PEMBlog

SEPTEMBER 6, 2023

Patients with psychosis caused by medical illness usually have abnormal vital signs, altered mental status, and impaired orientation with compromised intellectual function. Laboratory evaluation should be based on individual patient history and exam. Visual and tactile hallucinations (as opposed to auditory) are frequently prominent.

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Lab Testing Medical Patients Mental Health 52

Pamela Wible MD

JUNE 20, 2025

(Published 3/18/19, updated 6/20/25) What Is Physician “Burnout”—and Why It Matters Physician “burnout” is a state of emotional, physical, and mental exhaustion caused by prolonged stress in the medical workplace. So why are physicians experiencing physical and mental collapse from overwork?

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Medical Student Diagnosis Physicals Medical 246

The Clinical Problem Solvers

AUGUST 25, 2020

Pearls Defining Structural Racism Structural racism is a term that acknowledges that racism is perpetuated beyond individual interactions and interpersonal racism, but is present in the systems and policies that govern our everyday lives. N Engl J Med. 2016;375(22):2113-2115. doi:10.1056/NEJMp1609535 Alyasah Ali Sewell, Justin M.

Community 52

Community Patient-Centered Education Relationship 52

GeriPal

JUNE 8, 2023

Should we use Ozempic (if we can find it) in patients with serious illness, which often results in undesirable and profound weight loss? And my hypothesis is that’s because it’s no longer the individual managing their own diabetes, it’s the nursing home staff managing their diabetes. Listen in to learn more!

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Diabetes Management Patient-Centered Family 73

GeriPal

MAY 8, 2025

We’ll discuss three recent clinical trials involving patients with serious illness, joined by our guests James Downar , Ali John Zarrabi , and Margaret Ross. We’re going to be talking about new research in psilocybin in serious illness. Vincent’s Hospital in Melbourne, Australia. This is Eric Widera.

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Illness IT Patient-Centered Patients 107

The Clinical Problem Solvers

MAY 2, 2022

Dr. Valtis is a 4th year Med-Peds Resident at Brigham & Women’s Hospital and Boston Children’s Hospital, and his research focuses on race and the utilization of security responses in the inpatient hospital setting. Yannis Valtis, Ebi Okah, and Carine Davila, about research in their respective fields.

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Healthcare Utilities Hospital Internal Medicine 52

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.

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Patient-Centered Referral Patients IT 102

GeriPal

SEPTEMBER 22, 2022

Coming off as rote and scripted during a serious illness conversation can have a similar off-putting impact on patients and families. One bump is just the classic pitfalls we often talk about in serious illness communication: being very jargony, very information focused, and just providing information. It flows very well. Eric: Yeah.

Illness 101

Illness IT Patient-Centered Patients 101

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.

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Patient-Centered IT Illness Patients 122

GeriPal

DECEMBER 19, 2024

Still, we havent talked about integrating palliative care into psychiatry or in the care of those with severe mental illness. What does it look like to take a palliative approach to severe mental illness? Is “terminal” mental illness a thing? For more details, please click here. (AP AP Recruit Job No.

Illness 101

Illness Mental Health IT Patient-Centered 101

GeriPal

OCTOBER 5, 2023

Summary Transcript Summary Communicating about a serious illness is hard. Last week’s podcast we talked about the challenge around miscommunication in serious illness. Why it’s such a natural way to explain the condition of someone with an acute critical illness that’s threatening their life. This is Eric Widera.

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Illness IT Patient-Centered Family 136

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.

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Patient-Centered Hospital Patients IT 132

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?” Bennett, C.R., Schilling, L., Doorenbos, A. PMID: 26701962.

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Patient-Centered Illness Healthcare IT 115

GeriPal

JULY 28, 2022

GeriPal post on “fast food” style palliative care in chronic critical illness. 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. Additional links: Editorial on Areej’s study. Palliative care in lung and GI cancers. Transcript.

Illness 110

Illness Hospital Patient-Centered Patients 110

GeriPal

AUGUST 29, 2024

Summary Transcript CME Summary Serious illness communication is hard. We must often deliver complex medical information that carries heavy emotional weight in pressured settings to individuals with varying cultural backgrounds, values, and beliefs. Eric 01:42 So we’ ve got an exciting topic today. Eric 05:03 Nice.

