The Motivated MD

NOVEMBER 19, 2024

Because of this, carving out the time for family remains a top priority, and as our family grows, more and more time is needed to make that goal a reality. Publishing post after post, week after week, while juggling my clinical burdens, family life, personal goals, my health… it just became too much.

Finance 52

Finance Education Family Families 52

GeriPal

JUNE 8, 2023

And yet we’re also in a different place in diabetes monitoring and management. AlexSmithMD Additional Links: – Fingerstick monitoring in VA nursing homes (too common!) – Improving diabetes management in hospice – Continuous Glucose Monitoring complicating end of life care Transcript Eric: Welcome to the GeriPal podcast.

Diabetes 73

Diabetes Management Patient-Centered Family 73

GeriPal

JULY 19, 2024

Alex 00:20 And she’s professor of family medicine at USC, deputator at JAGS, and co lead of the bold center of Excellence in early detection of dementia. Well, because they’re hard on people with dementia and they can be very hard on families, and they’re a form of crisis. Is that right, Soo? Soo 00:32 Thanks.

Screening 119

Screening Primary Care Patient-Centered IT 119

Mesa Family Physician

MARCH 13, 2025

However, at Mesa Family Physicians , we believe that preventive healthcare is the cornerstone of long-term wellness for our Mesa, Arizona community. Regular visits to your primary care physician at Mesa Family Physicians provide opportunities for early detection of potential health issues before they become serious problems.

Family Physician 100

Family Physician Preventative Care Preventive Care Families 100

GeriPal

JUNE 16, 2022

There are a lot of old myths out there about managing urinary tract symptoms and UTI’s in older adults. Then we chat with Scott Bauer, internist and researcher at UCSF, about how to assess and manage lower urinary tract symptoms in men. The family asks you for an antibiotic and their goals are limited additional interventions.

Management 122

Management IT Medical Patient-Centered 122

GeriPal

OCTOBER 10, 2024

social worker, chaplain), everyone should be able to ask a question or two about spiritual concerns, social concerns, or physical concerns. For instance, a family meeting or an update or communication with families. So, for instance, I do a psychosocial screen, I do a physical screen, I do screens in all the other domains.

Screening 119

Screening IT Family Families 119

GeriPal

JULY 21, 2022

Often the work of the certified driving rehab specialist is to assess the older drivers goals, assess prognosis for driving, and help the family navigate discussions around driving cessation (hmmm…sounds like an approach to family meetings). Were those people self referring, or family members calling you asking? Eric: Yeah.

IT 102

IT Family Families Diagnosis 102

GeriPal

FEBRUARY 8, 2024

Hospital Chaplains, Spirituality, and Pain Management: A Qualitative Study. Pain Manag Nurs. I mean, to me, the Buddhist concept that there are multiple forms of suffering, like there’s the suffering that’s due to pain and physical symptoms. 2023 Dec 20:S1524-9042(23)00202-3. doi: 10.1016/j.pmn.2023.11.004.

IT 137

IT Family Families Physicals 137

GeriPal

JUNE 27, 2024

I have so many questions, and I promise we’re going to get to the management of anxiety and serious illness. So it tends to be future oriented and tends to show up as a physical sensation in our body. But it’s this physical sensation that comes along with these ideations. Brianna 00:41 Thanks. Great to be here.

Illness 129

Illness IT Diagnosis Patient-Centered 129

GeriPal

AUGUST 29, 2024

It feels nearly impossible if you add another degree of difficulty, whether it be a crying interpreter or a grandchild from another state who shows up at the end of a family meeting yelling how you are killing grandma. And you’re in the ICU family meeting, and it gets heated. Is the sort of task to manage.

IT 132

IT Illness Family Families 132

GeriPal

FEBRUARY 15, 2024

The insight started when Carmen, an orthopedic surgeon-researcher, and Katie, a physical therapist- researcher participated in ride-alongs with EMS providers to patient’s homes. Eric: Well, what are the odds that two family members focus on a similar topic and do research together? laughter] Alex: We love the family theme.

Community 114

Community Transportation IT PCP 114

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. Tamra: I wrote this… Eric: Thinking that the perceived role for inpatient physical therapist is a discharge consultant.

Patient-Centered 132

Patient-Centered Hospital Patients IT 132

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. And I would say we weren’t doing training on symptom management, for example.

