GeriPal

NOVEMBER 9, 2023

Alex: We’re delighted to also welcome Greg Pawlson, who’s Senior Faculty at Lodestar Consulting & Executive Coaching and former President of the American Geriatric Society. You can do this many different ways, but the first one is a little bit more structured, like an assessment that we’re all familiar with clinically.

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Board-Certified IT Primary Care Referral 110

GeriPal

JUNE 8, 2023

When I’m on palliative care consults and attending in our hospice unit we have to counsel patients about deprescribing and de-intensifying diabetes medications. If in your own work, your clinical work, is this something that you see people struggle with you, you see yourself struggle with? Summary Transcript Summary Diabetes is common.

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Diabetes Management Patient-Centered Family 73

Plum Health

OCTOBER 11, 2024

Have you ever found yourself in need of medical attention but overwhelmed by the myriad of clinics and healthcare options out there? Navigating the healthcare system can be daunting, especially when you're unwell or caring for someone who is. How do you choose the right clinic when every option seems equally promising?

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Clinic Primary Care Doctor Primary Care Chronic Condition 52

The Medical Futurist

JUNE 21, 2025

SkinIO , Scanoma , Miiskin , FirstDerm , Direct Derm , iDoc24 , and SkinVision all work based on the same principle: they promise patients the option to self-check their symptoms and then to connect to a dermatologist online for consultation within a very short period of time. If there were ever a time to join us, it is now.

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GeriPal

FEBRUARY 2, 2024

This week, we talk about the other major palliative care trial of default palliative care consults for hospitalized older adults with COPD, kidney disease, or dementia, published in the same issue of JAMA. and consulting for Papa Health. This is 24,000 encounters, over 15,000 patients, 11 hospitals, eight states.

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Consulting Hospital Patient-Centered IT 120

GeriPal

JUNE 12, 2025

I’m sort of seeing them in clinic for consideration of palliative radiation, they have a lot going on. I didn’t know where they existed within the hospital. Eric 07:04 You actually created things like a curriculum for hospital medicine fellows in radiation oncology. So you have the consultation.

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My Green Doctor

JULY 2, 2025

The EIB developed a first-of-its-kind tool to quantify how climate hazards like heatwaves, floods, and poor air quality will drive up healthcare demand across Europe. in the need for healthcare—translating into over 500 million extra days of inpatient hospital care and more than 100 million emergency department visits across Europe by 2050.

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Healthcare Healthcare Professional Management Community 52

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. Liz: Well, some aspects of this paper around clinical momentum and things around defaults and that sort of thing. Proud Mary.

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Hospital IT Patient-Centered Patients 125

GeriPal

JANUARY 25, 2024

You can also listen to an audio interview with Alex and JAMA Deputy Editor Preeti Malani about this study and the other RCT of default palliative care for hospitalized older adults with noncancer serious illness published in the same issue. People had to be in the top 20th percentile of risk for being hospitalized or dying in the next year.

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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. Consultations versus telehealth. But watch out! That’s what I’m waiting for, Alex.

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Telehealth Patient-Centered IT Patients 105

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. Kate: It was done in 10 hospitals, 17 ICUs in Atrium Health down in North Carolina. I’m just stunned even writing that!

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Consulting Patient-Centered IT Patients 115

GeriPal

JUNE 9, 2022

Clinical growth of geriatrics programs has lagged academic research, despite the rapid aging of the population. . Palliative care, in contrast, saw explosive growth in US hospitals. And palliative care was as a program was just growing at Penn moving from just consult hospice to actually having a team when I was training.

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Consulting Patient-Centered Diagnosis Referral 99

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. Alex: And Sarguni Singh, who’s a hospitalist researcher, Assistant Professor of medicine in the division of Hospital Medicine at the University of Colorado. Ann: Thank you.

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Patient-Centered Hospital Patients IT 132

GeriPal

OCTOBER 10, 2024

Of note: these lessons apply to geriatrics, primary care, hospital medicine, critical care, cancer care, etc, etc. And they begin on today’s podcast with one clinical ask: everyone should be a generalist and a specialist. And just to name a few of the more of those from the book, this is on the clinical education and training chapter.

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Doctor On Demand

APRIL 28, 2025

Urgent care clinics provide quick diagnoses and treatments, including antibiotics if needed. In fact, most sore throat symptoms resolve in three days for 60-70% of patients, according to March 2025 UpToDate, an evidence-based clinical decision support system used by healthcare professionals.

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ER Telehealth Primary Care Doctor Appointment 52

GeriPal

DECEMBER 8, 2022

As Thor notes, capturing patient stories has face validity as positively impacting the patients who share their stories and have them documented, and for the clinicians who get to truely and deeply know their patients in far greater depth than “what brought you to the hospital?” Within the VA it’s now at 70 VA hospitals.

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Patient-Centered Illness Healthcare IT 115

GeriPal

FEBRUARY 15, 2024

So it’s just a wide-opening lens that most of us never really get to see if we’re on the hospital-based side. I was like, “I have all these things I’m doing in the hospital to try to make people better and then I might be sending them right back to a big hazardous environment.”

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GeriPal

FEBRUARY 27, 2025

Substance use disorder is one of those complex issues in which clinical practice is changing rapidly. Sach Kale set up an outpatient clinic focused on substance use disorder for patients with cancer. Do you need to be an addiction medicine trained physician to start such a clinic (no: Sach is not). What do they do?

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Patients Clinic Patient-Centered Illness 72

GeriPal

FEBRUARY 23, 2023

Imagine her hearing for the first time that you’re sick, that you’re hospitalized, that you’re in the ICU, and that you can’t make your own decisions? And then we were involved, palliative care was consulted when the patient was really sick and decompensating in the ICU. That’s a huge amount of news all at once. Eric: Lynn or Anne?

