Dr. Aaron Rothstein's {gem} Generalist Medicine Podcast

This episode of my new Let's Talk Now LTN project is relevant to Generalist Medicine. I really enjoy talking and being inspired with Marc-David Munk MD, a Canadian-American physician with a recent book release:  Urgent Calls from Distant Places: An Emergency Doctor's Notes About Life and Death on the Frontiers of East Africa. We get to talk about writing the book, his work in East Africa with AMREF Flying Doctors, challenges working in the ER in North American health care system, and his retraining in Palliative Care Medicine. He has also worked as an innovator in health care delivery with, for example, CVS pharmacy and Iora Health, and he mentions some alternative ways of approaching primary care delivery. Questions or comments? Email pleaseletstalknow@gmail.com

It is with a poignant sadness that I close the GeM Generalist Medicine Podcast - a project which has been filled with fun, learning and memories over the past 9 years. If you have any feedback, please email me at gempodcast@gmail.com I am moving on to a new podcast project - Lets Talk Now  (LTN)   Thank you so kindly for listening - it has been a true joy and pleasure to make these and be on this learning journey with you, Aaron Rothstein

A discussion through the challenging topic of EKGs - how to put it in clinical context, some key pearls and approaches. If you find this hard, you are not alone!

We're back! After a year sabbatical, Dr Rogy Masri and Dr Aaron Rothstein discuss finding meaning in medicine.  This talk deals with how to cope with the current challanges, finding purpose and how two people are navigating their medical careers. We hope this will give you food for thought on building and enriching your own career.

I'm here with Dr. Blake MacKay to discuss the basics of ultrasound. Blake is a generalist with a strong interest in ultrasound and training through CPoCUS.  We discuss ultrasound basics including an array of clinical uses which can help guide management. Motivates me to do more ultrasound!

This is a discussion on the resurgent topic of Psychedelic Medicine. I talk with Dr. Ryan Patchett-Marble, a generalist physician with strong interest in addictions and mindfulness who has recently become interested in this emerging field.  Additional Info: Ryan and a patient he treated with Psilocybin:  https://nosm.brightspacestreaming.com/1/Watch/660834.aspx Resources PDF - https://genmed.libsyn.com/

Let's talk about the hot topic of fever! We'll talk about why we get fevers, whether we should treat them, and different causes of fever including forms of hyperthermia. We'll also touch on special populations such as febrile neutropenia and febrile infants.

I am very excited to discuss Interventional Cardiology with my cousin Eric Rothstein who works at Dartmouth-Hitchcock Medical Centre in New Hampshire. We discuss the field of Interventional as well as some STEMI/Acute Coronary Syndrome insights, with a bit on stable ischemic heart disease and mechanical circulatory support.

I speak to Dr. Larry Willms about a very fundamental topic that doesn't get much discussion in medical learning - Food and Nutrition. We discuss the things that are well-established consensus in the field, why we get so confounded by nutrition research and fads, how to communicate the information to patients as well as some thoughts and ideas we have on the subject!  

I am joined by Dr. Josh Smith, an EM registrar in Dunedin, New Zealand, who discusses with me a basic approach to patients in the ER.  We talk about key principles including that patients often require early treatment before we have much information, that a disposition is often more important than a definitive diagnosis and that we should be considering life threatening diagnoses early in our assessment. We also touch on identifying sick patients, how patient scenarios can evolve, and ways to deal with uncertainty in medicine.    

We are joined by local family and ER physician Jesse Zroback to discuss his passion and excitement for Space! We talk about his recent work with Canadian Space Agency, becoming one of the final candidates to become Canada's 4th generation of astronaut, as well as more generally the concept of Space Medicine -  medical considerations in space, application to life on Earth, and a bit on the current climate around Space travel! 

I had the opportunity to talk to Tonya Caylor, a family physician from Anchorage, Alaska with an inspiring interest in physician health. We talk about the important topic of Burnout as well as her interest in Coaching to help physicians in both their personal and professional lives. For more information on her, check out her site! https://www.joyinfamilymedicine.com/.

Lyrics: Necrotizing Fasciitis/Necrotizing Fasciitis/So much pain/ React or be slain/ Necrotizing Fasciitis Necrotizing Fasciitis/Dissolving don’t delight us/Pain out of proportion I need a limb abortion/All from a sore shin! I’m on the lookout when I see soft tissue/Is it going fast? Are you sick? I asked. It feels like’s it’s a shark beneath the surface/The fascia elevator is at their service! Oh no doc, is it do or die!?Why yes, TBH, lucky I’m your guy Piptazo, Vanco, Clinda after cultures/ toxins swarming like in, like mini super vultures What kinda mean bug got me through this wound?/First type’s a party cracking bubbly; stay tuned Type two a hitman - strep pyogenes on your knees/ Or maybe Vibrio from the ocean seas! Call the surgeon in the middle of the night/Hey good sir could you join the fight? What is the meaning of disturbing my slumber?/To Save a life. Glad you had my number! CHORUS When the surgeon arrives patient has less pain (of course)/ Is it effects of sepsis to the brain? When I push he jum

Let's talk about Necrotizing Soft Tissue Infections, including primarily the really scary one - Necrotizing Fasciitis!  This is a topic to constantly keep in the back of your head... to really save some lives.   Update Sept 7th: Made some modifications to the surgical segment thanks to Dr. Matt Strickland

A conversation with Dr. Adam Moir, a generalist physician in Dryden, Ontario and a personal mentor about Teaching in medicine. We have an off the cuff conversation on our experience in teaching, the reciprocity of teaching, some pearls, and what can be learned and gained doing it!

Discussion with our local GP Anaesthetist Dr. Cory McFarlane around the Covid situation in Northern Ontario, oxygen delivery in Covid, Airway considerations, approaches to various critical scenarios and a bit on treatment

An unscripted, zany conversation with rural legend Mike Kirlew about airway and breathing ; ideas around who and how to intubate, who can be managed with Non-Invasive or High Flow, and about Ventilators

We talk to rural family medicine resident Dr. Tiffany Desruisseaux about the new IDSA 2019 guidelines on community acquired pneumonia, atypical pneumonias, some great pharmacology and a brief tidbit on VAPI (vaping-associated pulmonary injury)

Let's talk about AKI and what it means, how it is diagnosed, some key points and pitfalls, and also some focus on key diagnoses.  Also: check out www.worrykit.com for our new Mental Health App. We are always looking for feedback and ways to improve it -- email me at gempodcast@gmail.com

Fast Facts about Procedures Including: Pericentesis Thoracentesis Pericardiocentesis Lumbar Puncture Seldinger Technique eg: for Central Lines/ Pigtails Peri-Mortem C- Section ED Thoracotomy