Podcasts about neda frayha

Pursuing Passion in Medicine: Dr. Neda Frayha's Journey from Academia to Audio StorytellingIn this episode, Christine hosts Dr. Neda Frayha, who shares her journey from the University of Maryland School of Medicine and her work in academic medicine to a career in audio storytelling. With a deep passion for humanizing medicine through education and storytelling, Neda discusses her transformative experience at an audio storytelling workshop and her fulfilling role as a Senior Medical Editor at HIPPO Education and host of the Primary Care Reviews and Perspectives Podcast. The conversation delves into the importance of following personal passion, the significance of caring and listening in medicine, and how setting healthy boundaries (also check out Only Human - the Boundaries episode! on Spotify, Apple Podcasts, or Hippo Education) and prioritizing self-awareness can significantly impact one's professional and personal life.00:00 Introduction and Guest Welcome00:04 Dr. Neda Frayha's Background and Achievements01:50 Journey into Audio Journalism03:50 Transition to Freelance Reporting and Career Change04:40 Lessons Learned from Career Shift06:19 Challenges and Reflections in Medicine10:43 Importance of Caring in Medicine15:48 Balancing Personal and Professional Life24:02 Final Thoughts and Conclusion

Neda Frayha was at the beach with her family when one of her primary care patients called her on her cell phone with some routine questions. Neda became increasingly resentful at the boundary violation. And then she thought of her friend Nirav Shah, who always invites his patients to contact him anytime. Boundaries in medicine are seldom taught, yet they're crucial for professional health and personal well-being. And yet we tend to idolize the clinicians who give of themselves endlessly to their patients. Is this good? Or are we setting ourselves up for resentment and burnout? In this episode of Only Human: Real Clinician Stories, Unfiltered, we hear from physicians with different approaches to boundaries. We explore why they're so tricky, how to figure out what boundaries we really want, and how to establish them with greater confidence. We would love to hear from you! You can write us or send a voice memo with thoughts, reactions, questions, or ideas for future episodes to podcasts@hippoeducation.com. Explore more of what Hippo Education has to offer by clicking here.

Four years ago, we learned that the USMLE Step 1 exam would become graded on a Pass/Fail basis, rather than each student receiving a 3-digit score. We covered this change in episode 54 of The OSA Insider, featuring an interview with national expert Dr. J. Bryan Carmody. This change went live in January 2022, and we can't help but wonder: where do things stand today? Why did this switch to P/F happen in the first place? Are things better? How are med students feeling about Step 1, anxiety-wise? And how is the UMSOM responding to the current moment? Dr. Nirav Shah and Dr. Devang Patel answer all of these questions and more in their conversation with host Dr. Neda Frayha.    Resources: UMSOM OME page on USMLE Prep The Pass/Fail Effect: A Longitudinal Study of USMLE Step 1 Performance Over a Decade

As we close out 2023, we get to become acquainted with Dr. Bruce Jarrell, transplant surgeon and President of the University of Maryland, Baltimore. He taught our host Dr. Neda Frayha when she was a medical student, so this reunion conversation felt very special. We learn about his decision to pursue surgery as a career, his approach to leadership, his path to the presidency of UMB, how he thinks of UMB and its role in the surrounding community, and his advice for all students listening.  

Time Magazine just announced that their Heroes of the Year are the Women of Iran. Today we're bringing you a personal story about these heroes, an essay written and recorded by our host Dr. Neda Frayha. This was originally written and recorded for Mighty Forces, where it was published under the title "Iranian Women Are A Mighty Force." https://mightyforces.substack.com/p/iranian-women-are-a-mighty-force

Getting the right diagnosis can be life-changing. It can mean the end of pain and the beginning of answers; it can mean treatment, a cure — or at least a path forward; or it can just mean validation for everything a patient has been through. Diagnosis is at the heart of medicine — and yet it seems like it often goes wrong. Patients sometimes wait months or even years for answers. They suffer through endless tests, ineffective treatments, overlooked issues — or straight-up misdiagnoses. And for some patients, answers never come at all. On today's episode, we travel down the long and winding road to diagnosis. We get an inside look at how diagnoses are made, what they mean to and for patients, and the challenges doctors face in getting them right. We hear about the dangers of too much testing, the debate over “gaming disorder,” and a medical mystery from The New York Times columnist Lisa Sanders. Also heard on this week’s episode: Primary care physician Neda Frayha discusses the challenges of making the right diagnosis, the fear of getting it wrong, why it sometimes takes so long to get answers, and why it's okay to cry when you are communicating a tough diagnosis to a patient. We also hear from another primary care physician Jay-Sheree Allen, about the importance of taking a good patient history, and getting comfortable with the unknown. In a perfect world, medical tests help narrow down the possibilities, leading to a diagnosis. But sometimes, the opposite happens — a suspicious finding leads to more tests, which leads to a specialist visit, which leads to scans or x-rays, and on it goes. This is what experts call “a cascade of care” — seemingly endless diagnostics that are time-consuming, anxiety-provoking, not to mention expensive. In this story from the health policy podcast Tradeoffs, Dan Gorenstein explores what's behind cascading care, and what it would take to stop it. The New York Times “Diagnosis” columnist and physician Lisa Sanders shares one of her latest mysteries — and explains why confirmation bias can point health care providers in the wrong direction. The World Health Organization recently added a controversial new illness to its comprehensive manual of diseases: gaming disorder. Reporter Alan Yu looks into why gaming disorder has sparked so much debate, and whether this new diagnosis is actually changing the way patients are treated.

So much has changed since the start of the Covid-19 pandemic, including all the new treatment options for outpatients with SARS-CoV-2 infection. From oral medications to IV infusions, the range of options can feel overwhelming. Which treatment should we prescribe when? And for which patients? How does the omicron variant surge affect our choices? What's even available? In this conversation originally recorded for Hippo Education, our own Dr. Devang Patel joins host Dr. Neda Frayha to break it all down for us. Feel free to check out the quick reference medication table as an added resource.   Resources: Hippo Education's Quick Reference Table for Outpatient Treatment and Pre-Exposure Prophylaxis Options for SARS-CoV-2 Infection Department of Health and Human Services (HHS) Covid-19 Therapeutics Locator HHS Protect Public Data Hub – Therapeutics Distribution National Infusion Center Association (NICA) State and Territorial Health Department Websites 

In this episode we hear from eight leading physician educators about a core principle of patient care:  primum non nocere. We learn that limiting harm can translate into doing what's medically right, putting the patient's welfare first, judicious use of IV fluids, reducing opioid prescribing, making a habit of pausing when depleted, acknowledging the end of life, and allowing a natural death.    Listen on: iTunes Spotify Stitcher   Guests:  Cam Berg MD, Neda Frayha MD, Scott Weingart MD, Josh Russell MD, Haney Mallemat MD, Alan Sielaff MD, Vicky Vella MD, and Mike Weinstock MD    We Discuss: The importance of figuring out the core principles that drive your medical decision-making [1:30]; Primum non nocere, and how it is good for patients and good for us [02:40]; Cameron Berg is concerned about the harm caused by excessive prescription of opiates in the ED [05:10];    Neda Frayha learned that ordering more tests on patients can cause more harm than good [07:25];.  Scott Weingart applies the “do no harm” principle to the use of IV fluids when resuscitating patients in septic shock [09:20]; Josh Russell tries to limit harm by thinking about what he'd want to have done, if he were in his patient's shoes [11:00]; Haney Mallemat has come to learn that many patients are predestined for bad outcomes, and the provision of maximal therapy is actually harmful [13:40]; Alan Sielaff uses shared decision-making to help guide him in doing no harm [15:50]; Vicky Vella believes that “do no harm” is recognizing when a patient is near the end of their life and, as a physician, trying to act in a way that reflects that [16:20]; Mike Weinstock makes an effort to treat all patients as he would treat them if they were his own family member [17:15]; And more.   Shownotes by Melissa Orman, MD For complete and detailed show notes, previous episodes, or to sign up for our newsletter: https://www.stimuluspodcast.com/   If you like what you hear on Stimulus and use Apple/iTunes as your podcatcher, please consider leaving a review of the show. I read all the reviews and, more importantly, so do potential guests. Thanks in advance! Interested in sponsoring this podcast? Connect with us here Follow Rob:Twitter: https://twitter.com/emergencypdx Facebook: https://www.facebook.com/stimuluswithrobormanmd Youtube: https://www.youtube.com/c/emergencypdx

In this episode we hear from eight leading physician educators about a core principle of patient care:  primum non nocere. We learn that limiting harm can translate into doing what's medically right, putting the patient's welfare first, judicious use of IV fluids, reducing opioid prescribing, making a habit of pausing when depleted, acknowledging the end of life, and allowing a natural death.    Listen on: iTunes Spotify Stitcher   Guests:  Cam Berg MD, Neda Frayha MD, Scott Weingart MD, Josh Russell MD, Haney Mallemat MD, Alan Sielaff MD, Vicky Vella MD, and Mike Weinstock MD    We Discuss: The importance of figuring out the core principles that drive your medical decision-making [1:30]; Primum non nocere, and how it is good for patients and good for us [02:40]; Cameron Berg is concerned about the harm caused by excessive prescription of opiates in the ED [05:10];    Neda Frayha learned that ordering more tests on patients can cause more harm than good [07:25];.  Scott Weingart applies the “do no harm” principle to the use of IV fluids when resuscitating patients in septic shock [09:20]; Josh Russell tries to limit harm by thinking about what he'd want to have done, if he were in his patient's shoes [11:00]; Haney Mallemat has come to learn that many patients are predestined for bad outcomes, and the provision of maximal therapy is actually harmful [13:40]; Alan Sielaff uses shared decision-making to help guide him in doing no harm [15:50]; Vicky Vella believes that “do no harm” is recognizing when a patient is near the end of their life and, as a physician, trying to act in a way that reflects that [16:20]; Mike Weinstock makes an effort to treat all patients as he would treat them if they were his own family member [17:15]; And more.   Shownotes by Melissa Orman, MD For complete and detailed show notes, previous episodes, or to sign up for our newsletter: https://www.stimuluspodcast.com/   If you like what you hear on Stimulus and use Apple/iTunes as your podcatcher, please consider leaving a review of the show. I read all the reviews and, more importantly, so do potential guests. Thanks in advance! Interested in sponsoring this podcast? Connect with us here Follow Rob:Twitter: https://twitter.com/emergencypdx Facebook: https://www.facebook.com/stimuluswithrobormanmd Youtube: https://www.youtube.com/c/emergencypdx

