The Clinical Problem Solvers

AUGUST 25, 2020

Public health advocate, leader, and scholar, Dr. Camara Phyllis Jones , is credited for creating the framework many healthcare professionals and researchers use to think about systemic racism’s impacts on Black health. Links References discussed throughout episode Hardeman RR, Karbeah J, Kozhimannil KB. N Engl J Med.

Community 52

Community Patient-Centered Education Relationship 52

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 Family 73

GeriPal

JUNE 12, 2025

Summary Transcript CME Summary If you’re anything like me, you might find the process of what happens to patients when they visit a radiation oncologist somewhat mysterious. Anish 01:02 Well, I speak, you know, from a physician lens of some of the patients that I get referred, and by the time there’s. This is not a good option.

Patient-Centered 102

Patient-Centered Referral Patients IT 102

GeriPal

MAY 8, 2025

Summary Transcript CME Summary Weve covered psychedelics on the podcast beforefirst in 2019 with Ira Byock, where we explored their potential role in medicine , and then again in 2023 with Stacy Fischer, Brian Anderson, and Theora Cimino, focusing on the reasons to approach psychedelic use in patients with caution. This is Eric Widera.

Illness 107

Illness IT Patient-Centered Patients 107

Plum Health

OCTOBER 11, 2024

These services go beyond treating illnesses; they aim to keep you healthy in the first place. Your ongoing appointments help foster a strong patient-doctor relationship , making it easier to discuss your concerns and receive personalized care. Do you prefer a full-service medical center or a walk-in clinic?

Clinic 52

Clinic Primary Care Doctor Primary Care Chronic Condition 52

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. Who do we have with us today? Devon, welcome to GeriPal.

Illness 136

Illness Patient-Centered Screening Clinic 136

GeriPal

NOVEMBER 21, 2024

We are going to tackle this question and so many more about coping on this week’s podcast with Dani Chammas , a recurring GeriPal guest, psychiatrist, and palliative care doc at UCSF, and Amanda Moment , a Palliative Care Social Worker at Brigham and Women’s Cancer Center. Coping in the setting of serious illness.

Illness 125

Illness IT Patient-Centered Patients 125

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. Today Liz Dzeng discusses her journey towards studying this issue in detail. I guess the VA is federal though.

Hospital 125

Hospital IT Patient-Centered Patients 125

GeriPal

JANUARY 25, 2024

Summary Transcript Summary In a JAMA 2020 systematic review of palliative care for non-cancer serious illness, Kieran Quinn found many positives, as we discussed on our podcast and in our editorial. He also found gaps, including very few studies of patients with lung disease, and little impact of trials on quality of life.

Patient-Centered 122

Patient-Centered IT Illness Patients 122

GeriPal

SEPTEMBER 22, 2022

Have you ever had that moment when talking to a patient, when you realized that the phrase you just uttered, which you’ve uttered a hundred times before, came out rote and scripted? And in response, the family or patient looked at you like you were from another planet? Summary Transcript Summary. Yeah, I’ve been there too.

Illness 101

Illness IT Patient-Centered Patients 101

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. My Life, My Story: VA’s healthcare improvements through deliberate storytelling – YouTube. Storytelling Helps Hospital Staff Discover The Person Within The Patient.

Patient-Centered 115

Patient-Centered Illness Healthcare IT 115

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? For more details, please click here. (AP AP Recruit Job No.

Illness 101

Illness Mental Health IT Patient-Centered 101

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.

Illness 133

Illness Patient-Centered Patients IT 133

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.

Illness 136

Illness IT Patient-Centered Family 136

GeriPal

FEBRUARY 22, 2024

As she said, when you think about the hardest patients you’ve cared for, in nearly all cases there was some aspect of psychological illness involved. Today we talk with two psychologists who are deeply invested in addressing psychological aspects of care for people living with serious illness. That rings true to me.

Mental Health 122

Mental Health Patient-Centered Illness Screening 122

GeriPal

OCTOBER 6, 2022

Earlier this year palliative care was the correct response to the following clue on the game show Jeopardy: From a Latin word for “to cloak”, it’s the type of care given to seriously ill patients to provide comfort without curing. We had tried to actually select people who didn’t have a serious illness. Marian: Thank you.

Illness 101

Illness Patient-Centered IT Nurse Practitioner 101

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.

Illness 110

Illness Hospital Patient-Centered Patients 110

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

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.

Patient-Centered 132

Patient-Centered Hospital Patients IT 132

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?

Patient-Centered 116

Patient-Centered Hospital IT Illness 116

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?” That’s a huge amount of news all at once. Lynn: I do.

Family 97

Family Families Patient-Centered IT 97

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.

IT 105

IT Patient-Centered Healthcare Illness 105

GeriPal

JUNE 9, 2022

Palliative care, in contrast, saw explosive growth in US hospitals. The National Palliative Care Research Center (NPCRC)and Palliative Care Research Cooperative (PCRC)were founded in part to meet this need. (see We can’t possibly meet the needs of all people with newly diagnosed serious illness. What is a pragmatic trial ?

Consulting 99

Consulting Patient-Centered Diagnosis Referral 99

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.

IT 96

IT Patient-Centered Patients Board-Certified 96

GeriPal

OCTOBER 19, 2023

Certainly SOME of those avoided hospitalizations, CPR, and ICU stays were due to documentation of those orders in the POLST. 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. This is Eric Widera.

Patient-Centered 126

Patient-Centered IT Patients Illness 126

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.

Patient-Centered 109

Patient-Centered IT Patients Healthcare 109

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 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. . AlexSmithMD . Transcript.

Illness 109

Illness IT Family Families 109

GeriPal

SEPTEMBER 28, 2023

First, a clinician’s thoughts must be encoded into words, then transmitted often via sounds, and finally decoded back to thoughts by a patient or family member. Patient Values: Three Important Questions-Tell me more? Simple, right? Not so much, as each one of these steps is fraught with miscommunication. What else? Abby: Thank you.

Family 144

Family Families Patient-Centered IT 144

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.

Management 116

Management Patient-Centered Patients IT 116

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

Patient-Centered 101

Patient-Centered Complication Patients IT 101

GeriPal

MARCH 24, 2022

Then listen to these prior podcasts with Sean Morrison and Rebecca Sudore about this issue, and we recently discussed differences between Advance Care Planning and Serious Illness Communication with Juliet Jacobsen and Rachelle Bernacki. . Where does POLST fit in with this debate? This is Eric Widera. Alex: This is Alex Smith.

Illness 72

Illness IT Healthcare Patient-Centered 72

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. Kate: Thank you.

Consulting 120

Consulting Hospital Patient-Centered IT 120

GeriPal

JUNE 15, 2023

Alex: And we have Matt DeCamp, who’s joining from the University of Colorado, where he is a primary care internist and bioethicist at the Center for Bioethics and Humanities. My worry though with that is that are we going to be expected to be more productive then, to see more patients? The patient is crying in front of you.

IT 99

IT Patient-Centered Patients Healthcare 99

GeriPal

APRIL 4, 2024

The hospital refused without a court order, and the case eventually made its way to the Supreme Court. The Cruzan ruling led to a flood of interest in Advance Directives, and eventually to the Patient Self Determination Act, which mandates provision of information about advanced directives to all hospitalized patients.

Family 112

Family Families Patient-Centered IT 112