62. Primum Non Nocere (First, Do No Harm)
Stimulus | Helping Doctors overcome burnout, excel in leadership, and unlock their most fulfilling careers
English - October 18, 2021 08:30 - 20 minutes - 28.7 MBMedicine Health & Fitness Education Self-Improvement career leadership burnout doctor physician Homepage Download Google Podcasts Overcast Castro Pocket Casts RSS feed
In this episode we hear from eight leading physician educators about a core principle of patient care: primum non nocere. We learn that limiting harm can translate into doing what’s medically right, putting the patient’s welfare first, judicious use of IV fluids, reducing opioid prescribing, making a habit of pausing when depleted, acknowledging the end of life, and allowing a natural death.
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Guests: Cam Berg MD, Neda Frayha MD, Scott Weingart MD, Josh Russell MD, Haney Mallemat MD, Alan Sielaff MD, Vicky Vella MD, and Mike Weinstock MD
We Discuss:
The importance of figuring out the core principles that drive your medical decision-making [1:30]; Primum non nocere, and how it is good for patients and good for us [02:40]; Cameron Berg is concerned about the harm caused by excessive prescription of opiates in the ED [05:10]; Neda Frayha learned that ordering more tests on patients can cause more harm than good [07:25];. Scott Weingart applies the “do no harm” principle to the use of IV fluids when resuscitating patients in septic shock [09:20]; Josh Russell tries to limit harm by thinking about what he’d want to have done, if he were in his patient’s shoes [11:00]; Haney Mallemat has come to learn that many patients are predestined for bad outcomes, and the provision of maximal therapy is actually harmful [13:40]; Alan Sielaff uses shared decision-making to help guide him in doing no harm [15:50]; Vicky Vella believes that “do no harm” is recognizing when a patient is near the end of their life and, as a physician, trying to act in a way that reflects that [16:20]; Mike Weinstock makes an effort to treat all patients as he would treat them if they were his own family member [17:15];And more.
Shownotes by Melissa Orman, MD
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