Primary Medicine Podcast

In today’s bonus episode we talk to Michael Dutra, the CEO of Michael Dutra Real Estate Planning and Insurance, about Disability Insurance. This is perhaps the most important insurance policy for professionals during their working careers.

Dr Seth is a leader and a practitioner of generative AI in improving healthcare for both patients and healthcare practitioners. We will discuss what generative is AI, what its currently capable of, and how it can be used practically used by doctors to enhance their practice, their mental health, and their patients experience.

We are honoured to have Dr. David J. Stewart the author of “A Short Primer On Why Cancer Still Sucks”, an excellent book that tackles the big questions for patients and for doctors.

As host of beyond the MD podcast, Dr. Chada interviews experts on topics covering insurance, finance, tax management and law. During this episode, he is kind enough to share his wisdom about topics ranging from disability insurance, to incorporation, to investments.

This month, we are very excited to bring you a preview of our upcoming conference for Physician Empowerment. This year, our focus is on personal resilience and practice management. On today's episode, Kevin shares a remarkably refreshing view on wellness within our profession. To find out more, visit us at https://www.physempowerment.ca/banff.

It is estimated that about 40% of patients with type 1 or type 2 diabetes will have diabetic kidney disease. The suggested progression of this disorder is glomerular hyperfiltration due to a high-pressure state caused by elevated blood sugar, proteinuria due to glomerular damage, and chronic renal failure to renal hypoperfusion. Recent studies show that this progression is not always linear. Given the prevalence of this disease in diabetics, it is best practice to screen for diabetic kidney disease on a yearly basis with a urinary albumin to creatinine ratio and a serum creatine. Treatment is based on slowing the progression of diabetic kidney disease by controlling the blood glucose levels, targeting blood pressure below 130/80, inhibiting the RAAS, and inhibiting SGLT activity.

The C-Reactive Protein and the Erythrocyte Sedimentation Rate are both lab tests used to measure inflammation in the body. They are usually elevated during infectious, inflammatory, and malignant diseases.

As a follow up to podcast 67, Eric Harvey, a 3rd year Mcgill medical student, is joining the Primary Medicine Podcast to go over the treatment approach for male hypogonadism.

It is important to consider both benefits and risks of testosterone therapy, before initiating treatment. The clearest benefit is to men with abnormally low serum testosterone levels who present with sexual dysfunction. The clearest risks are erythrocytosis, cardiac, and prostate disease. It is important to do routine testosterone, lipids, hematocrit, and PSA levels.

There are many different forms of testosterone therapy ranging from oral to intramuscular. The choice of medication is based on patient preference, cost, and side effect profile.

We end the podcast with a brief discussion about Eric and his classmate’s experiences during the COVID shutdown. A situation without a recent historical precedent.

In podcast 67, Dr. Dimitre will cover the diagnostic approach to late-onset hypogonadism also known as andropause. Late-onset hypogonadism (LOH), causes a gradual yearly decrease in testosterone levels of 1 to 2% in men over the age of 40. While this condition is commonly known as Andropause there is no cessation of hormone production. However, just like menopause, this change in hormone levels can lead to a significant reduction in the quality of life of patients.

After a short hiatus, Dr. Dimitre is back to talk about subclinical hypothyroidism. Sometimes referred to as mild thyroid failure, it is diagnosed when peripheral thyroid hormone (T3 and T4) levels are within the normal range, but thyroid stimulating hormone (TSH) is mildly elevated.
It is common, occurring in 10% of the population, and carries a risk of progression to overt hypothyroidism of around 5% per year. There is no consensus on which patients should be treated, although there are some recommendations.
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Posted on 17/06/2018 by Dr. Dimitre