GeriPal

MAY 19, 2022

Dr. Akhila Reddy and colleagues study looking at converting hospitalized cancer patients from IV hydromorphone to PO morphine, PO hydromorphone, or PO oxycodone. It depends on the clinical situation. But I think people would have an embolic event if you gave them a flipping range. Eric: All right. Eric: I got two questions.

IT 139

IT Patients Individual Relationship 139

My Green Doctor

JULY 2, 2025

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. In the United States, extreme weather events and air pollution are already costing the healthcare system over $820 billion annually.

Healthcare 52

Healthcare Healthcare Professional Management Community 52

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.”

Community 114

Community Transportation IT PCP 114

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.

Patient-Centered 132

Patient-Centered Hospital Patients IT 132

GeriPal

NOVEMBER 7, 2024

Additional link to study with heatmaps of specific locations (hospital, nursing home, home) after initiating dialysis. -@AlexSmithMD ** NOTE: To claim CME credit for this episode, click here ** Transcript Eric 00:11 Welcome to the GeriPal podcast. Clinical experience. Let it be (hint hint). Most patients don’t recover.

Management 116

Management Patient-Centered Patients IT 116

GeriPal

FEBRUARY 20, 2025

We also explored several questions with them, including how to define trauma, its prevalence in older adults, the impact of past traumatic experiences, the potential triggers of trauma screening, and the application of trauma-informed principles in clinical practice. So there’s an event or a series of events.

Patient-Centered 66

Patient-Centered IT Screening Patients 66

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. So if one of my patients gets admitted, I also see them on the inpatient side of our hospital. I started our liver embedded liver clinic about seven and a half years ago.

Patient-Centered 109

Patient-Centered IT Patients Clinic 109

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. difficile infections. difficile that patients are exposed to and antibiotic resistance.

Complication 52

Complication Patient-Centered IT Patients 52

GeriPal

FEBRUARY 17, 2022

This tool provides a clinical recommendation for starting/stopping medications and cancer screening based on the prognosis of the patient in front of you. And they really have been shown in several clinical trials to have reductions in vertebral fractures, non-vertebral fractures, and hip fractures. See screenshot below.

Clinic 67

Clinic IT Patients Medical 67

GeriPal

JULY 28, 2022

Alex: And we are also delighted to welcome Areej El-Jawahri, who is an oncologist at Massachusetts General Hospital as well, who specializes in blood cancers. Jennifer: They have a meaningful impact on what happens to them during the hospitalization and after. They all self-identified as a hospital based practice.

Illness 110

Illness Hospital Patient-Centered Patients 110

GeriPal

OCTOBER 17, 2024

He’s a medical director of H ebrew S enior L ife outpatient clinic at Newbridge. Alex 04:07 A heart failure clinic playing in the background. Because I also feel like we target people’s low sodium diets in the hospital. He’s in Boston. And also I was in the HVMA primary care program.

Primary Care 113

Primary Care Patient-Centered IT Patients 113

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. So, Alex, imagine you’re a seriously-ill hospitalized patient and I’m your doctor, unluckily for you. Eric: Either.

Consulting 120

Consulting Hospital Patient-Centered IT 120

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. What is sludge?

Patient-Centered 116

Patient-Centered Hospital IT Illness 116

GeriPal

MAY 25, 2023

LJ: I’ll take that one that I feel really strongly that we are not assessing the right outcomes in advance care planning, and I think that’s part of the problem, is that we I think we do this in a lot of science and a lot of research in clinical medicine too. Hillary: So those all differ.

Community 95

Community IT Patient-Centered Primary Care 95

GeriPal

MAY 22, 2025

When we started doing more music stuff for our patients in the hospital, a lot of people started to think, hmm, what would I want to listen to? So our inpatient hospitals are kind of under resourced for music therapy. It’s something that has no place in a hospital in most people’s thinking. Tyler 01:43 Okay.

IT 96

IT Patient-Centered Patients Board-Certified 96

GeriPal

APRIL 3, 2025

So if you haven’t been to this event, there is a literature review where we. It always has clinical relevance to practice today. I’m gonna be very brief on the other two because of that warning, but Eric talked me into, in the first year in doing an article on the impact of rudeness on clinical care that.

IT 64

IT Hospital Screening Patients 64

GeriPal

SEPTEMBER 12, 2024

Ishwaria 05:29 And that’s really how this field of professional well being, healthcare professional well being, clinician well being, has evolved, is that there is an important place in our overall professional well being for personal resilience and our individual coping strategies, recovery methods from day to day.

IT 110

IT Healthcare Healthcare Professional Patient-Centered 110

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 Family Families Patient-Centered 128

GeriPal

DECEMBER 5, 2024

It’s that mixture of intimacy and vulnerability, of shared clinical experiences, that fosters a sense of belonging. Alex 00:40 We’re delighted to welcome Alexis Drutchas, who is a palliative care doc at the Massachusetts General Hospital and Harvard Medical School and co founder, also of the Palliative Story Exchange.

IT 107

IT Community Patients Family 107

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

MARCH 3, 2022

A little over a decade ago, Ken Covinsky wrote a GeriPal post about a Jack Iwashyna JAMA study finding that older adults who survive sepsis are likely to develop new functional and cognitive deficits after they leave the hospital. GeriPal podcast with Tom Gill on the Precipitating Events Study, distressing symptoms, disability, and hospice.

