My Green Doctor

MAY 3, 2025

Powering Health, Protecting the Planet – Why Renewable Energy Belongs in Every Clinic Healthcare professionals have always been trusted voices on public health. This isn’t just about saving the planet—it’s also about saving money, protecting patients, and strengthening our healthcare systems from the inside out.

Clinic 52

Clinic Healthcare Healthcare Professional Consulting 52

GeriPal

MARCH 14, 2024

This simple challenge was focused on putting ourselves in the shoes of our patients with dysphagia who are prescribed thickened liquids. And I think that we’re at this kind of crossroads right now in dysphagia, and dysphagia management where our patients are suffering. We revisit it, and make things better for our patients.

IT 125

IT Patient-Centered Hospital Individual 125

GeriPal

JULY 19, 2024

What hasn’t been shown, Eric, is that if you apply tools like this, clinical outcomes down the road are better for patients. So I think we’re poised now with the guide model and with the evidence we have about healthcare utilization, impact on caregivers, course of dementia, comorbidity management and all of that.

Screening 120

Screening Primary Care Patient-Centered IT 120

GeriPal

MAY 5, 2022

COVID-19, masks, and hearing difficulty: Perspectives of healthcare providers. Association of Sensory and Cognitive Impairment With Healthcare Utilization and Cost in Older Adults. Including more hospital utilization or healthcare utilization, maybe cognitive impairment issues. Is that right?

IT 102

IT Screening Hospital Clinic 102

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. Going into patient’s homes was eye opening. It was eyeopening to see patients in their own home. And so that really triggered my interest.

Community 116

Community Transportation IT PCP 116

GeriPal

JANUARY 25, 2024

He also found gaps, including very few studies of patients with lung disease, and little impact of trials on quality of life. Your research is a lot in this patient population, right? However, its main predictors are age, comorbidity, and healthcare utilization. Big randomized control study that came out. Lyndsay: Yes.

Patient-Centered 123

Patient-Centered IT Illness Patients 123

GeriPal

APRIL 14, 2022

Adapting Palliative Care Skills to Provide Substance Use Disorder Treatment to Patients With Serious Illness . And I remember being there and there was a patient who had seen inpatient and then subsequently outpatient who was so thankful in the weirdest in just this irrational way for having been diagnosed with liver cancer.

Illness 103

Illness Patient-Centered IT Patients 103

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 133

Patient-Centered Hospital Patients IT 133

GeriPal

OCTOBER 19, 2023

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. For a trial to have value, it should not exclude patients over age 80, or those with dementia, or patients residing in nursing homes.

Patient-Centered 127

Patient-Centered IT Patients Illness 127

GeriPal

MARCH 28, 2024

What we did was ask clinicians earlier in the ICU stay for very sick patients to document prognosis, and for those who they thought would survive, to document six-month functional prognosis. Eric: And who are the patients including in this trial, again? Kate: These are very sick patients. I’m just stunned even writing that!

Consulting 116

Consulting Patient-Centered Patients IT 116

GeriPal

JUNE 9, 2022

Patients have all sorts of problems. We all focused on studying the outcomes for patients and families of our intervention and then the processes to get there. Whether it’s the consult rate or documentation of a conversation, hospice referrals, those kinds of things, and then patient outcomes, quality of life, symptom burden.

Consulting 100

Consulting Patient-Centered Diagnosis IT 100

GeriPal

FEBRUARY 2, 2024

First, in our editorial, we expressed concern about the length of stay metric not being patient centric, though important for health systems focused on cost savings. And, of course, this is what families of patients undergoing palliative care go through. This is 24,000 encounters, over 15,000 patients, 11 hospitals, eight states.

Consulting 122

Consulting Hospital Patient-Centered IT 122

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? Most emergency providers wanted to do the right thing for seriously ill patients, but they didnt have the knowledge, skills, or experience to do it.

Patient-Centered 78

Patient-Centered IT Hospital Patients 78

GeriPal

AUGUST 25, 2022

Second, Hospice was originally designed for patients with advanced cancer, but the fastest growing admitting diagnosis is dementia. Krista Harrison found , to her surprise, that caregivers of people with dementia who died rated hospice as well as similar patients without dementia who died on hospice. AlexSmithMD. Transcript.

Families 107

Families Family IT Patients 107

GeriPal

SEPTEMBER 1, 2022

So I’m going to last longer in my position and I’m going to seek opportunities to grow and to help families and patients more and more. And we’ll tell you the scope of practice, and this is top of license, and this is how you can best utilize a social worker and, no, actually that skillset belongs over here.”

IT 102

IT Families Family Clinic 102

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. Clinicians were randomized to 4 groups: Usual care Prognosis nudge – EHR prompt asking, do you think your patient will be alive in 6 months?

