PEMBlog

SEPTEMBER 26, 2024

This year, in addition to the 10 finalists Maneesha Agarwal will be presenting at the National Conference and Exhibition we will be sharing four cases online in advance of the conference. No recent illnesses or any other symptoms. He required external cephalic version for breech presentation. This is the last of the four cases.

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Patient-Centered Routine Screenings Diagnosis Clinic 59

GeriPal

OCTOBER 13, 2022

We have a discussion about the decision to remove race, a social construct, from clinical risk calculators (though I’m not 100% sold that race should always be removed – if removal is likely to worsen disparities for example – at least until a superior race-blind calculator can be developed). One of your articles addresses that.

Complication 97

Complication Patient-Centered IT Patients 97

GeriPal

MAY 19, 2022

It depends on the clinical situation. And really, the best that had ever been looked at, especially in our population and sort of a cancer serious illness population. I know this is like, we’re talking about math and so that makes it all a little complicated, but think about it this way. Eric: All right. Landmark study.

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IT Patients Individual Relationship 139

PEMBlog

OCTOBER 2, 2024

I’ll dive into the latest clinical practice guidelines and discuss evidence-based approaches to diagnosis and treatment. Understanding dyspepsia and its clinical presentation. Both conditions can present with similar symptoms. And the presentation for GERD varies by age.

Diagnosis 52

Diagnosis Management IT Patient-Centered 52

GeriPal

JUNE 27, 2024

I have so many questions, and I promise we’re going to get to the management of anxiety and serious illness. The question I would ask is, how helpful is that in our clinical practice? Because it can be important to think about how people are coping with their illness. But before we do, we always have a song request.

Illness 130

Illness IT Diagnosis Patient-Centered 130

GeriPal

NOVEMBER 21, 2024

Coping in the setting of serious illness. Coping in the setting of a serious illness about a patient encounter you had with somebody who used an. The clinical trials and the this and that. Here are some more resources we’ve discussed in the podcast Dani’s NEJM article on coping: “ Should I Laugh at That? Should I laugh at that?

Illness 126

Illness IT Patient-Centered Patients 126

Mesa Family Physician

MARCH 13, 2025

During your comprehensive check-up at our Mesa clinic, our board-certified physicians will not only assess your current health status but also help you understand your risk factors for various conditions based on your family history, lifestyle, and previous medical records.

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Family Physician Preventive Care Preventative Care Family 100

Rao Doctor

APRIL 3, 2025

In my previous article I covered the types of illness and the causes. Infrared thermometers, which measure temperature from the forehead or ear, are also prevalent in clinical settings. F (38°C) is generally regarded as indicative of illness. Managing and treating an illness involves several steps. FEVER FAQs (contd.)

Diagnosis 130

Diagnosis Management Illness Diagnose 130

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? Eric 01:34 Oh, I love that. Dani 01:36 More to talk about there.

Illness 102

Illness Mental Health IT Patient-Centered 102

GeriPal

JUNE 13, 2024

Summary Transcript Summary I always find cachexia in serious illness puzzling. In today’s podcast, we had the opportunity to learn from a renowned expert in palliative care, Eduardo Bruera, about cachexia and anorexia in serious illness. When people have no appetite, they know they’re ill. Eduardo 10:42 Sure, Eric.

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Illness Patient-Centered Patients IT 134

GeriPal

OCTOBER 20, 2022

There’s the complications associated with immune senescence, comorbidities, atypical clinical presentations. It’s another article, another major article that has triggered the complicated UTI circuit. But what I did want to highlight is how we got to thinking about men that have UTIs have complicated UTIs.

Complication 52

Complication Patient-Centered IT Patients 52

GeriPal

JULY 11, 2024

Can you come and be in our clinic once a week? It used to also be a social worker and myself who would actually go to clinic and spend some time up there. And so I was driven by the fact that I needed more information, and so it sort of became my clinical focus as well as I dabble in the research.

Patient-Centered 110

Patient-Centered IT Patients Clinic 110

GeriPal

FEBRUARY 23, 2023

My favorite line from Emily’s paper: “Geriatric assent has not been widely adopted in clinical care, but bioethicists should advocate for this, as adoption of partial-involvement strategies can prolong the period in which individuals are (appropriately) engaged in decisions about their health care.” This is a clinical intervention.

