Within Normal Limits: Navigating Medical Risks

Dr. Susan Sgambati, a colorectal surgeon and medical director with COPIC, is our guest on this episode that looks at the increased use of semaglutide medications driven by the popularity of Ozempic being used for weight loss. The discussion focuses on liability and risk issues, including recently issued FDA warning letters surrounding the use of compounded forms of the medication. Dr. Sgambati talks about how the medication works, side effects, how to assess patients who are interested in these medications, and other considerations as part of your evaluation.     

Feedback or episode ideas email the show at wnlpodcast@copic.com

Disclaimer: Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition.

Pamela Johnson—a nurse and Senior Manager of Practice Quality and Facilities Risk Management at COPIC—joins us for a discussion about data around patient falls in health care facilities. Pamela highlights the top three areas where falls occur in these settings and talks about top risk factors that contribute to these incidents. She also points to adjustments that can make an immediate preventative impact, such as proper lighting and pathways, the importance of environmental rounds, and dispels major myths about falls and healthcare.

CDC STEADI- Older Adult Fall Prevention https://www.cdc.gov/steadi/index.html

John Hopkins- Fall Prevention- https://www.hopkinsmedicine.org/health/wellness-and-prevention/preventing-falls

John Hopkins- Fall Risk Assessment- https://www.hopkinsmedicine.org/institute_nursing/_docs/JHFRAT/JHFRAT%20Tools/JHFRAT_acute%20care%20original_6_22_17.pdf

Feedback or episode ideas email the show at wnlpodcast@copic.com

Disclaimer: Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition.

Anna Barr, a nurse risk manager with COPIC, joins us for this episode to talk about the benefits of using informed consent in your medical practice. Anna highlights how informed consent is a process (not just a form), the goals of shared decision making that guide this, and how it can be a tool to foster trust and understanding with patients. In addition, we look at what situations require informed consent and key considerations in how you approach the process. Anna also explains what informed refusal is, how this differs from “against medical advice,” and provides examples of when you may want to utilize it.

Feedback or episode ideas email the show at wnlpodcast@copic.com

Disclaimer: Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition.

This episode is part of a special series that focuses on organizations that received grant funding from the COPIC Medical Foundation for initiatives that address the issue of reducing fragmentation across care settings. Dr. Zacharias welcomes back Jennifer Disabato, DNP, and William Anderson, MD, who are co-directors for the ImPACT Program and Navigation Hub, which focuses on care coordination for complex pediatric patients as they transition to adult care. Jennifer and Dr. Anderson talk about the progress made in building skilled teams to support patients going through these transitions. In addition, they discuss the other key focus of the program—coaching medical clinics on these transitions through trainings, evidenced-based templates, and resources to address EHR communication challenges and other related issues.  

Feedback or episode ideas email the show at wnlpodcast@copic.com

Disclaimer: Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition.

This episode is part of a special series that focuses on organizations that received grant funding from the COPIC Medical Foundation for initiatives that address the issue of reducing fragmentation across care settings. Dr. Zacharias welcomes two staff members from West Mountain Regional Health Alliance—Christina Gair, Executive Director, and Namrata Shrestha, Assistant Director. Grant funding went toward a care coordination effort to support individuals experiencing homelessness with coordination by hospitals, health and behavioral health providers, community organizations and government agencies. The discussion looks at the challenges of coordination across multiple organizations and different workflows, consideration of factors such as social needs (e.g., food, housing, transportation) and behavioral health, and the importance of creating a useful tool that helps “connect the dots” for care teams.   

Guest Website: https://westmountainhealthalliance.org/

Feedback or episode ideas email the show at wnlpodcast@copic.com

Disclaimer: Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition.

This episode is part of a special series that focuses on organizations that received grant funding from the COPIC Medical Foundation for initiatives that address the issue of reducing fragmentation across care settings. Dr. Zacharias welcomes Dr. Matthew Gonzales and Dr. Deborah Unger who are affiliated with a grant provided to the Providence Portland Medical Foundation. Grant funding supported Providence and the Oregon Physician Orders for Life Sustaining Treatment (POLST) Registry for a partnership to build a bi-directional interface which integrates Providence's Epic electronic health record with the Registry. Dr. Gonzales and Dr. Unger discuss about how POLST is designed to respect people’s wishes around care/treatment inside and outside of health care settings. They also talk about how POLST is utilizing digital technology to inform others across different systems, the challenge of state-by-state legislation, and the insight gained through the project so far.

Feedback or episode ideas email the show at wnlpodcast@copic.com

Disclaimer: Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition.

This episode is part of a special series that focuses on organizations that received grant funding from the COPIC Medical Foundation for initiatives that address the issue of reducing fragmentation across care settings. Dr. Zacharias welcomes Tori Bahr, MD and Katie Stangl who are affiliated with a grant provided to the Minnesota Medical Association Foundation. Grant funding supported Project ECHO, which focuses on the challenge of transitioning youth with medical complexity to adult care in Minnesota. The discussion explains the different conditions that fall under “childhood onset medical complexity” and how the ECHO hub-and-spoke model leverages virtual collaboration to expand expertise and knowledge, and connects providers across different settings to address patient care issues.