Left to their own devices, viruses are pretty much helpless. They need cells to infect in order to replicate. But they're sneaky — many of them also manage to stick around long after we think they're gone. When the immune system sets out to kill infected cells, many viruses hide and continue to cause problems. This aspect has come into much sharper focus during the pandemic, with thousands of people suffering serious symptoms months after first being diagnosed with COVID-19. On this episode, we explore viruses — how they affect our bodies, and what happens when they stick around. We hear from a physician who's treating long-haul COVID-19 patients, and find out from an immunologist how viruses manage to avoid and evade our body's defense system. We'll also explore how new research into the after-effects of viruses could benefit many people who are suffering with other little-understood conditions. Also heard on this week’s episode: What fascinated immunologist Carolina Lopez about viruses is how they are simultaneously so powerless and mighty. They can't do anything without cells to infect — but once they manage to do that, they can inflict so much damage. Carolina explains what we know about how viruses manage to evade the body's immune system, and what their continued presence could mean. What can be done for the long-suffering COVID-19 long-haulers? We talk with internist Neda Frayha about how she is helping patients who are coming to her with this post-viral illness. Viruses are always inside of our bodies, infecting our cells. Researcher Eric Delwart explains how sometimes that can work to our advantage.

Anxiety can feel like a buzzing electric current that fuels our thoughts and behaviors. There are the well-known symptoms — chest pains, rapid heartbeat, constant fidgeting, shortness of breath, nausea — but anxiety can also be sneaky, rearing its head in all different ways. For instance — maybe it shows up in the way you check your phone constantly, worried that a friend who hasn’t texted back has gotten in a car accident. Or it manifests in your constant chatter at the office, trying to mask the fact that you feel uncomfortable around others. Or it's the endless doctor's visits, trying to find some kind of physical reason for why you're not feeling well. On this episode, we explore the undercurrent of anxiety so many of us feel, how it impacts our behaviors, and what we can do about it. We hear stories about the unexpected relief from anxiety that some people have felt while working from home during the pandemic, the relationship between anxiety and uncertainty, and advice on how to get through it. We also hear how Maiken Scott attempts to reduce her own over-the-top startle response. Also heard on this week’s episode: Primary care physician Neda Frayha often sees patients who have different symptoms — pain, headaches, dizziness — but test after test finds that nothing is wrong. By all measures, the person is healthy, but they're just not feeling well. How can she help these patients? Neda discusses what's called somatic symptom disorder with psychiatrist Melissa Shepard.

Left to their own devices, viruses are pretty much helpless. They need cells to infect in order to replicate. But they’re sneaky — many of them also manage to stick around long after we think they’re gone. When the immune system sets out to kill infected cells, many viruses hide and continue to cause problems. This aspect has come into much sharper focus during the pandemic, with thousands of people suffering serious symptoms months after first being diagnosed with COVID-19. On this episode, we explore viruses — how they affect our bodies, and what happens when they stick around. We hear from a physician who’s treating long-haul COVID-19 patients, and find out from an immunologist how viruses manage to avoid and evade our body’s defense system. We’ll also explore how new research into the after-effects of viruses could benefit many people who are suffering with other little-understood conditions. Also heard on this week’s episode: What fascinated immunologist Carolina Lopez about viruses is how they are simultaneously so powerless and mighty. They can’t do anything without cells to infect — but once they manage to do that, they can inflict so much damage. Carolina explains what we know about how viruses manage to evade the body’s immune system, and what their continued presence could mean. What can be done for the long-suffering COVID-19 long-haulers? We talk with internist Neda Frayha about how she is helping patients who are coming to her with this post-viral illness. Viruses are always inside of our bodies, infecting our cells. Researcher Eric Delwart explains how sometimes that can work to our advantage.

The state rollout of the Covid-19 vaccine has been slow, chaotic and frustrating. But even with the glitches … nearly 800-thousand Marylanders have managed to secure a slot and get vaccinated. What does immunity offer … and how maddening is it for those still waiting? We talk with Dr. Neda Frayha, Dr. Zackary Berger, Gregory Terry, Renee Wilson, Sara Torvik and Jackie Oldham. Oldham says the quest for an appointment feels like a life-or-death competition: “I liken it to the hunger games where you’re forced to go out and fight for this really necessary incredibly vital vaccine.”  See omnystudio.com/listener for privacy information.

In this special conversation, our own Dr. Neda Frayha sits down with the amazing Dr. Louise Aronson, geriatrician and Professor of Medicine at UCSF and author of the fantastic book Elderhood to learn more about how we can take better care of our over-65 patients. Hint: many of these pearls can help us become better doctors all around. This conversation originally aired on Hippo Education's Primary Care Reviews and Perspectives podcast

For most of us, people over the age of 65 make up a huge portion of the patients we see and the energy we pour into clinical care. And yet most of us receive woefully inadequate training to provide the best care for these patients and to overcome structural, systemic biases against the elderly. In this special conversation, our own Dr. Neda Frayha sits down with the amazing Dr. Louise Aronson, geriatrician and Professor of Medicine at UCSF and author of the fantastic book Elderhood to learn more about how we can take better care of our over-65 patients. This conversation originally aired on Hippo Education's Primary Care Reviews and Perspectives podcast. 

Well, 2020 has been a year. And it is finally coming to an end! Our host Dr. Neda Frayha knew the last podcast episode of the year had to be a heart-to-heart with her good friends, Dr. Elizabeth Lamos and Dr. John Allen. Together they reflect back on 2020 and share their honest thoughts, frustrations, fears, and hopes for 2021 and beyond. 

This free iTunes segment is just one tiny snippet of the fully-loaded 3-hour monthly Urgent Care RAP show. Earn CME on your commute while getting the latest practice-changing urgent care information: journal article breakdowns, evidence-based topic reviews, critical guideline updates, conversations with experts, and so much more. Sign up for the full show at hippoed.com/UCRAPPOD When someone comes in with prostate related symptoms and infection, it’s hard to know if we’re working with prostatitis vs prostate abscess. How can we improve our prostate game? Tarlan Hedayati, MD schools Matthieu DeClerck, MD, and Neda Frayha, MD with her prostate pro-tips.   Pearls: Think about acute bacterial prostatitis when someone presents with symptoms of acute prostatitis AND has the following characteristics: immunocompromised, symptoms > 36 hours, progressive urinary retention, recent antibiotics for prostatitis. Avoid prostate exams in people with neutropenia given theoretical risk of seeding bacteria.   Distinguishing between acute bacterial prostatitis and prostate abscess can be difficult because patients will look sick (fever, tachycardia, abdominal pain) in both cases Suprapubic pain Abdominal pain Urinary retention History of having had prostatitis in the past Pain with defecation or with prolonged sitting Immunocompromised patient Protracted symptoms > 36 hours Progressive urinary retention Patients who have received antibiotics for prostatitis but are getting worse Overlap symptom: Physical exam and CT scan ultimately will help rule out deadly abscess or other Things to make you think more about abscess: Pearl: do not send a PSA during acute prostatitis. Leads to unnecessary worry and future monitoring of PSA levels. Prostate exam tips: Start with palpation of the anal-rectal junction to get a sense if discomfort is coming from the exam itself versus the prostate and examine if there a rectal abscess Palpate the prostate last to feel for bogginess, tenderness Prostate massage is supposed to increase the sensitivity of urine culture by squeezing bacteria out of the prostate into the urethra. However given the discomfort, probably not needed in the emergency or even primary care setting → it should be a quick exam Pearl: avoid prostate exam in people with neutropenia given theoretical risk of seeding bacteria Categories of prostatitis: A urinalysis, gram stain and culture should not have any bacteria Patients have been dealing with for a longer time and are non-toxic appearing Chronically have WBC’s in the urine with no symptoms Diagnosed by biopsy Acute bacterial prostatitis  Chronic bacterial prostatitis Chronic prostatitis or chronic pelvic pain (90% of prostatitis) Asymptomatic inflammatory prostatitis Treatment: E-coli is the bacteria you’re treating against → check your local antibiogram for resistance patterns Prostate abscess  5th or 6th decade of life Immunosuppression End stage renal disease Indwelling catheter Any recent instrumentation of the prostate Potential complication of inflammatory prostatitis At most 2.5% of patients Risk factors:   REFERENCE: Carroll DE, Marr I, Huang GKL, Holt DC, Tong SYC, Boutlis CS. Staphylococcus aureus Prostatic abscess: a clinical case report and a review of the literature. BMC Infect Dis. 2017 Jul 21;17(1):509. Datillo WR, Shiber J. Prostatitis or prostatic abscess. J of Emerg Med. 2013; 44(1):e121-e122 Hsieh MJ, Yen ZS. Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. BET 1: Is there a role for serum prostate-specific antigen level in the diagnosis of acute prostatitis? Emerg Med J. 2008 Aug;25(8):522-3. Khan FU, Ihsan AU, Khan HU, Jana R, Wazir J, Khongorzul P, Waqar M, Zhou X. Comprehensive overview of prostatitis. Biomed Pharmacother. 2017 Oct;94:1064-1076.

