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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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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. People had to be in the top 20th percentile of risk for being hospitalized or dying in the next year.

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Buprenorphine Use in Serious Illness: A Podcast with Katie Fitzgerald Jones, Zachary Sager and Janet Ho

GeriPal

Our experts include Katie Fitzgerald Jones (palliative nurse practitioner and doctoral student at Boston College), Zachary Sager (palliative care physician at the Boston VA and Dana-Farber Cancer Institute), and Janet Ho (physician at UCSF in addiction medicine and palliative care). This was the hot topic at AHPM. Katie: Thank you.

Illness 102
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What is going on with MAID in Canada? Bill Gardner, Leonie Herx, & Sonu Gaind

GeriPal

Summary Transcript Summary Four percent of deaths in Canada are due to Medical Assistance in Dying (MAID). What’s up with Medical aid in dying in Canada? Alex: And we’re delighted to welcome Sonu Gaind, who is a Chief of psychiatry and professor at the Sunnybrook Health Sciences Center at the University of Toronto.

Illness 144
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Normalcy, Introspection, & the Experience of Serious Illness: Bill Gardner, Juliet Jacobsen, and Brad Stuart

GeriPal

We have a wide ranging conversation that touches on how to place aging, disability, and multimorbidity in the context of serious illness conversations, “striving toward normal,” stoicism, existentialism, psychedelics, the goals of medicine, medical aid in dying and more. We could have talked for hours! We have a Canadian theme going.

Illness 128
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Substance Use Disorder in Aging and Serious Illness: A Podcast with Katie Fitzgerald Jones, Jessica Merlin, Devon Check

GeriPal

Lastly, we discuss Katie’s paper on substance use disorder in an aging population and how one can incorporate the 5 Ms (ie, matters most, medications, mind, mobility, and multicomplexity) into a framework for age-friendly care for older adults with substance use disorder. Katie, welcome back to GeriPal. Bragging rights. Alex: Yeah.

Illness 136
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RCT of Chaplaincy: Lexy Torke, Karen Steinhauser, LaVera Crawley

GeriPal

A friend of GeriPal, and prior guest, Guy Micco commented today that we need an RCT for chaplaincy is like the idea that the humanities need to justify their value in medical training: “It’s like being told to measure the taste of orange juice with a ruler.” These studies are important. It meets in-person, once a month, over nine sessions.

IT 99