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 15, 2024

So it’s just a wide-opening lens that most of us never really get to see if we’re on the hospital-based side. I was like, “I have all these things I’m doing in the hospital to try to make people better and then I might be sending them right back to a big hazardous environment.”

Community 114

Community Transportation IT PCP 114

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. People had to be in the top 20th percentile of risk for being hospitalized or dying in the next year.

Patient-Centered 122

Patient-Centered IT Illness Patients 122

GeriPal

OCTOBER 20, 2022

And so there was a report in 2009 by the Institute of Medicine saying that we need to equip all of these individuals in caring for older person in an evidence based manner. There’s the complications associated with immune senescence, comorbidities, atypical clinical presentations. One of your articles addresses that.

Complication 52

Complication Patient-Centered IT Patients 52

GeriPal

NOVEMBER 14, 2024

And the big things that we think about as far as complications, so there, obviously the thing that comes to everybody’s mind is like fractures. Like there’s nothing we can do or do you feel like and we can talk about if so there are things that we can do to prevent falls and prevent the complications of those falls.

IT 124

IT Screening Patient-Centered Community 124

GeriPal

JULY 21, 2022

I’ve worked in hospital settings as an occupational therapist, inpatient rehab and outpatient rehab. Emmy: I was seeing people in the hospital setting, saying they had had a massive brain injury. Emmy: Ended up starting a program, outpatient at our hospital at the time. How did you get interested in this? Alex: Yeah.

IT 102

IT Family Families Diagnosis 102

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 IT Individual Healthcare 87

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

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? ” and the answer is no, that probably was more just about do you need anybody to support you kind of emotionally or during this hospital stay, just give information to.

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. What is sludge?

Patient-Centered 116

Patient-Centered Hospital IT Illness 116

GeriPal

JULY 11, 2024

So if one of my patients gets admitted, I also see them on the inpatient side of our hospital. I’ve seen patients post transplant when they start having complications. They are complicated. They’re complicated from a symptom standpoint. Can you come and be in our clinic once a week? So I go between.

Patient-Centered 109

Patient-Centered IT Patients Clinic 109

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.

Patient-Centered 132

Patient-Centered Hospital Patients IT 132

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: They have a meaningful impact on what happens to them during the hospitalization and after. They all self-identified as a hospital based practice.

Illness 110

Illness Hospital Patient-Centered Patients 110

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. Was the clinician working frontline in those community hospitals? hospice use).

Patient-Centered 77

Patient-Centered IT Hospital Patients 77

GeriPal

MARCH 28, 2024

Kate: It was done in 10 hospitals, 17 ICUs in Atrium Health down in North Carolina. Asking clinicians to document prognosis did not change the primary outcome of hospital length of stay or really any of the secondary outcomes, which I’ll get into. Also the same hospital system? That’s when they got enrolled.

Consulting 115

Consulting Patient-Centered IT Patients 115

GeriPal

AUGUST 29, 2024

We must often deliver complex medical information that carries heavy emotional weight in pressured settings to individuals with varying cultural backgrounds, values, and beliefs. This is a complicated case. Gordon 41:13 The hospital is also on fire. I want you to be able to be in the hospital and be with your loved one.

IT 132

IT Illness Family Families 132

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

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!

Patient-Centered 126

Patient-Centered IT Patients Illness 126

GeriPal

NOVEMBER 7, 2024

Additional link to study with heatmaps of specific locations (hospital, nursing home, home) after initiating dialysis. -@AlexSmithMD ** NOTE: To claim CME credit for this episode, click here ** Transcript Eric 00:11 Welcome to the GeriPal podcast. He would go home, and then three weeks later he would be back in the hospital.

Management 116

Management Patient-Centered Patients IT 116

GeriPal

MAY 25, 2023

Complicated grief? Health care system drives where you end up, which hospital, which state you live in. So if we said, like, did you make a decision while one of your loved ones was in the hospital, they would say, Oh, yeah, absolutely. Did the caregiver feel heard and understood? Did they have PTSD? Depression?

Community 95

Community IT Patient-Centered Primary Care 95

GeriPal

JUNE 9, 2022

Palliative care, in contrast, saw explosive growth in US hospitals. They were at the VA, but not so much at our main hub hospital where I trained. I do tend to focus in the hospital setting. That’s just not how the hospital works. Or the hospital, the intervention delivery is by who’s in practice.

Consulting 99

Consulting Patient-Centered Diagnosis Referral 99

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: Yeah.

IT 83

IT Family Families Illness 83

GeriPal

MARCH 24, 2022

Although, certainly when you start facing complications of serious illness, it is increasingly important to engage as individuals and conversations about goals, values, and preferences. So it’s an example of something that can start outside of the healthcare system and move its way in. And the reality is they don’t.