This free iTunes segment is just one tiny snippet of the fully-loaded 3-hour monthly Primary Care RAP show. Earn CME on your commute while getting the latest practice-changing primary care information: journal article breakdowns, evidence-based topic reviews, critical guideline updates, conversations with experts, and so much more. Sign up for the full show at hippoed.com/PCRAPPOD Paul Offit, MD is a world-renowned expert on the safety and efficacy of vaccines. He has authored over 160 articles, co-invented the rotavirus vaccine, and been featured on shows like “60 Minutes,” “The Daily Show,” and “The Colbert Report,” among many others. In this segment, Sol Behar, MD, and Neda Frayha,  MD pick Dr. Offit’s brain about why our patients may be skeptical about vaccines and how best to communicate with them for the safety and wellbeing of all our patients. Pearls: It is understandable that parents are questioning vaccines now given that they do not encounter the effects of these infections in their day to day life. The role of the clinician is to make the consequences of vaccine preventable diseases real for parents so that they can understand how truly scary they are.   Why might parents be skeptical of vaccines? Parents are no longer scared of the diseases that vaccines aim to protect children from. In comparison to the twenties and thirties, when children were dying from diphtheria or becoming disabled from polio, this generation of parents have not seen firsthand the effects of these infections. As practitioners, we are asking parents to vaccinate their children against 14 different diseases in the first year of life to prevent diseases that most people do not see, using biological fluids that most people do not understand. With these facts in mind, Dr. Offit underscores is reasonable it is for parents to be skeptical. What can practitioners do when faced with a vaccine skeptical parent? The first thing to do when you see someone who is hesitant about vaccines is to ask them what they are scared of. If there is a specific issue, be it autism, diabetes or multiple sclerosis, there likely will be data to answer those questions. As the clinician, you try to present the data in a compelling, passionate, and compassionate way. As Dr. Offit says, science alone is not good enough. It is also important to make people realize that the choice not to vaccinate is not a risk free choice. By referring to parent activist groups like Families Fighting Flu or National Meningitis Association, you can provide parents with examples of the very serious risk associated with not vaccinating. What is Dr. Offit’s approach to dealing with a parent that is unsure about vaccines? The way that Dr. Offit goes about it is as follows: he finds out what the parent is worried about, tries to go through how one would answer those question, he talks about what has been done to answer those questions and ends by emphasizing why it is important to vaccinate. He makes it personal, making sure that the parent knows that he has his own children that are fully vaccinated and says that vaccinating is a matter of loving the child. He tells parents that by not vaccinating their child, the parent is asking him to practice substandard care. Why might parents continue to believe that autism is linked to the MMR vaccine? As Dr. Offit explains, if you are a parent of a child that suffers from autism, you want to try and figure out why. What Andrew Wakefield offered was a reason why; in his explanation it was the vaccine that caused the development of autism. With this explanation, parents were allowed some control over the disease. For example, parents believed that they could control whether or not their future children developed autism but choosing not to vaccinate them. As practitioners we can say things like vaccines are good and vaccine protect against preventable disease but what we still cannot say is what causes autism and parents want that explanation. How can practitioners advocate for their patients? Say something. It is important for clinicians to speak up when they see misinformation being presented because these false claims are devaluing the truth of science.

This free iTunes segment is just one tiny snippet of the fully-loaded 3-hour monthly Primary Care RAP show. Earn CME on your commute while getting the latest practice-changing primary care information: journal article breakdowns, evidence-based topic reviews, critical guideline updates, conversations with experts, and so much more. Sign up for the full show at hippoed.com/PCRAPPOD   Rana Awdish, MD a pulmonary and critical care physician in Detroit, Michigan, wrote an incredibly powerful, bestselling memoir (In Shock) about her own experiences as a critical care patient. In this segment, she sits down with Neda Frayha, MD to talk about healing, the ways the giant medical education industrial complex contributes to provider burnout, and the redemptive power of connection. Pearls: Dr. Rana Awdish shares her story and takeaways from her experience as a patient that have changed how she practices medicine. A summary won’t do this justice - it’s a must listen!   Dr. Awdish’s medical story: She was in the final days of her training in pulmonary/critical care when she developed acute-onset abdominal pain while being 7 months pregnant. They assumed she had HELLP because her liver enzymes were in the 10,000’s, platelets were 15 and she was in hemorrhagic shock. It turns out that she had a ruptured hepatic adenoma, ended up losing the pregnancy, and went  into multiorgan failure in the surgical ICU. Some of her takeaways from that experience: She needed to be seen as a patient navigating an illness and having emotions about it Individual medical providers can have a profound impact on a patient’s experience during illness, both negatively and positively Providers often lose sight of the person immediately in front of us, caught up in things that are less patient-centric (ie: how many patients you have to see that day) Providers come in with an agenda without understanding what is important to the patient The medical education complex has a way of taking really idealistic and compassionate young people and often turns them into jaded cynics Part of this may be from a lack of modeling joy in work and a sense of purpose We often avoid hard conversations and leaning into the discomfort for the short-term benefit at the detriment of missing the long-term benefit Getting to know patients and tailoring your recommendations to their values is liberating as a provider Give yourself the permission to be the kind of providers our patients actually want us to be   References: Awdish R. In Shock: My Journey from Death to Recovery and the Redemptive Power of Hope. New York, New York: St. Martin’s Press; 2017.        

This free iTunes segment is just one tiny snippet of the fully-loaded 3-hour monthly Primary Care RAP show. Earn CME on your commute while getting the latest practice-changing primary care information: journal article breakdowns, evidence-based topic reviews, critical guideline updates, conversations with experts, and so much more. Sign up for the full show at hippoed.com/PCRAPPOD Post-contrast AKI (or contrast induced nephropathy as it used to be called) is one of those hot-button issues in modern medicine. Is it really a thing? Was it ever, really? Neda Frayha, MD sits down with Salim Rezaie, MD of Rebel EM for an invigorating conversation about this controversial topic and what the literature actually tells us about it.    Pearls: The term contrast-induced nephropathy has fallen out of favor to post-contrast AKI because the debate about contrast’s role in kidney injury rages on. Much of the recent literature has not shown a difference in AKI for those who receive a CT with contrast. Earlier studies were based on contrasts of higher volume and osmolarity given arterially that are not routinely used today. Remember that studies excluded those who had a renal transplant, GFR4.   Terminology: contrast-induced nephropathy has fallen out of favor to post-contrast AKI because we aren’t sure if contrast is really the culprit Issues with the literature: Many studies involved high volume, high osmolar contrast given arterially, not venous, low volume or low osmolar contrast Early studies used 15,000 milliosmole contrast whereas today we are using 320-800 milliosmoles or even iso-osmolar contrast Shown that route does make a difference. People receiving arterial contrast (ie: coronary angiography) are more at risk of AKI Studies are observational so you cannot get to causation, just association Other potential risk factors: comorbid conditions (diabetes, heart failure, hypertension), volume depletion, concurrent medications (vancomycin, NSAIDs, diuretics) Are outcomes clinical or patient-oriented (ie: dialysis, death, increased length of stay) or a lab value change? New literature: 1. Annals of EM 2017 (Hinson et. al) Single center Retrospective cohort study 17,000 patients who underwent CT with contrast, without contrast or no CT at all Excluded if Cr > 4mg/dL or renal transplant Bottomline: no difference in patient-oriented outcomes (dialysis, mortality) 2. Annals of EM 2017 (Aycock et. al) Meta-analysis 28 articles with 100,000 patients Bottomline: no difference in patient-oriented outcomes (dialysis, mortality) 3. Lancet 2017 (AMACING trial) Randomized control trial (three parallel group, open label, non-inferiority) Excluded if GFR

This free iTunes segment is just one tiny snippet of the fully-loaded 3-hour monthly Primary Care RAP show. Earn CME on your commute while getting the latest practice-changing primary care information: journal article breakdowns, evidence-based topic reviews, critical guideline updates, conversations with experts, and so much more. Sign up for the full show at  hippoed.com/PCRAPPOD We have been waiting and waiting and waiting for the new community acquired guidelines. And here they are! Infectious Diseases expert Devang Patel,MD joins Matt DeLaney, MD and Neda Frayha, MD for a conversation on CAP in general and the new guidelines in specific. Pearls: The latest guidelines for community acquired pneumonia now includes amoxicillin or doxycycline for 5-7 days as first-line treatment given the rising rates of macrolide resistance and less emphasis on coverage of atypical pneumonia pathogens.   Review of pathophysiology: Lower respiratory tract often preceded by an upper respiratory tract infection, that inhibits ability to clear mucus and pathogens invade the lungs Other risk factors: Smoking Elderly Immune compromise (ie: infection, steroids, cancer) Pathogens: Typical - strep pneumo, haemophilus, staph aureus Atypical (more common) - influenza, parainfluenza, mycoplasma, chlamydia pneumoniae, legionella, coccidioidomycosis (in the southwest) EPIC Study (2015) - study to determine pneumonia pathogens using all the tools we have available (culture, PCR) 62% no pathogen detected 22% viral - most were rhinovirus which does not cause lower respiratory tract infections but predisposes to pneumonia Strep pneumonia was the number one bacterial pathogen Bottomline: we still don’t know what causes most pneumonias but just that our patients get better with antibiotics Differentiating between typical v. atypical pneumonias - there’s no good way to know viral versus bacterial → default is to treat as bacterial pneumonia with antibiotics Diagnosis: Clinical features (cough, fever, sputum production, pleuritic chest pain, crackles) Guidelines recommend a chest x-ray For outpatient uncomplicated pneumonia, don’t get blood or sputum cultures For severe cases (those with risk factors for multidrug resistance, MRSA, or pseudomonas) you still want to get blood and sputum cultures Pearls: No more healthcare-associated pneumonia Emphasis on CURB-65 to assess severity of who does NOT need to be admitted Procalcitonin is NOT endorsed as a way to determine who gets antibiotics and who doesn’t Treatment: Increasing strep pneumo resistance to macrolides so no more monotherapy with macrolide (azithromycin) unless resistance is less than 20% in the area First-line in non-hospitalized adult is amoxicillin or doxycycline for 5-7 days Steroids recommended not use but may be considered in septic shock Commentary from Dr. Patel (ID specialist): Not a major change in practice other than to consider not covering atypicals in an otherwise healthy person   REFERENCES: Metlay JP, Waterer GW, Long AC, et al on behalf of the American Thoracic Society and Infectious Diseases Society of America. Diagnosis and Treatment of Adults with Community-Acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019 Oct 1;200(7):e45-e67. doi: 10.1164/rccm.201908-1581ST. https://www.atsjournals.org/doi/10.1164/rccm.201908-1581ST  Jain S, Self WH, Wunderink RG, et al for the CDC EPIC Study Team. Community-acquired pneumonia requiring hospitalization among U.S. adults. N Engl J Med 2015; 373:415-427. Postma DF, van Werkhoven CH, van Elden LJR, et al for the CAP-START Study Group. Antibiotic treatment strategies for community-acquired pneumonia in adults. N Engl J Med 2015; 372:1312-1323.

