=== About Us ===

The Primary Care Pearls (PCP) Podcast is created in collaboration with faculty, residents, and students from the Department of Internal Medicine at the Yale School of Medicine. The project aims to create accessible and informative podcasts about core primary care topics centered around real patient stories. 

Hosts: Helen Cai

Producers: Helen Cai, Josh Onyango

Logo and Name: Eva Zimmerman

Theme music and Editing: Helen Cai, Josh Onyango

Other background music: Steve Adams, The Mini Vandals, Density & Time

Instagram: @pcpearls

Twitter: @PCarePearls

Listen on your favorite podcast platforms: linktr.ee/pcpearls

=== About Us ===

The Primary Care Pearls (PCP) Podcast is created in collaboration with faculty, residents, and students from the Department of Internal Medicine at the Yale School of Medicine. The project aims to create accessible and informative podcasts about core primary care topics centered around real patient stories. 

Hosts: Helen Cai

Producers: Helen Cai, Josh Onyango

Logo and Name: Eva Zimmerman

Theme music and Editing: Helen Cai, Josh Onyango

Other background music: Schwartzy

Instagram: @pcpearls

Twitter: @PCarePearls

Listen on your favorite podcast platforms: linktr.ee/pcpearls

=== Outline ===

Chapter 1: The realities of Infant Feeding

Chapter 2: The history and science behind formula

Chapter 3: Safe practices in handing infant formula

Chapter 4: Formula’s unintended benefits on family life

=== Learning Points ===

1. All infant formula are safe and complete due to regulations by the FDA and Infant Formula Act of 1980
2. The majority of infants thrive on standard intact cow’s milk protein formula
3. Prepared, refrigerated formula can be safely stored for up to 24 hours
4. Never dilute formula to stretch it, as this can lead to electrolyte abnormalities and failure to thrive

=== Our Expert(s) ===

Dr. Anthony Porto is a board-certified pediatric gastroenterologist and Professor of Pediatrics at Yale, where he serves as Associate Chief of Pediatric Gastroenterology and Medical Director of the Yale Pediatric Celiac Program. He is a recognized expert in infant nutrition and feeding, co-author of The Pediatrician’s Guide to Feeding Babies and Toddlers, and a spokesperson for the American Academy of Pediatrics

=== Further Reading ===

• CDC 2022 Breastfeeding Report Card: https://www.cdc.gov/breastfeeding-data/breastfeeding-report-card/index.html 
• NASPGHAN list of formula equivalents:  https://naspghan.org/recent-news/naspghan-tools-for-hcps-affected-by-formula-recall/
• Cernioglo K, Smilowitz JT. Infant feeding practices and parental perceptions during the 2022 United States infant formula shortage crisis. BMC Pediatr. 2023 Jun 24;23(1):320. doi: 10.1186/s12887-023-04132-9. PMID: 37355589; PMCID: PMC10290398. 
• Calello DP, Jefri M, Yu M, Zarraga J, Bergamo D, Hamilton R. Notes from the Field: Vitamin D–Deficient Rickets and Severe Hypocalcemia in Infants Fed Homemade Alkaline Diet Formula — Three States, August 2020–February 2021. MMWR Morb Mortal Wkly Rep 2021;70:1124–1125. DOI: http://dx.doi.org/10.15585/mmwr.mm7033a4
• Anderson CE, Whaley SE, Goran MI. Lactose-reduced infant formula with corn syrup solids and obesity risk among participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Am J Clin Nutr. 2022 Oct 6;116(4):1002-1009. doi: 10.1093/ajcn/nqac173. PMID: 35998087; PMCID: PMC10157812. 

=== About Us ===

The Primary Care Pearls (PCP) Podcast is created in collaboration with faculty, residents, and students from the Department of Internal Medicine at the Yale School of Medicine. The project aims to create accessible and informative podcasts about core primary care topics centered around real patient stories. 

Hosts: Helen Cai

Producers: Helen Cai, Josh Onyango

Logo and Name: Eva Zimmerman

Theme music and Editing: Helen Cai, Josh Onyango

Other background music: Jeremy Black, Nat Keefe, Schwartzy, Corbyn Kites, Dan Bodan, The Mini Vandals, Moonrise, Density&Time, Quincas Moreira, Jesse Gallagher, John Patitucci, Steve Adams

Instagram: @pcpearls

Twitter: @PCarePearls

Listen on your favorite podcast platforms: linktr.ee/pcpearls

=== Outline ===

Chapter 1: Motivation for Learning

Chapter 2: Counseling on benefits of Breastfeeding

Chapter 3: Collecting a history and troubleshooting

Chapter 4: Not all situations are the same

=== Learning Points ===

1. Breastfeeding Pain is Not Normal: While some tenderness may occur in the very early days, ongoing pain, is a sign of a problem.
2. Supply and Demand Basics: Breastfeeding largely operates on supply and demand. Parents need to be encouraged to drain the breast 8 to 12 times in 24 hours to establish an adequate milk supply.
3. Universal Provider Responsibility: All primary care physicians should have a foundational knowledge of common breastfeeding challenges and counseling techniques.
4. Focus on Parent Goals and Informed Decision: Counseling should avoid shaming and move past yes/no questions and use motivational interviewing.

=== Our Expert(s) ===

Deanna Nardella, MD, MHS is a general pediatrician at Yale who completed her pediatrics residency at The Children’s Hospital of Philadelphia and later joined Yale as a National Clinician Scholar, bringing a strong background in infant care and breastfeeding medicine to her work with families.

=== Further Reading ===

1. American Academy of Pediatrics. Policy Statement: Breastfeeding and the Use of Human Milk https://publications.aap.org/pediatrics/article/150/1/e2022057988/188347/Policy-Statement-Breastfeeding-and-the-Use-of?autologincheck=redirected 
2. Academy of Breastfeeding Medicine: links to “Need to Know” videos
   https://www.bfmed.org/need-to-know-videos
3. Institute for the Advancement of Breastfeeding and Lactation Education (IABLE): Offers online CME and eCourses, including a “1 Day Primary Care Breastfeeding Medicine Course for Physicians and Other Providers”
   https://lacted.org/ 
4. Global Health Media Project: Offers free instructional videos on a wide range of breastfeeding topics
   https://globalhealthmedia.org/video/?_topic=breastfeeding&_language=english&~1 
5. E-lactancia: Spanish and English information about compatibility between medications and breastfeeding. https://www.e-lactancia.org/ 
6. Drugs and Lactation Database (LactMed), maintained by the NIH: https://www.ncbi.nlm.nih.gov/books/NBK501922/ 

=== About Us ===

The Primary Care Pearls (PCP) Podcast is created in collaboration with faculty, residents, and students from the Department of Internal Medicine at the Yale School of Medicine. The project aims to create accessible and informative podcasts about core primary care topics centered around real patient stories. 

Hosts: Helen Cai

Producers: Helen Cai, Josh Onyango

Logo and Name: Eva Zimmerman

Theme music and Editing: Helen Cai, Josh Onyango

Other background music: Alge, futuremono, Joel Cummins, Schwartzy, Density & Time, The Tower of Light, Asher Fulero, Track Tribe, Penguinmusic, Esther Abrami, the Mini Vandals, Godmode, Quincas Moreira, Nathan Moore, Adam MacDougall, 

Instagram: @pcpearls

Twitter: @PCarePearls

Listen on your favorite podcast platforms: linktr.ee/pcpearls

=== Outline ===

Chapter 1: Building a team of specialists

Chapter 2: Transitions to adult care

Chapter 3: The role of parents

Chapter 4: Parting advice

Chapter 5: Conclusion

=== Learning Points ===

1. While it’s tempting to think of adolescents as simply younger versions of adult patients, we need to recognize that they have their own needs and considerations. They’re learning about how to navigate the health care system for the first time, and will likely need our help to understand it. 
2. If you’re listening to this as a specialist or as an adult provider who sees young adults, just remember that they may need a little bit of extra grace and kindness when they show up to see you for the first time. Your attitude easily becomes their attitude.
3. Emphasize interdependence, rather than independence. Who do teens have on their team, and how can we build up their toolkit of strategies and problem solving to best set them up for success?

=== Our Expert(s) ===

Sheila M. Quinn, DO, is an attending physician in the Craig-Dalsimer Division of Adolescent Medicine and the Transition to Adult Care Program at Children's Hospital of Philadelphia. Her areas of expertise include adolescent and young adult health, reproductive health, and health care transitions.

=== Toolkits and Resources ===

• https://gottransition.org/ 

=== About Us ===

The Primary Care Pearls (PCP) Podcast is created in collaboration with faculty, residents, and students from the Department of Internal Medicine at the Yale School of Medicine. The project aims to create accessible and informative podcasts about core primary care topics centered around real patient stories. 

Hosts: Addy Feibel

Producers: Helen Cai, Josh Onyango

Logo and Name: Eva Zimmerman

Theme music and Editing: Helen Cai, Josh Onyango

Other background music: Patrick Patrikios, Nat Keefe, The Mini Vandals, John Patitucci, DivKid, Joel Cummins, Godmode, Ammil

Instagram: @pcpearls

Twitter: @PCarePearls

Listen on your favorite podcast platforms: linktr.ee/pcpearls

=== Outline ===

Chapter 1: Definitions

Chapter 2: Establishing a relationship with the patient

Chapter 3: Mental health

Chapter 4: Social media

Chapter 5: Sexual and reproductive health

Chapter 6: Conclusion

=== Learning Points ===

1. First impressions are important. How you set up and frame the relationship with a teen patient will set the tone for the teen’s trust, and how much they choose to confide in you in the coming years. 
2. Instead of being prescriptive or setting limits, such as with social media, we can equip teens with the skills to reflect on their interactions. What does it mean to be kind in an online world? Is it leading to meaningful and constructive interactions? Or is it quickly becoming a detriment to someone’s identity and how they see themselves?
3. No matter the topic, using normalizing language can go a long way in empowering adolescents to share. When discussing topics included in the social history, using simple language can go a long way in avoiding misunderstandings. Remember, it might be the first time that teens are hearing these words being used.