Illness 72

Illness IT Healthcare Patient-Centered 72

GeriPal

MARCH 6, 2025

Michaels Hospital in Toronto, and health justice activist. 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. Today we talk with Naheed Dosani, a palliative care physician at St.

Healthcare 100

Healthcare IT Community Illness 100

GeriPal

MARCH 30, 2023

Today we’re going to be talking about narrative writing specifically for healthcare professionals. Then in the OpenNotes work that I do, I was hired to take something complicated like transparency and patients having access to their full records in medicine, and then making that something that the lay public understood.

IT 95

IT Patient-Centered Patients Healthcare 95

GeriPal

MAY 12, 2022

I mean, just such struggles around corruption in hospitals, access to opioid pain medication, and you almost had to wait until a friend of yours was in power, so you could have access, get permission. Alex: I love the story of this book, how it starts so locally and then moves on to the Kerala region and then moves to India.

Community 115

Community IT Relationship Healthcare 115

GeriPal

MARCH 3, 2022

A little over a decade ago, Ken Covinsky wrote a GeriPal post about a Jack Iwashyna JAMA study finding that older adults who survive sepsis are likely to develop new functional and cognitive deficits after they leave the hospital. To this day, Ken’s post is still one of the most searched and viewed posts on GeriPal. Eric: What was that paper?

Patient-Centered 96

Patient-Centered Patients IT Hospital 96

GeriPal

FEBRUARY 13, 2025

Marie 03:08 So, living in Alabama, which is our palliative care desert in the south, there were no palliative care services in any of the small rural hospitals. We went to a hospital in Mississippi, one in Alabama, and one in South Carolina. The black individuals wanted to have a separate one from the white individuals.

Consulting 63

Consulting Community Patient-Centered Family 63

GeriPal

AUGUST 24, 2023

Had multiple physical, psychological complications as a result of that. Just an extraordinary cast of individuals who were really so incredibly inspiring. I guess one question for providers is, as we dive into individual sense of dignity, and I guess threats to that dignity, is potentially feeling like we’re opening this box.

Patient-Centered 98

Patient-Centered Patients IT Illness 98

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. Because in medicine as somebody who works in the hospital, there’s always other treatment options. So it started off for individuals with a terminal illness.

Illness 144

Illness IT Medical Provider 144

GeriPal

AUGUST 25, 2022

And then secondly, around some of our quality measures, there’s been differences found in multiple papers by many teams around hospice disenrollment, higher rates of hospice disenrollment in for-profit hospices, and higher rates of healthcare utilization. Because people, they go to the hospital, then they revoke. Lauren: Oh.

Family 106

Family Families IT Patients 106

GeriPal

DECEMBER 19, 2024

* This episode of the GeriPal Podcast is sponsored by the Zuckerberg San Francisco General Hospital Division of Hospital Medicine , which is committed to providing outstanding, compassionate care to all patients, advancing health equity, and fostering excellence in hospital medicine. For more details, please click here. (AP

Illness 101

Illness Mental Health IT Patient-Centered 101

GeriPal

FEBRUARY 8, 2024

Hospital Chaplains, Spirituality, and Pain Management: A Qualitative Study. 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”? Pain Manag Nurs. 2023.11.004.

IT 137

IT Family Families Physicals 137

GeriPal

MAY 29, 2025

Andrew complicates this definition , stating it raises more questions than answers. So I think the examples that we’ve seen is an individual will all of a sudden start using humor in a particular way or will using wry humor and that is reminiscent of the kind of humor the person used prior to developing dementia. And the Clin.

Family 93

Family Families IT Patient-Centered 93

GeriPal

JULY 25, 2024

First time on the GeriPal podcast, Liz Lilley, who’s a surgeon and faculty in surgery at the Brigham Women’s Hospital and Harvard Medical School. Eric 07:03 And those classic studies, were those done in the hospital and PALP care units and clinic? Alex 00:18 Prognosis, super special today. And we have some great guests.

Family 106

Family Families Patient-Centered IT 106

GeriPal

MAY 1, 2025

And when she was here, she co founded the Golden Compass Clinic at San Francisco General Hospital for older adults living with HIV. And, you know, I’ve seen that some primary care providers, there’s still so much stigma that they don’t feel comfortable or they feel like that managing HIV is somehow too complicated.

Primary Care 94

Primary Care IT Provider Clinic 94

GeriPal

MARCH 27, 2025

But the process of implementing this project across two big health systems in our area was very complicated and had its share of both challenges and rewards. And is it at all individualized to the patient? Danny 12:07 I don’t know how individualized it is. The intervention itself is very straightforward. It’s a lot.

Primary Care 79

Primary Care IT Clinic Illness 79