GeriPal

JUNE 8, 2023

When I’m on palliative care consults and attending in our hospice unit we have to counsel patients about deprescribing and de-intensifying diabetes medications. And yet we’re also in a different place in diabetes monitoring and management. Eric: And you can probably tell already, the topic at hand is diabetes management in late life.

Diabetes 73

Diabetes Management Patient-Centered Family 73

GeriPal

OCTOBER 13, 2022

Sonali: This seven versus 14 days for male UTI combines really well with the gram negative bacteriemia paper because sometimes we are faced with patients in the hospital which are disposition issue. So transmission of other drug resistant organisms and C difficile to other patients in the hospital reduces if you control.

Complication 97

Complication Patient-Centered IT Patients 97

GeriPal

JUNE 12, 2025

I didn’t know where they existed within the hospital. Eric 07:04 You actually created things like a curriculum for hospital medicine fellows in radiation oncology. So you have the consultation. So we need to have a discussion upfront about how we’re managing the patient’s pain.

Patient-Centered 102

Patient-Centered Referral Patients IT 102

The Medical Futurist

JUNE 21, 2025

SkinIO , Scanoma , Miiskin , FirstDerm , Direct Derm , iDoc24 , and SkinVision all work based on the same principle: they promise patients the option to self-check their symptoms and then to connect to a dermatologist online for consultation within a very short period of time. If there were ever a time to join us, it is now.

Patients 111

Patients Healthcare Board-Certified Telemedicine 111

GeriPal

FEBRUARY 2, 2024

This week, we talk about the other major palliative care trial of default palliative care consults for hospitalized older adults with COPD, kidney disease, or dementia, published in the same issue of JAMA. and consulting for Papa Health. This is 24,000 encounters, over 15,000 patients, 11 hospitals, eight states.

Consulting 120

Consulting Hospital Patient-Centered IT 120

Plum Health

OCTOBER 11, 2024

It's the first point of contact for all your medical needs, from routine check-ups to managing chronic conditions. Patients who have a trusted primary care doctor are more likely to follow medical advice, manage their chronic conditions effectively, and ultimately enjoy better health outcomes. Why is it called a clinic?

Clinic 52

Clinic Primary Care Doctor Primary Care Chronic Condition 52

GeriPal

DECEMBER 14, 2023

More recently Sharon Kaufman ‘s book And a Time to Die described the ways in which physicians, nurses, hospital systems, and payment mechanisms influenced the hour and manner of patient’s deaths. Today Liz Dzeng discusses her journey towards studying this issue in detail. I guess the VA is federal though. Liz: Right.

Hospital 125

Hospital IT Patient-Centered Patients 125

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

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. However, there are “Red Flag” symptoms that require urgent evaluation and management.

ER 52

ER Telehealth Primary Care Doctor Appointment 52

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

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

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. You get a consult if you get a consult.

Telehealth 105

Telehealth Patient-Centered IT Patients 105

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

OCTOBER 10, 2024

Of note: these lessons apply to geriatrics, primary care, hospital medicine, critical care, cancer care, etc, etc. DorAnne 30:25 I also wanna make a shout out for pain and symptom management with social work and chaplains. So we totally forget that all of us are symptom managers as well. The collaboration is actually the center.

Screening 119

Screening IT Family Families 119

GeriPal

JUNE 5, 2025

And so I tried to get her actually to pain management, and I couldn’t. Pain management wouldn’t come to the facility, and she was bedbound. And so it really got me interested in how we improve symptom management. Not just pain, but symptom management, then for people that are in a nursing home and that.

Nurse Practitioner 78

Nurse Practitioner Referral Consulting Board-Certified 78

GeriPal

FEBRUARY 27, 2025

Why the field is moving away from prescribing methadone to bupenorphine; how to manage patients prescribed methadone for opioid use disorder who then develop serious and painful illness – should we/can we split up the once daily dosing to achieve better pain control? When to consider bupenorphine vs methadone? They’re often angry.

Patients 72

Patients Clinic Patient-Centered Illness 72

GeriPal

DECEMBER 8, 2022

As Thor notes, capturing patient stories has face validity as positively impacting the patients who share their stories and have them documented, and for the clinicians who get to truely and deeply know their patients in far greater depth than “what brought you to the hospital?” Within the VA it’s now at 70 VA hospitals.

Patient-Centered 115

Patient-Centered Illness Healthcare IT 115

GeriPal

AUGUST 29, 2024

Is the sort of task to manage. I mean, how do you negotiate that with the oncologist who is the one who consulted you, by the way, Eric, who does that go to? They’re asking you for a consultation. After a very long 1 hour consult, you’re exhausted. Who do you want to go to with this? They confirm patients DNI.

IT 132

IT Illness Family Families 132

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. hospice use). Tammie 02:56 It usually doesn’t work no matter what. So that’s great.

Patient-Centered 77

Patient-Centered IT Hospital Patients 77

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.

Patient-Centered 116

Patient-Centered Hospital IT Illness 116

GeriPal

JANUARY 18, 2024

In particular, we talk about Katie’s and Jesica’s paper in NEJM titled “ Juggling Two Full-Time Jobs — Methadone Clinic Engagement and Cancer Care ,” which described the difficulty in managing cancer pain and methadone for opioid use disorder. Maybe we’ll get to talking about that today. Jessie, welcome back to GeriPal. Should they?

