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.

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Patient-Centered IT Screening Patients 66

GeriPal

JUNE 27, 2024

Alex is a triple-boarded (palliative care, internal medicine, and psychiatry) assistant professor of medicine at Stanford. MOC points per podcast in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. The question I would ask is, how helpful is that in our clinical practice?

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Illness IT Diagnosis Patient-Centered 129

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. This is Eric Widera. Eric 20:31 Yeah.

Patient-Centered 109

Patient-Centered IT Patients Healthcare 109

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 did your clinic look like?

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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. Todd: Thank you.

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Medical IT Patients Clinic 97

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. Maria 29:14 We’ll be more statistical than clinical, I think. Most patients don’t recover.

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Management Patient-Centered Patients IT 116

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. And then we had clinical decision support. What is a clinical decision support? Long overdue.

Patient-Centered 77

Patient-Centered Hospital IT Patients 77

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. . That was one thing.

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Illness IT Family Families 109

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. Alex 00:12 We have a guest host who has requested this episode, Matt Shuster, who’s a geriatrician and palliative care doc. He’s in Boston.

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Primary Care Patient-Centered IT Patients 113

GeriPal

MAY 22, 2025

We start each podcast with a song in part to shift the frame, taking people out of their academic selves and into a more informal conversation. Well, todays guests love music at least as much if not more than me, and they each make a strong case for music as medicine. Tyler 34:44 Jenny, you’re giving me chills over here.

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IT Patient-Centered Patients Board-Certified 96

GeriPal

MAY 15, 2025

This specific study , published in JAMA Internal Medicine, was conducted in 17 ICUs in North Carolina. At one end of the spectrum you can provide decision makers with information that doesn’t work very well in most contexts. We didn’t make them do anything with that information, just document it.

Patient-Centered 116

Patient-Centered Hospital IT Illness 116

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.

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Hospital IT Patient-Centered Patients 125

GeriPal

MAY 29, 2025

And I think this just hasn’t made it into, like, our academic clinical training space. And then I think the flip side of that is we don’t deal with it as clinicians and help them understand how to interpret that information. And like, she retained that information for so long, but she does not really Speak.

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Family Families IT Patient-Centered 93

GeriPal

MARCH 3, 2022

And Lauren Ferrante has found in a study published in JAMA Internal Medicine that trajectories of disability in the year prior to ICU admission were highly predictive of disability post-ICU, on the same order of magnitude as mechanical ventilation. It was this slow build, I would say. Absolutely. Alex: Bye everybody.

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Patient-Centered Patients IT Hospital 96

GeriPal

MARCH 10, 2022

Now when I say variation, I’m not talking about small little clinically questionable variations. Archives of Internal Medicine 2010. One of them is Karen Steinhauser’s Annals of Internal Medicine paper on, In Search of a Good Death. Rehabbed to Death. Ruth: Aw, thanks.

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Nurse Practitioner Hospital Family Families 60

GeriPal

FEBRUARY 13, 2025

And then we incorporated that information into the consultation process. Later on, of course, we added health professionals to, you know, give us more information. You just email them or email them information on prepare for your care. And it was both statistically and clinically significant on that scale.

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Consulting Community Patient-Centered Family 63

GeriPal

AUGUST 24, 2023

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? Eric: So how do you do that?

Patient-Centered 98

Patient-Centered Patients IT Illness 98

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. And in addition, my work in palliative care, I also am a clinical ethicist. So the ethics is a little different, but my clinical experience is just the emotion is much higher in these instances.

Patient-Centered 77

Patient-Centered IT Patients Illness 77

GeriPal

MARCH 20, 2025

I was part of a writing group that wrote clinical guidelines for VSET for voluntarily stopping eating and drinking. Who do you give informed consent to? This is just because this arose organically in clinical practice as a way of balancing these underlying competing ethical issues. Why did you write this paper?

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IT Patient-Centered Patients Medical 87

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.

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Patient-Centered IT Patients Consulting 128

GeriPal

APRIL 26, 2024

MOC points per podcast in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. I was a clinical ethics fellow at Baylor College of Medicine.

Patient-Centered 119

Patient-Centered IT Patients Consulting 119

GeriPal

AUGUST 1, 2024

Anna Pleet is an internal medicine resident at Allegheny Health Network who has a collection of amazing YouTube videos on aging and the Mediterranean diet. Elizabeth Eckstrom is a geriatrician, professor of medicine at OHSU, and author of a new book, the Gift of Aging. Who do we have with us on this podcast? Great to be here.

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IT Diabetes Chronic Disease Patient-Centered 116

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.

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Primary Care IT Clinic Illness 79

GeriPal

JULY 6, 2023

I’ve been on a quest to build those services and support so that people can make true, informed decisions for themselves and their families. We’re selling objectivity, information, independence and choice. Take some time to get trust, to get real information. Susan: Yeah, I don’t think the word even surfaced.

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Community Nurse Practitioner Provider IT 89

GeriPal

JULY 25, 2024

MOC points per podcast in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. Alex 04:51 Most used prognostic index on e prognosis.

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Family Families Patient-Centered Patients 106

GeriPal

JULY 7, 2022

And I was an internal medicine resident. Like yourself, when I was a resident, and pain has been shaped in our mind as being a purely physical sensation, especially on the clinical side, where this idea that pain is complex and that pain is as much an emotion as much as physical sensation is not really something we are trained to do.

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Patient-Centered Physicals IT Patients 105

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. I could walk down the hall and get information. So IU, we have been able to convert our paper, Chris Callahan paper that was published in 2006, the first clinical trial that was positive.

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.

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Patient-Centered IT Patients Healthcare 108