GeriPal

NOVEMBER 9, 2023

Today we learn more about coaching from 3 coaches: Greg Pawlson, coach and former president of the American Geriatrics Society, Vicky Tang, geriatrician-researcher at UCSF and coach , and Beth Griffiths, primary care internist at UCSF and coach. We address: What is coaching? How does it differ from therapy? From Beth Israel and UNC.

Board-Certified 110

Board-Certified IT Primary Care Referral 110

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. We also worked a little bit with the primary care team certain of the risk factors. So, for me, I don’t think it’s something I would advocate for patients.

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Physicals IT Hypertension Education 85

GeriPal

FEBRUARY 6, 2025

So, the question becomes, what, if anything, should we do differently in the primary care setting to diagnose the disease? 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. Great to be back.

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GeriPal

JANUARY 25, 2024

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. He also found gaps, including very few studies of patients with lung disease, and little impact of trials on quality of life.

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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. And also I was in the HVMA primary care program.

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Primary Care Patient-Centered IT Patients 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). I was going to start off by asking Jerry about why he wrote the JAMA article.

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Board-Certified IT Community Medical Student 91

GeriPal

NOVEMBER 14, 2024

Summary Transcript CME Summary Falls are very common among older adults but often go unreported or untreated by healthcare providers. Patients may feel like falls are just part of normal aging. You know, I wonder how much, because it’s probably not brought up a lot in primary care settings. Eric 04:51 Yeah.

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IT Patient-Centered Screening Community 124

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. John: Thank you.

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Patient-Centered IT Patients Clinic 129

GeriPal

MAY 18, 2023

There are some older adults in whom these are the correct drugs, either because of their particular clinical circumstances or because shared decision making and patient values and preferences. So we want to alert clinicians as well as patients and policy makers to the presence of these drugs. Is this the right drug for this patient?”

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Medical IT Patients Clinic 97

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.

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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.

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Patient-Centered Hospital Patients IT 132

GeriPal

JUNE 15, 2023

Alex: And joining us via Zoom, we have Charlotta Lindvall, who is a palliative care physician researcher who studies the intersection of natural language processing and communication data at Dana Farber Cancer Institute, where she also works in clinical informatics. Alex: Yeah, that means you could see more patients, right.

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IT Patient-Centered Patients Healthcare 99

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. Eric: Which brings us to an article. Jessie: Exactly.

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Illness Patient-Centered Screening Clinic 136

GeriPal

APRIL 4, 2024

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. You write about this, you’ve written this New England Journal article, you’ve written past articles.

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Family Families Patient-Centered IT 112

GeriPal

SEPTEMBER 5, 2024

And Bill Andereck is still haunted by the decision he made to have the police break down the door to rescue his patient who attempted suicide in the 1980s, as detailed in this essay in the Cambridge Quarterly of HealthCare Ethics. So while you don’t have to, we’re gonna summarize these articles.

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Patients IT Patient-Centered Hospital 98

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 that was one, very interesting to me. We do not improve mortality. Eric: All right.

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Management IT Medical Patient-Centered 122

GeriPal

MAY 25, 2023

Advance care planning doesn’t work. 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. Your thoughts? LJ: Definitely read it.

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Community IT Patient-Centered Primary Care 95

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. And man, I still remember those sessions, some of the most powerful learning experiences of my career as a palliative care doctor. Susan: Thank you.

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Illness IT Families Family 109

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. 150 (54.3) p<0.001 Doctor 83 (65.9) 126 (45.7) 162 (58.7) 228 (82.6)

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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.

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Patient-Centered IT Patients Illness 77

GeriPal

JUNE 22, 2023

Michele: Yeah, so in May of 2018, there was an article by Suleika Jaouad in the New York Times Magazine, and they spent about two weeks in our hospice with us learning about the work that’s done. And so the article focuses on the work of these three men who were mostly gang involved and did something really bad when they were young.

