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). difficile infections.

Complication 97

Complication Patient-Centered IT Patients 97

Permanente Medicine

MAY 20, 2025

When I started over 20 years ago, saw babies being born, used to do circumcisions in clinics, and then taking care of patients as they got more mature in their life, so to speak, and really loved that. I’m a family physician by training. Couldn’t imagine doing anything else. Outside of work.

Patient-Centered 52

Patient-Centered Patients Medical IT 52

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

Pamela Wible MD

JUNE 20, 2025

During that time, psychologist Herbert Freudenberger volunteered at a New York City free clinic treating addiction. He overheard the term and used it to describe himself and clinic staff in a 1974 article on staff burnout detailing long-term physical and psychological job stress. I’m a systems thinker, a scientist, a doctor.

Medical Student 246

Medical Student Diagnosis Physicals Medical 246

Today's Hospitalist

JUNE 7, 2025

Medical societies and hospitals are weighing in on periprocedural concerns in patients taking GLP-1s who need procedures or surgeries. That’s according to two internists who work closely with hospitalized patients who take GLP-1s. “I would not recommend starting a GLP-1 in the hospital.” Nor should they be.

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Hospital Management Diabetes Patients 63

Physician's Weekly

JUNE 22, 2025

Targeted ICD selection based on predicted therapy benefit enhances patient outcomes while cutting hospital costs by 16.7%. They collected clinical event data and hospital care expenditures from individuals enrolled in the Dutch DO-IT registry.

Individual 52

Individual Hospital Clinic Patients 52

Annals of Family Medicine

NOVEMBER 20, 2024

Using linked administrative databases, we identified all instances of PIP-AP according to the STOPP-START criteria, which have previously been shown to predict adverse clinical events such as ED visits and hospitalizations. Residents were followed for 1 year or to date of death, whichever occurred first.

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Patients Provider Individual Hospital 130

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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Community Transportation IT PCP 114

FDA Law

MARCH 17, 2022

Proposed 2022 CDC Clinical Practice Guideline for Prescribing Opioids, 87 Fed. et al, CDC Clinical Practice Guideline for Prescribing Opioids-United States, 2022, CDC. CDC Clinical Practice Guideline, 10. (We blogged on the final 2016 guideline here on March 17, 2016). 7,838 (Feb. 10, 2022); Dowell, Deborah, MD.,

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Patient-Centered Clinical Practice Patients Management 75

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

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. Alex 04:47 Probably was, yeah.

Primary Care 113

Primary Care Patient-Centered IT Patients 113

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

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

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.

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Management Patient-Centered Patients IT 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.

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Community IT Patient-Centered Primary Care 95

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. difficile infections. So you’re right.

Complication 52

Complication Patient-Centered IT Patients 52

GeriPal

FEBRUARY 17, 2022

When we have a medication with up front harms and downstream benefits, it’s critical that we consider the time to benefit, or how long it will take an individual to benefit from a test or treatment. For individuals with a life expectancy less than the time to benefit, the up front harms outweigh the downstream benefits. .

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Clinic IT Patients Medical 67

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

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

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. So if you haven’t been to this event, there is a literature review where we. But in spite of that, it is a lot of work for three individuals to pull all this together.

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IT Hospital Screening Patients 64

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. Eric: So we’re going to be talking about dementia and considerations around surgery for individuals with dementia. And she was rushed to the hospital. Did I get that right? Joel: Oh yeah.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

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. That’s true.

IT 110

IT Healthcare Healthcare Professional Patient-Centered 110

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

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.

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Family Families IT Patient-Centered 93

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

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

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

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. Welcome to the GeriPal podcast, Michele. Michele: Yep. Michele: Yeah.

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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

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

FEBRUARY 8, 2024

Hospital Chaplains, Spirituality, and Pain Management: A Qualitative Study. So there’s this, what is suffering to the individual, and is there some threshold that we could say, “This is real suffering,” or “This is the suffering we talk about in geriatrics or palliative care”? .” Pain Manag Nurs.

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IT Family Families Physicals 137

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

was supported by the fossil fuel industry , because it shifted responsibility for change from industry to individuals. And so any additional stressor such as heat or an extreme weather event or having to move from your home because of a climate related disaster can really tax an older adult whose window of resilience is more limited.

Healthcare 129

Healthcare IT Education Community 129

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. To Susan’s point. They touch every single system.

Community 89

Community Nurse Practitioner Provider IT 89

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.

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Family Families Patient-Centered Patients 106

GeriPal

APRIL 20, 2023

Today we talk with Margot Kushel about how we got here, including: That sense of powerlessness as a clinician when you “fix up” a patient in the hospital, only to discharge them to the street knowing things will fall apart. What are the structural factors and individual factors that contribute to homelessness? Really appreciate that.

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Mental Health Community IT Individual 123