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. I’ll dive into the latest clinical practice guidelines and discuss evidence-based approaches to diagnosis and treatment.

Diagnosis 52

Diagnosis Management Patient-Centered Diagnose 52

GeriPal

MAY 11, 2023

Certainly education, quality of education is extremely important. Physical activity is a big one. Some of them, like education, definitely social determinants of health. If we focused on prevention, from a public health standpoint, we would achieve far more than spending millions billions on treatment.

Physicals 85

Physicals IT Hypertension Education 85

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 120

IT Patient-Centered Patients Clinic 120

Tiny Physician

FEBRUARY 15, 2022

A few days back, a video went viral on social media in which a resident doctor (a doctor who is undergoing post-graduation / PG doctor) was shouting at the bystander of a patient. Nevertheless, PG doctors have to work 80 to 100 hours a week without any holidays and this tiring schedule does affect their physical and mental health.

Patient-Centered 52

Patient-Centered Government Referral Hospital 52

GeriPal

OCTOBER 13, 2022

When I’m on service these days there is inevitably a moment when a resident says “Patient so-and-so is on X” – and I have absolutely no idea what X is. Alex: And we are delighted to welcome Rasheeda Hall, who is a physician scientist in the division of nephrology at Duke University School of Medicine, and sees patients at the Durham VA.

Complication 97

Complication Patient-Centered IT Patients 97

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. And we invited Tamryn Gray from the Dana Farber joins us to ask insightful questions, including: What blood sugar range should we target for patients in the nursing home or hospice?

Diabetes 73

Diabetes Management Patient-Centered Family 73

GeriPal

DECEMBER 2, 2022

Judy Long, MDiv, BCC , palliative care chaplain and educator at UCSF and caregiver. She directs UCSF MERI’s patient, family, and clinician support with classes and consultation on resiliency, well-being, and grief. You wrote about how when it comes to talking about patients with dementia, they’re rarely portrayed as resilient.

Community 101

Community IT Individual Patient-Centered 101

Mere Mortal MD

JUNE 5, 2025

When I was in my pre-medical school education, taking the required science classes like organic chemistry and biochemistry—miles off from the usual English Literature Classes I was accustomed to taking—I found a book that drew me in by its title. This is why patients often have side effects like nausea and hair loss.

Patient-Centered 130

Patient-Centered Medical Patients IT 130

GeriPal

FEBRUARY 6, 2025

Eric 00:27 So we’re going to be talking about making the diagnosis of Alzheimer’s disease in a primary care setting, not specialty care, but maybe we could talk a little bit about that. How much should it change how we think about making a diagnosis of Alzheimer’s disease in primary care? Great to be back. Absolutely.

Primary Care 95

Primary Care Diagnosis Screening IT 95

GeriPal

JUNE 27, 2024

How, though, do we navigate anxiety and help our patients who may end up in the anxiety spiral that becomes so hard to get out of? So it tends to be future oriented and tends to show up as a physical sensation in our body. Something I’ll often point out to patients is, you know, how do you identify your emotions?

Illness 129

Illness IT Diagnosis Patient-Centered 129

GeriPal

MAY 9, 2024

all of whom focus their efforts on educating the general public about living and dying with a serious illness. How you actually physically started doing this and built up so many followers over time and why are you doing it? He was also the one who we have to thank for suggesting this podcast! AMA PRA Category 1 credit(s) ™.

Education 127

Education Illness IT Healthcare 127

GeriPal

MAY 22, 2025

Jenny Chen is a palliative care fellow at Yale who regularly sings for her seriously ill patients. Jenny reached out to us because she plays music regularly for her patients, and she said, you should do a podcast about music. And I performed for many palliative patients, and that’s when I started to understand.

IT 96

IT Patient-Centered Patients Board-Certified 96

GeriPal

JULY 21, 2022

Initially, it was just because there weren’t really answers for my patients. Often when there’s a cognitive concern, it’s a family member that is calling saying, “I just want to make sure my mom should still be driving after this happened, or after this diagnosis.” “When can I get back to driving?”

Family 102

Family Families IT Diagnosis 102

GeriPal

FEBRUARY 22, 2024

As she said, when you think about the hardest patients you’ve cared for, in nearly all cases there was some aspect of psychological illness involved. Then, “Keep your hand up if you frequently refer patients with cancer pain to a psychologist?” That rings true to me. All hands go up. All hands go down. AMA PRA Category 1 credit(s) ™.

Mental Health 122

Mental Health Patient-Centered Illness Screening 122

GeriPal

JULY 11, 2024

It’s a jampacked 50 minutes, filled with pearls on taking care of patients with liver disease. Kirsten 04:16 So, in emergency medicine, obviously, we are interacting and caring for these both exciting and interesting, but also very complex and humbling patients to care for in the ED setting. AMA PRA Category 1 credit(s) ™.

Patient-Centered 109

Patient-Centered IT Patients Clinic 109

GeriPal

AUGUST 29, 2024

During the podcast, we reference a newly released second-edition book that our guests published titled “ Navigating Communication with Seriously Ill Patients: Balancing Honesty with Empathy and Hope.” Why did you all decide to write an updated book on navigating communication with serious ill patients? Gordon 02:02 I do.

Illness 132

Illness IT Family Families 132

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. When I see a patient? Matthew, I get the lyrics.

Primary Care 113

Primary Care Patient-Centered IT Patients 113

GeriPal

FEBRUARY 29, 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 126

IT Patient-Centered Illness Education 126

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. Noelle Marie, welcome to the GeriPal Podcast. Noelle Marie 00:57 Hi, everyone.

