The Clinical Problem Solvers

APRIL 24, 2025

She is the Psychiatrist-in-Chief and Chair of the Department of Child and Adolescent Psychiatry and Behavioral Sciences at the Children’s Hospital of Philadelphia (CHOP). Dr. Benton mentors clinical and research physicians, fellows, and postdoctoral trainees.

Mental Health 52

Mental Health Community Hospital Appointment 52

GeriPal

JANUARY 12, 2023

But if ACE units are so great, why do so few hospitals have them? Kellie Flood’s paper in JAMA IM showing that not only ACE units deliver better care, but also help with the hospitals bottom line. Eric: And we’re going to be talking about improving hospital care for older adults via ACE units, or acute care for elders.

Hospital 100

Hospital Patient-Centered IT Nurse Practitioner 100

GeriPal

MARCH 14, 2024

We talk with them about the epidemiology, assessment, and management of dysphagia, including the role of modifying the consistency of food and liquids, feeding tubes, and the role of dysphagia rehabilitation like tongue and cough strengthening. Eric: And why is it more common in hospitalized adults? This is Eric Widera.

Hospital 124

Hospital IT Patient-Centered Individual 124

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). So you’re right.

Complication 97

Complication Patient-Centered IT Patients 97

GeriPal

JULY 19, 2024

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. What hasn’t been shown, Eric, is that if you apply tools like this, clinical outcomes down the road are better for patients.

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

GeriPal

JANUARY 23, 2025

Join us as we dive deeper into these studies and discuss the implications for clinical practice and patient care. And there’s so much work on, you know, you’ve got to take these medicines, you got to prevent this treat, that there isn’t that same sort of clinical momentum towards deprescribing. Ethical and practical.

Specialization 119

Specialization IT Patient-Centered Medical 119

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 we still, regardless of how you do this calculation have to temper it with clinical judgment. Eric: All right. Eric: Yeah.

IT 139

IT Patients Individual Relationship 139

Physician's Weekly

JULY 2, 2025

Shared decision making (SDM) plays a central role in managing kidney failure (KF) in many nephrology [centers],” researchers wrote in BMC Nephrology. The progressive nature of KF underscores the need for continuous collaboration between patients and healthcare professionals, allowing personalized treatment choices as kidney function declines.

Patient-Centered 85

Patient-Centered Healthcare Professional Clinical Practice Hospital 85

Plum Health

OCTOBER 11, 2024

Have you ever found yourself in need of medical attention but overwhelmed by the myriad of clinics and healthcare options out there? Navigating the healthcare system can be daunting, especially when you're unwell or caring for someone who is. How do you choose the right clinic when every option seems equally promising?

Clinic 52

Clinic Primary Care Doctor Primary Care Chronic Condition 52

The Medical Futurist

JUNE 21, 2025

Matthew Enevoldson, PR Manager at SkinVision told The Medical Futurist that technology such as their own is becoming more integrated within the health system, to both ensure that those who need treatment are made aware of it and that those who have an unfounded concern do not take up valuable time and resources.

Patients 111

Patients Healthcare Board-Certified Telemedicine 111

GeriPal

JUNE 12, 2025

I’m sort of seeing them in clinic for consideration of palliative radiation, they have a lot going on. I didn’t know where they existed within the hospital. Eric 07:04 You actually created things like a curriculum for hospital medicine fellows in radiation oncology. Eric 00:59 Why did you choose this song?

Patient-Centered 102

Patient-Centered Referral Patients IT 102

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. We also discuss (without trying to get too wonky!) Let it be (hint hint).

Management 116

Management Patient-Centered Patients IT 116

My Green Doctor

JULY 2, 2025

Here we suggest steps that healthcare managers and clinicians can take to protect their patents. The EIB developed a first-of-its-kind tool to quantify how climate hazards like heatwaves, floods, and poor air quality will drive up healthcare demand across Europe. Because sustainable healthcare isn’t optional—it’s essential.

Healthcare 52

Healthcare Healthcare Professional Management Community 52

GeriPal

DECEMBER 14, 2023

More recently Sharon Kaufman ‘s book And a Time to Die described the ways in which physicians, nurses, hospital systems, and payment mechanisms influenced the hour and manner of patient’s deaths. Liz: Well, some aspects of this paper around clinical momentum and things around defaults and that sort of thing. Proud Mary.

Hospital 125

Hospital IT Patient-Centered Patients 125

GeriPal

JANUARY 25, 2024

You can also listen to an audio interview with Alex and JAMA Deputy Editor Preeti Malani about this study and the other RCT of default palliative care for hospitalized older adults with noncancer serious illness published in the same issue. People had to be in the top 20th percentile of risk for being hospitalized or dying in the next year.

Patient-Centered 122

Patient-Centered IT Illness Patients 122

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? So there is this meaningful difference between appropriate reactions to illness and clinically significant symptoms of mental health problems. It’s high, it’s too high.

Mental Health 122

Mental Health Patient-Centered Illness Screening 122

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

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

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 Clinic 136

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

OCTOBER 10, 2024

Of note: these lessons apply to geriatrics, primary care, hospital medicine, critical care, cancer care, etc, etc. And they begin on today’s podcast with one clinical ask: everyone should be a generalist and a specialist. In other words, in addition to being a specialist (e.g. Naomi 01:09 Thank you. Good to be here.

Screening 119

Screening IT Family Families 119

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 folks that are having refractory ascites or refractory encephalopathies, challenging emotional symptom management as well. Alex 06:50 So you’re an embedded model.

Patient-Centered 109

Patient-Centered IT Patients Clinic 109

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. Kate: It was done in 10 hospitals, 17 ICUs in Atrium Health down in North Carolina. Also the same hospital system?

Consulting 115

Consulting Patient-Centered IT Patients 115

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

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 Nurse Practitioner 102

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

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. But at that time I was struck by how in that field, there wasn’t a focus or really interest in symptom management and support for patients and their families.

Illness 110

Illness Hospital Patient-Centered Patients 110

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. Mazie, welcome to GeriPal. William: Sure.

Patient-Centered 129

Patient-Centered IT Patients Clinic 129

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

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

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. It’s very rare and they may be a male patient. So you’re right.

Complication 52

Complication Patient-Centered IT Patients 52

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. I’ve worked in hospital settings as an occupational therapist, inpatient rehab and outpatient rehab. Emmy: I was seeing people in the hospital setting, saying they had had a massive brain injury.

Family 102

Family Families IT Diagnosis 102

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

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

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. And so there’s complexity in Understanding how each state manages this. They have an advance directive.

Patient-Centered 109

Patient-Centered IT Patients Healthcare 109