Common Sense Family Doctor

DECEMBER 14, 2024

James Stevermer and Kenneth Fink wrote in an AFP editorial : Few men diagnosed with and treated for prostate cancer will experience a mortality benefit, and an estimated 20% to 50% of those treated will never become symptomatic, even without treatment. Explaining the AAFP’s position, Drs. Watchful waiting refers to clinical observation only.

Routine Screenings 52

Routine Screenings Screening Complication Diagnose 52

The Clinical Problem Solvers

FEBRUARY 9, 2020

Objectives Define likelihood ratios and their utility in diagnostic reasoning Identify how likelihood ratios alter the probability of a diagnosis Apply likelihood ratios in clinical reasoning What are likelihood ratios and how do they work? A LR > 1 increases the probability of a specific diagnosis.

Clinic 52

Clinic Diagnosis Hypertension Patients 52

The Clinical Problem Solvers

SEPTEMBER 28, 2019

If you’re anything like me, you’ve probably found yourself asking that question after listening to a discussant on the podcast arrive at some unexpected diagnosis, only to have the biopsy or lab test prove them right. Some specific activities mentioned by the participants included patient-directed reading (e.g., NEJM , JHM , JGIM ).

Lab Testing 52

Lab Testing Clinic Education Clinical Practice 52

AMMD

FEBRUARY 14, 2025

The average age of a breast cancer diagnosis has statistically been around 65. Now, roughly 9% of breast cancer diagnoses are in women under age 45 with this percentage continually rising(1). I will have an article about the dangers of gadolinium dye soon. Breast Cancer, as are all cancers, is on the rise. Don’t worry!

Diagnosis 130

Diagnosis Screening IT Patient-Centered 130

AMMD

APRIL 9, 2025

This is why many people fail to get a diagnosis. In this article, I’m going to help guide you through signs, symptoms, and ways to test for SIBO. How to Diagnose SIBO: Testing Options Conventional medicine fails us when it comes to solving complex gut issues. Many people chalk up digestive drama to something bad they ate.

IT 130

IT Diagnose Physicals Mental Health 130

AMMD

MARCH 13, 2025

In this article, you’ll learn what brain fog is, the causes of brain fog, and how to get rid of it. Brain fog is not a medical condition or a diagnosis. I’ll discuss more about how you can get rid of brain fog later in this article. I battled thyroid disease in medical school after being diagnosed with Graves’ disease.

IT 130

IT Medical Patient-Centered Relationship 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

PEMBlog

OCTOBER 26, 2023

Recognizing the characteristic features and understanding the differential diagnosis is crucial in managing patients with lower gastrointestinal bleeding. The Diagnosis of Meckel’s Diverticulum: A Continuing Challenge. Reference article, Radiopaedia.org (Accessed on 26 Oct 2023) [link] Sagar J, Kumar V, Shah DK.

Diagnosis 64

Diagnosis Complication Consulting Management 64

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 124

IT Hospital Patient-Centered Individual 124

GeriPal

JULY 19, 2024

There’s an article about her in New York Times. And so certainly from a family’s perspective, a family caregiver perspective, the last thing we want to have when it comes to good dementia care is a diagnose and audio scenario, or in this case, some type of screening result, and then we’ll see you again in six months.

Screening 119

Screening Primary Care Patient-Centered IT 119

GeriPal

DECEMBER 2, 2022

She directs UCSF MERI’s patient, family, and clinician support with classes and consultation on resiliency, well-being, and grief. You wrote about how when it comes to talking about patients with dementia, they’re rarely portrayed as resilient. Eric: In the article, you wrote about creative engagement. When was that, 2010?

Community 101

Community IT Individual Patient-Centered 101

GeriPal

NOVEMBER 9, 2023

On the other hand, there is a concerning side, described in this Guardian article titled, I’m a life coach, you’re a life coach: rise of an unregulated industry. We make a diagnosis. I was coaching someone this morning, who really wanted to know, what does your clinic template look like, and how do you respond to patient messages?

Board-Certified 110

Board-Certified IT Primary Care Referral 110

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

FEBRUARY 6, 2025

So, the question becomes, what, if anything, should we do differently in the primary care setting to diagnose the disease? We address the following questions with Nate: Has anything changed for the primary care doctor when diagnosing Alzheimers? How should we screen for cognitive impairment? Does a good history matter anymore?

Primary Care 95

Primary Care Diagnosis Screening IT 95

GeriPal

MAY 11, 2023

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. The biomarker discovery is tremendous, and I think truly will change the entire way ADRD is diagnosed and conceptualized in some ways. AlexSmithMD Transcript Eric: Welcome to the GeriPal Podcast.

