PEMBlog

SEPTEMBER 6, 2023

This is a blog post designed to disseminate the important work of Choosing Wisely , an initiative of the the American Board of Internal Medicine Foundation, the goal of which is the spark conversations between clinicians and patients about what tests, treatments, and procedures are needed – and which ones are not.

Lab Testing 52

Lab Testing Medical Patients Mental Health 52

GeriPal

MARCH 14, 2024

This simple challenge was focused on putting ourselves in the shoes of our patients with dysphagia who are prescribed thickened liquids. We also talk about the importance of a proactive approach to involving speech-language pathologists in the care of individuals early on with neurodegenerative diseases like dementia and ALS.

IT 124

IT Hospital Patient-Centered Individual 124

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. She directs UCSF MERI’s patient, family, and clinician support with classes and consultation on resiliency, well-being, and grief.

Community 101

Community IT Individual Patient-Centered 101

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.

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Complication Patient-Centered IT Patients 97

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 IT Patient-Centered 52

Pamela Wible MD

JUNE 20, 2025

Psychiatrists define burnout as a job-related dysphoria in an individual without major psychopathy—meaning you’re normal; your job is killing you. Dr. Shay’s original definition was based upon his patients’ war narratives and Homer’s Iliad (762 B.C.) Yet moral injury is not an official diagnosis.

Medical Student 246

Medical Student Diagnosis Physicals Medical 246

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 Families 73

Mesa Family Physician

JUNE 24, 2025

The Role of Internal Medicine in Preventive Health Care Internal medicine plays a central role in adult health, especially when it comes to prevention, diagnosis, and long-term care. Internal medicine is a medical specialty focused on the prevention, diagnosis, and treatment of diseases in adults. It’s about staying ahead of disease.

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Internal Medicine GP Family Doctor Primary Care 130

Rao Doctor

APRIL 3, 2025

In my previous article I covered the types of illness and the causes. In case you have missed it, click below to read- FEVER FAQ- Part 1 Fever Diagnosis: How is your health assessed? When assessing a fever, we doctors employ a systematic approach to ensure accurate diagnosis and effective management. FEVER FAQs (contd.)

Diagnosis 130

Diagnosis Management Illness Diagnose 130

GeriPal

APRIL 14, 2022

On today’s podcast we talk with three experts on buprenorphine on why, when, and how to use it in serious illness. Adapting Palliative Care Skills to Provide Substance Use Disorder Treatment to Patients With Serious Illness . Katie, before we jump into the topic of buprenorphine in serious illness, what’s the song request?

Illness 102

Illness Patient-Centered IT Patients 102

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. Transcript Eric: Welcome to the GeriPal podcast. It’s me.

Illness 136

Illness Patient-Centered Screening IT 136

Mesa Family Physician

MAY 8, 2025

These visits help catch illnesses before they become more serious, reduce healthcare costs in the long term, and improve overall quality of life. Why Preventive Health Maintenance Matters The importance of public health and individual wellness cannot be overstated. The goal is to avoid disease, not just treat it.

Preventive Care 100

Preventive Care Preventative Care Wellness Visit Physicals 100

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

AUGUST 31, 2023

Summary Transcript Summary How do people react when they hear they have a serious illness? And some people, in addition or instead, engage in deep introspection on how to make meaning or live with or understand this experience of serious illness. Shock, “like a car is rushing straight at me” (says Bill Gardner on our podcast).

Illness 128

Illness IT Diagnose Medical 128

GeriPal

DECEMBER 19, 2024

Still, we havent talked about integrating palliative care into psychiatry or in the care of those with severe mental illness. What does it look like to take a palliative approach to severe mental illness? Is “terminal” mental illness a thing? Eric 01:34 Oh, I love that. Dani 01:36 More to talk about there.

Illness 101

Illness Mental Health IT Patient-Centered 101

GeriPal

FEBRUARY 27, 2025

Today we talk with experts Janet Ho, Sach Kale, and Julie Childers about opioid use disorder and serious illness. We address: Why is caring for patients with this overlap so hard? Sach Kale set up an outpatient clinic focused on substance use disorder for patients with cancer. What is making this hard for me? What do they do?

Patients 72

Patients Clinic Patient-Centered Illness 72

GeriPal

AUGUST 29, 2024

Summary Transcript CME Summary Serious illness communication is hard. We must often deliver complex medical information that carries heavy emotional weight in pressured settings to individuals with varying cultural backgrounds, values, and beliefs. Eric 01:42 So we’ ve got an exciting topic today. Eric 05:03 Nice.

IT 132

IT Illness Families Family 132

GeriPal

JUNE 19, 2025

Eric 01:04 So we’re going to be talking about transgender health in older adults and those with serious illness. To note that I am an individual who goes through this world. I face a lot of different stressors and challenges similar to other individuals, but I also have my own unique experiences. Noelle Marie 01:15 I do.

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Individual Community IT Chronic Condition 85

GeriPal

JANUARY 30, 2025

In one corner, weighing in at decades of experience, well known for heavy hits of bedside assessments, strong patient-family relationships, and a knockout punch of interdisciplinary collaboration, we have in-person palliative care consults. But watch out! Travel time can leave this champ vulnerable to fatigue and no-shows.

