The Clinical Problem Solvers

FEBRUARY 8, 2023

Between 2007 – 2019, Black individuals experienced a higher death rate for opioid overdose deaths than any other racial or ethnic group. These narratives have vilified individuals who would benefit from comprehensive, person-centered substance use treatment, rather than incarceration and other adverse harms.

Community 52

Community Patient-Centered Mental Health Board-Certified 52

The Clinical Problem Solvers

APRIL 5, 2022

This is the last of three episodes interrogating the relationships between race, place, housing, and health. Dr. Kushel and Mr. Watts remind healthcare providers to speak out about the structural causes of homelessness. Push back against individual narratives that blame individuals for systemic injustice.

Community 52

Community Patient-Centered Emergency Room Medical 52

Vida Family Medicine

JUNE 29, 2022

I care deeply about each and every one of my patients, and I do not want a difference in opinion to create a wedge in our relationship. A patient must have the autonomy to choose whether in their individual situation, the potential benefits outweigh the potential harms. What Roe v. My office is a safe space.

Family Physician 52

Family Physician Family Families Healthcare Professional 52

GeriPal

FEBRUARY 15, 2024

The insight started when Carmen, an orthopedic surgeon-researcher, and Katie, a physical therapist- researcher participated in ride-alongs with EMS providers to patient’s homes. And yet, after assisting the older adult to their feet, the EMS providers would leave. I think, as providers, we don’t get to see that.

Community 115

Community Transportation IT PCP 115

GeriPal

JULY 21, 2022

If they’re in a major car crash, they’re going to have more long-term complications probably than a 20-year-old would. But I think then the other factor in this that makes it complicated is the decision for someone in Manhattan might be very different than the decision for someone in, like, rural Wyoming. Alex: Yeah.

IT 102

IT Family Families Diagnosis 102

GeriPal

JANUARY 25, 2024

Panelists David Bekelman, Lyndsay DeGroot, and Diah Martina have no relationships to disclose. With their regular providers? And really learning from them about what kinds of things healthcare might provide, that might be of help to them. It used to be a much more complicated model. AMA PRA Category 1 credit(s) ™.

Patient-Centered 122

Patient-Centered IT Illness Patients 122

GeriPal

JULY 11, 2024

Widera and Smith have no relationships to disclose. Guests Kirsten Engel, Sarah Gillespie-Heyman, Brittany Waterman, & Amy Johnson have no relationships to disclose. I’ve seen patients post transplant when they start having complications. They are complicated. They’re complicated from a symptom standpoint.

Patient-Centered 109

Patient-Centered IT Patients Clinic 109

GeriPal

FEBRUARY 23, 2023

Rather, most of us live and make decisions in relationship to one another. But once we realize that almost everybody makes decisions in the context of relationships. And so the family is there in much more of an advisory role rather than providing say, cognitive scaffolding that they might provide in supported decision making.

Family 98

Family Families Patient-Centered IT 98

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. And for many years, I think there was a focus on physicians and then providers. Summary Transcript CME Summary Serious illness communication is hard.

IT 132

IT Illness Family Families 132

GeriPal

MARCH 7, 2024

We are delighted to welcome Jane Euler, who is lead doula and co-founder of Present for You, which is a benefit LLC company that provides doula support at the end-of-life. We are doulas for those with serious illness and those at end-of-life, just a longitudinal relationship, nonmedical support to provide presence. Jane: Right.

Provider 117

Provider Illness IT Healthcare 117

GeriPal

FEBRUARY 8, 2024

** Claim your CME credit for EP297 “The Nature of Suffering” [link] Note : If you have not already registered for the annual CME subscription ( cost is $100 for a year’s worth of CME podcasts ), you can register here [link] For more info on the CME credit, go to [link] Disclosures: Moderators Drs Widera and Smith have no relationships to disclose.

IT 137

IT Family Families Physicals 137

GeriPal

MAY 4, 2023

I wonder from a provider perspective, if you’re open to talking about your team. Patients that remind us of loved ones, patients that are often younger, really hard stories, complicated issues. Eric: Yeah. From a personal emotional perspective, what do you think makes it hard? Nick: Such a good question. It’s very fraught.

IT 83

IT Family Families Illness 83

GeriPal

MARCH 6, 2025

link] PEACH Good Wishes Program A program that provides meaningful gifts for unhoused individuals who are terminally ill. By the time he got into us, the tumor grew, he had experienced, he was experiencing significant pain and so trauma, informed care and building a relationship with him was such a big part of the care.

Healthcare 100

Healthcare IT Community Illness 100

GeriPal

NOVEMBER 7, 2024

And I think the question for our field is, is that because the estimates that we have of GFR based on creatinine provide misrepresentation or an inaccurate representation of someone’s kidney function. Or is it just this lingering practice of starting dialysis early before really severe complications develop? And we have these.

Management 116

Management Patient-Centered Patients IT 116

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 92

IT Patient-Centered Healthcare Patients 92

GeriPal

MAY 12, 2022

When we think about palliative care delivered here, like individuals with chronic pain, non-serious illness chronic pain, non-life threatening illness, oftentimes if we get consulted on them, we don’t even see them, may just be discontinued in most palliative care places. I’m not sure he would really approve.

