GeriPal

JUNE 20, 2024

On our last podcast about urinary incontinence the song request was, “Let it go.” This time around several suggestions were raised. Eric suggested, “Even Flow,” by Pearl Jam. Someone else suggested, “Under Pressure,” but we’ve done it already. We settled on, “Oops…I did it again,” by Britney Spears. I suggested even flow. That’s a good one.

IT 120

IT Patient-Centered Patients Clinic 120

GeriPal

MAY 11, 2023

Kristine, do you have a song request for Alex? Kristine: Well, I did have a song, but I was negligent at giving it to him. So, he tried to read my mind… Eric: What was your song? Kristine: I was going to do David Bowie Changes for a variety of reasons, but it was sort of somewhat around the topic. Alex: (singing) Eric: That was wonderful.

Physicals 85

Physicals IT Hypertension Education 85

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 Family 73

Rao Doctor

APRIL 3, 2025

In case you have missed it, click below to read- FEVER FAQ- Part 1 Fever Diagnosis: How is your health assessed? When assessing a fever, we doctors employ a systematic approach to ensure accurate diagnosis and effective management. Understanding the patient’s medical history is crucial for an accurate diagnosis.

Diagnosis 130

Diagnosis Management Illness Diagnose 130

Plum Health

OCTOBER 11, 2024

Have you ever found yourself in need of medical attention but overwhelmed by the myriad of clinics and healthcare options out there? Navigating the healthcare system can be daunting, especially when you're unwell or caring for someone who is. It's a common challenge many people face.

Clinic 52

Clinic Primary Care Doctor Primary Care Chronic Condition 52

GeriPal

JUNE 27, 2024

Summary Transcript Summary “Anxiety is a lot like a toddler. It never stops talking, tells you you’re wrong about everything, and wakes you up at 3 a.m.” I’m not sure who wrote this quote, but it feels right to me. Brianna is one of UCSF’s palliative care fellows who just completed her psychiatry residency. Alex Gamble, do you have a song?

Illness 129

Illness IT Diagnosis Patient-Centered 129

Doctor On Demand

APRIL 28, 2025

In fact, most sore throat symptoms resolve in three days for 60-70% of patients, according to March 2025 UpToDate, an evidence-based clinical decision support system used by healthcare professionals. Most sore throats are common cases, so it can be hard to know when to seek urgent care or when to just rest at home.

ER 52

ER Telehealth Primary Care Doctor Appointment 52

GeriPal

OCTOBER 24, 2024

Summary Transcript CME Summary Cannabis is complicated. It can mean many things, including a specific type of plant, the chemicals in the plant, synthetic analogs, or products that have these components. Eric 00:49 And I just want a big shout out to Alex Gamble, who said, we have to get Eloise on a podcast to talk about this topic.

Medical 98

Medical IT Patient-Centered Healthcare 98

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 Family Families Diagnosis 102

GeriPal

MAY 22, 2025

The ability to appreciate, recognize, and engage with music is preserved even until late stages of dementia, and Theresa is examining how music can be useful from the time of diagnosis, not only for the person with dementia, but their caregivers. This is not highly scripted orchestral music, people, its Jazz. -S Tyler 01:12 AHPM.

IT 96

IT Patient-Centered Patients Board-Certified 96

GeriPal

JUNE 15, 2023

Hallucinations, or when the AI lies or b *s, then denies it When the AI approaches sentience, is it ethical to unplug it? I’m sure this is a subject we will return to, given the rapid progress on AI. But then it asked me, “Oh, that sounds really interesting. Who are you going to be talking to?” ” And I said, “Sure.”

IT 99

IT Patient-Centered Patients Healthcare 99

GeriPal

JULY 11, 2024

Summary Transcript Summary In May we did a podcast on KidneyPal (the integration of palliative care in renal disease) , which made us think, hmmm… one organ right next door is the liver. Maybe we should do a podcast on LiverPal? (or or should we call it HepatoPal?) ABIM MOC credit will be offered to subscribers in November, 2024. Excited to be here.

Patient-Centered 109

Patient-Centered IT Patients Clinic 109

GeriPal

AUGUST 29, 2024

Gordon 02:12 So I think it speaks to one of the big lessons we’ve learned, which is that docs and other health professionals often sort of give way too much information and spend a lot of time talking. That’s a hard enough task, given that most of us have never had any communication skills training. Gordon 02:02 I do. Elise 03:53 Nice.