Show Email- WNLpodcast@COPIC.com

Gillette Children's Hospital Transitions - https://www.gillettechildrens.org/get-involved/attend-an-event#medical-professionals

Legal Disclaimer: Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition. 

Feedback or episode ideas email the show at wnlpodcast@copic.com

Disclaimer: Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition.

Documentation in medicine is no one’s favorite topic. In this episode, host Dr. Eric Zacharias aims to simplify guidance surrounding “what” and “how much” is needed for patient safety and risk management purposes. What follows is not “hard” science, but rather a discussion of basic criteria—and what's realistic and reasonable outside of policy rules and guidelines.

Feedback or episode ideas email the show at wnlpodcast@copic.com

Disclaimer: Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition.

In this episode, we are joined by David Weill, MD, a transplant doctor and author of Exhale: Hope, Healing, and a Life in Transplant. Dr. Weill shares openly about losing and saving patients, dysfunctional teams and systems, and burnout in transplant medicine. Through the lens of his own emotional and physical exhaustion, he explores the underbelly of hospital systems and the clinical, administrative, and financial issues plaguing the specialty. He is an advocate of shifting the blame of burnout away from the individual and placing it on the macro problems that contribute to physician dissatisfaction. 

Feedback or episode ideas email the show at wnlpodcast@copic.com

Disclaimer: Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition.

We continue the conversation about artificial intelligence (AI) in this second episode of a two-part series. Our guest is Dr. Michael Victoroff, a family medicine physician, patient safety and risk management specialist, and clinical informatics expert. Dr. Victoroff uses image interpretation in radiology as an example of AI because it sees things humans miss and humans see things AI misses. We look at other AI applications—support for diagnosing and creating a treatment plan, concerns with visit notes (e.g., inaccuracies, information designed for billing purposes versus information for patient care, bias that can emerge, etc.), and the knowledge medical providers will need to acquire about AI’s role in medicine. In addition, Dr. Victoroff highlights key risk considerations such as cyber risks, AI impersonation of other medical professionals and facilities, and how this technology may extend into our personal lives.

Feedback or episode ideas email the show at wnlpodcast@copic.com

Disclaimer: Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition.  

Feedback or episode ideas email the show at wnlpodcast@copic.com

Disclaimer: Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition.

In this two-part series, we look at the rise of artificial intelligence (AI) and examine the potential ways it may impact medicine. Our guest is Dr. Michael Victoroff, a family medicine physician, patient safety and risk management specialist, and clinical informatics expert who has gone down the rabbit hole of trying to understand the good, the bad, and the ugly of AI. Dr. Victoroff explains the fundamental technology behind AI applications, such as ChatGPT, and its interactive structure designed to generate human-like language and conversation. He talks about the concept of machine learning, how the “garbage in, garbage out” theory applies, and the “black box” dilemma of not knowing exactly how this technology got to its answers and what sources or information were used. We then look at the potential roles of AI in health care related to replacing scribes and documentation, voice recognition and language translation capabilities, and the ever-present concerns over accuracy and inadvertent errors that may arise.  

Feedback or episode ideas email the show at wnlpodcast@copic.com

Disclaimer: Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition.  

Feedback or episode ideas email the show at wnlpodcast@copic.com

Disclaimer: Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition.

In this episode, we look at a major challenge in obstetrics (OB) care with our guest, Lori Adams, who is a nurse, COPIC risk manager, and OB expert. Lori talks about her experience in a rural hospital and educating providers. The discussion focuses on “maternity care deserts” where access to OB services is limited or not available. Lori highlights how these deserts contribute to maternal death rates, the disparities we are seeing in certain geographic and demographic areas, and how emergency care units are dealing with OB situations. She also points to the training and education that is being implemented to address this issue and how state-level perinatal collaboratives are working to improve maternal health.

Resources mentioned: https://www.marchofdimes.org/maternity-care-deserts-report

Email the show: wnlpodcast@copic.com

Legal Disclaimer: Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition.  

Feedback or episode ideas email the show at wnlpodcast@copic.com

Disclaimer: Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition.

In this episode, we are joined by Dr. Shanta Zimmer, associate dean for diversity and inclusion at the University of Colorado School of Medicine. Dr. Zimmer talks about how the COVID-19 pandemic highlighted racial disparities and health care inequities in severity of illness and the role the health care system ultimately plays in systemically-addressing social determinants of health. She also speaks on how the university is working toward inclusive excellence and removing barriers that prevent the best and brightest from entering medical education. COPIC has supported diversity, equity and inclusion (DEI) scholarships for medical students and purchased simulation equipment for medical education, including a set of diverse mannequins to better represent patients and students.

