The Motivated MD

NOVEMBER 19, 2024

When Passion Loses to Productivity Adjusting to Life’s Cadence Anyone Can Do It Plans Moving Forward Lessons Learned From My Hiatus Where Have I Been? So, lets start by addressing my absence. There is no one thing I can point to explain my hiatus in it entirety. I no longer found it enjoyable to write post after post. Anyone can do it.

Finance 52

Finance Education Families Family 52

GeriPal

AUGUST 4, 2022

Today we are coming back for more (or less given the content), talking about the following articles with their lead authors: First up, we talk with Ariel Green about her article in JAMA Network on preferred phrases a clinician may use to explain why they should reduce or stop the medication. Alex: So this is Super special 2.

Specialization 104

Specialization Medical Patient-Centered Provider 104

GeriPal

DECEMBER 2, 2022

So on today’s podcast we invite four brilliant individuals to talk about their perspective on how to change how we as a society and health care system partner with individuals with dementia. We’re going to be talking about things like creative engagement in individuals with dementia. Summary Transcript Summary.

Community 101

Community IT Individual Patient-Centered 101

GeriPal

MAY 5, 2022

We talk with Nick and Meg about: Why hearing loss is important not just in geriatrics but also for those caring for seriously ill individuals. Communication techniques we can use when talking to individuals with hearing loss. COVID-19, masks, and hearing difficulty: Perspectives of healthcare providers. I’m guessing not.

IT 102

IT Screening Hospital Clinic 102

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. Summary Transcript Summary Coaching is in. When I was a junior faculty, coaching wasn’t a thing. We address: What is coaching? How does it differ from therapy? This is Eric Widera.

Board-Certified 110

Board-Certified IT Primary Care Referral 110

GeriPal

JULY 19, 2024

What should we use to screen individuals? There’s an article about her in New York Times. Summary Transcript Summary The US Preventive Services Task Force (USPSTF) concluded back in 2000 that there is insufficient evidence to recommend for or against routine screening for dementia in older adults. Should it? Soo 00:32 Thanks.

Screening 119

Screening Primary Care Patient-Centered IT 119

GeriPal

JUNE 8, 2023

We debate the merits of use of CGM in the nursing home and other late life settings (Eric and I argue against CGM and lose). Ozempic is a new fancy med that, by the way, leads to weight loss among celebrities, resulting in shortages of the drug from people using it off-label for that purpose. Listen in to learn more! Nadine: I do. Good choice.

Diabetes 73

Diabetes Management Patient-Centered Families 73

GeriPal

MAY 11, 2023

And because we can’t resist, we dip into aducanumab and lecanemab at the end. AlexSmithMD Transcript Eric: Welcome to the GeriPal Podcast. This is Eric Widera. Kristine, do you have a song request for Alex? Kristine: Well, I did have a song, but I was negligent at giving it to him. So, he tried to read my mind… Eric: What was your song?

Physicals 85

Physicals IT Hypertension Education 85

Rao Doctor

APRIL 3, 2025

In my previous article I covered the types of illness and the causes. While mild fevers often resolve on their own, persistent or severe fevers warrant professional evaluation. FEVER FAQs (contd.) In case you have missed it, click below to read- FEVER FAQ- Part 1 Fever Diagnosis: How is your health assessed? And I do this regularly.

Diagnosis 130

Diagnosis Management Illness Diagnose 130

The Motivated MD

SEPTEMBER 19, 2024

For the better half of 2024, I have been periodically writing posts that are individual articles that double as potential chapters to a future book. Before we discuss each individual savings account, let us first highlight exactly what it means to ‘automate’ your savings. So yes, humans make mistakes.

Finance 52

Finance Individual Education Healthcare Professional 52

GeriPal

MARCH 24, 2023

For a deeper diver into these issues, check out some of the following links: Ira’s Stat new article “Hospice care needs saving” GeriPal’s episode on the growing role of private equity in hospice care Acquisitions of Hospice Agencies by Private Equity Firms and Publicly Traded Corporations. JAMA Health Forum. Is it you, Ira?