IT 132

IT Illness Family Families 132

GeriPal

OCTOBER 20, 2022

It’s Lona Mody who is a translational infectious disease researcher at the University of Michigan and VA Ann Arbor Healthcare System. There’s the complications associated with immune senescence, comorbidities, atypical clinical presentations. How to make your voice heard and get involved. This is Eric Widera.

Complication 52

Complication Patient-Centered IT Patients 52

GeriPal

JUNE 9, 2022

By diagnosis? We talk with Kate about how despite how far we’ve come in palliative care research, we still don’t have answers to some fundamental questions, such as: Who should get specialized palliative care? Should eligibility and access be determined by clinician referral? By prognosis? Can nudges help? What is a pragmatic trial ?

Consulting 99

Consulting Patient-Centered Diagnosis IT 99

GeriPal

FEBRUARY 23, 2023

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.” We owe it to the patient to explore the reasons behind the “no,” commonly not wanting to be a burden to their family. And I’m worried that there may come a time when you have trouble making decisions for yourself.

Family 97

Family Families Patient-Centered IT 97

GeriPal

JUNE 30, 2022

Should she have an operation, and risk the pain, potential complications, and attendant delirium associated with the operation? You have a patient with dementia severe enough that she cannot recognize relatives. She falls and breaks her hip. Should she be treated non-operatively, with aggressive symptom management? It was Remember Me.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

GeriPal

JUNE 16, 2022

We discuss with her how we should work-up and manage “urinary tract infections” (I’ve added air quotes to “UTI” in honor of Tom Finucane’s JAGS article titled “Urinary Tract Infection”—Requiem for a Heavyweight in which he advocated to put air quotes around the term UTI due to the ambiguity of the diagnosis.). Chrissy: I do. Alex: (Singing).

Management 122

Management IT Medical Patient-Centered 122

GeriPal

SEPTEMBER 28, 2023

Summary Transcript Summary Medical communication is tough, although fundamentally at its most basic unit of delivery, it includes really only three steps. First, a clinician’s thoughts must be encoded into words, then transmitted often via sounds, and finally decoded back to thoughts by a patient or family member. Simple, right? Alex: (Singing).

Family 144

Family Families Patient-Centered IT 144

GeriPal

OCTOBER 12, 2023

Instead, what if your surgeon told you that the operation she was discussing could help with only 4 things: live longer, feel better, prevent disability, or obtain a diagnosis? And, what if your surgeon openly discussed the expected ‘bad stuff’ of post-operative recovery, instead of rotely reciting a list of possible complications?

IT 128

IT Family Families Patient-Centered 128

GeriPal

MAY 4, 2023

Eric: So we’re going to be talking about palliative care for adolescents, and young adults. Why does it feel different? Does it feel different? How should we think about the care? But before we do, Abby, I think you have a song request for Alex. Abby: I do. So I requested that Alex play for us, Let It Grow, which is from The Lorax soundtrack.

IT 83

IT Family Families Illness 83

GeriPal

OCTOBER 19, 2023

Summary Transcript Summary What level of evidence do we need for POLST to use it ourselves, to advocate for wider usage, and for establishing POLST completion as a quality metric? The answers to these questions will vary. Reasonable people will disagree. And today, on our podcast, our guests disagree. But is it a tiny, meaningless, fraction?

Patient-Centered 126

Patient-Centered IT Patients Illness 126

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. Summary Transcript Summary Four percent of deaths in Canada are due to Medical Assistance in Dying (MAID). Four percent. It is the slippery slope made real. It was amazing.

Illness 144

Illness IT Medical Provider 144

GeriPal

JULY 28, 2022

Jennifer: Yeah, so I think as all the listeners of this podcast know, and I know he did do a podcast with you guys when he was still able to verbally communicate, with Randy Curtis’ diagnosis of, I keep wanting to say AML, ALS. But before we do, I think somebody has a song request for Alex. Alex: (singing). Areej: Wow. Jennifer: Yeah.

Illness 110

Illness Hospital Patient-Centered Patients 110

GeriPal

MAY 12, 2022

Raj faced in pain management: access to opioids, corruption, a system that doesn’t see addressing suffering as a priority. Prognosis communication and the subtle ways we may communicate it without intention. Social pain and loneliness. Community-based palliative care networks . Raj’s reflections on the state of palliative care in the US. Transcript.

