Doctor On Demand

APRIL 28, 2025

Urgent care clinics provide quick diagnoses and treatments, including antibiotics if needed. 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.

ER 52

ER Telehealth Primary Care Doctor Appointment 52

GeriPal

JULY 21, 2022

I’ve worked in hospital settings as an occupational therapist, inpatient rehab and outpatient rehab. Emmy: I was seeing people in the hospital setting, saying they had had a massive brain injury. Emmy: Ended up starting a program, outpatient at our hospital at the time. How did you get interested in this? Is this our role?

Families 102

Families Family IT Diagnosis 102

GeriPal

FEBRUARY 22, 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.

Mental Health 122

Mental Health Patient-Centered Illness Screening 122

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

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

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? And so the family is there in much more of an advisory role rather than providing say, cognitive scaffolding that they might provide in supported decision making.

Family 97

Family Families Patient-Centered IT 97

GeriPal

OCTOBER 20, 2022

This office is tasked with providing aging policy research and recommendations within ASPE, including long term care and the National Alzheimer’s Project Act. And that led to many specialists doing work and advancing their fields within their professional societies, providing guidance and so on for older adults.

Complication 52

Complication Patient-Centered IT Patients 52

GeriPal

JANUARY 18, 2024

If somebody has cancer and they’re recently diagnosed, somebody has cancer and they’re undergoing active treatment, somebody has cancer and they’re in early remission, now they’re a year or two years, three years, four years out and they still have pain. AMA PRA Category 1 credit(s) ™. Jessie: Yes. So, one out of 10?

Illness 136

Illness Patient-Centered Screening Clinic 136

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 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

SEPTEMBER 1, 2022

In day-to-day practice, It’s hard to imagine providing excellent hospice or palliative care services without access to a team social worker. And I think that’s when I got hooked on how do we improve care, in my case again, for kids and families, but also for us, the providers. I can figure out how to provide care in this way.

IT 102

IT Families Family Clinic 102

GeriPal

MARCH 24, 2023

This was an investigative report about fraud and healthcare, pure fraud, pure victimization of vulnerable people. She happened to focus on some specific for-profit hospice providers. They were all actually publicly traded or private equity owned for-profit hospice providers. It feels somewhat random in some ways.

IT 113

IT Provider Patients Families 113

GeriPal

JANUARY 30, 2025

But in reality, given workforce shortages and just the challenges and the resources necessary to be able to provide early integrated palliative care from the time of diagnosis of advanced cancer, the model simply is not implementable, at least not in our current state with our available infrastructure and resources. Eric 10:25 Great.

Telehealth 105

Telehealth Patient-Centered IT Patients 105

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. Eric: And Laurie for this patient, were you the outpatient provider?

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. And this complete lack of attention to the real needs of persons with dementia is really kind of a shameful part of US healthcare. And very frail.

IT 64

IT Hospital Screening Patients 64

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. Basically, there’s a lot of variation amongst hospice providers.

Families 106

Families Family IT Patients 106

GeriPal

FEBRUARY 27, 2025

But, you know, I’ve talked to a lot of palliative care providers, a lot of people caring for people with serious illness. I see this in the hospital when I’m doing addiction medicine consults. Like if a person has an issue, struggle with alcohol, I’m not their alcohol provider, but I may be their opioid provider.

Patients 72

Patients Clinic Patient-Centered Illness 72

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

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

MAY 9, 2024

Why focus on the public rather than other health care providers? How do they deal with professional barriers and the barrage of comments? And one of the things that really differentiates us is that you’ve chosen to be public-facing, whereas we are like clinician, provider-facing, so to speak. Julie: I have one.

Education 127

Education IT Illness Healthcare 127

GeriPal

APRIL 13, 2023

Check out some of their recent work, including: Dr. Holt-Lunstad’s and Dr. Perissinotto’s powerful perspective piece in the New England Journal of Medicine which provides a clinical framework for addressing loneliness and social isolation. I think I feel more comfortable as a provider in trying to support people in their isolation.

