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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. Its basic argument was that it isn’t sustainable to only see patients one by one in traditional doctor visits. 1) Healthcare is not at all customer centered. We meet people where they are and in many different ways.

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Deprescribing Super Special III: Constance Fung, Emily McDonald, Amy Linsky, and Michelle Odden

GeriPal

Today, we explore four fascinating studies highlighting innovative approaches to reducing medication use and improving patient outcomes. Patients received brochures detailing the risks of gabapentinoids, nonpharmacologic alternatives, and a proposed deprescribing regimen (see here for the brochure ). in the usual care group.

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Substance Use Disorder in Aging and Serious Illness: A Podcast with Katie Fitzgerald Jones, Jessica Merlin, Devon Check

GeriPal

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. AMA PRA Category 1 credit(s) ™. Katie, welcome back to GeriPal.

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RCT of Palliative Care for Heart Failure and Lung Disease: David Bekelman and Lyndsay DeGroot

GeriPal

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. Panelists David Bekelman, Lyndsay DeGroot, and Diah Martina have no relationships to disclose. Important implications.

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Episode 275: Anti-Racism in Medicine Series – Episode 19 – Reframing the Opioid Epidemic: Anti-Racist Praxis, Racial Health Inequities, and Harm Reduction

The Clinical Problem Solvers

There is a special emphasis on the use of public health models that prioritize harm reduction and person-centered care to prevent drug-related fatalities and curb the opioid epidemic along lines of race and class. This discussion is hosted by Ashley Cooper, Sudarshan Krishnamurthy, and new team member Gillette Pierce.

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Music as Medicine: Jenny Chen, Tyler Jorgensen, & Theresa Allison

GeriPal

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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Psychological Issues in Palliative Care: Elissa Kozlov and Des Azizoddin

GeriPal

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. Analyzing the Health and Retirement Study, she found 60% of older adults screened positive for depression in the last year of life (related study here ). That rings true to me.