GeriPal

JANUARY 12, 2023

Which patients are eligible to go to an ACE unit? If you want to do a deeper dive in ACE units, check out some of the following articles: The original NEJM paper on ACE units from 1996. So I picked the Ed Sheeran song, The A Team, because it reminds me of our ACE team that goes around the hospital and cares for our older patients.

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Hospital Patient-Centered IT Nurse Practitioner 100

Rao Doctor

APRIL 3, 2025

In my previous article I covered the types of illness and the causes. When assessing a fever, we doctors employ a systematic approach to ensure accurate diagnosis and effective management. Understanding the patient’s medical history is crucial for an accurate diagnosis. FEVER FAQs (contd.)

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Diagnosis Management Illness Diagnose 130

GeriPal

NOVEMBER 7, 2024

Summary Transcript CME Summary We recently published a podcast on palliative care for kidney failure, focusing on conservative kidney management. Today we’re going to focus upstream on the decision to initiate dialysis vs conservative kidney management. This is Eric Widera. Alex 00:12 This is Alex Smith. So we got a lot to cover.

Management 116

Management Patient-Centered Patients IT 116

GeriPal

JUNE 16, 2022

There are a lot of old myths out there about managing urinary tract symptoms and UTI’s in older adults. Then we chat with Scott Bauer, internist and researcher at UCSF, about how to assess and manage lower urinary tract symptoms in men. Summary Transcript Summary. And so really am fascinated by tough medical decisions. Eric: Yeah.

Management 122

Management IT Medical Patient-Centered 122

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

JANUARY 25, 2024

He also found gaps, including very few studies of patients with lung disease, and little impact of trials on quality of life. The article we discuss today, also published in JAMA , addresses these two gaps. Your research is a lot in this patient population, right? Big randomized control study that came out. Lyndsay: Yes.

Patient-Centered 122

Patient-Centered IT Illness Patients 122

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. Katie, welcome back to GeriPal. Jessie, welcome back to GeriPal.

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Illness Patient-Centered Screening Clinic 136

GeriPal

OCTOBER 24, 2024

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 I met a patient in clinic once who asked me a lot of really intelligent questions about medical cannabis, what it does. They just kept at it.

Medical 98

Medical IT Patient-Centered Healthcare 98

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.

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IT Patient-Centered Patients Board-Certified 96

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. Des delivered a plenary at this year’s National Palliative Care Research Center’s Foley retreat. That rings true to me. All hands go up. All hands go down. Des: Thank you so much.

Mental Health 122

Mental Health Patient-Centered Illness Screening 122

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

SEPTEMBER 7, 2023

Does it improve outcomes that patients, caregivers, and clinicians care about? hint: 80% can be done in advance by patients or caregivers) Why is it that some oncologists are resistant to conducting a geriatric assessment, yet have no problem ordering tests that cost thousands of dollars? Welcome back, William. Delighted to be here.

Patient-Centered 129

Patient-Centered IT Patients Clinic 129

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

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

JANUARY 16, 2025

So I think the first reason that we saw and felt the opportunity was ripe for updating was that some of us had come across some anecdotal examples of patients expressing some offense to that terminology. And I was asking this patient about if he had filled out an advanced directive. Is the patient in your descriptor?

Patient-Centered 109

Patient-Centered IT Patients Healthcare 109

GeriPal

DECEMBER 8, 2022

Clinicians “catching” patient life stories. . Our patients aren’t “the 76 year old with heart failure in room 202,” as Heather Coats astutely noted. My Life, My Story: VA’s healthcare improvements through deliberate storytelling – YouTube. Storytelling Helps Hospital Staff Discover The Person Within The Patient.

Patient-Centered 115

Patient-Centered Illness Healthcare IT 115

GeriPal

MARCH 2, 2023

The FDA-approved indications for gabapentin are only for treating patients with partial seizures or postherpetic neuralgia. valproic acid and gabapentin), in nursing homes, particularly patients with Alzheimer’s disease and related dementias. There are a lot of reasons that may explain the massive increase in use of these drugs.

Patient-Centered 96

Patient-Centered IT Healthcare Medical 96

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. The patient’s capacity to make decisions was marginal, and his sons were shouldering much of the responsibility.

Patient-Centered 132

Patient-Centered Hospital Patients IT 132

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

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 128

IT Families Family Patient-Centered 128

GeriPal

MAY 8, 2025

Summary Transcript CME Summary Weve covered psychedelics on the podcast beforefirst in 2019 with Ira Byock, where we explored their potential role in medicine , and then again in 2023 with Stacy Fischer, Brian Anderson, and Theora Cimino, focusing on the reasons to approach psychedelic use in patients with caution. Gordon Alwasa.

Illness 107

Illness IT Patient-Centered Patients 107

GeriPal

FEBRUARY 8, 2024

Hospital Chaplains, Spirituality, and Pain Management: A Qualitative Study. Pain Manag Nurs. I think even the word patient, patient, I think, comes from the word suffer, the one who suffers. Our guests are BJ Miller, palliative care physician and c-founder of Mettle Health , and Naomi Saks, chaplain at UCSF. 2023.11.004.

