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“The physician–patient encounter is health care’s choke point” -NEJM

A Country Doctor Writes

Six years ago, I wrote the essay below about an article I read in the New England Journal of Medicine. This week’s Journal has a very profound article about why healthcare has not evolved through its technology the way other sectors of society have. We meet people where they are and in many different ways.

Patients 130
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Palliative care for cancer: Podcast with Jennifer Temel and Areej El-Jawahri

GeriPal

Alex: And we are also delighted to welcome Areej El-Jawahri, who is an oncologist at Massachusetts General Hospital as well, who specializes in blood cancers. 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? Jennifer: Thanks.

Illness 110
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Storycatching: Podcast with Heather Coats and Thor Ringler

GeriPal

As Thor notes, capturing patient stories has face validity as positively impacting the patients who share their stories and have them documented, and for the clinicians who get to truely and deeply know their patients in far greater depth than “what brought you to the hospital?” Every Veteran has a story. Our mission is to help them tell it.

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AGS Beers Criteria for Potentially Inappropriate Medication Use: A Podcast with Todd Semla and Mike Steinman

GeriPal

Eric: And in the article that’s being published in JAGS, you have multiple tables. I feel like geriatricians have a, maybe it’s more of a hate/hate relationship with NSAIDs right now. Ruining the patient doctor relationship because you get into a fight about what anti-coagulants should be on.

Medical 97
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Surrogate Decision Making: Bernie Lo and Laurie Dornbrand

GeriPal

The hospital refused without a court order, and the case eventually made its way to the Supreme Court. The Cruzan ruling led to a flood of interest in Advance Directives, and eventually to the Patient Self Determination Act, which mandates provision of information about advanced directives to all hospitalized patients.

Family 112
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Is it time for geriatricians to get on board with lecanemab? Jason Karlawish and Ken Covinsky

GeriPal

In an article in the NEJM (a published article this time, wonder of wonders!) Been in the hospital four times, vented, been told the story to her family, she won’t live. Within the VA it’s now at 70 VA hospitals. But wait, there’s a shiny new anti-amyloid drug, lecanemab! (No She was a heart failure patient.

IT 105
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RCT of PC in ED: Corita Grudzen, Fernanda Bellolio, & Tammie Quest

GeriPal

Today we discuss: Why the study was negative for the primary (hospitalization) and all secondary outcome (e.g. Tammie 03:04 Depends on how long they were pre-hospital. So that study was focused on patients admitted to the hospital. Corita 09:39 Yeah, so we used the electronic health record, I think, in support.