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

GeriPal

MAY 11, 2023

But I would say that in terms of education, it’s really complicated because it’s so confounded by socioeconomic status and so many social determinants of health. Now, that doesn’t mean it’s a one-to-one, and this is very hard as we see it with our patients who have done all these things. Alex: Yeah. Eric: Okay.

Physicals 85

Physicals IT Hypertension Education 85

Plum Health

OCTOBER 11, 2024

Your ongoing appointments help foster a strong patient-doctor relationship , making it easier to discuss your concerns and receive personalized care. Choosing the right primary care clinic involves considering several factors, such as clinic locations, healthcare system, and the services offered. What is in a clinic?

Clinic 52

Clinic Primary Care Doctor Primary Care Chronic Condition 52

GeriPal

JUNE 27, 2024

How, though, do we navigate anxiety and help our patients who may end up in the anxiety spiral that becomes so hard to get out of? Something I’ll often point out to patients is, you know, how do you identify your emotions? On today’s podcast, we’ve invited Alex Gamble and Brianna Williamson to talk to us about anxiety.

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. Infections or allergic reactions can block your airway and lead to life-threatening complications.

ER 52

ER Telehealth Primary Care Doctor Appointment 52

GeriPal

FEBRUARY 16, 2023

Summary Transcript Summary Think about the last time a patient yelled at you in anger. Dani and Kery present three steps for interacting with an angry patient: Look within: What is this anger bringing up in me? 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

MAY 22, 2025

Jenny Chen is a palliative care fellow at Yale who regularly sings for her seriously ill patients. Jenny reached out to us because she plays music regularly for her patients, and she said, you should do a podcast about music. And I performed for many palliative patients, and that’s when I started to understand.

IT 96

IT Patient-Centered Patients Board-Certified 96

GeriPal

OCTOBER 24, 2024

Summary Transcript CME Summary Cannabis is complicated. 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 one patient who really knew more about a topic than I did, which unfortunately happens much more often.

Medical 98

Medical IT Patient-Centered Healthcare 98

GeriPal

JULY 21, 2022

Initially, it was just because there weren’t really answers for my patients. Often when there’s a cognitive concern, it’s a family member that is calling saying, “I just want to make sure my mom should still be driving after this happened, or after this diagnosis.” “When can I get back to driving?”

Families 102

Families Family IT Diagnosis 102

GeriPal

JULY 11, 2024

It’s a jampacked 50 minutes, filled with pearls on taking care of patients with liver disease. Kirsten 04:16 So, in emergency medicine, obviously, we are interacting and caring for these both exciting and interesting, but also very complex and humbling patients to care for in the ED setting. What’s the connection and why?

Patient-Centered 109

Patient-Centered IT Patients Clinic 109

GeriPal

OCTOBER 20, 2022

And, who within ASPE guides aging policy and connects policy to every day health challenges experienced by patients and clinicians? 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 52

Complication Patient-Centered IT Patients 52

GeriPal

AUGUST 29, 2024

During the podcast, we reference a newly released second-edition book that our guests published titled “ Navigating Communication with Seriously Ill Patients: Balancing Honesty with Empathy and Hope.” Why did you all decide to write an updated book on navigating communication with serious ill patients? Gordon 02:02 I do.

IT 132

IT Illness Families Family 132

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?

Families 97

Families Family Patient-Centered IT 97

GeriPal

JUNE 15, 2023

” And Bing responded, I should ask about how AI can help identify patients who need palliative care and reduce hospitalizations, what are the benefits and challenges of using AI in decision-making, communication, palliative care, and how could AI support the quality of life and dignity of patients for those who are receiving palliative care?

IT 99

IT Patient-Centered Patients Healthcare 99

GeriPal

JUNE 9, 2022

By diagnosis? Patients have all sorts of problems. We all focused on studying the outcomes for patients and families of our intervention and then the processes to get there. And while they identified thousands of patients and enrolled. You’re usually not soliciting thousands of patient reported outcomes.

Consulting 99

Consulting Patient-Centered Diagnosis Referral 99

GeriPal

JUNE 30, 2022

You have a patient with dementia severe enough that she cannot recognize relatives. Should she have an operation, and risk the pain, potential complications, and attendant delirium associated with the operation? Samir: For me, it really came out of an interest in improving the care of patients who undergo surgery. AlexSmithMD.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

GeriPal

SEPTEMBER 28, 2023

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. Patient Values: Three Important Questions-Tell me more? Simple, right? Not so much, as each one of these steps is fraught with miscommunication. What else?

Families 144

Families Family Patient-Centered IT 144

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.). Eric: All right. Eric: Yeah.

Management 122

Management IT Medical Patient-Centered 122

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. What are the patients that we remember?

IT 83

IT Families Family Illness 83

GeriPal

OCTOBER 12, 2023

Summary Transcript Summary For surgeons and patients, deciding if and when to operate can be challenging. Often, the way surgeons communicate about these decisions doesn’t make things any easier for themselves or their patients. We hope you enjoy this episode. I did it before and this guy, he was 85, but he was climbing Mount Everest.”

