are 10 minutes and they just briefly summarize each of the articles.  Some of them are long, like NEJM, takes about 25 minutes to give you A broad overview of the whole issue.  Something like the BMJ or the Lancet they go into specific detail about one of the articles that's in the paper or the journal that week of what is the proposed detail that they really like.  And, I have to say those are oft-times subjects I wouldn't find myself reading about.  After I hear the in depth report I feel that quite a bit more informed.  So this is just a lot to learn.  And then there's just the practicality.  We're all searching for time to keep up with the literature.  I listen to those podcasts for instance when I'm exercising or when I'm in my commute, and so I'm able to use that time in a way I wouldn't otherwise, keep up.  I encourage everyone to try a couple of them.  It's part of the cross-training approach, where you just get here, and interact with the material in a different way.  So it sticks a little more in your brain.  Me:  I really like his idea about cross training.  Although that term seems a little 90s for me.  So, instead, I might call it, mental crossfit, to give it more edge.  But what do y'all do in your day to day practice?  Does this sound like something doable to you?  Or do you still feel like you're getting overloaded with breaking news and alerts?  As always, we'd love to hear your feedback on this.  So if you have any burning questions or comments.  You can post them on our Facebook page or email them to caanocecp@gmail.com.  And if you had time, be sure to head on over to our Facebook page for the Northern California chapter of the ECP Council of Early Career Physicians so you can find out more about the events going on in the chapter.  And just to try out a new closing, thanks for joining me and tune in next time for Easy for, for more ABZs, from ECPs.  Two ECPs as well.

Reading by Gurpreet Dhaliwal, MD, author of The Oral Patient Presentation in the Era of Night Float Admissions: Credit and Critique