The Clinical Problem Solvers

OCTOBER 23, 2019

Download CPSolvers App here Human Dx case link Dr. Rachel Redfield Dr. Redfield is a third-year internal medicine resident at Thomas Jefferson University Hospital. She is a graduate of University of Maryland and received her MD from University of Texas Health Science Center in San Antonio.

Internal Medicine 52

Internal Medicine Hospital Mental Health Education 52

The Clinical Problem Solvers

JANUARY 19, 2022

Elliot Tapper discusses a clinical unknown case presented by Dr. Jennifer Mundell Jennifer Mundell Jennifer Mundell, MD FACP is the associate program director for Ascension St Vincent Internal Medicine Residency Program. She graduated from University of Louisville School of Medicine and completed IM residency at Ascension St.

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Physician's Weekly

JULY 2, 2025

WEDNESDAY, July 2, 2025 (HealthDay News) — A considerable proportion of bowel preparation claims for screening colonoscopy involve patient cost-sharing, according to a research letter published online June 20 in Gastroenterology.

Screening 52

Screening Patient-Centered Preventative Care Preventive Care 52

Physician's Weekly

JUNE 25, 2025

Insurance companies have promised changes like these before, in 2018 and 2023, but many didn’t follow through, Dr. Mehmet Oz , head of the Centers for Medicare & Medicaid Services (CMS), said. Insurers must provide clearer explanations when care is denied and explain how patients can appeal.

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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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GeriPal

DECEMBER 8, 2022

Clinicians “catching” patient life stories. . Our patients aren’t “the 76 year old with heart failure in room 202,” as Heather Coats astutely noted. Our loves, our triumphs, our failures, our work, our families. . VA “gets” the importance of storytelling in medicine, without the need for reams of research to back it up.

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GeriPal

JANUARY 16, 2025

Summary Transcript CME Summary Many older adults lose decision-making capacity during serious illnesses, and a significant percentage lack family or friends to assist with decisions. And I was asking this patient about if he had filled out an advanced directive. Is the patient in your descriptor? Alex 10:41 No, they don’t.

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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? Alex is a triple-boarded (palliative care, internal medicine, and psychiatry) assistant professor of medicine at Stanford. Because the experience tends to be fairly consistent.

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GeriPal

DECEMBER 15, 2022

Along the way we address: Is this degree of slowed cognitive decline meaningful to patients or care partners? Eric: So patient narrative storytelling, independent of what we call it, I’d like to turn to both of you and just how you got interested in this as a subject. She was a heart failure patient. Heather: Sure.

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IT Patient-Centered Healthcare Illness 105

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.

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Primary Care Patient-Centered IT Patients 113

GeriPal

NOVEMBER 7, 2024

If the purpose of initiating dialysis is improving function – our complex, frail, older patients are likely to be disappointed. 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.

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Management Patient-Centered Patients IT 116

GeriPal

AUGUST 11, 2022

Susan led the Project on Death in America’s Faculty Scholars program , used her dual training in internal medicine and psychiatry to shine a light on psychosocial aspects of palliative care, and founded the Department of Psychosocial Care at the Dana Farber Cancer Institute and Brigham and Women’s Hospital. .

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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. This specific study , published in JAMA Internal Medicine, was conducted in 17 ICUs in North Carolina. What is sludge? Where was it?

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Patient-Centered Hospital IT Illness 116

GeriPal

DECEMBER 14, 2023

More recently Sharon Kaufman ‘s book And a Time to Die described the ways in which physicians, nurses, hospital systems, and payment mechanisms influenced the hour and manner of patient’s deaths. We discuss the moral distress that clinicians felt including, as one physician put it, a sense of your soul being ripped out.

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Hospital IT Patient-Centered Patients 125

GeriPal

APRIL 24, 2025

We and our guests have noticed that in our clinical practices, patients and caregivers seem to be asking for such treatments more frequently. Daneila Lamas wrote about this issue in the New York Times this week -after we recorded – in her story, a family requested an herbal infusion for their dying mother via feeding tube.

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Patient-Centered IT Patients Illness 77

GeriPal

MARCH 3, 2022

This idea that for critically ill patients in the ICU, geriatric conditions like disability, frailty, multimorbidity, and dementia should be viewed through a wider lens of what patients are like before and after the ICU event was transformative for our two guests today. GeriPal podcast with Linda Fried on frailty.

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Patient-Centered Patients IT Hospital 96

GeriPal

APRIL 10, 2025

I asked emergency medicine clinicians what they thought when a patient who is seriously ill and DNR comes to the ED, and some responded, (paraphrasing), what are they doing here? This is not why I went into emergency medicine. I went into emergency medicine to act. I went into emergency medicine to act.

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Patient-Centered IT Hospital Patients 77

GeriPal

AUGUST 24, 2023

Harvey is probably best known for his work in developing dignity therapy, a psychological intervention designed specifically to address many of the psychological, existential, and spiritual challenges that patients and their families face as death approaches. So I identified myself, and was working in our local cancer center.

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Patient-Centered Patients IT Illness 98

GeriPal

MAY 29, 2025

Today we talk about lucid episodes and what they might mean to the person with dementia, their family and loved ones, to philosophers, to clinicians, to neuroscientists. Particularly patients, families. Alex 06:05 And, oh, for that family, it was so meaningful. That their loved one is in there. Eric 01:34 Yeah.

