GeriPal

AUGUST 4, 2022

My take home from this is that while the most preferred explanation for deprescribing statins and sedative-hypnotics is one focused on the risk of side effects, we also need to individualize it to the patient and the medication that they are taking. Welcome, Ariel. Ariel: Thanks. I’m excited to be here. Kevin: Thank you. Another in JAG.

Specialization 103

Specialization Medical Patient-Centered Provider 103

GeriPal

JUNE 20, 2024

Accreditation In support of improving patient care, UCSF Office of CME is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

IT 119

IT Patient-Centered Patients Clinic 119

GeriPal

OCTOBER 13, 2022

When I’m on service these days there is inevitably a moment when a resident says “Patient so-and-so is on X” – and I have absolutely no idea what X is. In this context, we’re excited to hear from infectious disease experts and nephrologists about updates in the care of older adults. Summary Transcript Summary. Welcome back Lona.

Complication 96

Complication Patient-Centered IT Patients 96

GeriPal

NOVEMBER 9, 2023

Today we learn more about coaching from 3 coaches: Greg Pawlson, coach and former president of the American Geriatrics Society, Vicky Tang, geriatrician-researcher at UCSF and coach , and Beth Griffiths, primary care internist at UCSF and coach. Summary Transcript Summary Coaching is in. We address: What is coaching? Indeed, matey.

Board-Certified 109

Board-Certified IT Primary Care Referral 109

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. Alex 00:26 And we’re delighted to welcome Emily Martin, who is a palliative care doc at UCLA. Anish 00:24 Thanks so much for having me. Evie 00:41 Thank you.

Patient-Centered 101

Patient-Centered Referral Patients IT 101

Plum Health

OCTOBER 11, 2024

Have you ever found yourself in need of medical attention but overwhelmed by the myriad of clinics and healthcare options out there? Navigating the healthcare system can be daunting, especially when you're unwell or caring for someone who is. 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

FEBRUARY 6, 2025

So, the question becomes, what, if anything, should we do differently in the primary care setting to diagnose the disease? On todays podcast, weve invited Nathaniel Chin back to the GeriPal podcast to talk about what primary care needs to manage this new world of Alzheimers disease effectively. Great to be back.

Primary Care 94

Primary Care Diagnosis Screening IT 94

GeriPal

JULY 3, 2025

Summary Transcript CME Summary In this week’s episode, we dig into two deceptively simple questions: When does someone become a cancer survivor, and should palliative care be in the business of caring for them? She’s a palliative care doc and researcher at Massachusetts General Hospital and Harvard Medical School.

Patient-Centered 90

Patient-Centered Illness Clinic IT 90

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 121

Patient-Centered IT Illness Patients 121

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. And also I was in the HVMA primary care program.

Primary Care 112

Primary Care Patient-Centered IT Patients 112

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 128

Illness IT Diagnosis Patient-Centered 128

GeriPal

FEBRUARY 15, 2024

Going into patient’s homes was eye opening. They were stunned by the number of calls for lift assistance for older adults who had fallen. There were trip hazards, loose carpets, some people were hoarders. And yet, after assisting the older adult to their feet, the EMS providers would leave. Their job was done. Alex: That is true.

Community 113

Community Transportation IT PCP 113

GeriPal

SEPTEMBER 7, 2023

Does it improve outcomes that patients, caregivers, and clinicians care about? hint: 80% can be done in advance by patients or caregivers) Why is it that some oncologists are resistant to conducting a geriatric assessment, yet have no problem ordering tests that cost thousands of dollars? Welcome back, William. Alex: Thank you.

Patient-Centered 128

Patient-Centered IT Patients Clinic 128

GeriPal

NOVEMBER 14, 2024

Summary Transcript CME Summary Falls are very common among older adults but often go unreported or untreated by healthcare providers. Patients may feel like falls are just part of normal aging. This is Sarah Berry, who is at the Hebrew Senior Life and Beth Israel Deaconess Medical center and Harvard Medical School.

IT 123

IT Screening Patient-Centered Community 123

GeriPal

OCTOBER 10, 2024

The many arguments, theories, & approaches across settings and conditions are explored in detail in the book they edited, “ Intentionally Interprofessional Palliative Care ” (discount code AMPROMD9). Of note: these lessons apply to geriatrics, primary care, hospital medicine, critical care, cancer care, etc, etc.

Screening 118

Screening IT Families Family 118

GeriPal

JANUARY 18, 2024

Summary Transcript Summary The CDC’s Guideline for Prescribing Opioids for Chronic Pain excludes those undergoing cancer treatment, palliative care, and end-of-life care. Jessie, last time we had you on in 2017, we asked you the question, should palliative care fellowship training include management of chronic pain?

Illness 135

Illness Patient-Centered Screening IT 135

GeriPal

JUNE 15, 2023

AlexSmithMD Links: Papers on AI and palliative care and concerns about bias: [link] [link] Comparison of machine learning vs traditional prognostic methods based on regression: [link] Other links on the issue of AI and racial or ethnic bias: Are Robots Racist? I’m sure this is a subject we will return to, given the rapid progress on AI.

IT 99

IT Patient-Centered Patients Healthcare 99

GeriPal

JUNE 19, 2025

Alex 00:41 And we’re delighted to welcome Noelle Marie Javier, who goes by “she” “her” and is a geriatrician and palliative care doc professor, newly minted – c ongratulations – And a clinician educator at Mount Sinai in New York City. Jace, welcome to the GeriPal Podcast. Noelle Marie 01:19 Cyndi Lauper’s True Colors.

