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. What are the risks and rewards of new classes of medications? When I’m on nursing home call, the most common page I receive is for a blood sugar value. How high is too high?

Diabetes 74

Diabetes Management Patient-Centered Families 74

GeriPal

MAY 11, 2023

Then I went to medical school and I thought, “Well, should I go into psych? 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. We had diabetes, hypertension, risky medications. This is Eric Widera.

Physicals 86

Physicals IT Hypertension Education 86

GeriPal

OCTOBER 24, 2024

Summary Transcript CME Summary Cannabis is complicated. David is a physician who wrote the book “ Stoned: A Doctor’s Case for Medical Marijuana ” and gave a TED talk on “ A Doctor’s Case for Medical Marijuana ” that was watched over 3 million times. Eloise 00:59 Thank you so much. Eric 01:34 Yeah. David 04:31 Yes.

Medical 99

Medical IT Patient-Centered Healthcare 99

Rao Doctor

APRIL 3, 2025

In my previous article I covered the types of illness and the causes. More severe symptoms, such as difficulty breathing, persistent vomiting, chest pain, or seizures, are red flags that necessitate immediate medical attention. Understanding the patient’s medical history is crucial for an accurate diagnosis.

Diagnosis 130

Diagnosis Management Illness Diagnose 130

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. This is Sarah Berry, who is at the Hebrew Senior Life and Beth Israel Deaconess Medical center and Harvard Medical School.

IT 124

IT Screening Patient-Centered Community 124

GeriPal

OCTOBER 20, 2022

Alex: And we are also delighted to welcome Devika Nair, who is a nephrologist at Vanderbilt University Medical Center in Tennessee Valley VA Healthcare System. That includes many medical specialists, surgical specialists, many specialists and many other disciplines who are on our older adults team. Rasheeda, welcome to GeriPal.

Complication 52

Complication Patient-Centered IT Patients 52

GeriPal

MARCH 9, 2023

Today we largely focus on reasons for caution, including: We know almost nothing about psychedelics in older adults – only about 1% of patients in published trials were older adults, much less older adults with multiple chronic conditions, multiple medications, and frailty. Alex: It’s complicated. Or does it? Eric: Yeah.

Patient-Centered 91

Patient-Centered Community IT Medical 91

GeriPal

SEPTEMBER 28, 2023

Summary Transcript Summary Medical communication is tough, although fundamentally at its most basic unit of delivery, it includes really only three steps. Eric: Well, this is the part that I love about your article, too, is that it’s not just these big, big family meetings where miscommunication happens. Simple, right?

Families 144

Families Family Patient-Centered IT 144

GeriPal

JANUARY 25, 2024

The article we discuss today, also published in JAMA , addresses these two gaps. Alex: We are delighted to welcome David Bekelman who’s a palliative care physician and researcher at the University of Colorado School of Medicine Anschutz Medical Campus. It used to be a much more complicated model. David: Thank you.

Patient-Centered 122

Patient-Centered IT Illness Patients 122

GeriPal

NOVEMBER 7, 2024

And the main topic of today is a paper in Annals of Internal Medicine , Maria first author, that addressed the tradeoffs between initiating dialysis vs continued medical/supportive management. Eric 00:13 And, Alex, I am very excited today because there was an awesome article on Annals on conservative management versus dialysis.

Management 116

Management Patient-Centered Patients IT 116

GeriPal

MAY 22, 2025

You can hear Tyler and I having a great time singing together and sharing stories around his podcast My Medical Mixtape. And I was fortunate to record an episode of my medical mixtape with Tyler at the w hich meeting were we at, Tyler ? And so this is a shout out to our inpatient palliative team at Dell Medical School.

IT 97

IT Patient-Centered Patients Board-Certified 97

GeriPal

OCTOBER 12, 2023

And, what if your surgeon openly discussed the expected ‘bad stuff’ of post-operative recovery, instead of rotely reciting a list of possible complications? Alex: And we’re delighted to welcome Justin Clapp, who is assistant professor of anesthesia and critical care and medical ethics and health policy. Gretchen: Thank you.

IT 128

IT Families Family Patient-Centered 128

GeriPal

FEBRUARY 8, 2024

Accreditation In support of improving patient care, UCSF Office of CME is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

IT 137

IT Families Family Physicals 137

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 really am fascinated by tough medical decisions. Scott: Sure. Thanks Eric.

Management 122

Management IT Medical Patient-Centered 122

GeriPal

NOVEMBER 17, 2022

We’ve got a, Sheryl published a great article, and Kenny and Ken published an editorial for that article. The songs about how saving lives is actually a pretty complicated business. And that’s why I think your article is so important is that we need standards. And which journal again? Eric: JAMA Network Open.

Community 97

Community IT Mental Health Medical 97

GeriPal

AUGUST 11, 2022

He’s assistant professor of medicine at UCSF, and he’s one of my former research mentees, and he’s very interested in medical ethics and decision making in the ICU. There was a Stanford article talking about you as a pioneer in this field. I was a medical and psychiatric resident between 1977 and 1982.

Illness 109

Illness IT Families Family 109

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’s been a while since we’ve done a Covid/bioethics podcast (see prior ethics podcasts here , here , here , and here ). Emily: Great to be here. Emily: I do.

Vaccination 88

Vaccination Individual IT Healthcare 88

GeriPal

SEPTEMBER 7, 2023

He had a very aggressive lymphoma, highly aggressive, with a lot of different medical conditions. I slowly introduced higher doses as he recovered from his medical conditions that were acute. Eric: 80% that, I work with a lot of cancer patients, sometimes they have a lot of hope, maybe not a lot of trust in the medical system.

