GeriPal

APRIL 27, 2023

“What we’ve seen to make it really work is you either have to be in the hospital, where we’ve taken over palliative care in the hospital, or you have to be contracted with managed care and get it at some kind of risk, because community-based palliative care is very difficult to make operate right now from a profitable [perspective].”

Specialization 93

Specialization Illness Healthcare Patient-Centered 93

GeriPal

OCTOBER 13, 2022

When I’m on service these days there is inevitably a moment when a resident says “Patient so-and-so is on X” – and I have absolutely no idea what X is. Alex: And we are delighted to welcome Rasheeda Hall, who is a physician scientist in the division of nephrology at Duke University School of Medicine, and sees patients at the Durham VA.

Complication 97

Complication Patient-Centered IT Patients 97

Tiny Physician

FEBRUARY 15, 2022

A few days back, a video went viral on social media in which a resident doctor (a doctor who is undergoing post-graduation / PG doctor) was shouting at the bystander of a patient. For example, a PG doctor, while examining a case, will be asked to collect blood test results from the lab and to accompany a patient for a CT scan after that.

Patient-Centered 52

Patient-Centered Government Referral Hospital 52

GeriPal

MARCH 14, 2024

This simple challenge was focused on putting ourselves in the shoes of our patients with dysphagia who are prescribed thickened liquids. And I think that we’re at this kind of crossroads right now in dysphagia, and dysphagia management where our patients are suffering. We revisit it, and make things better for our patients.

IT 125

IT Patient-Centered Hospital Individual 125

Tiny Physician

AUGUST 12, 2021

Health facilities and the health-seeking behavior of the community are far superior as compared to national standards. Student of Kottayam Medical College Certain faculty members pass off belittling comments such as “ leggings will make patients sexually attracted to you ”.

Medical 52

Medical Medical Student Illness Education 52

GeriPal

JUNE 8, 2023

When I’m on palliative care consults and attending in our hospice unit we have to counsel patients about deprescribing and de-intensifying diabetes medications. Should we use Ozempic (if we can find it) in patients with serious illness, which often results in undesirable and profound weight loss? How high is too high?

Diabetes 74

Diabetes Management Patient-Centered Families 74

GeriPal

MAY 8, 2025

Summary Transcript CME Summary Weve covered psychedelics on the podcast beforefirst in 2019 with Ira Byock, where we explored their potential role in medicine , and then again in 2023 with Stacy Fischer, Brian Anderson, and Theora Cimino, focusing on the reasons to approach psychedelic use in patients with caution. This is Eric Widera.

Illness 109

Illness IT Patient-Centered Patients 109

Edge Family Medicine

FEBRUARY 10, 2025

Healthcare has evolved, and patients now have more choices than ever for medical consultations. Telemedicine allows you to consult with a doctor remotely via video, phone, or online messaging. Accessibility – Ideal for patients in rural areas or with mobility challenges. Safety – Reduces exposure to contagious illnesses.

Telemedicine 130

Telemedicine Family Medicine DO Chronic Disease Management 130

GeriPal

JANUARY 25, 2024

Summary Transcript Summary In a JAMA 2020 systematic review of palliative care for non-cancer serious illness, Kieran Quinn found many positives, as we discussed on our podcast and in our editorial. He also found gaps, including very few studies of patients with lung disease, and little impact of trials on quality of life.

Patient-Centered 123

Patient-Centered IT Illness Patients 123

GeriPal

FEBRUARY 27, 2025

Today we talk with experts Janet Ho, Sach Kale, and Julie Childers about opioid use disorder and serious illness. We address: Why is caring for patients with this overlap so hard? Sach Kale set up an outpatient clinic focused on substance use disorder for patients with cancer. What is making this hard for me? What do they do?

Patients 74

Patients Clinic Patient-Centered Illness 74

GeriPal

JANUARY 30, 2025

In one corner, weighing in at decades of experience, well known for heavy hits of bedside assessments, strong patient-family relationships, and a knockout punch of interdisciplinary collaboration, we have in-person palliative care consults. Consultations versus telehealth. But watch out! Alex 01:06 Yeah, go in person.

Telehealth 106

Telehealth Patient-Centered IT Patients 106

GeriPal

OCTOBER 6, 2022

Earlier this year palliative care was the correct response to the following clue on the game show Jeopardy: From a Latin word for “to cloak”, it’s the type of care given to seriously ill patients to provide comfort without curing. We had tried to actually select people who didn’t have a serious illness. Marian: Thank you.

Illness 101

Illness Patient-Centered IT Nurse Practitioner 101

GeriPal

DECEMBER 8, 2022

Clinicians “catching” patient life stories. . Our patients aren’t “the 76 year old with heart failure in room 202,” as Heather Coats astutely noted. Storytelling Helps Hospital Staff Discover The Person Within The Patient. What Mattered Then, Now, and Always: Illness Narratives From Persons of Color. What’s in a story?

Patient-Centered 116

Patient-Centered Illness Healthcare IT 116

GeriPal

JUNE 19, 2025

Eric 01:04 So we’re going to be talking about transgender health in older adults and those with serious illness. Knowing that the community is really underrepresented in sort of our knowledge, what we do, how we provide care that’s truly inclusive and welcoming. Happy pride and thanks for the invitation, Alex and E.

Individual 82

Individual Community IT Chronic Condition 82

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. The patient’s capacity to make decisions was marginal, and his sons were shouldering much of the responsibility.