=== Our Expert(s) ===

Sheila M. Quinn, DO, is an attending physician in the Craig-Dalsimer Division of Adolescent Medicine and the Transition to Adult Care Program at Children's Hospital of Philadelphia. Her areas of expertise include adolescent and young adult health, reproductive health, and health care transitions.

=== Toolkits and Resources ===

• n/a

=== About Us ===

The Primary Care Pearls (PCP) Podcast is created in collaboration with faculty, residents, and students from the Department of Internal Medicine at the Yale School of Medicine. The project aims to create accessible and informative podcasts about core primary care topics centered around real patient stories. 

Hosts: Addy Feibel

Producers: Helen Cai, Josh Onyango

Logo and Name: Eva Zimmerman

Editing: Helen Cai, Josh Onyango

Theme music: Josh Onyango

Other background music: Nat Keefe, TrackTribe, Geographer, Asher Fulero, Loopop, Freedom Trail Studio, Chris Haugen, Aaron Kenny, Ammil, penguinmusic, 

Instagram: @pcpearls

Twitter: @PCarePearls

Listen on your favorite podcast platforms: linktr.ee/pcpearls

=== Outline ===

Chapter 1: Approaching dialysis

Chapter 2: Hemodialysis vs peritoneal dialysis

Chapter 3: Practicalities of living on dialysis

Chapter 4: Kidney transplantation

=== Learning Points ===

1. Hemodialysis and peritoneal dialysis are the two primary options for long-term renal replacement therapy. The two modalities are very different, and the patient’s lifestyle and individual needs should be considered when choosing a form of dialysis.
2. The decision to start dialysis is complex and should involve shared decision-making between the patient and their healthcare team with open communication. 
3. Dialysis significantly impacts patients’ lives by requiring them to change their daily routines and dietary restrictions. Beyond this, it can significantly impact their emotional and social well-being. 
4. Kidney transplantation offers a potential for improved quality of life and further longevity, as compared to dialysis options.

=== Our Expert(s) ===

Dr. Paul Bernstein graduated from Union College in 1982, where he earned a BA in Biology.  He then attended the Albert Einstein College of Medicine, where he was elected to AOA.  In 1988, he joined the Yale Traditional Internal Medicine Residency, serving as Chief Resident from 1991-1992.  From 1992-1995, he was a Yale nephrology fellow, and after that, he joined the faculty at the University of Rochester.  From 1997-2000, he was an APD for the University of Rochester Primary Care Residency, and from 2000-2012, he was Program Director for the Internal Medicine Residency at Rochester General Hospital.  

=== Further Reading ===

1. NIH National Institute of Diabetes and Digestive and Kidney Diseases: Facts about Peritoneal Dialysis
   https://www.niddk.nih.gov/health-information/kidney-disease/kidney-failure/peritoneal-dialysis
2. Wong B, Ravani P, Oliver MJ, Holroyd-Leduc J, Venturato L, Garg AX, Quinn RR. Comparison of Patient Survival Between Hemodialysis and Peritoneal Dialysis Among Patients Eligible for Both Modalities. Am J Kidney Dis. 2018 Mar;71(3):344-351. doi: 10.1053/j.ajkd.2017.08.028. Epub 2017 Nov 22. PMID: 29174322. 

=== About Us ===

The Primary Care Pearls (PCP) Podcast is created in collaboration with faculty, residents, and students from the Department of Internal Medicine at the Yale School of Medicine. The project aims to create accessible and informative podcasts about core primary care topics centered around real patient stories. 

Host: Josh Onyango

Producers: Helen Cai, Josh Onyango

Logo and Name: Eva Zimmerman

Theme music and Editing: Helen Cai, Josh Onyango

Other background music: Aaron Kenny, The Tides, TrackTribe, Dan Bodan, Astron, Asher Fulero,  VYEN, The Soundlings

Instagram: @pcpearls

Twitter: @PCarePearls

Listen on your favorite podcast platforms: linktr.ee/pcpearls

=== Outline ===

Chapter 1: A gradual progression

Chapter 2: A history of EGFR through the lens of race

Chapter 3: Involving the nephrologist

Chapter 4: Medication adjustments and monitoring

=== Learning Points ===

1. The symptoms underlying a progression from CKD to ESRD are often vague. A definitive diagnosis requires measuring kidney function. 
2. The history of measuring kidney function includes the use of creatinine as a biomarker and the development of equations to calculate EGFR. Many of these equations have historically explicitly involved race, which has come under scrutiny and controversy. 
3. Once a patient’s creatinine is consistently higher than 1.6, consider referral to a nephrologist for assistance with ongoing monitoring and considerations for transplantation. 
4. A diagnosis of ESRD may require medication adjustments and careful monitoring for complications such as anemia, electrolyte changes, bone mineral disease, and swings in blood pressure.

=== Our Expert(s) ===

Dr. Paul Bernstein graduated from Union College in 1982, where he earned a BA in Biology.  He then attended the Albert Einstein College of Medicine, where he was elected to AOA.  In 1988, he joined the Yale Traditional Internal Medicine Residency, serving as Chief Resident from 1991-1992.  From 1992-1995, he was a Yale nephrology fellow, and after that, he joined the faculty at the University of Rochester.  From 1997-2000, he was an APD for the University of Rochester Primary Care Residency, and from 2000-2012, he was Program Director for the Internal Medicine Residency at Rochester General Hospital.  

=== Further Reading ===

1. NIH National Institutes of Diabetes and Digestive and Kidney Diseases: Fast Facts on Kidney Disease https://www.niddk.nih.gov/health-information/health-statistics/kidney-disease
2. Diao JA et al. National Projections for Clinical Implications of Race-Free Creatinine-Based GFR Estimating Equations. J Am Soc Nephrol. 2023 Feb 1;34(2):309-321. doi: 10.1681/ASN.2022070818. Epub 2022 Nov 11. PMID: 36368777; PMCID: PMC10103103.
3. St Peter WL et al; Written on behalf of the National Kidney Foundation Workgroup for Implementation of Race-Free eGFR-Based Medication-Related Decisions. Moving forward from Cockcroft-Gault creatinine clearance to race-free estimated glomerular filtration rate to improve medication-related decision-making in adults across healthcare settings: A consensus of the National Kidney Foundation Workgroup for Implementation of Race-Free eGFR-Based Medication-Related Decisions. Am J Health Syst Pharm. 2024 Nov 18:zxae317. doi: 10.1093/ajhp/zxae317. Epub ahead of print. PMID: 39552516. 

=== About Us ===

The Primary Care Pearls (PCP) Podcast is created in collaboration with faculty, residents, and students from the Department of Internal Medicine at the Yale School of Medicine. The project aims to create accessible and informative podcasts about core primary care topics centered around real patient stories. 

Host: Josh Onyango

Producers: Helen Cai, Josh Onyango

Logo and Name: Eva Zimmerman

Theme music and Editing: Helen Cai, Josh Onyango

Other background music: I Think I Can Help You, John Patitucci, Chris Haugen, DivKid, Asher Fulero, Jesse Gallagher, Saidbysed

Instagram: @pcpearls

Twitter: @PCarePearls

Listen on your favorite podcast platforms: linktr.ee/pcpearls

=== Outline ===

Chapter 1: An Unexpected Diagnosis

Chapter 2: Diagnosing Dementia

Chapter 3: Dementia Treatment and Specialist Care

Chapter 4: Supporting Caregivers

=== Learning Points ===

1. Dementia is characterized by both functional and cognitive impairment. While it’s important to consider a broad differential, it’s not strictly necessary to rule out all causes of impairment before proceeding with assessment for dementia. 
2. Once a diagnosis of dementia has been made, there are certain components of long-term care to be addressed. This is where referral to a geriatrician can be helpful, as they can help to connect patients with resources and help to provide long-term counseling. 
3. As dementia progresses, behavioral issues in patients may emerge. It’s important to gather as much information about the context of these issues as possible, in order to think about non-pharmacologic solutions and interventions. 
4. Maintain a high index of suspicion for caregiver burnout, and try to determine what resources a caregiver needs and/or if they are willing to accept help.

=== Our Expert(s) ===

Dr. Gregory Ouellet graduated from Brown University in Providence, RI with a Bachelor of Science in biology and then attended medical school at the University of Rochester. Dr. Jennifer Ouellet is a geriatrician who specializes in the care of older adults with multiple chronic illnesses. They completed their clinical training in Internal Medicine and Geriatrics at Yale and are currently full time faculty in the Section of Geriatrics.

