The Clinical Problem Solvers

NOVEMBER 22, 2021

Together, these two phenomenal guests help us understand the structural and individual challenges of Indigenous peoples in academic medicine, public health, and beyond. Sophie Neuner, proud member of the Karuk Tribe, and a Research Associate at the Johns Hopkins Center for American Indian Health.

Community 52

Community Patient-Centered Medical Student Medical 52

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. Think about the last time you attended a talk on communication skills or goals of care discussions.

IT 102

IT Screening Hospital Clinic 102

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

Pamela Wible MD

JUNE 20, 2025

He overheard the term and used it to describe himself and clinic staff in a 1974 article on staff burnout detailing long-term physical and psychological job stress. Psychiatrists define burnout as a job-related dysphoria in an individual without major psychopathy—meaning you’re normal; your job is killing you. So what’s the real issue?

Medical Student 246

Medical Student Diagnosis Physicals Medical 246

GeriPal

JUNE 8, 2023

Should we use Ozempic (if we can find it) in patients with serious illness, which often results in undesirable and profound weight loss? 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.

Diabetes 74

Diabetes Management Patient-Centered Families 74

GeriPal

MAY 8, 2025

We’ll discuss three recent clinical trials involving patients with serious illness, joined by our guests James Downar , Ali John Zarrabi , and Margaret Ross. We’re going to be talking about new research in psilocybin in serious illness. This is Eric Widera. Alex 00:03 This is Alex Smith. Thats a lot of S s. Gordon Alwasa.

Illness 107

Illness IT Patient-Centered Patients 107

Rao Doctor

APRIL 3, 2025

In my previous article I covered the types of illness and the causes. Assessing Accompanying Symptoms in fever In addition to temperature measurement, we doctors evaluate accompanying symptoms to determine the potential causes of illness. F (38°C) is generally regarded as indicative of illness. FEVER FAQs (contd.)

Diagnosis 130

Diagnosis Management Illness Diagnose 130

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

APRIL 14, 2022

On today’s podcast we talk with three experts on buprenorphine on why, when, and how to use it in serious illness. 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: . Transcript.

Illness 102

Illness Patient-Centered IT Patients 102

GeriPal

AUGUST 31, 2023

Summary Transcript Summary How do people react when they hear they have a serious illness? And some people, in addition or instead, engage in deep introspection on how to make meaning or live with or understand this experience of serious illness. Shock, “like a car is rushing straight at me” (says Bill Gardner on our podcast).

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Illness IT Diagnose Medical 128

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. The article we discuss today, also published in JAMA , addresses these two gaps. Welcome to GeriPal, Lyndsay. Lyndsay: Thank you so much.

Patient-Centered 122

Patient-Centered IT Illness Patients 122

GeriPal

OCTOBER 5, 2023

Summary Transcript Summary Communicating about a serious illness is hard. Last week’s podcast we talked about the challenge around miscommunication in serious illness. This week we dive into the challenges with communication when it comes to life sustaining treatments and CPR. Welcome to the GeriPal podcast. Jacky: Thank you.

Illness 136

Illness IT Patient-Centered Families 136

GeriPal

DECEMBER 19, 2024

Still, we havent talked about integrating palliative care into psychiatry or in the care of those with severe mental illness. What does it look like to take a palliative approach to severe mental illness? Is “terminal” mental illness a thing? Dani, welcome back. Dani 01:17 Always a pleasure. Dani 01:30 The Pal.

Illness 101

Illness Mental Health IT Patient-Centered 101

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.

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IT Patient-Centered Healthcare Illness 105

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 114

IT Provider Patients Families 114

GeriPal

MARCH 9, 2023

Two of our guests today, Stacy Fischer and Brian Anderson, are involved in large multicenter trials of psychedelics for patients with advanced cancer (Fischer) or life-limiting illness (Anderson). And yet there are reasons for caution. Eric, did you take your ketamine before this podcast? Eric: No, I did a little psilocybin. Theora: It is.

Patient-Centered 91

Patient-Centered Community IT Medical 91

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

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

DECEMBER 8, 2022

Unpacking characteristics of spirituality through the lens of persons of colour living with serious illness: The need for nurse-based education to increase understanding of the spiritual dimension in healthcare. What Mattered Then, Now, and Always: Illness Narratives From Persons of Color. Summary Transcript Summary. Wonderful work.

Patient-Centered 115

Patient-Centered Illness Healthcare IT 115

GeriPal

JULY 28, 2022

GeriPal post on “fast food” style palliative care in chronic critical illness. And I just want to highlight, Jennifer has a great JPSM article that just came out. Areej’s study is remarkably novel in that it is, to our knowledge, the first study of palliative care during curative treatment. . Palliative care in lung and GI cancers.

