The Motivated MD

NOVEMBER 19, 2024

True we have a fulltime nanny, but we still both work full-time clinically and still wish to have a steady hand in our children’s lives. Second, we have had some unexpected transitions at my job, and this has left me to cover extra clinical obligations with some consistency. This may be a bold statement, but I believe it to be true.

Finance 52

Finance Education Family Families 52

GeriPal

MAY 5, 2022

Was there any mention about the impact that hearing loss has in communication or what we should do about it in clinical practice? We talk with Nick and Meg about: Why hearing loss is important not just in geriatrics but also for those caring for seriously ill individuals. I’m guessing not. How to screen for hearing loss. Transcript.

IT 102

IT Screening Hospital Clinic 102

GeriPal

AUGUST 4, 2022

Today we are coming back for more (or less given the content), talking about the following articles with their lead authors: First up, we talk with Ariel Green about her article in JAMA Network on preferred phrases a clinician may use to explain why they should reduce or stop the medication. Welcome, Ariel. Ariel: Thanks.

Specialization 104

Specialization Medical Patient-Centered Provider 104

GeriPal

DECEMBER 2, 2022

So on today’s podcast we invite four brilliant individuals to talk about their perspective on how to change how we as a society and health care system partner with individuals with dementia. We’re going to be talking about things like creative engagement in individuals with dementia. Susan: Yeah, that was me.

Community 101

Community IT Individual Patient-Centered 101

GeriPal

NOVEMBER 9, 2023

On the other hand, there is a concerning side, described in this Guardian article titled, I’m a life coach, you’re a life coach: rise of an unregulated industry. I think in medicine, in particular and probably in all clinical specialties, there is this sense of a rival fallacy of, “When I finish residency, I’ll be happy.

Board-Certified 110

Board-Certified IT Primary Care Referral 110

GeriPal

JULY 19, 2024

What should we use to screen individuals? There’s an article about her in New York Times. Joe 03:55 You know, my thoughts are screening is important for a variety of reasons, and certainly Doctor Boris and Soo and Anna, Doctor chodos can provide a lot greater clinical insight than I. Who should get it if anyone?

Screening 119

Screening Primary Care Patient-Centered IT 119

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.

Diabetes 73

Diabetes Management Patient-Centered Family 73

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

Rao Doctor

APRIL 3, 2025

In my previous article I covered the types of illness and the causes. Infrared thermometers, which measure temperature from the forehead or ear, are also prevalent in clinical settings. While mild fevers often resolve on their own, persistent or severe fevers warrant professional evaluation. FEVER FAQs (contd.)

Diagnosis 130

Diagnosis Management Illness Diagnose 130

GeriPal

APRIL 3, 2025

We discuss our favorite articles, parody songs, and memories from AGS meetings past, with a little preview of a song for this years meeting. We covered: The first parody song I wrote, for AGS 2018 in Orlando , about this article by Nancy Schoenborn on how to discuss stopping cancer screening. And then I got to choose the first article.

IT 64

IT Hospital Screening Patients 64

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 18, 2024

We start off the conversation by talking about whether patients with cancer and cancer pain are really that different, and their paper that was just published on January 11 th in JAMA Oncology showing that substance use disorder is not uncommon in individuals with cancer. Eric: Which brings us to an article. Jessie: Exactly.

Illness 136

Illness Patient-Centered Screening Clinic 136

GeriPal

JANUARY 25, 2024

The article we discuss today, also published in JAMA , addresses these two gaps. David: Similarly informed by my clinical experience, really, actually, beginning in residency when I took care of a lot of sick folks in the hospital, particularly those with cancer and heart and lung diseases like these. Eric: How about you, David?

Patient-Centered 122

Patient-Centered Illness IT Patients 122

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 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

MAY 26, 2022

This week, we discuss an article by bioethicists Govind Persad and Emily Largent arguing that the NIH guidance for allocation of Paxlovid during conditions of scarcity. And then tier two is unvaccinated individuals not included in tier one who are at risk for severe disease. What’s wrong with that? Why not prioritize them?

Vaccination 87

Vaccination Individual IT Healthcare 87

GeriPal

MAY 18, 2023

Alex: And we’re delighted to welcome Todd Semla, who is a clinical pharmacist and associate professor at the Feinberg School of Medicine at Northwestern University. Eric: And in the article that’s being published in JAGS, you have multiple tables. So in those clinical situations, you should consider avoiding that drug.

Medical 97

Medical IT Patients Clinic 97

GeriPal

MARCH 9, 2023

FDA is considering approval, shifting away from Schedule I restrictions, paving the way for use in clinical practice. And some people in studies and just in clinical use have found that to be helpful, including for patients with serious illness. If you put on your clinical hats, what is demoralization to you? Eric: Yeah.

