The Clinical Problem Solvers

DECEMBER 16, 2020

Our guests explain how we can incorporate race-conscious medicine in clinical settings, medical education, and biomedical/epidemiological research to responsibly recognize and address the harms of racial inequality. education, income, number of previous hospitalizations) that also lead to clinical outcomes, not only race-based stratification.

Clinic 52

Clinic Education Clinical Practice Patient-Centered 52

East Cary Family Physicians

OCTOBER 20, 2023

It’s crucial to recognize the prevalence of breast cancer to underscore the importance of awareness and education. Most breast cancers are diagnosed in women over the age of 50. Genetic counseling and testing can help individuals understand their risk. While it primarily affects women, men can also develop this disease.

Family Physician 40

Family Physician Families Family Screening 40

Vascular Physician

JULY 11, 2021

Normally, when a healthy individual is exposed to cold temperatures the blood vessels in the fingers and toes vasoconstrict or narrow. How is Raynaud's Phenomenon diagnosed? Educating patients on the link between emotional stress and Raynaud's phenomenon is important and attention to mental health disorders should be considered.

Referral 52

Referral Mental Health Patients Diagnose 52

GeriPal

DECEMBER 2, 2022

So on today’s podcast we invite four brilliant individuals to talk about their perspective on how to change how we as a society and health care system partner with individuals with dementia. Judy Long, MDiv, BCC , palliative care chaplain and educator at UCSF and caregiver. Transcript. Eric: Welcome to the GeriPal podcast.

Community 102

Community IT Individual Patient-Centered 102

GeriPal

JUNE 20, 2024

Accreditation In support of improving patient care, UCSF Office of CME is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

IT 121

IT Patient-Centered Patients Clinic 121

GeriPal

OCTOBER 13, 2022

And so there was a report in 2009 by the Institute of Medicine saying that we need to equip all of these individuals in caring for older person in an evidence based manner. And so to develop that equation, they use the cohort of individuals and their data, their blood samples, creatine and other physical attributes.

Complication 97

Complication Patient-Centered IT Patients 97

GeriPal

MAY 11, 2023

Certainly education, quality of education is extremely important. Some of them, like education, definitely social determinants of health. Like, education, is it that it prevents you from getting Alzheimer’s disease, or does it just give you more reserve so Alzheimer’s peeks out later?

Physicals 86

Physicals IT Hypertension Education 86

PEMBlog

OCTOBER 2, 2024

I’ll make the important distinction between gastritis – which is diagnosed only via endoscopy – and dyspepsia, the term best used to describe the symptoms many patients experience. Endoscopy, upper GI and endoscopy is the gold standard for diagnosing gastritis. Non invasive H. Non invasive H. pylori in the kid.

Diagnosis 52

Diagnosis Management IT Patient-Centered 52

Annals of Family Medicine

NOVEMBER 20, 2024

Methods: In-depth semi-structured interviews using the Database of Individual Patient Experiences (DIPEx) methodology. Only a few received stage 1 diagnoses. Furthermore, the need for an intersectional lens is critical given that many women were also immigrant, Spanish speaking, and often from lower education and socio-economic status.

Diagnosis 130

Diagnosis Screening Transportation Diagnose 130

GeriPal

MAY 9, 2024

all of whom focus their efforts on educating the general public about living and dying with a serious illness. So we are going to leapfrog over the healthcare system education and we’re going to go straight to the citizens of the world and we’re going to give them the insider tips to how to improve their illness experience.”

Education 128

Education IT Illness Healthcare 128

GeriPal

JUNE 19, 2025

Alex 00:41 And we’re delighted to welcome Noelle Marie Javier, who goes by “she” “her” and is a geriatrician and palliative care doc professor, newly minted – c ongratulations – And a clinician educator at Mount Sinai in New York City. To note that I am an individual who goes through this world. And we also need it.

Individual 82

Individual Community IT Chronic Condition 82

GeriPal

JANUARY 18, 2024

We start off the conversation by talking about whether patients with cancer and cancer pain are really that different, and their paper that was just published on January 11 th in JAMA Oncology showing that substance use disorder is not uncommon in individuals with cancer. AMA PRA Category 1 credit(s) ™. Who do we have with us today?

