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“The physician–patient encounter is health care’s choke point” -NEJM

A Country Doctor Writes

And, as the NEJM article points out, there are no financial incentives to have nurses or other non-providers manage routine problems like hypertension in our current system. The drugs are better, but the way patients engage with doctors during office visits and hospital stays is unchanged.

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Reasoning during the COVID-19 pandemic

The Clinical Problem Solvers

No prior history of atrial fibrillation – just hypertension and diabetes. Many parts of the country are currently experiencing dramatic surges in cases, with entire hospitals in New York being dedicated to the care of COVID-19 patients. Yet, managing uncertainty is the “name of the game” in diagnostic reasoning.

Illness 52
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How to manage GLP-1s in the hospital

Today's Hospitalist

Key takeaways: Hospitalists will increasingly have to manage inpatients taking GLP-1s. Medical societies and hospitals are weighing in on periprocedural concerns in patients taking GLP-1s who need procedures or surgeries. That’s according to two internists who work closely with hospitalized patients who take GLP-1s.

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Guidelines or Goals in Heart Failure: A Podcast with Parag Goyal, Nicole Superville, and Matthew Shuster

GeriPal

And in fact, as Alex mentioned in the intro, probably more than 20 years ago, Muriel Gillig asked me to help out with the geriatric modules at the Brigham women’s hospital primary care medicine sort of sessions. He was describing his, like, 87 year old grandma who was placed on a low salt diabetic diet. Was it sodium hf?

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Substance Use Disorder in Aging and Serious Illness: A Podcast with Katie Fitzgerald Jones, Jessica Merlin, Devon Check

GeriPal

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.

Illness 136
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Caring for the Unrepresented: A Podcast with Joe Dixon, Timothy Farrell, Yael Zweig

GeriPal

And so there’s complexity in Understanding how each state manages this. So on the clinical side, people are really focused on how long do they have to be on the ventilator and managing that. So you mentioned the burden of chronic multimorbidity and sort of flogging through the diabetes and the hypertension.

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Cachexia and Anorexia in Serious Illness: A Podcast with Eduardo Bruera

GeriPal

Alex 00:20 Today we’re delighted and honored to welcome Eduardo Bruera, who is one of the biggest symptom management gurus, if not the biggest symptom management guru in palliative medicine. Eduardo 07:17 Well, we had a palliative care unit in another hospital that was 510 minutes away. Who do we have with us today?

Illness 133