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. This hasn’t floated into our hospital systems yet, but at least in the real world, people are using these to make insulin dosing decisions without needing to poke their fingers.

Diabetes 73

Diabetes Management Patient-Centered Family 73

GeriPal

JUNE 12, 2025

The physics and mathematics that went into radiation therapy planning. Eric 04:49 Drew me to the field physics and math. 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.

Patient-Centered 102

Patient-Centered Referral Patients IT 102

Plum Health

OCTOBER 11, 2024

Your insights could help someone else in their healthcare journey! A clinic is a medical facility where healthcare professionals provide specialized medical care to patients. They also have a team of healthcare professionals such as doctors, nurses, medical assistants, and administrative staff.

Clinic 52

Clinic Primary Care Doctor Primary Care Chronic Condition 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. 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. Carmen: Thank you.

Community 114

Community Transportation IT PCP 114

GeriPal

OCTOBER 26, 2023

Physical therapy had walked with him that day and noted improvement compared to previous walks, suggesting that he should be discharged to a skilled nursing facility for rehabilitation on discharge. At the end of the day, I lamented that physical, occupational, and speech therapists aren’t more tightly integrated with palliative care teams.

Patient-Centered 132

Patient-Centered Hospital Patients IT 132

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. Paramedics can provide life-saving treatment on the way to the hospital. Then, they’ll perform a physical examination.

ER 52

ER Telehealth Primary Care Doctor Appointment 52

GeriPal

JUNE 9, 2022

Palliative care, in contrast, saw explosive growth in US hospitals. And palliative care was as a program was just growing at Penn moving from just consult hospice to actually having a team when I was training. I have never myself called a palliative care consult as a trainee because we didn’t have one.

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Consulting Patient-Centered Diagnosis Referral 99

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 10, 2024

Of note: these lessons apply to geriatrics, primary care, hospital medicine, critical care, cancer care, etc, etc. social worker, chaplain), everyone should be able to ask a question or two about spiritual concerns, social concerns, or physical concerns. In other words, in addition to being a specialist (e.g. But how about you!

Screening 119

Screening IT Family Families 119

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

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

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? Your patients expect you to care for them, their mental well being, their physical well being. They’re asking you for a consultation. After a very long 1 hour consult, you’re exhausted.

IT 132

IT Illness Family Families 132

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

APRIL 28, 2022

So for those listening to the podcast, this is a clown looking very sad and what looks like a hospital administrator. And the hospital administrator says, “No, the hospital definitely values your contributions to the interdisciplinary team. Did they ask for a consult?” ” Nathan: The clown is a surrogate.

IT 145

IT Hospital Patients Illness 145

GeriPal

MAY 8, 2025

Vincent’s Hospital in Melbourne, Australia. And I spent the past couple years just collecting data from several hundred early palliative care patients and did a network analysis, which basically just looks at the Correlations between different constructs, whether they’re physical, emotional, social or spiritual.

Illness 107

Illness IT Patient-Centered Patients 107

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

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

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. What she called total pain, physical, psychosocial, and spiritual, and she started addressing it. They shared their experiences.

Community 115

Community IT Relationship Healthcare 115

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.

Healthcare 100

Healthcare IT Community Illness 100

GeriPal

MARCH 10, 2022

On today’s podcast we dive into drivers of invasive procedures and hospitalizations in advanced dementia by talking to some pretty brilliant nursing and nurse practitioner researchers focused on dementia, geriatrics, and palliative care in nursing homes: Ruth Palan Lopez, Caroline Stephens, Joan Carpenter, and Lauren Hunt. Ruth: Thank you.

Nurse Practitioner 60

Nurse Practitioner Hospital Family Families 60

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

OCTOBER 5, 2023

I have never had a patient come into the hospital and say, Doctor, regardless of what you do, do a little CPR that’ll make me feel better. I would say most of the time we offer CRT in the hospital. I point this out a lot more nowadays to the resident teams that consult. This is Eric Widera. Alex: This is Alex Smith.

Illness 136

Illness IT Patient-Centered Family 136

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

SEPTEMBER 22, 2022

Stop thinking the physical exam or the differential diagnose, whatever, and just be there. 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. Josh: Mm-hmm. Yeah, totally. Stop being the expert.

Illness 101

Illness IT Patient-Centered Patients 101

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. Eric 12:11 And we consult psychiatry.

Illness 101

Illness Mental Health IT Patient-Centered 101

GeriPal

JANUARY 11, 2024

And so in that context, knowing that there was going to be some evolution of policy in this area, that’s how I got involved consulting with members, trying to understand the situation better, that type of thing. Because in medicine as somebody who works in the hospital, there’s always other treatment options.

Illness 144

Illness IT Medical Provider 144

GeriPal

OCTOBER 6, 2022

Alex: And we’re so delighted to welcome to the GeriPal Podcast Marian Grant, who is a palliative care nurse practitioner and marketing consultant, and she is at the University of Maryland Medical Center in Baltimore. We have a problem in the field that we’re considered the acute death team at the hospital. Great to be here.

Illness 101

Illness Patient-Centered IT Nurse Practitioner 101

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. When they built a new prison hospital in Stockton, the dialysis went there. These older patients are costing a ton in healthcare costs. Michele: Yep.

Family 132

Family Families IT Community 132

GeriPal

APRIL 24, 2025

Years and years ago, the first few years as an attending physician, I was consulted to take care of a gentleman with metastatic esophageal cancer. For this weekly treatment, the cancer team that had been consulted in the hospital told him this is nonsense. And this is one of those examples. And he was admitted with hemoptysis.

Patient-Centered 77

Patient-Centered IT Patients Illness 77

GeriPal

APRIL 13, 2023

And so I was really thinking about why are some of my people that are hospitalized doing better than others? Things like smoking status, level of physical activity, a variety of other lifestyle and biological risk factors that may be alternative explanations. But also in addition, so that rules out reverse causality.

IT 99

IT Community Patient-Centered Medical 99

GeriPal

FEBRUARY 16, 2023

And while I was in the hospital, I never actually got over, like you were talking about, Eric, my defensiveness, the sting to my ego and my character and my worth, enough to get to the place of thinking about how I could be a good doctor for him. And we received this consult to assist with goals of care. It has nothing to do with you.

Patients 109

Patients IT Family Families 109

GeriPal

SEPTEMBER 5, 2024

He had a 14 month recovery in hospital and rehab and continually asked to have life sustaining treatment suspended so that he could be allowed to die. So she bled a lot and finally called for help and was transferred to the hospital, where she started crashing in the trauma room. She didn’t die in the hospital.

Patients 98

Patients IT Patient-Centered Hospital 98

GeriPal

SEPTEMBER 19, 2024

Alex 00:34 We are delighted to welcome back Jennifer Tem e l, who is a thoracic oncologist at Massachusetts General Hospital in Boston. 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.

Patient-Centered 119

Patient-Centered IT Patients Hospital 119

GeriPal

NOVEMBER 3, 2022

That was the lesson I learned from reading a new book edited by Matt Loscalzo along with Marshall Forstein called “ Loss and Grief: Personal Stories of Doctors and Other Healthcare Professionals ”. These debriefings create a safe outlet for health care professionals to talk about the feelings resulting from their work.

Healthcare Professional 102

Healthcare Professional Healthcare IT Relationship 102