My Green Doctor

JULY 2, 2025

in the need for healthcare—translating into over 500 million extra days of inpatient hospital care and more than 100 million emergency department visits across Europe by 2050. In the United States, extreme weather events and air pollution are already costing the healthcare system over $820 billion annually.

Healthcare 52

Healthcare Healthcare Professional Management Community 52

GeriPal

FEBRUARY 15, 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.

Community 114

Community Transportation IT PCP 114

GeriPal

OCTOBER 17, 2024

Summary Transcript CME Summary When treating heart failure, how do we distinguish between the expanding list of medications recommended for “Guideline Directed Medical Therapy” (GDMT) and what might be considered runaway polypharmacy? He’s a medical director of H ebrew S enior L ife outpatient clinic at Newbridge.

Primary Care 113

Primary Care Patient-Centered IT Patients 113

GeriPal

NOVEMBER 7, 2024

And the main topic of today is a paper in Annals of Internal Medicine , Maria first author, that addressed the tradeoffs between initiating dialysis vs continued medical/supportive management. Susan 01:36 To reflect continuing medical management versus starting dialysis, which is what Maria’s wonderful paper goes through.

Management 116

Management Patient-Centered Patients IT 116

GeriPal

OCTOBER 26, 2023

Within hours of recording this podcast, I joined a family meeting of an older patient who had multiple medical problems including cancer, and a slow but inexorable decline in function, weight, and cognition. And I started my career at Barnes-Jewish Hospital in St. But rarely does the podcast and clinical reality meet in the same day.

Patient-Centered 132

Patient-Centered Hospital Patients IT 132

GeriPal

FEBRUARY 20, 2025

The SAMHSA defines trauma as an event, series events or set of circumstances experienced by an individual as physically or emotionally harmful or life threatening, with lasting adverse effects on the individual’s functioning and mental, physical, social, emotional or spiritual. So there’s an event or a series of events.

IT 66

IT Patient-Centered Screening Patients 66

GeriPal

MAY 22, 2025

You can hear Tyler and I having a great time singing together and sharing stories around his podcast My Medical Mixtape. And I was fortunate to record an episode of my medical mixtape with Tyler at the w hich meeting were we at, Tyler ? And so this is a shout out to our inpatient palliative team at Dell Medical School.

IT 96

IT Patient-Centered Patients Board-Certified 96

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. And so I went into medical school wanting to cure cancer. I entered medical school and I did a course that was offered that’s called living with a life threatening illness.

Illness 110

Illness Hospital Patient-Centered Patients 110

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

FEBRUARY 17, 2022

When we have a medication with up front harms and downstream benefits, it’s critical that we consider the time to benefit, or how long it will take an individual to benefit from a test or treatment. And really, the more important question is how quickly they would benefit from starting these medications. See screenshot below.

Clinic 67

Clinic IT Patients Medical 67

GeriPal

MAY 25, 2023

Van Scoy who is a pulmonary critical care advance care planning researcher at Penn State Hershey Medical Center in Pennsylvania. I see us measuring choice of a medical durable power of attorney. Health care system drives where you end up, which hospital, which state you live in. Well, what’s a major medical decision?

Community 95

Community IT Patient-Centered Primary Care 95

GeriPal

OCTOBER 20, 2022

Alex: And we are also delighted to welcome Devika Nair, who is a nephrologist at Vanderbilt University Medical Center in Tennessee Valley VA Healthcare System. That includes many medical specialists, surgical specialists, many specialists and many other disciplines who are on our older adults team. Rasheeda, welcome to GeriPal.

Complication 52

Complication Patient-Centered IT Patients 52

GeriPal

APRIL 3, 2025

So if you haven’t been to this event, there is a literature review where we. I believe the age range was over 80 hospitalized patients and showed that relatively light level physical activity, often with weights, improved hospital outcomes. To learn more about CME for other GeriPal episodes, click here. And very frail.

