The Clinical Problem Solvers

Tahir Malik, a 4th-year medical student at Baylor College of Medicine with a keen interest in AI and global health, joins Dhruv Srinivasachar, who shares his journey from research to empathetic clinical care. They tackle a compelling case of right-sided weakness and numbness, dissecting potential neurological issues like stroke. The conversation emphasizes the importance of patient history and differential diagnosis. They also navigate the complexities of diagnosing stroke symptoms in younger patients and explore the role of muscle relaxants on neurological health.

 https://clinicalproblemsolving.com/wp-content/uploads/2020/12/ARM-EP-3-Structural-Inequities-and-the-Pandemics-Winter-Surge-1.mp3In this episode of Clinical Problem Solvers: Anti-Racism in Medicine, we sit down with Ed Yong, an award-winning journalist and science writer with The Atlantic, to discuss the structural inequities amplified by COVID-19 as well as the social concerns associated with the impending/present second wave of the pandemic.Learning ObjectivesAfter listening to this episode listeners will be able to…Understand the trajectory of the COVID-19 pandemic’s unique impact on communities of color in the United States and its tie to historical discrimination and structural inequitiesDescribe the racialized and politicized national response to COVID-19Recognize the crucial role that social interventions can and could have played in decreasing the burden of COVID-19CreditsWritten and produced by: Dereck Paul, MS, Utibe R. Essien, MD, MPH, Rohan Khazanchi, LaShyra Nolen, Michelle Ogunwole, MD, Naomi Fields, Chioma Onuoha, and Jazzmin WilliamsHosts: Dereck Paul, MS, Utibe R. Essien, MD, MPHInfographic: Creative Edge DesignGuests: Ed Yong staff writer at The Atlantic (@edyong209)Clinical Problem Solvers: Anti-Racism in MedicineShow Notes – Episode 3: Structural Inequities and the Pandemic’s Winter SurgeDecember 3rd, 2020By: Chioma OnuohaTimestamps00:00 Music/Intro00:20 Mission and Vision00:32 Introduction of Ed Yong02:00 Disproportionate impact of COVID-19 on minority communities04:00 Racism in the national/policy response to COVID-1907:00 Health Care Worker Fatigue09:30 Grief and the Unique Frustrations of Health Care Workers of Color11:30 The “Chinese” Virus and the history of the pandemic14:00 Administrative Blame Shifting17:00 How Could This Have Been Prevented?20:00 COVID-19 and indigenous populationsTakeawaysSocial Interventions are ValuableCurrently in the COVID-19 pandemic, social interventions are the only interventions available to us. When it comes to pandemics more broadly, the role of non-pharmaceutical interventions, like mask wearing, social distancing, and stay at home orders, must be recognized for their robust potential to reduce disease spread and burden. (Reflection Question: How can I best communicate the importance of social interventions to my extended family, community, and patients?)The Racial Disparities Exposed by COVID-19 are Not a Result of Biological DifferenceIt is dangerous to look at the racial and ethnic health disparities highlighted by COVID-19 and attribute them to biological differences*. Many of the populations who suffer from these disparities also suffer from structural inequity and historical discrimination which impact their quality of life and health outcomes. Marginalized communities have historically received the brunt of the blame when it comes to widespread pandemics without recognition of the role that structural factors play in creating and maintaining health inequity.*To learn more about the danger of biological explanations for health disparities see the CPS Anti-Racism in Medicine three-part episode series Dismantling Race-Based Medicine. Part 1: Historical & Ethical Perspectives featuring Professor Edwin Lindo is available now.Health Policy Must Target Structural Inequities Inequities worsen if they are not specifically addressed in policy. Without intentional effort put into addressing the root cause of structural inequities, it is possible that interventions will cause more harm than good. (Reflection Question: How should the concept of equity vs. equity be applied in creation of health policy?)Pearls The disparities amplified by COVID-19 are not new or unsurprising The narrative of COVID-19 being a “ great equalizer” is largely untrue. If anything, COVID-19 has removed “the veil” and made the extent of the inequities in this country very clear. Marginalized communities are especially vulnerable to COVID-19 due to structural factors like segregation, lack of access to clean water, poor air quality, and limited availability of health care.  