The Motivated MD

NOVEMBER 19, 2024

True we have a fulltime nanny, but we still both work full-time clinically and still wish to have a steady hand in our children’s lives. Because of this, carving out the time for family remains a top priority, and as our family grows, more and more time is needed to make that goal a reality.

Finance 52

Finance Education Family Families 52

GeriPal

JULY 19, 2024

Alex 00:20 And she’s professor of family medicine at USC, deputator at JAGS, and co lead of the bold center of Excellence in early detection of dementia. What hasn’t been shown, Eric, is that if you apply tools like this, clinical outcomes down the road are better for patients. Is that right, Soo? Soo 00:32 Thanks.

Screening 119

Screening Primary Care Patient-Centered IT 119

GeriPal

JUNE 8, 2023

And yet we’re also in a different place in diabetes monitoring and management. AlexSmithMD Additional Links: – Fingerstick monitoring in VA nursing homes (too common!) – Improving diabetes management in hospice – Continuous Glucose Monitoring complicating end of life care Transcript Eric: Welcome to the GeriPal podcast.

Diabetes 73

Diabetes Management Patient-Centered Family 73

Mesa Family Physician

MARCH 13, 2025

However, at Mesa Family Physicians , we believe that preventive healthcare is the cornerstone of long-term wellness for our Mesa, Arizona community. Regular visits to your primary care physician at Mesa Family Physicians provide opportunities for early detection of potential health issues before they become serious problems.

Family Physician 100

Family Physician Preventative Care Preventive Care Families 100

GeriPal

AUGUST 4, 2022

Liz Bayliss is Senior Investigator at Kaiser Permanente Colorado Institute for Health Research, and Professor of Family Medicine at the University of Colorado. Alex: And we have Kevin McConeghy, who is a clinical pharmacy specialist at the VA Medical Center in Providence, and a PhD candidate at the Brown School of Public Health.

Specialization 104

Specialization Medical Patient-Centered Provider 104

GeriPal

NOVEMBER 7, 2024

Summary Transcript CME Summary We recently published a podcast on palliative care for kidney failure, focusing on conservative kidney management. Today we’re going to focus upstream on the decision to initiate dialysis vs conservative kidney management. This is Eric Widera. Alex 00:12 This is Alex Smith. So we got a lot to cover.

Management 116

Management Patient-Centered Patients IT 116

GeriPal

JUNE 16, 2022

There are a lot of old myths out there about managing urinary tract symptoms and UTI’s in older adults. Then we chat with Scott Bauer, internist and researcher at UCSF, about how to assess and manage lower urinary tract symptoms in men. Summary Transcript Summary. Alex: This is Alex Smith. Welcome to the GeriPal podcast, Chrissy.

Management 122

Management IT Medical Patient-Centered 122

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 Family Families 119

GeriPal

SEPTEMBER 29, 2022

Have you had difficulty managing a particular type of cancer pain? Janet Abrahm is one of the world’s experts in pain and symptom management for patients with cancer joins us to talk about (among other things): Ketamine for hyperalgesia and allodynia, how to treat dissociative side effects. Summary Transcript Summary. Janet: Thank you.

Management 101

Management IT Patients Family 101

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. So delivering those month visits in clinic, often in tandem with their other oncology appointments.

Telehealth 105

Telehealth Patient-Centered IT Patients 105

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

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. It used to also be a social worker and myself who would actually go to clinic and spend some time up there. Sarah 06:23 It’s just me.

Patient-Centered 109

Patient-Centered IT Patients Clinic 109

GeriPal

JANUARY 25, 2024

And so, three years of seeing over and over people having really difficult end of life experiences in the ICU, not being able to advocate for themselves, a lot of trauma for their families, I just thought, we have to do better than this. I was really passionate about helping the people and also their families. Eric: Oh, wow.

Patient-Centered 122

Patient-Centered IT Illness Patients 122

GeriPal

AUGUST 29, 2024

It feels nearly impossible if you add another degree of difficulty, whether it be a crying interpreter or a grandchild from another state who shows up at the end of a family meeting yelling how you are killing grandma. And you’re in the ICU family meeting, and it gets heated. Is the sort of task to manage.

IT 132

IT Illness Family Families 132

GeriPal

JULY 21, 2022

Often the work of the certified driving rehab specialist is to assess the older drivers goals, assess prognosis for driving, and help the family navigate discussions around driving cessation (hmmm…sounds like an approach to family meetings). Were those people self referring, or family members calling you asking? Eric: Yeah.

IT 102

IT Family Families Diagnosis 102

GeriPal

JUNE 27, 2024

I have so many questions, and I promise we’re going to get to the management of anxiety and serious illness. Because I might be able to cope and manage in one situation with the skills and supports that I have, and with those same skills and supports, and another situation kind of come unraveled. Brianna 00:41 Thanks.