Individual 84

Individual Community IT Chronic Condition 84

GeriPal

MAY 25, 2023

Others cited the call from communities to meet them where they are – be they senior centers, Black-owned businesses, or churches (we have a podcast planned in the fall with Fayron Epps and Karen Moss on the church setting). Eric: On today’s podcast, we’re going to be talking about improving equity in advance care planning.

Community 95

Community IT Patient-Centered Primary Care 95

GeriPal

NOVEMBER 2, 2023

But, it’s also hard not to be bullish on the future of the field to see the consistent strides geriatrics has made in the last two decades in improving care for older adults. I’ve seen this question come up a lot since finishing fellowship nearly two decades ago. Mike, welcome to GeriPal. Mike: Great to be here. It was JAMA, right?

Board-Certified 90

Board-Certified IT Community Medical Student 90

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 131

Patient-Centered Hospital Patients IT 131

GeriPal

JUNE 9, 2022

In contrast to geriatrics, the evidence base for palliative care lagged clinical growth, in part because palliative care has no centralized “home” at the National Institutes of Health. The National Palliative Care Research Center (NPCRC)and Palliative Care Research Cooperative (PCRC)were founded in part to meet this need.

Consulting 99

Consulting Patient-Centered Diagnosis Referral 99

GeriPal

JUNE 16, 2022

And in my medical training, becoming a primary care doctor, I realized that older adults, women and men were having a lot of these same symptoms. Very interested in decision making around as we get older, individualizing care, sort of patient centered, values driven, it’s a tough decision to figure out.

Management 120

Management IT Medical Patient-Centered 120

GeriPal

MARCH 28, 2024

And we have Kate Courtright, who’s at University of Pennsylvania, the PAIR Center. They study palliative care. She’s pulmonary critical care and palliative medicine trained. And we have Tom LeBlanc, who’s from Duke, who is also palliative care trained and an oncologist. We’ve come so far as a field.

Consulting 114

Consulting Patient-Centered IT Patients 114

GeriPal

APRIL 4, 2024

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. The hospital refused without a court order, and the case eventually made its way to the Supreme Court.

Families 111

Families Family Patient-Centered IT 111

GeriPal

AUGUST 17, 2023

However, as noted in our editorial published with the donanemab trial , the modest benefits of amyloid antibodies would likely not be questioned by patients, clinicians, or payers if amyloid antibodies were low risk, inexpensive, and simple to administer. However, they are none of these. Welcome back to the GeriPal podcast, Jason.

Patient-Centered 98

Patient-Centered IT Clinic Patients 98

GeriPal

OCTOBER 20, 2022

And, who within ASPE guides aging policy and connects policy to every day health challenges experienced by patients and clinicians? We also touch briefly on topics discussed in prior podcasts such as loneliness and federal responses to the pandemic in relation to long-term care. How to make your voice heard and get involved.

Complication 52

Complication Patient-Centered IT Patients 52

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. Summary Transcript Summary. She falls and breaks her hip.

Patient-Centered 101

Patient-Centered Complication Patients IT 101

GeriPal

MARCH 24, 2022

Completion of advance directives and billing codes for advance care planning as quality metrics. Links to a few couple items mentioned on the podcast: Objectives for Advance Care Planning. Alex: And we have returning, Bob Arnold, who is a palliative care doctor at the University of Pittsburgh. Among other topics. Here we go.

Illness 72

Illness IT Healthcare Patient-Centered 72

GeriPal

APRIL 10, 2025

Summary Transcript CME Summary Early in my research career, I was fascinated by the (then) frontier area of palliative care in the emergency department. 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?

Patient-Centered 76

Patient-Centered IT Hospital Patients 76

GeriPal

AUGUST 11, 2022

We talk with Susan about how far the field has come, from early days when the attending physician would decide which patients were DNR and place a black “no code” dot in the chart. Susan: Well, I think first of all, there was no palliative care back then. We talk about challenges facing the field today. Brian: Thanks so much.

Illness 108

Illness IT Families Family 108

BMJ

MAY 10, 2022

Family health centers are the facilities where the vaccination intention is much more vital, as they carry out the contact and case follow-ups during the pandemic and are the center of vaccination application. There are 44 family health centers, including 158 family physicians and 165 family health workers working in the district.

Vaccination 40

Vaccination Healthcare Professional Healthcare Primary Care 40

GeriPal

JUNE 23, 2022

Mara Schonberg is associate professor of medicine at Beth Israel Deaconess Medical Center and Harvard Medical School. In the podcast she gives very practical advice with language to use, and references her decision aid, which is available on ePrognosis here. Mara keeps working at it, and the more she works, the closer we are to fine.

Screening 98

Screening PCP PCP IT 98

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.

Patient-Centered 76

Patient-Centered IT Patients Illness 76

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 Illness 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

MARCH 7, 2024

It was started by a social worker who really saw some gaps in care with those at end-of-life, particularly those with chronic long-term illness, having important conversations. But before we jump into that topic, John, do you have the song request for Alex? John: I do. It’s Jimmy Buffett’s song, Bubbles Up. You were a what?

Provider 116

Provider Illness IT Healthcare 116