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

The Physicians Foundation

Diminishing Workforce: Primary care clinician shortages worsen access to care The number of primary care clinicians, including physicians, nurse practitioners (NPs), and physician assistants (PAs), decreased from 105.7 when excluding those practicing in hospitals—marking the lowest rate in a decade. per 100,000 in 2022.

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Diabetes in Late Life: Nadine Carter, Tamryn Gray, Alex Lee

GeriPal

And yet we’re also in a different place in diabetes monitoring and management. And we invited Tamryn Gray from the Dana Farber joins us to ask insightful questions, including: What blood sugar range should we target for patients in the nursing home or hospice? Listen in to learn more! This is Eric Widera. Welcome back, Alex.

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Telehealth vs In-Person Palliative Care: A Podcast with Joseph Greer, Lynn Flint, Simone Rinaldi, and Vicki Jackson

GeriPal

In one corner, weighing in at decades of experience, well known for heavy hits of bedside assessments, strong patient-family relationships, and a knockout punch of interdisciplinary collaboration, we have in-person palliative care consults. And I would say we weren’t doing training on symptom management, for example.

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

GeriPal

You can also listen to an audio interview with Alex and JAMA Deputy Editor Preeti Malani about this study and the other RCT of default palliative care for hospitalized older adults with noncancer serious illness published in the same issue. Panelists David Bekelman, Lyndsay DeGroot, and Diah Martina have no relationships to disclose.

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PC for Patients with Substance Use Disorder: Janet Ho, Sach Kale, Julie Childers

GeriPal

Why the field is moving away from prescribing methadone to bupenorphine; how to manage patients prescribed methadone for opioid use disorder who then develop serious and painful illness – should we/can we split up the once daily dosing to achieve better pain control? When to consider bupenorphine vs methadone? They’re often angry.

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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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Caring for the Unrepresented: A Podcast with Joe Dixon, Timothy Farrell, Yael Zweig

GeriPal

All right, and finally we have Yael Zweig, who is a geriatric nurse practitioner at NYU. And so there’s complexity in Understanding how each state manages this. So those types of relationships, clergy, non family members, we talk about, I think cohabitating unmarried couples. Joe 01:59 Ann Arbor. I’m excited.