These structural inequities are longstanding and will require long-lasting and intentional rectification.Frontline Workers Pushed to their Limits Touching accounts from frontline workers, in particular, nurses, who are uniquely positioned to face the devastating impacts of the disease, have clarified the toll that COVID-19 has placed on care workers. The emotional and physical fatigue associated with such immense loss of human life is leading to burnout among the very group that is required to address this disease. For many health care workers of color, their struggles are compounded by personal grief and increased expectations to lead anti-racism efforts within institutional walls.Blame shiftingDuring COVID-19, we have seen marginalized communities be positioned as scapegoats to explain the prevalence and persistence of the disease. This is not a new phenomenon. Ed Yong cites anti-Blackness during the Ebola outbreak; homophobia, transphobia, and condemnation of sex workers and people who use drugs during the HIV epidemic; and current anti-asian rhetoric during COVID-19 and the original SARS as examples. Blame is deflected to populations on the outskirts of society and used as justification to delay or fail to provide aid. Throughout the duration of the pandemic, we have seen the nature of this blame evolve. While it started with accusations that Black people and POC do not take the virus seriously and/or have chronic diseases and unhealthy habits, most presently it manifests through discourse around black people’s weariness of taking the forthcoming COVID-19 vaccine. Rather than placing blame on marginalized populations, it is crucial that we first analyze history and external influences that may explain the behaviors and outcomes being observed.Overreliance on Biomedical Measures “[Rudolf Virchow] specifically writes ‘Medicine is a social science’ and we have lost that understanding” – Ed YongFor much of the COVID-19 pandemic, rhetoric in the United States has centered around waiting for biochemical and pharmaceutical interventions to be developed rather than fully taking advantage of the social interventions currently available. Social interventions are powerful, and as we can see from the COVID-19 responses of countries like South Korea and Taiwan, they are effective at managing this disease. This reality highlights the importance of sociological and anthropological expertise in medicine and the need to expand interdisciplinary exchange in health care more broadly.References Discussed in Episode 01:30Yong, E. (2020, September 20). How Pandemic Defeated America. The Atlantic. https://www.theatlantic.com/magazine/archive/2020/09/coronavirus-american-failure/614191/04:00Serwer, A. (2020, May 8). The Coronavirus Was an Emergency Until Trump Found Out Who Was Dying, The Atlantic. https://www.theatlantic.com/ideas/archive/2020/05/americas-racial-contract-showing/611389/Kendi, I. X. (2020, April 6). What the Racial Data Show. The Atlantic. https://www.theatlantic.com/ideas/archive/2020/04/coronavirus-exposing-our-racial-divides/609526/05:50APM Research Lab Staff. (2020, November 12). The Color of the Coronavirus: COVID-19 Deaths by Race and Ethnicity in the U.S. APM Research Lab. https://www.apmresearchlab.org/covid/deaths-by-race07:00Yong, E. (2020, November 13). No One Is Listening to US. The Atlantic. https://www.theatlantic.com/health/archive/2020/11/third-surge-breaking-healthcare-workers/617091/Yong, E. (2020, November 20). Hospitals Know What’s Coming. The Atlantic.https://www.theatlantic.com/health/archive/2020/11/americas-best-prepared-hospital-nearly-overwhelmed/617156/Yong, E. (2020, July 7). The Pandemic Experts Are Not Okay. The Atlantic. https://www.theatlantic.com/health/archive/2020/07/pandemic-experts-are-not-okay/613879/10:30Dr. Uche Blackstock (@uche_blackstock)Dr. Esther Choo (@choo_ek)19:00Rashawn, R. (2020, April 9). Why are Blacks dying at higher rates from COVID-19?. Brookings. https://www.brookings.edu/blog/fixgov/2020/04/09/why-are-blacks-dying-at-higher-rates-from-covid-19/Hernandez, E. (2020, April 23). Inequities in COVID-19 are tragic but preventable. The Hill. https://thehill.com/blogs/congress-blog/healthcare/494251-inequities-in-covid-19-are-tragic-but-preventable#bottom-story-socials20:00McFarling, U.L. (2020, November 