Telehealth 105

Telehealth Patient-Centered IT Patients 105

GeriPal

JANUARY 25, 2024

And so, three years of seeing over and over people having really difficult end of life experiences in the ICU, not being able to advocate for themselves, a lot of trauma for their families, I just thought, we have to do better than this. I was really passionate about helping the people and also their families. Eric: Yeah.

Patient-Centered 122

Patient-Centered IT Illness Patients 122

GeriPal

JULY 11, 2024

So folks that are having refractory ascites or refractory encephalopathies, challenging emotional symptom management as well. I think for families and for other providers who are not trained in that, it’s very hard to predict. Sarah 07:12 It’s mostly our decompensated cirrhosis patients.

Patient-Centered 109

Patient-Centered IT Patients Clinic 109

GeriPal

FEBRUARY 22, 2024

A lot of those symptoms of depression can also be attributed to different kinds of physical symptoms. They’re still engaging fully with their family and with the activities and the hobbies that they’re still able to do. If you’re low energy, well, is that the illness or depression? I’m dying.”

Mental Health 122

Mental Health Patient-Centered Illness Screening 122

GeriPal

DECEMBER 8, 2022

Our loves, our triumphs, our failures, our work, our families. . So I think as palliative care clinicians, we use narrative as we try to understand more about the persons that we’re caring for and their families. Been in the hospital four times, vented, been told the story to her family, she won’t live.

Patient-Centered 115

Patient-Centered Illness Healthcare IT 115

GeriPal

MAY 22, 2025

A music therapist would use music deliberately to achieve a rehabilitation goal, just like a physical therapist or an occupational therapist. And we got all into his family stuff and how he’d been suffering with cancer and his goal. Just encourage patients and families to bring music into their healthcare experience.

IT 96

IT Patient-Centered Patients Board-Certified 96

GeriPal

MAY 4, 2023

It is really difficult for the patients and the families. They do choose to rely more on their family and parents in ways that might feel like a step backwards and is yet, still developmentally appropriate and autonomous. You’re recognizing that, wow, this could happen to me, and I wonder sometimes about the challenges.

IT 83

IT Family Families Illness 83

GeriPal

SEPTEMBER 7, 2023

So my family is from Maui and were impacted by the wildfires, so I really appreciate this. Alex: How is your family doing? My family’s also from Maui. And her dad’s family, the Makekaus family, which is based in Lahaina, and we actually visited their grave sites there, when we were there a few years ago.

Patient-Centered 129

Patient-Centered IT Patients Clinic 129

GeriPal

JUNE 13, 2024

Alex 00:20 Today we’re delighted and honored to welcome Eduardo Bruera, who is one of the biggest symptom management gurus, if not the biggest symptom management guru in palliative medicine. If the patient has a spectacular response to HIV management or the cancer treatment, then the main factors are removed.

Illness 133

Illness Patient-Centered Patients IT 133

GeriPal

JULY 28, 2022

This is my early father’s day gift from the family. 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. Alex: I’ve got to show you the back of the Jersey. Eric: Yeah. Alex: That’s right.

Illness 110

Illness Hospital Patient-Centered Patients 110

GeriPal

DECEMBER 15, 2022

So I think as palliative care clinicians, we use narrative as we try to understand more about the persons that we’re caring for and their families. Been in the hospital four times, vented, been told the story to her family, she won’t live. And so I really gain that and I love the chorus words that she uses in this song.

IT 105

IT Patient-Centered Healthcare Illness 105

GeriPal

JUNE 19, 2025

And I think a big part of that journey was just having that right time, that right moment, with the right network and support groups of individuals, including my family, to really lift me up and allow me to celebrate my authentic self. Gender expression is your physical outward manifestation of how you express your gender identity.

Individual 85

Individual Community IT Chronic Condition 85

GeriPal

OCTOBER 12, 2023

” Somehow, there’s this signal that the patients and families had to pick up that maybe the surgeon wasn’t so enthusiastic, or if I just dump risk on them, maybe they’ll say, “I don’t want this.” What I need to navigate with that patient and their family, is it valuable to you? Every time.