IT 99

IT Community Patient-Centered Medical 99

GeriPal

FEBRUARY 9, 2023

And I think the crisis that we’re in right now in healthcare delivery, the idea of laying down my badge, I think that’s maybe a metaphor for being a sheriff, but what about being a healthcare provider? It also feels like, I also grew up in med school in a three hospital system. Alex: That’s great.

Patient-Centered 111

Patient-Centered Patients IT Healthcare 111

GeriPal

APRIL 14, 2022

Adapting Palliative Care Skills to Provide Substance Use Disorder Treatment to Patients With Serious Illness . 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.

Illness 102

Illness Patient-Centered IT Patients 102

GeriPal

SEPTEMBER 21, 2023

Karen has a Cambia Sojourns award to pilot an intervention in which Black/African American former caregivers are trained to provide peer support to current caregivers (Peer2Care). I think as researchers, we need to do our due diligence to follow that and healthcare providers, of course, ’cause we want to be sensitive.

Community 128

Community Families Family IT 128

GeriPal

AUGUST 24, 2023

And the role of the palliative care provider is to figure out, knowing that different things affect different people, is what causes somebody in that particular instance to feel their dignity is being undermined. So tiny, tiny, in a hospital bed. ” Whereas for others, it is very much kind of a spiritual journey.

Patient-Centered 98

Patient-Centered Patients IT Illness 98

GeriPal

JANUARY 26, 2023

Can you give us some examples, even the ones you mentioned in the paper, about how some of these structural races, like these common things that may occur in the hospital or in the clinics that we use, and we may not even think about? Ramona: Glomerular Filtration Raterate. I probably should have said GFR. Eric: Yes. I just choose GFR.

IT 91

IT Patient-Centered Healthcare Patients 91

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. They have so much going on.

Screening 99

Screening PCP PCP IT 99

GeriPal

JUNE 13, 2024

I feel like I recognize it when I see it, but I struggle to give a clear definition or provide effective ways to address it. Eduardo 07:17 Well, we had a palliative care unit in another hospital that was 510 minutes away. We have an epidemic of BMI and therefore never use the way the patient looks like to diagnose cachexia.

Illness 133

Illness Patient-Centered Patients IT 133

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. Alex: Mm-hmm.

Illness 101

Illness IT Patient-Centered Patients 101

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 also the whole potential psychiatric diagnoses. It has nothing to do with you.

Patients 109

Patients IT Families Family 109

GeriPal

OCTOBER 27, 2022

And really providing these estimates of how long a person has to live affects a lot of the decisions we have to make clinically. That’s a difficult decision to make, and providing these estimates can help clinicians and patients with that type of shared decision-making. Those have a very, very long time horizon.

IT 95

IT Clinic Screening Patients 95

GeriPal

OCTOBER 3, 2024

I wonder if you could say a little bit more about the meta Institute in particular and what it is that clinicians today can do to learn, to be more present and learn about the need to be thoughtful and compassionate in the care that they provide people with serious illness. Frank 08:43 Well, briefly. We never mentioned caregivers. Yeah, yeah.

IT 122

IT Patient-Centered Patients Relationship 122

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. So at our cancer center, we have physicians, advanced practice providers.

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

JULY 6, 2023

It was designed to really balance what Medicaid at the time was to provide nursing homes and Medicare is obviously health insurance. 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. But, what you need is a community-based game there.

Community 89

Community Nurse Practitioner Provider IT 89

GeriPal

MAY 1, 2025

One in 10 people with newly diagnosed HIV is an older adult. And when she was here, she co founded the Golden Compass Clinic at San Francisco General Hospital for older adults living with HIV. Have been now a care provider for people with HIV for over 40 years. People are living with HIV into advanced ages. Eric 16:08 Yeah.

Primary Care 94

Primary Care IT Provider Clinic 94

GeriPal

JULY 7, 2022

Haider is a physician at the Brigham and Women’s Hospital, and the VA in Boston. And I wonder as you think about that and as you think about pain being a vital sign, every shift in the hospital people are asking if they’re having pain, we’re going in there asking people, “Are you hurting?

Patient-Centered 105

Patient-Centered Physicals IT Patients 105