IT 113

IT Provider Patients Families 113

GeriPal

NOVEMBER 2, 2023

First, we’ve invited Jerry Gurwitz to talk about his recently published article in JAMA titled The Paradoxical Decline of Geriatric Medicine as a Profession (while it’s not the most upbeat title for the future of geriatrics, Jerry sees it as a call to action). Mike, welcome to GeriPal. Mike: Great to be here. Jerry: I sure am.

Board-Certified 91

Board-Certified IT Community Medical Student 91

GeriPal

APRIL 3, 2025

We discuss our favorite articles, parody songs, and memories from AGS meetings past, with a little preview of a song for this years meeting. We covered: The first parody song I wrote, for AGS 2018 in Orlando , about this article by Nancy Schoenborn on how to discuss stopping cancer screening. And then I got to choose the first article.

IT 64

IT Hospital Screening Patients 64

GeriPal

DECEMBER 15, 2022

In an article in the NEJM (a published article this time, wonder of wonders!) We’ve talked at length on prior podcasts about the failures of aducnumab, Biogen, and the FDA’s decision to approve it. . But wait, there’s a shiny new anti-amyloid drug, lecanemab! (No No it’s not just the French version of Aducanumab). . Transcript.

IT 105

IT Patient-Centered Healthcare Illness 105

GeriPal

JANUARY 25, 2024

The article we discuss today, also published in JAMA , addresses these two gaps. Summary Transcript Summary In a JAMA 2020 systematic review of palliative care for non-cancer serious illness, Kieran Quinn found many positives, as we discussed on our podcast and in our editorial. Welcome to GeriPal, Lyndsay. Lyndsay: Thank you so much.

Patient-Centered 122

Patient-Centered IT Illness Patients 122

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. How does life expectancy fit in with all of this? To learn more about CME for other GeriPal episodes, click here. Alex 00:41 Free Fall in’?

IT 124

IT Patient-Centered Screening Community 124

GeriPal

MAY 18, 2023

We’ve invited two members who helped update the criteria including Todd Semla and Mike Steinman. We discuss a little history of the Beers criteria, including the original Beers Criteria that was published by the late Dr. Mark Beers, and how it has evolved over the last three decades. Alex: We’re having Beers. We’ll learn about that.

Medical 97

Medical IT Patients Clinic 97

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 ). Evusheld is the latest case in point. . Emily: It is.

Vaccination 87

Vaccination Individual IT Healthcare 87

GeriPal

JANUARY 30, 2025

Find out on this weeks podcast where we invite Joseph Greer, Simone Rinaldi, and Vicki Jackson to talk about their recent JAMA article on Telehealth vs In-Person Early Palliative Care for Patients With Advanced Lung Cancer – A Multisite Randomized Clinical Trial. But watch out! Alex 01:06 Yeah, go in person. Vicki 02:10 Thank you.

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. He’s in Boston. Parag 01:06 Thank you.

Primary Care 113

Primary Care Patient-Centered IT Patients 113

GeriPal

FEBRUARY 8, 2024

MOC Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 0.75 MOC points per podcast in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. ABIM MOC credit will be offered to subscribers in November, 2024. Alex: Yeah.

IT 137

IT Families Family Physicals 137

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. ABIM MOC credit will be offered to subscribers in November, 2024.

Illness 136

Illness Patient-Centered Screening Clinic 136

GeriPal

OCTOBER 20, 2022

It’s Lona Mody who is a translational infectious disease researcher at the University of Michigan and VA Ann Arbor Healthcare System. And so there was a report in 2009 by the Institute of Medicine saying that we need to equip all of these individuals in caring for older person in an evidence based manner. This is Eric Widera.

Complication 52

Complication Patient-Centered IT Patients 52

GeriPal

MARCH 2, 2023

I could go on and on, but listen to the podcast instead and for a deeper dive, take a look at the following articles and studies: Gabapentin in the Perioperative setting: Prolonged use of newly prescribed gabapentin after surgery. By 2015 that number increased to 4% of US adults. J Am Geriatr Soc. Tasce: I do. Tasce: Yes. Taylor Swift.

Patient-Centered 96

Patient-Centered IT Healthcare Medical 96

GeriPal

FEBRUARY 29, 2024

The hot sauces progressed from mild to extreme (and I mean extreme) heat. Can I just say…it works? Being asked a question with your mouth on fire, sweat streaming down your face, feeling the most awake and terrified you have ever been in your life, forces you to give an unadorned answer, straight from the heart. Lynn: Okay. Anne: GeriPal edition.

