GeriPal

JUNE 12, 2025

Summary Transcript CME Summary If you’re anything like me, you might find the process of what happens to patients when they visit a radiation oncologist somewhat mysterious. Anish 01:02 Well, I speak, you know, from a physician lens of some of the patients that I get referred, and by the time there’s. This is not a good option.

Patient-Centered 102

Patient-Centered Referral Patients IT 102

GeriPal

FEBRUARY 27, 2025

Substance use disorder is one of those complex issues in which clinical practice is changing rapidly. We address: Why is caring for patients with this overlap so hard? Sach Kale set up an outpatient clinic focused on substance use disorder for patients with cancer. See Sachs write up about setting up this clinic in JPSM.

Patients 72

Patients Clinic Patient-Centered Illness 72

GeriPal

JUNE 27, 2024

How, though, do we navigate anxiety and help our patients who may end up in the anxiety spiral that becomes so hard to get out of? Alex is a triple-boarded (palliative care, internal medicine, and psychiatry) assistant professor of medicine at Stanford. Widera and Smith have no relationships to disclose.

Illness 129

Illness IT Diagnosis Patient-Centered 129

GeriPal

NOVEMBER 7, 2024

If the purpose of initiating dialysis is improving function – our complex, frail, older patients are likely to be disappointed. 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.

Management 116

Management Patient-Centered Patients IT 116

GeriPal

JANUARY 16, 2025

So I think the first reason that we saw and felt the opportunity was ripe for updating was that some of us had come across some anecdotal examples of patients expressing some offense to that terminology. And I was asking this patient about if he had filled out an advanced directive. Is the patient in your descriptor?

Patient-Centered 109

Patient-Centered IT Patients Healthcare 109

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 we want to alert clinicians as well as patients and policy makers to the presence of these drugs. Is this the right drug for this patient?”

Medical 97

Medical IT Patients Clinic 97

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. When I see a patient? He’s in Boston.

Primary Care 113

Primary Care Patient-Centered IT Patients 113

GeriPal

MAY 22, 2025

Jenny Chen is a palliative care fellow at Yale who regularly sings for her seriously ill patients. Jenny reached out to us because she plays music regularly for her patients, and she said, you should do a podcast about music. And I performed for many palliative patients, and that’s when I started to understand.

IT 96

IT Patient-Centered Patients Board-Certified 96

GeriPal

DECEMBER 8, 2022

Clinicians “catching” patient life stories. . Our patients aren’t “the 76 year old with heart failure in room 202,” as Heather Coats astutely noted. VA “gets” the importance of storytelling in medicine, without the need for reams of research to back it up. She was a heart failure patient. What’s in a story?

Patient-Centered 115

Patient-Centered Illness Healthcare IT 115

GeriPal

DECEMBER 15, 2022

Along the way we address: Is this degree of slowed cognitive decline meaningful to patients or care partners? Eric: So patient narrative storytelling, independent of what we call it, I’d like to turn to both of you and just how you got interested in this as a subject. She was a heart failure patient.

IT 105

IT Patient-Centered Healthcare Illness 105

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. .

Illness 109

Illness IT Family Families 109

GeriPal

APRIL 10, 2025

I asked emergency medicine clinicians what they thought when a patient who is seriously ill and DNR comes to the ED, and some responded, (paraphrasing), what are they doing here? This is not why I went into emergency medicine. I went into emergency medicine to act. I went into emergency medicine to act.

Patient-Centered 77

Patient-Centered IT Hospital Patients 77

GeriPal

APRIL 28, 2022

Times , The BMJ , and Annals of Internal Medicine. . Eric: I’m looking forward to talking about art and humor in palliative care and we’re caring for seriously ill patients. What are your thoughts about using humor to convey ideas, thoughts, clinical work? His work has been published in places like the L.A.

IT 145

IT Hospital Patients Illness 145

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

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.

Patient-Centered 66

Patient-Centered IT Screening Patients 66

GeriPal

MARCH 3, 2022

This idea that for critically ill patients in the ICU, geriatric conditions like disability, frailty, multimorbidity, and dementia should be viewed through a wider lens of what patients are like before and after the ICU event was transformative for our two guests today. GeriPal podcast with Linda Fried on frailty.

Patient-Centered 96

Patient-Centered Patients IT Hospital 96

GeriPal

DECEMBER 5, 2024

We talked with Thor Ringler, who helped found the My Life My Story Project at the VA and beyond, and Heather Coats about the evidence base for capturing patient stories. 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.

IT 107

IT Community Patients Families 107

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. If its potentially unsafe, but has robust evidence, well thats most of the treatments we offer seriously ill patients! Think chemotherapy to imminently dying patients, or CPR.

