Everyday Medicine

In this episode, Christopher Chiu speaks with Dr. Duncan Campbell, a Med-Peds trained primary care physician at Ohio State. They dive into Celiac disease with comprehensive insights into its diagnosis, prevalence, symptoms, and treatment. Learn about the recommended screening tests, the importance of a gluten-free diet, and how to manage and monitor patients effectively. This episode is perfect for medical professionals aiming to deepen their understanding of Celiac disease and provide better care to their patients.00:00 Introduction to Everyday Medicine Podcast00:42 Meet Dr. Duncan Campbell01:19 Personal Connection to Celiac Disease02:07 Understanding Celiac Disease03:13 Prevalence and Risk Factors04:23 Symptoms in Children and Adults08:29 Diagnostic Testing for Celiac Disease13:17 Treatment and Dietary Management15:22 Monitoring and Follow-Up17:43 Complications of Untreated Celiac Disease22:00 Final Thoughts and Resources

In this episode of Everyday Medicine, host Dr. Christopher Chiu speaks with Dr. Dan Jonas, the Division Director of General Internal Medicine at Ohio State University, about screening for alcohol use disorder. The discussion covers the prevalence and impact of unhealthy alcohol use in the U.S., the importance of screening in primary care, and effective screening tools like the single alcohol screening question and the AUDIT-C. They also delve into the STUN (Stop Unhealthy Alcohol Use Now) trials, which explore strategies to improve the implementation of screening and brief counseling for alcohol use in primary care settings. Dr. Jonas emphasizes the significant benefits of these interventions and offers practical advice for integrating screening into routine patient visits.00:00 Introduction to Everyday Medicine00:32 Meet Dr. Dan Jonas00:41 Understanding Alcohol Use Disorder02:28 Screening Tools and Recommendations06:25 Implementing Screening in Primary Care08:24 The STUN Trials13:33 Key Takeaways and Resources16:42 Conclusion and Farewell

In this episode Christopher Chiu speaks with Dr. Harrison Jackson about diabetic retinopathy. The discussion focuses on the importance of screening for diabetic retinopathy to prevent vision loss, emphasizing ADA guidelines for patients with type 1 and type 2 diabetes. Dr. Jackson outlines common barriers to screening adherence and proposes solutions, including in-office retinal photography and artificial intelligence as promising tools to improve screening rates. The conversation provides insights on integrating these technologies into primary care to enhance patient outcomes. 00:00 Introduction to Everyday Medicine Podcast 00:36 Guest Introduction: Dr. Harrison Jackson 01:28 Understanding Diabetic Retinopathy 02:41 Screening Guidelines for Diabetic Retinopathy 03:55 Barriers to Screening Compliance 05:28 Effective Strategies for Screening 07:33 In-Office Retinal Photography 09:14 Cost and AI in Retinal Photography 10:15 Future of Retinal Screening and AI 15:15 Key Takeaways and Conclusion

In this episode of Everyday Medicine, Christopher Chiu is joined by clinical pharmacist Lindsey Lee, who provides an in-depth overview of PrEP (Pre-Exposure Prophylaxis), its effectiveness in preventing HIV, the populations that should be considered for PrEP, and the disparities in its usage. They discuss various PrEP medications, including oral options like Truvada and Descovy, and the injectable Apretude, addressing their indications, side effects, and monitoring requirements. Lee also talks about prescribing practices, counseling patients, and ensuring adherence to PrEP regimens, as well as resources for patients who face financial barriers to accessing PrEP. The episode highlights the importance of primary care physicians in managing and discussing PrEP with eligible patients. 00:00 Introduction to Everyday Medicine 00:53 Guest Introduction: Pharmacist Lindsey Lee 01:10 Understanding PrEP Therapy 01:34 Who Should Consider PrEP? 04:30 Oral Medications for PrEP 06:34 Injectable PrEP: Apretude 08:06 Baseline Labs and Monitoring 10:04 Counseling Patients on PrEP 15:11 Intermittent PrEP: The 2-1-1 Method 18:04 Affordability and Assistance Programs 19:03 Conclusion and Final Thoughts

