AMMD

FEBRUARY 14, 2025

The average age of a breast cancer diagnosis has statistically been around 65. I will have an article about the dangers of gadolinium dye soon. I also did a screening blood test to look for circulating tumor cells, which I will have an article on this soon! Breast Cancer, as are all cancers, is on the rise. Don’t worry!

Diagnosis 130

Diagnosis Screening IT Patient-Centered 130

GeriPal

OCTOBER 13, 2022

When I’m on service these days there is inevitably a moment when a resident says “Patient so-and-so is on X” – and I have absolutely no idea what X is. These articles are part of a new series called Clin-Star Corner , a new series in JAGS that reviews practice changing articles in the care of older adults. .

Complication 97

Complication Patient-Centered IT Patients 97

Physician's Weekly

JUNE 11, 2025

Experts shared updated guidance for treating chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) in a recent viewpoint article published in Blood Advances. CT Imagin g: CT is recommended at diagnosis if lymphadenopathy or splenomegaly is present, or if clinically indicated.

Management 52

Management Diagnosis Complication Screening 52

PEMBlog

OCTOBER 26, 2023

Other complications include obstruction due to intussusception or volvulus, leading to bowel ischemia and shock. Recognizing the characteristic features and understanding the differential diagnosis is crucial in managing patients with lower gastrointestinal bleeding. The bleeding is usually painless.

Diagnosis 64

Diagnosis Complication Consulting Management 64

GeriPal

JULY 19, 2024

There’s an article about her in New York Times. What hasn’t been shown, Eric, is that if you apply tools like this, clinical outcomes down the road are better for patients. But it seems very apropos to the topic. Soo 01:37 It’s a little obvious. Anna 01:38 Yeah. She’s doing a tour. So this is great. Here we go.

Screening 120

Screening Primary Care Patient-Centered IT 120

GeriPal

MARCH 14, 2024

This simple challenge was focused on putting ourselves in the shoes of our patients with dysphagia who are prescribed thickened liquids. And I think that we’re at this kind of crossroads right now in dysphagia, and dysphagia management where our patients are suffering. We revisit it, and make things better for our patients.

IT 125

IT Hospital Patient-Centered Individual 125

GeriPal

JUNE 8, 2023

When I’m on palliative care consults and attending in our hospice unit we have to counsel patients about deprescribing and de-intensifying diabetes medications. And we invited Tamryn Gray from the Dana Farber joins us to ask insightful questions, including: What blood sugar range should we target for patients in the nursing home or hospice?

Diabetes 74

Diabetes Management Patient-Centered Family 74

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.)

Diagnosis 130

Diagnosis Management Illness Diagnose 130

GeriPal

MAY 11, 2023

But I would say that in terms of education, it’s really complicated because it’s so confounded by socioeconomic status and so many social determinants of health. Now, that doesn’t mean it’s a one-to-one, and this is very hard as we see it with our patients who have done all these things. This is Eric Widera.

Physicals 86

Physicals IT Hypertension Education 86

GeriPal

MAY 22, 2025

Jenny Chen is a palliative care fellow at Yale who regularly sings for her seriously ill patients. Jenny reached out to us because she plays music regularly for her patients, and she said, you should do a podcast about music. And I was looking for articles, and I wasn’t seeing as many as I expected. Come join us.

IT 98

IT Patient-Centered Patients Board-Certified 98

GeriPal

OCTOBER 20, 2022

And, who within ASPE guides aging policy and connects policy to every day health challenges experienced by patients and clinicians? Alex: And we are delighted to welcome Rasheeda Hall, who is a physician scientist in the division of nephrology at Duke University School of Medicine, and sees patients at the Durham VA.

Complication 52

Complication Patient-Centered IT Patients 52

GeriPal

SEPTEMBER 28, 2023

First, a clinician’s thoughts must be encoded into words, then transmitted often via sounds, and finally decoded back to thoughts by a patient or family member. Patient Values: Three Important Questions-Tell me more? Simple, right? Not so much, as each one of these steps is fraught with miscommunication. What else?

Family 144

Family Families Patient-Centered IT 144

GeriPal

OCTOBER 24, 2024

Summary Transcript CME Summary Cannabis is complicated. If you believe the evidence for efficacy to manage symptoms like neuropathic pain, how do you even start to think about recommending these products to patients? And then one patient who really knew more about a topic than I did, which unfortunately happens much more often.

Medical 100

Medical IT Patient-Centered Healthcare 100

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. Upon entering the room, you find the patients nurse at the bedside already in mid-conversation with the patients parent. Use IV labetalol or nicardipine continuous drips to lower blood pressure.

Hypertension 75

Hypertension Management Physicals Lab Testing 75

GeriPal

OCTOBER 12, 2023

Summary Transcript Summary For surgeons and patients, deciding if and when to operate can be challenging. Often, the way surgeons communicate about these decisions doesn’t make things any easier for themselves or their patients. We hope you enjoy this episode. Alexis, welcome to GeriPal. Alexis: Thanks for having me. Alexis: Yeah.

IT 129

IT Family Families Patient-Centered 129

GeriPal

JUNE 15, 2023

” And Bing responded, I should ask about how AI can help identify patients who need palliative care and reduce hospitalizations, what are the benefits and challenges of using AI in decision-making, communication, palliative care, and how could AI support the quality of life and dignity of patients for those who are receiving palliative care?

IT 100

IT Patient-Centered Patients Healthcare 100

GeriPal

FEBRUARY 23, 2023

Summary Transcript Summary You know when you walk out of a patient’s room and have that sense, “This isn’t going to go well.” The patient is sick and getting sicker, and refuses to let you talk with family or other members of her inner circle. Should you stop at “no?” Lynn: I do. Alex, can you play Send the Sun, by Nikki Lane?