This free iTunes segment is just one tiny snippet of the fully-loaded 3-hour monthly Urgent Care RAP show. Earn CME on your commute while getting the latest practice-changing urgent care information: journal article breakdowns, evidence-based topic reviews, critical guideline updates, conversations with experts, and so much more. Sign up for the full show at hippoed.com/UCRAPPOD Arun Sayal, MD runs through a thoughtful approach to the knee exam with Neda Frayha, MD, Matthieu DeClerck, MD. One that includes the Mnemonic “SLR-CDEF” as a reminder of what diagnosis we should think about with every knee injury. The mnemonic stands for Septic knee, Locked knee, Referred pain, Compartment syndrome, Dislocation (spontaneously reduced), Extensor mechanism disruption (Over 40, look over the patella – i.e., a quadriceps tear. Under 40 look under the patella  – i.e., a patellar tendon rupture), Fracture (radiographically occult … Pearls: History of injury and patient age often will narrow the differential for post-traumatic knee pain to a short list of possible diagnoses.  Knee dislocations can occur in obese patients with very minor trauma and often spontaneously reduce resulting in ‘normal’ x-rays. Adding oblique x-ray views improves the sensitivity in the diagnosis of tibial plateau fracture. Radiologists ability to read films in a helpful way is highly influenced by the completeness of the history and the differential diagnoses of concern provided to them.     History will often reveal the source of knee pain after trauma, as a full and careful exam is not generally possible due to pain, swelling, and spasm.  For example, patients with an ACL tear will describe four classic historical features:  Deceleration mechanism Swelling within 1 hour Sensation of a “pop” or shift at the knee joint Inability to return to play Patients with a meniscal tear will describe a twisting mechanism. The force of twisting required to tear the meniscus decreases with age.   Elderly patients can simply tear their meniscus by standing up. Valgus (ie: knee bending inward) stress tends to cause different injuries depending on the age of the patient. Salter-Harris Femur and/or Proximal fibula in adolescents MCL injury in younger patients (ie: 20-30 years old) Lateral tibial plateau fractures in older patients (ie: >50 years) Examining patients before reviewing their x-rays will help to determine what to suspect clinically and look for radiographically.  Other advantages of performing a history and physical prior to ordering x-rays include recognizing that additional views may be helpful and providing a more complete history for the radiologist interpreting the films.  A mnemonic for x-ray ‘negative’ injuries of the knee that can prove useful is SLR-CDEF. S - Septic joint L - Locked knee (ie: when the knee cannot be fully extended) from meniscal injury R - Referred pain (e.g. hip pathology) due to Obturator nerve irritation Knee pain which is not reproduced when ranging the knee is suggestive of a referred source of pain.   C - Compartment syndrome  This can easily excluded by palpating the compartments and, when in doubt, comparing the firmness to the contralateral, uninjured side. D - Dislocation (ie: at least 3 of 4 collateral ligaments have been disrupted) Instability is the key finding indicating that a knee dislocation has likely occurred. Knee dislocations commonly will spontaneously reduce, however, even if reduced, patients are at high risk of popliteal artery injury and subsequent ischemia/amputation.  In very obese patients, knee dislocation can occur with minimal force (e.g. stepping off a curb). E - Extensor Disruption (e.g. Patellar fracture, Patellar tendon rupture, and/or Quadriceps tendon rupture) Patient will be unable to extend their knee/lower leg fully against gravity. Patellar tendon rupture generally occurs in younger patients with high mechanism injury. Quadriceps tendon rupture is more often spontaneous or low mechanism in older patients.  F - Fracture (occult)  The most common occult fracture of the knee is a lateral tibial plateau fracture. Oblique knee films can allow for better examination for tibial plateau fractures. Segond fractures involve the tibial spine.  Osteochondral fragments from the patella can be seen radiographically after certain injuries in adolescent athletes, commonly gymnasts, and should be suspected if when there’s significant knee swelling. Osteochondritis desicans is caused by a twisting mechanism (similar to medial meniscal injury) in adolescents.

To continue our conversations on Race and Medicine, Dr. Neda Frayha and her Hippo Education colleague Dr. Jay-Sheree Allen sit down with noted health disparities researcher Dr. Utibe Essien, an Assistant Professor of Medicine at the University of Pittsburgh School of Medicine and Core Investigator for the Center for Health Equity Research and Promotion at the VA Pittsburgh Healthcare System. They explore reasons for disparities in the health care outcomes of our patients, disparities in the diversity of our medical profession, and the crucial bridge that connects these two. They close with three concrete steps we all can take to improve our clinical practice and reduce health disparities in our patient communities. This conversation originally aired on Hippo Education.  References:   Youmans Q, Essien U, Capers Q. A Test of Diversity — What USMLE Pass/Fail Scoring Means for Medicine. N Engl J Med. 2020; 382:2393-95. Gross CP, Essien UR, Pasha S, Gross JR, Wang SY, Nunez-Smith M. Racial and Ethnic Disparities in Population-Level Covid-19 Mortality [published online ahead of print, 2020 Aug 4]. J Gen Intern Med. 2020;1-3. doi:10.1007/s11606-020-06081-w Essien UR, Eneanya ND, Crews DC. Prioritizing Equity in a Time of Scarcity: The COVID-19 Pandemic [published online ahead of print, 2020 Jun 30]. J Gen Intern Med. 2020;1-3. doi:10.1007/s11606-020-05976-y Egbert A, et al. The Color of Coronavirus: Covid-19 deaths by race and ethnicity in the U.S. Published 5 August 2020. Accessed: 7 August 2020. https://www.apmresearchlab.org/covid/deaths-by-race 

A cough lasting longer than 8 weeks can be a major frustration for our patients (and everyone around them). In this segment, pulmonologist and cough expert Dr. Kathryn Robinett walks Neda Frayha, MD, and Paul Simmons, MD through a real-world approach to chronic cough and drops tons of beautiful, shimmery knowledge pearls along the way. To view the references and show notes for this segment CLICK HERE   

In this Hippo Education bonus conversation, Drs. Jay-Sheree Allen and Neda Frayha sit down with noted health disparities researcher Dr. Utibe Essien, an Assistant Professor of Medicine at the University of Pittsburgh School of Medicine and Core Investigator for the Center for Health Equity Research and Promotion at the VA Pittsburgh Healthcare System. They explore reasons for disparities in the health care outcomes of our patients, disparities in the diversity of our medical profession, and the crucial bridge that connects these two. They close with three concrete steps we all can take to improve our clinical practice and reduce health disparities in our patient communities. CLICK HERE to view the references and join our thriving online community of clinicians

In this Hippo Education bonus conversation, Drs. Jay-Sheree Allen and Neda Frayha sit down with noted health disparities researcher Dr. Utibe Essien, an Assistant Professor of Medicine at the University of Pittsburgh School of Medicine and Core Investigator for the Center for Health Equity Research and Promotion at the VA Pittsburgh Healthcare System. They explore reasons for disparities in the health care outcomes of our patients, disparities in the diversity of our medical profession, and the crucial bridge that connects these two. They close with three concrete steps we all can take to improve our clinical practice and reduce health disparities in our patient communities. CLICK HERE To view the references and join our thriving community of clinicians

In this Hippo Education bonus conversation, Drs. Jay-Sheree Allen and Neda Frayha sit down with noted health disparities researcher Dr. Utibe Essien, an Assistant Professor of Medicine at the University of Pittsburgh School of Medicine and Core Investigator for the Center for Health Equity Research and Promotion at the VA Pittsburgh Healthcare System. They explore reasons for disparities in the health care outcomes of our patients, disparities in the diversity of our medical profession, and the crucial bridge that connects these two. They close with three concrete steps we all can take to improve our clinical practice and reduce health disparities in our patient communities. CLICK HERE to view the references and join our thriving online community of clinicians.