Patient-Centered 129

Patient-Centered IT Patients Clinic 129

GeriPal

JANUARY 26, 2023

Our guests Tim Farrell, Ramona Rhodes, and Nancy Lunderbjerg wrote an article in JAGS on this issue, and Sharon Brangman wrote a separate JAGS article on the need to achieve diversity in study populations. The article was titled, “ Change is coming ” – which also gives you a hint as to today’s song request.

IT 92

IT Patient-Centered Healthcare Patients 92

GeriPal

JUNE 30, 2022

Should she have an operation, and risk the pain, potential complications, and attendant delirium associated with the operation? And I came to the now I think naive conclusion that fixing and avoiding complications was the secret. You have a patient with dementia severe enough that she cannot recognize relatives. Did I get that right?

Patient-Centered 101

Patient-Centered Complication Patients IT 101

GeriPal

OCTOBER 26, 2023

Within hours of recording this podcast, I joined a family meeting of an older patient who had multiple medical problems including cancer, and a slow but inexorable decline in function, weight, and cognition. Eric: I felt that reading the article. We’ll have a link to that article on our show notes. Very excited to be here.

Patient-Centered 132

Patient-Centered Hospital Patients IT 132

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.” Emily is a bioethicist in the Department of Medical Ethics and Health Policy at the University of Pennsylvania. And I know we’re talking a lot about medical decision making.

Families 98

Families Family Patient-Centered IT 98

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. And I don’t think necessarily, that appointment needs to be a medicalized process. If you’re new to this discussion, don’t start with this podcast! I need structure.”

Illness 73

Illness IT Healthcare Patient-Centered 73

GeriPal

MAY 25, 2023

Complicated grief? Van Scoy who is a pulmonary critical care advance care planning researcher at Penn State Hershey Medical Center in Pennsylvania. 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. Depression?

Community 96

Community IT Patient-Centered Primary Care 96

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

AUGUST 24, 2023

Summary Transcript Summary I hear the word dignity used a lot in the medical setting, but I’m never sure what people mean when they use it. Medical Assistance in Dying and Palliative Care: Shared Trajectories Transcript Eric: Welcome to the GeriPal Podcast. Had multiple physical, psychological complications as a result of that.

Patient-Centered 98

Patient-Centered Patients IT Illness 98

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. We’re pretty familiar with that in palliative care.

Illness 101

Illness Mental Health IT Patient-Centered 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 ). I’m unsure what they do, how often they’re used, and who pays for their work. Jane: Right.

Provider 117

Provider Illness IT Healthcare 117

GeriPal

NOVEMBER 21, 2024

Here are some more resources we’ve discussed in the podcast Dani’s NEJM article on coping: “ Should I Laugh at That? It’s amazing how often when we’re taking care of somebody in the hospital, if you have Say, you know, a family member who is not showing up for visits with the medical team or who is. Does that sound right?

Illness 125

Illness IT Patient-Centered Patients 125

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. And so for me, I started off at one particular institution for medical school and went to another and noticed quite a few differences. ” So we kept going.

Hospital 125

Hospital IT Patient-Centered Patients 125

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! And he’s a professional Uber driver for his daughter’s softball games. Respectful disagreement is in short supply these days.

Patient-Centered 126

Patient-Centered IT Patients Illness 126

GeriPal

JANUARY 11, 2024

Summary Transcript Summary Four percent of deaths in Canada are due to Medical Assistance in Dying (MAID). What’s up with Medical aid in dying in Canada? Eric: So again, the topic is going to be medical aid in dying in Canada. Four percent. Transcript Eric: Welcome to the GeriPal Podcast. This is Eric Widera.

Illness 144

Illness IT Medical Provider 144

GeriPal

JUNE 15, 2023

For example, there was one article that we reviewed for Jags where it asked great questions, they gave great prompts, and ChatGPT answered great questions about antipsychotics and gave a list of references to back up ChatGPT’s assertions. Our names were slightly off. And they were complete hallucinations.

IT 99

IT Patient-Centered Patients Healthcare 99

GeriPal

MARCH 30, 2023

We’ve also love to hear from you on twitter and facebook your own experiences writing for the medical world (and please include links!) Today we’re going to be talking about narrative writing specifically for healthcare professionals. Transcript Eric: Welcome to the GeriPal podcast. This is Eric Widera.

IT 96

IT Patient-Centered Patients Healthcare 96

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. Raj: It was indeed very, very gradual, and the seeds were sown when I was a medical student. Raj: That’s one of the high tech medical absurdities that we have developed.

Community 115

Community IT Relationship Healthcare 115

GeriPal

SEPTEMBER 5, 2024

And he’s also chaired the California Pacific Medical Center’s ethics committee since 1985. And for this podcast in particular, both Bill and Louise wrote articles that we’re going to be discussing particular patient cases. So while you don’t have to, we’re gonna summarize these articles. Here we go.

Patients 98

Patients IT Patient-Centered Hospital 98

GeriPal

MAY 4, 2023

We remember bucking the rules, figuring out who you are, hair on fire, feeling invulnerable, trying to figure out who you are – and now those adolescents are stuck in the hospital, with doctors and parents telling them what to do, having their autonomy crushed by the medical institution, realizing they’re not invulnerable. Abby: Yeah.

IT 83

IT Families Family Illness 83