=== References ===

1. Albrecht T, Schroeder M, LeCaire T, Endicott S, Marschall K, Felten K, Sayavedra N, Russmann S, Kern V, Blazek MC, Kales HC, Carlsson CM, Mahoney J, Walaszek A. Training dementia care professionals to help caregivers improve the management of behavioral and psychological symptoms of dementia using the DICE Approach: A pilot study. Geriatr Nurs. 2022 Nov-Dec;48:74-79. doi: 10.1016/j.gerinurse.2022.08.016. Epub 2022 Sep 22. PMID: 36155312; PMCID: PMC11881159.
2. Mehrani I, Sachdev PS. The role of Memory Clinics in the assessment and management of dementia, now and into the future. Curr Opin Psychiatry. 2022 Mar 1;35(2):118-122. doi: 10.1097/YCO.0000000000000777. PMID: 35026801.
3. Reuben DB, Romero T, Evertson LC, Jennings LA. Overwhelmed: a Dementia Caregiver Vital Sign. J Gen Intern Med. 2022 Aug;37(10):2469-2474. doi: 10.1007/s11606-021-07054-3. Epub 2021 Aug 13. PMID: 34389938; PMCID: PMC9360256.
4. van Dyck CH, Swanson CJ, Aisen P, Bateman RJ, Chen C, Gee M, Kanekiyo M, Li D, Reyderman L, Cohen S, Froelich L, Katayama S, Sabbagh M, Vellas B, Watson D, Dhadda S, Irizarry M, Kramer LD, Iwatsubo T. Lecanemab in Early Alzheimer's Disease. N Engl J Med. 2023 Jan 5;388(1):9-21. doi: 10.1056/NEJMoa2212948. Epub 2022 Nov 29. PMID: 36449413.

=== About Us ===

The Primary Care Pearls (PCP) Podcast is created in collaboration with faculty, residents, and students from the Department of Internal Medicine at the Yale School of Medicine. The project aims to create accessible and informative podcasts about core primary care topics centered around real patient stories. 

Hosts: Helen Cai

Producers: Helen Cai, Josh Onyango, Daniel Wang

Logo and Name: Eva Zimmerman

Theme music and Editing: Helen Cai, Josh Onyango

Other background music: True Cuckoo, Asher Fulero, Dan Bodan, Ammil, Dan Bodan

Instagram: @pcpearls

Twitter: @PCarePearls

Listen on your favorite podcast platforms: linktr.ee/pcpearls

=== Outline ===

Chapter 1: Introduction to Advance Care Planning

Chapter 2: Discussing Difficult Topics

Chapter 3: Who’s in the room? Stakeholders

Chapter 4: Key Elemaents of an Advance Care Plan

=== Learning Points ===

1. We can define advance care planning in 1 of 2 ways: as a form of legal document or contract, or as an ongoing conversation about a patient’s values that will be revisited over the course of a patient’s lifetime. 
2. Another way of approaching the topic of ACP is in framing it as building a team who will be able to best support the patient through a difficult time: this could include family members, home health aides, financial planners, and so on. The most important member of this team to identify is the healthcare proxy: this person is designated to assist in making decisions should the patient be unable to.
3. Discussing ACP is applicable in any care setting: on the floors, in the ICU, and in the clinic. In the clinic, we have the benefit of time and a longitudinal relationship to keep on revising this topic--since a patient’s goals and priorities may shift over time, and the interventions they may desire will also shift accordingly.

=== Our Expert(s) ===

Dr. Gregory Ouellet graduated from Brown University in Providence, RI with a Bachelor of Science in biology and then attended medical school at the University of Rochester. He completed his clinical training in Internal Medicine and Geriatrics at Yale. He concomitantly completed a postdoctoral fellowship in Geriatric Epidemiology and Aging-Related Research and a Master in Health Science degree in 2018. Dr. Ouellet subsequently joined the full time faculty in the Section of Geriatrics. 

Dr. Jennifer Ouellet is a geriatrician who specializes in the care of older adults with multiple chronic illnesses.

=== References ===

1. Sudore RL, Fried TR. Redefining the "planning" in advance care planning: preparing for end-of-life decision making. Ann Intern Med. 2010 Aug 17;153(4):256-61. doi: 10.7326/0003-4819-153-4-201008170-00008. PMID: 20713793; PMCID: PMC2935810.
2. Sudore RL, Lum HD, You JJ, Hanson LC, Meier DE, Pantilat SZ, Matlock DD, Rietjens JAC, Korfage IJ, Ritchie CS, Kutner JS, Teno JM, Thomas J, McMahan RD, Heyland DK. Defining Advance Care Planning for Adults: A Consensus Definition From a Multidisciplinary Delphi Panel. J Pain Symptom Manage. 2017 May;53(5):821-832.e1. doi: 10.1016/j.jpainsymman.2016.12.331. Epub 2017 Jan 3. PMID: 28062339; PMCID: PMC5728651.
3. Fried TR, Bradley EH. What matters to seriously ill older persons making end-of-life treatment decisions?: A qualitative study. J Palliat Med. 2003 Apr;6(2):237-44. doi: 10.1089/109662103764978489. PMID: 12854940.

=== About Us ===

The Primary Care Pearls (PCP) Podcast is created in collaboration with faculty, residents, and students from the Department of Internal Medicine at the Yale School of Medicine. The project aims to create accessible and informative podcasts about core primary care topics centered around real patient stories. 

Hosts: Helen Cai

Producers: Helen Cai, Josh Onyango

Logo and Name: Eva Zimmerman

Theme music and Editing: Helen Cai, Josh Onyango

Other background music: Noir Et Blanc Vie, Asher Fulero, Astron, The Tides

Instagram: @pcpearls

Twitter: @PCarePearls

Listen on your favorite podcast platforms: linktr.ee/pcpearls

=== Outline ===

Chapter 1: Managing Alcohol Withdrawal in the Outpatient Setting

Chapter 2: Medications for AUD

Chapter 3: Recovery Group/Social Support

=== Learning Points ===

1. Although our training has historically focused on the inpatient setting, managing alcohol withdrawal in the outpatient setting is also possible. A sample regimen for this may be 10mg diazepam every 6 hours on the first day, then every 8 hours on the second day, every 12 hours on the third day, and then once on day 4.
2. Medications approved by the FDA in the treatment of alcohol use disorder include: naltrexone, acamprosate, and disulfiram. Disulfiram is considered a first-line medication. 
3. Successful treatment of AUD often requires trying lots of combinations of interventions, which can include medications and non-pharmacologic interventions such as mutual support groups or therapy. The diversity of support groups is growing, making them more accessible to patients; but patients may need to trial many different groups before finding one that “works” for them.

=== Our Expert(s) ===

Dr. Stephen Holt attended Columbia University’s College of Physicians & Surgeons and subsequently completed his residency training and Chief Residency at Yale's Primary Care Internal Medicine Residency Program before joining the program as an Assistant Professor. He currently serves as the Associate Program Director for Ambulatory Education in the Primary Care Program. His areas of interest include addiction medicine, medical education, and the art and science of physical diagnosis. 

=== References ===

1. Tiglao SM, Meisenheimer ES, Oh RC. Alcohol Withdrawal Syndrome: Outpatient Management. Am Fam Physician. 2021 Sep 1;104(3):253-262. PMID: 34523874.
2. McPheeters M, O'Connor EA, Riley S, Kennedy SM, Voisin C, Kuznacic K, Coffey CP, Edlund MD, Bobashev G, Jonas DE. Pharmacotherapy for Alcohol Use Disorder: A Systematic Review and Meta-Analysis. JAMA. 2023 Nov 7;330(17):1653-1665. doi: 10.1001/jama.2023.19761. Erratum in: JAMA. 2024 Oct 2. doi: 10.1001/jama.2024.11331. PMID: 37934220; PMCID: PMC10630900.
3. Garbutt JC, Kranzler HR, O'Malley SS, et al. Efficacy and tolerability of long-acting injectable naltrexone for alcohol dependence: a randomized controlled trial. JAMA 2005; 293:1617.
4. Skinner MD, Lahmek P, Pham H, Aubin HJ. Disulfiram efficacy in the treatment of alcohol dependence: a meta-analysis. PLoS One 2014; 9:e87366.

=== About Us ===

The Primary Care Pearls (PCP) Podcast is created in collaboration with faculty, residents, and students from the Department of Internal Medicine at the Yale School of Medicine. The project aims to create accessible and informative podcasts about core primary care topics centered around real patient stories. 

Hosts: Dylan Balter

Producers: Helen Cai, Josh Onyango

Logo and Name: Eva Zimmerman

Theme music and Editing: Helen Cai, Josh Onyango

Other background music: Asher Fulero, Dan Bodan, Penguin Music, Nathan Moore, Chris Haugen

Instagram: @pcpearls

Twitter: @PCarePearls

Listen on your favorite podcast platforms: linktr.ee/pcpearls

=== Outline ===

Chapter 1: Early Development of a Relationship with Alcohol

Chapter 2: Diagnosing AUD

Chapter 3: Approaching the Conversation

Chapter 4: Motivational Interviewing

=== Learning Points ===

1. Someone’s relationship with alcohol is shaped by many factors. Learning more about these elements--such as upbringing, social circles, and if alcohol is used to cope with stressors--will provide a comprehensive biopsychosocial understanding about the role that alcohol plays in a patient’s life. 
2. Be familiar with and use screening tools for excessive alcohol use. These might include the AUDIT-C or the NIAAA Single Alcohol Screening Question. 
3. Motivational interviewing not only allows us to understand more about someone’s relationship with alcohol, but provides the guiding framework to explore what they are willing to take on in terms of change and intervention. A key aspect of motivational interviewing in this context is eliciting the patient’s perspectives on what is beneficial and detrimental about their alcohol use, and pointing out the discrepancies in alcohol’s impact on their life.

