GeriPal

JULY 19, 2024

What should we use to screen individuals? So we measure things like hospitalizations and ed visits and the like, and those data are a bit weaker, but they’re also, you know, I think they need to be contextualized in what, why we would even want to reduce hospitalizations right. Who should get it if anyone?

Screening 119

Screening Primary Care Patient-Centered IT 119

GeriPal

JUNE 12, 2025

The physics and mathematics that went into radiation therapy planning. Eric 04:49 Drew me to the field physics and math. I didn’t know where they existed within the hospital. Eric 07:04 You actually created things like a curriculum for hospital medicine fellows in radiation oncology. Anish 04:13 Yeah. Thank you.

Patient-Centered 102

Patient-Centered Referral Patients IT 102

The Motivated MD

SEPTEMBER 19, 2024

For the better half of 2024, I have been periodically writing posts that are individual articles that double as potential chapters to a future book. Before we discuss each individual savings account, let us first highlight exactly what it means to ‘automate’ your savings. So yes, humans make mistakes.

Finance 52

Finance Education Individual Healthcare Professional 52

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. So it’s just a wide-opening lens that most of us never really get to see if we’re on the hospital-based side. Carmen: Thank you.

Community 114

Community Transportation IT PCP 114

GeriPal

JULY 21, 2022

I’ve worked in hospital settings as an occupational therapist, inpatient rehab and outpatient rehab. Emmy: I was seeing people in the hospital setting, saying they had had a massive brain injury. Emmy: Ended up starting a program, outpatient at our hospital at the time. How did you get interested in this? Alex: Yeah.

Family 102

Family Families IT Diagnosis 102

GeriPal

OCTOBER 26, 2023

Physical therapy had walked with him that day and noted improvement compared to previous walks, suggesting that he should be discharged to a skilled nursing facility for rehabilitation on discharge. At the end of the day, I lamented that physical, occupational, and speech therapists aren’t more tightly integrated with palliative care teams.

Patient-Centered 132

Patient-Centered Hospital Patients IT 132

GeriPal

JANUARY 25, 2024

You can also listen to an audio interview with Alex and JAMA Deputy Editor Preeti Malani about this study and the other RCT of default palliative care for hospitalized older adults with noncancer serious illness published in the same issue. People had to be in the top 20th percentile of risk for being hospitalized or dying in the next year.

Patient-Centered 122

Patient-Centered IT Illness Patients 122

GeriPal

MAY 26, 2022

They argue that the current guidelines, which prioritize immunocompromised people and unvaccinated older people on the same level, should be re-done to prioritize the immunocompromised first, and additionally move up older vaccinated individuals or vaccinated persons with comorbidities. What’s wrong with that? Why not prioritize them?

Vaccination 87

Vaccination Individual IT Healthcare 87

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. But we’re not perfect individuals.

Primary Care 113

Primary Care Patient-Centered IT Patients 113

Doctor On Demand

APRIL 28, 2025

In fact, most sore throat symptoms resolve in three days for 60-70% of patients, according to March 2025 UpToDate, an evidence-based clinical decision support system used by healthcare professionals. Paramedics can provide life-saving treatment on the way to the hospital. Then, they’ll perform a physical examination.

ER 52

ER Telehealth Primary Care Doctor Appointment 52

GeriPal

DECEMBER 8, 2022

As Thor notes, capturing patient stories has face validity as positively impacting the patients who share their stories and have them documented, and for the clinicians who get to truely and deeply know their patients in far greater depth than “what brought you to the hospital?” Within the VA it’s now at 70 VA hospitals.

Patient-Centered 115

Patient-Centered Illness Healthcare IT 115

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

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. Jennifer: They have a meaningful impact on what happens to them during the hospitalization and after. They all self-identified as a hospital based practice.