Community 115

Community IT Relationship Healthcare 115

GeriPal

JANUARY 11, 2024

** Claim your CME credit for EP293 “What’s Up With MAID in Canada” [link] Note : If you have not already registered for CME, you can register here [link] For more info on the CME credit, go to [link] Disclosures: Moderators Drs Widera and Smith have no relationships to disclose. AMA PRA Category 1 credit(s) ™. Eric: Yeah.

Illness 144

Illness IT Medical Provider 144

GeriPal

APRIL 10, 2025

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. We weren’t randomizing providers or patients. Yeah, that’s a more complicated story. But yeah, it’s complicated. I went into emergency medicine to act.

Patient-Centered 77

Patient-Centered IT Hospital Patients 77

GeriPal

DECEMBER 14, 2023

On this podcast we talk about her paper in JAMA Internal Medicine which studied three hospitals that varied in the intensity of care they provided to seriously ill patients. And so one of the things that I felt as a resident was moral distress around some of the treatments that we provide near the end-of-life.

Hospital 125

Hospital IT Patient-Centered Patients 125

GeriPal

FEBRUARY 13, 2025

And so we worked closely with a community advisory group who, through focus groups, told us how it was that black and white individuals with serious illness had wanted to be treated. Like, would you include the doctors that I work with, healthcare providers where I live in Marin? From just the abstracts we had so many questions.

Consulting 63

Consulting Community Patient-Centered Family 63

GeriPal

MAY 29, 2025

Andrew complicates this definition , stating it raises more questions than answers. This is, you know, has to do with our personal relationship. Andrew, you might remember more about it with individuals who I think were maybe in the neuro ICU and they are undergoing resuscitation. It, like, looks real good. And the Clin.

Family 93

Family Families IT Patient-Centered 93

GeriPal

JULY 28, 2022

But the palliative care clinicians didn’t have the time or opportunity to foster and develop a longitudinal relationship with patients and their families. The model is predominantly physicians, advanced practice providers. So their practices were really collaborative and informed. And those studies are being done.

Illness 110

Illness Hospital Patient-Centered Patients 110

GeriPal

SEPTEMBER 8, 2022

It’s complicated, it’s messy. How does that defer from is it complicated grief, prolonged grief disorder? Eric: Is that the same as complicated grief? So one of the criticisms is that it’s an insult to the dignity of a loving relationship. Holly: Oh absolutely. Holly: They’re the same symptoms.

IT 100

IT Complication Relationship Specialization 100

GeriPal

MARCH 30, 2023

This week we’ve invited three guests to share their stories about storytelling that’s written for healthcare providers. 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 96

IT Patient-Centered Patients Healthcare 96

Family Medicine Initiative

APRIL 10, 2024

Having Your Own Long-Term GP Can Save Your Life Patients who choose a GP rather than a specialist as their primary care provider have a 19% 8 lower mortality and produce 22% 9 -33% 8 lower healthcare spending. GPs Provide Most Healthcare The following graph shows that by far most patient/doctor contacts are with GPs.

Family Physician 130

Family Physician Family Families GP 130

GeriPal

JULY 25, 2024

Widera and Smith have no relationships to disclose. Guests Kara Bischoff, James Deardorff, and Elizabeth Lilley have no relationships to disclose. This is a particularly interesting topic because we know that individuals with dementia have a high rate of entering nursing home. AMA PRA Category 1 credit(s) ™.

Family 106

Family Families Patient-Centered Patients 106

GeriPal

MAY 1, 2025

Have been now a care provider for people with HIV for over 40 years. And I became more and more involved in it, including becoming involved in research and developing some of the programs initially to provide care for people with both drug use and HIV related problems, women with HIV vulnerable populations.

Primary Care 94

Primary Care IT Clinic Provider 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 so a lot of it was the facilitators calling out with the approval of the provider to the patients ahead of time to see, like, you have a visit coming up. It’s a lot.

Primary Care 79

Primary Care IT Clinic Patient-Centered 79

Mesa Family Physician

MARCH 6, 2025

Tertiary Prevention: Managing Existing Conditions Tertiary preventive care focuses on managing existing chronic diseases to prevent complications, improve quality of life, and reduce the negative impact of disease. These measures are taken after a disease has been diagnosed.

Preventative Care 100

Preventative Care Preventive Care Family Physician Screening 100

GeriPal

JANUARY 5, 2023

“Typically when we think about conscience in medical ethics we think about it in terms of a negative claim of conscience, where a clinician refuses (or objects) to provide care. Lisa was writing about providing abortion care, but she just as easily could have been writing about providing medical aid in dying in states where it is illegal.

Provider 19

Provider Medical Hospital IT 19

GeriPal

JUNE 2, 2022

So take a listen and if you want a deeper dive into some of the references we discuss on the podcast, here is a list: Medscape article on how “ COVID-19 Vaccines Work Better and for Longer Than Expected Across Populations, Including Immunocompromised Individuals”. Stat news article about variants/COVID becoming more predictable. Monica: Yes.

Vaccination 100

Vaccination IT Hospital Management 100