Patient-Centered 133

Patient-Centered Hospital Patients IT 133

GeriPal

FEBRUARY 23, 2023

Summary Transcript Summary You know when you walk out of a patient’s room and have that sense, “This isn’t going to go well.” The patient is sick and getting sicker, and refuses to let you talk with family or other members of her inner circle. Should you stop at “no?” Lynn: I do. Alex, can you play Send the Sun, by Nikki Lane?

Family 98

Family Families Patient-Centered IT 98

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 116

Consulting Patient-Centered IT Patients 116

GeriPal

MAY 4, 2023

But when I have, I find that they’re often some of the hardest patients to care for. I just had this experience where in the space I was in, very few people believed that this was even a legit thing to study and certainly that it would make a difference for the patients we cared for. Eric: Yeah.

IT 83

IT Families Family Illness 83

GeriPal

DECEMBER 15, 2022

Along the way we address: Is this degree of slowed cognitive decline meaningful to patients or care partners? Eric: So patient narrative storytelling, independent of what we call it, I’d like to turn to both of you and just how you got interested in this as a subject. She was a heart failure patient.

IT 106

IT Patient-Centered Healthcare Illness 106

GeriPal

OCTOBER 24, 2024

If you believe the evidence for efficacy to manage symptoms like neuropathic pain, how do you even start to think about recommending these products to patients? And then I met a patient in clinic once who asked me a lot of really intelligent questions about medical cannabis, what it does. Eloise, welcome to the GeriPal podcast.

Medical 100

Medical IT Patient-Centered Healthcare 100

GeriPal

JANUARY 16, 2025

Summary Transcript CME Summary Many older adults lose decision-making capacity during serious illnesses, and a significant percentage lack family or friends to assist with decisions. And I was asking this patient about if he had filled out an advanced directive. Is the patient in your descriptor? Alex 10:41 No, they don’t.

Patient-Centered 110

Patient-Centered IT Patients Healthcare 110

GeriPal

OCTOBER 20, 2022

And, who within ASPE guides aging policy and connects policy to every day health challenges experienced by patients and clinicians? 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). Sonali: Thank you for having me.

Complication 52

Complication Patient-Centered IT Patients 52

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. You did a rural tele-palliative care consultation study. Who would/should be on that board?

Consulting 64

Consulting Community Patient-Centered Families 64

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 116

Community IT Relationship Healthcare 116

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. Participants were critically ill and intubated. What is sludge? Where was it?

Patient-Centered 118

Patient-Centered Hospital IT Illness 118

Plum Health

OCTOBER 16, 2024

Whether you’re in Detroit , Corunna , Lansing , Royal Oak , or Van Buren , this clinic is offering comprehensive care that puts patient well-being first. Comprehensive Primary Care for Michigan Communities What sets this clinic apart is its comprehensive approach to primary care. Here’s why everyone is talking about it!

Clinic 52

Clinic Chronic Disease Management Primary Care Medical 52

GeriPal

JUNE 5, 2025

nursing homes grapple with serious illnesses, and roughly half experience dementia. Eric 03:25 So we have a lot to talk about, but I’m wondering if we can kind of take a big step back and just talk about the patient population that’s in nursing homes. Consider this: the majority of the 1.4 million adults residing in U.S.

Nurse Practitioner 78

Nurse Practitioner Referral Consulting Board-Certified 78

GeriPal

APRIL 28, 2022

Eric: I’m looking forward to talking about art and humor in palliative care and we’re caring for seriously ill patients. If you look back to some of my cartoons from late in residency, they showed just how dehumanized I felt and definitely give windows into how dehumanized I imagined my patients to be. Nathan: I do.

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? Most emergency providers wanted to do the right thing for seriously ill patients, but they didnt have the knowledge, skills, or experience to do it.

Patient-Centered 78

Patient-Centered IT Hospital Patients 78

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 100

IT Community Patient-Centered Medical 100

GeriPal

JANUARY 11, 2024

In further contrast to the United States, MAID in Canada is almost entirely administered by a clinician, whereas in the United States patients must self administer. A planned expansion of MAID to include people with mental illness was placed on hold until March 2024. They could have a prognosis of years, or decades.

Illness 144

Illness IT Medical Provider 144

GeriPal

JUNE 30, 2022

You have a patient with dementia severe enough that she cannot recognize relatives. A huge part of this decision rests on (1) her previously stated wishes, values, and goals (prior to the onset of dementia); and (2) the outcomes of surgery for patients with dementia. Summary Transcript Summary. She falls and breaks her hip.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

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. So we’re going to be today talking about serious illness palliative care in the homelessness population.

Healthcare 102

Healthcare IT Community Illness 102

GeriPal

JUNE 22, 2023

Through a series of events, I started working as a consultant to the Department of Corrections in around 2006, and I was assigned to the California Medical Facility. Healthcare staff were afraid of patients with HIV because there wasn’t clarity on how it was transmitted. It’s by choice, just like in the community.

Families 133

Families Family IT Community 133

GeriPal

MARCH 24, 2023

Usually I don’t put a lot of background on this podcast, but I got to … in November of 2022, Ava Kofman, along with ProPublica, published … well I won’t want to say great, published an article in The New Yorker that I think it was divisive in the hospice and palliative care community. Eric: Great. Now it’s 70%.

IT 115

IT Provider Patients Families 115

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. We discuss the moral distress that clinicians felt including, as one physician put it, a sense of your soul being ripped out.

Hospital 126

Hospital IT Patient-Centered Patients 126

GeriPal

MARCH 7, 2024

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. That was really the theme song of how the community came together. He looked very ill. But in the end, I see these as my patients and I’m trying to define what is the right model.

Provider 119

Provider Illness IT Healthcare 119