GeriPal

JULY 19, 2024

Lastly, Soo Borson is a self-described primary care leaning geriatric psychiatrist, developer of the Mini-Cog, and co-leads the CDC-funded BOLD Center on Early Detection of Dementia. What should we use to screen individuals? Who should get it if anyone? What happens after they test positive? Who do we have with us today?

Screening 119

Screening Primary Care Patient-Centered IT 119

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

OCTOBER 13, 2022

Devika Nair and Rasheeda Hall talk about their JAGS article highlighting updates from nephrology in the care of older adults, including a link to this new eGFR calculator that does NOT include race. There’s the complications associated with immune senescence, comorbidities, atypical clinical presentations. So you’re right.

Complication 97

Complication Patient-Centered IT Patients 97

GeriPal

JUNE 20, 2024

Alex 00:30 And we’re delighted to welcome Alison Huang, who’s a primary care doc and researcher and professor of medicine, urology, and epi-biostats at UCSF in the division of General Internal Medicine. George 03:01 So I would say that as many clinical issues in older adults, we need to think about them in two ways.

IT 120

IT Patient-Centered Patients Clinic 120

GeriPal

NOVEMBER 9, 2023

Today we learn more about coaching from 3 coaches: Greg Pawlson, coach and former president of the American Geriatrics Society, Vicky Tang, geriatrician-researcher at UCSF and coach , and Beth Griffiths, primary care internist at UCSF and coach. We address: What is coaching? How does it differ from therapy? From Beth Israel and UNC.

Board-Certified 110

Board-Certified IT Primary Care Referral 110

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

GeriPal

FEBRUARY 6, 2025

So, the question becomes, what, if anything, should we do differently in the primary care setting to diagnose the disease? 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. Great to be back.

Primary Care 95

Primary Care Diagnosis Screening IT 95

GeriPal

JUNE 12, 2025

I’m sort of seeing them in clinic for consideration of palliative radiation, they have a lot going on. But there are times that a primary care physician or an internal medicine physician may make the referral. Sometimes individuals have lung tumors that make it difficult for them to breathe.

Patient-Centered 102

Patient-Centered Referral Patients IT 102

Doctor On Demand

APRIL 28, 2025

Most sore throats heal on their own, but severe cases may require urgent care. Learn more about which symptoms mean you should go to urgent care or the ER, as well as when to use telehealth or see a primary care doctor. Urgent care clinics provide quick diagnoses and treatments, including antibiotics if needed.

ER 52

ER Telehealth Primary Care Doctor Appointment 52

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

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. And also I was in the HVMA primary care program.

Primary Care 113

Primary Care Patient-Centered IT Patients 113

GeriPal

JANUARY 25, 2024

David: Similarly informed by my clinical experience, really, actually, beginning in residency when I took care of a lot of sick folks in the hospital, particularly those with cancer and heart and lung diseases like these. And not just statistically significant, but clinically meaningful. Eric: And your primary outcome was what?

Patient-Centered 122

Patient-Centered IT Illness Patients 122

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. Who do we have with us today? Katie, welcome back to GeriPal.

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

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

FEBRUARY 15, 2024

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. All of these are factors that are on the individual level. Same thing with kind of medication management. When you ask stakeholders, they just feel safe.

Community 114

Community Transportation IT PCP 114

GeriPal

MAY 25, 2023

And, you know, I really leaned in from my perspective as a primary care geriatrician to hearing from what my patients and their family caregivers are asking me for and asking me about, and they’re asking me about how they can prepare. Hillary: I certainly agree lots to think about. Hillary: So those all differ.

Community 95

Community IT Patient-Centered Primary Care 95

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

NOVEMBER 14, 2024

You know, if you want to think about the problem, think about clinical research. You know, I wonder how much, because it’s probably not brought up a lot in primary care settings. Sarah 11:14 So it’s really assessing patients for their individual risk factors for falls. Eric 03:49 Great. Eric 04:51 Yeah.

IT 124

IT Screening Patient-Centered Community 124

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

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

OCTOBER 20, 2022

As you know, our population is aging at a rapid speed and older, adult older persons is no longer cared for only by a geriatrician or a primary care physician. There’s the complications associated with immune senescence, comorbidities, atypical clinical presentations. So you’re right.

Complication 52

Complication Patient-Centered IT Patients 52

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. And so that was one, very interesting to me. Chrissy: That’s fascinating. Scott: Yeah.