Illness 129

Illness IT Diagnosis Patient-Centered 129

GeriPal

SEPTEMBER 7, 2023

Based on this surge in evidence, the American Society of Clinical Oncologists recently updated their guidelines for care of older adults to state that all older adults receiving systemic therapy (including chemo, immuno, targeted, hormonal therapy) should receive geriatric assessment guided care. Alex: How is your family doing?

Patient-Centered 129

Patient-Centered IT Patients Clinic 129

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

JANUARY 16, 2025

Summary Transcript CME Summary Many older adults lose decision-making capacity during serious illnesses, and a significant percentage lack family or friends to assist with decisions. And so there’s complexity in Understanding how each state manages this. Alex 16:45 That really rings true with my clinical experience.

Patient-Centered 109

Patient-Centered IT Patients Healthcare 109

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

FEBRUARY 22, 2024

Is it that they’re clinically depressed or that they’re understandably sad at the situation that they’re in or specific issues? They’re still engaging fully with their family and with the activities and the hobbies that they’re still able to do. It’s high, it’s too high. Eric: Yeah.

Mental Health 122

Mental Health Patient-Centered Illness Screening 122

GeriPal

DECEMBER 8, 2022

Our loves, our triumphs, our failures, our work, our families. . So I think as palliative care clinicians, we use narrative as we try to understand more about the persons that we’re caring for and their families. Been in the hospital four times, vented, been told the story to her family, she won’t live.

Patient-Centered 115

Patient-Centered Illness Healthcare IT 115

GeriPal

FEBRUARY 8, 2024

Hospital Chaplains, Spirituality, and Pain Management: A Qualitative Study. Pain Manag Nurs. The more we can notice that, the more we can actually be present for that family and actually see how they’re experiencing it. Family member, and with some chagrin- Eric: Powerful nudge. 2023 Dec 20:S1524-9042(23)00202-3.

IT 137

IT Family Families Physicals 137

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

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. These were clinically significant and statistically significant improvements. I’m just stunned even writing that!

Consulting 115

Consulting Patient-Centered IT Patients 115

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

DECEMBER 15, 2022

So I think as palliative care clinicians, we use narrative as we try to understand more about the persons that we’re caring for and their families. Been in the hospital four times, vented, been told the story to her family, she won’t live. And so I really gain that and I love the chorus words that she uses in this song.

IT 105

IT Patient-Centered Healthcare Illness 105

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

FEBRUARY 6, 2025

On todays podcast, weve invited Nathaniel Chin back to the GeriPal podcast to talk about what primary care needs to manage this new world of Alzheimers disease effectively. So let’s just say you have a healthy 55 year old or 65 year old in your clinic. Eric 05:13 All right, I’m going to start off at the beginning, then.

Primary Care 95

Primary Care Diagnosis Screening IT 95

GeriPal

SEPTEMBER 22, 2022

And in response, the family or patient looked at you like you were from another planet? Coming off as rote and scripted during a serious illness conversation can have a similar off-putting impact on patients and families. Links: – Uncanny Valley post on Josh’s fantastic substack Notes from a Family Meeting. Eric: So yeah.

Illness 101

Illness IT Patient-Centered Patients 101

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). It is really difficult for the patients and the families. Welcome to the GeriPal podcast, Abby. Abby: Thank you.

IT 83

IT Family Families Illness 83

GeriPal

MAY 22, 2025

And we got all into his family stuff and how he’d been suffering with cancer and his goal. Just encourage patients and families to bring music into their healthcare experience. We introduce it to families and patients and explain how it works and show them. And it was like the lights came on. This guy came alive.

IT 96

IT Patient-Centered Patients Board-Certified 96

GeriPal

APRIL 13, 2023

Summary Transcript Summary Social connections impact our health in profound ways, whether it is the support we receive from family and friends in navigating serious illness, the joy from shared social activities, or connecting with our community. I moved to Baltimore in 2015 and did clinical fellowship in geriatrics.

IT 99

IT Community Patient-Centered Medical 99

GeriPal

JUNE 19, 2025

And I think a big part of that journey was just having that right time, that right moment, with the right network and support groups of individuals, including my family, to really lift me up and allow me to celebrate my authentic self. If we think of discrimination, how people are treated by their biological family. Caregivers too.

Individual 85

Individual Community IT Chronic Condition 85

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

NOVEMBER 21, 2024

Like, how do we help ourselves maintain psychological integrity in the face of the stressors that we have to manage? The clinical trials and the this and that. But if we’re going to have a family meeting, that’s a different circumstance. That’s how I managed without screaming at my 4 year old who was coping.

Illness 125

Illness IT Patient-Centered Patients 125

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