GeriPal

JANUARY 30, 2025

In one corner, weighing in at decades of experience, well known for heavy hits of bedside assessments, strong patient-family relationships, and a knockout punch of interdisciplinary collaboration, we have in-person palliative care consults. Consultations versus telehealth. But watch out! Alex 01:06 Yeah, go in person.

Telehealth 105

Telehealth Patient-Centered IT Patients 105

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

It is really difficult for the patients and the families. They do choose to rely more on their family and parents in ways that might feel like a step backwards and is yet, still developmentally appropriate and autonomous. Eric: Yeah. I wonder from a provider perspective, if you’re open to talking about your team.

IT 83

IT Family Families Illness 83

GeriPal

JUNE 15, 2023

Now actually suggesting perhaps that you missed a diagnosis that you should have considered? So there’s some stuff out there like that, but also using AI to determine who at high risk and should get a palliative care consult. Eric: Yeah. And I think that’s where it gets really interesting from the standpoint of ethics.

IT 99

IT Patient-Centered Patients Healthcare 99

GeriPal

JUNE 19, 2025

And I think a big part of that journey was just having that right time, that right moment, with the right network and support groups of individuals, including my family, to really lift me up and allow me to celebrate my authentic self. If we think of discrimination, how people are treated by their biological family. Caregivers too.

Individual 85

Individual Community IT Chronic Condition 85

GeriPal

OCTOBER 24, 2024

Eloise 10:29 Yeah, I think what we saw in California was, prior to legalization, there was curiosity, but also a lot of their healthcare professionals didn’t know enough about it, so they didn’t discuss it with them. But you really should be looking at family history, personal history. Is that your feeling, too?

Medical 98

Medical IT Patient-Centered Healthcare 98

GeriPal

JUNE 22, 2023

Through a series of events, I started working as a consultant to the Department of Corrections in around 2006, and I was assigned to the California Medical Facility. In many cases, the families were the victims of the crime. And we’ve really tried to serve that hospice mission of serving the patient and the family.

Family 132

Family Families IT Community 132

GeriPal

JUNE 30, 2022

And then, the family, her kids got together, my wife and her brother and sister got together and said, wait a minute, mom did not want this, right? But we know that 30% of all decedents who are Medicare beneficiaries either die from dementia or have an existing diagnosis of dementia, which is something we talk about quite often, Joel and I.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

GeriPal

APRIL 14, 2022

So for those of you listening via YouTube, here’s the live version for those of you who are listening on the podcast, you’re going to get my prerecorded version with lots of loops and I’m doing consultation with my new music teacher who’s a music producer in LA. Alex: So we’ll see what these come out like.

Illness 102

Illness Patient-Centered IT Patients 102

GeriPal

MARCH 7, 2024

We’ve invited two death doulas, Jane Euler and John Loughnane (who is also a family doc and palliative care physician), to talk about the role of a doula at the end of life. John: I am what I am, which is a family practice doctor. Eric: When I try to think about what a doula does, should I call it a consult? That dawned on me.

Provider 117

Provider Illness IT Healthcare 117

GeriPal

FEBRUARY 16, 2023

So when we encounter anger clinically, when we’re in an encounter with a patient and their family, what are perhaps three steps, and we have the three step model for how we can look within ourselves and respond. What feelings do we have toward the patient and toward their families? I wish they were just a diagnosis.

Patients 109

Patients IT Family Families 109

GeriPal

JANUARY 18, 2024

Our field really lacks specificity in the terms that we use, and I think we really don’t know how chronic cancer pain, let’s say, a few years out from that initial diagnosis differs from, let’s say, chronic low back pain. Have you had a family history of substance use disorder? Most of our population has trauma.

Illness 136

Illness Patient-Centered Screening IT 136

GeriPal

JANUARY 11, 2024

What happened is that firstly, in terms of my clinical background, my background is psycho-oncology, so that’s working with patients with cancer and their families, including when they’re going through periods. Alex: Self-administer and psychiatric illness is not considered a qualifying diagnosis. Eric: Yeah. Eric: Yeah.

Illness 144

Illness IT Medical Provider 144

GeriPal

MAY 12, 2022

It’s easier to concentrate on cure, diagnosis, cure. 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.

Community 115

Community IT Relationship Healthcare 115

GeriPal

DECEMBER 19, 2024

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? Eric 12:11 And we consult psychiatry. But some of the nuance I would want to point out is that, like Brent mentioned, first of all, this is not a diagnosis. Ptsd, depression, anxiety.

Illness 101

Illness Mental Health IT Patient-Centered 101

GeriPal

APRIL 18, 2024

For the foreseeable future, it’s going to be right 90%, 95%, 85%, so the safety system, of course, will be, the AI says something, makes a recommendation or gives you a draft diagnosis or drafts your note, and then, the failsafe is, the doctor reads it over. AI has a long and not storied history in healthcare. This is GPT-4.

IT 139

IT Electronics Patients Healthcare 139

GeriPal

SEPTEMBER 19, 2024

Alex 10:53 Yeah, or like palliative care if they get a consult for whatever reason, but not trn consult, like standardized, you know, randomized to palliative care versus whatever they’re doing before. If they get palliative care consult, they get one. Within eight weeks of diagnosis of advanced disease.

Patient-Centered 119

Patient-Centered IT Patients Hospital 119

GeriPal

JULY 25, 2024

Eric 04:39 Yeah, I see it used on inpatient, side on consult clinics in hospices. We started a clinic here in 2008 at the VA, and what we found was that, you know, our median time from consult to death before we started clinic was like 18 days, somewhere around there, like somewhere around two weeks. Eric 10:44 No, all consults.

Family 106

Family Families Patient-Centered Patients 106

GeriPal

FEBRUARY 24, 2022

We see our patients and our families throughout the illness trajectory into the hospital. It’s hard for your family to know. That this is iterative from diagnosis to end-of-life, right? But we’re going to have this forum for us to hear from family members, hear from patients, for them to hear from us.

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. And one would be when care is continuing a case where people believe that the patients died, or oftentimes, this is also a source of controversy between families and clinicians.

IT 113

IT Family Families Patient-Centered 113