=== Our Expert(s) ===

Dr. Stephen Holt attended Columbia University’s College of Physicians & Surgeons and subsequently completed his residency training and Chief Residency at Yale's Primary Care Internal Medicine Residency Program before joining the program as an Assistant Professor. He currently serves as the Associate Program Director for Ambulatory Education in the Primary Care Program. His areas of interest include addiction medicine, medical education, and the art and science of physical diagnosis. 

=== References ===

1. What is a standard drink? https://www.niaaa.nih.gov/alcohols-effects-health/what-standard-drink
2. Highlights for the 2022 National Survey on Drug Use and Health: https://www.samhsa.gov/data/sites/default/files/reports/rpt42731/2022-nsduh-main-highlights.pdf 
3. Facts About U.S. Deaths from Excessive Alcohol Use: https://www.cdc.gov/alcohol/facts-stats/index.html 
4. AUDIT-C: https://www.mirecc.va.gov/cih-visn2/Documents/Provider_Education_Handouts/AUDIT-C_Version_3.pdf
5. AUDIT: https://auditscreen.org/ 

=== About Us ===

The Primary Care Pearls (PCP) Podcast is created in collaboration with faculty, residents, and students from the Department of Internal Medicine at the Yale School of Medicine. The project aims to create accessible and informative podcasts about core primary care topics centered around real patient stories. 

Hosts: Dylan Balter

Producers: Helen Cai, Josh Onyango

Logo and Name: Eva Zimmerman

Theme music and Editing: Helen Cai, Josh Onyango

Other background music: Puddle of Infinity, Adam MacDougall, Density & Time, Jesse Gallagher, Asher Fulero, Astron, Lauren Duski, 

Instagram: @pcpearls

Twitter: @PCarePearls

Listen on your favorite podcast platforms: linktr.ee/pcpearls

=== Outline ===
1. Introduction
2. Chapter 1:  Lifestyle Changes (Diet/Exercies)
3. Chapter 2: Weight Loss Medications
4. Chapter 3: Bariatric Surgery
5. Chapter 4: Advise to Young Clinicians and Fellow Patients
6. Conclusion

=== Learning Points ===

1. Lifestyle modifications need to be tailored to the patient. This often involves starting with a careful dietary and activity history and helping the patient incorporate small, healthy changes that are congruent with their cultural background
2. There are multiple medications available for weight loss and selecting the right one requires knowledge of a patient's comorbid health conditions, as well as taking into account their personal preference. Side-effects tolerance cost, and or insurance coverage
3. Recognize how to counsel patients on when it may be appropriate to pursue bariatric surgery and what they can expect following the procedure.
4. The most important step in helping patients manage obesity is by starting the conversation and letting patients know that you are there to support them along every step of the way.
5. 
   

=== Our Expert(s) ===

Dr. Jorge O. Moreno is an Assistant Professor of Medicine at Yale School of Medicine.

Dr. Moreno is originally from Mexico and is also fluent in Spanish. He grew up in New Rochelle, NY and completed his undergraduate degree at Columbia University in 2006.  In 2011, he obtained his medical degree from the University of Rochester School of Medicine and Dentistry. He completed his internal medical residency at the Yale University’s Primary Care Residency Program Yale New Haven in 2014.

=== References ===

1. Heymsfield SB, Wadden TA. Mechanisms, Pathophysiology, and Management of Obesity. N Engl J Med. 2017 Jan 19;376(3):254-266. doi: 10.1056/NEJMra1514009. PMID: 28099824. https://www.nejm.org/doi/full/10.1056/nejmra1514009
2. Wilding, J. P. H., et al. (2021). "Once-Weekly Semaglutide in Adults with Overweight or Obesity." New England journal of medicine 384(11): 989-1002.

=== About Us ===

The Primary Care Pearls (PCP) Podcast is created in collaboration with faculty, residents, and students from the Department of Internal Medicine at the Yale School of Medicine. The project aims to create accessible and informative podcasts about core primary care topics centered around real patient stories.

Hosts: Maisie Orsillo
Producers: Helen Cai, JW Allen, August Allocco
Logo and Name: Eva Zimmerman
Theme music and Editing: Josh Onyango
Other background music: Corbyn Kites, Quincas Moreira, Jesse Gallagher, Patrick Patrikios

Instagram: @pcpearls
Twitter: @PCarePearls
Listen on your favorite podcast platforms: linktr.ee/pcpearls

=== Outline ===
1. Introduction
2. Chapter 1:  Personal Relationship to Weight
3. Chapter 2: Impact of Weight on Mental Health
4. Chapter 3: Relationship with PCP
5. Conclusion

=== Learning Points ===

1. Commonly used measures of obesity include BMI and waist circumference. These measures are imperfect, since they are attempting to quantify adiposity. 
2. Patients often undergo an emotional journey that is related to their weight. Many patients prefer to move towards tangible end goals such as increased mobility, lowered risk for future adverse health events, or other factors rather than a specific weight, BMI, or waist circumference.
3. Screening and treatment of mental health conditions such as anxiety and depression can be instrumental in the  care of patients who have elevated BMI. 
4. Be sure to ask permission to discuss the patient’s weight before jumping in. Set SMART goals with your patients and set expectations early.

=== Our Expert(s) ===

Dr. Jorge O. Moreno is an Assistant Professor of Medicine at Yale School of Medicine.

Dr. Moreno is originally from Mexico and is also fluent in Spanish. He grew up in New Rochelle, NY and completed his undergraduate degree at Columbia University in 2006.  In 2011, he obtained his medical degree from the University of Rochester School of Medicine and Dentistry. He completed his internal medical residency at the Yale University’s Primary Care Residency Program Yale New Haven in 2014.

=== References ===

1. Hales CM, Carroll MD, Fryar CD, Ogden CL. Prevalence of obesity and severe obesity among adults: United States, 2017–2018. NCHS Data Brief, no 360. Hyattsville, MD: National Center for Health Statistics. 2020. Retrieved from: https://www.cdc.gov/nchs/products/databriefs/db360.html
2. https://www.cdc.gov/obesity/data/adult.html

*For additional resources discussed in the episode, check out our transcript!

=== About Us ===

The Primary Care Pearls (PCP) Podcast is created in collaboration with faculty, residents, and students from the Department of Internal Medicine at the Yale School of Medicine. The project aims to create accessible and informative podcasts about core primary care topics centered around real patient stories.

Hosts: Nate Wood
Producers: Helen Cai, JW, August Allocco
Logo and name: Eva Zimmerman
Theme music and Editing: Josh Onyango
Other background music: Emily A. Sprague, Unicorn Heads, Godmode, Corbyn Kites, Ammil, Coma

Instagram: @pcpearls
Twitter: @PCarePearls
Listen on most podcast platforms: linktr.ee/pcpearls

=== Outline ===
1. Introduction
2. Chapter 1:  Food Environment
3. Chapter 2: Social Determinants of Health
4. Chapter 3: Concluding the Nutrition Series
5. Conclusion

=== Learning Points ===

1. Setting up an environment for success and encouraging new habits are the most important strategies for success in changing eating patterns. 
2. While it’s important to understand the effects of social determinants of health, our patients are resilient in enacting change and should not be underestimated. 
3. Many fad diets and trends exist within mainstream cultures. At the end of the day: point patients to an evidence-based lifestyle (such as eating a whole food, predominantly plant-based diet).
4. Time within the office is limited. Provide patients with brief, targeted teaching while they are within the office, and additional resources for patients to explore after the visit.

=== Our Expert(s) ===

Dr. Justin Charles is a graduate of the Yale Primary Care Internal Medicine Residency Program.

His clinical interests are in Lifestyle Medicine, the use of evidence-based lifestyle interventions to not only prevent, but treat and reverse chronic disease from a root cause perspective. He has received training in Plant-Based Nutrition through the T. Colin Campbell Center for Nutrition Studies and eCornell, as well as Dr. John McDougall's Starch Solution Certification Course. 

=== References ===

Re: similarities between processed foods and “illicit” drugs:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4334652/  

Re: our environment being obesogenic: https://www.sciencedirect.com/science/article/abs/pii/S0091743599905856 

Structures being a fundamental cause of disease:
https://www.jstor.org/stable/2626958 

Re: systemic solutions mentioend at the White House Conference: https://www.whitehouse.gov/briefing-room/statements-releases/2022/09/28/fact-sheet-the-biden-harris-administration-announces-more-than-8-billion-in-new-commitments-as-part-of-call-to-action-for-white-house-conference-on-hunger-nutrition-and-health/ 

*For additional resources discussed in the episode, check out our transcript!

=== About Us ===

The Primary Care Pearls (PCP) Podcast is created in collaboration with faculty, residents, and students from the Department of Internal Medicine at the Yale School of Medicine. The project aims to create accessible and informative podcasts about core primary care topics centered around real patient stories.