Show email: wmlpodcast@copic.com

greenhousescholars.org

https://www.cuanschutz.edu/offices/advancement/home

Disclaimer: 

Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition.  

Feedback or episode ideas email the show at wnlpodcast@copic.com

Disclaimer: Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition.

In this episode, we’re joined by surgeon and COPIC risk manager, Dr. Jeff Varnell. Starting with the premise that, like driving, the practice of medicine is governed by systemic rules and dependent on individual responsibility, Dr. Varnell uses metaphors and general understandings we hold about driving to illustrate how adverse events in medicine are often avoidable and preventable, like many of our road-based accidents. He invites listeners to examine through a lens of personal accountability the human factors that lead to errors in communication and cognitive bias, including "reckless" versus "risky" behavior.  a

Email: wnlpodcast@copic.com

Disclaimer: Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition.  

Feedback or episode ideas email the show at wnlpodcast@copic.com

Disclaimer: Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition.

With 28 million Americans at risk for limb loss due to trauma, tumors, or infections, the nonprofit Limb Preservation Foundation is enhancing the quality of life of people in the Rocky Mountain region. Executive Director Marcy Rubik joins us to talk about how health care professionals from all backgrounds have joined this effort to offset financial stressors, provide education, and advance research.

***Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition.  

Website: https://limbpreservation.org/

Show email : Wnlpodcast@COPIC.com

Feedback or episode ideas email the show at wnlpodcast@copic.com

Disclaimer: Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition.

Understanding the regulatory environment is key to managing risks associated with working with advanced practice providers (APPs), Dr. Alan Lembitz, COPIC's Chief Medical Officer says. But he cautions providers to understand this isn’t always simple. He reminds providers that it’s on them to ensure they are following the regulatory rules, which vary based on state and provider type. COPIC has seen cases of plaintiff attorneys alleging APPs practicing outside of the scope of licensure and inadequate supervision. In this episode, Dr. Lembitz breaks down high-risk areas, as well as what physicians and APPs need to know about managing risks in all practice settings.

***Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition.  

On Demand Courses mentioned are restricted to COPIC Insured Providers and not open to the public. 

Feedback or episode ideas email the show at wnlpodcast@copic.com

Disclaimer: Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition.

The guest for this episode is Stephen Siegel, MD, a urologist in a multi-specialty group and a medical school classmate of our host. The former classmates discuss the impact of COVID-19 on surgical intervention, delay of diagnosis, and routine screening. They also discuss general risk areas in urology, including transitions of care, telehealth, and risks associated with PSA-level management across a patient’s lifetime.

Legal Disclaimer: 

Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition.  

Feedback or episode ideas email the show at wnlpodcast@copic.com

Disclaimer: Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition.

This episode features Dr. Alan Lembitz, Chief Medical Officer for COPIC, and focuses on uncertainty around federal and state opioid education requirements for medical providers. The conversation examines common questions from “what do I need to do to fulfill my licensure requirements?” to “how do I prove that I am in compliance with these requirements?” Dr. Lembitz also looks at details with the new DEA requirement of eight hours of training around substance use disorders, concerns if providers don’t fulfill these requirements, and highlights of COPIC resources that are available to help meet these requirements.

Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition.  

Feedback or episode ideas email the show at wnlpodcast@copic.com

Disclaimer: Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition.

This episode’s guest is Scott Humphreys, MD, forensic psychologist and medical director of the Colorado Physician Health Program (CPHP). This nonprofit independent peer assistance program provides licensed professionals with confidential, individualized evaluation and treatment referrals for health problems such as psychiatric illness and substance abuse. Dr. Humphreys discusses the stigma associated with physicians transitioning into the role of patient and the approach CPHP takes to ensure they can ultimately have a healthy practice and healthy life. 

Disclaimer: Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition.  

Feedback or episode ideas email the show at wnlpodcast@copic.com

Disclaimer: Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition.

Dr. Michael Victoroff, a family medicine physician and COPIC consultant with expertise in clinical informatics, is our guest for this episode that focuses on situations where patients may become violent. The discussion examines emotional states in patients, such as frustration or unhappiness, that can escalate into physical conflict and why we have seen a substantial increase in these types of encounters. Dr. Victoroff talks about de-escalation and conflict management skills, our innate flight-or-fight reactions, and the importance of appropriate training for the health care setting. In addition, the conversation explores ethical and legal considerations along with the moral dilemma of protecting yourself while trying to protect others.

**Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition.  

Feedback or episode ideas email the show at wnlpodcast@copic.com

Disclaimer: Information provided in this podcast should not be relied upon for personal, medical, legal, or financial decisions and you should consult an appropriate professional for specific advice that pertains to your situation. Health care providers should exercise their professional judgment in connection with the provision of healthcare services. The information contained in this podcast is not intended to be, nor is it, a substitute for medical diagnosis, treatment, advice, or judgment relative to a patient’s specific condition.