17). ‘They’ve been following the science’: How the Covid-19 pandemic has been curtailed in the Cherokee Nation. STAT. https://www.statnews.com/2020/11/17/how-covid19-has-been-curtailed-in-cherokee-nation/Additional ReferencesEssien, U. R., & Venkataramani, A. (2020, April 28). Data and Policy Solutions to Address Racial and Ethnic Disparities in the COVID-19 Pandemic. JAMA Health Forum. https://jamanetwork.com/channels/health-forum/fullarticle/2765498Gold, J. (2020, June 12). ‘I Am Tired’: What Black Doctors Need You To Know Right Now. Forbes. https://www.forbes.com/sites/jessicagold/2020/06/12/i-am-tired-what-black-doctors-need-you-to-know-right-now/?sh=29a644254ad7Gross, C. P., Essien, U. R., Pasha, S., Gross, J. R., Wang, S., & Nunez-Smith, M. (2020). Racial and Ethnic Disparities in Population-Level Covid-19 Mortality. Journal of General Internal Medicine, 35(10), 3097–3099. https://doi.org/10.1007/s11606-020-06081-wJones, CP (2020, April 7). Coronavirus Disease Discriminates. Our Health Care Doesn’t Have To | Opinion. Newsweek. https://www.newsweek.com/2020/04/24/coronavirus-disease-discriminates-our-health-care-doesnt-have-opinion-1496405.htmlKendi, I. X. (2020, June 16). Black People Are Not to Blame for Dying of COVID-19. The Atlantic. https://www.theatlantic.com/ideas/archive/2020/04/race-and-blame/609946/Krishnan, L., Ogunwole, S. M., & Cooper, L. A. (2020). Historical Insights on Coronavirus Disease 2019 (COVID-19), the 1918 Influenza Pandemic, and Racial Disparities: Illuminating a Path Forward. Annals of Internal Medicine, 173(6), 474–481. https://www.acpjournals.org/doi/full/10.7326/M20-2223Tavernise, S., & Oppel, R. A. (2020, June 2). Spit On, Yelled At, Attacked: Chinese-Americans Fear for Their Safety. The New York Times. https://www.nytimes.com/2020/03/23/us/chinese-coronavirus-racist-attacks.htmlWilliams DR, Cooper LA. (2020). COVID-19 and Health Equity-A New Kind of “Herd Immunity”. JAMA.323(24):2478-2480. doi:10.1001/jama.2020.8051Williams, V. (2020, March 27). A poll finds African Americans and Latinos are more worried about the coronavirus; a public health expert explains why. The Washington Post. https://www.washingtonpost.com/nation/2020/03/27/poll-finds-african-americans-latinos-more-worried-about-covid-19-doctor-explains-why/?arc404=trueYong, E. (2020, August 19). We Live in a Patchwork Pandemic Now. The Atlantic.https://www.theatlantic.com/health/archive/2020/05/patchwork-pandemic-states-reopening-inequalities/611866/Yong, E. (2020, September 14). America Is Trapped in a Pandemic Spiral. The Atlantic. https://www.theatlantic.com/health/archive/2020/09/pandemic-intuition-nightmare-spiral-winter/616204/DisclosuresThe hosts and guests report no relevant financial disclosures.CitationYong E,  Essien UR, Nolen L, Khazanchi, R, Ogunwole M, Fields N, Onuoha C, Williams J, , Paul D. “Episode 4: Structural Inequalities and a Second Wave.” The Clinical Problem Solvers Podcast. https://clinicalproblemsolving.com/episodes. December 3, 2020.Download Transcript Here

https://clinicalproblemsolving.com/wp-content/uploads/2020/11/Nov-HDx-Case_FINALjkfdja-2.mp3Kushal presents a Human Dx unknown to Jack, Kushal, Gabe, and Jake.Download CPSolvers App herePatreon websiteSchema 1Want to test your learning?Take our Episode Quiz hereKushal VaishaniKushal is a hospitalist and contributing editor for the Adult Medicine section at Human Dx. After finishing his medical school in India, he completed his residency training at Brandon Regional Hospital and LSUHSC – University Hospital and Clinics. His academic interests include clinical reasoning, medical education, high-value care, and infectious diseases.Gabe SiegelGabe Siegel is currently a PGY-1 Emergency Medicine Resident at Denver Health. Gabe completed medical school at Rush Medical College in Chicago, IL. When not working, he is busy enjoying the outdoors in Colorado and hunting for good food in Denver. His academic interests include health policy, critical care, and social EM.Jake HersheyJake is currently a PGY-1 in the IM hospital training track at the University of Colorado and graduated from Rush Medical College alongside his friend and co-discussant Gabe. His passions in medicine include medical education, clinical reasoning, and after-work commiseration with his co-residents. In his free time, he loves exploring the Colorado wilderness to experience the amazing hiking, kayaking, and snowboarding that the state has to offer.