IT 126

IT Patient-Centered Illness Education 126

GeriPal

MAY 25, 2023

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. And as you know, it’s a great article. In a group visit there is a social norming effect – “if my neighbor is doing it, perhaps I should be doing it to?”

Community 95

Community IT Patient-Centered Primary Care 95

GeriPal

MARCH 9, 2023

Eric, did you take your ketamine before this podcast? Eric: No, I did a little psilocybin. Eric: Thanks to our Ira Byock podcast. I forget how long ago that was. Alex: Yeah, it’s time to update, psilocybin is having a moment. We’re going to talk about that. Welcome back to GeriPal, Stacy. Stacy: It’s great to be here. Alex: Yeah.

Patient-Centered 91

Patient-Centered Community IT Medical 91

GeriPal

JANUARY 16, 2025

These individuals may become unrepresented, meaning they lack the capacity to make a specific medical decision, do not have an advance directive for that decision, and do not have a surrogate to help. How should we care for unrepresented individuals in inpatient and outpatient settings? Why not use the older term unbefriended?

Patient-Centered 109

Patient-Centered IT Patients Healthcare 109

GeriPal

SEPTEMBER 1, 2022

Social workers augment a team’s ability to provide whole-person care, often aiding to identify and meaningfully address the wide variety of challenges and unmet needs faced by individuals and families facing serious illness. So in preparation for this, I read a couple articles about social work leadership in palliative care.

IT 102

IT Families Family Clinic 102

GeriPal

MAY 8, 2025

And it kind of made its way into medicine probably around, I’m going to say the 50s after there was a fairly interesting Time Life article that was published. And when that article went to print, it just went ballistic. I’m actually going to show you a picture of the green doors just so you can see it. It’s there.

Illness 107

Illness IT Patient-Centered Patients 107

GeriPal

NOVEMBER 7, 2024

Eric 00:13 And, Alex, I am very excited today because there was an awesome article on Annals on conservative management versus dialysis. Do target trials differ from randomized trials and “ordinary” observational studies, or do they differ?!? Eric is skeptical. Let it be (hint hint). This is Eric Widera. Alex 00:12 This is Alex Smith.

Management 116

Management Patient-Centered Patients IT 116

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: . Article on buprenorphine in the elderly. It’s been around for a long time but is acting like the hot new kid in town.

Illness 102

Illness Patient-Centered IT Patients 102

GeriPal

FEBRUARY 6, 2025

Cant we skip all this and just send some blood-based biomarkers? What is the role of the amyloid antibody treatments? And my wife went to over, I want to say, 20 concerts. Eric 00:58 Have you been to a concert? Nate 00:59 I went one in Milwaukee, Wisconsin, and I’m so glad I did. Alex 01:07 And Bruce Springsteen did a stage dive. I loved it.

Primary Care 95

Primary Care Diagnosis Screening IT 95

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 before we get into this topic, does someone have a song request? Chrissy: I do. Alex: (Singing).

Management 122

Management IT Medical Patient-Centered 122

GeriPal

FEBRUARY 17, 2022

When we have a medication with up front harms and downstream benefits, it’s critical that we consider the time to benefit, or how long it will take an individual to benefit from a test or treatment. For individuals with a life expectancy less than the time to benefit, the up front harms outweigh the downstream benefits. . James: I do.

Clinic 67

Clinic IT Patients Medical 67

GeriPal

OCTOBER 26, 2023

Ann: Well, I think teamwork is key in this space and I am a big baseball fan, big Red Sox fan, which is not a good thing to be right now, but I really think it’s indicative of how we should all be working together on this team to help our seriously ill patients. Ann: No, he was very excited. And this time everybody’s joining in.

Patient-Centered 132

Patient-Centered Hospital Patients IT 132

GeriPal

OCTOBER 5, 2023

We’ve invited Jacqueline Kruser and Bob Arnold on this week’s podcast to talk about their recently published JAMA Viewpoint article titled “ Reconsidering the Language of Serious Illness. ” Summary Transcript Summary Communicating about a serious illness is hard. Welcome to the GeriPal podcast. Jacky: Thank you. It’s a pleasure.

Illness 136

Illness IT Patient-Centered Families 136