GeriPal

JULY 19, 2024

What should we use to screen individuals? Joe 03:55 You know, my thoughts are screening is important for a variety of reasons, and certainly Doctor Boris and Soo and Anna, Doctor chodos can provide a lot greater clinical insight than I. It can’t be diagnosed and adios. Who should get it if anyone? Joe, your thoughts?

Screening 119

Screening Primary Care Patient-Centered IT 119

GeriPal

NOVEMBER 9, 2023

But oftentimes, a therapist has deeper training and really history of trauma and specific diagnoses, versus a coach may be a little bit more future-focused and really works with people, regardless of whether they’re having any diagnosable challenge at the moment. Eric: Vicky, anything you’d add to that? We learn in context.

Board-Certified 110

Board-Certified IT Primary Care Referral 110

GeriPal

MAY 11, 2023

There I was, extremely overly trained with brain stuff, and I wanted to learn how to do clinical research. I just thought there was so much we could learn and offer from every sense, from the clinical point of view, from the family point of view, from prevention, from treatment, epidemiology, et cetera. One might argue they still are.

Physicals 85

Physicals IT Hypertension Education 85

Rao Doctor

APRIL 3, 2025

One of the primary tools used in diagnosing fever is the thermometer, an instrument that measures body temperature. Infrared thermometers, which measure temperature from the forehead or ear, are also prevalent in clinical settings. Fever is a common indication that the body is fighting off infection.

Diagnosis 130

Diagnosis Management Illness Diagnose 130

GeriPal

JUNE 19, 2025

Noelle Marie 01:24 I think it really speaks a lot to my own personal journey and I’m pretty sure a lot of trans and gender diverse individuals also resonate with and it really speaks about our transition, celebrating our authentic selves, how society views us and how we view ourselves when we stand in front of a mirror.

Individual 85

Individual Community IT Chronic Condition 85

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. Who do we have with us today? Katie, welcome back to GeriPal.

Illness 136

Illness Patient-Centered Screening IT 136

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 17, 2024

We talk about what is heart failure, particularly HFpEF, how we treat it (including the use of sodium–glucose cotransporter-2 inhibitors (SGLT2’s), and how we should apply guidelines to individual patients, especially those with multimorbidity who are taking a lot of other medications. He’s in Boston.

Primary Care 113

Primary Care Patient-Centered IT Patients 113

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. So no differences between the modalities.

Telehealth 105

Telehealth Patient-Centered IT Patients 105

GeriPal

JULY 21, 2022

I don’t practice clinically in outpatient settings, and often the folks I’m seeing are there for other kinds of issues. That’s where it really gets to this individual risks and balances, individual situation. Love to talk about also in the serious illness population. I’m going to first turn to Emmy.

IT 102

IT Family Families Diagnosis 102

GeriPal

FEBRUARY 6, 2025

So, the question becomes, what, if anything, should we do differently in the primary care setting to diagnose the disease? We address the following questions with Nate: Has anything changed for the primary care doctor when diagnosing Alzheimers? So let’s just say you have a healthy 55 year old or 65 year old in your clinic.

Primary Care 95

Primary Care Diagnosis Screening IT 95

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. Jennifer Temel study did not have a social worker as part of the clinical team. So … Barbara: Yeah.

IT 102

IT Family Families Clinic 102

GeriPal

OCTOBER 20, 2022

And so there was a report in 2009 by the Institute of Medicine saying that we need to equip all of these individuals in caring for older person in an evidence based manner. There’s the complications associated with immune senescence, comorbidities, atypical clinical presentations. So you’re right.

Complication 52

Complication Patient-Centered IT Patients 52

GeriPal

AUGUST 17, 2023

Praised by the FDA, Alzheimer’s Association (AA), and Pharma as a “game changer”, but derided by others for the drug’s lack of clinical efficacy, risk of severe adverse effects, absence of diversity in trial populations, high costs, and an FDA approval process that was in the kindest words “rife with irregularities”. I’m a prescriber.

Patient-Centered 98

Patient-Centered IT Clinic Patients 98

GeriPal

APRIL 14, 2022

This is both a research and a clinical interest of yours. But that just didn’t really resonate with what I saw clinically which was that there was lots of suffering both in the patient, their family and on the clinical team and just felt it was really this space where I didn’t have a lot of evidence to guide me.

Illness 102

Illness Patient-Centered IT Patients 102

GeriPal

JUNE 9, 2022

Clinical growth of geriatrics programs has lagged academic research, despite the rapid aging of the population. . We can’t possibly meet the needs of all people with newly diagnosed serious illness. And I know you’re very interested in clinical trials and pragmatic clinical trials. What does “early” really mean?

Consulting 99

Consulting Patient-Centered Diagnosis Referral 99

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

JUNE 16, 2022

First, we talk with Christine, a researcher and geriatrician from the University of North Carolina, who recently published a JAGS article titled Overdiagnosis of urinary tract infections by nursing home clinicians versus a clinical guideline. 50 to 70% of people who are diagnosed with UTIs probably don’t have a UTI. Scott: Yeah.

Management 122

Management IT Medical Patient-Centered 122

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

SEPTEMBER 21, 2023

I started going to the literature and I noticed that communities of color, those with the Hispanic background, Black individuals were disproportionately impacted by dementia, and I couldn’t believe it. I think, again, it’s the person’s individual, their preference. Alex: Yeah, I like that approach too.