IT 137

IT Families Family Physicals 137

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

DECEMBER 15, 2022

In an article in the NEJM (a published article this time, wonder of wonders!) Along the way we address: Is this degree of slowed cognitive decline meaningful to patients or care partners? She was a heart failure patient. But wait, there’s a shiny new anti-amyloid drug, lecanemab! (No Alex: It’s a great choice.

IT 105

IT Patient-Centered Healthcare Illness 105

GeriPal

JUNE 15, 2023

Alex: And we have Matt DeCamp, who’s joining from the University of Colorado, where he is a primary care internist and bioethicist at the Center for Bioethics and Humanities. My worry though with that is that are we going to be expected to be more productive then, to see more patients? Welcome to the GeriPal podcast, Charlotta.

IT 99

IT Patient-Centered Patients Healthcare 99

GeriPal

FEBRUARY 6, 2025

On todays podcast, weve invited Nathaniel Chin back to the GeriPal podcast to talk about what primary care needs to manage this new world of Alzheimers disease effectively. He is associate professor at the University of Wisconsin and medical director of their Alzheimer’s Disease Research Center. Nate 00:25 Thanks for having me.

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Primary Care Diagnosis Screening IT 95

GeriPal

DECEMBER 14, 2023

More recently Sharon Kaufman ‘s book And a Time to Die described the ways in which physicians, nurses, hospital systems, and payment mechanisms influenced the hour and manner of patient’s deaths. We discuss the moral distress that clinicians felt including, as one physician put it, a sense of your soul being ripped out.

Hospital 125

Hospital IT Patient-Centered Patients 125

GeriPal

FEBRUARY 29, 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 126

IT Patient-Centered Illness Education 126

GeriPal

MAY 15, 2025

Prior podcasts on the ethics of nudging , and a different trial conducted by Kate and Scott in which the default for hospitalized seriously ill patients was to receive a palliative care consult. Clinicians were randomized to 4 groups: Usual care Prognosis nudge – EHR prompt asking, do you think your patient will be alive in 6 months?

Patient-Centered 116

Patient-Centered Hospital IT Illness 116

GeriPal

AUGUST 11, 2022

We talk with Susan about how far the field has come, from early days when the attending physician would decide which patients were DNR and place a black “no code” dot in the chart. There was a Stanford article talking about you as a pioneer in this field. There was no conversation with the patient or the family about this.

Illness 109

Illness IT Families Family 109

GeriPal

JUNE 30, 2022

You have a patient with dementia severe enough that she cannot recognize relatives. Should she be treated non-operatively, with aggressive symptom management? And there’s been some recent research specifically about in fractures for patients that are very frail or have dementia and it’s sort of the same thing.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

GeriPal

AUGUST 24, 2023

Harvey is probably best known for his work in developing dignity therapy, a psychological intervention designed specifically to address many of the psychological, existential, and spiritual challenges that patients and their families face as death approaches. So I identified myself, and was working in our local cancer center.

Patient-Centered 98

Patient-Centered Patients IT Illness 98

GeriPal

FEBRUARY 2, 2024

First, in our editorial, we expressed concern about the length of stay metric not being patient centric, though important for health systems focused on cost savings. And PAIR stands for the Palliative and Advanced Illness Research Center. Also a core faculty member at the PAIR Center at the University of Pennsylvania.

Consulting 120

Consulting Hospital Patient-Centered IT 120

GeriPal

APRIL 24, 2025

We and our guests have noticed that in our clinical practices, patients and caregivers seem to be asking for such treatments more frequently. We discuss an article they wrote about PULET for the American Journal of Hospice and Palliative Medicine, including: What makes a PULET a PULET? Ivermectin to treat cancer. Stem cell treatments.

Patient-Centered 77

Patient-Centered IT Patients Illness 77

GeriPal

APRIL 10, 2025

I asked emergency medicine clinicians what they thought when a patient who is seriously ill and DNR comes to the ED, and some responded, (paraphrasing), what are they doing here? Most emergency providers wanted to do the right thing for seriously ill patients, but they didnt have the knowledge, skills, or experience to do it.

Patient-Centered 77

Patient-Centered IT Hospital Patients 77

GeriPal

NOVEMBER 21, 2024

We are going to tackle this question and so many more about coping on this week’s podcast with Dani Chammas , a recurring GeriPal guest, psychiatrist, and palliative care doc at UCSF, and Amanda Moment , a Palliative Care Social Worker at Brigham and Women’s Cancer Center. Coping is something that we see our patients do.

Illness 125

Illness IT Patient-Centered Patients 125

BMJ

MAY 10, 2022

Introductory article to İkİIşik H, Sezerol MA, Taşçı Y, et alCOVID-19 vaccine hesitancy and related factors among primary healthcare workers in a district of Istanbul: a cross-sectional study from TurkeyFamily Medicine and Community Health 2022;10:e001430. Statistical significance level was accepted as p<0.05. 150 (54.3)

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Vaccination Healthcare Professional Healthcare Primary Care 40