GeriPal

FEBRUARY 27, 2025

Substance use disorder is one of those complex issues in which clinical practice is changing rapidly. Inspired by Dani Chammass paper in Annals of Internal Medicine titled, Wishing for a no show we talk about countertransference: start by asking yourself, Why am I having difficulty? What is making this hard for me?

Patients 72

Patients Clinic Patient-Centered Illness 72

GeriPal

DECEMBER 8, 2022

As Thor notes, capturing patient stories has face validity as positively impacting the patients who share their stories and have them documented, and for the clinicians who get to truely and deeply know their patients in far greater depth than “what brought you to the hospital?” Within the VA it’s now at 70 VA hospitals.

Patient-Centered 115

Patient-Centered Illness Healthcare IT 115

GeriPal

NOVEMBER 7, 2024

And the main topic of today is a paper in Annals of Internal Medicine , Maria first author, that addressed the tradeoffs between initiating dialysis vs continued medical/supportive management. Clinical experience. He would go home, and then three weeks later he would be back in the hospital. Let it be (hint hint).

Management 116

Management Patient-Centered Patients IT 116

GeriPal

APRIL 10, 2025

Today we discuss: Why the study was negative for the primary (hospitalization) and all secondary outcome (e.g. 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.

Patient-Centered 77

Patient-Centered Hospital IT Patients 77

GeriPal

DECEMBER 15, 2022

Been in the hospital four times, vented, been told the story to her family, she won’t live. And now my program of research is around testing that person-centered narrative intervention or PCNI because you have to give them an acronym in healthcare. Within the VA it’s now at 70 VA hospitals.

IT 105

IT Patient-Centered Healthcare Illness 105

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

MAY 18, 2023

Alex: And we’re delighted to welcome Todd Semla, who is a clinical pharmacist and associate professor at the Feinberg School of Medicine at Northwestern University. So in those clinical situations, you should consider avoiding that drug. You have to take that into consideration clinically. Todd: Thank you.

Medical 97

Medical IT Patients Clinic 97

GeriPal

AUGUST 11, 2022

Susan led the Project on Death in America’s Faculty Scholars program , used her dual training in internal medicine and psychiatry to shine a light on psychosocial aspects of palliative care, and founded the Department of Psychosocial Care at the Dana Farber Cancer Institute and Brigham and Women’s Hospital. . Eric: Yeah.

Illness 109

Illness IT Family Families 109

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.

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IT Patient-Centered Patients Board-Certified 96

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. This specific study , published in JAMA Internal Medicine, was conducted in 17 ICUs in North Carolina. Many were community hospitals.

Patient-Centered 116

Patient-Centered Hospital IT Illness 116

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. Alex 16:45 That really rings true with my clinical experience. And I know I do primarily inpatient work.

Patient-Centered 109

Patient-Centered IT Patients Healthcare 109

GeriPal

APRIL 28, 2022

Times , The BMJ , and Annals of Internal Medicine. . So for those listening to the podcast, this is a clown looking very sad and what looks like a hospital administrator. And the hospital administrator says, “No, the hospital definitely values your contributions to the interdisciplinary team. Alex: Right.

IT 145

IT Hospital Patients Illness 145

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

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. To this day, Ken’s post is still one of the most searched and viewed posts on GeriPal. Eric: What was that paper?

Patient-Centered 96

Patient-Centered Patients IT Hospital 96

GeriPal

MARCH 10, 2022

On today’s podcast we dive into drivers of invasive procedures and hospitalizations in advanced dementia by talking to some pretty brilliant nursing and nurse practitioner researchers focused on dementia, geriatrics, and palliative care in nursing homes: Ruth Palan Lopez, Caroline Stephens, Joan Carpenter, and Lauren Hunt. Rehabbed to Death.

Nurse Practitioner 60

Nurse Practitioner Hospital Family Families 60

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. Ashwin 18:08 These are things that we often see from a clinical standpoint.

Patient-Centered 66

Patient-Centered IT Screening Patients 66

GeriPal

FEBRUARY 13, 2025

Marie 03:08 So, living in Alabama, which is our palliative care desert in the south, there were no palliative care services in any of the small rural hospitals. We went to a hospital in Mississippi, one in Alabama, and one in South Carolina. By then they usually were out of the hospital actually. Eric 10:25 And who was included?

