The Clinical Problem Solvers

FEBRUARY 8, 2023

Identify realistic solutions to drug policy reform that promote health equity among marginalized communities living in the United States. Screening for substance use and offering connections to treatment and community-based services are important strategies that clinicians can implement in their own practice today.

Community 52

Community Patient-Centered Mental Health Board-Certified 52

GeriPal

NOVEMBER 2, 2023

First, we’ve invited Jerry Gurwitz to talk about his recently published article in JAMA titled The Paradoxical Decline of Geriatric Medicine as a Profession (while it’s not the most upbeat title for the future of geriatrics, Jerry sees it as a call to action). I was going to start off by asking Jerry about why he wrote the JAMA article.

Board-Certified 91

Board-Certified IT Community Medical Student 91

GeriPal

JANUARY 30, 2025

In one corner, weighing in at decades of experience, well known for heavy hits of bedside assessments, strong patient-family relationships, and a knockout punch of interdisciplinary collaboration, we have in-person palliative care consults. So delivering those month visits in clinic, often in tandem with their other oncology appointments.

Telehealth 105

Telehealth Patient-Centered IT Patients 105

GeriPal

JANUARY 25, 2024

The article we discuss today, also published in JAMA , addresses these two gaps. Panelists David Bekelman, Lyndsay DeGroot, and Diah Martina have no relationships to disclose. In their communities? They’re mostly living at home and living their lives in the community.” With their regular providers?

Patient-Centered 122

Patient-Centered IT Illness Patients 122

GeriPal

SEPTEMBER 7, 2023

Based on this surge in evidence, the American Society of Clinical Oncologists recently updated their guidelines for care of older adults to state that all older adults receiving systemic therapy (including chemo, immuno, targeted, hormonal therapy) should receive geriatric assessment guided care. Mazie, welcome to GeriPal. William: Sure.

Patient-Centered 129

Patient-Centered IT Patients Clinic 129

GeriPal

FEBRUARY 8, 2024

** Claim your CME credit for EP297 “The Nature of Suffering” [link] Note : If you have not already registered for the annual CME subscription ( cost is $100 for a year’s worth of CME podcasts ), you can register here [link] For more info on the CME credit, go to [link] Disclosures: Moderators Drs Widera and Smith have no relationships to disclose.

IT 137

IT Families Family Physicals 137

GeriPal

MAY 8, 2025

We’ll discuss three recent clinical trials involving patients with serious illness, joined by our guests James Downar , Ali John Zarrabi , and Margaret Ross. Alex 00:33 Our next guest is Margaret Ross, who’s a clinical psychologist and researcher at St. And when that article went to print, it just went ballistic.

Illness 107

Illness IT Patient-Centered Patients 107

GeriPal

MAY 22, 2025

And I was looking for articles, and I wasn’t seeing as many as I expected. Jenny 04:45 Like, the last article was, like, 10 years ago. Eric 11:13 And, Tyler, that’s why I loved your article at J Gym on bringing music and benefits to patients at the bedside. Relationships are usually more complicated.

IT 97

IT Patient-Centered Patients Board-Certified 97

GeriPal

APRIL 13, 2023

Summary Transcript Summary Social connections impact our health in profound ways, whether it is the support we receive from family and friends in navigating serious illness, the joy from shared social activities, or connecting with our community. But then recognizing that our relationships impact our health even outside the context of stress.

IT 99

IT Community Patient-Centered Medical 99

GeriPal

FEBRUARY 27, 2025

Substance use disorder is one of those complex issues in which clinical practice is changing rapidly. Sach Kale set up an outpatient clinic focused on substance use disorder for patients with cancer. Do you need to be an addiction medicine trained physician to start such a clinic (no: Sach is not). What do they do?

Patients 73

Patients Clinic Patient-Centered Illness 73

GeriPal

JANUARY 16, 2025

I, for example, had one patient, I remember during my fellowship, I was in geriatrics clinic and had a very well read patient who came in and was reading a New York Times article, I think in the well section at one point. So those types of relationships, clergy, non family members, we talk about, I think cohabitating unmarried couples.

Patient-Centered 109

Patient-Centered IT Patients Healthcare 109

GeriPal

JULY 28, 2022

And I just want to highlight, Jennifer has a great JPSM article that just came out. Would you also just mind mentioning kind of the JPSM article too? What drove you to write that article on this important trip to Seattle? And my article is about when I was a mid to junior faculty member trying to build this career.