Illness 137

Illness Patient-Centered Screening Clinic 137

GeriPal

OCTOBER 17, 2024

We talk about what is heart failure, particularly HFpEF, how we treat it (including the use of sodium–glucose cotransporter-2 inhibitors (SGLT2’s), and how we should apply guidelines to individual patients, especially those with multimorbidity who are taking a lot of other medications. Yes, over diagnosed in older adults are about right.

Primary Care 114

Primary Care Patient-Centered IT Patients 114

GeriPal

JULY 21, 2022

That’s where it really gets to this individual risks and balances, individual situation. Then I would say any clear deficits in thinking, vision, physical mobility, big new diagnoses, those; certainly cognitive changes, because that’s a really big one in terms of risk. Alex: Yeah. Emmy: Yeah.

IT 102

IT Families Family Diagnosis 102

GeriPal

SEPTEMBER 21, 2023

I started going to the literature and I noticed that communities of color, those with the Hispanic background, Black individuals were disproportionately impacted by dementia, and I couldn’t believe it. I think, again, it’s the person’s individual, their preference. Alex: Yeah, I like that approach too.

Community 129

Community Families Family IT 129

GeriPal

AUGUST 17, 2023

So what is the role of individuals like geriatricians in prescribing amyloid antibodies and caring for individuals who are receiving them? And I do think geriatricians need to as individuals make that decision, largely based on their comfort with the diagnostics and the specifics of the therapeutics. I’m a prescriber.

Patient-Centered 98

Patient-Centered IT Clinic Patients 98

GeriPal

FEBRUARY 6, 2025

So, the question becomes, what, if anything, should we do differently in the primary care setting to diagnose the disease? We address the following questions with Nate: Has anything changed for the primary care doctor when diagnosing Alzheimers? But these tests were never designed to diagnose. Does a good history matter anymore?

Primary Care 97

Primary Care Diagnosis Screening IT 97

GeriPal

SEPTEMBER 1, 2022

Social workers augment a team’s ability to provide whole-person care, often aiding to identify and meaningfully address the wide variety of challenges and unmet needs faced by individuals and families facing serious illness. It’s used a lot in the education world. And that’s something we have to just think about.

IT 102

IT Families Family Clinic 102

GeriPal

APRIL 13, 2023

And so I began to think about the training that I had and that there was no mental health condition that was diagnosed. I think some of that is from some of my thinking about maybe what I can potentially think about with the individual to support them. In fact from the time he was diagnosed, he passed away within two and a half weeks.

IT 100

IT Community Patient-Centered Medical 100

GeriPal

OCTOBER 20, 2022

And so there was a report in 2009 by the Institute of Medicine saying that we need to equip all of these individuals in caring for older person in an evidence based manner. And so to develop that equation, they use the cohort of individuals and their data, their blood samples, creatine and other physical attributes.

Complication 52

Complication Patient-Centered IT Patients 52

GeriPal

APRIL 3, 2025

Annie 02:31 So if you go to the A G S meeting every year, you know that this group of three individuals comprises the AGS literature update. But in spite of that, it is a lot of work for three individuals to pull all this together. So that this is not something that might affect the individual clinician patient decision.

IT 65

IT Hospital Screening Patients 65

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. It can influence education systems. So I think you can see how there’s a lot of work to do among multiple sectors within healthcare, including education and training.

IT 92

IT Patient-Centered Healthcare Patients 92

GeriPal

APRIL 14, 2022

And I remember being there and there was a patient who had seen inpatient and then subsequently outpatient who was so thankful in the weirdest in just this irrational way for having been diagnosed with liver cancer. Janet: It was this young man. He was in his mid twenties. And it started off with Tylenol then it went to low dose morphine.

Illness 103

Illness Patient-Centered IT Patients 103

GeriPal

MARCH 24, 2023

I think some individuals thought there was cherry-picking of stories that made it seem like hospice is this bad thing, that it’s taking advantage of vulnerable individuals and it didn’t talk enough about the good things that hospice does. On the other side, there’s another group that thinks, you know what?