Physicals 85

Physicals IT Hypertension Education 85

GeriPal

FEBRUARY 27, 2025

We address: Why is caring for patients with this overlap so hard? Sach Kale set up an outpatient clinic focused on substance use disorder for patients with cancer. Who follows the patient once the cancer goes into remission? Why am I having difficulty with this patient? Why am I feeling frustrated with this patient?

Patients 72

Patients Clinic Patient-Centered Illness 72

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. But watch out! Travel time can leave this champ vulnerable to fatigue and no-shows.

Telehealth 105

Telehealth Patient-Centered IT Patients 105

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. When I see a patient? Matthew, I get the lyrics.

Primary Care 113

Primary Care Patient-Centered IT Patients 113

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

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

APRIL 14, 2022

And if you want to learn more about buprenorphine from these amazing palliative care clinicians and others, check out of some of these articles: Learn more about caring for those with substance use disorder: . Adapting Palliative Care Skills to Provide Substance Use Disorder Treatment to Patients With Serious Illness . Transcript.

Illness 102

Illness Patient-Centered IT Patients 102

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. We’re going to be covering it in both cancer and in aging.

Illness 136

Illness Patient-Centered Screening Clinic 136

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 99

IT Patient-Centered Patients Healthcare 99

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 110

Illness Hospital Patient-Centered Patients 110

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 122

Management IT Medical Patient-Centered 122

GeriPal

FEBRUARY 22, 2024

As she said, when you think about the hardest patients you’ve cared for, in nearly all cases there was some aspect of psychological illness involved. Then, “Keep your hand up if you frequently refer patients with cancer pain to a psychologist?” That rings true to me. All hands go up. All hands go down.

Mental Health 122

Mental Health Patient-Centered Illness Screening 122

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?

Families 97

Families Family Patient-Centered IT 97

GeriPal

AUGUST 31, 2023

You’re a senior author on this article in JPSM, where you interviewed some geriatricians and other people caring for older adults, nurse practitioners, social workers, et cetera. One colleagues of mine in the Netherlands did just interviews with 30 cancer patients and this theme kept coming out. We could have talked for hours!

Illness 128

Illness IT Diagnose Medical 128

GeriPal

AUGUST 17, 2023

However, as noted in our editorial published with the donanemab trial , the modest benefits of amyloid antibodies would likely not be questioned by patients, clinicians, or payers if amyloid antibodies were low risk, inexpensive, and simple to administer. The patients continued to be followed. However, they are none of these.

Patient-Centered 98

Patient-Centered IT Clinic Patients 98

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.

Families 106

Families Family IT Patients 106

GeriPal

SEPTEMBER 1, 2022

So in preparation for this, I read a couple articles about social work leadership in palliative care. And the title of his article is, does culture of modern day palliative care social work leave room for leadership, where he interviewed six leaders in palliative care, five or six for social workers. Eric: All right, Barbara.

IT 102

IT Families Family Clinic 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 117

Provider Illness IT Healthcare 117

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. I think this is a really difficult topic to talk about with patients. She has a point. Prognosis is inherently uncertain.

IT 95

IT Clinic Screening Patients 95

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. And importantly the patient has to have capacity and they have to be able to take the drug themselves. So being well and also potentially periods of dying. Eric: Yeah.

Illness 144

Illness IT Medical Provider 144

AMMD

APRIL 1, 2025

Before I do, I want to set the intention for this article. Additionally, ensuring you have a proper diagnosis prevents treating the wrong problem. How Is Candida Diagnosed? If you suspect candida overgrowth, getting an accurate diagnosis is essential. Is candida a sexually transmitted disease?

Diagnose 130

Diagnose IT Provider Healthcare 130

GeriPal

APRIL 18, 2024

We discuss, among other things: Findings that in several studies AI was rated by patients as more empathetic than human clinicians (not less, that isn’t a typo). The experience of both patients and clinicians isn’t very good. Bob recently wrote an essay in JAMA on AI and delivered a UCSF Grand Round s on the same topic.

IT 139

IT Electronics Patients Healthcare 139

GeriPal

SEPTEMBER 19, 2024

Give too much, it may cause harm (even if the higher dose had no significant side effects, it would require patients to take a lot of unnecessary additional pills as well as increase the cost.) So, what is the effective dose of palliative care? Give too little – it may not work. Jennifer 04:25 I can take that on. Eric 05:32 Yeah.

Patient-Centered 119

Patient-Centered IT Patients Hospital 119