GeriPal

FEBRUARY 23, 2023

Imagine her hearing for the first time that you’re sick, that you’re hospitalized, that you’re in the ICU, and that you can’t make your own decisions? The supporter might offer note-taking or they might come and help with interpreting information or they might help in doing some comparative reasoning exercises. Eric: Lynn or Anne?

Families 97

Families Family Patient-Centered IT 97

GeriPal

OCTOBER 17, 2024

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. Is your impression that HFpEFde is under diagnosed in older adults? Parag 13:23 So I think I would say under diagnosed.

Primary Care 113

Primary Care Patient-Centered IT Patients 113

GeriPal

JANUARY 18, 2024

It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. And here, just to clarify, we’re using that term to mean, people diagnosed with cancer, not necessarily people who were treated with curative intent. Jessie: Yes. So, one out of 10?

Illness 136

Illness Patient-Centered Screening IT 136

GeriPal

JULY 28, 2022

Alex: And we are also delighted to welcome Areej El-Jawahri, who is an oncologist at Massachusetts General Hospital as well, who specializes in blood cancers. Jennifer: They have a meaningful impact on what happens to them during the hospitalization and after. They all self-identified as a hospital based practice.

Illness 110

Illness Hospital Patient-Centered Patients 110

GeriPal

JUNE 9, 2022

Palliative care, in contrast, saw explosive growth in US hospitals. We can’t possibly meet the needs of all people with newly diagnosed serious illness. They were at the VA, but not so much at our main hub hospital where I trained. I do tend to focus in the hospital setting. That’s just not how the hospital works.

Consulting 99

Consulting Patient-Centered Diagnosis Referral 99

GeriPal

FEBRUARY 22, 2024

It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. While everyone says we should be doing this to the best science available, every hospital has a different interpretation of that. ” Some say, “Everyone gets a PHQ-9.

Mental Health 122

Mental Health Patient-Centered Illness Screening 122

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. So, Alex, imagine you’re a seriously-ill hospitalized patient and I’m your doctor, unluckily for you.

Consulting 120

Consulting Hospital Patient-Centered IT 120

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

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. The hospital refused without a court order, and the case eventually made its way to the Supreme Court. Laurie: Yeah, she was an On Lok patient, and I went in to see her in the hospital.

Families 112

Families Family Patient-Centered IT 112

GeriPal

APRIL 3, 2025

And I also worry about this push towards just amyloid blood testing so as a way of diagnosing Alzheimer’s disease without doing the workup that’s needed beforehand. I believe the age range was over 80 hospitalized patients and showed that relatively light level physical activity, often with weights, improved hospital outcomes.

IT 64

IT Hospital Screening Patients 64

GeriPal

JUNE 23, 2022

And that’s another huge source of data and that’s the data that generally informs the USPSTF and other guidelines. 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. They have so much going on.

Screening 99

Screening PCP PCP IT 99

GeriPal

MAY 9, 2024

It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. It was about me talking about what happens about six months, when you have six months or less to live, the general information of what people usually look like. Alex: Not frequently, no.

Education 127

Education IT Illness Healthcare 127

GeriPal

JANUARY 30, 2025

Essentially we’re testing the early integrated palliative care model, which is monthly visits with a specialty trained palliative care physician or advanced practice provider for patients who are diagnosed with advanced non small cell lung cancer. Lynn 37:39 I was in the hospital. So it matters. What happened during this study?

Telehealth 105

Telehealth Patient-Centered IT Patients 105

GeriPal

FEBRUARY 27, 2025

I see this in the hospital when I’m doing addiction medicine consults. We got admitted to the hospital, our inpatient palliative team developed their skill set because they had a place to send patients when they got discharged. He’s now hospitalized to break up that methadone into three times a day dosing.

Patients 72

Patients Clinic Patient-Centered Illness 72

GeriPal

JANUARY 11, 2024

It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. We can talk about the informal and the formal differences in expansion later. Because in medicine as somebody who works in the hospital, there’s always other treatment options.

Illness 144

Illness IT Medical Provider 144

GeriPal

MARCH 24, 2023

But I think what we’re missing a lot of information on what Joe is talking about is just how much variation there is in that within both non-profit and for-profit, and I think these issues are coming up in non-profit hospices as well, and we just don’t have the data because the information is not reported to anybody.

IT 113

IT Provider Patients Families 113

GeriPal

SEPTEMBER 22, 2022

One bump is just the classic pitfalls we often talk about in serious illness communication: being very jargony, very information focused, and just providing information. Stop thinking the physical exam or the differential diagnose, whatever, and just be there. It’s going to feel like they’re in free fall.

Illness 101

Illness IT Patient-Centered Patients 101

GeriPal

FEBRUARY 9, 2023

It also feels like, I also grew up in med school in a three hospital system. There’s the variation between the hospitals, feels like there’s cultural issues that play a role. So then you drill down further, just like you said, Eric, when you were going back between different hospitals. Eric: Yeah.

Patient-Centered 111

Patient-Centered Patients IT Healthcare 111

GeriPal

AUGUST 25, 2022

And then secondly, around some of our quality measures, there’s been differences found in multiple papers by many teams around hospice disenrollment, higher rates of hospice disenrollment in for-profit hospices, and higher rates of healthcare utilization. Because people, they go to the hospital, then they revoke. Lauren: Oh.

