FDA Law

NOVEMBER 1, 2023

However, FDA states that this exemption does not apply to corporate or hospital laboratories that employ licensed practitioners, and the agency says FD&C Act otherwise contains no exception or limitation for devices manufactured by laboratories. This comparison is misplaced.

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Manufacturing Hospital Healthcare Medical 81

GeriPal

MAY 19, 2022

A patient is on morphine and you want to convert it to another opioid like hydromorphone (dilaudid). Dr. Akhila Reddy and colleagues study looking at converting hospitalized cancer patients from IV hydromorphone to PO morphine, PO hydromorphone, or PO oxycodone. Step four is adjusting it for your patient.

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IT Patients Individual Relationship 139

Pamela Wible MD

JUNE 20, 2025

Moral injury is a normal human response to an abnormal traumatic event—a deep soul wound shattering one’s identity and morality. Dr. Shay’s original definition was based upon his patients’ war narratives and Homer’s Iliad (762 B.C.) In medicine, combating illness requires primary, secondary, and tertiary prevention.

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StorytellERdoc

FEBRUARY 8, 2019

I dedicate this to each of you who have cared for or are currently caring for an ill parent or family member. Although this may seem like it should be the standard, you would be surprised at just how many elderly patients present to our emergency department alone. The aide and I continued to lead the patient into the room.

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GeriPal

OCTOBER 5, 2023

Summary Transcript Summary Communicating about a serious illness is hard. Last week’s podcast we talked about the challenge around miscommunication in serious illness. This week we dive into the challenges with communication when it comes to life sustaining treatments and CPR. This is Eric Widera. Alex: This is Alex Smith.

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Illness IT Patient-Centered Family 136

GeriPal

JUNE 13, 2024

Summary Transcript Summary I always find cachexia in serious illness puzzling. In today’s podcast, we had the opportunity to learn from a renowned expert in palliative care, Eduardo Bruera, about cachexia and anorexia in serious illness. But the patient would say, well, but it still hurts, though.

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Illness Patient-Centered Patients IT 133

GeriPal

JULY 28, 2022

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

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Illness Hospital Patient-Centered Patients 110

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.

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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. The patient’s capacity to make decisions was marginal, and his sons were shouldering much of the responsibility.

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Patient-Centered Hospital Patients IT 132

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.

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IT Patient-Centered Patients Board-Certified 96

GeriPal

MAY 15, 2025

Prior podcasts on the ethics of nudging , and a different trial conducted by Kate and Scott in which the default for hospitalized seriously ill patients was to receive a palliative care consult. Many were community hospitals. Participants were critically ill and intubated. What is sludge? What to make of that?

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Patient-Centered Hospital IT Illness 116

GeriPal

NOVEMBER 7, 2024

If the purpose of initiating dialysis is improving function – our complex, frail, older patients are likely to be disappointed. Are we seeing people like more older adults, more nursing home patients starting dialysis, and even at a higher gfr? Let it be (hint hint). So I wonder if I could turn to either of our nephrologists.

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Management Patient-Centered Patients IT 116

GeriPal

FEBRUARY 20, 2025

If you want a deeper dive, check out the following resources: Our Nature of Suffering podcast with BJ Miller and Naomi Saks Dani Chammas Annals paper on countertransference and why we shouldnt say that the patient was difficult rather than that I felt frustrated. So there’s an event or a series of events. Eric 04:19 Yeah.

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Patient-Centered IT Screening Patients 66

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?

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Patient-Centered IT Patients Clinic 109

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. And PAIR stands for the Palliative and Advanced Illness Research Center. and consulting for Papa Health.

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Consulting Hospital Patient-Centered IT 120

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. Alex: And the Brigham and Women’s Hospital. Transcript.

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Patient-Centered Complication Patients IT 101

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.

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Complication Patient-Centered IT Patients 52

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.

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Patient-Centered Patients IT Hospital 96

GeriPal

SEPTEMBER 5, 2024

And Bill Andereck is still haunted by the decision he made to have the police break down the door to rescue his patient who attempted suicide in the 1980s, as detailed in this essay in the Cambridge Quarterly of HealthCare Ethics. The patient case. I think the theme is more saving someone’s life and the regret that follows.

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Patients IT Patient-Centered Hospital 98

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? In todays podcast we welcome some of the early pioneers in palliative care to talk about the roots of palliative care.

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IT Patient-Centered Family Families 104

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.”

