Pamela Wible MD

JUNE 20, 2025

Characterized by cynicism, exhaustion, and reduced job satisfaction, physician burnout can lead to devastating personal and professional consequences, including strained relationships, substance abuse, early retirement, and even suicide. Wendy Dean and Simon Talbot with their landmark 2018 article, Physicians aren’t ‘burning out.’

Medical Student 246

Medical Student Diagnosis Physicals Medical 246

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

The Clinical Problem Solvers

FEBRUARY 8, 2023

Between 2007 – 2019, Black individuals experienced a higher death rate for opioid overdose deaths than any other racial or ethnic group. These narratives have vilified individuals who would benefit from comprehensive, person-centered substance use treatment, rather than incarceration and other adverse harms.

Community 52

Community Patient-Centered Mental Health Board-Certified 52

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

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. Panelists David Bekelman, Lyndsay DeGroot, and Diah Martina have no relationships to disclose. And not just statistically significant, but clinically meaningful. Eric: How about you, David? Why this particular population? So, it was super exciting.

Patient-Centered 122

Patient-Centered Illness IT Patients 122

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

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 Family Families Physicals 137

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

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

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

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

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.

Family 97

Family Families Patient-Centered IT 97

GeriPal

APRIL 13, 2023

Are there meaningful ways of assessing loneliness and social isolation in clinical settings and connecting patients with interventions? The Listening “EAR” approach that simplifies assessment of loneliness and social isolation in clinical settings, and other practical pointers.

IT 99

IT Community Patient-Centered Medical 99

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 4, 2024

In case you miss the introductions at the start of the podcast, Bernie and Laurie are married, and offer wonderful reminiscence of their clinical practice over the last several decades. Widera and Smith have no relationships to disclose. Guest Laurie Dornbrand has no relationships to disclose.

Family 112

Family Families Patient-Centered IT 112

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

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

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, we did try to get some breadth of guests on our show.

IT 126

IT Patient-Centered Illness Education 126

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. Some of them are really deeply individual experiences.

Patient-Centered 66

Patient-Centered IT Screening Individual 66

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. And then we also have another Vas, many of the interviews are done by medical students or other healthcare trainees as part of their clinical rotation at the VA.

Patient-Centered 115

Patient-Centered Illness Healthcare IT 115

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

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 Hospital IT Patients 77

GeriPal

JANUARY 26, 2023

Second, as we discussed in last week’s podcast , older adults, particularly those in nursing homes, were far more likely to die than younger individuals. The article was titled, “ Change is coming ” – which also gives you a hint as to today’s song request. Ramona: Glomerular Filtration Raterate. I probably should have said GFR.

IT 91

IT Patient-Centered Healthcare Patients 91

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 ). It sets space between us and the individuals we’re trying to take care of.

Provider 117

Provider Illness IT Healthcare 117

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

MARCH 13, 2025

Yes, it means to cloak, but theres more Whole-person-care Total pain Healing as a process distinct from the deterioration of the body Sympomatologists The patient and family as the unit of care Our guests referenced many articles on this podcast, linked above and below. I loved the relationship that we developed and the fun we had.

IT 104

IT Patient-Centered Family Families 104

GeriPal

OCTOBER 5, 2023

We’ve invited Jacqueline Kruser and Bob Arnold on this week’s podcast to talk about their recently published JAMA Viewpoint article titled “ Reconsidering the Language of Serious Illness. ” You recently published an article in the New Yorker titled, I can’t even read my own, what was the title again? Of course not.

Illness 136

Illness IT Patient-Centered Family 136

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?

Patient-Centered 77

Patient-Centered IT Patients Illness 77

GeriPal

APRIL 6, 2023

Chaplains can do an assessment of the spirituality of the individual and then they use interventions that are part of their discipline and those interventions are tailored to the individual’s spiritual and religious needs of the person that they’re caring for. What were those spiritual domains? Is that your grandchildren?

Patient-Centered 99

Patient-Centered IT Family Families 99

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

FEBRUARY 13, 2025

We’re gonna be talking about three different articles that are gonna be presented Saturday, I believe, at the annual meeting. Three different articles. The black individuals wanted to have a separate one from the white individuals. From just the abstracts we had so many questions. I’m Na Ouyang. Have to see.

Consulting 63

Consulting Community Patient-Centered Family 63

GeriPal

MAY 29, 2025

And I think this just hasn’t made it into, like, our academic clinical training space. This is, you know, has to do with our personal relationship. Andrew, you might remember more about it with individuals who I think were maybe in the neuro ICU and they are undergoing resuscitation. These are windows. And the Clin.

Family 93

Family Families IT Patient-Centered 93

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. So it started off for individuals with a terminal illness. Bill: Thank you.

Illness 144

Illness IT Medical Provider 144

GeriPal

JUNE 5, 2025

So, how can we improve palliative care for individuals in nursing homes? 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. Some will have stronger relationships with hospice.

Nurse Practitioner 78

Nurse Practitioner Referral Consulting Board-Certified 78