Families 98

Families Family Patient-Centered IT 98

GeriPal

OCTOBER 26, 2023

Summary Transcript Summary Often podcasts meet clinical reality. But rarely does the podcast and clinical reality meet in the same day. Ann Henshaw is an occupational therapist who works clinically at Georgetown and teaches at GW. Alex: Today we are delighted to welcome Ann Henshaw who brought this podcast idea to us.

Patient-Centered 133

Patient-Centered Hospital Patients IT 133

GeriPal

MARCH 24, 2022

Then listen to these prior podcasts with Sean Morrison and Rebecca Sudore about this issue, and we recently discussed differences between Advance Care Planning and Serious Illness Communication with Juliet Jacobsen and Rachelle Bernacki. . Where does POLST fit in with this debate? This is Eric Widera. Alex: This is Alex Smith.

Illness 73

Illness IT Healthcare Patient-Centered 73

GeriPal

OCTOBER 24, 2024

Summary Transcript CME Summary Cannabis is complicated. Alex 00:30 And we are also delighted to welcome Eloise Theisen, who’s a palliative care nurse practitioner at Stanford and CEO and co- c ounder of Radical Health Clinician Network, which helps patients use cannabis to treat chronic and age related illness.

Medical 100

Medical IT Patient-Centered Healthcare 100

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. Bill, welcome back to GeriPal.

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Illness IT Medical Provider 144

GeriPal

MARCH 28, 2024

Ten years ago we would have been hard pressed to find 3 clinical trial abstracts submitted to the annual meeting, much less high quality randomized trials with robust measures, sample sizes, and analytics plans. Alex: Recently you talked about the other trial, also with a nudge, and that was non-cancer, serious illness. Tom: Thank you.

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Consulting Patient-Centered Patients IT 116

GeriPal

OCTOBER 19, 2023

And we have Scott Halpern, who is Professor of Medical Ethics and Health Policy and Director of the Palliative and Advanced Illness Research Center or Payer Center at the University of Pennsylvania. Alex: National POLST Collaborative. Good to know. And he’s a professional Uber driver for his daughter’s softball games.[laughter]

Patient-Centered 127

Patient-Centered IT Patients Illness 127

GeriPal

MARCH 7, 2024

In addition to being a palliative and hospice RN, she is the Executive Director for Goodwin Hospice , a large non-profit hospice that added end-of-life doula care to their services in collaboration with Jane and John’s doula organization, Present for You. He looked very ill. Jane, welcome to the GeriPal podcast.

Provider 119

Provider Illness IT Healthcare 119

GeriPal

MAY 25, 2023

Summary Transcript Summary Our guests today present an important rejoinder to the argument that we should refocus away from advance care planning (ACP). Complicated grief? So am I measuring it for that specific clinic level quality metric or am I measuring it for my research study? Did the caregiver feel heard and understood?

Community 96

Community IT Patient-Centered Primary Care 96

GeriPal

JULY 21, 2022

Love to talk about also in the serious illness population. I don’t practice clinically in outpatient settings, and often the folks I’m seeing are there for other kinds of issues. If they’re in a major car crash, they’re going to have more long-term complications probably than a 20-year-old would.

Families 102

Families IT Family Diagnosis 102

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 78

Patient-Centered IT Hospital Patients 78

GeriPal

OCTOBER 12, 2023

And, what if your surgeon openly discussed the expected ‘bad stuff’ of post-operative recovery, instead of rotely reciting a list of possible complications? We invited Gretchen Schwarze and Justin Clapp to discuss with us these communication strategies, which are the focus of a series of 4 Viewpoints recently published in JAMA Surgery.

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IT Families Family Patient-Centered 129

GeriPal

NOVEMBER 17, 2022

AlexSmithMD (still on Twitter at present). The songs about how saving lives is actually a pretty complicated business. And when I was getting my PhD, I wanted to find something that spoke to me, and I had been doing clinical work in nursing homes. Transcript. Eric: Welcome to the GeriPal podcast. This is Eric Widera. Alex: Yeah.