Family 98

Family Families Patient-Centered IT 98

GeriPal

JUNE 30, 2022

You have a patient with dementia severe enough that she cannot recognize relatives. Should she have an operation, and risk the pain, potential complications, and attendant delirium associated with the operation? Samir: For me, it really came out of an interest in improving the care of patients who undergo surgery. AlexSmithMD.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

GeriPal

JULY 28, 2022

And I just want to highlight, Jennifer has a great JPSM article that just came out. But at that time I was struck by how in that field, there wasn’t a focus or really interest in symptom management and support for patients and their families. Would you also just mind mentioning kind of the JPSM article too?

Illness 111

Illness Hospital Patient-Centered Patients 111

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. But really those urinary tract signs and symptoms should be driving your diagnosis.

Management 123

Management IT Medical Patient-Centered 123

GeriPal

MAY 4, 2023

But when I have, I find that they’re often some of the hardest patients to care for. I just had this experience where in the space I was in, very few people believed that this was even a legit thing to study and certainly that it would make a difference for the patients we cared for. What are the patients that we remember?

IT 83

IT Family Families Illness 83

GeriPal

AUGUST 25, 2022

Second, Hospice was originally designed for patients with advanced cancer, but the fastest growing admitting diagnosis is dementia. Krista Harrison found , to her surprise, that caregivers of people with dementia who died rated hospice as well as similar patients without dementia who died on hospice. AlexSmithMD. Transcript.

Family 107

Family Families IT Patients 107

GeriPal

OCTOBER 19, 2023

Caveat as well that RCTs should not be placed on pedestal as the only answer- often patients enrolled in RCTs do not represent real world patients – observational studies do. For a trial to have value, it should not exclude patients over age 80, or those with dementia, or patients residing in nursing homes.

Patient-Centered 127

Patient-Centered IT Patients Illness 127

GeriPal

DECEMBER 19, 2024

Here are a couple of articles if you want to do a deeper dive: Dani and colleagues article on Psychiatry and Palliative Care: Growing the Interface Through Education. Dani and colleagues article on Palliative Care Psychiatry: Building Synergy Across the Spectrum. Eric 05:46 So I got a question.

Illness 102

Illness Mental Health IT Patient-Centered 102

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 ). But in the end, I see these as my patients and I’m trying to define what is the right model.

Provider 119

Provider Illness IT Healthcare 119

GeriPal

JANUARY 11, 2024

In further contrast to the United States, MAID in Canada is almost entirely administered by a clinician, whereas in the United States patients must self administer. 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.

Illness 144

Illness IT Medical Provider 144

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. It’s easier to concentrate on cure, diagnosis, cure. It was wonderful for me, as a rehab doctor, to be able to see patients with spinal cord injuries and how they were living in their homes.

Community 116

Community IT Relationship Healthcare 116

GeriPal

SEPTEMBER 8, 2022

Holly has accumulated mountains of evidence for the diagnosis of prolonged grief disorder as a specific condition primarily notable for a yearning over a year after the death. 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 100

IT Complication Relationship Specialization 100

AMMD

APRIL 1, 2025

Technically, no… but it’s a little more complicated than that. Before I do, I want to set the intention for this article. Additionally, ensuring you have a proper diagnosis prevents treating the wrong problem. If you suspect candida overgrowth, getting an accurate diagnosis is essential. How Is Candida Diagnosed?

Diagnose 130

Diagnose IT Provider Healthcare 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. Why do this?

Family 108

Family Families Patient-Centered Patients 108

GeriPal

MAY 1, 2025

And so the patients who had been admitted there to die, essentially most, if not all, got better and HIV became much more of a chronic condition. A review article, which I still like to go to. It is kind of weird that my first publication was in jama, part of the Care of the Aging Patient series. Meredith 11:29 Yeah.

Primary Care 96

Primary Care IT Clinic Provider 96

GeriPal

MARCH 27, 2025

Only 5% of intervention patients received the facilitator-led component of the intervention (there were other components, facilitator-led was the most engaged component). I’m hearing dementia patients or patients with dementia. Eric 09:15 And then who were the patients just with dementia or were they. Is that right?

Primary Care 80

Primary Care IT Clinic Illness 80

GeriPal

JUNE 6, 2024

Summary Transcript Summary As Eric notes at the end of today’s podcast, we talk about many difficult issues with our patients. But one issue we’re not as good at discussing with our patients is sexual health. Clearly this issue is important to patients. You know, I address all the supportive care needs of my patients.

Illness 131

Illness IT Physicals Patients 131

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.” We see our patients and our families throughout the illness trajectory into the hospital. We see them struggle, right? We see how hard it is.

Illness 98

Illness Patient-Centered IT Patients 98

GeriPal

AUGUST 22, 2024

I love these topics, too, because even how do we define what is a diagnosis? Patients families want to know whether their loved one has died. Doctors want to know whether the patient has died. You know, when is it okay to harvest organs from a patient? So there may be caps if the patient died versus no caps.

IT 115

IT Family Families Patient-Centered 115

GeriPal

JANUARY 5, 2023

We start by talking with Robert Brody, an internist who recalls physicians helping patients die during the height of the AIDS epidemic in San Francisco. Robert was first asked by one of his own patients for assistance in dying in 1991, far before aid in dying was legalized in California in 2016. Lisa Harris piece mentioned on podcast.

Provider 19

Provider Medical Hospital Patient-Centered 19

Pamela Wible MD

JUNE 19, 2025

In order to heal her patients she first had to heal her ailing profession. And this is a medical system that needs to be disrupted because our medical system (as you know) is endangering the lives of patients right now—and physicians. I give you Dr. Pamela Wible. Born into a family of physicians who warned her not to pursue medicine.

Clinic 246

Clinic Nurse Practitioner IT Medical 246