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IT Illness Family Families 132

GeriPal

JULY 21, 2022

Love to talk about also in the serious illness population. 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. Or somebody who has other physical cognitive problems at any age.

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IT Family Families Diagnosis 102

GeriPal

DECEMBER 15, 2022

So during the dissertation, that was a method for my PhD research and that’s related to… I was learning about African American elders experiences of psych-social-spiritual healing and serious illness. Been in the hospital four times, vented, been told the story to her family, she won’t live.

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IT Patient-Centered Healthcare Illness 105

GeriPal

JUNE 9, 2022

Palliative care, in contrast, saw explosive growth in US hospitals. We can’t possibly meet the needs of all people with newly diagnosed serious illness. She’s also a member of the PAIR Center, which stands for Palliative Advanced Illness Research Center. I do tend to focus in the hospital setting.

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Consulting Patient-Centered Diagnosis Referral 99

GeriPal

JANUARY 11, 2024

To be eligible in Canada patients must have a “ grievous and irremediable ” condition, including disability ; they do not have to have a terminal illness with a prognosis of less than 6 months. A planned expansion of MAID to include people with mental illness was placed on hold until March 2024. So less than six months to live.

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Illness IT Medical Provider 144

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.

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IT Family Families Illness 83

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.

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Complication Patient-Centered IT Patients 52

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. His story, which he shares on todays podcast, is remarkable.

Healthcare 100

Healthcare IT Community Illness 100

GeriPal

FEBRUARY 8, 2024

Hospital Chaplains, Spirituality, and Pain Management: A Qualitative Study. The illness narratives suffering, healing, and the human condition. I mean, to me, the Buddhist concept that there are multiple forms of suffering, like there’s the suffering that’s due to pain and physical symptoms. Pain Manag Nurs.

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IT Family Families Physicals 137

GeriPal

MAY 9, 2024

all of whom focus their efforts on educating the general public about living and dying with a serious illness. How you actually physically started doing this and built up so many followers over time and why are you doing it? We’ve invited: Julie McFadden (aka Hospice Nurse Julie ): Julie is a social media superstar, with 1.5

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Education IT Illness Healthcare 127

PEMBlog

MARCH 27, 2024

She aims to become a physician-scientist in pediatrics and medical genetics, engaging in bench-to-bedside research that utilizes multi-omics-based approaches to provide a molecular diagnosis and support personalized care for individuals with suspected rare genetic diseases and their families. References Jeanmonod R, Asuka E, Jeanmonod D.

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Consulting Individual Family Families 59

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. We really spent a lot of time helping the clinicians see that a patient’s illness, understanding and prognostic awareness was just as important as their pain scale, their pain score.

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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. by Kearney. Lovely to be here.

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IT Patient-Centered Family Families 104

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.

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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.

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Consulting Patient-Centered IT Patients 115

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?

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Patient-Centered Patients IT Hospital 96

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.

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Community IT Relationship Healthcare 115

GeriPal

JULY 11, 2024

We get a bit of, in the veteran population, kind of a mix of a lot of mental health issues thrown into these comorbid illnesses, including cirrhosis, but it’s usually the decompensated cirrhotics or the folks with liver cancer and cirrhosis, or one of both. I’m embedded in the ICU in one of our smaller hospitals.

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Patient-Centered IT Patients Clinic 109

GeriPal

AUGUST 24, 2023

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. Had multiple physical, psychological complications as a result of that. I mean, I was very much a clinician.

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Patient-Centered Patients IT Illness 98

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’s just not.

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IT Healthcare Healthcare Professional Patient-Centered 110

GeriPal

JUNE 22, 2023

But now we have older people dying of older people illnesses. 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. The person didn’t believe in the medications.

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Family Families IT Community 132

GeriPal

FEBRUARY 9, 2023

For example, we spend the first half talking about a RCT simulation study of clinician verbal and non-verbal communication with a seriously ill patient with cancer. It also feels like, I also grew up in med school in a three hospital system. We find the same thing when you actually measure at the level of the hospital.

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Patient-Centered Patients IT Healthcare 111

GeriPal

APRIL 13, 2023

Summary Transcript Summary Social connections impact our health in profound ways, whether it is the support we receive from family and friends in navigating serious illness, the joy from shared social activities, or connecting with our community. And so really thinking about people’s individual experiences, what might help for them.

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IT Community Patient-Centered Medical 99