Hosts: Nate Wood
Producers: Nate Wood, Helen Cai, August Allocco
Logo and name: Eva Zimmerman
Theme music and Editing: Josh Onyango
Other background music: Dan Henig, Bobby Richards, Asher Fulero, Jesse Gallagher, VYEN

Instagram: @pcpearls
Twitter: @PCarePearls
Listen on most podcast platforms: linktr.ee/pcpearls

=== Outline ===
1. Introduction
2. Chapter 1: Taking a Dietary History
3. Chapter 2: Motivational Interviewing
4. Conclusion

=== Learning Points ===

1. Changes in food habits and eating patterns can mean breaking patterns that have been ingrained over lifetimes
2. Fear and shame are not effective motivators, and so should not be used to persuade patients to change behaviors. Instead, emphasize the positive benefits that are present in the short term.
3. Taking a detailed hour-by-hour dietary history can uncover additional opportunities to change eating patterns. Be sure to ask patients how they prepare foods, dress foods with condiments, and so forth.
4. Empowering patients and removing judgment is critical. Motivational interviewing is a technique that frames change in an actionable, self-empowering manner, while uncovering reasons for changing eating patterns that are not solely weight-centered.
5. In addition to achieving weight loss goals, changing nutrition is an opportunity to help patients get excited about other health goals, such as improving their blood pressure or reducing their risk of developing diabetes.

=== Our Expert(s) ===

Dr. Justin Charles is a graduate of the Yale Primary Care Internal Medicine Residency Program.

His clinical interests are in Lifestyle Medicine, the use of evidence-based lifestyle interventions to not only prevent, but treat and reverse chronic disease from a root cause perspective. He has received training in Plant-Based Nutrition through the T. Colin Campbell Center for Nutrition Studies and eCornell, as well as Dr. John McDougall's Starch Solution Certification Course. 

=== References ===

Arab L, Tseng CH, Ang A, Jardack P. Validity of a multipass, web-based, 24-hour self-administered recall for assessment of total energy intake in blacks and whites. Am J Epidemiol. 2011 Dec 1;174(11):1256-65. doi: 10.1093/aje/kwr224. Epub 2011 Oct 20. PMID: 22021561; PMCID: PMC3224251.

=== Recommended Reading ===

1. Moshfegh, A.J., Rhodes, D.G., Baer, D.J., Murayi, T., Clemens, J.C., Rumpler, W.V., Paul, D.R., Sebastian, R.S., Kuczynski, K.J., Ingwersen, L.A., Staples, R.C., Cleveland, L.E. The US Department of Agriculture Automated Multiple-Pass Method reduces bias in the collection of energy intakes. A J Clin Nutr. 2008;88:324-332
2. Johnston CA, Stevens BE. Motivational Interviewing in the Health Care Setting. Am J Lifestyle Med. 2013;7(4):246-249. doi:10.1177/1559827613485923
3. Hauser ME, McMacken M, Lim A, Shetty P. Nutrition—An Evidence-Based, Practical Approach to Chronic Disease Prevention and Treatment. Fam Pract. 2022;71((1 Suppl Lifestyle)). doi:10.12788/jfp.0292

*For more reading recommendations, check out our transcript!

=== About Us ===

The Primary Care Pearls (PCP) Podcast is created in collaboration with faculty, residents, and students from the Department of Internal Medicine at the Yale School of Medicine. The project aims to create accessible and informative podcasts about core primary care topics centered around real patient stories.

Hosts: Nate Wood
Producers: Nate Wood, Helen Cai, August Allocco
Logo and name: Eva Zimmerman
Theme music and Editing: Josh Onyango
Other background music: Patrick Patrikios, pATCHES, Myuu, VYEN, Reed Mathis, 

Instagram: @pcpearls
Twitter: @PCarePearls
Listen on most podcast platforms: linktr.ee/pcpearls

=== Outline ===
1. Introduction
2. Chapter 1: Types of Eating Patterns
3. Chapter 2: Whole Food Plant-Based Diet
4. Chapter 3: Emotional and Psychological Nature of Eating
5. Conclusion

=== Learning Points ===

1. Patients have different motivations for changing their eating habits: they may wish to lose weight as measured on the scale, change their appearance, or prevent or treat chronic disease. 
2. The keto diet, a popular eating diet, can appear to be healthful in the short term: patients are able to lose weight, decrease their blood pressure, and decrease their blood sugar. However, it is not sustainable in the long term and may lead to increased risk of adverse health outcomes. 
3. Many scientifically vetted eating patterns, including the DASH diet and Mediterranean diet, share one thing in common: eating a whole food, plant-based diet. Eating a whole food, plant-based diet does not mean the same thing as “vegan;” rather, it emphasizes eating foods in their minimally processed form and minimizing consumption of animal-based foods. 

=== Our Expert(s) ===

Dr. Justin Charles is a graduate of the Yale Primary Care Internal Medicine Residency Program.

His clinical interests are in Lifestyle Medicine, the use of evidence-based lifestyle interventions to not only prevent, but treat and reverse chronic disease from a root cause perspective. He has received training in Plant-Based Nutrition through the T. Colin Campbell Center for Nutrition Studies and eCornell, as well as Dr. John McDougall's Starch Solution Certification Course. 

=== Recommended Reading ===

1. Comparison of sociodemographic and nutritional characteristics between self-reported vegetarians, vegans, and meat-eaters from the NurtiNet-Santé Study.
2. Rosenfeld DL. The psychology of vegetarianism: Recent advances and future directions. Appetite 2018; 131:125-38;and Ruby MB. Vegetarianism. A blossoming field of study. Appetite 2012; 58:141-150.
3. Plante CN, Rosenfeld DL, Plante M, Reysen S. The role of social identity motivation in dietary attitudes and behaviors among vegetarians. Appetite 2019; 141 https://doi.org/10.1016/j.appet.2019.05.038
4. Dehghan M, Mente A, Zhang X, et al. Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five contents (PURE): a prospective study.

=== About Us ===

The Primary Care Pearls (PCP) Podcast is created in collaboration with faculty, residents, and students from the Department of Internal Medicine at the Yale School of Medicine. The project aims to create accessible and informative podcasts about core primary care topics centered around real patient stories.

Hosts: Nate Wood
Producers: Nate Wood, Helen Cai, August Allocco
Logo and name: Eva Zimmerman
Theme music and Editing: Josh Onyango
Other background music: pATCHES, Unicorn Heads, Asher Fulero

Instagram: @pcpearls
Twitter: @PCarePearls
Listen on most podcast platforms: linktr.ee/pcpearls

Share your reactions and questions with us at  Speak Pipe . We might feature you on a future episode!

=== Outline ===
1. Introduction
2. Chapter 1: Tina's Story
3. Chapter 2: Eating for Joy
4. Chapter 3: Busting Nutrition Myths
5. Conclusion

=== Learning Points ===

1. Eating behavior is deeply rooted in personal experience. 
2. Healthy eating can be a joyous experience, a message that is often lost in mass media and cultural myths. 
3. Instead of focusing on individual components of food such as macronutrient profiles, carbohydrates, or fats, focus more on what a particular food offers as a whole.  
4. Robust literature is available to guide physicians in counseling patients on their nutrition choices (more on this to come in future episodes). 

=== Our Expert(s) ===

Dr. Justin Charles is a graduate of the Yale Primary Care Internal Medicine Residency Program. His clinical interests are in Lifestyle Medicine, the use of evidence-based lifestyle interventions to not only prevent, but treat and reverse chronic disease from a root cause perspective. He has received training in Plant-Based Nutrition through the T. Colin Campbell Center for Nutrition Studies and eCornell, as well as Dr. John McDougall's Starch Solution Certification Course. 

=== References ===

1. Ros E. The PREDIMED study. Endocrinol Diabetes Nutr. 2017 Feb;64(2):63-66. English, Spanish. doi: 10.1016/j.endinu.2016.11.003. Epub 2017 Feb 1. PMID: 28440779.
2. Le LT, Sabaté J. Beyond meatless, the health effects of vegan diets: findings from the Adventist cohorts. Nutrients. 2014 May 27;6(6):2131-47. doi: 10.3390/nu6062131. PMID: 24871675; PMCID: PMC4073139.

=== Recommended Reading ===

1. Zhang B, Zhai FY, Du SF, Popkin BM. The China Health and Nutrition Survey, 1989-2011. Obes Rev 2014; 15(suppl 1):2–7.
2. Campbell TC, Parpia B, Chen J. Diet, lifestyle, and the etiology of coronary artery disease: the Cornell China Study 
3. Davey GK, Spencer EA, Appleby PN, et al. EPIC–Oxford: lifestyle characteristics and nutrient intakes in a cohort of 33,883 meat-eaters and 31,546 non meat-eaters in the UK.
4. Wilkins JT, Karmali KN, Huffman MD, et al. Data resource profile: the cardiovascular disease lifetime risk pooling project. Alles B, Baudry J, Mejean C, et al.

=== About Us ===
The Primary Care Pearls (PCP) Podcast is created in collaboration with faculty, residents, and students from the Department of Internal Medicine at the Yale School of Medicine. The project aims to create accessible and informative podcasts for furthering the medical education of residents and clinicians in early stages of their careers. Building on the work of other medical education podcasts, Primary Care Pearls includes contributions from patients themselves, who have the autonomy to share their own experiences of how their primary care physician directly impacted the quality of their care.

Hosts: Nate Wood
Producers: Nate Wood, Helen Cai, August Alloco,
Logo and name: Eva Zimmerman
Theme music and Editing: Josh Onyango
Other background music: TrackTribe, The Tide, Patrick Patrikios, Asher Fulero, Windows of Ken, Joel Cummins

Instagram: @pcpearls
Twitter: @PCarePearls
Listen on most podcast platforms: linktr.ee/pcpearls

Share your reactions and questions with us at  Speak Pipe . We might feature you on a future episode!

