The Clinical Problem Solvers

MAY 2, 2022

Dr. Davila is a palliative care physician at Massachusetts General Hospital and her work examines racial and ethnic inequities in patient-clinician communication. On the other hand, those who believed that differences in social conditions explain racial differences in health outcomes were less likely to practice race-based medicine.

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 Families Family 109

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 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?

Families 112

Families Family Patient-Centered IT 112

GeriPal

MARCH 28, 2024

Well, as a kick off to this year’s first in-person State of the Science plenary, held in conjunction with the closing Saturday session of the AAHPM/HPNA Annual Assembly, 3 randomized clinical trials were presented. Eric: And who are the patients including in this trial, again? Kate: These are very sick patients.

Consulting 115

Consulting Patient-Centered IT Patients 115

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

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

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. We’re just like, “Okay, I see this patient has a need. Okay, I see this team member has a need.

IT 102

IT Families Family Clinic 102

The Clinical Problem Solvers

NOVEMBER 16, 2020

37:50​ Race vs. ancestry vs genetics–implications for research and clinical practice 52:02 ​What can we start doing tomorrow? Much of the data promoting biological difference amongst races comes from poorly-designed studies where race as a variable is ill-defined or confounding variables are inadequately controlled.

Clinical Practice 52

Clinical Practice Clinic Medical Education 52

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

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

MAY 25, 2023

Summary Transcript Summary Our guests today present an important rejoinder to the argument that we should refocus away from advance care planning (ACP). LJ: And I think that’s one of the reasons that we’ve not done a very good job in research around… Eric: How are patients defining it?

Community 96

Community IT Patient-Centered Primary Care 96

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. Well, even for somebody like you, who’s pretty familiar with the instruments, it might cause distress for the patient, maybe their family.

Primary Care 96

Primary Care Diagnosis Screening IT 96

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. And so in that way, it’s not the letterhead or the four walls and the roof that are perpetuating the present, it’s the people.

IT 111

IT Healthcare Healthcare Professional Patient-Centered 111

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 67

Patient-Centered IT Individual Screening 67

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 84

Patient-Centered IT Hospital Patients 84

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

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 116

IT Clinic Illness Hypertension 116