Got time? A lot of our resident listeners have been asking for tips and tools for time management in the clinic. Dr. Nikki Southall joins Paul Simmons, MD, and Neda Frayha, MD for a conversation about typical time sinks, some great time management tips, and strategies for becoming more efficient at work.  Click here to view references and show notes

In recent weeks, many of our medical organizations have released official statements declaring racism to be a public health crisis. In this introduction to Hippo Education’s new Race and Medicine audio series, Dr. Jay-Sheree Allen sits down with Primary Care RAP host Dr. Neda Frayha for a candid conversation exploring the definition and types of racism, the historical and present-day manifestations of racism in medicine, and potential strategies we all can incorporate into our daily practices to go beyond the hashtag and become true allies.  To view the references for this segment: Click Here  

In recent weeks, many of our medical organizations have released official statements declaring racism to be a public health crisis. In this introduction to Hippo Education’s new Race and Medicine audio series, Dr. Jay-Sheree Allen sits down with Primary Care RAP host Dr. Neda Frayha for a candid conversation exploring the definition and types of racism, the historical and present-day manifestations of racism in medicine, and potential strategies we all can incorporate into our daily practices to go beyond the hashtag and become true allies. To View the references from this segment: Click Here

In recent weeks, many of our medical organizations have released official statements declaring racism to be a public health crisis. In this introduction to Hippo Education’s new Race and Medicine audio series, Dr. Jay-Sheree Allen sits down with Primary Care RAP host Dr. Neda Frayha for a candid conversation exploring the definition and types of racism, the historical and present-day manifestations of racism in medicine, and potential strategies we all can incorporate into our daily practices to go beyond the hashtag and become true allies.  To view the references for this segment: Click Here    

How are you coping with all of the death around us these days? In this Hippo Education update, Primary Care RAP host Dr. Neda Frayha interviews Dr. BJ Miller, a hospice and palliative care specialist at the University of California, San Francisco whose TED talk on what really matters at the end of life has been viewed over 10 million times. Along with Shoshana Berger, Dr. Miller is the co-author of the book, A Beginner’s Guide to the End: Practical Advice for Living Life and Facing Death and founder of the Center for Dying and Living. In this conversation, he helps us come to terms with our own mortality and provide better support to our patients at the end of life.    To view the references and show notes from this podcast Click here

How are you coping with all of the death around us these days? In this Hippo Education update, Primary Care RAP host Dr. Neda Frayha interviews Dr. BJ Miller, a hospice and palliative care specialist at the University of California, San Francisco whose TED talk on what really matters at the end of life has been viewed over 10 million times. Along with Shoshana Berger, Dr. Miller is the co-author of the book, A Beginner’s Guide to the End: Practical Advice for Living Life and Facing Death and founder of the Center for Dying and Living. In this conversation, he helps us come to terms with our own mortality and provide better support to our patients at the end of life.    To view the references and show notes from this podcast Click here

The coronavirus pandemic’s impact on our health care system may be seen in more ways than in how we manage people with COVID-19. Since March, routine care, scheduled surgeries and wellness exams have been put mostly on hold or done via teleconference. Primary care physicians are at the front lines of care and can help identify issues before they develop into something more serious. Hosts Maiken Scott of WHYY in Philadelphia and Brian Ellison of KCUR in Kansas City discuss what the future of health care may look like. Will physicians rely more on telemedicine? How will this affect the future of the medical profession? What should patients expect of their physicians? You'll hear from: Dr. Neda Frayha, internist and primary care physician in Baltimore; Shantell Williams, recent Truman Medical Center patient; Dr. Catricia Tilford, Pediatrician at Samuel U. Rodgers Health Clinic; and Raina Merchant, Director of Penn Medicine Center for Digital Health.

In this Hippo Education update, Primary Care RAP host Dr. Neda Frayha interviews regular guest and Infectious Diseases expert Dr. Devang Patel for a discussion of where the IDSA stands on all the potential treatments for COVID-19, a review of the remdesivir paper that is all the rage lately, and a look back on whether or not their very first conversations on the novel coronavirus have stood the test of time.    To view the references and show notes from this podcast Click here

In this Hippo Education update, Primary Care RAP host Dr. Neda Frayha interviews regular guest and Infectious Diseases expert Dr. Devang Patel for a discussion of where the IDSA stands on all the potential treatments for COVID-19, a review of the remdesivir paper that is all the rage lately, and a look back on whether or not their very first conversations on the novel coronavirus have stood the test of time.  To view the references and show notes from this podcast Click here

In this Hippo Education update, Primary Care RAP host Dr. Neda Frayha interviews regular guest and Infectious Diseases expert Dr. Devang Patel for a discussion of where the IDSA stands on all the potential treatments for COVID-19, a review of the remdesivir paper that is all the rage lately, and a look back on whether or not their very first conversations on the novel coronavirus have stood the test of time.    To view the references and show notes from this podcast Click here

Have you ever had a patient who is on peritoneal dialysis? What does this even mean? How does it work? Paul Simmons, MD and Neda Frayha, MD answer these questions and more in this 2 part-segment about peritoneal dialysis.  To see the show notes and references  Click Here  Subscribe today to hear Part 2 and the rest of this month's program.  

UMSOM class of 2015 alum and psychiatrist Dr. Melissa Shepard sits down with Dr. Neda Frayha for some real talk on the mental health challenges facing health care workers in the COVID-19 pandemic, and some concrete, tangible tools to help us get through this period. Spoiler alert: it's more than yoga. This conversation originally aired on Hippo Education's podcasts.  Resources: Free mental health crisis line for physicians impacted by Covid-19 related issues, staffed by US Psychiatrists (support only, cannot prescribe medications). 1-888-409-0141. www.physiciansupportline.com  COVID-19 Resource and Information Guide. National Alliance on Mental Illness. https://www.nami.org/getattachment/About-NAMI/NAMI-News/2020/NAMI-Updates-on-the-Coronavirus/COVID-19-Updated-Guide-1.pdf  Mental Health America, Mental Health And COVID-19 – Information And Resources Darnall B. The COVID-19 Wellness and Coping Toolkit: 11 Tips for Health Care Workers, Patients, and the Public. Psychology Today, 31 March 2020. https://www.psychologytoday.com/us/blog/empowered-relief/202003/the-covid-19-wellness-and-coping-toolkit    Good Therapy. https://www.goodtherapy.org  Psychology Today, Find a Therapist. Doxy.me Physician Support Line. https://doxy.me/physiciansupportline  Free access to Headspace Plus app (guided meditations) for healthcare professionals. https://www.headspace.com/health-covid-19 Center for Mind-Body Medicine at Georgetown. Introduction to evidenced-based techniques for helping people through and after trauma (things like guided imagery, body scans, breathing techniques) https://cmbm.org/thetransformation/resources/   References: Lai J, Ma S, Wang Y, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open. 2020;3(3):e203976. doi:10.1001/jamanetworkopen.2020.3976   Chen QC, Liang M, Li Y, et al. Mental health care for medical staff in China during the COVID-19 outbreak. Lancet Psychiatry 2020; 7(4):E15-16. doi:https://doi.org/10.1016/S2215-0366(20)30078-X   Garfin DR, Silver RC, Holman EA. The novel coronavirus (COVID-2019) outbreak: Amplification of public health consequences by media exposure. Health Psychology. 2020 May;39(5): 355-357. Advance online publication. doi: https://doi.org/10.1037/hea0000875   Rosenberg AR. Cultivating deliberate resilience during the coronavirus disease 2019 pandemic. JAMA Pediatr. Published online April 14, 2020. doi:10.1001/jamapediatrics.2020.1436   Galea S, Merchant RM, Lurie N. The mental health consequences of COVID-19 and physical distancing: the need for prevention and early intervention. JAMA Intern Med. Published online April 10, 2020. doi:10.1001/jamainternmed.2020.1562   Pfefferbaum B, North CS. Mental Health and the Covid-19 Pandemic. N Engl J Med. Published online April 13, 2020. doi: 10.1056/NEJMp2008017

Psychiatrist Dr. Melissa Shepard sits down with Primary Care RAP host Dr. Neda Frayha for some real talk on the mental health challenges facing health care workers in the COVID-19 pandemic, and some concrete, tangible tools to help us get through this period. Spoiler alert: it’s more than yoga.  To view the references and show notes from this podcast Click here    

In this Hippo Education Short, psychiatrist Dr. Melissa Shepard sits down with Primary Care RAP host Dr. Neda Frayha for some real talk on the mental health challenges facing health care workers in the COVID-19 pandemic, and some concrete, tangible tools to help us get through this period. Spoiler alert: it’s more than yoga.    To view the references and show notes from this podcast Click here

Psychiatrist Dr. Melissa Shepard sits down with Primary Care RAP host Dr. Neda Frayha for some real talk on the mental health challenges facing health care workers in the COVID-19 pandemic, and some concrete, tangible tools to help us get through this period. Spoiler alert: it’s more than yoga.    To view the references and show notes from this podcast Click here

None of us are immune from stress, especially now. This is a critical moment for us to look out not only for our own mental health but that of our colleagues. In this episode, psychiatrist Dr. Melissa Shepard sits down with our good friend Dr. Neda Frayha to discuss the mental health challenges facing health care workers in the COVID-19 pandemic, and some concrete, tangible tools to help us get through this period.    HIPPO Education COVID Resource Center. Link Free mental health crisis line for physicians impacted by Covid-19 related issues, staffed by US Psychiatrists (support only, cannot prescribe medications). 1-888-409-0141. www.physiciansupportline.com  COVID-19 Resource and Information Guide. National Alliance on Mental Illness. Link Darnall B. The COVID-19 Wellness and Coping Toolkit: 11 Tips for Health Care Workers, Patients, and the Public. Psychology Today, 31 March 2020. Link  Good Therapy. https://www.goodtherapy.org  Doxy.me Physician Support Line. https://doxy.me/physiciansupportline  Free access to Headspace Plus app (guided meditations) for healthcare professionals. Link Center for Mind-Body Medicine at Georgetown. Introduction to evidenced-based techniques for helping people through and after trauma (things like guided imagery, body scans, breathing techniques) Link  

None of us are immune from stress, especially now. This is a critical moment for us to look out not only for our own mental health but that of our colleagues. In this episode, Dr. Melissa Shepard sits down with Primary Care RAP host Dr. Neda Frayha for some real talk on the mental health challenges facing health care workers in the COVID-19 pandemic, and some concrete, tangible tools to help us get through this period. Spoiler alert: it’s more than yoga.   HIPPO Education COVID Resource Center. Link Free mental health crisis line for physicians impacted by Covid-19 related issues, staffed by US Psychiatrists (support only, cannot prescribe medications). 1-888-409-0141. www.physiciansupportline.com  COVID-19 Resource and Information Guide. National Alliance on Mental Illness. Link Darnall B. The COVID-19 Wellness and Coping Toolkit: 11 Tips for Health Care Workers, Patients, and the Public. Psychology Today, 31 March 2020. Link  Good Therapy. https://www.goodtherapy.org  Doxy.me Physician Support Line. https://doxy.me/physiciansupportline  Free access to Headspace Plus app (guided meditations) for healthcare professionals. Link Center for Mind-Body Medicine at Georgetown. Introduction to evidenced-based techniques for helping people through and after trauma (things like guided imagery, body scans, breathing techniques) Link To learn more about Rob's new show Stimulus: stimuluspodcast.com