IT 64

IT Hospital Screening Patients 64

GeriPal

JULY 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.

Patient-Centered 109

Patient-Centered IT Patients Clinic 109

GeriPal

DECEMBER 5, 2024

Alex 00:23 All right, first, we’re welcoming back Ricky Le it er, who’s a palliative care doc at Dana Farber Cancer Institute in Brigham Women’s Hospital and Harvard Medical School and is co-founder of the Palliative Story Exchange. I’ve been running a medical storytelling program called the Nocturnus.

IT 107

IT Community Patients Family 107

GeriPal

SEPTEMBER 12, 2024

She’s a geriatrician and palliative care doc and is associate chair for professional development in the department of Psychosocial Oncology and Palliative Care at the Dana Farber Cancer Institute and Harvard Medical School. We were often the only ones left in the hospital. Jane, welcome to the GeriPal podcast.

IT 110

IT Healthcare Healthcare Professional Patient-Centered 110

GeriPal

JUNE 22, 2023

Summary Transcript Summary In the early 1990’s, California Medical Facility (CMF) created one of the nation’s first licensed hospice units inside a prison. Alex: We are in the California Medical Facility and we will ask our guest about that. I’ve known Michele a long time, since the Joint Medical Program. Michele: Yep.

Family 132

Family Families IT Community 132

GeriPal

MARCH 13, 2025

Summary Transcript CME Summary As far as weve come in the 50 years since Balfour Mount and Sue Britton opened the first palliative care at the Royal Victoria Hospital in Quebec, have we lost something along the way? You’re a disgruntled medical student. You’re thinking about dropping out of medical school.

IT 104

IT Patient-Centered Family Families 104

GeriPal

OCTOBER 12, 2023

Alex: And we’re delighted to welcome Justin Clapp, who is assistant professor of anesthesia and critical care and medical ethics and health policy. He’s a linguistic and medical anthropologist at the University of Pennsylvania. You’re a linguistic and medical anthropologist. Gretchen: Thank you. Justin: Hello.

IT 128

IT Family Families Patient-Centered 128

GeriPal

MARCH 3, 2022

A little over a decade ago, Ken Covinsky wrote a GeriPal post about a Jack Iwashyna JAMA study finding that older adults who survive sepsis are likely to develop new functional and cognitive deficits after they leave the hospital. GeriPal podcast with Tom Gill on the Precipitating Events Study, distressing symptoms, disability, and hospice.

Patient-Centered 96

Patient-Centered Patients IT Hospital 96

GeriPal

FEBRUARY 8, 2024

Hospital Chaplains, Spirituality, and Pain Management: A Qualitative Study. ” BJ: Well, I fall back on using physiology in the sort of medical sense. Usually events open up some insight into the person themselves as they’re describing the suffering. We medicate that away. Pain Manag Nurs. doi: 10.1016/j.pmn.2023.11.004.

IT 137

IT Family Families Physicals 137

GeriPal

JANUARY 26, 2023

Alex: And we are delighted to welcome Sharon Brangman, who is a geriatrician and chair of the Department of Geriatrics at Upstate Medical University. Then, of course, that falls into medical rules. No need for me to get rid of that pesky J in my name. Welcome to the GeriPal podcast Sharon. Sharon: Thanks for having me. Eric: Yes.

IT 91

IT Patient-Centered Healthcare Patients 91

GeriPal

JUNE 30, 2022

Alex: Today, we are delighted to welcome Joel Weissman, who is a health services researcher and deputy director and chief science officer for surgery at the Center for Surgery and Public Health at Harvard Medical School. Joel: The Brigham and Women’s Hospital likes me to say that too. And she was rushed to the hospital.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

GeriPal

MAY 29, 2025

I think we have ideas about are these paradoxical events, are they expected? And I think Andrew’s going to have good ideas about, like, why the term paradoxical and are these events paradoxical, truly? So what I remember is, is multiple hospitals and they did EEG during CPR during a cardiac arrest. Do you have like a.