https://clinicalproblemsolving.com/wp-content/uploads/2020/11/HDx_DM_NOV_UAB_FINAL-2.mp3Dr. John Alexander presents a Human Dx unknown to Dr. Courtney Wagner, Dr. Ryan Goetz, and DanDownload CPSolvers App herePatreon websiteWant to test your learning?Take our Episode Quiz hereCourtney WagnerCourtney Wagner is PGY-2 in Internal Medicine resident at the University of Alabama at Birmingham. She is a Florida native and grew up in and around the water either swimming competitively, SCUBA diving, or fishing. She initially graduated from the University of Central Florida with a biological sciences degree and taught high school science before going back to school for nursing at the University of South Florida.  After gaining experience at the bedside as an ICU nurse, she pursued a career in medicine by returning to UCF for medical school. Currently interested in academic medicine with a heart for hospice and palliative and the geriatric population. She loves cooking, hiking, and triathlons, having completed over 60 races, including Ironman Cozumel. John AlexanderJohn Alexander is a PGY-2 internal medicine resident at the University of Tennessee Health Science Center in Memphis. He got his undergraduate degree in history from Rhodes College and graduated from William Carey University College of Osteopathic Medicine. His research interests include clinical and diagnostic reasoning and cardiology. He hopes to pursue a career in academic medicine. Outside of the hospital he enjoys playing tennis, traveling, and spending time with family and friends. Ryan GoetzRyan Goetz is a second-year internal medicine resident at the University of Alabama Birmingham. He attended medical school at the Medical College of Georgia. He wants to pursue a career in pulmonary/critical care medicine after completing his residency. His clinical/research interests include ventilator physiology/teaching, clinical reasoning, bronchiectasis, and ARDS. In his spare time, Ryan enjoys Orange Theory Fitness workouts, craft beer, and history podcasts.

https://clinicalproblemsolving.com/wp-content/uploads/2020/11/WDx-Episode-5_FINAL-2.mp3Sharmin, Lindsey, and Alex discuss a clinical unknown with Dr. Natasha Chida from Johns HopkinsWant to test your learning?Take our Episode Quiz here Dr. Natasha ChidaDr. Chida is an Assistant Professor in the Division of Infectious Diseases at Johns Hopkins University School of Medicine. She serves as the Associate Program Director for the infectious diseases fellowship training program. She is also the Co-director of the Osler and Bayview Internal Medicine Residency Programs Medical Education Pathway, and firm faculty in the Osler Program, where she serves as a resident coach. Her research interests include career development for early-career professionals, women in medicine, and HIV education for fellows.

https://clinicalproblemsolving.com/wp-content/uploads/2020/11/ARCP-EP-2-Take-3-postaup-11_16_20-1.05-AM-2.mp3This is the first episode of a three-part series on understanding and dismantling race-based medicine by unearthing its origin and exposing the paucity of rigorous evidence in support of it. In this episode, we invite Critical Race Theory scholar Edwin Lindo, JD to discuss the invention of race, how its definition has changed over time, and how the fields of science and medicine contributed to its legitimacy as a tool for political and social oppression. Episode Learning ObjectivesAfter listening to this episode learners will be able to…Define race and what is meant by “race is a social construct”Describe the influential role of science and medicine in creating race Understand why race is a poor proxy for genetics or ancestryCreditsWritten and produced by: Rohan Khazanchi, LaShyra Nolen, Michelle Ogunwole, MD, Naomi Fields, Chioma Onuoha, Jazzmin Williams, Dereck Paul, MS, and Utibe R. Essien, MD, MPH Show Notes: Jazzmin WilliamsHosts: Dereck Paul, MS, Rohan Khazanchi, LaShyra NolenInfographic: Creative Edge DesignGuests: Prof. Edwin Lindo, Assistant Dean for Social & Health Justice, University of Washington School of Medicine (@EdwinLindo) Time Stamps00:00 ​Music/intro00:11 ​Our mission and vision00:38 ​Introduction to the Antiracism in Medicine team02:08​ ​Introduction of this episode and the Dismantling Race-Based Medicine series 02:49 ​Introduction of Prof. Edwin Lindo03:28 ​What is race? How is race a social construct? Why was it constructed in the first place?16:10​ Why color-blindness is not a solution to dismantling race-based medicine20:00 ​How has medicine played a key role in defining race throughout history? 