The Clinical Problem Solvers

FEBRUARY 9, 2020

With the help of the #MedTwitter community, we have started a list of helpful LRs at the bottom of this article that we hope serves as a foundation for you to build on! Clinical Reasoning Corner: Likelihood Ratios By Jack Penner Welcome back, Clinical Problem Solvers! Today, we’re going to talk about likelihood ratios – let’s dive in!

Clinic 52

Clinic Diagnosis Hypertension Patients 52

GeriPal

JANUARY 23, 2025

Alex 00:36 And next we have Connie Fung, who I know well through the Beeson community and is a physician, researcher, professor of medicine at UCLA. Today, we explore four fascinating studies highlighting innovative approaches to reducing medication use and improving patient outcomes. We’re still working on this issue. Alex 01:23 Yeah.

Specialization 119

Specialization IT Patient-Centered Medical 119

GeriPal

JULY 19, 2024

Summary Transcript Summary The US Preventive Services Task Force (USPSTF) concluded back in 2000 that there is insufficient evidence to recommend for or against routine screening for dementia in older adults. Are there, though, populations that it may be helpful in, or should that change with the advent of the new amyloid antibodies? Should it?

Screening 119

Screening Primary Care Patient-Centered IT 119

GeriPal

MAY 19, 2022

Dr. Akhila Reddy and colleagues study looking at converting hospitalized cancer patients from IV hydromorphone to PO morphine, PO hydromorphone, or PO oxycodone. Summary Transcript Summary. A patient is on morphine and you want to convert it to another opioid like hydromorphone (dilaudid). How do you do that? Oh boy, what should we do?

IT 139

IT Patients Individual Relationship 139

PEMBlog

AUGUST 20, 2024

ECPR involves using ECMO (Extracorporeal Membrane Oxygenation) to take over heart and lung functions, offering a last-resort option that is becoming more common in large pediatric hospitals. The episode highlights the importance of understanding eCPR as a critical therapy for both in-hospital and out-of-hospital cardiac arrests.

Patient-Centered 52

Patient-Centered Hospital Patients IT 52

PEMBlog

SEPTEMBER 24, 2024

It is believed that this sequestered portion of his lung placed him at an elevated risk for infections as this is a known complication of bronchopulmonary sequestration. Pulmonology and surgery were consulted during his hospital stay, and he has since had a left lower lobectomy after healing from his pneumonia. 2004 Nov;49(4):302-9.

Diagnosis 52

Diagnosis Diagnose Patients Asthma 52

GeriPal

JUNE 8, 2023

We debate the merits of use of CGM in the nursing home and other late life settings (Eric and I argue against CGM and lose). Ozempic is a new fancy med that, by the way, leads to weight loss among celebrities, resulting in shortages of the drug from people using it off-label for that purpose. Listen in to learn more! This is Eric Widera.

Diabetes 73

Diabetes Management Patient-Centered Families 73

The Clinical Problem Solvers

APRIL 5, 2022

Bobby Watts about what brought them into their fields, how their work reaches the most marginalized, and what can be done at the community and structural level to address homelessness. Know your community resources. Our guests emphasize that physicians must be familiar with community resources.

Community 52

Community Patient-Centered Emergency Room Medical 52

GeriPal

NOVEMBER 17, 2022

Assisted Living Communities (no longer preferable to call them Assisted Living Facilities, as we learned on the podcast) are…what, exactly? If you’ve seen one Assisted Living Community you’ve seen one Assisted Living Community. . If you’ve seen one Assisted Living Community you’ve seen one Assisted Living Community. .

Community 97

Community IT Mental Health Medical 97

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. Their job was done.

Community 114

Community Transportation IT PCP 114

Doctors for America

MAY 30, 2025

COVID-19 infection continues to result in hundreds of thousands of hospitalizations annually, and causes the deaths of hundreds of Americans each week. Millions of Americans continue to live with complications of this disease and long COVID. We need all tools available to prevent complications of COVID-19.

Vaccination 65

Vaccination Medical Student Patient-Centered Community 65

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. This field is not new. Today Liz Dzeng discusses her journey towards studying this issue in detail. We can’t stop ourselves.

Hospital 125

Hospital IT Patient-Centered Patients 125

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. Alex 00:41 Free Fall in’?

