What is moral residue vs. moral injury vs moral distress? How do these concepts impact us as clinicians? Sponsor: Whether you're looking to open your own practice or buy into a group, Panacea Financial understands the unique needs of physicians and offers tailored financial solutions. Timestamps: (04:59) | Definitions (6:50) | Moral Distress (09:01) | Moral Residue (09:01) | Moral Residue (11:34) | Moral Injury (13:32) | Causes of Moral Distress and Moral Injury (18:18) | Consequences Transcript and Show notes Tags: IMCore, CorelM, Burnout, Moral Distress, Moral Injury, Moral Residue, medical humanities, humanism Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Listen to 3 cardiorenal cases that highlight that “without flow it really doesn't matter what you're doing with the diuretic!” Sponsor: Freed is an AI scribe that listens and writes your note in < 30 seconds. Freed learns your style over time and is HIPAA compliant! Use the code CORE50 to get 50% off your first month with Freed Timestamps: (01:53) | Case 1: Diuretic Resistance from Ascites and Intra-abdominal Hypertension (09:57) | Case 2: Diuretic Resistance from Low Cardiac Output (26:34) | Case 3: Diuretic Resistance from Inadequate Renal Perfusion Pressure Transcript and Show notes Cardiorenal Considerations: 5 Pearls Segment Tags: IMCore, CoreIM, Diuretics, Cardiorenal, Medical Education, nephrology, cardiology, CCU, ICU, critical care Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Signouts! How can we do them better? Hear these memorable stories & ask yourself these FIVE questions when getting your handoff ready for the covering team. Sponsor: Glass Health is a platform that empower clinicians with best-in-class AI for clinical decision support Use promo code COREIM for 1 month of free access to Glass Pro for unlimited A.I queries ! Timestamps: (2:44) What makes this patient different from others with similar symptoms or diagnosis? (7:28) Does your covering team have the tools to follow up on tasks and information they need for success? (16:06) Is the handoff updated? (18:26) What information about goals of care and prognosis should be communicated to the night team, especially for critically ill patients? (22:41) What are we still uncertain about? (25:30) Closing thoughts Show notes & transcripts Tags: IMCore, CoreIM, Contingency Planning, Handoffs, Medical Education, Nocturnists. Signouts, hospitalist Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

What is the philosophy of hospice? (3:04) Who qualifies for hospice (6:13) Who makes up the hospice team (8:17) Who pays for hospice (17:24) What are the different levels of care (21:31) What are some limitations of the hospice medicare benefit? (31:57) Behind the Scenes Youtube Interview: Hospice Music Therapy Show notes & Transcript Sponsor: Freed is an AI scribe that listens and writes your note in < 30 seconds. Freed learns your style over time and is HIPAA compliant! Use the code CORE50 to get 50% off your first month with Freed Tags: IMCore, CoreIM, primary care, palliative care, end-of-life, oncology nurse practitioner, pharmacist, physician assistant Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Dive into 4 microskills from the book “Microskills: Small Actions, Big Impact” that offer tangible tools for navigating the professional world with grace and intention. Book by Dr. Adaira Landry, Dr. Resa E. Lewiss: MicroSkills: Small Actions, Big Impact Show notes & Transcript Tags: IMCore, CoreIM, primary care, humanities, nurse practitioner, pharmacist, physician assistant Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Does colonoscopy prevent colon cancer, and does it save lives? There has never been a randomized controlled trial on screening colonoscopies before NordICC trial, even though it is a guideline based recommendation for everyone over 45! How did this come to be? What do we tell our patients who are on the fence about undergoing screening colonoscopy? To find out, tune into the sixth episode of Beyond Journal Club, a new series brought to you by Core IM in collaboration with NEJM Group. Sponsor: At Panacea Financial, you get a personal banker and a competitive high-yield savings account. Learn why its the #1 rated bank on Trustpilot. Timestamp: 00:00 Introduction 02:28 Pathophysiology of Colorectal Cancer & Why Screening Makes Sense 06:15 General Cancer Screening – Observational Studies 09:17 General Cancer Screening – Randomized Controlled Trials 14:40 NordICC Trial 22:36 Implications for Patient Care Show notes & Transcript Tags: IMCore, CoreIM, primary care, gastroenterology, nurse practitioner, pharmacist, physician assistant, sigmoidoscopy, per protocol analysis and intention to treat analysis Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

What causes HFpEF? (1:59) Does diastolic dysfunction imply HFpEF? (11:22) Is the BNP level helpful in HFpEF? (19:21) What scoring systems can be helpful in ruling in HFpEF? (25:06) What's the treatment for HFpEF? (32:03) Sponsor: Freed is an AI scribe that listens and writes your note in < 30 seconds. Freed learns your style over time and is HIPAA compliant! Use the code CORE50 to get 50% off your first month with Freed Tags: cardiology, primary care, CoreIM, IMcore, nurse practitioner, physician assistant, hospital medicine, pharmacy, nursing education, heart failure with preserved ejection fraction Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

