GeriPal

JUNE 8, 2023

-@AlexSmithMD Additional Links: – Fingerstick monitoring in VA nursing homes (too common!) – Improving diabetes management in hospice – Continuous Glucose Monitoring complicating end of life care Transcript Eric: Welcome to the GeriPal podcast. This is Eric Widera. Alex Smith: This is Alex Smith. Is that your experience?

Diabetes 74

Diabetes Management Patient-Centered Families 74

Annals of Family Medicine

NOVEMBER 20, 2024

Context: Complications contribute to significant type 2 diabetes mellitus (T2DM) morbidity. While preventable, many fail to receive timely treatment in primary care, leading the most vulnerable to accumulate complications. Results: We included 49,843 individuals in model 1.

Complication 130

Complication Diabetes Primary Care Utilities 130

PEMBlog

OCTOBER 2, 2024

Red flags that you should always ask about include hematemesis, melana, dysphagia, and Unintentional weight loss, these all need further investigation for complications like esophagitis or another diagnosis such as EOE or peptic ulcer disease. If any of those red flags are present, you should definitely consider a further diagnostic workup.

Diagnosis 52

Diagnosis Management IT Patient-Centered 52

GeriPal

JUNE 12, 2025

But now that at least at the University of Pennsylvania, the radiation oncology department is sort of well integrated into the cancer center here, and we have a really strong relationship with the palliative care team and even the internal medicine residents whom we give talks to. Widera and Smith have no relationships to disclose.

Patient-Centered 103

Patient-Centered Referral Patients IT 103

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. Push back against individual narratives that blame individuals for systemic injustice. If we are not part of the solution, we are complicit in structural injustice. Push back against dehumanizing language.

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.

Family Physician 52

Family Physician Families Family Healthcare Professional 52

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.

Families 102

Families IT Family Diagnosis 102

GeriPal

FEBRUARY 15, 2024

Panelists Carmen Quatman and Katie Quatman-Yates have no relationships to disclose. All of these are factors that are on the individual level. Same thing with kind of medication management. So we’ve published a couple of studies ourselves and we’re finding more and more groups that are trialing in different capacities.

Community 116

Community Transportation IT PCP 116

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. Relational autonomy was was first introduced to bioethics by feminist scholars, who observed that most people do not make decisions as isolated islands.

Families 98

Families Family Patient-Centered IT 98

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 110

Patient-Centered IT Patients Clinic 110

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 Families Family Physicals 137

GeriPal

JANUARY 25, 2024

Panelists David Bekelman, Lyndsay DeGroot, and Diah Martina have no relationships to disclose. It used to be a much more complicated model. As a nurse, how challenging would it be to do eight hours of training and jump into this complicated world? David: Right. Eric: VA people will know what that is. David: Yeah. Eric: Okay.

Patient-Centered 123

Patient-Centered IT Illness Patients 123

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. Eric 26:25 So if that therapeutic relationship reverses and now they’re supporting you. There’s this therapeutic relationship.

IT 133

IT Illness Families Family 133

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 116

Community IT Relationship Healthcare 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

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 102

Healthcare IT Community Illness 102

GeriPal

MARCH 7, 2024

An end-of-life doula is a non-medical support person that provides a longitudinal relationship with aspects of medical, I mean, aspects of companionship, presence, holding space, some logistics, some practical help, decision making perhaps. It sets space between us and the individuals we’re trying to take care of. John: Yeah.

Provider 119

Provider Illness IT Healthcare 119

GeriPal

MAY 4, 2023

Patients that remind us of loved ones, patients that are often younger, really hard stories, complicated issues. Part of that, as you’re alluding to, Eric, is this relationship with authority and with rules and word association, teenage rebellion. How do we see each of you as individuals who are having your own struggles?

IT 83

IT Families Family Illness 83

GeriPal

APRIL 10, 2025

Yeah, that’s a more complicated story. But yeah, it’s complicated. You’d have to tailor it to each individual emergency department because you couldn’t. This is what gets to be complicated for standardization. Do we know these individual things really work in big randomized control?

Patient-Centered 78

Patient-Centered IT Hospital Patients 78

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.

Families 94

Families Family IT Patient-Centered 94

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. The black individuals wanted to have a separate one from the white individuals. So absolutely, it is complicated. Our consultation.

Consulting 64

Consulting Community Patient-Centered Families 64

GeriPal

NOVEMBER 7, 2024

Or is it just this lingering practice of starting dialysis early before really severe complications develop? So we created these heat maps where you could see for each individual what actually happened in the days and you. Widera and Smith have no relationships to disclose. Eric 06:16 To it in our show. And we have these.

Management 117

Management Patient-Centered Patients IT 117

GeriPal

DECEMBER 14, 2023

And so the combination of the institutional structures, as well as the extreme cases that each individual doctor feels will actually help create this different culture, be it high or low intensity. It’s not explainable that each individual physician has independently arrived at this very aggressive practice pattern.

Hospital 126

Hospital IT Patient-Centered Patients 126

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

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. We needed to build the relationships and trust and really provide a really good example of the value of palliative care outside of end of life care and advanced care planning.

Illness 111

Illness Hospital Patient-Centered Patients 111

GeriPal

MARCH 30, 2023

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. They’re limited. You’d said she wanted this, but not yet. Anne: Yeah. Yeah, my essay was not a timely thing.

IT 96

IT Patient-Centered Patients Healthcare 96

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. I think that’s a big mistake.

Illness 144

Illness IT Medical Provider 144

Family Medicine Initiative

APRIL 10, 2024

This graph illustrates that the benefit of long-term GP-patient relationships is even dose-dependent (longer GP-patient-relationship = lower risk of dying prematurely): Why do long-term GP-patient relationships improve health and reduce costs? GPs improve chronic disease management, which prevents complications.

Family Physician 130

Family Physician Families Family 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. So you’re kind of the guest host today.

Families 108

Families Family Patient-Centered Patients 108

GeriPal

MAY 1, 2025

But the HIV we do see, and it feels tragic because the people who are dying of and affected by the more kind of traditional, if you call it that, kinds of complications, some of which can be fatal of HIV AIDS are the people who are not on treatment. We don’t want to deal with this too complicated.

Primary Care 96

Primary Care IT Clinic Provider 96

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. Widera and Smith have no relationships to disclose.

Primary Care 80

Primary Care IT Clinic Illness 80

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.

Preventive Care 100

Preventive Care Preventative Care Family Physician Screening 100

GeriPal

JANUARY 5, 2023

And the argument was framed more as a healthcare choice made by individuals in conjunction with their clinicians. Robert: Professional relationship. Alex: … professional relationship to the patient? Robert: And I’m not going to what the individual provider believes is right or wrong. So religion, much less.

Provider 19

Provider Medical Hospital Patient-Centered 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