IT 124

IT Patient-Centered Screening Community 124

GeriPal

JANUARY 25, 2024

You can also listen to an audio interview with Alex and JAMA Deputy Editor Preeti Malani about this study and the other RCT of default palliative care for hospitalized older adults with noncancer serious illness published in the same issue. Stay tuned for a GeriPal podcast with the authors of the other study next week. Is it you Lyndsay?

Patient-Centered 122

Patient-Centered IT Illness Patients 122

Annals of Family Medicine

NOVEMBER 20, 2024

Context: People experiencing homelessness (PEH) and type 2 diabetes are hospitalized more often, develop diabetes complications, and die on average 10 years earlier than their housed peers due to poorly controlled chronic physical and behavioral health conditions. Results: We found high acceptability on the CSQ-8 with a mean of 30.5 (SD

Diabetes 130

Diabetes Medical Complication Physicals 130

GeriPal

OCTOBER 20, 2022

How HHS and ASPE solicit input from clinicians, community leaders, and older adults and how much it impacts policy decisions (spoiler alert: this involvement is CRUCIAL). There’s a team now with them behind them making sure that they stay safe and held in our communities. How to make your voice heard and get involved.

Complication 52

Complication Patient-Centered IT Patients 52

Vida Family Medicine

MARCH 28, 2024

Diabetes, cardiovascular disease, and metabolic associated fatty liver disease all have the potential to cause life-altering complications and premature death. As most of you know, I follow a Health at Every Size® approach to the care of my patients. Often medication is useful to better control these conditions and help reduce these risks.

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

Physician's Weekly

JUNE 23, 2025

It will support one to three projects that focus on tracking and understanding health issues in the community, CNN reported. NIH is working to ensure that the people of East Palestine and the surrounding communities are listened to, cared for, and get the answers they deserve,” said NIH Director Dr. Jay Bhattacharya.

Community 52

Community Asthma Engineering Complication 52

GeriPal

MAY 22, 2025

When we started doing more music stuff for our patients in the hospital, a lot of people started to think, hmm, what would I want to listen to? This is not highly scripted orchestral music, people, its Jazz. -S And I was fortunate to record an episode of my medical mixtape with Tyler at the w hich meeting were we at, Tyler ? Tyler 01:12 AHPM.

IT 96

IT Patient-Centered Patients Board-Certified 96

GeriPal

SEPTEMBER 7, 2023

Summary Transcript Summary The comprehensive geriatric assessment is one of the cornerstones of geriatrics. But does the geriatric assessment do anything? Does it improve outcomes that patients, caregivers, and clinicians care about? We talk about: What is a practical geriatric assessment and how can busy oncologists actually do one? Thank you.

Patient-Centered 129

Patient-Centered IT Patients Clinic 129

GeriPal

FEBRUARY 23, 2023

Imagine her hearing for the first time that you’re sick, that you’re hospitalized, that you’re in the ICU, and that you can’t make your own decisions? Today we talk with Anne Rohlfing, Lynn Flint, and Anne Kelly, authors of a JGIM article on the reasons we shouldn’t stop at “no.” That’s a huge amount of news all at once. This is Eric Widera.

Families 97

Families Family Patient-Centered IT 97

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. Many were community hospitals. The intervention was a negative study for the primary outcome, hospital length of stay.

Patient-Centered 116

Patient-Centered Hospital IT Illness 116

GeriPal

OCTOBER 26, 2023

Today we talk with Sarguni Singh, hospitalist-researcher at the University of Colorado, Ann Henshaw, Occupational Therapist who teaches at George Washington and works clinically at Georgetown, and Tamra Keeney, Physical Therapist-researcher at Mass General Hospital and Harvard Medical School. Tamra, welcome to the GeriPal podcast. Here we go.

Patient-Centered 132

Patient-Centered Hospital Patients IT 132

GeriPal

JULY 21, 2022

Because I don’t think we think about that so much in palliative care, but we do in geriatrics. But I believe before we start, somebody has a song request for Alex. Is it you, Emmy? Emmy: It is. Eric: What’s the song? Emmy: I just forgot the name of the song… [laughter]. Alex: Pink Cadillac by Bruce Springsteen? I like that song.

