#216 Homeless Healthcare with Stefan Kertesz MD
Learn the nuances of caring for and building relationships with patients experiencing homelessness from expert internal medicine and addiction medicine physician, Stefan Kertesz MD, return guest from Episode 74 on Opioids and Health Policy (highly recommend a re-listen, y’all!). To teach us the tricks of the trade, Dr. Kertesz draws on his many years of treating the underserved and researching homelessness, housing, and addiction in Birmingham, Alabama, where he currently serves as professor at UAB and Birmingham VA Medical Center. In the course of this episode, we discuss the challenge of creating a welcoming and useful space for individuals experiencing homelessness (this is the preferred term, per Dr. Kertesz), how to meet patients where they’re at--both physically and mentally--the challenge of managing diuretics for those without stable access to a bathroom (avoid, if possible), and why the foot exam is of paramount importance.
Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).
- Written and Produced by Nora Taranto MD
- Infographics by Nora Taranto MD
- Cover Art by Kate Grant MBChB, MRCGP
- Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Nora Taranto MD
- Editor: Carolyn Chan (written materials); Clair Morgan of nodderly.com
- Guest: Stefan Kertesz MD
We are excited to announce that the Curbsiders are now partnering with VCU Health Continuing Education to offer continuing education credits for physicians and other healthcare professionals. Check out curbsiders.vcuhealth.org for and create your FREE account!
- 00:00 Intro, disclaimer, guest bio
- 3:17 Guest one-liner
- 8:55 Picks of the Week*: Dr. Kertesz’s Book Recommendation: Saul Weiner’s On Becoming A Healer; Nora’s Pick of the week: BackStory (especially their episode on dynamite!) https://www.backstoryradio.org/
- 10:07 Case from Kashlak
- 10:56 Language: How to ask where a patient lives?
- 13:25 Terminology: Persons Experiencing Homelessness:
- 14:35 The stats on prevalence of health and illness in the homeless population, and the importance of both medical and environmental factors
- 20:44 How to start the visit, and how to establish trust early on?
- 27:40 Why is the mortality rate higher?
- 35:15 Special conditions and Medication Considerations: Hypertension, Diuretics, Insulin and Food Insecurity, Substance Use Disorders, Feet, and Hepatitis C
- 54:15 COVID and homeless healthcare
- 57:00 Care Models
- 62:30 Take Home Points and Outro
Listeners will learn the unique health challenges posed to individuals who are experiencing homelessness, and the best practices for addressing these challenges.
After listening to this episode listeners will…
- Screen for and identify patients experiencing homelessness
- Identify the unique challenges facing this population
- Identify best practices in caring for this population
- Differentiate between different structures of healthcare delivery, and their advantages and disadvantages for the homeless population.
Dr Kertesz reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.
Kertesz S, Taranto NT, Williams PN, Brigham SK, Chan, Caroyn, Watto MF. “#216: Homeless Healthcare with Stefan Kertesz MD”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. May 28,2020.