IT 128

IT Families Family Patient-Centered 128

GeriPal

JULY 28, 2022

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. Eric: And what a research agenda that you’ve done, including one of the most seminal papers that we have in palliative care in lung cancer patients.

Illness 110

Illness Hospital Patient-Centered Patients 110

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

AUGUST 25, 2022

Second, Hospice was originally designed for patients with advanced cancer, but the fastest growing admitting diagnosis is dementia. Krista Harrison found , to her surprise, that caregivers of people with dementia who died rated hospice as well as similar patients without dementia who died on hospice. AlexSmithMD. Transcript.

Families 106

Families Family IT Patients 106

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. 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.

Illness 144

Illness IT Medical Provider 144

GeriPal

DECEMBER 19, 2024

A NY Times article titled Should Patients Be Allowed to Die From Anorexia ? That’s how do we treat the mental health needs of patients with serious medical illness? So in those cases, can we adopt an approach to mental health care that centers primarily around quality of life of patients and their families?

Illness 101

Illness Mental Health IT Patient-Centered 101

GeriPal

MARCH 7, 2024

Whenever I take care of a patient, I see myself as a family practice doctor, but I’ve been a hospitalist, I’ve been a primary care doctor, and I’ve done palliative. But in the end, I see these as my patients and I’m trying to define what is the right model. I wonder, is this only for patients in hospice?

Provider 117

Provider Illness IT Healthcare 117

GeriPal

MAY 12, 2022

It’s easier to concentrate on cure, diagnosis, cure. And then there are a number of groups that go out in vans and cars and go out into the surrounding community of Kerala to provide care for patients who are in their homes. And I’ll share that my own relationship with my father, who was a doctor, was a complicated one.

Community 115

Community IT Relationship Healthcare 115

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. It’s complicated, it’s messy. How does that defer from is it complicated grief, prolonged grief disorder? Holly: Oh absolutely.

IT 100

IT Complication Relationship Specialization 100

GeriPal

MAY 1, 2025

And so the patients who had been admitted there to die, essentially most, if not all, got better and HIV became much more of a chronic condition. It is kind of weird that my first publication was in jama, part of the Care of the Aging Patient series. And then in the years soon after, everything changed completely. Meredith 11:29 Yeah.

Primary Care 94

Primary Care IT Provider Clinic 94

GeriPal

JULY 25, 2024

The PPS is one of the most widely used prognostic tools for seriously ill patients, but the prognostic estimates given by the PPS are based on data that is well over a decade old. It is appropriate for all patient populations, and it is developed specifically for the palliative care and hospice populations. Why do this?

Families 106

Families Family Patient-Centered Patients 106

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. You know, I address all the supportive care needs of my patients.

Illness 130

Illness IT Physicals Patients 130

GeriPal

MARCH 27, 2025

Only 5% of intervention patients received the facilitator-led component of the intervention (there were other components, facilitator-led was the most engaged component). I’m hearing dementia patients or patients with dementia. Eric 09:15 And then who were the patients just with dementia or were they. Is that right?

Primary Care 79

Primary Care IT Clinic Illness 79

GeriPal

FEBRUARY 24, 2022

We see our patients and our families throughout the illness trajectory into the hospital. And I think the advanced planning debate is really a question of, how do we help this very complicated situation? And maybe we should have more patient-centered conversations. That this is iterative from diagnosis to end-of-life, right?

Illness 98

Illness Patient-Centered IT Patients 98

GeriPal

AUGUST 22, 2024

I love these topics, too, because even how do we define what is a diagnosis? Patients families want to know whether their loved one has died. Doctors want to know whether the patient has died. You know, when is it okay to harvest organs from a patient? So there may be caps if the patient died versus no caps.

IT 113

IT Families Family Patient-Centered 113

GeriPal

SEPTEMBER 14, 2023

We talk with Bruce Leff and Tacara Soones about the hospital-at-home movement, which has been shown to reduce costs, improve outcomes and improve the patient experience. JAGS Hospital-at-Home Interventions vs In-Hospital Stay for Patients With Chronic Disease Who Present to the Emergency Department: A Systematic Review and Meta-analysis.

Hospital 115

Hospital Patient-Centered Supply Chain IT 115

GeriPal

JANUARY 5, 2023

We start by talking with Robert Brody, an internist who recalls physicians helping patients die during the height of the AIDS epidemic in San Francisco. Robert was first asked by one of his own patients for assistance in dying in 1991, far before aid in dying was legalized in California in 2016.

Provider 19

Provider Medical Hospital Patient-Centered 19

GeriPal

JULY 16, 2024

Ken Covinsky reminds us that we should not be making a diagnosis based on what we see on TV, and that if a patient’s daughter expressed a concern that their parent “wasn’t right,” we would conduct an in depth evaluation that might last an hour. Cecilia Poon says, what are some best practices to highlight professional ethics?

Diagnosis 141

Diagnosis Diagnose IT Physicals 141