Community 97

Community IT Mental Health Medical 97

GeriPal

AUGUST 24, 2023

Fox gives patients hope there may be a place that illness doesn’t touch Depression is a Liar Why is Being a Patient Such a Difficult Pill to Swallow Better Patient Care Calls for a ‘Platinum Rule’ to Replace the Golden One. Had multiple physical, psychological complications as a result of that. So there are three primary domains.

Patient-Centered 98

Patient-Centered Patients IT Illness 98

GeriPal

FEBRUARY 16, 2023

The last time this happened to me I immediately went on the defensive despite years of training in serious illness communication skills. Dani and Kery present three steps for interacting with an angry patient: Look within: What is this anger bringing up in me? How did you react? Afterwards, I thought there must be a better way.

Patients 110

Patients IT Families Family 110

GeriPal

FEBRUARY 13, 2025

Summary Transcript CME Summary In todays podcast we were delighted to be joined by the presenters of the top scientific abstracts for the Annual Assembly of the American Academy of Hospice and Palliative Medicine ( AAHPM ) and the Hospice and Palliative Medicine Nurses Association ( HPNA ). I’m a PhD candidate at Yale School of Nursing.

Consulting 64

Consulting Community Patient-Centered Families 64

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. Lauren: Yeah. That’s just one hypothesis. Lauren: Yeah.

Patient-Centered 96

Patient-Centered Patients IT Illness 96

GeriPal

MAY 22, 2025

Jenny Chen is a palliative care fellow at Yale who regularly sings for her seriously ill patients. So I actually was doing a grand rounds as my final presentation here at Yale for my fellowship on the role of music in host pice and palliative medicine. Relationships are usually more complicated. Jenny 04:15 Good question.

IT 98

IT Patient-Centered Patients Board-Certified 98

GeriPal

FEBRUARY 8, 2024

The illness narratives suffering, healing, and the human condition. The more we can notice that, the more we can actually be present for that family and actually see how they’re experiencing it. Hospital Chaplains, Spirituality, and Pain Management: A Qualitative Study. Pain Manag Nurs. 2023 Dec 20:S1524-9042(23)00202-3.

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IT Families Family Physicals 137

GeriPal

FEBRUARY 24, 2022

Juliet and Rachelle are two of the authors of a recent JAMA viewpoint titled “Shifting to Serious Illness Communication.” . Also see the image below from Alex’s editorial in JAGS , a Venn diagram of advance care planning and serious illness communication. Shifting to Serious Illness Communication. Transcript. What is it?

Illness 98

Illness Patient-Centered IT Patients 98

GeriPal

JUNE 6, 2024

Sharon Bober, clinical psychologist at DFCI, notes that clinicians can get caught in an anxiety cycle, in which they are afraid to ask, don’t ask, then have increased anxiety about not asking. Eric 01:13 So we got a lot to cover today on sexuality, sexual health and serious illness. Clearly this issue is important to patients.

Illness 131

Illness IT Physicals Patients 131

GeriPal

MARCH 27, 2025

Summary Transcript CME Summary A pragmatic trial evaluates the effectiveness of a treatment or intervention in real-world clinical practice. Alex 02:44 Still suffering from some illness from there, which is why I was sick and not in the office with Eric today. We did it by the clinic level. I’ve had fun relearning Spanish.

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Primary Care IT Clinic Illness 80

GeriPal

MAY 1, 2025

Funding for research and clinical care is at risk, as USAID and PEPFAR (which is under USAID), are shuttered. And when she was here, she co founded the Golden Compass Clinic at San Francisco General Hospital for older adults living with HIV. Millions of lives are at stake. Meredith wore a shirt that said Silence=death.

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Primary Care IT Clinic Provider 96

GeriPal

JULY 25, 2024

The PPS is one of the most widely used prognostic tools for seriously ill patients, but the prognostic estimates given by the PPS are based on data that is well over a decade old. So the palliative performance scale, or PPS, is essentially a tool to help clinicians with prognostication for seriously ill or palliative care populations.

Families 108

Families Family Patient-Centered Patients 108

GeriPal

NOVEMBER 3, 2022

I t’s a collection of personal stories of a small number of health professionals, including Craig Blinderman and Susan Block , who have been struck by personal illness and loss. And I think that’s not only a personal, psychological, spiritual, but it’s also social as well. Eric: And how does that differ from grief?

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Healthcare Professional Healthcare IT Relationship 103