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. Second, we have had some unexpected transitions at my job, and this has left me to cover extra clinical obligations with some consistency. This may be a bold statement, but I believe it to be true.

Finance 52

Finance Education Family Families 52

GeriPal

MARCH 14, 2024

We also talk about the importance of a proactive approach to involving speech-language pathologists in the care of individuals early on with neurodegenerative diseases like dementia and ALS. So as you mentioned, dementia, there’s some research that show about 86% or 93% of those individuals will get that. Raele: Yes, of course.

IT 124

IT Hospital Patient-Centered Individual 124

GeriPal

JUNE 20, 2024

It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. George 03:01 So I would say that as many clinical issues in older adults, we need to think about them in two ways. Eric 11:57 In, let’s say, my clinic. Everybody ages.

IT 120

IT Patient-Centered Patients Clinic 120

GeriPal

AUGUST 4, 2022

My take home from this is that while the most preferred explanation for deprescribing statins and sedative-hypnotics is one focused on the risk of side effects, we also need to individualize it to the patient and the medication that they are taking. Maybe that’s where the individualizing it, the person that’s front of me.

Specialization 104

Specialization Medical Patient-Centered Provider 104

GeriPal

MAY 19, 2022

It depends on the clinical situation. The chart that I have in my book and that I use in practice and so many healthcare systems have adopted already, is the very best, cutting edge data we have. But we still, regardless of how you do this calculation have to temper it with clinical judgment. Eric: All right. Thoughts on that.

IT 139

IT Patients Individual Relationship 139

GeriPal

MAY 5, 2022

Was there any mention about the impact that hearing loss has in communication or what we should do about it in clinical practice? We talk with Nick and Meg about: Why hearing loss is important not just in geriatrics but also for those caring for seriously ill individuals. I’m guessing not. How to screen for hearing loss. Transcript.

IT 102

IT Screening Hospital Clinic 102

GeriPal

JULY 19, 2024

What should we use to screen individuals? 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. So how can we make it more integrated with other activities in the clinic?

Screening 119

Screening Primary Care Patient-Centered IT 119

GeriPal

JUNE 8, 2023

If in your own work, your clinical work, is this something that you see people struggle with you, you see yourself struggle with? So my background clinically is working with cancer patients and families and those who underwent bone marrow transplant, and a lot of times for their treatment regimen, it includes steroids.

Diabetes 73

Diabetes Management Patient-Centered Family 73

GeriPal

MAY 11, 2023

There I was, extremely overly trained with brain stuff, and I wanted to learn how to do clinical research. I just thought there was so much we could learn and offer from every sense, from the clinical point of view, from the family point of view, from prevention, from treatment, epidemiology, et cetera. One might argue they still are.

Physicals 85

Physicals IT Hypertension Education 85

Rao Doctor

APRIL 3, 2025

Infrared thermometers, which measure temperature from the forehead or ear, are also prevalent in clinical settings. This information can help pinpoint possible causes of illness and guide further investigations. While mild fevers often resolve on their own, persistent or severe fevers warrant professional evaluation.

Diagnosis 130

Diagnosis Management Illness Diagnose 130

GeriPal

JUNE 12, 2025

I’m sort of seeing them in clinic for consideration of palliative radiation, they have a lot going on. Sometimes individuals have lung tumors that make it difficult for them to breathe. Now patients are living so much longer that they’re coming back to my clinic after I’ve treated them with radiation.

Patient-Centered 102

Patient-Centered Referral Patients IT 102

GeriPal

FEBRUARY 20, 2025

Thats my main take-home point after learning from our three guests today when talking about trauma-informed care, an approach that highlights key principles including safety, trustworthiness, peer support, collaboration, empowerment, and cultural sensitivity. Eric 00:15 And we have three guests to help us talk about trauma informed care.

IT 66

IT Patient-Centered Screening Patients 66

GeriPal

JUNE 19, 2025

Noelle Marie 01:24 I think it really speaks a lot to my own personal journey and I’m pretty sure a lot of trans and gender diverse individuals also resonate with and it really speaks about our transition, celebrating our authentic selves, how society views us and how we view ourselves when we stand in front of a mirror.

Individual 85

Individual Community IT Chronic Condition 85

GeriPal

JANUARY 18, 2024

We start off the conversation by talking about whether patients with cancer and cancer pain are really that different, and their paper that was just published on January 11 th in JAMA Oncology showing that substance use disorder is not uncommon in individuals with cancer. ABIM MOC credit will be offered to subscribers in November, 2024.

Illness 136

Illness Patient-Centered Screening IT 136

Vida Family Medicine

JUNE 29, 2022

This included additional classes in medical ethics as well as a scholarly project examining the medical ethics of a specific clinical situation. A patient must have the autonomy to choose whether in their individual situation, the potential benefits outweigh the potential harms.