Patient-Centered 91

Patient-Centered Community IT Medical 91

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 Family Families Clinic 102

GeriPal

FEBRUARY 17, 2022

When we have a medication with up front harms and downstream benefits, it’s critical that we consider the time to benefit, or how long it will take an individual to benefit from a test or treatment. For individuals with a life expectancy less than the time to benefit, the up front harms outweigh the downstream benefits. .

Clinic 67

Clinic IT Patients Medical 67

GeriPal

NOVEMBER 7, 2024

Eric 00:13 And, Alex, I am very excited today because there was an awesome article on Annals on conservative management versus dialysis. Eric 11:50 I also have to ask, because we will have a link to this article. One of my favorite articles. Would you mind just describing what you did in that article? Clinical experience.

Management 116

Management Patient-Centered Patients IT 116

GeriPal

MAY 25, 2023

I’m not sure if you read that article and whether or not it’s changed your mind or whether or not you want to do any more research in advance care planning. And as you know, it’s a great article. So am I measuring it for that specific clinic level quality metric or am I measuring it for my research study?

Community 95

Community IT Patient-Centered Primary Care 95

GeriPal

OCTOBER 17, 2024

We talk about what is heart failure, particularly HFpEF, how we treat it (including the use of sodium–glucose cotransporter-2 inhibitors (SGLT2’s), and how we should apply guidelines to individual patients, especially those with multimorbidity who are taking a lot of other medications. But we’re not perfect individuals.

Primary Care 113

Primary Care Patient-Centered IT Patients 113

GeriPal

NOVEMBER 14, 2024

If you want to do a deeper dive into some of the articles we discuss, take a look at the following: An awesome JAMA review by Sarah on fall risk assessment and prevention in community-dwelling adults. You know, if you want to think about the problem, think about clinical research. I see a lot of Tai Chi falls articles out there.

IT 124

IT Screening Patient-Centered Community 124

GeriPal

FEBRUARY 6, 2025

So let’s just say you have a healthy 55 year old or 65 year old in your clinic. So whether it’s 50, 52, 55, 65, we should ask every person who comes into clinic at least once a year, how do you feel like your thinking is? So I’m in a specialty clinic, so I’m in this interdisciplinary memory assessment clinic.

Primary Care 95

Primary Care Diagnosis Screening IT 95

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

BMJ

FEBRUARY 8, 2021

The proximity to campus health clinics may also afford college students greater accessibility to healthcare providers for prescription medications such as stimulants which could end up being misused. Besides the risks to an individual, there are also population-level harms from normalizing certain harmful behaviors (e.g.,

Medical 40

Medical Holistic Care Healthcare Healthcare Professional 40

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. Chrissy: That’s fascinating. And so really am fascinated by tough medical decisions.

Management 122

Management IT Medical Patient-Centered 122

GeriPal

JANUARY 16, 2025

These individuals may become unrepresented, meaning they lack the capacity to make a specific medical decision, do not have an advance directive for that decision, and do not have a surrogate to help. How should we care for unrepresented individuals in inpatient and outpatient settings? Why not use the older term unbefriended?

Patient-Centered 109

Patient-Centered IT Patients Healthcare 109

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

MARCH 24, 2023

For a deeper diver into these issues, check out some of the following links: Ira’s Stat new article “Hospice care needs saving” GeriPal’s episode on the growing role of private equity in hospice care Acquisitions of Hospice Agencies by Private Equity Firms and Publicly Traded Corporations. Ira: I like the article. Thank you, Anne.

IT 113

IT Provider Patients Family 113

GeriPal

OCTOBER 26, 2023

Summary Transcript Summary Often podcasts meet clinical reality. But rarely does the podcast and clinical reality meet in the same day. Ann Henshaw is an occupational therapist who works clinically at Georgetown and teaches at GW. Alex: Today we are delighted to welcome Ann Henshaw who brought this podcast idea to us.

Hospital 132

Hospital Patient-Centered Patients IT 132

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

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”. I’m a prescriber.

Patient-Centered 98

Patient-Centered IT Clinic Patients 98

GeriPal

MARCH 2, 2023

I could go on and on, but listen to the podcast instead and for a deeper dive, take a look at the following articles and studies: Gabapentin in the Perioperative setting: Prolonged use of newly prescribed gabapentin after surgery. I understand that it can be a hard place clinically. J Am Geriatr Soc. Alex: Gabapentin for opioids.

Patient-Centered 96

Patient-Centered IT Healthcare Medical 96

GeriPal

FEBRUARY 8, 2024

Alex: I wonder when we talk about it, because we’ll have links to both Eric Cassell’s argument, and we mentioned another article from Tate. Eric Cassell’s article, The Nature of Suffering, that you might think suffering would appear in the definition of palliative care. Alex: That’s a big spectrum right there.

IT 137

IT Family Families Physicals 137

GeriPal

DECEMBER 8, 2022

And now my program of research is around testing that person-centered narrative intervention or PCNI because you have to give them an acronym in healthcare. 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