Patient-Centered 118

Patient-Centered Hospital IT Illness 118

BMJ

MAY 10, 2022

Two hundred seventy-six of the healthcare professionals were reached (response rate: 85.4%). 276 (100) *Column % ** The P-Value was calculated by Chi-square test Suggestions regarding vaccination: 60.1% (n=166) of healthcare professionals considered COVID-19 disease as a threat to their health. 150 (54.3) 126 (45.7)

Vaccination 40

Vaccination Healthcare Professional Healthcare Primary Care 40

GeriPal

APRIL 28, 2022

Eric: I’m looking forward to talking about art and humor in palliative care and we’re caring for seriously ill patients. If you look back to some of my cartoons from late in residency, they showed just how dehumanized I felt and definitely give windows into how dehumanized I imagined my patients to be. Nathan: I do.

IT 145

IT Hospital Patients Illness 145

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 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 64

Consulting Community Patient-Centered Families 64

GeriPal

JUNE 5, 2025

Eric 03:25 So we have a lot to talk about, but I’m wondering if we can kind of take a big step back and just talk about the patient population that’s in nursing homes. Connie 06:18 So, I’ve been a clinician working in the nursing home since back in the 80s, and I saw a lot of patients that really needed palliative care.

Nurse Practitioner 78

Nurse Practitioner Referral Consulting Board-Certified 78

GeriPal

DECEMBER 19, 2024

A NY Times article titled Should Patients Be Allowed to Die From Anorexia ? That’s how do we treat the mental health needs of patients with serious medical illness? So in those cases, can we adopt an approach to mental health care that centers primarily around quality of life of patients and their families?

Illness 102

Illness Mental Health IT Patient-Centered 102

GeriPal

APRIL 6, 2023

Today we have a star-studded lineup, including Lexy Torke of Indiana University, who discusses her RCT of a chaplaincy intervention for surrogates of patients in the ICU , published in JPSM and plenary presentation at AAHPM/HPNA. These studies are important. So, learn as many as you can and what they’re all about.

IT 99

IT Patient-Centered Families Family 99

GeriPal

MARCH 7, 2024

Whenever I take care of a patient, I see myself as a family practice doctor, but I’ve been a hospitalist, I’ve been a primary care doctor, and I’ve done palliative. But in the end, I see these as my patients and I’m trying to define what is the right model. I wonder, is this only for patients in hospice?

Provider 119

Provider Illness IT Healthcare 119

GeriPal

JANUARY 20, 2023

I know you’ve been a strong advocate for nursing home patients particularly in California. Eric: Yeah, I guess in the very beginning of the COVID pandemic really highlighting the structural issues, lack of PPE, really people ignoring it outside of just the place to send COVID patients to. It’s been such a challenge.

Finance 95

Finance Board-Certified IT Provider 95

FDA Law Blog

AUGUST 21, 2023

After all, the labeling is intended to do exactly that: it informs patients and prescribers of the risks to ensure the product is used effectively and in a manner that mitigates risks, according to FDA’s understanding of the relevant science. FDA, in other words, directed, and continues to direct, pregnant women to a learned intermediary.

Manufacturing 40

Manufacturing Consulting Healthcare Professional Vaccination 40

GeriPal

SEPTEMBER 19, 2024

Give too much, it may cause harm (even if the higher dose had no significant side effects, it would require patients to take a lot of unnecessary additional pills as well as increase the cost.) So, what is the effective dose of palliative care? Give too little – it may not work. Jennifer 04:25 I can take that on. Eric 05:32 Yeah.

Patient-Centered 120

Patient-Centered IT Patients Hospital 120

GeriPal

JUNE 26, 2025

And then when you see clinically patients coming into hospital, they’ll have, you know, they’ll be admitted for aspiration pneumonia. There are probably other pneumonias that don’t are treated as patients or patients are in hospice at the time that they develop the pneumonia and they’re not hospitalized.

Illness 63

Illness Hospital IT Patient-Centered 63

GeriPal

JULY 13, 2023

On that podcast he and collaborators tested a combined patient and clinician facing communication priming intervention to promote goals of care conversations. I wonder if we can just start off just going back a little bit because we had Randy on back in 2018 talking about Jumpstart, priming patients to do goals of care conversations.

Patient-Centered 84

Patient-Centered IT Patients Hospital 84

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

FEBRUARY 24, 2022

We see our patients and our families throughout the illness trajectory into the hospital. And maybe we should have more patient-centered conversations. We want to do meaningful work and so we want to know that the conversations we have impact patient care. Eric: Well, how about just with the debate? We see them struggle, right?

Illness 98

Illness Patient-Centered IT Patients 98

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.” Care Ecosystem.

Patient-Centered 126

Patient-Centered IT Families Family 126

FDA Law Blog

JUNE 1, 2025

The Protecting Patients from Deceptive Drug Ads Online Act, co-sponsored with Senator Mike Braun (R-IN), seeks to close regulatory gaps by empowering FDA to issue Warning Letters and impose fines on social media influencers and telehealth companies that promote prescription drugs without proper disclosures of risks and side effects.

Healthcare Professional 59

Healthcare Professional Manufacturing Healthcare Utilities 59

GeriPal

JULY 20, 2023

Clinicians could care for patients across state lines, could prescribe opioids without in person visits, could bill at higher rates for telemedicine than previous to the pandemic. Many patients benefited, not only those isolating due to covid, but also patients in rural areas, patients who are homebound, and many others.

Telemedicine 73

Telemedicine Telehealth Patient-Centered Board-Certified 73