My Green Doctor

MAY 3, 2025

In This Issue : Why Renewable Energy Belongs in Every Clinic Medical Waste: One Model for Improvement OnTrack with your Sustainability Goals? Powering Health, Protecting the Planet – Why Renewable Energy Belongs in Every Clinic Healthcare professionals have always been trusted voices on public health.

Healthcare 52

Healthcare Healthcare Professional Consulting Management 52

The Clinical Problem Solvers

APRIL 24, 2025

Dr. Benton mentors clinical and research physicians, fellows, and postdoctoral trainees. Clinically, he cares for youth and families through the Department of Psychiatry & Behavioral Sciences and the new Division of Addiction Medicine at Boston Children’s Hospital. References 1. Benton TD , Boyd RC , Njoroge WF.

Mental Health 52

Mental Health Community Hospital Appointment 52

GeriPal

MARCH 14, 2024

We talk with them about the epidemiology, assessment, and management of dysphagia, including the role of modifying the consistency of food and liquids, feeding tubes, and the role of dysphagia rehabilitation like tongue and cough strengthening. This is Eric Widera. Alex: This is Alex Smith. Here at UW Health, we call it our Swallow Service.

IT 124

IT Hospital Patient-Centered Individual 124

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). So you’re right.

Complication 97

Complication Patient-Centered IT Patients 97

GeriPal

JANUARY 12, 2023

So that’s one, this patient-centered geriatric assessment and management approach. Number four, again, structure and process that promotes early mobilization which may or may not require a formal OT and PT consultation. And then number five, really proactive care transitions planning out of the gate on day one.

Hospital 100

Hospital Patient-Centered IT Nurse Practitioner 100

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. And yet we’re also in a different place in diabetes monitoring and management. Eric: And you can probably tell already, the topic at hand is diabetes management in late life.

Diabetes 73

Diabetes Management Patient-Centered Families 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?

Clinic 52

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.

Patients 111

Patients Healthcare Board-Certified Telemedicine 111

GeriPal

JUNE 12, 2025

I’m sort of seeing them in clinic for consideration of palliative radiation, they have a lot going on. So you have the consultation. So we need to have a discussion upfront about how we’re managing the patient’s pain. Did their pain management last throughout that entire session? And was that okay?

Patient-Centered 102

Patient-Centered Referral Patients IT 102

Rao Doctor

APRIL 3, 2025

When assessing a fever, we doctors employ a systematic approach to ensure accurate diagnosis and effective management. Infrared thermometers, which measure temperature from the forehead or ear, are also prevalent in clinical settings. What are the Management and Treatment Options in a case of fever? And I do this regularly.

Diagnosis 130

Diagnosis Management Illness Diagnose 130

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. So in this case consultations. Scott: Kate would miss you. laughter] Alex: Yeah.

Consulting 120

Consulting Hospital Patient-Centered IT 120

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.

Telehealth 105

Telehealth Patient-Centered IT Patients 105

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.

ER 52

ER Telehealth Primary Care Doctor Appointment 52

GeriPal

OCTOBER 10, 2024

And they begin on today’s podcast with one clinical ask: everyone should be a generalist and a specialist. They are looking to build on both their research and clinical programs and are interviewing candidates for the Associate Chief of Research and for full-time physician faculty to join them in the inpatient and outpatient setting.

Screening 119

Screening IT Families Family 119

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. It did not change the frequency of palliative care consultation, the timing of such, ICU mortality, or six-month mortality.

Consulting 115

Consulting Patient-Centered IT Patients 115

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. Who do we have with us today? Katie, welcome back to GeriPal. Jessie: Thank you.

Illness 136

Illness Patient-Centered Screening IT 136

GeriPal

JANUARY 25, 2024

David: Similarly informed by my clinical experience, really, actually, beginning in residency when I took care of a lot of sick folks in the hospital, particularly those with cancer and heart and lung diseases like these. And not just statistically significant, but clinically meaningful. Eric: How about you, David? Eric: Oh, wow.

Patient-Centered 122

Patient-Centered IT Illness Patients 122

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?