In this episode of Everyday Medicine, hosted by Christopher Chiu, Dr. Paul Shaniuk discusses Point of Care Ultrasound (POCUS) during the Ohio chapter of the American College of Physicians' Annual Conference. Dr. Shaniuk, a hospitalist at the VA Northeast Ohio Healthcare System, explains POCUS, which is performed by clinicians at the bedside for real-time diagnostic interpretation. He describes the evolution and significance of POCUS compared to the traditional stethoscope. The conversation covers practical applications, including assessing dyspneic patients, cardiac evaluation, and volume status assessment, as well as the differences between POCUS and formal ultrasounds. Dr. Shaniuk also talks about how clinicians can obtain training and credentialing in POCUS, the integration of POCUS into daily practice, and the importance of developing robust POCUS programs within medical institutions. 00:00 Introduction to Everyday Medicine 00:37 Introducing Dr. Paul Shaniuk and POCUS 04:04 Practical Uses of POCUS in Hospital Medicine 08:05 POCUS in Outpatient and Primary Care 10:57 Training and Credentialing in POCUS 15:07 Building a POCUS Program 19:54 Final Thoughts and Takeaways 20:45 Closing Remarks

In this follow-up episode to ADHD diagnosis, Dr. Christopher Chiu interviews Dr. Stephen Koesters about treatment approaches for ADHD in both children and adults. They discuss pre-treatment assessments, non-medication strategies, medication options including stimulants and non-stimulants, and practical approaches to monitoring and managing treatment. [00:01:24] - Discussion of pre-treatment assessments [00:03:59] - Overview of non-medication treatment options [00:08:24] - Introduction to medication categories (stimulant vs. non-stimulant) 00:09:00] - Detailed discussion of non-stimulant medications [00:11:54] - Overview of stimulant medications [00:17:07] - Discussion of medication formulations for young children [00:20:44] - Follow-up care and monitoring [00:23:16] - Discussion of drug screening and monitoring [00:26:02] - Managing medication side effects [00:29:27] - Discussion of drug holidays [00:31:08] - Final management tips and pearls

Dr. Christopher Chiu interviews Dr. Stephen Koesters, an experienced internal medicine and pediatrics physician at Ohio State University, about ADHD diagnosis in both children and adults. They discuss the prevalence of ADHD, diagnostic criteria, assessment tools, and practical approaches to diagnosis in primary care settings. [00:00:30] - Introduction of Dr. Stephen Koesters  [00:01:40] - Discussion of what ADHD is and its neurochemical basis  [00:02:44] - Overview of ADHD prevalence in children and adults [00:04:14] - Discussion of adult ADHD recognition and diagnosis challenges  [00:05:24] - Impact of undiagnosed ADHD on patients  [00:06:37] - Core symptoms and diagnostic criteria  [00:07:18] - Approach to diagnosis in children  [00:09:57] - Overview of diagnostic tools and rating scales  [00:12:18] - Detailed discussion of Vanderbilt forms  [00:15:29] - Adult ADHD assessment tools (ASRS)  [00:16:49] - Discussion of comorbid conditions  [00:18:04] - Guidelines for referrals and neuropsychological testing

Dr. Christopher Chiu interviews Dr. Laura Bridge, a general internal medicine physician at Ohio State University with expertise in eating disorders, about weight stigma in healthcare and weight-inclusive medical care. They discuss the impact of weight stigma on patient health outcomes, the relationship between weight and health, and practical approaches to providing weight-inclusive care in primary care settings. Time-Stamped Show Notes: [00:00:39] - Introduction of Dr. Laura Bridge  [00:02:07] - Beginning discussion of weight stigma  [00:03:24] - Examination of correlation vs. causation in weight and health  [00:05:59] - Discussion of effects of weight stigma on patients  [00:07:50] - Explanation of weight cycling and its impacts  [00:10:16] - Connection between weight stigma and disordered eating  [00:11:59] - Healthcare providers' role in addressing weight stigma  [00:17:03] - Overview of Health at Every Size (HAES) movement  [00:19:46] - Final discussion of healthcare provider biases and impact

Dr. Christopher Chiu interviews Dr. Richard Wardrop III, a distinguished medical educator and immediate past program director at Cleveland Clinic, at the Ohio ACP regional meeting. They discuss the concept of high-value medical education, examining traditional practices, evidence-based approaches, and future directions for medical education. The conversation explores how to maximize educational value while considering resources, outcomes, and patient care. [00:00:21] - Introduction at Ohio ACP regional meeting  [00:02:26] - Discussion of high-value medical education concept  [00:04:09] - Framework for assessing educational value  [00:07:19] - Examples of low vs high-value educational practices  [00:09:43] - Discussion of "zombie practices" in medical education  [00:11:22] - Overview of Wardrop's Maxims  [00:14:01] - Analysis of "Choosing Wisely" campaign effectiveness [00:16:40] - Discussion of successful system-level changes  [00:18:15] - Future priorities for medical education