Illness 110

Illness Hospital Patient-Centered Patients 110

GeriPal

APRIL 10, 2025

Why this study was a success due to the sheer size (nearly 100,000 patients in about 30 EDs) of the study, and the fact that, as far as the investigators know, all study sites continue to employ the clinical decision support tool. And then we had clinical decision support. What is a clinical decision support? Long overdue.

Patient-Centered 77

Patient-Centered IT Hospital Patients 77

GeriPal

FEBRUARY 29, 2024

Widera and Smith have no relationships to disclose. Guest hosts Lynn Flint and Anne Kelly have no relationships to disclose. The ones who are publishing interesting articles are easy as we knew MAID is always going to be a controversial topic. So, I’m super proud of being able to reach out to people in rural communities.

IT 126

IT Patient-Centered Illness Education 126

GeriPal

FEBRUARY 23, 2023

Today we talk with Anne Rohlfing, Lynn Flint, and Anne Kelly, authors of a JGIM article on the reasons we shouldn’t stop at “no.” Rather, most of us live and make decisions in relationship to one another. But once we realize that almost everybody makes decisions in the context of relationships. This is a clinical intervention.

Families 98

Families Family Patient-Centered IT 98

GeriPal

OCTOBER 27, 2022

As Alex Lee says on our podcast today, all prognostic models will be wrong (in some circumstances and for some patients); our job is to make prognostic models that are clinically useful. As Sei Lee notes, the argument for developing prognostic models has won the day, and we increasingly use prognostic scores in clinical decision making.

IT 95

IT Clinic Screening Patients 95

GeriPal

JANUARY 26, 2023

Our guests Tim Farrell, Ramona Rhodes, and Nancy Lunderbjerg wrote an article in JAGS on this issue, and Sharon Brangman wrote a separate JAGS article on the need to achieve diversity in study populations. The article was titled, “ Change is coming ” – which also gives you a hint as to today’s song request. Eric: Yes.

IT 92

IT Patient-Centered Healthcare Patients 92

GeriPal

FEBRUARY 13, 2025

We covered some of our questions on the podcast, others you can ponder on your own or in your journal clubs, including: Maries tele/video palliative care intervention was tailored/refined with the help of a community advisory board. Three different articles. Eric 04:27 Yeah, I gotta ask about the community advisor. Have to see.

Consulting 63

Consulting Community Patient-Centered Families 63

GeriPal

DECEMBER 15, 2022

In an article in the NEJM (a published article this time, wonder of wonders!) Tell me how your illness has impacted your relationships with others, your healthcare team, your family, friends, your beliefs, your values, your preferences. Working with our clinical decision support team and thinking about where that could be.

IT 105

IT Patient-Centered Healthcare Illness 105

GeriPal

DECEMBER 8, 2022

Tell me how your illness has impacted your relationships with others, your healthcare team, your family, friends, your beliefs, your values, your preferences. So we have community volunteers who often they have a background in writing or background in healthcare, certainly an interest in interviewing and an interest in writing.

Patient-Centered 115

Patient-Centered Illness Healthcare IT 115

GeriPal

MARCH 7, 2024

Check out the Pub Crawl GeriPal post for more info, and follow #HPMParty on Twitter to keep us as we crawl! ** In the last several years, I’ve seen more and more articles about end-of-life doulas ( like this NY Times article from 2021 ). That was really the theme song of how the community came together. How do you see the light?

Provider 117

Provider Illness IT Healthcare 117

GeriPal

DECEMBER 5, 2024

It’s that mixture of intimacy and vulnerability, of shared clinical experiences, that fosters a sense of belonging. – @AlexSmithMD Here’s a link to an article about the Palliative Story Exchange. ** This podcast is not CME eligible. I think it started off from a need, a hunger in the community. Eric 04:44 Yeah.

IT 107

IT Community Patients Families 107

GeriPal

DECEMBER 14, 2023

Similarly Jessica Zitter, an intensivist and palliative care doctor analogized the inevitable clinical momentum toward highly aggressive intensive care in US hospitals as a conveyor belt. Liz: Well, some aspects of this paper around clinical momentum and things around defaults and that sort of thing. Liz: I do, indeed. Proud Mary.

Hospital 125

Hospital IT Patient-Centered Patients 125

GeriPal

APRIL 6, 2023

We are also joined by LaVera Crawly, a physician turned chaplain, now VP of Spiritual Care at Common Spirit Health (and author of another of my favorite and most cited papers on palliative care in the African American Community ). ” And you start entering into a conversation about support or relationships and things of that nature.

IT 99

IT Patient-Centered Families Family 99

GeriPal

APRIL 28, 2022

What are your thoughts about using humor to convey ideas, thoughts, clinical work? Because just like in the bedside space, if you are using humor in a way that builds bonds and relationships with the patient can be really beautiful, and normalizing. The best ideas for research come from my clinical experience. Nathan: Yeah.

IT 145

IT Hospital Patients Illness 145

GeriPal

FEBRUARY 20, 2025

We also explored several questions with them, including how to define trauma, its prevalence in older adults, the impact of past traumatic experiences, the potential triggers of trauma screening, and the application of trauma-informed principles in clinical practice. Ashwin 18:08 These are things that we often see from a clinical standpoint.

IT 67

IT Patient-Centered Individual Screening 67

GeriPal

MAY 4, 2023

We talk about why it’s so hard with Abby Rosenberg (chief of PC at DFCI and Boston Childrens), Nick Purol (clinical social worker at DFCI and Boston Childrens), Daniel Eison (pediatric PC doc and co-host of PediPal). But when I have, I find that they’re often some of the hardest patients to care for. Welcome to the GeriPal podcast, Abby.

IT 83

IT Families Family Illness 83

GeriPal

JUNE 5, 2025

We also take a dive into these 2 articles that Connie first authored: Palliative care in nursing homes: A qualitative study on referral criteria and implications for research and practice. And, you know, some, some relationship with hospice, some might not do many referrals at all to hospice. Almost all of them have hospice contracts.

Nurse Practitioner 78

Nurse Practitioner Referral Consulting Board-Certified 78

GeriPal

MARCH 30, 2023

Then I got online as a patient advocate and started connecting with the brain tumor community on social media and Facebook and Twitter, and actually started working in the healthcare space, in palliative care advocacy, for a palliative care advocacy organization in California, which is where I’m based, about eight years ago.

IT 96

IT Patient-Centered Patients Healthcare 96

GeriPal

JANUARY 11, 2024

Panelists Bill Gardner, Sonu Gaind, Leonie Herx have stated they have no relationships to disclose. Alex: We’re delighted to welcome Leonie Herx, who’s a palliative care physician and clinical professor at the University of Calgary. And he writes about his experience living with cancer at billgardner.substack.com.

Illness 144

Illness IT Medical Provider 144

Family Medicine Initiative

APRIL 10, 2024

This graph illustrates that the benefit of long-term GP-patient relationships is even dose-dependent (longer GP-patient-relationship = lower risk of dying prematurely): Why do long-term GP-patient relationships improve health and reduce costs? Over time, communication improves. If so, please share this article!

Family Physician 130

Family Physician Families Family GP 130

GeriPal

SEPTEMBER 19, 2024

So you, Jennifer, probably have, like, the most cited, probably should be the most cited randomized controlled trial of palliative care and lung cancer patients that everybody, every palliative care article I’ve seen, whether or not it works, always includes, it was outpatient palliative care in lung cancer patients. All of this is.

Patient-Centered 119

Patient-Centered IT Patients Hospital 119

GeriPal

JUNE 26, 2025

But from our clinical work, many of us are familiar with people with dementia who experience sudden shocks to their health, think hip fracture, think hospitalization for pneumonia. Sometimes people call them health shocks, but we kind of all, like, clinically, intuitively know what these things are. Has really changed.

Illness 73

Illness Hospital IT Patient-Centered 73

GeriPal

JULY 6, 2023

Alex: We’ve got a lot to talk about…what states are doing and cities are doing to support older adults in the community. But, what you need is a community-based game there. The long-term care is being actually provided in the community at a much higher rate than what the formal system provides. You go back home.

Community 89

Community Nurse Practitioner Provider IT 89

GeriPal

DECEMBER 7, 2023

Leslie Wharton is a leader in the 26,000 member grassroots organization Elders Climate Action , which organizes older adults to create communities engaged in making a difference at local, state, and national levels.

Healthcare 129

Healthcare IT Education Community 129

GeriPal

APRIL 21, 2022

Look also for a forthcoming article by Mike and Redwing in Journal of Pain and Symptom Management on poetry as a healing modality, to be published mid May (will add link when out). This is a poem that gets into this issue of, what is the clinician relationship to all that stuff that’s going on around us? Mike: Yeah. Thank you.

Patient-Centered 93

Patient-Centered IT Community Illness 93

GeriPal

JULY 25, 2024

Summary Transcript Summary We are dusting off our crystal balls today with three amazing guests who have all recently published an article on prognosis over the last couple months: Kara Bischoff, James Deardorff, and Elizabeth Lilley. Widera and Smith have no relationships to disclose. Eric 00:09 Welcome to the GeriPal podcast.

Families 106

Families Family Patient-Centered Patients 106