How do immune checkpoint inhibitors work? (01:56) How do you organize the different immune-related adverse events (irAEs)? (07:15) Generally, when do different adverse events can present? (13:42) What makes someone more likely to develop an adverse effect? (22:20) What role does complementary & alternative medicine play in this patient population? (26:38) Sponsor: At Panacea Financial, you don't need co-signers for personal loans and have reduced payments during training! Tags: Side effects, oncology, cancer, primary care, CoreIM, IMcore, nurse practitioner, physician assistant, hospital medicine, pharmacy, pharmacology Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Urinalysis in a patient with AKI from purely cardiorenal syndrome? (~02:05) What is bioavailability, duration of action, and outcomes with furosemide, torsemide, and bumetanide? (~08:47) How can spot urine sodium measurements be used to assess diuretic response? (~18:08) What are the differences between thiazides (PO Metolazone vs. IV Chlorothiazide) and acetazolamide augment diuresis? (~27:35) Spaced Repetition: RAAS inhibitors or SGLT2 inhibitors as GMDT in CKD? (~35:08) Sponsor: Freed is an AI scribe that listens and writes your note in < 30 seconds. Freed learns your style over time and is HIPAA compliant! Use the code CORE50 to get 50% off your first month with Freed Get CME-MOC credit with ACP! Tags: nephrology, cardiology, primary care, CoreIM, IMcore, nurse practitioner, physician assistant, hospital medicine, pharmacy, diuretic resistance Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

What are the benefits of early rhythm control versus rate control alone? When is electrical cardioversion used and what information can it tell us? What side effects for amiodarone, dofetilide, and sotalol, propafenone and flecainide? When should catheter ablation be considered in patients with atrial fibrillation? Time stamps: 02:05 Pearl 1 - Rhythm control 11:23 Pearl 2 - Electrical cardioversion 17:53 Pearl 3 - Class III antiarrhythmics and side effects 26:31 Pearl 4 - Class Ic antiarrhythmics and side effects 31:55 Pearl 5 - Catheter ablation Tags: cardiology, primary care, CoreIM, IMcore, nurse practitioner, physician assistant, hospital medicine, pharmacy, nursing education, atrial fibrillation Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Should your patients be reaching for albuterol when their asthma flares up? Some of us may have been treating asthma exacerbations incorrectly for many years… What is the right approach? Tune in to the fifth episode of Beyond Journal Club, a new series brought to you by Core IM in collaboration with NEJM Group, to learn about the latest asthma management trials and guidelines, and how to translate them into better patient care. Show Notes & Transcript Time Stamps 01:47 Evolving story of asthma management 03:26 Pathophysiology of asthma management 06:01 Key players & terms 08:56 Story of asthma through the decades 17:55 MANDALA Trial Tags: IMCore, CoreIM, primary care, pulmonary, nurse practitioner, pharmacist, physician assistant, inhalers Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

How do you choose btw PO vs. IV iron? What is the best counseling for oral iron formulations? How do you choose between different IV iron formulations? Should you use the Ganzoni formula? What is a Fishbane reaction? And how is it different from anaphylaxis? Sponsor: At Panacea Financial, you don't need co-signers for personal loans and have reduced payments during training! Time stamps: 02:09: Spaced repetition from the last Gray Matters Episode 05:29: Choosing between oral and IV iron 11:17: Considerations with oral iron repletion 24:02: Considerations with IV iron repletion 32:36: Complications and side effects of IV iron Tags: hematology, primary care, CoreIM, IMcore, nurse practitioner, physician assistant Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

What do the different iron labs mean?! How to interpret iron labs in the setting of inflammation? How to take a good menstrual history? Sponsor: Freed is an AI scribe that listens, prepares your notes, and writes your note in < 30 seconds. Freed learns your style over time and is HIPAA compliant! Use the code CORE50 to get 50% off your first month with Freed Expert Interviews on Youtube Time stamps: 03:43 Iron deficiency labs and interpretation in inflammation 16:08 Heavy menstrual bleeding evaluation 27:04 When should a premenopausal woman with iron deficiency have endoscopy? 35:15 Recap Tags: hematology, women's health, gastroenterology, heavy menstrual bleeding, primary care, CoreIM, IMcore, nurse practitioner, physician assistant, iron deficiency diagnosis Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Uncover many blind spots on tube feeds! Sponsor: At Panacea Financial, every single customer gets their OWN 24/7 primary care banker who actually knows you! Youtube Interviews: Short-term enteral access Durable enteral access What is venting aka decompression? Show Notes & Transcript Timestamp 02:21 Indications for tube feeds 09:36 Routes of enteral access 19:20 Components of tube feeds 7:03 Tube feeds complications 34:50 Counseling patients before discharge and medication interactions Tags: IMCore, CoreIM, nursing home, primary care, dietician, nutrition support, hospital medicine, interprofessional education, enteral feeds Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