Patient-Centered 77

Patient-Centered IT Patients Illness 77

GeriPal

MAY 15, 2025

Prior podcasts on the ethics of nudging , and a different trial conducted by Kate and Scott in which the default for hospitalized seriously ill patients was to receive a palliative care consult. This specific study , published in JAMA Internal Medicine, was conducted in 17 ICUs in North Carolina. What is sludge? Where was it?

Patient-Centered 116

Patient-Centered Hospital IT Illness 116

GeriPal

AUGUST 24, 2023

Harvey is probably best known for his work in developing dignity therapy, a psychological intervention designed specifically to address many of the psychological, existential, and spiritual challenges that patients and their families face as death approaches. Scientific American Letter to the Editor: Response to Downar et al.

Patient-Centered 98

Patient-Centered Patients IT Illness 98

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. I’m also a geriatrician and a palliative care physician, so I’ve talked to families and patients about death and dying.

IT 122

IT Patient-Centered Patients Relationship 122

GeriPal

FEBRUARY 13, 2025

How to be sensitive to the risks of stereotyping based on recommendations from the few members of the board to the many heterogeneous patients served? And so it was really the patients, you know, the caregivers, the family members were the ones who were sort of the closest in observing. Who would/should be on that board?

Consulting 63

Consulting Community Patient-Centered Family 63

GeriPal

MAY 29, 2025

Particularly patients, families. Eric 05:30 And Andrew, I remember when I was a med student, I had a patient with a diffuse brain injury in the ICU on a ventilator. People are patients, families are wondering if their loved one is still in there. You know, I’ve been trying to think of metaphors for thinking about this.

Family 93

Family Families IT Patient-Centered 93

GeriPal

MARCH 31, 2022

And maybe, just maybe, we convince that poetry skeptic Eric Widera that there is a place for poetry in medicine after all. Patient Poets: Illness from the Inside Out. I think it’s titled Patient Poets Illness. Marilyn: Patient Poets: Illness From Inside Out. Alex: Patient Poets: Illness From Inside Out.

IT 70

IT Patients Medical Illness 70

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

MARCH 20, 2025

Recently, discussion has emerged about how these issues intertwine in caring for patients with advancing dementia who have stated that they would not want to continue living in that condition: for those with an advanced directive to stop eating and drinking, how do we balance caring for their rational past self and their experiential current self?

IT 87

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.

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. Widera and Smith have no relationships to disclose.

IT 116

IT Diabetes Chronic Disease Patient-Centered 116

GeriPal

APRIL 26, 2024

Who spends the most time with the patient in the infusion center? 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.

Patient-Centered 119

Patient-Centered IT Patients Consulting 119

GeriPal

MARCH 27, 2025

Summary Transcript CME Summary A pragmatic trial evaluates the effectiveness of a treatment or intervention in real-world clinical practice. Only 5% of intervention patients received the facilitator-led component of the intervention (there were other components, facilitator-led was the most engaged component). Is that right?

Primary Care 79

Primary Care IT Clinic Illness 79

GeriPal

JULY 25, 2024

The PPS is one of the most widely used prognostic tools for seriously ill patients, but the prognostic estimates given by the PPS are based on data that is well over a decade old. Eric 04:39 Yeah, I see it used on inpatient, side on consult clinics in hospices. Why do this? Widera and Smith have no relationships to disclose.

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 105

Patient-Centered Physicals IT Patients 105

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. We just kind of start to amass these handouts and I would give them to the patient. Is it the patient? Eric: Wait, county 911?

Community 89

Community Nurse Practitioner Provider IT 89

GeriPal

AUGUST 15, 2024

Lingsheng (and I) recently published studies on this in JAMA Internal Medicine , and JAGS. Ongoing reports from patients about anti-Asian hate experiences Should clinicians screen for Anti-Asian hate? And a lot of my patients at that time identified as older asian immigrant. question used to screen for domestic violence.

Mental Health 116

Mental Health Community Screening IT 116

GeriPal

APRIL 21, 2022

Poetry puts us in our patient’s shoes. Poetry holds us in that liminal space so many of our patients are in. 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.

Patient-Centered 93

Patient-Centered IT Community Illness 93

GeriPal

DECEMBER 21, 2023

Don’t get me wrong, the evidence points to cost savings, but as Chris Callahan and Kathleen Unroe pointed out in a JAGS editorial in 2020 “in comprehensive dementia care models, savings may accrue to Medicare, but the expenses accrue to a fluid and unstable network of local service providers, patients, and their families.” Care Ecosystem.

Patient-Centered 125

Patient-Centered IT Family Families 125

GeriPal

DECEMBER 12, 2024

Surrogates often either dont know what patients would want, or think they know but are wrong, or make choices that align with their own preferences rather than the patients. Alex 01:29 And we’re delighted to welcome Teva Brender, who’s a third year resident in internal medicine at UCSF. Can we do better?

Patient-Centered 108

Patient-Centered IT Patients Healthcare 108