Illness 136

Illness Patient-Centered Screening IT 136

GeriPal

DECEMBER 15, 2022

Been in the hospital four times, vented, been told the story to her family, she won’t live. Tell me how your illness has impacted your relationships with others, your healthcare team, your family, friends, your beliefs, your values, your preferences. So those questions we ask when we’re doing a palliative care consult.

IT 105

IT Patient-Centered Healthcare Illness 105

GeriPal

OCTOBER 12, 2023

I’m just wondering, how do we get surgeons, and maybe, how do we teach surgical trainees to move away from this fix-it mentality into the space of deliberation where deliberation is actually invited and prioritized in the surgical consultation? People think of the phases of a typical clinical consultation. ” Eric: Yeah.

IT 128

IT Family Families Patient-Centered 128

GeriPal

OCTOBER 20, 2022

Sonali: This seven versus 14 days for male UTI combines really well with the gram negative bacteriemia paper because sometimes we are faced with patients in the hospital which are disposition issue. So transmission of other drug resistant organisms and C difficile to other patients in the hospital reduces if you control.

Complication 52

Complication Patient-Centered IT Patients 52

GeriPal

MAY 8, 2025

Vincent’s Hospital in Melbourne, Australia. And those of us who work in palliative care are more familiar with the 5ht3 receptor, which we use for nausea management. Now they’re getting psychedelic experiences, you know, and transformation in a consulting office. James, welcome to the GeriPal Podcast. So 5ht2 was.

Illness 107

Illness IT Patient-Centered Patients 107

GeriPal

MARCH 6, 2025

Michaels Hospital in Toronto, and health justice activist. Michael’s Hospital in the Department of Family and Community Medicine. You didn’t have to walk many blocks down the street to a hospital or another facility where people were getting world class care. Naheed, welcome to the GeriPal Podcast. Naheed 15:56 2014.

Healthcare 100

Healthcare IT Community Illness 100

GeriPal

APRIL 14, 2022

Management of chronic pain in the elderly: focus on transdermal buprenorphine. And how am I going to manage their pain? And then part of our role as folks in palliative care who as Katie mentioned, really try to help folks manage distress around serious illness. Two great videos on buprenorphine initiation. Transcript.

Illness 102

Illness Patient-Centered IT Patients 102

GeriPal

JANUARY 16, 2025

And so there’s complexity in Understanding how each state manages this. Eric 13:00 I also love that too, because even on our inpatient ballot of care consult service, whenever somebody says that they’re unrepresented or they don’t have a surrogate, we never believe that until we usually look up.

Patient-Centered 109

Patient-Centered IT Patients Healthcare 109

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

Tiny Physician

MARCH 30, 2022

Archana Sharma committed suicide because of the harassment by the bystanders of the patient who died at her hospital. She was a post-graduate in Obstetrics and Gynaecology (the branch which covers pregnancy and the female reproductive system) and she had won various accolades during her student and consultant days.

Hospital 52

Hospital Government Patient-Centered Medical 52

GeriPal

JUNE 30, 2022

Should she be treated non-operatively, with aggressive symptom management? 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. They stayed in the hospital for longer. Did I get that right? Joel: Oh yeah.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

GeriPal

DECEMBER 19, 2024

We invited Dani Chammas , a palliative care physician and psychiatrist at UCSF (and a frequent guest to the GeriPal podcast), as well as Brent Kious , a psychiatrist at the Huntsman Mental Health Institute, focusing on the management of severe persistent mental illnesses. Eric 12:11 And we consult psychiatry. AP Recruit Job No.

Illness 101

Illness Mental Health IT Patient-Centered 101

GeriPal

MARCH 13, 2025

Summary Transcript CME Summary As far as weve come in the 50 years since Balfour Mount and Sue Britton opened the first palliative care at the Royal Victoria Hospital in Quebec, have we lost something along the way? I was trained in the hospital where it started, and we were trained to be bedside nurses. Sue 01:26 Thank you.

IT 104

IT Patient-Centered Family Families 104

GeriPal

MAY 12, 2022

In this podcast, we cover a great deal of ground, including: Early challenges Dr. Raj faced in pain management: access to opioids, corruption, a system that doesn’t see addressing suffering as a priority. We are joined by guest-host Tom McNally, a rehab and pediatric palliative care doc at UCSF. They shared their experiences.

Community 115

Community IT Relationship Healthcare 115

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. Eric: Yeah.

IT 83

IT Family Families Illness 83

GeriPal

MARCH 24, 2023

And the hard part is, as a provider in palliative care, I actually have very little say of which hospice the individuals we consult to go to. How many patients is my hospice nurse case manager responsible for on any given day? Management, it’s hard. It feels somewhat random in some ways. Are you going to see a doctor are?

IT 113

IT Provider Patients Family 113

GeriPal

SEPTEMBER 22, 2022

I like to tell my trainees… Often with the earliest stage trainees, they’ll go in the room and they’ll ask the patient what brought them to the hospital. And that’s not the information that we’re looking for as much when we’re the palliative care consult team. Josh: Mm-hmm. Yeah, totally.

Illness 101

Illness IT Patient-Centered Patients 101