=== Outline ===
1. Introduction
2. Chapter 1: Causes of Primary Hypertension
3. Chapter 2: Secondary Hypertension
4. Chapter 3: Treating Hypertension in Special Populations
6. Conclusion

=== Learning Points ===

1. About 90% of patients with hypertension experience primary hypertension. About 10% of patients with hypertension experience secondary hypertension due to an underlying disease or interfering medication. Causes of secondary hypertension can include pheochromocytoma, renal artery stenosis, CKD, primary hyperaldosteronism, fibromuscular dysplasia, and obstructive sleep apnea.
2. Workup for diagnosing the cause of hypertension should include a detailed history and a focused physical exam. Basic labs should include assessment for acute nephritis (e.g. hematuria, pyuria, or proteinuria), lipid panel, and A1C to screen for type 2 diabetes. 
3. “Hypertensive urgency” is differentiated from forms of hypertensive emergency by the absence of hypertensive end organ damage. Distinguishing between the two conditions is key for determining the therapeutic goal for blood pressure.
4. Patients who are elderly, pregnant, may become pregnant, or have chronic kidney disease require special attention and management of their hypertension.

=== Our Expert(s) ===

Benjamin Gallagher, MD, FACP is an Assistant Professor of Clinical Medicine (General Medicine) at Yale School of Medicine.

=== References ===

de la Sierra A, Segura J, Banegas JR, Gorostidi M, de la Cruz JJ, Armario P, Oliveras A, Ruilope LM. Clinical features of 8295 patients with resistant hypertension classified on the basis of ambulatory blood pressure monitoring. Hypertension. 2011 May;57(5):898-902. doi: 10.1161/HYPERTENSIONAHA.110.168948. Epub 2011 Mar 28. PMID: 21444835.

Anderson TS, Jing B, Auerbach A, et al. Clinical Outcomes After Intensifying Antihypertensive Medication Regimens Among Older Adults at Hospital Discharge. JAMA Intern Med. 2019;179(11):1528–1536. doi:10.1001/jamainternmed.2019.3007

=== About Us ===

The Primary Care Pearls (PCP) Podcast is created in collaboration with faculty, residents, and students from the Department of Internal Medicine at the Yale School of Medicine. The project aims to create accessible and informative podcasts about core primary care topics centered around real patient stories.

Hosts: Josh Onyango, Maisie Orsillo
Producers: Helen Cai, Kevin Wheelock, Danish Zaidi
Logo and name: Eva Zimmerman
Theme music and Editing: Josh Onyango
Other background music: Coma Media, Defekt_Maschine, Chris Haugen, Unicorn Heads, and Slynk.

Instagram: @pcpearls
Twitter: @PCarePearls
Listen on most podcast platforms: linktr.ee/pcpearls

Share your reactions and questions with us at  Speak Pipe . We might feature you on a future episode!

=== Outline ===
1. Introduction
2. Chapter 1: Setting goals
3. Chapter 2: Lifestyle modifications
4. Chapter 3: Initiating Pharmacotherapy
5. Chapter 4: Adherence to Medications
6. Conclusion

=== Learning Points ===

1. Most patients with hypertension would benefit from having a low blood pressure, regardless of the degree of lowering.
2. Recognize that asking patients to start medications can be a large ask for a patient, especially if they are otherwise healthy and have several other conditions to manage. 
3. Lifestyle modifications—such as reducing salt intake and drinking water—may lower blood pressure to some degree. However, finding such “low-hanging fruit” in lifestyle modifications is difficult, and providers should not shy away from pharmacotherapies. 
4. Firstline therapies for lowering blood pressure include long-acting calcium channel blockers, ACE inhibitors/ARBs, and diuretics. Optimizing a patient’s regimen may require a combination of therapies, and combination pills may be effective in improving adherence.

=== Our Expert(s) ===

Benjamin Gallagher, MD, FACP is an Assistant Professor of Clinical Medicine (General Medicine) at Yale School of Medicine.

=== References ===

1. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 2018;71:e127-e248.
2. Ostchega Y, Fryar CD, Nwankwo T, Nguyen DT. Hypertension prevalence among adults aged 18 and over: United States, 2017–2018. NCHS Data Brief, no 364. Hyattsville, MD: National Center for Health Statistics. 2020.
3. SPRINT Research Group, Wright JT Jr, Williamson JD, Whelton PK, Snyder JK, Sink KM, et al. A randomized trial of intensive versus standard blood-pressure control. N Engl J Med 373(22):2103–16. 2015.
4. Thomopoulos C, Parati G, Zanchetti A. Effects of blood pressure-lowering treatment on cardiovascular outcomes and mortality: 14 – Effects of different classes of antihypertensive drugs in older and younger patients: Overview and meta-analysis. J Hypertens 36(8):1637–47. 2018.

=== Recommended Reading ===

1. Appel LJ, Brands MW, Daniels SR, Karanja N, Elmer PJ, Sacks FM; American Heart Association. Dietary approaches to prevent and treat hypertension: a scientific statement from the American Heart Association. Hypertension. 2006 Feb;47(2):296-308. doi: 10.1161/01.HYP.0000202568.01167.B6. PMID: 16434724.

=== About Us ===

The Primary Care Pearls (PCP) Podcast is created in collaboration with faculty, residents, and students from the Department of Internal Medicine at the Yale School of Medicine. The project aims to create accessible and informative podcasts about core primary care topics centered around real patient stories.

Hosts: Josh Onyango, Maisie Orsillo
Producers: Helen Cai, Kevin Wheelock, Danish Zaidi
Logo and name: Eva Zimmerman
Theme music and Editing: Josh Onyango
Other background music: Dan Lebowitz, penguinmusic, future mono, Jesse Gallagher, VYEN, madriFan, 

Instagram: @pcpearls
Twitter: @PCarePearls
Listen on most podcast platforms: linktr.ee/pcpearls

Share your reactions and questions with us at  Speak Pipe . We might feature you on a future episode!

===  Outline ===
1. Introduction
2. Chapter 1: Taylor's Story/Hypertensive Urgency
3.  Chapter 2: Defining Hypertension
4. Chapter 3: Measuring Blood Pressure
5. Chapter 4: White Coat Hypertension
6. Conclusion

=== Learning Points ===

1. The ideal target for a patient’s blood pressure is based on their risk score for cardiovascular events and mortality in the long term. 
2. Measurement of blood pressure in an office setting is often performed in nonideal conditions.Out-of-office monitoring of blood pressure monitoring should be used whenever possible. 
3. The “white coat effect” refers to high blood pressure that is above a patient’s treatment goal in the office, but below their treatment goal at home. This effect is still clinically significant.

=== Our Expert(s) ===

Benjamin Gallagher, MD, FACP is an Assistant Professor of Clinical Medicine (General Medicine) at Yale School of Medicine.

=== References ===

1. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 2018;71:e127-e248.
2. Ostchega Y, Fryar CD, Nwankwo T, Nguyen DT. Hypertension prevalence among adults aged 18 and over: United States, 2017–2018. NCHS Data Brief, no 364. Hyattsville, MD: National Center for Health Statistics. 2020.
3. SPRINT Research Group, Wright JT Jr, Williamson JD, Whelton PK, Snyder JK, Sink KM, et al. A randomized trial of intensive versus standard blood-pressure control. N Engl J Med 373(22):2103–16. 2015.
4. Powers BJ, Olsen MK, Smith VA, Woolson RF, Bosworth HB, Oddone EZ. Measuring blood pressure for decision making and quality reporting: where and how many measures? Ann Intern Med. 2011 Jun 21;154(12):781-8, W-289-90. doi: 10.7326/0003-4819-154-12-201106210-00005. PMID: 21690592.
5. de la Sierra A, Segura J, Banegas JR, Gorostidi M, de la Cruz JJ, Armario P, Oliveras A, Ruilope LM. Clinical features of 8295 patients with resistant hypertension classified on the basis of ambulatory blood pressure monitoring. Hypertension. 2011 May;57(5):898-902. doi: 10.1161/HYPERTENSIONAHA.110.168948. Epub 2011 Mar 28. PMID: 21444835.

=== About Us ===

The Primary Care Pearls (PCP) Podcast is created in collaboration with faculty, residents, and students from the Department of Internal Medicine at the Yale School of Medicine. The project aims to create accessible and informative podcasts for furthering the medical education of residents and clinicians in early stages of their careers. Building on the work of other medical education podcasts, Primary Care Pearls includes contributions from patients themselves, who have the autonomy to share their own experiences of how their primary care physician directly impacted the quality of their care.

Hosts: Josh Onyango, Maisie Orsillo
Producers: Helen Cai, Kevin Wheelock, Danish Zaidi
Logo and name: Eva Zimmerman
Theme music and Editing: Josh Onyango
Other background music: The Mini Vandals, Asher Fuller, Astron, Joel Cummins, penguinmusic, Unicorn heads, Dan Bodan, 

Instagram: @pcpearls
Twitter: @PCarePearls
Listen on most podcast platforms: linktr.ee/pcpearls

Share your reactions and questions with us at Speak Pipe . We might feature you on a future episode!

=== Outline ===

1. Introduction
2. Chapter 9 - Starting Insulin
3. Chapter 10 - Day-to-Day Management
4. Chapter 11 - Hypoglycemia and Difficult Conversations
5. Chapter 12 - Lifestyle Changes
6. Chapter 13 - Advice to Patients and Practitioners
7. Conclusion

=== Learning Points ===

1. When adding a new insulin therapy, consider factors such as cost, the patient’s eating habits, and their attitude toward injections
2. The ADA recommends starting insulin if the A1c is over 10% when symptoms of hyperglycemia are under poor control, or in patients with ESRD. 
3. When teaching patients how to monitor their own glucose, take the time to teach them how to use a glucometer and record their blood sugars
4. Educate patients and loved ones on how to identify hypoglycemia and how to treat it.

