The Curbsiders Internal Medicine Podcast20 Aug 2018

#109: Things We Do For No Reason: A High Value Episode

Things We Do For No Reason #TWDFNR highlights some widespread practices that are difficult to justify based on lack of proven health benefits, but significant cost (both financial and non-financial harms). Avoid these low value practices and inflated medical bills with tips from expert, Dr Lenny Feldman, MD, FACP, Associate Professor of Medicine Johns Hopkins. Topics include: renal ultrasound and urine electrolytes in acute kidney injury (AKI), folate deficiency and anemia work-up, prealbumin and malnutrition, blood transfusions, shellfish and contrast allergies, monitoring after switch from IV or oral antibiotics, and “against medical advice” discharges.

Don't forget to check out Clinicwiki.org a free, online resource for teaching ambulatory medicine.

Full show notes available at http://thecurbsiders.com/podcast. Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com.

Credits:

Written and produced by: Justin Berk MD, MPH, MBA
Editor: Matthew Watto, MD
Hosts: Justin Berk MD, MPH, MBA; Matthew Watto MD; Paul Williams MD, FACP
Guest: Lenny Feldman MD, FACP

Time Stamps

00:00 Announcements
00:38 Disclaimer, intro, and guest bio
03:53 Guest one liner, some recommendations, and advice
08:35 Defining high value care and things we do for no reason (TWDFNR)
12:40 Why do clinicians order useless testing?
14:58 Urine electrolytes for acute kidney injury
20:30 Renal ultrasound for acute kidney injury
25:54 Stop ordering folate for anemia workup
31:47 How many units should I transfuse?
34:40 Prealbumin and albumin for malnourishment.
43:24 Iodine, shellfish and contrast allergy
50:28 Patient leaving against medical advice
56:45 Switching from IV to oral antibiotics
63:27 Dr Feldman’s plugs
65:36 Outro

Det här avsnittet är hämtat från ett öppet RSS-flöde och publiceras inte av Podme. Det kan innehålla reklam.

Avsnitt(500)

#528 Hospital Addiction Medicine 3.0 with Dr. Maggie Lowenstein

Become the Medetomi-Dean of AdmissionsStep up your hospital addiction medicine game by learning to troubleshoot methadone dose confirmations/missed doses and understanding how medetomidine’s emergency...

8 Juni 1h 18min

#527 Oncology Potpourri for the Hospitalist

Malignant Bowel Obstruction, VTE and Goals of CareMaster malignant bowel obstruction, cancer-associated thrombosis, and goals-of-care conversations in hospitalized patients with advanced cancer. Learn...

1 Juni 59min

#526 DIGEST – game changers in pancreatic cancer, lipid guideline updates, and GLP-1/GIP endoscopy holds

Join us as we review recent articles and news featured in The DIGEST, including updated lipid guidelines, GLP1 agonists holds and procedures, the newest drug in pancreatic cancer, and discontinuing th...

25 Maj 1h

#525: Multi-Cancer Early Detection Testing

Cut through the hype of Multi-Cancer Early Detection (MCED) tests and learn how to counsel patients on the real-world utility, false-positive risks, and the "stage shift" debate of these emerging bloo...

18 Maj 48min

REBOOT: #509 Fresh Hypertension Guidelines. West Philadelphia Doc Jordy Cohen Keeps Our Hypertension Management Fresh

We have another classic episode for you. Don’t get caught treating high blood pressure like it is 2024. Dr. Jordy Cohen (@jordybc.bsky.social, University of Pennsylvania) guides us through the new hyp...

11 Maj 1h 17min

#524 SHM Converge 2026–Recap

We go so that you want to go next year!Stay current with updates in hospital medicine from SHM Converge 2026 in Nashville, TN. Claim CME for this episode at curbsiders.vcuhealth.org!Patreon | Episodes...

4 Maj 1h 45min

#523 Hotcakes: Left Atrial Appendage Closure vs AC for Afib, Apixaban vs Rivaroxaban for VTE, Intensive LDL Targeting, GLP1s and Substance Use Disorders, and more

Join us as we review recent practice-changing articles on left atrial appendage closure vs AC for AFib, apixaban vs rivaroxaban for VTE, intensive LDL targeting, GLP1s and substance use disorders, and...

27 Apr 1h 6min

#522: Healthy Aging with Dr. Elizabeth Eckstrom

Join us as we explore practical, evidence-based strategies to help patients age with strength and confidence, and navigate the transition into retirement. We’re joined by Dr. Elizabeth Eckstrom (Orego...

20 Apr 1h 16min