Individual 85

Individual Community IT Chronic Condition 85

GeriPal

JULY 28, 2022

But at that time I was struck by how in that field, there wasn’t a focus or really interest in symptom management and support for patients and their families. Eric: And what a research agenda that you’ve done, including one of the most seminal papers that we have in palliative care in lung cancer patients.

Illness 110

Illness Hospital Patient-Centered Patients 110

GeriPal

OCTOBER 12, 2023

Summary Transcript Summary For surgeons and patients, deciding if and when to operate can be challenging. Often, the way surgeons communicate about these decisions doesn’t make things any easier for themselves or their patients. We hope you enjoy this episode. I did it before and this guy, he was 85, but he was climbing Mount Everest.”

IT 128

IT Family Families Patient-Centered 128

GeriPal

OCTOBER 20, 2022

And, who within ASPE guides aging policy and connects policy to every day health challenges experienced by patients and clinicians? Alex: And we are delighted to welcome Rasheeda Hall, who is a physician scientist in the division of nephrology at Duke University School of Medicine, and sees patients at the Durham VA.

Complication 52

Complication Patient-Centered IT Patients 52

GeriPal

DECEMBER 19, 2024

Here are a couple of articles if you want to do a deeper dive: Dani and colleagues article on Psychiatry and Palliative Care: Growing the Interface Through Education. A NY Times article titled Should Patients Be Allowed to Die From Anorexia ? When you think about the word palliative psychiatry, is that what we’re talking about?

Illness 101

Illness Mental Health IT Patient-Centered 101

GeriPal

JANUARY 11, 2024

In further contrast to the United States, MAID in Canada is almost entirely administered by a clinician, whereas in the United States patients must self administer. And importantly the patient has to have capacity and they have to be able to take the drug themselves. AMA PRA Category 1 credit(s) ™. But that was separate from MAID.

Illness 144

Illness IT Medical Provider 144

GeriPal

SEPTEMBER 19, 2024

Give too much, it may cause harm (even if the higher dose had no significant side effects, it would require patients to take a lot of unnecessary additional pills as well as increase the cost.) So, what is the effective dose of palliative care? Give too little – it may not work. Jennifer 04:25 I can take that on. Eric 05:32 Yeah.

Patient-Centered 119

Patient-Centered IT Patients Hospital 119

GeriPal

JUNE 26, 2025

Wait, so one key message is that social health is linked to physical and cognitive health?!? And then when you see clinically patients coming into hospital, they’ll have, you know, they’ll be admitted for aspiration pneumonia. And the government can do something about that?!? Lauren 18:33 Yeah. Alex 18:34 Okay. By evidence.

Illness 93

Illness Hospital IT Patient-Centered 93

GeriPal

JUNE 6, 2024

Summary Transcript Summary As Eric notes at the end of today’s podcast, we talk about many difficult issues with our patients. But one issue we’re not as good at discussing with our patients is sexual health. Clearly this issue is important to patients. You know, I address all the supportive care needs of my patients.

Illness 130

Illness IT Physicals Patients 130

GeriPal

JULY 25, 2024

The PPS is one of the most widely used prognostic tools for seriously ill patients, but the prognostic estimates given by the PPS are based on data that is well over a decade old. It is appropriate for all patient populations, and it is developed specifically for the palliative care and hospice populations. Why do this?

Family 106

Family Families Patient-Centered Patients 106

GeriPal

MARCH 27, 2025

Only 5% of intervention patients received the facilitator-led component of the intervention (there were other components, facilitator-led was the most engaged component). I’m hearing dementia patients or patients with dementia. Eric 09:15 And then who were the patients just with dementia or were they. Is that right?

Primary Care 79

Primary Care IT Clinic Illness 79

GeriPal

APRIL 20, 2023

Today we talk with Margot Kushel about how we got here, including: That sense of powerlessness as a clinician when you “fix up” a patient in the hospital, only to discharge them to the street knowing things will fall apart. It was in the mid-nineties, and about half of the patients that we cared for in the inpatient service were homeless.

Mental Health 123

Mental Health Community IT Individual 123

GeriPal

DECEMBER 21, 2023

Don’t get me wrong, the evidence points to cost savings, but as Chris Callahan and Kathleen Unroe pointed out in a JAGS editorial in 2020 “in comprehensive dementia care models, savings may accrue to Medicare, but the expenses accrue to a fluid and unstable network of local service providers, patients, and their families.”

Patient-Centered 125

Patient-Centered IT Family Families 125

GeriPal

SEPTEMBER 14, 2023

We talk with Bruce Leff and Tacara Soones about the hospital-at-home movement, which has been shown to reduce costs, improve outcomes and improve the patient experience. JAGS Hospital-at-Home Interventions vs In-Hospital Stay for Patients With Chronic Disease Who Present to the Emergency Department: A Systematic Review and Meta-analysis.

Hospital 115

Hospital Patient-Centered Supply Chain IT 115

Pamela Wible MD

JUNE 19, 2025

In order to heal her patients she first had to heal her ailing profession. An inspiring leader and educator of the next generation of physicians, Doctor Wible has been named one of the 2015 Women Leaders in Medicine and the “Physicians Guardian Angel.” I give you Dr. Pamela Wible. Dr. Pamela Wible soon discovered why. Think about it.

Clinic 246

Clinic Nurse Practitioner IT Medical 246

GeriPal

JULY 16, 2024

Ken Covinsky reminds us that we should not be making a diagnosis based on what we see on TV, and that if a patient’s daughter expressed a concern that their parent “wasn’t right,” we would conduct an in depth evaluation that might last an hour. Of note, we talk about candidates from all parties today.

Diagnosis 141

Diagnosis Diagnose IT Physicals 141