Learn the nuances of caring for and building relationships with patients experiencing homelessness from expert internal medicine and addiction physician Stefan Kertesz, return guest from Episode 74 on Opioids and Health Policy (highly recommend a re-listen, y’all!). Topics: the challenge of creating a welcoming and useful space for individuals experiencing homelessness, how to meet patients where they’re at--both physically and mentally--the challenge of managing diuretics for those without stable access to a bathroom (avoid, if possible), and how absolutely essential the foot exam is.

Credits

Written and Produced by Nora Taranto MD
Infographics by Nora Taranto MD
Cover Art by Kate Grant MBChB, MRCGP
Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP, Nora Taranto MD
Editor: Carolyn Chan (written materials); Clair Morgan of nodderly.com
Guest: Stefan Kertesz MD

Sponsor: VCU Health CE

Time Stamps

00:00 Intro, disclaimer, guest bio
3:17 Guest one-liner
8:55 Picks of the Week*: Dr. Kertesz’s Book Recommendation: Saul Weiner’s On Becoming A Healer; Nora’s Pick of the week: BackStory (especially their episode on dynamite!) https://www.backstoryradio.org/
10:07 Case from Kashlak
10:56 Language: How to ask where a patient lives?
13:25 Terminology: Persons Experiencing Homelessness:
14:35 The stats on prevalence of health and illness in the homeless population, and the importance of both medical and environmental factors
20:44 How to start the visit, and how to establish trust early on?
27:40 Why is the mortality rate higher?
35:15 Special conditions and Medication Considerations: Hypertension, Diuretics, Insulin and Food Insecurity, Substance Use Disorders, Feet, and Hepatitis C
54:15 COVID and homeless healthcare
57:00 Care Models
62:30 Take Home Points and Outro

#216 Homeless Healthcare with Stefan Kertesz MD

The Curbsiders Internal Medicine Podcast