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New Report: U.S. Primary Care System Crumbling Amid Historic Disinvestment and Surge in Chronic Diseases

The Physicians Foundation

Scorecard with National and State Level Data Reveals Workforce Shortages, Low Primary Care Reimbursement, and Reduced Patient Access to Vital Services February 18, 2025 – As the nation faces a widespread surge in chronic diseases, the third Primary Care Scorecard highlights how systemic disinvestment in U.S.

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RCT of Palliative Care for Heart Failure and Lung Disease: David Bekelman and Lyndsay DeGroot

GeriPal

We are also joined by Diah Martina, a palliative care doctor trying to grow palliative care in Indonesia, in part by starting a palliative care podcast in Indonesian (she was observing today). People had to be in the top 20th percentile of risk for being hospitalized or dying in the next year. David: Yeah, yeah, I agree.

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CDC Proposes Updating Practice Guideline for Prescribing Opioids, Warning Against Continued Misapplication

FDA Law

As explained more fully below, CDC concedes that states, insurers, pharmacies and pharmacy benefit managers have implemented laws, regulations and policies that have misapplied the 2016 guideline. Clinicians should use noninvasive, nonpharmacologic approaches to help manage chronic pain. (b) 7,838 (Feb. 2016 Guideline. Methodology.

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Implementing Palliative Care in Nursing Homes: A Podcast wtih Connie Cole, Kathleen Unroe, and Cari Levy

GeriPal

And so I tried to get her actually to pain management, and I couldn’t. Pain management wouldn’t come to the facility, and she was bedbound. And so it really got me interested in how we improve symptom management. Not just pain, but symptom management, then for people that are in a nursing home and that.

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Intentionally Interprofessional Care: DorAnne Donesky, Michelle Milic, Naomi Saks, & Cara Wallace

GeriPal

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.

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CDC Emphasizes Opioid Guideline is Voluntary and Should Support, Not Supplant, Patient Care

FDA Law

In addition, the guideline has been misapplied to cancer and palliative care patients, and there have been rapid opioid tapers without patient collaboration, rigid application of opioid dosage thresholds, application of opioid use for pain to opioid use disorder treatment, insurer and pharmacy duration limits, patient dismissals and abandonment.

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Substance Use Disorder in Aging and Serious Illness: A Podcast with Katie Fitzgerald Jones, Jessica Merlin, Devon Check

GeriPal

In particular, we talk about Katie’s and Jesica’s paper in NEJM titled “ Juggling Two Full-Time Jobs — Methadone Clinic Engagement and Cancer Care ,” which described the difficulty in managing cancer pain and methadone for opioid use disorder. Katie, welcome back to GeriPal. Bragging rights. Alex: Yeah. Jessie, welcome back to GeriPal.

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