Community 115

Community IT Relationship Healthcare 115

GeriPal

FEBRUARY 16, 2023

As Keri put it in the podcast, we must go beyond “a hammer and a nail” philosophy to approaching anger by developing a toolkit for anger that is vast and varied. Dani and Kery present three steps for interacting with an angry patient: Look within: What is this anger bringing up in me? Is that you Dani? Dani: It is me. laughter] Alex: Not at all.

Patients 109

Patients IT Family Families 109

GeriPal

AUGUST 25, 2022

Second, Hospice was originally designed for patients with advanced cancer, but the fastest growing admitting diagnosis is dementia. Thus, they have little in the way of long term vision for hospices, instead focused on cutting costs and maximizing profits. . People with dementia make up about half of hospice admissions. Is it you, Melissa?

Family 106

Family Families IT Patients 106

GeriPal

MARCH 7, 2024

But before we jump into that topic, John, do you have the song request for Alex? John: I do. It’s Jimmy Buffett’s song, Bubbles Up. It was on his last album. As you may know, Jimmy Buffett passed away in August of a rare skin cancer. When I heard Bubbles Up, I was really struck by two things. How do you see the light? You were a what?

Provider 117

Provider Illness IT Healthcare 117

GeriPal

DECEMBER 19, 2024

We invited Dani Chammas , a palliative care physician and psychiatrist at UCSF (and a frequent guest to the GeriPal podcast), as well as Brent Kious , a psychiatrist at the Huntsman Mental Health Institute, focusing on the management of severe persistent mental illnesses. What does it look like to take a palliative approach to severe mental illness?

Illness 101

Illness Mental Health IT Patient-Centered 101

GeriPal

SEPTEMBER 8, 2022

Holly has accumulated mountains of evidence for the diagnosis of prolonged grief disorder as a specific condition primarily notable for a yearning over a year after the death. This led her on a remarkable journey. Prolonged grief is associated with increased risk of suicide and other negative health outcomes. Holly: Yes, I do. Alex: Right.

IT 100

IT Relationship Complication Specialization 100

GeriPal

MAY 1, 2025

Meredith wore a shirt that said Silence=death. Eric gave me the hook during my live cover of One, by U2, a song released in 1992 whose proceeds went entirely to AIDS research. I couldnt help it, forgive me dear listeners, I had to do a longer than usual cut at the start! But this song was actually a fundraiser for AIDS when it was released.

Primary Care 94

Primary Care IT Provider Clinic 94

GeriPal

JULY 25, 2024

MOC Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 0.75 MOC points per podcast in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. ABIM MOC credit will be offered to subscribers in November, 2024. You got it.

Family 106

Family Families Patient-Centered IT 106

GeriPal

JUNE 6, 2024

Don Dizon, oncologist specializing in pelvic malignancies at Brown, suggests speaking in plain language, starting by normalizing sexual health issues, to paraphrase, “Many of my patients experience issues with intimacy and sexual health. Is that an issue for you? I’m happy to talk about it at any time.” This is Eric Widera. Ra ra ra ra.

Illness 130

Illness IT Physicals Patients 130

GeriPal

MARCH 27, 2025

We are delighted to welcome Jennifer Wolf f , who is a health services researcher and gerontologist and professor at Johns Hopkins. Jennifer, welcome to the GeriPal Podcast. Jennifer 00:28 It’s great to be here. But before we dive into the study and the implications it has for the practice that we do, I believe someone has a song request.

Primary Care 79

Primary Care IT Clinic Patient-Centered 79

GeriPal

FEBRUARY 24, 2022

And I’m worried about all of us as healthcare workers, but particularly… And when I say particularly those in the hospital, because they are just tired. And I’m worried about all of us as healthcare workers, but particularly… And when I say particularly those in the hospital, because they are just tired.

Illness 98

Illness Patient-Centered IT Patients 98

GeriPal

AUGUST 22, 2024

Why does this issue keep coming up? Why is it unresolved? Today we put these questions to Winston Chiong, a neurologist and bioethicist, and Sean Aas, a philosopher and bioethicist. We’ll have a link to that in our show notes. We’re gonna double up on that subject. Alex 01:07 We haven’t figured it out. Alex 01:48 All right.

IT 113

IT Family Families Patient-Centered 113

GeriPal

SEPTEMBER 14, 2023

The pneumonia could get treated, but I think geriatricians, actually, were well aware of iatrogenic complications of care and quality gaps, even well before the IOM reports of the late 1990s and the like. In addition to discussing these outcomes, we also discuss: The history of the hospital-at-home movement. Alex: Good challenge. Eric: Okay.

Hospital 115

Hospital Patient-Centered Supply Chain IT 115