Physician's Weekly

JUNE 23, 2025

As a family physician, my days are filled with caring for individuals and families across the lifespan and in multiple healthcare settings. While natural infection can indeed lead to immunity, it comes at the cost of potentially severe illness, complications, and even death.

Vaccination 80

Vaccination Community Individual Illness 80

PEMBlog

OCTOBER 2, 2024

Red flags that you should always ask about include hematemesis, melana, dysphagia, and Unintentional weight loss, these all need further investigation for complications like esophagitis or another diagnosis such as EOE or peptic ulcer disease. So in the odd, rare scenario where you have a family member being treated for H.

Diagnosis 52

Diagnosis Management Patient-Centered IT 52

GeriPal

MAY 11, 2023

The beautiful thing about it, it’s more than just having a career development award; it’s a community of aging researchers. One of the highlights really is the networking and the community that it fosters and highlighted, in some ways, by the meeting, which of course you often lead the sing along at. I agree with you.

Physicals 85

Physicals IT Hypertension Education 85

Vida Family Medicine

JUNE 29, 2022

These are intellectually interesting but often personally devastating to the patient and family involved. A patient must have the autonomy to choose whether in their individual situation, the potential benefits outweigh the potential harms. Medicine involves many extremely ethically challenging situations. What Roe v.

Family Physician 52

Family Physician Family Families Healthcare Professional 52

GeriPal

FEBRUARY 15, 2024

So Carmen and Katie developed an EMS Community Partnership program. They created a seamless link between this Community Partnership program and 911 calls for falls. Eric and I enjoyed talking with Carmen and Katie about this innovative and common sense approach to addressing falls in the community. Word of mouth spread rapidly.

Community 114

Community Transportation IT PCP 114

Vida Family Medicine

MARCH 28, 2024

As a primary care physician, I am asked about these medications at least once a day, either by a patient, a colleague, a family member, friend, or acquaintance. Diabetes, cardiovascular disease, and metabolic associated fatty liver disease all have the potential to cause life-altering complications and premature death.

Diabetes 52

Diabetes Primary Care Physician Medical Patients 52

GeriPal

MAY 25, 2023

Sarah Nouri, Hillary Lum, and LJ Van Scoy argue that diverse communities are asking for ACP. Sarah Nouri gives an example from her work in the LGBTQ+ community of a trans woman who was buried as a man because existing laws/rules did not protect her wishes. Complicated grief? Did the caregiver feel heard and understood?

Community 95

Community IT Patient-Centered Primary Care 95

GeriPal

NOVEMBER 14, 2024

If you want to do a deeper dive into some of the articles we discuss, take a look at the following: An awesome JAMA review by Sarah on fall risk assessment and prevention in community-dwelling adults. Sarah 03:57 Yeah, it’s a pretty big problem for older adults, I’d say in community dwellers. It’s one out of two.

IT 124

IT Screening Patient-Centered Community 124

GeriPal

FEBRUARY 23, 2023

The patient is sick and getting sicker, and refuses to let you talk with family or other members of her inner circle. We owe it to the patient to explore the reasons behind the “no,” commonly not wanting to be a burden to their family. Should you stop at “no?” AlexSmithMD Transcript Eric: Welcome to the GeriPal podcast.

Family 97

Family Families Patient-Centered IT 97

GeriPal

JULY 21, 2022

Often the work of the certified driving rehab specialist is to assess the older drivers goals, assess prognosis for driving, and help the family navigate discussions around driving cessation (hmmm…sounds like an approach to family meetings). Were those people self referring, or family members calling you asking? Eric: Yeah.

Families 102

Families Family IT Diagnosis 102

GeriPal

MARCH 9, 2023

Psychedelics have been used by communities around the globe for hundreds of years (or more). Alex: It’s complicated. We, for very complicated reasons, ended up with niacin. The efficacy of psychedelics without therapy, and the impact of variations in therapy type, training, duration, is unknown. Eric: Yeah.

Patient-Centered 91

Patient-Centered Community IT Medical 91

GeriPal

JANUARY 25, 2024

And so, three years of seeing over and over people having really difficult end of life experiences in the ICU, not being able to advocate for themselves, a lot of trauma for their families, I just thought, we have to do better than this. In their communities? I was really passionate about helping the people and also their families.