Patients 72

Patients Clinic Patient-Centered Illness 72

GeriPal

OCTOBER 24, 2024

If you believe the evidence for efficacy to manage symptoms like neuropathic pain, how do you even start to think about recommending these products to patients? And then I met a patient in clinic once who asked me a lot of really intelligent questions about medical cannabis, what it does. They just kept at it.

Medical 98

Medical IT Patient-Centered Healthcare 98

GeriPal

APRIL 14, 2022

Management of chronic pain in the elderly: focus on transdermal buprenorphine. This is both a research and a clinical interest of yours. And how am I going to manage their pain? And then part of our role as folks in palliative care who as Katie mentioned, really try to help folks manage distress around serious illness.

Illness 102

Illness Patient-Centered IT Patients 102

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 132

Patient-Centered Hospital Patients IT 132

GeriPal

JUNE 5, 2025

And so I tried to get her actually to pain management, and I couldn’t. Pain management wouldn’t come to the facility, and she was bedbound. And so it really got me interested in how we improve symptom management. Not just pain, but symptom management, then for people that are in a nursing home and that.

Nurse Practitioner 78

Nurse Practitioner Referral Consulting Board-Certified 78

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. Ali John 24:35 In clinical trials. James 00:32 Good afternoon.

Illness 107

Illness IT Patient-Centered Patients 107

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.

IT 99

IT Patient-Centered Patients Healthcare 99

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. Is the sort of task to manage. I mean, how do you negotiate that with the oncologist who is the one who consulted you, by the way, Eric, who does that go to?

IT 132

IT Illness Families Family 132

GeriPal

DECEMBER 8, 2022

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. Working with our clinical decision support team and thinking about where that could be.

Patient-Centered 115

Patient-Centered Illness Healthcare IT 115

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. And so there’s complexity in Understanding how each state manages this. They have an advance directive.

Patient-Centered 109

Patient-Centered IT Patients Healthcare 109

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.

IT 128

IT Families Family Patient-Centered 128

GeriPal

APRIL 10, 2025

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. And then we had clinical decision support. What is a clinical decision support? Long overdue.

Patient-Centered 77

Patient-Centered IT Hospital Patients 77

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.

Complication 52

Complication Patient-Centered IT Patients 52

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

DECEMBER 15, 2022

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. Working with our clinical decision support team and thinking about where that could be.

IT 105

IT Patient-Centered Healthcare Illness 105

GeriPal

APRIL 13, 2023

Are there meaningful ways of assessing loneliness and social isolation in clinical settings and connecting patients with interventions? The Listening “EAR” approach that simplifies assessment of loneliness and social isolation in clinical settings, and other practical pointers.

IT 99

IT Community Patient-Centered Medical 99

GeriPal

JUNE 19, 2025

But you know, the clinical piece, I think it starts out with collecting sexual orientation, gender identity in your databases. One is to seek additional training because the standards of care from wpath, which literally outlines how you would manage hormones, is there. What are the things that the listeners to this podcast can do?

Individual 85

Individual Community IT Chronic Condition 85

GeriPal

DECEMBER 19, 2024

We invited Dani Chammas , a palliative care physician and psychiatrist at UCSF (and a frequent guest to the GeriPal podcast), as well as Brent Kious , a psychiatrist at the Huntsman Mental Health Institute, focusing on the management of severe persistent mental illnesses. Eric 12:11 And we consult psychiatry. I gotta get some sleep.

Illness 101

Illness Mental Health IT Patient-Centered 101

GeriPal

DECEMBER 14, 2023

Similarly Jessica Zitter, an intensivist and palliative care doctor analogized the inevitable clinical momentum toward highly aggressive intensive care in US hospitals as a conveyor belt. Liz: Well, some aspects of this paper around clinical momentum and things around defaults and that sort of thing. Liz: I do, indeed. Proud Mary.

Hospital 125

Hospital IT Patient-Centered Patients 125

GeriPal

MAY 4, 2023

We talk about why it’s so hard with Abby Rosenberg (chief of PC at DFCI and Boston Childrens), Nick Purol (clinical social worker at DFCI and Boston Childrens), Daniel Eison (pediatric PC doc and co-host of PediPal). But when I have, I find that they’re often some of the hardest patients to care for. Welcome to the GeriPal podcast, Abby.

IT 83

IT Families Family Illness 83