=== Our Expert(s) ===

Dr. Tracy Rabin is an Internist and Pediatrician who joined the Yale faculty in 2011 as a member of the Section of General Internal Medicine (YSM Department of Internal Medicine), and currently serves as the  Associate Program Director for Global and Community Health in the Yale Primary Care Internal Medicine Residency Program (YPC). She attends and teaches on the medical wards at the St. Raphael's Campus (SRC) of Yale-New Haven Hospital; directs care and precepts residents in the SRC Adult Primary Care Diabetes Clinic.

=== References ===

1. [American Diabetes Association] Standards of Medical Care in Diabetes—2022 Abridged for Primary Care Providers: https://diabetesjournals.org/clinical/article/40/1/10/139035/Standards-of-Medical-Care-in-Diabetes-2022  
2. HUSKY Health Program | Providers | Continuous Glucose Monitors (CGM) Policy: https://www.huskyhealthct.org/providers/provider_postings/policies_procedures/Continuous_Glucose_Monitors_Policy.pdf 
3. [American Diabetes Association] Hypoglycemia: https://www.diabetes.org/healthy-living/medication-treatments/blood-glucose-testing-and-control/hypoglycemia 

=== About Us ===

The Primary Care Pearls (PCP) Podcast is created in collaboration with faculty, residents, and students from the Department of Internal Medicine at the Yale School of Medicine. The project aims to create accessible medical education podcast episodes that center on a patient's lived experience with a disease.

Hosts: Katie Gielissen, Maisie Orsillo
Post-Production Assistant: Christina Liu
Logo and name: Eva Zimmerman
Theme music and Editing: Josh Onyango
Other background music: The Tides, Yen, Joel Cummins, Underbelly & Ty Mayer, Bobby Richards, DJ Williams, Dan Henig, Surviving the Asteroid Belt

Instagram: @pcpearls
Twitter: @PCarePearls
Listen on most podcast platforms: linktr.ee/pcpearls

Share your reactions and questions with us at Speak Pipe . We might feature you on a future episode!

=== Outline ===

1. Introduction
2. Chapter 5 - Patient Centered Approach
3. Chapter 6 - Medication
4. Chapter 7 - Comorbidities
5. Chapter 8 - Barriers to medication
6. Conclusion

=== Learning Points ===

1. There are several non-insulin medications for diabetes that can be differentiated by their mechanisms and all have different indications on when to use them
2. A patient’s comorbidities may guide your choice for starting a non-insulin therapy. 
3. Explaining the side effects of a medication in the context of its mechanism of action may go a long way in helping the patient manage expectations around new medications. 
4. Addressing mental health comorbidities such as depression and anxiety can be key to initiating and maintaining the management of diabetes.
5. Create adestigmatizing environment when asking patients about their medication consistency

=== Our Expert(s) ===

Dr. Tracy Rabin is an Internist and Pediatrician who joined the Yale faculty in 2011 as a member of the Section of General Internal Medicine (YSM Department of Internal Medicine), and currently serves as the Associate Program Director for Global and Community Health in the Yale Primary Care Internal Medicine Residency Program (YPC). She attends and teaches on the medical wards at the St. Raphael's Campus (SRC) of Yale-New Haven Hospital; directs care and precepts residents in the SRC Adult Primary Care Diabetes Clinic

=== References ===

1. [American Diabetes Association] Standards of Medical Care in Diabetes—2022 Abridged for Primary Care Providers: https://diabetesjournals.org/clinical/article/40/1/10/139035/Standards-of-Medical-Care-in-Diabetes-2022  
2. Figure depicting patient and disease factors that may be used to determine optimal HbA1C targets: Inzucchi, S.E., Bergenstal, R.M., Buse, J.B. et al. Management of hyperglycaemia in type 2 diabetes, 2015. Diabetologia 58, 429–442 (2015). https://doi.org/10.1007/s00125-014-3460-0 
3. Herkert D, Vijayakumar P, Luo J, Schwartz JI, Rabin TL, DeFilippo E, Lipska KJ. Cost-Related Insulin Underuse Among Patients With Diabetes. JAMA Intern Med. 2019 Jan 1;179(1):112-114. doi: 10.1001/jamainternmed.2018.5008. PMID: 30508012; PMCID: PMC6583414.

=== Recommended Reading ===

1. American Diabetes Association; 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Medical Care in Diabetes—2021. Diabetes Care 1 January 2021; 44 (Supplement_1): S111–S124. https://doi.org/10.2337/dc21-S009

=== About Us ===

The Primary Care Pearls (PCP) Podcast is created in collaboration with faculty, residents, and students from the Department of Internal Medicine at the Yale School of Medicine where give patients the autonomy to participate as experts of the lived experience of their condition.

Hosts: Katie Gielissen, Maisie Orsillo
Post-Production Assistant: Christina Liu, Helen Cai
Logo and name: Eva Zimmerman
Theme music and Editing: Josh Onyango
Other background music: Mini Vandals, Kevin MacLeod, Patrick Patrikios, Dan Bodan, Nate Blaze

Instagram: @pcpearls
Twitter: @PCarePearls
Listen on most podcast platforms: linktr.ee/pcpearls

Share your reactions and questions with us at  Speak Pipe . We might feature you on a future episode!

=== Outline ===

1. Introduction
2. Chapter 1 - Screening for Diabetes
3. Chapter 2 - Diagnosis/Breaking the News
4. Chapter 3 - Setting Expectations After the Diagnosis
5. Chapter 4 - Shame, Stigma, and Support
6. Conclusion

=== Learning Points ===

1. Screen all adults >35yo for diabetes every 3 years. You might screen other patients if  they have risk factors placing them at higher risk
2. Begin conversation about diabetes before ordering tests
3. Ensure that you have enough time to listen to and address patient's concerns about a new diabetes diagnosis
4. Be attentive for signs of distress in patients with diabetes, which could affect their care.

=== Our Expert(s) ===

Dr. Tracy Rabin is an Internist and Pediatrician who joined the Yale faculty in 2011 as a member of the Section of General Internal Medicine (YSM Department of Internal Medicine), and currently serves as the Director of the Office of Global Health, and the Associate Program Director for Global and Community Health in the Yale Primary Care Internal Medicine Residency Program (YPC). She co-directs the Makerere University-Yale University (MUYU) medical education capacity building collaboration which is based at the Makerere University College of Health Sciences/Mulago National Referral & Teaching Hospital in Kampala, Uganda.

=== References ===

1. [American Diabetes Association] Standards of Medical Care in Diabetes—2022 Abridged for Primary Care Providers: https://diabetesjournals.org/clinical/article/40/1/10/139035/Standards-of-Medical-Care-in-Diabetes-2022  
2. Diabetes Distress Scale: https://diabetesdistress.org/take-dd-survey

=== Recommended Reading ===

1. [CDC] 10 Tips for Coping with Diabetes Distress: https://www.cdc.gov/diabetes/managing/diabetes-distress/ten-tips-coping-diabetes-distress.html 

=== About Us ===

The Primary Care Pearls (PCP) Podcast is created in collaboration with faculty, residents, and students from the Department of Internal Medicine at the Yale School of Medicine. The project aims to create accessible and informative podcasts for furthering the medical education of residents and clinicians in early stages of their careers. Building on the work of other medical education podcasts, Primary Care Pearls includes contributions from patients themselves, who have the autonomy to share their own experiences of how their primary care physician directly impacted the quality of their care.

Hosts: Katie Gielissen, Maisie Orsillo
Post-Production Assistant: Helen Cai, Christina Liu
Logo and name: Eva Zimmerman
Theme music and Editing: Josh Onyango
Other background music: the Mini Vandals, Wes Hutchinson, E's Jammy Jams, Futuremono, Ammil, Emmit Fenn, Humam-Huma, Patrick Patrikios, Jesse Gallagher, Emily A. Sprague, Corbyn Kites

Instagram: @pcpearls
Twitter: @PCarePearls
Listen on most podcast platforms: linktr.ee/pcpearls

1. Introduction (0:00)
2. Chapter 9: Therapy (individual vs group) (3:29)
3. Chapter 10: Sponsors (17:33)
4. Chapter 11: Return to Use (21:40)
5. Conclusion: (34:39)

=== Learning Points ===

1. While resources such as group therapy, NA, and other 12-step programs are not for everyone, they can be important tools to offer our patients. 
2. Sponsors can often relate to a patient’s struggles with opioid use disorder more authentically than we can as their providers. While a sponsor may not be for everyone, they can be invaluable to walk alongside some patients on their journey. 
3. Return to use is hard, both for patients and providers. We must accept that return to use is part of the disease of addiction, and this is not an excuse to pull back on medication treatment or to give up on our patients.

=== Our Expert(s) ===

Dr. Carolyn Chan is an academic hospitalist at Yale New-Haven Hospital with interests in medical humanities, quality improvement, and addiction medicine. You can reach her on twitter @CarolynAChan.

 Dr. Lisa Sanders, MD, FACP, associate professor of medicine (general medicine) and author of the popular Diagnosis column for the New York Times Magazine offers her media expertise to the PCP team as a production consultant for the podcast.