IT 115

IT Provider Patients Families 115

GeriPal

APRIL 4, 2024

She was resuscitated by EMS, but did not regain higher brain function, and was eventually diagnosed as being in a persistent vegetative state. I do think that some of the basics, like making sure that we’re updating the surrogate, which require us to find the surrogate is vital and something that we should educate folks about.

Families 113

Families Family Patient-Centered IT 113

GeriPal

FEBRUARY 23, 2023

My favorite line from Emily’s paper: “Geriatric assent has not been widely adopted in clinical care, but bioethicists should advocate for this, as adoption of partial-involvement strategies can prolong the period in which individuals are (appropriately) engaged in decisions about their health care.” This is Eric Widera. Eric: Lynn or Anne?

Family 98

Family Families Patient-Centered IT 98

GeriPal

MARCH 7, 2024

It sets space between us and the individuals we’re trying to take care of. I think that consistency of what is the expectation of our roles is crucial in a lot of ways, but that role is determined by the individuals we’re serving. I think the market and others will determine those individuals and who they work with.

Provider 119

Provider Illness IT Healthcare 119

GeriPal

JUNE 23, 2022

If you know that there’s a group that you don’t treat even after they’re diagnosed, it causes anxiety, but you’re not causing them harms from treatment. So I’m actually interested in also trying to help women who’ve been diagnosed figure out what to do too. Meanwhile, there is risk to the procedure.

Screening 100

Screening PCP PCP IT 100

GeriPal

JANUARY 11, 2024

Accreditation In support of improving patient care, UCSF Office of CME is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Illness 144

Illness IT Medical Provider 144

GeriPal

JULY 28, 2022

And as a resident, I just was drawn, similar to many oncology clinicians and fellows, to just be traumatic and difficult experience of patients with blood cancers during prolonged and intense hospitalizations, where they experience a lot of physical symptoms, emotional trauma related to the diagnoses. Alex: Okay. What year did it come out?

Illness 111

Illness Hospital Patient-Centered Patients 111

GeriPal

FEBRUARY 27, 2025

For those individuals, how do you think about that? So let’s say a patient who has lung cancer, relatively newly diagnosed, has a long history of substance use disorder, had been taking methadone as an outpatient, and now has this pain. Sach 17:32 For me, it’s our first line opioid. You know the case.

Patients 74

Patients Clinic Patient-Centered Illness 74

GeriPal

OCTOBER 3, 2024

They had triple diagnoses, often life threatening illness, but also mental illness and usually some kind of addiction. It’s put its emphasis much more on educational work, which is fantastic. I cracked myself in my head of these individuals. We didn’t honestly have much more of a plan than that.

IT 123

IT Patient-Centered Patients Relationship 123

GeriPal

SEPTEMBER 19, 2024

So, for example, everyone who was diagnosed with an advanced or metastatic lung cancer had a prognosis on the order of months. Eric 16:38 So everybody was diagnosed with an advanced lung cancer sometime in the last twelve weeks and then they were randomized. So it even changed over the course of the study. So you’re seeing.

Patient-Centered 120

Patient-Centered IT Patients Hospital 120

GeriPal

JUNE 26, 2025

Those are all things that could dramatically be a major health shock for an individual. May not even know that the patient has dementia, or they might think that, but it’s not been diagnosed. Maybe you lose your home or you get evicted from where you’re living or you’re suddenly, no, you no longer have stable housing.

Illness 63

Illness Hospital IT Patient-Centered 63

GeriPal

JULY 25, 2024

Accreditation In support of improving patient care, UCSF Office of CME is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Families 108

Families Family Patient-Centered Patients 108

GeriPal

JULY 6, 2023

It could be in housing, it could be a standalone senior center, home delivered meals, nutrition counseling and nutrition education done by registered dieticians. I have 24,500 veterans on our caseload, 14,000 individuals with diagnosed mental health issue, 8,500 with an alcohol and substance abuse. To Susan’s point.

Community 89

Community Nurse Practitioner Provider IT 89

GeriPal

MARCH 27, 2025

But most people with dementia are initially diagnosed and medically managed in primary care, and they really desire clinicians to initiate these conversations but there are a number of really important barriers for these conversations taking place. There’s also education that goes with it, educating, like, what does that mean?

Primary Care 80

Primary Care IT Clinic Illness 80