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Families Family IT Patient-Centered 93

GeriPal

FEBRUARY 13, 2025

How to be sensitive to the risks of stereotyping based on recommendations from the few members of the board to the many heterogeneous patients served? I’m Marie Bakitas, and I’m a professor at the University of Alabama at Birmingham and also the associate Director of the center for Palliative and Supportive Care.

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Consulting Community Patient-Centered Families 63

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. And also of course this, the psychosocial support we can, can give.

Patient-Centered 66

Patient-Centered IT Screening Patients 66

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. Lingsheng, welcome back to GeriPal.

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IT Patient-Centered Patients Relationship 122

GeriPal

MARCH 20, 2025

Recently, discussion has emerged about how these issues intertwine in caring for patients with advancing dementia who have stated that they would not want to continue living in that condition: for those with an advanced directive to stop eating and drinking, how do we balance caring for their rational past self and their experiential current self?

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IT Patient-Centered Patients Medical 87

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.

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Healthcare IT Community Illness 100

GeriPal

APRIL 11, 2024

This podcast was initially sparked by Josh’s “Note From a Family Meeting” Substack post titled “ Ambivalence in Clinical Decision-Making ,” which discussed Bryanna’s and Jenny’s 2022 article titled “ Two Minds, One Patient: Clearing up Confusion About Ambivalence.” Welcome to the GeriPal podcast. Josh, welcome back to GeriPal.

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Patient-Centered IT Patients Consulting 128

GeriPal

APRIL 26, 2024

Who spends the most time with the patient in the infusion center? And we’re delighted to welcome Jenny back to the GeriPal podcast, Jenny Blumenthal-Barby, who’s a philosopher and bioethicist and associate director for the Center for Medical Ethics and Health policy at the Baylor College of Medicine.

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Patient-Centered IT Patients Consulting 119

GeriPal

AUGUST 1, 2024

Anna Pleet is an internal medicine resident at Allegheny Health Network who has a collection of amazing YouTube videos on aging and the Mediterranean diet. Elizabeth Eckstrom is a geriatrician, professor of medicine at OHSU, and author of a new book, the Gift of Aging. Who do we have with us on this podcast? Great to be here.

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IT Diabetes Chronic Disease Patient-Centered 116

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?

Families 106

Families Family Patient-Centered Patients 106

GeriPal

MARCH 27, 2025

Today we are delighted to welcome Jennifer Wolff, Sydney Dy, and Danny Scerpella, who conducted a pragmatic trial of advance care planning (ACP) in primary care practices; and Jasmine Santoyo-Olsson, who wrote an accompanying commentary in JAMA Internal Medicine. I’m hearing dementia patients or patients with dementia.

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Primary Care IT Clinic Illness 79

GeriPal

JULY 6, 2023

Administration on Aging connecting you to services for older adults and their families California’s Master Plan for Aging New York’s Master Plan for Aging Transcript Eric: Welcome to the GeriPal Podcast. I would hope a referral would go to what’s called an ADRC, and it’s called an Aging and Disability Resource Center.

Community 89

Community Nurse Practitioner Provider IT 89

GeriPal

AUGUST 15, 2024

Lingsheng (and I) recently published studies on this in JAMA Internal Medicine , and JAGS. Ongoing reports from patients about anti-Asian hate experiences Should clinicians screen for Anti-Asian hate? And in our reporting center, we tracked physical assaults, verbal harassment. Eric 14:41 You mentioned the study.

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Mental Health Community Screening IT 116

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. Alex: We also have Mike Rabow, who is director of palliative care at the Cancer Center at UCSF. Isn’t that what we always work with, with patients, with our colleagues, with ourselves? Redwing: Thank you.

Patient-Centered 93

Patient-Centered IT Community Illness 93

GeriPal

FEBRUARY 2, 2023

For example, is reluctance to take on more responsibility at work or relocate because you feel inadequate or is it because of genuine concern about the impact on your family? Alex: This was the National Palliative Care Research Center’s Annual Foley retreat for investigators, researchers. And it was a wonderful talk on mentoring.

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IT Medical Student Medical Families 104

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.”

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Common Sense Family Doctor

JUNE 11, 2025

Several past colleagues in the family medicine department at Georgetown recently published an informative scoping review of specialty disrespect in the medical learning environment. The authors term "primary care yield" as the percentage of physicians who start training in primary care and complete it in primary care. in 2023-24.

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Primary Care Community Primary Care Physician DO 90

GeriPal

DECEMBER 12, 2024

Surrogates often either dont know what patients would want, or think they know but are wrong, or make choices that align with their own preferences rather than the patients. Alex 01:29 And we’re delighted to welcome Teva Brender, who’s a third year resident in internal medicine at UCSF. Can we do better?

Patient-Centered 108

Patient-Centered IT Patients Healthcare 108

Physician's Weekly

JUNE 17, 2025

Until recently, the only treatment was growth hormone therapy to help patients stay leaner and grow taller, but it didn’t address appetite. This breakthrough for these patients comes as other drugs are revolutionizing how doctors treat obesity, which affects more than 40% of American adults. Kennedy Jr.

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