None of us are immune from stress, especially now. This is a critical moment for us to look out not only for our own mental health but that of our colleagues. In this episode, psychiatrist Dr. Melissa Shepard sits down with our good friend Dr. Neda Frayha to discuss the mental health challenges facing health care workers in the COVID-19 pandemic, and some concrete, tangible tools to help us get through this period.    HIPPO Education COVID Resource Center. Link Free mental health crisis line for physicians impacted by Covid-19 related issues, staffed by US Psychiatrists (support only, cannot prescribe medications). 1-888-409-0141. www.physiciansupportline.com  COVID-19 Resource and Information Guide. National Alliance on Mental Illness. Link Darnall B. The COVID-19 Wellness and Coping Toolkit: 11 Tips for Health Care Workers, Patients, and the Public. Psychology Today, 31 March 2020. Link  Good Therapy. https://www.goodtherapy.org  Doxy.me Physician Support Line. https://doxy.me/physiciansupportline  Free access to Headspace Plus app (guided meditations) for healthcare professionals. Link Center for Mind-Body Medicine at Georgetown. Introduction to evidenced-based techniques for helping people through and after trauma (things like guided imagery, body scans, breathing techniques) Link  

Times are weird. In the first week of April 2020, Drs. Kimberly Lumpkins and Neda Frayha had a conversation about what is going on in the world, how they're coping, and some healthier approaches moving forward. 

Sometimes it can seem like every other child we see has a food allergy. How prevalent are food allergies in the general population, and how can we best diagnose and manage them? To shed light on these questions, as well as recent guideline changes in the allergy community and novel therapies on the horizon, PC RAP welcomes back Torie Grant, MD MHS a Med/Peds allergist and immunologist at Johns Hopkins. She sits down with Neda Frayha, MD to share the full scoop on food allergies. To hear Part Two of this conversation and to view the show notes as well as detailed references click here

Has your clinical practice shifted to telemedicine yet? In the era of COVID-19, clinicians everywhere are being thrown into telemedicine, often without any experience or background knowledge. To help us all get up to speed with this patient care technology, Hippo Education’s Dr. Neda Frayha sits down with Dr. Edward Kaftarian, the Vice Chair of Mental Health at the American Telemedicine Association and CEO of Orbit Health Telepsychiatry. Together they explore the benefits and potential pitfalls of telemedicine, the equipment required, billing and coding considerations, appropriate etiquette, and much more. For more information and to view all the detailed notes and get all the references for this segment please click here

Has your clinical practice shifted to telemedicine yet? In the era of COVID-19, clinicians everywhere are being thrown into telemedicine, often without any experience or background knowledge. To help us all get up to speed with this patient care technology, Hippo Education’s Dr. Neda Frayha sits down with Dr. Edward Kaftarian, the Vice Chair of Mental Health at the American Telemedicine Association and CEO of Orbit Health Telepsychiatry. Together they explore the benefits and potential pitfalls of telemedicine, the equipment required, billing and coding considerations, appropriate etiquette, and much more. For more information and to view all the detailed notes and get all the references for this segment please click here

Has your clinical practice shifted to telemedicine yet? In the era of COVID-19, clinicians everywhere are being thrown into telemedicine, often without any experience or background knowledge. To help us all get up to speed with this patient care technology, Hippo Education’s Dr. Neda Frayha sits down with Dr. Edward Kaftarian, the Vice Chair of Mental Health at the American Telemedicine Association and CEO of Orbit Health Telepsychiatry. Together they explore the benefits and potential pitfalls of telemedicine, the equipment required, billing and coding considerations, appropriate etiquette, and much more. For more information and to view all the detailed notes and get all the references for this segment please click here

Our panel of podcast hosts from a variety of practice settings discuss the logistical and psychological impact of the COVID-19 pandemic on healthcare workers and discuss strategies to mitigate the stress associated with the pandemic. Featuring: Solomon Behar, MD, Neda Frayha, MD, Mike Weinstock, MD, and Matthieu DeClerck, MD References: Click Here

Our panel of podcast hosts from a variety of practice settings discuss the logistical and psychological impact of the COVID-19 pandemic on healthcare workers and discuss strategies to mitigate the stress associated with the pandemic. Featuring: Solomon Behar, MD, Neda Frayha, MD, Mike Weinstock, MD, and Matthieu DeClerck, MD References: Click Here

Our panel of podcast hosts from a variety of practice settings discuss the logistical and psychological impact of the COVID-19 pandemic on healthcare workers and discuss strategies to mitigate the stress associated with the pandemic.  Featuring:  Solomon Behar, MD, Neda Frayha, MD, Mike Weinstock, MD, and Matthieu DeClerck, MD  For References: Click Here  

Our own Infectious Diseases specialist Dr. Devang Patel and our regular host Dr. Neda Frayha discuss the latest, clinician-focused updates on the COVID-19 coronavirus outbreak. This conversation originally aired on Hippo Education's Primary Care Reviews and Perspectives podcast.    

In this Hippo Education Short, Infectious Diseases specialist Dr. Devang Patel and our own Dr. Neda Frayha discuss the latest, clinician-focused updates on the COVID-19 coronavirus outbreak.  Subscribe to PEDS:RAP today to support this show and the important work being done to provide you with the most up-to-date medical knowledge from the world experts in the field.  https://www.hippoed.com/ For References go to:  https://www.hippoed.com/peds/rap/episode/bonusshortcovid/covid19update

In this Hippo Education Short, Infectious Diseases specialist Dr. Devang Patel and our own Dr. Neda Frayha discuss the latest, clinician-focused updates on the COVID-19 coronavirus outbreak.  Subscribe to Urgent Care:RAP today to support this show and the important work being done to provide you with the most up-to-date medical knowledge from the world experts in the field.  http://www.hippoed.com   References: https://www.hippoed.com/urgentcare/rap/episode/bonusshortcovid/covid19update

In this Hippo Education Short, Infectious Diseases specialist Dr. Devang Patel and our own Dr. Neda Frayha discuss the latest, clinician-focused updates on the COVID-19 coronavirus outbreak.  Subscribe to Primary Care:RAP today to support this show and the important work being done to provide you with the most up-to-date medical knowledge from the world experts in the field.  http://www.hippoed.com References Available at  https://www.hippoed.com/pc/rap/episode/bonusshortcovid/covid19update

On February 12, 2020, we learned that the USMLE Step 1 exam is going pass/fail in 2022. What does this mean? How will this affect medical students? How will residency program directors evaluate applicants? How should medical schools approach their curricula? Our own Dr. Neda Frayha sat down with Dr. J. Bryan Carmody, Assistant Professor of Pediatrics at Eastern Virginia Medical School and a pediatric nephrologist at Children's Hospital of the King's Daughters in Norfolk, VA, to ask these questions about #USMLEPassFail and many others. Dr. Carmody is a leading voice on this subject nationwide; you can find him on Twitter and via his blog, The Sheriff of Sodium.   References: Change to Pass/Fail Score Reporting for Step 1. United States Medical Licensing Examination. https://www.usmle.org/inCus/ (Accessed 15 Feb 2020) Carmody JB. #USMLEPassFail: A Brave New Day. The Sheriff of Sodium. https://thesheriffofsodium.com. (Accessed 19 Feb 2020) Carmody JB. Step 1 Mania: The Case for #USMLEPassFail. 28 April 2019. https://www.youtube.com/watch?v=T-V6dOWxNz0&feature=youtu.be (Accessed 19 Feb 2020) Carmody JB, Rajasekaran SK. More on the Role of Step 1 of USMLE Step 1 in Resident Selection. Acad Med 2019; 94(7):921. doi: 10.1097/ACM.0000000000002744 Carmody JB. On Residency Selection and the Quantitative Fallacy. J Grad Med Educ 2019; 11(4):420-421. doi: 10.4300/JGME-D-19-00453. Carmody JB, Sarkany D, Heitkamp DE. The USMLE Step 1 Pass/Fail Reporting Proposal: Another View. Acad Radiol 2019; 26(10):1403-1406.  Carmody JB, Rajasekaran SK. On Step 1 Mania, USMLE Score Reporting, and Financial Conflict of Interest at the National Board of Medical Examiners. Acad Med 2019 Dec 17. doi: 10.1097/ACM.0000000000003126. [Epub ahead of print] 