IT 128

IT Family Families Patient-Centered 128

GeriPal

JUNE 22, 2023

We really like the community doctors to know, so those of you listening, that our patients, they’ve lost their physical freedom, but they have autonomy in terms of their medical decision-making just like anybody else. In many cases, the families were the victims of the crime. They suffered from it. We’ve had baptisms.

Family 132

Family Families IT Community 132

GeriPal

SEPTEMBER 12, 2024

Ishwaria 05:29 And that’s really how this field of professional well being, healthcare professional well being, clinician well being, has evolved, is that there is an important place in our overall professional well being for personal resilience and our individual coping strategies, recovery methods from day to day.

IT 110

IT Healthcare Healthcare Professional Patient-Centered 110

GeriPal

MARCH 28, 2024

I am part of some other work in the ICU world looking at time-limited trials and trying to better define what those are, how we talk about them, how we talk about them with patients and families. We have our social workers and our psychologists and we know how to manage these symptoms. I’m going to go to stem cell transplants.

Consulting 115

Consulting Patient-Centered IT Patients 115

GeriPal

OCTOBER 17, 2024

People’s goals are often much more than, you know, perfect management or heart failure, even living as long as possible. One of our first podcasts, over 300 podcasts ago, was with Nate Goldstein, who studies heart failure management in older adults, and particularly older adults nearing the end of life. Was it sodium hf?

Primary Care 113

Primary Care Patient-Centered IT Patients 113

GeriPal

JUNE 15, 2023

I actually like reading books and the physical,” and what the internet 2.0 And patients and family members tell us that they worry that their clinician is going to be overly focused on that mortality number now. We should build models to identify symptoms, to do proactive symptom management, and AI can totally do that.

IT 99

IT Patient-Centered Patients Healthcare 99

GeriPal

MARCH 13, 2025

Yes, it means to cloak, but theres more Whole-person-care Total pain Healing as a process distinct from the deterioration of the body Sympomatologists The patient and family as the unit of care Our guests referenced many articles on this podcast, linked above and below. A good prescriber, a good symptom control manager. Balfour amount.

IT 104

IT Patient-Centered Family Families 104

GeriPal

FEBRUARY 16, 2023

Managing anger is hard, it’s really hard. And yet we don’t ever talk about how to manage it. So when we encounter anger clinically, when we’re in an encounter with a patient and their family, what are perhaps three steps, and we have the three step model for how we can look within ourselves and respond.

Patients 109

Patients IT Family Families 109

GeriPal

MARCH 3, 2022

And then when I did residency in internal medicine first, there was just a lot of focus on a lot of heroic management in the ICU that didn’t always appeal to me without thinking about what the morbidity might look like. I think we’re probably managing sicker patients on the floor. Alex: What happens when people survive?

Patient-Centered 96

Patient-Centered Patients IT Hospital 96

GeriPal

FEBRUARY 29, 2024

Eric: I do not want my family to listen to my podcasts. So, I generally don’t listen to the podcast afterwards, nor force them on my family. Alex: And, it means pain management. Alex: We are only on the fourth of 10. They ordered mild to hot. laughter] Alex: Yeah. I’m sure we all have the same issue. Alex: Thank you.

IT 126

IT Patient-Centered Illness Education 126

GeriPal

MAY 12, 2022

In this podcast, we cover a great deal of ground, including: Early challenges Dr. Raj faced in pain management: access to opioids, corruption, a system that doesn’t see addressing suffering as a priority. What she called total pain, physical, psychosocial, and spiritual, and she started addressing it. Healthcare industry cannot do it.

Community 115

Community IT Relationship Healthcare 115

GeriPal

MARCH 2, 2023

2022 Perioperative Gabapentin Use in Older AdultsRevisiting Multimodal Pain Management JAMA IM. These are families who are in distress. Now that we are in this position, when I think about data for pain management specifically, I feel like yes, there’s value to it. J Am Geriatr Soc. These are patients who are in distress.

Patient-Centered 96

Patient-Centered IT Healthcare Medical 96

GeriPal

MARCH 6, 2025

Michael’s Hospital in the Department of Family and Community Medicine. And this is really traumatic event for his street family and the street community that he knew. 80% died exactly where they wanted to and 83% were reconnected to family or friends through a psychosocial support system that we put into place. Yeah, yeah.

Healthcare 100

Healthcare IT Community Illness 100