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. But you worry that the advance directive does not provide enough guidance for the specific decision at Yael Jo, do you.

Patient-Centered 109

Patient-Centered IT Patients Healthcare 109

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. But you’re right, there has been a shift in policy to incentivize patients and providers to choose home therapies.

Management 116

Management Patient-Centered Patients IT 116

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. But it does kind of provide that caution, it kind of slows things down to make sure you’re really paying attention. Mike: Thanks for having me.

Medical 97

Medical IT Patients Clinic 97

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. And which of those experiences would you like to share with us that we could then write into a story that we’ll share with providers? Thor: That’s correct, yeah.

Patient-Centered 115

Patient-Centered Illness Healthcare IT 115

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. And which of those experiences would you like to share with us that we could then write into a story that we’ll share with providers? Thor: That’s correct, yeah.

IT 105

IT Patient-Centered Healthcare Illness 105

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? And so here’s a picture of four healthcare providers behind bars. ” The first healthcare provider said, “I said withdrawal of care.

IT 145

IT Hospital Patients Illness 145

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. And then we had clinical decision support. Long overdue.

Patient-Centered 77

Patient-Centered IT Hospital Patients 77

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.

Primary Care 113

Primary Care Patient-Centered IT Patients 113

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

FEBRUARY 20, 2025

Summary Transcript CME Summary Trauma is a universal experience, and our approach as health care providers to trauma should be universal as well. And we often do, as healthcare providers, care for people who are going through traumatic events, through just being sick in the hospital or a home or dying at home.

IT 66

IT Patient-Centered Screening Patients 66

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 96

IT Patient-Centered Patients Board-Certified 96

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

AUGUST 24, 2023

And the role of the palliative care provider is to figure out, knowing that different things affect different people, is what causes somebody in that particular instance to feel their dignity is being undermined. And the data was saying, “What is really important is the way you, the care provider, experience that person.”

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. It’s just that he was foregoing things that we think would have provided him more benefit. And in addition, my work in palliative care, I also am a clinical ethicist.

Patient-Centered 77

Patient-Centered IT Patients Illness 77

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.

Patient-Centered 96

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. The Lived Experience of Providing Feeding Assistance to a Family Member with Dementia. I was really struck by the difference in care provided to people with advanced dementia.

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. At one end of the spectrum you can provide decision makers with information that doesn’t work very well in most contexts. And it’s the right thing to do clinically for patients and families. Prior-auth forms?

Patient-Centered 116

Patient-Centered Hospital IT Illness 116

GeriPal

FEBRUARY 13, 2025

Like, would you include the doctors that I work with, healthcare providers where I live in Marin? 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. Like, what communities would have been included for that study?

Consulting 63

Consulting Community Patient-Centered Family 63

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 20, 2025

And is there a middle path to provide some degree of comfort while also hastening the end of life? I was part of a writing group that wrote clinical guidelines for VSET for voluntarily stopping eating and drinking. And then finally you have the moral distress of the providers. Why did you write this paper? Well, how can I be.

IT 87

IT Patient-Centered Patients Medical 87

GeriPal

JULY 6, 2023

It was designed to really balance what Medicaid at the time was to provide nursing homes and Medicare is obviously health insurance. The long-term care is being actually provided in the community at a much higher rate than what the formal system provides. But, what you need is a community-based game there. They deal with that.

Community 89

Community Nurse Practitioner Provider IT 89

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.” What about ambivalence on the part of the provider?

Patient-Centered 128

Patient-Centered IT Patients Consulting 128

GeriPal

APRIL 26, 2024

Some numbers to back it up: ELNEC has trained more than 48,000 providers in a train the trainer model Over 1.5 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. Bry: Yeah, Eric.

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. 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 Illness 79

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

JULY 25, 2024

Accreditation In support of improving patient care, UCSF Office of CME is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Family 106

Family Families Patient-Centered IT 106

GeriPal

AUGUST 15, 2024

Lingsheng (and I) recently published studies on this in JAMA Internal Medicine , and JAGS. This question, while providing an opportunity to talk about direct and indirect experiences, can be asked of all patients, and opens the door to conversations about anti-semitism, islamophobia, or anti-Black racism.

Mental Health 116

Mental Health Community Screening IT 116

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

APRIL 21, 2022

To the deeper emotions – of loss and grief, of wonder and transcendence – that are at the heart of the complex care we provide. Mike: It was really then it was when I was a internal medicine resident that I heard a Mary Oliver poem, and it really connected to where I was at. AlexSmithMD . How much does it matter?

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.”

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.

Patient-Centered 108

Patient-Centered IT Patients Healthcare 108