GeriPal

NOVEMBER 9, 2023

I think in medicine, in particular and probably in all clinical specialties, there is this sense of a rival fallacy of, “When I finish residency, I’ll be happy. You can do this many different ways, but the first one is a little bit more structured, like an assessment that we’re all familiar with clinically.

Board-Certified 110

Board-Certified IT Primary Care Referral 110

GeriPal

MAY 11, 2023

Should do medicine?” ” Because I loved internal medicine. There I was, extremely overly trained with brain stuff, and I wanted to learn how to do clinical research. They’re not a lot of randomized clinical trials. I presented this at the big clinical trials meeting in November in San Francisco.

Physicals 86

Physicals IT Hypertension Education 86

GeriPal

JUNE 12, 2025

I’m sort of seeing them in clinic for consideration of palliative radiation, they have a lot going on. There were a number of opportunities to be involved in medical oncology and doing medical oncology rotations as a medical student, as an internal medicine residential. Eric 00:59 Why did you choose this song?

Patient-Centered 102

Patient-Centered Referral Patients IT 102

GeriPal

JUNE 27, 2024

Alex is a triple-boarded (palliative care, internal medicine, and psychiatry) assistant professor of medicine at Stanford. I think I certainly have had a lot of friends and colleagues in internal medicine who are so fearful that, oh, if I get this definition wrong, I’m going to cause some harm.

Illness 129

Illness IT Diagnosis Patient-Centered 129

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?

Patients 73

Patients Clinic Patient-Centered Illness 73

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

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.

Management 116

Management Patient-Centered Patients IT 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

DECEMBER 8, 2022

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. So we have community volunteers who often they have a background in writing or background in healthcare, certainly an interest in interviewing and an interest in writing.

Patient-Centered 115

Patient-Centered Illness Healthcare IT 115

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.

Illness 109

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. And I have the luxury in my clinic to see them back every few weeks and. He’s in Boston. And also I was in the HVMA primary care program. Nicole 40:18 Yeah.

Primary Care 113

Primary Care Patient-Centered IT Patients 113

GeriPal

DECEMBER 15, 2022

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. So we have community volunteers who often they have a background in writing or background in healthcare, certainly an interest in interviewing and an interest in writing.

IT 105

IT Patient-Centered Healthcare Illness 105

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 IT Hospital Patients 77

GeriPal

APRIL 28, 2022

Times , The BMJ , and Annals of Internal Medicine. . What are your thoughts about using humor to convey ideas, thoughts, clinical work? Occasionally, people will come to me and say, like when I’m meeting them in the clinic and say, “Hey, we Googled you. His work has been published in places like the L.A.

IT 145

IT Hospital Patients Illness 145

GeriPal

MAY 22, 2025

Eric 34:49 And Jenny, how are you planning to involve music once you’re done with fellowship in your clinical work? I’m going to be doing inpatient palliative medicine mainly, so I’ll continue Doing what I’m doing now. Tyler 34:44 Jenny, you’re giving me chills over here. That was beautiful. Oh, my gosh.

IT 97

IT Patient-Centered Patients Board-Certified 97

GeriPal

DECEMBER 5, 2024

It’s that mixture of intimacy and vulnerability, of shared clinical experiences, that fosters a sense of belonging. Emily 03:59 Medicine is both a science and an art. We definitely draw on the sciences, on biomedical science, on clinical trials, on pharmaceutical design and all sorts of things like that. Ricky 11:23 Yeah.

IT 107

IT Community Patients Family 107

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.

IT 67

IT Patient-Centered Individual Patients 67

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.

Hospital 125

Hospital IT Patient-Centered Patients 125

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. Alex: Bye everybody.

Patient-Centered 96

Patient-Centered Patients IT Hospital 96

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

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. Joan: A lot of my work comes out of my clinical practice.

Nurse Practitioner 60

Nurse Practitioner Hospital Family Families 60

GeriPal

MAY 15, 2025

This specific study , published in JAMA Internal Medicine, was conducted in 17 ICUs in North Carolina. And it’s the right thing to do clinically for patients and families. Prior-auth forms? Examples of nudges, some based in health care, others in coffee. Many were community hospitals. Like, it doesn’t.

Patient-Centered 117

Patient-Centered Hospital IT Illness 117

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

MAY 29, 2025

And I think this just hasn’t made it into, like, our academic clinical training space. I think that what gets really challenging is what Andrew’s talking about, which is like we need to somehow differentiate between what’s meaningful to others and what, you know, what might be otherwise clinically significant.

Family 93

Family Families IT Patient-Centered 93

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. The wisdom and experiences of hospice caregivers (who are often underpaid and undervalued). Lingsheng, welcome back to GeriPal.

IT 122

IT Patient-Centered Patients Relationship 122

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. The post Poetry about Aging: Marilyn McEntyre and Guy Micco appeared first on A Geriatrics and Palliative Care Podcast for Every Healthcare Professional.

IT 70

IT Patients Medical Illness 70

GeriPal

FEBRUARY 13, 2025

And we had a greater decrease in symptom intensity at day seven versus the usual care group by both a clinically meaningful and a statistically significant difference. And it was both statistically and clinically significant on that scale. So the resource intensive arm. For any MOC questions, please email moc@ucsf.edu.

Consulting 63

Consulting Community Patient-Centered Family 63

GeriPal

MARCH 20, 2025

I was part of a writing group that wrote clinical guidelines for VSET for voluntarily stopping eating and drinking. This is just because this arose organically in clinical practice as a way of balancing these underlying competing ethical issues. Smith has no Meal Times, Minimal Comfort feeding for Patients with Advanced Dementia.

IT 88

IT Patient-Centered Patients Medical 88

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

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. Eric 18:14 Elizabeth, how do you bring it up in your clinic?

IT 116

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.

Primary Care 79

Primary Care IT Clinic Patient-Centered 79

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. I was a clinical ethics fellow at Baylor College of Medicine. Mary: So not unusual for most clinical ethicists.

Patient-Centered 119

Patient-Centered IT Patients Consulting 119

GeriPal

JULY 6, 2023

Eric: Which is, so let’s say I am a provider, a healthcare provider taking, let’s say a nurse practitioner working in an older, a clinic that’s mainly caring for older adults. And then, the system responds in turn. Alex: I want to pick up on this thread and talk- Lindsey: I really- Alex: Oh, Lindsey, jump in there.

Community 89

Community Nurse Practitioner Provider IT 89

GeriPal

JULY 25, 2024

Eric 04:39 Yeah, I see it used on inpatient, side on consult clinics in hospices. Eric 07:03 And those classic studies, were those done in the hospital and PALP care units and clinic? The folks that we were seeing either in clinic or inpatient, were probably a lot sicker than the ones that we’re seeing now.

Family 106

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.

Patient-Centered 106

Patient-Centered Physicals IT Patients 106

GeriPal

AUGUST 15, 2024

Lingsheng (and I) recently published studies on this in JAMA Internal Medicine , and JAGS. We do talk about healthcare policy. We do a lot of clinical focused discussions. We shouldn’t be screening every older age and adult who comes into our clinic about these incidents for different reasons.

Mental Health 116

Mental Health Community IT Screening 116

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