Patient-Centered 122

Patient-Centered IT Illness Patients 122

GeriPal

MAY 4, 2023

It is really difficult for the patients and the families. Patients that remind us of loved ones, patients that are often younger, really hard stories, complicated issues. They do choose to rely more on their family and parents in ways that might feel like a step backwards and is yet, still developmentally appropriate and autonomous.

Families 83

Families Family IT Illness 83

GeriPal

JUNE 30, 2022

Should she have an operation, and risk the pain, potential complications, and attendant delirium associated with the operation? Eric: So we’re going to be talking about dementia and considerations around surgery for individuals with dementia. You have a patient with dementia severe enough that she cannot recognize relatives.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

GeriPal

MAY 12, 2022

Prognosis communication and the subtle ways we may communicate it without intention. Community-based palliative care networks . And I believe it needs the community. Raj: So in Kerala, because it started with the involvement of laypeople, we included the community in care because the existing system had no space for this.

Community 115

Community IT Relationship Healthcare 115

GeriPal

MAY 26, 2022

They argue that the current guidelines, which prioritize immunocompromised people and unvaccinated older people on the same level, should be re-done to prioritize the immunocompromised first, and additionally move up older vaccinated individuals or vaccinated persons with comorbidities. What’s wrong with that? Why not prioritize them?

Vaccination 87

Vaccination Individual IT Healthcare 87

GeriPal

FEBRUARY 8, 2024

So there’s this, what is suffering to the individual, and is there some threshold that we could say, “This is real suffering,” or “This is the suffering we talk about in geriatrics or palliative care”? Family member, and with some chagrin- Eric: Powerful nudge. What are you seeing?”

IT 137

IT Families Family Physicals 137

GeriPal

JANUARY 26, 2023

Second, as we discussed in last week’s podcast , older adults, particularly those in nursing homes, were far more likely to die than younger individuals. We lump everybody who’s 65 and older together, and then we don’t look at the individual characteristics of that person, so we fall into these patterns based on racial premises.

IT 91

IT Patient-Centered Healthcare Patients 91

GeriPal

FEBRUARY 13, 2025

We covered some of our questions on the podcast, others you can ponder on your own or in your journal clubs, including: Maries tele/video palliative care intervention was tailored/refined with the help of a community advisory board. Eric 04:27 Yeah, I gotta ask about the community advisor. So I don’t want my Marin community to.

Consulting 63

Consulting Community Patient-Centered Families 63

GeriPal

MARCH 6, 2025

link] PEACH Good Wishes Program A program that provides meaningful gifts for unhoused individuals who are terminally ill. Michael’s Hospital in the Department of Family and Community Medicine. The social determinants of health and what community well being was a big part of. those experiencing homelessness).

Healthcare 100

Healthcare IT Community Illness 100

GeriPal

MAY 15, 2025

Many were community hospitals. We did another nudging trial where the deep default was for default palliative care consultations for high risk patients, and it significantly increased individuals who were receiving palliative care. We tested two different nudges individually and then we combined them. I highly encourage you.

Patient-Centered 116

Patient-Centered Hospital IT Illness 116

GeriPal

AUGUST 25, 2022

And yet, disenrollment from hospice, either due to patient/family revoking the benefit or stabilization of illness (extended prognosis) is remarkably high for people with dementia among some hospices. It’s really a pretty traumatic experience for a lot of patients and families. And I had a blast playing Take the Money and Run!

Families 106

Families Family IT Patients 106

GeriPal

DECEMBER 14, 2023

It’s the clinicians on the rounding team, yes, but also the multidisciplinary team is really important, how they support the patient, the family, the doctors, the nurses, but also how the broader institutional structures such as ethics committees, et cetera, how they support. And then was trying to find different hospitals.

Hospital 125

Hospital IT Patient-Centered Patients 125

GeriPal

MARCH 24, 2022

And especially for those who may have nontraditional families. I think if you’re from a nontraditional family, it’s very important to make sure that people understand who you would want to talk to. Assigning a surrogate decision maker is important for everyone, including those who do don’t have a serious illness.

Illness 72

Illness IT Healthcare Patient-Centered 72

GeriPal

MARCH 7, 2024

We’ve invited two death doulas, Jane Euler and John Loughnane (who is also a family doc and palliative care physician), to talk about the role of a doula at the end of life. And then second, I was someone who was a Parrot Head for years and years and it was just amazing how the community came together. How do you see the light?

