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.)

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Diagnosis Management Illness Diagnose 130

GeriPal

JUNE 8, 2023

Should we use Ozempic (if we can find it) in patients with serious illness, which often results in undesirable and profound weight loss? If in your own work, your clinical work, is this something that you see people struggle with you, you see yourself struggle with? Listen in to learn more! Eric: Let me ask you a question.

Diabetes 74

Diabetes Management Patient-Centered Families 74

GeriPal

APRIL 14, 2022

On today’s podcast we talk with three experts on buprenorphine on why, when, and how to use it in serious illness. 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: . Transcript.

Illness 103

Illness Patient-Centered IT Patients 103

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. Who do we have with us today? I look forward to your findings of your study. Devon: Thanks so much.

Illness 137

Illness Patient-Centered Screening Clinic 137

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 97

Primary Care Diagnosis Screening IT 97

GeriPal

DECEMBER 19, 2024

Still, we havent talked about integrating palliative care into psychiatry or in the care of those with severe mental illness. What does it look like to take a palliative approach to severe mental illness? Is “terminal” mental illness a thing? Eric 01:34 Oh, I love that. Dani 01:36 More to talk about there.

Illness 102

Illness Mental Health IT Patient-Centered 102

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 106

Telehealth Patient-Centered IT Patients 106

GeriPal

SEPTEMBER 28, 2023

A “Three-Stage Protocol” for Serious Illness Conversations: Reframing Communication in Real Time Transcript Eric: Welcome to the GeriPal podcast. 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. What else?

Families 144

Families Family Patient-Centered IT 144

GeriPal

FEBRUARY 22, 2024

As she said, when you think about the hardest patients you’ve cared for, in nearly all cases there was some aspect of psychological illness involved. Today we talk with two psychologists who are deeply invested in addressing psychological aspects of care for people living with serious illness. That rings true to me.

Mental Health 123

Mental Health Patient-Centered Illness Screening 123

GeriPal

JULY 28, 2022

GeriPal post on “fast food” style palliative care in chronic critical illness. 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? Transcript.

Illness 111

Illness Hospital Patient-Centered Patients 111

GeriPal

FEBRUARY 27, 2025

Substance use disorder is one of those complex issues in which clinical practice is changing rapidly. Today we talk with experts Janet Ho, Sach Kale, and Julie Childers about opioid use disorder and serious illness. Sach Kale set up an outpatient clinic focused on substance use disorder for patients with cancer. What do they do?

Patients 74

Patients Clinic Patient-Centered Illness 74

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

SEPTEMBER 1, 2022

Social workers augment a team’s ability to provide whole-person care, often aiding to identify and meaningfully address the wide variety of challenges and unmet needs faced by individuals and families facing serious illness. So in preparation for this, I read a couple articles about social work leadership in palliative care.

IT 102

IT Families Family Clinic 102

GeriPal

MAY 22, 2025

Jenny Chen is a palliative care fellow at Yale who regularly sings for her seriously ill patients. 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. Look for Jenny to potentially appear on the show Americas Got Talent (no lie).

IT 98

IT Patient-Centered Patients Board-Certified 98

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 100

IT Patient-Centered Patients Healthcare 100

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?

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IT Families Family Patient-Centered 129

GeriPal

OCTOBER 24, 2024

Alex 00:30 And we are also delighted to welcome Eloise Theisen, who’s a palliative care nurse practitioner at Stanford and CEO and co- c ounder of Radical Health Clinician Network, which helps patients use cannabis to treat chronic and age related illness. Eloise, welcome to the GeriPal podcast. They just kept at it.

Medical 100

Medical IT Patient-Centered Healthcare 100

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 98

Family Families Patient-Centered IT 98

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 68

Clinic IT Patients Medical 68

GeriPal

JANUARY 11, 2024

To be eligible in Canada patients must have a “ grievous and irremediable ” condition, including disability ; they do not have to have a terminal illness with a prognosis of less than 6 months. A planned expansion of MAID to include people with mental illness was placed on hold until March 2024. Bill, welcome back to GeriPal.

Illness 144

Illness IT Medical Provider 144

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. Not the most common circumstances that people with serious illness face where attention and understanding of what my goals and values are. So, we did try to get some breadth of guests on our show.

IT 127

IT Patient-Centered Illness Education 127

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 ). He looked very ill. My wife is also a physician and she said he’s dying.

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Provider Illness IT Healthcare 119

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! Respectful disagreement is in short supply these days. OK, I’ll step off my soap box. AlexSmithMD Transcript Eric: Welcome to the GeriPal podcast.

Patient-Centered 127

Patient-Centered IT Patients Illness 127

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 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

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.

Families 107

Families Family IT Patients 107

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

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.

Families 133

Families Family IT Community 133

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. So a ton to talk about. What is it, Hope? Is that right, Hope?

IT 89

IT Patient-Centered Patients Medical 89

GeriPal

FEBRUARY 24, 2022

It’s not a new debate but has gathered steam at least in palliative care circles since Sean Morrisons published a JPM article titled “ Advance Directives/Care Planning: Clear, Simple, and Wrong.” Juliet and Rachelle are two of the authors of a recent JAMA viewpoint titled “Shifting to Serious Illness Communication.” . Transcript.

Illness 98

Illness Patient-Centered IT Patients 98

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 63

Illness Hospital IT Patient-Centered 63

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 120

Patient-Centered IT Patients Hospital 120

GeriPal

JUNE 6, 2024

Sharon Bober, clinical psychologist at DFCI, notes that clinicians can get caught in an anxiety cycle, in which they are afraid to ask, don’t ask, then have increased anxiety about not asking. Eric 01:13 So we got a lot to cover today on sexuality, sexual health and serious illness. Clearly this issue is important to patients.

Illness 131

Illness IT Physicals Patients 131

GeriPal

MARCH 27, 2025

Summary Transcript CME Summary A pragmatic trial evaluates the effectiveness of a treatment or intervention in real-world clinical practice. Alex 02:44 Still suffering from some illness from there, which is why I was sick and not in the office with Eric today. We did it by the clinic level. Jasmine, is it you? Is that right?

Primary Care 80

Primary Care IT Clinic Illness 80

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. Why do this?

Families 108

Families Family Patient-Centered Patients 108

GeriPal

MAY 1, 2025

Funding for research and clinical care is at risk, as USAID and PEPFAR (which is under USAID), are shuttered. And when she was here, she co founded the Golden Compass Clinic at San Francisco General Hospital for older adults living with HIV. A review article, which I still like to go to. Is a new diagnosis of HIV.

Primary Care 96

Primary Care IT Clinic Provider 96

GeriPal

DECEMBER 1, 2023

Summary Transcript Summary There is a growing push to change how we define Alzheimer’s disease from what was historically a clinically defined syndrome to a newer biological definition based on the presence of positive amyloid biomarkers. That’s in my view as analogous as to any other illness. This is Eric Widera.

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IT Clinic Illness Hypertension 117