Management 122

Management IT Medical Patient-Centered 122

GeriPal

MARCH 28, 2024

Summary Transcript Summary One marker of the distance we’ve traveled in palliative care is the blossoming evidence base for the field. Eric: And we’re going to get to results, but that’s why I also love that 2016 paper: I think it was the very first palliative care trial that ever looked at individuals getting curative therapy.

Consulting 115

Consulting Patient-Centered IT Patients 115

GeriPal

NOVEMBER 2, 2023

So the data relating to the number of geriatricians in this country, salaries in comparison to hospitalists or primary care physicians. And I met with the clinical pharmacist who worked in that clinic and she told me, “You know what? How do we train primary care doctors to do geriatrics?

Board-Certified 91

Board-Certified IT Community Medical Student 91

GeriPal

JUNE 9, 2022

Clinical growth of geriatrics programs has lagged academic research, despite the rapid aging of the population. . Palliative care, in contrast, saw explosive growth in US hospitals. And so I took a palliative care elective in my last two weeks of fellowship with Nina O’Connor an amazing mentoring clinician. Kate: Sure.

Consulting 99

Consulting Patient-Centered Diagnosis IT 99

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. Some of them are really deeply individual experiences.

IT 66

IT Patient-Centered Screening Patients 66

GeriPal

JUNE 30, 2022

Eric: So we’re going to be talking about dementia and considerations around surgery for individuals with dementia. So, that was maybe 20 years ago at this point and it really got me down the road thinking about advance care planning, end-of-life care, and similar consequences. Welcome to the GeriPal podcast, Samir.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

GeriPal

OCTOBER 26, 2023

Summary Transcript Summary Often podcasts meet clinical reality. That’s why we do this podcast- to address real world issues in palliative care, geriatrics, and bioethics. But rarely does the podcast and clinical reality meet in the same day. Dear listeners, if you have a podcast idea, feel free to reach out to us.

Patient-Centered 132

Patient-Centered Hospital Patients IT 132

GeriPal

APRIL 10, 2025

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. Essentially a primary palliative care intervention of sorts. What is a clinical decision support?

Patient-Centered 77

Patient-Centered IT Hospital Patients 77

GeriPal

APRIL 4, 2024

Today, we talk with Bernie Lo, prominent bioethicist and practicing primary care internist, and Laurie Dornbrand, geriatrician at the IOA On Lok PACE, about the legacy of Nancy Curzan. We use Bernie’s NEJM Perspective as a springboard for discussion. Should we abandon the term, “comfort measures?”

Family 112

Family Families Patient-Centered IT 112

GeriPal

MARCH 24, 2022

I worry, as a ex-primary care doctor, how much time I have. Although, certainly when you start facing complications of serious illness, it is increasingly important to engage as individuals and conversations about goals, values, and preferences. I think it’s all about how important. I think Bob also noted documenting it.

Illness 72

Illness IT Healthcare Patient-Centered 72

GeriPal

JUNE 5, 2025

Despite these substantial needs, specialized palliative care beyond hospice is rare in nursing homes. Furthermore, only about half of nursing home residents nearing the end of life receive hospice care. So, how can we improve palliative care for individuals in nursing homes? Kathleen 20:36 Right. Cari 39:51 Right, right.

Nurse Practitioner 78

Nurse Practitioner Referral Consulting Board-Certified 78

GeriPal

JUNE 22, 2023

So they can be referred by their primary care doctor or to us. You can choose comfort-focused care or you can choose to continue chemotherapy. Eric: So in some ways, this is kind of like the VA, where you don’t have to follow Medicare guidelines, but you can actually actively do concurrent care for these individuals.

Family 132

Family Families IT Community 132

GeriPal

MARCH 7, 2024

Whenever I take care of a patient, I see myself as a family practice doctor, but I’ve been a hospitalist, I’ve been a primary care doctor, and I’ve done palliative. It sets space between us and the individuals we’re trying to take care of. I often say that doulas are mirrors. Alex: Yeah.

Provider 117

Provider Illness IT Healthcare 117

GeriPal

MARCH 3, 2022

I am wondering whether it’s the conversations and preparation that’s primary care providers and outpatient providers are having with a lot of these patients and families to either prevent an ICU admission or potentially address their goals, such that they don’t go into the ICU. So, that part was not surprising.

Patient-Centered 96

Patient-Centered Patients IT Hospital 96

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. Eric 06:58 It could be CPR in an individual with metastatic cancer in the icu. And in addition, my work in palliative care, I also am a clinical ethicist. Stem cell treatments.

Patient-Centered 77

Patient-Centered IT Patients Illness 77