Consulting 63

Consulting Community Patient-Centered Family 63

GeriPal

AUGUST 24, 2023

So tiny, tiny, in a hospital bed. And so the importance of the picture and the epiphany that really came many years later, I published a paper in the Journal of Clinical Oncology called Dignity in the Eye of the Beholder. How do you do that in clinical practice, in a way that doesn’t take five hours of sitting down with somebody?

Patient-Centered 98

Patient-Centered Patients IT Illness 98

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. Eric 19:59 And I gotta say, it also just reminds me of the entire idea of, like, slow medicine, too. Lingsheng, welcome back to GeriPal.

IT 122

IT Patient-Centered Patients Relationship 122

GeriPal

APRIL 24, 2025

We and our guests have noticed that in our clinical practices, patients and caregivers seem to be asking for such treatments more frequently. For this weekly treatment, the cancer team that had been consulted in the hospital told him this is nonsense. And in addition, my work in palliative care, I also am a clinical ethicist.

Patient-Centered 77

Patient-Centered IT Patients Illness 77

GeriPal

MARCH 31, 2022

So all of that, the language dimension of clinical work is, it seems to me very much more fine tuned or refined. Oh, is emeritus professor at UCSF, internal medicine. Another was sent to me when I was very sick in the hospital by a patient of mine. It’s more of a precision instrument. So Guy go on.

IT 70

IT Patients Medical Illness 70

GeriPal

MAY 29, 2025

And I think this just hasn’t made it into, like, our academic clinical training space. So what I remember is, is multiple hospitals and they did EEG during CPR during a cardiac arrest. MOC points per podcast in the American Board of Internal Medicines (ABIM) Maintenance of Certification (MOC) program.

Family 93

Family Families IT Patient-Centered 93

GeriPal

APRIL 11, 2024

This podcast was initially sparked by Josh’s “Note From a Family Meeting” Substack post titled “ Ambivalence in Clinical Decision-Making ,” which discussed Bryanna’s and Jenny’s 2022 article titled “ Two Minds, One Patient: Clearing up Confusion About Ambivalence.” I was a clinical ethics fellow at Baylor College of Medicine.

Patient-Centered 128

Patient-Centered IT Patients Consulting 128

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

APRIL 26, 2024

Alex: We are delighted to welcome Bryanna Moore, who is a philosopher and bioethicist, and she’s at the University of Texas Medical Branch where she also directs the clinical Ethics Fellowship. Mary Dwyer, who is a lawyer, and bioethicist and assistant professor at Case Western Reserve and University Hospitals. Bry: Yeah, Eric.

Patient-Centered 119

Patient-Centered IT Patients Consulting 119

GeriPal

MARCH 27, 2025

Summary Transcript CME Summary A pragmatic trial evaluates the effectiveness of a treatment or intervention in real-world clinical practice. At a high level to sort of step in and start, you know, tinkering with workflows that, you know, are kind of as healthcare is a giant machine in primary care. We did it by the clinic level.

Primary Care 79

Primary Care IT Clinic Illness 79

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

GeriPal

JULY 7, 2022

Haider is a physician at the Brigham and Women’s Hospital, and the VA in Boston. And I was an internal medicine resident. And that’s just one example of how, especially when you’re on the clinical side, talking about it as a science and talking about it to scientist pain is very, very clean.

Patient-Centered 105

Patient-Centered Physicals IT Patients 105

GeriPal

APRIL 21, 2022

Then it really wasn’t until I got into medicine, medical school and residency, that I discovered poetry per se, and a mentor commented, I think to a number of us on this podcast, Steve McKee introduced me to poetry. I think that in almost every clinical encounter, we struggle with what’s ours and what’s someone else’s?

Patient-Centered 93

Patient-Centered IT Community Illness 93

GeriPal

DECEMBER 21, 2023

Malaz: One day I was in internal medicine residency and I had to take care of a patient who was admitted from a nursing home with dementia. The way we were treating him with dementia in the hospital, the way we talked about him, that he’s not there. Malaz: … to restrain them in the hospital.

Patient-Centered 125

Patient-Centered IT Family Families 125

GeriPal

DECEMBER 12, 2024

Ill end this intro with a quote from Deb Grady in an editors commentary to our thought piece in JAMA Internal Medicine about this topic: Voice technology that creates a searchable database of patients every encounter with a health care professional? Does this issue ring true to you clinically? Jenny 01:27 Thanks.

Patient-Centered 108

Patient-Centered IT Patients Healthcare 108