=== References ===

1. SAMHSA’s National Helpline: https://www.samhsa.gov/find-help/national-helpline

=== Recommended Reading ===

1. Buresh M, Stern R, Rastegar D. Treatment of opioid use disorder in primary care. BMJ. 2021 May 19;373:n784. doi: 10.1136/bmj.n784. PMID: 34011512.
2. Alexander GC, Stoller KB, Haffajee RL, Saloner B. An Epidemic in the Midst of a Pandemic: Opioid Use Disorder and COVID-19. Ann Intern Med. 2020 Jul 7;173(1):57-58. doi: 10.7326/M20-1141. Epub 2020 Apr 2. PMID: 32240283; PMCID: PMC7138407.
3. Hoffman KA, Ponce Terashima J, McCarty D. Opioid use disorder and treatment: challenges and opportunities. BMC Health Serv Res. 2019 Nov 25;19(1):884. doi: 10.1186/s12913-019-4751-4. PMID: 31767011; PMCID: PMC6876068.

=== About Us ===

The Primary Care Pearls (PCP) Podcast is created in collaboration with faculty, residents, and students from the Department of Internal Medicine at the Yale School of Medicine. The project aims to create accessible and informative podcasts for furthering the medical education of residents and clinicians in early stages of their careers. Building on the work of other medical education podcasts, Primary Care Pearls includes contributions from patients themselves, who have the autonomy to share their own experiences of how their primary care physician directly impacted the quality of their care.

Hosts: Nate Wood, Maisie Orsillo, Addy Feibel
Logo and name: Eva Zimmerman
Theme music and Editing: Josh Onyango
Producers: Helen Cai, Addy Feibel
Other Background music: Slynk, Astron, Nathan Moore, Dream-Protocol, Emmit Fenn, and Arcadia

Instagram: @pcpearls
Twitter: @PCarePearls
Listen on most podcast platforms: linktr.ee/pcpearls

1. Introduction (0:00)
2. Chapter 5 - Risk Assessment and Harm Reduction  (3:43)
3. Chapter 6 - Medication Assisted Treatment (11:31)
4. Chapter 7 - Counseling on Treatment Options (15:47)
5. Chapter 8 - How PCPs can start treating OUD (28:16)
6. Conclusion (33:04)

=== Learning Points ===

1. The RIP-TEAR mnemonic can assist in taking a good history of a patient with an opioid use disorder.
2. There are three FDA-approved medications for the treatment of opioid use disorder: methadone, buprenorphine (i.e. Suboxone), and naltrexone. 
3. Physicians who would like to prescribe for up to 30 patients do not require additional training to receiving an X-waiver, thus removing one barrier to treating opioid use disorder within the primary care setting.

=== Our Expert(s) ===

Dr. Carolyn Chan is an academic hospitalist at Yale New-Haven Hospital with interests in medical humanities, quality improvement, and addiction medicine. You can reach her on twitter @CarolynAChan.

 Dr. Lisa Sanders, MD, FACP, associate professor of medicine (general medicine) and author of the popular Diagnosis column for the New York Times Magazine offers her media expertise to the PCP team as a production consultant for the podcast.

=== References ===

1. [FDA] Information about Medication-Assisted Treatment (MAT): https://www.fda.gov/drugs/information-drug-class/information-about-medication-assisted-treatment-mat
2. [SAMHSA] Become a Buprenorphine Waivered Practitioner: https://www.samhsa.gov/medication-assisted-treatment/become-buprenorphine-waivered-practitioner

=== Recommended Reading ===

1. Buresh M, Stern R, Rastegar D. Treatment of opioid use disorder in primary care. BMJ. 2021 May 19;373:n784. doi: 10.1136/bmj.n784. PMID: 34011512.
2. Alexander GC, Stoller KB, Haffajee RL, Saloner B. An Epidemic in the Midst of a Pandemic: Opioid Use Disorder and COVID-19. Ann Intern Med. 2020 Jul 7;173(1):57-58. doi: 10.7326/M20-1141. Epub 2020 Apr 2. PMID: 32240283; PMCID: PMC7138407.
3. Hoffman KA, Ponce Terashima J, McCarty D. Opioid use disorder and treatment: challenges and opportunities. BMC Health Serv Res. 2019 Nov 25;19(1):884. doi: 10.1186/s12913-019-4751-4. PMID: 31767011; PMCID: PMC6876068.

=== About Us ===

The Primary Care Pearls (PCP) Podcast is created in collaboration with faculty, residents, and students from the Department of Internal Medicine at the Yale School of Medicine. The project aims to create accessible and informative podcasts for furthering the medical education of residents and clinicians in early stages of their careers that include contributions from patients themselves, who have the autonomy to share their own experiences of how their primary care physician directly impacted the quality of their care.

Hosts: Nate Wood, Maisie Orsillo, Addy Feibel
Logo and name: Eva Zimmerman
Theme music and Editing: Josh Onyango
Producers: Helen Cai, Addy Feibel
Other background music: OfShane, Lesfm, ComaStudio, penguinmusic, Ammil, Lauren Duski, and Slynk

Instagram: @pcpearls
Twitter: @PCarePearls
Listen on most podcast platforms: linktr.ee/pcpearls

=== About Us ===
The Primary Care Pearls (PCP) Podcast is created in collaboration with faculty, residents, and students from the Department of Internal Medicine at the Yale School of Medicine. The project aims to create accessible and informative podcasts for furthering the medical education of residents and clinicians in early stages of their careers. Building on the work of other medical education podcasts, Primary Care Pearls includes contributions from patients themselves, who have the autonomy to share their own experiences of how their primary care physician directly impacted the quality of their care.

Hosts: Nate Wood, Maisie Orsillo
Logo and name: Eva Zimmerman
Theme music and Editing: Josh Onyango
Producers: Helen Cai
Other background music: penguinmusic

Instagram: @pcpearls
Twitter: @PCarePearls
Listen on most podcast platforms: linktr.ee/pcpearls

1. Remember to use the 3 C’s: control, craving, and consequences when meeting a patient with potential OUD for the first time. Use the DSM-V criteria to quantify the severity
2. Stay away from language such as opioid abuse and instead use patient-centered language such as opioid use disorder or substance use disorder. Instead of clean urine, say negative urine drug screen. 
3. A history and physical are key parts of the evaluation for a patient with OUD, looking for signs of recent use, complications of use (such as infections) or signs of withdrawal. 
4. It is essential to the safety and well-being of our patients that we promptly treat the symptoms of opioid withdrawal, as this can lead to using a batch of opioids that could cause overdose.

=== Our Expert(s) ===

Dr. Carolyn Chan is an academic hospitalist at Yale New-Haven Hospital with interests in medical humanities, quality improvement, and addiction medicine. You can reach her on twitter @CarolynAChan.

 Dr. Lisa Sanders, MD, FACP, associate professor of medicine (general medicine) and author of the popular Diagnosis column for the New York Times Magazine offers her media expertise to the PCP team as a production consultant for the podcast.  


=== References ===

1. CDC Drug Overdose Prevention: https://www.cdc.gov/drugoverdose/prevention/index.html
2. CDC Newsroom report on Overdose Deaths Accelerating During COVID-19: https://www.cdc.gov/media/releases/2020/p1218-overdose-deaths-covid-19.html 

=== Recommended Reading ===

1. Buresh M, Stern R, Rastegar D. Treatment of opioid use disorder in primary care. BMJ. 2021 May 19;373:n784. doi: 10.1136/bmj.n784. PMID: 34011512.
2. Alexander GC, Stoller KB, Haffajee RL, Saloner B. An Epidemic in the Midst of a Pandemic: Opioid Use Disorder and COVID-19. Ann Intern Med. 2020 Jul 7;173(1):57-58. doi: 10.7326/M20-1141. Epub 2020 Apr 2. PMID: 32240283; PMCID: PMC7138407.
3. Hoffman KA, Ponce Terashima J, McCarty D. Opioid use disorder and treatment: challenges and opportunities. BMC Health Serv Res. 2019 Nov 25;19(1):884. doi: 10.1186/s12913-019-4751-4. PMID: 31767011; PMCID: PMC6876068.

=== About Us ===
The Primary Care Pearls (PCP) Podcast is created in collaboration with faculty, residents, and students from the Department of Internal Medicine at the Yale School of Medicine. The project aims to create accessible and informative podcasts on various primary care topics, allowing patients the autonomy to share their stories with our audience and for young clinicians to learn from their experiences.

Hosts: Nate Wood, Maisie Orsillo, and Addy Feibel
Logo and name: Eva Zimmerman
Theme music and Editing: Josh Onyango
Producers: Helen Cai and Addy Feibel
Other Background music: TrackTribe, Jesse Gallagher, Madirfan, The Tides, Corbyn Kites, and pATCHES

Instagram: @pcpearls
Twitter: @PCarePearls
Listen on most podcast platforms: linktr.ee/pcpearls

=== Social Media ===
Instagram: @pcpearls
Twitter: @PCarePearls
Listen on most podcast platforms

=== About Us ===
The Primary Care Pearls (PCP) Podcast is created in collaboration with faculty, residents, and students from the Department of Internal Medicine at the Yale School of Medicine. The project aims to create accessible and informative podcasts for furthering the medical education of residents and clinicians in early stages of their careers. Building on the work of other medical education podcasts, Primary Care Pearls includes contributions from patients themselves, who have the autonomy to share their own experiences of how their primary care physician directly impacted the quality of their care.