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. Summary Transcript Summary “Anxiety is a lot like a toddler.

Illness 129

Illness IT Diagnosis Patient-Centered 129

GeriPal

FEBRUARY 27, 2025

We address: Why is caring for patients with this overlap so hard? Inspired by Dani Chammass paper in Annals of Internal Medicine titled, Wishing for a no show we talk about countertransference: start by asking yourself, Why am I having difficulty? Who follows the patient once the cancer goes into remission?

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Patients Clinic Patient-Centered Illness 72

GeriPal

DECEMBER 15, 2022

Along the way we address: Is this degree of slowed cognitive decline meaningful to patients or care partners? Eric: So we’ve had an interesting topic today, storytelling and medicine, narrative medicine… We’ll talk about what we should call it, but before we do, Heather, I think you have a song request.

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IT Patient-Centered Healthcare Illness 105

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. Eric 01:27 So we ve got a podcast on music and medicine. Theresa 00:32 Thank you. Come join us.

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IT Patient-Centered Patients Board-Certified 96

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. He’s in Boston. Parag 01:06 Thank you.

Primary Care 113

Primary Care Patient-Centered IT Patients 113

GeriPal

JANUARY 16, 2025

So I think the first reason that we saw and felt the opportunity was ripe for updating was that some of us had come across some anecdotal examples of patients expressing some offense to that terminology. And I was asking this patient about if he had filled out an advanced directive. Can you guys do that one? Eric 02:39 Absolutely.

Patient-Centered 109

Patient-Centered IT Patients Healthcare 109

GeriPal

MAY 18, 2023

We’re delighted to welcome Mike Steinman, who’s a geriatrician professor of medicine at UCSF in the division of geriatrics, prior guest on this podcast. Alex: And we’re delighted to welcome Todd Semla, who is a clinical pharmacist and associate professor at the Feinberg School of Medicine at Northwestern University.

Medical 97

Medical IT Patients Clinic 97

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.

Management 116

Management Patient-Centered Patients IT 116

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. VA “gets” the importance of storytelling in medicine, without the need for reams of research to back it up. Because that really is what this is about. What’s in a story?

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Patient-Centered Illness Healthcare IT 115

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. . Brian: Thanks so much.

Illness 109

Illness IT Family Families 109

GeriPal

APRIL 28, 2022

Graphic Medicine. Nathan is a Palliative Care doctor and an assistant professor of Medicine at Johns Hopkins. Times , The BMJ , and Annals of Internal Medicine. . Eric: I’m looking forward to talking about art and humor in palliative care and we’re caring for seriously ill patients. Graphic Novels.

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IT Hospital Patients Illness 145

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. This field is not new. At the end we also pay tribute to Randy Curtis, senior author on this paper and mentor to Liz. Eric: Great.

Hospital 125

Hospital IT Patient-Centered Patients 125

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?

Patient-Centered 116

Patient-Centered Hospital IT Illness 116

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. Alex 02:53 Did the patient survive the CPR?

Patient-Centered 77

Patient-Centered IT Hospital Patients 77

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. That’s medicine. What’s the value of stories in medicine? Emily 03:59 Medicine is both a science and an art. Eric 00:18 Throwing us off.

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IT Community Patients Family 107

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. We discuss an article they wrote about PULET for the American Journal of Hospice and Palliative Medicine, including: What makes a PULET a PULET? How does integrative medicine fit in with this?

Patient-Centered 77

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. Alex: (Singing).

Patient-Centered 96

Patient-Centered Patients IT Hospital 96

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. Mariah, welcome to the GeriPal Podcast. Mariah 00:29 Glad to be here.

IT 66

IT Patient-Centered Screening Patients 66

GeriPal

AUGUST 24, 2023

We talk with Harvey about how he defines “dignity” and how we can understand what it means to our patients. Fox gives patients hope there may be a place that illness doesn’t touch Depression is a Liar Why is Being a Patient Such a Difficult Pill to Swallow Better Patient Care Calls for a ‘Platinum Rule’ to Replace the Golden One.