In this episode of Everyday Medicine, Dr. Christopher Chiu discusses The Ohio State University's Internal Medicine Primary Care Track with Dr. Mark Troyer, Associate Program Director. They explore the unique aspects of the primary care track, its curriculum structure, training opportunities, and how it differs from the categorical residency program. Dr. Troyer shares insights about the program's emphasis on outpatient care, community building, and preparation for various career paths in medicine. [00:00:29] - Introduction and context of primary care track discussion  [00:01:10] - Dr. Troyer's background and experience in global health  [00:02:59] - Explanation of primary care track structure  [00:04:39] - Comparison with categorical residency program schedule  [00:07:11] - Discussion of training experiences and opportunities  [00:10:59] - Overview of scholarly work and academic opportunities  [00:13:10] - Special training opportunities (gender affirming care, women's health)  [00:15:35] - Discussion of urban, suburban, and rural health experiences  [00:17:36] - Career paths and achievements of program graduates  [00:21:05] - Program's approach to patient care and decision-making  [00:22:06] - Flexibility in career choices for track graduates  [00:23:57] - Closing thoughts and resources for prospective students

In this second episode of the two-part series on obesity medicine, Chris Chiu discusses medication management with Dr. Allison Rhodes and Dr. Sara Li. The experts explore various medication options for obesity treatment, including traditional medications like metformin and phentermine, combination therapies, and newer GLP-1 agonists. They discuss medication selection criteria, insurance considerations, side effects, contraindications, and practical implementation in primary care settings. [00:02:01] - Discussion of first-line medication options [00:02:57] - Metformin usage and dosing strategies [00:04:13] - Review of weight-positive medications to avoid [00:05:55] - Four-step process for prescribing anti-obesity medications [00:08:25] - Overview of medication categories and options [00:10:12] - Discussion of combination therapies vs. monotherapy [00:13:12] - Detailed discussion of phentermine safety and efficacy [00:19:14] - Coverage of GLP-1 agonists and newer medications [00:24:35] - Side effects and contraindications of GLP-1 agonists [00:29:08] - Practical implementation of GLP-1 therapy in primary care [00:32:22] - Future outlook for obesity medications

In this episode of Everyday Medicine, Chris Chiu discusses obesity medicine with Dr. Allison Rhodes and Dr. Sara Li, focusing on evaluation and counseling approaches. The experts share insights on how to effectively discuss weight management with patients, set realistic goals, and implement comprehensive lifestyle interventions. They emphasize the importance of using non-stigmatizing language and individualizing treatment approaches while addressing various barriers to weight management. [00:00:00] - Introduction and episode overview  [00:00:43] - Introduction of guests Dr. Allison Rhodes and Dr. Sara Li  [00:02:04] - Discussion on importance of treating obesity and using non-stigmatizing language  [00:04:20] - Approaches to discussing weight in primary care settings  [00:06:41] - Time management for obesity-related appointments  [00:09:09] - Motivational interviewing techniques  [00:12:36] - Comprehensive patient evaluation approach  [00:17:44] - Discussion of barriers to weight management  [00:20:46] - Addressing food insecurity and resources  [00:26:59] - Components of a weight loss program  [00:28:00] - Nutrition counseling approaches  [00:34:18] - Physical activity goals and recommendations  [00:41:38] - Setting realistic weight loss goals  [00:44:02] - Final thoughts on stress management, sleep, and nutrition