Provider 117

Provider Illness IT Healthcare 117

GeriPal

MARCH 30, 2023

Then I got online as a patient advocate and started connecting with the brain tumor community on social media and Facebook and Twitter, and actually started working in the healthcare space, in palliative care advocacy, for a palliative care advocacy organization in California, which is where I’m based, about eight years ago.

IT 95

IT Patient-Centered Patients Healthcare 95

GeriPal

OCTOBER 26, 2023

Within hours of recording this podcast, I joined a family meeting of an older patient who had multiple medical problems including cancer, and a slow but inexorable decline in function, weight, and cognition. We provide critical conversations with colleagues and families to coordinate transition planning.” And oh, guess what?

Patient-Centered 132

Patient-Centered Hospital Patients IT 132

GeriPal

APRIL 10, 2025

So Tammie developed something called EPIC for Emergency medicine, which is a curriculum that was one of the first ways that I think palliative care got spread in our community. We adapted a small group of us, Vital Talk for emergency medicine, which is communication skills training using simulation. But yeah, it’s complicated.

Patient-Centered 77

Patient-Centered Hospital IT Patients 77

GeriPal

JULY 28, 2022

This is my early father’s day gift from the family. But at that time I was struck by how in that field, there wasn’t a focus or really interest in symptom management and support for patients and their families. So at least in my oncology community, I really didn’t have anyone guiding or supporting or mentoring me.

Illness 110

Illness Hospital Patient-Centered Patients 110

Family Medicine Initiative

APRIL 10, 2024

Family medicine is neither the most prestigious nor the highest paid medical profession. GPs Are the Backbone of Effective Healthcare Systems Countries with a stronger focus on primary care and family medicine, rather than on hospitals and specialists, enjoy better health, 1 , 2 lower health inequalities, 2 , 3 and prevent hospitalizations.

Family Physician 130

Family Physician Family Families GP 130

GeriPal

OCTOBER 19, 2023

It’s like how liberating it is to eliminate resentments, regrets and envy from our lives and how great it is in our clinical practice when we’re able to help families reconcile after an estrangement, how much relief that brings. So we have the intervention is a big part. Again, it’s not the only part. Karl: Okay.

Patient-Centered 126

Patient-Centered IT Patients Illness 126

GeriPal

MARCH 28, 2024

None of the changes that we saw in end-of-life care processes relied on specialist palliative care increases or resources, which is really important because seven of the 10 hospitals that participated were rural or community-based, which is where most Americans receive their care, and also where specialist palliative care is often most limited.

Consulting 115

Consulting Patient-Centered Patients IT 115

GeriPal

MARCH 3, 2022

When patients leave the hospital, the infection may be cured, but the patient and family will need to contend with a host of major new functional and cognitive deficits. You can use that when you’re talking to families about prognostication. Alex: What happens when people survive? It’s not just about the ICU.

Patient-Centered 96

Patient-Centered Patients IT Hospital 96

GeriPal

SEPTEMBER 8, 2022

It’s complicated, it’s messy. How does that defer from is it complicated grief, prolonged grief disorder? Eric: Is that the same as complicated grief? We say it’s about 4% of those who are bereaved, who are from community-based samples. They don’t want to interact with their family.

IT 100

IT Complication Relationship Specialization 100

GeriPal

JANUARY 11, 2024

So we’re going to be talking about this complicated topic that a lot of people have differing opinions to and potentially very strong opinions, medical aid in dying. So it started off for individuals with a terminal illness. And making most I can do, I can use my mouth even though I only have six fingers here.

Illness 144

Illness IT Medical Provider 144

GeriPal

JULY 25, 2024

Next, we talk with James Deardorff about whether we can accurately predict nursing home level of care in community-dwelling older adults with dementia. This is a particularly interesting topic because we know that individuals with dementia have a high rate of entering nursing home. So you’re kind of the guest host today.

Families 106

Families Family Patient-Centered Patients 106

GeriPal

MAY 1, 2025

Alex 00:07 We are delighted to welcome Peter Selwyn, who is a family medicine and palliative medicine doctor and chairman of the Department of Family and Social Medicine and director of the Palliative Care Program at Montefiore E instein and author of Surviving the the Personal Journey of an AIDS Doctor. Who are our guests?

Primary Care 94

Primary Care IT Provider Clinic 94