Community 128

Community Family Families IT 128

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 26, 2023

Second, as we discussed in last week’s podcast , older adults, particularly those in nursing homes, were far more likely to die than younger individuals. We lump everybody who’s 65 and older together, and then we don’t look at the individual characteristics of that person, so we fall into these patterns based on racial premises.

IT 91

IT Patient-Centered Healthcare Patients 91

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 97

Families Family Patient-Centered IT 97

GeriPal

MARCH 24, 2023

I think some individuals thought there was cherry-picking of stories that made it seem like hospice is this bad thing, that it’s taking advantage of vulnerable individuals and it didn’t talk enough about the good things that hospice does. On the other side, there’s another group that thinks, you know what?

IT 113

IT Provider Patients Family 113

GeriPal

OCTOBER 27, 2022

As Alex Lee says on our podcast today, all prognostic models will be wrong (in some circumstances and for some patients); our job is to make prognostic models that are clinically useful. As Sei Lee notes, the argument for developing prognostic models has won the day, and we increasingly use prognostic scores in clinical decision making.

IT 95

IT Clinic Screening Patients 95

GeriPal

APRIL 3, 2025

Annie 02:31 So if you go to the A G S meeting every year, you know that this group of three individuals comprises the AGS literature update. But in spite of that, it is a lot of work for three individuals to pull all this together. It always has clinical relevance to practice today. So this is something. It is a sold out crowd.

IT 64

IT Hospital Screening Patients 64

GeriPal

AUGUST 24, 2023

Just an extraordinary cast of individuals who were really so incredibly inspiring. And then the final category, the third category is what we called the dignity conserving repertoire, which really has to do with kind of the spiritual, and psychological landscape and makeup of that individual. I mean, I was very much a clinician.

Patient-Centered 98

Patient-Centered Patients IT Illness 98

GeriPal

MAY 9, 2024

Alex: And Sammy Winemaker, who’s a palliative care physician and Associate Clinical Professor at McMaster University in the Department of Family Medicine, Division of Palliative Care. ” And I won’t… I’m not getting in the business of diagnosing or recommending particular medications or anything like that.

Education 127

Education IT Illness Healthcare 127

GeriPal

FEBRUARY 9, 2023

Amber tells the moving story of how these findings led a clinical colleague, her chief, to question and change his behavior. Alex: We are delighted to welcome Amber Barnato, who’s a palliative care physician and health service researcher, and she’s director of the Dartmouth Institute for Health Policy and Clinical Practice.

Patient-Centered 111

Patient-Centered Patients IT Healthcare 111

GeriPal

APRIL 4, 2024

She was resuscitated by EMS, but did not regain higher brain function, and was eventually diagnosed as being in a persistent vegetative state. In case you miss the introductions at the start of the podcast, Bernie and Laurie are married, and offer wonderful reminiscence of their clinical practice over the last several decades.

Family 112

Family Families Patient-Centered IT 112

GeriPal

JULY 28, 2022

And as a resident, I just was drawn, similar to many oncology clinicians and fellows, to just be traumatic and difficult experience of patients with blood cancers during prolonged and intense hospitalizations, where they experience a lot of physical symptoms, emotional trauma related to the diagnoses. Improved quality of life.

Illness 110

Illness Hospital Patient-Centered Patients 110

GeriPal

JANUARY 11, 2024

Alex: We’re delighted to welcome Leonie Herx, who’s a palliative care physician and clinical professor at the University of Calgary. Sonu: Prior to that it was illegal and actually in the criminal code, so not only illegal, it’s actually a prohibition in the clinical code. Bill, welcome back to GeriPal.

Illness 144

Illness IT Medical Provider 144

GeriPal

AUGUST 25, 2022

And yet, we know little about the clinical experience of people with dementia in hospice. My interest in this paper and this topic goes back a long time and is based on my clinical experience as a hospice nurse, where I was taking care of what I felt like and what we’ve confirmed with research is about half of my patients.

Family 106

Family Families IT Patients 106

GeriPal

MARCH 7, 2024

It sets space between us and the individuals we’re trying to take care of. I think that consistency of what is the expectation of our roles is crucial in a lot of ways, but that role is determined by the individuals we’re serving. I think the market and others will determine those individuals and who they work with.

Provider 117

Provider Illness IT Healthcare 117

GeriPal

OCTOBER 3, 2024

How the act of drawing can help us sloooow down, pay attention to the people and world around us, and ultimately let go… The possibility of incorporating drawings in research and even clinical care. They had triple diagnoses, often life threatening illness, but also mental illness and usually some kind of addiction.

IT 122

IT Patient-Centered Patients Relationship 122

GeriPal

SEPTEMBER 19, 2024

So, for example, everyone who was diagnosed with an advanced or metastatic lung cancer had a prognosis on the order of months. Eric 07:31 A clinical perspective, why is it important to test this stepped care model versus implementing more? And there’s a mortality number of people who just can’t make it to get to our clinic.

Patient-Centered 119

Patient-Centered IT Patients Hospital 119

GeriPal

JUNE 26, 2025

But from our clinical work, many of us are familiar with people with dementia who experience sudden shocks to their health, think hip fracture, think hospitalization for pneumonia. Sometimes people call them health shocks, but we kind of all, like, clinically, intuitively know what these things are. Has really changed.

Illness 93

Illness Hospital IT Patient-Centered 93