37:50​ Race vs. ancestry vs genetics–implications for research and clinical practice 52:02 ​What can we start doing tomorrow?57:35 ​Conclusion and outroEpisode Takeaways:History matters​. Medicine has never been an apolitical field, and understanding the specific ways the medical field contributed to socio-political definitions of race through practices rooted in medical racism can help us avoid repeating the same harms of the past (e.g. racial essentialism). This education needs to span the whole MedEd continuum.Definitions matter​. In research, clinical practice, and MedEd, we need to be explicit in our understanding and discussion of race vs. ethnicity vs. ancestry, and how each of these categorizations does or does not impact biological or genetic traits.Bias is everywhere​. Objectivity is a top priority in medicine and research; however, history shows us how initial assumptions have tainted both study design and interpretation of results.Conversation Starters and Reflection Questions for Trainees​ & ​FacultyWhat teachings lie at the root of your belief that race has a biological basis?– Dismantling race-based medicine starts at home by asking yourself, colleagues, andclassmates this question. Much of the data promoting biological difference amongst races comes from poorly-designed studies where race as a variable is ill-defined or confounding variables are inadequately controlled. This reflexive acceptance that race is rooted in biology comes from stereotypes created by Carl Linnaeus and other racial taxonomists.How is racism causing the outcomes that I am seeing in my patient?– Recognizing that racism, not race, is the root cause of racial health disparities is the first step to improving health outcomes for Black, Indigenouls People of Color (BIPOC) patients. Acknowledging this truth highlights the necessity of mitigating the harms of racism as part of any comprehensive treatment plan. This is done on an individual level, by offering existing support and resources, as well as on a systemic level through advocacy.PearlsDefining RaceRace is a socio-politically constructed taxonomy that was invented based on factors such as perceived skin color and culture, not science or biology. The concept of race emerged for the purpose of allocating and/or extracting resources. In the United States, the concept of race was key to extracting resources from Black and Indigenous peoples during the formation and expansion of the country.The Role of Science and Medicine in Defining Race and RacismScientists and physicians legitimized race as a category by positing “objective” proof that white persons were biologically superior to other races. In 1735, Carl Linnaeus, often known as the the “father of taxonomy,” classified four “varieties” of human species and ascribed stereotypical characteristics to each race: “Native Americans as reddish, stubborn, and easily angered; Africans as Black, relaxed, and negligent; Asians as sallow, avaricious, and easily distracted; while Europeans were depicted as white, gentle, and inventive.”In 1839, Dr. Samuel Morton asserted that White people were the most intelligent of all races and Black people were the least so based on head circumference and cranial capacity. In an 1850 report commissioned by the Louisiana legislature, Dr. Samuel Cartwright argued that Black people were lazier, less intelligent, and more susceptible to infectious diseases than White people because they had less lung capacity. Cartwright’s study influenced the equations that medical professionals still use to calculate the impact of various diseases on lung function. This baseless race correction impacts treatment decisions, which contributes to racial health inequities. In the early 1900s, eugenicists and social anthropologists claimed that Black people were predisposed to violent crime, which justified institutionalization and sterilization of Black people. Despite their claims being based on unproven assumptions, their research was praised for scientific rigor and used to justify subjugation based on race.“The scientific method is only as strong as the variables you input into it and if you are not critical of the questions you are asking, who you are researching, how you are doing that research then the biases, the history, the legacy, they seep in.” – Edwin Lindo, JDWhy is color-blindness not a solution to dismantling race-based medicine?Ignoring race and racism does not negate the profound impact that race and racism have on our BIPOC patients’ health. Colorblindness inflicts harm through erasure. Instead, researchers and clinicians must be aware of the impact of racism in order to explore ways of mitigating its damage. For more on this concept, stay tuned for the next episode!Is race a good proxy for ancestry? For genetics?Since race is a socio-political construct, its definition has changed over time and space. For example, racial categories in the US Census have changed numerous times, with new categories being created and others disappearing or returning depending on the political atmosphere at the time. In another example, a person who is considered Latinx in the US could be considered Mulatto in Brazil or Coloured in South Africa. Given that there is no standard definition of race, its imprecision does not meet the standards of clinical medicine. As