IT 102

IT Families Family Diagnosis 102

GeriPal

MAY 12, 2022

Prognosis communication and the subtle ways we may communicate it without intention. Community-based palliative care networks . Raj faced in pain management: access to opioids, corruption, a system that doesn’t see addressing suffering as a priority. Social pain and loneliness. The intro is the upbeat guitar driven version.

Community 115

Community IT Relationship Healthcare 115

GeriPal

APRIL 10, 2025

Today we discuss: Why the study was negative for the primary (hospitalization) and all secondary outcome (e.g. Tammie 03:04 Depends on how long they were pre-hospital. So that study was focused on patients admitted to the hospital. I cant do the primary thing Ive been trained to do: ABC, ABC, ABCs. They got feedback.

Patient-Centered 77

Patient-Centered IT Hospital Patients 77

GeriPal

JUNE 30, 2022

Should she have an operation, and risk the pain, potential complications, and attendant delirium associated with the operation? Joel: The Brigham and Women’s Hospital likes me to say that too. Alex: And the Brigham and Women’s Hospital. And she was rushed to the hospital. She falls and breaks her hip.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

GeriPal

JULY 28, 2022

Alex: And we are also delighted to welcome Areej El-Jawahri, who is an oncologist at Massachusetts General Hospital as well, who specializes in blood cancers. Jennifer’s study is most widely known for the “kicker” – not only did it improve quality of life, palliative care was associated with a couple months longer survival. .

Illness 110

Illness Hospital Patient-Centered Patients 110

GeriPal

MAY 26, 2022

The basis of their argument is the ethical notion of “reciprocity” – people who are vaccinated have done something to protect the public health, and we owe them something for taking that action. Eric and I attempt to poke holes in their arguments, resulting in a spirited discussion. Evusheld is the latest case in point. . Alex: Love this.

Vaccination 87

Vaccination Individual IT Healthcare 87

GeriPal

JANUARY 26, 2023

Eric: So we’re going to be talking about the intersection between structural racism and ageism, but before we go into that topic, Ramona, I think you have a song request for Alex. Ramona: I do. It’s called A Change Is Gonna Come by Sam Cooke. Eric: And can you describe why you picked that song? Alex: Thank you. I love this song.

IT 91

IT Patient-Centered Healthcare Patients 91

GeriPal

MARCH 6, 2025

Michaels Hospital in Toronto, and health justice activist. Michael’s Hospital in the Department of Family and Community Medicine. Today we talk with Naheed Dosani, a palliative care physician at St. His story, which he shares on todays podcast, is remarkable. Today we discuss: What is the best terminology? Homelessness?

Healthcare 100

Healthcare IT Community Illness 100

GeriPal

OCTOBER 19, 2023

Certainly SOME of those avoided hospitalizations, CPR, and ICU stays were due to documentation of those orders in the POLST. Additional links mentioned in the podcast: Recent JGIM article on POLST in California nursing homes, hospitalization, and nursing home care Karl’s GeriPal post on appropriate use of POLST Enjoy! Welcome, Karl.

Patient-Centered 126

Patient-Centered IT Patients Illness 126

GeriPal

MAY 4, 2023

We remember bucking the rules, figuring out who you are, hair on fire, feeling invulnerable, trying to figure out who you are – and now those adolescents are stuck in the hospital, with doctors and parents telling them what to do, having their autonomy crushed by the medical institution, realizing they’re not invulnerable. Abby: I do.

IT 83

IT Families Family Illness 83

GeriPal

FEBRUARY 8, 2024

Hospital Chaplains, Spirituality, and Pain Management: A Qualitative Study. Pain Manag Nurs. 2023 Dec 20:S1524-9042(23)00202-3. doi: 10.1016/j.pmn.2023.11.004. 2023.11.004. Epub ahead of print. MOC Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 0.75

IT 137

IT Families Family Physicals 137

GeriPal

MARCH 28, 2024

Kate: The problem is we communicate late, we share prognosis late, we elicit goals and values late, so all the time while they’re in the ICU getting prolonged intensive care, we don’t really know that we’re providing goal concordant care, so we wanted to nudge it a little upstream. I’m just stunned even writing that!

Consulting 115

Consulting Patient-Centered IT Patients 115

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. We went to a hospital in Mississippi, one in Alabama, and one in South Carolina. Which is it?

Consulting 63

Consulting Community Patient-Centered Families 63