Family 93

Family Families IT Patient-Centered 93

GeriPal

MARCH 6, 2025

Michaels Hospital in Toronto, and health justice activist. link] Promising Practice Recognition PEACH was named a Promising Practice in equity-oriented palliative care as part of a national initiative funded by Health Canada, operated by Healthcare Excellence Canada & the Canadian Partnership Against Cancer.

Healthcare 100

Healthcare IT Community Illness 100

GeriPal

OCTOBER 5, 2023

And I’ve noticed how we can say things like, you’re not a surgical candidate or you’re too weak to get more chemotherapy, but we can never really talk about CPR as a medical procedure in the ways we talk about other procedures and can make recommendations and offer reasoning about those procedures. This is Eric Widera.

Illness 136

Illness IT Patient-Centered Family 136

GeriPal

SEPTEMBER 5, 2024

And he’s also chaired the California Pacific Medical Center’s ethics committee since 1985. He had a 14 month recovery in hospital and rehab and continually asked to have life sustaining treatment suspended so that he could be allowed to die. She didn’t die in the hospital. Bill, welcome to the GeriPal podcast.

Patients 98

Patients IT Patient-Centered Hospital 98

GeriPal

JUNE 13, 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 133

Illness Patient-Centered Patients IT 133

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. Those disruptive events or shocks often portend a major decline in function from which people with dementia never fully recover. worsening prognosis.

Illness 93

Illness Hospital IT Patient-Centered 93

GeriPal

OCTOBER 27, 2022

But if they’re not going to live another 20 years, then there’s no point in giving them the extra medication for lowering their A1C. So I think that’s a great example of how time to benefit is really important in terms of comparing that with the expected life expectancy that a patient has. ” I love The Onion.

IT 95

IT Clinic Screening Patients 95

GeriPal

OCTOBER 3, 2024

I was on a retreat with Guy Micco , who’s been on this podcast several times, and he was teaching a class on death while I was in medical school. What is it about the images of the dying that helps teach medical students? And dying is too big, too profound for any one model, including the medical model. Home caregivers.

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. Additionally, in case patients didn’t step up, we did have sort of events where they were scheduled to see palliative care. Eric 26:47 How soon after from a hospitalization, all.

Patient-Centered 119

Patient-Centered IT Patients Hospital 119

GeriPal

DECEMBER 7, 2023

And so any additional stressor such as heat or an extreme weather event or having to move from your home because of a climate related disaster can really tax an older adult whose window of resilience is more limited. And it is going to affect, if it hasn’t already, our food quality, the food that’s available, our medications.

Healthcare 129

Healthcare IT Education Community 129

GeriPal

NOVEMBER 3, 2022

That was the lesson I learned from reading a new book edited by Matt Loscalzo along with Marshall Forstein called “ Loss and Grief: Personal Stories of Doctors and Other Healthcare Professionals ”. These debriefings create a safe outlet for health care professionals to talk about the feelings resulting from their work.

Healthcare Professional 102

Healthcare Professional Healthcare IT Relationship 102

GeriPal

JULY 6, 2023

The idea was to create a robust community-based infrastructure that could help older adults succeed in their homes and communities, whether they were healthy, how to keep them healthy or they were at imminent risk of emergency room visits, hospitalizations, or nursing home placements. And that’s critical. Eric: Yeah.

Community 89

Community Nurse Practitioner Provider IT 89

GeriPal

JULY 13, 2023

[laughter] Bob: That’s what happens when junior faculty get invited on the podcast [laughter] Eric: So we’re going to be talking about the article that just came out in JAMA on a priming intervention for goals of care conversations in hospitalized patients with serious illness. Three hospitals all within the UW medicine system.

Patient-Centered 83

Patient-Centered IT Hospital Patients 83

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. We would admit them to the hospital. Who doesn’t want to leave the hospital? They got sick.

Mental Health 123

Mental Health IT Community Individual 123