The Clinical Problem Solvers

MAY 2, 2022

Dr. Okah is a family medicine clinician and NRSA research fellow at the University of North Carolina School of Medicine, and she studies the association between the use of race in medical decision-making and beliefs regarding the etiology of disparities in health outcomes.

Healthcare 52

Healthcare Utilities Hospital Internal Medicine 52

GeriPal

JUNE 13, 2024

Summary Transcript Summary I always find cachexia in serious illness puzzling. In today’s podcast, we had the opportunity to learn from a renowned expert in palliative care, Eduardo Bruera, about cachexia and anorexia in serious illness. But the patient would say, well, but it still hurts, though.

Illness 133

Illness Patient-Centered Patients IT 133

GeriPal

FEBRUARY 16, 2023

Summary Transcript Summary Think about the last time a patient yelled at you in anger. The last time this happened to me I immediately went on the defensive despite years of training in serious illness communication skills. Ask why: What is underneath the anger for this particular patient? Taking care of the hateful patient.

Patients 109

Patients IT Family Families 109

GeriPal

MARCH 9, 2023

FDA is considering approval, shifting away from Schedule I restrictions, paving the way for use in clinical practice. Early data on efficacy in patients with anxiety and demoralization are promising. And some people in studies and just in clinical use have found that to be helpful, including for patients with serious illness.

Patient-Centered 91

Patient-Centered Community IT Medical 91

GeriPal

APRIL 4, 2024

The Cruzan ruling led to a flood of interest in Advance Directives, and eventually to the Patient Self Determination Act, which mandates provision of information about advanced directives to all hospitalized patients. Other states set lower bars, including oral assignment of surrogate decision-makers. What words to use?

Family 112

Family Families Patient-Centered IT 112

GeriPal

SEPTEMBER 1, 2022

Social workers augment a team’s ability to provide whole-person care, often aiding to identify and meaningfully address the wide variety of challenges and unmet needs faced by individuals and families facing serious illness. And so when you have that, that’s so good for the family. That’s so good for us.

IT 102

IT Family Families Clinic 102

GeriPal

FEBRUARY 29, 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. Alex: Okay.

IT 126

IT Patient-Centered Illness Education 126

GeriPal

OCTOBER 19, 2023

Caveat as well that RCTs should not be placed on pedestal as the only answer- often patients enrolled in RCTs do not represent real world patients – observational studies do. For a trial to have value, it should not exclude patients over age 80, or those with dementia, or patients residing in nursing homes.

Patient-Centered 126

Patient-Centered IT Patients Illness 126

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! Ivermectin to treat cancer. Stem cell treatments.

Patient-Centered 77

Patient-Centered IT Patients Illness 77

GeriPal

APRIL 13, 2023

Summary Transcript Summary Social connections impact our health in profound ways, whether it is the support we receive from family and friends in navigating serious illness, the joy from shared social activities, or connecting with our community. But, should we as clinicians care about the social lives of our patients?

IT 99

IT Community Patient-Centered Medical 99

GeriPal

FEBRUARY 9, 2023

For example, we spend the first half talking about a RCT simulation study of clinician verbal and non-verbal communication with a seriously ill patient with cancer. In one room the physician under study interacts with a white patient-actor, and in another room interacts with a Black patient-actor. Amber: Thank you guys.

Patient-Centered 111

Patient-Centered Patients IT Healthcare 111

GeriPal

MARCH 28, 2024

What we did was ask clinicians earlier in the ICU stay for very sick patients to document prognosis, and for those who they thought would survive, to document six-month functional prognosis. Eric: And who are the patients including in this trial, again? Kate: These are very sick patients. And that’s it. Kate: Sure.

Consulting 115

Consulting Patient-Centered IT Patients 115

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

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. And that’s also kind of where I leaned in.

Community 95

Community IT Patient-Centered Primary Care 95

GeriPal

FEBRUARY 6, 2025

That screening influences kind of further treatment, actually, probably more importantly, patient outcomes. And when I asked the patient, well, what happened, the test was sprung on them. And then the family tells me they can’t keep an appointment, they can’t manage their finances. Nate 06:04 Right.

Primary Care 95

Primary Care Diagnosis Screening IT 95

GeriPal

SEPTEMBER 12, 2024

Eric 04:44 Could just make you a little bit more resilient, you can increase your Rvus so you can see more patients. It’s really not about helping the patient or physician. So people are not so excited about this idea of resilience in the old fashioned way, this idea that it’s up to you. If you were just. Eric 17:16 Right.

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IT Healthcare Healthcare Professional Patient-Centered 110

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. Which may not be necessarily traumatizing.

Patient-Centered 66

Patient-Centered IT Screening Individual 66

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

JUNE 6, 2024

Summary Transcript Summary As Eric notes at the end of today’s podcast, we talk about many difficult issues with our patients. But one issue we’re not as good at discussing with our patients is sexual health. Clearly this issue is important to patients. So we got a lot to cover on sexuality, sexual health, and serious illness.

Illness 130

Illness IT Physicals Patients 130

GeriPal

JULY 13, 2023

On that podcast he and collaborators tested a combined patient and clinician facing communication priming intervention to promote goals of care conversations. Eric and I also reflect on the podcast Randy generously did with us on his experience living with and studying serious illness. He really practiced what he preached.

Patient-Centered 83

Patient-Centered IT Hospital Patients 83

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). Eric 06:26 Great.

Primary Care 79

Primary Care IT Clinic Illness 79

GeriPal

DECEMBER 1, 2023

In particular we spend a good deal of time talking about what this means for asymptomatic patients who may have an abnormal biomarker, which by the proposed new definition would mean they would now have Alzheimer’s disease. That’s in my view as analogous as to any other illness. You need the plaques to have that illness.

IT 115

IT Clinic Illness Hypertension 115

Common Sense Family Doctor

MARCH 23, 2025

Nonetheless, its work has often been politically unpopular and unheralded outside of a small community of health services researchers and patient advocates. You need not be ill enough to be hospitalized or care about practice guidelines to suffer if AHRQ is eliminated for good. spends on health care more wisely or efficiently.

Healthcare 52

Healthcare Patient-Centered Primary Care Illness 52