Prof. Lindo states, “our eyes see race” when we study disease disparities, but the true risk factor may actually be racism, geographic ancestry, or a specific genetic variant. However, assuming a genetic difference based on a perceived association with race is poor science.LinksReferences discussed throughout episode“The Praxis” Podcast: ​https://clime.washington.edu/praxisBoyd RW, Lindo EG, Weeks LD, McLemore MR. On Racism: A New Standard ForPublishing On Racial Health Inequities. ​Health Aff Blog​. Published online July 2, 2020.https://www.healthaffairs.org/do/10.1377/hblog20200630.939347/full/Marya R, Lindo E. Healing the Nation’s “Broken and Scattered” Hoop. ​Common Dreams. Published online June 19, 2020.https://www.commondreams.org/views/2020/06/19/healing-nations-broken-and-scattered -hoopTsai J, Cerdeña JP, Khazanchi R, Lindo E, et al. There is no “African American physiology”: The fallacy of racial essentialism. ​J Intern Med.​ 2020;288(3):368-370. doi:10.1111/joim.13153Chadha N, Lim B, Kane M, Rowland B. “Toward the Abolition of Biological Race in Medicine.” ​Institute for Healing & Justice in Medicine​; 2020. https://www.instituteforhealingandjustice.org/download-the-report-hereWilkerson, I. (2020). Caste: The Origins of Our Discontents. Random House.Additional references and papers as mentioned in episodeRoberts, D. (2012). Fatal Invention: How Science, Politics, and Big Business Re-create Race in the Twenty-first Century (50852nd ed.). The New Press.Braun, L. (2014). Breathing Race into the Machine: The Surprising Career of the Spirometer from Plantation to Genetics (1st ed.). Univ Of Minnesota Press.Harris, C. (1993). Whiteness as Property. Harvard Law Review, 106(8), 1707-1791. doi:10.2307/1341787Williams DR. Miles to go before we sleep: racial inequities in health. J Health Soc Behav. 2012 Sep;53(3):279-95. doi: 10.1177/0022146512455804.DisclosuresMr. Khazanchi is a member of the American Medical Association’s Council on Medical Education, but the views presented herein represent his own and not necessarily those of the AMA or the Council. The hosts and guests report no other relevant financial disclosures.CitationLindo E, Nolen L, Paul D, Ogunwole M, Fields N, Onuoha C, Williams J, Essien UR, Khazanchi R. “Episode 140: Dismantling Race-Based Medicine, Part 1: Historical & Ethical Perspectives.” ​The Clinical Problem Solvers Podcast.​ ​https://clinicalproblemsolving.com/episodes​ November 17, 2020.Show TranscriptMusicIntroductionIntroduction to the Antiracism in Medicine teamIntroduction of this episode and the Dismantling Race-Based Medicine seriesIntroduction of Prof. Edwin LindoWhat is race? How is race a social construct? Why was it constructed in the first place?Why color-blindness is not a solution to dismantling race-based medicineHow has medicine played a key role in defining race throughout history?Race vs. ancestry vs genetics–implications for research and clinical practiceWhat can we start doing tomorrow?Conclusion and outroDownload Transcript Here

https://clinicalproblemsolving.com/wp-content/uploads/2020/11/New-Schema-online-audio-converter.com_.mp3Reza, Rabih, Sharmin, and Arsalan share their approach to CNS and lung lesions.Lung Nodule SchemaAtaxia SchemaPatreon websiteDownload CPSolvers App hereWant to test your learning?Take our Episode Quiz here.

https://clinicalproblemsolving.com/wp-content/uploads/2020/11/Dell-Episode.mp3Reza and Rabih discuss an unknown case presented by Drs. Ramesh and Moriates at Dell Medical SchoolDownload CPSolvers App herePatreon websiteSchema #1Schema #2Want to test your learning?Take our Episode Quiz here.Dr. Jan RameshJan Ramesh is the Hospital Medicine Fellow in Quality and Safety at Dell Medical School at The University of Texas at Austin.  Outside of the hospital, she enjoys writing poetry, drawing, and spending time with her husband and her two cats. Dr. Chris MoriatesChris Moriates is a practicing hospitalist, Assistant Dean for Healthcare Value, and Associate Chair for Quality and Safety at Dell Medical School at The University of Texas at Austin, where he also directs the Distinction Track in Care Transformation for internal medicine residents and the Hospital Medicine fellowship. When not in the hospital, he most enjoys running around the lakes in Austin accompanied by his 9-year-old son on his bike, or hanging out with his 5-year-old daughter. 

https://clinicalproblemsolving.com/wp-content/uploads/2020/11/RLR-24_Pruritus_F.mp3Reza and Rabih tackle a case of pruritus.These additional episodes will be available on Patreon only.Why?More about the RLR series here.Want to test your learning? Take our Episode Quiz

https://clinicalproblemsolving.com/wp-content/uploads/2020/11/RLR-23_Renal-Injury-11_3_20-2.03-PM.mp3Episode descriptionReza and Rabih tackle a case of renal injury.These additional episodes will be available on Patreon only.Why?More about the RLR series here.Want to test your learning? Take our Episode Quiz