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IT Family Families Patient-Centered 128

GeriPal

MAY 25, 2023

And, you know, I really leaned in from my perspective as a primary care geriatrician to hearing from what my patients and their family caregivers are asking me for and asking me about, and they’re asking me about how they can prepare. Health care system drives where you end up, which hospital, which state you live in.

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Community IT Patient-Centered Primary Care 95

GeriPal

DECEMBER 5, 2024

We talked with Thor Ringler, who helped found the My Life My Story Project at the VA and beyond, and Heather Coats about the evidence base for capturing patient stories. It was like kind of a co op with this common space that different groups could rent for events and meetings and things like that. Ricky 00:38 Great to be back.

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IT Community Patients Families 107

GeriPal

JUNE 22, 2023

Through a series of events, I started working as a consultant to the Department of Corrections in around 2006, and I was assigned to the California Medical Facility. Healthcare staff were afraid of patients with HIV because there wasn’t clarity on how it was transmitted. Welcome to the GeriPal podcast, Michele. Michele: Yep.

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Family Families IT Community 132

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.

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Clinic IT Patients Medical 67

GeriPal

FEBRUARY 8, 2024

Hospital Chaplains, Spirituality, and Pain Management: A Qualitative Study. The illness narratives suffering, healing, and the human condition. I think even the word patient, patient, I think, comes from the word suffer, the one who suffers. I’ve had a patient in one room, they have stage four breast cancer.

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IT Family Families Physicals 137

GeriPal

MARCH 6, 2025

Michaels Hospital in Toronto, and health justice activist. link] PEACH Good Wishes Program A program that provides meaningful gifts for unhoused individuals who are terminally ill. Michael’s Hospital in the Department of Family and Community Medicine. Today we talk with Naheed Dosani, a palliative care physician at St.

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Healthcare IT Community Illness 100

Tiny Physician

JULY 14, 2021

The patient population Image taken from [link] This is probably the most obvious difference between these two branches. On a funny note, now I feel allergic whenever adults come to me for treatment of some ailments as now I am used with pediatric patients.

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Internal Medicine Medical Student Medical Patients 52

GeriPal

OCTOBER 3, 2024

Alex 00:08 UCSF’s Division of Palliative Medicine are looking to build on their research and clinical programs and are interviewing candidates for the associate chief of research position and for full time physician faculty to join them in the in-patient and out-patient settings. I wonder why you did that. Where can they go?

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IT Patient-Centered Patients Relationship 122

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.

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Illness Hospital IT Patient-Centered 93

GeriPal

OCTOBER 27, 2022

As Alex Lee says on our podcast today, all prognostic models will be wrong (in some circumstances and for some patients); our job is to make prognostic models that are clinically useful. I think this is a really difficult topic to talk about with patients. She has a point. Prognosis is inherently uncertain.

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IT Clinic Screening Patients 95

GeriPal

SEPTEMBER 12, 2024

Eric 04:44 Could just make you a little bit more resilient, you can increase your Rvus so you can see more patients. It’s really not about helping the patient or physician. So people are not so excited about this idea of resilience in the old fashioned way, this idea that it’s up to you. If you were just. Eric 17:16 Right.

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IT Healthcare Healthcare Professional Patient-Centered 110

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, welcome back to the GeriPal podcast.

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Patient-Centered IT Patients Hospital 119

GeriPal

JULY 13, 2023

On that podcast he and collaborators tested a combined patient and clinician facing communication priming intervention to promote goals of care conversations. Eric and I also reflect on the podcast Randy generously did with us on his experience living with and studying serious illness. We have lost a giant. Eric: By One Direction.

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Patient-Centered IT Hospital Patients 83

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. So the palliative performance scale, or PPS, is essentially a tool to help clinicians with prognostication for seriously ill or palliative care populations.

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Family Families Patient-Centered Patients 106

GeriPal

APRIL 21, 2022

Poetry puts us in our patient’s shoes. Poetry holds us in that liminal space so many of our patients are in. Poetry helps us grapple with our own experiences of illness. Isn’t that what we always work with, with patients, with our colleagues, with ourselves? To let it go. . Alex: Mm-hmm (affirmative).

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Patient-Centered IT Community Illness 93

GeriPal

NOVEMBER 3, 2022

You’d imagine though that our professional expertise and experiences in helping patients and families cope with loss and grief would be helpful in managing our own personal losses. So people are less able to have the language when the loss event actually happens. Turns out, it’s maybe not. And we don’t talk about it as much.

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Healthcare Professional Healthcare IT Relationship 102