Illness 110

Illness Hospital Patient-Centered Patients 110

GeriPal

FEBRUARY 8, 2024

Hospital Chaplains, Spirituality, and Pain Management: A Qualitative Study. So there’s this, what is suffering to the individual, and is there some threshold that we could say, “This is real suffering,” or “This is the suffering we talk about in geriatrics or palliative care”? Pain Manag Nurs. 2023.11.004.

IT 137

IT Family Families Physicals 137

GeriPal

OCTOBER 20, 2022

And so there was a report in 2009 by the Institute of Medicine saying that we need to equip all of these individuals in caring for older person in an evidence based manner. So transmission of other drug resistant organisms and C difficile to other patients in the hospital reduces if you control. Diff rates, for example at a unit level.

Complication 52

Complication Patient-Centered IT Patients 52

GeriPal

DECEMBER 15, 2022

Been in the hospital four times, vented, been told the story to her family, she won’t live. Within the VA it’s now at 70 VA hospitals. It started here at Madison at one and it’s also spread outside the VA now to hospitals in Boston, Providence and now starting up actually in California and UCLA and UCSF.

IT 105

IT Patient-Centered Healthcare Illness 105

GeriPal

APRIL 3, 2025

Annie 02:31 So if you go to the A G S meeting every year, you know that this group of three individuals comprises the AGS literature update. But in spite of that, it is a lot of work for three individuals to pull all this together. So that this is not something that might affect the individual clinician patient decision.

IT 64

IT Hospital Screening Patients 64

GeriPal

MAY 8, 2025

Vincent’s Hospital in Melbourne, Australia. And I spent the past couple years just collecting data from several hundred early palliative care patients and did a network analysis, which basically just looks at the Correlations between different constructs, whether they’re physical, emotional, social or spiritual.

Illness 107

Illness IT Patient-Centered Patients 107

GeriPal

MARCH 2, 2023

Eric: And we have Tasce Bongiovanni, who is an acute care trauma surgeon at UCSF and the San Francisco General Hospital. I also heard that if you look at all individuals in the US, about 4% of individuals are taking one of the gabapentinoids, 10% over 65. Welcome to the GeriPal podcast, Nisha. Nisha: Thank you so much.

Patient-Centered 96

Patient-Centered IT Healthcare Medical 96

GeriPal

FEBRUARY 20, 2025

Kate and Ashwin talked about their research on the prevalence of lifetime trauma and its association with physical and psychosocial health among adults at the end of life. And you can’t really predict how each individual might react to the same experience. Some of them are really deeply individual experiences.

Patient-Centered 66

Patient-Centered IT Screening Patients 66

GeriPal

MARCH 28, 2024

Kate: It was done in 10 hospitals, 17 ICUs in Atrium Health down in North Carolina. Asking clinicians to document prognosis did not change the primary outcome of hospital length of stay or really any of the secondary outcomes, which I’ll get into. Also the same hospital system? That’s when they got enrolled.

Consulting 115

Consulting Patient-Centered IT Patients 115

GeriPal

AUGUST 29, 2024

We must often deliver complex medical information that carries heavy emotional weight in pressured settings to individuals with varying cultural backgrounds, values, and beliefs. Your patients expect you to care for them, their mental well being, their physical well being. Gordon 41:13 The hospital is also on fire. And I want.

IT 132

IT Illness Family Families 132

GeriPal

JANUARY 30, 2025

However, lack of physical presence may make this contender struggle to land the emotional support punch that is at the very heart of palliative care. If they physically come here, it’s sort of just the natural course of things that they’ll walk into the room with the patient. Lynn 37:39 I was in the hospital.

Telehealth 105

Telehealth Patient-Centered IT Patients 105

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? I was trained in the hospital where it started, and we were trained to be bedside nurses. Sue 01:26 Thank you.

IT 104

IT Patient-Centered Family Families 104

GeriPal

JUNE 9, 2022

Palliative care, in contrast, saw explosive growth in US hospitals. They were at the VA, but not so much at our main hub hospital where I trained. I do tend to focus in the hospital setting. That’s just not how the hospital works. Or the hospital, the intervention delivery is by who’s in practice.