Patient-Centered 96

Patient-Centered Patients IT Hospital 96

GeriPal

MAY 29, 2025

I think we have ideas about are these paradoxical events, are they expected? And I think Andrew’s going to have good ideas about, like, why the term paradoxical and are these events paradoxical, truly? And I think this just hasn’t made it into, like, our academic clinical training space. Andrew could talk about.

Family 93

Family Families IT Patient-Centered 93

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

JANUARY 26, 2023

Can you give us some examples, even the ones you mentioned in the paper, about how some of these structural races, like these common things that may occur in the hospital or in the clinics that we use, and we may not even think about? Eric: Six months ago. Ramona: Glomerular Filtration Raterate. I probably should have said GFR.

IT 91

IT Patient-Centered Healthcare Patients 91

GeriPal

MARCH 13, 2025

Summary Transcript CME Summary As far as weve come in the 50 years since Balfour Mount and Sue Britton opened the first palliative care at the Royal Victoria Hospital in Quebec, have we lost something along the way? I was trained in the hospital where it started, and we were trained to be bedside nurses. Ive got a name.

IT 104

IT Patient-Centered Family Families 104

GeriPal

FEBRUARY 8, 2024

Hospital Chaplains, Spirituality, and Pain Management: A Qualitative Study. She softened to her suffering, and she trusted me enough to have a moment, that she could look into that and see that, yes, she had her clinical judgment, which was fine, but also that there was another processes going on, which was her own suffering.

IT 137

IT Family Families Physicals 137

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. Those disruptive events or shocks often portend a major decline in function from which people with dementia never fully recover. Glad to be here.

Illness 93

Illness Hospital IT Patient-Centered 93

GeriPal

JUNE 13, 2024

Eduardo 07:17 Well, we had a palliative care unit in another hospital that was 510 minutes away. How should I define cachexia and anorexia when I’m talking to fellow students or thinking about it in my own clinical practice? Alex brought up the ESAs, the Edmonton symptom assessment scale. Like, how would I define it?

Illness 133

Illness Patient-Centered Patients IT 133

GeriPal

JUNE 22, 2023

Through a series of events, I started working as a consultant to the Department of Corrections in around 2006, and I was assigned to the California Medical Facility. When they built a new prison hospital in Stockton, the dialysis went there. There are clinics. These older patients are costing a ton in healthcare costs.

Family 132

Family Families IT Community 132

GeriPal

OCTOBER 5, 2023

We need to strike it from our vocabulary and leave sort of a gap in the clinical vernacular about how we talk about life-sustaining treatment. I have never had a patient come into the hospital and say, Doctor, regardless of what you do, do a little CPR that’ll make me feel better. This is Eric Widera. Alex: This is Alex Smith.

Illness 136

Illness IT Patient-Centered Family 136

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. And, like, you try to find a caregiver’s name in a hospital chart, you just can’t. We never mentioned caregivers. Yeah, yeah.

IT 122

IT Patient-Centered Patients Relationship 122

GeriPal

SEPTEMBER 19, 2024

Alex 00:34 We are delighted to welcome back Jennifer Tem e l, who is a thoracic oncologist at Massachusetts General Hospital in Boston. Eric 07:31 A clinical perspective, why is it important to test this stepped care model versus implementing more? Chris 17:25 Yeah, I think a month is pretty uncommon, at least in our clinic.

Patient-Centered 119

Patient-Centered IT Patients Hospital 119

GeriPal

DECEMBER 7, 2023

AlexSmithMD Additional links: JAMA paper on clinical research risks, climate change, and health Geriatric medicine in the era of climate change Health Care Without Harm: [link] Practice Green Health: [link] Global Consortium for Climate and Health Education: [link] Transcript Eric: Welcome to the GeriPal podcast.

Healthcare 129

Healthcare IT Education Community 129

GeriPal

NOVEMBER 3, 2022

That was the lesson I learned from reading a new book edited by Matt Loscalzo along with Marshall Forstein called “ Loss and Grief: Personal Stories of Doctors and Other Healthcare Professionals ”. These debriefings create a safe outlet for health care professionals to talk about the feelings resulting from their work.

Healthcare Professional 102

Healthcare Professional Healthcare IT Relationship 102

GeriPal

JULY 6, 2023

The idea was to create a robust community-based infrastructure that could help older adults succeed in their homes and communities, whether they were healthy, how to keep them healthy or they were at imminent risk of emergency room visits, hospitalizations, or nursing home placements. And that’s critical. Eric: Yeah.

Community 89

Community Nurse Practitioner Provider IT 89

GeriPal

JULY 13, 2023

[laughter] Bob: That’s what happens when junior faculty get invited on the podcast [laughter] Eric: So we’re going to be talking about the article that just came out in JAMA on a priming intervention for goals of care conversations in hospitalized patients with serious illness. Three hospitals all within the UW medicine system.

Patient-Centered 83

Patient-Centered IT Hospital Patients 83

GeriPal

JULY 25, 2024

First time on the GeriPal podcast, Liz Lilley, who’s a surgeon and faculty in surgery at the Brigham Women’s Hospital and Harvard Medical School. Eric 04:39 Yeah, I see it used on inpatient, side on consult clinics in hospices. Alex 00:18 Prognosis, super special today. And we have some great guests. Liz 00:32 Thanks.

Family 106

Family Families Patient-Centered Patients 106