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Family Families Patient-Centered IT 97

GeriPal

APRIL 10, 2025

Today we discuss: Why the study was negative for the primary (hospitalization) and all secondary outcome (e.g. Why this study was a success due to the sheer size (nearly 100,000 patients in about 30 EDs) of the study, and the fact that, as far as the investigators know, all study sites continue to employ the clinical decision support tool.

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Patient-Centered IT Hospital Patients 77

GeriPal

JANUARY 18, 2024

In particular, we talk about Katie’s and Jesica’s paper in NEJM titled “ Juggling Two Full-Time Jobs — Methadone Clinic Engagement and Cancer Care ,” which described the difficulty in managing cancer pain and methadone for opioid use disorder. Katie, welcome back to GeriPal. Should they? No, you can’t- Eric: Why not?

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GeriPal

DECEMBER 15, 2022

Been in the hospital four times, vented, been told the story to her family, she won’t live. Tell me how your illness has impacted your relationships with others, your healthcare team, your family, friends, your beliefs, your values, your preferences. So those questions we ask when we’re doing a palliative care consult.

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IT Patient-Centered Healthcare Illness 105

GeriPal

OCTOBER 20, 2022

There’s the complications associated with immune senescence, comorbidities, atypical clinical presentations. And I think that’s where this clinical trial which looked at seven versus 14 days was really practice-changing for many of us. It’s very rare and they may be a male patient. So you’re right.

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Complication Patient-Centered IT Patients 52

GeriPal

AUGUST 29, 2024

Alex 01:24 And Elise Carey, who’s a palliative care doc and geriatrician and associate professor of medicine at the Mayo Clinic in Rochester, Minnesota. Gordon 25:52 I mean, I think that what I’d say, just in general, about our own clinical team’s emotions, is that what I try to think about? Holly, welcome to GeriPal.

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IT Illness Family Families 132

GeriPal

OCTOBER 12, 2023

Gretchen: Yeah, I think probably the underlying story here is that I’m really good at doing negative randomized clinical trials, but there is a good thing about doing a big clinical trial, which is that you get tons of data even if you don’t end up with the result that you want. And that’s how we connected.

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IT Family Families Patient-Centered 128

GeriPal

APRIL 4, 2024

The hospital refused without a court order, and the case eventually made its way to the Supreme Court. 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.

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Family Families 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. Many were community hospitals. The intervention was a negative study for the primary outcome, hospital length of stay.

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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. Welcome to the GeriPal podcast, Charlotta. Charlotta: Thank you.

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IT Patient-Centered Patients Healthcare 99

GeriPal

APRIL 28, 2022

So for those listening to the podcast, this is a clown looking very sad and what looks like a hospital administrator. And the hospital administrator says, “No, the hospital definitely values your contributions to the interdisciplinary team. What are your thoughts about using humor to convey ideas, thoughts, clinical work?

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IT Hospital Patients Illness 145

GeriPal

JUNE 5, 2025

And so they’re in there for a very short time, couple weeks, get a little bit stronger and transition home after a hospitalization. And so we do have consultants who come in the building. And usually it’s simply for a consultation. So they were a lot of preoccupied with other tasks, but clinical gestalt.

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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. Alex 00:33 Our next guest is Margaret Ross, who’s a clinical psychologist and researcher at St. Vincent’s Hospital in Melbourne, Australia.

Illness 107

Illness IT Patient-Centered Patients 107

GeriPal

APRIL 14, 2022

So for those of you listening via YouTube, here’s the live version for those of you who are listening on the podcast, you’re going to get my prerecorded version with lots of loops and I’m doing consultation with my new music teacher who’s a music producer in LA. This is both a research and a clinical interest of yours.

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Illness Patient-Centered IT Patients 102

GeriPal

SEPTEMBER 22, 2022

And I think also some of the stuff we’ll be talking about, when it comes to communication, I mean, a lot of the clinical encounter is listening to the music. Tell me about the clinical enc… How do you think the uncanny valley fits into medicine and communication training and skills? What is the uncanny valley? Eric: Yeah.

Illness 101

Illness IT Patient-Centered Patients 101

GeriPal

JANUARY 16, 2025

I, for example, had one patient, I remember during my fellowship, I was in geriatrics clinic and had a very well read patient who came in and was reading a New York Times article, I think in the well section at one point. Alex 16:45 That really rings true with my clinical experience. Decision making hierarchies by default.

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Patient-Centered IT Patients Healthcare 109

GeriPal

FEBRUARY 13, 2025

You did a rural tele-palliative care consultation study. Marie 03:08 So, living in Alabama, which is our palliative care desert in the south, there were no palliative care services in any of the small rural hospitals. And so the video consult was what became the mode. NCP guideline, standard consultation.

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Consulting Community Patient-Centered Family 63

GeriPal

JUNE 30, 2022

Joel: The Brigham and Women’s Hospital likes me to say that too. Alex: And the Brigham and Women’s Hospital. And she was rushed to the hospital. And they agreed on that and they talked to the people at the hospital, the surgeons and the nurses. They stayed in the hospital for longer. Joel: Oh yeah.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

GeriPal

DECEMBER 19, 2024

* This episode of the GeriPal Podcast is sponsored by the Zuckerberg San Francisco General Hospital Division of Hospital Medicine , which is committed to providing outstanding, compassionate care to all patients, advancing health equity, and fostering excellence in hospital medicine. Eric 12:11 And we consult psychiatry.

Illness 101

Illness Mental Health IT Patient-Centered 101