Illness 110

Illness Hospital Patient-Centered Patients 110

GeriPal

OCTOBER 20, 2022

This all came out from JAGS just published their first Clin-STAR corner, which is, and we’ll talk about what that is, but it’s a series of articles bringing in specialists to talk about updates in the last couple years within their field. How to make your voice heard and get involved. Eric: Welcome to the GeriPal podcast.

Complication 52

Complication Patient-Centered IT Patients 52

GeriPal

FEBRUARY 8, 2024

The illness narratives suffering, healing, and the human condition. Hospital Chaplains, Spirituality, and Pain Management: A Qualitative Study. Pain Manag Nurs. 2023 Dec 20:S1524-9042(23)00202-3. doi: 10.1016/j.pmn.2023.11.004. 2023.11.004. Epub ahead of print. PMID: 38129210. Kleinman, A. Accepting This Poem by Mark Nepo [link] Saks, N.,

IT 137

IT Families Family Physicals 137

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 96

Community IT Patient-Centered Primary Care 96

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

JANUARY 16, 2025

Summary Transcript CME Summary Many older adults lose decision-making capacity during serious illnesses, and a significant percentage lack family or friends to assist with decisions. How should we care for unrepresented individuals in inpatient and outpatient settings? Why not use the older term unbefriended? Can you guys do that one?

Patient-Centered 109

Patient-Centered IT Patients Healthcare 109

GeriPal

FEBRUARY 23, 2023

Today we talk with Anne Rohlfing, Lynn Flint, and Anne Kelly, authors of a JGIM article on the reasons we shouldn’t stop at “no.” We owe it to the patient to explore the reasons behind the “no,” commonly not wanting to be a burden to their family. That’s a huge amount of news all at once. This is Eric Widera. Alex: This is Alex Smith.

Families 98

Families Family Patient-Centered IT 98

GeriPal

MARCH 24, 2022

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. Assigning a surrogate decision maker is important for everyone, including those who don’t have serious illness. Where does POLST fit in with this debate? Among other topics.

Illness 73

Illness IT Healthcare Patient-Centered 73

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

NOVEMBER 7, 2024

We also briefly mention Susan Wong’s terrific studies that found a disconnect between older adults with renal failure’s expressed values, focused on comfort, and their advance care planning and end-of-life care received, which focused on life extension; and another study that found quality of life was sustained until late in the illness course.

Management 116

Management Patient-Centered Patients IT 116

GeriPal

MAY 4, 2023

Eric: So we’re going to be talking about palliative care for adolescents, and young adults. Why does it feel different? Does it feel different? How should we think about the care? But before we do, Abby, I think you have a song request for Alex. Abby: I do. So I requested that Alex play for us, Let It Grow, which is from The Lorax soundtrack.

IT 83

IT Families Family Illness 83

GeriPal

OCTOBER 19, 2023

Additional links mentioned in the podcast: Recent JGIM article on POLST in California nursing homes, hospitalization, and nursing home care Karl’s GeriPal post on appropriate use of POLST Enjoy! The answers to these questions will vary. Reasonable people will disagree. And today, on our podcast, our guests disagree. Welcome, Karl.

Patient-Centered 126

Patient-Centered IT Patients Illness 126

GeriPal

JANUARY 11, 2024

To be eligible in Canada patients must have a “ grievous and irremediable ” condition, including disability ; they do not have to have a terminal illness with a prognosis of less than 6 months. A planned expansion of MAID to include people with mental illness was placed on hold until March 2024. Four percent.

Illness 144

Illness IT Medical Provider 144

GeriPal

FEBRUARY 27, 2025

Today we talk with experts Janet Ho, Sach Kale, and Julie Childers about opioid use disorder and serious illness. Eric 00:51 So we’re gonna be talking about caring for people with serious illness and substance abuse. Who has a song request for Alex before we talk about substance use disorder and serious illness?

Patients 73

Patients Clinic Patient-Centered Illness 73

GeriPal

APRIL 4, 2024

This topic came up with Bernie published an article in New England Journal called Deciding for Patients Who Have Lost Decision-Making Capacity Finding Common Ground in Medical Ethics. The hospital refused without a court order, and the case eventually made its way to the Supreme Court. What words to use? Is the POLST useful? Alex: Thank you.

Families 112

Families Family Patient-Centered IT 112

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. Participants were critically ill and intubated. P AI R stands for Palliative and Advanced Illness Research Center. What is sludge?

Patient-Centered 117

Patient-Centered Hospital IT Illness 117

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 96

Primary Care Diagnosis Screening IT 96

GeriPal

APRIL 24, 2025

We discuss an article they wrote about PULET for the American Journal of Hospice and Palliative Medicine, including: What makes a PULET a PULET? If its potentially unsafe, but has robust evidence, well thats most of the treatments we offer seriously ill patients! Key ingredients are both potentially unsafe and low evidence.

Patient-Centered 77

Patient-Centered IT Patients Illness 77