Consulting 99

Consulting Patient-Centered Diagnosis Referral 99

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.

Healthcare 100

Healthcare IT Community Illness 100

GeriPal

JULY 11, 2024

So if one of my patients gets admitted, I also see them on the inpatient side of our hospital. I’m embedded in the ICU in one of our smaller hospitals. As this patient has an x percent mortality in three months, there’s a little more nuance to it, and it isn’t really applied to the individual. So I go between.

Patient-Centered 109

Patient-Centered IT Patients Clinic 109

GeriPal

MAY 12, 2022

I mean, just such struggles around corruption in hospitals, access to opioid pain medication, and you almost had to wait until a friend of yours was in power, so you could have access, get permission. What she called total pain, physical, psychosocial, and spiritual, and she started addressing it. They shared their experiences.

Community 115

Community IT Relationship Healthcare 115

GeriPal

MAY 9, 2024

How you actually physically started doing this and built up so many followers over time and why are you doing it? Alex: Generally in the hospital-based hospice. Matt: I’m more of a hospital guy. Eric: So we got a lot to talk about. And that’s not particularly sexy. Alex: Not frequently, no. Sammy: Oh, okay.

Education 127

Education IT Illness Healthcare 127

GeriPal

MAY 4, 2023

We remember bucking the rules, figuring out who you are, hair on fire, feeling invulnerable, trying to figure out who you are – and now those adolescents are stuck in the hospital, with doctors and parents telling them what to do, having their autonomy crushed by the medical institution, realizing they’re not invulnerable.

IT 83

IT Family Families Illness 83

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. To this day, Ken’s post is still one of the most searched and viewed posts on GeriPal. Eric: What was that paper?

Patient-Centered 96

Patient-Centered Patients IT Hospital 96

GeriPal

APRIL 13, 2023

And so I was really thinking about why are some of my people that are hospitalized doing better than others? I think some of that is from some of my thinking about maybe what I can potentially think about with the individual to support them. And so really thinking about people’s individual experiences, what might help for them.

IT 99

IT Community Patient-Centered Medical 99

GeriPal

MARCH 10, 2022

On today’s podcast we dive into drivers of invasive procedures and hospitalizations in advanced dementia by talking to some pretty brilliant nursing and nurse practitioner researchers focused on dementia, geriatrics, and palliative care in nursing homes: Ruth Palan Lopez, Caroline Stephens, Joan Carpenter, and Lauren Hunt. Ruth: Thank you.

Nurse Practitioner 60

Nurse Practitioner Hospital Family Families 60

GeriPal

FEBRUARY 9, 2023

It also feels like, I also grew up in med school in a three hospital system. There’s the variation between the hospitals, feels like there’s cultural issues that play a role. They look at the signs and symptoms, they do a physical exam, maybe some lab tests or some imaging. Eric: Yeah. Amber: Right, exactly.

Patient-Centered 111

Patient-Centered Patients IT Healthcare 111

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. When they built a new prison hospital in Stockton, the dialysis went there. Michele: Yeah. We have that.

Family 132

Family Families IT Community 132

GeriPal

JANUARY 11, 2024

So I didn’t mention this at the beginning, but after my time as President of Canadian Psychiatric Association, I actually also went on to be the physician chair of my former hospital’s MAID team. Because in medicine as somebody who works in the hospital, there’s always other treatment options.

Illness 144

Illness IT Medical Provider 144

GeriPal

OCTOBER 5, 2023

I have never had a patient come into the hospital and say, Doctor, regardless of what you do, do a little CPR that’ll make me feel better. I would say most of the time we offer CRT in the hospital. It’s such a physical act, showing just how strong doctor’s moral resolve is to save a life. This is Eric Widera.

Illness 136

Illness IT Patient-Centered Family 136