Telehealth 105

Telehealth Patient-Centered IT Patients 105

GeriPal

JUNE 9, 2022

By diagnosis? We can’t possibly meet the needs of all people with newly diagnosed serious illness. She’s also a member of the PAIR Center, which stands for Palliative Advanced Illness Research Center. And bringing more palliative care to the living with serious illness instead of dying from serious illness population.

Consulting 99

Consulting Patient-Centered Diagnosis Referral 99

GeriPal

FEBRUARY 23, 2023

Summary Transcript Summary You know when you walk out of a patient’s room and have that sense, “This isn’t going to go well.” The patient is sick and getting sicker, and refuses to let you talk with family or other members of her inner circle. Should you stop at “no?” AlexSmithMD Transcript Eric: Welcome to the GeriPal podcast.

Families 97

Families Family Patient-Centered IT 97

GeriPal

JULY 21, 2022

Love to talk about also in the serious illness population. Initially, it was just because there weren’t really answers for my patients. Emmy: So that older person or person with maybe terminal illness or developing impairments, it might make sense for them to just keep driving because they don’t have a good replacement.

IT 102

IT Families Family Diagnosis 102

GeriPal

JULY 28, 2022

GeriPal post on “fast food” style palliative care in chronic critical illness. 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. Additional links: Editorial on Areej’s study. Palliative care in lung and GI cancers.

Illness 110

Illness Hospital Patient-Centered Patients 110

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. Alex: Okay.

IT 126

IT Patient-Centered Illness Education 126

GeriPal

MAY 4, 2023

But when I have, I find that they’re often some of the hardest patients to care for. I just had this experience where in the space I was in, very few people believed that this was even a legit thing to study and certainly that it would make a difference for the patients we cared for. Young adulthood is super hard.

IT 83

IT Families Family Illness 83

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. What’s the connection and why?

Patient-Centered 109

Patient-Centered IT Patients Clinic 109

GeriPal

JUNE 30, 2022

You have a patient with dementia severe enough that she cannot recognize relatives. A huge part of this decision rests on (1) her previously stated wishes, values, and goals (prior to the onset of dementia); and (2) the outcomes of surgery for patients with dementia. Summary Transcript Summary. She falls and breaks her hip.

Patient-Centered 101

Patient-Centered Complication Patients IT 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. A planned expansion of MAID to include people with mental illness was placed on hold until March 2024. They could have a prognosis of years, or decades.

Illness 144

Illness IT Medical Provider 144

GeriPal

OCTOBER 19, 2023

Caveat as well that RCTs should not be placed on pedestal as the only answer- often patients enrolled in RCTs do not represent real world patients – observational studies do. For a trial to have value, it should not exclude patients over age 80, or those with dementia, or patients residing in nursing homes.

Patient-Centered 126

Patient-Centered IT Patients Illness 126

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

MAY 9, 2024

all of whom focus their efforts on educating the general public about living and dying with a serious illness. And one of the most common things that I would hear from patients, family caregivers would be I’d ask them at the end of the encounter, “What questions do you have?”

Education 127

Education IT Illness Healthcare 127

PEMBlog

MARCH 27, 2024

She is a member of the Clinical Genome Resource Inborn Errors of Metabolism (IEM) Clinical Domain Working Group, where as a biocurator she assesses the pathogenicity of variants in IEM-associated genes to facilitate expedited genetic diagnosis for IEMs. Inborn errors of metabolism in infancy: a guide to diagnosis. Pediatr Rev.

Consulting 59

Consulting Individual Families Family 59

GeriPal

MARCH 7, 2024

He looked very ill. We are doulas for those with serious illness and those at end-of-life, just a longitudinal relationship, nonmedical support to provide presence. But in the end, I see these as my patients and I’m trying to define what is the right model. My wife is also a physician and she said he’s dying.

Provider 117

Provider Illness IT Healthcare 117

GeriPal

FEBRUARY 17, 2022

I tell this story because these issues don’t typically register as more than a nuisance for clinicians, who frequently don’t understand why their older patient with osteoporosis is not taking a bisphosphonate. But our patients are walking with their feet, and adherence to bisphosphonates for osteoporosis is poor and decreases with time.

Clinic 67

Clinic IT Patients Medical 67

GeriPal

AUGUST 25, 2022

Second, Hospice was originally designed for patients with advanced cancer, but the fastest growing admitting diagnosis is dementia. Krista Harrison found , to her surprise, that caregivers of people with dementia who died rated hospice as well as similar patients without dementia who died on hospice. AlexSmithMD. Transcript.

Families 106

Families Family IT Patients 106

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. We’re just like, “Okay, I see this patient has a need. Let me just fill right in.

IT 102

IT Families Family Clinic 102

GeriPal

FEBRUARY 9, 2023

For example, we spend the first half talking about a RCT simulation study of clinician verbal and non-verbal communication with a seriously ill patient with cancer. In one room the physician under study interacts with a white patient-actor, and in another room interacts with a Black patient-actor.

Patient-Centered 111

Patient-Centered Patients IT Healthcare 111