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Family Families IT Community 132

GeriPal

JUNE 30, 2022

You have a patient with dementia severe enough that she cannot recognize relatives. A huge part of this decision rests on (1) her previously stated wishes, values, and goals (prior to the onset of dementia); and (2) the outcomes of surgery for patients with dementia. Summary Transcript Summary. She falls and breaks her hip.

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Patient-Centered Complication Patients IT 101

GeriPal

MARCH 24, 2022

This is the latest in our series of podcasts on concerns about, and potential of advance care planning. 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. I worry, as a ex-primary care doctor, how much time I have.

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Illness IT Healthcare Patient-Centered 72

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 ).

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GeriPal

AUGUST 31, 2023

Juliet, last time we talked to you, you were talking about shifting from advanced care planning to serious illness conversations. 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.

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GeriPal

JUNE 5, 2025

How to think about primary and specialized palliative care in this setting. The obstacles hindering referrals to palliative care services. Practical strategies to overcome these barriers and enhance care. JAGS 2024 Nursing Home Palliative Care Referral Process, Barriers, and Proposed Solutions: A Qualitative Study.

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Referral Nurse Practitioner Consulting Board-Certified 78

GeriPal

APRIL 10, 2025

Summary Transcript CME Summary Early in my research career, I was fascinated by the (then) frontier area of palliative care in the emergency department. 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?

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Patient-Centered IT Hospital Patients 77

GeriPal

FEBRUARY 20, 2025

If you want a deeper dive, check out the following resources: Our Nature of Suffering podcast with BJ Miller and Naomi Saks Dani Chammas Annals paper on countertransference and why we shouldnt say that the patient was difficult rather than that I felt frustrated. We’re going to be talking about trauma informed care.

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IT Patient-Centered Individual Screening 66

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.

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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.

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GeriPal

MARCH 3, 2022

This idea that for critically ill patients in the ICU, geriatric conditions like disability, frailty, multimorbidity, and dementia should be viewed through a wider lens of what patients are like before and after the ICU event was transformative for our two guests today. GeriPal podcast with Linda Fried on frailty.

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Patient-Centered Patients IT Hospital 96

GeriPal

DECEMBER 5, 2024

We talked with Thor Ringler, who helped found the My Life My Story Project at the VA and beyond, and Heather Coats about the evidence base for capturing patient stories. – @AlexSmithMD Here’s a link to an article about the Palliative Story Exchange. ** This podcast is not CME eligible. And we had these amazing stories.

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GeriPal

MARCH 10, 2022

And to keep it short work for an article. Nursing homes are subsidized by their Medicare, by their rehab patients. And Medicaid doesn’t pay enough to pay for long-term care. Once a nursing home gets a bad reputation and they can’t attract the rehab patients anymore, they’re in big trouble. Eric: Yeah.

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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). And I’d say, particularly in healthcare, where we’re not very good. The experience of both patients and clinicians isn’t very good.

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IT Electronics Patients Healthcare 139

BMJ

AUGUST 20, 2021

By John Scott Frazer, Glenn Ross Frazer Reference : Frazer JS , Frazer GR, Analysis of primary care prescription trends in England during the COVID-19 pandemic compared against a predictive model, Family Medicine and Community Health 2021; 9: e001143.

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Primary Care Supply Chain General Practitioner Vaccination 40

GeriPal

MARCH 27, 2025

Today we are delighted to welcome Jennifer Wolff, Sydney Dy, and Danny Scerpella, who conducted a pragmatic trial of advance care planning (ACP) in primary care practices; and Jasmine Santoyo-Olsson, who wrote an accompanying commentary in JAMA Internal Medicine. Jennifer, welcome to the GeriPal Podcast. Sydney 00:41 Thank you.

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Primary Care IT Clinic Patient-Centered 79

GeriPal

MAY 1, 2025

And so the patients who had been admitted there to die, essentially most, if not all, got better and HIV became much more of a chronic condition. A review article, which I still like to go to. It is kind of weird that my first publication was in jama, part of the Care of the Aging Patient series. Meredith 11:29 Yeah.

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