Cognitive decline is tough for all parties. What are the high-yield questions to ask? What should you add to your one-liner? When do you stop using MOCA and try to clearly describe their functional status? Do all patients with cognitive decline need an MRI?

🔹Sponsor: DoxGPT by Doximity - an AI assistant built with practicing clinicians to deliver bottom-line clinical answers, chart summaries, secure calls, and faxing directly inside the Doximity app. See how fast it is and how easy to read at DoxGPT.com

🔹Transcript & Shownotes:

01:12 | Cognitive Concerns During a Routine Follow-Up

03:41 | Deep Dive 1: How do you pivot when you recognize unexpected memory issues?

15:08 | Deep Dive 2: What tools should we use to characterize and stage cognitive decline?

31:09 | Deep Dive 3: How do we determine the etiology of cognitive decline?

Tags: CoreIM, Internal Medicine, Medical Education, Cognitive Screening, primary care, nurse practitioner, physician assistant

From metformin to basal insulin to overlooked older medications, this episode reviews the T2D medication toolkit clinicians use every day. We then dive into new evidence on once-weekly insulin to help you individualize therapy while reducing treatment burden.

🔹 Sponsor: Pain Management and Opioids Adaptive Learning Free Online Course by NEJM Group: https://cme-info.nejm.org/core-im/

🔹Transcript and Shownotes:

00.58 | Insulin Hx & Types

06:00 | Indications for Insulin and the Burden on Patients

08:26 | What is the QWINT-1 Trial?

16:18 | Discussion

Tags: CoreIM, Internal Medicine, Evidence-Based Medicine, Insulin Resistance, Clinical Reasoning, Hospital Medicine, Medical Education, Endocrine, Endocrinology

Is patient confidentiality absolute or conditional? When does protecting privacy put others at risk? Can you follow a former patient in the EHR for learning? Should you post a compelling case online even if it’s “de-identified”? And when does the law force you to betray patient trust? In this episode of At the Bedside, learn how clinicians should act when ethics, law, and trust collide.

🔹 Sponsor: DoxGPT by Doximity - an AI assistant built with practicing clinicians to deliver bottom-line clinical answers, chart summaries, secure calls, and faxing directly inside the Doximity app. See how fast it is and how easy to read at DoxGPT.com

🔹Transcript and Shownotes:

03:51 | What is the difference between Privacy and Confidentiality?

05:50 | Guidelines and laws

10:06 | Limits/appropriate breaches (competing principles/obligations)

22:03 | Privacy vs education

35:34 | Conclusion

Baby alligators - those betrayals of purpose , or, death by a thousand paper cuts !

Check out our latest episode, where Dr. Eileen Barrett walks us through how to tackle baby alligators with:

Regulated curiosity

Strategic empathy

Small, well-chosen moves...

...and change that is big enough to matter, and small enough to win!

🔹 Sponsor: Caraway’s cookware set is a favorite for a reason.

For 10% off, go to Carawayhome.com/CoreIM or use code CoreIM at checkout.

🔹 Transcript & Shownotes

00:00 | What are “baby alligators” in medicine?

02:24 | Rifaximin & Workflow Fixes

14:17 | Verbal Orders Policy

18:39 | Micro Skills for Change

25:12 | Key Takeaways

#PhysicianBurnout #DoctorLife #HealthcareEfficiency, CoreIM, Internal Medicine, Career Development, Quality Improvement, QI

Gray zones of VTE management! How to approach anticoagulation duration in unprovoked, provoked-irreversible, and provoked-reversible clots?

When dose-reduced DOACs make sense for long-term secondary prevention? What truly constitutes DOAC failure? We also devle into how APLAS a critical do-not-miss diagnosis that changes management entirely.

🔹 Sponsor: Pain Management and Opioids Adaptive Learning Free Online Course by NEJM Group: https://cme-info.nejm.org/core-im/

🔹 Transcript & Shownotes

(2:56) - (13:15) | PEARL 1: Managing clots in the “unprovoked”/provoked-irreversible patient

(13:21) - (18:10) | PEARL 2: Managing provoked, “reversible” clots

(18:14) - (25:14) | PEARL 3: DOAC failure: time to step it up?

(25:20) - (37:25) | PEARL 4: APLAS: the exception to everything

Tags: CoreIM, Internal Medicine, ClinicalPearls, Medical Education, IMCore, hospitalist, physician assistant, nurse practitioner, medical student, internal medicine, hematology

We hope these stories resonate with anyone who has felt pulled between professional purpose and personal life, and remind you that you’re not alone in wanting both.

🔹 Sponsor: Oakstone CME

Use the code "CORE30" for 30% off: https://www.coreimpodcast.com/MKSAP

🔹 Transcript and Shownotes

(1:09) | How the Horn Award Opened the Door to Growth in Dr. Tyra Fainstad’s Career and Life

(10:28) | How Dr. Carol Ward Created the Horn Award and Honored Mary Horn’s Legacy

(14:16) | Dr. Hilit Mechaber’s Story of Courage, Vision, and Impact Beyond the Award

(17:55) | Why does the Horn Award Matter?

Tags: CoreIM, Internal Medicine, Career Development Award, Mary O'Flaherty Horn Award, Clinical Care, Scholarship, Teaching, Leadership, Wellness and Care, Family Responsibilities

Antibiotic duration for bacteremia is something most of us learned by habit, not by trial data. In this episode, we walk through the BALANCE trial and use it as a lens to revisit how 1) host, 2) organism, and 3) source should guide treatment. When shorter really is enough, and when it isn’t?

🔹 Sponsor: Oakstone CME

Use the code "CORE30" for 30% off: https://www.coreimpodcast.com/MKSAP

🔹 Transcript and Shownotes

Timestamp

(02:58) | Host, Organism, Source: The Core Framework Behind Duration

(09:02) | How Evidence Shifted Practice

(11:27) | The BALANCE Trial: Short-Course vs Standard-Course Therapy

(18:55) | Where does this leave us?

Tags: CoreIM, Internal Medicine, Infectious disease, Evidence-Based Medicine, Clinical Reasoning, Hospital Medicine, Medical Education

How quickly can triglycerides rise? At what threshold are patients at risk of pancreatitis or cardiovascular adverse outcomes? What do you have to rule out? How do you counsel on lifestyle changes? Which medications do you start with why and when?

🔹 Transcript and Shownotes

(03:19) | Lipoprotein Lipase and Why Triglycerides Fluctuate Fast

(05:27) | Triglycerides as a Cardiovascular Risk Marker

(09:28) | Acute Management For Pancreatitis induced by Triglycerides

(14:34) | Lifestyle Counseling

(17:31) | Medications That Lower Triglycerides

(25:29) | How to Choose the Right Triglyceride Therapy

(27:56) | Genetic Causes and When to Suspect Familial Disorders

Tags: CoreIM, Internal Medicine, Lipidology, lipid, Cardiology, Metabolic Health, Triglycerides, Evidence-Based Medicine, Clinical Reasoning, Hospital Medicine, Medical Education, primary care