We have been waiting and waiting and waiting for the new community acquired guidelines. And here they are! Infectious Diseases expert Dr. Devang Patel, MD joins Matt DeLaney, MD, FACEP, FAAEM and Neda Frayha, MD for a conversation on CAP in general and the new guidelines in specific. For more incredible segments like this, subscribe to PC:RAP today. You'll never miss a moment of the program and earn 42 hours of CME per year.  Pearls: The latest guidelines for community acquired pneumonia now includes amoxicillin or doxycycline for 5-7 days as first-line treatment given the rising rates of macrolide resistance and less emphasis on coverage of atypical pneumonia pathogens. Review of pathophysiology: Lower respiratory tract often preceded by an upper respiratory tract infection, that inhibits ability to clear mucus and pathogens invade the lungs Other risk factors: Smoking Elderly Immune compromise (ie: infection, steroids, cancer) Pathogens: Typical - strep pneumo, haemophilus, staph aureus Atypical (more common) - influenza, parainfluenza, mycoplasma, chlamydia pneumoniae, legionella, coccidioidomycosis (in the southwest) EPIC Study (2015) - study to determine pneumonia pathogens using all the tools we have available (culture, PCR) 62% no pathogen detected 22% viral - most were rhinovirus which does not cause lower respiratory tract infections but predisposes to pneumonia Strep pneumonia was the number one bacterial pathogen Bottomline: we still don’t know what causes most pneumonias but just that our patients get better with antibiotics Differentiating between typical v. atypical pneumonias - there’s no good way to know viral versus bacterial → default is to treat as bacterial pneumonia with antibiotics Diagnosis: Clinical features (cough, fever, sputum production, pleuritic chest pain, crackles) Guidelines recommend a chest x-ray For outpatient uncomplicated pneumonia, don’t get blood or sputum cultures For severe cases (those with risk factors for multidrug resistance, MRSA, or pseudomonas) you still want to get blood and sputum cultures Pearls: No more healthcare-associated pneumonia Emphasis on CURB-65 to assess severity of who does NOT need to be admitted Procalcitonin is NOT endorsed as a way to determine who gets antibiotics and who doesn’t Treatment: Increasing strep pneumo resistance to macrolides so no more monotherapy with macrolide (azithromycin) unless resistance is less than 20% in the area First-line in non-hospitalized adult is amoxicillin or doxycycline for 5-7 days Steroids recommended not use but may be considered in septic shock Commentary from Dr. Patel (ID specialist): Not a major change in practice other than to consider not covering atypicals in an otherwise healthy person   REFERENCES: Metlay JP, Waterer GW, Long AC, et al on behalf of the American Thoracic Society and Infectious Diseases Society of America. Diagnosis and Treatment of Adults with Community-Acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019 Oct 1;200(7):e45-e67. doi: 10.1164/rccm.201908-1581ST. https://www.atsjournals.org/doi/10.1164/rccm.201908-1581ST  Jain S, Self WH, Wunderink RG, et al for the CDC EPIC Study Team. Community-acquired pneumonia requiring hospitalization among U.S. adults. N Engl J Med 2015; 373:415-427. Postma DF, van Werkhoven CH, van Elden LJR, et al for the CAP-START Study Group. Antibiotic treatment strategies for community-acquired pneumonia in adults. N Engl J Med 2015; 372:1312-1323.

In this Hippo Education Short, Infectious Diseases specialist Dr. Devang Patel sits down with our own Dr. Neda Frayha to discuss what we know so far about the new 2019-n-CoV coronavirus outbreak and what front-line clinicians can do if we suspect a patient of ours might have this viral illness.  References: Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med, 24 Jan 2020. DOI: 10.1056/NEJMoa2001017.  Munster VJ, Koopmans M, van Doremalen M, et al. A novel coronavirus emerging in China - key questions for impact assessment. N Engl J Med, 24 Jan 2020. DOI: 10.1056/NEJMp2000929 Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet, 24 Jan 2020. https://doi.org/10.1016/ S0140-6736(20)30183-5    Chan JF, Yuan S, Kok KH, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet, 24 Jan 2020. https://doi.org/10.1016/S0140-6736(20)30154-9 Phan LT, Nguyen TV, Luong QC, et al. Importation and human-to-human transmission of a novel coronavirus in Vietnam. N Engl J Med, 28 Jan 2020. DOI: 10.1056/NEJMc2001272 Wuhan Coronavirus - 2019-n-CoV. Infectious Diseases Society of America. https://www.idsociety.org/public-health/wuhan-coronavirus/. Accessed 29 Jan 2020 2019 Novel Coronavirus (2019-n-CoV), Wuhan, China. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/summary.html. Accessed 29 Jan 2020. Update and Interim Guidance on Outbreak of 2019 Novel Coronavirus (2019-n-CoV) in Wuhan, China. Centers for Disease Control and Prevention. https://emergency.cdc.gov/han/han00426.asp. Accessed 29 Jan 2020.   Resource: Centers for Disease Control and Prevention 2019-n-CoV PUI Case Investigation Form: https://www.cdc.gov/coronavirus/2019-ncov/downloads/pui-form.pdfpdf icon

In this Hippo Education Short, Infectious Diseases specialist Dr. Devang Patel sits down with our own Dr. Neda Frayha to discuss what we know so far about the new 2019-n-CoV coronavirus outbreak and what front-line clinicians can do if we suspect a patient of ours might have this viral illness.  References: Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med, 24 Jan 2020. DOI: 10.1056/NEJMoa2001017.  Munster VJ, Koopmans M, van Doremalen M, et al. A novel coronavirus emerging in China - key questions for impact assessment. N Engl J Med, 24 Jan 2020. DOI: 10.1056/NEJMp2000929 Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet, 24 Jan 2020. https://doi.org/10.1016/ S0140-6736(20)30183-5    Chan JF, Yuan S, Kok KH, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet, 24 Jan 2020. https://doi.org/10.1016/S0140-6736(20)30154-9 Phan LT, Nguyen TV, Luong QC, et al. Importation and human-to-human transmission of a novel coronavirus in Vietnam. N Engl J Med, 28 Jan 2020. DOI: 10.1056/NEJMc2001272 Wuhan Coronavirus - 2019-n-CoV. Infectious Diseases Society of America. https://www.idsociety.org/public-health/wuhan-coronavirus/. Accessed 29 Jan 2020 2019 Novel Coronavirus (2019-n-CoV), Wuhan, China. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/summary.html. Accessed 29 Jan 2020. Update and Interim Guidance on Outbreak of 2019 Novel Coronavirus (2019-n-CoV) in Wuhan, China. Centers for Disease Control and Prevention. https://emergency.cdc.gov/han/han00426.asp. Accessed 29 Jan 2020.   Resource: Centers for Disease Control and Prevention 2019-n-CoV PUI Case Investigation Form: https://www.cdc.gov/coronavirus/2019-ncov/downloads/pui-form.pdfpdf icon

In this Hippo Education Short, Infectious Diseases specialist Dr. Devang Patel sits down with our good friend Dr. Neda Frayha to discuss what we know so far about the new 2019-n-CoV coronavirus outbreak and what front-line clinicians can do if we suspect a patient of ours might have this viral illness.  References: Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med, 24 Jan 2020. DOI: 10.1056/NEJMoa2001017.  Munster VJ, Koopmans M, van Doremalen M, et al. A novel coronavirus emerging in China - key questions for impact assessment. N Engl J Med, 24 Jan 2020. DOI: 10.1056/NEJMp2000929 Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet, 24 Jan 2020. https://doi.org/10.1016/ S0140-6736(20)30183-5    Chan JF, Yuan S, Kok KH, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet, 24 Jan 2020. https://doi.org/10.1016/S0140-6736(20)30154-9 Phan LT, Nguyen TV, Luong QC, et al. Importation and human-to-human transmission of a novel coronavirus in Vietnam. N Engl J Med, 28 Jan 2020. DOI: 10.1056/NEJMc2001272 Wuhan Coronavirus - 2019-n-CoV. Infectious Diseases Society of America. https://www.idsociety.org/public-health/wuhan-coronavirus/. Accessed 29 Jan 2020 2019 Novel Coronavirus (2019-n-CoV), Wuhan, China. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/summary.html. Accessed 29 Jan 2020. Update and Interim Guidance on Outbreak of 2019 Novel Coronavirus (2019-n-CoV) in Wuhan, China. Centers for Disease Control and Prevention. https://emergency.cdc.gov/han/han00426.asp. Accessed 29 Jan 2020.   Resource: Centers for Disease Control and Prevention 2019-n-CoV PUI Case Investigation Form: https://www.cdc.gov/coronavirus/2019-ncov/downloads/pui-form.pdfpdf icon

In this Hippo Education Short, Infectious Diseases specialist Dr. Devang Patel sits down with our own Dr. Neda Frayha to discuss what we know so far about the new 2019-n-CoV coronavirus outbreak and what front-line clinicians can do if we suspect a patient of ours might have this viral illness.  References: Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med, 24 Jan 2020. DOI: 10.1056/NEJMoa2001017.  Munster VJ, Koopmans M, van Doremalen M, et al. A novel coronavirus emerging in China - key questions for impact assessment. N Engl J Med, 24 Jan 2020. DOI: 10.1056/NEJMp2000929 Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet, 24 Jan 2020. https://doi.org/10.1016/ S0140-6736(20)30183-5    Chan JF, Yuan S, Kok KH, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet, 24 Jan 2020. https://doi.org/10.1016/S0140-6736(20)30154-9 Phan LT, Nguyen TV, Luong QC, et al. Importation and human-to-human transmission of a novel coronavirus in Vietnam. N Engl J Med, 28 Jan 2020. DOI: 10.1056/NEJMc2001272 Wuhan Coronavirus - 2019-n-CoV. Infectious Diseases Society of America. https://www.idsociety.org/public-health/wuhan-coronavirus/. Accessed 29 Jan 2020 2019 Novel Coronavirus (2019-n-CoV), Wuhan, China. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/summary.html. Accessed 29 Jan 2020. Update and Interim Guidance on Outbreak of 2019 Novel Coronavirus (2019-n-CoV) in Wuhan, China. Centers for Disease Control and Prevention. https://emergency.cdc.gov/han/han00426.asp. Accessed 29 Jan 2020.   Resource: Centers for Disease Control and Prevention 2019-n-CoV PUI Case Investigation Form: https://www.cdc.gov/coronavirus/2019-ncov/downloads/pui-form.pdfpdf icon

Primary Care RAP has covered the start-screening-mammos-at-age-50 perspective in the past. Today, we’ll explore the other side of the coin: why women’s health focused organizations recommend beginning annual screening mammography at age 40. Neda Frayha, MD sat down with Dr. Alison Chetlen, DO a breast imaging expert and Associate Professor and Vice Chair of Education in the Department of Radiology at Penn State Health and Hershey Medical Center, for a deeper dive into the evidence we don’t always hear about in primary care. 

Hoarseness is a common complaint in the primary care setting. Our ENT colleague, Dr. Elizabeth Guardiani, sits down with Drs. Matt DeLaney and Neda Frayha to discuss how we can approach this in primary care as well as when to refer to a specialist.  For more incredible segments like this, subscribe to PC:RAP today. You'll never miss a moment of the program and you'll stay up-to-date on all the latest with your favorite Primary Care RAP hosts and contributors.

