The Clinical Problem Solvers

FEBRUARY 8, 2023

Identify realistic solutions to drug policy reform that promote health equity among marginalized communities living in the United States. Screening for substance use and offering connections to treatment and community-based services are important strategies that clinicians can implement in their own practice today.

Community 52

Community Patient-Centered Mental Health Board-Certified 52

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. Sarah 03:57 Yeah, it’s a pretty big problem for older adults, I’d say in community dwellers. Alex 04:10 Wow.

IT 125

IT Patient-Centered Screening Community 125

GeriPal

OCTOBER 20, 2022

How HHS and ASPE solicit input from clinicians, community leaders, and older adults and how much it impacts policy decisions (spoiler alert: this involvement is CRUCIAL). There’s a team now with them behind them making sure that they stay safe and held in our communities. How to make your voice heard and get involved.

Complication 52

Complication Patient-Centered IT Patients 52

GeriPal

MAY 25, 2023

Sarah Nouri, Hillary Lum, and LJ Van Scoy argue that diverse communities are asking for ACP. Sarah Nouri gives an example from her work in the LGBTQ+ community of a trans woman who was buried as a man because existing laws/rules did not protect her wishes. Complicated grief? And as you know, it’s a great article.

Community 96

Community IT Patient-Centered Primary Care 96

GeriPal

MARCH 9, 2023

Psychedelics have been used by communities around the globe for hundreds of years (or more). Stacy: I honestly read Michael Pollan’s New Yorker article and was really inspired, and cold emailed the group at NYU, and they responded. Alex: It’s complicated. We, for very complicated reasons, ended up with niacin.

Patient-Centered 91

Patient-Centered Community IT Medical 91

GeriPal

JANUARY 25, 2024

The article we discuss today, also published in JAMA , addresses these two gaps. In their communities? It used to be a much more complicated model. As a nurse, how challenging would it be to do eight hours of training and jump into this complicated world? With their regular providers? David: Right. David: Yeah.

Patient-Centered 123

Patient-Centered IT Illness Patients 123

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 88

Vaccination Individual IT Healthcare 88

PEMBlog

JUNE 2, 2025

What you can expect to learn from this article: Recognize signs of end-organ injury when BP is 95th percentile + 30 mmHg. Before your blood pressure rises as well, know that this PEMBlog article is here to provide an overview of the recognition and management of hypertensive emergencies.

Hypertension 75

Hypertension Management Physicals Lab Testing 75

GeriPal

JUNE 30, 2022

Should she have an operation, and risk the pain, potential complications, and attendant delirium associated with the operation? Eric: So we’re going to be talking about dementia and considerations around surgery for individuals with dementia. You have a patient with dementia severe enough that she cannot recognize relatives.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

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. The same thing happens in geriatrics. What are your thoughts on that?

IT 92

IT Patient-Centered Healthcare Patients 92

GeriPal

MAY 12, 2022

He is also author of the book, “ Walk with the Weary: Lessons in Humanity in Health Care ,” and was featured in this Atlantic article. Prognosis communication and the subtle ways we may communicate it without intention. Community-based palliative care networks . And I believe it needs the community.

Community 116

Community IT Relationship Healthcare 116

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 Families Family Physicals 137

GeriPal

MAY 4, 2023

Patients that remind us of loved ones, patients that are often younger, really hard stories, complicated issues. The whole idea of holding hope seems also so much more complicated for younger people because the hopes that they had, the normal hopes are not likely to be realized. What are the patients that we remember? Abby: Yeah.

IT 83

IT Families Family Illness 83

GeriPal

DECEMBER 14, 2023

So we’re going to have a link to the article that you published in JAMA IM titled The Hospital Culture and Intensity of End-of-Life Care at Three Academic Hospitals. So before we talk about the results, can you give us a very brief overview of what you did in this article? Eric: Yeah, and for our listeners, excellent job, Kai.

Hospital 126

Hospital IT Patient-Centered Patients 126

GeriPal

FEBRUARY 13, 2025

We covered some of our questions on the podcast, others you can ponder on your own or in your journal clubs, including: Maries tele/video palliative care intervention was tailored/refined with the help of a community advisory board. Three different articles. Eric 04:27 Yeah, I gotta ask about the community advisor. Have to see.

Consulting 64

Consulting Community Patient-Centered Families 64

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 111

Illness Hospital Patient-Centered Patients 111

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 ). That was really the theme song of how the community came together. How do you see the light?

Provider 119

Provider Illness IT Healthcare 119

GeriPal

OCTOBER 26, 2023

Having read at least some of your research articles there’s a lot of focus around this intersection between what happens to people after the hospital stay post-acute, especially in the cancer patients. Eric: I felt that reading the article. We’ll have a link to that article on our show notes. Ann: Likely.