Patient-Centered 98

Patient-Centered Patients IT Illness 98

GeriPal

MAY 29, 2025

Particularly patients, families. Summary Transcript CME Summary Have any of you watched the movie The Notebook ? At the end, one of the characters, who has dementia, experiences an episode of lucidity. When I watched it, between tears (Im a complete softie) I remember thinking, Oh no! This will give people false hope! Thanks for having me.

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Family Families IT Patient-Centered 93

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 6, 2025

And it just really upset me internally that we were living in a society where we were letting people fall through the cracks again, again, again and again at the end of life. Eric 05:34 Let me ask you this, is that probably every one of us and every intern and resident has cared for a Terry. Homelessness? Marginally housed?

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Healthcare IT Community Illness 100

GeriPal

MARCH 31, 2022

And maybe, just maybe, we convince that poetry skeptic Eric Widera that there is a place for poetry in medicine after all. Patient Poets: Illness from the Inside Out. I think it’s titled Patient Poets Illness. Marilyn: Patient Poets: Illness From Inside Out. Alex: Patient Poets: Illness From Inside Out.

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IT Patients Medical Illness 70

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? Does every institution need to get a community advisory board to tailor their rural tele-palliative care initiative (or geriatrics intervention) to the local communities served? Which is it?

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Consulting Community Patient-Centered Family 63

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?

IT 87

IT Patient-Centered Patients Medical 87

GeriPal

MARCH 10, 2022

Archives of Internal Medicine 2010. One of them is Karen Steinhauser’s Annals of Internal Medicine paper on, In Search of a Good Death. For a deeper dive, check out some of these other studies and resources we talked about in the podcast: The Influence of Nursing Home Culture on the Use of Feeding Tubes.

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Nurse Practitioner Hospital Family Families 60

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. MOC points per podcast in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Who do we have with us on this podcast?

IT 116

IT Diabetes Chronic Disease Patient-Centered 116

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.” What about ambivalence on the part of the provider?

Patient-Centered 128

Patient-Centered IT Patients Consulting 128

GeriPal

APRIL 26, 2024

Who spends the most time with the patient in the infusion center? MOC points per podcast in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Summary Transcript Summary As Betty Ferrell says on our podcast today, nurses play an essential role in care of people with serious illness.

Patient-Centered 119

Patient-Centered IT Patients Consulting 119

GeriPal

JULY 7, 2022

So take a listen and if you are up for it, check out some of Haider’s other books including Modern Death: How Medicine Changed the End of Life and State of the Heart: Exploring the History, Science, and Future of Cardiac Disease. . Haider is a physician at the Brigham and Women’s Hospital, and the VA in Boston. This is hurting me.

Patient-Centered 105

Patient-Centered Physicals IT Patients 105

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. MOC points per podcast in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Why do this? You got it.

Family 106

Family Families Patient-Centered IT 106

GeriPal

JULY 6, 2023

Summary Transcript Summary You may have heard of Area Agencies on Aging, but do you really know what they do or how they do it? What about State Departments of Aging or state master plans for aging? Do you know how these agencies fit in with programs like Meals-on-Wheels or other nutritional support programs? Susan: It is my anthem.

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Community Nurse Practitioner Provider IT 89

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. Jennifer, welcome to the GeriPal Podcast. Jasmine, is it you?

Primary Care 79

Primary Care IT Clinic Illness 79

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? Ongoing reports from patients about anti-Asian hate experiences Should clinicians screen for Anti-Asian hate?

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Mental Health Community Screening IT 116

GeriPal

FEBRUARY 2, 2023

It is not surprising we would internalize these norms. Summary Transcript Summary Sometimes you read a book and get a flash of insight – that “ah ha!” moment – about yourself and the ways you interact with others. That happened to me when reading “Range: Why Generalists Triumph in a Specialized World.”

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IT Medical Student Medical Family 104

GeriPal

APRIL 21, 2022

Poetry holds us in that liminal space so many of our patients are in. Then it really wasn’t until I got into medicine, medical school and residency, that I discovered poetry per se, and a mentor commented, I think to a number of us on this podcast, Steve McKee introduced me to poetry. To let it go. . Eric: What song is it?

Patient-Centered 93

Patient-Centered IT Community Illness 93

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.” Malaz: I love it.

Patient-Centered 125

Patient-Centered IT Family Families 125