We all know what to do in pre-op visits for non-cardiac surgery. But guidelines on the pre-op management of cardiac surgery patients are hard to find. Neda Frayha, MD sat down with Dr. Michael Grant, a cardiac anesthesiologist at the Johns Hopkins University School of Medicine, to learn what we need to worry about (and what our pre-op evaluations should include) when our patients go off to cardiac surgery. For more incredible segments like this, subscribe to PC:RAP today. You'll never miss a moment of the program and earn 42 hours of CME per year. 

Post-contrast AKI (or contrast induced nephropathy as it used to be called) is one of those hot-button issues in modern medicine. Is it really a thing? Was it ever, really? Neda Frayha, MD sits down with Dr. Salim Rezaie of Rebel EM for an invigorating conversation about this controversial topic and what the literature actually tells us about it.    For more incredible segments like this, subscribe to PC:RAP today. You'll never miss a moment of the program and earn 42 hours of CME per year.   

We see “ALL: PCN” all the time. But how often is it true? And why does it matter? Our own Dr.Neda Frayha sits down with Dr. Torie Grant, a Med/Peds Allergist and Immunologist at Johns Hopkins, to learn all about the risks attached to a penicillin allergy label and some easy approaches to debunking this allergy in the primary care setting.  Thanks for listening to Primary Care RAP on iTunes. We hope you've learned some fantastic pearls so far from the free chapter segments.  How would you like to listen to 6 months of full episodes for free? For the month of September, when you refer a friend to sign up for Primary Care RAP,  you'll get 6 free months of Primary Care RAP for yourself--on top of the $25 Amazon gift card you get for every friend who signs up! Start sharing below!   Refer a friend

Hopefully we all try to do the right thing on a regular basis, but how many of us have blown the whistle on a massive public health crisis? Dr. Neda Frayha got to interview Dr. Mona Hanna-Attisha, the Flint, MI pediatrician who opened the world's eyes to the lead in the water that was poisoning Flint's citizens. They talk about how to become a more effective patient advocate, and how to face situations that feel scary but ultimately benefit our patients. This conversation originally aired on Hippo Education's Primary Care Reviews and Perspectives podcast.

Can HIV be managed in the primary care setting? With today’s advances in antiretroviral therapy, the answer is yes. Infectious Disease expert Dr. Devang Patel sits down with Mizuho Morrison, DO and Neda Frayha, MD for a conversation about the latest developments in HIV treatment.  For more incredible segments like this, subscribe to PC:RAP today. You'll never miss a moment of the program and earn 42 hours of CME per year.   

In this segment, Dr. Sandra Quezada teaches Tom Robertson, MD, and Neda Frayha, MD about the importance of specific health maintenance components in the care of patients with inflammatory bowel disease. We primary care providers can feel empowered to take great care of these patients without sending them back to their gastroenterologists for true primary care needs. For more incredible education like this, subscribe to PC:RAP today.You'll never miss a moment of the program and earn 42 hours of CME per year. 

Ever struggled with how to prescribe lancets, test strips, or insulin pen needles? Or wondered which syringe length or gauge to order? In this mind-blowingly practical, helpful segment, endocrinologist and clinician educator Dr. Rana Malek teaches Mizuho Morrison, DO, and Neda Frayha, MD the basics of what to order for our diabetic patients, along with tips for injection techniques, common prescribing pitfalls to avoid, attention to insulin pricing, and the new continuous glucose monitor that primary care providers will be prescribing. This segment will change your practice.   For more incredible podcasts like this, subscribe to PC:RAP today.You'll never miss a moment of the program and earn 42 hours of CME per year. 

Dr. Neda Frayha is back with internist and educator Dr. Todd Cassese as well as Lawrence Levy, the former CFO of Pixar and co-creator of the non-profit Juniper Foundation to continue their conversation about physician wellness and burnout. Here they talk about the need for continuous self-care rather than "checkbox yoga," and how to change the system while also working on ourselves to find joy in our work. This is part 2 of a conversation that originally aired on Hippo Education's Primary Care Reviews and Perspectives podcast. 

What does the former CFO of Pixar have to do with physician burnout and the culture of medicine? You're about to find out: our own Dr. Neda Frayha interviews Dr. Todd Cassese and Lawrence Levy, who helped build Pixar into the company it is today. Together they talk about changing professional cultures, the narrative of medicine being out of sync with the reality of medicine, perfectionism, emotional intelligence, and how Eastern philosophy's The Middle Way can apply to all of our lives. This is part 1 of a conversation that originally aired on Hippo Education's Primary Care Reviews and Perspectives podcast. 

Matthieu DeClerck, MD and Neda Frayha, MD and Dr. Jaime Hope discuss how patient satisfaction can have negative connotations to it. More importantly considering the patient’s experience in our clinical setting is important. The trio shares their insights on more than just patient satisfaction scores and why we should all be interested.   Need a bigger dose of Urgent Care RAP each month? Click Here  and get more of what you love along with 3.5 CME hours per month. It's a win win! 

We all advocate for our patients on a regular basis, but how many of us have blown the whistle on a massive public health crisis? In this segment, Neda Frayha interviews Dr. Mona Hanna-Attisha, the Flint, MI pediatrician who opened the world’s eyes to lead in the water that was poisoning Flint’s citizens. They talk about how to become a more effective patient advocate, and how to face situations that feel scary but ultimately benefit our patients.   For more incredible education and 3.5 hours of CME each month CLICK HERE!  

How much do we really know about the pharmacologic treatment of alcohol use disorder? After this segment with Dr. Michael Baca-Atlas and our own Neda Frayha, the answer will be, a whole lot.   Subscribe today to hear the rest of this months episode

There are four main types of hypertensive disorders in pregnancy, and there are nuances to how each should be managed differently. In this segment, Drs. Megan Jones and Neda Frayha walk us through these four categories, how to tell them apart from one another and how to manage them, including when to consider early delivery.

How is being a health care consumer like buying a TV? If we all need car insurance in order to drive a car, why is health insurance so controversial? In this episode, our own MS4 Daniel Imas runs the show with Professor Diane Hoffmann from the University of Maryland School of Law and Dr. Neda Frayha. Listen in and join their discussion about the health care markets and how physicians can help our patients navigate this stressful landscape. 

Dr. Rana Awdish, MD a pulmonary and critical care physician in Detroit, Michigan, wrote an incredibly powerful, bestselling memoir (In Shock) about her own experiences as a critical care patient. In this segment, she sits down with Neda Frayha, MD to talk about healing, the ways the giant medical education industrial complex contributes to provider burnout, and the redemptive power of connection.

We have a very special episode for you today! Dr. Paul Offit is a world-renowned vaccine expert and pediatric infectious diseases specialist who has been on The Daily Show, The Colbert Report, and 60 Minutes, among many other shows. He just happened to go to the University of Maryland for medical school, and he is passionate about educating others on the safety and efficacy of vaccines. He sat down with our own Dr. Neda Frayha, as well as her friend and colleague Dr. Solomon Behar, to share tips and tools for how we can communicate more effectively with our patients who may be skeptical about vaccines. This conversation was recorded for and originally aired on the Hippo Education podcast Primary Care Reviews and Perspectives. 

Dr. Paul Offit is a world-renowned expert on the safety and efficacy of vaccines. He has authored over 160 articles, co-invented the rotavirus vaccine, and been featured on shows like “60 Minutes,” “The Daily Show,” and “The Colbert Report,” among many others. In this segment, Sol Behar and Neda Frayha pick Dr. Offit’s brain about why our patients may be skeptical about vaccines and how best to communicate with them for the safety and wellbeing of all our patients.

Dr. Paul Offit is a world-renowned expert on the safety and efficacy of vaccines. He has authored over 160 articles, co-invented the rotavirus vaccine, and been featured on shows like “60 Minutes,” “The Daily Show,” and “The Colbert Report,” among many others. In this segment, Sol Behar and Neda Frayha pick Dr. Offit’s brain about why our patients may be skeptical about vaccines and how best to communicate with them for the safety and wellbeing of all our patients.

Dr. Neda Frayha (@nedafrayha) of Primary Care RAP (Hippo Education) joins us this month for our thoughts and analysis of some recent (and not so recent) journal articles that interested us this month. Our articles spanned topics that include at cancer survival among patients pursuing treatment with complementary medicine, the effect of body weight on effectiveness of preventive aspirin dosing, strategies to promote physician leadership, respiratory symptoms in those with marijuana use and MRSA risk among patients with penicillin allergies. ACP members can claim free CME-MOC at acponline.com/curbsiders (goes live 0900 EST on podcast release date). Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list to receive a PDF copy of our show notes every Monday! And hey, while you’re here, consider rating us on iTunes and leaving a review. The Curbsiders thank you! Thoughts on the Journal Club series? Article or guest nominations? Compliments or complaints? You can reach us at thecurbsiders@gmail.com. We are also on Facebook, Instagram, and Twitter: @thecurbsiders.   Credits: Written by: Sarah Phoebe Roberts MPH, Neda Frayha MD, Christopher Chiu MD Producers: Sarah Phoebe Roberts MPH, Christopher Chiu MD Hosts: Matthew Watto MD, Stuart Brigham MD, Paul Williams MD, and Christopher Chiu MD Editor: Matthew Watto MD  Time stamps: 00:00 Disclaimer, intro, guest bio 05:05 Do patients using complementary medicine for cancer therapy have worse outcomes? 13:11 Does low dose aspirin work for primary prevention of major adverse cardiac events? 19:16 Do physicians make better leaders? 24:55 Does marijuana cause respiratory symptoms? 30:40 Does penicillin allergy confer increased risk for C Diff and MRSA infection? 38:40 Wrap-up and outro Tags:​ aspirin, cardiac risk, mortality, cancer, complementary, alternative, conventional, therapy, marijuana, cannabis, respiratory, symptoms, leader, leadership, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student