Patient-Centered 133

Patient-Centered Hospital Patients IT 133

GeriPal

APRIL 10, 2025

So Tammie developed something called EPIC for Emergency medicine, which is a curriculum that was one of the first ways that I think palliative care got spread in our community. We adapted a small group of us, Vital Talk for emergency medicine, which is communication skills training using simulation. But yeah, it’s complicated.

Patient-Centered 78

Patient-Centered IT Hospital Patients 78

GeriPal

MAY 15, 2025

Many were community hospitals. We did another nudging trial where the deep default was for default palliative care consultations for high risk patients, and it significantly increased individuals who were receiving palliative care. We tested two different nudges individually and then we combined them. I highly encourage you.

Patient-Centered 118

Patient-Centered Hospital IT Illness 118

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.” This is not a process where they can see into the future around what complications or challenges may arise, but this is the world that we live in and we can anticipate that. Should you stop at “no?”

Families 98

Families Family Patient-Centered IT 98

GeriPal

AUGUST 25, 2022

I had looked at a research article that had recently evaluated the prevalence of private equity transactions in the hospice market and noted that there was a pretty substantial uptick in the past decade, and really over the course of say around 2015 to 2019. Melissa, do you want to describe that paper? Melissa: Sure. It waxes and it wanes.

Families 107

Families Family IT Patients 107

GeriPal

MARCH 24, 2022

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. Although, certainly when you start facing complications of serious illness, it is increasingly important to engage as individuals and conversations about goals, values, and preferences.

Illness 73

Illness IT Healthcare Patient-Centered 73

GeriPal

MARCH 30, 2023

Then I got online as a patient advocate and started connecting with the brain tumor community on social media and Facebook and Twitter, and actually started working in the healthcare space, in palliative care advocacy, for a palliative care advocacy organization in California, which is where I’m based, about eight years ago.

IT 96

IT Patient-Centered Patients Healthcare 96

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! Eric: That’s a complicated form then. If it was going to be for 48 hours to get them through a community acquired pneumonia.

Patient-Centered 127

Patient-Centered IT Patients Illness 127

GeriPal

JANUARY 11, 2024

So we’re going to be talking about this complicated topic that a lot of people have differing opinions to and potentially very strong opinions, medical aid in dying. So it started off for individuals with a terminal illness. You get me with one-finger-chords on the guitar if you’re watching on YouTube (best I could manage).

Illness 144

Illness IT Medical Provider 144

GeriPal

SEPTEMBER 8, 2022

And I got from your article, while the peaks follow this pattern, people feel a lot of different things where it just reminds me of the times I’ve grieved. It’s complicated, it’s messy. How does that defer from is it complicated grief, prolonged grief disorder? Eric: Is that the same as complicated grief?

IT 100

IT Complication Relationship Specialization 100

GeriPal

MARCH 3, 2022

Eric: I got a question because it was a ways back, but we did a podcast on keep your hands to yourself from a JAMA IMR article that showed that use of mechanical ventilation for nursing home residents with advanced dementia doubled between 2000 and 2013, that was a John Tino study. I think it’s really, really complicated.

Patient-Centered 96

Patient-Centered Patients IT Hospital 96

Family Medicine Initiative

APRIL 10, 2024

You know your patients’ evolving story as well as their family, friends, coworkers, and the peculiarities of their local community. Over time, communication improves. All of that is especially important for disadvantaged individuals with more risk factors, more chronic diseases, more medications, and lower health literacy.

Family Physician 130

Family Physician Families Family GP 130

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.

Families 108

Families Family Patient-Centered Patients 108

GeriPal

MAY 1, 2025

So it felt like it was being part of this huge kind of change in the whole environment and the whole experience of that community. A review article, which I still like to go to. I couldnt help it, forgive me dear listeners, I had to do a longer than usual cut at the start! Eric 11:14 Yeah, we go way back. And I also remember.

Primary Care 96

Primary Care IT Clinic Provider 96

GeriPal

MARCH 27, 2025

Eric 01:07 So we have an amazing lineup of guests and we’re going to be talking about a pragmatic study on advanced care planning, which we’ll have links to in our show, notes for the actual article. In our planning sessions, one of the biggest barriers to advanced care planning in this community is just talking about death.

Primary Care 80

Primary Care IT Clinic Patient-Centered 80

GeriPal

JUNE 2, 2022

So take a listen and if you want a deeper dive into some of the references we discuss on the podcast, here is a list: Medscape article on how “ COVID-19 Vaccines Work Better and for Longer Than Expected Across Populations, Including Immunocompromised Individuals”. Stat news article about variants/COVID becoming more predictable.

Vaccination 100

Vaccination IT Hospital Management 100