Chris Chiu and Kevin Consevage delve into the intricacies of pre-operative assessment, emphasizing its role as a risk mitigation strategy rather than surgical clearance. This episode offers a comprehensive breakdown of assessing surgery types, patient functionality, and the necessary pre-op evaluations and medications. [00:00:00] Introduction to Everyday Medicine and episode objectives. [00:00:32] Kevin's introduction and background. [00:01:06] Discussion on the philosophy behind pre-op assessment. [00:01:34] Breaking down the steps of pre-op assessment: surgery type, patient's functional ability, and a systems-based approach. [00:02:05] Detailed analysis on types of surgeries and the importance of assessing surgery urgency. [00:04:26] Functional assessment in pre-op evaluation, including ASA classification and METs. [00:07:29] Utilizing the ACC/AHA algorithm in pre-op assessment. [00:09:37] The role of the Revised Cardiac Risk Index (RCRI) and NSQIP in evaluating surgery risks. [00:11:38] Considerations for additional cardiac testing and when to involve cardiology. [00:12:35] Quick hits on necessary pre-op tests: CBC, coags, liver function tests, and PFTs. [00:14:43] Review of perioperative medication management. [00:15:49] Closing remarks and key takeaways.

In this episode of Everyday Medicine, Dr. Chris Chiu from The Ohio State University interviews Dr. Michael Neiger about the care of adults with Down Syndrome. Dr. Neiger discusses the importance of this topic, highlighting the increased life expectancy of this population and the associated medical challenges. They delve into recent guidelines published in JAMA, specific health concerns such as atlantoaxial instability, celiac disease, obesity, thyroid disease, osteoporosis, and mental health issues. Dr. Neiger also emphasizes the importance of specialized guidelines and resources provided by the Global Down Syndrome Foundation. 00:00 Introduction to Everyday Medicine Podcast 00:30 Meet Dr. Michael Neiger 01:02 Care of Adults with Down Syndrome 02:20 New Guidelines for Down Syndrome Care 02:57 Atlantoaxial Instability in Down Syndrome 05:02 Celiac Disease in Down Syndrome 06:02 Obesity and Endocrinological Concerns 09:30 Behavioral and Mental Health 14:25 Cardiovascular Screening and Stroke Prevention 16:26 Conclusion and Resources

In this episode of Everyday Medicine, hosted by Christopher Chiu from The Ohio State University's Division of General Internal Medicine, lead pharmacist Kelli Barnes discusses the role of population health in primary care. Kelli shares insights from her recent talk at the American Pharmacists Association annual meeting, explaining the definition of population health, its importance, and the barriers faced in its implementation. She highlights the interdisciplinary approach needed, particularly the integration of pharmacists in care teams, to improve chronic disease management and patient outcomes. Kelli also outlines a six-step process for population health management and provides a detailed example of how OSU successfully manages uncontrolled diabetes among its patients. The episode concludes with a discussion on the financial sustainability of population health initiatives and the future of integrating pharmacists within primary care settings. 00:00 Introduction to Everyday Medicine Podcast 00:23 Meet Kelli Barnes: Lead Pharmacist 00:43 Kelli's Talk at the American Pharmacists Association 01:26 Understanding Population Health 04:09 Barriers and Team Dynamics in Population Health 04:51 Pharmacy's Role in Population Health 06:10 Six-Step Process for Population Health Management 09:28 Case Study: Managing Uncontrolled Diabetes 12:00 Financial Sustainability in Population Health 14:34 Final Thoughts on Population Health 16:14 Closing Remarks and Subscription Information

In the inaugural episode of Everyday Medicine, a podcast by the Division of General Internal Medicine at The Ohio State University, host Chris Chiu and guest Dr. Francisco Magaña discuss updates and best practices in STI screening and treatment. The episode focuses on the latest guidelines for HIV, gonorrhea, and chlamydia, utilizing a structured approach to discussing sexual health with patients. Dr. Magaña explains the rationale behind the current screening recommendations and shares practical tips for testing and treating these infections, including the use of expedited partner therapy (EPT) to address re-infections. The conversation emphasizes destigmatizing sexual health discussions to ensure comprehensive patient care. 00:00 Introduction to Everyday Medicine Podcast 00:29 Meet Dr. Francisco Magaña 01:19 STI Screening Guidelines 03:00 The 5 P's Framework for Sexual Health Conversations 08:02 Gonorrhea: Symptoms, Testing, and Treatment 16:53 Chlamydia: Symptoms, Testing, and Treatment 21:33 Expedited Partner Therapy (EPT) 24:21 Conclusion and Future Episodes

Welcome to Everyday Medicine, a podcast from the Division of General Internal Medicine at The Ohio State University. This podcast is focused on primary care and aims to provide current information to medical professionals from our experts in Ohio. We are graciously sponsored by collaboration with The Ohio Chapter of The American College of Physicians.