GeriPal

MAY 11, 2023

Should do medicine?” ” Because I loved internal medicine. Now, that doesn’t mean it’s a one-to-one, and this is very hard as we see it with our patients who have done all these things. So, for me, I don’t think it’s something I would advocate for patients. Should I do neuro?

Physicals 85

Physicals IT Hypertension Education 85

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?

Patients 72

Patients Clinic Patient-Centered Illness 72

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. Widera and Smith have no relationships to disclose.

Illness 129

Illness IT Diagnosis Patient-Centered 129

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 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.

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. Is the patient in your descriptor?

Patient-Centered 109

Patient-Centered IT Patients Healthcare 109

GeriPal

MAY 18, 2023

There are some older adults in whom these are the correct drugs, either because of their particular clinical circumstances or because shared decision making and patient values and preferences. So we want to alert clinicians as well as patients and policy makers to the presence of these drugs. Is this the right drug for this patient?”

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. She was a heart failure patient. What’s in a story?

Patient-Centered 115

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. .

Illness 109

Illness IT Family Families 109

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

APRIL 28, 2022

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. Patients will tell our team after we’ve been through, “Oh, I just love that I was able to laugh with you guys. Nathan: I do.

IT 145

IT Hospital Patients Illness 145

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.

Patient-Centered 96

Patient-Centered Patients IT Hospital 96

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.

Hospital 125

Hospital IT Patient-Centered Patients 125

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.

Patient-Centered 77

Patient-Centered IT Hospital Patients 77

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

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. And it was born when I was a medical resident at UCSF Internal Medicine. Because we all interface with it at the end of the day as patients.

IT 107

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. If its potentially unsafe, but has robust evidence, well thats most of the treatments we offer seriously ill patients! Think chemotherapy to imminently dying patients, or CPR. Think chemo.

Patient-Centered 77

Patient-Centered IT Patients Illness 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. Scientific American Letter to the Editor: Response to Downar et al.

Patient-Centered 98

Patient-Centered Patients IT Illness 98

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.

IT 66

IT Patient-Centered 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.

IT 122

IT Patient-Centered Patients Relationship 122

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? And so it was really the patients, you know, the caregivers, the family members were the ones who were sort of the closest in observing. Who would/should be on that board?

Consulting 63

Consulting Community Patient-Centered Family 63

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.

IT 70

IT Patients Medical Illness 70

GeriPal

MAY 29, 2025

Particularly patients, families. Eric 05:30 And Andrew, I remember when I was a med student, I had a patient with a diffuse brain injury in the ICU on a ventilator. People are patients, families are wondering if their loved one is still in there. You know, I’ve been trying to think of metaphors for thinking about this.

Family 93

Family Families IT Patient-Centered 93

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. Nursing homes are subsidized by their Medicare, by their rehab patients. The Lived Experience of Providing Feeding Assistance to a Family Member with Dementia.

Nurse Practitioner 60

Nurse Practitioner Hospital Family Families 60

GeriPal

MARCH 6, 2025

And I wonder if that is key in patients, people who are experiencing homelessness as well. As you can imagine, get referrals from healthcare workers, emergency departments, primary care, cancer care hospital, you know, internal medicine to our service. Or as we said in the podcast, abandonment. Naheed 21:58 Absolutely.

Healthcare 100

Healthcare IT Community Illness 100

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. Widera and Smith have no relationships to disclose.

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.” Widera and Smith have no relationships to disclose. What is ambivalence?

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? And so we had this run of consults and we walked out of each consult thinking and talking about how different each patient’s experience was. Eric: So not from the patient perspective or family, but from the provider perspective? Doing home care?

Patient-Centered 119

Patient-Centered IT Patients Consulting 119

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?

Family 106

Family Families Patient-Centered IT 106

GeriPal

JULY 7, 2022

And I was an internal medicine resident. Haider: And because it is so subjective and because we have these arbitrary rules around what the right patient with pain looks like, I think we really trap patients in a really difficult situation. One of the patients I spoke to really said this quite well.

Patient-Centered 105

Patient-Centered Physicals IT Patients 105

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.

Primary Care 79

Primary Care IT Clinic Illness 79

GeriPal

JULY 6, 2023

And just going back to that patient, I’ll tell you, before I started this role, I would have probably looked at the handout box in our clinic and been like, oh, okay. We just kind of start to amass these handouts and I would give them to the patient. Is it the patient? Eric: Wait, county 911? Lindsey: Our county 211.

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 a lot of my patients at that time identified as older asian immigrant. question used to screen for domestic violence.

Mental Health 116

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. 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.

Patient-Centered 93

Patient-Centered IT Community Illness 93

GeriPal

FEBRUARY 2, 2023

Bob: Well, it changed how I helped talk to people who are seriously ill and it acknowledged some of the feelings that I have and helped me be more aware of those feelings when I’m taking care of patients. Bob: It’s a little bit like patient care, right? Eric: Yeah. It can be your second or third reaction. Eric: Yeah.

IT 104

IT Medical Student Medical Family 104