Family Physician 52

Family Physician Family Families Healthcare Professional 52

GeriPal

JANUARY 16, 2025

These individuals may become unrepresented, meaning they lack the capacity to make a specific medical decision, do not have an advance directive for that decision, and do not have a surrogate to help. How should we care for unrepresented individuals in inpatient and outpatient settings? Why not use the older term unbefriended?

Patient-Centered 109

Patient-Centered IT Patients Healthcare 109

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

JANUARY 25, 2024

It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. I’d be operating at the top of what I’m capable of doing, to provide really tailored and individualized care for my patients and their care partners, where they are. Eric: Yeah.

Patient-Centered 122

Patient-Centered IT Illness Patients 122

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

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. That’s where it really gets to this individual risks and balances, individual situation. Certainly my bias is that healthcare professionals really do have a role in this discussion.

IT 102

IT Family Families Diagnosis 102

GeriPal

MARCH 9, 2023

FDA is considering approval, shifting away from Schedule I restrictions, paving the way for use in clinical practice. And some people in studies and just in clinical use have found that to be helpful, including for patients with serious illness. If you put on your clinical hats, what is demoralization to you? What is this?

Patient-Centered 91

Patient-Centered Community IT Medical 91

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 15, 2024

It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. I mean, we work at a different part of the health system a lot of times, although we have acute care therapists who do the same thing, but the gap in information flow is similar.

Community 114

Community Transportation IT PCP 114

GeriPal

MAY 26, 2022

They argue that the current guidelines, which prioritize immunocompromised people and unvaccinated older people on the same level, should be re-done to prioritize the immunocompromised first, and additionally move up older vaccinated individuals or vaccinated persons with comorbidities. What’s wrong with that? Why not prioritize them?

Vaccination 87

Vaccination IT Individual Healthcare 87

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. .

Clinic 67

Clinic IT Patients Medical 67

GeriPal

AUGUST 29, 2024

We must often deliver complex medical information that carries heavy emotional weight in pressured settings to individuals with varying cultural backgrounds, values, and beliefs. Alex 01:24 And Elise Carey, who’s a palliative care doc and geriatrician and associate professor of medicine at the Mayo Clinic in Rochester, Minnesota.

IT 132

IT Illness Family Families 132

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. But we’re not perfect individuals.

Primary Care 113

Primary Care Patient-Centered IT Patients 113

GeriPal

JULY 11, 2024

It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. 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.

Patient-Centered 109

Patient-Centered IT Patients Clinic 109

BMJ

FEBRUARY 8, 2021

The proximity to campus health clinics may also afford college students greater accessibility to healthcare providers for prescription medications such as stimulants which could end up being misused. Besides the risks to an individual, there are also population-level harms from normalizing certain harmful behaviors (e.g.,

Medical 40

Medical Holistic Care Healthcare Healthcare Professional 40

GeriPal

FEBRUARY 23, 2023

My favorite line from Emily’s paper: “Geriatric assent has not been widely adopted in clinical care, but bioethicists should advocate for this, as adoption of partial-involvement strategies can prolong the period in which individuals are (appropriately) engaged in decisions about their health care.” This is a clinical intervention.

Families 97

Families Family Patient-Centered IT 97

GeriPal

AUGUST 17, 2023

Praised by the FDA, Alzheimer’s Association (AA), and Pharma as a “game changer”, but derided by others for the drug’s lack of clinical efficacy, risk of severe adverse effects, absence of diversity in trial populations, high costs, and an FDA approval process that was in the kindest words “rife with irregularities”. I’m a prescriber.

Patient-Centered 98

Patient-Centered IT Clinic Patients 98

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 or Sarah. Thoughts on that. Hillary: So those all differ.

Community 95

Community IT Patient-Centered Primary Care 95

GeriPal

JUNE 16, 2022

First, we talk with Christine, a researcher and geriatrician from the University of North Carolina, who recently published a JAGS article titled Overdiagnosis of urinary tract infections by nursing home clinicians versus a clinical guideline. I appreciate that information. Chrissy: That’s fascinating. Scott: Yeah. Is that right?

Management 122

Management IT Medical Patient-Centered 122

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

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. Mike: Thanks for having me.

Medical 97

Medical IT Patients Clinic 97

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. Eric: I think about it as the first one to address individuals’ curative therapy. I’m just stunned even writing that!

Consulting 115

Consulting Patient-Centered IT Patients 115

GeriPal

NOVEMBER 7, 2024

About half of patients who are over the age of 65 start dialysis with a GFR of over 9, which is sort of the level below which we have clinical trial evidence for suggesting that there may not be a benefit to starting at that level of GFR. Clinical experience. Maria 29:14 We’ll be more statistical than clinical, I think.

Management 116

Management Patient-Centered Patients IT 116