How do you manage GDMT in a frail older adult? When is a guardian needed and what is the process for obtaining guardianship? Sponsor: Echonous, the maker of Kosmos, is redefining point-of-care ultrasound at half the price (or less) of comparable carts. Mention Core IM at the Demo to get a free A.I application of choice! Youtube Interviews: When to consider a guardian? Guardianship Process Limitation and value of individualism Show Notes & Transcript Timestamp 04:03 Deep Dive 1: How do you approach guideline-directed medical therapy of heart failure with reduced ejection fraction in a frail older adult? 11:55 Deep Dive 2: When is a guardian needed and what is the process for obtaining guardianship? 28:30 Deep Dive 3: How do you re-evaluate GDMT in a frail older adult once an adverse event has occurred? 33:27 Reflections 37:06 Recap Tags: IMCore, CoreIM, nursing home, primary care, cardiology, palliative care hospital medicine, interprofessional education, social work, case management Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

How do you counsel patients eligible for the RSV vaccines? What do the results of the RENOIR and AReSVi trials tell us and how do they compare? How should we interpret vaccine trials in the first place? Tune in to the fourth episode of Beyond Journal Club, a new series brought to you by Core IM in collaboration with NEJM Group. Sponsor: Pathway FREE evidence-based clinical decision support app. Guideline summaries, interactive algorithms, landmark trials & more Show Notes & Transcript Time Stamps 02:30 Epidemiology of RSV 03:46 Development of RSV vaccine 05:55 Vaccine trial design 12:22 ARESVI and RENOIR Trials 18:18 Who should we recommend the RSV vaccine to? 19:50 What don’t we know? Tags: IMCore, CoreIM, primary care, infectious disease, nurse practitioner, pharmacist, physician assistant Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

When you see a low mag or a low phos, what are you thinking about? And do PPIs effect magnesium absorption? How much sodium and potassium are found in a typical oral phosphorus supplement? Sponsor: Pathway FREE evidence-based clinical decision support app. Guideline summaries, interactive algorithms, landmark trials & more Youtube interview on key points on magnesium Youtube interview on key points on phosphate CME : http://bit.ly/CIMCME || Show Notes & Transcript Timestamp 01:37 Pearl 1: Magnesium 09:39 Pearl 2: Framework for hypomagnesemia 16:53 Pearl 3: Magnesium repletion 22:39 Pearl 4: Phosphorous 28:36 Pearl 5: Phosphorous repletion Tags: IMCore, CoreIM, nephrology, hospital medicine, interprofessional education, renal Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Sharpen your de-escalation skills! Sponsor: GlassHealth | Get unlimited A.I queries for 1 month with promo code: COREIM ! Timestamps: 02:26 Difficult Patients 10:25 Mediation Toolkit 17:20 Maxims of Mediation 26:46 When the Conversation Still Breaks Down 35:11 Conclusion Tags: IMCore, CoreIM, ethics, humanities, nurse practitioner, pharmacist, physician assistant, burnout Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

In community-acquired pneumonia, can steroids improve mortality? Past studies of steroids in CAP have been conflicting, with some showing a mortality benefit and others showing no difference. How does the CAPE COD trial change how we think about patients hospitalized with severe CAP? To find out, tune into the third episode of Beyond Journal Club, a new series brought to you by Core IM in collaboration with NEJM Group. Show Notes & Transcript 01:50 Pathophysiology of Steroids and Infection 03:50 Steroids in PNA Studies 08:56 CAPE COD Trial 14:13 Discussion of CAPE COD Trial 18:36 Takeaways/Discussion Tags: IMCore, CoreIM, primary care, cardiology, nurse practitioner, pharmacist, physician assistant Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Syncope history, PPM/ICD prior to MRI or surgery, anticoagulation for pacemaker or ICD procedures and new cardiac devices and how they may look different on EKG or chest x-ray! Sponsor: Post Investment: Real Estate Syndications Show Notes & Transcript Timestamps: 01:13 Pearl 1: Should we approach syncope history differently in our patients with pacemakers and ICDs? 06:31 Pearl 2: Considerations for patients with implantable devices before surgery. 12:26 Pearl 3: Considerations for patients with implantable devices before MRI. 14:45 Pearl 4: Anticoagulation in patients undergoing pacemaker or ICD procedures. 18:17 Timestamp 5: Emerging cardiac device technology and how they might look different on EKG or chest x-ray Tags: IM Core, CoreIM, cardiology, prodromal symptoms, CRT, biventricular pacing Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy