Rao Doctor

APRIL 3, 2025

In my previous article I covered the types of illness and the causes. In case you have missed it, click below to read- FEVER FAQ- Part 1 Fever Diagnosis: How is your health assessed? When assessing a fever, we doctors employ a systematic approach to ensure accurate diagnosis and effective management. FEVER FAQs (contd.)

Diagnosis 130

Diagnosis Management Illness Diagnose 130

GeriPal

MAY 11, 2023

There I was, extremely overly trained with brain stuff, and I wanted to learn how to do clinical research. I just thought there was so much we could learn and offer from every sense, from the clinical point of view, from the family point of view, from prevention, from treatment, epidemiology, et cetera. This is Eric Widera.

Physicals 85

Physicals IT Hypertension Education 85

GeriPal

JUNE 8, 2023

If in your own work, your clinical work, is this something that you see people struggle with you, you see yourself struggle with? So my background clinically is working with cancer patients and families and those who underwent bone marrow transplant, and a lot of times for their treatment regimen, it includes steroids. This is great.

Diabetes 73

Diabetes Management Patient-Centered Family 73

GeriPal

FEBRUARY 6, 2025

Eric 00:27 So we’re going to be talking about making the diagnosis of Alzheimer’s disease in a primary care setting, not specialty care, but maybe we could talk a little bit about that. How much should it change how we think about making a diagnosis of Alzheimer’s disease in primary care? Great to be back. Absolutely.

Primary Care 95

Primary Care Diagnosis Screening IT 95

GeriPal

JANUARY 30, 2025

Find out on this weeks podcast where we invite Joseph Greer, Simone Rinaldi, and Vicki Jackson to talk about their recent JAMA article on Telehealth vs In-Person Early Palliative Care for Patients With Advanced Lung Cancer – A Multisite Randomized Clinical Trial. So no differences between the modalities.

Telehealth 105

Telehealth Patient-Centered IT Patients 105

GeriPal

OCTOBER 24, 2024

And then I met a patient in clinic once who asked me a lot of really intelligent questions about medical cannabis, what it does. I’d been a nurse at the time, and I went back to do my clinicals in an oncology clinic locally. And I decided at that point to hang a shingle and start a clinic with a physician.

Medical 98

Medical IT Patient-Centered Healthcare 98

GeriPal

OCTOBER 20, 2022

This all came out from JAGS just published their first Clin-STAR corner, which is, and we’ll talk about what that is, but it’s a series of articles bringing in specialists to talk about updates in the last couple years within their field. Mody for the mentorship and for the opportunity to bring together these articles.

Complication 52

Complication Patient-Centered IT Patients 52

GeriPal

JANUARY 18, 2024

In particular, we talk about Katie’s and Jesica’s paper in NEJM titled “ Juggling Two Full-Time Jobs — Methadone Clinic Engagement and Cancer Care ,” which described the difficulty in managing cancer pain and methadone for opioid use disorder. We got a couple of articles to discuss and a lot of different components of this.

Illness 136

Illness Patient-Centered Screening Clinic 136

GeriPal

SEPTEMBER 28, 2023

Eric: Well, this is the part that I love about your article, too, is that it’s not just these big, big family meetings where miscommunication happens. Yeah, I think we took a pretty broad definition in the article, but really it’s any failure to communicate clearly and adequately. Eric: Yeah.

Family 144

Family Families Patient-Centered IT 144

GeriPal

APRIL 14, 2022

And if you want to learn more about buprenorphine from these amazing palliative care clinicians and others, check out of some of these articles: Learn more about caring for those with substance use disorder: . Article on buprenorphine in the elderly. This is both a research and a clinical interest of yours. Transcript.

Illness 102

Illness Patient-Centered IT Nurse Practitioner 102

GeriPal

MAY 22, 2025

The ability to appreciate, recognize, and engage with music is preserved even until late stages of dementia, and Theresa is examining how music can be useful from the time of diagnosis, not only for the person with dementia, but their caregivers. And I was looking for articles, and I wasn’t seeing as many as I expected.

IT 96

IT Patient-Centered Patients Board-Certified 96

GeriPal

SEPTEMBER 1, 2022

So in preparation for this, I read a couple articles about social work leadership in palliative care. And the title of his article is, does culture of modern day palliative care social work leave room for leadership, where he interviewed six leaders in palliative care, five or six for social workers. Eric: All right, Barbara.

IT 102

IT Family Families Clinic 102

GeriPal

JUNE 16, 2022

First, we talk with Christine, a researcher and geriatrician from the University of North Carolina, who recently published a JAGS article titled Overdiagnosis of urinary tract infections by nursing home clinicians versus a clinical guideline. But really those urinary tract signs and symptoms should be driving your diagnosis.

Management 122

Management IT Medical Patient-Centered 122

GeriPal

OCTOBER 12, 2023

Instead, what if your surgeon told you that the operation she was discussing could help with only 4 things: live longer, feel better, prevent disability, or obtain a diagnosis? And, what if your surgeon openly discussed the expected ‘bad stuff’ of post-operative recovery, instead of rotely reciting a list of possible complications?

IT 128

IT Family Families Patient-Centered 128

GeriPal

FEBRUARY 17, 2022

This tool provides a clinical recommendation for starting/stopping medications and cancer screening based on the prognosis of the patient in front of you. He will post like articles that he’s read highlighted with key points noted, absolute treasure. It’s in the title of this article. See screenshot below.

Clinic 67

Clinic IT Patients Medical 67

GeriPal

JUNE 15, 2023

Alex: And joining us via Zoom, we have Charlotta Lindvall, who is a palliative care physician researcher who studies the intersection of natural language processing and communication data at Dana Farber Cancer Institute, where she also works in clinical informatics. Welcome to the GeriPal podcast, Charlotta. Charlotta: Thank you. Eric: Yeah.

IT 99

IT Patient-Centered Patients Healthcare 99

GeriPal

FEBRUARY 22, 2024

Is it that they’re clinically depressed or that they’re understandably sad at the situation that they’re in or specific issues? We might say, “Of course you’re sad, you just got a very serious diagnosis.” It’s high, it’s too high. Or is it that I’m just not screening? Eric: Yeah.

Mental Health 122

Mental Health Patient-Centered Illness Screening 122

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 72

Patients Clinic Patient-Centered Illness 72

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

AUGUST 17, 2023

Praised by the FDA, Alzheimer’s Association (AA), and Pharma as a “game changer”, but derided by others for the drug’s lack of clinical efficacy, risk of severe adverse effects, absence of diversity in trial populations, high costs, and an FDA approval process that was in the kindest words “rife with irregularities”. That was an FDA decision.

Patient-Centered 98

Patient-Centered IT Clinic Patients 98

GeriPal

OCTOBER 17, 2024

I’d also like to give a shout out to a recent ACP article on HFpEF with an outstanding contribution from Ariela Orkaby, geriatrician extraordinaire (we also just did a podcast with her on frailty ). ** This podcast is not CME eligible. He’s a medical director of H ebrew S enior L ife outpatient clinic at Newbridge.

Primary Care 113

Primary Care Patient-Centered IT Patients 113

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.” In general, the case is a patient who wound up with a new diagnosis of metastatic cancer during the course of the admission and at a certain point had full capacity, was able to make decisions and communicate.

Family 97

Family Families Patient-Centered IT 97

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

DECEMBER 19, 2024

Here are a couple of articles if you want to do a deeper dive: Dani and colleagues article on Psychiatry and Palliative Care: Growing the Interface Through Education. Dani and colleagues article on Palliative Care Psychiatry: Building Synergy Across the Spectrum. Eric 33:23 Article on Thaddeus Pope. And you can talk.

Illness 101

Illness Mental Health IT Patient-Centered 101

GeriPal

FEBRUARY 29, 2024

The ones who are publishing interesting articles are easy as we knew MAID is always going to be a controversial topic. But when we have people in rural areas of California, so we don’t know our clinical site, we go from San Francisco all the way to the Northern California border, super rural areas. We mentioned her name before.

IT 126

IT Patient-Centered Illness Education 126

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 ). Well, I’d agree, John, for palliative care ideally starts around the time of diagnosis.

Provider 117

Provider Illness IT Healthcare 117

GeriPal

JUNE 30, 2022

In today’s podcast we talk with surgeon Samir Shah and Health Services Researcher Joel Weissman about a pair of JAGS articles they published on the outcomes of high risk surgery and advance care planning among persons with dementia. Fifty percent have a diagnosis in their record of decedents have dementia. Eric: Yeah. Eric: Mm-hmm.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

GeriPal

JANUARY 11, 2024

Alex: We’re delighted to welcome Leonie Herx, who’s a palliative care physician and clinical professor at the University of Calgary. Sonu: Prior to that it was illegal and actually in the criminal code, so not only illegal, it’s actually a prohibition in the clinical code. Bill, welcome back to GeriPal. Eric: Yeah.

Illness 144

Illness IT Medical Provider 144

GeriPal

AUGUST 25, 2022

Second, Hospice was originally designed for patients with advanced cancer, but the fastest growing admitting diagnosis is dementia. And yet, we know little about the clinical experience of people with dementia in hospice. It’s something we need to pay attention to, which is what we were talking about in the article.

Family 106

Family Families IT Patients 106

GeriPal

OCTOBER 19, 2023

Additional links mentioned in the podcast: Recent JGIM article on POLST in California nursing homes, hospitalization, and nursing home care Karl’s GeriPal post on appropriate use of POLST Enjoy! Gretchen Schwarze like surgery, four things, live longer, feel better, be more functional, make a diagnosis. OK, I’ll step off my soap box.

Patient-Centered 126

Patient-Centered IT Patients Illness 126

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.

Family 83

Family Families IT Illness 83

GeriPal

JUNE 22, 2023

Michele: Yeah, so in May of 2018, there was an article by Suleika Jaouad in the New York Times Magazine, and they spent about two weeks in our hospice with us learning about the work that’s done. And so the article focuses on the work of these three men who were mostly gang involved and did something really bad when they were young.

Family 132

Family Families IT Community 132

GeriPal

MARCH 20, 2025

To delve into these questions, we spoke with Hope Wechkin, medical director of EvergreenHealth home hospice, who authored an article describing a process of Minimal Comfort Feeding (MCF) for patients who have expressed an interest in not wanting to live with advanced dementia. Just got the diagnosis based on blood tests of amyloid.

IT 87

IT Patient-Centered Patients Medical 87

GeriPal

APRIL 18, 2024

Because I remember there was an article maybe six months ago in JAGS, maybe it was longer than that, everybody was talking about ChatGPT-3.5, And you say, “Okay, that’s fine, but can it really … What about a real live clinical situation?” Let me ask you a question. And they suck at it for a lot of reasons.

Electronics 139

Electronics IT Patients Healthcare 139

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 93

Illness Hospital IT Patient-Centered 93

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

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. Eric 00:13 And Alex, we have a super special today, three different articles. This is Eric W id era.

Family 106

Family Families Patient-Centered Patients 106