GeriPal

NOVEMBER 9, 2023

Today we learn more about coaching from 3 coaches: Greg Pawlson, coach and former president of the American Geriatrics Society, Vicky Tang, geriatrician-researcher at UCSF and coach , and Beth Griffiths, primary care internist at UCSF and coach. We address: What is coaching? How does it differ from therapy? From Beth Israel and UNC.

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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.

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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.

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GeriPal

FEBRUARY 6, 2025

So, the question becomes, what, if anything, should we do differently in the primary care setting to diagnose the disease? On todays podcast, weve invited Nathaniel Chin back to the GeriPal podcast to talk about what primary care needs to manage this new world of Alzheimers disease effectively. Great to be back.

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GeriPal

JANUARY 25, 2024

Summary Transcript Summary In a JAMA 2020 systematic review of palliative care for non-cancer serious illness, Kieran Quinn found many positives, as we discussed on our podcast and in our editorial. The article we discuss today, also published in JAMA , addresses these two gaps. Eric: And your primary outcome was what?

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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.

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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.

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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.

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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.

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Complication Patient-Centered IT Patients 52

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.

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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.

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GeriPal

MAY 25, 2023

Advance care planning doesn’t work. 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. Your thoughts? LJ: Definitely read it.

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Community IT Patient-Centered Primary Care 95

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.

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IT Screening Patient-Centered Community 124

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. And so that was one, very interesting to me. Scott: Yeah. So very common. Eric: Its high.

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GeriPal

OCTOBER 26, 2023

Summary Transcript Summary Often podcasts meet clinical reality. That’s why we do this podcast- to address real world issues in palliative care, geriatrics, and bioethics. But rarely does the podcast and clinical reality meet in the same day. Dear listeners, if you have a podcast idea, feel free to reach out to us.

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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.

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IT Patient-Centered Patients Healthcare 99

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. It wasn’t just to get healthcare workers to stay on the job, it was to thank them or recognize their service.

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GeriPal

APRIL 4, 2024

Today, we talk with Bernie Lo, prominent bioethicist and practicing primary care internist, and Laurie Dornbrand, geriatrician at the IOA On Lok PACE, about the legacy of Nancy Curzan. You write about this, you’ve written this New England Journal article, you’ve written past articles.

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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.

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Patient-Centered IT Clinic Patients 98

GeriPal

AUGUST 11, 2022

And man, I still remember those sessions, some of the most powerful learning experiences of my career as a palliative care doctor. There was a Stanford article talking about you as a pioneer in this field. ” And I wonder, how did you fall in love with palliative care? My question is, what article are you most proud of?

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GeriPal

MARCH 24, 2022

This is the latest in our series of podcasts on concerns about, and potential of advance care planning. Start by reading this article by Sean Morrison, Diane Meier, and Bob Arnold in JAMA , and this response from Rebecca Sudore, Susan Hickman, and Anne Walling. I worry, as a ex-primary care doctor, how much time I have.

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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. Essentially a primary palliative care intervention of sorts. What is a clinical decision support?

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Patient-Centered IT Hospital Patients 77

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. We’re going to be talking about trauma informed care.

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IT Patient-Centered Screening Individual 66

GeriPal

JUNE 5, 2025

How to think about primary and specialized palliative care in this setting. The obstacles hindering referrals to palliative care services. Practical strategies to overcome these barriers and enhance care. JAGS 2024 Nursing Home Palliative Care Referral Process, Barriers, and Proposed Solutions: A Qualitative Study.

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GeriPal

APRIL 24, 2025

We and our guests have noticed that in our clinical practices, patients and caregivers seem to be asking for such treatments more frequently. We discuss an article they wrote about PULET for the American Journal of Hospice and Palliative Medicine, including: What makes a PULET a PULET? Why did you even decide to write this article?

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Patient-Centered IT Patients Illness 77

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.

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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. Samir: For me, it really came out of an interest in improving the care of patients who undergo surgery.

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Patient-Centered Complication Patients IT 101

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.

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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. And I turned to my dad and I said, I think mom needs palliative care. Ricky 11:23 Yeah.

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GeriPal

MARCH 3, 2022

I am wondering whether it’s the conversations and preparation that’s primary care providers and outpatient providers are having with a lot of these patients and families to either prevent an ICU admission or potentially address their goals, such that they don’t go into the ICU. How do I reconcile these two issues?

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Patient-Centered Patients IT Illness 96

GeriPal

MARCH 10, 2022

This study explored nursing home organizational factors and staff perceptions that are associated with the variation in care for residents with advanced dementia. Now when I say variation, I’m not talking about small little clinically questionable variations. And to keep it short work for an article. Ruth: Mm-hmm (affirmative).

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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. They had no idea.

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GeriPal

MARCH 27, 2025

Summary Transcript CME Summary A pragmatic trial evaluates the effectiveness of a treatment or intervention in real-world clinical practice. In the primary care practices that received the advance care planning intervention, rates of advance care planning were higher (about double). Sydney 00:41 Thank you.

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Primary Care IT Clinic Illness 79

GeriPal

MAY 1, 2025

Our second guest, Meredith Greene, is a geriatrician and researcher who focuses on care of older adults living with HIV, in the US and Africa. Funding for research and clinical care is at risk, as USAID and PEPFAR (which is under USAID), are shuttered. A review article, which I still like to go to. And I also remember.

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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. And it actually came up during a clinical encounter that I had. Clearly this issue is important to patients. Sharon, welcome to Jerry Powell.

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GeriPal

APRIL 20, 2023

I would talk about this, except I was a clinician, and I’m seeing these folks in the hospital and in clinic. The journal section’s requirements are the same as for a clinical investigation. But nothing in healthcare. We’ll have all of the articles we talked about on our show notes. So thank you, Margot.

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GeriPal

JULY 20, 2023

You wrote the SF Chronicle article on an op-ed. Carly: Absolutely, and I will say we had a really hard time narrowing it down to these three because amongst those of us who wrote that article, we can think of hundreds of people. So Carly, I’m going to start off with you. What instigated you to write an op-ed? Eric: Yeah.

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