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\nThings We Do For No Reason #TWDFNR highlights some widespread practices that are difficult to justify based on lack of proven health benefits, but significant cost (both financial and non-financial harms). Avoid these low value practices and inflated medical bills with tips from expert, Dr Lenny Feldman, MD, FACP, Associate Professor of Medicine Johns Hopkins. Topics include: renal ultrasound and urine electrolytes in acute kidney injury (AKI), folate deficiency and anemia work-up, prealbumin and malnutrition, blood transfusions, shellfish and contrast allergies, monitoring after switch from IV or oral antibiotics, and \u201cagainst medical advice\u201d discharges.
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\n\n\nDon't forget to check out Clinicwiki.org a free, online resource for teaching ambulatory medicine.
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\n\n\n\nCredits:
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• Written and produced by: Justin Berk MD, MPH, MBA
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• Editor: Matthew Watto, MD
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• Hosts: Justin Berk MD, MPH, MBA; Matthew Watto MD; Paul Williams MD, FACP
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• Guest: Lenny Feldman MD, FACP
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• 00:00 Announcements
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• 00:38 Disclaimer, intro, and guest bio
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• 03:53 Guest one liner, some recommendations, and advice
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• 08:35 Defining high value care and things we do for no reason (TWDFNR)
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• 12:40 Why do clinicians order useless testing?
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• 14:58 Urine electrolytes for acute kidney injury
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• 20:30 Renal ultrasound for acute kidney injury
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• 25:54 Stop ordering folate for anemia workup
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• 31:47 How many units should I transfuse?
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• 34:40 Prealbumin and albumin for malnourishment.
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• 43:24 Iodine, shellfish and contrast allergy
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• 50:28 Patient leaving against medical advice
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• 56:45 Switching from IV to oral antibiotics
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• 63:27 Dr Feldman\u2019s plugs
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• 65:36 Outro
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