Families 106

Families Family IT Patients 106

GeriPal

OCTOBER 27, 2022

But we know from previous studies that a lot of older adults actually want this information, but might not feel comfortable bringing it up. Someone who’s healthy in their 60s and just got diagnosed with diabetes, yeah, they might benefit, if they have a very long life expectancy, to prevent that decline in kidney function.

IT 95

IT Clinic Screening Patients 95

GeriPal

JUNE 13, 2024

It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. Eduardo 07:17 Well, we had a palliative care unit in another hospital that was 510 minutes away. So cachexia, I would put it involuntary weight loss is the number one way to diagnose it.

Illness 133

Illness Patient-Centered Patients IT 133

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. Keri: It’s all normal, and it’s all data that can better inform our practice.

Patients 109

Patients IT Families Family 109

GeriPal

AUGUST 8, 2024

These kind of tropes inform the mindset that keeps people. And I can’t imagine anyone working in an end of life situation, in hospital palliative care situations. This is both informative and I also felt like a therapeutic session for me. Or if we burn the trash, we bury the treasure. Somebody like me goes to the retort.

IT 124

IT Families Family Relationship 124

GeriPal

AUGUST 24, 2023

So tiny, tiny, in a hospital bed. And a moral compass that’s informed by understanding that the world isn’t the way you see it necessarily. We examine, we diagnose, we fix. To diagnose, to come up with a formulation, to be able to really get hold of the cause of this individual suffering.

Patient-Centered 98

Patient-Centered Patients IT Illness 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. So, for example, everyone who was diagnosed with an advanced or metastatic lung cancer had a prognosis on the order of months. Eric 26:47 How soon after from a hospitalization, all.

Patient-Centered 119

Patient-Centered IT Patients Hospital 119

GeriPal

JUNE 26, 2025

But from our clinical work, many of us are familiar with people with dementia who experience sudden shocks to their health, think hip fracture, think hospitalization for pneumonia. And then when you see clinically patients coming into hospital, they’ll have, you know, they’ll be admitted for aspiration pneumonia.

Illness 93

Illness Hospital IT Patient-Centered 93

GeriPal

APRIL 18, 2024

The results were that the chat bots got the diagnoses right and had an escalation strategy that was better than the doctors, as judged by blinded specialists reading the transcripts. It was specific to the relationship with the patient, the patient’s social context in which they might take this information. They had no idea.

IT 139

IT Electronics Patients Healthcare 139

GeriPal

JULY 6, 2023

I’ve been on a quest to build those services and support so that people can make true, informed decisions for themselves and their families. Equally as important, is if you wind up in an ED or being hospitalized or wind up in rehab, eventually you’re going to be discharged back home. Eric: Great, thank you both.

Community 89

Community Nurse Practitioner Provider IT 89

GeriPal

JULY 25, 2024

It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit. First time on the GeriPal podcast, Liz Lilley, who’s a surgeon and faculty in surgery at the Brigham Women’s Hospital and Harvard Medical School. And we have some great guests.

Families 106

Families Family Patient-Centered Patients 106

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. It was information about our ACP facilitator. This is a pragmatic trial.

Primary Care 79

Primary Care IT Clinic Patient-Centered 79

GeriPal

JULY 7, 2022

Haider is a physician at the Brigham and Women’s Hospital, and the VA in Boston. Every time you experience pain, it is informed by so many different things. You can have all these sort ideas about nociception pain suffering, but when you see patients in the hospital, it’s never one thing. Sometimes it is that simple.

Patient-Centered 105

Patient-Centered Physicals IT Patients 105

GeriPal

JUNE 6, 2024

Alex 00:06 We are delighted to welcome back Areej El-Jawahri, who’s an oncologist at Massachusetts General Hospital who specializes in blood cancers. A lot of people, and we have some data to say that you might have distress, but sex is not one of the reasons for your distress when you’re first diagnosed. I have as well.

Illness 130

Illness IT Physicals Patients 130

GeriPal

AUGUST 22, 2024

Knowing I was interested in neurology and had opportunities to observe brain death determination in the hospital. So in the case of Jahi McMath, you were talking about, you know, her family was kicked out of the hospital. We do have, like, a relatively operable consensus around this where, you know, it’s working in the hospitals.

IT 113

IT Families Family Patient-Centered 113

GeriPal

DECEMBER 21, 2023

The way we were treating him with dementia in the hospital, the way we talked about him, that he’s not there. I could walk down the hall and get information. Eric: And looking back at that time, what do you think the healthcare system could have done to help with that? They could have diagnosed him earlier.

Patient-Centered 125

Patient-Centered IT Families Family 125

GeriPal

JULY 16, 2024

Eric Widera reminds us of the history of the Goldwater Act created by the American Psychological Association in the 1960s which states that psychiatrists should refrain from diagnosing public figures, and the American Medical Association code of ethics which likewise discourages armchair diagnosis (rule established in 2017).

Diagnosis 141

Diagnosis Diagnose IT Physicals 141